By John Ubaldi
Columnist, In Homeland Security
The opioid crisis that has hit all corners of the United States in recent years has the potential to become a national security threat beyond anything America has experienced from a foreign power.
A report from the Centers for Disease Control and Prevention (CDC) said an estimated 1.7 million individuals suffered from some form of substance abuse disorder in 2017. The result was 47,600 fatalities due to opioids. According to the U.S. Department of Health & Human Services (HHS), more than 130 people died each day in 2016 and 2017 from opioid-related drug overdoses.
The Beginning of the Opioid Crisis
The opioid crisis began in the early 1990s with a sharp increase in the prescribing of opioid and opioid-combination medications for the treatment of various pain aliments, including cancer. Additionally, the use of opioid medications in the treatment of non-cancer illnesses increased. By the end of the 1990s, 86 percent of all opioid pain medication users were non-cancer patients.
As a precaution, medical practitioners began making opioids harder to obtain, which forced some people to turn to a cheaper and more easily obtained – and deadly – form of opioid, heroin.
The National Capital Poison Center reported that heroin-related overdose deaths increased by a staggering 286 percent from 2002 to 2013. The report also stated that approximately 80 percent of heroin users admitted to misusing prescription opioids before turning to heroin.
Fentanyl Is Introduced in America
More recently, deadly synthetic opioids like fentanyl have hit America’s streets. Fentanyl is a highly addictive synthetic opioid that is 80 to 100 times stronger than morphine – initially prescribed to patients suffering the effects of pain from cancer.
However, because of the addictiveness of fentanyl, drug cartels and other nefarious groups add it to heroin, which greatly increases its potency. Far too often, individuals who think they have bought heroin have actually bought fentanyl. The result has been thousands of overdose deaths.
One might assume that the high quantities of fentanyl make their way into the U.S. via border crossings from Mexico or Canada. However, a majority of the fentanyl originates in China.
China Is the Largest Distributor of Fentanyl in the US
Without any strict regulation of its pharmaceutical industries, China has become the largest distributor of illegal drugs, exporting raw fentanyl, fentanyl analogs and counterfeit prescription drugs, including oxycodone laced with fentanyl. Some fentanyl arrives in the U.S. from China via the Mexican border, but most of it arrives in the United States mail.
In October 2018, President Trump signed into law the Synthetics Trafficking & Overdose Prevention Act. The new legislation targets a loophole in the global postal system that international criminals have exploited for more than a decade shipping deadly drugs, including fentanyl, into the U.S. without detection.
Packages sent via private carriers must include advance electronic data (AED), which is used by Customs and Border Protection agents to screen for high-risk material. However, shipments sent through the international postal system and delivered by the U.S. Postal Service do not require AED. The Synthetics Trafficking & Overdose Prevention Act mandates AED on all international packaging, including deliveries by USPS.
The CDC recently issued new guidelines on the dispensing of prescription opioids not intended for cancer treatment, palliative care and end-of-life situations. This change aims to make non-opioid drugs the preferred method of treatments for chronic pain, leaving opioid treatment as an option only after a careful analysis and assessment of the patient’s pain followed by frequent follow-up evaluations.
Pharmaceutical Industry Opposes Changes in Opioid Distribution
The pharmaceutical industry’s continued opposition to any change to the prescribing of opioid medications through lobbying and advocacy groups has made it more difficult to prevent the growing proliferation of opioids.
In April, the U.S. Justice Department charged a major pharmaceutical distribution company, Rochester Drug Co-Operative, and two of its executives, former CEO Laurence Doud III and former chief of compliance William Pietruszewski, with conspiracy to distribute controlled narcotics – oxycodone and fentanyl – for non-medical reasons and conspiracy to defraud the United States.
“This prosecution is the first of its kind: executives of a pharmaceutical distributor and the distributor itself have been charged with drug trafficking, trafficking the same drugs that are fueling the opioid epidemic that is ravaging this country,” U.S. Attorney for the Southern District of New York Geoffrey Berman said in a statement. “Our office will do everything in its power to combat this epidemic, from street-level dealers to the executives who illegally distribute drugs from their boardrooms,” Berman added.
On June 3, California Attorney General Xavier Becerra announced that the state was suing Pharma L.P.; Purdue Pharma Inc.; some of Purdue Pharma’s affiliates; and Dr. Richard S. Sackler, former president and board member of Purdue, for allegedly utilizing unlawful practices in the marketing, sale and distribution of opioids.
With the opioid epidemic reaching new heights across the country, it will take a combination of public and private coordination and law enforcement to end the devastation of American communities.