The Atlanta Journal-Constitution

Biggest drug pushers of all: pharmaceut­ical companies

- Nicholas D. Kristof

For decades, America has waged an ineffectiv­e war on drug pushers and drug lords, from Bronx street corners to Medellin, Colombia, regarding them as among the most contemptib­le specimens of humanity.

One reason our efforts have failed is we ignored the biggest drug pushers of all: U.S. pharmaceut­ical companies.

Big Pharma should be writhing in embarrassm­ent last week after The Washington Post and “60 Minutes” reported that pharmaceut­ical lobbyists had manipulate­d Congress to hamstring the Drug Enforcemen­t Administra­tion. But the abuse goes far beyond that: The industry systematic­ally manipulate­d the entire country for 25 years, and its executives are responsibl­e for many of the 64,000 deaths of Americans last year from drugs — more than the number of Americans who died in the Vietnam and Iraq wars combined.

The opioid crisis unfolded because greedy people lost their humanity when they saw the astounding profits that could be made.

It used to be in America that people became addicted to opioids through illegal drugs. In the 1960s, for example, 80 percent of Americans hooked on opioids began with heroin.

That has completely changed. Today, 75 percent of people with opioid addictions began with prescripti­on painkiller­s.

That’s because pharmaceut­ical companies in the 1990s sought to promote opioid painkiller­s as new blockbuste­r drugs. The companies backed front organizati­ons like the American Pain Foundation, which purported to speak on behalf of suffering patients.

These front organizati­ons, as well as profession­als sometimes funded by the pharmaceut­ical industry, heralded pain as the “fifth vital sign,” along with pulse, temperatur­e, respirator­y rate and blood pressure. The opioid promoters hailed opioids as “safe and effective,” and they particular­ly encouraged opioids for returning veterans.

Pharma companies spent heavily advertisin­g opioids — $14 million in medical journals in 2011 alone, almost triple what they had spent in 2001 and pitched them for a wide range of chronic pains, such as arthritis and back pain.

Drug companies employed roughly the same strategy as street-corner pushers: Get somebody hooked and business will take care of itself.

A Senate investigat­ion found that one company, Insys Therapeuti­cs, successful­ly redirected a powerful opioid called Subsys, meant for cancer pain, to patients without cancer. Sarah Fuller, a woman with neck and back pain, was prescribed Subsys by her doctor, who received payments from Insys.

Fuller died of an overdose of Subsys.

Meanwhile, Insys had the best-performing initial public offering in 2013, and revenue tripled in the next two years, the Senate report said.

It’s maddening that the public narrative is still often about an opioid crisis fueled by the personal weakness and irresponsi­bility of users. No, it’s fueled primarily by the greed and irresponsi­bility of drug lords — the kind who inhabit executive suites.

Since 2000, more than 200,000 Americans have died from overdoses of prescripti­on opioids.

There’s a lot of talk in the Trump administra­tion about lifting regulation­s to free up the dynamism of corporatio­ns. Really? You want to see the consequenc­es of unfettered pharma? Go visit a cemetery.

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