Now we have more evidence that pharmaceutical companies have helped cause the opioid epidemic in America, which was associated with a record 47,600 overdose cases of opioids in 2017: A new study links drug marketers to opioid painkillers in more deaths overdose.
Over the years, pharmaceutical companies spend billions of dollars to sell their products to doctors, doctors and other doctors with speaking fees, free nights, paid trips, and more. When pharmaceutical companies release their opioid pills, like OxyContin, starting in the 1990s, they use many of these same tactics to convince doctors, contrary to the evidence that drugs are safe and effective by persuading them to prescribe many more drugs. ,
The New Study in JAMA Network Open examine the potential link between the marketing of opioids by US doctors and overdose deaths caused by opioid painkillers. Researchers found that where there is more marketing, there are more deaths.
The study, conducted by researchers at Boston University, UC Davis, New York University and Brown University, reviewed more than 430,000 marketing payments, amounting to 39.7 million dollars, to nearly 68,000 doctors in the US between August 2013 and December 2015 County-level data to see if payments had an effect on pain-relieving overdose deaths one year later. If marketing leads to more prescriptions for opiate use, and more prescriptions for opiate use have led to more abuse, addiction and overdose, then you could expect overdose deaths caused by painkillers to increase in places that have more marketing.
This is exactly what the researchers found: District regions that had more marketing in the past year saw more prescriptions for painkillers and more overdose deaths.
"[T]The United States continues to significantly exceed the rest of the developed countries in terms of prescribing opiates, and many people with opioid use have been introduced for the first time in opioids by prescription, "the researchers write. "Our findings suggest that opiate marketing directly to a doctor may counteract current national efforts to reduce the number of prescribed opiates and that policymakers may consider restrictions on these activities as part of a robust evidence-based response to the overdose epidemic opiate in the United States. "
It seems that the cost of marketing is not as influential as the number of marketing interactions, which implies not much the financial impact, but the contact with a marketer-doctor that has a significant effect on prescribers. practices. For countries (such as New Jersey) who are trying to limit opiate marketing, understanding this dynamics is key to delivering the most effective policies.
"Evidence suggests that food-sponsored food contributes to increased prescription, data suggests that the biggest impact of pharmaceutical companies can be subtle and widespread, by showing low-value payments that are on a very large scale "The researchers have warned.
The study had some important warnings. On the one hand, the researchers did not rule out the reverse causality. For example, traders may go to doctors who are already prescribing more opiates, as marketers see these doctors as reliable targets. In this case, it may not be that marketing has led to more overdose prescriptions and deaths, but that more prescriptions have led to more marketing.
Another warning: Opioid painkillers are not the only driver of overdose deaths in the US – especially when illegal opioids, such as illegal fentanyl and heroin, have disappeared – although they still account for 40% of overdose deaths, according to a study. It needs to be further investigated whether and how more prescriptions for opioid use could lead to other types of overdose opioid deaths, the researchers have warned.
The study also can not distinguish between deaths caused by opioid painkillers that were prescribed to the victim and those that were illegally obtained through, for example, a family member or the black market.
Still, along with a study published in JAMA Internal Diseases Last year, the findings certainly suggest – exposing one of the ways that pharmaceutical companies have probably helped, this is the most deadly overdose crisis in US history.
There is other evidence that opioid marketing has helped the overdose crisis
The opiate epidemic can be understood in three waves. In the first wave, beginning in the late 1990s and early 2000s, doctors prescribed many opioid painkillers. This causes the spread of drugs to widespread abuse and addiction – not just patients, but also friends and family of patients, teenagers who have taken medicines from their parents' medical cabinets, and people who buy pills from the black market.
The second wave of drug overdoses began in the 2000s when heroin flooded the illicit market, as drug dealers and traffickers took advantage of a new population of people who used opiates but either lost access to painkillers or just looked for better cheaper high. In recent years, the US has seen a third wave as fentanyl offers an even stronger, cheaper and more lethal alternative to heroin.
But this is the first wave that really pushed the opioid crisis – and there is probably the marketing of opioid painkillers most likely. (However, the survey can only look at recent data because such statistics do not exist in previous years, so we do not know if things are getting worse or better when it comes to marketing.)
Over the last few years, we have seen more and more messages that opioid companies aggressively market their products, even when it becomes clearer that drugs are not safe, an effective alternative to other painkillers in the market who claim that opioids are,
More recently, Massachusetts Chief Prosecutor Maura Hailey, opposed to Percy Pharma, producer of OxyContin, has revealed how Richard Sackler, then Purdue's president and part of the Sacler family who owns Purdue, personally took part in some of these efforts. The statement claims that Sacher is forced to sell OxyContin as "non-narcotic" in other countries, although it is an opioid; Robert Caiko, who created OxyContin, had to deviate it from the idea.
It is alleged that the company ignores excessive prescriptions in the United States, although some of Purdue's staff warned about pill factories that had to be reported to federal officials, Maia Szalavitz told Tonic.
Purdue argued that filing "is full of biased and inaccurate features of these papers and individual defendants, often highlighting potential ways of action that were ultimately rejected by the company."
Other reports, however, show that opioid companies are widely irresponsible. As a group of public health experts explained Annual Public Health Review, opioid companies exaggerate the benefits and safety of their products, support advocacy groups and "education" campaigns that promote the widespread use of opiates, and lobby legislators to loosen access to drugs. Purdue, as the producer of the then OxyContin, played a major role in these efforts, but there were also companies like Endo, Teva and Abbott Laboratories.
The result: With the increase in sales of opiates, too, addiction and overdose were observed.
Not only did the drugs have been lethal; they were also not as efficient as Purdue and others. There is only very little scientific evidence that opioid painkillers can effectively treat long-term chronic pain as patients grow tolerant to the effects of opioids – but there is much evidence that prolonged use can lead to very bad complications including a higher risk of addiction, overdose, and death. In short, risks and disadvantages outweigh the benefits for most patients.
In some cases, pharmaceutical companies are facing consequences for their defective claims. In 2007, Purdue Pharma and three of its senior executives paid over $ 630 million federal fines for their misleading marketing. The three leaders were also convicted of criminal liability, each of whom was sentenced to three years of probation and 400 hours of community service.
Last year, with public pressure and careful monitoring, Purdue announced he would stop selling his opiate to doctors.
But Purdue and others may soon face greater consequences. A Cleveland judge has consolidated lawsuits against opioid companies in an attempt to reach a big deal. The hope is that the deal will not only curb trade by opioid companies, but will also lead to a financial settlement that will pay for drug treatment in the US.
The latest study in Open Network of JAMA suggests that these steps, in particular market constraints, should help overcome the current opioid crisis and perhaps also prevent future crises.
For more information on how to fight the problem of the American Opioid Pain Relief, read the Vox Explanator.
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