Last week, a commission set up by Stanford University and the Lancet found that the devastating opioid crisis in North America could happen again, and not just there. The unethical practices that Patrick Radden Keefe documented in his prize-winning 2021 book, Empire of Pain, were not restricted to one company, Purdue Pharma, and the part of the Sackler family that owned it. They were and remain normal behaviour in the pharmaceutical industry and in the agencies that are supposed to regulate it.
The Covid pandemic has, in some senses, been big pharma’s redemption. The vaccines that were developed at record speed, albeit on the back of decades of painstaking, publicly funded research, have been portrayed as a miracle of public-private cooperation. But this report reminds us that the question of trust isn’t going away – and it won’t until we do something about it.
At a Lancet webinar last week, the addiction expert at Stanford, Keith Humphreys, who led the commission, noted that if you measure the opioid crisis in terms of years of life lost, rather than absolute numbers of deaths, the fallout in the US and Canada has been on a par with that of Covid. Measure it by deaths relative to the populations of those countries, and it’s worse than the HIV/Aids epidemic at its North American peak. This “epidemic” was caused not by a virus, but by human greed. And it’s not over.
Because those who became addicted to prescription painkillers often progressed to heroin and then fentanyl, the crisis is still growing despite tighter controls on prescription. The commission’s modelling suggests that without major policy changes, the US alone could lose another million lives before this decade is out. That’s not to mention the damage that
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