Myths Of The Opiate Crisis

The so-called opioid epidemic, notwithstanding the fresh attention attracted by the recent death of Prince, which may have involved prescription painkillers.


According to the National Survey on Drug Use and health (NSDUH), nonmedical use of opioid analgesics such as oxycodone and hydrocodone peaked in 2012 and has since dropped below the rate in 2002. Although the recent decline in prescription painkiller use was accompanied by an increase in heroin use, total opioid use was still lower in 2014 than in 2012. Despite the decline in use, reported by the Centers for Disease Control and Prevention (CDC) continued to rise through 2014, when there were 29,467, a record number. An overwhelming majority of such deaths—more than nine out of 10, according to data—involved mixtures of opioids with other drugs rather than straightforward overdoses.


That pattern, illustrated by the untimely ends of celebrities ranging from Janis Joplin to Philip Seymour Hoffman, suggests that the most effective way to prevent opioid-related deaths is to discourage people from combining painkillers or heroin with other drugs, especially depressants such as alcohol and benzodiazepines. It also suggests that the inherent deadliness of opioids has been greatly exaggerated. The CDC says “health care providers wrote 300 million prescriptions for painkillers in 2012, enough for every Noth-American adult to have a bottle of pills.” That year the CDC counted about 16,000 deaths involving opioid analgesics, or one for every 16,000 or so prescriptions.


Some of the legislative responses to the increase in opioid-related deaths, such as shielding people who report overdoses from criminal charges and making the opioid antagonist naloxone more widely available, are sensible. But the crackdown on painkiller prescriptions is bound to hurt bona fide patients while driving opioid users to black-market heroin, which is more dangerous because its potency is unpredictable—a hazard created by an earlier round of antidrug legislation. A little bit clearer now-I hope.


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Photo credit: wiseGEEK  




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