Heroin and other opioids are ravaging communities across America. Deaths from heroin increased 328% between 2010 and 2015, and drug deaths from fentanyl and other synthetic opioids are now seeing a sharp rise as well. More Americans die from drug overdoses than in car crashes, and this increasing trend is driven by Rx painkillers.
A new study released earlier this week confirms that deaths in opioid-related hospital stays in the U.S. have quadrupled between 1993 and 2014, PBS NewsHour reports.
Zirui Song, an assistant professor of health care policy at Harvard Medical School and a physician at Massachusetts General Hospital, launched the study in 2016 in an effort to gain a better understanding of the patients he treated.
Dr. Song analyzed nearly 385,000 hospital stays involving patients who were admitted for opioid use with data from the National Inpatient Sample of the Healthcare Cost and Utilization Project, a national database compiled by the Agency for Healthcare Research Quality.
His research confirmed that by 2014, four times as many patients died from opioid-related causes while staying in the hospital, rising from 0.43 percent before 2000 to 2.02 percent.
Over the same time period, the study also found that patients admitted to the hospital for opioid use skewed younger — the average age was 39 years old — and were more likely to be Caucasian. The number of black and Hispanic patients admitted to hospitals for opioid or heroin use remained relatively stable.
Dr. Song said his study is intended to raise awareness for the need for better strategies for hospitals when patients are admitted for using opioids, in addition to continuing and improving public health.
Doctors need to STOP prescribing Opiates and, those who do, need to properly detox their patients so they don’t have to go to Heroin! Talk to your doctor about this today.
When it comes to acknowledging the opioid epidemic, the U.S. has been faced with some harsh realities over the past several months. Perhaps most notable is a recent report from the Centers for Disease Control and Prevention that indicates the leading cause of death for Americans under 50 is now accidental death by drug overdose. The 2016 count of lives lost exceeds 64,000, a 19 percent increase from the previous year’s 52,000. These figures are heartbreaking.
Perhaps a more important statistic is that overdose deaths among adolescents (those ages 12 to 17) are up as well, with a strikingly similar 19 percent increase in the past year. This information is significant, and not just because it’s alarming. It also begs a different approach in how to address the problem.
Several governmental actions have been taken to curb the effects of this devastating crisis. Many states have adopted Good Samaritan laws, which encourage bystanders to call law enforcement for help if there’s concern for a potential overdose, without fear of prosecution for being involved in illicit activities themselves. There are also federal regulations with heavy sanctions on misguided prescribers who may be buffering their revenues by pumping out scripts for prescription opioids. Plus, there’s the overdose-reversing drug Narcan and subsequent funding for free community trainings, with ease of access through your physician or local pharmacy.
But where is the haste toward prevention?
In my 13 years working in the mental health and addictions counseling field, I can list over a dozen adolescent treatment programs (that I was personally acquainted with) that have closed simply due to lack of census. Services were being offered, but few were using them. Some of these programs, responding to an increase of young adults (18- to 26- year-olds) in need of treatment, converted their juvenile programs to fit the business’s needs.
Alongside the trend for more young adults seeking treatment, service providers continued to see further declines in adolescents accessing services. In essence, what we’re seeing is a decrease of identification in teens, and an increase as they transition into adulthood. There’s something horribly wrong with this picture. As a culture, we’re being reactive to a crisis as opposed to placing efforts to be proactive. This, unfortunately, is a making of the tragedy we see on the news each and every day.
Yes, prevention does exist; however, it’s fragmented at best. Most common prevention efforts take place in the school setting. One of the most frequently used school-based prevention programs has been empirically suggested to be ineffective, and yet the program gets renewed year after year in some states. Some states’ education departments require that school boards employ a specialist to handle substance use and other crises in their students; however, these professionals often occupy several roles within the district, and their time is often stretched too thin. Programming targeting parents to provide information on current trends and concerns regarding substance use are lightly attended. I’ve facilitated many of these workshops myself; in a student population of 1,200, if you can get 20 parents to attend, you’re in luck.
One thing is blatantly clear: When we’re not appropriately addressing substance use and addiction in adolescence, we are inundated with young adults literally fighting for their lives shortly thereafter.
I’m not saying that the approach we’re taking to the opioid crisis is wrong. Rather, it’s incomplete. We need to start the conversation about drug use and addiction at an early age. And no, “just say no” isn’t an acceptable means of prevention. “Just say no” is something that we feel more comfortable doing. We can just check it off the list, say that we “had the conversation,” and be done with it. In order to create change, we have to be OK with getting uncomfortable. This is how we’re going to save these kids lives.
Talk to your families about substance use. If you have a family history of addiction, there’s all the more reason to do this – your children may have a predisposition. Go to prevention programs offered in your community. Most, if not all, are free. Bring your kids with you. Talk about the program on the drive home. Have family dinners once in a while. Bring up any pop-culture or media references to overdose deaths, and listen to their reactions. Reach out and call the school your child attends to find out how they address prevention. Acquaint yourself with the personnel who coordinate it. Introduce your child, too. Research other agencies in your community, and participate or volunteer in their events from time to time.
There are limitless ways that we can make small impacts in our families and our communities. Stigma usually hold us back. Stigma also adds to this crisis. However, if we’re more active in our prevention efforts, not only will we see a reduction in adolescent overdoses, but over time we will not have an opioid epidemic on our hands.
You just may not know you’re addicted when your drug dealer is your doctor.
When you’re sick or have suffered from a serious injury, the first few days after a visit to the doctor you rely heavily on the prescribed drug to ease the pain and get you through the day. However, you may reach a point where you feel compelled to continue taking the prescription long after you need it. If you think you or a loved one might have a problem with prescription drugs, there are some red flags you should watch out for.
The Cheat Sheet spoke with some of the country’s top addiction experts to learn more about prescription drug abuse.
There is sudden behavior change
One of the first signs of a prescription drug addiction is an abrupt change in behavior. If you suspect the abuse of prescription medication, take note of unusual behavior you hadn’t observed before.
Psychologist Matthew Polacheck, director of outpatient services at the Betty Ford Center in West Los Angeles, said behavioral changes may also be accompanied by cognitive and physical changes. “The first thing we look for is a change in behavior of any kind. [Someone] who never naps comes home and goes to sleep. [Someone] who is passive suddenly becomes more euphoric. More specific behavior includes nodding off, drowsiness, slurred speech, confused thinking, and pupils can also be constricted.”
The drug becomes part of a daily routine
If you or someone you know can’t seem to go a day without a prescription drug that was meant for short-term use, this is another red flag. Over time, short-term medication should be slowly tapered down until there is no longer a need for it.
Audrey Hope, an addictions specialist at Seasons in Malibu World Class Addiction Treatment, said if there is difficulty in stopping a drug, this should be a cause for concern. “The main sign that you are a prescription drug addict is that you use the drugs every day. You can’t function without them. You rely on them. You need them. You lie to yourself that it is for the ‘pain’ and because ‘the doctor prescribed it.’ You say it is OK to use them,” said Hope.
More of the drug is used than prescribed
For Article Source with edits: Click Here.
President Trump’s Commission on Combating Drug Addiction and the Opioid Crisis released its final report on Wednesday, calling for expanding drug courts into all 94 federal court jurisdictions. The commission also recommended easier access to alternatives to opioids to treat pain, The Washington Post reports.
Drug courts are specialized court programs that target criminal defendants and offenders, juvenile offenders, and parents with pending child welfare cases who have alcohol and other drug dependency problems.
The commission made more than 50 recommendations, including requiring doctors and others who prescribe opioids to demonstrate they have received training in safely providing the drugs before they can renew their licenses to handle controlled substances with the Drug Enforcement Administration.
Providers should be required to check prescription drug monitoring databases to ensure patients aren’t “doctor shopping” for prescription drugs, the commission said. In some states, use of the databases is voluntary, the article notes.
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I almost never thought I’d see the day when a Big Pharma founder and owner was finally arrested for running a criminal drug cartel, but that day has arrived.
“Federal authorities arrested the billionaire founder and owner of Insys Therapeutics Thursday on charges of bribing doctors and pain clinics into prescribing the company’s fentanyl product to their patients,” reports the Daily Caller News Foundation, one of the best sources of real journalism in America today.
Addictive drugs that include opioids, we now know, are claiming over 64,000 lives a year in the United States alone.
From the DCNF:
The Department of Justice (DOJ) charged John Kapoor, 74, and seven other current and former executives at the pharmaceutical company with racketeering for a leading a national conspiracy through bribery and fraud to coerce the illegal distribution of the company’s fentanyl spray, which is intended for use as a pain killer by cancer patients. The company’s stock prices fell more than 20 percent following the arrests, according to the New York Post.
Kapoor stepped down as the company’s CEO in January amid ongoing federal probes into their Subsys product, a pain-relieving spray that contains fentanyl, a highly-addictive synthetic opioid. Fentanyl is more than 50 times stronger than morphine, and ingesting just two milligrams is enough to cause an adult to fatally overdose.
The series of arrests came just hours after President Donald Trump officially declared the country’s opioid epidemic a national emergency. Drug overdoses led to 64,070 deaths in 2016, which is more than the amount of American lives lost in the entire Vietnam War.
As the opioid crisis has developed, more and more states have begun holding doctors and opioid manufacturers accountable for over-prescribing and over-producing the highly-addictive painkillers.
“We will be bringing some major lawsuits against people and companies that are hurting our people,” Trump said Thursday. He also spoke about a program similar to Nancy Reagan’s “Just Say No” initiative.
“More than 20,000 Americans died of synthetic opioid overdoses last year, and millions are addicted to opioids. And yet some medical professionals would rather take advantage of the addicts than try to help them,” Attorney General Jeff Sessions said in a statement. “This Justice Department will not tolerate this. We will hold accountable anyone – from street dealers to corporate executives — who illegally contributes to this nationwide epidemic. And under the leadership of President Trump, we are fully committed to defeating this threat to the American people.
President Trump is bringing the war to Big Pharma’s doorstep
Under President Trump, who continues to fight to end the drug cartels and health care monopolies that are destroying this nation, we may see more and more drug companies finally facing the legal scrutiny they deserve for engaging in the mass medical murder of Americans with dangerous, deadly drugs.
And then there’s the question of vaccines, the autism cover-up and the criminal racket run by the CDC, Big Pharma and the lying mainstream media. When that medical fraud and corruption scandal blows sky-high, we may see dozens of pharmaceutical officials going to prison.
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Calling it a “national shame” and “human tragedy,” President Trump on Thursday declared the opioid epidemic crippling American communities a “public health emergency” and pledged federal resources to help combat the growing problem.
“Addressing it will require all of our effort, and it will require us to confront the crisis in all of its real complexity,” Trump said during a speech in the East Room of the White House.
“As Americans, we cannot allow this to continue,” Trump said. “It is time to liberate our communities from the scourge. … We can be the generation that ends the opioid epidemic.”
Trump spoke to an audience at the White House that included family members of those affected by the opioid crisis, as well as several administration officials and elected leaders.
The president, who said “not one part of American society has been spared” from the crisis, stopped short of calling it a national emergency, something he previously promised he’d do. The announcement follows months of debate on how to tackle the problem.
‘We can be the generation that ends the opioid epidemic.’
Trump himself has gone on record more than once saying he would declare the crisis a national emergency. Such a designation would allow states to tap into the same federal funds typically reserved for natural disasters like hurricanes through the Stafford Disaster Relief and Emergency Assistance Act.
Instead, Trump signed a presidential memo that directs acting Health and Human Services Secretary Eric Hargan to declare a public health emergency under the Public Health Services Act — which directs federal agencies to provide more grant money to combat the epidemic.
White House officials say the step helps cut through regulatory red tape and gives states more flexibility in how they use federal funds to fight the problem.
The designation will also allow changes such as expanded access to medical services in rural areas.
It doesn’t, however, create any additional funding.
The emergency declaration will last 90 days but can be renewed.
In 2015, 33,091 people died from opioid overdose, while 12.5 million people misused prescription opioids, according to the most recent statistics available from the Department of Health and Human Services.
The president on Thursday also revealed plans to take an “evil” opioid off the market immediately as well as the government’s intention to bring lawsuits against some of the drug makers, though he did not provide specifics. He also vowed to crack down on heroin imports from Mexico and fentanyl imports from China.
Pharmaceutical fentanyl is an opiate drug that’s up to 100 times more potent than morphine. In the past, drug dealers used it to spike the potency of the heroin they sold but traffickers are now selling fentanyl by itself.
Drug deaths involving fentanyl increased nearly 600 percent from 2014 to 2016, The Washington Post reported. There were 582 fatal overdoses linked to the synthetic drug in 2014. Last year, the number jumped to 3,946.
Trump also discussed the alcohol addiction that claimed his older brother Fred’s life in 1981.
“[Fred] had a problem with alcohol, and he would tell me, ‘Don’t drink, don’t drink,’” Trump said.
The president said watching his brother as well as other friends struggle with addiction is what set him on a no-drug, no-alcohol, no-cigarette path.
“There is nothing desirable about drugs,” Trump said. “They’re bad.”
Trump vowed to tackle the opioid crisis on the campaign trail, but critics claim his administration has been slow to act.
Trump created a presidential commission that in August recommended he declare the crisis a national emergency.
“Your declaration would empower your Cabinet to take bold steps and would force Congress to focus on funding and empowering the executive branch even further to deal with this loss of life,” the Commission on Combating Drug Addiction and the Opioid Crisis wrote. “It would also awaken every American to this simple fact: If this scourge has not found you or your family yet, without bold action by everyone, it soon will.”
However, White House officials told reporters Thursday morning that a national emergency declaration was not necessary in the case of opioids.
The public health emergency will “reorient all of the federal government and executive branch resources toward focusing on providing relief to this urgent need.”
Past instances of public health emergencies include the H1N1 influenza outbreak in 2009.
Since the commission released its report, Health and Human Services Secretary Tom Price has stepped down from his post while Trump’s pick for drug czar, Rep. Tom Marino, withdrew his nomination.
At an event at the Heritage Foundation earlier Thursday, Attorney General Jeff Sessions said it’s important to “reestablish the view that people should say no to drugs.”
“I do think this whole country needs to not be so lackadaisical about drugs,” he said. “Much of the addiction starts with marijuana. It is not a harmless drug.”
My comment on the above is that the addiction liability begins with Big Pharma and the doctors who prescribe them for anything else but to relieve extreme pain during the last days of life. At that time, they were being misused by doctors as well. I am a nurse who worked during those times. A doctor would verabally say to a nurse, “sleep him through”. That meant to overdose him with so much morphine so as to end life. No – I never honored those doctors’ orders because my job is to heal, not kill; however, most nurses did it. I believe God is the One to decide when one dies. So, throughout time, it’s the doctors who should be made to be accountable for their sins by holding them as murderers and drug dealers. Do you have an opinion on that?
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Over a 40-year career, Philadelphia attorney Daniel Berger has obtained millions in settlements for investors and consumers hurt by a rogues’ gallery of corporate wrongdoers from Exxon to R.J. Reynolds Tobacco. But when it comes to what America’s prescription drug makers have done to drive one of the ghastliest addiction crises in the country’s history, he confesses amazement.
“I used to think that there was nothing more reprehensible than what the tobacco industry did in suppressing what it knew about the adverse effects of an addictive and dangerous product,” says Berger. “But I was wrong. The drug makers are worse than Big Tobacco.”
The U.S. prescription drug industry has opened a new frontier in public havoc, manipulating markets and deceptively marketing opioid drugs that are known to addict and even kill. It’s a national emergency that claims 90 lives per day. Berger lays much of the blame at the feet of companies that have played every dirty trick imaginable to convince doctors to overprescribe medication that can transform both teens and adults into zombified junkies.
So how have they gotten away with it?
A Market for Lies
The prescription drug industry is a strange beast, born of perverse thinking about markets and economics, explains Berger. In a normal market, you shop around to find the best price and quality on something you want or need—a toaster, a new car. Businesses then compete to supply what you’re looking for. You’ve got choices: If the price is too high, you refuse to buy, or you wait until the market offers something better. It’s the supposed beauty of supply and demand.
But the prescription drug “market” operates nothing like that. Drug makers game the patent and regulatory systems to create monopolies over every single one of their products. Berger explains that when drug makers get patent approval for brand-name drugs, the patents create market exclusivity for those drugs, which protects them from competition from other brand drugs that treat the same condition as well as from generics. The manufacturers can now exploit their monopoly positions created by the patents by marketing their drugs for conditions for which they never got regulatory approval —and this dramatically increases sales. They can also charge very high prices because when you’re in pain or dying, you’ll pay virtually anything.
Using all these tricks, opioid manufacturers have been able to exploit the public and have created a whole new generation of desperate addicts. They monopolize their products and then, as Berger puts it, “market the hell out of them for unapproved and dangerous uses.”
Opioids are a drug class that includes opium derivatives like heroin (introduced by German drug maker Bayer in 1898), synthetics like fentanyl, and prescription painkillers like oxycodone (brand name: OxyContin). A number of factors are aggravating the addiction crisis: There has been a movement in medicine to treat pain more aggressively, while at the same time wide-ranging economic distress has generated a desire to escape a dismal reality. But a key driving force is doctors who have been wooed by Pharma marketing reps overprescribing for chronic pain.
“For the first time since the years after heroin was invented,” writes investigative journalist Sam Quinones in Dreamland: The True Tale of America’s Opiate Epidemic, “the root of the scourge was not some street gang or drug mafia but doctors and drug companies.”
Doctors were once reluctant to write prescriptions for opioids. The U.S. drug regulator, the Food and Drug Administration, would only approve such drugs for severe cases like cancer patients in chronic agony or certain people in short-term pain after, say, an operation. But representatives of Connecticut-based drug maker Purdue, which released OxyContin in 1996, along with other companies, began to flood doctors’ offices with reports asserting that using the drug for off-label purposes was harmless. Often the targets were primary care physicians with little training in addiction. Have a chronic arthritis case? Give your patient OxyContin. Tell folks to take it every day, for weeks, even years, to treat just about any kind of chronic pain. The upshot was dependence, typically not because people were getting high for fun, but because they were using a legal drug in precisely the way the doctor ordered.
Purdue and others whisked doctors to stylish retreats to push them to prescribe drugs for uses not approved by U.S. regulators—a marketing strategy banned by federal law. They even created fake grassroots organizations to make it seem as though patients were demanding more prescriptions. Pharmaceutical companies like to dodge responsibility for the opioid crisis by blaming dishonest distributors and pointing out that they’re not the ones prescribing or handing out drugs to patients. True enough: They don’t need to, because they’ve done their work hooking you long before the drug is in your hands.
“The marketing is not only fraudulent; it’s incredibly elaborate,” says Berger. “Fake scientific studies promote the lie that opioids are better than other medications for pain. They’ve gone to just about any length. Bribery, you name it. It’s outrageous.”
OxyContin is so addictive it can create physical dependency in a matter of weeks. As drug makers and doctors who began to dole out pills by the handful in pain clinics learned, addicts do not behave like ordinary consumers: They don’t “choose” to buy or to wait until next week. They need their drug right away and will do anything to get it because if they don’t they will suffer excruciating symptoms.
A Los Angeles Times report shows that among the lies Purdue spread about OxyContin was that one pill subdued pain for 12 hours. Except that for many patients it wears off much sooner, exposing them to unbearable pain and withdrawal. Purdue knew this, but feared lower sales if it admitted the truth. So sales reps advised doctors to just give stronger doses, which increased the addiction risk. As the money from hooked patients piled up, so did the bodies.
In 2007, Purdue pleaded guilty in federal court in Virginia to misleading doctors and patients about OxyContin’s safety and paid a $600 million fine. But that sum was hardly an annoyance. From 1995 to 2015, Purdue made $35 billion from OxyContin sales alone. The Sacklers, who own the company, is now one of the richest families in America, as revealed by this triumphant Forbes spread. They know that lax regulation keeps the heat off, and that even litigation and criminal prosecutions can do little to stop them. Berger says that until such legal programs are massive in scale and scope, companies will go on with business as usual.
“We have to have injunctive relief [a court order to stop a behavior] that bans the marketing to doctors of opioids completely for unapproved uses, as well as an expansion of the FDA and DEA to specifically target the drugs,” says Berger. His law firm, Berger & Montague, is involved in the effort to seek relief for the city of Philadelphia, which has seen above-average opioid prescribing and suffered the highest rates of fatal drug overdoses in the state last year.
Even though prescriptions have been slightly reduced across the country since 2012, Philadelphia is finding out what happens to many people hooked on opioids when they can’t get a prescription or find the price too high: They turn to heroin. Fatal overdoses of heroin, oxycodone’s close cousin, have been skyrocketing since 2007 across the country.
‘Landscapes of Despair’
The opium poppy has been part of human history since at least 3,400 BCE, when it was cultivated in Mesopotamia as the “joy plant.” Derivatives such as laudanum and morphine offered more convenient, and people wrongly believed, safer ways to get the plant’s benefits. Bayer originally touted heroin as a non-addictive substitute for morphine (even for children) until it was outlawed in the U.S. in 1925. Rendering it illegal did not stop it from destroying the lives of many of America’s most celebrated artists, from Billie Holiday to Philip Seymour Hoffman. Drug overdoses now kill more people than gun homicides and car crashes combined. In 2015, nearly two-thirds of all overdoses had one thing in common: opioids.
Syracuse University’s Shannon Monnat, a sociologist focused on rural issues and an INET grantee, has been studying the epidemic and how it impacts various populations. Her research reveals that the rise in drug-induced deaths has been especially sharp among middle-aged people (45-55), with prescription opioid overdoses increasingly impacting both middle-aged and older populations. Heroin, whose sedating and euphoric effects are very similar to prescription narcotics, looks to be the culprit in more young adult overdoses.
Monnat considers how the opioid crisis points to bigger societal problems impacting the economy, educational institutions, the health care system, political systems, and communities. Her work centers on investigating the characteristics of what she calls “landscapes of despair”—places where people are hurting economically and socially, like Appalachia, the industrial Midwest and parts of New England. She points out that persistent disadvantage and long-term poverty are clearly connected to the opioid crisis, noting that many of the areas most impacted were once robust centers of manufacturing before jobs moved to other countries.
Opioid addiction seems to thrive in downwardly mobile small cities in rural areas—but not all of them. “What’s fascinating is that some of these areas have very high mortality rates from drug overdose, like Appalachia,” say Monnat. “But others, like the Southern ‘Black Belt’ [a region that stretches across Alabama and Mississippi], have not seen such rises.”
Originally named for its rich, dark, soil, which attracted cotton planters in the 19th century, the Black Belt has a high population of African Americans. The area has a history of unremitting poverty, low incomes, high unemployment, and high mortality. Yet despite many hardships, which are linked to the legacy of slavery, Monnat says that the region is also distinct for its “very tight-knit communities, strong kinship networks, and other networks where people can find emotional support.” It seems that when people have somewhere to turn in hard times, they may build up immunity to an epidemic like the opioid scourge.
Ironically, another factor that may have protected these communities, discussed by Quinones in Dreamland, is prejudice: The low-profile heroin dealers originating from Mexico’s west coast who are associated with the current opioid scourge prefer to target white communities. They also avoid big cities where large cartels are already established. So small, predominately white towns are their sweet spot.
Appalachia is known for kinship networks, but it also has a legacy of isolation and an outlaw tradition associated with the history of moonshining and bootlegging which can feed into today’s underground selling and distribution of opioid drugs. In this region, much of the struggling white working-class has seen economic distress with little hope of relief from America’s political system. Democrats often openly disdain the people they call rednecks and hillbillies, while concentrating on identity politics rather than economic distress. Republicans promote policies of free trade and deregulation that cast the region further into destitution.
Monnat has found that counties with large numbers of people employed in physical labor—especially physical occupations with higher disability rates—have higher drug fatalities. These are places where coal miners work in backbreaking positions and military veterans suffer the pain of injuries. Drug companies have besieged these areas with aggressive marketing of pain pills. “In Appalachia, you’d see mining companies with physicians on staff prescribing opioids to keep people in pain working,” she says. “That was happening before OxyContin, but companies like Purdue targeted these communities to push OxyContin as a safer alternative to other pain medications.”
The National Institutes of Health report that the opioid epidemic, which started as a regional crisis, is now a national crisis, decimating communities and even helping to reshape the American political landscape. Monnat finds a relationship between the landscapes of despair and the 2016 presidential election. Voting patterns show that areas in which President Trump did better than expected, like Pennsylvania and Ohio, were also places where opioid overdoses and deaths from alcohol and suicide occurred at high rates over the past decade.
During his campaign, Trump expressed concern for people in regions like Appalachia and flung stinging barbs at the politicians who had failed them. These voters supported him in high numbers, yet his policies will likely give more power to the pharmaceutical companies that have turned their suffering into stock windfalls.
Profit Trumps People
Trump the campaigner shook his fist at Big Pharma for “getting away with murder”—one of those statements that occasionally drops from his lips with atomic accuracy. But Trump the president has done an about-face. As journalist David Dayen pointed out, a draft of an executive order on drug prices (which never materialized) called for deregulation of the FDA and favors to industry. It was written by a pharmaceutical lobbyist.
In March, President Trump issued an executive order creating a commission to study drug addiction and the opioid epidemic. The commission, headed by New Jersey Governor Chris Christie, has so far released recommendations that locate the overprescribing problem “in doctor’s offices and hospitals in every state in our nation,” while making nary a mention of pharmaceutical marketing departments. The panel suggests insufficient remedies like new treatment facilities and educating schoolchildren on the dangers of opioids, along with ineffective ideas like more funds to Homeland Security. Regulation of Big Pharma? Nope.
The federal government did announce it would team up with drug makers to research and generate non-opioid pain medications and additional medication-assisted treatment options. Among the participants? Purdue.
Economist William Lazonick of the University of Massachusetts Lowell and an INET grantee, agrees with Berger that the way the pharmaceutical industry operates amounts to a catastrophe for the public. “It’s crazy that each and every drug is not treated like a regulated monopoly,” he says. “Taxpayers fund much of the research that goes into creating these drugs through the NIH and other public research facilities. Moreover, the companies are gifted with a monopoly through patents which last two decades.”
Lazonick notes that Big Pharma claims it needs high profits to keep inventing new drugs, but the industry spends more of its profits buying back its own stock than increasing investment in R&D on new drugs. Executives running drug companies are incentivized to make profits any way they can because they are rewarded by high stock prices. Lazonick explains that they stoke those stock prices by gouging patients or lying about the safety of products—whatever it takes.
He observes that for the past several decades America has undergone a devastating experiment based on the philosophy of economist Milton Friedman, who claimed that the only social responsibility of a company is to make a profit. Untimely deaths from tobacco-related illnesses, auto safety failures, and now, harmful opioid drugs, prove that the experiment is a tragic failure.
Lazonick sees the need for nothing less than a new structure of corporate governance that ensures the ethical responsibly of drug makers to do what they are supposed to do: create high-quality, low-cost products that are safe. The current structure, based on the misguided idea that companies should be run for the sole purpose of enriching shareholders, is particularly perverse when it comes to products that are potentially fatal. The problem with this model is that when shareholders are the only people who matter, the rest of us suffer.
Since taxpayers support pharmaceutical companies by funding public research and many other things they require to do business, Lazonick says it is only fair and logical that someone representing the public sits on their boards. Berger adds that companies should be required to make drugs widely available at affordable prices in return for their use of publicly funded basic research at no cost whatsoever.
America, for the time being, stands out among nations in letting pharmaceutical companies run amok to inflate drug prices, advertise and market drugs without proper regulation, and use taxpayer resources while exposing them to egregious harm. “The only thing America’s drug companies are competitive about,” says Lazonick, “is getting people addicted.”
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A murder-suicide is being implicated in the ongoing and growing opioid addiction crisis besmirching Indiana. Michael Jarvis shot Dr. Todd Graham after the latter refused to prescribe opioids to the former’s wife to help alleviate her chronic pain. Jarvis later committed suicide. The police are still investigating if drug addiction played a role in the killing and caution the public not to jump to conclusions.
In a press conference, St. Joseph County Prosecutor Ken Cotter said that Jarvis and his wife had visit Dr. Graham last July 26. Jarvis’ wife had been complaining of severe pain and asked Dr. Graham to prescribe her a few opioids for relief. Dr. Graham refused. The couple left soon afterwards. Allegedly, Jarvis drove back a few hours later; this time, armed with a gun. The two argued in the parking lot. Two witnesses saw the argument and were ordered by Jarvis to leave.
Police say that Jarvis then shot Dr. Graham and drove to a friend’s home, where “he gave indication that he was no longer going to be around.” The friend became concerned and notified the police. However, Jarvis had already shot himself in his home before the police arrived.
Jarvis’ wife is not being seen as a suspect in the crime. Investigators believe she had no knowledge of her husband’s intentions to murder the doctor or take his own life.
Law enforcement officers are pursuing the avenue that Jarvis may have wanted the drugs for himself. Cotter addressed the media by saying, “there’s some indication that Jarvis may have also had his own issues. We’re still investigating that….we’re talking about a man who made a choice to kill another person. We’re not talking about the opioid problem…was that a contributing factor in his decision? We don’t know that yet.”
Dr. Graham was a physical medicine and rehabilitation specialist at the South Bend Orthopaedics. He was 56 and is survived by his wife and three children.
A growing crisis
The Midwestern state has seen a nearly 60 percent increase in opioid overdose E.R. visits in only five years. The Indiana State Department of Health estimate that the state’s emergency room sees around 400 overdose visits a week; a number, they say, that is only expected to rise as access to illegal drugs and opioids becomes easier. (Related: The United States has crossed the pandemic threshold in the opioid epidemic…and Big Pharma keeps cashing in.)
Gov. Eric Holcomb recently added five addiction centers to help treat opioid addicts, including the use of controversial drug methadone as a treatment. “If I could only accomplish but one thing in my time, it would be to bend that trajectory [of increased overdose deaths], to bend that arc down on the course that we’re currently on,” he told IndyStar.
Critics of this controversial decision say that addicts are just trading one addiction for another. Nevertheless, Indiana officials say that medication-assisted methadone-use can help addicts wean from their drug habit after federally-approved drugs Suboxone and Vivitrol. One interesting fact to consider is that methadone is also the cheapest option among the three drugs. Dr. Jennifer Walthall, secretary of the Family and Social Administration, insists on the treatment, saying, “we have said over and over that we wanted all the tools in the toolbox.” She says that addicts should have all treatment options available to them.
There are patients who have used methadone to help treat their opioid addiction and say that the drug has helped give their lives back.
The future of healthcare in the state is still unclear.
Read more stories like this on DangerousMedicine.com.
If you think that America’s opioid epidemic hasn’t touched your life, statistics show there is a good chance you are wrong, with one out of every three American adults taking opioids during 2015. That equates to 92 million adults. It’s a shocking statistic that means you could well know more than one person who is taking these highly addictive drugs.
A disturbing new government study published in the Annals of Internal Medicine revealed that 38 percent of American adults were prescribed opioids such as OxyContin and Percocet in 2015, and many of these people misused these dangerous drugs. The author of the study, the National Institute on Drug Abuse Deputy Director Dr. Wilson Compton, said that he was surprised by the findings.
The researchers assessed the data collected from more than 50,000 American adults in 2015 in face-to-face interviews carried out by the National Survey on Drug Use and Health. The groups that were most likely to be prescribed opioids were women, people aged 50 and above, and people who were not college graduates.
In total, 5 percent of American adults, or 11.5 million people, were misusing opioids, whether it was by taking the drugs without a prescription, taking them to get high, or taking more than prescribed. Moreover, around 1 percent of adults reported being addicted to the drugs. If that sounds like a small fraction to you, think again: It equates to around 1.9 million Americans, and it’s possible some people who are addicted were not so forthcoming in interviews and that the real number is higher. Those with low family incomes and no job or health insurance were more likely to have this problem.
Among those who misuse opioids, nearly two thirds said they were doing it in order to alleviate pain. More than two out five got the drugs from friends or family. The researchers said that many people are prescribed opioids they don’t really need and then pass them on to family and friends who are in pain. This indicates that doctors are not only prescribing the drugs when they’re not needed, but that they are also writing prescriptions that are too big.
Prescribing practices need to change
It’s mind-boggling to see such a high number of people being prescribed these drugs even as concerns about widespread addiction and deadly overdoses grow. According to the U.S. Centers for Disease Control and Prevention, opioid prescriptions and fatal overdoses involving opioids have both quadrupled since 1999. That cannot be a coincidence, and Compton said that the medical profession is not prescribing these painkillers appropriately.
Indeed, a recent audit discovered that one third of all Ohio doctors failed to check patients’ prescription histories in a database as required prior to prescribing opioid-based painkillers. In that state, eight people die every day from overdoses. One particularly egregious doctor prescribed opioids to more than 700 patients in one month without carrying out a single check.
The CDC reports that opioids killed more than 33,000 Americans in 2015, breaking the previous record. Nearly half of all of these deaths involved prescription opioids.
Opioids should be a last resort
Boston University School of Medicine’s associate professor of medicine and public health, Dr. Karen Lasser, wrote in an editorial accompanying the study that a stepped-care approach should be adopted to pain management and that opioids should always be the last resort. She feels that doctors should first try non-drug pain management techniques like yoga, physical therapy or acupuncture, or give patients milder pain medication like ibuprofen or aspirin first. She also suggested that patients should be asked to sign a treatment agreement prior to taking opioids that highlights the risks of the medications so that they have a better understanding of their addictive nature.