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Conflict of interest education could help curb opioid epidemic

Kitchener Today with Kelly Grindod 28 August 2019


The pharmaceutical industry in Canada and the United States is being fundamentally changed.

That’s according to Kelly Grindrod, an associate professor at the University of Waterloo, who spoke with the Mike Farwell Show on 570 NEWS.

Her comments come after a court ruling in Oklahoma that found Johnson & Johnson guilty of helping to fuel the opioid crisis through marketing, and subsequently being ordered to pay a fine of $572 million USD.

There are ongoing lawsuits in Canada and the United States against pharmaceutical companies.

Grindrod said this shows that there’s validity to the idea that pharmaceutical companies can be held responsible.

“These pharmaceutical companies knowingly hid some information about opioids, like the fact that they’re addictive,” Grindrod said. “They promoted them more than they should be promoted, saying they could be used for mild or moderate pain. They also played up this idea [to doctors] that ‘many of your patients have pain that’s not being taken seriously, you should be giving them an opioid.'”

Despite the fine, Johnson & Johnson shares increased the following morning by 3 per cent.

Grindrod explained that one of the main fueling factors of the opioid crisis was marketing on behalf of these companies. 

She also said this is a system-wide issue, explaining that there was active doctor-targeted marketing.

“Even myself as a researcher, I’m often offered incentives from pharmaceutical companies,” explained Grindrod. “It’s everywhere.”

While discussing this issue, the topic of “who’s to blame” is often discussed, whether that be doctors, nurses, pharmacists or the companies.

While penalizing big pharmaceutical companies will be part of the solution, another will be to make sure that medical professionals are educated on marketing tactics.

Grindrod said the University of Waterloo is doing just that.

“What we’ve done a lot more in school is trying to teach medical students — pharmacy students, nursing students,  people in the health profession — about things like conflict of interest,” explained Grindrod. “You don’t necessarily want to get your information from a drug rep. It’s better to seek a source at a university program that can provide education without that bias.” 

She noted how difficult it is to avoid some of these marketing tactics, even with an education on conflicts of interest.

“The most effective stuff is what the pharmaceutical manufacturers do,” explained Grindrod. “Even having a pen for a brand-name drug on a physician’s desk that they’re writing a prescription with is actually a very powerful motivator to prescribe that drug, and it’s very subconscious.”

She also noted that there are lawsuits against pharmacy chains, but that pharmacists have had very little opportunity and power to stop or intervene into bad prescriptions.

Grindrod said these lawsuits are going to tip the scale of power, allowing nurses and other medical professionals at different levels to influence or protect patient health.

“Physicians are people. They’re just people. This is a system problem, not an individual ‘bad physician’ problem.”

There have been 46 overdose-related deaths in Waterloo Region this year compared to 53 in all of 2018.

There have been 11,000 overdose-related deaths in Canada since 2016.

Kelly Grindod is an assistant professor at the School of Pharmacy at the University of Waterloo.