Ep. 43: 115 Deaths a Day: The American Opioid Epidemic with Andrew Kessler

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Episode Description

The United States is being ravaged by an opioid epidemic. Every day in the United States, 115 living, breathing people die due to opioid overdose. The toll of these drugs is staggering.

Our guest today is Andrew Kessler. He is the founder of Slingshot Solutions, a firm working to implement policy to put an end to opioid abuse and misuse. We learn where the drugs are coming from, where they’re going, who they’re hurting, and how we can protect our communities from devastation.

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Show Notes (abridged script)

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Andrew’s Background

Andrew has been working on substance abuse issues from the research side, to the professional side, for about 20 years.

In 2008, Andrew founded Slingshot Solutions. Around 2014, the opioid crisis began to attract much more attention from Capitol Hill, meaning Andrew’s firm began to garner more clients.

The Start of Addiction

“There are many different gateways to addiction.” ~ Andrew Kessler

Kessler makes clear that prescribing practices are not the only cause of the opioid epidemic. In fact, he lists two other causes: trauma and availability.

Using Prescription Drugs

“What the CDC unveiled, was that people who were addicted to prescriptions would switch to heroin because it was cheaper. They could get a similar high for a much cheaper price.” ~ Andrew Kessler

Kessler tells that many people become addicted after receiving prescriptions for opioids. After running out of their prescription, some transition to heroin because of its low cost and similar high.

A Traumatic Event

“Over 50% of people who have turned to illicit drugs cite trauma.” ~ Andrew Kessler

Kessler explains that the most common reason for use of illegal drugs is trauma. Whether it is physical or emotional trauma, the users are often looking for ways to ease the pain by self-medicating.

Availability of Heroin

“The amount of heroin that’s available now is far more than we’ve ever seen.” ~ Andrew Kessler

We might be talking about another drug right now if it were as, or more available, than heroin, Kessler says.

The Source of the Opioid Epidemic

Mexican Cartels and Tunnels

“There’s no doubt that [drug] smuggling from Mexico plays a role.” ~ Andrew Kessler on the opioid epidemic

While Kessler acknowledges that many drugs do come from Mexican drug cartels, he does not believe a border wall will work, “The DEA has identified and attempted to shut down over 2,000 tunnels going under the US border.”

China, Fentanyl, and the Postal Service

“When we talk about China, we’re not talking about heroin, we’re talking about fentanyl.” ~ Andrew Kessler

Kessler tells us that fentanyl, a synthetic opioid often shipped from China, is responsible for many of the overdoses in the US.

“We used to say there was heroin laced with fentanyl. But now we’re hearing reports of so much fentanyl, that the saying has become, ‘It’s fentanyl laced with heroin.'” ~ Andrew Kessler

We also learn, as we did in our immigration policy episode, that the US Postal Service is used to ship drugs to the United States.

“It’s no secret that the US Mail is the distributer of choice for fentanyl coming from China.” ~ Andrew Kessler

The Places Hit Hardest by the Opioid Epidemic

The North East

Kessler lists a few regions of the country as being hit particularly hard by the opioid epidemic: New Hampshire, New England, Vermont, Massachusetts, and Rhode Island.

Appalachia

“West Virginia is leading the nation per capita in terms of [drug] overdoses.” ~ Andrew Kessler, citing a statistic from the CDC.

Additionally, regions such as Southern Ohio, West Virginia, Kentucky have experienced myriad overdoses. Kessler says many of the black market pills were coming up from Florida and ending up in Appalachia.

New Mexico

“It’s no secret that the cartels are economic entities. They use business models.” ~ Andrew Kessler

Surprisingly, Kessler states, New Mexico is being hit hard by the opioid epidemic. His theory is that the state’s proximity to Mexico lends itself to illicit drug trade.

Small Towns

The Wall Street Journal has reported that small, rural towns have been hit particularly hard by the opioid epidemic. Kessler says these areas are an “untapped market.”

“When you have a lack of law enforcement that is a heroin dealer’s paradise.” ~ Andrew Kessler on opioid dealers targeting rural areas

He also attributes the spread of the drugs to these rural markets to the lack of strong law enforcement. Comparatively cities, have more focused resources to treat and prevent illicit drug use.

The Demographics of the Opioid Epidemic

“Words like ‘average’ are really tough for us because we have to treat the individual.” ~ Andrew Kessler

Younger Users

Kessler cites anecdotal evidence, which he says is still useful, of younger people receiving treatment more often. This could be evidence of a trend of younger Americans toward abuse.

Abuse Older Americans

“We’re also seeing [opioid] abuse climb in older Americans.” ~ Andrew Kessler on how the opioid epidemic is affecting older Americans.

The increase in the use of opioids among the elderly may be due to prescribing practices. If we think about who is being prescribed pain-killers, Kessler says, it is the more often the elderly than the young.

The Peripheral Effects of the Opioid Epidemic

The Children of the Opioid Crisis

“[The Opioid Epidemic] is an incredible burden on the childcare and welfare system.” ~ Andrew Kessler

The Wall Street Journal has extensively covered the opioid crisis. Some of their reports detail how many drug addicts are leaving their young children behind after they overdose. As a result, grandparents and the foster system are having to care for them. This, Kessler says, is overburdening the foster systems in many states across the country.

“Addiction is a family disease.” ~ Andrew Kessler on the impact of the opioid crisis on American families.

The problem, Kessler tells us, expands beyond basic care needs. Children who watch their parents struggle through drug addiction, and possibly drug overdose, often need psychiatric care after this.

“[The children’s] needs are no less important than the needs of the person seeking out the treatment.” ~ Andrew Kessler

Other Economic Costs

America’s opioid epidemic is harming not just the families, but also basic aspects of our civilized society. Kessler describes how courts are being flooded with cases, property is being destroyed, and productivity in the workplace is lessened.

Policy Solutions

“There’s really not much you can do with the private system. But when it comes to the public health system, that’s where we’re most focused.” ~ Andrew Kessler

Mental Health Addiction and Parity Act (MHAPA)

In 2008, Paul Wellstone and Pete Domenici passed the Mental Health Addiction and Parity Act, in what Kessler says was one of the first victories in the fight against opioid addiction. The law forced insurance providers who provided mental health and addiction services, must reimburse at an equal level as general medical services. If mental health and addiction services were offered, they had to be offered the same as general services.

Affordable Care Act (ACA)

Kessler also cites President Obama’s Affordable Care Act as being a victory. The ACA had certain essential health benefits that had to be covered across all exchanges. Some of these essential health benefits covered mental health and addiction services.

Comprehensive Addiction and Recovery Act (CARA)

CARA worked to expand the amount of money and resources for treatment, prevention, recovery, and criminal justice in the fight against the opioid crisis.

Recovery Services

“You’re talking about people who have not received a lot of job training or don’t have a home. If they don’t have these things the odds of staying sober are not in their favor.” ~ Andrew Kessler

Kessler discusses how many addicts started when they were adolescents. As a result, they missed many crucial years of development. They may not have built up the proper social skills, working skills, or the personal skills necessary to thrive in everyday life post-recovery.

Prevention

“If you were to ask me the one area we’re not investing enough, it’s prevention.” ~ Andrew Kessler

Evidence-Based Prevention in Schools

“Studies have shown that every dollar invested in evidence-based prevention in a school setting can save as much as $18 over the next decade in other costs.” ~ Andrew Kessler

Kessler cites a study showing the massive returns on investment from investing in evidence-based prevention of drug use. He would like to see more money invested into these areas.

Law Enforcement Policy

Kessler does not believe that President Trump’s proposal to give the death penalty to drug dealers will be effective. First, he argues that our criminal justice system cannot effectively carry out such a policy. Second, that drug dealers already face death on a daily basis, and a threat from the federal government is unlikely to stop them.

Recent Legislative Action

An Overwhelming Number of Bills Passed in the House

“It’s overwhelmingly bi-partisan.” ~ Andrew Kessler on the congressional effort to address the opioid crisis

In June this year, the House of Representatives passed dozens of bills addressing different policy solutions to the opioid epidemic. This move surprised many policy experts on the topic; however, they were glad to be receiving so much attention for the topic.

“Government works best when you don’t know it’s working.” ~ Andrew Kessler

Bills with Luke Scorziell does not provide investment, tax, or legal advice or recommendations. This material is solely intended for educational purposes based on publicly available information and may change at any time. Additionally, this article’s content is a summary of the Interviewee’s comments and, while rephrased by the Author, are not from the Author himself.

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About Luke Scorziell

Mr. Scorziell created The Edge of Ideas when he was 15 years old. After a few years of blogging he found a passion for podcasting and now regularly has guests on his show, Bills with Luke Scorziell. Find out more about Luke and his unique journey. Feel free to send Luke a message below.