YALE STUDY: COMPROMISED CLINICAL AND ETHICAL COMPETENCE OF MEDICAL PROFESSIONALS AT ROOT OF OPIOID CRISIS
All it took for trained doctors – against all indications and established evidence – to dole out addictive opioids were the gifts and pitches from pill salesmen
by Clark Miller
Published May 10, 2024
The interesting analysis that affirms what we know about the behaviors of American licensed medical professionals (LMP) and their institutions in generating the lethal crisis comes from the Yale School of Public Health.
Decades after Purdue Pharma began to push physicians to prescribe addictive pain pills, the opioid crisis has been a slow-motion disaster, with overdoses destroying lives and families across the country.
Now, it appears the consequences of those early marketing efforts are even more devastating. In a new study, researchers at the Yale School of Public Health show that infectious disease rates in the United States also climbed as a direct long-term result of the marketing of OxyContin.
By comparing U.S. states that saw heavier OxyContin promotion with states that experienced less, the Yale study shows for the first time that this marketing caused long-term rises not only in overdose deaths but also in hepatitis diagnoses and deaths from infective endocarditis, a bacterial infection in the heart. This occurred after 2010, when many people with addiction to pills began to use intravenous opioids instead, running the risk of spreading infections through contaminated needles.
“The most shocking finding is that we’re still seeing the ramifications of marketing decisions from 25 years ago,” said first author Julia Dennett, a postdoctoral associate in the YSPH Department of Epidemiology of Microbial Diseases.
The findings were published online July 19 in the journal Health Affairs.
That’s all congruent with what we know, what has been established by analyses, investigatory reporting, and historical accounts of generation of the avoidable crisis, as well as the continuing surge in infectious injection-related disease tied to high-risk opioid use.
Including this investigatory report from 2018.
The Yale SPH release announcing and describing the research tacitly acknowledges the role of what can only be accurately described as malfeasant, compromised abdication by LMPs and American Medicine of clinical and ethical responsibility to patient safety and wellbeing.
In the mid-1990s, Purdue Pharma began to target physicians in some states with an aggressive marketing campaign for its potent opioid pain pill OxyContin.
Pharmaceutical representatives offered free meals, swag, and conference trips alongside a pitch that aimed to convince prescribers — particularly those who treated cancer patients — that the drug was also safe and appropriate for non-cancer pain, such as chronic back pain.
“There was a lot of misleading information in the advertising materials,” Dennett said. “They very much downplayed the risks of addiction.”
Then it gets interesting. The language and framing of the Yale SPH release is as telling, significant, important and harm-predicting as the study outcomes.
Let’s take a look.
Here are those opening paragraphs again, with emphasis added.
Decades after Purdue Pharma began to push physicians to prescribe addictive pain pills, the opioid crisis has been a slow-motion disaster, with overdoses destroying lives and families across the country.
Now, it appears the consequences of those early marketing efforts are even more devastating. In a new study, researchers at the Yale School of Public Health show that infectious disease rates in the United States also climbed as a direct long-term result of the marketing of OxyContin.
By comparing U.S. states that saw heavier OxyContin promotion with states that experienced less, the Yale study shows for the first time that this marketing caused long-term rises not only in overdose deaths but also in hepatitis diagnoses and deaths from infective endocarditis, a bacterial infection in the heart. This occurred after 2010, when many people with addiction to pills began to use intravenous opioids instead, running the risk of spreading infections through contaminated needles.
“The most shocking finding is that we’re still seeing the ramifications of marketing decisions from 25 years ago,” said first author Julia Dennett, a postdoctoral associate in the YSPH Department of Epidemiology of Microbial Diseases.
The findings were published online July 19 in the journal Health Affairs.
That’s pretty clear, isn’t it? The “marketing decisions” themselves are the cause of overprescribing that generated the increasingly lethal opioid crisis. As if nothing happened, nothing was required to happen, between the marketing decisions being made and the pharmacologically, scientifically and medically untrained and unqualified pill salesmen explaining research basis for safety and enticing the LMPs to engage in graft, then . . . a patient walking into a pharmacy with a prescription for oxycodone signed by their LMP.
Ha! Funny. Would be funny if not for the pain and costs of an increasingly lethal opioid epidemic.
Here’s more, again with emphasis added.
Dennett said regulatory systems need to take steps to prevent similar crises in the future, such as limiting the ability of the pharmaceutical industry to promote drugs to physicians or influence regulatory bodies.
Meanwhile, she said, it’s crucial to ensure more support for communities harmed by their exposure to long-ago OxyContin marketing.
“Policymakers can promote harm-reduction services to try to reduce the spread of infectious disease and reduce overdoses, and they can also take steps to expand access to treatment for opioid use disorder,” Dennett said.
limiting the ability of the pharmaceutical industry to promote drugs to physicians
Because America’s medical practitioners are unable to use their training, intellect, readily accessible information, and clinical judgment to make choices that protect the safety and lives of their patients? They abdicate all of that when pill salesmen promote drugs to physicians ?
All things considered, that seems to be a fair point.
communities harmed by their exposure to long-ago OxyContin marketing
Get the point? It has been the marketing itself deceased patients and those trapped in the lethal crisis experienced exposure to. That generated the dependence and deaths. The marketing.
Not the addictive medically-prescribed opioids dispensed by their doctors, could only have obtained by prescriptions from their doctors.
The Yale piece is a clear whitewashing of medical responsibility for the lethal crisis, disguised as a description of a research analysis as means to that whitewashing.
From an earlier post with added explanation and sources, worth taking a look at –
What we know, because it is established by multiple lines of longstanding evidence, is that misprescription of opioids generating and perpetuating the increasingly lethal epidemic is not attributable to a small number of outlier “pill mill” prescribers – it’s about generalized, incompetent, and reckless misprescribing by America’s licensed medical providers. That, after all, is what generated the crisis, prescription of opioids for all forms of pain, in the context of longstanding, widely available evidence against that practice that would have been part of any legitimate medical training.
As if those licensed medical providers, over the course of an American medical education, would not have necessarily become aware of the evidence and their clinical and ethical obligations to practice accordingly, based on the longstanding indications against the runaway provision of those Schedule II opioids: the potential for hyperalgesia; the addictive potential of opioids; the lack of evidence for effectiveness; the psychogenic nature of common chronic pain; and the effective, durable, indicated use of cognitive behavioral therapy (CBT) for common chronic pain.
In the face of that longstanding evidence could it ever have been in good faith medical practice to be persuaded to deviate from safe prescribing as advised by pill salesmen?
Back to our current post –
Follow the first link above (“longstanding indications . . .”) to an earlier post with added detail, like this –
The high abuse and addictive potential of opioids including those prescribed for chronic pain is long-established (1), generating a history of statutory control (2) e.g. Harrison Act (1914); Boggs Act (1951) and others.
The 1970 Controlled Substances Act (3) lists opioid drugs commonly prescribed for chronic pain as Schedule II Substances (4), highly controlled as “drugs with a high potential for abuse, with use potentially leading to severe psychological or physical dependence”
