Treating Pain or Creating More and Profiting From It?


Rodney Warner
Rodney Warner

Are pharmaceutical companies greasing America’s increasing slide into greater heroin addiction? That’s the question posed by a lawsuit filed by Orange County California District Attorney Tony Rackauckas on behalf of the State of California. Much like the tobacco industry was accused of denying problems with its products in order to profit, five pharmaceutical companies are facing similar charges concerning the sale of very powerful, highly addictive opioid pain killers, according to a recent article in the Philadelphia Inquirer.

Opioid painkillers killed 16,651 Americans in 2010, twice the number of deaths from cocaine and heroin combined, the suit states, according to the article. Prescription drug overdoses are now the leading cause of accidental death in the United States, surpassing the number of fatalities caused by auto accidents.

Allegations of covering up the dangers of opioid pain medications, while pushing hard to sell more

Rackauckas accuses the companies of lying to the public and physicians about the dangers of these drugs. He claims the defendants told doctors that they were only imagining that their patients were becoming addicted to the painkillers, calling it “pseudo-addiction.” Their solution to the problems was to have doctors prescribe more of the drugs.

As more Americans become addicted to the pain meds, they often will buy the drugs illegally, which are far more expensive than the increasingly available heroin. Many pain pill addicts later become heroin addicts in order to get the same feeling for less money. According to the article, the federal Centers for Disease Control and Prevention estimates seven of ten heroin addicts have a previous history of opioid abuse.

The lawsuit alleges:

  • Starting in 1994, the pharmaceutical companies started an aggressive marketing campaign to change public perception of the drugs. The companies marketed directly to the public, targeting well-insured veterans and the elderly, encouraging them to ask doctors for opioids to relieve chronic pain.
  • The defendants funded organizations to promote the use of opioid painkillers for ailments that had never been treated with opioids before, including arthritis, back pain, headaches and fibromyalgia.
  • Defendants published unbranded brochures, books, websites and online talk shows that were not subject to approval by the FDA and “dramatically” understated or denied the risk of addiction.
  • The campaign worked well, with prescriptions more than doubling in twenty years from 76 million to 207 million. In 2007, Americans consumed an estimated 51.6 tons of the generic form of Oxycontin, oxycodone, or 82% or the world’s supply of the drug.
  • Opioid painkillers generated an estimated $8 billion in revenue in 2010. They are the most prescribed type of drug in America, prescribed more often than drugs for blood pressure, cholesterol or anxiety.

Just because something is alleged in a lawsuit doesn’t mean it’s true. Rackauckas claims the lawsuit isn’t about getting money from the defendants (though they’re looking for that too). He states he wants the lawsuit to go to trial (which could potentially take years) to force the defendants to divulge their marketing of these drugs.

This just might be the beginning

I think there are parallels to this case and the tobacco litigation, where tobacco companies agreed in 1998 to curtail their marketing efforts and pay out at least $206 billion to 46 states over a period of 25 years. Those states claimed their medical expenses went up because of the harm done by tobacco to its users, which the states had to partially pay for through Medicaid.

More states may see blood (and money) in the legal water and join California, claiming the medical and law enforcement costs they’ve incurred due to prescription pain pill and related heroin addiction. If there is some truth to these allegations, expect a swelling number of private attorneys to represent individuals who became addicts, or relatives of those whose deaths were related to opioid pain pill addiction, seeking compensation.

There are multiple billions of dollars at stake in this lawsuit. I would like to think these corporations didn’t use the tactics claimed, engage in a cover up and profit from widespread drug addiction. But I honestly wouldn’t be surprised if they did.


*Editor’s note: The sad part for the oncology world is that the media’s portrayal of stories of addiction and over-prescribing only further the myth that cancer patients will become addicted to pain medications if they use them. People with cancer should not suffer due to the fear of addiction, which is extremely rare in the oncology population.