Prescription for addiction
The “Opium Wars” were fought by the British Government to legalize their control of the opium trade to China in the mid 17th Century. Reports estimated that 25 percent of the Chinese people were addicted to opium by 1905. That same year in the U.S., heroin addiction had risen to alarming rates, and the U.S. Congress passed a ban on opium. Another American heroin epidemic began again in 1967 in Chicago and New York, and then spread widely through the early 1980s. The son of the U.S. Attorney General, Robert Kennedy, died of a heroin overdose in New York City on April 24, 1984. Physicians in medical school were taught that opioids were dangerously addicting substances that should be used only for short-term severe pain and terminal cancer.
Despite this teaching and the raging heroin epidemic in America, a letter was published in the New England Journal of Medicine in 1980.1 The author reported that of the patients in their hospital who were treated with narcotics, less than one percent became addicted. In 1986 the journal Pain,2 reported on a study of only 38 patients who were treated with narcotics for several years. The authors concluded that there was little risk of addiction. There were no other significant addiction studies reported.
Shortly after the study in Pain, one of the co-authors went on to head the American Pain Society. This organization was one of several similar nonprofit groups funded by the Pharmaceutical Industry like Purdue Pharma, the producers of the narcotic Oxycontin. These opioid producers also funded medical education programs and advocacy groups. Within a short time the pharmaceutical companies began an aggressive nationwide campaign to market opioids for long term non-cancer pains such as back and neck pain. During the 1990s the incidence of opioid misuse rose markedly, fueled by the number of opioid prescriptions written by many physicians and nurses.
Where were the Food and Drug Administration (F.D.A.) and the American Medical Association (A.M.A.) when they were presented with blatant disregard for the truth about opioid addiction? What evidence did they demand before they abandoned 150 years of knowledge about the dangers of opioids? Where were the evidence-based studies needed to refute what was known around the world about the risks of opioids?
As of February 2009, Dr. Zee, writing in the Journal of Public Health, revealed that “we lack any large...rigorous prospective study addressing the issue of…addiction, during long term opioid use for chronic non-cancer pain.”
The medical schools and physician training programs did not publicly denounce this unscientific pharmaceutical propaganda. Why? The F.D.A., the organization responsible for ensuring that prescription drug promotion is truthful, continued to authorize more and more forms of opioids over the years. Why? To this day, the F.D.A. and the A.M.A., have refused to demand mandatory education for opioid prescribers. Why? Furthermore, The Federation of State Medical Boards accepted money from pharmaceutical firms to produce prescribing guidelines.3
Why did physicians not sound the alarm to expose the fact that the pharmaceutical industry was establishing treatment guidelines for the medical profession?
Dr. David A Kessler, the past commissioner of the F.D.A., from 1990-1997, the very years the epidemic was accelerating, stated in an article in the New York Times on May 7, 2016: “It has proved to be one of the biggest mistakes in modern medicine.” Doctors, regulators and drug makers “missed one fundamental: The more opioids prescribed, the more opioid abuse there will be.”
I beg to differ. This was no mistake. The reality is that physicians in the leadership of the F.D.A., A.M.A., and The Federation of State Medical Boards, willfully abandoned their scientific integrity and over 150 years of wisdom regarding the dangers of opioids. This was simply a catastrophic violation of their duty to “do no harm.”
In their complicity with the Pharmaceutical Companies, many physicians and nurses abandoned their responsibility to their patients by writing prescriptions for addiction. The consequences are now staring us in the face. Well over a-hundred-thousand people have overdosed and died, and there are now three million addicts as the epidemic continues to devastate families across the nation.
Let’s set the record straight.
Dr. Nayvin Gordon, Board Certified for over 30 years in Family Medicine, has written many articles on health-related issues. He lives in Oakland, California.
—May 11, 2016