When news broke that Purdue Pharma intentionally downplayed the habit-forming qualities of Oxycontin to boost sales, was anyone really surprised? If privatized medicine is primarily concerned with shareholders’ profits then of course a giant of industrial medications would lie to make a buck. And when the BC Government recently announced it would sue over 40 opioid manufacturers (including Purdue) for their role in creating the overdose crisis? Many were happy to hear these corporations might finally be forced to pay.
The widespread belief that “Big Pharma” single-handedly created this crisis is understandable, but this story distracts from the Government of Canada’s own culpability, and from the need for immediate political actions that will not be as popular as this lawsuit. Getting to the root causes of surging overdose fatalities will require overturning laws that criminalize drugs, shifting government funding from law enforcement to ending poverty, and increasing public access to pharmaceutical grade opioids. This latter point may seem counterintuitive (considering the critiques of pharmaceutical companies) but history has shown that trying to control drug consumption by eliminating the available supply has exasperated stigma and created harm.
The so-called ‘over-prescription problem’ and inaccessible alternatives
The claim that today’s opioid overdose crisis was caused by doctors duped into writing a prescription for addiction is a common misconception. Sharp increases in overdose fatalities are not from “overprescribing” but they are (in part) connected to draconian measures to severely limit licit opioids. When regulatory institutions concluded something had to be done about drug diversions and dependency, they decided the cure was to just say no. Rather than advocate for more healthcare options for those who wanted to stop using opioids, patients were deemed “problematic” and cut off from medical support. Many who relied on pharmaceuticals for pain management found themselves forced to taper off. Many low-income people, and particularly those with disabilities, did not have access to pain-management alternatives like physiotherapy. They turned to the illegal market to meet their needs, which has steadily become more precarious as bootleg Fentanyl has filled the growth in demand.
This is not to suggest the overdose crisis is purely a product of recent changes to prescribing practises. Not only would this be a short and narrow view of history, but is a narrative that lends itself to a respectability politics that divides people who use drugs into sub-groups of innocent victims and dangerous deviants. An example of this view can be found in the US group Patients Not Addicts, who assert the problem with the war on drugs is that real patients (read: the white and well-off) are being mistaken for “junkies” and unfairly punished alongside “criminals.” In this version of events, people with chronic pain are being made to suffer because those damn addicts keep dying and ruining things for everyone. Rather than identify with illicit drug-users (many of whom also experience chronic pain), groups like Patient Not Addicts disavow other so-called “drug seekers” in the hopes of getting a prescription refill. Examples like this are missed opportunities for solidarity and struggle against punitive drug-policies that have pushed the illicit market to a point where Fentanyl rose to prominence.
Prohibition makes drugs dangerous
When alcohol was outlawed, beer and wine was rare because spirits were easier for bootleggers to transport. Poisoning from redistilled alcohol was a huge issue, and alcoholism became even more stigmatized when drinking was considered a crime. Looking back at the history of alcohol prohibition, it’s easy to see why drug-users and their allies say the overdose crisis is also the result of criminalization and a lack of social supports. Yet rather than defunding the police and prisons in order to bolster community health, the government is pointing the finger at pharmaceutical companies. The BC Government’s class-action lawsuit is not without precedent, but when they continue to bookmark an enormous portion of emergency funds for “anti-trafficking” measures, it’s hard to see their case as anything but a distraction from demands for decriminalization and a safer supply of drugs.
Throwing money at a lengthy legal battle (that may not even end in their favor) is a hindrance to more significant action the BC NDP should be taking to end this emergency. Instead of suing Big Pharma, Attorney General David Eby could defund law enforcement agencies that exacerbate stigma and hog finite resources that would be better spent on healthcare based in harm reduction. Provincial tax dollars could be dedicated to meeting the immediate need for greater public access to prescription drugs. It’s a tough pill to swallow when the pharmaceutical industry is not without blame, but at this moment their product is desperately needed as an alternative to the Fentanyl-saturated illicit market. The government claims that suing opioid manufacturers will help “recoup costs” from the overdose crisis, but there’s no recouping the lives that will continue to be lost to the War On Drugs.