Opioid pain relievers play an unmistakable role in reducing human suffering. Yet, they are the most abused pharmaceutical agents on the market. Addiction to prescription pain relievers and the associated medical, social, and economic ramifications affect an estimated 26 to 36 million people worldwide. More than 2 million people are battling substance abuse disorders in the United States alone.
But, when a patient takes opiate medications on legitimate prescriptions and ends up with an addiction, who is to blame? The pharmaceutical company that manufactured the drug? Or the doctor who prescribed it?
Skyrocketing Prescriptions of Vicodin and Percocet
Since the early 2000s, opioid analgesic poisoning has overtaken cocaine and heroin as a leading cause of death. This is not surprising given the skyrocketing prescriptions of these medications in the past two decades. In 1991, global prescriptions for opioids such as Vicodin and Percocet numbered 76 million. This figure has ballooned to nearly 250 million currently. Interestingly, the United States is the biggest consumer of opiates, accounting for 100 percent of Vicodin (hydrocodone) prescriptions and more than 80 percent of Percocet (oxycodone) prescriptions.
Incorrect Use of Opioids
Opioids are chemically similar to heroin and have an intrinsic liability for abuse. Taking these medications incorrectly compounds the risk of addiction. Some habits are known to increase the dangers of opioid addiction:
- Use for non-medical purposes
- Increased euphoric effect by crushing pills and snorting and injecting the powder
- Combining opioids with other drugs or alcohol
- Taking more than the prescribed number of pills
- Taking pills more frequently than prescribed
Some people become addicted to pain medications despite taking them as prescribed. They are left battling a crippling addiction for no fault of theirs. Who is to blame for their opioid addiction?
Are Pharmaceutical Companies to Blame for Opioid Addiction?
When Purdue Pharma launched OxyContin nearly three decades ago, they boldly claimed the drug provided 12 hours of pain relief. Patients were promised smooth and sustained pain relief around the clock. The drug became America’s bestselling pain pill and earned its manufacturer more than $30 billion in revenue. Yet, a Los Angeles Times investigation in 2016 revealed that the stunning success of OxyContin masked several fundamental problems, including:
- Less than the claimed 12 hours of pain relief (the drug is priced at hundreds of dollars per bottle, much higher than generic painkillers, and this price hinges on the unique advantage of 12 hours of pain relief)
- The manufacturer’s focus on stronger dosing as opposed to more frequent dosing to maintain the promise of 12 hours of pain relief, creating additional risks of overdose and death
An estimated 7 million Americans have suffered from OxyContin abuse in the three decades since it appeared on the market. The drug is believed to be largely responsible for the nearly 200,000 lives claimed by prescription opioid abuse.
In 2007, Purdue pleaded guilty to deception about the actual addiction dangers of pain medications. The company was forced to back off from aggressively marketing OxyContin and conduct post-marketing safety assessments. Other Big Pharma companies are not without blame either. In 2016, Pfizer agreed to add warnings about addiction on its packaging as part of a lawsuit settlement in Chicago regarding the marketing of pain medications.
Are Doctors Responsible for Addiction to Opioid Drugs?
Patients have been known to file medical malpractice suits against their doctors who they claim enabled their addiction by over-prescribing pain medication. However, proving negligence when it comes to addiction is tricky, to say the least. First, addiction to painkillers taken through legitimate prescriptions occurs in a relatively small number of people. Second, it is difficult to prove that the mere act of prescribing a drug constituted negligence. However, doctors are not without blame for the following reasons:
- Research has shown that the effects of opioids last 12 weeks. Doctors who continue to prescribe opioids beyond this duration are contributing to a patient’s addiction
- Many doctors prescribe opioids without counseling despite being aware of the patient’s drug history
- Antonio Tramontana, a medical malpractice attorney in Louisiana, says there is an inherent predicament regarding opioid abuse and physician negligence. For one, patients tend to be hesitant about filing a lawsuit against a doctor because this is seen as attacking a person who tried to help them, notwithstanding the fact that compensation may be essential to manage the consequences of an addiction. Second, totally abdicating the patient from responsibility is difficult (but not impossible) considering the forewarnings the patient is given about potential addiction.
The role of drug manufacturers and physicians in a patient’s addiction is complicated. Negligence on the part of these two entities is near impossible to prove. Until scientists discover newer non-addicting ways to treat pain and more effective ways to prevent overdose deaths, the overwhelming majority of patients will continue to be held responsible for their opioid addiction.