A new report from the Centers for Disease Control and Prevention has this cheerful news,
“Heroin use has increased across the U.S. among men and women, most age groups, and all income levels. Some of the greatest increases occurred in demographic groups with historically low rates of heroin use: women, the privately insured, and people with higher incomes … Between 2002 and 2013, the rate of heroin-related overdose deaths nearly quadrupled, and more than 8,200 people died in 2013.”
The reason is simple economics.
We’ve known that heroin is a bad drug since Bayer (the company that originally marketed it) pulled it from the market back in the 1920s. It’s on the FDA’s Schedule 1 list of drugs, which means it is highly addictive and has no medical value. LSD is also on that list, as is marijuana (which means someone in Washington is on drugs).
When a drug company pulls a product, though, it misses the revenue the drug generated. So we saw Bayer and others look for heroin substitutes. Enter oxycodone (Schedule 2, highly addictive, with some medical usefulness), hydrocodone (also Schedule 2) and other opioids.
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Oxycodone (which has several brand names like Roxicodone, Oxycontin and Oxecta among others) has been called synthetic heroin, and that just isn’t so. While chemically related, they are different at the molecular level. What difference could that make? Carbon dioxide is a carbon atom with two oxygen atoms, and you exhale it when you breathe. Carbon monoxide is a carbon atom and one oxygen atom, and it can kill you. The two are distinct molecules.
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However, as opioids, they do have similar effects on the nervous system. Addicts say that the highs have slightly different feels — heroin has a rush that oxy doesn’t, etc. I don’t know as I have never used either, but those who have say the same thing: Heroin substitutes nicely for oxy.
Once upon a time, these serious painkillers were reserved for treating cancer pain and end-of-life situations. Then things changed, and you could get a script for these for dental work and if you have chronic back pain.
“We are priming people to addiction to heroin with overuse of prescription opiates,” explained Dr. Tom Frieden, director of the CDC. “More people are primed for heroin addiction because they are addicted to prescription opiates, which are, after all, essentially the same chemical with the same impact on the brain.”
A few years ago, oxycodone was THE PAINKILLER, and hydrocodone was popular as well. Rules on prescribing them tightened somewhat, and in the case of hydrocodone, it was moved from relatively relaxed Schedule 3 to more restrictive Schedule 2. This meant supply contracted, and when that happens, prices rise. When the price of a commodity rises, consumers often prefer to substitute a similar item to paying the higher price. Buying heroin on the street was cheaper than getting a doctor’s prescription and paying the pharmacist.
Anyone over the age of 10 knows that buying drugs from a dealer on a street corner means you aren’t getting pure goods, and rarely does such a dealer provide dosage advice. So, people overdose.
What can be done? Three things come to mind:
1. Drug treatment is underfunded and underutilized. I know spending money on junkies isn’t popular, but it is necessary.
2. Doctors need to stop handing out pills for every little ache and pain. Of course, that bumps up against Big Pharma’s desire to sell as many pills as possible (a single-payer system can alleviate most of that pressure).
3. Opioids are not the only substances that kill pain. If we need something stronger than aspirin, maybe, just maybe, the FDA should move marijuana from Schedule 1 so it can be studied as a pain-management drug.
After all, there is no record of anyone ever dying from a pot overdose.
Jeff Myhre is a contributing journalist for TheBlot Magazine.