[Peace-discuss] Correspondence re opioid issue

Mon Jan 1 20:09:36 UTC 2018

(from Sal Rodriguez)

HiDavid,

Iactually wrote this response quite a while ago but then slacked on editing itdown for your convenience. If you're still interested in my take, here it is.

I'llbegin with a response to the Esquire article on the Sackler family, which Ifigure is representative of a lot of the coverage of them.

First,I think the fact that they are a wealthy family who engage in a wide set ofphilanthropy including potentially politically disagreeable efforts like"school choice," is irrelevant. 

Mostof the media I think has consistently failed to dig very deep into what the"opioid crisis" really is - instead resorting to tropes like"the evil corporation profiting from misery," "extremelydangerous drugs are killing people and the government MUST do something aboutit."

TheEsquire piece, and most of the links you sent, falls into those two categories.

They want to frame the entirety of the "opioid epidemic" as the soleand direct consequence of sinister rich people making these evil pills thatmake everyone addicts and kill them. 

For left-leaning people, this is attractive: they get to bash Big Pharma, theyget to bash big corporations, they get to blame addiction on capitalism, andthey get to celebrate marijuana. For right-leaning people, they get to expresstheir compassionate conservatism, talk about the importance of religion, talkabout law and order and the need for more border controls to stop the drugsfrom coming in, etc.

Butsuch narratives almost entirely rely on superficial analysis and loads ofhysteria.

The Esquire article, for example, asserts that Oxycontin is "regarded bymany public-health experts as among the most dangerous products ever sold on amass scale."

Itnever gets into any real support for this claim other than going to saythat  since 1996 "more than two hundred thousand people in the UnitedStates have died from overdoses of OxyContin and other prescriptionpainkillers."

Asthat sentence reveals, and as Esquire goes on to note, "Not all of thesedeaths are related to OxyContin—dozens of other painkillers, includinggenerics, have flooded the market in the past thirty years."

That'sa pretty weak basis for the assertion that OxyContin specifically is"among the most dangerous products every sold on a mass scale."

Butsetting that technicality aside,  the overdose numbers are complicated bythe reality that many overdoses are in fact the result of polydrug use,including people who attempt to enhance the effects of opioids with alcohol orbenzodiazepines because their doctor wasn't able or willing to prescribe anadequate number of pills.

It'sworth noting that, in 2013, 77 percent of deaths involving prescription opioidswere known to involve a combination of a prescription opioid with another drugor alcohol. The figure is likely higher, given the inconsistent reporting andcollecting of information by medical examiners. 
https://hams.cc/polydrug.pdf

Thisfact is rarely ever mentioned by the mainstream media.

TheEsquire article also attempts to blame heroin overdoses on prescription drugs:"Thousands more have died after starting on a prescription opioid and thenswitching to a drug with a cheaper street price, such as heroin."

WhatEsquire leaves out is that a major factor in the "heroin epidemic"was the wide range of federal crackdowns over the past decade - with doctorsand pharmacists targeted, arrested and monitored. The result has been a drop inthe number of opioid prescriptions, but more people moving to heroin and thusbeing exposed to the problems of the black market, including drug tainting withfentanyl and carfentanil.

Therecent position paper of the Global Commission on Drug Policy breaks this chainof events down quite well: http://www.globalcommissionondrugs.org/position-papers/opioi d-crisis-north-america-positio n-paper/

Esquiregoes on to uncritically repeat the corny line by Chris Christie that opioidscreate the equivalent loss of life as “September 11th every threeweeks."  A previously noted, the overwhelming majority of opioiddeaths involve drug mixing, either out of recklessness or lack of educationabout the risks of drug mixing, and by now the big problem isn't prescriptionopioids, but fentanyl-laced heroin, which is a direct consequence of the War onDrugs.

Fromthere, the article mostly goes on to complain about how rich the family is, andnothing of great significance is actually said.

Anyserious analysis of the current "opioid epidemic" must begin with anunderstanding that:

1) the vast majority of people who are prescribed opioids never develop aproblem with them, 
2) the vast majority of people who do misuse opioids weren't prescribed them, 
3) there are a lot of people struggling with under-treated pain because ofcrackdowns on opioid prescriptions, 
4) most deaths related to opioids involve drug mixing, intended and unintended,

5)crackdowns are the reason so many people have moved to the black market,

6)heroin is only dangerous because it is illegal,

7)addiction is about more than just the drug - it's as much about thecircumstances of a person's life and environment,

8)opioids shouldn't be universally condemned and curbing excesses in prescribingshouldn't prevent doctors from prescribing to those who might need more thanaverage.

Ihighly recommend this discussion of the opioid problem and how/why our drugpolicies created it: https://www.youtube.com/watch?v=ySJuGhI0lVQ

Hopethis helps.

Sal

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OnMon, Nov 13, 2017 at 4:13 PM, David Green <davegreen84 at yahoo.com>wrote:

HiSal,

Iwrote you back in March regarding your critiques of the "war onopioids" on Counterpunch.

I'mfollowing up with a query regarding your views on the recent coverage of theSackler family (see links below, which I presume you're aware of anyway), aswell as Johann Hari's view expressed on the Real News Network.

Yourperspectives on how to continue to approach the opioid crisis in the generalcontext of neoliberalism would be greatly appreciated.

Best,

DavidGreen

ChampaignIL

http://www.esquire.com/news-politics/a12775932/sackler- family-oxycontin/

https://www.democracynow.org/2017/10/19/who_profits_from_ the_opioid_crisis

https://www.newyorker.com/magazine/2017/10/30/the- family-that-built-an-empire- of-pain

The Super Wealthy Oxycontin FamilySupports School Privatization With Tactics Similar to Those That Fueled theOpioid Epidemic | naked capitalism

http://therealnews.com/t2/index.php?option=com_content& task=view&id=767&Itemid=74&jumival=20307

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The Super Wealthy Oxycontin Family Supports School Privatization With Ta...

A fortune derived from the relentless marketing of painkillers is now being used to expand charter schools.
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