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Why Opioids are such an American Problem

CFC

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Mar 9, 2013
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Why opioids are such an American problem

When it comes to taking opioids, the United States has the dubious honour of leading the world.

For every one million Americans, almost 50,000 doses of opioids are taken every day. That's four times the rate in the UK.

There are often good reasons for taking opioids. Cancer patients use them for pain relief, as do patients recovering from surgery (codeine and morphine are opioids, for example).

But take too many and you have a problem. And America certainly has a problem.

In two years, the town of Kermit in West Virginia received almost nine million opioid pills, according to a congressional committee.

Just 400 people live in Kermit.

Nationally, opioids killed more than 33,000 people in 2015, according to the Centers for Disease Control and Prevention.

That figure includes deaths from heroin, an illegal opioid. But almost half involved a prescription opioid - that is, a painkiller available from a pharmacy with a note from a doctor.

So why does America - more than any country in the world - have an opioid problem?

There is more than one cause. But these are some of the most important.

American doctors prescribe - a lot

Unlike most European countries, the US does not have universal healthcare paid for by taxes.

Instead, Americans must get their own insurance - usually via an employer or the government.

"Most insurance, especially for poor people, won't pay for anything but a pill," says Professor Judith Feinberg from the West Virginia University School of Medicine.

"Say you have a patient that's 45 years old. They have lower back pain, you examine them, they have a muscle spasm.

"Really the best thing is physical therapy, but no one will pay for that. So doctors get very ready to pull out the prescription pad.

"Even if the insurance covers physical therapy, you probably need prior authorisation (from the insurer) - which is a lot of time and paperwork."

The CDC says opioid prescriptions have fallen by 18% from their peak in 2010. But the total is still three times higher than in 1999.


Read the rest here:

http://www.bbc.co.uk/news/world-us-canada-41701718
 
I'm so sick of these articles that miss the point. We work longer hours for worse pay and have little hope for the future. Opiods make that possible without wanting to kill yourself
 
America is rife with stress and misery. Judgement is all around and the best way to deal with any problem is to suck it up.

When hard work doesn't pay with either reverence or adequate compensation it's tantalizing to turn to something that offers the reward you've been looking for.
 
I'm so sick of these articles that miss the point. We work longer hours for worse pay and have little hope for the future. Opiods make that possible without wanting to kill yourself

Psychedelics allowed me to change my outlook and get past my selfish misery. As Americans we are incredibly self-absorbed and don't realize just how out of touch we are.

I don't expect you to agree but I certainly don't think opiates have been handled responsibly by medical professionals and this article sounded sensible to me.
 
Man, I hate to say this, but they nailed it with the pic. Anytime I saw a male in a white T-shirt with tattoos on the arm, I knew Id be heading for the narc safe. Usually had a snapback hat too.

I say this with love as I am not only a pharmacist but also an opioid lover.

Oh and fuck prior authorisation to hell.
 
/\ I think the problem has a lot more to do with the doctors and culture surrounding prescription pills, especially when it comes to getting drugs from a pharmacy. There are people that capiltalize on the over prescription of opioids and a culture has developed around that, but I doubt it is men in white t's with tattoos driving the culture so much as it is salesman in suits and doctors in lab coats.
 
I believe kratom is the answer to the (North)-American opioid problem
 
The only solution to the opioid problem is ending the war on drugs. Anything short of this will not make a serious dent in the problem. And frankly my opinion is that things are going to get worse on this front before they really improve in any truly meaningful way.

Opioid use is only a problem when society makes it a problem - there isn't anything inherently unhealthy or toxic about their use when used responsibly. However its really hard to use them responsibly when they're criminalized and demonized to the degree they are. Opioid use is unhealthy less because of anything inherent to opioids and really only because the environment we've created that people are forced to use them in is so incredibly draconian, stigmatized and unhealthy.

Other countries have demonstrated there is a better way to handle the opioid problem. Namely, allowing for safe, regulated access for anyone who genuinely needs them - and not only for people in extreme cases like cancer patients. There is a solution, but it's ending the war on drugs and engaging in some serious "social recovery" a la Bruce Alexander's work.

Opioids are going to continue to be a serious problem for as long as we treat opioid use as a public safety issue instead of a public health concern. End of story.
 
And actually I should have said "the only sustainable solution." Because there are actually lots of other "smaller" solutions that would help, such as decriminalizing person use, providing access to effective ORT programs, more needle exchanges, money for safe housing (not sober livings, but just low income housing), etc. But ultimately the solution must be an end to the war on drugs.
 
Opioid use is by no means only a societal problem. Criminalizing usage definitely does not improve the situation, but it could be problematic whether or not there at legal ramifications. The legality of a substance has little to nothing to do with the addictive potential of a substance.

Decriminalization and harm reduction and rehabilitative programs would be a suitable long term solution. Making opioids more available and easier to obtain is not a solution for someone struggling with an opioid use disorder.
 
North-America is waaaaaaaaaaaaaaaaaayyyyyyyyyyyyy behind Holland and Portugal.

They are still treating this as a criminal problem, which it isnt
 
Making opioids more available and easier to obtain is not a solution for someone struggling with an opioid use disorder.

If opioids were accessible and affordable, a great many of the people with "opioid use disorder" wouldn't have a "disorder" anymore because they would be able to live their lives with relative normalcy, just like people who, say, smoke cigarettes (whom we do not designate as having a "nicotine use disorder").
 
/\ I think the problem has a lot more to do with the doctors and culture surrounding prescription pills, especially when it comes to getting drugs from a pharmacy. There are people that capiltalize on the over prescription of opioids and a culture has developed around that, but I doubt it is men in white t's with tattoos driving the culture so much as it is salesman in suits and doctors in lab coats.

I know. Was more a commentary from the junkie side of me than the professional though.
 
If opioids were accessible and affordable, a great many of the people with "opioid use disorder" wouldn't have a "disorder" anymore because they would be able to live their lives with relative normalcy, just like people who, say, smoke cigarettes (whom we do not designate as having a "nicotine use disorder").

No one denies that cigarettes are addicting and have negative consequences. I've heard most every person who smokes cigarettes talk about how they should quit. The negative aspects of a nicotine habit/addiction/use disorder are largely due to the ROA. Even with the negative aspects people can still function near full capacity immediately after consuming a large amount of nicotine. Opioids are far more disruptive than nicotine and it has little to nothing to do with whether it is accepted socially or not.

Opioids are already widely available in the US... that's what the article is about, talking about how opioids are prescribed far more frequently in the US than anywhere else in the world, so they are already readily accessible, and for those who have health care assisting payment its pretty affordable when compared with those who are buying drugs on the street.

Again, opioids can cause cognitive, emotional and physical problems as well as financial and social problems. The fact that it's use is taboo has literally nothing to do with its potential for addiction.

A more accurate comparison would be alcohol. Look how many people suffer from an alcohol use disorder, yet alcohol is readily accessible, affordable and socially accepted.
 
We have an acceptability not an accessibility problem with opioids. Im pro legalization but the logistics of it make my head spin and while it would solve the purity problem, Mafioso is correct in that addiction would continue. I dont know the solution but think it starts with accepting some people want to use drugs so lets make that safe as possible.
 
Again, opioids can cause cognitive, emotional and physical problems as well as financial and social problems. The fact that it's use is taboo has literally nothing to do with its potential for addiction.

A more accurate comparison would be alcohol. Look how many people suffer from an alcohol use disorder, yet alcohol is readily accessible, affordable and socially accepted.

Alcohol addiction is far more damaging mentally and physically than opioid addiction (removed from any consequences of prohibition) is. I think tobacco is a better comparison, although of course, tobacco is still far more physically damaging.

I recommend that anyone interested in this topic read through The Consumers Union Report: Licit and Illicit Drugs (specifically Part I, although the entire tome is worth reading) for a thorough analysis of the effects of opioids on people addicted to them.
 
Alcohol addiction is far more damaging mentally and physically than opioid addiction (removed from any consequences of prohibition) is. I think tobacco is a better comparison, although of course, tobacco is still far more physically damaging.

I recommend that anyone interested in this topic read through The Consumers Union Report: Licit and Illicit Drugs (specifically Part I, although the entire tome is worth reading) for a thorough analysis of the effects of opioids on people addicted to them.

Alcohol is a much better comparison in terms of intoxication and social consequences due to intoxication. Yes alcohol may be more damaging to organs but that's not to say that opioids are harmless and have no physiological impact despite not being immediately neurotoxic. Physical dependence and receptor down regulation are very real physiological occurrences.

The main point of comparison was to demonstrate social consequences are not entirely related to legal status. Legal status can result in additional social consequences, but social consequences would still exist even if culturally accepted. People may not want to associate with an opiate user simply because the intoxication, not because the use of an illicit substance. Also, whether prescription or illicit, opioids can prevent a person from fulfilling social duties because of the physiological effects, unrelated to legal status. A person could get fired from a job because they are too high to function, not because they failed a drug test.
 
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I'm so sick of these articles that miss the point. We work longer hours for worse pay and have little hope for the future. Opiods make that possible without wanting to kill yourself

This.

You want to stop addiction? Fix society.

Even in a legalized world there would be addicts, but make life as bleak as possible and you create more addicts. Anything to escape the pain of living, short of killing oneself. Ever notice how these small industrial no-where towns have some of the highest addiction rates? Yeah... because who wants the best their life has to offer being some kind of factory that he whole town works at, if they're lucky.
 
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