Harsher Punishments Are the Only Way to Stop the Opioid Epidemic

The opioid epidemic has been progressively getting worse since its start in the late 1990s. According to the CDC, in 2021 there was a staggering “…100,306 drug overdose deaths in the United States…in April 2021, an increase of 28.5% from the 78,056 deaths during the same period the year before.” This is the first time ever that opioid overdose deaths have surpassed 100,000, and it will keep exponentially rising until action is taken. The only way to stop the opioid epidemic is to establish harsher punishments on anyone illegally distributing opioids, including doctors that overprescribe their medications and pharmaceutical companies that overdeliver opioids or distribute unsafe versions of them. 

Opioids are medications that are prescribed by doctors to patients to ease the severe or persistent pain of their patients. They act by blocking the pain receptors in the brain and make you feel happy and relaxed.  However, these prescriptions are highly addictive that can easily kill someone.  Common deadly types of opioids include Oxycontin, Vicodin, Percocet’s, and Fentanyl. The only legal way to obtain opioids is getting prescription from a doctor for a legitimate medical reason. Drug dealers are people who illegally distribute opioids and other drugs, while an opioid distributor is anyone who gives out opioids including drug dealers, doctors, and pharmaceuticals. 

A prescription is when a doctor writes a note that claims the patient needs a drug and authorizes the pharmacist to give it to them. However, sometimes doctors overprescribe their opioids which can be extremely deadly to their patients. Physician Ronald Hirsch, in his article, “The Opioid Epidemic: It’s Time to Place Blame Where It Belongs,” admits that “…we prescribe 30 or 60 pills when 5 or 20 would have been adequate.” Although doctors sometimes overprescribe medications without ill intent and just want their patient to not feel as much pain, prescribing too many opioids will most likely cause them to become addicted and search for the drugs anywhere they could find them.             

For most people that road leads to the same destination: a drug overdose. An overdose is when someone takes a poisonous number of drugs at the same time which results can cause slow or stopped heart rate, unconsciousness, seizures, etc. If any of these symptoms go without intervention, the person can die. 

Overdoses and its effects are well known by anyone distributing opioids, whether it be drug dealers, doctors, or pharmaceuticals, and they know that it will lead to death in most cases. However, many of these opioid providers give these opioids regardless of its dangers, so if the person they provided the opioids to dies, these providers should be charged with manslaughter or even murder. 

Manslaughter is killing someone without malice aforethought while murder is the premeditated killing of someone. Manslaughter is typically a one-to-five-year sentence whereas murder is generally a life sentence. Manslaughter is a more appropriate charge in most cases because while distributing opioids leads to people dying, most of the time the distributor is not giving drugs to kill someone, but rather for money or sex. However, if an opioid dealer gives out ridiculous amounts of opioids, they should be charged with murder instead because they know that with that many opioids, an overdose is certain. 

Targeting the providers of opioids rather than opioids themselves is important because opioids are beneficial when used properly by medical professionals and making them completely illegal would just create more of an underground demand for them. By charging opioid distributors with harsher punishments instead, they will be much more careful when giving out opioids.

In the court case, R vs Kennedy, a drug dealer, Simon Kennedy, was charged with manslaughter when his customer, Marco Bosque, died of an overdose. The prosecutor’s case was that because Kennedy supplied the opioid that led to Bosque’s death, he is responsible and should be convicted of manslaughter. However, the court sided with Kennedy and established that when a person supplies a drug to a fully informed and responsible adult, and they end up dying from freely using the drug, the supplier cannot be held responsible.

Many people agree with the court’s decision and think drug dealers are not responsible for a customer overusing an opioid and the drug dealer should just be charged with illegal drug distribution and nothing more.

This argument is invalid because an opiate abuser cannot be classified as a “responsible” after opioids have altered their state of mind. Opioids cause damage to major brain systems which hinders decision-making ability. According to the National Library of Medicine, opioids target areas such as the Locus Coeruleus, which has neurons that are responsible for “[producing] a chemical, noradrenaline (NA), and [distributing] it to the other parts of the brain where it stimulates wakefulness, breathing, blood pressure, and general alertness, among other functions.”

Opioids also target the prefrontal cortex which is “important for regulation of judgement, planning, and other executive functions.” Use of opioids suppress the release of NA causing tiredness and decreased vigilance and convinces the prefrontal cortex that the drugs are worth it. With compromised brain functions, an opiate abuser is not responsible enough to control himself/herself, so if a drug dealer supplies them opiates, they are responsible if anything happens to them. The dealers know what the consequences are of taking an opioid, yet they give it anyway just for some money. 

Drug dealers are the smallest contributors to the opioid epidemic. The bigger problem are doctors because they have a larger access to opioids and have the responsibility to only give them for medical emergencies. If they abuse their power by overprescribing, it is even more dangerous and murder would be more appropriate than manslaughter. 

Doctors all around the United States have been accused of handing out prescription opioids to patients for personal gain. New York Times author Campbell Robertson, in his essay, “Doctors Accused of Trading Opioid Prescriptions for Sex and Cash,” discusses “the ’single largest prescription opioid law enforcement operation in history.’” In 2019, “…60 people, including 31 doctors, seven pharmacists, and eight nurses…” were all charged with “…schemes to illegally distribute millions of pain pills.” They prescribed opioids for fake operations, wrote blank signed prescription pads, and even brought opioids to their own homes and invited prostitutes to come over.

Investigations revealed that more than 32 million pills were distributed which is “the equivalent of a dose of opioids for every man, woman, and child across the states of Ohio, Kentucky, Tennessee, Alabama, and West Virginia,” according to Campbell. These 5 states are significant because they were where almost all the accused doctors were from, and all of them, besides Alabama, also happen to be in the top 5 states with the highest rates of drug overdose deaths that year according to the CDC drug mortality rates. 

These illegally given prescriptions are the reason those states have extremely high overdose death rates, meaning the doctors are directly responsible. While some of them did receive up to 10 years of jail time, the sentences should be much larger considering their crimes. A life sentence would be much more appropriate because not only did they commit drug trafficking, but they also exploited drug-addicted prostitutes by having sex with them when they were not in the right state of mind and murdered people by providing so many highly addictive opioids.

People argue that doctors that overprescribe medications already face hard enough punishments whether it be exorbitant fines or losing their license to practice and adding manslaughter would be too harsh.

Just last year in San Diego, “Brenton Wynn, M.D., has paid $200,000 to resolve allegations that he illegally prescribed opioids and other dangerous drugs to his patients…” according to the Department of Justice. He had been illegally providing these drugs for over 5 years, and the prescriptions consisted of all deadly opioids including “…fentanyl, oxycodone, hydromorphone, methadone, oxymorphone, morphine…Xanax, and valium.”

Because these were just allegations, there was no determination of how liable Brenton was, so he only lost his ability to prescribe these medications and had to pay the fine. However, this is not enough punishment because $200,000 is not nearly enough to compensate for any human lives lost because of his own greed. Over the course of 5 years, these drugs could have led to dozens of people to die from overdosing because of how dangerous they are especially when using more than one at the same time.

For justice to be served, further investigations by the Department of Justice need to be done on all his patient histories to find which patients he prescribed opioids to, how legitimate the prescriptions were, and if anyone died from overdosing on one of his prescriptions. If there are any patients that did die, then Wynn should not only lose his license to practice, but also should be charged and arrested for manslaughter. 

The jury made the wrong decision because Keller should have been found guilty for being directly responsible for all 9 patients’ deaths. He prescribed the maximum dosage of highly addictive opioids to his patients along with Soma, a muscle relaxant, which is extremely dangerous if taken with opioids. Rob Bonta, in his report, “Attorney General Becerra Announces Arrest and Charges Against Santa Rosa Doctor for Overprescribing Opioids, Second-Degree Murder” explains that “Keller is alleged to have continued his dangerous treatment despite Red Flag warnings from pharmacies and insurance companies, his own observations of his patients, and knowledge of his patients’ deaths from drug overdose.” The fact that he knew that his patients were dying, yet he continued prescribing the opioids is what makes this murder, and not just manslaughter. 

Many people think setting such harsh punishments would cause people to be less willing to go into healthcare which is already a profession that desperately needs more workers. However, healthcare is an extremely consequential career where mistakes can lead to people dying unnecessarily, so weeding out anyone that fears making those mistakes is not a problem. Also, if it is a genuine mistake, they are right that murder would be too harsh of a punishment, but the manslaughter might still be necessary for cases with gross negligence involved. 

An example of this would be the case of, “RaDonda Vaught, a former nurse criminally prosecuted for a fatal drug error in 2017, [who] was convicted of gross neglect…” according to Brett Kelman, in his article, “Former nurse found guilty in accidental injection death of 75-year-old patient.” Vaught was supposed to administer Versed, a relaxant, but instead administered vecuronium, a powerful paralyzer. The patient died because his lungs became paralyzed, and Vaught was held responsible after ignoring multiple warnings signs and administering the drug anyway.

While unrelated to opioids, this case was a recent groundbreaking case that established that gross neglect could result in jail time as Vaught was sentenced to eight years in prison. Many nurses are upset with the decision because they claim, “this could be any of us” and that it’s not worth it to continue working with so much at risk. 

However, there were many red flags that Vaught ignored when she made this mistake. According to the WKRN Web Staff, in their article, “Documents: Former Vanderbilt nurse missed red flags before administering fatal dose,” explains that “…Vaught was familiar with Versed and had given it to patients before. The steps to administer Vecuronium are very different.” The cap on the vial for Vecuronium has “paralyzing agent” written in bright red on it, and she would’ve had to have seen this to draw the medication into a syringe. She also should’ve stayed with the patient after giving the medication to make sure nothing goes wrong, and if she did that, she would notice that the patients were showing symptoms of paralysis. 

This type of gross negligence is extremely dangerous because hospitals always have harmful drugs, including opioids, so vigilance is one of the most important things a health care professional could have. The argument that nurses make, “this could happen to any of them,” is seriously concerning because it means that mistakes like this are common and not frowned upon. Decisions like this need to be made so that health care workers are reminded how much their work means, and by establishing manslaughter as a common punishment for doctors, they too will be more careful. 

Other doctors that were proven responsible for the deaths of their patients due to overdose were charged with murder. Dr. Thomas Keller was charged with 9 counts of second-degree murder for over-prescribing medications. However, Chantelle Lee, in his essay, “Jury acquits Santa Rosa pain doctor of two murder charges but hung on remaining murder charges” explains that “…the jury returned a not guilty verdict for four of the nine counts against Keller,” and were undecided on the rest of the 5 charges.  

Another major cause for the immense number of opioid overdoses in the Unites States is the pharmaceutical companies that marketed their drugs as not that addicting. 

According to the U.S. Department of Health and Human Services, the opioid epidemic started “In the late 1990s, [when] pharmaceutical companies reassured the medical community that patients would not become addicted to pain relievers and healthcare providers began to prescribe them at greater rates.” Because of the increased prescriptions being given out, people became highly addicted to the opioids causing widespread opioid abuse. 

One of the main pharmaceutical companies that did this was Purdue Pharma, manufacturer of OxyContin. They aggressively marketed Oxycontin as a non-addictive and necessary drug for pain management. After the opioid epidemic began, Purdue Pharma insisted that they did not know that their drugs were addictive.

However, Barry Meier, in his article, “Origins of an Epidemic: Purdue Pharma Knew Its Opioids Were Widely Abused” claims that “…a copy of a confidential Justice Department report shows that…Purdue Pharma knew about the ‘significant’ abuse of OxyContin in the first years after the drug’s introduction in 1996 and concealed that information.” 

They received reports early on that the drugs were being stolen from pharmacies to be crushed and snorted on the streets, yet they continued to market their drugs as not addictive. Organizations like the “American Pain Society” and “Joint Commission” were also misled by Purdue Pharma and stressed the safety of Oxycontin as well. Joint Commission even “[published] a guide sponsored by Purdue Pharma…[that] stated ‘Some clinicians have inaccurate and exaggerated concerns out addiction, tolerance and risk of death.’” These vouches for safety directly caused Oxycontin to be underestimated and widely abused. 

Fortunately, Purdue Pharma was held responsible for turning a blind eye. Meier continued “In 2007, Purdue Pharma pleaded guilty to a felony charge of ’misbranding’ OxyContin, while marketing the drug by misrepresenting, among other things, its risk of addiction and potential to be abused.” The company had to pay $634.5 million in fines and the top officials of the company had to perform community service. 

However, this was not enough justice considering the 500,000 people that died from opioid abuse in the last 2 decades and many people publicly protested and criticized this lackluster punishment; in 2021, the federal government acted and forced Purdue Pharma into bankruptcy. The owners, the Sackler family, were forced to pay up to $10 billion dollars to settle the damages OxyContin caused and dissolve their company. The only issue was that this deal enabled the Sackler family to avoid liability and keep their personal wealth.

After more protests, in March 2022, “A federal judge…overturned Purdue Pharma’s settlement…[that] contained a provision that would protect members of the Sackler family from civil lawsuits without declaring themselves personally bankrupt.” claims Amah-Rose Abrams in, “A Federal Judge Has Overturned Purdue Pharma’s Highly Contested Oxycontin Settlement.” 

This level of prosecution has been long awaited and a critical step in holding the guilty parties responsible. Purdue Pharma being prosecuted was a ground-breaking case which warns companies to prioritize safety over greed.

People claim that pharmaceutical companies aren’t even providing drugs to individual people, so a manslaughter charge would not make sense. 

However, pharmaceutical companies produce all the opioids, and they control where they go and how much goes there. If there is a particular place that seems to be ordering an abundant number of opioids, pharmaceutical companies need to act as checks and balances system by either investigating why there are so many opioids being delivered, or limiting the delivery based off population. According to the Washington Post, a small town in West Virginia with a population of just over three thousand, was shipped “…nearly 21 million prescription painkillers [over the past decade]” to split between just two pharmacies that are 0.2 miles apart.

The two pharmacies, Tug Valley Pharmacy and Hurley’s Drug Store, are within 4 blocks of each other. When asked about the deliveries, Tug Valley declined to comment while the Hurley’s Drug Store claimed that “…while the numbers may seem disproportionate, the two pharmacies have to cover a large service area.” Opioids are meant to be given sparingly and only for emergencies, so even if the population is larger than the small town, 2.1 million drugs is way too many for them all to be given legitimately.

In his article, “Why were millions of opioid pills sent to a West Virginia town of 3,000?” Chris McGreal interviewed Sgt. Mike Smith, part of the West Virginia state police, about the two pharmacies. Smith said “‘Let’s call this whole thing what it is. It’s pretty much a cartel. A drug trafficking organization…then right in the middle of this drug trafficking organization, you have a little pharmacy that pops up and everybody’s OK with it.’”

West Virginia is the leading state in drug overdose cases, and suspicious activity like these pharmacies is the reason why. Smith confirmed that these pharmacies are handing out illegal prescriptions, and if people die from these prescriptions, the pharmaceutical companies need to be held responsible in some sort of way for their lack of surveillance. Although they can’t be charged with manslaughter, they should have to pay exorbitant fines.

The argument that manslaughter is too harsh a punishment for doctors and dealers because they are not responsible for how someone used their product is not valid. This is because a person that has used opioids in the past is not under the right state of mind and can’t be classified as “responsible” for themselves. The argument that manslaughter is too harsh because there are already harsh enough punishments is also not valid because the outcome of their negligence or indifference is death.

The reason these increased criminal measures need to be taken is because drug use has reached all time high numbers with close to 100,000 people dying a year, and countless others having health problems due to these drugs with Oxycontin, Percocet’s, and Vicodin being major contributors to that number. “About 38% of adults in 2017 battled illicit drug disorders” and “drug abuse and addiction cost American society more than $740 billion annually…”. These statistics were taken 5 years ago and the numbers have increased even more since then. The only way to stop the opioid epidemic is to target the source.

References:

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Centers for Disease Control and Prevention. (2021, November 17). Drug overdose deaths in the U.S. top 100,000 annually. Centers for Disease Control and Prevention. Retrieved May 5, 2022, from https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2021/20211117.htm

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Hirsch, R. (2017). The opioid epidemic: It’s time to place blame where it belongs. Missouri medicine. Retrieved May 4, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6140023/

Lee, C. (2020, March 21). Santa rosa pain doctor acquitted of two murder charges. Santa Rosa Press Democrat. Retrieved May 4, 2022, from https://www.pressdemocrat.com/article/news/jury-acquits-santa-rosa-pain-doctor-of-two-murder-charges-but-hung-on-rema/

Attorney general Becerra announces arrest and charges against Santa Rosa Doctor for overprescribing opioids, second-degree murder. State of California – Department of Justice – Office of the Attorney General. (2019, August 19). Retrieved May 6, 2022, from https://oag.ca.gov/news/press-releases/attorney-general-becerra-announces-arrest-and-charges-against-santa-rosa-doctor

Meier, B. (2018, May 29). Origins of an epidemic: Purdue Pharma knew its opioids were widely abused. The New York Times. Retrieved May 4, 2022, from https://www.nytimes.com/2018/05/29/health/purdue-opioids-oxycontin.html

Robertson, C. (2019, April 17). Doctors accused of trading opioid prescriptions for sex and cash. The New York Times. Retrieved May 5, 2022, from https://www.nytimes.com/2019/04/17/us/doctor-arrested-prescription-drugs.html

Abrams, A.-R. (2021, December 17). A federal judge has overturned Purdue Pharma’s highly contested Oxycontin Settlement. Artnet News. Retrieved May 6, 2022, from https://news.artnet.com/art-world/judge-overturns-purdue-pharma-settlement-ruling-2050562

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