An opioid overdose crisis? No, a deception on a grand scale.

THE 'OPIOID OVERDOSE CRISIS' EXPLAINED

The portrayal of opioid medication as the predominant drug-related threat to society is baseless and patently absurd. The greatest drug-related danger to health and welfare is by far, tobacco. The second most dangerous drug is alcohol.

Introduction

In the U.S. and in countries politically influenced by it, authorities are proclaiming the existence of an 'opioid overdose crisis'. However, as with all things related to policy concerning drugs other than alcohol, tobacco and caffeine, it is pure fabrication designed to justify and enhance the so-called 'War on Drugs'. Following is an explanation of the phenomenon.

The clear inference: fatal opioid overdose

The message from authorities is clear: an 'opioid overdose crisis'. The clear and intentional message is that people are dying due to simply taking 'too much' opioid and apparently all-too frequently, 'too much' of an opioid prescription pain medication. These deaths are allegedly due to the effects of excessive amounts of the opioid drug on breathing.

However, this is not the case, has never been the case, and never will be the case:

Firstly, as detailed in the 'Heroin' page of this site, opioids, in significant overdose, do not reach levels in the body greater than those found in people receiving treatment for pain. This is due to the efficiency with which opioids are metabolised, or broken down in the body.

Toxicological examination consistently shows very low, non-problematic levels of opioids present in deaths where they have been present.

Secondly, in the vast majority of drug-related deaths in which opioids were present, drugs other than opioids have also been present. Such drugs include alcohol and medications capable of causing sedation such as benzodiazepines, anti-depressants and anti-histamines.

Combinations of central nervous system depressant drugs can present a danger to breathing due to heavy sedation leading to airway obstruction. This means the person cannot breathe properly due to a blockage or restriction in their throat due to being sedated to the point that they cannot protect their airway. This can lead to a lack of oxygen causing injury or death.

The 'opioid crisis': an aggressively promoted hoax.

The statistics on which the 'crisis' is based, are completely fraudulent. Alcohol has been intentionally omitted. Alcohol is the most common and dangerous central nervous system depressant drug in combination with opioids. The omission of alcohol completely invalidates the statistics on what is referred to as drug 'poisoning' or 'overdose'.

An apparent situation of people succumbing to 'overdoses' of opioids is being alleged, when clearly, this is not what is happening. No evidence exists to support the assertion that people are dying due to taking 'too much' of an opioid drug, be that an illicit substance or a medication.

If the situation in relation to drug-related deaths was to be properly described, it would be as multiple-drug toxicity deaths in which opioids are present.

Other drugs present: multiple - drug toxicity

The crucial factor in drug-related deaths in which opioids are present and which is explained in the 'Overdose' page of this site, is not the ingestion of 'too much' opioid. It is a combination of substances leading to heavy sedation, airway obstruction and asphyxiation.

Following is an example of how the true circumstances of the deaths is sometimes touched upon in official literature:

"In addition, available data suggest approximately 76% of accidental apparent opioid-related deaths between January 2016 and March 2018 (Footnote b) also involved one or more types of non-opioid substances." (1)

Statistics have consistently shown that alcohol and benzodiazepines are the drugs most commonly associated with mixed-drug deaths and adverse drug-related events in combination with opioids.

In the context of the so-called 'opioid overdose crisis', even though multiple classes of central nervous system depressant drugs are present in the vast majority of incidents, the deaths are being intentionally misrepresented as being solely due to opioids.

The statistics

The fundamental statistical literature provided by the Centers for Disease Control and Prevention in the U.S. entitled 'Drug Overdose Deaths in the United States, 1999 - 2017', (2) has a glaring and disturbing omission:

Alcohol, the most dangerous central nervous system depressant drug in relation to multiple-drug toxicity deaths, is omitted from statistics.

Code groupings from the International Classification of Diseases used in the counting of what are incorrectly termed 'overdose' deaths, do not include alcohol.

The class 'Accidental poisoning by and exposure to noxious substances' includes the codes X40 through to X44. (2) X45 addresses alcohol. The class 'Intentional self-harm' includes the codes X60 through to X64. X65 addresses alcohol. Finally, the class 'Event of undetermined intent' includes the codes Y10 through to Y14. Y15 addresses alcohol. The codes for alcohol involvement are omitted from all three groupings.

The omission of alcohol from statistics unequivocally invalidates the portrayal of acute drug-related deaths in terms of causality and statistics.

The role of alcohol in acute drug-related deaths or 'overdoses' as they are misleadingly termed, is being purposefully ignored. Alcohol is commonly implicated in mixed-drug related deaths.

Notwithstanding the deceptive nature of the statistics, even the numbers officially quoted indicate the relative scale of the so-called 'crisis'. The U.S. Centers for Disease Control and Prevention quotes figures of 13.1 deaths per 100,000 head of population with involvement of any type of opioid drug in 2016. (3)

Importantly, the vast majority of these deaths also involved other drugs. Put into perspective with major causes of drug-related mortality, the deaths of thirteen thousandths of one per cent of the total population does not constitute an 'epidemic'.

Tobacco, the largest cause of drug-related mortality.

To provide some perspective, the figures for cigarette smoking in the U.S. are "... more than 480,000 deaths per year ...", which equates to "... about one in five deaths annually, or 1,300 deaths every day." It is the "... leading cause of preventable death." (4)

The death rate for smoking is about 169 per 100,000 head of population per annum. If ever there was a drug worthy of having the title 'epidemic' in terms of death and disease, tobacco is that drug.

What the strategy achieves for the 'War on Drugs'

What does the strategy achieve for those profiting from and therefore seeking to perpetuate the so-called 'War on Drugs'? It achieves several important objectives, all of which are related to economic activity based on intentionally-created crime:

Distribution of money - First and foremost, it creates apparent justification for increased distribution of public money under the guise of addressing a (contrived) threat to the welfare of society.

DEA agents and police

The funding program in the U.S. specifically directed under the pretense of the 'opioid crisis' is the State Opioid Response (SOR) and Tribal Opioid Response (TOR) grant program. (5) The program "... will award nearly $3 billion over two years to help states and tribes provide community-level resources for people in need of prevention, treatment and recovery support services."

This public money distributed as a response to a contrived health concern is the present day manifestation of the fundamental mechanism of the so-called 'War on Drugs': distribution of public money facilitating political gain. The recipients will not be concerned that the money is founded on a system of intentionally-created crime and comes at the expense of the human rights of a minority.

Apart from enforcement agencies, a major beneficiary of funding is the 'treatment' sector, which is paid to 'treat', often on a mandated basis, those whose drug of choice happens to be opioids. In the U.S., 'recreational' opioid users are referred to in a pejorative manner using terms such as 'addicts', and use is invariably described as 'opioid use disorder', therefore inferring 'treatment' is required.

Creation of work - The so-called 'opioid crisis' provides a substantial source of work for enforcement agencies such as the Drug Enforcement Administration in the U.S., for which they are funded by public money. The DEA ensures the vibrancy of the black market by minimising supply of unregulated illicit substances. This is done by investigation, apprehension and prosecution of suppliers and interdiction of the substances themselves, including precursor chemicals.

The Diversion Control Division of the DEA monitors the manufacture, distribution, sale and prescribing of medical opioids. They have the authority to set production quotas for the drugs and doctors prescribing 'controlled' substances require a permit issued by them.

The black market - It protects and perpetuates the black market in opioids from unregulated sources, which constitutes a world-wide economy of massive proportions. Measures are implemented at many levels, such as restrictions on prescribing, which minimises opioid medications being diverted to 'recreational' users and thereby taking market share from unregulated substances.

The Drug Enforcement Administration aggressively prosecutes those who it deems to have been involved in the supply of regulated opioids to 'recreational' users, thereby protecting the black market in unregulated substances.

Reinforcement of a falsehood - It reinforces the falsehood perpetuated amongst the populace that opioid use is uniquely dangerous. Many people will mistakenly accept that the threat is legitimate, merely because it is government inspired.

This ensures public support for the strategy and more broadly, apparent reinforced justification for the so-called 'War on Drugs', which has as its basis, the creation of political advantage through the allocation of huge amounts of public money to address intentionally-created crime.

Perpetuation of oppression - It assists in keeping opioid users as an oppressed and exploited minority due to their drug of choice being deceptively and incorrectly portrayed as being uniquely dangerous and apparently in need of 'control'. A massive world-wide industrial complex is therefore protected and perpetuated.

For example, they remain criminalised via an association with their drug of choice and are forced because of this to endure a chaotic lifestyle. This aids in portraying them as requiring 'treatment' and associated assistance, which is funded by public money and employs a large number of people in the 'welfare' and medical professions.

Commercial opportunities

Ironically, the situation presents a substantial commercial opportunity for pharmaceutical companies involved in the supply of Naloxone. Naloxone blocks the effects of opioids and is incorrectly portrayed as the panacea to opioid 'overdose'.

It can remove the opioid component of dangerous sedation brought about by combinations of central nervous system depressant drugs. It is of no use to a solitary person who is rendered unconscious by multiple-drug induced sedation.

The so-called 'opioid crisis': a huge commercial opportunity for suppliers of Naloxone.

There are opportunities for those who provide apparent alternatives to opioids:

Specialised 'pain clinics' are proliferating. These businesses provide 'alternative' treatment modalities for people that suffer from chronic pain and apparently highly regulated and reluctant prescribing of opioids. The inference here is that pain is a specialised area of medicine and somehow outside the expertise of general medical practitioners.

The discipline of 'pain psychologist' is prominent in the U.S. and is inherently focused on non-pharmacological treatment for those with chronic, intractable pain. Restriction or denial of opioid medications on which people would have been otherwise stable, can bolster the client base of such practitioners.

Those who provide non-opioid pharmacological treatments for pain stand to profit due to their commercial competition being maligned and their availability restricted.

The legal profession benefits handsomely through being involved in action taken against those in the pharmaceutical and medical industries who are charged by authorities with supplying opioids apparently in contravention of official guidelines. The 'crisis' creates a rich source of litigation courtesy of the intentionally-created crime related to the 'recreational' use of opioids.

Ramifications for people

What are the effects of the strategy on people who for whatever reason, consume opioids? For people who rely on opioids for treatment of pain, it has serious negative ramifications. Opioids (specifically morphine), are the 'gold standard' for the treatment of serious pain.

Doctors are actively and aggressively discouraged by authorities from prescribing opioids, leaving many patients untreated or under-treated for chronic serious pain. This has obvious and sometimes catastrophic consequences for them, with some driven to suicide.

Some of these people may see no other option than obtaining opioids from the black market, therefore making them vulnerable to criminal sanctions which can further negatively affect their lives. This of course, is a favourable situation for those who profit from addressing the intentionally-created crime that is the basis of the 'crisis'.

For those who consume opioids on a 'recreational' basis, their desire to obtain a supply of their drug of choice of known quality is further hindered by authorities, whose aim is to obligate them in acquiring their substance from a highly profitable black market in opioids originating from unregulated sources.

Conclusion

Is there an 'opioid overdose crisis'? No, not at all. People that have died due to drug-related causes will predominately have succumbed to a series of events comprising heavy sedation, airway obstruction and asphyxiation brought about by a combination of substances.

Those who have died not having combined drugs will have blood-opioid levels in the range found in living people. These people will have died due to non drug-related causes.

The allegation that there are people dying solely due to overdoses of opioids is a complete fabrication and no evidence exists to justify the claim.

Many of those succumbing to drug combinations would have been unaware of the dangers due to the emphasis being on the fallacy of fatal 'opioid overdose'. The continued untrue assertion that people are dying due to taking 'too much' opioid has the effect of the actual hazard (drug combinations) not being adequately publicised, therefore leading to many more preventable deaths.

Perhaps the most salient observation is that there is never a 'crisis' or 'national emergency' relating to any of the truly dangerous drugs in society: alcohol and tobacco, or caffeine.

There are only ever 'crises' or 'emergency' situations declared concerning the drugs of a minority or in other words, 'controlled' substances. These are the drugs for which authorities wish to have a black market in place and which define their users as being subject to criminalisation.

REFERENCES

1. Special Advisory Committee on the Epidemic of Opioid Overdoses. National report: Apparent opioid-related deaths in Canada (January 2016 to March 2018). Web-based Report. Ottawa: Public Health Agency of Canada; September 2018.

2. National Center for Health Statistics. Drug overdose deaths in the United States, 1999–2017. NCHS Data Brief, no 329. Hedegaard H, Miniño AM, Warner M. 2018

3. Centers for Disease Control and Prevention. Drug Overdoses. Web Page. 2019. https:// www. cdc. gov/ nchs/ fastats/ drug- overdoses. htm

4. Centers for Disease Control and Prevention. Smoking and Tobacco Use, Fast Facts. Web Page. 2019. https:// www. cdc. gov/ tobacco/ data_ statistics/ fact_ sheets/ fast_ facts/ index. htm

5. Substance Abuse and Mental Health Services Administration. HHS releases $1.5 billion to states, tribes to combat opioid crisis. Web Page. 2020. https://www.samhsa.gov/ newsroom/ press - announcements/ 202008270530

Page head image: National Opioid Crisis Community Summit, Aberdeen Proving Ground, MD - December 11, 2018 (U.S. Army Photo by Sean Kief)

Page images: Bciccocioppo (speaker) and Intropin (naloxone)