How Doctors And Pharma Created A New Population Of Opioid Addicts In America

The opioid crisis began with pharmaceutical companies pushing their narcotic painkillers as a nonaddictive treatment to doctors. Now the companies are chastened and doctors are more careful about prescribing opioids. But the cat is already out of the bag. Mexican drug cartels have skipped heroin and are now mass-producing fentanyl, which is much more potent and cheaper to make. And now it has hit every corner of the country.

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Image Credit, K-State Research and Extension

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Quinones: What the opioid epidemic did was create a new population of opioid-addicted folks Americans all across the country because it was promulgated by pharmaceutical companies who pressured doctors to prescribe. And doctors were all over the country and doctors all over the country bought into the idea that they could now prescribe narcotic painkillers you know morphine but also branded ones Vicodin Percocet of course oxycontin without any risk of running of addiction for those folks who were pain patients. This idea was not supported by the science but nevertheless was essentially accepted and taught in medical schools etc. and so over about a 20 year 15 so year period we saw this enormous increase in supply all across the country from prescriptions from doctors prescribing to people. and then of course a lot of that leaked out into the black market and you found black markets for pills in pretty much every region of the country that was expensive on the street. A dollar a milligram usually folks were up to that point by doing 150-200 milligrams a day. They couldn't sustain that. And when they did they switched to heroin and when they did that the Mexican trafficking world which had really ignored heroin for a long time sat up and took notice and began trafficking. That population has existed continues and continues actually to grow. And that population is really probably the first driver of the folks who is using fentanyl. And the reason p the reason traffickers in Mexico figured out fentanyl was they saw gee this is a growing population it's so much cheaper easier less risk we don't need land to make synthetic drugs like fentanyl instead of growing poppies that kind of thing. And so that's kind of what led us into the fentanyl issue that we're dealing with today and the methamphetamines as well.

Emma: Yeah so so what was the difference that you really saw when your book dreamland came out in 2015 and fentanyl is just everywhere now. I mean how stark was it when comparing your research for your first book with your current book?

Quinones: It's radically different, it's a radically different scene. What is the same though is an interesting thing. That the supply of drugs is almost comparable and when with the part with the pharmaceuticals painkillers you saw just an amazing coverage. You know the west coast to the east coast. Really intensely in some states certainly particularly in the midwest and Maine new Mexico Oregon various places like that. but nevertheless,, you found them all over the country. And now we've seen the underworld take over that role. The doc doctors have stepped back, pharmaceutical companies are chastened. And you're not seeing the heavy sales force promotion that you used to see for narcotic painkillers. And doctors' offices are nearly as much as they used to be. barely at all, I think. And so now but when we opened that Pandora's box we created that consumer market with that enormous supply of pills. And then the doc the underworlds stepped in. and when they did they made a transition they were already in the middle of but they it really with the vengeance again switching from plant-based drugs. which the Mexican trafficking world had grown up on. Marijuana poppies etc. away from that really towards synthetics. and the main ones being fentanyl and and and methamphetamine now. so this it's a fascinating switch because there's a totally different source for what we see on the streets today. But the coverage is remarkably similar. So complete you know about the entire country. Something we've never really seen before is the homogenization of the drug offered all across the country.