The opioid crisis

This week the PBS Newshour kicks off a weeklong series on the opioid crisis.

The first episode looked at Huntington, WV of the 100,000 in the region more than 10% are addicts and 20% of the babies have signs of drug addiction. More than 100 people will die of ODs in Huntington and more 2,000 people will overdose.
Statistically, you are almost as likely to go to the hospital because of an OD spending one year in Huntington, then if you were at the Las Vegas concert.

One drug alone Fentanyl a synthetic opioid killed 20,100 people almost twice as many as many as were murdered by guns last year. Far more troubling is that Fentanyl deaths increased by an amazing 540% in the last 3 years.

Not surprisingly, Trump promises to declare opioid addiction a national crisis has come and gone. Sadly, he seems to reflect popular opinion with only 26% viewing as a national emergency, 58% as a serious problem and the rest being idiots.

I just wish opioids generated a fraction passion, that guns, Trump idiocy, and the evil Republicans did on P&R, or Facebook did.

The reason you see less acute discussion is simple: there are no singular events to highlight the policy failures. It is a slow motion car crash.

I absolutely have the same kind of passionate feelings on this one as gun control, perhaps more because there are more realistic and achievable ways to alter the trajectory. But the over medication of our nation is a long term trend that ties directly into many monied interests. Things like the fact we allow medical advertizing, unlike most other countries, the pharmecutical companies that give preferential development to drugs for mediation of symptoms rather than treatment of underlying issues, that we’ve seen the financial incentives distort what treatments are offered, all are symptoms of national failure.

The supply is a problem, but not necessarily a cause. But the amelioration of pain is a simple thing to do when medical care for many people in the hardest hit regions is invariably tied to economic downturns that make medical care unaffordable. Many of these people live in states that did not accept Medicare expansion, or set up exchanges.

But like so many things it slips just below the threshold of major coverage. Always below the surface, but listing the names of the overdosed dead isn’t as splashy as bellowing about the blowhard in the oval offices latest disgrace of our nation. It is a dispersed story, which makes it harder to tell in real time. Such things require the long lens of hindsight, which our soundbte culture is terrible at comprehending.


To be honest, I had forgotten about that thread. That said, I was struggling but failed to understand what BadSport was trying to say, which is I why never posted in it.

I also think it is too easy to point to the drug companies and say they got everybody hooked and much less asking them to fix it. Although they certainly bare a lot of responsibility IMO.

I’m hoping the Newshour highlights some places which have been successful in slowing or stopping the epidemic.

One of the interesting policy questions is should 1st responders and health department on limits on helping addicts who refuse to enter treatments? The Ohio police chief who refused to let his cops and EMTs carry Narcan at $50 per dose is going overboard. But what about the EMT who said that he gave 2 dozen Narcan dose to one house in this year?

This is a great read on the topic

It sure was and heartbreaking. Thanks for posting I read it when it first came out, but couldn’t remember what city newspaper published it. I was actually going to post a link to it.

You’d think a google search of ohio newspaper opioid crises would lead me to it.

Pretty much every reasonable person agrees that this is a deadly serious problem. Through the magic stupidity of social networks, things that everyone agrees on receive much less attention. See: The Toxoplasma of Rage. The issues that everyone ends up discussing endlessly are precisely the ones that are most divisive. Hence Mike Brown’s death ends up being the source of a lot more outrage than Eric Garner’s.


This episode focused on alternative to opioids for pain control
Some of the alternate approaches include things that have been around for a while like hypnosis as well as cutting edge stuff as VR. I do wonder if a better game with deeper gameplay without VR would do as well control pain as a simple VR game?

Thursday’s episode was about the economic impact. In Ohio employers are saying between 25-50% of otherwise eligible applicants are rejected because of current drug use. (Often show up to the job interview high).

One professor estimates that 20% of the drop in the labor force participations since the great recession is because of drug addiction. That would be equal to approximately a 1% higher unemployment rate.

Very interesting stuff. However, I contend that while there is agreement that drug addiction a serious problem. There isn’t and (frankly shouldn’t be) agreement on the best ways to treat it. My hope is to spur the serious debate we had on healthcare on the opioid crisis. I’m copying my rant from the never ending gun control debate.

Those are sad videos. It makes me think that fundamentally we need a society that “gently nudges” i.e. tells people how to live. I mean, sure, the opioid crisis is very real but even deeper is this malaise of like half the population just not able to manage their own day to day affairs and lives.

copied from Las Vegas shooting thread.

Here are some of the issues that I think are worth debating.

Do we follow the path of Indonesia and Malaysia and routinely execute drug dealers? Or do we skip the formalities of a trial, and just kill them on the street like Duterte does in the Phillippines?

What about user do we adopt the approach of number European country and make sure they have access to clean needles and skip any kind of punishment? Or do we use a carrot and stick approach, stick with rehab or go to jail?

And how do we go about breaking the addictions, for decades we sent people to 12 step programs. They do work for many people, but generally only after multiple attempts. Or are there better programs?

Is marijuana part of the solution for pain treatment, or the legalization trend part of the normalization that is ok to be high in society and part of the problem? Should we use less dangerous opioid to treats opioid addiction? I can honestly say I don’t have a definite answer to any of these questions Although, it would take a mountain of evidence before I’d sanction Duterte style executions.

Tom Petty died this week of a cardiac arrest at 66.
Tom was an amazing rocker and a heroin addict. I’m going to make a prediction that drugs were a primary or contributing factor in his early death.

I’ll also predict if I’m right what we WON’T see on Facebook or QT3 is a demand that Congress pass laws and do something to rid this country of this deadly product. There won’t be posting of cute meme comparing America drug problem to other countries. There won’t be calls for Americans who use drugs (including alcohol) in a responsible way to change their behavior.

(To be fair having a tried and failed for 50 years to win the war on drugs, I don’t know if I trust the Federal government to find a solution, but IMO the government at some level has to do something, which also should be part of the discussion.)

In short, we will see none of the outrage that mass shooting causes will happen because of yet another drug-related death.

I know this because none of these celebrities who died of OD, or this much longer list of famous people caused a demand for action.

I wish I had something other than mostly cynical reasons to explain the differences in reaction between gun deaths on drugs deaths.

But most importantly, how do we move societal reactions from the attitude of it sucks another entertainer got mixed up in drugs and ODed, to we need to something like XYZ. How do we harness the passion we see in black live matters, the gun control, or even Trump sucks to this?

After an injury I had pretty severe chronic pain. It was bad enough that it was keeping me awake at night and making it hard to concentrate. I went to my surgeon and asked him for a prescription. He just told me to take ibuprofen and suck it up. Fortunately the pain mostly went away after awhile. It only ruined a year of my life, not the rest of it like addiction would have.

One problem I see is that in our society we don’t hold people in the professional class accountable. This is a national disaster that’s directly ruined the lives of millions of people and I’ve still never heard anyone even suggest that some doctors should go to prison over it.

Our legal system is designed to make the problem worse. If you commit a violent crime to support your drug habit, you get years in prison and a felony on your record. Now your life is ruined, so there’s no point in avoiding drugs. If you traffic dozens of kilos and a hundred desperate people commit violent crimes to pay for it then you’re a “non-violent drug offender” and all you get is sympathy.

I doubt it will work any better than when they tried the same thing in Thailand. Piles of dead bodies make the public feel better but there isn’t any lasting benefit.

The people who love to tell you how much better Europe is than America don’t seem as interested when it comes to Singapore.

I feel like in Canada we’ve done as much as we reasonably can to restrict weapons (and we are still worse off than other countries with similar laws). If it were politically feasible for the US to adopt the Canadian approach to guns, it would probably save lives. However, the history, the culture, the second amendment makes it just a very thorny problem. I think that at least that America could take some steps to try to reduce the number of toddlers dying from unsecured firearms, so at least that’s a direction.

On the drug front, I can’t muster up a hotblooded call for action because I can’t figure out what the hell to do. The US is an outlier in terms of gun violence, so it’s easier to think that solutions can be found in what other countries have done. I’m not sure it’s so much of an outlier in terms of drug abuse, and things other countries seem to have done all have drawbacks. It’s easy to think the drug war is counterproductive but I don’t know too many people who think something like heroin should be legal. I don’t understand why people start using heroin, and I don’t have a clue how to make them stop, or stop them from starting.

I honestly wasn’t sure how the US ranks. Sadly we are doing worse for drugs than guns 3rd most death per capita in the world. at 7 per 100K… Note this data is from WHO 2014, so the actual data was collected in 2013. The last few years have been awful so there is good chance we will be #2 right behind Estonia as the worst in the world.
Our drug deaths are three times Canada, seven times Mexico and 17 times more drugs deaths per capita as Japan and the Philippines (which does raise the question why the fuck is Duterte is slaughtering people on the streets.)

By comparison, the US is only 85th in the world in violent deaths per capita. at 5.5/100K, in fact, we may be the only country with the dubious distinction of having more drug deaths than violent deaths.

Singapore is an authoritarian city state, not a model I’d like to see replicated.

Pretty much this. I can’t see legalizing addictive drugs (meth, heroin) but decriminalizing it for end users (treatment clinics instead of jail) seems reasonable. I didn’t even know NH (an otherwise low crime state) had a big problem until the 2016 election - which doesn’t reflect well on me, certainly, but also speaks to how little attention it gets from the media.

Speaking from within the authoritarian Singapore. I feel a lot safer for my child. I cannot imagine the worries a typical middle (median, not average) income family experiences for their children in the US. Judging from the news I see almost every other week.

Don’t let our fear-mongering media suck you in, @cicobuff! Most of the things middle income parents worry about happening to their children are nigh statistically impossible. Kidnapping, murder, etc., are an insane rarity for that group. Their biggest threat each week is the 45 minute car trip to the mall with the parents.

That’s good to know. Things tend to be blown out of proportion for whatever reasons. Just like how the west tend to view authoritarism in Singapore I suppose. The locals tend to perceive things differently in day to day living.

Politics, for any subject material, is toxic.