Purdue Pharma files for bankruptcy with $10B plan to settle claims

I can't recall the story exactly but there was a doctor who spoke out against a popular medication. He found that it increased a chance of a heart attack I believe by over 50%. They released a small study in a journal and his existence became a living hell. Eventually, the knowledge became main stream.

I for example had a serious reaction to cipro, left me with chronic pain. This reaction is starting to become common knowledge, yet I have found a single doctor willing to put down possible side effects of cipro in my chart. People have been reporting these side effects to FDA for 15+ years, it is affecting many people but symptoms take up to 12 months to surface and doctors don't want to accept it. I have talked to number of people diagnosed with fibromyalgia for example that later realized they took cipro for UTI right before symptoms began. Plus, the FDA has been making the label more severe almost every year. The European organization EMA suggested doctors use these medication only in life threatening infections.

Legally selling the drug is orthogonal from morally/ethically dealing with the consequences of the drug, including regulating how it is sold, how it is marketed, how it deals with its own consequences.

1. Overprescription, in the US, there were 240 million opioid prescriptions in the US in 2015, enough for one for every adult in the general population.[1]

2. Poor mental health treatment, "in the United States, 18.7% of all patients with mental health conditions receive 51.4% of the total opioid prescriptions distributed each year, meaning that having a mental health disorder was associated with a two-fold greater use of prescription opioids"[1]

3. Greater availability + lower cost and higher purity of opioids sold by criminal orsg. Mexican criminal orgs have been pushing much greater amounts of opioids in the last ten years, probably due to profits from marijuana being undercut. Prescription drug OD deaths have actually decreased as people switch from controlled substances to heroin/other opiates.[2]

4. Lack of access to effective treatment procedures. The US is woefully inadequate in this regard. "n the United States and Canada, rehabilitation programmes are still mainly abstinence based (Annan et al., 2017[75]). More specifically, in the United States only 8-9% of all substance treatment facilities between 2006 and 2016 had MAT programmes certified by SAMHSA...This happens despite evidence showing that opioid users who are treated only with psychological support are at twice greater overdose death risk than those who receive opioid agonist pharmacotherapy (Pierce et al., 2016[77])"

5. Stigmatization causing addicts not to seek treatment. "Research indicates that stigma contributes to individuals poor mental and physical health, non‐completion of substance use treatment, delayed recovery and reintegration processes, and increased involvement in risky behaviour (e.g. needle sharing)"

OxyContin is a controlled substance, so it's not actually legal. Here is an excerpt from an OECD publication on the opioid crisis on a specific case of decriminalization of opioids:

In 2001, Portugal decriminalised the possession and consumption of all narcotics and psychotropic substances for personal use, intended as the quantity required for an average individual consumption during a period of ten days. Exceeding this quantity, criminal procedures apply. Portugal’s decriminalisation reform has been particularly influential, since by introducing a de jure decriminalisation (changes in the law instead of changes in the daily practice), it has been a pioneer of the explicit decriminalisation of all drugs. Some of the main benefits of decriminalisation mentioned by Portuguese authorities can be summarised as follows:

Changes in the mind-set of the general population, contributing to consider drug use disorders as a medical condition rather than a criminal offence.

Creation of supplementary entrance doors to the public health system, particularly, through the Commissions for the Dissuasion of Drug Dependence.

Coherence enhancement between the health and judicial systems, markedly, to provide and expand access to public health interventions.

...

The decriminalisation of drugs is controversial in nature. However, empirical evidence shows that following decriminalization, Portugal has not witnessed major increases in drug use, but has experienced reductions in problematic use, drug-related harms (e.g. HIV-AIDS, hepatitis, overdose deaths) and criminal justice overcrowding (EMCDDA, 2018[223]; Hughes and Stevens, 2010[224]; Greenwald, 2009[225]). In addition, decriminalisation seems to have caused no harm through lower illicit drugs prices, which would lead to higher drug usage and dependence (Félix and Portugal, 2017[226]).[1]

I recommend checking out the sources I've linked, there's a lot of interesting information in them.

1. https://www.oecd-ilibrary.org/social-issues-migration-health...

2. https://www.overdosefreepa.pitt.edu/wp-content/uploads/2017/...

Opioids are addictive and become less effective over time. Opioids can also be a valuable tool for relief of severe pain over a short to moderate period. The actual issue is not the drug in this case it’s a drug company pushing for more scales.

PS: I have seen a friend become addicted while in cancer treatment. But, I have also been prescribed opioids after major surgery. So yes they are clearly extremely dangerous, but they can treat levels of pain that are difficult to describe.