The Pain Refugees: The forgotten victims of America’s opioid crisis
harpers.org
harpers.org
Back in the 1980s, people were severely under-treated for pain. Things changed and being on opioids long-term was OK in certain circumstances. Now we've come full circle and people in pain are being denied effective treatments, all in the name of moral panic.
Rinse...and repeat.
A moral panic is exactly what this is.
Meanwhile, nearly a million people die in the USA every single year from obesity, dietary choices, and lifestyle decisions leading to heart disease, diabetes, etc, which is a very real and preventable crisis.
I think "moral panic" implies "nothing is wrong, but are all panicking anyway."
Something is clearly wrong. And those pills are coming from somewhere.
It seems like the true panic is over finding the right balance, if that's even possible.
Not sure, but if you're suggesting these are from legal prescription pain pills, please read the article and look at CDC data. You'll note that most opiate deaths aren't from pills, but from illegal heroin, fentanyl, and carfentanyl. Pain pill prescriptions are down 40% the past 5 years, even as opiate deaths are up 40%.
40% drop on one hand and 40% rise on the other... ah reckon thar maht be a connection!
Are their pill mills out there? Yes, and the DEA should shut them down.
But should we be undertreating real pain in order to “do something” about opioid deaths? He’ll no.
"A study of young, urban injection drug users interviewed in 2008 and 2009 found that 86 percent had used opioid pain relievers nonmedically prior to using heroin, and their initiation into nonmedical use was characterized by three main sources of opioids: family, friends, or personal prescriptions (Lankenau et al., 2012). This rate represents a shift from historical trends. Of people entering treatment for heroin addiction who began abusing opioids in the 1960s, more than 80 percent started with heroin. Of those who began abusing opioids in the 2000s, 75 percent reported that their first opioid was a prescription drug (Cicero et al., 2014)."
https://www.drugabuse.gov/publications/research-reports/rela...
That doesn’t mean you should be denying pain medication to people who need it.
What about causality? Confounding? Multivariate analysis? Nah?
You'll just assume they're causally related?
By the way, I rounded off the second of those numbers from 37% to 40%. Does that change the conclusion you reached using your statistical system? If not, what would be the threshold percentage at which you would determine there to be no direct inverse relationship between the two, after all?
A moral panic is a feeling of fear spread among a large number of people that some evil threatens the well-being of society.
In the 1960s, benzodiazepines were widely prescribed for the routine treatment of anxiety and insomnia. Eventually, we realised that they were highly addictive and extremely dangerous, so we stopped prescribing them except as a short-term treatment for acute and severe episodes. Some patients remained addicted for years or decades; many died as a result.
I'd really like history to stop repeating itself. I have a horrible suspicion that it won't.
It was commonly seen in homes in the 1980s, successor to meprobamate of the 1960s.
Both of these are technical problems.
As for where it's more desirable to be on the cycle, in a climate of skepticism you can at least argue strenuously that you really, really need it. You can improve your own situation, by your own power. In a climate of liberalism we just have to hope that someone will notice and intervene on behalf of someone killing himself with drugs. One of these climates will result in an excess of pain; the other will result in an excess of death. Since neither is desirable, I suggest you focus on technical solutions rather than rabble-rousing to advance the cycle.
This has never really not been true. E.g. the IOM's current recommendation is for easier access to pain medication, including opioids:
https://www.nap.edu/catalog/13172/relieving-pain-in-america-...
An absolutely chilling ending to a great read. It brings to light serious problems in how society is handling cracking down on opioid addiction, but also there aren’t many solutions available.
Properly funding mental health and rehabilitation services would be a start.
Disclaimer: I work for Eaze.
For those who haven’t yet heard of it, kratom (variously pronounced “KRAY-tum”, “KRAT-um”, and “kra-TOME”) is a southeast Asian tree in the coffee family, whose leaves are chewed or ground into powder and swallowed in capsules or brewed into tea; it acts as an atypical opioid agonist, which appears to be less addictive and significantly less dangerous than traditional opioids, while offering comparable pain relief. The DEA and FDA have been making moves toward banning it for a few years now, lacking both sufficient evidence that it’s dangerous, and sufficient research to confirm the considerable anecdotal evidence that it’s safe and useful as a mild natural remedy for pain, anxiety and depression, and addiction—particularly opioid withdrawal.
So I hope cannabis legalisation continues to proceed and that kratom achieves secure legal status so that it can be used directly, as well as studied and used to produce derivatives, for safer and less addictive pain management.
Thousands of people claim that it has saved their lives from opioid addiction and pain. Personally, I’ve found it useful for my minor chronic pain, but it truly gave me my life back from alcoholism by greatly reducing my desire to drink. I fear that if it’s banned, it will result in needless deaths and further worsen the opioid crisis.
They couldn't care less about bad PR because their patents are a massive barrier to entry and they're pretty much the only ones hiring highly educated biologists outside of academia and medicine.
Some pharmaceutical manufacturers have made billions of dollars from oxycodone, hydrocodone and other synthetic opioid drugs. They used bad science, deception and outright criminality to flood the United States with powerful narcotics, sparking an epidemic of addiction. Nobody forced them to do it. Nobody asked them to do it. They should bear the consequences of their actions.
[1]https://www.nytimes.com/2007/05/10/business/11drug-web.html
[2]https://www.bloomberg.com/news/articles/2017-10-26/insys-the...
[3]https://www.justice.gov/opa/pr/mckesson-agrees-pay-record-15...