What if I told you that over one-third of the population of Texas, misused opioids last year, and the entire population of Galveston died from it?
OK, well, I’d be lying. But only about the location, because those are the numbers nationwide. A little over 10 million people, equal to a third of the population of the Lone Star State, are not just taking opioids, but misusing them. And last year, it killed 47,000 of them, equal to the population of Our Lady of the Brown Surf on the Gulf Coast. Opioids accounted for 70% of the overdoses in America from everything, aspirin to heroin.
Now, this isn’t the usual snarky political stuff I usually traffic in, but I met a woman last week who inspired this, and whose dilemma, I think, is underappreciated.
Drug manufacturers, drug chains, insurance companies and doctors have all been sued over these drugs, some successfully, and for letting it happen. It all began in the late 1990's with a drug we all know too well, Purdue Pharmaceutical's Oxycontin. And even then, it only became widely known when a popular talk radio gasbag named Rush Limbaugh began slurring his words on the air. I was in radio at the time, and heard that show. Rumors flew that he was drunk. But he actually was abusing Oxy, a lot of it. So much so that in 2006, he was arrested on drug charges at his Florida home.
Three years earlier, his housekeeper told the tabloids he had been doctor shopping to get the drugs he needed. He cut a deal with the feds, took a leave from his show, went to rehab and his fans forgave him as though he were a quarterback sending crotch pics to a groupie. But it cost him his hearing and he spent the rest of his life dependent upon a cochlear implant.
He was lucky, on more than just the legal deal. It could have cost him much more. And now we know that Purdue, and later others, downplayed the dangers of addiction, doctors began overprescribing, pharmacies gave them a pass and people got hooked.
“From 2000 through 2011, the number of prescriptions for the Manufacturer Defendants’ opioid drugs more than quadrupled nationwide, even though there was no scientific basis for any significant increase in opioid treatment as medically necessary or appropriate,” according to a lawsuit filed by Letitia James, Attorney General for the State of New York.
The Website Drugwatch (https://www.drugwatch.com/opioids/lawsuits/) chronicled the history of the investigation.
"Senator Claire McCaskill of the U.S. Senate Homeland Security & Governmental Affairs Committee conducted an investigation into opioid distributors and manufacturers and released a series of reports from 2017 to 2018.
Some allegations in the various lawsuits are based on information contained in these reports.
One report for example: Fueling an Epidemic: Exposing the Financial Ties Between Opioid Manufacturers and Third Party Advocacy Groups.
This report exposed the millions of dollars in payments from opioid manufacturers to 14 outside groups and physicians in these groups working on chronic pain and other opioid-related issues from 2012 to 2017.
'Initiatives from the groups in this report often echoed and amplified messages favorable to increased opioid use—and ultimately, the financial interests of opioid manufacturers,' the report authors wrote."
The list of distributors sued by the feds and the states contains a lot of familiar names.
- Bergen Drug Corporation
- Cardinal Health Inc.CostcoCVSEndo Health Solutions and its affiliates
- Endo International and its affiliates
- Janssen Pharmaceuticals and its affiliates (including its parent company Johnson & Johnson)
- Mallinckrodt LLC and its affiliates
- McKesson Corporation
- Purdue Pharma and its affiliates
- Rite-Aid Corporation
- Rochester Drug Cooperative Inc.
- Teva Pharmaceuticals USA Inc. and its affiliates; and Allergan Finance LLC and its affiliates
If you want to see an excellent portrayal of the fight with Purdue, watch “Dopesick” on HULU. It’s well done and shows the 50-megaton cynicism at work in big pharma, and their ventriloquist dummies in the capital of this fair nation.
In fact, our own Senator Ted Cruz (R-Cancun), has proposed making the approval of new drugs faster than the current FDA process. It’s called the RESULT Act and Forbes Magazine summed it up this way…”Reciprocity Ensures Streamlined Use Of Lifesaving Treatments (RESULT) Act. The RESULT Act would allow for reciprocal approval of drugs, devices and biologics from foreign sponsors in European countries, as well as from Japan, Canada, Australia and Israel. In addition, the bill would allow Congress to overrule FDA rejections of life-saving drugs with a majority vote via joint resolution.”
If you are uneasy with Purdue Pharma making these calls, how about the Parliament of Whores (hat tip to the late PJ O’Rourke) they fund with an IV bag filled with cash?
So, the big boys have been sued, doctors are suitably chastened. Abuse will be tougher to manage with the new awareness, and the drugs will be hard, and in some cases, damned near impossible to get. But that leaves out one factor in this ugly mess.
There are men and women in this country, 5-8 million of them, who suffer chronic pain from injuries, back issues and other problems, who have legitimate and needed opioid prescriptions. And they are just the tip of the iceberg. An estimated 100 million of your neighbors in this country suffer chronic pain to some level or the other and it imposes limitations on their lives and activities. It is the primary reason so many are on disability, and costs the country around $600 billion dollars a year in missed workdays and medical expenses.
But getting the relief they need sometimes requires powerful meds, and doctors are now gun shy. I spoke with one Texas physician about the reluctance and he was blunt. "It’s become such a minefield for doctors, that few primary care docs take on chronic pain patients. Some do (not me). Even pain management docs are often reluctant to prescribe, but some do or will after all other measures are tried; physical therapy, spine injections, surgery," he said.
And we met one such sufferer at our church the other day. She is in her 60's, and suffers from ruptured discs and scoliosis. As she got older, the pain became more intense, and about 25 years ago, she started having pain meds prescribed, including Oxy. That allowed her to do the things necessary to care for her family, husband and kids.
But now, doctors are scared. They want to try anything but opioids. I asked her about surgery, and she said her doctor recommended against it. He said the odds are roughly 50-50 that it would do more harm than good. She got an electrical stimulator implant, like a pacemaker, surgically inserted below her waist, with electric leads running on either side of the spine.
She has a remote controller and can literally light herself up and vibrate if not careful. When set at a tolerable level, it helps, but the pain is still intense. And now her doctors are all but refusing medications stronger than Ibuprofen due to the potential for addiction.
She was practically in tears as she explained that she had always been responsible and never misused the medications. She understood that there is always going to be some degree of addictive response to a pain killer this strong, but anything weaker simply doesn't help.
I mentioned this to my doctor friend and he replied, "If there's any town in Texas that has plenty of pain management doctors, it ought to be Houston. Not sure why they won't prescribe, but there may be more to the story?"
But the problem is, she doesn’t live in Houston, but in the little East Texas town of Center where we are now. And this woman told us she is talking to doctors as far away as Dallas for help. The local druggists in this town are obviously nervous and offering excuses for the inability to fill the prescriptions. It's a dilemma with which she and many like her are struggling.
When I was a TV News Director, we did a series of stories in 2020 on the opioid crisis, but like everyone else, we piously focused on people who were hopelessly hooked, allowed kids access to their meds, even resorted to heroin when cut off by their doctor. Suitably self-satisfied after many shots of a reporter nodding and furrowing his brow in compassion, we went on to the next social issue that would clothe us in the saintly robes of civic concern.
But this woman is none of those folks. She is a middle-aged woman, in a lot of pain, and simply wanting some relief. And she is caught up in a series of Hobson's choices not of her making. And she is the kind of person we didn’t interview, but should have if we had just a little more concern for accuracy than Tucker Carlson.
Frankly, it’s hard to see a way out of this for many people. That is particularly true if they live in small towns in rural areas. The other option? Just keep hurting.