Saturday, December 10, 2016

The Heroin Epidemic and the News/ DC Dave

The following piece was written by DC Dave, who shares my take on the opioid crisis, and its roots in the US deployment in Afghanistan.  He has elaborated on the heroin epidemic, noting how the mass media have shied away from a realistic discussion and interpretation of the epidemic of injected opioids sweeping the world, which killed (newly reported this week by CDC) 15,000 Americans in 2015.  Why did it take a year to come up with the 2015 number?   I previously discussed the fact that CDC has been assigning deaths in which fentanyl was found (even when the death was obviously due to injection) as "prescription opioid deaths." I suspect that as fentanyl use and deaths skyrocketed faster than those due to heroin during the past two years, this turned into a problem for CDC.  Fentanyl tends to be mixed with heroin or to replace heroin as a similar, stronger, cheaper alternative narcotic, which can be synthesized without poppies or opium.  So assigning all fentanyl deaths to prescription drugs is being noticed, and criticized.  The states and communities know whether people are dying from prescription fentanyl or from a needle.  My last post showed that Massachusetts is now releasing its own statistics.  While CDC claims over 50% of narcotic OD deaths are due to prescription drugs, Massachusetts says sorry, but our illicit narcotic OD deaths are 80%, and prescription OD deaths are only 20%.  Here is DC Dave's piece:

Heroin Epidemic and the News

When you discover something that seems to you to be important but then you notice that the people who tell us what is supposed to be news are ignoring it, you know that it must be really important.  I can cite a number of examples just from my own web site.  Most recently we had the almost total press blackout of the justice system wrist slap of the man most responsible for the flood of illegal aliens into the country.  It figures that they would black out the news of the piddling punishment that the man, Stan Eury, received, because they had blacked out his prosecution, and most of what they had reported on his operations previously had, amazingly enough, been favorable.

Before that we had their total failure to report in 2004 that the long suppressed report on the suspicious 1949 death of Secretary of Defense James Forrestal had at long last been made public.  The press silence was extremely telling.  They couldn’t report it because it was full of information that contradicted what they had unanimously told us for 55 years, that is, that Forrestal, the leading opponent in the U.S. government of recognition of the new state of Israel, had killed himself. 

Before that, in 1997, the press had completely blacked out the news that Kenneth Starr’s report on the death of deputy White House counsel Vincent W. Foster, Jr., contained, by judges’ order, 20 pages that thoroughly undermined the conclusion that Foster had committed suicide.  In Part 3 of my “America’s Dreyfus Affair, the Case of the Death of Vincent Foster,” I called it “The Great Suppression of ’97.”

These stories are plainly of enormous importance, and the fact that they are completely ignored by the American news media magnifies their importance.  So too is the story of the heroin-death epidemic that is currently ravaging the country.   In this case the news hasn’t been ignored completely, but it has been spun in such a way that one would hardly realize its magnitude.  In the first place, only the lesser news organs dare suggest that the sharply rising death rate in the country from drug overdoses might be coming from widely available cheap heroin.  “Heroin’s Death Toll Reaches Another Gruesome Landmark,” a headline that appeared above an October 16, 2016, article in the leftist Mother Jones magazine is one that you will never see in The Washington PostThe New York Times, or one of their many clones around the country.  The article’s subtitle was even more disturbing: “Most states now lose more citizens to overdoses than to car accidents.” 

The heroin factor in drug overdose deaths is also played down by the major news media by focusing all of what inadequate attention they have given to the problem on the deaths from prescription opioids.  The Washington Post furnished a good recent example of what I am talking about on October 22 of this year.  I posted an online comment, which received a supporting response from a medical doctor.  Since, together, they get us right into the heart of the distorted reporting on the matter, I reproduce them both here:

I believe this is a very misleading statement: "Prescription narcotics cause more overdose deaths every year than any street drug, including heroin." 
 
The following is from an article by Meryl Nass, MD:  
 
"According to CDC itself, 'CDC has programmatically characterized all opioid pain reliever deaths (natural and semisynthetic opioids, methadone, and other synthetic opioids) as ‘prescription’ opioid overdoses.' That means illegally produced drugs in these categories are being designated as prescription drugs, when they are not. A further confounder is that heroin metabolizes to morphine, which is a prescription drug. So if fully metabolized at the time of autopsy, a death due to heroin will be labeled as due to a prescription narcotic." 
 
Dr. Nass observes further: "While nationally, heroin overdoses jumped from 1.0 per 100,000 in 2010 to 3.4 per 100,000 in 2014, the number of prescribed narcotics held steady over the same period. A 2015 UN document noted that 'A recent [US government] household survey in the United States indicated that there was a significant decline in the misuse of prescription opioids from 2012 to 2013.'" 
 
http://www.washingtonsblog.com/2016/01/ny-times-depth-article-us-heroin-epidemic-gets-cause-solution-wrong.html *
 
Furthermore, the statistics do not distinguish between accidental and intentional drug overdose deaths. You know what you're getting from a prescription drug, but not from heroin bought on the street. I believe that all this fuss about out-of-control prescription drugs is a big smokescreen to cover for what is overwhelmingly an epidemic of deaths from heroin overdoses. Most of that heroin comes from Afghanistan and the producers are protected by our government.

To which “Pathologist, MD,” replied:

You are exactly spot-on correct. I've been saying this for over two years to deaf/blind ears/eyes including the CDC who's just fine with their bogus statistics. A competent high school math student should be able to debunk CDC stats which are hyperbole and designed for one thing - the addictionologists who've taken over at the CDC (like Andrew Kolodny - a psychiatrist/addictionologist who worked with Tom Frieden while they were together in NYC before Friedenbecame head of the CDC). If anyone will do a bit of research, instead of getting to the root causes of this problem, a band of zealots took over the CDC so-called 'prescription drug epidemic' and embellished everything in the language of addiction when only a small fraction of legitimate chronic pain patients have ANY problems with addiction issues (around 5%). Instead, they inflate numbers and create problems for patients while doing nothing for the real problem - illicit drugs and mostly young addicts. Then the major networks (like CNN and 60 minutes) pile on without doing any research whatsoever to further embellish the illegal side by taking pain medication away from legitimate patients. And NO ONE wants to hear from patients - I'm a 30 year senior in-house staff hospital physician who can't get an audience with anyone in power - they'd rather mislead everyone. Editors of major media outlets are aware of this but have chosen to take the low road and are doing nothing but making it all worse for everyone. Whether they're innumerate (bad at math) or prefer hyperbole, it's all the same. Misinformation on a grand scale and screwing over patients. How honorable.

Ignoring for the moment the last point in my letter, that most of the heroin behind the drug overdose surge is coming from Afghanistan, we can easily find support for Dr. Nass’s claim that heroin deaths are mainly behind the drug-death surge in the CDC’s own literature

From 2000 through 2013, the age-adjusted rate for drug-poisoning deaths involving heroin nearly quadrupled from 0.7 per 100,000 in 2000 to 2.7 per 100,000 in 2013. During this 14-year period, the age-adjusted rate showed an average increase of 6% per year from 2000 through 2010, followed by a larger average increase of 37% per year from 2010 through 2013…

Several factors related to death investigation and reporting may affect measurement of death rates involving specific drugs. For example, toxicological tests to determine the types of drugs present may vary by jurisdiction. Measurement errors related to these factors are more likely to affect substance-specific death rates than the overall drug-poisoning death rate. In 2013, 22% of drug-poisoning deaths did not include information on the specific types of drugs involved. Some of these deaths could potentially involve heroin or opioid analgesics.

Metabolic breakdown of heroin into morphine in the body can make it difficult to distinguish between deaths from heroin and deaths from morphine based on the information on the death certificate. Some deaths reported to involve morphine could actually be deaths from heroin.  This may result in an undercount of heroin-related deaths.

A person examining the tables and charts in that report entitled “Drug-poisoning Deaths Involving Heroin: United States 2000-2013” can easily come to the conclusion that it is readily available cheap heroin that is primarily responsible for the surge in drug overdose deaths in recent years.  As Dr. Nass says in another article, “The true cause of the current heroin epidemic is massive amounts of heroin flooding into the U.S., exceeding what can be sold in our large cities, and now finding its way into even the tiniest hamlets.”

Local Reporting Better
One of those hamlets is Nashville, the county seat of my home county of Nash in North Carolina.  The chief of Nashville’s police department recently instituted a program inviting addicts to turn themselves in for treatment, with a promise of no punishment by the law.  
Of the 32 people who responded, “29 were addicted to heroin or opioid painkillers, two were crack-cocaine users and one abused alcohol.” "If you've got a thousand-percent increase here, it's not really something you can sweep under the rug," [Town Manager Hank] Raper said. "It's already here. It's not a matter of 'We'll address it when it gets here.' I think you're in denial if that's what you think."
The town manager noted that many users migrate to heroin after receiving legitimate prescriptions for opioids like hydrocodone, oxycodone, codeine and morphine.
“People who abuse heroin also defy demographics -- with young and old, rich and poor, whites and minorities all developing a physical and psychological dependence on the substance.
"Children are addicted to heroin," Raper said. "Elderly senior citizens, 80, 90 years old, are hooked on heroin. Wealthy individuals, poor individuals. It's a cheap drug. For $10, you can buy a hit of heroin. That's really not unaffordable to anybody. If you want it bad enough, you can find 10 bucks."
The Wilson Daily Times, in which this article appeared, seems not to have gotten the word from propaganda central that they’re supposed to shy away from the dreaded “h” word and to call this an “opioid epidemic” instead.  The article carried this title, “Police can’t arrest their way out of the heroin epidemic.  Nashville tries a different approach to break the cycle.”  Further down in the article we see the section heading, “Heroin Epidemic,” followed by this lead sentence, “A scourge in the northeastern United States for years, heroin has gained popularity in the Tar Heel State, where many of its users found the drug cheaper and easier to obtain than opioid painkillers.” 
We can find an echo of this small town North Carolina newspaper in Lancasteronline, from Lancaster, Pennsylvania.  “Frustration mounts as Lancaster County drug epidemic grows,” says the headline from October 16, 2015, and the first sentence cuts right to heart of the matter, “They don’t all agree on the way the war on drugs should be fought, but prosecutors, emergency responders, educators and health professionals in Lancaster County say heroin use is an epidemic here.”  The article continues in that vein, zeroing in on heroin, not opioids in general:
The frustration has its roots in the number of people who overdose on heroin here. Robert Patterson, a lieutenant with Lancaster EMS, said emergency medical technicians have treated 585 people for overdoses in the eight months from February through September; and 163 were treated with naloxone.

Naloxone is the heroin antidote that first responders now carry as do emergency medical personnel. He said overdoses happened not just in the city but in 22 different townships in the county so far in 2015.

“Pennsylvania is now the third worst state in the country for heroin abuse,” said [Craig] Stedman, the district attorney, “and one of the worst for mortality (from heroin).”
Stedman said arrests for bulk heroin are up, indicating larger supplies are coming into the county.

“The Drug Task Force had three cases of bulk heroin in 2011-2012, nine cases from 2012-2013,” Stedman said. “They’ve investigated 38 cases of bulk heroin in 2014 and there were already 27 cases through the first half of 2015.”
By correctly labeling the problem as a heroin overdose epidemic and then talking about its abundant supply these small newspapers steer us in a direction that the big opinion molders like The Washington Post and The New York Times don’t want us to go. 
In its power and influence, the Raleigh News and Observer falls squarely between the two small and two large newspapers I have cited.  Its reporting on the heroin epidemic has, for the most part, mirrored that of its larger cousins, but it did manage to print one bold letter to the editor:  
Regarding the Sept. 19 news article “US attorneys focus on prescription opioid and heroin abuse”: I am weary of articles blaming the opium (opioids/opiates) epidemic on our physicians. When opium products became rampant on our streets again, officials had difficulty explaining this epidemic to the public. Our government faced similar problems in the 1960s when our military troops were sent to Vietnam and the Golden (opium) Triangle.

Let’s follow the money trail. According to the United Nations, almost two-thirds of illegal street opium is cultivated in Afghanistan, but not processed there. Most opium is processed into pills, powders, patches and heroin in factories in other foreign countries. The vast majority of opium products sold on the streets is not processed in U.S. factories, not at any time ordered by our physicians or dispensed by our pharmacies. According to the U.N., most opium products used illegally in the U.S. are believed to be processed in Mexican and other factories in Central and Latin America. It is estimated the illegal opium trade is a $69 billion to $79 billion a year business.

While some bad apples exist, U.S. physicians didn’t start and don’t maintain the illegal opium epidemic, so stop the scapegoating. There is a better question. Why are we still in Afghanistan?

Raleigh

Even though from something of a local celebrity, such a letter is very unlikely to have seen the light of day in The Washington Post or The New York Times or any other big city newspaper in the country, because it carries a message that they are working hard to keep a lid on.

A Google Search

A simple web search reveals the mainstream news suppression starkly.  Readers may go as I did to Google and type in “Heroin epidemic Afghanistan.” I have listed in order below, with links, the articles that came up on the first page of the search.  Pay particular attention to the news organs that produced them.  All are well worth reading in their entirety; I have quoted the opening passages from three of them for particular emphasis upon their message.   The third article, one might notice, is the second of Dr. Nass’s two articles that I have linked to previously above:


MINNEAPOLIS — The “War on Drugs” and the “War on Terror” are more intertwined than that media and our elected officials would like us to think.

And this became full front and center when the U.S.-led global crusades overlapped in Afghanistan, leaving in their wake a legacy of death, addiction and government corruption tainting Afghan and American soil.

In the U.S., the War in Afghanistan is among the major contributing factors to the country’s devastating heroin epidemic.

Over 10,000 people in America died of heroin-related overdoses in 2014 alone– an epidemic fuelled partly by the low cost and availability of one of the world’s most addictive, and most deadly, drugs.





The heroin epidemic resembles the days when “Crack cocaine” became the major drug that destroyed communities across the United States and other parts of the world including the Caribbean that began in the early 1980’s. The Crack epidemic coincidently began around the same time when the Iran-Contra Scandal was being exposed. U.S. cities such as Los Angeles, Miami and New York City experienced a rise in crime and disease. The Center for Disease Control (CDC) reported back in 2015 that “heroin use in the United States increased 63% from 2002 through 2013.” Fast forward to 2016, heroin is sweeping across the United States at unprecedented levels.




Barack Obama ended opium eradication efforts in Afghanistan in 2009, effectively green lighting Afghan opium and the heroin trade. U.S. policy has allowed Afghan opium and heroin since. And heroin deaths here tripled from 3,036 in 2010 to 10,574 in 2014; so has heroin use, from 1,500,000 in 2010 to 4,500,000 heroin users in 2014.

Now let us take stock.  The first thing one should notice is that none of these very informative and well-researched articles was in a mainstream United States news organ.  The closest thing to it is the last one which appeared in Newsmax, which I have previously identified as a likely intelligence operation headed up by thenotorious Christopher Ruddy.  As its opening passage indicates, consistent with the mission of the web site, it acknowledges a connection between the U.S. heroin scourge and our involvement in Afghanistan, but it spins the story to blame everything on the Obama administration. 

Not until I got to the second page of my Google search did I encounter anything from the generally recognized U.S. mainstream press, and that was this one from NBC News:


That sounds promising, but as one can see from the opening passage below, the spin that the network puts on the story almost makes one dizzy:
In Afghanistan, opium production is growing like a weed — and nothing, not even billions of dollars of U.S. money, has been able to quell it. 
According to the United Nations, the war-torn nation provides 90 percent of the world's supply of opium poppy, the bright, flowery crop that transforms into one of the most addictive drugs in existence. 
And as the Centers for Disease Control and Prevention sounds the alarm about a worsening heroin epidemic here in the U.S., opium production in Afghanistan shows no signs of slowing down. 
"Afghanistan has roughly 500,000 acres, or about 780 square miles, devoted to growing opium poppy. That's equivalent to more than 400,000 U.S. football fields — including the end zones," John Sopko, Special Inspector General for Afghanistan Reconstruction, said in a speech in May. 
The U.S. has spent $8.4 billion in counternarcotics programs in Afghanistan. But opium output keeps rising: Fifteen years ago, Afghanistan accounted for just 70 percent of global illicit opium production. 
Did you get that, dear reader?  We are being flooded with cheap heroin originating in Afghanistan not in any way because of U.S. intervention in the country but in spite of the U.S. invasion and the history of the CIA fattening its coffers through engaging in the extraordinarily profitable illicit drug trade.
Is it any wonder that the confidence of the American public in its major news media is at an all-time low?  Most people in the country still get most of their news from the major television networks, but people who are dependent upon them would hardly know that we even had this heroin epidemic, that is, if, in all likelihood, it hadn’t already hit pretty close to their own homes.  So wary are the mainstream media of using the “h” word and addressing the problem head on, that it is left to government officials like the Attorney General of Virginia to produce a documentary like “Heroin: The Hardest Hit” or the BBC to give us “Smack in Suburbia.”  How much more effective might those documentaries have been in alerting people to the problem had they been aired on a major American television network!  
One can’t help thinking that they don’t give this horrible new scourge the attention it deserves because, if they did, people would begin asking too many questions, and a big income stream that likely filters down to all of them might be jeopardized.


* A better link to Dr. Nass’s article, it has been pointed out to me, is at her web site http://anthraxvaccine.blogspot.com/2016/10/my-old-post-and-comment-recovered-from.html, because there you can read the additional valuable observations of a military veteran of Afghanistan:

The comment below was made to a cross-posting of my article on the Global Research Facebook page, and speaks to trafficking heroin from Afghanistan to the US -- Meryl Nass

Hold on, folks. Don't be so hasty. [He is responding to a prior comment blaming the military for the heroin trafficking.]

As a veteran who served in Afghanistan, I can tell you that the military involvement is limited and knowledge/awareness even more so. The CIA and contractors are running unmarked cargo aircraft out of our airbases at Bagram and Kandahar. Yes, Air Force personnel load the shrink-wrapped palates onto the planes, but they don't know what's inside.

For those of you who doubt that, let's recall the case of Ciara Durkin.  Ciara was a Massachusetts National Guardsman who died "under mysterious circumstances" from a rifle bullet to her head at Bagram. Details reveal that her death was not suicide, as some may be quick to suspect: She was shot from a distance as she left the base chapel. She worked in finance and had recently wrote a letter to her family that she uncovered something."  That was in 2007.

Let's not forget Pat Tillman. He was killed in 2004, right before I left the country. A member of the Army Rangers, his unit was working extensively in the opium territory along the Pakistani border. While everyone has heard that his death was officially ruled "friendly fire," what most don't know is that he had undergone a change of heart while serving in Afghanistan--out of FOB Salerno, where I spent my 30th birthday. A man of conscience, he could have been swayed by the racism, prejudice, and general de-humanization the US military had affected toward the Afghani people. Or, he could have taken issue with the fact that the official policy towards all military personnel was "hands-off" of the opium fields. He was certainly in position to do so. Whichever was the case, we'll never know.

It is the CIA that is primarily responsible for the clearance of targets for military operations . . . and of aircraft allowed to enter/leave the Afghani airspace. The military--all branches--merely comply with the orders, authorizations, or restrictions handed down.

And let's not forget that many of our military are themselves having changes of heart, awakenings of conscience, or whatever you want to call it. They are disheartened and disillusioned about the occupation--its goals and intentions. They are stuck, however, and unable to change anything, protest, question, or even disobey without facing court marshal or fratricide. This is why so many end up depressed, turn to drugs themselves, or commit suicide. They see the unmarked planes being loaded. They are told to "look the other way," or "you don't see anything," or "that plane doesn't exist." But they do see them and they know they exist . . . and are powerless to do anything about it.

No, please, don't blame the military. Blame the CIA. Blame the civilian contractors. It's Air America all over again. First it was a geopolitical strategy to divert a major source of revenue for Iran, but then it surely took on a life of its own when they realized how much money they could bring in by controlling the world's heroin supply. And so they have. And with such an undocumented and unlimited supply of money, they don't care about Congress or even the POTUS. With all of the destabilization operations, Color Revolutions, and direct support for IS, it would seem that they've gone rogue. God help us all! 

David Martin
December 1, 2016


Addendum

I received the following depressing email message from Dr. Nass on December 3, 2016:

I am going to bring up a side issue, since your earlier email quoted me on the method used by CDC to assign a death to prescription opioids vs heroin. (She is referring to my article, which I sent her by email.  ed.)

CDC has not released the 2015 data on deaths.  I have been waiting for it.

I have a strong suspicion that CDC’s “programmatic” way of assigning deaths to prescription opioids has now gotten CDC into hot water, such that if they use the “programmatic” method for 2015-6 everyone will know they are FOS.  

This is because a) so much heroin is cut with fentanyl, a fully synthetic opioid that can be obtained by prescription, but is probably entering the US from illegal synthesis in huge quantities.  Mg for mg it is up to 50 times more potent than heroin.  So not only do you need less for the same kick, you don’t require any opium to make it.

In Massachusetts, more of the ODs (by a small margin) contained fentanyl than heroin. Like 80% and 70% respectively.  If CDC calls all the ODs that involved fentanyl 'prescription drug ODs', when the cops and medical examiners know they involved injected heroin and fentanyl, CDC will be seen to be a liar.  So they are withholding the stats, imho, until they design a different method of calculation and have come up with a plausible story for the change in methodology.

Yes, I am very concerned about heroin from Afghanistan, and there was allegedly a very good crop last season.

But fentanyl is catching up to it so even if we get out of Afghanistan, the problem will not be ameliorated.

BTW we do not have enough medical examiner resources to check every OD for what did it.  And this will likely worsen since the numbers the medical examiner system now has to deal with, using flat resources, has gotten so high.  This may enable CDC to do some mealy mouthing about the whole issue.

Fentanyl is mentioned in one of the videos to which we link in the penultimate paragraph.  It was news to me when I heard it, and I believe I was remiss in not calling attention to it because it represents such a lethal threat to unsuspecting heroin users.  It is one opioid that is a good deal more dangerous than heroin.

David Martin
December 5, 2016





Tuesday, November 8, 2016

Who's Fooling Who? CDC Says Most Overdose Deaths Involve a Prescription Opioid. But in Massachusetts Only 20% do.

Drug overdose deaths in the United States hit record numbers in 2014

 At least half of all opioid overdose deaths involve a prescription opioid. HHS/CDCMore people died from drug overdoses in 2014 than in any year on record. The majority of drug overdose deaths (more than six out of ten) involve an opioid.1 And since 1999, the number of overdose deaths involving opioids (including prescription opioid pain relieversand heroin) nearly quadrupled.2 From 2000 to 2014 nearly half a million people died from drug overdoses. 78 Americans die every day from an opioid overdose.
We now know that overdoses from prescription opioid pain relievers are a driving factor in the 15-year increase in opioid overdose deaths. Since 1999, the amount of prescription opioids sold in the U.S. nearly quadrupled,2 yet there has not been an overall change in the amount of pain that Americans report.3,4 Deaths from prescription opioids—drugs like oxycodone, hydrocodone, and methadone—have also quadrupled since 1999.5

In Massachusetts, real time data have just been made available, and fentanyl and heroin overdose deaths outweigh those involving prescription opioids 4 to 1 and 3 to 1, respectively. Prescription opioids were only found in 20% of OD deaths.

Afghanistan had a bumper crop of opium this year, while illicit fentanyl consumption and production (which, unlike heroin, does not require opium as a raw material, and its potential production is virtually limitless) is also booming.  

Why does CDC blow smoke about the narcotic crisis?


Tuesday, November 1, 2016

She didn’t think a flu shot was necessary — until her daughter died/ WaPo

Last week's Washington Post had a very sad, haunting story about the death of a twelve year old girl from flu-related causes.  Her mother had tried for ten years to have her, and finally succeeded using in vitro fertilization.  Then her daughter developed flu, organ failure and died, in rapid succession, last January.

It was probably no coincidence the story was published in October, the prime month for advertisements for flu shots.  While the take home message was to get your children vaccinated, the odds that a vaccine would have prevented this death are less than even. 

My comment:

This story omitted important information. 
According to CDC, the flu shot has been, on average, 37% effective over the past 12 years. However, also according to CDC, the FluMist nasal vaccine used in children was pulled this year, because it *did not work* over the past 3 flu seasons. 

According to the Cochrane Collaboration, there are no data on flu vaccine efficacy in infants and toddlers. Therefore I would not encourage parents of very young children to vaccinate them for flu, as the vaccine might be considered experimental in this age group. 

Last year there were 85 pediatric deaths from flu. There are 80 million flu vaccine-eligible children in the US. If you vaccinated 80,000,000, you might prevent an estimated 31 pediatric deaths (37% x 85)---but you would cause many cases of Guillain-Barre paralysis and other side effects. So the net cost/benefit of vaccinating children is uncertain, and could well be negative. 

Finally, nearly all people who die from flu-related causes die from a complication of flu, like pneumonia. In Piper Lowery's case, her mother took her to the hospital "several times" in the 4 days from illness onset to death. Why was she sent home several times? Her doctors should have known better. 

Sunday, October 30, 2016

My disappeared post, and important comment, recovered from the WayBackMachine, about how US heroin comes mostly from Afghanistan, not Mexico, and the US Government could easily stem the supply, if it wished to

Saturday, January 30, 2016


NY Times' penetrating look at the heroin epidemic gets the cause and solution all wrong


On October 30, 2015 the NY Times published an in-depth article on the heroin epidemic, focused on New Hampshire, which saw the greatest increase in deaths from drug overdoses (74%) in the US between 2013 and 2014.  New Hampshire is a bucolic place, where villages of tidy white capes and saltboxes lie sprinkled among the mountains and pine forests.

Manchester, New Hampshire's largest city, has a population of 110,000.  In one 6 hour period on September 24, Manchester police responded to 6 separate heroin overdoses. Manchester saw over 500 overdoses and over 60 deaths between January 1 and September 24, 2015.

At presidential campaign stops throughout the state, candidates were forced to respond to the problem when New Hampshire citizens demanded answers.  Hillary has a $10 billion dollar plan for prevention and treatment of abuse.  Chris Christie prefers treatment to jail time for first offenders. Obama announced a $5 million initiative in August to combat heroin addiction and trafficking. (Later he upped it to a billion.) New Hampshire has designated a drug czarNH Senator Ayotte says,"We've got to reduce the stigma."  Narcan, an opiate antidote that has been made widely available, is admittedly a band-aid.  It saves lives from acute overdoses, but does absolutely nothing to stem the tide of abuse.
 
The solutions being touted by politicians and the media include "working together:" police, citizens, and health-care facilities--though to what end is unclear; educating; reducing the stigma of heroin use (now that users are predominantly white and middle class we can relabel addiction a disease, not a crime); adding treatment facilities; and adding more police.

I call this salutary--but almost entirely missing the mark.  

Overdose deaths and heroin users are at an all time high in the United States. Between 2 and 9 of every thousand Americans (0.2-0.9% of the population) is currently using heroin. In Maine, 8% of babies are born "drug-affected"--a stratospheric rise from 178 babies in 2006 to 995 babies in fiscal 2015.  A NEJM study found opiate-addicted babies in neonatal ICUs quadrupled between 2006 and 2013. 

Despite what you have heard, the cause of our current heroin epidemic is not as simple as doctors over-prescribing narcotics, or users switching to heroin when prescription drugs became more scarce and expensive.
According to CDC itself, "CDC has programmatically characterized all opioid pain reliever deaths (natural and semisynthetic opioids, methadone, and other synthetic opioids) as 'prescription' opioid overdoses."  That means illegally produced or trafficked drugs, in these categories, are incorrectly being designated as prescription drugs. Further confusing the issue is that heroin is broken down to morphine in the body, which is a prescription drug. So, if fully metabolized at the time of autopsy, a death due to heroin may be labeled as due to a prescription drug. Fentanyl, a stronger (synthetic--no poppies needed) narcotic than heroin, is often used to "cut" heroin. While it may be a prescription drug, it is also illegally manufactured. Deaths due to fentanyl may be incorrectly classified as prescription overdoses. Also, many overdoses are due to simultaneous use of multiple drugs, so identifying the drug that caused death may be impossible.

The implication is that some iv heroin deaths are being misclassified as due to legal drugs, and the 10,500 heroin overdose deaths recorded in 2014 may be a gross underestimate.

The undeniable root cause of the current heroin epidemic is a massive increase in availability
--huge amounts of relatively cheap heroin have been flooding into the US in the last few years, exceeding what can be sold in our large cities, and now finding its way into even the tiniest hamlets. Without it, there would be no epidemic. The NY Times story failed to mention this.

Here's the problem with the NY Times' and the politicians' solutions:  neither fifty individual states nor thousands of towns and villages can treat, educate, exhort, investigate or imprison their way out of the heroin maelstrom, while the next fix is cheap and just around the corner. There are nowhere near enough social workers, foster parents, police, prisons, treatment facilities or sources of funding to handle the numbers affected.  Narcan and clean needles don't cut the mustard. And most active addicts don't want to be treated, coming to treatment only when pushed by the legal system.

There is only one possible solution, and that is stemming the supply.  Until this is understood, and acted on, the epidemic of heroin abuse will continue. 

In my September 7 blog post, I explained why 96% of US heroin does not come from Mexico and Colombia, as claimed by multiple US government agencies.  Mexican and Colombian production is inadequate to supply even half the US market.

At least Canada knows where its heroin comes from:  "According to the Royal Canadian Mounted Police National Intelligence Coordination Center, between 2009 and 2012 at least 90 per cent of the heroin seized in Canada originated in Afghanistan." (page 46)

If one wants to get into the weeds on this issue, a 2014 RAND report titled What America’s Users Spend on Illegal Drugs: 2000-2010 is a good place to start.  The  report, performed under contract for DHHS and released by the White House, looks at multiple databases and identifies many problematic issues with estimates of heroin country-of-origin.

It shows that while Colombian opium was allegedly supplying 50% of a growing US heroin market between 2001 and 2010 (pages 82-83), Colombian production actually sank from 11 metric tons in 2001 to only 2 in 2009.

Furthermore, US government estimates for the 2000-2010 decade of Mexican production relied on a claimed 3 growing seasons per year, while in reality there were only 2. RAND admits Mexican production estimates by the US government were juiced: 
"The US government now recognizes that the previous estimates were inflated. There are no back-cast revised estimates (marijuana and poppy/heroin) for the whole country of Mexico prior to 2011."
Mexico historically produced lower quality, "black tar" heroin, used west of the Mississippi, while the influx of heroin to the US, and particularly in the eastern US, has been of higher quality white/tan powder. The DEA's 2015 National Heroin Threat Assessment notes, "Availability levels are highest in the Northeast" [that part of the continental US furthest from the Mexican border] "and in areas of the Midwest, according to law enforcement reporting," which would make no sense if the heroin originated in Mexico. In fact, the same report revealed that the Southwest US [the area adjacent to Mexico] had the lowest number of respondents of any US region (only 4.3%) who felt heroin was the greatest drug threat, compared to 63.4% of law enforcement respondents in New England.

Meanwhile, according to RAND"in recent years, there have been no [heroin] seizures or purchases from Southeast Asia [Myanmar, Laos, Thailand] by DEA's Domestic Monitoring Program."

Back in 1992, DEA estimated that 32% of US heroin came from Southwest Asia (mainly Afghanistan). Since then, Afghan opium production has tripled. But in the years 1994 through 2010 only 1-6% of US heroin had a Southwest Asian origin, according to DEA's Domestic Monitoring Program. Yet Afghan production accounts for 85-90% of the world heroin supply. 

It would be great if we could point to improved US interdiction at the source, or to poppy field eradication to explain this anomaly.  But neither is the case. Seizures of heroin in Afghanistan dropped from 27 metric tons in 2010  to 8 metric tons in 2013, according to the UN, figure 41. Only 1.2% of Afghan poppy fields were eradicated in 2014, also according to the UN.

The UN Office on Drugs and Crime 2013 Report acknowledges that US estimates of where its heroin comes from (claiming about 50% comes from Colombia) make no sense:
"Continued inconsistency in the information available from the Americas on opiate production and flows makes an analysis of the situation difficult – while Mexico has the greater potential production of opium, it is Colombia that is reported as the main supplier of heroin to the United States. The Canadian market seems to be supplied by producers from Asia." (page 30) 
"It is unclear how Colombia, given its much lower potential production, could supply larger amounts to the United States market than Mexico." (page 37)
It is undeniable:  there has been profound, systematic deception by the US government to inflate estimates of the amount of heroin coming from Mexico and Colombia, presumably to conceal the actual origin of most US heroin, and possibly to protect its means of entry into the US.

We know where and how to look for heroin. Afghanistan and Myanmar are the world's #1 and #2 producers, accounting for over 95% of world production.   Historically, most heroin bound for the US left these countries by air. There are a manageable number of flights departing Afghanistan and Myanmar.  We could put all the needed personnel in place, today, to fully inspect every flight and every airport.

The fact that we have looked the other way and pointed in the wrong direction is itself the smoking gun.

UPDATE: In June 2016 the Drug Enforcement Agency confirmed what I said about methodologic issues leading to underestimates of heroin deaths (page 10):

"Heroin deaths are often undercounted because of variations in state reporting procedures, and because heroin metabolizes into morphine very quickly in the body, making it difficult to determine the presence of heroin. Many medical examiners are reluctant to characterize a death as heroin-related without the presence of 6-monoaceytlmorphine (6-MAM), a metabolite unique to heroin, but which quickly metabolizes into morphine.11 Thus many heroin deaths are reported as morphine-related deaths. Further, there is no standardized system for reporting drug-related deaths in the United States. The manner of collecting and reporting death data varies with each medical examiner and coroner.12 "
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The comment below was made to a cross-posting of my article on the Global Research Facebook page, and speaks to trafficking heroin from Afghanistan to the US--Meryl Nass

Hold on, folks. Don't be so hasty. [He is responding to a
prior comment blaming the military for the heroin trafficking.]

As a veteran who served in Afghanistan, I can tell you that the military
involvement is limited and knowledge/awareness even more so. The CIA and
contractors are running unmarked cargo aircraft out of our airbases at
Bagram and Kandahar. Yes, Air Force personnel load the shrink-wrapped
palates onto the planes, but they don't know what's inside.

For those of you who doubt that, let's recall the case of Ciara Durkin.
Ciara was a Massachusetts National Guardsman who died "under mysterious
circumstances" from a rifle bullet to her head at Bagram. Details reveal
that her death was not suicide, as some may be quick to suspect: She was
shot from a distance as she left the base chapel. She worked in finance and
had recently wrote a letter to her family that she "uncovered something."
That was in 2007.

Let's not forget Pat Tillman. He was killed in 2004, right before I left
the country. A member of the Army Rangers, his unit was working extensively
in the opium territory along the Pakistani border. While everyone has heard
that his death was officially ruled "friendly fire," what most don't know
is that he had undergone a change of heart while serving in
Afghanistan--out of FOB Salerno, where I spent my 30th birthday. A man of
conscience, he could have been swayed by the racism, prejudice, and general
de-humanization the US military had affected toward the Afghani people. Or,
he could have taken issue with the fact that the official policy towards
all military personnel was "hands-off" of the opium fields. He was
certainly in position to do so. Whichever was the case, we'll never know.

It is the CIA that is primarily responsible for the clearance of targets
for military operations . . . and of aircraft allowed to enter/leave the
Afghani airspace. The military--all branches--merely comply with the
orders, authorizations, or restrictions handed down.

And let's not forget that many of our military are themselves having
changes of heart, awakenings of conscience, or whatever you want to call
it. They are disheartened and disillusioned about the occupation--its goals
and intentions. They are stuck, however, and unable to change anything,
protest, question, or even disobey without facing court marshal or
fratricide. This is why so many end up depressed, turn to drugs themselves,
or commit suicide. They see the unmarked planes being loaded. They are told
to "look the other way," or "you don't see anything," or "that plane
doesn't exist." But they do see them and they know they exist . . . and are
powerless to do anything about it.

No, please, don't blame the military. Blame the CIA. Blame the civilian
contractors. It's Air America all over again. First it was a geopolitical
strategy to divert a major source of revenue for Iran, but then it surely
took on a life of its own when they realized how much money they could
bring in by controlling the world's heroin supply. And so they have. And
with such an undocumented and unlimited supply of money, they don't care
about Congress or even the POTUS. With all of the destabilization
operations, Color Revolutions, and direct support for IS, it would seem
that they've gone rogue. God help us all!