Like many Americans, I want to know how we got to the point that nearly 30,000 of our fellow countrymen and women died last year from overdosing on opioids. Answers, lots of answers, are to be found in a report written by staff working in the US Senate. But the senators overseeing the report have failed to release it.

In 2012, the chair and ranking member of the Senate Finance Committee, Max Baucus (D-Mont.) and Chuck Grassley (R-Iowa), launched an investigation into financial ties between drug manufacturers and medical organizations that were setting guidelines for opioid use. When the investigation began, the federal government had already reported that opioid overdoses were killing more people each year than car accidents. Many staffers working for Baucus considered his home state of Montana to be ground zero for the epidemic of opioid addiction.

The committee focused on the American Pain Foundation, the Center for Practical Bioethics, and five other organizations. It also targeted three leading opioid makers: Purdue Pharma (OxyContin), Endo Pharmaceuticals (Percocet), and Johnson & Johnson (Duragesic). The committee demanded to see documents and get answers to its questions.

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Over the course of many months, congressional investigators collected and analyzed a mountain of material. These documents, and the report that was drafted from them almost a year later, have never seen the light of day. Instead, they remain sealed in the Senate Finance Committee’s office.

As a former investigator who helped the Senate Finance Committee uncover corruption in science and medicine, I know firsthand the hard work that goes into these inquiries. Making information public can change policy, without needing to pass new laws. The public, the press, and lawmakers deserve to know what the committee learned about how the drug industry influenced opioid prescribing practices.

I also have personal reasons for wanting to see the report and learn more about the causes of the opioid epidemic. I have lost two cousins to opioids, and my father unwittingly became addicted to fentanyl. His personal physician had prescribed this painkiller for back pain without warning him that it is a powerful and addictive opioid. After a while, my father decided to stop taking the medication. That led to his being rushed to the emergency room in the middle of the night with severe abdominal pain and a feeling that fire was shooting up his arms and into his hands. The emergency doctors explained that he was experiencing opioid withdrawal, and put him on a morphine drip. Shocked that he was now a “junkie,” he restarted fentanyl the next day, and slowly tapered off the drug.

The players

The American Pain Foundation was a nonprofit that described itself as America’s largest organization for pain patients. Yet its guidance on opioid use for patients and policymakers exaggerated the benefits of these drugs while downplaying the risks. At one point, pharmaceutical and medical device companies provided 90 percent of the foundation’s funding. Days after the Senate investigation began, ProPublica reported that the foundation had shut down “due to irreparable economic circumstances.” Senate investigators later combed through a treasure trove of the foundation’s documents, which helped explain how the foundation, affiliated physicians, and drug companies helped fuel prescriptions for opioids.

The Finance Committee also targeted the Center for Practical Bioethics, a nonprofit which bills itself as an independent national leader in helping policymakers and corporate leaders struggle with health care decisions. The Kansas City Star reported that Purdue Pharma had showered the center with funds, providing seed money to create the center’s $1.5 million chair in pain management, held by Myra Christopher, one of the center’s founders, and donating a sizable amount to the group’s annual dinner and symposium.

In 2008, Christopher coauthored a study to calm physicians’ fears that they might be criminally prosecuted or disciplined for inappropriately prescribing opioids. In 2011, as money from pharmaceutical companies continued to pour into the center, she wrote a commentary titled “It’s Time for Bioethics to See Chronic Pain as an Ethical Issue” for the American Journal of Bioethics, which was then housed at the Center for Practical Bioethics. The commentary failed to disclose that the center had received funding from the pharmaceutical industry and was one of many articles promoting opioid use the journal published. By the time the Senate launched its investigation, the journal had changed homes and sought to distance itself from the center.

Change of leadership further threatens the report

Baucus left the Senate in January 2014 to become the US ambassador to China. Grassley lost his leadership position with the Senate Finance Committee after becoming chairman of the Senate Judiciary Committee. They were succeeded by Senator Orrin Hatch (R-Utah), who now chairs the Senate Finance Committee, and Senator Ron Wyden (D-Ore.), its ranking Democrat. These new leaders are likely to do little to release the opioid report.

When Hatch took over the committee, he promised to lead aggressive investigations, just as Grassley had done. He has broken that promise. While Grassley zealously investigated nonprofits across the political spectrum, Hatch avoids rankling corporate America with aggressive investigations into corruption and, as I was told by one staffer, Hatch wants to keep his hands off nonprofits. Why? Hatch holds to an ideological conviction that government is bad and can be replaced by more efficient nonprofits. Releasing a report that hints at how corrupt some of these nonprofits can be would harm that ideology — even as it would help his home state. According to the Utah Department of Public Health, opioid poisoning kills about 30 people each month, more than die from firearms, falls, or auto accidents.

When Hatch took over the committee, he promised to lead aggressive investigations. … He has broken that promise.

Voters in Oregon, which has had the second highest rate of opioid abuse in the country, shouldn’t expect much better from Wyden. Like many Democrats, Wyden has no love for corporate corruption. But this is balanced by an aversion to the pain and drudgery required to hold wrongdoers accountable through congressional investigations. Instead of investigating and laboriously tinkering to improve the system we have, the senator seems to prefer writing new pieces of legislation onto which he can solder the Wyden nameplate.

Do the right thing

Last September, dozens of public health advocates pleaded with both senators to release the findings of the opioid prescribing report. They noted that many of the companies and groups targeted by the investigation “have continued to promote aggressive opioid use and continue to block federal and state interventions that could reduce overprescribing.” In response, Hatch said he would bring up the possibility of releasing the report with other senators. That hasn’t happened.

Every day, an estimated 78 Americans die from an opioid overdose and more than 1,000 are treated in emergency departments for misusing prescription opioids. Medical evidence tells us that these overdoses are “accidents.” A sense of justice tells us that they aren’t. Instead, they are preventable incidents tied to corporate profit. Those at fault should be named and held accountable.

Senators Hatch and Wyden have sponsored new legislation to control the societal impact of opioid addiction. These are Band-Aids that treat the symptoms of the opioid epidemic while ignoring the parasitic elements that caused the disease.

Release the report, senators. Americans deserve to know who created the national scourge of opioid addiction.

Paul D. Thacker, a former investigator on the United States Senate Finance Committee, is a writer living in Spain.

A previous version of this article incorrectly stated that opioid poisoning is Utah’s leading cause of death.

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  • now the new thing is pain injections , epidurals . becarefull folks , alot of horror story with these things .. people are getting messed up .. and just like when the opiod problem started , the lack of public awareness of risks and side effects that they should tell you about , but dont.. i have heard nightmares and now those people need pain meds more then ever. . now if thats not a double edged sword for patients who just want to able to live a normal life with out pain… its the patients who are suffering for all this unethical garbage going on in our medical community .. its a shame theres higher forces behind this epidemic , in away you cant blame the doctors for not perscribing pain meds anymore . there livelyhood is being threatened there practices and liscences are being taken away from them.. they dont want to perscribe these meds anymore . and therefore alot of good people have turned to herion on the street and dying .. statistics prove it . every year .since 2010 or 2011 to 2017 . i dont no how alot of the people can sleep at night knowing there responscible for creating this herion epidemic..

  • Happy event. Did injection influenza vaccine , then made a complete blood count . Leukocyte 7.6 . This means that my body can develop antibodies to Zika

  • The results of this inquest may be interesting, but not currently relevant: Opioid analgesic prescribing and associated overdose fatalities peaked in 2011, with both in multi-year decline from 2012-16. This only becomes apparent when devoting extensive time to comb through the details of CDC, FDA and DEA web pages and publications.

    The current problem is CDC’s control over the informational content in media reports related to the prescription opioid epidemic, and power over dictating how physicians treat their pain patients. Prescription opioid analgesics, as a public health issue, require a balance of control and access. CDC has solely focused on control, and their successful efforts to further restrict access are increasingly leaving patients in chronic, severe and uncontrolled pain.

  • Absolutely fascinating the attempts here (in the comments) to defend grossly irresponsible behavior (at best) or criminal behavior (in plenty of cases). One person says that deaths have never exceeded 19,000 a year. As if that’s a number that makes it all OK, or is even slightly tolerable (even assuming it’s accurate). Another person says that experiencing life-threatening withdrawls should not be classified as addiction (since the correct protocols were not followed). I cannot fathom what is going on here.

    My conservative, church-lady mother is addicted to prescription opioids. Her thinking is terribly muddled and confused and she goes through mild withdrawls on routine basis. And since she cannot admit it, and since she can easily find doctors to continue prescribing, there’s nothing I or anyone else can do. She could easily end up being one of those 19,000 that Dr. Oberg finds to be a tolerable loss. Or she could just have greatly diminished quality of life from now until she dies.

    This is a scandal of epic proportions and only someone deeply ethically and morally compromised would argue otherwise. SHAME.

    • One of the largest problems surrounding this issue, is the general publics inability to accept reality. MANY family members claim that their mothers (fathers sisters brothers) are “ADDICTED” to opioids, when this is in fact not true. Dependency is not only natural, but needed for this to work. The grossly over represented statistic regarding opioid misuse have scared people to death, of a drug that is less damaging to the body than most over the counter drugs. People who are prescribed opioids are IN PAIN, people who are in pain constantly go in and out of fogs (as you describe), as a result of their body coping with the physiological changes occouring in their body as it copes with pain. While opioids CAN cause a fog, this generally happens when a patient is UNDER medicated, and they breifly obtain relief, then fall back below the effective dosage…or never obtain relief at all. A person propperly using opioids should rarely if ever experience withdrawl, and the experience of it is becoming more and more prevalent, as the fear and resulting cumbersom retrictions on prescriptions; create an atmouphere where under prescribing is considered the norm. We are creating the problems many are claiming are the pitfalls of opioid use (chicken or egg crap). This stems from the misunderstanding of tolerance and dependency, which are subsequently labled as addiction (because its easier), and perpetuated by the emerging recovery industry (who is the OTHER side of the pharmecutical giants profiting off your confusion). People say “Wow thats a high dosage, so and so only takes THIS much” completely unaware of the fact that this is the nature of not only the drug, but of individualized care. It is our unrelenting need for a one size fits all guidline that disrupts opioid therapy, and makes it dangerous ond or ineffective. Its absolutely asinine that people belive that living a life limited by pain, is better than being a functional indiviual who is “addicted”…it basically come down to making YOU comfortable, not thw person suffering. This is a mental block created by the war on drugs and the disproportional fear to benefit ratio. Your mother is more than likely suffering silently through not only the rollercoaster of pain and undertreatment, but the stigma and subsequent greif from well meaning (but misinformed) family members…which is a hell on earth. I strongly urge you to stop looking at the opioids as the problem, and start looking at the particular regimentation of. The information will NOT be found on web MD, and the people you currently think are in bed with pharma, are for the most part NOT. The war on opioids IS the problem with opioids, as a majority of their “science” is pure speculation. The people this article is reffering to are NOT thinking of whats best for your health, they are looking for votes. The chances of you seeing evidence of collusion is slim…and if you DO its more than likely the result of an alternative agenda. There is a reason opioids have been used for centuries, and a reason we invaded afgan for them. Its an unfortunate truth, but its a dog eat dog world, where the ruling class want control of the most effective tools. I understand your concern but IF she is addicted , this STILL is your mothers problem and no one elses. There are far more (90+percent )that are greatly aided by these medications, and would have no life without them. I think you should give your mother a bit more credit.

    • Ted —

      This article is labeled in several spots as a First Opinion, which is STAT’s op-ed/perspective section.

  • Come on guys. Are you afraid to release that it was possibly own government? Listen to FRANK YOUNG! TELL THE TRUTH…

  • How people can misuse data already skewed by the CDC is beyond me but it’s everyone’s favorite hobby. Heroin IS NOT a prescription opioid and deaths due to PRESCRIPTION OPIOIDS have never exceeded 19,000 (again by the CDC) and those number are likely overstated due to bootleg fentanyl which cannot be discerned from scripted fentanyl by drug tests and are probably closer to 16,000 – those also include ILLEGAL use of prescription drugs btw. Prescription opioids have NEVER exceeded deaths due to auto accidents – why this myth is repeated seems to be for agenda purposes only and auto accidents rose from 33,000 in 2014 to 38,000 in 2015 – an inconvenient fact Paul Thacker seems uninformed about or is too lazy to look up. Look up yearly deaths due to alcohol and tobacco and educate yourself about which are really ‘epidemics’. More pablum and there’s plenty of it around because people like this are innumerate or have some other agenda to further trying to make it even more difficult for legitimate pain patients getting their meds. In many states like ours (Tennessee) it’s already bad enough – do some homework on that why not? As mme’s of prescription pain meds here have gone down since 2012, deaths due to illegal drugs go up and state officials are very aware of it. Stop confusing addiction with diseases or conditions that are painful and miserable and be glad you don’t have one. Yet another government manufactured crisis (that really got worse after 2008 – been keeping up with finances?) and we don’t need more government interference keeping legitimate patients from their medication.

  • To say that a person becomes inadvertently addicted to opioids is not a responsible assertion. when a person is prescribed opioids for a chronic pain condition and takes them as directed, the result becomes, as time passes, that the body has a physiological response and abrupt stopping of the drug is not advised, instead, a tapering off the medication by lower and lower amounts until the dosage becomes zero usually results in no withdrawal. If the patient compliant and has not abused the drug this is very effective.
    The opioid “crisis” is not about the drug but it is really about abuse of it.
    Congress does not want to deal the problem of the people who abuse the drug and cost society billions, instead, they just want to put the problem on the backs of physicians and industry and let the criminal behavior of abusers continue.

    • From that CDC report, the following NOTES accompany the graph showing that in 2000, approximately twice as many deaths were caused by opioids as contrasted to heroin. By 2010, that contrast jumped to five times the number of deaths due to opioids as compared with heroin, and by 2013 the number of deaths due to heroin rose, changing the ratio back to approximately twice as many deaths due to opioids.

      “NOTES: The number of drug-poisoning deaths in 2013 was 43,982, the number of drug-poisoning deaths involving opioid analgesics was 16,235, and the number of drug-poisoning deaths involving heroin was 8,257. A small subset of 1,342 deaths involved both opioid analgesics and heroin. Deaths involving both opioid analgesics and heroin are included in both the rate of deaths involving opioid analgesics and the rate of deaths involving heroin. Access data table for Figure 1 [PDF – 86KB].
      SOURCE: CDC/NCHS, National Vital Statistics System, Mortality.”

      *snip*

      Your logic: that the report is withheld because heroin deaths have returned to half rather than a fifth times the number of opioid deaths. Amazing. Tens of thousands of people die a year, and as families have pushed back against drug companies and doctors who advocated for increasing access for “pain management” and maybe, just maybe, prescribing has tightened up…
      And heroin laced with fentanyl has appeared and killed so many more…
      your conjecture is that the report “does not back up the current party line to further restrict opioid use.”

      Politics and Big Money are unbeatable.
      Until they’re not.

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