An opioid that is 50 times stronger than pure heroin (and 100 times more potent than morphine) is being over-prescribed by physicians nationwide as the delineation between medical ethics and personal gain fades even further. Fentanyl, a powerful prescription pain medication, is an entirely synthetic opioid initially meant to ease cancer patients to death. Even with its intended purpose, health regulation groups repeatedly warn of the drug’s deadly side effects and caution doctors to only prescribe it as a last resort. That being said, recent data reveals that more doctors are prescribing fentanyl to their patients, even for cases such as tonsillitis.
An explosive report on NJ.com showed that the number of fentanyl dispensed in the state since late 2011 is enough to allow every person who has died of cancer in New Jersey to fill a prescription for the drug eight times. Similarly, between 2013 and 2015, the number of fentanyl-related deaths in New Jersey rose from 42 to 417.
Nationwide awareness on the dangers of this prescription drug began last year, when pop music icon, Prince, died of a fentanyl overdose. Unlike other opioids listed under the same category (such as oxycodone, morphine, and hydrocodonne), fentanyl is highly-addictive and easier to source (the drug is supposedly a favorite in the black market trade other than it being readily available as a prescription). This has led to a worrisome trend of fentanyl-related deaths increasing nationwide. The latest Centers for Disease Control and Prevention (CDC) data showed that from 2014 to 2015, fentanyl-related death shot up by around 73 percent. In the same period, deaths related to other legal prescription drugs rose by only four percent.
While controlling the illegal sale of fentanyl could prove to be challenging, what is more troubling is that licensed doctors are freely distributing the drug to their patients — seemingly without care or concern of the health risks involved. (Related: Toxic Pharma: Fentanyl overdose deaths doubled in just one year.)
In the same NJ.com expose, it was suggested that doctors are colluding with pharmaceutical companies to increase fentanyl sales. Arthur Caplan, head of the Division of Bioethics at New York University has been quoted as saying, “There’s enough money going around that if you saw this in the abstract, you’d think there was a drug cartel happening.”
Reporters at the news site claim to have looked at financial records of major drug maker, INSYS Therapeutics and their fentanyl drug, Subsys (a lingual spray marketed to cancer patients to treat intense pain). It was revealed that INSYS had made numerous payments to doctors under the vague reason of “speaker programs.” These speaking engagements, according to a lawsuit filed against an employee of the company, were a ruse to influence physicians to start prescribing the drug. It had been alleged that these repeated payments to medical practitioners (which, incidentally, the doctors would bill as “educational events”) was directly linked to the number of prescriptions filled for Subsys in New Jersey, which jumped from 400 in 2012 to around 1,800 in 2013, and 3,000 in 2014. The lawsuit further claimed that if a doctor appeared hesitant to participate, they would receive bullying emails.
Apart from receiving single payments of $1,000 for each “speech” given, doctors were treated to fancy dinners in high-end restaurants. All that was asked in return was to keep prescriptions for Subsys running, according to the plaintiff.
INSYS is not the only pharmaceutical company being implicated in this disturbing phenomenon. NJ Advanced Media found in acquired pharmaceutical payout data between 2013 to 2015 that marketing companies of fentanyl released at least $1.67 million to state doctors. Broken down, it appears that dozens of New Jersey doctors each received more than $10,000 from pharmaceutical companies to prescribe fentanyl.
The Executive Director of Physicians for Responsible Opioid Prescribing, Dr. Andrew Kolodny said that pharmaceutical companies would pay off even legitimate doctors looking for advice on specific medicine with the “understanding” that such a consultation should raise prescription numbers. “It’s an indirect way of incentivizing them to prescribe the drug,” he said.
Dr. Iqbal Jafi, who used to lead the pain management program at JKF Medical Center has stated, “I’m really very much concerned. I need to see more response from the medical community, more vigilance. We are losing people. Families are losing loved ones. So I’m concerned, not for me, but for the entire United States.”
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