Tasmania is more than 14,500 kilometres from Oklahoma, but Australia’s island state has found itself caught in the crossfire of a devastating drug epidemic that has claimed more than 700,000 lives in the US.
- Tasmania is home to a poppy-farming industry that supplies 50 per cent of the raw materials to make the world’s opioid painkillers
- The state was specifically mentioned in a US court case in which a US pharmaceutical giant was found to have helped fuel Oklahoma’s opioid crisis
- Poppy farmers say they comply with all international and US federal regulations and are not to blame
Widely known for its rich history and pristine national parks, Tasmania is also the world’s largest producer of legal alkaloids — the raw materials from poppies that make powerful opioid painkillers.
In Bothwell, a small town nestled in the state’s central highlands that boasts a population of about 400, farmer Tom Edgell says the state’s poppy growers have been unfairly maligned.
“There’s an implication that somehow we are responsible for the prescription drug overdoses, but I feel that’s not accurate or fair,” Mr Edgell said.
“I guess poppy growers bear the same amount of responsibility that a wheat grower might for the obesity epidemic.”
It was the first state opioid case to make it to trial in the US.
Prior to the trial, Oklahoma reached settlements with two other defendant groups — a $US270 million ($398.5 million) deal with OxyContin-maker Purdue Pharma, which has subsequently filed for bankruptcy; and a $US85 million ($125 million) settlement with Israeli-owned Teva Pharmaceutical Industries Ltd.
Prominent prescription opioids
- Hydrocodone (eg. Vicodin)
- Oxycodone (eg. OxyContin, Percocet, Endone)
- Oxymorphone (eg. Opana)
- Morphine (eg. Kadian, Avinza)
* According to the US National Institute on Drug Abuse
Among the undisputed facts of the J&J case was that in 2015, 362 million opioid pills were dispensed to Oklahoma residents — enough for every adult to have 110 pills.
In his judgement, District Court Judge Thad Balkman detailed J&J’s efforts to influence doctors and government agencies, and the buying off of advocacy groups and organisations, which influenced prescribing doctors.
Judge Balkman also ruled J&J’s marketing, “in its multitude of forms, was false, deceptive and misleading”.
“The opioid crisis has ravaged the state of Oklahoma,” he said. “It must be abated immediately.”
But he also made mention of Tasmania, and its link to the highly addictive oxycodone family of painkillers.
It is estimated the US opioid crisis claimed 700,000 lives between 1999 and 2017. (ABC News: Gregor Salmon)
In his findings of fact, Judge Balkman detailed how J&J had acquired and formed subsidiaries Tasmanian Alkaloids and US-based Noramco in the 1980s “in order to ‘ensure a reliable source of raw narcotic materials'”.
“Noramco, located in the US, imports the narcotic raw materials supplied by Tasmanian Alkaloids, like morphine or thebaine, into the US, processes them into API [active pharmaceutical ingredients], then sells them to drug manufacturers,” the judgment read.
Thebaine is used to make oxycodone, commonly branded as Endone or OxyContin.
Judge Thad Balkman found Johnson & Johnson had helped fuel Oklahoma’s opioid crisis. (Pool via AP: Sue Ogrocki)
Judge Balkman said J&J, “in concert with subsidiary Tasmanian alkaloids, ‘anticipated demand’ for oxycodone”.
“Scientists at Tasmanian Alkaloids began a project ‘in 1994 in order to develop a high-thebaine poppy variety to meet the anticipated demand’,” Judge Balkman summarised.
The “Norman Poppy”, as it was dubbed, was described internally as a “transformational technology that enabled the growth of oxycodone”, the judgement read.
Describing Normaco and Tasmanian Alkaloids as “key parts of [J&J’s] ‘pain management franchise'”, Judge Balkman said by 2015, J&J’s “Noramco World Wide Narcotics Franchise, comprised of Noramco and Tasmanian Alkaloids, had become ‘the number-one supplier of narcotic API in the United States, the world’s largest market”.
J&J sold Tasmanian Alkaloids in 2016, but the prosecutor representing the state of Oklahoma, Brad Beckworth, went as far as to say “we know that the root of this entire crisis began in Tasmania and New Jersey [J&J headquarters]”.
State attorney Brad Beckworth said Johnson & Johnson pushed doctors to prescribe more opioids in the 1990s. (AP: Chris Lansberger)
Farmers ‘at the bottom of the process’
But the 450 farmers who make up Tasmania’s poppy industry say they have complied with international and US federal regulations at every stage of the supply chain.
There is a limit to how much poppy straw can be grown in the world. Every year the volume is set by International Narcotics Control Board (INCB), and the industry’s output is not what it once was.
Six years ago, Tasmania was harvesting 30,000 hectares of poppies — now that number has been slashed by almost two-thirds.
The body representing the sector, Poppy Growers Tasmania, described the J&J case as “unfortunate”, but said farmers were not to blame.
“When the products leave Tasmania, we’re at the very bottom of the process,” former chairman Keith Rice said.
“We have the growers and then the product itself is processed in Tasmania into narcotic raw material, then it is on-sold further up the chain … it’s on-sold again up to what is final dosage or tablet form.
“Once the product leaves Tasmania, is subject to the international controls of the country it’s going to.”
Yasmin Hurd, the director of the Icahn School of Medicine at Mount Sinai Addiction Institute in New York, agreed.
She argued the blame for the opioid epidemic lay with the pharmaceutical companies, who acted as middle men.
“At the end of the day where the poppies originated didn’t change much within the past 50 years,” she said.
“What changed was the pharmaceutical companies that made potent opioids that then made the difference.
“There are also a lot of synthetic opioids that don’t come from Tasmania that are killing people and that is a huge problem.
“We did not cause an epidemic because of Tasmania, we caused an epidemic because pharmaceutical companies started pushing physicians, and in the US they could speak directly to the consumer [telling them] that they should feel no pain and treat even acute pain as if it’s a chronic pain.
“That’s not at the beginning of the supply chain, it clearly was the so-called middle man, that made opioids accessible to a larger part of our society than would have ever gotten access.”
‘People are potentially dying because of what they’re selling’
The view is not necessarily shared by those impacted personally by the crisis.
According to the Centre for Disease Control and Prevention, 702,000 people in the United States died from drug overdoses between 1999 and 2017.
At the peak of the crisis in 2017, more than 70,000 Americans died from drug overdoses, 68 per cent of which were opioid-related.
Purdue Pharma filed for bankruptcy after its settlement with the state of Oklahoma. (AP: Jessica Hill)
About 1,600 Australians died from opioid-related overdoses in the same year.
Melbourne woman Kayla Caccaviello became addicted to opioids as a child when treating her chronic migraines.
“As I got older, the stronger the medication got,” she said.
“So it started with Panadeine Forte and by the time I was 10 I was prescribed Endone and when I was 15 I had my first Pethidine shot.”
She said while pharmaceutical companies were to blame, farmers had also played a role.
“I just wonder if they know what they’re growing and how that impacts people’s lives,” she said.
“I wonder if they consider that and if they care what’s happening with their product.
“Do they care that people are potentially dying because of what they’re selling?”
Despite the unwanted attention his industry has received, farmers such as Phillip Loane, whose family has grown poppies for more than 50 years at Sunnyside in Tasmania’s north, remains proud of the industry.
“What has happened in America is very unfortunate … it’s unfortunate that people are addicted to pain management,” he said.
Tasmanian poppy farmers say the situation in the US is “unfortunate”. (ABC News: Cara Jeffery)
“There are millions of people who need pain management, for cancer, or if they’ve had a bad car accident.
“I’m quite happy to be growing it for that industry, to help people.
“Tasmanian farmers are very passionate about the industry. They regard it very carefully and we feel that we are doing something that is good for the world.”