The Third Opium War – key drivers of the fentanyl crisis

Last year, 250 million prescriptions were written for opioids in the USA – that is enough for every adult to have a bottle of pills and more. How many in Canada?

Canada is now the second-largest per capita consumer of prescription opioids, after the United States, according to the International Narcotics Control Board (2013). Globally, North America consumes approximately 80% of the world’s opioids.

We are in the “Third Opium War”.

The first two Opium Wars weren’t just a battle over drugs – they were about control over a country and its resources.

What does the race for resources have to do with fentanyl?

Opium ruined the Chinese empire

If you take a look at Chinese textbooks today they all talk about how the British ruined the Chinese empire in the mid 1800s by bringing shiploads of opium to China.

China used opium paste for all sorts of medical ailments, but by and large it didn’t get abused. When the British didn’t have enough silver to pay for Chinese tea, they paid in opium that was manufactured in India. This opium could be smoked. Before long, everyone in China was smoking opium. People were going broke as all their money was being spent in opium dens.

The Chinese tried to rehabilitate the drug addicts and punish the drug pushers.  Government officials poured confiscated opium into pools of lye. But they could hardly make a dent in the problem. As fast as they confiscated the stuff, the more was unloaded from British ships.

In the meantime, China’s economy took a nosedive as workers were too sick to do anything.

Finally the emperor realized that they had to cut off opium from entering China.

When they told Britain they weren’t going to allow them into the country anymore to trade, Britain turned their gunboats on them and the first of two Opium Wars began. The First Opium War was 1839 to 1842 and the Second Opium War took place from 1856 to 1860.

“Century of Humiliation”

Chairman Mao once said that it wasn’t just a simple case of the Brits not having enough silver to pay for all the Chinese goods they imported. The Brits, he claimed, used opium as a wedge to weaken China and to take over China’s resources. The Opium Wars marked the start of China’s terrible “Century of Humiliation” at the hands of the West.

Oxycontin – Blockbuster Drug

Dr. Arthur Sackler,  “Oxy King”

Dr. Arthur Sackler, inducted into the Medical Advertising Hall of Fame, is considered the father of modern pharmaceutical marketing. Dr. Sackler and his brothers purchased Purdue Pharma in 1952. Forty years later they patented OxyContin in Canada.

Oxycontin became a blockbuster drug with profits of $30 billion.

In 2006, Purdue Pharma had to pay $634 million in fines for misleading marketing in the United States, but not a penny in Canada. Yet Canada has seen a sharp increase in overdoses and deaths resulting from the use of fentanyls since 2012, when the Federal government removed Oxycontin from the legitimate market.

For the last 20 years, doctors have prescribed opioids – drugs such as oxycodone, hydromorphone, fentanyl and others – liberally for chronic pain.  Between 2005 and 2012, the number of people who were prescribed opioids in BC increased by 100,000. How many of those patients became addicts?

The opioid epidemic has hit Vancouver Island in a big way.

Drug overdose deaths have skyrocketed since 2007 in BC.
Drug overdose deaths have skyrocketed since 2007 in BC.

Between 2009 and 2014 there were over 1,000 fentanyl-related drug poisoning deaths in Canada, with more than half occurring during 2013 and 2014. It’s been getting worse every year. In 2016 alone, 755 have officially died from fentanyl overdoses in BC. Many believe that the actual numbers are much higher. These weren’t street people by the way – a good lot of them died indoors and the majority were over the age of 30.

Opioid Consumption up by 31%

The total number of people using prescription opioids is growing. In BC, between 2005 and 2013, opioid consumption increased by 31%! The number of new users in this province is equal to the number of people who are newly diagnosed with diabetes every year in BC, or about three times the number of people hospitalized for stroke or heart attack.

In 2016 approximately two people died every day in BC from accidental drug overdoses, and 62% of those cases were fentanyl overdoses. In small BC communities fentanyl is also an issue. Penticton had about 13 overdoses and one death over the course of two weeks in November.

The problem has become so severe that in March 2016, Health Canada removed Naxalone from the Prescription Drug List to non-prescription status so that any layperson can administer this antidote which can reverse an opioid overdose. By the time paramedics arrive on the scene, it’s often too late.

CBC reported that the 911 service has received as many as 170 overdose-related calls a day across BC. This is on top of an already strained system as you can see from the tweet above.

The BC government has set up a mobile medical unit in Vancouver where paramedics are dropping off overdosed patients who need to be revived, because the hospital emergency rooms are too full to handle these patients.

Safe injection sites

Last year the Chief Medical Officer for Vancouver Island came and spoke to Nanaimo Council about the opioid epidemic.  The City of Nanaimo set up a committee to look at the issue.  At the last council meeting in December the clock struck 11pm and council voted to end the meeting before they had a chance to discuss this epidemic, (but the Events Centre received several hours of attention that evening).

The federal government passed Bill C-37 which will make it easier for safe injection sites (SIS) to be set up in communities.

A temporary safe injection site was put up on Boxing Day in the parking lot at City Hall in Nanaimo.

Temporary safe injections sites are one immediate solution. But what is next for these people?

The BC government announced that they would ban pill presses which would stop pill-producing clandestine laboratories. But is that enough?

Researchers have been sounding the alarm that vital statistics data should be openly shared to get a better grasp on prescription-opioid related deaths.

The Bohn laboratory is dedicated to learning about opiate receptors in the brain and how synthetic opioids like fentanyl have lasting effects.

Killing the BC economy

Where is this fentanyl coming from? China. China is the primary source of supply for fentanyls and fentanyl precursors destined for the United States, Canada, and Mexico. According to the Chinese Anti-Smuggling Bureau, China does not have a  fentanyl consumption problem; therefore, fentanyls illicitly produced in China are most likely intended for export to the Americas. Customers can purchase fentanyl products from Chinese laboratories online, by travelling to China and purchasing in person, or through a chemical broker.

What would Chairman Mao think of that? Is this the start of Canada’s “Century of Humiliation”? At least in China they knew they had to say no to Britain’s narco-empire before their country was ruined. But what is Canada doing now in 2017? Will we wake up in time before it’s too late or will we just stay doped while China takes over our real estate and resources?

We’re putting Canada’s healthcare system at risk. The full cost to the Canadian health-care system of ‘inappropriate prescriptions’ to older Canadians is $1.8 billion, that doesn’t include opioids.

Someone has to take ownership of the problem. Resource extraction economies are key drivers of this fentanyl crisis. Therefore, why not get the oil companies to cough up some money to offset the cost to society?

There are only a few pharma companies that make naxalone products and they are making money hand over fist. Is this fair? Naxalone is cheap to make – as cheap as seawater some say – so why not make it open source?

Yemen, Estonia, Afghanistan, Canada

What’s happened in other countries?

Take Yemen for example – years before Saudi Arabia decided to invade, they got everyone hooked on ghat (or khat). Everyone in Yemen was chewing the stuff and every last bit of water was being used to grow it.  By the time Saudi Arabia rolled in with tanks, they met little resistance because the Yemenis were heavily addicted to ghat.

How many countries have tried to gain control of Afghanistan? Why? Because Afghanistan is rich in minerals. They have trillions’ worth of iron, copper, gold, cobalt, and lithium. Despite all of this, they are a poor country. Opium there is now cheaper than food. Out of a population of around 35 million, at least one million Afghans are now drug addicts.

Estonia is another example. They used to be part of the Soviet Union and became independent after the Second World War. Now, because of their fentanyl crisis which has been ongoing for the last 10 years, their independence is in jeopardy.

Here in BC we are in a state of emergency with the fentanyl crisis breaking our communities. This epidemic will spread across Canada.  And just like the story in Afghanistan we have the resources everyone wants. It’s all about control.

Speaking of resources, the BC government spent $716 million to build the Northwest Transmission Line to benefit a few mining companies. There was no outcry from the public about wasting taxpayers’ money on that, yet how much is the government willing to spend to deal with this opioid crisis? Certainly not $700 million.

And what happens when those mining companies say they have to bring in foreign workers because all the local people are sick from addiction?

The 3rd Opium War is here. Will our Prime Minister raise this issue when he goes to China in February to discuss free trade?

A few grains of fentanyl can kill