Two Courts Debunk Widely Accepted Opioid Myths

State and local governments filed thousands against drug companies since 2014 to sue them for creating the opioid crisis. They claim that they exaggerated the benefits of pain medications and minimized the risk. This theory is simple: The drug companies lied and people were killed.

Two recent rulings—one by a California judge, the other by the Oklahoma Supreme Court—show how misleading this widely accepted narrative is. These two decisions acknowledge that pain undertreatment is an issue and that patients who are healthy don’t become dependent on prescription opioids.

The lawsuit against the opioid manufacturer was started by three California counties and the city of Oakland seven years ago. They filed a claim that they created a public nuisance by encouraging more use of their product through misleading or false marketing campaigns. These four counties sought damages in excess of $50 billion.

Following a bench trial that began on April 19 and wrapped up at the beginning of last month, Orange County Superior Court Judge Peter J. Wilson concluded that the plaintiffs had failed to prove any of their allegations. Wilson issued a 42-page judgment on November 1 that stated in detail that the plaintiffs’ allegedly incriminating statements were not false or misleading.

As Nora Volkow, director of the National Institute on Drug Abuse, noted in a 2016 review of the evidence, “addiction occurs in only a small percentage of persons who are exposed to opioids—even among those with preexisting vulnerabilities.” But, California’s plaintiffs claimed that the statement that most opioid users are not addicted was inaccurate or misleading.

Wilson concluded that the plaintiffs claim that one out four people become addicted is true, but that such a statement was consistent with Wilson’s assertion. According to Wilson, the “more reliable data” would indicate a figure of less than 5% rather than 25 percent.

The plaintiffs also characterized the idea of pseudoaddiction, which suggests that doctors may mistakenly consider patients seeking pain relief as drug-seeking addicts, to be a marketing tactic. Wilson said that the term “pseudoaddiction”, which is medically accepted, and California law allows for this confusion.

Plaintiffs considered any suggestion that an opioid “improves functionality” to be deceptive. Wilson believed it was beyond debate that opioids could improve function because they can control pain sufficiently to allow patients to return to their normal activities, such as shopping, cooking and cleaning.

Wilson observed that plaintiffs did not distinguish between prescriptions considered medically necessary and inappropriate. Wilson stated that since both California’s and federal governments had determined the risks of opioid abuse outweigh the benefits, any increase in prescriptions can not be considered “public nuisance.”

A week later, the Oklahoma Supreme Court rejected similar claims against Johnson & Johnson, one of the defendants in the California case. In a 2019 landmark ruling, Thad Balkman of Cleveland County held the company responsible for its opioid-related problems. The court stated that he “erred” in expanding the public nuisance statute to include the manufacture, marketing and sale prescription opioids.

Wilson’s justices also emphasized the importance of distinguishing between misuse and use. Many of these were caused by the “improper use” of prescription opioids. [opioid-related]According to them, there were “very few” deaths when people used prescribed pharmaceutical opioids.

It was noted by the court that opioids are “at present a crucial treatment option” to treat chronic pain. This is a condition that has “deadly consequences for millions of Americans”. In addition, the court noted that the Food and Drug Administration has “endorsed appropriately managed medical opioid use (as prescribed) as safe and effective pain management and seldom addictive.”

That is not the impression left by the lawsuits that seek to blame drug companies for opioid-related deaths, which nowadays overwhelmingly involve illicit fentanyl. The fact that the medications they require can be misused does not mean patients should suffer unrelieved pain.

© Copyright 2021 by Creators Syndicate Inc.