What I find fascinating and disappointing is how much the opioid crisis isn't being talked about or addressed proportional to other societal issues.
Billions of dollars of private research being poured into self-driving cars by our greatest minds and millions of dollars in lobbying against gun laws all in the name of preventing unnecessary human deaths... yet according to Ben Bernanke (and his references), opioid overdose killed more people in 2015 than automobile accidents and firearms related crimes combined [1].
I'm curious whether the disproportionate concern has more to do with the perception of drug addicts as weak and deserving of their fate or because they're not a group that can be profited from politically or commercially or is overdosing just not as easy to solve as gun crime or automobile deaths?
Personally, I find all those excuses to be sad and bullshit so I'm hoping it's something else entirely.
I'm reminded of this Twitter exchange, in which Alan Kay graffiti'd YCombinator's "Make something people want" poster to say "Make something people need" and Paul Graham retorted that "making something people need but don't want kills startups".
The point of business is to create a customer. For that to happen, there has to be someone out there who has voluntarily decided they want to use (and ideally pay for) your product. The same goes for political movements - to build a mass political movement, you need a critical mass of people who voluntarily decide that this cause is worth investing time and money into.
By definition, addiction means that your voluntary choices are going to serve the furtherance of your addiction. So there's no customer there, and no profit potential, unless you're a drug dealer. Social interventions like drug treatment clinics could perhaps work, relying on the desires of loved ones, but it's very hard to help someone else unless they make choices to help themselves. When your brain chemistry has been altered so all it wants is more of the drug, that's not a given.
It's a hard problem. Unfortunately history hasn't been kind to populations with mass drug abuse; when I think of countries with a societal drug problem [1][2] or even subpopulations within a larger nation with widespread drug abuse [3][4], the cultures involved all basically collapsed. For countries, the general pattern involved top-down reforms -> military defeats -> revolution -> conquest by another power. For subcultures within a larger nation, it's the total marginalization of the group in question, assimilation into the larger population of the remaining productive members, and then long-term decay and blight on the remnants of the subculture.
Except in the case of opioids, government and regular ARE the problem. If they were legal and available through a regulated supply, most of the OD's would never happen. They happen because someone gets a dose of the drug that's 10-100 times stronger than the one they had yesterday.
That's no different than people going blind/dying from wood alcohol during prohibition.
The solution is to legalize and regulate, but I'm not holding my breath.
While I agree that a lot more funds for treatment are needed to fight the opioid epidemic, it is really a fundamentally different problem that road fatalities. The only thing they really have in common are the fatalities.
The opioid crisis seems like a symptom of our social problems (hopelessness in the rust belt, unscrupulous over-prescribing of pain meds) that has fatal consequences.
Short of a drug that provided a permanent cure for opioid addiction itself, I'm not sure what sort of solutions can be pursued by scientific/tech research, as opposed to addressing the root social causes.
I'm interested in what ideas others might have though.
Over the past decade, pharmaceutical companies have spent more than $880 million on lobbying and political contributions at the state and federal level. That’s more than eight times what the gun lobby and more than 200 times what those advocating for stricter prescribing rules spent over the same time period.
The makers of prescription painkillers have adopted a 50-state strategy that includes hundreds of lobbyists and millions in campaign contributions to help kill or weaken measures aimed at stemming the tide of prescription opioids
The United States alone holds over 45 percent of the global pharmaceutical market [1]. And less then 5 percent of earths population. Welcome to the society of pharmaceutical addiction.
You're comparing a measure in dollars with a measure in people. Yes, per capita expenditure on prescription medication is high in the US. Most other countries have a national health care system which negotiates the price for the whole country. The US market is where pharmaceutical companies expect to recoup their R&D costs, which makes drugs more expensive in the US than anywhere else. This effectively means that the US subsidizes drug prices for the rest of the world in exchange for determining which drugs are safe for humans (via the FDA) and getting slightly earlier access to newly developed drugs.
I would restate that to the "US market is where pharmaceutical companies like recoup their executive officer costs, which makes drugs more expensive in the US than anywhere else. The US subsidizes executive salaries for the rest of the world..."
http://www.ibtimes.com/healthcare-pharma-ceos-paid-more-top-...
> You're comparing a measure in dollars with a measure in people.
I'm not parent, but I'm sure this is intentional as the consequences of such a scenario are easy to extrapolate...
> The US market is where pharmaceutical companies expect to recoup their R&D costs.
They could do this in two ways - having high margins on their drugs, and/or selling a lot of drugs. It is no surprise to see pharma lobbying against tight laws on prescriptions, or anything that gets in the way of the 'market' getting access to their products. Not coincidentally, the opioid crises means they get to sell more drugs.
I think that they have both high margins on drugs (my gut estimate would be ten times what the rest of the world pays, but it looks like it is ordinarily only 2-5 times [0]) and they're selling a lot of drugs. It is disingenuous to claim that the US consumes 9 times more prescription drugs than the world average. The reality is probably closer to 2-5 times more drugs and that these drugs are 2-5 times more expensive by virtue of being sold in the US.
On the other hand in my home country we had some big pharmaceutical companies (compared to the size of the country) exporting drugs world wide. I thought that for example the pain killers I knew as I child would be used everywhere on the world. When I moved to Germany I realized that I was wrong. There are tons of different drugs for the same purpose with the same ingredients sold by different producers. Therefore only becasue you in the US buy some expensive - and highly addictive - pain killers you are not automatically financing the R&D of pain killers sold in Europe by Europian companies to the Europian people.
Let me be a smart ass and improve your calculation:
45% of drug revenue is generated by 5% of earth's population:
45% / 5% = 9
but you do not compare this number to 1 but to
55% of drug revenue is generated by 95% of earth's population:
55% / 95% = 0.58
So a US citizen spends 9 / 0.58 = 15.54 more on drugs as a non US citizen. Even if price difference is a valid argument, this number is still too high.
That, and criminalizing drug use. When people can no longer get access to or afford pharma drugs, they shift to illegal drugs. Once they are hooked on that, they are criminals, and they hide their problem, out of shame and fear or prosecution.
This. Anecdotally I know a friend whose doctor offered a potentially addictive medication, when the doctor knew or at least was told the friend drank frequently. The friend did not fill prescription for fear it would become addictive.
Did the doctor just say "Here, have these drugs" or did he/she prescribe the "potentially addictive" medication for a medical issue that should have been treated with that medication? Just not taking medication that your doctor thinks is necessary is not a good choice; you rarely know more than your doctor about the risk/reward profile of the medication.
That's not true at all. Drug companies bribe prominent doctors with multi-million dollar payments to convince other doctors that drugs are safer and more widely applicable than they actually are. If you refuse to take an opioid painkiller for fear of developing addiction, you are empirically demonstrating that you know more care more than your doctor about the risk/reward profile of the medication.
What if you are actually in pain? In that case, it might be fully rational to take the potentially addictive opioid painkiller, despite the possibility of developing an addiction.
I agree that the lobbying is a huge problem, but exposing/stopping that is a sociopolitical approach to the problem, not a scientific/technological approach. I am skeptical that the latter can do much for this problem, but I'm curious if others have ideas on that front.
> Short of a drug that provided a permanent cure for opioid addiction itself, I'm not sure what sort of solutions can be pursued by scientific/tech research, as opposed to addressing the root social causes.
Just give them the opiates for free in supervised facilities and let them have otherwise normal, albeit constipated lives. It works and costs very little.
Every time I bring this up people look at me like I am insane for suggesting such a thing.
What people don't think about is the extra societal costs associated with drug addition: thefts/violent crimes, prison costs, unproductive time from seeking the next high, etc. Cutting out the middleman would solve a great deal of these issues, and save the taxpayer money too.
It seems the moral issue of giving "free drugs" to addicts is just too much to bear, unfortunately.
How much do you give out then? At some point you'll be giving someone a dose so high they are guaranteed to die. Obviously no one can do that because of legal justifications. However now you have to set an arbitrary limit to what someone can receive. The user may not agree with this amount and will seek to acquire more. Thereby resorting to the same tactics as before it was given away. I don't think it's as simple as you want it to be.
I honestly believe drug addiction is a symptom of a greater issue in someone's life. There is no person who wakes up and says "I think I'll get addicted to heroin today"; it becomes a means of escape and relief from something that gradually turns into its own monster and creates a terrible cycle of dependence.
By cutting out the time and money needed to "feed the beast" while providing professional help, they can break this cycle and move towards bettering themselves when they don't have the nagging of addiction voicing itself at every turn.
Of course its not simple and perhaps there will be people who refuse to better themselves. My biggest point is that it not only will save money from going underground, but allow potentially productive members of society to have a means to break the cycle.
The vast majority of heroin addicts today started with prescription painkillers. Many of them went into a doctor's office and took the pill that was prescribed to them by a trusted community member with a diploma on the wall. The problem was that these doctors were frequently either directly corrupt or under the unwitting influence of false advertising from Purdue Pharmaceuticals.
When I had my wisdom teeth pulled and was prescribed an entire bottle of Vicodin, when I didn't even need a single one, that wasn't a greater issue in my life. That was medical malfeasance and a just society would execute the principal architects of it.
I think this is definitely the problem in the United States. In my country they don't just willy nilly prescribe opioids. The best you get is ibuprofen. For example, after a terrible shoulder injury or tooth extraction, that's all you get. It helps with the pain, but doesn't remove it 100%, doesn't get you hooked though. Of course they give IV opioids after surgeries and such, but even then something mild and in small doses, and only for a certain period time. I remember still feeling pain after an appendectomy, but they refused to give me any more tramadol and just switched to IV ibuprofen. It's just not a thing as a prescription medicine. Except maybe for terminal cancer patients or something equally drastic.
Going off on a tangent, what my country might have a problem with, is benzos, however. They're prescribed like psychiatric vitamins.
What does the manufacturer of OxyContin (Purdue) have to do with you being prescribed Vicodin? And the world generally agrees that a just society wouldn't execute anyone. And the greatest issue in your life was that you were prescribed some pills you didn't need to take, just in case you had been in pain? That's a pretty good life.
A just society executing the principal architects sounds similar to Italy recently prosecuting the seismologists for incorrectly predicting earthquakes.
I agree that there is a problem with over prescription of opioids, but this problem isn't solely due to a simple conspiracy of drug makers. I think that sort of rhetoric is unhelpful.
What you fail to see in drawing your analogy is that seismologists aren't being incentivized to give specific readings. Pharmaceutical companies are loading the gun and they know it.
I see your point with the pharmaceuticals and they have a share of blame, but I would argue that the analogy has merit as the prosecution in the seismology case would not have pushed for punishment if the scientists were merely wrong.
From my reading (and I will admit I do not see the logical reasoning at all, which I think is why the case was later overturned) the judge thought that they were guilty not of failing to predict it, but of giving an inadequate message. Presumably, to me this implies some sort of laziness, or intent to not make more of an effort despite knowing better.
I will admit that I am biased being a doctor dealing with this daily, but I think that blaming this solely on the pharmaceutical companies is easier to do than looking at what is happening to our culture, expectations of pain, the way we deliver healthcare, how we grade healthcare (for example read about Press Ganey's Fifth Vital Sign).
> At some point you'll be giving someone a dose so high they are guaranteed to die.
This is not how opioid pharmacology works. Tolerance to the desired effects (analgesia) increases but so does tolerance to the problematic effects (respiratory depression).
Opioid use -- even chronic and long-term use -- is not a death sentence. The phenomenon of so many opioid-related deaths referred to as the "opioid epidemic" is an extremely recent one (compared to the timescale that humans have been using opiates for pain relief) and is a product of drug policy/enforcement, not of the inherent evil of opioids.
No, at least opioids don't work that way. There is no dose so high as to be guaranteed to be fatal -- it's entirely dependent upon an individual person's tolerance. There is effectively no ceiling opioid dose.
There is also, IIRC (though it's been a few years since I was last researching this) for many people a limit on the tolerance one builds up (though it certainly gets very high). I recall something about addicts in the Netherlands—which has a program like the one suggested—eventually hitting a stable dose and staying there.
> Short of a drug that provided a permanent cure for opioid addiction itself, I'm not sure what sort of solutions can be pursued by scientific/tech research, as opposed to addressing the root social causes.
People have actually been trying vaccine approaches to opioid addiction for a while, but it's tricky since opioids are small molecules which inherently don't give you a lot to work with as far as antigen presentation.
Apparently there has been some promising evidence recently though. See Derek Lowe's blog below for details.
Short of a drug that provided a permanent cure for opioid addiction itself, I'm not sure what sort of solutions can be pursued by scientific/tech research
Along with its therapeutic cousins Cannabis and MDMA, look what else we have on the list of substances for which federal research funds are banned (Schedule I):
> Ibogaine causes long QT syndrome at therapeutic doses, apparently by blocking hERG potassium channels in the heart.
Yea. That doesn't necessarily sound good:
> Clinical studies of ibogaine to treat drug addiction began in the early 1990s, but concerns about cardiotoxicity led to termination of those studies. There is currently insufficient data to determine whether it is useful in treating addiction.
I'm not really sure this is some sort of miracle drug that the establishment just doesn't want us to know about.
I'm not really sure this is some sort of miracle drug that the establishment just doesn't want us to know about
The thing is, it doesn't matter if you're "sure" or not, because while it's on Schedule I there can be no federal funds used for research into whatever degree it may be a "miracle" (nirvana fallacy) drug. I hope we can agree that therapeutic substances have been derived from harmful ones.
It can be done in the US with proper licensing, "just" if you get the funds from elsewhere. Not a small hurdle by any means, but it's not like you'll be blackballed (you can see plenty of studies of schedule 1 substances on PubMed, which is run by the US government).
I don't necessarily agree with it being Schedule I, but at the same time it's not "one weird trick" that the establishment doesn't want you to know about either. It's not something that's only waiting to be packaged up and sent to drug trials to start getting used (but is held back because "the man" thinks it will upset the status quo).
The drug is toxic in humans but I think it also means we can't do comparative trials on the mechanism in mice. There might be something to discover about the mechanism that could be brought by a different drug that doesn't have the cardiotoxicity.
> I'm curious whether the disproportionate concern has more to do with the perception of drug addicts as weak and deserving of their fate
This. The AIDS epidemic in the 1980's was the same. Tens of thousands of people dying every year, with more than forty thousand per year at jts peak, and more than 600,000 dead to date. Because of homophobia, the public at large didn't care about the victims - most people, if they took notice at all, only expressed groundless fear in catching HIV just going about their business.
Opiate addiction isn't a disease in the sense that there's a biological virus or bacteria that can be transmitted from person to person, so "normal" people think they can't "catch" it. And so without public sympathy for the victims, no wonder there isn't some mass political movement trying to get Congress to fund a proper response.
This is dead on, no pun intended. And it's made worse by the fact that even people who are personally affected by the overdose epidemic usually are culturally conditioned to shun the addicts (e.g. friends or family), and so instead of coming out and saying in public, "Yes, I have been personally affected by this horrible thing, we need to do something about it," you find that people keep this kind of thing quiet, because addiction and addicts are looked down upon. I think the analogy with HIV/AIDS is very succinct and relevant.
I fortunately don't have a ton of direct experience in this area. But spent alot of time with a recovering addict/alcoholic and drug counselor.
Maybe his point of view was out of date, but I recall that he saw kicking any of these problems was something that came from within. You had to want out strongly. My friends moment was when his kids didn't want to see him.
People shun addicts to survive, not out of cultural conditioning. The addiction comes first, and the addict will hurt anyone to get it.
A lot of money is being spent on this, but the obvious solution--providing addicts with known, tested opiates and safe places to use--is illegal. Addicts are most certainly a group that can be profited off. We have entire industries that do that, sometimes exclusively: sugar, alcohol, tobacco, marijuana, big pharma, etc. In fact, it's this intention of our laws to encourage such profiting off of the suffering and deaths of addicts that I think is the reason no one is really trying to fix much. The other reason is, likely, that this is a rather unfixable cultural problem stemming from poverty, loneliness, and other cultural factors.
Methadone clinics, rehabs and other places like that, however, do profit off of addicts' recovery and may even have genuine intentions of helping (it seems to vary from place to place). Those profits are minor compared to the profit off of addicts' misery and death, however, and their efforts are not usually talked about much in the press. Laws also hold back such institutions from providing good treatment and dehumanize the addicts trying to stay clean. In many places, addicts are treated horribly and made to suffer intentionally by the staff, often having to wait around sick for hours just to see a doctor before getting a dose of methadone even though they've been on the program for years. They are made to line up daily or weekly for a dose when a regular prescription would do just fine, even after they've been on methadone for years. At many of these clinics, it's a wonder that anyone stays clean. There is no professionalism. Doses are messed up when addicts travel and they are left without their methadone. Staff end up stealing either money or methadone. There is no accountability. Not all clinics lack compassion and treat addicts badly, but many do. It's no wonder these places try to fly under the radar while the good clinics and rehabs are too busy helping addicts to be in the press or make much noise. If cancer or heart patients were treated this way, you can bet your ass there'd be a national backlash, but our society has been conditioned to have no compassion for addicts. This is the result. It's ugly and nasty.
Interestingly, when the DEA was trying to emergency schedule kratom late late year, one of the biggest groups lobbying for the scheduling were addiction recovery clinics. These groups also lobby heavily for kratom scheduling on the state level. They were instrumental, for example, in the effort to schedule kratom in Alabama (which incidentally saw a 30% increase in the number of opiate overdose deaths in the weeks after kratom was scheduled). It takes no imagination to understand why they would want to eliminate a cheap, accessible, safe competitor that works, like kratom.
For sure. This is why I question the idea of for-profit businesses helping rather than hurting and say it's a mixed bag. There really are some places that care about helping (especially outside the US and in rich areas in the US), but there are also plenty of places that do more harm than good. For-profit, free market capitalism's goals are hardly ever aligned with the goals of society and humanity.
Incredibly spot on. That's why I went on Suboxone instead, solely because it means I only have to go in once a fortnight. Nice regular prescription, but yeah the amount of travel I do is difficult with it, despite being on the program for 5 years.
Yup. From what I've seen as a family member of an addict in recovery, you can work your way up to 28 bottles of methadone and do guest dosing, but the amount of planning, waiting, preparation, and willingness to deal with fuckups is colossal. Colossal enough that it stresses me out and I'm not even the patient. And this is traveling a few times a year. Imagine ending up in a foreign country with not enough medicine because the people handing it out are too incompetent to count the days of your vacation and rush you out of there. That's how we found out how much of a difference in compassion there is between clinics in Europe and the US. The ones in Europe really went out of their way to treat the patients with cordiality and to help them, even though the patient was a foreigner. Free of charge. While the one here took dozens of phone calls just to figure out there was a mistake. I really hope attitudes start to change. It's so hard to see a family member struggling with this and of course, that's absolutely nothing compared to their actual struggle. It's great to hear about others doing well on their path to recovery. I wish you all the best!
In Sam Quinone's "Dreamland" (well worth a read) he talks about how the opioid epidemic stayed out of the public eye for so long, and he attributes a lot of it to the general perception of addiction as a moral failure, or weakness - parents don't talk about their dead children dying of addiction, because of the shame and judgement they feel [0]. So a lot of the deaths (and the suffering that can lead up to it) is hushed up. This tide is turning, now, as people are more willing to speak honestly and openly about how they and their families have been affected by addiction, and the realisation that anyone can be addicted to opiates, and it's not just a matter of not having sufficient backbone to resist their effects.
On the matter of self-driving car investment, vs opiate addiction treatment - car makers need to turn a profit, so they need something new to sell. A lot of people also commute daily, and don't enjoy doing so. So in the (distant) shiny future where your car drives you to work, they are building something that I think a lot of people will be willing to pay for, or use as a service.
[0] Addendum - it also avoided the public eye because of where addiction was happening, and who to. A lot of it started in smaller towns, often those struggling economically. The kind of places that don't get a lot of attention.
Well, I've been following the GOP Senate healthcare bill closely over the last month, and several GOP Senators have stood their ground amidst pressure from party leaders as well as the Whitehouse to protect funding for their Home State's opioid epidemic. It's been a frontline issue in nearly every article I've read regarding the GOP's difficulty in getting to 50 votes.
So while the public at large may be ignorant of this crisis (and honestly, on how many issues is even the most educated of us truly knowledgeable about?) the States' representatives that have these problems back home appear to be taking it very seriously.
1. The opioid crisis is getting a lot of airtime in the media outlets that I read.
3. The opioid crisis is one of the biggest reasons why the Senate's Trumpcare bill is now dead, and was also a major topic of discussion in the weeks leading up to its unexpected loss this week. In short, its drastic cuts to Medicaid would have decimated opioid treatment in some of the states hit hardest, and Senator Capito of West Virginia, at least, would have voted against it because the $40-odd billion dollars that Mitch McConnell would've specifically allocated to opioid treatment would have been a 'drop in the bucket.' Here's some earlier discussion of this point: http://talkingpointsmemo.com/dc/capito-says-opiod-treatment-...
So, all said, maybe find some new sources of news and discussion?
What I was referring to was the proportionality, obviously it IS being discussed (I linked a prominent policy maker discussing it), so really what I'm saying is that the amount of airtime/attention given to stories on the opioid crisis was far less than the combined number of stories attending to gun crimes or self-driving car successes/failures.
I remember seeing a Vanguard episode on the "pain management" industry in Florida called the Oxycontin Express [1] back in 2009 (won a Peabody). And yet it's only in the last year or so that I've actually heard about it being addressed more publicly.
If you're telling me that I'm wrong and that actually more people, dollars, and attention are going toward saving people from opioid overdose than automobile accidents and gun crime, then I would be happy to be wrong and would want to see numbers.
Otherwise it sounds like you're telling me to tune my news inputs so I hear stories in a proportion that would please me better?
Everybody dies from something so there'll always be a top cause of death. I think we accept diseases of old age like heart disease and cancer as an inevitable part of being human. Sure it'd be nice to cure them. It'd also be nice to have immortality.
You could go further and say brain death is the leading cause of death, affecting 100% of Americans. Let's put more effort into transferring our consciousness into computers so we can survive it! Again, it would be nice but seems tolerable to carry on as we are.
I believe at least one of the reasons why those are given more attention is because they are more likely to affect younger people and they seem more preventable. As opposed to cancer and heart disease which are more likely to kill older people and often develop over a lifetime.
Not quite true. More auto accident deaths than opioid overdose deaths.
From your own link:
"According to the Center for Disease Control, in 2015 52,404 people died from drug overdoses in the United States. 33,091 of those deaths involved opioids. In comparison, 35,092 people died in auto accidents in 2015 (Department of Transportation), and 12,195 people died from non-suicide firearm-related injuries in 2014 (CDC, 2015 data not yet available)."
What I find fascinating and disappointing is how much the opioid crisis isn't being talked about or addressed proportional to other societal issues.
I'm not surprised at all, and the only emotion I feel is complete disgust, directed at politicians that refuse to work together. It started the second Obama was elected POTUS and the opposing party declared they would not work with him, and that lasted the full 8 years.
Your mistake is believing that people invest in self-driving cars as a sort of charity or social service in the same way as drug clinics. Even if that were the case, I think there's a reasonable case to be made that solving self-driving cars would be a better lives-saved/$ investment than opioids. Even if it was a comparable investment, it wouldn't make addicts as socially-productive a group as crash victims--this would take tens/hundreds of millions more in social services.
Even neglecting that, crash victims are more worthy (on average) than overdose victims, as they come into their fate largely on accident, while overdose victims largely make an informed choice to roll the dice. I don't like saying this; it sounds judgmental and it certainly won't be popular, but this is the logical conclusion. Fortunately, the choice between self-driving cars and combatting the opioid epidemic doesn't remotely hinge on this point.
> while overdose victims largely make an informed choice to roll the dice
Don't most people develop an opioid addiction after being prescribed insufficient pain medication by their doctor? After that, sure, once they realize that getting more opioids - much more than they ought to, medically or legally - is literally the only way to stop the daily pain?
There are a number of factors at work. One of them is existing factions. There are existing political power blocks that stand strongly against "solutions" to "the gun problem".
What do you want to see? What would you consider an ideal world here?
I know how you feel. It's utterly ridiculous that a society should so heartlessly abandon the most vulnerable among us who struggle so needlessly. We should do better! We can do better! We MUST do better! It's a moral imperative.
Yet, for all that, it's possible that resources are limited. And when resources are limited, questions of sustainability, achievability, returns, and cost-effectiveness become relevant. This is particularly true when there multiple goals to be chased - would you be happy if all Medicare funding for the elderly was stripped away in favor of treating opioid addiction?
Resources are not limited. It is plentiful, except that society sees the resource of human labor and love as only valuable when it is profitable.
If corporations found it profitable to ensure everybody was happy and living well, I can guarantee you that the vulnerable would be taken care of very well.
It is just a matter of perception. By graviating towards money and profit, we undermine the worth of all humans and hence you asking "would you be happy if all Medicare funding for the elderly was stripped away in favor of treating opioid addiction?".
> Resources are not limited. It is plentiful, except that society sees the resource of human labor and love as only valuable when it is profitable.
You're right! Resources are unquestionably plentiful! However, it's possible that plentiful might be slightly different from unlimited. If I wanted a billion PhD-educated engineers to colonize Mars tomorrow, I might run into limits, no?
It is just a matter of perception. By thinking about how to best utilize plentiful-but-limited resources, considering the value and independence of all humans, we think about how best to create a system in which all these wonderful and infinitely valuable humans self-organize for what's best for them. That way we can gravitate towards happiness and wellness!
I'd glad we agree on the value of humanity. I see human labor, human love, and human affection as valuable at all times and places. I also see that humans are plentiful-but-limited, time is plentiful-but-limited, and resources are plentiful-but-limited.
> Of course nobody would be happy! :)
Yeah. That's because it's obviously a bad way to distribute plentiful-but-limited resources like human labor and human love and human-run biochemical production facilities to make the greatest number of people as happy and well as possible.
Who would win and lose by addressing the Opioid crisis or not? Consider their relative power (wealth) and organization/unity.
It's the same for basically every issue. Humans can be altruistic, but organizations rarely are.
Simply: change happens when expending power leads to a greater expected increase in (relative) power than doing nothing for a sufficient amount of power-brokers to overcome costs of change and opponents(those who expect to lose from the change). This is a structural issue, not human nature.
Blaming the addicts helps to reduce the cost of doing nothing. The good(?) news is that this is tending to hit wealthier people than past epidemics and so is getting correspondingly greater attention.
Rejoice! The problem is far worse than these sad, bullshit excuses.
>perception of drug addicts as weak and deserving of their fate
I think you're right but the reasoning is one step removed from the conclusion.
Drug addition is a poor people problem (in part because it takes resources and support to break the cycle).
Opiod (and meth for that matter) addiction skews rural and therefore white.
A lot of people take the attitude that poor rural white trash are poor white trash because they live in a dying town with no industry and refuse to relocate to somewhere they can more easily scrape by. The catch is that the people making these judgements generally have a very different set of values than the people they're judging.
When you take the attitude that the situation that leads one to easily become an addict is the fault of the addict then it's hard to have sympathy for addicts.
There's also a lot of (well meaning) "optimism to the point of stupidity" in assessing how effective firearms legislation is as an avenue to reduce violent crime and how easy it is to make a driver-less car that can effectively share the roads with vehicles operated by people
My company (https://pelorushealth.com) is a remote case-management/recovery coach app suit for people who are recovery from substance abuse, namely opioids and alcohol.
One of our biggest blockers has been the existing recovery industry. Addiction is so stigmatized that getting people to use an app on their phone, even after treatment, is problematic because they feel like the data could get out that they're an addict. This is another reason more research isn't done. These existing facilities literally don't collect data - much less use it in any relevant way.
Value-based payments and growing oversight from insurance companies is changing that somewhat. These facilities are starting to be required to report outcomes data - so from a business perspective we're good. But man this industry and it's privacy/secrecy are something else.
Self-driving cars actually would have a benefit for society in terms of higher durability for vehicle and optimal road selection leading to lower carbon emissions, lower traffic accidents, and less use of natural resources.
I am more annoyed by all the time and effort going into Google's and Facebook's ad-tech optimizations.
> millions of dollars in lobbying against gun laws
Wait, what? This is a "lobby"?
I thought the NRA with their even larger resources, backed by industrial interests, is the actual lobby. You know, the one who pushed forward those laws into insane directions, which you'll find almost nowhere else in the world.
The recent Nautilus article about why our brain hates other people[1] makes an attempt at categorizing how we view people along two axis. How emotionally warm we perceive members of another group and how competent we perceive them. The article than goes on to describe how we react to these categorizations. According to the article we are physically disgusted by people with both perceived low competence and low warmth. The effect is compared to seeing a maggot infected wound. The article uses drug addicts as the example of a group we perceive that way.
I'm not sure where you concern lies... you mentioned millions being poured into a fight against gun laws to prevent deaths?
Assuming that might have been misspeech, it's easy to see why autonomous vehicles have so much more interest. The interest isn't in preventing human death, the interest is there because not only is it a more fascinating problem to solve, but it saves everybody time and hassle. Lowering the number of deaths is just a great effect.
Focus on a problem isn't always about sheer concern, sometimes the focus is so much higher just because it's a problem more people feel they can contribute to solving. Parkinson's law of triviality...
Along those same lines, how about our modern day obsession with LGBT and racial issues. Yes, those are important, but I feel like the amount of time that is put into them is completely disproportionate relative to other very troubling issues(such as the opioid epidemic)
I agree to some extent. Many times when discussing these other societal issues we point to the levels of violence and conditions that affect one group proportional to other groups.
Young black males are disproportionately the victims of gun crime, pretty sure that is a well-known fact that I don't need to look up. I also believe the data is in on young white males disproportionately being the victims of opioid overdose [1].
Are opioids a white problem and guns a black problem? Or are both actually related to a different condition and it's actually a young male problem? What about if we looked at the socio-economic class of these people ignoring age, sex and race? Something common there?
I think that the focus on the racial/ethnic/sexual/gender makeup of the victims is less useful than some people want it to be.
If anything I'd say it's an economic and community issue, this Kutzgesat video goes into it somewhere [2]. If there were better community support systems for people of lower economic classes then I think we'd see far less overdose and gun crime.
One thing I will say though, and it is addressed in the first link somewhat, is the way drug enforcement is (and has been) conducted differently in different communities. That certainly exposes much of the systematic discrimination in drug enforcement which I do hold as almost as serious a problem as these deaths.
Solving the self driving car issue seems possible, and you have a way to make money. I don't think it is possible to end the opium crisis so long as you have areas where there is nothing else to do and these people don't really.have anything else to aspire to. Even if you.solved it how are you going to make money on it? The addicts don't have the money, the local communies are already broke and it will take forever to get a federal grant.
Well...depending on what you're selling they are probably excellent customers. Sorry, couldn't resist.
On a more serious note however, I understand what you mean. I think there's also the perception that significant cases of drug abuse, addiction and the crimes related to this are something that seems to happen far, far away for most people in a position to offer help. Something you see in movies and dramatic VICE documentaries, but not in your own backyard. If you're not confronted with the problem it's easy to not perceive it as one.
Why don't you go solve it? Who are you waiting for? Maybe some of us wanna work on self-driving cars. I often see people lamenting about the world's problem. Waiting for someone else to solve it. If you find it so disappointing, go for it! You can do it!
Our society is one built upon the idea of specialization. And when the specialists fail, they are asked to correct course. Your attitude is unwarranted.
Billions of dollars of private research being poured into self-driving cars by our greatest minds and millions of dollars in lobbying against gun laws all in the name of preventing unnecessary human deaths... yet according to Ben Bernanke (and his references), opioid overdose killed more people in 2015 than automobile accidents and firearms related crimes combined [1].
I'm curious whether the disproportionate concern has more to do with the perception of drug addicts as weak and deserving of their fate or because they're not a group that can be profited from politically or commercially or is overdosing just not as easy to solve as gun crime or automobile deaths?
Personally, I find all those excuses to be sad and bullshit so I'm hoping it's something else entirely.
[1] https://www.brookings.edu/wp-content/uploads/2017/06/es_2017...