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America’s opioid epidemic is worsening

economist.com

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Re: America’s opioid epidemic is worsening

#31

Post by mmanfrin »

DougN7 wrote: post #14
mmanfrin wrote: post #7

Earlier quoted context omitted.

Decriminalization and an expansion of social programs to help addiction recovery. It's hard for people to get help when they fear legal troubles. Unfortunately neither of these will happen in the next 4 years; and likely the opposite will happen, so we're in for a worsening.

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.

Re: America’s opioid epidemic is worsening

#32

Post by fdsfsafasfdas »

sdenton4 wrote: post #26
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…

My understanding is that the reintroduction of prescription opioids is a major source of new addicts. Once the prescription lapses, people have often become addicted and seek out other sources. It's clear that we need to do a lot more to help these problems, as you suggest. We can also do a lot to keep people from getting addicted in the first place, by choosing (and regulating) better options for pain relief.

Amen.

Cannabis criminalization kills.

Re: America’s opioid epidemic is worsening

#33

Post by ZanyProgrammer »

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…

I've had friends get fucked up by head shop and online Kratom. It's very far from benign.

Re: America’s opioid epidemic is worsening

#34

Post by AnimalMuppet »

tyingq wrote: post #11
savanaly wrote: post #4

Given that this article only touches on the supply of these drugs, is there a tacit assumption that the demand for opioids is driven by unemployment? If so, what can be done about the demand for these drugs in the long term? "Bringing back jobs" to those people whose comparative advantage is no longer manufacturing by taxing robots or imposing tariffs is a temporary stall, and to the degree it does work it amounts to…

I'm not sure anyone really knows why the demand is so huge. Unemployment seems obvious, but it's not. New Hampshire, for example, if often cited as one of the areas hit the worst by opiate addiction. Yet, it's doing well with unemployment, in relative terms. 1 year old, but relevant: http://www.nationalreview.com/corner/430841/whats-matter-new...

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 of them can you call at 3 AM because your marriage is about to fall apart, or because you're feeling suicidal? Technology has given us more relationships, but I think that in the process, we've lost much of the depth. That leaves a huge hole, because people are wired to connect to people. We crave human contact, and we get tweets. It's not enough.

So my suspicion is that we're turning to opioids to try to fill that void. But as I said, this is just my suspicion.

Re: America’s opioid epidemic is worsening

#35

Post by AaronFriel »

devopsproject wrote: post #15
savanaly wrote: post #4

Given that this article only touches on the supply of these drugs, is there a tacit assumption that the demand for opioids is driven by unemployment? If so, what can be done about the demand for these drugs in the long term? "Bringing back jobs" to those people whose comparative advantage is no longer manufacturing by taxing robots or imposing tariffs is a temporary stall, and to the degree it does work it amounts to…

> Fighting the "epidemic" at the supply level seems like a losing battle Kermit, West Virginia. Population 392. They received over 9 million hydrocodone pills in a two year period. In a 6 year period, the entire state of WV received 780 million pills. Over 400 pills for every man, woman, and child living in WV. Seems like attacking the supply is great place to start. WV doesn't need this many pills.

I agree with the substance of your comment - opioid over-prescription is a huge problem.

The stat though about Kermit, West Virginia example has to be due to fraud and illegal sales, though? Or include vastly more people within the area covered by its pharmacies and/or doctors, which ever the data source used?

Otherwise each person in that town is receiving (on average) 31 pills/day. Maybe I wildly misunderstand hydrocodone prescriptions, but dozens of pills per day seems to be an excess.

Re: America’s opioid epidemic is worsening

#36

Post by quakeguy »

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?

Re: America’s opioid epidemic is worsening

#37

Post by tetrep »

DougN7 wrote: post #14
mmanfrin wrote: post #7

Earlier quoted context omitted.

Decriminalization and an expansion of social programs to help addiction recovery. It's hard for people to get help when they fear legal troubles. Unfortunately neither of these will happen in the next 4 years; and likely the opposite will happen, so we're in for a worsening.

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

> This doesn't help the root cause of people starting to use them in the first place.

I don't think you can stop at drug use and claim "root cause." There's a variety of motivating factors involved in using particular drugs, and ignoring those is what leads to things like Prohibition, The War on Drugs, and other related failures.

If you want to stop people from doing something, you need to look at their motivations for doing it.

Re: America’s opioid epidemic is worsening

#38

Post by rwmj »

savanaly wrote: post #4

Given that this article only touches on the supply of these drugs, is there a tacit assumption that the demand for opioids is driven by unemployment? If so, what can be done about the demand for these drugs in the long term? "Bringing back jobs" to those people whose comparative advantage is no longer manufacturing by taxing robots or imposing tariffs is a temporary stall, and to the degree it does work it amounts to…

It helps to separate out several aspects of the demand side:

- Addiction: may or may not be a problem at all, heroin isn't actually very expensive so the government can just keep giving it even to large numbers of people

- Other health risks: the risk of catching Hep C or dying of an overdose.

- Acquisitive crime: largely caused by the drugs being illegal.

- Morality: drug users are "bad people" because they lack moral strength or whatever. (Personally I have no truck with this, but it seems to be very important for a lot of people)

Re: America’s opioid epidemic is worsening

#39

Post by XorNot »

pnathan wrote: post #20
devopsproject wrote: post #15

Earlier quoted context omitted.

> Fighting the "epidemic" at the supply level seems like a losing battle Kermit, West Virginia. Population 392. They received over 9 million hydrocodone pills in a two year period. In a 6 year period, the entire state of WV received 780 million pills. Over 400 pills for every man, woman, and child living in WV. Seems like attacking the supply is great place to start. WV doesn't need this many pills.

> 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…

It has value at an individual level. Plenty of people get started into this by over-prescription by doctors and blind dispensing by pharmacists.

In both cases, mandating a little common sense in how these drugs are used would potentially help a lot of people avoid a life they don't want.

Re: America’s opioid epidemic is worsening

#40

Post by oxide »

ZanyProgrammer wrote: post #33
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…

I've had friends get fucked up by head shop and online Kratom. It's very far from benign.

I've gone ahead and edited my comment, not because of your comment, but just because I felt like I wasn't making a clear point. Kratom is not even mentioned anymore, sorry.

While kratom is habit forming and can "fuck you up" if you have no tolerance, the true value is for the person already addicted to opiates looking to get clean.

If you want to keep drugs out of the hands of kids, make them all legal and watch the usage numbers fall. Banning a powdered leaf, that is quite self-regulating, albeit habit-forming, is a step backwards in the quest to put out the structure fire that the opiate crises has become.

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