Overdose deaths? Most come from prescription painkillers

Possession of street drugs, even small amounts of marijuana, lands millions of people in prison, sometimes for life, especially if they happen to be Black or Latino/a. For more than 40 years the government’s “war on drugs” has fueled the expanding prison-industrial complex in the United States, targeting alleged users and small dealers, particularly in communities of color.

Every day in the U.S., about 100 people die from drug overdoses. The rate has tripled since 1990. But contrary to the mythology used to justify the government’s spending $1 trillion over four decades for its “drug war,” today more overdose deaths stem from the use of prescription painkillers than from crack cocaine and heroin use combined.

According to the Centers for Disease Control, the leading cause of death in drug overdoses in the U.S. today is not cocaine or heroin — but prescription drugs, developed and promoted by the billion-dollar pharmaceutical industry for a considerable profit return.

Prescription painkillers that are narcotic or opioid analgesics, including oxycodone, methadone and hydrocodone, are produced by more than 20 drug companies, including Pfizer, Inc., Janssen Pharmaceutical Inc. and Purdue Pharma, maker of OxyContin.

Oxycodone is the key ingredient in OxyContin, as well as in Percocet and Percodan, produced by Endo Pharmaceuticals. According to Dr. Nora Volkow, director of the National Institute on Drug Abuse at the National Institutes of Health, heroin and OxyContin have an “almost identical” chemical structure. (Courier-Journal.com, April 12)

Hydrocodone is the key ingredient in Vicodin, produced by Abbott Laboratories; Norco, from Watson Pharmaceuticals; and Lortab, a product of Keltman Pharmaceuticals.

Yet, as U.S. prisons are filled with people accused of drug-related crimes, the odds are that none of the drug-pushing CEOs of these pharmaceutical companies has ever done a day of hard time.

The global U.S. “war on drugs” is used as an excuse to intervene militarily in Mexico, Central America and the Caribbean, often to stop popular uprisings. Washington has just announced it is expanding not only its military presence but its “war on drugs” in Africa. It’s willing to spend billions of dollars this way, but don’t expect to see an invasion of a pharmaceutical boardroom any time soon.

Prescription painkiller abuse ‘epidemic’

At one time, people who suffered excruciating pain from terminal illnesses like cancer had to beg their doctors for painkillers. Many with chronic pain still cannot afford the drugs that could give them relief.

Nevertheless, these new drugs are now more readily available. They are often prescribed to provide temporary relief to people who are not getting other kinds of help they need to address the underlying causes of their conditions.

According to the CDC, prescription painkiller abuse is becoming epidemic — costing the health care insurance industry up to $72.5 billion annually. Misuse and abuse of these painkillers was responsible for more than 475,000 emergency room visits in 2009.

More than 12 million people admitted using prescription painkillers non-medically in 2010. Of this number, 2 million people — nearly 5,500 a day — used these drugs for the first time. “Enough prescription painkillers were prescribed in 2010 to medicate every adult in the U.S. around the clock for a month.” (cdc.gov, December 2011)

Most of these painkillers are prescribed by primary care doctors and dentists. Low-income people, particularly those in rural areas, are most at risk. Workers with job-related injuries and veterans recovering from war-related injuries are frequently prescribed these drugs in lieu of other treatment options.

People on Medicaid are prescribed painkillers at twice the rate of non-Medicaid patients.

A Washington State study found that 45 percent of people who died from overdoses of these legal drugs were Medicaid enrollees.

The highest prescription drug overdose rates are in New Mexico (27 percent) and West Virginia (25.8 percent), which recently sued 14 pharmaceutical distributors for failing to keep track of drugs shipped to doctors and drug stores.

By 2008, the sale of all prescription drugs grossed $291 billion a year in the U.S., which remains the largest market for pharmaceuticals in the world. In 2011, sales of painkillers reached about $8.5 billion. Even though there is limited evidence of their long-term benefits or risks, high-strength painkillers are now the most widely prescribed class of medications in the U.S.

History of corporate profit from narcotics

Corporate profiting from the sale of narcotics is nothing new. In 1887, an ad for Mrs. Winslow’s Soothing Syrup for Children Teething showed an attractive woman about to offer a dropper of the syrup, primarily morphine, to a chubby infant.

Laudanum, an opiate, was given to Victorian women for relief of menstrual cramps and headaches. Infants were fed laudanum to keep them quiet while their mothers worked long hours in 19th-century sweatshops.

Bayer Pharmaceuticals sold heroin as an over-the-counter cough remedy in the early 1900s. Opium, cocaine and their derivatives were widely available as over-the-counter remedies until 1914, when President Woodrow Wilson signed the Harrison Narcotics Tax Act that placed a special tax on these substances, although they could still be obtained through physicians.

Today corporate sales of these now illegal-to-sell narcotics have been replaced by easily available prescription drugs.

Market-driven industry

There is no doubt that the pharmaceutical industry in the U.S., like all capitalist enterprises, is market driven. The question is to what extent is the industry willing to go and what factors are driving their decisions?

The pharmaceutical companies are in a race to recoup the investments they make in research and development for their major prescription drugs before their patents expire and/or cheaper generic drugs can flood the market. According to IMS Health, from 2011 to the end of 2015, more than $100 billion of brand-name drug sales will be open to generic competition. (New York Times, Feb. 2)

U.S. sales of Pfizer’s anti-cholesterol drug, Lipitor, have fallen more than 40 percent since the drug lost patent protection in November 2011. While Pfizer spent $156 million on Lipitor television ads in 2011, more than on any other drug, that was a 14 percent decline from advertising expenditures the year before.

In 2010, the pharmaceutical industry had $860 billion in sales worldwide, an increase of 3 percent over 2009. Thirty-four percent of the market — $295 billion — came from just 133 major drugs, 13 of which will lose patent protection by 2013.

Even as the CDC is sounding the alarm, more drug companies are announcing plans to produce these powerful and addictive painkillers. Israel-based Teva Pharmaceuticals is in the final stages of testing TD Hydrocodone, anticipating $500 million in annual sales. Four other companies, including Zogenix and Purdue Pharma, have been working to develop pure forms of hydrocodone. Tweaking the formula will allow them to apply for new patents and thus much higher profits. n