I mentioned the other day that opioid use is now the biggest threat to teenagers and young adults. Consider the following facts about buprenorphine (suboxone), a relatively new treatment for opioid-addicted people.
Suboxone is the blockbuster drug most people have never heard of. Surpassing well-known medications like Viagra and Adderall, it generated $1.55 billion in United States sales last year, its success fueled by an exploding opioid abuse epidemic and the embrace of federal officials who helped finance its development and promoted it as a safer, less stigmatized alternative to methadone.
It has also become a lucrative commodity, creating moneymaking opportunities — for manufacturers, doctors, drug dealers and even patients — that have undermined a public health innovation meant for social good. And the drug’s problems have emboldened some insurers to limit coverage of the medication, which cost state Medicaid agencies at least $857 million over a three-year period through 2012, a New York Times survey found.
There are some serious problems with suboxone, but at least the drug was created in an effort to help opioid-dependent people from continuing to use heroin and other powerful prescription drugs that can kill them or lead them to a life of dissolution and crime.
Consider that it is costing Medicaid programs almost $300 million a year just for this one strategy of treating opioid addiction. Consider the magnitude of the problem if suboxone is generating over $1.5 billion in sales annually. That the drug is outselling Viagra is a pretty strong indicator of how how widespread the opioid problem has become.
Yet, how often do you hear anyone talk openly about this?
This may be changing, however. The Pennsylvania legislature held a hearing about the issue last week. Some things they learned:
They don’t have to sell Delaware County District Attorney Jack Whelan. He saw the alarming numbers and quickly put together the task force to combat this new scourge.
Whelan explains one of the “hidden” facets of this new public health menace. Many times people are introduced to the problem through legal prescriptions for opioids and other powerful painkillers. Soon they’re addicted. Then these addicts start looking for a cheaper high. That often leads them to heroin. Or to crime to feed their habit. Or to their parents’ medicine cabinet to steal prescription drugs.
How serious is the problem. Delaware County Executive Director Marianne Grace offered some sobering numbers for the House panel.
Grace noted that in 2007 Delaware County had 16 heroin fatalities. That number mushroomed to 61 in 2011. In total, there were 232 heroin-related deaths from 2007 to 2013.
And the problem seems to be getting worse.
County Medical Examiner Dr. Fredric Hellman told the panel that just this year, the county has been rocked by 130 drug-related deaths. Of those, he concluded that half were heroin-related. He correctly referred to it as “the scourge that we have been chasing.”
The anonymous nature of 12-Step programs has long-interfered with people in recovery’s ability and willingness to speak out as advocates for better and more sensible public policy on addiction, but the stigma attached to heroin is so strong that parents groups have been slow to emerge. My sense is that the problem has grown so quickly and ferociously that it is overwhelming whole communities, and we’re about to see more openness about the issue.
I’m glad that the Pennsylvania legislature is taking a look at the problem, but I don’t know if they will figure out that sustained rehabilitative services are a much better investment than throwing a whole generation of kids in prison. They didn’t figure that out for crack, but maybe recovery activists will have more success this time since this is a suburban scourge as well as an urban one. I hate to say it, but white kids have a prayer that brown ones never had. The government might have mercy upon them.
