Who is really guilty of the US opioid crisis? - ForumDaily
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Who is really guilty of the US opioid crisis?

Фото: Depositphotos

A look at the dark side of American medicine - in the material The Guardian, the translation of which is published by “Idealist«.

Faced with the danger of litigation and the threat of their profits, pharmaceutical companies insist that the epidemic does not stem from the massive use of powerful painkillers - essentially heroin in the form of pills - but because of the abuse of some of those who become addicted.

The number of opioids discharged in the United States is enough for every American to receive their 24 / 7 for three weeks.

In court documents, pharmaceutical companies cite a figure of two million people who, as a result of using legal pills, have become addicted.

Фото: Depositphotos

Some buy drugs on the black market or switch to heroin. But too often, this dependence began on the advice of a doctor, who, in turn, followed the instructions of the drug manufacturers.

As noted by the Commission of President Trump, this epidemic is not caused by those who are in its networks. “We have a huge problem that often begins not on the street; it starts in the offices of doctors and hospitals in every state of our country, ”the report says.

Opioids killed more 33 000 Americans in 2015, and the number was certainly higher in 2016. About half of deaths are caused by overdose of painkillers. Most of those who end up with an overdose of heroin or synthetic opiates, such as fentanyl, first sit down on legal pills.

This is almost exclusively an American crisis, caused largely by special American problems, ranging from the influence of pharmaceutical companies on medical policy to a culture "for every sore there is a pill." The Trump Commission, calling the opioid epidemic “unprecedented,” noted that the grim reality is that “the number of opioids discharged in the United States is enough for every American to receive them around the clock for three weeks.”

The US consumes more than 80% of the world production of opioid drugs, although less than 5% of the world's population lives in this country. Over the past 20 years, one federal agency has been surrendering to another one before the claims of drug manufacturers about an epidemic of insurmountable pain in the United States. Officials didn’t seem to have wondered why no other country seems to be suffering from such an epidemic or saving opioids to their patients at every opportunity.

Thanks to the unprecedented lobby of pharmaceutical companies, Congress changed the rules for prescribing painkillers, and doctors were able to prescribe as many tablets as they wanted. Moreover, doctors sometimes faced ethical advice because they did not prescribe enough painkillers.

This is an epidemic, because behind it is a business model. Follow the money

Unlike most other countries, the US healthcare system operates as an industry, not a service. This provides ample opportunities to influence drug manufacturers, health care providers and health insurance companies.

Too often, their goal is profit, not health. Opioid pills are much cheaper and easier than other forms of pain treatment, such as physical therapy or psychiatry. As noted last year by Senator Joe Manchin from West Virginia in an interview Guardian: “This is an epidemic, because behind it is a business model. Watch out for the money. Look at the number of pills they sent to certain parts of our state. This is a business model. ”

Фото: Depositphotos

But the system also gives a lot of power to patients. People who spend large sums of money on health insurance expect results. After all, they are more clients than patients. Doctors complain about patients coming and waiting for the pill to solve medical problems, not taking responsibility for their own health, instead of eating better and leading a healthier lifestyle.

In particular, the pharmaceutical industry has adopted the idea that there is a right to the absence of pain. Other countries are pursuing strategies to reduce and manage pain, and not to the expectation that it can simply be made to disappear. In all this, regulators have become intermediaries. The Food and Drug Administration approved one opioid pill after another.

The Food and Drug Administration approved one opioid pill after another

Already in the 2013 year, when the scale of the epidemic was clear, the FDA allowed the powerful opioid to enter the market Zohydro with the almost unanimous objection of its own control committee. From the hearing it became clear that doctors understand the dangers, but it seems the agency has made commercial considerations a priority.

The US states have long felt the crisis, when mortality has grown, social services are choked on the number of orphans, and the epidemic has led to an economic recession. Police chiefs and local politicians claimed that it was a social crisis, not a problem of law and order.

Some state legislatures began to restrict mass appointments. All this time they were looking at Washington. They did not receive much from Obama or Congress, although legislation that approved 1 billion dollars for addiction treatment was passed last year..

Last year, the director of the Centers for Disease Control Tom Frieden noted that doctors do not recommend opioids as a first step for chronic or ordinary pain, although even this caused a political protest in Congress, where the power of the pharmaceutical lobby did not decrease much.

There are also signs of a shift to the FDA after it forced the manufacturer to abandon the opioid drug, Opanawhich should never have been sold in the first place. It was initially seized in the 1970s, but the FDA allowed it to return to the market in the 2006 year after the drug testing rules were changed. At that time, many blamed pharmaceutical companies for paying for this decision.

Trump's opioid commission hoped that the epidemic would finally draw attention to it. She made a number of reasonable, though limited, recommendations: more psychiatric treatment and more effective forms of rehabilitation.

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