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Drug abuse and drug overdoses have taken on a new form in recent years: Prescription painkillers.

Prescription opioids, because of their highly addictive nature, were long reserved for the most severe forms of pain associated with surgery, injury or terminal diseases like cancer. That changed in the 1990s with a surge in prescribing for more common ailments like back pain, arthritis and headaches. A combination of factors fueled the trend, including new medical guidelines, insurance policies and pharmaceutical marketing for long-acting drugs like OxyContin.

With such powerful painkillers being more widely prescribed, the possibility of addiction and overdose increased: Deaths linked to addictive drugs like OxyContin, Vicodin and Percocet had increased more than fourfold since 1999, accounting for more fatal overdoses in 2012 than heroin and cocaine combined, the Associated Press reported last week. Prescription opioid abuse has claimed the lives of roughly 165,000 Americans since 2000, according to federal estimates.

Local law enforcement agencies and members of state legislatures and Congress are taking steps to attempt to combat the epidemic. But they’re running into formidable opposition from the makers of the prescription painkillers themselves.

Groups like the Pain Care Forum, a loose coalition of drug-makers, trade groups and dozens of nonprofits supported by industry funding. Painkillers are among the most widely prescribed medications in the U.S., but pharmaceutical companies and allied groups have a multitude of legislative interests beyond those drugs. From 2006 through 2015, participants in the Pain Care Forum spent more than $740 million lobbying in the nation’s capital and in all 50 statehouses on an array of issues, including opioid-related measures, according to an analysis of lobbying filings by the Center for Public Integrity and the AP.

That combined spending on lobbying and campaigns amounts to more than 200 times the $4 million spent during the same period by the handful of groups that work for restrictions on painkillers. Meanwhile, opioid sales reached $9.6 billion last year, according to IMS Health, a health information company.

While Purdue Pharma (the maker of OxyContin), Endo Pharmaceuticals and other members have maintained the forum does not take policy positions — although Purdue’s Washington lobbyist, Burt Rosen, is the forum’s co-founder — the AP and Center for Public Integrity’s reporting shows the group’s participants have worked together to push and draft federal legislation, blunt regulations and influence decisions around opioids.

The Pain Care Forum had, through a 2012 report, successfully persuaded the Food and Drug Administration of a “crisis of epidemic proportions:” That 100 million Americans were suffering from chronic pain. In a 2014 online essay, then-FDA commissioner Margaret Hamburg said reducing the escalating toll of opioid addiction and abuse in American communities was a “highest priority,” but that her agency had to “balance it with another major public health priority: managing the pain that affects an estimated 100 million Americans.”

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But Michael Von Korff of the Group Health Research Institute, whose research contributed to the statistic, said the number has no connection to opioids. Instead, he said, it mostly represents “people with run-of-the-mill pain problems who are already managing them pretty well.”

To fight this epidemic of opioid addiction and overdose, we’re going to all need to work together. Patients’ family members and other caregivers will need to educate themselves about the dangers and warning signs of opioid addiction.

That also means that the pharmaceutical companies — which make products that are supposed to ease pain and suffering — also must not use their lobbying power to fight legislation which addresses the epidemic. The greater good must be of greater importance than profit margins to Big Pharma.

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