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Our Public Health Problems

Opioids as the White Death

All of us necessarily focus on different areas, and until quite recently I’d never paid much attention to public health issues, naively assuming that these were in the hands of reasonably competent and reasonably honest government servants, monitored by journalists and academics of similar reliability.

For many of us, myself included, an important crack in that assumption came in 2015, when the pages of the New York Times and our other major newspapers were filled with reports of a shocking new study by Anne Case and Angus Deaton, a married pair of eminent economists, with Deaton’s career having been crowned a few weeks earlier by winning the Nobel Prize in his discipline.

Their remarkable finding was that during the previous 15 years, the health and survival rates of middle-aged white Americans had undergone a precipitous decline, completely breaking with the pattern of non-white American groups or with whites living in other developed nations. Moreover, this sharp fall in physical well-being represented a radical departure from the trends of the previous half-century, being almost unprecedented in modern Western history.

Although their short paper filled merely a half-dozen pages in the Proceedings of the National Academy of Sciences, it was quickly endorsed by a host of prominent public health experts and other scholars, who emphasized the dramatic nature of the discovery. A couple of Dartmouth professors told the Times “It is difficult to find modern settings with survival losses of this magnitude,” while an expert in mortality trends exclaimed “Wow.” Their striking results were illustrated by numerous simple graphs based upon easily obtained government statistics.

The two authors were both economists, whose normal work was distant from public health issues, and according to their account, they had stumbled into these remarkable results quite accidentally, while exploring a different topic. So the natural question that came to my mind was how such a momentous calamity affecting a large fraction of the American population could have been entirely ignored for so long by all the academics and researchers actually working in public health. Perhaps a short trend of three or four years might have escaped notice, but missing fifteen years of such a deadly national decline?

Moreover, the source of this drastic reversal in long-term mortality trends was narrowly confined to a few particular categories. For white Americans aged 45-54, deaths due to drug overdoses and other poisonings had soared almost 10-fold during the period in question, easily overtaking lung cancer to become the leading cause of death.

Mortality by cause, white non-Hispanics ages 45-54 (PNAS)

Together with the steep rise in suicides and chronic alcoholism, drug deaths accounted for the great change in life-expectancy. This situation was particularly acute for the working-class, with the death rates soaring a remarkable 22% for white Americans who lacked a college-education.

Case and Deaton grouped together drug overdoses, suicides, and chronic alcoholism as “deaths of despair,” and in 2020 they expanded their ground-breaking study into a book of that title, which was widely discussed and praised. Their subtitle emphasized “the Future of Capitalism” and they argued that the central cause of America’s deadly predicament was the opioid prescription drug epidemic, produced by the FDA’s 1996 approval of addictive OxyContin and its subsequent massive marketing by Purdue Pharmaceutical. Under the pressure of manipulative corporate lobbying, our government had “essentially legalized heroin,” with the consequences being exactly as might be expected. By 2015, 98 million Americans—more than one-third of all adults—had been prescribed opioids and the level of drug overdoses and other deaths of despair reached 158,000 per year by 2017.

Unlike other pharmaceutical giants, Purdue was privately owned by the Sackler family, who were the central villains in this story. The Sacklers earned more than $12 billion in profits from these drug sales and reached the pinnacle of American wealth even as millions of lives were destroyed, with sales of their OxyContin drug alone totaling as much as $50 billion. The authors drew a close analogy with the key figures in the 19th century British East India company, who earned their huge fortunes by organizing the opium trade into China, despite the devastating social consequences for that country.

The same year that Case and Deaton published their seminal PNAS article, former Los Angeles Times reporter Sam Quinones released Dreamland, his deeply-reported account of the human side of our national opioid tragedy, which was widely praised and won the National Book Circle Award.

The most striking declines in life-expectancy had been among the working-class, but Quinones emphasized that unlike most previous drug epidemics, this one was not only entirely concentrated in America’s white population, but even heavily afflicted the middle and upper-middle class whites of small towns and suburbia, among whom such hard drug use had previously been very rare.

These powerful opioids were massively marketed as legitimate pain medication, prescribed by doctors and obtained from pharmacies in bottles. This entirely respectable distribution channel overcame the previous social stigma, but once the victims had become addicted, large numbers began injecting the drugs and eventually turned to similar but far cheaper illegal heroin. So a star high school football player from a successful family would be given OxyContin to alleviate a minor injury, and within a couple of years he might have become a heroin junkie, dying of a drug overdose in his own bedroom. An unprecedented wave of such grisly heroin deaths suddenly flooded affluent white communities, which had never previously experienced such events.

Beth Macy’s national bestseller Dopesick appeared in 2018 and covered some of the same ground, focused primarily upon the opioid and other drug addictions in Appalachia and nearby portions of Virginia. Her account seemed fully consistent with that of Quinones and was filled with numerous moving personal stories. However, since it was so overwhelmingly descriptive and anecdotal rather than analytical, I generally found it less useful.

Case and Deaton are among the most respectable of mainstream academics, but the historical narrative that they and their journalistic counterparts provide is a horrifying one, with millions of American families destroyed by the deliberate corporate policies that elevated the Sacklers into becoming one of the world’s wealthiest families, surpassing the Rockefellers and the Mellons. But in an unusual twist, a considerable slice of their victims were from affluent, well-educated backgrounds and thus could effectively articulate their rage over what had been done to their communities.

One such individual writes under the pen-name Giles Corey. Coming from a supportive, wealthy family in a small white Southern town, he says he began using heroin in high school and eventually spent years suffering from severe drug addiction. Having lost many of his friends to overdoses and suicides, he was intensely hostile to the Sacklers, and in 2020 he drew upon all these fully mainstream books as well as Gerald Posner’s encyclopedic Pharma: Greed, Lies, and the Poisoning of America to produce a blistering 20,000 word portrayal of their business and political history, which we republished. Although obviously skewed by his extreme ideological views, he mined the 1,900 pages of those underlying sources to produce a gripping history of what he calls “the white plague” that can be read within a couple of hours.

  • The White Plague
    Giles Corey • The Unz Review • July 25, 2020 • 19,400 Words

The Forgotten Vioxx Disaster

In 2015 I was greatly surprised to discover that these striking American mortality trends had been ignored for so many years by our media and research establishments, but perhaps I should not have been. The cause of this epidemic of death was the widespread use of dangerous but highly lucrative opioid prescription drugs, and just a few years earlier I had published an article about the similarly ignored public health consequences of Vioxx, another very profitable but harmful prescription drug. As I told the story in 2012:

In September 2004, Merck, one of America’s largest pharmaceutical companies, suddenly announced that it was voluntarily recalling Vioxx, its popular anti-pain medication widely used to treat arthritis-related ailments. This abrupt recall came just days after Merck discovered that a top medical journal was about to publish a massive study by an FDA investigator indicating that the drug in question greatly increased the risk of fatal heart attacks and strokes and had probably been responsible for at least 55,000 American deaths during the five years it had been on the market.

Within weeks of the recall, journalists discovered that Merck had found strong evidence of the potentially fatal side-effects of this drug even before its initial 1999 introduction, but had ignored these worrisome indicators and avoided additional testing, while suppressing the concerns of its own scientists. Boosted by a television advertising budget averaging a hundred million dollars per year, Vioxx soon became one of Merck’s most lucrative products, generating over $2 billion in yearly revenue. Merck had also secretly ghostwritten dozens of the published research studies emphasizing the beneficial aspects of the drug and encouraging doctors to widely prescribe it, thus transforming science into marketing support. Twenty-five million Americans were eventually prescribed Vioxx as an aspirin-substitute thought to produce fewer complications.

Although the Vioxx scandal certainly did generate several days of newspaper headlines and intermittently returned to the front pages as the resulting lawsuits gradually moved through our judicial system, the coverage still seemed scanty relative to the number of estimated fatalities, which matched America’s total losses in the Vietnam War. In fact, the media coverage often seemed considerably less than that later accorded to the Chinese infant food scandal, which had caused just a handful of deaths on the other side of the world.

The circumstances of this case were exceptionally egregious, with many tens of thousands of American deaths due to the sale of a highly lucrative but sometimes fatal drug, whose harmful effects had long been known to its manufacturer. But there is no sign that criminal charges were ever considered.

A massive class-action lawsuit dragged its way through the courts for years, eventually being settled for $4.85 billion in 2007, with almost half the money going to the trial lawyers. Merck shareholders also paid large sums to settle various other lawsuits and government penalties and cover the heavy legal costs of fighting all of these cases. But the loss of continuing Vioxx sales represented the greatest financial penalty of all, which provides a disturbing insight into the cost-benefit calculations behind the company’s original cover-up.

This story of serious corporate malfeasance largely forgiven and forgotten by government and media is depressing enough, but it leaves out a crucial factual detail that seems to have almost totally escaped public notice. The year after Vioxx had been pulled from the market, the New York Times and other major media outlets published a minor news item, generally buried near the bottom of their back pages, which noted that American death rates had suddenly undergone a striking and completely unexpected decline.

The headline of the short article that ran in the April 19, 2005 edition of USA Today was typical: “USA Records Largest Drop in Annual Deaths in at Least 60 Years.” During that one year, American deaths had fallen by 50,000 despite the growth in both the size and the age of the nation’s population. Government health experts were quoted as being greatly “surprised” and “scratching [their] heads” over this strange anomaly, which was led by a sharp drop in fatal heart attacks.

On April 24, 2005, the New York Times ran another of its long stories about the continuing Vioxx controversy, disclosing that Merck officials had knowingly concealed evidence that their drug greatly increased the risk of heart-related fatalities. But the Times journalist made no mention of the seemingly inexplicable drop in national mortality rates that had occurred once the drug was taken off the market, although the news had been reported in his own paper just a few days earlier.

A cursory examination of the most recent 15 years worth of national mortality data provided on the Centers for Disease Control and Prevention website offers some intriguing clues to this mystery. We find the largest rise in American mortality rates occurred in 1999, the year Vioxx was introduced, while the largest drop occurred in 2004, the year it was withdrawn. Vioxx was almost entirely marketed to the elderly, and these substantial changes in national death-rate were completely concentrated within the 65-plus population. The FDA studies had proven that use of Vioxx led to deaths from cardiovascular diseases such as heart attacks and strokes, and these were exactly the factors driving the changes in national mortality rates.

The impact of these shifts was not small. After a decade of remaining roughly constant, the overall American death rate began a substantial decline in 2004, soon falling by approximately 5 percent, despite the continued aging of the population. This drop corresponds to roughly 100,000 fewer deaths per year. The age-adjusted decline in death rates was considerably greater.

AIDS and the Duesberg Hypothesis

I published my Vioxx analysis almost a decade ago, and although it generated some discussion at the time and even provoked a bit of secondary coverage in the mainstream media, the matter was soon once again forgotten. Vioxx had already been withdrawn years earlier, and whether its past use had resulted in tens of thousands or instead hundreds of thousands of premature American deaths among the elderly was merely water under the bridge, of little interest to most journalists.

Over the years, I occasionally referred to my findings in subsequent articles, but hardly paid much attention to the related issues of prescription drugs or public health, even after the current Covid epidemic brought those topics back to center-stage.

However, in November I happened to read Robert F. Kennedy, Jr.’s new book on exactly these issues, and was very impressed with the enormous amount of important material he provided, most of it entirely unfamiliar to me. As a result, I wrote a long and strongly favorable review which was widely read and even linked on the author’s own website.

Kennedy’s central theme was the total corruption of the American public health system at the hands of profit-hungry corporations, which had effectively subverted the regulatory process to ensure that lucrative drugs—sometimes even dangerous ones—were mass-marketed to our unprotected citizenry like any other consumer product. The forgotten Vioxx Scandal seemed a perfect example of this, so I included a brief mention of my 2012 findings in the review, and was quite gratified a couple of weeks later when Kennedy resurrected the Vioxx story during his lengthy interview with Jimmy Dore.

Although I found much of Kennedy’s criticism of the pharmaceutical industry reasonably persuasive, under normal circumstances his book would not have drawn me into public health issues, given my lack of familiarity with the topic. But what completely shocked me was that nearly half his text—some 200 pages—was devoted to presenting and promoting the astonishing claim that everything we have been told about HIV/AIDS for more than 35 years probably constituted a hoax. This issue became the heart of my review, especially because it had previously received almost no attention from his readers.

Yet according to the information provided in Kennedy’s #1 Amazon bestseller, this well-known and solidly-established picture, which I had never seriously questioned, is almost entirely false and fraudulent, essentially amounting to a medical media hoax. Instead of being responsible for AIDS, the HIV virus is probably harmless and had nothing to do with the disease. But when individuals were found to be infected with HIV, they were subjected to the early, extremely lucrative AIDS drugs, which were actually lethal and often killed them. The earliest AIDS cases had mostly been caused by very heavy use of particular illegal drugs, and the HIV virus had been misdiagnosed as being responsible. But since Fauci and the profit-hungry drug companies soon built enormous empires upon that misdiagnosis, for more than 35 years they have fought very hard to maintain and protect it, exerting all their influence to suppress the truth in the media while destroying the careers of any honest researchers who challenged that fraud. Meanwhile, AIDS in Africa was something entirely different, probably caused mostly by malnutrition or other local conditions.

I found Kennedy’s account as shocking as anything I have ever encountered.

I was deeply impressed by the scientific credibility of some of the individuals supporting Kennedy’s seemingly outlandish claims.

However, the first endorsement on the back cover is from Prof. Luc Montagnier, the medical researcher who won a Nobel Prize for discovering the HIV virus in 1984, and he writes: “Tragically for humanity, there are many, many untruths emanating from Fauci and his minions. RFK Jr. exposes the decades of lies.” Moreover, we are told that as far back as the San Francisco International AIDS Conference of June 1990, Montagnier had publicly declared “the HIV virus is harmless and passive, a benign virus.”

Perhaps this Nobel Laureate endorsed the book for other reasons and perhaps the meaning of his striking 1990 statement has been misconstrued. But surely the opinion of the researcher who won a Nobel Prize for discovering the HIV virus should not be totally ignored in assessing its possible role.

Kennedy noted that three additional science Nobel Laureates have expressed similar public skepticism for the conventional HIV/AIDS narrative, one of them being Kary Mullis, the renowned creator of the revolutionary PCR test.

The medical and media establishments were intensely hostile to Kennedy and his huge bestseller, and I became extremely suspicious when I noticed that their very harsh attacks scrupulously ignored the “HIV/AIDS Denialism” that constituted the largest and most explosive portion of his book, suggesting that they feared to challenge his claims.

Prior to the recent Covid outbreak, AIDS had probably spent four decades as the world’s highest-profile disease, and I was staggered by the notion that I might have been completely misled for all those years by our dishonest public health establishment and its subservient media. So I began exploring that half-forgotten controversy of the 1990s, which I had largely ignored at the time.

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