A (Badly Needed) Math Lesson for Sen. Joe Manchin

Let's give West Virginian Senator Joe Manchin the benefit of the doubt. Aside from professional mathematicians, a cohort that may or may not share the same genome as normal humans, who among us hasn't slipped a bit in arithmetic prowess since high school or college? If you ask (both of) my readers, they will tell you that when I do even the most simple algebraic calculations in my articles – especially those involving decimal points – I get the wrong answer roughly 100% of the time. Fortunately, there are always those kind folks who catch and correct the obligatory errors I make, and I thank them for it, even though I may look like a boob now and then.

So, why am I – of all people – giving a math lesson to a US Senator? Although I could neither describe, let alone solve, the quadratic formula (does it have something to do with thigh muscles?), if my life depended on it, I can still add and subtract with the best of them the first graders out there. Check it out!

EXAMPLE 1

1 apple plus 2 apples equals 3 apples. Pretty good, right? Let's make it a little harder...

EXAMPLE 2

1 apple plus 2 pineapples does not equal 3 apples, but it does equal 3 pieces of fruit. Overarching lesson: When you add two different fruits, you can't use the sum as an answer for either fruit, but it is perfectly legit to use it as the sum of both fruits, something that Senator Manchin will be reminded of shortly. Finally...

EXAMPLE 3

1 apple plus 2 turds don't equal 3 apples, 3 pieces of fruit, or 3 turds.

Which example best applies to some of the verbiage coming out of Senator Manchin's mouth? I'll leave that for you to decide. I'm impartial. As usual.

Manchin's Turdy Math

Those of us even remotely involved with exposing the decade of lies coming from our "beloved" CDC and its not-especially-honest cronies at PROP (we'll hear from them soon) know full well that the following is a big fat lie. [my emphasis]

“It is devastating and completely unacceptable that in 2022, more than 109,000 Americans died from a drug overdose, and nearly 80,000 of those deaths were related to opioid or synthetic opioid use...Our bipartisan legislation mandates the FDA to prioritize public safety and fix their flawed marketing practices for dangerous opioids. I urge my colleagues on both sides of the aisle to support this commonsense legislation and save countless American lives from this epidemic.”

Sen. Joe Manchin, Press Release, Sept. 7, 2023

(In case you'd like to treat yourself to some high-quality vomiting sounds in celebration of Manchin's quote, here ya go.)

Before we go any further, let's give some major props to the fearless Dr. Chad Kollas, who may have replaced me in the center of Andy Kolodny's dartboard. 

@ChadKollas - Totally badass. Note to Manchin: Nice touch with the helicopter, dude. 

The Big Lie: Intentional Conflation of Pharmaceutical and Illicit Fentanyl

Manchin's carefully worded statement is technically true but inherently dishonest. Why? Because it implies that the fentanyl (and analogs), aka "synthetic opioids" (1) that are killing people, is, let's say, something like an "equal" mixture of prescribed and illicit drugs. (See the turd math lesson above.) This, of course, is a bunch of nonsense. Most of the deaths are due to illicit fentanyl, primarily made in China and exported into the US via Mexico. (You can read my colleague, Dr. Chuck Dinerstein's take on why Senators Joe Manchin and Ed Markey opposed FDAs randomized controlled clinical trials on the use of opioids for chronic pain here.)

This is hardly the first time that this trick has been used. My 2018 article, The CDC Quietly Admits It Screwed Up Counting Opioid Pills, slams the CDC for doing essentially the same thing in 2016:

"In 2016, 63,632 persons died of a drug overdose in the United States; 66.4% (42,249) involved an opioid."

Same lie, different day. CDC combines apples and turds to fool us into thinking that prescription opioid pills are responsible for many/most (?) opioid overdose deaths.

Too bad for them that in 2018, the Government Accounting Office published a report stating the opposite: [my emphasis]

According to the CDC, the rates for fentanyl prescriptions have remained stable demonstrating that the recent increase in fentanyl misuse is largely attributable to illicitly produced, non-pharmaceutical fentanyl.

GAO, Illicit Opioids, 2018

It should now be clear how insidious Manchin's statement really is. Why? First, it's now five years since the GAO report, and the role of fentanyl as a killer is beyond dispute. Even the sheep in the media are (finally) reporting that we are having a "fentanyl crisis." Google "fentanyl crisis," and you'll see 1.5 million hits and more than 7,000 in the news. People finally know this illicit fentanyl is "the bad guy." 

Second, saying that "nearly 80,000 of those deaths were related to opioid or synthetic opioid use" is a calculated, manipulative "partial" truth that is obviously designed to keep alive the lie that drug manufacturers are responsible for today's deaths, which are not only primarily caused by illicit fentanyl but increasingly xylazine and nitazene opioids, neither of which has ever been approved for or prescribed for human use. What industry will Manchin blame for these drugs, which make fentanyl look tame? Maybe Pickle Packers International or the Dollar Shave Club?

Kolodny Hops on the Manchin Express

Of course, no press release about opioids would be complete without a self-serving statement from America's favorite non-practicing physician, _Dr. Andrew Kolodny. He does not disappoint.

“The FDA has been putting new painkillers on the market based on improper studies that skew results in favor of approval. The methodology they're using was cooked up in private meetings with drug makers. The time for outside experts to examine the use of enriched enrollment randomized withdrawal is long overdue."

Dr. Andrew Kolodny, Medical Director, Opioid Policy Research Collaborative at Brandeis University.

Nice misdirection! In a calculated effort to keep the attention and blame on drug companies that dare to manufacture essential medicines, Kolodny seems to be blaming new (or maybe even not-yet-discovered) prescription opioids for the continuously rising death toll (despite a decline of more than 50% in the number of prescriptions). Of course, it's probably just a coincidence that he earned $500,000 (at a mere $725/hour) testifying in a shakedown of J&J by Oklahoma (1) for having the unmitigated gall to manufacture opioids drugs.

What a lovely world we live in! Trial lawyers and their "expert" witnesses get rich, and politicians get re-elected (and maybe even a helicopter). All at the expense of pain patients who suffer mightily after losing their meds (and let's thank the CDC for this too) because their physicians have been thrown in prison or left pain management out of fear of the predatory DEA. And let's not forget the deaths of tens of thousands of drug abusers and addicts who took up heroin and later, fentanyl. Its, appearance on the scene was inevitable once the zealots managed to "remove" safer drugs, like hydrocodone. from circulation.

The corruption and hypocrisy that drive this anti-opioid farce are nothing short of sickening.

NOTE:

(1) Oklahoma "won" the case, and J&J was ordered to pay $465 million to the state. That got tossed out in a 5-1 vote by the Oklahoma State Supreme Court in 2021.