What’s really causing the prescription drug crisis?

Moreover, certain types of marijuana do a superlative good job of providing non-opiod relief from chronic pain and aren't psychoactive, so in the same way you or a co-worker might have some Tylenol if they're feeling physical pain while at the office, you or a co-worker could use marijuana to manage chronic pain, without their mental state being noticably altered.

That's not to say marijuana cannot be abused nor is it a silver bullet, but in the middle of an opioid epidemic, holy shit, maybe something many people are illegally using to manage chronic pain without causing an epidemic; maybe it might be worth studying? The vast majority of users continue to be productive members of society; judging by the number of states that have legalized marijuana, we should be in the middle of a marijuana crisis compared to opioids, yet no such crisis exists. Yet the DEA classifies marijuana as having zero medical benefit, which makes it almost impossible, practically speaking, to study properly.

"an average of 1,826 fewer doses" is what percent?

This was almost my own reaction. I don't know how time and time again, blame goes everywhere but the providers and the system in place that ensures their almost sole authority.

It's puzzling to me how drug regulation persists in the face of examples like we have. The argument goes "oh, we need gatekeepers to protect citizen safety." But then these gatekeepers proceed to prohibit marijuana as a dangerous substance unsafe for any use, which is absurd, before turning around to recklessly prescribe oxycontin. How is the current prescribing monopoly / regulation regime really keeping people safe? To me, it's only resulted in lack of competition in health care provision, a militaristic police force, a lack of hemp, and an epidemic of narcotic addiction that benefits doctors and hospitals. A physician-police-industrial complex.

If anything, it increases the dangers, because it creates the illusion of safety and shifts responsibility onto a concentrated authority, who has their own agenda and interests that do not necessarily align with the long-term best interests of the citizen in need.

Replying to self long after the edit deadline passed: perhaps I should have mentioned that my experience is in Norway, not the US.

its mainly the acetaminophen (tylenol) that its cut with that would damage your liver the most. when people overdose on oxy, the biggest concern is the tylenol.

I'm not saying its great on the liver, but under normal dosage and (provided you dont have liver disease) its safe. about as safe as having a few beers at the bar at least.

> What do you mean they were turned into alcoholic by methadone?

Of the three alcoholics I mentioned, only one was (possibly/probably) triggered by methadone maintenance therapy.

Methadone is well-known to cause sugar cravings. This one started drinking heavily after about a month of methadone. She justified this as 'okay' because she wasn't driving.

Alcohol is just another form of fuel (derived from carbohydrates) for the body to burn. The alcoholic brain preferentially burns acetate (one of the breakdown products of ethanol):

https://www.jci.org/articles/view/65153 https://www.medicaldaily.com/heavy-drinking-alcohol-actually...

Apparently an old strategy for dealing with alcohol cravings is to feed them tons of sugar.

It's cheap in much of the US too. As little as $7 for a liter of 80 proof in my state (liquor regulation varies by state).

A liter of Smirnoff is $17.

Children and youth is a key part of the GP, the younger you are addicted to something the worse off you are in terms of quitting and the more damage it's doing. Drugs with significant brain damage accompanying heavy use (like alcohol) are also going to double-fuck you by adding the bonus challenge of doing so with lower IQ, executive control, etc.

While you're correct about availability, the rest of your statement is absurdly reductive as well as incorrect.

I agree with this statement. Especially if you look over a few thousand year timeline. Of course, the rate of technology has accelerated but also some of the earlier changes have been normalized though we still reel from them. Even the sense of community has been completely redefined (or minimized) by technology today, or the concept of society being focus on nuclear family only. Some are a direct result of technology, but some changes, like the concept of leisure time, come indirectly as we restructure our lives around this technology (capitalism and the industrial revolution).

Compare this to where we were 2,000 years ago or 10,000 years ago.

Probably. I suspect it is not a simple one but look at alcohol consumption patterns in Russia. On the other hand there are plenty of poor people in other countries who do not drink so there are probably cultural and climate influences too.

I read this recently:

Drug wholesalers shipped 780 million prescription painkillers to West Virginia over a six-year period. In a state of 1.84 million residents, the shipments amount to 433 pain pills for every man, woman and child in West Virginia.

http://www.nbcwashington.com/news/local/Drug-Wholesalers-Shi...

Although tablet formulations of diamorph also exist

>The doctors I work with who have done fellowships in USA state that oxycodone is (?was) given out like lollywater compared to hospitals here, where it is only prescribed if the patient has a REALLY good reason they can't have oral morphine.

My experience as a medical student on elective in the US was this - I couldn't believe the quantities of opiates prescribed cf. Australia

But people in UK do get oramorph, which is a liquid oral morphine.

> "For long term pain opioids don't treat the pain"

I imagine if you or someone very close to you had severe chronic pain your ill informed opinion would soon change.

This is an odd question, but for people with chronic and essentially untreatable pains (which is many people, particularly older ones): What is the problem with being addicted to opiates if you are going to take them to manage that pain for the rest of your life anyway? I would want the opiates at that point.

What's the better alternative?

Yes. Depends on a person, like in your case, also depends on dosage and tolerance, but being more outgoing, honest and speaking more is certainly possible as an effect of using opiates.

What opiates do is they simply make you feel good. They give you a feeling of enjoying yourself. They don't make you ecstatic (for most people), but they give you all the pleasant feelings you could get after - for example - running and winning a race, for free. How those feelings affect your actions differs from person to person.

Like most mind altering drugs the effects are relative to your personality and mood when you take them.

Yes. I am not commenting strictly in context of the article. But there are many documentaries stating that opiates are pushed to doctors.

Drug use is almost entirely victimless. This is well studied, researched, documented.

By definition a victimless crime involves consenting parties with no harm to outside parties. There can be situations where something does impact a non-consenting party, which is when it stops being victimless.