The opioid alarm bell should have been rung long ago
Hindsight is 20/20, and it is hard to understand the full depth and consequences for the future in any given moment; but the healthcare industry, regulators and pharmaceutical companies should have reversed course well before the opioid crisis cost passed the Vietnam War in lost American lives.
Thanks to The Washington Post and the Charleston Gazette-Mail in West Virginia – who had to sue the federal government to get the U.S. Drug Enforcement Administration to disclose just how widespread painkiller prescribing had become – we now know exactly how many Oxycontin, Vicodin and other opioid painkillers were in circulation from 2006 to 2012, the years immediately before the spike in the overdose rate. Worcester was the opioid capital of New England, with pharmacies stocking 49 million pills in that time period, 20% more the next highest city (Brockton, with 40 million). In Athol, pharmacies dispensed enough opioids for every one of the town’s residents to consume 84 pills per year, and in neighboring Gardner the number was 82.
In 2001 – well before opioid prescribing spiked – the DEA warned Purdue Pharma, the Connecticut maker of OxyContin, of the widespread abuse and urged the company to limit the painkiller’s marketing. The Centers for Disease Control & Prevention later urged doctors and other healthcare providers to be wary of prescribing too many opioids. Still, the prescriptions kept rising through 2012, and meaningful measures weren’t taken to curb opioid prescriptions until the fatal overdose rate spiked in the mid-2010s. The 2,100 people who died in Mass. in 2016 was nearly triple the 660 in 2006.
In reacting to a numbingly high death rate, you’d think we’d have pulled out all the stops to put hard corrective measures in place. Yet, we did not. Yes, statewide measures like limiting opioid prescriptions for first-time patients and developing a database to track patients’ use have at least stemmed the annual increases in the death toll, but the data screams more should have been done much earlier in the process. Pharmacists, doctors, and – above all – the pharma companies selling the drug share culpability in this becoming the massive, deadly crisis we have on our hands today. When 1.3 billion opioid pills were flowing into Mass. pharmacies, no one on watch effectively rang the alarm bell. The pharma industry is awash with money and influence, and a radical shift in a business line would have been bad for profits – but it would have been good for humanity.
Now, even as new regulations are slowing prescription use, law enforcement and behavioral health providers have to deal with tens of thousands of patients in Mass. seeking out street drugs like heroin and fentanyl, which are far more dangerous. Recognition of this slow-moving tragedy by all the culpable parties earlier in the process would have saved lives. We owe it to all those who lost their battle with this deadly disease to bring the crisis to an end, while providing the resources needed to support the many residents in recovery.
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