BY ANDREW MCDONALD
SOMETIMES you hear people complaining about the “nanny state” when it comes to medication. Somebody can’t get a pill for this or that and instantly they put the blame on the medical profession and/or the government. There are occasions when there may even be a little substance to their protests. The truth is, compared to certain other parts of the globe, the prescription drug industry and the work of physicians are heavily regulated areas. The question is however, are we actually more rather than less lucky that we live with such a system? A docudrama recently featured on Disney+, having earlier been screened on Hulu in America, suggests the answer is a resounding yes for the former of these two options.
Dopesick, which dramatised the opioid scandal in the United States, tells the story of what can happen when regulation is weak. Throw in a bit of corruption and the potential is there for a desperate crisis. In the nineties, Purdue Pharma, a major American pharmaceutical company developed a drug, and drove a campaign of aggressive promotion, including intimidation of healthcare professionals, which was supposed to “end pain”. Through trickery, manipulation and corruption they painted their medication, OxyContin, as essentially non-addictive. This was lies. It was ferociously addicting. So much so that it became colloquially known by the derogatory term “hillbilly heroin” as one of the areas most targetted by Purdue were the mining communities of the Appalachian region. It literally turned people into desperate addicts simply by them following their doctors’ advice. In an overwhelming number of cases, they didn’t initially abuse it, it abused them. It was even being prescribed in huge amounts for minor issues like a sore back, dental pain or headaches.
The Sackler family who owned Purdue Pharma wanted to sell their drug worldwide and made a concerted effort to get it approved in Germany. The idea was Germany, having famously tough pharmaceutical regulation, giving approval would make life easier to get the drug on the market elsewhere. The Germans steadfastly refused. There is no reason to doubt that similarly vigorous regulatory authorities in Ireland wouldn’t have met the Sacklers with the same response.
Opioids are serious stuff. Used in the right way, they have an important role to play in medicine. A weak version, codeine, is available without prescription in Ireland. Even with this much less potent opioid, pharmacists are very careful to restrict who purchases it, in what amount and will demand good reasons to sell it over a safer, non-opium based painkiller. Even with codeine, people can become addicted very quickly. In Ireland, as elsewhere, pain medication addiction is a serious issue.
All of which leads us to another question. Should we be so quick to reach for painkillers when we’re feeling sore? Certainly there are painful ailments which call for pills, whether prescribed or over-the-counter, but others we can remedy without needing to swallow a tablet. Next week, we’ll look at some of the alternatives.