Purdue Pharma “Fights Opioid Epidemic” – Too Little, Too Late?

Perdue pharma

Purdue Pharma is one of the largest opioid makers in the country and the subject of countless lawsuits in the past few years. They’ve received scrutiny over their choices to market and push Oxycontin on the doctors, and in February, they promised to stop actively marketing the drug. Now, this opioid maker is making efforts to help the people that are now addicted to their drugs. But is it just another PR campaign to mitigate the company’s bad reputation?


Critics say that all of this is “too little, too late.” Thousands have died from what even lawmakers say are irresponsible and maybe even illegal practices to push the drug. However, the dire consequences of opioid addiction make it so many localities can’t discriminate between funds. For many people addicted to opioids across the US, there simply isn’t enough help available. The federal government’s Opioid Commission is considered pretty much a “bust”, with lots of recommendations and few monetary resources to implement them. Many states are spending too much money simply on saving lives with tools such as the opioid-antagonist Naloxone. Budgets are tight in areas where the most vulnerable are finding addiction pervasive.


What Purdue Has Done to Help Fight Addiction


·      Purdue has partnered with the National Sheriffs’ Association to give free naloxone overdose-antidote kits and training to front-line officers. Total, the second phase of this program will allow total funding of the program up to $850,000 since its inception. 


·      They have funded pill disposal boxes in pharmacies, clinics and police stations in various states, including North Caroline.


·      They have run a radio campaign in Connecticut warning of the dangers of opioid abuse.


·      Lawsuits they have lost have inadvertently funded treatment for addiction in places like West Virginia, where the opioid epidemic is still raging. (This is inadvertant funding, but the settlements for lawsuits still help cities and states.)


Why People Aren’t Buying it


·      OxyContin sales dropped in recent years, from $2.8 billion in 2012 to $1.7 billion in 2017, with many competitive drugs on the market, especially generic drugs.


·      Purdue almost exclusively sells and manufactures various opioid drugs. They have only promised to quit marketing Oxycontin.


·      Alongside running ads warning about opioid abuse, they also have been marketing a new medicine to treat opioid-induced constipation, which is just another drug in their line of products.


·      In 2007, Purdue Pharma pleaded guilty in federal court to misleading doctors and patients about OxyContin’s risk of addiction and potential for abuse. They agreed to pay $600 million in fines, but did not stop marketing the drug until there was a nationwide outcry as the opioid crisis progressed.


·      The company press releases never use the words “addicted” or “addictive” in any statements or literature, preferring to use the words “use” and “abuse”, which minimizes the opioid crisis.



Purdue is far from the only bad actor in the addiction crisis, but they are certainly the most well-known and litigated against. There are lawsuits on the state level, county level, and city level across the country. Most recently, last week, Greenville County, South Carolina filed suit against several opioid manufacturers, including Perdue. The lawsuit accuses pharmaceutical manufacturers and distributors of participating in a “scheme to change prescriber habits and public perception.”


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Dr. Phil’s Addicted Guests Allegedly Exploited

Dr. Phil at the 1st Annual Merv Griffen/Beverly Hills Country Club Celebrity Tennis Classic to benefit ChildHelp USA, Beverly Hills Country Club, Beverly Hills, CA 09-21-02

Dr. Phil at the 1st Annual Merv Griffen/Beverly Hills Country Club Celebrity Tennis Classic to benefit ChildHelp USA, Beverly Hills Country Club, Beverly Hills, CA 09-21-02 via Yayimages.com

A little over a week ago, revelations that Dr. Phil exploited people with addiction disorders made its way all over the news, shocking addiction recovery advocates and dismaying many of the treatment centers and interventionists he frequently works with when staging interventions.

Several guests appearing on Phil McGraw’s talk show told of temptation in their green rooms, and drug offerings such as pills that “calm nerves,” casting doubt on his good intentions.

Guests that have appeared on his show are often left without a support system in place as they wait for their turn on the recorded show. For some, this means they are required to “detox” alone in a hotel room, without medical intervention, for up to 48 hours. By the time they arrive at the studio, many of them are physically and emotionally exhausted.

Experts say that this is because the show has partnerships with treatment centers in other states, who are not licensed to provide assistance in the state where Dr. Phil’s show is taped for television.

People coming to get help on the show don’t expect to find alcohol in their “green room” when they arrive, but, of course, it happens. In fact, one guest with an opioid use disorder described bringing his heroin, with the consent of Dr. Phil’s staff, according to a family member who spoke with reporters.

Another guest, who became a “frequent flyer” through Dr. Phil’s show, described how he compulsively downed a bottle of liquor once he landed comfortably in the green room. (The room came equipped with more than just a mini-bar, there were bottles of several favorite liquors for those who liked to drink.) Unfortunately, for this particular guest, alcohol was his drug of choice. He got wasted and later told friends and family he didn’t remember anything about the show itself.

The Real Issue is Addiction Treatment Access

For many people, desperation is what drove them to Dr. Phil’s shows in the first place. They were promised free drug treatment (if they agreed to go) at some of the most reputable (and expensive) treatment centers in the US.

One man with an alcohol use disorder went on the show three times– knowing that he would suffer from humiliation but also knowing that he just couldn’t afford treatment at all.

Addiction treatment centers are woefully underfunded, and there are few beds for people who don’t have the money or insurance to help pay. Funding is such an essential issue for addiction treatment advocates to continue to pursue in 2018 and beyond.

Dr. Phil’s show is just a symptom of what goes on when the government fails to address a public health crisis like the current opioid addiction crisis. Address the problem at the roots, and branches like the exploitation on television shows will fail to grow.

Treatment — especially quality, evidence-based addiction medicine is not accessible for many people, especially those who are vulnerable and come from the middle to lower-class households. Television has always proven itself to be a platform willing to exploit

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Sublocade, New Med FDA-Approved for Opioid Abuse Disorder

Subclocade once a month

Last week, the FDA announced approval of a once-a-month drug, Sublocade, for individuals with an opioid use disorder who need drug-assisted treatment to get and stay clean.

For people suffering from the opiate-related disorders, there are just a few options for drug-related therapy to help them reduce cravings and stay clean. Suboxone and methadone have been the most available forms, but each has its drawbacks, including the fact that methadone is regulated in a way that means it must usually be dispensed just a dosage at a time. Missing a dosage can cause awful withdrawal symptoms and cravings. Even something as simple as inclement weather such as snow can make it difficult for drug treatment clients to get the medication they need.

Suboxone has become popular because it has fewer drawbacks, with one of the main complaints being that a person prescribed the pill must be consistent with its dosage, taking it once a day, at the same time every day. This is why Sublocade, just approved by the FDA last week, offers hope to some addiction recovery professionals. It can help fill a treatment void for those who need it.


Why a Monthly Injection to Combat Addiction Cravings?


While not seen as a perfect drug, Sublocade can function as a new tool in the box for addiction professionals and medical providers to fight addiction. Patients with substance abuse disorders – as well as mental health disorders – may have difficulty with medication compliance for a number of reasons. People may think that they are “cured” or simply be too “busy” or overwhelmed in life to remember to take their pills like clockwork. And while it often goes unmentioned, this can lead to relapse when cravings set in.

Suboxone is a prescribed medicine that when used as directed can block early, mild withdrawal symptoms while blocking opiate receptors, which relieves painful opiate withdrawal symptoms. When a person misses a dose, however, they may get “sick” and experience immediate withdrawal symptoms. Some people don’t experience these symptoms immediately, but for others, the symptoms may be severe.

Sublocade is the first once-monthly injectable buprenorphine product for the treatment of moderate-to-severe opioid use disorder (OUD) in adult patients. Prior to using the monthly dosage, the patient must have been on the regular Suboxone drug for 7 days without any ill effects.

Medication-assisted treatment does its job, but as the FDA has warned, it is most effective when used with other treatment modes, such as therapy and 12-step programs.

Daily Suboxone treatment, also known as buprenorphine, is usually taken as a tablet or film that dissolves in the mouth. It is also available as an implant under the brand name Probuphine.


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Insurance Giant Cigna to Halt Coverage for Oxycontin

Cigna health insurance, the fourth largest insurer in the US company with over 11,400,000 members, has taken what is seen as a drastic step in the fight against opioid addiction. Effective in January, the insurance giant will effectively stop covering the cost of use of the opioid OxyContin.

While many in the addiction treatment profession have lauded this change, it’s important to look more carefully at what’s really going on. At the same time that Cigna announced they would no longer be providing coverage for Oxycontin, the company also announced a contract to continue covering a competing oxycodone alternative by the name of Xtampza ER. The contract includes a financial penalty on that drug’s maker if Cigna discovers the drug is overprescribed or there are other patterns indicating the drug has become a drug of abuse. Because of this stipulation, the manufacturer also has more motivation to monitor sales and look for areas of abuse and high prescription rates.

Cigna’s announcement comes just a year after the insurer said it intended to cut opioid use among its customers by 25% by 2019. Out of 33,000 opioid-related deaths in 2015, nearly half are attributed to Oxycontin or similar formularies, according to the CDC. (The remaining are attributed to heroin or to fentanyl, a synthetic opioid)

OxyContin is the only opioid-based prescription painkiller that Cigna is removing in 2018 from its formulary. (A formulary is the list of medications that an insurer will cover for its members.) Cigna will review individual prescriptions for OxyContin on a case-by-case basis, but people with terminal diseases will be able to continue taking it.

Will Cigna’s Actions Reduce Opiate Abuse?

So while this announcement sounds like a big move in taking drugs off the market, it appears to be more of a punishment for the manufacturers. A spokesman for Purdue Pharma, the Connecticut company that makes OxyContin, says that the drugs are pretty much the same in makeup, although Jon Maesner, Cigna’s chief pharmacy officer, insists that the insurer is “not specifically singling out Oxycontin.”

However, it appears trust is a central issue. “We found a strong sense of commitment” to reducing opioid overuse from Collegium Pharmaceuticals, the maker of the oxycodone drug that Cigna plans to cover instead. Purdue Pharma is currently facing dozens of lawsuits from cities, counties, and states across the US, all of them alleging that the drug makers cared more about profits and misled users and doctors about their addictive nature.

The contract with a new manufacturer helps create a relationship that makes drug makers more accountable to others involved in pain medicine. This is a great beginning for insurers who want to protect their patients.

However, there are literally dozens of other opioid and opiate drugs on the market, and many of them have yet to answer for their own part in creating the addiction epidemic. Until all of the “shady” pharma companies are held to account, there will be more pills mills and rampant addiction waiting in the shadows of this under-regulated industry.


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Addiction Treatment Under AHCA

Five hundred thousand Americans have died from opioid addiction in the last 15 years According the U.S. Centers for Disease Control and Prevention (CDC). The amount of deaths is four times that of the previous fifteen years. This an American crisis of addiction to opioids and the problem is only getting worse.  Because of this increase in use of opioids the issue has made it’s way into the forefront of American policy.

Financial Dilemma

Meanwhile, with the growing number of addicts, the availability of resources for recovery become less attainable and more costly. This creates a new financial dilemma that is hanging over the heads of the addicts in our communities and puts  pressure onto the policy makers in government.

Lack of Coverage

The severity of these issues then brings into question the Trump Era’s health care policies and his team’s ability to confront this epidemic. The forecast is grim considering this new administration’s policy towards the healthcare of Americans. There is a substantial lack of coverage for people with pre-existing conditions and many addicts will fall into this category.

Losing Obamacare

The new policy has yet to be made into law as it still needs senate approval. Addicts most likely will fall under pre-existing condition clauses and will not be afforded the addiction recovery resources as was seen under Obamacare.  Treatment for this epidemic will dwindle leaving tens of thousands of American opioid dependent people untreated and the death toll will continue to go up.

Donald Trump has acknowledged America’s problem with opioids and hired New Jersey’s Governor Chris Christie to lead a commission on the opioid problem in the US.  However this appointment does very little to ease the concerns of the medical community.

How the insurers will approach the new system of healthcare is the big question. It is important to have a clear understanding of the actual monetary costs required for the the treatment of opioid addiction.

Estimated Cost for Treatment 2017

  • Methadone            $600 to $800       annually
  • Buorenorphine     $400 to $600       annually
  • Vivitrol                   $1000                     monthly
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Pros and Cons of Bunavail Approved by FDA


  •  Twice the bioavailability of Suboxone

    teen on pills then heroin

    Pills Lead to Heroin All Too Often

  •  Promising alternative to methadone
  •  Treatment includes psychiatric therapy


  • Causes respiratory issues
  • Can cause death

Bio Delivery Sciences International’s new drug application has reached the final phase of approval by the FDA. Their supplemental application (sNDA) for Bunavail can step out of the management phase for opioid addiction patients and begin the use of the drug for treatment of opioid addiction.

Bunavail has twice the bioavailability of Suboxone film, which has increased it’s marketability ten fold and and therefore an attractive alternative for bottom line of the manufactures.


Bioavailability –  the proportion of a drug or other substance that enters the circulation when introduced into the body. When a drug is injected it has 100% bioavailability. Other means of administration have less than 100% bioavailability such as oral methods.

Bunavail will be administered to patients that are just beginning recovery from opioid dependency. This is a major step in the right direction for the addicts who seek a break from dependency that may have otherwise not found relief from transitional drugs like Methadone.

The company offers a comprehensive package of recovery support through counselling and psychiatric therapy along with administering of Bunavail.  The advantages are promising for the recovering addicts  and it will be a shift in the methods used by the pharmaceutical community via the melding of medication and hands on personal analysis.

Some Drawbacks

There are still drawbacks of Bunavail, which as promising as it could be it has stirred some speculation.  It has been shown to affect respiratory function and in some cases death by overdose through the synergistic effects when combined with benzodiazepines, various tranquillizers and or alcohol.  As well withdrawal symptoms similar to that of heroin are seen with the decreasing dose.

Withdrawal issues are not unfamiliar to this family of drugs and can be controlled through proper dose. The most common of the side effects are the withdrawal symptoms in the form of headaches, fatigue and inability to sleep.  Sweating and constipation have both been noted in the studies and do raise concerns when considering the cost benefit analysis of Bunavail.

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Narcan (Naloxone) Becoming a Life Saving Option for Police to Use

While calling Narcan (the brand name for active ingredient naloxone) an “antidote” to heroin isn’t quite accurate, the reality that the drug can be dispensed via a nasal spray in order to revive a drug user who is dying of overdose certainly give the impression that it is a miracle elixir out of a movie.

Recent articles from The Greenville Sun and and the Idaho Press highlight how police officers in Tusculum (Tennessee) and Nampa (Idaho) have been trained in administering the potentially life saving concoction.

This is emblematic of the full blown health crisis that opiate addiction and overdose now represents in the United States.

The United states contains 5% of the total world population yet consumes 80% of the world’s narcotic medications. The Center for Disease Control (CDC) has gone on record as describing the opiate addiction and overdose epidemic as a “full blown health crisis.”

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New Oxy Guidelines For Kids Alarm Lawmakers, But Drs. Say They’re Needed

The Food and Drug Administration’s decision last August to officially approve use and set guidelines for the use of Oxycontin, for certain children as young as 11 has triggered a huge debate among lawmakers, health care professionals, and parents about whether or not the drug is appropriate for treating pain in people under the age of 18.

The new guidelines do not “legalize” Oxycontin, per se – prescription opiates have been prescribed for years off-label – but this is the first time there have been recommended guidelines for doctors to prescribe the powerful drug to children suffering from certain conditions that cause chronic pain.

Some elected officials, as well as candidates running for office including Hillary Clinton, have echoed sentiments of addiction specialists who say the new guidelines will encourage doctors to expand access to a drug at the center of an epidemic of opiate abuse in the U.S. that was responsible for over 24,000 overdose deaths in 2013. They say health care providers need to focus on alternative pain management rather than relying on such an addictive drug to help their young patients.

Unfortunately, many physicians and families are pleased that the FDA has chosen to provide guidelines to doctors treating children with serious, debilitating and sometimes fatal conditions. Opiates are strong painkillers that can alleviate suffering of children with terminal conditions and rare musculoskeletal disorders.

Previously, doctors have had to rely on adult dosing information when prescribing the painkiller to children off-label, which are unsuited to young, very sick kids. The new guidelines help doctors safely administer the controversial drug and prevent accidental overdoses in youngsters.

The FDA says that the intent of the guidelines is to provide safe and reliable information, not expand availability or increase the use of the drug in children. The federal agency approved the drug for treating children ages 11-17 that suffer from severe, long-term pain, such as terminal diseases like cancer or kids recovering from severe automobile accidents. Many children in this age group have already been taking an opioid painkiller to help them cope with their health problems, and the guidelines set standards and dosages for safety purposes.

In addition to giving guidelines for the prescription, the FDA is requiring the drug’s manufacturer, Purdue Pharma LP, to conduct more studies on the drug’s use in children, and to report and keep track of all adverse events connected to the drug’s use in children.

Lawmakers, however, are not convinced that the benefits of the drug’s use in minors outweighs the risk, especially in states where opiate abuse has run rampant in recent years. Some elected officials in states grappling with rampant painkiller abuse are furious. “When we make it easier for kids to get this stuff, we are sentencing ourselves to more opiate addiction and more misery for America,” Gov. Peter Shumlin of Vermont told the Wall Street Journal.


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Does Narcan Offer Opiate Users A False Sense Of Security?

At least 17 states in America, as well as first responders in the District of Columbia, have been trained to publicly administer the heroin overdose antidote called Narcan, and at least 10 states allow for prescriptions to family or friends of drug users who worry that they will lose their loved one to addiction. While the drug has saved an estimated 10,000 lives, many officials are wary of its use, saying that an increase in its availability is causing public health problems.

Officials in New Castle, Pennsylvania say the drug is giving users a false sense of, giving them the confidence to engage in more risky behavior with the belief that when they overdose, they’ll be brought back from death. While inarguably, the drug, recently approved for first responders in New Castle, saves lives. But the city has also seen its share of “repeat offenders” – drug addicts that overdose on opiates multiple times in a week, and sometimes, more than one time a day, causing concern and frustration among public officials.

Studies have shown that Narcan, if widely available, could have the public health benefit of slicing fatal heroin overdoses in half. In the United States, over 15,000 people die each year from opioid pain relievers overdoses such as Oxycontin, a rate that has grown rapidly and more than tripled since 1990.

Addiction advocates believe that the medication should be made available over-the-counter since it has little potential for abuse, and even when taken in excess, is nontoxic. Many public health agencies, including the Centers for Disease Control (CDC) and the director of the National Institute on Drug Abuse have supported making Narcan more widely available.

The Food and Drug Administration, (FDA) however, has no policy for allowing over-the-counter usage of medication approved in an injectable form, and is unlikely to approve the antidote in its current form. Experts say that a pharmaceutical company needs to develop a safer form of the drug, preferably an intranasal version, the agency isn’t likely to OK over-the-counter sales.

In many cases, the drug is a lifesaver, but the total cost of the drug is still costly to public health services. The antidote could lead to more risk-taking behavior, and, as a Catch 22, more fatal overdoses. Only about 50% of overdoses are reached in time to administer the life-saving antidote, and more often than not, paramedics in New Castle said that they had to use two and three vials of Narcan to revive people from overdoses.

“It’s like a double dog dare you. They keep pushing the limits, knowing we’ll be there to bring them back,” Butler, Pennsylvania Mayor Tom Donaldson told local news affiliate WPSI. Sadly, many addicts who overdose on opiates still won’t be reached in time for the medication to be effective.

The best way to prevent opiate overdose is to never pick up the drug, and offer treatment for the disease of addiction for those who are ready. Often it takes an extreme circumstance such as an overdose for an individual to hit bottom and admit they have problem with drugs. Once an individual recognizes they need to change, there must be accessible treatment options available in the community and a support system to guide them along the way.


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California Fights Prescription Drug Abuse

Prescription drug abuse has become a serious problem in the U.S. and California is leading the way in putting this to a stop. Most people do not realize how much of a problem prescription drug abuse has really become. Our lives are busy and
no one wants to complicate theirs by thinking about something that does not directly affect them.

Many teens abuse prescription drugs from the family medicine cabinet

A person addicted to prescription drugs did not intend to get that way. Sure, they started out following the doctor’s orders, but when the pain came back earlier or the anxiety just would not go away, it was too easy to take another pill. These people would tell themselves that it would get better tomorrow while in reality they compounded their problems by taking more pills and depending on an artificial crutch to get them through the day, the week, and even the month.

Eventually, people who abuse prescription drugs have to get more pills from their doctor or from another doctor. The situation can escalate as their body develops a tolerance for the drugs they’re abusing. California has recognized this as a vital facet of the war on prescription drugs. They have introduced new legislation to have coroners statewide report all prescription-related deaths. The intention here is to begin a paper trail that leads to the doctors who are willing to put pills in addicts’ hands.

Not all addicts get their drugs from doctors. They may purchase them from friends, steal them from family, or as is the case with teenagers who abuse prescription drugs, they may just find them in their parents’ or grandparents’ medicine cabinets.
Therefore, it is important to get rid of all prescriptions you are no longer using and to put all prescriptions that you need to use in a safe and secure place. It is also important to encourage anyone you know who show signs of this terrible problem to seek treatment.

Some addictions, such as those to painkillers, can be dangerous to quit cold turkey. Thankfully, many drug treatment centers that previously specialized in alcohol and “hard” drugs, now also treat prescription drug abuse. It is even possible to find treatment centers that will work with your health insurance provider to give you quality care.

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