The Great American Cartels Explaining the Opioid Crisis
During the 1990s, pharmaceutical companies informed the medical community that patients would not get addicted to prescription opioid pain relievers. Consequently, healthcare providers began prescribing medications at greater rates, encouraged by Purdue Pharma, who amped up sales with an aggressive campaign in the early 2000s to make narcotics the default treatment for long-term chronic pain. Michigan, Ohio, Kentucky, Tennessee, North Carolina, Maine, Vermont, West Virginia, and other vulnerable populations suddenly found themselves flooded with mass quantities of the drugs, including OxyContin and heroin. But profits of a web of firms- Purdue Pharma, Johnson & Johnson, KeySource Medical, McKesson, among others- skyrocketed; essentially, they are profiting off the backs of widespread American suffering in the biggest drug epidemic in the history of the nation.
Today, more than 130 people overdose on opioids every day. The Midwestern region saw opioid overdoses increased 70 percent from July 2016, roughly 21 to 29 percent of patients prescribed opioids for chronic pain misuse them; Opioid overdoses increased 30 percent from July 2016 through September 2017 in 52 areas in 45 states. These statistics show how, with the combined efforts of a deluded medical community, duped federal regulators and unwitting politicians, misinformation can be deadly. Clearly, prescription opioids are frighteningly addictive.
But can we classify the crisis as capitalism gone wrong? The opioid crisis symbolizes the concentration of money in the hands of a few through the exploitation of many. Though this is neither the heart nor intent of a capitalistic economy, it is an unfortunate side effect: ignoring negative externalities in favor of the individual. When the economic system incentivizes quarterly gains rather than promoting long-term stability, our very livelihood is jeopardized. It means big corporations will continue to hoard power and wield influence for the sake of their profits and therefore themselves. At the very core of the American opioid crisis lies corporate greed, pure and simple.
Take recent events in a federal court of Ohio, where a judged released secret data: various corporations had inundated the country with more than 75 billion opioid pills over just six years, targeting regions already worst hit by the epidemic. Victor Borelli, a national account manager for Mallinckrodt, told Steve Cochrane, the vice president of sales for KeySource Medical, about information that would later be released in Ohio federal court. This correspondence in the form of email started in 2009, much earlier than when the issue rose to prominence, containing heinous, utter disregard for human toll: Borelli told Cochrane in another email, according to The Guardian, that 1,200 bottles of oxycodone 30 mg tablets had been shipped, to which Cochrane responded: “Keep ’em comin’! …Flyin’ out of there. It’s like people are addicted to these things or something. Oh, wait, people are. . .” Borelli responded: “Just like Doritos, keep eating. We’ll make more.”
Connecting the Coasts
In a national crisis which is geographically removed from ourselves, how can we humanize the issue and turn the lens from cold statistics to something we can empathize with? Though on a base level we can offer our condolences to those affected, the answer lies in a city 40 miles from our own: Seattle. We know that the homelessness crisis is the most pressing concern in the great metropolis of Amazon and Starbucks; more than 12,000 people were counted as homeless in Seattle and King County this year, an astonishing figure second only to Los Angeles and New York, however, both of the latter cities have millions more in population.
Drug addiction- opiates, in particular- are fueling homelessness on the West Coast. According to the Seattle government, “…drug overdose is currently the leading cause of death among people who are homeless.. In 2014, the 156 opiate overdose deaths were the highest ever recorded in King County – more than triple the number of deaths in 2009.”
In King County, more people enter detox (rehab) for heroin than they do alcohol, heroin being classified as an opiate. Often, drugs like these are easier to obtain on the streets than prescription opioid pills. Here we see a clear connection between the Midwest and east coast’s inundation of opiates and our own local situation.
To be sure, economic disparity, the fundamentally flawed criminal justice system, and mental health are key factors as well, but access to these drugs is what keeps people on the streets, if not what got them there initially. The problem is, there’s only so much the Seattle police force can do; there are very few state-funded drug rehab centers in Washington state for officers to turn the homeless to, and even costly treatments like these don’t ensure a non-relapse.
Bike officers are beginning to carry naloxone (Narcan), a lifesaving medication that reverses overdoses, but this too has its issues. If the addicted homeless have the knowledge that a special task force will come to their rescue with an immediate fix, they don’t have to face the otherwise potentially fatal fallout.
Massive and Complex Litigations
Amidst the crisis, you may have wondered how some of these brands rose to twisted prominence. Johnson&Johnson? The quintessential family brand selling baby cribs and toys, baby powder and Band-Aids? Who assures families in its very (ironic) credo that their customers’ health comes first? Turns out, the brand has had quite a string of misdemeanors punished in court, preceding the sale of OxyContin. It has been clobbered by astronomical payouts and dozens of state lawsuits, primarily in thanks to product misfires. They went through five years of litigations over their blood-thinner Xarelto, of which they failed to inform the public would cause internal bleeding. They paid $775m to settle the 25,000 lawsuits yet failed to assume liability, and then failed to inform the FDA that at least three tests by three different labs from 1972 to 1975 had found asbestos in their talc ( the main component of their baby powder). But even from their antipsychotic drug lawsuits to their patented opium poppy, Johnson&Johnson has never managed to lose public trust and investor faith quite as well as through the opioid crisis.
As of October 1, 2019, they’ve paid $572m to the state of Oklahoma and $20m to two counties in Ohio for damages, but this isn’t where the multi-billion dollar federal trials end. “Early next year, a similar case brought by West Virginia’s Cabell County and the city of Huntington — which have the highest opioid overdose rates in the country — is set to be taken up,” as reported by National Public Radio (NPR).
The first federal trial of the U.S opioid epidemic is set to begin on October 21, 2019, in which the three big distributors of drugs in the nation, controlling an estimated 85-90% of distributions, could face a predicted $73 million settlement. Though the monetary amount seems like a failure on principle, it is actually quite a relief for investors who feared a settlement of billions of dollars. But for bearing the responsibility of the suffering of a nation and complete devastation of communities, will these companies ever get their dues?
The landmark battle for who is responsible involves thousands of plaintiffs at every level of government -municipal, city, town- to defendants in the actual drug manufacturing and individual doctors. So what is at stake here? Primarily, the amount of money communities and cities will receive to mitigate the crisis, and when they’ll get that amount. Because it is unnecessarily complex to have different hearings played out all across the nation, the judicial panel ruled to narrow the process by putting the thousands of lawsuits under the jurisdiction of a single judge: U.S District Judge Dan Polster.
To give you an idea of just how many defendants are involved here, if one were to put all their names on a single Google Doc, the document would be 139 pages long. Again, this is just a number. But if you really consider what that means, thousands of multi conglomerates, corporations, doctors, and drug dealers were addicting people to line their own pockets. It means that, according to local news, we are experiencing a drug crisis so severe that life expectancy for Caucasians is declining for the first time since the AIDS epidemic; companies knew that the risk of addiction was far higher than marketing materials implicated.
But the plaintiffs are divided on one thing: how to divvy up the settlement money, a clash mainly between state attorneys general and local government. Resentment still remains from the settlement of Big Tobacco back in 1998, where local governments claim that the $246 billion amount did not reach them. State governments, they claim, aren’t in the unique position to address the impact as local ones are.
Additionally, some lawmakers want criminal charges for drug executives, particularly Purdue Pharma, who filed for Ch. 11 bankruptcy protection last month. Owned by members of the Sackler family, Purdue is accused of pushing doctors to overprescribe OxyContin even after pleading guilty to misleading federal regulators in a 2007 case. They could face paying up to 3 billion dollars of their personal fortunes to the plaintiffs, but many people want more. “‘The Sackler family does not belong in bankruptcy court,” Rep. Max Rose, D-N.Y., has said. “They belong in handcuffs.’”
On October 8th, our city of Bainbridge Island joined the almost 2,600 other cities suing opioid manufacturers and distributors. The Kitsap Sun reported that Bianbridge’s suit stated how we’ve “felt the profound consequences of the epidemic..pervading the country..[we have] suffered significant and ongoing harms.”
Joe Levan, city attorney, explained the motives behind the lawsuit in the Bainbridge Islander: “It’s not really about the money..it’s about holding these irresponsible companies responsible.” However, if the settlement goes through, Bainbridge’s city government could receive money to help mitigate the damage, an undefined amount which mayor Kol Medina would put towards preventing opioid use among teenagers.
The defendants in this lawsuit include none other than members of the Sackler family, owners of Purdue Pharma, who tentatively agreed to pay 12 billion dollars to states over a period of time- an offer which the state of Washington rejected.
Though the issue may seem far removed- the term “opioid crisis” flung around without any actual meaning- it is one affecting our very community; Native communities surrounding us, counties next to us, and the people in them. Because ultimately, the U.S opioid is about the American people. The people who have died at the hands of greedy corporations, those who have become stuck in the cycle of addiction and homelessness, those who went into surgery one day and came out with a pain reliever prescription that would change the course of their lives and wreak havoc upon a nation.