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Columns

The Opioid Disaster—Who Benefits?

October 4, 2017 - 6:00am

The opioid crisis in America is real, it is lethal and it may be killing the nice family that lives next door to you.

More people are dying of opioid overdoses than died of AIDS at the height of the epidemic. The death toll is nearly twice that from global terrorism. The crisis is so bad that it seems to be “raining needles”; 13,000 discarded syringes were collected last March in San Francisco, compared with 2,900 in March 2016. Coroners are experiencing personnel shortages and equipment failures across the U.S. In Berkeley County, West Virginia, two-thirds of the emergency-medication budget is now spent on Narcan, used to treat overdoses.

Doctors are getting blamed. More potent oral drugs became available, and guidelines for using them in chronic pain liberalized in the “Pain Decade” of the 1990s. So why are we having the epidemic now, when medical opinion is shifting in the opposite direction?

Between 1999 and 2011, annual opioid deaths nearly tripled, from 8,048 to 22,784, and the trend is accelerating. Probably not coincidentally, participation in the U.S. labor force started to decline at the same time, dropping to an all-time low of 62.4 percent in 2015. While many people evidently have trouble finding a job, one building contractor said he has trouble finding workers who could pass a drug test and did not have a criminal record.

The decades-long War on Drugs has obviously failed. Some recommended legalization, to reduce the profits from illicit drugs. That option is being tried for marijuana in some states. The odor of maturing marijuana plants in rural Oregon has become so pervasive that people worry about getting a “second-hand high.” And the drug cartels’ profits did suffer. So the Sinaloa drug cartel diversified into the heroin business. Mexican heroin is of very high quality, and is cheaper than OxyContin.

Legalizing what was formerly called the “gateway drug” obviously hasn’t reduced heroin use. The new gateway is now said to be prescription painkillers, and the chief villains are claimed to be legal pharmaceutical manufacturers, doctors, and pharmacists. Because of multiplying regulations and physician prosecutions, patients who urgently need pain relief are being left in agony. But the ODs continue to mount, mostly on drugs not stocked at Walgreen’s—such as heroin laced with fentanyl, an extremely potent synthetic opioid.

What is going on? On the demand side, Americans are well indoctrinated by the sea of advertising about taking a pill for every ill. Nearly 70 percent of Americans take at least one prescription drug. Then there is the pervasive culture of instant gratification and moral relativism. As Paul Harvey predicted in his classic 1965 monologue “If I Were the Devil,” these trends would lead to metal detectors and drug-sniffing dogs in schools.

On the supply side, profits are enormous. The largest seizure to date of 63.8 kg of powdered fentanyl plus 30,000 counterfeit drug tablets, found in a tractor-trailer rig at a checkpoint near Yuma, Arizona, had a street value of $1.2 billion. Most of the fentanyl comes from China—a turnabout from the Opium Wars. In the 18th and 19th centuries, the British smuggled Indian opium into China, selling 1,400 tons per year in 1838, writes Dr. Marilyn Singleton, with devastating effects on the Chinese economy and political stability.

America’s rivals and enemies clearly benefit from the “deadly craving” that kills or disables a large portion of the U.S. population, while imposing huge costs on the economy. Also benefiting is the multi-billion dollar treatment industry, including the manufacturers of drugs used in “medically aided treatment.”

Where are the drug-sniffing dogs in schools where children are known to be getting addicted? And if taxi drivers know where the drug trades are happening, the police know too, and yet they continue. Huge money-laundering operations by the transnational drug cartels continued for years in upscale Florida suburbs despite undercover penetration by police.

While pouring billions into costly treatment methods with a one-year failure rate of around 90 percent, the government continues to provide “free” opioid prescriptions to Medicare and Medicaid enrollees, some of whom sell them on the street. And the Massachusetts attorney general shut down a network of sobriety-centric primary-care-based clinics with an astonishingly high success rate and imprisoned the founder, Dr. Punyamurtula Kishore. His alleged crime: ordering too many urine tests.

Is there any way that such massive international trafficking could thrive without some level of political protection? And is the government attempt to remedy the problem making it worse?

 Jane M. Orient, M.D. obtained her undergraduate degrees in chemistry and mathematics from the University of Arizona in Tucson, and her M.D. from Columbia University College of Physicians and Surgeons in 1974. She completed an internal medicine residency at Parkland Memorial Hospital and University of Arizona Affiliated Hospitals and then became an Instructor at the University of Arizona College of Medicine and a staff physician at the Tucson Veterans Administration Hospital. She has been in solo private practice since 1981 and has served as Executive Director of the Association of American Physicians and Surgeons (AAPS) since 1989. She is currently president of Doctors for Disaster Preparedness. Since 1988, she has been chairman of the Public Health Committee of the Pima County (Arizona) Medical Society. She is the author of YOUR Doctor Is Not In: Healthy Skepticism about National Healthcare, and the second through fourth editions of Sapira's Art and Science of Bedside Diagnosis published by Lippincott, Williams & Wilkins. She authored books for schoolchildren, Professor Klugimkopf’s Old-Fashioned English Grammar and Professor Klugimkopf’s Spelling Method, published by Robinson Books, and coauthored two novels published as Kindle books, Neomorts and Moonshine. More than 100 of her papers have been published in the scientific and popular literature on a variety of subjects including risk assessment, natural and technological hazards and nonhazards, and medical economics and ethics. She is the editor of AAPS News, the Doctors for Disaster Preparedness Newsletter, and Civil Defense Perspectives, and is the managing editor of the Journal of American Physicians and Surgeons.

Comments

Why is this website full of over-the hill white liberal antifa women ?

This doctor supports the police state. Government has no place telling a person how to lead their lives. These are consentual sales. No one is forcing anyone to take pills. They choose to. Government has no place putting people in jail or hindering them. When and if they violate another's rights is when government is to get involved. The war on drugs is a farce.

Your comment reminded me why I left the Libertarian Party after fifteen years' membership. I left the LP for the same reason I grow weary of the Republican Party: its philosophy, to the extent it has one, is sterile. By sterile, I mean its lack of appeal to higher law and our nobler passions. For instance, the libertarian assertion that my rights only go so far as to not impinge on those of others is all well and good. However, without at least introducing why this is so, that our rights are gifts from God, is to limit our spiritual understanding and ultimate happiness. I suspect the lack of spirituality is responsible for the LP’s slow growth. http://articlevblog.com/2016/04/on-sterile-politics-christianity-and-liberty/

The "tune for smoke" method: Let them that will, DO IT ! (can't stop them anyway). The "theory"?... "EVERYONE is entitled to 'go to hell' in the fashion of their own choosing"... The "Result"?... The winnowing of 'druggees' (...or, "separating the chaff from the Wheat"..) !

Doc, you missed the boat on this one. You probably should not have even mentioned Marijuana, or Heroin in this article. It is not the problem. The problem is the prescription drug/opioid epidemic. These drugs are abused more than ALL other drugs combined and it is not even close. It is about 550%. The problem lies with a number of entities, but mostly prescription drug makers, politicians and doctors. The drug lobby is tremendous and greedy. They basically pay politicians to look the other way and give Doctors anything they want to continue to support the cause. There have been several safety step bills introduced that would have required several steps of approval and a double check by pharmacists prior to renewing repeat prescriptions for pain meds. They could not even be heard in committees because they were shut down due to that same prescription drug lobby and our esteemed politicians. The same group of politicians have been in power in the U.S. legislature (and most states) for roughly 20 years (I will not name names as I am not a political party proponent, but independent). There is your problem and there have been solutions proposed, but nothing acted upon as of yet. Vote for people who will represent you and not special interests...

A well written article, too bad the doctor has no solution. Perhaps the Portugal Method should be looked at more closely.

You mean decriminalize use of any drug? You crazy!!! The private prison lobby will scream. I'm all for it, maybe people will get help and thrown in jail.

and not thrown in Jail.

Hey doc, medical cannabis can be used as an exit ramp for these patients. It is not a gateway drug as you describe. If your first responsibility is do no harm and you have a choice between pain relief that can kill you if overdosed or one that has never killed a human being, what should you do? Pretty simple choice in my mind. Your profession needs to look deeply into the mirror and educate yourself.

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