Williamson with & # 39 is a town of 3000 inhabitants in the US state of West Virginia. Despite its small size, the city consumed "tsunami" of opioid tablets in the period between 2006 and 2016: there were, according to the report of the Congress, 20 million units of the drug that causes the epidemic on a national scale and made trouble in the US public health.
The last episode of this crisis occurred on March 26, when the pharmaceutical giant Purdue agreed – on one of the many lawsuits around the theme – to pay $ 270 million of Oklahoma, who accuses opioids manufacturer of OxyContin is, through aggressive marketing of your product, help to stimulate overdose wave that left thousands of dead in the state.
In general, officials believe that 218,000 Americans died from an overdose of prescription opioids in the period between 1999 and 2017, and the small Williamson has become a symbol of the problem.
But, as a provincial city, it may have been flooded with drugs? As the crisis in the field of Health adopted the current measurement, putting into focus the pharmaceutical giant?
Inflow tablets Williamson leads on average more than 6500 units per medicament citizen.
Opioids are a class of drugs naturally in opium, the same used to produce heroin. They are prescribed for the treatment of different degrees of pain, because they are faster, stronger and more durable than conventional analgesic regimen.
But these are the same characteristics that make opioids not only potentially addictive, but also relatively easy to cause an overdose. Despite this, they were widely prescribed to patients across the country over the past two decades. In the peak year in 2012, the amount of revenue increased from 225 million, or 81.3 for every 100 Americans.
Williamson is one of hundreds of cities, counties, or states of Americans who have opened court cases against the pharmaceutical industry.
And OxyContin, Purdue, steel opioid prescribed associated with so many excessive use of in accordance with government agency, National Center for Biotechnology Information.
"Williamson was given the nickname" Pilliamson "(pun tablets, which means in English) because of this inacrediável number of tablets," says BBC Eric Eyre, a journalist from West Virginia.
Eyre won Pulitzer journalism award in 2017 for the researcher, generating a series of news about the excessive prescription of painkillers in West Virginia, one of the poorest states in the US.
Data from the CDC, a major US health agencies show that West Virginia has the highest rate of deaths from overdoses in the country: there were 57.3 deaths per 100,000 inhabitants in 2017, more than twice the national average (21.7) .
County Ming, where Williamson, is the fourth largest national mortality rate from an excess of drugs.
"The high level of mortality of drug concentrated or shakes and turned to mining communities, or those who depend on jobs in the service sector," says Shannon Monnat, an assistant professor at Syracuse University, who has studied the effects of opioids, the crisis in the American countryside.
"For many people, working facilities and there & # 39; and separated for the past 30 years, and this has left some people with little direction in life. Drugs way to avoid emotional pain or reality lack of communication or purpose in life. "
In 2017, a report from NBC interview & # 39; nd in the emergency medical services Williamson, who at the time did meet an average of 50 cases of overdoses in the last month.
"It is correct to say that all in Williamson must know someone who suffered from drug abuse," says the BBC, Roger May, a photographer born in the city.
"(Abuse) began with the employees of the mining industry, who need medicine to control their pain, but quickly began to hear family stories of people also use drugs (opiates), including teenagers who stole a pill to take part. then after a few years, we have seen people posting on Facebook, someone had overdosed or died. "
Amounts that Eric Eyre discovered in its accounts newspaper Charleston Gazette-mail showed that the crisis in Williamson is just the tip of the iceberg.
The documents, obtained by him at the National Agency for Drug Enforcement (DEA, its acronym in English) show that the pharmaceutical distributors shipped 780 million tablets of oxycodone and hydrocodone painkillers the most common opiates for pharmacies in West Virginia between 2007 and 2012.
"There is a case Kerman, 400 residents of West Virginia, which also received millions of tablets. But Williamson has become more symbolic because of the & # 39; volume (medicines), and the fact that people have traveled hundreds of kilometers to buy drugs there, "adds Eyre.
Williamson West Virginia near the border with the states of Kentucky and Tennessee.
This geographical position, coupled with lax regulation in time drug influx, cause the city turned into an ideal place for the opening of the so-called "clinical treatment of pain" – and a wave of prescription opioids.
People started lining up at 6:00 am at the door of the pharmacy to pick up medications.
Medical One, Katherine Hoover, opened an office in Williamson in 2002, and by 2010 – when the police carried out the intervention in his clinic – it is already prescribed opioid 333,000 times.
Frankie Tack, an expert on drug addiction at the University of West Virginia, with a & # 39 is part of a group of scientists who believe that the rural community was a good opportunity for the growth of the pharmaceutical giants of business.
"I do not think that the company accidentally dropped all these pills, in cities such as Williamson. He was part of the business model to target communities that are most at risk, "said Tack Force.
"In West Virginia, there is a lot of cities with people engaged in manual labor (which can cause pain in the body), and limited access to health services. Some even hospitals. "
He says that the interview & # 39; nd in patients consuming opiates, "not knowing that they were much smaller than it was exciting."
"If you look at this epidemic, seeing that the victims were originally middle-aged people, people are likely to need pain medication."
But manufacturers and dystryb & # 39; drug Yutariya consistently denied the allegations.
But in order to understand how the epidemic arrived at the moment one has to go back two decades in time.
In the mid 90 DECADE, about 100 million Americans are estimated to suffer from chronic pain, prompting health officials to ask for less regulation in the use of more powerful painkillers.
The main argument in favor of this was the fact that chronic pain patients – older workers, carried back, the bustle – will have a better quality of life if they have access to more powerful drugs.
Discussion evolved to the point where the pain level is declared the "fifth vital" patients – this means that their measurement and management is seen as just as important as temperature control, blood pressure, respiratory rate and heart rate,
Soon, recipes with opioids have become common across the country – and the pharmaceutical initiated the launch of its market share.
One of these companies & # 39 is Purdue Pharma. In 1996, the company began selling its flagship, OxyContin. In 2001, she was awarded $ 1 billion with sales of opioid USA.
Soon, however, they began with the & # 39; to appear reports of death associated with an excess of opioids, pulling the overall increase in mortality rates from overdoses in the US – from 16.849 in 1999 to 36,000 in 2007.
In the same year, the Purdue was fined more than US $ 600 million after the admission of guilt for deceiving the public about the risk of addiction to OxyContin. It was one of the highest fines ever imposed on a pharmaceutical company in US history.
Company health status information IQVIA estimates OxyContin generated Perd & # 39; nd in the US $ 35 billion in sales. Studies show that the product accounted for 82% of sales in 2017.
Earlier this month, the Purdue announced pricing for bankruptcy to keep a lawsuit against you and to enter into agreements with the Court.
Oklahoma agreement will be the first in the company to respond to the jury on the responsibility of pharmaceutical companies in the US Opioids crisis. It was decided in the resolution of the court, but the drug with a & # 39 is a defendant in hundreds of other processes.
Overdose deaths continues to rise – there were more than 70,000 cases in 2017. The authorities kept prescription, but they are still high – 58.7 income every 100 Americans.
At the same time, a commitment to Opioids are turning to counterfeit medicines or illicit drugs such as heroin.
Studies in Congress
Overdose is now a & # 39 is the leading cause of death among adults aged 55 years and kill as much as firearms and road traffic accidents combined.
"There has been an epidemic drugs before in the US, but they tend to be concentrated in the" pocket "That's different:. Many people become addicted, even if opioids correctly, "says Frank Tack.
The "tsunami" tablet Williamson was one of the highlights of the Congress of the investigation – published in December – about opioids crisis in West Virginia.
Studies have strongly criticized not only pharmaceutical companies, but also drug agency DEA.
"Our study showed systemic failures by both distributors and from the DEA, which contributed – and could not hold back – opioid crisis in the state," he said in a statement the leader of the Energy and Commerce Committee, Greg Walden.
Experts predict that the mountain of lawsuits against pharmaceutical vultuosos by extrajudicial agreements, such as those involving the American tobacco industry in the late 1990s – one of the agreements exceeded the value of 200 billion US $.
"Cities, counties and states have begun legal proceedings to seek reparation for public expenditures associated with opioid epidemic," explains Nora Engstrom, a law professor at Stanford University. "Some economists have estimated that in 2015 the economic cost of this crisis was 504000 .000.000 $, or 2.8% of US GDP. "
At the local level, these costs increasingly felt. The Ming County, where Williamson, review estimated that the opioid crisis cost about $ 7,000 per resident – whose per capita income is just over $ 20 thousand people.
"Opiates devastated entire communities in West Virginia and other parts of the US," said Roger in May. "The feeling is that they took advantage of some people."
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