by
Douglas Messserli
Two of the parents were lying on the ground, unconscious, several yards
apart. …The couple’s thirteen-year-old daughter was sitting behind a
chain-link backstop with her teammates, who were hugging her and com-
forting her. The couple’s younger children, aged ten and seven, were
running back and forth between their parents, screaming, “Wake up!
Wake up!” When Barrett and Mulligan [the paramedics] knelt down to
administer Narcon…some of the other parents got angry….saying “This
is bullcrap.” “Why’s my kid gotta see this? Just let ‘em lay there.’”
Some states became inundated with opiates. According to the Charleston
Gazette-Mail, between 2007 and 2012 drug wholesalers shipped to West
Virginia seven hundred and eighty million pills of hydrocodone (the
generic name for Vicodin) and oxycodone (the generic name for Oxy-
Contin). That was enough to give each resident four hundred and thirty-
three pills.
Affecting the state even harder, is the
number of children removed from parental care because of drug abuse, which rose
from 970 in 2006 to 2,171 in 2016. Entire families have been uprooted, now
living with aunts, uncles, grandparents, and foster parents. And people are
dying daily in private and public spaces. How could we imagine a more
destructive world other than conjuring up a city under the siege of a war?
As
my own recounting of “pain,” after knee surgery in 2014 reveals, there is
sometimes good reason for pain-killers such as OxyContin and other powerful
drugs. And most Americans, some doctors have indicated, have a difficult time
with such pain, particularly long-term back pain and serious bouts with
arthritis—pains which I endured for many years before the surgery. Today I
still have a daily stiff knee, although, strangely, my left knee—where the
bones are still literally rubbing against one another—no longer hurts. I also
have a strong aversion to drugs, so, as I reported, I insisted that I receive
less powerful painkillers immediately after the first week, despite my
continued suffering.
Thank heaven! For in the years since, it
has increasingly become clear that hundreds of thousands of
Americans—particularly in the rural areas of New Hampshire, West Virginia, Ohio,
and Michigan, as well as in parts of California and elsewhere, are now addicted
to such pain-killers, and, unable to afford the high costs of their addictions,
have turned to slightly cheaper drugs such as heroin.
Even during my operation word had begun
spreading about such problems. But in 2016 and into 2017, it became even
clearer that the US was suffering a kind of mass epidemic of serious
addictions.
On August 19, 2016 the small city of
Huntington, West Virginia, according to the Los
Angeles Times endured 26 overdoses in just a few hours, sending the small
police force and emergency servers in chaos. At one location, police arrived to
one house where they found seven people passed out, 4 within the house, and 3
outside. Throughout Cabell County, in which Huntington is located, police
report that they see from 18 to 20 cases of overdosed people each week.
Earlier in the year Sacramento,
California saw 11 deaths from opiate mixes in one short period. New Hampshire
has one of the nation’s highest number of people addicted to opioids, resulting
in a suit from that state against OxyContin’s maker, Purdue Pharma. Ohio sued
all the major producers of narcotic pain-killers by mid-year.
The
New York Times reported that on September 18, 2016 in Lawrence, Massachusetts,
that in a local Family Dollar store, police discovered an unconscious woman
lying on the floor from a drug overdose, while her 2-year old daughter lay next
to her, attempting to tug her mother into consciousness. The local police force
commented that at about 10% of the drug calls they receive, children are
present. There has been a 7.62% increase in child neglect investigations in
that area in 2016 alone.
According to the Associated Press, there
were 3,050 people who overdosed during the year, most from powerful painkiller
fentanyl. And on September 15th, in the Western part of that state,
a couple was found parked on the street, passed out from a heroin overdose,
with a toddler in the back seat. The 8-year old boy who discovered them went
running off to his parents living nearby, screaming for them to come help. The
pictures that were taken of this event have become something close to poster
statements of the serious of what is happening throughout the US.
Similar problems have been discovered
among the homeless in Los Angeles who, unable to afford even marijuana are
consuming a cheaper, man-made drug called “spice,” which is often sprayed with
chemicals that cause deadly results. In LA’s skid row, 38 people had to be
transferred to hospitals in one August Friday after consuming a batch. And the
very next Monday 14 others were found with similar symptoms. The Los Angeles
City Council has now requested an ordinance to ban the substance, which can
also kill. Perhaps the recent legalization of marijuana, at least in this
particular case, will help with the problem.
But the above reports represent just a
few of the numerous stories that reveal that we are slowly turning into a kind
nation of zombies, formerly hard-working men and women who, facing pain and
aging becoming hooked on devastatingly powerful drugs, often by
over-prescribing doctors and clinics. If job-loss can account for much of the
private suffering faced by so many individuals in the poor areas of the country
such as upstate New England and the midland’s rust-belt—areas where,
incidentally, Donald Trump did very well in the election—drugs have clearly
contributed to our cumulative pain instead of relieving it.
An editorial in The New York Times on January 16, 2017, not only reiterated the
national tragedy of opioid and heroin-substitute abuses, but spoke to a
previously unexplored problem about its effects upon the children of those who
abused and died.
The editorial began by expressing that
“Opioid overdoes have claimed more than 300,000 lives in the last 15 years,
including some 33,0000 in 2015 alone.” But it immediately brought up the fact
that nationally, the number of children, often removed from parents for drug
abuse, had risen substantially. Between the years of 2012 and 2015, foster care
had jumped 8% nationally, and suggested that at least 32.2% if these cases in
2015 were a result of parental substance abuse. Citing a particularly tragic
situation in Pennsylvania, where a couple, having died from apparent overdoes,
and left their baby behind to die from starvation, the editors went on to
suggest that the problem was possibly even far worse, citing that one group,
Generations United, had estimated that 2.5 million children now live with
relatives of family friends rather than their parents. “In Texas” (where
funding has been substantial cut),“conditions have gotten so bad that officials
have assigned dozens of foster care children to sleep in state offices and
other temporary shelters.”
A major contribution to the problem,
argued the Los Angeles Times in a
June 2, 2017 article by Karen Kaplan, had to do with a simple-minded argument
expressed in just five sentences in the 1980 edition of The New England Journal of Medicine. Those sentences argued that of
the cases on report to date, only four cases of 11 reported from major medical
centers could be traced to actual addiction among individuals who had no
history of previous addiction.
As Kaplan makes clear, however, these
examples were only from patients who still remained in hospitals, while making
no account of those who had returned home and might have had more private
problems with addiction. Moreover, no specific examples in these sentences were
included. Yet, even as millions of Americans became addicted to opioid
painkillers from 1999 to 2015, these same sentences were cited again and again,
among 608 papers arguing for the drugs non-addictive qualities. Even as the
major drug producers began to see more and more evidence that their products
had led to more than 183,000 deaths as a result of patients with addiction,
they continued to obfuscate through restatement the 1980 article and outrightly
lied to doctors and others who proscribed the drugs. Kaplan sites as a major
example was a 2002 statement by Dr. Sian Iles, associate professor of radiology
at Dalhousie University in Nova Scotia in the International Journal of Clinical Practice:
Fear of addiction may lead
to reluctance by the physician to prescribe.
However, there is no evidence that this
occurs when prescribing
opioids for pain.
In
a 1999 report in Nursing Economics,
nurse-practitioner Nancy Kowal, at the University of Massachusetts Medical
Center in Worcester, Massachusetts, wrote:
This pain population with no
abuse history is literally at no risk for
addiction.
The very same week when the Los Angeles Times piece was published, The New Yorker featured a long essay by
Margaret Talbot, focusing in on just one city in West Virginia, Martinsburg,
population about 18,000. This city, reports Talbot, along with the entire
“eastern panhandle” of West Virginia in which it is located, has “devastated”
the population where nearly everyone has family members or knows someone who is
a heroin addict, brought about by an addiction to painkillers. Just a few
paramedics must work as long as 24-hour shifts for the Berkeley County
Emergency Medical Services in order to save dying addicts by providing does of
life-saving Narcon.
The essay begins with a dramatic event—the
kind we are now hearing daily in newspapers and magazines across the
nation—where at a Little League baseball game, two individuals suddenly
collapsed and lay dying from a heroin overdose. Talbot captures the horror of
the event:
Two of the parents were lying on the ground, unconscious, several yards
apart. …The couple’s thirteen-year-old daughter was sitting behind a
chain-link backstop with her teammates, who were hugging her and com-
forting her. The couple’s younger children, aged ten and seven, were
running back and forth between their parents, screaming, “Wake up!
Wake up!” When Barrett and Mulligan [the paramedics] knelt down to
administer Narcon…some of the other parents got angry….saying “This
is bullcrap.” “Why’s my kid gotta see this? Just let ‘em lay there.’”
Although many in the community express
similar sentiments in the local newspaper, others, particularly those with
family members who suffer similar addictions, are more sympathetic. And some
have even gathered into groups, such as the Hope Dealer Project, run primarily
by three women, who, recognizing that the small town of Martinsburg has little
available to help addicts, take in those who are willing to try to break their
addiction, traveling with the to sometimes long away destinations in other states
to help them get care. But even after, they continue to try to place them on
further programs that work to help their patients from relapsing. Nonetheless,
the possibility of falling back into addiction is common, and Talbot’s article
is dotted with stories of families who sons, daughters, husbands, and wives,
had broken the habit only to take up heroin again, often ending in their
deaths.
West Virginia, with its hard-working
miners and poor, often uninsured, often sickly citizens, was particularly
hard-hit by Purdue Pharma OxyContin marketing.
Some states became inundated with opiates. According to the Charleston
Gazette-Mail, between 2007 and 2012 drug wholesalers shipped to West
Virginia seven hundred and eighty million pills of hydrocodone (the
generic name for Vicodin) and oxycodone (the generic name for Oxy-
Contin). That was enough to give each resident four hundred and thirty-
three pills.
The addiction, moreover, is not limited
to hard working fathers and mothers, but to their children, observing their own
parents taking drugs and, sometimes, even being encouraged, perhaps, to imbibe.
West Virginia has an overdose death rate today, so Talbot reports, of 41.5 per
hundred thousand people, with New Hampshire having the second highest, at 34.5
per hundred thousand.
Finally, if anyone might imagine that
the attention this drug crisis has now received might have meant that there has
been some resolution of the problem, the June 6, 2017 front page of The New York Times revealed it as a
delusion. In fact, deaths from drug overdose have startlingly risen in the last
year, and are likely to be even worse by the end of this year. With more than
59,000 deaths in 2016, reporter Josh Katz summarizes, “Drug overdoses are now
the leading cause of death among Americans under 50.” And beyond the states
named above, there have been significant increases of such deaths in other East
Coast states, particularly in Maryland, Florida, Pennsylvania, and Maine. As
Dr. Tom Frieden, the former director of the Centers for Disease Control
(C.D.C.) concluded, it’s the only aspect of American health that is getting
significantly worse. It is now estimated that over two million Americans are
dependent on opioids, and an additional 95 million used prescription
painkillers in the past year.
If the Senate were to pass the new
health care act approved by Paul Ryan and the House of Representatives and
approved by Trump, even the few services already provided would become
nonexistent or severely curtailed, and the possibility of recovery made even
more difficult with the cuts to Medicaid. Even the small offering of hope the
thousands of addicts now have would be dimmed, and an entire generation of
small-town, mostly white, hometown citizens would ultimately disappear, leaving
their lost children behind.
There have been many instances, unfortunately,
of derelict behavior by the government in American history, but this may be one
of the worst.
Los Angeles,
January 10, 2017,
January 16, 2017, June 1, 2017, and June 3, 2107, June 6, 2017