Thursday, July 8, 2021

Opiod Overdoses are Up and Prescriptions are Down - Did All of This Legislation Accomplish Anything?


I was reading this article in one of my favorite news sites and I couldn't help but wonder what all of the "clamping down" on prescriptions has gotten us.

I will readily admit that the prescribing pendulum had gotten way to one side.  People were getting pain medicine for darn near *everything*.  Perdue Pharma even managed to convince the healthcare field that pain was a vital sign.  That was wrong.

However, instead of 'pumping the breaks' and working on educating professionals to cut back prescribing AND providing more treatment, legislatures *stood* on the brakes and began passing all kinds of laws that limited prescribing.

No one seemed to figure out that overdoses were a sign of addiction.  The unfortunate result of all of these pain pills flying around was that lots and lots of people got addicted.  That even applies to good God fearing folk who took them as directed.  After a while even following the rules creates physical dependency.  Then suddenly all of those people who were dependent were cut off... cold turkey.

And guess what?  When you cut off the legal supply and people start going through withdrawal, the black market of illegal drug sales is more than happy to make up for the sudden legal deficiency.

Illegal drugs aren't regulated.  Users don't know what they are taking, but they take what they are sold because withdrawal is a horrible, painful thing they want to avoid. Unfortunately the drug dealers are now lacing their products with Fentanyl.  That provides a significant high, but is also highly, highly addictive.  There's also a pretty low margin of safety.  A *tiny* amount of Fentanyl can be fatal.

Here's a scenario I'd like you to consider.  Someone being treated for chronic pain becomes physically dependent on hydrocodone.  They go to their doctor for a refill and are told the doctor will no l longer refill this prescription.  A day or so after the last pill they start to get sick... really sick.  The withdrawal is horrible.  The person can't work, can't sleep, can't eat, and are doing time in the 9th circle of hell.  In desperation they buy illegal pills that they are told are hydrocodone.  But instead, they get hydrocodone laced with Fentanyl.  Within a few days they are REALLY addicted and the cycle continues.  More illegal pills, more Fentanyl, more addiction.

Society has let this person down.  They were left with a physical dependence and no way to cope with it.  No treatment, no weaning off, no nothing.  But hey, fewer prescriptions are written so it's all good right?

A philosophy professor once told me "you cannot legislate morality" and truer words were never spoken.  As opioid and opiate prescriptions have gone down, illegal drug sales including for heroin have gone up more than proportionately.  Basically we've traded legal drugs for illegal ones and people are STILL dying.  It's sad.

I feel where the mistake in all of this is, was a lack of addiction and dependence treatment.  Leaving folks to go through withdrawal with no support system is inhumane.  You cannot just cut the supply, you have to change the entire dynamic.  People are still dying.

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