The opioid crisis has continued to run unabated, despite the efforts of lawmakers, treatment providers, and healthcare professionals. Americans are now more likely to die from an overdose than a car crash. And as this recent article in US News and World Report states, the opioid epidemic has become America’s “deadly new normal” with no end in sight for the current, historically high rates of addiction, overdoses, and deaths. Let’s take a look at where we stand with the opioid crisis, and how we are moving forward.
New Regulations, But Are They Enough?
Many analysts would trace the growth of the opioid crisis to Purdue Pharma’s aggressive marketing of OxyContin as a painkiller. The drug was made for patients suffering from moderate to severe pain, but a sales force that irresponsibly downplayed the substance’s potential for abuse led many health professionals to over-prescribe the drug. As detailed in this article in the American Journal of Public Health, Purdue Pharma’s sales force was armed with research that dramatically downplayed the risk of addiction, and convinced doctors and dentists that OxyContin was an effective, low-risk option for pain management.
US News and World Report notes that a decade after the introduction of OxyContin, regulators had yet to take the spread of opioid addiction seriously. A 2011 report from The Institute of Medicine on pain relief was longer than 350 pages, yet only mentioned addiction a few times. As FDA Commissioner Dr. Scott Gottlieb has stated: “The old notion was that if you were using opioids for a legitimate purpose, you couldn’t become addicted. We now know that’s not true.”
Meanwhile, pharmaceutical companies were making massive profits by flooding small towns with millions of addictive pills. This scathing report from an American Congressional Committee, which found that distributors and the DEA “failed to abate [the] US opioid crisis,” details how pharmaceutical giant McKesson shipped 9650 hydrocodone pills per day to a pharmacy in Kermit, West Virginia, a town with a population of just 400! These shipments were 36 times above the companies own monthly dosage threshold.
The American DEA is still attempting to work out a “centralized way to analyze suspicious order reports”, but earlier this year they approved a rule change that requires drug producers to identify a legitimate need for opioids to justify their rates of production. This new regulation is an attempt to limit the supply of pills, but it’s too early to judge its effectiveness
Meanwhile, pharmaceutical companies are facing lawsuits from various levels of government across America for failing to detect and report suspicious orders of pain pills. McKesson has already paid $150 million to settle a federal complaint about negligence, and they have agreed to a multi-year suspension from sales of controlled substances in four states. Sixteen states and hundreds of cities and counties are currently suing pharmaceutical companies for the negligence and aggressive, misleading marketing campaigns that brought the crisis to its current, deadly state. As Mississippi Attorney General Mike Moore states “Should taxpayers pay to clean up the mess caused by multi-billion dollar companies who lied to sell their products, or should the companies who profited pay?”
Meanwhile, The Crisis Rages On
While it’s certainly a positive development that governments are taking legislative and legal action to fight the spread of addiction, it will be a while before these actions have their effect. In the meantime, those already afflicted are in increasingly dire straits. As the supply of legal pills dries up, more and more users will turn to counterfeit prescription opioids, pills that are often laced with, or made entirely from, fentanyl. The Partnership for Safe Medicines has found counterfeit pills containing fentanyl in 44 of the 50 US states, and deaths attributed to those pills have occurred in at least 26 states. In 2017 over 275 million packages flowed through the American government’s international mail facilities, and authorities estimate that 9% of them contained drugs of some kind. In a report on the situation the FDA noted that currently only 10,000 packages are inspected each year.
Even if governments can dramatically reduce the legal supply of opioids, the opioid crisis could worsen. It’s estimated that over $800 million dollars worth of fentanyl has been shipped from China to the US in the past few years, and this is bad news for any opioid addict or anyone who cares about one. Fentanyl is 30-50 times stronger than heroin, and can be lethal in doses of just 2 milligrams. As a US Attorney in Ohio has noted: “One of the truly terrifying things is the pills are pressed and dyed to look like oxycodone. If you are using oxycodone and take fentanyl not knowing it is fentanyl, that is an overdose waiting to happen. Each of those pills is a potential overdose death.”
Is There Any Good News Out There?
It is a positive step forward that governments, the courts, and even pharmaceutical companies are finally taking action to contain the current opioid crisis. Furthermore, Chinese Leader Xi Jinping recently pledged to declare fentanyl a controlled substance and clamp down on its production and sale. But for those already facing the nightmare of opioid addiction, that is cold comfort. The only way to stay safe is to seek treatment and build a healthy, sober life without the painkillers that are causing 130 Americans to die every single day.
And on this front, there is good news. Exciting new treatments such as ibogaine, suboxone, and ayahuasca are helping many addicts with the withdrawals and cravings that make getting sober so difficult. Ibogaine has proven to be particularly effective in treating short-action opioid withdrawals, including commonly abused substances such as codeine and oxycodone. Because these drugs leave the system quickly, the treatment can be administered during the early stages of withdrawal, where it minimizes the horrific symptoms associated with quitting “cold turkey.” Ibogaine also resets dopamine receptors in the brain to a pre-addicted state, normalizing the addicts’ ability to experience pleasure and significantly lowering their tolerance for opioids.
Addictions thought leader Dr. Gabor Maté believes that “A hurt is at the centre of all addictive behaviours. It is present in the gambler, the Internet addict, the compulsive shopper and the workaholic. The wound may not be as deep and the ache not as excruciating, and it may even be entirely hidden—but it’s there.” Addictions experts across the globe are gaining an ever greater understanding of the roots of addiction, a dis-ease which often begins as a response to mental and physical pain. Millions turned to opioids in response to chronic physical and emotional pain. But the relief that they offered was temporary, and the horrifying toll they have taken on our societies has been huge. If you’re ready to end the nightmare of opioid addiction, don’t hesitate to get in touch!
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