Once a week.
Subscribe to our weekly newsletter.
Why Does the Drug to Fight Opioid Addiction Cost $500 a Month?
The pharmaceutical industry excels at exploiting the free market by making recovery often inaccessible.
The September issue of Harper’s features juror excuses for why they were unfit to serve on the Martin Shkreli case. One called him the “most hated man in America,” for good reason: in 2015 his company, Turing Pharmaceuticals, raised the price of Daraprim by 5,000 percent. Over 200 potential jurors were excused. The responses were telling.
Shkreli didn’t help himself by being so outspokenly arrogant. While my favorite reply from the selection process is “he disrespected the Wu-Tang Clan,” his case points to something deeper in the human psyche: profiting from people’s sickness is gross. Shkreli is not the only one to have done it. Most prefer to fly under the radar.
Take one of the nation’s greatest problems, opioid addiction. I’ve covered this often on this site, having had a family member and friends succumb to this addiction—thankfully, all have pulled through and recovered, at least for now. But addiction is insidious, and research on technology addiction has shown that everyone is vulnerable; there is no “addiction gene.” Regardless, we didn’t need the president to announce it as a national crisis, as it’s been the case for years.
In his book, The Power of Habit, journalist Charles Duhigg writes that addiction involves a three-step loop. First there’s a trigger informing your brain what habit to pursue. The following routine leads to the reward, which is how your brain remembers what routine to use when a cue is presented. So, trigger-routine-reward. He writes,
When a habit emerges, the brain stops fully participating in decision making. It stops working so hard, or diverts focus to other tasks. So unless you deliberately fight a habit—unless you find new routines—the pattern will unfold automatically.
This pattern explains opioid addiction: I don’t like the way I’m feeling. This pill makes me feel better. I feel better. Repeat. Duhigg argues that unless you find new routines to achieve a similar reward as offered by, in this case, opioids, you’re unlikely to break the chain of addiction.
There are other routes, however. One is Suboxone, a combination of buprenorphine and naloxone. An interesting and somewhat controversial method, as Suboxone can also be addictive: buprenorphine is an opioid while naloxone blocks the pain relief and other effects of opioids. There is evidence that Suboxone could get you high, though probably not as much as, say, heroin. Many side effects exist, though for some the drug works like a nicotine patch: lower dosages until you free yourself from the grip of addiction.
There’s a larger issue, however: cost. While the patent on Suboxone expired a while ago, the price remains prohibitive. As University of California professor Robin Feldman writes,
Oral film strips now cost over US$500 for a 30-day supply; even simple tablets cost a whopping $600 for a 30-day supply.
How is this possible for a generic? Patents offer corporations an opportunity to recoup money spent on research for their products. You have twenty years to earn your money back, plus, if you’re smart about it, some on top. But pharmaceutical companies delay expiration through a variety of means: slight changes in the medicine’s dosage or formulation; refusing to sell generics to other companies; petitions for further research that are merely stalling tactics. If you’ve got a blockbuster, you don’t want to lose out.
Few industries have exploited the concept of free market capitalism like pharmaceutics. As Feldman reports, 80 percent of profit growth in 2015 for the top twenty companies were from price hikes. And America is their favorite target audience. As she reports,
The liver failure drug Syprine, for example, sells for less than $400 a year in many countries; in the U.S., the average list price is US$300,000. Gilead’s hepatitis C drug, Sovaldi, reportedly sells for the equivalent of $1,000 abroad – in the U.S., it sells for $84,000.
One contentious paragraph in a minor study from 1980 kicked off the opioid epidemic. The graph claimed opioids were not addictive. Our understanding of addiction has changed much, but unfortunately opioids remain highly profitable for doctors and corporations. As long as they earn a profit on both ends—relieving pain then slowing the ensuing addiction—they’ll want to maximize their bottom end.
Sadly, for us, the bottom is where too many end up. While the black market and pill-happy doctors continue to prescribe a feasible route to addiction recovery remains inaccessible thanks to expense and blocked access to generic companies. The epidemic is showing no signs of slowing, and the industries that are supposed to be helping are doing everything but.
Derek is the author of Whole Motion: Training Your Brain and Body For Optimal Health. Based in Los Angeles he is working on a new book about spiritual consumerism. Stay in touch on Facebook and Twitter.
What is human dignity? Here's a primer, told through 200 years of great essays, lectures, and novels.
- Human dignity means that each of our lives have an unimpeachable value simply because we are human, and therefore we are deserving of a baseline level of respect.
- That baseline requires more than the absence of violence, discrimination, and authoritarianism. It means giving individuals the freedom to pursue their own happiness and purpose.
- We look at incredible writings from the last 200 years that illustrate the push for human dignity in regards to slavery, equality, communism, free speech and education.
The inherent worth of all human beings<p>Human dignity is the inherent worth of each individual human being. Recognizing human dignity means respecting human beings' special value—value that sets us apart from other animals; value that is intrinsic and cannot be lost.</p> <p>Liberalism—the broad political philosophy that organizes society around liberty, justice, and equality—is rooted in the idea of human dignity. Liberalism assumes each of our lives, plans, and preferences have some unimpeachable value, not because of any objective evaluation or contribution to a greater good, but simply because they belong to a human being. We are human, and therefore deserving of a baseline level of respect. </p> <p>Because so many of us take human dignity for granted—just a fact of our humanness—it's usually only when someone's dignity is ignored or violated that we feel compelled to talk about it. </p> <p>But human dignity means more than the absence of violence, discrimination, and authoritarianism. It means giving individuals the freedom to pursue their own happiness and purpose—a freedom that can be hampered by restrictive social institutions or the tyranny of the majority. The liberal ideal of the good society is not just peaceful but also pluralistic: It is a society in which we respect others' right to think and live differently than we do.</p>
From the 19th century to today<p>With <a href="https://books.google.com/ngrams/graph?year_start=1800&year_end=2019&content=human+dignity&corpus=26&smoothing=3&direct_url=t1%3B%2Chuman%20dignity%3B%2Cc0" target="_blank" rel="noopener noreferrer">Google Books Ngram Viewer</a>, we can chart mentions of human dignity from 1800-2019.</p><img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNDg0ODU0My9vcmlnaW4ucG5nIiwiZXhwaXJlc19hdCI6MTY1MTUwMzE4MX0.bu0D_0uQuyNLyJjfRESNhu7twkJ5nxu8pQtfa1w3hZs/img.png?width=980" id="7ef38" class="rm-shortcode" data-rm-shortcode-id="9974c7bef3812fcb36858f325889e3c6" data-rm-shortcode-name="rebelmouse-image" />
American novelist, writer, playwright, poet, essayist and civil rights activist James Baldwin at his home in Saint-Paul-de-Vence, southern France, on November 6, 1979.
Credit: Ralph Gatti/AFP via Getty Images
The future of dignity<p>Around the world, people are still working toward the full and equal recognition of human dignity. Every year, new speeches and writings help us understand what dignity is—not only what it looks like when dignity is violated but also what it looks like when dignity is honored. In his posthumous essay, Congressman Lewis wrote, "When historians pick up their pens to write the story of the 21st century, let them say that it was your generation who laid down the heavy burdens of hate at last and that peace finally triumphed over violence, aggression and war."</p> <p>The more we talk about human dignity, the better we understand it. And the sooner we can make progress toward a shared vision of peace, freedom, and mutual respect for all. </p>
Scientists find that bursts of gamma rays may exceed the speed of light and cause time-reversibility.
- Astrophysicists propose that gamma-ray bursts may exceed the speed of light.
- The superluminal jets may also be responsible for time-reversibility.
- The finding doesn't go against Einstein's theory because this effect happens in the jet medium not a vacuum.
Jet bursting out of a blazar. Black-hole-powered galaxies called blazars are the most common sources detected by NASA's Fermi Gamma-ray Space Telescope.
Cosmic death beams: Understanding gamma ray bursts<div class="rm-shortcode" data-media_id="cu2knVEk" data-player_id="FvQKszTI" data-rm-shortcode-id="c6cfd20fdf31c82cb206ade8ce21ba3f"> <div id="botr_cu2knVEk_FvQKszTI_div" class="jwplayer-media" data-jwplayer-video-src="https://content.jwplatform.com/players/cu2knVEk-FvQKszTI.js"> <img src="https://cdn.jwplayer.com/thumbs/cu2knVEk-1920.jpg" class="jwplayer-media-preview" /> </div> <script src="https://content.jwplatform.com/players/cu2knVEk-FvQKszTI.js"></script> </div>
Philosophers have been asking the question for hundreds of years. Now neuroscientists are joining the quest to find out.
- The debate over whether or not humans have free will is centuries old and ongoing. While studies have confirmed that our brains perform many tasks without conscious effort, there remains the question of how much we control and when it matters.
- According to Dr. Uri Maoz, it comes down to what your definition of free will is and to learning more about how we make decisions versus when it is ok for our brain to subconsciously control our actions and movements.
- "If we understand the interplay between conscious and unconscious," says Maoz, "it might help us realize what we can control and what we can't."
Puerto Rico's iconic telescope facilitated important scientific discoveries while inspiring young scientists and the public imagination.
- The Arecibo Observatory's main telescope collapsed on Tuesday morning.
- Although officials had been planning to demolish the telescope, the accident marked an unceremonious end to a beloved astronomical tool.
- The Arecibo radio telescope has facilitated many discoveries in astronomy, including the mapping of near-Earth asteroids and the detection of exoplanets.
Bradley Rivera via twitter.com<p>In 1963, the concave dish was built into a natural sinkhole on the northern coast of Puerto Rico. The location was <a href="https://www.space.com/20984-arecibo-observatory.html" target="_blank">picked because it was near the equator,</a> providing scientists a clear view of planets passing overhead, and also of the ionosphere, which is the uniquely reactive layer of Earth's upper atmosphere where the northern lights form.</p><p>Since its construction, scientists have used the Arecibo telescope to map near-Earth asteroids, detect gravitational waves, study pulsars, detect exoplanets and <a href="https://www.seti.org/goodbye-arecibo" target="_blank">search for alien civilizations</a>, among other projects. Here's a brief look at some of the discoveries and accomplishments made using the Arecibo telescope:</p><ul><li>1964: Astronomer <a href="https://en.wikipedia.org/wiki/Gordon_Pettengill" target="_blank" rel="noopener noreferrer">Gordon Pettengill</a> discovers that Mercury's rotation period is 59 days, significantly shorter than the previous prediction of 88 days.</li><li>1974: Physicists Russell Alan Hulse and Joseph Hooton Taylor Jr. discovers the first binary pulsar, for which they won a Nobel Prize in Physics.</li><li>1974: Scientists use the telescope to transmit the "Arecibo message" to <a href="https://en.wikipedia.org/wiki/Great_Globular_Cluster_in_Hercules" target="_blank" rel="noopener noreferrer">globular star cluster M13</a>. The message, when translated into image form, contains basic information about humanity and human knowledge: the numbers one to 10, a map of our solar system, an illustration of a human being, and the atomic numbers of certain elements.</li><li>1989: Scientists use the telescope to image an asteroid for the first time.</li><li>1992: Astronomers Alex Wolszczan and Dale Frail become the first to discover exoplanets.</li></ul>
The Google-owned company developed a system that can reliably predict the 3D shapes of proteins.