The New Yorker’s Patrick Radden Keefe tries to blame a drug company for the current opiate epidemic. His piece nicely illustrates the government’s malfeasance, but Keefe puts the blame elsewhere. Tucked in the middle of the report, though, is this paragraph:
Richard Sackler worked tirelessly to make OxyContin a blockbuster, telling colleagues how devoted he was to the drug’s success. The F.D.A. approved OxyContin in 1995, for use in treating moderate to severe pain. Purdue had conducted no clinical studies on how addictive or prone to abuse the drug might be. But the F.D.A., in an unusual step, approved a package insert for OxyContin which announced that the drug was safer than rival painkillers, because the patented delayed-absorption mechanism “is believed to reduce the abuse liability.” David Kessler, who ran the F.D.A. at the time, told me that he was “not involved in the approval.” The F.D.A. examiner who oversaw the process, Dr. Curtis Wright, left the agency shortly afterward. Within two years, he had taken a job at Purdue.
So, the Food and Drug Administration, tasked with proving the safety and efficacy of medication, was either bought off by the drug company or failed in their due diligence.
The FDA’s purpose is to protect consumers and yet Radden portrays the FDA as the victim of the company.
The doctors who prescribed these powerful painkillers were victims, too.
The drug company, which produced an extremely powerful pain medication, deserves blame for doing its job–making and marketing a useful drug. It is useful in some rare cases. It is just extraordinarily powerful.
Here’s who is most definitely not to blame: the addicts. They are innocent in all of this. Doctors prescribed OxyContin like it was aspirin, and patients, unaware of the power they held, took the medication and found themselves helpless to get off it. The doctors, rather than closely monitoring the patients (have to see lots of patients a day to make up for Medicaid patients), would give huge long-term prescriptions well beyond the patient’s need. By the time they saw the patients again, they had created an addict.
I saw some of these addicts in practice. As a chiropractor, I cannot prescribe medication, but I cross-treat with surgeons who do. As patients recovered from surgery, they’d find themselves feeling weak, shaky, and scared. They feared the pain rushing back. They hated the fog of the medication. It took courage for them to wean off their medication and feel again. Many were surprised to find that they could feel okay without pain medication.
Other chronic pain sufferers, cut off from their drugs because their doctors grew scared of being targeted by the government, panicked when the pain returned. Many of these people are addicts. This is where the heroin crisis started.
The fault is not the patient’s. They started the drug because they were doing as they were told.
Doctors bear some responsibility.
The government, though, made this mess. They failed to test OxyContin and they failed to educate doctors on the perils because they didn’t know them because they didn’t test for them. And then, when the FDA saw the opioid crisis bloom, they made it worse by restricting prescriptions which forced many pain-wracked people into the arms of the illegal drug market. Doctors wanted to cover their liability so they cut these patients off. Desperate and suffering, many formerly average, working Americans became strung out druggies. Many ended up dead.
Just as a doctor’s treatment plan only works if he’s correctly diagnosed the disease, American lawmakers can’t make a law if the problem is misdiagnosed. The temptation will be to further regulate drug companies, but drug companies are already regulated so extensively that it takes decades to get a good drug to market.
The real solution would be for the FDA to do its job. The regulators who let this medication through without testing, should be prosecuted. This was gross governmental negligence. Start holding bureaucrats responsible for the lives they ruin. They’ll be more fastidious next time.
Start investigating the doctors associated with heroin fatalities. Who was the doctor who prescribed? Did he properly wean the patient? Did he refer to a pain management specialist?
This story is a story of government failure and over 200,000 people died because of it.
Photo credit: Karen Neoh, Flickr, Creative Commons