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America’s opioid epidemic is worsening

economist.com

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Re: America’s opioid epidemic is worsening

#41

Post by mholmes680 »

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 think its more dissatisfaction with life in general, with unemployment maybe being one of many triggers.

You're probably right about addressing at the demand level. But, I see the problem being more societal - think no one really understands everything. You take away self-reliance of people (whether they realize it or not) at many levels... its cheaper to get some good-enough quality food at 13 places near my home, so why should I learn to cook. I can get any vegetable I want at the store, so I probably don't need to learn how to tend a garden. In both instances as examples I'm losing a little control of my life. And then....

TV gives me entertainment, and the internet even more so, so maybe i'll just sit back and let it entertain me. So maybe I don't need to read anymore. Its easier to have short non-contextual entertainment bits, which rewire my brain further to think differently [wrongly?]... [0]

And, now capitalism has made all margins of businesses so slim that there's no real way to enter a business and still have a safety net in case you fail. You either need to disrupt an industry, create a marketplace, find a niche, or fail hard.

I think we're just starting to see the uglier stuff here. Short of some great awakening I also don't see the correct prescription. Pun intended.

[0]: https://en.wikipedia.org/wiki/Amusing_Ourselves_to_Death

Re: America’s opioid epidemic is worsening

#42

Post by rwmj »

devopsproject wrote: post #29
pnathan wrote: 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/

The pill supply has to lowered ... in the past.

However now the US made that mistake, what's the problem with continuing to give out the pills "like candy", although with tighter controls to make sure that they don't go to create new addicts?

Re: America’s opioid epidemic is worsening

#43

Post by maxxxxx »

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…

One thing I have noticed with American doctors is that they are very quick prescribing heavy pain meds. Much quicker than in Germany for example.

Re: America’s opioid epidemic is worsening

#44

Post by cryptarch »

the-dude wrote: post #25
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…

In The Netherlands, supervised injection sites exist for ~30 years now. Also, The Netherlands provide methadone. It seems to have worked / be working. Our heroine epidemic is far behind us, the addicts are dying out.

The Netherlands also have a few legal highs: weed, kratom and psilocybin.

Re: America’s opioid epidemic is worsening

#45

Post by rm_-rf_slash »

rwmj wrote: 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…

Spice is in some ways worse, as many U.K. prisons are reporting troubles with contraband use getting prisoners and guards alike high with secondhand smoke.

Re: America’s opioid epidemic is worsening

#46

Post by dcroley »

There is something obviously wrong or at least strange with the data that backs that map. Look at the contrast across the border between Tennessee and Georgia or between West Virginia and Virginia. I think some states must be under-reporting things or reporting them differently. I would expect such a map to track poverty maps or unemployment maps, but it does not.

Re: America’s opioid epidemic is worsening

#48

Post by ucaetano »

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. And with no activity in the central nervous system, it would dodge opioid’s serious side-effects, including addiction and systemic responses that can be lethal during overdoses.

They're testing a modified version of fentanyl that only works in lower pH, restricting its activity to injured areas of the body, eliminating the risk of overdose and dependence:

In further experiments, the researchers noted that, unlike fentanyl, high doses of NFEPP weren’t lethal to the rats. And rats on the NFEPP didn’t display impaired motor activity or reward-seeking behavior linked to addiction.

Re: America’s opioid epidemic is worsening

#50

Post by devopsproject »

rwmj wrote: post #42
devopsproject wrote: post #29

Earlier quoted context omitted.

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/

The pill supply has to lowered ... in the past. However now the US made that mistake, what's the problem with continuing to give out the pills "like candy", although with tighter controls to make sure that they don't go to create new addicts?

They don't need to be given out like candy. That's the point. The supply needs to be drastically reduced to prevent new addicts and we should be looking at what other countries are doing for their existing addicts: safe injection sites etc.
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