As the nation grapples with a worsening opioid crisis, a new report suggests that drug makers provided substantial funding to patient advocacy groups and physicians in recent years in order to influence the controversial debate over appropriate usage and prescribing.
Specifically, five drug companies funneled nearly $9 million to 14 groups working on chronic pain and issues related to opioid use between 2012 and 2017. At the same time, physicians affiliated with these groups accepted more than $1.6 million from the same companies. In total, the drug makers made more than $10 million in payments since January 2012.
“The fact that these same manufacturers provided millions of dollars to the groups suggests, at the very least, a direct link between corporate donations and the advancement of opioid-friendly messaging,” according to the report released on Monday night by U.S. Sen. Claire McCaskill, who has been probing opioid makers and wholesalers.
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This is a politically incorrect comment.
Ed, this is another one sided article typical of everything being written these days by mainstream media. There are many people who legitimately need opioids long term, even for life, in order to function and survive but they are being drowned out and pilloried. And their life is being threatened — if they can’t get the meds they need, suicide or street drugs are their only real alternatives.
A total of 10mm over 5 years across multiple manufacturers to support multiple organizations of patients and professionals who advocate for appropriate treatment of chronic pain is a scandal?? Really??? Take a deep breath and do the math. And consider there are (gasp) 2 sides to this story, like anything in life.
Virtually all short term pain treatment with opioids are generics, and have been for decades. This is the vast majority of prescriptions, and where most of the trouble starts. Generic companies don’t promote their drugs and spend little-to-no money supporting them, including donations to advocacy or professional groups.
Brand manufacturers all sell extended release opioids. These are only used for long term treatment of chronic pain. With the exception of theft in the homes of patients, these are not a significant source of abuse. Severe chronic pain patients legitimately need these medications. Full stop. But their need and their voices are drowned out and even outright ignored.
A relatively small contribution each year helps organizations that represent and advocate for these people provide some small raft on a stormy sea of outrage.
Another note of reality — almost all the fentanyl and other semi-synthetic opioids referenced in this article are illegal drugs, not Rx. This is increasingly where the addiction and overdoses are coming from. And the idea that most of these patients started on a prescription opioid and moved to street drugs lacks evidence. But that is the narrative, and it is being repeated so routinely that it has become unchallenged ‘truth”.
I’m looking for some journalists with the courage and integrity to question the prevailing narrative. Is it you Ed? Not so far.
The pendulum has swung so far back on pain management that legitimate patients fear for their lives.
Can we have a little compassion and a little balance please?
This was a great response to this article and debate!
TW, thank you for your well-written, well-constructed and thoroughness in this comment. As a 27 year sufferer of severe, intractable pain, you wrote what I wish I could have written. Because of TBI, I get too wordy and easily get sidetracked, as you can see in my comments below. But your concise, relevant and logical comment is as good as I’ve seen anywhere, in terms of presenting the facts in such an excellent manner. Again, thank you for taking the time to write something that represents far more people than the general public realizes. I hope you will continue commenting on this issue of the needs of chronic pain sufferers as often as possible.
One thing big Pharma is fighting hard against is cannabis. With good reason. As more people like myself Question, and even distrust, the medical community’s relationship with big Pharma, more will discover the numerous health benefits of cannabis.
I so wish that the makers of Oxycontin would reconsider there decision and still produce the drug. There are many legit Chronic Pain Patients and Veterans that require opioids to help manage there pain. The Government should stay out of the individuals and Dr’s role concerning what and how many Opiods are prescribed to each person. All we read about is the overdoses and how (they assume) it started with prescription medications. Every person should have the right to choose what they take for there own health problems, not the CDC, JEFF SESDIONS, the DEA or anyone affiliated with the government. My Uncle, who is a Veteran and is 71 years old was denied any pain medication by his VA Dr. for his constant suffering in his back, legs and shoulders. This man fought for our rights just to be slapped in his face when he asked ( for the first time ever) for pain medication. Way to go Government. America is becoming a communist country if you ask me.
Tammy, the announcement by Purdue was about promotion of their opioids, including OxyContin, via their sales force. Nothing about no longer manufacturing or distributing their opioids in the announcement.
He’s so true this country is no longer a free society the government’s is slowly taking away our freedom to choose !!!!! Plus it should be the choice of a chonicly pain veteran to choose to be comfortable and take pain pills before they die!!! Than too suffer and still die in pain!!! With a life of misery!!!!! Who are they to deny us vets comfort ????? I say to all planning to join the military DON’T DO IT!! When you are used and are damaged in pain the GOVRERMENT WILL NOT GIVE YOU COMPASSION & RELIEVE YOUR SUFFERING !!!! YOU WILL BE TOLD THERE IS A EPIDEMIC AND THEY CAN’T HELP YOU???? BUT BECAUSE YOU SERVERD THIS COUNTRY AND DAMAGED YOUR SPINE AND LEGS ?? A DOCTOR THAT HAS NEVER HAD PAIN OR WORKED PHYSICALLY HARD THEY’RE WHOLE LIFE WILL TELL YOU HAVE NO PAIN AND THEY ARE CUTTING OR STOPPING YOUR PAIN PILLS WITH NO COMPASSION AT ALL!!! THEN LEAVE ON A MONTH LONG VACATION!! THIS IS WHAT OUR VETERANS ARE EXPERIENCING WITH THE PUBLICS KNOWLEDGE!!! EVERY DAY!!!! IT’S VERY TRUE AND VERY SAD!! M.R.I. DON’T LIE!! THEY NEED TO STOP TORMENTING THE REAL VETERANS WITH CHRONIC ISSUES BECAUSE IT’S NOT RIGHT I ASKED MY PRIMARY CARE DR . AFTER ASKING HER TO ADJUST MY PAIN PILLS I WAS PUT WITH NO PAIN PILLS FOR FIVE WHOLE DAYS AND SUFFER WITH WITHDRAWS AND MY AGANISING SPINE AND LEGS PAIN !!!! NOTHING WAS DONE ABOUT IT!! I GUESS IT’S THERE WAY OF MAKING NOT ASK FOR HELP!!! THIS IS HAPPENING AT V.A. S ACROSS THE U.S.A. THE VA SYSTEM IS A WASTE OF TAX PAYERS MONEY!!!! THEY HAVE ALL THESE FOREIGN DRS. THAT DON’T LIKE AMERCANS.!!! IT’S VERY SAD!!!!!
What about those who go to a pain clinic and only get 30 pain pills to try to relieve pain for a whole month and still be in pain and not able to get any more for the rest of the month what are they suppose to do?
“… despite overwhelming evidence opioids are not safe or effective for the vast majority of people with chronic pain,” said Andrew Kolodny. Where is the” overwhelming evidence” Mr. Silverman? Kolodny gets away with this kind of statement all the time, but why didn’t you either print said evidence or give a link to it? I can tell you why: IT DOESN’T EXIST! There are no scientific, fact-based studies that prove this regurgitated point. I suffered Traumatic Brain Injury in 1991, and have taken every treatment known, including hypnosis, acupuncture and pain medications. The ONLY thing that works is the medication. I now have seen a Pain Management Specialist for 16 years, and have been on the exact same medication the whole time. No increases in strengths or amounts. It’s the only 16 years that I have functioned as a human being out of the 27 years since the accident. Print the evidence and give readers the footnotes to verify it. I challenge you to do so. I know that you can’t because it doesn’t exist!
Danny Elliott, please read the doctor’s statement again: “…for the vast majority of people…”. Obviously you are not one of that majority, and no one is suggesting you have to be. Meanwhile, take a look at the most recent study just published in JAMA last week, showing no difference between opioid and non-opioid analgesics on hundreds of chronic pain patients for a full year. In fact the non-opioids fell more on the plus side than the opioids.
Rod MacTaggart, I appreciate your reply to my comment. And I especially appreciate the opportunity to reply to the specific things you mentioned in your comment. Concerning Andrew Kolodny’s statement, you say that “Obviously, (I) am not one of that majority”. But Kolodny doesn’t make any distinction between people with problems such as mine versus some that may have what’s considered to be lesser pain issues. If he did, the organization that he leads, PROP (Physicians for Responsible Opioid Prescribing), wouldn’t have filed a petition with the FDA to ban ALL opioids over a certain strength threshold. Not limit or monitor the use of, but literally BAN their existence throughout the USA. So, I actually am one of those people that would be affected and Kolodny has not only suggested it, he’s on record as saying so. Fortunately, the FDA has shown common sense and has virtually stopped the petition in its tracks due to its extreme nature and the presence unsubstantiated issues presented as facts by PROP.
I’m especially grateful for the opportunity to address the study printed in JAMA last week. There are several problematic issues with the study and with the information, or the lack of, regarding its participants. I really hope you will read the information in the two links posted at the end of my comment. However, I must address two specific issues with the study: First, 108 of the participants took opioid medications for a full year, and not a single one person developed any issues associated with abuse or addiction. Not one! No doctor shopping, no street drug abuse, nothing. After a full year! This study was headline news for a day or two after its release. Many people accepted the headlines and the accompanying articles, filled with cherry-picked details, as fact. However, what the study has actually proven, in an atmosphere of scientific research, is that what has been repeated over and over by “experts” about how abuse and addiction begins, has now been proven to be scientifically and factually false! So much misinformation and propoganda has been released saying that a single prescription of opioids, lasting a week or a month, is very likely to lead to abuse and/or addiction to “opioids” and then to heroin. This is the main reason for the large amounts of state and federal legislation limiting such prescriptions and large pharmacy chains refusing to fill them. Anybody who hasn’t lived in a cave for the last few years knows this is true. Well, this propaganda, used by the CDC, FDA, DEA and CVS, is a bunch of hogwash, as my grandmother used to say. And it’s been proven as such by a study that supposedly says NSAIDs are better than opioids “for chronic pain”, as opposed to specifically low-back pain and osteoarthritis that was actually studied.
The second problem with the study is that actually both medications worked for all test subjects and, Mr. MacTaggart, they worked equally well, statisticallly speaking. The only difference, of statistical value, was in the “intensity of pain” category. One single category. But what must be understood is that this study was of participants who were experiencing moderate-to-severe low-back pain and hip or knee osteoarthritis pain. In terms of medication, the first option of choice for any of these conditions. I’ve had two lumbar disc (L4 & L5) microdiscectomy surgeries, one in 1987 and the second in 2010. For both, I was prescribed NSAID medication until diagnostic testing determined that the surgery was required. I’ve suffered several injuries to my right knee resulting in four surgeries. The first injury was severe: I tore the anterior cruciate ligament and had a significant tear in the cartilage. The other three surgeries were for cartilage tears or deterioration. The first two operations took place before my electrical accident, so I wasn’t using any pain medicine at the time. (The last one was in 2013, and the orthopedic surgeon said afterwards that he “hoped he’d bought me five years before a knee-replacement would be required” due to the extensive and severe osteoarthritis he found – at 56-years old. I won’t have another operation for anything unless I absolutely cannot function or live without having the operation.) I also broke a bone in my left wrist 4-6 times. I had three surgeries for bone spurs before a fourth was required for the removal of the bone as well as three small bones that surrounded it. All were removed due to the “extreme” osteoarthritis that had developed. I’m only mentioning these knee and wrist injuries to point out that I have a great deal of experience with osteoarthritis and I have never been prescribed or asked for “opioid” medicine for the discomfort and relatively minor pain it caused. The NSAIDs worked well enough for me. I just wanted it to be fixed or “cured”, just as I would give anything to be able to have an operation that could fix or “cure” my head pain.
I forgot to post the links I mentioned in my reply, Mr. MacTaggart. I tried to post them earlier, but it didn’t appear to go through. Here they are:
https://www.painnewsnetwork.org/stories/2018/3/10/what-the-krebs-opioid-study-didnt-find#.WqQ71Ir86oY.twitter
https://www.npr.org/sections/health-shots/2018/03/09/592305410/questions-and-answers-about-opioids-and-chronic-pain?utm_campaign=storyshare&utm_source=twitter.com&utm_medium=social
https://reason.com/blog/2018/03/09/does-that-jama-study-really-show-that-ad/amp?__twitter_impression=true
These types of things appear to be happening with currently used psychiatric drugs too. In addition, many biases seem to operate in drug trials as indicated by the following study: Lancee, M., et al. (2017), Outcome reporting bias in randomized-controlled trials investigating antipsychotic drugs, Translational Psychiatry, 7, e1232].
Prescription opioids killed my best friend’s brother. Neither of us particularly liked him, but it was a tragedy his son was the one who discovered his dead body. Following a motorcycle accident, he became addicted to the opioids, and somehow he was always able to find a doctor willing to prescribe them. I believe addicts were sharing information on which doctors to go to.
My mother was prescribed hydrocodone after a fall accident two months ago. The side effects were awful. She had terrifying hallucinations. I strongly recommended to her doctors we get her off opioids as soon as possible. If necessary for pain management, I recommended oxycodone which also produced hallucinations, but not terrifying ones. Fortunately, we’re past that point so no more opioids. There’s a crying need for new analgesics which do not have these problems, but our understanding of pain and the brain is like looking at the Moon 200 years ago and wondering how we can ever get there.
“The solution to the opioid epidemic is prescribing fewer opioids, and that is not a message opioid manufacturers want to promote,” said Dr. Adriane Fugh-Berman-LOL, my sides!!!
If she actually believes that, I’ve got a nice bridge to sell her