Revenge for the Opium Wars?

In the 1800s, the Chinese Qing dynasty found itself on the defending end of two wars designed to open closed Chinese ports to foreign trade, and essentially get the Chinese people addicted to opium. Fast forward to 2018, and one of the aggressors in those wars—the US—finds its own population dangerously addicted to opium. Well, opium derivatives at least. A US Senate investigation reported last Wednesday that Chinese e-commerce sellers are a huge supplier for carfentanil, which is: 10,000 times more powerful than morphine, mainly used as an elephant tranquillizer, and considered for use as a chemical weapon. And it’s coming right through US ports via the US Postal Service, who haven’t fully implemented suspicious package detection systems. So that’s fun!

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Trump: opioids a yuuuuge problem

Just days after declaring his administration would throw law enforcement resources at the opioid crisis, The Donald referred to the crisis as a national emergency. According to an article by NPR, that stops juuuust a bit short of an official declaration of emergency status, which would carry with it access to specific legal authorities and access to government coffers for a more wide-spread, wholistic approach to dealing with the crisis. The President has indicated the official designation is forthcoming. This is significant. National emergency status has historically been used for things like natural disasters (i.e., hurricanes) and communicable diseases (i.e., the Zika virus). Here’s a list of declared U.S. public health emergencies. Once official, expect states like Ohio and New Hampshire—among the hardest hit—to seek federal funds for help.

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1. Good or bad news first?

In an effort to combat the prescription drug abuse epidemic, several companies, like Purdue Pharma, have created reformulated opioids. These abuse-deterrent painkillers make it more difficult to snort, smoke or inject the drug—some estimates show that revised OxyContin has curtailed abuse by 40%. Well done, Purdue. Buuuuuut… a new study from the University of Pennsylvania and Rand Corp. shows that since the reformulation of OxyContin, heroin overdoses have surged and the increase in deaths can be attributed directly to the new-and-improved Oxys. One finding shows the number of heroin deaths tripled from 3,000 in 2010 (when reformulated Oxy was introduced) to 10,500 in 2014. InsightCity’s analysis? Addiction is painful and destructive, and the healthcare ecosystem plays too large of a role in the problem.

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4. Living up to its Limitless reputation

Modafinil, a drug used to treat sleepiness caused by narcolepsy and sleep apnea, has a fan base among grinders who recreationally use smart drugs to “upgrade themselves.” Now, an official study confirms that modafinil reduces impulsive behavior stemming from a variety of conditions, from food addiction to schizophrenia, ADHD and alcohol dependence. Biohackers report a crisp, soft clarity and concentration beyond one’s imagination when taking the drug, but its impact on impulsivity means it could be a better treatment for obesity driven by food addiction, drug and alcohol dependence, attention deficit hyperactivity disorder and anxiety than the meds currently on the market. Turns out that 15x uptick in patients over the past decade for off-label use may have been more than just recreational.

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4. The crackdown continues

The city of Chicago is getting even more serious about snuffing out an epidemic that has claimed the lives of hundreds of Chicagoans so far. In a continued effort to stem opioid addiction, the city may soon require pharmaceutical sales reps to carry special licenses in order to pitch medications. “Oh just a piece of plastic to flash around, not a big deal!” the young unsuspecting sales rep might muse. Um, no. License requirements call for representatives to report back to the city on several measures including how many doctors they contact and whether these doctors receive payout. Patients and doctors can also report unethical behavior. Add this to Chicago’s record of opioid crackdowns, which includes a lawsuit filed against several drug makers’ misleading opioid marketing in June of 2014.

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4. Compounding addictions

You know what sounds crazy? The FDA’s “2016 Naloxone App Competition.” The idea, to develop a location-based, social search service application (a la Tinder) that connects opioid users and first responders to someone nearby with a dose of naloxone, was presented as a challenge by the FDA to programmers, public health advocates, researchers and entrepreneurs in an attempt to slow the death rate from opioid overdoses. Naloxone is a prescription drug able to reverse the effects of an opioid overdose when administered quickly enough; the FDA believes this antidote is currently in too few hands to save all who might benefit. But an FDA sanctioned app that unites drug users with drugs? Just like opioids and smartphones, this app seems ripe for abuse.

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