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Saturday, December 24, 2016

How the feds are fueling America’s opioid disaster

By Josh Bloom
New York Post

December 19, 2016-- Federal policy is unquestionably making the nation’s opioid problem worse — while also inflicting collateral damage on Americans in genuine need of pain medication.

And this disaster is being further driven by a myth that has gained additional credence from the Centers for Disease Control and Prevention’s latest guidelines for prescribing opioids.

The myth: that lax prescription of opioid drugs, such as oxycodone, is a primary driver of addiction. This notion has triggered a nationwide crackdown on these prescriptions in the name of preventing addiction and saving lives, an action that has been a catastrophe by almost any measure.

Dissenting opinions do exist. Physicians for Responsible Opioid Prescribing, a group that promotes strict control of prescriptions, admits that chronic pain patients have a “very legitimate fear” of restrictions. Yet the group, which was involved in formulating the CDC guidelines, nonetheless recommends a one-size-fits-all daily cap on the permissible opioid dose, regardless of the patient.

Reviewers have rightly criticized PROP for using shoddy evidence in support of its findings. In the past decade, more than a dozen professional papers — including a systematic analysis known as a “Cochrane Review” of 26 other studies, and a 38-study review in the journal Pain — have debunked the idea that addiction routinely starts with legal use. In most cases, it doesn’t; people who use prescription opioids properly and legally rarely become addicts. Overwhelmingly, the ones who become addicted are those who start off using opioids for recreational purposes. The next stop is street drugs.

Paradoxically, the CDC guidelines managed to harm both addicts and patients with legitimate needs in one fell swoop. Consider OxyContin — a major drug of choice for addicts that in 2010 was reformulated to make it far harder to abuse.

Illegal OxyContin use did indeed plummet immediately — but abusers then switched in droves to heroin, which is far more dangerous, and deaths from heroin overdose soared from 3,000 in 2009 to 13,000 in 2015.

Worse still, black-marketeers are now blending fentanyl — a highly potent, synthetic version of heroin — with heroin itself, or substituting it outright for the “natural” drug. That’s responsible for much of the soaring ODs.

The Department of Health in Ohio — which has the highest number of opioid deaths in the nation — reported in 2015 that more than 80 percent of opioid deaths arose from heroin or fentanyl, up from 20 percent in 2010. Health agencies in Florida and Massachusetts report similar trends. It’s now indisputable that most recent opioid deaths result from heroin/fentanyl, not pain pills.

Another side of the equation is the cruel and needless suffering inflicted on blameless Americans who can no longer easily get pain medications. Just as addicts will do almost anything to feed their addiction, people in severe pain will do what is needed to escape it — even suicide.Indeed, escaping pain is becoming increasingly difficult. People who have been treated appropriately and responsibly for years are now finding it difficult to obtain the relief they need, even from the same doctors. And you can’t blame the doctors.

Physicians rightly view the CDC “advice” as anything but voluntary. With the DEA looking over their shoulders, they fear losing their licenses for overprescribing. This creates just another wall between doctors and patients, many of whom are now forced to cope with their pain by using non-opioid, over-the-counter drugs such as Advil and Tylenol. These drugs are less effective and also carry their own risks, chiefly liver, kidney, stomach and heart toxicity.

But perhaps nothing illustrates the folly of government policies better than the rising number of pain sufferers who turn to street heroin because they can no longer get legal medication. What a travesty.

As a nation, we now find ourselves in a worse place than before this simple-minded crackdown began. While the most vulnerable suffer, rivers of the real killer drugs pour into our country illegally unabated.

“First, do no harm” is the essence of the Hippocratic Oath. Federal policymakers should honor that principle — and abandon their cruel and unconscionable war on pain medication.

Josh Bloom is director of Chemical and Pharmaceutical Sciences at the American Council on Science and Health.

19 comments:

Anonymous said...

99.99% of the addicts started out using pot, get rid of that, you will get rid of most of the problem. period.

Anonymous said...

Its the same with Guns Control. When the government gets involved, it always over involves. Why does it take 20,000 laws to enforce the Ten Commandments?

Louise said...

I know an elderly gentleman who worked hard all his life and never used illegal drugs. Because of his hard work he had to have multiple shoulder surgeries which has left him in great pain. He must gradually increase his dose of hydrocodone to have the same pain-relieving effects. These new laws will potentially make him suffer as his doctor relies on the new guidelines.

Good article!

Kathy said...

Wondering if we're about to see more new vaguely-
tested pain-relievers which will fit the new guidelines, which will be very expensive and a bonus for the drug companies. Later they will be taken off the market after they have caused deaths and disabilities?????

Bottoms up? NOT! said...

Wow 7:40. That's quite a statistic. Did you make that up on your way to the pub? Or coming back from the state owned liquor store? A real statistic; for every dollar of tax revenue the state earns in alcohol sales tax, they spend EIGHT dollars dealing with alcohol related problems! DUI, imprisonment, child abuse, courts, alcoholic treatment. 98.4765 of alcoholics say that beer is a gateway drug. There first exposure to alcohol was by drinking beer. Get rid of beer, problem solved. Period. 80,000 people die in the US each year of alcohol related problems and most started out with that first beer. They were then addicted and would do anything to get more alcohol. Beat their family, rob stores, drive while drunk, etc. How many people have ODd on marijuana since 1850?........

ZERO. It's impossible.
So 7:40, crawl back under your rock and rewrite your Christmas list and ask Santa for some logical thinking skills! Maybe have someone show you how to use the internet so you can educate yourself and maybe someday you can graduate to fry cook. Look what alcohol related problems costs society versus pot and get back to us, OK?
BTW, the 98.4765 number was plucked out of the air as the 99.99 number was.

Anonymous said...

Saturday, December 24, 2016 at 7:40:00 AM EST <<<< Bet you can`t back your senseless post with any facts...

Anonymous said...

While this writer makes some solid points, he fails to acknowledge that MANY doctors DO over-prescribe opiods when Motrin, Tylenol and other alternatives will work without the risk. That is conveniently ignored in his essay. It's hanus to intentionally ignore such an important fact in what looks to be a thoughtful essay.

Anonymous said...

Anybody got a beer?

Anonymous said...

Beer time now.....
Woooooooooo. ...
Hoooooooooo.....

Anonymous said...

I'll "hiccup " drink to that!

Kluso said...

Gee, I wonder if it starts with tobacco? Maybe booze? Pot? Coke? Is it all about sex, does anyone really know?









Anonymous said...

People since the beginning of time have wanted to get high and its not going to change anytime soon!

Jonny B Goode said...

In my opinion, anyone who uses drugs, booze, or tobacco and can't control themselves in moderation has no common sense in the first place. Th government should lift ALL restrictions on all of them...tax the bejesus out of them and let the chips fall where they may. Anyone that dies from any of these things obviously weren't smart enough to preserve their own lives and needed thinned out of the gene pool anyway.

Anonymous said...

Pot kills...

Anonymous said...

Pot and alcohol are both addictionso why fight such a simple fact, crazy!

Anonymous said...

Alcohol kills !!!
Nicotine Kills!!
Drugs Kills !!!!
Pot kills, yrs of abuse of anything thats not good to your body will eventually destroy the kidneys, liver, bladder, the heart, etc

Anonymous said...

POTS KILL...SO DO PANS. When you come home intoxicated and your wife smacks you upside your head with them!

Kathy said...

This was such a well-written, thoughtful article. Why do people respond with such foolishness?

Anonymous said...

Because most of the people responding are slack jawed rednecks that sit on their brains.