Introduction
The Opiate epidemic is not just confined to the US, France is a close second, also with a widespread opiate addiction. Both countries providing a carte blanche to pain doctors handing out huge amounts of opiate painkillers, however France is attempting to stem the addiction tsunami by prescribing Buprenorphine. In terms of the most popular opiate painkiller OxyContin, its manufacturer, who aggressively marketed their product nationwide in the US poured fuel on the addiction fire that ensued during the 1990s. By doing so they set themselves up for eventual prosecution, while Mexican families from small Mexican towns ( called Ranchos) were flooding many US cities with inexpensive, potent black tar heroin So, what is the situation today with the opiate epidemic.
Opiate Addiction suppression
Buprenorphine (Brand name Subutex)another opiate drug with less potency, with the literature claiming it is a partial opioid agonist, providing less euphoria and physical dependence and a mild withdrawal profile. In fact, Reckitt Benckiser from Slough UK, a drug manufacturer ( they also manufacture Lysol disinfectant), claim that their product suppress symptoms of opioid withdrawal, almost as if Buprenorphine were OxyContin/Heroin antagonists. They have another product called Suboxone which contains both Buprenorphine and naloxone. Naloxone is supposed to reverse the effects of opioid medication. Another example of ‘Chasing the dragon’, an expression used during the19th century referring to opium addicts, but in my opinion it is more apt in this case because you are taking one drug to counteract another..chasing ( or replacing -replacement therapy) out one more potent drug from the body’s opiate receptors, and replacing it with a less potent drug. However, you are still using the body as a poisonous drug experiment centre, and the so called opioid suppressor still comes with a myriad of side effects. The drug makers discovered that Subutex could be easily abused by converting it from an oral tablet into something injectable ( melting the active ingredient) to achieve a better ‘high’ going directly into the bloodstream, so Suboxone was created to stop this practice. True to form, this pharmaceutical firm was facing a massive anti-trust lawsuit by attempting to undermine the generic drug market when its own Suboxone product was reaching its patent expiry. By ‘Product Hopping’ the drug maker tweaked an existing product and rebranded it to avoid losing their 85% market share . They went a stage further by negative selling the generic form of their own tablet version of Suboxone creation, encouraging prescribing doctors to push their dissolvable strip version, developed by one of their ‘spin-off’ companies MonoSol RX.
The Purdue law suits
The attorney General of West Virginia sued Purdue Pharma in 2004 for reimbursement of excessive prescription costs paid by the state. Since the drug effects subsided within 12 hours, patients would take more of the prescribed drug to maintain its pain killing purpose. The evidence submitted by the plaintiff argued that Purdue failed to perform efficacy and safety tests of OxyContin after 8 hours, and failed to amend the labelling accordingly. The case was settled out of court, where Purdue agreed to pay $10 million toward programs to discourage drug abuse. In May 2007, Purdue settled another lawsuit agreeing to pay $600 million for the charge of misleading the public with respect to OxyContin’s risk of addiction. Furthermore, Purdue Pharma’s president agreed to pay $19 million, Howard Udell, its top lawyer paid $8 million, and Paul Goldenheim its former medical director paid $7.5 million on misbranding charges. Three other executives were charged with a felony and sentenced to 400 hours of community service in drug treatment programs.
Kentucky sues Purdue
In Oct 2007, Kentucky sued Purdue for its complicity in widespread OxyContin abuse in Appalachia, and finally 8 years later in 2015 Purdue settled paying $24 million. In Jan 2017 the city of Everett Washington sued Purdue as being responsible for the increased cost to the city to deal with the Oxycontin epidemic citing Purdue’s failure to follow up on suspicious excess ordering of the drug, the encouragement of unscrupulous doctors, using the homeless to purchase Oxycontin, to then sell on to the general public, and the blackmarket sales out of legal pharmacys based in LA using distribution points in the city of Everett. The suit is requesting a yet to be determined amount to reimburse the costs of housing,health care, rehab,the criminal justice system, parks and recreations department as well as the loss of life, and the compromised quality of life of its citizens,
The fine does not fit the crime
So the total amount Purdue has paid to date is around $670 million. By 2016 Oxycontin had wracked up somewhere in the region of $31 billion and by 2017 $35 billion…I ask you, does the financial punishment fit the crime ?.,,compared to their sales, $670 million, which they regard as the cost of doing business is a ‘drop in the bucket’..hardly a deterrent to stop this criminality. I hope that the city of Everett calculate a settlement amounting to $30 billion less $670 million already paid + tax,,and part of that settlement to find its way to look after those children and families LEFT BEHIND.
The ‘Philanthropists behind Purdue Pharmaceutical
From the title you would think that the Sackler family, being philanthropists may not be all that bad, and I would agree, if they had funneled some of the massive fortune accumulated from the sale of their OxyContin drug into helping the people that they had a hand in destroying. Guess what ?, their philanthropy is purely self centred..it is for the glory of the great Sackler empire, so they can be remembered like the pharaohs of Egypt or the mythical Greek Gods. Lets us see what their generosity has provided for the world. London’s Victoria & Albert Museum ( a place my mother used to take me) now has an 11,000 white porcelain tiled Sackler courtyard covering the equivalent surface area of 6 tennis courts. They even invited the Duchess of Cambridge Kate Middleton to ‘consecrate’ the area ( whatever that means ). Within the Metropolitan Museum of Art in New york there is a Sackler wing, which houses the majestic Temple of Dendur, a sandstone shrine from Egypt ( you see the Pharaoh connection and illusions of grandeur).
There are also Sackler wings in the Louvre, and the Royal Academy. In both Harvard and Peking Universities there are stand alone Sackler museums..displaying what exactly..OxyContin’s poisonous hall of fame. There is a Sackler gallery in the Smithsonian housing Asian art. Sackler donated money to extend the library at Oxford’s museum of Art & Archeology ( Ashmolean) housing such treasures as Egyptian mummies ( Egypt association again..no its Sackler’s association with fine literary treasures of archeology and classical civilization). An Arts education centre was built with Sackler money at the Guggenheim Museum in New York, and in the American Museum of Natural history. Many of these places were built in 2001 which is around the time the OxyContin Epidemic was raging. There is even a Sackler school of medicine, a Sackler institute for nutrition science supporting research on obesity and micronutrition, and sackler institutes at Cornell, Columbia, McGill, Edinburgh, Glasgow Sussex and Kings College UK teaching psychobiology.( the science of Behaviour and mental phenomena). Any of these institutions welcome donations, and this family can donate money to every eminent building of science or the arts on the planet but it won’t redeem or hide the misery and destruction that their product caused and continue to cause. What about a Sackler trust to help abandoned children whose mothers and entire families lost their lives through hopeless opiate addiction and the thousands that were turned into homeless wrecks and still are today.
The Mexican black tar heroin epidemic
Well the best account of this saga was written by Sam Quinones in his book ‘Dreamland’ who met with some of the characters and spent time in Mexico, so I draw upon his in-depth knowledge. It was the late 1980’s when law enforcement began to notice Mexicans selling small quantities of Heroin on the street, but it was unusual since the heroin product resembled a ‘Tootsie roll’; it was black and tarry, hence the name Black Tar Heroin and there were stories that this substance was cut using boiled coca cola which became thick and black. It was also discovered that the Mexicans came from a small town called Nayarit which is a little north of Guadalajara on the south west coast of Mexico. Another town where other heroin dealers came from was Jalisco (Xalisco), just south of Guadalajara. Gradually, the sale of this type of Heroin became like a Pizza delivery service where they would have a one man call centre who would receive heroin orders and delivery men in cars would be dispatched to the client’s location where the product would be delivered to. This heroin sales unit of a dispatcher and a fleet of delivery personnel would be like a dope cell. The heroin was delivered in small uninflated balloons ( 1/10 of a gram each) that each driver would carry in their mouths with more hidden in the car. The driver would carry a bottle of water so if they were stopped by law enforcement they could swallow the merchandise and dispel later through their waste.
Dope-express delivered to your door
Business hours 8am-8pm, and each cell member kept a low profile, no violence, no turf hopping so everybody was happy. There was some slight competition but members of each competitive cell knew each from back home in Mexico so there was acceptance without fighting and no guns. Even if cell drivers were caught with the product the bust would be minimal due to the small amounts of the drug. By the mid 90’s there were 8-10 cells each with 3 or 4 drivers working daily in Denver, and there were at least 12 major metro areas in the western US being serviced by this fast dope franchise operation. It was every Mexican’s dream to return to their hometown with money in their pocket and show the other townspeople how successful they had become. Staying in their villages meant toiling in the sugar cane fields from dusk to dawn with very little, if any prospects, and a meagre income from hard work day in day out, when they could earn much more without the intense labor, driving for one of the black tar heroin franchises.
Methadone
An American doctor Vincent Dole (1913-2006), a metabolic specialist, with his wife Dr Marie Nyswander (1919-1986), herself a psychiatrist/psychoanalyst, pioneered the use of narcotic agonist Methadone to treat heroin addiction. Although Methadone is an addictive opiate in itself, its use meant replacing one addiction for another ( so called ‘replacement therapy’) but they discovered, given the correct dosage of a prescription drug as opposed to an illegal street drug the drug user could be partially rehabilitated back into society, provided they received one dose of methadone that could last 24 hours. Whereas with Heroin the user becomes single minded just thinking about the drug and nothing else, but at least methadone opens the mind allowing the user to think about other things in life like family and a job. By 1964 at the Rockefeller institute they experimented their idea using 6 heroin addicts which was a success, so in 1967 there were 300 addicts receiving the methadone maintenance treatment (80-120 mg/day). As a result the patients ceased their heroin habit, but still needed a shot of daily Methadone and became fully engaged into society again, shifting their priorities from constant drug craving to family responsibilities and employment. Psychiatrists were also available for counselling but this psychotherapy was obligatory. The management of this replacement therapy ( Heroin for Methadone) was successful because it only required a small dose in most cases, which was enough for addicts to get through their day, but as the years went on the many clinics that had been established, fell into poorly managed centers, and many addicts began to crave for more in the afternoon due to physiological drug tolerance, a phenomena that we discussed in previous articles.
‘Game reserves’
During the 1990’s the Mexican black tar heroin cells became aware of these Methadone clinics and in the words of Sam Quinones they became ‘Game reserves’ to sell their product. Like drug predators they would stalk the different clinics looking for potential customers. The strategy conducted by the cell members were to spot an addict, and then confront him/her with some ruse like asking for directions and then spit a balloon out of their mouths and give it the addict for free with a phone number and then leave by saying “ Give us a call if we can help you out”.
The opiate epidemic today
Today, the opioid epidemic has become the worst drug crisis in american history, killing more than 27,000/annum. In 2014 fatalities from automobile accidents equalled 29,230, while 47.055 people were dying of drug overdoses, the majority of which is from opioids and heroin according to the CDC. In 1991 physicians wrote 76 million prescription opiate pain killers, and by 2011 this figure had escalated to 219 million ( National Institute on Drug Abuse report). The chart below shows that from the year 2000 to 2014 overdose deaths caused by Opioids exceeded overdose deaths caused by Heroin. The racial groups affected the most were caucasian and Native Americans.
In 12 US states the number of opioid prescriptions exceeded the number of inhabitants in 2012:
| STATE | # Prescriptions/100 inhabitants |
| Alabama | 142.9 |
| Tennessee | 142.8 |
| West Virginia | 137.8 |
| Kentucky | 128.4 |
| Oklahoma | 127.8 |
| Mississippi | 120.3 |
| Louisiana | 118 |
| Arkansas | 115.8 |
| Indiana | 109.1 |
| Michigan | 107 |
| South Carolina | 101.8 |
| Ohio | 100.1 |
Heidi Shafer, chair of the Shelby county commission, reports that her mother had a minor outpatient surgery which required 1 day of recovery, and to help her along, her physician prescribed a months (30 tablets) prescription worth of opioid painkillers. This occurred today, in 2017, and these so-called doctors are still over subscribing. Did we not talk of the prison guard that was given a months supply of OxyContin and it took him 31/2 years to kick his addiction after only taking the drug for 1 month. There lies your problem America..Pain Doctors..this is the wrong name..ignorant dope peddlers..you will never get behind the problem until you clean up your so-called health care and remove their medical licenses because they are too stupid to have one. Are they not aware of what has been going on since the 1990’s…and the government should wake up and remove this poison from the market and take the rest of the drug haul as well..the SSRI’s etc and burn it all. Shafer is making an effort to hire an attorney and file a lawsuit against offending pharmaceutical companies for their role in the opioid crisis…well that’s been done before, but whatever settlement you get,will only amount to their cost of doing business…peanuts..a drop in the bucket..we can pay that fine out of the petty cash…the justice system should think bigger..billions to match their profits..let them forfeit their profits in paying fines..that would be a blast across the bows. If you don’t and I suspect it can’t be done because the drug companies have congress positioned exactly where they want them, they are wasting their time….congress in general does not care..whats a few thousand lives worth,,,whats a few million lives worth…nothing..nobody cares…the infection is too deep.
The pill mills still exists, even today Dr Robert Rand ‘the monster with the stethoscope’ as described by USA Today behaving the same way as Procter and Volkman did back in the 1990’s, and he was handed down a 10 year sentence for causing the death of one patient and ordered to pay $11,000 restitution money to Michael Yenick ‘s ( the dead victim) family and a $25,000 fine. Another patient, Richard West was being oversubscribed OxyContin that he was selling for profit; he was sentenced to 2 years. This is a small carbon copy that was repeated many times over. Why is this oversubscribing practice and Pill mills allowed to continue…because nobody cares..it’s staring you in the face. In the 1990’s or certainly by 2005 when everybody was aware of what was going on in these pill mills they should all have been closed down and the conventional medicine should have gone back to their old practice of restricting access to opioid drugs unless its somebody dying of cancer and the risk of addiction becomes secondary to their primary pain issues. However, it is not all doom and gloom, Sam Quinones reported in his book’ dreamland’ that slowly Portsmouth Ohio where the nightmare of opiate addiction began is starting to recover, and many addicts are going into rehab centres to rid themselves of the horrific addiction that ripped their lives apart, and the pill mills and the unscrupulous physicians are all gone but I encourage all readers to read Sam Quinones excellent book ‘Dreamland’ the true tale of America’s opiate epidemic..you won’t want to put it down until you have finished reading it.
Conclusions
This has been a long journey and I hope that you all enjoyed reading this 24 article series ‘The Destruction of Society’s social fabric and drugs’ as I have, writing them. Remember, you can only avoid synthetic chemicals, the kind that conventional physicians and psychiatrists prescribe if you provide the raw materials that the body was designed for…healthy unprocessed organic food, healthy animal fats and supplement with all 90 essential nutrients. If you need to familiarize yourself read the 17 article series entitled ‘the 90 essential nutrients’. I wish I could conclude that modern conventional medicine has made progress in psychiatric care, but the system insists in medicating patients with psychotic disorders as a total replacement for non invasive psychotherapy. Psychosis has a huge social element attached to it, so it requires human dialog as a therapy, diet as a therapy and above all compassion, understanding and relationship building. Pain management can be approached by neuroplasticity; rewiring the brain by mere thought to stimulate the brain to release endorphins and close the pain gates that exist in the spinal cord. Michael Moskowitz a psychiatrist turned pain specialist uses this technique without the use of addictive opiate painkillers. Low intensity laser light, music are both powerful healing mediums for the body, including the brain without the use of psychotropic drugs. There are successful alternatives out there, you just have to know they exist. Alas, the root of the problem remains elusive within conventional medicine, rushing you through their patient assembly line prescribing chemicals…even though the body has enough chemicals. This Pharmacological driven healthcare/psychiatric system and the mountains of money spent convincing the general public that this system is there as a safety net to nurse you back to health is a medical myth. Money, greed, power and intellectual narcissism has created a system of health that only serves to make the sick sicker, and the drivers of this system has convinced government that their system works, despite the massive waste of money to support it. In the land of the blind the one eyed man is king.
Um, hey, um, listen, about the um, about that uh, jail thing… I-I-I- I can’t. I-I I can’t go. Um, uh, well, not because I don’t want to go, but, um, it, uh, oh God, my hands, you know, they just keep doing that. That’s not normal. I just– there’s something wrong with my hands– um, well, with me. Cause, uh, what kind of person just jumps out of a- what kind of person jumps out of a window, you know? Because she can’t sit still, you know? And be alone and, you know, in a room, without– You know a person should be able to just be alone, right? You know, human beings should be able to just breathe. I can’t breathe. And I feel that I think I know– I think I know that if I go to jail… like this, you know, I’ll die, and, uh, I don’t wanna die.
If that will make you happy, I will stop drinking. And then I would tell myself, “Tonight, I will not get wasted.” And then something would happen. Or nothing would happen. And, uh, I’d get that feeling. I think you all know what that feeling is. When your skin is screaming and your hands are shaking. Uh, and your stomach feels like it wants to jump through your throat. And you know, that if anyone had a clue how wrong it felt to be sober, they wouldn’t dream of asking you to stay that way. They would say, “Oh, geez, I didn’t know. Here. It’s okay for you. Do that mound of cocaine. Have a drink. Have 20 drinks. Whatever you need to do to feel like a normal human being, you do it. And boy, I did it. I drank and I snorted, and I drank and I snorted, and drank and I snorted, and I did this day after day after day after night after night. And I didn’t care about the consequences, because I knew they couldn’t be half as bad as not using. And then one night, something happened. I woke up. I woke up on a sidewalk. And I had no idea where I was. I couldn’t have told you the city I was in. And my head was pounding, and I looked down and my shirt is covered in blood. And as I’m lying there, wondering what happens next, I heard a voice, and it said, “Man, this is not a way to live. This is a way to die.”
Quotes from the movie ’28 Days'( 2000)
References/Acknowledgments :
- Buprenorphine The National Alliance of advocates for Buprenorphine
- Suboxone creato’s shocking scheme to profit off heroin addicts Chris Maroff 2016 Daily Beast
- Purdue Pharma, Vincent Dole Wikipedia
- How bad is the opioid epidemic ? Dan Nolan, Chris Amico 2016 Frontline
- Schafer : Why we took on big Pharma, Opioid abuse 2017 USA Today
- ‘Monster with a stethoscope’; Reno Pill Mill doctor Robert Rand gets 10 years Anjeanette Damon 2017 USA Today
- The secretive family making billions from the opioid crisis Christopher Glazek 2017 Esquire
- Dreamland Book 2015 Sam Quinones
- Movie Quotes 28 days Wikiquote