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The Pharmaceutical Industry’s Part in the Opioid Epidemic

By EMILY WEIKL

Staff Writer

Prescriptions can be given for just about any medication, but can become addictive if used illicitly. When medications aren’t enough, they can become a gateway to doing more harmful drugs.

It is under the Drug Enforcement Administration’s (DEA) jurisdiction to prevent an excess of prescription drugs. But this has been curtailed dramatically.

“In April 2016, at the height of the deadliest drug epidemic in U.S. history, Congress effectively stripped the Drug Enforcement Administration of its most potent weapon against large drug companies suspected of spilling prescription narcotics onto the nation’s streets,” The Washington Post reported.

CBS’ “60 Minutes” and The Washington Post are conducting a joint investigation into the current opioid epidemic. They are also examining former DEA agent Joe Rannazzisi’s assertion that it is being fueled by drug distributors who send pills to pharmacies unchecked.

Rannazzisi ran the Office of Diversion Control, which investigates the pharmaceutical industry. He decided to go after those of higher rank in the industry after noticing that prosecuting doctors and pharmacists didn’t stem the epidemic.

Distributers McKesson and Cardinal Health were given respective fines of $13.2 million and $34 million dollars by the DEA for filing hundreds of suspicious orders in 2008.

Rannazzisi, along with DEA attorney Johnathan Novak, noticed a difference in how cases were being handled in the following years.

“In 2011, more than 17,000 Americans died from opioid prescription overdoses,” according to CBS News. “That same year, Cardinal Health, the second largest distributor, started pushing back at Joe Rannazzisi. The companies’ attorneys went over his head and called his bosses at the Justice Department, who called in Rannazzisi to have him explain his tactics.”

Novak prosecuted cases that were brought to him by Rannazzisi’s investigators. He observed that his caseload slowed down steeply in 2013. Novak said that, at this point, an increasing amount of evidence was needed to prosecute crimes.

“But now, three undercovers by four officers over three months, that wouldn’t be enough,” Novak said. “Maybe we need an expert to explain how recording equipment works. Maybe we need an expert to explain – the system or prescribing. What’s a prescription? It felt honestly confusing and almost insane.”

The 2016 law was the culmination of the distributors’ pushback. Large amounts of drugs and narcotics can be shipped without any legal ramification. The more drugs that are sold equal more money, but also equaled more overdose deaths in the first nine months of 2016.

“The National Center for Health Statistics reported that overdose deaths reached a record 19.9 per 100,000 population in the third quarter, a big increase over the 16.7 recorded for the same three months in 2015,” according to The Washington Post.

For Rannazzsi, the blame for the current opioid epidemic falls squarely on the pharmaceutical industry for their lack of restraint.

“This is an industry that’s out of control,” Rannazzsi said. “What they wanna do, is do what they wanna do, and not worry about what the law is. And if they don’t follow the law in drug supply, people die. That’s just it. People die.”

An example of this misuse of power can be seen in Purdue Pharma, a private company owned by the wealthy Sackler family that distributes the drug OxyContin.

“Its [OxyContin] sole active ingredient is oxycodone, a chemical cousin of heroin which is up to twice as powerful as morphine,” according to The New Yorker.

Purdue Pharma marketed OxyContin aggressively.

According to former sales representative Steven May, doctors’ fears about the drug becoming addictive were allayed with the line, “The delivery system is believed to reduce the abuse liability of the drug.”

OxyContin was then prescribed to many in pain, including those with arthritis and those recovering from surgery.

 

“The marketing of OxyContin relied on an empirical circularity: the company convinced doctors of the drug’s safety with literature that had been produced by doctors who were paid, or funded, by the company,” according to The New Yorker.

The persistent marketing of OxyContin has led to addiction for many people.

“Since 1999, two hundred thousand Americans have died from overdoses related to OxyContin and other prescription opioids,” according to The New Yorker.

But Purdue Pharma pushed the blame on drug abusers for OxyContin’s now bad reputation.

“Notwithstanding Purdue’s claims, many people who were not drug abusers—and who took OxyContin exactly as their doctors instructed— began experiencing withdrawal symptoms between doses,” according to The New Yorker.

The new report has had one immediate effect in its aftermath. A crafter of the law, Rep. Tom Marino, was in the running to become the next drug czar. Marino resigned soon after The Washington Post’s and “60 Minutes’” report went public, and President Trump took action on the crisis.

“Trump directed the U.S. Department of Health and Human Services to declare a limited 90-day public health emergency, but he declined to declare a broader national emergency or ask Congress to fund any expansion in treatment or insurance coverage for Americans struggling with addiction,” according to the Los Angeles Times.

 

The DEA’s abilities were restricted severely in the law’s aftermath, but news outlet Vox argues that they wouldn’t have been able to avert the epidemic, also arguing that more should be done for the people who have been affected by the epidemic.

“Would the DEA have been able to reverse the opioid crisis without the new law? Almost certainly not,” according to Vox. “The agency acted far too slowly — only going after the industry after this all turned into a full- blown epidemic. And now so many people are suffering in this crisis that the response must focus on providing greater access to addiction treatment, not solely law enforcement action.”

The distributors of opioids and other drugs know what they are doing, but why do they still do it?

Andrew Kolodny, co- director of Opioid Policy Research at the Heller School for Social Policy and Management, gave one possible answer to The New Yorker reporter Patrick Radden Keefe.

“Greed can get people to rationalize pretty bad behavior,” Kolodny said.

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