PHYSICAL COSTS AND RESULTING DEMAND

[Note:  This posting is a continuation of a report on the development of a civics unit of study.  This unit is directing students to formulate informed positions on the opioid epidemic.  Presently, this development, in real time, is reporting a set of factoids on a mode of dispensing illicit opioids which is a contributing element of this epidemic.]

Before continuing this report, this posting adds a few words on the extent of the opioid epidemic in the US.  This epidemic has been characterized as a crisis.  This word was used by the US Surgeon General as a reaction to the observed over-prescription of opioid pain pills back in the 1990s.  As early as those years, opioids became the most prescribed type or class of medications in this country.  Over-use, regardless of whether the user seeks pain relief or to induce euphoric feelings, is likely to lead to an addiction.[1]

          As with other addictive drugs, the over-user builds a tolerance and, in turn, needs higher doses of the drug to achieve the intended results.  The user becomes dependent on the drug; further consumption relieves or avoids withdrawal symptoms.  Those symptoms are very serious.  To begin with, over-use of the various opiates “changes how brain chemistry work leading to physical and psychological dependence.”[2] 

Dividing opiates between short acting ones and long acting ones, the onset of symptoms varies:  short-acting ones start within 6 to 12 hours while it takes 30 hours for the longer-acting types.  Immediate symptoms are tearing up, muscle aches, agitation, interrupted sleep routines, excessive yawning, anxiety, nose running, sweats, racing heart, hypertension, and fever.  Longer lasting symptoms (peaking within 72 hours and last for about a week) are nausea, muscle cramping, depression, agitation, anxiety, and further opiate cravings.[3]

There have been cases where users intentionally inflict horrendous injuries to themselves to get prescriptions for more opioids.[4]  This, of course, reflects serious demand.  And where there is a demand, a segment of the population that is willing to buy a product, there will be suppliers of that product.  At times, that includes illicit products, such as illegal opioids.  The prime source of the opiates is Mexico.

There, the role of drug cartels is central.  They are held responsible for providing a virtual “flood” of these drugs.  Their initial interest was to significantly increase heroin supplies.  Now, heroin is not a prescribed drug, so why emphasize its export into the US?  It turns out that heroin is cheaper, more potent, and easier for perspective or established users to acquire than other – prescribed – opioids.[5]  There has been some speculation that the increase in heroin was due to tightening prescription policies; CDC reports this is not the case.[6]

Heroin makes its way into the US from various other nations, but Mexico leads that list.  Between the years 2005-2009, there has been increased production in Mexico of heroin from 8 metric tons to 50 metric tons, an over 600% increase.[7]  Another figure reflecting this increased traffic of heroin is how much more of the opioid has been seized at the border; it doubled between 2010 and 2014.[8]  With those types of numbers, according to DEA, it is not hard to believe that profits from this trade has become central to the fate of Mexican cartels.[9]

Mexican criminal organizations, primarily the Sinaloa Cartel, makeup the primary traffickers of the other insidious opioid drug, fentanyl.  By one account, 80 percent of seized fentanyl in New York is linked to that cartel.[10]  And, are the profits these criminal organizations reeking from Americans all due to irresponsible behaviors on the part of those Americans?  The next posting will address this question.

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[1] Jacqueline Howard, “Why Opioid Overdose Deaths Seem to Happen in Spurts,” CNN, February 8, 2017, accessed July 11, 2018, https://www.cnn.com/2017/02/08/health/opioids-overdose-deaths-epidemic-explainer/ .

[2] “Opiate Withdrawal Timelines, Symptoms and Treatment,” American Addiction Centers, n.d., accessed July 11, 2018, https://americanaddictioncenters.org/withdrawal-timelines-treatments/opiate/ .

[3] Ibid.

[4] The writer has seen these ads on TV.

[5] Dan Nolan and Chris Amico, “How Bad Is the Opioid Epidemic?” Frontline, February  23, 2016, accessed July 12, 2018, https://www.pbs.org/wgbh/frontline/article/how-bad-is-the-opioid-epidemic/ .

[6] Abby Goodnough, “Opioid Prescriptions Fall after 2010 Peak, C. D. C. Report Finds,” The New York Times, July 6, 2017, accessed July 12, 2018, https://www.nytimes.com/2017/07/06/health/opioid-painkillers-prescriptions-united-states.html?ribbon-ad-idx=5&rref=us&module=Ribbon&version=context&region=Header&action=click&contentCollection=U.S.&pgtype=article .

[7] Dan Nolan and Chris Amico, “How Bad Is the Opioid Epidemic?”

[8] Clare Ribando Seelke and Liana W. Rosen, “Heroin Production in Mexico and U. S. Policy,” CRS Insight, March 3, 2016, accessed July 12, 2018, https://fas.org/sgp/crs/row/IN10456.pdf .

[9] “2015 National Drug Threat Assessment Summary,” Drug Enforcement Administration, October 2015, https://www.dea.gov/docs/2015%20NDTA%20Report.pdf .

[10] Joel Achenbach, “Wave of Addiction Linked to Fentanyl Worsens As Drugs, Distribution, Evolve,” The Washington Post, October 24, 2017, accessed July 12, 2018, https://www.washingtonpost.com/national/wave-of-addiction-linked-to-fentanyl-worsens-as-drugs-distribution-evolve/2017/10/24/5bedbcf0-9c97-11e7-8ea1-ed975285475e_story.html?utm_term=.15ed0524413b AND Nick Miroff, “Mexican Traffickers Making New York a Hub for Lucrative – and Deadly – Fentanyl,” The Washington Post, November 13, 2017.