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Conservatives and the Opioid Epidemic


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#41 Traveler

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Posted 22 January 2018 - 05:18 PM

View PostAnBr, on 22 January 2018 - 05:02 PM, said:

More than that, he is Steve Beshear's son. Steve Beshear was the KY Democratic governor that implemented Kynect, the nation's most successful implementation of the ACA.
And the POGer let him stay on?
"Men occasionally stumble over the truth, but most of them pick themselves up and hurry off as if nothing had happened."-- Winston Churchill
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#42 AnBr

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Posted 22 January 2018 - 07:05 PM

If it is an elected position they would not have had a choice. I believe that Gov. Steve Beshear was term limited, otherwise popular.
“Trump’s a stupid man’s idea of a smart person, a poor man’s idea of a rich person & a weak man’s idea of a strong man.”

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“One of the saddest lessons of history is this: If we've been bamboozled long enough, we tend to reject any evidence of the bamboozle. We’re no longer interested in finding out the truth. The bamboozle has captured us. It's simply too painful to acknowledge, even to ourselves, that we’ve been taken. Once you give a charlatan power over you, you almost never get it back.”

— Carl Sagan


Pray for Trump: Psalm 109:8

"Science is more than a body of knowledge; it is a way of thinking. I have a foreboding of an America in my children's or grandchildren's time - when the United States is a service and information economy; when nearly all the key manufacturing industries have slipped away to other countries; when awesome technological powers arc in the hands of a very few, and no one representing the public interest can even grasp the issues; when the people have lost the ability to set their own agendas or knowledgeably question those in authority; when, clutching our crystals and nervously consulting our horoscopes, our critical faculties in decline, unable to distinguish between what feels good and what's true, we slide, almost without noticing, back into superstition and darkness.

— Carl Sagan
The Demon-Haunted World: Science as a Candle in the Dark
1995


“As democracy is perfected, the office of president represents, more and more closely, the inner soul of the people. On some great and glorious day the plain folks of the land will reach their heart's desire at last and the White House will be adorned by a downright moron.”

— H.L. Mencken
On Politics: A Carnival of Buncombe


“The test of our progress is not whether we add more to the abundance of those who have much; it is whether we provide enough for those who have too little.”

— Franklin Delano Roosevelt
Second inaugural address January, 1937

#43 D. C. Sessions

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Posted 22 January 2018 - 07:45 PM

View PostTraveler, on 22 January 2018 - 05:18 PM, said:

477/6yr/capita? That comes to 80/yr/capita in my math.

Yup. Too much electrodynamics lately, so things are getting divided by two everywhere.
The way a lot of catastrophes happen is that X doesn't occur because there are safeguards in place, therefore people assume X isn't a worry and they remove the safeguards. Then X happens.
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"Robots aren't the problem. Capitalism is." -- Last words of Stephen Hawking.
These days, "libertarian" is just a euphemism for a Nazi who's afraid to commit.
"If you're not outraged, you're not paying attention." -- Heather Heyer
"I'd rather have my child, but by golly, if I gotta give her up, we're gonna make it count." -- Her mother
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#44 LFC

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Posted 23 January 2018 - 11:11 AM

To all those who voted for Trump or any other Republican who is suffering or having loved ones suffering from this horrible addiction, here's what you voted for. Please don't whine that "the government" does nothing for you. You voted for the party most dedicated to doing the least about it. You're on your own.

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The Republican-led Congress has turned the work of the president's opioid commission into a "charade" and a "sham," a member of the panel told CNN.

"Everyone is willing to tolerate the intolerable -- and not do anything about it," said former Democratic Rep. Patrick Kennedy, who was one of six members appointed to the bipartisan commission in March. "I'm as cynical as I've ever been about this stuff."

President Donald Trump declared the opioid epidemic a 90-day public health emergency in October, but did not make any new funding available. In November the president said he would donate his third quarter salary to the Department of Health and Human Services to help fight the crisis.

Critics say the declaration did virtually nothing to change the status quo and that overdose deaths have continued to mount in the months since. The public health emergency declaration was, in fact, set to expire on January 23, but as the government was headed toward a shut down on Friday, Acting Secretary of the Department of Health and Human Services Eric Hargan renewed the national public health emergency for another 90 days.

"This and the administration's other efforts to address the epidemic are tantamount to reshuffling chairs on the Titanic," said Kennedy. "The emergency declaration has accomplished little because there's no funding behind it. You can't expect to stem the tide of a public health crisis that is claiming over 64,000 lives per year without putting your money where your mouth is."

CNN sought to catch up with the six members of the opioid commission, including former New Jersey Governor Chris Christie who headed the panel, about their views on progress made and what more needs to be done. We also wanted to speak with Kellyanne Conway, the White House's point person on the opioid crisis.

Only Kennedy and Bertha K. Madras, a deputy director of the White House Office of National Drug Control Policy during the George W. Bush administration, agreed to speak.

With the recent government shutdown, Kennedy blasted Trump for "playing politics instead of pursuing solutions for issues that impact the lives of Americans."

"For people and families struggling with addiction in this epidemic, it's essentially been a government shutdown from the start," he said.

Kennedy has become a fervent advocate for people with addiction issues, opening up about his own struggles with drugs and alcohol in recent years and pushing for better treatment programs around the nation.

His fiery passion was on display in a wide-ranging 30-minute phone interview with CNN. At one point, he deepened his voice and gave a full-throttled impersonation of Trump, saying the president gave a "great, great speech" in declaring the public health emergency and then did "nothing." Other times, Kennedy grew starkly serious about the gravity of the epidemic and the more than 500,000 lives lost to overdoses since 2000.

"Forget the crumbling infrastructure," Kennedy said, "we're losing this country from the inside out."

He paused. "Now, you're going to ask me how I really feel," he said.


Lots more on Trump's failure on this issue. Of course the White House, ever classy under Trump, tried to take credit for shit it didn't do.

Quote

When asked what actions the administration has taken since the declaration was made, the White House's Office of National Drug Control Policy provided a list of 30 actions that the Trump Administration has taken to respond to the opioid crisis. Just four of these measures were enacted after the declaration, and even those were already on-going efforts.

Traditionally, the Office of National Drug Control Policy coordinates the White House's drug policies, but it has been without a permanent director since Trump came into office.

In fact, one of the actions that the administration lists is $485 million in grants, funding that was approved under the 21st Century Cures Act that was signed into law by President Barack Obama.

" 'Individual conscience' means that women only get contraceptives if their employers, their physicians, their pharmacists, their husbands and/or fathers, pastors, and possibly their mayors, Governors, State Secretaries of Health, Congressmen, Senators, and President all agree that in that particular case they're justifiable." --D.C. Sessions

"That's the problem with being implacable foes - no one has any incentive to treat you as anything more than an obstacle to be overcome."

"The 'Road to Serfdom' is really all right turns." --Progressive Whisperer

""The GOP ... where every accusation is also a confession." --Progressive Whisperer

#45 Traveler

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Posted 23 January 2018 - 11:23 AM

I think we should pay more attention to the failures of the FDA during Bush and Obama's administration. I never thought about it till this morning when it came up on the news.
"Men occasionally stumble over the truth, but most of them pick themselves up and hurry off as if nothing had happened."-- Winston Churchill
"Anyone who has the power to make you believe absurdities has the power to make you commit injustices" Voltaire

#46 LFC

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Posted 23 January 2018 - 01:32 PM

View PostTraveler, on 23 January 2018 - 11:23 AM, said:

I think we should pay more attention to the failures of the FDA during Bush and Obama's administration. I never thought about it till this morning when it came up on the news.

I'd only agree if the failures give us insight into what we need to do now. The crisis exists. There are paths forward. Actions can be taken to move us down these paths. And we're in the process of standing still.
" 'Individual conscience' means that women only get contraceptives if their employers, their physicians, their pharmacists, their husbands and/or fathers, pastors, and possibly their mayors, Governors, State Secretaries of Health, Congressmen, Senators, and President all agree that in that particular case they're justifiable." --D.C. Sessions

"That's the problem with being implacable foes - no one has any incentive to treat you as anything more than an obstacle to be overcome."

"The 'Road to Serfdom' is really all right turns." --Progressive Whisperer

""The GOP ... where every accusation is also a confession." --Progressive Whisperer

#47 AnBr

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Posted 23 January 2018 - 09:12 PM

View PostTraveler, on 23 January 2018 - 11:23 AM, said:

I think we should pay more attention to the failures of the FDA during Bush and Obama's administration. I never thought about it till this morning when it came up on the news.

Quote

The United States is in the midst of the worst drug crisis in its history

This struck me as being a little naïve given the huge opium addiction problem of Civil War veterans. I stumbled on this when looking for a source. https://journalofthe...ion-gilded-age/
“Trump’s a stupid man’s idea of a smart person, a poor man’s idea of a rich person & a weak man’s idea of a strong man.”

— Fran Lebowitz


“One of the saddest lessons of history is this: If we've been bamboozled long enough, we tend to reject any evidence of the bamboozle. We’re no longer interested in finding out the truth. The bamboozle has captured us. It's simply too painful to acknowledge, even to ourselves, that we’ve been taken. Once you give a charlatan power over you, you almost never get it back.”

— Carl Sagan


Pray for Trump: Psalm 109:8

"Science is more than a body of knowledge; it is a way of thinking. I have a foreboding of an America in my children's or grandchildren's time - when the United States is a service and information economy; when nearly all the key manufacturing industries have slipped away to other countries; when awesome technological powers arc in the hands of a very few, and no one representing the public interest can even grasp the issues; when the people have lost the ability to set their own agendas or knowledgeably question those in authority; when, clutching our crystals and nervously consulting our horoscopes, our critical faculties in decline, unable to distinguish between what feels good and what's true, we slide, almost without noticing, back into superstition and darkness.

— Carl Sagan
The Demon-Haunted World: Science as a Candle in the Dark
1995


“As democracy is perfected, the office of president represents, more and more closely, the inner soul of the people. On some great and glorious day the plain folks of the land will reach their heart's desire at last and the White House will be adorned by a downright moron.”

— H.L. Mencken
On Politics: A Carnival of Buncombe


“The test of our progress is not whether we add more to the abundance of those who have much; it is whether we provide enough for those who have too little.”

— Franklin Delano Roosevelt
Second inaugural address January, 1937

#48 Practical Girl

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Posted 23 January 2018 - 09:32 PM

AnBr, "worst in history" has taken on a farcical meaning in the Trump world.

But let's not forget- in the Gilded Age, there weren't private prisons who needed all those white people to pay the rent. We didn't have huge court organizations- probation all the way up to trials-that rely on wealthy, panicked people to pay the rent. We didn't have cops who staked out known, even large drug dealing organizations and did nothing but arrest addicts, who often have nothing on them but that the $10-$20 could buy.

Naive? I don't think so. Worst in history? I still don't know. Nobody does. But unfortunately, we have a system to pay for. And a lot of people do, while the dealers and the manufacturers stay scot free.

EDIT: Further thought: the prisons couldn't care less about the color of the person, along as the state gets paid.
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--- On September 17, 1787, as Benjamin Franklin was leaving the deliberations of the Constitutional Convention, at Independence Hall, in Philadelphia, a woman called out to him, saying, “Well, Doctor, what have we got, a republic or a monarchy?”
“A republic,” Franklin said, “if you can keep it.”


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#49 Progressive whisperer

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Posted 24 January 2018 - 09:23 AM

View PostPractical Girl, on 23 January 2018 - 09:32 PM, said:

AnBr, "worst in history" has taken on a farcical meaning in the Trump world.

But let's not forget- in the Gilded Age, there weren't private prisons who needed all those white people to pay the rent. We didn't have huge court organizations- probation all the way up to trials-that rely on wealthy, panicked people to pay the rent. We didn't have cops who staked out known, even large drug dealing organizations and did nothing but arrest addicts, who often have nothing on them but that the $10-$20 could buy.

Naive? I don't think so. Worst in history? I still don't know. Nobody does. But unfortunately, we have a system to pay for. And a lot of people do, while the dealers and the manufacturers stay scot free.

EDIT: Further thought: the prisons couldn't care less about the color of the person, along as the state gets paid.

Prisons (or the state that sends inmates to them) only care in that if they treat too many white people like they treat POC they will provoke a backlash that costs money or power. As long as it’s mostly “them” and a few bad apples among “us” going to jail, there is no issue.

Trump delenda est.
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#50 Practical Girl

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Posted 24 January 2018 - 10:10 AM

A good article on the racial divide in our prisons. It's a bit of a truism- white folks get rehab, black folks get jail. But that's missing the main component- money. Truth, is that money talks. If a family has enough money to spend 5 figures on good legal advice, and then a whole lot more. all the hoops like rehab and counseling and after care and sober living and diversion programs and probation fees and court fees?

Much more likely to avoid jail/prison. Much more likely to have a life, after, that isn't destroyed by a felony, criminal. record. Pay for records suppression- that costs. White or black- if you don't have the money to pay the system, you're likely going down. Lots and lots of white people in this mess. Prison couldn't give one whit about "among us" or whatever, They only care about money. But I admit that more white people have this ability to pay. The court system AND the law enforcement systems do, as well.
Every woman needs a blowtorch.
---Julia Child


--- On September 17, 1787, as Benjamin Franklin was leaving the deliberations of the Constitutional Convention, at Independence Hall, in Philadelphia, a woman called out to him, saying, “Well, Doctor, what have we got, a republic or a monarchy?”
“A republic,” Franklin said, “if you can keep it.”


--- LFC, on Gorsuch ruling: "Awesome. A Christianist who swore an oath to uphold the laws of the nation and bore false witness when he did it"

--- "Write hard and clear about what hurts"
Ernest Hemingway

#51 D. C. Sessions

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Posted 24 January 2018 - 10:37 AM

View PostPractical Girl, on 24 January 2018 - 10:10 AM, said:

They only care about money. But I admit that more white people have this ability to pay. The court system AND the law enforcement systems do, as well.

Yes and no. Oh, at the back end of the process money makes a big difference. At the front? Color makes a huge difference, e.g. the black Florida State Attorney who was pulled over for DWB -- and the fact that the car was an upscale late model if anything made her more likely to get pulled over. That's not a new story, either; same thing happened to an LA official who later admitted that it was a routine occurance. African-Americans in the USA use neither more nor less in the way of illegal drugs than "whites," but the are stopped more often, those stopped are more likely to be arrested, those arrested are more likely to be charged. Somewhere around the "charge" step is where the money really starts to matter. Of course, the systems -- formal or informal -- like New York's, where cops are allowed a budget of "get out of jail free cards" move some people into the earlier ranks. How much of that depends on money instead of which church you attend is another matter.
The way a lot of catastrophes happen is that X doesn't occur because there are safeguards in place, therefore people assume X isn't a worry and they remove the safeguards. Then X happens.
— Nate Silver
"Robots aren't the problem. Capitalism is." -- Last words of Stephen Hawking.
These days, "libertarian" is just a euphemism for a Nazi who's afraid to commit.
"If you're not outraged, you're not paying attention." -- Heather Heyer
"I'd rather have my child, but by golly, if I gotta give her up, we're gonna make it count." -- Her mother
"Your purpose, then, plainly stated, is that you will destroy the Government, unless you be allowed to construe and enforce the Constitution as you please, on all points in dispute between you and us. You will rule or ruin in all events." -- some RINO

#52 Practical Girl

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Posted 24 January 2018 - 11:09 AM

Quote

"African-Americans in the USA use neither more nor less in the way of illegal drugs than "whites,"

It's sort of a "pinhead". White people have been dying/OD-ing at a faster clip the POC, mainly because this has been a question of opioid painkillers, vs street drugs. Whites are still #1, but now that the street drugs are overtaking, it's anybody's guess.
Every woman needs a blowtorch.
---Julia Child


--- On September 17, 1787, as Benjamin Franklin was leaving the deliberations of the Constitutional Convention, at Independence Hall, in Philadelphia, a woman called out to him, saying, “Well, Doctor, what have we got, a republic or a monarchy?”
“A republic,” Franklin said, “if you can keep it.”


--- LFC, on Gorsuch ruling: "Awesome. A Christianist who swore an oath to uphold the laws of the nation and bore false witness when he did it"

--- "Write hard and clear about what hurts"
Ernest Hemingway

#53 Progressive whisperer

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Posted 24 January 2018 - 11:18 AM

The money matters because it affords better lawyers. That matters early because why charge someone who can afford a really good lawyer who will not only get them off but also maybe cause problems for the department by raising a fuss (sue over procedure, bring negative attention, call in favors from politiatians with oversight on the department). This slides into power - influence as well as money, and white people clearly tend more toward all of the above.

Trump delenda est.
GOP delenda est.
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#54 LFC

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Posted 24 January 2018 - 11:52 AM

View PostD. C. Sessions, on 24 January 2018 - 10:37 AM, said:

Color makes a huge difference, e.g. the black Florida State Attorney who was pulled over for DWB -- and the fact that the car was an upscale late model if anything made her more likely to get pulled over. That's not a new story, either; same thing happened to an LA official who later admitted that it was a routine occurance.

NYC's "Stop & Frisk" was statistically shown to be racist. People of color were stopped and frisked more often but the hit rate for illegal items was higher for the whites stopped. Crazy Rudy, of course, just LOVED this program.
" 'Individual conscience' means that women only get contraceptives if their employers, their physicians, their pharmacists, their husbands and/or fathers, pastors, and possibly their mayors, Governors, State Secretaries of Health, Congressmen, Senators, and President all agree that in that particular case they're justifiable." --D.C. Sessions

"That's the problem with being implacable foes - no one has any incentive to treat you as anything more than an obstacle to be overcome."

"The 'Road to Serfdom' is really all right turns." --Progressive Whisperer

""The GOP ... where every accusation is also a confession." --Progressive Whisperer

#55 LFC

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Posted 25 January 2018 - 05:16 PM

View PostLFC, on 14 January 2018 - 01:09 PM, said:

Looks like one of Trump's "best people" is now on the job!

Looks like one of Trump's "best people" is already OUT of a job!

Quote

The inexperienced 24-year-old who quickly ascended from Trump campaign volunteer to the highest levels of the White House’s Office of National Drug Control Policy (ONDCP) will leave that office by the end of the month, the White House confirmed to the Washington Post Wednesday night.

The Post first profiled Taylor Weyeneth 11 days ago, reporting based on public records requests that his resumes misleadingly included a masters degree from Fordham University (one he never completed) and a claim that he’d worked at a New York law firm for eight months longer than he had (he was “discharged” after not showing up for work), among other irregularities.

Weyeneth joined the ONDCP, the director of which is known as the White House’s “drug czar,” in March, from a job at the Treasury Department, where he’d begun shortly after Trump’s inauguration. Having graduated from St. John’s University in May 2016, the Post reported, Weyeneth’s only professional experience after college had been with the Trump campaign.

Within months, due to staff turnover and vacancies, the Post reported, Weyeneth was named deputy chief of staff of the office. According to a memo from Jan. 3 of this year, his responsibilities in that role included covering for the vacant chief of staff role, along with the office’s acting director — the drug czar himself.

" 'Individual conscience' means that women only get contraceptives if their employers, their physicians, their pharmacists, their husbands and/or fathers, pastors, and possibly their mayors, Governors, State Secretaries of Health, Congressmen, Senators, and President all agree that in that particular case they're justifiable." --D.C. Sessions

"That's the problem with being implacable foes - no one has any incentive to treat you as anything more than an obstacle to be overcome."

"The 'Road to Serfdom' is really all right turns." --Progressive Whisperer

""The GOP ... where every accusation is also a confession." --Progressive Whisperer

#56 golden_valley

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Posted 29 January 2018 - 03:55 PM

This American living in Germany writes about her surgery for which she was given ibuprofen, not any opioids, for post op pain. She followed doctor's recommendations to rest and ended up taking 2 ibuprofen. Reading it makes me wonder if Americans just want to erase discomfort in lieu of resting to let the body heal. Is there a cultural component to opioid abuse in the US...a version of the need for instant gratification?

#57 andydp

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Posted 29 January 2018 - 08:23 PM

I agree. I had hand surgery done 2 years ago. Got a four day supply of OxyContin. Didn’t really need anything that heavy after day one. Went to one overnight dose. By third day I had stopped the oxy.
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#58 D. C. Sessions

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Posted 29 January 2018 - 09:14 PM

The thing is, you don't know what people will need. I had to fight the night nurse to make her let me sleep instead of waking me to give me pain control after a leg fracture and never needed anything after that, the tendon rebuild, or the new knee.

Plenty of others are reporting that their prosthetic knees are causing serious pain after a month or more.

Finally, the local pain pharmacologist tells me that opiates and opioids are only really good for acute pain. The body adjusts to that and then they're less and less effective. Ibuprofen has limits, but it works year after year.
The way a lot of catastrophes happen is that X doesn't occur because there are safeguards in place, therefore people assume X isn't a worry and they remove the safeguards. Then X happens.
— Nate Silver
"Robots aren't the problem. Capitalism is." -- Last words of Stephen Hawking.
These days, "libertarian" is just a euphemism for a Nazi who's afraid to commit.
"If you're not outraged, you're not paying attention." -- Heather Heyer
"I'd rather have my child, but by golly, if I gotta give her up, we're gonna make it count." -- Her mother
"Your purpose, then, plainly stated, is that you will destroy the Government, unless you be allowed to construe and enforce the Constitution as you please, on all points in dispute between you and us. You will rule or ruin in all events." -- some RINO

#59 J-CA

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Posted 30 January 2018 - 09:47 PM

View PostTraveler, on 23 January 2018 - 11:23 AM, said:

I think we should pay more attention to the failures of the FDA during Bush and Obama's administration. I never thought about it till this morning when it came up on the news.
The "neoliberalism" thing in here is a bit hard to take. Narcotics made a comeback here in Canada too and have caused problems. It is convenient to say now that the approval of oxycontin and subsequent drugs was some plot all about corporate profit but if you travel back in time what you actually find is industry and patient advocates scolding regulators for prioritizing clinical issues over the suffering of people in pain. Some variation of "won't somebody think of the children" pleading.
The real start was in 1987, Morphine Sulfate was approved and subsequently not a noticeable problem, this undermines the argument that somehow the root cause of the problem was the Clinton-era legal changes - the notion that the FDA makes decisions based on their funding sources is at best simplistic, I suspect it is intentionally used as an ad hominem.
There are institutional problems in pretty much any regulatory environment that makes the status quo bias infuriating, but when the status quo bias saves us all from a new drug that is rejected we never hear about that triumph, it cuts both ways.

I think that it is funny that the article above links to this study saying it is demonstrating a lack of evidence that opioids work (my bolding):
http://www.cmaj.ca/content/174/11/1589

Quote


Results: Included were 41 randomized trials involving 6019 patients: 80% of the patients had nociceptive pain (osteoarthritis, rheumatoid arthritis or back pain); 12%, neuropathic pain (postherpetic neuralgia, diabetic neuropathy or phantom limb pain); 7%, fibromyalgia; and 1%, mixed pain. The methodological quality of 87% of the studies was high. The opioids studied were classified as weak (tramadol, propoxyphene, codeine) or strong (morphine, oxycodone). Average duration of treatment was 5 (range 1–16) weeks. Dropout rates averaged 33% in the opioid groups and 38% in the placebo groups. Opioids were more effective than placebo for both pain and functional outcomes in patients with nociceptive or neuropathic pain or fibromyalgia. Strong, but not weak, opioids were significantly superior to naproxen and nortriptyline, and only for pain relief. Among the side effects of opioids, only constipation and nausea were clinically and statistically significant.

Interpretation: Weak and strong opioids outperformed placebo for pain and function in all types of CNCP. Other drugs produced better functional outcomes than opioids, whereas for pain relief they were outperformed only by strong opioids. Despite the relative shortness of the trials, more than one-third of the participants abandoned treatment

Shorter interpretation: Strong opioids work.
The whole problem would be a lot easier to solve if they didn't work!
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#60 indy

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Posted 31 January 2018 - 09:19 AM

Like most issues in the public sphere, there is enough blame to spread around. It's mostly a useless exercise but we like to do it because hindsight makes us all look good in our criticisms.

When 21 million pills are shipped to a town of 2900 without anyone really noticing, one thing we can say for sure though is that things are definitely broken right now.





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