People are dying all over the country from opioid overdoses. There’s a movement to have the antidote naloxone available in all ambulances and even over the counter. This temporarily reverses the fatal effect of opioids, which stop the patient’s breathing. First responders themselves may need a dose because of contact with a tiny amount of fentanyl, an extremely potent narcotic, while attending a patient.
No, the fentanyl does not come from the patient’s bottle of legal prescription drugs.
Rep. Bill Foster (D-Ill.) introduced a proposal that he claims would “go a long way to fight the practice of doctor shopping for more prescription pain pills amid a deadly opioid crisis.” Doctor shopping “involves visiting multiple doctors.” Hardly new, this proposal, now passed by the House of Representatives as an amendment to a $99.4 billion Health and Human Services appropriations bill, lifts the ban on funding a Unique Patient Identifier (UPI).
The UPI is part of the Health Insurance Portability and Accountability Act (HIPAA) of 1996. You don’t have one yet because former congressman Ron Paul, M.D., (R-Tex,) sponsored a prohibition on funding it as part of a 1999 appropriations bill. Rep. Foster’s amendment repeals Dr. Paul’s prohibition.
So how is this 1996 idea supposed to work? And why would it be better than the Prescription Drug Monitoring Programs (PDMPs) now in effect in nearly every state? Every prescription for a controlled substance must be reported to the PDMP, and the doctor must check it before writing a prescription, to be sure the patient is not lying about having prescriptions from other doctors. This costly program that creates time-consuming hassles for doctors has not prevented opioid deaths.
PDMPs are ineffective because doctor shopping is not the cause of the problem. Only 2.5 percent of misused prescription pain medicine was obtained by doctor shopping. And this small percentage apparently increased after PDMPs. More than 97% of misused medications are obtained from a single physician—or from an illicit source. The spike in opioid deaths after 2013 was caused by illicit fentanyl, as Dr. John Lilly concludes from painstaking analysis of official data.
If Rep. Foster’s amendment is not removed, you might have to have a UPI to get legitimate medical care—“no card, no care”—but the drug cartel won’t mind. You can shop drug dealers as much as you like. There is a flood of fentanyl, mostly from Mexico or China, coming across our borders. Rep. Foster is apparently unaware of the armed lookouts protecting the smuggling routes in the Tucson sector. And once here, the drugs go to distributors—such as illegal aliens protected in sanctuary cities.
So, what about the other touted benefits of the UPI? “Specifically, assigning a unique number to a patient would give doctors a way to immediately identify a patient’s medical history,” said Rep. Mike Kelly (R-Pa.). He says it “would lower the cost of medical mix-ups due to misidentification.” His elderly father was nearly given the wrong medication.
To prevent medical errors, you need alert nurses and doctors—and the UPI is not going to fix the hazards of the electronic health record. The EHR, touted as the solution that will bring efficient, quality care, has created its own type of errors.
There is no guarantee that a UPI will improve access to the record, and critical information will still be buried in voluminous, repetitious data of dubious reliability, some of which may have been cut-and-pasted from another patient’s record. There may be critical gaps as patients withhold information they don’t want in a federal database. The new problem that brings the patient to the hospital won’t be in the old record—but may be the result of an old misdiagnosis that should be corrected instead of copied.
Patients need to be able to shop for doctors, especially if the one they have has not solved their problems. Some of them desperately need opioids, which are increasingly difficult to obtain. They do not need a UPI, and neither does their doctor.
The UPI is ideally suited for government tracking and control of all citizens. People like J. Edgar Hoover or Lois Lerner might find it very useful. But it would be the end of privacy, and the foundation for a national health data system.
Donald Trump has repeatedly said he wants drug dealers to face the death penalty for their crimes, but hasn’t gone into any detail as to what sort of drug crimes would warrant capital punishment if he and U.S. Attorney General Jeff Sessions had their way.
Are we only talking about the leaders of drug cartels? Are we talking about the drug “mules” who move the drugs into the country? Are we talking about the people who cut up and deliver the drugs? Are we talking about the doctors prescribing the drugs? What about the manufacturers of opioids?
Trump’s death-penalty-for-drug-dealers plan is what he thinks will reign in the opioid epidemic. But opioid addicts don’t go straight to fentanyl and overdose. They start on Vicodin prescribed by their doctor, one in 12 of whom has received money from drug companies marketing prescription opioid medications, according to a recent study by Boston Medical Center. These doctors are just as responsible for opioid overdose deaths as other drug dealers.
More than 40,000 people died of opioid overdoses in 2016, 40 percent of which involved prescription opioids. So putting drug dealers and drug lords to death for trafficking heroin and fentanyl only addresses part of the problem. If opioid addicts don’t have access to the cheaper, stronger heroin and fentanyl, that doesn’t mean they’re going to stop using opioids. They’re just going to use more prescription opioids, whether their doctor prescribes them or not. And they can still overdose on prescription opioids.
The death penalty has been and continues to be reserved almost exclusively for murderers. In fact, of the 31 states still sentencing people to death, only Texas kills people convicted of “criminal homicide” and those suffering from mental illness. Even now, a bill filed by Democratic State Rep. Toni Rose of Dallas to bar the death penalty for the mentally ill is unlikely to pass in the Lone Star State. The state would likely be the first to embrace Trump’s death-penalty-for-drug-dealers plan given the border it shares with Mexico, from where 90 percent or more of America’s heroin supply originates.
Mexican drug lord Joaquín “El Chapo” Guzmán Loera was scheduled to stand trial in April, but the federal judge in Brooklyn presiding over the case postponed the trial until September. It gives the prosecutors ample time to prepare their case against the most wanted drug dealer in the world, but they won’t likely need it. They have access to over 300,000 pages of documents and thousands of secretly recorded conversations to help make their case.
The real question isn’t whether “El Chapo” is guilty, but whether he actually has the $14 billion in cash from narcotic sales U.S. authorities want to seize. Most experts think this figure is too high, but the point is the man made billions of dollars selling opium around the world, and especially to Americans.
While “El Chapo” is charged with federal crimes that would subject him to the death penalty, the Mexican government wanted assurance the death penalty would not be sought when negotiating the terms of his extradition. So “El Chapo” won’t be the first drug dealer Trump gets to put to death. International drug lords are already subject to capital punishment, though, because they’d be charged with federal crimes. Drug lords like “El Chapo” certainly deserve the death penalty, but Trump isn’t just talking about killing drug lords. I’d hope he knows we can already do that.
“El Chapo” had a 30-year career dealing illegal drugs because of his “security” detail. Not only did they keep him alive and out of jail all those years (and broke him out of jail twice), but they left no witnesses and eliminated troublemakers for the cartel.
These killers fulfill the “murder prerequisite” required by 30 of the 31 states still sentencing criminals to death, and are deserving of the death penalty. But murder charges would have to be brought in the country where the murder occurred. If no blood is shed on American soil, they are not subject to American law.
Trump’s death-penalty-for-drug-dealers plan seems to be targeted at the people who don’t deserve it. Sessions did his best to implement Trump’s plan by sending a memo to federal prosecutor’s requesting they pursue the death penalty in cases “dealing with extremely large quantities of drugs.” But the people found in possession of those “extremely large quantities of drugs” are the least deserving of the death penalty. Some aren’t even aware they’re trafficking drugs.
Most drug mules are only guilty of being desperate. They’re just trying to find a better life for themselves and their family and might not have another means to do so or, frankly, a choice. I dare Jeff Sessions to refuse a drug lord’s order to traffic heroin across the border. The thought that you could be sentenced to death if arrested isn’t as bad as being killed where you stand. Plus, what if you get away with it?
Many of these people are looking to move to America just to do a job an American is unwilling to do. Drug lords “help” them realize that dream -- for a price. There are over 55 million poor people in Mexico and 15 millionaires who amass roughly 13 percent of the Mexican economy’s total value. So 45 percent of Mexico’s population is impoverished and for every millionaire in the country, there are roughly 3,660,000 poor people. Now you know why so many Mexicans are eager to move to America and work a shitty job you wouldn’t do for double or triple what they’re paid.
Put yourself in the shoes of a poor Mexican with a family to support. Even if you don’t have kids, you still have mouths to feed in Mexico. Mexicans take care of their familial elders, and not just their parents. Aunts, uncles and other immediate family members living under one roof with their nieces, nephews, sons, daughters, grandsons and granddaughters is common in Mexico. So a working-aged couple could have no children but still be expected to support a family of five or more. And when it comes to feeding the family, the oldest and youngest are the first priorities. Those who provided the meal are most likely to eat the least.
Despite a 3.8-percent unemployment rate in 2017 and a 17-percent increase in the number of Mexican workers gaining access to social security in the first half of 2017, 57.2 percent of Mexican workers still have jobs in the “informal economy.” This means more than half of the country’s laborers aren’t receiving health insurance or earning retirement benefits nor are they protected in the workplace. Their wages are not collectively bargained; they are dictated. The hours they work per day are not subject to Mexican law, and neither is the condition of their workplace nor the treatment they receive from their superiors.
Even worse, the informal economy accounts for roughly a quarter of Mexico’s gross domestic product, so programs meant to help impoverished Mexicans are severely underfunded because the government is raising revenue from just 75 percent of its economy. It’s something that’s taken a long time to correct. Mexico’s congress eased restrictions on hiring and firing back in 2012, and over the next five years, participation in the informal economy fell just 2.2 percent.
And in a country where drug lords earn more than CEOs and have not only assassins but cops on the payroll, you can bet that Mexico’s informal economy will never disappear. Every country has an informal economy. It doesn’t matter where you go, there will be jobs there that pay cash under the table. Governments can’t monitor every dollar that changes hands, but countries where large amounts of illicit drugs are produced will always have larger informal economies. Since we mostly just consume drugs in America and not produce them, the informal economy created from drug trafficking in the United States is modest when compared to that of Mexico, Colombia or Afghanistan, the leading provider of opium to the world.
So when a Mexican laborer struggles to find work in the formal economy, the informal economy awaits to prey and profit on his or her desperation. At some point, any type of work for any amount of money will look a lot better than the starving, disappointed faces of your family at home. Scrape by long enough working 16-hour days for barely enough money to feed your family and trafficking a little heroin across the border to a dealer in the states sounds like an opportunity instead of a risk. And when your employer, the drug lord, a surprisingly amiable fellow, promises to send your family to join you upon your successful completion of this most simple task, you too would turn mule for a chance at the American Dream.
Just deliver a package across the border, and you’ll be working an American farm and earning more money than you ever thought was possible, even though it’s less than what most American, fast food employees earn. You’ll send some of the money from your first paycheck back to your family with a letter telling them how long it will be until you can afford a foreclosed fixer-upper you can renovate together and turn into a home. But your family won’t likely receive that letter or the enclosed American money because the cartel probably has a murderous goon holding your family captive in their own home who reviews and censors all incoming mail and pockets any money he discovers. Getting you out of Mexico allowed the cartel to “recruit” your family.
Members of your family would likely be forced to take your place working for the cartel, regardless of their health or ability. The cartel doesn’t care if they die on the job, and neither do the police. That’s the risk that comes with working in the informal economy: you are treated like slave labor. The cartel needs its laborers to be so uncomfortable that they welcome the work because it means they will eat. Threats aren’t as effective a form of persuasion as a person’s instinct to survive. Threaten your workforce with death, and they’ll soon welcome it; provide just enough for your workforce to survive, and they’ll do just that -- survive.
Those who do survive will ride off into “retirement” as a drug mule when the cartel has no use for them anymore. Everyone becomes a liability eventually, and processing heroin, from planting to harvesting the opium poppies to splitting and scraping the poppies to extract the opium, is not work suited for the arthritic. Your former employer, the drug lord, provided them with no knowledge of your whereabouts despite reviewing your mail. His only interest is in his product reaching its destination, and he doesn’t want his drug mule thinking about his brother, the American mule. The drug lord wants his mule’s mind on the job.
Unfortunately, your family member is probably better off being caught at the border and locked up in an American prison than they’d be having delivered their drugs successfully. Unlike you, they aren’t fit for the type of work available to them in the states, or anywhere else for that matter, and will likely resort to working for the cartel’s drug dealer in the states, hoping to put away enough money to try and find you and the rest of the family. That hope dissipates upon discovering the cost of living in America, eventually giving way to those survival instincts once again.
There’s no room for hope in drug cartels. Families can’t discover their escaped, American dreamer is actually living the American Dream and saving to buy a house for the family. Slave owners didn’t want their slaves learning how to read for a reason. That reason is reason -- the ability to think, understand, and form judgements logically. Your family receiving a letter from America saying how well you’re doing, how much money you’re making and, most importantly, your return address, will have them escaping north the first chance they get, consequences be damned. Hope makes people risk their lives, not because of the potential payoff, but because of the realization that they aren’t actually living. The hopeless are simply surviving, and hope makes people risk survival for the chance to truly live.
Drug mules don’t deserve the death penalty because despite being responsible for trafficking the drugs into the country, they’re usually doing so to preserve their own life or the lives of their family. To hold them responsible for deaths that result from the drugs they traffic is asinine, unless, of course, your goal all along was to limit immigration.
The people Trump and Sessions seem to be targeting are the cartel’s lowest-level, nonviolent laborers. Putting these people to death is not going to solve anything. There are plenty of mules drug lords can recruit or force across the border. You don’t think a drug lord would kidnap a man’s wife or child to persuade him to traffic some drugs?
Drug mules are not drug dealers; they’re drug movers, and when drug movers are caught, no harm has yet come to anyone in this country because the drugs haven’t reached the drug dealer. And even the drug dealers aren’t all bad.
Drug dealers provide a service in high demand, especially in America, where roughly a trillion dollars was spent on illegal drugs from 2000 to 2010. If there’s one thing the Drug War has proved, it’s that you can’t stop people from using drugs. The opioid epidemic in this country is a perfect example of how drug users find a way to abuse drugs. Even in places where illegal drugs are hard to find like West Virginia and Indiana, Americans find a way.
Is cocaine too expensive and too stepped-on where you live? Is good heroin hard to find? No worries. Just make an appointment with your doctor and tell him or her you’re suffering from intense pain that’s keeping you up at night. You’ll have a prescription for opioids the same day, and less than a month later, you can tell your doctor the dosage isn’t working anymore and get something stronger. Within a few months, you’ll have access to the strongest opium legally available.
Drug users use drugs, regardless of accessibility or legality. In fact, the illegality of drugs makes them more desirable because of the coolness that comes with being forbidden. Illegal drugs are also more dangerous than legal ones because the people in charge of regulating the purity and dosage are the drug dealers, who do not have their customers’ interests or lives in mind.
Drug prohibition is also responsible for the violence associated with drug trafficking. Since drug dealers and traffickers risk imprisonment, the cost associated with that risk goes into the price of the drug. Every time a drug dealer is arrested, drug prices increase. Every time a drug mule is caught at the border and product is seized, drug prices increase. And every time an “El Chapo” is arrested, drug prices increase.
These inflated prices as a result of illegality make drugs less affordable, forcing drug users to come up with more money. Unlike most products, the demand for drugs doesn’t drop considerably when supply is low and prices high. Casual drug users might be turned off by high prices, but addicts care little about cost and will do just about anything to acquire the extra cash they need except wait for their next paycheck. Unfortunately, methods for acquiring money quickly tend to be illegal.
The illegality of drugs causes more illegal activity in order to obtain those drugs. It’s responsible for convenience stores, homes and cars being robbed and purses being snatched. It results in violence, death and increased costs to the judicial and prison systems. Oh, and then there’s the costs of enforcing drug laws, which came to roughly $76 billion in 2015. That’s almost half of what the federal government spends to fund public schools.
Legalizing drugs and making them available for purchase at pharmacies that ensure purity and safe dosage for human consumption would make drugs and access to those drugs safer, cheaper, and result in less violent crime and fewer overdose deaths. Daily purchases would be limited to a safe dosage determined by health professionals, and users would be getting a pure, uncut substance that won’t kill them because the “dealer” would have their interests in mind instead of trying to maximize profit.
Drug dealers are looking to make a buck any way they can, which includes cutting up drugs with synthetic additives designed to offer a similar effect as the actual drug but at a cheaper price for the drug dealer. This is why methamphetamine ends up in Ecstasy and fentanyl ends up in cocaine and heroin: it’s cheaper. Of all drug dealers, the dealers of bad drugs are the only ones who deserve the death penalty.
Hunter S. Thompson ran for sheriff of Aspen, Colo. on a platform that included the legalization of recreational drugs, but also a plan for punishing drug dealers who sold bad drugs. He thought such dealers should be put in stocks and displayed in public places so locals could mock them and even molest them. Thompson was concerned with buying ineffective drugs, though, not dying from heroin cut with fentanyl. I think drug dealers who sell bad drugs that result in an overdose death should be tried for murder and sentenced to death if so ruled by a jury of their peers in states where capital punishment is still enacted.
If Trump sees his death-penalty-for-drug-dealers plan as a way to further limit immigration of Mexicans he thinks are “bringing drugs, crime and rapists” to the U.S., he’s going to be disappointed in its ineffectiveness. Sentencing every drug mule to death might send a message, but do you think “El Chapo” or any drug lord will have a sudden shortage of available mules because they’re scared of receiving the death penalty if arrested in America? No, they’ll be scared of the gun the drug lord is holding to their head.
But if Trump sees his death-penalty-for-drug-dealers plan as a way to hold drug dealers responsible for deaths that are a direct result of their greed and help ensure drug users get what they order and not a surprise overdose, his plan would sound less crazy.
If he sees his plan applying to doctors who blatantly overprescribe opioids resulting in the deaths of patients all while taking money from the manufacturers of those opioids, I’d have no objection. If those doctors are practicing in a state where the death penalty is still enacted, and their carelessness resulted in one of their patients becoming addicted to opioids and eventually dying from that addiction, a jury should consider the death penalty as a possible sentence for the doctor.
Hell, if by “drug dealers” Trump means the producers of prescription opioids, like Purdue Pharma, Teva, Cephalon, Johnson & Johnson, Janssen, Endo, Allergan and Watson, I wouldn’t find his plan crazy at all. The executives who created this crisis are most responsible for the resulting deaths. Whether their drugs were specifically responsible for the deaths is irrelevant. You don’t have to wield the knife to be guilty of murder.
These pharmaceutical companies not only downplayed the addictive effects of opioids in the late 1990s, but rewarded salespeople with luxury trips and $20,000 scratch tickets for getting doctors to switch patients to opioids and also paid doctors to prescribe them. The pharmaceutical CEOs and executives who made OxyContin into a billion-dollar revenue stream annually are just as guilty of murder as “El Chapo,” and perhaps more so. “El Chapo” didn’t get Americans hooked on opioids; big pharma did that by providing the “gateway” to heroin and fentanyl. Without $30 billion in OxyContin sales, “El Chapo” doesn’t become “El Chapo” -- the drug dealer worth $14 billion.
Since Trump won’t likely enact his death-penalty-for-drug-dealers plan for his rich, pharma friends who paid for his campaign, at least someone is doing something to hold big pharma accountable. New York City Mayor Bill de Blasio is suing the opioid manufacturers previously listed to recoup some of what the United States has lost to the opioid epidemic big pharma created. A recent report by the White House Council of Economic Advisers found that the opioid epidemic cost America more than $500 billion in 2015. That’s in one year!
If you like this, you might like these Genesis Communications Network talk shows: America’s Healthcare Advocate, The Bright Side, The Dr. Daliah Show, Dr. Asa On Call, Dr. Coldwell Opinion Radio, Good Day Health, Health Hunters, Herb Talk, Free Talk Live