A Meal For An Overdose

Hey, how you doing? Welcome to another episode of The White Bicycle Review. 

In this post the talking point will be centered back on the opioid epidemic; more importantly, this time around the discussion will be centered on how the marketing of opioids to doctors actually seemed to correlate with the number of overdose death in a region. See, what a new study found was that when pharmaceutical companies did things like pay for trips, or even meals those targeted doctors prescribed more drugs. We’ll get take a more in-depth look at that in one moment. I hope you enjoy, and without any further delays let us begin. 

For a long time, the pharmaceutical companies have been known to be the cause of the rampant crisis that is the opioid epidemic. A health crisis that has taken hundreds of thousands of lives all the flag of the Hippocratic oath. It was already been revealed that the marketing that had been used to advertise for the painkillers played a part in the over-prescribing of these substances, but a new study has presented new evidence of just how effectively deleterious it was. 

The study that had been published on January 18th,  2019 found that the bigger the gift/payout sales reps gave to doctors the more they wrote a prescription. The report found that the industry spent about $40 million promoting the pills. They were targeted despite the ongoing public outrage at the destructiveness of that misuse of those drugs. 

Gifts can do amazing things. Even the smallest of presents can accomplish so much, and if you don’t believe it then all you have to do is look at the opioid epidemic to the power of giving. What do I mean? Well, a new study that was published in JAMA Network Open that explained that they had discovered that the gifts that pharmaceutical reps had to give doctors resulted in an increase of opioid prescriptions which lead to an 18 percent increase in overdoses in that County. 

The study exposed the fact that despite the growing knowledge of an all-consuming health crisis doctors when given gifts of some kind (including a simple meal) had continued to prescribed painkillers. In fact, with the gifts, those doctors actually wrote more scripts than those who did not receive any type of present. Some might say that that is unbelievable. Doctors are supposed to put the patient first, they took an oath yet for something as little a meal a doctor will prescribe particularly drug (or brand) more than is sometimes needed or warranted. That is astonishing, even horrific, and unethical. That being said there is a sad fact which makes this even more tragic if you will, and that is that how many of the physicians behaved is actually very human.  

Now I know what you are thinking, how could a gift even a small one, result in something so catastrophic as the opioid epidemic. Well, the answer lies in the research that has been done on the subject of reciprocity. Reciprocity is the practice of giving/exchanging things with another for mutual benefit. It is a practice that when done right can trigger an instinctive need for the recipient to give back. It is something that is, as much as even the most hardened of us may hate to admit, hardwired into the makeup of us as people. What that means is a simple small little gift like a cup of coffee, or a five dollar Starbucks gift card can result in bigger rewards for the giver down the line. A perfect example of this is a study that was discussed in a recent article in The Atlantic titled Did Free Pens Cause The Opioid Crisis? where it was discovered that even the smallest of gifts would result in greater rates of reciprocation. Take for example one experiment performed by economist Armin Falk, where potential donors were sent something as simple as postcards that were made by the children who benefited from that charity. Those simple gifts resulted in a fairly substantial increase in giving; in some instances a very impressive one. In reality, those gifts cost only pennies to print and weren’t actually made by any children, yet the idea of that sentimental and hand made craft being given as an early sign of gratitude resulted in the percentage of giving going up. 17% for just one and 75% for four postcards. What that study showed was by giving something as simple as a postcard or a pen you could get back, yield, even greater rewards. In this case, a body count. That fact begs us to ask a question, should marketing practises like this be regulated? 

Are there certain products, like narcotics, whose marketing and sales need to supervise in order to prevent the crisis that we are currently in. How do we ensure the safety of patients and their loved ones? With a very human response that we as people have built into us, how do prevent such harm? How do we prevent a free lunch from taking the life of a child’s parent? The answers to questions like that aren’t clear. Medicine as much as many may not want to view it this way, is a business, a field that people join in part to making a living. And whether we like it or not this is how things are; and this is the price of healing. Pain has always been a problem, but greed has always been much larger and harder to treat. Until then practises like gifting in return for favors is one that will probably proliferate industries like this which many leave a shattered population in the process. An unanswerable question in desperate times.