How many pain pills were sold in your county? How many deaths?


Data compiled by CDC and DEA — Washington POST

❝ The Post obtained and analyzed a previously unreleased database maintained by the Drug Enforcement Administration that tracks the path of every pain pill sold in the United States – by manufacturers and distributors to pharmacies in every town and city. That data was compared with individual death records from the Centers for Disease Control and Prevention, which were obtained and analyzed by The Post.

Phew!

Ethics-challenged judges added to opioid deaths…and more


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❝ For years, they sealed evidence about the risks as the body count mounted. And as a Reuters analysis found, it’s only one of many big product-liability cases in which judges have countenanced a lethal and often unlawful secrecy.

❝ In an unprecedented analysis, Reuters found that over the past 20 years, judges sealed evidence relevant to public health and safety in about half of the 115 biggest defective-product cases consolidated before federal judges in so-called multidistrict litigation, or MDLs. Those cases comprised nearly 250,000 individual death and injury lawsuits, involving dozens of products used by millions of consumers: drugs, cars, medical devices and other products. And the numbers don’t convey the full extent of information locked away because they don’t include thousands of product-liability cases heard in state courts.

Frankly, they need to be indicted and tried in something more than the court of public opinion. However, I doubt there is any appropriate body in American jurisprudence or politics with sufficient courage – or dedication to the common good – to do so.

OxyContin makers avoid televised courtroom trial — Settle out of court for $270 million.


Click to enlargeJustin Lane/EPA

❝ Purdue Pharma, the maker of OxyContin, and its owners, the Sackler family, agreed to pay $270 million to avoid going to a state court trial over the company’s role in the opioid addiction epidemic that has killed more than 200,000 Americans over the past two decades.

❝ The payment, negotiated to settle a case brought by the state of Oklahoma, was far larger than two previous settlements Purdue Pharma had reached with other states. It could jolt other settlement talks with the company, including those in a consolidated collection of 1600 cases overseen by a federal judge in Cleveland.

❝ “Purdue appears to have concluded that it was less risky to settle the Oklahoma case than have the allegations publicly aired against it during a televised trial and face exposure to what could have been an astronomical jury verdict,” said Abbe R. Gluck, a professor at Yale Law School who directs the Solomon Center for Health Policy and Law.

Lock ’em up and throw away the key!

Drug dealers rediscover behavioral market analysis

❝ Major dark web drug suppliers have started to voluntarily ban the synthetic opioid fentanyl because it is too dangerous, the National Crime Agency has said.

They are “delisting” the high-strength painkiller, effectively classifying it alongside mass-casualty firearms and explosives as commodities that are considered too high-risk to trade. Fentanyl can be up to 100 times stronger than heroin and can easily cause accidental overdoses, particularly when mixed with heroin.

❝ Vince O’Brien, one of the NCA’s leads on drugs…[says] that dark web marketplace operators appeared to have made a commercial decision, because selling a drug that could lead to fatalities was more likely to prompt attention from police.

It is the first known instance of these types of operators moving to effectively ban a drug.

RTFA. I don’t expect junkies to have beaucoup decision smarts. Anyone else, please don’t go experimenting with instant death – smiling or otherwise.

Opioids are killing thousands of veterans and the VA played a role in that

❝ Opioids, mostly illegally obtained counterfeit pills and heroin, now account for 63 percent of all drug deaths in the U.S., with fatalities climbing at an astounding rate of nearly 20 percent a year. In fact, the estimated number of drug deaths in 2016 topped the total number of soldiers killed in the Iraq and Vietnam wars. There’s a grim irony in that statistic, because the Department of Veterans Affairs has played a little-discussed role in fueling the opioid epidemic that is killing civilians and veterans alike. In 2011, veterans were twice as likely to die from accidental opioid overdoses as non-veterans. One reason…is that for over a decade, the VA recklessly overprescribed opiates and psychiatric medications. Since mid-2012, though, it has swung dangerously in the other direction, ordering a drastic cutback of opioids for chronic pain patients, but it is bungling that program and again putting veterans at risk…

❝ Today, the number of patients affected by the VA’s swinging opiate pendulum is staggering: 60 percent of veterans who fought in the Middle East and 50 percent of older veterans have chronic pain. Since 2012, though, there has been a 56 percent drop to a mere 53,000 chronic pain VA patients receiving opioids—leading to swift, mandated cutoffs regardless of patient well-being and with virtually no evidence that it’s a safe approach…

RTFA. The VA stumbles from one side of the wrong-way highway to the other. Crippled by the fake president and tame bureaucrats relying on positions already corrupt and ineffectual – our veterans’ medical treatment is on the way to being as useless as any Republican-designed healthcare system.

The drug industry’s triumph over the DEA – with the help of Congress

❝ In the midst of the worst drug epidemic in American history, the U.S. Drug Enforcement Administration’s ability to keep addictive opioids off U.S. streets was derailed — that according to Joe Rannazzisi, one of the most important whistleblowers ever interviewed by 60 Minutes. Rannazzisi ran the DEA’s Office of Diversion Control, the division that regulates and investigates the pharmaceutical industry. Now in a joint investigation by 60 Minutes and The Washington Post, Rannazzisi tells the inside story of how, he says, the opioid crisis was allowed to spread — aided by Congress, lobbyists, and a drug distribution industry that shipped, almost unchecked, hundreds of millions of pills to rogue pharmacies and pain clinics providing the rocket fuel for a crisis that, over the last two decades, has claimed 200,000 lives…

❝ JOE RANNAZZISI: This is an industry that allowed millions and millions of drugs to go into bad pharmacies and doctors’ offices, that distributed them out to people who had no legitimate need for those drugs.

BILL WHITAKER: Who are these distributors?

JOE RANNAZZISI: The three largest distributors are Cardinal Health, McKesson, and AmerisourceBergen. They control probably 85 or 90 percent of the drugs going downstream.

RTFA. All of it. If you’re cynical as I am about our Congress-critters and how most of them are bought-and-sold, none of this will be a surprise.

Still, read the article. You will be better equipped to lambaste your friendly neighborhood politicians about their incompetence in the face of this epidemic.

Fentanyl Passes Heroin as Leading Cause of U.S. Drug Deaths

Drug overdoses killed roughly 64,000 people in the United States last year, according to the first governmental account of nationwide drug deaths to cover all of 2016. It’s a staggering rise of more than 22 percent over the 52,404 drug deaths recorded the previous year — and even higher than The New York Times’s estimate in June, which was based on earlier preliminary data.

Drug overdoses are expected to remain the leading cause of death for Americans under 50, as synthetic opioids — primarily fentanyl and its analogues — continue to push the death count higher. Drug deaths involving fentanyl more than doubled from 2015 to 2016, accompanied by an upturn in deaths involving cocaine and methamphetamine. Together they add up to an epidemic of drug overdoses that is killing people at a faster rate than the H.I.V. epidemic at its peak…

The explosion in fentanyl deaths and the persistence of widespread opioid addiction have swamped local and state resources. Communities say their budgets are being strained by the additional needs — for increased police and medical care, for widespread naloxone distribution and for a stronger foster care system that can handle the swelling number of neglected or orphaned children.

It’s an epidemic hitting different parts of the country in different ways. People are accustomed to thinking of the opioid crisis as a rural white problem, with accounts of Appalachian despair and the plight of New England heroin addicts. But fentanyls are changing the equation: The death rate in Maryland last year outpaced that in both Kentucky and Maine.

Monthly provisional reporting looks like things are only getting worse. Too bad it doesn’t get through to a government more concerned with crushing expanded healthcare for Americans.

Yup, we have an opioid overdose crisis — & cigarettes kill 15 X more people

❝ Cigarettes still kill nearly half a million people in the US each year — 15 times the death toll from the opioid crisis. That’s also more than alcohol, car accidents, AIDS, illegal drugs, murders, and suicides combined.

❝ Thanks to tobacco taxes and cigarette bans, the smoking rate in America has declined dramatically — from around 32 percent in the 1980s to 15 percent today. But over the past couple of years, the smoking prevalence here hasn’t budged while rates have continued to drop in other rich countries like the UK and Canada. Australia has even managed to reduce its smoking rate to an all-time low of 13 percent…

❝ Last week, the US Food and Drug Administration announced a new initiative that could — if it pans out — drive down the US smoking rate much, much further. Scott Gottlieb, the commissioner of the FDA, said the agency plans to set new, much lower limits on the amount of nicotine in tobacco, essentially forcing companies to reengineer cigarettes so they’ll be less addictive…

Given who owns most of Congress, this will take years.

❝ In the meantime, though, there are many other policies the US could pursue to bring down the smoking rate. Adding graphic picture health warnings to cigarette packs or ratifying the UN’s Framework Convention on Tobacco Control are among a couple of measures America hasn’t put in place even though hundreds of other countries have. So while the new nicotine announcement is a real public health power move, we’re still missing some tobacco control basics.

Other countries have proven that just making cigarette packaging plain deters smoking.

❝ …More than 100 countries around the world have added gruesome pictures of the health effects of cigarettes on packs. (The most recent review of the research suggests the graphical warnings are more effective than text-only warnings at curbing the appeal of smoking.)…

The US hasn’t updated the health warnings on packs in 32 years

While our erstwhile voices of the people mostly blather about what a great job they’re doing fighting on our behalf – just might be time for you to call or write or email your Congress-critter and tell them to actually do something quick and easy to help keep more of us alive.

The risk of a single 5-day opioid prescription


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❝ Now that it’s clear opioid painkillers have helped cause the worst drug epidemic in history, health experts are scrambling to figure out when dependency on these powerful prescription drugs starts — and how to prevent it.

❝ A new study from the Centers for Disease Control and Prevention looked at the relationship between the number of days of someone’s first opioid prescription and their long-term use. It found that that number has a huge impact: Patients face an increased risk of opioid dependency in as few as four days of taking the drugs.

As you can see in the chart…opioid prescriptions longer than five days in length significantly increased the likelihood of continued opioid use both one and three years later…

❝ “There’s nothing magical about five days versus six days, but with each day your risk of dependency increases fairly dramatically,” said Bradley Martin of the CDC, one of the study authors.

❝ The study, which analyzed 1.3 million non-cancer patients, also found that only 6 percent of patients prescribed a one-day supply of opioids were still taking the drugs a year later, but that number doubled to 12 percent if patients were prescribed a six-day supply and quadrupled to 24 percent if patients were given a 12-day supply.

Pretty solid warning, I’d say.