Our next several blogs will catalogue the various ways drug companies have ruthlessly promoted our nation's deadly opioid epidemic. This first installment on just the latest outrage- political lobbying to block the legalization of medical marijuana. Future blogs will each tell other aspects of this sordid story.
The exponential growth of addiction to prescription opioids offers a classic example of selfish corporate greed swamping any vestige of corporate conscience. The Pharma drug pushers are attempting to protect their blood money profits by blocking fair competition from much safer and much cheaper medical marijuana. As usual, Pharma displays great loyalty to its executives, its shareholders, and its subservient politicians, while displaying a shameful disregard for the lives of its customers and the welfare of our society.
Drug cartels are rightly reviled. But drug companies are now more deadly and only marginally less ruthless.
Policymakers should weigh the considerable evidence that legalized medical pot improves pain management and reduces opioid addiction. They should focus less on the few real dangers and be less susceptible to powerful Pharma pressure.
Medical Pot Reduces Opioid Abuse And Deaths
Twenty-five states and the District of Columbia have legalized pot for medical purposes. It turns out that medical marijuana is over-rated for many of the conditions currently treated with it.
But pot could have a major role in improving our currently horrible management of chronic pain. A review of 79 studies found "30% or greater improvement in pain with cannabinoid compared with placebo."
Studies also show that legalizing medical pot, and making it available in dispensaries, reduces by 15-35% admissions for prescription opioid abuse and opioid overdose deaths.
In states that legalize medical marijuana, doctors also write many fewer prescriptions for medications meant to treat pain, depression, anxiety, seizures, and nausea.
The dangerous over-use of prescription opioids has become our national nightmare. Any rational assessment of risks versus benefits would much favor pot over addicting pain pills.
Pharma Fights To Defend Its Opioid Profits
Pharma is the most active and powerful opponent of legalized medical pot. Its subversive activities take the usual form used by all rich and powerful industries to defend their selfish commercial interests when these conflict with the broader public weal: sponsoring friendly anti-pot researchers; funding friendly anti-pot organizations; lobbying government agencies; paying off politicians; and mounting public relations campaigns.
The financial stakes are high. On one side, Pharma is protecting its revenues of about $10 billion per year. On the other, the costs of opioid addiction to our society mount to many multiples of this. Consider all the medical and rehab treatments required to deal with prescription opioid abuse and addiction; the lost work productivity; the impact on the legal and correctional systems; and all the additional costs occasioned by downstream heroin addiction.
And this is to say nothing of all the lives lost and of all the lives ruined. Pharma will fight to the last dollar to protect profitable product, however deadly it is and however costly to society. Society needs to learn how to fight back and protect itself from predator drug companies.
Several other industries are allied with Big Pharma in actively opposing the legalization of pot- particularly the beer makers, distillers, Big Tobacco, and the prison lobby. All are blatantly self-interested, but none is quite so hypocritical as the drug industry -- which constantly trumpets its devotion to patient welfare while consistently sacrificing it on the altar of obscene profit.
What Needs To Be Done
It is crazy public policy to make a relatively safe drug illegal, while simultaneously allowing Pharma to legally push an extremely deadly one.
The epidemic of addiction to, and deaths from, legal prescription opioids is a national tragedy plaguing all fifty states. It will have no simple solution, but clearly the universal legalization of medical pot should be part of the tool kit.
Political opposition is partly based on ideological and puritanical grounds; partly on groundless over-estimation of risk; and partly on Pharma's greedy efforts to hold its opioid market share against an effective and much safer competitor.
Recent history makes clear that Pharma owns Washington and also many state capitals. It invests twice as much on marketing and lobbying as it does on research and is much better at buying politicians than producing better products.
But right sometimes triumphs over might, particularly when the evidence is so clear and the stake in lives so high. Pharma's pressure on the many politicians beholden to it is increasingly meeting counter-pressure generated by the unprecedented spread of addiction to the general population and the consequent rising death toll.
Now that 25 states have legalized medical pot and have derived such clear benefit from doing so, can the other 25 states afford to continue suffering the huge human and financial cost of unfettered legal opioids.
Legalizing medical pot will not by itself solve the overall opioid mess, but it is an obvious and effective step in the right direction. Other steps will be discussed in later blogs.
Allen Frances is a professor emeritus at Duke University and was the chairman of the DSM-IV task force.