Like I've been saying for years. But here's some official confirmation.
As
the death toll from opioid overdoses in Kentucky and the rest of the
Midwest continues to soar, it’s truly disconcerting to see that
policymakers are taking steps that are not only devoid of medical and
common sense, but virtually guaranteed to make matters worse.
The
recent passage of the ill-conceived House Bill 333, which imposes a
three-day limit (with certain exceptions) on opioid prescribing,
reflects a fundamental misunderstanding of the reasons behind the
addiction epidemic.
All this new law will
accomplish is to make matters worse for both pain patients and addicts.
The former will suffer needlessly; the latter will die in even greater
numbers.
The absence of common sense in
Kentucky’s approach to this problem is mind-boggling. Lawmakers, who
believe that further tightening of the already-stringent legal
prescription practices of opioid painkillers will stop the wave of
deaths that has hit the region so hard, have it dead wrong.
It
is crystal clear in multiple states across the country that the
overwhelming majority of opioid overdose deaths are not a result of
pills. Death from opioid pills (in the absence of other drugs) is
uncommon.
Perversely,
the increase in deaths we are seeing now is a direct result of the
difficulty in obtaining pills. Within the past decade, opioid pills
became difficult to get and prohibitively expensive, which caused
addicts to switch in droves to heroin. This is the root cause of soaring
overdose deaths, not pills from pharmacies.
Second,
and far worse, heroin is no longer the “safe” drug that it once was.
Over the past three years, it has been increasingly mixed with, or
replaced entirely by, fentanyl and its far more potent chemical cousins.
It is this progression from pills to heroin to fentanyl that is
responsible for the skyrocketing overdose deaths we are now seeing.
Although it is convenient and plausible to blame today’s
crisis on prior over-prescription of pain medications, this is simply a
false narrative. This is seen in multiple literature analyses,
including a review of 30 studies in the journal Pain and a comprehensive
Cochrane review, which examined 26 more.
Patients
who are being treated responsibly for moderate-to-severe pain rarely
become addicted. The Cochrane review found that only 0.46 percent of
pain patients became addicted. The vast majority of today’s
addicts became so by using opioid pills recreationally and later
progressing to injectable opioids once the supply of pills dried up.
But the real victims here are pain patients.
Many
of them, who have been treated for very painful chronic injuries or
medical conditions for decades, are terrified of being cut off from the
medicines that are essential for their survival. That’s because states
are already beginning to impose arbitrary limits of maximum daily doses
of the drugs.
That is both cruel and
scientifically flawed, especially since it’s known there is a very wide
range in how people metabolize opioids — as much as a 15-fold difference
between individuals, which drastically affects blood levels of the
drugs.
This ensures a “one-size-fits-all”
approach is doomed to fail. Although anecdotal, stories involving
suicides of pain patients who have been unable to obtain the drugs that
they need just to exist are easy to find.
When
states and government agencies crack down on a legally prescribed,
essential medicine, they are not only addressing the wrong problem but
also are making matters worse for both addicts and patients. Laws such
as Kentucky’s may seem to make sense on the surface, but even a little
digging reveals how flawed they really are. Everyone gets hurt.
Legalize pot. It's the only way out.