— Reuters Top News (@Reuters) September 11, 2019
What the heck is Purdue Pharma and why should we care?
Readers of the Sparta Report might recall that Purdue Pharma is largely responsible for the Opiod epidemic.
From the article I wrote in July of 2018:
How did the “opioid crisis” creep up on the United States? Before 2000, there wasn’t a crisis and now, eighteen years later, we’re faced with numerous opioid addiction problems. As we all know, Rush Limbaugh was one of the early victims of the opioid addiction crisis in 2006.
How did this all come about?
Well, it had to do with fraud, government good intentions, unintended consequences, corporate lying, and greed. To say the story is shocking is a bit of an understatement.
There were two events that occurred at pretty much the same time. Whether they were a coincidence, collusion by greedy companies with greedy physicians, incompetence by the federal government combined with a greedy pharmaceutical company is unclear. You can draw your own conclusions.
In 1999, the Veterans Administration, in an effort to improve pain management, launched the “Pain as the 5th Vital Sign” program requiring the reporting of a pain intensity rating (0 to 10) by patients. The program wasn’t fully implemented until January 2001 when computer systems were updated to capture the new data.
The noble idea was to draw attention to pain management and develop a standard of care. It was believed that pain was under-treated. A number of physician groups expressed a strong disapproval with the notion of having patients self-report pain on a scale of zero to ten since there was no evidence that people could accurately assess their pain in this way. However, it was a bad idea whose time had come perhaps aided and abetted by physicians who also were on the payrolls, in one way or another, of pharmaceutical companies.
What do you think would happen if a physician at the VA is told by a patient that their pain was a ten and this information is reported to a database? Well, of course, the physician will prescribe something!
And fortuitously, there was something new to prescribe.
In 1996, Purdue Pharma introduced a new drug that was a time-released formulation of oxycodone that they called OyxContin. In their literature, Purdue stated “that the risk of addiction from OxyContin was extremely small.”
Purdue Pharma had a very aggressive marketing campaign headed by the same person who was instrumental in promoting Valium. From 1996 to 2001, Purdue conducted more than 40 national pain-management and speaker-training conferences at resorts in Florida, Arizona, and California. More than 5000 physicians, pharmacists, and nurses attended these all-expenses-paid symposia, where they were recruited and trained for Purdue’s national speaker bureau.
A lucrative bonus system encouraged sales representatives to increase sales of OxyContin in their territories, resulting in a large number of visits to physicians with high rates of opioid prescriptions, as well as a multifaceted information campaign aimed at them. In 2001, in addition to the average sales representative’s annual salary of $55,000, annual bonuses averaged $71, 500, with a range of $15,000 to nearly $240,000. Purdue paid $40 million in sales incentive bonuses to its sales representatives that year.
In 2007, Purdue Pharma, along with three company executives, pled guilty to criminal charges of misbranding OxyContin by claiming that it was less addictive and less subject to abuse and diversion than other opioids. The company paid over $600 million in fines.
As an aside, one of the reasons OxyContin was supposed to be less addiction prone was that it had a timed release coating. What users discovered was that the pills could be crushed to defeat the coating giving an immediate oxycodone high.
The Oxy high feeling is pretty similar to what happens when someone uses heroin because both act on the central nervous system in similar ways. Some people may also want to get an even more profound Oxy drug high by combining it with another substance, such as benzodiazepines like Xanax, other opioids, or alcohol.
The pill has since been reformulated to make it more difficult to crush.
Thirteen states are currently in litigation with Purdue Pharma.
Obamacare also played a role in exacerbating the opioid epidemic.
As part of an Obamacare initiative meant to reward quality care, the Centers for Medicare and Medicaid Services (CMS) is allocating some $1.5 billion in Medicare payments to hospitals based on criteria that include patient-satisfaction surveys. Among the questions: “During this hospital stay, how often did the hospital staff do everything they could to help you with your pain?” And: “How often was your pain well controlled?”
Of course, the highest satisfaction scores were from patients whose pain was aggressively controlled – often by opioids.
Let me teach you a new phrase – iatrogenic addiction – addiction which is caused by a doctor. Rush Limbaugh’s addiction was iatrogenic and so is the entire opioid crisis.