oxycodone – Opiate Nation

The Politics of Drugs: Purdue & the DOJ

(Seventh in a series of topical blogs based on chapter by chapter excerpts from Opiate Nation. Translation into most languages is available to the right.)

When public health is at risk, one can only wonder about the motives behind politicians’ decisions – our “public servants” as they used to be referred to – regardless of what they may say. But we don’t have to guess their motives because actions speak louder than words and the actions of the US Department of Justice (DOJ) this week regarding Purdue Pharma and the Sackler family are unconscionable. This deal is not justice for the victims and their families for this pervasive and criminal corporate greed.

Lifespan of Heroin & Opioid Addicts

(Second in a series of topical blogs based on chapter by chapter excerpts from Opiate Nation. Translation into most languages is available to the right. If you feel this blog is important, please repost to your social media using the buttons below. Thank You!)

When our 25 yr old son died of a heroin overdose in 2014, the statistics for the average life-span of a heroin addict was 5 years. Five years. Not very long if you are 15 or 20 or even 30, the age when most young adults’ nowadays are just getting in gear with their career, a long-term relationship, and planning a family. To have your life swept away before you have a chance to experience some of the most wonderful years of living on this earth is painful to consider.

Where the Buck Stops and Where It's Hiding

Arizona brought a case to the Supreme Court that sought to stop the Sackler family, who own Purdue Pharma, from transferring billions of dollars from the company in an attempt to avoid paying the claims made against them concerning flooding communities with the prescription opioid painkiller Oxycontin. The Court said they would not hear the case – the justices like to hear rulings from lower courts first.

One of the places the Sackler’s have hidden their money is in an estate in England. A recent article* states: “A complex web of companies and trusts are controlled by the family, and an examination reveals links between far-flung holdings…The estate is proof of the great wealth belonging to the family accused of playing a key role in triggering the US opioid epidemic. But there’s little evidence of that connection. On paper, the land is owned by a handful of companies, most based in Bermuda, all controlled by an offshore trust.” Read the rest of the article which cites the Associated Press’ findings of the deceptive and convoluted practices of a family dynasty that has lived like kings and queens off the misery and deaths of millions of people world-wide. Our son was one of them.

An estimated 10.3 million Americans aged 12 and older misused opioids in 2018. These estimates are likely too low. How many people who are taking opioid Rx’s for pain that could be relieved by physical therapy or a change in lifestyle actually report they are “mis-using” them? My next blog will delve further into this aspect of a country that has become averse to pain…

America’s Love Affair with Opioids

Andrew Sullivan’s 2018 article for the NY Magazine entitled “The Poison We Pick”, wrote: “…For millennia, the Opium Poppy has salved pain, suspended grief, and seduced humans with its intimations of the divine. It was a medicine before there was such a thing as medicine. Every attempt to banish it, destroy it, or prohibit it has failed…This nation pioneered modern life. Now epic numbers of Americans are killing themselves with opioids to escape it…According to the best estimates, opioids will kill up to half a million Americans in the next decade.

“Most of the ways we come to terms with this wave of mass death…miss a deeper American story. It is a story of pain and the search for an end to it. It is a story of how the most ancient painkiller known to humanity has emerged to numb the agonies of the world’s most highly evolved liberal democracy. Continue reading “America’s Love Affair with Opioids”

Medication Assisted Treatment – Part 1

Medication Assisted Treatment, or MAT, is finally gaining acceptance as a response to drug addiction in the US––it is a cultural shift from the view that addiction is a “moral failure.” The Hazelden Betty Ford Foundation, one of the top drug treatment providers in the country, used to subscribe almost exclusively to the abstinence-only model, based on an interpretation of the 12 steps of Alcoholics Anonymous and Narcotics Anonymous popularized in American addiction treatment in the past several decades. But in 2012, they announced they would begin providing MAT. There are four opioid substitutes that are used for MAT in opioid addiction: methadone, buprenorphine, naloxone, and naltrexone. More on these in the next blog.

November 6, 2013, the New York Times did an extensive article discussing the development, use, and risks of opioid substitutes, in particular bupreorphine and the combination drug, Suboxone. The author explaining that “While addiction is considered a chronic, relapsing disease, experts believe that replacing illegal drugs with legal ones, needles with pills, or more dangerous opioids with safer ones reduces the harm to addicts and to society. Addicts develop a tolerance to its euphoric effects and describe themselves as normalized by it, their cravings satisfied. It also diminishes the effects of other opioids but, studies have shown, does not entirely block them, even at the highest recommended doses.”

In a Frontline report in 2016, one of the doctors who specializes in addiction medicine related that doctors are limited by the DEA to treat only 100 patients per year with Suboxone. The thought behind this law is that they don’t want it to be abused––and it can be abused, as a commodity sold on the street to ward of withdrawals or for those who cannot afford the cost of a doctor and the medication. Our family faced the dilemma of the high costs for the doctors visits and the Suboxone because they were not covered by our son’s health insurance. We made the decision for him to not use this option, all hoping that a sober living house and meetings would help him succeed in his desire for sobriety. He was dead from a heroin overdose 7 months later.

The physician on Frontline pointed out the contradiction––the contradiction that has frustrated me and my husband for years––that there is still no limit on how many oxycodone or other opioid prescriptions physicians can write—the very abuse of which is documented to be fueling the opiate epidemic and creating the need for Suboxone. I personally experienced this absurd mentality towards opiates when my oral surgeon sent me home with 60 Vicodin after a root canal––60. I used two. He is the same oral surgeon who did JL’s wisdom teeth extraction and gave him multiple prescriptions for Percocet two weeks before and two weeks after the surgery––which fueled his relapse on heroin and ultimately, his death. He should have his license revoked.

As of a 2017 report by SAMHSA (Substance Abuse and Mental Health Services Administration), physicians who have prescribed buprenorphine/Suboxone to 100 patients for at least one year can now apply to increase their patient limits to 275 under new federal regulations. It is good to see movement in the right direction and I hope there will be more progress soon, especially in terms of making medication options a covered public health care benefit available to addicts who want to get their lives back.