20 April 2011

Unhealthful News 110 - NYT manages to report about overdoses without reporting on drug use

To clarify that title, this New York Times article described some of the damage that recreational use of prescription painkillers is causing, focusing on the Appalachian population in the state of Ohio (my own ancestral culture and home state).  The report includes the observation that overdoses have surpassed auto accidents as the leading cause of accidental death in Ohio, a staggering statistic that I had not heard before, but that seems plausible.  But somehow the authors of this and a related piece, also in todays NYT, seem remarkably uncurious about why people are willing to create such risks for themselves and harm to others in order to use OxyContin and such.  And, no, the substitution of the phrase "drug addiction" for "drug use" does not count.

(Aside:  That word substitution is not only knee-jerk rhetoric, but is also a pretty silly non-equivalence.  "Addiction" is a vaguely-defined existential state, not an action.  This makes it rather embarrassing that a reporter, presumably someone trained in proper use of language, would write that people "died from addiction" rather than from overdose or long-term use, but she did.)

The related article was a story about how the Obama administration has introduced a plan to try to further restrict the supply of these drugs.  Isn't it funny how the NYT runs a non-timely feature story about the effects of prescription painkillers on an Ohio community on the same day it reports this proposal?  Well, no, it is not funny or surprising at all given that the NYT news department, along with much of the rest of the U.S. corporate media, generally tries to carry water for whoever is in power in Washington (strangely, the NYT analysts and editorial writers offer a more balanced view than the news reporters).  After all, the NYT led the war drumming and dissemination of disinformation that facilitated the Iraq War.  This does not affect most of the health news since it is not usually related to Washington power politics, but drug use is an obvious exception.

If the press merely decided to conveniently highlight a problem in order to bolster the message that government intervention is warranted, the damage would be limited to over-hyping the problem of the day.  But the reporting implicitly supports the specific policy approach, though it is hopelessly flawed.  The Obama plan is a simplistic attempt to raise the street price of the drug (which is to say, make the supply chain less efficient – they are basically the same thing) by imposing mandatory training before a medic is allowed prescribe it.  This would likely have a trivial effect, given that someone in the business of supplying these drugs for recreational use, as enough medical clinics are, is probably already quite familiar with the intended lessons on how to "unmask patients feigning pain to get drugs they then abuse".  Indeed, they probably consider such knowledge to be central to their business model.  At most, the plan would restrict supply a bit, driving up prices, and thereby creating more incentive for blatant prescription mills and the pure black market, and for the associated violence whose toll the NYT article laments.  This concern, however, was absent from both articles.

Great plan, Obama.  Great reporting, NYT.  This might seem to be surprising behavior from these particular factions, but as I have noted before, the madness of the American Drug War seems to come more from what is thought of as the political left.

Starkly absent from the discussion, as I allude to in my title, was any acknowledgment of why someone might want to use these drugs.  There was no mention of their benefits or appeal, nor even of the sense of pessimism in that community that would lead to drug use that hardly even seems beneficial.  There was no apparent awareness that serious reduction in use requires demand-side interventions.  Curtailing supply when people are willing to kill for these drugs, as the NYT report described, will lead to more acts of desperation as well as switching to equally dangerous drugs.  Of course, dealing with the big picture would require Obama or the NYT to stand up to the oligarchs and call for a serious economic stimulus plan and other interventions that would provide hope for the nation's working class.  This is just not going to happen.  Another solution to some of the problems would be to try to encourage the substitution of other drugs that offer some of the benefits but with little overdose potential and less of the behavior that is attributed to addiction.  It seems like the most promising intervention would be to shift the cultural norms from pain pills (and that other scourge of middle-American, methamphetamine) to cannabis and other low-risk drugs.  Of course, promoting sensible drug use is even less likely to happen than a stimulus plan.

Also not mentioned in the articles are the many people who "abuse" these drugs to relieve chronic pain – which is to say, they use the drugs as designed, and with good reason, but without Big Brother writing an Official Permission-Slip.  There will always be a black market for these drugs, even if the authorities shut down the gray market prescriptions, because they are so valuable to some people who cannot otherwise get them.  Most other recreational drugs, excepting heroin, are no substitute for pain killers when someone suffers terrible pain but anti-drug madness prevents them from receiving enough treatment legally.  Of course, it would be nice if someone could develop highly-effective pain killers that were not so "addictive", but something is better than nothing.

It would also be nice if we had a press corps that: would avoid writing stories about the human condition without actually communicating with the humans at the center of the story (no actual drug users were troubled with a request for a interview in the making of this article); does not assume that proposed laws are a good idea and will accomplish what is promised just because some guy who wears a suit said so (hint: if the guy in the suit reports to the person who proposed the policy, or actually is that person, then he has a bit of a conflict of interest when assessing it); and is not willing to accept that the solution to any major problem is to just tell all those clueless idiots to quit doing what they are doing (because, of course, no one would ever do anything that hurt themselves and spilled over onto others, except out of ignorance).

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