How drug warriors made the ‘opioid epidemic’ deadlier – Reason.com

How drug warriors made the ‘opioid epidemic’ deadlier – Reason.com

How drug warriors made the ‘opioid epidemic’ deadlier – Reason.com

According to the demands that four pharmaceutical companies agreed to resolve Last week, the “opioid epidemic” was caused by overprescribing pain relievers, suggesting that reducing the supply of pain relievers such as hydrocodone and oxycodone is the key to reducing opioid-related deaths. But that assumption has proven disastrously wrong, revealing how prohibition makes drug use more deadly.

Opioid Prescriptions Per Capita in the United States, which began to rise in 2006, it fell steadily after 2012, reflecting the impact of government efforts to restrict and discourage the medical use of these drugs. However, in 2019, when the dispensing rate was lower than since 2005, the US saw more opioid-related deaths than ever before.

Last year, according to preliminary estimates From the Centers for Disease Control and Prevention (CDC), that record was broken once again: Opioid-related deaths increased by 40 percent. As opioid prescriptions fell, the upward trend in deaths (which generally involve more than one drug) not only continued but accelerated.

That evil effect was completely predictable. The crackdown on painkillers led non-medical users to use black market substitutes, replacing legally manufactured and reliably dosed products with drugs of unknown provenance and composition.

As that was happening, illicit fentanyl became increasingly common as a booster or replacement for heroin, making the potency even more variable and unpredictable. In 2020, according to the CDC projections, “synthetic opioids other than methadone,” the category that includes fentanyl and its analogues, were involved in 83 percent of opioid-related deaths, compared with 14 percent in 2010.

Today, fentanyl appears in black market pills sold as hydrocodone or oxycodone and even in stimulants like cocaine and methamphetamine. Their proliferation is a response to the same supply-side measures that were supposed to reduce drug-related deaths.

As the government succeeds in putting pressure on the supply of illegal intoxicants, it encourages traffickers to distribute stronger drugs, which are easier to conceal and smuggle. Since fentanyl is so much more potent than heroin, a pack that weighs less than an ounce can replace one that weighs a couple of pounds.

Opioid synthesis is also a less vulnerable and much cheaper process than production based on poppy crops. Researchers at RAND Corporation estimate that heroin production is at least 100 times more expensive than fentanyl, adjusting for potency.

Black market drugs were already dubious due to prohibition; the rise of fentanyl driven by the ban has made them an even more dangerous game of chance. And these are the substitutes that non-medical opioid users turned to after the drug warriors succeeded in reducing the supply of painkillers.

That policy has also hurt genuine patients by depriving them of the medication they need to make their lives more bearable. Last week, the American Medical Association (AMA) again urged the CDC to review its opioid prescribing recommendations, which have been widely interpreted as imposing strict limits on daily doses.

“Patients with pain continue to suffer from under-treatment of pain and the stigma of having pain,” wrote AMA Board of Trustees Chairman Bobby Mukkamala. “This is a direct result of the arbitrary dose and quantity thresholds contained in the 2016 CDC Guidance.”

Although “physicians have reduced opioid prescribing by more than 44 percent since 2012,” Mukkamala noted, “the drug overdose epidemic has worsened.” The government wrongly assumed that the availability of toxic substances in particular was causing drug-related deaths, which is clearly not true in light of the social, economic and psychological factors that plausibly explain last year’s increase, such as financial insecurity. , emotional stress, isolation, etc. and disengagement from significant activities.

The COVID-19 pandemic magnified those problems, but did not create them. A 2019 Joint Economic Committee report on “deaths from despair” he noted that “drug-related deaths have been on the rise since the late 1950s.”

The rise in opioid deaths is the latest manifestation of that long-term trend. By now it should be clear that when it comes to drug-related “deaths of despair”, the root of the problem is despair, not drugs.

© Copyright 2021 by Creators Syndicate Inc.

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