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“Empire of Pain”
Aug. 26th, 2022 01:02 amI read Patrick Radden Keefe’s Empire of Pain for the No Strings Attached Book Club meeting ten days ago. The book certainly makes the Sacklers, the family behind Purdue Pharma, the manufacturer of OxyContin, look like an ethically challenged bunch, and details the efforts of Purdue’s drug reps to get physicians to stop worrying about addiction, and prescribe more opiates. And yet, there is another side to it. I remember one of my long distance friends, an elderly lady, telling me how a friend of hers, another elderly lady, had committed suicide, because she was in chronic pain, and the DEA intimidated doctors from prescribing opioids; I commented that John Waters (the drug czar a number of years ago) had much to answer for.
Mr. Keefe does write in the Afterword to his book, “l have heard from many readers who suffer from chronic pain and worry that my investigative reporting on the misdeeds of Purdue might jeopardize their access to appropriate medication, by stigmatizing opioids and the patients who rely on these drugs to live their lives.” Just so.
On Wednesday the eighteenth, the day after the book club meeting, we heard from the president of the club about a court ruling requiring CVS, Walgreens, and Walmart to pay some Ohio counties 650 million dollars for the harm they had supposedly done by filling prescriptions for opioids. I have to wonder whether it is part of the job of a CVS pharmacist to diagnose each patient for himself, and determine that the OxyContin prescription which Dr. Smith has written for Melissa Jones is perfectly legitimate, whereas the prescription which Dr. Carpenter has written for Evan McGrath is a medical error, which the pharmacist should refuse to fill. What if Mr. McGrath then sues CVS for subjecting him to severe pain? What if Mr. McGrath substitutes black market heroin or fentanyl for the OxyContin? I point out that with the DEA pressuring doctors, and reducing the amount of legal opioids which may be manufactured and prescribed, we have seen an increase in the number of deaths from opioids, as a result of people turning to black market drugs.
And what incentive will this $650 million award have on future behavior? Drug store chains may either get out of filling opioid prescriptions in Appalachia altogether, or do so only if they can charge high prices, to cover future legal bills and possible awards for supposed damage. The Sacklers may be called callous, but one could say the same about politicians and regulators who do not concern themselves with the consequences of their anti-drug crusading.
Mr. Keefe does write in the Afterword to his book, “l have heard from many readers who suffer from chronic pain and worry that my investigative reporting on the misdeeds of Purdue might jeopardize their access to appropriate medication, by stigmatizing opioids and the patients who rely on these drugs to live their lives.” Just so.
On Wednesday the eighteenth, the day after the book club meeting, we heard from the president of the club about a court ruling requiring CVS, Walgreens, and Walmart to pay some Ohio counties 650 million dollars for the harm they had supposedly done by filling prescriptions for opioids. I have to wonder whether it is part of the job of a CVS pharmacist to diagnose each patient for himself, and determine that the OxyContin prescription which Dr. Smith has written for Melissa Jones is perfectly legitimate, whereas the prescription which Dr. Carpenter has written for Evan McGrath is a medical error, which the pharmacist should refuse to fill. What if Mr. McGrath then sues CVS for subjecting him to severe pain? What if Mr. McGrath substitutes black market heroin or fentanyl for the OxyContin? I point out that with the DEA pressuring doctors, and reducing the amount of legal opioids which may be manufactured and prescribed, we have seen an increase in the number of deaths from opioids, as a result of people turning to black market drugs.
And what incentive will this $650 million award have on future behavior? Drug store chains may either get out of filling opioid prescriptions in Appalachia altogether, or do so only if they can charge high prices, to cover future legal bills and possible awards for supposed damage. The Sacklers may be called callous, but one could say the same about politicians and regulators who do not concern themselves with the consequences of their anti-drug crusading.
