A crisis compounded by greed

When I was a teenager, the War in Vietnam was raging. It was a terribly costly war in terms of lives lost. In order to supply the soldiers needed for the combat, the draft was in full swing. Every young man had to register before his 18th birthday and a lottery was in place to determine, by date of birth, who would be drafted. It took a long time after the end of the war to get an official number on the US soldiers killer or lost in action in Vietnam. In 1982 the Vietnam Memorial was inscribed with the names of 57,939 members of US armed forces who had died or were missing as a result of the war. Additions to that have brought the total past 58,200. At least 100 names on the memorial are those of servicemen who were Canadian citizens serving in the US forces. We often use the round number of 58,000 as the count. There were far more losses of Vietnamese combatants. Allies of the United States also lost soldiers, including South Korea, Thailand, Australia and New Zealand. Then there were the civilian casualties.It was a costly enterprise.

That war pales, by number, however, with the war in which we are currently engaged. No, I’m not talking about Iraq (4,486 US soldiers). I’m not talking about Afghanistan (2,345 US soldiers). I’m talking about the victims of prescription drug overdoses. Since 2000, more than 200,000 people have died of prescription drug overdoses - more than three times the number of American lives lost during the Vietnam War.

We’ve seen a lot of lip service recently about opioid addiction. In fact President Donald Trump on Thursday suggested using the death penalty on drug dealers to address the opioid epidemic. While it is true that those who are addicted often end up purchasing illegal drugs after their addiction becomes so severe that their need for drugs outstrips what can be obtained legally or the price of legal drugs makes illegal drugs appealing to them, a large number of victims of opioid overdoses began their addiction with legally prescribed drugs obtained from pharmacies and other legal distributers. It may be politically acceptable to go after the pushers of illegal heroin and fentanyl, but the lethal results of drugs sold for profit by legal companies are just as real.

And the laws protect the drug companies. And the drug companies invest a significant amount of their profits in lobbying congress for laws to protect them and their high profits. As recently as 2016, The Ensuring Patient Access and Effective Drug Enforcement act was pushed through Congress by a small band of lawmakers backed by a powerful array of drug companies. The initial version of this law as written by a drug industry attorney. Sponsored by Tom Marino (R-Pa.) and Orrin Hatch (R-Utah), it made it nearly impossible for the Drug Enforcement Agency to use immediate suspension orders against drug distributors. It protects drugstores suspected of diverting prescription narcotics to the black market from suspension of their orders. Even when enforcement agents can prove that those shipments pose an imminent danger to the community, it is insufficient evidence according to the new law.

Instead of combatting the destructive killer of opioid addiction, congresses has made it more difficult to prosecute those who are shipping huge numbers of prescription medications - far beyond the amount needed for effective treatment of pain - to pharmacies across America. The industry defends the law as necessary to ensure that legitimate pain patients can receive their medication without disruption. When DEA officials do discover companies delivering unreasonable amounts of drugs, rather than prosecute, DEA must bring “corrective action plans” before the companies can be sanctioned. The result is that enforcement against companies that ship huge amounts of drugs is nearly impossible. This legislation has been documented by the Washington Post and by a “60 Minutes” investigation last October.

Part of the problem is that there is a huge amount of profit involved in health care in the United States and there is no shortage of companies who are scooping up those profits. Drug manufacturers dole out $240 million a year for the purpose of lobbying congress. The insurance industry adds $157 million per year. Those are just dollars invested in lobbying, Health care companies spend additional millions on campaign donations. Those dollars buy a lot of attention from those in congress who are constantly engaged in raising big money for election bids. These companies don’t spend money on lobbying out of altruism. They are inviting money and they expect a return. They see buying legislation as an effective method of increasing profits.

Congress does a bit of talking about our nation’s drug crisis. But their actions don’t make it look like they are truly seeking solutions.

At the heart of the crisis is pain. Americans experience a lot of pain. In a recent Centers for Disease Control and Prevention study, on in four adults said they suffered a daylong bout of pain in the past month. One in 10 said they have experienced chronic pain that lasted a year or more. The amount of pain in our country makes pain killers a gold mine for drug companies. Those suffering pain will do almost anything to get relief. Unscrupulous doctors are willing to exploit their patient’s desperate need for relief.

But the promise of a pain-free life is always a false promise. Real living involves pain. Learning to live with pain is part of being human. A doctor can’t eliminate pain. Responsible physicians can take away some of the pain, but they cannot eliminate it. Responsible doctors are beginning to cut back on prescribing opioids. When they are prescribed, it is done for much shorter periods of time. Still, the drugs are dangerous. A dependency can develop in as little as two weeks.

Non-pharmacological therapies are essential to living with pain. Physical therapy, proper posture and body mechanics, weight loss, proper diet and other therapies are as critical as is medication.

We’ve got a bit problem - a lethal problem. We can’t count on congress, with its deep addiction to big dollars, to provide the solutions. We need to learn to deal with this in other ways. As is true with every war, sacrifices will need to be made. There will be real costs. But only when we take responsibility for this crisis ourselves will we find our way out of this mess.

Copyright (c) 2018 by Ted E. Huffman. I wrote this. If you would like to share it, please direct your friends to my web site. If you'd like permission to copy, please send me an email. Thanks!