The government’s war on pain patients

· December 14, 2018  
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Prescription pill bottles
Feverpitched | Getty Images

If congressional legislators are committed to letting out transnational drug traffickers from prison next week, can they at least give pain patients consuming prescription drugs some relief too?

One could not possibly conceive of a more perverse, unjust, and counterintuitive policy than what government is doing with drug traffickers and pain patients. The federal and state governments are inviting in criminal alien drug traffickers, protecting them with sanctuary cities, releasing hardened traffickers of illicit drugs from prison, and then attacking doctors and pain patients who prescribe and consume legitimate pain medication. It’s immoral, it’s built upon a lie, and it’s time for it to end.

I’ve spent much of this year in this column exposing the fact that the entire baseline increase in drug fatalities during this epidemic was due to illicit street drugs brought in by open borders and sheltered by sanctuary cities. The crisis was not the result of prescription drugs. Prescriptions have been plummeting since before the epidemic, and prescription deaths are down. Even at the height of the prescribing trend for opioids, 2005-2010, the rate of overdoses was remarkably low among legitimate pain patients. Those who’ve overdosed in recent years are mainly among the demographic with a history of abuse and other mental or emotional issues or people who are mixing illicit drugs with alcohol, benzodiazepines (sleeping pills, tranquilizers) and legitimate prescription drugs. They mainly do so, as one study found, “to self-medicate psychological problems” or “provided a means to “escape” from the stresses of everyday life.”

In one of the few acts of good journalism on this issue, Elizabeth Llorente, a reporter for Fox News, published an article this week exposing how chronic pain patients and post-surgery patients are living in pain because of the needless war on painkillers. She talks about cancer patients or amputees who experience excruciating pain and are cut off from medicine either because of state law, confusion about federal guidelines, or the general culture that the media and political class have created to scare doctors away from prescribing.

But aren’t so many people dying from this stuff?

Actually, prescriptions have long swung back the other way, with prescribing rates cut off so severely that they are back to 1990s levels in many states.

While drugs like oxycodone, percocet, and tramadol are very potent and require careful supervision, the number of overdoses of people who have been properly prescribed and who have never exhibited other risk factors is remarkably low. A 2008 Oxford study, done at the height of the prescribing regime, sought to ascertain the level of addiction inherently brought on by prescription opioids. Therefore, the study authors purposely excluded chronic-pain patients with prior drug abuse and addiction from their data and found that only 0.19 percent of the remainder of patients developed any addiction to opioids. A similar 2007 study of those seeking addiction treatment for OxyContin found that “86% reported use of the drug to ‘get high or get a buzz,’ and 78% reported receiving prior treatment for a substance use disorder.”

Not exactly your stable chronic pain or post-surgery patients.

So, what is the crisis?

It’s all illicit drugs being trafficked by transnational cartels and distributed by transnational gangs, as well as all the drug traffickers whom we refuse to prosecute or whom we let out of prison. Now the political class, the same people who treat pain patients as drug traffickers, desire to let out even more and remove the deterrent of mandatory sentencing.

The CDC just published fresh data from the period 2011-2016 proving this point. But new preliminary federal and state data from 2017 as well as other studies demonstrate this point even more clearly.

According to the CDC, the entirety of the increase in overdoses above the existing baseline beginning around 2011-2013 was due to illicit fentanyl and then heroin, meth, and cocaine, often mixed with fentanyl. While deaths from heroin and meth tripled and fatalities from fentanyl skyrocketed ninefold, “the age-adjusted rate of drug overdose deaths involving oxycodone decreased from 1.8 per 100,000 population in 2011 to 1.6 in 2013, then increased to 1.9 in 2016; however, these decreasing and increasing trends were not statistically significant.”

More current state data in every major overdose state shows that this trend of rising meth, cocaine, and fentanyl deaths and stagnation or decrease of prescription deaths has accelerated even more over the past two years.

Even those who were listed as having died from a prescription drugs often had mixed prescription drugs with illicit drugs or they picked up the prescriptions through street trafficking and diversion, not from a legitimate doctor. As I’ve explained before, the Medicaid expansion exacerbated this problem of the black market for prescriptions.

Furthermore, the CDC notes that many of the deaths due to morphine are likely really heroin death but recorded as morphine in toxicology “because morphine is a metabolite of heroin.” This further overinflates the stated numbers for prescription deaths.

Thus we have a criminal alien drug trafficking problem as a result of sanctuaries and Obama’s open-borders policies over the past seven years, now codified by the courts. To the extent there is a problem with drugs that can be prescribed, it’s a drug abuse, trafficking, and diversion problem, not an inherent usage problem. Yet, even when these facts were known, the CDC was still saying that “prescription opioids … are no less addictive than heroin.” The CDC issued guidelines to taper patients from opioids, and now states like Oregon are looking to cut them off entirely for many patients. At least half the states imposed some sort of restriction in dosage or duration of prescribing, and insurers have also moved to cut coverage based on the guidelines. The VA has slashed prescriptions by 41 percent, even as illicit drug deaths are skyrocketing. So now we have more mercy on drug traffickers than on veterans.

Our immigration policies have enriched the cartels allowed them to make these drugs so cheap, pure, and ubiquitous that any kid or young adult can get ahold of them for a few bucks. As long as potent substances are made available, youngsters will consume them. Due to the cultural problems of mental illness, depression, and kids looking for a buzz, all sorts of stimulants and illicit drugs will be abused as long as they are available cheaply thanks to open borders. Even Ritalin and Adderall abuse is surging across the country. Abuse of tranquilizers and sedatives is increasing as well. In Maryland, deaths from benzodiazepines have doubled since 2011. This will continue to happen even if we cure all physical pain and don’t need any painkillers, much less opioids.

This is borne out by several facts:

  • A slight majority of pain patients are women, while the overwhelming majority of drug deaths are male. In most state data sets I’ve studied, 70-80 percent of the annual drug fatalities are men. This is why life expectancy declined for American males in 2017 but was unchanged for females.
  • Most pain patients are older, while most drug deaths are younger people.
  • While the biggest driver of the epidemic is illicit and synthetic opioids, meth and cocaine are the fastest-growing problems. They are not opiate-based. Just the opposite; they are psychostimulants.
  • We are always lectured on how Europe has a fraction of our prescribing regime. Then why does Europe have an epidemic-level cocaine problem that is so prevalent it is giving Hezbollah billions a year in profits, as revealed in a recent documentary put out by Israel’s Abba Eban Institute? Answer: It’s not pain medication driving the addiction to drugs; it’s the culture meeting a breakdown of law enforcement.
  • Contrary to the lie that pain medication for non-risk patients is a gateway to heroin (and other non-opioids), the latest HHS report makes it clear that the ubiquitous use of marijuana among youth, most of whom have no pain, is a much bigger gateway. According to a brand-new National Survey on Drug Use and Health (NSDUH) , the most comprehensive government survey of its kind, “Frequent marijuana use, in both youth (aged 12-17 years) and young adults (aged 18-25 years), appears to be associated with opioid use, heavy alcohol use, and major depressive episodes.” It’s therefore not surprising, as Dr. Stephen Martin observed, that “Colorado is in the lowest quintile of opioid prescribing but the highest quintile of nonmedical use.”
  • Some of the fastest-growing epidemic states are some of the lowest proscribing states. Alabama has long topped the list of top prescribing states but has one of the lowest overdose rates. There is no statistical correlation between state prescribing rates and overdoses. No state has more seniors than Florida, who would naturally be susceptible to prescription drug deaths. Yet, according to the Florida Department of Health, the number of people admitted to treatment programs for prescription drug addiction declined by 79.4 percent from 2011 to 2016, while heroin treatment admissions spiked by 142.6 percent. But the fastest-growing killer in Florida is cocaine, which is all coming from the drug cartels and is not even an opioid.

Besides, all of the states have seen a dramatic decline in prescribing rates since before the epidemic, and the only result we are seeing is suicide of pain patients. In fact, total oxycodone ER prescriptions had already decreased by 29.7% percent long ago, around 2007-2011, and decreased 39 percent from 2010 to 2015.

Indeed, this graphic is worth 1,000 words:

Sure, there are doctors or pill mills that are involved in trafficking and diverting drugs. But that is a law enforcement issue, not a health care issue. Government has no business interfering with legitimate prescribing and clinical practices. Government needs to do its job of closing the border, ending the magnets that invite criminal alien networks, eliminating sanctuary cities, and busting up the gangs and networks doing the distribution for the Mexican cartels.

This is a deadly mix of policies. States are now looking at taxing opioids. The DEA has already cut annual production rates by 20-25 percent for the past two years – without any regard for clinical need. The government’s war on pain medication has already driven up the price and has diminished the supply, now creating a shortage of morphine in hospitals even for in-house use! Yet at the same time, the amalgamation of family units and UACs coming from central America empowering and enriching drug cartels, sanctuary cities, and weak-on-crime policies are creating a spike in supply of the deadliest drugs at the cheapest costs!

Living a life on opioids is not ideal, but it’s better than the living hell or suicide to which many pain patients ultimately succumb. They still feel pain, but are able to live functioning lives. Until another analgesic is produced in the market that has the same effect without the side effects, there is no reason to further clamp down on prescriptions, especially beyond what has already been done for the past six to eight years. The time has come to go after the drug traffickers and leave pain patients and veterans alone. Where is this Koch-funded libertarian juggernaut when it comes to hands off on health care? The problem is that pain patients don’t write checks to politicians the way special interest groups who love to coddle criminal aliens and drug traffickers do.


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Author: Daniel Horowitz

Daniel Horowitz is a senior editor of Conservative Review. Follow him on Twitter @RMConservative.