Inside Big Pharma’s Coordinated Effort to Block Opiate Reform

By Kelly Burch 09/21/16

In the past 10 years, opiate manufacturers have spent $880 million fighting tighter controls on prescription pills. 

Inside Big Pharma’s Coordinated Effort to Block Opiate Reform

Makers of prescription pills have been fighting tighter regulations with a comprehensive and well-organized lobbying effort, spending more than eight times as much money as the notorious gun lobby in order to sway votes.

Drug manufacturers spent $880 million on lobbying and campaign contributions between 2006 and 2015, according to a recent Associated Press investigation. That is 200 times the amount of money spent by organizations advocating for tighter prescription regulations.

"The opioid lobby has been doing everything it can to preserve the status quo of aggressive prescribing," said Dr. Andrew Kolodny, founder of Physicians for Responsible Opioid Prescribing. "They are reaping enormous profits from aggressive prescribing.”

Sales of opiate painkillers, which are closely tied to addiction and heroin use, have quadrupled between 1999 and 2010. Last year, 227 million opiate prescriptions were written in the U.S., which is enough to give a bottle of pills to 9 out of every 10 American adults, AP noted in its report.

At the same time, deaths from opiate overdoses have skyrocketed. Since 2000, 165,000 Americans have died from prescription opiate-related overdoses, according to the CDC.

Despite these grim statistics, drug manufacturers continue to rake in profits from the sale of opiates. Purdue Pharma, the maker of OxyContin, made $2.4 billion in profits from opiates just last year, despite the fact that company executives pled guilty to misleading marketing and paid more than $600 million in fines.

One of the most powerful organizations backed by Big Pharma is the Pain Care Forum, a network formed more than a decade ago that is not part of the public record. Analyzing records from the National Institute on Money in State Politics, AP found that the Pain Care Forum targeted state initiatives that sought to regulate prescriptions. The group spent $24 million supporting 7,100 potential state legislators between 2006 and 2015, focusing on people who control legislative agendas including governors, house speakers, senate presidents and health committee chairs.

The pharmaceutical companies also operated through trusted non-profits, including the American Cancer Society. The organization's Cancer Action Network used drug makers’ donations to fight against legislation in Tennessee aimed at reducing the number of babies born addicted to opiates.

"A lot of times those legislators, they don't have the ability to really thoroughly look into who these organizations are and who's funding them," said Edward Walker of the University of California Los Angeles.

In their fight against more regulation, prescription drug proponents argue that the drugs help improve quality of life for patients.

"There's such a hysteria going on" about those who have died from overdoses, said Barby Ingle, president of the International Pain Foundation, which receives pharmaceutical funding. "There are millions who are living a better life who are on the medications long term.”

However, research has shown that opiates are not a particularly effective means of treating pain. In one study, up to 40% of non-cancer patients on these drugs exhibited signs of addiction.

AP also found strong industry ties to the Academy of Integrative Pain Management, a group of doctors that was known until recently as the American Academy of Pain Management. Seven of the academy’s nine council members are opiate manufacturers, while the other two companies' products are also involved with opiate medications. The academy’s state advocacy project is funded entirely by money from opiate manufacturers, but Executive Director Bob Twillman said that does not sway the academy’s interests.

"We don't always do the things they want us to do," he said. "Most of the time we're saying, 'Gosh, yes, there should be some limits on opioid prescribing, reasonable limits,' but I don't think they would be in favor of that.”

Many bills in favor of regulation are advocated for by families touched by addiction, who have less political experience and money. One bill that failed was a New Mexico initiative that would have limited initial prescriptions for pills to treat acute pain to seven days, in order to reduce the likelihood of addiction and leave fewer leftover pills that could be illegally sold.

However, the bill never stood a chance against Big Pharma. "The lobbyists behind the scenes were killing it," said Bernadette Sanchez, the Democratic state senator who sponsored the measure.

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Kelly Burch writes about addiction and mental health issues, particularly as they affect families. Follow her on TwitterFacebook, and LinkedIn.