Pharmaceutical Industry Pushes Fentanyl On New Jersey

Much as Donald Trump and the Republicans like to imply that the massive opioid epidemic devastating America is somehow the work of illegal immigrants and related gangs, the reality is that this epidemic is largely created by the pharmaceutical industry in its quest to get patients addicted for profit. The most recent evidence comes from New Jersey, where pharmaceutical companies have been paying massive bribes in order to get doctors to prescribe the most addictive and deadly opioid of all, fentanyl.

Fentanyl was created in order to help terminally ill cancer patients deal with pain that perhaps other opioids could not deal with. The fact that is was incredibly addictive and dangerous was not so significant because the patients were not likely to be using the drug for long. Instead, pharmaceutical companies started pushing doctors in New Jersey to prescribe fentanyl for regular, mundane pain issues such as sore knees or tonsillitis. Correspondingly, the rate of addiction in New Jersey started to explode and the number of deaths related to fentanyl grew by a factor of 10 in the two years from 2013 to 2015. In fact, while oncologists, the group most expected to use the drug, wrote only around 2,200 Medicare prescriptions in 2014, internal medicine, family practice, nurse practitioner, and physical rehab specialists wrote over 50,000 prescriptions combined.

The basic method that these pharmaceutical companies used to encourage doctors was to simply bribe them. In that same two year period, 2013 to 2105, doctors in New Jersey were paid nearly $1.7 million by pharmaceutical companies to prescribe fentanyl. INSYS Therapeutics sold its version of fentanyl under the brand name of Subsys. Their preferred method of bribery was the bogus "Speaker Program" where doctors would be paid over $1,000 per speech discussing the benefits of Subsys. These speeches would often occur at fancy restaurants and were paid for by INSYS. In many cases the doctor giving the "speech" never even attended and the people who did attend were INSYS employees just getting a nice meal on the company. The doctors who received the payments for these speeches were just being paid for maintaining or increasing the number of fentanyl prescriptions they were writing. If a doctor started to cut back on those prescriptions, the INSYS bribes would also disappear and the INSYS sales staff would begin bullying and harassing them. According to nj.com, "dozens of doctors in New Jersey each received more than $10,000 from pharmaceutical companies marketing fentanyl between 2013 and 2015."

Arthur Caplan, head of the Division of Bioethics at New York University, describes the situation thusly, "There's enough money going around that if you saw this in the abstract, you'd think there was a drug cartel happening." I don't think we need to look in the abstract to see this actually is a cartel at work. The pharmaceutical oligopoly actually exists on two levels. Not only are there just a handful of companies that dominate the industry as a whole, but within specific products there is often a monopoly or oligopoly that controls pricing. And as long as that is the case, we can expect the industry to engage in more illegal behavior and make more attempts to make Americans addicts for profit.