Who Is to Blame for the Opioid Crisis?

I find it interesting that many people pin the blame for the opioid crisis on pharmaceutical manufacturers, wholesalers and distributors.

States, cities, and even small municipalities have jumped on board to sue the manufacturers and/or wholesalers of prescription drugs.

The lure of no-cost attorneys who only take a portion if a suit is successful has drawn many governmental entities into the legal arena. Of course, some of the politicians initiating the suits are up for re-election soon, which is probably not a coincidence.

One thing I have learned is that complex and difficult problems seldom have quick and easy solutions. The opioid crisis came about for multiple reasons, and identifying one cause as the primary or only culprit is wrong and counterproductive.

Pharmaceutical manufacturers and wholesalers and distributors, which send those drugs onto retail entities, are thought to have deep pockets, and many of them do. But smaller wholesalers, which are also vulnerable, are not necessarily as well off financially, and these suits could potentially bankrupt them. These companies are painted as the villains, and they garner little sympathy. Hating big companies, especially pharmaceutical manufacturers that charge a lot of money, is common and well-justified in the minds of many.

Pharmaceutical manufacturers, like all for-profit companies, are certainly driven by making money. However, making money in the pharmaceutical industry also comes with significant risk. Non-generic manufacturers develop new drugs to address a plethora of diseases, symptoms, and health problems. Bringing a new product to the marketplace is not a simple process. There are many steps required by the FDA that include clinical trials before final approval is given. Although lengthy and very expensive for pharmaceutical companies, this process is the best way to assure that a new drug won’t be worse than the disease itself.

I remember one CII pain reliever that was removed the market in less than a year after its launch because of the potential dangers for overdose death if taken with copious amounts of alcohol. I always considered it common sense to not drink alcohol when taking opioid pain medications, and I am sure it was on the warning label, but nonetheless the drug was squashed. I am sure millions of dollars were lost with no chance of recovering the investment. As I recall, no tears were shed for the company when that happened.

The point is that if pharmaceutical companies can no longer see the profit potential for a drug or the risk outweighs the possibility of gains, it will affect the number of ground-breaking medications that are released. Research and development for other pain relievers such as the opioid abuse-deterrent formulations that are effective, will not occur or will be greatly reduced. To put it bluntly, a disease or other condition that any of us could develop over the next few years may not have a treatment or cure due to the pressure put on these companies.

If pharmaceutical companies were to blame for the opioid crisis and it would go away if we simply clamped down on them even harder, I would be all for it. The truth is that the fault and remedy is much more complex, and fixing this scourge takes all of us. I sincerely doubt that these companies are being sued with the thought that this will solve the opioid crisis but more so to solve the governmental entities’ fiscal crisis and/or to be a feather in the cap of politicians seeking re-election.

Cmdr John Burke is a 40-year veteran of law enforcement and the past president of the National Association of Drug Diversion Investigators. He can be reached by e-mail at burke@rxdiversion.com or via www.rxdiversion.com.