The Corner

Politics & Policy

Punishing Pain Patients for the Addiction Crisis

Bottles of prescription painkiller OxyContin sit at a local pharmacy in Provo, Utah, April 25, 2017. (George Frey/Reuters)

We are in the midst of an opioid epidemic that has taken the lives of thousands of people. It’s a real crisis. But solutions risk punishing patients in terrible pain for the abuse of these medicines by others.

Case in point: Purdue Pharma is paying Nebraska $270 million to settle a lawsuit brought by the state because of the toll caused by the abuse of oxycontin and other opioids. But the crisis was caused by the abuse of  drugs, illegal sales, and improper prescribing by doctors — not legitimate use of these humane medicines as approved by the FDA. I am a big believer in the tort system as a market remedy for a market system. But sometimes it becomes a form of extortion.

The theory of  liability appears to be improper marketing practices by the drug companies. From a Washington Post analysis:

The state contends that the drug manufacturers’ deceptive marketing of their products set off the epidemic and created a “public nuisance” that injured or endangered the health of Oklahoma citizens. The state could seek more than $1 billion from the companies, either in a settlement or at trial, according to people familiar with the case.

Maybe. But perhaps this is really more a search for deep-pocketed scapegoats to pay the incredible public costs caused by a wider cultural decline and dissipation of which the opioid tragedy is a tragic symptom rather than a cause.

Beyond that, think about the disincentives these lawsuits create to the development of new and better pain medications. Why would companies invest the many billions required to develop powerful and efficacious new pain medicines (and other beneficial pharmaceuticals) when executives know their companies may one day be bankrupted if their medications are used improperly and for reasons never intended?

By the way, the Medicare for All Act of 2019 would permit the government to steal pharmaceutical companies’ patents if they refuse to accede to the government’s price fixing. What would legalized intellectual property theft do to the development of new pain medicines?

The real victims in all of this are going to be pain patients. Doctors are already under terrible pressure to cut back on their palliative prescribing. (I have heard from readers experiencing increasing difficulty accessing the pain treatment they need.) And now, Senators have introduced legislation to micromanage the supply of pain prescriptions doctors are allowed to prescribe with the potential to restrict access even further. From the MSN story:

U.S. Sens. Kirsten Gillibrand (D-NY) and Cory Gardner (R-CO) announced bipartisan legislation that would limit the supply of initial opioid prescriptions for acute pain to seven days. The bill is called The John S. McCain Opioid Addiction and Prevention Act, named after the late Republican Senator who died of brain cancer in Aug. 2018 and was formerly leading this legislation.

The senators believe this legislation will help prevent and combat opioid addiction in the United States as the rates of drug overdoses and addictions continue to rise.

Wait, I thought it was wrong for government to come between patients and doctors.

Meanwhile, the push to legalize assisted suicide is pushing forward energetically, with New Jersey just joining the list of states allowing doctors to prescribe opioids to intentionally cause death. My head is exploding! Do the pain-control prescription inhibitors want people driven into the metaphorical arms of Jack Kevorkian because they can’t obtain proper pain control? Brilliant!

But hey, these proposals and actions let politicians display their righteousness like so many peacocks spreading their tail feathers. And if legitimate pain patients become collateral damage? Oh well, priorities are priorities. They just should have stayed out of pain.

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