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America Set an Awful New Record in 2016

Preliminary data from the CDC suggest an unprecedented number of Americans died of a drug overdose last year.

Sen. Chris Murphy (D-Conn.) listens to testimony on the opioid crisis. Photo credit: Senate Committee on Health, Education, Labor & PensionsSen. Chris Murphy (D-Conn.) listens to testimony on the opioid crisis. Photo credit: Senate Committee on Health, Education, Labor & Pensions"Preliminary data for 2016 indicate at least 64,000 drug overdose deaths, the highest number ever recorded in the U.S.," Deborah Houry of the Centers for Disease Control told the Senate Health, Education, Labor and Pensions Committee on Thursday. By the CDC's estimate, more than 300,000 people have died from opioid overdoses since 2000.

That is an extraordinary amount of suffering endured by a relatively small user population. And it's largely a result of bad policy combined with inaction.

"It is well-documented that the majority of people with opioid addiction in the U.S. do not receive treatment, and even among those who do, many do not receive evidence-based care," Houry wrote in her testimony, noting a lack of medication-assisted therapy (MAT) programs nationwide. According to data from the Substance Abuse and Mental Health Administration, less than one million of the 2.5 million Americans with an opioid use disorder received MAT treatment in 2014.

Only 57 percent of drug court programs in the U.S. incorporate MAT, according to Hoary. The rest employ forced sobriety, despite the fact that relapsing is far more dangerous for patients who quit cold turkey and then resume using with a lower opioid tolerance. Correctional facilities are even less equipped to treat opioid users. According to Pew, roughly 66 percent of America's 2.3 million prisoners have a substance use disorder, but only 11 percent of them receive evidence-based treatment.

Here's the the National Institute on Drug Abuse's Nora Volkow—someone I frequently disagree with on drug policy—rightly touting the benefits of MAT back in 2014:

When prescribed and monitored properly, MATs have proved effective in helping patients recover. Moreover, they have been shown to be safe and cost-effective and to reduce the risk of overdose. A study of heroin-overdose deaths in Baltimore between 1995 and 2009 found an association between the increasing availability of methadone and buprenorphine and an approximately 50% decrease in the number of fatal overdoses. In addition, some MATs increase patients' retention in treatment, and they all improve social functioning as well as reduce the risks of infectious-disease transmission and of engagement in criminal activities. Nevertheless, MATs have been adopted in less than half of private-sector treatment programs, and even in programs that do offer MATs, only 34.4% of patients receive them.

And yet SAMSHA is still imposing limits on how many MAT patients one physician can treat and for how long (100 and a year respectively), as well as requiring extensive training and certification in order to receive a waiver that will allow them to treat up to 275 patients concurrently. The agency only recently allowed nurse practitioners and physician assistants to apply for that waiver, even though most states give both types of licensees normal prescribing power for substances that are in the same class as MAT drugs like methadone and buprenorphine. Would we see more medical providers offering MAT if the regulations surrounding it were less cumbersome? I have no idea, but I find it hard to imagine the externalities of scrapping those regs would be worse than incentivizing tens of thousands of people to use heroin.

The other problem Hoary identified in her testimony was excessive opioid prescribing by doctors. Yet according to new research published in Addictive Behaviors, the number of problem users who "started" on prescription drugs fell from 80 percent in 2005 to 52 percent in 2015; over the same period, the number of users who started on heroin climbed from less than 10 percent to more than 30 percent. I'd be shocked if the number of people who started on a black market opioid had not risen substantially in the two years since that data was collected, and I'm not sure why public health advocates keep talking about prescribing practices as the major culprit in light of the increase in heroin use.

Photo Credit: U.S. Senate Committee on Health, Aging, Labor and Pensions

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  • Shirley Knott||

    It's one of the wedge issues driving towards finding an excuse to nationalize health care. One the state is the only employer, the state will mandate prescription standards.
    After this, it's antibiotic prescribing.
    Pretty soon individual physician discretion in prescribing is gone, it's all by the book. And the book will wind up driven by the diagnostic codes. Which sooner or later will lead to some bright young thing to think that treatments for that code are effectively interchangeable, so we really only need one. Then the FDA can stop new drug evaluations after a candidate treatment is approved, which will speed up the over-all approval process by removing needless redundancies.

    No matter how cynical I get, it's just never enough.

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  • sharmota4zeb||

  • Bra Ket||

    And 58 in the Las Vegas shooting the other day.

  • Fist of Etiquette||

    ...less than one million of the 2.5 million Americans with an opioid use disorder received MAT treatment in 2014.

    Fewer. I expect better of you, Riggs.

    Do most in the criminal justice system want the opioid addicted to be cured? That's like a dealer wanting his customers cured. Who cuts off the source of his income? If law enforcement even thinks of them as people at all. At a certain point, these are products, widgets going by on a conveyor belt.

  • Scarecrow Repair & Chippering||

    How can any prescriptivist be a libertarian?

    Fuck off, slaver!

  • Trigger Warning||

    Right, we should just let Joe Dumbass decide that his seasonal cold needs meropenem, because fuck the state and stuff. Chemistry and pharmacokinetics are tools of statist oppression. Off to CVS.

  • Telcontar the Wanderer||

    If he really is a dumbass, then his pain is his own and will serve to educate the wiser, and if he *isn't* a dumbass, then, congratulations, you just made someone suffer for no reason. More often than not, people will know what is best for themselves in the circumstances the world has given them.

  • Scarecrow Repair & Chippering||

    Schmuck. "Prescriptivist" meaning lesser vs fewer.

    Dumbkoff.

    In other news, Telcontar is right. People have survived for thousands of years making their own decisions about almost everything that matters. Whether they learned from grandma or asked witch doctors, it didn't take too many mistakes before everyone discovered the goo dand bad sources of advice.

    Ya know why this worked? Because free markets. Ya know why it doesn't work with governments? Because they can't stand competition -- theirs is the one true path. Whether it's nutritional advice, health advice, or judicial fairness, governments have the kind of track record that would have run them out of business long ago if not for their self-defined coercive monopoly.

    Want another example? Poisonous critters and their imitators. Monarch butterflies, skunks, poisonous toads, all sorts of animals earn tthe reputation of making predators sick. Predators learn this pretty damned quick. Imitators spring up too, but not very many, otherwise they'd dilute the true message so much that it would no longer apply.

    People are just as smart as predators. They learn the fakers and the reliable advisors.

    But you, no, you want Uncle Sammie to hold your hand, even if it's got the wrong advice or if the advice changes yearly and never does get close to correct.

    Fuck off, slaver!

  • HeteroPatriarch||

    Because he couldn't possibly ask someone at CVS what might help with his symptoms?

  • Bra Ket||

    preventing Jow Dumbass from overusing antibiotics is more important than hundreds of thousands of dead addicts.

  • Telcontar the Wanderer||

    *preventing Joe Dumbass from overusing antibiotics and thus delaying the formation of new MRSA-type superbugs by another 6 or 7 years, optimistically.

    The arrogance of the medical community in thinking they can find a "balance" between allowing overuse and restrictions that cause under-use and death would be astounding if we all here weren't libertarians (the MRSA of statism) and thus used to such hubris.

  • BestUsedCarSales||

    We need Riggs to be our American Jesus. Let Him take all of our drugs into himself and cleanse us of our addictions.

  • Trigger Warning||

    I don't care if people like to get high on opiates. I am a legalizer, no exceptions.

    However, in a medical context, opiates should be used for short-term for pain relief, except for palliative care, or otherwise intractable pain. They are great short term. Long-term, they make people feel like dogshit. I see people who have been taking opiates for back pain or whatever for ten years, without addressing the root cause of the back pain, and they seem to be doubly miserable. Back hurts, have a monkey to feed, etc. It sucks.

  • Trigger Warning||

    Delving a bit deeper, lawmakers should not be dictating medical practice. AG Sessions is robustly unqualified to decide who gets what drug.

    Also, physicians are also people. They have buman strengths, and human failings. Let's stop pretending that they are unicorns who can save people from themselves. That's what nurses are for.

  • Rich||

    Delving a bit deeper, lawmakers should not be dictating medical practice.

    Exactly. They should stick to legislating things they know about, like "assault weapons".

  • Homple||

    If you don't want to die of an overdose, leave that shit alone. Also, one way to avoid dying of a gunshot wound is don't put the muzzle of a loaded pistol in your mouth and pull the trigger.

  • Barnstormer||

    Hands down, the most intelligent post here.

  • Paul E||

    Agreed. Often, physicians are blamed for prescribing medications for chronic pain; the bizarre assumption being that someone using medication to treat pain will be seduced to use it to get high. I have an unhealed fracture in my foot and have been on narcotics for pain for a few years (the ACA is to thank for the fact that I can't afford the deductible to get it fixed). I am, currently, addicted to them, I can't go much past 12 hours without them before I start to go through withdrawl. The difference is I still use them as prescribed. I don't dose myself in an attempt to get high. The people who are using them to get high are, more often than not, those who would be using any drug to get high. Alcohol, heroin and weed are easily available as well and plenty of people dying from alcohol as well. Drug abuse is a symptom of a problem, not the problem itself. As long as the government tries to "fix" the problem by addressing the symptom there will be no progress.

  • Telcontar the Wanderer||

    "I'm not sure why public health advocates keep talking about prescribing practices as the major culprit in light of the increase in heroin use."

    Because pharma corporations are pharma CORPORATIONS. That word is like the Twat-Signal to people of statist persuasion- "nothing outside the state, nothing against the state", so any NGO is by definition suspicious and presumed hostile. Plus, they can rely on a legal corporation to actually show up for their show trial- getting the legal teams of extralegal corporations (colloquially known as "drug cartels") to show up in court usually requires a good bit more work, along the lines of putting a few bursts of 7.62 through a speed-boat's motor, fast-roping into twilit Mexican villas, etc.

  • MarkLastname||

    Is the Sinaloa Cartel not a corporation? Capitalism run amok!!!

  • Telcontar the Wanderer||

    "Wreckers! Saboteurs!"

    -J. B. Sessions

  • ALWAYS RIGHT||

    Every overdose sob story ends the same: "my kid was taking pills for fun".

  • Ken Shultz||

    I maintain that opioid addiction has become worse in recent years because of the ObamaCare Medicaid expansion.

    I'll provide three links with three facts.

    1) Showing that these days opioid abuse is substantively different.

    "Of people entering treatment for heroin addiction who began abusing opioids in the 1960s, more than 80 percent started with heroin. Of those who began abusing opioids in the 2000s, 75 percent reported that their first opioid was a prescription drug (Cicero et al., 2014). Examining national-level general population heroin data (including those in and not in treatment), nearly 80 percent of heroin users reported using prescription opioids prior to heroin"

    ----National Institute of Health

    http://tinyurl.com/h6jwps8

    Notice, addicts are now getting addicted because of prescription medication--which wasn't the case before.

  • Ken Shultz||

    2) By the data, upwards of 75% of the people who are getting opiods for non-medical use now are either getting them directly from a doctor by prescription or from a friend or relative for free (who is getting them from a doctor by prescription).

    ----US Department of Health and Human Services

    http://tinyurl.com/ybhy8d94

    3) People who make less than $20,000 per year are 3.4 times as likely to become addicted to opiods as people who make more than $50,000 a year.

    ----Center for Disease Control

    http://tinyurl.com/y7r8rto5

    Does it need to be pointed out that people who make less than $20,000 per year are disproportionately on Medicaid?

  • Ken Shultz||

    Add those three points up:

    1) Opioid addiction arrives by way of prescription medication.

    2) More than 75% of opiod addicts are getting their drugs through doctors by way of a prescription.

    3) People who qualify for Medicaid are in a group that's 340% more likely to become addicted to opioids.

    Given those facts, I defy anyone to explain why lowering the eligibility requirements for Medicaid wouldn't have led to an increase in opioid addiction.

    There are, of course, two different questions on how to deal with opioid addiction. One question is what to do about the people who are already addicts, but the second question is what to do to stop creating more opiod addicts. I'm not sure what to do about the people who are already addicted, but we won't cut down the rate of new addicts until we raise the eligibility requirements for Medicaid to at least what they were before ObamaCare again.

    Lowering the eligibility for Medicaid simply increased the available supply of opioids--for free--to the very population that is most susceptible to addiction.

  • Telcontar the Wanderer||

    Eh...

    "Yet according to new research published in Addictive Behaviors, the number of problem users who "started" on prescription drugs fell from 80 percent in 2005 to 52 percent in 2015; over the same period, the number of users who started on heroin climbed from less than 10 percent to more than 30 percent."

    And the number of such ODs increased rather markedly in that period, so it's not like the percentage is increasing because the number of new addicts is being tapered.

    Meanwhile, a UK study indicated that 80% of all larcenies in the country were motivated by drug addicts getting their fix money. I cannot imagine that the percentage in the United States is much smaller.

    I would politely contend that the change is not the result of subsidized supply, but rather the metastasis of the Rust Belt courtesy of automation and trade-related job loss followed by inability to move to new jobs by urban CoL tampering (see today's article about NYC). Cutting off Medicaid might encourage addicts to get jobs, but it will also encourage larceny, burglary, robbery and fraud, and certainly will not cause depressed people to be less likely to fill the emptiness that defines them with narcotics, be they heroin, meth, or, worst of all for public safety, alcohol.

  • Ken Shultz||

    You're suggesting that adding millions of people to the Medicaid rolls, from the demographic with the highest propensity for opioid addiction, mind you, didn't significantly add to the number of new addicts--because only 70% of new addicts become addicted through prescription medication?

    That does not compute.

    Did you know West Virginia and Kentucky are both states in the top 6 in terms of the highest rates of Medicaid utilization?

  • Telcontar the Wanderer||

    "You're suggesting that adding millions of people to the Medicaid rolls, from the demographic with the highest propensity for opioid addiction, mind you, didn't significantly add to the number of new addicts--because only 70% of new addicts become addicted through prescription medication?"

    I'm suggesting that cracking down on new opioid prescriptions didn't prevent new addicts from starting on *any* opioid, merely caused more of them to start on heroin, which is notably not available on Medicaid's prescription options list. 20% or so more of them, specifically.

    If the opioid crisis were being caused by "free Oxy", then cutting off some of that supply, as has occurred over the last 5 or so years, should have reduced the rate at which new addicts are produced. It did not. Instead, it caused more people to become new addicts using heroin alone, with no subsidy, roughly correlated with the reduction in "free" Oxy prescriptions, while the overall addict population increased same as it had been already.

    Indicating that those new addicts were still able to pay for those heroin doses, even without almighty Gov's help. Most likely by raiding your friend's great-aunt's medicine cabinet at 3 in the morning. Or by converting food stamps... Which might well condemn "welfare" as a concept, but would require eliminating *all* welfare to put a stop to.

  • Ken Shultz||

    I'm not saying that adding millions of new patients to the Medicaid rolls is the only factor that creates new addicts--but, for goodness' sake, having given millions more people access to free, legal opioids couldn't possibly be a non-factor.

    Again please look at the link I supplied above. Look at the chart on the link:

    http://tinyurl.com/ybhy8d94

    As I said above, "75% of the people who are getting opiods for non-medical use now are either getting them directly from a doctor by prescription or from a friend or relative for free (who is getting them from a doctor by prescription)."

    I'm not trying to tie causality to correlation here. According to the Department of Health and Human Services, more than 75% of the people using these drugs for non-medical use are getting them by way of a prescription. It is what it is.

    That's where they're getting them. They're disproportionately people who qualify for Medicaid, and they're mostly getting them by prescription.

  • Telcontar the Wanderer||

    The problem with your theory is that it begs a solution that *has already been tried*. if free Oxy were the cause of the increase in addiction and overdoses, then cracking down on the prescription should have cut down on both. But WE TRIED THAT. All across the country for the last 5 to 10 years with greater and greater urgency, the gov has been terrorizing doctors who prescribe opioids, and the result is the above datum: prescriptions decreased, the rate of accumulation for new prescription addicts decreased, the Oxy OD rate increased more slowly.

    But overall addiction sped up. And not just because Oxy addicts switched to heroin, but because all-new addicts were minted who had never touched a legal opioid in their life. Enough to balance out the legal opioid addicts lost, seemingly almost perfectly: a 30% decrease and a 20% increase, per the paragraph I quoted in my first comment.

    Once more for auld lang syne:

    If people were acquiring opioids due to their being free, where they wouldn't have been able to afford them in the absence of the government's largesse... Why. Didn't. The prescription crackdown. HELP?

    You act like that crackdown never happened; as if we hadn't learned. But, what am I saying... we never do learn, do we?

  • Telcontar the Wanderer||

    Incidentally, I actually think you're right about government subsidizing drug abuse. But you're wrong about Medicaid being the culprit.

    Have you read Kevin Williamson's articles about Appalachia? He described the way heroin addicts get their fix in detail:

    Step 1: get food stamps.
    Step 2: buy bulk food, especially soda. Any decent food will do, of course, but soda is the most popular, apparently.
    Step 3: sell the soda to somebody (often the heroin dealer himself).
    Step 4: buy heroin.
    Step 5: profit! Or overdose and die.

    Welfare is a payment. Payments are fungible. ANY welfare payment will become a drug subsidy, the only question is whether they will be safe, factory drugs, or street poison.

    Cutting off Medicaid Oxy wouldn't reduce addiction, it would just kickstart TANF heroin, send the FBI UCR's crime data shooting off the tables and get even more people killed. Medicaid Oxy is basically accidental MAT, compared to Fentanyl-laced trailer shit.

  • Ken Shultz||

    The problem isn't just in Appalachia, but Appalachian states are among those with the highest rates of Medicaid enrollment per capita.

    Certainly, eliminating steps one through five and replacing them all with going to the doctor and getting a prescription doesn't make it harder to get your hands on opioids.

    "Cutting off Medicaid Oxy wouldn't reduce addiction . . ."

    I already wrote earlier that there are two different opioid addiction problems. No, rolling back Medicaid eligibility to what it was before the ACA probably won't do much to help with people who are already addicts, but it should have a significant impact on the creation of new addicts.

    The suggestion that if we stopped offering the most susceptible demographic a free, legal supply of opioids, it should lead to the creation of fewer new opioid addicts in the future than we would have otherwise really shouldn't be controversial.

  • Ken Shultz||

    "All across the country for the last 5 to 10 years with greater and greater urgency, the gov has been terrorizing doctors who prescribe opioids, and the result is the above datum: prescriptions decreased, the rate of accumulation for new prescription addicts decreased, the Oxy OD rate increased more slowly."

    I dispute those statistics. I've already posted a link showing that opioid addiction rates have soared despite whatever efforts you're talking about.

    Meanwhile, the data continues to show that new addicts overwhelmingly start on prescriptions.

  • Telcontar the Wanderer||

    "Meanwhile, the data continues to show that new addicts overwhelmingly start on prescriptions."

    Did you not read the article? Once more for effect:

    "Yet according to new research published in Addictive Behaviors, the number of problem users who "started" on prescription drugs fell from 80 percent in 2005 to 52 percent in 2015; over the same period, the number of users who started on heroin climbed from less than 10 percent to more than 30 percent."

    And the opioid prescribing crackdown is not "disputable". Reason has been covering it for at least the last 5 years now, including covering the reasons it hasn't worked and has made things worse. And the quoted paragraph above proves why: because not only are Oxy users switching to heroin, but new *first-time* users are STARTING on heroin. And the rate of increase in *all-opioid* ODs ACCELERATED, thanks to street heroin being vastly deadlier.

    The fact that 52% of new addicts start on Oxy tells us nothing about whether they would start on heroin instead: but that 10% becoming 30%? That does.

  • Telcontar the Wanderer||

    "The suggestion that if we stopped offering the most susceptible demographic a free, legal supply of opioids, it should lead to the creation of fewer new opioid addicts in the future than we would have otherwise really shouldn't be controversial."

    It isn't really. The problem is that you have apparently not absorbed the revelation that *all welfare payments* offer a free supply of opioids, and the illegality or inconvenience of food-stamp conversion vs. Medicaid is rather self-evidently insufficient to deter the kind of person who is, or becomes, an addict. Do you think addicts don't know that fentanyl-laced heroin is 10+ times deadlier than Oxy? If that isn't enough to stop them, what makes you think spending their afternoon on a car trip to launder their food stamps will?

    The argument that government should not subsidize drug addiction is legitimate. The argument that any specific kind of welfare is worse than others is not- because all payments are fungible to the determined, and no one is more determined than an addict- and in this instance it is actually murderous: because that Medicaid Oxy is relatively safe, whereas the heroin that TANF pays for is far dealier. Your preferred policy has already been implemented, and it has not saved lives, but ended more of them.

  • Robert||

    Fungible, but at what rate of exchange? I would venture to guess that the efficiency of conversion of Medicaid to narcotics is much greater than that of food stamps to narcotics, as long as the prescription is available for the former.

  • Telcontar the Wanderer||

    I don't think addicts are greatly fussed about efficiency. Given that they're evidently willing to use opioids that are 5 to 10 times deadlier purchased with that TANF moolah. Which kinda sorta balances out any advantage the policy might've had, I'ma thinkin'.

  • Qsl||

    Adding-

    It is entirely within the realm of possibility that so many of the addicted are on medicaid because it is hard to maintain a job when you are in constant pain.

    You don't say.

    Also any comparison of prescription addiction rates from the 60s that doesn't take into account the changing standards of treating pain since then is pissing in the wind.

    And I would find it impossible to tease out those chronically in pain from simple addicts. In fact, I imagine there is a great deal of overlap between the two.

    Certainly there are numerous narratives that can be drawn from any data points. As earnest research into addiction ended with the closing of the Narcotics Farm, I doubt any of them hold more than a glimmer of truth.

  • Ken Shultz||

    Well maybe you can be help me understand, then. Is there another situation in which a demographic most likely to consume didn't react to dropping prices to zero and revving up supply by consuming more?

    . . . or is fewer people becoming addicted to opioids because the price drops to zero when they're on Medicaid and prescribing them opioids gives them a steady legal supply--the only time that's ever happened in history?

    Is it really shocking to anybody that lowering the price of opioids to zero for millions of people newly elligible for Medicaid and then giving them a legal supply of opioids would increase the number of addicts? These are foundational economics principles I'm talking about--not some novel narrative.

  • Qsl||

    Well, you'd have to do a comparison against a control, like heroin, which also went up during the same (you can read your own graphs, right?). I am unaware of when heroin prices dropped to zero.

    Also, you'd have to compare medicaid prescribing rates for opioids over time, rates of addiction among that population; which as far as I'm aware hasn't been done.

    Or the short version- three data points doesn't constitute a policy (yea Hayek).

    These are foundational economics principles I'm talking about

    There's a reason why it's called the "dismal science".

    Rates of addiction tend to stay relatively static, otherwise Portugal would be a hive of scum and villainy by now.

    The only real question is why the death rates have increased.

    Try again.

  • Ken Shultz||

    You want me to "try again" to show that lowering prices and increasing supply leads to increased consumption?

    I've met creationists who understand that.

    Are you unaware that addiction rates have continued to increase?

    Go figure it out for yourself.

  • Qsl||

    I see you can't differentiate between increased consumption and increased rates of consumption. Surprisingly, even though the price of heroin is at historical lows, I've yet to be tempted to buy. Can you explain that?

    Can you show how the fluctuating price of alcohol has altered alcoholism rates (I mean it is a foundational economic principle and all).

    Are you unaware that addiction rates have continued to increase?

    https://tinyurl.com/jh99p4o

    Nope. As I said, rates of addiction tend to stay relatively static.

    I've met creationists who understand that.

    Ah, I see the problem is the company you keep.

    Nevermind.

  • Ken Shultz||

    Your data from that link includes one year of increased Medicaid eligibility (2012?) due to ObamaCare--and very little information about opioid addiction.

    Here's from the top of my google search list:

    "An analysis from Blue Cross Blue Shield of its members found that from 2010 to 2016, the number of people diagnosed with an addiction to opioids -- including both legal prescription drugs like oxycodone and hydrocodone, as well as illicit drugs -- climbed 493%."

    http://tinyurl.com/y99g3qc4

    That analysis period starts before the ACA Medicaid expansion.

    If opioid abuse, especially that associated with prescription drug abuse, climbed like that (493%!) even as the use of other illegal non-opioid drugs declined--per your link--then we should be looking for something that happened associated with either the price or availability of prescription opioids as the likely catalyst, right?

    Right.

    Well guess what happened during that time period?

    P.S. More than 75% of non-medical opioids users report getting their opioids, ultimately, from a prescription, Medicaid patients are 3.4 times more likely to become addicted to opioids, since they're in the lower income quintile, and between 70 and 80 percent of new addicts start with opioids. Try to put two and two together.

  • Qsl||

    Um, you are aware that Blue Cross is private insurance, right? You realize that an analysis of its members would have NOTHING to do with medicaid, and that even a 59871% increase of in the number of its members diagnosed means squat without knowing the rate of addiction, since we can surmise they might have had an increase in the number of its members with Obamacare seeking private treatment?

    And even with that, the TOTAL percentage of addicts doesn't need to change.

    Well guess what happened during that time period?

    Per the literature of the time, clinicians were advised to treat pain aggressively and hand out narcotics like candy as the rates of addiction under supervised use was less than 5%. In fact, JACHO made it a standard where care facilities would loose accreditation without aggressively treating pain.

    Ohhh....

    Try to put two and two together.

    Trying knowing something more than three factoids, and thinking you've solved the mysteries of the universe.

  • MarkLastname||

    You've illustrated the problem with reasoning from a price change. The lack of correlation between price and consumption doesn't mean demand is independent of supply; 1st, if change in demand leads to a summary supply response, there would be no sustained change in price, meaning no correlation; secondly, with drugs, demand, and prices, are also a function of law enforcement pressure. If easing of law enforcement pressure on distribution led to increased demand for a given supply, dealers would raise prices, and consumption may not increase much due to the price increase.

    Law enforcement pressure (and how much of it is applied to the distribution vs. production) confounds prices a great deal, so lack of correlation between price and addiction rate doesn't mean as much as you think.

  • Ken Shultz||

    "Um, you are aware that Blue Cross is private insurance, right? You realize that an analysis of its members would have NOTHING to do with medicaid"

    I've spent a long time in the hospital reimbursement industry, both working in an acute care hospital and working as a quality control analyst for a software company that serves some of the largest hospitals and hospital chains in the country. I was the guy that made sure the software worked correctly and accurately for every state in the country. I'm not claiming expertise because of that, but I am claiming familiarity.

    I'm familiar to the point that I know Blue Cross/Blue Shield does provide service to Medicaid patients.

    https://tinyurl.com/ya4frtk6

    That link to BC/BS contains a couple of relevant statistics. For one, it says Blue Cross/Blue Shield provides health insurance for 6.6 million people on Medicaid. The other statistic is that it says the ACA added 11 million more low income adults to the Medicaid rolls. Do you really believe that adding giving that many people access to free, legal opioids doesn't and didn't significantly contribute to the problem of opioid addiction?

  • Ken Shultz||

    Oh, and I might add, even if Blue Cross/Blue Shield didn't provide insurance to Medicaid patients, would you expect people on private insurance to have higher or lower rates of addiction than people on Medicaid?

    Haven't we already shown that Medicaid patients (people who make less than $20,000 a year) are 3.4 times more likely to be opioid addicts than people who make more than the average income? What is it about giving people legal opioids for free (courtesy of the government)that makes you think their addiction rates will be lower than rates among the privately insured?

    I'm starting to suspect you may be Tulpa.

  • Qsl||

    I'm less concerned at your vast expertise with healthcare (although presenting your credentials as QA for hospital software isn't really holding you in high esteem) than your ability to parse English- marking Blue Cross members and people they also treat on medicaid... well, which is it?

    Is Blue Cross counting those people among its members when determining addiction rates? If so, any measurement comparing the two will be skewed. If not, then Blue Cross has nothing to do with medicaid. Pick one.

    From your last link, the number of people on medicaid is about 74 million. Even if every opioid addict were on medicaid, it would make up less than 2% of the total.

    Medicaid seems to be doing a piss-poor job of creating junkies then (so typical of government).

  • Ken Shultz||

    If you're not Tulpa, you might as well be.

  • Robert||

    Blue Cross can be a Medicaid carrier. Medicaid recipients in some states have that choice.

  • vek||

    I would totally buy that your theory contributed. It may or may not have been the main driving factor in making opiates more popular in recent years, but it helped. The logic simply makes sense.

    Also the fact that many newer addicts are starting on heroin doesn't discount the idea. Drug use has been shown to kind of go in "fads" like many other things. Kicking off free opiates for poor people by Obamacare could have started the fad, which helped build the infrastructure for users who switched to heroin. Then once legal opiates were cut off, the fad of doing heroin had already been built up, hence new people just got drawn straight to that. There are many other factors here too, like the rust belt being shitty etc.

    I imagine the fad is probably going to start dying down soon either way. They DID cut down on legal prescriptions, and opiates in general have been in vogue for awhile now. These things usually seem to not last much more than a decade, so it'll probably chill out soon.

  • Diane Reynolds (Paul.)||

    Government should pay more people not to work.

  • Telcontar the Wanderer||

    536 of them, to be exact.

  • Hank Phillips||

    So... any questions as to why "we" have replaced Great Britain as occupiers of Afghanistan? A graph of these poisonings versus time would be valuable for assessing the side effects of policy decisions.

  • Telcontar the Wanderer||

    Are you actually implying that heroin wouldn't just be made elsewhere in as great quantities if we withdrew from Afghanistan?

    There are plenty of reasons to talk about withdrawing, but our only mistake re: heroin is not legalizing it and pulling the rug out from under the Talibs' feet. Combine a sudden legalization with a big surge and the shock of the income loss might even be enough to 86 the cunts.

  • MarkLastname||

    You expect expect me, I mean my friend to switch from sweet Afghan black tar to that brown shit the Mexicans grow?

  • Telcontar the Wanderer||

    No, no, I just want you to buy it OTC from the ISAF instead. Buy American, Die American!

  • JeremyR||

    Given the population increases, shouldn't every year be a record year? For all sorts of things.?

  • AndyWingall||

    Perhaps the government should stop bringing in drugs to places like the Port of Baltimore that spread through the inner cities and then into the wealthy suburbs.

  • Earth Skeptic||

    What do you call 64,000 OD fatalities?

    A good start.

  • Eman||

    #firstworldproblems

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