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Editorial: Fresh thinking is needed to overcome addiction crisis

As horrific as Erie County’s opioid crisis is, there is no reason to believe it has peaked or that its severity and consequences have sufficiently sunk in. This is a burgeoning calamity that is ruining lives, punishing children, driving up public costs and that shows no sign of abating. It requires new and innovative approaches.

Erie County and the rest of New York are, in some way, fortunate, because the scourge of opioid addiction is not as severe here as in other places around the country, including Kentucky, West Virginia, northern New Hampshire and many  places in the western United States. There, the overdose rates are much higher than just about anywhere in this state.

If Dr. Richard Blondell is correct – and there is every reason to believe he is – this drug crisis is unlike any other. As the vice chairman of addiction medicine at the University at Buffalo’s Jacobs School of Medicine and Biomedical Sciences, Blondell understands this tragic landscape. The epidemic, he says, is largely traceable not to foolish people experimenting with drugs and becoming hooked – a standard though dated view – but on people suffering severe pain and trusting that the prescriptions offered by their physicians were safe.

They turned out to be anything but.

“The bulk of addiction is now created by the health care system,” Blondell told The Buffalo News. “This is an artificial epidemic. It’s the unintended consequences of aggressive pain management.”
It wasn’t just aggressive, but misinformed. Worse, if critics filing lawsuits are correct, that misinformation was delivered both knowingly and maliciously.

Those painkillers, chemical cousins to heroin, are fiercely addictive and when prescriptions expire, patients are left to feed a craving that they can satisfy through inexpensive and available street-corner heroin. Anyone who has suffered or witnessed the pernicious grip of addiction has some sense of that desperation.

And it gets worse, because heroin dealers – who have no concerns about depleting their client base – are spiking heroin with synthetic fentanyl, making each dose even more deadly. And people are dying.
There must be a greater, broader effort to prevent those addictions in the first place and, critically, to treat them once they have taken root. First, though, enough Americans – especially elected officials – need to understand that this crisis is not about individuals making terrible personal decisions, but the terrible consequences of rational decisions.

Consider: Over a three-day period last weekend, eight people died in Erie County of suspected drug overdoses. In Buffalo, three people died in less than 24 hours. With that grim tally, the number of confirmed overdose deaths reached 40 in Erie County this year, with another 122 suspected cases in which toxicology testing remains incomplete.

It’s a scythe, cutting through communities, destroying families and threatening disorder. How many of these people were innocently dragged into addiction because of pain that was otherwise unbearable? How many of them leave behind loved ones who will never fully recover from their loss, leaving children without a parent and perhaps without the support they need to flourish in life? What will that mean to American society in 10, 20 or 30 years?

We should not be waiting to find out. This is a crisis that demands an all-hands-on-deck response, both short- and long-term. That is, we must help those we can to overcome addictions that overwhelm so many. But we must also, as Blondell says, move “upstream” to prevent addictions in the first place.
Among those who should help fund this effort are the drug companies that manufactured these products, then marketed them without notifying doctors or patients about their terrible effects.
Some states and localities, including Erie County, have filed lawsuits against those manufacturers, contending that they purposely misled both doctors and the public about the pills’ addictiveness. They should be required to help undo the damage their product caused.

But as Blondell observed, the insurance companies also have an important role to play, since they know who is overprescribing opioids. “They know who these outliers are. They could put the screws to these doctors,” he said. They need to act.

In addition, he said, dentists who prescribe these painkillers for a tooth extraction need to stop. Doctors also need better training in dealing with these issues and politicians have to stop pandering. That would include the one in Missouri who Blondell quoted as cheerfully observing that “If they die of a drug overdose we’re just removing them from the gene pool.”

Here, at least, Erie County Executive Mark C. Poloncarz, Health Commissioner Gale R. Burstein, M.D., and Buffalo Mayor Byron W. Brown are making real efforts at combatting this deadly, long-term problem.

They understand the threat. But not enough people are on board, some out of ignorance and some out of indifference. The price of that will be high and, in one way or another, it will be paid by us all.

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