Painkiller sales soar around U.S., fuel addiction

Thursday, April 5, 2012 | 10:15 a.m. CDT; updated 6:38 p.m. CDT, Thursday, April 5, 2012

NEW YORK — Sales of the nation's two most popular prescription painkillers have exploded in new parts of the country, a The Associated Press analysis shows, worrying experts who say the push to relieve patients' suffering is spawning an addiction epidemic.

Drug Enforcement Administration figures show dramatic rises between 2000 and 2010 in the distribution of oxycodone, the key ingredient in OxyContin, Percocet and Percodan. Some places saw sales increase sixteenfold.


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Meanwhile, the distribution of hydrocodone, the key ingredient in Vicodin, Norco and Lortab, is rising in Appalachia, the original epicenter of the painkiller epidemic, as well as in the Midwest.

The increases have coincided with a wave of overdose deaths, pharmacy robberies and other problems in New Mexico, Nevada, Utah, Florida and other states. Opioid pain relievers, the category that includes oxycodone and hydrocodone, caused 14,800 overdose deaths in 2008 alone, and the death toll is rising, the Centers for Disease Control and Prevention said.

Pharmacies received and ultimately dispensed the equivalent of 69 tons of pure oxycodone and 42 tons of pure hydrocodone nationally in 2010, the last year for which statistics are available. That's enough to give 40 5-mg Percocets and 24 5-mg Vicodins to every person in the United States. The DEA data records shipments from distributors to pharmacies, hospitals, practitioners and teaching institutions. The drugs are eventually dispensed and sold to patients, but the DEA does not keep track of how much individual patients receive.

The increase is partly due to the aging U.S. population with pain issues and a greater willingness by doctors to treat pain, said Gregory Bunt, medical director at New York's Daytop Village chain of drug treatment clinics.

Sales are also being driven by addiction, as users become physically dependent on painkillers and begin "doctor shopping" to keep the prescriptions coming, he said.

"Prescription medications can provide enormous health and quality-of-life benefits to patients," Gil Kerlikowske, the director of national drug control policy, told Congress in March. "However, we all now recognize that these drugs can be just as dangerous and deadly as illicit substances when misused or abused."

Opioids like hydrocodone and oxycodone can release intense feelings of well-being. Some abusers swallow the pills; others crush them, then smoke, snort or inject the powder.

Unlike most street drugs, the problem has its roots in two disparate parts of the country — Appalachia and affluent suburbs, said Pete Jackson, president of Advocates for the Reform of Prescription Opioids.

"Now it's spreading from those two poles," Jackson said.

The AP analysis used drug data collected quarterly by the DEA's Automation of Reports and Consolidated Orders System. The DEA tracks shipments sent from distributors to pharmacies, hospitals, practitioners and teaching institutions and then compiles the data using three-digit ZIP codes. Every ZIP code starting with 100-, for example, is lumped together into one figure.

The AP combined this data with census figures to determine effective sales per capita.

A few ZIP codes that include military bases or Veterans Affairs hospitals have seen large increases in painkiller use because of soldier patients injured in the Middle East, law enforcement officials said. In addition, small areas around St. Louis, Indianapolis, Las Vegas and Newark, N.J., have seen their totals affected because mail-order pharmacies have shipping centers there, said Carmen Catizone, executive director of the National Association of Boards of Pharmacy.

Many of the sales trends stretch across bigger areas.

In 2000, oxycodone sales were centered in coal-mining areas of West Virginia and eastern Kentucky — places with high concentrations of people with back problems and other chronic pain.

But by 2010, the strongest oxycodone sales had overtaken most of Tennessee and Kentucky, stretching as far north as Columbus, Ohio and as far south as Macon, Ga.

Per capita oxycodone sales increased five- or six-fold in most of Tennessee during the decade.

"We've got a problem. We've got to get a handle on it," said Tommy Farmer, a counterdrug official with the Tennessee Bureau of Investigation.

Many buyers began crossing into Tennessee to fill prescriptions after border states began strengthening computer systems meant to monitor drug sales, Farmer said.

In 2006, only 20 states had prescription drug monitoring programs aimed at tracking patients. Now 40 do, but many aren't linked together, so abusers can simply go to another state when they're flagged in one state's system. There is no federal monitoring of prescription drugs at the patient level.

In Florida, the AP analysis underscores the difficulty of the state's decade-long battle against "pill mills," unscrupulous doctors who churn out dozens of prescriptions a day.

In 2000, Florida's oxycodone sales were centered around West Palm Beach. By 2010, oxycodone was flowing to nearly every part of the state.

While still not as high as in Appalachia or Florida, oxycodone sales also increased dramatically in New York City and its suburbs. The borough of Staten Island saw sales leap 1,200 percent.

New York's Long Island has also seen huge increases. In Islip, N.Y., teenager Makenzie Emerson said she started stealing oxycodone that her mother was prescribed in 2009 after a fall on ice. Soon Emerson was popping six pills at a time.

"When I would go over to friends' houses I would raid their medicine cabinets because I knew their parents were most likely taking something," said Emerson, now 19.

One day she overdosed at the mall. Her mother, Phyllis Ferraro, tried to keep her daughter breathing until the ambulance arrived.

"The pills are everywhere," Ferraro said. "There aren't enough treatment centers, and yet there's a pharmacy on every corner."

The American Southwest has emerged as another hot spot.

Parts of New Mexico have seen tenfold increases in oxycodone sales per capita and fivefold increases in hydrocodone. The state had the highest rate of opioid painkiller overdoses in 2008, with 27 per 100,000 population.

Many parts of eastern California received only modest amounts of oxycodone in 2010, but the increase from 2000 was dramatic — more than 500 percent around Modesto and Stockton.

Many California addicts are switching from methamphetamine to prescription pills, said John Harsany, medical director of Riverside County's substance abuse program.

Hydrocodone use has increased in some areas with large Indian reservations, including South Dakota, northeastern Arizona and northern Minnesota and Wisconsin. Many of these communities have battled substance abuse problems in the past.

Experts worry painkiller sales are spreading quickly in areas where there are few clinics to treat people who get hooked, Bunt said.

In Utica, N.Y., Patricia Reynolds has struggled to find treatment after becoming dependent on hydrocodone pills originally prescribed for a broken tailbone.

The nearest clinics offering Suboxone, an anti-addiction drug, are an hour's drive away in Cooperstown or Syracuse. And those programs are full and are not accepting new patients, she said.

"You can't have one clinic like that in the whole area," Reynolds said. "It's a really sad epidemic. I want people to start talking about it instead of pretending it's not a problem and hiding."

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mike mentor April 5, 2012 | 4:23 p.m.

14,800 overdose deaths from legal opioid painkillers in 2008 alone.

0 overdose deaths from illegal marijuana in all of history.

Things that make you go hmmm...

(Report Comment)
Mark Foecking April 6, 2012 | 6:06 a.m.

Well, opiates and marijuana are apples and oranges when it comes to reliability and potency of pain relief. I support legalization of marijuana for both medical and recreational use (and a lot of the former is more the latter than many proponents will admit), but they're really two different things as far as legitimate medicine.

The reason Marinol is used is because it is a pure, standard preparation. Marijuana can vary tremendously in its potency, and has the added disadvantage of being usually administered by smoking it.

Prescribing addictive drugs to an addict is considered malpractice (except in strictly regulated cases like methadone treatment). This has to be something physicians tighten up on. Surely in our computer age, we could detect someone that is getting a lot of narcotics prescribed to him, even from different doctors.


(Report Comment)
mike mentor April 6, 2012 | 9:26 a.m.

I wasn't really trying to make a case that we should substitute marijuana for opiates for pain relief in all cases right now. Just highlighting some hypocrisy. There is plenty to go around... We have so many legal pain relievers that can kill you with an overdose or get you physically addicted or both. Yet, one that could be grown by anyone, anywhere in the country, that has never killed anyone from overdose in the thousands of years that it has been used and is not addictive is illegal.

That makes me go hmmm...

(Report Comment)
Greg Allen April 6, 2012 | 10:16 a.m.

"...has never killed anyone from overdose in the thousands of years that it has been used and is not addictive..."

One doctor estimated that in order to overdose on marijuana you would have to smoke a joint the size of a telephone pole. However, to imply that nobody has died from smoking marijuana is misleading. Research by Dr. David Olms in St. Louis concluded that the damage one joint does to the lungs is equivalent to the damage that an entire pack of cigarettes does, so smoking three joints a day is akin to smoking three packs of cigs a day. There is a highly increased risk of lung cancer in marijuana smokers.

Marijuana affects perception, in different amounts for different people. When spatial and time perception is altered, driving a vehicle is dangerous. We just haven't kept stats on marijuana-related incidents because there wasn't a quick test (such as a breathalyzer for alcohol) on the side of the road for marijuana.

Just as alcohol isn't addictive for upwards of 90% of people who drink, marijuana isn't addictive for all who smoke. But it is for some. And addiction takes your life apart piece by piece.

I'm sorry if I don't provide references; this is info I've collected and observed as a substance abuse counselor for the last 25 years. And I've seen an increase in the last couple of years of people with pain problems seeking opiate medications.

(Report Comment)
Michael Williams April 6, 2012 | 10:35 a.m.

GregA says, "this is info I've collected and observed as a substance abuse counselor for the last 25 years."

Experience is a great teacher. Your comments should not be discounted or dismissed out-of-hand, even with references to the contrary.

(Report Comment)
mike mentor April 6, 2012 | 10:41 a.m.

"marijuana isn't addictive for all who smoke. But it is for some."

Per Websters
addiction- compulsive need for and use of a habit-forming substance (as heroin, nicotine, or alcohol) characterized by tolerance and by well-defined physiological symptoms upon withdrawal

Nope! Marijuana is not addictive for anyone because it does not produce the physiological symptoms upon withdrawal needed to meet the definition of addiction.

I have heard the joint/cig comparison at more like 1 to 5 and that is because of filtering. If the drug were legalized federally, we wouldn't need to worry about all of that because pharma co's could then rationalize spending money to research potency and delivery methods. That isn't going to happen as long as the feds won't let them sell it.

(Report Comment)
mike mentor April 6, 2012 | 11:11 a.m.


I compared the deaths from overdose because that is the statistic that was given for opiates. I don't have the statistics for deaths from car crashes from people on opiate painkillers.

Any idea of what the most prescribed medicine in the US is?

Generic vicodin, an opiate painkiller, ranked number one in 2010 according to Time per the National Library of Medicine.

Are we to assume that none of these folks are driving while under the influence?

IMHO, those irresponsible people that would drive around stoned are already doing it. The illegality just retards improving the potency and delivery methods and sends millions of untaxed dollars to criminals to finance their endeavors...

(Report Comment)
Greg Allen April 6, 2012 | 2:42 p.m.

"...well-defined physiological symptoms..."

Marijuana isn't highly physically addictive, like cocaine, nicotine, and caffiene, although there will be slight physical withdrawal reactions for a week or two. But, like these other substances, the psychological withdrawal can last for months. Our culture emphasizes the physical over the psychological (how many doctors are there in the yellow pages, compared to psychologists?), but the addiction field does recognize and work with the psychological end.

(Report Comment)
mike mentor April 6, 2012 | 3:53 p.m.


I support your work and wish you and those you come in to contact with well.

Some may see it as splitting hairs, but I wanted to make a point that marijuana does not fit the classic definition of addictive. Most refer to it as habit forming rather than addictive to keep this straight.

The "authorities" told so many lies about this particular drug that most older than me were deliberately misinformed.

Here is the most recent study I read on web MD...

20-Year-Long Study Finds No Decline in Lung Function for Occasional Pot Smokers
By Brenda Goodman, MA
WebMD Health NewsReviewed by Laura J. Martin, MD Jan. 10, 2012 --

Woodstock generation, breathe easy. One of the largest and longest studies ever to look at the effect of marijuana smoking on lung health finds that pot smoking doesn’t appear to cause chronic breathing trouble.

The study has followed more than 5,000 young adults in four cities for more than two decades. More than half of the people in the study reported smoking tobacco, marijuana, or both.

Over time, researchers repeatedly checked two measures of lung function: One was a test that measured the amount of air forcefully exhaled in a single second. The second test measured the total amount of air exhaled after taking the deepest possible breath.

Those tests help doctors diagnose chronic, irreversible breathing problems like chronic obstructive pulmonary disease (COPD).

Cigarette smoking is a leading cause of COPD.

As more states legalize marijuana -- 16 states and the District of Columbia now allow its medical use -- experts have worried that the kinds of lung damage caused by cigarettes could also be brought on by pot smoking.

Indeed, cigarette smokers in the study saw their lung function drop significantly over 20 years.

But that didn’t happen to people who only smoked marijuana.

In fact, the study found that the lung function of most marijuana smokers actually improved slightly over time.

(Report Comment)
mike mentor April 6, 2012 | 3:53 p.m.

A healthy adult man can blow out about a gallon of air in one second, says researcher Stefan Kertesz, MD, an assistant professor of medicine at the University of Alabama at Birmingham.

Pot smokers, on average, were able to blow out that gallon of air plus about 50 milliliters.

“That’s roughly one-sixth of a size of a can of soda,” Kertesz says. “It’s not anything anybody would notice.”

Researchers estimated that lung capacity would stay slightly elevated even if a person had smoked as much as a joint a day for seven years, or two to three joints a day for three years.

The study is published in the Journal of the American Medical Association.

Advice to Patients
Donald P. Tashkin, MD, medical director of the pulmonary function laboratory at the David Geffen School of Medicine at UCLA, has spent his career studying the health effects of marijuana.

He says this study is helpful because it was relatively large and followed people for a long time, which gives him confidence in the results.

“The main thrust of the paper has confirmed previous results indicating that marijuana in the amounts in which it is customarily smoked does not impair lung function,” he says.

His own study of heavy, habitual marijuana smokers -- people who smoked the equivalent of a joint a day for 50 years -- found no harmful effect on lung function.

But he says none of these studies should be taken as the last word.

Other experts agree.

Barry J. Make, MD, co-director of the COPD program at National Jewish Health in Denver, says it can take years and even decades for the lungs to become so damaged by smoking that it would affect airflow, the measure of lung function used in the study.

“It doesn’t mean that there isn’t more damage that you can’t see with these tests,” says Make.

Until more is known, experts say if you are using the drug, it might be safer not to smoke it.

“The smoke in marijuana contains thousands of ingredients, many of which are toxic and noxious and have the potential, at least, to cause airway injury,” Tashkin says. “In an ideal world, it would be preferable to take it in another form.”

(Report Comment)
Derrick Fogle April 6, 2012 | 8:58 p.m.

Mentor hits the nail on the head about hypocrisy. Americans are conditioned to run to the doctor to get a prescription for *whatever* troubles them. 113 tons of just oxy- and hydrocodone alone. 7 tons of ritalin, mostly given to children under 18. 118 Million prescriptions for SSRI's. The list goes on.

And we wonder why the message "Drugs are Bad" just doesn't quite sink in?!?

Prescription drug deaths in 2011 numbered over 37,000 - even more than traffic fatalities, which is a favorite topic of mine to harp on.

Yet, roughly half of all drug interdiction efforts are targeted at one specific drug: Marijuana. And, and Mentor states, there have been ZERO confirmed overdose deaths from it, in the 8,000 year plus history of human use. Before it was banned, cannabis was one of the leading pharmacological ingredients in the US.

The prohibition of cannabis - one of the safest drugs known to man - compared to the acceptance and rampant distribution of deadly pharmaceuticals, is one of the most farcical and hypocritical facets of modern society. Marijuana is a very mild drug, with mild effects and mild addictiveness, and almost zero toxicity. In states where MMJ has been legalized, there has been a significant reduction in both traffic fatalities and suicides, because pot use displaces alcohol use.

The prohibition of cannabis is so stupid, and so wrong, and the propaganda for prohibition is so grossly inaccurate, it boggles the mind. Mentor already put the smackdown on Allen's "lung damage" BS. The same can be done for almost any other claim about the dangers of marijuana use.

If we're going to be such a drug use centric nation, we might as well stop creating artificial walls around certain relatively harmless "illicit" drugs, and stop spending tens of billions of dollars per year to fail to adequately control them.

(Report Comment)
Michael Williams April 6, 2012 | 9:19 p.m.

I'm ready to legalize and tax it.

Two things, tho:

(1) Anyone who thinks those who will find themselves out of a job (selling) will go meekly into another low-paying flippin' burgers-type job is whistling dixie. There will be problems we have to deal with. Hank Waters is dead wrong on this issue.

(2) I view users in two categories: (a) those who handle the psychology of it well and go the recreational route (not driving, not on the job, etc.), and (b) those who chronically check out anyway (feels better than life does) a similar category as those who abuse alcohol.

PS: Will only the smoking leaf be legal, or hashish, too? Can it be sold as an ingredient in any foodstuff...a dessert, if you the store or pharmacy? How will its sale be taxed and regulated? Like pseudoephedrine or somesuch?

(Report Comment)
Jimmy Bearfield April 6, 2012 | 9:22 p.m.

Smackdown on lung damage BS? You need to reread the final few paragraphs:

"But he says none of these studies should be taken as the last word.

"Other experts agree.

"Barry J. Make, MD, co-director of the COPD program at National Jewish Health in Denver, says it can take years and even decades for the lungs to become so damaged by smoking that it would affect airflow, the measure of lung function used in the study.

“'It doesn’t mean that there isn’t more damage that you can’t see with these tests,' says Make.

"Until more is known, experts say if you are using the drug, it might be safer not to smoke it."

(Report Comment)
Derrick Fogle April 6, 2012 | 10:43 p.m.

@Jimmy: Way to focus on the negative, unsubstantiated "what ifs," instead of the concrete data. The study Mentor cited followed users for "over 2 decades" already, and found no significant negative consequences, and even a small positive effect for those that smoke both tobacco and cannabis. But OMG the contrarians say it could take "years, or even decades" for the damage to show?

This is exactly what I mean by the propaganda for prohibition being grossly inaccurate. Yet, it seems to be what people latch onto for this one particular drug, even as they glibly ignore warnings about the cornucopia of legal pharmaceuticals and alcohol, and the death toll they create.

I certainly agree with MW that there will be a lot of issues to deal with after legalization. But our country didn't collapse before it was prohibited, in fact cannabis was commonly sold as medicine. It won't collapse after re-legalization, either. We seem to be comfortable dealing with the issues of all the other legal pharma and alcohol. I would much rather see our society identify and deal with the specific problems caused by legal access, than continue a campaign of violent and expensive blanket prohibition against a drug that is not only very mild and non-toxic, but also proven in placebo-controlled, double-blind clinical trials to be safe and effective medication against several medical conditions.

(Report Comment)
Jimmy Bearfield April 7, 2012 | 8:49 a.m.

@Mr. Cranky Pants: To repeat: "But he says none of these studies should be taken as the last word."

Pot is like any other drug: Even after decades, no one really knows everything that it's doing to a body. Rose-colored glasses and wishful thinking don't change that.

(Report Comment)
Michael Williams April 7, 2012 | 9:01 a.m.

Derrick: Expensive war...yes...but I don't think we'll spend any less than we do now if marijuana is legalized. After all, we still have cocaine, heroin, and any other damnphool thing folks are willing to snort, inject, ingest, etc., in order to "check out" for while.

Unless we're willing to legalize those drugs, too.

As for negative "what ifs", I think Jimmy does have a good point. Two decades of health data on many "what ifs" is simply insufficient for a full assessment. How long does it take black lung, COPD, or mesothelioma to manifest itself? It simply does not make sense that deep inhalation of ANYTHING other than air will be benign. The notion that a combusted inhalant with all its unknown oxidized products and <10 nm particles will be A-ok is unreasonable. I agree, tho, that the dose makes the poison...which is why combusted cigarettes will always trump combusted weed on a scale of harm.

I won't worry much about recreational users any more than I worry about Joe Doaks who has a couple of beers/belts in front of the TV. My concern will be with those unable to handle "life" and go searching for something that soothes. I do believe there is an indirect psychological addiction with which society will have to deal....or not. What is your obligation to an alcoholic or stoner who does not hold up their end of the societal bargain?

(Report Comment)
Derrick Fogle April 7, 2012 | 10:26 a.m.

@Mike:For the record, I think cannabis is the ONLY one that should be legalized, at least for now, because it is the ONLY one that's non-toxic and has not produced an overdose death. That "Then we have to legalize everything" is just more grossly inaccurate propaganda. No, we don't, and there's a very good reason why: cannabis is the only one that's virtually non-toxic.

If cannabis legalization works out, then we can start moving up the chain in terms of known toxicity and addictiveness, legalizing each in turn until we hit a real equilibrium point.

Again, roughly half of all drug interdiction efforts and costs are targeted at one drug: pot. Removing the reason for half of all costs is going to have an economic effect. Even if other drug related costs increase by 50%, that's still a 25% reduction, overall.

Sure, there's going to be some, even significant, "migration" as pot becomes legitimate and criminals move on to other black market products. But there will also be a lot of other "migration" the other way as non-criminal elements move toward the now legal and in comparison very safe pot, away from other stuff. The biggest negative economic impact will be on alcohol and current pharma products. And sorry, I'm not gonna cry for them.

Of course if cannabis were just taken off schedule 1, pharmaceutical companies could start studying the interactions of the myriad of cannabinoids in the plant, and perhaps come up with new cannabis-based drugs that are much safer and just as effective as today's drugs.

And speaking of pharmaceutical research, absolutely no other drug has ever been subject to the scrutiny that people insist be applied to pot. Other pharmaceutical drugs usually have a few years timeline for approval, but we insist on, what... 3+ decades of studies for pot? How many years of research did it take for Oxycontin to be put on the market? And despite thousands of deaths per year, why is it still on the market?

The market is riddled with evidence that there really does need to be a lot more research - perhaps decades more - on the legal pharmaceuticals. But that doesn't happen, does it? Fact is, we already have over 8,000 years of documentation on human use of cannabis, and not a single recorded OD death. Isn't that enough research to deem this drug reasonably safe?

This also brings up one of the classic "bait and switch" prohibition propaganda techniques: insisting that "OMG we need more research on it!" ...but of course behind the scenes, the drug is kept on Schedule 1 so that research cannot be done.

I wouldn't mind pharmaceutical companies making some money off specialized cannabinoid-based products. In fact, they already do. Marinol, drobinol, sativex... these are all cannabis-based medications that are patented, manufactured by pharmaceutical companies, and profitable. These are just the tip of the iceberg in terms of what cannabinoid-based medications could do for mankind.

(Report Comment)
Michael Williams April 7, 2012 | 10:50 a.m.

Derrick: I've already said I'm OK with legalization. I did not say we would then have to legalize everything else.

I do think you will have arguments pinning down that "equilibrium point", tho. Indeed, that's what is being discussed here. Some won't agree on this particular "equilibrium point" argument, and although your/my "equilibrium points" may agree here, they may not at the next level. Who is the referee? Is a tiny bit of meth in your instant oatmeal OK for that quick morning pick-me-up? Or, how about just a small...tiny, no harm...dose of barbiturates in that warm milk product for a dreamless, relaxing sleep? We could call it "Nod-Away".

I do not agree less money will be spent in spite of your claim that 50% of all interdiction is against weed. The money will simply be spent elsewhere, either on regulation, taxation, things-we-haven't-thought-of, etc.

What is your obligation to an alcoholic or stoner who does not hold up their end of the societal bargain?

(Report Comment)
Derrick Fogle April 7, 2012 | 12:40 p.m.

@Mike: Yes, I appreciate your willingness to consider legalization, and I think you've got a lot of salient points about the unintended consequences. I'm not intending to argue with you so much, as to continue a campaign of exposing inaccurate propaganda for what it is.

This is semi-personal for me. I watched my brother, a classic case of "-aholism", get wrung through the wringer of prohibition. After the 4th or 5th time he was moved from one facility to another, and each time we had to wire money so he could buy new toiletries at exorbitant commissary prices, it became obvious this was just a racket. In total, he was moved 14 times in the space of 3-1/2 years. Each time, we either had to wire money to the commissary, or tell him, "Sorry Bro, no toothbrush or toothpaste for you this time."

When he got out, and put on probation, he turned to meth because it's so much easier to evade detection of that during drug testing. Watching him nearly kill himself on meth was a very disturbing experience. Chronologically, he's only a year and a half older than I am; physically, he's now at least 20 years older.

Today, he's well beyond probation, and doesn't do meth anymore, thank goodness. But he's got real chronic back pain, and some neuropathy from the ravages of meth. Cannabis might not be the only thing that brings him some relief from these problems, but it's by far the safest one for him to use. Considering his '-aholism', I'd quite frankly rather see him smoking pot, legally and without fear of going back to jail, than doing anything else. And this is the way it works, in fact. If he can smoke pot in reasonable safety, he just does that, and drinks. If he can't smoke pot, he drinks much more, and gets in trouble with other drugs.

And no, after seeing what meth did to my brother, I don't think street meth should ever be legal in any amount.

(Report Comment)
Derrick Fogle April 7, 2012 | 12:43 p.m.

To bring this discussion back to the content of the original article: Adderall, a legal pharmaceutical, is very similar to meth, and provides the same kind of pick-me-up that meth does. I could get a prescription for it easily, too; I'd just go to a doctor and say I'm having trouble concentrating on my work, that I get distracted real easy, and mention a couple friends who have found relief in the product. Boom, I've got a prescription for a legal close cousin to street meth that at least doesn't have a lot of the side effects (rotting teeth, etc.) that street meth has.

This is how the legal, pharmaceutical drug trade works, to the tune of hundreds of tons of drugs consumed every year. It's got very little to do with solving or controlling real medical problems. It's all about dispensing drugs to make people feel better. I.E., recreational drug use.

I actually did get a script for a phych med once a few years ago when I was still in the throes of my midlife crisis, and it really was that easy: "Doctor, I'm depressed." "Here, have an SSRI." It turned out to be the worst, most horrible drug I'd ever tried. It made me feel like crap all the time. It didn't take me long to wise up and throw the stuff out.

Ironically, despite my advocacy of pot legalization, I'm probably one of the most drug-free people on this list. The ONLY drug I use on a regular basis is caffeine. I rarely consume any alcohol, very, very rarely use ibuprofen, I will take an antibiotic if there's good enough evidence I have a bacterial infection (haven't done that in several years), and... that's it. I don't take cold or allergy or any other OTC medications, no prescription painkillers or other prescription medication, nothing.

Even if I did use cannabis, my total drug intake would still probably be a tiny fraction of the average American's. Yet, because I advocate for legalization, people who take many times the number of drugs that I do, have accused me of being a "druggie." That's rank hypocrisy.

(Report Comment)
Ray Shapiro April 7, 2012 | 12:56 p.m.

The problem with narcotic painkillers being over prescribed by doctors is that it is easier for the doctor to just keep writing prescriptions to the now addicted patient. Unless the patient is willing to go into withdrawal and rehab for the addiction, it is impossible to know if the pain is treatable by other means or if the pain is being created by the brain because of the physical addiction cycle.
Also, marijuana is a drug and should be regulated as such. But not as a narcotic as Richard Nixon decreed.

(Report Comment)
Michael Williams April 7, 2012 | 1:13 p.m.

Derrick: I don't care much what a person ingests, inhales, injects, long as they don't adversely affect me or mine. That's a very general statement without the specifics of what "me or mine" entails, tho. Basically, it means leave me and mine alone, and it includes any financial obligation, too. I'll be responsible for me and mine; others should do the same.

I have a couple of relatives who went down the wrong path, including state pen stuff. Both were weak from the time we were kids; you could see it coming...even back then.

There are those who chronically abuse ________(fill in the blank). They've checked-out well beyond any recreational use. Perhaps GregA can comment on "Why?" Whatever the case, beyond the actions of my own family and a few close friends, I do not intend to accept any responsibility or, time, political, etc.

I may be ready to legalize it, but I won't advocate for it with my time or my money. Basically, I don't give a flyin'-flip anymore so long as me and mine are left alone.

(Report Comment)
Derrick Fogle April 7, 2012 | 1:52 p.m.

As for my social responsibilities to addicts: What do I/we do now for alcoholics? We fund a few treatment centers, we push people to AA, but not much, really. Mostly, we end up helplessly watching in horror as they slowly poison themselves, and sometimes quickly kill others.

I would expect much the same for potaholics, although pot doesn't cause anywhere near the physiological damage that alcohol does, and there's plenty of evidence that the secondary effects (accidents, traffic fatalities, and general violent behavior) are significantly less compared to alcohol use, as well. My brother doesn't hurt other people when he's stoned.

This comes back to the whole "personal responsibility" mantra: why should I care that much that someone else can't use pot responsibly? My responsibility is to determine whether or not I can, and act accordingly. My experience watching my brother has driven home the point that there's only so much I can do. I still love him, I still support him emotionally, I do what I can to keep him from a meth relapse; I do not judge him for what he does.

When faced with the "lesser of evils" choice for my brother, it's clear to me that pot is by far the least of the evils. When faced with the need to deal with chronic stoners, my first concern is that they not hurt others, then not hurt themselves. It's a lot easier to do this for potheads than alcoholics. Keeping them from being a drain on society is another consideration, although I've never personally known potheads to be any lazier than the general population. That's really just another piece of grossly inaccurate propaganda. Most of the footbag players I've known that have practiced the hardest and become the best, have in fact been the potheads. I think lazy people might tend to be drawn to the escapism of smoking pot, but I see no evidence that smoking pot induces laziness.

(Report Comment)
Gregg Bush April 7, 2012 | 5:12 p.m.

Self Medication:
A public health concern - not
A criminal one.

Smart policy: match
The right intervention to
The social problem.

(Report Comment)
mike mentor April 7, 2012 | 6:24 p.m.

Prohibition of alcohol created an underground market dominated by gangsters who sometimes battled it out in the streets and killed innocents. This, plus the worries about turning an otherwise law abiding citizen in to a criminal eroding general respect for the law led to repeal of prohibition. The parellels are there.

(Report Comment)
Michael Williams April 7, 2012 | 7:51 p.m.

Derrick: I've never personally known potheads to be any lazier than the general population.

My experience is the opposite and similar to my observations of alcoholics and other substance abusers.

In my experience, folks in the "abuser" category tend (I said "tend") to be rather unproductive folks unhappy with life and looking for a good sooth. I saw this over and over....recall that I'm 62 and was of college age when this all really hit the big-time. Many acquaintances, relatives, and not a few friends turned on, tuned in, and dropped out. Many recovered and became productive citizens, but many stayed "dropped out". The latter remain dependent upon society in some fashion or the other. They aren't and weren't very productive.

I think folks have an obligation to contribute within a society if they choose to live within one. I have an obligation to do something that someone needs, and other folks have the obligation to do something that I need. That is what "commerce" and "interaction" needs for a stable society. When one of those two sides drops out and does not pull their weight, others have to take up the slack.

Further, my experience shows that abusers, including potheads and alcoholics, make poorer parents. They care more about how *they* are feeling in the midst of a perceived "life sucks" world. You've concentrated on the physiological side of this equation, but have not touched much on the psychological side. The second may be more important then the first if an abuser is introspective and withdraws from family or society obligations. 'Tis true, stoners don't do much direct "hurting"...but they also don't do much "helping". I don't consider their lethargy a good thing at all.

A drug may be quite safe physiologically. That doesn't mean it's a good thing for society, tho, if there are qualities that make folks unproductive in many things a human should be doing.

Finally, I am aware there are folks who receive true benefits from weed and other analgesics. Unfortunately, like those abusing conventional addictives, many are also liars and are abusers themselves. Historically, society has not known how to tell the difference; hence the war on weed as a perceived protection against some bad societal outcomes.

So long as me and mine are not affected, I'm tuning out and simply don't care any longer. Sooth yourself on whatever you wish ('you' is generic, not specific), but I support serious societal penalties for those who do not leave me and mine out of it.

(Report Comment)
Ellis Smith April 8, 2012 | 4:51 a.m.

My remark (below) assumes that pain management is the reason why drugs (and we'll include marijuana) are being employed, and not some other reason (for example, "recreation"). "Management" requires professional monitoring.

Pain management is NOT an exact science! I doubt that any of its professional practitioners would claim it is.

There's a difference between "popping pills," or smoking something on an ad hoc basis and being placed on a well monitored course of pain medications.

Pain management is what it says it is: it is an attempt to manage pain, not to remove it altogether. The latter may even be impossible.

(Report Comment)

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