Outside Influences in Opioid Crisis

Written by: Duke Regan, Esq.

President Trump’s recent declaration of a national state of emergency regarding the opioid crisis serves as yet another reminder of the scope and seriousness of the opioid threat. Some states, such as Florida, have already declared state emergencies and established state databases to assist healthcare providers in assessing and fighting the opioid crisis.

While organized efforts are certainly a significant step in the fight against the opioid crisis, health care facilities and health care providers need to consider factors extending beyond their own patient encounters. These include a patient’s drug seeking tendencies, opioid tolerance, and also outside pressures from the pharmaceutical industry. Since 2009 pharmaceutical companies have been allowed to disseminate information suggesting certain products may have uses beyond their specific FDA approvals. The companies cannot directly market these uses but can suggest some medications, including opioids, have broader applications. There is no question so called off-label use is an accepted practice. Health care providers should be mindful, however, that strong opioid medications such as those designed to treat breakthrough pain in cancer patients is likely not a viable option for treating everyday aches and pains. Several currently available opioids and synthetic opioids are incredibly potent and carry with them even higher risks of dependency and death. At least one pharmaceutical company is facing lawsuits and investigations in more than 10 states regarding its aggressive marketing practices. Those practices returned an over 300% increase in sales following the FDA’s approval of the medication in question. Aggressive marketing practices include sponsored trips and entertainment under the guise of educating health care providers about a drug’s potential benefits. Other pharmaceutical companies are working with the FDA to fight the opioid crisis. Endo recently removed its opioid brand, Opana, from the market after a first of its kind request from the FDA over the agency’s concerns the previously approved drug’s risks outweigh its potential benefits.

As the fight against the opiod crisis continues providers must remain vigilant in not only screening and prescribing but also in assessing information from pharmaceutical companies regarding new medications and broader suggested applications for existing medications.