Lawsuit against CVS generates conversation about prescription opioids

Discussion online also highlighted overdose deaths among Black men and warned about a synthetic opioid.

Recent posts responded to the U.S. Department of Justice’s lawsuit against CVS for allegedly illegally dispensing opioids, with comments questioning whether pharmacies, doctors, or patients are to blame for overdose deaths. Plus, in response to an article about racial disparities in U.S. overdose deaths, posts called for more overdose prevention resources tailored to Black men. Other posts warned about the synthetic opioid protonitazene, which has been linked to a recent death.

These conversations provide an opportunity for communicators to explain how anyone can develop a substance use disorder; share overdose prevention resources, particularly resources geared toward Black men; and share information about protonitazene.

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What’s trending nationally in conversations about opioids

Last month, the U.S. Department of Justice filed a lawsuit accusing the pharmacy chain CVS of “unlawfully dispensing massive quantities of opioids and other controlled substances to fuel its own profits at the expense of public health and safety.” The lawsuit also claimed that CVS filled thousands of prescriptions for opioids written by “‘known ‘pill mills.’” Articles about the lawsuit appeared across social media platforms, and prominent figures—including President-elect Donald Trump—shared posts expressing outrage at CVS for allegedly fueling the opioid crisis. Some posts about the lawsuit received hundreds of thousands of views. Comments debated whether CVS is to blame for overdose deaths, with some expressing stigmatizing attitudes toward people who use opioids, including those who have legitimate prescriptions.

The Baltimore Banner—in partnership with newsrooms across the country—recently published an article highlighting racial disparities in U.S. overdose deaths. The article noted that while overdose deaths are declining overall, Black men ages 54 to 73 are still dying of overdoses at more than four times the rate of men of other races. In cities like Chicago, the article noted, government agencies “have done little to distribute resources to this population.” The Baltimore Banner shared a post about the article on Instagram, where it received approximately 2.1 million views, 15,300 likes, and 200 comments as of January 8. While some comments called for more overdose prevention resources geared toward Black men and older populations, many expressed stigmatizing views, stating, “The decision to engage in addictions is one’s own.”

On December 19, 2024, ABC News published an article warning about protonitazene, a synthetic opioid that is three times more powerful than fentanyl and has been linked to the death of a person in Los Angeles. ABC News shared the article on Facebook, where the post received approximately 38,000 views as of January 8. Several comments on the post blamed immigrants and liberals for allegedly allowing protonitazene to enter the U.S., and many expressed fear that the drug will lead to more deaths.

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Recommendations for public health professionals

Each week, the Infodemiology.com team will provide messaging recommendations in response to some of the trending narratives outlined above. These helpful tips can be used when creating content, updating web and FAQ pages, and developing strategy for messaging about opioids.

Persistent stigma toward people who use drugs indicates a need for more education about how substance use disorder is a chronic health condition that can happen to anyone. As many as one in four patients receiving long-term opioid therapy prescribed by a primary care physician struggles with opioid use disorder. Additionally, anyone can overdose on opioids, but some populations face higher risk, including people who have a history of substance use disorder, sleep apnea, or kidney or liver failure; people who also take benzodiazepines; and people who are 65 or older. Communicators may also want to outline the signs of an opioid overdose and explain where people can access naloxone—which reverses an opioid overdose—and how to use it.

In light of conversations about overdose deaths among Black men, communicators—particularly health departments, community organizations, and other partners that primarily serve Black populations—may share information about local harm reduction programs and explain where people can access naloxone and drug test strips (if they are legal in your state). Sharing SAMHSA’s National Helpline, which connects people to mental health and substance use disorder treatment, is also recommended. Communicators may also want to share mental health resources geared toward Black men, such as referral services that connect people to culturally competent therapists, the peer support hotline Call BlackLine, Black Men Heal, and The Confess Project.

In response to concerns about protonitazene, messaging may emphasize that protonitazene is a potent, synthetic opioid that is approximately three times stronger than fentanyl. Reiterating that naloxone can reverse an overdose on opioids—including synthetic opioids—is recommended. However, multiple doses of naloxone may be required, and bystanders should call 911 immediately. Messaging may explain that if naloxone is administered and overdose signs do not resolve, additional doses should be given every two to three minutes until the person begins to breathe normally or until medical help arrives. Messaging may also emphasize that naloxone can be administered by any bystander and that many states have laws protecting people who are overdosing and those assisting them from certain legal repercussions. Naloxone will not harm a person who is not overdosing on opioids.