Doctors “over-prescribing” opioids did not cause our “drug crisis.” Nearly half of all overdoses don’t involve opioids at all. Among remaining drug-related deaths in 2017, half involved illicit drugs — imported fentanyl and heroin. Only about 18,000 deaths involved a “prescription opioid” -- and most of those also involved multiple illegal drugs and alcohol. Medical exposure is not the problem.
The National Institute on Drug Abuse says most addicts begin to abuse alcohol and drugs in their teens or early 20s – before they encounter opioids. Contrast that with folks over age 55. Seniors are prescribed opioids for pain three times more often than youth under age 18. But seniors have the lowest overdose rates of any age group. Kids now overdose six times more often.
We do have an addiction crisis in America. But it’s related to lack of care, not prescribing. Prescriptions to people in pain are rarely involved in this tragedy. Restricting drug supply and counting pills won’t help. Forcing pain patients off the only medications that work won’t help.
Restrictive policies are now driving pain management doctors out of practice across America — and driving patients into agony, disability, and sometimes suicide when they are deserted. Most of what we hear in press about opioids and addiction is flat out wrong.
We know what we really need. Politicians just don’t want to pay for it.
Nobody knows how to “cure” addiction. We may never know. The best we can do is early prevention and later harm reduction. Some educational programs in Middle School don’t work (“Just Say No” was a total failure). But others have shown results. For people already addicted, the most effective harm reduction is Medication Assisted Treatment (Methadone or Buprenorphine), combined with long term community reintegration.
Reintegration means job training, safe housing, mental-health and recovery counseling — and support for people who relapse. 28-day detox clinics and Narcotics Anonymous don’t work alone. Such programs have high relapse rates when recovering addicts are discharged without support into the same circumstances that made them vulnerable to drugs in the first place.
Addiction recovery is neither cheap nor easy. We must invest billions every year in our labor force, housing and communities. We must also divert non-violent drug offenders out of the justice system. Even the Christie Commission got that one right. But more restrictions on doctors and their patients aren’t the answer.