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Who is to Blame for the Opioid Crisis?

“Just Say Know”

President Trump declared a public health emergency this past week because of opioid addiction in the U.S. Ninety-one Americans die every day from an opioid overdose, according to the U.S. Centers for Disease Control and Prevention. Opioids now kill more people each year than car crashes. Who is to blame for this public health crisis?

There’s enough blame to go around starting with users who must take responsibility for their actions. My advice is to be an educated consumer and make sure you know what the effects may be of using opioids. Don’t trust your doctors to be transparent about it. Many doctors take the easy way out and prescribe opioids when less evasive medications are available. It’s an offshoot of our “managed” health care system. Prescribe a pill and hope the problem will go away over time rather than addressing the deep rooted behavioral patterns that lead to addictive behavior in the first place.

Pharmaceutical companies share in the blame as well. Rather than consider the side effects of taking medications, Big Pharma prefers to pad their bottom line and ignore the public health fallout. This is how they make money – by getting the most vulnerable around us hooked, much in the same way cigarette companies did to hook smokers on their products without regard for the addictive effects of nicotine.

Pharmacies can play a positive role, although it is limited in scope. For example, CVS Health will limit opioid prescription to a seven-day supply compared to as much as 20 days.

A May 2017 survey conducted by Fortune magazine found that 29 percent of Americans said the people hooked on opioids were most responsible for the epidemic. Doctors and pharmaceutical companies also rated highly – with 19% and 15% of the votes – as the most deserving of blame. Of the sample, 47 percent identified opioid abuse as either an “extremely big” or a “very big problem” in their communities. The majority said it was at least “somewhat easy” to get prescription painkillers that weren’t prescribed to them. Almost 40 percent knew someone who suffered from an opioid addiction; 23 percent knew someone who had overdosed on the drugs.

There is a history of over-prescribing painkillers. In the early 1990s, the number of painkiller prescriptions filled at U.S. pharmacies increased by 2 to 3 million each year. By 1996, they jumped by 8 million, as doctors became part of the prescription-writing epidemic.

Here's one example of Big Pharma ignoring the addictive effects of opioids. The makers of Oxycontin launched an advertising campaign with a video promotion called “I Got My Life Back,” where a doctor enthusiastically endorsed the drug. This is a classic conflict of interests and irresponsible behavior on the part of such doctors. The campaign profiled six patients whose pain was stopped because of the powerful pill, grabbing the attention of doctors around the world who should have known better, and patients who asked for it by name.

We have an addictive society. Just look around you. It’s not just over-prescribing painkillers. We’re constantly barraged by television commercials touting bigger and fatter burgers and other foods, which contribute to the addiction to food – you want more and more of it just like painkillers.

At the end of the day we need a national dialogue about the harmful effects of opioids, much like the “Just Say No” campaign started by former first lady Nancy Reagan. She addressed the “War on Drugs” when she gave a piece of advice in 1982 to a young girl who asked what she should do if offered drugs. Her spontaneous answer, of course, was “just say no.” Her thoughtful advice triggered the D.A.R.E. (Drug Abuse Resistance Education) program started by the Los Angeles Police Department in 1983, making its way into 75% of school districts in America.  Just say no

As the “Just Say Know” program evolved, many folks saw it as too simplistic and the new D.A.R.E slogan became “Keepin’ it Real.” Three decades after Nancy Reagan’s famous advice, in schools and communities all over the country, parents and educators are embracing a new mantra. It’s “Just say know,” and offers, in addition to stressing the value of abstinence, reality-based information that teens trust. 

I have previously blogged about the coming problem for America of the legalized use of marijuana for recreational purposes. The jury is still out on the possible long-term effects of smoking pot and it’s not an opioid. Still, long-term pot use may create a craving for stronger substances such as opioids.

The time is right to take the opioid addiction crisis seriously and take concrete steps to educate youngsters to the problems, increase regulatory controls over doctors who over-prescribe the pills, and hold Big Pharma responsible for pushing these drugs on society.

Blog posted by Steven Mintz, aka Ethics Sage, November 2, 2017. Dr. Mintz is a Professor Emeritus from Cal Poly San Luis Obispo. Visit his website to sign up for his newsletter.

Dr. Mintz is a writer, speaker, ethics trainer, litigation consultant and expert witness on ethics issues. If you are interested in his services, please send an email to: steve@ethicssage.com.

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