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Over the past decade, prescription pills have become the latest drug-epidemic bogeyman. A study published earlier this year claimed that one in four American teenagers have misused medications at least once—a 33 percent increase from 2008—and OxyContin has been leading the charge. The painkiller’s active ingredient, oxycodone, gives users a feel-good high similar to heroin and is much easier to score than other hard drugs. But how did it get so popular in the first place?
A recent Canadian study from public-health professionals titled “Too Few, Too Weak: Conflict of Interest Polices at Canadian Medical Schools” may have part of the answer. The researchers found that most Canadian medical schools had problematic ties to pharmaceutical companies—more than half of the 17 schools surveyed “had either no policy or a permissive policy” when it came to potential conflicts of interests like instructors receiving gifts or having consulting arrangements with drug merchants.
These results came as no surprise to Toronto-based physician Dr. Nav Persaud. Earlier this year Persaud published an article in the UK-based Journal of Medical Ethics about the University of Toronto’s cozy relationship with OxyContin manufacturer Purdue Pharma when he was a student there. Persaud described a lecture series on pain management, which had been mandatory for students from 2002 to 2010, that was full of misstatements and outright falsehoods. For instance, oxycodone was described as a “weak opioid,” and less potent than morphine, even though the latter is actually the weaker of the two. Purdue provided funding for part of the program, the lecturer had ties to the company, and students were given biased supplemental reading. It was as if medical students at the University of Toronto were unwittingly required to sit in on a live advertisement for Oxy.
The university uninvited the lecturer and revamped the program in 2010 after being criticized by Persaud and others, but the fallout from conflicts of interest like that is clear. In 2011, 1.6 million prescriptions for Oxy were filled in Canada, and US sales of the drug brought in $2.8 billion.
And though the University of Toronto has slightly cleaned up its act, Adrienne Shnier, one of the authors of “Too Few, Too Weak,” said that abuses of this sort were ongoing.
“Canadian universities are allowing faculty to engage in conflict-of-interest relationships, bring in external lecturers, accept gifts, research funding, and scholarships for their students,” she said. “Each of these ties to drug companies can contribute to biased understandings and the dissemination of incorrect information on drugs… Furthermore, having affiliations with drug companies is considered a prestigious and acceptable practice by medical students, who are not taught to decode what these relationships mean.”