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Big Pharma Is Partly to Blame for America’s Opioid Epidemic

Penguin Random House

Akikur Mohammad, M.D., is an adjunct professor at University of Southern California Keck School of Medicine and the author of The Anatomy of Addiction.

The Super Bowl ad was a reminder that some drug companies have a vested interest in painkiller use

It stood out like a sore thumb. On the Super Bowl 50 telecast—amid the slick ads for high-end sports cars and celebrities shilling everything from beer to snack chips—was a commercial for “OIC” (opioid-induced constipation). Why is a $5 million TV spot for something as seemingly esoteric as OIC being broadcast during the most widely viewed television event in America?

Unfortunately, the ad speaks volumes not about OIC, but the much greater problem of opioid addiction—both overly prescribed prescription painkillers and the current problem of illicit street drugs like heroin. For those of us in the community of addiction treatment professionals, the AstraZeneca ad’s underlying message was as obvious as a blinking neon sign that read “Use More Opioids!”

It almost feels like the drug companies want to keep their flagship product (opioids) going full steam ahead by countering a major side effect with another drug. It’s certainly in the best interest of the pharmaceutical companies to keep their clients satisfied enough to continue using their products.

I’m not suggesting that pain medication isn’t important for those who truly need it, nor am I suggesting that people who suffer from constipation related to taking necessary pain medication don’t deserve relief. But the fact that there are enough painkiller users to necessitate the likely millions of dollars that ad cost underscores we have an epidemic. And prescribing doctors must be more responsible in doling out prescription painkillers to combat it.

The CDC reports that clinical use of prescription opioids has more than doubled between 2000 and 2014, and the rate of fatal overdoses is at an all-time high today. This is one of the reasons for the Prescription Drug Monitoring program in use in every state except Missouri.

A major problem with the drug-monitoring program is that many physicians still aren’t using it. It’s unclear whether the doctors aren’t using the program because of their ignorance of the program, it’s too time-consuming to use, or gross offenders would rather not see their revenues dry up. Whatever the reason, their role in the opioid epidemic cannot be overlooked, and they must take, at the very least, a shared responsibility for the problem.

Another recent turn of events to combat the painkiller epidemic is the rescheduling of hydrocodone opioid products by the Drug Enforcement Agency, from Class III to Class II because they have a high potential for abuse. The rescheduling makes it more difficult for pharmacists and physicians to automatically refill prescriptions and restricts many jurisdictions to only a 30-day supply of the painkillers. This has the potential to keep many people from reaching the point of dependence and ultimately addiction.

It’s clear that these measures, among others, have been put in place by the powers-that-be to help curtail the epidemic. Addiction treatment professionals, presidential candidates on the campaign trail, family members of addicts, and even the White House are all onboard to solve the continuing problem of opioid misuse in America.

Everyone is on board with these new initiatives except the opioid drug manufacturers and a segment of doctors who overly prescribe their products. Many of them are only looking at ways to make more money, even if it’s at the expense of those who might already be addicted or will be soon. They seem immune to the problem and will do whatever it takes to promote their products, even if it means advertising on the biggest stage there is—the Super Bowl.

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