John A. Meynardie, Assistant U. S. Attorney, Criminal Division, Southern District of Mississippi, spoke to the Rotary Club of North Jackson at the Club's July 23, 2019, meeting. The subject of his talk was the Opioid Epidemic in Mississippi. He said that in 2018, the U.S. Center for Disease Control & Prevention (CDC) estimated that in the U.S. there is one opioid death every 8 minutes and that opioid overdoses are the leading cause of death from injuries in the US. The primary causes of those deaths are heroin and prescription opioids plus fentanyl. He said that the term opioid arises from the fact that opium poppies are the original source of opioid pain killers that act on the opiate receptors in the human brain. The primary drugs being abused today are heroin, oxycodone, and hydrocodone. Fentanyl is an impurity in the drugs.
According to Mr. Meynardie, the common misconception in the public is that prescribed opioids are "safe" because they are from a doctor. HIstorically physicians prescribed 30-day supplies of the drugs following surgery or injuries as pain killers. Recent studies have shown that a person who takes the prescribed pain-killers for 30-days has a 1 in 4 chance of becoming addicted and that if a person is taking these medicines without a doctor's supervision the addiction chances increase immensely. The properties of these drugs are such that the longer you take them and the more you take, the more your chances of becoming addicted increase. As the costs of drugs increases, addicts seek cheaper alternatives; i.e., heroin. Mr. Meynardie cited that 75-80% of heroin users began with pain pills. For high school seniors, the most abused medicines are pain pills such as oxycodone and hydrocodone. the sources of those pills are relatives or friends. He cited an example of a football quarterback who was injured and prescribed pain pills. He followed a familiar track until 4 years later he died of a heroin overdose.
Data show that Mississippi has more painkiller prescriptions than most other states with in excess of 100 painkiller prescription per 100 people, but that the number of prescriptions in both our state and the nation has decreased since the epidemic was identified. Another cause of the deaths is counterfeit pills that have become available from the black market. The risks of these pills are:
- they come from an unknown source,
- they may contain an unsafe active ingredient, and
- they may contain harmful/toxic ingredients such as fentanyl which Mr. Meynardie calls a "Game Changer."
Fentanyl is many times more potent than heroin or prescribed opioids. He cited that 1 milligram of fentanyl is lethal.
Another contributing factor to the abuse of illicit opioid pills is the wide availability of pill presses and binding agents in the U.S. The DOJ is currently investigating pill press manufacturers. Many of the black market pills sold as opioids contain no oxycodone but do contain significant amounts of heroin and fentanyl. In 2015, the overdose deaths were primarily due to heroin and fentanyl. The following slide provided by Mr. Meynardie shows the changes in the causes of US Overdose death causes in the 2000-2015 period. It is interesting to note the increase in the fentanyl and fentanyl analog deaths from essentially zero to over 20,000 deaths annually or about 2 per hour.
We thank Mr. Meynardie for his very informative presentation and for his service to our country. He (right) is shown in the following photo with Club Past President Mike Dawkins (center) who introduced him and with Daren LaMarca (left) of the Jackson U.S. Attorney's office.
