I believe the real cause of this is lead exposure that happened while these people were very young and before birth. lead's been shown to damage part of the brain responsible for impulse control. Americans born from 1955 to 1995 were exposed to lead from auto exhaust. It has been fairly clearly shown that the elevated crime and teen pregnancy of the 1970s through 2000s resulted from this lead exposure (search Lead: America's real criminal element, or the lead-crime hypotheses). In the past, the 0-24 year olds were having the most overdoses, but in 2017 there were 4,137 of those, while every other age group was higher 25-34 had 13,181. 35-44 had 11,149. 45-54 had 10,207. 55+ had 8,877. It is obviously hitting the 24-55 the hardest...exactly the group that was exposed to the most lead.
I which this was more useful, but lead damage is permanent. All we can do is try to reduce the lead exposure of those being conceived and growing up now. That means getting lead out of old apartment buildings, stopping the use of leaded fuels in aviation gasoline, and banning the sale of lead bullets/shot, lead sinkers, athletic equipment, electronics/wires, makeup/hair dye, and new lead-acid starter batteries. We have already developed new fuels for aircraft. It was supposed to be fixed in 2018...but...Trump. 80% of lead smelting is for batteries. Lithium/capacitor batteries would last 3x longer. Mexico is making our lead batteries right over the boarder, belching the crud into our air.
1
When are the people of this country going to get it. Thanks to the government for inventing these drugs. They just created a super opioid and is now on the way to the drug stores. The government is to blame for a lot of the addiction and overdose's that we see on a daily basis. Buthey're not going to admit that. Wake up people and tell your State representative to push for the drug companies and scientist to STOP creating a bigger problem.
1
This war on opioids has turned into a war on pain patients. My daughter is a medical social worker and now daily has to deal with her clients being shut off of pain and anxiety meds due to draconian rules passed by state legislatures with no regard for human suffering.
Really is it necessary to shut off grandma's pain pills for arthritis which she has taken for the last 15 years? Is it really necessary to shut off a persons angiolytics anxiety meds so they no longer can leave their house because they are so gripped with fear and anxiety? Or do we shut off the COPD patient that uses narcotics to help their breathing?
Human suffering still exists no matter what the state legislature says and we as a country have forgotten all about human suffering if we don't luckily participate in it's crippling effects on our lives. What does my daughter say or do for these people when their own doctors have chosen to let the state dictate who gets help for their suffering and who doesn't.
Truly a sad state of affairs in our country and I don't see much hope as long as human suffering is not someone else's problem. A small amount of just common sense would be in order but that too seems to have been legislated away. Truly medicine needs to be left to medical professionals and not state legislatures known for their inhuman actions.
It's a national disgrace known only by those who are suffering.
1
That they need treatment is in itself stigma.
It really is mostly a matter of personal accountability.
I still think we're missing entire dimensions. But that's just me.
This and similar articles have pointed out that the opioid crisis is worse east of the Rockies than in the West. Higher death rates in the East are due to fentanyl distribution, as the article details. But non-fentanyl opioid abuse also seems more severe in the East.
I have lived all over the Northeast, east coast, prairie states, west coast, and now the Intermountain West. My (strictly anecdotal) observation is that people east of the divide drink more alcohol than in the west, and those in the west smoke more cannabis than Easterners.
The harder the drug, the more likely it is to become a gateway to even harder drugs. I'm just speculating, but maybe this suggests another reason why the opioid crisis hit the East harder than the West.
1
The DEA and the current administration is partly fuelling the fire by threatening doctors to restrict prescription opioid to chronic pain patients. Without cutting of the illegal fentanyl supply, these efforts will clearly escalate the severity of crisis as addicts move from legal opioid to illegal to stave of withdrawals. We clearly need a supply of legal opioids to meet the demand from chronic pain patients and addicts while treatment options are widely available.
2
88,0000 people die each year from alcohol abuse, why doesn’t anyone ever get upset about that? Why is drug overdose different? Each cause of death is due to the addiction which is looked down upon instead of addressed. How many die of obesity each year ? Until addiction is treated like any other medical condition, this will never improve.
1
According to the C.D.C. estimates, overdose deaths involving synthetic opioids rose sharply, while deaths from heroin, prescription opioid pills and methadone fell.
So why do we make legitimate doctors with authentic pain patients the boogey-man? When the statistics show that prescription pharmaceutical overdoses are down.
I think the NYTimes need to make clear to the reader that the so called Opiate Epidemic is an epidemic of street drug users who want to get high, and often purchase Fentanyl from China.
This blanket “War on Opiates” is hurting the Americans who are legitimately in pain, with horrendous medical conditions. Making it difficult for these patients to get relief and live somewhat of a normal life, because of the mostly young, daredevil high-seeking druggies—is cruel and unfair,
The NYTimes is disappointing me in taking this Cry Fire in a Movie Theater tactic.
Please let your readers know that the danger of overdosing on your prescription your doctor responsibly gives you for pain is really very low. And Opiates for these people is not the devil most of these articles make it out to be—but in many cases a medical lifesaver in every sense of the world. Please NYTimes try and present the other side of the story—and don’t contribute to the frenzy that is currently sweeping the country that Opiate Prescriptions for Pain is an evil epidemic.
1
My heart is broken. Truly broken. I lost my best friend on Saturday to heroin/street fentanyl. He was a fantastic bipolar man. My ex-neighbor. And ex-recovering drug addict. Unfortunately in our area drugs have recently become easily available so we assume he got his hands on it from a street dealer and it had fentynal in the heroin. Upper class, super educated, etc.
We lived in a Doorman building in Williamsburg Brooklyn. I was suppose to pick him up on Friday at 9 pm for dinner. I waited, went to the Apt, banged on his door - twice, but no news. I thought he was sleeping and had taken a sleeping pill. Saturday morning I got worried, went back to the old building and since I knew the people there.. Partner was in LA for work, got his number, he got in touch and building manager...I was the only person in NYC from his side, so I witnessed my best-friends body on the kitchen floor dead - for 4 hours. Followed by 20 other people from 6 different Departments come/go into the apartment with Awards (they are famous) and taking pictures as I was repeating the same story for hours. I showed them my texts and they ruled-me out. Their job is to try to piece together the story. His body is going to get cremated. Nothing will happen to the Dealer. His case will go in a pile bcuz there aren't enough detectives to investigate anymore. Lets be real. Rather than dying with respect, you get that treatment. Nevermind the autopsy and the rest. Tragic. Horrible.
I'm not particularly interested in leaving this world. And I'm not the sort of person to suggest that someone choose to leave this world. But I'm glad fentanyl is available. Guns are so messy.
2
Alcohol kills ~90,000. /yr, tobacco ~400,000/yr and they're legal. The u.s. has 5% of the worlds population using 60% of the drugs. There are a few people who need longterm narcotics, but not many. The question is, why do people feel the need to use this stuff? It's not a mystery what can happen. What empty hole could this poison possibly fill. I don't get it.
The CDC statistics are misleading. The 72,000 figure is the number of people who died in emergency facilities with narcotics in their bodies, NOT the number of deaths directly caused by drug overdoses.
If you have taken a single Percocet and die in a vehicle accident, your death will be reported as "drug related", even though drugs had nothing to do with your dying.
Recreational drug users often take two or more narcotics at the same time. Each drug is counted as an overdose death. The actual number of deaths directly caused by illegal narcotics is closer to a third of the CDC's reported count.
Statistics can be manipulated to say anything a clever researcher wants them to say.
No. Absolutely not so. Drug overdoses did not kill about 72,000 Americans last year.
Those 72,000 -- or double that number -- Americans killed themselves.
How many of them were driving while stoned? How many of them broke how many laws to keep getting stoned? How many of them are going to cost us billions more dollars in care and treatment, with nothing to show for it?
How big is this epidemic going to get? Are we going to become a nation of 20% addicts?
What a heartbreaking, shocking number of deaths. And I am surprised; didn't Donald Trump say he was going to take care of this problem?
We simply need another way to transfer money from the poor to the rich. We should simply hand all the benefits of our labor directly to the rich. That way they won't have to kill us with pollution and drugs to get our money.
Since Sandy Hook (2012) there have been 150 people killed in school shootings, or approximately 25 people killed annually at schools due to guns. Opioids kill 25 people every 8 hours. There were approximately 25 children who died at Sandy Hook. So, opioids have a Sandy Hook every 8 hours.
If we had 3 Sandy Hook's every single day, parents would not let their children attend school, or maybe even leave the house. But somehow, for some reason we just do not conceptualize death in this manner. It is as if we accept death by opioids as a personal choice, or an inevitable fact of life, and therefore much more palatable than say a Sandy Hook, to me, seems to say that the value of an individual human life is variable. This seems very Orwellian, and quite unnerving.
We band-aid another problem but maybe our escapes of drugs, screens or food are pointing to the inadequate structure of our culture. The biological and social needs of our species have been replaced by consumerism---and if we don't win the consumption game, we feel broken.
Today I chose to read the article, “Bleak New Estimates in Drug Epidemic: A Record 72,000 Overdose Deaths in 2017.” This has really interested me because drugs are severely affecting a major part of our population and this issue must be contained. A growing number are using opioids and the drugs are becoming more deadly, which is causing this outbreak of deaths.
I have no idea why this opiod epidemic occures in the USA and not in Europe, where exactly the same painkillers are used.
After I lead my men in Afghanistan (yes, I'm a loyal NATO ally) and my car was blown from under me, I now am in constant pain.
But, luckely there are Fentanyl patches that last 3 days and Oxycodone for the real bad days. My doctor prescribes them every month and my pharmacy fills that prescription without any fuss.
But, we have a central database with every patient's records and medication. So every doctor has your medical history in a mouse click and every pharmacist knows when you have had your last prescription filled, so abuse or doctor/pharmacy shopping is out of the question.
Last, but not least, in all my years of having to use those medication, I never experienced any form of high. The only noticable side effects for me are a loss of concentration (so no alcohol, otherwise you become a zomby) and a mild drowsyness. So I never felt the need to take anything if I was not in severe pain.
So I am addicted/dependant and my body would strongly object when I would go of those drugs. But Meanwhile, even in a wheelchasir, I now can still live a fullfilling life and care for my wife who has a braintumor.
2
My grandparents treated their aches and pains into old age with a shot of whiskey before bed each night and during the day if necessary.
It rejuvenated their spirit and we know now is good for their body and especially their brain.
We lived through most of human history without these opoids to disguise our pain which don't contribute to recovery and need to get back to that place again
2
My seven chronic conditions have been treated for 29 years without becoming addicted. The five highest states nationally of opioid deaths have their geographical center 350 miles from the DEA Headquarters in Washington D.C.. Now the errant policy since 2008 is being implemented nationwide. Everyone will suffer as i have since 2012, when the first of eight Pain Clinics closed with me as a patient.
In 2015, the DEA stopped distribution of Oxyconten to all pharmacies, probably in the D.C. Region of the DEA. West Virginia and other states denied dozens of Pain Clinic applications in 2015. Both these elements are believed to have caused the record opioid deaths of 2016!
All hope is lost!
As a neurologist who treats a number of chronic pain patients with narcotics (the majority suffering from 'failed back syndrome' after one or more 'failed' surgeries), it is dismaying that the well intentioned efforts to stem the overdose epidemic by limiting access to adequate pain relief will simply change who overdoses. The enormous pressure on physicians to stop prescribing narcotics along with an ever increasing number of hoops to jump through to get prescriptions approved has led many physicians to suddenly cut off chronic pain patients altogether or drastically reduce the amounts of narcotics they prescribe. I have to wonder how much of the increase in overdose deaths is due to such patients obtaining street drugs laced with fentanyl. I strongly warn my patients of this problem, citing how Prince died from fentanyl laced vicodin. I also warn them that fentanyl kills much more rapidly and requires much more naloxone to reverse than other narcotics. In much of Europe, medically supervised injection sites offer safer places for addicts and offer treatment on demand. Portugal reduced it's overdose deaths by 1/3 in the first year of instituting such programs. We need to learn from them, recognize that addiction is a chronic disease and medically manage it just as we do diabetes and heart disease.
1
A misused moral code has led to 72,000 deaths a year. Legalize these drugs and administer them clinically. The death rate will evaporate.
Drug overdose can only be slowed or stopped by one mechanism . The persons who abuse the drugs must stop stop taking them. Chronic pain is a terrible place to be. I know because I have been there. Substance abuse is not an easy out because there are always consequences. Most substance abuse programs don't have a recovery rate that is above 20% longterm and the cost is outrageous. Individuals with addictive personality traits cannot opt out of them. That means that prescribing these drugs is probably a mistake but taking them comes with warnings and often repeated negate consequence awareness. Living with pain is difficult but achievable. In America as in other Western countries drug abuse is a norm. Alcohol abuse is rarely addressed and leads to cultural abuse or at best cultural ignorance. That places the responsibility squarely on the individual taking the drug. Isn't that really where it has to be to achieve any real and long term result? I know that is the only way it could and did for me.
The Fentanyl apparently mostly comes from China. This is not to say that the Chinese government winks at these shipments.
We should insist that all shipments of anything coming from China should be inspected for Fentanyl and other opioids, at the expense of the shipper. This is a reasonable request. Hard to say what would plunge more rapidly, the opioid death rate or the trade deficit. That would be a race to the bottom that every American could cheer.
Dan Kravitz
1
If Russia wants to defeat the U. S., it’s simple. Why bother with hacking elections, planting spies or building even more nuclear weapons? Just support big pharma and get more opioids on the streets of America. The statistics don’t lie. Our hospitals, police, first responders, judiciary and prisons are already overwhelmed by this crisis. It could be the tipping point for our society. I feel guilty writing this.
Our culture glorifies drug use. The Top 50 Billboard songs are full of references to drug use, often in sexy, cool or daring connotations. I have noticed a significant uptick since the 1990s. Until this changes, the drug epidemic will continue to rise.
Glorify drug use, get more drug use. Simple as that.
1
doctors who prescribe these highly addictive drugs for minor ailment s should be thrown out of the medical profession. pharma has to be held accountable for this carnage.
3
But Fentanyl is fine for state-sponsored killing, as seen this week.
Given the non-stop media coverage of the Fentanyl experience in that most of us know by now not to take such unless we want to commit suicide, are many of the dead there because they want to be?
Thanks heavens these drugs are legal, while marijuana is not,
clearly improving the lives of all sensible thinking Americans.
heroin doesnt kill people
heroin overdosage kills people
heroin overdose is caused by the state
the states action in refusing to allow clean manufacturing packing distribution in safe well marked and handled known dosage for personal use is now undeniably mass murder of its own people.
callous disregard for human life and dignity.
I wonder if narcotics are a new form of life, like Prion Proteins. Take the Rabies virus. A dog bites you with virus in its saliva. The virus slowly travels to your own salivary glands and to a part of your brain that controls aggression and biting. This centre takes over your life and makes you an angry savage aggressive biter with rabies virus in your foaming saliva. I was being abused by a patient last week for not prescribing Endone for a shoulder bursitis and it dawned on me that it was her craving for opium talking, not a normal, rational fair minded person. Opium was self replicating through its affects on peoples brains. It acts like an infectious disease and we may need to add addictive substances to the list of self replicators like Genes, Memes and Prions.
@Johnwarnock This is EXACTLY why we have an illicit fentanyl crisis w/NO solution in sight (what does Vietnam have to do this? Here are much worse death rates, however unsexy: half a million annual tobacco deaths, anyone?). Currently, we have NO cure for addiction, at least not by the $35 billion p.yr Rehab-Industrial-Gravy Train which has fought scientific efforts to find a cure+what ARE “adequate resources” to throw at it? Yes, BigPharma came out with Oxycontin, and drug addicts figured out a way to abuse it. I believe BP has paid some $zillions in fines. Is punishing them and throwing ever more money at rehabs going to stop the the “core” problem—the flow of illicit Chinese and Mexican fentanyl into the country? Is BP importing illicit fentanyl? Is BP responsible for desperation, social ills—poverty, unemployment, minimum wage, dead-end, no-benefits, no-future jobs— that contribute to addiction? No, and if Americans hate BP so much, then get rid of your for-profit system that allows it to thrive, and go invent a vaccine for drug addiction.This is a massive govmt policy failure born at the CDC, which ignored the complexity of the problem, falsified statistics and info, focused on Rx opioids and ruining lives of sick people. DEA said it years ago: “Law enforcement strategies to reduce the illicit opioid supply must...be supported.”
The graph shows three levels of increase but the legend only has two...
Brought to you by America’s pharmaceutical industry, imho.
1
Good, 72,000 useless addicts we no longer have to give healthcare to.
2
Commenter Oliver Jones presents a great argument for legalizing drugs. We’ve instead been pursuing the “war on drugs” strategy for 30+ years. And as this report attests, things only continue to get worse.
We should at least ensure that the “replacement drugs” such as Suboxone and Vivitrol can be obtained with ease and at no cost for any addict under a doctor’s care. But I think we have to go way beyond that—and commit to a moonshot-like national effort to provide effective lifetime rehab-on-demand for all Americans who need it.
We’ve lost this war so far because we’ve only worked to cut supply. Now we need to use treatment to cut demand, and to do it so well that we yank the rug out from underneath the drug dealers. If we could pull this off it would not only greatly reduce the tragedy that drugs are inflicting on millions of Americans and their families each year, it should also put a huge dent in our crime problems, so much of which is an offshoot of drugs and the drug economy.
Now, wouldn’t something like this be a great project for the President of the United States? Unfortunately, our current president seems to instead spend his day locked in the White House watching TV and firing off increasingly inane “tweets.” Apparently, he thinks that is his job. What if we had a president who truly was immersed in the job of “making America great again,” and instead spent all day moving us forward on these issues? But we may have to wait until January of 2021 for that.
Once again, the public has to pick up the bill for pharmaceutical consumption fallout in the form of government intervention. It seems high time that the drug manufacturers pay for the damage they helped create instead of heaping it on to the back of the tax payer.
1
What these dire statistics show is that Prohibition does not work. For the past few years, the government has been trying to limit those who can get opioid prescriptions and we can see that that doesn't help, if it did, then we would see across the board reductions, and greatest reductions in areas that are heavy Prohibtion, as in restriction of supply and incarceration as punishment for possession.
Since Prohibition seems to be making the epidemic worse and is costing trillions of dollars, it would seem wise (or at least not as insane as the current policy) to look at countries that have stopped Prohibition, such as Portugal and much of Northern Europe.
Portugal decriminalized all drugs 20 years ago, with great results. Starting with Swiszerland (but now including Denmark, the Netherlands and Norway) the government has begun prescription heroin, which breaks the heroin drug cartels and drug culture.
Or even if the US needs to still Prohibition, at least focus more on treatment than punishment. But the catch with that is that the most popular treatment AA, doesn't work for opioids, as Yale researches and others have gone public on.
Instead we need better access to free MAT-medication assisted treatment, methadone, Suboxone.
Yale also has an exciting computer program that is more effective than therapy and therapy tests best than self-help groups.
Self-help groups more effective with opioids than AA, include HAMS, SMART, LifeRing, Women for Sobriety, the Freedom Model.
This isn't going to stop without a nationwide increase in medication assisted treatment programs. Reams of data demonstrate the efficacy of using medications such as methadone and buprenorphine to treat opioid addiction. In conjunction with behavioral therapy and access to services and treatment for other mental health issues that were underlying causes, it gives people their lives back,
Abstinence-only treatment does not work. Addicts, many of whom have already gone through abstinence based treatment at least once, know it doesn't work, and that only contributes to the hopelessness that perpetuates the cycle and eventually ends in death.
One of the contributing factors to this method's under utilization is a lack of public understanding. To clarify, this isn't trading one drug addiction for another. These medications satiate the brain's receptors, but do not cause any euphoria or other pleasurable side effects. It's like the difference between smoking a pack a day and using patches - it's infinitely safer, and allows for slow, tapering reduction. In the meantime, the person is clear-headed, free from cravings, and much less likely to backslide. All approaches require the addict's eager willingness and commitment to stick with the process, and stop chasing the high. This approach is the only one that actually gives opioid addicts a way to follow through and take back control of their lives.
5
@Januarium
I totally agree with you! Furthermore, there is no mental health "help" out there without money or celebrity status. MDs prescribe & treat the symptoms not the cause. The PHds want to write & not treat & do not take insurance. Moreover, they do not want & reject these type of patients.
They want "typical" everyday dysfunction. The best of the Rehabs are revolving doors-- also just a business.The (ahem) intake counsellors you speak with when you call a private rehab are sales people . Yes(!) that IS really who they are. THIS is what our mental health system is.
My wife and I lost our only child, our son, at the age of 25. We are strong advocates in the fight against the shame and stigma associated with this disease, participating in statewide panels and meeting local County and State officials.
We march in the annual FedUp! rally each year, walk the halls of Congress meeting elected officials for funding and change.
Here’s what has occurred over these 7 years:
- it is an uphill battle to simply get addiction recognized as a disease, not a choice. Who chooses to live this life?
- Bills pass with $0 funding so politicians can claim they care.
- Narcan distribution/education is vastly improved but being won at the local level only. I’ve heard comments how this encourages the continuation of drug usage. When asked if they deny treatment to a repeat diabetic overdose I’m met with blank stares.
- The FDA continues to approve opioids and doctors continue to prescribe without safeguards or alternatives. Big Pharma is a legal drug cartel.
- Federally, anyone heard of a serious attempt to stem the tide of illegal drugs coming into this country? By serious I mean cutting aid to those countries, as an example?
- How many people do you, as the reader, know who is affected by this disease?
- Legalizing pot is all the rage. Why? Tax revenue. No thought about the consequences.
- Rehabs are not regulated, some are good, some worse than horrible.
There is an acceptable level of death in our country for this crisis. When will it change?
4
I have sympathy for opioid addicts. I really do. But I also remember our nation's reaction to the crack cocaine epidemic of the late 80's into the 90's. Hmmm...what did we do then? Well, we got "tough on crime, " had three-strike laws and locked up millions of addicts on drug crimes. What was the difference? Crack cocaine users and addicts were statistically more likely to be black. Interesting now since we have a larger percentage of white opiod addicts, how concerned everyone is about this "health crisis." Wasn't the crack cocaine epidemic a health crisis too? Just saying...
2
The downside of such coverage is that people in unbearable, chronic pain are now viewed as suspicious and often denied the drugs they need.
@Rolf
100% CORRECT!!! not fair to them
I don't know what policy makers think is the magic number of deaths to achieve before we start seriously investing in primary prevention research and teaching primary substance abuse prevention in public schools. Myself, I think we passed that threshold a long time ago.
3
The article makes the following point but without specific numbers. 72,000 died last year in America from drug overdoses. Before laws were passed that made safety equipment mandatory, car wrecks killed roughly half that number (out of a population that was much smaller than it is now). Gun deaths are presently also about half the drug death number. Roughly two thirds of all gun deaths are suicides. Car deaths are now much lower than they once were. However car deaths are climbing again, and the principal cause for the recent increase is cell phones. Little has been done to address the cell phone problem. And the federal government has done almost nothing to prevent gun deaths. The large decrease in car deaths tells us that smart fact-based policy makes a big difference. Gun deaths and drug deaths are problems of roughly the same scale.
2
Let's not forget that quality of life and standards of living have something to do with the problem as well. It's no coincidence that overdoses continue to increase where poverty is rampant, and where adequate medical care (or even basic shelter and nutrition) have become increasingly unaffordable. The pain of depression and hopelessness will drive people to seek out some form of relief, even an unwise one, just as surely as any physical injury.
1
There has been a downturn in Mass. of drug deaths because of the fact that Narcan is widely available and used more frequently to reverse an overdose. It is in the homes of users and readily available OTC to buy. This is the temporary life ring. But again the users will just go back using. Eventually more bodies will pile up again. It's just a lull right now with the advent of Narcan.
Stop taking this bad stuff
2
I think America needs a real soul searching in order to fight the illegal drug abuse and addiction. Of course are practical problems already identified: the over prescription of opioid painkillers, the easy access to illegal drugs, the drug trafficking at our bordes etc. However, is interesting that in LatinAmerican countries is really easy to find and buy illegal drugs, but they don't have the same addiction problem that we have in this country. I have my own theories (and of course are people that became addicts because they were prescribed or overprescribed opioid painkillers). Some people decide to use drugs because of loneliness, difficult to deal with frustration, poor family relations and many others similar causes. Until Americans do this soul searching the problem will continue
1
Many chronic pain patients are being forced off their pain meds even when used responsibly. This is stupid and cruel. People will go to the streets and get drugs that they can’t handle and die. Some people are committing suicide. I would hope the doctors and the government would reevaluate what they are doing to people who aren’t sufferin this is stupid and cruel. People will go to the streets and get drugs that they can’t handle and die. Some people are committing suicide. I would hope the doctors and the government will Realize that they have over corrected and stop torturing people. At the VA many people have been suddenly dropped off of their pain meds, And I wonder if this could have something to do with the high rate of veteran suicide.
3
cocain is NOT an opioid in any way shape or form not even a an analog of any opiate whats so ever. Its a narcotic stimulant. That comes from the coca plant not from opium. Tho it might sound trivel. Its not being that if giving out wrong and misleading info it makes people discredit and dismiss all the other info even if the other info is factual.
1
@jj, There is now fentanyl laced cocaine available on the streets today. Some are OD'ing on it.
States that legalize medical cannabis dispensaries experience a significant and immediate decline in opioid overdose deaths: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1898878
5
New Jersey’s ex-Gov Christie was put in charge of the opioid crisis by President Trump. I have not seen a word about Christie’s plans or work. Chris, are you out there? Anywhere? What is your plan? I would like to see you accomplish something/anything for your years of public service.
3
Shame on the President, his administration and the members of congress. This is the most urgent of issues in this country. Does anything else account for as many American lives lost in this country?
Stop trying for more tax cuts for the rich, start pouring money into the states for treatment and prevention services. What will it take the loss of someone in the politicians family for this issue to truly matter.
1
Whatever happened to personal responsibility? My oral surgeon prescribed oxy for me after surgery knowing the effects it could have I took as prescribed but only one pill. It didn't alleviate the pain I was in it heightened it. took extra strength Tylenol instead pain went away. These people who take the drug and if they have half a brain have to be aware of this epidemic but take it anyway kind of have themselves to blame. It's a highly addictive drug. Tell your doctor to prescribe something other than oxy. Educate yourselves.
4
As reader Tom pointed out, “No one is immune because of the addictive strength of these drugs.” Perhaps you could come out here in flyover land’s epicenter of this crisis (yes, crisis), educating yourself as to the whys of this mess. Then you can do some of the educating.
Margo,
I do not think you understand addiction. You are fortunate you do not have that disease but others do. It is not as simple as you say. I wish it was.
Life expectancy of Americans increased up to 2012, stayed constant 2012-2015, and has decreased since since 2015.
Details :
"During 1999-2016, all cause mortality in midlife increased not only among non-Hispanic (NH) whites but also among NH American Indians and Alaskan Natives. Although all cause mortality initially decreased among NH blacks, Hispanics, and NH Asians and Pacific Islanders, this trend ended in 2009-11. Drug overdoses were the leading cause of increased mortality in midlife in each population, but mortality also increased for alcohol related conditions, suicides, and organ diseases involving multiple body systems. Although midlife mortality among NH whites increased across a multitude of conditions, a similar trend affected non-white populations. Absolute (year-to-year) increases in midlife mortality among non-white populationsoften matched or exceeded those of NH whites, especially in 2012-16, "
"NH American Indians and Alaskan Natives experienced large increases in midlife mortality from 12 causes, not only drug overdoses (411.4%) but also hypertensive diseases (269.3%), liver cancer (115.1%), viral hepatitis (112.1%), and diseases of the nervous system (99.8%).
See:
Changes in midlife death rates across racial and ethnic groups in the United States: systematic analysis of vital statistics
https://www.bmj.com/content/362/bmj.k3096.abstract
The ultimate cause,I believe is the stress of living in an ever increasing global competition.
Remind me how refusing old ladies like me sufficient pain relief after a total knee replacement stops druggies from overdosing on fentanyl...
13
The suburban town I live in has 23k residents. This is like the death of three suburban towns- every year
Put 2 and 2 together. The big increase in overdose deaths only started AFTER the government started putting limits on how much and how often a doctor can prescribe opioids. The more the access to these medications is restricted the more people will go out and find them on the street, where they may be laced with something else, start taking something much stronger than they were, resort to heroin or something else. The government allowed the pharmaceutical industry to lie about these drugs and to convince all these doctors to prescribe away, then when all these people become addicted to these medications the government is punishing the people who really do need the medications by cutting their prescriptions down or taking them away, because they have this illogical belief that if we make the doctors prescribe less and less than the ones who are addicted won’t be able to get them and we won’t have any new addicts. Most of the people dying from opioids are not getting the stuff from doctors anymore, because doctors are not prescribing them like they used to. They are bought off the street, where they were stolen or mixed with other drugs. The word “opioid” is being misconstrued. The deaths are not because of hydrocodone and oxycodone, they are occurring at such a high rate from heroin, fentanyl, and other much stronger drugs. Most of the people being prescribed opioids today are only the ones who really need the medications. So stop punishing the people who really need them.
6
"The county has reduced medical opioid prescribing;" and congress has a bill to make it even tougher for pain patients. Low hanging fruit. That is what the pain patient is, low hanging fruit. The Sackler family made billions off oxycontin, the Chinese are doubtless making big money off fentanyl and carfentanyl, the DEA agents are buying Porsches with their overtime. Even the newspapers are selling more ad space. Works out for everybody. Except the pain patient.
3
I have written in the past that fentanyl is the main culprit in this opiate overdose scourge. It is no longer about prescription medication from doctors. And those who legitimately rely upon them for their severe pain relief should not be penalized because of these abusers. Do we entirely take away alcohol from everyone because of the fact there are some alcoholics?
7
My gruesome arithmetic tells me that one person is dying every 7.3 minutes from opiods.
I got a haircut the other day in the next town over from my very small town. The barber told me that in her slightly larger town opiods were an epidemic. Sadly, they probably are in mine as well.
1
There's something sad and scary about seeing "ghost bikes" on the seeming safe 5' shoulder of a highway along the Ohio River east out of Cincinnati. Or the (paraphrased) "Report drug caused driving" signs for miles on I-70 east out of Columbus, Ohio. Or the billboards around smaller towns pleading with folks to get help with their addictions and to get tested for HIV at the tip of Appalachia in Eastern Ohio. Any ideas, Mr. Trump? Kentucky Senators McConnell and Paul? At least Gov, Kasich has tried with his limited resources.
1
Nebraska just used a Fentanyl cocktail to kill a condemned
inmate. Why? Because it kills quick and painlessly. Just as
it is killing the general population. Except for rare and
controlled cases, the public must not use any amount
Fentanyl or OxyCodone because it can start the "Opioid
Chain of Death". OcyContin to Fentanyl to Heroin to death.
No one is immune because of the addictive strength of these drugs.
1
What mystifies me is why drug makers make dosages so strong that they kill their customers. The market incentives would be to lower dosages (that presumably would be cheaper) and expand your market by keeping older and new customers alive. But the evidence points to the opposite behavior. What explains that?
I thought the same thing until I read that some addicts actually seek out the dealers when they hear someone has overdosed. To them it’s a selling point. I’m sure this isn’t everyone, but I found it interesting. As a legitimate pain patient, this attack on our community has to stop. If someone wants drugs, they’ll get them. If heroin/fentanyl addicts want to kill themselves with the “good stuff” that killed someone else, I’m not sure anyone can help that kind of risky behavior.
Cigarettes kill 480,000 people in the US annually. Alcohol kills 88,000 per year in the US, and 15.1 million people are alcoholics. At least prescriptions opioids have a medical use - pretty sure alcohol and tobacco doesn’t. One tool that does help is to invest in medical research for non-opioid treatments for pain and addiction. The treatments we have out there for both are less than perfect. BUT if opioids are the only thing that works for a legitimate pain patient, they shouldn’t be denied to hopefully save a hypothetical person who is shooting up in an alley. Sorry for the rant, but I was hoping that the info at the beginning is interesting to you.
I can tell you from first hand experience that the problem isn't the addiction to opiates. It's the difficulty in obtaining the medication necessary to fully detox.
I am a Heroin addict. I have been for almost 10 years, now. I've been trying to get sober for the last 2 years. "Why don't you just, stop?" I've heard that more times than I can count. Going cold turkey off opiates is PAINFUL! While some can do it, most can not. Most addicts require medication like Suboxone or Subutex to get clean, and therein lies the problem.
My addiction costs me around $800 a month. There are ways to bring that cost down, though for arguments sake I won't mention how. In order to get prescribed Suboxone-at least here in Utah-every clinic I've talked to requires an Up Front payment of $2,500 cash, Minimum! I've heard some clinics charge as much as $5,000! That price covers your medication for 1 month and 3-4 forced group rehab classes a week. A cost that insurance agencies won't help with.
In a nutshell, a majority of the Heroin addicts I've met only spend $20-30 a day on their addiction. Yet to get sober, these clinics charge Thousands of dollars per month and force them to talk about their addiction with complete strangers. And the worst part? Rehab NEVER helps. All it does is introduce you to more addicts and forces you to constantly think about your addiction.
Basically, it's cheaper to continue being an addict than it is to get sober. Nothing will change so long as that's true.
3
@Andy
Thank you for your comment. We need to hear more voices from the front-line..
Could you clarify one thing, please. If, as you say, rehab never works what is it you are referring to in your last 2 sentences, when you conclude that until something is cheaper than using, nothing will change.
What is it that you are implying, if the cost came down (relative to using) would make "change" possible? If not, rehab what?
PS I hope you find what you need.
2
@kfm It's the cost of the Detox Medication that needs to go down. Right now you'll pay $2,000-3,000 Minimum for one month, cash only. Insurance won't cover these medications. Rehab doesn't make this cheaper, it only lets you spread the cost out over the month.
I don't want to mislead anyone reading this. Detox medications are available with a prescription without the need to go through Rehab, unless you're poor and uninsured-like I am. Without health insurance or thousands of dollars cash in your pocket, the medication has to be financed. So far, every doctor and clinic I've seen in Utah has told me that the only way to get financing is by attending their forced group Rehab. Except, they require you to pay for the classes up front even with financing.
I don't have exact numbers, so what I'm about to type is purely HYPOTHETICAL. It is only meant to give you an idea of the cost to get clean.
1 month supply of Detox Meds can run around $2,000-3,000, cash upfront. However, some places can drop that price down to $100 or less if you agree to take their individual and group rehab classes, which cost around $2,400 for the month-or 6 classes a week at $100 a class. They drop the price of the medication, but you're still required to pay for the rehab up front. If at any time you miss a class, you're out of the program, all investments forfeited.
In a nutshell being an addict cost about $200 a week. Getting clean cost about $600 a week. So long as that's true nothing will change.
Wow. I find your comments to be the most enlightening thing here, and that includes the actual article. I wish everyone could read them. I also wish you all the best, Andy, and I hope one day you find the help you are seeking.
Americans are going to pay dearly for their lack of historical knowledge. As the Russians pay us back for facilitating the collapse of the Soviet Union with our own Boris Yeltsin, the Chinese flood our communities with cheap fentanyl, payback for us English speaking people... for the Opium Wars.
1
My frustration with the whole discussion of drug abuse crisis over the years is that all that is talked about is who and what drug is primary which then determines which solutions are applied. 80-90s it was crack promarily plaguing poor & black people so the response was 'lock them up'. Now its heroin, fentanyl & meth which is currently plaguing primarily rural, white people and the refrain is more rehab.
What is rarely address is what is at the root of these epidemics: Income inequality, lack of social upward mobility, indv & family poverty, lack of good equal, affordable education, lack of healthcare.
All these issues are primarily initiated and worsened through Republican's continue campaign to eliminate our social safety nets, workers right, voter rights and tax law manipulation and corporate take over of our legislative bodies at state and federal level. Republicans (and their voters) have enrolled us in a race to the bottom. Drug abuse is just one of many symptoms underscoring our nation's affliction.
5
Fentanyl is about 100x more powerful than heroin. As such the safety of mixing it with whatever inert 'filler' a pusher might be using to pass it off as garden variety smack or to boost a weak batch will depend on the rigor of their process and quality control.
Didn't measure it right(is it a level teaspoon of fentanyl or heaping teaspoon? meh) and you possibly have a batch 2-3x more powerful than you intended.
Measured it right but didn't mix it thoroughly... you have a batch that will contain 'hot-spots' where the fentanyl concentration is very high.
Maybe the good folks and Perdue Pharma who came up with Oxycodone can give them some tips.
1
The figures for deaths by substance abuse ought to include alcohol.
3
Billions wasted over the War on Drugs, and this same nation's government run by the same two political parties which couldn't tolerate someone growing a pot plant in their backyard — found no objection when large corporations decided to mass produce and dump upon every town and hamlet heroin in pill form.
These same companies not only keep their profit from drug pushing, they continue to produce and dump the drugs, receiving hand slaps from regulators and sprinkling the blood money across reelection campaigns everywhere.
I don't recognize this country. This is not hypocrisy, it's on too massive a scale to be merely despicable. This is dickensian "they had best die and decrease the surplus population" that's what american capitalism has become. Pharmacuetical companies and their political lakeys aren't just spoiled and pampered and cynical — this is real evil.
5
@Arthur, This drug crisis was manufactured or by design. It just worked a whole lot faster or better than anticipated. We'll find out all of the truths perhaps someday.
Why not legalize the sale of cannabis to eliminate the K2 overdoses?
There is an alternative painkiller, not physically addictive, very safe, that has been providing relief to people in pain for years. I grows readily out of the ground, and is so common, it's nickname is weed.
That the federal government refuses to allow people in pain to try relief from marijuana is nothing short of criminal. But big pharma's profits from opioids and law enforcement's hunger for bigger, better man toys from asset seizures, means we'll be stuck with this misery and suffering until we finally get up off our backsides and do something about it.
3
Drugs have becomes huge problem in the last few years in our country- with the amount of overdoses increasing every year. I believe that mental health needs to start to be on the top of the list of priorities in the United States, so that instead of turning to drugs for happiness or pleasure we can seek happiness in the world itself. We also put our kids in different drug programs to prevent them from doing drugs, but the whole system sometimes can be sugar coated. I think to stop kids from doing drugs is to be completely blunt with everything you can lose, but also the real truth about it. I feel that we should express how the drugs feel, and then explain the effects after and how they affect the body. In conclusion, I believe that we need to crack down on mental health and the way that we teach our kids about drugs and the life-long affects that it can give you. @[email protected]
Four out of five of those addicted to opioids started because of prescribed opioids. The problem is, while opioids have a place in medicine, we can't yet tell who have the potential to become addicted and those who don't.
In the mean time, providers have to stop prescribing such drugs for minor ailments like wisdom tooth extraction (like I had) and minor surgeries.
1
A record number of overdose deaths! And Congress is considering legislation that would shorten the jail terms for convicted drug dealers? Does any see a disconnect between reality and desire? Not only that But Chicago is experiencing record violence as drug gangs shoot it out for control of turf! Perhaps if Congress passes this "reform" legislation, all the (newly released) drug dealers will migrate to the Windy City to help settle to dispute over which drug gang controls which turf.
A little over 58,000 US soldiers died over the long course of the Viet Nam war. That was over the a period of over twenty years. That the overdose numbers eclipse those casualties in a single year is outrageous.
That the federal government's response has been lukewarm in funding treatment and not pursuing commercial distributors and their sources amounts to criminal negligence on the part of multiple administrations.
5
It's just a natural extension of the drug war. Decriminalization would allow these people to seek help openly and from real professionals without fear of imprisonment. However, our leaders are more concerned with maintaining their grip on power and don't really care about the people dying. The drug war has made many millionaires and now many rich shareholders. So it's more profitable for many, including private prisons, law enforcement and the justice system (whose case loads is mostly drug related crimes-most criminal lawyers are employed handling drug crimes)) and many others too numerous to mention. It has created drug crime organizations that are violent and vicious.
The people are just fodder for wealth creation, and many are loyal slaves who embrace their role as the lambs going to slaughter. It is difficult to be empathetic to those who suffer when they, as well as most people, are so weak when it comes to what they believe and who they select to lead us all. Our leaders are clearly corrupt and greedy and work for corporations. They were elected by these people.
When I see someone figuratively hitting themselves in the face with a hammer I know that they have made a choice to do that. American voters constantly hit themselves in the face with a hammer.
3
@Chris Please come to SF. The city is over-run with dug addicted individuals, very few of whom want (except in the most general sort of way) to escape from their addiction. The addicts I've talked with - and I live in SOMA - do drugs because they enjoy the sensation of being high. They fear (quite naturally) being "dope sick" (as they describe it) but that fear and the knowledge that sooner or later addiction will kill them is not sufficiently powerful to drive them away from drug use.
All the funding and counseling in the world will not convince the addicts of SF (and I suspect other places) to abandon drug use.
7
There is a scary similarity between your map showing increases in overdose deaths and a map showing increases in Trump's vote over Romney's.
This may be an indicator for many other types of dysfunction and distress.
5
I was prescribed Oxy 22 years ago after 6 botched back surgeries, fibromyalgia and a cracked pubic bone. Back then, no one told us how addictive it was. Unlike the narrative the CDC,DEA is spinning; I voluntarily reduced my dose during that period by over 200 mg daily (an obscenely high amount.)
Those of us legit pain patients knew this was coming. We saw the increasing number of bloggers talking about acquiring Oxy to snort and inject. We heard our pain doctors complaining about the DEA’s overly restrictive paper trails. We felt the humility of urinating in paper cups, having our pills counted and presenting our driver’s licenses to Doctor’s receptionists as they welcomed us by our name. It was ludicrous and people who needed this drug to survive were the targets.
For me it came to a crashing halt on 6/17. My doctor was reprimanded and I was given 6 weeks to go off a drug I had been on for 22 years; with no medical support. 13 months later my withdrawal symptoms read like a warning list on a new drug commercial.
But here’s the thing; more people die from Alcohol each year. And if Opioids are linked to Heroin; why are really pain patients suffering? I haven’t tried, but I have researched and I know if I wanted Heroin I could find it. So what was the DEA trying to achieve because the result has been increased suicides among the disabled and obviously, the flow of Heroin hasn’t decreased. The “crisis” sent many pain patients running to Heroin. Was that the plan?
8
Am I the only one who senses the dark, sinister presence of Big Pharma lurking in the background, quietly driving the increased availability--thus dependence--of these opioid killers for the sole purpose of driving up profits? Read 'The Constant Gardener' then see what you think. I think Pharma will do anything for a buck. Anything.
4
This epidemic is a direct result of the war on drugs. More aggressive suppression of prescription opiates and heroin, which caused ~50,000 deaths a year, led to fentanyl, which brought that up to ~70,000. We could end these deaths, as other countries have done, by taking the responsibility away from cops and giving it to doctors.
https://www.ijdp.org/article/S0955-3959(17)30154-8/fulltext
https://www.ijdp.org/article/S0955-3959(17)30154-8/pdf
Today’s fentanyl crisis: Prohibition’s Iron Law, revisited
Leo Beletsky, Corey S. Davis
Int J Drug Policy. 2017 Aug;46:156-159.
doi: 10.1016/j.drugpo.2017.05.050.
Abstract: More than a decade in the making, America's opioid crisis has morphed from being driven by prescription drugs to one fuelled by heroin and, increasingly, fentanyl. Drawing on historical lessons of the era of National Alcohol Prohibition highlights the unintended, but predictable impact of supply-side interventions on the dynamics of illicit drug markets. Under the Iron Law of Prohibition, efforts to interrupt and suppress the illicit drug supply produce economic and logistical pressures favouring ever-more compact substitutes. This iatrogenic progression towards increasingly potent illicit drugs can be curtailed only through evidence-based harm reduction and demand reduction policies that acknowledge the structural determinants of health.
1
Whether it's the financiers that arranged the 2008 economic collapse, or the tobacco executives that lied to congress, or the opioid manufacturers who push their products and pretend; those most responsible for great injustices walk away without a whimper. And children with darker shades of skin go to jail for a single stick of weed. Send a few of the opioid CEOs to jail and watch how quickly the problem is solved. These criminals are the new drug lords and deserve nothing less.
3
@Rodger Parsons
Yes & send the Mds with them!
We were given a brain, to use and to think! If people want to take drugs, this is the risk they are taking. You can't continue to bail out people who think little of their lives.
6
No mention from Margot on manufacturing leaving the US and it’s direct correlation to the opioid crisis. There is dignity in work. But when past administrations sold these factories down the Asia and Mexican rivers along with flooding our country with low wage illegals, what did they expect? So sad, they ruined this country.
Hmmmm
And... no deaths of marihuana overdoses eh?
What about including in the graph alcohol related deaths? Probably ten times higher than any other drug.
3
I’m saddened to learn of this, but not surprised. Since a car accident in 2003 unleashed chronic neck/shoulder pain and fibromyalgia, I’ve struggled to find ways to manage pain and maintain a reasonable quality of life. I’ve been in pain management for thirteen years, but it plays a very different role in my life these days. At first I bought into the opioids and injections (although I quickly abandoned injections after a doctor punctured one of my lungs). I developed unpleasant side effects from the opioids and decided to stop taking them. One nurse helped me get smaller dosages of the med for weaning down, but otherwise I was on my own. It was hell for about six months, but I managed it. I’m in the process of quitting pain management entirely, relying instead on acupuncture, tai chi, and herbal remedies. Sure, the opioids worked better on pain, and the other remedies are more expensive. Having gone through withdrawal, I’ll never put myself in a position to have to face that again. My continuing beef with pain management and pharmaceutical companies is that they make it very easy to start taking their drugs but provide virtually no help to those who want to stop.
4
@Innocent Bystander
very well said
An opioid epidemic in the US and a record number of deaths therefrom, Russian interference in our elections, a crisis in affordable healthcare and affordable housing; global warming and the droughts, wildfires and refugees springing therefrom; stagnant wages, growing income inequality, a record number of school shootings; a Russian threat to our international alliances, our cyber security, democracy, and the liberal word order; a crumbling infrastructure; a looming shortage of skilled labor; record levels college debt; extraordinary levels—compared to the rest of the developed world—of child poverty. And what has been the Trumpublican response to these problems? Ignore or exacerbate. It’s the party’s new slogan.
2
One of the largest reasons for the increase in deaths from opioid overdose is because of the government itself. The D.E.A. has continued to place limits upon the physicians ability to prescribe these medications, mostly to patients who truly need them, and the criminal prosecution of doctors who they deemed to over-prescribe. All of these things only serve to hurt individuals such as myself. I suffer from a debilitating spinal disease that has left me unable to walk without assistance and I live in constant pain. The medications I take (oxycodone and MS Contin) are among the targeted medications that I take just to live a somewhat normal life without the full-blown constant pain. My medications have been cut because of these limitations and I sometimes wonder if they take me off my medication completely will I end up being one of the people who become addicted to something illegal because of it. I am not a drug addict, I don’t ever take more than prescribed, but I am one of many being punished because of this new war on another drug. The constant reporting and articles about opioids just fan the flames. I know firsthand how people who truly need these medications get into this cycle of abuse. My loving and kind brother died last year because of an accidental overdose. He suffered from the same hereditary disease that I suffer from. His neurologist cut his medications by a third. He resorted to buying pills from someone else and didn’t know how strong they were. Rethink this.
6
Our vile crimes against humanity war on drugs combined with our government's hateful zero health care murdered 72,00 citizens last year.
This ALL boils down to our broken hateful greedy politicians doing what they do and just as important what they refuse to do. When are Americans finally going to have enough of this??
2
The primary people dying from opioid overdoses are young and middle aged white Americans. Therefore, I find it odd that the NY Times only mentioned race, to point out that older "urban black Americans" have experienced an increase in overdoses (when these deaths are very low and account for such a small makeup of the deaths reported in 2017). The devil is in the details.. the NY times needs to post the raw data, showing the number of overdoses by race.
3
Humm! How many black persons did the CDC count back in the 80's and 90's? And where was the outcry? "Lock them up!" and "Let them die!!" were the cries I recall when I was then living in NYC. Now every white person in the country is expected - at his/her personal expense - to be armed with emergency meds to revive those (mostly) white persons who overdose ...even though most will do it again a short time later. Where is "Lock them up!" today? Guess those Black lives really didn't matter - then, or now. From an old white dude living in a drug-ridden city.
17
I suspect that the overwhelming majority of white people also would have white heroin addicts who commit crimes locked up too.
1
72,000. That is the size of a large city. America needs a spiritual healing.
1
72,000 a large city? No. A large city is well over a million. 72,000 is a midsized town.
1
Fentanyl is the reason for this spike in deaths. I lost my brother on March 25, 2017 to an overdose while living in a “sober home “ in Yonkers , NY. My brother was an accountant with a college degree, very smart guy . This epidemic knows no race, religion, sex, sexual orientation, or social status . It just kills . When I received his toxicology report he had 8 mg of fentanyl in his body. 3 mg of fentanyl will
kill a human. No heroin at all in his system . It takes one moment of weakness for someone who is addicted to heroin. Help those in your life who have this terrible disease . Until we treat this as a disease the vicious cycle will continue.
84
@Mike M. I lost my older brother in 2017 too, for the same reason. He was supposed to be moving to Seattle in just a few weeks and we planned to live in the same neighborhood. He'd suffered from addiction before but seemed to be doing so well. It was a shock to us all. 72,000 probably is under-representing the actual number of fatalities resulting from this dangerous and poorly understood drug. My heart goes out to you and your family.
3
@Mike M."Until we treat this as a disease the vicious cycle will continue. " There is no cycle! These people die and there are no repeat offenders. The incidence of self inflicted death drops because the offenders are gone. It is a self limiting problem. Build a wall. Shoot drug smugglers. Cry for your loved ones. But do not call this a disease.
3
@Mike M.
One reason?
72,000 Americans died of a drug overdose last year? That number stuns me. If we want to beat this crisis, the Center for Disease Control needs to get that number out there... and make sure it hits home. Demonstrate (with graphics) just how many lives that is.
1
@Tom Over 100,000 people died every year from the use alcohol, but I constantly see commercials for Budweiser and Jack Daniels and numerous others. I don’t understand the big outrage over opioids when there is no outrage over alcohol. The “opioid crisis” is just the lasted bandwagon for the media to jump on, and then Congress to act on so it looks like they’re doing something other than allowing some other industry to rip us off or kill us faster.
1
There are no medals given for people who cope without using narcotic meds and I’m glad some commenters understand this. I am also aware that some will read about those who adapt to chronic pain using alternatives to opioids, and think that they are “stronger” for enduring and coping with pain that others might not choose to endure or cannot without opioids. I have used oxycodone for 10 years without a problem. There are far more people like me using opioids to gain a measure of relief and improved functionality than there are abusers. Doctors are running scared because the “epidemic hysteria” has touched them professionally through there prescription pads. “First, don’t go near a public health issue that you are afraid of” Is not part of the Hippocratic Oath. Those who wind up with a substance abuse disorder or overdose (addiction is not in the DSM-V) do not do so simply because they have opioids made medically available. But the public and the media have a preference for simple answers, to complex problems. Statistics such as those that headline this article certainly grab attention, but without more context, are misleading from a medical and ethical standpoint. It’s the comment writers who need to stand up to the profession and the media demanding less hysteria and more of the work required to understand substance abuse as a complex system problem and learn to use these meds correctly with proper surveillance. BTW, I’m a retired doc, a psychophrmacologist.
7
Illegal fentanyl and heroin are now being purchased by chronic pain patients who have been denied legal opioids by their physicians. Why? The DEA is threatening doctors who prescribe "too many" opioids with the loss of their licenses to practice medicine and the confiscation of their property through asset forfeiture laws.
Those of us with broken bodies are given a choice: "Live" with disabling chronic pain, buy illegal drugs and hope we don't overdose on unknown substances in those drugs, or turn to Dr. Glock or the Smith and Wesson Pain Clinic.
Politicians are using our country's current opioid hysteria as a campaign platform. No one wants to think too hard about how easy it is to become one of the 40 million Americans tortured by chronic pain. We are all one misstep, one car accident, one unwelcome diagnosis away from a lifetime of suffering.
14
@Kris Aaron, Wealthy people (including politicians) will always be able to get their scripts for whatever they may need from their high end concierge doctors. The rest of us peons must suffer in constant pain.
3
How can an important article like this be written with out the mention of the fact that the mass majority of heroin and and fentanyl enters our country across our southern border and that fentanyl in the main is manufactured by one country, China and passes to the US across our southern border with Mexico. With hundreds of billions of dollars of trade deficits with China one would think that we could deal with China and if they don't stop their factories from fueling the fentanyl market they could lose the US market for the legitimate pharmaceutical products that China sells to us. Concerning Mexico an answer come with stopping it at the border and if that means building walls between our nations so be it. Deaths will drop precipitously if supply is curtailed.
5
As commented on here in the, uh, comments, a secondary effect is the inability to get legitimate pain control for those who need it.
I had osteoarthritis in my left knee for many years, but rarely a problem. Starting last summer, it got worse, fast. Steroid shots were barely effective. Several times I experienced the worst pain of my life, merely trying to bring my leg into my car. I screamed so loudly you would have thought I was being stabbed. (And a side thought about our society, no one in the parking lot came to see if I was OK, or what.)
All my large clinic (Austin Regional) would do is prescribe ineffective Celebrex, and later, a totally ineffective topical analgesic. I was told that I could get opioids post surgery only. Policy, reading between the lines.
And that's what happened. I had my knee replaced, I was given plenty of pills that I begged for earlier. Now, three months later, I'm just fine in all respects.
I've wondered if the refusal to give me effective analgesics was malpractice.
14
@Jus' Me, NYT My brother was passing a kidney stone and couldn't get an appointment with the ultrasound machine for a week. The doc refused to prescribe painkillers. He was in agony and it was really inhumane. My brother is a solid guy - no history of "doctor shopping", no addiction issues, has a good job, a wife, a dog and a child. There didn't seem to be a reason to withhold effective pain meds other than the doctor's fear of liability.
12
@Jus' Me, NYT, Don't you just love it when others suggest doing yoga or P/T? Or just start doing some hard physical activity, right? I dealt with an undiagnosed hip fracture and was told literally it was all in my head.
4
@Jus' Me, NYT it was not malpractice in the least. The OARSI guidelines for the non-surgical management of knee osteoarthritis state that the efficacy and safety of the use of opioids for the management of OA of the knee is uncertain and it is therefore not recommended. The UK NICE guidelines state that acetaminophen or topical NSAIDs are insufficient for pain relief for people with
osteoarthritis, then the addition of opioid analgesics should be considered. Risks and benefits should be considered, particularly in older people. Ultimately, total knee replacement is the only solution
There are two immediate legislative steps which can be taken at the national level, overriding the necessity of contested state legislative action.
The first is the outlawing of the so-called "pain clinics", which proliferated after 1999, when the governmental authorities, the drug companies, and the profitting medical establishment succeeded in changing the legal rules governing addictive opioid prescription. These "pain clinics" serve no good purpose except for making money for the doctors, hospitals who employ and supply the drugs to the doctors, and the opoid drug industry. They should be put out of business, immediately.
These "pain clinics" were and are the means by which ordinary Middle and working class America got addicted in the first place.
Anybody who needs drugs can get them through a specially licensed doctor or the hospital ER. No other doctor should have the right or opportunity to prescribe, and foster addiction.
Secondly, the prescription rules have to be changed back to what they were before 1999. The legal rules at that time specified that only immediate post-operative pain and terminal cancer were indications for opioid prescription. Several readers have indicated a few terminal-like palliative indications below, which can be covered by the specially licensed doctors and ERs specified above.
No other ordinary doctor should ever again prescribe addictive opoids for generalized pain, back pain, or traumatic sports injuries.
2
Where is marijuana on that chart of overdoses?
3
God help us all when the next recession occurs ...especially if the healthcare system starts to collapse.
Vote out the do-nothing-good Congress.
7
This is a very important map.
Its most striking feature is the block of eight states that have worsened most, or nearly so: Illinois, Indiana, Ohio, Pennsylvania, New Jersey, Michigan, West Virginia, and Delaware. This is the heart of drug death intensification. One might see this drug crisis area as the focus of despair in the country.
Now, look at the Blue/Red state map of the 2016 election, NYT 9 August 2017. Note the "flipped states", which gave the election to Trump.
A comparison of the Blue/Red map with today's drug map shows that the despairing region made Trump president. Three of the six states flipped by Trump are in the heart of the intensifying drug death zone: Michigan, Ohio, and Pennsylvania. In addition, two more flipped states, Wisconsin and Iowa are contiguous with it. The only flipped state missing is Florida.
So, despair led to Trump. Whence the despair?
That is also clear. In the early 1970s, the postwar boom ended. Wages had to be constant or decline in the industrial heartland, the aging locus of the slump.
The decent course would have been to compensate the Midwest for its sacrifice, via a tax on the rest of the nation. This would sustain it while it invested in new technology.
Instead, the Establishment chose an indecent solution: amputating the Midwest, and turning to lower wage areas here (eg, Tennessee) and abroad (globalization).
A straightforward progression: amputation; economic collapse; despair; rage; Trump.
Stay tuned.
4
It’s not that simple. And there are many more things for which we should stay tuned.
1
When drug abuse addiction and overdose deaths swept through the urban blsck community it was treated as an ignorant, immoral and lazy crime wave worthy of criminal prosecution and mass incarceration.
Now that rural and suburban white people are afflicted by drug overdose deaths it is treated as a sympathetic health medical abuse epidemic. Unless and until the law is changed these white folks should be arrested, criminally prosecuted and imprisoned like they were blsck people. At least they would still be alive.
14
@Blackmamba Yes. What was a crime wave then is now a medical epidemic. Yet, that never becomes a part of the news story. Look at all the black men who were locked up for drug use and lost huge parts of their lives, and compare it to public safety officials carrying around narcan on the taxpayer's dime to revive the white middle class suburban youth who are feeling lost. And who will do it again and again and again. Addiction awareness is not color blind.
Illicit fentanyl is not a “big culprit.” It is THE culprit. In the last 5 years, opioid prescriptions have dropped by 25% while opioid overdose deaths have increased 25-fold, as confirmed by the CDC’s 7/11 report announcing “sharp rise in overdose deaths involving [illicit] fentanyl...continued increase in…supply of [illicit] fentanyl.” NO amount of rehab is going to address the unrestricted flow of illicit fentanyl into the country. While that is allowed to go on, users of illicit fentanyl will continue to die in increasing numbers. And feeding the public on the word opioid plus addiction, deaths, abuse, and overdoses with a side of the word prescription is really getting old. It’s disingenuous. It’s tantamount to suggesting that there are 1000 annual deaths due to eating untainted and rotten fish. Unless you state that one person died eating untainted fish, and 999 died eating rotten fish, the reader will believe that fish, generally, is the problem.
Allow me to refer to my commentary on the underreported subject, published in the Minneapolis Star Tribune last week:
http://www.startribune.com/counterpoint-it-s-not-the-prescription-opioid...
Thank you.
9
What a crazy country we live in, opioids are killing all these people yet they are prescribing and creating new addicts everyday. Step one ban opioids and reduce new addicts.
3
It would be nice if the NYT was more careful in its use of language. The expanding problem is really with illegal users, and you are not careful enough to say this in your introductory paragraph. The problem is not patients this taking medications as advised by pain specialists — a very small percentage of patients in a specialists care overdose. The ensuing hysteria created by the kinds of misleading language and statistics presented in this article then causes government officials to react in ways that harm the patients who desperately need these medications to function, instead of creating laws and programs that actually address the issue of growing illegal drug use and tainted street drugs.
9
@Melissa
Excellent post and you are correct. Millions of people use painkillers with no problems - and they NEED them. I'm already hearing from a lot people that they are now denied opiates because of paranoid doctors.
America vastly over reacted to marijuana and millions of innocent people were wrongly jailed or incriminated - especially in the minority communities. And it's still going on. The war on pot and resulting horror shows is the worst mass injustice in America since slavery, even surpassing the internment of Japanese citizens in WWII.
When will we learn?
6
@Melissa Exactly. Interstate 91 from CT up through VT is a major pipeline for this. You can guess which cars are running it pretty accurately, as the state police pull the offenders over regularly. They're not bringing heroin to pain-wracked, medically incapacitated individuals in VT who can't get enough percocets from their doctor; they're bringing it to the mentally pained, addicted youths. And when the drugs don't make it up there, they come down to Springfield and Holyoke to buy it. Watching older family members struggle to get the pain medications they need for chronic conditions because of this misconception is very sad.
2
We lost the "War on Poverty" and now we've lost the "War on Drugs" ...
5
Dead addicts leave behind a trail of human wreckage. I know, my brother held our family hostage for years before he died of an oxycontin overdose in 2003. My hearts goes out to the friends and families they leave behind. Most addicts will od with or without help. That's just the way it is.
81
@mina grace. Build the wall, stop illegal drugs coming in
This is the harsh reality. A massive amount of money is wasted on repeated rehab visits (becoming really big business). The toll on the family, incalculable. My brother ruined his marriage, my parents marriage, my dad's retirement, my relationship with my enabling mother and now, his son. I've given up. I'm fed up. At what point does the abuser take responsibility? And repeated Narcan administration. Just keep bringing them back for what?
1
My father killed himself two days ago. 87 years old, in terrible distress from chronic obstructive pulmonary disorder. Opioids are used to treat patients with this disease. Two days before dad died I was in the emergency room. What did I spend most of my time doing? Trying to find a local pharmacy that carried fentanyl patches. I was told by the attending doctor that he could not prescribe fentanyl for my dad in the ER because of tightening laws and restrictions; only if he was admitted as a patient to the hospital. Wal-Mart did not a carry them. The next drugstore was closed. Walgreens did carry them and his prescription was filled so I could take it to the ER and get it on him...because they take 12-24 hrs to take effect. In the end, not even the fentanyl could help.
So think about this, those who wring their hands for the addicts who incurred their troubles because they wanted to use recreational drugs. If only we could treat addiction as a medical problem. If only people would take responsibility for their behavior when choosing to use street drugs. If only there was not stigma attached, because some people legitimately do become addicted despite having done all the 'right' things.
What we will lose--are already losing--is access to the quality-regulated opioid supply available from our doctors and pharmacies. The street drugs that really will kill a person who can't know what they are putting in their bodies will always be available.
157
I am sorry for the loss of your father. It is hard enough to lose a parent, let alone having them be in pain and experiencing the difficulty you did trying to get him relief. Prescribing opiates for elderly / palliative patients clearly nearing end of life should definitely fall into a different category than prescribing relief to people who may have a much higher chance of becoming addicted. Condolences.
43
@Ann Smith I totally agree with this. Where is the common sense here? It is not fair at all to withhold pain meds from someone who is really in pain.
2
@Ann Smith
First of all opioids are not a good idea for anybody with a respiratory disorder as opioids suppress respiration (it's how they cause death). This is especially true of a long acting opioid like the fentanyl patch where, unlike short acting opioids that come out of her body fairly quickly, high levels of the drug remain for days.
As to prescribing fentanyl in the ER. I assume you are talking about the transdermal patch and as it can take up to 3-5 days to attain full analgesic effect, it would be inappropriate to prescribe this in an ER. An ER is not the place to obtain chronic care. And there is no requirement that physicians must apply the patch. In fact, I am a physician and I've never heard of any physician who has done so.
And a question: why did your father go to an ER instead of his own physician to get what obviously was not emergency care?
1
I'm starting to feel that at some point we all need to start taking more responsibility for ourselves. I've had prescriptions for opioids about 3 times for various injuries over the past 10 years. I learned from various sources (the media) that these can be addictive, so I made the decision to only take them for a few days after the injury and then stop. I had pills left over. I had a shot of Fentanyl in the ambulance last year for an injury and it didn't do much for me. One of my injuries lasted for months with pain but I just didn't want to take too many pain pills, and I dealt with it in other ways.
As I write this, I realize that I had plenty of paid sick leave from my job and didn't have to worry about dulling pain in order to be present at a job. These stories and comments really get me thinking about the plight of others and how our situations may be different leading to different outcomes. Best wishes to those who are suffering and hope they get the help they need.
137
There's the Iron Law of Prohibition: When a class of substances are outlawed, the most powerful kinds of substances drive out the less powerful.
During the US's experiment prohibiting alcohol, nobody, but nobody, smuggled light beer. They smuggled overproof rum, whiskey, and bathtub gin. The iconic Anheuser Busch Clydesdale horses were a celebration of the end of prohibition, when it became legal to flaunt the delivery of beer.
In this decade, a dangerously powerful form of opiod is fentanyl. It's gaining market share because it's easier to smuggle and hide than other opiods. Never mind that it's so strong and addictive that it's a good idea to get the assistance of a trained pharmacist to dispense a safe dose, and the monitoring of an anesthesiologist while using the stuff.
Because opiods are illegal, trained people are pushed out of the market and dangerous forms of the drug are pulled in.
Don't get me wrong. I don't advocate a return to the bad days when Purdue Labs and other pharmaceutical marketers were making vast fortunes getting people addicted in a quasi-legal way. Nothing good comes from addiction.
But nothing good comes from prohibition either. If people with addictions had access to safe and legal doses many of them would be able to live productive lives, and eventually work to get rid of their addictions. I'm not making this up. It's happening in Portugal.
In the US we demonize addicts. Why?
346
@Oliver Jones
The problem is that in the last third of the 19th century, when opioids and cocaine were readily available without a prescription and without any restriction on their sale, the U.S. had a severe problem with abuse of and addiction to them which led to the first laws restricting access to them.
The idea that if its laws that create the problem goes against history.
2
@Steve
And how pure were those last 1/3 of the 19th century opioids and cocaine? Things are purer today, except for the production of cocaine, which, if widely-known, I don't think anyone would use.
Even absinthe production has begun again, since it has been found that its obviously deranging effects were not from the thujone (wormwood) but from the content of alcohol: Upwards of 75%.
2
@Oliver Jones Not sure I follow what you are saying. Opioids are still prescribed by Doctors across the country, so technically they are not 'illegal" but an interesting notice at the FDA site when this new regulation came into effect regarding opioid pain meds was the announcement of a NEW (patented) time release Opioid. I suspect they wanted to try to pass off this expensive (copay) med to make more profit.
Many Gov. Official made money during prohibition when they bootlegged alcohol to the masses (and pocketed their profits) and arrested anyone making their own to sell to neighbors.
4
And what percentage of those obverdoes are related to depression and desperation.
4
It's been one year since my niece died in the Town of Palm Beach.
Our private investigation has discovered that PB F/R took 20-30 minutes to arrive once called; even though they were 2-3 minutes away. They couldn't find an address right on Ocean Ave.
After Nia was already brain-dead; the Town of Palm Beach Detective Bureau intentionally ignored that a felony crime (capital murder) had been committed; and, ordered the crime scene cleared -although responding Officers insisted a felony was committed.
The FDLE is no longer investigating because of how badly the Town of Palm Beach handled the crime scene: "We've got nothing. Try pursuing a civil suit.".
The 15th Judicial District and Palm Beach Sheriff's Office have been as silent and cold as Nia's grave.
We've been denied any statement of the crime from the FDLE and the Town of Palm Beach to pursue State Victim's Compensation.
The civil phase begins; now that the FL governmental immunity cap of $200,000 in remedies will not discourage Attys from taking the case (due to the now deep pockets of the "internet map" and computer aided dispatch vendors).
Usually, civil cases arise from criminal; but, since local authorities are obstructing justice - in Nia's case - the criminal charges will have to come from pursuing civil remedies.
5 Aug 2018
https://www.linkedin.com/pulse/palm-beach-county-opiate-massacre-reality...
4
The DEA has caused most of the problems associated with overdoses.
4
Trump now owns the problem, but of course he, and DHHS, truly do not care, being so focused on destroying the ACA and President Obama’s legacy.
3
21C opium wars, this time China is the manufacturer and the US provides the addicts.
12
I have two reactions, the first is political and the second is personal. Politically, drug addiction did not become a so-called "medical problem" until white people started dying of overdoses. When black and brown people were addicts, the official response was strict and unforgiving incarceration, moralizing about the breakdown of families and personal responsibility, and the mythology of 'super predators' and illicit ghetto culture.
Personally, my half sister was born to a teenage mother who eschewed personal responsibility for a hippie ghetto life resulting in a complete breakdown of family and middle class values. The result is a 50 year old white loser drug addict welfare queen with no skills and a lifetime of misery which is repeating itself over generations.
Yet as a white woman with some intelligence, my sister has completely escaped any law enforcement punishments, CPS questioning, jail time, mental health interventions, etc. She lives life with impunity and official indifference because the authorities in Michigan don't care. When my niece started cutting herself the school district didn't even call home.
Although the DEA, FBI, state police, local sheriff, child protective services, truant officer, and many many other officials have "investigated" her meth lab home which is 600 feet from an elementary school, no one has done anything to stop the train wreck. In Southwestern Michigan, this "bleak outcome" can't arrive soon enough, especially for the children.
7
Please, please start reporting on the pervasive Mexican drug cartel connection that has made viscous gun-wielding gang members of our inner city youth while their deadly, but profitable, poison is spread across the US.
4
These numbers are mind blowing.
7
This is the real problem, not the tiny number of foreign terrorist killings we devote trillions to stopping.
9
Lots of blue states up there with opioid deaths: NJ, PA, etc. so now all the red states cannot be blamed as the democrats would like people to think. Legalizing marijuana (another democrat socialist demand) does not help. Yesterday drugs were laced in drinks of people in a park in CT. Just shows what the dangers of legalizing marijuana can do. We will see many more deaths and those who demanded legalization of marijuana will never see or admit what they started has done to this country.
So far the legalization of marijuana has killed no one.
1
The picture is not equally bleak everywhere. In parts of New England, where a more dangerous drug supply arrived early, the number of overdoses has begun to fall. That was the case in Massachusetts, Vermont and Rhode Island; each state has had major public health campaigns and has increased addiction treatment. Preliminary 2018 numbers from Massachusetts suggest that the death rate there may be continuing to fall.
___
Using which metric?
Based on causes of death, in total, for the year? Or
Based on causes of death, in total, for the year when factored against the year over year [declining] birth rates/state populations?
1
If human beings were an intelligent species, we wouldn't have so many problems.
4
Headline from just one year ago, when Boy Wonder was given the job(s) of solving the opioid crisis, the failings of veteran's health care, systemic destabilization in the Middle East... oh and 'manufacturing innovation', and Mexico... and squeezing in at least a little time for skiing in Switzerland.
"Jared Kushner is now tasked with solving the opioid crisis as well as Middle East peace".
WOW. This guy is AMAZING! Just LOOK at how much he's accomplished!
12
Trump promised to fix this. As usual, he is doing a bang up job.
4
I more than understand the alarm bells going off over opioids, but what about alcohol and cigarettes? They cause more deaths than anything AND they are so socially acceptable all at the same time.
5
The large majority of fentanyl is synthesized in China and imported via Mexico/US. If you believe that the Chinese government doesn;t know about the drug companies that synthesize it, I have a bridge to sell you.
China executes its own drug users/dealers (i wonder why) but does nothing when these same drugs are "exported" to the US (i wonder why). How about slapping 100% tariffs on EVERY Chinese import until they shut down those fentanyl factories?
7
Each American consumes roughly the same amount of resources, in terms of Joules or watts, as a Blue Whale.
While individually each o.d. is a terrible tradgedy and one feels for the families, on a societal level we need to get these numbers up, big time.
2
Bengal12rana052500 I chose this article because as we look into the world drugs are becoming a problem everywhere. But there should be change and the numbers should drop. Drugs are no joke and the incline in synthetic drugs is concerning. Hopefully with time people some people will understand the danger of drugs.
1
Like when school, health and income scores are released, crickets from the "red states are better than blue states" crowd.
And MARIJUANA has never caused one death .... far safer than alcohol or tobacco .... which cost this country hundreds of BILLIONS every year.
7
The core issue is not addiction as a disease that must be addressed with proper resources and care, although this will certainly help, rather it is the sequitur to the core issue of unabated supply of opioids in America.
Its new synthetic variant called fentanyl only makes the problem much worse for authorities due to its wide use in hospitals for patient care.
America needs to decide whether fentanyl's advantages are worth the tens of thousands of lives it is claiming each year and its attendant bigger threats.
Unabated supply means addiction will continue to rise. More addicts means a greater slice of America's shrinking health resources that burdened taxpayers will have to shoulder. It also means America's unproductive adult population, whether in rehab or not, will rise each year.
Where do you think all this pernicious interlocked trends will lead? What will happen to America's society and economy when this current epidemic inevitably turns into a national disaster? Can America afford to just sit back and wait for this imminent addiction tsunami to strike?
1
@Bob. Putting the blame for Fentanyl overdoses on Medical Fentanyl is misplaced. Medical Fentanyl was first made in 1960, and is used mainly in hospitals, end-of-life pain medication and chronic pain treatment. It’s most frequently used, for chronic and end-of-life Pain, as a patch that is worn for 48-72 hours and then replaced. It is only prescribed to pain patients if they are already on round-the-clock opioids.
The synthetic form of Fentanyl causing all of the od problems is made either in China or South America and then laced into heroin. This is the Fentanyl causing all the overdose deaths because it is so much stronger than the heroin that the addict is used to. They are also lacing heroin with Carfentanyl, which is used for large animals (think elephants) and is 100 times as potent as Fentanyl and 5000 times as potent as heroin.
Those of us who are living with chronic and/or end-of-life Pain and are on the Fentanyl patches are NOT dying from it because we use our meds responsibly. It is the illegal Fentanyl in the illegal heroin that is killing people, yet WE are the ones who will be kicked off our opioid Pain meds because drug addicts are dying from the ILLEGAL drugs.
It’s already headed that way in Oregon, and Congress is apparently working on legislation aimed at PRESCRIPTION OPIOIDS.
Yep, go after the chronic pain patients, who have already tried most, if not all, alternate treatments, to try to reduce the deaths from ILLEGAL DRUGS.
12
@Margaret Easy, high visibility "solutions" by pandering politicians. Notably no matter what insane restrictions or cruelties they inflict on others, their own Cadillac benefits will most certainly remain unaffected.
The other reason besides the potency and proliferation of fentanyl is the economic decline of the middle and working classes. That decline preceded cultural decline, as was made abundantly clear by the social pathologies that afflicted urban blacks during the mid-20th century, only ideologues at the time blamed blacks themselves for their own plight. Now that whites have followed the same path to despair. The answers to this epidemic not only have a medical dimension, but an economic one. Bring back high-paying, unionized jobs so that people have a chance at buying a home, raising a family and securing a comfortable retirement and you’ll see this epidemic recede within a generation.
8
Poor, hopeless and addicted is a recipe for drug use.
Forcing those drug users into the black market is the reason for their deaths. We need to treat addiction as a medical problem and provide medical treatment for drug users don't drive them to their deaths.
2
US government estimates 100,000 died from alcohol and 400,000 died from tobacco last year. Anyone want to rationally discuss drug deaths in America? I thought not.
6
Well, where are the War on Drugs warriors? Whatever you do for God's sake keep everyone away from pot -it has absolutely no positive aspects and could not possibly be used for pain. Having stigmatized it into a ridiculous bogeyman over half the country still keels over at a whiff of the odor in the air. The odor in the air is from Big Pharm and doctors who make the drug "dealers" of the past decades look puny in comparison. We won't be seeing too many of these over-prescribing "docs" sweating years out in prison like a pot or coke dealer, in any for that matter.
2
This is worse than death due to gun violence. Seems there is a crisis in America. All the talk about Chicago my be a deflection of the bigger issue in America—Drug Overdoses.
1
Well, we should bring back the military draft, at least those who made it in the service would be alive--e.g. not "hopeless"--and we will need them as President Trump is insane and is on a course to get many Americans killed--which will be the most presidential thing he has done--in the traditional sense (Nixon, Bush, Sr. and Jr., etc.)
1
Decriminalize psychedelics could be part of the answer to this problem.. not the number one way to end addiction but an option that should be looked into..
This report is frighting. The question is how do we address this drug use issue. Hopefully we can do more upstream through education and mental health treatment. But for those that are current users we need to address the poor state of treatment centers. Way too many addiction treatment centers are big marketing machines and convince parents and the addict to sign up only to provide poor treatment. I wasted $32,000 on Fresh Start owned by Narconon in California. They did a great job describing their program and were happy to help pull in my son who was on heroin at the time. Unfortunately we found the treatment to be shallow and the counselors there were most often X-drug addicts with little training. They were not compassionate and were not responsive to my questions and concerns. Fresh Start was a big waste of money. Now my son is back n jail. Until we clean up these addiction treatment centers we will not make a dent in the overall overdose problem.
65
A-4151: I’m so sorry your $32,000 was wasted on a Narcanon rehab program. Did you know that Narcanon was created by and is run by the “Church” of Scientology? A total scam. Please report your experience to the police, the Better Business Bureau, the American Medical Association, and anyone else who will listen. Legitimate rehab centers suffer because Narcanon programs give them a bad name. You can help prevent others from being robbed the way you were. Sincere wishes for your son’s recovery some other way!
2
@A-4151
It is odd that we expect recovering drug addicts to be the experts on its treatments but don't expect this in any other diseases. You wouldn't trust someone who had cancer or heart disease to be an expert on their treatment simply by the fact that they had had them.
It is a problem in the addiction community. It wants addiction to be seen as a disease yet wants it to be completely different from any other disease.
1
@A-4151: Thank you for your letter describing sham drug tratment centers that aren't duly overseen and in the long run don't help addicts, but actually ma harm them while defrauding loved ones out of big bucks. The Orange County Register, a major paper in So. California did a wonderful expose on these centers sometime back, and how they advertise nationwide for unwary addicts. It would behoove the NYT, if they haven't already, do an article on this. It's not only in CA these centers proliferate, but in other states also. Shame on these centers for taking advantage of people and families in pain who are seeking legitimate help.
1
The opioid epidemic is a product of the for-profit commercial healthcare system where patients are treated like customers and given whatever they want. If we had a centralized single-payer system, this could’ve been monitored, disincentivized and prevented. But if you treat healthcare like a marketplace and patients like the customers, they have to be pleased for you to be economically successful. Granting requests for opioids was, and still is, an easy way of doing that. Plain and simple.
As a Primary Care physician who opposed this and wouldn’t give my patients opioids when circumstances were suspicious, I was reported by the irate, vengeful patients to my hospital and the state medical board, who legitimated their complaints and forced me to submit written and oral explanations plus register me on a list of problematic doctors. The customers were not happy, and the system prioritized them and their perspective.
This only would happen in a laissez-faire, commercial medical system. It is not happening on this scale in any country that has a centralized healthcare system. The American level of opioid prescription would never be allowed to occur, nor this downstream addiction cost in human life, productivity and resources. The invisible hand does not work in medicine.
239
@BoxengoThere is a single-payer system in Canada, and the opiate crisis is as bad there, and it started the same way: overprescribing.
In BC, the opiate crisis has been declared a health emergency. Not a day goes by that the papers don't report on the fentanyl ODs that are sweeping the province.
This is not about lack of access to health care or economic difficulty, etc. This really does come down to giving lots of people access to the planet's most addictive substance.
6
@Boxengo I find myself curious as to whether or not you have ever lived with a medical condition involving considerable pain. Migraine, spinal damage, things of that nature. Or what constitutes 'suspicious circumstances' to your viewpoint. I have been pondering lately the concept of medical paternalism and physician bias; your comment is an opportunity to ask a healthcare professional for greater insight concerning the decision-making process.
My old and weak, drug addicted mom in law was led to her addiction to opiates in her 70s by medicare doctors.
I see that many comments want to blame economic despair, social division, and lack of universal health care for the opiate crisis. That's an awfully parochial view.
Please look past your own borders. Our Northern neighbor is facing the same addiction and overdose crisis with the same substances. BC declared the opiate crisis a major health emergency several years ago. Almost every day, Canadian news outlet report on this problem. The overdose and fatality numbers are staggering. Fentanyl is everywhere, and the CBC reports that it is now in almost every street drug in Vancouver.
And it started the same way as in the US: by overprescribing extremely addictive drugs, because a generation of doctors was taught that opiates were good for all types and levels of pain, reversing decades of medical wisdom and policy.
You want to find complex reasons for the addiction crisis, but it is actually very simple: if you give huge numbers of people heroin-like substances, many will get addicted. It's about the lock-and-key relationship between opiates and the brain's opiate receptors.
If you're not among those who got hooked, good for you. For others, opiates awaken a tendency to addiction they didn't even know they had. And it has nothing to do with willpower. I've seen lawyers, surgeons, Marines, triathletes and PhDs get addicted to opiates—people who clearly have no problem with self-discipline and delayed gratification. There is nothing on earth like heroin and its relatives.
14
“But nationwide, the crisis worsened in the first year of the Trump presidency”. This fact illustrates the upset of having Trump as our new President. Having to deal with his verbal abuses through insult and cognitive bias, a form of Trump’s personal propaganda machine on twitter blasts his ignorance through social media, an oxymoron for certain.
When African-Americans lost manufacturing jobs in the inner cities of the "rust belt" in the 80's, and drugs and crime skyrocketed, the conservative reaction was that they were obviously morally inferior, and should be thrown "under the prisons". Now it's white folks in the heartland in the same jam, and it's a national emergency. We suddenly have to do all the things the country refused to do when it was "those bad people" - offer compassion, funding for medical treatment, etc. etc. Those things are all for the good, but why did we only start doing them when white people started dying by the tens of thousands?
6
Loneliness is America’s scourge, its most widespread disease, and the root cause of almost all addiction. It’s as sad and as simple as that.
2
And I am betting the majority of them are Trump supporters. They voted for him and they got him. Four more for Trump so he can give the people what they deserve
1
Pharmaceutical opioid abuse is one problem.
Fentanyl cocktails are quite another and is a consequence of having a porous Southern border.
The same gangs that profit from smuggling 'immigrants' bring the deadly drugs too.
2
The Genie is out of the bottle and putting him to back is going to be a job. In the world of drug users the more people a certain drug kills the more attractive that drug is. Addiction is said to be cunning baffling and insiduos and so it is. Sane people would run from a deadly drug but the addict yearns for a drug that will almost cause them to OD. So telling addicts to avoid Fentanyl is like advertising the merits of it. Being without drugs scares an addict more than a drug that kills.
2
Let’s continue to hand out clean needles and give drug users places to go to use these drugs. While they abuse drugs and become addicted to pain pills let’s make it impossible for those people who suffer from chronic pain and go the legal route, to be penalized because others choose to abuse the drugs and acquire them illegally.
4
Exactly why drugs should be legal so that people know exactly what they are getting, they are not holed up in out of the way places, far far away from help if needed.
As it stands, folks don't know what they are getting, and even if someone tries to "do them right" by given them "better" stuff --that increase in dosage is often --too often if it is one time-the thing that kills people.
We have to stop the carnage, the cartels, the gangs, the waste of resources --and lives -- due to the silly belief that if we criminalize and strike at and push away human nature, we will address the issue.
We will not. We have not.
We need to get real.
And save lives.
4
Remember Trump's big solution for this? A big, really "tough" ad campaign. As if just the right commercial could rewire the circuitry of the brain that leads to addiction.
1
From a social darwinian perspective........so what.
Yes they are people.
Yes they have value.
But it is a personal choice.
If addiction is genetic, this cleanses the pool via voluntary action.
Each person must recognize their own foibles and want to change.
Or not......
1
Have the addicts register with a health organization who can then provide them with safe drugs, treatment and counseling.
Why are synthetic marijuana products such as these not yet federally illegal for sale in the US while natural marijuana (which does not cause any such catastrophic side effect) remains a Scedule I substance? The failure to act in the parts of the DEA and FDA is appalling.
2
There's probably more deaths because people in need are now going to the street to get heroin. And it dangerous. Legitimate pain medication like Oxy & other narcotics are not being given out. I recently had an issue with my back & needed something heavy for the pain, just to get out of bed. I finally went to the hospital after a week of the worst pain I ever had, I was taking upwards 15 to 20 tylenol, aspirin, advil, excedrin a day and figured one or two oxy is better than blowing my liver and kidneys out. I felt like I would die.... they didn't give me anything but a prescription to advil plus, which does nothing. Sent home to suffer & continue with massive doses of Tylenol that lasted another 2 weeks until my back got better. I feel like I did some real damage this time to my body. I had no choice. If it happens again I will look for heroin or fentanyl on the street. It's absolutely ridiculous what's going on now. These drugs can be life savers. But because people can't take responsibility for their own actions and have to blame someone everyone has to suffer. ............ when a soldier gets wounded they don't give them a joint to smoke or advil.... they give them morphine, because it works. The doctor in the emergency where I went admitted her hands were tied and it was a shame. Let people who need these drugs sign a waiver or something so they (we) can function and have somewhat normal existence. And not live feeling there's no way, dying would be actually better.
9
We need to get on this drug crisis now.
I'm worried about how to get political parties to work together and fight this scourge.
1
What constitutes a crisis? To me this seems like a crisis. This is almost one and half times as many Americans as were killed in the Viet Nam war, and this is is just one year. It's not going to get better on its own or die out like some passing fad. Except for some hand wringing and the occasional "thoughts and prayers," I see nothing of any significance being done. Perhaps if the victims were all first-trimester fetuses we see some real action.
Who is behind the surge of this epidemic? It remembers me the conspiracy theory concerning the 1968 student protests and the control of their political opposition to the Italian government. The marijuana gradually disappeared and the heroin took place (with a lower price). It was named Operation Blue Moon.
Cutting back new prescriptions of opioids will help - getting people into pain management without getting them hooked - but there is a population of people already hooked on their prescriptions. Cutting their dosage back without supportive treatment will simply drive them to illegal drugs. These politicians have got to get it through their heads that passing laws doesn't mean much in a lot of instances.
1
Finally, an article that makes the distinction between synthetic opiods and those processed into black tar and "traditional" white powder clear. The graph shows overdoses of the latter types are about the same as those due to cocaine. The increase in deaths is mostly due to synthetics (fentanyl). If synthetics were removed from the drug supply, most of the epidemic would return to pre-crisis levels. Increase the penalties for the sale of synthetic opiods.
1
A Record 72,000 Overdose Deaths in 2017
According to the NIH's web site, an estimated 88,000 die from alcohol-related causes annually.
While smoking killed 480,000 Americans in the same time frame.
The way Trump talks, all these numbers pale in comparison to the carnage wrought by MS-13.
Where's Jeff Sessions when we need him. Surely he can do more than chasing and jailing immigrants seeking refugee status. Unless these others are not an Administration priority.
Most of the comments are spot on. Overdose deaths are rarely caused by physician-prescribed opoids these days. There is far too much supervision for that to occur regularly, and if it does occur, it can easily be remedied through state oversight.
The overdoses are caused largely by non-prescribed street drugs such as heroin and fentanyl.
Meanwhile, the crazy over-reaction against pain-killers impacts people who really need opoids, and will not abuse it.
I am proud to read that so many Times commentators recognize that drug use, like alcoholism, is often motivated by a miserable life, painful injuries, and no chance of improvement.
Blaming the victim is an all too common reaction in these trumpian times.
5
What are these people running from? Living life on life's terms can be challenging- but it isn't fatal..
1
While Chinese authorities control fentanyl, they’ve been slow to ban new analogues. And they didn’t begin restricting fentanyl’s two most common ingredients until this year. At worst it's state sanctioned chemical warfare on their part. At best it's tacit approval to allow this poison to be manufactured and imported to the U.S. costing taxpayers hundeds of billions of dollars a year and resulting in tens of thousands of deaths. What's bad for the U.S. isn't necesarily bad for China. In this case they profit from Americans dying, and bleed our taxpayers dry in the process.
3
Are our economic peers, with better social safety nets, experiencing the same numbers? Because these overdoses appear to be a social issue. Oh that's right, that is socialist thinking. Imagine what the numbers will be as technology gallops ahead and more people are kicked to the curb.
Canada, which is not "socialist", but highly evolved democratic socialism, has the same issue. it appears that there is a certain percentage of a population that has the addiction gene. once given a taste of these types of drugs, it's a slippery slope. only the addict can effect change.
1
Maybe—in some perfect world—I am supposed to feel bad about 72,000 dying from fentanyl last year and over 80,000 dying from it in 2018. But I don’t. I know people who may ultimately die of alcohol, cigarettes and a bad diet, but not fentanyl.
Regardless, this isn’t about fentanyl, or alcohol, or tobacco, or fatty hamburgers and French fries. Rather, it is about creating meaning for oneself. You don’t stop smoking for your wife—you do it for yourself. You eat a good diet so you look a lot better in the mirror and feel better, too. But it is harder to stay on the path of righteousness, so to speak, in a world of alienation and increasing loneliness. And I don’t see those problems being turned around in our world.
3
Recreational drugs need to be fully legalized, so that dosages and quality control are reasonably regulated.
Just as with alcohol, there will be abuse, and we will need case-by-case prohibition, but the "war on drugs" kills people from the violence over the growing and production end, through the distribution chain, to the user who gets irregular products, while corrupted law enforcement allow the distribution system to continue.
The current "moral panic" over drugs simply reinforces destructive policies.
2
I am more concerned about politicians making decisions about prescriptions than I am of doctors. I trust my doctor a LOT more than any politician. I had a back problem with a pain of 10 of a pain scale of 10. I needed a STRONG pain killer. I did not take the pain killer long. I do not want politicians influencing my doctor as to what my pain surpression needs are. In the articles I read there is often no destination between prescribed meds and junkies.
7
"Strong synthetic opioids like fentanyl and its analogues have become mixed into black-market [illegal or schedule 1] supplies of heroin, cocaine, methamphetamine and the [prescription legal] class of anti-anxiety medicines known as benzodiazepines."
sometimes the causes of death are mixed--including with alcohol--so the cause of death is difficult to ascertain and to categorize:
"Note: These numbers are adjusted to account for some death investigations that are not completed. Some deaths involve more than one drug."
when data are freely available, the graph should have data for at least 10 years, if not 20 years, to better determine trends. also, remember the crack cocaine epidemic?
n.b. alcohol (legal) is not in the graph, neither is cannabis (legal, decriminalized or quasi-legal).
p.s. when considering possible legislative solutions (new laws) to the current situation, it might be best to start with considering the current laws and enforcement by courts and police. other countries also have laws, courts and police, which can function to a better or worse degree relative to those in the US.
2
There is definitely a place for those of us that suffer chronic pain. Eight years ago I was diagnosed with a rare disease; Pulmonary Arterial Hypertension. There is no cure, only eventual death due to Right heart failure. I was given six months to live without treatment. I chose the most aggressive treatment possible, and the side effects are often severe pain. After a long search for pain control, including non medication therapies, I was put on methadone.
I don't tell any of my family or friends what I take because people assume you're an addict. I have tried many times to reduce my dosage and eliminate it altogether, but then I can't walk. Seven years later I am only able to get medication if I have a monthly appointment with my pain management doctor, and pee in a cup.
Seven years people! Yes, I am dependent, but am I an addict? No. I am alive. And functional.
I read so many stories of people with chronic pain who are unable to get adequate pain control, and they're miserable. Many doctors will not even prescribe these medications because they are protecting themselves. And FYI, docs know who they can trust.
Adjust your thinking. Because not prescribing these medications condemns some of us to a non-functional life of misery.
129
@Julie Annie Unfortunately, the bandwaggoners and drug war holdovers do not care about you, or any other patients. They only care about political posturing and a claim of "doing something". Of all these deaths, almost all are from illegal drug users, and none are from the chronic pain community - but in this day and age, facts don't matter.
4
@Julie Annie well said, brava…..as a pain sufferer myself, it's awful the hoops we have to jump through just to live a normal life. I never tell anyone outside my family that I'm on pain meds. They just look at you like you're some kind of junkie...….I haven't even told my husband's side of the family. They don't get mental illness or pain management.
3
@Julie Annie
The opiod “crisis” has all but condemned those with chronic pain to a life of pain. It disgusts me that a dying cancer patient should even have to consider worrying about pain control.
Really good health insurance, like the kind I have with the ACA, takes really good care of addiction and treatment.
I am glad you have a doctor who treats you with the medication you need. Best to you.
3
The opioid crisis wasn't caused by prescribing to patients in pain and won't be solved by restricting prescriptions. Drug prescribing is now at a ten year low, while overdose deaths continue to climb. The contribution of medical opioids to overdose mortality is so small that it gets lost in the noise of illegal street drugs. Search for "The Phony War Against Opiods - Some Inconvenient Truths" published by The Crime Report on June 21.
The only significant role of prescription opioids is in initiating drug abuse among people who never saw a doctor. This is diversion and theft, not prescription. Denial of pain relief and arbitrary discharges and desertions by doctors afraid of DEA persecution are killing patients. This is MADNESS.
11
I’m confused by two things. When my father was at home dying from cancer in 2002, the day of his death a hospice nurse came to the house and took all the oxycodone that was left in the bottle. This was 16 years ago. My sense was that this kind of drug was strictly controlled. Is this still the case?
Why would a drug dealer be supplying drugs laced with opioids that are killing his customers? That makes no sense to me. The ultimate manufacturer of the illicit street drug is killing the demand for it.
Legal tobacco was responsible for nearly *seven times* the total overdose deaths via all listed substances.
Why is tobacco still legal? Why aren’t the executives and stockholders of tobacco companies in jail?
2
I am approaching 76 years of age, very ill, and make the following comments from that frame of reference. We do not control our arrival into this thing called 'life,' nor a variety of the conditions which influence our conditioning and / or subsequent quality of living. Yet, we do have an some ability to determine as to when and how we exit.
I suggest that most "overdose deaths" fall into two distinct categories: unintended and intended. In the group which may be 'intended,' I will refer to one category of 'pain killers' with which I am intimately familiar: Oxycodone, which I am prescribed 90 - 15 mg. pills per month.
All indicators suggest a single dose of 80 mg. will end one's life. Thus if I elect to eat the entire monthly allotment of 1,350 grams, that should kill me around 17 times.
Where a person to do just that, is it a display of the "drug epidemic" or a responsible, adult decision to get off the pain train?? You see, just because 'medical science' can keep your heart thumping while you fall apart, isn't there something reasonable to be said for no going through what is inherently inevitable?
In this respect, my reason also suggests "pain pills" can serve as a positive tool ... and, if so, such a death should not be tabulated as a 'drug overdose' or socio-politically defined "epidemic." In this regard,'suicide' is neither immoral nor illegal; it can be a rational decision when confronted with unacceptable alternatives.
Your thoughts??
4
My nephew told me in May that he has recently had three of his friends from high-school turn up dead from drugs (New Jersey, Pennsylvania).
Living abroad for so long, I was very much shocked to discover how bad an epidemic this has become. Drug use and overdosing was never as bad as this during my high school or college days.
Where is the outrage for drug overdose deaths? From 1956 - 2006, 58,220 Americans lost their lives in the Viet Nam war. There were demonstrations against the war, and politicians tried to end the war. Yet last year, there were 72,000 drug overdose deaths. There aren't any demonstrations against drug deaths. Politicians seem mostly absent. Funding for community treatment programs is lacking. Something is wrong.
1
Narcan (naloxone), I've been told by Paramedics, must be administered every 5-10 minutes after a fentanyl overdose, unlike heroin, when every 45' to one hour is sufficient.
The importation of fentanyl and heroin--from where and how sold-- and the consequent target demographics really should't leave any room for wonderment. This was purposeful and deliberate.
2
People who want to kill themselves will succeed as each new fix will ultimately assure. I read in the article that two of the New Jersey addicts were stabilized and then the addicts returned to hospital when they had their next OD.
Young people don't think they will actually die. They like being high over any other life experience. I was on opiods for over 10 years (oxycodone, oxycontin, the lot) for relief of pain from degeneration of spine (2014). Soon after my surgery, I asked my doctor to let me ease off the pills. I did, and have not taken any of it since.) I had no withdrawal symptoms.
There has been plenty of information about the effects and dangers of drug use. None of that matters if people choose to live in their hopped-up heads. It's not that they don't know what drugs are doing to them. They don't care. Society is not going to fix this.
2
Call it despair, hopelessness, physical pain, soul pain, anomie, anhedonia, unaddressed underlying learning disability, hidden abuse at home, mental illness, accident of birth....whatever. Compassion is called for, not dismissal or disdain.
1
@Auntie social
Instead of selecting from a menu of pedantic excuses, the remedy is much simpler: people need to DECIDE what they want for their life -- regardless of the hardships they have endured. Pandering to rebellious people is a waste of time. They need to grow up or give in. It's their choice/their life. If they want to get off drugs they will do whatever it takes to do it.
US military funding has ballooned to $300 billion annually while trying to get someone into rehab- as my job required of me to do- was nearly impossible. The official count of American war dead due to US policies in Vietnam is 58,220. Around 7,000 US soldiers have died-so far- in Iraq & Afghanistan. Now we hear that 72,000 Americans died of drug overdoses IN ONE YEAR. I have no doubt that there are A LOT of returned veterans in that latter group. I also have no doubt that if Democrats set funding priorities, there will be a saner response to this tragic mayhem.
I won't accuse opiate-addicts of being fully aware the dangers of their drug of choice, but hopefully this tale may help some people, mothers, fathers, siblings, spouses who care for them aware of the ease of unintentionally killing yourself.
I was on a fentanyl patch for nearly 2 years for pain from a non-healing spinal fracture. The dosage I was on barely took the edge of excruciating pain. I had to change the patch every 24 hours on the hour to avoid withdrawal. I kept the dose intentionally low so I could work.
On my birthday a dear friend brought me to a special sushi restaurant. He ordered sake, and while I'm not a drinker in general, on this occasion I had a traditional small cup of sake, perhaps 2 ounces, forgetting the strict instructions to consume alcohol since I don't usually drink. Shortly after, I had difficulty breathing, not enough to call an ambulance but to get to an UC right away. N=1, but even I, reasonably well-versed on management of chronic pain with powerful opiates, didn't think that two ounces of wine could impair my breathing.
What about someone who has no idea?
I wonder how many deaths are due purely to an overdose, or whether that overdose was aided and abetted by alcohol.
1
Our country needs a comprehensive strategy for this crisis. Innovative solutions to combat this devastating epidemic exist. Urge your local, state, and federal representatives to support them:
1) Fund and support needle exchanges. People are going to continue to inject heroin and other street drugs. Needle exchanges mitigate the spread of infectious diseases and keep dirty needles off our streets and out of the community. While needle exchanges are often stigmatized, what’s really going on inside is CPR training, education about safe injection practices, naloxone training, and community and healthcare engagement.
2) Expand access to mental healthcare and help employ more mental health providers. Doing so will continue to help extinguish the stigma associated with seeking mental health services and obviously provide much needed help to a overwhelmed mental health care system.
3) Expand access to Naloxone and naloxone training so more people can be prepared to administer that antidote in an emergency.
4) Support supervised injection facilities where users can test their drugs—to distinguish if they are taking fentanyl or heroin, for example—and also inject safely, titrate doses down, and engage in the other services mentioned here: NE, MAT, etc.
5) Fund and support medication assisted treatment (MAT) programs. For people who are ready to quit and are screened to be appropriate candidates for MAT, Suboxone really can work wonders and help people turn their lives around.
1
let's face it, we love our prescription drugs and Big Pharma is only happy to oblige
Ask your doctor, are opioids right for you? CNN promotes 24/7 the use of one form of drug over another while they lambast Trump with their expert talking heads. The top 1`% make money. Like the prison system, you can and do make money off this stuff.
Thank goodness this story is being reported. Hard to imagine so many OD deaths. For anyone who thinks drugs should legalized: look at the death tally. Treatment is rarely successufil. Addication sadly, resuts in death.
58,220 Americans died in the Vietnam War.
72,000 in 2017? Wow!
I remember back in the Nixon Aministration they were blaming “the black family“. Now that drug addiction is affecting white people in record numbers, where is all the talk about “the white family“?
1
@Jonathan, the answer to your question is simple:
"White Privilege"
1
Many heroin addicts rely on Suboxone to wean off heroin and it helps. Only problem the cost for a prescription is around $700.00 a month and without insurance, which most of them don't have access to, they return to street drugs which are cheaper.
On another note:
What part of the problem does the DEA have in all of this? Another government agency not doing their job.
1
Recent experience shows that as usual the reaction has been overly broad and has dragged in people who should have pain medication. My partner had bi-lateral knee replacement surgery and due to new regulations and overly cautious CVS we had several instances where getting proper pain medication was a full time job. We treat our animals better.
5
Humans, for reasons we do not completely understand, like to get intoxicated. We have done some research into the biochemical reasons for addiction but the predominant wisdom is that addiction is a moral failure and that we blame the drugs, the sources, anything but the biochemical drivers of addiction.
While 12-step based programs work, I would not submit to a surgical procedure with the same success rate as a 12-step program.
What is lacking is research into the root-causes of addiction despite the commonly held belief that it is simply a moral failure. We also need to legalize an open intoxicant production, distribution and monitoring system so that people aren't getting their daily high from some street corner distributor. Yes, that means that we have to change our attitude and understanding of this human problem.
Despite the opponents, the reality is that around 10% of humans will become addicted to intoxicants. Others will experiment but few need die if we take the problem out of the moral-failure ghetto and recognize it as part of who we are as a people and deal with it openly.
24
@George N. Wells
I agree with much of what you say - but first start may be to drop use of word intoxicate: Webster definition: to lose control of their faculties or behavior.
Humans have long wanted to change their experience with reality - including coffee, cigarettes, mild drug effects all the way to total loss of function. The use of a Vicodin isn't experienced as intoxicated - ask the millions of folks with said experience. The sad part is the slippery slope it begins for many. I agree - we need to change how we approach entire "drug" dilemma.
@George N. Wells
"for reasons we don't understand"??? It's no different than the pig who rolls in mud- it feels good.
1
@Martin X, et al.,
It isn't that simple. Frankly it is quite complicated and we do not fully understand addiction. Statistics tell us that only about 10% of people get addicted. To be sure more than that occasionally get "high" but not addicted.
Addiction is dependency at a biochemical level not simply a case of moral-failure or even because "it feels good."
I'm the child of an alcoholic but I don't even like getting high on anything (actually done that twice in my life with alcohol and hated the feeling).
A bit more empathy and a lot more science is required to address the root-cause of the problem.
It's ironic that the states who will not legalize medical marijuana or who make it so difficult to get a medical card and then restrict the use of medical marijuana are states where there is the highest concentration of opioid prescriptions. Admittedly, some people will always prefer opioids and get them however they can but most people who take them for pain would like an alternative and can't legally get one.
13
Correlation != causation
Changes in death rates are interesting and indicate an increasing problem, but they don't necessarily tell the overall mortality rate, which is the real damage done. Sometimes they just tell that the numbers of deaths were originally low so they are more likely to go up, or that they were originally high and therefore more likely to go down. Think of it this way: If virtually everyone in a particular demographic area has died from overdose the rate is going to fall because there are fewer and fewer people to die from overdose.
6
We had over 72 K2 overdoses in New Haven in the last 24 hours. This is what despair looks like. Nearly all people with jobs that pay them enough to prosper - own a home, take a real get-away vacation every year or so, and save for their retirement- don't want to escape reality. People with no hope of a future do. Fix the root of the problem. Spread the wealth fairly.
75
@mimi I don't think this is accurate at all. There are plenty of folks in middle to upper class situations that have substance abuse problems. Having money, as the very old saying goes, does not make you happy. Humans are complex beings. This is not as simple as spreading the wealth. More studies need to be done to figure out the root causes before we start throwing money around that we don't enough of to waste.
1
@mimi
Those were 72 people who chose to smoke fake weed well-known to be a roll of the dice and filled with unknown chemicals. Those were 72 people who made an extremely poor choice that day and now they're gone and honestly we're no worse off.
I was experiencing pain in my shoulder due to, get this, hours upon hours at an office desk typing away. Performing typical financial work hours upon hours, weekends too. My shoulder doctor gave me a pain killer that kicked in immediately. I became an addict in 5 seconds. Looking back, I did not know why, but the Doctor would not provide another shot. Bless him! However, employers need to take care of their people. There are deadlines, but also effective resource management. So when you proclaim you care about your workforce, show us the proof.
19
With the overwhelming amount of overdose deaths, one must ask themselves, when will it affect me? I live in New Mexico, and I love New Mexico, but it’s scares me sometimes. Living in a lower income family, I am no stranger to people doing drugs, I know children of the age of 12 who smoke. It’s terrible. And it’s affected my family before. My uncle overdosed not only a month ago on heroin and was put in a medically enduced coma for 2 weeks. His lungs weren’t functioning properly, and he wasn’t getting enough oxygen curtuclated. I was so scared. He thankfully came out of the coma. But some scenarios, they don’t. My family has been very lucky. But there are others not as lucky as I. And the amount of fear and anxiety that went through me is something I’d never wish upon another. For lower income communities, overdoses are a real and present fact. There needs to be more outlets for help!
23
@Justin Pena
Drug abuse hits all income levels, believe me. But I feel for you because people with more family resources are probably going to have a better chance to overcome the problem.
Most physicians I know have already severely cut back prescriptions for pain medication several years ago. The kids getting addicted now are getting it from each other and dealers.
The supply has to be interrupted and search laws need to be made in favor of law enforcement.
The notion that a fully addicted unfortunate individual is making a “free choice “ is also an absurd problem. There has to be laws in all 50 states that make it easier to commit an addict to 90 days treatment. Also the HIPA privacy laws are being used in an absurd way by the addict to block family members from helping. All addict inpatients should have a family member assigned to the case regardless of what the addict wants.
Penalties for pushing and dealing should be severe like 30 years prison.
Start with these points and you may make a dent into a very serious difficult problem.
9
@Mickey
My nephew, a young man in his mid-20s, had a minor out-patient sinus procedure earlier this summer. The doctor sent him home with an oxycontin prescription. He took one dose the first day, and then switched to tylenol -- I have to say that if I had been that doctor, I am not sure I would have handed out oxycontin quite so easily -- altho maybe he was just lucky not to have had a lot of pain, and the average patient having that procedure would have really needed the prescription.
@Mickey This tactic has failed for the past 80+ years, while making out country much less free. Why do you think it would be different this time???
1
Wyoming, North Dakota and Oklahoma should be commended for bucking the trend. However, their populations are small and a larger percent change cannot yet be said to be statistically significant. Utah, New Hampshire and Massachusetts should be held up as examples of what other states need to do. States that fail to show results also need to be accountable for failing to provide any relief for this horrendous problem.
9
My son is a licensed neuromuscular therapist (aka therapeutic massage) who gets excellent results relieving some kinds of pain. Insurance will not cover his therapy but it will cover chiropractic adjustments and physical therapy. I myself have been treated with all three for lower back pain and therapeutic massage was the most effective. We should demand that insurance cover all non-drug pain relief therapies. It's time to support healing, not just pain cover-up.
105
Absolutely. My father has a debilitating chronic headache and vertigo syndrome diagnosed by the Mayo Clinic as effects from him being prescribed Vicodin for the past 20 years after a botched back surgery. It ruined the quality of his retirement and day to day life. I more than partially blame his general practitioner for not pursuing any alternate treatments over these many years. I posted a similar comment a year or so ago and was blasted by several doctors who said I had no empathy nor understanding of my father’s pain and had no place challenging the diagnosis of his GP. To those, I am my father’s care giver and am more than aware of his pain. It’s time for the medical community to stop the self defense and begin to address the destruction caused by long term narcotic pain medication.
15
@abigail49 This is so right. The medical world needs to face the fact that they can not solve all health problems but that there are modalities that can. I had a debilitating back problem and the orthopedic folks said all they could do was to inject and maybe that would help. It finally went away and I attribute my healing to acupuncture and kinesiology. But paying for the acupuncture treatments is expensive--not possible for everyone.
2
@abigail49
I have to say, I had moderate back pain, and I found that a monthly deep tissue massage was an amazingly effective treatment. I know it won't work for everyone, but it certainly worked for me.
1
I think the drug problem including opioids is basically due to the frustrations that occurs when a person is living on the edge of survival. When even a minor hospitalization can cost you your house because the mortgage can't be paid for a few months, many people retreat into the use of drugs to shield the mental pain.
51
@Hank
Yes we are unique in this. Canada has opened supervised injection sites with great success. One European country started prescribing government issue heroin to incurable addicts. They come in to a center at scheduled times during the day, and then go off to their jobs. They are supported in rebuilding their lives, so all that’s left over is their physical addiction. This is helping to cut off the
black market, and less young people are being introduced/socialized to the drug.
Other first world countries also have better access to preventative healthcare and stronger social safety nets.
There are many innovative interventions and preventative means. The question is whether we are willing to try them -or if we want to insist on continuing to try and fail to punish and ostracize people into sobriety.
30
@Chelsea - First, I think you replied to the wrong post.
But more to the point, Canada is indeed having a huge surge in overdoses nearly as bad as the US, and like the US, the surge is due to fentanyl and other synthetic opioids in street heroin.
Canada's response is surely more humane; aside from injection sites, clean needles are readily available and Narcan is widely distributed to addicts along with instructions for how to use it to counteract overdose. But make no mistake, the problem is just as severe here.
@Hank
My father was prescribed oxycontin following knee replacement surgery, and ended up needing to take the drugs to deal with chronic pain. I was one of the people who complained about how hard it became to fill his prescriptions after the authorities started cracking down. But then he had to stop taking the drugs because of constipation issues. It was tough for about a month, and the chronic pain went away. I think what we (and he) thought was chronic pain due to osteoarthritis was actually withdrawal symptoms.
1
s the USA unique in this way? What other countries have a problem with fentanyl/opioid overdoses? What are they doing about it?
20
@Jim - Canada has the same problem. What are we doing? Distributing a lot of Narcan. Is it helping? I honestly don't know.
An economic analysis of the increase was carried out by Angus Deaton, the Dwight D. Eisenhower professor of economics and international affairs emeritus at Princeton University and the 2015 Nobel laureate in economics and his wife Anne Case, Princeton Professor of Economics
And published in the NY TIMES with the headline
The media gets the opioid crisis wrong. Here is the truth.
The last sentence in their article is the most important one
"But the long-run solution is much harder to attain. We need higher wages and better jobs for working people. The past 40 years suggest that is a far more difficult goal to attain."
https://www.washingtonpost.com/opinions/the-truth-about-deaths-of-despai...
Yes , it is, as in a global economy with free trade and no tariffs where wages of those exposed to global competition must run settle on the global average.
This elementary fact is vehemently denied by proponents of free trade and no tariffs, notably Paul Krugman, but this is what keeps wages low in the US and better jobs for working people disappearing to low wage countries
Recommended read:
Becoming a steel worker liberated her, than her job moved to Mexico.
https://www.nytimes.com/2017/10/14/us/union-jobs-mexico-rexnord.html
17
I don't want to oversimplify matters -- this is a crisis with multiple causes and just as many "solutions." However, I'm not sure what rationale can be used for the continued futile "war on drugs." It's not working, it hasn't work, and it probably won't work. A move toward legalization would free up money for prevention and treatment, not to mention (perhaps) addressing more effectively some of the factors that can contribute to addiction: abuse, trauma, poverty. It would also allow for users to have access to non-adulterated drugs, which is the primary cause of these overdoses. Our attachment to funding the big government programs that benefit from the current arrangement (law enforcement/corrections), as well as our attachment to controlling others choices of how they alter their consciousness, will likely prevent this. Btw. I'm a progressive, but those on the Right please note that the arguments for legalization are actually closely aligned w/ conservative/libertarian principles.
35
@Andrew N - "It would also allow for users to have access to non-adulterated drugs, which is the primary cause of these overdoses."
That point deserves to be underscored. People like always think about what can be done to curtail addiction (mostly criminal penalties, which haven't prevented the current situation, have they?), but too seldom ask what really causes the lion's share of harms associated with addiction.
As this article points out, addiction itself is not rising at nearly the rate that fatal overdoses are. The reasons for rising addiction are myriad, it may be too many prescriptions, the increased pressures of the modern economy, or whatever you might want to ascribe it to; and solutions are few and wanting. But the reason for the epidemic of overdoses is clear: street heroin is increasingly adulterated with fentanyl and other even more potent synthetic opioids, which are more potent than pure heroin by orders of magnitude and are correspondingly difficult to disperse in accurate dosages. An addict does not know when s/he is getting a double dose or more, and fatalities result. There is a simple solution to this: ensure addicts have access to drugs of known and consistent quality. Unfortunately, in our prohibition-determined society, that looks too much like legalization for most people comfort, so instead we opt to watch addicts needlessly die.
Even with this increasingly affecting white people, I've little hope of our society ever changing course.
20
@Andrew N
Those who cannot remember the past are condemned to repeat it.
Around 100 years ago opiates were not illegal. They were made illegal in response to the crises caused by their ready availability, in the same way Prohibition was a response to the terrible toll alcohol took on this country.
Simply legalizing these dangerous substances will lead to a return of those disastrous circumstances, and believe me, we will be funding other government programs to deal with it.
@Andrew N
It didn't really begin as a war on drugs, it began as a war on black people.
This situation is not about to get better any time soon. It’s far more complicated than the ease of access to prescription opiates, or the complete black market saturation of heroin (basically the most euphoric recreational substance, as well as the cheapest).
The multitude of reasons that different individuals wind up using to justify their respective addictions is almost immaterial at this point. We can each either choose to treat our loved ones prohibitively or compassionately. There’s really not much space in between.
8
Our corrupt system enabled a drug unsuitable for chronic pain to be approved for use by chronic pain suffers.
Chronic pain is not necessarily severe pain. It is pain from injury or disease that will either take a long time to go away or may never go away.
The body adapts to opioid drugs, which means over time opioids must be taken in larger doses and/or more frequently. When you've gone through the Sackler-patented drugs, Vicodin, oxy-this and oxy-that, then stronger and more dangerous drugs are needed.
Our stock-trading Congressmen and women won't legalize marijuana for chronic pain, even though it has been proven to work for many pain suffers. The reason is they cannot make absurd profits off something that cannot be patented, farmed not "pharmed."
Why do you think so many Republicans and neo-Liberals in the Democratic party are in love with privatizing? Sure their major donors from the one percent like it, but they do well, too. Many of their offices have looked like day-trading shops, and probably still do given these volatile times.
21
@Carl Lee Tolerance isn't so simple. It doesn't necessarily build in response to repeated exposure. Anyway, physicians have options for rising insensitivity besides dosage or frequency.
I'm sure you understand that, as a cancer survivor with chronic pain, I'm unnerved by the misapprehensions. And they're myriad -- little wonder, reading the coverage.
Over-prescribing isn't the issue. The vast majority of abusers aren't using prescribed drugs. And those who are? Their names aren't on the scripts.
Prescription is policy's focus because administered intervention is operationalizable, but the dilemma is psychosocial.
9
@Joy I wholeheartedly agree with your comments, Joy.
I see some comments here advocating the severe restriction of the prescribing of opiates. Yet, the article addresses the falsity of this argument - the number of opioid prescriptions has already been falling steadily since 2012, yet overdose deaths are still rising. Moreover, most of these deaths involve synthetic, illegal versions of opioids, not personally prescribed drugs.
Those tasked with “solving” this crisis will always be tempted to characterize the problem as one of regulation, but the dynamics here are more complex than simply enacting draconian measures. When wrenching issues like addiction, chronic pain, suffering and death collide, the most effective solutions are ones that are nuanced and thoughtful. This means the increase of available and affordable (or free) addiction and dependence treatment, destigmatization of addiction, and (most importantly) a revolution in the treatment of chronic, severe pain.
Dear Doctor,
Stop. Prescribing. Opioids. For. Every. Minor. Ailment. Or. Injury.
Talk to your patients about the underlying cause for their pain look at alternative ways to relieve pain Ending this scourge starts with you.
---
www.rimaregas.com
25
@mayatola
I didn't write take it all away, but what goes on is intolerable.
They even offer Fentanyl to children! A former neurologist of ours wanted my daughter to take a "tiny" nightly dose for better sleep. She was ten years old!
2
You are absolutely right. Just stop prescribing opioids. in 36 years of primary care practice, I only prescribed to cancer patients and acute injuries. Even some cancer patients were suspect for diversion. many patients who I got off of opioids were very grateful.
I call it the Opioid-Industrial Complex. Make money addicting people and make money treating them. the deaths are just collateral damage in the profiteering.
20
@Rima Regas
Dear Rima,
I. Usually. Agree. Wholeheartedly. With. Your. Wise. Comments. Not. This. Time.
Like others who have responded to you, I am an older physician with 30+ years in practice, mostly in emergency care. Yes, we do have a great responsibility to limit prescribing. But the vast majority of doctors don't prescribe opioids for every minor ailment. There is a small segment of practitioners who vastly over-prescribe. Some legitimately have taken on the toughest pain patients around - they're not treating minor ailments.
Others are doing the prescribing in large amounts for profit, or out of ignorance or incompetence. Those docs need to be stopped.
When a person turns on their TV these days, there's a pill being pitched for every ailment. A doctor can spend 30 minutes talking to a patient about how antibiotics aren't going to help their virus, or how opiates are the religion of the masses. At the end of the time, a fair number still want their pills. They're not interested in prevention or the cause of their pain, or the alternatives. We need to learn to say no persistently. But cultural change would assist in the process.
There are lots of people whose hopelessness and psychological pain from horrible economic circumstances get caught in the trap of opiate abuse to dull their senses. The medical community can't fix that.
Docs should shoulder part of the blame and must be part of the solution. But we aren't the only solution.
13
“A large government telephone survey?” Does that mean landlines?
Nobody under 40 even has a landline anymore. Useless survey if the population is skewed older.
18
@Julie Zuckman
And what sort of caller ID do these surveys use? If it's just some 800 number, most people with caller ID (including all cell phone users) will just ignore the call.
8
@Julie Zuckman: that meme -- "surveys and polls only use landlines" was barely true in the early 00s and now it is ridiculous.
The survey firms and pollsters ARE ALL KEENLY AWARE that most people -- yes, even seniors and your grandma -- now have cellphones. They do the surveys via cellphone or sometimes internet.
Nobody is doing surveys of landlines and not for a dozen years or more.
Statistics (when accurate) can support the benefit of change. But with regard to opiate addiction, I'm not sure we can successfully impose our values on those who are addicted. It is tragic that purported 72,000 people died from opiate-related deaths, but they are victims of their own choices.
If we believe that statistics should be acted upon, perhaps we should act on resolving the challenges that killed 250,000 patients in hospitals in 2017.
https://www.cnbc.com/2018/02/22/medical-errors-third-leading-cause-of-de...
Hospitalized patients are vulnerable. It is likely that we will all be patients some day. It is unlikely that we will all become addicted to prescribed or street acquired opiates.
While addiction is tragic, I have to respect and accept the autonomous choice of adults to use opiates for pleasure....even when it hastens their death.
I do not have to accept that I might die in a hospital when I seek paid recovery from illness or injury.
28
I agree to a point. While you are at risk of death in a hospital, you would most certainly die without the opportunity to seek medical care. Life has its uncertainties and humans are fallible
@Brigette Quinn Please stop with the whataboutism. What about heart disease, which kills many more Americans than opiates or medical mistakes? What about cancer? What about any number of other things which are also important? In trying to deflect attention to another cause YOU happen to care more about, you're choosing to discount these 72,000 lives and the effects on their loved ones. You're also choosing to ignore the effects the opioid addiction crisis has on the healthcare system you claim you'd like to improve. Believe me, it's not inconsequential.
2
@Brigette Quinn
Why can we not address both problems? Why do you assume that because some people are addressing the opiate overdose issue that no-one is working on the problems of preventable deaths in hospitals? Our nation has immense resources and we as a society are quite capable of doing multiple things as once.
These deaths, or the majority of them, must be from illegally acquired drugs and by combining drugs --because prescriptions are down or non-existent. Over two years ago, my clinic took on a policy to not prescribe opioids, period. I had a choice: seek another doctor or wean myself off them. I weaned myself off them and discovered that my particular pain got better through P.T. and medical massage which is what was my request as a condition on staying. For now, at least, that works.
14
@Flo, my sisters death one year ago at age 21 was a prescription fentanyl patch that her doctor gave her. He hadn’t seen her in 6 months but left the rx at the front desk monthly for her to pick up. I’m glad you found a safe option for pain relief.
7
I come from a family of addiction; addiction to work, money, alcohol, food, drugs, television, clothes, and a few others. Some of us let those take control at times, and some of us think about the big picture and even when difficult, say enough is enough. Yes, addiction is a disease, but as chronic and painful as it feels sometimes, you can get better.
16
This is a considerably higher number than gun deaths, or even suicides which are also higher than murders. Sinc 1980 I have been prescribed hydrocodone and oxycodone many times with no addiction issues and no difficulty in sticking to the correct dosage and stopping when no longer needed. Right now I have a bottle of oxycodone since March, waiting for an instance I may need them and not have to face the ridiculous 5 day dosage now demanded by law. The problem lies not with the drug nor even with Big Pharma. It lies in the hearts of people who want a particular high and can con their families into believing their pain is unrelenting and their doctor tricked them into addiction. I am sure they do have unrelenting pain, but of the psychological sort. It's not an opioid crisis. it's a crisis of unhappy self-destructive people.
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@Eli
It’s also a crisis of genetics. Some people have the genetics that predispose them to addiction and you can see the genetic tree of addiction throughout their family history. Others do not and shouldn’t be made to pay for the accidental genetics of addicts by being denied adequate temporary pain relief when needed.
Hopefully we’ll get to the point where everyone will have their DNA scanned as part of their medical record and can be given individualized treatment based on that, not the fear politics of white opioid addicts. I especially loathe the fact that this is only now a media-hyped crisis because it’s primarily a white problem while black and brown addiction has been a problem for decades with no corresponding response from media or government.
1
@Eli There does also appear to be a genetic pre-disposition to addiction, which should not be surprising as it involves expression of receptors in the brain that mediate their effects. So even though you personally may have no propensity for addiction, this is not true for everyone else.
2
@Marc
Sorry to disappoint you, but I have the genetic predisposition myself - I come from multiple generations of alcoholics. I may be "predisposed" to many things, but that does not mean I cede control (I do not drink alcohol nor am I in recovery).Therapy for adult children of alcoholics taught me that it is not a matter of will power, it is a matter of won't power. I realize that we live in times where free will is only attributed to success, and predestination - genetic or otherwise - is associated with failure.
There's a HUGE uptick it meth use. And legally prescribed opioids aren't part of the problem. Illegal fentanyl and heroin are.
https://www.nytimes.com/2018/02/13/us/meth-crystal-drug.html
17
For many people life is a real burden. Dead end, low paying jobs. Unforgiving bosses. And constant mocking displays of unimaginable wealth dangled by the one tenth of one percent.
Now unions, thanks to the two most recent Supreme Court picks (the Trump stooges), are pretty much on the way out and anyone not solidly in the one percent will effectively become a serf in 10-20 years. Certainly their children or grandchildren will.
May as well take drugs.
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@Will. I fail to understand the logic. If the situation you described produces addicts, why weren't we tripping over the bodies of the dead during the Great Depression? WWI?
A member of my family contributed to this statistic. Not a day passes without pondering what went wrong.
I have read all the readers comments so far: Here is a list of some people beliefs on what is the cause of this crisis. With so many passionate opinions, how do we formulate a coherent public response?
dehumanizing nature of our life and times – Richard Baker
Keep denying that opioid addiction is a moral failing – Jack
inevitable in a capitalist society – Insight, US
Addiction is “elective disease” – BMD
Logical end of atheist worldview – Kennel Touryan
Result of growth of population and not enough opportunity - Daniel K. Statnekov
reality for millions of its citizens that is so bleak – Fred
19
When black people did it in the 80's, it was because they were genetically inferior, their families were dysfunctional, they were burdening society, etc.
When white people do it in the 2010's, it's because they're innocent, beautiful people who are the victims of drugs (brought in by Mexicans).
Them's the facts, clear as day, for anybody who's lived through both times.
326
I have to agree. Cigarettes kill hundreds of thousands and alcohol kills thousands, including innocent bystanders. But white men make millions or even billions of dollars, so you can buy these drugs in the supermarkets. And we let the Sacklers make their millions before cracking down on opiods. You have to wonder at human logic.
1
@KS:"When white people do it in the 2010's, it's because they're innocent, beautiful people who are the victims of drugs (brought in by Mexicans)."
Actually you've stated a common thread: their families were/are dysfunctional, they were /are burdening society.
Congratulations.
@KS
You are so right. I observed the same thing about economic policy. Now, they would destroy the global economy for these midwestern manufacturing whiners. But in the 1980s and 1990s, they did nothing for Blacks suffering from "the disappearance of work," as William Julius Wilson powerfully analyzed.
2
The Times discussion of the "real reasons" for the opioid epidemic misses the biggie. More specifically, unless and until we begin a real dialogue respecting the dehumanizing nature of our life and times, we are doomed to a never ending cycle of addiction to whatever substance (I'll drink to that) or activity provides most immediate and effective escape from the inescapable and very real insecurity that defines our age.
I grew up in a time when a guy (sorry for admittedly but accurate sexist reference) could get and hold A BLUE COLLAR JOB that paid enough to buy a home, provided leisure time and pension, while his wife stayed home to keep the kids out of trouble and on the right path. Fast-forward to a now when a college education and 2 or sometimes 3 incomes don't cut it.
My folks passed proud of their kids accomplishments and relatively secure in the knowledge that we'd been well prepared for the world. My kids are postgrad professionals (kinda hoped for a plumber) & while none suffer addiction disorders, is their anyone out there deluded enough to opine that their futures are as secure as ours were?
Sorry Margot but until we make our society fit for human habitation, statistics about where we get our drugs were about as useful as deck chairs on the Titanic
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@Richard Baker Your example is too simplistic. While one income could support a family, the family didn't expect to have mobile devices, subscription television, annual vacations, multiple vehicles, etc. In addition, just because women could stay home and raise children doesn't mean that all would have chosen that path if given other options. We cannot go back in time, so the real question is how do we all move forward?
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@Shari
And in the 1970s, the average home size was 900 square feet. I know that people in Manhattan would kill for that much space, but the reality is that overall, that number has tripled. And the people I know who constantly complain about not being able to make ends meet have 2-3 cars, 2500 square feet, and four televisions. We have a lifestyle problem in this country.
@Shari
Time to pull back on mobile devices and phones for kids (which actually exacerbate their depression), subscription TV, vacations and multiple vehicles. We have become the worst example of "keeping up with the Jones". No one NEEDS most of this junk. Be brave and be the mean mom. As to vacations, personally, go back to the Poconos. Time to stop spending a fortune to attend a cookie cutter Broadway play or mortgaging the house to visit a Disney property so you kids can wave at one of a dozen Mickies.
Keep denying that opioid addiction is a moral failing, and this is the result. More excuses and accommodations, followed by more deaths. The money spent (wasted) on helping those who won't help themselves is outrageous and irresponsible.
29
they're so weak willed and reprehensible they deserve to suffer and even die, huh, Calvin?
@Jack No it is not a moral failing. It is a failure to invest emotionally in our children, giving them things, but not our time. It is a failure of a country with a president and dominant party that is vile and disgusting, with our president not being a role model for anyone's children, a complete ethical and moral monster.
Young people see no future. The nation is divided as never before and the public hostility (KKK marches, alt-right, Bannon, the Charlottesville "Jews will not replace us" racial and ethnic hatred leads to a loss of meaning and purpose in our young people.
The language of 'moral failing' may make the Jacks of the world feel morally superior, and I guess their ego requires that, but alas, it makes more people feel helpless and stigmatized. I hope Jack will learn more about opioid addiction and open both mind and eyes to a reality that seems to elude him so far...
8
@Jack So what do you suggest? Penal colonies? Bigger and more profitable private prisons might be an approach that is appealing. There are unquestionably issues derived from personal choices and poor decisions for some of those addicted to opioids, but you seem to assume that this is universally a moral question. What morals? If you think that helping those who are addicted is irresponsible, then I suppose you are resigned to increasing property thefts as a new normal for this country. That seems like a national moral failure to me.
7
One day sooner than later maybe u will have an article on the number of people - including their caretakers, on the relief the Opioids have provided and another story on how miserable the refusal to provide those pain killers to people -including their care takers, has made their lives and in some cases making them to street drugs.
59
So is there anything North Dakota, Wyoming, Utah, or Oklahoma doing right? Just blind luck?
12
Sadly, this sort of thing is inevitable in a capitalist society in which there is 1) huge profit to be made from manufacture and sales of synthetic opioids, and 2) little profit to be made from helping people overcome addiction.
13
We read so much about the "opioid crisis," and all the tragic overdose deaths. I would find it helpful if articles such as this would differentiate, or at least use language that would help me to know if they are talking about illegal/street opiate use, versus prescription use. Prescription opioids still have a major place in medical treatment I assume, at least for short-term, severe pain management, or in the setting of chronic cancer pain, etc. Are these a major component of the crisis? Fentanyl is widely used in medicine, so I assume that fentanyl "abuse" is outside of that, in the form of illegitimate production and adding it to heroin, etc. "Opioid use disorders"---what is that exactly? Addiction to prescription drugs? Street drugs? or what?
Wherever the source, it is no less tragic of course, but it would help me to understand it better.
57
@Steve The problem is that people get hooked through 'legal' means when the doctor over proscribes unnecessary doses of opioids. Then those 'legal' users seek it out and the rest we can see on the charts.
8
@Steve
There are small towns in West Virginia where pharmacies have filled prescriptions for millions of pills, legally, through medical doctors. This is big business, high profits, for the drug companies, the regional distributors, the doctors and the pharmacies. That this was allowed to go on unchecked for so long is the ultimate root of the overdose problem. Profits from death.
31
@Doug Terry
I am a nurse working in hospice for a third of a century in southern Indiana so I've seen a lot of good opioids do. Unfortunately lately I've seen a lot of really really bad. Austin Indiana for some time has had a "doctor feel good" prescribing incredible quantities of Opana. That drug is not designed to be shot up but the locals do it anyway. Sharing needles, local residents made Austin the HIV capital of rural America... and a major center of more traditional general diseases and hepatitis.
1
I have in the past found Sanger-Katz very reliable on health care. I'm a nurse in Indiana, where opioid misuse has been skyrocketing. I find that my first two reactions were "Such a high number could not possibly be right" and "No! It's worse than that! A lot of deaths are just not being reported as drug related."
I guess I will just have to accept that I do not know how many deaths there really were. I do know that among those who did not die, there were immensely greater numbers of tragedies.
24
Another factor to keep in mind: the overdose rate in New England may be receding not just because the states have improved access to treatment, but because the people at highest risk of death by overdose are already dead. New England was one of the earliest regions to be hit by the opioid epidemic. It could be burning itself out simply because so many of the highest risk users are no longer alive.
130
a grim but reasonable assumption.
otoh, there's one born every minute, as a famous New Englander once said.
but the very fact this story is appearing means there is a vast amount of unalloyed misery, physical, emotional, and psychological, in America and we don't have the will to confront it, let alone deal with it.
so, blame the weakness and moral failings of the victims, who may have been making a dangerous but reasonabke choice: the horrors of opiod addiction v the misery of knowing you are worthless to the world.
4
@Ana This article is fairly concrete evidence that any user of opiates is in the high risk category. A 10 year veteran of IV heroin use is just as much at risk as a teenager trying for the first time. It’s truly horrifying .
Treatment and education work.
2
Meanwhile, marijuana remains illegal. One of the absolute safest ways to treat pain (arguably safer than ibuprofen). Doctors tried pushing opioids on my 71 year old mother, but she chose grass instead (thankfully).
195
Couldn’t agree more. After my shoulder surgery in Sweden one year ago, I was given OxyContin for the pain. I couldn’t stand the way these pills affected me and I quickly changed to grass. The results were fantastic!
23
@ASG Great! Now she can die of lung cancer instead, which is much more painful than an opioid overdode
@ASG That can help, but it is no substitute for opioids in treatment of severe, chronic pain patients.
1
I was an RN before retiring. I also have herniated disks and arthritis in my lower spine, L3 L4, L5. In 2015, I moved from Washington state to Indiana. I suspect a higher rate of abuse in the midwest is Doctors failing to relieve pain adequately.
In Washington, for 8-years I took 1-tablet of 5/325 Percocet at 10 am, and 1-tablet at 10 pm which managed my pain and gave me a normal life if I paced myself.
In Indiana, the doctor under my insurance did not see a herniated disk causing pain and a very lose of this med for 8 years controlling it. He only saw the drug and stopped it cold turkey and dragged his feet to see a Pain Management doctor who was a quack, also.
Stopping a drug such as this cold turkey can cause sudden death from a heart attack, or other causes. I suffered chest pain and difficulty sleeping for a good 3-weeks. I also informed my 23-year-old son of what was happening and instructed him to sue this group should I literally die from a Heart attack, and why.
In Washington, the doctors actually use the brains God gave them. There are ways to spot drug seekers vs people with legitimate pain. He had the CT Scan results showing the damage to my back, he has 8 years of summary showing I never increased the dosage in 8 years.
The problem just may be a good majority of people are in legitimate pain and the doctors refuse to treat it, people on the streets are helping with more addictive drugs to be pain-free. Drs. may be pushing people to dealers.
176
@Delores I am so sorry to hear of your negative experience with doctors in Indiana. I, too, am originally from WA, now in IN. What a marked difference in quality of care between these two regions.
I'm an inpatient medical coder and have read more than my share of documentation from Pain Management physicians. It has been my experience that the majority of these MD's live to label anyone needing opiate medications -- legitimately or not -- as hopelessly addicted. Whatever they document in the record, we coders must capture in ICD-10. So, "opiate dependency" (F11.20), a diagnosis that will forever be linked with that patient as pre-existing, can wind up in cases where...
* the patient was not receiving opiates prior to the hospital admission (but needs them in the postoperative period)
* the patient is clearly noted to be needing opiate medications intermittently (ie, is not requiring or asking for 24/7 dosing)
* the Pain Mgmt MD has chosen to switch the patient's regimen from NSAIDs to opiates for "more effective pain relief" (and still decides to label the patient as opiate dependent)
* patients are quadriplegic...or in persistent vegetative states...or whose sole response to pain is a grimace...can still be marked with the diagnosis of opiate dependency should the PM MD declare it.
It's madness.
5
@DeloresNo one dies of a heart attack from going off 10 mg /day of oxycodone cold turkey. That's a very low dose. The withdrawals would be a bit unpleasant, but not severe. That said, you're right: doctors are withholding meds from people who need them, and are going to the opposite extreme from before.
Many doctors treating pain have been jailed, medical license revoked, controlled substances Registration DEA number revoked, money and assets forfeited.
Why fentanyl? To a chemist it is a fairly simple molecule readily made using standard reactions and equipment. The other opioids, by comparison, are natural products made by, for example, poppies. These opioid molecules are structurally complex and not amenable to industrial synthesis like fentanyl is.
Given its ease of synthesis (= low cost) fentanyl will remain a street corner curse. A large amount of the street fentanyl has been traced to clandestine operations in China.
To me, solutions to the problem are not obvious except that current approaches appear to be ineffectual. Serious rethinking of the entire program needs to occur and fast. I do not see any impetus to go there by any level of government.
14
It is the same with war, many deaths just because of the money that can be made.
As long as the companys which make the money have very close ties with the government nothing will be done.
17
@Lex Dont forget that includes the cops, courts, "drug treatment centers", prisons, and drug testing labs...
1
“The dominant factor is the drug supply,” sounds reasonable as a description but can be considered to be misleading as a useful explanation.Are we to believe that a more effective controlled supply would guarantee that fellow beings who engage in risky behaviors would make “healthier” and wiser daily choices? In their/our daily lives as all of us cope, adapt and function, as best as we can, given who and what we are? Who we are not, as limited “organisms, and may never BE? Who we may yet BE come,with our (un)available and (in)accessible internal and external human and other resources? It is surely time to stop “blaming” the chemicals which we empower and the diverse, stigmatized, targeted, selected, “users, ” whom we continue to disempower in our socio-political created WE-THEY violating culture and world for realities outcomes!The interacting unpredictable, uncontrollable and random outcomes of risk-taking include death. Transmuting and dehumanizing a complex-risking Person into a number-trajectory, linear or non-linear, on a graph, doesn’t help to raise necessary questions nor stimulate/explain viable options to plan, begin to implement effective, viable options and to learn from both the processes and the outcomes.The 72,000, whatever its validity does help us to better know and to understand: what is effective and indicated ;what is contra-indicated; what is irrelevant, wasting limited resources, including time, and what is/can be temporarily or permanently harmful?
And now a state has used fentanyl for executing a prisoner.
Who needs novichok when a speck of fentanyl will do the job quicker and with less collateral. Watch out! There will be fentanyl-spraying drones before you know it.
6
Dear BMD: Your position on "conflating addiction " with other diseases lacks merit. How do you define elective? Many behaviors which are elective activities contribute if not cause disease. Smoking, overeating, lack of excercise, and risk taking behaviors. No one elects an addiction, which by the way is now confirmed by the AMA and the APA as a disease and disorder.
4
Seems to me that if anyone should lose their citizenship and be expelled from the country, it should be the Big Pharma executives that promoted this stuff.
62
@Geoman Sorry, but crime and punishment in America are for the little people.
1
All you believers in the Darwinian theory of 'survival of the fittest'. These deaths from overdose are humanly disheartening, but remember, nature knows how to eliminate those who are not fit for living and procreating....
Sound cruel? It simply is the logical end of an atheistic world view.
9
Atheism does not equal darwinism. Darwinism is a theory of biology. In this type of discussion it would be more suitable to see humanism as an alternative to deism.
33
@Kenell Touryan What you call "Darwinism" is natural selection which is part of a scientific theory of evolution which is more than natural selection (even though that is a key component). Scientific theories (good ones) are testable and falsifiable and refined continuously.
Atheism is a belief system (I say this as an atheist). It is not a scientific theory (and cannot be one in a Popperian sense).
Natural selection isn't about a individual person's fitness - it is fitness of the species and fitness at multiple scales. But saving lives and helping people lead healthy lives may lead to increased fitness of the species taken to its logical extreme. This is why we have cooperative instincts. So your views are simply not being logical enough.
13
@RamS I do not deny at all , our efforts as human beings to help addicts from their folly. It is more of a spoof for those whose values are based on the theory that we are slightly above chimps in the evolutionary tree...conclusion; we humans have no intrinsic value...
My position is different, we humans are created in Imago Dei and ergo, are responsible to help our fellow humans.
This is what hopelessness looks like. Russians turned to vodka with despair and now Americans are turning to opiates.
154
@Vote with your $'s Its not new , Americans have been turning to hard liquor and/or cocaine and its derivatives and/or opioids since the foundation of the Union . Greater potency , fentanyl etc, and availability, mass marketing and ubiquitous pharmacies , mark the only differences today then one hundred or two hundred years ago.
1
The Russians didn’t turn to vodka. They always coexisted.
@Vote with your $'s
Thanks for connecting the dots.
Having lived in eastern Europe during Soviet days, this is what we saw...people lying on the street hopelessly drunk, and just hopeless.
I have speculated that this drug epidemic is a symptom of the times here in the U.S., especially given mean-spirited government policies that lack any vision or hope except for the already-quite-rich.
I am not naive about drugs, but when this many people take their chances with drugs that can get them high AND cause death, it seems much more is going on.
Just this week over 70 people ODed on the Green in New Haven. I bet that not many were Yalies who are well-positioned for hope. This is in contrast to the many Americans who have less to look forward each day, in terms of jobs, income, health, functional families. or social mobility.
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Did they count the guy Nebraska executed the other day?
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Most addicts in recovery, like me, know that addiction leads to jails, institutions, and death. This article only discusses death, and thus, does not paint a complete picture about the degree to which various drugs are becoming more or less prevalent and destructive. Meth, for example, is less likely to kill you directly than heroin, but its evil scourge, which is seeing a resurgence, should also be considered a top public health priority.
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@Brent Adams, As should alcohol.
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@Brent Adams
Good luck on you journey to recovery Brent.
If you succeed, try to help at least one other person in recovery.
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@Brent Adams Hope you get through treatment and back to living a normal life.
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Unfortunately, no, make that, "tragically," the problem is NOT caused by or the result of the opioids. Essentially the problem is identifying the underlying reason why people take these drugs. Something is gravely amiss. Perhaps it's something to do with there not being enough opportunity for young people to enthusiastically embark on a productive course in life. We might view this as partially the result of the growth in population of the younger sector of our society pushing mightily against the stark reality of fewer opportunities for meaningful, gainful employment, an overwhelmed school system which is unable to guide students into a life's path which is appropriate or 'matched' to the student's capacity, and last, but certainly not least, the deep search for that thing or subject which best aligns with the student's enthusiasm as well as their capacity. The educational system must be re-calibrated to identify the very same delight which prompted a squeal of delight from their students when they were children. Removing the opioids by itself will not solve the problem.
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@Daniel K. Statnekov You have that right (as do a few other commentors). People become addicted to escapism because the real world doesn't offer them much and causes boredom, for whatever reasons. There are many things we can identify that are problematic in society but fixing them will require us to think more deeply about the interconnectedness of our lives.
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@RamS I'm not religious, but life has become soul-killing and for young people, demoralizing. They are losing hope.
@Daniel K. Statnekov Brilliant response. For once, couldn't respectable and credible media please qualify the misuse of any drugs as "illegal"? I'm one of the countless thousands of people who have been locked out of reasonable and side-effect free treatment of chronic pain from degenerative arthritis. There are, of course, many other reasons for chronic pain, but arthritis is the most common. It always gets worse. I'm in my seventies, and had been taking one to three tabs of an opiod drug a day in order to live my life. No "high", no begging for more, never abusing the drug, never taking more than necessary. But now, because so many people are abusing, selling, adulterating and turning the meds into huge profits on the street, I have been denied this simple, inexpensive relief. The meds don't remove pain, btw, they just push it into the background, leaving us to take care of ourselves and our families without agony. There has been no suitable replacement, and in fact, the side effects from these experiments have caused me more pain. My husband is so frustrated - "After all these months, all these additional treatments for weird side effects, the expense and the time wasted, you are sicker now than you have ever been!" He's right. I believe the medical profession has abandoned countless thousands in my situation. Yes, these abusers are responding to things other than physical pain. Yet those with good quality of life are and the means to track use and abuse exist. Politics?
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It’s telling that injection of fentanyl recently was approved by one of our states as the method of carrying out the death penalty.
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That sends the clear message fentanyl kills. Wish there were a way to say there is no cure for drug addiction.
Your characterization of the president's declaration is incorrect--he declared a "public health emergency," not a "national emergency," as written. Please seen the Times' own reporting on this issue, which characterized the lesser public health declaration as being much smaller in scope than a national emergency declaration: https://www.nytimes.com/2017/10/26/us/politics/trump-opioid-crisis.html
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When seeing these reports appear more often, it shows how dangerous drugs have become. They are also known to seem cool because of social media making it more popular among today's youth. I was interested in hearing what has statistically changed by reading this article and it opens people up to seeing what consequences can happen.
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It's heartbreaking when you open the local paper, cross the obit page and read of people in their twenties and thirties losing their struggle against addiction. I laud the parents brave enough to open our eyes to the fact its not some down and out person in the seedy part of town. It could be and increasingly is the kid next door.
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Overdose Deaths Reached Record Level of 72,000 in 2017, New Estimates Show
A record was reached in 2017 when studies showed that about 72,00 people died because of drug overdose. According to Center for Disease Control this is more than car crashes and deaths by gunshot at its peak. There are a growing amount of people using drugs called opioids. Opioids are drugs used to reduce pain. Deaths in New Jersey alone rises up 27 percent. While the east are getting help there is no sign of the west getting help. People get desperate when laws are enforced and they find these drugs on the street.
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A study earlier this summer found that cirrhosis and liver cancer deaths jumped 65 percent from 1999-2014. The rise was most significant for young adults ages 25-34, who had annual average increases of 10.5 percent, driven entirely by alcohol-related liver disease.
Total alcohol-related deaths annually are at 88,000 in the U.S., which is higher than opiate overdose deaths.
We only seem to hear about the opiate epidemic. Why don't we hear more about the craft beer epidemic?
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@Bryan
We tried that between 1919 and 1932 and it was a failure.
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@M Collins Prohibition of any drug is doomed to failure. The evidence is everywhere.
Soon we’ll be hearing about the esophageal cancer epidemic caused by drinking so much coffee that everyone develops GERD. Not joking.
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Regarding bills to reduce the amount of opioids prescribed. There are no doubt far too many opioids prescribed although this is declining from its peak. The problem is that simply limit amounts prescribed doesn't insure that those who may benefit from opioids will get them or that those abusing them won't.
Also, if fentanyl is the major problem, I don't see how restrictions on prescriptions for opioids will address this. The only prescriptions fentanyl forms available by prescription are a transdermal patch and various forms absorbed through the mouth and its difficult to abuse either of these except by using far more than prescribed.
By the way, the chart shows methadone as being separate from "synthetic opioids." Perhaps someone can explain to me how methadone isn't a synthetic opioid as it is manufactured. If the chart want to tease these out, then it should say synthetic opioids other than methadone.
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According to the NIH's web site, an estimated 88,000 die from alcohol-related causes annually. In 2012 alcohol misuse cost the US 249 BILLION dollars. In 2014 alcohol impaired driving fatalities accounted for 9,967 deaths, (30% of overall driving fatalities). More than 10% of US children live with an alcoholic parent. Yet we are not all up in arms about alcohol nor have we regulated its sales or made it impossible for people to obtain it.
Our country clearly has addiction problems all around.
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@thomas
Tobacco dwarfs all of that.
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@thomas I'd say it's an addiction to hypocrisy and prohibition models, frankly. The police unions are up in arms about the loss of pot as job security, and need some new boogeymen.
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@thomas That’s because alcohol does not touch or “tarnish” the medical profession by way of their prescription pads. “Do not go near a public health problem because you are scared about losing your license and do not prescribe and properly surveil patients using opioids because you are scared they will OD or move on to fentanyl/heroin” are not part of the Hippocratic Oath as I understand it. Hysterical headlines grab readers attention... but without additional, more nuanced context (like this article) they are inaccurate and unethical. It is up to commenters to take a stand. BTW I’m a retired doc, a psychopharmacologist.
Even though the use of prescription opiates has declined, overdoses are continuing to increase. Due to new laws and regulations, people can’t get the levels of painkillers they are addicted to so they turn to the streets. Without access to medical detoxification and mental health care, they continue using these powerful synthetic opioids which often cause a fatal overdose. Illicit drugs purchased on the street are very likely to contain Fentanyl or other synthetic variations. Fentanyl is 50 times stronger than heroin and up to 100 times stronger than morphine. Since efforts to improve access to effective, individualized treatment have been minimal, we’re likely to see even more lives lost in 2018. Have many lives will it take to make the necessary changes?
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@Waismann Detox not only a matter of getting Rx substances of addiction, but also MDs refusing to treat legitimate paid d/t fear of repercussions.
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@Waismann Detox This has nothing to do with FDA recommendations. The "new laws" are either state law,
or doctors not interpreting the FDA Regulations properly.
I had no problem getting adequate pain relief for my herniated discs in WA state, but moving to the midwest nearly killed me because of poor medical judgment from paranoid doctors here.
You are right in what you are saying about street drugs and treatment, but it is my hunch that failure to control pain is pushing people TO the street to relieve their pain when doctors fail them, also.
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It's now official.
Between Catholic priests, Omarosa, Donald Trump, Paul Manafort,
the migrant kids, the wildfires in California and this, I'm finally sick and tired of winning.
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The right-wing justification for taking children away from their immigrant parents is that their parents were breaking the law. Since use of opioids without prescriptions is also against the law, these same people should favor putting users in cages and their children in foster care. Harsh measures are only for brown people.
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@Nana2roaw
Just one person's experience. My step daughter is now the foster mom of a 5 yr old & a 1 yr old. The cops & CYS took the kids from their parents after the parents were found zonked out from dope of some form. Fentynal? Maybe? Anyway. All parties to this debacle are white and US born. And Yep... the parents went into cages. Cages "down at the County" as it is called. The sword cuts both ways.
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@Nana2roaw
Nope they should -and do - go to jail
ANd they regularly lose custody of their kids who go into foster care
In many areas the foster care system is overwhelmed with the kids of drug addicts
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I agree wholeheartedly. I have no more sympathy for a white, unemployed coal worker in West Virginia who is hooked on oxy than I do for Brooklynites using crack in the 1980’s. Protect society by removing those who cannot, do not or will not adhere to the rules. Skin color should not matter. Hempstead has as much right to its quality of life as Old Brookville does.
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This is a crisis, but it’s also sensationalized beyond its impact when compared to other “preventable” deaths.
Smoking killed 480,000 Americans in the same time frame.
Both are preventable.
Both are tragic.
Only one seems to matter.
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@Mike Magan A bit of a false equivalency there. As I understand it, the opioid epidemic is alarming because of its rate of growth, not necessarily the total numbers of deaths. Sure, smoking may have killed more Americans, but the rate of smoking deaths is not increasing, and even if it is, it's increasing at a rate far lower than the opioid death. Further, the U.S. was able to do a reasonably good job of making cigarettes more expensive and stigmatized while also creating such great awareness among the population that smoking is harmful to the point that almost no one claims that smoking is not these days. With opioids, it's nearly the opposite, in that treatment is stigmatized, the use is criminalized and very few are ready to come to terms with the measures that are required to stem the tide of this crisis.
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@Joel
The opioid "epidemic" (what it's being called this time around) is alarming because this time it includes 20-30 year old and middle-aged white people. Forty years ago no one called it an epidemic when it was only poor minorities who were addicted, thieving to support themselves, and dying in neighborhoods where no one wanted to live. That generation died out and the scourge skipped a generation or two before making a comeback, devastating in part because it now includes people you went to school with, worked with, people who were your neighbors. It's now visible for everyone so it's only now an epidemic. The biggest problem then as now is that the government, has no plan to deal with it other than to incarcerate addicted people.
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@Mike Magan - smokers do not break into my home looking to steal to support their habit. Smokers do not end up in some homeless camp downtown like the addicts do.
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This article does not discuss the critical questions of why do people use opioids at all. Is it poverty? Economic uncertainty? Big Pharma pushing oxycontin? or just addictive personalities?
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@Thomas O Meerwarth perhaps hopelessness?
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@Thomas O Meerwarth People self medicate for a variety of reasons, none of which are small. We don't have the money to deal effectively with the problems associated with it apparently, but it seems once insurance got wind of the profit making possibilities they started turning rehab centers into cash cows. I've heard much anecdotal evidence that they do not work that well.
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@Thomas O Meerwarth
Thomas, you pose the big question. Why??? There is no secret that this stuff is BAD. It will KILL YOU. So why?
I see where people with more than adequate education and certainly at least some awareness of all this. Why?? I am no fan of "government studies" but this one needs an answer.
I would like to see a breakdown by age, sex, race, income, rural/urban/suburban. How many addicts began use "recreationally" and how many for physical pain?
Changing behavior patterns is just as difficult as treating the physical addiction.
How much opium/heroin is currently imported from Afghanistan?
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that last is the $64,000 question, isn't it?
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@Make America Sane: actually today the source is MEXICO.
Please read the excellent book "Dreamland" by Sam Quinones. It explains precisely how heroin gets into our nation from Mexico.
Bingo. The demographics of addicts/ODs are completely different than legitimate pain patients. It’s a very important point in discussing why this approach (taking away needed medicine from suffering pain patients) won’t work.
The public health emphasis is welcome and necessary. However, we must face the fact that there is something gone deeply wrong when a nation, for decades on end, creates reality for millions of its citizens that is so bleak that they turn to such extreme methods to escape it. Why is there so much pain, so little skill in getting through it without substances, and so little will to really change it? I think most addicts are simply trying not to feel bad, mentally or physically. Why do we accept so many people doing bad?
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Did we have a similar or larger epidemic during the Great Depression? During the collapses of the late 19th century? The fact is we have become a willing society of weaklings.
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@Fred Well, what if a lot of these addictions began with a person going to a doctor for legitimate pain (e.g. high school football captain blows out his knee in the Friday night game) but is prescribed a dosage that leads almost immediately to an addiction? In reality, so much of this crisis began just in that way.
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Most of the world's poor live outside the U.S., and some on less than two dollars a day. They can't afford illicit drugs. Some addicts are rich people, and bored.
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Like with any other dangerous object, drug, the best way to handle it is with legality, regulation, responsibility and non promotion.
It has worked the best with drunk driving, cig. smoking and the worst with gun deaths and yes drug overdoses.
Specifically with something like Oxycontin, making it legal was right but we failed miserably on regulation, responsibility and non promotion.
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Alas, you’ve framed the issue incorrectly.
Our country is facing a serious problem: it has a middle class, and no economy to support it.
Fortunately our politicians recognize the problem and are on the job, working hard to deregulate opioids, firearms, tobacco, alcohol, and other profitable items, with the goal of enriching the makers of these items while systematically downsizing the American middle class.
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@Observer-Thank you for your reply. As usual, the reason a dangerous object/drug problem is not cured is because the public only looks at one aspect of the cure instead of the whole thing.
With guns, the left looks only at regulation and the right only looks at legality and neither one looks at non promotion.
With you and opioids you only look at regulation and not legality, responsibility and non promotion.
That is issue framed right in my opinion.
Again it worked wonders with cig smoking and drunk driving and miserable with gun deaths and opioids deaths.
Do a word search on this article and see if you can find the word "prevention" in the text. Not there. Also not in the political and policy thinking in this country. States are required to spend only 20% of their Federal Block Grant funding for substance abuse on prevention. This, while treatment is frequently paid for via Medicaid expansion and other aspects of the ACA and the Wellstone Domineci Mental Health Parity Act. What are states doing with that money and why are we not working harder at developing evidence based primary prevention initiatives?
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@Frank because this Backwards thinking Administration doesn’t believe in science and the Resident himself has stated just saying NO worked for him!
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@Joan
I dunno Joan. In the last couple years I sustained a ripped quadricep with surgical repair. Among the pills I was given was a quantity of Oxy. More recently I experienced a severe bout of diverticulitis. Like a meat hook in my guts for a few days. I still have more than half of those Oxy pills ,,, untouched. I am not crediting Trump nor am I blaming him. I don't think he is much of an influence in who gets hooked on this dope.
Phenomenal statistics:
"As my colleague Josh Katz has reported, this death toll is more than the peak yearly death totals from H.I.V., car crashes or gun deaths.
"It’s not clear whether the opioid epidemic has reached its peak."
There looks to be an incipient knee in that curve for synthetic opioids, so we'll see. It's horrible that so many people cannot break away from these drugs. Society also pays the price.
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72,300 is figure that is breath-taking. I have been examining trends in drug related deaths using data collected by the CDC from 1999 to 2016. My own worst case scenario for 2017 was 69,000 based on a computed curvilinear growth rate trend line based on the eight most recent years. My worst case computed exponential growth rate suggests that in 2025 the drug related death rate would be between 150,000 and 160,000. I have had a difficult time believing the numbers my models have produced, but to discover that even my worst case prediction has been lower than the actual number is a stunning development. It should be clear to anyone who is paying attention that the opioid crisis has moved into a more deadly phase and with it, we will see a death rate and the number of deaths beyond all comprehension if there is no widespread intervention to stem this rising tide. Unless people in the country don't care about yearly numbers of deaths of their fellow citizens of over a 100,000 per year and rising, we must act as a society to stop the bitter and rapidly increasing horror in our midst.
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These numbers aren’t soldiers dying in battle or civilians attacked in their workplaces. Every one of them was at their own hand.
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@FromSouthChicago: I care...my own nephew (age 29) died in Feb 2017 from a overdose of heroin contaminated with fentanyl. But nobody made him do drugs. HE CHOSE TO DO DRUGS because he'd been a druggie his whole life from his teens onward. He liked to get high. Apparently this was a very good high until it killed him. His affluent parents (who gave him everything) enabled him to be able to buy drugs, and they put him on Ritalin in 5th grade so he'd be passive and studious in school. They never said "no". They never practiced "tough love". They paid for FIVE rehabs and he was doing drugs on the day after he got out. I do not see anyway to help this epidemic, except to let it "burn itself out" -- until all the weak drug-seeking addicts kill themselves of their own free will.
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@FromSouthChicago More likely the data is being manipulated somehow.
Does not sound like our efforts are making any difference at all. Citing small pockets of decrease in a few states is not a trend down. This paralells the clamp on prescriptions and is a direct result.
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Pharmaceutical companies should be directed to research Non addictive pain medication. It may be that prescription
pain meds are the new gateway drug.
Surely some of the billions made from their addictive offerings could be used in developing Non addictive meds.
I realize that Non addictive meds would cut their profits some. It would also cut down on the need of addicted pain patients to seek out any substitute once their so called legitimate prescriptions run dry.
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@Patsy One can become addicted to anything but there are non-addictive pain medications that are potent. But for various reasons, they can't be used in all situations and some cannot be used chronically. Opiods aren't that great for chronic pain either but they can be tolerated for longer and so people get dependent on them. The line between dependence and addiction is an easy one to cross, especially given the opiods' mind altering effects.
Suboxone is composed of a couple of compounds, one of which is a partial opiod agonist and it is as non-addictive a pain reliever as we'll get in this class of compounds. Some people can still abuse it but the vast majority won't IMO. So I think doctors should start by prescribing suboxone for pain as they do in other places in the world.
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Everyone should ask their legislator to increase funding to NIH for pain and addiction treatments. The gov’t can’t force private companies to research certain diseases (although wouldn’t that be nice), but most new treatments coming from private companies started with NIH. I go to DC every year to advocate in increases to NIH for pain. I wish everyone knew more about NIH. Trump wants to cut their budget.
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In a 13 year period in Vietnam, we lost close to 60,000 lives, with no accounting for those lost in the ensuing years as a result of that conflict. In 2017 over 72,000 deaths from overdoses and over 60,000 in 2016. Extrapolate that out and it is easy to see the drug epidemic could take ten times the lives lost in Vietnam in a comparable period. Big pharma had much to do with the opioid crisis and has not been held fully accountable. Our Federal Government is not addressing the core issues of the problem. Addiction is a disease and until we address that with adequate resources this cris will continue to fester. Also, the Citizens United decision allows corporations to buy the political cover they need to operate in a reckless manner as did Big pharma. There are consequences, often unseen, to who we put on the Supreme Court.
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Please do not conflate drug and alcohol addiction with real diseases (cancer, ALS, Parkinson's, etc.) You aren't stunned one day with a diagnosis of addiction - it takes time and effort (i.e., continuous use). If there was rehab for cancer, ALS, and Parkinson's, ALL sufferers would attend. Addicts, however, may go to rehab and get clean, but most do not. Addiction is an elective condition.
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@bkd You are not stunned by a diagnosis of Chronic Obstructive Pulmonary Disease either. Being stunned has nothing to do with the brain science of a reward system in the brain gone askew. Addiction is a not a monolithic entity. For some, it is hereditary, for others it is acquired. For some it is situational. Some "age out" and others are stricken for life. It is easier to think about (and dismiss) addiction when you think about it as somebody's fault. But the neurobiological reality is far more complicated.
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@bkd While you make a good point regarding not conflating drug and alcohol addiction with cancer, ALS, etc., characterizing addiction as an "elective condition" is specious. The paths to addiction are numerous, and are often manifestations of other medical conditions such as mental health problems,, response to pain needs associated with physical conditions,etc.
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