Opioid crisis in the US

By  |  15 / November / 2017

For the past decade, a very serious crisis of mortality due to overdose of narcotics, related to a high legal prescription of potent opioid analgesics, has been brewing in the United States. The health authorities of that country estimate that in 2016 there were 64,070 deaths due to this cause, with an increase of 21 percent over the previous year. This means that these deaths are higher than those caused by weapons, car accidents, homicides and suicides. The history of this crisis has illustrative elements of the political manipulation of this tragedy, on the one hand, and the absence of scruples of the pharmaceutical companies and the lack of ethics of many doctors, on the other.

At the end of October, Trump declared a public health emergency in this regard, with great sensitivity and great media coverage, but by classifying it as public health and not as a national emergency, there was no new funding to act until Congress expressly assigns them. The funds currently available correspond to 2 cents per addict! Trump did not miss the opportunity to suggest that his plans to build the wall on the border with Mexico will have positive effects to stop the flow of heroin.

In the context of their declaration, the publication of the DEA (the US anti-drug agency) last July becomes very important. It notes that the landscape of narcotics has changed over the past decade with the opiate epidemic, including prescription painkillers, fentanyl, other synthetic opiates and heroin, although methamphetamine, cocaine and marijuana are still important. He emphasizes that the Mexican cartels are the most important criminal drug threat for the United States, being the wholesale suppliers of the bands of that country. The accusations of Trump and the DEA feed the new narrative about Mexico and Mexicans, which would justify a more direct and even military intervention; it also warns that cocaine consumption is recovering as a result of an increase in the production in Colombia, which reveals the failure of Plan Colombia, that is, the war against drugs, as well as the pattern of the Merida plan with Felipe Calderón.

The opiate epidemic is directly related to the pharmaceutical industry and its intense marketing campaign of powerful opioid analgesics of legal prescription. Already in 2009 an article in the American Journal of Public Health showed this relationship and warned about the aggressive commercial maneuver of OxyCotin, oxycodone drug of extended-release, among doctors, through representatives of the company Purdue, which increased its sales from 48 million to 1.1 billion dollars in four years. He also suggests that the FDA (the Food and Drug Administration) could intervene to stop this unethical business.

Despite the opportune alert of the specialists, nothing serious has been done to restrict the commercialization. A case in the United States was the unanimous approval of a law that limited the possibilities of the DEA to restrict the distribution of these opiates. The Washington Post did an investigation and showed the great influence of the pressure of the pharmaceutical companies, the most important contributor in the political campaigns, in the drafting of the law. It even found that the first draft was written by a former employee of the DEA who became a lobbyist for this industry. Despite abundant evidence that legal opiate addicts tend to switch to heroin use, nothing has been done; nor have public substitution therapy programs been approved for them.

It is important to remember that in May the US Attorney, Jeff Sessions, instructed federal prosecutors to seek the highest penalties for drug-related crimes. It is the return to a domestic policy of “war against the drug” that led to that country to have the highest number of prisoners in the world and that has proven to be totally useless to solve the problem. Of course, neither Trump nor Sessions want to investigate the causes of the huge domestic drug market, a question denied, although death from overdoses is now more common among Trump’s voters base: white men of productive age with low level educational and often unemployed.

The repressive solutions will not solve the problem in the United States or Mexico. The right, particularly the extreme right, uses this path because it cannot admit that the bottom of the problem is the structural social exclusion and the desperation created by its economic model.

This article was first published in Spanish at La Jornada.

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