At the Chicago Department of Public Health, many of the diseases we seek to fend off are as inevitable as natural disasters, but the prescription drug epidemic -- consisting largely of the abuse of narcotic prescription pain medications known as opioids -- is not. Mayor Rahm Emanuel is taking action and proving Chicago is a leader in the U.S. in the fight against this preventable addiction, which was fueled in part by pharmaceutical companies seeking to increase their profits.
This manufactured epidemic of addiction has taken a toll on our country's health systems, a problem most recently documented in a national study of hospital emergency department visits for opioid overdoses in JAMA Internal Medicine. The study found that nearly seven in 10 opioid overdoses that were treated in emergency departments around the country involved prescription opioids -- not illegal opioids like heroin -- and concludes that "further efforts to stem the prescription opioid overdose epidemic are urgently needed."
They are right. Emergency departments have been inundated as a result of this epidemic. Out of every 100,000 people, according to a 2009 U.S. Department of Health and Human Services report, 40 people in the Chicago metropolitan area visit emergency departments due to adverse events from opioid, which translates to 1,080 preventable trips to the emergency departments per year.
But the problem also exacts a significant financial burden on health systems. In fact, during the last seven years, the City of Chicago, through its health benefits and workers compensation programs, paid more than $10 million for opioid prescriptions. That does not include the additional money we have spent for ambulance runs or emergency department visits for opioid overdoses and drug treatment to try to break the cycle of addiction. Perhaps more troubling, the addiction to prescription opioids has caused law-abiding people to turn to the streets to seek out heroin, which is cheaper and can be easier to obtain. Contrary to industry reassurances that these drugs are safe, addiction to opioids is powerful and not at all rare, including for patients prescribed these drugs. As a result, families have been shattered, careers have been lost and lives have been destroyed.
Enough is enough, and the City of Chicago is taking action. In June, at the direction of Mayor Emanuel, the City filed suit against five manufacturers of opioid drugs for misleading doctors and their patients about the dangerously addictive nature of opioids. We are seeking to hold the pharmaceutical companies who manufacture these drugs accountable for what we now believe was a methodically executed plan to deceive doctors and patients into over-prescribing opioids.
The reality is that in order to make more money, Purdue Pharma, Janssen, Cephalon, Actavis, and Endo obscured the dangerous effects of these drugs. They claimed the drugs were rarely addictive, misrepresented their medical value in treating chronic pain, and assured doctors and patients that the drugs were safer than over-the-counter pain relievers.
Their actions contributed to the creation of what the Centers for Disease Control and Prevention has called a "national epidemic" and, while other actors did play a role, the evidence of just how successful the marketing practices of these pharmaceutical companies were in Chicago, is impossible to ignore. We now know that the rate at which opioids were prescribed in Chicago consistently increased as pharmaceutical companies' fraudulent marketing began to achieve its desired effect. In 2003, the City health plans funded 32,091 opioid prescriptions. By 2011, however, this number had almost doubled, with the City health plans paying for 61,434 prescriptions. The lawsuit is a landmark action to address not only the millions of dollars spent by the City and by Chicago residents, but more importantly the thousands of lives harmed and lost as a result of these drug companies' deceptions. It seeks injunctive relief to require the drug companies to set the record straight and provide doctors and patients with complete and accurate information about opioids so that they can make informed choices about their care.
Chicago is not alone in its suffering. In the U.S., there are more than 2.4 million people addicted to opioids. What is worse, these addictions usually began with a relatively common trip to the doctor for back pain or arthritis.
As a doctor I know these drugs have a very legitimate, but limited, use. They are effective for treating people with cancer and terminal illnesses or for short-term acute pain. But the data shows that only about 15 percent of opioid prescriptions are for these kinds of treatments. The rest are prescribed for chronic pain, a use for which there is no scientific evidence.
As a public health official, it is my responsibility to manage the systems that care for all Chicago residents. Whatever the disease, it is my responsibility to track down the root problem and prevent it from spreading any further. The same is true for the crisis of manufactured addiction that these pharmaceutical companies helped cause -- and I am pleased to work with Mayor Emanuel to stand up to these companies on behalf of the City of Chicago.
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Need help with substance abuse or mental health issues? In the U.S., call 800-662-HELP (4357) for the SAMHSA National Helpline.