Ohio’s Trumbull County Holds The Line Against Prescription Opioids Pharmacies

It appears Lake County and Trumbull County of Northeast Ohio are bringing some much needed sunshine¹Sunshine is the best disinfectant. to the prescription opioids drug cartel, which includes a supply chain that may be best described as a “public-private partnership” since some of the companies involved tend to “lobby” members in Congress for favorable legislation and even lead, or at least indirectly guide, much of the “scientific” studies to earn FDA approval.²You may read about the latter in a Los Angeles Times investigative report dated May 2016 titled, “You Want a Description of Hell? OxyContin’s 12-hour Problem.”

Overview

Trumbull and Lake counties sued Giant Eagle, Walgreens (aka, “A Store-closing Machine” as WolfStreet wrote), CVS, and Walmart for essentially doling-out excessive amounts of “prescription” opioids with impunity. Giant Eagle settled for an undislosed amount, according to the article by One America News Network (OAN) titled “Pharmacy Chain Operator Giant Eagle Settles Ohio Opioid Lawsuits Mid-Trial.” Giant Eagles’ settlement statement began as such:

“While Giant Eagle denies it was a cause of the opioid crisis, it recognizes the severity of the crisis…”

Settlement statement by Giant Eagle

We understand why Giant Eagles’ counsel settled mid-trial, after all the lawsuit didn’t claim that Giant Eagle “caused” the epidemic, but rather contributed to it (actually exacerbated it). Big difference.

Giant Eagle clearly didn’t deny it has negatively contributed to the opioid epidemic. The company’s statement is what is called lying by omission and also incorporates a Straw Man Argument (a logical fallacy). Rite-Aid, by the way, already settled with the counties back in August 2021 for $1.5 million, which is not even a slap on the wrist financially. But, that’s a separate issue and topic.

Nevertheless, the lawsuits are not, or were not, an attempt to ban prescription opioids; the lawsuits were put forth to curtail the abuses within the supply chain. For example, approximately 80 million prescription opioid pills were doled-out between 2012 and 2016 in just Trumbull County. The county only has a total population – newborns/babies to elderly – of under 200,000.

To put these numbers into perspective, there were 400 prescription opioid pills doled-out between 2012 and 2016 for every man, woman, and child living in Trumbull County by pharmacies operated by Giant Eagle, Wal-Mart, CVS, Walgreens, Rite-Aid, and some others.

However, if only, say, 20,000 adults (that would be at least 20%+ of the adult population in Trumbull County) have a legitimate need for prescription opioids due to surgery, cancer, chronic back pain, and such, then that means pharmacies doled-out roughly 4,000 prescription opioid pills during this four year period to each of these 20,000 adults.

A Prescription Drug Kingpin

One manufacturer, Purdue Pharma, a long-time prescription drug kingpin of sorts with ties going back to Germany, and its owner (now former owner), the Sackler family, settled (read in context: lost) the lawsuits against it, too. The New Yorker wrote an article on the family back in October 2017 by Patrick Radden Keefe titled, “The Family That Built an Empire of Pain | The Sackler dynasty’s ruthless marketing of painkillers has generated billions of dollars—and millions of addicts.” It’s worth the read.

Incidentally, the company and family used to hawk a morphine pain pill called MS Contin. But, when the patent was approaching its expiration, it created OxyContin (1995), another “extended relief” pill. The company generated $35+ billion in revenues since inception of marketing and selling the allegedly toxic and addictive OxyContin to the masses using a public-private partnership supply chain.

OxyContin: The Prescription Drug of Choice

OxyContin (short for Oxycodone Continuous), presumably the most prescribed opioid drug, has a maximum dosage of two pills per day (one every 12 hours) and may only be prescribed and doled-out for severe pain management, per the FDA. Why are the extra pills being “prescribed” by some licensed medical doctors (aka “Pill Pusher, M.D.s”) and being doled-out by pharmacists at corporate-controlled pharmacies? Cui Bono?³Latin. To whose advantage or benefit? Or, in other words, follow the money.

For instance, here’s an infographic showing that the nation’s 10 largest opioid distributors gave more than $23 million to federal candidates during the last decade. Of the 20 federal candidates that received the most money, 6 were from Ohio (including Rob Portman R and Sherrod Brown D)! Further commentary about the infographic is available at MapLight News Archive. The infographic will look something like this screenshot below (we can’t embed it on our blog, though).

Many patients who initially take OxyContin and other prescription opioids quickly build up a tolerance and require greater dosages (more than two per day with respect to OxyContin) for pain relief and doctors oblige in writing the prescriptions. At this point, addiction for many is already established.

Then there are the “patients” who are not actually taking the opioid pills being prescribed to them, but are simply distributing the pills themselves or to street dealers. The latter might be ultimately tied to organized drug cartels and gangs, both foreign and domestic, to sell the opioid pills on the street corners and at schools.

Oxycodone, The Active Ingredient

Oxycodone, a synthetic drug (and toxic to the body) used in prescription pain pills such as OxyContin⁴It’s primarily Oxycodone with time release attributes. (available since 1995) and Percocet, among many other brand names and formulations, is a powerful pain relieving narcotic and one of the most commonly abused prescription drugs in the country. These synthetic opioid drugs and the professional “public-private partnership” supply chain of manufacturers, wholesalers, distributors, prescription writers/doctors, government/FDA, and dealers/pharmacies/pharmacists – are at the heart of the mostly synthetic prescription opioids epidemic in the Heartland⁵Parts of the Heartland are called the Rust Belt or North Coast of NE Ohio and W. Pennsylvania and the broader Appalachia, which includes at least West Virginia and eastern Kentucky and surrounding rural areas of the Appalachian Mountains.

Alternatives to Oxycodone?

The drug epidemic is complicated. We won’t attempt to address the numerous factors since we would need to conduct a lot of research about addiction and compare/contrast different cultures and legal jurisdictions to gain insight into what might help improve the situation without restricting liberties and creating more laws and regulations. Portugal, Singapore, Iceland, Japan, and some other nations could provide clues. Also, we are aware of the counter-arguments against governments’/politicians’ suing companies for political purposes and confiscating financial assets, as Breitbart put forth in an article titled, “Politicians Get the Opioid Crisis Wrong as Patients Suffer and Street Drugs Kill.”

That said, what did people use as pain relief throughout history and prior to advancements in pharmaceutical-based medicines and drugs?

Most people know of the benefits of aspirin as a mild pain reliever, right? Well, prior to 1897, when aspirin was synthesized, many people and cultures used willow tree bark and meadowsweet as mild pain relievers, among other herbs and tinctures (see herbs and tinctures below).

“…Historians of medicine have traced its birth in 1897 [when a Bayer chemist synthesized aspirin from willow bark], but the fascinating history of aspirin actually dates back >3500 years, when willow bark was used as a painkiller and antipyretic by Sumerians and Egyptians, and then by great physicians from ancient Greece and Rome.”

Montinari, Maria Rosa et al. “The first 3500 years of aspirin history from its roots – A concise summary.” Vascular pharmacology vol. 113 (2019): 1-8.

All-natural (sort-of) extracts:

Codeine, Morphine, Thebaine, and Opium are opiates (all-natural derivatives of the poppy plant) extracted from the sap of immature green seed pods of the opium poppy plant, Papaver somniferum.⁶The species name somniferum (Latin. somnus: sleep; and ferre: bring) refers to the narcotic properties of opium.

Yes, they are, or can be, addictive given the high concentrations of opium extract. However, they are at least a step, or several steps, closer to what Mother Nature offers for free, compared to synthesized versions of these opiates. Also, as the New Yorker indicates, humans have cultivated the opium poppy plant for 5,000 years, mostly for therapeutic reasons.⁷Actually, according to Scientific Reports, opium poppy cultivation goes back much earlier, to 5900 BCE, or 7,900 years ago.

“Humans have cultivated the opium poppy for five thousand years. The father of medicine, Hippocrates, recognized the therapeutic properties of the plant. But even in the ancient world people understood that the benevolent powers of this narcotic were offset by the perils of addiction. In his 1996 book, ‘Opium: A History,’ Martin Booth notes that, for the Romans, the poppy was a symbol of both sleep and death.”

The New Yorker, Oct. 23, 2017

Herbal Tinctures

Laudanum, an herbal tincture.⁸Do note, it’s a felony to possess this tincture without a prescription.

For a short history lesson, the tincture (various recipes) was used for hundreds of years in Europe and America without prescription until the early 20th century when many governments decided to regulate the use of the tincture. It is addictive as it contains 10% opium (equivalent to 1% morphine). It was used, and probably still is used in some parts of the world, as an effective pain reliever and cough suppressant, and a treatment for diarrhea.

As Case Adams, PhD wrote in an article titled, “Herbs and Other Natural Solutions to the Opioid Crisis” published in the Journal of Plant Medicines, “Long before pharmaceutical grade heroin and morphine were distributed by drug companies, natural opium was utilized by herbalists as a therapeutic medication. This came in the form of a tincture called laudanum, utilized not only as an analgesic but also as a treatment for maladies such as colic, lung infections, anxiety and insomnia. And because it wasn’t extracted specifically for its morphine content, a variety of medicinal constituents were available in the tincture. Laudanum tincture contains about 1% morphine.”

Herbs

There are probably so many herbs and combinations of herbs that might be effective for relief of pain. Be your own researcher and decision maker regarding herbs that are considered legal in your jurisdictions. Here are a few herbs referenced in various literature just to illustrate there are, and have been, natural pain relievers throughout cultures and history.

1. Willow bark (salix alba): we wrote about it earlier.
2. Meadowsweet: (filipendula/spiraea ulmaria ): it has similar compounds as willow bark. It is a common use as a flavoring agent in meads and ales. It is a sweet-smelling astringent herb that is commonly used for excessive diarrhea, ulcers, pain, stomach aches, fevers and gout.
3. Kratom (Mitragyna speciosa): Used for severe pain and for treatment of addictions to the pharmaceutical derivatives of opium. “Using results of a survey of more than 2,700 self-reported users of the herbal supplement kratom, sold online and in smoke shops around the U.S., Johns Hopkins Medicine researchers conclude that the psychoactive compound somewhat similar to opioids likely has a lower rate of harm than prescription opioids for treating pain, anxiety, depression and addiction.”
4. Wild Opium Lettuce (Lactuca serriola): “There are few studies of opium lettuce in the Western world, but researchers in Iran have confirmed that opium lettuce was well known as a painkiller and sedative before the Victorian period.”
5. Blue Lotus (Nymphaea caerulea): “Though considered a weaker painkiller among the natural plants with this ability, it can be especially useful for relieving muscle spasms, migraines, menstrual cramps, and tinnitus (ringing in the ears).”
6. Kava Kava (Piper methysticum): “Used extensively in the Polynesian culture, Kava Kava gives a mild feeling of euphoria when it is imbibed. It also happens to be wonderful for those who suffer from back pain.” Massachusetts Institute of Technology (MIT) released a video titled, “How the kava plant produces its pain-relieving and anti-anxiety molecules.”
7. Marijuana (Cannabis): “It’s no surprise to many people that marijuana is a plant that has medicinal properties, including the ability to relieve pain. References to using marijuana as a pain reliever date back to 2700 BC.”

Closing Words

Although the factors involved in causing and contributing to the opioid and narcotics epidemic are complicated and multi-faceted, we believe Trumbull County and Lake County in Ohio are fairly representing their constituents in pursuing legal action against corporations that are abusing the medicine supply chain with respect to doling-out too many prescribed opioids.

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