US communities crumbling under an evolving addiction crisis

March 19, 2017
Pills. Credit: Public Domain

Of the 2,900 babies born last year in Cabell County, West Virginia, 500 had to be weaned off of opioid dependence.

In Ohio, counties are renting refrigerated trailers to store the mounting number of bodies of drug overdose victims.

In New Hampshire, hospitals have so many overdose patients they have to treat them in operating rooms and neonatal nurseries.

And in Palm Beach County, Florida, where President Donald Trump spends his weekends, 10 people died of overdoses on Friday alone, likely from a batch of heroin tainted by fentanyl, a powerful, synthetic opioid pain medication.

After a decade and hundreds of thousands of deaths, the US opioid addiction crisis is entering a new phase. With the government finally cracking down on the free flow of prescription pain killers fueling the crisis, addicts are turning to heroin pouring in from Mexico.

And towns, cities and states are being overwhelmed.

Overdose deaths surging

More than 33,000 people across the country died in 2015 from opioid overdoses, up 15.5 percent from 2014. That equated to a record 10 for every 100,000 people—10 times the level in 1971, when the US government declared its "War on Drugs" after a surge in overdoses.

But whereas six years ago four out of five overdose deaths came from prescription painkillers like oxycodone and hydrocodone, now heroin and heroin-fentanyl deaths account for about half.

In Cabell County, the overdose death rate was about 30 per 100,000, not even the highest in West Virginia, the state hit hardest by the addiction crisis.

Lawyer Paul Farrell last week filed suit for Cabell and a neighboring county, Kanawha, seeking damages from drug companies for dumping massive amounts of addictive opioids into the state, fueling the addiction epidemic.

"My community is dying on a daily basis," he said. Every sixth baby born locally suffers from neonatal abstinence syndrome, in which a mother's addiction is passed on to her child.

"The hospital has to rock these babies 24 hours a day as they scream their way through addiction," Farrell said.

He said counties like his had little choice but to sue to force drug companies to pay for the present and future costs of the crisis.

"What we're asking for is not only to hold them responsible for blatantly violating federal and state laws, but to fix the damage they caused, so that we stop creating another generation of addicts," Farrell said.

Hundreds of millions of pills

How prescription opioid producers and distributors fed the crisis is made clear by previously unreleased US Drug Enforcement Agency (DEA) data reported in December by the Charleston (West Virginia) Gazette-Mail.

It showed that from 2007 to 2012, those companies sold 780 million opioid painkillers in West Virginia, 421 extremely addictive pills for every man, woman and child in the poor eastern state.

Every state is feeling the impact. On March 1, Maryland Governor Larry Hogan declared the addiction crisis a "state of emergency," allowing him to draw on funds normally appropriated for natural disasters to deal with the problem.

Two weeks ago, New York City Mayor Bill de Blasio announced a sweeping new campaign to cut addiction, after the city's overdose death toll hit 1,075 last year.

"The pharmaceutical industry for years has encouraged the overuse of addictive painkillers," he said.

From prescription drugs to heroin

The surge in deaths follows a shift in the nature of the crisis. After the DEA last year ordered a 25 percent cutback in the distribution of prescription opioids, addicts turned to heroin. But that drug is frequently cut with extremely potent fentanyl, causing even more overdoses.

"Everybody is starting to see a slowdown of prescription opiates. As you see supply drop, what we are seeing is an equal rise of heroin," said Farrell.

"We are going to see an all-time high transition to heroin abuse in the next five years."

To raise funds to deal with it, cities and counties are suing manufacturers like Purdue Pharma, which makes OxyContin, the most prevalent of the opioid painkillers; mega-drug wholesalers McKesson, Cardinal Health and AmerisourceBergen; and pharmacy operators like Rite Aid and Walmart.

New Hampshire, the New England state which rivals West Virginia for the rate of overdose deaths, has sued Purdue.

"Last year we had 450 overdose deaths" in a state of 1.3 million, Senior Assistant Attorney General James Boffetti told AFP. "Their marketing exacerbated this addiction problem."

Paul Hanly, whose law firm Simmons Hanly Conroy LLC is suing 11 opioid distributors and manufacturers on behalf of Erie County, New York, said the companies' behavior resembled that of neighborhood drug pushers.

"Certain of the conduct that is alleged in our cases and the West Virginia cases do smack of racketeering and conspiracy," he said.

The companies are fighting the suits, denying they are to blame.

In a statement to AFP that reflected the stances of the others, Cardinal Health said: "We believe that these copycat lawsuits do not advance any of the hard work needed to solve the opioid abuse crisis - an epidemic driven by addiction, demand and the diversion of medications for illegitimate use."

The US addiction crisis in numbers

The United States is experiencing a drug addiction crisis of rare proportions. An estimated 2.6 million people are hooked on prescription opioid painkillers like oxycodone and hydrocodone, or on heroin and fentanyl, an extremely potent synthetic opioid. Here are some key facts:

How many Americans are addicted to opioids?

In 2015, an estimated two million Americans were addicted to prescription opioid painkillers, and 591,000 to heroin. But the tightening of supplies of prescription opioids has sent many opioid addicts moving to heroin. Heroin producers and dealers in turn are increasingly cutting their drug with fentanyl, which is so potent that a minuscule amount can turn a standard heroin dose deadly.

How are prescription drugs and heroin use linked?

Experts say four out of five US heroin users started with prescription opioids like oxycodone and hydrocodone. A new study ties the likelihood of addiction to the amount and strength of the opioid painkiller first prescribed by a doctor. Patients who are given a prescription lasting more than three days, or who get a second prescription, or who are prescribed longer-lasting painkillers, are significantly more likely to be using the drug a year later.

How many people are dying from opioid overdoses?

The latest US data show that in 2015, 33,091 people died from overdoses tied to , and fentanyl. That was up 15.5 percent from the previous year, and four times the number of deaths in 1999. Experts say the surge continued last year.

Which states have the highest levels of overdose deaths?

The national average for opioid overdose deaths in 2015 was 10 for every 100,000 people. In West Virginia, the figure was 41.5 per 100,000; New Hampshire, 34.3 per 100,000; Kentucky and Ohio, 29.9 per 100,000; and Rhode Island, 28.2 per 100,000. Nineteen of 50 states saw significant increases in overdose deaths that year.

— Data from the Centers for Disease Control, the Substance Abuse and Mental Health Services Administration, and the American Society of Addiction Medicine

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Adjust slider to filter visible comments by rank

Display comments: newest first

2.5 / 5 (8) Mar 19, 2017
Our health care"system", a collection of Capitalist screeds, makes the patient into the victim.
1.8 / 5 (5) Mar 19, 2017
"With the government finally cracking down on the free flow of prescription pain killers fueling the crisis, addicts are turning to heroin pouring in from Mexico."

Read more at: https://medicalxp...html#jCp

BUILD THE WALL.............of course george will soon respond with why we shouldn't, right george?
1 / 5 (1) Mar 19, 2017
If governments were better about policing workplaces for actual safety then there would be many fewer people who are injured at work and thus put on the opiates to begin with. Also, the CIA has been using military flights to bring heroin in from Afghanistan and West Virginia, where the CIA has it's Training 'Farm', is, amazingly, right at the heart of the worst addicted State we have. This is not even conspiracy theory, this is confirmed facts.
5 / 5 (4) Mar 19, 2017
Benni, I think you're missing what the actual problem is here.

Let me re-quote it from your quote:
"the free flow of prescription pain killers fueling the crisis"

That problem is on the north side of the border. The topic of discussion here is not the wall. If this doesn't make sense, then someone else will have to take a crack at pointing out the problem's root cause.
1.8 / 5 (5) Mar 19, 2017
Air America and the buddy of Ollie North (Albert Hakim), were running it out of Korat Royal Thai Air Force Base when I was there in 1967-68.
Mark Thomas
3 / 5 (2) Mar 19, 2017
"More than 33,000 people across the country died in 2015 from opioid overdoses".

The official numbers for 2016 may not be in, but unofficially they are over 50,000 deaths. Drug overdose is now a far bigger problem than either firearm or automobile deaths in the U.S. EMTs are starting to routinely carry naloxone, a drug that can reverse a heroin overdose, but the number of overdoses continues to rise. This is an extremely serious problem that demands a corresponding serious response.

not rated yet Mar 19, 2017
First let me say that heroin cut with fentanyl is a huge problem here in New Hampshire. I suspect that the heroin is getting cut twice with fentanyl which makes it instantly deadly.

On the other side of the equation, I'm seventy years old, and have fibromyalgia. One of the drugs I take that makes it possible for me to live outside of assisted care is Tramadol, and I take over 1000 doses of Tramadol a year.

What is the solution? The major problem in NH could be solved by making it legal to sell heroin over the counter, and for use in hospitals, and going after the companies that are selling fentanyl, many in China. (Heroin got its name since it was a much better opioid than morphine. Fentanyl is much stronger, but is not better than heroin.)

Oh, and another thing that needs to be widely spread. Opioids are not addictive if taken for pain--and they work. If they don't work, call your doctor and discontinue use immediately.
1.8 / 5 (5) Mar 19, 2017
I have no scorn for those addicted to opioids, they are the victims of our "health care" industry, built to crank out profits.
1 / 5 (3) Mar 19, 2017
Our health care"system", a collection of Capitalist screeds, makes the patient into the victim.

If left alone Opioid addiction is self correcting.
5 / 5 (2) Mar 20, 2017
This article hurts to read. I have a relatively minor chronic pain problem, I cut 50mg Tramadol tablets in half, usually only go through one a day. Five years ago I saw my GP about once a quarter, now it's an expensive obstacle course I have to run every month. Most costs have quintupled and no one is safer.
3 / 5 (2) Mar 20, 2017
I have no scorn for those addicted to opioids, they are the victims of our "health care" industry, built to crank out profits.
-while as a lifelong pothead you are a self-made man, cranking out profits for the cartels.

My sombrero is off to you.
1 / 5 (1) Mar 20, 2017
The cure, unavailable to mothers because of "blighted ovum" aka "Bruce Effect" resorption of embryo caused by pheromones, for heroin addiction is 250mg of healthy adult male facial skin surface lipid pheromone taken by mouth. Airborne emissions from collected skin surface pheromone are emotionally dangerous: astonishment/stupidity, arrogance, suspicion, and finally jealousy. Use supplied air respirators. Use oscillating fans when administering. Use sealed packaging and activated charcoal dunnage. Isolate patients for 40 days, the time it takes for the pheromone to wear off.
3 / 5 (2) Mar 21, 2017
What is the solution? The major problem in NH could be solved by making it legal to sell heroin over the counter
Perhaps the solution is legalizing natural forms of these drugs like opium and coca leaves and marijuana, or even wine and beer, and making their conversion into more potent forms a capital offense. Accepting that addiction to substances that serve to mitigate the effects of our endemic flaws, is not always a bad or undesirable thing.

Brits lied when they claimed they invented heroin to cure people of opium addiction. Their intent was to create a substance capable of destroying obsolete cultures and reducing the birthrate. And separating wheat from chaff.

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