The opioid industry's use of scientific evidence to advance claims about prescription opioid safety and effectiveness (24 October 2024)

Summary

It is widely recognised that pharmaceutical marketing contributed to the ongoing US opioid epidemic, but less is understood about how the opioid industry used scientific evidence to generate product demand, shape opioid regulation and change healthcare professionals' behaviour. This qualitative study looks at select scientific articles used by industry to support safety and effectiveness claims and uses a novel database, the Opioid Industry Documents Archive, to look at industry and non-industry documents citing the scientific articles to advance each claim.

The authors found that 15 scientific articles were collectively mentioned in 3666 documents supporting five common, inaccurate claims:

1. Opioids are effective for treatment of chronic, non-cancer pain.
2. Opioids are “rarely” addictive.
3. “Pseudo-addiction” is due to inadequate pain management
4. No opioid dose is too high
5. Screening tools can identify those at risk of developing addiction.

The articles contributed to the eventual normalisation of these claims by:

• symbolically associating the claims with scientific evidence
• building credibility
• expanding and diversifying audiences and the parties asserting the claims
• obfuscating conflicts of interest.

These findings have implications for regulators of industry products and corporate activity and can inform efforts to prevent similar public health crises.