Is Pharma the Death Star? by @LynnRWebsterMD
Author’s Note: This blog contains references to “Star Wars,” but you will find no spoilers here.
In my world, a physician working with Pharma is perceived to be serving the Death Star. It doesn’t matter that thousands of drugs have been developed to save millions of lives, and have enabled millions more to live longer with fewer infirmaries. According to the critics, Pharma is totally evil, intent on destroying lives, and profiting from their destruction. This, they say, is especially true for the opioid manufacturers.
Physicians like myself, who have been conducting research to discover safer and more effective analgesics, have been caught in the web of this demonizing characterization. We’re used to being cast as the bad guys, however unreasonable that label may be.
But then a real Darth Vader comes along. His name is Martin Shkreli, and he is the 32-year-old C.E.O. of Turning Pharmaceuticals who bought the rights to market Daraprim and immediately increased the price by five thousand per cent. Daraprim is the only drug available to treat a deadly infectious disease, AIDS. He felt he was justified in extracting every last drop of blood from the proverbial turnip. Mr. Shkreli is facing a tsunami of legal issues unrelated to his pricing scheme, but it is his unconscionable behavior that is so repugnant and damaging to the reputations of scientists who devote their lives and careers to improve the health of mankind.
Mr. Shkreli, we hope, will get his comeuppance. But it is not fair, nor is it appropriate, to paint all of Pharma with the Shkreli brush. There are greedy and obnoxious behaviors in all areas of our society.
The people who work in Pharma are like everyone. We all want to be proud of what we do, and most importantly, we all want to make a positive difference in the lives of others. Let the Force Awaken so that good will triumph over evil.
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Completely agree Cannot lump all together! Hmm, sounds familiar (opioids &heroin)
Well said & all chronic pain patients who are lumped in with “addicts” & “drug seeking” have much empathy for you & your peers. We’re grateful for the tireless efforts in trying to improve our QOL & relieve our pain. How Mr Shrekli received no legal action for his drug scheme is as surreal as the CDC & all levels of government not taking 100 million legitimate, compliant pain patients into consideration. What goes around, comes around.
Kolodny and his PROPaganda members needed to consider their own financial ties before they started casting stones…..and build a fortress to protect themselves from the onslaught of stones now coming their way.
Yes, some of the pharmaceutical company allegiances are questionable, but this exists throughout medical specialties. This problem exists in larger society as well. This is where financial disclosures and common sense come to play. It’s no different than not allowing oneself to be overly influenced by commercials on television. If Kolodny wants to attack pain specialists for Pharma ties, then he needs to also do the same with his friends in addiction medicine, psychiatry, primary care, dermatologists, cardiologists, neurologists, allergists, anesthesiologists, and most every other specialty. To his argument that opioids don’t work in chronic pain, I’d say he’s absolutely correct that opioids not work in all chronic pain patients. Just like any medication, you don’t continue taking something that does not produce any benefit.
Opioids DO benefit some patients though – like me. If someone is really suffering despite other measures, you don’t withhold a treatment because you fear what MAY happen especially if appropriate supervision and personal responsibility can reduce the likelihood of the feared effect (substance abuse). The patient should make an informed choice about taking opioids, just like with any other treatment.
I’d challenge Kolodny and Ballantyne to review my history, see what my life is like with and without opioids, and then look me in the eye and tell me I shouldn’t be able to enjoy the decreased muscle spasm and pain relief that opioids afford me. If that doesn’t matter, maybe the fact that I can live independently and cost society less would matter to him.
Tapering last summer was absolutely the worst thing I have ever been through in my entire life. I had to go across the country, literally, to find a new physician. I’ve never felt more grateful in my entire life. I’m savoring every single day because I fear being forced back into that living hell once again due to the hysteria that presently exists. I feel like we are literally fight for our very lives. Life without quality is not living at all, it’s only existing.
No one deserves to endure what I went through, not even the worst serial killer or war criminal. I do wish that Kolodny and those aligned with him could experience what this is like for a few short minutes if basic compassion and decency do not allow them to understand why chronic pain patients should have access to opioids in adequate doses if they improve their quality of life.
Drugs used as alternatives to opioids also have life-threatening side effects. 16,000 arthritis sufferers die from GI bleeds as a result of NSAIDS each year. This doesn’t include all the other people who have fatal GI bleeds that take NSAIDS for indications like fractures, surgery, dental work or headaches. Serious cardiovascular risks are something we are only starting to understand and scientists cannot yet quantify the degree of risk to the individual or the rate of complications and deaths for society as whole.
NSAID’s, acetaminophen, and muscle relaxers (i.e. baclofen, tiznidine, etc) are known to cause significant elevations in liver enzymes and produce permanent damage if usage continues despite enzyme elevations. Some people can tolerate low to moderate elevations long term others will progress to to serious damage. Kidneys are also at risk from NSAID’s and acetaminophen.
Anti-convulsants benefits are debatable, though some patients clearly benefit, just as is the case with opioids. Pregabalin and gabapentin have received scrutiny recently for impeding healing within the nervous system. This is a huge concern for SCI patients especially, but worrisome for pain patients too as new knowledge regarding the centralization of pain emerges. Ant-convulsants, tricyclic anti-depressants, and muscle relaxers can be very difficult to tolerate. Sedation or orthostatic hypotension (low BP after sitting up or standing) is very common and can result in falls or fainting that result in serious fractures. For some patients, sedation and / or orthostatic hypotension are persistent and don’t resolve with time.
Substance abuse IS a serious issue, but there is ALSO a degree of choice involved at least initially. We wouldn’t ban simple sugars because diabetes and obesity are are increasing exponentially. I love junk food, but it has no legitimate medical use – unlike opioids.
I didn’t have ANY choice in whether I’d develop my genetic condition. I feel I deserve the ability to decide with my health care providers what is best for ME without some options being withheld because other people might make poor choices.
Just like Al Capone.. the Feds couldn’t get him on selling liquor during prohibition.. so the Feds got him on tax evasion.. Since Medicare/Medicaid is paying for a lot of this medication for pts… Mr Shrelki poked the “sleeping bear” in the eye…. and he is discovering the consequences 🙁
I present the facts. Is all of this fabricated. Doctors are drug dealers in these modern times, and you apologists view is of course predictable. Even some of the drugs I have been given for my heart condition were very harmful to me.
Over 100 Americans died from overdose deaths each day in 2013vi
46 Americans die each day from prescription opioid overdoses; two deaths an hour, 17,000 annuallyvii
While illicit opioid heroin poisonings increased by 12.4% from 1999 to 2002, the number of prescription opioid analgesic poisonings in the United States increased by 91.2% during that same time periodviii
Drug overdose was the leading cause of injury death in 2013, greater than car accidents and homicideix
About 8,200 Americans die annually from heroin overdosesx
About 75% of opioid addiction disease patients switch to heroin as a cheaper opioid sourcexi
In 2012, 259 million opioid pain medication prescriptions were written, enough for every adult in America to have a bottle of pillsxii