A dangerous fabrication...
An opioid overdose crisis? No, a deception on a grand scale.
The portrayal of opioid medication as the predominant drug-related threat to society is baseless and patently absurd. The greatest drug-related danger to health and welfare is by far, tobacco. The second most dangerous drug is alcohol.
In the U.S. and in countries politically influenced by it, authorities are proclaiming the existence of an 'opioid overdose crisis'. However, as with all things related to policy concerning drugs other than alcohol, tobacco and caffeine, it is pure fabrication designed to justify and enhance the so-called 'War on Drugs'. Following is an explanation of the phenomenon.
The message from authorities is clear: an 'opioid overdose crisis'. The clear and intentional message is that people are dying due to simply taking 'too much' opioid and apparently all-too frequently, 'too much' of an opioid prescription pain medication. These deaths are allegedly due to the effects of excessive amounts of the opioid drug on breathing. However, this is not the case, has never been the case and never will be the case:
Firstly, as detailed in the 'Heroin' page of this site, opioids, in significant overdose, do not reach levels in the body greater than those found in people receiving treatment for pain. This is due to the efficiency with which opioids are metabolised, or broken down in the body. Toxicological examination consistently shows very low, non-problematic levels of opioids present in deaths where they have been present.
Secondly, in the vast majority of drug-related deaths in which opioids were present, drugs other than opioids have also been present. Such drugs include alcohol and benzodiazepines etc., and medications capable of causing sedation such as anti-depressants and anti-histamines.
Combinations of central nervous system depressant drugs can present a danger to breathing due to heavy sedation leading to airway obstruction. This means that people cannot breath properly due to a blockage or restriction in their windpipe due to being sedated to the point that they cannot protect their airway. This can lead to a lack of oxygen causing injury or death.
The 'opioid crisis': an aggressively promoted hoax.
An apparent situation of people succumbing to 'overdoses' of opioids is being alleged, when clearly, this is not what is happening. No evidence exists to support the assertion that people are dying due to taking 'too much' of an opioid drug, be that an illicit substance or a medication. If the situation in relation to drug-related deaths were to be properly described, it would be as multiple-drug toxicity deaths in which opioids are present.
The crucial factor in drug-related deaths in which opioids are present and which is explained in the 'Overdose' page of this site, is not the ingestion of 'too much' opioid. It is a combination of substances leading to heavy sedation, airway obstruction and asphyxiation. Following is an example of how the true circumstances of the deaths is sometimes touched upon in official literature:
"In addition, available data suggest approximately 76% of accidental apparent opioid-related deaths between January 2016 and March 2018 (Footnote b) also involved one or more types of non-opioid substances." (1)
Statistics have consistently shown that alcohol and benzodiazepines are the drugs most commonly associated with mixed-drug deaths and adverse events in combination with opioids. In the context of the so-called 'opioid overdose crisis', even though multiple classes of central nervous system depressant drugs are present in the vast majority of incidents, the deaths are being intentionally misrepresented as being solely due to opioids.
The fundamental statistical literature provided by the Centers for Disease Control and Prevention in the U.S. entitled 'Drug Overdose Deaths in the United States, 1999 - 2017' (2), has a glaring and disturbing omission:
Alcohol, the most dangerous central nervous system depressant drug in relation to acute drug-related deaths is omitted from statistics.
Code groupings from the International Classification of Diseases used in the counting of what are incorrectly termed 'overdose' deaths, do not include alcohol. The class 'Accidental poisoning by and exposure to noxious substances' includes the codes X40 through to X44. (2) X45 addresses alcohol. The class 'Intentional self-harm' includes the codes X60 through to X64. X65 addresses alcohol. Finally, the class 'Event of undetermined intent' includes the codes Y10 through to Y14. Y15 addresses alcohol. The codes for alcohol involvement are omitted from all three groupings.
The omission of alcohol from statistics unequivocally invalidates the portrayal of acute drug-related deaths in terms of causality and statistics.
The role of alcohol in acute drug-related deaths or 'overdoses' as they are misleadingly termed, is being purposefully ignored. Alcohol is found in approximately half of cases in which opioids are present.
Notwithstanding the nature of the statistics, even the numbers officially quoted indicate the relative scale of the so-called 'crisis'. The U.S. Centers for Disease Control and Prevention quotes figures of 13.1 deaths per 100,000 head of population with involvement of any type of opioid drug in 2016. (3) Importantly, the vast majority of these deaths also involved other drugs. Put into perspective with major causes of drug-related mortality, the deaths of thirteen thousandths of one per cent of the total population does not constitute an 'epidemic'.
Tobacco, the largest cause of drug-related mortality.
To provide some perspective, the figures for cigarette smoking in the U.S. are "... more than 480,000 deaths per year ...", which equates to "... about one in five deaths annually, or 1,300 deaths every day." It is the "... leading cause of preventable death." (4) The death rate for smoking is about 169 per 100,000 head of population per annum. If ever there was a drug worthy of having the title 'epidemic' in terms of death and disease, tobacco is that drug.
What does the strategy achieve for those seeking to perpetuate the 'War on Drugs'? It achieves several important objectives, all of which are related to economic activity based on the criminalisation of a minority:
It protects and perpetuates the black market in unregulated opioids, which constitutes a world-wide economy of massive proportions. Measures are implemented at many levels, such as restrictions on prescribing, which make it less likely that medical opioids are diverted to 'recreational' users.
In the U.S., the Drug Enforcement Administration ruthlessly and with militaristic precision, monitors the production and distribution of opioid medications in order to minimise diversion to 'recreational' users and thereby protect and maintain the black market in opioids. Recreational opioid users are therefore less able to acquire a substance who's quality is known and they are further obligated to obtain and use substances which are manufactured in unregulated conditions.
It creates work for those involved in prosecuting the 'War on Drugs'. This activity is funded by public money and the so-called 'opioid overdose crisis' provides apparent justification for this funding. Enforcement agencies are the predominant beneficiaries of the billions of dollars of public money distributed by government.
DEA agents and police
The work created by the 'crisis' includes monitoring the production and distribution of medical opioids, surveillence of medical practitioners, pharmacists and users of opioid medications and prosecution of those found to be in contravention of laws. Legal action taken against medical practitioners for instance, benefits the legal profession through their involvement in prosecution and defendant actions.
It creates an incorrect perception amongst the populace of a threat to survival, specifically, the use of opioids. Many people will mistakenly accept that the threat is legitimate, merely because it is government inspired. This ensures public support for the strategy and more broadly, apparent reinforced justification for the so-called 'War on Drugs', which has as its basis, the creation of political advantage through the allocation of huge amounts of public money.
Recipients of this money are many and diverse, including enforcement agencies, 'treatment' providers, community organisations and those who supply and support them.
It assists in keeping opioid users as an oppressed and exploited minority due to their drug of choice being deceptively portrayed as being uniquely dangerous. Possession and supply of their drug of choice steadfastly remains a criminal act, obligating them to endure a chaotic lifestyle. Users and suppliers of the two most dangerous drugs in existence, alcohol and tobacco (and caffeine), are not criminalised due to their involvement with the substances.
Ironically, the situation presents a substantial commercial opportunity for pharmaceutical companies involved in the supply of Naloxone. Naloxone blocks the effects of opioids and is portrayed as the panacea to opioid 'overdose'. It can remove the opioid component of dangerous sedation brought about by combinations of central nervous system depressant drugs. It is of no use to a solitary person who is rendered unconscious by multiple-drug induced sedation.
The so-called 'opioid crisis': a huge commercial opportunity for suppliers of Naloxone.
There are opportunities for those who provide apparent alternatives to opioids:
Specialised 'pain clinics' are proliferating. These businesses provide 'alternative' treatment modalities for people that suffer from chronic pain and apparently highly regulated and reluctant prescribing of opioids. The inference here is that pain is a specialised area of medicine and somehow outside the expertise of general medical practitioners.
Those who provide non-opioid pharmacological treatments for pain stand to profit due to opioids being maligned and their availability restricted.
What are the effects of the strategy on people who for whatever reason, consume opioids? For people who rely on opioids for treament of pain, the strategy has serious negative ramifications. Opioids (specifically morphine), are the 'gold standard' for the treatment of chronic serious pain. Doctors however, are actively discouraged by authorities from prescribing opioids, leaving many patients untreated or under-treated for serious pain.
This has obvious and sometimes catastrophic effects for their wellbeing. Some of these people may be forced to obtain their medication from the black market, making them vulnerable to criminal sanctions, which can further negatively affect their lives.
For those who consume opioids on a 'recreational' basis, their desire to obtain a supply of their drug of choice of known quality is futher hindered by authorities, whose aim is to obligate them in acquiring their drug from a highly profitable black market.
Is there an 'opioid overdose crisis'? No, not at all. People that have died due to drug-related causes will predominately have succumbed to a series of events comprising heavy sedation, airway obstruction and asphyxiation brought about by a combination of substances.
Those who have died not having combined drugs will have blood opioid levels in the range found in living people. These people will have died due to non drug-related causes. The allegation that there are people dying solely due to overdoses of opioids is a complete fabrication and no evidence exists to justify the claim.
Many of those succumbing to drug combinations would have been unaware of the dangers due to the emphasis being on the fallacy of fatal 'opioid overdose'. The continued untrue assertion that people are dying due to taking 'too much' opioid has the effect of the actual hazard (drug combinations) not being adequately publicised, therefore leading to many more preventable deaths.
Perhaps the most salient observation is that there is never a 'crisis' or 'national emergency' relating to any of the truly dangerous drugs in society: alcohol and tobacco, or caffeine. There are only ever 'crises' or 'emergency' situations declared concerning the drugs of a minority or in other words, 'controlled' substances. These are the drugs for which authorities wish to have a black market in place and their users subject to criminal sanctions.
1. Special Advisory Committee on the Epidemic of Opioid Overdoses. National report: Apparent opioid-related deaths in Canada (January 2016 to March 2018). Web-based Report. Ottawa: Public Health Agency of Canada; September 2018.
2. National Center for Health Statistics. Drug overdose deaths in the United States, 1999–2017. NCHS Data Brief, no 329. Hedegaard H, Miniño AM, Warner M. 2018
3. Centers for Disease Control and Prevention. Drug Overdoses. Web Page. 2019. https:// www. cdc. gov/ nchs/ fastats/ drug- overdoses. htm
4. Centers for Disease Control and Prevention. Smoking and Tobacco Use, Fast Facts. Web Page. 2019. https:// www. cdc. gov/ tobacco/ data_ statistics/ fact_ sheets/ fast_ facts/ index. htm
Page head image: National Opioid Crisis Community Summit, Aberdeen Proving Ground, MD - December 11, 2018 (U.S. Army Photo by Sean Kief)
Page images: Bciccocioppo (speaker) and Intropin (naloxone)