Let's Talk About The Opioid Problem

[MontuckyFried]

Among the general population this is the norm, not the exception.

That's interesting. I honestly didn't know until that person told me their 1st hand account of the experience. Sounded freaking awful.

Watch junkie interviews on Soft White Underbelly. Look at clinical data on OUD. The common thread in studies and anecdotes is that these people are self-medicating to relieve psychological pain from untreated trauma. Opioid addiction is a symptom of society's inability to treat that trauma.

Indeed. Saw an interview with Mark Laita (of Soft White Underbelly) talking about just that, and the devastating thing is how he brought up the painful reality that there simply is no going back in time to fix childhood trauma, which too often is of a sexual and/or violent nature. The best hope is therapy and such, but sssoooooo much damage has already been done.

I don't know how we can fix that, and I haven't heard any REALISTIC solutions be proposed as of yet.

[lowsparkco]

It’s striking how big of a downward spiral it can be. Life gives you a shit sandwich, a divorce, loss of a job, maybe just too much stress and anxiety. Often, these very real problems would take time and effort for a healthy functional person to address. Then you turn to drugs or alcohol and dig a huge hole in addition to the problematic place where you started. So, you were so scared and distraught that you turn to drugs, then make it much worse, what are you looking at if you get sober?

Every single person I’ve known that has successfully gotten sober had people, wealth, or something to look forward to on the other side. Something to make it worth it.

One of my best friends little brother got into H for a period. He got his girlfriend pregnant and was able to kick it. They had this beautiful little girl and seemed really happy. He went in for routine dental work (hey dentists!) and died from an infection. The consensus opinion was that his immune system was simply too weak to fight even a small infection. Fucking tragic.

[Bunion 2020]

I don't know how we can fix that, and I haven't heard any REALISTIC solutions be proposed as of yet.

Not sure without some type of Total Recall therapy there really is much to be done. Whether its childhood trauma, sexual abuse or PTSD getting the help seems a daunting task and getting the relief seems damn near impossible.

[baron]

interesting last few pages..good thoughts mags

One thing I see is it is likely the Small Clinic facilities that prescribe needlessly or for profit. E R and Large Hospitals are doing what they need to to stabilize trauma and effects from surgery.

Turning to addiction for mental / life problems seems like a vicious circle society spirals toward naturally. If you lost a loved one and your job and had divorce or whatever> you will naturally gravitate to hanging out with other jobless people with time on their hands, and its far to common for recreational drug use be on their menu.

[MontuckyFried]

Not sure without some type of Total Recall therapy there really is much to be done. Whether its childhood trauma, sexual abuse or PTSD getting the help seems a daunting task and getting the relief seems damn near impossible.

QFT. And one of the worst things about abuse is that it's often perpetuated by the abused when they bring about the next (and populationally expanded) generation. Perhaps THAT'S one of the underlying reasons behind the staggering expansion of opioid abuse, aside from the pharmaceutical companies' culpability of course.

I was blessed to at least grow up in a non-abusive household, so perhaps that's been my biggest disconnect from serious addicts and why I have struggled to understand the temptations to begin with. Man, this topic's dark.

I know we disagree on a lot, but perhaps this is a topic where we might find some common ground: I believe, and maybe you do too, that THIS is an area where we need to ensure everybody has access to therapy and treatment, and yes 100% subsidized. Now there are currently a multitude of such services already available, BUT here's where I differ from the bureaucrats in charge. I would make it completely anonymous paperwork wise. No ID required. No insurance cards. No proof of anything. No questions asked (at the front desk I mean). No paperwork to get seen. Just show up, and help is there. You could call yourself "Mickey M. Mouse" for all I care. As it currently stands, the paperwork, privacy concerns, and the bureaucracy alone is enough of a barrier to keep many from getting the help they need. Of course they also need to WANT the help, but that's a different rabbit trail. But of course bureaucrats want miles long paper trails, proof of progression in the system, names/socials/dates of birth, ID, etc. Which makes it tough for people who have been out of the system for years, often times intentionally so. I'm not aware of a way to re-integrate yourself back in without getting kind of dicked over in the process. So back to the streets people go. For some, it seems easier than dealing with the system. But I digress. People not completely separated from normal society ALSO need the complete anonymity. A white collar guy who's turned to H after a struggle with surgery-related painkillers likely does not want ANYBODY in his family, work, etc. to find out. Scared of losing their jobs, their families, their social status, whatever. I'm guessing those are people who quite often refuse to seek out treatment or help as well. Not to mention the exorbitant costs for rehab that their spouses will of course have to know about. Rehab IS big business after all (another problem).

[MontuckyFried]

Now if you want to get REALLY cynical about the systems in place, start by reading Philip K. Dick's "A Scanner Darkly." (published in 1977!!! - about a dystopian Orange County, CA in 1994) And then follow that up with a quick look into Purdue Pharma and "Project Tango." Hoooooooly crap it's some twisted stuff. So much of our opioid crisis is very much by design. As they say, it's a feature, not a bug.

Purdue Pharma sought secret plan to become ‘end-to-end pain provider,’ lawsuit alleges
https://www.cnn.com/2019/01/31/healt...uit/index.html


^from an internal Purdue presentation

[bennymac]

maybe someday psychadelics + therapy will show results with helping deal with past trauma

issue is that, even if that works, you'd need a society that values tax dollars going to fund it for citizens that can't afford it

[MontuckyFried]

maybe someday psychadelics + therapy will show results with helping deal with past trauma

There have been some promising advancements in that lately. Hopefully it can help.

issue is that, even if that works, you'd need a society that values tax dollars going to fund it for citizens that can't afford it

Or I'd argue even for citizens that "CAN" afford it. It's crazy expensive for us regular folks, so it really shouldn't even be means based. It should be fully and freely accessible to anybody seeking help. No questions asked. (see my post above) However, that does beg the question. How do we keep profiteering assholes like Purdue from trying to take advantage and purposefully drive up the costs? "Oh, the Feds are picking up the tab? Did we say it was $1K per session? Ya know, due to inflation and all, it's now $100K per session. You know how it is, right?" That's what sadly seems to happen too often, which of course gives people loads of ammunition to oppose it. How do we keep everybody in check? I honestly don't know.

[baron]

the Government would not be overpaying(as much) if they listened to voters and not the lobbyists from multi billion dollar companies.

we don't get a say in any of the multi billion $ spending sprees they go on...and they pass them in 2k page novels, to sneak in all sorts of stuff voters would never approve.

America has more than enough money and resources to deal with these problems like Opioids ...our leaders are to busy lining each others pockets to bother

[Trackhead]

So fructose corn syrup is the fentanyl of the food world?

Ya I know that's the worst hyperbole ever. End of the day, fat shaming is no different than alcohol or drug shaming..

Who’s fat shaming? Discussing human physiology is not fat shaming.

[Bunion 2020]

OK, what about Adderall? CBS just ran a piece on the current shortage and dropped the stat that 45 million people are on a monthly regimen. They interviewed a woman who is on Add for her ADHD, so is her husband and 1 of her teenage boys. Says her brain is mush without the Big-A and she just cannot function. WTF?

[Trackhead]

OK, what about Adderall? CBS just ran a piece on the current shortage and dropped the stat that 45 million people are on a monthly regimen. They interviewed a woman who is on Add for her ADHD, so is her husband and 1 of her teenage boys. Says her brain is mush without the Big-A and she just cannot function. WTF?

Likely over prescribed. Most pediatric patients on it have high ACES (adverse childhood experiences) scores.

A pill for every emotion in adults. One to wake up, one to sleep, one for depression, another for anxiety. See it every day.

There are predatory online companies with monthly subscription fees for quick eval/access to ADHD meds. It's not unlike the predatory "mens health" clinics that prescribe testosterone replacement therapy to everyone.

[Bunion 2020]

Adverse childhood experiences (ACEs) can have a tremendous impact on future violence victimization and perpetration, and lifelong health and opportunity. CDC works to understand ACEs and prevent them.

https://www.cdc.gov/violenceprevention/aces/index.html

That isn't very cheerful reading. Damn it is a fucked up world we are living in.

[Dantheman]

QFT. And one of the worst things about abuse is that it's often perpetuated by the abused when they bring about the next (and populationally expanded) generation. Perhaps THAT'S one of the underlying reasons behind the staggering expansion of opioid abuse, aside from the pharmaceutical companies' culpability of course.

I was blessed to at least grow up in a non-abusive household, so perhaps that's been my biggest disconnect from serious addicts and why I have struggled to understand the temptations to begin with. Man, this topic's dark.

I know we disagree on a lot, but perhaps this is a topic where we might find some common ground: I believe, and maybe you do too, that THIS is an area where we need to ensure everybody has access to therapy and treatment, and yes 100% subsidized. Now there are currently a multitude of such services already available, BUT here's where I differ from the bureaucrats in charge. I would make it completely anonymous paperwork wise. No ID required. No insurance cards. No proof of anything. No questions asked (at the front desk I mean). No paperwork to get seen. Just show up, and help is there. You could call yourself "Mickey M. Mouse" for all I care. As it currently stands, the paperwork, privacy concerns, and the bureaucracy alone is enough of a barrier to keep many from getting the help they need. Of course they also need to WANT the help, but that's a different rabbit trail. But of course bureaucrats want miles long paper trails, proof of progression in the system, names/socials/dates of birth, ID, etc. Which makes it tough for people who have been out of the system for years, often times intentionally so. I'm not aware of a way to re-integrate yourself back in without getting kind of dicked over in the process. So back to the streets people go. For some, it seems easier than dealing with the system. But I digress. People not completely separated from normal society ALSO need the complete anonymity. A white collar guy who's turned to H after a struggle with surgery-related painkillers likely does not want ANYBODY in his family, work, etc. to find out. Scared of losing their jobs, their families, their social status, whatever. I'm guessing those are people who quite often refuse to seek out treatment or help as well. Not to mention the exorbitant costs for rehab that their spouses will of course have to know about. Rehab IS big business after all (another problem).

There's already a huge shortage of therapists, let alone ones with experience and expertise treating homeless addicts. Even if we were willing to spend the money it would take at least a generation to create the capacity.

maybe someday psychadelics + therapy will show results with helping deal with past trauma

issue is that, even if that works, you'd need a society that values tax dollars going to fund it for citizens that can't afford it

Psychedelic therapy is incredibly promising, but it's important to manage expectations. All the studies to date have aggressively excluded people with schizophrenia and bipolar and they're being run by some of the most brilliant people in the world. It also takes *two* trained therapists, though for far fewer sessions than normal long-term talk therapy.

[SumJongGuy]

Who’s fat shaming? Discussing human physiology is not fat shaming.

Not happening in this thread but it's all over forums like this. You don't have to look hard to see it. People assume overweight people are lazy and don't try to exercise or control their diet.. It's not that simple..

Drug and booze shaming is also not really happening in this thread for the most part. Did see something mentioning willpower or weak minded or something like htat.

I was just adding to the discussion about obesity now having evidence of genetics, hereditary..

[bennymac]

There's already a huge shortage of therapists, let alone ones with experience and expertise treating homeless addicts. Even if we were willing to spend the money it would take at least a generation to create the capacity. Psychedelic therapy is incredibly promising, but it's important to manage expectations. All the studies to date have aggressively excluded people with schizophrenia and bipolar and they're being run by some of the most brilliant people in the world. It also takes *two* trained therapists, though for far fewer sessions than normal long-term talk therapy.

yeah dealing with schizophrenia and bipolar is a whole other different problem - or a problem stacked on top of a problem - I was more thinking about how do you break the cycle of kids having ACEs and then being fucked up from that - and then as a result giving their own kids ACEs and so on. We can't soley medicate our way out of that cycle - with pharmaceuticals and/or street drugs.

I don't have the answers - I just know it's not gonna be gov funded psych meds and problem solved (I know no one here is saying that either to be clear)

[Trackhead]

I was more thinking about how do you break the cycle of kids having ACEs and then being fucked up from that - and then as a result giving their own kids ACEs and so on. We can't soley medicate our way out of that cycle - with pharmaceuticals and/or street drugs.

I spent a short time working primary care in an Alaska Native clinic and learned a lot about life. For the past 20+ years in ER, my cynicism was out of control taking care of drunks in the ER. When I saw the other side of it in the clinic, my empathy was finally engaged. These young and old homeless addicts/drunks universally had horrible childhoods filled with rape, absent parents, drug/alcohol addicted parents, etc.

Spent some time working briefly in clinics in rural/roadless AK villages, and an Alaskan Native grandfather told me "all the grand parents are raising our grandkids because the parents are all on drugs".

As a child, how do you escape that? Most don't. And in the "white folks" clinics, many of the kids we see with ADHD have obviously fucked up parents/home life/recent divorce/etc. Not all, but many. It's so obvious. There's drama at home, universally. Like I said, not always, but usually.

[lowsparkco]

As mentioned earlier, those that have been abused tend to repeat the cycle and abuse their kids. The only solution is interventions that create awareness and lower the number of ACE in the next generation.

Free talk therapy would go a long way towards accomplishing that.

[californiagrown]

Likely over prescribed. Most pediatric patients on it have high ACES (adverse childhood experiences) scores.

A pill for every emotion in adults. One to wake up, one to sleep, one for depression, another for anxiety. See it every day.

If used in moderation, is there really much harm in using low doses of amphetamines like adderall/vyvanse/ritalin etc? Most literature and medical folks ive read/heard dont seem to think so, especially if used in moderation and with breaks every so often.


I love the fact that there is a pill out there for every emotion/feeling. What a world, and what a time to be alive. The disconnect (IMO) is treating symptoms as the first and only option instead of only falling back on pills after you have done everything feasible to treat the cause. And the second disconnect is the amount of pills being prescribed in the dosages being prescribed- pain pills shouldnt block the pain- they should barely take the edge off enough to make it barely possible to function. Same with all pills they should be minimum dosages to get a return to functionality.

[californiagrown]

People assume overweight people are lazy and don't try to exercise or control their diet.. It's not that simple. I was just adding to the discussion about obesity now having evidence of genetics, hereditary..

Fat shaming is not comparable, and is borderline offensive to equate to opioid addiction (which is what you did by bringing it up out of the blue in this thread). There is a large movement celebrating being big and "Healthy at any size"... no one in their right mind would start a movement "Healthy with a heroin addiction" and be celebrated because sucking dick for heroin or pills and literally rotting away is a whole nother fucking level of bad than being unable to button your pants because you can't not eat a whole tray of oreos.


Show me the obese people sucking dick, living on the street, committing crime and losing everything because of a dependence on inhaling excess calories. Ill wait.

[Trackhead]

If used in moderation, is there really much harm in using low doses of amphetamines like adderall/vyvanse/ritalin etc? Most literature and medical folks ive read/heard dont seem to think so, especially if used in moderation and with breaks every so often.


I love the fact that there is a pill out there for every emotion/feeling. What a world, and what a time to be alive. The disconnect (IMO) is treating symptoms as the first and only option instead of only falling back on pills after you have done everything feasible to treat the cause. And the second disconnect is the amount of pills being prescribed in the dosages being prescribed- pain pills shouldnt block the pain- they should barely take the edge off enough to make it barely possible to function. Same with all pills they should be minimum dosages to get a return to functionality.

Amphetamines, like opioids and benzodiazepines, require escalating doses for the same “effect”. Some folks are stable at the same dose for years, others not. Question is, do you really want 10% of the population on drugs that alter brain chemistry? Is that the answer?

[californiagrown]

Question is, do you really want 10% of the population on drugs that alter brain chemistry? Is that the answer?

Depends i guess. Do you think 10% or greater of the population has brain chemistry that could be improved/optomized?

I guess what im getting at is maybe its not the drugs, but the method of administration and oversight of the patient that needs the be much better regulated.

[MontuckyFried]

OK, what about Adderall? CBS just ran a piece on the current shortage and dropped the stat that 45 million people are on a monthly regimen. They interviewed a woman who is on Add for her ADHD, so is her husband and 1 of her teenage boys. Says her brain is mush without the Big-A and she just cannot function. WTF?

Talk about a gateway drug! And not just accepted in American culture, but downright encouraged! It's basically legal speed. President Trump is an Adderall junkie, which actually explains a lot, right?

This one in particular pisses me off because it's our society's way of telling people with ADHD that there's something wrong with them instead of rechanneling that into a way that works in their favor. I had a boss (a VP at a good company) with severe ADHD and he shared with me that as frustrating as it is do deal with at times, how he actually uses his frantic brain to his advantage. That dude was able to track an insane level of stuff, basically managing an entire statewide operation. Was difficult trying to keep up at times, but I was always impressed by his ability to think how he did. He chose NOT to medicate, because he said when he tried it per his doctors' insistence, it made him TOO focused on the minutiae and made it harder to be what he was best at.

I have also had friends and family with ADHD who while maybe not the best students of the traditional school path, went the trades route and thrived. In many trades, having a mind that works like that can be a distinct advantage. Who cares if those people aren't cut out to be a desk jockey that mans a cubicle mindlessly staring at a computer screen for the next 40 years? Friend told me his parents put his hyperactive ass on it when he was a kid and he HATED how it made him feel. Like he was a drugged up zombie. Sure he could concentrate, but he felt like a mindless drone. We're trying to shove square pegs into round holes. People like this have ALWAYS been around. It's just that only recently have we treated them like there's something "wrong" with them. I'm sick of our society acting like it's a disease to be squashed. /rant

[SumJongGuy]

^^^^^ Up until about 4 years ago I had the same views about ADHD and Adderall type drugs.... i.e. there's gotta be other/better behavioral/motivational methods to achieve the desired results..

Being someone who was a daily weed user over 20 years and have tried Adderall and another similar ADHD med it's my opinion that using weed daily to help focus on the tasks at hand is very VERY similar to using Adderall for the same. All the college kids are on Adderall now, just like we were all smoking weed when we were in college and beyond. Too much weed and you lose motivation but just the right amount is MONEY to learn new things and get shit done.

I decide to try a couple doses of my kids' meds before making my mind up about whether or not they were going to be a problem for us all. It's pretty much EXACTLY like weed but with a little caffeine on top of it.. WIN WIN!

Trump's still a compete ass without the drugs, same with Jr..

Point being if you're good with people using weed as a daily maintenance routine it's hard to be critical of people using other similar things for the same purpose..

[Dantheman]

Fat shaming is not comparable, and is borderline offensive to equate to opioid addiction (which is what you did by bringing it up out of the blue in this thread). There is a large movement celebrating being big and "Healthy at any size"... no one in their right mind would start a movement "Healthy with a heroin addiction" and be celebrated because sucking dick for heroin or pills and literally rotting away is a whole nother fucking level of bad than being unable to button your pants because you can't not eat a whole tray of oreos.


Show me the obese people sucking dick, living on the street, committing crime and losing everything because of a dependence on inhaling excess calories. Ill wait.

Mark my words, if we made Mt. Dew and Oreos illegal and let cartels control the supply at 100x inflated prices the 40-inch waisted among us would be stealing copper wire and sucking dick behind a Walmart dumpster within a week.