As I have written on numerous occasions, most recently here, the opioid overdose crisis was never caused by doctors “overprescribing” pain medicine to their patients. As researchers at the University of Pittsburgh reported in 2018, the overdose rate has been rising exponentially since the late 1970s, with different drugs dominating at different points in time. The researchers stated, “This process may continue along this path for several more years into the future.” The U.S. Congressional Joint Economic Committee reported that overdose deaths began their rise as far back as 1959. Now a new report by modelers at Northwestern University, the University of Florida, and Yale University, reported in the Journal of the American Medical Association, predicts the U.S. may be heading towards an even larger wave of overdose deaths.
In a Cleveland Plain Dealer interview with the study’s lead author, Lori Ann Post of Northwestern University School of Medicine, reporter Gretchen Cuda Kroen wrote:
The reason for the most recent increases in opioid overdose fatalities is thought to be due to the fact that people are now mixing cocktails of extremely dangerous and potent opioids like fentanyl, which is 100 times stronger than morphine, and carfentanyl, which is 100 times stronger than fentanyl. In addition, users have begun adding stimulants like cocaine and methamphetamines to the mix.
“Now we have people taking a stimulant with their opioid cocktail, and they are killing themselves on it,” said Post.
What Post and her colleagues found even more striking was the fact that while opioid deaths have been the scourge of rural communities rather than cities in the past, the coming wave doesn’t appear to discriminate between the two.
All this is happening despite a 60 percent drop in opioid prescribing from 2011 to 2020. Furthermore, the Drug Enforcement Administration (DEA) placed quotas on the manufacturing of all types of prescription opioids, ratcheting those quotas downward year after year. By 2019, the reduction in the prescribing rate led the DEA to announce that less than one percent of controlled substances distributed to retail purchasers were getting diverted.
As I wrote with co-authors in the Journal of Pain Research, there is no correlation between prescription rates and non-medical use of or addiction to opioids. On June 7, 2022, I stressed this and other facts at a Soho Forum debate in New York City. I pointed to data from the National Survey on Drug Use and Health showing the addiction rate among persons aged 18 and above has been essentially unchanged while prescription rates were first surging to record highs and then, starting in 2012, dropped 60 percent. I also argued that there is no reason to conclude that doctors “hooking” patients on opioids would compel them to use multiple other drugs in “cocktails.” We now know the great majority of overdose deaths are “polysubstance” deaths.
No one familiar with the Iron Law of Prohibition should be surprised at the modelers' prediction. Sadly, until policymakers finally realize that drug prohibition, not doctors treating patients in pain, is the cause of the overdose crisis and the coming “tsunami” of overdoses the modelers predict, expect the deaths to keep mounting and patients to continue suffering needlessly.
# Reprinted with permission. Dr. Singer's original post can be read here.
