Politicians Get the Opioid Crisis Wrong as Patients Suffer and Street Drugs Kill

http://www.breitbart.com/big-government/2018/04/18/politicians-get-opioid-crisis-wrong-patients-suffer-street-drugs-kill/

Determining the true cause of the opioid crisis is crucial – is it prescription painkillers or street drugs? Congress should not be passing legislation to solve the wrong problem. There will be serious public health consequences for cracking down on the wrong type of drugs.

The crisis will not abate if the real problem is not addressed effectively. There are good reasons to fear that special interests are pushing us in the wrong direction by targeting deep-pocketed pharmaceutical companies instead of elusive street dealers and foreign drug cartels.

A critical data point was provided by research confirming what police and doctors working on the front lines have said for years: the center of gravity in the opioid epidemic shifted from the overprescription and abuse of prescription painkillers to heroin and deadly fentanyl about a decade ago. If policymakers insist on treating pain medications as the more serious aspect of the epidemic, they will be making a grave mistake.

The skeptical position on our current drug war, stated bluntly, is that trial lawyers are eager to bring enormous lawsuits against pharmaceutical companies, and they have more than enough political influence to shape legislation. Many legislators prefer the narrative of rapacious Big Business getting the American people hooked on pills to reap windfall profits.

On the other hand, there is no money to be made by going after drug dealers and street gangs. There is no political profit from tightening border security to choke off the flow of drugs from Mexico and South America. Border security looks like all pain and no gain to politicians – they get hassled by activists, ridiculed as xenophobes by the media, and shunned by special interests. Fighting the War on Drugs is even more thankless, as clear-cut victory has proven elusive for decades.

One element of the opioid crisis is a problem the Washington elite loves to attack, while the other is something it doesn’t want to touch with a ten-foot pole. It seems reasonable to worry that the establishment will reverse-engineer a diagnosis that justifies the course of treatment it would much rather pursue.

Daniel Horowitz wrote in the fifth installment of his opioid series at Conservative Review that the danger of political misdiagnosis was the primary reason he set pen to paper (or keyboard to pixel, if you prefer):

The politicians are still blind to nature of the illicit drug/chemical warfare crisis in this country that they misleadingly refer to as a prescription opioid crisis. The good news is that Congress has made this issue the top legislative priority for the coming month. The bad news is that, as we have noted in our continuous series of articles, legislators are completely misdiagnosing the problem, ignoring the data showing both what the crisis actually is and what caused it. As such, their solutions are making the problem worse, as they focus exclusively on government practicing medicine, monitoring patients, restricting prescriptions and even morphine use in hospitals (not just outpatient prescriptions), and shoveling billions of dollars to special interest health care cartels to “treat” a problem they refuse to properly identify.

This week, four House and Senate committees will hold hearings and analyze over 30 pieces of legislation to address the “opioid crisis.” Almost all of the hearings, witness testimony, and legislation fail to address the core problems causing the alarming flood of illicit drugs: Mexican cartels, transnational gangs, open borders, and sanctuary cities.

Horowitz added that even the prescription drug side of the opioid crisis has been deliberately misunderstood for political reasons:

To the extent that this is a health care issue, they refuse to address the 800-pound gorilla in the room – the role of the Medicaid expansion fueling over-use of painkillers among Medicaid patients, a population inherently vulnerable to addiction, while they severely restrict use of much-needed painkillers for other patients.

At least one major government report, released by the Senate Homeland Security Committee in February, has examined the relationship between Medicaid expansion and increased levels of painkiller prescription and abuse, but it was resolutely ignored by the media and trashed as a cheap shot at Obamacare by Democrats.

Horowitz charges that the current round of congressional hearings on the drug crisis “feature heads of organizations and programs that stand to benefit from endless taxpayer funds,” while very little attention is paid to the politically awkward and unprofitable problem of drug cartels flooding America’s streets with heroin, fentanyl, and cocaine.

Meanwhile, a legal offensive comparable to the gigantic lawsuits against Big Tobacco is taking shape in the courts, led by some of the same lawyers and firms that went after the tobacco companies.

“The prospect of the biggest payday since the $200 bill­­ion tobacco settlement in 1998 has drawn many of the same plaintiff lawyers who appear again and again in big tort cases over everything from VW diesels to Vioxx to the BP Deepwater Horizon disaster,” Daniel Fisher observed at Forbes in January, as multi-district legislation against opioid manufacturers and distributors gained momentum.

Fisher quoted University of Georgia law professor Elizabeth Burch comparing the legal muscle behind these mega-lawsuits to an “oligopoly” and noting that “the same five lawyers are involved in practically every proceeding.”

Lawsuits against drug companies and distributors allege they have deceived the public on a massive scale with advertising for their products, flooded markets with opioids, pushed doctors to prescribe them, and failed to investigate illicit drug orders properly. The industry responded by accusing litigants of misunderstanding how the distribution system for prescription drugs works and turning pharmaceutical corporations into lucrative scapegoats.

On the legislative side, Senator Bernie Sanders (I-VT) introduced a bill this week targeting opioid manufacturers with $7.8 billion in fines for deceptive advertising and establishing criminal liability for corporate executives found to have “contributed to the epidemic.”

Sanders expressed a desire to extract even more money from the industry to deal with the drug crisis he accuses them of creating: “At a time when local, state and federal government are spending many billions of dollars a year, those people will be held accountable and asked to contribute to help us address the crisis. It shouldn’t just be the taxpayer that has to pay for the damage that they did.”

If Congress and the courts get the opioid crisis wrong, patients who truly need medication for chronic pain will suffer even more than they already do. They already complain that the drugs they need have been excessively stigmatized and doctors have been intimidated out of writing prescriptions.

The patients themselves resent being treated like drug addicts. They have good reason to fear their access to vitally needed medication will grow even more restricted, between heavy-handed legislation and lawsuits that could clobber drug companies with billions of dollars in damages and settlements. Insurance companies are in the mix as well, performing calculations of benefit and risk, including legal risk, that can contradict the judgment of physicians.

“I’m looked at as an addict. I feel this stigma every single day: you’re a chronic pain patient, you must be an addict,” fibromyalgia patient Edwina Caito told the IndyStar in November.

“Nobody is hearing us, because everyone on the no-opiate bandwagon is screaming the loudest and we don’t have a voice.” Caito added.

Some doctors are worried that severe new limits on prescription opioids proposed by the Center for Medicare and Medicaid will leave chronic pain patients unable to obtain the medications they need. Doctors who questioned the new limits said they could force patients to seek out more dangerous illegal substances to manage their pain or even drive them to suicide.

“People who are gonna use heroin and fentanyl are gonna go ahead and use it. People who are really dependent on opioids, because there is no access to treatment, they are gonna move on to heroin. Only set of people this is going to affect is a lot of people who are stable on this medications,” Yale University addiction medicine fellow Dr. Ajay Manhapra predicted in March.

In early April, officials with the Centers for Disease Control conceded that its 2016 guidelines on opioid prescription might have been based on flawed data. Specifically, the research supporting the guidelines was criticized for failing to distinguish between overdoses of legally obtained pain medication and deaths resulting from illicit heroin and fentanyl. The number of deaths attributed to prescription drugs in 2016 was almost doubled by this faulty analysis, according to doctors who believe the CDC should scrap its current guidelines completely and explain why the data was handled so badly.

None of this is meant to absolve drug companies of all possible misbehavior, argue that prescription drug abuse is no longer a problem at all, or dismiss all funding for addiction treatment as taxpayer money siphoned off by special interests. The point is that government at every level should examine the opioid crisis clearly and honestly, with the vision of lawmakers as unclouded as possible by big money or political narratives, before regulations are imposed and funds are allocated.

There are already too many examples of people suffering unnecessarily because the problem has been diagnosed incorrectly. There should be no room in this process for political narratives, hidden agendas, grandstanding, or blind panic.

4 Responses

  1. Your article is almost exactly correct. You just aren’t nearly cynical enough. The congressmen know exactly what the truth is. They would rather kill off millions of innocent chronic pain patients and disabled veterans by depriving them of access to pain meds and cut costs by over a trillion dollars than do what is right and attack the mexican cartels and illegal heroin/fentanyl analogs since there isn’t any money in that and the mexican cartel pays them to leave them alone and would retaliate and shoot them if they bothered them. It is so much more in keeping with their goals to kill off 10s of millions of the weakest member of society through attrition and suicide and have them no longer be a drain on social programs or insurers and the congress can still sue the big pharma for billions. Isn’t that always the politically expedient solution for politicians in the USA do what is best to line their own pockets? Never what is best for the american public. That might cost them some money. The don’t care what the truth is or what the facts are. The care what makes the wealthiest wealthier. What will lower the median lifespan in america. What will make insurers happy so they can get donor money. What will keep costs lowest and keep killing off those elderly. So undertreat pain. That will surely kill them prematurely quicker than just about anything else we can think of. That’s how cynical you should be.

  2. Thank you so much Steve! Are they blind? Pain patients have called, written,faxed, texted used Resistbot. People have met with their congressional leaders. Doctors and patients have testified before panels, State Boards. People are not given pain relief after surgical procedures, gall bladder removal, knee replacement, hip replacement as well as open heart surgery. Are they really blind, or is our death their agenda, their goal?

    • On February 28th i had a 3 level acdf cervical discs 3 thru 7 was replaced with cadaver bone i have a plate on one side that connects to another on the other side. My pain was what woke me up in post op and i was freaking out hallucinating each time i came to. Then i heard someone say to dc the ketamine. I kept telling them i was in terrible pain but nothing was done. My pain pump i saw right before it was dcd was only delivering 000.01 of dilauded every 6minutes if i pushed the button. It did nothing for my pain. I was given 3 .5mg of oxy every 3hours which barely took the edge off for approx 20 minutes. It was so horrible i finally went and checked into the er to see if they’d help me out they called the charge nurse on my floor and she came down and spoke to me andi was finally medicated on idk what but went to sleep and slept good since i came to from the surgery i was awake for approx 72hours after coming to begging them to do something for my pain. It’s been undertreated for the whole 6weeks i was given pain meds. And when i kept telling them it wasn’t adequate they told me to go to my local er which would do next to nothin. My life is nothing but a complete nightmare. I’ve got so many health issues popping off right now and my pcp and my internal medicine doc i saw yesterday formy positive ra and lupus results included myalgia encephomyletis central nervous system sensory syndrome bone and joint disease fibromyalgia and each one says i need to get into pm but nobody will write the freaking referral for me to start getting treated. It’s a shitshow and i’m left to suffer while they figure it out

  3. I knew the CDC was grossly negligent with the 2016 guidelines statistics. tomorrow I’m back on the grind. I’m going after 4 of the 12authors my research has indicated are responsible for the the issues many of us have been faced with and been thru so much and still not given enough to feel adequate enough to just get a shower. Along with those 4 I’ll be including the incident of August 28, 2017, fire the malicious intent and denial of treatment, which i have told ya’ll about that has scarred me for life so it seems and I’m still pretty mental about it all. It was so terrible that we moved.

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