In an effort to cut prescription painkiller addiction and overdose deaths, the CDC created prescribing guidelines. But it looks like Big Pharma is delaying those guidelines, likely to protect drug sales.

Under the proposed guidelines, doctors would prescribe patients non-opioid painkillers first for chronic pain, and only prescribe opioids, like OxyContin, if the non-opioid drugs don’t work. The agency also wants physicians to prescribe the smallest amount of the drugs possible, typically 3 days or less for acute pain. Doctors would only continue prescribing the drugs if patients show significant improvement. [1]

Those guidelines were set to go into effect this month, but last month, the agency abandoned its January release date amid harsh criticism from drug-makers, industry-funded organizations, and public health officials.

A federal panel – the Interagency Pain Research Coordinating Committee (IPRCC) – has been one of the guidelines’ most vocal opponents. The panel, consisting of federal scientists, outside academics, and patient representatives, has a lot to lose from the release of the directive.

Nearly 1/3 of members on the committee have financial ties to dangerous prescription painkiller makers. [2]

Earlier this month, U.S. Food and Drug Administration (FDA) officials and other agencies convened a meeting of pain experts, where at least 5 of the 18 committee members who attended had Big Pharma connections.

One of those Big Pharma shills is a pain specialist from Duke University who has received thousands of dollars from drug manufacturers, such as Purdue Pharma, the maker of OxyContin, and Teva Pharmaceuticals, which sells generic painkillers.

The Duke University professor, Dr. Richard Payne, who implied that the experts who helped to draft the CDC guidelines had undisclosed “conflicts of interests in terms of biases, intellectual conflicts,” has financial links to numerous drug companies. Between 2013 and 2014, Payne received $8,660 in speaking fees, meals, travel accommodations, and other payments from pain drug-makers, according to federal records.

More than half of that amount came from Purdue Pharma, which raked in $2.5 billion in OxyContin sales in 2014.

Additionally, Payne holds a chair at the Center for Practical Bioethics, a Kansas City nonprofit with longstanding ties to Purdue, Teva, Endo Pharmaceuticals, and other drug-makers. The Center for Practical Bioethics claims that drug and device manufacturers have contributed approximately 4-5% of its funding in the last 4 years, but the center does not publish specific donation amounts.

Payne is just one example of panel members who have a clear conflict of interest. Another member connected to the drug-industry, a patient advocate, holds a nonprofit position created by a $1.5 million donation from Purdue Pharma.

At least 3 other panelists who attended the meeting work for nonprofits that receive funding from Big Pharma, including The U.S. Pain Foundation, the American Chronic Pain Association, and the Chronic Pain Research Alliance, all of which receive funding from Purdue Pharma. [3]

The IPRCC has unabashedly slammed the CDC’s efforts to curb prescription drug abuse. Just last month, some committee members called the draft “ridiculous,” “horrible,” and “shortsighted.” One group threatened to sue.

The CDC announced within a week of the committee’s temper tantrum that it would seek public comments on its guidance for 30 days.

Dr. Michael Carome of Public Citizen, a consumer watchdog group that is not connected to the panel, said the conflicts “reflect failings of the federal staff” who vetted the panelists. “It corrupted the process, or gives the perception of corrupting the process,” he told The New York Times.

A Department of Health and Human Services (DHHS) spokeswoman said in a statement that all panel members “have met the criteria for membership, including disclosure requirements.”

The National Institutes of Health (NIH) claims it can’t release the panelists’ financial disclosure forms, even under the Freedom of Information Act.

Anti-addiction groups are concerned that the Interagency Pain Research Coordinating Committee’s rabblerousing will just result in more delays, and, in turn, more addiction and deaths. But pitted against physician and patient groups linked to Big Pharma, anti-addiction groups will most certainly lose.

“They’re very well-funded and they have a lot of pharma money behind them,” said Dr. Lewis Nelson of New York University, an FDA adviser who is also advising the CDC on its guidelines. “And then you have the anti-addiction groups on the other side, which is clearly much less funded and organized.”

In 2014, there were 18,893 deaths related to opioid painkiller overdoses, according to the U.S. Centers for Disease Control and Prevention (CDC). Drug overdose was the leading cause of injury death in 2013. CDC statistics show that among people aged 25-64 years old, drug overdose caused more deaths than car accidents.

Something needs to change.

Sources:

[1] The Associated Press

[2] Philly.com

[3] The New York Times


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About Julie Fidler:
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Julie Fidler is a freelance writer, legal blogger, and the author of Adventures in Holy Matrimony: For Better or the Absolute Worst. She lives in Pennsylvania with her husband and two ridiculously spoiled cats. She occasionally pontificates on her blog.