When does recklessness become complicity? What responsibility do the vendors of highly addictive products have their customers and society at large? How far can responsibility for an individual's well being be shifted away from the addiction industries to the consumer? Until recently there were few hard and fast answers to these questions, but America appears to be providing them.
The US opioid crisis, which on average kills 130 Americans a day has been developing steadily over the course of two decades. American pharmaceutical manufacturers argued that drugs such as fentanyl could be taken for pain relief without becoming addictive. This was music to the ears of countless doctors across the USA, for whom pain relief had become a significant part of their job. Prescribing of drugs dramatically increased and so did industry profits.
The reality, of course, was that the opioids being prescribed were highly addictive and the assumption that they were not was based around a skewed understanding of addiction itself. Advocates of opioid pain medicine made a fatal and flawed distinction between 'good' and 'bad' users and assumed that individuals with legitimate reasons for needing pain relief medicine would not abuse it once it was prescribed. This sent a message to doctors across America that their natural and professional caution in prescribing was no longer required.
The harm that this flawed assumption has led to is immense. Over a fifth of chronic pain sufferers misuse opioids and roughly half of those develop a dependency. For many who become dependent of opioids, transitioning on to street heroin becomes the only way to sustain the addiction once doctors try to reduce the opioid dosage. Eight out of ten heroin addicts in the USA first used prescription opioids.
The selling of opioids, as addictive as street drugs, has become enormously profitable and the resources of an entire industry that produces, markets and sells drugs entirely legally was brought to bear. The pharmaceuticals industry has outproduced and outsold its illegal counterparts many times over. Proving that any crime has been committed has been very difficult for law enforcement officers in America, but a recent series of arrests by the Drug Enforcement Agency has changed this.
This week, drug distributor, Rochester Drug Co-Operative, was charged with conspiracy to violate narcotics laws, conspiracy to defraud the U.S., and willfully failing to file suspicious order reports. Laurence Doud III, the company's former chief executive, and William Pietruszewski, have both been charged with conspiracy to distribute controlled substances in the USA and to defraud the USA. These are the types of charges faced by the Colombian cocaine cartels.
What has changed? How have companies who have distributed drugs with impunity been held to account? The question of what a company should reasonably do to prevent itself being used as a distributor for those who wish to sell prescription drugs as narcotics is pivotal here. Some companies distributing opiates were able to claim that they had no idea that the end product would be misused.
However, when companies like Rochester were found to have supplied unverified purchasers with tens of thousands of pills, it wasn't hard for law enforcement authorities to make a strong case that they knew full well they were facilitating the illegal drugs business. Under current regulations it is down to manufacturers and distributors to ask searching questions about unorthodox or suspicious purchases. Simply claiming that the drugs were sold in good faith is not enough in the eyes of the law and unless the drug companies wanted to claim an almost childlike naivety, the argument that there was any good faith at all to speak of is hard to maintain.
So far the focus of the opioid crisis has been on America, but a recent Guardian report suggests that a similar problem is emerging in the UK. In the past decade, opioid use has increased by 60 percent, and the Heath Secretary Matt Hancock has announced that there will be health warnings about addiction printed on the side of painkiller packages. This follows a doubling of codeine related deaths in England and Wales in the past ten years as well.