Big Pharma Fueled Opioid Crisis
by Stephen Lendman (stephenlendman.org - Home - Stephen Lendman)
Predatory capitalism is world's apart from small family business I was involved in for most of my formal working life.
All private businesses need profits to stay viable. No government handouts sustained us in good or hard times.
The difference between my experience and how corporate America operates is that I and my colleagues didn't try to prosper at the expense of harming others.
Just the opposite. We believed it was good business practice to provide services for clients for fair compensation, taking advantage of no one.
What's mutually beneficial worked well for us. Doing business honestly and ethically was good policy, what I understood early on — despite nothing in my MBA program teaching me this way of operating. I don't recall the topic of ethics ever raised in any courses.
The widespread opioid epidemic is perhaps the most serious public health crisis in the US.
It's fueled by Big Pharma greed and indifference to the health and welfare of ordinary people — facilitated by ruling authorities in Washington, doing little to contain it beyond rhetorical posturing.
The Mayo Clinic explained opioid prescription drugs as follows, saying they're "a broad group of pain-relieving drugs that work by interacting with opioid receptors in your cells."
"Opioids can be made from the poppy plant — for example, morphine (Kadian, Ms Contin, others) — or synthesized in a laboratory — for example, fentanyl (Actiq, Duragesic, others)."
"When opioid medications travel through your blood and attach to opioid receptors in your brain cells, the cells release signals that muffle your perception of pain and boost your feelings of pleasure."
What relieves pain can be addictive and hugely dangerous. High doses slow "breathing and heart rate, which can lead to death."
Opioid addiction is the leading drug overdose issue in the US, responsible for over 50,000 deaths in the country annually.
According to new information published by the US Drug Enforcement Administration (DEA), drug producers and distributors sold about 76 billion opioid pain pills between 2006 and 2012 alone, likely much more than earlier in years after this timeframe to the present day.
Millions of Americans use legal and illicit opioids. When used by pregnant women, infants can be drug-dependent at birth.
Trump earlier declared a public health emergency, yet did nothing to address it, no plan or federal funding to combat the crisis, no efforts to control the proliferation of these drugs.
Like his predecessors for the last half century, Trump prioritizes war on drugs strategy, the long ago failed approach to dealing with the crisis. Addiction to legal and illicit drugs is a health issue, not a crime.
Director of Public Citizen's Access to Medicines Program Peter Maybarduk said the following in response to Trump's hollow announcement:
"Declarations and tweets will do little to curb the deadly opioid push into our communities spurred by Big Pharma."
Drug companies "hooked millions of Americans on opioids through illegal marketing, greed and undermining safety standards."
"Big Pharma created this epidemic. Ending its corruption is a necessary part of the solution."
Trump instead is beholden to corporate interests, doing nothing to curb their destructive practices.
His shameful war on drugs and "Just say no" agenda assures a greater opioid crisis, not the other way around.
A Washington Post report on the growing epidemic quoted Big Pharma emails "show(ing) indifference to" what's going on, taking scores of US lives daily.
A WaPo quoted email from Mallinckrodt Pharmaceuticals national account manager Victor Borelli to drug distributor KeySource Medical's sales vice president Steve Cockrane said check your inventories.
"If you are low, order more. If you are okey, order a little more, Capesce?"
He earlier used the phrase "ship, ship, ship" to describe his job, said WaPo, adding:
"Those email excerpts are quoted in a 144-page plaintiffs' filing along with thousands of pages of documents unsealed by a judge's order Friday in a landmark case in Cleveland against many of the largest companies in the drug industry."
"Nearly 2,000 cities, counties and towns are alleging that the companies knowingly flooded their communities with opioids, fueling an epidemic that has killed more than 200,000 since 1996."
The figure is likely way understated as the cause of many US deaths go unreported or are misreported.
The Controlled Substances Act requires drug companies to report to the DEA unusually large and frequent orders — and refrain from shipping what may be diverted to the black market.
Plaintiffs in litigation against drug companies and distributors claim firms "ignored red flags and failed at every level."
WaPo was part of a lawsuit for release of previously sealed DEA documents on opioid sales and distribution.
Drug companies and the DEA unsuccessfully tried to block the release, ordered at the district and appeals court levels, the latter OKing certain redactions, information sought now made public.
WaPo: "(F)or the first time, provides specific information about how and in what quantity the drugs flowed around the country, from manufacturers and distributors to pharmacies."
"The case also brings to light internal documents and deliberations by the companies as they sought to promote their products" indifferent to public health and welfare.
Companies named in what amounts to a Racketeer Influenced and Corrupt Organizations (RICO) "civil racketeering enterprise" suit include Mallinckrodt, Cardinal Health, McKesson, Walgreens, CVS, Walmart and Purdue Pharma.
Plaintiffs claim opioid producers and distributors failed to "design serious suspicious order monitoring systems that would identify suspicious orders to the DEA," adding:
"Their failure to identify suspicious orders was their business model: they turned a blind eye and called themselves mere 'deliverymen' with no responsibility for what they delivered or to whom."
"They made no effort actually to identify suspicious orders, failed to flag orders that, under any reasonable algorithm, represented between one-quarter and 90 percent of their business, and kept the flow of drugs coming into Summit and Cuyahoga Counties" — similar practices going on nationwide.
By deposition, an unnamed Mallinckrodt employee called the company the "kingpin within the (opioid) drug cartel."
In 2011, the DEA said the company "sold excessive amounts of the most highly abused forms of oxycodone, 30 mg and 15 mg tablets, placing them into a stream of commerce that would result in diversion," adding:
"(E)ven though Mallinckrodt knew of the pattern of excessive sales of its oxycodone feeding massive diversion, it continued to incentivize and supply these suspicious sales," — never notifying the DEA of suspicious orders.
McKesson is the largest US opioid distributor. According to the ongoing lawsuit, the company "has a long history of absolute deference to retail national account customers when it comes to (opioid) threshold increases," often increasing amounts shipped to pharmacies like Walgreens, Walmart, and other large chains.
"In August 2014, (the) DOJ noted that McKesson appeared to be willing to approve threshold increases for opioids for the flimsiest of reasons."
For shipments to Summit and Cuyahoga counties, the company failed to report a single suspicious order from May 2008 to July 2013, according to the lawsuit, adding:
In 2017, the company "failed to design and implement an effective system to detect and report 'suspicious orders' " — after fined earlier for this practice.
"(B)efore the ink of the settlement agreement was even dry," the company continued "business as usual" by maintaining an unrestricted flow of these drugs.
Its former regulatory affairs director was recently indicted for illegally distributing opioids.
According to the DEA in 2012, "(n)otwithstanding the ample guidance available, Walgreens has failed to maintain an adequate suspicious order reporting system and as a result, has ignored readily identifiable orders and ordering patterns that, based on the information available throughout the Walgreens Corporation, should have been obvious signs of diversion."
What's clear from information released, opioid producers and distributors continue trafficking in these dangerous drugs freely even after fined for abusive practices.
Judicial action won't stop them. Nor will Congress or the White House.
America's political process is money controlled, aspirants and officeholders bought like toothpaste, beholden to their large donors.
Corporate giants run things. Elections when held are farcical. Dirty business as usual wins every time.
Trump is like the vast majority of others in Washington, serving corporate interests, doing nothing to curb their destructive practices.
The drug industry fueled opioid crisis keeps worsening because of a bonanza of profits it generates.
Addiction and an overdosing epidemic killing tens of thousands in the US annually is considered a cost of doing business — paid by victims, not opioid traffickers.
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