Drug companies alleged to have flooded West Virginia with opioid painkillers
arstechnica.com
arstechnica.com
> “If these figures are accurate, HD Smith supplied this pharmacy with nearly five times the amount a rural pharmacy would be expected to receive,”
So it's normal to supply 1124 pills per capita&year to rural pharmacies? Something seems strange about these two pieces of information...
I used to think that the old argument that drug companies killed marijuana legalization efforts behind the scenes was tinfoil hat stuff, but now I'm not so sure. This is basically a giant funnel of government money (many people in these tiny communities have been on government assistance ever since the mines shut down) directly into the revenue streams of these drug companies. Sure it also tears the communities apart and destroys countless lives, but it's great for the bottom line.
See my other comment, but it appears that there are a small number of doctors "robosigning" prescriptions, almost certainly in the knowledge that the drugs will be resold into the black market.
And yea, the pharmaceutical companies are to blame -- of course it's not all their fault, but a huge, HUGE % of it is. It started with over-prescribing of pain pills. Particularly OxyContin. The pharmaceutical companies and their reps, intentionally and knowingly, told the doctors "don't prescribe a higher doseage, prescribe more pills of the lower dose" -- along with giving them financial incentives including straight cash kickbacks. They knew how addictive these drugs were, and they didn't care, if any of them say different they are flat out lying.
Then the government steps in, the DEA either pressures the doctors who are over-prescribing until they give up and quit, or they shut them down directly. Now there's a vacuum with a ton of cold hard cash floating around in it - the addicts still have to have their opiates but the suppliers (which were their doctors) are gone... what an opportune time for the heroin dealer to step in and fill the void?!?! And that is exactly what happened, and is happening right now everywhere in the country.
And it's not like the DEA doesn't know this is what happens, they would have to be bumbling idiots not to, but they have to show results in order to justify their budgets and keep their jobs.
That's three a day, so I could imagine that there would be older people or disabled people that would have more and would also offset children and people who don't take any.
I think it's because there are some hidden assumptions going on that the author just needs to come out and fess up to.
One, that drug companies should look at shipments per town as being an indicator of problems.
Two, that by shipping drugs, drug companies are causing the epidemic. They may be profiting from it, they may support legislation to make it worse, but it doesn't take millions of pills to get hooked. This is a result of additiction, not a cause of it. You shut-off/slow-down the pill flow, you just create a bigger black market. Addiction is a natural result of using opiods to treat pain. It is not caused by too many pills.
Three, that drug companies are the only people with agency here. Surely there are doctors, pharmacists, nurse-practitioners, ministers, social workers, and a slew of other people in these towns that are exposed to this problem every day. Many of them assist in the problem, either directly or through studied ignorance. This is a complex social problem with lots of players. Simplifying it to "evil drug companies" dumbs the problem down to the point of being intractable.
I'm not sure this article educated anybody as much as it made them upset. I'm struggling to find something useful and positive to say about how it could be improved. I sure don't want drug companies using some kind of statistical process control to determine who can get pills or not. That's whack.
When you make the medication you know how additictive it is. You have all the studies you published showing that it's mildly addictive. You have all the studies you didn't publish showing it's somewhat more addictive.
You also know what safe dosing levels are, and what the target audience is, and how many pills you predict to sell per capita in a region.
So when you see a small doctor's office ordering vast quantities you should be clued in that maybe they're not a good doctor, maybe they're a pill-mill.
https://www.wvgazettemail.com/news/cops_and_courts/drug-firm...
Yes, in general there's something amiss, no doubt. But in general people are married with 2.3 kids. Generalities don't public policy make.
If we're all going to go banging on the drug companies, and I'm fine with that, by the way, then let's talk about lobbying, kickbacks for doctors, marketing, and so forth. They're doing actual direct things that may be making the problem worse. Failure to follow up on anomalies like this isn't one of them. What would you have them do? Create a report, investigate each problem? Will you deny pain drugs to people who need them because other people in their town are using a pill mill? There's no remedy here that makes any sense.
What it feels to me like is an easy fishing expedition where you can put together some reports, make a few statements, bring in Big Pharma for a photo op. Maybe get some donations for the next election. It doesn't feel like any kind of process aimed at either discovering or dealing with causality. It's crap.
Worse still, you play these stupid games, you end up having discussions like we did with the cigarette companies. Most people who smoke do not get cancer. That's a true stat -- they usually die from heart disease or other causes before they live that long. Stats are fun. You can do all kinds of things with them, just about anything. (Insert long discussion here about the problems encountered when stats are used)
Sorry. I didn't mean to pick on you. Like I said, the article itself bugged me. We have a serious problem and we need to take serious action to help people. I think because it's such a serious problem, people tend to overreact in public discussion. A bit of hyperbole is fine. Personal attacks are not. Hopefully I didn't do that.
I hope you're right and it's not the other way around.
If you had told me a few years ago that drug companies were in on the take — that the drug companies had caused the opioid crisis, I would have told you to put your tin foil hat back on and stop watching 70's conspiracy films.
But with the millions (billions?) of dollars we're talking about and pharma's questionable track record....
Sadly, it is the other way around. Purdue spent millions of dollars advertising Oxycontin as a safe, less-addictive painkiller for chronic pain. Doctors were inundated with "FDA-approved" marketing info, telling them that this specific kind of heroin was an easy, twice-per-day way to deal with back problems, knee pain, arthritis, etc. It was so deceptive that three of their executives were found guilty of criminal charges, and the company was hit with a fine so high it was a record in the pharmaceutical industry.
After people had been prescribed what is effectively heroin on a regular basis for months or years, they were addicted.
And epidemic takes two things, and infection vector, and a high spread rate. Supplying far too many pills, if that is indeed what they did, allows for a higher infection rate, and let's a problem become an epidemic.
> You shut-off/slow-down the pill flow, you just create a bigger black market. Addiction is a natural result of using opiods to treat pain. It is not caused by too many pills.
If it's already established, then yes, you create a large black market because the demand is already there. When looking at the problem from the beginning though, it's clear to me that restricted supply would lead to restricted growth to some degree. The question is what degree?
If there were no pills to be shipped to these locations, and there never was, what would it look like now? What about 10% of the amount that was shipped? What if it was 1000% of the amount that actually shipped? Unless those scenarios would cause little or no difference in the current situation, it's clear that supply has considerable effect on how the problem develops and progresses.
> Three, that drug companies are the only people with agency here. Surely there are doctors, pharmacists, nurse-practitioners, ministers, social workers, and a slew of other people in these towns that are exposed to this problem every day.
Yes, but we talk about and deal with those people all the time. Doctors and pharmacists lose their licenses, people go to jail. But that's individual people, and their individual effect on the problem is necessarily small. There are relatively few drug companies, so if even one is acting negligently then we need to look very closely, and very hard, as their effect on the system and thus the problem is much greater. It's the same everywhere. Out of a clerk, policeman, judge, and politician, whose corruption has the ability to cause harm to the most people? The drug companies are at the top of this pyramid, so they deserve quite a bit of scrutiny.
The story is actually very old and the writer may be very new to it - I have known of the epidemic for only a year and clearly it goes back a long time before that. Therefore 'strange wording' might be just because the writer is learning too. Since even Trump has paid lip service to the epidemic it is not that new but maybe the scam is new to most people.
'Only a decentralised blockchain can solve the crisis and win the war on drugs' would have been a new update to the story, alas no, here we have what we already know.
The entities mentioned in the article seem to be drug wholesalers who act as middle men between manufacturers and pharmacies. This is not merely a semantic difference.
There is certainly an opioid crisis in this country but poorly edited journalism that does not adhere to the accepted nomenclature of the industry only clouds the issues and obfuscates who the actual bad actors are.
The drug wholesalers and drug companies both stand to make truckloads of cash. Seems likely that both parties know exactly what they're doing.
I'm not party to the industry and have no special insight — just a citizen watching from the sidelines but suspicious when it is suggested that it's just a couple of bad actors.
https://www.wvgazettemail.com/news/health/drug-firms-shipped...
"In 2015, more than 40 percent of the oxycodone prescriptions filled by Westside Pharmacy in Oceana were coming from the Virginia doctor, according to the committee’s letter. The following year, the Virginia Board of Medicine suspended the doctor’s license, finding his practice posed a “substantial danger to public health and safety.”"
Possibly the person named here: https://pilotonline.com/news/local/health/article_7b369428-0...
It's no surprise that many of them simply can't do it, and thus turn to a VERY thriving black market.
The DEA gets involved again, and now those people hooked on pain meds given to them by their doctor are in the legal cross-hairs because they're buying the same shit from somebody who illegally imported it from Mexico or China.
This is not a new problem in America. It's been an issue in the past. First it was morphine after the civil war, then it was Bayer-brand Heroin (which was marketed as a non-addictive morphine substitute) after WW1. Every time somebody gets the bright idea to restrict an opioid because of how many addicts it creates, they never seem to have an answer to the follow-up question - what do we do with the addicts? Then we are collectively shocked about the size of the black market afterwards.