Every campaign season — and often in between — we hear certain politicians rail against “big government.” We hear them bemoan how government is too “heavy-handed,” how there are too many “burdensome regulations,” how government “stifles innovation.”
All that’s probably true, of course. We can all think of things government tries to do that it probably shouldn’t — and we’ve all heard about regulations that don’t make much sense.
But how can we reconcile the belief that government regulators are squashing free enterprise with the recent revelations about how drug companies flooded the nation with highly-addictive pain pills without much regard for the consequences?
Where was the heavy-handed regulation then?
The Drug Enforcement Administration maintains a database of every pain pill sold in the United States — a remarkable statement in and of itself. Everyone, on left and right, likes to make sport of government inefficiency but here’s a rather striking example of government efficiency.
That data — once kept secret — has now been released to the public as part of a landmark lawsuit underway in Cleveland against opioid makers. For this release, we can thank the federal judge presiding over the case — and two newspaper companies who spent a year arguing in court that documents and data filed in the case should not be kept under seal.
You must believe in the value of newspapers or you wouldn’t be reading this editorial. Here’s yet another reason to value newspapers: If it wasn’t for The Washington Post and HD Media, the owner of the Charleston Gazette-Mail in West Virginia, we wouldn’t know any of this. We didn’t see any politicians, from either party, showing up in federal court in Ohio to argue for the public’s right to know. Now, thanks to those newspapers, here’s what we do know:
• “America’s largest drug companies saturated the country with 76 billion oxycodone and hydrocodone pain pills from 2006 through 2012 as the nation’s deadliest drug epidemic spun out of control.”
— The Washington Post.
• “In 2012, as the death toll from the nation’s opioid crisis mounted, drug companies shipped out enough of the powerful and addictive painkillers for every man, woman and child in the U.S. to have nearly a 20-day supply. In some counties, mostly in Appalachia, it was well over 100 days.”
— The Associated Press
Some things are simply too big for us to comprehend them. So here’s another way to think about all this: Between 2006 and 2012, enough painkillers were shipped to Norton to measure out at 306 for every person in town. Martinsville received 242 pills per person. No other place in the country got as many painkillers as Norton. CNBC recently ranked Virginia as No. 1 in its annual rankings of the best states in which to do business. These two small Virginia cities rank No. 1 and No. 3 — just in different ways.
When the Washington Post took this database and ran it through a mapping program, what emerged was what the paper called “a virtual road map to the nation’s opioid epidemic that began with prescription pills, spawned increased heroin use and resulted in the current fentanyl crisis, which added more than 67,000 to the death toll from 2013 to 2017.” Those 67,000 deaths, by the way, are on top of the nearly 100,000 overdose deaths from 2006 to 2012, the period covered by the court’s data release.
You can see that map at right: The opioid epidemic is nationwide, but concentrated in Appalachia. In the ’80s and ’90s, there were conspiracy theories that the CIA was responsible for flooding America’s inner cities with crack cocaine. Here’s the modern version of the same thing — just a different drug, a different part of the country, and different distributors. It’s also not a conspiracy theory; here we have actual documentation.
Now, there are lots of people to blame: Doctors who wrote prescriptions with wild abandon, and drug companies that were more than happy to ring up extraordinary profits. Their concern for the public was slight, to say the least. Besides the DEA database, the documents released included a deposition with an executive at Cardinal Health, one of the nation’s largest drug distributors. The executive was asked whether the company wanted to “ensure that it does what it can to prevent the public from harm.”
The executive replied: “I don’t know that Cardinal owes a duty to the public regarding that.”
Keep in mind that this wasn’t an ordinary executive, it was the company’s lawyer — who you’d like to think would be mindful of such quaint notions as a “duty to the public.” Guess not.
So who is looking out for the public here? Doesn’t look like anybody is — which brings us back to our original question: Where’s all the heavy-handed regulation we’ve been warned about? It sure doesn’t look like “burdensome regulations” were “stifling innovation” here. Drug companies were innovating, all right, and the next thing you know, nearly 100,000 people were dead and lots of others were addicted. The federal government had all this information quite literally at its fingertips and seems to have done almost nothing. The 2006 to 2012 timeline is curious because it overlaps both Republican and Democratic administrations in Washington — but mostly a Democratic one. Democrats have the reputation of being the party of big government, so where was all that big government regulation here?
The DEA has declined to comment, citing pending litigation. But there seems a lot for politicians to talk about, if they dare. Why did the government fail here? True, there are lots of people and entities who failed here, but most of those are private companies. The government, though, works for us — or is supposed to. Keith Humphreys, a Stanford University professor of psychiatry and behavior sciences, was a drug policy adviser to the administrations of both George W. Bush and Barack Obama. He told the Post that the problem is that the DEA is tough on drug dealers of the criminal variety but pays little attention to drug dealers of the corporate variety. “We have a tradition of trusting companies, and the [government] is kind of weak here,” Humphreys said. “Here it was misplaced trust.”
Ronald Reagan used to say that government wasn’t the solution, it was the problem. Here, he was right: Government was (part of) the problem. Just not in the way we usually think of.