Today's Managing Health Care Costs Number is 33,000.
Source Note the close correlation between oxycodone and hydrodone dispensing and overdose death rate
Last year, 33,000 people died of opioid overdoses. 33,000.
That means that opioid overdose deaths are about as common as deaths from motor vehicle accidents, or deaths from guns . Opioid overdose deaths are one of the reasons that our march toward longer life expectancy in the US has halted -and they disproportionately affect men without education beyond high school. Nearly half of all opioid overdose deaths come from prescription opioids -not illegally purchased heroin and not fentanyl manufactured in rogue labs.
Two recent journalism reports document how we got here. I hope they'll both be shortlisted for the Pulitzer Prize.
The Charleston (WV) Gazette had a disturbing article this weekend outlining the parallel rise of opioid deaths and the distribution of massive quantities of the narcotics oxycodone and oxyccontin by pharmaceutical distributors over the last half dozen years. 78 million doses of these two drugs were shipped to West Virginia between 2007 and 2012, while 1728 West Virginians died of overdoses from these drugs. That understates the problem - many began with addiction to these drugs, and graduated to heroin or other opioids (and deaths from these are not part of the 1728). This was 433 doses of these two narcotics over 6 years for every resident of West Virginia.
The Los Angeles Times has been running a series on Purdue Pharmaceuticals ,the maker of Oxycontin. The most recent report was published this week.
Part One focuses on the development of the drug and its initial approval. The FDA official who led the agency's review was working on new product development at Purdue 2 years later. The company doubled its sales force, and pulled out all the stops to be sure their new drug was not relegated to cancer patients only. Three top executives of Purdue pled guilty to downplaying the risk of addiction in 2007, and the company paid over $600 million in fines. Revenue from Oxycontin has been over $31 billion. The LA Times describes overwhelming evidence that Oxycontin does not last a full 12 hours - but Purdue encouraged physicians to increase the dose rather than increase the number of doses. This increased profit, and also maintained Oxycontin's competitive advantage as one of the only twice a day opioid medications. It also led to severe daily withdrawal - which made Oxycontin more addictive than other formulations of the same drug.
Part Twofollows one "pill mill" run from an decrepit industrial building in Southern California; a physician there wrote prescriptions for more than 1.1 million Oxycontin pills before the clinic was shut down by police. Many of these pills ended up for sale in Everett, Washington, transported up the Pacific coast by criminal gangs. Purdue collected information about this and other criminal enterprises for a decade before sharing information with police.
Part Threeshows how Purdue (through a related company, Mundipharma) is looking for growth opportunities abroad, now that the market for long-acting highly abused narcotics is on the wane in the US. Mundipharma is using same techniques Purdue used in the US - junkets for prescribing physicians, highly paid lectures given by doctors who prescribe more narcotics, cheerful marketing about how patients can get pain relief and resume normal life activities, if only physicians get over their "opiophobia."
So, that's how we got here. Distributors looked the other way when independent pharmacies in West Virginia dispensed unthinkable amounts of opioids. A pharmaceutical company marketed shamelessly patients desperate for relief and to physicians, who didn't heed the oath to "do no harm." A multibillion dollar industry got larger and more powerful, and young and old men and women are dying.
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