The opioid crisis has been much publicized over the past few years. The infamous Sackler family, the overprescriptions, the bribery of doctors, the crisis had it all. How did this happen?
Until the 1980s, most doctors did not believe pain required much treatment. This view started to shift and new methods for relieving pain. One method that quickly grew in popularity was opioids. Opioids had been previously reserved for short-term issues such as relief for pain after surgery or advanced cancer. At the same time, many medical professionals began to doubt the addictiveness of opioids. Famously, one doctor claimed in 1985 that out of 11.882 people in hospitals prescribed opioids, only four became addicted. Other “studies” also spread prevalently across the medical community, despite the lack of evidence that surrounded them. This led to a shift in the view of opioids among medical professionals; many doctors started to believe that people would only become addicted if they used opioids recreationally and would be safe if they used them for pain. This led to doctors prescribing even more opioids.
Throughout the 1980s and early 1990s, the number of prescribed opioids started to increase. But the release of OxyContin in the mid-1990s by Perdue Pharmaceuticals sent opioid prescriptions soaring. Perdue Pharmaceuticals and other companies who made similar products claimed that OxyContin, which released the medication over a longer period of time, was not as addictive as normal opioids. The release of the supposedly safer OxyContin was not the only reason for the increase in prescription opioids. Pharmeutcital companies used a variety of marketing methods to convince doctors that opioids were safe to prescribe for pain by sponsoring various seminars on pain and sending representatives to meed with doctors. Many physicians lacked experience when dealing with pain control and believed the pharmaceutical companies’ marketing. Combined with monetary rewards for prescribing more medication, the issue soon spiraled out of control.
The opioid epidemic showed the dangers of the private sector having such a large influence on the healthcare system. Companies like Perdue had obvious conflicts of interest when educating doctors about the dangers of their own medication. Many doctors simply believed what representatives told them without checking with more independent sources. Additionally, the fundamental structure of the healthcare system compensates doctors for prescribing more medication, giving them an incentive to ignore potential issues and continue prescribing opioids. In more extreme cases, doctors were motivated to prescribe opioids for minor ailments that didn’t require them to make more money.
To prevent this issue from occurring again, new medication coming to the market has to be more heavily scrutinized. Unreliable studies and claims for drug manufacturers should not be enough to influence how doctors prescribe the medication. Third-party reviewers need to study the medication and its effects on patients and then instruct doctors on how to prescribe them. More importantly, doctors should not be paid for the medication they prescribe. This would remove many incentives for overprescriptions.