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Cornell Student Articles on Topical Affairs

Decades-Old Courtroom Victories Against Big Tobacco Could Provide a Roadmap for Solving the Opioid Crisis

The United States in the midst of an unprecedented public health crisis concerning the use of and overuse of so-called opioids, very strong pharmaceutical drugs usually prescribed after surgery or in the case of chronic pain, in order to alleviate pain and its related symptoms. Painkillers are nothing new, but opioids are incredibly powerful and very addictive, and they are being doled out in ever larger doses. No one has ever been hospitalized for an Aspirin addiction, but these new drugs are serious, and deadly. While the public is increasingly calling for a solution to the crisis, the companies that manufacture opioids are incredibly powerful, and a resolution still seems to be far off.

But how bad is the opioid crisis, really? One aspect of the current epidemic that makes it difficult to understand for the layperson is that for many people, it begins with a doctor’s prescription. People usually trust doctors implicitly, and their advice carries the weight of professional merit and years of intensive training. Of course, doctors never say “Take these twice a day until you form a potentially fatal addictive habit,” but new opioids are so strong that it can sometimes be unavoidable. The strongest opioid medications prescribed by doctors can cause an addictive fixation to form in as little as two days, and for a patient recovering from a major surgery or dealing with a serious illness, the pain will likely take much longer to subside. Physical addiction, the kind caused by opioid use, is also incredibly difficult to overcome by willpower alone, as the body becomes physically dependent on the drug, so much so that a common cause of relapse is simply to alleviate the harsh symptoms of withdrawal. Patients who reach the end of their prescriptions are more and more often turning to illegal opioids, with heroin being the most common, forming a dangerous pipeline from the doctor’s office to the streetside drug dealer. The issue is so serious that Americans are now more likely to die from accidental overdose than car accidents.

While the situation certainly seems grim, the history of lawsuits against tobacco companies in the late 90s seems to offer a potential solution. Sweeping tobacco reform was introduced near the turn of the century as a result of lawsuits brought by dozens of states, following a series of largely unsuccessful individual suits since the 1950s. But who really benefited from these lawsuit? Las Vegas Personal Injury Lawyers were recently called out by an opinion piece in Las Vegas Review-Journal, claiming that in any injury settlement case involving large companies, lawyers are the big winners, while everyone else loses. At first, it might appear that court settlements would be a dead-end for solving the current health crisis. Yet the article was authored by Tiger Joyce, president of the American Tort Reform Association. ‘Tort reform’ began as an effort spearheaded by none other than tobacco giant Philip Morris, in an effort to curb potential settlement losses. Joyce claims the settlements have resulted in largely inadequate efforts to curb smoking by the states receiving much of the settlement money, but in reality, smoking rates have been cut by as much as 50% as a result of the lawsuits.

Another claim that Joyce makes is that lawsuits are frivolous and unnecessary because the drugs in question are subject to significant regulatory oversight by government organizations. This is another claim that rings hollow in light of repeated scandals revealing close ties between pharmaceutical companies and the federal bodies that are supposed to be regulating them. It’s an all-too common issue pervading American politics as a result of the lobbying system, with a figurative revolving door between the executive ranks of large companies, the lobbying firms that represent them to Congress, and the Congressional representatives themselves, with powerful figures moving between positions in all three sectors with relative ease. The head of the FDA, the government’s main regulatory body overseeing consumer safety, was ironically famously tough on illicit tobacco sales, but his resignation was the result of repealing regulatory oversight on pharmaceutical companies, a sector where he had worked as an executive for ten years.

One major difference between today’s opioid crisis and the tobacco lawsuits of 20 years ago is that dozens of people – over half of them doctors in the most recent crackdown – are actually being arrested and facing criminal charges for their roles in the illegal distribution of opioids. Granted, authorities aren’t going after doctors prescribing drugs legally or the companies that are pushing doctors to prescribe them, but it’s a start. Another recent development is the settlement of lawsuits against Teva and Johnson & Johnson for their aggressive marketing campaigns, causing doctors to over-prescribe and patients to push their doctors for prescriptions after seeing the ads. These cases may spur others to act, drawing further similarities between the industry commonly referred to as ‘big pharma’ today and big tobacco decades ago.

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