As of Friday, October 12, 2018
Greg Walden’s battle cry rings out in his Oct. 1 e-newsletter. He calls all of us — medical professionals, law enforcement, families and community members — to band together in the fight against the opioid crisis. He recalls tragic stories and struggles as he congratulates himself on the passage of his bill, H.R.6, in the House.
I commend Mr. Walden for taking on this challenge and agree the crisis requires teamwork. However, I’m disappointed that he fails to mention the pharmaceutical companies. Those familiar with the opioid crisis know drug companies were the spark that set off the epidemic. Strangely, Mr. Walden doesn’t call for them to join us on deck.
As a rural family doctor who grew up in a remote logging/ranching town, I saw firsthand the local economy crumble in the ‘90s and pave the path for pervasive opiate abuse. My entrance to medical school in 2005 coincided with a growing awareness in medicine that pharmaceutical companies were manipulating physicians with expense-paid vacations, free lunches and false reassurances about their drugs.
The makers of the opiate, OxyContin, were perhaps the worst — notorious for falsely reassuring prescribers that their powerful new product was not addictive. The medical profession responded with the PharmFree movement — demanding medical schools prohibit drug companies from influencing their education and prescribing patterns. Free perks and drug reps became almost non-existent.
Graduating residency in 2013, I entered the workforce as pain pill addicts turned to heroin. Patients cursed at me when I wouldn’t fill their addiction with a prescription, heroin deaths became common, pain medication was traded in the clinic parking lot and lifelong friends brutally beat each other over their drugs.
We, as physicians, held responsibility. It’s a bitter pill to swallow — knowing that your profession, aimed at healing, was manipulated into contributing to suffering.
What pill are the pharmaceutical companies swallowing for their role? From the looks of Mr. Walden’s bill, it resembles a sugar pill. His legislation fails to punish the companies financially and, in fact, the only accountability it requires is an FDA meeting to discuss barriers they face in developing non-addictive pain medications. Given the industry blatantly lied about the safety of highly addictive medications as a way of insuring profits, we don’t need a meeting to understand the barriers.
H.R.6 also liberalizes regulations on buprenorphine — the long-acting opiate used for treating addiction. Currently, only specially trained providers can prescribe it, and to a limited number of patients. The medical community understands that addiction treatment requires more than medication. Social work, counseling and frequent monitoring — which are time-consuming — round out comprehensive treatment programs. H.R.6 allows providers to triple their prescribing capacity. Though this increases access to treatment, the focus shifts from coordinated treatment back to medication, again benefiting the pharmaceutical industry.
So, Mr. Walden, if you are calling all hands on deck, why ignore the most powerful? Perhaps it’s time you consider the grip they have on you. This election cycle, Mr. Walden has the greatest total donations, in both houses, from pharmaceutical manufacturing (Center for Responsive Politics). His donors include nine of the top 10 U.S. drug companies, as well as dozens of drug manufacturers and PACs (Federal Election Commission), including numerous producers of opiates.
The medical community has looked in the mirror and is taking responsibility for our role. Mr. Walden should do the same. He’s filling his campaign pockets with drug company dollars, begging the community to unite to fight this, all while hoping we won’t notice Big Pharma slip away without accountability. Mr. Walden, it’s time for you to hand over the ship. No matter how many hands are on deck, if the captain is conspiring with pirates, the ship is going down.
Jessica Porter is a Hood River physician.