Opioid Crisis Episode 2

The podcast discusses the reasons behind the opioid crisis, including the role of doctors, drug companies, marketing, and drug cartels. Opioids are prescribed to treat pain by blocking pain receptors in the brain, but they can also lead to addiction and the need for higher doses. Illegally sold opioids primarily come from China and Mexico, while legally sold opioids are produced by Purdue Pharmaceuticals, who marketed OxyContin as less addictive. Overprescribing by doctors and the availability of leftover pills contribute to addiction. Some doctors exploit the system by setting up pill mills. Purdue Pharmaceuticals denied the harmful effects of their drug, undermining trust in doctors. The next episode will focus on who is affected by the crisis. Hi, I'm Riley Mitchell, and in this episode 2 of my podcast on the opioid crisis, we will be discussing the why of the opioid crisis. I will be examining all of the key players in the epidemic, such as doctors, drug companies, marketing and drug cartels, page management, the patient-doctor relationship, when did this shift change, and risk factors that lead people to abusing opioids, as well as overprescription. Opioids are often, or meant to, be prescribed to treat pain. As stated by Georgetown University's behavioral health website, a brief explanation on the way they work is by binding to receptors in the brain and spine that block pain. This pain blocking can result in a feeling of a quote, high. This feeling is what causes people to fall into addiction. Not only can you become addicted, but you can become accustomed to the initial amount you took the first time you took the opioid, leading for a need for a higher dose in the future. First, let's discuss where do these drugs come from when they're sold illegally. As I researched and found on Congressman from Maryland's David Trone's website, China is the primary source of these chemicals used in fentanyl. They are then brought to Mexico to be made into these synthetic opioids, which are then sold in the United States. 99% of fentanyl is coming from those precursor drugs in China, and from two major cartels, Jalisco and Sinaloa, which bring them across the border. This is why it is extremely important to try and stop the problem at its starting point. Wuhan is called the quote, fentanyl capital of the world, end quote, which is then set off an extreme rise in meth production in Mexico, raising drug prices in the United States. Fentanyl is often produced to look like pills such as Xanax, Adderall, and Oxycodone. This means many people do not even know that they are doing fentanyl when they do. Fentanyl producers in China have begun to try and find new ways to escape protocols made in the United States. One major way being modifying their products so it does not technically live on the U.S. control list. Now, where do these products come from when sold technically legally? Using the National Library of Medicine's website, one of the largest factors in the modern opioid crisis is Purdue Pharmaceuticals. Purdue is one of the largest drug companies in the world, and they manufacture OxyContin, a version of Oxycodone. Developed by the FDA in 1995, Purdue launched this drug with heavy, positive, and intense marketing strategies, even though it actually went through much less testing than other drugs they had sold in the past. This marketing campaign they used got an added warning from the FDA to warn for misleading facts in 2003 because it was being advertised as a less addictive pill, which led doctors to think they could prescribe it without harm. The Joint Commission even published this, quote, some clinicians have inaccurate and exaggerated concerns about addiction, tolerance, and risk of death. This attitude prevails despite the fact that there is no evidence that addiction is a significant issue when persons are given opioids for pain control, end quote. This statement was sponsored by Purdue. This is completely denying any of the known and proven facts or potential harms of any drug that are always present. This increased addiction rates and lessened worry. The marketing used towards doctors worked, as it didn't just advertise to the customers, and they began to over-prescribe. If a doctor only prescribes a patient, for example, 6 to 10 pills, the patient will undoubtedly need more. This leads to time spent on the phone with a pharmacy or provider that could have just been handled up front if they were given 12 to 20 initially. But then, those 12 to 20 are not all used, and leftovers sit in a cabinet until stolen by a visitor or a member of the household, which is one of the most common ways people start an addiction. The initial prescription being prescribed is not always the issue. It can be the amount. A study came out which a doctor claimed that in order to have high success, you must have high rankings from patients and satisfaction levels. But then, in a study done by UC Davis, it is proven to be untrue and that way of thinking is actually harmful. It gives doctors fear that patients will give them lower reviews, which leads them to prescribe or over-prescribe for what their patients want rather than what they need. While not all doctors mean harm, there are definitely some that do. There are quote pill mill end quote doctors who will set up shops to sell pills, accepting only cash, so it is done all under the table. These doctors do not care if the claim to pain is real or not, therefore, it is important to acknowledge that while most doctors do not mean harm, some take all of this to their advantage and do. One of the things that I found most alarming through my research was the fact that Purdue Pharmaceuticals completely denied what the FDA put in their label in 2003 and still released that statement saying that their drug was not as harmful as it was made out to be. As a society, we are meant to trust doctors and we should be able to, and when big pharmaceutical entrusted companies are saying that their drug isn't harmful, when it actually is, that is completely denying anything that could have happened to people and addiction that could have been caused. In my next episode, we'll be learning about the who of the opioid crisis, who is affected and how does it affect them. Once again, as you're listening, please remember that these are not just data and statistics, they're about real people and real stories. Thank you for listening.