Tag: opioid epidemic

Facts and Feistiness, vs. Fake Feelings?


The Cabinet meeting this Monday was chock full of facts and feistiness. As a matter of fact, of a whole series of interconnected facts, the American people are experiencing the tangible benefit of electing a politician who actually takes his campaign promises deadly seriously. I commend the whole transcript or the video to your consideration.

One sample of facts and feistiness especially struck me: there has been a substantial, real reduction in overdose deaths for the first time in 30 years! For those scoring the presidential game at home, a president gets a maximum of eight years, and the two big parties do tend to fall in and out of favor, or vary in the quality of their bench, so we already know this is a bipartisan milestone. 2018 minus 30 takes us back to 1988, which just happens to be the last year of President Reagan’s administration, if my math is correct.

You remember President Reagan, and all the sophisticated snark about Nancy Reagan’s “Just Say No” (to drugs). Oh, that program continued on under its own inertia for a few years into the 1990s, but there was new thinking with new presidents: President Bush the First, President Clinton, President Bush the Second, President Obama.* Now we have a doer for president, who won on the basis of appealing to forgotten and discounted people in some of the places hardest hit by the opioid epidemic.

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Well for me this was a first.  This morning I took the wife for her initial visit to a neurosurgeon, his hair was just beginning to gray.  He has a good reputation, is part of the Vanderbilt system, and his medical questions and the way he conducted the exam I appreciated.  His plans for follow-up and […]

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On this AEI Events Podcast, AEI welcomes Sen. Mike Lee (R-UT) alongside an esteemed panel to discuss “The Numbers Behind the Opioid Epidemic,” a report from the Joint Economic Committee’s Social Capital Project.

The Social Capital Project of the Joint Economic Committee is a multiyear research effort investigating the quality of the nation’s associational life — a term applied to the web of social relationships such as families, communities, and workplaces. A recent report from the project titled “The Numbers Behind the Opioid Crisis” suggests that a focus on economic sources of despair is unlikely to be productive and that social disrepair is the stronger force.

FDA Asks Diarrhea Treatment to Contain Itself


Over a year ago, I noted that both the DEA and NIDA had expressed concern over the diarrhea treatment loperamide, widely known by the brand name Imodium. Loperamide is an opioid that, with normal use, mostly stays in the gut where it belongs, but which, if it’s taken in massive doses or combined with a P-glycoprotein inhibitor, works its way into the bloodstream and crosses the blood-brain barrier for a pathetic sort of high. Or, if you believe methadone treatment works, the high becomes somewhat less pathetic: loperamide has gotten a reputation among addicts as the poor man’s methadone, a means of easing withdrawal for those done with the dope.

One reason methadone is supposed to work as an addiction treatment is that it’s metabolized so slowly. It has an extremely long half-life (15-55 hours) compared to heroin’s (2-3 minutes). This smooths out the highs and lows to help those treated establish a normal life. Since methadone treatment is dispensed at clinics, not by pushers, it redirects addicts’ dependency toward authorized channels, which regularizes their life in another way. Loperamide has a half-life between heroin’s and methadone’s (9-14 hours). That half-life makes loperamide tempting as “DIY methadone treatment”.

This week on Banter, Representative Greg Walden (R–OR) joins the show to discuss the opioid epidemic and how Congress is addressing the crisis. Rep. Walden is the Chairman of the House Committee on Energy and Commerce. He keynoted an event at AEI hosted by AEI Resident Scholar Sally Satel on addressing the opioid epidemic.

This is the first installment of a series on “Bridging the Dignity Divide.” Over the next six weeks, Banter guests will address topics such as ending the opioid epidemic, expanding career and technical education, reintegrating the incarcerated into society, and promoting work and family formation to overcome poverty. This series is part of a broader institutional push to help close the dignity gap by creating a culture and economy where everyone is needed. The links below provide more information on AEI’s work promoting dignity.

In this AEI Events Podcast, AEI’s Sally Satel and Nicholas Eberstadt join a distinguished panel to begin a series of conversations addressing the opioid crisis ravaging the nation. The panel discussion touches the cultural factors underpinning today’s crisis, the social, cultural, economic factors driving overdose deaths, and the role of the federal government to provide treatment and prevent overdose.

Panelists include Christopher Caldwell (The Weekly Standard), Nicholas Eberstadt (AEI), Harold Pollack (University of Chicago), and Danny Seiden (Office of the Governor, Arizona). The discussion is moderated by Sally Satel (AEI).

Dreamland – A Review


Billed as “the true tale of America’s Opiate epidemic,” Sam Quinones’s Dreamland is a pretty quick read considering it’s about 350 pages. The blurbs on the back promise “expert storytelling,” and I suppose it is. The storytelling is good enough to make me wonder how heavily Quinones selected for stuff that would make a good story, while other stuff, equally true and relevant, but less dramatic, got discarded along the way. Quinones focuses on the marketing of OxyContin as a safe prescription drug, its subsequent abuse, the spread of a new means of dealing black tar heroin, and the connection between these, telling the tale of several colorful characters along the way.

To Quinones, the spread of opiate use to white America – not just to impoverished “rust belt” regions, but also to the offspring of the wealthy, managerial class – is fraught with moral meaning, though perhaps contradictory moral meaning. Heroin tempts us when we’re too wealthy, when we’re too poor, because we feel entitled to pain relief, because we don’t feel entitled to stop when it hurts but instead succumb to pressure to tough it out by any means necessary; it tempts us when we’re underwhelmed by life, it tempts us when we’re overwhelmed… Opiates are both the new party drug and the new drug of social isolation… Addiction is simultaneously a moral indictment of American consumerist excess during the pre-crash boom, a testament to post-crash misery, and an illness which deserves less moral stigma than it gets. Forgive me for suspecting at times that, to Quinones, opiates serve mostly as a random moral generator.

Which isn’t to say Dreamland is a bad book. There seems to be plenty of impressive journalism in here, crime journalism especially, although the science journalism falls rather short: there are multiple errors in describing how drugs are metabolized; in describing the drugs derived from the opium poppy (in particular, using “the morphine molecule” as shorthand for all of them); and sometimes there’s just illiterate wording, like calling what’s not statistical mechanics “statistical mechanics” or calling a lumbar sprain “a sprained lumbar” (a sprained lumbar… what?). Still, for someone like me – someone who uses opioids conservatively as part of a pain-management regimen, considering them a not-very-fun occasional treatment reserved for pain that inhibits productivity even more than being doped up would – Dreamland is a tour of a world Quinones, if his story is to be believed, claims I could easily have become a part of, yet haven’t.

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Fire and Ice Bernie Sanders and Donald Trump couldn’t be more different, yet they have much in common. Both ran for the nomination of parties in which they are not real members. Both men recognized better than 20 competitors the brazen corruption of elites in Washington DC, Silicon Valley, Hollywood, and the coastal metropoles that […]

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