‘They’re here, then they just die’

The Press - - World - JOSH GLANCY

At first glance, Manch­ester, New Hamp­shire, seems a typ­i­cal New Eng­land town. A pleas­ant, low-key sort of place, free of ex­treme poverty or ur­ban de­cay.

You do not have to look far, how­ever, to see some­thing is amiss: this is a town firmly in the grip of the opi­oid cri­sis that is dev­as­tat­ing Amer­ica. Dot­ted around the cen­tral squares and parks are small groups of peo­ple vis­i­bly suf­fer­ing from ad­dic­tion. Yes­ter­day, hun­dreds of res­i­dents took part in a ‘‘rally for re­cov­ery’’ in the town cen­tre, gath­er­ing to highlight the plight of their friends and neigh­bours.

On the walls of the Hope ad­dic­tion re­cov­ery clinic, a few hun­dred yards away, are pic­tures from a kayak­ing ex­pe­di­tion. Karla Gal­lagher, who works at the clinic, can­not look at it with­out be­com­ing close to tears.

‘‘We lose these peo­ple all the time,’’ she said, point­ing to a pic­ture of a smil­ing young girl on a ca­noe. ‘‘We lost her. One day they’re here and then they just die.’’

Gal­lagher lost her own brother to ad­dic­tion. Her story is not un­usual. Ev­ery­where you go in Manch­ester, some­one has a friend, a sib­ling, a niece or a cousin who has died be­cause of drug ad­dic­tion. Many of those af­fected are or­di­nary work­ing peo­ple, who be­gan with a pre­scrip­tion for a sore back and ended up dy­ing with a heroin nee­dle in their arm.

Last month, fol­low­ing the rec­om­men­da­tion of a pres­i­den­tial com­mis­sion, Don­ald Trump de­clared that Amer­ica’s opi­oid cri­sis was a ‘‘na­tional emer­gency ... the likes of which we have never had’’. He ap­pointed Chris Christie, the gov­er­nor of New Jersey, to tackle the prob­lem.

The cri­sis has been steadily wors­en­ing for more than a decade. Fig­ures show that in 2016 more than 64,000 Amer­i­cans - 175 a day died from drug over­doses, a 22 per cent in­crease on 2015.

The spike is largely driven by a sin­gle drug, fen­tanyl, an opi­oid that can be up to 50 times more pow­er­ful than heroin. It claimed 20,000 lives last year.

Car­fen­tanil, a ver­sion of it, was de­vel­oped as an ele­phant tran­quil­liser. Yet those hooked on opi­oids are seek­ing out this of­ten fa­tal drug, which is traf­ficked through New York and Bos­ton up into New Hamp­shire.

Five hun­dred deaths from opi­oids were re­ported in the tiny ‘‘gran­ite state’’ last year alone. It has been de­scribed by its gov­er­nor as ‘‘ground zero’’ for the opi­oid cri­sis.

The state gov­ern­ment is tak­ing mat­ters into its own hands. Last month it filed a law­suit against Pur­due Pharma, the com­pany that many hold par­tially re­spon­si­ble for the be­gin­ning the cri­sis. It has made bil­lions from the widely used opi­oid OxyCon­tin.

The law­suit al­leges that Pur­due ‘‘ag­gres­sively mar­keted opi­oids’’ to doc­tors and pa­tients and en­gaged in ‘‘un­fair or de­cep­tive mar­ket prac­tices’’ by ‘‘sig­nif­i­cantly down­play­ing the se­ri­ous risk of ad­dic­tion posed by OxyCon­tin’’.

Pur­due’s sales teams were ‘‘pill push­ers, putting these pills out to as many peo­ple as you can’’, said a per­son with close knowl­edge of the law­suit. ‘‘They treated it like Pepsi-Cola.’’

Pur­due de­nied the al­le­ga­tions, but said ‘‘we share New Hamp­shire of­fi­cials’ con­cerns about the opi­oid cri­sis, and we are com­mit­ted to work­ing col­lab­o­ra­tively to find a so­lu­tion’’.

The com­pany has al­ready paid out hun­dreds of mil­lions of dol­lars in charges re­lat­ing to the mis­brand­ing of OxyCon­tin, in­clud­ing US$634.5m to re­solve a jus­tice depart­ment in­ves­ti­ga­tion.

Or­man Hall, for­mer head of Ohio’s opi­ate ac­tion team, ac­cused the Food and Drug Ad­min­is­tra­tion, which reg­u­lates the phar­ma­ceu­ti­cal in­dus­try, of be­ing com­plicit in the scan­dal.

‘‘They’ve pro­tected these guys, but they haven’t pro­tected Amer­i­cans,’’ he said. ‘‘This is still a cri­sis of un­par­al­leled pro­por­tions. We’re go­ing to look back on this pe­riod of time and be shocked that it was al­lowed to oc­cur.’’

He added: ‘‘The phar­ma­ceu­ti­cal in­dus­try has spent vast amounts in the po­lit­i­cal arena.’’

So far, the only real so­lu­tions to the cri­sis have come at the com­mu­nity level, at cen­tres like the Hope clinic. Treat­ment and re­cov­ery cen­tres are dot­ted around town. Fire fight­ers carry nalox­one, which helps com­bat over­doses.

‘‘It’s still bad out there, but we are at least con­fronting the prob­lem,’’ said Gal­lagher. ‘‘Com­pas­sion and open­ness are on the rise in the com­mu­nity.

‘‘There are still peo­ple who think it’s a moral fail­ing, but there’s a will­ing­ness to talk about it now. I think that’s help­ing.’’

- Sun­day Times

Opi­oid ad­dic­tions kills 175 Amer­i­cans every day.

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