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Who do you hold responsible for the opioid problem?

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  • Who do you hold responsible for the opioid problem?

    There is no question that opiods have become a real problem, and now a number of states are taking the pharmaceutical companies to court over the marketing of opiods.
    But who is responsible in your opinion?
    The company that made the drugs and actively encouraged doctors to prescribe It?
    The doctors who prescribed them?
    Or the FDA who has the regulatory power to police pharmaceutical companies?
    Dispite our best intentions, the system is dysfunctional that intelligence failure is guaranteed.
    Russ Travers, CIA analyst, 2001

  • #2
    I blame the educational system. People are not taught the skills they need to navigate life and learn them the hard way. It's also something of a spiritual problem in that hopelessness is preventable even with chronic pain.
    We hunt the hunters

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    • #3
      https://www.youtube.com/watch?v=T5sOh4gKPIg

      AHIKS - Play by (E)mail board wargaming since 1965.
      The Blitz - Play by Email computer wargaming.

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      • #4
        Just because there is a problem doesn't mean that someone is directly responsible.

        Companies developed better pain management drugs, and users failed to adhere to the dosage orders. From the very onset, no user should have been caught by surprise that opiods are addictive if used improperly.

        A big cause was the invention of fentanyl, which has turned the criminal narcotics market on its ear, and the failure of the Obama administration to target opium product in Afghan while we had a substantial presence there.

        But in the end, addicts are addicts.
        Any man can hold his place when the bands play and women throw flowers; it is when the enemy presses close and metal shears through the ranks that one can acertain which are soldiers, and which are not.

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        • #5
          These are all legitimate points,
          There is plenty of blame to go around, where has the FDA been hiding for the past twenty years?
          Dispite our best intentions, the system is dysfunctional that intelligence failure is guaranteed.
          Russ Travers, CIA analyst, 2001

          Comment


          • #6
            Originally posted by Urban hermit View Post
            These are all legitimate points,
            There is plenty of blame to go around, where has the FDA been hiding for the past twenty years?
            Why is there blame? Some things just happen.

            Opoids, if used correctly, are safe; my wife recently had spinal surgery, and used both morphine and opoid painkillers with no side effects whatsoever.

            The DEA has moved up the rating of Oxycontin so it is being prescribed less and is harder to get, but the flood of heroin can more than pick up the slack.

            People make their own choices. Many don't read the literature packaged with their meds, they don't read the paperwork given out by the doctor's office.

            It is neither the government's fault, not the chemical compound. The fault rests with the individual.
            Any man can hold his place when the bands play and women throw flowers; it is when the enemy presses close and metal shears through the ranks that one can acertain which are soldiers, and which are not.

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            • #7
              Originally posted by Arnold J Rimmer View Post

              Why is there blame? Some things just happen.

              Opoids, if used correctly, are safe; my wife recently had spinal surgery, and used both morphine and opoid painkillers with no side effects whatsoever.

              The DEA has moved up the rating of Oxycontin so it is being prescribed less and is harder to get, but the flood of heroin can more than pick up the slack.

              People make their own choices. Many don't read the literature packaged with their meds, they don't read the paperwork given out by the doctor's office.

              It is neither the government's fault, not the chemical compound. The fault rests with the individual.
              As several states AGs have filed lawsuits, the courts may or may not agree, there is also the problem of illegally produced and marketing of Fentanyl, imported mainly from China.
              I'm not taking any sides, the courts will decide. But it will be interesting.
              Dispite our best intentions, the system is dysfunctional that intelligence failure is guaranteed.
              Russ Travers, CIA analyst, 2001

              Comment


              • #8
                There is a difference between blame in the sense of being morally culpable and blame in the sense of cause and effect.

                Can institutions be morally responsible? The argument reminds me of the strange debate over corporations being people too. Once again the damage done by intellectuals such as the postmodernist/multiculturalists is evident. Groups may have identities and individuals do in part acquire their identity from groups. Groups however do not have rights they may represent the rights of individuals. Think of it this way. If you can't be punished you can't have rights. We don't put computer AI systems in prison for example we simply terminate their existence when they cause the loss of life. You have to have skin in the game to be a moral entity.

                That said we do punish institutions when they make mistakes that harm society. The institution is like an organism with all the individuals working for it being " cells in it's body". By punishing the institution we are punishing the individuals who do have skin in the game. Unfortunately the punishment is often inflicted disportinately to the amount of control the individual has over the institution.

                This brings us to the dodgy question of intent. We can rule out the idea that the drug companies intended to do harm by making opioids readily available on the basis that it would make them irrational actors free of culpability. The legal standard that applies is therefore gross indifference. Of course legal and moral should not be confused. Even from a moral perspective it is the duty of the drug companies management to make a profit within the boundaries of legality. If they sell their products through the legally established network it is hard to see how they are culpable for the damage those products do unless the products have known defects. Opioid as far as know have the effects they are advertised to have. There are other issues such as corporatism that are beyond the scope of this discussion, at least for the moment.

                If we accept that the drug companies are selling a product that is effective and safe within their guidelines then we can move on to the doctors. I think we can rule out once again the intent to do harm as oxymoronic. The question of gross indifference is more difficult than with the drug companies. The doctors must be aware by now that opiate addiction is a concern. Their moral responsibility exists to the extent that some percentage of their patients cannot participate in a reciprocal moral relationship because of some incompetence on the part of their patients. The problem I would suggest is that their culpability is severely limited by a culture that encourages moral incompetence. The perversion of science that denies freewill, the welfare state, victim and identity culture in the academy, Marxists and postmodern teaching, ambulance chasing lawyers and their political organizations, corporate immunity, irresponsible unions, bureaucratic nepotism, to name a few other institutions all work to limit moral competence.

                As a practical matter we can not restore moral competence without the innocent suffering. Is someone with an IQ under 130 really able to understand complex social institutions? Can people with addictive personality defects be expected to avoid addiction in a promiscuous culture? Are our institutions meritocratic enough that character is relevant? Can the majority of people be moral without the threat of punishment in an imaginary hereafter? Drug addiction is just one symptom of nihilism, nihilism is the problem.

                We hunt the hunters

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                • #9
                  Originally posted by Urban hermit View Post

                  As several states AGs have filed lawsuits, the courts may or may not agree, there is also the problem of illegally produced and marketing of Fentanyl, imported mainly from China.
                  I'm not taking any sides, the courts will decide. But it will be interesting.
                  State AGs are politicians. The lawsuits are all about politics/finding a bit more $$ for the budget.

                  I have yet to meet an opioid addict who became addicted because of prescribed pain killers. I have met opioid addicts who had just "leveled up" from lesser drugs, specifically marijuana, to get a better high.

                  Tuebor

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                  • #10
                    Originally posted by Tuebor View Post

                    State AGs are politicians. The lawsuits are all about politics/finding a bit more $$ for the budget.

                    I have yet to meet an opioid addict who became addicted because of prescribed pain killers. I have met opioid addicts who had just "leveled up" from lesser drugs, specifically marijuana, to get a better high.

                    Tuebor
                    It isn't as if this is a new problem. There was a reason that the 18th amendment was passed. The problem of drug abuse is as old as civilization the degree and severity vary over time.

                    There is evidence that the opioid problem in certain segments of the population is related to how pain is experienced. Stress and inactivity cause psychological pain that activate the same pathways as physical pain. This can be especially intense when it is compounded by social alienation real or imagined. It can especially effect those who by temperament are otherwise high in conscientiousness.

                    So, if physical and emotional pain have similar neural signatures, why not take Tylenol (acetaminophen) for grief, loss, or despair? People who had experienced a recent social rejection were randomly assigned to take acetaminophen vs. a placebo daily for three weeks. The people in the acetaminophen condition reported fewer hurt feelings during that period. When their brains were scanned at the end of the treatment period, the acetaminophen takers had less activation in the anterior insula and the anterior cingulate cortex.
                    https://www.psychologytoday.com/us/b...-brain-regions

                    People who live lives that have meaning are less likely to become addicted to drugs. The opioid crisis however has some interesting statistics. Alabama is the most religious state and one of the lowest overall illicit drug use and alcohol abuse rates if you exclude tobacco. Massachusetts is one of the least religious states and has one of the highest drug use rates. Of course correlation is not causation but Alabama also has the highest opioid prescription rates.

                    https://www.pewresearch.org/fact-tan...?state=alabama

                    https://www.pewresearch.org/fact-tan...?state=alabama

                    https://www.moveforwardpt.com/Resour...of-50-states-2

                    A look at possible explanations include the effect of social support and mental health which seem to not be a factor.

                    Religiosity and decreased risk of substance use disorders: is the effect mediated by social support or mental health status?


                    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2901801/


                    Why does opioid abuse not follow the same pattern as other drug abuse?



                    We hunt the hunters

                    Comment


                    • #11
                      Originally posted by Urban hermit View Post
                      There is no question that opiods have become a real problem, and now a number of states are taking the pharmaceutical companies to court over the marketing of opiods.
                      But who is responsible in your opinion?
                      The company that made the drugs and actively encouraged doctors to prescribe It?
                      The doctors who prescribed them?
                      Or the FDA who has the regulatory power to police pharmaceutical companies?
                      Doctors and patients with addictive personality disorder.

                      Unfortunately, as usual in our dysfunctional American society, the patients in genuine need of pain control are the ones who are punished.
                      Quis Custodiet Ipsos Custodes? Who is watching the watchers?

                      Comment


                      • #12
                        Originally posted by wolfhnd View Post

                        It isn't as if this is a new problem. There was a reason that the 18th amendment was passed. The problem of drug abuse is as old as civilization the degree and severity vary over time.

                        There is evidence that the opioid problem in certain segments of the population is related to how pain is experienced. Stress and inactivity cause psychological pain that activate the same pathways as physical pain. This can be especially intense when it is compounded by social alienation real or imagined. It can especially effect those who by temperament are otherwise high in conscientiousness.



                        https://www.psychologytoday.com/us/b...-brain-regions

                        People who live lives that have meaning are less likely to become addicted to drugs. The opioid crisis however has some interesting statistics. Alabama is the most religious state and one of the lowest overall illicit drug use and alcohol abuse rates if you exclude tobacco. Massachusetts is one of the least religious states and has one of the highest drug use rates. Of course correlation is not causation but Alabama also has the highest opioid prescription rates.

                        https://www.pewresearch.org/fact-tan...?state=alabama

                        https://www.pewresearch.org/fact-tan...?state=alabama

                        https://www.moveforwardpt.com/Resour...of-50-states-2

                        A look at possible explanations include the effect of social support and mental health which seem to not be a factor.

                        Religiosity and decreased risk of substance use disorders: is the effect mediated by social support or mental health status?


                        https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2901801/


                        Why does opioid abuse not follow the same pattern as other drug abuse?


                        You do know that Prohibition (18th Amendment) ended a long time ago, right? You also are aware that alcohol is legal? And that tincture of opium - laudanum - was also legal at one time?

                        Opioid addiction is medically assisted drug addiction, sought out because it is far cheaper than buying from illegal dealers, and is a common form of escape for weak personalities, since it does not carry the stigma associated with alcoholism.

                        Society in general no longer teaches or encourages self-discipline, self-reliance, coping mechanisms, or mental and physical toughness, preferring to label all of us "victims" of something, and things like self-created "disabilities" are rewarded and reinforced by this weakling attitude. Why work when you can line up for disability payments and drugs?
                        Quis Custodiet Ipsos Custodes? Who is watching the watchers?

                        Comment


                        • #13
                          OxyContin is meant to be taken by mouth and is time released .

                          I've seen plenty of patients who ground up OxyContin pills and snortted them. Usually they are some one elses pills. Is it the manufacturers problem if these patients overdose?

                          Opiates are a great thing if used as prescribed by a competent doctor.
                          "I disapprove of what you say, but I will defend to the death your right to say it" Beatrice Evelyn Hall
                          Updated for the 21st century... except if you are criticizing islam, that scares the $hii+e out of me!

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                          • #14
                            Originally posted by Mountain Man View Post

                            You do know that Prohibition (18th Amendment) ended a long time ago, right? You also are aware that alcohol is legal? And that tincture of opium - laudanum - was also legal at one time?

                            Opioid addiction is medically assisted drug addiction, sought out because it is far cheaper than buying from illegal dealers, and is a common form of escape for weak personalities, since it does not carry the stigma associated with alcoholism.

                            Society in general no longer teaches or encourages self-discipline, self-reliance, coping mechanisms, or mental and physical toughness, preferring to label all of us "victims" of something, and things like self-created "disabilities" are rewarded and reinforced by this weakling attitude. Why work when you can line up for disability payments and drugs?
                            Thus the importance of education and some form of "religion" that takes into account the "spiritual" needs of society. Most people are simply not going to be able to create "meaning" in their lives independent of a social structure. I use religion in an allegorical sense here. The French revolution is ample proof that the "Goddess of Reason" nor the kind of humanism that the enlightenment engendered are likely candidates. The enlightenment has already taken us on the unfortunate but predictable path that has scientists denying the bedrock of civilization, freewill and personal responsibility. Even if it were possible, which I'm confident it is not, the restoration of traditional religion seems equally unsuitable. Perhaps Nietzsche was overly pessimistic and each of us can be are own superman in our own way. That is what Jordan Peterson is preaching and with a modicum of success. The nexus of art, literature, science and politics along with an appreciation of cultural heritage including the great myths combined with responsibility and family is certainly not a bad start.
                            We hunt the hunters

                            Comment


                            • #15
                              Originally posted by Urban hermit View Post

                              As several states AGs have filed lawsuits, the courts may or may not agree, there is also the problem of illegally produced and marketing of Fentanyl, imported mainly from China.
                              I'm not taking any sides, the courts will decide. But it will be interesting.
                              What Tubor said. Politicians love headlines.

                              You seem to be taking the side that someone is to blame.

                              The simple truth is that opoids produced legally are mixed with a agent that releases them over time. Addicts chew them or crush them to get around the time-release feature.
                              Any man can hold his place when the bands play and women throw flowers; it is when the enemy presses close and metal shears through the ranks that one can acertain which are soldiers, and which are not.

                              Comment

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