Tag Archives: opiates

Network drives increase in painkiller prescriptions

In the latest installment of his ongoing investigation for the Milwaukee Journal Sentinel and MedPage Today, John Fauber looks for the source of America’s prescription painkiller boom (graphic), outlining what he describes as “a network of pain organizations, doctors and researchers that pushed for expanded use of the drugs while taking in millions of dollars from the companies that made them.”pills-and-money

Beginning 15 years ago, the network helped create a body of dubious information that can be found in prescribing guidelines, patient literature, position statements, books and doctor education courses, all which favored drugs known as opioid analgesics.

Apparently, that network has been effective. Federal data shows that prescription painkiller sales have quadrupled in the past decade or so, Fauber found, and some of those sales may not have been warranted.

A band of doctors who get little or no money from opioid makers has begun to challenge the hype behind the drugs. They say pharmaceutical industry clout has caused doctors to go overboard in prescribing the drugs, leading to addiction, thousands of overdose deaths each year and other serious complications.

Several of the pain industry’s core beliefs about chronic pain and opioids are not supported by sound research, the Journal Sentinel/MedPage Today investigation found. Among them:

  • The risk of addiction is low in patients with prescriptions.
  • There is no unsafe maximum dose of the drugs.
  • The concept of “pseudoaddiction.”

That concept holds those who display addictive behavior, such as seeking more drugs or higher doses, may not be actual addicts – they are people who need even more opioids to treat their pain.

His investigation dips deep into each of those beliefs and how they helped push painkillers. For a case study, see this companion infographic.

Drug-funded research group failed to disclose ties to makers of painkillers

In his latest conflict of interest investigation, Milwaukee Journal Sentinel reporter John Fauber takes on a challenge that, even by his standards, is an ambitious one.

Photo by somegeekintn via Flickr.

He attempts to show the effect pharmaceutical money and the local researchers who received it had on national opinions toward powerful prescription painkillers and how it all influenced the American epidemic of opiate abuse.

He focuses on the University of Wisconsin Pain and Policy Studies Group, which has received millions from painkiller manufacturers while publishing drug-friendly research and warning against increased regulation of OxyContin and its ilk. Many of these millions, Fauber found, appear not to have been disclosed in relevant publications even as the group was paving the way for the rapid rise of painkiller prescriptions in America.

The drugs had initially been approved for a very narrow range of uses, but became extremely popular as off-label use for the management of chronic pain spread like wildfire. It’s not easy to draw clean lines between the Wisconsin group and off-label use, but Fauber’s deft investigative work and careful sourcing make a strong case.


Read more of Fauber’s work

Florida pill mills spread, resist prosecution

With South Florida beginning to crack down, the pain pill mills that fuel the Appalachian drug trade are moving northward. Kate Howard and Paul Pinkham of the Florida Times-Union report that the trade, which has ravaged Appalachia for a decade and exploded in recent years, has hit Jacksonville with a vengeance. There are more than 50 pain clinics in the area, and they even tell stories of 20-something clinic owners and physicians driving sports cars and intimidating each other in competition for the lucrative out-of-state trade. Florida’s first statewide steps to combat the trade haven’t yet taken hold, the duo writes.

After years of trying, Florida became the 39th state to pass a prescription monitoring bill last year, but it wasn’t funded. Amid lingering questions about its potential effectiveness, the database was slated to launch in December with $500,000 raised through grants and private funding, but is now on hold because of a bid dispute.

Even if Florida does succeed in stopping the pill mills, there are fears that tough legislation will just push the problem into neighboring (and less regulated) Georgia.

Why is it so hard to crack down on pill mills?

Across the state, Letitia Stein and Susan Taylor Martin of the St. Petersburg Times explore what makes it so impossible to shut down the handful of rogue doctors who can each put thousands of pills a day into the hands of abusers. In some ways, it’s similar to other disciplined doctors stories we’ve been seeing lately, as it carefully details the administrative wasteland that stands between local doctors and actual punishment for their actions. Cases languish for an average of 18 months, there is not always consistent communication between enforcement agencies, and disciplinary board members say they don’t have the legal power to search for problem doctors.

“The biggest problem is. we can’t discipline anybody unless a complaint is filed,” said Rosenberg, a West Palm Beach dermatologist on the Board of Medicine. “And drug addicts aren’t about to complain about their drug dealer.”

Stein and Martin looked at about 200 Florida doctors who had been disciplined or investigated for inappropriately prescribing pain pills in the past five years, and found that more than a quarter still have active licenses. Most of them are experienced doctors with specialty certifications, and some practice despite being convicted of crimes or linked to fatal overdoses.

And Florida’s new legislative crackdown on pill mills? The reporters say it specifically targets pain clinics, yet rogue physicians often operate out of other settings.

(Hat tip to Carol Gentry of Health News Florida)

How prescription drugs dethroned heroin in Seattle

Heather Bosch, of Seattle radio station KIRO, dedicated a five-part series to explaining why “Prescription drugs – used incorrectly – are killing more people in King County than all other illegal drugs, combined.”

It’s the latest in a string of prescription drug localizations; one which distinguishes itself with an emphasis on the move from heroin to prescription pills.

In part one, Bosch explains how prescription opiates overcame their illicit cousin, heroin, to become the drug of choice in the Seattle area. In part three, she talks to a recovering opiate addict about the toll the pills took on his life and psyche. And in part four, Bosch looks into how ready access has made it easier for teens to become addicted to prescription drugs.