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Expert sounds alarm on new wave of US opioids crisis

theguardian.com

71–80 of 202 posts

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

#71
post #43

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.

As a Scandinavian I find this an odd take on the situation. To me it seems like the US has a very, very, broken healthcare system that you’ve chosen to have by electing politicians who aren’t going to reform it into something reasonable. My wife and I presently had twins, and we spent 7 days living in the hospital with a lot of help from nurses and so on, and it cost us $130. Which was me paying for 3 days of living…

As a fellow Dane, you must also know how close our public healthcare is to crumbling, how long wait times are for care, our record highest cancer rate in the world of any nation, and a policy of treating only acute conditions (no cancer screenings deemed "unnecessary" etc.)

I have been misdiagnosed a number of times and was finally treated in the US for a major condition the doctors missed here in Denmark.

We get a number of privileges for our very high tax: childcare is cheap, education is free, and births cost us virtually nothing but let's not try and overstate the value of our system to theirs. Ours too is broken, it's just a matter of degrees and where.

Our middle-class, in return, gets taxed to high heaven while our income disparity between rich and poor continues to widen.

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

#72

I was in the care of a pain clinic when the fire hose was abruptly shut off. I wasn't being given oxycontin, but I still suffered from the sudden change. I went from sustainable maintenance to a drug that gave me serious side effects, but the doctors refused to listen. Even when a sleep study objectively showed the damage the buprenorphine was doing, I was told it's that or nothing. The doctors were terrified of new…

The harm to society of people who need them not getting pain drugs far outweighs the pain to society of those who don’t need them abusing them. I’ve had similar experiences with them not giving me proper painmeds are having all 4 of my wisdom teeth removed. They gave me 2 weeks of Tylenol #3 and some homeopathic bullshit and expected that to be good enough. Luckily my stepdad is a serious medical patient with lots of…

> The harm to society of people who need them not getting pain drugs far outweighs the pain to society of those who don’t need them abusing them.

I can see the argument here morally (and I agree with it), but in practice I know far more people negatively affected by drug addictions and drug addicts than I know people unable to get pain management medication they need. I imagine my experience may be typical, and so I am unsurprised the pendulum has swung so far.

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

#73
post #66

Earlier quoted context omitted.

How are opioids worse than antidepressants ?

Do antidepressants hijack people's reward systems so that they no longer enjoy things other than antidepressants?

And antidepressants are known to induce psychosis.

But just answer the question plainly. I really want to know.

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

#74

[flagged]

I feel your anguish.

However, you must realize that if you were living in 1924 instead of 2024, the outlook for humanity would be far more bleak. Penicillin wouldn't be invented for another four years, so bacteriological infections were lethal. Measles, mumps, or rubella had likely claimed the lives of your siblings or neighbors. And your life would be bracketed by the world paroxysm of war that you had just endured, and the paroxysm that was to come.

Compared to that life, we are free from disease, the food supply is more vast and diverse, and the technology is simply stunning.

But, in a particularly human way, we dig for misery and we are very good at finding it.

I don't know what to tell you, except maybe put the shovel down for a little while, if you can.

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

#75

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…

My mom worked as an ER physician in Pennington Gap, VA during the early years of opioid abuse there (late nineties through through the early oughts) [1]. She would constantly complain about drug seekers there and refused to give out pain meds. According to her, she was the only doctor who would refuse to give out pain meds.

Fast forward to 2022, she needed heart surgery and was in the ICU for three weeks afterward. She never asked for pain meds and regularly refused them when asked. I think she had became so accustomed to denying people pain meds, that she even denied herself, though it was clear she was in pain.

[1]: https://www.nytimes.com/2019/08/18/health/opioids-purdue-pen...

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

#77
post #12
post #2

[flagged]

Believe it or not, this concept of having strong pain killers available to the public is somewhat American-centric. Much of Europe does not consider the need for strong pain killers available in society, and pain tolerance is quite different in, for example Germany or the Netherlands, where it has been nearly impossible to get anything strong for pain for many decades.

I've actually been offered fentanyl for medical procedures that involved moderate discomfort several times.

I refused it and endured the pain. The physicians had never seen anyone do that before.

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

#78
post #12
post #2

[flagged]

Believe it or not, this concept of having strong pain killers available to the public is somewhat American-centric. Much of Europe does not consider the need for strong pain killers available in society, and pain tolerance is quite different in, for example Germany or the Netherlands, where it has been nearly impossible to get anything strong for pain for many decades.

in Germany i think there is a general bias by medical professionals against using medicine at all for the treatment of symptoms, not only pain.

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

#79
post #51
post #30

Earlier quoted context omitted.

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 gov…

> 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.

these things are not written in stone, or the laws of physics. Layers of policy and taxation choices have led to this. Nothing says that the current system is stable, either.

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

#80
post #43

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.

As a Scandinavian I find this an odd take on the situation. To me it seems like the US has a very, very, broken healthcare system that you’ve chosen to have by electing politicians who aren’t going to reform it into something reasonable. My wife and I presently had twins, and we spent 7 days living in the hospital with a lot of help from nurses and so on, and it cost us $130. Which was me paying for 3 days of living…

Yes, every reason why we don't have universal healthcare comes down to voting in politicians that are against it, but what outsiders and party hardliners fail to appreciate is where the resistance comes. When the Democrats controlled the presidency and both houses, we failed to push out any reasonable form of universal healthcare and that is due to several specific interests that have a hold on the Democrat party then and today.

I would love a Medicare for all, because that's the most cost-effective system we can possibly get short of having no system at all. It'd also increase job mobility--nobody tied to their jobs for "benefits"--and put a sane check the price of basic-level care.

However not all countries with public healthcare are drug-free--Portugal just manages, not solves, its problem despite 50 years of public health--and that's because the incentives to both sell and use these powerful painkillers don't merely go away with a public system. Medical doctors were also complicit; or the more responsible ones, yanked-away the prescription out of caution but unintentionally drove their patients to the black market.

I'll concede that a streamlined system would have helped alert the powers that be sooner, but I'm not convinced that the powers-that-be would have done anything concrete until it became a crisis.

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