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Opioids: The addiction across the United States

Who would have pictured a prescribed pain-killer causing pain and devastating friends and families across the United States?

Throughout the past two decades, opioids have been aggressively marked as the safer pain pill, primarily by the manufacturers Purdue Pharma and Johnson & Johnson.

 

Now let’s start from the drug in question, what are opioids and what makes them so addictive?

 

Opioids are a broad group of pain-relieving drugs that work by interacting with opioid receptors in your cells. Opioids can be made from the poppy plant — for example, morphine heroin, tramadol, oxycodone and methadone. How they work is that when opioid medications travel through your blood and attach to opioid receptors in your brain cells, the cells release signals that muffle your perception of pain and boost your feelings of pleasure.

What makes opioid medications effective for treating pain can also make them dangerous. At lower doses, opioids may make you feel sleepy, but higher doses can slow your breathing and heart rate, which can lead to death. The feelings of pleasure that result from taking an opioid can make you want to continue experiencing those feelings, which may ultimately lead to addiction.

 

Opioids Prescriptions

In 2016, healthcare providers across the US wrote more than 214 million prescriptions for opioid pain medication. As many as 1 in 5 people receive prescription opioids long-term for noncancer pain in primary care settings.

Now, what made the opioid addiction spread so rapidly is that more than 11 million people abused prescription opioids in 2016. The database covers 2006 to 2012 when opioid prescriptions reached a peak of 282m a year, it was enough to supply every American adult with a month’s worth of pills. By then, annual sales of narcotic painkillers had surged past $8bn.

The opioid crisis has been put to blame to one pharmaceutical company in particular; Purdue Pharma. Meanwhile, Purdue Pharma is alleged to have played a catalyst in driving the over-prescribing of opioids that triggered the epidemic by influencing the practice and culture of addictive pain treatment. Purdue Pharma was the fourth-largest manufacturer but with a much smaller proportion of the market of approximately 3% market share.

The manufacturer sold $3bn of its high-strength branded drug, OxyContin, in 2010, about one-third of the opioid market by value at its peak.

The pill consists of oxycodone, which is a powerful opioid derived from the opium poppy and is supposedly stronger than morphine. The drug has been widely put to blame for an exponential rise in overdose deaths through the 2000s.

As a result, Purdue Pharma has previously been hit with a $600m fine for a criminal conviction over its marketing of opioids, and in March the company agreed to pay $270m to settle a civil suit by the state of Oklahoma.

 

Effects and Consequences

Consequently, Purdue Pharma was not the only company accused of promoting the opium-derived drug. The pharmaceutical giant Johnson & Johnson ran a “cunning, cynical and deceitful scheme” to mass-market opioid painkillers that created the biggest drug epidemic in US history, Oklahoma’s attorney general alleged in closing arguments on Monday in the first major industry trial over the crisis. The state attorney general, Mike Hunter, is suing Johnson & Johnson for $17bn, to fund treatment and offset other costs of the epidemic in Oklahoma.

Balkman was presented with two very different versions of the role played by Johnson & Johnson in an epidemic in which more than 400,000 people have died over the past two decades. (Mcgreal)

Since the initial trial, Johnson & Johnson have been ordered to settle the lawsuit at $572m according to (Kuchler, 2019). Judge Thad Balkman stated that the world’s largest pharmaceutical company had caused a “public nuisance” due to the addictive nature of the opioid affecting thousands of civilians across the US. Although the fine was considerably less than the initial $17bn; Mike Hunter, the attorney-general of the state of Oklahoma mentioned that the payment will be used to cover the cost of the crisis. Primarily used for rehabilitation for the thousands of civilians affected by the drug, the fee will also be used for educational purposes as well as medical treatments for new-born babies that may be addicted to the opioid.

As a consequence of the events above, Purdue Pharma has filed for bankruptcy which has resulted in JPMorgan dropping them as a client.

Purdue, owned by the billionaire Sackler family, was forced to find a new bank after JPMorgan told the pharmaceuticals company that it was cutting ties due to the growing reputational risk.

It is quite ironic that JPMorgan feared that the reputation risk of its client will affect have a negative impact on the business. On the 11th of July 2019, a cargo ship was seized contained 20 tons of cocaine according to Brito & Silverstein (2019). The ship belonged to JPMorgan which raises more questions. Have JPMorgan themselves influenced another drug epidemic? How would this affect JPMorgan’ reputation?

 

What’s Next? 

Although there is a rise in lawsuits to tackle the exploitation of the opioid market. I do not believe that this will deter pharmaceutical companies from making significant changes within this market. The lawsuits are put in place to cover the fees associated with the rehabilitation process for those that are affected. The opioid market is far too profitable for pharmaceutical companies, although, manufacturers can control the number of drugs being produced; they cannot, however, control the number of people who abuse the prescriptions.

76 billion opioid pills have saturated the United States. Now the profitably of the opioid market is too great for pharmaceutical companies to reduce the production levels. McGreal (2019) states that in the year 2000, $1bn worth of sales were made from just opioids. It raises ethical questions as to whether pharmaceutical companies really care about the health and wellbeing of its’ consumers. Well, the profits begin to suggest that it’s simply not the case. McGreal (2019) also claimed that pharmaceutical companies and shying away from taking responsibility of the opioid crisis by putting the blame on Mexican doctors for false prescriptions which begs the question, are these pharmaceutical companies here to help solve the addiction or simply become marketing billboards for opioids?

 

By Shakir Hossain

 

References

https://www.washingtonpost.com/investigations/76-billion-opioid-pills-newly-released-federal-data-unmasks-the-epidemic/2019/07/16/5f29fd62-a73e-11e9-86dd-d7f0e60391e9_story.html?noredirect=on

https://www.theguardian.com/us-news/2019/jul/24/opioids-crisis-big-pharma-drugs-carnage

https://www.cbsnews.com/news/ship-seized-in-1-3-billion-cocaine-bust-is-owned-by-jp-morgan-chase/

https://www.theguardian.com/commentisfree/2019/aug/29/opioids-crisis-drug-makers-pharma

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