Opioid Addictions

Once again, and for all the wrong reasons, we are at the top of a list. Arkansas leads the nation in childhood abuse of opioids. Basically, our teenagers consume more prescription pills and various street drugs such as heroin than those of any other state.

Opioids include drugs, whether legal or not that are derived from the Opium poppy – codeine and morphine, also semi-synthetic drugs that are made by chemical conversion of opium – notably oxycodone and hydrocodone. Fentanyl and related compounds (congeners) are made completely synthetically.

The only difference among these drugs is relative potency, the amount (dose) necessary to produce a given effect. The range is incredibly broad. Fentanyl and its congeners are hundreds, even thousands of times as potent as morphine. Emergency personnel have been poisoned by simply touching pills. The adage “one pill can kill” is frighteningly true.

The death rate due to this epidemic is rising and seems to cross all lines – red states and blue states, rich states and poor states. The top ten states for death rates include both the poorest and richest states based on income.

In some states there seems to be a concerted effort to oversell prescription drugs. Over a recent 5 year period, 780 million pills were shipped to West Virginia. Its population is only 1.8 million. Every man, woman and child received the equivalent of over 400 pills! It is no wonder that they lead the nation in opioid overdose deaths.

The numbers are no less staggering in Arkansas. In 2016 physicians prescribed 236 million opioid pills. That’s about 80 pills per person. Almost half of all adults filled one or more prescriptions that year. In Arkansas, someone’s son or daughter dies on a near daily basis from an opioid overdose.

A coalition of cities and counties in Arkansas recently sued dozens of makers and distributors of opioids, arguing that the companies should bear the cost of drug abuse in the state. Whereas this should help with prescription drugs it may drive those already addicted towards street drugs which are much more dangerous due to the unreliability of dosages and the vagaries of intravenous drug use.

Some states have begun needle exchanges to reduce the secondary infection rate due to shared needles. New York City has gone so far as to create safe sites where clean needles and a safe location for injection are provided.

A silver lining to the opioid cloud may be about to appear in Arkansas. Studies consistently show that states with medical marijuana have much lower rates of opioid overdose deaths. Researchers examined medical marijuana laws and death certificate data in all 50 states between the years of 1999 and 2010. At the time, only 13 states had medical marijuana laws. It was obvious that the rates of fatal opioid overdoses were lower in states that had legalized medical marijuana.

The effect seems to be due to the lower use of legal opioids among those who have access to marijuana. Ironically the federal government classifies marijuana as a schedule one chemical or substance – drugs with no currently accepted medical use and a high potential for abuse.

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