US needs to invest 'tens of billions or hundreds of billions' to fight opioid epidemic
The goal of an opioid is to reduce pain, but the addictive drugs are creating pain for millions of families suffering through the crisis. Deaths from opioid overdoses number at least 42,000 a year in the U.S., according to the Centers for Disease Control.
"This is an epidemic that's been getting worse over 10 to 20 years," Caleb Alexander, co-director of Johns Hopkins Center for Drug Safety, told CNBC's "On The Money" in a recent interview. "I think it's important that we have realistic expectations about the amount of work that it will take and the amount of coordination to turn this steamship around," Alexander added.
[...] Alexander added: "The statistics are stunning. More than 2.1 million Americans have an opioid use disorder or opioid addiction" and he says the country needs to "invest tens of billions or hundreds of billions of dollars" to shore up the treatment system. He said patients should be able to access medications that "we know work to help reduce the cravings for further opioids."
Don't mention the Portugal model!
Meanwhile, the Massachusetts Attorney General is suing members of the family that runs Purdue Pharma:
Their family name graces some of the nation's most prestigious bastions of culture and learning — the Sackler Center for Arts Education at the Guggenheim Museum, the Sackler Lefcourt Center for Child Development in Manhattan and the Sackler Institute for Developmental Psychobiology at Columbia University, to name a few.
Now the Sackler name is front and center in a lawsuit accusing the family and the company they own and run, Purdue Pharma, of helping to fuel the deadly opioid crisis that has killed thousands of Americans. Massachusetts Attorney General Maura Healey took the unusual step of naming eight members of the Sackler family this week in an 80-page complaint that accused Purdue Pharma of spinning a "web of illegal deceit" to boost profits.
While prosecutors in more than a dozen other states hit hard by the opioid epidemic have sued Purdue Pharma, Healey is the first to name individual Sackler family members, along with eight company executives.
(Score: 1, Insightful) by Anonymous Coward on Monday June 18 2018, @04:02PM (31 children)
this is a wasted human potential epidemic. drugs are just a symptom. if the school system would have taught these people anything useful they would have passions in life and a thirst for knowledge. also, the poorer or more screwed up people get the more the government predators want to feed on them. this makes things much worse. stop sending your monopoly money to washington dc to be used for these slave training centers and the predator and parasite classes. fund local neighborhood/home schools. teach kids how to learn and create (and how to defend themselves against the morlocks and the government).
(Score: 5, Informative) by Anonymous Coward on Monday June 18 2018, @04:14PM (28 children)
Most of these people had legitimate medical problems, then sought care from highly trained medical professionals with appropriate licenses. The people trusted doctors, and the doctors trusted Purdue Pharma. The fact that many now turn to sketchy unlicensed street dealers is a result of addiction. The addicts started off with legitimate care that they should have been able to trust.
It's not like so many other drugs, where nearly everybody started off without a real medical problem or a licensed medical professional. It wasn't "hey, let's get fucked up!!!" but rather "my hip joint is fucked up".
(Score: 2, Insightful) by tftp on Monday June 18 2018, @04:26PM (7 children)
(Score: 2) by frojack on Monday June 18 2018, @06:02PM (6 children)
My question as well.
Lets see some proof of "Most".
Young (previously) healthy people make up the bulk of opioid addicted people, as well as a large percentage of women.
Sources of statistics a significant portion [asam.org] of users arrive at opioid addiction via a medical route, but certainly not "most".
10%, (bad as that is) is not MOST.
No, you are mistaken. I've always had this sig.
(Score: 2) by VLM on Monday June 18 2018, @06:44PM (3 children)
Wikipedia seems to imply you graph prescriptions and the abuse stats are just a couple years delayed.
The usual path seems to be legal pain killer possibly "free" with insurance, then addiction, then the insurance company "saves money" by cutting them off, then its street drugs, which leads to personal disaster.
Its interesting that the drugs biochemically seem to cause no ill effect even with very long term use, whats called the "crisis" is the result of the end of medical supervision "to save money" resulting in street drugs as a replacement. Now street drugs are a complete disaster for personal life, that is true.
You get your first hit for free from the nice doctor, and your last hit from Leon the H pusher on the street corner over there as your life and family are completely vaporized. But the drugs themselves biochemically speaking when taken under real supervision of a real doctor, are pretty harmless.
I guess the best analogy I can come up with, is imagine hospitals and emergency rooms have out free packs of cigs for people to smoke to help chill in the waiting room, and then everyone acts surprised when tens of millions die of lung cancer from smoking illegal cigs once they're addicted.
(Score: 5, Insightful) by sjames on Monday June 18 2018, @07:42PM (2 children)
Perhaps we should look at what happened after WWI. Many soldiers then got heroine after being injured in combat. Quite a few ended up being addicted. They weren't terribly happy about needing a fix, but they were generally able to get what they needed fairly cheaply, and so lived productive lives after the war.
Much of the current "crisis" is based on an attempt to studiously avoid looking at why our society has gotten so good at producing people who feel so little hope for the future that shooting up and checking out looks like their best option.
Since everyone likes gamification these days, what happens when a game has too much grinding for too little progress? People rage quit.
(Score: 2) by mhajicek on Monday June 18 2018, @08:31PM (1 child)
Thank you for that analogy, it seems to fit well. The rage quit is a likely reason for school/mass shootings as well. People with meaning in their lives do not do these kinds of things.
The spacelike surfaces of time foliations can have a cusp at the surface of discontinuity. - P. Hajicek
(Score: 2) by sjames on Wednesday June 20 2018, @10:35PM
Agreed.
(Score: 0) by Anonymous Coward on Monday June 18 2018, @07:13PM
That quote only describes what substance they were using to satisfy their craving, not what substance began their addiction.
(Score: 3, Interesting) by takyon on Monday June 18 2018, @08:23PM
The 20.5 million number seems to count things that aren't related to opioids, such as cocaine and probably alcohol. Subtract those out of there and your conclusion may be very different.
[SIG] 10/28/2017: Soylent Upgrade v14 [soylentnews.org]
(Score: 2) by Runaway1956 on Monday June 18 2018, @04:49PM (10 children)
Like tftp, I question that "most" bit. I'm not certain of it, but I think that "most" people who are hooked got that way through recreational use. I don't mean to detract from the horrifyingly huge number of people who were hooked due to bad advice from doctors and pharma pushers. But, it would take some convincing to make me believe that "most" addicts were created by those doctors. We live in a nation of people who dabble in drugs. Designer drugs, cocaine, heroine, you name it. If you tell some people that snorting Drano will get them high, they're likely to try it.
“I have become friends with many school shooters” - Tampon Tim Walz
(Score: 4, Interesting) by NewNic on Monday June 18 2018, @05:05PM (9 children)
"also that three in four new heroin users start out using prescription drugs."
https://www.cnn.com/2017/09/18/health/opioid-crisis-fast-facts/index.html [cnn.com]
"Today's typical heroin addict starts using at 23, is more likely to live in the affluent suburbs and was likely unwittingly led to heroin through painkillers prescribed by his or her doctor."
https://www.cnn.com/2014/08/29/health/gupta-unintended-consequences/index.html [cnn.com]
lib·er·tar·i·an·ism ˌlibərˈterēənizəm/ noun: Magical thinking that useful idiots mistake for serious political theory
(Score: 3, Interesting) by Runaway1956 on Monday June 18 2018, @05:33PM (8 children)
The CNN articles aren't especially informative. They toss numbers around, without showing how those numbers are related.
The questions I want answered is:
How many individuals in the US received legally prescribed opioids in any given year?
How many of those individuals became addicted?
Can we discount terminally ill patients who were going to die anyway, and used the drugs to maintain some facsimile of normal life in their last days/weeks/months? They shouldn't be part of the statistics.
How many opioid addicts gamed the doctors, to obtain the drugs for recreational use?
How many opioid addicts acquired their addictions without the aid of doctors?
Maybe someone would add some questions to my list. Then, someone with access to that sort of data might arrange it into some kind of table, year-by-year. That done, people could actually compare, year-by-year, how many people were hooked by Big Pharma advertising, and active pushing of the drugs. And, at the same time, we could compare the number of young idiots who just wanted to get high, and never had any legitimate injury that justified a prescription.
Breathles exclamations such as
That quote is almost meaningless. Does that mean that 6.2 billion pills were manufactured - and many of them sent overseas for further distribution? Or, does it mean that 6.2 billion were manufactured for domestic use, and that half (or more) are still warehoused? Or, does it mean that all of those 6.2 billion were manufactured, distributed within the US, dispensed, and consumed, all within 2016? Which leads into another question: Were all of those 6.2 billion legally prescribed? If not, what percentage were diverted from "legitimate" channels, to the black market?
I've voiced my opinion above, that "most" addicts become addicts through decisions and actions of their own. I need some convincing that doctors have been responsible for all of the increase in addictions.
This nation imports drugs from around the world, to feed it's hunger for drugs. Big Pharma does not bear responsibility for the heroine coming in through our ports, nor for the cocaine. Yet, we have huge problems with both, in their various forms.
“I have become friends with many school shooters” - Tampon Tim Walz
(Score: 2) by frojack on Monday June 18 2018, @06:13PM
Yes, CNN is full of shit. (as usual).
Of the 20.5 million Americans 12 or older that had a substance use disorder in 2015, 2
million had a substance use disorder involving prescription pain relievers and 591,000 had
a substance use disorder involving heroin.
https://www.asam.org/docs/default-source/advocacy/opioid-addiction-disease-facts-figures.pdf [asam.org]
The "Doctor" route at most accounts for 10%.
Also, people that do get addicted via the doctor route have to seek alternative sources way before they are addicted.
Sure chronic pain patients run a much larger risk.
No, you are mistaken. I've always had this sig.
(Score: 2) by VLM on Monday June 18 2018, @06:59PM (5 children)
https://en.wikipedia.org/wiki/Opioid_epidemic [wikipedia.org] claims 289 million prescriptions per year, so 6.2 B / 289 M = a completely reasonable 21 pills per prescription in the sort of united states.
IIRC my dentist prescribed me a 12 pack of ... some damn thing that felt like I had about a six pack in me. At the rate of about 4 pills per day (effects were short-lived) that didn't last long and my jaw minus its wisdom teeth hurt quite a bit for another week, I can totally see someone with a more severe problem turning to something else. Now the question is why did my dentist prescribe me something so strong that I was not just in no pain, but pretty Fing high as a kite, but only for 3 days worth despite knowing wisdom tooth extraction is going to sting like hell for a week? I'm sure the insurance company save money giving me 12 pills instead of 28 or so pills...
Of course 12 pills didn't turn me into an addict requiring $1M worth of legal and medical addiction care, so depending who profits, its either good or bad that I got 12 pills instead of 28 pills. Now whats the difference in addiction rates between being high as a kite for a week vs 3 days? With a side dish of I knew no matter how much it hurt my wisdom teeth would feel OK "eventually" but there's a large number of people with chronic as opposed to acute pain. So you break your back in Iraq in an IED explosion and the VA will only give you 3 days of pills (to save money) for pain that might last the rest of your life? Sounds likely...
There's a "pain clinic" down the road that I used to have to drive past, which is somehow not illegal, my understanding is if you're poor there is a whole infrastructure of how to obtain (for free because you're poor) and sell pills (at a high price to addicts), so a significant fraction of that 289 million scripts is likely illegal... At that facility probably 100% illegal.
(Score: 2) by hendrikboom on Monday June 18 2018, @08:41PM (2 children)
When I had teeth extracted (two at a time) I was given ibuprofin. It sufficed.
(Score: 2) by VLM on Monday June 18 2018, @08:57PM (1 child)
Well, that's nice. For you.
Pain is an example of a problem that "big data AI" type stuff could probably help a lot with, reducing a lot of human pain and suffering.
It would seem trivial to upload DNA sequence and medical records and recent dental x-rays to 'the cloud' and a bunch of math magic happens then it spits back a result like "Yer screwed here have 100 pills" vs "just put an ice pack on it and walk it off". I donno what the financial model could be other than wait until AI is so cheap it can be used to alleviate human misery.
Some day I'm sure future doctors will look back on 21st century pain management about like how we look back at leech and astrology use, like WTF were those barbarians thinking?
(Score: 0) by Anonymous Coward on Monday June 18 2018, @11:14PM
The most important thing to remember about pain management is: if you think it'll hurt then it's gonna hurt.
A good example of that is the surgery for the caved-in chest defect. They cut you open on the side, slide a metal bar under your ribs in order to push our your sternum, then sew you back up and leave the bar in place for 6 months. It's said to be one of the most painful surgeries you can have. Pain medication use from such patients backs that up. Except when doctors stopped telling their patients it was going to be the most painful thing in their life, then pain medication use dropped to normal after-surgery usage. In other words, it's all in your mind. If you expected it to be painful you'll amplify any pain signals to make it painful. If you don't think it'll hurt much then you'll suppress most of the pain signals. Learning to self-manage your pain through thinking is one of the easiest types of self-hypnosis and the most effective use of placebos.
Taking meds to deal with pain should never be your first choice. If people can dissociate away their pain enough to handle invasive surgery without being put under, and they can, you can learn to manage after-surgery pain without getting high. It's best to learn these skills before you need them.
(Score: 2) by NewNic on Monday June 18 2018, @08:58PM (1 child)
That depends on how often and how many times an individual receives a prescription for opiates. It would not be reasonable for almost every person in the USA to receive one prescription of opiates per year.
lib·er·tar·i·an·ism ˌlibərˈterēənizəm/ noun: Magical thinking that useful idiots mistake for serious political theory
(Score: 3, Insightful) by VLM on Monday June 18 2018, @09:39PM
Arithmetic being a revolutionary act, lets commit some treason...
Lets say the average bastard lives 100 years to make the math easy, so thats 620 billion pills manufactured per lifetime. That seems a lot, but hold on... Google says the USA population in 2017 was 325.7M people no idea if that counts illegal invaders don't matter lets call it 333.333333 million to make the math easy and assume the population is constant at that number. That seems to be 1.8Kpills per lifetime which seems a lot. However, I took four pills per day for taking all my wisdom teeth out at once, and it hurt like hell just my bad luck, so I'd guess dying of cancer or having a broken back would take... I donno, ten pills per day. That's an average of half a year of pill use per lifetime? And I'm already three days into my lifetime allocation because of my wisdom teeth? I donno this doesn't sound very unreasonable at all. How many years can someone live with arthritis, like ... 99 years or so at a somewhat reduced dose? I mean not every gets it, and not everyone needs pills every day, but ... similar math argument is I'm allocated half a year of painkillers per lifetime at present rate of production/consumption... now what if I get painful terminal cancer that takes more than six months to croak, that would suck. My mother in law had her gallbladder out maybe a decade ago, she was in some pain for awhile before and after. Of her lifetime allocation of 6 months pain meds, she's only got like 5 1/2 months left, hope she doesn't get painful cancer or something.
I'm just sayin, for innumerate people 6.2B is a meaningless number that sounds impressive, but when you do some treasonous math to hack the establishment message, all it really means is the average terminal cancer patient gets a couple months of pain pills. There really is NOT that much med use going on out there. Or rephrased, all the hell that's being raised due to pills is due to a really small amount of (mis) use.
(Score: 2) by NewNic on Monday June 18 2018, @08:53PM
Can I suggest that someone has put up a website that might help you with your research. It's been up and usable for a little while now. It's called Google. [google.com]
The information is out there, if you are actually interested in facts.
lib·er·tar·i·an·ism ˌlibərˈterēənizəm/ noun: Magical thinking that useful idiots mistake for serious political theory
(Score: 2) by DannyB on Monday June 18 2018, @05:45PM (8 children)
I have a legitimate medical problem. (ain't arthritis fun) I started hydrocodone about ten years ago. I went to my Dr and explained how I had an episode where I was in such intense pain that lasted so long, I almost went to the ER.
She gave me the hydrocodone.
I firmly stated that I didn't want to get addicted to narcotics. I have a great life and I don't want to screw it up. She explained that it was unlikely I would get even dependent let alone addicted. I don't even want to develop a tolerance, and I don't think I have one. I can't remember when I last took any, but I think it was last December. She would monitor how often I refill, and it's not very often. It's been almost ten years now.
I often take between 1000 and 2000 mg of acetaminophen per day, plus prescription NSAIDs. And other drugs to treat it. But there are some days when that is not enough. I rarely reach for the narcotics, but when I do, I'm having a bad day.
When you have chronic pain, always looking for humor in things is helpful.
It is hard to believe there is an opioid crisis. But I do, in fact, believe it. I just cannot understand WHY. It's a tool. A great tool. When I need it, I use it. When I don't need it, I don't use it. When I need it, I always want it to work, and not developing a tolerance is key to that.
But then, I've never understood alcoholism either. And I don't drink. Maybe a glass of wine, once in a great long while every one or two years. But basically none.
I cannot give up control of my intellect. I don't know why anyone would.
One thing British schools lack that American schools have is active shooter drills so we are prepared.
(Score: 3, Informative) by HiThere on Monday June 18 2018, @06:00PM (4 children)
The thing is, even low level use is bad if it's chronic rather than episodic, as you are describing.
You seem to be handling the drugs in the correct way: Occasional use for unusual events. When used that way opioids currently look relatively safe. But if the label said "No more than one a day for pain" and you interpreted it at "take one a day for pain" things would quickly go downhill.
Javascript is what you use to allow unknown third parties to run software you have no idea about on your computer.
(Score: 2) by frojack on Monday June 18 2018, @06:28PM (2 children)
The label almost always says Take (X) per (period) AS NEEDED for pain. Often there is a DNE restriction as well as a refill restriction as well.
After they chainsawed my chest (triple cabbage) They gave me a prescription for 60 doses with the above language.
I still have 59 left 4 years later. I told the doctor I was more afraid of the pills than the pain. He that was a healthy fear.
People make choices.
No, you are mistaken. I've always had this sig.
(Score: 2) by DannyB on Monday June 18 2018, @07:23PM
Hit the nail on the head! That describes how I feel exactly!
Years ago, the doctor who gives me hydrocodone also gave me a one time oxycodone with NO acetaminophen -- in case I was every already maxed out on acetaminophen but still needed relief. I have 28 of the original 30 left, and I've had that bottle for years.
One thing British schools lack that American schools have is active shooter drills so we are prepared.
(Score: 3, Interesting) by requerdanos on Tuesday June 19 2018, @12:50AM
When I underwent the same procedure in 2010*, I went home with a prescription for Darvocet, which was later removed from the market [wikipedia.org] in part because it often causes heart problems. So you were definitely on to something.
It was months before I could sleep in a bed again because of pain (couldn't lie down--the stress on my chest hurt too badly to sleep; I slept in a reclining chair), but I made it through, no problem, and now I'm fine.
* I had three coronary artery blockages which I understand were bypassed with two additional blood sources, one from my mammary artery, and the other from a vein from my left leg that was grafted onto my aorta at one end. Awesome, cool scars from that.
(Score: 3, Informative) by DannyB on Monday June 18 2018, @07:19PM
It says: take 1 or 2 tablets by mouth every 4 hours as needed for pain.
Only two times have I ever worked up to 2 tablets in what I would describe as one dose. (Over a period of about 90 minutes, working up to 2 tablets.)
Only a few times traveling (most often Disney World) have I ever had 3 tablets in a single day (over multiple doses).
My doctors both know why and how I use it, and they know how infrequently I refill. When I asked, they have expressed that they do not have any concerns I am getting myself into any trouble. If you know more about my condition it would be easy to believe that I might use narcotic pain killers.
A couple years ago there were several kidney stone episodes. That pain was different. It was extremely focused and persistent by comparison. More intense, but not always, surprisingly. I was not accustomed to having that much pain in a different place. On 3rd trip to ER they asked if I needed any more narcotics: "no thanks, I've got plenty". I did not like the oxycodone they gave me and have no intention of ever finishing it.
One thing British schools lack that American schools have is active shooter drills so we are prepared.
(Score: 4, Insightful) by Thexalon on Monday June 18 2018, @07:11PM (2 children)
Part of the story is that your life is otherwise great. Numerous experiments have suggested that if your life is great, you're less likely to foul it up and more likely to be able to shake any addiction you develop.
So part of the story for opioids is that there are a lot of people whose life totally sucks right now, and despite the dangers heroin offers them an out.
The only thing that stops a bad guy with a compiler is a good guy with a compiler.
(Score: 2) by DannyB on Monday June 18 2018, @07:27PM
That might have something to do with it. I say I have a great life -- despite the chronic pain. But I overlook the pain. By every other measure I have a great life.
Part of it is that my intellect knows that I could take pills for even lesser amounts of pain -- and it would work great! For a while. But only for a while.
One thing British schools lack that American schools have is active shooter drills so we are prepared.
(Score: 0) by Anonymous Coward on Tuesday June 19 2018, @05:54AM
If one's life is bad, clearly the best thing to do is make it even worse by using drugs. How logical. Clearly, we're dealing with inferior beings here.
(Score: 2) by MichaelDavidCrawford on Monday June 18 2018, @05:36PM
In response to one of my posts about my mental illness and my work.
I have every reason to believe that he really did have a thirst for knowledge, yet he simply could not make it through his day without shooting up.
Yes I Have No Bananas. [gofundme.com]
(Score: 2) by aim on Tuesday June 19 2018, @07:00AM
Not just the school system, which seems to be configured mostly to provide cannon fodder to the armed forces. This is also a dire indictement of the healthcare system in the US. People wouldn't throw in opiates for pretty much any reason if they had better access to decent medical care.
"Obamacare" was a baby step in the right direction, severely hobbled by the republicans in house and congress. You USians need to have a serious look at how things work over at your still-more-or-less-allies (not much longer if Trump continues as-is) in Western Europe. And no, I don't mean the british NHS. Even a look at Cuba might be inspiring.