Network drives increase in painkiller prescriptions
Filed under: Conflicts of interest, Government, Health policy, Hot Health Headline, Pharmaceuticals, Public records
In the latest installment of his ongoing investigation for the Milwaukee Journal Sentinel and MedPage Today, John Fauber looks for the source of America’s prescription painkiller boom (graphic), outlining what he describes as “a network of pain organizations, doctors and researchers that pushed for expanded use of the drugs while taking in millions of dollars from the companies that made them.”
Beginning 15 years ago, the network helped create a body of dubious information that can be found in prescribing guidelines, patient literature, position statements, books and doctor education courses, all which favored drugs known as opioid analgesics.
Apparently, that network has been effective. Federal data shows that prescription painkiller sales have quadrupled in the past decade or so, Fauber found, and some of those sales may not have been warranted.
A band of doctors who get little or no money from opioid makers has begun to challenge the hype behind the drugs. They say pharmaceutical industry clout has caused doctors to go overboard in prescribing the drugs, leading to addiction, thousands of overdose deaths each year and other serious complications.
Several of the pain industry’s core beliefs about chronic pain and opioids are not supported by sound research, the Journal Sentinel/MedPage Today investigation found. Among them:
- The risk of addiction is low in patients with prescriptions.
- There is no unsafe maximum dose of the drugs.
- The concept of “pseudoaddiction.”
That concept holds those who display addictive behavior, such as seeking more drugs or higher doses, may not be actual addicts – they are people who need even more opioids to treat their pain.
His investigation dips deep into each of those beliefs and how they helped push painkillers. For a case study, see this companion infographic.
Drug-funded research group failed to disclose ties to makers of painkillers
In his latest conflict of interest investigation, Milwaukee Journal Sentinel reporter John Fauber takes on a challenge that, even by his standards, is an ambitious one.
He attempts to show the effect pharmaceutical money and the local researchers who received it had on national opinions toward powerful prescription painkillers and how it all influenced the American epidemic of opiate abuse.
He focuses on the University of Wisconsin Pain and Policy Studies Group, which has received millions from painkiller manufacturers while publishing drug-friendly research and warning against increased regulation of OxyContin and its ilk. Many of these millions, Fauber found, appear not to have been disclosed in relevant publications even as the group was paving the way for the rapid rise of painkiller prescriptions in America.
The drugs had initially been approved for a very narrow range of uses, but became extremely popular as off-label use for the management of chronic pain spread like wildfire. It’s not easy to draw clean lines between the Wisconsin group and off-label use, but Fauber’s deft investigative work and careful sourcing make a strong case.
Related
Reporter examines W.Va.’s drug epidemic
Filed under: Hot Health Headline, Pharmaceuticals, Public health
The Charleston (W.Va.) Gazette’s Alison Knezevich has geared an in-depth series around the fact that West Virginia has the highest rate of drug deaths in the nation. The overwhelming majority of those drug deaths involved prescription drugs.
In subsequent stories, Knezevich shifted her focus from the abusers to the medical community, beginning with those gatekeepers whose prescription pads are constant reminders that “nearly two-thirds of West Virginians who misuse pain relievers get them from friends or relatives for free.”
The tightrope walk between managing real pain and supplying addicts is such an exhausting one that some doctors fear employment in rural West Virginia clinics. It’s a dilemma faced even by those physicians who specialize in rehab, thanks to a newly popular brand-name drug for recovering addicts.
Seniors more vulnerable to painkillers’ risks
Filed under: Health data, Hot Health Headline, Pharmaceuticals
Mary Shedden, of The Tampa Tribune, delves into the dangers of prescription medicines in older people, whose bodies may be weaker and process medications differently than younger people.
She tells the story of a 62-year-old woman who says she was diligent about controlling her use of oxycodone following back surgery. Despite her efforts, she was found nearly comatose and, after a visit to the emergency room, had to spend several days detoxifying because of a buildup of prescription medications in her body. “As [Susan] Schubert’s body was getting older, its physiological ability to efficiently process medications was weakening and changing.”
Aging bodies can become more sensitive to the effects of drugs and some drugs can build up in the body.
Designed to heal, prescription drugs also carry certain risks, depending on a person’s health, weight, gender and, yes, age. Seniors accustomed to taking a drug for years may think changes are unnecessary, but human aging and an increased tolerance to a medication can alter its effect.
As Shedden explains, “drugs known to make a person drowsy can affect focus, balance and cognitive abilities already weakened by age.”
Shedden’s story, published before yesterday’s report from the Agency for Healthcare Research and Quality about the increase in medication- and drug-related hospital visits in people older than 45, is an interesting look into some challenges of geriatric pain management and drug dependence in an aging population.
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