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Action Against ‘Pill Mill’ Distributors is Important, But Not Enough

Against ‘Pill Mill’ Distributors

West Virginia Attorney General, Darrell McGraw, is finally taking steps that should have been forthcoming a long time ago. The office of the Attorney General has been cracking down on prescription drug distributors, 14 out-of-state drug distributors in fact. According to McGraw, West Virginians lose over $430 million every year because of prescription drug abuse in the state.

Of course prescription pain medication has a place in our society. In no way are we advocating that people should ‘live with pain’ just because there are a number of unscrupulous distributors that abuse the system. However, actions such as these should have come a lot sooner. Two small pharmacies in Kermit, West Virginia filled 3.19 million dosage units of hydrocodone prescriptions in 2006. That ranks those two small pharmacies in Kermit (a town that has less than 250 residents) as the 22nd in distributors of hydrocodone in the nation. Considering that there are only 97,000 doses filled in a year by an average pharmacy, it should have been obvious a long time ago that something was not right.

The Problem with Opioids

The problem with many of these ‘pill mills’ is the fact that they try to balance on the brink of legality and drug peddling. The question deserves to be asked; what is it that we are doing in this country? We trust our doctors to make the right decision, to present us with the type of medication that is going to provide us with the most benefits and comes with the fewest negative side effects, but are we being unrealistic when we hope for that?

For example, few people are aware of the fact that the manufacturer of the leading prescription opioid pain reliever (OxyContin), Purdue Pharma sent videos to more than 15,000 doctors as a marketing campaign. In that video, the manufacturer claimed that the drug was less subject to abuse and less addictive than other available drugs on the market. Of course, this was a blatant lie. In 2007, they agreed to pay $634.5 million in penalties for the misrepresentation of the drug. However, that fine was not enough to stop the pharmaceutical industry from promoting OxyContin and similar pain killers. In fact, instead of targeting the cancer-induced, intense short-term pain market, they went after a much larger group of potential customers – those with chronic, long-term pain.

Building the Market

Before the introduction of the aforementioned marketing video, many medical professionals were hesitant when it came to prescribing opioids for chronic pain. There was little evidence for long-term effectiveness and safety, besides people being wary of the risk of addiction. However, that changed because of more marketing by Purdue Pharma and other drug makers.

These campaigns had a single goal in mind; convince prescribers of the safety and efficacy of their products. The people and organizations that write treatment guidelines started to recommend and endorse opioids for chronic pain more and more. It should come as no surprise to anyone that the people who were writing these treatment guidelines were closely affiliated (in a financial way) to the pharmaceutical companies. It didn’t take long for more and more prescriptions for opioids to be written every day, including Percocet, Vicodin and OxyContin. Of course, the unique appeal of OxyContin was the fact that it provided a special time-released formula. This means that patients with chronic pain would only need two pills a day and it would allow them to sleep throughout the night without being woken up in pain. Those who advocated for the use of opioids at the aforementioned Purdue Pharma even went so far as to say, “Opioids don’t wear out.”