American Consequences - September 2018



or chronic pain. And that number jumps to 40% among older people. Before we fully understood the addictive nature of these drugs, synthetic opioid painkillers were considered a breakthrough for these patients. They are now the most prescribed form of medicine in the U.S. – with around 215 million prescriptions dispensed per year, as of 2016 (the most recent data available). The U.S. Drug Enforcement Administration (DEA) cautions that these drugs are highly dangerous and have a high potential for abuse and addiction. And yet, prescriptions remain common. Given the number of prescriptions, the drugs’ addictive nature, and the fact that patients’ tolerance can increase with use, it’s not surprising that people have begun to call it an “epidemic.” In 2016 alone, 42,249 people died from opioid overdoses... Many of them were just like Ernest Gallego. Right now, the public, the government, and outside competition is stacking up against the wholesalers that distribute these drugs. Let’s take a look at the industry that is fueling the widespread drug distribution that we’re seeing... THE MOST VULNERABLE PLAYERS IN THE DRUG MARKET It’s not an exaggeration to say that in the opioid epidemic, the “Big Three” drug wholesale distributors – McKesson,

AmerisourceBergen, and Cardinal Health – bear a huge share of the blame. Collectively, the Big Three hold 85% of the opioid-distribution market. Their reckless distribution practices are flooding the market with opioids. According to the more than 350 lawsuits filed by states, counties, and municipalities at the end of February 2018, the distributors have been woefully irresponsible. You see, companies have to obtain licenses to distribute drugs... especially controlled substances. The government imposes strict duties on distributors – requiring them to identify, stop, and report suspicious orders. These lawsuits say that the companies with these licenses have neglected their duties. And they’re also being accused of outright fraud. Allegations include regularly filling orders so large that there could be no legitimate purpose. Many believe these neglectful practices have contributed to the tragedy that we face in the U.S. today. Drug overdoses are now the No. 1 cause of death for Americans under 50. And analysts estimate that opioids could contribute to nearly half a million deaths over the next decade. The problem has become so massive that it’s causing strain on state and local governments who pay for treatments. And that doesn’t even count the associated law-enforcement costs. All told, Bloomberg Intelligence estimates the costs at about $20 billion a year. Governments can no longer look the other way.

50 September 2018

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