Bivens on the sociopathy of the opioid crisis.

Matt Bivens, blogger and full-time emergency room doctor, today came out with the second part of his series on “the sociopathy of the option crisis.  The first part came out in early May.  A third part is yet to come.

He shows that the pharmaceutical companies knowingly lied when they claimed opioids were not addictive to most patients.  The “study” they used to support the claim was a five-sentence letter to the editor of the New England Journal of Medicine in 1980.

The most glaring and cynical example their attitude is an Austin Powers-themed motivational and training video by the opioid manufacturer Cephalon in 2006.

Click on this to watch the full video

As Dr. Bivens described it:

This Austin Powers-themed motivational video … … was made by the opioid manufacturer Cephalon, Inc. for its sales staff, and discusses how they will market their new dissolve-in-the-mouth fentanyl tablet. Cephalon was able to patent generic fentanyl as Fentora® by adding in Alka Seltzer®-style “plop plop fizz fizz” effervescence. It was also able to patent generic fentanyl as Actiq® by making it into a lollypop. Feel free to eye-roll in disgust, but that’s how you make a cheap drug expensive: Tweak how the medication gets delivered into the body, and claim it’s now a completely new substance, worthy of a new patent. … …

The 2006 Fentora® motivational video, shown to a New York jury in 2021 over the strenuous objections of the Cephalon legal team, edits new audio into scenes from the cult classic movie Austin Powers: International Man of Mystery. “Gentlemen! I have a plan. It’s quite brilliant,” says Dr. Evil. “We are going to roll out a blockbuster marketing campaign, focusing on ‘effervescent speed’ — a concept so nebulous, so indecipherable, it will absolutely help drive prescriptions … to Fentora®!”

When his staff of fellow villains tell him that’s already been tried but “FDA shut it down,” a disappointed Dr. Evil quickly recovers. Punctuating his speech with frequent air quotes, he outlines his next evil plan:

“We will do studies in low-back breakthrough pain, neuropathic breakthrough pain and for all non-cancer breakthrough pain — a new ‘pivotal study.’  Using these ‘studies,’ we will … show doctors around the world that Fentora® ‘works for all breakthrough pain.’ “

Cephalon (later taken over by Teva Pharmaceuticals) failed to get the FDA to agree that fizzy or lollypop fentanyl were safe for anyone other than a patient with terminal cancer, and in 2008 had to pay a $425 million fine for marketing fun-and-fizzy fentanyl too broadly.

But at moment, I’m more interested in the frank, mocking acknowledgement of how pharmaceutical companies fund and organize “studies” — the very studies used to justify their commercially-sold products. That practice has massive implications for what we call evidence-based medicine. … …

It’s one thing to nudge-wink people into buying Paxlovid® or Tamiflu® — stuff that’s questionably effective, yet basically harmless. It’s something else entirely to con people into prescribing, buying or ingesting the world’s most dangerous and addictive substances. We are looking at hundreds of thousands of opioid overdose deaths so far, with models predicting we’ll chalk up the millionth opioid-specific overdose death sometime in the next 2-3 years. Tens of millions of families have been ravaged by the tragedy of an avoidable opioid addiction. In just one 10-year period of this 25-plus-years nightmare (2011-2021), more than 320,000 children lost a parent to an opioid.

And yet, to this day, the House of Medicine simply can’t be bothered to look into how it happened. Everyone knows we serenely and calmly let deception-based scientific “studies” (Dr. Evil air quotes) — lie, after lie, after dishonest lie — lead us doctors into bringing about a public health catastrophe. But there’s no reckoning. The House of Medicine says: “Well, the lawyers will take care of it.” Did our collective screw-up kill the mother or father of more than 300,000 children? Medicine whistles nervously, and looks away.

LINKS

Truest Crime: a deep dive into the sociopathy of the Opioid Crisis by Matt Bivens M.D. for The 100 Days.

The Conspiracy to Game the Medical Literature: Part II chronicling the sociopathy of the Optoid Crisis by Matt Bivens M.D.  for The 100 Days.

Austin Powers parody film by Cephalon Inc. from the Internet Archive.

Tags: Drug Addiction, Opioids