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The lucrative business of America’s opioid crisis

nytimes.com

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Re: The lucrative business of America’s opioid crisis

#191

Post by microcolonel »

DoreenMichele wrote: post #184
microcolonel wrote: post #181

Earlier quoted context omitted.

> We need to pass universal basic healthcare and solve the affordable housing crisis to make headway on that. Just like them, you jump to your own conclusions.

Just like them, Them? To whom are you comparing me? you jump to your own conclusions. I am not jumping to anything. I have spent a lot of years studying and contemplating certain problem spaces.

> Them? To whom are you comparing me?

Well...

> I just don't see this issue the way others do.

Maybe the others you're referring to.

You still jumped to the conclusion, you provided no reasoning to support the (not widely accepted) ideas that single-payer health insurance and subsidized housing will make people less desperate in a way which affects opioid addiction dramatically.

Re: The lucrative business of America’s opioid crisis

#192

Post by DoreenMichele »

microcolonel wrote: post #191
DoreenMichele wrote: post #184

Earlier quoted context omitted.

Just like them, Them? To whom are you comparing me? you jump to your own conclusions. I am not jumping to anything. I have spent a lot of years studying and contemplating certain problem spaces.

> Them? To whom are you comparing me? Well... > I just don't see this issue the way others do. Maybe the others you're referring to. You still jumped to the conclusion, you provided no reasoning to support the (not widely accepted) ideas that single-payer health insurance and subsidized housing will make people less desperate in a way which affects opioid addiction dramatically.

I comment on this fairly often, so I saw no reason to do a long write up and lots of reasons not to. If you are curious as to my thinking on the matter, you can just ask rather than taking swipes at me.

Re: The lucrative business of America’s opioid crisis

#193

Post by unlmtd1 »

jijji wrote: post #9

Heroin is a Schedule I (in the US) which means no medical benefit, and its a 20 year felony for distributing it. There is also the Federal Analogue Act, 21 U.S.C. § 813, which is supposed to group similar drugs in the same category. So, how do these companies get away with selling analogs of heroin? Shouldn't the people who work there and make money off these opioid drugs be arrested? Why haven't they?

It would indeed be extraordinary if - alone among the neurotransmitter systems of the brain - the endogenous opioid families were immune from dysfunction. Enkephalins are critical to "basal hedonic tone" i.e. whether we naturally feel happy or sad. Yet the therapeutic implications of a recognition that dysfunctional endogenous opioid systems underlie a spectrum of anxiety-disorders and depression are too radical - at present - for the medical establishment to contemplate. In consequence, the use of opioid-based pharmacotherapies for "psychological" pain is officially taboo. The unique efficacy of opioids in banishing mental distress is neglected. Their unrivalled efficacy in treating "physical" nociceptive pain is grudgingly accepted.

Re: The lucrative business of America’s opioid crisis

#194

Post by microcolonel »

DoreenMichele wrote: post #192
microcolonel wrote: post #191

Earlier quoted context omitted.

> Them? To whom are you comparing me? Well... > I just don't see this issue the way others do. Maybe the others you're referring to. You still jumped to the conclusion, you provided no reasoning to support the (not widely accepted) ideas that single-payer health insurance and subsidized housing will make people less desperate in a way which affects opioid addiction dramatically.

I comment on this fairly often, so I saw no reason to do a long write up and lots of reasons not to. If you are curious as to my thinking on the matter, you can just ask rather than taking swipes at me.

There's nothing to support your assertions on the first page of your current threads page [0], so could you explain your reasoning?

It seems like a real pain to put the argument in words here, so is there an opinion piece somewhere which argues more or less what you argue? You write professionally, so have you recorded your position somewhere?

[0]: https://news.ycombinator.com/threads?id=DoreenMichele&next=1...

Re: The lucrative business of America’s opioid crisis

#195

Post by DoreenMichele »

microcolonel wrote: post #194
DoreenMichele wrote: post #192

Earlier quoted context omitted.

I comment on this fairly often, so I saw no reason to do a long write up and lots of reasons not to. If you are curious as to my thinking on the matter, you can just ask rather than taking swipes at me.

There's nothing to support your assertions on the first page of your current threads page [0], so could you explain your reasoning? It seems like a real pain to put the argument in words here, so is there an opinion piece somewhere which argues more or less what you argue? You write professionally, so have you recorded your position somewhere? [0]: https://news.ycombinator.com/threads?id=DoreenMichele&next=1...

To my mind, this is a reasonable collection of related writings on the topic by me:

http://micheleincalifornia.blogspot.com/p/ir2.html

But I don't know that it will seem pertinent to you. So let me try to give you a nutshell version:

Average size of new homes in the US has more than doubled since the 1950s. Meanwhile, average number of occupants has dropped.

We tore down up to 80 percent of SROs, a low cost form of housing that used to be common, but now has to be explained because people don't know what they are, so here is a link in case you don't know: https://en.m.wikipedia.org/wiki/Single_room_occupancy

Healthcare in the US accounts for a crazy high percentage of expenses and this disproportionately impacts the poor.

If 20 percent or more of your income is eaten by healthcare and 50 percent or more is eaten by housing costs, life will be pretty damn bleak and UBI won't solve it. This likely is a large factor in things like the opioid crisis and rising suicide rates.

Poverty in the US should not routinely mean homelessness or being unable to afford essential healthcare. It should mean you live in a tiny speck of an apartment and you can't afford a fancy wardrobe.

The way we abandon our own people in a very rich country is monstrous and certainly promotes depression for a lot of people. I spent years homeless and asking for help to figure out how to make money online from people who make money online. The way I was treated was pretty psychologically scarring.

I'm a tough cookie and have more support than is apparent from my general lack of sufficient income. If I had less education or less social support or whatever, I would not have overcome all that. I would have been destroyed by it.

So I infer that's an issue for many Americans.

You aren't required to agree. That's just what I think.

Re: The lucrative business of America’s opioid crisis

#196

Post by MichaelMoser123 »

SnowingXIV wrote: post #26

It does not take much, I had injury that resulted in a prescription and once it's no longer hitting just the pain receptors (I don't really understand how this all works or claim to) and you feel the "calming" effect you can pretty quickly see why it can become so addictive and scary. Even being educated, happy, well-off, and aware you can fall to these type of addictions, I can't imagine how hard it must be for many…

i am a foreigner trying to understand this issue: why don't they just stop prescribing opium based pain killers to the general public and limit them to cancer patients - like they do in the rest of the world, wouldn't that scale down the crisis? How did the problem get this large? Even Imperial China went to war when Britain started pushing Opium to the public, why wasn't this whole thing stopped much earlier?

Re: The lucrative business of America’s opioid crisis

#197

Post by rand_r »

MichaelMoser123 wrote: post #196
SnowingXIV wrote: post #26

It does not take much, I had injury that resulted in a prescription and once it's no longer hitting just the pain receptors (I don't really understand how this all works or claim to) and you feel the "calming" effect you can pretty quickly see why it can become so addictive and scary. Even being educated, happy, well-off, and aware you can fall to these type of addictions, I can't imagine how hard it must be for many…

i am a foreigner trying to understand this issue: why don't they just stop prescribing opium based pain killers to the general public and limit them to cancer patients - like they do in the rest of the world, wouldn't that scale down the crisis? How did the problem get this large? Even Imperial China went to war when Britain started pushing Opium to the public, why wasn't this whole thing stopped much earlier?

Opium-based pain killers are the most reliable way to ease pain without causing organ damage in the near term.

Drugs like Advil and Tylenol cause organ damage even at small doses and are thus unusable for extreme pain.

Opiates are used the world over for pain relief, not just for cancer patients. If we had a way to ease pain with something non-addictive that didn’t cause immediate organ damage that would be great.

Re: The lucrative business of America’s opioid crisis

#198

Post by MichaelMoser123 »

rand_r wrote: post #197
MichaelMoser123 wrote: post #196

Earlier quoted context omitted.

i am a foreigner trying to understand this issue: why don't they just stop prescribing opium based pain killers to the general public and limit them to cancer patients - like they do in the rest of the world, wouldn't that scale down the crisis? How did the problem get this large? Even Imperial China went to war when Britain started pushing Opium to the public, why wasn't this whole thing stopped much earlier?

Opium-based pain killers are the most reliable way to ease pain without causing organ damage in the near term. Drugs like Advil and Tylenol cause organ damage even at small doses and are thus unusable for extreme pain. Opiates are used the world over for pain relief, not just for cancer patients. If we had a way to ease pain with something non-addictive that didn’t cause immediate organ damage that would be great.

But only in the US there is overprescription and a crisis. Why?

Re: The lucrative business of America’s opioid crisis

#199

Post by microcolonel »

DoreenMichele wrote: post #195
microcolonel wrote: post #194

Earlier quoted context omitted.

There's nothing to support your assertions on the first page of your current threads page [0], so could you explain your reasoning? It seems like a real pain to put the argument in words here, so is there an opinion piece somewhere which argues more or less what you argue? You write professionally, so have you recorded your position somewhere? [0]: https://news.ycombinator.com/threads?id=DoreenMichele&next=1...

To my mind, this is a reasonable collection of related writings on the topic by me: http://micheleincalifornia.blogspot.com/p/ir2.html But I don't know that it will seem pertinent to you. So let me try to give you a nutshell version: Average size of new homes in the US has more than doubled since the 1950s. Meanwhile, average number of occupants has dropped. We tore down up to 80 percent of SROs, a low cost form of h…

> If 20 percent or more of your income is eaten by healthcare and 50 percent or more is eaten by housing costs, life will be pretty damn bleak and UBI won't solve it. This likely is a large factor in things like the opioid crisis and rising suicide rates.

Figures do seem to indicate an increase between 2001 and 2009 in health care spending as a percentage of income, but isn't most of this a difference in real after-tax income? It's hard to make heads or tails of post-2010 data because of the PPACA. As for SRO, do you have some idea of why these properties have been disappearing? Has it become a bad deal for aesthetic/cultural reasons, or is it a matter of excess liability for the landlords? The Wikipedia article for them seems to suggest that they just don't make sense anymore for landlords in San Francisco at least. It seems to me like a simple matter of places becoming more financially valued, and therefore no longer viable places to rent for anyone below the naturally matching income bracket. If you want affordable housing, you'll have to travel a few kilometres in any other direction (this of course being especially hard for coastal cities, where you're typically restricted to 170 or fewer degrees of sprawl which may or may not offer attractive employment.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3955379/figure/...

Re: The lucrative business of America’s opioid crisis

#200

Post by Noos »

vanderZwan wrote: post #61
StreamBright wrote: post #57

Earlier quoted context omitted.

Actually the opposite. Government regulations outlaw cheap non-dangerous alternatives (like cannabis) and create a monopoly by granting patents to a single entity. https://qz.com/1125690/big-pharma-is-taking-advantage-of-pat... http://www.washingtonexaminer.com/outdated-treatments-and-dr... The solution is to make cannabis legal for everybody in every state for medical use and since it cannot be patented there will b…

> Actually the opposite. Government regulations... I'm from the Netherlands so you won't hear me disagree with the argument that criminalizing cannabis and drugs is not the solution[0]. Having said that, the typical undertone on HN of "regulation is bad by definition" really irks me. I can imagine that if the only perspective one has is a dysfunctional government, one might think that, but please take a look abroad a…

What irks me is how people on the one hand believe that you can't trust companies like Google or Facebook over moderate things, and say "we need federated, decentralized alternatives," and yet when it comes to government (apart from their own pet issues) we magically trust powerful bodies with even less accountability with more important things.

I wish there'd be some consistency.

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