Here are some developments worth watching in the nation’s battle against the epidemic of opioid drug misuse that killed 28,000 Americans in 2014 alone:
CONGRESS ACTS: Congressional negotiators now must confer to determine which parts of House and Senate measures to combat opioid drug abuse will go forward. The House just passed a package of bills, while the Senate approved its measures a month ago. A key difference dividing the two chambers is funding, with Democrats complaining that GOP lawmakers, particularly in the House, aren’t putting up new and real money for the anti-drug efforts to be effective. President Obama has sought $1.1 billion to combat the abuse of heroin and prescription, opioid medications.
JUDGE UNSEALS OXYCONTIN FILES: A state judge in Kentucky has rejected a drug maker’s attempt to keep sealed court records from a recent lawsuit over the marketing and abuse of the powerful opioid painkiller OxyContin. The online health news site Stat asked the court to open the records, arguing that the public had a huge need to know how OxyContin’s maker had so aggressively sold the drug, leading to widespread deaths and addiction, particularly in poor parts of the state. The drug maker settled with Kentucky, paying $24 million over allegations it illegally promoted OxyContin; the citizens of Kentucky had the right to know details of the case to decide if that settlement was fair and reasonable, the judge ruled in unsealing the court records. A key document from the Kentucky files that likely will attract considerable attention is sworn testimony from Richard Sackler. He’s a member of the family that owns the maker of OxyContin and is the firm’s president. He’s also an MD who was deeply involved in OxyContin’s development and marketing.
FORMER FDA HEAD BLASTS Rx PAINKILLERS: David Kessler, the physician who headed the federal Food and Drug Administration for seven years, has provided an unusually blunt assessment of the opioid epidemic, ripping narcotic prescription painkillers as “one of the great mistakes of modern medicine.” In an interview with CBS News, he said, “FDA has responsibility, the pharmaceutical companies have responsibility, physicians have responsibility. We didn’t see these drugs for what they truly are.” He goes on to blast Big Pharma, saying: “The inappropriate promotion of drugs contributed significantly to this epidemic. Because drug companies took a small piece, a sliver of science and widely promoted it as not being addictive. That was false.” He does cop out some, saying the epidemic took hold after he left as FDA chief in 1997.
A CRACKDOWN BY MAJOR INSURER, HMO: In California, one of the state’s largest health maintenance organizations and one of its largest health insurers both have taken steps to combat opioid drug abuse, according to a Los Angeles affiliate of National Public Radio. The HMO, Kaiser Permanent of Southern California, says it has instituted new measures in its care facilities to not only monitor the prescribing of painkillers but also to work with its physicians to reduce dosages of the potent medications. The insurer, Anthem Blue Cross, also is monitoring patients for whom it is paying to receive prescription painkillers. Anthem says it is requiring doctors to get insurer approval in advance before prescribing opioid meds, and it is asking them to explain and curtail larger, longer lasting dosages of the drugs.
ADDICTIVE DEBASEMENT: How debasing can prescription drug addiction become? Some of them turn to loperamide when they can’t get high from their usual supplies, emergency room doctors report. In case loperamide isn’t a familiar substance, the New York Times helpfully explains it is the key ingredient in such over-the-counter diarrhea treatments as Immodium. Addicts take the OTC drug to treat the stomach and gastric ills associated with withdrawal. But loperamide taken in extreme amounts also can produce its own dangerous high─with ER docs saying they have treated addicts with irregular heartbeats and death by overdose. Meantime, ProPublica, the Pulitzer Prize-winning investigative web site, finds itself in the odd position of defending its public, online database that provides hard-to-find information on physicians’ prescribing practices. The site’s editors say they have information that some users may be using the data to find doctors more inclined to dispense painkillers for abuse. The database is intended to let patients and physicians understand how their prescribing compares with peers and best practices. ProPublica says that, for now, the data’s benefits outweigh its possible misuses, and the site is committed to being transparent and keeping the information available.