With opioids, government is the problem


By Jeffrey A. Singer

To paraphrase President Reagan, in this present opioid crisis, “government is not the solution to our problem; government is the problem.”

The never-ending War on Drugs has led to a proliferation of counterfeit opioids widely available on the black market. Oftentimes, these drugs are laced with more dangerous and powerful opioids such as fentanyl and carfentanil that cause death by cessation of breathing. Many times, the actual strength of the dose of opioids purchased from illegal drug dealers is unknown or greater than expected.

The federal government has encouraged pharmaceutical companies to develop “tamper-resistant” prescription opioids, so that recreational users who illegally obtain them cannot crush them and snort them.

An example is when oxycodone and Oxycontin tablets were made crush-proof starting in 2010. Some users found a way to illegally boil and inject the drugs, spreading HIV and hepatitis C with dirty needles. Others just decided to switch to the easier-to-obtain and user-friendlier heroin, available for a fifth of the price of “street prescription opioids.”

Meanwhile, state and federal regulators pressure health care providers to curtail the prescription of opioids, often making genuine acute and chronic pain patients suffer needlessly. Over the past two decades, 49 states have set up Prescription Drug Monitoring Programs to monitor the prescribing habits of providers, often with the effect of intimidating them into being more frugal in prescribing certain medications.

How has that been working out? The Centers for Disease Control and Prevention report that opioid overdose deaths continue to soar, reaching an all-time high of more than 33,000 in their latest report — mostly due to heroin overdoses.

Studies show that monitoring programs could be associated with driving desperate pain patients to the illegal market, where counterfeit and laced opioid pills and heroin are readily available.

If we are really interested in addressing the opioid overdose problem, we should get government out of the way and let doctors be doctors. Trust health care providers to follow their best judgment, use “harm reduction” strategies and abide by their oath to ease pain and suffering and “do no harm.”

Jeffrey A. Singer practices general surgery in Phoenix and is a senior fellow at the Cato Institute.

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