Marketing plays a major role in the types of drugs that physicians prescribe and patients request. Anyone who remembers the iconic “little sad blob” from Zoloft commercials knows that advertising can make a powerful impact on patients. However these companies have been reluctant to curb these actions. This is primarily because marketing and advertising efforts provide a core source of revenue for pharmaceutical companies. In an unprecedented move, Pfizer recently agreed to adopt a code of conduct for marketing opioid painkillers. The effects of this marketing code remain to be seen, but it could help patients recognize the inherent risks in taking prescription opioids.
Risks of Widespread Opioid Use
Taking opioid medications makes a person vulnerable to numerous risks. One major risk is opioid dependence. This is a physiological state in which a person’s body becomes accustomed to the presence of opioids. When people take opioid medications over long periods of time, their bodies begin to adjust to the fact that opioids are always present. This means that they often develop a tolerance to the drug. Thus, requiring larger and larger doses to achieve the same effect. Additionally, prescription opioid users may experience withdrawal symptoms when they go without the drug. This includes a profile of symptoms in which the body is reacting to the loss of the drug.
Nearly everyone who uses prescription opioids over the long term will develop some degree of opioid dependence. Additionally, some patients will develop opioid addiction. Addiction is a behavioral state in which a person craves the drug, engages in persistent drug-seeking behavior, and continues using drugs despite harm. Opioid addiction can lead to patients taking more and more of the drug, placing them at risk of an opioid overdose.
We Cannot Overlook The Benefits of Prescription Opioids
Although opioids have very serious risks and our country is facing an opioid epidemic of unprecedented proportions, it is important not to overlook the very real benefits of prescription opioids. Since the introduction of morphine in the 1800s, doctors have been using opioids to alleviate pain associated with surgery and other medical conditions. This has transformed the face of medicine and improved quality of life for millions of patients. Without prescription opioids, facing a surgical procedure, acute injury, or cancer-related pain would lead to intense pain and suffering.
Opioids are also commonly prescribed as a treatment for chronic pain. While these medications do cause relief for many patients, they are a double-edged sword. In the short term, prescription opioids lead to symptom relief and can help chronic pain patients regain their everyday functions. Unfortunately, long term use of prescription opioids can actually lead to hyperalgesia, or increased sensitivity to pain. The exact mechanisms by which this occur are not clearly understood. It appears that using opioids over longer periods of time alter the neurons in pain pathways. This causes them to be more sensitive to painful stimuli. In short, using opioids for chronic non-cancer pain not only can lead to addiction but may also make patients more sensitive to pain. In the long run, this ends up hurting chronic pain patients even more.
How the Pfizer Code of Conduct May Restore Truth in Advertising
In a shocking move, Pfizer has disclosed that prescription opioid medications “carry serious risk of addiction — even when used properly.” This is a huge turnaround for a major pharmaceutical company. Most drug manufacturers are reluctant to admit that prescription opioids can have harmful effects. Furthermore, Pfizer has agreed to change its marketing practices surrounding prescription opioids.
This code of conduct includes disclosures in promotional materials that say that using prescription opioids seriously increases risk of addiction, even when the drugs are used as prescribed. Pfizer also agreed not to market prescription opioids for off-label purposes, such as for chronic, non-cancer pain. Finally, Pfizer disclosed that there isn’t good scientific evidence showing opioids are effective for a period longer than 12 weeks. Many industry leaders hope that the new Pfizer guidelines will push other major pharmaceutical companies to take similar actions.
Risks of Long-Term Opioid Use, University of Utah Health Care. Retrieved on 07/18/2016.
Physical Dependence and Addiction, NAABT. Retrieved on 07/18/2016.