It seems like it would be easy to see either the total number of pills made is roughly equal to the total number of pills prescribed. Of course there would be error, but the apparent market of the illicit opiate abuse seems to dwarf the actual intended purpose.
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Physician A gives person B a prescription for a drug to treat his ailment C.
I don’t really see how any amount of number crunching could trivially determine whether C has been faked convincingly, B exists at all or whether or not A is acting in good faith. Either of these factors can lead to medications leaving the system unnoticed – and that’s only looking at what can happen **after** manufacturing and shipping.
Yes it is obvious. However there is literally nothing pharma or the government can do to control it. Look at cartels and their products, it used to be just cocaine, heroin and marijuana. Now they produce and export every drug under the sun. Whenever you see these huge “busts” by the DEA it’s almost always purposely put right in front of them so that the government can gloat whilst 10 times more drugs get through. If the black market or the internet market bothered pharma they would have done something by now. It clearly doesn’t
A lot of this is based on bureaucracy (or lack thereof) and simply allowing things to happen. The US, for instance, has a massive problem with opiate addiction, partly because there is no clear record of who gets prescribed which drug at which time, and which pharmacy needs to give that out. If you can fill your prescription at 15 pharmacies who don’t communicate with each other, what’s stopping you from just filling it 15 times? Countries with centralized medical records (many in Europe, for example) have a less difficult time keeping track of prescriptions, and are thus able to effectively limit the outflow of drugs from pharmacies. If we were to construct a global centralized medical record and pharmacies could only give out prescriptions that were sent directly from the physician, there could be no abuse. (Well, unless you manage to convince/bribe your doctor, of course.)
Yes, it is obvious that the pills are being abused. Very, very obvious. That’s one of the many reasons why people are so angry at the people who run companies like Purdue Pharmaceuticals. There were cases that should have lit up a zillion red flags and any company concerned about misuse of their products would have done something about it. They did nothing not because they didn’t realize it, but because they just wanted to make a profit and didn’t care about all of the people becoming addicted and dying (and, incidentally, they massaged the data and put forth deceptive messages about Oxycontin in order to conceal how addictive they are).
One of the pretty obviously corrupt things taht went on is that there would be specific clinics in various parts of the country where one or a few corrupt doctors would just write zillions of prescriptions. Drug dealers and addicts from literally all over the country would drive there on a daily basis and stock up on massive quantities of pills, which would gradually make their way throughout the United States to addicts everywhere. There was this one clinic in Florida that was responsible for an enormous percentage of opiate prescriptions–like 5% of all Oxycontin, oxycodone, etc. prescriptions in the entire USA for one single clinic The clinic was making so much money that they literally burned up all of the $1 bills they received because they didn’t have a place to put it all (and they were concealing their loot so couldn’t just take to a bank). There was a clinic in West Virginia that was similarly responsible for a very large percentage of all Oxy prescriptions in the US. ([https://www.washingtonpost.com/investigations/76-billion-opioid-pills-newly-released-federal-data-unmasks-the-epidemic/2019/07/16/5f29fd62-a73e-11e9-86dd-d7f0e60391e9_story.html](https://www.washingtonpost.com/investigations/76-billion-opioid-pills-newly-released-federal-data-unmasks-the-epidemic/2019/07/16/5f29fd62-a73e-11e9-86dd-d7f0e60391e9_story.html))
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