There was an opioid epidemic 130 years ago. Can it teach us anything about today’s crisis?

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Image: Pharmaceutical Journal

The 1890s and 1990s were both characterized by unopposed amplification of the benefits of opioids, the transformation of physicians into unabashed cheerleaders, and the central role of China — first as a global consumer of opium and later as a manufacturer of fentanyl. In the 1890s, the compound marketed by Bayer to supposedly treat morphine addiction was heroin, while in the 1990s, the drug made by Purdue Pharmaceuticals and marketed as a painkiller with low potential for abuse and addiction was OxyContin.

Every prescription opioid that killed an American had a physician sign off on it. That’s why it is essential for the medical community to examine itself to see how it contributed to this tragedy.

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The biomedical industry holds broad sway over not just what physicians do but what they are taught, shaping them throughout their careers. Most training materials about opioids have been funded and developed by opioid manufacturers themselves.

Unless we make wholesale changes in how the biomedical industry can manipulate patients and physicians, we will surely find ourselves back in this quagmire at some point down the road. Training materials need to be vetted for bias, and physicians with financial conflicts of interest should be restricted from medical journal editorial boards as well as from FDA.

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