The use, overuse and abuse of opioids is now at EPIDEMIC PROPORTIONS, so said opioid expert Bruce Taylor.
It is staggering to know that some 2 million people in our country suffer from substance abuse disorders related to prescription opioid pain medicine and some 600,000 suffer from heroin abuse disorder. And those numbers do not count. Millions of Americans who use these painkillers, these opioids on some kind of regular basis which of course makes them candidates for overuse and abuse. It is indeed an epidemic, opioid addiction is and every day, 91 Americans fatally overdose on an opioid drug.
OPIOIDS are a class of drugs that include the illegal drug heroin, made from the poppy plant, synthetic opioids such as fentanyl and pain relievers available legally by prescription such as oxytocin, Vicodin, codeine, morphine and many others. These powerful and potentially lethal drugs interact with opioid receptors on nerve cells in the body and the brain. They do indeed produce pain relief, even the most serious kinds but as well, the drugs, all three classes, produce EUPHORIA in addition to pain relief. It is that incredible feeling of euphoria for some which creates the overuse and misuse of Opioids, creating addiction and driving the user to overuse them and begin the pathway to destruction by taking larger and larger quantities. For 91 Americans daily, this overuse leads inexorably to death itself.
Almost 10% or 1 in 10 Americans who misuse painkillers transition to the stronger drug heroin. Even more lethal and tragic, many of those addicts, heroin over users, switch to a more potent synthetic cousin of heroin, the drug fentanyl, the use of which has tragically escalated the opioid crisis. Now get this my fellow Americans.
Fentanyl is 50-100 MORE POTENT than morphine and this powerful drug is able to enter the brain especially quickly because of its high fat solubility. A minimal dosage of 2 milligrams can KILL A PERSON, kill a person. It is so powerful, fentanyl is that emergency personnel who may touch the over user or even breathe the drug in during treatment can be put in danger themselves! Even though fentanyl is so potentially lethal, it continues to be a medicine prescribed for post-surgical pain and palliative care. And it becomes more widely available than ever, LEGALLY AND ILLEGALLY.
Much of this death-dealing drug is made illicitly in China and unbelievably dangerous, imported to the U.S. via MAIL. Can you believe that? Actually sent to the United States through the U.S. Post Office by mail. Much of the other supply to America comes from MEXICAN DRUG CARTELS. The drug is easily manufactured, synthetically so, and its high potency makes the drug enormously profitable to produce and sell. The economics are staggering. According to the DEA, one kilogram of fentanyl can be purchased in China for approximately $3,000 and when that kilogram is shipped to the United States, the illegal sale of the drug can generate as much as:
$1.5 MILLION
$1.5 MILLION. On top of that, the distributors of these illicit synthetic opioid drugs quickly adulterate heroin or cocaine powder with this fentanyl or added to counterfeit prescription drugs such as pills made to look like prescription pain relievers or sedatives. That increases profitability from the sale. Fentanyl when added to heroin or cocaine not only increases the potency but heightens the addition as a result of increased euphoria from usage. Small wonder that President Trump who formed his commission on opioid abuse and governors like Chris Christie of New Jersey are standing up, educating the public and making everyone aware of this insidious problem. They remind us that deaths from fentanyl and a handful of other synthetic opioids tripled through and including the year 2015 and the use of opioids begins to spread among teenagers, the so-called new GenZ and even older millennials. It is for all Americans a tragic epidemic indeed.
Not only is opioid abuse and addiction a serious national crisis which affects public health, but there are tragic effects on social and economic welfare. The setters for Disease Control and Prevention (CDCP) estimates that the total economic burden of prescription opioid misuse alone in the United States is almost:
$80 BILLION ANNUALLY
That number includes the costs of healthcare, lost productivity, addiction treatment and criminal justice involvement, all four. And that number keeps growing and is probably a low estimate given the ever-growing overuse problem in America.
In the late 1990s, pharmaceutical companies, Big Pharma assured the medical community that patients would not become addicted to prescription opioid pain relievers and as a result, healthcare providers began to prescribe them at greater rates. This of course led to widespread diversion and misuse of these medications and of course opioid overdose rates began to increase significantly. In 2015 alone, more than 33,000 Americans died as a result of an opioid overdose, including prescription opioids, heroin and illicitly manufactured fentanyl. Those numbers have only increased in the past 1-1.5 years.
Almost 30% of patients using prescribed opioids for chronic pain MISUSE THEM. As the addiction grows, so does overuse. 12% or more of these users develop an opioid use disorder. Some 6% or more who misuse prescription opioids transition to a stronger illegal drug heroin. Some 80% of people who use heroin first misuse prescription opioids and then became addicted to the strong drug heroin. I never thought we would see the day when there would be drugs available stronger than heroin. But now comes that satanic fentanyl, some 50-100s more powerful than heroin, death-dealing so quickly when there is any kind of overuse or abuse. Opioids are indeed becoming a national crisis, a national epidemic and it simply must be stopped.
Virtually every family has a member who has been prescribed oxycodone or hydrocodone, serious pain relievers after surgery. There are millions of such prescriptions every year. They are often found in medicine cabinets by those wishing to use them illegally for euphoric purposes and the abuse spreads. These painkillers reduce the perception of pain by binding to opioid receptors which are found on cells in the brain and in other organs of the body. The binding of these opioid receptors in REWARD regions of the brain produces a sense of wellbeing. In addition, opioids, especially when mixed with fentanyl go deeper into brain regions and consequently result in drowsiness and respiratory depression which can lead to overdose deaths. The use of larger quantities of opioids produces this deeper penetration into the brain and when that happens over and again, death is inevitable. The regular use of opioids produces a condition called TOLERANCE, lessening the euphoric effect and necessitating a higher dose to achieve that same effect and that is the pathway to addiction. And once addicted to opioids, heroin, synthetic drugs such as fentanyl and prescription drugs, that addiction is life-changing or life-ending.
Unfortunately and unwittingly, Medicaid can exacerbate the problem. A so-called Medicaid card can be used to purchase opioids and for a $1.00 copay, 240 oxycodone pills can be resold on the street illegally for as much as $4,000-$5,000! A single Vicodin pill can garner as much as $50! A spokesperson for the Department of Health and Human Services stated:
“It appears that Medicaid has created a perverse incentive for people to use opioids, sell them for large profits and stay hooked.”
The Department of HHS conducts an investigation of Medicaid even now to make certain there are adequate controls at work to prevent such abuses.
THE NATIONAL INSTITUTE ON DRUG ABUSE (NIDA) reminds us of the terrible disorders which occur in the body due to overuse. And of course, that overdosing can lead to death and pregnant women users will see the effect of that opioid use or overuse in their newborn babies. An overuse can, says NIDA, foster the increase of infectious diseases including HIV and Hepatitis C (HCV)! It is just an unbelievable tragedy, is it not my fellow Americans? Medically, culturally and economically, the overuse of opioids can weaken and even tear apart so much of our beloved country. And, injecting these drugs, the fastest way to euphoria can again, cause outbreaks of HIV and HCV, disastrous diseases themselves. GOD HELP AMERICA! Small wonder that opioid overdoses are now THE LEADING CAUSE OF DEATH among Americans under the age of 50.
But fortunately, the majority of individuals who used prescribed painkillers do not become addicted. Used right, and prescribed properly by doctors, opioid based drugs like oxycodone and hypercodone are necessary for doctors and surgeons as pain relief post-surgery. If, says NIDA, doctors prescribe properly and monitor the pain and pain relief of their patients, addiction problems can be largely avoided. But there are doctors, unfortunately, who both oversubscribe and fail to monitor a patient’s progress or use of the painkillers. Those who use the drugs for euphoric purposes or for illegal sale on the street often engage in doctor shopping to find those who will prescribe generously even carelessly. The opioid problem can never really be solved unless prescription abuse is stopped in its tracks. May that be so.
And it really is a national crisis, the use of opioids is, my fellow Americans. John Kelly, an Associate Professor of Psychiatry in Addition Medicine at Harvard Medical School stated the following about opioid abuse:
“We are now at the public health equivalent of DEFCON 5 with this opioid crisis.”
And that is the highest level of the national crisis metrics. Not only must there be greater controls at the governmental and medical levels of our country, but the public, the people, the families of our great country must be far better educated and far more aware of the potential abuse and overuse of these drugs, especially among teenagers, college students and the so-called millennial generation. We the people must be far more proactive in preventing the spread of this tragedy and finding the cures for addicted individuals, especially our loved ones. And of course, we should attack the source, countries and entities who produce these illegal drugs. So much production occurs in China. We can prevent the importation with active governmental control. And the same with Mexico and the Mexican drug cartels. We can monitor their activities and prevent their illegal products from entering our shores far better than we do now. There was at one time a cocaine epidemic in America, which was caused by cocaine production for the most part in the country of Peru. And the same in Columbia. The military was used against cocaine-producing rebel groups and crop-eradication programs and a far greater governmental awareness produced the decline in cocaine use in America. The same means can be applied to opioid production whether from natural or synthetic sources. Perhaps the new Trump commission on opioid abuse and the action of so many of the governors of our states will create a far greater public awareness on the one hand but motivate all others including our government, the military, health insurance companies, medical doctors and hospitals and those who may legally use these potentially lethal drugs to both control and limit their usage. If not, in the next decade, millions more Americans may well become addicted to opioids and suffer this addiction for a lifetime. I pray it never happens.
Interestingly, over 65% of all prisoners meet the diagnostic criteria for drug abuse or dependence. But tragically, only 1 out of 10 of those prisoners receives adequate treatment while incarcerated. Upon release and left untreated, these prisoners with potential substance abuse disorders relapse to drug use and return to criminal behavior. It is imperative that this necessary medical treatment be made available to such prisoners who upon release have the potential to be some of the largest over users and abusers of illegal drugs.
To this point, METHADONE has been the acknowledged source for treating opioid use disorders. The drug treats the addiction but more often than not provides no cure. There comes now a new drug efficacy known as BUPRENORPHINE. Hopefully, with Methadone and behavioral treatment, addiction and overuse can be controlled if not cured.
We, my fellow citizens, should really be aware of this insidious tragedy at work. We have dealt as a country and even the world over with alcohol abuse. Alcoholism is itself a terrible disease. But it seems as though we are almost encouraging the use of other drugs no matter their effect because we have legalized the use of alcohol. So, why not marijuana? And of course, the growing, production, sale and distribution and use of marijuana now becomes legal in any number of states and more to come. What, the critics ask, is next? In fact, opioids, as prescribed drugs are also legal and perhaps more to come. Hopefully and prayerfully, my fellow Americans, we rise up and deal with this tragic epidemic and prevent its spread, minimize its addictive powers, monitor the use of all such drugs among our family and friends especially, attack the illegal producers and distributors and band together in the spread of information, education and public awareness of this DEFCON 5 tragedy.
If not, millions of Americans and especially young Americans and those under 50 will be lost to our society and become medical, economic and cultural burdens perhaps for the rest of their lives. I for one pray we act, stand together and deal with this tragic opioid crisis with all of our might. For the sake of our country, our future and the very structure and foundation of our nation:
WE HAVE NO OTHER CHOICE!