How Consulting May Have Fueled the OPIOID Epidemic

Purdue, Mallinckrodt, Endo International. If you aren’t familiar with these companies, the words may seem like they have nothing in common. But the three companies are similar in a few ways. All were among the largest manufacturers of opioids in the U.S. All three were also clients of giant consulting firm McKinsey.

All three filed for bankruptcy earlier this year as they and McKinsey faced and continue to face lawsuits for the role they played in furthering the epidemic of opioid addiction in America.

But first, what makes a drug an opioid and why are they so dangerous?

There are many kinds of opiates, but all in that class of drugs are either derived from or synthesized to mimic the natural drug opium, which comes from the poppy plant. Opioids numb pain by blocking pain receptors in the brain, and also cause a euphoric high. While this makes them excellent prescription pain killers, it has the unfortunate power to be extraordinarily addictive. Some examples of opioids, derived from Johns Hopkins Medicine: morphine, heroin, codeine, oxycodone, hydrocodone and fentanyl.

Opioid drugs are often used in surgery. When prescribed legally and used as ordered, they can relieve immense and crushing pain. Repeated opioid use, however, can be harmful because patients can grow dependent on them. They’re highly addictive and can lead to opioid use disorder (OUD).

What makes them so dangerous is that, when used illegally over time, opioids can stop sparking the high that an addicted person might crave. In chasing a high, a person can easily encounter a fatal overdose; opioids are incredibly powerful drugs. The article from Johns Hopkins states that “about 75% of people in the U.S. who became addicted to street opioids such as heroin during the 2000s report that they started out taking prescription opioid drugs.”

According to a report by the Texas Health and Human Services Department, a lethal dose of fentanyl is even just 2 milligrams of fentanyl, equal to 10 or 15 grains of table salt.

Users can put themselves, family members, first responders, and healthcare providers at risk.

According to the Wall Street Journal, in an article last updated in April of this year, McKinsey has denied allegations of “exacerbating opioid addiction” in hundreds of lawsuits filed by government and private plaintiffs. Purdue was declared bankrupt in 2019. According to the Wall Street Journal, court filings released following the bankruptcy detailed “recommendations McKinsey made to Purdue on how to aggressively boost sales of its OxyContin painkiller at a time the country was reeling from opioid addiction and deaths.”

OxyContin- Purdue’s “flagship drug”- can cause severe liver damage and potentially fatal breathing problems if used over a long period of time, in addition to its high risk for addiction. McKinsey, hired by Purdue, analyzed their data and provided suggestions for maximizing sales output. These ideas, which may have proved very effective, included having the sales team focus their calls and pitches on the physicians who prescribed OxyContin the most. In fact, wrote the Journal, these doctors prescribed- not just more- but 25 times as much oxycodone as their counterparts who prescribed less. More advice McKinsey offered was for these major opioid manufacturers to target the U.S. Department of Veterans Affairs.

According to the National Center for Health Statistics, drug overdose deaths in the United States have been rising over the past two decades. Even if McKinsey’s actions were legal, there is a moral line that was crossed. Ethical dealings should be at the center of all our business. Opioids don’t exist to increase sales for the manufacturer. It is entirely wrong for an industry to abuse a pharmaceutical gift which has the purpose of relieving debilitating pain. This story is another reminder of the power we all have to make change. Consulting firms have a lot of power to shape our buying decisions, as these lawsuits illustrate. McKinsey and similar firms are chock-full of Ivy League grads just a few years older than myself. Armed with the research skills, we can help big business make big decisions.

Profit should never be at the cost of our morals. What good is money when it costs us lives? 💉