This story is a collaboration between STAT and ProPublica.

In 2004, Purdue Pharma was facing a threat to sales of its blockbuster opioid painkiller OxyContin, which were approaching $2 billion a year. With abuse of the drug on the rise, prosecutors were bringing criminal charges against some doctors for prescribing massive amounts of OxyContin.

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  • This is a shoddy attempt to take down Dr Satel by mere insinuation. The whole point of ProPublica is to undermine anything it thinks smells of corporate interest, and it when it comes to Pharma, especially opioids, it seems to be STAT’s MO too. David Armstrong, the reporter here, specializes in Bad Pharma stories (especially about “excesses in the pain industry”). He’s beaten this drum as staff writer for Bloomberg, the WSJ, STAT itself, and now ProPublica. It’s not as if these platforms don’t pay Armstrong for his opinions, handsomely. Why doesn’t anyone ever ask who funds ProPublica?

    Here we have a veteran “investigative reporter” citing CDC as an authority on the “opioid crisis.” By double-and triple-counting, the CDC grossly inflated figures on deaths involving prescription opioids. Once outed, it made half-hearted amends only quietly, in a piece behind a paywall in an innocuous journal. And at the outset, CDC concocted its 2016 opioid prescribing guideline behind closed doors (a violation of law about which it was warned by congress) using hand-picked contributors who had undeclared competing interests. The chief movers and shakers, it’s finally turned out, were advising lawfirms shopping anti-pharma litigation to states. And these were only some of their competing interests.

    Fascinating to read as well that “pain patient advocacy stories” have been heavily repped by the PR firm Dezenhall. What patient advocacy stories? I guess I blinked and missed them.

    This is interesting, too—to derail Dr Satel, Armstrong quotes a paid litigation witness whom he wants us to understand is reliable: “’Efforts to reverse the epidemic have had to counter widespread narratives that opioids are generally safe and that it is people who abuse them that are the problem,’ said Caleb Alexander, co-director of the Center for Drug Safety and Effectiveness at the Johns Hopkins Bloomberg School of Public Health, who has served as a paid expert witness in litigation alleging that Purdue’s marketing of OxyContin misled doctors and the public. ‘These are very important narratives, and they have become the lens through which people view and understand the epidemic. They have proven to be potent means of hampering interventions to reduce the continued oversupply of opioids.’”

    So, Dr Alexander’s opinion is sound, though it’s bought and paid for, while Dr Satel’s opinion is deceitful — yet the writer has not come close to demonstrating that Satel was paid.

    Most incredulously, Dr Alexander’s comment appears to be current. Does it in any way reflect the dominant narrative out there, the way “people view and understand the epidemic”? Of course not – pain patients and their doctors are blamed and persecuted.

    And what’s this “continued oversupply of opioids” Dr Alexander decries, when last month the DEA proposed another 10% cut to production? In 2017, DEA reduced production by 25%, and in 2018 shaved it another 20%—while hospitals across the US struggled with consequent shortages of injectables, and while DEA acknowledged that only 1% of medical narcotics make it to the street. The 2019 cuts will now leave us at 53% of 2016 levels. What “oversupply”?

    Before he attacks someone else he makes a living by disagreeing with, perhaps Mr Armstrong could attempt to get his facts straight.

  • David Armstrong,,thee author of this article,,you Sir are a liar.,and here’s why..Explain your definition of ,”related,” when liefully claiming 200,000 dead from prescribe opiate medicine.The fact/truth,,never ever has a single person ever died from taking the medicine opiates as prescribe by their doctors,ever..Show me any study that proves the MEDICINE opiates,,alone,,taken as prescribed by a doctor,,has killed 1 person,,,Pro-publica is bias,I have emailed them a couple of times’ to investigate Andrew Kolodny earnings/entire addiction warehouse industry earnings since this fake opiate MEDICINE epidemic lie by liars.,,never once have they investigated anyone on thee addiction side,,Suboxone is advertising just like purdue did,soo why aren’t they sitting in a court room?
    U know thee other night,,i was watching a movie,,a book,,that was required reading in my day,,it was called,,”To Kill A Mockinbird,”,,,It reminded of us and exactly the same prejudice ue over 100 years ago is being used again by a man named Kolodny,Why soo many so-called educated ones would follow such hatred,bigotry and age old prejudice is beyond me,,THANK GOD..For the same is happening now a days the bigotry,prejudice,torture and murder onto all chronic physical pain patients due to a medical condition by the like of Andrew Koldny and all opiatephobic liars and spreaders of propaganda.Thee exact same prejudice described in the story,,To Kill A Mockingbird,”is happen now. The medically ill,in physical pain,,are now,the Mockingbird,,a harmless,innocent ,weakest physically due to their medical illness.Some psychiatrist,addiction ,prop, took our weakness and used to to bully,harm, kill,,the weakest innocent people in our society,,like killing a mockingbird because u can,not because its moral right,not because they have harmed u in some way,,just because of the type of person,who see’s fit,to kill the weakest,,because they can,,,its called prejudice,its called bigotry,its called using hatred to a cause of killing off the weakest in society because they can,and make a lot of money doing it..Your propaganda,,is right up there,,with,,”simply because u can,”,,your pen is poisen to all who need the medicine opiates to live life,,,not just to exist,,but to live,,but arrogance ,blinds them of the truth,,that truth being,,their wrong to kill the weakest,the sick,the dieing,,simple because they can or the $$$ is good.What good could possible come from taking away thee only truly effective medicine to lessen the physical pain of the medically ill,,No good can come from it,,,only all the thing I associate w/evil,,hatred,,cruelity,,all tools use by those on the ,”addiction false narrative,”There is a opiate epidemic ,”CRAP,,,,,,,,,Until the lawfully use of opiate medicine is rightfully separated from those who willfully use the propaganda, illegal drugs of herion,illegal fentaly,all drugs used for non-medical purposes,,until its all seperated,,the legal use from illegit use,and deletion of lieful propaganda,,the innocent will continue to be tortured/murder’d,,and a story set in the deep south over 100 years ago,,will still be true today,,maryw

  • It does not make sense to cause such suffering to pain patients, while legally promoting, and legalizing alcohol, and tobacco, known addictive substances that kill and ruin lives-both the addicted, and innocent victims of the legal killers. Politics have not offered any explanations to causing such harm to pain patients, while confusing some consumers using the word opioid, when they know ilegal opioids, and legal opioid treatment to pain patients. Yes, some people may develop an addiction to pain treatments, but is it ethical to punish, and demonize pain patients, while promoting alcohol, and tobacco, two of the most addicting, and dangerous substances, that can kill and injure both the users, and innocent bystanders? It does not make sense, and people in pain are victims of these scams to promote political gain, and cause such severe harm to pain patients. Lawsuits makee sense to protect doctors, and pain patients, and we would like an explanation of why alcohol and tobacco use is protected, with no positive effects, yet those in pain are being severly punished.

  • Purdue’s reckless,illegal and arrogant activities in pushing huge numbers of oxycontin into the “hillbilly” regions and Florida haven’t been punished enough. Jail time should go to all top executives of Purdue for monumental destruction of lives. That being said, we must have a personalized medically driven and compassionate approach to the many people who unfortunately require a high potency opioid for severe, intractable pain. And we must realize that some addiction to oxycontin may result from patients using it on a longer term basis. So careful monitoring of patients from knowledgeable doctors is necessary. The initial and draconian CDC rules were unconscionable.

  • Percocet, made of oxy and tylenol, has saved my life these last 11 years since I developed horrific chronic pain after what should have been a routine surgery.

    This article’s citing the CDC as saying that 1 in 4 patients can get addicted is absolutely wrong. The number is MUCH MUCH MUCH lower; a tiny fraction of a percent.

    Like other CPP’s, I am DEPENDENT; NOT addicted.

    On my worst days I take the maximum allowed. On better days, I take less. A couple of times when I’ve had bizarrely decent days, I’ve even skipped entire days. Addicts dont’ take less than they can and especially dont’ skip entire days. My pill intake is directly related to my pain. If my pain went away, so would my need to spend $ on opioid rx’s and to go to monthly doc appts and be subjected to tox screens.

    And, if I lost access to my meds, I’d kill myself, b/c I can’t live with neverending horrible pain w/o some treatment.

    The oxy isn’t a cure — maybe due to its relatively low dose — and my quality of life is very poor and I seldom go out — but it at least I don’t want to kill myself the way I did last year during the worst of my forced taper which my PM felt compelled to imposed due to the CDC Guidelines and his fear of govt pressure.

    My forced taper has been eased due to my begging to my doctor accompanied by last spring’s FDA statement that each patient is unique, and the CDC author statement saying that the 2016 Guidelines have been misinterpreted and misapplied, and the HHS Pain Mgmt Best Practices Task Force Report agreeing that CPP’s have been horribly mistreated due to the CDC Guidelines.

    Plus, this article doesnt’ distinguish between OD’s caused SOLELY by Rx oxy vs OD’s involving Rx oxy plus alchohol and/or other drugs. OD’s caused solely by Rx oxy taken by pain patients are almost nonexistent and so this article’s failure to specify is a big problem.

  • Once more where am i am to begin or start writing or commenting on the broad , extensive .over all health care system or industry in this nation ,primarily The United States Of America and less so Globally is a struggle to really place or reflect the reality of the issue Health Care . in other words ,the protecting saving and keeping human beings alive for a reasonable time for a significant percent of we same human beings to be alive . while reflecting and been aware that some of us will die earlier than others from various reasons or causes . So yes with all of the above mentioned where do we go from here with all that are or is taking place within the same sector or area of life .when the means and products that are suppose to make us well . most of not all of them through us as human beings are making us even more unhealthy and even more tragic dying by tens upon tens of thousands and even billions as such . I have heard , read and see the name Purdue so many ,many times over the past seven months or so . however just looking brief at this one currently on your web site that you forwarded to us as subscribers is so deadly without i reading the full and or entire transcript . We really are in trouble and unfortunately the health care issue is the most devastating and destructive with most of the players , agenda on blood money . Purdue at this current juncture appears to be even more deathly that Merck and or Johnson and Johnson just to list these two

  • Terribly one-sided op-ed. The voice of chronic pain patients is again, unheard. The cold analytical analysis falls apart when you put yourself in the position of a long-term pain patient. We are not talking about addiction in these patients. The ability of a doctor to diagnose addiction from real pain is very difficult. Is it worth the risk of forcing people to lose their quality of life? Suicides are sure to follow. Of course if a pain patient intentionally uses his/her drugs to commit suicide by overdose then we are just talking about an addict, right?

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