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Old 29 August 2017, 04:37 PM
erwins's Avatar
erwins erwins is offline
Join Date: 04 April 2006
Location: Portland, OR
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Icon86 Fact checking the opioid epidemic

I am interested in understanding what is fact, what is fiction, what is spin, and what is media hype about the opioid epidemic.

There are aspects of what is being reported that remind me of the whole "crack baby" hysteria.

I've sought out some articles, but, for example, on the federal HHS site, there are articles that seem to me to lump relatively unrelated things together as part of the same statistic, which makes the statistics less useful to me, and also makes the site seem less trustworthy to me.

For example, it listed a number for something like how many people abused a prescription drug in 2015. The number included people who had taken prescribed medication for a nonmedical reason, and people who had taken a prescription drug that was not prescribed to them. While both are undesirable, the details of the latter could often have little to do with what is commonly thought of as drug abuse.

Other articles cite percentage increases in deaths over 30 years without giving the actual numbers, or providing the death *rate*. Looking up the numbers for the actual death rates, it looks like there has been a potentially large increase in the death rate from heroin in the past 4 years, and much smaller changes in the death rates from prescription opioids.

Anyway, I am hoping that there can be some discussion of the data and the reporting, and some serious Snopesing about what is true, what is hype and ideologically-driven spin, and what is still to be proven, etc.
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Old 29 August 2017, 05:43 PM
Die Capacitrix's Avatar
Die Capacitrix Die Capacitrix is offline
Join Date: 03 January 2005
Location: Kanton Luzern, Switzerland
Posts: 3,356

From this article
Because his staff covers one-fifth of Ohio, he estimates that the state will see 10,000 overdoses by the end of 2017 — more than were recorded in the entire United States in 1990.
Just overdose numbers, but nothing about whether the drug was prescribed or not.

Same soundbites, different article.

More blowing it out of proportion? In opioid crisis, a new risk for police: accidental overdose

Interestingly enough the opioid epidemic isn't getting a lot of coverage here. I mentioned something to my coworkers about an article I read about the epidemic, and most hadn't heard anything about nor did they know, or ever knew, any users, as it seems to be less common here. At least in small town Switzerland, especially after the cleaning up the needle parks in cities such as Zurich. There are users, but they seem to be better taken care of, and maybe they aren't getting the high octane stuff here.
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Old 29 August 2017, 06:06 PM
overyonder overyonder is offline
Join Date: 03 March 2010
Location: Charlotte, NC
Posts: 2,127

This is a start, I think.

While I know this will sound very incidental and non-scientific, and it is, here are some of the events that have happened to me:

- I had to let go a cleaning lady because she had gotten into my medicine cabinet for stealing Oxycontin. She also did the same at a friend's place.
- I had a chat with an acquaintance at a bar where she worked, and she was discussing how many Oxycontin she took that week-end along with some booze.
- I had a coworker that asked me for leftover pain (opioid-based) medicine after I had knee surgery (he got none).

By appearances alone... there's a lot of people using that stuff.

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Old 29 August 2017, 06:14 PM
jimmy101_again jimmy101_again is offline
Join Date: 29 December 2005
Location: Greenwood, IN
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There is no doubt some hype in the "opioid crisis", but that is pretty much always the case when there is a big push to change an entrenched system.

There is certainly lots of evidence that the number of pills being sold is way out of proportion to any reasonable medical need.
As the number of deaths attributed to overdoses on legal opioid painkillers have quadrupled since 1999 in the US, pharmaceutical distributors have been quietly stocking pharmacy shelves with these pills in areas where addiction is the highest.
Nine million pills over two years to one pharmacy, that averages out to the one pharmacy selling more than 12,000 pills a day.
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Old 29 August 2017, 06:32 PM
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Dr. Winston O'Boogie Dr. Winston O'Boogie is offline
Join Date: 23 February 2000
Location: Fox Lake, IL
Posts: 5,256

[ slight hijack ] A few weeks ago, the Chicago Tribune had an editorial about our first Opioid epidemic. The late 1800s saw the invention of the hypodermic needle, and...
An enthusiastic medical profession began injecting morphine on a vast scale for all manner of aches and pains, much the way that a more recent generation of doctors began prescribing Oxycontin and other legal drugs in a reaction against widespread undertreatment of pain. Wounded veterans became addicts, but so, too, did people suffering from arthritis. Women also became addicts en masse, thanks to the practice of treating menstrual cramps or for that matter, any female complaint of pain with injections of morphine.
Full article here

[ / slight hijack ]
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Old 29 August 2017, 08:02 PM
erwins's Avatar
erwins erwins is offline
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Location: Portland, OR
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Certainly lots of people are abusing these drugs, and that abuse is detrimental. What I'm wondering is, comparing apples to apples, and looking at meaningful measures, how much is the current state of things different from the past?

Which ties in with the comment about changing an entrenched system--it can't be that entrenched. It seems very cyclical to me. People get up in arms about high prescription rates and abuse of narcotic medicines. There are new restrictions put in place and pressure on doctors not to prescribe them. It becomes extremely difficult to get effective pain medication for people with severe pain. There is a push to make obtaining effective pain medication easier for those who need it. Rinse and repeat.

I am not suggesting that the very real issues connected with opioid abuse be ignored. I just want a better understanding of whether there is really anything that different happening on this particular pendulum swing.
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Old 29 August 2017, 09:21 PM
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thorny locust thorny locust is offline
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Ah. So you're not asking only whether there's been a surge in, say, overdose problems recently; but whether such surges have happened repeatedly historically, perhaps not involving the exact same versions of the drugs as the most recent one, but with an overall similar pattern.

That is an interesting question. I'd like to know the answer; but don't really have time to do the research. There have certainly recently been deaths in my area from overdoses, and they hit the paper, and there's lots of commotion about it -- but would they have hit the paper in 1950, or 1920, or 1890? and, even if well recorded, where would the records be?

It does seem to me that there's an essential tension between attempting to prevent people who would be harmed by such drugs from taking them, and allowing people in severe pain to have access to relief. There's sometimes such a tension in an individual case -- many drugs and other medical treatments, not only opoids, do both good and harm to the same person. I'd like to see it dealt with by the person affected and their doctors, not by the law; but of course not all doctors are dealing with it well, either.

ETA: The deaths in this area seem to in at least some cases to be caused, to some extent, by the fact that the drugs are illegal, and so are often adulterated and/or the user has no reliable way to tell how strong the dose is.

Last edited by thorny locust; 29 August 2017 at 09:29 PM.
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