Risky(er) Driving

Risky(er) Driving

    Land in an airplane and you hear that, the most dangerous part of your journey is about to begin, that of driving on the highway (touting the airline's record of safety).  And let's face it, what could be riskier or more deadly than driving a car or truck, especially when it comes to debilitating accidents and fatalities.  Well, it turns out that something has indeed emerged that is riskier, something that even brought the U.S. Senate together in a near unanimous vote (unfortunately, the bill is expected to die in the more partisan House of Representatives)...opiate addiction.  Yes, I wrote earlier about the over 220 million addictive and legal drug prescriptions for opiates written in 2011 (the next year, that number climbed to 259 million and continues to rise).  And now, death from opioid overdose has surpassed that of highway fatalities.

    

Table from Center for Lawful Access and Abuse Deterrence

    Actually, you can see that death by drug overdose, including prescription drugs, had passed both highway fatalities and firearm fatalities in the U.S. way back in 2010 (as of 2014, that total number of death by drug overdose had climbed almost another 10,000 deaths, the new figure being over 47,000 deaths).  What's worse, just a year ago, Healthline had this to report: Heroin use rose by 75 percent between 2007 and 2011, with an 80 percent increase in first-time use among 12- to 17-year-olds since 2002, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).  Teenagers!   Bad enough, certainly, but now comes a new threat, something 50 times more powerful than heroin (and 100 times more powerful than morphine) and hitting the streets in a big way...fentanyl.

    Three sugar-sized grains of fentanyl is lethal to an adult.  Never heard of it?  As it turns out, many cancer patients are prescribed it, the drug being a pain killer of many forms...lollipops, patches and such.  And the drug cartels have found the market lucrative, a real-life Breaking Bad scenario complete with a better-than-Walter-White amateur chemist working out of Wichita, Kansas (recently released after serving 22 years in prison; his arrest in the 1990s temporarily collapsed the fentanyl underground market, all of which is captured exceedingly well in the documentary by Fusion).  Yes, this fentanyl crisis actually goes way back when amateur fentanyl users and producers were in the experimental stage.  But now, the market has changed...legally prescribed fentanyl is the drug of choice and the cartels are well aware of the competition (which are the pharmaceutical companies). 

    Here's what the Fusion piece had to say: Fentanyl is a particularly scary opioid because of its strength: It’s 50 times more powerful than heroin.  That makes it much more economical to smuggle across borders or in the mail – it’s easier to get a small brick of fentanyl past customs than a huge cooler of heroin.  The fentanyl responsible for the last rash of overdoses likely came from China, and was probably purchased via Silk Road or a similar darknet site, according to Dennis Wichern, who directs the Drug Enforcement Administration’s operations in the five-state region surrounding Chicago...(but) fentanyl isn’t really the problem.  It’s a problem, but not the problem.  The problem is that thanks to the overprescribing of related painkillers like fentanyl, Vicodin and OxyContin, more people than ever are hooked on opioids, and there are more opportunities than ever to get the wrong cut from some random dealer.  One in 15 people who take a nonmedical prescription pain reliever will try heroin within 10 years, according to the National Institute on Drug Abuse.  On the Opiate Addiction Support site, it is not teenagers but middle-aged adults who have the highest rate of opiate addiction, although theirs is from prescribed drugs.

    The antidote of sorts, a drug-overdose reversal drug if you will, is naloxone or Narcan...often made by the same pharmaceutical companies that produce fentanyl.  Even our small city of 34,000 is purchasing Narcan for their emergency crews (Narcan sells kits to cities such as ours for over $800 per two doses; on average, the single dose from other companies can run about $40 and can even be purchased at some CVS pharmacies).  Larger cities such as Chicago have provided Narcan to some drug addicts; again, from Fusion's site: The Chicago Recovery Alliance, the biggest drug-harm-reduction group in the city, gave out about 3 million syringes last year, along with 10,000 vials of naloxone (three vials per person, max) last month.  In 2014, just by asking drug users who’d come to the group’s trucks and treatment centers, Alliance staff heard of 5,767 overdoses reversed with naloxone.  In other words, while overdose deaths are holding relatively steady, there’s an insane amount of heroin and opioid use going on each day in Chicagoland.  

    As one can imagine, the potential profit is huge and as such, the lobbying efforts in Congress and among insurance groups is high regarding the antidote (insurance covers much of Narcan expense, that is for those carrying insurance).  But as is noted, the Narcan does nothing to curb the opioid addiction, or the physicians writing the painkiller prescriptions.  And addiction recovery centers continue to scratch their heads at the ever-increasing demand for painkillers, one which now stretches across all age groups, all ethnicities, and all income brackets from the homeless to the hedge fund trader.  Which is great news for the cartels...a touch of added fentanyl and your heroin is top of the line.  An overdose?  Well, that's the risk...next in line.

    As with all such issues, one has to wonder how we've reached this point?  Are we really in such pain, or are we simply looking to get "out there?"  And if it's pain, what sort of pain is it?  Physical, emotional, mental, perhaps all three?  Are we lacking someone to talk to, to really talk to?  And even if we had that person or persons, would it be enough?  As with so many things, it is difficult to relate to such urges or reliefs unless we are there.  Can we sympathize, criticize, subsidize...sure.  But unless we are ourselves paralyzed or riddled with cancer or suffering a loss of a spouse or hanging onto life, we can't really know what is going on in that person's head.  This is more than evident to the emergency crews that revive such overdoses, a person foaming at the mouth but perhaps wearing a really expensive suit or a regular indigent being revived for the third time in some dark location.  It is likely easy to judge, even among the crews dedicated to just saving a life, but perhaps such judgements, especially among ourselves, should be reserved for the manufacturers...just as with bullets and such, if the drugs weren't so readily available would the problem be so large (opioid addiciton is now considered an epidemic in many parts of the U.S.).  It is something appearing everywhere, perhaps even in your grocery stores' parking lots (as has happened in our small city).  It was all nicely summed in the final segment of Fusion's documentary: For Kevin Doherty, a veteran firefighter at the Revere Fire Department in Massachusetts, just outside Boston, there’s deeper significance in keeping Narcan in stock.  “It’s not just overdose calls,” he said.  “It’s people in our community who we grew up with.  It’s friends, it’s our coworkers’ friends and families.  It’s become a piece of emotion along with every call.”