Connect with us

Healthcare

Trump’s epic drug fail: The case for safe, legal heroin

Published

on

President Trump declared that opioids are now a “National Public Health Emergency.” At the same time he demonstrated his ignorance of important facts. That is likely the fault of Chris Christie’s chairmanship of the President’s Commission on Combating Drug Addiction and the Opioid Crisis. Only one of the Commission members, Dr. Bertha Madras, has any subject matter expertise. The other five are elected officials, all of whom have publicly demonstrated allegiance to the idea that the Drug War is the proper way to deal with an epidemic of overdoses.

To say that this is wrong-headed would be the observation of an astute student of the obvious. The War on Drugs was officially declared by Richard Nixon in 1971, but has been going on at least since the Harrison Narcotics Act of 1914. In a century we have experimented with banning one addictive drug, alcohol, only to discover that prohibition does not work. Yet politicians and their lapdogs in the press have slavishly insisted that if we do more of the same, we will eventually get a different result. Albert Einstein famously noted that this is one definition of insanity.

Widely distributing Narcan to drug addicts will probably save some lives when they overdose, but that’s like calling a wrecker to tow you to the tire store when one blows out after all four have been bald for a year. Sometimes you’ll get in safely, but other times you’ll end up injured or dead in an accident.

Dr. Madras is an expert in the cellular biology of addiction, but it is clear from her writings that she is most comfortable with remedies based in formulary controls, claims data surveillance, and education of physicians on reducing opioid risks. This top-down regulatory approach is shared by the congressman, state attorney general, and three governors who fill out the commission. In short, the Commission’s prescription was printed and signed before the Commission ever met. It completely ignores a century of experience in the field.

Opiates 101: A short course

In my 36 years in Anesthesiology, I became intimately familiar with the salient fact that all opiates are essentially the same drug. (See table) All work on the same receptor in the brain. All depress breathing so that in an overdose, the victim completely forgets to breathe until he is completely dead. All cause constipation, nausea, and vomiting. All change how one sees the world, and once your body is used to them, they all cause horrible withdrawal symptoms.

The only material differences between opiates lies in how quickly their effects start, how long they last, and how the drug is administered. In a sense, Remifentanyl is short acting Fentanyl, while Morphine, Heroin, and Dilaudid are delayed release Fentanyl. Oxycodone is essentially an oral form of Morphine. I could go on, but you get the point.

Knowing those facts made it easy for me to administer literally gallons of opiates safely. Had Heroin been legally available, it could have joined Fentanyl, Morphine, and Dilaudid as my front-line drugs for pain. After all, it has the same onset, duration, and side effects as Morphine and Dilaudid, with potency between them.

History 101: Why opium was banned

By now it should be painfully clear that there is no medical reason whatever for Heroin to be banned. It’s a good drug with definite medical utility. And Fentanyl has proven itself to be a very good drug since it was introduced into clinical medicine over fifty years ago. Yet suddenly there are wild cries to eliminate a “public health emergency” from a drug we’ve used safely for decades. Why should this be?

Opium has been used for both intoxicant and medical purposes for as long as we can trace history. It is an extract from a pretty flower that grows wild in many countries. It dulls pain by working more effectively at the endorphin receptor than endorphins, which your brain makes. As long as the strength of the drug is known, it is extremely safe. But do-gooders can’t leave well enough alone. Could it be they see some benefit for themselves?

Opium has been a cash crop for millennia, but by itself isn’t that highly profitable since harvesting and refining it is inexpensive. An addict can easily be supplied for a couple of dollars a day. A supplier needs a large market. Or he can have a smaller market at a higher price.

Our current obsession with the bad habits of others took full flower at the pen of William Randolph Hearst. During the building of the Trans-Continental Railroad, large numbers of Chinese laborers were imported. They took their one day a week off in the nearest shanty town where many smoked opium, got high, and slept it off. Hearst was a blatant racist with the largest megaphone in the country, the Hearst newspapers.

His hatred for the “coolie” sprang vividly from the headlines, cartoons, and editorials of his papers. Soon the “opium fiend” was a matter of public condemnation, even though the demon created in the printed word never existed, since opium does not lead to aggressive behavior. Shortly Congress passed the Chinese Exclusion Act of 1882, which prevented further Chinese immigration.

This did not end the frenzy. In 1914 Congress passed the Harrison Narcotics Act, again in the complete absence of evidence that individual consumption of narcotics caused harm to those not engaged in its use. Further, many, in the footsteps of the “coolies,” were able to use the intoxicating drug and continue to live a productive life.

When Harry Anslinger became the first Director of the Federal Bureau of Narcotics in 1930, the War on Drugs (by other names) became fully fledged. Never again would the wisdom of the effort to stamp out drug abuse be seriously questioned in the halls of power. Prohibition of one intoxicant, alcohol (1920-1933) was extended to other intoxicants, the opiates. Unlike alcohol which is consumed across wide socioeconomic classes and has been released from constitutional imprisonment, opiates remain the forbidden fruit.

The benefit of prohibition: Risk premium

While it is clear that, in the absence of proper medical indication, opiates are detrimental to well-being, addicts who are maintained on their meds are no threat to society. Many are able to function at a high level. So what benefit arises from prohibition? As James Carville famously said, “It’s the economy, stupid!”

When intoxicants are prohibited, a “risk premium” is created.

A risk premium is the return in excess of the risk-free rate of return an investment is expected to yield; an asset’s risk premium is a form of compensation for investors who tolerate the extra risk, compared to that of a risk-free asset, in a given investment.

– Investopedia

When drugs are legal, there is no legal risk, and the cost to the consumer is the basic economic cost of the steps of production and distribution. As we noted earlier, this is less than the cost of your daily Starbucks latte’. It’s enough for a basic business but simply lacks the margin to support a criminal enterprise.

When drugs are illegal, a market still remains, since a significant portion of the population has wanted intoxicants throughout history. But now there is a notable risk to supplying the demand. So price increases to cover that risk. The curbside pharmacist has to get his supply somewhere. His supplier has the same problem, so the price goes up more. Now the customer has a problem.

If he’s going to empty his wallet to pay for all that risk, he wants a real bang for his buck. After all, he could end up in jail, too! This potency requirement raises the price on the other steps… again. It’s a vicious cycle. What started out as something cheap has become very expensive. And now there is profit for criminal enterprises.

Those enterprises will want to protect their turf from competition, and now we see violent crime start to appear around the drug trade. Customers who become addicted now have to find ways to support their habits, and various other crimes become common. Note that every level of crime was absent in the open trade for opioids. As soon as drugs became criminalized, bigtime crime moved in, because prohibition creates profits for them.

One more problem arises. How does a dealer keep his customers? He has to provide high quality product. This was demonstrated very well in the late 1960’s when Laotian General Ouana Rattikone marketed “999” heroin. It was a very consistent product so that a safe dose could easily be administered. When competitors made more highly refined heroin, he upped his game and produced “Double Uoglobe Brand” heroin. Reliable quality led to large sales.

Rattikone was in a protected area. Your distributor can’t do the same thing without attracting attention. But he can mix his product with other things. If he cuts it with inert materials, he can spread it further, but competitors will attack his poor quality. On the other hand, if he adds something a bit more potent, such as fentanyl, he will give the appearance of a better product.

Unfortunately, this competitive commercial response is now being seen in multiple markets with radically differing amounts of fentanyl. Now each addict is taking on a new risk every time he administers a dose. It may be worthless or it may completely stop his breathing until he is completely dead.

What if we legalized heroin?

Let’s review the chain of events. Prohibition introduces a risk premium, making crime pay. It also prevents the customer from knowing what dose he is getting. Many users will get overdoses, and many will die. Should we be surprised when that is today’s headline?

Suppose we legalized drugs? Apologists for prohibition claim we’ll see more addiction and more deaths. Instead “we need more detox and rehab programs.” Should we be surprised that this approach is promoted by people who profit from those programs?

Fortunately, we have laboratories that show what works. One of them is called Portugal. There, heroin was made legal in 2001. Sixteen years have shown that overdose deaths have almost vanished.

Addicts are maintained on steady doses of drugs they get for free from clinics. The total cost is less than that latte’ we mentioned earlier. And, curiously, addicts are slowly weaning themselves off of opioids in an average of ten years.

Imagine that! When they don’t have to resort to crime, addicts are able to maintain relatively normal lives and then act in their own self-interest. And no funds are diverted to unnecessary detox and rehab programs. And, by the way, no funds are spent on expensive drug interdiction efforts. No undercover cops infiltrate drug rings, because there aren’t any.

Suppose the United States was to do this? Our expensive rehab programs would go away, allowing money to be spent where it can actually do some good. But more important, the profit that fuels the Mexican drug cartels would dry up. We wouldn’t have Border Patrol agents running up against heavily armed drug gang members. There will be no need to prosecute the next El Chapo, because he won’t get rich enough to matter or to export his crime to the US.

What’s not to like?

Ted Noel MD is a Board Certified Anesthesiologist with 36 years of experience. He produces a video blog on current political subjects weekly at www.VidZette.com.

Continue Reading
Advertisement
Click to comment

Leave a Reply

Your email address will not be published. Required fields are marked *

Federalists

The Obamacare Debacle: Why we need a second political party

Published

on

By

Sometimes you simply hope that your predictions will be wrong and that events will miraculously turn out differently; unfortunately, this is not one of those times. Most people with a modicum of common sense anticipated that the Republicans would now take the blame for the troubles of Obamacare, and that has come to pass.  The aphorism ‘You broke it, you bought it’ comes to mind, and while somewhat unfair to the situation, perception is reality in the world of politics.

Tear it down and start over.

While not endeavoring to reign blows upon a deceased equine, this is why the Republican party needed to keep its promise on Obamacare. It’s also the reason why it’s time to sweep away the old and begin anew with a brand new second major political party. That phrase was deliberately used because it has become quite evident that the Republican and Democratic parties have started to merge in far too many ways.

The Obamacare debacle is a prime illustration of this unfortunate merging. O’Sullivan’s First Law explains this to a fair degree since the denizens of a certain party will – over time – want to keep the bureaucratic levers of power with the false idea that they can have it run more efficiently. Besides the simple expedient of term limits, a new party could start anew with a mandate to avoid this political trap.

An illustration from the world of engineering seems more than appropriate in this instance. There are times when a machine or structure has become so riddled with worn out or failed components that it is far better to simply scrap or tear it down and build something from scratch. The aphorism is to start with a clean sheet of paper such that the old assumptions and constructs are swept away in favor of something entirely new and innovative. “We’ve always done it this way” is replaced with questioning skepticism with regard to what works, and what doesn’t.

Existing components that have proven to be of service can be utilized in the new construct but only if they meet certain criteria, not simply because they are carried along with everything else of the old. By the same token, members of the old party can become a vital part of the new but only if they are up to the task.

The final word on the Republican party.

It is more than likely that the people responsible for that bureaucratic mess will use it to good political advantage against those who opposed it in the first place. We should be getting rid of governmental interference in the free market, but instead will see a complete control with national socialist healthcare [i.e., the ‘single payer’ deception].

There is no other choice than to limit the damage now with a new party that will stay true to conservative principles. The results of the alternative are too horrible to contemplate.

Continue Reading

Democrats

Chuck Schumer threatens Obamacare fix over GOP tax bill repealing individual mandate

Published

on

Chuck Schumer threatens Obamacare fix over GOP tax bill repealing individual mandate

Chuck Schumer went after the GOP’s proposed tax plan today, saying the bill the Democrats currently support to bail out Obamacare, Alexander-Murray, will not get their support if Obamacare’s individual mandate is repealed.

“Any Republican senator who thinks they can pass the individual mandate and then turn around and get Alexander-Murray passed is dead wrong.”

The Senate Minority Leader has supported the plan to save the Affordable Care Act, but is now holding it hostage to try to preserve the individual mandate that forces millions of Americans to pay for health insurance they don’t want.

Further Reading

Chuck Schumer: Democrats won’t back Alexander-Murray if Obamacare individual mandate is repealed

http://www.washingtonexaminer.com/chuck-schumer-democrats-wont-back-alexander-murray-if-obamacare-individual-mandate-is-repealed/article/2640780Republicans on Tuesday added repeal of the individual mandate, which requires Americans to purchase health insurance or pay a fine, to their tax overhaul bill. Senate GOP leaders also said that if it were to pass, they would also be willing to take up a bipartisan bill known as Alexander-Murray, which includes payments to insurers and flexibility for states. The proposal was meant to win over centrist Republicans, who worry about some of the projections from the Congressional Budget Office showing that 13 million more people would be uninsured in a decade if the individual mandate were to be repealed.

Continue Reading

Healthcare

It’s a health issue: The left opens up a new front in the war on liberty

Published

on

By

Its a health issue The left opens up a new front in the war on liberty

The desire for control has differentiated Left from Right, now the Left is using health concerns to further this effort

The desire for control on the part of the Left is the main difference between the two sides of the political divide. As a general rule, Left continually advocates increased government control with everything from taxation to climate change. One of the Left’s newest methods is to use health issues with nary a concern over those pesky notions of liberty and freedom.

The Left began using this with the 2nd amendment, with everyone’s health and safety taking precedent over that restraint on the government. And now they are expanding the assault, moving into the areas of free-speech

The Leftist case for restricting liberty due to health concerns

Back in June the LA Times published an Op-ed basing the need for restricting free-speech on health issues:

The case for restricting hate speech

http://beta.latimes.com/opinion/op-ed/la-oe-nielsen-free-speech-hate-20170621-story.htmlIn fact, empirical data suggest that frequent verbal harassment can lead to various negative consequences. Racist hate speech has been linked to cigarette smoking, high blood pressure, anxiety, depression and post-traumatic stress disorder, and requires complex coping strategies. Exposure to racial slurs also diminishes academic performance. Women subjected to sexualized speech may develop a phenomenon of “self-objectification,” which is associated with eating disorders.

And most recently the New York Times published an opinion piece titled: We’re Sick of Racism, Literally In that opinion piece, the author asserts that one doesn’t even experience racism ‘in person’ to have an adverse impact on their health:

Worse, we know that racism doesn’t have to be experienced in person to affect our health — taking it in the form of news coverage is likely to have similar effects.

The piece concludes with this:

We shouldn’t need the specter of disease to denounce hatred in all its forms. Racism, bigotry, sexism, anti-Semitism, Islamophobia, homophobia, xenophobia, should have no place in our society. But the illness associated with discrimination adds injury to insult and magnifies the suffering of these times.

The Takeaway

One can easily see where this is going to lead. Soon enough it will be more important to remove the restraints of the 1st and 2nd amendments on the government due to health concerns – no matter the consequences to liberty – because who can argue against better health for everyone?

The problem is that history has shown that increasing Leftist control has always lead to far worse consequences than detailed in these opinion pieces.

Continue Reading

NOQ Report Daily

Advertisement

Facebook

Twitter

Advertisement

Trending

Copyright © 2017 NOQ Report.