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America’s opioid epidemic is worsening

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181–190 of 321 posts

Re: America’s opioid epidemic is worsening

#181
post #94
post #21

In the UK it appears that there's a Spice epidemic. It's often called "synthetic cannabis" or "(formerly) legal highs", but it in reality it's all kinds of research chemicals sprayed onto leaves to be smoked. It has some pretty hideous side effects, and seems very addictive ( https://video.vice.com/en_uk/video/the-hard-lives-of-britain... ) Oh, and the government just handed the whole market over to illegal drug deal…

The spice epidemic is mostly prison related though. Prisons should stop testing for cannabis; and should consider prescribing cannabis of known strengths (and higher CBD rather than THC content). (Also, they need to start providing a lot more mental health support and meaningful activity).

Artificial cannabinoids are also highly used in homeless populations because of how cheap and powerful they are.

https://www.vice.com/en_ca/article/synthetic-weed-is-a-scour...

Re: America’s opioid epidemic is worsening

#182
post #30

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…

Isn't the counterargument to this to point out the Oxycontin abuse epidemic? Doctors are prescribing years worth of opiates to patients. There have been suggestions that Purdue Pharma's formulation of Oxy practically guarantees dependence, because of the way it's dosed. Are the people dying of heroin overdoses in white rural Ohio starting on heroin, or transitioning to it after prescription opioids become too expensi…

You mean less violent within the U.S., right? Because believe me that keeping drug prohibition in the U.S. and the bilateral consensus of fighting drug trade militarily is causing quite a violent situation in Mexico, to the tune of 200,000+ dead by official numbers in the last 10 years (>0.2% of national population, and arguably the official numbers are a severe under-estimate).

Re: America’s opioid epidemic is worsening

#183
post #162

The first time I saw a TV commercial here in the US for a pill to battle opiod induced constipation, I realized just how many people are taking large doses of the stuff. Pretty staggering to me.

Yeah, those commercials are painful. If you're taking so many opioids that you have trouble pooping, maybe the solution is to take fewer opioids rather than adding another medication to the mix. Really damning commentary on how easily and flippantly we overmedicate.

Even a low dose of less potent opioids such as codeine or dihydrocodeine can cause constipation

Re: America’s opioid epidemic is worsening

#184
post #53

I know the United States will never do it, but Singapore barely has a drug problem because they execute dealers and have mandatory treatment for users. I'm not advocating the ridiculous policy that the Phillipines has, but Singapore doesn't mess around if they find distribution levels of illegal drugs on you. There also needs to be much stricter control of new prescriptions for opioids, which lead to addiction.

The U.S. tried very harsh punishment to stop drug use, the War on Drugs. It resulted in massive increases in incarceration; millions of innocent lives ruined (along with their families' lives); massive costs to society for law enforcement, prisons, crime and violence; and not much impact on drug use.

Re: America’s opioid epidemic is worsening

#185
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

Were they given out without prescription? If not, I feel like MDs have to share some blame on this.

Re: America’s opioid epidemic is worsening

#187

I'm going to comment here with a plug for the March For Science, on April 22. Why? Because the opioid epidemic started with a simple matter of scientists not being allowed to science. Purdue Pharmaceuticals marketed oxycontin as a drug that lasts for 12 hours. The evidence indicated it only lasted for 8. If Purdue's scientists were allowed to act on the evidence, i.e. to be actual scientists, the whole world would ha…

> Instead, hundreds of thousands of patients were subjected to 4 hours of pain a day, and they sought relief with other drugs, including illegal ones. And the epidemic began.

No, I believe the purpose of this scheme was to let the drug wear off before the next dose, in order to reinforce the withdrawal/pain->relief cycle. Oxycodone users typically didn't seek out illegal drugs (heroin) until several years after starting prescription usage.

Re: America’s opioid epidemic is worsening

#188

Earlier quoted context omitted.

What's funny is there is no evidence that these opioid pain killers are actually effective in the long term for the management of pain. If it wasn't for lobbying they likely wouldn't be legal to use in that way.

I've been taking opioids for nearly a year and they still work fine. Not sure how long-term you mean.

Stop taking them for a few days and you'll see what I mean. Many studies have shown that patients who do not consume opioid medications have better long term outcomes than those who do. It simply isn't effective in managing pain long term, and also is not indicated for use in that manner.

Re: America’s opioid epidemic is worsening

#189

Earlier quoted context omitted.

I'm guessing, but... technology? There was a tremendous amount of unemployment during the Great Depression - far worse than now. Sure, opioids weren't as available, so people didn't turn to them. (Alcohol, on the other hand...) But I think a lot of what people did then was turn to each other. They had deeper relationships with people than (many) people do today. Sure, you've got two hundred Facebook friends. How many…

I don't know, I see young people taking to each other about suicidal thoughts and making support groups do each other all the time. Teenagers making Discord chats where they can talk about how their families are abusive and they want to kill themselves, Skype chats where young adults discuss obscure chronic illnesses that the rest of the world can't empathize with them for.

Fair enough. Technology allows people to connect who would not have been able to in the past. But I still claim that, for the average (or perhaps median) person, the net result has been dehumanizing - it has resulted in less depth of relationship.

Re: America’s opioid epidemic is worsening

#190

And a potential solution to it: https://arstechnica.com/science/2017/03/tweaking-fentanyls-c... For their chemical makeover, the researchers noted that when tissue is damaged and hurting, it becomes inflamed and more acidic. The pH drops from approximately 7.4—what’s seen in normal, healthy tissue—to between 5 and 7. Fentanyl can work regardless of the pH, so it’s active throughout the nervous system no matter what.…

But, if it was altered to only work at the lower pH, then it could target just the pain source at the peripheral nerves, the researchers hypothesized.

It's been a while since I took a pharmacology class, but opioids work centrally - that is, the pain relief is due to their action in the brain. That's why an opioid like loperamide (can't cross the CNS barrier) doesn't have an analgesic effect, only constipating.

If fentanyl only worked peripherally, it wouldn't have a painkilling effect.

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