14 ms·

What’s really causing the prescription drug crisis?

105 points by danharaj 10y ago

danharaj 10y ago
Excerpt: Doctors in many parts of the world — including Canada and some European countries — prescribe more powerful opiates than their peers in the United States. In England, if, say, you get hit by a car, you may be given diamorphine (the medical name for heroin) to manage your pain. Some people take it for long periods. If what we’ve been told is right, they should become addicted in huge numbers. But this doesn’t occur. The Canadian physician Gabor Maté argues in his book “In the Realm of Hungry Ghosts” that studies examining the medicinal use of narcotics for pain relief find no significant risk of addiction. I’ve talked with doctors in Canada and Europe about this very issue. They say it’s vanishingly rare for a patient given diamorphine or a comparably strong painkiller in a hospital setting to develop an addiction.
- anon4this1 10y ago
  Diamorphine is given IV/IM/SC - not orally - which generally means that its use is confined to a short period in the first few hours/days of a hospital admission until the patient can be switched to oral medication. Noone is sent home with diamorphine unless they are end stage palliative and they are on a home syringe driver to get it. OTOH oxycodone is almost always orally administered which means patients stay on it for longer in hospital and are commonly discharged with a prescription for more. The doctors I work with who have done fellowships in USA state that oxycodone is (?was) given out like lollywater compared to hospitals here, where it is only prescribed if the patient has a REALLY good reason they can't have oral morphine.
  - DanBC 10y ago
    But people in UK do get oramorph, which is a liquid oral morphine.
    - anon4this1 10y ago
      Patients (and addicts) state there is a particular euphoria that oxycodone has (and diamorph/heroin) that morphine doesn't really have. Of course oral morphine does cause addiction, but oxycodone just seems to have greatly increased rates.
  - robbiep 10y ago
    Although tablet formulations of diamorph also exist >The doctors I work with who have done fellowships in USA state that oxycodone is (?was) given out like lollywater compared to hospitals here, where it is only prescribed if the patient has a REALLY good reason they can't have oral morphine. My experience as a medical student on elective in the US was this - I couldn't believe the quantities of opiates prescribed cf. Australia
  - tcbawo 10y ago
    I read this recently: Drug wholesalers shipped 780 million prescription painkillers to West Virginia over a six-year period. In a state of 1.84 million residents, the shipments amount to 433 pain pills for every man, woman and child in West Virginia. http://www.nbcwashington.com/news/local/Drug-Wholesalers-Shipped-780M-Pain-Pills-to-West-Virginia-407331135.html http://www.nbcwashington.com/news/local/Drug-Wholesalers-Shi...
- DanBC 10y ago
  It's pretty well known that opioids for short term pain pose little risk of addiction; but opioids for long term pain are a bad idea. For long term pain opioids don't treat the pain, and they risk addiction. That's why we have things like "Opioids Aware": http://www.fpm.ac.uk/faculty-of-pain-medicine/opioids-aware http://www.fpm.ac.uk/faculty-of-pain-medicine/opioids-aware
  - michaelmrose 10y ago
    What's the better alternative?
  - mark_edward 10y ago
    This is an odd question, but for people with chronic and essentially untreatable pains (which is many people, particularly older ones): What is the problem with being addicted to opiates if you are going to take them to manage that pain for the rest of your life anyway? I would want the opiates at that point.
    - DanBC 10y ago
      The opioids do not treat the pain! You end taking life threateningly high doses of opioids, which are not working to reduce your pain. People with chronic pain need other interventions - rapid access to specialist pain clinics being most important.
      - wycx 10y ago
        Are you a chronic pain sufferer?
        maxxxxx 10y ago
        I know a chronic pain sufferer and according to her opioids are of short term help but make everything worse in the long run. Unfortunately there are not many ways to treat chronic pain.
        DanBC 10y ago
Alex3917 10y ago
> Gin is legal today, and it is not causing social collapse. Gin isn't legal the way it was back then. It's only sold in stores and places with liquor licenses, it's heavily taxed, and there are all sorts of rules surrounding it. If in we had gin carts every twenty feet hawking it at kids and the homeless and it only cost a few cents per shot, I'm sure we'd have all the same problems.
- justinlaster 10y ago
  I literally have struggled to come up with an appropriate question that addresses the several different misconceptions about your statement, so I'll just go with this: what? How is anything you stated remotely analogous to what is in the article.
  - Alex3917 10y ago
    https://en.m.wikipedia.org/wiki/Gin_Craze https://en.m.wikipedia.org/wiki/Gin_Craze
    - justinlaster 10y ago
      That doesn't answer anything.
  - deleted 10y ago
    [deleted]
- haraldooo 10y ago
  Over here in Europe (at least in Germany) you can buy as much Gin as you like in every supermarket - if you're over 18. I don't know if we have higher alcohol abuse numbers than countries with stricter laws but I doubt it. Does anyone have internationally comparable numbers? EDIT: forgot: it's very cheap. If I remember correctly, you can get a one litre bottle for < 10 EUR - certainly not the best there is but "good enough" to get drunk as f* - even with little or no money
  - 10y ago
tcj_phx 10y ago
The alcoholics I've known have all had underlying emotional problems. One can't get over the business partner who left him holding the bag - it cost hundreds of thousands of dollars for him to get the bank to leave him alone. Another couldn't deal with her marriage falling apart. Prison also didn't help her learn how to better deal with life. I believe the third was turned into an alcoholic by methadone. The etiology of this one's addictions is fascinating, but I think the main consideration is the lack of stability growing up. Money was never a problem, but her family life during childhood and teenage years was ... sub-optimal. Emotionally-stable people tend to not become addicted to alcohol, heroin, cocaine, etc. I've met former cocaine users whose attitude is "been there, done that, no need to use again." That's kind of my attitude about alcohol - I don't care for it at all, no matter the price. A wise woman once said, "... When a person feels safe, the false ego goes away." Helping people feel safe should be the #1 priority of every effort to help someone with substance abuse problems.
- TheSageMage 10y ago
  > Helping people feel safe should be the #1 priority of every effort to help someone with substance abuse problems. Exactly this thought. I've helped a lot of kids over the year through abusive homes and the greatest thing you can give them is the feeling of safety above all else. This isn't necessarily helicopter parenting, but it's attentive to the needs to help them feel like they can fail without losing the essential securities of life.
- manmal 10y ago
  I cannot recommend mindfulness meditation (or yoga, or deep breathing,...) enough for this - it brings a feeling of safety automatically (seems to have to do with meditation reducing amygdala responses; I read something about taking 8 weeks to produce a lasting effect).
- sidek 10y ago
  You're absolutely right. Good emotional state is probably the key factor in combating addiction. Yet it's important to remember that there exist other factors at play in addiction, and that we should target them too. For instance, addiction to alcohol seems to have some genetic factors. In some genetic lines, almost every person with a low emotional state might be at huge risk for addiction. And in others, almost no one might be at risk. We need to also understand why that is, and combat that, too.
jordanb 10y ago
This doesn't explain why people turn specifically to opiates and not to booze or weed. A recent article suggested that Purdue Pharmaceuticals dosing guidelines pretty much guaranteed addiction to OxyContin, by advising doctors to only ever prescribe the drug at 12 hour intervals despite the fact that it wore off more quickly for a large number of patients. When patients complained about the drug wearing off early, Doctors were advised to not adjust the schedule but instead increase the dosage. The pain-pleasure-reward cycle when the drug wears off early is what creates the physical addiction, and increasing the dosage only made it worse. Purdue insisted on a 12 hour schedule because that is the marketing differentiater between OxyContin and generic opiates. http://www.latimes.com/projects/oxycontin-part1/ http://www.latimes.com/projects/oxycontin-part1/
- tominous 10y ago
  People do turn to weed when it is legal [1]: "The researchers found that doctors in a state where marijuana is legal ended up prescribing an average of 1,826 fewer doses of painkillers per year" [1] http://time.com/4404697/marijuana-opioid-epidemic/ http://time.com/4404697/marijuana-opioid-epidemic/
  - fragmede 10y ago
    Moreover, certain types of marijuana do a superlative good job of providing non-opiod relief from chronic pain and aren't psychoactive, so in the same way you or a co-worker might have some Tylenol if they're feeling physical pain while at the office, you or a co-worker could use marijuana to manage chronic pain, without their mental state being noticably altered. That's not to say marijuana cannot be abused nor is it a silver bullet, but in the middle of an opioid epidemic, holy shit, maybe something many people are illegally using to manage chronic pain without causing an epidemic; maybe it might be worth studying? The vast majority of users continue to be productive members of society; judging by the number of states that have legalized marijuana, we should be in the middle of a marijuana crisis compared to opioids, yet no such crisis exists. Yet the DEA classifies marijuana as having zero medical benefit, which makes it almost impossible, practically speaking, to study properly.
  - 10y ago
devoply 10y ago
It's the economy stupid. Americans have nothing in their lives but their jobs. Take those away and they start self-medicating. Well that's my pet theory any way. Also have to consider the demographic most affected by job loss. Why not weed or alcohol? Because opiates produce a high and make you feel good. Much like work might, if you had it.
- knieveltech 10y ago
  Late stage capitalism is a bitch, isn't it?
- adentranter 10y ago
  Agreed. I think the second big problem after feeling safe is identity. A lot of people see their work as there identity. This is not going to play out well with automation and the removal of jobs. As for why opiates? They produce a much cleaner high probably.
- marknutter 10y ago
  Is there any correlation between the rate of alcoholism and the economy?
  - kwhitefoot 10y ago
    Probably. I suspect it is not a simple one but look at alcohol consumption patterns in Russia. On the other hand there are plenty of poor people in other countries who do not drink so there are probably cultural and climate influences too.
- CuriouslyC 10y ago
  Jobs are just a manifestation of a deeper problem. The truth is, the pace of change is too fast for society at large. It has eroded our traditions and ideas about life, and we have yet to rebuild them.
  - chillwaves 10y ago
    I agree with this statement. Especially if you look over a few thousand year timeline. Of course, the rate of technology has accelerated but also some of the earlier changes have been normalized though we still reel from them. Even the sense of community has been completely redefined (or minimized) by technology today, or the concept of society being focus on nuclear family only. Some are a direct result of technology, but some changes, like the concept of leisure time, come indirectly as we restructure our lives around this technology (capitalism and the industrial revolution). Compare this to where we were 2,000 years ago or 10,000 years ago.
jsz0 10y ago
From what I've seen most people get started with opiates using them as an instant gratification anti-depressant. For that purpose they are effective for a while until the consequences of addiction start to set in. The worst part of this is in that period before addiction they actually are happier, more outgoing, more fun to be around, etc. So there's a sort of social dependency that goes along with the chemical dependency.
- uvnq 10y ago
  Speaking from personal experience, I completely agree with your comment. Also, I've seen people move from regular opiate use to not even caring about opiates, on account of (what I assume was) their transition from emotional instability to emotional stability. I think that a large part of prescription drug abuse is due to using them, as you said, as an instant gratification anti-depressant.
- autokad 10y ago
  "... more outgoing" does that happen with people taking them? i felt when I took oxycodone I wanted to be left alone. it could have also been I was physically unwell, but it felt like the 'wanting to be alone' was a symptom and wasnt in pain
  - klibertp 10y ago
    Yes. Depends on a person, like in your case, also depends on dosage and tolerance, but being more outgoing, honest and speaking more is certainly possible as an effect of using opiates. What opiates do is they simply make you feel good. They give you a feeling of enjoying yourself. They don't make you ecstatic (for most people), but they give you all the pleasant feelings you could get after - for example - running and winning a race, for free. How those feelings affect your actions differs from person to person.
  - jsz0 10y ago
    Like most mind altering drugs the effects are relative to your personality and mood when you take them.
a_imho 10y ago
Going off tangent, visiting a friend who has a TV I could not help noticing roughly 2/3 of ads are for drugs, sometimes there was a full block filled with them.
- tunap 10y ago
  The other 1/3 seem to be malpractice lawyers and sugar products... unless you included the sugar in the drugs category. This is why I watch sports on pirate feeds, the repetitive, inane ads replaced by a static image and bad(not worse) muzak.
sidcool 10y ago
Pharma profits are one of the reasons for the opiate crisis, which results in Heroin addiction in some cases. India is a good model where pharmas don't get a free hand.
- autokad 10y ago
  how do you figure pharma profits are one of the reasons for the crisis and to what extent is that reason? also out of curiosity, did you read the article?
  - sidcool 10y ago
    Yes. I am not commenting strictly in context of the article. But there are many documentaries stating that opiates are pushed to doctors.
akjainaj 10y ago
The first theory "has been endorsed by some excellent journalists and broadcasters, from Sam Quinones to HBO’s John Oliver", two die-hard liberals, and according to this article it does not make sense; the one that makes sense, though, is the one that says that people living in zones historically neglected by liberals (such as the Rust Belt) "feel more distressed and disconnected".
moomin 10y ago
Given that the "first story" is thoroughly misrepresented and then the key facts lack important distinctions between short and long term use, I'm going to hazard a guess that the whole of this article is bunk.
DoodleBuggy 10y ago
Is there really a crisis? Some people use and abuse drugs, drink, gamble, who cares? It's a victimless crime.
- mikeyouse 10y ago
  Not sure a more substantive post would be helpful but opiate epidemic is anything but victimless; http://imgur.com/2UNEmfF http://imgur.com/2UNEmfF
  - DoodleBuggy 10y ago
    Drug use is almost entirely victimless. This is well studied, researched, documented. By definition a victimless crime involves consenting parties with no harm to outside parties. There can be situations where something does impact a non-consenting party, which is when it stops being victimless.
    - tcbawo 10y ago
      There is often collateral damage among family (children!), friends, and coworkers of addicts. Complications caused by prenatal drug/alcohol use are also well documented.
      - DoodleBuggy 10y ago
        > By definition a victimless crime involves consenting parties with no harm to outside parties. There can be situations where something does impact a non-consenting party, which is when it stops being victimless.
        tcbawo 10y ago
        I agree. I just think that the phrase "entirely victimless" is a little strong for most types of drug use.
        aaron695 10y ago
alpineidyll3 10y ago
This article is not quantitative or scientific, although I am certain there is some validity to it's claims. Any same person would agree that trying to take these drugs away from addicts will only push them to heroin. However to become addicted one must try a substance, and or medical system has allowed far too many opiates to be sold and facilitated far too many first experiences. To the tune of 4x the number of prescriptions which should exist given US epidemiology. The interesting question is how you could show rigorously that this type of safety net is effective.

105 points by danharaj 10y ago

Excerpt: Doctors in many parts of the world — including Canada and some European countries — prescribe more powerful opiates than their peers in the United States. In England, if, say, you get hit by a car, you may be given diamorphine (the medical name for heroin) to manage your pain. Some people take it for long periods. If what we’ve been told is right, they should become addicted in huge numbers. But this doesn’t occur. The Canadian physician Gabor Maté argues in his book “In the Realm of Hungry Ghosts” that studies examining the medicinal use of narcotics for pain relief find no significant risk of addiction. I’ve talked with doctors in Canada and Europe about this very issue. They say it’s vanishingly rare for a patient given diamorphine or a comparably strong painkiller in a hospital setting to develop an addiction.

anon4this1 10y ago
Diamorphine is given IV/IM/SC - not orally - which generally means that its use is confined to a short period in the first few hours/days of a hospital admission until the patient can be switched to oral medication. Noone is sent home with diamorphine unless they are end stage palliative and they are on a home syringe driver to get it. OTOH oxycodone is almost always orally administered which means patients stay on it for longer in hospital and are commonly discharged with a prescription for more. The doctors I work with who have done fellowships in USA state that oxycodone is (?was) given out like lollywater compared to hospitals here, where it is only prescribed if the patient has a REALLY good reason they can't have oral morphine.
- DanBC 10y ago
  But people in UK do get oramorph, which is a liquid oral morphine.
  - anon4this1 10y ago
    Patients (and addicts) state there is a particular euphoria that oxycodone has (and diamorph/heroin) that morphine doesn't really have. Of course oral morphine does cause addiction, but oxycodone just seems to have greatly increased rates.
- robbiep 10y ago
  Although tablet formulations of diamorph also exist >The doctors I work with who have done fellowships in USA state that oxycodone is (?was) given out like lollywater compared to hospitals here, where it is only prescribed if the patient has a REALLY good reason they can't have oral morphine. My experience as a medical student on elective in the US was this - I couldn't believe the quantities of opiates prescribed cf. Australia
- tcbawo 10y ago
  I read this recently: Drug wholesalers shipped 780 million prescription painkillers to West Virginia over a six-year period. In a state of 1.84 million residents, the shipments amount to 433 pain pills for every man, woman and child in West Virginia. http://www.nbcwashington.com/news/local/Drug-Wholesalers-Shipped-780M-Pain-Pills-to-West-Virginia-407331135.html http://www.nbcwashington.com/news/local/Drug-Wholesalers-Shi...
DanBC 10y ago
It's pretty well known that opioids for short term pain pose little risk of addiction; but opioids for long term pain are a bad idea. For long term pain opioids don't treat the pain, and they risk addiction. That's why we have things like "Opioids Aware": http://www.fpm.ac.uk/faculty-of-pain-medicine/opioids-aware http://www.fpm.ac.uk/faculty-of-pain-medicine/opioids-aware
- michaelmrose 10y ago
  What's the better alternative?
- mark_edward 10y ago
  This is an odd question, but for people with chronic and essentially untreatable pains (which is many people, particularly older ones): What is the problem with being addicted to opiates if you are going to take them to manage that pain for the rest of your life anyway? I would want the opiates at that point.
  - DanBC 10y ago
    The opioids do not treat the pain! You end taking life threateningly high doses of opioids, which are not working to reduce your pain. People with chronic pain need other interventions - rapid access to specialist pain clinics being most important.
    - wycx 10y ago
      Are you a chronic pain sufferer?
      - maxxxxx 10y ago
        I know a chronic pain sufferer and according to her opioids are of short term help but make everything worse in the long run. Unfortunately there are not many ways to treat chronic pain.
      - DanBC 10y ago

Alex3917 10y ago

> Gin is legal today, and it is not causing social collapse. Gin isn't legal the way it was back then. It's only sold in stores and places with liquor licenses, it's heavily taxed, and there are all sorts of rules surrounding it. If in we had gin carts every twenty feet hawking it at kids and the homeless and it only cost a few cents per shot, I'm sure we'd have all the same problems.

justinlaster 10y ago
I literally have struggled to come up with an appropriate question that addresses the several different misconceptions about your statement, so I'll just go with this: what? How is anything you stated remotely analogous to what is in the article.
- Alex3917 10y ago
  https://en.m.wikipedia.org/wiki/Gin_Craze https://en.m.wikipedia.org/wiki/Gin_Craze
  - justinlaster 10y ago
    That doesn't answer anything.
- deleted 10y ago
  [deleted]
haraldooo 10y ago
Over here in Europe (at least in Germany) you can buy as much Gin as you like in every supermarket - if you're over 18. I don't know if we have higher alcohol abuse numbers than countries with stricter laws but I doubt it. Does anyone have internationally comparable numbers? EDIT: forgot: it's very cheap. If I remember correctly, you can get a one litre bottle for < 10 EUR - certainly not the best there is but "good enough" to get drunk as f* - even with little or no money
- 10y ago

tcj_phx 10y ago

The alcoholics I've known have all had underlying emotional problems. One can't get over the business partner who left him holding the bag - it cost hundreds of thousands of dollars for him to get the bank to leave him alone. Another couldn't deal with her marriage falling apart. Prison also didn't help her learn how to better deal with life. I believe the third was turned into an alcoholic by methadone. The etiology of this one's addictions is fascinating, but I think the main consideration is the lack of stability growing up. Money was never a problem, but her family life during childhood and teenage years was ... sub-optimal. Emotionally-stable people tend to not become addicted to alcohol, heroin, cocaine, etc. I've met former cocaine users whose attitude is "been there, done that, no need to use again." That's kind of my attitude about alcohol - I don't care for it at all, no matter the price. A wise woman once said, "... When a person feels safe, the false ego goes away." Helping people feel safe should be the #1 priority of every effort to help someone with substance abuse problems.

TheSageMage 10y ago
> Helping people feel safe should be the #1 priority of every effort to help someone with substance abuse problems. Exactly this thought. I've helped a lot of kids over the year through abusive homes and the greatest thing you can give them is the feeling of safety above all else. This isn't necessarily helicopter parenting, but it's attentive to the needs to help them feel like they can fail without losing the essential securities of life.
manmal 10y ago
I cannot recommend mindfulness meditation (or yoga, or deep breathing,...) enough for this - it brings a feeling of safety automatically (seems to have to do with meditation reducing amygdala responses; I read something about taking 8 weeks to produce a lasting effect).
sidek 10y ago
You're absolutely right. Good emotional state is probably the key factor in combating addiction. Yet it's important to remember that there exist other factors at play in addiction, and that we should target them too. For instance, addiction to alcohol seems to have some genetic factors. In some genetic lines, almost every person with a low emotional state might be at huge risk for addiction. And in others, almost no one might be at risk. We need to also understand why that is, and combat that, too.

jordanb 10y ago

This doesn't explain why people turn specifically to opiates and not to booze or weed. A recent article suggested that Purdue Pharmaceuticals dosing guidelines pretty much guaranteed addiction to OxyContin, by advising doctors to only ever prescribe the drug at 12 hour intervals despite the fact that it wore off more quickly for a large number of patients. When patients complained about the drug wearing off early, Doctors were advised to not adjust the schedule but instead increase the dosage. The pain-pleasure-reward cycle when the drug wears off early is what creates the physical addiction, and increasing the dosage only made it worse. Purdue insisted on a 12 hour schedule because that is the marketing differentiater between OxyContin and generic opiates. http://www.latimes.com/projects/oxycontin-part1/ http://www.latimes.com/projects/oxycontin-part1/

tominous 10y ago
People do turn to weed when it is legal [1]: "The researchers found that doctors in a state where marijuana is legal ended up prescribing an average of 1,826 fewer doses of painkillers per year" [1] http://time.com/4404697/marijuana-opioid-epidemic/ http://time.com/4404697/marijuana-opioid-epidemic/
- fragmede 10y ago
  Moreover, certain types of marijuana do a superlative good job of providing non-opiod relief from chronic pain and aren't psychoactive, so in the same way you or a co-worker might have some Tylenol if they're feeling physical pain while at the office, you or a co-worker could use marijuana to manage chronic pain, without their mental state being noticably altered. That's not to say marijuana cannot be abused nor is it a silver bullet, but in the middle of an opioid epidemic, holy shit, maybe something many people are illegally using to manage chronic pain without causing an epidemic; maybe it might be worth studying? The vast majority of users continue to be productive members of society; judging by the number of states that have legalized marijuana, we should be in the middle of a marijuana crisis compared to opioids, yet no such crisis exists. Yet the DEA classifies marijuana as having zero medical benefit, which makes it almost impossible, practically speaking, to study properly.
- 10y ago

devoply 10y ago

It's the economy stupid. Americans have nothing in their lives but their jobs. Take those away and they start self-medicating. Well that's my pet theory any way. Also have to consider the demographic most affected by job loss. Why not weed or alcohol? Because opiates produce a high and make you feel good. Much like work might, if you had it.

knieveltech 10y ago
Late stage capitalism is a bitch, isn't it?
adentranter 10y ago
Agreed. I think the second big problem after feeling safe is identity. A lot of people see their work as there identity. This is not going to play out well with automation and the removal of jobs. As for why opiates? They produce a much cleaner high probably.
marknutter 10y ago
Is there any correlation between the rate of alcoholism and the economy?
- kwhitefoot 10y ago
  Probably. I suspect it is not a simple one but look at alcohol consumption patterns in Russia. On the other hand there are plenty of poor people in other countries who do not drink so there are probably cultural and climate influences too.
CuriouslyC 10y ago
Jobs are just a manifestation of a deeper problem. The truth is, the pace of change is too fast for society at large. It has eroded our traditions and ideas about life, and we have yet to rebuild them.
- chillwaves 10y ago
  I agree with this statement. Especially if you look over a few thousand year timeline. Of course, the rate of technology has accelerated but also some of the earlier changes have been normalized though we still reel from them. Even the sense of community has been completely redefined (or minimized) by technology today, or the concept of society being focus on nuclear family only. Some are a direct result of technology, but some changes, like the concept of leisure time, come indirectly as we restructure our lives around this technology (capitalism and the industrial revolution). Compare this to where we were 2,000 years ago or 10,000 years ago.

jsz0 10y ago

From what I've seen most people get started with opiates using them as an instant gratification anti-depressant. For that purpose they are effective for a while until the consequences of addiction start to set in. The worst part of this is in that period before addiction they actually are happier, more outgoing, more fun to be around, etc. So there's a sort of social dependency that goes along with the chemical dependency.

uvnq 10y ago
Speaking from personal experience, I completely agree with your comment. Also, I've seen people move from regular opiate use to not even caring about opiates, on account of (what I assume was) their transition from emotional instability to emotional stability. I think that a large part of prescription drug abuse is due to using them, as you said, as an instant gratification anti-depressant.
autokad 10y ago
"... more outgoing" does that happen with people taking them? i felt when I took oxycodone I wanted to be left alone. it could have also been I was physically unwell, but it felt like the 'wanting to be alone' was a symptom and wasnt in pain
- klibertp 10y ago
  Yes. Depends on a person, like in your case, also depends on dosage and tolerance, but being more outgoing, honest and speaking more is certainly possible as an effect of using opiates. What opiates do is they simply make you feel good. They give you a feeling of enjoying yourself. They don't make you ecstatic (for most people), but they give you all the pleasant feelings you could get after - for example - running and winning a race, for free. How those feelings affect your actions differs from person to person.
- jsz0 10y ago
  Like most mind altering drugs the effects are relative to your personality and mood when you take them.

a_imho 10y ago

Going off tangent, visiting a friend who has a TV I could not help noticing roughly 2/3 of ads are for drugs, sometimes there was a full block filled with them.

tunap 10y ago
The other 1/3 seem to be malpractice lawyers and sugar products... unless you included the sugar in the drugs category. This is why I watch sports on pirate feeds, the repetitive, inane ads replaced by a static image and bad(not worse) muzak.

sidcool 10y ago

Pharma profits are one of the reasons for the opiate crisis, which results in Heroin addiction in some cases. India is a good model where pharmas don't get a free hand.

autokad 10y ago
how do you figure pharma profits are one of the reasons for the crisis and to what extent is that reason? also out of curiosity, did you read the article?
- sidcool 10y ago
  Yes. I am not commenting strictly in context of the article. But there are many documentaries stating that opiates are pushed to doctors.

akjainaj 10y ago

The first theory "has been endorsed by some excellent journalists and broadcasters, from Sam Quinones to HBO’s John Oliver", two die-hard liberals, and according to this article it does not make sense; the one that makes sense, though, is the one that says that people living in zones historically neglected by liberals (such as the Rust Belt) "feel more distressed and disconnected".

moomin 10y ago

Given that the "first story" is thoroughly misrepresented and then the key facts lack important distinctions between short and long term use, I'm going to hazard a guess that the whole of this article is bunk.

DoodleBuggy 10y ago

Is there really a crisis? Some people use and abuse drugs, drink, gamble, who cares? It's a victimless crime.

mikeyouse 10y ago
Not sure a more substantive post would be helpful but opiate epidemic is anything but victimless; http://imgur.com/2UNEmfF http://imgur.com/2UNEmfF
- DoodleBuggy 10y ago
  Drug use is almost entirely victimless. This is well studied, researched, documented. By definition a victimless crime involves consenting parties with no harm to outside parties. There can be situations where something does impact a non-consenting party, which is when it stops being victimless.
  - tcbawo 10y ago
    There is often collateral damage among family (children!), friends, and coworkers of addicts. Complications caused by prenatal drug/alcohol use are also well documented.
    - DoodleBuggy 10y ago
      > By definition a victimless crime involves consenting parties with no harm to outside parties. There can be situations where something does impact a non-consenting party, which is when it stops being victimless.
      - tcbawo 10y ago
        I agree. I just think that the phrase "entirely victimless" is a little strong for most types of drug use.
      - aaron695 10y ago

alpineidyll3 10y ago

This article is not quantitative or scientific, although I am certain there is some validity to it's claims. Any same person would agree that trying to take these drugs away from addicts will only push them to heroin. However to become addicted one must try a substance, and or medical system has allowed far too many opiates to be sold and facilitated far too many first experiences. To the tune of 4x the number of prescriptions which should exist given US epidemiology. The interesting question is how you could show rigorously that this type of safety net is effective.