In 2016, more than 42,000 people died in the United States as a result of opioid overdoses, according to a study done last year by the Centers for Disease Control and Prevention (CDC). And while heroin, which is an illegal opioid, contributed to the number of deaths, the CDC study found that 40% of all opioid overdose deaths involved a prescription drug. The usual culprits are oxycodone (brand name OxyContin), hydrocodone (brand name Vicodin), morphine, Fentanyl and methadone, all of which are addictive and are commonly prescribed by doctors in the US and elsewhere for moderate to severe pain.
Late last year, the US declared that it was in the midst of an opioid overdose epidemic and President Donald Trump announced a public health emergency and the start of a war on opioids. However, the latter consists mainly of anti-drug messages and tougher law enforcement, reminiscent of the other war on drugs. The ‘Just Say No’ campaign did not have the desired impact and law enforcement is still chasing down the bosses, sellers, buyers and users of the hard drugs targeted in that war which seemingly has no end.
The irony of prescription drug addiction is that it afflicts sick people who go to doctors for help and are prescribed drugs that have the potential to make them that much more helpless. Prescription drugs on the whole have numerous side effects, long lists of them in some cases that must be weighed against the illness and the lesser of two evils decided on.
The problem with opioids is that patients who are handed prescriptions often do not have the necessary knowledge that may cause them to refuse these drugs in the first instance. It usually is the classic case of a visit to the doctor’s office or hospital for an injury involving pain and receiving a drug that takes away that agony. However, some people, one in four, according to the CDC study, are susceptible to becoming hooked because of the feeling induced by the drug.
Moreover, an audit confirmed that over the years, the number of prescriptions written for opioids increased exponentially growing to nearly 250 million prescriptions in 2013, which is alarming when one considers that the entire population of the United States is just around 320 million. The CDC found that the numbers of prescriptions being written for opioids did not tally with the nation’s state of health, and sure enough it was found that there were several doctors who were basically selling opioids to addicts. Guyanese-born Dr Noel Blackman was one of them.
The now-disgraced Blackman, who was a former health minister of Guyana under the PNC administration as well as an executive member of the World Health Organisation, practised as a medical doctor out of clinics in Queens, Brooklyn and Long Island in New York. He pleaded guilty in 2016 to illegally distributing oxycodone and was last year sentenced to 50 months’ imprisonment and three years of supervised release.
In addition, he was made to forfeit US$536,200 said to be the illegal proceeds of his actions. According to court documents, he admitted to selling over 1,900 prescriptions to addicts at a cost of US$300 a pop. Despicable does not aptly describe such actions and unfortunately, there are many other medical officers who have done/are doing the same thing; to date at least 20 doctors in the state of Kentucky have faced charges for selling opioid prescriptions. Investigators have found that the problem is widespread across the US. Doctors are being caught, disciplined and/or charged as the case may be, and their patients prescribed a different narcotic drug, which is intended to detoxify them. There is clearly no shortage of irony in this tragic turn of events.
It is estimated that some two million Americans are addicted to or abuse opioids. In the last three years more than 60,000 of them went beyond reach, not to mention the thousands of others in previous years. Then there are those who upgrade to heroin and slip under the radar of this particular effort.
However, not everything done to date has been reactive. Last year, the CDC issued new prescribing guidelines for doctors, which should see them trying other options for pain management and making an opioid prescription more of a last resort. They are also mandated to tell patients about the risk of addiction as well as to check databases to try and find out if the patient has been receiving opioids anywhere else.
This would hit at the root of the addiction crisis, but it seems that there is some amount of difficulty in enforcing and policing these guidelines as there is no discernible slowing in the epidemic just yet. One snag, of course, is the dollar signs some providers see when an addict shows up. Like the rest of us, doctors are human, products of society and susceptible to failings.