It is easy, and to some extent certainly fair, to laud Luzerne County’s lawsuit against opioid manufacturers and wholesalers. The suit’s fundamental contention is readily embraced: Big pharma helped cause the crisis by pushing modern prescription pain killers as safe from addiction woes.
As Jennifer Learn Andes reported in Thursday’s paper, the suit contends the 16 defendants engaged in “false, deceptive and unfair marketing and/or unlawful diversion of prescription opioids.”
The paperwork alleges they participated in racketeering, and knew the problems their actions could cause, but put profit above truth, turning patients into addicts. “These pharmaceutical companies aggressively advertised to and persuaded doctors to prescribe highly addictive, dangerous opioids.”
This argument dovetails with the National Institute of Health’s stance. The NIH opioid crisis web page makes a straight dive into the same claim, under the heading “How did this happen?”
“In the late 1990s, pharmaceutical companies reassured the medical community that patients would not become addicted to prescription opioid pain relievers, and healthcare providers began to prescribe them at greater rates. This subsequently led to widespread diversion and misuse of these medications before it became clear that these medications could indeed be highly addictive.”
County Manager C. David Pedri bolstered the argument by citing a Centers for Disease Control and Prevention statistic: 85 of every 100 county residents had opioid prescriptions in 2016.
So, yeah, let’s hold big pharma accountable. There are ample examples of industry giants hiding hazards of their products in favor of profits — think tobacco, to name just one. This suit can be a valuable step in reshaping the prescription drug landscape for the better.
But there are caveats.
For starters, it is helpful to distinguish between prescription and non-prescription opioids. Heroin and illegally-produced fentanyl are a big part of this crisis. And while many addicts start with prescription pills, escalating into the illegal options is not, strictly speaking, a big pharma issue. NIH says only 4 to 6 percent who misuse prescription opioids transition to heroin though about 80 percent of heroin users also misused prescription opioids.
It is also helpful to differentiate between an opioid use crisis and an opioid overdose crisis. As is usually the case in this debate, the lawsuit stresses the growth of overdoses in Luzerne County to make its point. There are many people who use prescription opioids for needed pain management without overdosing.
And finally, it is important to remember that not all opioid abusers are using legitimately prescribed drugs. Many abusers steal the drugs from others, or obtain them through other illegal means.
The opioid crises here and nationally is real. The lawsuit is reasonable. But in the rush to fix the problem, we must be careful not overreact in ways that deny prescriptions for valid pain control.