US pressure group that pushed doctors to prescribe painkillers forced to close

A leading medical society, described by a US Senate report as a pawn of the pharmaceutical industry for its prominent role in pressuring doctors to prescribe opioids, is to shut down in the face of lawsuits blaming it for America’s worst drug epidemic.

Related: Purdue Pharma accused of 'corrupting' WHO to boost global opioid sales

The American Pain Society led the campaign to promote the concept of “pain as the fifth vital sign” which resulted in hospitals across the US introducing smiley-face pain scales into consulting rooms in the 2000s and requiring doctors to prioritize pain treatment.

Doctors said the policy resulted in patients in effect writing their own prescriptions because medics faced disciplinary action, including ethics hearings, if they did not satisfy demands for pain relief even in cases where it endangered patients.

The APS is one of a group of supposedly independent medical advocacy organizations that critics allege were captured by the drug industry and used to drive sales of narcotic painkillers that grew into a multibillion-dollar-a-year industry.

Last year, a Senate report named the APS as part of a web of organizations it said were turned into “cheerleaders for opioids” by drug manufacturers’ money. The society took nearly $1m from the leading opioid makers over the five years to 2017, including Purdue Pharma, the manufacturer of OxyContin – the drug that kickstarted an epidemic that has claimed more than 400,000 lives.

This week, the APS was named in another report, by two members of Congress, that accused Purdue of corruptly influencing the World Health Organization into encouraging the use of opioids .

A slew of lawsuits by states and cities have targeted the APS alongside opioid manufacturers, distributors and pharmacies for allegedly driving the epidemic. This week, the society’s board said it had decided to close the organization with a “heavy heart”.

It said: “APS has been named as a defendant in numerous spurious lawsuits and is subject to numerous subpoenas. Despite our best efforts, APS was unsuccessful in its attempts to resolve these lawsuits with the need for what will be lengthy and expensive litigation.”

The membership, mostly pain specialists, is expected to vote to confirm the filing for bankruptcy and closure next week.

The news of the APS’s demise was mourned by some specialists who said it had been important in helping to fund research and promoting the interests of pain patients. But its reputation was dented by its close association with the opioid industry.

Through the 1980s, the society was at the forefront of promoting a broad approach to pain treatment and was cautious about the use of opioids. But changes in leadership led the APS and similar groups to take a different stance in favor of narcotics for pain relief.

In 1996, the society issued an influential statement saying opioids were safe and effective for treatment of chronic pain and that the risk of addiction was low, a claim that has since been discredited. The co-author of the statement and chair of the committee that agreed it was a doctor, David Haddox, who was a paid speaker for Purdue Pharma. Haddox went on to become the company’s vice-president of health policy and a leading advocate for prescribing OxyContin.

Former APS presidents include Dr Russell Portenoy, a pain specialist who has since admitted to overstating claims for the safety and effectiveness of opioids in order to break down what he regarded as unwarranted resistance within the medical profession to prescribing them. Portenoy was then paid by Purdue Pharma to help drive sales of OxyContin. He has now agreed to testify against the drugmaker and other companies, and accused them of overstating the benefits and undertaking the danders of opioids.

But the APS’s greatest impact was in pushing for the treatment of pain as a fifth vital sign alongside blood pressure, temperature, pulse and respiration rate, launched by its then president, Dr James Campbell, in 1996.

The society even copyrighted the phrase: “Pain: the 5th Vital Sign.”

The Joint Commission for Accreditation of Healthcare Organizations, which licenses hospitals, used patient satisfaction surveys to measure whether people felt they were receiving adequate pain treatment. Doctors said that contributed to pressure to prescribe because hospitals feared that dissatisfied patients could cost them their licenses.

By 2012, more than 250m opioid prescriptions a year were dispensed in the US, enough to provide every American adult with 30 days of pills.