Commission on the Opioid Crisis Calls for Changes in Pharmaceutical Marketing and Managed Care

In the report published by The Lancet, the group provides a brief history of drug use and addiction, describes the opioid landscape and includes 7 recommendations.

The worsening opioid epidemic, which may have worsened during the COVID-19 pandemic, has led the Stanford University School of Medicine and The Lancet form a commission to study the crisis.

In the article published in The Lancetthe commission called for changes to address urgent public health needs, including banning direct marketing to drug prescribers, decoupling pharmaceutical industry donations to professional associations and universities from oversight of medical education and by encouraging health accrediting bodies to refuse to accept pharmaceutical money.

“Millions of people have become addicted to opioids, triggering an increase in other disorders, disability, family breakdown, unemployment, and child neglect,” Jonathan Caulkins, PhD, Professor of Operations Research and of public policy at Heinz College of Carnegie Mellon University and a member of the commission, said in a statement.

In the report, the commission provided a brief history of opioid use and addiction in North America, described the opioid overdose landscape, and included 7 categories of recommendations. These are:

  1. Building integrated and well-supported systems for the care of substance use disorders, which include standardized addiction care within health and social care systems and the expansion of private and public insurance to finance appropriate management of opioid use disorders.
  2. Creating healthy environments that can lead to long-term decline in addiction, such as improving the quality of programs to eliminate excess opioids and integrating substance use prevention programs with programs targeting drug addiction. other problems.
  3. Improving criminal justice system care for people with opioid dependence. This includes the provision of addiction-related health services during and after incarceration and non-incarceration of individuals for simple possession or use of illicit opioids. The commission also recommended ending collateral sentences for drug-related crimes and sentences for substance use during pregnancy.
  4. Recognize the benefits and risks of opioids in the drug approval process with greater consideration of the risk of diversion to illegal markets and unsupervised use, in addition to the risks when drugs are taken as directed. The commission also recommended tackling chronic pain by implementing pain management strategies, conducting clinical trials on the benefits and risks of opioids, and improving the impact of policies that restrict opioids.
  5. Preventing opioid crises beyond North America by prohibiting U.S. pharmaceutical producers from exporting corrupt and fraudulent opioid promotion practices overseas and distributing free generic morphine for pain relief to hospices and hospitals in low-income countries.
  6. Reduce the influence of the pharmaceutical industry on the practice and training of prescribers. This includes banning direct marketing of drugs by prescribers and encouraging Congress to remove the tax deductibility of pharmaceutical marketing.
  7. Stimulate innovation in response to addiction by implementing policies that correct failures in patent law and commercialization incentives, prioritizing the development of non-opioid drugs and the redesign of opioid molecules, and weighing international data more heavily in drug approval decisions.

The commission, formed in the fall of 2019, includes 18 members, who have expertise in addictions, law, neuroscience, pain medicine, public health and other areas of interest.

Reference

The Commission on the Opioid Crisis calls for urgent changes in the marketing of pharmaceuticals and the management of care. Eurek alert. Press release. February 15, 2022. Accessed February 16, 2022. https://www.eurekalert.org/news-releases/943555

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