Today I’m simply re-posting recent articles — written by others — directly related to the opioid epidemic, which is the subject of my recently published novel.
New readers are signing up almost daily to receive this blog, and many are medical students or political science majors interested in the topics and the accompanying research. Perhaps this will help.
Look for original pieces arriving in the next few days.
First, from the St. Louis Post-Dispatch 4/3/17:
Social change and economic disappointment create an epidemic of ‘deaths by despair’
Two years ago, Princeton University economists Anne Case and Angus Deaton disclosed a shocking finding: Between 1999 and 2014, middle-aged (45-54) white Americans with a high school education or less died at a rate never before seen in a modern industrialized society.
Alone among every other demographic group they studied, this group’s life expectancy was shrinking. The group’s annual mortality rate jumped from 281 per 100,000 to 415 per 100,000 during the 15 years studied.
Big reasons: Striking increases in the number of suicides, drug overdoses and liver disease caused by alcohol poisoning. Case and Deaton called them “deaths by despair.”
Now the two scholars have returned to try to explain why this is happening. In a report published by the Brookings Institution, they suggest that while income inequality and wage stagnation may play a background role, a lifetime of “cumulative disadvantage” catches up with this demographic.
They are the slice of the population who hit the job market as low-skill jobs were being mechanized, computerized and globalized. They grew into adulthood as cohesion-building social institutions like marriage, family and churches became weaker. Often they didn’t have spouses, pastors, work buddies or kids to back them up.
They did have opioid painkillers, which Case and Deaton say “added fuel to the flames, making the epidemic much worse than it otherwise would have been.” They cite a study from the Boston Federal Reserve that found that among men not in the labor force, nearly half are taking pain medication, most often by prescription.
Case is a professor of economics and public affairs; Deaton, her husband, was the 2015 Nobel laureate in economics. They admit their research is not a “smoking gun,” but it has ominous implications:
“This account, which fits much of the data, has the profoundly negative implication that policies, even ones that successfully improve earnings and jobs, or redistribute income, will take many years to reverse the mortality and morbidity increase, and that those in midlife now are likely to do much worse in old age than those currently older than 65.”
Obviously the same forces affecting low-income middle-aged whites also affect poor educated middle-aged blacks and Hispanics. But mortality rates are decreasing among those groups and they don’t suffer high rates of deaths by despair. The authors speculate that expectations may be higher among whites, leading to greater disappointment when things don’t work out.
Many of these folks put their faith in Republican promises of help, and the GOP owes them something. Addressing opioid addiction is a place to start. So is keeping the social safety net intact. GOP politicians can boast about bringing back jobs and passing right-to-work laws, but voters must hold them accountable if they make things worse for the people the corporate economy has left behind.
Dallas Morning News 4/6/17
At the heart of our opioid crisis: the doctors who overprescribe them
President Donald Trump held a “listening session” about opioids and drug abuse at the White House last week. The gathering included former addicts, parents of children who had overdosed, top federal officials and others. Trump vowed to make drug treatment more widely available — a worthwhile goal with bipartisan appeal. He also spoke of strengthening law enforcement and dismantling drug cartels.
But there is a cheaper, low-risk tactic for curbing some opioid misuse that was neglected: changing doctors’ prescribing habits and better educating patients. A recent study found that for every 48 patients who receive an opioid prescription in the emergency room, one will likely become a long-term user. A more cautious approach to prescribing could save lives.
Across the United States, health care professionals wrote 249 million prescriptions for opioid pain medicines in 2013. In 2015, about 22,000 Americans died after overdosing on some form of opioid drug, legal or illicit, according to the Centers for Disease Control and Prevention. Of those deaths, 15,000 were attributed to prescription opioid overdoses. In fiscal 2015, Texas pharmacies dispensed almost 7 million prescriptions for the opioid painkillers hydrocodone or oxycodone alone.
There is no medical explanation for the rise in opioid use. Sales of prescription opioids nearly quadrupled from 1999 to 2014, even though Americans don’t report having more pain now. Prescribing rates vary widely among states, even though health conditions don’t. Even among doctors working in the same emergency room, some prescribe opioids much more frequently than others.
The federal government — along with some states and professional associations — has produced extensive prescribing guidelines. Opioid medications are not the preferred option for managing chronic pain; doctors and patients should try other approaches first and carefully weigh risks before starting prescription opioids. For acute pain, such as after surgery, doctors should prescribe the lowest possible dose of opioid for the shortest duration. Prescribers must be especially careful with older adults because opioid painkillers can put seniors at higher risks of falls and fractures.
Pharmacists and patients have an important role. In Texas, lawmakers are considering a bill, SB 316, which tightens the state’s prescription drug monitoring program. The bill would make it easier for pharmacists and regulators to quickly spot patients who fill multiple prescriptions for addictive medications and doctors who prescribe inappropriately.
And the public can help, too. How do most people who misuse prescription pain medications get them? One large study showed that about half obtained them free from friends or relatives. So, if you have pain pills left over from surgery or dental work, drop them in the toilet. Really. These medications are so dangerous when misused that the FDA recommends flushing them down the sink or the toilet if you can’t find an official drug take-back event. That will keep everybody in your home — you and your friends, relatives, kids and pets — safe.
What you can do
April 29 is National Prescription Drug Take Back Day, which aims to provide a safe, convenient and responsible means of disposing of prescription drugs, while providing education about the potential for abuse and medications. To find a drop-off location near you or to learn more about the program, visit dea.gov or call 800-882-9539.
Associated Press 3-10-17:
Workers comp programs fight addiction among injured workers
Fourth, the Kingsport Times-News 7/3/16: