The prescription painkiller and heroin epidemic, explained

[Felonious Monk]

The prescription painkiller and heroin epidemic, explained

The drug epidemic currently tearing through large parts of the US began with the best intentions from doctors and a profit-driven campaign from pharmaceutical companies.

Back in the 1990s, doctors agreed — and most still do — that America has a serious pain problem: Tens of millions of Americans experienced debilitating pain, and it was left untreated. So they looked for a solution — and, fueled by a misleading marketing push from pharmaceutical companies, landed on opioid-based painkillers, widely known by brand names such as OxyContin, Percocet, and Vicodin. The drugs proliferated.

But this led to unintended, devastating results. Prescription painkiller abuse went up, and overdose deaths linked to the drugs did as well. Then as policymakers and doctors took notice of widespread painkiller abuse, they pulled back access to the drugs. But federal data now shows many of these addicts didn't just quit the drugs altogether — some instead moved to another opioid, heroin.

The result: In 2013, more than 16,200 deaths were linked to opioid painkillers, and another 8,200 were linked to heroin. That makes opioid painkillers the deadliest drug in America after tobacco and alcohol. And both painkillers and heroin made up more than half of all 44,000 drug overdose deaths, which now kill more people than AIDS did at the height of the HIV/AIDS epidemic in the 1990s.

It's a big public health crisis. And, surprisingly, policymakers are treating it as a public health crisis — whereas previous drug epidemics invited harsh tactics typical of the war on drugs, like increased prison sentences for drug possession, the current crisis is being handled as a problem that requires more access to treatment programs. That reflects not just the opioid epidemic's unique beginnings, but a general shift in how the country views the decades-old drug war.

Continued Here


I like how they claim the jump in heroin use/deaths was "unexpected." Yeah, to politicians and PP wonks unaware that the real world exists. I'm pretty sure even the CDC raised the alarm a few years ago, and users knew within a few months...

 

[belligerent drunk]

I like how at one point they say that even though they realize that the crackdown would cause people to turn to heroin and have a bigger chance of dying, it's ok, because the next generation will not be as addicted. I don't know if it's me, but what I heard in that paragraph was "yeah well, we messed up and this current 'generation' is addicted, but we'll let them die, because they're no good anyway and hope the next one turns out better".

 

[dopamimetic]

I believe that part of our generation these days has a deeply interconnected metabolic imbalance (?) leading overactivity of NMDA / glutamatergic neurotransmission, which then gives rise to numerous yet-hard-to-grasp mental illnesses - emotional hyper sensibility, physical / psychical hyperalgesia, with varying coping strategies between individuals which makes the symptoms vary so greatly.

It could be a genetic variation, or it could be due to an infection / inflammation in the CNS related to an over expression of quinolinic acid. This could explain part of the ADHD / addiction / depression / social anxiety / etc surges these days.

 

[manboychef]

That makes opioid painkillers the deadliest drug in America after tobacco and alcohol

This really stuck out at me. They should of left this out of the article....they just wanted to put the word deadliest in there.

 

[manboychef]

I believe that part of our generation these days has a deeply interconnected metabolic imbalance (?) leading overactivity of NMDA / glutamatergic neurotransmission, which then gives rise to numerous yet-hard-to-grasp mental illnesses - emotional hyper sensibility, physical / psychical hyperalgesia, with varying coping strategies between individuals which makes the symptoms vary so greatly.

It could be a genetic variation, or it could be due to an infection / inflammation in the CNS related to an over expression of quinolinic acid. This could explain part of the ADHD / addiction / depression / social anxiety / etc surges these days.

Actually, I think the rise in mental health problems is because we live in a system that is draining the life out of us. Think about the difference from the fifties till today. Mom could afford to take care of the kids without working, dad could afford a couple cars and a house without a college education. Now, even with a college education and constant hard work its a gamble at best if you can keep your head above water, let alone save for the future or plan a retirement. We live in an employer's market and because of deregulation and the fall of the union vacations and sick days are slowly vanishing as well.

These are anxiety causing situations that also contribute to depression.

 

[dopamimetic]

Yeah, this of course being a strong factor too... as well as the overabundance of information everywhere, society forcing one to be able to multitask between socialization, Facebook, hobbies, etc... ever-increasing thresholds where the next generation of anything (be it sports, education, whatever...) has to outmatch.. and depending on if you believe the theories or not, the surge of electromagnetic radiation could contribute it's own part too, leading to neurons who can not get to rest ever at all - a too high rise of too much input in too short time for the human being to adjust. Chronic stress and all that.

I'm really unsure about this, but I somewhat have the feeling that people get more and more stressed as the years pass ... more and more violent outbursts occur due to inability to cope with all the things etc ... less and less time is left for humanity and emotions ...

We're running head first into apocalypse with 900km/h It'll become interesting for sure. For these who happen to catch up.. but more and more people will fall under 'collateral damage' of ever-accelerating society..

 

[belligerent drunk]

Actually, I think the rise in mental health problems is because we live in a system that is draining the life out of us. Think about the difference from the fifties till today. Mom could afford to take care of the kids without working, dad could afford a couple cars and a house without a college education. Now, even with a college education and constant hard work its a gamble at best if you can keep your head above water, let alone save for the future or plan a retirement. We live in an employer's market and because of deregulation and the fall of the union vacations and sick days are slowly vanishing as well.

These are anxiety causing situations that also contribute to depression.

That is true and that's why I said "fuck that" and mostly forgot about the stuff that people think is important. I know I wouldn't be able to keep up with the rat race and eventually lose, so I decided to save myself from the needless stress and just do what I enjoy and am good at; aka get high and a couple other things.

 

[Burnt Offerings]

Back in the 1990s, doctors agreed — and most still do — that America has a serious pain problem: Tens of millions of Americans experienced debilitating pain, and it was left untreated. So they looked for a solution — and, fueled by a misleading marketing push from pharmaceutical companies, landed on opioid-based painkillers, widely known by brand names such as OxyContin, Percocet, and Vicodin. The drugs proliferated.

I think the story by this point is pretty widely known...new painkillers proliferated the market (most notably OxyContin), opioid addiction increased, the feds clamped down, addicts moved to heroin. Pretty simple. But I'm curious as to what the system was like re: pain management prior to the 1990's?

 

[cj]

I think the story by this point is pretty widely known...new painkillers proliferated the market (most notably OxyContin), opioid addiction increased, the feds clamped down, addicts moved to heroin. Pretty simple. But I'm curious as to what the system was like re: pain management prior to the 1990's?

My understanding is that there was no such thing as pain management as we would recognize it.

 

[Felonious Monk]

My understanding is that there was no such thing as pain management as we would recognize it.

That's my understanding as well. You simply did not receive ongoing opiate prescriptions if you were expected to live.

It was only in the early-90s (somewhat concurrent with the introduction of OxyContin in 1996) that the AMA recognized that non-cancer pain (and non-injury/surgery/etc) was bad enough to be treated with opiates. That was the major departure from past treatment.

My personal view is that this was an evolution and unintended consequence of the tightening of the War on Drugs in the 80s and 90s, preventing people with partial disabilities from accessing cannabis medicine and pushing them towards pharmaceutical options.

 

[SixBuckets]

That's my understanding as well. You simply did not receive ongoing opiate prescriptions if you were expected to live.

It was only in the early-90s (somewhat concurrent with the introduction of OxyContin in 1996) that the AMA recognized that non-cancer pain (and non-injury/surgery/etc) was bad enough to be treated with opiates. That was the major departure from past treatment.

My personal view is that this was an evolution and unintended consequence of the tightening of the War on Drugs in the 80s and 90s, preventing people with partial disabilities from accessing cannabis medicine and pushing them towards pharmaceutical options.

Chronic pain management as a discipline (at least, resembling what we know as pain management today) emerged in the 1940s, but treatment was mostly surgical from the 1940s - 1970s. That said, in the 1940s and earlier, a lot of medications/drugs that are now criminalised were freely available - they weren't explicitly prescribed for chronic pain, but they were easy to get your hands on if you had a chronic pain condition and found them effective.

 

[aerne210]

That is true and that's why I said "fuck that" and mostly forgot about the stuff that people think is important. I know I wouldn't be able to keep up with the rat race and eventually lose, so I decided to save myself from the needless stress and just do what I enjoy and am good at; aka get high and a couple other things.

Please tell me How top manager life like yours. What are the couple other things? How are you staying afloat?

 

[belligerent drunk]

I've found something that I enjoy doing which pays, not a lot, but just enough to "stay afloat".

 

[dopamimetic]

But what if the actual cause of the surge in hyperalgesia (physical as well as psychical) wouldn't be really related to opioid mechanisms but more to over excitatory glutamatergic effects by whatever cause - giving a link to ADHD, introverts / extroverts etc ...? (I know it is totally speculative of course.)

Then the pain killers would relieve the symptoms but cause a downward spiral by not treating the actual origin, leading to addiction, tolerance, even more hyperalgesia etc.

 

[Burnt Offerings]

Do people with ADHD complain of pain more than the general population?

 

[dopamimetic]

It could be that differently wired individuals get different symptoms from the same cause - the more sensible people getting hyperalgesia, depression, others getting ADHD like disorders, etc. and all sorts of mixed subtypes.

 

[belligerent drunk]

Dopamimetic, it's obvious that opioids don't treat the cause, only the symptoms. I don't think it's as simple as an overactive glutamatergic system either, but what do I know.

 

[manboychef]

Most of the problems we have with medications can be linked back to Big Pharma and how they lobby the government. IIRC oxycontin was purported to not cause addiction/dependence by purdue pharma. Basically, these huge pharmacy groups and manufactures have enough money to pass laws that effect how we as healthcare consumers are treated.

Anyone else remember the story of the young ceo of a company raising the price 1000% for a cancer med that is necessary "because his company needs to make a profit." then he was forced by public outcry to lower the prices. He is still making a profit, and it no doubt is still expensive, but this is only one situation that was remarkably transparent. There is a whole lot of this type of situation going on with big Pharma that is not transparent.

edit: sorry my sleeping meds haven't worn off yet and I don't think I am getting the point I want to make across. After I wake up more I will find a couple of articles to back this up.

 

[Burnt Offerings]

It is somewhat difficult to fathom how the pharmaceutical industry could claim that a drug like oxycodone had very little addiction potential, considering the fact that people have known of the addictive power of opiates for a loooooong time. I've also seen that now infamous promotional video that Purdue (IIRC?) put out marketing OxyContin to healthcare providers, and the claims they make about addiction/abuse potential. It's bizarre to look at in hindsight.

 

[dopamimetic]

Most of the problems we have with medications can be linked back to Big Pharma and how they lobby the government. IIRC oxycontin was purported to not cause addiction/dependence by purdue pharma. Basically, these huge pharmacy groups and manufactures have enough money to pass laws that effect how we as healthcare consumers are treated.

Anyone else remember the story of the young ceo of a company raising the price 1000% for a cancer med that is necessary "because his company needs to make a profit." then he was forced by public outcry to lower the prices. He is still making a profit, and it no doubt is still expensive, but this is only one situation that was remarkably transparent. There is a whole lot of this type of situation going on with big Pharma that is not transparent.

Oh yeah. Honestly, being a pacifist, I hate to think / say things like these but this guy should face jail time. They are psychopathic capitalists driving the world into apocalypse.