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Under Pressure From Opioid Lawsuits, One Pain Research Society Considers Bankruptcy

The enormous opioid lawsuits across the nation are affecting pain science too.
Oxycodone pain pills prescribed for a patient with chronic pain lie on display.

Oxycodone pain pills prescribed for a patient with chronic pain lie on display.

After being named in lawsuits blaming the pharmaceutical industry for the United States' opioid addiction epidemic, the American Pain Society is considering bankruptcy.

The American Pain Society isn't a pharma company. It's a professional group for scientists who study, and clinicians who treat, chronic pain. But research societies are among the lesser-known targets of opioid litigation across the country; in one filing I found, the American Academy of Pain Medicine and the American Geriatrics Society are also named as defendants, alongside opioid manufacturers, such as Purdue Pharma and Johnson & Johnson. All these societies have taken grants from opioid manufacturers, and lawyers for the plaintiffs say that, in return, they "deceptively" encouraged doctors to prescribe opioids for chronic pain, thus acting as "front groups" for the manufacturers' desired policies. The American Pain Society, in particular, invented the controversial idea of pain as the "fifth vital sign" of people's health. The concept helped lead to rampant opioid over-prescribing, the lawsuit argues.

"We have always been at arms'-length from pharmaceutical companies with respect to our guidelines and our policies," American Pain Society President Bill Maixner told me in April. "Never have we had the intention of interacting with manufacturers in this way." The spokeswoman for the American Academy of Pain Medicine didn't return my requests for comment, while a spokesman for the American Geriatrics Society referred me to existing court filings. The filings I found didn't respond directly to the plaintiffs' claims; instead, they were mostly motions to delay the suits until a judge could decide whether they should be combined with other opioid suits pending across the country.

For the American Pain Society, at least, the pressure the lawsuits have exerted has become nearly unbearable. In April, Maixner announced the organization wouldn't have an annual meeting in 2020, as it tried to stay afloat under the weight of the suits, as well as declining membership and pharmaceutical industry support. Even as the society was hit with legal action, it was already receiving fewer grants from opioid manufacturers, who may be growing wary of public criticism for their gifts to clinicians.

Last week, an email went out to American Pain Society members, explaining that the board recommended the society enter bankruptcy proceedings. "The anticipated time-consuming and costly litigation combined with the declining membership and meeting attendance has created the perfect storm placing APS in a precarious financial position," the email reads. Filing Chapter 7 bankruptcy would help because "all lawsuits pending against APS will be subject to an automatic stay pending further order of the bankruptcy court. This will allow APS to minimize legal expenses and maximize recoveries for its creditors, as opposed to future dissipation of assets in defending the lawsuits which have no end in sight."

American Pain Society members must agree, by vote, for the organization to start the bankruptcy process. The vote closes today.

In April, Maixner had told society members, at their 2019 annual meeting, that he was hopeful that their organization would be released from the suits against it. "We've heard from our attorneys there is no desire, among plaintiff attorneys, to prosecute APS. So they're not after our dollars," he said in a recording I obtained. Last week, I asked American Pain Society spokesman Chuck Weber if the status of the suits had changed since April. He said it hadn't.

Pain scientists worry that the dissolution of groups like the American Pain Society will slow critical research into how to treat pain without addictive opioids. "[T]he specialty, patients, and medical community will pay a price as an unintended consequence of these money grabs!" Edward Michna, a pain specialist at Brigham and Women's Hospital and former American Pain Society board member, writes in an email. Advocates outside of the society, however, aren't always convinced of the group's value. "They do no good at all," Adriane Fugh-Berman, a pharmaceutical marketing researcher at Georgetown University who has been a paid expert witness in opioid lawsuits, told me in April. She believes scientists would be better served by a professional society that doesn't take industry money.

One early career pain scientist and American Pain Society member, who asked to remain anonymous to protect her job prospects, seemed keen on that idea too. "I feel a little bit sad" about the society's possible bankruptcy, she says. "But also a little bit hopeful for the changes that will definitely have to happen, at this point." If the American Pain Society were to reinvent itself as a new group that doesn't accept pharma money, she thought it might be able to recoup some past members it had lost, who might have been uncomfortable with the American Pain Society's industry grants.