The real story behind the overdose epidemic — Pain News Network

By Stefan Franzen, guest columnist

A recent comment in The New York Times by German Lopez (“The Perils of Legalization”) states categorically that prescription opioids have caused the overdose epidemic.

“The problem started with a legal, regulated drug: prescription painkillers,” Lopez writes, while arguing against legalization as a solution to our drug problems.

“A lot of people who are now using heroin or fentanyl started out on painkillers. And the drug cartels started shipping heroin and fentanyl more aggressively into the United States once they got there. have seen a promising customer base among the growing number of painkiller users.

Mr. Lopez is confused. Heroin has been illegal in the United States since Congress passed the Harrison Act in 1914, but that hasn’t stopped millions of Americans from trying heroin, just as prohibition hasn’t stopped people drinking alcohol. The same goes for other illegal drugs, like cocaine, LSD, and marijuana.

Prescription opioids are legal drugs when obtained by prescription from a doctor. To suggest that we tried legalization and it failed is simply not true. Perhaps Mr. Lopez is confusing the liberalization of opioid prescribing that began in 1997 with legalization. In this case, yes, there was a movement in the medical community and by some drug makers to expand the use of opioids for pain.

Mr. Lopez correctly reports that many of the problems that arose during this period resulted from the failure of the Drug Enforcement Administration to fulfill its responsibility to investigate when there was evidence of mass shipments of painkillers. to rural counties by companies such as Purdue Pharma. .

The government’s role in the failure of consumer protection is the real story missed by the mainstream media, which is too busy telling the public about the latest lawsuit against pharmaceutical companies and opioid distributors. The consumers who suffered the most were, and still are, patients with persistent pain.

Of course, it’s also tragic that many people got caught up in prescribing opioids and became addicted, due to a complete failure to investigate when Purdue began shipping millions of OxyContin pills to rural counties in states like West Virginia and Tennessee. The mistake made here was not “legalization”. This allowed greed and corruption to co-opt an effort by the medical community to reach those who suffered the most.

It is a false narrative that the overdose epidemic was born from the expansion of opioid prescribing and that drug cartels only target pain patients.

Recent data from the Centers for Disease Control and Prevention shows why this is a totally false assumption. The CDC estimates that nearly 108,000 people died from overdoses in 2021, a 15% increase from the previous year. Drug-related deaths involving synthetic opioids – mostly illicit fentanyl – rose to 71,000, and there were 33,000 deaths linked to methamphetamine and other stimulants.

Last year, only 13,000 overdoses were linked to prescription opioids – about 12% of all drug-related deaths – but there is no data available to tell us how many of these overdoses involved patients who were the drugs had actually been prescribed. It is safe to assume that most of the deceased took a prescription opioid intended for someone else that was purchased or stolen. Or maybe they took one of the millions of counterfeit pills flooding the country.

Overdose deaths from illicit fentanyl and other illicit drugs have been on the rise for years, yet nearly all media reports continue to exaggerate the role of prescription opioids, leaving the public with the completely mistaken impression that physicians prescribing pain patients caused the overdose epidemic. Commentators like Mr. Lopez, who have few facts to back up their statements, have no idea of ​​the harm these statements cause our most vulnerable citizens.

There was no “legalization” of prescription drugs because they were already legal. And it wasn’t a failed experiment to treat sufferers with more decency – just the greed, corruption and incompetence that marred efforts to bring some quality of life to patients who suffer from the worst kinds of pain. , be it sickle cell disease, ankylosis spondylitis, psoriatic arthritis, Ehlers-Danlos syndrome, muscular dystrophy or adhesive arachnoiditis.

Others suffering terribly are injured veterans, car crash survivors and burn victims. I didn’t mention cancer, which obviously can be extremely painful, only because cancer is the only disease that commentators sometimes agree should be treated with opioid therapy. In the absence of a pain measurer to provide data, I will simply point out that any disease that causes substantial physiological changes, inflammation, or tissue degeneration can be extremely painful. We should all respect that fact. We are all sensitive to pain.

We need to meet the anti-opioid zealots every time they write or speak and call them out for their inaccurate and misinformed comments. Unfortunately, forums like National Public Radio and The New York Times did not respond to my attempts to draw attention to the facts that they got it wrong. As a scientist, I believe in evidence.

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