The drugs are at the heart of a crisis that has cost 165,000 Americans their lives and pushed countless more to addiction.
The drugmakers vow they’re combating the addiction epidemic, but reporters found that they use a statehouse playbook of delay and defend to fight limits on their drugs, such as OxyContin, Vicodin and fentanyl, the narcotic linked to Prince’s death.
The industry and its allies spent more than $880 million nationwide on lobbying and campaign contributions from 2006 through 2015 – more than 200 times what advocates for stricter policies spent. That’s eight times more than the gun lobby recorded in the same period.
The drugmakers and allied groups – such as the American Cancer Society Cancer Action Network – also employed an annual average of 1,350 lobbyists in state capitals during that span, as opioids’ addictive nature came under scrutiny.
The pharmaceutical companies have other legislative interests, but their steady presence in state capitals means they’re poised to jump in quickly on any debate that affects them.
“The opioid lobby has been doing everything it can to preserve the status quo of aggressive prescribing,” said Dr. Andrew Kolodny, an outspoken advocate for opioid reform. “They are reaping enormous profits from aggressive prescribing.”
Prescription opioids are the cousins of heroin, prescribed to relieve pain. Sales of the drugs quadrupled from 1999 to 2010, rising in tandem with overdose deaths. Last year, 227 million opioid prescriptions were doled out in the U.S., enough to hand a bottle of pills to nine out of every 10 American adults.
The industry says it’s committed to solving problems linked to its painkillers. Major opioid-makers have launched initiatives to, among other things, encourage more cautious prescribing.
“We and our members stand with patients, providers, law enforcement, policymakers and others in calling for and supporting national policies and action to address opioid abuse,” Pharmaceutical Research and Manufacturers of America said.
Doctors continue to prescribe opioids for ailments such as back pain and headaches, even though studies have shown weak or no evidence that opioids effectively treat routine chronic pain.
In 2007, executives at Purdue, the maker of OxyContin, pleaded guilty to misleading the public about the drug’s addictive nature and agreed to pay $600 million in fines.
Lawmakers have begun to try limit the flood of prescriptions and overdoses. In 2012, for example, New Mexico considered a bill to limit initial prescriptions of opioids for acute pain to seven days to reduce addictions and keep leftover pills off the street. The bill died in the House Judiciary Committee.
Pharmaceutical lobbyists are now pushing bills to fight opioid abuse that also promote a new product that pads their bottom lines: patent-protected abuse-deterrent opioids. They lobby for laws requiring insurers and pharmacists to give preferential treatment to the drugs, even though experts say their abuse-deterrent qualities are easily circumvented. Lawmakers have introduced scores of bills on the topic, with at least 21 using nearly identical language – some of it supplied by lobbyists.
One of the drugmakers’ most powerful political engines is their financial support for opioid-friendly advocacy groups.
Such groups led the countercharge in Tennessee in 2014 when Republican state Rep. Ryan Williams began work to stanch the flow of prescription painkillers, alarmed by a rising number of drug-addicted babies. More than 900 were born the year before, nine times the amount in 2001, many of them hooked on the prescription opioids their mothers had taken.
Doctors told Williams that part of Tennessee’s problem was a 2001 law that allowed clinicians to refuse to prescribe powerful narcotics only if they steered patients to an opioid-friendly doctor.
Williams’ mission to repeal the law failed that year, after lobbying from the American Cancer Society Cancer Action Network and the Academy of Integrative Pain Management – a surprise since cancer patients would have been exempted.
Both the academy and the cancer group have contacted legislators and other officials about opioid-related measures in at least 18 states.
The society’s annual ranks of about 200 lobbyists around the country opposed opioid restrictions even in some cases where they specifically exempted cancer patients.
The Cancer Action Network listed four major opioid makers who donated at least $100,000 in 2015 and five more who gave at least $25,000. Companies that offer such sums get one-on-one meetings with the group’s leaders. The network said 6 percent of its funding last year came from drugmakers.
The American Academy of Pain Management receives 15 percent of its funding from pharmaceutical companies, according to Executive Director Bob Twillman. Its state advocacy project is 100 percent funded by drugmakers, but he said that does not mean it is beholden to pharmaceutical interests.
As for Williams, he tried again last year to repeal Tennessee’s opioid prescribing law – and succeeded, even though the cancer network still opposed the repeal. The extra year had given Williams and his co-sponsor time to help educate their fellow lawmakers, he said.