Politicizing and Misunderstanding the Opioid Crisis
By Seth Leibsohn| April 5th, 2017|
The nation’s opioid crisis is real and it is serious. As Christopher Caldwell recently pointed out, “those who call the word ‘carnage’ an irresponsible exaggeration are wrong.” And so, too, are those playing politics with the crisis. Even beyond the politicization–or, perhaps, because of it–there is still a great deal of misunderstanding as to what is driving this crisis.
As for the first problem, the politics: Senator Claire McCaskill (D., MO) has announced that she is initiating an investigation of several opioid manufacturers, and is requesting “reams of information” from them. But note the one manufacturer she did not target and from which she did not request information–Mallinckrodt. Mallinckrodt, after all, is headquartered in Missouri, her own state. Odd, that. And it’s not as if Mallinckrodt is a bit player in the manufacture and sales of opioid drugs. Indeed, “it is one of the nation’s largest” producers, responsible for nearly 20 percent of the market share of opioid prescriptions. The companies McCaskill has targeted are responsible for a total market share of 5.25 percent combined. Odd, that. If she were serious about investigating pharmaceutical companies, she most certainly would be investigating the one based in her own home state which also happens to be the one responsible for most opioid sales in America.
But all of this is not even the beginning of the beginning in addressing America’s opioid crisis. For when political leaders like Senator McCaskill are not playing politics with the issue, they are too often misunderstanding it. Some of that is not their fault.
Part of the problem in addressing the opioid crisis is that the terminology can be confusing or misleading. People hear “opioid” or “prescription opioid” or “fentanyl” and begin to lump the problems all together as a crisis driven by legitimately prescribed drugs. No doubt, that is a part of the problem, but it is nowhere near the biggest part of it. Take a look at the best statistics available (taken from the Office of National Drug Control Policy and the CDC):
- In 2015, there were 33,091 opioid overdose deaths.
- Heroin deaths constituted 12,990 of those deaths.
- Synthetic opioids (mostly illegal fentanyl) constitute another 9,580 deaths.
Because opioid deaths usually involve the use of more than one drug, percentages and raw numbers will not neatly add up to 100% or the 33,091 deaths. As the White House Website puts it: “A portion of the overdose deaths involved both illicit opioids and prescription opioids.” But what we can see from the above is that over 68 percent of the problem is from the use of illegal drugs. Or, as the CDC put it in December of 2016: “[T]he increase in opioid overdose death rates is driven in large part by illicit opioids, like heroin and illicitly manufactured fentanyl, a synthetic opioid.”
As for the prescribed opioids, the majority of overdose deaths from those come from the diversion and illegal distribution of them. As the CDC notes: “Most people who abuse prescription opioids get them for free from a friend or relative.” The people “at highest risk of overdose” “get opioids using their own prescriptions (27 percent), from friends or relatives for free (26 percent), buying from friends or relatives (23 percent), or buying from a drug dealer (15 percent).” Thus, for the population that overdoses from opioid prescriptions, 64 percent abuse them from a diverted or illegal source. In other words, the abuse of opioid prescriptions that leads to overdose deaths involving a patient acquiring a legal prescription and misusing that prescription on himself is less than 30 percent of the prescription problem and constitutes about 15 percent of the overall opioid overdose problem.