Matt Bivens M.D. is an emergency room doctor who writes a blog. He is angry about how the nation, the drug industry and the medical profession are handling the optoid crisis. Here are the highlights of the first installment of a series he is writing on the topic.
At the turn of the century, about 20,000 people each year would take an opioid — as a pill, or as a snorted or injected powder — and then stop breathing and die. Those of us working on ambulances or in emergency departments (EDs) could not save them.
But for every death, there are about 20 non-fatal overdoses. So, with bag mask ventilation and opioid reversal agents, we have dragged millions of people back to life. How many suffered anoxic brain injuries, and today are mentally a half-step slower? Unknown.
Overdoses at this scale were a new development, and they were occurring hand-in-hand with the aggressive new marketing and prescribing of opioids. This is the era chronicled so well by popular miniseries — “Dopesick” on Hulu, “Painkiller” on Netflix. In the midst of it, the Sackler family-owned Purdue Pharma pled guilty to a deception campaign meticulously designed to bring about recklessly liberal opioid prescribing. As punishment, the company had to shell out $600 million, and three top executives got multi-million-dollar fines and 400 hours of community service.
That should have been peak “Opioid Crisis.” But it was only 2007. Heck, George W. Bush was still president. The Sacklers were never contrite. They’d been raking in about $1 billion a year for more than a decade. The $600 million fine sounded impressive — but the Sacklers shrugged, cut the government in to the tune of less than 5 percent of the cash rolling in, and got right back to slinging opioids. And in the 17 years since, everything has gotten terribly worse.
Did it feel like a catastrophe back in 2007, when 20,000 people a year would die, and people were enraged at Purdue?
Or a decade later, in 2017, when President Donald Trump declared it a national emergency, and 50,000 people a year would die?
That’s nothing. For the past three years, we’ve reliably seen 80,000 people each year take an opioid, stop breathing and die.