We need to work together to tackle S.C. opioid crisis


The Charleston County Medical Society wrote an op-ed that was published Aug. 13 in The Post and Courier. I appreciate the group engaging in this discussion, and I want to offer some additional thoughts, mainly focused on long-term sustainable solutions to the opioid epidemic.

I believe now is the time for all of us to willingly come to the table with solutions on how we can work together to curb the rising death toll plaguing this state and save lives.

In order to do that, and to ensure that we are never placed in this position again, we have to take an honest look at the circumstances that brought us to this point. Only then can we begin to address the real source of this grave epidemic.

In 2017, my office filed a lawsuit against Purdue Pharma, the manufacturer of OxyContin.

This is one step in holding accountable the company that, in my view, helped engineer the opioid epidemic through its deceptive marketing tactics.

The medical community has long recognized the addictive nature of opioids. Prior to Purdue Pharma's alleged deceptive marketing of its opioid OxyContin, physicians prescribed opioids sparingly to treat conditions such as short-term acute pain, cancer and end-of-life care.

The suit my office filed alleges that, in order to expand its market, sales and profits, Purdue Pharma deceptively played down the risk that patients could become addicted to opioids and swayed medical practice and public perception about the safety and efficacy of opioids.

Over time, other companies followed Purdue's marketing model. Some doctors started issuing prescriptions for widespread chronic conditions, such as back pain, migraines and arthritis. The widespread use of opioids on a long-term basis increased the number of our residents addicted to them.

Today, many people in South Carolina who now find themselves battling opioid addiction had no prior issue with drugs until they received a prescription and began taking an opioid painkiller. Addiction treatment centers in South Carolina report that at least 50 percent of their patients migrated from prescription opioids to heroin. And this issue is not unique to our state. For example, a study of 254 accidental opioid overdose deaths in Utah found that 92 percent died after receiving prescriptions from health care providers for treatment of chronic pain.

We alleged in our suit against Purdue Pharma that the company misled everyone, including doctors. For example, our lawsuit says Purdue falsely assured doctors that patients receiving opioid prescriptions for pain generally would not become addicted. The company also claimed that doctors could manage the risk of addiction simply by using screening tools to identify patients at greatest risk. Those assertions are, and always were, false.

We also allege Purdue told doctors that patients who did appear addicted were not; they were "pseudo-addicted" and needed more opioids - the most dangerous possible response.

Our lawsuit says Purdue claimed opioids relieved pain when used long term, even though there's no long-term evidence about the safety or effectiveness of opioids or the risk of using them long term. And finally we allege that Purdue told doctors that opioids could be taken in higher and higher doses, even though high-dose opioids increase the risk of addiction and overdose.

While the roots of the opioid epidemic are now becoming clearer, the solution is large and complex. We need accountability and open, constructive conversations across industry, county and city lines to develop and implement a strategy that works for South Carolina. I hope to see everyone at the table.

Alan Wilson is attorney general of South Carolina.