Opioid prescriptions plummeted for years before the epidemic-level increase in drug deaths. The entire increase in drug deaths is due to illicit drugs flooding the market with the collapse of immigration enforcement and the advent of sanctuary cities around 2013-2014. Pain patients have relatively low rates of overdose, yet the whole legislative focus of the Senate is on further monitoring, restricting, and stigmatizing prescription drugs while ignoring 100 percent of the true problem.
Today, the Senate will vote on H.R. 6, a package of dozens of bills designed to treat the opioid crisis, which is misdiagnosed and misidentified from head to toe. But they have a lot of solutions! The bill provides grants for the endless “evidenced-based” treatment programs for addiction groups that live rent-free in government. It also hands the pharmaceutical companies more money to work on research and development for non-addictive painkillers. Yup, after pushing the medical industry into treating pain, then pushing them out of it, now they will get it just right with their social engineering. The bill increases the scope of Medicaid coverage for addiction treatment. It also gives the DEA a more flexible mandate to set targets for manufacturing of painkillers and shutting down the supply.
Notice what is missing? Anything dealing with drug cartels, stiffer punishments for drug traffickers, clamping down on sanctuary cities that refuse to break up criminal alien drug networks, or border security. This is all a border issue and a national security issue. People who have never had chronic pain or prescription drugs are dying from illicit drugs laced with all sorts of poison. This is all about illicit drugs, not prescription drugs. Meanwhile, efforts of the federal and state governments to ignore the illicit drug problem and clamp down on pain patients is causing catastrophic damage to stable, chronic pain patients, yet they are completely forgotten in this virtue-signaling package.
The most amazing thing about the discussion about opioids is that members of Congress are unaware of the most basic data and trends concerning prescriptions and deaths from illicit drugs. The number of prescription painkillers in this country rose steadily in the late 1990s and 2000s, peaking between 2010 and 2012. But then it began to drop precipitously as state laws and medical profession protocols began limiting them. It wasn’t until after the decrease that the fatalities from drugs spiked above the long-term baseline increase.
How is it that fatalities are spiking while prescriptions have already been severely limited?
This is simply a question the politicians refuse to explore. Anyone who understands the issue would realize there is no mystery. Even using the CDC’s misleading data, which conflates a lot of illicit drug deaths with prescription deaths, the entire above-baseline increase in deaths over the past few years was due to illicit drugs, not prescriptions. These include both opioids like heroin and fentanyl and non-opioids, such as cocaine and meth. In addition, there has been a surge in deaths from benzodiazepines over the past few years. What gives? Suddenly people are being mis-prescribed sleeping pills? Obviously, it’s the same demographic that is hooked on illicit drugs that mixes them with alcohol, illicit drugs, or prescriptions they are either legitimately prescribed or purchase on a black market.
But none of this has anything to do with stable, chronic pain patients or patients who receive painkillers after surgeries. The surge in deaths was all from illicit drugs due to the collapse in border security and interior enforcement around 2013-2014. And as we’ve mentioned before, to the extent there is a prescription problem, it’s not a prescription use problem that inherently makes patients addicted, but an abuse problem by those who divert them to the black market. What is the biggest culprit? The Medicaid program, which legislators now use as the savior for the problem it created.
Here are the facts.
According to the preliminary 2017 data (still just an estimate), only 14,330 fatalities were from prescription opioids, which is fewer than the 16,800 in 2016 and in line with the long-standing trend. But how many of those deaths were exclusively due to prescriptions that were responsibly taken and responsibly prescribed? Very few. And this has been the case for years. We’ve had a drug abuse problem, not a prescription use problem. Just like car accidents grew with the wider use of cars, so too there were more overdoses by those who abuse drugs or divert them for non-medical use (yes, Medicaid, we are looking at you). But that is very different from saying there is an inherent problem with painkillers.
According to Drs. Michael Schatman and Stephen Ziegler in the Journal of Pain Research, in New Hampshire, one of the hardest-hit states by the crisis, “72% of the deaths involving oxycodone included alcohol, a benzodiazepine (or both alcohol and a benzodiazepine), kratom, methamphetamine, or another prescription opioid (which may or may not have been prescribed concurrently).” They conclude, “[T]hese data strongly suggest not a “prescription opioid crisis” but rather a “polypharmacy crisis.” The consequences are dire: “For the CDC to suggest that more than 15,000 died in that year from ‘prescription opioids’ when a closer examination of the data indicates that illicit opioids and/or polypharmacy were involved is not only inaccurate and disingenuous, it can negatively impact patients who are well-managed on long-term opioid therapies and have no effective safe alternatives that are covered by insurance, negatively impact health care providers who seek to relieve suffering, and negatively impact people who are suffering from substance use disorders.”
Recently, Dr. Stefan Kertsesz wrote in a journal article that most people checking into opioid treatment programs “reported psychiatric disorders predating opioid use and described having sought opioids to manage their emotions.” (You can listen to his discussion on my podcast here.) We are targeting the wrong people with government regulations.
The evidence we have shown from states that are better than the CDC in producing data demonstrates the same point – that deaths among those legitimately prescribed have always been relatively low and are getting lower.
There was a 27.8 percent decrease in prescriptions in just four years. Can you imagine the number of people who are needlessly in pain thanks to the government? According to a new study from the IQVIA Institute for Human Data Science, opioid dosage volume decreased 12 percent just in 2017, the largest drop in 25 years. Living on painkillers is not ideal, and someday the free market will come up with a solution to pain, but in the meantime we don’t need to be harming pain patients in order to protect the drug traffickers.
Yet politicians and the media think it’s not enough and desire to shut off prescriptions even more – all the while letting out illicit drug traffickers from prison (under “criminal justice reform”) and continuing the flow of Central Americans bringing in the drugs and MS-13. Even the liberal media recognizes we now have an MS-13 problem flooding our communities since 2014. According to a new Congressional Research Service report, in recent years MS-13 has “developed relationships with transnational drug trafficking organizations to facilitate the flow of drugs within the United States.”
There is your drug crisis right there. Yet Congress has refused to hold a single hearing exploring the very premise, data, and trends behind the crisis they seek to solve.
Some might accuse me of defending pharmaceutical companies, but the truth is Big Pharma gets a big handout in these bills, which fund programs to develop “addiction-resistant” formulas. Guess who benefits? Big Pharma. It’s the same with any big regulations, such as ethanol and CAFE standards. The big industries that already gamed out the system benefit from the “solutions.” Which is why nobody in the pharmaceutical industry is speaking the truth and showing the open borders as the culprit for the post-2014 illicit drug crisis.
What we are really facing in this country is a political morphine crisis, whereby our voters, particularly conservatives, are completely numb to the policy lies being told by both parties because we are so distracted by the endless political soap opera.
Daniel Horowitz is a senior editor of Conservative Review. Follow him on Twitter @RMConservative.