Scapegoating opioid makers lets true offender get away – UPI – by Dr. Jeffrey A. Singer – Apr 2019
This article contains a slew of opioid addiction facts and numbers, clearly showing that opioid prescriptions for pain are *not* the problem.
Like the tobacco companies in the 1990s, it is understandable to focus indignation at companies, driven by the profit motive, that purvey products that can cause harm and even death. It is reasonable to question and criticize their marketing ethics and aggressiveness.
But at the end of the day, extracting a pound of flesh from the Sacklers won’t stop the overdose rate from climbing.
That’s because the standard narrative that overprescribing of opioids caused the overdose crisis is based upon misinformation — as is the belief that opioids have a high overdose and addiction potential.
Data from the National Survey on Drug Use and Health, as well as the Centers for Disease Control and Prevention, clearly show no correlation between the number of opioid prescriptions dispensed and “past month non-medical use” or “pain reliever use disorder” among adults over age 12.
- As high-dose opioid prescriptions dropped 58 percent from 2008 to 2017 and
- overall prescriptions dropped 29 percent in that time period,
- the overdose rate continued to climb.
- In 2017, heroin and fentanyl comprised 75 percent of opioid-related overdose deaths.
- Deaths from prescription pain pills also involved drugs like cocaine, heroin, fentanyl, alcohol and benzodiazepines 68 percent of the time.
- Less than 10 percent of overdoses from prescription pain pills in 2017 did not involve other drugs.
Opioids prescribed in the medical setting have been repeatedly shown to be safe:
- Researchers following over 2 million North Carolina patients prescribed opioids noted an overdose rate of 0.022 percent, and nearly two-thirds of those deaths had multiple other drugs in their system.
- A 2011 study of chronic pain patients treated in the Veterans Affairs system found an overdose rate of 0.04 percent.
- A larger population study found an overdose rate of 0.01 percent.
- Researchers at Harvard and Johns Hopkins universities recently found a total misuse rate of 0.6 percent in over 560,000 patients prescribed opioids for acute and post-op pain between 2008 and 2016.
- Cochrane studies, highly regarded for their rigor, found addiction rates in chronic pain patients on opioids of roughly 1 percent.
People often mistakenly equate physical dependency with addiction. Physical dependency is seen with a variety of drugs, including antidepressants, anti-epileptics, and beta blockers. A person can be slowly weaned off these drugs.
But addiction is a compulsive behavioral disorder with a genetic component featuring repeated use despite self-destructive consequences.
And it’s exactly for this reason that punishment doesn’t work when people are addicted because they already cannot help causing themselves harm.
They already lose their money, jobs, relationships, housing, and much more, so jail time would be just another dire consequence they cannot avoid in the pursuit of their substance of choice.
The director of the National Institute on Drug Abuse points out in a 2016 paper that true opioid addiction “occurs in only a small percentage of persons who are exposed to opioids — even in those with pre-existing vulnerabilities.”
Even though this clarification is coming from our government’s own Institute of Drug Abuse, it’s being completely disregarded by many medical groups, hospitals, the DEA, and politicians, who have all been whipped into a frenzy by the anti-opioid zealots.
As researchers at the University of Pittsburgh recently demonstrated, non-medical use has been on a steady exponential increase at least since the mid-1970s and shows no signs of slowing down.
The only things that have changed over the years are the drugs in vogue for non-medical use.
People falling into addiction, not the drugs themselves, is the phenomenon that’s causing all this grief, and it’s spurred by many other factors more than just a drug’s popularity.
It seems sociocultural factors are at play.
At the end of the day, the drug overdose problem is the result of sociocultural dynamics intersecting with drug prohibition — and all the dangers that a black market in drugs present
Prohibition also presents powerful incentives to corrupt doctors, pharmacists and pharmaceutical representatives who seek the profits offered by the underground trade.
When Portugal decriminalized all drugs in 2001, it saw a 75 percent drop in its population of heroin addicts by 2015, and now has the lowest overdose rate in Europe
None of this is meant to defend the conduct of a few pharmaceutical companies or those who work for them. It is meant to refocus energy and anger where it belongs.
The real villain is the war on drugs. Yet it’s getting off scot-free.
I believe this is really the crux of the problem. All of our resources are being directed to fight an unwinnable drug war.
I say it’s unwinnable because history shows that it’s human nature to seek and enjoy intoxicants. We cannot change human nature, no matter how many people we put in jail for it.
Author: Dr. Jeffrey A. Singer is a general surgeon in Phoenix and a senior fellow at the Cato Institute