Tag Archives: statistics

Deadly Scope of America’s Fentanyl Problem

The True Deadly Scope of America’s Fentanyl Problem – JAMA April 2018 – by Nora Volkow, the director of the National Institute on Drug Abuse (NIDA)

Ms. Volkow seems to understand that our problem is with fentanyl, not prescriptions opioids. I wish she could convince other government agencies and bureaucrats of this truth.

A year ago I wrote on this blog about the escalating numbers of people dying from overdoses involving the extremely potent synthetic opioid fentanyl and its analogues. Continue reading

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FDA Finds Errors in Opioid Data, calls for quality review

FDA finds errors in its opioid sales data, calls for quality review – by Meg Tirrell | @megtirrell – May 16, 2018

The Food and Drug Administration says it’s found mistakes in opioid sales data provided by industry researcher Iqvia that led to an overestimation of the amount of prescription fentanyl being used in the U.S

This means that they assumed more of the fentanyl found on the streets and involved in overdoses was from prescriptions when instead it was illicit.

Because the larger number fed into the prevailing narrative that prescription opioids are fueling the “opioid crisis”, these numbers weren’t questioned closely.  Continue reading

First Look at Latest REAL Data on Opioid Overdoses

US Opioid Prescribing vs. Overdose Deaths and Hospital ER Visits
Implications for Public Policy
Richard A. Lawhern, PhD – May 2018

The ATIP advocacy group has sourced a new statistical analysis of the latest overdose data. Founding member Richard Lawhern has written a paper conclusively illustrating how the CDC presented deceptive views of the data to show a supposed link between opioid overdoses and opioid prescribing.

Abstract

An analysis has been performed on data for opioid prescribing, opioid-overdose related mortality, and hospital emergency room visits recorded for 1999-2016 by the US Centers for Disease Control and Prevention (CDC) and the US Agency for Healthcare Research Quality (AHRQ).   Continue reading

CDC Rx Opioid Overdoses Over-Reported by Half

CDC Opioid Overdose Death Rates Over-Reported by Half – Apr 2018 – A PPM Brief

Agency says inflated estimates were caused by blurred lines between prescription and illicit opioids.

The CDC is supposed to be an evidence and science-based agency, yet they published their opioid prescribing guidelines based on their own erroneous data.

Many laypeople and even their own authors have known for years that illicit fentanyl was causing overdoses, yet the CDC is just now starting to admit it.  

Continue reading

War on Opioids Will Only Punish Patients in Pain

 Trump’s False War on Opioids Will Only Punish Patients in Pain | Opinion – By Josh Bloom and Henry I. Miller On 4/6/18

The ongoing battle to control opioid addiction has not gone well, to say the least.

Many of the government’s efforts, mostly from the Centers for Disease Control and Prevention (CDC), have been unproductive.

Some have been counterproductive, medically and scientifically flawed, punitive, and perhaps most frightening, have usurped control of patient care from physicians.   Continue reading

Opioid Overdose Crisis Is from Illicit Fentanyl

Opioid Overdose Crisis Is from Illicit Fentanyl – AAPS | Association of American Physicians and Surgeons – March 23, 2018  

The U.S. is said to be suffering from a crisis in deaths from opioid overdoses, prompting legislative and other efforts to clamp down on physician prescribing of these drugs.

One look at this chart shows how misguided, foolish, or even malicious this effort is: Continue reading

Problems with CDC’s Fentanyl Reporting

Here are two more articles about the CDC’s latest numbers of opioid overdoses:

CDC Blames Fentanyl for Spike in Overdose Deaths — Pain News Network – March 29, 2018/ Pat Anson

The Centers for Disease Control and Prevention released a new report today estimating that 63,632 Americans died of a drug overdose in 2016 – a 21.5% increase over the 2015 total.  

The sharp rise in drug deaths is blamed largely on illicit fentanyl, a powerful synthetic opioid that has become a scourge on the black market. Deaths involving synthetic opioids doubled in 2016, accounting for about a third of all drug overdoses and nearly half of all opioid-related deaths.

For their latest report, CDC researchers used a new “conservative definition” to count opioid deaths – one that more accurately reflects the number of deaths involving prescription opioids by excluding those attributed to fentanyl and other synthetic opioids.

See earlier post: CDC Over-Counting Rx Opioid Overdose Deaths

Over 17,000 deaths were attributed to prescription opioids in 2016, about half the number that would have been counted under the “traditional definition” used in previous reports.

The new report, based on surveillance data from 31 states and the District of Columbia, shows overdose deaths increasing for both men and women and across all races and demographics.  A wider variety of drugs are also implicated:

  • Fentanyl and synthetic opioid deaths rose 100%
  • Cocaine deaths rose 52.4%
  • Psychostimulant deaths rose 33.3%
  • Heroin deaths rose 19.5%
  • Prescription opioid deaths rose 10.6%

The CDC also acknowledged that illicit fentanyl is often mixed into counterfeit opioid and benzodiazepine pills, heroin and cocaine, likely contributing to overdoses attributed to those substances.

“Inaccurate and Misleading” Overdose Data

Not all opioids are identical in abuse potential and likely lethality, yet government statistics group causes of death in a way that obscures the importance of identifying specific agents involved in deadly overdoses,” Lilly wrote in a peer reviewed article recently published in the Journal of American Physicians and Surgeons..

Lilly faults the National Institute on Drug Abuse (NIDA) for using “inaccurate and misleading” death certificate codes to classify drug deaths. In its report for 2016, NIDA counted illicit fentanyl overdoses as deaths involving prescription opioids. As a result, deaths attributed to pain medication rose by 43 percent, at a time when the number of opioid prescriptions actually declined.

Rather than legal prescription drugs, illicit fentanyl is rapidly increasing and becoming the opioid of choice for those who misuse opioids… Targeting legal prescriptions is thus unlikely to reduce overdose deaths, but it may increase them by driving more users to illegal sources.”

We have a real crisis, and one of the things we need to invest in, if we’re going to make progress, is getting better information,” said Christopher Ruhm, PhD, a professor at the University of Virginia and the author of a overdose study recently published in the journal Addiction.

Is Government Opioid Data Telling the Wrong Story? – March 27, 2018 – By Ed Coghlan

Another report has been issued that concludes that the CDC strategy of targeting legal prescriptions to reduce opioid overdose deaths is not working.

Finally, somebody is stating the obvious. I hope this starts a reappraisal of policy regarding medicinal opioids, but the giant anti-opioid PROPaganada oceanliner has developed so much momentum that it could take a long while to correct it.

Dr. Lilly’s study–published online by the Association of American Physicians and Surgeons– reviewed existing government data. After looking at the Centers for Disease Control and Prevention (CDC) Wonder data base, Dr. Lilly sorts out the deaths associated with illicit fentanyl.  

Until 2013, deaths attributed to synthetic opioids were fairly stable, but a sharp upward trend began then, with an increase of 635% from 2014 to 2016.

Notably, the spike in deaths has occurred while opioid prescribing is being heavily discouraged and placed under increasingly severe constraints.

Dr. Lilly concludes that these policies are apparently driving opioid misusers from legally prescribed drugs to illicit drugs, which are far deadlier because of high potency and unreliable dosing.

One of the critics is Dr. Terri Lewis; a public health advocate shared her feelings with the National Pain Report.

Since the CDC Guidelines were a cloud on the horizon, persons with chronic and intractable pain have questioned the assumptions that CDCs guidelines are predicated upon.  The ultimate error is to base wholesale changes to public policy without accounting for all of the data – including the missing data.

“If fewer than 2% of persons who rely on opiates get into trouble, what’s to be said about the 98% of users for whom opiates have made a profound difference in the quality of their days?

When we ask the wrong questions we get the wrong answers. The recent analyses by Michael Schatman and Stephen Ziegler, Stefan Kertesz, Josh Bloom, and now John Lilly make it abundantly clear that not only is CDC’s recent mea culpa insufficient, but it is still wrong from a design of data perspective.

It demands that the systemic error installed throughout the entire system must be addressed to right the wrong course of public policy so that we can get back to the business of caring for patients instead of servicing errors.”

How many more articles will have to point out that the overdose problem is from illicit fentanyl and has little to do with prescribed medication?

Politicians want to make policies more and more extreme, yet never revisit them to see how they worked out. There seems to be very little thought about the results of the misery they are inflicting on growing numbers of pain patients being cut off.

Surrogate endpoints in global health research

Surrogate endpoints in global health research: still searching for killer apps and silver bullets?March 2018

In clinical research, there is widespread acceptance that surrogate endpoints may not translate to long-term benefits.

Clinical epidemiologists highlight the hazards of surrogate measures (eg, biomarkers, laboratory test results and short-term improvements in health) that substitute for outcomes which are important for patients (eg, avoiding premature death or severe disability).

For example, in cardiovascular research, improvements in parameters such as blood pressure or cholesterol may not improve outcomes such as deaths.   Continue reading

DEA’s Targeting of Doctors and Pharmacies

Opinion: A Reaction to DEA’s Efforts to Target Pharmacies with ‘Unusual’ Opioid Prescription Rates

In response to “Sessions: DEA to Target Pharmacies, Prescribers in Crackdown” as published in The Hill, it should be obvious to responsible medical clinicians that Sessions and colleagues are naïve to the complex and biopsychosocial, medical, and pharmaceutical paradigms that are actually driving the opioid epidemic.

The article states that in 2016 there were “at least 66,000 deaths from overdoses reported, including 42,249 deaths from opioids. Opioid overdose deaths now kill more Americans every year than breast cancer, according to the latest statistics from the CDC.”  

Adding together 1. prescription medication use and 2. illicit drug abuse in the same number hides which of these two is causing the problem. Continue reading

Columnist Needs to Get Her Opioid Facts Right

Washington Post Columnist Needs to Get Her Opioid Facts Right | Cato @ Liberty – Dec 2017 – By JEFFREY A. SINGER

Though he writes for a “conservative/libertarian” organization, the Cato Institue is “dedicated to the principles of individual liberty, limited government, free markets and peace”, Mr. Singer has emerged as an advocate for a more rational response to the “opioid crisis”.

In a December 28, 2017 column for the Washington Post entitled, “Opioid Abuse in the US Is So Bad It’s Lowering Life Expectancy. Why Hasn’t the Epidemic Hit Other Countries?,” Amanda Erickson succumbs to the false narrative that misdiagnoses the opioid overdose crisis as being primarily a manifestation of doctors over-prescribing opioids, goaded on by greedy, unethical pharmaceutical companies.  Continue reading