11 ms·

What I find fascinating and disappointing is how much the opioid crisis isn't being talked about or addressed proportional to other societal issues. Billions o

What I find fascinating and disappointing is how much the opioid crisis isn't being talked about or addressed proportional to other societal issues. Billions of dollars of private research being poured into self-driving cars by our greatest minds and millions of dollars in lobbying against gun laws all in the name of preventing unnecessary human deaths... yet according to Ben Bernanke (and his references), opioid overdose killed more people in 2015 than automobile accidents and firearms related crimes combined [1]. I'm curious whether the disproportionate concern has more to do with the perception of drug addicts as weak and deserving of their fate or because they're not a group that can be profited from politically or commercially or is overdosing just not as easy to solve as gun crime or automobile deaths? Personally, I find all those excuses to be sad and bullshit so I'm hoping it's something else entirely. [1] https://www.brookings.edu/wp-content/uploads/2017/06/es_20170626_whengrowthisnotenough.pdf https://www.brookings.edu/wp-content/uploads/2017/06/es_2017...

mobiletelephone 9y ago
Autonomous cars have benefits beyond being safer, which would explain why the investment outweighs the deaths/year
aaronbrethorst 9y ago
A couple notes: 1. The opioid crisis is getting a lot of airtime in the media outlets that I read. 3. The opioid crisis is one of the biggest reasons why the Senate's Trumpcare bill is now dead, and was also a major topic of discussion in the weeks leading up to its unexpected loss this week. In short, its drastic cuts to Medicaid would have decimated opioid treatment in some of the states hit hardest, and Senator Capito of West Virginia, at least, would have voted against it because the $40-odd billion dollars that Mitch McConnell would've specifically allocated to opioid treatment would have been a 'drop in the bucket.' Here's some earlier discussion of this point: http://talkingpointsmemo.com/dc/capito-says-opiod-treatment-carveout-not-enough-sway-vote-obamacare-repeal http://talkingpointsmemo.com/dc/capito-says-opiod-treatment-... So, all said, maybe find some new sources of news and discussion? edit: here's a new wire article from the AP that just crossed my RSS reader: http://talkingpointsmemo.com/news/democrats-trump-action-opioid-crisis http://talkingpointsmemo.com/news/democrats-trump-action-opi...
- gooseus 9y ago
  What I was referring to was the proportionality, obviously it IS being discussed (I linked a prominent policy maker discussing it), so really what I'm saying is that the amount of airtime/attention given to stories on the opioid crisis was far less than the combined number of stories attending to gun crimes or self-driving car successes/failures. I remember seeing a Vanguard episode on the "pain management" industry in Florida called the Oxycontin Express [1] back in 2009 (won a Peabody). And yet it's only in the last year or so that I've actually heard about it being addressed more publicly. If you're telling me that I'm wrong and that actually more people, dollars, and attention are going toward saving people from opioid overdose than automobile accidents and gun crime, then I would be happy to be wrong and would want to see numbers. Otherwise it sounds like you're telling me to tune my news inputs so I hear stories in a proportion that would please me better? [1] https://www.youtube.com/watch?v=wGZEvXNqzkM https://www.youtube.com/watch?v=wGZEvXNqzkM
  - aaronbrethorst 9y ago
    "isn't being talked about or addressed proportional to other societal issues" Talked about, from my perspective, it is. Addressed, no, it most certainly is not being addressed.
vosper 9y ago
In Sam Quinone's "Dreamland" (well worth a read) he talks about how the opioid epidemic stayed out of the public eye for so long, and he attributes a lot of it to the general perception of addiction as a moral failure, or weakness - parents don't talk about their dead children dying of addiction, because of the shame and judgement they feel [0]. So a lot of the deaths (and the suffering that can lead up to it) is hushed up. This tide is turning, now, as people are more willing to speak honestly and openly about how they and their families have been affected by addiction, and the realisation that anyone can be addicted to opiates, and it's not just a matter of not having sufficient backbone to resist their effects. On the matter of self-driving car investment, vs opiate addiction treatment - car makers need to turn a profit, so they need something new to sell. A lot of people also commute daily, and don't enjoy doing so. So in the (distant) shiny future where your car drives you to work, they are building something that I think a lot of people will be willing to pay for, or use as a service. [0] Addendum - it also avoided the public eye because of where addiction was happening, and who to. A lot of it started in smaller towns, often those struggling economically. The kind of places that don't get a lot of attention.
danans 9y ago
While I agree that a lot more funds for treatment are needed to fight the opioid epidemic, it is really a fundamentally different problem that road fatalities. The only thing they really have in common are the fatalities. The opioid crisis seems like a symptom of our social problems (hopelessness in the rust belt, unscrupulous over-prescribing of pain meds) that has fatal consequences. Short of a drug that provided a permanent cure for opioid addiction itself, I'm not sure what sort of solutions can be pursued by scientific/tech research, as opposed to addressing the root social causes. I'm interested in what ideas others might have though.
- rhizome 9y ago
  Short of a drug that provided a permanent cure for opioid addiction itself, I'm not sure what sort of solutions can be pursued by scientific/tech research Along with its therapeutic cousins Cannabis and MDMA, look what else we have on the list of substances for which federal research funds are banned (Schedule I): https://en.wikipedia.org/wiki/Ibogaine https://en.wikipedia.org/wiki/Ibogaine
  - pyre 9y ago
    > Ibogaine causes long QT syndrome at therapeutic doses, apparently by blocking hERG potassium channels in the heart. Yea. That doesn't necessarily sound good: > Clinical studies of ibogaine to treat drug addiction began in the early 1990s, but concerns about cardiotoxicity led to termination of those studies. There is currently insufficient data to determine whether it is useful in treating addiction. I'm not really sure this is some sort of miracle drug that the establishment just doesn't want us to know about.
    - bdamm 9y ago
      The drug is toxic in humans but I think it also means we can't do comparative trials on the mechanism in mice. There might be something to discover about the mechanism that could be brought by a different drug that doesn't have the cardiotoxicity.
    - rhizome 9y ago
oh_sigh 9y ago
Along those same lines, how about our modern day obsession with LGBT and racial issues. Yes, those are important, but I feel like the amount of time that is put into them is completely disproportionate relative to other very troubling issues(such as the opioid epidemic)
- gooseus 9y ago
  I agree to some extent. Many times when discussing these other societal issues we point to the levels of violence and conditions that affect one group proportional to other groups. Young black males are disproportionately the victims of gun crime, pretty sure that is a well-known fact that I don't need to look up. I also believe the data is in on young white males disproportionately being the victims of opioid overdose [1]. Are opioids a white problem and guns a black problem? Or are both actually related to a different condition and it's actually a young male problem? What about if we looked at the socio-economic class of these people ignoring age, sex and race? Something common there? I think that the focus on the racial/ethnic/sexual/gender makeup of the victims is less useful than some people want it to be. If anything I'd say it's an economic and community issue, this Kutzgesat video goes into it somewhere [2]. If there were better community support systems for people of lower economic classes then I think we'd see far less overdose and gun crime. One thing I will say though, and it is addressed in the first link somewhat, is the way drug enforcement is (and has been) conducted differently in different communities. That certainly exposes much of the systematic discrimination in drug enforcement which I do hold as almost as serious a problem as these deaths. [1] http://www.medscape.com/viewarticle/872062 http://www.medscape.com/viewarticle/872062 [2] https://www.youtube.com/watch?v=ao8L-0nSYzg https://www.youtube.com/watch?v=ao8L-0nSYzg
  - dsfyu404ed 9y ago
    >If anything I'd say it's an economic and community issue And nobody with political power will admit it because it will make them the enemy of both camps on both issues.
e40 9y ago
What I find fascinating and disappointing is how much the opioid crisis isn't being talked about or addressed proportional to other societal issues. I'm not surprised at all, and the only emotion I feel is complete disgust, directed at politicians that refuse to work together. It started the second Obama was elected POTUS and the opposing party declared they would not work with him, and that lasted the full 8 years.
- sjg007 9y ago
  There were two years before the mid terms but yes then it totally changed. People should hold the republicans accountable for that.
Kalium 9y ago
There are a number of factors at work. One of them is existing factions. There are existing political power blocks that stand strongly against "solutions" to "the gun problem". What do you want to see? What would you consider an ideal world here? I know how you feel. It's utterly ridiculous that a society should so heartlessly abandon the most vulnerable among us who struggle so needlessly. We should do better! We can do better! We MUST do better! It's a moral imperative. Yet, for all that, it's possible that resources are limited. And when resources are limited, questions of sustainability, achievability, returns, and cost-effectiveness become relevant. This is particularly true when there multiple goals to be chased - would you be happy if all Medicare funding for the elderly was stripped away in favor of treating opioid addiction?
- sethjgore 9y ago
  Resources are not limited. It is plentiful, except that society sees the resource of human labor and love as only valuable when it is profitable. If corporations found it profitable to ensure everybody was happy and living well, I can guarantee you that the vulnerable would be taken care of very well. It is just a matter of perception. By graviating towards money and profit, we undermine the worth of all humans and hence you asking "would you be happy if all Medicare funding for the elderly was stripped away in favor of treating opioid addiction?". Of course nobody would be happy! :)
  - Kalium 9y ago
    > Resources are not limited. It is plentiful, except that society sees the resource of human labor and love as only valuable when it is profitable. You're right! Resources are unquestionably plentiful! However, it's possible that plentiful might be slightly different from unlimited. If I wanted a billion PhD-educated engineers to colonize Mars tomorrow, I might run into limits, no? It is just a matter of perception. By thinking about how to best utilize plentiful-but-limited resources, considering the value and independence of all humans, we think about how best to create a system in which all these wonderful and infinitely valuable humans self-organize for what's best for them. That way we can gravitate towards happiness and wellness! I'd glad we agree on the value of humanity. I see human labor, human love, and human affection as valuable at all times and places. I also see that humans are plentiful-but-limited, time is plentiful-but-limited, and resources are plentiful-but-limited. > Of course nobody would be happy! :) Yeah. That's because it's obviously a bad way to distribute plentiful-but-limited resources like human labor and human love and human-run biochemical production facilities to make the greatest number of people as happy and well as possible.
solatic 9y ago
> I'm curious whether the disproportionate concern has more to do with the perception of drug addicts as weak and deserving of their fate This. The AIDS epidemic in the 1980's was the same. Tens of thousands of people dying every year, with more than forty thousand per year at jts peak, and more than 600,000 dead to date. Because of homophobia, the public at large didn't care about the victims - most people, if they took notice at all, only expressed groundless fear in catching HIV just going about their business. Opiate addiction isn't a disease in the sense that there's a biological virus or bacteria that can be transmitted from person to person, so "normal" people think they can't "catch" it. And so without public sympathy for the victims, no wonder there isn't some mass political movement trying to get Congress to fund a proper response.
- fapjacks 9y ago
  This is dead on, no pun intended. And it's made worse by the fact that even people who are personally affected by the overdose epidemic usually are culturally conditioned to shun the addicts (e.g. friends or family), and so instead of coming out and saying in public, "Yes, I have been personally affected by this horrible thing, we need to do something about it," you find that people keep this kind of thing quiet, because addiction and addicts are looked down upon. I think the analogy with HIV/AIDS is very succinct and relevant.
  - Spooky23 9y ago
    I fortunately don't have a ton of direct experience in this area. But spent alot of time with a recovering addict/alcoholic and drug counselor. Maybe his point of view was out of date, but I recall that he saw kicking any of these problems was something that came from within. You had to want out strongly. My friends moment was when his kids didn't want to see him. People shun addicts to survive, not out of cultural conditioning. The addiction comes first, and the addict will hurt anyone to get it.
acover 9y ago
Is the opioid crisis largely caused by prescription opioids getting people addicted?
wu-ikkyu 9y ago
>or because they're not a group that can be profited from politically They already are being profited from politically via the War on Drugs.
mnm1 9y ago
A lot of money is being spent on this, but the obvious solution--providing addicts with known, tested opiates and safe places to use--is illegal. Addicts are most certainly a group that can be profited off. We have entire industries that do that, sometimes exclusively: sugar, alcohol, tobacco, marijuana, big pharma, etc. In fact, it's this intention of our laws to encourage such profiting off of the suffering and deaths of addicts that I think is the reason no one is really trying to fix much. The other reason is, likely, that this is a rather unfixable cultural problem stemming from poverty, loneliness, and other cultural factors. Methadone clinics, rehabs and other places like that, however, do profit off of addicts' recovery and may even have genuine intentions of helping (it seems to vary from place to place). Those profits are minor compared to the profit off of addicts' misery and death, however, and their efforts are not usually talked about much in the press. Laws also hold back such institutions from providing good treatment and dehumanize the addicts trying to stay clean. In many places, addicts are treated horribly and made to suffer intentionally by the staff, often having to wait around sick for hours just to see a doctor before getting a dose of methadone even though they've been on the program for years. They are made to line up daily or weekly for a dose when a regular prescription would do just fine, even after they've been on methadone for years. At many of these clinics, it's a wonder that anyone stays clean. There is no professionalism. Doses are messed up when addicts travel and they are left without their methadone. Staff end up stealing either money or methadone. There is no accountability. Not all clinics lack compassion and treat addicts badly, but many do. It's no wonder these places try to fly under the radar while the good clinics and rehabs are too busy helping addicts to be in the press or make much noise. If cancer or heart patients were treated this way, you can bet your ass there'd be a national backlash, but our society has been conditioned to have no compassion for addicts. This is the result. It's ugly and nasty.
- girvo 9y ago
  Incredibly spot on. That's why I went on Suboxone instead, solely because it means I only have to go in once a fortnight. Nice regular prescription, but yeah the amount of travel I do is difficult with it, despite being on the program for 5 years.
  - 9y ago
dsfyu404ed 9y ago
>perception of drug addicts as weak and deserving of their fate I think you're right but the reasoning is one step removed from the conclusion. Drug addition is a poor people problem (in part because it takes resources and support to break the cycle). Opiod (and meth for that matter) addiction skews rural and therefore white. A lot of people take the attitude that poor rural white trash are poor white trash because they live in a dying town with no industry and refuse to relocate to somewhere they can more easily scrape by. The catch is that the people making these judgements generally have a very different set of values than the people they're judging. When you take the attitude that the situation that leads one to easily become an addict is the fault of the addict then it's hard to have sympathy for addicts. There's also a lot of (well meaning) "optimism to the point of stupidity" in assessing how effective firearms legislation is as an avenue to reduce violent crime and how easy it is to make a driver-less car that can effectively share the roads with vehicles operated by people
nostrademons 9y ago
I'm reminded of this Twitter exchange, in which Alan Kay graffiti'd YCombinator's "Make something people want" poster to say "Make something people need" and Paul Graham retorted that "making something people need but don't want kills startups". https://twitter.com/sama/status/656892679817527296 https://twitter.com/sama/status/656892679817527296 The point of business is to create a customer. For that to happen, there has to be someone out there who has voluntarily decided they want to use (and ideally pay for) your product. The same goes for political movements - to build a mass political movement, you need a critical mass of people who voluntarily decide that this cause is worth investing time and money into. By definition, addiction means that your voluntary choices are going to serve the furtherance of your addiction. So there's no customer there, and no profit potential, unless you're a drug dealer. Social interventions like drug treatment clinics could perhaps work, relying on the desires of loved ones, but it's very hard to help someone else unless they make choices to help themselves. When your brain chemistry has been altered so all it wants is more of the drug, that's not a given. It's a hard problem. Unfortunately history hasn't been kind to populations with mass drug abuse; when I think of countries with a societal drug problem [1][2] or even subpopulations within a larger nation with widespread drug abuse [3][4], the cultures involved all basically collapsed. For countries, the general pattern involved top-down reforms -> military defeats -> revolution -> conquest by another power. For subcultures within a larger nation, it's the total marginalization of the group in question, assimilation into the larger population of the remaining productive members, and then long-term decay and blight on the remnants of the subculture. [1] https://en.wikipedia.org/wiki/Opium_Wars https://en.wikipedia.org/wiki/Opium_Wars [2] https://en.wikipedia.org/wiki/Drug_policy_of_Nazi_Germany https://en.wikipedia.org/wiki/Drug_policy_of_Nazi_Germany [3] https://en.wikipedia.org/wiki/Crack_epidemic https://en.wikipedia.org/wiki/Crack_epidemic [4] https://en.wikipedia.org/wiki/Alcohol_and_Native_Americans https://en.wikipedia.org/wiki/Alcohol_and_Native_Americans
- lostlogin 9y ago
  > making something people need but don't want kills startups. And this is what government and regulation are for in my view.
  - 9y ago
abandonliberty 9y ago
Who would win and lose by addressing the Opioid crisis or not? Consider their relative power (wealth) and organization/unity. It's the same for basically every issue. Humans can be altruistic, but organizations rarely are. Simply: change happens when expending power leads to a greater expected increase in (relative) power than doing nothing for a sufficient amount of power-brokers to overcome costs of change and opponents(those who expect to lose from the change). This is a structural issue, not human nature. Blaming the addicts helps to reduce the cost of doing nothing. The good(?) news is that this is tending to hit wealthier people than past epidemics and so is getting correspondingly greater attention. Rejoice! The problem is far worse than these sad, bullshit excuses.
awkwarddaturtle 9y ago
> What I find fascinating and disappointing is how much the opioid crisis isn't being talked about or addressed proportional to other societal issues. Actually, it is the opposite. Gun violence, opioid crisis, etc are given too much attention. The deaths of opioid crisis and gun deaths are minuscule compared to the deaths cause by obesity, sedentary lifestyle, cancer, heart disease, etc. Take the top two killers in america - heart disease and cancer ( about 600K deaths each ) vs gun violence + opioid crisis ( about 30K each ). Heart disease by itself kill 10X more people than gun violence and opioid crisis combined.
- dehue 9y ago
  I believe at least one of the reasons why those are given more attention is because they are more likely to affect younger people and they seem more preventable. As opposed to cancer and heart disease which are more likely to kill older people and often develop over a lifetime.
  - cmurphycode 9y ago
    Yeah, I think that's definitely part of it. https://www.heart.org/idc/groups/heart-public/@wcm/@sop/@smd/documents/downloadable/ucm_449846.pdf https://www.heart.org/idc/groups/heart-public/@wcm/@sop/@smd... http://www.kff.org/other/state-indicator/opioid-overdose-deaths-by-age-group/?currentTimeframe=0&sortModel=%7B%22colId%22:%2225-34%22,%22sort%22:%22desc%22%7D http://www.kff.org/other/state-indicator/opioid-overdose-dea...
- averagewall 9y ago
  Everybody dies from something so there'll always be a top cause of death. I think we accept diseases of old age like heart disease and cancer as an inevitable part of being human. Sure it'd be nice to cure them. It'd also be nice to have immortality. You could go further and say brain death is the leading cause of death, affecting 100% of Americans. Let's put more effort into transferring our consciousness into computers so we can survive it! Again, it would be nice but seems tolerable to carry on as we are.
- nyolfen 9y ago
tomjen3 9y ago
Solving the self driving car issue seems possible, and you have a way to make money. I don't think it is possible to end the opium crisis so long as you have areas where there is nothing else to do and these people don't really.have anything else to aspire to. Even if you.solved it how are you going to make money on it? The addicts don't have the money, the local communies are already broke and it will take forever to get a federal grant.
deleted 9y ago
[deleted]
blintz 9y ago
Not quite true. More auto accident deaths than opioid overdose deaths. From your own link: "According to the Center for Disease Control, in 2015 52,404 people died from drug overdoses in the United States. 33,091 of those deaths involved opioids. In comparison, 35,092 people died in auto accidents in 2015 (Department of Transportation), and 12,195 people died from non-suicide firearm-related injuries in 2014 (CDC, 2015 data not yet available)."
occams_chainsaw 9y ago
I'm not sure where you concern lies... you mentioned millions being poured into a fight against gun laws to prevent deaths? Assuming that might have been misspeech, it's easy to see why autonomous vehicles have so much more interest. The interest isn't in preventing human death, the interest is there because not only is it a more fascinating problem to solve, but it saves everybody time and hassle. Lowering the number of deaths is just a great effect. Focus on a problem isn't always about sheer concern, sometimes the focus is so much higher just because it's a problem more people feel they can contribute to solving. Parkinson's law of triviality...
weberc2 9y ago
Your mistake is believing that people invest in self-driving cars as a sort of charity or social service in the same way as drug clinics. Even if that were the case, I think there's a reasonable case to be made that solving self-driving cars would be a better lives-saved/$ investment than opioids. Even if it was a comparable investment, it wouldn't make addicts as socially-productive a group as crash victims--this would take tens/hundreds of millions more in social services. Even neglecting that, crash victims are more worthy (on average) than overdose victims, as they come into their fate largely on accident, while overdose victims largely make an informed choice to roll the dice. I don't like saying this; it sounds judgmental and it certainly won't be popular, but this is the logical conclusion. Fortunately, the choice between self-driving cars and combatting the opioid epidemic doesn't remotely hinge on this point.
- pavel_lishin 9y ago
  > while overdose victims largely make an informed choice to roll the dice Don't most people develop an opioid addiction after being prescribed insufficient pain medication by their doctor? After that, sure, once they realize that getting more opioids - much more than they ought to, medically or legally - is literally the only way to stop the daily pain?
  - paulddraper 9y ago
    Over prescription, not under perception is more often blamed.
  - weberc2 9y ago
    I don't think it's most people, but I understand some do. Hence my wording. That said, I don't have any data to back that up.
segmondy 9y ago
Why don't you go solve it? Who are you waiting for? Maybe some of us wanna work on self-driving cars. I often see people lamenting about the world's problem. Waiting for someone else to solve it. If you find it so disappointing, go for it! You can do it!
- Retra 9y ago
  Our society is one built upon the idea of specialization. And when the specialists fail, they are asked to correct course. Your attitude is unwarranted.
ajmurmann 9y ago
The recent Nautilus article about why our brain hates other people[1] makes an attempt at categorizing how we view people along two axis. How emotionally warm we perceive members of another group and how competent we perceive them. The article than goes on to describe how we react to these categorizations. According to the article we are physically disgusted by people with both perceived low competence and low warmth. The effect is compared to seeing a maggot infected wound. The article uses drug addicts as the example of a group we perceive that way. [1]http://nautil.us/issue/49/the-absurd/why-your-brain-hates-other-people http://nautil.us/issue/49/the-absurd/why-your-brain-hates-ot...
creyes 9y ago
My company (https://pelorushealth.com https://pelorushealth.com) is a remote case-management/recovery coach app suit for people who are recovery from substance abuse, namely opioids and alcohol. One of our biggest blockers has been the existing recovery industry. Addiction is so stigmatized that getting people to use an app on their phone, even after treatment, is problematic because they feel like the data could get out that they're an addict. This is another reason more research isn't done. These existing facilities literally don't collect data - much less use it in any relevant way. Value-based payments and growing oversight from insurance companies is changing that somewhat. These facilities are starting to be required to report outcomes data - so from a business perspective we're good. But man this industry and it's privacy/secrecy are something else.
phil21 9y ago
It's really simple. Addicts don't make good customers.
- deleted 9y ago
  [deleted]
- thirdsun 9y ago
  Well...depending on what you're selling they are probably excellent customers. Sorry, couldn't resist. On a more serious note however, I understand what you mean. I think there's also the perception that significant cases of drug abuse, addiction and the crimes related to this are something that seems to happen far, far away for most people in a position to offer help. Something you see in movies and dramatic VICE documentaries, but not in your own backyard. If you're not confronted with the problem it's easy to not perceive it as one.
jsemrau 9y ago
> our greatest minds Self-driving cars actually would have a benefit for society in terms of higher durability for vehicle and optimal road selection leading to lower carbon emissions, lower traffic accidents, and less use of natural resources. I am more annoyed by all the time and effort going into Google's and Facebook's ad-tech optimizations.
hkmurakami 9y ago
Well, I've been following the GOP Senate healthcare bill closely over the last month, and several GOP Senators have stood their ground amidst pressure from party leaders as well as the Whitehouse to protect funding for their Home State's opioid epidemic. It's been a frontline issue in nearly every article I've read regarding the GOP's difficulty in getting to 50 votes. So while the public at large may be ignorant of this crisis (and honestly, on how many issues is even the most educated of us truly knowledgeable about?) the States' representatives that have these problems back home appear to be taking it very seriously.
- greeneggs 9y ago
  > ... the States' representatives that have these problems back home appear to be taking it very seriously. Rather, "several" out of 52 GOP senators are taking it seriously. Or do I misunderstand you?
vog 9y ago
> millions of dollars in lobbying against gun laws Wait, what? This is a "lobby"? I thought the NRA with their even larger resources, backed by industrial interests, is the actual lobby. You know, the one who pushed forward those laws into insane directions, which you'll find almost nowhere else in the world.

mobiletelephone 9y ago

Autonomous cars have benefits beyond being safer, which would explain why the investment outweighs the deaths/year

aaronbrethorst 9y ago

A couple notes: 1. The opioid crisis is getting a lot of airtime in the media outlets that I read. 3. The opioid crisis is one of the biggest reasons why the Senate's Trumpcare bill is now dead, and was also a major topic of discussion in the weeks leading up to its unexpected loss this week. In short, its drastic cuts to Medicaid would have decimated opioid treatment in some of the states hit hardest, and Senator Capito of West Virginia, at least, would have voted against it because the $40-odd billion dollars that Mitch McConnell would've specifically allocated to opioid treatment would have been a 'drop in the bucket.' Here's some earlier discussion of this point: http://talkingpointsmemo.com/dc/capito-says-opiod-treatment-carveout-not-enough-sway-vote-obamacare-repeal http://talkingpointsmemo.com/dc/capito-says-opiod-treatment-... So, all said, maybe find some new sources of news and discussion? edit: here's a new wire article from the AP that just crossed my RSS reader: http://talkingpointsmemo.com/news/democrats-trump-action-opioid-crisis http://talkingpointsmemo.com/news/democrats-trump-action-opi...

gooseus 9y ago
What I was referring to was the proportionality, obviously it IS being discussed (I linked a prominent policy maker discussing it), so really what I'm saying is that the amount of airtime/attention given to stories on the opioid crisis was far less than the combined number of stories attending to gun crimes or self-driving car successes/failures. I remember seeing a Vanguard episode on the "pain management" industry in Florida called the Oxycontin Express [1] back in 2009 (won a Peabody). And yet it's only in the last year or so that I've actually heard about it being addressed more publicly. If you're telling me that I'm wrong and that actually more people, dollars, and attention are going toward saving people from opioid overdose than automobile accidents and gun crime, then I would be happy to be wrong and would want to see numbers. Otherwise it sounds like you're telling me to tune my news inputs so I hear stories in a proportion that would please me better? [1] https://www.youtube.com/watch?v=wGZEvXNqzkM https://www.youtube.com/watch?v=wGZEvXNqzkM
- aaronbrethorst 9y ago
  "isn't being talked about or addressed proportional to other societal issues" Talked about, from my perspective, it is. Addressed, no, it most certainly is not being addressed.

vosper 9y ago

In Sam Quinone's "Dreamland" (well worth a read) he talks about how the opioid epidemic stayed out of the public eye for so long, and he attributes a lot of it to the general perception of addiction as a moral failure, or weakness - parents don't talk about their dead children dying of addiction, because of the shame and judgement they feel [0]. So a lot of the deaths (and the suffering that can lead up to it) is hushed up. This tide is turning, now, as people are more willing to speak honestly and openly about how they and their families have been affected by addiction, and the realisation that anyone can be addicted to opiates, and it's not just a matter of not having sufficient backbone to resist their effects. On the matter of self-driving car investment, vs opiate addiction treatment - car makers need to turn a profit, so they need something new to sell. A lot of people also commute daily, and don't enjoy doing so. So in the (distant) shiny future where your car drives you to work, they are building something that I think a lot of people will be willing to pay for, or use as a service. [0] Addendum - it also avoided the public eye because of where addiction was happening, and who to. A lot of it started in smaller towns, often those struggling economically. The kind of places that don't get a lot of attention.

danans 9y ago

While I agree that a lot more funds for treatment are needed to fight the opioid epidemic, it is really a fundamentally different problem that road fatalities. The only thing they really have in common are the fatalities. The opioid crisis seems like a symptom of our social problems (hopelessness in the rust belt, unscrupulous over-prescribing of pain meds) that has fatal consequences. Short of a drug that provided a permanent cure for opioid addiction itself, I'm not sure what sort of solutions can be pursued by scientific/tech research, as opposed to addressing the root social causes. I'm interested in what ideas others might have though.

rhizome 9y ago
Short of a drug that provided a permanent cure for opioid addiction itself, I'm not sure what sort of solutions can be pursued by scientific/tech research Along with its therapeutic cousins Cannabis and MDMA, look what else we have on the list of substances for which federal research funds are banned (Schedule I): https://en.wikipedia.org/wiki/Ibogaine https://en.wikipedia.org/wiki/Ibogaine
- pyre 9y ago
  > Ibogaine causes long QT syndrome at therapeutic doses, apparently by blocking hERG potassium channels in the heart. Yea. That doesn't necessarily sound good: > Clinical studies of ibogaine to treat drug addiction began in the early 1990s, but concerns about cardiotoxicity led to termination of those studies. There is currently insufficient data to determine whether it is useful in treating addiction. I'm not really sure this is some sort of miracle drug that the establishment just doesn't want us to know about.
  - bdamm 9y ago
    The drug is toxic in humans but I think it also means we can't do comparative trials on the mechanism in mice. There might be something to discover about the mechanism that could be brought by a different drug that doesn't have the cardiotoxicity.
  - rhizome 9y ago

oh_sigh 9y ago

Along those same lines, how about our modern day obsession with LGBT and racial issues. Yes, those are important, but I feel like the amount of time that is put into them is completely disproportionate relative to other very troubling issues(such as the opioid epidemic)

gooseus 9y ago
I agree to some extent. Many times when discussing these other societal issues we point to the levels of violence and conditions that affect one group proportional to other groups. Young black males are disproportionately the victims of gun crime, pretty sure that is a well-known fact that I don't need to look up. I also believe the data is in on young white males disproportionately being the victims of opioid overdose [1]. Are opioids a white problem and guns a black problem? Or are both actually related to a different condition and it's actually a young male problem? What about if we looked at the socio-economic class of these people ignoring age, sex and race? Something common there? I think that the focus on the racial/ethnic/sexual/gender makeup of the victims is less useful than some people want it to be. If anything I'd say it's an economic and community issue, this Kutzgesat video goes into it somewhere [2]. If there were better community support systems for people of lower economic classes then I think we'd see far less overdose and gun crime. One thing I will say though, and it is addressed in the first link somewhat, is the way drug enforcement is (and has been) conducted differently in different communities. That certainly exposes much of the systematic discrimination in drug enforcement which I do hold as almost as serious a problem as these deaths. [1] http://www.medscape.com/viewarticle/872062 http://www.medscape.com/viewarticle/872062 [2] https://www.youtube.com/watch?v=ao8L-0nSYzg https://www.youtube.com/watch?v=ao8L-0nSYzg
- dsfyu404ed 9y ago
  >If anything I'd say it's an economic and community issue And nobody with political power will admit it because it will make them the enemy of both camps on both issues.

e40 9y ago

What I find fascinating and disappointing is how much the opioid crisis isn't being talked about or addressed proportional to other societal issues. I'm not surprised at all, and the only emotion I feel is complete disgust, directed at politicians that refuse to work together. It started the second Obama was elected POTUS and the opposing party declared they would not work with him, and that lasted the full 8 years.

sjg007 9y ago
There were two years before the mid terms but yes then it totally changed. People should hold the republicans accountable for that.

Kalium 9y ago

There are a number of factors at work. One of them is existing factions. There are existing political power blocks that stand strongly against "solutions" to "the gun problem". What do you want to see? What would you consider an ideal world here? I know how you feel. It's utterly ridiculous that a society should so heartlessly abandon the most vulnerable among us who struggle so needlessly. We should do better! We can do better! We MUST do better! It's a moral imperative. Yet, for all that, it's possible that resources are limited. And when resources are limited, questions of sustainability, achievability, returns, and cost-effectiveness become relevant. This is particularly true when there multiple goals to be chased - would you be happy if all Medicare funding for the elderly was stripped away in favor of treating opioid addiction?

sethjgore 9y ago
Resources are not limited. It is plentiful, except that society sees the resource of human labor and love as only valuable when it is profitable. If corporations found it profitable to ensure everybody was happy and living well, I can guarantee you that the vulnerable would be taken care of very well. It is just a matter of perception. By graviating towards money and profit, we undermine the worth of all humans and hence you asking "would you be happy if all Medicare funding for the elderly was stripped away in favor of treating opioid addiction?". Of course nobody would be happy! :)
- Kalium 9y ago
  > Resources are not limited. It is plentiful, except that society sees the resource of human labor and love as only valuable when it is profitable. You're right! Resources are unquestionably plentiful! However, it's possible that plentiful might be slightly different from unlimited. If I wanted a billion PhD-educated engineers to colonize Mars tomorrow, I might run into limits, no? It is just a matter of perception. By thinking about how to best utilize plentiful-but-limited resources, considering the value and independence of all humans, we think about how best to create a system in which all these wonderful and infinitely valuable humans self-organize for what's best for them. That way we can gravitate towards happiness and wellness! I'd glad we agree on the value of humanity. I see human labor, human love, and human affection as valuable at all times and places. I also see that humans are plentiful-but-limited, time is plentiful-but-limited, and resources are plentiful-but-limited. > Of course nobody would be happy! :) Yeah. That's because it's obviously a bad way to distribute plentiful-but-limited resources like human labor and human love and human-run biochemical production facilities to make the greatest number of people as happy and well as possible.

solatic 9y ago

> I'm curious whether the disproportionate concern has more to do with the perception of drug addicts as weak and deserving of their fate This. The AIDS epidemic in the 1980's was the same. Tens of thousands of people dying every year, with more than forty thousand per year at jts peak, and more than 600,000 dead to date. Because of homophobia, the public at large didn't care about the victims - most people, if they took notice at all, only expressed groundless fear in catching HIV just going about their business. Opiate addiction isn't a disease in the sense that there's a biological virus or bacteria that can be transmitted from person to person, so "normal" people think they can't "catch" it. And so without public sympathy for the victims, no wonder there isn't some mass political movement trying to get Congress to fund a proper response.

fapjacks 9y ago
This is dead on, no pun intended. And it's made worse by the fact that even people who are personally affected by the overdose epidemic usually are culturally conditioned to shun the addicts (e.g. friends or family), and so instead of coming out and saying in public, "Yes, I have been personally affected by this horrible thing, we need to do something about it," you find that people keep this kind of thing quiet, because addiction and addicts are looked down upon. I think the analogy with HIV/AIDS is very succinct and relevant.
- Spooky23 9y ago
  I fortunately don't have a ton of direct experience in this area. But spent alot of time with a recovering addict/alcoholic and drug counselor. Maybe his point of view was out of date, but I recall that he saw kicking any of these problems was something that came from within. You had to want out strongly. My friends moment was when his kids didn't want to see him. People shun addicts to survive, not out of cultural conditioning. The addiction comes first, and the addict will hurt anyone to get it.

acover 9y ago

Is the opioid crisis largely caused by prescription opioids getting people addicted?

wu-ikkyu 9y ago

>or because they're not a group that can be profited from politically They already are being profited from politically via the War on Drugs.

mnm1 9y ago

A lot of money is being spent on this, but the obvious solution--providing addicts with known, tested opiates and safe places to use--is illegal. Addicts are most certainly a group that can be profited off. We have entire industries that do that, sometimes exclusively: sugar, alcohol, tobacco, marijuana, big pharma, etc. In fact, it's this intention of our laws to encourage such profiting off of the suffering and deaths of addicts that I think is the reason no one is really trying to fix much. The other reason is, likely, that this is a rather unfixable cultural problem stemming from poverty, loneliness, and other cultural factors. Methadone clinics, rehabs and other places like that, however, do profit off of addicts' recovery and may even have genuine intentions of helping (it seems to vary from place to place). Those profits are minor compared to the profit off of addicts' misery and death, however, and their efforts are not usually talked about much in the press. Laws also hold back such institutions from providing good treatment and dehumanize the addicts trying to stay clean. In many places, addicts are treated horribly and made to suffer intentionally by the staff, often having to wait around sick for hours just to see a doctor before getting a dose of methadone even though they've been on the program for years. They are made to line up daily or weekly for a dose when a regular prescription would do just fine, even after they've been on methadone for years. At many of these clinics, it's a wonder that anyone stays clean. There is no professionalism. Doses are messed up when addicts travel and they are left without their methadone. Staff end up stealing either money or methadone. There is no accountability. Not all clinics lack compassion and treat addicts badly, but many do. It's no wonder these places try to fly under the radar while the good clinics and rehabs are too busy helping addicts to be in the press or make much noise. If cancer or heart patients were treated this way, you can bet your ass there'd be a national backlash, but our society has been conditioned to have no compassion for addicts. This is the result. It's ugly and nasty.

girvo 9y ago
Incredibly spot on. That's why I went on Suboxone instead, solely because it means I only have to go in once a fortnight. Nice regular prescription, but yeah the amount of travel I do is difficult with it, despite being on the program for 5 years.
- 9y ago

dsfyu404ed 9y ago

>perception of drug addicts as weak and deserving of their fate I think you're right but the reasoning is one step removed from the conclusion. Drug addition is a poor people problem (in part because it takes resources and support to break the cycle). Opiod (and meth for that matter) addiction skews rural and therefore white. A lot of people take the attitude that poor rural white trash are poor white trash because they live in a dying town with no industry and refuse to relocate to somewhere they can more easily scrape by. The catch is that the people making these judgements generally have a very different set of values than the people they're judging. When you take the attitude that the situation that leads one to easily become an addict is the fault of the addict then it's hard to have sympathy for addicts. There's also a lot of (well meaning) "optimism to the point of stupidity" in assessing how effective firearms legislation is as an avenue to reduce violent crime and how easy it is to make a driver-less car that can effectively share the roads with vehicles operated by people

nostrademons 9y ago

I'm reminded of this Twitter exchange, in which Alan Kay graffiti'd YCombinator's "Make something people want" poster to say "Make something people need" and Paul Graham retorted that "making something people need but don't want kills startups". https://twitter.com/sama/status/656892679817527296 https://twitter.com/sama/status/656892679817527296 The point of business is to create a customer. For that to happen, there has to be someone out there who has voluntarily decided they want to use (and ideally pay for) your product. The same goes for political movements - to build a mass political movement, you need a critical mass of people who voluntarily decide that this cause is worth investing time and money into. By definition, addiction means that your voluntary choices are going to serve the furtherance of your addiction. So there's no customer there, and no profit potential, unless you're a drug dealer. Social interventions like drug treatment clinics could perhaps work, relying on the desires of loved ones, but it's very hard to help someone else unless they make choices to help themselves. When your brain chemistry has been altered so all it wants is more of the drug, that's not a given. It's a hard problem. Unfortunately history hasn't been kind to populations with mass drug abuse; when I think of countries with a societal drug problem [1][2] or even subpopulations within a larger nation with widespread drug abuse [3][4], the cultures involved all basically collapsed. For countries, the general pattern involved top-down reforms -> military defeats -> revolution -> conquest by another power. For subcultures within a larger nation, it's the total marginalization of the group in question, assimilation into the larger population of the remaining productive members, and then long-term decay and blight on the remnants of the subculture. [1] https://en.wikipedia.org/wiki/Opium_Wars https://en.wikipedia.org/wiki/Opium_Wars [2] https://en.wikipedia.org/wiki/Drug_policy_of_Nazi_Germany https://en.wikipedia.org/wiki/Drug_policy_of_Nazi_Germany [3] https://en.wikipedia.org/wiki/Crack_epidemic https://en.wikipedia.org/wiki/Crack_epidemic [4] https://en.wikipedia.org/wiki/Alcohol_and_Native_Americans https://en.wikipedia.org/wiki/Alcohol_and_Native_Americans

lostlogin 9y ago
> making something people need but don't want kills startups. And this is what government and regulation are for in my view.
- 9y ago

abandonliberty 9y ago

Who would win and lose by addressing the Opioid crisis or not? Consider their relative power (wealth) and organization/unity. It's the same for basically every issue. Humans can be altruistic, but organizations rarely are. Simply: change happens when expending power leads to a greater expected increase in (relative) power than doing nothing for a sufficient amount of power-brokers to overcome costs of change and opponents(those who expect to lose from the change). This is a structural issue, not human nature. Blaming the addicts helps to reduce the cost of doing nothing. The good(?) news is that this is tending to hit wealthier people than past epidemics and so is getting correspondingly greater attention. Rejoice! The problem is far worse than these sad, bullshit excuses.

awkwarddaturtle 9y ago

> What I find fascinating and disappointing is how much the opioid crisis isn't being talked about or addressed proportional to other societal issues. Actually, it is the opposite. Gun violence, opioid crisis, etc are given too much attention. The deaths of opioid crisis and gun deaths are minuscule compared to the deaths cause by obesity, sedentary lifestyle, cancer, heart disease, etc. Take the top two killers in america - heart disease and cancer ( about 600K deaths each ) vs gun violence + opioid crisis ( about 30K each ). Heart disease by itself kill 10X more people than gun violence and opioid crisis combined.

dehue 9y ago
I believe at least one of the reasons why those are given more attention is because they are more likely to affect younger people and they seem more preventable. As opposed to cancer and heart disease which are more likely to kill older people and often develop over a lifetime.
- cmurphycode 9y ago
  Yeah, I think that's definitely part of it. https://www.heart.org/idc/groups/heart-public/@wcm/@sop/@smd/documents/downloadable/ucm_449846.pdf https://www.heart.org/idc/groups/heart-public/@wcm/@sop/@smd... http://www.kff.org/other/state-indicator/opioid-overdose-deaths-by-age-group/?currentTimeframe=0&sortModel=%7B%22colId%22:%2225-34%22,%22sort%22:%22desc%22%7D http://www.kff.org/other/state-indicator/opioid-overdose-dea...
averagewall 9y ago
Everybody dies from something so there'll always be a top cause of death. I think we accept diseases of old age like heart disease and cancer as an inevitable part of being human. Sure it'd be nice to cure them. It'd also be nice to have immortality. You could go further and say brain death is the leading cause of death, affecting 100% of Americans. Let's put more effort into transferring our consciousness into computers so we can survive it! Again, it would be nice but seems tolerable to carry on as we are.
nyolfen 9y ago

tomjen3 9y ago

Solving the self driving car issue seems possible, and you have a way to make money. I don't think it is possible to end the opium crisis so long as you have areas where there is nothing else to do and these people don't really.have anything else to aspire to. Even if you.solved it how are you going to make money on it? The addicts don't have the money, the local communies are already broke and it will take forever to get a federal grant.

deleted 9y ago

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blintz 9y ago

Not quite true. More auto accident deaths than opioid overdose deaths. From your own link: "According to the Center for Disease Control, in 2015 52,404 people died from drug overdoses in the United States. 33,091 of those deaths involved opioids. In comparison, 35,092 people died in auto accidents in 2015 (Department of Transportation), and 12,195 people died from non-suicide firearm-related injuries in 2014 (CDC, 2015 data not yet available)."

occams_chainsaw 9y ago

I'm not sure where you concern lies... you mentioned millions being poured into a fight against gun laws to prevent deaths? Assuming that might have been misspeech, it's easy to see why autonomous vehicles have so much more interest. The interest isn't in preventing human death, the interest is there because not only is it a more fascinating problem to solve, but it saves everybody time and hassle. Lowering the number of deaths is just a great effect. Focus on a problem isn't always about sheer concern, sometimes the focus is so much higher just because it's a problem more people feel they can contribute to solving. Parkinson's law of triviality...

weberc2 9y ago

Your mistake is believing that people invest in self-driving cars as a sort of charity or social service in the same way as drug clinics. Even if that were the case, I think there's a reasonable case to be made that solving self-driving cars would be a better lives-saved/$ investment than opioids. Even if it was a comparable investment, it wouldn't make addicts as socially-productive a group as crash victims--this would take tens/hundreds of millions more in social services. Even neglecting that, crash victims are more worthy (on average) than overdose victims, as they come into their fate largely on accident, while overdose victims largely make an informed choice to roll the dice. I don't like saying this; it sounds judgmental and it certainly won't be popular, but this is the logical conclusion. Fortunately, the choice between self-driving cars and combatting the opioid epidemic doesn't remotely hinge on this point.

pavel_lishin 9y ago
> while overdose victims largely make an informed choice to roll the dice Don't most people develop an opioid addiction after being prescribed insufficient pain medication by their doctor? After that, sure, once they realize that getting more opioids - much more than they ought to, medically or legally - is literally the only way to stop the daily pain?
- paulddraper 9y ago
  Over prescription, not under perception is more often blamed.
- weberc2 9y ago
  I don't think it's most people, but I understand some do. Hence my wording. That said, I don't have any data to back that up.

segmondy 9y ago

Why don't you go solve it? Who are you waiting for? Maybe some of us wanna work on self-driving cars. I often see people lamenting about the world's problem. Waiting for someone else to solve it. If you find it so disappointing, go for it! You can do it!

Retra 9y ago
Our society is one built upon the idea of specialization. And when the specialists fail, they are asked to correct course. Your attitude is unwarranted.

ajmurmann 9y ago

The recent Nautilus article about why our brain hates other people[1] makes an attempt at categorizing how we view people along two axis. How emotionally warm we perceive members of another group and how competent we perceive them. The article than goes on to describe how we react to these categorizations. According to the article we are physically disgusted by people with both perceived low competence and low warmth. The effect is compared to seeing a maggot infected wound. The article uses drug addicts as the example of a group we perceive that way. [1]http://nautil.us/issue/49/the-absurd/why-your-brain-hates-other-people http://nautil.us/issue/49/the-absurd/why-your-brain-hates-ot...

creyes 9y ago

My company (https://pelorushealth.com https://pelorushealth.com) is a remote case-management/recovery coach app suit for people who are recovery from substance abuse, namely opioids and alcohol. One of our biggest blockers has been the existing recovery industry. Addiction is so stigmatized that getting people to use an app on their phone, even after treatment, is problematic because they feel like the data could get out that they're an addict. This is another reason more research isn't done. These existing facilities literally don't collect data - much less use it in any relevant way. Value-based payments and growing oversight from insurance companies is changing that somewhat. These facilities are starting to be required to report outcomes data - so from a business perspective we're good. But man this industry and it's privacy/secrecy are something else.

phil21 9y ago

It's really simple. Addicts don't make good customers.

deleted 9y ago
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thirdsun 9y ago
Well...depending on what you're selling they are probably excellent customers. Sorry, couldn't resist. On a more serious note however, I understand what you mean. I think there's also the perception that significant cases of drug abuse, addiction and the crimes related to this are something that seems to happen far, far away for most people in a position to offer help. Something you see in movies and dramatic VICE documentaries, but not in your own backyard. If you're not confronted with the problem it's easy to not perceive it as one.

jsemrau 9y ago

> our greatest minds Self-driving cars actually would have a benefit for society in terms of higher durability for vehicle and optimal road selection leading to lower carbon emissions, lower traffic accidents, and less use of natural resources. I am more annoyed by all the time and effort going into Google's and Facebook's ad-tech optimizations.

hkmurakami 9y ago

Well, I've been following the GOP Senate healthcare bill closely over the last month, and several GOP Senators have stood their ground amidst pressure from party leaders as well as the Whitehouse to protect funding for their Home State's opioid epidemic. It's been a frontline issue in nearly every article I've read regarding the GOP's difficulty in getting to 50 votes. So while the public at large may be ignorant of this crisis (and honestly, on how many issues is even the most educated of us truly knowledgeable about?) the States' representatives that have these problems back home appear to be taking it very seriously.

greeneggs 9y ago
> ... the States' representatives that have these problems back home appear to be taking it very seriously. Rather, "several" out of 52 GOP senators are taking it seriously. Or do I misunderstand you?

vog 9y ago

> millions of dollars in lobbying against gun laws Wait, what? This is a "lobby"? I thought the NRA with their even larger resources, backed by industrial interests, is the actual lobby. You know, the one who pushed forward those laws into insane directions, which you'll find almost nowhere else in the world.