Misdiagnosing the opioid crisis

According to the Maryland Department of Health, a record 2,282 people died in Maryland from unintentional drug-and-alcohol-related intoxication in 2017. That’s more than double the number of such deaths in Maryland in 2014. Keep that year in mind.

88 percent of the intoxication deaths in Maryland in 2017 were opioid-related. Opioid-related deaths include deaths due to heroin, prescription opioids, and nonpharmaceutical fentanyl.

Large increases in the number of fentanyl-related deaths are responsible for the overall rise in opioid-related deaths in Maryland. Between 2016 and 2017, the number of fentanyl-related deaths increased by 42 percent (from 1119 to 1594).

The number of cocaine-related deaths began rising in 2014. They increased 110 percent between 2015 and 2016, and another 49 percent between 2016 and 2017.

We’ve heard plenty about a prescription opioid crisis. However, in Maryland the number of prescription-opioid related deaths decreased by 1 percent (from 418 to 413) in 2017. Moreover, many of these deaths occurred in combination with heroin and/or fentanyl. Deaths solely related to prescriptions have declined during the past three years.

Reviewing this data, Daniel Horowitz concludes that we have an illicit drug crisis, not a prescription crisis — at least not one that’s driving the massive surge in deaths in Maryland since 2014. Horowitz writes:

As the Maryland report indicates, deaths from Cocaine, which is all a drug cartel issue, not a doctor issue, started surging in 2014, the exact time of the surge in the border from Central America.

(Emphasis added)
And, as noted, the overall surge in deaths from unintentional drug-and-alcohol-related intoxication also began that year.

The Maryland Health Department’s report contains additional information to support Horowitz’s thesis that we face not a prescription drug crisis, but an illicit drug problem fueled by drug cartels. He notes that almost three times as many men died from overdoses as women, even though women comprise the majority of chronic pain patients. In addition, rural, sparsely populated Cecil County had the second highest rate of overdose. According to Horowitz, Cecil County is a transit point for the largest drug trafficking hub in the east along I-95, headed north to the major northeastern cities.

But why are drug networks, most of which are comprised of foreign nationals at the primary level, able to operate so effectively in Maryland? Horowitz says the answer lies in immigration policy:

[T]he three largest jurisdictions in Maryland are Baltimore City, Montgomery County and Prince Georges County. They are all sanctuary cities that refuse to hand over drug traffickers to ICE. This has contributed tremendously to the growth of criminal alien drug trafficking networks in the area. Prince Georges County is also overrun with drugs from the large population of Central American teens that have come in since 2014. MS-13 has saturated the county and has become a primary distributor of deadly drugs.

It’s politically correct to blame the opioid crisis on prescription drugs, and to wage war on drug companies, doctors, and pain patients. It’s politically incorrect to blame our immigration and criminal law policies.

But the Maryland report strongly suggests that the politically correct line is a misdiagnosis. Horowitz provides good reason to believe that the politically incorrect explanation comes much closer to the truth.

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