"Breaking the Mold: Rethinking Strategies in the Opioid Epidemic"
The first link from the CDC should not surprise us. The death rates from drug overdoses are climbing, largely due to fentanyl. We have no viable strategy to reduce and ultimately end the opioid epidemic. The ‘weapons’ we are deploying are woefully inadequate.
What are we doing? Aggressively distributing naloxone kits to reverse opioid-induced overdoses. There are companies marketing higher potency naloxone, and yes, Purdue, the company that marketed Oxycontin and triggered the opioid epidemic has introduced a third medication to reverse an opioid overdose. The medication is Nalmefene, the third ‘opioid’ in the class called opioid antagonists. The other two being naloxone and naltrexone. Opioid antagonists are classified as ‘opioids’, but they are non-addicting and pharmacologically, the polar opposite of opioids like heroin, fentanyl, oxycodone, methadone etc.
The other measures talked about and covered in the press are safe injection site for users to bring their own drugs and inject in a facility supervised by staff. There is nothing wrong with proposing these measures, but they are woefully inadequate and likely to trigger a strong NIBY (not in my backyard) response from the community.
The next link is a clip from a British TV channel about the fentanyl crisis in Baltimore. Every big city has this problem. Frustrated politicians are suggesting sending US troops to Mexico to destroy the fentanyl labs in Mexico!! The DEA, CIA and other agencies are aggressively monitoring the operations and so far with little success.
We have a highly broad-spectrum opioid antagonist that will prevent every known opioid from binding with the opiate receptor in the brain and protecting the patients from accidentally or impulsively overdosing. Most overdoses occur accidentally. Patients may not know the drug they are using is laced with fentanyl. Naltrexone overcomes the limitations of naloxone. Naloxone can only be administered after an overdose has occurred and by a person other than the patients. One single pill of naltrexone protects the opiate receptors for a 24-hour period.
Where are the investigative reporters from national newspapers like the WSJ, NYT, Washington Posts and magazines like the Economist, Politico, Vox. STAT and many others. Why are the investigative reports so reluctant to talk to experts who use naltrexone as a distinct prevention option. Do they really believe that the opioid epidemic can be ended with the present strategy? It has not worked for the last twenty years!
We have exactly five medications to fight the opioid epidemic. Naloxone and Nalmefene to reverse an opioid overdose; buprenorphine and methadone to treat opioid addiction and naltrexone to prevent relapse to opioid use. The widespread deployment of naltrexone as a prevention strategy is more viable than sending US troops into Mexico. I hope our politicians and policy wonks rethink their strategy.
Percy Menzies, M. Pharm.
Assisted Recovery Centers of America (ARCA)
1585 Woodlake Drive
St Louis, MO 63017