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Can we get real about opioid abuse?

February 12, 2018

Let’s say you are fat. Should legislators make laws and lawyers file suit against the farmers for providing the products that make you that way?

If you use the same logic that is driving the “war on opioids” the answer is a resounding yes.

Musings is no fan of big pharma and the biotech companies with their drugs that cost thousands and even millions of dollars per year per patient, nor of the physicians who may have taken kickbacks to promote them.

But believing that the opioid abuse problem can be solved by suing the companies that legally develop and wholesale them is just a feel-good fantasy compounded by greed.

Another fantasy is that by making safe spaces for addicts to shoot up you will somehow make them safer from drug abuse is also BS, unless of course you scoop up the attendees and put them in a mandatory treatment facility.

Pragmatists argue a different line of attack…law enforcement.

Every article eventually makes the point that the opioids are invariably a stepping stone to cheaper and unregulated illegal street drugs like heroin.

That would indicate that the problem is not the legal medication, but the illegal use of it.

Forcing a manufacturer to stop marketing the opioids does not solve the problem, it just forces it further into the criminal underworld.

Legal vs. illegal drug use.

Take Fentanyl, for example. The drug, a synthetic morphine, is effective for many patients suffering from a terminal disease like bone cancer or other intense pain, and was originally marketed in low dose patches and pills for that use.

It has become a deadly street drug, but the supply isn’t coming from Big Pharma. Its chemical components have been reverse engineered, sometimes by U.S. college graduates from foreign counties, and then hijacked by criminals.

Even USA Today acknowledges that what’s on the streets today is being manufactured illegally overseas, mostly in China, and then smuggled across the Mexican and Canadian borders for distribution by sophisticated cartel networks and even by small-time pushers who redistribute their supply through the mail.

How is suing Purdue Pharma until they quit marketing Oxycontin or go out of business going to control that?

If there was a large and profitable enough market for it, criminal enterprises could reverse engineer ANY medication, even aspirin, and take it to the streets. In fact many of the antibiotics and herbal remedies purchased online are also counterfeited, because there’s good money in it.

Can you see a pattern here?

Businesses are sued because they have cash and assets that are relatively easy (and profitable) to confiscate.

Criminal enterprises take expensive (and unpopular) law enforcement and border control efforts to close down. Any cash recovered goes back into interdiction efforts or into the treasuries of the states and Federal government, not into the pockets of lawyers and claimants.

That calls into question the purity of the motives behind the war on opioids.

The complicated world of cause and effect.

If a company can be proven to have broken a law, then fine, prosecute them.

But believing that taking Big Pharma down is going to end addiction, or that providing clean needles to keep addicts from contracting HIV or viral hepatitis will remove the underlying market demand for addictive drugs makes about as much sense as protecting criminal aliens from deportation or commuting or pardoning 209 sentences of drug offenders on one just day in 2016. Many of those “nonviolent offenses” were for intent to distribute and also included unlawful possession of a firearm.

It is quite likely that Oxycontin-based drugs (like Oxycodone or Percocet for instance) will eventually be banned, as was propoxyphene, once marketed as Darvon or Darvocet but banned in 2010 for causing heart-related side effects rather than because it was addictive (which it was.)

Oxycontin, fentanyl and other narcotic substitutes are prescribed legally for pain control. The problem arises when physical dependency occurs but the pain remains.

Even OTC anti-inflammatory  (NSAIDS) medications like acetaminophen and ibuprofen require continuous use for managing chronic pain, like that experienced from slow-to-heal injuries or chronic conditions like arthritis or degenerative disc disease. Although neither NSAID is considered to be physically addictive as are opiates, both have health risks, namely that prolonged use can quite literally destroy your liver, among other things.

That doesn’t make their manufacturers criminals.

It would be better to focus on the illegal parts of opioid abuse (which is just a trendy name for drug addiction) instead of the medications themselves.

Or maybe we could just pass a law making it illegal to feel pain, or even come up with a different type of pain control or treatment for the underlying medical condition. Surely we can do that, right?

Or we could come up with another strategy that focuses on the wrong targets.

Can’t you just hear this exchange now?

Patient: “Doctor, my back hurts so bad I can’t work. What should I do?”

Doctor:  “Take this club home and hit yourself hard in the head each morning. You still won’t be able to work, but you won’t feel the pain.”

Ah, logic.


From → op-ed

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