HJAR Jul/Aug 2022

DRUG ADDICTION 14 JUL / AUG 2022 I  HEALTHCARE JOURNAL OF ARKANSAS   THE AWAKENING By the late 1990s to early 2000s, the num- ber of deaths due to opioid overdose events started to cause real concern and awareness of the alarming situation patients in pain were suffering. Just to give us an idea, the number of prescriptions for opioids went from 25 million to 100million in a matter of a decade (from years 1990 to 2000), more than tripling. 8 During this period, there were whistle- blower attempts and reports of overdose events all over the country. The Department of Justice, DEA, and FBI were investigating. Unfortunately, the powerful lawyers from Purdue Pharma either silenced the inves- tigations, settled, or gave tremendous amounts of donations to different medical organizations and schools of medicine to keep the situation concealed. A particularly important moment in the early 2000s was the fact that a brave and committed pharmacist who lost his son due to a drug deal gone wrong started an extremely focused search for answers around the metropolitan area of New Orleans, conducting hundreds of hours of interviews that he recorded when he could — when calling authorities, e.g., the police, the agencies assigned to investigate, the Louisiana Medical Board, etc. Sev- eral months passed before he could get anywhere. He found out that there was a clinic in New Orleans, the sole purpose of which was to prescribe excessive amounts of opi- oids, benzos, and Soma, which, in black- market lingo, are known as “The Holy Trin- ity,” an extremely dangerous and deadly combination. Finally, after numerous attempts at show- ing the authorities tangible proof of the wrong doings in the mentioned clinic, bet- ter known as a “pill mill,” and after almost being killed or suffering serious aggressions from those in the organized crime, he con- vinced the authorities to investigate, expos- ing the doctor who subsequently lost her medical license and was even institutional- ized to treat her own opioid addiction. She never accepted guilt, by the way, and was obviously swimming in money and wealth. 4 FACING REALITY Little by little, the medical community, authorities, and society realized the severity of the situation with the increment of deaths due to overdose events. The CDC, FBI, and the state medical boards developed a task force to prevent, control, and mitigate the terrible situation the American society was suffering. Just to give us an idea of how badly the situation was out of control, among the global production of opiates all over the planet, and knowing that 7.6 billion people live on our earth, only 20% of the opioid production is used to manage the pain of the rest of the world; the other 80% is con- sumed here, in the U.S., with only approxi- mately 314 million population. With this fig- ure, it did not take too long to understand how serious the opioid epidemic was. One of the first questions that came to mind was: How in the world did this happen? Well, trying to produce a simple answer would be impossible, but someone could say: money, greed ... Right? Thanks to the first two wonderfully writ- ten pieces about drug addiction published here — “Historical and Cultural Aspects of Man’s Relationship with Addictive Drugs” from the March/April 2022 issue, and “Addiction as a brain disease revised: why it still matters, and the need for consilience” from the May/June 2022 issue — it is obvi- ous that addictive personality had a very important role in the development of the opioid epidemic. In medicine, we assess “UNFORTUNATELY, ISOLATION, DEPRESSION, ANXIETY, AND LACK OF HOPE [DURING COVID] TRIGGERED THE MISUSE AND ABUSE OF OPIOIDS AGAIN. ON TOP OF ALL THAT, THE TRENDING IN THE DECLINE OF AVAILABILITY OF PRESCRIBED OPIOIDS DUE TO IMPROVED VETTING MADE PATIENTS TURN TOWARD HEROIN AND DRUGS LACED WITH FENTANYL, AN OPIOID 100 TIMES MORE POTENT THAN MORPHINE.”