Pain and Suffering in New England

 

imageHere in New England, it’s hard to get through a news cycle without at least one mention of the region’s opioid epidemic. Every media outlet covers it; governors are creating task forces faster than you can count; and the presidential candidates expect daily questions on the matter, often from parents who lost a child to an overdose. (Notably, Jeb Bush’s daughter has struggled with addiction for years, and Carly Fiorina’s stepdaughter died of an overdose.)

Is the problem worthy of the hype? More so than I had thought. In Massachusetts last year, there were nearly 1,100 confirmed deaths from opioid poisoning, and that number is likely to crawl higher as some investigations are completed. That’s up from 711 deaths in 2012, which constituted very nearly 30 percent of all accidental deaths in the state. Most depressingly, confirmed overdose deaths have increased every year since 2010, when the number was just 555. New Hampshire has only a fifth as many people as Massachusetts, but almost a third as many fatal cases. These rates are significantly higher than national averages.

Now, statistics like this are only a reflection of reality and often a distorted one: It’s wholly possible that the increase in the number of recorded incidents reflects, at least in part, a growing awareness of such causes of death (when you start looking for things, you tend to find them). Still, that’s a staggering number of deaths, both in absolute numbers and as a proportion of preventable deaths. I’m hesitant to use the word “epidemic” to describe things short of the Spanish Flu, but there’s a undoubtedly a very serious problem here.

One of the more interesting aspects of this is that a large and growing percentage of addicts start with prescription opioids and then progress to illegal ones. That is, they get hooked on OxyContin or similar pain killers — dangerous in itself — and then switch to heroin when their prescription runs dry or they can’t afford to refill it. (Like many folks, I know someone who got hooked on prescription narcotics. It was a mess. She’s recovered, but she had a really strong support network).

Indeed, the numbers of legal painkillers prescribed are astonishing (for a really interesting piece on pain treatment, do check out this one we published earlier this week). Via the Boston Globe, consider:

The council also received new data on prescriptions for controlled substances, such as painkillers, derived from the monitoring program. It showed that prescriptions had declined slightly in 2014, returning to 2011 levels. But the numbers remain staggering: In a state with 6.7 million people, 4.4 million opioid prescriptions — including 240 million pills, capsules, or tablets — were dispensed in 2014.

One of the more interesting responses to the crisis has been the distribution of naloxone, a drug that can reverse the effects of an opioid overdose. Though effective, safe, and available to medical professionals for more than three decades, some municipalities have experimented with distributing it widely, including to treatment facilities, police, family of addicts, and — controversially — the addicts themselves. A few years back, the police department in Quincy, Mass. spearheaded a program of training all officers to carry and administer emergency doses; they’ve saved dozens of lives locally in the last few years and have trained other departments in the region. Also controversially, the Gloucester, Mass. PD has unilaterally decided not to arrest addicts who walk in the door, and to divert them to treatment instead.

On the other hand, Massachusetts Governor Charlie Baker is considering a number of responses, including short-term involuntary treatment, restricting the number of pills that can be prescribed at any given time, and requiring pharmacies to do more reporting.

Of course, there’s only so much state and local agencies can do, and the real work is almost certainly best done by private institutions and churches. Laws and regulations might be able to mitigate the damage, but family and religion stand a much better chance of addressing the underlying human crisis.

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  1. James Madison Member
    James Madison
    @JamesMadison

    You describe the second Misery Index. The result of medically prescribed or over prescribed pain-killers.

    The first Misery Index was set forth in a book that came out last year, A Nation in Pain by Judy Foreman, documenting the poor understanding, impediments and practice of pain-killers where a patient is in need.

    Here is a synopsis – http://www.weeklystandard.com/articles/misery-index_804815.html#

    • #1
  2. Barkha Herman Inactive
    Barkha Herman
    @BarkhaHerman

    I have no experience with addiction.  No one in my family was addicted.  I had an alcoholic uncle when I was very young, but my experience with him was limited, and ended at a young enough age to be insignificant.

    I do have a lot of friends that are recovering addicts.  A young man, the same age as my daughter, who was addicted since the age of 15, once told me that will power has nothing to do with overcoming addiction.  What he attributed to getting over his addiction was community.

    Here’s an article on the famous Rat experiment:

    https://www.intellihub.com/rat-park-experiment-shows-cultural-roots-drug-addiction/

    Addiction is about pain; however it is more than about physiological pain.  Delegating the responsibility of child rearing to state is part of the problem with deteriorating communities.  Strong communities create better citizens.

    Anyway, here’s a statistics on drug use by state:

    http://interventionstrategies.com/drug-abuse-statistics-by-state/

    • #2
  3. Misthiocracy Member
    Misthiocracy
    @Misthiocracy

    Tom Meyer, Ed.: Still, that’s a staggering number of deaths, both in absolute numbers and as a proportion of preventable deaths.

    How about as a proportion of the region’s total population?

    How about when compared to “preventable deaths” in previous periods of history?

    If these people existed in previous generations, would they have lived full prosperous lives or would they simply have died from a different cause and/or vice?

    • #3
  4. Manny Member
    Manny
    @Manny

    So now can Libertarians finally get off the legalizing drug position?  Anyone that thinks that the common good is served by legalizing drugs is purely ideological.

    • #4
  5. Fred Cole Inactive
    Fred Cole
    @FredCole

    I wonder how these numbers compare
    To deaths from Tylenol overdoses.

    • #5
  6. Barkha Herman Inactive
    Barkha Herman
    @BarkhaHerman

    Manny:So now can Libertarians finally get off the legalizing drug position? Anyone that thinks that the common good is served by legalizing drugs is purely ideological.

    Are drugs legal in New England?

    • #6
  7. Bryan G. Stephens Thatcher
    Bryan G. Stephens
    @BryanGStephens

    Addiction is a horrible thing that destroys someone’s ability to be a rational actor.

    As such, I think we need to have a serious discussion not on drugs being legal, but on where the lines of liberty lay. Drug Diversion courts work, but they do so because they take away some of the liberty of the people in them. Instead of the usual conversation on legalization, how about we talk about hard choices that might help.

    • #7
  8. Annefy Member
    Annefy
    @Annefy

    There are no easy answers. On one hand, I have long condemned the enthusiasm doctors have for prescribing drugs like Ritalin to our youth. I think it starts a comfort with drugs and an attitude that there’s a medication answer to all that ails you, and pathologizes normal – but correctable – behavior

    On the other hand, I have two friends whose brother has been homeless for years. He had been a millionaire back in the 90s, wife, kids.. Large and loving family. At some point he started using crack and now he’s on the street. I don’t know him, but I read about him yesterday, the LA Times did an article about him as part of a homeless project called Project 50. (Google Paul Sigler if you’re interested). My impression is that there was probably some sort of mental illness that went undiagnosed. Or is the mental illness a result of the drug abuse? At a minimum the guy seems to be a manic depressive.

    On the other hand (I know I’m out of hands) I found myself very moved by a Chris Christie video yesterday where he spoke of a friend who died from a drug overdose. He had lost everything after getting hooked on Percocet. As CC said, to be pro life is to value that guy’s life also and to do everything thing we can to help.

    But even with a strong network and lots of help (certainly the case with CC’s friend and the brother of my friends) there is no hope for some.

    • #8
  9. PHenry Member
    PHenry
    @PHenry

    Manny:  Anyone that thinks that the common good is served by legalizing drugs is purely ideological.

    So only when it promotes the common good being served can liberty be allowed?

    Prohibition of drugs does very little to prevent abuse, as shown by this post.  However, it does further persecute and destroy the life of those users… As I have said before, prohibition essentially says ” Drug use might ruin your life.  So if we catch you using drugs, we will ruin your life.”

    To oppose prohibition is not akin to advocating use.

    • #9
  10. Annefy Member
    Annefy
    @Annefy

    I think some level of self awareness must be taught. I have always known I have an addictive personality and have avoided all drugs because of that. (As long as you don’t count nicotine.) I have a good friend who spent 40 days whacked on morphine after a car accident where he suffered burns over 40% of his body. He went through two years of skin grafts and refused morphine – he said morphine is too good, and he knew himself well enough to know that he was in danger.

    I have kids and nephews that have smoked and I never made a big deal out of it. It’s a benign method of self medication.

    • #10
  11. Mate De Inactive
    Mate De
    @MateDe

    How much is this related to the problems we have in dealing with mental health issues and homelessness? I have recently noticed more and more homeless in my city and I listen to Adam Carolla’s podcasts and he was commenting on the huge amount of homeless in LA to the point that there are entire encampments of people living under a bridge.

    The majority of homeless are mentally ill, addicts or both. There has also been a rise in the death rate of middle aged white males, in this country. These kinds of problems are societally driven, and men especially are becoming more and more marginalized and apparently this is the result.

    • #11
  12. Annefy Member
    Annefy
    @Annefy

    It is true that many of the homeless are either mentally ill or addicts.

    The mentally ill could have possibly benefited from the right medications at the right time, while the addicts were exposed to drugs (legal or illegal) and got hooked.

    No easy answers.

    • #12
  13. Larry3435 Member
    Larry3435
    @Larry3435

    It would not surprise me in the least if it turns out that the number of overdoses has risen as a result of the government’s campaign to prevent “over-prescription” of pain killers.  People in agonizing pain, who cannot get the medication they need, go to the streets to get whatever they can.  Heroin is a cheap and readily available alternative.

    The worst possible thing the government could do here is to crack down further on prescription pain killers.  And since the government will almost always address any problem by doing the worst possible thing it could do…

    • #13
  14. Fake John Galt Coolidge
    Fake John Galt
    @FakeJohnJaneGalt

    Fred Cole:I wonder how these numbers compare To deaths from Tylenol overdoses.

    I suspect they are all counted as the same to get the numbers up.

    • #14
  15. Mate De Inactive
    Mate De
    @MateDe

    Annefy:No easy answers.

    Of course there are no easy answers. But we can start by allowing men to be men. I believe that many men have just checked out. They do not thrive in school, many of them do not have good male role models in society, many of them don’t get married, and many are unemployed or may feel unproductive and unnessesary.

    I think there is a link to all of this. The feminization of the culture has lead a percentage of men to check out. Also human beings need to have a purpose in life, some meaning and the rise in secularism and godlessness I also believe has not been a benefit to American society.

    • #15
  16. Fred Cole Inactive
    Fred Cole
    @FredCole

    Fake John Galt:

    Fred Cole:I wonder how these numbers compare To deaths from Tylenol overdoses.

    I suspect they are all counted as the same to get the numbers up.

    No.  I think opiate overdoses are counted differently.

    The problem with counting acetaminophen overdoses is that the damage can be long term, and acetaminophen is in so many products that it may not be immediately clear that that’s the cause.

    • #16
  17. Manny Member
    Manny
    @Manny

    Barkha Herman:

    Manny:So now can Libertarians finally get off the legalizing drug position? Anyone that thinks that the common good is served by legalizing drugs is purely ideological.

    Are drugs legal in New England?

    Pain killers are, yes.  Further legalizing currently illegal drugs would add to the problem, probably by orders of magnitude.  The softening of pot legalization has doubled pot use in the last five years, and made the quality of the pot much more potent.

    • #17
  18. Manny Member
    Manny
    @Manny

    PHenry:

    Manny: Anyone that thinks that the common good is served by legalizing drugs is purely ideological.

    So only when it promotes the common good being served can liberty be allowed?

    Hmm, yes.  The constitution guarantees you the freedoms in the bill of rights.  Nothing else.  Everything else is open for legislation.  Legislation is a democratic process where the the community decides what is best for the common good.  Individuals don’t make laws.  Community makes laws.  And if you’re a conservative, community decides based on traditional values and past history, very long past history.

    • #18
  19. Larry3435 Member
    Larry3435
    @Larry3435

    Manny:

    Barkha Herman:

    Manny:So now can Libertarians finally get off the legalizing drug position? Anyone that thinks that the common good is served by legalizing drugs is purely ideological.

    Are drugs legal in New England?

    Pain killers are, yes. Further legalizing currently illegal drugs would add to the problem, probably by orders of magnitude. The softening of pot legalization has doubled pot use in the last five years, and made the quality of the pot much more potent.

    It has doubled pot use?  Those statistics are based on the number of pot users self-reporting to government survey-takers in jurisdictions where it is illegal?

    • #19
  20. Larry3435 Member
    Larry3435
    @Larry3435

    Manny:

    PHenry:

    Manny: Anyone that thinks that the common good is served by legalizing drugs is purely ideological.

    So only when it promotes the common good being served can liberty be allowed?

    Hmm, yes. The constitution guarantees you the freedoms in the bill of rights. Nothing else. Everything else is open for legislation. Legislation is a democratic process where the the community decides what is best for the common good. Individuals don’t make laws. Community makes laws. And if you’re a conservative, community decides based on traditional values and past history, very long past history.

    Also known as mob rule.  Well, that’s what the Second Amendment is there for.

    • #20
  21. Barkha Herman Inactive
    Barkha Herman
    @BarkhaHerman

    The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people.

    • #21
  22. PHenry Member
    PHenry
    @PHenry

    Manny: Legislation is a democratic process where the the community decides what is best for the common good.

    That is a mighty fine tyranny you advocate there!

    In the last few years, we have been told what light bulb we can buy, what size toilet tank we can have, even an attempt to say what size soda pop we can drink.   All for the ‘common good’.

    Liberty is something else, all together.  You advocate something far closer to socialism than to individual freedom.

    Manny: Further legalizing currently illegal drugs would add to the problem, probably by orders of magnitude

    Apparently, you believe there are lots of people out there who only choose not to use heroin because it is illegal, and that if made legal they would run out and get addicted?

    This gives a bit of insight in to how much you trust individuals to make their own choices.   You instead prefer the government (collective, the ‘community’ etc) to make individual choices for people, since, like children, they can’t be counted upon to make the ‘right’ choices?

    • #22
  23. Barkha Herman Inactive
    Barkha Herman
    @BarkhaHerman

    Barkha Herman:The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people.

    I did not expect this on Ricochet.

    • #23
  24. Manny Member
    Manny
    @Manny

    Barkha Herman:

    Barkha Herman:The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people.

    I did not expect this on Ricochet.

    Retained by the people means it’s open for legislative decision.  Are you saying legislators don’t have the authority to create laws?

    Otherwise, why is heroin illegal now?  Why do you need a doctor’s prescription for certain drugs?

    • #24
  25. Manny Member
    Manny
    @Manny

    PHenry:

    Manny: Legislation is a democratic process where the the community decides what is best for the common good.

    That is a mighty fine tyranny you advocate there!

    What I advocate is what the father of modern conservatism advocated:

    “The only liberty that is valuable is a liberty connected with order; that not only exists along with order and virtue, but which cannot exist at all without them. It inheres in good and steady government, as in its substance and vital principle.” – Edmund Burke

    • #25
  26. Titus Techera Contributor
    Titus Techera
    @TitusTechera

    Manny:

    PHenry:

    Manny: Legislation is a democratic process where the the community decides what is best for the common good.

    That is a mighty fine tyranny you advocate there!

    What I advocate is what the father of modern conservatism advocated:

    “The only liberty that is valuable is a liberty connected with order; that not only exists along with order and virtue, but which cannot exist at all without them. It inheres in good and steady government, as in its substance and vital principle.” – Edmund Burke

    May I interrupt briefly to note my agreement with your opinion?

    • #26
  27. PHenry Member
    PHenry
    @PHenry

    Manny: “The only liberty that is valuable is a liberty connected with order; that not only exists along with order and virtue, but which cannot exist at all without them. It inheres in good and steady government, as in its substance and vital principle.” – Edmund Burke

    So you think he is advocating legislation of morality/virtue?  Instead, I submit he is suggesting that only a moral/virtuous people can get the full benefit of that liberty.

    It is a contradiction to say that liberty is only valuable when virtue is legislated.  That isn’t liberty any more!  Its like saying you had to destroy the village in order to save it…

    • #27
  28. Manny Member
    Manny
    @Manny

    PHenry:

    Manny: “The only liberty that is valuable is a liberty connected with order; that not only exists along with order and virtue, but which cannot exist at all without them. It inheres in good and steady government, as in its substance and vital principle.” – Edmund Burke

    So you think he is advocating legislation of morality/virtue? Instead, I submit he is suggesting that only a moral/virtuous people can get the full benefit of that liberty.

    It is a contradiction to say that liberty is only valuable when virtue is legislated. That isn’t liberty any more! Its like saying you had to destroy the village in order to save it…

    There is certainly a symbiotic relationship between legislation and virtue.  Legislation does codify values.  It does create a boundary line of acceptability.  One thing I do know, you can’t have a democracy without virtue.

    • #28
  29. PHenry Member
    PHenry
    @PHenry

    Manny: One thing I do know, you can’t have a democracy without virtue.

    agree.  I just don’t believe for a minute you can create virtue with legislation!

    • #29
  30. Annefy Member
    Annefy
    @Annefy

    Manny:

    PHenry:

    Manny: “The only liberty that is valuable is a liberty connected with order; that not only exists along with order and virtue, but which cannot exist at all without them. It inheres in good and steady government, as in its substance and vital principle.” – Edmund Burke

    So you think he is advocating legislation of morality/virtue? Instead, I submit he is suggesting that only a moral/virtuous people can get the full benefit of that liberty.

    It is a contradiction to say that liberty is only valuable when virtue is legislated. That isn’t liberty any more! Its like saying you had to destroy the village in order to save it…

    There is certainly a symbiotic relationship between legislation and virtue. Legislation does codify values. It does create a boundary line of acceptability. One thing I do know, you can’t have a democracy without virtue.

    This is true. With one niece the argument is that yes, abortion may be legal but it’s not moral. So far I have made no head way, but I will keep trying.

    With a nephew the argument is that yes, pot is legal in Colorado but your employer has the right to fire you if you pop positive. Again, no head way.

    The “legality” of something seems to make them impervious to any discussion of right and wrong.

    They are young. I’d like to say there’s hope, but I despair nonetheless.

    • #30

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