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Expert sounds alarm on new wave of US opioids crisis

theguardian.com

151–160 of 202 posts

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

#151

Why is there no opioid crisis in Europe ?

An analysis of this question here: https://www.thelancet.com/journals/lancet/article/PIIS0140-6... A lot has to do with the availability of health care in Europe (universal health care), and specifically addiction care.

Are you sure?

I'd wager that Europe and most of the world was slower--thankfully--in adopting a new painkiller like Oxycontin and dodged a bullet, by seeing what the US was already facing.

https://www.latimes.com/projects/la-me-oxycontin-part3/

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

#152
post #30

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.

> 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.

The problem is this is completely untrue. One party had been talking about coal-mining industry ending and promoting job retraining for over a decade if not longer. Federal funds were administered to pre-empt this exact problem that was foreseen. That same party had frequently about the need for social programs to support this transition so people can still be productive. The problem is, this party never wins in Appalachia - all of their policies are ignored. Nobody takes the job training. Everyone locally votes against it and opposes those social support systems.

The problem isn't costal elites ignoring the issue, it's that no matter what one party does to help resolve the problem the other party says don't trust them do it on your own. Which isn't possible when entire industries aren't viable any more.

It's pretty similar to people desperately needing health care in the same regions and yet refusing to get it because it's been slandered by the party they vote for.

Fundamentally the issue is that one party has not supported policies to help this region for ages, but still gets voted for due to a few key touch button issues.

https://www.reuters.com/article/idUSKBN1D14FT/

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

#153

Earlier quoted context omitted.

An analysis of this question here: https://www.thelancet.com/journals/lancet/article/PIIS0140-6... A lot has to do with the availability of health care in Europe (universal health care), and specifically addiction care.

Are you sure? I'd wager that Europe and most of the world was slower--thankfully--in adopting a new painkiller like Oxycontin and dodged a bullet, by seeing what the US was already facing. https://www.latimes.com/projects/la-me-oxycontin-part3/

I didn't write the study in the Lancet -- maybe you should read it

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

#154

Earlier quoted context omitted.

Are you sure? I'd wager that Europe and most of the world was slower--thankfully--in adopting a new painkiller like Oxycontin and dodged a bullet, by seeing what the US was already facing. https://www.latimes.com/projects/la-me-oxycontin-part3/

I didn't write the study in the Lancet -- maybe you should read it

Fair but I only have the access to the summary, which I already read before posting (unless that 3 or 4 paragraph article was it).

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

#155

Earlier quoted context omitted.

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. How do you measure that? Opioid overdoses accounted for at least 72,800 deaths last year [0] and there are countless more addicts out there whose entire lives are ruined because of that addiction. Many of those people, if they ever recover, will never take opioids again for…

How many millions of people use opioids and do not abuse them, nor get addicted?

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

#156
post #53

Earlier quoted context omitted.

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.

Drug policy is complicated. Amphetamines and opioids certainly have very valid medical uses - but also giving the public unrestricted access to them is a complete disaster. Psychedelics likely have various mental health treatment uses but they are for some bizarre historical reasons considered dangerous. Mental health medication like benzos are also tricky. They are amazingly affective but also amazingly addictive an…

Having been a cannabis smoker myself for years, I can understand the danger of self-medicating with psychedelics. They aren’t entirely harmless.

Any drug with a high is a dopamine button. It’s easy to hit that button instead of doing something else to feel good. It’s easy to stop doing other things in favor of just hitting that button all day. But the effects of that button diminish over time, so you hit it more often, and the more you hit it the less other things you want to do.

Psychedelics powerfully activate and deactivate different parts of the brain, changing the way you think and process information. Controlled and intentional, this has huge potential for positive mental health outcomes. With chronic recreational use, cannabis leads toward negative mental health outcomes like depression, disordered thinking, anxiety, and low agency.

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

#157
post #83
post #66

Earlier quoted context omitted.

How are opioids worse than antidepressants ?

I am not greatly familiar with the dangers of antidepressants. I do know that abruptly lowering the dose for some can cause thoughts of suicide. Some have side effects of sexual dysfunction. Some cause weight gain. That's about the limit of my knowledge. What I know about the opioid class of drugs is that tolerance builds so the dosages commonly increase, too much stops the heart, and trying to stop causes violent wi…

> too much stops the heart

At the risk of pedantry, opioids don't work directly on heart function.

Too much opioids in the system cause respiratory depression. That can go on to become respiratory arrest, which can then cause cardiac arrest.

Same end result, but the point is, opioid overdose is primarily a respiratory concern. In my county some EMS do not even carry Narcan (which is a debate in itself) but are directed to focus on positive pressure ventilation and transport to ER or, if carried, to gently titrate Narcan such that the person becomes gradually more alert at the ER and may be more open to addiction help, rather than the "heroic dose" that you get with IN (intra-nasal) Narcan.

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

#158

Earlier quoted context omitted.

To a small extent you are correct, but a larger factor is automaton. It doesn't take that many people to grow food or extract resources anymore. The people that don't exist don't need grocery stores, bars, restaurants, or barbers either. We would still be in this situation even without immigration or overseas trade.

No way. https://www.nps.gov/articles/000/terrain-of-struggle.htm https://www.farmworkerjustice.org/about-farmworker-justice/w... I'm not knowledgeable on agriculture, but even a city-boy like myself has read-up on how much we rely on migrant labor during harvesting season.

Immigrants do those gigs because citizens won't.

Those are not community sustaining jobs.

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

#159
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…

The biggest problem is/was the quest for greater corporate profits, which drives consolidation, cost-cutting, offshore outsourcing, reducing the power of the unions, product enshittification, etc.). When the mission of a company is to deliver value to its shareholders -- the mantra of capitalism -- this is the end result, and it's highly destructive. We saw it at the end of the 19th century, and we're seeing it again…

While that is largely true, I don't see another scheme that would be unaffected. For example, a lot of what happened with consolidation was also due to efficiency and economy of scale, which would still be desirable even if profits weren't the main motive. The offshore and outsourcing has more to due with trade imbalance (not necessarily overall, but within specific sectors) and consumer preference (race to the bottom) than with profits. I think imbalance of where the profits end up is the bigger issue than profits themselves - the higher ups and the people with capital make sure they get a bigger slice of the pie while the average people/workers are left behind.

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

#160

Earlier quoted context omitted.

Well yes, because OxyContin was oversold and the company's behaviour was unethical. https://www.nytimes.com/2018/05/29/health/purdue-opioids-oxy...

I cannot read the article. What is the pharmacy’s role? OxyContin requires a prescription, so did the pharmacy sell without prescriptions? Bottom line is, do you want pharmacies to be making non medical judgment calls on which prescriptions to fill and not fill? If so, then don’t complain when they exercise judgment. I, for one, would rather not deputize everyone I interact with.

You do have a point. MDs should have been prosecuted. Execs should have been prosecuted.

But alas, they did not.

https://www.wsj.com/articles/founder-of-purdue-pharma-made-a...

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