Can the Opioid Overdose Epidemic Ever Be Curbed?

In my previous column about Scott Weiland’s death, I made the point that for every celebrity who gets media coverage for going to rehab, there are thousands of common folk who overdose in silence.

The only coverage they get is in the statistics column.

In the past year alone, the total number of drug-related overdoses in the United States exceeded 47,000. Up 7% from last year, these cases include prescription painkiller deaths, which increased to nearly 19,000, and heroin deaths, which climbed to about 10,500.¹

The more I see numbers like this, the less I think that man’s manipulation of the poppy was a good idea.

Dying soldiers from the era of Alexander the Great were given the poppy plant to chew on, passing on with smiles on their faces.

Its natural purpose was perfect, but the 2 problems were:

1. Using the plant recreationally.

2. The human race’s inherent need to make a naturally occurring substance more powerful.

In the later 1800s, when heroin and morphine syringes were available in the Sears and Roebuck catalog, pharmaceutical benefit was looked at, but nobody noticed the seeds of addiction being planted in society.

It hasn’t gotten any better since. The scheduling of heroin as Class I and other opioids as Class II came too little too late.

Yes, people are responsible for their own actions, but physicians, pharmacists, and even the government have hefty hands in the overdose epidemic.

Over the years, the line between managing somebody’s symptoms and gross overprescribing has thinned. The hospice care “days-to-live” doses of 20 years ago are today’s daily, lifetime maintenance doses.

Pharmacists used to question these outrageous doses incessantly, but we got tired of the lectures from the physicians about medical necessity, as well as the hassle from patients on why we won’t “just give them their medicine.” We also prefer not to have the talk with management on why we are refusing to fill prescriptions.

Since the pain management boom of the mid-1990s, the FDA has been increasing the amount of opiates that can be produced annually. I’m not sure what the current total is, but you could probably ski down it.

The point is that in all of the years I have been practicing, I didn’t know that there were limits on such things. While blood pressure medications are constantly on back order, causing pharmacists to really scramble, I haven’t seen it happen to an opiate since I've been licensed.

There is plenty to go around for the pharmacies and the streets. Prescribed or not, American culture is drug happy.

From prescribed psychiatric cocktails to illicit self-medication, we like to ingest things that improve our mental well-being. The drug war of the Nixon era has been an abject failure.

Billions have been spent on law enforcement, yet the drugs are still there and thousands are still dying from them.

Jay Sochoka, RPh, is the author of Fatman in Recovery: Tales from the Brink of Obesity.

Reference

1. Stobbe M. Painkillers, heroin drive increase in US overdose deaths. The Associated Press. December 10, 2015. http://bigstory.ap.org/article/e1b453e5622744708eae9175daad5e55/painkillers-heroin-drive-increase-us-overdose-deaths. Accessed December 14, 2015.