Investigative journalist takes a trip through America’s opioid epidemic

The U.S. opioid epidemic left roughly 30,000 people dead in 2014 — with overdose deaths outnumbering fatalities from car accidents in 16 states.

In his book, “Dreamland: The True Tale of America’s Opiate Epidemic,” Sam Quinones, a former reporter for the Los Angeles Times, traces the history of this epidemic, and the forces that fueled the crisis to grow, unnoticed and unabated for years.

❝ The story begins in the “ranchos” of one small Mexican community, continues at paid speaker training seminars in Boca Raton, Fla., and slowly unravels in places like Portsmouth, Ohio; Huntington, W.Va.; and Denver.

Quinones met with addicts and others who’ve witnessed the crisis up close. He spoke with scientists, physicians, marketing representatives, and former drug dealers. He spoke with MedPage Today (MPT) about his quest to answer the question — how did this epidemic happen?…

MPT: What surprised you the most when you spoke with healthcare professionals about the opioid epidemic?

Quinones: I guess how many of them actually bought the idea that you could prescribe [opioids] without any consequences. That was weird…but when you have forces of economics and law and culture and peer pressure all in play, things like this can happen…

MPT: What about the environment physicians were working in as the opioid epidemic began to grow?

Quinones: Being a doctor in certain areas is a withering, wearying job, because you are constantly confronted with people whose health is part of a much larger issue — lack of work , maybe a culture of poverty, poor diet, there’s a long list of things. People tend to look at these doctors like keys to life strategies; a linchpin to a survival strategy: ‘Get me workers comp.’ How do I get [supplemental security income]?’ The only way you can get that is with a doctor…

MPT: What responsibility do healthcare providers have for the opioid crisis, and how can they help to resolve it?

Quinones: I feel for doctors. They were in a very difficult place. If they didn’t give people these pills, then people might be in horrible pain, and if they did, they might risk addiction.

RTFA. There’s a lot more – covering a broader analysis. Maybe you should read Quinone’s book.

My central criticism of the epidemic reflects the use of doctors to perform means testing to satisfy conservative creeps in Congress. The concept of healthcare as a privilege, not a right, permeates our politics. It’s lousy economics. It’s lousy politics. Neither of which means much to the beancounters Americans keep electing and re-electing.

12 thoughts on “Investigative journalist takes a trip through America’s opioid epidemic

  1. Regulatory capture says:

    “WASHINGTON — The 21st Century Cures Act, which speeds up approval of medical devices and drugs and sets up a sweeping medical research framework for everything from Alzheimer’s disease to opioid addiction, passed the last technical barrier to adoption in the U.S. Senate Monday. The bill is now assured an overwhelming approval vote and the president’s signature in the days to come.” http://www.startribune.com/senate-vote-clears-way-for-21st-century-cures-act/404890536/
    “But there’s a complication: Instead of cracking down on the pharmaceutical companies that fueled the boom in opioid abuse, lawmakers are rewarding the industry. No health care-related bill of this size could move through Congress without the support of Big Pharma. The authors of the 21st Century Cures Act earned the industry’s support by including regulatory rollbacks that drugmakers have long sought and creating cheaper and quicker paths for drug approval by reducing safeguards. It’s as if the fire department had to pay off the arsonist to get permission to put out a fire.” http://www.huffingtonpost.com/entry/congress-21st-century-cures_us_583e3d98e4b0ae0e7cdaca32
    See also “The 21st Century Cures Act: A huge handout to the drug industry disguised as a pro-research bounty” (LA Times 12/5/16) http://www.latimes.com/business/hiltzik/la-fi-hiltzik-21st-century-20161205-story.html

    • Ka-Ching! says:

      “The price of Narcan — the lifesaving heroin-overdose antidote that revives the dying — has skyrocketed, with one formulation rising more than 500 percent in two years, according to an article published in the New England Journal of Medicine.
      Although Narcan first hit the market in 1971, demand has skyrocketed as the opioid epidemic worsens. And with more potent opioids on the street — such as fentanyl — first responders, the largest consumers of the drug, are finding they need multiple doses to revive overdose victims.
      The drug is available in several formulations: injectable, nasal spray and auto-injectors — a single-dose injector designed for people without medical training.
      The patented single-dose auto injector sold by Evzio, which provides real-time, audible instructions on how to use the device, has seen the biggest spike. In 2014, a two-pack of single-use prefilled auto-injectors cost $690, according to the article. The current price is $4,500.” http://www.allgov.com/news/where-is-the-money-going/price-of-antidote-for-heroin-overdose-skyrockets-as-much-as-500-161216?news=859925

      • Ka-Ching! says:

        “CHARLESTON, W.Va. – The state Department of Health and Human Resources will send out 8,000 doses of the lifesaving antidote naloxone to non-EMS first responders this week, State Health Officer and Commissioner of the Bureau for Public Health Dr. Rahul Gupta said Monday. The first statewide naloxone distribution project will end up being 16,000 doses. The second 8,000-dose distribution will be determined by application.” http://wvmetronews.com/2017/02/06/dhhr-to-distribute-16000-doses-of-overdose-antidote-across-mountain-state/
        “The price of a life-saving overdose treatment has increased 680% to $4,500 in the last 3 years” http://www.businessinsider.com/price-of-naloxone-auto-injector-evzio-2017-2 “…the only auto-injector version of naloxone, is called Evzio, and it’s made by Kaleo. Kaleo, a private company based in Richmond, Virginia, also owns Auvi-Q, the emergency epinephrine device that made headlines in October 2016 when the company announced it would come back to the US as competition to the EpiPen after getting recalled a year earlier. The Auvi-Q and Evzio use the same auto-injector technology to deliver their respective emergency medications. the list prices of the two drugs is catching the eye of Democratic Senator Amy Klobuchar of Minnesota, who sent a letter Friday to Kaleo asking for more information about the company’s pricing strategy.”
        See “Klobuchar Presses Pharmaceutical Company kaléo for Answers on High Prices of Medications that Treat Opioid Overdoses and Food Allergies” http://www.klobuchar.senate.gov/public/index.cfm/news-releases?ID=F6F53A2F-C3C1-4250-8FC2-F5AEC324DB44

  2. Instant Gratification™ says:

    “Drug Overdoses Now Kill More Americans Than Guns” http://all-that-is-interesting.com/drug-overdoses-guns “Drug overdoses are not only now killing more Americans than guns, they’ve also made the nation’s life expectancy go down for the first time in more than 20 years. Abuse of heroin, synthetic opioids, and prescription painkillers killed more than 52,404 Americans in 2015, according to government data released Thursday. The death figures come from the Centers for Disease Control and Prevention’s (CDC) annual death and death rate tally.”
    See also “33 maps that explain the world’s drug problem.” http://all-that-is-interesting.com/drug-maps

  3. New Norm says:

    Louisville, Kentucky, has seen an alarming spike in drug overdoses in recent days. According to The Courier-Journal newspaper, first responders took on 52 calls for overdoses in the 32 hours from 12:01 a.m. Thursday until 8 a.m. Friday. One overdose was fatal. The high number of overdoses isn’t new to Louisville and the surrounding county. Jefferson County had been averaging 22 overdoses a day this year. There have already been 695 overdoses through the first month of 2017, according to The Courier-Journal. http://www.huffingtonpost.com/entry/louisville-kentucky-heroin-overdoses_us_589e43f9e4b0ab2d2b155c81

  4. SOMA™ says:

    “America’s opioid epidemic is worsening : States are losing the battle against deadly drugs like heroin and fentanyl” (The Economist 3/6/17) http://www.economist.com/blogs/graphicdetail/2017/03/daily-chart-3 See map, also http://cdn.static-economist.com/sites/default/files/images/2017/03/blogs/graphic-detail/20170311_woc100_0.png In 2015 more than 52,000 Americans died of drug overdoses, according to the Centers for Disease Control and Prevention. That is an average of one death every ten minutes. By comparison there were a total of 58,220 U.S. military fatal casualties during the entire Vietnam War.

  5. Nancy says:

    “Lawsuit: Greedy drug maker purposefully flooded black market with opioids : City of Everett, WA prepares for legal battle with Purdue Pharma over opioid epidemic.” https://arstechnica.com/science/2017/03/lawsuit-greedy-drug-maker-purposefully-flooded-black-market-with-opioids/ “Purdue isn’t new to court battles. In 2007, the infamous drug maker and three of its executives pled guilty in federal court and paid out $634.5 million in fines for purposefully misleading regulators, doctors, and patients about the addictiveness of their opioid painkiller.” See also “American Carnage : The New Landscape of Opioid Addiction” https://www.firstthings.com/article/2017/04/american-carnage

  6. Nelson Algren says:

    “America’s Opioid Epidemic Is Destroying the Rainforest” https://motherboard.vice.com/en_us/article/americas-opioid-epidemic-is-destroying-the-rainforest See also “The Number of Heroin Users in America Grew Five Times in a Decade” @ https://motherboard.vice.com/en_us/article/the-number-of-heroin-users-in-america-grew-five-times-in-a-decade According to a recent JAMA Psychiatry study the people most vulnerable to heroin use and heroin disorders are single white men in their thirties and forties who had either no degree or just a high school degree.” http://jamanetwork.com/journals/jamapsychiatry/article-abstract/2612444

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