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Expert sounds alarm on new wave of US opioids crisis

theguardian.com

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Re: Expert sounds alarm on new wave of US opioids crisis

#51

Post by kibwen »

Loughla wrote: post #30
nobodyandproud wrote: post #10

I see this as analogous to the Dust Bowl, where the politicians and coastal elite ignored or dismissed the growing problem until it was too big to ignore. - https://www.smithsonianmag.com/smart-news/1000-mile-long-sto... - https://mallhistory.org/items/show/274 100 years and more information than ever, yet we have’t figured out this out-of-sight, out-of-mind problem.

Bingo. The center of this country (outside of a few major urban/sub-urban areas) is hollow. Between the loss of agriculture as a family job, loss of industrial jobs, and opioid use after decades of methamphetamine use, it's bleak. And no one really cares. As a general rule, we're told, "just move to Chicago (St. Louis, Kansas City, wherever)". That's not a solution, or a possibility for a lot of folks.

> That's not a solution, or a possibility for a lot of folks.

Then we need to work to make it a solution and a possibility, because I don't know what the alternative is. I'm from Appalachia, though my former oil-town retains a meager amount of relevance via the nearby industrial dairy farm. The owner of the only grocery store retired and nobody was interested in taking over, so the storefront laid empty until the government gave tax breaks to a hardware chain to set up shop and stock a little corner in the back with groceries so that it wouldn't become a food desert. But the situation isn't sustainable; there's not enough jobs. The population is declining. Most everybody drives to neighboring towns to work. I got out and moved to a big city, and wild horses couldn't drag me back.

I love the idea of small towns; not everyone needs to live in a big city (and almost nobody should be living in a remote cabin in the woods either; what an isolating experience). But if they're not economically viable, I'm not going to pay people to live there just so that small towns can continue to exist as a concept. What I will pay people to do is move to a city where they can find opportunity, and fight for more housing so that it's more affordable to do so.

Re: Expert sounds alarm on new wave of US opioids crisis

#52

Post by not1ofU »

Jedd wrote: post #22

From TFA: “It’s so easy to demonise Purdue and the Sacklers. I agree that what they did was terrible. I think a number of them should be in jail. But I’ve thought for some time that the issue behind it all is the structure of the system,” he said. I really do get that sentiment, but IF the USA legal system had properly prosecuted Purdue execs from the get-go - there's a reasonable chance others would have been less i…

McKinsey are also part of this story, doesn't appear to be mentioned anywhere else in the comments as yet

https://www.nytimes.com/2021/02/03/business/mckinsey-opioids...

Re: Expert sounds alarm on new wave of US opioids crisis

#53

Post by op00to »

diamondap wrote: post #44

A few years ago, I talked to three retired federal law enforcement agents who had each spent 20+ years fighting the cartels that were bringing drugs into the US from Mexico and South America. All three felt betrayed by the US government. They said, essentially, "We put our lives on the line many times to try to stop the flow of drugs. Then the government turned around and basically gave the pharmaceuticals license to…

Just a point - the same people who thought they were “saving” people with a drug war were destroying lives themselves over drugs that not so many years later are legal and accepted to possess. Somehow they’re not harmful anymore. It’s all BS.

Re: Expert sounds alarm on new wave of US opioids crisis

#54

Post by giantg2 »

gedy wrote: post #49
giantg2 wrote: post #16

Earlier quoted context omitted.

"Oxycontin was misclassified due to fraudulent reportings of the drug's capabilities and marketing campaign. However that should have never affected people getting legit pain care, but it definitely did." What does legit pain care look like? Does it include the prescription of narcotics to outpatients on an ongoing basis, or for more than a couple days? While the safety of oxycontin was misrepresented, I assume there…

> What does legit pain care look like? A sibling was on low dose hydrocodone for years for back and ankle issues. Seemed to be fine from my perspective.

Perhaps that was the dosing or your siblings biology. Hydrocodone is also a narcotic that is potentially habit forming. The addictive potential of oxycodone is supposed to be very similar or only slightly higher than that of hydrocodone.

Re: Expert sounds alarm on new wave of US opioids crisis

#55

Post by impossiblefork »

swayvil wrote: post #31
impossiblefork wrote: post #24

Earlier quoted context omitted.

It's a bad idea. Opioids are incredibly addictive. At one point something like 25% of the male population of China 'regularly consumed' opium, i.e. they were addicted to it, and China has always been a country with at least a certain sense of order. Opium is also special, even among other dangerous drugs. It takes over your brain's reward system and makes things you previously regarded as pleasurable as uninteresting…

Consider that 10% of the population is on antidepressants. And the world hasn't blown up. Given the choice between antidepressants and opioids, I'll take opioids.

Opioids are almost certainly worse than antidepressants, and I don't see why you appear to believe that they are alternatives to each other.

Any entity participating in an endeavour which as part of its activities distributes, markets or which through propaganda or political action defends the use of opioids must be destroyed, because opioids are a chemical weapon.

They aren't 'illegal drugs'. They're a means to destroy somebody, and that is all they are.

Re: Expert sounds alarm on new wave of US opioids crisis

#56

Post by jmyeet »

Every part of this is made worse by capitalism.

We start with over-prescription of opioids. Pharma companies make money selling them. Doctors may even make money in kickbacks (a practice that should be illegal).

The disastrous War on Drugs that made opioids cheaper and easier to obtain (eg black tar heroin) than cannabis.

Those who became addicts from a legal prescription turn to illegal products. Illegal pills are expensive. Street heroin is much cheaper.

To feed this habit, it eventually leads to crime. And what do we do with petty criminals including those charged with drug posession? Whey we incarcerate them of course. That's expensive and ineffective but prisons create jobs. Some private prisons have a direct profit motive to fill their prisons as they're paid by the state per-inmate.

Oh and convict labor is yet another profit opportunity.

A lot of people self-medicate because of unresolved trauma, just as a coping mechanism or whatever. If you're an average worker this might be just going to a bar and having a few drinks. But that's relatively expensive. Poorer folks would once sit out on the streets or in a park, often in a group, and do the exact same thing except it would be a bottle in a brown paper bag. If you're homeless, you're even more likely to self-medicate.

Yet police harass the second groupo. We criminalize all sorts of things, including feeding people [1].

Fentanyl makes all of this worse because it's so cheap to produce that it laces other drugs to give them a kick. The amount can wildly vary so you may accidentally get a lethal dose.

We have a societal failure by robbing people of basic hope and dignity and then profiting off incarcerating them.

[1]: https://www.jacksonville.com/story/news/2014/11/05/90-year-o...

Re: Expert sounds alarm on new wave of US opioids crisis

#57

Post by chasil »

giantg2 wrote: post #39

I'm glad this article is highlighting the environment that this happened in. The lack of hope is what is at the root of the issue for many. If you have no decent job prospects and multiple issues in your life, you won't care about what a drug will do to you as long as you get to forget those problems for a while. Pretty similar for alcohol too. They blame the coal barrons for not leaving anything behind. They certain…

I am more aghast at the pharma barons that have retained their wealth, as that was a quick cycle of unequal riches and ruin that looked nothing like the impact of coal upon society (as it was able to empower industrialization for a long duration). There was no long-duration benefit to OxyContin mass-marketing.

That the Sackler family remains at liberty is conclusive proof that the FDA was bought and owned on the question of opioids, and had no ability or intention of acting in the public good. Most other countries would have stopped this.

A similar theme pervades most of the checks and balances of the U.S. Constitution in general. These were brilliant controls in 1789 that have long since been disabled by an ocean of cash.

Re: Expert sounds alarm on new wave of US opioids crisis

#58

Post by maximus-decimus »

bottlelion wrote: post #17
swayvil wrote: post #13

Earlier quoted context omitted.

Here's how. If you have good opioids in hand then there's no need to buy opioids of uncertain strength from dubious sources. Thus your dosage is more controllable. If your supply is reliable then there is no seesaw of deprivation when you're out and overindulgence when you're flush. For further data, apply the same logic that keeps people from oding on alchohol.

And then what? Does overall opioid use go up? Or do you believe it would stay the same?

Is that the metric we care about? Wouldn't "amount of people dying of opiods" and "amount of people having their lives ruined by opiods" be better ones?

Th way I see it, alcohol issues wouldn't be reduced if you made it illegal and less people drank it, but now people are drinking unregulated moonshine that makes them blind or kills them because it contains methanol and isopropanol.

Re: Expert sounds alarm on new wave of US opioids crisis

#59

Post by dns_snek »

op00to wrote: post #53
diamondap wrote: post #44

A few years ago, I talked to three retired federal law enforcement agents who had each spent 20+ years fighting the cartels that were bringing drugs into the US from Mexico and South America. All three felt betrayed by the US government. They said, essentially, "We put our lives on the line many times to try to stop the flow of drugs. Then the government turned around and basically gave the pharmaceuticals license to…

Just a point - the same people who thought they were “saving” people with a drug war were destroying lives themselves over drugs that not so many years later are legal and accepted to possess. Somehow they’re not harmful anymore. It’s all BS.

Excellent point, and it's not just a thing of the past, it's still happening right now. Cannabis might be at various stages of legalization throughout the US, but there are countless other substances that are criminalized without any justification, like psychedelics.

The damage that the US-led war on drugs has done throughout the world is staggering. It's probably going to take decades until all the brainwashing and propaganda washes away and we get some form of legalization in Europe, not to mention other parts of the world that take it even more seriously.

Re: Expert sounds alarm on new wave of US opioids crisis

#60

Post by zdragnar »

diamondap wrote: post #44

A few years ago, I talked to three retired federal law enforcement agents who had each spent 20+ years fighting the cartels that were bringing drugs into the US from Mexico and South America. All three felt betrayed by the US government. They said, essentially, "We put our lives on the line many times to try to stop the flow of drugs. Then the government turned around and basically gave the pharmaceuticals license to…

A friend of mine was a mechanic in the air Force and took a wrench to the knee. The VA basically prescribed him a giant bottle of benzos and told him to take them as needed.

Young man laid up at home with nothing to do but sit on the couch playing video games and drink beer. Add in a big bottle of pain pills to take "as needed" and you've got an addict.

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