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Bleak New Estimates in Drug Epidemic: A Record 72,000 Overdose Deaths in 2017

nytimes.com

51–60 of 217 posts

Re: Bleak New Estimates in Drug Epidemic: A Record 72,000 Overdose Deaths in 2017

#51
post #14

Earlier quoted context omitted.

Many say that big Pharma corporations have a large share of the responsibility because they began promoting strong pain killers heavily, starting in the 90s [1]. Now it has become part of American culture (doctors, patients, pharmacistse etc) to treat any pain with these pain killers. It’ll cost a lot and take a long time to reverse that [2] [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2622774/ [2] https://www.vo…

At the same time, know that every time a politician gets a bullet point on his re-election flier for "fighting the opioid epidemic" or "keeping our streets clean", there are real people in real pain who get stranded without the medication they need to function. After the birth of my youngest child, my wife spent the immediate recovery period blindsided by pain because new regulations meant the hospital was unwilling…

Floridian here - I was given 1 month morphine prescriptions for 6 months. I believe 1 month is the max. This was this year.

Re: Bleak New Estimates in Drug Epidemic: A Record 72,000 Overdose Deaths in 2017

#52
post #38

Earlier quoted context omitted.

.. are you sure? This is the same Hollywood that's been editing cigarettes out of movies? Could you cite an example scene?

??? Are you for real? Just google "stoner movies". Off top of my head: The Pineapple Express, This is the End, Harold and Kumar go to the White Castle, Jay and Silent Bob strike back.

I'm not sure stoner movies are equivocal to increasing broader drug use generally.

Studies show that legal marijuana is associated with decreasing opiate prescriptions

https://jamanetwork.com/journals/jamainternalmedicine/articl...

Re: Bleak New Estimates in Drug Epidemic: A Record 72,000 Overdose Deaths in 2017

#54
post #50

Earlier quoted context omitted.

??? Are you for real? Just google "stoner movies". Off top of my head: The Pineapple Express, This is the End, Harold and Kumar go to the White Castle, Jay and Silent Bob strike back.

Weed (now legal in several states and not related to overdose deaths) is a different prospect to opiates, though.

You can argue that weed is legal because of sustained Hollywood propaganda.

Re: Bleak New Estimates in Drug Epidemic: A Record 72,000 Overdose Deaths in 2017

#55

The amount of responsibility laundering that's happening is staggering. Is it the fault of the doctors for prescribing strong painkillers or the responsibility of lobbyists for keeping the status quo as it is. Or is it the responsibility of patients to not seek strong opiates for the smallest aches? On whom falls the blame for this?

The doctors. Anyone who spends the better part of a decade studying medicine can't be ignorant about opioids and addiction, regardless of what the slimy Purdue representative tells them.

The only excuse they have for the blatant over prescribing of opioids (2 months worth of oxy for getting wisdom teeth pulled kind of thing) is that if they don't do it, the patient will just go to another doctor.

But how can you justify setting someone up with fistfuls of oxy (knowing full that heroin / fentanyl and a world of misery for them and their loved ones is just around the corner) just "to make money" ?

> Or is it the responsibility of patients to not seek strong opiates for the smallest aches?

What the patient seeks is irrelevant. The only one who decides what prescriptions a patient should take is a doctor.

Personally I suffered from lower back pain for about 10 years and went from one useless quack to the next. Eventually I found a physio who taught me how to strengthen my core, now I'm at the gym 2x a week and loving it, did couch25K (and beyond) and am pain free for 3 years.

All I sought was pain relief but pills is not what I needed. If I was in W-Virginia instead of the EU I guess I'd be shooting heroin by now.

The US health care system is broken in more ways than one, no doubt this is made worse by various societal factors like joblessness.

Re: Bleak New Estimates in Drug Epidemic: A Record 72,000 Overdose Deaths in 2017

#56
post #41

The amount of responsibility laundering that's happening is staggering. Is it the fault of the doctors for prescribing strong painkillers or the responsibility of lobbyists for keeping the status quo as it is. Or is it the responsibility of patients to not seek strong opiates for the smallest aches? On whom falls the blame for this?

My own preferred hypothesis is that this is the result of despair : https://www.theatlantic.com/health/archive/2017/04/joblessne... Someone will no doubt reply that US unemployment is falling, and therefore so should the opiates crisis, but it's not a simple matter of economics and statistics, it's a question of what people believe about the world and their future in it. Someone who gets a bad, painful job with no ag…

Manufacturing jobs are booming in the US. The very people that you're implying are hopeless, that specific demographic, have access to blue collar jobs in a way they haven't in nearly a generation. The US hasn't seen this kind of sustained manufacturing job growth since the mid 1990s.

The US has drug problems, and has for 50 years, that other first or second tier nations in worse structural condition never picked up. This goes all the way back to peak US economics of the 1960s and early 1970s, when the US had a standard of living that it has taken the best European nations 50 years to catch up to. The opioid crisis is the latest extension of the US being a drug abusing nation, which it has been for a very long time, even at the peak of US economic success when it had 1/2 of all global manufacturing. It has had multiple heroin waves, multiple cocaine craze waves, multiple pill abusing waves.

The people of Spain didn't overdose at 2x or 4x the rate of the US despite having a drastically worse economic situation. Their economic desperation is still far beyond that of the US.

The standard response to that is: yeah, but the US doesn't have a welfare state. Yes it does, it has a massive welfare state, and its welfare spending as a percentage of GDP is higher than Canada or Australia.

The opioid problem has particularly hit poorer Americans. Why aren't Bulgarians or Moldovans overdosing at far higher numbers? They're radically poorer. Part of this equation is access: Americans have massive, low cost, easy access to all the drugs. People in the US have an almost unique position in the world in regards to having enough money, easy access and combining it with the way drugs get pushed to Americans.

Some of this is in fact unique to the US and doesn't require there be a particular high level of stress.

Every economic metric indicates Americans are doing better today than they were seven years ago, and yet the opioid crisis isn't receding and it's far worse than it was seven years ago.

Japan has lost a minimum of 1/3 of its standard of living in 15-20 years. They're not overdosing on opioids like people in the US are. They've suffered far worse than people in the US have.

Every culture behaves differently under stress, there's no question about that. There's also zero evidence that the on-going opioid crisis is a result of active high level desperation. That's where it started; those are not the same things.

Do people in Sweden and Belgium commit suicide at higher rates than people in the US, because their standard of living is collapsing? Belgium's suicide rate is nearly 100% higher today than the US rate was in the year 2000. Does wealthy Europe have among the highest rates of suicide on earth because it's so terrible there and they're under incredible economic stress? Or is it more likely these cultural issue are in fact complex rather than simple.

Re: Bleak New Estimates in Drug Epidemic: A Record 72,000 Overdose Deaths in 2017

#57
I have always wondered how pain killers could be so addictive.

Stimulants are physically addictive. They modify signals in your physiology to increase signal performance, in some way, and the body reacts to the temporary performance boost. There is a craving for the stimulant the body has becoming reliant upon and a withdrawal in the absence of that chemical. This manner of physical addiction isn't a choice and everybody is roughly equally at risk. Even laxatives are equally physically addictive in this manner even though there is absolutely no modification to behavior from laxative consumption.

Pain killers, and other depressants, on the other hand, don't work this way. With a very narrow exception to extreme alcohol consumption depressants are not immediately physically addictive. They require a modification to behavior to be addictive. In this way marijuana, which has no known physically addictive properties, has shown to be addictive to a small segment of users.

I have always wondered how depressant addiction occurs. Unlike with stimulants we are not all created equal. Some people are more prone to addiction from depressants than others. Some few people do not find depressants at all addicting and even detest their use. It makes me wonder what is the primary behavioral switch that enables this manner of addiction.

Re: Bleak New Estimates in Drug Epidemic: A Record 72,000 Overdose Deaths in 2017

#58
post #45

Interestingly, this all is happening through legal routes. What would happen if hard drugs are fully legalized? Another weird thing, there are already loads of deaths through overdoses in the inner city, but only now it is an epidemic? What changed?

I see your point, but most overdoses are likely due to imperfect dosage information (excluding suicide, obviously).

I think there may be some argument for legalisation but with medically-supervised consumption in pharmacies or specialised clinics.

Overdoses could (excepting human error) be removed entirely with improved dosage calculations from experienced healthcare staff.

Re: Bleak New Estimates in Drug Epidemic: A Record 72,000 Overdose Deaths in 2017

#59

I have always wondered how pain killers could be so addictive. Stimulants are physically addictive. They modify signals in your physiology to increase signal performance, in some way, and the body reacts to the temporary performance boost. There is a craving for the stimulant the body has becoming reliant upon and a withdrawal in the absence of that chemical. This manner of physical addiction isn't a choice and every…

It's rather simplistic to view opiates as mere depressants. They also create euphoria.

I also don't think you'll find everyone is equally at risk from stimulant addiction in the way you describe, or that you can generalise across multiple, vastly different families of drugs like this...

Re: Bleak New Estimates in Drug Epidemic: A Record 72,000 Overdose Deaths in 2017

#60
post #33
post #14

Earlier quoted context omitted.

Many say that big Pharma corporations have a large share of the responsibility because they began promoting strong pain killers heavily, starting in the 90s [1]. Now it has become part of American culture (doctors, patients, pharmacistse etc) to treat any pain with these pain killers. It’ll cost a lot and take a long time to reverse that [2] [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2622774/ [2] https://www.vo…

In the end of the day doctors are the only ones holding the pen to write prescriptions, no matter how you look at things.

That's somehow like saying: the guy in the store that sold the weapon is solely responsible for a killing with the same gun.
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