Saturday, 11 June 2022

Ketamine: The Unused Answer to the Opioid Epidemic

The opioid epidemic is getting to a fever pitch, yet government bodies are not responding appropriately, even now. While there is no direct cure for hundreds of thousands of addicted people, there is an answer, that should at the very least work for some. Since we’ve already established it can work on different levels regarding addiction and pain, why is ketamine not immediately being used as an answer to the opioid epidemic?

Ketamine might not be officially approved for it, but it could work as a solution to the growing opioid epidemic as it helps with addictive thought processes and can be used for pain control, without causing the addiction of opioids. Why is this ignored in the face of so many deaths? Welcome to a wholly independent publication focused on cannabis and psychedelics reporting. Play along by signing up for the The Cannadelics Weekly Newsletter, and get a daily dose of updates, along with putting yourself in first place for all product promotions, as they become available to the public.

What’s the deal with the opioid epidemic?

Just that the word ‘epidemic’ is widely used for this problem, should get our attention. An epidemic generally refers to the widespread proliferation of a disease, although we now use it to describe the out-of-control use of synthetic opium drugs. Epidemic it most certainly is though, and its not slowing down at all. The problem is so bad, that anything that can help reduce deaths should be used, which brings up the question of why ketamine is not being employed as an alternative in this opioid epidemic.

The latest numbers come from a May 11th release by the CDC, in which preliminary data for 2021 show that the overdose death numbers in the US have skyrocketed up to 107,622 for that year. This is a 15% increase from 2020, when the number was just over 93,000, which itself was a 30% increase over 2019, which saw about 73,000 deaths. These are total overdose death numbers, and apply to all drug overdoses. There were not over 100,000 opioid overdose deaths, but there were certainly enough to shock a person.

Exact numbers aren’t out for 2021 in terms of how many of the overdose deaths were caused by opioids, but of the ~93,000 that died in 2020, over 68,000 were opioid deaths, and that’s pretty extreme. While these numbers are not finalized, small changes wouldn’t do much to change the heaviness of the reality, because give or take a few thousand, there’s still a massive problem at hand.

opioid deaths

To give an idea of why this is, consider that in 2017, over 191 million opioid prescriptions were written, which means 58.7 prescriptions written for every 100 people. 45% of these were written by primary care physicians, who are not supposed to write such prescriptions in the first place. They should be written by a specialist only. For 2017 the economic burden of these drugs on the entire country amounted to $78.5 billion between health care costs, emergency services, addiction treatment, lost productivity, and the criminal justice system.

Opioids belong to a class of drugs that are based on compounds from opium, a component of poppy plants. Opioids bind to receptors in the central nervous system, peripheral nervous system, and gastrointestinal tract, mainly of the μ, κ, and δ (mu, kappa, and delta) varieties. They are used mostly to treat acute pain, though they have other functions as well, like cough suppression. Opioids are incredibly addictive, so regardless of why a person starts taking them, or if they want to continue, a powerful physical addiction can make it extremely hard to stop, and can threaten the life of the person if they do so without medical help.

A bit about ketamine

Before getting into why ketamine can be an answer to the opioid epidemic, let’s get into what ketamine is. Ketamine is a dissociative hallucinogen that was created by Parke-Davis in 1962 for use as an anesthetic in both humans and animals. It has remained a schedule III drug with no other official uses beyond being an anesthetic, according to the US government.

That isn’t to say that more isn’t known though. Ketamine was used in studies on prisoners in the 1960’s which made clear at that time a few things: ketamine is great at dealing with pain, that it doesn’t lower heart rate or breathing rate, that it has little-to-no direct death risk, and that it can affect psychological thought. This last point was noticed during these early studies, but its full abilities in this realm were not elucidated until after. However, it’s ability for pain control was made clear enough at this time, that ketamine was subsequently used on the fields of Vietnam. Ketamine has never shown much ability for physical addiction like opioids, meaning users can stop at will.

In fact, ketamine’s ability to help people with psychological issues, like treatment-resistant depression, is so well understood, that it was recognized by the FDA. In 2019, the FDA approved ketamine’s half-brother esketamine for this purpose, updating the legalization to cover suicidal thoughts in 2020. Esketamine is put out by Johnson & Johnson, one of the main big pharma companies to pay out billions in multiple recent opioid lawsuits related to the damage these drugs have done.

Of course, ketamine itself isn’t only used as an anesthetic, thanks to a helpful little loophole. Since it’s legal for medical use, ketamine is often prescribed off-label for both pain management, and for help with a range of psychological issues, which is above-board according to the FDA. As such, there is a large and growing gray ketamine clinic industry in which patients can access ketamine as medicine, by receiving a prescription in the clinic. This is preferable for those who do not want to take a standard antidepressant, which is a government requirement for using esketamine. Plus, ketamine cannot officially be prescribed for pain, but is used for pain treatment in these clinics.

ketamine clinic

Though ketamine is a pharma product (it certainly doesn’t exist in nature), it’s a pharma product that is made by any pharmaceutical company, big or small, or even in a person’s basement should they have the right training. This means ketamine isn’t a big money-maker for the big pharma companies that pump money into government representative pockets, and therefore, it doesn’t make extra money for the government either.

Ketamine as the yet-unused treatment for opioid epidemic

The more amazing thing about the existence of ketamine in an opioid epidemic like this, is that its been shown to work with compulsive thoughts, which are a part of any addiction. For example, an eating disorder study found that after ketamine administration, the majority of patients reduced or eliminated their compulsive thoughts well after the ketamine administration. While it’s not 100% understood how, its thought that the following mechanism was in action:

“Memory is a neocortical neuronal network, excitation of which involves the hippocampus, with recall occurring by re-excitement of the same specific network. Excitement of the hippocampus by glutamate-NMDA receptors, leading to long-term potentiation (LTP), can be blocked by ketamine.”

To clarify the point, ketamine has the ability to allow someone to exit their normal thought cycle, and create a new one. The same has been found with other psychedelics, including MDMA. In ongoing trials by the organization MAPS into PTSD, it has already been found that over half of the treatment resistant cases treated with MDMA, no longer qualified as PTSD a year after treatment. Ketamine makes a better candidate for opioid replacement, as it can also satisfy the pain issue, which got so many addicts in this mess in the first place.

This means a hallucinogenic drug exists with essentially no real death toll, that can take care of the pain issue that led to the opioid crisis, and that can help with the circular thinking of addiction that keeps many people addicted. Can someone think of a reason why its not immediately being used to treat this problem? Possibly because it’s not a money-maker for big pharma or the US government. And people without addictions… don’t keep buying medications.

Funny how the only approved version is made by the same pharma company that helped get everyone addicted to opioids in the first place. Back in the 1980’s Johnson & Johnson was selling Tylenol with codeine (Tylenol 3) and needed a better supply of raw materials. The company bought a farm in Tanzania to produce the raw materials, becoming the top provider for opioid raw materials by 2015. This is one reason that J&J is paying out billions of dollars in settlements right now, including to virtually the entire Native American population, and the whole state of Idaho, with more likely on the way.

opioid lawsuit

Where did this issue come from?

When 2019 information was released, it made clear how people were dying, and from what. That year, of approximately 73,000 drug overdose deaths, less than 15,000 were heroin overdoses, and a massive 48,000 were from synthetic opioids like oxycodone and fentanyl.

The thing about synthetic opioids, is that they’re the ones made by pharmaceutical companies and prescribed by doctors. In comparison, heroin causes problems, but nothing that can’t be kept in check. This is evident with its over 100 years of use, starting with legal sales in 1898 by the company Bayer. But then in 1996 Purdue came out with Oxycontin, surrounded by tons of lies that got it propelled to a top-prescribed medication, despite immediate issues coming up regarding the time the pills last, and the mass ability for addiction due to the strength.

Technically, opioids are in generic form, like ketamine, meaning anyone can make them. However a 2019 report made clear that between 2006-2012, of the over 76 billion opioid pills that made it to market, three companies were responsible for manufacturing 88%: SpecGx, a subsidiary of Mallinckrodt; ­Actavis Pharma; and Par Pharmaceutical, a subsidiary of Endo Pharmaceuticals. The creator of this epidemic, Purdue, which consistently lied about its product Oxycontin in terms of how long it lasted and safety information, was fourth.

In 2006 8.4 billion pills were put on the market, in 2012, that number was up to 12.6 billion, and that was 10 years ago, when the death rate wasn’t nearly as high. This is a 100% pharmaceutically made, and government promoted epidemic. And we know the government is complicit because it takes money from the companies, allows the situation to keep going, and has tried ruthlessly to cover the information I am talking about now (particularly through the DEA and the Justice Department). In fact, if the government wasn’t complicit, it probably would have released way more information, and the reason I’m giving numbers from years ago, is because the government, along with the big pharma companies involved, have made that information extremely hard to get to.

What we can glean, is that the four companies that are paying out the most, probably caused the biggest issues. That would be Johnson & Johnson, AmerisourceBergen, Cardinal Health, and McKesson, the latter three being drug wholesale companies. Together, these four companies are set to pay $21 billion from global lawsuits, out of a $26 billion total.

So even though a practically-no-death-toll drug like quaaludes was banished because of its lied-about threat (when in reality it was a black market that the government wasn’t profiting from), opioids are still allowed while killing people by the tens of thousands. In fact, the government just made it clear it wants fewer prescribing guidelines in the face of all this controversy, which makes them easier to get.

opioid epidemic

For whatever its worth, I am not the only one with this idea, and in fact, there is medical research on the issue of ketamine vs opioids already. Like this review which showed ketamine as a safe and effective alternative to opioid treatment, through the analyzation of 76 relate papers. And this study of 870 adult patients who showed up in emergency rooms with severe pain, that showed ketamine as a comparable treatment to opioids for control of acute pain.

Conclusion

It’s not shocking that the government doesn’t want to correct the problem; because it likes the problem. And it certainly doesn’t want to be considered complicit in it. Much like with big tobacco, it might never have to pay the price for its complicity; it might even wage its own lawsuit similarly in this industry, just to make it look like it was never involved. Forget that the government has to approve medications, regulate their safety, and has the power to take them off the market… If it didn’t want this, if it really didn’t want this, it would already be substituting ketamine for opioids, banning them, and trying to get as many people as possible, to find a different option than the one killing them.

Perhaps if you’re someone who hasn’t ever questioned your government, now is the time to start.

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