Only officials drunk on alcohol money would call opioids the 'biggest health crisis'

The maker of OxyContin, Purdue Pharma, and the company’s controlling Sackler family agreed March 26 to pay $270 million to settle an Oklahoma lawsuit claiming they helped create the opioid crisis with aggressive marketing of the painkiller. “The $270 million is less than what the lawyering would have cost Purdue. The did the 'right' thing,” says author Scott Stevens.

This is the first settlement emerging from wave of nearly 2,000 lawsuits against Purdue threatening to push the company a bankruptcy safe-haven, says the author of Look What Dragged the Cat In: The Rise of an Opioid Crisis. In the book, presented in hardcover at academic conferences in Europe in 2018 and now available in e-book, Stevens demonstrates how the neither the drugmaker – nor doctors – are to blame in the 'ab irato' lawsuits. “Are their hands clean? No. But they didn't create this crisis, or the two it's spawned (benzodiazepines and methamphetamine),” according to Stevens.

Oklahoma Attorney General Mike Hunter announced the settlement, calling the crisis “this nightmarish epidemic” and “the worst public health crisis in our state and nation we’ve ever seen.” Stevens responds, “First, the death toll from opioids in Oklahoma is about 400. They're all tragic. No question. Alcohol kills at least 1,300 a year in that state. If opioids are an epidemic, alcohol is a pandemic that costs their state $4.5 billion a year, and the U.S. 90,000 lives and $250 billion a year.” His numbers are according to the Centers for Disease Control and Prevention (CDC). “We don't call out the real problem because the alcohol business is an an advertiser, a campaign contributor, and an adored and endorsed part of our culture.”

The fifth book by Wisconsin author, Scott Stevens, calls out the beverage alcohol business and a 'buzz' culture, not pharmaceutical companies and doctors, as the culprits behind the opioid crisis. Stevens says, “If you examine how many opioid-related deaths are alcohol-related, the answer is that they all are. Two thirds of illicit drug users point to alcohol as their first drug, and all of us learn to self-prescribe from alcohol.”

The book was released Aug. 23, 2018 at the International Conference on Addiction Therapy & Clinical Reports in Paris, France, capping two-years of research by the author into the escalation of opioid overdoses. “It's the same root cause of every drug 'crisis' we've observed. Cocaine in the 1980s, heroin again in the 1970s and before that the 1920s, and between the two prior heroin crises, a methamphetamine crisis in the 1950s,” says Stevens. “The thread cinching all of them together is alcohol: The drug we don't call a drug or treat as the deadly drug it is. We encourage use of this drug, then when users can't get where they want with alcohol, they up the ante with other, harder drugs. No runner runs a marathon as their first race out.”

The book examines the self-regulation of alcohol-industry ads, the pricing, and availability of alcohol. “There really is a straight-line relationship between the opioid crisis with the gateway drug, alcohol.”

The World Congress on Addiction Science in London in Sept. 2018, as well as the 2018 International Conference on Clinical Psychology in Amsterdam, also were forums for launch of Stevens' work. He's now doing radio and conferences in support of the e-book launch of the book March 26.

Stevens has no ties to the pharmaceutical industry, nor does he practice medicine, yet he finds only moderate culpability for either profession in the rise of the opioid situation. “They were accomplices to some degree, but we fail to look deeper. What causes problems is one. We just have this fear of tagging the alcohol business because of our glorification of drinking.” The book points out that society also has a notion that anything resembling reining in the alcohol business looks like Prohibition, generally considered a failure. Americans also don't 'want to believe alcohol is a drug or a problem outside of car wrecks, cirrhosis, and disease of alcoholism. “We're told we can drink responsibly when there is no responsible way to drink a toxin and known carcinogen. Buying into the glamour of the drug seduced Americans right into opioids.”

Americans defend the gateway drug, says the author. Among his solutions is a strategy like the anti-smoking campaign that began with the Master Settlement Agreement for tobacco companies in the 1990s. “We defend drinking as some sort of rite. All we're doing by guarding drinking as a personal choice is sacrificing our own children for a product with zero life-extending or life-saving properties.”


Stevens is author of five alcohol, health, and recovery books and is principal of alcohologist.com. He is a founding influencer of the world’s largest medical portal, healthtap.com. He Chaired the 2018 International Conference on Addiction Therapy and Clinical Reports in Paris, France, where Look What Dragged the Cat In was officially launched. He's also the Chair for Addiction Science 2018, in London, UK.

Image byTom Baker, used with permission.

Look What Dragged the Cat In: The rise of an opioid crisis

Excerpted from the 2018 USA Best Book Winner, Look What Dragged the Cat In.

The decade of the 2010’s shelled hospitals and first responders with an explosion of opioid-related illness, injury, and death. Preventable drug overdoses tallied 54,793 lives lost in 2016 – an increase of 391 percent since 1999. Accidental drug overdose deaths increased 327 percent over the same period. The majority of OD deaths (38,000) involve opioids, The drug category most frequently involved in opioid overdoses and growing at the fastest pace includes fentanyl, fentanyl analogs, and tramadol. The fentanyl category of opioids accounted for nearly half of opioid-related deaths. The dirty cat in the litter, heroin, accounted for the second highest number of deaths, claiming 14,606 lives.

America struggles with what the opioid cat dragged in: Hard-to-treat opioid addictions, fatal relapses, and needless loss of mainly young lives. Now legislators, first responders, treatment pros, and those in the medical field are forced to focus not on the death toll the cat dragged in, but instead what dragged the cat in.

Every opioid related death is alcohol related

The abuse of drugs, regardless of classification, begins with the permissiveness granted the world’s most lethal drug and third-leading cause of all preventable deaths: Alcohol. It’s a straight line.

Nearly every non-Muslim civilization on this rock has embraced alcohol. As a result, ours is largely a numbing planet, especially in the sedation-happy Americas. This is the root. This is the seed of the opium trade that has gone unstemmed since prehistory. There is legit medical use for opium derivatives: What has driven growth is demand – not by the sick but by people who cannot get the mind alteration they desire through alcohol use alone.

Alcoholics and non-alcoholics alike drink the first drink for the same reason: To relieve a stress. In the U.S., which has a laissez faire agenda toward alcohol since its prohibition failure, the culture embraces a drinking lifestyle. Americans normalize alcohol use. In other words, Americans (like many cultures) normalize drug use. The 1960’s have nothin’ on the 2010’s.

What you ignore, you permit. What you permit, you condone.

Opioid abuse happens when a person can’t get where they want to get with alcohol. The opioid crisis wasn’t created by doctors overprescribing, manufacturers wooing doctors, China shipping heroin and cheaper fentanyl via cartels and the U.S. mail. Drinking, especially binge drinking, is the pandemic that dragged in the opioid ‘epidemic.’ Americans condone the buzz, the sedation. We created this monster on our own.

What’s the way out?

Legislative attempts to curb use of potentially lethal drugs resemble shooting an arrow and then drawing a target around where it hit. Locking up dealers and traffickers, creating prescription databases and prescribing limits, and promoting Narcan availability all deal with control of the supply and its aftermath. The demand is unchanged. Within a cultural adoration of the buzz, our current crisis can only be curbed by control of the demand. If a drug user wants a drug, theywill get that drug. It’s the American freedom thing.

In 1967, 72 percent of adult men smoked. Today, 72 percent don’t. Prevention works. If there is genuine interest in healthy outcomes and preventing premature death from opioids, Americans’ permissiveness of the starter or feeder or gateway or predecessor drug has to be addressed on five levels to reduce demand for all antecessor drugs.

• Advertising agencies court alcohol manufacturers with a promise of creating demand for the drug. You can ban advertising without banning the product. When cigarette marketing/advertising was banned, demand dropped without banning the product. The National Bureau of Economic Research (NBER) studied bans in 20 countries over 26 years. The results indicate that an increase of one ban could reduce alcohol consumption by five to eight percent.

• Public drinking encourages drug use. Smoke-free regs cut down on the demand by curtailing where cigarettes can be smoked. Applying the same model for drinking – instead of popping up a brew pub on every corner – can reduce demand. The idea of having a cocaine bar on every corner is absurd, but a pub peddling a drug that kills more people (89,000 Americans per year) is somehow acceptable. The availability of alcohol can be regulated either through restricting the hours or days it can be sold or by reducing the number of alcohol retail outlets, according the a World Health Organization (WHO) study. Logicaly, reduced sales hours have been found to be effective in lowering consumption. In the former Soviet union in the mid-1980s, strict alcohol regulation, which included among other measures restricted hours and fewer outlets, led to a dramatic reduction.

• The ‘Smoking Stinks’ campaign brought an anti-smoking message down to the earliest grades. A modest effort to create similar anti-drinking messages demonstrating health risks of even moderate use (see viewbook.at/prehab) will stunt demand by discouraging the very first drink of the gateway drug.The American Journal of Public Health analysis of the anti-smoking campaign suggests that per capita consumption would have been one-fifth to one-third larger than it actually is, had the years of anti-smoking publicity never materialized.

• Increase the tax on the gateway drug. The bottom line is that many states and municipalities balance their bottom lines with so-called ‘sin taxes.’ The sin taxes on alcohol haven’t kept pace with inflation. These taxes are usually based on the amount of beverage purchased (not on the sales price), so their effects can erode over time due to inflation if they are not adjusted regularly. The Community Preventive Services Task Force (CPSTF) recommends increasing taxes on the sale of alcoholic beverages, on the basis of strong evidence of the effectiveness of this policy in reducing excessive alcohol consumption and related harms. Opioid use is a related harm. The CPSTF is an independent, non-federal panel of public health and prevention experts that provides evidence-based findings and recommendations about community preventive services, programs, and other interventions aimed at improving population health.

• Many will argue that legalizing recreational use of marijuana will reduce opioid abuse and erroneously point to Colorado as an example. (By the Center for Disease Control and Prevention’s (CDC) numbers, you can call BS: Colorado’s death rate from opioid overdose is barely in the top half of the state-by-state death-rate comparison … if you wanted to complete the morbid, pointless comparison. One death is too many.) What’s entirely missing from the debate is that no evidence exists that encouraging recreational use of another drug furthers public health in general. Marijuana is revenue-neutral when you subtract societal, medical, and legal costs.

When we rethink the drink we can douse the pandemic that begat the current opioid crisis. Legislators and treatment experts must lead the transition from managing aftermaths of the current crisis to prevention of the next one. And phase out the ancient alcohol crisis – the elephant in the room – America ignores.

Stevens is author of four alcohol, health, and recovery books and is principal of alcohologist.com. He is a founding influencer of the world’s largest medical portal, healthtap.com. He will Chair the 2018 International Conference on Addiction Therapy and Clinical Reports in Paris, France.

The A-Files, Alcohol A-Z for Alcohol Awareness Month: Overdose

(see video in online video/article)

Twenty-six episodes of 'The A-Files' air throughout Alcohol Awareness Month on YouTube, Facebook, LinkedIn, Alcohologist.com and AddictedMinds.com, among other web and social media sites. Episode O looks at overdose. There are two types of overdose concerns with alcohol. The first is an overdose with the drug, alcohol, the second is a fatal drug interaction with other drugs, including prescription and over the counter remedies. Neither has a warning sign except what you're getting now.

Alcohol is a central nervous system depressant drug. Several times each year the news headlines capture the tragedy of a binge episode death. A teen, a college student, an otherwise productive and smart adult will go down a path of dangerously high consumption. Six people die every day from drinking too much, too fast, shutting down the central nervous system. Three of four are men, three of four are between the ages of 35 and 64 according to the Centers for Disease Control and Prevention (CDC). These are poisoning deaths, not death from the disease of alcoholism.

Impairment from intoxication begins at a blood alcohol concentration of .02. That's the first drink. Intoxication escalates from there… with .08 the legal limit permitted for driving in the U.S. Commonly, charts peg the pass out dosage of alcohol between .02 and .03 BAC and death as likely at .40. The fact is, it can happen lower or higher than that, depending upon the person's general health and tolerance. Singer Amy Winehouse died at .04, a college student in Arizona recently died at .032, I've been in the E.R. with a BAC of .612 and survived. You simply won't know which drink puts you in a coffin until you take it.

The other side of the equation, which can happen at dramatically lower levels of intoxication, is overdose from combining alcohol with other drugs. Even moderate drinking has the potential to interfere with 210 commonly used meds. Many popular pain medications -- and cough, cold, and allergy medications -- contain more than one ingredient that can adversely interact with alcohol (see related story). Alcohol interactions range from nausea and vomiting and dizziness; to irreversible – and potentially fatal – internal bleeding, liver and heart damage. One of the most common causes of severe liver damage is a combination with acetaminophen, available over the counter as Tylenol. Other serious alcohol interactions are associated with herbal remedies such as St. John's wort, valerian and lavender. Alcohol IS a drug, fatal on its own or in combination with other ones.
The entire 26 episode HD series is available on disc, along with fact sheets, for helping professions. See the preorder special at tr.im/AFiles

Visit alcohologist.com for a replay of CBS Sports' Power Up Your Health featuring Scott Stevens.  Another interview is on Alcohol Awareness.  Syndicated radio program Savvy Central Radio did this interview, too. Lucy Pireel's "All That's Written" included a feature called "When alcohol doesn't work for you anymore."  Details on the third literary award for Every Silver Lining Has a Cloud and the first for Adding Fire to the Fuel also can be found on www.alcohologist.com. Download the FREE Alcohology app in the Google PlayStore today. Stevens also is the public relations officer with AddictedMinds.com 

Philip Seymour Hoffman's three lessons for those of us who aren't celebs

Academy Award winner Philip Seymour Hoffman died from apparent heroin overdose Feb.2, according to updated reports in the New York Times. Hoffman spoke candidly over the years about past struggles with drug addiction. His passing packs three valuable messages to counter the over-the-top behavior of pop-music teen star Justin Bieber for a generation of abusers of alcohol and other drugs.

1. Addiction is the only disease that convinces you that you don't have it. Regardless of how long the disease is in remission, without vigilance, it will convince a drinker or drug user he “can handle it” of “have just one.” Twelve-step groups refer to it as the “cunning, baffling and powerful” nature of substance use disorders. Control is an illusion.

2. There is treatment, but no cure, for addiction and the disease of alcoholism. Hoffman sought treatment at least two times. In 2006, he said in an interview with CBS-TV's “60 Minutes” that he had given up drugs and alcohol many years earlier, when he was 22. Last year he checked into a rehabilitation program for about 10 days after a reliance on prescription pills resulted in his turning again to heroin.

Hoffman died in a relapse. He had 23 years of continuous sobriety. He was sober longer than Bieber has been alive. Then the addiction and urge to use became more important than anything else in his life. Within a year he was dead.

3. Drugs – and alcohol is a drug – do not discriminate. They can kill, regardless of social status, religion, career, education, bank account, genes, tolerance, gender, size, race, ethnicity or marriage. And it isn't glamorous.

Hoffman died like many drug users. Alone. Discovered by a friend who found his body in the apartment and phoned police. FoxNews.com reports authorities are investigating whether Hoffman received a more potent type of heroin that's being blamed for numerous deaths over the past two weeks, first in the Pittsburgh area and later along the east coast. The substance combines heroin and fentanyl, an opiate used to soothe the pain of cancer patients, and is being blamed for dozens of deaths across the country. Average people. Not celebs.

Ego makes a person say, “That can't happen to me.” Hoffman's death is a tragic reminder that “Oh, yes it can.”
-- from examiner.com (see full article)