Opioid and presidential decisions

Opioids are “highly potent” medicine against pain and the most famous brand these days, at least in this country, is Fentanyl. President Duterte admitted last February to having used it to kill severe pain he suffers from spinal injuries in a motorcycle accident and other ailments years ago.

Duterte’s testimonial to the product, said to be 80-100 times more potent than morphine, would gladden Fentanyl makers (Insys Therapeutics Inc.): it removes the pain, the president said, and puts him on “cloud nine -- parang everything is OK with the world.”

Not OK to his critics. Earlier, Sen. Antonio Trillanes IV said Duterte’s confession of Fentanyl overuse “would qualify him as a drug addict.” Last week, Jose Ma. Sison, co-founder of CPP-NPA and consultant-on-exile of the rebel group, called Duterte the “No. 1 drug addict in the country.”

Prescribed

The drug was prescribed by his doctor. He said he overused it but suggested that his doctor had made him kick the habit. As flippant as his admission that he killed people and would kill more if they “endanger my country.” And addiction is not a crime, or has it become a crime punishable by mass execution? He couldn’t be held liable for anything by talking it, anyway not during his term when he enjoys immunity from suit.

Still, the propaganda may not work among Filipinos who seem not to care what he’d say or do, no matter how outrageous at times they can be.

Nation’s stake

The nation though claims a larger and more well-meaning stake in the good health of its president than any critic, notably not Joma, who has spent most of his adult life trying to tear down our institutions. The people don’t want the president to suffer physical pain and they’re glad he has easy access to Fentanyl or some other painkiller.

Those are drugs most doctors don’t prescribe because of strict rules (separate license and bought yellow prescription pad) and high risk under the Comprehensive Drugs Act of 2002. The Pain Society of the Philippines lamented in a 2015 forum that many people suffering from chronic pain can’t get relief from unwilling or reluctant doctors. Breach of human ights, the group said.

Obviously, not the likes of Duterte who don’t have to go to the streets where, they say, theres less hassle than getting a doctor’s prescription.

‘Serial Killer’

In the U.S. alone, incidents of overdose may kill half a million people in the next decade. Street names for opioids are “Drop Dead” and “Serial Killer.” Not likely to hurt presidents though who are tightly watched even in private.

More worrisome is the downside for decision-makers like Duterte who must make choices on matters involving national interest any day, any hour. Doctors warn of “a surging sense of euphoria” from Fentanyl, which may affect lucidity and ability to decide.

Not on cloud 9

Maybe not much harm from an opioid-induced verbal rant or a sexist remark from a podium. But what if he must assess a sensitive police operation or decide whether to declare martial law or send out troops and unleash bombs?

The nation would feel safer if the commander-in-chief giving the order were not gripped by pain but also not cavorting on cloud nine.