This Is Public Health Book Club discussion

In the book's first part, we are introduced to an epidemic started by greed that affects some of the poorest regions in the country. The author is a journalist who lived in a town, that like many others, was heavily affected by the opioid epidemic. In four chapters, we are introduced to the tactics used by the pharmaceutical companies to push doctors to prescribe the drugs and the lies they told to convince people to take the drugs, the families and victims affected by the use of opioids, and the small town doctors and activists working to bring light to the issue. In the final chapter of part 1, we hear of the legal actions taken against the company and the executives who took the blame and received light sentences with no real consequences for their actions and roles in the death of many people. There is a lot packed into the four chapters of the first part but it is a necessary set-up for the rest of the book. Here are some discussion questions to guide us:
1)The United States is one of the few places that allows pharmaceutical companies to advertise drugs to patients. Is this ethical? Should patients be advocating for medications that they heard about on TV? Should pharmaceutical companies be allowed to bribe doctors to prescribe their products? Would you be hesitant to go to a physician who had to wear their pharmaceutical contacts like sponsors in NASCAR races?
2) One of the facts that was cited repeatedly by the company and its lawyers was about the addiction potential of the new drug. The study was conducted by the company trying to sell the drug. Should companies that stand to make a large profit off medications be allowed to conduct their own safety and efficacy trials?
3) Along those same lines, clinical trials do not specifically assess addiction potential in a separate section. Should the current rules be amended to include a specific section for addiction potential?
4) How can we as public health ambassadors/citizen scientists successfully advocate for best practices when it comes to pain management, when corporations can buy policymakers?
5) My undergraduate university had one of the Purdue Pharma executives on its board of trustees. When he retired, he donated a large sum of money to expand the health science research programs. This sparked large protests from students who knew of the role of Purdue in the opioid epidemic. We hear mention of some good works done by another executive after the trial. Is it enough? The money being used was earned from the deaths of vulnerable people. Is there an appropriate way to repurpose that kind of money?
6) Who is most at fault for the epidemic? Should we hold all stakeholders accountable or is having a public trial for the top executives enough to make substantial change in the way the system operates?
7) Finally, what are some action items we can take away to help combat the epidemic at any level?