Americans have gotten stark reminders of the nation’s struggles with harmful substances and how the coronavirus pandemic has worsened these problems, with the Biden Administration outlining its strategy to combat the opioid abuse and drug overdose crisis and Big Tobacco reporting a rare spike in cigarette sales.
The opioid crisis — which is sending the country toward a grim 100,000 fatalities this year alone — has forced the federal government into urgent steps, including “harm reduction” strategies as one of its four pillars of U.S. plans to combat drug abuse, according to Xavier Becerra, head of the Health and Human Services department.
Harm reduction approaches can be controversial, as critics assail them as officials going soft on law enforcement and criminal prosecution of drug use.
But experts quoted by the Washington Post said that the nation can both crack down on illicit drug sales, and it will be well-served by harm-reduction efforts, for example, to bolster the supply and use of testing strips so drug users can avoid overdoses of fentanyl. It is a highly potent synthetic painkiller that is easily made in illicit factories and can be lethal in tiny amounts.
Becerra said the federal government also will push harder still to expand the availability and use of naloxone, the antidote to opioid overdoses which the newspaper reported is in short supply now.
The U.S. will support needle-exchange programs, in which street users can swap used syringes for hygienic ones, avoiding infections including Hepatitis C and HIV-AIDS.
The HHS secretary said states, with federal support, must make the important, fundamental decisions about “safe use” sites, which can anger neighbors and those who argue for tough enforcement of drug laws.
As the newspaper reported, harm reduction is one aspect of a broader federal strategy to combat drug-abuse:
“The four-part strategy also includes measures to prevent drug addiction, in part by continuing to reduce the inappropriate prescribing of opioids; expanding medication-based treatment, which research has shown to be the most effective approach; and improving support for people recovering from substance use disorder.”
Federal authorities are racing to battle the opioid crisis, Becerra said, not only because 2021 may see unacceptable numbers of overdose deaths:
“From 1999 to 2019, an HHS report … notes, 840,000 people died of drug overdoses. By some estimates, there have been 20 to 30 times as many nonfatal overdoses.”
The Washington Post quoted experts who said the opioid crisis is worsening fast, not only because of the loneliness, isolation, joblessness, uncertainty, and other disruption caused by the pandemic, but also due to the pervasive influx of fentanyl, which dealers are tainting an array of pills and street-pushed substances, authorities already have warned:
“Fentanyl has so thoroughly infiltrated the illegal drug supply that users often cannot be sure what they are consuming, and the government must act simply to keep them alive and disease-free.”
Cigarette sales spike
The economic and social tumult caused by the pandemic also led to the first increase in tobacco cigarette sales in two decades, the Federal Trade Commission reported. As the Washington Post reported:
“The largest U.S. cigarette producers sold an estimated 203.7 billion cigarettes to wholesalers and retailers in 2020, representing an increase of about 800 million over 2019, according to an annual report … by the Federal Trade Commission. Sales of smokeless tobacco products such as chewing tobacco also increased slightly to 126.9 million, according to a parallel FTC report. The FTC figures … do not include e-cigarettes, aerosol-based cigarettes also known as vape pens. The FTC issued subpoenas for e-cigarettes sales data in mid-February but is yet to publish data on them. The CDC has reported that 14.2% of adults over the age of 18 smoked cigarettes as of 2019, and 4.4% used e-cigarettes.”
Anti-smoking advocates expressed concern about the increased cigarette sales and use, adding that they are worrisome, especially since the federal Food and Drug Administration, in their view, seems to have gone wobbly on preventing the health harms of vaping, e-cigarettes, and tobacco use.
The Wall Street Journal, reporting on recent sales figures by Altria, which makes half the cigarettes sold in this county, may snuff a bit of the worry about tobacco smoking: The company reported that its 2021 sales in the most recent quarter slumped after the 2020 spike.
In my practice, I see not only the harms that patients suffer while seeking medical services, but also the damage that can be inflicted on them by dangerous drugs, as well as substances proven to be deleterious to their health like tobacco.
The FDA needs to reevaluate its recent e-cigarette and vaping decisions and resume its toughest stands against tobacco use, which has been proven to damage the heart, lungs, and other body systems. The opioid crisis, which we now must tackle in the most aggressive way possible, took time to develop, fostered by Big Pharma, doctors, hospitals, insurers, and others in health care. The wrongdoers must be held accountable, and the tens of millions who have been injured must find care — and justice from the injuries they and their loved ones suffer.