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posted by martyb on Monday June 18 2018, @03:39PM   Printer-friendly
from the addiction-sucks dept.

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.


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  • (Score: 3, Interesting) by Runaway1956 on Monday June 18 2018, @05:33PM (8 children)

    by Runaway1956 (2926) Subscriber Badge on Monday June 18 2018, @05:33PM (#694595) Journal

    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

    In 2016, 6.2 billion hydrocodone pills were distributed nationwide.

    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.

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  • (Score: 2) by frojack on Monday June 18 2018, @06:13PM

    by frojack (1554) on Monday June 18 2018, @06:13PM (#694619) Journal

    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)

    by VLM (445) on Monday June 18 2018, @06:59PM (#694643)

    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)

      by hendrikboom (1125) Subscriber Badge on Monday June 18 2018, @08:41PM (#694700) Homepage Journal

      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)

        by VLM (445) on Monday June 18 2018, @08:57PM (#694706)

        It sufficed.

        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

          by Anonymous Coward on Monday June 18 2018, @11:14PM (#694737)

          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)

      by NewNic (6420) on Monday June 18 2018, @08:58PM (#694708) Journal

      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.

      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

        by VLM (445) on Monday June 18 2018, @09:39PM (#694718)

        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

    by NewNic (6420) on Monday June 18 2018, @08:53PM (#694704) Journal

    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 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