Thank you Dr Matt Bivons for writing this and Matt Taibbi for publishing it.
As someone who’s been in recovery for many years now and who once had a $400 a day opioid (dilaudid) habit, I can tell you firsthand that our country has never seen an epidemic this massive or destructive. If there was another country shelling the United States a…
Thank you Dr Matt Bivons for writing this and Matt Taibbi for publishing it.
As someone who’s been in recovery for many years now and who once had a $400 a day opioid (dilaudid) habit, I can tell you firsthand that our country has never seen an epidemic this massive or destructive. If there was another country shelling the United States and killing 100,000+ citizens a year I can assure you there would be an all out scorched earth campaign against them by the US military and the public would be arm in arm in full support. But addiction is messy, shameful and still stigmatized and as a result, doesn't get the funding and priority from Washington. Since the prescription crackdown that started some years ago, the Chinese and the Mexican cartels have ramped up importing tons of poisonous fentanyl and now xylazine into our country doing irreparable damage to our communities and loved ones. Clearly we have a huge demand side in the US and I'm not downplaying that, but we desperately need to ramp up our interdiction efforts.
The Sackler family, the board of directors at Pfizer and any other executives who've been complicit in fueling and profiting from this epidemic should all be on death row right now awaiting lethal injection. These psychopaths and the companies they run are worse than war criminals….they are the modern day mass murderers and should be treated as such. If we sent these people to prison or life or to be put to death, I can promise you things in the board room, marketing departments and sales conferences would get different quick.
The families that have lost loved ones to these drugs are simply ignored by our politicians because they receive so much money from the big pharma lobbyist and its easy to stigmatize the person who's become addicted. It’s truly criminal.
Michael Shellenberger, Alex Gutentag and Leighton Woodhouse have some great articles concerning how we address the demand and treatment/recovery side of this and are all worth reading over on the Public substack .
Its clear to me that addiction must be addressed from all sides but unfortunately as a society we are falling short. Lets hope something changes so that we can turn the tide of this tragedy that continues to grow and break our hearts.
And then there are people like me, who live in serious chronic pain due to accidents that have lifelong effects, who can’t get adequate pain relief because someone somewhere might get addicted.
I took 200mg of morphine daily for years before neuroscience came along with a device that literally gave me my life back.
I told my anesthesiologist I wanted off the morphine and had a couple of months of step down, the last two weeks of which were not pleasant, and that was that.
If the device fails for some mechanical reason and it’s a weekend I am shit out of luck.
I feel for those who get addicted but I’m also outraged that people like me are assumed drug seekers.
This is a really important perspective. The opioid addiction problem started because we have a really nasty chronic pain problem. Before we start panicking about a few people getting high from these drugs we need a plan for the people who need them to live.
"The de facto legalization of heroin in some states'?
Are you referring to decriminalization? That's always been a horrible idea, a half-assed measure that has led thousands of addicts to migrate to and use publicly in those places that have adopted this stupid policy. It does nothing to police the black market sale of Fentanyl or other drugs purported to be "heroin."
What the half-measure of decriminalization + de facto impunity for retailers creates is the worst of all possible policy solutions: the monopoly over the supply is retained by criminals who benefit from the price support of illegality, with little threat that their activities will be penalized by law enforcement.
I think we can do better than simply legalizing all opioids for legal sale. But that would be an improvement over both user decrim supplied by the criminal monopoly AND a return to the sad old ineffective status quo of Drug War Prohibition. With full legalization, at least there would be a selection of opioids available that are less lethal than the ultrapowerful fentanyls.
Restricting access to pain killers for people in pain to prevent recreational users from getting their kicks is wrong. People in pain shouldn't have to be Heroisch.
Yes. A huge downside of the craze to reduce opioid prescriptions is that people who genuinely have to have them end up being denied. And just suffer. There is a move to assert other remedies (from NSAIDS to yoga) are just as good and sometimes they are, but too often not. Some people must have opioid and the addiction tradeoff is justified, far better than being in pain.
Taking prescription meds from pain patients doesn't decrease Addicts! Addiction isn't a trade off. Chronic pain patients are not Addicts. Recognize An Addict takes anything & wants more, more to get high. Recognize an Addict isn't taking med for pain . They take it to get high & their supply is Street drugs, Street Fentanyl is #1... it's cheap. But these are not chemist mixing street drugs. The street drugs may be strong, so strong it would kill an elephant. or a batch may be weak. weak. Sadly a person with addictive trait will display addictive behavior...they want to get high & constantly seek a better high
Drug Addiction like Alcoholism are disease entities.
Taking away pain meds meds, prescribed & taken as ordered is cruel. They don't seek a high...and a months supply last one month. An Addict would take a months supply in a day or two .
It would be great if we knew who has the addictive trait before they feel their first high.
Thanks to state and federal law and regulations I have little to no hope of getting help from a medical professional except my neurosurgeon or anesthesiologist if something goes wrong with the device.
For those with privacy concerns, that was thrown out the window by Trump’s administration.
Every opioid prescription goes from the physician to a state agency, at which the patient’s medical history is stored, where the prescription is approved or denied before being forwarded to the pharmacy. Some faceless bureaucrat has the final say regarding whether or not that prescription is filled. There is no appeal or even method to contact those bureaucrats or their bosses.
People trumpeting the privacy invasion of the censorship regime as if it’s something new amuse me. Where were you in 2017/2018?
You're suffering from a regime of overcompensation. And also some cognitive dissonance, as a side effect.
If there had been accountability across state lines for opioid prescriptions in the late 1990s, the Oxy problem would have been nipped in the bud, because the vast majority of it was the result of unethical script docs writing prescriptions for mass quantities to dealers who diverted it to the street market. The DEA couldn't track their own Schedule II Federally controlled substances- because regulation was left to the separate states, and some of them, like Florida and Tennessee, had practically no accountability enforcement.
Along about 2014, the Feds finally began to put a regime of accountability for opioid prescriptions in place. And, as bureaucracies so often do in the aftermath of negligence, the DEA has started off by overdoing it- cracking down on prescriptions of opioids, even to people with legitimate chronic pain needs.
That said, folks should know that opioids of one sort or another are still among the most heavily prescribed classes of drugs. Opioids aren't going anywhere; for most pain conditions, they're still the most effective painkillers out there.
Also, to be fair to Donald Trump (not Presidential material, imo) the latest Federal crackdown on opioid prescriptions actually began in the Obama era.
The current regime of "drug control" is folly stacked on top of folly. There's no need for bupenorphine prescriptions to cost hundreds of dollars a month, for instance. That's just more profiteering. The only reason why fentanyl dominates the street market is because street addicts have no other recourse. It isn't like there's some selection of milder products available in the illicit marketplace. Most street retail markets, it's fentanyl or nothing. In the 1960s, at least it was possible to purchase mild opioid cough medicines from drug stores.
The Federal government's own survey statistics indicate that about 80% of people who experiment with opioids for recreational purposes are able to walk away from them without being addicted.
I think illegality does currently put a damper on repeating experiments of that sort too frequently; I don't support full-scale legalization of all opioids. But it has to be admitted that even most recreational users are able to keep from getting addicted. It also has to be said that the massive marketplace in illicit drugs does not do ID checks, and the population most vulnerable to addiction are users who had their first exposure as teenagers.
This is exactly what brought me here to comment. I hear more and more stories of people who can't get painkillers that work when they have very painful ailments. "You may die screaming, but you'll be pure" seems like it might not be a consolation to everyone.
I'm 10 years in due to injury, Marie. I'd like to be more specific, but hell, me using my real name and all makes for public preclusion. Know for certain though, my empathy is genuine, 24/7/365. If you are getting good (sufficient) results from a TENS, that's wonderful. If it is something more sophisticated I haven't heard of, I'd sure like to be apprised if you have the inclination. Sincere best wishes to you.
TENS did nothing for me at all. The device is an implanted spinal cord stimulator and it’s been an absolute Godsend for me. It’s specific to neuropathy so it’s not for everyone but for me, it literally gave me my life back. I’m working full time, got my leg strength and balance back, and live a relatively normal life.
In the space of 14 months I went from housebound to employed, etc.
It has its downsides, life is always a trade off, but I’m glad I took the plunge.
My adult daughter has a progressive degenerative neurological disorder. She had a spinal cord stimulator, which helped her dramatically for several years. These days, she's in debilitating pain all the time. And, when she goes to refill her medications from her Palliative doc, the restrictions are odious, and she feels like "a drug seeker," although a quick glance at her medical history would belie that. I understand the INTENT of these strict guardrails for prescribers & pharmacists. But it regularly places the pain patient in a very humiliating position. I don't know the answer. But pain is pain. And we as a society need to figure it out.
I’m so sorry to hear it stopped working for your daughter. Pain like that is unimaginable to almost everyone.
I hear you about the degradation we face. Heaven forbid a voluntary addict’s behavior be criticized as it might cause “harm” while your daughter’s real and involuntary suffering is ignored.
That's really great to hear, thank you for responding. I'm still holding out hope even at this late stage of the game (for me.) It's good to know there might be options yet, I decided against fusion several years ago myself. Like you said, "It's a trade-off," and I most certainly agree. Glad to know you are doing well. Peace be yours!
I take 20 mg per day of hydrocodone, plus Lyrica and indomethacin for my pain. It is harder and harder to get my meds. And it's not like I want lots of drugs. I used to take 40 mg per day but I worked with my doctors to take less. One benefit is that I am not constipated any more.
See? That's just ignorant. They make my sister jump through hoops to get meds, & if there's a glitch & she runs out, oh well. The people making these stupid laws & regulations have no empathy whatsoever.
That’s the inevitable consequence of bureaucratic involvement I think.
My best to your sister. Neuropathic pain is beyond bad. I thought 48 hours of labor without so much as a Tylenol was as bad as it could be until my accident. How little I knew.
Reporting is so mixed up. They report as if every person given opiates/opioids will be an Addict.
Every one who takes a drink does not become an Alcoholic.
An addict seeks drugs, runs out, wants more..Always MORE, more, more.Anythingbto get high. They don't pick up a prescription. at the pharmacy
They report as if Fentanyl is a killer. Fentanyl is an old drug. It was used in OR in the 70s. Very safe in the prescribed dose.
The crisis of death , the killer opioids, are illicit, street drugs. Street Fentanyl is easy to mix but when nixed in street labs no one knows how potent a batch may be until people start dying from one pill.
Sadly an addict resorts to street drugs to stay high...street Fentanyl is cheap ,& deadly.
A chronic pain patient who receives a prescription for 30 days.. and takes meds as ordered. The prescription lasts 30 days. They are not drug addicts seeking a high....they take pain meds to have a better quality of life.
FYI if a person has the addictive trait you will know quickly...they will take anything to get high.. Alcohol, street drugs, crack ... or street Fentanyl. They don't get meds at local pharmacy! A prescription for 30 would last a day & the addict seeks more, more, more...
My sister is in chronic pain from ankylosing spondylitis, among other things, & she has a heck of a time getting pain relief. They've made it very difficult for people who actually need pain meds to get them. She's in a pain management program, & every once in a while, there's some sort of glitch with communications between the doctor's office and the pharmacy, & she's in a world of hurt while out of meds. She recently switched from Vicodin to Dilaudid.
Fair argument, but not that binary. These drugs aren't like having a drink or smoking a little weed. These kids try them and after as little as 5 days of use, they are physically addicted to them.....and they are incredibly deadly.
I have a nephew now in his 40s, he got addicted to Oxy when in middle school. My sister has lived in a guilt-ravaged world ever since. All these years of waiting for. . . . the Call. Many, many rehab attempts futile. The kids get the worst of it, their brains are sponges for Oxy addiction, they get hooked early and seemingly irrevocably. A life sentence. So fucking sad, so helpless for family.
Tolerance to opiates is built rapidly and that’s how people end up with $400/day habit just to face the day. I worked in detox and suboxone really helped but if it’s stopped, the cravings for the drug are so bad it sends detoxed people directly back to the drug when they’re released. It’s a terrible problem.
It's not so much "craving for the drug" as wanting relief from the horrible anxiety and insomnia/restlessness that comes along with withdrawal.
The depression that frequently attends detoxification leads to more use, unfortunately. One's ability to cope with this and the intensity of the desire to quit (or lack of it) determines whether one starts using again. Also, if the conditions that make using appealing are not removed (boredom, grinding poverty, existential hopelessness, no future prospects, etc.) "relapse" is likely.
The nuance to your statement is that there are circumstances within people's lives that lead to the desire to use drugs likes heroin and fentynal. They are not all rock stars who can afford the heavy usage and recovery. Some are tricked (peer pressured or enticed), coerced, come from broken families, have mental health issues similarly caused by myriad circumstances.
It's a very difficult problem to solve, if not unsolvable. I cringe in saying it's one way to chip away at the overpopulation issue. However, there are far more humane ways to mitigate that and I feel for those who lost loved ones to drug overdose/addiction. It's a terrible plague against humanity.
Two words: "Rat Park". Nobody seems to ask *why* do Americans have such an insatiable appetite for drugs?
For that matter, I understand that meth is making a comeback, and I don't think too many methheads got their start with doctor-prescribed methamphetamine. Maybe I am wrong.
I also understand that The New Hotness in opioids is "tranq" (aka Fentanyl and Xylazine), and I don't think Xylazine is approved for human use. (There's also benzo dope, which is Fentanyl mixed with benzodiazepines, and benzos can be obtained via prescription but I don't think many people got hooked on legal benzos and then decided to mix in fent).
"I don't think many people got hooked on legal benzos and then decided to mix in fent" I can tell you that's very much the case with many many addicts. Dope hopping is totally part of the addiction pathway, just like when we started drinking beer, some of us went to whiskey, or when we started using a little coke, moved to crack cocaine or meth. It's very normal for those with addiction problems to have a progression path like that.
The bigger question of "why" we have such an appetite is a topic that is vast and way outside my punt coverage. Have a great day man.
Why ? I think because we are trying to escape a very ill, toxic society with skewed values and false gods....when you have to use all of your energy to protect yourself and your children from the idiocy around you and them, it becomes an exhausting effort. One can create a loving "bubble" in ones' home, but eventually you have to send your offspring out into the madness beyond the door.....many lack the armour and coping skills to deal with what they must encounter....three quarters of a century have taught me that one clear thing......and it is not always possible to instill all the necessary things to survive....the unknowns they now face have become deadly, deadly.... as their need to experiment is the only way to truly learn a thing until they become experienced enough to recognize inherent dangers and pitfalls....our "Society " is 'culling the herd before our children are even fully born into Life. ( Excuse my diatribe)
And your point about the "ill, toxic society" is bigger than our ill, toxic society can admit: "it is no measure of health to be well-adjusted to a sick society."
Why do Americans have such an appetite for drugs? Actually, humans have a propensity for addiction--we've seen it with TV, mass media, engineered super-palatable foods, sugar, alcohol...
What's sort of unique ("exceptional" according to J. Stalin) about America is the profit machine is so finely tuned, and the sociopaths (as the author called them) at the ready to shunt the money their way.
Maybe passing criminal statutes that ended up making tens of millions of people criminals and social pariahs wasn't such a brilliant idea, hmm?
American Drug Prohibition will go down in history as a generation of parents unwittingly making war on their own children. Or a sizable fraction of them, anyway. The societal breakdown that had already taken place by 1970 is only now beginning to heal, in that respect. In the meantime, 55 years of Drug War has created iatrogenic problems that I would never have believed possible as a 20-year-old in 1975. I thought that the elders would have had more sense. It was all about Stopping Marijuana back then, can you believe it? Trying to put the toothpaste back in the tube.
The irrational,draconian regime of US drug policy is overdue for an overhaul. Our political class would still rather kick the can down the road on that. I get what that is- actual work is required, meanwhile with extremist banshees and partisan opportunists out to jump on every last rhetorical misstep and every last detail of policy change. But, it has to be done eventually. A nuanced, comprehensive overhaul of the drug laws has to be done.
A criminalized subculture of tens of millions of children laid the groundwork for the pariah subculture between the 1960s and the 1980s. But even after 25 years of underground economy and subterfuge, our opioid addiction problems were relatively minor, up until the Oxycontin era. Not negligible, but relatively minor. About on par with what they were in the late 19th century.
Oxy really did change the game in the mid-1990s. By the early 2000s, more 15 year olds were having their first (non-alcohol, non-tobacco) "drug experience" with prescription opioid pills than were trying pot. Setting aside the overdose death and addiction part and considered on a "bang for your buck" basis, hard drugs have been cheaper to get high on than pot for around the past 40 years. When Oxy first came in, a pill was cheaper than a joint of sinsemilla or a pint of whiskey. $10 for a 40mg Oxy, that was stronger than a bag of street heroin, and it lasted longer.
I keep up; I read the annual University of Michigan Monitoring The Future, SAMHSA and ONDCP surveys (none of those sites make it easy to navigate to the pages where the surveys are. I find that baffling. But all of those reports can be found online.)
One piece of good news that has been practically absent from the headlines is that most teenagers have gotten the message about how dangerous opioids are- particularly the fentanyl-tainted counterfeit pills. Teenage experimentation has dropped off drastically; it's less than 1/3 of what it was ten years ago. A fact that almost never gets mentioned by the news media. My local news reports on every high school overdose incident, but I've never once heard any news report mention that the teenage opioid user population is much, much lower than it was in the late 1990s-2015.
I'm not progressive in the slightest and I do believe there are too many people. However, before you blast me for being misanthropic, my perspective is influenced by maximizing available resources, quality of life, and real human progress - for all.
I would prefer people make better choices on their own than to dictate those choices to them. Alas, a progressive would say, "that's the problem right there."
Can we give the "stuffing words in the mouths of the partisan opposition" thing a rest, already? Inventing cheap shots is just bogus. Whichever partisan side does it.
Well, maybe not too many people, per se, but too many of the wrong kind. I'm kinda okay with idiots killing themselves and dismantling big pharma at the same time
Well, I'm not CIA. And dismantling big pharma is a much bigger priority. I don't want people to die, but the ones who can't learn a pretty simple lesson aren't worth spending much on
My son died at 25 in 2017 from an accidental Fentanyl overdose. He was many things but he definitely was not an idiot. This isn't just happening to drug users and people on the street, we've lost way too many young, smart, promising "kids next door" from this epidemic.
Okay, but I bet that fentanyl didn't come from a pharmacy. And while there was much we didn't know in 2017, we do now. Taking anything not from a pharmacy is easy enough to understand now
Unless you've lived it, you have no idea. It never ends but I have 2 daughters and a wife who all need the best version of me I can bring, so bring it I do. People always say, "Life goes on." Now I know what they mean by that statement. It will never be as full, as kind or as hopeful a life but it definitely goes on and you have two choices. I choose to live it the best I can.
Sorry you were one of the victims of pharma. Were you started on pain meds for something minor or major? I ask because I find it interesting how many minor injuries were the start of opiate addiction. I had some minor orthopedic sports related surgeries and was always offered, sometimes even pressed, to take opiates. Totally understand if you don’t want to share on a public forum btw
Thanks. It was a long and ugly road to recovery, but today my life is really good. I was prescribed them after a surgery. This was early on the the oxy days and I was terribly over prescribed by the doctor. I don't really believe it was his fault as he was listening to what the pharma reps were telling him and what the FDA was saying early on. I became physically and mentally addicted in less than 2 weeks of using them. I eventually went to buying them on street which led to a 6 year, nose down, full throttle, into the side of the mountain tail spin that almost killed me. Again, recovery is possible but not easy. My substack posts are based only on recovery as I have a passion to share that there is hope and a great life in recovery from chronic addiction. Have a great day.
Evan’s, speaking as someone who has enjoyed and/or benefited from your contributions here, may I say how glad I am you are still among us. What a harrowing battle you’ve had.
I read the book "Dope Sick." The main take-away is that for many years there were only a few people raising hell about this - or trying to draw attention to what was really happening.
One analogy might be the stock analyst who always knew Bernie Madoff was a fraud and running a Ponzi scheme. He did everything he could think of to expose him and stop him ... and was ignored over and over.
I feel like that guy with some of my Covid stories!
Thanks for sharing. Sadly I think doctors still readily advise opiates after most surgeries. That has been my experience with 3 ortho surgeries. I don’t think the risk / reward is solid for opiates after surgery. Reward: less pain for a couple weeks. Risk: addiction and corresponding life devistated , possibly death
Give me the opioids. Ive taken Percocet (5mg oxycodone) for a few weeks at a time twice due to injuries. Didn't overdo it, one or two a day. No addictive effects, tapered naturally as pain diminished.
There is addiction risk and it's a tradeoff. Med literature that I have read mentions that there are times where the addiction is a better choice than otherwise unmanageable pain. Should be between you and your doctor.
Indeed, "There are times where the addiction is a better choice than otherwise unmanageable pain. Should be between you and your doctor."
100%. Unfortunately, this fact is usually overlooked in most discussions of the "crisis."
We have a crisis of purpose and meaning, a chaotic society, and ineffectual, craven, corrupt "leaders." Opiate addiction is a symptom of this. The rate of addiction is directly proportional to the general level of despair.
All that. You and I share the same outlook on our era.
People who appoint themselves to "solve" any crisis end up stomping on other people in their zeal to craft a solution and be seen as doing such. No matter what you do to solve a problem it is guaranteed that unintended negative consequences will occur.
And on that topic, you don't often notice people that suggest doing nothing can be, though not ideal, better than any alternative.
Overregulating opioids has been utterly unfair to people who have a legitimate need for them, and pretending that other alternatives are just as good when they're not so you can reduce prescription numbers and thus claim "success" at the expense of inflicting pain on other people is a crime.
Good you know your limits. Personally I never had a problem. In fact I got tired of them long before 2 weeks was out and had no problem quitting.
I was burned between 5 to 10 percent of my body. Second and third degree. Even with opiates I was in pain. That is when I discovered Oxy was shite. It is like crack, you go up and crash. I had to ask for codeine, just to have the 6-8 hour relief that allowed me to sleep. The first week was hellish.
Without opiates however, I would have gone into shock from the pain. I don't believe we should keep surgical/cancer/burn patients from opiods just because someone somewhere can get addicted. Maybe we should go back to milder opiates with a longer half-life in the bloodstream.
"I became physically and mentally addicted in less than 2 weeks of using them."
Not to diminish your account of suffering, but while you may have WANTED more oxycodone once your pain was resolved ("mentally addicted" as you put it), you would have discovered that there are no withdrawal symptoms with only 2 weeks daily use.
Not everyone enjoys the opiate effect. These folks are able to stop using once their prescriptions expire.
Yes....exactly. My son was a D1 Collegiate soccer player and member of our National Team. He suffered an ACL injury in college, had surgery and became addicted to Oxycontin. He graduated and started working so had money to secure drugs once his pain medication from MD's grift ran it's course. He bought what he thought was Oxy on the street but it turned out to be fentanyl. I'm aware of at least two other HS classmates of his who have also died from fentanyl poisoning. We live in a very affluent community. Our government clearly doesn't care about this. The perps (Sackler family) are buying their way out of prison by paying fines representing a fraction of their wealth.
Thanks for sharing this Evan. I’ve got a similar situation but different experience with opioids. In 2017 I suffered a traumatic back injury, fracturing three vertebra, one of which was categorized as the worst of the burst compressions while the other two were merely bad burst compressions. I was briefly paralyzed below the waist but movement came back within and hour and full movement, sensation the next day. It occured overseas and required a med jet for extraction back to the States. I’ve seen multiple neuro’s for chronic pain, although I could be standing next to you and you wouldn’t know I was a 5 or 7 of 10- it becomes a new normal so you just carry on. I’ve been on opioids, Gabapentin, multiple muscle relaxants, prescription NSAIDs and use non THC (and sometime THC) CBD gummies. Just saw the same surgeon that did the fusion surgery for Tiger Woods last week for another opinion and still a no for any type of surgery. So more PT and my mini pharma of drugs for like
Back in 2017, all the fuss about opioids hadn’t peaked and I left the receiving ER with scripts for Oxy, Hydro, Tylenol III and Tramadol. I could refill any whenever I needed, up the dosage amounts, drop them, etc with no major pushback. But I’ll add that I am also a recovering alcoholic (23 years on June 4th) and sensitive to addiction issues. After settling in to a routine for pain management and just dealing with one primary doctor for my back, we dropped all the opioids but Hydrocodone 10/325 3x daily. Sometimes 4x, sometimes 5x but at the time, the Fed hadn’t tightened the screws on doctors prescribing. But that was short lived and now, I’m pretty much stuck at 3x 10/325 as my doc is very reluctant to go up in the 90 per month. Which really kind of sucks as I’ve definitely built up a tolerance and while some days are only a 2x day, I have more 4x and 5x days than 2x or 3x ones as I still work full time (outside tech sales). And trying to change out to Oxy (which I really don’t like) or try time release fentanyl patches is just not going to happen. So I’m stuck and hence have upped the NSAID use and supplement with legal and quasi legal (and totally unregulated) CBD gummies.
Where we differ and maybe it’s dosage, but I do not find Hydrocodone addictive. I am at the point where I get to experience withdrawal every month now, usually for just about a week but I start tapering off when I’m down to 6-8 pills and then reserve 2 for the last days before being out. At worst is an hour or so of stomach cramps and maybe one night of restless sleeping but I get no seeking type behavior that would have me trying to find them on the street. I had months of angst after I quit drinking, with little triggers and stuff that I’d fight through. I went through rehab and a little AA. I don’t really get anything like that with the opioids and as I mentioned, I get to quit every month for a week or so before I refill. If my doc said, “that’s it, your done” I’d be very disappointed but I wouldn’t start shooting up. I’d just no that life was going to be several degrees more painful than it had been.
In rehab I learned a lot about addiction and some of it is more habit than addiction, ie more behavioral. Not saying that is 100% with opioid users/abusers but it plays an important role. And some folks are just unwilling to change parts of their behavior they can control. Like a homeless person given the choice of a warm shelter on a cold winter night v sleeping on the street and they opt for the cold. You just can’t fix them. But for users in scenarios following a surgery or some event where short term prescribed opioids make sense for pain relief, behavioral therapy shoud be able to mitigate any addiction issues with tapering off of the medicines involved. The street abusers are gonna do what they do. Basically, there needs to be a middle ground for folks like you and I caught up in the middle of all of this. As much as I would love to drop my meds for a month or two, just to see how I could manage, I am literally afraid to do so, since there is no guarantee I could get the prescription started up again.
Understand and thank you for sharing. I just had to get to the point where I was totally off of them. I couldn't control my intake over any prolonged period of time....it would always get out of control. I just have an addictive disposition about me that I've had since I was a child. We all get to deal with these hurdles in life in the best manor that fits our situations thank goodness. Have a great night.
Nothing’s going to change as long as the C_IA is using the money for black ops just like they have been since the 50’s. In fact they’re still transporting drugs in from South America Asia Thailand and others in military jets so I’m sorry to say nothing will change as long as government benefits from the sales. For anyone interested it’s called Operation Gladio and bush sr setup the contacts and transportation while he was in the agency up until he became VP for Reagan.
Right. Those Pfizer creeps hold down innocent victims and force-feed them opiates.
I have no love for "big pharma" and its obviously unethical marketing of useless or dangerous Coof vaccines, but opiate manufacturers and doctors who prescribe them are not responsible for the large number of users, addicts and overdoses. Likewise, those who overdose on prescribed opiates are responsible for their own deaths. Those who become victims of black market dealers and their unmeasured, impure drugs are not. Relying on illegal supplies is the direct result of prohibition.
Imagine if you could have got your Dilaudid legally. You would not have paid that much to maintain your addiction and it would have been nowhere near as "messy, shameful or stigmatized."
Too true Evans W....follow the money......"Filthy Lucre" as my Mother would say....Good luck with your continued sobriety young man, you are brave....my son didn't make it out alive.
There's a 'ladder' of organization and control in all of the huge industries with corporate media and Big Pharma locked together financially where one can't survive without the other. Follow the ladder up from there and you come to the big banks, Wall Street, and government. Follow the ladder up a couple more steps and you come to the people who own the Central Banks of Europe and the Federal Reserve. They're all in on it. That's why there's no scorched Earth policy to end it, solve it, or fix it. The CIA is the world's largest drug trafficker. Those labs in Mexico, the traffickers who move the precursors to Mexico, the mules who move it across the border into the US, and the media and pharma executives all do what they do and get away with it because they're all clandestinely controlled and manipulated by the dark forces running our government's policies on behalf of the owners of the Central Banks. It sounds like a crazy conspiracy theory, but Satan literally uses Earth as his playground and his most successful lie is convincing you that he doesn't exist
"As someone who’s been in recovery for many years now and who once had a $400 a day opioid (dilaudid) habit, I can tell you firsthand that our country has never seen an epidemic this massive or destructive."
- Lol. Really? You should have "Just Said No" or gotten mandatory minimum sentencing at the very least.
"Its clear to me that addiction must be addressed from all sides but unfortunately as a society we are falling short. "
- No. Mandatory minimum sentencing.
To bad treatment/recovery was included in Obamacare. Guess some states missed out. :)
Congratulations to you for finding a way out of the addiction abyss. Someone very close to me has, is, and always will be battling an opioid addiction. From what I can tell, recovery entails a complete and very intentional rewiring of the brain. Kicking the habit is indescribably difficult, and as you wrote, compounded by inadequate professional support and above all shame. In addition to knowing someone with an opioid addiction, I live in a land where it is enabled and abetted. Every single day of my life I have to diligently avoid running an addict over. They wander through busy streets right around the corner from my house. Many have been hit and killed in my town. Many. No exaggeration. How is this happening? If you read this comment, will you please share a link or two to the articles you referenced?
Thank you Dr Matt Bivons for writing this and Matt Taibbi for publishing it.
As someone who’s been in recovery for many years now and who once had a $400 a day opioid (dilaudid) habit, I can tell you firsthand that our country has never seen an epidemic this massive or destructive. If there was another country shelling the United States and killing 100,000+ citizens a year I can assure you there would be an all out scorched earth campaign against them by the US military and the public would be arm in arm in full support. But addiction is messy, shameful and still stigmatized and as a result, doesn't get the funding and priority from Washington. Since the prescription crackdown that started some years ago, the Chinese and the Mexican cartels have ramped up importing tons of poisonous fentanyl and now xylazine into our country doing irreparable damage to our communities and loved ones. Clearly we have a huge demand side in the US and I'm not downplaying that, but we desperately need to ramp up our interdiction efforts.
The Sackler family, the board of directors at Pfizer and any other executives who've been complicit in fueling and profiting from this epidemic should all be on death row right now awaiting lethal injection. These psychopaths and the companies they run are worse than war criminals….they are the modern day mass murderers and should be treated as such. If we sent these people to prison or life or to be put to death, I can promise you things in the board room, marketing departments and sales conferences would get different quick.
The families that have lost loved ones to these drugs are simply ignored by our politicians because they receive so much money from the big pharma lobbyist and its easy to stigmatize the person who's become addicted. It’s truly criminal.
Michael Shellenberger, Alex Gutentag and Leighton Woodhouse have some great articles concerning how we address the demand and treatment/recovery side of this and are all worth reading over on the Public substack .
Its clear to me that addiction must be addressed from all sides but unfortunately as a society we are falling short. Lets hope something changes so that we can turn the tide of this tragedy that continues to grow and break our hearts.
And then there are people like me, who live in serious chronic pain due to accidents that have lifelong effects, who can’t get adequate pain relief because someone somewhere might get addicted.
I took 200mg of morphine daily for years before neuroscience came along with a device that literally gave me my life back.
I told my anesthesiologist I wanted off the morphine and had a couple of months of step down, the last two weeks of which were not pleasant, and that was that.
If the device fails for some mechanical reason and it’s a weekend I am shit out of luck.
I feel for those who get addicted but I’m also outraged that people like me are assumed drug seekers.
This is a really important perspective. The opioid addiction problem started because we have a really nasty chronic pain problem. Before we start panicking about a few people getting high from these drugs we need a plan for the people who need them to live.
The de facto legalization of heroin in some states while prescription opioids are treated like Pu-239 is baffling.
It makes me think the addiction excuse is a veil for something else.
"The de facto legalization of heroin in some states'?
Are you referring to decriminalization? That's always been a horrible idea, a half-assed measure that has led thousands of addicts to migrate to and use publicly in those places that have adopted this stupid policy. It does nothing to police the black market sale of Fentanyl or other drugs purported to be "heroin."
What the half-measure of decriminalization + de facto impunity for retailers creates is the worst of all possible policy solutions: the monopoly over the supply is retained by criminals who benefit from the price support of illegality, with little threat that their activities will be penalized by law enforcement.
I think we can do better than simply legalizing all opioids for legal sale. But that would be an improvement over both user decrim supplied by the criminal monopoly AND a return to the sad old ineffective status quo of Drug War Prohibition. With full legalization, at least there would be a selection of opioids available that are less lethal than the ultrapowerful fentanyls.
Restricting access to pain killers for people in pain to prevent recreational users from getting their kicks is wrong. People in pain shouldn't have to be Heroisch.
Yes. A huge downside of the craze to reduce opioid prescriptions is that people who genuinely have to have them end up being denied. And just suffer. There is a move to assert other remedies (from NSAIDS to yoga) are just as good and sometimes they are, but too often not. Some people must have opioid and the addiction tradeoff is justified, far better than being in pain.
Taking prescription meds from pain patients doesn't decrease Addicts! Addiction isn't a trade off. Chronic pain patients are not Addicts. Recognize An Addict takes anything & wants more, more to get high. Recognize an Addict isn't taking med for pain . They take it to get high & their supply is Street drugs, Street Fentanyl is #1... it's cheap. But these are not chemist mixing street drugs. The street drugs may be strong, so strong it would kill an elephant. or a batch may be weak. weak. Sadly a person with addictive trait will display addictive behavior...they want to get high & constantly seek a better high
Drug Addiction like Alcoholism are disease entities.
Taking away pain meds meds, prescribed & taken as ordered is cruel. They don't seek a high...and a months supply last one month. An Addict would take a months supply in a day or two .
It would be great if we knew who has the addictive trait before they feel their first high.
I had to have a genetic analysis performed to see if I have “markers” for addictive psychology. Required.
The report itself is interesting for what is says and what it doesn’t.
It isn't just that street fentanyl is inexpensive. It's become the only product on the street market.
I've always hated the term "drug seekers" as a quick way to minimize and dismiss people without any evaluation or critical thinking.
Thanks to state and federal law and regulations I have little to no hope of getting help from a medical professional except my neurosurgeon or anesthesiologist if something goes wrong with the device.
For those with privacy concerns, that was thrown out the window by Trump’s administration.
Every opioid prescription goes from the physician to a state agency, at which the patient’s medical history is stored, where the prescription is approved or denied before being forwarded to the pharmacy. Some faceless bureaucrat has the final say regarding whether or not that prescription is filled. There is no appeal or even method to contact those bureaucrats or their bosses.
People trumpeting the privacy invasion of the censorship regime as if it’s something new amuse me. Where were you in 2017/2018?
You're suffering from a regime of overcompensation. And also some cognitive dissonance, as a side effect.
If there had been accountability across state lines for opioid prescriptions in the late 1990s, the Oxy problem would have been nipped in the bud, because the vast majority of it was the result of unethical script docs writing prescriptions for mass quantities to dealers who diverted it to the street market. The DEA couldn't track their own Schedule II Federally controlled substances- because regulation was left to the separate states, and some of them, like Florida and Tennessee, had practically no accountability enforcement.
Along about 2014, the Feds finally began to put a regime of accountability for opioid prescriptions in place. And, as bureaucracies so often do in the aftermath of negligence, the DEA has started off by overdoing it- cracking down on prescriptions of opioids, even to people with legitimate chronic pain needs.
That said, folks should know that opioids of one sort or another are still among the most heavily prescribed classes of drugs. Opioids aren't going anywhere; for most pain conditions, they're still the most effective painkillers out there.
Also, to be fair to Donald Trump (not Presidential material, imo) the latest Federal crackdown on opioid prescriptions actually began in the Obama era.
The current regime of "drug control" is folly stacked on top of folly. There's no need for bupenorphine prescriptions to cost hundreds of dollars a month, for instance. That's just more profiteering. The only reason why fentanyl dominates the street market is because street addicts have no other recourse. It isn't like there's some selection of milder products available in the illicit marketplace. Most street retail markets, it's fentanyl or nothing. In the 1960s, at least it was possible to purchase mild opioid cough medicines from drug stores.
Huge amen. Even all the freight that accompanies "drug addicts" paints an often inaccurate picture.
I know a gal who willfully put her hand onto a hot stove burner just so she could get drugs. True story, she is an ex-gf. We met in rehab.
The drugs change the brain...even with a single use.....they are caught in a trap.....
No, use for post surgical pain does not create craving or addition. Go have a root canal sans powerful painkillers and get back to us.
You couldn’t be more wrong.
The Federal government's own survey statistics indicate that about 80% of people who experiment with opioids for recreational purposes are able to walk away from them without being addicted.
I think illegality does currently put a damper on repeating experiments of that sort too frequently; I don't support full-scale legalization of all opioids. But it has to be admitted that even most recreational users are able to keep from getting addicted. It also has to be said that the massive marketplace in illicit drugs does not do ID checks, and the population most vulnerable to addiction are users who had their first exposure as teenagers.
This is exactly what brought me here to comment. I hear more and more stories of people who can't get painkillers that work when they have very painful ailments. "You may die screaming, but you'll be pure" seems like it might not be a consolation to everyone.
Any MD who refuses or under prescribes opiates for pain ought to be forced to undergo the same ordeal.
Same for DEA agents and craven, ignorant politicians.
Suicide is very common among those of us living this life.
I'm 10 years in due to injury, Marie. I'd like to be more specific, but hell, me using my real name and all makes for public preclusion. Know for certain though, my empathy is genuine, 24/7/365. If you are getting good (sufficient) results from a TENS, that's wonderful. If it is something more sophisticated I haven't heard of, I'd sure like to be apprised if you have the inclination. Sincere best wishes to you.
TENS did nothing for me at all. The device is an implanted spinal cord stimulator and it’s been an absolute Godsend for me. It’s specific to neuropathy so it’s not for everyone but for me, it literally gave me my life back. I’m working full time, got my leg strength and balance back, and live a relatively normal life.
In the space of 14 months I went from housebound to employed, etc.
It has its downsides, life is always a trade off, but I’m glad I took the plunge.
My adult daughter has a progressive degenerative neurological disorder. She had a spinal cord stimulator, which helped her dramatically for several years. These days, she's in debilitating pain all the time. And, when she goes to refill her medications from her Palliative doc, the restrictions are odious, and she feels like "a drug seeker," although a quick glance at her medical history would belie that. I understand the INTENT of these strict guardrails for prescribers & pharmacists. But it regularly places the pain patient in a very humiliating position. I don't know the answer. But pain is pain. And we as a society need to figure it out.
I’m so sorry to hear it stopped working for your daughter. Pain like that is unimaginable to almost everyone.
I hear you about the degradation we face. Heaven forbid a voluntary addict’s behavior be criticized as it might cause “harm” while your daughter’s real and involuntary suffering is ignored.
It’s a crazy world.
That's really great to hear, thank you for responding. I'm still holding out hope even at this late stage of the game (for me.) It's good to know there might be options yet, I decided against fusion several years ago myself. Like you said, "It's a trade-off," and I most certainly agree. Glad to know you are doing well. Peace be yours!
If it is not too intrusive, what brand is it?
Boston Scientific
And if SCS isn’t for you I hope the big brains’ next discovery applies to you!
I take 20 mg per day of hydrocodone, plus Lyrica and indomethacin for my pain. It is harder and harder to get my meds. And it's not like I want lots of drugs. I used to take 40 mg per day but I worked with my doctors to take less. One benefit is that I am not constipated any more.
Marie, is it possible for you to have some painkiller on hand, in case your dreaded weekend mechanical failure scenario presents?
Alas no. If I were caught with that I’d be under the jail.
See? That's just ignorant. They make my sister jump through hoops to get meds, & if there's a glitch & she runs out, oh well. The people making these stupid laws & regulations have no empathy whatsoever.
That’s the inevitable consequence of bureaucratic involvement I think.
My best to your sister. Neuropathic pain is beyond bad. I thought 48 hours of labor without so much as a Tylenol was as bad as it could be until my accident. How little I knew.
Reporting is so mixed up. They report as if every person given opiates/opioids will be an Addict.
Every one who takes a drink does not become an Alcoholic.
An addict seeks drugs, runs out, wants more..Always MORE, more, more.Anythingbto get high. They don't pick up a prescription. at the pharmacy
They report as if Fentanyl is a killer. Fentanyl is an old drug. It was used in OR in the 70s. Very safe in the prescribed dose.
The crisis of death , the killer opioids, are illicit, street drugs. Street Fentanyl is easy to mix but when nixed in street labs no one knows how potent a batch may be until people start dying from one pill.
Sadly an addict resorts to street drugs to stay high...street Fentanyl is cheap ,& deadly.
A chronic pain patient who receives a prescription for 30 days.. and takes meds as ordered. The prescription lasts 30 days. They are not drug addicts seeking a high....they take pain meds to have a better quality of life.
FYI if a person has the addictive trait you will know quickly...they will take anything to get high.. Alcohol, street drugs, crack ... or street Fentanyl. They don't get meds at local pharmacy! A prescription for 30 would last a day & the addict seeks more, more, more...
My sister is in chronic pain from ankylosing spondylitis, among other things, & she has a heck of a time getting pain relief. They've made it very difficult for people who actually need pain meds to get them. She's in a pain management program, & every once in a while, there's some sort of glitch with communications between the doctor's office and the pharmacy, & she's in a world of hurt while out of meds. She recently switched from Vicodin to Dilaudid.
Do you have a Spinal Cord Stimulator?
There would be no drug trade in Mexico worth talking about, if it were not for Americans' insatiable appetite for drugs.
Fair argument, but not that binary. These drugs aren't like having a drink or smoking a little weed. These kids try them and after as little as 5 days of use, they are physically addicted to them.....and they are incredibly deadly.
I have a nephew now in his 40s, he got addicted to Oxy when in middle school. My sister has lived in a guilt-ravaged world ever since. All these years of waiting for. . . . the Call. Many, many rehab attempts futile. The kids get the worst of it, their brains are sponges for Oxy addiction, they get hooked early and seemingly irrevocably. A life sentence. So fucking sad, so helpless for family.
Rubbish. Most of the time it is because of allergy to Morphine.
Not here to argue with anyone......its just my experience and my 2 cents. Which is probably overpriced. :-) Cheers.
Tolerance to opiates is built rapidly and that’s how people end up with $400/day habit just to face the day. I worked in detox and suboxone really helped but if it’s stopped, the cravings for the drug are so bad it sends detoxed people directly back to the drug when they’re released. It’s a terrible problem.
It's not so much "craving for the drug" as wanting relief from the horrible anxiety and insomnia/restlessness that comes along with withdrawal.
The depression that frequently attends detoxification leads to more use, unfortunately. One's ability to cope with this and the intensity of the desire to quit (or lack of it) determines whether one starts using again. Also, if the conditions that make using appealing are not removed (boredom, grinding poverty, existential hopelessness, no future prospects, etc.) "relapse" is likely.
The nuance to your statement is that there are circumstances within people's lives that lead to the desire to use drugs likes heroin and fentynal. They are not all rock stars who can afford the heavy usage and recovery. Some are tricked (peer pressured or enticed), coerced, come from broken families, have mental health issues similarly caused by myriad circumstances.
It's a very difficult problem to solve, if not unsolvable. I cringe in saying it's one way to chip away at the overpopulation issue. However, there are far more humane ways to mitigate that and I feel for those who lost loved ones to drug overdose/addiction. It's a terrible plague against humanity.
Two words: "Rat Park". Nobody seems to ask *why* do Americans have such an insatiable appetite for drugs?
For that matter, I understand that meth is making a comeback, and I don't think too many methheads got their start with doctor-prescribed methamphetamine. Maybe I am wrong.
I also understand that The New Hotness in opioids is "tranq" (aka Fentanyl and Xylazine), and I don't think Xylazine is approved for human use. (There's also benzo dope, which is Fentanyl mixed with benzodiazepines, and benzos can be obtained via prescription but I don't think many people got hooked on legal benzos and then decided to mix in fent).
"I don't think many people got hooked on legal benzos and then decided to mix in fent" I can tell you that's very much the case with many many addicts. Dope hopping is totally part of the addiction pathway, just like when we started drinking beer, some of us went to whiskey, or when we started using a little coke, moved to crack cocaine or meth. It's very normal for those with addiction problems to have a progression path like that.
The bigger question of "why" we have such an appetite is a topic that is vast and way outside my punt coverage. Have a great day man.
Why ? I think because we are trying to escape a very ill, toxic society with skewed values and false gods....when you have to use all of your energy to protect yourself and your children from the idiocy around you and them, it becomes an exhausting effort. One can create a loving "bubble" in ones' home, but eventually you have to send your offspring out into the madness beyond the door.....many lack the armour and coping skills to deal with what they must encounter....three quarters of a century have taught me that one clear thing......and it is not always possible to instill all the necessary things to survive....the unknowns they now face have become deadly, deadly.... as their need to experiment is the only way to truly learn a thing until they become experienced enough to recognize inherent dangers and pitfalls....our "Society " is 'culling the herd before our children are even fully born into Life. ( Excuse my diatribe)
And your point about the "ill, toxic society" is bigger than our ill, toxic society can admit: "it is no measure of health to be well-adjusted to a sick society."
No apology needed. Your experience is real and valuable. Thank you for chiming in.
Why do Americans have such an appetite for drugs? Actually, humans have a propensity for addiction--we've seen it with TV, mass media, engineered super-palatable foods, sugar, alcohol...
What's sort of unique ("exceptional" according to J. Stalin) about America is the profit machine is so finely tuned, and the sociopaths (as the author called them) at the ready to shunt the money their way.
It also raises the question why we see such levels of addiction in America more than in other developed countries.
America is in deep trouble culturally.
Maybe passing criminal statutes that ended up making tens of millions of people criminals and social pariahs wasn't such a brilliant idea, hmm?
American Drug Prohibition will go down in history as a generation of parents unwittingly making war on their own children. Or a sizable fraction of them, anyway. The societal breakdown that had already taken place by 1970 is only now beginning to heal, in that respect. In the meantime, 55 years of Drug War has created iatrogenic problems that I would never have believed possible as a 20-year-old in 1975. I thought that the elders would have had more sense. It was all about Stopping Marijuana back then, can you believe it? Trying to put the toothpaste back in the tube.
The irrational,draconian regime of US drug policy is overdue for an overhaul. Our political class would still rather kick the can down the road on that. I get what that is- actual work is required, meanwhile with extremist banshees and partisan opportunists out to jump on every last rhetorical misstep and every last detail of policy change. But, it has to be done eventually. A nuanced, comprehensive overhaul of the drug laws has to be done.
A criminalized subculture of tens of millions of children laid the groundwork for the pariah subculture between the 1960s and the 1980s. But even after 25 years of underground economy and subterfuge, our opioid addiction problems were relatively minor, up until the Oxycontin era. Not negligible, but relatively minor. About on par with what they were in the late 19th century.
Oxy really did change the game in the mid-1990s. By the early 2000s, more 15 year olds were having their first (non-alcohol, non-tobacco) "drug experience" with prescription opioid pills than were trying pot. Setting aside the overdose death and addiction part and considered on a "bang for your buck" basis, hard drugs have been cheaper to get high on than pot for around the past 40 years. When Oxy first came in, a pill was cheaper than a joint of sinsemilla or a pint of whiskey. $10 for a 40mg Oxy, that was stronger than a bag of street heroin, and it lasted longer.
I keep up; I read the annual University of Michigan Monitoring The Future, SAMHSA and ONDCP surveys (none of those sites make it easy to navigate to the pages where the surveys are. I find that baffling. But all of those reports can be found online.)
One piece of good news that has been practically absent from the headlines is that most teenagers have gotten the message about how dangerous opioids are- particularly the fentanyl-tainted counterfeit pills. Teenage experimentation has dropped off drastically; it's less than 1/3 of what it was ten years ago. A fact that almost never gets mentioned by the news media. My local news reports on every high school overdose incident, but I've never once heard any news report mention that the teenage opioid user population is much, much lower than it was in the late 1990s-2015.
But if you read my post above Feral. In the USA I was NEVER offered a similar painkiller.
Did you not read the article?
Nope not you, the comment was directed to the lead post. And I hope all of my comments are understood as directed at the argument and not the person.
IF you are talking to me Art. Morphine does not work if you are allergic.
Progressives will say, "Well you do know there are just too many people on the planet?"
I'm not progressive in the slightest and I do believe there are too many people. However, before you blast me for being misanthropic, my perspective is influenced by maximizing available resources, quality of life, and real human progress - for all.
I would prefer people make better choices on their own than to dictate those choices to them. Alas, a progressive would say, "that's the problem right there."
Can we give the "stuffing words in the mouths of the partisan opposition" thing a rest, already? Inventing cheap shots is just bogus. Whichever partisan side does it.
Well, maybe not too many people, per se, but too many of the wrong kind. I'm kinda okay with idiots killing themselves and dismantling big pharma at the same time
I believe this is the CIA's position as well, minus the "dismantling big pharma" part.
Well, I'm not CIA. And dismantling big pharma is a much bigger priority. I don't want people to die, but the ones who can't learn a pretty simple lesson aren't worth spending much on
My son died at 25 in 2017 from an accidental Fentanyl overdose. He was many things but he definitely was not an idiot. This isn't just happening to drug users and people on the street, we've lost way too many young, smart, promising "kids next door" from this epidemic.
Okay, but I bet that fentanyl didn't come from a pharmacy. And while there was much we didn't know in 2017, we do now. Taking anything not from a pharmacy is easy enough to understand now
I’m very sorry for your loss. Every parent’s worst nightmare.
Unless you've lived it, you have no idea. It never ends but I have 2 daughters and a wife who all need the best version of me I can bring, so bring it I do. People always say, "Life goes on." Now I know what they mean by that statement. It will never be as full, as kind or as hopeful a life but it definitely goes on and you have two choices. I choose to live it the best I can.
I’ve survived a lot but never faced that one.
I’ve never known what to say to that loss except I’m sorry. It’s genuine sorrow.
Sorry you were one of the victims of pharma. Were you started on pain meds for something minor or major? I ask because I find it interesting how many minor injuries were the start of opiate addiction. I had some minor orthopedic sports related surgeries and was always offered, sometimes even pressed, to take opiates. Totally understand if you don’t want to share on a public forum btw
Thanks. It was a long and ugly road to recovery, but today my life is really good. I was prescribed them after a surgery. This was early on the the oxy days and I was terribly over prescribed by the doctor. I don't really believe it was his fault as he was listening to what the pharma reps were telling him and what the FDA was saying early on. I became physically and mentally addicted in less than 2 weeks of using them. I eventually went to buying them on street which led to a 6 year, nose down, full throttle, into the side of the mountain tail spin that almost killed me. Again, recovery is possible but not easy. My substack posts are based only on recovery as I have a passion to share that there is hope and a great life in recovery from chronic addiction. Have a great day.
Evan’s, speaking as someone who has enjoyed and/or benefited from your contributions here, may I say how glad I am you are still among us. What a harrowing battle you’ve had.
Thank you.
I read the book "Dope Sick." The main take-away is that for many years there were only a few people raising hell about this - or trying to draw attention to what was really happening.
One analogy might be the stock analyst who always knew Bernie Madoff was a fraud and running a Ponzi scheme. He did everything he could think of to expose him and stop him ... and was ignored over and over.
I feel like that guy with some of my Covid stories!
Thanks for sharing. Sadly I think doctors still readily advise opiates after most surgeries. That has been my experience with 3 ortho surgeries. I don’t think the risk / reward is solid for opiates after surgery. Reward: less pain for a couple weeks. Risk: addiction and corresponding life devistated , possibly death
Give me the opioids. Ive taken Percocet (5mg oxycodone) for a few weeks at a time twice due to injuries. Didn't overdo it, one or two a day. No addictive effects, tapered naturally as pain diminished.
There is addiction risk and it's a tradeoff. Med literature that I have read mentions that there are times where the addiction is a better choice than otherwise unmanageable pain. Should be between you and your doctor.
Indeed, "There are times where the addiction is a better choice than otherwise unmanageable pain. Should be between you and your doctor."
100%. Unfortunately, this fact is usually overlooked in most discussions of the "crisis."
We have a crisis of purpose and meaning, a chaotic society, and ineffectual, craven, corrupt "leaders." Opiate addiction is a symptom of this. The rate of addiction is directly proportional to the general level of despair.
All that. You and I share the same outlook on our era.
People who appoint themselves to "solve" any crisis end up stomping on other people in their zeal to craft a solution and be seen as doing such. No matter what you do to solve a problem it is guaranteed that unintended negative consequences will occur.
And on that topic, you don't often notice people that suggest doing nothing can be, though not ideal, better than any alternative.
Overregulating opioids has been utterly unfair to people who have a legitimate need for them, and pretending that other alternatives are just as good when they're not so you can reduce prescription numbers and thus claim "success" at the expense of inflicting pain on other people is a crime.
Good you know your limits. Personally I never had a problem. In fact I got tired of them long before 2 weeks was out and had no problem quitting.
I was burned between 5 to 10 percent of my body. Second and third degree. Even with opiates I was in pain. That is when I discovered Oxy was shite. It is like crack, you go up and crash. I had to ask for codeine, just to have the 6-8 hour relief that allowed me to sleep. The first week was hellish.
Without opiates however, I would have gone into shock from the pain. I don't believe we should keep surgical/cancer/burn patients from opiods just because someone somewhere can get addicted. Maybe we should go back to milder opiates with a longer half-life in the bloodstream.
This misguided program didn't help.... https://time.com/4292290/how-obamacare-is-fueling-americas-opioid-epidemic/
"I became physically and mentally addicted in less than 2 weeks of using them."
Not to diminish your account of suffering, but while you may have WANTED more oxycodone once your pain was resolved ("mentally addicted" as you put it), you would have discovered that there are no withdrawal symptoms with only 2 weeks daily use.
Not everyone enjoys the opiate effect. These folks are able to stop using once their prescriptions expire.
I reiterate...you are Brave...thank you....and honest...
I’m glad you made it out! You have an important story to tell.
Yes....exactly. My son was a D1 Collegiate soccer player and member of our National Team. He suffered an ACL injury in college, had surgery and became addicted to Oxycontin. He graduated and started working so had money to secure drugs once his pain medication from MD's grift ran it's course. He bought what he thought was Oxy on the street but it turned out to be fentanyl. I'm aware of at least two other HS classmates of his who have also died from fentanyl poisoning. We live in a very affluent community. Our government clearly doesn't care about this. The perps (Sackler family) are buying their way out of prison by paying fines representing a fraction of their wealth.
Thanks for sharing this Evan. I’ve got a similar situation but different experience with opioids. In 2017 I suffered a traumatic back injury, fracturing three vertebra, one of which was categorized as the worst of the burst compressions while the other two were merely bad burst compressions. I was briefly paralyzed below the waist but movement came back within and hour and full movement, sensation the next day. It occured overseas and required a med jet for extraction back to the States. I’ve seen multiple neuro’s for chronic pain, although I could be standing next to you and you wouldn’t know I was a 5 or 7 of 10- it becomes a new normal so you just carry on. I’ve been on opioids, Gabapentin, multiple muscle relaxants, prescription NSAIDs and use non THC (and sometime THC) CBD gummies. Just saw the same surgeon that did the fusion surgery for Tiger Woods last week for another opinion and still a no for any type of surgery. So more PT and my mini pharma of drugs for like
Back in 2017, all the fuss about opioids hadn’t peaked and I left the receiving ER with scripts for Oxy, Hydro, Tylenol III and Tramadol. I could refill any whenever I needed, up the dosage amounts, drop them, etc with no major pushback. But I’ll add that I am also a recovering alcoholic (23 years on June 4th) and sensitive to addiction issues. After settling in to a routine for pain management and just dealing with one primary doctor for my back, we dropped all the opioids but Hydrocodone 10/325 3x daily. Sometimes 4x, sometimes 5x but at the time, the Fed hadn’t tightened the screws on doctors prescribing. But that was short lived and now, I’m pretty much stuck at 3x 10/325 as my doc is very reluctant to go up in the 90 per month. Which really kind of sucks as I’ve definitely built up a tolerance and while some days are only a 2x day, I have more 4x and 5x days than 2x or 3x ones as I still work full time (outside tech sales). And trying to change out to Oxy (which I really don’t like) or try time release fentanyl patches is just not going to happen. So I’m stuck and hence have upped the NSAID use and supplement with legal and quasi legal (and totally unregulated) CBD gummies.
Where we differ and maybe it’s dosage, but I do not find Hydrocodone addictive. I am at the point where I get to experience withdrawal every month now, usually for just about a week but I start tapering off when I’m down to 6-8 pills and then reserve 2 for the last days before being out. At worst is an hour or so of stomach cramps and maybe one night of restless sleeping but I get no seeking type behavior that would have me trying to find them on the street. I had months of angst after I quit drinking, with little triggers and stuff that I’d fight through. I went through rehab and a little AA. I don’t really get anything like that with the opioids and as I mentioned, I get to quit every month for a week or so before I refill. If my doc said, “that’s it, your done” I’d be very disappointed but I wouldn’t start shooting up. I’d just no that life was going to be several degrees more painful than it had been.
In rehab I learned a lot about addiction and some of it is more habit than addiction, ie more behavioral. Not saying that is 100% with opioid users/abusers but it plays an important role. And some folks are just unwilling to change parts of their behavior they can control. Like a homeless person given the choice of a warm shelter on a cold winter night v sleeping on the street and they opt for the cold. You just can’t fix them. But for users in scenarios following a surgery or some event where short term prescribed opioids make sense for pain relief, behavioral therapy shoud be able to mitigate any addiction issues with tapering off of the medicines involved. The street abusers are gonna do what they do. Basically, there needs to be a middle ground for folks like you and I caught up in the middle of all of this. As much as I would love to drop my meds for a month or two, just to see how I could manage, I am literally afraid to do so, since there is no guarantee I could get the prescription started up again.
Understand and thank you for sharing. I just had to get to the point where I was totally off of them. I couldn't control my intake over any prolonged period of time....it would always get out of control. I just have an addictive disposition about me that I've had since I was a child. We all get to deal with these hurdles in life in the best manor that fits our situations thank goodness. Have a great night.
Nothing’s going to change as long as the C_IA is using the money for black ops just like they have been since the 50’s. In fact they’re still transporting drugs in from South America Asia Thailand and others in military jets so I’m sorry to say nothing will change as long as government benefits from the sales. For anyone interested it’s called Operation Gladio and bush sr setup the contacts and transportation while he was in the agency up until he became VP for Reagan.
Right. Those Pfizer creeps hold down innocent victims and force-feed them opiates.
I have no love for "big pharma" and its obviously unethical marketing of useless or dangerous Coof vaccines, but opiate manufacturers and doctors who prescribe them are not responsible for the large number of users, addicts and overdoses. Likewise, those who overdose on prescribed opiates are responsible for their own deaths. Those who become victims of black market dealers and their unmeasured, impure drugs are not. Relying on illegal supplies is the direct result of prohibition.
Imagine if you could have got your Dilaudid legally. You would not have paid that much to maintain your addiction and it would have been nowhere near as "messy, shameful or stigmatized."
Too true Evans W....follow the money......"Filthy Lucre" as my Mother would say....Good luck with your continued sobriety young man, you are brave....my son didn't make it out alive.
There's a 'ladder' of organization and control in all of the huge industries with corporate media and Big Pharma locked together financially where one can't survive without the other. Follow the ladder up from there and you come to the big banks, Wall Street, and government. Follow the ladder up a couple more steps and you come to the people who own the Central Banks of Europe and the Federal Reserve. They're all in on it. That's why there's no scorched Earth policy to end it, solve it, or fix it. The CIA is the world's largest drug trafficker. Those labs in Mexico, the traffickers who move the precursors to Mexico, the mules who move it across the border into the US, and the media and pharma executives all do what they do and get away with it because they're all clandestinely controlled and manipulated by the dark forces running our government's policies on behalf of the owners of the Central Banks. It sounds like a crazy conspiracy theory, but Satan literally uses Earth as his playground and his most successful lie is convincing you that he doesn't exist
"As someone who’s been in recovery for many years now and who once had a $400 a day opioid (dilaudid) habit, I can tell you firsthand that our country has never seen an epidemic this massive or destructive."
- Lol. Really? You should have "Just Said No" or gotten mandatory minimum sentencing at the very least.
"Its clear to me that addiction must be addressed from all sides but unfortunately as a society we are falling short. "
- No. Mandatory minimum sentencing.
To bad treatment/recovery was included in Obamacare. Guess some states missed out. :)
Congratulations to you for finding a way out of the addiction abyss. Someone very close to me has, is, and always will be battling an opioid addiction. From what I can tell, recovery entails a complete and very intentional rewiring of the brain. Kicking the habit is indescribably difficult, and as you wrote, compounded by inadequate professional support and above all shame. In addition to knowing someone with an opioid addiction, I live in a land where it is enabled and abetted. Every single day of my life I have to diligently avoid running an addict over. They wander through busy streets right around the corner from my house. Many have been hit and killed in my town. Many. No exaggeration. How is this happening? If you read this comment, will you please share a link or two to the articles you referenced?
How did you afford the habit ?
But they're not on death Row, are they? That tells you All you need to know about the System.