Unsettled issues at the Minnesota Legislature: Drugmakers must help pay for opioid solutions

Nearly everyone has been affected by the opioid crisis. More than 2 million Americans struggle with opioid addiction today, most of whom need access to treatment. Societal losses are devastating. Over the past six years, more than 200,000 Americans died from opioid overdose, more than three times the number of American lives lost in Vietnam.

Unlike other drug epidemics, this one does not discriminate. It affects rich and poor, Republicans and Democrats, young and old, urban and rural. In short — everyone. The U.S. Centers for Disease Control and Prevention estimate that the national "economic burden" resulting from the crisis is $78.5 billion a year, including losses in economic productivity, as well as criminal justice and health care costs.

Community groups, physicians, local health officials, state lawmakers, county attorneys and even the president of the United States have rallied for immediate remedies to this epidemic. Despite recent progress in reducing prescriptions, more people continue to die annually from opioid overdoses than ever before. In 2016 alone, the death rate was five times higher than in 1999.

In fact, for the first time in more than 100 years, life expectancy is declining in the United States, largely due to opioid overdose. More Americans are expected to die annually from opioids than from breast cancer, HIV/AIDS, car accidents or firearms.

Sadly, this epidemic could have been avoided had we known earlier what drug manufacturers knew about the risks of opioids. Pharmaceutical companies misled the medical community and public about opioids’ benefits while minimizing risks. Thousands died across the country while drug manufacturers profited from the sales of opioids.

Drug manufacturers continue to profit today. These companies sponsored approximately 20,000 educational events that misled health professionals about opioid research, claiming their potential for addiction was low, even though they had clear warning signs that said otherwise. One company actually gave money to the American Pain Society, which later advocated for pain as the "fifth vital sign" for medicine. The addition of this vital sign has been viewed as part of the campaign to encourage physicians to prescribe more opioids for pain, purported to be in the name of "best practices."

While many have sued these companies, what is needed are policy changes. These include changes in how pain is treated, how drugs are tracked and approved, how treatment for those in need is supported. Without these changes, the opioid epidemic will continue unabated as drug manufacturers and distributors continue to profit and thousands continue to die.

A good first step for Minnesota is to promote efforts to re-educate prescribers about best practices in pain management, including nonopioid approaches to pain. Another policy advancement would be to improve the ability of the state and physicians to monitor and track prescriptions for opioids and other related drugs. A further suggestion is to support the growth of evidence-based treatment programs for those struggling with addiction and to increase the knowledge of providers on the front line of health care, like primary care doctors, on how to recognize and treat addiction.

Like any worthwhile reform, these changes come with a price tag. Thanks to leadership from Sens. Julie Rosen, R-Vernon Center, and Chris Eaton, DFL-Brooklyn Center, the Minnesota Senate recently passed legislation that alleviates the cost to taxpayers by holding the pharmaceutical industry financially accountable to help pay for the epidemic they created. Thanks to Rep. Dave Baker, R-Willmar, the Minnesota House now has an opportunity to do the right thing and make this a reality.

Our communities have already paid dearly for the opioid crisis, in dollars and in lives lost. What’s needed is for pharmaceutical companies to contribute to the costs of prevention and treatment, whether by paying a tax or increased registration fees on those doing business in Minnesota. Taking it out of the pockets of Minnesota taxpayers is unconscionable.

Jon L. Pryor is CEO and Charles Reznikoff is an addiction medicine specialist at Hennepin Healthcare.

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