“No one should approach the temple of science with the soul of a money changer.”
~ Thomas Browne
Article after article in recent news headlines discusses how big pharma and addiction to opioids are integrally connected. Most recently, John Oliver took on the topic of big pharma and addiction in his Last Week Tonight show, stating that at least three-quarters of opioid addicts begin their dependency with prescription medication like Vicodin, Percocet and OxyContin before using heroin. Even just plain old common sense makes it clear that even if big pharma is not a friend of addiction, it is certainly not taking any drastic steps to work against addiction. This makes it a de facto foe of those with addictive personalities – not to mention those who already addicted to prescription medication. The question of how big pharma and addiction are linked is not necessarily cut and dry. Pharmaceutical companies have brought a great deal of good to the world, developing medication and treatment for everything from depression to malaria. However, the relationship between big pharma and addiction to prescription medicine has been amped up in recent decades, making it dubious at best. Medication is sometimes prescribed and used even when it is not needed and after it has been shown to be ineffective. This is particularly true of medication designed to address mental health but applies almost equally to prescription opioids and painkillers. Antonella Gambotto-Burke, writing in her Memoir of a Suicide, discusses this dubious relationship between big pharma and addiction:
“Suicide rates have not slumped under the onslaught of antidepressants, mood-stabilizers, anxiolytic and anti-psychotic drugs; the jump in suicide rates suggests that the opposite is true. In some cases, suicide risk skyrockets once treatment begins (the patient may feel not only penalized for a justifiable reaction but permanently stigmatized as malfunctioning). Studies show that self-loathing sharply decreases only in the course of cognitive-behavioral treatment.”
While the focus of this post is more on opioids (that is, prescription painkillers) than anti-depressants, the resulting question remains the same: do the benefits of prescription drugs outweigh the risks of addiction and abuse? This is the overarching question regarding big pharma and addiction that this post aims to address. As a result, we will address all of the following questions:
- What is big pharma and how does the industry work?
- Does the pharmaceutical actively advertise addiction?
- Why are prescription painkillers addictive, and what risks do they pose?
- How do patient interests and profits interact with big pharma?
- How are big pharma and addiction connected?
- What can you do about addiction and big pharma?
- How can you mitigate the effects and abuse of addictive prescription painkillers?
What is Big Pharma?
Big pharma, as an industry, is relatively nebulous if only due to its massive size. Taken altogether, the fifteen largest companies in the pharmaceutical sector have a market value of over $2 trillion. This is a massive, and quite profitable, industry. According to The Motley Fool, big pharma is “a collective term to describe the world’s largest publicly traded pharmaceutical companies. While no concrete definition exists, the big difference between big pharma and just plain old pharmaceutical companies is market valuation… Big pharma has a more diverse product portfolio and pipeline.” In other words, big pharma is a subset of the pharmaceutical industry, with companies that can have millions, and even billions, of dollars invested into a single type of medication. To get an idea of just how big this subset of the pharmaceutical industry is, and how it operates, consider some of the following:
- Pharmaceutical advertising spending hits close to $5 billion every year.
- Roche, one of the largest pharmaceutical companies in the United States, had 115 ongoing clinical trials in 2015.
- Pharmaceutical companies tied with banks for the highest profit margin in 2013, at 19%.
- Big pharma companies regularly get fined for illegal marketing and sales practices.
None of these facts speak directly to how big pharma and addiction interact, but they set the stage for the larger picture.
Is Big Pharma a Friend or Foe of Addiction?
Now that you have an understanding of what big pharma is and how the industry operates, the next logical question is whether or not it is here to help or hinder the fight against addiction. Is big pharma a friend or foe of addiction, in other words? As mentioned above, we are not here to indict big pharma in causing addiction or even actively promoting it. However, we can at least tell you this: when it comes down to it, large pharmaceutical companies (big pharma, in other words) do not necessarily have your best interests in mind as a patient. There have certainly been wonderful advancements in medication and medicine the past few decades, but when it really comes down to it these pharmaceutical companies have the bottom line in mind. Profits, that is. This contrast between profit interests and patient interests is driven home by Donald M. Berwick, the former Administrator of the Centers for Medicare and Medicaid Services in the United States: “Competition makes things come outright. Well, what does that mean in health care? More hospitals so they compete with each other. More doctors compete with each other. More pharmaceutical companies. We set up a war. Wait a minute, let’s talk about the patient. The patient doesn’t need a war.” In other words, patient health and profits are on two different avenues, if not mutually exclusive. If the former CMS administrator pits patient interests against profits, it is not a good sign. It is not necessarily a cheery thought, but when it comes to health care, profits often eclipse patient interests. Because of this fundamental truth, there is no question that big pharma has had at least some part to play in America’s addiction to opioids. As Dr. Nora D. Volkow writes for the National Institute on Drug Abuse, the phenomenon of prescription opioid abuse has a special cause, inextricably linking big pharma and addiction:
“Several factors are likely to have contributed to the severity of the current prescription drug abuse problem. They include drastic increases in the number of prescriptions written and dispensed, greater social acceptability for using medications for different purposes, and aggressive marketing by pharmaceutical companies. These factors together have helped create the broad environmental availability of prescription medications in general and opioid analgesics in particular.”
In other words, prescription opioids are becoming increasingly available in the United States, due to increasing social acceptability and a rising number of prescriptions. As a result, there is a rising problem of prescription drug addiction throughout the country. However, behind these two factors lies an even greater cause: the active marketing, lobbying, and even pushing of pharmaceutical companies. To say that big pharma is behind the rise of prescription drugs is common sense, bordering on the platitudinous. But how has this rise in pharmaceutical drugs in the United States influenced addiction to the country? Consider the following facts and figures as a start to gaining the full picture of this relationship:
- The number of opioid pain relievers prescribed by doctors skyrocketed from 76 million in 1991 to almost 207 million in 2013.
- The United States accounts for nearly 100 percent of prescriptions for hydrocodone (like Vicodin) and over 80 percent for oxycodone (Percocet).
- Emergency room visits for nonmedical use of opioids went from 144,600 in 2004 to 305,900 in 2008.
- From 1997 to 2007, the percentage of drug abuse treatment admissions for opiates besides heroin went from one percent to five percent of admissions.
- As of 2002, prescription opioid poisoning eclipsed heroin and cocaine overdose as a cause of death.
- There have been no long-term studies to determine whether or not the benefits of prescription painkillers outweigh the risks of addiction.
- In 2013, 16,000 Americans died from an overdose on prescription painkillers.
- In 2012, at least five percent of the U.S. population over the age of twelve had used opioid pain relievers non-medically.
In answering the question of how big pharma and addiction to prescription medication are connected, these sobering facts tell a convincing story. Don’t get us wrong – it is not like big pharma is actively working to develop addictive drugs to push on the population. Instead, some of the most effective pharmaceutical drugs also happen to be highly addictive and associated with serious side effects.
What to Do About Addiction & Big Pharma
Then the connection between big pharma and addiction is readily apparent. But what can be done about it? Dr. Nora D. Volkow, writing for the National Institute on Drug Abuse, goes on to conclude that the resolution to painkiller and prescription drug addiction must be balanced if it is to be effective:
“To address the complex problem of prescription opioid and heroin abuse in this country, we must recognize and consider the special character of this phenomenon, for we are asked not only to confront the negative and growing impact of opioid abuse on health and mortality but also to preserve the fundamental role played by prescription opioid pain relievers in healing and reducing human suffering. That is, scientific insight must strike the right balance between providing maximum relief from suffering while minimizing associated risks and adverse effects.”
In his segment on the issue of big pharma and addiction, John Oliver echoed this sentiment late last year: “There is no one simple answer here. Not all opioid addicts will respond to the same treatments, and not all people in pain will find relief from alternative therapies. This is going to take a massive effort and a significant investment.” So what can be done about addiction to prescription painkillers and opioids on an individual level? To begin with, if you or someone you know is currently taking prescription drugs, consider spending a few minutes to take a quiz on your current usage of prescription drugs and whether it is putting you on a path to addiction. There is no question that addiction to prescription drugs can have a detrimental impact on both personal and professional life, not to mention physical health. Thankfully, it is very possible to overcome addiction to prescription drugs. Just like any addiction, addiction to prescription opioids can be effectively treated with cognitive-behavioral therapy and group support. Intensive outpatient addiction treatment programs, for instance, offer individuals the ability to participate in support groups, receive individual counseling, and get to the source of their addiction while maintaining their daily schedules and responsibilities at home. According to the Mayo Clinic, effective treatment for prescription drug abuse includes the following elements:
- Providing a safe space for detoxification and prescription drug withdrawal.
- Determining what factors led to prescription drug abuse (i.e. mental health problems of relationship issues).
- Developing skills to cope with cravings and prevent relapse.
- Learning strategies to develop more positive relationships.
- Providing an alternative, healthier activities
Big pharma and addiction may be integrally connected, but that does not mean that you need to suffer the consequences of addictive medication. If you find that you are struggling with addiction to prescription opioids, you can choose to do something about it today. This post has covered a variety of questions related to big pharma and addiction, but the main takeaway point is this: prescription opioids may be addictive, but that does not mean that those who use them should be helpless. Cognitive-behavioral therapy has been shown, time and again, to be particularly effective in addressing the underlying issues of drug dependency, abuse, and addiction. Whether big pharma is a friend or foe of addiction, you have many friends of addiction recovery here to help you overcome the detrimental impact of prescription drug dependency. You do not have to deal with it on your own. If you still have questions about prescription drug abuse, big pharma, and addiction, feel free to contact us today. Do you have a story or comment to share about big pharma and addiction, or prescription drugs and recovery? Don’t hesitate to leave a comment in the section below.