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OPIOID CRISIS – THE NARRATIVE

January 27, 2018 444 38 No Comments

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OPIOID CRISIS – THE NARRATIVE

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Debbie Hancock
2018 January 19



  • Both the FDA and the CDC have recently taken steps to address an epidemic of opioid overdose and addiction. (4)

  • The​​ leading cause of drug overdoses in America is no longer cocaine, methamphetamine, or even heroin or common opioid painkillers like Percocet and OxyContin. It’s synthetic opioids like fentanyl and its analogs. (7)

  • Several states have filed lawsuits against​​ the drug company that manufactures OxyContin which some say had a major role in the opioid crisis. (3)​​ 

  • Doctors have gotten an unfair rap as addictions to opioids have ravaged communities throughout the country. (5)

  • Research has consistently shown that under the right medical supervision, the vast majority of opioid prescriptions do not result in addiction or heroin use. (5)

  • Three-quarters of the federal sentences for drug possession in 2014 were handed down to illegal immigrants. (6)

 


  • 1861 -1865 – Morphine is used on the battlefield during the Civil War. ​​ (8)

  • 1898 – Heroin is first produced for commercial distribution by the Bayer Company. ​​ (8)

  • 1914 – Congress passes a law requiring a written prescription for any narcotic. ​​ (8)​​ 

  • 1924 – The anti-Heroin Act​​ bans the production and sale of heroin in the United States. (8)

  • 1970 – The controlled substance act is written into law creating groups of drugs that are scheduled based on their potential for abuse – why not alcohol?

  • 1995 – OxyContin is introduced and aggressively marketed. ​​ (8)

  • 2010 April 23 – Jan Brewer, then governor of Arizona, signs a controversial law into effect allowing law enforcement officers to check legal status on immigrants in the state stopped for any reason in an attempt to curtail drugs coming across the Mexican border. (2)

  • 2013 Illegal immigrants were responsible for 38.6 percent of all federal sentencing for drug possession. (6)

  • 2014 – Illegal aliens made of 74.1 percent of the total sentenced for drug possession. ​​ (6)

  • 2015 – DEA arrests​​ 280 people including 22 doctors and pharmacists after a sting operation focused on health care providers.

  • 2016 – The CDC publishes recommendations for prescribing opioids forcing chronic pain sufferers to find less effective ways to treat pain as doctors​​ became wary of government scrutiny. ​​ (8)

  • 2016 Overdose deaths linked to synthetic opioids like fentanyl rose from 10,000 to 19,000. ​​ (7)

  • 2017 – President Trump declares a national public health emergency to combat the opioid crisis



According to two​​ recently released government studies, the widespread abuse of the potent and most popular opioid drug, fentanyl, appears to be mostly from the illicit manufacturing of the drug here and in China. ​​ Findings indicate that​​ drastic changes are occurring in the way that opioids are being abused, and the bulk of it is not from the misuse of legally prescribed opioids.  ​​​​ These drugs which are 50 to 100 times more potent than heroin are, in a majority of cases, manufactured in China and routed through Mexican cartels to the United States. ​​ While most of the focus has been on doctors and curtailing prescriptions, the crisis has gotten worse – not better, and the regulatory efforts will fail unless it is acknowledged that most of the problems are actually driven by​​ illicit – not medical drug use. (1) (4)

The typical narrative says the medical community helped make the United States the top country in terms of opioid consumption causing a surge in addiction and overdoses.  ​​​​ This is a misconception according to research which has consistently shown that under the right medical supervision, the vast majority of opioid prescriptions do not result in addiction or heroin use. ​​ While the media has presented numerous stories of people with addiction issues blaming their problem on medical use, according to the large annually repeated and representative National Survey on Drug Use and Health, most opioid misuse starts with people using medication that wasn’t prescribed for them, often obtaining the drugs from a dealer or stealing them from a family member or friend. ​​ 

A shocking 90% of all addictions – no matter what drug – start in the adolescent and young adult years and are typically people who already use alcohol and other drugs. ​​ This type of drug use and not medical treatment with opioids is by far the greatest risk factor for addiction, according to Richard Miesch and his colleagues at the University of Michigan. ​​ Their findings indicated that in general, new addictions are uncommon among people who take opioids for pain.​​ ​​ This has put many physicians in the tough position of choosing to help their patients suffering from pain but not wanting to jeopardize their practices with intense and sometimes unfair scrutiny from government enforcement agencies.  ​​​​ Coupled with mental​​ health issues and poverty levels, the crisis is far more complicated than tweaking how drugs are prescribed. (5)

Not surprisingly, poverty stricken areas are hardest hit. ​​ While addiction is certainly not limited to the poor, it’s big business in these areas where anything can be purchased on any street corner. ​​ A large portion of these powerful drugs, namely fentanyl, are manufactured in China and distributed in the U.S. by cartels and illegal immigrants through Latin America.  ​​ ​​​​ A large supply is actually mailed to users and dealers via the United States Postal Service. ​​ As the drug demand and supply increases, there is more and more evidence that people are now starting their opioid use on heroin to begin with while others were pushed to it with the crackdown on legitimate painkillers. (7)

It would appear that it has been easier to “go after” doctors and pharmacies, in the process, causing chronic pain sufferers to pay the price. ​​ Drug Enforcement officers admit that it is almost impossible to scratch the surface as more and more illegal drugs are brought into the United States daily.


A study conducted of nearly 136,000 opioid overdose victims treated in the emergency room in 2010 that was published in JAMA Internal Medicine in 2014 found that just 13 percent had a chronic pain condition. (4)

  • Targeting doctors to limit prescriptions runs the risk of harming pain patients without doing much to stop addictions. (4)

  • Recent research on approximately one million insurance claims for opioid prescriptions showed that just less than five percent of patients misused the drugs by getting prescriptions for them from multiple doctors. (4)

  • Studies find that most people who become addicted to painkillers start as teens or very young adults and already abuse alcohol in​​ many cases. (5)

  • The leading cause of drug overdoses in America is now synthetic opioids such as fentanyl. ​​ (7)

  • In 2010, then Governor Jan Brewer of Arizona was criticized for stating that “I believe today, under the circumstances that we’re facing, that the majority of illegal immigrants is to enter the United States to look for work, but that drug rings press them into duty as “drug mules”. ​​ She signed into law the requirement for police officers enforcing another law to question a person’s immigration status if there’s a reasonable suspicion that they are in the country illegally. ​​ (2)

  • Data from 2014 shows that illegal immigrants made up more than one-third of all federal drug sentences. ​​ (6)



1. ​​ David Armstrong, Stat News, Illegal Street Drugs, Not Prescriptions, Now Powering Opioid Abuse Study Says, 2016 November 25
https://www.statnews.com/2016/08/25/fentanyl-street-drugs-cdc/

2. ​​ AP, Arizona Governor: ​​ Most Illegal Immigrants Bring Drugs, 2010 June 25
https://www.cbsnews.com/news/ariz-gov-most-illegal-immigrants-bring-drugs/

3. Mike Mariani, Pacific Standard, “How the American Opiate Crisis was Started by One Pharmaceutical Company” 2015 March 04
http://theweek.com/articles/541564/how-american-opiate-epidemic-started-by-pharmaceutical-company

4. ​​ Maia Szalavitz, Scientific American, “Opioid Addiction is a Huge Problem but Pain Prescriptions are not the Cause” 2016 May 10
https://blogs.scientificamerican.com/mind-guest-blog/opioid-addiction-is-a-huge-problem-but-pain-prescriptions-are-not-the-cause/

5. ​​ Robert Gebelhoff, The Washington Post, “An Obvious Way to Fight the Opioid​​ Epidemic – and Make Doctor’s Lives Easier”, 2017, March 10
https://www.washingtonpost.com/news/in-theory/wp/2017/05/10/an-obvious-way-to-fight-the-opioid-epidemic-and-make-doctors-lives-easier/?utm_term=.8cc8a8e79816

6. ​​ Pete Kasperowicz, Washington Examiner, “Illegal Immigrants responsible for almost three-fourths of federal drug possession sentences in 2014”, 2017 December 28
http://www.washingtonexaminer.com/illegal-immigrants-responsible-for-almost-three-fourths-of-federal-drug-possession-sentences-in-2014/article/2567814

7. ​​ German Lopez, VOX, “How Fentanyl Became America’s Leading Cause of Overdose Deaths”, 2017 December 21
https://www.vox.com/science-and-health/2017/5/8/15454832/fentanyl-carfentanil-opioid-epidemic

8. 2017, Column Health, “Timeline of the Opioid Crisis”
https://columnhealth.com/blog_posts/timeline-of-the-opioid-crisis/

9. ​​ Jameson Taylor, Civitas Institute, “Illegal Immigration – Drugs, Gangs and Crime”, 2007 November 01
https://www.nccivitas.org/2007/illegal-immigration-drugs-gangs-and-crime/



https://celinemcarthurinvestigates.com/

A documentary entitled​​ “Beyond the Border – the Opioid Pipeline” describes the transit path of illicit drugs into this country and how Manchester, NH has become a major entry point.

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Story inspired by: ​​ article in Scientific American discussing the opioid crisis and the illicit​​ rather than medical component along with an article describing how illegal immigration has heightened the problem.


In general, new addictions are uncommon among people who take opioids for pain in general. ​​ A Cochrane review of opioid prescribing for chronic pain found that less than one percent of those who were well screened for drug problems developed new addictions during pain care.

4. ​​ Maia Szalavitz, Scientific American, “Opioid Addiction is a Huge Problem but Pain Prescriptions are not the Cause” 2016 May 10
https://blogs.scientificamerican.com/mind-guest-blog/opioid-addiction-is-a-huge-problem-but-pain-prescriptions-are-not-the-cause/

Mexican criminal groups in the southwestern states routinely use Mexican illegal immigrants as couriers to transport illicit drugs into the country. ​​ These groups exploit a growing number of Mexican population while their involvement grows in retail drug distribution. ​​ (9)

9. ​​ Jameson Taylor, Civitas Institute, “Illegal Immigration – Drugs, Gangs and Crime”, 2007 November 01
https://www.nccivitas.org/2007/illegal-immigration-drugs-gangs-and-crime/

Point​​ – ​​ Physicians and pharmacies are now monitored closely by government agencies implemented by each state with regard to opioid prescriptions, yet overdose deaths from opioids continue to​​ climb at an alarming rate. ​​ (5) ​​ Fentanyl, a powerful synthetic opioid – 100 times more potent than heroin in some cases, is now the leading cause of opioid related deaths. ​​ A majority of the supply is now coming from China into this country illegally via​​ South American countries.

5. ​​ Robert Gebelhoff, The Washington Post, “An Obvious Way to Fight the Opioid Epidemic – and Make Doctor’s Lives Easier”, 2017, March 10
https://www.washingtonpost.com/news/in-theory/wp/2017/05/10/an-obvious-way-to-fight-the-opioid-epidemic-and-make-doctors-lives-easier/?utm_term=.8cc8a8e79816

https://celinemcarthurinvestigates.com/

A documentary entitled “Beyond the Border – the Opioid Pipeline” describes the transit path of illicit drugs into this country and how Manchester, NH has become a major entry point.

Counter-Point – OxyContin, an opioid pain medication, was approved by the FDA in 1995 and marketed to doctors as a safer, less addictive drug for pain management. ​​ It is now being blamed, along with the manufacturer, for the beginning of what is​​ being called the “Opioid Crisis”.  ​​​​ The small privately owned pharmaceutical company, Purdue Pharma, controlled nearly a third of the entire United States market for pain pills until 2013 when their patent ran out.

While there were and still are some unethical doctors working out of “pill mills”, it appears, now, that most of the drugs are not coming from legal prescriptions but clandestine labs here and overseas.

​​ 3. Mike Mariani, Pacific Standard, “How the American Opiate Crisis was Started by One Pharmaceutical Company” 2015 March 04
http://theweek.com/articles/541564/how-american-opiate-epidemic-started-by-pharmaceutical-company

1. ​​ David Armstrong, Stat News, Illegal Street Drugs, Not Prescriptions, Now Powering Opioid Abuse Study Says, 2016 November 25
https://www.statnews.com/2016/08/25/fentanyl-street-drugs-cdc​​ 

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