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Rush Limbaugh should be remembered for being a very brave man.
He was one of the first public figures to speak about opioid addiction. Limbaugh discussed his painkiller addiction on his radio show way back in the early 2000s.
Limbaugh died Wednesday of lung cancer. But many years ago he fought a different battle.
Limbaugh’s painkiller addiction blew up and soon he was befuddled with legal problems. His reputation was raked through the mud. Even the National Enquirer wrote stories.
Prosecutors accused Limbaugh of "doctor shopping" to illegally receive about 2,000 painkillers. Prescriptions came from four doctors in six months to a pharmacy near his Palm Beach mansion, CBS News reported.
At the time Limbaugh’s radio audience was estimated at 20 million people.
As part of a plea, Limbaugh had to agree to drug treatment and repay the state the costs for investigating him.
It seemed harsh punishment for a man who fell on his sword about his addiction from the beginning. Limbaugh spoke from the heart about becoming addicted to the pills during his radio shows. Little did we know then that the opioid epidemic would become one of this nation’s greatest challenges.
Limbaugh was a trailblazer in admitting he was an opioid addict.
Prescription pill abuse down, but overdose deaths up
On Wednesday, the opioid epidemic again made the medical journals, this time in JAMA Psychiatry. A study showed a disturbing paradox: Prescription opioid abuse is down, but overdose deaths are up.
The study by Byungkyu Lee of the Sociology Department at Indiana University and colleagues examined claims data from more than 23 million commercially insured patients between 2007 and 2018. The researchers studied whether state programs aimed at curbing overdose and opioid abuse worked.
They did work. Sort of.
“State policies were associated with a reduction in known indicators of prescription opioid misuse as well as deaths from prescription opioid overdose," the authors reported. That was the good news. But the policies also were associated with "increases in diagnosis of opioid use disorder, overdose, and drug overdose mortality from illicit drugs,” the authors found.
In other words, it appears addicts are turning to street drugs, which are even more dangerous.
Finding drugs on the black market instead
“Although this study found that existing state policies were associated with reduced misuse of prescription opioids, they may have the unintended consequence of motivating those with opioid use disorders to access the illicit drug market, potentially increasing overdose mortality,” the authors continued. “This finding suggests that there is no easy policy solution to reverse the epidemic of opioid dependence and mortality in the U.S.”
It's not the solution policymakers are looking for.
The article offers an encyclopedic view the opioid epidemic. “The current opioid epidemic in the U.S. has its historical roots in the movement during the 1990s to address undertreated chronic pain,” the authors explained.
“In response, opioid-producing pharmaceutical companies engaged in aggressive marketing and prescribers overcorrected, relying on powerful opioid analgesics to treat acute and minor pain in addition to chronic and severe pain.”
Drug treatment must address root of problems
In short, Americans slid down the slippery slope. They progressed from painkillers to street drugs, including heroin, and then the even deadlier, synthetic opioids.
“Hence, to resolve the opioid paradox, it is imperative to design policies to address the fundamental causes of overdose deaths (e.g., lack of economic opportunity, persistent physical, and mental pain) and enhance treatment for drug dependence and overdose rather than focusing on opioid analgesic agents as the cause of harm,” the authors stressed.
The researchers called for a fundamental shift in addiction treatment.
“Heightened demand for diverted and illicit drugs might arise from limiting the supply of prescription opioids under certain conditions,” they wrote. “These unintended consequences may occur if the fundamental causes of demand for opioids are not addressed and if the ability to reverse overdose is expanded without increasing treatment of opioid overdose.
“We believe that policy goals should be shifted from easy solutions (e.g., dose reduction) to more difficult fundamental ones, focusing on improving social conditions that create demand for opioids and other illicit drugs.”