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Of course the overdose deaths are falling: you can die only once.

by TomK32 8y ago

shawnz 8y ago
This 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 ago
  It'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.)
- TomK32 8y ago
  No, I wasn't implying that, not even considering it. Sure, I was not cool enough to belong to any group in school during the late 90s (hence never smoked) and I'm European (barely got pain killers subscribed) but I do know that even me, when pushed hard enough to the edge, could fall into drugs or just plain suicide. Anyone can be. What's the "career path" of an addict? How many years before they are likely to overdose? Does that coincide with economic struggles of the recent years, military returning and suffering from PTSD? It might take drug addicts take more time to "progress" on their career than it does take new, deadlier drugs to kill them off. It sounds harsh, I know, but it's a possibility. I sincerely hope the fall is due to less fentanyl being imported and parts of the darknet shutdown (I like how the netherland police once took over a darknet market).

Of course the overdose deaths are falling: you can die only once.

by TomK32 8y ago

Of course the overdose deaths are falling: you can die only once.

This 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 ago
It'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.)
TomK32 8y ago
No, I wasn't implying that, not even considering it. Sure, I was not cool enough to belong to any group in school during the late 90s (hence never smoked) and I'm European (barely got pain killers subscribed) but I do know that even me, when pushed hard enough to the edge, could fall into drugs or just plain suicide. Anyone can be. What's the "career path" of an addict? How many years before they are likely to overdose? Does that coincide with economic struggles of the recent years, military returning and suffering from PTSD? It might take drug addicts take more time to "progress" on their career than it does take new, deadlier drugs to kill them off. It sounds harsh, I know, but it's a possibility. I sincerely hope the fall is due to less fentanyl being imported and parts of the darknet shutdown (I like how the netherland police once took over a darknet market).