After twenty years of escalating fatalities, I don’t know how we could avoid the conclusion that America is seriously overdependent on opioids.

Here’s an informative piece from Ezra Klein’s Vox  website that provides an overview– not just of the overdose issue, but of how we use opioids in medicine, versus other developed nations.

Some of the facts cited:

  • With just 4% of the world’s population, the USA accounts for 27% of its overdose deaths — the vast majority of those are opioid-related.
  • Again, that’s 4% of the world’s population consuming around 30% of its opioids.
  • In 2015, 8.5 million Americans “misused” opioid painkillers. If we include heroin, then some 2.5 million of us would qualify as addicted.
  • America – 33,000 opioid fatalities. All of Europe put together: 6,800.

It’s the unique trait of an addictive substance: It’s self-reinforcing, meaning it creates its own demand. The more we rely on it in medicine, the greater the risk of problems. Fatalities naturally draw the most attention, but the range of adverse consequences is actually far greater.

As we move to correct this, we’ll discover that millions of Americans, regular tax-paying citizens included, are already dependent on opioids. They’ll experience withdrawal symptoms as availability decreases. The discomfort of withdrawal and the presence of drug hunger will undermine their judgment and perhaps cause them to turn to street opioids as a replacement. We’ve already seen that phenomenon.

That brings on a host of other problems, as street drugs aren’t subject to quality control. There are no warning labels, no fear of malpractice suits– street sales are the free market at its absolute purest.

Except in this case, the product is both addictive and potentially dangerous.

As the article notes, taxation has been effective in reducing overall consumption of tobacco and alcohol, but raising the price of an addictive substance does spur the emergence of a vigorous black market.

At this point, the best we can expect is progress of the incremental sort. It won’t be the dramatic success that politicians crave as they build their political careers. We’ll need to track outcomes carefully from the outset, simply to convince a skeptical public. Our strategy will need to be focused on the long term, rather than a series of high-profile attempts to “fix” opioid use in America.

Is it doable? Sure. Maybe now is the time, as the nation is finally “woke”.

 


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