The Lede, Monday, Feb. 12, 2018
By David Royse
The End of an Era in Opioid Painkiller Marketing
Purdue Pharma, makers of opioid painkiller OxyContin, will no longer market opioid medicines to doctors.
The company said it will reduce its sales force by half and no longer send salespeople to doctors’ offices to try to sell them on the painkiller, which years ago was seen as a breakthrough medication for sufferers of the worst pain, but has since been blamed for starting an epidemic of addiction and overdoses.
Obviously, the public health crisis of way too widespread addiction and abuse that followed the rise in opioid prescribing remains and will be battled for a long time to come.
Purdue Pharma has faced several lawsuits over its manufacture of the drugs.
That effort continued over the past few days on several fronts – though many of these efforts admittedly will be marginal:
Lawmakers in Washington State are considering a wide-ranging approach to the crisis that includes making OD-antidote drug naloxone more easily available and expanding the state’s prescription monitoring program beyond hospitals.
The Seattle Times most recent story on that bill notes that opioids are now the leading cause of accidental death in Washington State. Let that sink in.
Other legislation under consideration in Washington State would limit the supply of opiate drugs to seven days in some circumstances. The story does quote some patients who note that could be a huge problem for people with legitimate pain needs who haven’t found relief any other way. (It also might be worth noting – and the story doesn’t – that losing access to legitimately prescribed prescription painkillers is also part of the problem – some addicted patients seek a replacement for prescribed opioids by seeking out heroin.)
The notion that we screwed up by so broadly and excitedly making opioids our pain-reliever of choice is firmly ensconced now in the national consciousness, in the medical community, the political community, and among the general public. It may be that for pain sufferers quoted in the Seattle Times story, the die is cast, and we’re headed eventually for a pharmacopeia without opioid pain medication.
SO WHAT’S NEXT?
What then, for pain sufferers who get no relief from other drugs or treatments?
The National Institutes of Health says about 1 in 10 American adults says some part of their body is in pain at least some of the time – many of them say it is all of the time. More middle-aged Americans than ever claim to be suffering with chronic pain.
If you or anyone you know suffers from difficult pain – or you just find this incredibly important question interesting – I have a story you should read when you have time. It’s a bit long, but you can hold it until this evening or the weekend. Or whenever, but give it a read.
The answer, like so many other answers, may lie in genetics.
I first read about sodium channel blockers late last year in a journal publication that deals with new therapies. The revolution in studying the genome has led researchers to understand that some genetic changes seem to correspond to pain syndromes- and are now interested in whether they may have a totally new way to deal with otherwise untreatable pain.
I started to report the story myself, but in my research found as good a story as you could hope for already existed – from Wired Magazine back in April.
Clinical trials on new drugs based on this new science are under way.
“Such a drug would not merely dull inflammation the way ibuprofen does or alter our neurochemistry the way opioids do: It would block the transmission of pain signals from cell to cell without ruinous side effects on the brain or body.”
The White House Wants To Help Fix This Opioid Problem, too
The president today released the White House’s proposed 2019 budget and among the proposed spending items is $17 billion for fighting the opioid epidemic, which is killing more Americans than car crashes.
The Department of Health and Human Services will get much of that to expand prevention, treatment, recovery and mental health services — $3 billion for 2018 and $10 billion for 2019, reports The Hill.
Genetic science may help us solve the problem of chronic pain, but something else recently replaced back pain as the number one cause of disability for people around the world. Want to guess?
MENTAL HEALTH MONDAY
An incredible 300 million people suffer from depression, according to the World Health Organization.
Forbes late last week reported on a new study in the Journal of General Internal Medicine that said the problem goes beyond that huge number: it says only about a third of those newly diagnosed with depression get treatment.
That kind of mental health news tends to be undercovered, in part because it’s hard for those who don’t suffer from mental illness to empathize.
But in case you missed it, there was a mental health story this morning that did get some coverage – the type that, probably, most often does: a celebrity opened up about battling a mental disorder.
Johnny Football, Hesiman Trophy Winner Johnny Manziel, said on Good Morning America this morning that he has battled depression and has bipolar disorder.
HOW WE WILL LIVE
News from the future.
We keep writing here about self-driving cars and trucks. But you never see them.
You’re not looking.
Autonomous vehicle technology company Embark recently completed a 2,400-mile, coast-to-coast journey in one of its self-driving trucks, going from California to Florida. There was a driver aboard who could take over when needed, and because of trucking work rules, the trip took longer than it would without a driver. Once the truck can make the trip without a driver, boom! A five-day trip becomes a two-day trip. Obviously bad for truck drivers. But good for trucking companies and anyone who wants to ship stuff across the country.
The New York Times has a story today about a Democratic candidate you’ve never heard of running for president in 2020 whose message is mostly about the coming robot appocalypse
Driverless trucks will create social unrest, he argues.
“’We’re going to have a million truck drivers out of work who are 94 percent male, with an average level of education of high school or one year of college,'” the candidate, Andrew Yang, says in The Times.
‘“That one innovation,'” he continued, ‘will be enough to create riots in the street. And we’re about to do the same thing to retail workers, call center workers, fast-food workers, insurance companies, accounting firms.’”
(He also argues that we’ve already, in effect, had that rioting in the streets in places where we’ve already replaced humans – in manufacturing centers. That “rioting” was the 2016 election).
(Elon Musk – who has given us some really cool tech – has also sounded some alarms about AI and called for some regulation.)
MORE NEWS TODAY FROM THE ADMINISTRATION – IT’S INFRASTRUCTURE
The president is expanding today on his proposal to boost the nation’s infrastructure, a plan that calls on federal, state and local government to put about $15 trillion into road, port, airport and other improvements.
“Administration officials previewing the plan said it would feature two key components: an injection of funding for new investments and help speed up repairs of crumbling roads and airports, as well as a streamlined permitting process that would truncate the wait time to get projects underway. Officials said the $200 billion in federal support would come from cuts to existing programs.
“Half the money would go to grants for transportation, water, flood control, cleanup at some of the country’s most polluted sites and other projects.”
The plan calls for the feds to put up just a fraction of the money – the $200 billion out of $1 trillion or more in called-for spending.
Notes CNN Money: “The rest is supposed to come from state and local governments, which are expected to match any federal allocation by a four-to-one ratio. That’s a reversal from precedent, in which the federal government has picked up around 80 percent of the cost of big projects.”
“The block grants would allot $20 billion for “transformative programs” meant for new projects rather than rehabilitation of old infrastructure.”
NORTHEAST: The New York Post notes that one of the biggest proposed infrastructure projects already out there, the New York-New Jersey effort to refurbish some bridges and tunnels connecting the two states at New York City known as The Gateway Project, remains stalled and may not get any money from Trump’s push.
L.A. SALES TAX A MODEL: As the LA Times reports, a 2016 local half cent sales tax increase there that helped expand the local subway and light rail system and boosted street and bridge renovations, is a model for how the administration views the way infrastructure upgrades should be paid for.
The U.S. Conference of Mayors agrees that local governments best know how to spend money meant for local infrastructure upgrades, and say cities should be central to the infrastructure revamp effort. BUT – they’d prefer the money come from federal taxpayers in the form of block grants, not local tax increases.
Nothing on public-private partnerships:
From CNBC: “‘Nothing [from the White House] will mandate public-private partnerships,’ one senior administration official said, though noting such transformative projects like the Hyperloop, were it pursued, would require such funding.”
Axios’ Jonathan Swan and Caitlin Owens write that the infrastructure plan is not likely to pass as is, because of Republican resistance to mushrooming debt.
NOTES FROM THE AGE OF DISRUPTION:
Is cutting hundreds of jobs in its consumer business in Seattle, as the company shifts resources into fast-growing areas like its work on voice assistant Alexa. Reuters
Is putting in place a new requirement that US drivers take a six-hour break after 12 consecutive hours of driving. Quartz
Is putting Cortana on Microsoft Launcher 4.6 for Android. Windows Central
Facebook and Google:
Unilever, one of the world’s biggest spenders on advertising, has threatened to pull ads from digital platforms such as Facebook and Google if they “create division” in society or fail to protect children. Reuters
This newsletter covers cryptocurrency quite a bit, so I apologize for failing to mention last week that it had a day in the Capitol Hill sun – but was baffling as ever. The Senate Banking Committee heard testimony on bitcoin and other cryptocurrency issues, but may have come away frustrated as they heard from regulators who don’t really know what to do with it – because they don’t know what it is. “What’s so challenging about bitcoin is that it has characteristics of multiple different things,” Commodity Futures Trading Commission Chairman Chris Giancarlo told the panel. You can watch the whole thing on C-Span.
Something that caught my eye:
FACEBOOK LOSING YOUNG USERS TO SNAPCHAT
From AdAge: “The social network is expected to shed 18-to-24-year-old users this year for the first time, according to a new report from eMarketer, which predicts a 5.6 decline for the age group on Facebook. The analytics and data firm had already predicted a decline in usage of kids younger than 18, but now sees that exodus widening.”
LEDE ON LEARNING – NEWS FROM THE SCHOOLS
The Tech Companies Have Research on Their Role in Education
Let’s be really careful with that. It may not be good research.
QUOTE OF THE DAY
“We have five to 10 years before truckers lose their jobs and all hell breaks loose.”
Andy Yang in a New York Times story outlining his “Humanity First” platform.
With that, I’ll let Flight of the Conchords play us out. In the future, there is only one kind of dance. The Robot.
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