Log In | Subscribe | | |

The Opioid Wars - developed nations and narcotics in the general population

Editorial Staff

USA: Deaths from opioid overdose continue to rise - and the problem has spread outside the USA

Almost anything we can write as a first sentence about this subject sounds flippant and that is absolutely not the impression we want to give. For sure, a recent press briefing from Tom Price, the Secretary for Health and Human Services is written in such poor English that at times one has to re-read it to work out what he is trying to say, and that's ignoring all the superfluous verbiage as he tries to sound interesting. But cut through the mass of chatter and vague statements and the hard facts are far more than merely interesting, they are disturbing: every year, the number of Americans who die from an overdose of legal pain-killers is more than the previous year and the numbers are big enough to become genuine statistics. For example, in 2015, approx half of all drugs overdoses resulting in death in the USA were from opioids. And that's not even the most fascinating fact, as other information shows.

According to figures from gunviolencearchive.org, in 2016, the total number of deaths in the USA from gun crime was 13,496.

According to Price, the number of deaths from opioid overdose in the same year was about 33,000.

Again, according to Price, the total number of deaths resulting from drugs overdoses was 52,000. Then he becomes vague and says that the 2016 figures were "no better, and the numbers in 2017 are even worse than 2016."

The big problem, the elephant in the room if you will, is that legal opioids have worked their way into the fabric of society that illicit drugs have not previously been able to do, and having done that, their effects are to bring more and more people into addiction and therefore, because of constraints on obtaining the legal drug legally, first into illegal markets for legal drugs and then into illegal markets for illegal drugs where quality and strength and, even, contents are unregulated. In addition, there is the problem of fake legal drugs where quality, strength and contents are not only unregulated but where profit depends on packing the drug with cheap fillers which may be toxic even in small doses.

There is no evidence that people who become addicted to e.g. Oxycodone are addictive personalities. Take the strange case of Matthew Perry who, persistent rumour had it, was repeatedly drunk on the set of "Friends" (a popular TV series that ran for a decade starting in the mid 1990s). He eventually admitted that there were problems of depression and drinking but that the problem was that, following a back injury, he had been prescribed Oxycodone and that, after a period of time, he not only became addicted but the effects diminished so that to achieve pain relief he needed ever increasing doses. There's the case of outspoken radio presenter Rush Limbaugh who made at least part of his name criticising "celebrities" for drug addiction: he was investigated for structuring cash transactions to avoid US Federal Cash Transaction Reporting laws - he arranged for a number of cash withdrawals of money that everyone accepted was legally his to pay for illegal supplies from legal sources of opioids after back surgery left him in pain. His drugs of choice were OxyContin and hydrocodone. Hydrocodone is the primary gateway drug to heroin and, in parts of rural USA, became so widely used that it became known as "hill-billy heroin."

Opioids were implicated in the deaths of singer Michael Jackson and actor Heath Ledger.

The scale of the problem cannot be overstated. The illegal trade in illegal narcotics is one thing but the illegal trade in legal narcotics is something else entirely. US Federal and State authorities are working hard at identifying the illegal suppliers of illegal drugs and while the world is somewhat inured to reports of large seizures of illegal drugs, it is the amount of legal drugs held by licensed medical practitioners for illegal, or allegedly illegal, purposes that needs far more prominent attention than it gets. The problem is that the stories are not dumb enough, or contentious enough, to become click-bait.

For example, a quick check of recent media report relating to "oxy" and "arrest" produced several isolated but relevant and important reports relating to medical practitioners and, let's be polite, errant prescription policies.

New York Post - July 2017 - "Authorities say Dr. Martin Tesher prescribed 2.2 million oxycodone pills to patients without a legitimate medical purpose — including those he knew were addicted to the powerful drug.

NJ.com - June 2017 - "Authorities plan to announce the arrests an Essex County doctor accused of supplying 16 members of Atlantic County drug ring with fraudulent prescriptions to get oxycodone pills. The dealers are accused of buying the prescriptions from the doctor in Essex, and then selling the drugs more than 100 miles away. The ring trafficked tens of thousands of oxycodone pills, authorities said."

NBC New York - April 2017 - "The investigation targeted three clinics in Brooklyn that allegedly operated as "pill mills." More than six million oxycodone pills, worth an estimated $60 to $100 million, were illegally prescribed and pumped onto the black market, officials said at a news briefing."

In April, a KTLA report demonstrated the cross-over into the supply of legal drugs through illegal channels for more common illegal narcotics: "Fullerton police arrested six people and seized over 14,500 Oxycodone pills, 2,000 MDMA pills, .7 pounds of mushrooms, 1.5 pounds of cocaine, 16.5 grams of methamphetamine, 85 Xanax pills, 4 pounds of ketamine, a loaded handgun and over $65,000 in cash from two homes during a drug raid, authorities announced on Friday."

In May, the San Diego Union-Tribune reported that what appeared to be OxyContin and which tested positive for at least some oxycodone had been discovered hidden in a compartment under a car crossing into the USA from Mexico. "The 47,340 tablets found in a hidden compartment under the woman’s car represent the largest seizure of oxycodone along the U.S.-Mexico border in at least five years, the U.S. Attorney’s Office said."

The USA is struggling with imports from foreign sellers of pharmaceuticals, some legal in the country where they do business, selling via internet advertising. Much of that is open but there are also traders operating on the so-called dark web.

While the USA is the primary point of focus for this problem at present, it is spreading. Opioids have long been prescribed in developed countries including the UK and Australia. Both countries are seeing worrying signs of addition and the related criminal conduct.

The reason appears to be that, when oxy-type drugs were first introduced, they were heavily sold to doctors without adequate warnings as to the dangers of heavy and / or prolonged use. More recent research shows that the drugs become counter-productive after a very short period and that's when the addiction sets in. Patients say that the feeling they get becomes the new normal and when the drug is de-prescribed, the return to their own personal reality, even if it is pain-free, feels so "weird" they choose the drug.

That, readers of history and literature, is essentially what Coleridge described as his reason for spending so much time in a haze of opium: it was not, it is said, because it helped his creativity (see Hubble, OPIUM ADDICTION AND ENGLISH LITERATURE https://www.ncbi.nlm.nih.gov/p... (1957) )

As Matthew Perry nearly said, to admit to the addition is almost to become the addiction; on a wider platform, to fail to admit that society has a problem and to raise it as widely as possible is to perpetuate it and to allow it to flourish.

After all, every right thinking person tries to argue for control of weapons in order to reduce gun crime and yet this one class of drugs killed more than twice as many people in the USA in 2015 as guns. Back to those all-important numbers: road safety gets massive coverage. According to the USA's Safety Council it "estimates 38,300 people were killed on U.S. roads" in 2015. Even that only just tops the number of over-dose deaths. And so far this publication has not been able to find data that shows how many road accidents were at least in part contributed to by opioid use or abuse.

Price's Press Briefing, in full, is here: https://www.whitehouse.gov/the...