Heroin in America

“How did 5 million become addicted? The epidemic began with a worldview.” Marvin Olasky

“One’s worldview has consequences, too, Jack!” Anon

Overview of an epidemic

Marvin Olasky, World magazine, August 6, 2016, p. 33

america-mental-illness1America’s opioid epidemic hit the headlines just before the New Hampshire primary in February, as mournful parents asked presidential candidates what they would do about it. The epidemic quickly fell off the front pages as contenders moved on to debate how long their fingers were and other silly things, but the tragedy is not going away.

How big: About 46,000 Americans died last year from overdoses of drugs, mostly opioids: heroin but also highly addictive, man-made, morphine-like pain relievers such as oxycodone, Percocet, and hydrocodone. Opioids reduce the perception of pain and can bring temporary elation, but a dose too high depresses the respiratory system, leaving blue-lipped users not breathing, and sometimes dying.

That’s the iceberg’s tip. The National Survey on Drug Use and Health in 2014 asked Americans age 12 or older whether they had illegally used a drug within the past 30 days. Ten percent—27 million—said yes. For 4 out of 5 drug users, that means marijuana, which some states are legalizing. For about 5 million Americans, it means pain pills or heroin, and sometimes death.

How did 5 million become addicted? The epidemic began with a worldview: In the 1980s the World Health Organization (WHO) declared “freedom from pain” to be a universal human right. Doctors, seeing some pain as inevitable after injuries and operations, have long been cautious about prescribing powerful addictive opioids, but organizations had some patients rating their doctors, and ratings fell if the patients didn’t feel good. Some hospitals told doctors they could be sued if they didn’t treat pain with opioids.

Journalistic laziness then played a part. In 1980 the New England Journal of Medicine published a one-paragraph letter from a Dr. Hershel Jick noting that in his database few patients treated with opioids while in hospitals became addicts. The paragraph said nothing about dosage or how long the patients used opioids. Some freedom-from-pain advocates began calling Jick’s letter a “study.” Time, for a 2001 story titled “Less Pain, More Gain,” apparently did not take the time to check out the paragraph: It called Jick’s letter a “landmark study” that showed fear of addiction was “basically unwarranted.” Wrong.

Medicaid laxness also contributed: Medicaid cards enabled holders for a $3 copay to get the hundreds of pills a “freedom from pain” doctor prescribed. The patient could use some pills and sell others on the street for thousands of dollars. Some who became addicted would not give in, and eventually beat the scourge. Many others succumbed. —Marvin Olasky

 

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