The US Opioid Epidemic

[Nice Squirrel]

Okay, I've decided to rename this thread as most politicians are occupied with other things, and the president is uninterested in doing anything beyond lip service.

Let's start a conversation about this.

Last year we had over 60,000 die of overdoses.
https://www.nytimes.com/interactive...rdose-deaths-are-rising-faster-than-ever.html

Drug overdose deaths in 2016 most likely exceeded 59,000, the largest annual jump ever recorded in the United States, according to preliminary data compiled by The New York Times.

The death count is the latest consequence of an escalating public health crisis: opioid addiction, now made more deadly by an influx of illicitly manufactured fentanyl and similar drugs. Drug overdoses are now the leading cause of death among Americans under 50.

'

Now the FDA is asking to pull a drug off the market because it is too addictive.
http://www.nbcnews.com/storyline/am...y-pull-its-opioid-opana-because-abuse-n770121

“Today, the U.S. Food and Drug Administration requested that Endo Pharmaceuticals remove its opioid pain medication, reformulated Opana ER (oxymorphone hydrochloride), from the market,” the FDA said in a statement.

“After careful consideration, the agency is seeking removal based on its concern that the benefits of the drug may no longer outweigh its risks. This is the first time the agency has taken steps to remove a currently marketed opioid pain medication from sale due to the public health consequences of abuse.”

CBS News Opioid Epidemic page: http://www.cbsnews.com/opioid-epidemic/

 

[Nice Squirrel]

Opioid Crisis Now Leading Cause of Death for Americans Under 50: https://www.democracynow.org/2017/6/7/worst_epidemic_in_us_history_opioid

So how do we stop this?

 

[funinspace]

Opioid Crisis Now Leading Cause of Death for Americans Under 50: https://www.democracynow.org/2017/6/7/worst_epidemic_in_us_history_opioid

So how do we stop this?

Send the B-52's over Afghanistan and dump as much Napalm as we can on the poppy fields....

 

[Elixir]

Opioid Crisis Now Leading Cause of Death for Americans Under 50: https://www.democracynow.org/2017/6/7/worst_epidemic_in_us_history_opioid

So how do we stop this?

Send the B-52's over Afghanistan and dump as much Napalm as we can on the poppy fields....

Why not MOABs?
We have been providing some NARCAN kits to CBP et al, and you wouldn't even believe the kind of regs and scrutiny that has put us under. Almost as if someone "up there" wants people to die if they overdose on heroin or related drugs. Seems consistent with the administration's tacit policy to let the unfortunate suffer - invest nothing in protecting them from themselves, and pocket the savings.

 

[dismal]

Send the B-52's over Afghanistan and dump as much Napalm as we can on the poppy fields....

Why not MOABs?
We have been providing some NARCAN kits to CBP et al, and you wouldn't even believe the kind of regs and scrutiny that has put us under. Almost as if someone "up there" wants people to die if they overdose on heroin or related drugs. Seems consistent with the administration's tacit policy to let the unfortunate suffer - invest nothing in protecting them from themselves, and pocket the savings.

The administration that has been in power for the last 4 months? Or the administration that was in power in 2016 when those 60,000 people died?

 

[whichphilosophy]

Okay, I've decided to rename this thread as most politicians are occupied with other things, and the president is uninterested in doing anything beyond lip service.

Let's start a conversation about this.

Last year we had over 60,000 die of overdoses.
https://www.nytimes.com/interactive...rdose-deaths-are-rising-faster-than-ever.html

'

Now the FDA is asking to pull a drug off the market because it is too addictive.
http://www.nbcnews.com/storyline/am...y-pull-its-opioid-opana-because-abuse-n770121

“Today, the U.S. Food and Drug Administration requested that Endo Pharmaceuticals remove its opioid pain medication, reformulated Opana ER (oxymorphone hydrochloride), from the market,” the FDA said in a statement.

“After careful consideration, the agency is seeking removal based on its concern that the benefits of the drug may no longer outweigh its risks. This is the first time the agency has taken steps to remove a currently marketed opioid pain medication from sale due to the public health consequences of abuse.”

CBS News Opioid Epidemic page: http://www.cbsnews.com/opioid-epidemic/

Your correct, nobody is doing anything about it even though we've known for a number of years

Manufacturers should cease using opiates in pain killers where I am sure there are a lot of alternatives.

https://www.drugabuse.gov/about-nid...ion-to-opioids-heroin-prescription-drug-abuse

The abuse of and addiction to opioids such as heroin, morphine, and prescription pain relievers is a serious global problem that affects the health, social, and economic welfare of all societies. It is estimated that between 26.4 million and 36 million people abuse opioids worldwide,[1] with an estimated 2.1 million people in the United States suffering from substance use disorders related to prescription opioid pain relievers in 2012 and an estimated 467,000 addicted to heroin.[

 

[Elixir]

Why not MOABs?
We have been providing some NARCAN kits to CBP et al, and you wouldn't even believe the kind of regs and scrutiny that has put us under. Almost as if someone "up there" wants people to die if they overdose on heroin or related drugs. Seems consistent with the administration's tacit policy to let the unfortunate suffer - invest nothing in protecting them from themselves, and pocket the savings.

The administration that has been in power for the last 4 months? Or the administration that was in power in 2016 when those 60,000 people died?

Both. The main difference is that the current administration is acting in contradiction to - or is impotent to fulfill - its promise.
BTW, opioid-related deaths are up in 2017 so far...

 

[dismal]

The administration that has been in power for the last 4 months? Or the administration that was in power in 2016 when those 60,000 people died?

Both. The main difference is that the current administration is acting in contradiction to - or is impotent to fulfill - its promise.
BTW, opioid-related deaths are up in 2017 so far...

The data in the article you linked appears to stop at 2015 on my computer. Maybe there's something wrong with it.

But given recent trends it would be somewhat surprising if it did not go up some in 2017:

 

[braces_for_impact]

The way see it, there's a lot of blame to go around for this, and like most social problems, there's no easy answer. Doctors, pharma companies, insurance companies, and patients themselves should all claim their fair share of what's going on. Each industry would have to have a reformation and frankly, give up on some money because their current practices are harming patients. Unfortunately there's a lot of finger pointing going on by each of these groups, and no real changes taking place. The only change that has taken place (eliminating pill mills, new regulations for pain clinics, etc.) has been enacted by government, but there's little funding to make changes, and most on are on the state level.

There's also the matter of changing the circumstances of patient's lives. When your life sucks and you have nowhere to turn, a hit of opioids can make it feel like it's not so bad, and it helps you cope. Often, "addiction specialists" kick the crutches out from underneath you, and do nothing to help about your broken leg.

 

[southernhybrid]

Okay, I've decided to rename this thread as most politicians are occupied with other things, and the president is uninterested in doing anything beyond lip service.

Let's start a conversation about this.

Last year we had over 60,000 die of overdoses.
https://www.nytimes.com/interactive...rdose-deaths-are-rising-faster-than-ever.html

'

Now the FDA is asking to pull a drug off the market because it is too addictive.
http://www.nbcnews.com/storyline/am...y-pull-its-opioid-opana-because-abuse-n770121



CBS News Opioid Epidemic page: http://www.cbsnews.com/opioid-epidemic/

Your correct, nobody is doing anything about it even though we've known for a number of years

Manufacturers should cease using opiates in pain killers where I am sure there are a lot of alternatives.

https://www.drugabuse.gov/about-nid...ion-to-opioids-heroin-prescription-drug-abuse

The abuse of and addiction to opioids such as heroin, morphine, and prescription pain relievers is a serious global problem that affects the health, social, and economic welfare of all societies. It is estimated that between 26.4 million and 36 million people abuse opioids worldwide,[1] with an estimated 2.1 million people in the United States suffering from substance use disorders related to prescription opioid pain relievers in 2012 and an estimated 467,000 addicted to heroin.[

Unfortunately, there are not currently any drugs other than opiates that are effective in treating moderate to severe acute or chronic pain. I have worked as a health care professional for over forty years and there are many people, primarily older adults, that suffer greatly from chronic pain. Currently the few other drugs like NSAIDS, which are sometimes effective in treating inflammatory diseases, have their own set of severe side effects if used on a regular basis. They can cause severe GI bleeds as well as renal failure. I personally know of a truck drive that died of liver failure from taking acetaminophen ( tylenol ) for chronic back pain. Drugs such as gabapentin are sometimes effective in treating neuropathy, but they also have a lot of side effects, and they aren't always effective. I've read books on pain control and experienced severe pain myself. Narcotic pain killers were the only thing that helped me. Fortunately my severe pain was acute and I only needed these drugs for a short period of time.

My biggest concern is that those who need these drugs the most, including about five of my current patients, will not have access to them due to increasingly draconian regulations, which haven't been effective in reducing the misuse of these drugs. These regulations which include physicians no longer be able to write refills for any of these control drugs, have caused a lot of hardship for these folks.

I think the addiction problem is probably a lot more complicated than some seem to think. It may be partially due to many nonrelated societal problems. Making it harder for people to obtain legally written pain Rxs. is not going to fix this problem. Drugs like fentanyl are now being illegally manufactured and obtained in countries like China, for example. I don't know what the solution is to this problem but I'm very sure that the answer isn't to deprive those who need these drugs the most from living more comfortable lives.

 

[Elixir]

When your life sucks and you have nowhere to turn, a hit of opioids can make it feel like it's not so bad, and it helps you cope.

Opioids make me sick. I have bottles of accumulated painkillers that I've been prescribed and have either never taken or have only taken one or two out of the bottle. Most came from dentists. But as an example, I had some hip pain past year and couldn't see my primary care doc. Got in to see his PA instead. She gave me the referral to PT that I wanted, and a prescription for Vicodin. I filled the prescription... the bottle seemed to be a bit large, but that's nothing unusual, But then I opened it - she had given me THIRTY pills! I took 1½ of them over the next 2 days, then went to ibuprofen. The rest remain in a bottle in a drawer, awaiting the rueful day when I experience pain that is more unpleasant than what that shit does to me.

IMHO there's no excuse for handing out THIRTY Vicodin for someone's pain coming from an un-diagnosed source.

 

[LordKiran]

When your life sucks and you have nowhere to turn, a hit of opioids can make it feel like it's not so bad, and it helps you cope.

Opioids make me sick. I have bottles of accumulated painkillers that I've been prescribed and have either never taken or have only taken one or two out of the bottle. Most came from dentists. But as an example, I had some hip pain past year and couldn't see my primary care doc. Got in to see his PA instead. She gave me the referral to PT that I wanted, and a prescription for Vicodin. I filled the prescription... the bottle seemed to be a bit large, but that's nothing unusual, But then I opened it - she had given me THIRTY pills! I took 1½ of them over the next 2 days, then went to ibuprofen. The rest remain in a bottle in a drawer, awaiting the rueful day when I experience pain that is more unpleasant than what that shit does to me.

IMHO there's no excuse for handing out THIRTY Vicodin for someone's pain coming from an un-diagnosed source.

I'm the same way and have to wonder how much of it is doctors not ensuring that their patients can't go hog wild on what they hand out. Perhaps instead of handing them out in one lump sum, there could be a delivery service which supplies them 2-4 at a time?

 

[whichphilosophy]

Opioid Crisis Now Leading Cause of Death for Americans Under 50: https://www.democracynow.org/2017/6/7/worst_epidemic_in_us_history_opioid

So how do we stop this?

Send the B-52's over Afghanistan and dump as much Napalm as we can on the poppy fields....

The problem is we should be targeting prescription drugs for alternatives

 

[Elixir]

Send the B-52's over Afghanistan and dump as much Napalm as we can on the poppy fields....

The problem is we should be targeting prescription drugs for alternatives

No Captain Obvious Award for that one, WP. A more opaque post would be hard to find. What do you mean by "targeting" and "alternatives"?

 

[funinspace]

Humor/sarcasm fail...

Send the B-52's over Afghanistan and dump as much Napalm as we can on the poppy fields....

The problem is we should be targeting prescription drugs for alternatives

So you want the US Air Force to bomb pharmaceutical companies...well that makes about as much sense as much of what you write.

 

[funinspace]

Opioids make me sick. I have bottles of accumulated painkillers that I've been prescribed and have either never taken or have only taken one or two out of the bottle. Most came from dentists. But as an example, I had some hip pain past year and couldn't see my primary care doc. Got in to see his PA instead. She gave me the referral to PT that I wanted, and a prescription for Vicodin. I filled the prescription... the bottle seemed to be a bit large, but that's nothing unusual, But then I opened it - she had given me THIRTY pills! I took 1½ of them over the next 2 days, then went to ibuprofen. The rest remain in a bottle in a drawer, awaiting the rueful day when I experience pain that is more unpleasant than what that shit does to me.

IMHO there's no excuse for handing out THIRTY Vicodin for someone's pain coming from an un-diagnosed source.

I'm the same way and have to wonder how much of it is doctors not ensuring that their patients can't go hog wild on what they hand out. Perhaps instead of handing them out in one lump sum, there could be a delivery service which supplies them 2-4 at a time?

I was given a 7-10 day supply of Vicodin and something else, one time when I had a nasty bout of vertigo...guess I had a stingy doctor. Didn't like either drug, but I did need them for 3ish days.

 

[Deepak]

Doctors, pharma companies, insurance companies, and patients themselves should all claim their fair share of what's going on.

I would say Pharmaceutical manufacturers bear the lion's share (Purdue Pharma especially), then doctors, then patients - but I'm not really sure how much blame should go to insurance companies. I think the ideal case is that insurance companies don't interfere with the specifics of the treatment plan a doctor recommends for their patient, and if anything they're incentivized to not pay for a prescription.

 

[Elixir]

The problem is we should be targeting prescription drugs for alternatives

So you want the US Air Force to bomb pharmaceutical companies...well that makes about as much sense as much of what you write.

Now that I think about it... it makes more sense (assuming your translation is accurate) than most WP screeds.

 

[whichphilosophy]

The problem is we should be targeting prescription drugs for alternatives

No Captain Obvious Award for that one, WP. A more opaque post would be hard to find. What do you mean by "targeting" and "alternatives"?

We can't leave patients in pain because opiates have long term effects but must see what alternatives can be researched into.

There are still a lot of alternatives to be looked into and more rigid controls on testing but the WHO report on acupuncture may be of interest

http://www.evidencebasedacupuncture.org/who-official-position/

In the UK Acupuncture is under the British Medical Association (The British Medical Acupuncture Society)

http://www.medical-acupuncture.co.uk/

The BMA own report can be found here

http://web.bma.org.uk/pressrel.nsf/...0083a901e4c072498025692100346d5e?OpenDocument

The BMA has commented that more research is required but many people use this as an alternative to medication.

 

[whichphilosophy]

The problem is we should be targeting prescription drugs for alternatives

So you want the US Air Force to bomb pharmaceutical companies...well that makes about as much sense as much of what you write.

We can't bomb them; it'll cause too much damage in the surrounding areas.