Felicia Detty loved with all her heart. Growing up in southern Ohio in the rural village of Frankfort, she earned the nickname “Bug” because she gave the best hugs. Her dad was her best friend, and her daughter, Averie, was the love of her life.
At 18, when Felicia visited the emergency room for severe tooth pain, she hadn't planned on getting addicted to prescription pain pills or later heroin. As her mother, Christina, put it: “She had no intention of growing up saying, ‘I want to be an addict. I want to suffer from substance-use disorder.' ”
In September, 2015, Felicia died of a heroin overdose.
Opioid addiction has become all too familiar in my home state of Ohio. The man-made public health-care disaster has spread to every county in the state. This is why, as state attorney general, I have filed suit against five of the largest manufacturers of brand-name and generic opioids.
We believe evidence will show that they flooded the market with prescription opioids, such as OxyContin and Percocet, and grossly misleading information about the risks and benefits of these drugs. And as a result, we believe countless Ohioans and other Americans have become hooked on opioid pain medications, all too often leading to the use of cheaper alternatives such as heroin and synthetic opioids. Almost 80 percent of heroin users start with prescription opioids.
Historically, opioid pain medications were considered too addictive and debilitating for anything but short-term acute pain and end-of-life care. But as we lay out in our legal complaint, starting in the late 1990s, manufacturers designed sophisticated marketing campaigns to target primary-care doctors — the doctors a typical Ohioan would visit — to convince them that opioids could and should be used for chronic pain.
These companies changed the prescribing culture, convincing doctors that opioids were not very addictive, that addiction was easy to overcome, and that addiction could actually be treated by taking more opioids. In 2014 alone, pharmaceutical companies spent $168 million to dispatch sales reps to win over these doctors with smooth pitches, slick slide decks, and glossy brochures that downplayed the risks and highlighted the benefits of their branded drugs. As Endo Pharmaceuticals openly advertised, “People who take opioids as prescribed usually do not become addicted.”
They hired doctors to serve as “key opinion leaders” on advisory boards and to be part of speaker bureaus. They funded professional societies and patient advocacy groups, which then heralded the benefits of these drugs. In 2011, they spent $14 million on ads just in medical journals.
And now, opioids are one of the most widely prescribed classes of drugs, raking in revenue of about $11 billion in 2014 and projected to grow to $17.7 billion by 2021. In 2012, Ohio patients received 793 million pills — enough to supply every man, woman, and child in the state with 68 pills each. By 2016, roughly 20 percent of Ohio’s population were prescribed opioids.
We can no longer ignore the tragic consequences of addiction to these drugs. By 2015, opioids caused 82 percent of all overdose deaths in Ohio. But it’s not just in my state. Each day, 3,600 Americans start misusing an opioid pain medication for the first time.
The opioid epidemic is ripping apart families and tearing at the fabric of our communities. More than 4,000 Ohioans died last year from accidental drug overdoses — a 36 percent increase over 2015. Our jails have become detox centers. The foster care system is overflowing. More than half of Ohio children and 70 percent of infants placed in the foster system had parents who abused drugs. County coroners are struggling to keep up with the mounting bodies. And one morgue has resorted to borrowing a 20-foot mass-casualty cold-storage trailer to make room for the corpses.
It is just and right that people who played a significant role in creating this mess should help clean it up. As Felicia Detty’s mother pondered the role these pharmaceutical companies played in her daughter's death, she said: “They had the ability to just consume all of our communities. ... But are they standing there when you kissed your child in a casket?”
I applaud President Trump in acknowledging the opioid crisis as a national emergency. Additional resources from the federal government will help hard-hit states such as Ohio.
In the mean time, it’s time for these pharmaceutical Goliaths to take responsibility for their actions and stop trying to deceive Ohio and America. What they’ve done is morally and legally wrong.
Mike DeWine is attorney general for the state of Ohio and contributed this essay to the Washington Post.
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