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Thursday, January 13, 2022

Recommended: Dopesick, the Hulu series & book

If you haven't watched it, I highly recommend Hulu's limited series starring Michael Keaton, Dopesick, based on the book Dopesick: Dealers, Doctors and the Drug Company that Addicted America by Beth Macy. It tells the story of the lawsuits of over-prescription of addictive pharmaceutical drugs and the corporations and marketing schemes behind opioid crisis. It shows the pain and the magnitude of the epidemic and behind the scenes dramatization of the executive greed, the doctors who prescribed and the attorney generals who ventured to take on a privately held billion dollar pharma. There are dozens of ongoing cases and also interesting angle is the Sackler's family philanthropy (from Harvard to the Louvre to Tel Aviv U to Guggenheim) and new questions about name removal (I believe the Louvre is the first to remove their name from association with the museum). 

Posted by Orly Lobel on January 13, 2022 at 04:44 PM | Permalink


So sorry, I meant to post this here, although I suppose there may be a need for a joint effort. Godspeed!

“The Court believes that these individuals have given a distorted meaning to the COVID-19 vaccine, rather than recognize the vaccine for what it is—an effective and safe means of minimizing transmission and illness.“

Where is the Data that affirms this is, in fact, factual?

Posted by: N.D. | Jan 19, 2022 4:08:21 PM

Could congress designate itself as an A3 court?

Posted by: thegreatdisappointment | Jan 14, 2022 8:07:51 AM

Prof. Sherry Colb wrote a blog post on it. Worthwhile.


Posted by: Joe | Jan 13, 2022 11:12:15 PM

The Sachlers did some bad things and a bunch of doctors either naively (or because they let themselves be I fluenced) did some bad things.

Unfortunately, the US is responding with it's usual moral panic about drugs. Rather than committing to more after approval advice to be given to doctors to balance pharmaceutical companies (that would potentially cost a fair bit of money) or helping to better educate the public as to when they should seek second opinions or are embarking on potentially risky treatments we are trying to impose liability on pharmacies and scare doctors with threats to their licenses if they prescribe too much.

But there are plenty of people who do really need these medications. The concern that pain was undermanaged was quite real (drugs can be both over and underprescribed at the same time) and others have huge quality of life benefits from other kinds of potentially abusable non-opiate medications.

But these gatekeepers simply lack the information or expertise to evaluate whether a prescription is proper. An overworked pharmacist at Walmart (nor even a medically untrained DEA employee) can't easily tell the difference between a legitimate pain management doctor whose patients are traveling across the state because so few doctors are willing to handle their pain and a pill mill.

Unfortunately, our current approach is ideally suited to create a two-tier system. Rich white patients can get whatever they want because the pharmacists aren't as suspicious (I rarely accept racial explanations but the quick deciscion by a pharmacist based on little info except appearence and what other scripts they've seen from that doctor is a perfect way to elicit latent stereotypes), they can easily shop around for doctors and more likely to have a helpful PCP who sees lots of patients for less urgent matters so won't raise suspicions. OTOH if you are poor and in pain or need other meds your best hope is a doctor who can specialize but see patients at volume.

And the incentives are in exactly the wrong direction. Ideally, we want these drugs primarily prescribed by experts who deal with this kind of thing all the time rather than shutting them down (well scaring them) and letting each PCP manage a few patients on these medications.

Posted by: Peter Gerdes | Jan 13, 2022 8:51:04 PM

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