If a slew of documents land in a closet with no one to read them, do they make a sound?
In 2012, Senate Finance Committee investigators sent letters to five pain patient organizations and three major pharmaceutical companies that make painkillers demanding information about financial ties between advocates and industry.
One of those organizations, the American Pain Foundation, took millions from drug companies while promoting the widespread use of the highly addictive drugs. The foundation closed down within days of receiving the letter, claiming it could no longer afford to fund its efforts.
But since then? Crickets, according to a group of 36 prominent doctors and policymakers who this month sent a letter to the Senate Finance Committee asking for the investigation's results.
"We respectfully request that you make public the findings from this investigation," reads the letter, whose signatories include the chief medical officer of the Hazelden Betty Ford Foundation, the executive director of the National Physicians Alliance, and the president of the American Society of Addiction Medicine.
Some of the pharma companies and pain organizations at the center of the investigation "have continued to promote aggressive opioid use and continue to block federal and state interventions that could reduce overprescribing," the letter continues. It also noted that several individuals named in the investigation currently serve as FDA and NIH advisors.
"We're dealing with a severe public health crisis caused by the way in which these drugs are promoted," letter signer Andrew Kolodny, director of Physicians for Responsible Opioid Prescribing and the chief medical officer for the addiction treatment organization Phoenix House, told BuzzFeed News.
"When it became clear overprescribing was causing public health problems, [the pharmaceutical] industry began using these organizations to convince policy makers any regulation in prescribing would be bad for pain patients," Kolodny said.
Pharmaceutical companies gain a lot from relationships with advocacy groups, which often organize and sponsor research, as well as write prescribing guidelines for doctors.
"These influences are subtle," letter signer Caleb Alexander, co-director of the Johns Hopkins Center for Drug Safety and Effectiveness, told BuzzFeed News. "Advocacy groups funded by manufacturers might undertake a campaign for chronic pain, and advocate for greater use of opioids in clinical guidelines than is supported by the evidence."
Two senators told BuzzFeed News there's still hope for the investigation.
One of the two senators who launched the investigation, then-chairman Max Baucus, has since resigned from the Senate.
The other investigator, Chuck Grassley, might be willing to reopen the inquiry, a spokesperson told BuzzFeed News by email. To do so, however, he would need the support of the current leaders of the Finance Committee.
"[T]he documents that came back are the products of the committee and likely would need to be released through an official vehicle, such as a committee report," the spokesperson, Jill Gerber, said.
The current chairman of the Senate Finance Committee, Orrin Hatch, also said it's possible that the investigation will reopen.
"While this was an investigation closed under a previous Chairman during another Congress, Chairman Hatch believes this is an issue of serious concern and will be talking with members of the Finance Committee on how they would like to move forward," Julia Lawless, a spokesperson for Hatch, told BuzzFeed News by email.
In the meantime, the influence of drug manufacturers continues to affect patients, Kolodny said.
"The idea we have these two discrete groups, drug abusers who are harmed and pain patients who are helped, is false," Kolodny told BuzzFeed News. "People with pain have been disproportionately harmed by this treatment."
Cat Ferguson is a writer based in Oakland, California. You can follow her on Twitter @biocuriosity or email her at firstname.lastname@example.org.
Got a confidential tip? Submit it here.