Dallas Morning News
Jeffrey Simon | Contributor

This country, Dallas County included, is in the midst of the largest drug epidemic in its history.

Approximately 47,000 Americans died in 2017 as a result of opioid-related accidental overdoses, according to the Centers for Disease Control. Every 18 months, more die as a result of accidental opioid overdoses than the total number of U.S. soldiers lost in the Vietnam War. In addition to this vast human misery, the economic cost of the opioid epidemic is staggering. The White House has estimated that nationwide the cost is over $500 billion a year.

Poppy-based pain serums have been around for thousands of years, with opioid drugs such as morphine available by prescription in the U.S. since before the Civil War. However, the current public health crisis created by opioids is relatively recent and unique in our history, beginning in the mid-1990s when certain drug companies began directly targeting health care providers with promotional messages disguised as new, objective science.

Beginning around 1996, opioid manufacturers sought to expand the opioid marketplace beyond a narrow population of patients with advanced cancer, acute physical trauma, or invasive surgeries to patients with virtually any persistent pain complaint. A target market comprising more than 50 million Americans, this presented a very big business opportunity for drug companies.

These patients, the drug companies insisted, were being vastly undertreated for their pain, and opioids were the answer, they claimed. Their marketing challenge at the time: Doctors closely monitored opioid use because they knew the drug was highly addictive and accidental overdose was a risk.

But drug companies turned to sophisticated marketing to help achieve their goals. Large, financially incentivized drug company sales forces canvassed the country, explaining to health care professionals that there was at long last a “new” class of opioids that provided effective pain relief without the dangerous, known side effects of ready addiction and overdoses. Specially engineered to prevent overdose and overuse, they claimed, these new opioids were effective and safe for perpetual use.

However, there were two problems with this messaging: It was false and it was harmful to human health.

The drug companies also targeted the mediums that they knew influenced the drug prescribing habits of physicians. By financially underwriting medical associations and accrediting agencies, drug companies literally wrote new prescribing guidelines for pain treatment: prescribe copious amounts of opioids, they told them. Drug companies also quietly, but handsomely, paid key pain management opinion leaders to promote these false promotional messages.

The marketing was both wildly successful and highly destructive. Oxycontin, introduced to market in 1996, earned its manufacturer Purdue Pharma more than $1 billion a year in revenue by the early 2000s. By 2004, Oxycontin was one of the most abused drugs in America, earning it the nickname “hillbilly heroin.”

Records reveal that in Dallas County alone, more than 461 million opioid pills were sold between 2006 and 2012. That’s enough for every man, woman and child in Dallas County to consume 28 narcotic pills a year during that span.

The manufacturers are not the only group that caused this public health crisis. Distributors and retailers had the duty to identify, report and stop shipments and sales of suspicious drug orders but chose not to do so. Some doctors and patients engaged in illegal sales and must be held accountable for their misconduct. But statistics show that the great majority of opioid overdoses occur in people who are taking the pills as prescribed by a doctor running a legitimate medical practice.

Dallas County government and its residents have seen enough of this plague. Something must be done to stem the tide. The fundamental question is who should pay for the treatment programs, extra law enforcement, and prevention programs that are needed to reduce this ongoing scourge: Dallas County taxpayers or companies that caused the epidemic and profiteered from it?

I say the drug companies that are legally responsible should be held financially accountable. It’s long overdue.

Jeffrey Simon is a name partner in Simon Greenstone Panatier and represents states, counties and municipalities seeking compensation from opioid manufacturers. He wrote this column for The Dallas Morning News.