The neverending, losing war on drugs

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Screen Shot 2014-08-28 at 1.43.32 PMAn article in today s New York Times has some sobering news about the enormous narcotic addiction problem that is so prevalent in this country. Since 2010, there has been a sharp increase in deaths from heroin overdoses in New York City.

According to the Times, The death toll from heroin has more than doubled over the last three years, presenting a growing challenge to city officials who have so far been unable to reverse the rise.

ACSH s Dr. Josh Bloom thinks that not only is the trend not reversible, but it will probably get worse, starting in October, when hydrocodone (Vicodin) becomes a Schedule II drug with far greater restrictions on its use.

Why? Dr. Bloom believes the cause is obvious. He says, The graph (from the Times article) shows when the surge of heroin deaths began. The superimposed red arrow represents August, 2010 the time when Purdue Pharma, the makers of OxyContin a high dose, time release oxycodone pill got FDA approval for a clever new formulation of the drug that made it essentially abuse proof. Prior to this, addicts found ways to defeat the extended release properties of the drug, and were thus able to get very large doses of oxycodone at once. But addicts will get their fix no matter what they have to do. They gave up on OxyContin and switched en masse to heroin. A 2012 article in the New England Journal of Medicine supports this on a nationwide basis. Coincidence? I think not.

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But there is more to the story than just the timing of the increase. The heroin that is killing people may very well not have any heroin in the syringe at all.

Dr. Bloom explains, Like any street drug, one never knows exactly what is in it, or what it has been cut with. Increasingly, what is sold as heroin on the street is cut with (or substituted entirely by) fentanyl a synthetic narcotic with heroin-like properties that is about 100-times more potent than heroin itself. It is so potent that a therapeutic dose is about one-tenth of a milligram twenty times lighter than a grain of salt. So, a little careless mixing and you may be getting a lethal dose of fentanyl, which will appear like (and often be reported as) a simple heroin overdose.

And it is very likely that this trend will continue, or even accelerate once the Vicodin restrictions go into effect.

ACSH s Dr. Gil Ross adds, If you can come up with a better example of the unintended consequences of a bad policy, please let us know. This will not be easy. True, as the article says, education and the opioid antagonist naloxone will save some lives, but you simply cannot tighten the screws on access to an addictive substance and pretend that the problem is solved in fact, it may get worse.

You can read Dr. Bloom s 2013 New York Post op-ed entitled New painful casualties of the drug war here.