8 ms·
Overdose deaths have fallen for six months
- nirElHeroinas 8y agoSad news, more welfare recipients.
- jacob019 8y agoStaggering numbers of dead, a major policy failure.
- a_humean 8y agoThat death rate is insane. How can republicans do effectively nothing about this public health disaster? I am singling out republicans rather than the political class generally as right now they have control of most state legislatures and governorships, control of congress, control of the senate, control of the supreme court, and control of the presidency. If they wanted to do something to address this, they can do it. Evidently they would rather people just die.
- znaji 8y agoHave you looked at the dates on the chart? https://www.statnews.com/wp-content/uploads/2018/10/CDC-Overdose-deaths-chart-2.jpg https://www.statnews.com/wp-content/uploads/2018/10/CDC-Over...
- a_humean 8y agoCongressional elections: 2016: 246-194 Republican 2014: 247-188 Republican 2012: 234-201 Republican Six year incumbency.
- DtnB 8y agohttps://www.whitehouse.gov/opioids/ https://www.whitehouse.gov/opioids/ ?
- cissou 8y agowouldn't the article suggest exactly the opposite of what you're saying? as in, since they control all branches, the crisis has started to improve?
- yostrovs 8y agoI think it's just too easy to write "republicans" in a comment. For a good chunk of the population that's enough to convince them that it's "republicans". Even for the author of the comment, once it's written it has to be defended and you can only become adamant about defending what you said not too long ago.
- deleted 8y ago[deleted]
- deleted 8y ago[deleted]
- dang 8y agoPlease don't take HN threads into political flamewars. Those are all the same, therefore boring; plus we don't want this place to burn. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
- a_humean 8y agoI'm sorry. Next time I'm be more indirect.
- deleted 8y ago[deleted]
- zaroth 8y agoFirst, the chart is showing the number of deaths in the previous 12 month period. Second, this isn’t a political football. This is something that every American can look at and agree that we need to be bringing powerful tools (regulatory, legal, policy, aid, EMS, hospital, pharmacy, education, volunteer, etc.) in a concerted and coordinated effort to fix this. Third, any efforts are obviously going to take time to show up in the death rate, but even if we are turning a corner will need to be sustained across administrations. One could sensibly make the argument that the root of the problem is the carving out of the middle class and manufacturing base of the country that occurred solidly during Obama’s years as a result of the push toward globalization. The massive economic improvement as a result of the tax cuts and deregulation since Trump’s election has helped get people whose jobs were “never coming back” to become gainfully employed again and motivated to face the hard fight against opioid dependence. But in the end it’s just finger pointing / and falsely ascribing causation to correlation to try to score political points or demonize the “other side”.
- grdeken 8y agoI know that in many states where there are serious problems they have provided narcan to all first responders. I'm wondering if this is a bit of a false positive in the data. The addiction levels could be the same, just fewer people dying of overdose because more access to narcan. HN WDYT?
- gwbas1c 8y ago> Many public health experts point to campaigns in Rhode Island, Vermont, and Massachusetts as models for addressing addiction, and all three states reported decreases in overdose deaths from March 2017 to March 2018 — declines that many of their neighbors did not see. > “The states that have been comprehensive and have gone after evidence-based methods are seeing the declines,” said Brandon Marshall, a Brown University epidemiologist. A good friend of mine is a cop in Massachusetts. He carries Narcan.
- dsfyu404ed 8y ago>A good friend of mine is a cop in Massachusetts. He carries Narcan. >cop in Massachusetts. >Massachusetts. C'mon. We both know he's too busy giving other drunk cops rides home and "working" overtime to actually administer narcan. ;) edit: For anyone not familiar with the shenanigans of MA cops this is a joke. They routinely get caught covering for drunk buddies and "working overtime" that wasn't actually "worked" so to speak.
- thrmsforbfast 8y agoThe most important take-away from this article is the Science paper by Jalal et al., "Changing dynamics of the drug overdose epidemic in the United States from 1979 through 2016" [1]. In that paper, the authors conclude: > The overall mortality rate for unintentional drug poisonings in the United States grew exponentially from 1979 through 2016. This exponentially increasing mortality rate has tracked along a remarkably smooth trajectory (log linear R2 = 0.99) for at least 38 years. By contrast, the trajectories of mortality rates from individual drugs have not tracked along exponential trajectories. The authors also suggest that we should attempt to "understand the forces that are holding multiple subepidemics together onto a smooth exponential trajectory", and suggest a double-whammy of increased supply (due to improved communication, transportation, and manufacture) and increase demand (despair, loss of purpose, and dissolution of communities) that cuts across both demographics and geographic regions. -- [1] http://science.sciencemag.org/content/361/6408/eaau1184 http://science.sciencemag.org/content/361/6408/eaau1184
- beezle 8y agoFor heroin specifically, I looked into usage rates a few years ago, unfortunately I can't find my notes so no sources here (and it is really hard to find such data). But from what I recall, usuage rates of heroin in the population in the late 60s and early 70s was comparable to recent years, then fell a bit and remained more or less stable through the early 2000s. The return of addicted GIs from Vietnam prompted the start of the war on drugs by Nixon [1] The big problem with heroin is what they are cutting it with. Prescription opioids, different ball of wax. [1] https://www.presidency.ucsb.edu/documents/special-message-the-congress-drug-abuse-prevention-and-control https://www.presidency.ucsb.edu/documents/special-message-th...
- JumpCrisscross 8y agoSo drugs aren't getting deadlier, it's just that more of us are using more of them? (Or more among us are using deadlier drugs than before?)
- docbrown 8y agoDrugs are still getting stronger and deadlier and much cheaper. This is obvious when you look at the a spike in Fentanyl use compared to other narcotics. While the amount needed to get high is lower, the potency is much higher. In addition to this, these packages are getting stepped on—where dealers cut it with another substance—a hundred times over before it ends up in someone’s veins with anything and everything.
- LaikaF 8y agoSo something they briefly touch on is new research chemicals. What they don't mention is what happened earlier this year. FOSTA has slaughtered many avenues of sourcing research chemicals. It is significantly more difficult to get them from a reliable source then it was this time last year. While this doesn't stop anyone sufficiently determined, it's harder to get a source of say fentanyl or U-47770 to cut with. The US has been cracking down on producers of these in China, and many chinese or US based resellers have either ceased to exist or changed their operation (US seems to be heavily targeting opioids, China seems to be going after ketamine and analogs) . In addition the Darknet Markets have taken a big hit from Operation Bayonet. It's not to say that DNMs or their vendors or customers are gone, just they're finding it harder to regroup. Though there have been a number of high profile busts from the data of Operation Bayonet This applies to more then just opioids though. Other drugs with overdose potential, like stimulants are just harder to get a hold of. Most US domestic sellers seem to focus on benzodiazepine analogs. We'll see how long this lasts though, I doubt that whole scene is truly gone but it might just be in hibernation for a bit.
- lostlogin 8y agoWould I be right in thinking that these changes would raise the price? I can’t find any data fine grained enough, and am just getting yearly data points. I’d also assume that there is big regional differences which make any trend hard to generalise. The price does seem to be trending ever lower over time though. https://www.unodc.org/wdr2018/prelaunch/7.5_Standardized_prices_of_cocaine_and_heroin_in_the_United_States_and_Western_Europe.xlsx https://www.unodc.org/wdr2018/prelaunch/7.5_Standardized_pri...
- LaikaF 8y agoI can't attest to street price. At a certain point people just stop buying drugs unless they're heavily addicted. The thing about research chems is that the ones that tended to stick around dose in the sub 50mg range. The cost per dose is still low since they're produced in multikg batches, resold in fraction to multi gram increments.
- post_break 8y ago
- Kaveren 8y ago> "and cocaine and stimulants — a group that includes methamphetamine — are each now killing more than 10,000 people a year, a threshold they only crossed in the past few years." I understand why people use drugs like heroin and fentanyl, but why methamphetamine? Why do they not just use Adderall or pure amphetamine? What is the gain? Amphetamine and Adderall in particular are not neurotoxic at normal doses, and are very safe if used responsibly. Methamphetamine seems to be inherently neurotoxic. Why risk your health when amphetamines and Adderall are just as good?
- RankingMember 8y agoI think it comes down to availability, and anyways it's probably a wash danger-wise considering that people who are dying from using these aren't taking normal doses. Methamphetamine is a prescribable drug (at least in the US) itself, so I imagine there's a "safe" dose for that too.
- istorical 8y agoI think some people have listened to hysteria about softer drugs like marijuana or psychedelics or softer uppers and looked at the histrionic warnings and contrasted those things to their own experiences, realized that some of the 'you're going to die instantly if you try this ___ once' fearmongering is false, and then assumed that all drugs have had the same overblown fearmongering. So they say 'well if marijuana isn't actually that harmful to me and I can control myself and not overdo it, then cocaine probably isn't that unhealthy or addictive to try once'. And after they get used to the idea of taking cocaine or MDMA in a more casual manner and feel they have control and can take it sparingly, they might end up with the same conclusion that 'this isn't that bad right?' and then decide the warnings about something like meth or heroin are probably overblown.
- fhood 8y agoHuh, I always assumed that like crack, the issue with meth is that it is usually laced with heroin.
- 8y ago
- hopefulengineer 8y agoGovernment has no incentive to do anything about this. They would prefer disgruntled, jobless people keep themselves in a drug induced stupor to people getting angry at their government stabbing them in the back for multi-national corporations. In reality these drugs coming in from foreign countries should be treated as an act of war, we've already lost significantly more Americans to this epidemic than Vietnam, the long term economic cost is probably in the hundreds of billions. If another country did that kind of damage via bombing we would retaliate, but these deaths from drugs don't have a big enough emotional impact to get citizens angry
- vorpalhex 8y agoRight, because dead people pay such awesome tax rates. Clearly this is the fault of those nameless multi-national corporations who are gleefully clasping their hands while laughing madly. Obviously these drug addicts having major problems and injecting themselves with illegally acquired, addictive drugs is exactly the same as bombing innocent people, and we should retaliate by having the marines storm the lobby of Pfizer.
- hopefulengineer 8y agoMajority of deaths are caused by fentanyl produced in foreign countries and shipped into the US to be cut into low quality drugs. So sanctioning those countries would be a good first step The initial addiction though is due to doctor's and drug companies. There's plenty of evidence of drug companies pushing doctors to prescribe these drugs when they really aren't needed. Fine the companies, arrest the doctors and executives who push this stuff in the name of profit. As for government, if you think the average congressmen cares about long term tax revenue vs that sweet pharma lobby money today, you're naive.
- emiliobumachar 8y agoDraconian enforcement against illegal drugs have been tried extensively. Up to and including labeling exporting countries "narco states" and invading them. It doesn't work. Someone else takes up the slack.
- ars 8y agoSeems to me this is entirely due to a better economy. If you have a job and money, you don't need to escape your life via drugs.
- borkt 8y agoThere can be other issues in life, such as interpersonal issues or stress reactivity that lead to addiction probably far more often than a lack of a job or money. See Michael Jackson, Prince, Demi Lovato, Philip Seymour Hoffman, Tom Petty... the list is endless. Virtually anyone can become addicted if they try these drugs and are dealing with stress.
- squish78 8y agoI think the more accurate common denominator of the people you listed above is past-peak career entertainers, not wealth
- 09bjb 8y agoAgreed. Not that many drugs aren't inherently risky, but stress/despair/loss of purpose cuts across lines (pun intended) of wealth and is a guarantor of increased addiction potential.
- bsder 8y agoI think the more accurate common denominator is "entertainer". Some of those were pretty damn popular when they died. The issue is that drugs tend to be available and encouraged for rockers and actors. Heroin, in particular, seems to have an unnatural appeal to guitarists and rockers and has claimed way more than it's fair share of them. I really wish we would legalize some of these drugs even if we still keep them behind a prescription. Legalizing the drugs would certainly help as then the dosages would be controlled.
- joewee 8y agoI don’t think this is a fair statement. Many of those listed were people suffering from physical injuries or mental health issues, making them more vulnerable. Prince started on opioids because of performance related injuries.
- TomK32 8y agoOf course the overdose deaths are falling: you can die only once.
- shawnz 8y agoThis comment has the subtle implication that you are "too good" to get addicted to opioids. You should reconsider that attitude before it's too late.
- philwelch 8y agoIt's very crudely stated, but there's a bit of a truth to it. Suppose that "susceptibility to opioid abuse" is a trait that's distributed throughout the population; some people are very susceptible, and some people are not very susceptible, but there's still an independent, individual factor that is separate from e.g. cultural/economic/social angst/uncertainty/etc., the availability of opioids, and so forth. When there is a breakthrough in one of these external social factors--either opioids become a lot cheaper and more available, people slip into greater levels of despair, whatever--more people are going to abuse opioids. Fair enough. But not everyone is equally likely to abuse opioids even given the exact same circumstances, so most of this increase in opioid abuse will be concentrated in the chunk of the population that was more susceptible to it all along. Once the opioid epidemic goes on for a few years, the people most likely to abuse opioids--and, for that matter, the people most likely to die from opioid abuse--will die. And so, if the underlying social causes of opioid abuse stay the same, you're going to see fewer opioid deaths, because the people who would have died already have. Since this isn't necessarily a genetic trait, we probably wouldn't see this effect persist on the order of generations, but on the order of months to years there's definitely a survivor bias, so to speak. There isn't necessarily any moral judgment in here, either. I mean, there can be, if you're a jerk about it, but the math itself doesn't work out any differently for "susceptibility to opioid addiction" than it does for "susceptibility to flu", and so if there's an epidemic of either one of those, odds are that, barring intervention, the epidemic is going to kill whoever it's going to kill and then move on. (This isn't cause for complacency, either! Some epidemics can kill huge supermajorities of the population if you just let them play themselves out, which is the true story of how the West[ern Hemisphere] was won.)
- deleted 8y ago[deleted]
- deleted 8y ago[deleted]
- aphextron 8y agoDeaths are falling, but are overall drug usage and overdose rates falling? Could this very well just be increased access and availability to Narcan, along with increased familiarity with the symptoms to get access to treatment quickly?
- docbrown 8y ago>Could this very well just be increased access and availability to Narcan Without looking up data right now: yes edit: whoever claimed my comment is inaccurate should look at the stats for Naxolene usage on opioid users (https://www.health.ny.gov/statistics/opioid/data/pdf/nys_jul18.pdf https://www.health.ny.gov/statistics/opioid/data/pdf/nys_jul...). In one (1) county, they administered Naxolene to over 6,000 users. With that information, arguing there is no correlation between the wide spread availability of reversal drugs and the drop in deaths is just.. wrong.
- NPMaxwell 8y agoThe main graph in the article is printed twice as wide as tall. Take the same axes and print twice as tall as wide, and the trend and change are much more obvious.
- golemiprague 8y agoCould it be related to the increase in jobs in general and specifically blue collar jobs under Trump presidency? Just the general sense of optimism and that someone care for those people might have helped after years of Obama who couldn't care less about the opioids and meth problem. The general sentiment was that it is stupid whites who did it for themselves and since they are "privileged" it is their fault. I have seen Anna Kasparian from the Young Turks express this sentiment clearly in the election night and I believe this is a sentiment that is quiet prevalent among the political elite.
- VLM 8y agoIsn't it just the usual logistical curve scenario? Rapid growth to meet the desired need, until market saturation and users are dying off faster than they can be born? From a creationist standpoint all people are equally likely to become addicted so you can use economic/cultural data as a proxy for susceptibility, however in the real evolutionary based world we have been brutally selecting for non addiction susceptible genetics and small scale culture for a long time, so at some point you'd expect a crash in addiction rates. Something like cig smoking can't be bred out because the addicts die horribly in their 60s long after reproducing, but every teenage heroin overdose for the last couple decades is a permanent culling of the herd of people who can't handle their chemicals responsibly. From a cultural standpoint I'm old enough that "Heroin just is not something our people do" works pretty well until it doesn't anymore, its interesting the study quotes seem to imply a grasp at any straw other than making heroin culturally unacceptable again, which ironically is probably the only thing that will work long term.