Without getting into a complex discussion about regulatory law, the proper scope of government authority or the dynamics of a free market economy, I’d like to remain in the realm of gut-level common sense and ask one simple question: How much should the same industry that unleashes a devastating public health crisis be allowed to profit from any potential solution to that crisis? If your answer is “completely” or “as much as they want,” you can probably stop reading now. But if you think there’s something inherently predatory, repugnant and dangerous about such a scenario, you may want to know about one of the biggest ironies and injustices currently playing out on the sad and complicated battlefield our national opiate epidemic has become.
In what has sometimes felt like a slow-moving avalanche of doom, prescription painkiller addiction has been steadily smothering our country in ruined lives and premature mortality for well over a decade. Fueled in large part by deceptive marketing and aggressive sales tactics unburdened by ethics, opioid pain medication’s surge up the hierarchy of pharmaceutical prominence has been awe-inspiring. And as they would with any powerfully addictive drug — illicit or prescription — astronomical sales can bring catastrophic societal consequences.
Initially, the consequences from the painkiller explosion were linear and foreseeable — the drugs became increasingly overprescribed and utterly ubiquitous in American medicine, and a population of opioid addicts sprung up from the seeds of recklessness the pharmaceutical industry had been sewing. As pharmacies could barely pump these pills into our national bloodstream fast enough to satisfy the craving, the problem was already out of control and too many people were dying.
Forced to play the sort of desperate catch-up game that all but guarantees half-baked solutions and unintended consequences, our government finally began cracking down on the unscrupulous and shortsighted overprescribing of painkillers, and many Americans began looking elsewhere for an inexpensive and readily available substitute high. Enter heroin, Oxycodone’s illegitimate sibling who doesn’t ask to see a doctor’s note before excusing you from life.
Make no mistake, the familial ties between painkillers and heroin are of the first degree: According to the CDC, three out of every four new heroin users report having first abused prescription painkillers. Now, likened by one senior DEA official to a weapon of mass destruction on families, communities and society, heroin is walloping our emergency rooms and morgues in grave tandem with the prescription drugs who invited it to the party — the unambiguously grim duo who just won’t quit.
Fortunately for those who find themselves escorted to the very edge of extinction by an opioid addiction, medications do exist that can reverse the effects of an overdose and save their life. That’s the good news. The bad news? At the same time that overdose deaths from painkillers and heroin have more than doubled, the prices for one of those lifesaving options are skyrocketing. Coincidence? More like opportunism and greed, the shameless fixing of a price on human life by an industry with an already strong bottom line and weak public image.
Naloxone, a drug that has been around since the ’60s and historically used in emergency rooms and by paramedics, has recently gained wider acceptance and recognition as a critical tool for combatting the scourge of opiate overdoses sweeping the country. Police departments from coast to coast have begun equipping their officers with the medication, much the same way they might be outfitted with radios, handcuffs, or another apparatus necessary to meet the challenges of any given shift. Some public officials — Boston’s Mayor Marty Walsh for example — are going even further and trying to make the drug available to anyone who might be in a position to prevent an overdose death.
Unfortunately but perhaps predictably, pharmaceutical companies are looking to shamelessly cash in on the increased demand for a drug needed to save people… from another drug. Recently, New York Attorney General Eric T. Schniederman joined a growing number of those expressing sharp criticism of the dramatic and inexplicable increase in the price of a lifesaving drug at a time when it has never been more needed. Now, more leaders should come forward and take the same important stance.
If it was wanton pharmaceutical industry ethics and lax government oversight that helped create the painkiller/heroin epidemic in the first place, the same two culprits shouldn’t be allowed to push even the most short-term, partial solutions out of reach. More can and should be done to make naloxone widely available at an affordable price, and we must demand better from an industry that would seek to profit from both the poison and the antidote.
The opinions expressed are solely those of Patrick R. Krill.
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