July 22, 2021

Overdose Deaths Increase

Overdose deaths soared to a record 93,000 last year in the midst of the COVID-19 pandemic, the U.S. government reported Wednesday. That estimate far eclipses the high of about 72,000 drug overdose deaths reached the previous year and amounts to a 29% increase.” AP News

“A group of state attorneys general unveiled on Wednesday a landmark $26 billion settlement with large drug companies for allegedly fueling the deadly nationwide opioid epidemic… Under the settlement proposal, the three largest U.S. drug distributors -- McKesson Corp, Cardinal Health Inc and AmerisourceBergen Corp -- are expected to pay a combined $21 billion, while drugmaker Johnson & Johnson would pay $5 billion.” Reuters

On July 8, “Fifteen more states reached an agreement with Purdue Pharma LP and members of its wealthy Sackler family owners that moved the OxyContin maker a step closer to resolving widespread opioid litigation and exiting bankruptcy protection… the Sackler contributions toward Purdue's bankruptcy-exit plan now total roughly $4.5 billion. The plan aims to resolve some 3,000 lawsuits brought by U.S. communities alleging Purdue and its family owners contributed to an opioid crisis that has claimed the lives of roughly 500,000 people since 1999.” Reuters

Many on both sides blame the increase in overdoses more on structural factors than the pandemic, and call on Congress to respond:

“It’s difficult to measure the real impact of isolation, or the psychological burden imposed by mass illness and death… So-called ‘deaths of despair,’ which include drug- and alcohol-related deaths and suicide, had been rising before the pandemic occurred. A massive economic downturn was unlikely to help reverse the trend. Nevertheless, experts have pointed out that there are other factors at work…

“In a January interview with NPR, economist Anne Case, known for her groundbreaking work on deaths of despair, cautioned against settling on the pandemic as a primary explanation for rising overdose deaths. ‘There’s this horribly dangerous, deadly drug on the market that is responsible for this explosion of drug overdoses,’ she pointed out at the time. Fentanyl is significantly more dangerous than heroin, as the Journal points out. When mixed into the drug supply, people may consume it without realizing it’s present and the results can be deadly.”
Sarah Jones, New York Magazine

“Even if 2020 were not a particularly bad year for the factors that determine drug demand—depression, despair, and disconnection—we could still have expected an increase in overdose deaths, as we have seen in 18 of the last 20 years. That’s because of a fundamental shift in the supply of drugs—a shift that continued last year. The two leading causes of overdose death are now, per the CDC data, synthetic opioids (primarily fentanyl and its analogs) and methamphetamine…

“Both drugs are differentiated from more traditional narcotics—heroin, cocaine, and prescription opioids—because they are synthesized in a lab from easily obtained precursor chemicals… This technological transition—from harvesting coca and poppy to synthesizing ultra-potent versions of their active ingredients in the lab—is the major driver of the multi-decade increase in drug-overdose deaths to levels never before seen in U.S. history. Covid-19 likely accelerated this grim process, but even post-pandemic, we should expect drug deaths to continue rising for the foreseeable future.”
Charles Fain Lehman, City Journal

Sens. Dianne Feinstein (D-CA) and Chuck Grassley (R-IA) write, “The recently enacted American Rescue Plan appropriated $4 billion for substance-abuse treatment and mental-health services. The COVID-19 pandemic has made treatment programs even more necessary, and they should be made available to all who need them. The president and Congress must also continue pressuring China and Mexico to crack down on the manufacturing of illicit drugs, including fentanyl, which is increasingly being mixed with other substances found in the U.S., such as heroin and cocaine…

“Congress must also focus more on methamphetamine overdoses. In 2009, there were 547 psychostimulant overdoses nationwide, many caused by methamphetamine. That figure rocketed to 16,167 in 2019, an astounding 3,000% increase, and those numbers continue to rise. The ‘Methamphetamine Response Act,’ which we introduced in March, would direct the Office of National Drug Control Policy to declare methamphetamine an emerging threat and develop and implement a plan to specifically address abuse of the drug…

“We have a responsibility—and an opportunity—to reverse the staggering number of drug overdose deaths that plague our country. We’re hopeful that Congress and President Biden can take the concrete steps necessary to stem this terrible tide.”
Dianne Feinstein and Chuck Grassley, Time

Other opinions below.

See past issues

From the Left

“The Biden administration has signaled strong support for needle exchanges as a harm-reduction strategy. The idea behind such programs is simple: Those suffering from addiction will inject drugs one way or another, so the government has an interest in making sure they can do so safely. Studies have regularly found that programs providing sterile needles not only help prevent the spread of diseases such as HIV and hepatitis but also reduce risky behavior such as needle-sharing…

Making drug use more difficult doesn’t make addiction go away. That only makes it more dangerous… The Biden administration promised to put compassion at the core of its public health strategies. [Drug czar nominee Rahul] Gupta can help deliver on that promise by embracing and defending syringe services.”
Robert Gebelhoff, Washington Post

Regarding the opioid settlements, “In 2016, a small-time drug dealer in Leesburg, Va., named Darnell Washington sold a customer a batch of what he thought was heroin. It turned out to be fentanyl. The customer shared it with a friend, and the friend died from an overdose… Mr. Washington had never met the person who overdosed. But, facing a mandatory minimum prison sentence of 20 years for distribution resulting in death, he pleaded guilty to the lesser charge of distribution and is now serving a 15-year sentence in federal prison…

“I thought about this the other day when it became clear that members of the billionaire Sackler family will most likely soon receive a sweeping grant of immunity from all litigation relating to their role in helping to precipitate the opioid crisis…

“[$4.5 billion] may seem like a lot of money, but billionaire math can be deceptive. The Sacklers proposed to pay the $4.5 billion out over nine years. Their current fortune is estimated to be at least $11 billion. Conservatively, with interest and investments, this means they can expect a 5 percent annualized rate of return on that fortune. If that’s the case, they’ll be able to pay the fine without even touching their principal. When they’re done paying in 2030, they will probably be richer than they are today.”
Patrick Radden Keefe, New York Times

From the Right

“There is no question that over-prescription and a lamentable lack of accountability and proper medical follow-up were major, though not exclusive, contributors to the crisis. But the medical community and pharmaceutical industry have recognized this, and their collective mea culpas have resulted in a dramatic decrease in the number of overdose deaths from prescription opioids over the past several years. At the same time, however, the fatality rate from illegal opioids, such as heroin, illegally manufactured fentanyl, and the like, have increased even more dramatically…

“Our tack to dealing with this issue should have changed with the changing nature of the problem. Regrettably, this has not been the case. It has been far easier for politicians to go after establishment bogeymen, such as the pharmaceutical industry, than to treat the 2021 crisis as it is; a crime problem. That is to say, a problem in which the criminal suppliers of this illegal poison need to be targeted and shut down. We must also do more to ensure that the unfortunate users of these substances receive treatment — even if that means arrests to get them into care.”
Kelly Sloan, Washington Examiner

Regarding the opioid settlements, “I’ve been having a hard time figuring out precisely what crime or at least ‘fault’ any of the four companies are being accused of and forced to atone for. I absolutely agree that we have a crisis in terms of the number of people who are addicted to these types of drugs and many lives have been ruined or ended as a result. But I’ve yet to see a single example of Johnson & Johnson producing and selling a drug that hasn’t been approved by the FDA…

“If the [distributors] had been selling opioids to unauthorized individuals or companies for illegal sales, there would obviously be a problem. Or if the drugs were somehow faulty and unsafe when used as directed by a doctor, J&J would surely hold some blame. But nothing of the sort has been mentioned. So what is it exactly that makes these four companies liable for laying out that much money, even if the cash is going to some noble causes? In the end, isn’t it the responsibility of the doctors to monitor how many prescriptions they write?”
Jazz Shaw, Hot Air

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