ProPublica reports that The American Pain Foundation has shut down just as two U.S. senators are launching a probe into the heavy financial support it received from painkiller-makers. Syndicated columnist Judy Foreman, author of the upcoming book “A Nation in Pain: Healing Our Biggest Health Problem,” considers the news and its background.
Okay, everybody, deep breath.
The US Senate on Tuesday launched what ProPublica, a generally terrific online investigative news organization, says is a probe into the makers of “narcotic painkillers” and the manufacturers’ ties to groups that advocate sane, responsible use of them. (By the way, “narcotic” is a loaded word; scientists prefer the less stigmatizing “opioid.”)
Let’s hope the Senate runs a genuinely open, fair investigation and that, in the laudable effort to examine the relationship between Big Pharma and advocacy and research groups, it doesn’t abandon pain patients who need the drugs and use them responsibly.
In the meantime, three thoughts. First off, what counts as an “epidemic?”
In a letter reportedly sent to drug makers by Chuck Grassley, an Iowa Republican, and Max Baucus, a Democrat from Montana, the Senate probe is necessary because of an “epidemic” of accidental deaths and addiction due to opioid pain relievers.
Government figures show there were 14,800 overdose deaths in 2008 that involved opioids (far fewer, incidentally, than from alcohol or cigarettes). And many of those 14,800 deaths, the data show, involved other drugs besides opioids. Is that an opioid overdose epidemic?
Secondly, the underlying assumption here is that if Big Pharma pays for advocacy groups or research studies, this automatically means that the advocacy groups or the researchers are tainted. Frankly, it often does. When research or advocacy is supported by Big Pharma money, it should raise red flags. But that’s also the easy, knee-jerk assessment. In truth, it’s often hard to know when the appearance of a conflict of interest is a real conflict.
Thirdly, the underlying problem is that pain researchers and advocacy groups more or less have to turn to Big Pharma for funding because nobody else has the money. The federal government, ideally, should be funding more pain research, but, aside from the fact that the government is broke, it does not hold pain research as a priority. Out of the massive budget for the National Institutes of Health, only 1.3 percent goes for pain research, even though pain is the main reason people go to doctors.
Big Pharma, obviously, is a mixed blessing. For better and for worse, we live in a capitalist system and the companies that make our drugs care mostly about profits. And they’re sometimes unscrupulous. In 2007, Purdue Pharma, the maker of OxyContin, pleaded guilty to federal criminal charges that it misled regulators, physicians and consumers about OxyContin’s addiction risk.
But it’s still a shame, I think, that one of the most valuable pain advocacy groups in the nation, the American Pain Foundation, has collapsed this week, as the Senate investigation gets under way. It posted an announcement on its website saying that it has ceased to exist, effective immediately, because of “irreparable economic circumstances.”
The American Pain Foundation did get 90 percent of its funding from pharmaceutical companies, as page 16 of its 2010 annual report shows. As a journalist trying to sort all this out, I really wish it didn’t. That’s a monstrous red flag.
But who will take up the cause of pain patients if groups like the APF disappear?