Opioids

Opioid Addiction Report Uses Panic to Sell More Federal Spending

At least it's not calling for harsher laws-yet.

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Gov. Chris Christie
Ron Sachs/dpa/picture-alliance/Newscom

Let's start with the best news from President Donald Trump's Commission on Combating Drug Addiction and the Opioid Crisis: Their interim report does not call for new harsh laws or punitive measures against American citizens who abuse drugs. It doesn't call for more jail cells or new mandatory minimum sentences. It does not pretend that American can arrest its way into ending opioid overdose deaths.

On the flip side, the commission recommends even greater government meddling in the frequency and manner by which doctors prescribe pain medication, bureaucratic behavior likely to result in more pain sufferers being denied treatment and potentially turning to the black market for dangerous alternatives.

That's the unfortunate irony of the report from New Jersey Gov. Chris Christie's commission, made up of four elected politicians and a former White House drug policy official who want to keep marijuana as a Schedule I forbidden drug.

Read the full report here.

The commission's stated goal is to try to reduce the recent dramatic increase in opioid overdose deaths. The report is deeply concerned about black market access to synthetic opioids and notes that it comes directly as a result of the tightening of access to prescription drugs.

Yet the report calls for more government involvement in overseeing the practices of pain medication prescribers and more state-level monitoring of prescription access to "assist prescribing doctors." Though the report doesn't appear to suggest punitive measures toward doctors who prescribe more than the government believes is appropriate, it's very easy to see how these practices will end up there.

Indeed, given that the news coverage of the report is focusing on the commission's desire to get Trump to declare opioid overdoses to be a "national emergency," it's hard to imagine how its recommendations won't be used as a mechanism to overwhelmingly scale back pain medication prescriptions.

The report says America has a drug overdose death toll equal to September 11 every three weeks. They even underline the "every three weeks" for emphasis. Drug overdoses now kill more Americans than gun homicides and car crashes combined, though the report doesn't mention gun and crash deaths trends had been on the decline.

It is true that drug overdose deaths have been trending upward, and have been for a while. But it's an absurd exaggeration for the report to claim "If this scourge has not found you or your family yet, without bold action by everyone, it soon will."

The report addressed Trump directly, telling him he's the "only person who can bring this type of intensity to the emergency and we believe [he has] the will to do so and to do so immediately."

So if they don't want to throw people in prison, what do they actually want after declaring such a crisis? That's easy: More money. More federal spending to the states.

The first recommendation is for the federal government to facilitate more inpatient clinics getting access to Medicaid reimbursement money for treatment. The report authors know that legislation is technically necessary to make changes, but they believe that if Trump declares an emergency, the Department of Health and Human Services can grant waivers to individual states so that reimbursement can happen more easily, and the availability of treatment will hopefully increase.

The report also calls for federal incentives to increase access to medication-assisted treatments like buprenorphine and methadone to help addicts, particularly among veterans and Medicare patients.

And while the report doesn't call for more harsh laws, it does call for more funding for the Department of Homeland Security and the Department of Justice to fight the flow of synthetic drugs across the border into the United States. It may not want to punish Americans for being drug addicts, but the commission remains committed to fighting the war on drugs.

Possibly the most positive component of the report is the recommendation that the feds assist the states in equipping law enforcement officers with naloxone to reverse opioid overdoses. It calls for the feds to help craft model legislation for the states to make the practice spread. And it encourages support for "Good Samaritan" laws that protect people from prosecution when they call 911 to report drug overdoses if they're also in possession of drugs or under the influence.

It's very much a mixed bag. It's great the commission is resisting the push by Trump and Attorney General Jeff Sessions to make the war on drugs even more punitive. But it fails to acknowledge how government meddling in prescription practices helps contribute to the black market for opioids.

Furthermore, at the end it bulletpoints a bunch of topics they may ultimately address in their final report. One of those topics includes a "supply reduction" of pills via law enforcement pushes, meaning yet more cranking up of the war on drugs. Those punitive measures the interim report is avoiding may make its way in eventually.

For an alternative solution, read Jeffrey A. Singer's recommendation that we consider a harm reduction approach for addicts (which, to be fair, is a concept this federal report certainly includes) instead of trying to tell doctors they have to prescribe less to people who are in serious pain.

Update (August 2): While this commission may not be calling for more punishment, it turns out the Justice Department has its own plans. On Wednesday, Attorney General Jeff Sessions announced a task force to try to crack down on doctors who overprescribe opioids. Read more here.

NEXT: This One Chart Will Fill You With Despair for Chicago

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  1. Way to burn a guy on the alt-text, Shackleton. I don’t even know if i LIKE nachos anymore.

    1. Shack’s just trying to be a big shot.

    2. McDonald’s french fries, more addictive than crack. .

  2. Because of these fucking assholes, my trigeminal neuralgia is basically uncontrollable.

    Thanks you fucks.

    1. Chris Christie is driven by a futile desire to bring his brother back, and doesn’t care how many people with legitimate need for opioids have to suffer for it.

    2. First they came for my sudafed…

      At least there are other (less effective) ways to deal with the minor inconvenience of nasal allergies. Can’t imagine being in actual pain and being told “we’d love to help, and we have some really good stuff that will help, but someone somewhere decided they know what’s good for you and you can’t have it (because FYTW).”

      1. I’m going to be 100 percent real here.

        The pain is so bad that I have legitimately considered killing myself. It is usually just barely controllable with strong opiates, which I ration carefully, and anti-cinvulsives.

        I live in constant fear of a crackdown on medication that I already can’t get enough of.

        1. That sucks. If I was in your position I would seriously consider growing opium poppies.

        2. Before reading your posts I had no idea what trigeminal neuralgia was or even that it existed.

          A variety of triggers may set off the pain of trigeminal neuralgia, including:
          Shaving
          Touching your face
          Eating
          Drinking
          Brushing your teeth
          Talking
          Putting on makeup
          Encountering a breeze
          Smiling
          Washing your face

          I will admit that this was the point in my research that I almost cursed loudly and profusely.

          Has your doctor(s) tried most or all of the treatments mentioned on the Mayo Clinic’s website? .

          1. Most of them, yeah. The medications have a tendency to work then stop working suddenly. You reach a point where, psychologically, the failures eat away at your resolve. I am on the list for surgery, which is supposed to be effective, but very often results in numbness.

            I’ll take it at this point, and if that doesnt work. Well. I don’t know.

            1. My aunt had this. It was terrible. She has surgery in Pittsburgh and fixed it…seriously no more pain. Don’t know if this is a possibility for you but I will ask the name of her surgeon for you. When she had to come off the pain meds the worst one was Cymbalta…I’ve come off Cymbalta and it’s a bitch…much worse than opiates…


  3. The report says America has a drug overdose death toll equal to September 11 every three weeks.

    Yeah, so? In the grand scheme of things, not a lot of people actually died on 9/11. Mostly they were just terrified and confused.

    1. Like you said, yeah, so? How did we decide it was “necessary and proper” to protect a bunch of idiots from themselves, or to do a whole shit-ton of stuff the gubmint does? Seems like that could be plank no. 1 of the LP platform.

      Slightly OT, but just finished reading a book called “Six Frigates” about the founding of the Navy and its growing pains in the wars against the Barbary states and the War of 1812. It was a good read, especially if you like the Hornblower/O’Brian genres, but longed for something more ‘Murican. It may or may not have been intentional on the part of the author, but that particular story is a microcosm of how government creeps, bloats, and eventually finds its way into everything. Adams, Jefferson, and Hamilton would absolutely recognize the arguments we’re still having today (assuming they could stop retching at just how out-of-control their experiment got).

    2. Strangers dying in ways that don’t endanger other people because of their own carelessness or stupidity is pretty low on my list of things to worry about, and certainly not something that needs a major governmental intervention. It sucks for the people who care about people who die from ODs, but (heartless libertarian time) it’s not my problem and shouldn’t affect anyone’s ability to get drugs they actually need to live comfortably.

      Comparing it to 911 is just shitty. Those people were murdered. That’s a whole different thing.

      One big problem I have with the “public health” approach to things is that they seem to treat every death and every cause of death as equal in some weird way. As if you can study murders or social problems like drug addiction just like the spread of a communicable disease. Like when they ask if you wear a seatbelt or own guns at the doctor’s office. Those may be risk factors in some sense, but they aren’t medical risk factors and have nothing to do with why I’m at the doctor’s for a checkup.

  4. The report addressed Trump directly, telling him he’s the “only person who can bring this type of intensity to the emergency and we believe [he has] the will to do so and to do so immediately.”

    Greasing his ego? Oh boy.

    he first recommendation is for the federal government to facilitate more inpatient clinics getting access to Medicaid reimbursement money for treatment. The report authors know that legislation is technically necessary to make changes, but they believe that if Trump declares an emergency, the Department of Health and Human Services can grant waivers to individual states so that reimbursement can happen more easily, and the availability of treatment will hopefully increase.

    Sure, legislation is “technically” needed, but we can get around those silly laws.

    And while the report doesn’t call for more harsh laws, it does call for more funding for the Department of Homeland Security and the Department of Justice to fight the flow of synthetic drugs across the border into the United States. It may not want to punish Americans for being drug addicts, but the commission remains committed to fighting the war on drugs

    Naturally.

  5. “If this scourge has not found you or your family yet, without bold action by everyone, it soon will.”

    Why, if it weren’t for vast armies of bureaucrats and drug warriors, we’d all be in fear of that nefarious Oxy pill lurking in the alley, just waiting to pounce on unsuspecting good people! And there’s nothing mere civilian mortals can do to avoid it. NEED MOAR LAWZ AND COPS!

    Or, I dunno, just don’t take too many of them?

    Reminds me of when big SUV’s really started taking over from little cars (15-20 years ago?). Based on the way routine, everyday car accidents were reported, you would’ve been forgiven for thinking that these mindless SUV’s were prowling the streets, just waiting to mow down unsuspecting people (“SUV plows into family” or “SUV collides with pedestrian”).

    1. … these mindless SUV’s were prowling the streets, just waiting to mow down unsuspecting people….

      Your statement reminded me of this cartoon.

      On a serious note, I do agree with your points.

    2. It also shows deep (and probably deliberate) ignorance about addiction. Not everyone is a potential junkie. Some people aren’t prone to addiction and some people just aren’t interested in getting high. I’ve known plenty of people who have taken opioids after an injury or surgery or something and didn’t really like the effects. They felt sick for a bit when they stopped taking it, but had no interest in taking the drugs anymore after the pain was manageable without them.

      1. I’ve been a chronic pain patient for over 30 years now. I always need to have them available, but I don’t take them unless the muscle relaxers haven’t been enough and I’m hurting bad enough that I can’t think straight anyway. After 30 years you would think that there’s absolutely no risk of addiction. But that’s not good enough anymore. There’s not one GP in town that will write a prescription for any longer than three days. The pain clinics want you in every month with all kinds of tests. Guess what – that costs more money than I can afford. I’ve practically given up on air conditioning in the summer and wear layers and layers of clothes in the winter. Dinner’s already down to pasta most nights. Cheap and filling, but not really good for you. Quit cereal in the morning … milk may have to go too. When you’re already down to $3 to $4 a day for food, there’s not much else that can be cut. But hey, they’ve saved me from the non-existent danger of an opioid overdose.

  6. Twice yesterday I heard agitprop artists on NPR use “mega-epidemic” to gin up anxiety amongst the statists.

    1. It’s a super-duper mega-epidemic, and most importantly, it affects white people.

    2. I’m hella scared.

  7. So when drug addiction reaches people above the “undesirables”, it’s suddenly a “mega-epidemic”.

    “Undesirables” being those people who are shuffled throughout the dysfunctional criminal justice system, poor people of all ethnicities, etc. You know, the “less worthy.”

  8. Or take weed off schedule one, and leave it to the states.
    Much cheaper,

    1. Or take weed off schedule one, and leave it to the states.

      FTFY. I’m all for federalism where it counts, but some things just don’t need to be governmented.

      1. But that’s what the federal government can do constitutionally. And would be a good and necessary step in the right direction.

  9. I’m told there is treatment for the opioid addicted. I’m confused, however. If I were to become addicted, say as the result of opioids being prescribed after back surgery, wouldn’t I go to the doctor and tell him and ask for treatment?
    Why would I start buying street heroin with the well known risk of overdose on some shitty cutting agent, with the knowledge, too, that if I survived, I’d be going into treatment some day anyway?

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  11. no only he hurts people with his rhetoric, he is advocating for greater public spending and he is advocating for himself as the chief appointees for that new police anti opioid government branch and on top of that he is NOT recognizing his dangerous and less justified food addiction.

  12. As a pain patient, I thank you. As a past certified pain management practitioner and board certified general surgeon, I have experienced both sides of the problem. Having broken my back and damaged my spinal cord, (cauda equina injury) I now suffer from an unusual peripheral neuropathy, consisting of severe tingling in the left ankle and foot.(ever have a friend pound on your arm when it “fell asleep”)?! But, I was told that it was not a neuropathy, by a neurologist I was forced to consult! It is a damaged nerve from trauma…pathology in the peripheral nerve…NEUROPATHY! I wondered where this foreign born, and trained, physician got his damned degree! I have never been accused of taking more pain medication than I was prescribed!

    1. (cont)

      Yet, the pain doctor cut me down when I moved to the state, and had to consult him, as per the “Family Practice” physician. He wrote Medicare , telling them I needed an expensive invasive procedure, stating that I had exhausted all other available pain control modalities. He lied. He tried nothing new. The medication I had been on, was cut back!. In fact, it was my first visit! I recently obtained a TENS unit, adding to my therapy, with great relief obtained when the nerve pain starts acting up. The science shows that, even, doctors, have it wrong! They are working on the basis of “old wive’s tales” and not science. Right now I am listening to lying media on the “opiod epidemic”. They are Idiots basing their opinions on others’ opinions, and not science! Practice cutting edge medicine in the rural counties in my state and you will be sanctioned!

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