Government solutions to the opioid epidemic aren’t working
I recently watched a video of a forum held in Wilmington Dec. 4 titled: "What Heroin Costs Delaware" sponsored by The News Journal. Authorities from police and fire departments, politicians, nurses and doctors gathered along with former users to discuss opioid addiction treatment and rehabilitation needs.
The keynote speaker, Dr. Andrew Kolodny, co-director of Opioid Policy Research, said the total U.S. overdose deaths in 2016 were an astounding 64,000 people, of which more than 45,000 were from opioids. Total deaths in Delaware were 308 in 2016, up 35 percent from 228 in 2015. About 11,000 are said to suffer from opioid addiction in the state, which will get worse over the next three to five years.
But, missing from the discussion were any tough solutions to stop the perpetrators of the epidemic.
It reminds me of an old column I saved by journalist Jonathan Power who reported that Mao Tse-tung kept China opium-free for 40 years through a "mixture of carrot and stick – addicts were not condemned but offered medical help and rehabilitation. Those who were uncooperative were sent to labor camps or imprisoned; dealers were summarily executed, often without a trial."
His hard-line policy was perhaps a delayed reaction to the opium traders in 19th century China when fortunes were amassed by the British, and Americans like FDR's grandfather Warren Delano.
Since our sensibilities prevent us from adopting Mao's approach, and we haven't yet accepted the benefits of managed legalization to eliminate black-market profits and violence, we are left in the middle ground of half-measures in dealing with addiction and death while fortunes continue to be made.
A look back at the 2015 Annual Review of Public Health (annualreview.org) reveals that, "In 1996, the rate of opioid use began accelerating rapidly. This acceleration was fueled in large part by the introduction in 1995 of OxyContin ... manufactured by Purdue Pharma.
"Between 1996 and 2002, Purdue Pharma funded more than 20,000 pain-related educational programs ... and launched a multifaceted campaign to encourage long-term use of Opioid Pain Relievers (OPRs) for chronic non-cancer pain. Physician-spokespersons for opioid manufacturers ... cited studies with serious methodological flaws to highlight the claim that the risk of addiction was less than 1 percent."
But, in fact, there were no studies to substantiate this claim, according to author Sam Quinones in his eye-opening book "Dreamland" about the opioid epidemic. He says, "It was, a one-paragraph letter to the editor, and not a scientific study..." that became "a landmark report" in journals and magazines, and was marketed aggressively with great success.
Moreover, according to Dr. Kolodny, there hasn't been any real crackdown on the "massive over-prescribing" of opioids. Nor apparently by the Drug Enforcement Administration's interdiction of the doctor "over-prescribers" of legal opioids. The Cape Gazette reported in April 2016 that the "DEA has been cracking down ... for more than a decade. But, since 2009 only 19 DEA registrations [licenses to prescribe - my add] have been revoked ... none included criminal investigations for illegal drug sales."
Then, when prescription opioid pills become tougher to obtain or too expensive, heroin is the go-to drug because it's cheaper and more readily available. Oxycontin, in effect, has created vast new markets for heroin among middle- and upper-class whites. And, instead of pharmaceutical sales reps pushing opium tablets, illegal Mexican drug traffickers feed a growing base of customers addicted to oxycontin with heroin.
They use methadone clinics as footholds, Quinones relates, giving free samples to the addicts, like Purdue Pharma sales representatives to doctors. They can gross $15,000 per day, one-tenth of a gram at a time. But, these cells are just one cog in the gears of the massive Mexican drug revenue machine that, investigator author Robert Saviano says, grosses from $25 billion to $50 billion a year.
On the legal side, Purdue's 2017 earnings are reported at $35 billion. In 2007, Purdue Pharma did plead guilty in federal court to criminal charges of misleading the public about Oxycontin's addiction risks, and paid $634 million (1.8 percent of 2017 earnings) in fines. And, though the top three executives paid heavy fines, they did no jail time, and only 400 hours of community service.
The Centers for Disease Control estimates that the total "economic burden" of prescription opioid misuse alone in the United States is $78 billion a year, including the costs of healthcare, lost productivity, addiction treatment, and criminal justice involvement.
So as the numbers make clear, the illegal and legal opium suppliers have profited immensely as the addicted suffer and die. Meanwhile, taxpayers pay enormous sums to mop up.
As for government solutions ... at least Mao's worked.
Geary Foertsch lives in Rehoboth and writes from a libertarian perspective to promote economic liberty, non-cronyism free markets, small government and a non-intervention foreign policy. He can be contacted at firstname.lastname@example.org.