Saturday, June 14, 2008

"Legal Drugs Kill Far More Than Illegal, Florida Says"

In Florida last year, there were 2,328 deaths due to "strong painkillers" like Vicodin(R) and Oxycontin(R), 743 deaths due to benzodiazepine-class drugs like Xanax(R) and Valium(R). Cocaine caused 843 deaths, methamphetamine caused 25 deaths, heroin caused 93 deaths, and marijuana zero deaths, according to the 2007 report by the Florida Medical Examiners Commission reported in The New York Times ("Legal Drugs Kill Far More Than Illegal, Florida Says," p. A10, June 14, 2008). "Drugs Identified in Deceased Persons by Florida Medical Examiners, 2007 Report" is 43 pages long.

Sounds like a public health problem, but the Times' Damien Cave can only quote law enforcement officials such as Sergeant Lisa McElhaney, in the Broward County Sheriff's Office, for her insight: "The abuse has reached epidemic proportions. It's just explosive."

However we should give the Times' Damien Cave a great deal of credit for taking the initiative to put the fact that marijuana caused zero deaths in the middle of story. That fact is obtained from the medical examiners' report only by deduction. It was not stated as a finding or a conclusion.

It is worth noting that the number of cocaine deaths has grown almost continuously from 821 in 1993 to 2179 in 2007.

Deaths among older drug users; and the political misrepresentation of who is dying
It is also significant that in 2007 the number of persons found with lethal levels of cocaine in their body under age 18 was 4, ages 18 to 25 was 96, and among persons older than 35 was 582.

Consider this fact and the mantra of politicians defending unjust laws such a mandatory minimums. This is Senator Hatch on PBS Frontline's "Snitch" in 1999:

Sen. ORRIN HATCH (R), Utah: Well, we found- the reason why we went to mandatory minimums is because of these soft-on-crime judges that we have in this society, judges who just will not get tough on crime, get tough especially on pushers of drugs that are killing our youth. And so that's why the mandatory minimums, so that we set some reasonable standards within which judges have to rule, rather than allowing them to just put people out on probation who otherwise are killing our kids.

The consequence of social misclassification of the problem
In covering this report, could the reporter have asked doctors, public health specialists or health educators about the meaning of such data and what could be done about it? No.

Michael Aldrich, Ph.D., explained very cogently -- about four years ago in San Francisco -- that for the society a tragic consequence of misclassifying the "problem" of drug misuse as a criminal problem has meant that for decades we have consulted the wrong "experts," such as police sergeants. In general, our police "drug experts" are untrained, unqualified, and fundamentally ignorant about the causes of these kinds of deaths and the various means that a public health expert might suggest to address the problem.

What could we do to reduce these deaths?
I'm not a doctor or a public health expert. But I would ask such professionals, "Is it possible that we could save lives and prevent some of these deaths by educating drug users on safer drug use practices?"

Could family practitioners talk with teenagers and young adults in a way that acknowledges that they might be using "legal" drugs socially and not medically, and that non judgmentally advises them about how to minimize the dangers? Not in the current drug paradigm. Such counsel would risk prosecution and loss of medical licenses for "sending an inconsistent, don't do drugs message."

When a physician prescribes Xanax or Oxycontin to a person, might it make sense for the physician to call in all the family members aged 14 and older to talk about the risks to family members and guests having such a drug sitting in a parental medicine cabinet?

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1 comment:

Marianne Skolek said...

The horse is out of the barn as relates to OxyContin. Purdue Pharma knew the drug had the potential for abuse and was highly addictive, but yet told physicians and patients the drug was less addictive than other opiods and had less abusive potential. They were criminally charged, pled guilty and were sentenced for this criminal behavior - Michael Friedman, Howard Udell and Paul Goldenheim. Their actions resulted in an epidemic of OxyContin death and addiction in every state in the country. All this activity was conducted under the watchful eye of the FDA and was allowed to continue. There is accountability from the FDA as well as J. David Haddox, the gatekeeper of Purdue Pharma. I have to believe there is a special place in hell for all of them.