American Pain Foundation Shuts Down As Senators Investigate Prescription Narcotics

A version of this story was published in The Washington Post.

As the U.S. Senate Finance Committee launched an investigation Tuesday into makers of narcotic painkillers and groups that champion them, a leading pain advocacy organization said it was dissolving "due to irreparable economic circumstances."

The American Pain Foundation, which described itself as the nation's largest organization for pain patients, was the focus of a December investigation by ProPublica in The Washington Post that detailed its close ties to drugmakers.

The group received 90 percent of its $5 million in funding in 2010 from the drug and medical-device industry, ProPublica found, and its guides for patients, journalists and policymakers had played down the risks associated with opioid painkillers while exaggerating the benefits.

It is unclear whether the group's announcement Tuesday evening -- that it would "cease to exist, effective immediately" -- was related to letters sent earlier in the day from Sens. Max Baucus, D-Mont., the finance panel chairman, and Charles Grassley, R-Iowa, to the foundation, drug companies and others.

In the letters, the senators cited an "an epidemic of accidental deaths and addiction resulting from the increased sale and use of powerful narcotic painkillers," including popular brand names like Oxycontin, Vicodin and Opana.

Growing evidence, they wrote, suggests that drug companies "may be responsible, at least in part, for this epidemic by promoting misleading information about the drugs' safety and effectiveness."

The American Pain Foundation's website carried a statement Tuesday night saying its board had voted May 3 to dissolve the organization because it couldn't stay "operational." The foundation did not respond to requests for comment Tuesday.

The senators are targeting a who's who of the pain industry, seeking extensive records and correspondence documenting the links, financial and otherwise, between them and the makers of the top-prescribed narcotic painkillers.

Letters went to three pharmaceutical companies, Purdue Pharma, Endo Pharmaceuticals and Johnson & Johnson, as well as five groups that support pain patients, physicians or research: the American Pain Foundation, American Academy of Pain Medicine, American Pain Society, Wisconsin Pain & Policy Studies Group, and the Center for Practical Bioethics.

The Federation of State Medical Boards, the trade group for agencies that license doctors, received a letter, as did The Joint Commission, an independent nonprofit that accredits hospitals nationwide and made pain management a national priority in 2001.

A report by the U.S. Government Accountability Office in 2003 noted that the commission partnered with Purdue Pharma, the maker of Oxycontin, to distribute pain educational materials nationwide. The committee's letter to Purdue noted that the company pleaded guilty in 2007 to federal criminal charges that it misled regulators, physicians and consumers about Oxycontin's risk of addiction.

The senators requested payment information since 1997 to 10 groups and eight people, including two doctors featured in ProPublica's December report. They asked about any influence the companies had on a 2004 pain guide for physicians that was distributed by the Federation of State Medical Boards; on the American Pain Society's guidelines; and on the American Pain Foundation's Military/Veterans Pain Initiative.

In addition to citing ProPublica's work, the letters also mention the reporting of the Milwaukee Journal Sentinel and MedPage Today.

Patients in serious pain need access to opioids, the senators wrote, but drugmakers and health-care groups "must distribute accurate information about these drugs in order to prevent improper use and diversion to drug abusers."

"The problem of opioid abuse is bad and getting worse," Sen. Grassley said in a statement. "Something has to change."

"When it comes to these highly addictive painkillers, improper relationships between pharmaceutical companies and the organizations that promote their drugs can put lives at risk," Baucus said in a prepared statement.

Dr. Andrew Kolodny, chairman of psychiatry at Maimonides Medical Center in Brooklyn, N.Y., and president of Physicians for Responsible Opioid Prescribing, applauded the investigation.

"These groups, these pain organizations ... helped usher in an epidemic that's killed 100,000 people by promoting aggressive use of opioids," Kolodny said. "What makes this especially disturbing is that despite overwhelming evidence that their effort created a public health crisis, they're continuing to minimize the risk of addiction."

Concerns about the overuse and abuse of painkillers have intensified in recent years. As sales of the powerful drugs have boomed -- rising 300 percent since 1999 -- so, too, have overdose deaths. Opioids were involved in 14,800 overdose deaths in 2008, more than cocaine and heroin combined, according to the U.S. Centers for Disease Control and Prevention.

In 2009, the use and misuse of the drugs were cited in more than 475,000 emergency department visits, nearly doubling the 2004 number, the CDC said.

Pain doctors and patient groups say that while drug overdoses are a legitimate concern, only a small percentage of deaths involves patients who receive them from their doctors. Most deaths involve illicitly obtained drugs, statistics show.

The groups also say that patients' risk is low if they do not have addictive personalities, and that any restrictions should not punish patients who suffer from serious pain.

In recent weeks, two articles in medical journals have documented different aspects of abuse.

According to a paper published online this week by the Archives of Pediatrics & Adolescent Medicine, one of every eight high school seniors surveyed said they had used prescription opioids for nonmedical reasons.

A paper released last month by The Journal of the American Medical Association found that the rate of newborns diagnosed with drug withdrawal jumped threefold from 2000 to 2009. And the rate of mothers using opioids at the time of delivery was five times higher in 2009. (Not all babies born to mothers using the drugs exhibit signs of withdrawal.)

Janssen Pharmaceuticals, a Johnson & Johnson subsidiary that makes the painkiller Nucynta, said in a statement that it "is committed to the responsible prescribing and appropriate use of opioid pain medications" and has supported educational websites about safe use.

The company is reviewing the senators' letter and "will work with them to fulfill their request for information," spokesman Mark Wolfe said via email.

Purdue Pharma acknowledged in a statement that it had received the letter, was reviewing it and looked forward to "cooperating with the committee on this matter."

Endo did not return a request for comment. A spokeswoman for The Joint Commission said the group had just received the senators' letter and had no comment yet. The Federation of State Medical Boards responded but did not offer immediate comment.

Comments

[moalcl]

04:16 PM on 05/17/2012

It is so interesting that people are knocking the doctors who prescribe, and most I will argue prescribe for legitimate reasons, but no one is considering the huge number of doctors who offer alternative or what is known as interventionist treatment for pain. They make millions having pain patients repeatedly come in to receive sometimes highly risk injections into spinal canals, facet joints, and similar. One slip with a needle can puncture a lung or paralyze. But these docs refuse to prescribe - not because of concern for the patient and fear of addiction. Oh no - they want the patient back to beef up their earnings period. Many will tell you how useless the injections are - for some the injections work wonders, if opiates are better, let the patient use them. Opiates, taken properly, are great for pain patients. If one has a legitimate pain condition, the opiates will travel to the receptors in the brain - no "high" will be achieved. Too bad so many drug seeking addicts are out there. American Pain Foundation probably did rely on drug manufactures to operate - most pain patients are not receiving proper treatment and cannot donate to an organization providing a much need service/resource.

[Jeanne Smith Hyatt]

04:36 PM on 05/12/2012

HuffPost, I usually support you but I think you rushed to judgement on this one. Why is it that 98% of the articles I read [everywhere, not just here] have this angry anti pain medication stance? Do you even realize the result of of all this hysteria has resulted in the FACT that today in Florida there is a CRISIS because of the DEA's efforts? God forbid you have legitimate chronic pain and you live in Florida because you WILL BE DENIED your prescription for your legal prescription. The pendulum has shifted in the opposite direction and now THOUSANDS of law abiding citizens are being denied at their local, longtime pharmacies. GET THE CURRENT FACTS! Ask Radley Balko!

[wayne64]

07:21 PM on 05/11/2012

You mods are training me well.

New term for posts that get burned by you folks....Post toasties.

[wayne64]

07:14 PM on 05/11/2012

American's make up 6% of the worlds population and consume 80% of the precription pain pills

[Steelsil]

01:14 AM on 05/11/2012

Due to the Baby Boom, the population is getting older, and in more pain due to arthritis.  Taken as prescribed, there is no problem with opiates.  Addiction is a psychological problem, not a physical problem.  Addiction counselors know that their clients have not one, but many addictions - including behavioral addictions such as spending, gambling, sexual promiscuity, etc.  This witch hunt is just more 'reefer madness.'

[Tammy Lawton]

05:58 PM on 06/03/2012

Another episode of "Crime of the times" People have pain I felt the sight was useful and I did not feel that it supported pills over the other alternatives. The sight explained the difference between chemical dependence v/s addiction. Cannabis might be my answer but I live in Florida and yes it has become an issue to get powerful narcotics. I do not take that strong of medicine. However, if I was busted with cannabis my problems would be worse. I agree with many people on this sight. Distraction by lawmakers has to stop. We need to focus on the crimes of government four years ago.

[ALL OK HERE ON PLANET X]

10:51 PM on 05/10/2012

Question is: what took the Gov't so long to say something? Has something to do with the big money from the big corporations in politics, I bet.

[wayne64]

04:18 PM on 05/10/2012

You'll post my..Why won't you post my post..post...but not post my well thought out and enlightening post based on personal experiece...I want to speak to the post manager..now.
I've been a non paying posting customer here for 4 years!

[wayne64]

03:58 PM on 05/10/2012

why won't you post my post

[VPerry24]

03:49 PM on 05/10/2012

Wouldn't marijuana done the same thing without the side effects. If people believe in god one would think he created something for everything and it is natural. Isn't that what opium does in the ME and/or Far East? Someone told me that their mom was on 4 types of pain killers. Isn't that overkill?

[VictoryBlue]

02:12 PM on 05/10/2012

Cannabis: Zero Deaths.

[southred]

09:00 PM on 05/10/2012

Weed: 0 Ambition

[Steelsil]

01:15 AM on 05/11/2012

Potheads have enough ambition to get weed...

[anonymous67]

12:00 PM on 05/10/2012

This things didn't "just happen" on their own. Individuals made these decisions and place GREED above human life and dignity. And individuals hiding behind these corporate masks MUST go to prison -- or crimes against the public will NEVER END.

As the pockets of America's vulnerable are emptied, property seized, organs harvested and teeth pulled from the dead, many are too weak and hungry to protest as the rape and pillaging continues. Yet America's government just turns its head -- and NO ONE is prosecuted.

Nearly four years later, and in the face of widespread evidence, not a single Wall Street executive has been prosecuted for their deliberate and systematic crimes against the American people. Millions lost their jobs, homes, retirements, savings, homes and jobs. And this country brought to its knees.

Indeed, our government has not even conducted a comprehensive investigation of the widespread and systematic criminality. And the token task force assigned by the DOJ has yet to be staffed.

America, your government is corrupt.

[Melissa McCarthy]

10:22 AM on 05/10/2012

Just another reason to legalize medical marijuana use.

https://wwws.whitehouse.gov/petitions/!/petition/remove-cannabis-schedule-i-controlled-substances-act/LCjqpt8d

[dadw5boys]

08:19 AM on 05/10/2012

And the Bond Fires behind the American Pain Foundations Executive's Homes could be seen from Space. News at 11:00
All reords seem to have disappeared .

[Tommy Marz]

04:44 PM on 05/14/2012

groups that are meant to look like grassroots organizations, but are more aptly described as astroturf. (That’s) because they’re artificial organizations created to serve the drug companies interests but meant to look like a grass roots groups. And these groups lobbied states and federal agencies to make sure that there would be no limit on overprescribing. But you now have other manufacturers who have gotten in the game and it’s become a very big business and you have millions of people who are now dependent on these medications. And you have people who may never be able to get off them. There’s also a thriving black market for these products. But these medications are as addictive as heroin. The street value for some pills are $40 each. So it wasn’t long before other companies realized Purdue had a good thing going. For instance, Endo Pharmaceuticals sells Opana

[Savage Saint Roger]

06:48 AM on 05/10/2012

No one needs narcotics! Everyone should be using marijuana and living better lives! Narcotics destroy tissue, marijuana does not.

[VictoryBlue]

02:13 PM on 05/10/2012

Cannabis never killed anyone.

[southred]

09:01 PM on 05/10/2012

It destroys energy,ambition and loss of job and family...

[nopilikia]

02:13 AM on 05/10/2012

Like Lloyd and GS doing God's Work in finance.......The American Pain Foundation and Big Pharma doing God's Work in pain relief.

[Veri]

03:21 AM on 05/10/2012

Big Business Pharma sending them to Heaven. This is not Sparta. This is American Death Capitalism.