Despite an increasing trail of bread crumbs between Russia and the Trump campaign to rig the 2016 election, it was much more probable in hindsight that his upset election was due to the same factors contributing to the opioid crisis.
Recent studies by the Centers for Disease Control and Prevention have shown a lowering of the U.S. life expectancy, and they attribute this reduction to despair and misery leading to abuse of opioids. This was especially the case in the industrialized Midwest areas and Ohio and Pennsylvania where Donald Trump surprised polling experts. While this was not-so-well publicized in 2016 and the data may have been somewhat unreported, this endemic use of opioids certainly existed. This era is well characterized in several novels by David Baldacci, most recently “The Fallen.”
Trump’s keen salesman’s ear may have picked this trend up, or he may just have been lucky. His hard hitting and trumpeted message to bring back manufacturing jobs to the Midwest resonated, and his doubling down technique made it a highly effective and eventually winning sales strategy.
To Trump’s credit, he did try hard to keep and bring in new manufacturing jobs. Perhaps his “tariff trade war” with China was motivated to bring back jobs. And the national job scenario is looking good. On the other hand, the 2017 Tax Reform, which passes a large majority of the wealth to the top 1 percent, makes the wealth distribution significantly more unbalanced.
Pennsylvania is my native state, and I grew up when jobs were plentiful. I elected to attend college, yet all of my classmates from high school got good jobs. Now it’s different. Pennsylvania was selected by former New York City Mayor Michael Bloomberg in November to do a three-year pilot study, receiving $50 million, to evaluate alternative treatment strategies. This could add as many as 10 additional states. The Bloomberg press release stated 2 million Americans are addicted to opioids. I salute Bloomberg for his efforts.
“States will have broad latitude in the three-year period to decide how to prioritize interventions, with support tailored to specific approaches. For example, if a state decides to emphasize emergency and long-term treatment, experts could assist in implementing plans to expand the use and availability of naloxone and expand the use of medication-assisted treatment such as buprenorphine in jails and hospitals to treat inmates and patients with substance use disorder,” according to the release.
Nobody likes pain, including me. I used to suffer from pancreatitis which is supposed to top the pain charts, but it only lasted for a day or two. Fortunately, lifestyle adjustments have fixed the problem. I really sympathize with folks who suffer from chronic and lasting pain. But in reality, much of the opioid problem comes down to people with emotional issues, a problematic future with no jobs, and just a bleak future in a depressed area. The oxycodone manufacturer (there are other drugs, but oxycodone seems most numerous) doesn’t know — or probably even care —who the end-use recipient is. It could equally be a terminal cancer patient or a despondent unemployed worker.
There is also the “chicken or the egg” concern. Highlighting pharmaceuticals as a causal factor — studies have shown 80 percent of opioid addicts get started on prescription drugs — there is a risk that prescription over-enforcement encourages users to switch to street drugs, e.g. heroin, often laced with deadly fentanyl.
I have done some volunteer fund raising for a clinic in Westminster, and I’m very impressed with their endeavor (which has resulted in awards). There was a recent letter in the Times regarding a clinic in Taneytown. I had a casual chat with a clinic director from central Pennsylvania on a recent vacation, and it’s clear to me that they know full well the problems in treatment.
Although I spent much of my career as a health risk expert, I’ll offer a suggestion from a neophyte on this sticky opioid problem. Since we are so close to Pennsylvania and the Bloomberg School of Public Health is in Baltimore, why doesn’t Carroll County leadership reach out to them, attempt to be part of the study and see what transpires? In the meantime, our local and excellent treatment programs can function as they have been so far.
If the Board of County Commissioners want to pursue litigation against opioid manufacturers, that’s fine with me. But I think a two-pronged approach will produce solid results — it may confirm that our programs are OK regarding treatment which I believe is the case — and may also show areas where we can improve. Public trust from all sectors — opioid users and non-users — is one key to addressing this large and increasingly serious and continuously evolving problem.