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Opioid Deaths: Another Drug War Failure

Prohibition is the cause of the problem; it's not the solution.

SessionsZach Gibson/EPA/NewscomIllicit drug use is an old phenomenon, and Jeff Sessions has an old solution: take off the gloves. "We have too much of a tolerance for drug use," the attorney general complained to an audience of law enforcement officials Wednesday, promising more aggressive policing. "Our nation needs to say clearly once again that using drugs is bad," he declared. "It will destroy your life."

That claim will fall on a lot of deaf ears among the 100 million Americans who have used marijuana—most of whom found it did not destroy their lives and some of whom found it made their lives better.

He is right, though, that tolerance is rampant. A Gallup Poll last year showed that 60 percent of Americans think pot should be legalized for recreational use—as eight states and the District of Columbia have done. Medical marijuana is allowed in 28 states and D.C. But in his prepared remarks, Sessions insisted cannabis is "only slightly less awful" than heroin.

Oh, please. The nation is in the midst of an epidemic of overdose deaths involving heroin and other opioids. In 2015, 32,000 Americans died of such overdoses. Compare that with the number of people who died from ingesting an excess of marijuana: zero.

Pot, in fact, appears to be saving lives. A 2014 study published in JAMA Internal Medicine found that states allowing medical marijuana had 25 percent fewer deaths from prescription drug overdoses than states forbidding it.

People often use opioids to relieve pain. But "individuals with chronic pain and their medical providers may be opting to treat pain entirely or in part with medical marijuana, in states where this is legal," said Johns Hopkins University professor Colleen Barry, the lead author. Sessions made a point of commenting on this unwelcome scientific data: "Give me a break."

He paid lip service to "treatment and prevention," but don't expect much there. The Affordable Care Act, which the Trump administration and congressional Republicans have vowed to repeal, has been "the largest expansion of drug treatment in U.S. history," according to Stanford University psychiatry professor Keith Humphreys. If they have their way, we can expect the largest contraction of drug treatment in U.S. history.

Promoting treatment goes against the approach long preferred by hard-line politicians. The most effective remedy for opioid addiction is medication-assisted treatment, or MAT, with drugs like methadone and buprenorphine. But if you'd like to stop shooting heroin, you may search in vain for help.

The Drug Policy Alliance reports that "access to MAT is severely limited by extensive federal and state regulations and restrictions. A scant 12 percent of individuals with opioid dependence receive methadone, and only nine percent of substance abuse treatment facilities in the United States offer specialized treatment of opioid dependence with MAT."

Among the people who could most benefit from this sort of treatment are prison inmates. But a DPA survey found no state correctional systems that provide it—even though a report last year from the surgeon general compared it to giving insulin to diabetics. Upon release, opioid-prone offenders are particularly susceptible to dying of an overdose, apparently because addicts' physical tolerance diminishes while they are locked up.

Zealous drug warriors bridle at anything except prohibition and abstinence. Closing down "pill mills," where physicians allegedly overprescribe opioids, is a favorite option. Such lifesaving measures as facilitating access to sterile syringes and naloxone, which is used to reverse overdoses before they kill, are inherently suspect.

The criminalization of opioid use often has fatal consequences, because it leaves addicts to obtain supplies from street dealers rather than pharmacists. The drugs they get may be surreptitiously laced with fentanyl or other synthetic opioids that are cheaper than prescription meds but much more potent—raising the overdose risk.

Crackdowns have other unhealthy side effects. "When the police shut down a local pill mill, they rarely identify the users and help them get treatment, and heroin and fentanyl dealers are quick to move in to exploit the new business opportunity," writes New York University professor Mark A.R. Kleiman in the March/April issue of Foreign Affairs. "In 2014, deaths from overdosing on prescription opioids fell, but deaths from fentanyl overdoses almost doubled."

It's often said that drugs are a crutch for those who can't cope with reality. Give Sessions credit: He needs no artificial substances to disregard truth.

© Copyright 2017 by Creators Syndicate Inc.

Photo Credit: Zach Gibson/EPA/Newscom

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  • buybuydandavis||

    Pot, in fact, appears to be saving lives. A 2014 study published in JAMA Internal Medicine found that states allowing medical marijuana had 25 percent fewer deaths from prescription drug overdoses than states forbidding it.

    An unserious statistic.

    There are all sorts of real statistics one might give, including the deaths before and after legalization, but non-normalized numbers of deaths by state is not one of them.

  • ||

    The most dangerous thing about drugs --especially marijuana -- is getting caught with them.

  • C. S. P. Schofield||

    I wouldn't bee too sure of that, but OTOH with all the lying done on all sides of the drug war, how would one tell?

  • Jonpete69||

    What would happen if we decriminalized all drugs? Portugal did it in 2001. Google it to find out what happened there. Hint, it's not what the experts predicted.

  • Louis Lucky||

    The title of this exercise in TDS mentions opioid addiction. The first and last sentences tell us exactly what the writer is concerned with.

  • Number 2||

    Of course, if Obama had used his fabled pen and phone to reclassify marijuana as a Schedule II drug, we would not be having this argument now, at least with respect to the medical use of marijuana.

    However, Obama's view of medical marijuana was not much different than Sessions', despite Obama's occasional noises to the contrary. Check out Obama's 2011 national drug control strategy, starting at page 21.

    https://obamawhitehouse.archives.gov
    /sites/default/files/ondcp/ndcs2011.pdf

  • SQRLSY One||

    "Choom Gang-Banger" Obama is-was a world-class hypocrite! Bad druggies are the ones that get your and my kids hooked. Your and my kids, though, THEY are GOOD kids who just momentarily fell under the sway of the BAD kids! ... We continue to vote for drug warrior politicians, while shelling out thousands or tens of thousands of dollars for OUR kids (or ourselves), when we are busted... For lawyers! Those who cannot afford lawyers? Off to jail with ye; go and support the lawyers-judges-cops-jailers complex!
    Drugs, BAD for thee and thy kids; OK for me and mine...
    Thus has it been for decades now...
    HOW LONG will this need to go on?

  • Billy Bones||

    What a person chooses to put into their body is their business and their business only. If Jeff Sessions enjoys sticking vodka laced tampons up his shriveled, puckered ass, that is his prerogative. Side note: I would suggest he buy his tampons in California where they will soon be tax free.

  • Social Darwinist||

    I'm all for legalizing all narcotics but I'm not in favor of paying for anyones sterile needles. Also, is 32,000 deaths in one year an epidemic? That's less than 2 people per day per state. Compared to other large population killers, alcohol, tobacco, cars, cancer, heart disease, etc. how is this an epidemic? According to the CDC (https://www.cdc.gov/nchs/data/hus/hus15.pdf#019), opioid overdoses don't even make the top 10. There may be a large spike in opioid related deaths compared to previous years, but does that make it an epidemic?

  • Social Darwinist||

    I enjoy the humor but Regan would have been a more accurate scapegoat. According to the left it was Regan's failure to recognize AIDS as an epidemic which caused millions to die across the country. It was horrible that the news reporting agencies at the time were completely ignoring AIDS and thereby contributing to the ignorance of Americans and no one can expect people engaging in sex or drug use to take any precautions to protect themselves.

  • Last of the Shitlords||

    'According to the left'............Yeah, they have all kinds of things to say about Reagan. Like that oft repeated bullshit line about Reagan increasing the deficit. I would not put any real stock in anything their kind say.

  • C. S. P. Schofield||

    If there was a drug out there that turned addicts into ravening zombies with an infectious bite I would be totally on board with the idea of a war against it.

    There isn't. What there is is a wide selection of sung that slowly ruin the health of a class of sad, wasted people. If there was some evidence that government action could prevent this without destroying our civil rights and hurting innocent people I might be willing to listen.

    There isn't. If, in the process of fighting an 'epidemic' of illicit opioid use, the government causes even one person in chronic pain to be unable to get the relief he needs, then the drug war is barbarity and those who argue for it should be impaled on a short stake.

  • Social Darwinist||

    Absolutely. Unfortunately many of those arguing for the drug war have been conditioned by the government, media, social cultures to think this way, a prohibitionist way of thinking. This applies to left, right, independent, and non-political people. I have hope that someday we will look back at the war on drugs like we do with the alcohol prohibition days.

  • Diane Merriam||

    yes, Yes, YES!!! The big group that everyone ignores ... the people who are actually in chronic pain and need ongoing medication to deal with it but is finding themselves locked out by the fear of opioids ... Well, actually by the fear of doctors for the government if they prescribe the needed opioids. Pharmacies who have to report every prescription filled. Doctors who have to justify every prescription written, each and every time. Dosages that don't do squat to meet the "guidelines," which are bad enough, but which are now are in the process of being turned into hard rules for Medicare and Medicaid patients.

  • Ladyhawk||

    Totally agree. This exact same thing happened in the seventies, and it took a generation to realize the HUGE inhumanity of it for people in pain, many of whom simply commit suicide for lack of relief. All began with Nixon's War on Drugs, And the latest madness is due to the Bush Administration scolding the DEA for failing to reduce the amount of street drugs in the same interminable, unwinnable War. Doctors should be rioting in the streets at this unconscionable interference in the Dr-patient relationship and in the way they do their jobs.

  • Last of the Shitlords||

    As someone who suffers from a laundry list of painful ailments, degenerative disc disease combined with osteoarthritis of the same area being at the top, I am sick and tired of government interference in my ability to acquire the pain medication I deem necessary to manage the more difficult periods caused by these conditions.

    That some people end up abusing opioids is not my fucking problem. I am tired of being treated like it is. Especially since Obamacare cost me my private insurance policy, and I now no long have a primary care physician. Making it even harder to get pain killer scrips.

  • MikeP2||

    "There isn't. If, in the process of fighting an 'epidemic' of illicit opioid use, the government causes even one person in chronic pain to be unable to get the relief he needs, then the drug war is barbarity and those who argue for it should be impaled on a short stake."

    Why is epidemic in scare quotes? Do you deny the reality of the epidemic and countless deaths due to widespread opioid addiction? I'm all for unrestricted drug availability providing that we, as a society, refrain from helping those with a problem and allowing them to destroy their lives at their own expense.
    But there is a massive societal cost at the moment due to the true epidemic of opioid abuse. Either end the cost, or fight the problem. It is proggy nonsense to continue to spend taxpayer dollars on people opting for slow suicide.

  • Ladyhawk||

    Read his stats again, no it is not an epidemic. There re bigger fish to fry.

  • gaoxiaen||

    How many pennies would a legal, disposable, over-the-counter needle cost?

  • gaoxiaen||

    How many pennies would a dose of legal, over-the-counter, unadulterated heroin cost?

  • Unicorn Abattoir||

    Less than the needle.

  • Diane Merriam||

    Couple of bucks, tops.

  • Spartacus||

    I used to have a diabetic cat, so we bought insulin syringes in bulk at Walgreen's. Cost was $14.99 for 100.
    Looks like you can do even better online.

  • pan fried wylie||

    that online price looks the same as what walmart charges.

    insulin syringes are for subcutaneous injection though, not intravenous, so...*shrug*

  • Spartacus||

    That's true, but the ones I linked to are 20 gauge, which is very big for insulin, so I just assumed these were for IV use without really reading through the ad.

    You can't expect me to spend 15 seconds making sure of my facts, for heaven's sake! It's not like I am POTUS or something.

  • JFree||

    As of 2011, opioids are also a big cause of emergency room visits - 366,000 out of 1.25 million total ER visits. Guess who pays for that?

    Now is it a problem that might be worth paying attention to?

  • JFree||

    Whoops - that 1.2million is a subset of total ER visits - visits that involve non-medical use of pharmaceuticals - http://bit.ly/2nXszhQ

    Still that 366,000 is much higher than alcohol (50k), benzodiazepines (100k), marijuana (36k), cocaine (25k)

  • JFree||

    Actually this might be a useful tax to apply directly to prescription opioids (that ISN'T covered by insurance) - the expected cost of ER visits that result from use - and make that part of the small print TV advertising of them (increases the chances that you end up in the ER). Might make people think twice about becoming dependent on them instead of dealing with root causes of pain.

  • Diane Merriam||

    Sometimes the root causes of pain aren't something that anything can be done about. Surgery can only go so far and when it's the nerves themselves that are involved, well, you're just SOL. All you can do is live with it the best you can and too often that means taking some sort of painkiller strong enough to knock it back to a tolerable level.

  • JFree||

    The US is responsible for 80% of the world's prescribed opioids. I find it inconceivable that either:

    a)we are uniquely unable to 'do anything' about pain in our healthcare system (esp given what we spend)
    b)something out there is uniquely attacking our nerves or something (ie prob not a physical thang)
    c)that the usage is a manifestation of our freedom or specialness (so 'ignore it' or 'encourage it' are good options)

  • Diane Merriam||

    I am not saying that everyone who takes opioids needs them. What I am saying is that there are many people who do that are finding it very difficult to get them or get the dosages they need any more. We're being thrown under the bus driven by today's drug warriors.

    They took off the end of my shoulder blade and hollowed out a bit more of it to reduce the pressure on my ulnar nerve after damage from a car accident. Later, when they went in to, what they thought was, just trim a growth off the side of a spinal disc they found that around my extra vertebra the spinal nerves were weaving in and out. Two fusions plus a rod and bolt locking the whole thing in place, still couldn't fix the nerve problem, but at least it's not getting worse as fast as it was previously.

    I don't even take opioids regularly. I don't like what they do to my head. But when I'm hurting so bad I can't think straight anyway, I do. It makes it a little easier to endure when I know that I have an option if it gets too bad ... or at least I used to. There's not one GP in town that will write a prescription for them. The pain clinic wants me to come in every month. I simply can't afford it.

    And yet my needs are nothing compared to what I've read from other pain sufferers around the country on pain/medical forums and how they're getting screwed.

  • MikeP2||

    Look at CDC's stats on injury deaths, particularly by age group. Unintentional poisoning (most of which is opioid overdose currently) is the leading cause in the 30-60 age brackets. Opioid abuse is rampant in middle age whites and the leading cause of accidental death above car fatalities.

  • jmg09||

    Drugs are bad, m'kay?

  • Uncle Jay||

    RE: Opioid Deaths: Another Drug War Failure
    Prohibition is the cause of the problem; it's not the solution.

    This is a victory, not a failure on the war on drugs.
    First, it gives The State more power over us little people, and that is always a good idea.
    Secondly, it takes away more excess capital the taxpayers have.
    Thirdly, it incarcerates more drug addicts which is always a good idea instead of rehabilitation.
    Lastly, it shows the unwashed masses they cannot ingest something with out Dear Leader's approval.
    So, how is this another "failure?"

  • JFree||

    Yeesh this seems really stretched.

    Hell I could just as easily make an argument that opioid overprescription results from overuse of 'internal medicine' specialists as G.P.s - because we don't have actual G.P.'s in this country anymore.

    'Internal medicine' is a body part specialist. When someone comes to them (and esp when the system pays them by transactions), they test and overtest and then prescribe pills when the tests are vague for a patient who describes 'pain' that doesn't result from an obvious cause like surgery/bleeding.

    G.P.'s would be far more inclined to also look for EXTERNAL causes of pain - obesity which causes posture problems and excess strain on knees/joints, sedentariness which weakens muscles and causes body to overcompensate, poor fitting shoes or crappy mattress. They would still prescribe pills short-term - but it would be part of a bigger regimen that actually works long-term without pills.

    But hey - let's ignore that. It's actually all about legalization of pot or opioids or marketing opioids on TV (so patients resist behavior change in favor of quick fix).

  • JFree||

    Just saw an interesting stat. The US is responsible for 80% of the world's prescribed opioids - and 99% of the world's prescribed hydrocodone.

    Since when did Americans become the victim of some invisible sadist out there who is inflicting 'chronic pain' on us and only us? Or maybe its just proof that we are the only remaining FREE country in the world - USAUSAUSA

  • AD-RtR/OS!||

    If people wish to give themselves Darwin Awards, who are we to stop them.

  • MikeP2||

    "Prohibition is the cause of the problem; it's not the solution."

    That is an utter crock of shite, Chapman. Marijuana is entirely separate from the opioid fiasco and there have been no links between prohibition of drugs and the huge uptick in opioid addiction and overdose. The opioid problem is directly related to the evils of crony capitalism, where pill producers are protected by corruption in congress that allow them to churn out supplies of pills with no responsibility to follow-up on where their pills go. There are pharmacies that sell volumes of pills orders of magnitude beyond local need, that anyone with a brain could track and investigate, but yet the problem is ignored because so much money is being made.
    Overdoses are not linked to black market drugs, but directly to the mass produced brand name pills that are so easy to get that there is no supply limitation to inhibit abuse on a massive scale.

    The very government has become a defacto pill pusher, encouraging addiction and abuse.

  • Bongstar420||

    Let the free market decide.

    We should let them sell Morphine candy.

    That will solve the problem

  • LEAPGuyAZ||

    Physicians are reducing opioid doses for chronic pain patients, cutting some by 50%. The problem is patients who have been on opioid pain medications for years have built a tolerance to the medications. Reducing the dose can only lead patients to turn to the street and drug dealers.

    With marijuana enforcement 70% of DEA business, they need to go after patients and physicians to justify their jobs. Looks like the new AG is looking for other ways like going after marijuana is states where people have already voted to legalize it. The 2018 election is going to be very interesting....

  • rageon||

    Back in the 90's, our government, desperate to revive flagging public interest in their precious "war on drugs," created a demand for meth as a street drug by cracking down on pharmaceutical speed. But as the ravages of meth addiction and the very real, if greatly exaggerated, dangers of home meth labs became daily news, did they back off? Did they retreat even a single step? No, the damage they caused only became an excuse to cause more damage. Each life destroyed, an excuse for more destruction. Now they're doing the same thing with prescription opiates. Only this time people are dying. Do they back down? No, of course not. Every dead drug user becomes a weapon in their arsenal to kill more. "Failure"? I think not.

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