Oh, the Opioids!

It’s the season of giving, of looking back and looking forward as one year ends and another begins. What better time to consider a fresh outlook on drugs?

Here we are amid the Opioid Crisis, the latest in a long line of similarly heralded events sparking fear, outrage, and call for action. One hundred years ago, it was the Cocaine Crisis quickly followed by the Marijuana Crisis, then the Heroin Crisis. By the late 60s, it was LSD that elicited our fear and loathing.

Doomed to fail from the start, the so-called Drug War was about ‘just saying no’ alongside arming our friendly local cops with military weapons. What we’ve since discovered is that ‘saying no’ meant not talking about it, and that’s a direct route to where we are now. Even worse, we failed to recognize that a war on drugs was actually a war on Americans who use drugs. Now we have embattled inner cities rampant with gun violence and police who dress/act/think like commandos.

What we as a society desperately need to realize is that DRUGS ARE NOT THE PROBLEM. Substance abuse is a SYMPTOM of a much larger and more insidious problem. We’re self-medicating for existential despair.

Existential philosophy arose in the 1950s and early 60s as a way to discuss the unique condition of modern man. Due to mechanization and urban living, the ancient traditions that have helped us cope no longer apply. We are isolated from Nature and its rhythms and lessons that used to sustain us. We are isolated from the sorcery and magic we used to believe was God. We are isolated from our fellow man, often living alone or in nuclear family settings instead of tribal or extended family groups. And most difficult, we are isolated from ourselves, distracted from our thoughts and feelings by constant chatter and material diversions. This is, briefly, the four-fold alienation that describes modern existentialism.

Exacerbating the problem of our modern age are the failures of education, lack of job opportunities, lack of self-esteem, and poor health.

Public or private, schools are missing the target for many youngsters who desperately need logic and critical thinking. Trades we’ll always use, from plumbers to carpenters to seamstresses, are not taught nor are the fundamentals of operating a self-owned business.

Our culture fails to offer a buy-in for young people who need to know they matter. Public service options in avenues other than military are few and far between. Self-esteem has been relegated to displays of material wealth even when no such wealth exists. Debt to last a lifetime is the price we pay for these trappings of social status.

Even more critical is our declining health. Not only are fast food and prepared meals low in nutrition, they’re more expensive than basic foods prepared at home. We’re overeating and starving at the same time, piling on calories in sugar and fat while missing out on the micronutrients, vitamins, and proteins that lead to an uplifted mood and greater energy. No one is advertising chard sautéed with garlic.

Yet the greatest fraud about drugs is perpetuated by the very industries that bear the name of ‘drug manufacturer.’ Since the 1950s, the insidious promotion of drugs by companies like Pfizer, Eli Lilly, or Merck (to name a few) has increased proportionately to the nation’s substance abuse problem.

Slick advertising convinces consumers that with one magic pill, all of life’s ills will go away.

Television especially holds out the false promise. The suffering victim is cast in a muted gray-tone atmosphere while around them everyone else is blissful. With the magic pill, suddenly the victim joins the bliss, bathed in golden light. Meanwhile the precautions about negative effects from the medication are described in a hurried low monotone that fails utterly to overcome the visual imagery.

The message? Consume a drug and your life will be better.

It’s a message that’s not lost on the audience, young and old alike. Who doesn’t want to be part of that golden bliss? Who doesn’t want to live without pain, without worry? All you have to do is take a drug.

It’s exactly this message that has led to the current opioid crisis. It’s not that doctors are overprescribing, although some are. It’s not that manufacturers falsely claimed that OxyContin and its family of synthetic opioids are safe to use, although some undoubtedly did. It’s that all of it is part of a bigger scam wrought upon the American citizenry—that the inevitable aches and pains of life can be made painless.

When we read about the pioneers and ‘old timers,’ we’re aghast at what they endured. No indoor plumbing? No central heat? No food unless they grew it? We marvel at their toughness, their ingenuity.

Yet amid all the labor saving devices and easy consumer goods, we find ourselves without any test of our endurance or strength. We spend too much time in activities that show us nothing at the end of the day. How can we prove ourselves without any proof?

We’re looking for adventure and new horizons. Our natural tendencies as humans drive us toward activities that may result in trauma, pain, or even death. How do we turn back the very features of our make-up that have brought us out of the caves?

The hazard of certain drugs that lead to laws against them is the fear that persons under the influence will harm us. By escaping rationality through intoxication, people may unleash violent tendencies. No abused substance in history lives up to this threat more than alcohol, but our failed war on alcohol should have taught us important lessons about the harm such policies cause.

The need for a national conversation about drugs is long past due. All drugs. Pharmaceutical advertisements should be banned, particularly those requiring a prescription. After all, why are we encouraging people to decide what drugs they need instead of allowing doctors to do their job? Profits for pharmaceuticals should be heavily taxed despite the persistent whine that the money only funds research.

… evidence that Gilead itself uses its profits to “innovate” is thin at best. In 2016, the company reported profit of $13.5 billion. It spent $11 billion to repurchase its own shares, and about $2.5 billion on stock dividends.[1]

Drug manufacturing ranks among the most profitable industries in the world.

Until we set aside our conditioned response to the drug problem, we cannot solve this escalating crisis. We are throwing people away by failing to address fundamental issues that lead people to hide in a drugged haze. We are throwing them away a second time when we stigmatize their drug problem by involving them in the criminal justice system. Or when we force them into a drug court program with limited resources and over-dependence on 12-step programs and which fail to address underlying conditions such as inadequate nutrition.

Treatment programs generally fail in many ways partly because they are set up to create profit. Instead of looking to make money off of people suffering from addiction, we should be looking for ways to express our collection compassion and concern. We should make sure that intake is immediately available for any and all comers, that they’ll be offered a safe setting full of comfort and light, that individual counseling is the best money can buy. When we invest in our fellow man, it’s a win-win for everyone.

So I urge you to give it some thought and talk about this over the holidays as you meet with friends and family. Enjoy that glass of wine as you celebrate the season. Acknowledge the difference between use and abuse. Love your neighbor as yourself. Be part of the change we so desperately need.

~~~

[1] http://www.latimes.com/business/hiltzik/la-fi-hiltzik-gilead-profits-20171023-story.html

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Straining on a Gnat

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In light of a recent update to federal regulation of commercial chemicals, pointed questions arise about laws governing controlled substances. Consider last week’s announcement of funding for a study of synthetic pot. The press release from the University of Arkansas for Medical Sciences emphasized the importance of knowing ‘what is safe.’ A federal grant of $2.7 million will fund research into K2 and Spice, a study to be led by Paul Prather, professor of pharmacology and toxicology.

“People who smoke K2 and Spice are basically playing Russian roulette,” Prather warned. “You’re injecting this compound that has literally never been tested.”

I had to laugh out loud. What are K2 and Spice compared to the 84,000 commercially used chemicals that have never been tested? What logic lies behind aggressive policing of intoxicants that a limited percentage of the population might voluntarily use periodically and the simultaneous abject failure to test chemicals that the entire population unwittingly touches, ingests, and inhales on a daily basis? Everything from dryer sheets to shampoo to spray sanitizers is loaded with mystery chemicals.

This lunacy fits perfectly with the hit-or-miss tradition of government policies rife with misinformation, driven by profiteering, and shrouded in hysteria and secret agendas instead of rational analysis of fact.

People who use K2 and Spice seek a legal alternative to marijuana.  Unlike these modern synthetics, however, marijuana has been in use as a medicine and intoxicant since pre-history. Archaeological evidence points to cannabis use in ancient China, ancient India, ancient Egypt, and by the Scythians contemporary to ancient Greece. If the criteria is ‘what is safe,’ then marijuana has long since exceeded the requirement.

If public policy were based on thoughtful analysis, marijuana would be legally sold like alcohol and this $2.7 million appropriated to study K2 would be spent on examination of why the U. S. has a higher rate of drug use and abuse than any other nation on earth (which goes hand in hand with our skyrocketing prison population).[1] The proportion of people in the United States who have used cocaine at some time during their lives is higher—by a factor of four—than in 16 other nations surveyed by the World Health Organization (WHO). The United States also leads in lifetime use of cannabis and tobacco.[2]

There’s a common misconception that drug laws are based on comprehensive scientific conclusions about the dangers of those drugs. Government funding to study drugs props up the fiction that our laws are based on ‘what is safe.’ This fantasy has been promoted by those with vested interests or a social agenda in mind. Drug laws have turned our local police departments into militaristic hit squads. Prisons are a growth industry. Selective enforcement of drug laws against immigrants, racial groups, the counter culture, and inner city poor places these potentially troublesome groups under government control.

Drug laws do nothing to stop addiction.

Consider the cautionary tale now unfolding about OxyContin. Blessed with extensive clinical testing and FDA approval, Oxy has been the darling of pain relief since the 1990s. Similarly, a century earlier Bayer Pharmaceutical introduced a new wonder drug named heroin.[3] “The sales pitch that created an instant market to American doctors and their morphine addicted patients was that heroin was a ‘safe, non-addictive’ substitute for morphine.”[4]

Now that OxyContin addiction rates have soared, a predictable crackdown has restricted supply. The result is a shift from oxy to black market heroin and rising overdose rates.

Drug warriors and doctors alike seem to be asking the wrong questions.

The more obvious right question: Why does the U.S. lead the world in substance abuse?

The less obvious: What role does our daily cocktail of manmade chemicals play in our mental and physical health, including addiction?

If the health and welfare of our citizenry were the force guiding federal and state policy, then why has it taken until June of this year for the federal government to authorize new provisions in the nation’s Toxic Substances Control Act? Originally passed in 1976, the TSCA allowed all 62,000 chemicals that were in commerce before that year to stay on the market unless the Environmental Protection Agency later found that they posed an “unreasonable risk.”

Now over 84,000 untested chemicals are in commercial use. In the intervening forty years, the EPA has required testing of only 250 chemicals and banned only nine, among them dioxin and hexavalent chromium. The new rules impose a mandatory requirement for the EPA to evaluate tens of thousands of in-use chemicals and establish risk-based safety standards along with requiring public transparency for chemical information. [5]

A day late and a dollar short. For decades, activists have pushed for laws more like those in Europe where substances generally can’t go to market unless manufacturers can provide data showing they’re safe.[6] Clearly we’ve got this backwards.

Before you start feeling reassured by this recent change in the U.S. regulation of chemicals, please note that

“The new law requires EPA to test tens of thousands of unregulated chemicals currently on the market, and the roughly 2,000 new chemicals introduced each year, but quite slowly. The EPA will review a minimum of 20 chemicals at a time, and each has a seven-year deadline. Industry may then have five years to comply after a new rule is made. At that pace it could take centuries for the agency to finish its review.”[7]

One gaping hole in our official ‘what is safe’ question is whether any of these chemicals might increase the risk of addiction. For example, the chemical Bisphenol A (BPA) is found in many products, including canned foods, plastics, and dental sealants, and is similar in structure to the hormone estrogen. Ask any woman whether hormones affect mood and attitude. Or any man, for that matter. Studies have linked BPA exposure with many health problems including obesity, early puberty, and miscarriage. Whether levels of BPA in the environment are harmful to people is still being studied.

Other chemical pollutants may affect mood, impair reproduction, and trigger cancer and other disease. Consider just one particular chemical, tributyltin, which is used as a wood preservative and glass coating among other things. In animal studies, it was found that exposure to tributyltin increased the number of fat cells, thus possibly setting into motion a genetic propensity at birth for obesity.  Some chemicals have been found to cause male frogs to become female.  It’s a long and terrifying list.

84,000.

Admittedly other factors in American life influence the rates of intoxicant abuse. As a multi-cultural society, we have few ties that bind. What are our rituals that serve as guideposts, rites of passage that help define a young person’s purpose or meaning? What shortcomings in Western medicine lead us to treat an ailment’s symptoms rather than dig out the cause? What ignorance and greed allows drug companies to saturate our media with ads that condition us to seek a pill for every ill?

Simultaneously, chemicals have become the modern savior for everything from bad odors to agriculture. We are routinely exposed to a smorgasbord of substances which may trigger our need for drugs or at least compromise us in myriad ways we hardly understand. While government awards contracts to study K2 which last year caused fifteen people to lose their lives, cause of death data from 2013 finds 29,000 deaths from alcohol, 18,893 deaths from prescription drugs, and 17,000 from all illegal drugs combined.

We can rest assured K2 will be proven harmful. Then what? Build more prisons?

Even those numbers pale in comparison to data from 2006 showing workers in chemical industries suffer more than 190,000 illnesses and 50,000 deaths annually related to chemical exposures. Workplace chemical exposures have been linked to cancers and other lung, kidney, skin, heart, stomach, brain, nerve, and reproductive diseases.

Consider the following abstract for a 2008 study by the National Institutes of Health:

“While proper brain function requires the complex interaction of chemicals perpetually occupied in purposeful biochemistry, it is well established that certain toxic substances have the potential to disrupt normal brain physiology and to impair neurological homeostasis. As well as headache, cognitive dysfunction, memory disturbance, and other neurological signs and symptoms, disruption of brain function may also manifest as subtle or overt alteration in thoughts, moods, or behaviors. Over the last four decades, there has been the unprecedented development and release of a swelling repertoire of potentially toxic chemicals which have the capability to inflict brain compromise.

“Although the ability of xenobiotics to induce clinical illness is well established, the expanding public health problem of widespread toxicant exposure in the general population is a relatively new phenomenon that has spawned escalating concern. The emerging area of clinical care involving the assessment and management of accrued toxic substances such as heavy metals, pesticides, plasticizers and other endocrine disrupting or neurotoxic compounds has not been fully appreciated by the medical community and has yet to be incorporated into the clinical practice of many consultants or primary care practitioners.”[8]

That pretty well says it all.

~~~ 

[1] http://www.cbsnews.com/news/us-leads-the-world-in-illegal-drug-use/

[2] https://www.drugabuse.gov/news-events/nida-notes/2009/11/united-states-ranks-first-in-lifetime-use-three-drugs

[3] https://en.wikipedia.org/wiki/Heroin

[4] http://www.narconon.org/drug-information/heroin-history.html

[5] https://www.epa.gov/assessing-and-managing-chemicals-under-tsca/frank-r-lautenberg-chemical-safety-21st-century-act

[6] https://www.washingtonpost.com/news/energy-environment/wp/2015/03/19/our-broken-congresss-latest-effort-to-fix-our-broken-toxic-chemicals-law/

[7] http://www.pbs.org/newshour/updates/it-could-take-centuries-for-epa-to-test-all-the-unregulated-chemicals-under-a-new-landmark-bill/

[8] http://www.ncbi.nlm.nih.gov/pubmed/18621076

 

Photo credit: https://www.flickr.com/photos/jurvetson/131023758/