Congress Is in Denial: The War on Drugs Is Driving Opioid Addiction

 In Defense

The American Psychological Association Dictionary of Psychology defines “denial” as “a defense mech­a­nism in which unpleas­ant thoughts, feel­ings, wishes, or events are ignored or exclud­ed from con­scious aware­ness. It may take such forms as refusal to acknowl­edge the real­i­ty of a ter­mi­nal ill­ness, a finan­cial prob­lem, an addic­tion, or a partner’s infi­deli­ty…”

Many pol­i­cy­mak­ers, includ­ing many in Congress, remain in a state of denial about the true cause of the over­dose crisis: drug prohibition.

The Centers for Disease Control and Prevention’s October 4, 2020 provisional report on over­dose deaths for the 12-​month period ending March 2020 shows a total over­dose death rate of 73,860 (up from 67,726 a year ear­li­er), of which 52,488 are opioid-​related. 39,535 (75 per­cent) of the opioid-​related deaths involved illic­it fen­tanyl and 13,793 (26 per­cent) involved heroin. Prescription-​type opi­oids were found among 12,002 of opioid-​related deaths (23 per­cent). Methamphetamine and psycho-​stimulants were found in 17,435 (33 per­cent), and cocaine was found in 16,970 (32 per­cent) of total over­dose deaths, also up dra­mat­i­cal­ly over the past year.

Despite these glar­ing num­bers, Senator Elizabeth Warren (D‑MA) and Representative Katherine Clark (D‑MA) joined with other House and Senate col­leagues in send­ing a letter to the Drug Enforcement Administration urging the agency to final­ize new reg­u­la­tions that would allow phar­ma­cists to par­tial­ly fill opioid pre­scrip­tions if they judge that patients don’t require the entire amount of opi­oids pre­scribed.

As Josh Bloom of the American Council on Science and Health points out:

On the sur­face, it would seem that the new reg­u­la­tion would be harm­less, pos­si­bly even help­ful. For exam­ple, it would enable some­one with a pre­scrip­tion for 20 Vicodin tablets to tell the phar­ma­cist “Gee, I don’t really need 20, just give me 15.” (As if that’s ever going to happen in this uni­verse.) What is far more likely is for the phar­ma­cist to say “you only need 15, not 20″ which isn’t the least bit dif­fi­cult to believe since phar­ma­cists have been hap­haz­ard­ly impos­ing their own lim­i­ta­tions pre­scrip­tions for years :

“As a patient advo­cate and health­care writer who is very active in social media, I see reports from thou­sands of patients who have been denied a refill of valid pre­scrip­tions for opioid pain med­ica­tions. This is par­tic­u­lar­ly true for pre­scrip­tions at high doses. And it is a trend rein­forced by insur­ance providers and phar­ma­cy chains as policy with­out sci­en­tif­ic sup­portIt’s pretty obvi­ous that Elizabeth Warren and her col­leagues lit­er­al­ly don’t know what they are talk­ing about.” — Richard “Red” Lawhern, Ph.D., Co-​founder of the Alliance for the Treatment of Intractable Pain, and a member of the ACSH Scientific Advisory Board

The sup­posed ratio­nale is to reduce the number of unused pre­scrip­tion opi­oids that can get stolen or oth­er­wise divert­ed into the black market for non-​medical use.

But the DEA and other pol­i­cy­mak­ers have effec­tu­at­ed a dramatic reduction in opioid pre­scrib­ing only to see the over­dose rate climb, as non-​medical users have switched over to cheap­er and more read­i­ly avail­able heroin and fen­tanyl pro­vid­ed by the effi­cient black market. Furthermore, there is no correlation between pre­scrip­tion volume and non-​medical use or addic­tion among per­sons age twelve and up.

As mil­lions of patients get abrupt­ly tapered off of their chron­ic pain med­ica­tions, and mil­lions of others go under-​treated for acute pain, pol­i­cy­mak­ers remain in a state of denial and con­tin­ue to press a quixot­ic war on pre­scrip­tion opi­oids in which patients in pain are civilian casualties.

This arti­cle first appeared at the Cato Institute.

Image: Reuters.

National Interest source|articles

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