The Washington Post (The Post) has obtained a copy of the DEA’s substance abuse database covering years 2006 through 2012. The data traces the number of Opioid pills manufactured, distributed to retailers and sold to patients. Not shown in The Post’s database are the ultimate purchaser’s name, and the name and license number of the prescribing physician; data known by the DEA, but not made available to The Post. 76 billion Opioid pills from production to consumption “flooding the country,” enough for 300 million men, women and children to use 36 pills each per year for seven years. The data is reported for county of every state; Puerto Rico and Washington, DC. The DEA database obtained by the Post is available online so the public may look up for any county the complete summary of commerce from producer to retailer. Finally, The Post reports hundreds of city, county and state public prosecutors have individually or collectively filed suits against the manufacturers and distributors claiming compensation for the public expense of the overload of Opioids. The State of Oklahoma filed a public nuisance suit, which has recently concluded after a “seven-week trial against Johnson & Johnson asking the judge to award the State $17.5 billion over thirty years to clean up the drug crisis.”
The Post would have one believe that the whole crisis is about greedy manufacturers making huge profits at the expense of a feckless public. Actually, the DEA database illustrates a conclusion far different. It shows that all of the 76 billion pills were legally manufactured, legally distributed to pharmacies that filled prescriptions for patients written by licensed physicians. Each one of the 76 billion pills was used for its purpose; to control pain. Pain control is normally needed when a patient has some dental procedures, hospital surgeries, rehabilitation from accidents and most of all for mental health reasons. Most patients use Opioids only for about ten days or less; mental health treatment can be as long as forever, or until the drug is abused by accidental overdose and death. Accidental death was a result for 70,200 licit and illicit Opioid overdoses. In 2015 2.6 million Americans 12 years or older had a substance abuse disorder. An essay written for the ”Independent Institute” by Raymond J. March, published by Real Clear Health, November 2, 2017 estimates pain management control is used briefly by 101.8 million U.S. adults, and by 24.3 million suffering chronically in 2015. The numbers of patients increase yearly.
Not included in the DEA database are illicit drugs, such as Heroin. The drugs taken by the 2.6 million known substance abuse addicts were seventy-seven percent licit and twenty-three percent illicit. Heroin users started on licit Opioids in four out of five instances. They switched to heroin because in 94% of the cases licit drugs were too difficult to obtain! Difficulty obtaining pills legally implies DEA enforcement for licit pills. The likely switch from legal pills is to illegal heroin or counterfeited Fentanyl. Both are known to result in more deaths. Counterfeiting occurs because of tight control of the licit market. Fentanyl use grew by a multiple of twelve times over the five-year period from 2011 through 2016, and Heroin use at three and one-third times. Licit drugs show no growth during the same period. (National Vital Statistics Report, December 2018).
I used the DEA database to determine the thirty most Opioid-saturated counties among the States. They are all in Appalachia, specifically in the coal-producing counties. These are today and have been for decades economically depressed and with despairing populations. Not mentioned by The Post is the cause-and-effect nature of poverty, depression of spirit, and pain-relieving drugs because of no jobs, incomplete formal education, no mobility, no “higher human needs” are satisfied, only bare existence. This is an inhuman existence. The ”highest human needs” (above subsistence) are what Maslow’s hierarchy explains as separating humans from animals. A new public policy needs to: Rehabilitate people to a drug-free life, create new infrastructure useful for satisfying people’s needs of Maslow’s hierarchy. This means restoring public schools to provide core education in English, mathematics, reading comprehension, composition, AND in promoting learning incentives to enjoy higher-level human needs.
The data supplied by Independent Institute (see three paragraphs above) was used to model how many pills would be required over seven-years to manage pain of everyday-users at the rate of 1.6 pills per day, and ten pills for a single pain-event – dental, hospital surgery, accident rehabilitation, et al one event per year – not the same person each year. That model uses all 76 billion pills for seven years. 76 billion pills have been taken by needy people with legal prescriptions. This predicts law suits by cities, counties and states will only benefit the lawyers!
The Opioid Crisis – In Need of New Public Policy.docx August 4, 2019