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Philip Seymour Hoffman, heroin epidemics and an “Open Letter” to the CDC

by Alen J. Salerian, M.D. (with Jim Fetzer)

 
Philip
The death of Philip Seymour Hoffman, like those of John Belushi and of River Phoenix before him, have unleashed a torrent of allegations of a national surge in the use of heroin, where The LA Times trumpeted, “Philip Seymour Hoffman dies amid major comeback of heroin in the U.S.”

But that interpretation of the data has been challenged by one of the nation’s leading experts in psycho-pharmacology, Alen J. Salerian, M.D., who has served as the FBI’s leading psychiatrist and as the head of its Rapid Response Psychiatric Team:

Hoffman and the rumor of a national heroin epidemic

Alen J Salerian, M.D.

 
The death of actor Philip Seymour Hoffman from an apparent heroin overdose has triggered national headlines of a heroin epidemic ravaging America. As tragic as it was to lose Hoffman, who was a gifted man, a far larger national tragedy has been media-driven misrepresentations about a “phantom” national heroin problem. While the use of heroin itself is a problem for those who resort to it, the nation’s problem with respect to drugs is far more complex than “a heroin epidemic.” And it reflects underlying neuro-psychiatric challenges, such as depression or untreated mental illness.

CDC statistics clearly show that the United States does not have a national heroin problem. The numbers provided by CDC should comfort all of us:

CDC 2008 statistics

When it comes to vital statistics, it is of importance to know that the crucial statistic is not the number of deaths per se but the number of annual fatalities per hundred-thousand population. The simple reason is we are a large country, in which roughly 300,000 people–or 1% of the population–die every year. As a general guideline in a modern and free society, a figure smaller than 3.6 (which averages motorcycle and swimming fatalities) should not be a cause for alarm unless we ban swimming and motorcycling, too.

From a psychiatric perspective, addiction is a complication of an untreated or unrecognized neuro-psychiatric disease, such as obsessive-compulsive spectrum disorder, bipolar disorder or depression. Annually, in a population of a hundred thousand, 11.2 people die of suicide versus less than 1.0—actually, 0.9–from heroin, which is a subgroup of depression or of psychiatric disorders, generally.

A spokesman for the DEA, Rusty Payne, has attributed the rise in the use of heroin to the success of drug smuggling operations, especially crossing the nation’s border from Mexico:

Although the autopsy results for Oscar-winning actor Philip Seymour Hoffman are not yet known, packets of the drug were found Sunday in his New York apartment where he died, a needle sticking in his arm.

“It’s reached epidemic proportions here in the United States,” Drug Enforcement Administration spokesman Rusty Payne said of heroin use.

Payne attributed the problem to a surge in heroin crossing the nation’s southwestern border, where soaring seizures of the drug are a sign of soaring smuggling operations. In 2008, the DEA reported seizing 559 kilograms of heroin at the southwestern border; that more than tripled to 1,855 kilograms in 2012.

The article was supported by graphs showing an increase in the use of heroin across all age groups, which is certainly suggestive of a national epidemic encompassing the nation:

CDC graphs of rise in heroine useage

While investigations into his death continue unabated, “4 arrested on drug charges after death of Philip Seymour Hoffman”, the larger question raised deserves the nation’s attention no less and probably far more: Is this another case in which the CDC is exaggerating the use of drugs in the U.S. for its own political purposes?

His knowledge and expertise in the area of psycho-pharmacology, combined with his admirable candor and integrity, has placed Dr. Salerian at odds with the CDC and, thereby, with the DEA and even the CIA. Their response has been brutal, including an unwarranted raid on his home, which terrorized his wife and daughter, and criminal charges for his prescriptions for his patients, as part of the criminalization of medicine.

The myth of a drug epidemic maintains public support for the War on Drugs, which in turn keeps drug prices and CIA profits high. And now a hit piece in a D.C. rumor mill, The Washingtonian, has been used to attack Alen in a grossly unjust fashion. The death of Philip Seymour Hoffman has been accompanied by highly exaggerated claims about “a heroin epidemic”, which has led Dr. Salerian to contribute to this article and to compose the following “Open Letter” to the Director of the CDC herself.

An Open Letter to the Director, CDC

By Alen J. Salerian, M.D.

 
Linda C Degutis Dr. Ph, MSN
Director
National Center for Injury Prevention and Control
Center for Disease Control and Prevention
Atlanta, GA 30333

Dear Dr. Degutis,

I am writing to request your assistance to correct a serious error by CDC that may adversely impact millions of Americans with chronic pain, psychiatric disorders and addiction.

For several years, there has been an alarming message about the devastating impact of opioid overdose fatalities promoted by the Center for Disease Control (CDC). Since 2010–when Vital Signs was launched–CDC has, on a monthly basis disseminated misinformation highlighting an epidemic of increasing opioid overdose deaths.

Determining the  accuracy of the alarm is critically important. This is because opioids are crucial in the treatment of millions of people with various chronic psychiatric conditions and pain and thus a potential false alarm may hurt great many people in need of opioids.

The Institute of Medicine report of June 2011 suggested that 110 million Americans lived with chronic pain and the under-treatment of chronic pain was a national challenge [1]. Furthermore, the advances in neuroscience and neuro-imaging have illustrated brain tissue loss from chronic pain [2]. It is also true that the criminalization of medicine–as part of the war on drugs–adversely impacted the use of opioids due to physician fears.

I hereby address the key misrepresentations by the CDC (printed in bold letters) in relation to an alleged epidemic of opioid-overdose deaths:

A. Prescription opioid pain relievers were involved in 14,800 deaths in 2008. This is an epidemic consistent with more than tripling fatalities in the past decade.

Observation:

Those 14,800 deaths involved benzodiazepines, alcohol, cocaine and over-the-counter pain medications. Attributing those 14,800 fatalities to prescription opioids is therefore inaccurate.

Heroin bar graph

B.  There is currently a growing deadly epidemic of prescription painkiller abuse. These drugs were involved in 14,800 deaths in 2008, more than cocaine and heroin combined.

Observation:

Those 14,800 fatalities represent approximately 4.5 deaths per hundred-thousand population versus 11.2 from suicide, 6 from alcohol, 5.5 from motorcycle accidents, 0.5 from cocaine and 0.5 from heroin.

Of special significance, the comparison with cocaine and heroin is both unscientific and inconsequential, because of their relative insignificance compared to the number of fatalities for other causes, such as from suicide, 11.2, and alcohol, 6. Equally importantly, the message is extremely misleading. The aggressive campaign to present opioid overdose deaths as the leading public menace–in contrast to the conspicuous lack of any campaign to inform the public about the number of depression associated suicidal deaths–conveys an impression via misinformation that is discriminatory against people with psychiatric disorders and problems of addiction.

Numerical comparison

C. There is currently a growing deadly epidemic of prescription painkiller abuse. These drugs were involved in 14,800 deaths in 2008.

Observation:

The current reporting system of opioid deaths is severely flawed due to reliance upon unscientific practices that render the results invalid [3]. In general many recorded cause of death reflect only medical opinion without objective evidence that necessitate great caution until the objective data are available [4]. ICD codes mix together legal and illegal drugs making it impossible to determine specific causation and are ambiguous about intent whether unintentional or suicide [4].

It is conceivable-–and has been directly observed by the first author–-for a sudden-death to be wrongly attributed to methadone based upon its presence in the system regardless of the fact that the blood methadone concentration falls within the therapeutic range. It is reasonable to assume that, because of methadone’s unusually long elimination life of 48 to 72 hours and its regular use by an estimated half a million people, the actual number of deaths attributed to methadone is being significantly exaggerated by current accounting procedures.

The evidence seems to be compelling to conclude that CDC’s alarm of an alleged rising epidemic of opioid overdose deaths is unwarranted and unscientific. In addition, there seems to be little or no objective data to support the current government-sponsored campaign to present prescription opioids as more dangerous and harmful than dozens of other medications with greater risk of adverse events. The effective dissemination of unscientific and misleading information by CDC may not only harm  millions with chronic pain, addiction and treatment refractory psychiatric conditions, but further perpetuates discriminatory practices against people with psychiatric disorders and problems of addiction.

In the spirit of governmental and scientific integrity and of public health, I kindly request that the CDC end its misleading campaign. As importantly, I request that CDC, FDA and other public agencies develop scientific guidelines for recording and reporting deaths associated with opioids, which is indispensable to acquire accurate information and statistics for appropriate programs and procedures. You are welcome to call me at (202) 320-6176; and I would be willing to travel to Atlanta to discuss all of this with you, at your invitation.

Respectfully,

Alen J. Salerian, M.D.
President
Doctors for Equal Rights for People with Mental and Physical Pain

References:

 
[1]  The Institute of Medicine Report (June 2011)

[2]  Apkarian et al., “Chronic pain is associated with increased prefrontal and thalamic gray brain density”, Journal of Neuroscience (2004) 24:10410–10415.

[3]  Libby, R., The Criminalization of Medicine. Praeger Publishers, 2008.

[4]  Webster, L.; Dasgupta, N., “Obtaining adequate data to determine causes of opioid related overdose deaths”, Pain Medicine (2011) 12:S86-S92.
 
Alen J. Salerian, M.D., Former Chief Psychiatric Consultant to the FBI’s Emergency Response Team, is President of Doctors for Equal Rights for People with Mental and Physical Pain.
 

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Posted by on Feb 6 2014, With 0 Reads, Filed under Editor, Health. You can follow any responses to this entry through the RSS 2.0. Both comments and pings are currently closed.

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21 Comments for “Philip Seymour Hoffman, heroin epidemics and an “Open Letter” to the CDC”

  1. This piece belongs on page two of every major American newspaper. My congratulations to both Mr. Fetzer and Dr. Salerian for making a contribution to sanity in America. I love it when the vindictive and failed parents of suicidal children, whom they have made that way, start cheering for the Bush’s “war” on drugs. As you pointed out Mr. Fetzer economics 101; control the availability of a commodity and you control its price. Its called setting the market.

  2. Wrong Dr. James:

    CIA & DEA have not been infiltrated:

    as well documented by the late research historian Gary Allen in his “Rockefeller files” ( I linked to his book here many times before) the Rockefellers established the CIA as their global private spying & terrorist network at same time that Rothschilds established their private global WMD terrorist monster which they called “Israel”.
    ++ DEA & FEMA are both documented as covers for fighting agaisnt drugs in childish hide & seeks by staging street level penny busts while working for bulk narco-traffickers. One of the best documents on this was the video testimony of Mrs. Kay Griggs the wife of the Marine Col. Griggs who had murdered his first wife. I had linked to this last year. She said that the his husband & top U.S. Marine folks are directly involved in bulk naro-trafficking & even giving green-cards & U.S. citizenships to major foreign narco-bosses!!!
    Remember all the revelations of VT’s own U.S. Marine Robert O’Dowd in his book + on VT about the massive shipments of narco-flights through the Marine airport south of Los Angeles called El Toro Marine Base which they left behind with hundreds of tons of radioactive & chemical & bio-weapon pollution & sold to developers who built houses on the deadly land & sold it to unwary people who are probably dying of all sorts of diseases by now!!!
    & once again:
    YouTube: “Kay Griggs: Colonel’s Wife Tell-All Interview .3 of 4”

  3. Oh yeah, the govt cares so very much about the health of every American that’s why they are trying to get the doctors to cut back pain med prescriptions. Yeah, Obamacare and lumbar screws, pacemakers, and stents used off label are all fine but not an opiate. They just care so much about the public health it’s amazing and could be touching really, if only I really believed. Maybe they became so popular they were cutting into non prescription street drug sales. Physicians take the Hippocratic Oath to relieve suffering and cause no harm. Now they can do neither.

  4. anybody here know how the % we “use” of our brain relates to the % of existence we can 3D? gotta be close.

  5. Thank you Mr. Fetzer for posting this.

    It is a shame today that in our Hoax “War on Drug’s” that many American Doctor’s have been bitten by the propaganda bug. I speaking for one who lives in pain due to a fused neck, destroyed back and peripheral neuropathy that burns 24/7 that disrupts sleep and daily functions that it has turned me not into a druggie but a keyboard warrior.

    Few realize that those like me can at anytime get a PHONE CALL from the prescribing doctor to take all medications back to your pharmacy for what is known as a “PILL COUNT.” Where any abuse is checked.

    They won’t increase your med’s, in fact if mentioned they do the exact opposite… Decrease them. I’ve rejected the bigger drugs because then I was working and was a danger to others as driving and type of work and power tools. So today I like millions lay around unable to do much that doesn’t irritate the problems.

    It is interesting to note that in 2001 the Taliban would chop your hands off as they eradicated the Opium fields of Afghanistan. Today after 12+ years while 100,000+ US/NATO forces roamed the country that Opium production is UP 800+%… Also with all the TSA/DSA and Border patrol. HOW is all them alleged drugs making it into the USA when you can’t even get WATER past them? Food for thought?

    • Joint Commission of Hospital Accreditation encourages the administration of narcotics to patients stating they are in pain–whether they are or not. Hospital personnel have no right to question or withhold pain medication. They must administer pain medication, or face being reported for denying them. To me they are part of the drug pushing taking place in this country today.
      When a patient asks for their pain shot and rate their pain a “10” then tell you to bring them a cup of coffee and a sandwich, talking on a cell phone, with the TV volume up loud, and 3-4-5 or more visitors in the room with them talking and laughing, it is doubtful they are in pain and the med will have any effect at all. This is part of when the addiction deepens or begins. JCH is mandating this and taking the abilityof the medical personnel to refuse to administer pain meds, as we expect bartenders to refuse a patron another drink when the are having trouble staying on the barstool or speaking with clarity, and they appear the least bit drunk. Bartender could be liable if pt drives away. What a hypocrisy, huh?

      • This is true and great to point out. Each visit that I have I have noticed that when my own pain has worsened that it is then that my blood pressure is higher.

        Oddly then faced with a sales pitch of being prescribed yet another PILL.

        Most medications have Sodium Lauryl Sulfate in them. A Poison. I was prescribed Lyrica for the pain and it did nothing. I then saw a report on the Pfizer site where in a double blind study that Lyrica did NOTHING to combat that pain. I printed that out. As the doctor wanted to keep increasing the dosage. When I presented that study from Pfizers own website to my doctor I was then asked, “Where did I get THAT> From the Internet???

        As with all webpages it in the PRINT gives the URL at the header. So was the study a Conspiracy too? Then there’s that other drug maker in the UK who just announced they were not going to pay doctors anymore for writing prescriptions for their pills.

        Big Pharma makes Billions and we are all just guinea pigs for them. That’s what a doctor’s job is called a “PRACTICE”. I’d rather be treated by a Veterinarian as their patients can’t talk so the Doctor has to know whats wrong. Agree?

        • Doctors have an office and it is called a “practice.” That is exactly what it is, exactly what they do. If you don’t stay sick, they do not make any money. The albatross of unnecessary blood tests, x rays, CT’s, MRI’s, is astronomical. BUT, remember, some doctor gets paid to read these tests, and consult with more doctors. If they cure you, you don’t come back, and thus, no more money. Repeat customers make Lexus payments. When they are stumped, the result is to write a prescription. Healing, the body knows what to do, and tries to react to whatever ails it. When w medical personnel step in with unnecessary guesses and chance-taking activities, we confuse the body, and it cannot regulate its own internal mechanisms.
          They spend the least amount of time with patients, consider the nurses and technicians buffoons, and think they know it all. Physicians have their place when they know to stop interferring with nature.
          When have you been told to eat large doses of yogurt after being given large doses of antibiotics over a lengthy duration of a hospital stay? Some have, some never are and they develop gastrointestinal problems. Letting kidneys fail is a favorite technique to keep dialysis machines and companies in business so they can make more money. All we have to do is stop and use some common sense about this, do not trust these doctors for they do not want to talk with the patients families and it is why they make their rounds when families with family nearby.

        • Lyrica has helped many with pain. I have seen it started stopped and rechallenged to prove this. Nerve pain is a tough one. Don’t generalize beyond what you know or you are doing the disinformation by accident and hopefully not planned. Lyrica is expensive and causes weight gain. One patient sticks out in my mind with Lymphoma. He had HZoster in his spinal fluid and spinal cord with extremely severe spinal cord and root pain. High doses Lyrica worked better than 2-3 other agents. There are patients too. I do not think it is a placebo effect. Many other patients others did not get relief with it. Maybe a 20% response rate if I guessed. So much disinformation on physicians, they want you at cattle call with RN and PA if you even get insurance at all. Some of the physicians are still honest like me. So it pains me to read some comments here at VT and I can only assume there are a panel of trolls/shills mixed I with disgruntled complainers.

  6. It is surreal to realize that the very essence of what this country was founded upon with the freedom of speech being the most important freedom to be able to openly discuss all matters is now a crime. This cannot last. Someday those in charge who no longer hear the problems of the people will wonder why they don’t know or understand why society is dysfunctional. They don’t want to hear the problems. If money and keeping their office is the only concern at some point we will have no laws and this country will become like so many others where money can buy anything and anyone. That doesn’t last very long. I wish I knew what to say but I find myself speechless. I can’t believe this is all really happening but it is.

    Sean Dix

  7. i don’t know what drives us to use a substance such as heroin or methanphetamene. i am pretty sure they are not prescibed by a physician . how many deaths from prescriptions ? the man made his choice . RIP

    • A young man in his 30’s today comes in repeatedly to the hospital. In the beginning, he was smoking meth., seeking a good time, when suddenly and without warning, his blood pressure shot up enormously high, and blew out a segment of his brain. He is now a perpetual spastic gyration in each extremity, slobbering on himself continually, and unable to move without severe jerking of his arms and legs. Cannot speak without grunting and screaming his words. Has no control at all over his bodily movements. He has no focal vision.
      I stand and look at him and watch knowing there is nothing anyone can do to return him to some control. He is fed formula through a feeding tube stuck into his abdomen into his stomach. he accidentally pulls it out with his jerking movements. Uncontrolled excretion caught by tubes placed inside him. If someone puts anything in his mouth, the first reaction is to gasp for breath, the piece of food is sucked into his trachea. He aspirates and chokes causing more spasms, wretching and vomiting, and loss of bodily fluids. Many times placed back on the ventilator under emergency measures. The youth is kept away from sites at this. They have no idea what their impulse behavior seeking fun and frolic can bring to them. Society keeps teenagers oblivious because society does not show them these scenes. They should be required to spend 30 minutes with this fellow. 10 minutes is all it would take, but 30 would drive it home. He made his choice is right!

  8. Mr. Hoffman, you had fame. I do not. You had money. I do not. You had a huge fan base. I do not. You had nice cars, chaffeurs, friends, talent, intelligence, popularity…I do not.
    I had something you didn’t…myself. The most valuable commodity a human being could possibly possess…their own self. I watched you in so many movies, and marveled at your talent. How you did what you did was amazing. How much if it was drugs? You are the reason why I don’t idolize another. You let me down trying to get away from yourself. What was it you could not tolerate about you? You make me glad I am poor. You let a lot of people down Seymour-but none so as you did yourself. if only you would’ve gotten to know you. Thanks, so go rest in peace. It ain’t that easy just saying “no” as we teach school children this useless phrase. To paraphrase Kermit the Frog, “It ain’t easy being clean.” We were there for you big boy, as we are for most of our heroes, and special people. Go back to your maker and try to find yourself, and get to know you, the look back and see how special you were. Your final curtain fell, and many will miss you. Good night!

    • Chandler: Thank you for your thoughtful commentary. It is unique (and refreshing) to see an internet posting that is sincere and soulful expression like this one. Well done! –James

  9. Perdue Pharma did a bait and switch with Oxycontin, the only problem is they switched it to heroin.

  10. Preston James, Ph.D

    Outstanding article that lays bare the usual USG exaggerations of the very problem they have created. The simple fact is that our zionist infiltrated CIA and DEA are continually bringing in “controlled deliveries” allegedly to catch the “Mr. Big drug-Kingpins”. But this almost never happens and the drugs ALWAYS end up on the street sold for black ops “off the books” money.

    The war on drugs, like the war on terror, is a complete scam, and created and exaggerated by the Controlled Major Mass Media. Dr. Salerian is an ethical, caring, exceedingly well-trained and competent MD psychiatrist. The way the USG has persecuted him for telling the truth about drugs is absolutely despicable and criminal, too. (Actually the scum who terrorized Dr. Salerian are true terrorists, and violent criminals–they should be arrested for domestic terrorism.)

    It’s just another example of an out of control USG terror machine picking on harmless, caring physicians like Dr. Salerian, who are desperately needed but so ethical and honest that they refuse to cover up the truth for the establishment.

    When these swat-team scum attack perhaps the most qualified Psychiatrist in the nation regarding drug-related disorders (a great physician and very caring person, too), you know that the USG does not want drug trafficking to stop or victims of their USG drug crimes to be helped, at all.

  11. Meth is probably the only thing still “Made in America.” Maybe our biggest export, too.

  12. Then we should expect a huge influx of meth when the snow melts in June.

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