Live data from Hacker News

Bleak New Estimates in Drug Epidemic: A Record 72,000 Overdose Deaths in 2017

nytimes.com

31–40 of 217 posts

Re: Bleak New Estimates in Drug Epidemic: A Record 72,000 Overdose Deaths in 2017

#31

Earlier quoted context omitted.

A few documentaries I've watched suggest that the dosages as recommended by the drug companies are designed to induce withdrawal symptoms before the next dose is due during treatment, I'd wager that's a good way to induce dependence during the course of treatment. The hypocrisy of the law when it comes to this is insane, but given how large the profits are and the power that money commands with lobbying, I'm not real…

Honestly, that sounds very conspiratorial and baseless. It assumes doctors are idiots and drug producers are comic book villains. Reality is more nuanced.

Comic book villainy quickly dissolves into nuanced realism when you distribute the elements of the "conspiracy" over the org chart. Then you end up with a lot of people who wanted to believe and mutually reassure each other that everything was fine, resulting in collective blindness to the evil they were doing.

Re: Bleak New Estimates in Drug Epidemic: A Record 72,000 Overdose Deaths in 2017

#32
post #14

The amount of responsibility laundering that's happening is staggering. Is it the fault of the doctors for prescribing strong painkillers or the responsibility of lobbyists for keeping the status quo as it is. Or is it the responsibility of patients to not seek strong opiates for the smallest aches? On whom falls the blame for this?

Many say that big Pharma corporations have a large share of the responsibility because they began promoting strong pain killers heavily, starting in the 90s [1]. Now it has become part of American culture (doctors, patients, pharmacistse etc) to treat any pain with these pain killers. It’ll cost a lot and take a long time to reverse that [2] [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2622774/ [2] https://www.vo…

At the same time, know that every time a politician gets a bullet point on his re-election flier for "fighting the opioid epidemic" or "keeping our streets clean", there are real people in real pain who get stranded without the medication they need to function.

After the birth of my youngest child, my wife spent the immediate recovery period blindsided by pain because new regulations meant the hospital was unwilling to prescribe opioid medication for "routine" things like an uncomplicated childbirth. She didn't have to deal with that for any of our other children, because back then, the hospital was willing to administer these medications.

Medicine is already over 8% of GDP, but the political complex is not satisfied with that -- every day it gets harder and more expensive to stay on the right side of the law while obtaining necessary medications.

In Florida, it is now unlawful for a physician to write for more than 3 days of narcotic painkillers (if there are extenuating circumstances, this can be pushed to a week, but the rationale must be documented and approved by at least one other physician, iirc). If your pain hasn't subsided in 3 days, you need to make another appointment -- which means paying another copay, or if uninsured, paying another out-of-pocket office visit -- to get a refill.

If you require pain medication for a chronic condition, you now, by law, have to acquire a separate doctor who specializes in "pain management"; your family doctor is legally not allowed to write for more. Good luck finding an appointment at a reputable pain management clinic within 3 months.

This is not a simple thing, and these medications continue to be prescribed because they help a great deal of people, relatively few of whom descend into addiction (and note that many who do go to the streets are driven there because their docs or pharmacists got spooked by the DEA and cut them off, leaving them in mind-numbing pain, or because they couldn't afford the substantial financial and social costs required to get controlled Rxs renewed and refilled on an ongoing basis).

Re: Bleak New Estimates in Drug Epidemic: A Record 72,000 Overdose Deaths in 2017

#33
post #14

The amount of responsibility laundering that's happening is staggering. Is it the fault of the doctors for prescribing strong painkillers or the responsibility of lobbyists for keeping the status quo as it is. Or is it the responsibility of patients to not seek strong opiates for the smallest aches? On whom falls the blame for this?

Many say that big Pharma corporations have a large share of the responsibility because they began promoting strong pain killers heavily, starting in the 90s [1]. Now it has become part of American culture (doctors, patients, pharmacistse etc) to treat any pain with these pain killers. It’ll cost a lot and take a long time to reverse that [2] [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2622774/ [2] https://www.vo…

In the end of the day doctors are the only ones holding the pen to write prescriptions, no matter how you look at things.

Re: Bleak New Estimates in Drug Epidemic: A Record 72,000 Overdose Deaths in 2017

#34

The amount of responsibility laundering that's happening is staggering. Is it the fault of the doctors for prescribing strong painkillers or the responsibility of lobbyists for keeping the status quo as it is. Or is it the responsibility of patients to not seek strong opiates for the smallest aches? On whom falls the blame for this?

Since the article talk exclusively about opioid use disorders, this not about using opiates for aches. It is a common replicated experiment that patient that use opiates exclusively for aches don't develop habits, and more control and choice by the patient usually result in lower doses.

However I have heard constantly during the last decade that stress and depression is on the rise and also spreading to younger age groups. I thus find it very questionable to view the problem from the drug supply perspective. Is it not a more logical conclusion that more people are self medicating and the problem is the social environment (stress, depression, looniness, and so on) and possible faults in the medical system in not helping those people as effective it could?

Re: Bleak New Estimates in Drug Epidemic: A Record 72,000 Overdose Deaths in 2017

#35
post #33
post #14

Earlier quoted context omitted.

Many say that big Pharma corporations have a large share of the responsibility because they began promoting strong pain killers heavily, starting in the 90s [1]. Now it has become part of American culture (doctors, patients, pharmacistse etc) to treat any pain with these pain killers. It’ll cost a lot and take a long time to reverse that [2] [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2622774/ [2] https://www.vo…

In the end of the day doctors are the only ones holding the pen to write prescriptions, no matter how you look at things.

Plenty of other people share responsibility.

The public often expects strong painkillers rather than dealing with extreme pain. You can request less extreme painkillers and use less than prescribed.

Doctors can’t directly measure pain so while the have an important role, they can’t do it alone.

On top of that drug companies had a strong incentive to change the culture around pain and succeeded.

The illegal drug market thrives via specific and changeable laws.

People doping illegal drugs have a direct moral responsibility to their customers, but frankly they are already breaking the law so you can only expect so much.

Illegal drug users often seek out stronger highs resulting in their deaths. Seeking treatment is a possibility for these users.

Re: Bleak New Estimates in Drug Epidemic: A Record 72,000 Overdose Deaths in 2017

#36
This is by design. Look at any comedy movie these days, and the young adults are doing drugs. It has become as natural as eating junk food. People view being drugged and dumb to be fine these days because that's the Hollywood propaganda and it's everywhere in western society.

Re: Bleak New Estimates in Drug Epidemic: A Record 72,000 Overdose Deaths in 2017

#37
post #28
post #25

Earlier quoted context omitted.

How about if everyone stopped playing the blame game (because it's irrelevant) and spent all that effort and time working on a solution instead. It feels like reality TV has crept into every day life, and now everything has to be turned into a drama. Stop pandering to the drama, start working on a solution already.

You can't defeat something if you don't understand it.

Understanding is very different from blame - that's the main lesson from air accident investigation.

In particular, when you want to assign blame, you create an incentive to destroy or conceal evidence about what's actually happening. For opiates there are criminal penalties as soon as someone steps across the grey boundary between "medically necessary" and "recreational", so obviously everyone involved is going to lie about what's happening.

Re: Bleak New Estimates in Drug Epidemic: A Record 72,000 Overdose Deaths in 2017

#38

This is by design. Look at any comedy movie these days, and the young adults are doing drugs. It has become as natural as eating junk food. People view being drugged and dumb to be fine these days because that's the Hollywood propaganda and it's everywhere in western society.

.. are you sure? This is the same Hollywood that's been editing cigarettes out of movies? Could you cite an example scene?

Re: Bleak New Estimates in Drug Epidemic: A Record 72,000 Overdose Deaths in 2017

#39

This is by design. Look at any comedy movie these days, and the young adults are doing drugs. It has become as natural as eating junk food. People view being drugged and dumb to be fine these days because that's the Hollywood propaganda and it's everywhere in western society.

Blaiming peoples behaviour on entertainment products is a very weak claim. Might as well blaim the gun violence on video games.
Post reply on HN