

The one statistic you never hear about drugs - Alex3917
http://alexkrupp.typepad.com/sensemaking/2014/05/the-one-statistic-you-never-hear-about-drugs.html

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bencollier49
You don't hear that statistic because it's cobbled together from a bunch of
completely different causes to make a shocking-sounding headline.

Basically, the take-home from the article is that smoking kills a lot of
people, drinking too much is bad for you, and people die from adverse
reactions to medication.

~~~
keithpeter
And that the deaths from illicit drugs were _relatively_ low. It's the things
you _don 't_ read about in the newspaper (not outrageous or tragic enough,
just normal) that will get you.

~~~
the_watcher
That is actually a pretty interesting nugget that I missed on my first pass.
I'm surprised that hasn't become a libertarian/anti-drug warrior rallying cry
to convince those less moved by the "victimless crime" approach.

~~~
keithpeter
I work as a teacher. Drug deaths are higher frequency in younger cohorts.
Emotional impact much higher. Libertarians probably staying away from that
one.

~~~
the_watcher
That's true, and again, something that more data like this can be really
helpful with. I disagree that it will steer people away from this argument
though, since "victimless crime" is alive and well, despite the very moving
and personal response of "parents of the children who die are very much
victims." Especially given that those who libertarians are trying to convince
are generally technocrats, assuming they don't bother attempting to convince
those arguing from morals.

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JoeAltmaier
Doesn't distinguish dying from smoking at 65, from dying from an overdose at
18. These are massively different problems.

So the article boils down to, middle-aged people die from smoking; all else is
noise in the statistics.

~~~
salmonellaeater
It does distinguish, at least between smoking and alcohol:

 _While many fewer Americans are killed from alcohol than from tobacco, the
absolute percentages are somewhat deceiving; whereas the lifespan of current
smokers is about 12 years shorter compared to those who have never smoked, the
average death from alcohol comes a whopping 29 years prematurely._

~~~
the_watcher
This seems like comparing apples to oranges. Looking at the average lifespan
of smokers v. the average age of an alcohol related death isn't right. It
should either be the average lifespan of those who drink (or perhaps even more
accurately, alcoholics) v. the average lifespan of smokers. Or, the average
age of a smoking related death v. the average age of an alcohol related death
(and within this, probably should add something that splits out causes between
alcohol related decision making, ie drunk driving and alcohol related
illnesses, although the point of the comparison is to highlight the dangers,
so the fact that smoking doesn't result in drunk driving accidents is
important).

~~~
Alex3917
> This seems like comparing apples to oranges. Looking at the average lifespan
> of smokers v. the average age of an alcohol related death isn't right.

It is an apples and oranges comparison, but that's just the data we have. I
tried to word this in a way that highlighted the fact that the comparison was
a little dodgy.

~~~
the_watcher
Thanks for the clarification. I'm just pretty wary of any conclusions drawn
from this comparison, given the issues I highlighted.

~~~
Alex3917
That's probably a good idea. But hopefully surfacing the lack of good data is
at least some productive.

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the_watcher
This is probably the most important stat about drugs, however, it falls victim
to a pet peeve of mine. For cigarettes and alcohol and drugs of abuse (the
ones without accepted medical applications - street heroin, cocaine, etc.),
the analysis is pretty useful. However, with prescription drugs, simply
counting the number of deaths is misleading. ADR's are tragic, and we should
be doing all we can to learn more to prevent them. However, a correct
analysis, at least when attempting to optimize the way it seems he is trying
to, is to total the number of deaths caused by drugs, and then subtract the
number of deaths prevented by these drugs. All optimizations should be
addressed through that lens. I think the author would agree with this, I just
didn't see any mention of the fact that while drug deaths are tragic, there
are also many deaths prevented by current application of drugs, and ignoring
the opportunity cost of changing drug application (potentially reducing the
number of lives saved) is potentially dangerous.

~~~
Alex3917
Yeah I didn't mention this in the essay, other than briefly alluding to the
fact that not all were preventable, but if you look at the footnotes the
sources I linked to go into this in more detail. It's difficult to come up
with an exact number though: the primary source I'm citing says that (IIRC)
only about a third of ADRs are preventable, but the FDA page citing that
source says that most ADRs are preventable. And in a way they could both be
correct; it's possible that someone could die from taking an emphysema drug
that they needed in that moment, but maybe the emphysema itself was
preventable.

~~~
the_watcher
Thanks for the clarifications. Don't get me wrong, this was a great effort at
summarizing the data available, I was just adding the additional data that
would be useful.

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DanBC
The information about medication non-compliance is interesting.

Non compliance doesn't appear to be related to cost (similar rate in England
with low cost or free prescriptions and US with expensive prescriptions), or
severity of illness (main reason for failure of transplanted organs is non-
compliance with med regimen), etc etc.

About half the English medication budget (£4.5 bn of £9 bn) is wasted because
people do not take their medications properly.

There's possibly big money if you can work out a way to get people to take
their meds correctly. Drug companies want this; health providers want this.

~~~
michaelochurch
Is there any data on why people don't take their meds? Do they just forget to
take a pill every day, or is it willful noncompliance due either to
fear/misinformation or adverse effects? And is the problem typically that the
drugs don't work if not taken every day (i.e. missing a day compromises
treatment fully) or do the noncompliant tend to just stop taking them
outright?

~~~
Alex3917
This paper, linked in the footnotes, is a good starting place:

[http://www.tandfonline.com/doi/abs/10.1080/17437199.2010.537...](http://www.tandfonline.com/doi/abs/10.1080/17437199.2010.537592?journalCode=rhpr20#.U2fKd61dXaR)

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jimrandomh
Sanity check: This post attributes 19.1% of all deaths to smoking, but this is
greater than the total number of smokers (18.1% according to
[http://www.cdc.gov/tobacco/data_statistics/fact_sheets/adult...](http://www.cdc.gov/tobacco/data_statistics/fact_sheets/adult_data/cig_smoking/)
which was the first search result I got). Since the author used that statistic
and _didn 't_ immediately launch into a justification of how it's not
completely crazy, I can't trust this article enough to read further.

~~~
currymesurprise
That is the expected result for a sub-population that has a shorter lifespan.

My sibling comment addresses deaths lagging over time. But even in the steady
state of (say) 18% smokers, you expect _more_ than 18% of deaths to be smokers
because their life expectancy is shorter.

~~~
jimrandomh
If every time a smoker dies you blame it on smoking, then sure. But while
smoking is really terrible, it's not quite _that_ terrible; smokers still
manage to die of unrelated things sometimes.

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petesoder
Appreciate all the data packed into this post. There are some amazing stats
here. Agree that we definitely need this type of clarity to increase awareness
and generate dialogue.

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michaelochurch
The drug abuse that pisses me off the most is the doping of livestock with
antibiotics, to (a) make them grow faster, and (b) enable disgusting living
conditions for the animals being housed.

There are a lot of things we do wrong with antibiotics (e.g. doctors who
prescribe them for a cold, patients who finish a course prematurely because
they "feel fine", and the aforementioned abuse of them in factory farming) and
drug-resistant bacteria kill people who had nothing to do with the original
abuse.

That should be included in those statistics as well.

~~~
the_watcher
Unfortunately that is almost impossible to measure with our current tools (at
least I have never seen it done convincingly, and I generally agree with you
that this is ignored too much. Although I have to qualify that GMO-food is
better than no food, while recognizing that in almost all cases, that's not
anywhere close to what the choice boils down to).

I think it was sama who said that factory farming is one of the things that in
50 years we will look back at in confusion over why anyone accepted it, and I
tend to agree.

