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America’s opioid epidemic is worsening

economist.com

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Re: America’s opioid epidemic is worsening

#51

Post by jbooth »

tptacek wrote: post #30
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…

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…

If you give them free H, they'll be a lot less desperate and a lot less violent, presumably.

And.. why not? I've got multiple friends in my age group prematurely dead from overdose. It's not like prohibition is accomplishing anything.

Re: America’s opioid epidemic is worsening

#52

Post by ribosometronome »

tptacek wrote: post #30
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…

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…

Opioid prescriptions are declining: https://www.nytimes.com/2016/05/21/health/opioid-prescriptio.... And will hopefully continue to decline.

Identifying the source of the problem is easy, though. Solving the problem for the masses who already find themselves in the midst of an addiction they might not even know they're in yet is much harder and what places like these injection sites are aimed to address.

Re: America’s opioid epidemic is worsening

#53

Post by troisx »

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.

Re: America’s opioid epidemic is worsening

#54

Post by dep_b »

cryptarch wrote: post #44
the-dude wrote: post #25

Earlier quoted context omitted.

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.

They're not legal in The Netherlands. Magic mushrooms have been banned a while ago (but at the same truffles still are not, clueless), weed was never legal. Also all production is illegal. Coffeeshops don't pay taxes.

They're just.....there?

We used to think it was the crazy US forcing the Dutch to have such a bipolar approach to drugs but pot is more legal in Colorado now than in Holland and still the Dutch laws are a mess.

Re: America’s opioid epidemic is worsening

#55

Post by devopsproject »

AaronFriel wrote: post #35
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.

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 hydr…

We have the numbers because the DEA tracks it. Why they didn't look into the numbers is beyond me.

Manufacturer seems to have played a role too by sticking to dosing they knew was ineffective and then pushing for higher doses which lead to big bonuses: http://www.latimes.com/projects/oxycontin-part1/

Re: America’s opioid epidemic is worsening

#56

Post by kolbe »

dcroley wrote: post #46

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.

Correct. States have a great deal of variance when it comes to tracking overdose deaths.

Re: America’s opioid epidemic is worsening

#57

Post by [deleted] »

tptacek wrote: post #30
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…

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…

[deleted]

Re: America’s opioid epidemic is worsening

#58

Post by Kluny »

maxxxxx wrote: post #43
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.

American doctors follow national guidelines, because if they don't they expose themselves to malpractice suits. The guidelines currently say that if someone is in pain, give them as much painkiller as they want. Their ability to use their extensive training and judgement to make a better call is somewhat limited.

Re: America’s opioid epidemic is worsening

#59

Post by delhanty »

tptacek wrote: post #30
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…

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…

Isn't there something in common there: drug dealers make money pushing heroin etc. and (some) doctors make money pushing Oxycontin?

Maybe if all these drugs were freely available at least some of the violence would go away and the incentives to push them would go away too ...

Re: America’s opioid epidemic is worsening

#60

Post by error54 »

DoodleBuggy wrote: post #8

Hard to believe there is really an "epidemic" beyond typical fearmongering and political noise. People have always used drugs, this is nothing new. Unfortunately all the hype and noise is having significantly negative consequences to the medical community, doctors, and patients who actually need these things.

It's a "national health crisis" because of the ethnicity and locations of the people it's affecting. Today, politicians are proposing more treatments and going after the pharmaceutical companies[1]. Back in the 80's and 90's, the response to the crack epidemic was harsher prison sentences for users and sellers because it was largely minorities who were affected[2].

Not arguing that treatments shouldn't be made available but it's important to keep all this in mind if someone ever suggests that all are equal in the eyes of the law when it comes to drug offenses.

1 - https://www.nytimes.com/2015/10/31/us/heroin-war-on-drugs-pa...

2 -http://www.cleveland.com/open/index.ssf/2016/02/heroin_vs_cr...

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