Opioid Prescribing Doctors Are Drug Dealers in White Coats

In 2019, America’s “public enemy number one” has manifested itself not as illegal substances like crack cocaine, but in the form of prescription painkillers. This opioid epidemic is fueled by a racketeering system that champions increased profits for pharmaceutical companies at the expense of public health.

The eyes of the federal court system and local law enforcement have historically been trained to focus squarely on the stereotypical Black or Brown street-level delinquent and the neighborhoods they live in, often locking up minorities for petty drug offenses. The devastating impact of the drug war on Black communities remains measurable today. However, a more high profile offender has infiltrated American communities to push pills more potent than heroin and cocaine, manufacturing guaranteed-to-return customers. As a result, American physicians are prescribing millions of opioid pills for patients who do not need them. PBS called the opioid epidemic the “unintended consequence of the increased use and acceptance of prescription opioids.”

Pharmaceutical companies spend more money marketing their drugs to doctors than they do on funding the development of new drugs and treatments. According to a report from US News, these companies spend “billions” on influencing physicians to write more prescriptions for their products. Forty-eight percent of doctors received some form of payment from pharmaceutical or device-manufacturing companies in 2015, and pharmaceutical representatives often offer to take physicians to lunch to discuss drugs or medical devices. Pharmaceutical companies intentionally position their products and services as the most desirable to influence a physician’s decision about which medication to prescribe. The “gifts” appear to influence a physician’s habits when writing prescriptions, according to UCLA professor Ian Larkin. According to a report by ProPublica, although doctors have long since claimed that compensation from pharmaceutical companies does not influence their medical decision-making process, “the more money doctors receive from drug and medical device companies, the more brand-name drugs they tend to prescribe.”

Prescribing highly addictive substances to countless patients who do not need them violates the first, and most essential part of the Hippocratic Oath: first do no harm.

Enough opioid prescriptions are written each year for every American to have their own bottle of pills. Painkillers literally “hijack the brain” and their effects are indistinguishable from those of heroin. The Centers for Disease Control and Prevention (CDC) links the rise in opioid addiction to changes in prescription practices; when the usage of opioids to treat pain was limited, the rate of opioid abuse remained limited. However, after pharmaceutical companies convinced doctors that opioids were safe and non-addictive, the number of prescriptions for painkillers doubled. Today, the opioid epidemic spans 50 states.

The most commonly prescribed opioids include hydrocodone and fentanyl. Coincidentally, those same drugs are also the most common causes of fatal opioid overdoses. A comparison of overdose rates among prescription and non-prescription illegal drugs demonstrates that opioids prove more deadly. In 2016, double the number of Americans died from overdosing on Fentanyl than on stereotypical “street drugs” like heroin, marijuana, and cocaine — the original antagonists of the crackdown on illegal substances.

Since Richard Nixon popularized the phrase in 1971, America’s War on Drugs has disproportionately targeted Black and Latinx people, and led to minority groups serving more prison time, even for lesser drug offenses. According to FBI data reviewed by the Southern Poverty Law Center, Black people are three times more likely to be arrested for marijuana possession. This is true even though Black and white people use the drug at very similar rates. Keep in mind, these individuals are being locked up simply for possession of marijuana — not for selling it — and aren’t likely to have access to enough people to push drugs on a massive scale. Meanwhile, the Centers for Disease Control and Prevention (CDC) report that doctors prescribe millions of pills to patients who have no medical need for them. Furthermore, a researcher for the National Survey on Drug Use and Health has stated that there is “virtually no risk” of death as a result of cannabis exposure, while the most commonly prescribed opioids are among the most common causes of the nation’s fatal overdoses.

Even when physicians do face legal recourse for their actions, these doctors are often granted reprieves that lessen the severity of the punishments. For example, in 2010, one Florida doctor was arrested for illegally selling 47 pain pills. In this case, the doctor was not pushing pills under the guise of bogus prescription; the doctor was openly selling painkillers and faced just two years of prison time. That same year, two physicians were arrested for selling pills from their office and faced no prison time at all. Meanwhile, in states like Oklahoma, Florida, and Tennessee, possession of less than one ounce of marijuana can make you a felon. Doctors are provided protections from legal punishment not afforded to average citizens. This extra protection provides an opportunity for these individuals to engage in criminal activity which harms public welfare.

Highly addictive substances are unleashed into neighborhoods for profit, while community members suffer premature death, broken families, and orphaned children. American physicians should be held to high standards and subjected to the same legal recourse as ordinary people in order to protect public health and slow the growth of the deadly epidemic facing the nation. In addition, pharmaceutical companies and physicians must conduct honest and transparent interactions that allow for patients to gain maximum understanding of their doctor’s relationship with drug companies, and gain awareness of the risks of taking certain drugs.

About the Author

Niara Savage is a Fisk University student and a political correspondent for The Nashville Voice online newspaper. Her debut novel, The Killing of Gregory Noble, was published in 2018 and explores American police brutality. She is passionate about social justice issues relating to education and healthcare, and plans to pursue a PhD in clinical psychology.