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Prescription opioids needed to combat opioid crisis

This week Purdue Pharma settled with the state of Oklahoma for $270 million to avoid a trial charging the company with what I call opioid drug dealing. Purdue Pharma and members of the Sackler family–founders and managers of the company–are enmeshed in 1,600 cases throughout the U.S. They are accused of illegal marketing activities that led to over-prescribing and rampant distribution of Oxycontin, which paved the way for millions to the addiction of opioids, with hundreds of thousands dying over the last decade.

It was not just Purdue but many drug companies—and the entire drug supply chain—that fueled the opioid death spiral. As drug companies and their allies in the drug supply chain continue to use the opioid crisis as a means to oppose prescription drug importation to lower drug prices in the U.S., we can only look on with amazement at their audacity.

In the meantime, some of those same drug companies can celebrate because now patients who are addicted to opioid drugs need prescription narcotic treatments. That means, ironically and depressingly, more pharmaceutical sales and taxpayer dollars. This New York Times Editorial Board op-ed is very convincing in its case that addicts need access to the right medication to save their lives. Methadone and buprenorphine have been proven to help people stop abusing prescription narcotics (e.g. oxycontin or fentanyl) or illegal drugs (e.g. heroin). Naltrexone is also helpful.

A big part of the problem is the stigma associated with these drugs to begin with. Most rehabilitation programs don’t include use of opioid-based treatments based on the belief that you can’t treat opioid addiction with other medicines containing opioids. Studies show that’s just bull.

Unfortunately, due to federal regulations that make it difficult to obtain prescriptions for these products, about two million people or 80% of the people who need these medicines are not getting them. This is complex because, of course, per the Sacklers, prescriptions for addictive drug became too plentiful. Finding the right mix of controlling prescriptions for narcotics without impeding access is urgent.

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