Friday, 14 Dec 2018

Heroin and Opioids

Everything about the massive increase in opioid use goes beyond the borders of drug use in the United States. It strikes white residents in the countryside as well as minorities in the cities. There are long-banned substances such as heroin, legally prescribed painkillers, including OxyContin, and, increasingly, illicit drugs mimicking powerful synthetic opioids such as the fentanyl. Their combined balance now exceeds that of car accidents or firearms, and opioid abuse is considered a prime factor in the decline in US longevity.

The situation

In December, US President Donald Trump hailed the commitment made by his Chinese counterpart Xi Jinping to strengthen fentanyl surveillance, revise drug rules and strengthen the work of law enforcement. with the United States. were not doing enough to stop fentanyl and related chemicals in the United States. In October, Congress passed a bipartisan bill to increase funding for treatment programs and expand access to inpatient rehabilitation services through the government's health program for the poor. The bill also requires the US postal service to filter fentanyl in packages from China and other countries. In 2017, Trump said the opioid situation was a national emergency. More than 200 states and localities have sued drug manufacturers and drug distributors, accusing them of creating a public health crisis by mishandling opioids. Representatives of Purdue Pharma Inc., the manufacturer of OxyContin and other drug companies are currently seeking a comprehensive claims settlement. States and the federal government have made naloxone, an antidote for opioids, more readily available. Nevertheless, in 2016, fatal overdoses of drugs jumped 21% and the number of deaths from synthetic opioids such as fentanyl doubled.

L & # 39; background

Poppy extracts have been a source of problems since the nineteenth-century opium wars. Heroin, first produced in 1898 by the German pharmaceutical group Bayer, was marketed as a non-addictive substitute for morphine. In the early 1900s, the widespread use of heroin led states such as New York to open drug treatment centers in hospitals. The latest wave of heroin is the result of changes in prescription opioid use. Opioid analgesics gained popularity in the 1990s, in part because of what was considered widespread underuse of chronic pain. In 1996, Purdue Pharma Inc. introduced OxyContin as an alternative to more potent opioids reserved primarily for the dying. Its annual sales reached $ 1 billion. In 2007, Purdue was fined $ 600 million and its leaders pled guilty to federal criminal charges for misreading the product as less addictive than other painkillers. In 2010, he released a reformulated version that was harder to crush for sniffing. A May 2015 study found that while the new version reduced the illicit use of painkiller, it was driving more people to consume heroin, which was priced down. In the United States, nearly 90% of new heroin users are now white, compared to an equal mix of whites and non-whites before 1980. In the world, poppy cultivation has reached its highest level since the 1930s.

L & # 39; argument

While Trump accepted his commission's call for a declaration of urgency, he said the most important solutions should be to tell people not to use drugs and cut off illegal supplies. But a commission he had named had instead focused on measures to educate health professionals about prescription abuse and to facilitate treatment. The hard-hit state officials have reprimanded federal regulators for not doing more to restrict opioid prescriptions. In response, health officials are encouraging doctors to reserve the most potent pain medications for patients who do not respond to less aggressive medications. Groups defending patients with chronic pain fear that the rush to solve the problem of addiction causes unnecessary suffering. Almost all states have enacted opioid abuse laws, including measures for doctors and pharmacists who prescribe or distribute too many pills, and offer criminal immunity to patients seeking treatment for an overdose. But with limited action at the federal level and little money available to fight addiction, many states hope to create a Big Tobacco-type legal settlement. In 1999, cigarette manufacturers agreed to pay $ 246 billion to settle lawsuits filed by states to recover the costs of smoking to society.

To contact the author of this QuickTake: Lauren Etter in Austin at

To contact the editor responsible for this QuickTake: John O'Neil at

First published on March 29, 2016

© 2018 Bloomberg L.P.


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