President* Trump got to make a speech today as part of his ongoing reality show, in which he finally got around to declaring opioids a national emergency. (Note: this is one of the few emergencies he hasn’t created personally — though he did come close to making it worse. See Tom Marino, below.)
Owen Amos, out of BBC News, Washington, has put together a background piece on why America leads the world with a problem over opioids. You may have seen the numbers elsewhere — “For every one million Americans, almost 50,000 doses of opioids are taken every day. That's four times the rate in the UK.” — but there’s some added info.
Here’s one Trump and the GOP won’t address:
American doctors prescribe - a lot
Unlike most European countries, the US does not have universal healthcare paid for by taxes.
Instead, Americans must get their own insurance - usually via an employer or the government.
"Most insurance, especially for poor people, won't pay for anything but a pill," says Professor Judith Feinberg from the West Virginia University School of Medicine.
"Say you have a patient that's 45 years old. They have lower back pain, you examine them, they have a muscle spasm.
"Really the best thing is physical therapy, but no one will pay for that. So doctors get very ready to pull out the prescription pad.
"Even if the insurance covers physical therapy, you probably need prior authorisation (from the insurer) - which is a lot of time and paperwork."
The CDC says opioid prescriptions have fallen by 18% from their peak in 2010. But the total is still three times higher than in 1999.
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There’s more factors behind the crisis. Amos cites drug company advertising which creates demand, drug company incentives to doctors to prescribe, poor medical training on pain control, bad science used to justify over prescribing, demand for ‘quick fixes’ to medical problems… and while doing that, he provides some contrast with what other countries do. That’s perspective too often missing from news coverage in the U.S.
One thing Amos omitted was a big part of the crisis — Big Pharma bought off Congress to cripple DEA efforts to rein in opioids. Charles P. Pierce has the details.
...For example, you may remember Eric Eyre's brilliant, Pulitzer-winning reporting about how West Virginia was virtually buried under an avalanche of opioids—780 million pills over the previous six years, 433 pills for each and every West Virginian. (And check out Christopher Glazek’s report from the November issue of Esquire about the family that's made billions off the opioid crisis.) For years, the DEA tried to crack down on the suspicious sale of thousands of pills to small towns and counties all over the country. The DEA made such a nuisance of itself in this regard that the pharmaceutical companies responsible for dishing out the pills lobbied Congress to get the DEA off their backs.
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It should be noted that the congressman, Tom Marino, who got the DEA hobbled was almost named as Drug Czar before being forced to withdraw. CBS 60 Minutes and the Washington Post have more on the DEA story. Their reporting forced him to withdraw.
It’s amazing how many things in America become clear once you follow the money.
CBS evening news for October 26 also brought up the story of John Kapoor, the drug company CEO indicted for bribing doctors to prescribe opioids to patients on the same day President* Trump made the announcement declaring opioids a national crisis.
As for his solution, what Digby said.