US opioid prescribing: the federal government advisers with recent ties to big pharma

The U.S. National Academies recognize the significance of the opioid crisis and have been at the forefront of efforts to advise our nation on how to combat it. We stand by our work in this area, which includes several consensus studies that were subjected to rigorous peer review, and an action collaborative to counter the U.S. opioid epidemic.

This article in the British Medical Journal focuses on our conflict-of-interest policy and a current consensus study charged with developing a framework to create guidelines for prescribing opioids. Our conflict-of-interest policy for study committees precludes service on a committee by anyone with a current financial conflict which would allow them to benefit from the outcome of the study. We do not allow individuals with a conflict to serve on committees except in rare circumstances, when we allow service by conflicted members only when the expertise cannot be found elsewhere, and in those cases, the conflict is disclosed. The members of the Committee on Evidence-based Clinical Practice Guidelines for Prescribing Opioids for Acute Pain are in compliance with our conflict-of-interest policy, and we look forward to their evidence-based, peer-reviewed report in the months ahead.

The National Academies have long taken conflict-of-interest matters very seriously. In conjunction with our governing board, we are conducting a thorough review of our policy for study committees.

As of earlier this year, endowment gifts from the Sackler family are no longer being used to support the prizes and colloquia for which they were designated while we review these gifts.

NAM President Victor Dzau has fully disclosed his financial interests to the National Academies and is in compliance with the applicable institutional policy. Prior to joining the Institute of Medicine/National Academy of Medicine in July 2014, Dr. Dzau ended all relationships with corporations. His deferred stock compensation was earned for prior board services at Medtronic, was in compliance with IRS policy, and was disclosed to the National Academies. As approved by the National Academies, the stocks were divested as soon as they vested and managed by his bank with no involvement from Dr. Dzau. The holdings have all been divested.

Dr. Dzau confirmed with major medical journals including New England Journal of Medicine, The Lancet, Journal of the American College of Cardiology, and Science that he has adhered to their conflict-of-interest policies and, in two cases, submitted letters of clarification to the Journal of the American Medical Association and British Medical Journal to be transparent.

The National Academies are committed to our mission of providing independent, objective, evidence-based advice to the nation on society’s most pressing issues, including the opioid crisis, and we look forward to continuing our service to the nation.

William Kearney
Executive Director, Office of News and Public Information
National Academies of Sciences, Engineering, and Medicine
Washington, D.C.