Thank You, Doc, for Your Kind Introduction

Remember when marijuana was the arch-villain in the 1936 motion picture, Reefer Madness? All though the 1960s until well into the new millennium, weed was described as the ultimate “gateway” drug. All that anti-marijuana proselytizing, all those claims of the massive and inevitable harm that begins with a single puff, probably did more to decimate the credibility of so many anti-narcotics claims. Users knew the damage from weed was marginal under the most destructive moments, and the young subculture applied that logic to dismiss the entire “just say no” anti-drug effort. Aside from its medical benefits, marijuana seems to be no more culpable that a cocktail, a fact more than vindicated in the vast legalization efforts for marijuana all across the United States. 

Even into the current day, Marijuana (cannabis, THC) and Synthetic marijuana and analogs (Spice, K2) are listed under federal law as “DEA Schedule 1” narcotics, along with heroin, LSD, peyote, etc. This puts so many state legalization efforts directly contrary to obviously antiquated federal drug policies. Federal enforcement can easily turn what is legal at a state level into a U.S. felony, a factor which also prevents state-legal marijuana suppliers from accessing the normal banking system, which is federally insured and operates under federal rules. This inane approach to illicit drugs, treating truly differentially-impactful drugs as if they were all the same, has made countering genuine drug problems that much more difficult. Among too many Americans, illegal drugs are just part of daily life, and the government’s enforcement policies “have always been out of step with the cooler culture.” The “everybody does it” reason to ignore the law. The “boy who cried wolf once too often” syndrome?

But do we have a drug problem in this country! Not just teenagers and young adults sowing their post-pubescent wild oats, not just artists and musicians or gangbangers, but lots of ordinary people at all ages who got hooked on prescription painkillers and never looked back. We’ve seen the epidemic also rise in areas of abysmal rust-belt unemployment, where hopelessness over jobs that will never return justifies (at least in their minds) a coping mechanism.

The numbers are anything but comforting. According to research and projections based on those findings, published on February 8^th in the journal JAMA Network Open,  opioid addiction and the concomitant deaths from overdose are going to continue to rise even if we somehow begin to stem the tide of doctors’ over prescribing painkillers; slowing the epidemic’s upward trajectory of opioid death before 2025 will require broad-based action and more than a bit of luck. According to the February 10^th Los Angeles Times, which summarized the above study, “[The] new projection of opioid overdose death rates suggests that even if there is steady progress in reducing prescription narcotic abuse across the country, the number of fatal overdoses — which reached 47,600 in 2017 — will rise sharply in the coming years.

“By 2022, these deaths would peak at around 75,400, and begin to level off thereafter, according to the new forecast… And that’s the rosiest scenario. Under conditions that are only slightly less optimistic, the U.S. could see 81,700 opioid overdose deaths per year by 2025.

“If the supply of prescription painkillers stops declining and there are other setbacks, researchers predict that yearly opioid overdose deaths could rise as high as 200,000 per year by 2025… No matter how you slice it, the nation’s opioid epidemic ‘is not finished growing,’ said Jagpreet Chhatwal of Harvard Medical School and Massachusetts General Hospital, who led the research… ‘It’s far from over,’ he said. ‘And it’s far from moving in the right direction.’

“Almost two decades after the widening use of prescription painkillers began to fuel an epidemic of addiction, opiates are claiming an average of 130 lives a day in the United States, according to the Centers for Disease Control and Prevention.” Oxycontin has certainly been over prescribed, but these days the explosion of overdose deaths seems to be caused more by the super-powerful heroin substitute, fentanyl, a painkiller that seems simply to have morphed into a plain killer. Bringing this epidemic under control will require multipronged attacks and is likely to take a decade or more. The issue even creeps into trade agreements, such as our limiting Chinese-manufactured fentanyl from being imported into the U.S. market.

And no, massive amounts of fentanyl that enter the United States illegally (and lots of the stuff is made here, much of it legal) are not spilling over those vast empty desert tracks of open border where occasional economic and political refugees cross. That’s just too difficult and inefficient. The problem lies at our busiest airports, truck crossings and harbors, where virtually all international fentanyl enters the country, legal and otherwise. A border wall with Mexico wouldn’t make the slightest dent in fentanyl trafficking. It going to take some realism, not a vanity wall that makes for clever sloganeering, to tackle this very serious overdose issue.

“The mathematical models [reported by the JAMA] that suggest a leveling-off of opioid deaths by 2022 require, first, that medical and public health professionals continue to drive down the numbers of Americans who get their first taste of addiction from a legitimate pharmacy prescription.

“They also assume that fewer Americans will start on the path to addiction with an illicit street drug such as heroin, or that successful treatment for such addictions will surge… Finally, this scenario assumes that progress in fighting the opioid epidemic won’t get blown up by some unforeseen trend, such as the appearance of a new and more lethal drug.

“In a market where illicit drugmakers are richly rewarded for introducing new products, narcotics such as the synthetic fentanyl — more addictive or more lethal than opioids already on the market — can appear seemingly out of nowhere.

“In short, Chhatwal said, reversing the surging epidemic will not be fast and it will not be simple… ‘Bending the curve’ will probably require a multi-pronged effort that includes limiting the supply of prescription painkillers that get into patients’ hands, providing more and better treatments for the addicted, increasing the use of overdose-reversal agents like Narcan, and shutting off the flow of heroin and fentanyl pouring into the country.” LA Times. And if those assumptions do not happen…? Wasting money on a border wall, not addressing the real causes and cures for the spike in opioid addiction and death, will only make a bad situation that much worse.

              I’m Peter Dekom, and why are hard facts and down-and-dirty reality so completely difficult for the tweet/slogan addicted Trump administration to accept?