[simonh]

According to the congressional report:

“Purdue Pharma used front organizations and sponsored research to deceive the World Health Organization and corrupt global public health policies”

If that is true and public policy was corruptly manipulated , how can you claim that this is all ok because it was allowed by public policy?

[rjf72]

I do not agree with him, but I think you're making a much more salient point indirectly.

Public policy that can be readily manipulated by bad actors (as the drug industry is certainly full of) should not be used as the final say for anything. Systems need to be able to tolerate: corruption, false information, and true but misleading information. Our regulatory systems in general seem to struggle with any of the above. If "health authorities" (to avoid naming any particular organization) can only effectively screen out good actors inadvertently engaged in bad behavior, then they're effectively useless - because bad actors do exist, and they're vastly more dangerous than the former.

[Retric]

WHO is not a regulatory agency and does not have finally authority for anything. https://www.who.int/about/role/en/

[rjf72]

It's not just the WHO. The same arguments apply equally to e.g. the FDA who played a similar role in this by rubber stamping the drugs. And similarly it also doesn't just end at the FDA as there are numerous smaller level regulatory agencies and operators involved on the medical side. Even non-regulatory agencies, such as the American Medical Association also showed themselves to be somewhat useless by decisions such as choosing to play into lobbying for consideration of pain as a vital sign.

The same is even true of things such as the FAA and the aviation industry where there were analogous issues. All of this is emphasizing that these organizations, which can be quite the burden on 'good players', are ultimately ineffective at restraining bad players which (I suppose depending on your philosophical view) should be their primary purview.

[Retric]

The FDA does quite a bit to keep both good and bad actors in check. They are not perfect, but for example they regularly track down outbreaks of food born illnesses in ways the producers simply can’t. https://www.fda.gov/safety/recalls-market-withdrawals-safety...

Making wide sweeping statements based on very specific issues simply demonstrates ignorance of how these organizations actually interact with the systems they regulate.

PS: As to FDA ‘rubber stamping’ the drug, using opioids for treatment of end of life cancer pain is perfectly reasonable. OxyContin is just one of a huge list of similar drugs that have been in use long before this outbreak. It’s not the chemical that’s the problem is the other actions by the company.

[rjf72]

Oxycontin wasn't just rubber stamped for end of life cancer treatment. You're referring to when the FDA decided to further expand Purdue's drug rights enabling it to be used on 11-16 year olds. Purdue, when seeking this approval, were already facing criminal charges for their marketing of oxycontin. And the FDA's decision in expanding treatment to kids was primarily driven by them asking Purdue to carry out studies evaluating the safety and effectiveness of oxycontin on kids, because they seem like trustworthy guys. Lo, and behold, Purdue's carried out some "studies" and told the FDA it's just awesome. And the FDA said, "Oh okay, cool." [1]

And this story repeats over and over since our entire regulatory system is, when it comes to the big and influential players from Purdue to Boeing, mostly just glorified self regulation. And that leads to a worst of both worlds scenario. We get the lack of oversight inherent in self regulation, yet it's paired with an undue faith in our regulatory systems as many people don't understand the actual regulatory processes, or lack thereof.

[1] - https://www.washingtonpost.com/national/health-science/fda-d...

[Retric]

To be clear doctors could and had already been prescribing OxyContin and other opioids to 11 year olds. The studies where about guidelines for use not ability to prescribe. In this very specific case, the system was working correctly.

Opioids are addictive and become less effective over time. Opioids can also be a valuable tool for relief of severe pain over a short to moderate period. The actual issue is not the drug in this case it’s a drug company pushing for more scales.

PS: I have seen a friend become addicted while in cancer treatment. But, I have also been prescribed opioids after major surgery. So yes they are clearly extremely dangerous, but they can treat levels of pain that are difficult to describe.