Pharmaceutical Company’s Stake in the Heroin Epidemic

A heroin epidemic has been sweeping the country, with countless news reports highlighting the thousands of overdose deaths that have been occurring in recent years. Reports show that out of every 100,000 people, at least 200 are addicted to heroin. This rate continues to increase, with overdose deaths escalating by 300%.

While there are treatment options in place, addiction is a tricky, complex and often controversial disease. Science has proven that once a person has developed a physical dependency for a drug,  their brain changes how it functions and develops structurally. When it comes to heroin, an opiate, the drug binds to the opioid receptors in a person’s brain. This causes an addict’s rational thinking capacity to be highly limited. For this reason, many addiction treatments target the brain’s receptors so that the narcotic can no longer bind to them.

Many people in the U.S. who are addicted to heroin, perhaps nearly half of them according to some reports, were prescribed an opioid drug before their use became more severe. Many of these people were legally prescribed painkillers because of a medical issue or injury. As their tolerance to one painkiller began to develop and their pain or dependence persisted, many became addicted to other painkillers or heroin.

Suboxone is often considered a “wonder” drug when it comes to opiate or heroin treatment in patients. Per the U.S. Drug Addiction Treatment Act it was the first Food and Drug Administration (FDA) approved medication that was legally permissible to prescribe to addicts to combat addiction. Suboxone functions in a manner similar to heroin or other opiates; it binds to the same brain receptors that the narcotics would, but does not provide patients with the full effect, or high. It also blocks a person’s ability to get high from opiates or heroin while they are being treated with it. Perhaps most important, it lets patients avoid serious and often-dangerous withdrawal symptoms, such as a craving for drugs, relapse, depression, agitation, insomnia, impaired respiration, depression, abdominal pain, sweating, nervousness, shaking and nausea.

Many drug addicts who try to kick their opiate or heroin habit end up relapsing because the pain of withdrawal symptoms becomes too severe and frightening, medications like Suboxone can be extraordinarily helpful. With at least 10,000 people dying annually from heroin overdoses and nearly 20,000 dying from overdosing on other forms of opiates, pharmaceutical companies have a great stake in finding a safe and effective treatment to help save addict’s lives.

Before Suboxone, Methadone was the go-to treatment drug for opioid and heroin dependency. But, patients had to go to a clinic to receive Methadone; doctors could not prescribe the medication out of their offices. Although Methadone clinics are still in place, Suboxone has by and large replaced it, with pharmaceutical companies now competing for a monopoly on the “addiction market”.

There is a lot of money to be made by selling Suboxone, and Reckitt Benckiser, a major consumer goods company, knows it. Reckitt was approved exclusive rights to Suboxone by the FDA, and was making over $2 billion every year from selling it. When generic and name brand versions of the pill were on the market, causing financial competition with Reckitt, the company requested that the FDA ban them. As a result, it became clear that Reckitt was truly trying to monopolize the market, and make money off of people’s suffering and addiction.

Towards the end of 2016, thirty-six state attorney generals launched an antitrust lawsuit against two companies that Reckitt had created to sell Suboxone in different forms. The lawsuit alleged that Reckitt was “product hopping”, a term that refers to a company making very small, inconsequential changes to justify owning rights to the product. Antitrust laws throughout the country act to regulate the organization and conduct of business corporations. The laws also act to ensure that there is a fair competition for the benefit of consumers occurring. Because Reckitt was trying to create an unfair monopoly and limit competition, antitrust laws applied.

Several states involved in the antitrust lawsuit claimed that Reckitt’s actions were having deadly consequences for people. When there is a lack of competition, prices go up. Because Reckitt staged the market to have this occur, many people were unable to access Suboxone for medical treatment. In Ohio, over 85% of people who suffered from heroin addiction were unable to obtain treatment because of the market’s instability.

As a result of numerous states getting involved in Reckitt’s unscrupulous and illegal behavior, a new treatment option began to emerge. Although Suboxone had many benefits, it posed problems outside of being distributed by Reckitt. It was easy to smuggle into jails or institutions, because it came in a filmstrip form. And, because of Reckitt’s monopoly on the market, it had become too costly for patients and prescribers.

Each state has a “preferred drug list”. This list is made up of drugs that have been evaluated by the state’s Pharmacy & Therapeutics Committee, tested for effectiveness, safety and clinical outcomes. Maryland was the first state to take Suboxone off of its preferred drug list, and to replace it with a drug called Zubsolv.

Zubsolv, unlike Suboxone, comes only in pill form; there is no filmstrip version. Suboxone is only available as a filmstrip and other states, such as Ohio and Wisconsin, are considering removing Suboxone from their preferred drug lists and switching to Zubsolv instead. When it comes to the patient’s themselves, there are reports of Zubsolv being much more tolerable than Suboxone. Importantly, Zubsolv is easier for patient’s to stop taking after a period of time, whereas many people report issues with weaning themselves off of Suboxone. Zubsolv is also less costly, allowing it to be more economically accessible.

A safe, effective and moral form of treating opioid and heroin addiction is necessary now more than ever throughout the U.S. In 2014 alone there was more than 47,000 drug-related deaths and over 20 million adults suffering from drug addiction. In the past two years, these numbers have continued to climb. On its own, addiction is a terrible disease. When pharmaceutical conglomerates, such as Reckitt Benckiser, try to exploit drug-addicted citizens for financial gain, even more people end up getting hurt and dying.

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