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A letter that started a crisis

Millions have been affected, and tens of thousands die every year from the so called opioid crisis in the US. Preliminary data shows that last year drug overdose has killed well over 62 thousand people in America, a 19% increase. And the problem keeps deepening. It has become the leading reason for mortality among Americans under 50 years of age, NYT reports. In comparison, car accidents have killed about 40 thousand people, now giving up the top spot in the ranking, the NSC reports as well. And this, despite the fact that 2016 was the deadliest year in terms of car accidents. (.pdf)


The number of overdose deaths has been constantly growing since the 80s, when it was under 10 thousand annually. The problem has more to do with illegal drugs than the legal sales of pain-relief drugs. For the last 3 decades, both the US and Canada have developed a mass practice of prescribing painkillers based on opioid alcaloids. This happened after fierce lobbying and advertisement campaigns from several big pharmaceutical corporations that declared "war on pain and suffering". In result, millions of people have become addicted to strong painkillers. There is now talk of an opioid crisis in North America the size of an epidemic.

In the 90s, both physicians and drug producers agreed, and many are still agreeing, that America does have a serious problem with pain. Tens of millions of Americans feel debilitating chronic pains and remain untreated on a regular basis. The solution, supported by misleading PR from the pharmaceutical companies, has been the prescription of powerful painkillers based on opioid alcaloides such as OxyContin, Percocet and Vicodin.

This leads to unforeseen and devastating results, MSN News explains. The drug abuse is constantly increasing, resulting in a steady increase of fatal cases from overdose related to these drugs. In cases where the politicians and physicians can no longer ignore the problem, they tend to partially restrict access to these drugs. But federal data shows that many patients have now become dependent and have not only not quit painkillers but they have shifted to cheaper and more poerful opioids such as heorine and even Fentanyl.

Canadian researchers have traced the origins of this opioid crisis back to a latter that was published almost 40 years ago. It argues that powerful painkillers based on opioid alcaloids do not lead to addiction. The letter was published at the New England Journal of Medicine in 1980. The researchers believe the prestige of the magazine had largely contributed to the false notion in the US that opioids are harmless.

The letter, which is actually quite short, has been cited over 600 times in various publications, many of them explivitly making the case that opioids do not lead to addiction. Specifically, it claims that a survey involving 11,882 patients with no prior history of addictions, who were treated with opioid-based drugs, resulted in just 4 subjects ending up with a newly acquired addiction. Although the research describes the effect of drugs that are no longer in use today in controlled conditions, that letter was used by the pharmaceutical companies as proof that modern drugs like Oxycotin are harmless in extra-hospital conditions.

However, in 2007 the producers of Oxycotin pleaded guilty in federal court for having erroneously claimed that the drug was less addictive and less subjective to abuse than other pain-control medicines.

But of course this did not help stop the opioid crisis even one bit. The genie had long been out of the bottle at that point. The crisis is far from being solved today, more than ever. In 2016, former president Obama called upon the legislators in Congress to take action, and he admitted there was no simple solution to a problem so complex that not only kills thousands eveyr year but ruins the lives of many more. Back then, he said the only way to decrease demand of these drugs is to provide accessible treatment, and treat the issue not as a purely health-related problem but also as criminal.

Now in March, president Trump announced the establishment of a special committee for dealing with the opioid crisis. "It's a total epidemic", he commented. Except, Trump's apparent readiness to face the powerful pharmaceutical lobby seems questionable, especially given his federal budget proposal for 2018, where funding for the services for national drug control has been slashed by 95%, from 388 to 24 million dollars. All indications point to the epidemic becoming a disaster of epic proportions within the next few years.

Source: Talk politics.

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