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Signs of hope amid the opioid crisis


"We were somewhere around Barstow, on the edge of the desert, when the drugs began to take hold.”

So began Hunter S. Thompson’s 1972 drug-addled novel “Fear and Loathing in Las Vegas: A Savage Journey to the Heart of the American Dream,” in which the two main characters destroy hotel rooms and cars and talk to imagined desert animals during wild hallucinations in Sin City. They are a mess, crippled by drug abuse, which killed thousands during the counterculture movement of the 1960s.

The book, made into a movie starring Johnny Depp and Benicio del Toro in 1998, was not written as a symbol of contemporary America, but it could have been. Since 1999, opioids have killed 400,000 Americans, according to federal data. That’s nearly seven times the number of American soldiers killed in the Vietnam War.

There are signs of hope, however. Opioid overdoses and fatalities have declined in recent years, thanks to federal, state and local education programs, stricter law enforcement and the widespread use of Narcan, an overdose antidote. In Nassau County, opioid deaths are down 20 percent over the past two years.

In recent years, federal and state governments across the nation have sued a number of major drug companies, including Allergan, Endo International, Johnson & Johnson and Purdue Pharma, charging that people were misled by these companies into believing that opioids were harmless and non-addictive.

This year, Johnson & Johnson was slapped with a $572 million fine in Oklahoma for under-reporting the risks of the opioid-based painkillers Nucynta and Duragesic, resulting in what the court called a “public nuisance.” Immediately afterward, the Sackler family and the company it owns, Purdue Pharma, said it would offer more than $10 billion to settle the thousands of federal and state lawsuits they are facing because of their opioid medications.

Now the U.S. attorney’s office for the Eastern District of New York has opened a criminal probe to examine whether pharmaceutical companies intentionally flooded communities with opioid painkillers. The office will apply laws typically used to prosecute drug dealers. Grand jury subpoenas from federal prosecutors in Brooklyn were sent to AmerisourceBergen Corporation, Amneal Pharmaceuticals Inc., Johnson & Johnson, Mallinckrodt PLC, McKesson Corporation and Teva Pharmaceutical Industries Ltd., according to regulatory filings.

In 2012, Gov. Andrew Cuomo signed a sweeping reform bill aimed at cracking down on prescription drug abuse. At the time, roughly 70 percent of New Yorkers who abused painkillers got them from friends or relatives who were prescribed them. Young adults and teens were considered highly susceptible to opioid abuse. The I-STOP Prescription Monitoring Program has been credited with substantially reducing the number of opioid painkillers by using a real-time medication registry, with all prescriptions that are potentially subject to patient abuse electronically transmitted from doctors’ offices directly to pharmacies.

Going after Big Pharma in civil lawsuits and strengthening laws governing the distribution of medically prescribed opioids are critical steps in reducing and eradicating the opioid epidemic. The last piece of the puzzle is us — the patients. We need to take responsibility for what we put into our bodies. A doctor’s prescription of a medication, or a pharmaceutical company’s approval by the federal Food and Drug Administration of a new drug the company claims is the latest cure-all, should not translate into instant and unfettered use.

Ask your doctor and pharmacist questions about the drugs they prescribe. What are their potential side effects and dangers, particularly if they are painkillers? Is addiction one of them? If so, beware. Any drug should be used precisely as prescribed, but particularly a painkiller.

If your doctor or dentist has prescribed a seemingly inordinate number of opioid pain pills, don’t be afraid to ask why, and understand that you have the right to refuse them. Doctors and dentists often prescribe painkillers pre-emptively, before a patient feels pain because of a procedure. The intent, in most cases, is good — the doctor doesn’t want the patient to suffer — but opioid use in the absence of pain potentially leads to addiction.

In short, take only the pills that you actually need, and no more. And be sure to properly dispose of any leftover opioids when you no longer need them — don’t save them for future use. By law, pharmacies in New York must now take them back.

We must all play a part in ending the opioid epidemic, starting with our individual actions.