46 deaths a day: how legal painkillers make Americans addicts
In the US, there is an opioid crisis. Forty-six Americans die daily from overdose of legal over-the-counter pain relievers. From 46 to 2011, mortality from the synthetic opioid fentanyl in the United States increased by 2016% and reached the alarming rate of 1000 deaths. Such deaths are steadily getting younger. Not all victims are residents of disadvantaged areas or come from poor families.
There is such a common opinion: in America, they overdo it with medicines and prescriptions, they write out powerful painkillers, which cause the strongest dependence. Harry Knyagnitsky for Rtvi I tried to find out who exactly is interested in so many opioids on the market and why the US authorities are not able to cope with this very real crisis.
Michelle in 12 years broke her leg. A doctor at the hospital prescribed a pain reliever, OxyContin. So Michelle became a drug addict.
“Doctors have prescribed these medicines for many children. People who live in that area started using. Gradually, they switched to heroin, everyone stuck out in the area. I have lost so many friends. Lots of. The couple stayed, [all because of] an overdose, ”says Michelle.
If in 1999 two thousand Americans died of heroin overdose, in 2017 there were already 15,5 thousand people. Mortality from fentanyl and other synthetic drugs from 1999 to 2017 has increased almost 40 times! But Americans are dying from opioid drugs, which are legally sold in pharmacies by prescription. In 1999, 3400 people died from an overdose of such drugs. In 2017, five times more.
“My mother found me, I generally fell asleep on the street in front of the house. She put me in a car and took me to the [rehabilitation] center, ”Michelle says.
So Michelle ended up at the Dynamite Rehabilitation Center in Brooklyn - the name was inherited first from the cinema, and then from the disco, which were located in the same building. The director of Dynamite, Marina Nakla, shows pictures of Folsberg, a town about 150 km from New York. They spend the first stage of rehabilitation: a year of life in essence in a commune, almost without communication with the outside world. For the second year, customers spend here, in Brooklyn - re-mastering the urban environment. They are allowed to go home for the night.
“They need not only to remove this dependence, but to teach them how to live again. They need time, treatment and support, ”explains Nakla.
Anja started in marijuana in 12 years. In 17, she switched to heroin, bypassing the intermediate stage characteristic of her friends.
“All these people with whom I spoke, who took heroin, started with OxyContin. I had another case, but everyone else started with it, ”Anna admits.
In 2017, almost every third American who died from an opioid overdose was not a classic addict, but took prescription medication.
At the Centers for Disease Control and Prevention it is estimated that at least 46 people die from overdose of legal drugs every day in the USA. For every 100 of thousands of men, six such deaths. For every 100 thousands of women - four. Basically we are talking about three drugs: methadone, oxycontin, vicodin.
“When people think of a person who uses heroin, who do they imagine? They represent some homeless person who has lost everything, he is already over 50 years old. There is no life for them and no prospects. When you think about just painkillers that people take after surgery, it doesn't seem so scary, ”says Anna.
But the finale is always the same. Actually, heroin was once a legal anesthetic. Bayer began producing it at the end of the nineteenth century. Then they found out that heroin is addictive, and it was removed from production. There have been many experiments with opioids: morphine, codeine, and oxycodone. But to launch it into a mass sale, such as, for example, Oxycontin, created on the basis of oxycodone, they only thought of it in the USA at the end of the 20 century on the wave of aggressive marketing.
“The attitude, mainly towards pain syndromes in America, has changed - that's what, in my opinion, provoked this epidemic. That is, do not tolerate pain. If you are in pain, ask and they will give you painkillers, ”explains Leonid Kopeikin, an employee of the insurance company.
“Some people knew doctors where they could just go and say how much their back hurts. Or somewhere they have an old fracture or an injury that hurts even three years later. And that's all - a recipe for OxyContin. There were also other places where these doctors could simply be given money, ”says Anna.
Today in America such doctors are periodically imprisoned. One of the most recent cases is life imprisonment for Stephen Hanson in Kansas. I wrote prescriptions without medical grounds. The Doctors of courage organization unsuccessfully tried to intercede for it. She advocates the right of doctors to decide for themselves whether there is any reason to save people from pain. On the website of the movement are 1199 surnames of doctors sentenced for different periods.
“In my opinion, this is just legalized genocide. Because people who are unable to endure the pain commit suicide, looking for drugs on the streets. I myself, when I was still a practicing therapist, found the suicide notes of my patients. They wrote that they could no longer bear the pain, ”says Linda Chick, head of Doctor of Courage.
While doctors are imprisoned, the manufacturer of OxyContin, the Perdue Pharma company, gets millions in claims on billions in profits from the sale of opioids. The pharmaceutical giant on the Internet encourages you to carefully read the inscriptions on the packaging. It is said that it can be addictive, so what is the demand from the manufacturer.
In the Guggenheim Museum in New York is the art education center Sacklers. It was the Sackler family that founded Perdue Pharma and became fabulously wealthy in sales of OxyContin. Sacklers donated millions of dollars to museums and art galleries around the world. But those who have experienced what is dependence on opioids, prescribed by doctors, have questions to such artists.
“400 thousands of people died from opioid drugs,” the rally participants chanted at the Guggenheim Museum in February 2019. At the head of the movement against Sacklers is the famous photo artist Nan Goldin, who herself sat on OxyContine. She was prescribed the drug after surgery. Then the addiction began, increasing the dose, refusing doctors to write prescriptions, buying from dealers, lack of money, trying to stifle breaking marijuana and overdosing with fentanyl. Nan eventually managed to heal.
19 March Nan Goldin announced that she would cancel her exhibition at the National Portrait Gallery in London if she accepted a donation from Sacklers. The family promised a grant of about a million to three hundred thousand dollars. Gallery refused.
Perdue Pharma did not respond to the RTVI request. On the company's website there is information about the drug called "Butrans". It is used to combat the effects of OxyContin. The active substance of "Butran" is a semi-synthetic opioid buprenorphine. On its basis, pharmacologists have launched another brand, Sabakson. In general, as if the same producer had poison and antidote. Although whether “Butrans” and “Sabakson” are an antidote is a big question. Former drug addict Michel, for example, this did not help at the time.
“Now here is the stream of this Sabaxon. We went to the doctors, and they prescribed me different medications: either sit on methadone, or on “Sabaxon”. And frankly, we all just sold it. Nobody accepted him. It's free money that the state pays for, ”says Michelle.
In New York State, the ISTOP program has been operating since 2013. So that it was impossible to buy prescription every day in different pharmacies, customers are entered into a single database. But here another problem came to light.
“We started to see that it is harder for people to get more drugs. But everyone was addicted - heroin began to go up. Much more, because they feel bad. They have to take something, and heroin is cheaper, ”explains Marina Nakla.
There are more heroin addicts, Nakla says, and they are younger now. If you used to sit on OxyContin before 18-19 years, now they come to heroin in 17. And no matter how the war ends with an opioid epidemic, the consequences of the crisis will remind of themselves for many years. Yes, and pharmacology does not stand still: in order to be treated for some opiates, others sell.
The White House acknowledged the fact of an opioid epidemic in the United States in 2017. Donald trump declared it a national disaster. But according to the US Senate, the pharmaceutical lobby continues to thrive, being perhaps the most powerful in the country. In 2018, pharmaceutical lobbyists spent $ 277 million - more than the military.
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