Oklahoma Wins $572 Million Settlement Against J&J for Role in Opioid Crisis
On the surface it appears to be a victory. Big Pharma is going to pay for its purported sins. The New York Times story begins with this bombshell:
“A judge in Oklahoma on Monday ruled against Johnson & Johnson, the deep-pocketed corporate giant, and ordered it to pay the state $572 million in the first trial of an opioid manufacturer for the destruction wrought by prescription painkillers.”
The story revealed that J&J supplies 60% of the opiate ingredients that drug companies use for oxycodone and other highly addictive pain medications. The pharmaceutical giant contracts with poppy growers in Tasmania to produce supplies for companies like Purdue Pharma and Teva, who have also been embroiled in lawsuits these past few years.
According to the Times article there are currently more than 2,000 similar lawsuits around the country directed against opioid makers, distributors and retailers.
My own first reaction here is to consider the impact of this information in another domain, the realm of terminal health care. What looks like a victory for those fighting for justice in the opioid crisis may produce unintended consequences for those seeking relief from suffering during end of life battles with cancer and other debilitating diseases.
I personally know of situations where cancer patients experiencing excruciating pain have had to do battle in order to obtain the relief they needed, which was available but withheld.
In the early 1990s, while researching and writing about ethical issues in terminal health care I learned of an association of oncologists who were striving to make it easier to provide pain relief for cancer patients. They saw that if we don’t allow doctors to mitigate pain, it will give increased leverage for those pushing for widespread acceptance of physician assisted suicide.
Dr. Tom Elliott, oncologist at the Duluth Clinic at that time and national lecturer in pain management among the terminally ill, offered two additional reasons why interest in euthanasia among lay people had been increasing. “Number one,” he said, “because people want to have more control over their lives and perceive that they have lost some control because of technology that may have taken something away from them, and they are trying to get back some of their personal autonomy.
“I think also it’s occurring because there is a perceived and real lack of high quality symptom management in the terminally ill,” Dr. Elliott said. “I think the public knows that, and knows that there is inadequate pain relief for the terminally ill, so that some of them are saying ‘If you can’t relieve my pain, at least give me the right to end my life.’”
Arthur Caplan, Ph.D., at that time director of the Center for Biomedical Ethics at the University of Minnesota, agreed. “I think pain control is a problem, and too many doctors don’t use it adequately in terminally ill patients,” he said. “It’s crazy, but it happens, and that frightens people.”
“Among the remedies which it has pleased almighty God to give to man to relieve his sufferings, none is so universal and so efficacious as opium.”
--Sir Thomas Sydenham (1680)
There’s no question that the opioid crisis is troubling. The courts are certainly one way to push back. But with 2000 more lawsuits waiting in the wings, it’s not hard to imagine a day when Johnson & Johnson shareholders say, “OK, we’ve had enough,” and abandon their poppy fields and opium processing whose sole purpose is to solve the problem of pain management in health care.
I have no interest in becoming a morphine addict at the end of my life, but if I’m experiencing excruciating pain and morphine will bring that from a 12 to a two, I want it. I know what pain feels like.
According to the National Center for Biotechnology Information, “approximately 27 million people are suffering in pain around the world” but “more than 150 countries cannot access morphine for patients needing palliative care.”
In other words, we are apparently blessed to live in a country where pain medication is abundant. The solution, then, is not to put the drug makers out of business but to ensure their products don’t get in the wrong hands.
What do you think?
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