Black Jet – Volume 2020-2 Opioids the Forgotten Crisis
May 8, 2020 by Marshall Snipes
In 2015 Sam Quinones wrote “Dreamland The True Tale of America’s Opiate Epidemic”. The book exposed the role Big Pharma played in fueling the opioid epidemic. Quinones a freelance writer and former investigative reporter for the Los Angeles Times, covered the illegal drug trade for years. Throughout his travels he had a Black Jet moment.
The Black Jet Theory is the notion that most of what currently happens, when viewed through the filter of common sense and critical thinking, leads to a different conclusion, than the widespread view of current thinking by those who control the dissemination and content of information (academia, the media, politicians and other “experts”.[1]
In the Introduction to his book Quinones states – “Crime was at historic lows, drug overdose deaths at record highs. A happy façade covered a disturbing reality. I grew consumed by the story.” [2] That consumption led Quinones to challenge conventional wisdom and write Dreamland. Oklahoma’s Attorney General Mike Hunter took the fight from there. Hunter filed multiple lawsuits against pharmaceutical manufacturers. “On August 26, 2019 Judge Thad Balkman of Cleveland County District Court in Oklahoma ruled that Johnson & Johnson had intentionally played down the dangers and oversold the benefits of opioids, and ordered it to pay the state $572 million …” [3]
The seven-week trial came on the heels of settlements of similar cases brought by Hunter against Purdue Pharma ($270 million) and Teva Pharmaceuticals ($85 million). Purdue’s plan “was to expand the use of long-lasting opioids from cancer centers into the mainstream of medicine by convincing thousands of family doctors, general practitioners, dentists, and anyone else who held a prescribing pen that Oxycontin was safe and wouldn’t lead to abuse and addiction by patients”[4]
The basis of the lawsuits was that pharmaceutical companies intentionally misled the public about the addictive nature of the opioids. Many doctors relied on these representations by drug reps and conveniently bypassed the “Do No Harm” mantra of the Hippocratic Oath. The Black Jets were flying high. Quinones and Hunter both applied common sense and critical thinking in questioning the cause of such an epidemic. Claiming and promoting the fact that opiods were safe did not make sense.
In the spring of 2019 before the Johnson & Johnson case went to trial, Hunter through his Opioid Task Force recommended reform measures to curtail the use of opioids. Those recommendations became law. There has been a decline in the number of opioids prescribed as a result. Several doctors have told me, they no longer prescribe opioids and rely on other methods to ease pain. They did not come to those conclusions lightly. The efforts by Hunter and others have saved countless lives. However, the problem remains. The Black Jets are quietly circling.
According to the current Center for Disease Control (“the CDC”) website, “Anyone who takes prescription opioids can become addicted to them. In fact, as many as one in four patients receiving long-term opioid therapy in a primary care setting struggles with opioid addiction. Once addicted, it can be hard to stop.”[5] ,“In 2017, prescription opioids were involved in 36% (in excess of 15,000 people) of the opioid-involved overdose deaths in the United States.”[6] “In 2018 an opioid prescription was filled by 19.2% of the adult American population (that’s over 40 million people) with an average of 3.6 prescriptions per patient”[7]
According to the current National Institute on Drug Abuse (“the NIDA”) website, “2018 data shows that every day, 128 people in the United States die after overdosing on opioids … The widespread use of opioids to treat acute and chronic pain contributed to the approximately 10.3 million people aged 12 years and older in the United States in 2018 who misused opioids, including heroin.” [8] That’s a lot of opportunity for misery. And those results repeat every year. Even after losing lawsuits and paying billions in fines the pharmaceutical companies continue to deny responsibility.
We have become de-sensitized and the results continue. Common sense says we still prescribe too many opioids resulting in too many overdoses, wrecked lives and in many cases death. Pharmaceutical companies dominate advertising, political contributions and have too much influence on the regulatory process – thus we are left with the “disturbing reality” that Quinones described in Dreamland. Critical thinking dictates that we determine the appropriate use of opioids. Allowing dentists to prescribe opioids for a toothache is certainly suspect.
We still live in a free country and people still have the freedom to make their own choices about health care, at least for now. All too often we rely on the “experts” to make our decisions for us. We don’t have informed consent where the patient is truly informed and understands the benefits versus the risk. The argument goes that we don’t have the same level of knowledge, training and experience our doctors have. Tell that to the families whose lives have been destroyed.[9] As a society we run a risk when we abdicate the responsibility for our own physical health to others.
Jeff Greene, CEO of Medencentive, says “… there is substantial peer reviewed evidence that the more information the patient has, the better decision they are able to make for themselves”[10]. Especially when it comes to one’s health, we should all use our own common sense and think critically based on all information available regarding all alternatives to treatment. We should ask our Doctors who prescribe opioids, if they are safe. We should ask about the risk you take if you swallow the pill. You might just bypass taking an opioid and lower your risk of harm.
Don’t take my word for it, think for yourself.
[1] Black Jet – Volume 2020-1, by Marshall Snipes, May 1, 2020.
[2] “Dreamland The True Tale of America’s Opioid Epidemic” by Sam Quinones, 2015
[3] “Johnson and Johnson Ordered to Pay $572 Million in Landmark Opioid Trial” by Jan Hoffman published in the New York Times August 26. 2019. Note: the Judge later lowered the amount to $465 Million.
[4] “Pain Killer, An empire of Deceit and the Origin of America’s Opioid Epidemic” by Barry Meier updated version 2018.
[5] www.cdc.gov/drugoverdose/opioids/prescribed
[6] “Variation in Adult Outpatient Opioid Prescription Dispensing by Age and Sex – United States, 2008-2018” by Lyna S. Schieber, MD; Gery P. Guy, Jr. PhD; Puja Seth, PhD; and Jan L. Losby, PhD, March 20,2020 / Vol.69 /No. 11 of the Morbidity and Mortality Weekly Report of the Centers for Disease Control and Prevention
[7] ibid
[9] A word about overdoses. An overdose as defined by the CDC in “Commonly Used Terms” on its website, as “Injury to the body (poisoning) that happens when a drug is taken in excessive amounts.” However, there is significant anecdotal evidence that injury can occur when opioids are taken as prescribed.