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A new study links marketing for opioids to more overdose deaths
We now have more proof that drug companies helped cause America’s opioid epidemic, which was associated with a record 47,600 opioid overdose deaths in 2017: A new study linked drug companies’ marketing for opioid painkillers to more overdose deaths.
Drug companies have for years spent billions of dollars to market their products to doctors, wooing physicians and other prescribers with speaking fees, free dinners, paid trips, and more. When pharmaceutical companies marketed their new opioid pills, like OxyContin, starting in the 1990s, they used many of these same tactics to convince doctors, contrary to the evidence, that the narcotics were safe and effective, persuading them to prescribe far more of the drugs.
The new study in JAMA Network Open looked at the potential link between marketing for opioids to doctors across the US and county-level opioid painkiller overdose deaths. The researchers found that where there was more marketing, there were more deaths.
The study, by researchers from Boston University, UC Davis, New York University, and Brown University, looked at more than 430,000 marketing payments, totaling $39.7 million, to nearly 68,000 doctors across the US between August 2013 and December 2015. They then looked at county-level data to see whether the payments had an effect on painkiller overdose death rates one year later. If the marketing led to more opioid prescriptions, and more opioid prescriptions led to more misuse, addiction, and overdoses, then you could expect to see painkiller overdose deaths rise in places that got more marketing.
That’s exactly what researchers found: The counties that got more marketing the year before saw more painkiller prescriptions and more overdose deaths.
“The United States continues to vastly exceed the rest of the developed world in opioid prescribing, and many individuals with opioid use disorder are first introduced to opioids through a prescription,” the researchers wrote. “Our findings suggest that direct-to-physician opioid marketing may counter current national efforts to reduce the number of opioids prescribed and that policymakers might consider limits on these activities as part of a robust, evidence-based response to the opioid overdose epidemic in the United States.”
The cost of the marketing didn’t seem to have as much of an impact as the number of marketing interactions, suggesting that it’s not so much the financial impact as it is the marketer-to-doctor contact that has a significant effect on prescribers’ practices. For states (like New Jersey) that are trying to limit opioid marketing, understanding this dynamic is key to enacting the most effective policies.
“As evidence mounts that industry-sponsored meals contribute to increased prescribing, data suggest that the greatest influence of pharmaceutical companies may be subtle and widespread, manifested through payments of low monetary value occurring on a very large scale,” the researchers warned.
The study had some important caveats. For one, the researchers didn’t rule out reverse causation. It’s possible, for example, that marketers went to doctors who were already prescribing more opioids, since the marketers saw those doctors as reliable targets. In that case, it may not be that the marketing led to more prescriptions and overdose deaths, but that more prescriptions led to more marketing.
Another caveat: Opioid painkillers aren’t the sole driver of overdose deaths in the US — particularly as illegal opioids, like illicit fentanyl and heroin, have taken off — though they’re still involved in 40 percent of opioid overdose deaths, according to the study. Whether and how more opioid prescriptions may lead to other kinds of opioid overdose deaths needs to be studied further, the researchers cautioned.
The study also couldn’t differentiate between deaths caused by opioid painkillers that were prescribed to the victim and those that were illicitly obtained through, say, a family member or the black market.
Still, coupled with a study published in JAMA Internal Medicine last year, the findings are certainly suggestive — exposing one of the ways that drug companies likely helped cause the deadliest drug overdose crisis in US history.
There’s other evidence that opioid marketing helped cause the overdose crisis
The opioid epidemic can be understood in three waves. In the first wave, starting in the late 1990s and early 2000s, doctors prescribed a lot of opioid painkillers. That caused the drugs to proliferate to widespread misuse and addiction — among not just patients but also friends and family of patients, teens who took the drugs from their parents’ medicine cabinets, and people who bought excess pills from the black market.
A second wave of drug overdoses took off in the 2000s when heroin flooded the illicit market, as drug dealers and traffickers took advantage of a new population of people who used opioids but either lost access to painkillers or simply sought a better, cheaper high. And in recent years, the US has seen a third wave, as fentanyls offer an even more potent, cheaper — and deadlier — alternative to heroin.
It’s the first wave, though, that really kicked off the opioid crisis — and it’s where marketing for opioid painkillers is likely most relevant. (The study, however, could only look at recent data, because similar statistics don’t exist for prior years. So we don’t know if things are getting worse or better when it comes to marketing.)
Over the past few years, we’ve seen more and more reports about opioid companies aggressively marketing their products, even as it became clearer that the drugs weren’t the safe, effective alternative to other painkillers on the market that they claimed opioids to be.
Most recently, a filing in Massachusetts Attorney General Maura Healey’s lawsuit against Purdue Pharma, the maker of OxyContin, exposed how Richard Sackler, then Purdue’s president and part of the Sackler family that owns Purdue, was personally involved in some of those efforts. The filing claims that Sackler pushed to market OxyContin as a “non-narcotic” in other countries, even though it’s an opioid; Robert Kaiko, who created OxyContin, had to talk him down from the idea.
The company also allegedly overlooked excessive prescribing in the US, even as some of Purdue’s staff warned of pill mills that should have been reported to federal officials, Maia Szalavitz reported for Tonic.
Purdue countered that the filing “is littered with biased and inaccurate characterizations of these documents and individual defendants, often highlighting potential courses of action that were ultimately rejected by the company.”
Other reports, however, suggest opioid companies were widely irresponsible. As a group of public health experts explained in the Annual Review of Public Health, opioid companies exaggerated the benefits and safety of their products, supported advocacy groups and “education” campaigns that encouraged widespread use of opioids, and lobbied lawmakers to loosen access to the drugs. Purdue, as the maker of the then-new OxyContin, played a big role in these efforts, but so did companies like Endo, Teva, and Abbott Laboratories.
The result: As opioid sales grew, so did addiction and overdoses.
As opioid painkiller sales increased, more people got addicted — and died.
It’s not just that the drugs were deadly; they also weren’t anywhere as effective as Purdue and others claimed. There’s only very weak scientific evidence that opioid painkillers can effectively treat long-term chronic pain as patients grow tolerant of opioids’ effects — but there’s plenty of evidence that prolonged use can result in very bad complications, including a higher risk of addiction, overdose, and death. In short, the risks and downsides outweigh the benefits for most pain patients.
In some cases, drug companies faced consequences for their faulty claims. In 2007, Purdue Pharma and three of its top executives paid more than $630 million in federal fines for their misleading marketing. The three executives were also criminally convicted, each sentenced to three years of probation and 400 hours of community service.
And last year, with public pressure and scrutiny mounting, Purdue announced that it would stop marketing its opioids to doctors.
But Purdue and others may soon face bigger consequences. A judge in Cleveland has consolidated lawsuits against opioid companies in an attempt to reach a big settlement agreement. The hope is that an agreement would not only restrict marketing from opioid companies but also lead to a financial settlement that would pay for addiction treatment across the US.
The latest study in JAMA Open Network suggests that those steps, particularly marketing restrictions, could help reverse the current opioid crisis — and maybe prevent future crises as well.
The period between Memorial Day and Labor Day is historically the most dangerous time of year for teen drivers. Some research shows up to 30% of all teen driving fatalities occur during the summer months. Teen drivers lack experience, and the summer months provide multiple reasons for increased risk. Not only is there more daylight and warmer weather, but most teens are out of school and have more free time to be behind the wheel. Here are five safety tips for your teen driver to practice, not just in the summer months but all year long. 1. Avoid Distraction . Research shows as high as 60% of all teen vehicle crashes involve driver distraction. One common misconception is that cell phones are the number one cause of distraction for teen drivers but that is actually not the case. Other passengers create more distractions for teen drivers than any other source. 2. Buckle Up . It is discussed so often that it may seem trite but seatbelt use is proven to reduce fatality rates in motor vehicle accidents. but data shows buckling up can reduce the risk of fatal injury by as much as 45%. 3. Impaired Driving . As high as 15% of all teen driving fatalities involve a blood alcohol content of more than twice the legal limit. 4. Limit Passengers. Most states, including Alabama, have graduated license laws restricting the number of passengers in vehicles operated by teen drivers. Literally all available data associates fewer passengers with lower fatality rates in motor vehicle accidents involving teen drivers. 5. Reduce Nighttime Driving. The fatal crash rate of 16-19-year-olds is nearly 400 times higher at night than during the day.
Identity theft affects millions of people each year and can cause serious harm. Protect yourself by securing your personal information, understanding the threat of identity theft, and exercising caution. Here are 10 things you can start doing now to protect yourself and your loved ones from identity theft: Protect your Social Security number by keeping your Social Security card in a safe place at home. Don’t carry it with you or provide your number unnecessarily. Be careful when you speak with unknown callers. Scammers may mislead you by using legitimate phone numbers or the real names of officials. If they threaten you or make you feel uneasy, hang up. Create strong, unique passwords so others can’t easily access your accounts. Use different passwords for different accounts so if a hacker compromises one account, they can’t access other accounts. Check out the Federal Trade Commission’s password checklist for tips. Never give your personal or financial information in response to an unsolicited call or message, and never post it on social media. Shred paper documents that contain personal information, like your name, birth date, and Social Security number. Protect your mobile device from unauthorized access by securing it with a PIN, adding a fingerprinting feature, or using facial recognition. You can also add a password and adjust the time before your screen automatically locks. Regularly check your financial accounts for suspicious transactions. You can also request and check a free credit report from each of the three credit bureaus every year: TransUnion , Equifax , and Experian . Avoid internet threats by installing and maintaining strong anti-virus software on all your devices—including your mobile device and personal computer. Use a virtual private network (VPN) to stay safe on public Wi-Fi. Do not perform certain activities that involve sensitive data, like online shopping and banking, on public Wi-Fi networks. Protect yourself on social media by customizing your security settings and deleting accounts you no longer use. Also, double-check suspicious messages from your contacts, as hackers may create fake accounts of people you know. Never click on any link sent via unsolicited email or text message—type in the web address yourself. Only provide information on secure websites.
Every accident case is different. Some settle more quickly than others. However, it is not uncommon, for a personal injury case to take a year or more to resolve after the case has been filed in court. Evaluating the Injury Prior to filing a lawsuit, it takes time to determine the full extent of your injuries. Doctors are often unable to give an opinion about the seriousness of an injury until your condition has stabilized. In serious injury cases, it may even take a year after the accident before your doctor can say whether or not your injuries are permanent. It is extremely important to take the necessary time to fully evaluate your injuries. You have only one chance to prove the extent to which you have been harmed. Once you accept a settlement offer, that decision is final. You cannot go back and ask for more money if you later find out your injuries are more serious. An experienced personal injury attorney knows how to keep your case moving through the legal system. Your personal injury case may move through these stages: 1. Written Discovery The written discovery period can last over six months. You will be asked to answer written questions (interrogatories) under oath. You will also be asked to produce documents or authorize others to produce documents such as accident reports and medical records. 2. Depositions During a deposition, you will be asked questions under oath. A court reporter types a record of everything that is said. Not only will you be questioned about the accident and your injuries, you will be asked questions about what your health, education, and work were like before the accident. 3. Mediation and Settlement The Court almost always requires a settlement conference or mediation before personal injury cases can go to trial. At mediation, a neutral trained mediator goes over the issues and evidence with the parties to help guide them toward a settlement agreement. 4. Trial If your case does not settle and goes to trial, a jury decides what your injury is worth. It can take eighteen months or longer to get the trial scheduled. Once the trial is over, there may be further appeals and motions. It's possible for the parties to settle the case during trial or even after trial in order to end an appeal. Your best strategy is to contact an attorney with experience in handling personal injury cases. Your attorney can give you an estimate about the length of time it takes to resolve your type of case. Also, ask your attorney to give you frequent reports on the status of your case so you know that your case is making its way through the legal process. It's understandable that you may be frustrated at the speed your case seems to be moving. However, you should never rush to take the first settlement offer made by an insurance company. The first offer is rarely your best settlement offer. .
Distracted driving has been on the increase for the last several years and continues to be one of the leading causes of vehicle accidents throughout the United States. If you are texting and driving down the highway at 55 mph, that’s like traveling the length of a football field with your eyes closed. You can only drive safely when your full attention is on the road. Any activity that isn’t related to driving is a potential distraction and increases your risk of a collision. While most research points to a mobile phone as the number one culprit, it is far from the only activity potentially stealing a driver's attention. Eating or drinking, grooming, radios, other passengers - especially children, and even pets can also be significant factors. Distracted driving accidents are preventable 99% of the time. Driving can become mundane at times, but we all must remember when driving we have an obligation to the safety of not only ourselves but those who ride with us and other drivers we share the road with. Some studies show listening to podcasts or certain types of music can enhance our concentration. It’s important to practice safe habits behind the wheel. You want to make sure that your passengers know how serious you are about driving without distractions. One of the most effective ways to lead is through example. Be a good example for your friends and family by avoiding driving while you’re distracted.
We see this question all the time. The injured party doesn’t want to use their own health insurance to pay for an injury. They believe it is the responsibility of the person at fault to pay for their medical bills. That may feel like the right position for an accident victim to take but the truth is, most of the time the injured party will end up with a larger settlement if they do, in fact, use their own medical benefits. Here's why; Health insurance companies have a negotiated price for medical services that is about 15 percent less than what people have to pay who don’t have health insurance. If your medical bills are $50,000.00 but Blue Cross Blue Shield pays $15,000.00 and the person who caused the wreck has $50,000.00 in liability coverage, that leaves $35,000.00 available for the injured party versus $0.00. Generally speaking, Blue Cross Blue Shield will reduce the $15,000.00 to $10,000.00 leaving $40,000.00 available. The point is that there’s more money available when you take advantage of your healthcare negotiated rates whether it’s United Health Care, Medicare, Medicaid, or Blue Cross Blue Shield. More money is better. Using your health insurance to pay your medical bills if you are injured, will almost always end up maximizing your settlement.
Once you reach the age of 65 you have many more options than before. As you know if you go on Medicare and you are under the age of 65 your options for health plans are limited. When you turn 65 you will have another open enrollment period to sign up for any plan you wish to get. In other words, just because you are already on Medicare does not prohibit you from having all the options a person not on Medicare and turning 65 would have.
This is one of the questions we get asked the most. In most cases, the answer to this is “no”. When you turn 65, if you are still working and on your employer’s health insurance plan you probably will not need Medicare Part B. I say probably because most employer plans do not file on Medicare if you have a claim. Because you have to pay a premium for Part B, Medicare does not require a person to sign up for Part B as long as you are on your employer’s plan. Also, because the rules can differ for companies with less than 20 employees, the safest thing to do is check with the benefits coordinator at your place of employment for guidance or call us at our office.
Social Security: 3 main reasons why the Government can deny Disability Benefits
For many working Americans, when the unexpected happens and they can no longer work due to a serious medical condition, Social Security Disability Insurance (SSDI) benefits can be a financial lifeline. Most American workers contribute to Social Security through federal payroll taxes. Social Security is designed for income during retirement years however if an individual’s working years are cut short by a severe, long-term illness or injury, they may need income before reaching retirement age. For many who find themselves in these circumstances SSDI provides monthly financial assistance. Seven facts every American should know about the SSDI program 1. SSDI is coverage that workers earn. If an individual has paid enough Social Security taxes through their lifetime earnings, SSDI is intended to provide support by replacing some of their income when they become disabled and unable to work. 2. The Social Security Administration (SSA) has a strict definition of disability. The SSA considers a person disabled if they can’t work due to a serious medical condition that is expected to last at least one year or result in death. SSDI is intended as a long-term solution and is not intended to offer temporary or partial disability benefits. 3. Disability can happen to anyone at any age. Serious medical conditions, such as cancer and mental illness, can affect the young and elderly alike. Studies prove one in four 20-year-olds will become disabled before retirement age. As a result, they may need to rely on Social Security disability (SSDI) benefits for income support. 4. SSDI payments help disabled workers to meet their basic needs. SSDI is not and was never intended to be a full wage replacement. The average monthly Social Security disability benefit is $1,280, as of April 2021, which is intended to allow an individual who has become disabled to meet their basic needs. 5. Social Security works aggressively to detect and prevent fraud. Every American worker who pays federal taxes invests in SSA. The agency is committed to protecting their investment by taking a zero-tolerance approach to fraud. The agency claims a fraud incidence rate that is a fraction of one percent. 6. SSA helps people return to work without losing benefits. Often, people would like to re-enter the workforce. However, many worry they will lose disability benefits if they try working again. They may also fear losing benefits if they are unsuccessful in returning to work. The agency has many programs designed to connect an individual to free employment support services while helping them maintain benefits, such as health care. 7. Millions of disabled Americans depend on SSDI benefits. Nearly 10 million disabled workers and their spouses and children receive benefits through SSA.
A circuit judge in Sarasota ruled Monday that the verdict in a legal malpractice case against the Morgan & Morgan law firm should stand. The judge also denied Morgan & Morgan’s motion for a new trial and another motion to reduce the $5 million award determined by the jury. Attorney Donald St. Denis of St. Denis & Davey in Jacksonville, who represented the plaintiffs in the malpractice lawsuit, said Friday he has a hearing scheduled Tuesday in Sarasota on a motion to award his firm $1.6 million in attorney’s fees and costs. “We’ve been working on this for two years. I’ve got a ton of time in this case,” he said Friday. St. Denis made offers on behalf of his clients in August 2016 and again in January 2017 for $2.5 million and $4 million, respectively, to settle the malpractice suit before going to trial, but Morgan & Morgan’s counteroffer was only $1,000, he said. Morgan & Morgan intends to appeal the jury’s verdict. John Morgan “This case is a long way from over,” John Morgan said Friday in an email response. “We defended this case because we think we are right. And we will continue fighting it because we still believe we are right. We fully expect to win outright on appeal and have a judgment in our favor entered by the appellate courts.” St. Denis represented Shawna and Rock Pollack in the malpractice action related to Morgan & Morgan’s handling of a personal injury case the couple filed after their child was permanently injured during birth. On Oct. 17, a jury in circuit court in Sarasota County found that Morgan & Morgan attorney Armando Lauritano was 100 percent responsible for Shawna and Rock Pollock losing their rights to a medical malpractice claim against a Sarasota obstetrics practice, a nurse midwife and the hospital where their child was born. The case began Nov. 2, 2006, when Shawna Pollock was admitted to Sarasota Memorial Hospital to give birth. After she was given a hormone to induce labor, the unborn infant began to experience slowed fetal heartbeat and Pollock began writhing in pain. By the time an emergency cesarean section was performed, Pollock’s uterus had ruptured, depriving the fetus of oxygen, which caused permanent brain damage. After the birth, the Pollocks contacted Morgan & Morgan. An investigator from the firm met the couple at Ronald McDonald House, where they were staying while their infant son was in All Children’s Hospital in Tampa. On Feb. 17, 2007, the Pollocks agreed to be represented by Morgan & Morgan. They agreed to pay the firm up to 40 percent of a recovery up to $1 million, 30 percent between $1 million and $2 million and 20 percent of recovery in excess of $2 million. St. Denis argued to the jury that Morgan & Morgan was focused on collecting a large fee for the child’s brain injury claim to the point that its representative failed to provide the required presuit notice of claims for injuries sustained during the delivery by Shawna Pollock, including that she no longer is able to have children. After it became clear that the baby would qualify for no-fault benefits from the Florida Birth-Related Neurological Injury Compensation Association, and after the statute of limitations period for submitting notice the Pollocks intended to seek compensation for their personal loss had expired, Morgan & Morgan withdrew from representing the Pollocks. The jury found that the OB-GYN practice, the nurse midwife and Sarasota Memorial Hospital were negligent in the care of Shawna Pollock. The medical practice and nurse midwife were found by the jury to be liable for $4.5 million in damages and the hospital was found liable for $500,000 in damages, if the Pollocks had not lost their rights to sue for damages. In its $5 million verdict, the jury further found that Lauritano was negligent in his handling of the Pollocks’ interests, that the Pollacks did not freely and intentionally give up their right to seek compensation from the physicians and hospital and that Lauritano was liable for the loss they incurred. original article https://www.jaxdailyrecord.com/article/court-upholds-dollar5-million-malpractice-verdict-against-morgan-and-morgan