Opioids

New Hampshire's Medical Examiner: Opioid Deaths Have "Completely Overwhelmed Us"

New CDC data finds fentanyl deaths doubled in 2016.

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A naloxone kit, used to reverse an opioid overdose. Photo credit: Chris Donovan/ZUMA Press/Newscom

In the six years since the federal government asked pharmaceutical companies to reformulate prescription opioids so patients couldn't use them illicitly, Thomas Andrew, the chief medical examiner of New Hampshire, has seen his caseload skyrocket.

"It's almost as if the Visigoths are at the gates, and the gates are starting to crumble," Andrew told The New York Times' Katharine Seelye. "I'm not an alarmist by nature, but this is not overhyped. It has completely overwhelmed us."

And he's not alone:

Some medical examiners, especially in hard-hit Ohio, have had to store their corpses in cold-storage trailers in their parking lots. In Manatee County, Fla., Dr. Russell Vega, the chief medical examiner, said that when he reaches "overflow" conditions, he relies on a private body transport service to store the bodies elsewhere until his office can catch up.

In Milwaukee, Dr. Brian L. Peterson, the chief medical examiner, said that apart from the "tsunami" of bodies — his autopsy volume is up 12 percent from last year — the national drug crisis has led to staff burnout, drained budgets and threats to the accreditation of many offices because they have to perform more autopsies than industry standards allow.

Andrew is leaving his job to enter a seminary. Meanwhile, the medical examiner's office in New Hampshire risks losing accreditation due to a National Association of Medical Examiners rule that says individual examiners may perform no more than 250 autopsies per year. We don't have enough places to store the bodies of overdose victims, nor enough people to cut them open.

We can thank bad policy for this carnage. The Centers for Disease Control have released preliminary data that show fentanyl-related deaths roughly doubled in 2016:

Courtesy of the CDC

That brown line denotes the fentanyl class of drugs (conventional prescription opioids are the blue line, which has ticked up slightly but remains within historical range). Deaths involving fentanyl, which is more potent per milligram than more commonly prescribed opioids, doubled over the last year, from 10,000 in 2015 to 21,000 in 2016. Here are the actual numbers:

Courtesy of the CDC

The category of natural and semi-synthetic opioids includes morphine, codeine, oxycodone, hydrocodone, hydromorphone, and oxymorphone. Those deaths increased, too, but nearly as much as the category that includes fentanyl. The fact that cocaine deaths increased as much as they did flummoxes me, but it perhaps shouldn't considering anecdotes from the northeastern U.S. about coke laced with fentanyl.

Why are so many more people using—and dying from—fentanyl? Because in 2010, the federal government began demanding that pharmaceutical companies create tamper-proof formulations. In more recent years, both the federal government and state governments have discouraged doctors from prescribing opioids for acute pain.

Combined, these actions greatly reduced the volume of prescription opioids available for non-medical use. But state actors did very little in conjunction with those policies to address the existing population of non-medical users, beyond locking up more people and modestly increasing the number of patients doctors can treat with buprenorphine and methadone.

That carelessness created a massive arbitrage opportunity for black market operators and introduced fentanyl into the American drugscape. The U.S. could not have planned a more effective epidemic.

*CORRECTION: The initial headline for this post claimed, based on a report from The New York Times, that New Hampshire Medical Examiner Thomas Andrew was quitting his job this year in response to the large number of opioid overdose deaths in his state. That claim is incorrect. In an interview with Alcoholism & Drug Abuse Weekly's Alison Knopf, Andrew said his retirement had been planned 15 years in advance.

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  1. Relax, trump is on the job.

    He couldn’t bungle this too.

    1. In fairness, if that God damned Bush hadn’t been president for the last 16 years, we would have never had this problem in the first place. I mean that guy!! The guy literally fucked up everything he touched, especially in the last 8 years. Those were the worst.

      1. Congress rubber-stamped everything Dubya wanted for eight years (except immigration and his Social Security privatization racket) and he left office in shame and with a miserable 22% approval rating.

        Luckily, Congress is resisting the Orange Fucking Moron’s agenda – and thanks to his incompetence we won’t see a repeat of 2008.

        1. I’m not sure we can say Congress is resisting Trump’s agenda. It’s just that he’s so damn incompetent that he’s managing to get people who basically agree with him to vote against him. It’s really an art.

          1. Or maybe it’s a science. Who knows?

          2. It is like all his bad real estate deals x 100. He really is a shitty deal maker.

            (Yeah, I know he made money in a lot of other deals. Right during a real estate boom in the greatest city on earth. Big fucking deal. A monkey throwing darts at a map of Manhattan could have picked winners)

            1. Have you paid your bet yet?

              Still lying and saying you did?

            2. “could have picked winners”

              Maybe he cpuld have helped you win that bet you never paid after you lost.

            3. Trump game plan:
              – don’t bother to think through your legislative strategy before starting
              – make lots of impossible to meet (and self-contradicting) promises to the public
              – don’t bother proposing any plans for people to gather around and instead just see what comes out the milieu.
              – always public insult people that you’re relying on, especially at the last minute before they take crucial votes
              – make lots of empty threats against members of your own party
              – demand your party take a bunch of embarrassing and sure to lose votes that will be held against them in the next election

              1. Trump game plan:

                I will be citing this. Excellent.

                1. So, why do you keep lying about paying your bet?

                    1. So, why do you keep lying about paying your bet?

                    2. And you can keep eating shit.

                      Oh, I need proof you don’t fuck your mother.

                    3. So, why do you keep lying about paying your bet?

                      Post the proof you paid and shut me up.

                    4. Dude, enough. Once a thread is plenty.

                    5. Yeah Shreek, tell us more about how the Hillary Presidency was inevitable.

    2. Relax, trump is on the job.

      He couldn’t bungle this too.

      In the six years since the federal government asked pharmaceutical companies to reformulate prescription opioids

  2. Combined, these actions greatly reduced the volume of prescription opioids available for non-medical use. But state actors did very little in conjunction with those policies to address the existing population of non-medical users, beyond locking up more people and modestly increasing the number of patients doctors can treat with buprenorphine and methadone.

    If a federal policy, per Reason, is now required to deal with opioids…why should outright banning them not be it? I thought legalization was preferred because people should be free to harm themselves. If the state has to protect them, then ban them all.

    1. Right! Just make all opioids illegal, you stupid morons at Reason and in the government.

    2. Right…over…your…head.

    3. If the Federal Government is dealing with opioids, i.e. it has an opioid policy, it should not be so blatantly BAD.

      I believe Reason is commenting on the existing policy in place in our current world, not the theoretical world where, you know, personal freedom actually exists. I don’t think it’s completely insane to comment on how bad of a job they are doing.

    4. Hey, you are finally using blockquote! Thank you. I think I can safely say that we all appreciate it. God bless.

  3. People loading their bodies with potentially lethal substances is killing people. If they would just leave that shit alone they wouldn’t be affected by government policy one way or the other.

    1. Every level of government endorses this statement.

    2. Yes, tell that to all the people who deal with chronic pain.

      Oh, and to the people who have been stopped, arrested, shot, had their houses raided or assets confiscated (with no charges filed) who left that shit alone

      1. The vast majority of overdose deaths are recreational users, not chronic pain sufferers.

        1. Chronic pain sufferers, however, are affected by government policy when it tries to restrict how certain drugs are prescribed. I’m pretty sure that was his point.

      1. Too hard to understand?

    3. Those “potentially lethal substances” are exactly the same substances you can get at the hospital. I’ve legally taken demerol, morphine, fentanyl, codeine, and percocet for pain control. I’ve never had any problems with overdose and addiction. The problem is, of course, that those same substances, when taken on the street, are highly dangerous due to unknown potency and composition. That is a prohibition problem, not an addiction problem.

  4. The fact that cocaine deaths increased as much as they did flummoxes me, but it perhaps shouldn’t considering anecdotes from the northeastern U.S. about coke laced with fentanyl.
    Nothing brings you back up from a fentanyl low than cocaine!

    1. I’m more or a meth man myself, but as the One True Libertarian I respect the right of others to choose their upper.

  5. If an individual did what the government is doing they would be tried for manslaughter at a minimum.

    1. Still waiting on that proof that you paid your bet.

      1. And you can keep eating shit.

        Oh, I need proof you don’t fuck your mother.

        1. So, why do you keep lying about paying your bet?

          1. Fuck off, you little cumstain.

            1. So, why do you keep lying about paying your bet?

                1. So, why do you keep lying about paying your bet?

  6. I don’t see how this is a problem. Is RAISIN claiming that lawbreakers don’t deserve to die?

  7. All of this started when criminal penalties for heroin were weakened according to the drug warrior exordinaires here in Louisiana.

  8. Most fascinating is that Andrew talks about not only leaving his longtime profession, but his plan to reinvent himself at age 60 ? he will become an ordained deacon in the United Methodist Church, serving as chaplain for the Boy Scouts of America, as well as joining the Appalachian Trail Chaplaincy of the United Methodist Church to minister to troubled hikers along the trails that wind through New Hampshire and its White Mountains.”

  9. This is a suicide epidemic among the Frankentrumpkensteins. Suicides are increasing from all causes, including gun shots and car crashes. Why? Because Trump promised to ‘make all your dreams come true’ and for many of them that meant passing into the great hereafter.

    1. MAGA!

      It is called “economic nationalism” by the Bratfarters. Mix in some immigrant/minority hate, flag waving at sports events, and beefing the military up 10x and you get something real close to fascism. (oops, the real “fascists” are liberals according to these idiots)

      1. So, why do you keep lying about paying your bet?

        1. You’re not the first dumbass conservative to try to run me off this board.

          Go on, keep trying. Shit the threads. It won’t work.

          1. So, why do you keep lying about paying your bet?

              1. So, why do you keep lying about paying your bet?

                1. You will be back at Free Republic soon.

                  1. So, why do you keep lying about paying your bet?

                    1. So, why do you keep lying about paying your bet?

                    2. So, why do you keep lying about paying your bet?

                    3. And you can keep eating shit.

                      Oh, I need proof you don’t fuck your mother.

                    4. So, why do you keep lying about paying your bet?

                      Post the proof you paid and shut me up.

                    5. Leave shreek alone. He is just having a hard time with that damn Hillary and the White House and all.

                    6. I get the feeling that they are the same person.

                    7. What do you think you are accomplishing here, dude? You are shitting up the thread worse than Shriek ever does.

                    8. It is just one part of the thred Zeb. Give him a break. It is fun to watch shreek curse and run away like a little girl.

    2. This is a suicide epidemic among the Frankentrumpkensteins. Suicides are increasing from all causes, including gun shots and car crashes. Why? Because Trump promised to ‘make all your dreams come true’ and for many of them that meant passing into the great hereafter.

      Evidence of this shocking increase since January this year, I have to assume, was forgotten at the time of this post. Feel to provide it.

      1. See these. Not all working-class white middle-aged men voted for Trump, but a sizable majority did. So, there’s statistically significant correlation.

        https://tinyurl.com/ybtl9s94

        https://tinyurl.com/y7tlbjdb

  10. Let’s just blame anyone and everyone except the people who are taking the drugs. Because then we can make snarky comments about the jerks that don’t care about people who kill themselves with drugs.

    1. Speaking of snarky…

      It makes a difference when you drink you alcohol whether or not it has antifreeze in it. You get that luxury because the government doesn’t prosecute you for drinking your beer. If they didn’t make things more difficult to where people could actually get something reasonably pure, they wouldn’t be dying from fentanyl as much.

      http://www.telegram.com/news/2…..l-exposure

      But let’s just be overly simplistic and ignore any external impetus. Because then we can make snarky comments about the jerks that we know nothing about other than we think they’re just bad people because Uncle Sessions told us so.

      1. Yes, let’s be crybabies at people who agree with the larger point but don’t care about drug users, of any kind, killing themselves. Because we just don’t understand.

        1. I agree that if people want to do drugs and kill themselves, that’s their choice. To me, it’s more sinister that the Feds are exacerbating the issue than that people are taking drugs in the first place.

    2. People should be free to kill themselves with drugs if they want to. They should also be free to do drugs without dying like they were before the FDA decided to make it more difficult for no discernible reason.

    3. I am one of those jerks. People are killing themselves on drugs. That is a bad thing but it is the result of the actions of the people. The drugs really have nothing to do with it. Would they be less dead if they shot themselves in the head?

      1. Ignorant people are dying from drugs that they wouldn’t otherwise be taking if not for Federal drug policy. Sure, the users are at fault. But if the Government is unnecessarily creating conditions that these folks are falling prey to, shouldn’t the Government change its policy? Sure, they’d still be taking opioids again instead of fentanyl. But they wouldn’t be dead.

        1. I agree with you about that. The solution to this is to end prohibition.

          1. This may be the only thing we agree on.

    4. “Let’s just blame anyone and everyone except the people who are taking the drugs.”

      Plenty of blame to go around.

      Drug abusers being stupid doesn’t mean government policy is good or harmless.

      1. Suppose, for instance, the government went into the meth business.

        The people who bought and used the meth would still be to blame for their actions, *and* the government would be to blame for selling meth.

        See?

    5. Those kinds of comments worked when the drug was meth or crack. But those drugs are exactly the same drugs taken in the hospital, which we know are safe and effective. Their “street” versions are, of course, dangerous. But that is a prohibition problem, not an addiction problem.

  11. Ministering to youth about not doing drugs is equivalent to teaching: “If you ever do drugs you will surely die. I know, I seen it.” This fuels the suicide epidemic, which by the way is worst among middle age white people. Not kids. Because those are the ones most likely to have been through rounds of ‘treatment’ (indoctrination). So he is only going to make the problem worse by starting kids down the path. It’s much easier to commit suicide when you can blame it on a ‘disease’. And yes he knows all this. It’s really despicable.

  12. http://www.nytimes.com/2017/10…..stein.html

    Ben Affleck to Rose McGowan, “Damn it I told Harvey to stop raping women.” I think Affleck and Damon’s reign of terror may be coming to an end.


    1. “Several directors with close ties to Mr. Weinstein, such as Quentin Tarantino and Robert Rodriguez, have not responded to requests for comment this week, however.”

      Somehow, I’m not at all surprised that Quentin isn’t commenting. He’s probably at least as big of a freak as Weinstein. Not as sure about Robert. His films don’t have an obvious recurring fetish that I’ve noticed.

      Maybe it’s not fair to lump those freaks into the same basket, but I’ve thought that there was something very, very off about Tarantino for a long time.

      1. Weinstein is a freak. It doesn’t seem to be about sex with him but just humiliating and assaulting women. The guy is a first class deviant who needs to be locked up.

      2. Rodriquez has a fucked up fetish for Salma Hayek in sexy lingerie on screen.

        1. Yeah but I wouldn’t consider that ‘fucked up’ I’d consider that ‘normal’.

          Quentin might be making some bizarre social commentary on various fetishes, I’d suppose, but I don’t think he’s a talented enough director to do that. I suspect his obsession with feet, among other bizarre fetishes, is an almost accidental revelation in his films.

          Lord knows the actors in his films appear to loathe him, but maybe that’s just because he’s so ‘artistic’. Yeah, sure. That’s the ticket.

        2. I am pretty sure every other straight man in the world has that fetish.

  13. This is why drug legalization is never going to happen.

    Making legal opioids harder to mimic is fine. That illegal opioids are laced with fentanyl is not a federal concern. Blaming the Feds for targeting policies for LEGAL controlled substances but ignoring illegal ones is insanity.

    If you’re in chronic pain, go to a doctor. If they feel you should not have an opioid, they have a reason. If you go to a dealer and buy it illegally, then well, Darwinism is a bitch.

    1. If they feel you should not have an opioid, they have a reason

      Yes, but the problem is that more and more the reason is fear of the DEA. Doctors’ prescribing habits should not be a federal concern either.

      1. Don’t fully agree with that. If a doctor has basically become a narcotics distributor and little else, there is a problem. If a prescription is required for the substances, then a prescription should actually mean something.

    2. “This is why drug legalization is never going to happen.”

      Adding 11 million to the Mediciad rolls amounts to legalization for them.

      The statistics say that some 75% of addicts get their opioids either from a friend or family member for free or directly from a doctor themselves, which is to say, they’re all getting their opioids from a legal prescription.

      Actually, for the millions of people on Medicaid, opioids are better than legalized–because they don’t even have to pay for them.

      One more time with feeling–putting people on Medicaid is effective legalization of opioids.

      People make less than $20,000 per year are four times as likely to become addicted to opioids as people who make the average income–and people who qualify for Medicaid get their opioids legally and free of charge–and we added 11 million to the Medicaid rolls with ObamaCare.

      This is a no-brainer.

  14. Huh, it’s almost like central planning creates bigger messes than emergent order. Weird.

  15. Because in 2010, the federal government began demanding that pharmaceutical companies create tamper-proof formulations.

    Ushering in the era of Obama’s junkie genocide

    Duterte is like a Filipino Obama

  16. It makes a difference when you drink you alcohol whether or not it has antifreeze in it. You get that luxury because the government doesn’t prosecute you for drinking your beer. If they didn’t make things more difficult to where people could actually get something reasonably pure, they wouldn’t be dying from fentanyl as much.

    Illegal alcohol is still very much made in areas. And it can still cause health problems. And it’s not the government’s fault that somebody does it.

    Come on, you’re fucking Libertarians…when the hell do the people have to take some blame for their problems?

  17. “Combined, these actions greatly reduced the volume of prescription opioids available for non-medical use.”

    So if I dispute this claim, where’s the link to the information backing this up?

    All the information I’ve seen suggests that opioid prescriptions tripled between 1999 and 2014–and have stopped growing at such astronomical rates since 2014. There was a huge upsurge in prescriptions after the ObamaCare Medicaid expansion–which should have been as predictable as the sunrise.

    We’ve added 11 million people to Medicaid.

    Why wouldn’t giving the demographic most susceptible to addiction (people who make less than $20,000 a year AKA Medicaid patients) access to free, legal opioids contribute significantly to the rate of opioid addiction. If you want to cut down on the number of new addicts and deaths, that probably won’t happen until the government stops giving poor people free, legal opioids.

    Market forces, people! Market fucking forces, price signals, and moral hazard, that’s what this is about, and the solution starts with rolling back Medicaid eligibility to what it was before ObamaCare expanded it–until someone does that, the source of the problem isn’t really being addressed.

  18. Rather than reposting the same data here that I did in the last thread on this topic, find my facts and figures in this thread here:

    https://tinyurl.com/yaj5e5yp

  19. I’m a physician and remember in 1999 when the government, through joint commission, told us to treat pain “better” I.e narcotics or else. We had mandatory educational materials we had to pass with propoganda saying there is no such thing as a “drug user.” Hospitals and clinics terrified of losing their accreditation would fire and punish doctors who didn’t give the patients what they wanted. The joint commission surveyors would audit charts, to make sure we were prescribing enough narcotics to keep patients happy. It frankly was Orwellian. I remember thinking this is pure madness!
    Now, the government blames the same doctors they forced to prescribe drugs and of course the evil pharmaceutical companies as well. They deny any culpability in any of this. It is nuts!

    1. Its TOP MEN 101.

      Change policies according to the winds of whatever makes politicians feel good.

    2. Exactly. The only two people involved in pain control should be the doctor and patient. And frankly, I’d be fine if it was just the patient.

  20. New Hampshire’s Medical Examiner: Opioid Deaths Have “Completely Overwhelmed Us” – Hit & Run : Reason.comis the best post byimo for pc New Hampshire’s Medical Examiner: Opioid Deaths Have “Completely Overwhelmed Us” – Hit & Run : Reason.comis the best post by imo app New Hampshire’s Medical Examiner: Opioid Deaths Have “Completely Overwhelmed Us” – Hit & Run : Reason.comis the best post by imo app New Hampshire’s Medical Examiner: Opioid Deaths Have “Completely Overwhelmed Us” – Hit & Run : Reason.comis the best post by snaptube for pc New Hampshire’s Medical Examiner: Opioid Deaths Have “Completely Overwhelmed Us” – Hit & Run : Reason.comis the best post by snaptube app

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