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America’s opioid epidemic is worsening

economist.com

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Re: America’s opioid epidemic is worsening

#251

Post by mirimir »

grondilu wrote: post #249

> The opioid epidemic has its roots in the explosive growth of prescription painkillers. Between 1991 and 2011, the number of opioid prescriptions (selling under brand names like Vicodin, Oxycontin, and Percocet) supplied by American retail pharmacies increased from 76m to 219m. As the number of pain pills being doled out by doctors increased, so did their potency. In 2002 one in six users took a pill more powerful t…

You either have a high pain threshold, or just haven't experienced severe pain. Extreme pain can cause neurogenic shock.

Re: America’s opioid epidemic is worsening

#252

Post by rtpg »

mirimir wrote: post #242
tptacek wrote: post #30

Earlier quoted context omitted.

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…

That's not really a counterargument. Sure, Purdue and other opiate pushers got people addicted, and tweaked distribution to get around regulation. Then governments freaked, and locked down prescription opiates. So addicts have turned to heroin. But they're naive about heroin, so they tend to fuck up and overdose. And then there's the problem that dealers boost unpredictably with Fentanyl. And about user violence, you…

But the original access helps feed the epidemic. You don't become an addict until you do, right?

Tobacco is as addictive as heroin[0], think about how much of a public health issue smoking has been. Do you think it would be that if tobacco was illegal? I could imagine making heroin legal would create many more addicts.

One of the core arguments for marijuana restriction is that it's not nearly as addictive as "hard" drugs. it's comparable to things like alcohol.

Access restriction seems like a good idea when a substance is so addictive that you develop lifelong dependence from it by default.

[0]: http://whyquit.com/whyquit/A_Henningfield_Benowitz.html

According to this, common drugs from least to most addictive (on dependence) are: Marijuana, Caffeine, Alcohol, Cocaine, Heroin, Tobacco

Re: America’s opioid epidemic is worsening

#253

Post by trome »

mirimir wrote: post #242
tptacek wrote: post #30

Earlier quoted context omitted.

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…

That's not really a counterargument. Sure, Purdue and other opiate pushers got people addicted, and tweaked distribution to get around regulation. Then governments freaked, and locked down prescription opiates. So addicts have turned to heroin. But they're naive about heroin, so they tend to fuck up and overdose. And then there's the problem that dealers boost unpredictably with Fentanyl. And about user violence, you…

Here is a counterargument:

Why not pull a Denmark, legalize and give at no cost heroin to addicts, and get these people back to work? A junkie can be productive, despite an ongoing chemical addiction, whether it be meth, heroin, alcohol or whatever else, many middle class and upper class folks live productive lives despite these addictions.

Why can't we bring these people back into being productive, economically net positive members of society, and deal with their addictions with compassion, as any reasonable human being & the Catholic Church preaches?

I've employed many addicts before, if they have a choice of smashing windows all night to maybe get $100 worth of shit they'll fence for $60, or a gig that'll pay them $110 to pull cabling & set up hardware for 8 hours, they will pick the latter every time. Outside of work hours, don't expect them to be contactable, and watch your shit well, but beyond that this group of humans can be a net positive for our society despite the chemical dependency issues they have.

Re: America’s opioid epidemic is worsening

#254

Post by rtpg »

trome wrote: post #253
mirimir wrote: post #242

Earlier quoted context omitted.

That's not really a counterargument. Sure, Purdue and other opiate pushers got people addicted, and tweaked distribution to get around regulation. Then governments freaked, and locked down prescription opiates. So addicts have turned to heroin. But they're naive about heroin, so they tend to fuck up and overdose. And then there's the problem that dealers boost unpredictably with Fentanyl. And about user violence, you…

Here is a counterargument: Why not pull a Denmark, legalize and give at no cost heroin to addicts, and get these people back to work? A junkie can be productive, despite an ongoing chemical addiction, whether it be meth, heroin, alcohol or whatever else, many middle class and upper class folks live productive lives despite these addictions. Why can't we bring these people back into being productive, economically net…

I think Denmark decriminalized heroin, but didn't legalize it. The distinction being that an addict is no longer a criminal, so they can get treatment without fear.

Re: America’s opioid epidemic is worsening

#256

Post by trome »

pfortuny wrote: post #227
peteretep wrote: post #224

Earlier quoted context omitted.

> the healthcare is free and high-quality > Pretty much like the rest of fantasy > Europe. Isn't high-quality healthcare that's "free at the point of use" available in most of real Western Europe too?

Well, as long as you are willing to wait about six months for knee surgery, yes, it is free. Or for any other type of intervention.

Uhh, hate to break it to ya, but even with insurance its not all roses and sunshine in the USA, you can easily go 6 months waiting for a knee replacement here. Watched a family member go through 4 over the past decade, and its a slow process no matter the insurance provider.

Plus, hospitals here on the West Coast have amped up doing a bunch of skeezy stuff recently, you could easily end up with a non-functional leg at a place like Swedish or Providence (two major hospital systems):

https://projects.seattletimes.com/2017/quantity-of-care/hosp...

Re: America’s opioid epidemic is worsening

#257

Post by mirimir »

trome wrote: post #253
mirimir wrote: post #242

Earlier quoted context omitted.

That's not really a counterargument. Sure, Purdue and other opiate pushers got people addicted, and tweaked distribution to get around regulation. Then governments freaked, and locked down prescription opiates. So addicts have turned to heroin. But they're naive about heroin, so they tend to fuck up and overdose. And then there's the problem that dealers boost unpredictably with Fentanyl. And about user violence, you…

Here is a counterargument: Why not pull a Denmark, legalize and give at no cost heroin to addicts, and get these people back to work? A junkie can be productive, despite an ongoing chemical addiction, whether it be meth, heroin, alcohol or whatever else, many middle class and upper class folks live productive lives despite these addictions. Why can't we bring these people back into being productive, economically net…

That's the sensible approach. Addiction isn't optimal, but criminalizing addiction just compounds the problem.

Re: America’s opioid epidemic is worsening

#258

Post by mirimir »

rtpg wrote: post #252
mirimir wrote: post #242

Earlier quoted context omitted.

That's not really a counterargument. Sure, Purdue and other opiate pushers got people addicted, and tweaked distribution to get around regulation. Then governments freaked, and locked down prescription opiates. So addicts have turned to heroin. But they're naive about heroin, so they tend to fuck up and overdose. And then there's the problem that dealers boost unpredictably with Fentanyl. And about user violence, you…

But the original access helps feed the epidemic. You don't become an addict until you do, right? Tobacco is as addictive as heroin[0], think about how much of a public health issue smoking has been. Do you think it would be that if tobacco was illegal? I could imagine making heroin legal would create many more addicts. One of the core arguments for marijuana restriction is that it's not nearly as addictive as "hard"…

Tobacco is far more addictive than opiates. And health and societal impacts are far worse. With consistent and affordable supply, opiate addicts can lead otherwise normal lives. No worse than caffeine addicts, really. And if there's chronic pain that's otherwise untreatable, the fact that they're addicts is almost irrelevant.

Re: America’s opioid epidemic is worsening

#260

Post by grondilu »

pjc50 wrote: post #250
grondilu wrote: post #249

> The opioid epidemic has its roots in the explosive growth of prescription painkillers. Between 1991 and 2011, the number of opioid prescriptions (selling under brand names like Vicodin, Oxycontin, and Percocet) supplied by American retail pharmacies increased from 76m to 219m. As the number of pain pills being doled out by doctors increased, so did their potency. In 2002 one in six users took a pill more powerful t…

> Pain is a minor consequence of disease There speaks someone young and healthy. Some conditions are extremely painful in the long term. "It is estimated that more than 100 million people suffer from chronic pain in this country,[11] and for some of them, opioid therapy may be appropriate. The bulk of American patients who need relief from persistent, moderate-to-severe non-cancer pain have back pain conditions (appr…

> "aggressive marketing by pharmaceutical companies"

I'm wondering what that means, concretely. How exactly do they convince GPs to prescribe pain killers even when it's not really appropriate? They can't just pay them, can they?

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