John Giordano DHL, MAC


Albert will never know what it’s like to cheer on his college football team or date the co-ed of his dreams. The tall and handsome blonde haired, blue eyed high school junior, who grew up in an upper-middle class family, was a bright student with a promising future. At 17 years old, Albert was dead – he took two pills, Methadone and Xanax, and those shut down his breathing. My heart goes out to Albert’s parents. I know how they feel as I nearly lost my son to an overdose.

Albert’s short life ended by a prescription drug overdose is emblematic of our current opium epidemic. It is beyond reason and sane thought that everyone in the pharmaceutical and medical fields are walking around aimlessly pretending there is not a problem and hiding from the fact that eight out of every ten opioid painkillers produced in the world is consumed by Americans. That translates into less than five percent of the global population consumes eighty percent of the world’s production of prescription painkillers. By any standards, this is a severe epidemic that is not caused by a virus or bacteria. Yet at a time when FDA approved prescription painkillers are involved in nearly 60 percent of all drug overdoses and three out of four overdose deaths, the most potent opioid painkiller ever imagined has been approved by the Food and Drug Administration – the government agency tasked with protecting the public’s health. This is complete and utter insanity! Alert the morgues because people are going to start dying within days of this poison hitting the market.

Zohydro is due to rollout this month (March 2014). It’s a hydrocodone-based drug that is banned in most modern countries. It joins a long line of (opioid analgesics) painkillers already available on the glutted U.S. market. What differentiates Zohydro from its competitors (Lorcet, Lortab, Norco, Vicodin, Vicodin ES, Vicodin HP, Anexsia, Lorcet Plus, Zydone, etc.) is that it is estimated to be about five times more potent than anything on the market today and comes in an easy to crush coating – a trait synonymous with potential for drug abuse. Addicts will crush pills and then swallow, inject or snort the powder like substance. However, what truly makes Zohydro unique is that it is pure hydrocodone. Its competitors add an additional drug like acetaminophen to improve the efficacy and also as an abuse deterrent.

The FDA said it approved the extended-release pill Zohydro ER for patients with pain that requires “daily, around-the-clock, long-term treatment” that cannot be treated with other drugs. As I stand here before you, I swear that in nearly thirty-years of addiction treatment, having worked with world leading experts on the subject, I’ve never heard of anyone in such pain that available pain medication couldn’t handle.

Just how did we get here? It wasn’t that long ago that opioid painkillers were once reserved for terminal cancer patients. The FDA was started in response to companies more concerned with their bottom line than that of their customers. It was formed in 1906 with the Pure Food and Drugs Act, signed into law by then President Theodore Roosevelt
to protect Americans from companies marketing dangerous and/or deadly products. So what changed?

An article published in the Journal of the American Medical Association (JAMA) opened the floodgates to our current opium epidemic. In 1997, 2 expert panels in the United States introduced clinical guidelines for management of chronic pain. Both guidelines encouraged expanded use of opioid pain medications after careful patient evaluation and counseling when other treatments are inadequate. They also claimed the risk of addiction was low. Two groups represented on the expert panel, American Academy of Pain Medicine and American Pain Society, have taken millions from the very same pharmaceutical companies who stood to benefit the most from the adoption of a broader policy towards prescribing opioid painkillers. Was this financial arrangement a quid pro quo for a favorable report to JAMA – the bible of the medical profession? This is an all too familiar playbook.

In 2001 the New England Medical Center medical director, Dr. Daniel Carr, told the New York Times’ Melanie Thernstrom this, ‘’It’s a field on the verge of an explosion,’’ Carr says. ‘’There’s no area of medicine with more growth and more public interest. Others called it a watershed moment. Mark Sullivan, MD, a professor of psychiatry and behavioral sciences at the University of Washington calls it “a situation that was ripe for the influence of the pharmaceutical industry.” “Doctors are prescribing like crazy,” said Dr. C. Richard Chapman, the director of the Pain Research Center at the University of Utah.

By 2010, pharmaceutical companies were selling four times as many prescription painkillers to pharmacies, doctors’ offices and hospitals as it did 10 years earlier. Research indicates that while opioid prescriptions increased throughout the 2000s, so did the dose of each pill. CDC researchers found that the average size of an oxycodone prescription – the entire amount in the bottle – increased from the equivalent of 923 milligrams of morphine in 2000 to 1,566 milligrams of morphine in 2010. Hydrocodone, the opioid used in Vicodin, the average dose per prescription increased from the equivalent of 170 milligrams of morphine in 2000 to 288 milligrams in 2010. Distribution of morphine, the main ingredient in popular painkillers, increased 600% from 1997-2007, according to the U.S. Drug Enforcement Administration. 241 million prescriptions for opioid painkillers were written in 2012 alone. Today, the ‘Chronic Pain’ market is estimated to be in the $22 billion dollar range.

In the early part of the twentieth century streptococcal infections were treated with the drug Sulfanilamide which came in a pill and powder form. To meet the growing interest of Sulfanilamide in liquid form a pharmaceutical company in Tennessee tasked its chief chemist and pharmacist to develop the Elixir. The S.E. Massengill Co. chief chemist, Harold Cole Watkins, found that sulfanilamide would dissolve in diethylene glycol (a.k.a. anti-freeze). The company tested their new product for taste, fragrance and appearance and found it to be completely satisfactory. At this time in our history, it was not required of a pharmaceutical company to test its products for toxicity before they hit the market. In the late summer of 1937, Massengill shipped their Raspberry flavored elixir all over the country.

Soon after, the country became outraged. People across this great land of ours were dying from a medicine made right here in the U.S. and prescribed by their trusted physicians. The anguish was unbearable. Americans felt betrayed and became skeptical. Congress knew the Food and Drugs Act of 1906 was weakened. They debated on how to shore it up for years prior. It took the deaths of over one-hundred Americans before Congress finally passed the 1938 Food, Drug, and Cosmetic Act, which put teeth into the FDA by giving it authority to regulate drugs.

Fast forward to 1999 – over four-thousand Americans died that year from prescription drug overdoses. The public is infuriated. They begin forming groups to bring greater awareness of the problem in an effort to effect change. But all of their continued efforts are for not. Prescription drug overdoses persist.

Once again, fast forward another fifteen-years to March 2014. More than an estimated seventeen-thousand Americans will die from prescription drug overdoses this year – one every 19 minutes. The Center for Disease Control (CDC) called prescription drug addiction an epidemic long ago. The FDA and Congress have the power to stop these preventable deaths, but instead they chose to fuel this crisis with their silence. This year enough prescription painkillers will be prescribed to keep every single American adult sedated 24/7 for an entire month! Yet complete silence from the very people charged with keeping us safe.

Recently I read a headline regarding three hundred and three people dying over a ten year period as a result of faulty air bags in cars. Three-hundred people die from prescription drug overdoses every week. However, it was the air bags that caused indignation in the voices of lawmakers. How could a car manufacturer be so irresponsible as to market a car with faulty safety features?! Elected officials in both the House and the Senate have announced plans for at least two Congressional hearings to investigate the failed air bags, yet they’re completely silent on the over 100,000 deaths – some of them in my arms – in the last decade at the hands of prescription painkillers. Not a word; not so much as a peep. Where is the disconnect?

There are some that will tell you that drug overdoses are the result of poor choices; that the addict got what they deserved and they need to be accountable for their own actions. As for the accountability, I agree. People must accept responsibility for their actions. However the rest of the aforementioned statement is simply unsubstantiated and is an outdated opinion preached by the grossly under-informed. Years ago my close friend and colleague Dr. Kenneth Blum – discoverer of the addiction gene – did a study at my addiction treatment center. The results revealed that three out of four people being treated for addiction had a genetic predisposition to the disease. Dr Blum claims this result is consistent with similar studies he’s done elsewhere. For people with a genetic predisposition to addiction, their choices are foggy at best. Their brains are wired differently. For them, the intense cravings are like a severe sun burn to someone else, they’ll do just about anything to ease the pain, or in this case, cravings.

Most people are under the misconception that addiction is strictly drug abuse. Nothing could be further from the truth. Addiction is a brain disease with many expressions. Take food for example. Have you ever wondered what pushed the U.S. over the edge in becoming the world’s most obese country? Certain foods can be just as addicting – although less intense – as opioids? It’s true. Sugar, and anything the turns into sugar in the body, had a similar effect on the brain as cocaine. What is even more concerning is that for decades the major process food companies have been using people’s addictions to help sell more products.

In his bestselling book: Salt Sugar Fat: How the Food Giants Hooked Us by New York Times Bestselling Pulitzer Prize–winning investigative journalist Michael Moss takes you behind the scenes of the process food industry. In his book the author goes into great detail on how for decades major process food companies have been spiking the national food supply with addictive agents that trick the brain into thinking it’s still hungry, thus forcing more sales. He claims more meals are being designed in laboratories than in kitchens. His book is worth a read. If nothing else, check out the introduction online.

Is there a silent assault on Americans with addictions? Are people with addictions being exploited for profit? The poignant facts speak for themselves. 100,000 Americans died from a prescription drug overdose in the last decade, prescription drug overdoses are the leading cause of accidental and preventative deaths in the U.S., the CDC declared prescription drug addiction as an epidemic long ago, 425,000 emergency department visits for misuse or abuse of opioids, including overdoses in 2013 – up from 166,338 in 2004, one in three adults, one in five kids in the U.S. is clinically obese and diabetes in the United States has doubled in the last ten years and so on. I could go on but the picture is crystal clear; whether you choose to see it remains the question.

A close friend of mine has a saying: “when elephants fight only the ants get killed.” How many more Albert’s have to die before the people we’ve elected to protect us stop pretending we’re invisible? The FDA was created to protect us from specifically these types of deadly products; yet they continue approving poison (many of which are banned in
most modern countries) for public consumption based on a company’s promising pro forma. Is the economy really worth it; is it worth killing hundreds of thousands of innocent Americans? Have we become
a cannibalistic economy where we feed on our own? Can’t these companies find a better use of their time and resources or are their year end bonuses just too much to say no to?

As I mentioned before I’m big on responsibility and accountability. Addicts need to be responsible for their actions and so do the CEOs of the pharmaceutical companies that supply the poison and the elected and appointed government officials charged with regulating these drugs and are responsible for our safety. With the “at any cost” mentality of gaining market share, improving the bottom line and beating the competition in this $20 plus billion dollar industry comes the causalities of corporate battles – the Albert’s of the world. Dr. Samual Evans Massengill, the owner of the pharmaceutical company that poisoned people in 1937, said this about the incident: “My chemists and I deeply regret the fatal results, but there was no error in the manufacture of the product.” We’ve all heard similar refrains from other CEOs in similar situations over the years. Consumer safety is an after thought, if it is even that. It’s time for our appointed government officials to put an end to this madness by simply doing what we elected them to do – their job!

John Giordano DHL, MAC is a counselor, President and Founder of the National Institute for Holistic Addiction Studies, Laser Therapy Spa in Hallandale Beach and Chaplain of the North Miami Police Department. For the latest development in cutting-edge treatment check out his website: