Opioids under attack
Government now is on the offensive
Two announcements from the federal government represent progress in the fight against opioids. On Monday, the Food and Drug Administration said it will require drug manufacturers to better educate physicians about the painkillers. On Tuesday, the Justice Department announced a $35 million settlement with Mallinckrodt Pharmaceuticals, a company charged with looking the other way when it had reason to believe some of its opioids were landing on the black market.
If the tide of the epidemic has not been turned, the battle at least is joined. In addition to the contributions of federal agencies, the states and local governments are becoming increasingly aggressive against drug dealers, manufacturers and the insurance companies that limit treatment for substance abuse. Pennsylvania Attorney General Josh Shapiro has been calling on insurers to make sure they adequately cover addiction treatment, make it easy for people to access that treatment and better cover alternatives, such as physical therapy, that can reduce the need for painkillers.
Ohio and other states have sued drug companies, alleging they fueled the epidemic by underplaying or misrepresenting the drugs’ danger. There’s more to come. Mr. Shapiro last month said he is part of a bipartisan coalition of attorneys general that is using “investigative tools, including subpoenas for documents and testimony, to determine the appropriate course of action.”
Pharmaceutical companies should regard the Justice Department’s settlement with Mallinckrodt as a shot across the bow. The agreement, described as the first with a manufacturer tied to the opioid crisis, carried more than a stiff financial cost. It requires the company to begin tracking its drugs as they move through the supply chain into the hands of consumers. That obligation, if required of other manufacturers and suppliers as well, should help to dampen what seems to be a free flow of drugs.
Physicians represent another potential choke point. If people aren’t prescribed opioids, they can’t become addicted and move on to related drugs, such as heroin. Last year, Pennsylvania restricted the prescription of opioids in emergency departments and to juveniles and ramped up physician training. The FDA’s expanded education mandate is another welcome step.
The FDA already requires drugmakers to provide training to physicians about extended-release opioids. Now, they’ll have to offer the training about fast-acting opioids, too, and provide information about pain management and non-drug therapies (some of the same ones that Mr. Shapiro wants insurance companies to cover). Physicians don’t have to accept the training, but they should. One wonders why physicians don’t learn enough about the dangers of opioids in medical school. Addiction, as Greensburg Bishop Edward Malesic has said, is not a moral failing. The failing would be if government and other parties did not marshal all available resources against the scourge. Increasingly, we are seeing what Mr. Shapiro has called a “multidisciplinary approach.”