Author: Justin Mckibben
When discussing the very real devastation of the opioid crisis some people are still skeptical as to how big of a part prescription opioids play in the problem. While all patients should have access to comprehensive care for conditions relating to severe pain, ignoring the fact that prescription drug abuse is a crucial element of the epidemic is far too careless.
Many states had to face the issue of pill mill clinics and doctor shopping. Now one state, in particular, is now taking massive action in hopes of ending a very serious problem that has only grown over the years. Authorities in North Carolina took a close look at how prescription drugs wind up on the streets.
One of the key factors to narcotic medications hitting the illicit market was doctor shopping.
Doctor Shopping Stats
First, let us explain what doctor shopping is for those unfamiliar with the concept. Innovations in Clinical Neuroscience described the practice of doctor shopping, saying it:
“- entails the scheduling by patients of office visits with multiple clinicians for the same agenda, either for a continuing illness or to procure prescription drugs illicitly. As expected, the explicit definitions in the literature vary considerably, with a significant proportion focusing on a given illness episode.”
Essentially, doctor shopping is when patients visit multiple doctors with the intention of having a prescription given and then filled from each physician, giving them an abundance of medications.
Now in the case of North Carolina, this tactic grew a great deal of momentum as the opioid epidemic spiraled out of control in the past few years. According to WRAL, a Raleigh-based news outlet:
- In 2010, the State Bureau of Investigation says there were 88 doctor shopping cases.
- In 2016, that number rose to 184
- That is a 110% increase in doctor shopping incidents!
According to NBC Charlotte:
- Approximately three people North Carolina die every day in due to drug overdoses.
- Around half of those deaths are due to opioid painkillers.
So now, what moves is North Carolina making to try and fight back?
The Strengthen Opioid Misuse Prevent Act
After realizing just how big of an issue prescription drugs were playing into their current drug problem, officials in North Carolina have decided to put measures in place to try and prevent doctor shopping.
Starting January 1st with the new year, North Carolina enacted a new law, referred to as the Strengthen Opioid Misuse Prevent Act. So what does this new measure do?
- It allows doctors to only give a five day supply of opioids for pain from certain injuries, like broken bones.
- After a surgery, it allows doctors to prescribe a seven day supply.
- Refills can be given as needed, but the first refill will be limited.
North Carolina also gave some thought to protecting those in severe need of pain management resources. The new law does not apply to those with:
Local Authorities Unsure of the Future
The executive director of the North Carolina Board of Pharmacy, Jay Campbell, told reporters that while the action is being taken, it will probably never be completely eliminated. Campbell states,
“We’re certainly hoping that we can radically reduce the scope of drug diversion from pharmacies or any place else. But it is a problem that is never going to go away.”
However, Campbell believes there are certain indications of doctor shopping that pharmacists can keep an eye on as well, such as:
- The patient is visiting a pharmacy far outside their normal location.
- The patient brings in prescriptions from doctors the pharmacy is not familiar with.
Officials trying to stop doctor shopping in the area are asking pharmacists to be alert and ask questions when appropriate. Meanwhile, they are also working to develop other means of drug monitoring, including a system in which North Carolina doctors can register when they prescribe opioids to monitor records and catch patterns of doctor shopping.
There may now be some light at the end of the tunnel. Overdose death rates due to many legal prescription opioids are still rising, but they are rising far more slowly than that of fentanyl and other synthetic opioids according to a CDC report. While it is terrible that the death rates are still increasing, the fact that the rate of progression has slowed noticeably could suggest that many of the recent efforts aimed at curbing widespread over-prescribing practices could be starting to have a positive impact on the extent of the opioid crisis.
Medical Detox for Opioids
An important thing to remember is that for those suffering from substance use disorder or a physical dependency to opioids should always seek safe medical treatment in order to get off these powerful drugs. Opioid abuse presents an inherent risk to the body and the brain. Because of the often difficult and uncomfortable withdrawals, detoxing from opioids is best done in a safe medical environment.
Palm Healthcare Company’s detox facilities will offer a more comprehensive model for recovery from opioid addiction. Medical detox consists of both psychological treatment from professionals for both addiction and co-occurring mental health issues, as well as pharmacological treatment from medical specialists who can decide if there are optional medications to help ease the detox process.
What a medical detox for opioids should always do is provide a trained staff to monitor important vital signs like:
- Respiration levels
- Blood pressure
- Body temperature
- Heart rate
Abruptly discontinuing opioids can be painful or even damaging to the body. Make sure to seek the appropriate help. If you or someone you love is struggling, do not wait. Please call toll-free now. You are not alone.
Author: Justin Mckibben
Overprescribing of powerful prescription medications is just one part of how the current American opioid crisis came to be. While incredibly dangerous synthetic drugs like fentanyl came pouring in from across the globe, the pharmaceutical industry right in our own backyard thrived off of the devastation it was helping create. And as more people became aware of how prescription drugs were contributing to one of the worst drug epidemics in the country’s history, Big Pharma has come under fire for a number of things over the years. To name a few, we’ve seen arguments against drug companies for:
With recent reports, such as the explosive piece of 60 Minutes last month, we have also been exposed to the corruption, greed and a disregard for the well-being of the consumer.
The Big Pharma propaganda machine has paid out countless dollars for criminal and civil settlements over the years. Now even state officials are resorting to lawsuits against drug manufacturers in the fight against the ongoing opioid crisis.
So how did all this happen? How deep does the Big Pharma propaganda go? Some of this you might already know, but some of it might actually surprise you.
In case you didn’t know, the pharmaceuticals and health products industry spends the most money on lobbying politicians. And not even by a little.
Big Pharma and Health Products spent $3,714,580,815
That means that Big Pharma spends:
- $1,134,783,913 more than 2nd place- Insurance Companies
- $1,717,237,691 more than Oil/Gas Companies
The pharmaceutical industry, including dealers of medical products and nutritional/dietary supplements, is consistently a top contributor more to federal campaigns than any other industry.
In essence, drug companies spend big money on politics.
Whether we can always see it or not, this kind of financial incentive is more than likely playing into our current work on policy. For example, moves to pass legislation earlier this year were called into question by one source who pointed out 13 senators who were trying to push through a bill that would benefit the health insurance and pharmaceutical companies were receiving hundreds of thousands of dollars in contributions from these companies between 2010 and 2016, including:
- Utah Republican Senator Orrin Hatch led the way with more than $471,000
- Kentucky Republican Senator Mitch McConnell with over $433,00 in donations
FUN FACT- Many lobbyists working on behalf of Big Pharma companies have previously held government jobs.
Truthfully, drug companies spend several years before a drug even makes it to the market on planning a strategy for selling it to you. Part of that strategy is proving drugs have value for treatment. However, according to some industry insiders, a lot of the time there is not enough comprehensive data to prove that value.
What you might also find surprising is that some of the earliest information drug companies have published about their products aren’t actually from credible sources. Ad agencies will hire writers to produce articles on behalf of the drug maker highlighting benefits of a drug. But the data is often cherry-picked and incomplete.
These articles are then sold to the public as ‘scientific’ because they are printed and published by some of the biggest scientific and medical publications, such as the New England Journal of Medicine. Those articles are then picked up by television and other news sources.
So essentially, drug companies often team up with marketing companies to fool not just doctors, but the public into thinking their product provides something that has yet to be proven. Big Pharma propaganda corrupts the research into their drugs and makes people believe their products are safer and more effective than they are.
For more important information on the dangers of prescription drugs, download our FREE E-BOOK “Big Secrets of Big Pharma: Why They Secretly Hope You Get Hooked”
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Big Pharma’s Billions in Ads
It isn’t just behind the scenes that Big Pharma propaganda takes place. Drug makers spend around $21 billion a year just to pedal products through advertising. One big problem for Americans is that many of their promotional techniques have been called out for being false advertising or misleading, to say the least.
- 2015, the industry spent a record-breaking $5.4 billion of direct-to-consumer ads alone.
- The same year, Americans spent over $450 billion on prescription drugs.
Some sources indicate there are about 80 drug advertisements per hour. While drug companies want people to think it is raising awareness, it is most definitely a commercial to sell you something.
Many pharma companies even have deep financial ties to medical communication companies (MCC) like WebMD or Medscape. This is just one more way they can influence physicians and consumers without people realizing the drug makers are funding the information.
Doctors Recruiting Doctors
But the drug makers don’t stop with recruiting politicians to support them. They also utilize doctors to help them push their products. The main target audience in most of the campaigns pushed by Big Pharma propaganda is not necessarily the consumer as much as it is the person who writes the prescriptions.
Drug companies giving kickbacks to doctors is nothing new.
So drugmakers create an advisory board, where some of the most successful and well-respected doctors are put on the payroll with huge payoffs to help drug companies design a marketing campaign that will help promote the drugs to other doctors. Once these doctors have helped highlight the best ways to convince other physicians these drugs work, they themselves validate the drug in a way that encourages other doctors to prescribe the drug.
Drugs to Treat Drugs
A while back there was an ad that ran during the Superbowl that caught the attention of a lot of people. It was an ad selling an anti-constipation drug for those so dependent on prescription opioids that they were suffering from constipation as a side effect.
This is another huge problem with how drugs are marketed to us… in tandem.
Instead of suggesting an alternative treatment, drug companies want to give you more drugs to combat the effects of other drugs. Doctors will often prescribe a second medication for no other purpose than to treat the effects of the first medication. Big Pharma propaganda can literally sell you the illness and the medicine in the same marketing campaign. A 2012 study published in the journal Annals of Family Medicine describes this as “prescribing cascade”.The study indicates that the practice of using drugs to treat problems with other drugs is a key component to the heavy reliance on pharmaceuticals in healthcare.
Another devastating way this has taken place is when doctors prescribe powerfully and potentially habit-forming narcotic medications to combat illicit drug use and substance use disorder. Heroin addicts are being treated with other strong narcotics, which can actually have their own withdrawal symptoms and side effects. They even highjacked the opioid overdose antidote and several makers gouged the prices to offensive new heights during the rise of the opioid epidemic.
Drug Companies Abuse of Americans
Now let us be fair; modern medicine does provide us with some life-saving resources that can be paramount to the health and wellness of our population. Thanks to great strides in medicine doctors are able to treat some conditions or illnesses that were once thought of as a death sentence. Today, we have some of the greatest opportunities to receive quality care with innovative and well-researched treatments.
However, the fact remains that drug companies have been caught red-handed more than a few times misrepresenting their products, hiding the side-effects, falsely advertising their benefits and even recently some huge names in pharmaceuticals have been accused of bribery and racketeering to sell potent and extremely dangerous drugs.
So, what can be done?
- We can take a closer look at how Big Pharma propaganda influences or elected representatives and their decisions on policy.
- We can pay attention to how the information provided by pharmaceutical companies or marketers is not always as reliable as it may seem.
- Look into excessive advertising for potent drugs
- Do more to combat drug makers from paying doctors to promote their drugs to other doctors.
- Pursue other forms of treatment that don’t require expensive and powerful drugs.
When it comes to drug abuse, maybe we shouldn’t let the drug companies continue to make massive profits from a problem they have a large hand in creating. There needs to be more commitment to finding alternative treatments that don’t rely so heavily on drugs in order to help people get healthy.
Holistic drug addiction treatment is a unique and effective way of helping people struggling with substance use disorder. The fact that powerful drugs help cause addiction, let us not forget the value of offering healing options that don’t require more drugs. Building a strong foundation with personalized therapy and innovative treatment opportunities helps thousands of people all over the nation overcome addiction. Palm Partners Recovery Center is committed to providing quality care for those dealing with drug abuse, whether it is illicit drugs or prescription drug dependence. If you or someone you love is struggling, please call toll-free now. We want to help.
CALL NOW 1-800-951-6135
Author: Justin Mckibben
Ever since the true nature of the opioid epidemic in America began to come to light, and people started to see the gravity of its impact in communities across the country, there have been plenty of efforts to find out how we ever got this far. We continue to ask who should be held accountable. Was it the black market drug trade? Was it the synthetic opioids coming from overseas? How did it get this bad?
Just this past week 60 Minutes and The Washington Post joined forces to interview Joe Rannazzisi, who is said to be the most important whistleblower ever on 60 Minutes.
Joe Rannazzisi is a former agent of the Drug Enforcement Administration (DEA) who ran the Office of Diversion Control; the department in charge of regulating and investigating the pharmaceutical industry. He is a former DEA deputy assistant administrator with a law degree, and a pharmacy degree, who believes the great injustice done to the American people cannot go overlooked.
Bad Business with Big Pharma
Through this inside look with Rannazzisi, he implicates Big Pharma drug makers in willingly distributed hundreds of millions of drugs to rogue pharmacies and pain-clinics-turned-pill-mills for over two decades.
Rannazzisi believes that the Big Pharma companies, some even multi-billion, Fortune 500 companies, have contributed to the problem by ignoring the truth; that powerful prescription pain medications were being diverted from doctors, clinics and pharmacies for illicit use. In the interview, Rannazzisi calls out a number of key drug makers, including:
He also calls out the three largest drug distributors:
- Cardinal Health
Saying they control probably 85%- 90% of drugs “going downstream.”
In fact, Rannazzisi said the way pain clinics seemed to pop up overnight all over the country made the whole crack-cocaine epidemic look like nothing, saying he had never seen anything like it, adding:
“These weren’t kids slinging crack on the corner. These were professionals who were doing it. They were just drug dealers in lab coats.”
Rannazzisi says after prosecuting pain doctors and pharmacists didn’t seem to put a real dent in the problem, he knew he had to work his way up; they went after distributors.
While drug distributors tried to defend themselves saying it was all on the doctors for over-prescribing medications, Rannazzisi says they know exactly how many pills are being sent out. Under the Controlled Substances Act, these distributors are required by law to report and stop what the DEA refers to as “suspicious orders”.
So what might “suspicious orders” look like? Probably something lie unusually large and/or frequent shipments of opioids being made to a location. Kind of like what was happening all over the nation for years and years.
For example, just one pharmacy in Kermit, West Virginia ordered 9 million hydrocodone pills in just over 2 years. That’s for a town of only 392 people. That’s over 11,479 pills a person each year! Almost 1,000 pills a month! From only one of the town’s pharmacies.
DEA investigators say many drug distributors ignored the DEA requirements and shipped anyway.
DEA Fighting Back
Rannazzisi wasn’t the only DEA agent to speak up about Big Pharma’s bad business. Several other DEA veterans say they saw thousands of suspicious orders and tried to fight the growing problem. Others said they tried on multiple occasions to get these companies to fix the issue, but they did nothing.
Eventually, in 2008 the DEA was able to hit some distributors with hefty fines for filing hundreds of suspicious orders, including:
- $13.2 million fine against the country’s largest drug distributor, McKesson
- $34 million fine against second-largest distributor, Cardinal Health
The fines for drug distributors over the last 7 years add up to around $341 million.
The High Rollers
In 2011, Cardinal Health attorneys called Rannazzisi’s boss at the Justice Department, who called Rannazzisi and pressed for an explanation for his policies. Rannazzisi believes that even after they had gone after small companies hundreds of times before, as soon as they went after the Fortune 500 drug makers, their power and influence started getting in his way.
Rannazzisi says that with these massive Big Pharma empires there was now money and influence being used to pressure top lawyers at the DEA to pursue a softer approach on penalizing drug distributors who broke the rules.
Former DEA attorney Jonathan Novak noticed that shocking shift in the way these kinds of cases were handled. Stating:
“These were not cases where it was black — where it was grey… These were cases where the evidence was crystal clear that there was wrongdoing going on.”
But suddenly the higher ups started to demand more and more evidence to stall the system. Fewer cases against Big Pharma companies were being approved, and road-blocks from Novak’s bosses seemed to pop up everywhere.
Novak also said he saw a huge migration of DEA lawyers switching sides to defend the drug industry in higher paying positions.
Taking it to Congress
While drug distributors started successfully stalling the progress of cases against them from the DEA, they also began to lobby Congress to get legislation that would destroy the DEA’s power over them.
Then one day Pennsylvania Congressman Tom Marino and Congresswoman Marsha Blackburn of Tennessee introduced a bill to the House that was promoted as a way to ensure that patients had access to the pain medication they needed. However, Jonathan Novak, who worked in the DEA’s legal office, claims that what the bill really did was strip the agency of its ability to immediately freeze suspicious shipments of prescription narcotics to keep drugs off U.S. streets.
The bill’s author… Linden Barber, a former employee of the DEA.
Congressman Tom Marino, along with Congresswoman Blackburn, later wrote the inspector general for the Justice Department, demanding that Rannazzisi be investigated for trying to quote “intimidate the United States Congress.” Even though this went nowhere, Rannazzisi was stripped of his responsibilities soon after.
Some former DEA agents believe that the Big Pharma industry not only used lobbying groups to donate money to politicians to get laws passed in their favor, but also to try and push Joe Rannazzisi out of his office.
In the end, the DEA signed off on the final version of the “Marino bill.” A senior DEA representative claiming that even though they fought to stop it, growing pressure from Congress and industry lobbyists forced them into a deal it did not want.
The bill was presented to the Senate in March of 2016.
Majority Leader Mitch McConnell introduced the legislation in the Senate.
It passed by unanimous consent with no objections and no recorded votes.
It passed the House the same way, and President Obama signed it into law.
Where Are We Now?
This whole thing reminds you of the saying- if you can’t beat em, join em.
It would seem that’s exactly what a lot of DEA agents did after fighting a losing battle against powerful Big Pharma companies.
Since it all began, the pharmaceutical industry and law firms that represent them have hired at least 46 investigators, attorneys, and supervisors from the DEA, including 32 directly from the division that regulates the drug industry.
Remember that guy Linden Barber, who authored the bill that many say stripped the DEA of the power to go after Big Pharma companies? Well 3 months ago Cardinal Health, that second-largest drug distributor we were talking about that went after Rannazzisi through his boss, hired Linden Barber as the senior vice president!
Other former DEA agents and lawyers have gone on to take up so pretty prestigious positions working for drug companies, or law firms and other organizations working in the pharmaceutical industries best interest.
Joe Rannazzisi now consults with state attorneys general who have filed suit against distributors for their role in the opioid crisis.
Oh… and let us not forget Congressman Marino, who was just nominated to become President Trump’s new drug czar.
Remarkably, there are a lot of instances of people in the DEA being influenced by pharmaceutical companies and lobbyists to stand up for drug companies instead of the tens-of-thousands of Americans dying from opioids each year. In many of these instances, the individual’s go on to get high-earning jobs defending the interests of the Big Pharma industry.
So is it a made-up conspiracy? Or are pharmaceutical companies buying their way out of trouble at every turn and pushing out people like Rannazzisi who stand up to them? Is it really that hard to believe when you connect the dots?
With an ongoing opioid epidemic doing major damage to the country, we have to acknowledge everything that has contributed to this issue. Even if we set aside the idea of placing blame, we cannot prevent it from getting worse or happening again if we don’t acknowledge what helped cause it. Every drug company, policy maker, pharmacy, crooked doctor and individual should be accountable to taking action to make things better. It starts with accepting the issue and building a foundation to recover. If you or someone you love is struggling, please call toll-free now. We want to help.
CALL NOW 1-800-951-6135
While the entire country has been impacted by this ongoing issue, more options for prevention and treatment have become paramount to changing the tides. Just this week Rick Scott, the governor of the state of Florida, proposed a strategy for fighting the opioid epidemic that has gained a lot of attention. Scott has decided to ask local lawmakers to impose a three-day limit on opioid prescriptions during the upcoming legislative session. This latest development is one new piece of recent initiatives to combat the opioid crisis.
Florida Governor Opioid Initiatives
During two press conferences on Tuesday, the Florida Governor announced a pushback on an abundance of opioid prescriptions, while also introducing other ideas for fighting addiction.
One of the initiatives Rick Scott is pushing is to require all health-care professionals who prescribe controlled substances to participate in the Florida Prescription Drug Monitoring Program, also known as the PDMP. This database involves health-care professionals to report important information on patients receiving powerful narcotic medications, including:
- Name of the doctor
- Patient name
- Prescription information after the prescription is filled
But this is not the last of Florida Governor Scott’s opioid initiatives. His office also plans to seek additional reforms such as:
- Fight unlicensed pain management clinics
- Requiring education on responsible opioid prescribing
- Creating more opportunities for federal grants
Scott apparently plans to put some more investments toward helping those already struggling. He is also pushing for more than $50 million for services including:
Part of this initiative is also boosting up the budget of the Florida Violent Crime and Drug Control Council.
At the moment the finer details of the Florida Governor’s proposals are not yet available. However, what it does tell us is that Scott is not ignoring the contribution Big Pharma makes in this current crisis. What we can tell from this outline is that Rick Scott says he is aiming to address prescription opioid pain medication, recognizing it as a key source of the growing problem.
Why 3 Days?
It has been reported time and time again that we should be paying attention to how powerful opioid medications impact rising addiction rates. Now the Centers for Disease Control and Prevention (CDC) has released a recent study showing how quickly someone could get hooked on these kinds of drugs. In this study it is shown:
- After three days of use, about 6% of patients were still using opioids a year later.
- Five days into use, about 10% of patients were still using opioids a year later.
- After 11 days of use, it jumps to 25% of patients still taking opioids a year later.
So it would seem that between 3-5 days, the chances of continued use almost doubled. Then between 5-11 days the chances of use more than doubled. This development may have helped inspire the idea to limit prescriptions to 3 days.
Back in March, Bradley Martin of the CDC, one of the study authors, told Vox magazine:
“There’s nothing magical about five days versus six days, but with each day your risk of dependency increases fairly dramatically,”
So while day 5 and day 6 may not be a dramatic leap over the edge, some may see this proposed limit as an attempt to at least slow a process down.
The Opposing Argument
The Florida Governor will probably face strong criticism, or at least skepticism, from crowds such as:
The opposition is still very real. This isn’t even the first time Florida lawmakers have seen something like this brought to the table. Just last year Florida legislatures quietly rejected an effort last year to impose a five-day cap on opioid prescriptions for acute pain.
Legislatures and doctors are the only concerns Florida Governor may have to tangle with in order to push this idea through. Other potential obstacles standing against this proposal include:
- Additional out-of-pocket co-pays that patients will incur
- The ability of patients with chronic pain and terminal illnesses to refill prescriptions
The Florida Society of Interventional Pain Physicians will discuss caps on prescriptions during a board meeting today. Dr. Sanford Silverman is a past president of the Florida Society of Interventional Pain Physicians. In regards to the 3 day limit he stated:
“We don’t think the cap is reasonable since it is a completely arbitrary number,”
“A better idea would be to mandate usage of the PDMP prior to writing an opioid for acute pain.”
Other states have created caps on prescriptions, although some may not seem as strict as the 3 day rule.
- Massachusetts limits the supply to seven days.
- New Jersey set it so that first-time prescriptions for acute pain cannot exceed a five-day supply. Also, patients being treated for cancer or under hospice care are exempt.
- Ohio caps distinguish between patients with chronic pain and those with acute pain.
At the end of the day, similar strategies may not be left up to the lawmakers. If pharmacies decide to impose their own limits on certain prescription drugs the Florida Governor might not have to push very hard to get the limits he is looking for.
CVS announced Friday that the company plans to:
- Limit the daily dosage of pain pills based on their strength
- Require the use of quick-release painkillers before extended-release opioids are dispensed
- Limit opioid prescriptions to seven days for certain conditions
This restriction will specifically apply to patients who are new to pain therapy.
Only time will tell how far Florida Governor Rick Scott’s new pitch will go, but it seems one thing people can agree on is that the opioid crisis does require some new approaches to prevention.
With more prevention we may be able to slow down the rising rates of opioid addiction. Meanwhile, the need for safe and effective treatment still means a lot for helping those already suffering. Real treatment resources matter. If you or someone you love is struggling, please call toll-free now. We want to help.
CALL NOW 1-800-951-6135
Author: Shernide Delva
These are just a few of the incentives doctors have received from prescription opioid companies. Did these goodies get you your last opioid prescription?
Could incentives be responsible for our current opioid epidemic?
That’s exactly what researchers set out to understand.
A recent report confirmed what many have suspected: doctors are receiving incentives from major opioid makers. In fact, one out of every 12 U.S doctors gets money, lunch or something else of value from companies that make opioid drugs, the study concluded.
Furthermore, companies are spending more time and effort marketing opioids to doctors than they are other less addictive painkillers. These finding will help understand why doctors have played such a major role in the opioid addiction crisis.
“A large proportion of physicians received payments — one in 12 physicians overall,” said Dr. Scott Hadland of the Boston Medical Center. “Tens of millions of dollars were transferred for marketing purposes for opioids.”
Dr. Hadland and colleagues went through databases from the Centers for Medicare and Medicaid Services, the federal government office that oversees public health insurance.
The 2010 Affordable Care Act includes the Physicians Payments Sunshine Act. This act required medical product makers to report any offerings or goodies made to doctors or to teaching hospitals. However, incentives are often disguised as something else.
“In some cases, they are money provided directly to physicians — for example, the speaking fees, the consultant fees and the honoraria. In other cases it is reimbursement for things like travel,” Hadland said.
On average, doctors get a single “payment,” usually a mean worth of $15 about once a year. Still, there are a select few doctors that are reaping the most benefits.
“The top 1 percent of physicians (681 of them) received 82.5 percent of total payments in dollars,” the team wrote in their report, published in the American Journal of Public Health.
These incentives could influence doctors to prescribe opioids to their patients:
“One of the main drivers of the epidemic has been the vast overprescribing of prescription pain medications,” the study notes.
Between 2013 and 2015, the team found 375,266 payments totaling 26 million distributed to more than 68,000 doctors.
While larger fees mostly accounted for speaker fees, more leisurely incentives like food and drink accounted for 94 percent of the payments.
“I do think the practice is exceedingly common. Increasingly, medical schools are restricting the ability of pharma companies to come to speak to medical students and even faculty,” Hadland said.
With all this said, do small incentives really make a difference? After all, can a doctor really be bought for the price of a boxed lunch?
The research indicates that, yes, these little goodies do influence prescribing. Last year, a study revealed that physicians who accepted even one meal by a drug company were more likely to prescribe a name-brand drug to patients later.
This is not the first time investigations were conducted on possible incentives. After earlier controversies and studies, the Pharmaceutical Research and Manufacturers of America issued a voluntary code of conduct to curb the once widespread practice of handing out free mugs, prescription pads, and other swag covered in drug brand names.
Some cities and states especially hit by the opioid abuse epidemic have even sued drug makers saying their practices have helped fuel the problem. The CDC states doctors have contributed to the addiction crisis by prescribing opioids to too many patients. These prescriptions are often prescribed at high doses for too long which only increases the vulnerability to addiction.
The result is deadly.
There were more than 30,000 fatalities in the United States in 2015, the federal government said.
“I think that first and foremost we have known that one of the main drivers of the epidemic has been the vast overprescribing of prescription pain medications,” said Michael Botticelli, former director of the White House Office of National Drug Control Policy, and now executive director of the Grayken Center for Addiction Medicine at the Boston Medical Center.
According to Botticelli, the answer is independent education, free of the need to promote a specific product.
“At the federal and state level (we may need to) move toward mandatory prescriber education to counteract industry’s influence over prescribing behavior,” he said. “Clearly, guidelines are not enough.”
For a long time, prescribing opioids was one of the first responses to pain management. Now other alternatives are being promoted such as pain management devices and holistic alternatives.
Botticelli agrees that while pain is a major problem, the answer is not more opioids.
“Yes, we want to make sure people’s pain is appropriately treated, but we know that longer and higher doses have significantly added to the addiction problem that we have in the United States,” he continued.
What are your thoughts? Did you know about these incentives? More studies are coming out revealing the back story to what led to the prescription opioid epidemic.
Opioid addiction has become a public health crisis. Now, more than ever is the time to seek treatment. Recovery is possible. You do not have to feel out of control. There is a solution. If you are struggling with substance abuse, call now. Do not wait.
CALL NOW 1-800-951-6135