ER doc here. I think that this is absolutely a large contributor of these mortality trends. There are so many more factors than just users turning to IV drugs /

ER doc here. I think that this is absolutely a large contributor of these mortality trends. There are so many more factors than just users turning to IV drugs / overdosing on rx meds though, and I think that's what we're just now finding out -- things like anhedonia that occurs because of neural-level changes in brain wiring due to long-term use of opioids, hyperalgesia (increased sensing of pain) from the same thing, and more and more people developing an illness script around chronic pain that they see themselves as victims of, necesitating ever-escalating doses of analgesia (whether that's in the form of opiates, opioids, alcohol, other substances) to deal with. Really, really big problem that I think we're just waking up to deal with.