Let’s Stop the Hysterical Rhetoric about the Opioid Crisis
https://www.cato.org/publications/commentary/lets-stop-hysterical-rhetoric-about-opioid-crisis
President Trump held a meeting earlier this summer with the Secretary of Health and Human Services (HHS), the Director of the Office of National Drug Control Policy (ONDCP), and other advisers to take a deep dive into solving the nation’s worsening opioid overdose problem.
The Trump administration is clearly shifting into high gear on this issue. HHS Secretary Price, for example, agreed with a reporter during the press briefing that followed, when the reporter called it a “national emergency.” Even more disturbing, however, were recent assertions made by New Jersey Governor Chris Christie in a recent interview. Christie, who heads a White House Drug Addiction Task Force, claims that in 2015 doctors prescribed enough opioid painkillers to medicate every American adult for 3 weeks.
If these numbers appear implausible or like they are missing some context, it’s because they are. And the Administration’s resorting to hyperbole creates an atmosphere of panic that is likely to lead to policies that will only make matters worse.
Let’s start with the context-dropping. What does the governor mean by “medicated?” To a practitioner “medicated” means being treated with a medicine in order to achieve a desired result. Does that mean one 5mg oxycodone tablet every 4 hours (6 per day) for 21 days? Some patients are prescribed two 5mg tablets every 6 hours. Or is he talking about 7.5 or 10 mg oxycodone tablets? Maybe he means hydrocodone. That also comes in 5mg, 7.5mg, and 10mg doses and is sometimes prescribed every 4 hours but sometimes every 6 hours. Then there’s hydromorphone (dilaudid), oxycontin, and let’s not forget codeine.
The point is, millions of Americans have genuine, medically necessary reasons to be taking opioids. They make up the vast majority of opioid users and it doesn’t make sense to lump them into the opioid crisis.
And opioid use itself, for medical purposes or otherwise, is indeed decreasing. In July the Centers for Disease Control (CDC) reported that prescriptions for opioids by health care providers have been coming down. And the National Survey on Drug Use and Health (NSDUH) has reported that nonmedical use of prescription opioids peaked in 2012 and has been steadily dropping.
That’s not to say the problem is resolving itself. Unfortunately deaths from opioid overdose have been steadily increasing, reaching a new peak of 33,000 in 2015. For the first time the majority of those deaths were from heroin overdose, and the death rate from fentanyl overdose comprised over 4,000 of those deaths. Meanwhile, overdose deaths from prescription opioids have stabilized.
With the crisis already this severe, it’s crucial we get the facts right. Frightening and imprecise rhetoric leads to hastily designed policies with unintended consequences, often making matters worse.
Not all solutions are created equal. States have made the opioid antidote naloxone more available to chronic pain patients and to first responders. And more money is being spent on rehab programs. But so far most proposals for dealing with the overdose problem focus on increased surveillance on patients and providers, inducing doctors to prescribe fewer opioids, and making manufacturers cut back on the amount of opioids produced.
No matter how much regulators clamp down on the medical use of opioids the overdose rate grows. Yet the overwhelming majority of overdose victims are not patients receiving opioids for pain. Less than 1% of well-screened patients become addicted to opioids, according to a 2010 Cochrane analysis. A less comprehensive 2015 review from researchers at the University of New Mexico found the addiction rate ranged from 8-12%. And the CDC has cited a recent study showing the risk of overdose in non-cancer patients chronically receiving opioids for pain at less than 0.2 percent.
In fact, it’s fair to say that many of the deaths from opioid overdoses are the result of drug prohibition. Opioids obtained on the black market are often counterfeit and frequently laced with dangerous additives, such as fentanyl and carfentanil. The dosages are unknown or unreliable. Prohibition also increases profits to drug dealers peddling cheaper and more powerful narcotics.
If policy makers in the Trump administration want to effectively address the problem, there are other ways to do it. They should promote “harm reduction” programs, including pilot “heroin maintenance” programs, such as those that have worked successfully in Switzerland, the UK, Germany, the Netherlands, and Canada. They should also take note of recent evidence from Johns Hopkins University, the University of Michigan, and the RAND Corporation that have shown a dramatic decrease in opioid use and overdose rates in states that have legalized marijuana for medicinal use.
The opioid overdose problem requires a calm and reasoned approach, and a willingness to admit to previous policy mistakes. Rhetoric aimed at frightening the public does not foretell a propitious start.
Filed under: General Problems
Why does everyone keep overlooking a point that is right under their nose.The drug with the most destructive potential of all,a powerful drug,so powerful it has been used as anasthesia, a drug that kills 88,000 people per year, a drug many are “addicted” to, is sold legally on every city block,ALCOHOL. It’s not,”drugs and alcohol.” That’s a deceptive phrase.Alcohol is addictive and kills. Alcohol is a drug. .But out of the millions that drink,how many become hopelessly addicted to it,and lose control? Answer,the same small percentage that lose control with any other “drug.” The vast majority that drink,do so safely.
What happened when alcohol was “prohibited?” Every one found a supply anyway, cartels made a fortune as they turned our streets into bloody war zones.Whats the point that is right under our nose? When there’s a demand,there’s a supply.Those prone to abuse,the minority,will abuse.Most will not.I cannot get my wife to even take a Tylenol when she’s hurting.Leagalize all drugs and guess what,my wife still won’t take a Tylenol nor any other drug. Drugs in one form or another have been used,and abused for thousands of years in every culture on earth.And guess what.That will continue.Why will it continue? Because people find pleasure and medical relief in drugs.It is natural to human nature,and they are not going to successfully “prohibit” human inclinations.
Stop the stupidity.Stop the games.The drug war was and is and will always be a failure.Its been monetarily lucrative for the DEA, law enforcement,rehabs,private prisons,etc. etc. It’s a big freakin game and most running the game know this.If all drugs were legalized today,what would change? NOTHING. Except of course a lot of layoffs in enforcement agencies.Yes drugs like street crap such as meth, heroin etc. are nasty and deadly. DEA going after the suppliers of that garbage makes sense.But that’s all that makes sense. The war against humans and human nature makes no sense.Try a new approach.Try and see what happens.The world will not end nor will drug use increase in any dramatic capacity.What did Einstein call madness? Doing the same thing over and over and getting the same result.Stop the madness.
Good luck making the powers that be see this!
It is sooooooooo far gone it will take an act of god to get it back to reality,,,if ever,,,but we gotta keep the truth going to those ,”abuse of power that be,”’ I just sent my senator a lovely email,,useing that survey over at pnn,,charging them w/torture and genocide of the medically ill in physical pain and being f—- liars on my dime,,,and my niece agreed to forward me Steve stuff,, seeing as though someone has censored me from getting on this site,,NOT STEVEI was walken my dog just now,,,90 degrees in chees land,,,but any how,,,The reality of what this tryannical government has done was becoming more and more clear,,,They have done what no-other civilized government would do..They have literally changed definitions,arrested innocent doctors for doing their job of treating the medically ill w/medicine.They have label us LTD,,,FOR taking medicine as prescribed,,,they have literally made up lies to arrest thee innocent.The last time a government willfully was this corrupt,,,willful;ly hurt soo many people,,Tortured people to death,,,was the 1776 REVOLUTION,,,maybe we need another?!
…My Pharmcist of 30 years,,,just retired,,she said,,when they start making laws up,,changen laws that have been on the book for a 100 years to arrest/hurt innocent people,,what is there to stop them from going after me,,,im out of here,,30 years,,,in shes gone,,,
The hysterical propaganda will not stop until we get enough people to WALK OVER WASHINGTON,,till we have the monies to walk out there,,,Fly out there for these corrupt meeting where we are purposedly not allowed,,Until the media stops playing ball w/the corrupt government…Until Andrew klonodyn is brought up on charges of torture,murder and willful abuse of power as a government official.Also it will not stop until someone sue’s the federal government for willfull torture and genocide.Furthermore the definition for torture needs to be honored in America,,and judges need to start honor ,”’informed consent,” for our doctors will never trust our government again..I know I won’t….ever!!!maryw