Saturday, April 29, 2017

GateHouse: Opioids: The medicine that kills

Matthew T. Mangino
GateHouse Media
April 28, 2017
The opioid crisis has moved from local misfortune to national calamity. Every day something new pops up that shocks the senses. This week, the Washington Post wrote about a new drug making the rounds. The new drug is Carfetanil, a substance used to tranquilize elephants. Carfetanil is 100 times more potent than Fentanyl, the powerful synthetic opioid that killed Prince.
In recent weeks, police departments across the country announced Carfentanil-related fatalities, including Maryland, Illinois, Ohio, Colorado, Wisconsin and Minnesota.
Are addicts afraid? Not likely. Last year this post appeared on the online discussion website, Reddit, “(h)ad my first Overdose yesterday, and it took 15 minutes of cpr and 35 minutes of manual breathing after the initial dose of narcan ... Okay so my question ... If i got narcan’d at 430pm central yesterday, when could i use dope without wasting it?”
Narcan, also known as Naloxone, is a drug that can counter an overdose. Many first responders and police officers carry Narcan to revive naive and uninformed drugs users who were duped into overdosing. Not so fast, last fall the Pennsylvania State police investigated an alleged drug overdose of a Johnstown police officer who was on duty and inside the Public Safety Building at the time, reported the Johnstown Tribune-Democrat.
Opioids are normally prescribed synthetic medicines that produce a morphine-like effect. They are most often use in painkillers such as Percocet, Fentanyl, Oxycodone and OxyContin.
No place has experienced the suffering of opioid addiction more than West Virginia. The Charleston Gazette-Mail analyzed shipment data from the U.S. Food and Drug Administration and found that 423 million opioid painkillers were delivered to West Virginia between 2007 and 2012. During that time, almost 2,000 people died from opioid overdoses.
In Kermit, West Virginia, population 392, drug companies shipped nearly 9 million opioid pills over 2 years to a single pharmacy.
Hamilton County, Ohio, which includes Cincinnati and nearly 50 law enforcement agencies, experienced an average of 50 to 70 reported overdoses a week in early 2016. One month after law enforcement learned Carfentanil had hit the county, overdoses skyrocketed to about 175 to 200 calls a week, reported The Post.
Drug overdoses already kill more Americans than car crashes and homicides, and the problem may be worse than it appears. Dr. Victoria Hall recently told CNN, “It’s quite concerning, because it means that the (opioid) epidemic, which is already quite severe, could potentially be even worse.”
More important, there’s no “national standardization for how to fill out a death certificate,” Hall told CNN, so when there’s a profound infectious disease, such as pneumonia, that’s the only thing noted. Hall fears as many as 50 percent of opioid overdoses go unreported.
The Donald Trump administration has called for spending $500 million more on opioid addiction in his proposed budget for the fiscal year beginning in October.
Democrats are not convinced of the administration’s commitment to the issue, noting that the health care legislation supported by Trump this year would have eliminated a requirement that Medicaid cover mental health and substance abuse.
Neither money nor politics will solve this problem. There comes a point when the destruction caused by a medicine outweighs the benefit. Imagine if there was an FDA approved drug that helped half the people who took it and killed the other half.
Would the FDA, the Congress, the public tolerate such odds? No, it is time to take opioids off the market.
-- Matthew T. Mangino is of counsel with Luxenberg, Garbett, Kelly & George P.C. His book The Executioner’s Toll, 2010 was released by McFarland Publishing. You can reach him at www.mattmangino.com and follow him on Twitter @MatthewTMangino.

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