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Ruling Against Johnson & Johnson raises more questions




It could be that Johnson & Johnson is not the culprit the media reports it to be. Johnson & Johnson must pay $572 million for helping create the opioid crisis, an Oklahoma judge ruled this week. The company, said the judge, minimized the addictive hazards of prescriptions opioids in promoting the drug. But, writes Jacob Sullum, the evidence shows that medically prescribed uses of opioids are not a significant source of addiction or overdose:

Ruling against Johnson & Johnson on Monday, Cleveland County District Court Judge Thad Balkman claimed the “current stage of the Opioid Crisis…still primarily involves prescription opioids.” According to records collected by the U.S. Centers for Disease Control and Prevention (CDC), however, pain pills were involved in just 30 percent of opioid-related deaths in 2017. Most of those cases also involved other drugs, mainly heroin and illicit fentanyl or fentanyl analogs, which were implicated in three-quarters of opioid-related deaths.

Balkman likewise seems to have accepted at face value Oklahoma’s assertion that “opioids are highly addictive.” The evidence also contradicts that claim.

In 2015, according to the National Survey on Drug Use and Health, about 2 percent of Americans who took prescription opioids, including nonmedical users, qualified for a diagnosis of “opioid use disorder,” a broad category that is not limited to addiction. By comparison, about 9 percent of past-year drinkers had an “alcohol use disorder.”

A 2018 BMJ analysis of medical records found evidence of “opioid misuse” in 1 percent of patients who took pain pills after surgery. While studies find that misuse is more common among chronic pain patients, a 2016 New England Journal of Medicine articleconcluded that “rates of carefully diagnosed addiction” average less than 8 percent.

That study, which was co-authored by Nora Volkow, director of the National Institute on Drug Abuse, noted that “addiction occurs in only a small percentage of persons who are exposed to opioids—even among those with preexisting vulnerabilities.” Yet Balkman deemed such statements by Johnson & Johnson “false, misleading, and deceptive.” […]

Balkman also thought Johnson & Johnson was wrong to say opioids could be appropriate for treating chronic pain and wrong to suggest that undertreated patients might look like addicts as they desperately sought relief. Yet as South Central Judicial District Judge James Hill pointed out when he dismissed North Dakota’s lawsuit against Purdue Pharma in May, the Food and Drug Administration (FDA) has endorsed both of those propositions.

[Jacob Sullum, “The False Premises of the Ruling Against Johnson & Johnson,” Reason, August 29]


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