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.

How others' alcohol use became your business: The Toxin-omics

Drinking is 'The American Way,' 'How We Roll,' 'Harmless Fun,' or just 'None of Your Damn Business.' Just ask a drinker. He or she doesn't even need to have the disease of alcoholism: You attempt to get between a person and the beverage of choice and you'll hear defense. The defense is offensive when you know the economics of the toxin and drug alcohol.

The economic impact of drinking – casual drinking and alcoholic use – tallies an eye-popping $250 billion every single year in the U.S. By way of comparison, smoking costs the economy $173 billion… all other drugs combined cost the economy $130 billion. A 2011 study in the Journal of the National Cancer Institute determined the cost of all cancer care in the U.S. totaled $124.5 billion in 2010 … half as large as the alcohol toll. How big is the we-don't-have-a-problem alcohol problem, by the numbers?

• That's enough to buy a 48 inch HDTV for every man, woman and child in the U.S. And an X-Box. Every year.
• Two-hundred-fifty billion dollars is the same as the annual expenditure on fashion and apparel in the entire U.S.
• The Treasury in 2008 bailed out the banks with a $250 billion “investment” that created critical echoing still heard in the 2016 Presidential campaign and brought hundreds of 99 Percenters camping in Wall Street. That was just a one year expense.
• For the ubersmart Keynesian economists out there, $250 billion is a NEGATIVE GDP (gross domestic product) value of $74 billion. (For those of us less-smart: Alcohol shrinks the economy the way it shrinks libido.)
• For the 216 world economies tracked in the CIA World Factbook, $250 billion is bigger than the 40th largest economy on the planet, and bigger than the output of the bottom one-third of countries COMBINED. 

The costs are in healthcare, lost productivity, legal and corrections costs. Alcoholism is part of the total, but $250 billion is driven by all drinking, even social or moderate use. The CDC readily admits the $250 billion is on the low side, too. The researchers believe that the study still underestimates the cost of excessive drinking because information on alcohol is often underreported or unavailable, and the study did not include other costs, such as pain and suffering due to alcohol-related injuries and diseases.

Alcohol revenue does not cover alcohol economic damage
The monetary consequences are something everyone shares: Drinkers and non-drinkers alike. The numbers get complicated, because the drug Americans enjoy and defend so vigorously, also costs the most in health and hard dollars. Each drink consumed has a median cost of $2.05 in economic harm (lost productivity, health care costs, property damage and criminal justice system expenses). That's according to the Centers for Disease Control and Prevention (CDC). So the drinker pays for that in alcohol tax, right? No. The median paid in tax per drink is less than a nickel a drink. The Tax Policy Center estimates that state and local taxes on alcoholic beverages bring in about $6 billion in revenue nationwide. The overall economic benefit from the manufacture and distribution is less than a quarter per drink.

Industry watchdog, Alcohol Justice, suggests closing the gap between tax revenue and the economic damage, which may also reduce use. According to Alcohol Justice's Charge for Harm Campaign, "Big Alcohol produces, sells, and promotes products that cause harm and incur costs - to both government and its citizens. Appropriately taxing alcohol at state and federal levels will help reduce related harm and provide needed funds. We support state and federal increases in alcohol taxes and fees."
Even if drinkers bore the full $2.05, everyone else still pays in lost productivity. Show up late, never, hungover or just without your A-game and someone has to step in or step up. It doesn't always happen that way. Which costs the company. So the company charges more for its goods or services. Lost productivity, according to the National Institutes of Health (NIH) is more than 70 percent of the $250 billion annual cost of alcohol use in the United States. Every shopper pays… no matter if we shop Walmart or Macy's.

This is the part of the revenue formula pro-alcohol forces leave out of the dialogue when pushing for more beverage licenses, longer hours of service, and absurd ideas like selling alcohol at college sports venues. With greater access to alcohol, the revenue does go up in a bar, store, or restaurant. But so does the economic damage. And never the twain shall meet.

Need a hospital bed? Wait. And pay more.
Here's another way to look at the economic harm. There is an alcohol-related hospital admission every 30 seconds and, according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA) 20-40 percent of general use (non-specialty) hospital beds are used to tend to alcohol-related complications. Heroin addicts aren't breaking the healthcare system. Aging Baby Boomers aren't pushing it past capacity. Alcohol use is drowning it.

Health care costs related to alcohol use are not limited to the drinker. There are unintended – and sober – victims in traffic crashes you've no doubt heard about from the impaired driving activists, Mothers Against Drunk Driving (MADD). However, children of alcoholics who are admitted to the hospital average 62 percent more hospital days and 29 percent longer stays according to the Children of Alcoholics Foundation.

Nested inside of every major cause of death in the U.S. is the fact that alcohol use is a contributing factor to each of those causes of death or hospitalization. Alcohol is a carcinogen, for example. It is the second-leading cause of oral cancers and is the only dietary connection ever made to an increased risk of breast cancer. The Agency for Healthcare Research and Quality (AHRQ) estimated the price of cancer care for one year of life increased to $207,000 in 2013.

Heart disease, not cirrhosis, is the leading killer related to drinking. Annually, about one in every six U.S. healthcare dollars is spent on cardiovascular disease. By 2030, annual direct medical costs associated with cardiovascular diseases are projected to rise to more than $818 billion, while lost productivity costs could exceed $275 billion. What is the preventative measure hiding in plain sight? Stopping drinking. About 1 in 3 adults—or approximately 86 million people—have at least one type of cardiovascular disease, which means many more Americans could die from what is often preventable through lifestyle changes or managing medical conditions. There are 1.5 million heart attacks and strokes in the U.S. annually. One in five strokes is alcohol-related. One dollar spent on alcohol education (e.g. abstinence) saves $4 in healthcare costs down the road. (Plus $7 in criminal justice system costs for good measure.)

Bottom line: We ALL pay
The healtcare cost equation under mandated insurance means part of every insurance policy premium is gobbled up to care for alcohol-related problems. An insured person doesn't have an account from which he or she dips. Insurance premiums are pooled. You can be a non-drinker… your own premium will be lower because of your relationship with alcohol… but your premium will still reflect the experience of the insurance pool. With insurance mandatory, and 67 to 70 percent of adults using alcohol in the past year, there is a majority of your insurance dollar used to mitigate the expense of drinking.

Binge drinking alone – four or more drinks per occasion for a woman and five or more drinks for a man – accounts for more than 75 percent of costs related to excessive alcohol use in all states, just under $171 billion. Binge drinking is reported by about 18 percent of adults in America. (Wager that the self-reported binge drinking number is MUCH higher, people aren't typically honest about their answer to the non-of-your-damn-business question.) According to the CDC. binge drinkers and their families paid less than half of the costs associated with high alcohol use (41.5 percent) while federal, state and local governments paid about 42 percent, or more than $94 billion, of the costs.

The government doesn't have a separate checkbook funded by drinkers or beverage companies to pay for this: It uses your checkbook.

Visit www.alcohologist.com for more on the health and economic costs of drinking a toxin and known carcinogen. And order The A-Files: Alcohol A-Z for what alcohol does TO you, not FOR you. I Can't See The Forest With All These Damn Trees In The Way is now available in paperback.

Yahoo! I heard another internet alcohol & health lie!

A ridiculous, and dangerous, piece of fiction emerges from cherry-picking observational studies. In that pursuit, anyone can find support for smoking, alcohol use, or use of any other drug. However, the evidence-based science demonstrates ZERO health benefit to even moderate use of a toxin and known carcinogen. (READ THE DELICIOUS PIECE OF FACT-MANUFACTURING YAHOO! UK IS PEDDLING)

Aside from the fact that daily drinking is one of several indicators of the disease of alcoholism, there is no health benefit to drinking any amount, at any age, for either gender. Spend 52 min. with The A-Filesif you want to find out what this drug does TO you, instead of this fiction of what it does FOR you.

For example, Women... this is the ONLY dietary factor shown to increase risk of breast cancer. Each drink daily (10g of alcohol) increases risk by 11 percent. More than four a day brings the same risk as smoking a pack of cigs a day. It's the #2 cause of oral cancers. Was cancer intentionally left from this article? Probably... because alcohol causes eight types of cancer. “The relationship between alcohol and cancer is not widely appreciated by the public and remains underemphasized even by physicians. When it comes to cancer, there is no safe level of alcohol consumption.” American Journal of Public Health Feb. 2014

The heart health myth was discredited more than a decade ago. It causes pre-diabetes, a precursor to type 2… it doesn’t reduce the risk as observational studies claim. Additionally, one in five strokes is alcohol-related. The risk of stroke is both long-term and short-term. In fact, stroke risk increases instantly and remains elevated for two hours after consuming alcohol. There are also consequences for liver, brain, pancreas. More than 60 diseases are caused by even "moderate" use of alcohol and it is the third-leading cause of preventable death and illness in the U.S. and U.K.. This dandy dietary tip just could kill someone.

The immune system is sacked by even moderate use: That's basic bioscience, not the junk science in this pro-alcohol piece. Sex problems linger even a year after complete abstinence (http://www.examiner.com/article/sex-problems-last-a-year-after-heavy-drinking-stops-according-to-new-study) and an older 2007 study -- evidence-based -- notes a falloff in sex drive with regular moderate use. And life expectancy? Jeez. The CDC notes a reduction of life expectancy 18 months (moderate use) to 20 years (heavy use).

Get evidence-based facts before succombing to Yahoo!'s dangerous and irresponsible article.

The entire 26 episode HD The A-Files: Alcohol A-Z series is available on disc, along with fact sheets, for helping professions. 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 

Wag the dog: Time to change alcohol education

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