re: Serious business: The opioid epidemic - it's on the rise in the United States

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I think the biggest issue, and this was mentioned in the ABC report, is that doctors are prescribing super strong opioid pain medications as a first choice these days and these lead to addiction, and then lead to heroin because it is cheaper/easer to get.

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That's all there is to it really. Doctors passed these things out like candy and then expected people to just put them down after a two week bender. Pills are more socially acceptable than heroin and easy to steal from the medicine cabinet, so it makes its way through every walk of life. Why is the better question. I'm not a conspiracy nut, but big pharma certainly doesn't seem mad that millions of people are hooked on a product they will steal, stab, or shoot for.

benzos are on of the most dangerous in terms of physical withdrawal along with alcohol.

if you consider physical withdrawal tired/grumpy/depressed I guess it has some. I mostly consider it psychological along with the intense craving which is same.

I only know one person who was as addicted to coke (doing it daily for an extended period of time) like heroin addicts are addicted - and it completely wrecked him coming off of it, maybe it was more due to the body recovering from the damage done during addiction, but I can't speak to all of that.

Those of us that work in healthcare have suspected this for quite a while. My dad works in triage at an ER in east B'ham and the number of ODs he has seen has absolutely ballooned over the past few years.

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Why is the better question. I'm not a conspiracy nut, but big pharma certainly doesn't seem mad that millions of people are hooked on a product they will steal, stab, or shoot for.

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As someone that dealt with chronic pain(back related) and was prescribed painkillers, I will say they did help me cope and make it through some tough days. I don't know if I would have been given the amount I was given had I went through it 20 years ago, but I'm guessing not. At the height, I was getting 120 lortab 10's per month. I did not need that many, and I told the pain clinic that but they gave them to me anyway. That is troublesome. This was almost 4 years ago, and I still have a huge bottle of them with probably close to 100 pills.

I don't know if it's a conspiracy, but I think it just gradually became more and more acceptable for primary care doctors to prescribe them, and it spun out of control. I'm not sure what role big pharma plays either, as most of the prescribed painkillers have generics available. I was only paying like $5 for the 120 pill prescription through my insurance, though I don't know what the pharmacy billed the insurance company.

absolutely. doctors giving out 80 mg oxycontin for almost anything. then after people started dying things started changing - how the pills were made / absorbed / break down and not sure about prescribing. but that's what started alot of this.

have a friend who's struggled with opiate addiction for the better part of 20 yrs but it hit a whole other level when he could get oxy prescribed for little reason.

Now we're locking them in cages when the turn to their only alternative to avoid withdrawal and severe pain. Really disgusting that our government turned their backs on millions of pain patients

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I don't know if it's a conspiracy, but I think it just gradually became more and more acceptable for primary care doctors to prescribe them, and it spun out of control. I'm not sure what role big pharma plays either, as most of the prescribed painkillers have generics available.

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This is the part I'm more interested in actually seeing some hard numbers on. What doctors prescribe can be influenced by the OT 10 sales reps that market drugs to them. That's another topic but I think it contributes. Also I'm curious to see what financial effect generics have had on opiates vs other drugs. The typical business model for a drug is to spend massive amounts on R&D and trials getting it to market, charge a premium for 7 years to make a profit on all that sunk cost before the patent expires. Generics hit as soon as it does, demand for the name brand drug plummets, on to the next drug.

Opiates seem different. Cheap to produce, and almost no R&D since they've been around so long. Even with the ultimate generic on the street, heroin, prices for painkillers remain high. Demand is almost limitless, it increases the more it's sold. I've seen oxy go for more than a $1/mg, that can be $80 for a single pill. Addictive drugs break the rules from an economic standpoint, flood the market and demand can actually grow.

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I was only paying like $5 for the 120 pill prescription through my insurance, though I don't know what the pharmacy billed the insurance company.

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The recent pain cream scandal showed that doctors aren't immune to the things I'm describing above. Sales rep greases the doc's palm in some way, doc prescribes more of the drug, drug company charges anything they want to the insurance company. Again, I'm not a conspiracy nut, but I would not be shocked at all to learn this was happening in some capacity. Maybe not even enough for those involved to realize it, but still happening nonetheless.

Go to school in Plano, I always heard about the epidemic that hit us in the 90s. Now it's back, I guess, and stronger than ever.

https://www.texasmonthly.com/articles/teenage-wasteland/

There were 9 teenage overdoses and fifteen overall in two years. It was a big deal, for a city of 200,000. I have a good buddy that was out in L.A. and got in to some bad crowds and ended up in rehab for heroin. Every time I see him, he still talks about how much he misses it every time he thinks about it, which is every single day. Supposedly the dopamine levels produced from heroin are 10-20 greater than anything else we can do. It's so overwhelming for people that the reward system of their brain is completely broken the first time they shoot up.

Bet he tried alcohol first. What's your point?