Well-intentioned policies can have unintended consequences. For example, while the rate of new opioid prescriptions has fallen in recent years, a large number of physicians have stopped initiating opioids altogether.  While that may sound like a good thing, it’s not clear whether this does more good or harm to patients in severe pain.

This isn’t the first time the rate of opioid deaths has slowed for a year. They appeared to stall in 2011 and 2012, but the death rate then shot back up as fentanyl made its way into the US.  Fentanyl deaths in 2018 continued to rise, but grew at a slower rate than the past several years. So, it’s right to be only cautiously optimistic when it comes to a possible break in the wave of opioid-related deaths.(The new numbers are still being finalised, and may increase when the final CDC report is published later this year. They also do not include deaths related to infection from intravenous drug use.)

Furthermore, renewed attempts to overturn President Obama’s Affordable Care Act are currently underway. Should these succeed, many people who currently receive legal pain relief may end up turning to illegal drugs if they lose their health insurance. Celebrating the end of the opioid epidemic is premature. (An edited version by Chelsea Whyte in the New Scientist , Aug 2019).

In our local pharmacy they informally stopped dispensing opioids months ago and tell you to go elsewhere, even if you have a legitimate prescription, written to deal with pain after an operation.  This not just because of the dependency and deaths they cause but because pharmacies which dispense these disastrous drugs can get physically raided by gangs or desperate addicts, and the place wrecked if the pharmacy is known to stock them. (I hasten to say that this could be just a local decision, not necessarily countrywide)

The family reputed to profit most from opioids, and which is famously generous in giving to the arts, is, as far as I know, still out and about and unrepentant. Of course, their profitable market is now being reduced by the sales of fentanyl.