Opioid overreaction creates a new ‘forgotten man’

Thomas Hennigan

Dr. Perry Cox, the bitter but witty character on the sitcom “Scrubs,” once observed: “It turns out we can’t save people from themselves — smokers, drinkers, druggies, fatties, whatever.”

But if you’re a state attorney general looking to score some cash based on the hype of an “opioid epidemic,” you’ll do just fine.

The lawsuits are inspired by those filed against “Big Tobacco” and the riches that settlement brought. But, as ClassAction.com points out, this time there’s a smaller profit pie and a lot more plaintiffs who want a piece.

Even with the tobacco “Master Settlement Agreement,” all has not been perfect. There has been some reduction in smoking-related diseases According to an American College of Chest Physicians 2010 report:

l The tobacco industry is alive and well.

l Smoking, tobacco use levels have plateaued (albeit and a lower rate than in 1990).

l The ghost of Joe Camel is still inveigling kids to start using tobacco.

l And the financial woes of the last decade caused many states to raid MSA monies for other purposes.

Next year will bring 20-year longitudinal studies and perhaps the news will be better, but the notion that a settlement between manufacturers and the states is a cure for addiction to a product is wishful thinking.

As of this writing, Purdue Pharma L.P. has tentatively settled lawsuits with 22 state and tribal entities suing it.

Faced with a death-of-a-thousand-cuts ordeal in the courts, Purdue — a major opioid producer — is trying to buy off the angry mob of plaintiffs out for its blood.

A report from National Review pegs the settlement amount at $12 billion. National Review also reports that the sum isn’t enough for some of the more outraged attorneys general.

It would have been better had the wise words of North Dakota’s Burleigh County District Judge James Hill prevailed:

“Purdue has no control over its product after it is sold to distributors, then to pharmacies and then prescribed to customers. ... The state’s effort to hold one company to account for this entire, complex public health issue oversimplifies the problem.” (Bismarck Tribune)

Too late for Purdue is the update from the National Survey on Drug Use and Health that “Opioid Deaths Do Not Correlate with Pain Pill Abuse or Addiction Rates,” as the headline at Reason put it on Sept. 3.

Writer Jacob Sullum summed up the significance of the survey:

“The evidence does not favor a simple narrative in which more opioid prescriptions led to more abuse and addiction, which in turn led to more deaths. The ‘opioid crisis,’ which seems to be part of a long-term upward trend in drug-related deaths that began in 1979, might more accurately be described as a problem of increasingly reckless polydrug use, a problem that cannot be solved — and may be worsened — by demanding wholesale reductions in pain pill prescriptions.”

Said wholesale reduction is, of course, just what the Center for Disease Control’s 2016 opioid prescription guidelines have created, worsening life for chronic pain sufferers. Blogger Teri Peters shows how the guidelines have created a new “forgotten man.” (https://ordinary-times.com/2019/06/24/the-other-victims-of-the-opioid-crisis)

Peters tells of chronic pain patients who have played by the rules for years, only to find themselves maligned as “drug seekers” in an overkill reaction to the CDC guidelines by doctors, insurers and pharmacists.

Most of them had heeded warnings about addiction and were already metering their opioid use and supplementing it with any effective alternatives. (Please do the same and get help doing so if you feel painkillers are getting the better of you.)

Peters shares several anecdotes about the overreaction to the opioid “crisis,” including a stage 4 cancer patient who couldn’t get a prescription filled.

She notes that there was some pushback this year against that overkill:

“ ... a group called Health Professionals for Patients in Pain wrote to the Centers for Disease Control and Prevention, urging the agency to respond to the ‘widespread misapplication’ of its 2016 Guideline for Prescribing Opioids for Chronic Pain. ... The letter was signed by more than 300 health professionals, including three former U.S. drug czars.”

However, that pushback wasn’t enough.

Now Purdue wants to settle.

Now the over-simplified narrative has prevailed over NSDUH’s math.

Media “opioid epidemic” hype continues, crises make good copy.

Illegal use of opioids continues more or less as it has. Overdoses will continue to increase because prescription use isn’t their source.

Law-abiding opioid prescription-holders will continue to serve as the whipping boy for abusers who buy street-corner fentanyl.

It all stinks. Now, about vaping.

Hennigan, of Lewiston, is an instructional technology administrator at Lewis-Clark State College. His email address is t0by_belch@yahoo.com.

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