The media loves headlines about the demon drug du jour.
Whether it is crack babies, meth labs, or heroin overdoses, the media loves scare heads that will sell papers and values these far more than accurate reporting which could save lives. This is why every paper is currently running scare heads about a heroin overdose epidemic that is killing people right and left.
There is just one little problem: these stories are misleading, inaccurate, and killing people with misinformation.
The evidence shows that over 90% of so-called opioid overdose deaths are the result of polydrug poisoning. It is relatively difficult to overdose on heroin alone or painkillers alone, although it can be done if you are determined enough. However, mixing heroin with another drug such as alcohol, benzodiazepines, cocaine, or opioid painkillers is extremely deadly.
The mix of opioids with benzodiazepines or alcohol is not simply additive; it is synergistic. The respiratory center in the brain contains both opioid and GABA receptors, and when the opioid receptors are shut down by heroin and the GABA receptors are shut down by alcohol or a benzodiazepine, the result is death.
The news media and television could be saving countless lives every day if they were running non-stop headlines about the dangers of drug mixing, but they are not. They have been bewitched by the myth of the "demon drug" and prefer to run stories inaccurately labeling opioid-related deaths as heroin overdoses instead of accurately reporting them as polydrug poisonings due to drug mixing.
The reason drug mixing is so common is that the current crop of new opioid users simply does not know how dangerous it is. This has not always been the case; as Edward Brecher attests, old time junkies in New York City used to pass on information about drug mixing to each other and they avoided it like the plague it is. If today's opioid users were equally well-informed of the dangers of drug mixing, most would avoid it and countless lives could be saved.
The reason drug mixing is so common is that the current crop of new opioid users simply does not know how dangerous it is.-Kenneth Anderson
Another myth propagated by the press is that only heroin leads to overdose death and that painkiller addiction is dangerous because it is a gateway drug to heroin, which will cause people to overdose and die. In reality, twice as many opioid poisoning deaths in the US involve painkillers as involve heroin. And let me reiterate that whether heroin or a painkiller is involved, over 90% of these deaths involve drug mixing. Figure 1 shows the CDC data for drug poisoning deaths in the US in 2013.
Figure 2 shows the percentage of opioid painkiller overdose deaths involving another drug in 2011 in New York City. As we see from this figure, drug mixing is extremely common in drug poisoning deaths.
Another extremely dangerous and deadly myth spread by the media is the myth of increased drug purity--the so-called "super heroin" as exemplified by this recent story in the New York Post.
The truth is that heroin purity peaked in New York City in 1995 at 70% pure and is only now approaching that level of purity again. But there was no spike in opioid poisoning deaths in New York City in 1995 because there were a lot fewer people mixing drugs and dying in 1995. Drug mixing kills; not drug purity.
The safest heroin is 100% pure prescription heroin which can be obtained at heroin maintenance programs in Europe. When the purity is known then the safe dosage can be calculated. Uncertainty in heroin purity in the US is a contributing factor to opioid poisoning deaths which could be eliminated by prescription heroin as is done in sane countries.
Another huge set of myths spread by the media which are exacerbating the polydrug poisoning epidemic in the US are myths about effective and ineffective treatments. The evidence is resoundingly and unequivocally in favor of the following strategies for preventing drug poisoning deaths:
- Overdose prevention training
- Narcan/naloxone distribution
- Safe injection facilities
- Maintenance with methadone or Suboxone/buprenorphine
- Heroin maintenance
Although the above strategies are all proven effective, the media either condemns them wholeheartedly or claims that they are somehow controversial. The media also promotes the myths that 28-day 12-step rehabs and NA meetings are effective at curing addiction and that no one can recover from addiction without treatment and AA/NA - that untreated addiction is 100% fatal. This, of course, is belied by every scientific epidemiological study such as NESARC which shows that the vast majority of people who kick an addiction do it on their own without rehab ad without the 12-steps.
Methadone has been studied now for over 50 years and it is thoroughly established that methadone maintenance reduces death rates to one fourth of those of active heroin users. Maintenance treatment with methadone or Suboxone is the gold standard for treating opioid dependence. Patients on the proper dosage of maintenance medications are neither high nor sick - they are normal and functional.
The media is even blaming the Charleston shootings by Dylann Roof on Suboxone, which makes about as much sense as blaming Dillinger's bank robberies on his cigarette habit.-Kenneth AndersonI have literally hundreds of friends who are employed and living normal lives thanks to methadone. But what does the media tell us about maintenance treatment? On King of the Hill Season 2 Episode 19, we see that methadone makes people loaded out of their minds and too high to function at work. Dr. Drew tells us that methadone and Suboxone are drugs of abuse, that they are not acceptable options for the treatment of opioid dependence, and that "Methadone just takes your soul away. It’s no way to live."
The media is even blaming the Charleston shootings by Dylann Roof on Suboxone, which makes about as much sense as blaming Dillinger's bank robberies on his cigarette habit. The media ought to be running stories on how many lives are saved and how many people are rehabilitated by the lifesaving medications methadone and Suboxone.
However, the media prefers to give us tales of lives saved by 12-step rehabs and 12-step NA meetings like Sandra Bullock in 28 Days. Script writers have magic powers to make fantasy appear to be reality, to make a house fall on the Wicked Witch of the West, to empower Mickey Mouse to give life to inanimate brooms, or to imbue rehab programs with great success rates. However, the reality does not match the fiction.
The research shows us that graduates of 28 day abstinence-based rehabs are over 30 times more likely to die of heroin-related drug poisoning (so-called "overdose") than untreated heroin addicts continuing to use on the streets. This was the kind of rehab Dr. Drew was running on television where he killed five of his patients. Odds are that if Dr. Drew had maintained these patients on methadone instead of telling them to surrender to a "Higher Power" every single one would still be alive.
Narcotics Anonymous has its own share of blame to shoulder for perpetuating and exacerbating the epidemic of drug poisoning deaths. The Narcotics Anonymous position statement on methadone says that anyone on this life-saving medication is an active addict who is still using and is ineligible for membership unless they express a desire to get off the medication that is saving their lives. NA tells people on methadone that they should not share at meetings lest they contaminate those who are actually "clean," but that they should just shut up and listen.
…in spite of all the NA meetings people have been coerced into attending the number of opioid poisoning deaths still continues to grow each year.-Kenneth AndersonHow many people has NA killed with these shaming tactics and its desire to practice medicine without a license? Well let's put it this way - in spite of all the NA meetings people have been coerced into attending the number of opioid poisoning deaths still continues to grow each year. Yet the gospel according to television melodrama is that the wages of not going to NA is death.
I would like to lay down a challenge to the New York Times, CNN, the Wall Street Journal and every other voice of the media to publish the truth about polydrug poisoning and the benefits of methadone, safe injection facilities, and heroin maintenance tomorrow and keep screaming the truth into people's ears every day until we cut the number of drug poisoning deaths down to a fraction of what they currently are. It shouldn't take long if the media does an abrupt about-face and starts telling the people the truth about drugs and addiction treatment.
Or the media can keep doing what they have been doing and putting the blame on mythic "super heroin" and pushing 28-day 12-step rehabs and NA the same as always...and we can watch the death toll continue to mount. The choice is yours.