If you’ve been paying attention to the nationwide narcotic catastrophe that is now claiming 142 lives every day (and seems to be getting worse), you may be shaking your head in disbelief. If so, it is not without reason. The idea that slapping three-day caps on Vicodin and Percocet prescriptions will in any way decrease overdose deaths is so supernaturally stupid that no one could really believe this nonsense anymore, right? No, wrong.
According to a new article in the Charleston Gazette-Mail, the faulty premise of controlling the overdose dilemma by restricting pain medications is still pervasive throughout the country. So much so that there are now 17 states that have passed laws limiting the number of days of opioid prescriptions, the total number of pills, and the maximum dose, with the goal of putting the breaks on an unprecedented epidemic of overdose deaths. How’s that working out? Exactly as you would predict—terribly.
Before I discuss the foolish actions that are blindly being implemented by regulators and legislators and how badly they are failing, we need to first understand the real causes of today’s opioid catastrophe. Because without a clear understanding of the problem, even a rational plan of attack – let alone a solution – will be impossible. Unfortunately, there is little evidence that public health officials understand what is really going on, which is why we keep hearing the same illogical and hackneyed responses over and over. Here’s the real story.
Today’s opioid overdose crisis began in force in 2010 (Figure 1), in what was a quintessential example of the law of unintended consequences. After years of research, Purdue Pharma finally discovered a new formulation for OxyContin—a significant driver of opioid addiction since its introduction in 1996. The new formulation was difficult to abuse; when users tried to grind up the pills so the drug could be smoked, snorted, or injected it turned into a gum instead of a powder as it had before.
Grinding up OxyContin before and after reformulation. Prior to 2010, the pill was easy to grind up, which defeated its time-release formulation, to give as much as 80 mg (16 Percocet pills) of pure oxycodone, which could be snorted, smoked or injected. The new formulation changed that. Photo: Popular Science
Figure 1 (below) shows a clear inverse relationship between the availability of abusable OxyContin and the subsequent mad rush to heroin—a fact that the press, the CDC, and many politicians either don’t understand or, choose to ignore. This is beyond obvious. Simply look at the red arrows on both graphs. As OxyContin use dropped (left) heroin overdose deaths soared (right). This relationship is indisputable. Although pre-2010 OxyContin played a significant part in creating a huge population of opioid addicts, it could be argued that the improvement of the pill inadvertently did even more damage. Addicts could no longer get the pure oxycodone they needed and promptly switched to heroin. This switch marked the beginning of the unprecedented surge in heroin (now fentanyl) deaths that now appear on the news almost every day.