A new Congressional report accuses the World Health Organization of being corrupted by Purdue Pharma, the Oxycontin manufacturer facing a wave of lawsuits for its alleged role in causing the opioid addiction crisis.
The WHO’s guidelines for opioid prescription understate risks of addiction and mirror false or disputed claims made by Purdue in its marketing materials, the report says. And those guidelines were written in consultation with groups and individuals funded by Purdue, it alleges.
“We are highly troubled that, after igniting the opioid epidemic that cost the United States 50,000 lives in 2017 alone and tens of billions of dollars annually, Purdue is deliberately using the same playbook on an international scale,” says the report, which was written by the Offices of U.S. Reps. Katherine Clark and Hal Rogers. “Moreover, we are disturbed that the WHO, a trusted international agency, appears to be lending the opioid industry its voice and credibility. Based on the course of events that has taken place in the U.S. over the past 20 years, if the recommendations in these WHO guidelines are followed, there is a significant risk of sparking a worldwide publish health crisis.”
“We have received the most recent letter from Congress and are reviewing it point by point,” WHO spokesman Christian Lindmeier wrote in an email.
Purdue Pharma disputed the report’s conclusions in a statement, saying the Food and Drug Administration has continued to certify Oxycontin as safe for use treating chronic pain.
“Purdue strongly denies the claims in today’s congressional report, which seeks to vilify the company through baseless allegations,” the company said. “Purdue Pharma L.P. is solely based in the United States with no international operations. The company has never violated any applicable rules or guidelines and no formal complaint or enforcement activity has resulted from Purdue’s financial support or relationship with any third party. These relationships are transparent and any potential conflicts of interest are fully disclosed.”
Purdue also cited the recent dismissal of a lawsuit against it by the state of North Dakota, in which a federal judge ruled that the company could not control how doctors prescribe its products. North Dakota’s Attorney General plans to appeal the ruling.
And that case is one of dozens of state-level suits still pending, including a suit from Massachusetts Attorney General Maura Healey. In March, Purdue settled with the state of Oklahoma for $270,000, which will be used to fund addiction treatment and research.
In 2018, more than 70,000 people died of drug overdoses in the United States — a figure driven by a years-long spike in opioid abuse. About 2,000 people died from opioid overdoses in Massachusetts last year.
The rising death rates have been deemed an ongoing crisis by advocates and policymakers across the country. And while the bulk of opioid deaths are due to black-market drugs like heroin or highly potent synthetic opioids like fentanyl, researchers have placed prescription drugs like Oxycontin at the origin of the epidemic.
In the 1990s, drug manufacturers like Purdue launched aggressive marketing campaigns that described prescription opioids as safe and unlikely to lead to addiction. According to the National Institute on Drug Abuse, that was not true, with contemporary research showing that eight to 12 percent of chronic pain patients develop opioid use disorders when prescribed the drugs.
The congressional report found that the WHO’s 2011 guidelines on opioid prescriptions claim that less than one percent of patients abuse their medications, with even fewer developing dependency. But by that time a study by the National Institute on Drug Abuse had already found a vastly higher rate of substance abuse among chronic pain patients — findings that were corroborated by later studies.
The report also found that another WHO report on opioid prescriptions for children modified its recommendations in ways sought by Purdue. While the WHO had previously recommended a three-step guideline for pain medications — moving from non-opioids like ibuprofen, to mixtures like acetaminophen and codeine, to strong opioids like Oxycontin — the new guidelines eliminated that second step.
Purdue had long sought that change, viewing those low-power opioids as competition, the report found. A 1996 Purdue budget plan, released by the Florida Attorney General’s Office, included a goal of establishing “OxyContin as the opioid of choice in Step 2 of the W.H.O. analgesic stepladder.”
The report also found that some groups who worked with the WHO to help craft its pain recommendations were funded by Purdue Pharma, including the International Association for the Study of Pain and the International Association for Hospice and Palliative Care. A 2017 congressional report found extensive financial ties between opioid manufacturers and advocacy groups that promoted the use of opioids for chronic pain.