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America’s opioid epidemic is worsening

economist.com

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Re: America’s opioid epidemic is worsening

#121

Post by skookumchuck »

padobson wrote: post #12

I live in Trumbull County in Ohio, the dark red county in North East Ohio. We recently had 23 (non-fatal) overdoses in a two-day period[0]. That's roughly .01% of the county's total population - so yeah, it's getting bad here. There were recently two shootings within a mile of my house. Several people dead. Both shootings were drug related. I can't help but look around and believe that the needs these folks are tryin…

Overdosing on heroin comes from inconsistent purity in black market heroin. Addicts have no reliable way to determine how much they are injecting.

Heroin addicts get their start from prescription drugs. When the doctors cut them off, or it gets too expensive, they turn to heroin.

Re: America’s opioid epidemic is worsening

#122

Post by johan_larson »

devopsproject wrote: post #16
DoodleBuggy wrote: post #8

Hard to believe there is really an "epidemic" beyond typical fearmongering and political noise. People have always used drugs, this is nothing new. Unfortunately all the hype and noise is having significantly negative consequences to the medical community, doctors, and patients who actually need these things.

Here are some alternative facts. Red means bad: https://www.brighthearthealth.com/wp-content/uploads/OpioidA...

Wonder why the northern great plains are so resistant to this problem?

Re: America’s opioid epidemic is worsening

#123

Post by tptacek »

narag wrote: post #119
tptacek wrote: post #92

Earlier quoted context omitted.

I'm not sure I was arguing that opiate addicts are violent when they're high . I'm not making a moral argument about legalization or even (as is being repeatedly suggested on this thread) subsidization of opiates. I'm saying that if the cause of the epidemic is prescription opioids, and the ultimate problem is "too many people are non-functional opioid addicts", then deregulation won't fix the problem .

I'm not sure "epidemic" is a good word here. When compared with infectious diseases, we see that cause (the microbe) and effect (from fever to death) are clearly related. Here we have deaths caused by a prescription. Why were opioids prescribed to start with? And if abused, why?

I'm just using the article's term, and thinking in terms of what the problem is, and what the likely solutions are.

Re: America’s opioid epidemic is worsening

#124

Post by cmdkeen »

the-dude wrote: post #25
padobson wrote: post #12

I live in Trumbull County in Ohio, the dark red county in North East Ohio. We recently had 23 (non-fatal) overdoses in a two-day period[0]. That's roughly .01% of the county's total population - so yeah, it's getting bad here. There were recently two shootings within a mile of my house. Several people dead. Both shootings were drug related. I can't help but look around and believe that the needs these folks are tryin…

In The Netherlands, supervised injection sites exist for ~30 years now. Also, The Netherlands provide methadone. It seems to have worked / be working. Our heroine epidemic is far behind us, the addicts are dying out.

Even in the US heroin use was massively down, because it had moved on from the edgy rock and roll era to realising how dangerous it was. The list of dead celebrities rather took the edge off heroin chic.

The US resurgence is tied to massive over-prescription of opiates who abusers turn to heroin if their supply is disrupted / their tolerance increases. The demographics of users is very different. There's an entire chapter in Narconomics covered to this. Supervised injections etc works in Denmark because its healthcare sector is set up to support it - the US healthcare sector is still actively poisoning the populace.

Re: America’s opioid epidemic is worsening

#125

Post by kilroy123 »

My sister is a heroin addict. To say this has devastated her life is an understatement. Her body is wrecked. She looks way older than she is, she has a pacemaker / defibrillator installed in her chest. And doctors keep saying she will die soon if she doesn't stop.

Here is the most frustrating part. She has wanted to go to rehab a few times, but since she is poor and unemployed, she has no health insurance for rehab. What are her options? My parents have no money to help her.

I'll never understand the bull-shit US policy towards drugs. Let's spend billions upon billions to "fight" drugs coming into the country, but let's turn a blind eye to the companies pumping out hundreds of millions of pills.

Why the hell don't we spend those hundreds of billions on actually treating the disease? If there was no demand, there would be no drug war to fight. Why don't we try a new way?

Re: America’s opioid epidemic is worsening

#126

Post by johan_larson »

devopsproject wrote: post #29
pnathan wrote: post #20

Earlier quoted context omitted.

> Seems like attacking the supply is great place to start. That is what was done, transferring the demand to heroin as opposed to oxy. Also, focusing on the supply side of things is the last 30 years of US policy: it's not worked effectively, and has a concomitant effect of incentivizing black market dealers to be wealthy and power. It'd be better to sell OTC heroin than to fund violent gangs, just in the name of lim…

Mostly wrong. Pills were given out like candy, then restricted which caused demand for cheaper alternatives. Had the drug companies been regulated in the first place, we might be OK. The pills aren't coming from mules or cartels, they are coming from US companies. The pill supply has to lowered. edit to add: http://www.latimes.com/projects/oxycontin-part1/

> Had the drug companies been regulated in the first place, we might be OK.

What are you talking about? Everything in medicine is highly regulated. Introducing a new drug is a very expensive process, run in the US by the FDA. It takes all sorts of expensive tests and trials to be allowed to sell a new medicine in the US.

Maybe the process messed up in this case. Sure. Many things are possible. But this was regulated start to finish.

Re: America’s opioid epidemic is worsening

#127

Post by microtherion »

tptacek wrote: post #92
_jal wrote: post #76

Earlier quoted context omitted.

> Isn't the counterargument to this to point out the Oxycontin abuse epidemic? I don't see the origins of addiction relevant to arguments about containing current addiction when it moves to the illegal market. But I agree that supply-side targeting when talking about legal industry makes a lot of sense. Being legal, they also have lobbyists, which reduces the impact, same as other legal drug suppliers. > If violence…

I'm not sure I was arguing that opiate addicts are violent when they're high . I'm not making a moral argument about legalization or even (as is being repeatedly suggested on this thread) subsidization of opiates. I'm saying that if the cause of the epidemic is prescription opioids, and the ultimate problem is "too many people are non-functional opioid addicts", then deregulation won't fix the problem .

> too many people are non-functional opioid addicts

Experience here in Switzerland would suggest that if the state takes dirty needles, expensive supply, and highly variable purity out of the equation, opioid addicts can lead a life that is, while far from ideal, considerably more functional than before.

My impression is that drugs like Heroin, taken in correct dosage, do not inherently cause massive health damage. It's not clear how deregulation would work with drugs like meth, which DOES seem to inherently cause health damage.

Re: America’s opioid epidemic is worsening

#128

Post by jessaustin »

tptacek wrote: post #92
_jal wrote: post #76

Earlier quoted context omitted.

> Isn't the counterargument to this to point out the Oxycontin abuse epidemic? I don't see the origins of addiction relevant to arguments about containing current addiction when it moves to the illegal market. But I agree that supply-side targeting when talking about legal industry makes a lot of sense. Being legal, they also have lobbyists, which reduces the impact, same as other legal drug suppliers. > If violence…

I'm not sure I was arguing that opiate addicts are violent when they're high . I'm not making a moral argument about legalization or even (as is being repeatedly suggested on this thread) subsidization of opiates. I'm saying that if the cause of the epidemic is prescription opioids, and the ultimate problem is "too many people are non-functional opioid addicts", then deregulation won't fix the problem .

If we believe that some addicts can be helped to deal more productively with their addiction (personally I think that's true), and we observe that prohibition tactics don't help addicts get that help (see TFA and basically every other serious examination of this), then ending prohibition will certainly help some addicts. One might argue that more people would start using without prohibition, but that would be pretty lame in the context of the Pill Doctor Pipeline described here.

Re: America’s opioid epidemic is worsening

#129

Post by rashkov »

quakeguy wrote: post #36
oxide wrote: post #24

Maintenance treatments with long-acting opioids like methadone tend to come with a withdrawal that lasts for months. Meanwhile, short-acting opiates like heroin have a withdrawal period that lasts about a week. Is it any wonder methadone patients switch back to heroin when they try to quit for good? Mark my words, this isn't going away or getting any better. You can prosecute doctors, regulate all you want, burn fiel…

It sounds like someone profits from shipping opiates to the U.S.. Someone who also controls the juristriction. Sounds ridiculous, i know. Mhmmm. Who could it be?

Please just make your point, and make it substantial

Re: America’s opioid epidemic is worsening

#130

Post by gozur88 »

mmanfrin wrote: post #31
DougN7 wrote: post #14

Earlier quoted context omitted.

This doesn't help the root cause of people starting to use them in the first place. It's helpful to some though.

The root cause was the never-allow-pain mantra of the 90s when it came to proscribing painkillers like Oxy; this was followed years later by a later tightening of prescription policy that led many to look to Heroin as an alternative.

You have to understand the context of what you call "the never-allow-pain mantra". The drug warriors had gotten us to the point where you couldn't get treatment for pain. Doctors were harassed out of prescribing opiates and would give you Tylenol for back surgery. People in hospice were allowed to spend their final days in terrible pain.

And now we're heading back in that direction. For some reason we can't seem to stop in the middle somewhere.

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