Recent reporting on the consequences of PHARMA bad behavior

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There were a couple of articles published this week about bad behavior from PHARMA.

First, Vox looks into the roots of the overdose epidemic and Purdue Pharma’s role in policy changes that set the stage for the explosion in opioid prescribing and addiction. (Of course, Purdue profited from these policy changes.)

Andrew Kolodny and other public health experts explained the history in the Annual Review of Public Health, detailing Purdue Pharma’s involvement after it put OxyContin on the market in the 1990s:

Between 1996 and 2002, Purdue Pharma funded more than 20,000 pain-related educational programs through direct sponsorship or financial grants and launched a multifaceted campaign to encourage long-term use of [opioid painkillers] for chronic non-cancer pain. As part of this campaign, Purdue provided financial support to the American Pain Society, the American Academy of Pain Medicine, the Federation of State Medical Boards, the Joint Commission, pain patient groups, and other organizations. In turn, these groups all advocated for more aggressive identification and treatment of pain, especially use of [opioid painkillers].

Choose you evidence carefully by rocket ship

Choose you evidence carefully by rocket ship

Second, BMJ published an analysis finding that drug manufacturers withheld information about antidepressants and suicidal thoughts and aggression in children.

In the latest and most comprehensive analysis, published last week in BMJ (the British Medical Journal),a group of researchers at the Nordic Cochrane Center in Copenhagen showed that pharmaceutical companies were not presenting the full extent of serious harm in clinical study reports, which are detailed documents sent to regulatory authorities such as the U.S. Food and Drug Administration and the European Medicines Agency (EMA) when applying for approval of a new drug. The researchers examined documents from 70 double-blind, placebo-controlled trials of two common types of antidepressants—selective serotonin reuptake inhibitors (SSRI) and serotonin and norepinephrine reuptake inhibitors (SNRI)—and found that the occurrence of suicidal thoughts and aggressive behavior doubled in children and adolescents who used these medications.

The article correctly frames this a part of a larger pattern.

This paper comes on the heels of disturbing charges about conflicts of interest in reports on antidepressant trials. Last September a study published in the Journal of Clinical Epidemiology revealed that a third of meta-analyses of antidepressant studies were written by pharma employees and that these were 22 times less likely than other meta-studies to include negative statements about the drug. That same month another research group reported that after reanalyzing the data from Study 329, a 2001 clinical trial of Paxil funded by GlaxoSmithKline, they uncovered exaggerated efficacy and undisclosed harm to adolescents.

The author offers this conclusion:

Taken together with other research that raises questions about the pros and cons of this class of drugs—including studies that suggest antidepressants are only marginally better than placebos—some experts say it is time to reevaluate. “My view is that we really don’t have good enough evidence that antidepressants are effective and we have increasing evidence that they can be harmful,” Moncrieff says. “So we need to go into reverse and stop this increasing trend of prescribing [them].”

4 Comments

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4 responses to “Recent reporting on the consequences of PHARMA bad behavior

  1. Gail Chmielewski

    Suboxone needs to be in this mix. The biggest lie ever! Reckitt Bensckiser is making billions off this opiate based drug that keeps addicts in the addiction cycle. Most sell the Suboxone (paid by Medicaid) to buy heroin and the cycle continues. Doctors with no understanding of addiction are now “addiction specialists” after 8 hours online training!

  2. Reckitt Benkiser lost their patent a year ago, so you have all kinds of formularies of buprenorphine like subutex, zubsolv, butrans and coming soon probuphine. Would love, Gail, to send you a DVD by Dr. Matt Torrington, free of charge, that explains how the opiate dependent brain is different and why buprenorphine has saved so many lives. If you still have the same opinion, after watching his hour long presentation and the questions asked by folks like you, so be it. However, if you are in the addiction field, you’d best get used to science increasingly becoming part of the treatment process. I respect your right to have an opinion, but, make sure that the evidence is accurate. You are right that it is in the narcotic family, however, it is an agonist and an antagonist on the indicated receptor sites. Please keep an open mind and realize that dead people don’t get sober, they are just dead.

    • Gail Chmielewski

      I have worked in the field for 24 years, see Suboxone at work every day. I tried to be open at first but the results are dismal.

      • And are your patients detoxed, using buprenorphine or are they maintained for an individualized time. Patient centered care, that includes quality education, family involvement, grief recovery and 12 step connections, appears to work very well with MAT, in our facility for the last ten years. We have, yet, to have an overdose death during treatment or on discharge. The majority of our patients stabilize and begin to get some hope that there is a life without opiates. The taper is individualized after a period of six months, or so, to allow them to grasp recovery and for the partial agonist to mitigate the Mu and Kappa receptors. Our outcomes have been consistently good. I can get into numbers, but anything like the 5% that we used to get combining clonidine and valium, would be an improvement. Perhaps, Dr. Torrington’s presentation could help your staff to gain a new perception of how it works and why so many programs are shifting to MAT.

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