The Gristle

Symptoms of Pain

Wednesday, April 25, 2018

SYMPTOMS OF PAIN: It suggests volumes about the condition of America that we’re suffering a national epidemic of addiction to painkillers—overprescribed on narcotics as a means to gloss the cruelest aspects of our benighted health care options, overconsumed as a means to numb our suffering receptors.

Today’s opioid crisis is already the deadliest drug epidemic in American history. Opioid overdoses killed more than 45,000 people in the 12 months that ended in September, according to the Centers for Disease Control and Prevention. The epidemic is now responsible for nearly as many American deaths per year as AIDS was at the peak of that crisis. And similar to that earlier crisis, early federal policy response has been almost nonexistent.

Roughly 2.6 million people suffer from opioid use disorder. But some experts say that data, which is based on a government survey, underestimates the number of pain patients who are addicted to their prescription pills because of how doctors ask people about drug use—the actual number might exceed 5 million, according to the Annual Review of Public Health.

Senator Patty Murray, the top Democrat on that body’s national health committee, this week released a new report on the economic impact of the opioid crisis in Washington and other states. The analysis, modeled after a national analysis conducted by the Council for Economic Advisers, found that in 2016 alone the opioid crisis cost Washington state more than $9 billion in fatalities, health care spending, addiction treatment, criminal justice, and lost productivity.

The analysis was released as the U.S. Senate prepares to vote on the bipartisan Opioid Crisis Response Act of 2018, which—if approved—may direct financial and support resources to a mounting national epidemic.

“While we can show that opioid-related deaths cost billions to Washington state, we also know that no calculation can show the loss each one of those tragedies meant to families and loved ones across our state,” Murray said, pledging to champion solutions that can help fight addiction and save lives.

Opioids and opiates include prescription painkillers—such as oxycodone, hydrocodone and methadone—as well as heroin, morphine and derivatives like fentanyl.

The number of opioid-related overdose deaths has increased dramatically in recent years, with deaths doubling over the past decade and quadrupling over the past 16 years. Forty percent of these deaths involved a prescription opioid.

Research indicates that 80 percent of those addicted to opioids and opiates of any form began their addiction with prescription painkillers. One study by Johns Hopkins Center for Drug Safety and Effectiveness estimated the volume of prescription opioids in circulation in 2017 amounted to 52 pills for every American.

In Whatcom County, 30 percent of residents surveyed reported experiencing a situation where they or someone they know personally had medicines taken from them for use or abuse by someone else. Admissions for opioid detox in Whatcom County increased more than 75 percent from 2000 to 2015, according to county research, fatal overdoses increased 22.8 percent—very much in line with national statistics.

Earlier this month, Whatcom County joined the widening legal fight against makers and wholesalers of prescription opioids, claiming they have contributed to a public health crisis. County Council voted unanimously to retain legal counsel to join Everett, Tacoma and other communities around the state in lawsuits against the distributors of these over-prescribed painkillers.

“There is a fairly strong record that certain pharmaceutical companies engaged in deceptive practices with doctors and patients about whether these products would be addictive, and aggressively over-encouraged physicians to overprescribe them,” Council member Todd Donovan explained.

In May 2007, Purdue Pharma, producer of the opioid oxycontin, pleaded guilty to misleading the public about the drug’s risk of addiction and agreed to pay $600 million in one of the largest pharmaceutical settlements in U.S. history. The City of Everett initiated a lawsuit against Purdue based on increased costs for the city from the use of oxycontin. Other communities in Washington have modeled similar actions on a broader scale as a means to develop financial support to address the public costs of opioid addiction.

“We’re seeking some support for the programs we have here locally to address opioid abuse,” Donovan said. “The goal for Whatcom County is to get some kind of judgment that requires these companies to help mitigate [these issues] and help us support programs to combat opioid addiction.”

After a protracted study period, the Whatcom County Health Department has finally begun distributing the opioid reversal drug naloxone through a five-year federal grant, replicating in reduced form the promising program initiated by Lummi Nation for tribal members.

Last year, the health department distributed 299 kits, containing 598 doses. Of that, 73 kits were used to reverse overdoses, according to reports provided to County Council. This year to date the county has distributed nearly 100 kits. The program is part of a statewide effort to widen access to naloxone, initiated by the governor’s executive order to address the emergent public health crisis.

“Blame for the opioid crisis is often placed on the supply side,” the National Institute for Drug Abuse cautions. “But we cannot hope to abate the evolving crisis without also addressing the lost hope and opportunities that have intensified the demand for drugs among those who have faced loss of jobs and homes due to economic downturns. Reversing the opioid crisis and preventing future drug crises of this scope will require addressing the economic disparities, housing instability, poor education quality, and lack of access to quality health care that currently plague many of America’s disadvantaged individuals, families, and communities.”

Past Columns
As Above, So Below

October 16, 2018

As Below, So Above

October 10, 2018

A Civil Disagreement

October 3, 2018

Zombie Pipeline

September 26, 2018

Too Little, Too Late

September 19, 2018

Open Secret Disclosed

September 12, 2018

Consent of the Governed

September 5, 2018

Let the People Decide

August 29, 2018

3-in-1 Oil

August 22, 2018

A Deeper Dive

August 15, 2018

Blue Wave Stalls Offshore

August 8, 2018

Mountains of Our Efforts

August 1, 2018


July 25, 2018

Trust Is Reciprocal

July 18, 2018

Pressure in the Bottle

July 11, 2018

Sharing the Pain

July 4, 2018

A Supreme Shifting

June 27, 2018

The Costs of Failure

June 6, 2018

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All-Paces Run

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