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UPDATE: EVIDENCE FROM HIGH-RISK OPIOID USE AND INFECTIOUS DISEASE INCIDENCE – HEPATITIS A

OPIOID SUBSTITUTION TREATMENT (OST) IS WORSENING, NOT TREATING AMERICA’S LETHAL EPIDEMICS

by Clark Miller

Published August 15, 2019

Updated April 14, 2021

Hepatitis A, a potentially lethal infectious liver disease, is raging in the U.S., with lethal outbreaks in 29 states and counting since 2016 and with the expectation of re-emergence as a public health threat in all states. Like other infectious diseases with increasing incidence, Hep A is spread partly or largely by use of illicit drugs by injection, often primarily injection of opioids, and by other modes associated with health-compromising stressors of illicit and high-risk injection drug use.

 

It is, per this recent USA Today news report from Ohio,

spreading mostly among drug users and the homeless. But anyone who hasn’t been vaccinated can get hepatitis A — as Akron health officials are now finding out.
“It’s getting into the general public,” said Tracy Rodriguez, communicable disease supervisor for Summit County Public Health. “It’s scary.”

That is, Hep A and other infectious drug injection-related diseases are on the rise in the U.S. “in wake of opioid crisis”, caused by unrelenting, continuing increases in high-risk opioid use.

And the more gold standard medical cure applied to diseased brains, the more high-risk use and the associated deaths mount.

 

And it’s a pattern, established here and here that – despite efforts of popularizers of the failed medical OST “treatment” – is not explained away by the known risks of fentanyl.

Runaway injection-related infectious disease is a national trend

In a variety of settings and nationally, high-risk opioid use as measured by non-lethal overdose incidence has worsened with increasing provision of the medical model fix, against prediction if OST provides benefit. Another, independent measure of high-risk use – incidence of opioid- and injection-related infectious diseases including endocarditis – also shows an OST-invalidating pattern of increase in response to large increases over decades of provision of opioid substitution medicine.

One type of opioid-related infection that researchers are grappling with involves diseased heart valves. Bacteria such as S. aureus can enter the bloodstream as a result of practices such as needle sharing or not cleaning the skin before injecting a drug. If the infection reaches the heart, it can damage the valves. Severe cases can require a heart transplant.
In an ongoing study, microbiologist Cecilia Thompson at the University of North Carolina in Chapel Hill is sequencing DNA from heart valves collected from people who have had surgery to replace diseased valves with artificial ones. Thompson found that valves taken from people who had injected drugs were more likely to be infected with S. aureus than were those of non-users.
Thompson presented her results at the American Society for Microbiology meeting in San Francisco, California, on 21 June. But these are just the latest observations of what seems to be a worrying trend. In a study published in January1, researchers found a tenfold increase in heart infections among drug users in North Carolina between 2007 and 2017. Doctors in the state used to perform less than 10 surgeries to treat drug-related heart infections five years ago, compared with more than 100 now.

There is no need to scramble to understand these trends.

They were predictable from everything we’ve known about the provision of a reductionist medical model fix for the complex non-medical problem of compulsive substance use and affirmed by consistently accumulating evidence that the diversion of public health resources to invalidated opioid substitution approaches and away from evidence-based therapies is driving and worsening illicit, high-risk opioid use and lethal epidemics.

The more deaths mount, the more pressure mounts to divert public healthcare resources to the unvalidated medical model provision of addictive, diverted and abused substitute opioids.

And the more addictive opioid  medical fix dispensed to be diverted, abused, and function as currency and commodity in illicit street economies, the more high-risk use drives overdose, disease, and death. 

See related posts for additional evidence and more thorough explanation of relationships among opioid substitution treatment (OST), high-risk opioid use, the worsening opioid crisis, and injection-related infectious disease. 

Akron, Ohio is not the only locale affected, 

as we would predict from everything we know about problem substance use and the failure of medical approaches to provide benefit for that non-medical problem, those diseases are increasing in prevalence.

That’s been true in Ontario, Canada and in Columbus, Ohio.

In Franklin County Ohio –

In Franklin County, Ohio, cases of drug-injection-related infectious endocarditis, a measure of injection drug use, have skyrocketed over the years 2012 – 2017.

Specifically, the increase in incidence of those cases increased 436 percent, most of that increase attributable to use of heroin by injection.

Investigators found that overall admissions for infective endocarditis at Ohio State University Wexner Medical Center increased 101% from 2012 to 2017, with most of the increase coming from the 436% jump in drug-related cases. The research, which was presented at the American College of Cardiology (ACC) 2019 Annual Scientific Sessions in New Orleans, LA, found that most of the cases of endocarditis related to drug use involved heroin.

Significant, extended increases in medical provision of buprenorphine and methadone OST should necessarily have resulted in the opposite outcome – decreases over the same time period of high-risk opioid use.  

In Kentucky, a worsening Hepatitis C outbreak is attributed to high-risk opioid use, by injection –

– constituting a measure of worsening high-risk opioid use despite steady, significant increases in provision of the medical treatment fix for high-risk opioid use.

Kentucky bupe doses

There are signs of a similar pattern in Indiana.

These consistently accumulating lethal results –

high-risk opioid use increasing in response to increasing provision of the medical model “treatment” for high-risk opioid use – predictably invalidate and expose the fabricated evidence base for the publicly-funded medical fix for the non-medical condition of compulsive substance use.

For rates of opioid injection-related infectious disease, as with increasing rates of another measure of high-risk opioid use – non-lethal overdose – as provision of the medical cure increases, predictable, invalidating outcomes and patterns are emerging.

Hep A and other infectious diseases are on the rise in the U.S. “in wake of opioid crisis”, caused by unrelenting, continuing increases in high-risk opioid use, that high-risk use generated by iatrogenic (medical provider-caused) runaway prescription of opioids over decades against all indications, for the non-medical condition of common chronic pain, now driven and worsened by the runaway dispersal of addictive and diverted opioids (methadone, buprenorphine) constructed without evidence of benefit as a medical “treatment” and fueling economies of abuse and high-risk use. And funded fraudulently with public healthcare money.

Against continued rationalizations (collaborative media/industry lies) for the failures of the fabricated medical “fix” for the medically-generated lethal opioid crisis – the increases in injection-related infectious diseases provide determinative confirmation of the predictable harms and failure of never-validated medical fixes for the non-medical condition of compulsive opioid and other substance use.

 

The more gold standard medical cure applied to “diseased” brains, the more high-risk use and deaths predictably mount.

Why A Critical Discourse?

Because an uncontrolled epidemic of desperate and deadly use of pain-numbing opioid drugs is just the most visible of America’s lethal crises of drug misuse, suicide, depression, of obesity and sickness, of social illness. Because the matrix of health experts and institutions constructed and identified by mass media as trusted authorities – publicly funded and entrusted to protect public health – instead collude to fabricate false assurances like those that created an opioid crisis, while promising medical cures that never come and can never come, while epidemics worsen. Because the “journalists” responsible for protecting public well-being have failed to fight for truth, traded that duty away for their careers, their abdication and cowardice rewarded daily in corporate news offices, attempts to expose that failure and their fabrications punished.

Open, critical examination, exposure, and deconstruction of their lethal matrix of fabrications is a matter of survival, is cure for mass illness and crisis, demands of us a critical discourse.

Crisis is a necessary condition for a questioning of doxa, but is not in itself a sufficient condition for the production of a critical discourse.

Pierre Bourdieu - Outline of a Theory of Practice 1972

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