Analyzing the Influence of Pharmaceutical Company Communication on Opioid Prescribing for Chronic Pain in Military Veterans

Research has linked efforts by pharmaceutical companies to target veterans with chronic pain in an attempt to increase opioid use, shedding light on the pharmaceutical industry's role in exacerbating the opioid crisis among military veterans.

Researchers highlighted that opioid-related overdose deaths have surged from 8050 in 1999 to 84 411 in 2022. Reports show that prescription opioids paved the way for the current crisis, despite heroin and synthetic opioids now dominating overdose cases. Legal settlements against pharmaceutical companies such as Johnson & Johnson have highlighted deceptive marketing practices and their potential role in the epidemic.

This study analyzed documents from the Opioid Industry Documents Archive (OIDA) at Johns Hopkins and the University of California, San Francisco, focusing on veterans and the military. Using SciServer, all relevant documents were extracted for analysis. A total of 30 988 documents referencing veterans and 30 182 referencing the military were extracted. CoCounsel, an AI platform, was used to identify and summarize relevant discovery documents. The "human-in-the-loop" approach ensured comprehensive analysis of documents related to the Image the Possibilities Pain Coalition (IPPC) and military/veterans. The authors worked together to analyze important documents and qualitative data in order to assess the marketing tactics of Janssen Pharmaceuticals' IPPC, which sought to promote the use of opioids by veterans experiencing chronic noncancer pain.

The study found that the IPPC utilized various tactics to impact the prescribing of opioids to veterans. This included distributing educational materials that downplayed the risks of addiction and emphasized the long-term benefits, as well as using empathy-driven stories that stressed the importance of immediate pain relief over potential negative effects. Ghostwriting was also used to ensure positive viewpoints on opioids were included in scientific literature, in line with larger industry efforts to advocate for opioids as a treatment for chronic pain.

“The findings of this study underscore the pharmaceutical industry’s role in contributing to the opioid crisis through targeted marketing strategies, specifically toward U.S. military veterans. Janssen Pharmaceuticals’ Imagine the Possibilities Pain Coalition (IPPC) exemplifies how industry-funded initiatives sought to increase opioid prescribing to veterans by downplaying addiction risks and overstating benefits,” researchers said. “These tactics, which included ghostwriting scientific literature and leveraging empathetic messaging, reveal the potential for industry influence to undermine evidence-based care. For the healthcare community worldwide, this study highlights the importance of prioritizing unbiased practices, ensuring transparency in public health initiatives, and scrutinizing educational materials for potential conflicts of interest.” 

Reference
Haddock CK, Elliott L, Kolodny A, et al. Imagine the possibilities pain coalition and opioid marketing to veterans: lessons for military and veterans healthcare. Healthcare. 2025;13(4):434. doi:10.3390/healthcare13040434