Opiate Nation

American exceptionalism is defined by many factors, some of them not so great.  No one would point to the nation’s millions of illegal drug users and smile with civic pride.  Yet there is another increasingly unhidden addiction – to prescription painkillers – that is killing our nation slowly.  Did you know that the U.S. consumes 80% of the world’s opiods, and 99% of hydrocodone, the active ingredient in Vicodin?[1]    That OD’s from Vicodin and its pals kill more people than auto accidents in seventeen states?[2]  The sheer numbers are staggering:  131 million doses of Vicodin are prescribed every year[3]; in 2001, U.S. sales of OxyContin exceeded $1 billion.[4]

Elizabeth Wurtzel, in what seems like an affectionate paen to a bygone era, wrote Prozac Nation in ’94.  Forget SSRIs.  The odds are higher that someone you know – your boss, co-worker, spouse, mom – is hooked on opiates, and your doctor is playing pusher.

Here’s how it goes:  we’ve all experienced pain at some point in our lives.  When I broke my ankle in  ‘98, I tried to take a Vicodin but the medication made me so ill that I lay down on the floor, not knowing how to get up (in a full fiberglass cast). Flash forward to 2010, when, after breast cancer surgery, I was prescribed the ubiquitous V.  This time, the pill was my friend.  I would count down the minutes until I could take the next one, my surgical site alive with pain.  I went through two prescriptions, but, being a rare American drug hater, stopped and never looked back.  Some people are not so fortunate.

There are stories upon stories of patients experiencing pain, getting the V. from Doctor, then realizing that if they get that “fuzzy warm” feeling after one pill, how much better will they feel after two?  Twenty? The allure of the drug is such that some addicts end up taking 75 pills a day.[5]  And why is that?  Because “opioids are essentially legal heroine.”[6]   And instead of getting a fix in the street, Americans feel so much better with a neatly packaged pharmacy bottle.

Of course, Vicodin and its cousin Percocet are mere dwarves when compared to the Sauron of the field:  OxyContin.  Introduced by Purdue Pharma in 1996, the drug maker initially told doctors that Oxy didn’t produce much euphoria, and that withdrawal wasn’t especially rough.[7]  Bullshit.   In 2007, Purdue ended up paying $634 million in fines for felony and misdemeanor misbranding.[8]  Oops!

Don’t think this enormous sum compensated for the mayhem left in Oxy’s wake.  Whole communities – even states – have been leveled by its scythe, espeically in rural areas.  Nearly every family in eastern Kentucky has been touched by prescription-drug addiction and death.[9]

Oxy abuse starts off like Vicodin, but with a bite:  Oxycodone is approximately 1.5–2 times as potent as morphine when administered orally.[10]   A woman named “Cheryl” reports that she became a full-blown addict in a week, started crushing and inhaling the pills, then, upon running out, spent days vomiting and dry heaving.   It wasn’t until she woke up in the hospital (her heart had stopped in the ambulance) that she could fully appreciate the insidious nature – and addictive allure —  of “hillbilly heroin.”  [11]  Another addict who started out with legitimate back pain got up to 240mg of Oxy a day by scoring prescriptions from his internist, pain management doctor, and surgeon.[12]  He ended up detoxing in a psychiatric hospital for 3.5 days.

But he was one of the lucky ones.  Accidental overdoses involving Vicodin and Oxy rose by nearly 115 percent in just the four years between 2001 and 2005.[13]  They have taken to their grave teens, and many “ordinary” Americans who got hooked before they had time to process what was happening.

Some states operate as “pill mills” for others, as in the case of Florida, which supplied so much Oxy to Appalachia that it was known as the “flamingo express.”[14]  In 2011, Florida doctors prescribed 10 times more oxycodone than those in the rest of the states combined.[15]  Governor Rick Scott (R) at first opposed shutting down the pill mills, but things got so bad that regulation was finally passed in March 2011.  Of course, the drug suppliers just pick up and move elsewhere.  Purdue, which wrought this evil upon the land, has tried to prevent Oxy users from crushing and snorting the pills by adding additional binders but it’s not known how effective this is.   In the meantime, Oxy is considered a “gateway” drug to heroin, and you know why?  Cause smack is cheaper.[16]

The moral of the story – and it’s a microcosm of U.S. business practice — is that Big Pharma like Purdue will lie and cheat to get their product on the market, and if thousands die in the process, oh well,  they can just pay a fine.  Of course, if you or I commit a homicide, we will be put away for life (at the least) but we apparently don’t have the level of “personhood” granted to rich corporations.

So next time you have pain, and your doctor hands you that V. prescription, think before you take the first pill.  This stuff is not child’s play.  It is a semi-synthetic opiate, produces the same euphoria as heroin before the elation fades and the hell of being hooked crawls into its place.  William S. Borroughs said it best:  “Junk is the ideal product… the ultimate merchandise. No sales talk necessary. The client will crawl through a sewer and beg to buy.”  Something Purdue knows all too well.


[2] Ibid

[3] Ibid

[4] Ibid

[5] Ibid

[6] Ibid Lewis Nelson , on FDA panel to revise Risk Evaluation and Mitigation Strategy of prescription drugs

[13] Ibid

[15] Ibid