Big Pharma, Bad Karma
By Adam Sanders
Without a doubt, we all like to be certain that the companies to whom we give our money are behaving honestly and ethically, and do not have questionable pasts. but off course, that is easier said than done. Even if we believe our preferred companies to be wholesome in their business practices, there is no guarantee that their business partners are as clean. For example, even if a video game company behaves ethically, they may manufacture their consoles made from resources bought from a company who has questionable business practices.
This raises the question: how can one be an ethical consumer when companies rest inside or operate inside of each other in large corporate webs? Undoubtedly, the consumer cannot know or influence everything about entire industries. That being said, we should attempt to answer this question anyway, and the pharmaceutical industry can be our intellectual laboratory.
Clearly, the pharmaceutical industry has suffered from a heavily tarnished reputation over the past few years, and it is rightly deserved. Nevertheless, many of us need pharmaceutical products, especially those of us with chronic health issues. Moreover, it was the pharmaceutical industry that has been producing all of the life-saving COVID vaccines. Thus, the pharmaceutical industry is still indispensable to everyday Americans. The industry’s products are stocked in pharmacies, supermarkets, doctor’s offices, and even gas stations all over the country. The most obvious corporate connection within the pharmaceutical industry is obviously that which links drug makers and hospitals.
The reason for this is that the lion’s share of opioids is fortunately not sold over the counter. How most people get dragged underfoot by the opioid crisis in the first place begins in hospitals and doctors’ offices. During the worst of the peddling spree by the pharmaceutical industries, particularly by Purdue Pharma, companies would frequently send drug representatives to hospitals and clinics in order to push the newest opioids to hit the market.[1] The deals negotiated involving the drug representatives, often with little to no oversight, often proved quite lucrative to less scrupulous medical professionals.
The result of these deals was the over prescription of opioids in exchange for kickbacks. The predation was particularly severe in rural areas.[2] The increased prevalence of high-risk jobs (e.g., construction, mining, and oil drilling) and an under-educated or uneducated population combined to provide easy targets to bilk. Additionally, it would have been bad enough had the opioids been merely overpriced and/or over-prescribed. However, as is well known, opioids are highly addictive. As a result, through the co-opting of physicians, predatory pharmaceutical corporations were able to shackle themselves to unsuspecting patients suffering from long-term or chronic pain.[3] These shackles stayed on the patients long after they were discharged from the hospital.
Even after patients left the hospital, their addiction to opioids continued. This is where the pharmacies enter into the epidemic. One would think that pharmacies would notice something suspicious about the same patients constantly having the same prescriptions filled for a disturbingly long time. However, the prescriptions were filled out by the patients’ legitimate doctors, so there would be no reason for pharmacies to think twice. Of course, that theory operates on the assumption that the pharmacies would care. More to the point, there was a major incentive for pharmacies to simply fill as many prescriptions as possible in order to get as big a cut from the sales as possible. Walgreens, CVS, and Rite-Aid were all implicated in questionable practices involving the distribution of opioid medications at various points over the past fifteen years, just to name a handful of companies.
This is where the consumer comes in. The consumer can always do their research, read the news, or consult medical experts. Sadly, as is in the case of the major three pharmaceutical chains, the consumer is often forced to choose not so much which brand is most ethical, but which brand is least unethical. To be sure, all three of these companies have their fair share of controversies and scandals entirely unrelated to the opioid epidemic. But consumers can include those concerns in their research as well. When it comes to doctor’s visits, consumers also have power unseen.
When the consumer goes to their doctor, a good idea is to do some research ahead of time to make sure that there are no other ways to treat pain apart from opioids if their doctor agrees with that approach (please do not take that, or any part of this article, as any kind of medical advice whatsoever). Additionally, if their doctor prescribes them opioids, the consumer should discuss the addiction risks or side effects with their doctor, as well as the company that makes the medication. The consumer should research what sort of involvement they may or may not have had in the Opioid Crisis. It may well prove indispensable.
If the consumer wants to arm themselves further with knowledge, it will also behoove them to look up their state’s laws and regulations regarding opioid usage, sale, and prescriptions. Furthermore, the consumer should research how the state regulates pharmaceutical companies more broadly. Like every other part of it, America’s regulatory system is a byzantine patchwork of broadly differing systems. Where the consumer lives can significantly impact their ability to navigate opioid-related issues. Finally, the consumer must research the giving and lobbying history of the pharmaceutical companies that involve the consumer’s purchasing choices. Open Secrets is a particularly beneficial resource for that.
In conclusion, there are always multiple layers to an industry’s layers of companies, producers, and suppliers. While it can seem daunting to go through the nesting doll of corporate relations, it is not as difficult as it appears to be. We live in a society with unfettered public and often free access to a company’s past dealings, controversies, litigation, and political activity. Nevertheless, our ability to harness that power pales in comparison to what was possible just twenty years ago. Thus, it is up to the consumer to utilize that power to make sure that the companies they do business with, and the companies that do business with those companies, match the consumers’ values and ethical standards.
[1] Santhanam, Laura, “What Purdue Pharma’s Settlement with Oklahoma Means for the Opioid Crisis.” PBS News Hour (PBS: March 26th, 2019). https://www.pbs.org/newshour/health/what-purdue-pharmas-settlement-with-oklahoma-means-for-the-opioid-crisis
[2] Strach, Patricia, Zuber, Katie, and Perez-Chiques, Elizabeth, “Stories from Sullivan: How a Rural Community Addresses the Opioid Crisis.” Rockefeller Institute of Government, Vol. 1 (June 27th, 2018). https://rockinst.org/wp-content/uploads/2018/06/6-26-18-Stories-from-Sullivan-Web.pdf
[3] National Institute on Drug Abuse, “Opioid Overdose Crisis.” National Institutes on Health (March 11, 2021). https://www.drugabuse.gov/drug-topics/opioids/opioid-overdose-crisis#:~:text=Roughly%2021%20to%2029%20percent,for%20chronic%20pain%20misuse%20them.&text=Between%208%20and%2012%20percent,develop%20an%20opioid%20use%20disorder.&text=An%20estimated%204%20to%206,prescription%20opioids%20transition%20to%20heroin
