Maybe The Problem Isn’t Drugs

Just 3 years after restrictions on opiate prescriptions became really tough, the CDC has decided this was the wrong stance to take, because while opiate prescriptions have decreased by more than 50%, opiate related deaths have continued to increase. The only thing making the prescriptions harder to get has done is hurt patients with chronic pain conditions and cancer. That was last week. This week, they announced drug overdoses related to drugs like cocaine, MDMA, and meth, have also been rising exponentially since 2010.

Furthermore, of those 33,000+ opiate related deaths in 2017, over 90% were related to illicit use and 18,000+ were directly related to illicit fentanyl use. However, this is an indicator of a larger trend, considering cocaine use rose by more than 143% between 2010 and 2015. Like meth, the cost of cocaine has gone down again, making it a cheaper drug to use. As has the cost of street fentanyl.

If the problem really was opiates, then cocaine, LSD, meth, MDMA, and Ritalin use wouldn’t also be on the rise. Furthermore the CDC admitted that a large portion of the 33,000+ deaths related to fentanyl and heroin, also included deaths where more than one illicit drug was found in the toxicology screening. Things like heroin and cocaine or fentanyl and Ritalin.

Someone commented in my circle of private acquaintances recently “well it doesn’t affect me that opiates are harder to get, it just keeps them out of the hands of teens.” Why? Do you intend to give your opiate prescription to a teen? Also, it may not affect you today, but tomorrow might be a very different story.

For example, after breaking his radius clean through and chipping his ulna, J was prescribed 12 hydrocodone tablets by the ER. They did not set the bone. Thankfully, we saw the surgeon the next day, who rolled his eyes when J told him how many hydrocodone he’d been prescribed for his pain. Setting a bone relieves some of the pain, so not setting it and having surgery 4 days later, would probably have done more damage than good. He then prescribed J 80 – 5 mg hydrocodone. For the 4 days his arm wasn’t set and the 4 weeks of healing after surgery before he started physical therapy. It was a reasonable number. After surgery and setting the bone, J’s daily hydrocodone use was cut in half and he did fine. But because of the prescribing restrictions, our insurance refused to pay for the second prescription.

Shortly after we dealt with this, one of our close friends had a heart attack and required a triple bypass. They cracked his chest open to do it. He was sent home from the hospital with just 45 oxycodone for healing from having his breast bone broken open. After 3 weeks, he was given a refill of 50 hydrocodone. And could only fill 32, that was the max his insurance would allow. In 1998, when my father had a massive heart attack and had to have a triple bypass he was sent home with 100 oxycodone. And my father, who is a recovering alcoholic, managed to not get addicted.

Then a few weeks ago, someone in one of my CRPS support groups came to us in emotional distress. Her husband had been diagnosed with stage 4 lung cancer. It is an extremely painful condition. and it’s standard operating procedure to prescribe pain medication for anyone with stage 4 cancer, especially lung cancer. Most doctors consider the prognosis so glum, that they prescribe a significant amount for stage 4 lung cancer, because the patient is unlikely to live long enough to become addicted to the medication. The oncologist prescribed her husband 90 – 10mg oxycodone and 50 – 15mg extended release morphine tablets. Insurance refused to pay for any of it, because he’d been prescribed too many. The pharmacy was nice enough to honor a coupon for the pain meds, but it shouldn’t have come to that.

The Opiate Crisis has created an atmosphere that has harmed sick or injured people. And all the restrictions have done nothing to curb the deaths or illicit use. If people want to get use drugs, they will. All the restrictions have only harmed people who need them for legitimate reasons. The best laid plans…

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