Rodz opioid rants, continued

You thing YOU got problems?

The New York Times today has an article about synthetic opioid sales on the darknet , which are booming. It turns out that the Mexican Cartels are buying their synthetic opioids (mostly fentanyl derivatives ) in China, then trans-shipping them to the USA.  Kinda like Borders used to buy books from the publishers and trans-ship them to your local Borders bookstore.

Well, just like Amazon put Borders out of business by connecting customers directly to suppliers ,  enterpreneurs on the darknet are connecting labs in China with consumers in the USA, Canada, and Europe.  Turns out that you can buy a gram of synthetic fentanyl for around  US$122 on any of these online shopping sites.  Let’s say this stuff is furanyl fentanyl for the sake of argument, which is only 10 times more potent than heroin. So to substitute for a dime bag of 25% pure heroin, you would need 2.5 mg of furanyl fentanyl. There are 400 doses of this in the $122 gram that is going to be in your mailbox next week. So you get the equivalent of $10 of heroin (or $160 of diverted oxycontin) for about 30 cents.  Got a quarter and a nickel?

So the Mexican Cartels are in serious danger of going the way of Borders and Blockbuster Video.  However, this does nothing to reverse the opioid epidemic we have created in our country (remember, we tripled the number of opioid addicts thanks to pharmaceutical companies, doctors, and our elected representatives). The Drug War has now dropped the price of your standard two oxy-80’s a day blast from $160 all the way down  to 30 cents.  We had Moore’s Law in IT, maybe this is Sessions’ Law in drug policy.

The only way to stop this disaster is to decrease demand for opioids among consumers. We know  how to do this . Let’s do something that is inexpensive and effective, not ruinously expensive and harmful.

Rodz opioid rant, continued

So the CDC just updated its reporting on our national opioid epidemic and it’s not looking good for our failed Drug War .  The good news: opioid prescribing nationally is DOWN to three times the 1999 levels.  The average American now gets only 1.75 mg of morphine every day, 640 mg/year.  The bad news: opioid prescribing continues to INCREASE in communities that are predominantly white, rural, low-education, and low-income. Northern NY was one region that saw an increase in opioid prescribing.

In short, national opioid prescribing is down, but our local opioid prescribing is UP.  Patients should be aware of this danger when they go to their health care providers with pain: if your doc dashes off a prescription for oxycodone or hydrocode, ask for “a non opioid treatment.”

If something sounds too good to be true, it probably is.

Opioids for chronic non cancer pain were Too Good to be True.  Don’t get sucked into this whirlpool.