A record-breaking 28,000 Americans died of opioid overdoses in 2014.
The truth is that many of those deaths are completely preventable and result not from painkillers, but from the Drug Enforcement Administration’s war on painkillers.
A study in the Journal of the American Medical Association showed that half of all troops who return from Iraq and Afghanistan suffer from chronic pain.
Forcing Users into the Black Market
I would not assume that many patients are trying to find pain pills in the streets because many patients, like me, do not know where to get “street drugs”.
Most are too frightened, both by the black market drug scene and the drugs themselves.
These days, fentanyl is regularly being passed off as prescription pills or heroin because it is so incredibly cheap – much cheaper and much more potent than the other drugs it imitates.
Some illicit drug organizations are importing pill presses and making prescription pill molds so they can press fentanyl into well-known opioid pills, like Norco.
Fentanyl is so potent that mere micrograms of it can kill. Because the concentrations of it in illicit pills is not well-controlled, these pills are very, very risky to ingest.
Accidents, failed surgery, degenerative conditions, or all of the above can cause chronic pain. It can hit anyone at any time.
In an unpublished paper, Dr. Harvey L. Rose told the story of a 28-year-old man with persistent leg pain caused by a work accident that lumbar disc surgery couldn’t fix.
Rose also treated a 78-year-old woman left with chronic back pain after surgery for degenerative cervical disk disease didn’t work.
The Drug Enforcement Administration actively prevents patients from getting the prescription painkillers they need.
It started in the 1970s, when the DEA’s reporting requirements made many doctors decide to stop prescribing painkillers altogether
Even in 1973, pain undertreatment was endemic.
And the regulations keep coming.
In 2015, the DEA decided to require patients to see their doctor, in person, every month in order to get refills for hydrocodone-based medicine. Earlier this year the CDC released guidelines that discourage clinicians from prescribing opioids.
The Black Market Solution
Opioids work by mimicking chemicals our brains produce naturally.
The problem for long-term users is that the brain stops producing them if it doesn’t have to
#Since constant pain constantly “consumes” opioids, both endogenous and from medication, it seems quite possible that our brains continue producing them even while we’re taking opioid medication for our pain.
Stopping medication leaves sufferers
- “constantly sore,
- sensitive to pain,
- fatigued but
- unable to sleep,”
according to Siegel.
Going without painkillers isn’t an option for many people who need them.
Dr. Rose’s 28-year-old patient turned to alcohol and street drugs after his doctor prescribed an antidepressant instead of a painkiller. He later hanged himself in his garage.
A 78-year-old woman got into her bathtub with an electric mixer after a series of physicians refused to prescribe an effective dose of painkillers. In all she tried to kill herself four times, slashing her wrists and overdosing on Valium and heart medication.
Thanks to the DEA, men and women who lost limbs serving in Iraq and Afghanistan are needlessly entering withdrawal. After the DEA rules changed, Schroeder’s VA doctor couldn’t see him for nearly five months.
This isn’t unusual. Schroeder spent those months bedridden in crippling pain and opioid withdrawal.
Another Iraq vet can’t drive due to shrapnel in his femur and pelvis. Getting his medications requires a monthly two-hour bus ride for “a one-minute consult.”
The CDC suspects that many, if not most, of the people who died of opioid overdoses in 2014 were taking black-market fentanyl. Many drug dealers add fentanyl to heroin without letting users know
When the CDC reports on opioid deaths, that includes street drugs like heroin and synthetic opioids.
Toxicology tests used by coroners and medical examiners can’t distinguish black-market fentanyl and prescription fentanyl.
But we do know that there was more of the illegally-manufactured, synthetic opioid-derived fentanyl available in 2014 than in previous years, according to law enforcement reports. This coincided with the 2014 jump in deaths from opioid overdoses.
In addition, we know that patients combine drugs when they can’t get enough painkiller.
Combinations of opioids and drugs like alcohol make up 60% of deaths ruled opioid overdoses by the CDC. New York City government data shows that more than 90% of opioid overdose deaths involve mixtures of opioids with other drugs
Dependence Isn’t Addiction
Jacob Sullum pointed out that bureaucrats accept “dependence” on heart or cholesterol medicine. Nobody talks about being addicted to Lipitor. But the government is willing to make criminals of people who depend on certain types of painkillers.
In 1973, Drs. Marks and Sachar looked at why patients were complaining about pain after doctors gave them medication. They found that, in “virtually every case.” doctors and nurses were under-prescribing pain medication.
The problem was, and is, that doctors don’t understand the difference between tolerance and physical dependence, causing “excessive and unrealistic concern about the danger of addiction.”
An article in a 1993 National Institute on Drug Abuse newsletter said narcotics “are rarely abused when used for medical purposes” and lamented that “thousands of patients suffer needlessly.”
This moralizing and dearth of empathy fuels policies that spend tax dollars to “make our lives more difficult and painful,” Sullum wrote.
If the goal is to prevent overdoses, we already know how to do that.
A 2015 U.K.-based study found that opioid-dependent patients treated with medication like methadone and buprenorphine were half as likely to die of an overdose within four years as counseling-only patients
The data is clear. By making methadone or buprenorphine harder to get, the DEA has caused death, disease, and crime.
The World Health Organization calls methadone or buprenorphine “essential” for keeping people out of the black market for opioids, which besides saving lives, also reduces crime and the spread of infectious diseases.
France allowed doctors to prescribe methadone and buprenorphine when they deemed it necessary during the 1995 HIV outbreak. In the years since, France reduced their overdose deaths by 80 percent. Baltimore cut overdose deaths by 66% by 2008 after making methadone or buprenorphine move available in 1995.
The DEA wants you to think that overprescribing opioids leads to addiction.
The irony of blaming prescriptions of OxyContin for opioid deaths is twofold.
- First, opioids are still underprescribed.
- Second, opioids are actually safer than most other pharmaceuticals. The most serious common side effect of long-term opioid use? Constipation.
Aggressive DEA enforcement causes opioid underprescribing.
This means patients can’t access safe pain medicine. Facing chronic pain and withdrawal, patients take black-market opioids. The reduction in prescription painkiller use has been accompanied by an increase in heroin use.
People simply don’t overdose on prescription painkillers under medical supervision.
They overdose when they can’t get the medicine they need and turn to the black market for help. The DEA’s efforts to keep chronic pain sufferers from accessing prescription painkillers and methadone is literally killing them.
And yet lawmakers and reporters keep buying the DEA’s lies that prescription opioids cause overdose deaths.
Portugal decriminalized heroin, along with every other drug, in 2001
In Portugal, three out of a million people die each year by overdosing on any drug. Just as a reminder, each year in America 9 out of every 100,000 people die of an opioid overdose.
In Portugal after 2001, fewer people reported doing drugs in the past year and the past month.
Psychiatrist Jerome H. Jaffe, Richard Nixon’s drug czar, himself said,
“No patient should ever wish for death because of his physician’s reluctance to use adequate amounts of potent narcotics.”