It is depressing to watch ignorance kill, inflict pain and maim -- even more so when misinformation spread by the media continually propagates it.
Recently, for example, dozens of drug addicts have died due to a combination of a synthetic opioid drug called fentanyl and heroin. The media has generally covered this story as though it is another example of the "epidemic" of prescription drug abuse -- implying that the fentanyl the addicts are consuming must have come from prescription fentanyl. Many stories have also avoided mentioning that there is an easy, safe way to prevent the vast majority of these deaths.
The first bit of misinformation is the false connection with prescription drug misuse. Prescription fentanyl is a liquid contained in patches and lolly-pop like applicators -- and heroin is sold as powder. Dealers are not going to waste their time breaking down single-use patches and lollies -- which can be sold for exorbitant prices without the extra labor and extra risk of detection and chemical processing -- to combine it with heroin. It is not economically sensible.
What's actually happening is something that we've seen on the street before -- synthetic fentanyl, manufactured illegally, is being mixed with heroin, either high up the dealing chain or by addicts who like to mix and match when they inject. And, because fentanyl is 80-100 times stronger than heroin, if the drug is not "cut" very carefully during manufacture, some people are going to get overdoses, while others get batches that produce no high at all. Also, if fentanyl is manufactured improperly, the drug produced may induce irreversible Parkinson's disease.
The claims that the fentanyl comes from legitimate pharmaceuticals feed into the misguided notion that over-prescribing of pain medication is producing increased addiction and death. In fact, however, the vast majority of prescription drug abusers do not become addicted because they are exposed to pain medication by doctors -- some 90% of Oxycontin misusers, for example, also take cocaine. Unless you want to believe that pain patients are becoming so enamored of drug use after their exposure to Oxy that they go out and find cocaine dealers, the more likely explanation is that they were drug abusers first, not pain patients hooked by evil doctors. What actual pain patients report is that getting enough medication to bring relief has become increasingly difficult -- because doctors are so afraid of being arrested due to the panic over prescription drug misuse!
Meanwhile, addicts are left to die of these overdoses because we haven't made the antidote -- a drug called naloxone (Narcan), which causes no harm other than uncomfortable withdrawal symptoms amongst those who are physically dependent -- widely available. Some needle exchange programs hand it out -- but that only helps established addicts who already attend needle exchanges. At greatest risk are new users or those who have just come out of prison or relapsed after treatment.
Since naloxone is a safe drug and produces little effect at all on people who have not taken opioids, I argued in the New York Times last year that we should make the drug available over-the-counter, should give it out with every prescription filled for opioids and should place it in every first aid kit. It could be packaged the way epinephrine is for severe allergy-sufferers -- in a one-shot "pen" that could simply be injected into the victim. Since most people do not inject drugs alone, if this drug were on hand, many of these lives could be saved. And, since the greatest risk associated with opioids is overdose death (they don't actually damage organs like Tylenol or Advil or even aspirin can: they kill by stopping breathing over time), wide availability of the antidote might make people less frightened of adequately treating pain. Of course, that would assume that we were behaving rationally about the risks of these drugs. We won't do that until the media starts getting the facts straight.
Also of note along these lines: keep your eyes on the coverage of the marijuana/lung cancer story. Note how hard it is for people to believe that marijuana doesn't cause lung cancer -- even though there's been data suggesting this is true for years. One important reason -- as the media tend not to explain -- is that the dose makes the poison. Even the heaviest marijuana smokers rarely smoke 20 joints a day for 20 years -- but it's this level of use or higher that kills half of all smokers (and still, most die of heart disease, not lung cancer). The cigarette smoking/lung cancer correlation was one of the most obvious in medical history -- the fact that a marijuana/lung cancer correlation couldn't be found earlier suggests that it's unlikely one will be. But just watch how the media looks for ways to make marijuana appear dangerous in its coverage of these stories, even as each particular danger gets debunked.
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