Legal ramifications of war on opioids
Last week, the Dauphin County commissioners filed suit against 11 drug manufacturers and three doctors for ignoring the effects of prescription opioids and pursuing profits over patients. We support that litigation.
It mimics a move made last year by Delaware County, taking the war on opioid abuse directly to the source, and asking tough, hard questions about the role of the pharmaceutical industry and some doctors - in contributing to the problem
We acknowledge that the solution to the opioid crisis is complicated, and a lawsuit alone will not solve the crisis locally.
But it does help address an important question: “Did pharmaceutical companies knowingly disregard and actively downplay the addictive nature of prescription drugs in order to increase sales?”
The inclusion of specific doctors from Utah and California in this suit suggest an additional question: “Did influential doctors acting as complicit agents of the pharmaceutical companies help guide physicians to believe that prescribing higher doses of painkillers was the best course of treatment for patients showing signs of addiction?”
The goal of the lawsuit is twofold, says Dauphin County Commissioner Jeff Haste. First, “to save lives,” and secondly, to plow any financial proceeds to off-setting the high cost of treatment and prevention programs.
Dauphin County spent $19.6 million to help over 2,500 people suffering from addiction in 2017.
But there is another welcome outcome: We’re beginning to understand how primary care physicians freely prescribed these drugs. That is why doctors from the western United States are named in this suit.
Two of them, Drs. Perry Fine and Lynn Webster of Utah, are not named as defendants filed by the Ohio attorney general (as well as a suit by the city of Chicago), but are cited as being members of a “small circle of doctors” who supported chronic opioid therapy in a series of published books, speeches and seminars.
Both are past presidents of the American Academy of Pain Medicine. Both were supported by the industry financially because of their public views.
Both are known as “thought leaders” in pain management.
Dr. Webster is “credited” with a concept known as “pseudo-addiction.” In essence, the concept he put forth is that if a patient being treated for pain with opioids starts asking for higher doses or showing signs of addiction, the most likely cause is that they are really in severe pain.
The first course of action, wrote Dr. Webster ... was to increase dosage. Let that sink in. A leading expert in pain management, supported by the industry, guided primary-care physicians to prescribe more addictive drugs to patients showing signs of addiction.
If the lawsuit filed by the commissioners can draw a straight line from Big Pharma to overprescribing, this is a connector. It’s as simple as the Watergateera phrase “follow the money.”
In fairness, it is one thing to observe a pattern and another thing to prove it (Dr. Webster has repeatedly stated he only had the welfare of patients in mind).
If we ever get there, it will only be after every party has their day in court: The companies deserve their day in court and the doctors deserve their day in court.
Dauphin County residents deserve their day in court — as do the citizens of every community ravaged by this epidemic.
Admittedly, this epidemic is as complex as are the solutions for mitigating it. There is no one simple, solitary solution, nor it there one single cause. But understanding the root causes as specifically as possible leads to answers.
And if along the way it leads to accountability then so much the better.
Much as Delaware County Council was in becoming one of the first government agencies to file such an action, the Dauphin County Commissioners were right to file this litigation. And we support their actions.