Representatives from Facebook, Google, Twitter, and roughly a dozen other tech companies will gather with academics, lobbyists, and government officials Wednesday for a summit hosted by the Food and Drug Administration. The goal of the summit, according to the FDA, is to get tech leaders to “discuss ways to collaboratively take stronger action” against the spread of illicit opioids online. But the gathering was mired in controversy before it even began, as the tech and pharmaceutical industries wrestled over the question of who bears more responsibility for a crisis that kills more than 115 Americans every day.
According to an invitation to the summit, which was sent to attendees by FDA Commissioner Scott Gottlieb in May, the FDA initially planned on asking tech companies to sign a “Pledge to Reduce the Availability of Illicit Opioids Online,” which it would publish 30 days after the event. “The purpose of this pledge is to allow Internet stakeholders to demonstrate an ongoing commitment to help address the terrible impact of the opioid crisis by taking concrete steps to reduce the availability of illicit opioids online,” the invitation read.
But after consulting with tech companies, the FDA says it put that plan on hold. “We will consolidate the feedback and ideas discussed at the summit and turn it into an actionable plan – not just for those in the room but for all internet stakeholders to join,” an FDA spokesperson said.
The shift left some attendees wondering whether tech companies objected to the pledge and got their way. “They’ve successfully changed the dynamics of the meeting,” says Tim Mackey, an associate adjunct professor at University of California, San Diego, who is also presenting at the summit.
‘If all drug sales happening on the internet were on the dark web, I’d throw a party.’
Libby Baney, the Alliance for Safe Online Pharmacies
The tech industry’s involvement in the opioid crisis has become the subject of harsh scrutiny in Washington over the last few months. In April, Commissioner Gottlieb told attendees at the National Rx Drug Abuse and Heroin Summit that tech companies “haven’t been proactive enough” in eliminating illicit drugs on their platforms.
“We find offers to purchase opioids all over social media and the Internet, including Twitter, Facebook, Instagram, Reddit, Google, Yahoo, and Bing,” Gottlieb said. Days later, when Facebook CEO Mark Zuckerberg testified before the House Intelligence Committee, members of Congress pressed him on Facebook’s handling of ads for illegal online pharmacies. And in early June, the FDA sent warning letters to nine companies that operate 53 online pharmacy websites, ordering them to stop marketing opioids or risk legal repercussions.
In the days leading up to the summit, tech companies and the lobbying group that represents them worked to deflect blame for the crisis and tout their early efforts to combat a problem they say the healthcare and pharmaceutical industry created. On Tuesday, the Internet Association, which represents several summit attendees including Microsoft, Google, Twitter, Facebook, Reddit, Pinterest, Snapchat, Amazon, and eBay, held a call with reporters previewing the event.
“The opioid epidemic is, in a majority of cases, primarily an offline problem,” a representative of the Association said, pointing to research by the Substance Abuse and Mental Health Services Administration that showed the vast majority of people misusing opioids acquire them from a drug dealer, doctor, or a friend.
And on Monday, the Center for Safe Internet Pharmacies, which is backed by Facebook, Google, Microsoft, Yahoo, and a slew of credit card companies, released a report suggesting that the bulk of illicit drug sales that do take place online are happening on the dark web, as opposed to the open web, and are being paid for with cryptocurrency. The report also found that the majority of the sites on the open web that purport to sell opioids are actually so-called “non-delivery schemes” that steal people’s personal information, but never actually sell them drugs.
“They’ll be websites that say, ‘Buy oxy here,’ and you go onto the website, and there’s no oxy for sale. It’s clickbait,” says Marjorie Clifton, executive director of CSIP. “People say, ‘Look at all the stuff the internet’s selling.’ But no one’s going through the purchasing process.”
That may be. But lobbyists working to crack down on illegal online pharmacies on behalf of the pharmaceutical industry say that the tech industry’s blame-shifting is unhelpful. “If all drug sales happening on the internet were on the dark web, I’d throw a party. Then the vast majority of Americans would be safe,” says Libby Baney, an advisor to the Alliance for Safe Online Pharmacies, who is appearing on a panel at the summit. The CSIP’s own study found dozens of sites purporting to sell opioids through simple organic searches, and spotted posts marketing opioids on sites like Twitter, Reddit, and even LinkedIn. But it’s hard to tell from a distance which advertisements are scams and which are the real deal.
Mackey and other researchers at UC San Diego have developed algorithms that hunt for opioid sales on Twitter. They’ve found that often those tweets link to illicit goods that have been sourced on the dark web. “What’s happening on the dark web is a lot of business-to-business sales,” Mackey says. “The digital drug dealers are sourcing from the dark web and using social media to sell directly to consumers.”
It’s not that tech companies have ignored this problem completely. Recently, they’ve taken several steps toward curbing opioid sales on their platforms. In April, Google Search’s homepage promoted an initiative by the Drug Enforcement Agency called Take Back Day, which encourages people to take their unused medications to safe collection sites. According to the Internet Association, over 50,000 people used the tool, contributing to a record-setting 1 million pounds of prescription drugs being collected on that day. And last week, Facebook announced it would begin to redirect users attempting to purchase opioids or seeking treatment to a federal crisis helpline. That move follows Instagram’s crackdown on opioid-related hashtags like #oxycontin. The companies involved in CSIP, meanwhile, collectively blocked 117 million ads that tried to appear on their platforms last year alone.
For Baney, all of that is a promising start, but it will be wasted if businesses on both sides don’t own up to the roles they’ve played in perpetuating a national tragedy. “This is a historic opportunity to do more with what we already know is true,” she says. “If it ends up being us versus them and there’s pointing fingers and a lot of ‘We’re already doing this or that,’ that’s an old-school way of thinking that isn’t responsive to the public health need.”