Vail Daily column: Leave pot out of opioid debate
More than 300 million prescriptions for opioids were written in 2014 — almost one for every woman, man and child in America. CNBC estimates that Americans consume 80 percent of the world’s opioid supply, and according to PBS 12 states had more prescriptions than people in 2012.
The Washington Post dates the onset of this crisis to the mid 1990s when doctors began prescribing opioids at ever-increasing rates thanks in part to marketing efforts by companies such as Purdue Pharma that downplayed the drugs’ addictiveness. Previously, opioids were rarely prescribed for long-term pain management due to concerns about addiction.
According to Dr. Robert Glatter, an emergency physician in New York City, “people addicted to painkillers — such as oxycodone and morphine — have increasingly turned to street drugs like heroin …” This is the miserable and potentially lethal vortex millions of Americans find themselves in once they develop an addiction after receiving an opioid prescription. When they can no longer get prescriptions they turn to street drugs. Mexican drug cartels obliged by increasing their heroin production six-fold between 2005 and 2009.
The upsurge in opioid prescriptions has abated while deaths from prescription opioid overdoses have increased. According to The National Library of Medicine more than 60 percent of drug overdose deaths in America are caused by prescription or illicit opioids. Since 2011 in Colorado, opioid overdose deaths have surpassed those from homicides, according to The Denver Post.
Ironically, the drugs to address pain today are eerily similar to those unreservedly peddled more than 100 years ago. Before the advent of modern, scientifically based medicine, superstition, gullibility, and desperation drove people’s pain and disease management efforts. The spread of literacy and the growth of the penny press coincided during the mid-19th century. Patent medicines, nostrums, and snake oil of dubious quality and efficacy were heavily advertised in these publications. In many concoctions the primary ingredient was alcohol, in others the ingredients were secret. Indeed, the secret recipe was often a critical aspect of a product’s allure. Teething medicine that contained opium, impotence cures that contained radium, and congestion remedies that contained cocaine were all legally sold in America.
Exposes revealed the dangers of these unregulated medicines at about the same time Upton Sinclair’s revelations about the meatpacking industry resulted in public outcry and federal legislation. In 1906 the Pure Food and Drug Act was passed in an attempt to improve the quality and safety of food and drugs. However, it would not be until 1938 that the law required drug manufacturers to verify the safety of their product. One of the chief proponents of this legislation was the emerging pharmaceutical industry. To be fair, they were likely motivated by the desire to provide safe, effective medicines, but eliminating some of the competition was a beneficial consequence.
A century later it is the pharmaceutical companies that are complicit in an epidemic that is destroying lives. Opioid prescriptions represent a $24 billion market. According to the National Institute on Drug Abuse, more than 2 million Americans suffer “from substance use disorders related to prescription opioid pain relievers …” This raises the question as to which addiction is more difficult to kick, opioids or drug profits.
Which brings me to marijuana, which the DEA continues to classify as a schedule 1 drug — in the same category as heroin and LSD. Now that more states have made marijuana sales legal, how many overdose deaths have been observed? Zero.
However, when asked about enforcement of federal drug laws that conflict with lenient state marijuana laws, White House Press Secretary Sean Spicer commingled marijuana use with the opioid epidemic. According to Spicer, “When you see something like the opioid addiction crisis blossoming in so many states around this country, the last thing we should be doing is encouraging people.”
The science does not support the contention that marijuana is a gateway drug, nor is it in any way as addictive as opioids. In fact, according to The Washington Post, “decriminalized marijuana is associated with lower rates of opioid abuse and fewer opioid-related fatalities.”
Addressing the opioid epidemic requires contending with the nexus of pharmaceuticals, doctors and patients; leave marijuana out of it. Going forward, treatment programs will be important, but more important is to prevent opioid addiction in the first place. Whether it is the 19th or the 21st century, an ounce of prevention is still worth a pound of cure.
Claire Noble can be found online at http://www.clairenoble.org and Claire Noble Writer on Facebook.
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