Opioid crisis: Pharmaceutical companies worsen epidemic

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  Quantumrun Foresight
• February 5, 2022

Insight summary

The misuse of opioids has spiraled into a major public health crisis in the US, leading to a decline in average life expectancy due to a rise in drug overdoses and suicides. This crisis, known as the opioid epidemic, emerged from a combination of factors including attempts to improve pain management and aggressive marketing by the pharmaceutical industry. As the crisis evolves, it not only poses a threat to other countries but also has wider implications, such as increased healthcare costs, changes in labor market dynamics, and potential shifts in regulatory policies.

Opioid crisis context 

The misuse of opioids has escalated into a significant public health crisis in the US, demanding immediate action from legislators, healthcare professionals, and the public at large. The average life expectancy in the US saw a decline from 78.8 years in 2015 to 78.7, and further plummeted to 78.5 by 2017. This decrease is largely attributed to a surge in drug overdoses and suicides, both of which are closely associated with opioid use. From 1999 to 2017, the death rate resulting from drug overdoses saw a threefold increase, while the mortality rate due to opioid overdoses surged by nearly six times.

This escalating crisis is often referred to as the opioid epidemic, and it follows a distinct pattern akin to a pandemic caused by an infectious disease. The roots of this epidemic can be traced back to the US, where it emerged as a result of a blend of factors. These include well-meaning efforts by physicians to improve pain management, coupled with aggressive marketing strategies employed by the pharmaceutical industry. The healthcare infrastructure, regulatory guidelines, societal norms, and economic trends in the US all played a part in shaping the current crisis.

As the epidemic continues to evolve, it has become increasingly lethal, posing a potential threat to other countries as well. The opioid epidemic is not merely a health crisis, but a societal issue that requires a comprehensive and coordinated response. It is essential to understand that the impact of this crisis extends beyond the individual, affecting families, communities, and the economy. 

Disruptive impact

In low- and middle-income countries, opioids are seldom used to treat pain associated with surgery, cancer, or the end of life. Should doctors begin to administer opioids in these regions, they may be at risk of a similar crisis to the US. And due to local healthcare spending, these countries may be susceptible to regulatory capture, a situation in which governments tend to serve the interests of the agents they should be monitoring. 

For example, small studies that showed patients having a minimal chance of developing an addiction to opioids were enthusiastically welcomed by the US medical establishment. Furthermore, the epidemic is worsened by countries like US and New Zealand that allow direct pharmaceutical advertising to consumers. This permissive regulatory environment encourages patients to seek doctors for specific medications. 

The current regulatory environment will likely continue well through the 2020s due to the healthcare sector’s political influence. And as the average population age grows older in developed countries, the pharmaceutical sector is likely to experience even higher profits and political influence during the 2020s and 2030s. More restrictive healthcare regulation and advertising laws have a chance of being passed in future decades depending on the activism of younger voters as they become the dominant voting demographic by the late 2020s. Meanwhile, there is already localized pressure on doctors, and the state-level healthcare associations that oversee them, to moderate their over-prescription of opioids.

Implications of the opioid crisis

Wider implications of the opioid crisis may include:

• Increased research initiatives into alternative pain medications, such as cannabis and psilocybin products, that are devoid of addictive qualities. 
• Increased state and municipal funding for addiction centers to help victims of opioid addiction. 
• The eventual prohibition of direct marketing by pharmaceuticals to consumers, leading to a loss of profits to pharmaceutical companies and mainstream cable news companies.
• A significant increase in healthcare costs, as resources are redirected towards managing addiction and its associated health complications, straining the economy and leading to higher taxes or insurance premiums for citizens.
• Employers having to invest more in employee health programs and drug-free workplace initiatives, affecting productivity and the overall competitiveness of businesses.
• Lawmakers focusing more on public health issues, leading to stricter regulations on pharmaceutical companies and possibly affecting the pace of new drug approvals.
• The disposal of unused or expired opioids needing to be managed carefully to prevent contamination of water supplies, leading to stricter waste management policies and practices.

Questions to consider

• What regulations might be most effective in curbing the opioid epidemic?
• What possible solutions might the private sector be able to contribute to minimizing the opioid epidemic?