The opioid one, that is. And just guess what the root of the “problem” really is? Go on, guess.
The long-term benefits of opioids have been well known for a very long time. The long-term side effects are equally well known. But the key side effect that is creating the panic does not come from long-term medical use. You heard me right. In spite of all the noise about “overprescribing,” that simply is not a problem. Less than 1% of the addicts on the street got their start with prescription opioids. And chronic pain patients rarely die of overdoses.
When Ed Thompson of Pharmaceutical Manufacturing Research Services tells Bill Whitaker that “the root cause of this epidemic is the FDA’s illegal approval of opioids for the treatment of chronic pain,” he’s simply wrong. This approvaldid create a marketing change, but for chronic pain patients, it didn’t make a lot of difference. Most pain management specialists and oncologists were already prescribing the drugs when needed for long-term care. But this opened the door for unscrupulous doctors to ring the cash register in an already illegal market.
Pass all the laws you like, but you’re never going to completely eliminate those unscrupulous doctors, any more than you’ll ever cull from the great herd of people who can and do use drugs recreationally but sanely without destroying their lives the inevitable statistical handful of people who use drugs—any drugs, all drugs—not medicinally but for fun, can’t handle it, lose control and lapse into addiction, and sometimes die from it.
Darwin had a little something or other to say about that sort of thing, as I recollect. Jesus did too, albeit in a different context: “These you will always have with you…”
The problem in the US began in earnest when William Randolph Hearst capitalized on racist sentiments against Chinese workers in his newspaper campaign against the “coolee.” He created the myth of the “opium fiend” who terrorized white women after smoking opium. It was a complete fabrication, but it sold the idea of opium restrictions to moralists and politicians. Who cares about facts when you can “Do something!”?
Next, when Andrew Kolodny says that “as the doses become higher [in response to drug tolerance] the drugs become more dangerous, and the risk of death goes up,” he is not telling the truth as I see it. He is pandering to a political narrative. The basic fact is that when you give opioids for an extended period, the endorphin receptors become tolerant to their presence. You do need to give more drug to achieve the same effect. But that very tolerance is what makes the drugs safer in the tolerant patient. Allow me to translate from medical to English.
If I need 10 milligrams of morphine for pain relief after surgery, and I just keep on taking 10 mg, after a while, I won’t get the relief. But my body will not need that degree of relief, so I will start spacing my doses out. This is something we saw in great detail when Patient Controlled Anesthesia (PCA) was introduced to pain management after surgery.
With the “morphine pump,” a patient was able to give himself lots of little doses of an opioid to help with pain after surgery. The PCA was rigged to prevent a repeat dose until 6 minutes after the previous dose, giving it time to work. We never saw overdoses with PCA if the patient was the only person to push the button. Never. As in “not once.”
Aww, but this guy’s only a doctor who works with these drugs and the patients in need of them every single day; what the hell does he know? Government “experts” are WAY more qualified than he’ll ever be to completely control who gets access to them, how, and why. This is another lengthy, detailed analysis of a “crisis” fabricated by the self-same bureaucratic boobs whose ceaseless, tireless meddling screwed up the health-care system entire in the first place, and who are now all too eager to “solve” it for us by making things even worse. Y’know, just like nearly every other problem we currently face in this country.