Bitter Pill

I see the argument on a near daily basis.  “Drug addict” used as a slur.  A term denoting worthlessness.  That person isn’t a worthwhile human being.  They’re a drug addict.  This is nothing new.  We’ve been treating addiction like a moral failing since humans could get high.  Obviously, if the person had any strength of character they’d not have gotten themselves into this situation.  

That lie is so far from the truth it’s not only tragic, it enrages me.  

Addiction is incredibly complex and begins as a result of a variety of factors – mental illness and inattention to appropriate mental healthcare, poor and prohibitively expensive treatment programs for addiction (My grandparents once put my uncle into rehab for his meth addiction – it cost them (I think, long time ago) $12,000 for a month.  They had to get a second mortgage to afford it and he left a few days into it), poverty, Hell…genetics predispose people to addiction.

I hear a lot of people talking about how they have no sympathy for drug addicts because they aren’t seeking help.  Please.  Next time you say this about someone – figure out where the Hell that “help” is supposed to come from.  There’s Narcotics Anonymous.  And that’s great, but it’s only one tiny facet in treating what is a medical problem.  While it works well for many, it doesn’t work for everyone.  

And let me emphasize that again.  Addiction is a disease.  The American Society Of Addiction Medicine defines addiction as:

“…a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.

Addiction is characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response. Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.”

Please note the absence of, “A thing that only happens to piss weak individuals who lack morals.”.  But we still treat people suffering addiction as though they’ve done something wrong.

“But Sandra”, I hear the pretend people in my mind saying (I’m not crazy, my mom had me tested (my mom did not have me tested).) – “it’s not like that person’s addicted to prescription painkillers, they’re shooting up fucking heroin.  They’re willingly putting that shit into their veins.  Can you IMAGINE?”

Kind of, yeah.  I mean I grew up around addicts.  There’s a big-ass reason the worst narcotic I’m willing to put in my body is alcohol.  And that is a pretty shitty risk. Alcohol is fucking dangerous and we treat it way more likely than we should.  If you know anything about me at all, you probably thought I was going to say marijuana.  And if you thought I was going to say marijuana it only serves to enforce my argument that the way we treat drugs and drug addicts is profoundly ass-backwards.  

The addicts I grew up with were …well all over the place really – but their primary drug of choice was methamphetamine.  My home town has been suffering a massive meth epidemic for as long as I can remember.  When I hear people here talk about the huge “ice epidemic” (ice is crystal meth) facing our local area I kind of want to roll my eyes.  Not because I don’t believe that ice is a significant problem here – it is – but walking down the street in Springfield was like playing tweaker bingo.  You knew what meth addicts looked like because a large percentage of ALL the people you ran into bore the telltale signs of meth use.  If I seem to not take the ice problem here seriously, it’s equal parts fatigue on our conterintuitive approach to addiction and my previous exposure to a far, far more visible epidemic of addiction.

Growing up in that environment made it easy to see how slippery that slope can be and how easily it could have been you had just a couple of things been different.

“But Sandra.”  Heroin.

How does a person get to a point where they’re injecting an extremely dangerous substance directly into their veins? Well – with heroin, it very often starts with a very legal prescription for narcotic pain medications.  For a very long time we saw these drugs as harmless.  

For years drug-related deaths have been climbing at a steady pace.  They now kill more Americans than car accidents or firearm-related deaths.  While direct prescriptions to the addict are not the main source of someone’s first opiate high, it’s clearly a massive contributing factor and the sheer availability of opiates makes those pills so incredibly easy to obtain.  I can’t tell you how many ads I’ve seen over the years promoting Vicodin for sale from online pharmacies.  My last experience with Vicodin (after an injury years ago) was so fun it freaked me out and I flushed those pills down the toilet (yes I now know not to do this), content to suffer with Tylenol instead.  I carefully stopped taking my Endone (oxycodone – the chemical component of Oxycontin) as soon as I could get away with after my surgery and took them to a chemist for disposal.  The internet wants me to know how easy it would be for me to get more.  You know, just in case you change your mind.  We’ll be over here.  

So how the Hell is this happening? If opiate prescriptions are a huge contributing factor to opiate addiction and subsequent heroin use (people turn to it because it’s significantly cheaper than the pills) why are we still prescribing them at alarming rates? Well, thankfully we aren’t.  We’re starting to address this.  Opiate prescription rates have fallen 40% since 2010, something that makes Purdue Pharma (the pharmaceutical company which makes Oxycontin) unhappy.  

Have you ever seen a drug dealer on a street corner and decided that they were garbage?  Hated them?  Wanted something terrible to happen to them because they were “getting people hooked” and ruining lives? I mean…drug dealers reel people in with false promises and false information – not informing them of the risks.  

If you think that behaviour is unacceptable, you should be really fucking pissed at Purdue Pharma.  Oxycontin was initially marketed as being great in part because it was along-acting drug, implying that it had a lower potential for abuse than opioids which were immediate and short-acting.  There was no evidence to back up this claim, but the FDA allowed it to be made and it was effective in pushing their product.  

(None of this is true)

Next time you see a drug dealer on a corner I want you to consider that the guy on your corner selling drugs to kids (btw, the FDA approved Oxycontin prescriptions for children as young as 11, get ’em while they’re young) – I want you to consider that they’re little more than poor, less organized versions of large pharmaceutical companies.  The guy on the corner may have a sweet ride but these guys are billionaires.  Which goes to show – it’s okay to be a drug dealer if you’re a rich white guy.

 

I decided to see where Purdue Pharma’s political contributions go and what the stance of the politicians they’re endorsing and giving money to vote on.  I suspect that I knew what I’d find, but god I hoped I’d be wrong. 

Purdue’s largest political contributions were to a US Senator named Richard Burr who claims to be some distant relative of Aaron Burr as though that were something to be proud of.  

And what are Burr’s positions on drugs? Unsurprising.  He has been quoted as stating:

“I’m on the record for believing that medical marijuana has no real intrinsic values that you can’t get through other things.”

(Like his donors’ highly addictive drugs.)  He also voted against needle exchange programs and medical marijuana – both very rational measures which help to protect the lives of addicts, not to mention literally everyone else who would benefit from medical marijuana.  When I read about the needle exchange denial in particular I snorted.  He accepts donations from a company which markets a drug which leads to the use of heroin while being opposed to common sense measures to protect those people after they’ve been hooked.  Just rubbing salt in the wound.

How does marijuana help opioid addicts? Well – its benefits range from decreasing anxiety in people with anxiety disorders (this lady) to pain relief to stopping seizures in people with certain forms of epilepsy.  Research has shown that in states where marijuana has been legalized for medicinal and recreational use, opioid deaths have fallen significantly.  I hear a lot from people that say that marijuana, if legalized, will cause car accidents – though according to the research, in some cases it may help to prevent them.  Deaths as a result of opioid overdose fell by nearly 25 percent in states which had legalized marijuana use.  When proponents of commonsense medical marijuana (and recreational marijuana) argue that marijuana saves lives, we aren’t fucking kidding.  

Let’s not pretend that marijuana still being a Schedule I narcotic isn’t highly beneficial for pharmaceutical companies.  Recently, the DEA determined that CBD, the non-psychoactive chemical component of marijuana which has been used to dramatically reduce seizures in very small children, reduce inflammation, and in treating chronic pain – should be considered a Schedule I narcotic with no proven medical benefit.  

I’d like to know exactly how many studies have to show the medical benefits of a substance before we start to pay attention to them.  Saying marijuana has no proven medical benefit is like saying that climate change hasn’t been proven or that vaccines haven’t proven safe when considering the risk of autism.  You can say that something is proven – but science fucking disagrees with you and at this point you’re wearing blinders because the facts make you feel uncomfortable and threatened.

Alongside marijuana and CBD, the DEA had opted to urgently schedule Kratom as a Schedule I narcotic.  What is Kratom? Kratom is an extract of a south-Asian evergreen.  While not an opiate in its own right, it is an opiate agonist which binds to the same receptors in the brain and mimics drugs like Oxycontin. Unlike marijuana, it can be relatively dangerous and has significant negative side effects – but there is no evidence of kratom being the sole cause of death in any person.  The cases of death which we do know about were kratom laced with other substances – mainly, you guessed it, opiates.  It shows significant potential in aiding the treatment of opioid addiction.  That the DEA rushed to make it a Schedule I now is, to me, highly suspicious.  It makes me ask, “Okay, so who got paid to get that to happen?”

Likely? Senators like Burr.

Thankfully – the massive public outcry was enough to get them to reverse the decision – an unprecedented shift and an amazing, positive sign of a changing tide.

Look, I’m not saying that Burr is the devil that got the US addicted to drugs – but he’s a symptom of the disease.  Even Purdue Pharma isn’t the cancer itself – merely a metastasized tumor of the cancer.  

While public perception is rapidly changing, there are still about 2500 people in the United States currently serving life without the possibility of parole for non-violent drug-related offenses.  What kind of drug offenses? Possessing a crack pipe.  Facilitating the sale of $10 in marijuana.  Conspiracy to distribute crack (no evidence but two people testified against her to avoid harsh sentences themselves). Selling small amounts of drugs to undercover officers.  You may have thought that these people were trying to import pallets of heroin into preschools – but many of the Americans service life sentences in the US for non-violent offenses were arrested on basic possession charges.

Meanwhile, Brock Turner raped a woman and served 3 months.  Normally I don’t advocate gleefully throwing people under busses but I got 0 problems with that piece of shit regularly being thrown under the bus.  The US has some seriously twisted priorities.

I have significant problems with it being completely legal to peddle a drug you fucking know is addictive as shit (as long as you’re rich enough to influence politics and call it a medication) while we shit on the people being killed by these policies and villainize the addicts who result from them.  I have significant problems with governmental agencies limiting research into far safer solutions while turning a blind eye to far more dangerous substances in the name of “medicine”.  

Now that perception of opiates in the US is changing and prescriptions are dwindling – Purdue Pharma (as part of Mundipharma) has turned its eye to countries overseas, urging them to ignore the “opiophobia” which has overcome the United States and to prescribe away – all in the name of the almighty dollar.

As they put it themselves – they’re “only just getting started”.