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Opioid Epidemic

The North American opioid crisis as a case study in multi-system regulatory failure

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The profit motives of actors inside and outside of the health care system will repeatedly generate harmful over-provision of addictive pharmaceuticals unless regulatory systems are fundamentally reformed.

The Commission therefore makes the following recommendations:

Curbing industry influence on prescribers

  • Recommendation 1a: Curtail pharmaceutical product promotion

  • Recommendation 1b: Decouple pharmaceutical industry donations to universities and professional associations from control over the content of medical education.

Curbing industry influence on regulators

  • Recommendation 1c: Close the “revolving door” of officials overseeing the pharmaceutical industry leaving government to work on the industry’s behalf.

  • Recommendation 1d: Post-FDA approval data collection on adverse effects of medications and provider education on risk mitigation should be made the responsibility of government.

  • Recommendation 1e: Bodies that have legal or regulatory power to shape prescribing should accept no funding from industry and include no individuals with direct financial ties to industry.

Curbing industry influence on the political process

  • Recommendation 1f: The USA should restore limits on the political campaign donations of pharmaceutical companies. 

  • Recommendation 1g: Prevent the pharmaceutical industry from covertly funding “astroturf” advocacy organizations.