To understand the opioid epidemic it helps to consider another addiction, one that persists longer leaving a trail of illness, disability and death while providing massive profits.
Even when all of the facts are on display, however, we need to acknowledge, and we especially need our elected officials at all levels to acknowledge, the severity of the opioid crisis and the unique challenges it presents.
While many offer condolences for the grieving, we need more than thoughts and prayers. We need massive amounts of money and a commitment to techniques that can work if given a chance. These include often-controversial efforts such as needle exchanges and supervised injection sites as well as medication assisted treatment, which is not always available and not always covered by insurance.
There was a time not too many years ago when tobacco use was both widespread and tolerated, a time when the research that revealed the deadly effects was known only to those inside the industry. Now New York state is going after Purdue Pharma, the maker of OxyContin, with similar allegations of fraud and deception. Other governments have taken action in hopes that the company responsible for creating what one called a “criminal nuisance” would pay for its transgressions.
Both crusades seek to tap the massive wealth of companies that ignored warnings in pursuit of profits. But there are dissimilarities, ones that make the opioid crusade more difficult.
While nobody needs to smoke, we have a significant number of people in chronic pain. As we know from centuries of experience, if there are strong medications they will be abused.
The first step, one that should have been taken long ago, would have been taken had Purdue been more forthcoming, is to make sure that medication is available only to those who need it in appropriate dosages with appropriate controls to reduce the possibility of addiction. We have made great strides in that area with limits on prescriptions and refills and laws forcing pharmacies to take back unused medication.
But the opioid epidemic is not isolated. Successful efforts to reduce the supply of pills and the ability of people to abuse them have sent many addicts into the illegal drug world, one in which heroin becomes the cheaper, more available alternative to opioids. And as we see daily in reports of overdoses and deaths, heroin is often mixed with even deadlier, even more addictive substances.
When we were fighting tobacco, there was a steady supply of good news. Each year brought charts showing how many people had stopped smoking. With opioids, we have only bad news getting worse.
In 2016, we set a record with 64,000 people dying from overdoses. Preliminary numbers for 2017 from the Centers for Disease Control and Prevention show that total rising to 72,000.
While it is dramatic to compare that to deaths from HIV/AIDS, guns, car accidents or casualties from the Vietnam and Iraq wars combined, we really do not need any more drama.
This is an election year. Ask those seeking your vote what they have done about this epidemic. Then, after hearing their promises, ask them again and again and again.