The Thin White Line

In the early-mid-19th century the British East India Trading Company maintained large poppy farms and opium factories in India to supply their growing market in China. When the Chinese defended themselves by seizing and destroying opium cargoes, the British Navy enforced what they called their “right to a free-market” – consigning a third of the Chinese population to addiction.

Between the Civil War and into World War I, opiate addiction grew in this country, as doctors liberally prescribed laudanum for various ills and malaises. Laudanum is opium.

After her death, I found the “baby book” my mother kept for me, in which was a note from her pediatrician suggesting “two drops of morphia in warm milk should I become fussy or colicy.”

American pharmaceutical companies have been over-marketing, and rewarding doctors for over-prescribing, Oxycontin, Vicodin, and Percocet for 25 years, flooding the drug market legally, while we spend $15B annually to deter the competitive tide selling street heroin.

In 2007, the president of Purdue Pharmaceuticals pled guilty to marketing Oxycontin for unapproved uses and personally paid a few million dollars in fines to avoid jail time. Yet in 2013, U.S. pharmacies filled 207 million opiate prescriptions. That same year, death from opiate overdoses exceeded 16,000 – half of which were from domestically manufactured drugs. This exceeds the annual murder rate by 2000. Opiate deaths quadrupled between 1999 and 2013. Today, 45 people a day die from prescribed opiates. When addicts can’t afford “legal meds” at $20-$50 a pill on the street, they turn to heroin at $5-10 a bag. So we spend billions fighting imported heroin, while prescription opiates develop new markets.

Meanwhile pharma’s advancing a whole new addictive market – meth. Adderall, Ritalin, and Vyvanse are all meth-based drugs, opening new markets for both pharma and meth-lab operators. Until recently, the focus was on children but last year the burgeoning adult market overtook the children’s market for ADHD drugs. Ritalin is supplanting cocaine among young adults and steroids among athletes.

Flemming Ornskov, CEO of Shire, says his company’s “shifting into the adult ADHD market,” using TV ads with pop star Adam Levine and tennis great Monica Seles. In January, Shire won FDA approval to use Vyvanse, as a treatment for “binge eating,” When I was a young, the “Dexedrine Diet” became for many, including my mother, an intractable addiction.

Meanwhile, we jail the user and street dealer and turn a blind eye to the industrial manufacturer-dealer. When all’s said and done, what’s the difference?

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