Steve May: Big Pharma' role in opioid crisis needs scrutiny

Editor's note: This commentary is by Steve May, who is a licensed clinical social worker with 15 years providing clinical services to addicts, alcoholics and their families. May has worked in a variety of settings across Vermont spanning agencies and private practice. He is a Democratic candidate for the state Senate in the Chittenden District.

[V]ermont authorities need to include a public inquiry as a part of any settlement involving the pharmaceutical industry and their involvement in the opiate crisis. An increasing number of states, counties and municipalities around the country have sought to recapture part of the costs associated with the care and treatment of heroin addicts and opiate-prescribed patients who developed a clinical dependence across several years. The pharmaceutical manufacturers who created these drugs and pedaled them to doctors need to be held accountable for their behavior and their business practices. These medications were sold to the medical community as being “… safer than aspirin and less habit forming than ibuprofen.”

We now know as a matter of fact, that this line about painkillers being safer than aspirin was actually scripted and repeated time and time again as part of the sales pitch by Pharma sales representatives to doctors. Both doctors and former Pharma sales reps have told us so. Even more disturbing, however; there is a body of mounting evidence that at the time they were saying this to doctors manufacturers knew that these painkillers were habit forming and either flat-out lied or downplayed greatly their addictive properties.

We need to put the business practices of the pharmaceutical industry under a microscope. It’s critical that we understand how these drugs are marketed to prescribers. We need to police the relationship between docs and those who would seek to influence their medical decision-process both for good and for ill. The public should demand nothing less than a complete and transparent disclosure process. Massive mistakes have occurred at most every level — those mistakes have resulted in conditions where patients who came to their doctors to address an ongoing pain concern find themselves in the crosshairs of this sustained medical disaster. A complete accounting of the facts which created this health crisis and then propelled it forward is prudent and necessary.

The experience of the bleeding disorders community is especially instructive in understanding the scale and scope of the current crisis. In the 1980s and 1990s tainted blood products were permitted to come to market. As a result, a generation of patients was misled into relying on tainted blood products to address their hemophilia. As a result of their use of tainted blood products they unknowingly were exposed to both HIV and hepatitis C. And, of those exposed, the overwhelming majority of those patients contracted HIV and hepatitis C as a result of their exposure. Congress ordered a compassionate care payment in lieu of litigation against the prescription drug makers and the federal government. However, patients and their families were cheated out of a public accounting; because there was never an admission of guilt or public review were we all could bear witness. We tend to see all these losses as individual events, but they also are the result of system-wide choices that have made by people of great authority and their choices have had grave consequences.

As a community and as a state we have sustained a significant trauma losing so many of our mothers and fathers, daughters and sons to this scourge. Leaders must hold accountable the companies that made this mess. These bad actors must be required to come forward, be scrutinized and have a full accounting of their conduct. The most important thing we can do is to help avoid going through this again. A public inquiry would promote community-wide healing. Inquiries are a type of public hearing. In this case, some version of an inquiry would upon completion of criminal and civil litigation here be used to detail and understand the pressures which drove profit-taking over the public interest; and make recommendations to ensure that a similar event does not happen again in the near future. Any litigation against the industry would serve to address the financial cost of the epidemic to the state. Lawsuits alone have little power to bring meaningful closure to anyone who has been touched by the face of this epidemic. An inquiry has the potential to provide for meaningful change and substantive healing. That’s why it’s so important that it be included as part of any eventual settlement between, Vermont and the pharmaceutical industry.

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