Not just an opioid crisis: What's really killing Americans

This week, President Trump will issue his plan to combat the opioid epidemic. While I was in Massachusetts this week, the governor of Massachusetts was in Washington, D.C., discussing the opioid crises.

Charles Baker, Massachusetts' Republican governor, won kudos from both sides of the aisle for helping to unanimously pass a bill to cut down on opioid abuse. It is the first bill in the country to limit opioid prescriptions to a seven-day supply. In other words, it limits what a doctor can prescribe to adults and minors. There are exceptions, but most important is that there are limits.

In addition, high-school athletes are getting information on these most addictive drugs when they get information on head injuries, a program that is required by law. Doctors also have to check a database to see if there has been misuse before writing prescriptions.

In a recent television interview, Gov. Baker said: "I think the big thing is to stay on the stuff that's we've done and recognize and appreciate that you don't get into … you don't get out of a problem like this in a year or two when it took 15 years to get into it."

Baker continued: "There are encouraging signs that we are heading in the right direction. Overdose deaths dropped by 5 percent in the first half of 2017 compared to last year, according to the Massachusetts Department of Public Health."

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He then asked: "Why are we the only state in the country where you have to take a course in pain management and opioid therapy to graduate from medical school, dental school, pharmacy school, and nursing school? That's the sort of thing the federal government can make a requirement for everybody."

The opioid crises is upon us, but the worst is fentanyl (often used to lace other drugs so people become more dependent), which is being made not just in the United States but in China. Because it takes so little to kill someone, let alone get someone addicted, it is becoming very hard to manage. The Chinese don't care about addicting our citizens or even killing them. So, the Chinese government looks the other way, and actually might encourage the making and exporting of fentanyl.

This week, there were two indictments issued for fentanyl for traffickers not based in the United States. The two Chinese fentanyl traffickers were indicted on charges of making and distributing fentanyl over the Internet and also via mail. They are Xiaobing Yan, 40, and Jian Zhang, 38, and both are still in China. China does not have an extradition agreement with the United States.

Although, there are different reports concerning the strength of fentanyl, scientific literature indicates that fentanyl can be 100 times more potent than morphine and 50 times stronger than heroin. It has been reported that Michael Jackson died from an overdose of fentanyl.

Again, according to the National Institute of Drug Abuse: "923 drugs are known to interact in an adverse way with fentanyl. Fentanyl is a powerful synthetic opioid analgesic that is similar to morphine but is 50 to 100 times more potent. It is a schedule II prescription drug, and it is typically used to treat patients with severe pain or to manage pain after surgery. It is also sometimes used to treat patients with chronic pain who are physically tolerant to other opioids. In its prescription form, fentanyl is known by such names as Actiq." Other names are Duragesic, and Sublimaze. Street names for fentanyl or for fentanyl-laced heroin include Apache, China Girl, China White, Dance Fever, Friend, Goodfella, Jackpot, Murder 8, TNT, and Tango and Cash.

In a June 2016 report on fentanyl, CNN said Ohio reported: "514 fentanyl-related deaths in 2014, up from 93 the year before. Maryland reported 185 fentanyl-related deaths, up from 58 in a year's time. In Florida, the number of deaths jumped to 397 in 2014, from 185. New Hampshire had 151 reported deaths due to fentanyl alone in 2015, five times the number of deaths from heroin, according to the office of the state's chief medical examiner."

We have an opioid crises to be sure, but we can't ignore that there is a subset of the opioid crisis involving fentanyl. The problem is, China has no incentive to help us with it. It makes money and kills Americans at the same time. We need to address fentanyl at the same time we address opioids. We also need to address China's role in our drug crisis.

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