IT'S TEMPTING to cite that overused term "perfect storm" in describing the crisis of opioid addiction, which in Philadelphia alone took the lives of about 900 people in 2016. Maybe a more accurate term would be "perfect tsunami."
This tsunami, though, is caused not by a single underwater earthquake or explosion, but a complex interaction of many factors, which makes solving this crisis so complicated.
One of the roots of the current crisis can be seen in a 2007 settlement with Purdue Pharma, manufacturer of OxyContin. The company aggressively marketed use of the painkiller, whose chemical composition makes it dangerously addictive, claiming that it was less addictive than it actually was. The company pleaded guilty to a federal criminal count of misbranding the drug to mislead the public and was fined $635 million in penalties. But this suit has had little impact on either Purdue's bottom line (it has made billions on the drug) or on the continuing wave of prescriptions for opioids in general.
Physicians, either misled into thinking the painkillers were safe or simply eager to help patients, also have played a role in getting so many hooked on the drugs by overprescribing them. And when those prescriptions run out, some desperate patients turn to heroin - which, in Philadelphia, is purer and cheaper than ever before.
Overdosing is far too easy, hence the startling mortality rates for those addicted. In the U.S. in 2015, 20,101 died from overdoses of prescription pain relievers, and nearly 13,000 died from heroin-related overdoses.
These are deadly storm fronts - an effective but dangerous medication, misleading marketing and an overdependence on prescribing. Now factor in the scarcity of addiction treatment and the stigma attached to addiction, not only by those who suffer from it but by society as a whole, and, well, put it this way: This is not an easy time to be in public health.
Both the city and the state have been grappling with the best approach to fighting this war. This week, a city opioid task force created by Mayor Kenney - made up of 16 public health experts, law enforcement personnel and others - began meeting to come up with recommendations for fighting this new drug war. Key to this will be coordinating the efforts of public health and mental health experts and practitioners who can address the crisis' complex factors; that includes everything from educating physicians on the hazards of overprescribing to trying to improve an inadequate and disjointed addiction treatment system.
Gov. Wolf also has called this a priority. Late last year, he signed a package of bills, including a long overdue strengthening of the prescription drug monitoring program. Pennsylvania has come late to the game in having a database that doctors will now be required to access before and after prescribing opioids to identify those who may be "doctor shopping."
Obviously, this crisis, a long time in the making and fueled by big pharma bucks, will take time to rectify. But a report this week by Highmark, a large state health insurance network, suggests that some progress is already on the horizon: It found that reimbursements for opioid prescriptions in the state have dropped in the last quarter of 2016 compared with earlier quarters in the year. It suggests that awareness of this deadly crisis can be a powerful tool.