Article by Sam Mellace, This
The year 2017 will be remembered as the year Canadian media finally got serious about reporting the deadly epidemic of opioid addiction in this country. The Globe and Mail, the CBC, the Toronto Star, Maclean’s, the Huffington Post, and many other outlets have devoted not just isolated stories but aggressive ongoing coverage of what is now considered to be the gravest health-care crisis of the twenty-first century.
The company that patented OxyContin, Purdue Pharma LP, has earned over $30 billion (US) from the drug since it was introduced in 1992. An aggressive marketing campaign focused on the drug’s revolutionary ability to treat severe pain over long periods of time, but the company has long been accused of concealing the risks of addiction inherent in its signature product.
In 2007, Purdue Pharma was forced to pay a $635-million (US) fine after three of its top executives pleaded guilty in a US Federal Court to criminal charges that they deliberately misled the government, doctors, and patients about OxyContin’s addiction properties. It was the largest monetary penalty in US pharmaceutical history, but it was equivalent to less than the amount of revenue the company earned on the drug every six months! In 2017, the company settled a class-action suit brought against it in Canada for $20 million, representing 2,000 Canadians who had become addicted to OxyContin. The company and other makers of prescription opioids continue to face lawsuits and accusations in many US states and in Canada concerning addiction, negligence, and misrepresentation of the drug’s benefits. And all makers of prescription opioids, like Vicodin, Demerol, Percocet, and their many generic equivalents, are bracing for a crackdown.
Sure, millions have found pain relief from OxyContin and its opioid cousins, but at the cost of thousands dead and tens of thousands addicted. The Globe and Mail reported that, since the turn of the millennium, over 6,000 people in Ontario alone have died from opioid abuse. Billions of dollars have been earned, but at the cost of billions more to the health-care system to treat addiction, and to the economy in lost productivity. And the true cost to families—that may be impossible to put a number on. In 2017, we’re starting to learn the tragic truth about prescription opioids. And even though pharmaceutical companies have been lying to the government and doctors for decades, it’s hard to forgive their ignorance. After all, these are opioids—powerful narcotics synthesized from the opium poppy—the same drugs that many governments sought to ban in the early twentieth century before they decided that it would be politically easier to demonize cannabis — a non-addictive, non-lethal drug.1
After my car accident, my doctors prescribed me opioids for the pain—morphine, Percocet and Demerol at first, and later the infamous OxyContin. I was taking up to 80 milligrams a day just to be able to sit up, walk, and get through my agonizing physical therapy. I never questioned my doctors — I just wanted pain relief. I wanted some part of my life back. But with each patented time-release capsule I popped, I was unwittingly sinking deeper and deeper into an abyss of depression, addiction, and bodily harm. I suffered through the side effects—vomiting, dizziness, irritability, headaches, a zombie-like state of constant drowsiness—because I so desperately needed the pain to go away. Recent studies have shown that prescription opioids can wreak all sorts of gruesome effects on the human body, including irregular heartbeat, difficulty breathing, swelling of muscle and organ tissue, and cyanosis (when your skin, lips and fingernails turn blue from lack of oxygen). We also know (now) that the most catastrophic effect of long-term or excessive prescription opioid use, other than simply death by overdose, is liver failure. The liver is responsible for metabolizing opioids (and other drugs introduced to the body, from Tylenol to alcohol and cannabis). Medical science is just starting to learn how the liver’s basic metabolic operations can become over-taxed by opioids, so severe is the process of metabolizing them. It’s like running your car at 7,000 rpm for hours on end—eventually the engine is going to overheat, the oil is going to burn out, and your car will break down in a smoking heap of charred metal.
Your liver uses special enzymes to metabolize drugs and introduce their beneficial (e.g. pain-killing) properties into your bloodstream. These enzymes essentially die off during metabolism and need to be regenerated. Your liver works hard to reproduce them—sometimes so hard that the organ itself becomes enlarged and starts interfering with other bodily processes. This is what happens with opioids like OxyContin. The liver can also simply start to decay from being overworked. With alcoholism this is called cirrhosis. With opioids it’s simply called failure. And it was, in truth, a massive failure, not just of my own body, but also of the people and institutions that recommended opioids to me in the first place.
My doctors told me I had a year to live—maybe less. This was after I returned home from Cuba, after I registered at Vancouver General Hospital for a course of chemotherapy that left me strung out and vomiting and barely able to stand, after I was prescribed a second, more intensive type of chemotherapy which also failed to work. When I treat or counsel people—anyone who’s suffered from the trauma of cancer—I know I can look them straight in the eye when I speak to them about the difficult choices they face. I’ve faced them too. “Get your affairs in order,” Susan’s oncologist told her. “Get your affairs in order,” Manni’s oncologist told her. That’s exactly what my doctors said to me in 2004. Chemo wasn’t working. My body was too broken. Within a year, the doctors told me, either my liver would fail completely, or I might hemorrhage and bleed internally to death, or the cancer would simply destroy my immunity and a simple infection would be the death of me. “One year to live.” Maybe.