A Few Thoughts on the Opioid Crisis

The Washington Post’s recent story on lobbyists from the pharmaceutical industry cutting the DEA off at the knees and preventing it from doing anything to intervene in the opioid crisis tracks with what I’ve seen throughout my career in healthcare.

Politicians like to talk a big game about ending the opioid crisis, but too many of them want to repeat the mistakes of the rest of the “war on drugs” by cracking down on patients and doctors.

But that’s not where the money is.

Just three companies — AmerisourceBergen, McKesson, and Cardinal Health — control 90% of the pharmaceutical distribution market in this country. They could (almost) literally snap their fingers and put a huge dent in the opioid black market overnight by flagging pharmacies that are moving implausibly large volumes of controlled substances, and making that data available to the government.

I know that’s how it would work, because I’ve spent years helping struggling rural hospitals cope with the skyrocketing cost of prescription drugs. I’ve *seen* the data I’m talking about.

The kicker to all of this is how *little* money we’re talking about in practice. A 5 mg oxycodone tablet costs less than 20 cents. Private corporations are willing to throw away people’s lives to make, oh, 2 or 3 bucks in profit on the average 30-day prescription.

That’s how much we’re worth to them.