Who Is Fighting for the Little Guy?

Most people, at one time or another in their lives, experience excruciating physical pain. For many individuals, this nightmare is something they deal with on a frequent, even daily, basis. Sympathetic physicians throughout the globe, eager to help their patients to be able to live normal lives, are prescribing ever more powerful types of painkillers.

For some of these patients, long-term use of these painkillers — including those in the class of prescription drugs known as opioids — has been a positive experience. It has enabled them to return to their regular routines and spend quality time with family and friends. But far too many others have traded one nightmare for an even worse one: The very same opioids that are being prescribed by doctors at alarming rates throughout the country are at the heart of a crisis that has cost 165,000 Americans their lives and driven countless more to devastating addiction.

The sheer amount that is being prescribed is staggering: Last year, 227 million opioid prescriptions were doled out in the U.S., enough to hand a bottle of pills to nine of every 10 American adults.

These facts have been known for some time, leading many to wonder why neither the federal nor local government — entities that have never shied away from regulating virtually every aspect of the lives of their citizens — has taken concrete actions to try to stem this terrible crisis.

An investigative report released this week may provide at least part of the answer.

According to The Associated Press and the Center for Public Integrity, while the makers of these painkillers are publicly claiming that they’re combating the addiction epidemic, behind the scenes they have adopted a 50-state strategy that includes hundreds of lobbyists and millions in campaign contributions to help kill or weaken measures aimed at fighting limits on the use of drugs such as OxyContin, Vicodin and Fentanyl.

The companies are making astronomical amounts of money on these drugs, and doing all they possibly can to protect those profits.

In 2007, executives at Purdue Pharma, the maker of OxyContin, pled guilty to misleading the public about that drug’s risk of addiction; the company agreed to pay more than $600 million in fines. Yet, Purdue Pharma raked in an estimated $2.4 billion from opioids last year alone, according to estimates from health-care information company IMS Health.

According to the AP report, drug companies and allied advocates spent more than $880 million on lobbying and political contributions at the state and federal level over the past decade; by comparison, a handful of groups advocating for opioid limits spent a mere $4 million — relatively speaking, a drop in the bucket.

It is hardly surprising, though worrisome, that the opioid industry and its allies contributed to more than 7,000 candidates for state-level offices, including governors, house speakers, senate presidents, and health committee chairs — all of whom control legislative agendas.

Even more disconcerting is the fact that they have been using a variety of front groups to achieve their aims. Many of the various non-profits that have taken an active role in the ongoing debate about how and whether these medications should be prescribed are receiving hefty donations from drugmakers, leaving ample room to wonder who their real constituents are.

For over a decade, an innocuous-sounding group called the Pain Care Forum has met with some of the highest-ranking health officials in the federal government, while quietly working to influence proposed regulations on opioids. The group consists of drugmakers and opioid-friendly nonprofits they help fund, and is coordinated by the chief lobbyist for Purdue Pharma, the maker of OxyContin.

This comes at a time when studies have shown weak or no evidence that opioids are the most effective in treating routine chronic pain. One 2015 study from a hospital system in Pennsylvania found about 40 percent of chronic non-cancer pain patients receiving opioids had some signs of addiction.

“You can create an awful lot of harm with seven days of opioid therapy,” Dr. David Juurlink, a toxicology expert at the University of Toronto, told the AP. “You can send people down the pathway to addiction when they never would have been sent there otherwise.”

The precise role for these highly addictive medications in treating individuals with incapacitating pain is a decision that should be based on the expertise of leading professionals and the best medical data available. It is vital, however, that this decision not be influenced by companies making billions of dollars selling these drugs.

We now know that big pharma is spending close to a billion dollars fighting for their interests. The question we should be raising is: Who is fighting for the interests of the little guy, the average citizen who is being put at risk for a deadly addiction?

It is imperative that, at the very least, the playing field be even.