Saturday, February 6, 2016

Drug policy = Whack-a-mole

Haven't made much time for the blog of late because of family germs. Couldn't resist this news story, though.

Pharmacists join fight against fentanyl abuse

There are reams of data that support the futility of the War on Drugs. The largest busts register nary a blip on the radar in terms of public health benefits--fewer overdoses, lower incidence of blood-borne infections--or affect the crime rate to any important degree. This story, however, illustrates how our approach to drugs has gone from futility to stupidity.

We've all heard the saga of OxyContin. A drug that was touted as being a terrific, non-addicting pain reliever turned out to be just the opposite, causing an epidemic of addiction, abuse, and all-over human misery. You might have also heard that in the past year or two, drug plans stopped paying for OxyContin, and opted for its "next generation" version, OxyNEO. OxyNEO has a different chemical coating that its forebear, and forms a gelatinous blob when it's snorted. It can't be abused! Yay! We solved the OxyContin problem!

Surprise, surprise, addicts discovered fentanyl, another insanely potent and addictive pain killer that's administered in a time-release patch. When the number of overdoses attributed to fentanyl started to climb, a new public health crisis was at hand. So along comes the patch exchange program described in the linked story.

Sometime in the past year or two, I had occasion to attend a talk on the results of the patch exchange program, a talk delivered jointly by health professionals and police. The patch exchange program has yielded real results...diversion is down, overdoses are down, and "bad guys" aren't distributing fentanyl anymore. For reasons the police can't quite wrap their heads around, though, they're seeing more street-level traffic of hydromorphone (Dilaudid), another drug from the morphine-OxyContin family.

I asked the officer if they'd noticed that this was a glorified game of Whack-a-mole, with drugs playing the part of the mole, and perhaps it was time for a new strategy to tackle the problem. I'm not sure my the gist of my question registered.

Yes, we're finally getting to the point of legal marijuana, but we have a loooooong way to go before the Idiocy on Drugs comes to an end.

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