US opioid deaths rise as gov'ts cut prescriptions

The Lethal Success of Pain Pill Restrictions - Jacob Sullum, Reason Hit and Run:

May 9, 2016 - "In a speech on Monday, Attorney General Jeff Sessions said the Justice Department is striving to 'bring down' both 'opioid prescriptions' and 'overdose deaths.' A study published the following day suggests those two goals may be at odds with each other, highlighting the potentially perverse consequences of trying to stop people from getting the drugs they want.

"Columbia University epidemiologist David Fink and his colleagues systematically reviewed research on the impact of prescription drug monitoring programs (PDMPs), which all 50 states have established.... Fink et al. say the evidence that PDMPs reduce deaths involving prescription opioids is 'largely insufficient,' adding that 'implementation of PDMPs may have unintended negative outcomes — namely, increased rates of heroin-related overdose'....

"The picture looks worse when you take into account deaths involving illegally produced drugs, which now account for a large majority of opioid-related fatalities.... To the extent that PDMPs succeed in making pain pills harder to obtain, they encourage nonmedical users to seek black-market substitutes. 'Changes to either the supply or cost of prescription opioids after a PDMP is instituted,' Fink et al. observe, 'might reasonably drive opioid-dependent persons to substitute their preferred prescription opioid with heroin or nonpharmaceutical fentanyl'....

"If the aim is preventing drug-related deaths, this shift is counterproductive, to say the least. Because their purity and potency are inconsistent and unpredictable, illegally produced opioids are much more dangerous than pain pills.

"A report published last month by the health care consulting firm IQVIA shows that the total volume of opioids prescribed in the United States fell by 29 percent between 2011 and 2017, from 240 billion to 171 billion morphine milligram equivalents. According to data from the U.S. Centers for Disease Control and Prevention (CDC), deaths involving pain pills nevertheless rose by 24 percent from 2011 to 2016, while total deaths involving opioids rose by 85 percent.

"That trend includes a 252 percent increase in heroin-related deaths and an astonishing 628 percent increase in deaths involving the opioid category that consists mainly of fentanyl and its analogues. Final CDC figures for 2017 are not available yet, but the provisional numbers indicate there will be more increases....

"Since the current strategy is manifestly not working, drug warriors are, as usual, redoubling their efforts. The Drug Enforcement Administration, which sets annual quotas for opioid production, reduced the limit by 25 percent in 2017 and 20 percent this year."

Read more: http://reason.com/archives/2018/05/09/the-lethal-success-of-pain-pill-restrict

Prohibition the real cause of the 'opioid crisis'

Stop Calling It an Opioid Crisis - Foundation for Economic Education - Working for a free and prosperous world - Jeffrey A. Singer, Cato Institute:

January 18, 2018 - "For nearly a decade, policymakers have bought into the misguided narrative that the opioid overdose crisis is a result of careless doctors and greedy pharmaceutical companies getting patients hooked on prescription opioids and condemning them to the nightmarish world of drug addiction. As a result, the Drug Enforcement Administration has ordered decreases in prescription opioid production. There was a 25 percent reduction in 2017 and a 20 percent reduction is ordered for 2018.

"States have set up monitoring programs that put doctors and patients under surveillance leading to a dramatic reduction in the prescription of opioids since 2010. In fact, high-dose prescribing fell 41 percent since 2010.... This focus on the supply and prescription of opioids makes many patients needlessly suffer in pain. Some, in desperation, turn to the illicit market to get relief, where they find heroin and heroin-laced fentanyl often cheaper and easier to get. Some others resort to suicide.

"Policymakers mistakenly focus on doctors treating their patients in pain. By intruding on the patient-doctor relationship, they impede physician judgment and increase patient suffering. But another unintended consequence is that, by reducing the amount of prescription opioids that can be diverted to the illicit market, they have driven nonmedical users to heroin and fentanyl, which are cheaper and easier to obtain on the street than prescription opioids, and much more dangerous....

"The overdose rate is not a product of doctors and patients abusing prescription opioids. It is a product of nonmedical users accessing the illicit market.

"The problem will not get better — it will probably only get worse — as long as we continue to call this an 'opioid crisis.' The title is too nonspecific. This is a crisis caused by drug prohibition, an unintended consequence of nonmedical drug users accessing the black market in drugs.

"Policymakers should stop harassing doctors and their patients and shift their focus to reforming overall drug policy. A good place to start would be to implement harm reduction measures, such as safe syringe programs, making Medication Assisted Treatments like methadone and suboxone more readily available, and making the opioid antidote naloxone available over-the-counter, so it can be easier for opioid users to obtain. Even better would be a sober reassessment of America’s longest war, the 'War on Drugs.'"

Read more: https://fee.org/articles/stop-calling-it-an-opioid-crisis/
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BC drug minister open to decriminalizing heroin

PM says no to decriminalizing drugs, B.C. addictions minister open to idea | Toronto Star - Camille Bains, Canadian Press:

September 7, 2017 - "Prime Minister Justin Trudeau has closed the door on decriminalizing illicit drugs to combat a national overdose crisis but British Columbia’s addictions minister says unprecedented deaths are a 'wake-up call' to reconsider that stance.

"Trudeau said decriminalization is not the approach Canada will take to deal with deadly overdoses often involving the opioid fentanyl.

"'We are making headway on this and indeed the crisis continues and indeed spreads across the country but we are not looking at legalizing any other drugs than marijuana for the time being,' Trudeau told a news conference Thursday at the end of a caucus meeting in Kelowna, B.C....

"Judy Darcy, British Columbia’s minister of mental health and addictions, said criminalizing people for having limited amounts of drugs for their own use instead of providing treatment puts them at risk of fatally overdosing.

"'I think we need to have this conversation in this country,' she said of decriminalizing small amounts of drugs such as heroin. 'Sometimes governments need to be pushed.'

"Darcy said decriminalization would go a long way in destigmatizing substance use because shame often bars people from getting treatment or even using supervised consumption sites.... 'If this overdose crisis is not a wake-up call, I don’t know what is,' she said. 'Not treating addiction the way we would any other chronic condition clearly is not working'....

"The BC Coroners Service said 876 people died in the province between January and July, up from 483 fatalities during the same months last year.

"Darcy, who spoke about the epidemic Thursday at a drug-conference headlined by an addictions expert from Portugal, said that country’s experience of decriminalizing limited amounts of some drugs in 2001, along with providing more treatment and programs that address stigma, should serve as a lesson for Canada."

Read more: https://www.thestar.com/news/canada/2017/09/07/pm-says-no-to-decriminalizing-drugs-bc-addictions-minister-open-to-idea.html
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Bradshaw wants BC voters to have more options (video)

Kamloops-South Thompson candidate profile: Jessica Bradshaw (Libertarian) - Kamloops This Week - Cam Fortems:

April 24, 2017 -"Jessica Bradshaw was looking for something a little different on the ballot for the May 9 provincial election.... 'I want people to have another option,' said the Libertarian candidate in Kamloops-South Thompson. 'I [was] looking for one and couldn’t find it. So I became one'....

"She is joining a long list of Libertarian candidates across B.C. The party is running a candidate in nearly half of B.C.’s 87 ridings. It pledges to repeal the carbon tax, bring in school vouchers to let parents take children to private or public school and allow private medical care — stripping away many of the rules and regulations of living in B.C. The party would allow private competition to agencies including BC Hydro, ICBC and WorksafeBC.

"''It’s not like I don’t like rules,' she said. 'It’s just regulations and rules government sets out have done more damage than benefit. It’s overregulation that causes issues with people.'

"The party also advocates for decriminalization of drug use. 'I think the illegality of it forces a lot of addicts to the point where they’re getting fentanyl. If it were decriminalized or legalized it would bring up the safety factor. It puts them at less risk'.....

"Bradshaw said she is largely a one-woman campaign at this point.... 'I’m going it alone. Other people have campaign teams and I’m just doing it myself.'"

Read more: https://www.kamloopsthisweek.com/kamloops-south-thompson-candidate-profile-jessica-bradshaw-libertarian/
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Opioid makers spend big to stop legal cannabis

Why Big Pharma is Spending so Much Money to Defeat Marijuana Initiatives - Hit & Run : Reason.com - Eric Boehm:

October 28, 2016 - "Legal marijuana will poison children and cause more Arizonans to die in car crashes, according to scary television and online ads running across the state in advance of Election Day. 'Edibles that look like candy, marketed to kids,' warns one ad, with a voiceover meant to sound like a concerned mother....

"The ads were created by Arizonans For Responsible Drug Policy, a group that's encouraging voters to reject Arizona's Proposition 205, which would allow people aged 21 and older to possess up to an ounce of marijuana and grow up to six plants in their own homes. Arizona is one of [five] states — along with California, Massachusetts, Maine and Nevada — that could vote to legalize recreational weed on November 8.

"Despite the voices and faces in the ads, though, Arizonans For Responsible Drug Policy and similar groups urging 'no' votes on marijuana legalization in other states are not funded by concerned parents and public officials. In large part, these groups are funded by pharmaceutical companies trying to protect their share of the market for painkilling drugs — and in Arizona, the biggest donor to the 'No On 205' campaign is a company that's been investigated for its role in overdose deaths.

"That company, Arizona-based Insys Therapeutics Inc., is best known for manufacturing a pain relief spray that contains fentanyl, an opioid that's been under heightened scrutiny for its role in several overdose deaths, including the high-profile death of Prince in April..... Insys Therapeutics in August made a $500,000 contribution to Arizonans For Responsible Drug Policy, the largest donation the group has received from a single source.

"It's not just happening in Arizona. According to a report from The Nation, Purdue Pharma and Abbott Laboratories, makers of the painkiller[s] OxyContin and Vicodin, respectively, are among the largest contributors to the Anti-Drug Coalition of America. Meanwhile, the Pharmaceutical Research and Manufacturers of America, which advocates on behalf of drug companies, spent nearly $19m on lobbying in 2015, according to a report from The Guardian, which called PhaRMA 'one of marijuana's biggest opponents.' Federal lobbying data aggregated by Maplight shows that PhaRMA has spent more than $150 million on lobbying since 2008 — a total that only includes federal lobbying efforts, not similar work done in state capitals, where PhaRMA is also active....

"[I]t's worth asking why they would be so keen to spend millions of dollars fighting marijuana legalization.

"One big part of the answer is that states with legal marijuana — medical or recreational — have lower rates of drug prescriptions."

Read more: http://reason.com/blog/2016/10/28/why-big-pharma-is-spending-so-much-money
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