More on the Opiate Abuse Epidemic: Where Again Does the Finger Point?

Originally published at Health Care Renewal

In a recent blog post we pointed to conservatives’ efforts to implicate Medicaid funding as somehow causative of, or at least promoting, the opiate “crisis.” After all, funding for medications means people will use, and sometimes abuse, those medications. Meds they might otherwise ill be able to afford. (Implied solution: cut Medicaid.)

We also alluded to some of the logical fallacies in such thinking. Here, though, let’s take it to another level: the blame game, where does it lead? Where does the finger point? Those who agree with Ronald Reagan that government is the problem, not the solution, fall into the trap of blaming public action and civic institutional development for the ills of our society.

But gosh, why is it that private actors get a bye? Isn’t it possible that something other than public action could end up being the culprit? What creates this blind spot?

For one thing, those (they’re discussed in the blog link above) who point fingers at Medicaid overlook inconvenient truths. Take the state-by-state data. True, West Virginia is among the top states, as it happens, for both Medicaid and addiction rates. But then look at New Hampshire. With Ohio, it is a close second for addiction but affluent enough to be near the bottom of states receiving Medicaid/CHIP. Somehow the great conservative logicians seem to miss data like this.

For another thing, when you go from the “faceless bureaucrats” to the families that run things in this country, there’s the matter of privacy. There’s a queasy feeling about ratting out your private “friends,” even when they’re not really friends at all. Even when they’re polluting your environment or selling you (in our new parlance) some newly slavered S on toast. And private actors, once in the, well, let’s say billionaire realm, can manage to protect their brand even while working behind the scenes to ruin–allegedly–people’s health through false advertising. Turns out New Hampshire doctors prescribe opiates at about double the national rate, responding not to government but to private (Big Pharma) signals.

Such private matters have been the case, allegedly, with the family that brought you all the flavors of the pharmacologic gift that keeps on giving: oxycodone. We know this is the case especially, more recently along with fentanyl, with this drug in its most controversial form, Oxycontin. Oxycontin was brought to your local pharmacy by the still barely-known Sackler family. It’s a dramatic story of a family out of Brooklyn by way of the medical schools of Glasgow and then the boardrooms and development offices of some of this nation’s most prestigious citadels of culture.

Two recent discussions of the Sacklers point to their possible culpability in spreading a false gospel of SOAP: a Safe Opiate Administration Policy. Last fall we considered blogging on the first of those discussions in The New Yorker. But it’s hard to access some literature hidden behind paywalls, so we held off. Now, however, a shorter and in a number of ways more accessible piece on the Sacklers now emerges in The Guardian.

The New Yorker piece, by investigative reporter and staff writer Patrick Radden Keefe, shows how this family of physician-entrepreneurs built an “empire of pain,” as he styles it, starting as far back as the mid-20th century. This was the era of Estes Kefauver’s aggressive committee hearings. But even congressional inquiry was no match for the aggressive advertising tactics and casuist hyperprofessionalism–hiding behind the degree–tactics of an Arthur Sackler, who “caught Kefauver in an error,” notes Keefe, “and said, ‘If you personally had taken the training that a physician requires to get a degree, you would never have made that mistake.’”

In related fashion, for health care the Sackler Brothers were among the first to use the megaphone of social media as a tool, in its primitive mid-century form, for disseminating messages to a gullible medical profession. They were sales geniuses, understanding the nudge-value of throwing money around. They created Medical Tribune, one of the most successful and impactful of what came to be known as throwaway journals These throwaways hit doctors’ mailboxes on a daily basis. (Medical Tribune was biweekly but there were lots of others.) Conflict of interest? Why do you ask? Potentiating the message that opiates were safe, especially when there was a “clear need” for such agents? Question answers itself.

Toward the end of the last century, the story of the Sackler family and opiates took two other important turns. In 1995 OxyContin received FDA approval for moderate-to-severe pain. (Not long after, in the great tradition of the Revolving Door, the very FDA official who oversaw the drug’s approval left the agency and went to work for the Sacklers at Purdue.)

Some of us recall that that was about the time an alarming tsunami of patients began to flood through our doors. Their complaint was stereotyped: months or even years after a mild-to-moderate injury, long after full healing could easily be documented, “If I don’t take this medicine I get my pain back.” Awareness of addiction was just about as conspicuous in its absence for us and our patients alike.

Some time also in the mid- to late-twentieth century, Sackler family largesse in the funding of the arts became an international phenomenon. While family names appeared conspicuously on galleries in prestigious institutions around the world, on the company website they equally conspicuously disappeared from the list of directors–up to eight in all.

This past week, New York journalist Joanna Walters, in The Guardian, related the story of Nan Goldin, a renowned Brooklyn artist-photographer. Goldin went from a case of tendinitis to a full blown OxyContin addiction that turned her into a recluse for three years. It is accessible with no paywall and makes intriguing reading. We watch Goldin out herself as an addict and valiantly seek to mount a counter-messaging movement. Goldin’s verdict: “I don’t know how they live with themselves.”

And so here we are. Private actors buy their way forward into the benign and beneficent ranks of the cultured plutocracy. They do so while covering their tracks backward as the real vectors of an epidemic. (See Arthur Sackler’s fascinating 1987 obituary in his own journal, extolling the “Renaissance Man” and implying he received medical school training at NYU.)

Meanwhile, the logicians in Washington, DC, still parrot Ronald Reagan that “government is the problem.” No, Wisconsin Senator Ron Johnson, government, of which you are allegedly a part, is not the problem. Unless you’re it. Those whom you protect with your flawed logic and equally flawed ideology are the problem. We suppose it’s no wonder that last year, at an event in the state that both you and the Speaker of the House call home, Donald Trump kept calling Paul Ryan “Ron.”

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  1. Steve H.

    There is an implicit assumption hidden within identifying opiod abuse as a health-care issue. This means, in the U.S., a medical response, which generally means pharmacological. Yet McKesson was identified as a driver of the problem by the DEA.

    Foxes at the henhouse gates are not even in the same dimension as what can solve this.

    1. Tomonthebeach

      Ann Case and Angus Deaton publish an article recently (a few actually) pointing out that the opioid crisis is not a medical problem, it is an economic one. Fix the hopelessness of high debt and under-employment, and watch things change. The rightly refer to these as deaths of despair.

      Addiction is only a medical problem if you want to blame the doctor who prescribed the opioid, and in the majority of cases appropriately so. Addiction starts well after the medical event when the “patient” starts over-medicating for the dopamine rush using Heroin and other street drugs. Alas, some physicians do not monitor chronic pain patients for signs of addiction – too busy – their shame.

      Yes, Hydrocodone was marketed as less addictive than morphine drugs. Back in 1895, Bayer marketed Heroin as a non-addicting substitute for morphine. Heroin did save many people from diphtheria deaths, but they got lifelong addiction instead. How’s that for irony? Well, the medical community is sadder but wiser, so scrips for opioids are decreasing.

      The opioid crisis is not a law enforcement/interdiction problem. Meanwhile, we still have the law-n-order Republicans who assert that the entire problem of addiction would go away with tougher laws and tougher enforcement. Well, 45 years of DEA on the job, and there is still ample supply for a growing market. So what is their value-added to the problem? A stupid border wall is a ridiculous solution as drugs arrive by plane, train, boat and auto. Build a $20BN wall and more drugs will come via alternate routes.

      The opioid crisis is clearly and economic problem. We have effective treatments IF people want to get clean. However, Narcan does not save OD victims from hopelessness. Jobs do. Buprenorphine will not get a recovering addict back to work if nobody is hiring.

        1. Procopius

          I sometimes wonder why we never see stories about cocaine rings of bankers getting arrested. We certainly hear lots of stories about bankers, brokers, and bond salesmen doing blow and hookers at company-sponsored parties, so it seems to me it should be easy to collect evidence. Somehow we never (or rarely, I remember a story about a medical student in Philadelphis about 30 years ago) hear about any of these prosperous folks getting busted. /sarc OK, OK, I know the answer, I’m just ranting.

  2. Ed

    The relationship of the CIA to BigPharma is described in the book “A Terrible Mistake” by H.P. Albarelli. The role of the US and the UK in Afghanistan to build and protect a global trade in heroin is well-known, well-documented and ongoing. Governor Charlie Baker’s state of the Commonwealth address last night also failed to acknowledge this smelly elephant in the room.

    1. sgt_doom

      While Albarelli wrote some very good stuff in that book, please keep in mind he repeats the CIA’s official disinformation line, long since debunked, that Frank Olson was unwittingly fed LSD and that was the cause of his supposed suicide attempt.

      Under later exhumation and examination of Olson’s body (the CIA demanded a closed coffin burial), forensic pathologists determined that Olson had first been bashed in the head, and his death resulted from that, not being thrown out of a building window.

      Previously, Olson had submitted his resignation to the CIA (he had been with the MK ULTRA program) after having witnessed an experiment on a non-volunteer British soldier several days prior, in England, where Sarin was topically applied to the soldier’s skin, and he died a most painful death.

      This was recounted in the outstanding book by Bob Coen, Dead Silence — a great read on the US Anthrax attacks.

      The death of Frank Olson in the late 1950s is very similar to the death of Maurice Gatlin, the fellow who delivered several hundred thousands of dollars to the French rightwing paramilitary group, the OAS, for Banister of New Orleans (CIA paymaster), prior to the assassination of President Kennedy.

      Gatlin, the sole civilian link to that transaction, would die from a fall from the Panama Hotel in Puerto Rico in, I believe, 1964.

  3. Summer

    On related note, people should down the memes like “crisis of democracy.”
    The crises are the result of the insistance on maintaining a plutocracy or oligarchy.

  4. pete

    It is insane that doctors are cut any slack in this. Everyone understands addiction if a doctor is unable to graps these ideas then they should not be allowed to practice because they dont understand it.

    1. Hana M

      The medical profession seems to swing from one extreme to the other. Back in the 80s I was editing a book by an oncologist and specialist in palliative care. Of necessity, given his specialty, he wrote a great many prescriptions for morphine (and if you don’t think that’s right, you’ve never seen someone die of, say, bone cancer). He was often called on by the DEA and more than once had his prescribing rights suspended.

      1. Lee

        But what if the person dying in agony becomes addicted? Oh, wait…..

        I’ve been taking low dose morphine for ten years to manage spinal spondylolisthesis and stenosis. Works well, keeps me on the road of life. Recently, a non-opioid alternative that works for some people and at the same time treats another chronic health problems has become available. It cannot be used in concert with opioids and I’m going to give this non-opioid twofer a try.

        My doctors are being most helpful in the process of gradually reducing my dosage. I think that having access to quality healthcare, not being poor, or economically insecure, and having good relationships with family and friends is making the process easier that it would otherwise be. If the new approach doesn’t work, I have no compunctions about returning to my opioid regime.

        1. Ed

          If the person dying in agony becomes addicted, up the dose. This is simply the preferred approach to both execution by injection and assisted suicide. Perhaps the issue for us is really having a more understanding approach to life and living, like better dialogues, relationships, and self-understanding. The physician is not to blame; pain management contains many other approaches that neither physicians nor patients know about or will acknowledge.

        2. LisaLisa

          Good luck with that, Lee. As far as I am concerned whether you are dying in agony or not, if you have a chronic illness with no chance of improvement AND the meds you are on are not causing a worse problem than your pain, the Feds should stay out of it.

        3. Pespi

          Apologies if this looks like spam, but google Jonathan Ott’s journal article about low dose naltrexone, and check the wiki for oxytrex. There are ways to prevent the hyperanalgesia that causes most addiction and tolerance.

          It has been shown that people can take the same dose of opioid with ultra low dose naltrexone with no need for increased dose. It’s also great for tapering off without as much grief and misery.

          1000 pardons if I sound like a shill, but this is something that’s working for people right now and no one in the drug business is making profits on it.

    2. Tooearly

      Your understanding of this has some serious gaps. Suggest you read Dreamland to learn how mainstream medical opinion has indeed swung wildly on the question of addictiveness of opioids and the proper use of them over the past 50 years

        1. DHG

          And yet my doctor tells me that the state I live in is coming for the short acting narcotics and is pushing the longer release ones. He wants to move me from 3 a day Norco to MS Contin when the laws change, I refused and will give them up rather than struggle every week to his office to get a damn script. I wont give the state the pleasure of paying doc fees multi times in a month not to mention the 4 copays instead of one. They can all goto he!!.

      1. tooearly

        And I say that as a MD who steadfastly limited opioid prescribing to such an extent that i caught serious flak for it…

        1. LisaLisa

          In B.C Canada, my doctor is being forced by government to take me off a very low dose of diazepam ( Valium 4 mg per day) to alleviate muscle pain from a chronic disease and anxiety from being housebound. I have been on it for years, without increase in dose or any problems.

          The government WILL allow her to give me massive doses of gabapentin though. Oh, and if I tell her I am taking some pretty strong over the counter benedryl, an antihistamine, to deal with anxiety…why, that’s okay too.

          Now, here is the interesting thing. Valium has been red flagged as a potential danger for falls in the elderly, which could well be true if the senior is taking a strong dose. It’s also been flagged as contributing to or causing dementia, much like being drunk all the time. But surely to God, this is dose dependent.

          What fascinates me is a drug like gabapentin which has caused problems with dizziness for everyone who takes it, doesn’t get the same treatment. Also, this drug can cause severe cognitive problems — as can over the counter antihistamines. And I shudder to think what it’s doing to my brain, so have quit taking them.

          The government would rather have people like myself reduced to drooling halfwits, stoned out of our minds on antihistamines — and bouncing off walls from gabapentin, than allow us to take low doses of Valium.

          As far as OxyContin goes, how many people who have died from fentanyl overdoses are former patients fighting very real pain, forced to turn to the streets for essential medication, not “drugs.”

          This is a baby/bath water phenonomenon and sanity has to be restored.

          1. Amfortas the Hippie

            ^^”how many people who have died from fentanyl overdoses are former patients fighting very real pain…”^^^

            this scares me.
            I’ve been taking vicodin for about ten years for chronic, global osteoarthritis. I’ve educated my doctor, who used to get hysterical with every new memo from the dea, et alia.
            I’m studious with my dosage, and will skip and endure if i forget if i’ve taken a dose.
            I also take regular drug holidays, in order to reset the receptors and prolong this medicine’s utility(and temporarily counteract side effects like constipation). I’ve never been high or had withdrawals.
            Texas has made it harder and harder to get this medicine….all of it ill conceived and largely unscientific knee-jerk nonsense, having little to do with actual people in pain.
            I’m also on medicaid.
            If I could, for whatever idiotic reason, no longer get this med, I’d likely become a raging drunk, since that’s really all that’s available way out here(a street vicodin goes for as much as $20/pill out here, which would be inaccessible for me. tequila is so much cheaper)
            I feel for those who end up addicted to this stuff. I know some of them.(even a few who have died from it)
            but the trend seems to be to lump painful folks like myself, who cannot function without opiates, in with everyone who abuses them, willingly or no.
            I am thankful that I’ve managed to have the same doctor and pharmacist for nigh on 20 years, so my appearance and mannerisms don’t cause undue issues(hairy, bearded, slovenly redneck hippie guy with one crazy eye and a habit of long philosophical digressions on everything except sports. It’s as if the profiles were written with me in mind)
            I pity others in the same situation who are not so fortunate.
            Pain is often invisible, and is entirely subjective.
            it’s also very real and debilitating(i sometimes don’t move from this spot for days).
            we should be careful about those babies in that bathwater, lest we cause even more suffering and death.

      2. Carl

        Yes, I was surprised not to find Dreamland referenced in this piece. It’s a comprehensive look at the Sacklers and their relationship to the marketing of Oxycontin, as well as an fascinating look at a variation of the Mexican black tar heroin distribution system into the US. Highly recommend.

  5. Synoia

    Big money has discovered how to profit from prohibition of milder opiates and pot. Misuse the medical system.

    I’d be very interested in the Marking brochures used to persuade doctors to prescribe such products.

  6. David Green

    Correspondence from Sal Rodriguez, who has published related views on Counterpunch:

    Hi David,

    I actually wrote this response quite a while ago but then slacked on editing it down for your convenience. If you’re still interested in my take, here it is.

    I’ll begin with a response to the Equire article on the Sackler family, which I figure is representative of a lot of the coverage of them.

    First, I think the fact that they are a wealthy family who engage in a wide set of philanthropy including potentially politically disagreeable efforts like “school choice,” is irrelevant.

    Most of the media I think has consistently failed to dig very deep into what the “opioid crisis” really is – instead resorting to tropes like “the evil corporation profiting from misery,” “extremely dangerous drugs are killing people and the government MUST do something about it.”

    The Esquire piece, and most of the links you sent, falls into those two categories.

    They want to frame the entirety of the “opioid epidemic” as the sole and direct consequence of sinister rich people making these evil pills that make everyone addicts and kill them.

    For left-leaning people, this is attractive: they get to bash Big Pharma, they get to bash big corporations, they get to blame addiction on capitalism, and they get to celebrate marijuana. For right-leaning people, they get to express their compassionate conservatism, talk about the importance of religion, talk about law and order and the need for more border controls to stop the drugs from coming in, etc.

    But such narratives almost entirely rely on superficial analysis and loads of hysteria.

    The Esquire article, for example, asserts that Oxycontin is “regarded by many public-health experts as among the most dangerous products ever sold on a mass scale.”

    It never gets into any real support for this claim other than going to say that since 1996 “more than two hundred thousand people in the United States have died from overdoses of OxyContin and other prescription painkillers.”

    As that sentence reveals, and as Esquire goes on to note, “Not all of these deaths are related to OxyContin—dozens of other painkillers, including generics, have flooded the market in the past thirty years.”

    That’s a pretty weak basis for the assertion that OxyContin specifically is “among the most dangerous products every sold on a mass scale.”

    But setting that technicality aside, the overdose numbers are complicated by the reality that many overdoses are in fact the result of polydrug use, including people who attempt to enhance the effects of opioids with alcohol or benzodiazepines because their doctor wasn’t able or willing to prescribe an adequate number of pills.

    It’s worth noting that, in 2013, 77 percent of deaths involving prescription opioids were known to involve a combination of a prescription opioid with another drug or alcohol. The figure is likely higher, given the inconsistent reporting and collecting of information by medical examiners.

    This fact is rarely ever mentioned by the mainstream media.

    The Equire article also attempts to blame heroin overdoses on prescription drugs: “Thousands more have died after starting on a prescription opioid and then switching to a drug with a cheaper street price, such as heroin.”

    What Esquire leaves out is that a major factor in the “heroin epidemic” was the wide range of federal crackdowns over the past decade – with doctors and pharmacists targeted, arrested and monitored. The result has been a drop in the number of opioid prescriptions, but more people moving to heroin and thus being exposed to the problems of the black market, including drug tainting with fentanyl and carfentanil.

    The recent position paper of the Global Commission on Drug Policy breaks this chain of events down quite well: http://www.globalcommissionond d-crisis-north-america-positio n-paper/

    Esquire goes on to uncritically repeat the corny line by Chris Christie that opioids create the equivalent loss of life as “September 11th every three weeks.” A previously noted, the overwhelming majority of opioid deaths involve drug mixing, either out of recklessness or lack of education about the risks of drug mixing, and by now the big problem isn’t prescription opioids, but fentanyl-laced heroin, which is a direct consequence of the War on Drugs.

    From there, the article mostly goes on to complain about how rich the family is, and nothing of great significance is actually said.

    Any serious analysis of the current “opioid epidemic” must begin with an understanding that:

    1) the vast majority of people who are prescribed opioids never develop a problem with them,
    2) the vast majority of people who do misuse opioids weren’t prescribed them,
    3) there are a lot of people struggling with under-treated pain because of crackdowns on opioid prescriptions,
    4) most deaths related to opioids involve drug mixing, intended and unintended,
    5) crackdowns are the reason so many people have moved to the black market,
    6) heroin is only dangerous because it is illegal,
    7) addiction is about more than just the drug – it’s as much about the circumstances of a person’s life and environment,
    8) opioids shouldn’t be universally condemned and curbing excesses in prescribing shouldn’t prevent doctors from prescribing to those who might need more than average.

    I highly recommend this discussion of the opioid problem and how/why our drug policies created it: v=ySJuGhI0lVQ

    Hope this helps.

    Sal Rodriguez

  7. Piotr K.

    Yes, goverment was the problem in Regan times. But you in US did legalize corruption, by allowing so-called lobbing.
    Can we say that its government fault now?

  8. Ian Perkins

    I point the finger at the regulators.
    Purdue and their ilk are and were doing their job – maximising profit for shareholders and all that. A repulsive and anti-social job to be sure, but within the logic of capitalism, their job.
    The regulators should have known that opioid painkillers are addictive. It’s absolutely elementary. A non-addictive opioid painkiller has been a holy grail for at least a century. Some pretty overwhelmingly convincing evidence should have been demanded when the pharmaceutical industry claimed it had found one.
    Instead the regulators accepted the line that if prescribed responsibly, addiction would not ensue.
    For a start, this is circular. What does prescribed responsibly mean? Not resulting in addiction?
    Second, if you gave junkies an unlimited supply of oxycodone for a month or two, then took it away, you’d soon see how addictive it is. Simple. (It needn’t be junkies, but they’d be more ethical to try it on.)

    1. Pespi

      Apologies for being catty, but the cliche ‘they were just doing their jobs’ while being darkly sarcastic, internalizes the idea that businesses only exist to wring profit from misery.

      Lots of people are running businesses that aren’t scams or misery factories. Lefitsts can make money and define acceptable behavior in the market from both supply/consumption sides. Lots of things used to be ‘beyond the pale.’ It’s time for the pale to be stretched back to its old place.

      If corporations are people, why not scold them and hold them morally and legally accountable. It will at least decrease their profit margins with all the consultants, pr, and rebranding eating away at bonus pools.

      1. Ian Perkins

        Doing their job was not meant sarcastically. Corporations are legally bound to maximise shareholder profit, I believe. Henry Ford was half-successfully sued for not doing so. ( )

        You are absolutely correct; not all companies and corporations are as amoral and ruthless in how they go about it, or if they are, the consequences are not so blatantly antisocial.

        Purdue etc seem to be very successful in terms of profit, and pretty extremely amoral and ruthless in their pursuit of it. The logic is the same, as many a conservative will agree.

        1. Scott

          I’m not an expert in business or law. That said, the link you provide doesn’t support the claim. There are two opinions that the court’s decision doesn’t say that in any way, one that it does. On top of that, the very ability to form a corporation in any sense is one that is created through legislation, not some natural law.

          It’s surely nice to be able to incorporate, offer stock or accept monies and remain largely free of liability in a personal sense, but a corporation is whatever the rules made say it is, and the same holds true for it’s obligations the investors of any type. Hell, it would probably take nothing more than issuing a restricted share, voting share, class b share, or some other simple definition, restriction or classification of the stock or share offered to change the dynamic you suggest.

          Corporations aren’t legally bound to maximize profit at the expense of other elements of mutual concern to the community in which they exist, the physical environment, or any other legitimate prerogative of the managers and board. The page you link to does say that as well.

  9. Steve Ruis

    NPR ran a piece some months ago about a former DEA agent who was on a task force to bring in rogue pharmacies which were selling opioids in very large quantities. (This was under the Obama administration.) One such pharmacy in Florida was responsible for filling tens of thousands of prescriptions per year when ordinary pharmacies might fill a few hundred per year at most. This pharmacy also had been convicted a crimes a number of times in the recent past, paid fines and just kept going. The agent said that he pushed paperwork to the agency to shut the operation down, but nothing seemed to happen. Shortly thereafter the federal courts of the region issued a query as to why the prosecutions of drug cases had dried up. They were sitting twiddling their thumbs. The agents were sending in cases, but the courts weren’t seeing them, so the “blockage” was in between. When the agent pushed the DEA, there was first stalling then there was push back … first from the agency which had been ordered to “go slow” on such cases and then … from Congress! Congress eventually pulled the fangs of the DEA to enforce such cases. The agent was furious and kept prying only to find out the Congressman who got the legislation through blocking the DEA’s efforts at reducing the opioid epidemic and found very large campaign donations from “the industry.”

    Follow the money gentlemen, and the amount of money being made selling Oxycontin and the like is quite astounding. Nothing is going to interrupt that flow of corporate profits any time soon.

  10. run75441

    DNC leader Howard Dean once called for a 50-state strategy to elect Democrats to public office. It appeared to work and then it fell by the wayside.

    Big Pharma does have a 50-state strategy which they use to lobby the state legislatures and also federal government. It is wildly successful and blocks most bills in the legislature before a vote is even taken. There is no open dialogue between legislators on the merits of certain bills. The lobbyists stop by their offices or over lunch or a game of golf to discuss the merits of each piece. Just ask Jennifer Weiss-Burke who was lobbying the New Mexico legislature to limit initial pain-killing opioid prescriptions to seven days outside of the needs of chronic pain patients. Her son died of an over dose three year after being given his first bottle of Percocet to combat and dull the pain from the break. From 2006 to 2015, pharmaceutical companies have spent $880 million from lobbying all of the state legislatures and in campaign contributions.

    There is a big problem with opioid addiction and the blocking of sensible solutions to short periods of pain killers outside of chronic pain.

    1. billy

      I point the finger at the state. The state has slow walked major drug case prosecution, the state has focused on Marijuana- just look to Mr. Sessions, the state has steadfastedly protected the Pharma companies, the state has consistently avoided any real effort to stop the flow of opioids and even though the state knows that tons of product are imported and that thousands die no real effort is made.

      Why would the state do this – money of course but also to chemically enslave the population and to make sure that any drug felon is off the voting rolls


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