We can't sue our way out of addiction, let the pols learn from the Portuguese | Mulshine

I was having a pleasant talk the other day with Joao Castel-Branco Goulao on the subject of drug addiction. As we talked I consumed my favorite stimulant, caffeine.

That can be consumed in Portugal without fear of criminal prosecution, as can just about any other drug you can name.

Castel-Branco is the director of SICAD, which is a service under the Portuguese Ministry of Health that deals with drug addiction. He was here at the invitation of a group called "Help Not Handcuffs" that seeks an alternative to criminal prosecution for drug use.

If the number of overdoses is any indication, the Portuguese deal with it a lot better than our guys do here in New Jersey.

"In 2015 we had 27 overdose deaths, while here you have thousands," he told me.

Meanwhile in New Jersey, which has roughly the same population as Portugal, we are trending toward 3,000 deaths per year.

The reason is not far to seek. The Portuguese avoid overdoses by putting the addicts under a doctor's care and weaning them off the opioids and onto a maintenance drug like methadone.

What do we do in Jersey? We sue the companies that manufacture the opioids legally.

That's what Attorney General Gurbir S. Grewal did last week when he announced the state was going after a Jersey-based Johnson and Johnson subsidiary named Janssen that manufactures pain-relief drugs by the name of Nucynta and Nucynta ER. Such suits have been filed all over the country against this and other drug companies. (The ambulance chasers in Florida are sucking up that exhaust as well.)

The suit charges that the state spent the State spent $12.5 million between 2010 and 2017 on more than 41,000 claims for Nucynta or Nucynta ER that were submitted to its employee health plans.

That raises an obvious question: If Nucynta is so bad, why did the state permit its health plans to pay for it?

In fact there is no evidence that it, or the other opioids prescribed by doctors

, are harmful when prescribed for long-term relief, said one surgeon who prescribes opioids almost daily.

"Doctors know more about how to treat their patients than lawyers do," said Jeffrey Singer, an Arizona physician who is also a fellow at the free-market Cato Institute.

The suit cites the cases of some patients who received Nucynta for three years or more. But that can be an acceptable treatment for chronic pain, he said.

"There are many patients who the only thing that works for them is opioids," Singer told me.

One lawyer who holds to the opposite theory is our own Chris Christie, who as governor started a jihad against Big Pharma for allegedly over-prescribing opioids. The theory is that these legal opioids are responsible for the recent rise in overdose deaths.

That theory is belied by the statistics, Singer said. Since 2010, the number of opioids has dropped drastically.  "But the overdose rate continues to grow," he said.

The obvious reason is that addicts are OD'ing on illegal drugs like heroin and Fentanyl, he said.  But government can't control the pushers of illegal drugs. So it goes after the companies that prescribe federally regulated  drugs - and the doctors that prescribe them.

Joao Castel-Branco Goulao

Singer notes that the board of directors of the American Medical Association recently passed a resolution opposing the efforts by states to outlaw opioid prescriptions in ranges above Centers for Disease Control guidelines.

Those guidelines were meant to be advisory not mandatory, the AMA argues.

The resolution stated that "some patients with acute or chronic pain can benefit from taking opioids at greater dosages than recommended by the CDC Guidelines" and that "physicians should not be subject to professional discipline, loss of board certification, loss of clinical privileges, criminal prosecution, civil liability, or other penalties or practice limitations solely for prescribing opioids" above the guideline levels.

So why is our attorney general going after New Jersey's No. 1 industry?

The suit states that the company attempted "to capitalize on and perpetuate ... deceptions about prescription opioids, including that the benefits of opioids for long-term use for moderate pain conditions significantly outweighed the risks."

But that's a judgment call - one that should be made by the feds who enforce federal regulations, not the state.

I suspect it's for the same reason Willie Sutton said he robbed banks - because that's where the money is.

In Grewal's case, he's seeking the same thing Christie sought when his effort to get Blue Cross to fund drug treatment led to a government shutdown - a big pot of money. In a plea for damages, his brief states:

"Remediating the opioid crisis requires tremendous financial resources and investment in infrastructure for treatment programs, education, prevention, and effective overdose response."

No, it doesn't. What it requires is for our politicians to sit down and have a cup of coffee with someone like my Portuguese pal.

Or Grewal could sit down with his fellow lawyer Christie to discuss it.

Just don't do it at the governor's beach house in summer.

ALSO: Check the website for the law firm that is helping to handle the suit for the AG. It boasts that the firm is "The most effective law firm in the United States for lawsuits with a strong social and political component."

If something has "a strong social and political component" it should be handled by the politicians, not the courts.

And here's another good explanation from Singer on why the Big Government approach to drug use has failed to pinpoint the real culprit:

"The opioid overdose crisis was never really about doctors treating their patients in pain. It has always primarily been caused by non-medical users accessing drugs through the dangerous black market that results from drug prohibition. The overwhelming majority of those overdose victims have multiple drugs in their system when they overdose. The New York City Department of Health reported in 2016 that three-quarters of all overdose deaths were either heroin or fentanyl, and 97% of those overdose victims have multiple drugs onboard -- 46% of the time that drug included cocaine. This hardly fits the profile of a patient receiving medical treatment for pain."

WHAT ABOUT POT? In his suit, Grewal goes back to 2010 to manufacture claims of abuse. That raises the following question: What will happen if some ambitious AG in 2026 decides that the legal pot growers of this era somehow abused his sensibilities?

I'd think twice about that if I were about to enter the market.

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