Tag: opioids

The opioid crisis and the border Wall

The states hardest hit by the opioid crisis are a long way from the Mexican border. Trump’s Wall remains a solution in search of a problem.

One of the sillier talking points in the Wall debate is that we need a physical barrier to keep opioids from coming into the country from Mexico.  Various commenters have pointed out that: (1) The fentanyls, which are the fastest-growing segment of opioid use and overdose deaths, mostly come directly from China; and (2) What does come across the U.S./Mexico border comes through overwhelmingly by common carrier at ports of entry; it isn’t backpacked through the desert by immigrants.

A point I haven’t seen made, and didn’t know about until Kevin Drum posted this graph based on data from the CDC’s Morbidity and Mortality Weekly Report, is that the crisis isn’t concentrated anywhere near Mexico. All of the hardest-hit states in terms of opioid mortality rates are east of the Mississippi and north of the Tennessee, about as far as they could be from the Rio Grande. Of the four states that actually border Mexico, New Mexico and Arizona are in the middle of the pack, while California and Texas rank 45th and 47th.

So Trump’s Wall remains a solution in search of a problem.

A primer on fentanyl(s)

The synthetic opioids - usually referred to both in the press and by law enforcement as “fentanyl” - have now outstripped not only the prescription opioids such as oxycodone but also heroin in terms of overdose deaths, and (as you can see below) the trend line is almost vertical.

Keith Humphreys warns of “fentanyl’s potential to permanently alter illegal drug markets.”

Kevin Drum asks about the causes of the change:   “Fentanyl has been around for a long time, and only recently has its use become widespread. Why?”

Why, I thought you’d never ask. Settle back; this is a complicated story, and it’s going to take a while to tell. But Keith is right: this is a BFD. So it’s worth understanding. Continue reading “A primer on fentanyl(s)”

Does cannabis availability help prevent opioid overdoses?

There’s been lots of chatter about the cannabis-opioid substitution question.

Newsweek headlines, “Can Legal Marijuana Solve the Opioid Crisis?”  while Dr. Jeff Sessions opines that cannabis is “only slightly less awful” than heroin.

People whose background is medical research tend to distrust anything that’s not a randomized controlled trial. They point to the positive correlation between cannabis use and opioid use at the individual level, and the fact that opioid deaths continue to rise even where cannabis is most freely available. Their position is, “We don’t know anything about this. Let’s due the clinical studies before taking action.”

But “not taking action” now means continuing to criminalize even the possession of cannabis. If cannabis substitutes for opioids, those laws cost lives: lives that can’t be regained ten years from now, after the clinical-trial results are in.

Moreover, the relevant clinical trials can’t actually be done in the U.S. Continue reading “Does cannabis availability help prevent opioid overdoses?”