States Have Good Reason to Investigate Opioid Makers
Frustrated by the ever-escalating opioid crisis, and short of effective strategies to tackle it, states are moving against drugmakers. More than half have joined a bipartisan investigation into whether the companies are to blame for the epidemic, because they marketed their prescription painkillers too aggressively, downplaying the risk of addiction. Some have already filed lawsuits seeking damages.
There is good reason for states, and some cities, to take this tack. In the 1990s, opioid makers pushed their drugs forcefully, arguing that the risk of addiction was low. Doctors, who had once reserved opioids to treat end-of-life pain, were persuaded to prescribe them for acute and chronic pain of all sorts. Prescriptions skyrocketed and, along with them, the incidence of addiction and abuse. Now, some 2 million Americans are addicted, many of them have turned to heroin and other illegal drugs, and the number dying of overdose has reached into the tens of thousands.
The states’ legal effort is justified despite its limitations. Granted, it casts the blame too narrowly. Doctors readily accepted the flimsy evidence that unlimited opioid prescribing would be safe. Many were slow to recognize signs of abuse, or to find alternative treatments for people most vulnerable to addiction. Too many patients have been willing to go along with the trend.
Also, the lawsuits are hardly certain to win in court. Opioids are sold with the approval of the Food and Drug Administration, after all, and their labels disclose the risk of addiction and abuse.
That said, if enough jurisdictions sue, the opioid makers might be persuaded to reach a settlement -- as Big Tobacco did decades ago. That could help states pay for substance-abuse treatment and police efforts against the rising tide of illegal opioid use.
The states’ actions should also lend strength to the gathering backlash against the overuse of opioids in medicine -- as new prescribing guidelines from the Centers for Disease Control and Prevention and state-mandated prescription-drug monitoring programs have done, and as new state limits on opioid prescriptions for acute pain are meant to do. The good news is that the number of opioid prescriptions in the U.S. peaked seven years ago, at 81 per year for every 100 people, and has since fallen 13 percent. (The continued rise in mortality is due largely to the street use of illegal heroin and fentanyl.)
But prescription levels remain far too high -- three times what they were in 1999 and nearly four times what they are in Europe. One way or another, opioid makers should be persuaded to join in the effort to push them down.
--Editors: Mary Duenwald, Clive Crook
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