The Nanny State

In the U.S., our government (federal, state, or local) is often determined to outlaw things for our own good.
Today’s rant is about the Food and Drug Administration (FDA), and the Drug Enforcement Administration (DEA), The FDA is charged with the responsibility of ensuring that food and drugs sold to the public are safe. Good idea. How are they doing? Not so well. My guess is they aren’t funded well enough to do the job right. Nobody even remembers who they are until there is some scare, like contaminated spinach. And then who gets blamed? The FDA! Not the growers. The FDA is in a Catch-22 world.
During the recent 16 day government shutdown, all their inspectors were suspended because their jobs were considered “non-essential”. Really?
In any case, the FDA announced about two weeks ago that they are going to start cracking down on Schedule III drugs. Let’s talk about the schedules. Schedule I drugs are those with a very high potential for abuse, have no accepted medical use in the US, and a lack of accepted safety even under medical supervision. This includes things like heroin and LSD, but also marijuana, which is pretty funny since at the state level, marijuana is legal in many states. So the Feds still consider it illegal, but there seems to be a hands-off policy when it comes to prosecuting people in states where it’s been legalized.
There are five schedules, each of which has a declining level of potential abuse, do have accepted medical uses, and have been tested for safety.
Schedule II includes drugs like cocaine, morphine (which is derived from opium) and various synthetic versions of morphine, including the heavy-duty pain killers Percocet, Oxycontin (considered the really big bad boy of the list), Percodan, Dilaudid and Demerol.
Schedule III includes such things as anabolic steroids and Hydrocodone, as long as it’s combined with an NSAID like ibuprofen or acetaminophen (Lortab, Vicodin, Vicoprofen).
Schedules IV and V aren’t worth mentioning.
So supposedly there’s a new epidemic of abuse of Schedule II drugs. Nonsense. It isn’t new. Thirty-five years ago I worked in a methadone clinic. I never met one person who was addicted to heroin. Apparently, heroin was pretty hard to come by. They were addicted to Dilaudid. How did they get it? In some cases, doctor shopping, going from doctor to doctor with phony complaints and getting prescriptions from each doctor. In some cases, from sympathetic doctors who knew they were addicts but didn’t want them to suffer. In some cases by breaking into or outright robbing pharmacies. And let me tell you, these people led miserable lives. Going from getting high to going into withdrawal. Always worried about where the next pill was coming from. Even if they didn’t rob pharmacies, they burglarized homes and fenced the take, to get the money to buy drugs. I knew a guy who bought a van, had signs painted on the side that said “Acme Movers” or something like that. He would back the van up to a house where he knew the people weren’t home, and clean it out, in broad daylight.
So the “new” epidemic has been around for a while, and the “cracking down” on Schedule II drugs has also been around, to the point where many doctors are afraid to prescribe them at all. Why? Because if you’re determined by the government to be over-prescribing them, they can revoke your medical license. Never mind if you’re an oncologist or an anesthesiologist (who typically run pain clinics for people with chronic pain) or an orthopedist.
The “cracking down” on Schedule III drugs will now remove the last effective alternative for treatment of pain, in my opinion. Pretty soon, if you, say, break your ankle, the doctor will put it in a cast, tell you to take two aspirin and call him or her in the morning. Not because they don’t think you need it, but because they will be scared.
Recently, the Florida Attorney General has been touting her success at closing down “pill mills”. The amount of Oxycontin prescribed in Florida is down by 20%. In a related story, heroin overdoses are up by 20%. What does that tell you? I seriously fear that this approach will not reduce addiction and overdoses, but will make it much more difficult for people who really need pain drugs for legitimate reasons to get them. A woman on NPR (National Public Radio) last week said she got a prescription for a pain drug, but couldn’t find a pharmacy that would fill it.
When will we ever give up on this ineffective “war on drugs”?
NPR also did a story about the issue, here’s a quote. “The US has about 4% of the world’s population, and we’re consuming more than 80% of the world’s oxycodone supply. We’re also consuming more than 99% of the world’s hydrocodone”. What a misleading statistic. What percentage of the world population has no access to medical care of any kind? What other countries have more lenient laws about drugs, and thus less crime associated with it?
You would think we (the US) would have learned when alcohol was banned in 1920 with the 18th Amendment to the Constitution. In 1933, the 18th was repealed by the 21st Amendment. Prohibition did not work then, and it doesn’t work now.