Excellent and very moving WSJ piece about the children who suffer because of the addictions of their parents, and the very common scenario of grandparents being required to spend their retirement years filling the parental void. Sad stuff.
Link - (
New Window )
This book is part memoir, part sociological overview, and part political science as it ties together one young man's plight as the son of an addicted mother, his analysis of his family and neighbors in Appalachia, and tangentially an explanation of how that strata's ideas about "politics" impacts our elections.
This is an unusual and important book, and for me it was eye-opening.
NY Times Review - ( New Window )
how in the world do you do that?
Can't even put into words how helpless, sad, etc the situation these kids are and how many of the parents were once kids in the same situation. It's an endless cycle yet the cycle appears to be growing rapidly. So many stories and, you can't get arms around it.
It's true, again from what I've read that many users graduate from opiods to heroin but it's illegal opioid use that may have started with someone else's prescription or pills, but not the model the media likes to use mentioned above.
How do you stop it? I don't believe it's all pill mills or doctors and the pharmaceutical companies in cahoots to push product. It seems more to me like opiods have just replaced cocaine or LSD or whatever prior drug of choice was for past generations.
It's an epidemic, but I'm not sure how you stop it.
Legalize weed?
And I should say I couldn't read past two lines of the story linked here it said I need to subscribe to WSJ, so I made some assumptions.
This book is part memoir, part sociological overview, and part political science as it ties together one young man's plight as the son of an addicted mother, his analysis of his family and neighbors in Appalachia, and tangentially an explanation of how that strata's ideas about "politics" impacts our elections.
This is an unusual and important book, and for me it was eye-opening. NY Times Review - ( New Window )
+1
Do you mean the "war on drugs"? didn't that become sort of a punchline?
I've heard it referred to as an unmitigated disaster and I admit not sure if it was the $$$ spent that was largely ineffective or just the lack of success.
I wasn't being facetious, though not necessary advocating it, but I have heard some opinions legalizing weed or other drugs would lessen the reliance on opioids. Not sure why other than something else being available legally, and that's state not federal, but with weed IMO it can't hurt to try.
http://www.nbcnews.com/news/us-news/wilkes-barre-faces-heroin-scourge-turning-it-most-unhappy-place-n699541 - ( New Window )
they are in fact already taking measures to stop the proliferation of legally prescribed opioids. Doctors are far more heavily scrutinized now for every single prescription. I believe it's now protocol to not use opioids for long-term pain management issues. some people used to simply have refillable percocet prescriptions (I was one of them). that ended.
Another example is simply prescribing less as part of medical protocol.
Anecdotally, I had shoulder surgery 5 years go on my left shoulder, I was prescribed 60 percocets. I needed maybe 10 - 20 for the pain. I took them all.
this past September I had the same surgery on my other shoulder but the damage was worse and the prescription was for 20 pills.
I think protocols are changing and scrutiny is higher.
Not sure what else is happening, but those are two things I notice.
drug use among poor urban blacks = thugs who should be in jail
drug use among poor urban blacks = thugs who should be in jail
You seeing this as a crisis that only affects one of those segments is the funny part. If you think striking ignorance is amusing.
drug use among poor urban blacks = thugs who should be in jail
Interesting to see your viewpoint.
I have a lot of empathy for addicts. That's true regardless of their drug of choice, whether it be opioids, crack cocaine, acid, molly, alcohol, tobacco, or gambling.
I find it interesting how we treat those who make money off these addicts differently. I've not really looked at it through the lens of race as you apparently do.
Which race should we blame for each of the different vices out there? How can we make sure we treat them all the same, so as to avoid being racist?
Just wondering.
But the one question it really boils down to is this: are the communities most impacted by the targeting of crack/cocaine better off for the loss of most of their criminal strata, by the reduction (by no means elimination) in the availability of crack and cocaine, the reduction in the number of babies born addicted to crack-cocaine, etc etc, or are they worse off for the removal of thousands of fathers, sons, brothers (and mothers) etc from the scene, the increase in the police presence and the intrusiveness of their tactics, etc etc.
It's not an easy question. There are assumptions in there on both sides that people will attack and there are clearly other issues at work in the war on drugs, but in debating whether a comparable response would be appropriate for heroin and opiates that's really the question that's at issue. The problem is at least that big. In Vermont an estimated 3+% of the babies born over the last five years have been born drug-addicted, and in some hospitals in WV the number is more than twice as high. Deaths from overdoses are mushrooming, it is that bad.
Of course that's not to say that there aren't other options besides incarcerating everyone who has ever sold heroin, we can and should learn from the shortcomings of the last such drug epidemic. But it is to say that a strategy based largely on policing and prosecution really has to answer that question.
I don't know what the impact of a drug addicted baby is, but I cannot imagine it's good.
Now VT or WV probably are not on this scale, but my kids were born at Brigham and Women's Hospital in Boston. They birth (and as late as 2012 at least) 9,000 babies a year.
270 babies a year or 1,350 over the 5 year period are drug addicted (if MA had those same rates) and parts of MA are not far behind WV in terms of opioid related addiction.
Link - ( New Window )
drug use among poor urban blacks = thugs who should be in jail
I think the race issue is not the main issue. But we can have both conversations as a society. It is hard to ignore the fact that the white drug epidemic gets phrased in terms of "the children of the opioid crisis" while the black drug epidemic had the derisive "crack babies". How much of that is race and how much of that is a kinder, gentler society I dont know. Part and parcel of how you think about society. For example, I dont think most Americans are racist, but I think race plays a role in the way we think about eachother, e.g. I think there is a lot of white resentment for welfare programs that are viewed as "for" minorities who live in big cities and not them.
Bigger picture, I dont have a ton to add. My life is blessed to be untouched by this crisis (TBK). I did read some interesting stuff re why places that suffered from crack are less hit by this. Some theories include better responses from communities/families that have been thru addiction, and also some data that physicians perscribe pain killers to blacks at lower levels than whites, reducing the pain-to-addiction path. Although pj makes a good point that the pure pain-to-addiction path is overhyped.
drug use among poor urban blacks = thugs who should be in jail
Who is seeing it this way? IMO, there needs to be an effective marketing campaign. It should be akin to the campaign that stopped many people from smoking cigarettes. Why did that work? Why can't it work with these drugs?
Thanks
From other sources, I did not realize fentanyl is disguised as other drugs.
From what I understand, the Feds may also have gone to some of the more prodigious script writers (mostly in Florida) and told them that maybe it was time to retire or face scrutiny.
Not even a little bit true.
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That allowed patients to score their Drs. on pain management. So the DRs. made sure their patients weren't in pain. Over proscribed opioids. Then the govt cut back opioids Rxs and the addicted went to heroin. Great work all around.
Not even a little bit true.
It's true. And that's straight from Drs. and pharmacists who saw it all happen.
there is a max amount of pills that can be prescribed via protocol per injury/incident and if more are needed/requested a revisit and re-evaluation by the doctor is required.
he was pretty candid with me about it, protocol has changed, for frequent pain management, narcotics are not protocol any longer. surgery or root cause treatment are what is being recommended.
fix the problem don't treat the symptoms.
Not saying every doctor (even in MA) follows this, but he was clear about the changes given the current state and there are repercussions.
there is a max amount of pills that can be prescribed via protocol per injury/incident and if more are needed/requested a revisit and re-evaluation by the doctor is required.
he was pretty candid with me about it, protocol has changed, for frequent pain management, narcotics are not protocol any longer. surgery or root cause treatment are what is being recommended.
fix the problem don't treat the symptoms.
Not saying every doctor (even in MA) follows this, but he was clear about the changes given the current state and there are repercussions.
Yup. That's the Feds trying to reign in the problem they created. Trouble is it put people who really need opioids in a bind because the pharmacies and Drs. reach their limit and those people can't get the drugs they legitimately need.
Just the fact Deej. Just the facts.
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feel the need to blame the government for everything
Just the fact Deej. Just the facts.
Well, taking your statement at face value, at most it is the opinion of Drs and pharmacists. Who may lack perspective. It's fairly common for people who do a not great thing to blame circumstances rather than themselves. I do it, you do it, we all do it.
Let me ask this: what happens if a doctors doesnt give Percocet to an addict, and the addict gives the doctor poor marks? Does the doctor lose his license? Or does he maybe make less money. Does the doctor get to rebut? I.e. tell the scorer why he had a different course of treatment.
So not just the facts. Mostly opinion.
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In comment 13321435 Deej said:
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feel the need to blame the government for everything
Just the fact Deej. Just the facts.
Well, taking your statement at face value, at most it is the opinion of Drs and pharmacists. Who may lack perspective. It's fairly common for people who do a not great thing to blame circumstances rather than themselves. I do it, you do it, we all do it.
Let me ask this: what happens if a doctors doesnt give Percocet to an addict, and the addict gives the doctor poor marks? Does the doctor lose his license? Or does he maybe make less money. Does the doctor get to rebut? I.e. tell the scorer why he had a different course of treatment.
So not just the facts. Mostly opinion.
" Or does he maybe make less money." Yup.
The Drs. could then get in trouble with the regulators which could effect their compensation and waste a huge amount of their time being called on the carpet. So, you nailed it Deej. See, no opinions necessary when you have the facts.
I don't have any answers. Like others, I am blessed not to have this in my life. I have friends who I sometimes worry about, mixing prescription medications and alcohol. But I can see the devastation. I know I get a bad rap because I come down hard on drug use. I take it seriously, alcohol too. Yes, I drink wine, and sometimes too much. Some people just can't handle this stuff. We also have the addition of people's lives seeming to be miserable, no future, economic stagnation, lack of social lives, no community support. It's hard when you fall through the cracks and have no way to get back up.
Second, what is known as 'black-tar' heroin from Mexico begins to be distributed using a pizza delivery model. A number of different 'cells' crop up that are all from the same place in Mexico - Nayarit. They avoid big cities b/c there is competition and instead focus on smaller cities. People addicted to opioids turn to black tar heroin b/c it is much cheaper and it is convenient. Literally it is distributed to people much as pizza would be, by calling a number and the driver comes to you.
I'd highly recommend the book "Dreamland" (see link) to learn about what happened.
Third, economies in middle America are dying and
Dreamland - ( New Window )
Also, last year more people died from opioids than car crashes.
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but my doctor in MA told me every single narcotic prescription he writes gets scrutinized now.
there is a max amount of pills that can be prescribed via protocol per injury/incident and if more are needed/requested a revisit and re-evaluation by the doctor is required.
he was pretty candid with me about it, protocol has changed, for frequent pain management, narcotics are not protocol any longer. surgery or root cause treatment are what is being recommended.
fix the problem don't treat the symptoms.
Not saying every doctor (even in MA) follows this, but he was clear about the changes given the current state and there are repercussions.
Yup. That's the Feds trying to reign in the problem they created. Trouble is it put people who really need opioids in a bind because the pharmacies and Drs. reach their limit and those people can't get the drugs they legitimately need.
Again though, I'll dig up one of the articles, the # of heroin addicts who got there by way of legit narcotic pain reliever prescription, became addicted and then could no longer get prescriptions is minuscule - not the narrative that plays well in many of the stories or articles.
Here is an excerpt from a pbs.org article.
Link - ( New Window )
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In comment 13321391 BillT said:
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That allowed patients to score their Drs. on pain management. So the DRs. made sure their patients weren't in pain. Over proscribed opioids. Then the govt cut back opioids Rxs and the addicted went to heroin. Great work all around.
Not even a little bit true.
It's true. And that's straight from Drs. and pharmacists who saw it all happen.
And why do you accept anecdotal evidence as incontrovertible fact?
You need to take a close look at the demographics of the people who are prescribed pain medication. You'll find that they are, in large part, not the people who are using heroin/fentanyl.
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In comment 13321414 BMac said:
And why do you accept anecdotal evidence as incontrovertible fact?
It isn't anecdotal evidence. It's first hand information from experienced medial professionals who know the profession, this problem, and the role the Feds played in it.
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In comment 13321426 BillT said:
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In comment 13321414 BMac said:
And why do you accept anecdotal evidence as incontrovertible fact?
It isn't anecdotal evidence. It's first hand information from experienced medial professionals who know the profession, this problem, and the role the Feds played in it.
No, it is 2nd hand anecdotal evidence
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In comment 13321497 BMac said:
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In comment 13321426 BillT said:
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In comment 13321414 BMac said:
And why do you accept anecdotal evidence as incontrovertible fact?
It isn't anecdotal evidence. It's first hand information from experienced medial professionals who know the profession, this problem, and the role the Feds played in it.
No, it is 2nd hand anecdotal evidence
Believe what you like Deej.
what you describe sounds like it would have to be far more widespread than that.
Meanwhile, cracking down on “pill mills” could address some of the problem but would hardly suffice, said Jonathan Chen, an instructor at the Stanford University School of Medicine who has researched painkiller abuse but is not associated with the review article. The top 10 percent of doctors prescribe about 57 percent of all painkillers, according to a study he co-authored that came out last December
what you describe sounds like it would have to be far more widespread than that.
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The CDC is currently finalizing new guidelines for doctors to help them better prescribe medication for pain, Compton said.
Meanwhile, cracking down on “pill mills” could address some of the problem but would hardly suffice, said Jonathan Chen, an instructor at the Stanford University School of Medicine who has researched painkiller abuse but is not associated with the review article. The top 10 percent of doctors prescribe about 57 percent of all painkillers, according to a study he co-authored that came out last December
It affected all Drs. But certainly there were Dr's who took advantage of it on a large scale. Those aren't mutually exclusive facts. When "pain management" became a reviewable part of a Dr.'s practice it allowed for abuse of those rules.
Still seems a small percent of doctors were freely handing out pain killer prescriptions like they were tic tacs (the pill mills).
I took one of the Valium the morning after surgery and was a complete space cadet. After that I threw out the rest of the pills.
I could not believe the number of people that approached me afterwards chastising me for not giving them the pills instead. My father-in-law is as straight laced as anyone I've ever known, and he told me he takes a Percocet a night to get to sleep. I couldn't believe it.
Still seems a small percent of doctors were freely handing out pain killer prescriptions like they were tic tacs (the pill mills).
But you didn't need to "hand out pain killer prescriptions like they were tic tacs" to contribute to the problem. Proscribing marginally more would be a big increase across all of America. And when you stopped proscribing those that became addicted or you thought didn't need more, they had the pill factories to go get more.