In a country where cannabis is federally prohibited and hemp is federally unregulated, FDA-approved opioids are killing people every day. Fortunately, drug companies are starting to pay.
On August 26, a judge ordered Johnson & Johnson to pay $572 million to the State of Oklahoma for the company’s role in the opioid epidemic, concluding a lawsuit that began in 2017.
“The opioid crisis has ravaged the state of Oklahoma and must be abated immediately,” Cleveland County District Judge Thad Balkman stated in his decision.
Balkman said that Johnson & Johnson’s misleading marketing and promotion of opioids caused an opioid crisis evidenced by increased rates of addiction, overdose deaths, and neonatal abstinence syndrome. These actions compromised the health and safety of thousands of Oklahomans.
Along with Johnson & Johnson, pharmaceutical companies Purdue Pharma and Tev also settled with Oklahoma, but for less than half the amount Johnson & Johnson paid.
Though this decision is the first of its kind in United States history, more than 40 other states have pending claims against opioid manufacturers and distributors, including a massive court case comprising over 600 lawsuits brought by numerous government entities, who allege that drug makers falsely advertised their opioid products as non-addictive.
The opioid epidemic began in the late 90s. Prior to the crisis, opioids were typically reserved for more serious complications like cancer, post-surgical pain, and end-of-life care, but companies like Johnson & Johnson began downplaying the addictive qualities of its opiate drugs and persuaded doctors to prescribe them for minor issues. Sales representatives would target doctors who were known to prescribe opioids at high-volumes, and encourage them to prescribe higher doses. They also convinced doctors and their patients that the drugs were safe and effective, that addiction was a non-issue, and that it was safe to take high doses for long periods of time.
These tactics proved extremely effective, and by the time the public realized just how addictive these drugs could be, it was too late. In the last two decades, opioid-related deaths nationwide quadrupled, and over 450,000 people have died from opioids in the United States from 1999 to 2017. An estimated 40% of these involved a prescription.
From the late 1990s until 2010, the majority of these deaths were attributed to prescriptions pain killers. From 2010 on, there has been a major increase in heroin-related deaths, and around 2013, synthetic opioids like fentanyl and tramadol began driving overdose deaths.
Oklahoma Attorney General Mike Hunter, who spearheaded the lawsuit, wrote that Johnson & Johnson’s “marketing scheme was driven by a desire to make billions for their pain franchise.” To accomplish this, “they developed and carried out a plan to directly influence and convince doctors to prescribe more and more opioids, despite the fact that defendants knew increasing the supply of opioids would lead to abuse, addiction, misuse, death, and crime.”
Responding to Balkman’s decision, Johnson & Johnson attorney Sabrina Strong said: “We have sympathy for those who suffer from opioid use disorder. But Johnson & Johnson did not cause the opioid abuse crisis here in Oklahoma or anywhere in this country.”
Johnson & Johnson’s argued they could not be held accountable for supplying legal products regulated by the FDA.
The debate over who to hold accountable for the opioid epidemic generally focuses on misinformation versus personal agency. Does the blame lie with the drug companies who actively misled the public, the doctors who actually did the prescribing, or the patients who were free to make their own choices? In reality, all three are contributing factors, but divvying up the blame will continue to prove a highly contentious matter.
But there are glimmers of hope. In addition to this landmark settlement, CBD may be able to treat opioid addiction and curb the use of opioids. A study published in the American Journal of Psychiatry found that CBD helped reduce cravings in addicts for heroin and other opioids. The effects were still present seven days after CBD exposure, and researchers found no serious adverse effects. The treatment also helped lower their anxiety.
CBD treatments for chronic pain are also in development. Certain cannabis molecules called cannflavins are nearly 30 times more effective at reducing inflammation than aspirin. But turning these molecules into viable treatment is difficult because cannflavins only make up a tiny amount of the plant matter. To work toward a solution, a research team from the University of Guelph in Ontario is partnering with Canadian cannabis company Anahit to biosynthesize cannflavins outside of the cannabis plant.
“Anahit will commercialize the application of cannflavin A and B to be accessible to consumers through a variety of medical and athletic products such as creams, pills, sports drinks, transdermal patches and other innovative options,” said Anahit COO Darren Carrigan.