November 26, 2018

Finding the proper use

Lost in all the very much necessary discussion about the opioid crisis in Massachusetts and across the country is opioid drugs actually help people when used properly. Whether used to treat hospital patients immediately after intensive surgery or prescribed in limited doses after an outpatient procedure, opioids can be more effective in treating pain and suffering.

That aspect of the conversation, though, is hard to have when five people die in Massachusetts per day from an opioid-related overdose. Over the last two years the Massachusetts Legislature has worked to limit the number of opioids a doctor can prescribe, as well as dedicate more resources to helping people with addiction find successful treatment. As News Editor Grant Welker notes in his cover story "An opioid shortage," the current shortfall of opioid for legitimate and medical purposes in Central Massachusetts hospital pharmacies has more to do with a lack of supply than legislative action. Still, Welker's story is important for noting while opioids have become a powerful and destructive weapon in our society, when used properly they have a place. It is all about making sure they are not abused, but used properly.

Broadly speaking, this logic applies to marijuana as well. Medical patients have been able to use the drug since 2012, and – just this month – retailers starting selling recreational marijuana. Retail customers are limited to one ounce of pot, which costs $420 with tax and is the equivalent of more than 50 joints. While this still may seem like a lot for a single person, it shows how a well-regulated market can work to fulfill the goal of legalization.

In making pot legal, Massachusetts is taking a previously illegal industry and bringing it into the light. This prevents consumers from having to commit a crime to obtain a widely available drug and removes the criminal element from the supply chain. By letting people buy up to an ounce – roughly the equivalent of a keg, in craft beer terms – Massachusetts can make sure consumers are well supplied while not providing enough of the drug for an illegal drug dealer to sell on the street. The high cost of buying recreational marijuana, too, prevents it from being resold on black market, since street prices typically remain lower than the legal market.

A decades-long battle to reduce cigarette smoking has been largely a success as smoking rates have steadily fallen since the 1970s. The downward trendline for both youth and adults is promising, and one of the more recent innovations for smokers to help kick the habit has been vaping. While vaping may work to help smoking cessation among adults, there is a growing concern of an epidemic of addictive vaping among teens. What new laws and guidelines ought to be set to reduce that risk? States are grappling with the problem, trying to weigh the benefits against the pitfalls.

As alcohol use is legal, it largely dodges the current debate, but we've all witnessed the effects of alcohol used in moderation vs. straight up abuse. Opioids, marijuana and vaping can all serve a purpose in a civilized society. However, we have to guard vigilantly against their abuse and misuse. Massachusetts seems to have struck the right note on its regulation of marijuana. The abuse of opioids remains the most deadly battle ground, and finding the right balance has a way to go, short of replacing opioids with a whole new class of pain reducing, non-addictive therapies. Teen vaping is an emerging battleground where we'll need to cut down on the easy supply to make a dent in the growing abuse. Knowing when to use a light touch and when to use a heavy touch will be the key to success.


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