Overdosing on Government

How government misregulation leads directly to drug abuse.

On Feb. 13, 2022, the New York Times daily email discussed the rising tide of drug overdose fatalities in the United States.  It started:

Drug overdoses now kill more than 100,000 Americans a year - more than vehicle crash and gun deaths combined.

Wow!  Drug abuse causes more deaths than vehicles and guns combined!  Why don't they advocate their favorite solution to gun deaths - banning drugs surely ought to solve the problem, right? 

Not even the Times is that silly - they know that banning drugs hasn't helped and they won't even discuss the only known solution to the drug problem.

The Times gave us their view of the history of the problem:

In the 1990s, drug companies promoted opioid painkillers as a solution to a problem that remains today: a need for better pain treatment. Purdue Pharma led the charge with OxyContin, claiming it was more effective and less addictive than it was. ...

Doctors bought into the hype, and they started to more loosely prescribe opioids. Some even operated "pill mills," trading prescriptions for cash.

It turned out that people such as Rush Limbaugh, who were prescribed pain pills for legitimate purposes, could become addicted.

A growing number of people started to misuse the drugs, crushing or dissolving the pills to inhale or inject them. Many shared, stole and sold opioids more widely.

When the government noticed the problem, their solution was to sue the pill manufacturers for overly-effective marketing, even though all the prescriptions had been written by government-licensed physicians and fulfilled by government-approved pharmacies.  The companies pointed out that only the government knew the total consumption of these drugs.  Each company knew how many pills they were selling, but carefully kept their sales figures as private as they could.

Juries and lawsuit settlements have awarded billions of dollars in damages against the businesses which produced drugs which had been approved by the FDA.  Perdue Pharma was put out of business.  On top of that, the New York Post tells us about government cracking down on doctors who seemed to have over-proscribed opioids whether for pain management or not.

Emergency-room records reveal that very few overdose victims were being treated by a doctor for chronic pain, according to the Journal of the American Medical AssociationInternal Medicine. Thats not how they got hooked.

Illegal drugs cause nearly all overdose deaths, not drugs patients get from their doctor. Fentanyl (a man-made heroin-like drug), heroin and cocaine play the biggest roles in overdose deaths in New York City, according to the citys health data. Fewer than one in five overdose victims even had a prescription drug in their system, and it was virtually never the only drug.

As usual with government, there were undesirable consequences: It became very difficult for people who suffered from extreme pain to get enough treatment to keep them functioning in society and addicts switched from high-quality manufactured pills to illegal compounds which aren't made as carefully or as consistently.

Victims of Pain

Our government has much more control over our medical system than they admit.  By threatening to cancel the medical licenses of anyone who prescribed "too many" painkillers, the government made it impossible for people who had unusual needs to get enough medicine to get through the day.  This was the same technique the government used to make it impossible for doctors to prescribe ivermectin for covid suffers regardless of the doctor's views of how well the drug worked.

WIRED describes the unfortunate results in "The Pain Was Unbearable. So Why Did Doctors Turn Her Away?"

The article describes a government-operated NarxCare database which is supposed to list all painkillers each person receives.  Whenever the government thinks a patient is getting too many painkillers, the doctor gets a nasty message.  The usual response is to terminate the relationship with the patient for fear of losing a license to practice.

NarxCare - the system that inspired Kathryn's gynecologist to part ways with her - is Appriss' flagship product for doctors, pharmacies, and hospitals: an "analytics tool and care management platform" that purports to instantly and automatically identify a patient's risk of misusing opioids.

Appriss is adamant that a NarxCare score is not meant to supplant a doctor's diagnosis. But physicians ignore these numbers at their peril. Nearly every state now uses Appriss software to manage its prescription drug monitoring programs, and most legally require physicians and pharmacists to consult them when prescribing controlled substances, on penalty of losing their license. In some states, police and federal law enforcement officers can also access this highly sensitive medical information-in many cases without a warrant-to prosecute both doctors and patients.  [emphasis added]

By raising the street price of competently-manufactured pills or making them unavailble to patients who "might" be getting "too many," the government forced addicts to turn to cheaper illegal drugs which aren't manufactured carefully at all.  As the Post put it,

Doctors fear legal trouble, and are cutting off patients. Some of these turned-away patients, like 52-year-old bed-ridden Debra Bales, who had taken painkillers for years, resort to suicide in desperation.

Why are we not surprised that suffers such as Kathrun would turn to illegal drugs?  Given the choice of maybe dying due to carelessly-compounded drugs or continuing to suffer unbearable agony, many people choose the low-quality route and die.

Addicts' Response to Higher Prices

As with making gasoline harder to pump out of the ground, making high-quality pills harder to get raised the price, so addicts naturally turned elsewhere to save money.  The Times explained

Opioid users moved on to more potent drugs, namely heroin. Some were seeking a stronger high, while others were cut off from painkillers and looking for a replacement.

Traffickers met that demand by flooding the U.S. with heroin. Then, in the 2010s, they started to transition to fentanyl, mixing it into heroin and other drugs or selling it on its own.

Drug cartels can more discreetly produce fentanyl in a lab than heroin derived from large, open poppy fields. Fentanyl is also more potent than heroin, so traffickers can smuggle less to sell the same high.

Their Simplistic Solution

The Times blames the problem on lack of treatment for drug addiction.

Experts have a concise, if crude, way to summarize this: If it's easier to get high than to get treatment, people who are addicted will get high. The U.S. has effectively made it easy to get high and hard to get help.

This assumes, without saying so, that government-run drug addiction treatment actually works.  This overly-simplistic idea totally ignores the possibility that some people suffer from so much pain that they need the drugs regardless of the danger of addiction.

Once again, we see that there is no problem that government can't make worse by throwing money and regulation at it.

Will Offensicht is a staff writer for Scragged.com and an internationally published author by a different name.  Read other Scragged.com articles by Will Offensicht or other articles on Bureaucracy.
Reader Comments

Good article. Glad to see some waking up about the true opioid OD crisis.

February 18, 2022 7:02 AM

I was severely injured after getting hit by a car on a motorcycle in 2015. Compound femur fracture. Surgeon said they had to clean asphalt off the exposed bone from scraping on the road prior to first of 3 surgeries to repair. Sorry for the visual.
I'm still seeing surgeon after almost 6 years although I'm healed and can walk. During early days, I was pumped full of morphine and then OxyContin until after about 16-18 days while at rehabilitation center, I realized pain level was subjective and discomfort was a more precise word to describe what I was experiencing and I stopped taking OxyContin. The rehab people were not happy. The surgeon told me the story. the federal government invented the totally subjective "pain scale 1-10" years ago, which every doctor has to ask anyone injured. And the federal government monitors data to determine if doctors are addressing patient claims of severe pain by loading them with pain meds. If the doctor is not giving the patient pain meds, that reflects negatively on the doctor. So the government is and has for years, incentivized doctors to prescribe highly addictive drugs to patients who are expected to pick a number from 1-10 with the only result being given drugs. There's no option for people like me who realize that while I might be uncomfortable, I'm not "in pain" and therefore do not need drugs.
And now, the same government that caused the problem - creating legions of addicts because the government forced doctors to give people drugs whether they needed them or not, now blames the doctors and drug manufacturers who were forced to respond to the governments edict to address peoples pain based on a subjective scale. It's beyond crazy but par for the course.
When I refused to take any more pain meds because I no longer needed them, the rehab doctor, not my surgeon, came to my room and chastised me saying "you have to take the drugs". I stated that while I was uncomfortable at times, I was not in pain and that I would not take the drugs. Zero support from them to stop drugs.
When I told my surgeon about the situation, he apologized that the best they could do was give me highly addictive drugs which the "system" demanded I take. He supported me not taking the meds and after additional surgeries, had me talk to the interns about the difference between pain and discomfort. The entire process..asking a patient to respond with a number is the problem. The government requirement that they ask you for a number from 1-10 without any other possibility is the problem.
As an old dentist told me when I was a young kid and had to have a cavity drilled and filled - .I asked him "is it going to hurt"? And he replied "I can't lie to you, it will be a little uncomfortable". He did this without Novocain because he knew it wouldn't "hurt". I went to him a number of times and he never used Novocain on me. When I finally moved and had to get a new dentist, I was shocked when he gave me Novocain every time I saw him, and no matter what he was doing to fix my teeth.
Life is full of discomfort whether it be physical discomfort or emotional/mental discomfort. And taking heavy duty, highly addictive drugs can only mask the discomfort. Just like anti depressants mask the symptoms. Neither eliminates the symptoms.
And what this teaches people is that they can't experience life without a drug, whether it be pain meds for physical discomfort or anti depressants for emotional pain due to life.
So it's no wonder so many people regularly take drugs.
No one said there wont be or shouldn't be discomfort in life. I prefer to experience it as clear minded as I can.as it's meant to be experienced. Yes, there are situations where one should take meds, but pain meds, like anti depressants never "cure" the issue.they only mask the symptoms.

February 18, 2022 2:17 PM

When caught, our betters then say "Mistakes were made, but not by me."

February 18, 2022 3:48 PM

NPR points out that we're talking serious money here:

4 U.S. companies will pay $26 billion to settle claims they fueled the opioid crisis

They do acknowledge the real problem:

Many Americans with opioid use disorder have shifted from taking prescription pain pills to street fentanyl, a synthetic opioid that is far more powerful and lethal.

The solution, then, is to make well-manufactured pills more readily available to addicts don't have to steal to support their habits and are less likely to die from accidental overdose.

https://www.npr.org/2022/02/25/1082901958/opioid-settlement-johnson-26-billion

Four of the largest U.S. corporations have agreed to pay roughly $26 billion to settle a tsunami of lawsuits linked to claims that their business practices helped fuel the deadly opioid crisis.

Johnson & Johnson, the consumer products and health giant that manufactured generic opioid medications, will contribute $5 billion to the settlement.

The company announced in 2020 it would get out of the prescription opioid business in the U.S. altogether.

Three massive drug wholesalers - AmerisourceBergen, Cardinal Health and McKesson - will pay a combined $21 billion.

"This settlement represents real accountability," said North Carolina state Attorney General Josh Stein, who helped negotiate the deal.

Stein noted that most of the funds are earmarked for health care and drug treatment programs designed to ease the opioid crisis.

"There will be people alive next year because of the programs and services we will be able to fund because of these settlement proceeds," he said.

None of the companies acknowledged any wrongdoing for their role manufacturing and distributing large quantities of pain medications at a time when opioid addiction and overdoses were surging.

In a joint statement, the drug wholesalers said they had determined that enough governments had signed onto the deal to move forward with a "comprehensive agreement to settle the vast majority of the opioid lawsuits."

In all, 46 states and roughly 90% of eligible local governments have signed on to the deal, according to the companies' assessment.

In a separate statement, Johnson & Johnson said its contribution to the deal would "directly support state and local efforts to make meaningful progress in addressing the opioid crisis."

The deal settles thousands of lawsuits
This settlement resolves thousands of civil lawsuits filed against the companies beginning in 2014 by local and state governments as well as Native American tribes nationwide.

"The settlement will provide thousands of communities across the United States with up to approximately $19.5 billion over 18 years," the drug distributors said in their statement.

AmerisourceBergen will pay $6.1 billion, Cardinal Health will pay $6 billion and McKesson, $7.4 billion.

Broad outlines of the deal were first unveiled in July 2021 but the companies said they wouldn't accept the settlement unless enough governments agreed to sign on and drop their suits.

Initial payments will begin in April and will continue over the next two decades.

A dangerous moment in the opioid crisis
The money will arrive at a moment when the opioid epidemic has escalated dangerously.

Many Americans with opioid use disorder have shifted from taking prescription pain pills to street fentanyl, a synthetic opioid that is far more powerful and lethal.

Drug overdoses now kill more than 100,000 people in the U.S. every year, according to the Centers for Disease Control and Prevention.

Joe Rice, with the firm Motley Rice, is one of the lead attorneys suing the drug industry over its alleged role in the opioid crisis.

He supports this settlement and said the funds will help devastated communities "start rebuilding ... and deal with this epidemic."

Rice said the deal was structured in collaboration with local government officials to avoid a problem that arose with the $246 billion tobacco settlement of the 1990s.

February 25, 2022 6:56 PM

In addition to everything in the article and the other comments is the fact that prescription pain drugs are tracked, to the pill, at every step in the process, and all to government regulation. There is no step in the process they don't control, yet it is not their fault when their system fails.

March 13, 2022 4:49 AM
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