Drugged America

Since 1943, the Association of American Physicians and Surgeons has been dedicated to the highest ethical standards of the Oath of Hippocrates and to preserving the sanctity of the patient-physician relationship and the practice of private medicine. Their monthly newsletter published in October 2017 had an excellent commentary on the heroin/opioid crisis in America. Here are several summary points:
  1. The rate of prescribing opioids has actually decreased since 1999, but the number of opioid overdose deaths continues to rise. More than 50% of those who misuse opioids got the drugs from friends or relatives.
  2. Blaming the doctor and the pharmaceutical industry brings no lasting change. More promising approaches are careful selection of patients for opioid therapy, reduced diversion of prescribed drugs, taking back leftover supplies, more research on pain and non-opioid treatment, increased availability of naloxone, and better access to effective drug treatment for opioid abusers.
  3. Heroin alone was responsible for 25% of the over-dose deaths in 2015. We will never hear the truth from media: drug poisons come from a transnational criminal organization that could not flourish without political protection.
  4. It’s not just a border problem: more than 1000 US cities have been infiltrated by at least one of four Mexican drug cartels. There were more than 50,000 drug-related murders in Mexico between 2006 and 2012. A number of journalists and Mexicans mayors have been assassinated. A wall will not stop drugs hidden in vehicles, many come by boat or air. Drug money is laundered through legitimate appearing businesses in upscale settings.
  5. The success rate of the drug treatment industry is abysmal. Only 20% of patients are still sober after one month, and up to 98% go back to drugs by one year.
  6. Medicaid provides free access to prescription drugs. In 2015, the seven states with the highest drug overdose death rates were Medicaid expansion states. Rather than helping to fix the overdose problem, government programs may be fueling it. Medicaid paid more than 34 million claims for opioids (>$500 million, fee for service only), and one-third of opioid prescriptions were for a month’s supply.