First, commentary by @StefanKertesz:
This is probably the best summary of the crisis I’ve seen. It’s got lots of references supporting all of its claims, and lots of links to more detailed information.
Note that pharma and misprescribing played a role, but that diversion and misuse are also specifically mentioned as key factors.
And this is NIDA, a government agency that presumably not unduly influenced by Big Pharma on one side or PROP on the other.
They collected data, did analyses, and drew conclusions. And they keep doing it because the crisis keeps evolving.
It’s easy to dismiss individual physicians or CPP advocacy groups as uninformed or biased. It is very hard to dismiss NIDA, which is basically a building full of experts who study all this stuff all the time.
Here is the report Dr. Kertesz was referring to from the official source, the National Institute of Drug Abuse. This is what the “opioid Crisis” looks like from the official government source:
Every day, more than 115 people in the United States die after overdosing on opioids.
This number is wildly inflated
The misuse of and addiction to opioids—including prescription pain relievers, heroin, and synthetic opioids such as fentanyl—is a serious national crisis that affects public health as well as social and economic welfare.
How did this happen?
In the late 1990s, pharmaceutical companies reassured the medical community that patients would not become addicted to prescription opioid pain relievers, and healthcare providers began to prescribe them at greater rates.
This subsequently led to widespread diversion and misuse of these medications before it became clear that these medications could indeed be highly addictive
Opioid overdose rates began to increase.
What do we know about the opioid crisis?
- Roughly 21 to 29 percent of patients prescribed opioids for chronic pain misuse them. [this is NOT addiction, but I believe I’ve seen it wrongly quoted as an opioid addictionpercentage]
- Between 8 and 12 percent develop an opioid use disorder. [this may still not be full-blown addiction, but it’s a far more reasonable number]
- An estimated 4 to 6 percent who misuse prescription opioids transition to heroin. [That’s a tiny number if you remember it’s a percentage of only the 8-12% that had already developed an OUD)
- About 80 percent of people who use heroin first misused prescription opioids. [it matters a lot whether these prescription opioids were legal or illicit (diverted) and if prescribed, whether the pills were prescribed to the end user or someone else]
- Opioid overdoses increased 30 percent from July 2016 through September 2017 in 52 areas in 45 states. [This is an odd selection of timeline: 14 months instead of the customary year]
- The Midwestern region saw opioid overdoses increase 70 percent from July 2016 through September 2017.
- Opioid overdoses in large cities increase by 54 percent in 16 stat
This issue has become a public health crisis with devastating consequences including increases in opioid misuse and related overdoses
What are HHS and NIH doing about it?
In response to the opioid crisis, the U.S. Department of Health and Human Services (HHS) is focusing its efforts on five major priorities:
- improving access to treatment and recovery services
- promoting use of overdose-reversing drugs
- strengthening our understanding of the epidemic through better public health surveillance
- providing support for cutting-edge research on pain and addiction
- advancing better practices for pain management
The National Institutes of Health (NIH), a component of HHS, is the nation’s leading medical research agency helping solve the opioid crisis via discovering new and better ways to
- prevent opioid misuse,
- treat opioid use disorders, and
- manage pain.
The order of these three goals perfectly matches our government’s ethically skewed priorities:
- taking opioids away from patients who need them, including hospice and cancer patients,
- treating people who are addicted, and
- treating pain with scientifically dubious and often ineffective non-opioid treatments like:
- antiepileptic and antidepressant drugs that either leave us in a stupor or send us into psychosis,
- chiropractors and acupuncturists who require weekly visit forever, or
- psychotherapy so we learn how to stop catastrophizing,