The US opioid crisis, almost on a daily basis, produces stories that would make one’s blood run cold. It’s one of the most damaging parts of modern US life and is driving many good people to despair. The latest story, then, is likely to cause even more anger and outrage. A recent study linked doctors who received more meals, trips and consultancy fees from opioid makers had a higher rate of opioid deaths thank to prescription opioids.

This is some of the strongest evidence to come out that shows a link between the marketing of opioids to doctors, and the rapid rise of the opioid crisis. Naturally, the study caused mass consternation on both sides of the debate.

The study, though, found some alarming information. There was a clear link between counties which offered gifts and payments to doctors and larger amounts of overdose deaths. In counties where marketing to doctors and physicians was less prevalent, overdose rates were smaller.

The study, published as part of JAMA Network Open and put together by experts at the Boston Medical Center and New York University School of Medicine, showed some terrifying insights into how this process works. From 2013-2015, it found that around $40m was spent promoting opioid medications to around 68,000 doctors. This included paying for food, trips and also consultancy costs to these doctors. Depressingly, it also found that for every three extra payments made to doctors, per 100,000 people in a county, overdose deaths were increasing by as much as 18%.

Indeed, the study shoed that around 1 in 12 doctors were subject to such marketing – and 1 in 5 doctors within family practices. Of course, there was a clear response from the American Academy of Family Physicians, when President Dr. John Cullen noted: “A limitation of the study, as acknowledged by the authors, is the many unknown variables that prevent drawing a direct causal link between pharmaceutical marketing and opioid-related deaths.”

Limited but worrying

Of course, the study team and authors did acknowledge some of these issues. One problem is the inability to differentiate between overdose deaths via prescription opioids, and illegally received painkillers. Lead author of the study, Dr. Scott Hadland, said: “We acknowledge that our work describes only one part of the very complex opioid overdose crisis in this country,”

The study did, though, notice a correlation between free meals provided to doctors and higher overdose rates. This was even more than the correlation between overdose rates and the amount of money spent on marketing. Each meal, according to Dr. Hadland, “seems to be associated with more and more prescriptions,” which is a worrying trend.

Hopefully, more states will follow the lead of New Jersey, who brought in a $10,000 per doctor, per year limit for marketing. The most important thing, though, will be to see a noticeable drop-off in the number of interactions between medical professionals and these companies.

Source

https://www.nytimes.com/2019/01/18/health/opioids-doctors-overdose-deaths.html