"These regressions are difficult to interpret for a number of reasons, but if cross-county differences in opioid prescription rates can be taken as an exogenous result of differences in medical practices and norms conditional on personal characteristics and broad region dummies, the effect of the growth in opioid prescriptions on labor force can be estimated. In particular, I assume that the based opioid prescription rate coefficient reflects inherent differences across regions, and the interaction between prescriptions and time captures the effect of changes in prescriptions on labor force participation over time. This is a big leap, and ideally I would have preferred to have a baseline measure of prescriptions (country-level MME data are unavailable before 2010), so this calculation is at best considered illustrative. These caveats aside, opioid prescriptions per capita increased by a factor of 3.5 nationwide between 1999 and 2015, which is the equivalent of 0.55 log units. Multiplying 0.55 by the coefficient on the interaction between opioids and the second period (.011), suggests that the increase in opioid prescriptions could account for perhaps a 0.6 percentage point decline in male labor force participation, which is 20 percent of the observed decline in this period."
Reporter: "Opioid Use Explains 20% of Drop in American Men From Labor Force"
So, which is better? That? Or accurate, nuanced reporting that the everyman does not even attempt to read because his eyes glaze over before he's done parsing the first sentence?
The problem is not with the news, the problem is that this is what human nature is. The vast majority of people are amazingly bad at absorbing information regarding things beyond their immediate interests and horizon.
And thorough, well researched, objective journalism has atrophied or gone underground in the wake of the digital readership monetization crisis.
And AFK, how many reporters are there now versus news readers? When you can buy your rhetoric and blurbs right from the think tanks in partnership with SocialCo(TM) and have anyone who looks the part read off the script, it makes sense not to spend the money on originality and depth.
It takes some mental acrobatics not to want to call that an ersatz representation or a fools interpretation of what journalism is.
EDIT: Suicide by cop article was Wapo, not NYT. I need to stop reading Wapo.
I don't even mind that much that they pick a side if they do it at the end, I just want them to present both arguments, and their merits so I can decide.
When the best out there does what the NYT is doing now, we're in trouble.
I tend to not go on Facebook too often. But when I do, there are two categories of news (or news and news-like, I should say) items on my feed:
- posts by Nautilus Magazine, Aeon Magazine, along with articles from more specialized journals like Sky & Telescope, etc
- reposts by Facebook friends from fringe blogs
The contrast is so huge, it's hilarious. I read one category for actual information; the other could be entertainment, except it tends to push me towards cynicism, so I end up just ignoring it.
Maybe I should restructure my Google News feed and just use that instead.
Is that "is much more widespread and is also insidiously damaging" or "is much more widespread and is much more insidiously damaging"?
So now that someone is beating them at their own game, they came out for blood and you see facebook effectively filtering out whatever is considered fake news, which is ridiculous on so many levels.
Opoid abuse has been _observed_ in other civilizations as leading to a collapse in labor throughput. The Middle Eastern empires, the Chinese Empires, etc... have all recorded _correlated_ evidence of opoid abuse to a collapse in economic throughput, but never "_proven_" it under the "rigor of Western Science".
The real question isn't so much as to _what_ caused the drop in labor force. It is obviously not only drug abuse, where drug abuse is understood to be a symptom of the problem(s). The question that the scientist cannot or will not answer is why the Americans did this to themselves.
The current title on the article:
> Opioid Use May Explain 20% of Drop in American Men’s Labor-Force Participation
This says more about the factory than the junkies. Figure out why nobody decent will work there.
Meanwhile opioids and meth are completely out of control, but because they are largely white rural/suburban drug users, they have been getting a free pass for decades.
"Good people don't smoke marijuana."
"We need grown-ups in charge in Washington to say marijuana is not the kind of thing that ought to be legalized, it ought not to be minimized, that it's in fact a very real danger."
“I thought those guys [the Ku Klux Klan] were OK until I learned they smoked pot.”
“Colorado was one of the leading states that started the movement to suggest that marijuana is not dangerous. And we’re going to find it, in my opinion, ripple throughout the entire American citizenry; and we’re going to see more marijuana use, and it’s not going to be good. We’re going to see more other drug use, illegal drug use, also, which is damaging.”
Are you saying what we need is a draconian crackdown on more drug users? I understand the impulse, but I don't agree that that is the solution, personally.
>rural and suburban Americans haven't been murdering anyone
Those drugs are brought into the US by very violent gangs and I certainly can grow pot peacefully in my home. Ignoring the trafficking of these drugs is morally inexcusable. How many of these addicts make their own opioids or meth? Meth linked crimes are a huge number and almost always violent. Opioid withdrawal brings in a great deal of crime too. Those rural towns that have fallen into opioid addiction are crime hellholes for this very reason.
Heavy opioid use is linked to crime, unlike some drugs:
>(2) heavy opioid users committed crimes significantly more frequently than did moderate opioid users, non-opioid polydrug users, cannabis users or alcohol users
>Methamphetamine was the only drug use variable that was strongly correlated with homicide.
I'd much rather work with "urban pot" users than rural meth and opioid addicts, and so would you. Why the former is more under attack than the latter shows our systemic problems with race in this country. Remember sentiment like this is why pot is illegal, from Harry J. Anslinger, the founder of the war on drugs:
“There are 100,000 total marijuana smokers in the U.S., and most are Negroes, Hispanics, Filipinos and entertainers. Their Satanic music, jazz and swing result from marijuana use. This marijuana causes white women to seek sexual relations with Negroes, entertainers and any others.”
“Reefer makes darkies think they’re as good as white men.”
Certainly, more ruled-as-murders per population unit happen in urban areas, but I'm aware of no statistics by urban/rural residence of killer (where a crime happens doesn't tell you where the criminal is from, and people who live in rural areas obviously can commit crimes in cities.)
And rural areas have higher death rates and it's at least plausible that the decreased population density makes it easier for evidence of homicide to be concealed and murders to be passed off as death by other causes, so the relative rates of ruled-as-murders may not accurately reflect the relative rate of actually-is-murder.
The idea that so many rural deaths could be covered-up murders is simply fanciful.
> “I do think it is related to declining labor-force participation among prime-age workers,”Federal Reserve Chair Janet Yellen said in a July Senate hearing when asked about the crisis. “I don’t know if it’s causal or if it’s a symptom of long-running economic maladies that have affected these communities and particularly affected workers who have seen their job opportunities decline.”
Edit: added the full quote.
It might also spur governments to do more to stay competitive in a sustainable way, e.g. investing more in education.
The only solution in elite policy circles is to spend more. The reality is we spend plenty, but we have a structure that makes it difficult to experiment. The problem is exacerbated because the most influential members of the upper classes can bypass the problem by either paying for private schools or by taking advantage of our neo-feudal school districting system and buy into exclusive neighborhoods with "public schools" — which are open to anyone who can swing a $1M mortgage!
Add in the fact that blue collar jobs are declining, most men are going to ask what is the point of trying. The answer they get back from society is one that they are unneeded.
The fact that many people are becoming unemployable is no fault of their own, and it's not the business' fault that don't need their labor. But as a society we need to decide what to do about it, because covering our ears and closing our eyes and yelling LALALALA and pretending it doesn't exist or will go away on its own is only going to make the problem worse.
Never mind that if every other business followed suit, they would destroy their customer base...
Bernie would have been a great UBI candidate.
Total private land value in the US is in the trillions.
Google and Apple could hardly make a dent in paying for a UBI.
>Landowners don't make profits from automation as much as corporations do.
Much of that land value is due to demand for space rather than productivity. Corporations generate wealth by adding value (at least theoretically) and benefit greatly from automation, so there is cash flow to tax.
Google and Apple are hardly the only corporations. They were just convenient examples of those who are successful at large-scale tax evasion and yet enjoy a generally good public image, along with Amazon, Facebook, et al.
Giving up actually makes sense. Drugs give back that feeling of satisfaction that has gone missing from people's lives.
EDIT: I changed up the first sentence to be less political as the downvotes reminded me HN is probably not the place for that sentiment.
It's ridiculous, because clearly automation and IT have increased output by huge factors; but clearly a number of forces (increased competition due to female candidates entering the workforce and lower-class candidates getting good education; adjustment of consumer prices over two salaries per family; etc etc) made it so that, on average, we "work" more for less pay. The work might be lighter on our bodies, and we all have running water in our homes, but apart from that we are not actually improving that much.
"We all have running water" is also a huge understatement on the improvements that have been made to American living conditions over the last several decades. As a nation we have bigger and better homes, safer and more reliable cars, cleaner air and water, unlimited access to knowledge, and the list goes on and on.
 - https://data.oecd.org/emp/hours-worked.htm
I was struck by my grandmother's stories about the sheer amount of totally manual labour she had to do in the early years of her marriage. Now I have automatic washer/dryers and don't have to make all my food from total scratch.
Inconveniently they get freed and you now have to pay them, worse they vote against you and without sufficient votes you are no longer viable and liable to lose the corruption money.
If only you could shake down the annoying population regularly and you know put them in their place wherein their place is a prison cell wherein you can work them for free again and take away their inconvenient vote.
Disenfranchisement has always been a tool as long as voting has been a thing in America. Its only a bold claim if you missed the last few hundred years.
So, the law may not make much difference in whether employers take felons, but it makes a huge difference in who is a felon.
It is, therefore, clearly intended that it continue, whether or not it was originally intentional.
It's definitely an uncomfortable and politically-incorrect claim, but I don't think it's a very bold one (in the sense of being a tenuously-supported leap of logic).
As I'm sure you know, the US has a very long history of racial bias in incarceration, going all the way back to the Civil War and before. Once black people were given the vote by the Fourteenth Amendment, Southern states took to underhanded means to re-disenfranchise them. Literacy tests, poll taxes, grandfather clauses, etc. Any arbitrary voting requirement they could manufacture that "just happened" to exclude more blacks than whites was fair game.
It was (and still is) bad enough to force a federal law to try to clamp it down, the Voting Rights Act of 1965, considered one of the most important pieces of civil rights legislation.
After that, Nixon declared the War on Drugs ostensibly to reduce drug use, which it has been famously ineffective at. John Erlichman, his domestic policy advisor at the time later claimed:
> The Nixon campaign in 1968, and the Nixon White House after that, had two
> enemies: the antiwar left and black people. You understand what I’m
> saying? We knew we couldn’t make it illegal to be either against the war
> or black, but by getting the public to associate the hippies with
> marijuana and blacks with heroin, and then criminalizing both heavily, we
> could disrupt those communities. We could arrest their leaders, raid their
> homes, break up their meetings, and vilify them night after night on the
> evening news. Did we know we were lying about the drugs? Of course we did.
In 2010, black people made up 13% of the US population, but 40% of the incarcerated. Black people are imprisoned at something like 5 times the rate of white people.
WTF. I wouldn't spend too much time defending this if I were you.
I'm sure it's not the whole story but I think it's reasonable enough to assume it will be a contributing factor for many.
I have never heard of peer pressure being a contributing factor in unemployment, does it work for employment, too? Cuz maybe that would make it a confounding variable.
I think the idea that unemployment may be socially transmissible to a degree is pretty reasonable. Part of the fear of unemployment is fear of social rejection, due to negative views about unemployment. If others in your peer group are unemployed, that component of the motivation is ameliorated. There are other, stronger, motivations to be employed of course. But it's an effect I would expect to see at the margin.
And yes, I would absolutely expect it to work for employment. I see nothing confounding about that.
The men aren't working because they're either injured or unemployed. Then, because their life sucks, the are more likely to turn to drugs.
Saying "opioids explain unemployment" has it exactly 100% backwards.
The average guy with a job, a house, wife, and 2.2 kids isn't going to get hooked on opioids. His life is already full.
Im interested on what there stance towards the DAO is going to be. A Contract-golem replacing CEOs - that's there audience being replaced.
Wonder if they are going to stay Neo-Liberal while the Revolution they spawned eats them.
Why? There's plenty of money to spread around in the drug wars too.
Empty mind is devils workshop.
"Opioid use COULD explain 20%..."
Seems backed up by this part of your quote:
"I don’t know if it’s causal or if it’s a symptom of long-running economic maladies..."
The title implies exactly what was quoted.
Low interest rates are supposed to help, but for the most part they've just led to bidding wars for real estate and financial assets, instead of building new businesses and increasing payrolls.
The 2016 US election is a sign of despair -- our politicians are seen as out-of-touch, barely acknowledging there is even a problem. You know it's bad if people are desperate enough that they're willing to vote for a guy like Donald Trump.
Unfortunately, little of his work is been translated into English yet, but Wikipedia has compiled a good list of articles: https://en.wikipedia.org/wiki/Bernard_Stiegler#Online_texts. This might help too: http://www.samkinsley.com/2011/11/01/reading-bernard-stiegle...
It's certainly anecdotal, but he started doing philosophy while serving a prison sentence (for armed robbery)
It makes addressing problems at that scale difficult because people tend to argue about individual causal links which are indeed related, but may not be the actual drivers.
1 - http://www.latimes.com/projects/oxycontin-part1/
2 - http://www.narconon.org/blog/heroin-addiction/5-reasons-pres...
One thing that rarely gets mentioned is how abundantly SAFE opiates are. If you know what you're getting, know what dosage it is, and know it's not adulterated with other substances, you can use opiates for decades without significant health complications (aside from constipation). Overdoses primarily happen with people mixing medications, trying to use unfamiliar medications recreationally (nothing can save a stupid person who wants to get high but can't be bothered to figure out what the right dose for that is for their body mass), or, most often now, having to get things from a black market where the supply is unknown potency or contents.
Fundamentally there is one group of people who is angry that other people are using a chemical to feel good because they feel that if other people aren't suffering as much as they have then they were cheated somehow. And they've been driving policy since the 80s, costing countless lives and monumental amounts of resources. Just to make sure no one has an easier time of life than they had.
But there's little evidence that opioids are effective for treating long term pain.
We know about 10% of people who take prescription opioids will become addicted, and that tends to be the people using them for chronic (long term) pain.
> Fundamentally there is one group of people who is angry that other people are using a chemical to feel good because they feel that if other people aren't suffering as much as they have then they were cheated somehow. And they've been driving policy since the 80s, costing countless lives and monumental amounts of resources. Just to make sure no one has an easier time of life than they had
No, that's wrong. There are people who see that opioids are massively over prescribed in the US, which is causing untold harm and death. Trying to cut back on that massive over-prescribing has to happen.
The problem lies with a fucked up health system that doesn't provide drug & alcohol rehab; and just cuts people off from their meds cold turkey.
There are a surprisingly large number of long-term wealthy opiate addicts who are not suffering from any sort of physical pain they are trying to cure. They are addicted, certainly, but manage their addiction like an alcoholic or smoker manages theirs. Unlike the alcoholic or smoker, however, they are unlikely to develop any cancers, cirrhosis, or other significant complications other than the constipation I mentioned. Constipation is inevitable because the gut has opioid receptors just like the brain does, only when those in the gut meet a receptor agonist, they stop gut movement. That's how Immodium A-D works. It's actually an opiate. But one formulated such that it will not cross the blood-brain barrier.
Also, my later statement, about the people who want to make sure no one is having it easier than they are, was in reference to the moralizers and the original drives to make various substances illegal as well as the 1980s 'war on drugs' push and similar. Drugs are not illegal because they're bad for you. That was never the basis of any of the laws. Poisons are not illegal to produce, possess, or ingest, generally speaking. Only chemicals which make people happy are.
Those concerned with dealing with the current opiate crisis certainly are not among that group of people simply angry that they didn't have the 'easy out' of popping a pill to be happy. I count myself among those deeply concerned. I live in West Virginia, a state with one of the highest rates of deaths from heroin overdose due to the restriction of the availability of prescription opiates with absolutely no attempt to provide any alternative to those dependent upon prescription opiates other than turning to heroin.
Dependence is simply a fact of opiate use. It's not evil. And it's not intractable. It CAN be dealt with by doctors, if they educate themselves through sources other than lying pharma company reps and avoid the inane moral stance that a patient should be able to stop taking them suddenly and any failure to do so is a moral one. Taper their dosage down. Do it over 6 months or a year if necessary. They're not blowing out their liver or kidneys or anything, and opiates are among the cheapest drugs there are (the non-synthetics at least), so there is no reason to hurry and try to force the patient to bear the discomfort of withdrawal. There is a hidden big problem behind that, though. It will only really work with patients who do not have other issues in their life which make stopping the use of opiates untenable. As we know from animal research, if you put mammals in a restrictive, unstimulating environment, they will naturally turn to addiction. If put in a stimulating, pleasant environment, they will avoid addiction and even wean themselves off automatically... but that requires providing people with a better life. The simple fact is that many people have terrible lives and desperately want an escape. I'm not sure what can be done in those situations... it almost seems immoral to ask them to drop the only thing that makes them feel good and simply bear their situation because we don't like the idea the pills are helping them.
It rarely gets mentioned because it's false.
First off, opiates are usually inefficient for long term pain management. We, at least, have no evidence they are effective for long term (>2 months) pain management and if you actually talk to pain patients the problems with long term opiate use are very obvious. I'm not talking about junkies on the street either, I'm talking about normal people who are obtaining their medication legally through a licensed physician, not the black market.
Patients often rapidly develop tolerance and then dependence. The can also induce hyperalgesia - a paradoxical increase in pain caused by long term opiate use, this is why patients on high doses of opiates usually feel less pain when weened off the drug. Additional side effects are disruption of hormone production, lethargy, listlessness, and sleep apnea.
There's just SO MUCH we don't know about long term use bit it's very clear there is significant harm with questionable benefit in a subset of the population.
>Fundamentally there is one group of people who is angry that other people are using a chemical to feel good because they feel that if other people aren't suffering as much as they have then they were cheated somehow
I don't doubt that prescription opioid abuse is itself a problem, nor that it may exacerbate the heroin epidemic, but the evidence suggests that it does not play a large casual role.
"Partly what you need to do is decide what your highest value is. It's the star. What are you aiming for? You can decide. But there are some criteria. It should be good for you in a way that facilitates your moving forward. Maybe it should be good for you in a way that's also good for your family, as well as for the larger community. It should cover the domain of life. There's constraints on what you should regard as a value, but within those constraints you have the choice. You have choice. The thing is that people will carry a heavy load if they get to pick the load. And they think, 'well, I won't carry any load.' Ok, fine, but then you'll be like the sled dog that has nothing to pull. You'll get bored. People are pack animals. They need to pull against a wait. And that's not true for everyone. It's not true for conscientious people. For the typical person, they'll eat themselves up unless they have a load. This is why there's such an opiate epidemic among so many dispossessed white, middle aged, unemployed men in the U.S. They lose their job, and then they're done. They despise themselves. They develop chronic pain syndromes and depression. And the chronic pain is treated with opiates. That's what we're doing. And you should watch when you talk to young men about responsibility. They're so thrilled about it. It just blows me away. Really?! That's what the counter-culture is? Grow up and do something useful. Really? I can do that? Oh, I'm so excited by that idea. No one ever mentioned that before. Rights, rights, rights, rights. Jesus. It's appalling. People have had enough of that. And they better have, because it's a non-productive mode of being. Responsibility, man. That's where the meaning in life is." --Jordan B Peterson
when society rejects you, it hurts at a tribal and physical level..
Why wouldn't they rather spend the money on things that mattered? like shelter/rent or food.
> Why wouldn't they rather spend the money on things that mattered?
Opioids are incredibly addictive. Once you're hooked, you don't think rationally about how you spend your money.
What good is a tin of beans compared to killing the craving for a smoke for an hour? No contest.
I could stop doing my shameful and deplorable thing any time I want to, but I will probably never want to stop as long as I keep doing it.
There is a button inside your brain labelled "do that again!", and it is an integral part of animal behavior control, to reinforce things that tend to increase survival potential. If you do something that pushes the button, you're probably going to do it again. And if you do multiple things that push it, you're going to do most often the thing that pushed it the hardest.
Eating food gives it a light tap, but nicotine mashes it really hard. That's why I decided a long, long time ago to never even touch a tobacco cigarette with my fingers, much less put one in my mouth. I'm afraid that not only would I not be able to stop, but that it would displace my lesser addictions, like overeating, video gaming, binge reading, and my other non-salubrious habits, so that I die from lung cancer instead of heart failure, which is the barrel I'm staring down now.
Why couldn't I have been addicted to exercise and fresh vegetables, right?
Q1: Medicaid co-pay for $1000 worth of OxyContin was (as of ~2014, might still be) on the order of $3-5. Those unable to get prescriptions fence stolen goods, primarily from rural WalMarts
Q2: Opiods are chemically similar to heroin. Addiction is severe and enslaving. Someone who wouldn't get off the couch to throw out the trash will walk miles in a snowstorm to get their fix.
> Where do they get the money to afford all those opoids?
"Shelter", when someone hits the bottom, consists of a flop-house or couch-surfing.
During the peak of my very long addiction, post retirement, I was spending $250/day - not counting the habits of friends that I helped to feed.
The only difference between what people call a junkie and myself is that I can afford it. That's also the reason why I was able to get adequate assistance to minimize the harmful behaviors. Err... I am on Suboxone, and probably will be for a very long time. I used for 35 years.
Anyhow, it can be expensive. Users equate use with life. Life always finds a way.
Nobody calls a guy a junkie, if said guy drives a new BMW and has a big house.
addicts aren't addicted to things that matter. they can want to spend their money on things to better their situation and be completely unable to do so. addiction is really hard to beat and is best treated with compassion, not judgement about irrational financial decisions.
Note how the crack cocaine is the drug here, after an unknown time on normal cocaine the nose got so bad that crack was the only way. Next there will be the mix with heroin, if this has not started yet. Then payment - said friend is blessed with a vagina so along with everything else this will be rented out for crack cocaine.
Coupled with this costs go up. As the addiction continues more crack cocaine is needed to get to baseline normal.
Along the way all friends and family get reamed out. Borrowed money is not returned. Then every line of credit is used, e.g. payday loans.
Moving in to a lover's pad means no rent and food doesn't matter by then.
There are jobs in the black economy for instance babysitting, for your dealer, for crack cocaine as payment, what could go wrong?
I have desperately tried to change the outcome for my friend but know I have as much luck with that as praying for my mum's arthritis to get better. I enabled too, I did lend her money to move flat share before I knew of the problem.
My friend does come from a background of poor single parenting and that gives rise to the so called addictive personality. All it took was to meet the allegedly cool crowd and get partying. It was great at the start but the price was addiction.
This is how a typical drug junkie should be - childhood narcissistic harm due to a lack of love. But we have not got that in America with the pill epidemic, that was a culture of greedy over prescribing by doctors. It has been a stupid epidemic, creating drug addicts. These people just get caught up in it like my friend and end up doing things they would never do just to pay for this descent into hell. It is just a matter of time.
My friend had a good job with great prospects, a lovely flat, a car, many things. Everything is gone. Paving the streets with gold would not have changed things. Making the drugs free would speed up the decline but I think this stuff is a lot cheaper than beer in a restaurant for your minimum next hit requirements. Begging can cover that, eventually.
It is easy to blame social economic matters but that is to miss the mark. The opioid crisis is a really bad deal and I believe that the numbers in the article are acceptable guesses as to the harm done.
I'm lucky to never had to deal with this, but if someone I'm close to is addicted I would get them checked into rehab even if I had to physically detain them.
This is the difference between an addiction and a hobby.
To answer your first question: Burglary, assault and theft, fraud, prostitution and drug dealing.
Get hooked on opioids and they ARE the only thing that matters.
My point? Maybe just because someone is taking opioids, people shouldn't automatically label them as unhireable.
People on suboxone and methadone would test positive for opioids as well...are these people also considered unhireable?
that introductory experience can be the start of a compulsive cycle that quickly leads to addiction.
Probably better sources, but the boogeyman scare tactics taught to children to keep them from experimenting with drugs is too simplistic and flawed - but hey no one is going to explain to kids how brain chemistry works because abstinence is ... easier.
It is really well written and researched and lays out the several separate events and trends that converged to make this perfect storm happen when and where it did:
You are 'unemployed' if you have looked for work in the last month. I'm only exaggerating a little when I say I haven't gone more than a month without looking for work... ever, past the age of fourteen or so. Even when I was happy with my current gig.
You are a 'discouraged worker' if you've looked for work in the last year. Year. A lot changes in a year. I personally do my best to interview at all of the top-tier silicon valley companies every year, because there's a lot of randomness in interviews, and I'm not completely unqualified, and getting a fte job at, say, netflix would net me a lot more than what I get as a contractor now, so I roll the dice. I can't imagine spending a year without looking for work.
I mean, I'm not saying these people shouldn't be helped; it's just that if you want to work, but you think there are no jobs for you, the rational thing to do is to re-evaluate that belief periodically. My own perception is that demand for my own labor varies sharply, opportunities come and go in a very short period of time. If you find logging into dice and sending some emails once a month too difficult, you have some other problem; I'm no shrink, but it sounds like depression to me.... Which is actually reasonably treatable these days; really, getting you treatment for depression so you can get a job is probably an incredibly good return on my social-services tax dollar.
This isn't an isolated incident it's an all too common pattern I've seen. The cycle works: you go to work and work as hard as you can, you get hurt, you can't afford the best care option, you take the cheaper meds so you can continue working, tolerance builds up, you can't perform, then you're let go. In the end you're left broke, hurting, unemployed, and addicted.
Opioids have never been found effective at managing chronic pain.
The other interesting thing is that women's labor participation is also down. There was pretty much an unbroken increase going back to the 50s, and then around 2000 it started to drop. The thing is, the drop in percentage points (the total number of non-working people) is about the same for men and for women, as far as I can see. So I don't understand where the idea comes from that it's men who are getting hit particularly hard.
Most of the people I know have (single?) parents who are in the same boat, making it almost impossible to move out on their own. Plus, you need reliable transportation, and vehicles are expensive. For someone just getting out of high school it's likely not an option.
Basically what I'm saying is, there are a lot of barriers that any employer would need to help overcome (wage being perhaps the biggest part) before you see any changes in this sector of society.
No kid my age wants to be a drug dealer. I don't care who you are or how poor your home life was. I would much rather go to work, get a loan for a half-decent (or even somewhat nice) vehicle that'll last me a decade if I take care of it, have my own apartment so I can have a few friends or my girlfriend over, etc.
I wouldn't say my generation is lazy. I just don't think factories or employers in general should require stable state of mind or hard work without paying enough to really make a difference in someone's life, i.e. enough to support a stable, independent way of life.
Actually, this seems to be borne out be reporting of newer surveys and studies. Those in stable employment and social settings are less vulnerable to addiction. Even when they "experiment"; they have more reasons not to chase the experience down the rabbit hole.
I've heard this specifically from several recent sources of reporting. Different shows and segments, largely on public radio.
That's not to mention the growing media and public re-evaluation of addiction and its causes, treatments, remediations, and possible solutions -- alongside comparison with the increasingly obviously counter-productive and expensive "tough on crime" practices with respect to it -- now taking place in the U.S.
 I could be wrong.
Has anybody actually asked these people why they use opioids? Or is it just economists running statistical regressions from their ivory towers?
Anecdotally, I believe the converse is true.
I wonder if "opioid addict" will replace the "welfare queen" stereotype for blame-the-victim-and-gov't memes.
The biggest problem with the 80s is the same problem we have now, Americans are easily scared shitless about every damn thing and the news just fuels it. In the 80's it was crack epidemic, devil worship and super predators. In the 90s, it was ecstasy and raves. In the 2000s it was meth, terrorism and trailer parks. Today it's opioids and ISIS.
As a country, we do irrational things because we always have an irrational fear. Who plants that fear? News.
Did you know we turned away boatloads of Jews during the holocaust because we were afraid German spies would be on the ships?
Remember Ebola? Zika? Anthrax? That scared the shit out of everyone and it ended up being a whole lot of not much.
When FDR said, "The only thing we have to fear is fear itself," he knew how afraid Americans are.
According to the paper, what follows is apparently what constitutes science these days.
To better understand the role of pain and pain medication in the life of prime age men who are neither working nor looking for work, I conducted a short online panel survey of 571 NLF prime men age 25-54 using an internet panel provided by Survey Sampling Inc, henceforth called the Princeton Pain Survey (PPS).20
That did an online survey of 571 persons and somehow they believe that this is real evidence?
Additionally they state that
Thus, on any given day, 31 percent of NLF prime age men take pain medication, most likely an opioid-based medication. And these figures likely understate the actual proportion of men taking prescription pain medication given the stigma and legal risk associated with reporting taking narcotics.
Consider the statement contained in the quote above.
most likely an opioid-based medication.
Now excuse me but the word most likely does not belong in any kind of scientific document.
Using an online form to gain information and then publish it as if it were valid is just ridiculous.
I cannot begin to understand why a “Real Study” was not conducted.
This paper while well meaning is in effect meaningless because of the lack of proper scientific investigation and procedures.
Additionally the number of Men surveyed, is in itself not a sufficient number to accurately predict any type of medical evidence of prescription drug use as a mediator for the so called, Opioid Crisis. In effect what has happened here is that there has been no scientific distinction between deaths associated with multiple drug use and prescription pain medication use. Even The CDC admits that they did not separate prescription drug deaths from illegal IV drug use, (Heroin) There is a need to call this what it is.
You can never expect to solve a problem when you are not willing to address what the problem actually is.
The problem is multiple illegal drug use involving IV Heroin, street drugs where the contents of those drugs is unknown.
Alcohol use along with multiple drug use most often is the common denominator for drug overdose deaths. How can anyone be expected to take this kind of nonsense seriously when the body of science as a whole "lumps" all conditions and all manner of drug induced deaths together and then "Label" it as a Crisis.
This is simply the War on Drugs 2.0
American men are using opioids because of the war on men waged by the elite and business elite.
When women are favored for jobs while men are being discriminated against and can't get jobs, then they turn to drugs.
Drug use is a result of lack of opportunities, it doesn't cause the lack of opportunities.
Look at what happened to china in the 1800s with their opium crisis when their society was attack by european powers.
Look at what happened to russia in the 1990s when lack of opportunities cause their male population to resort to drugs and alcohol.
This is a problem caused by bloomberg and the media.
When men are systematically disadvantaged in job prospects, when men are attacked as rapists in college campus and when the media wages a war against men in america, you can't offload the blame to "opioids".
The problem in america isn't opioids. It's the media and the elite.
The OP said men are attacked as rapists. There is just no way to interpret that as "decline of the acceptance of rape".
As background, see:
The typical University holds kangaroo trials for students accused of rape. Normal behavior includes:
* denial of due process
* refusing to see exculpatory evidence
* "independent investigators" who assist the plaintiff
* allowing the plaintiff to have representation, while denying it to the accused
* refusing to let the accused question the plaintiff
The accusation of rape is so evil that the universities fall all over themselves to violate their own investigative processes in order to convict the accused.
These students (overwhelmingly male) lose everything. They lose not only time at university, they lose grants, membership in university organizations, jobs, etc. Their entire life is destroyed.
So it's offensive for you to read that "men get attacked as rapists", and somehow turn that into a man-hating comment of a "decline in the acceptance of rape".
Do you really hate men that much, that you think they're upset that rape is no longer "accepted"?
Where did I say that? You are just resorting to outright straw man arguments now?
I'm just pointing out that the lies the media tells about "campus rape culture" as if every college woman is being raped and every college male is a rapist doe a disservice to both men and women.
> or the increasing awareness of discrimination against women in America is causing men to use opioids?
Discrimination of women? What about the discrimination against men?
There are more women at colleges than men. Corporations are favoring hiring women over men.
I guess we can blame the opioid crisis for that.
When more men attended college than women, then it was sexist patriarchy.
Now that more women are attending college than men, the media says it's the "natural" order.
"“At the same time, the slower social development and more serious behavioral problems of boys remained and allowed girls to leapfrog over boys in the race to college.”
In other words: As things got more equal for boys and girls, a natural advantage began to reveal itself."
Can you imagine if a man said it is the "natural order" for more men to attend colleges than women?
But yes, lets pretend that women are being discriminated against.
Millions more women attend college than men, but it's the women being discriminated against.
Your pain is gone and you're able to function normally. After a few weeks your supply runs out and the doctor refuses to renew your prescription despite your injury still causing you pain. The doctor provides no after-care or advice to avoid addiction, writes on your chart that you've exhibited "drug seeking behavior" and tells you to leave.
Your buddy says he has a friend, who hooks you up with a few Oxies (at least you think they're Oxy, the writing is in Chinese), and you're back to feeling "normal" again. After a while you run out of money, but your friend can supply you heroin at a lower price. Congrats you're a junkie, despite being a tee-totaler just a few months before.
Kinda condensed and I'm sure many people on HN will say "but that wouldn't be me". But it is the slope for many, many people in this country.
Yes the US proscribes opiate based pain killers at a higher level then Socialized Medicine nations, mainly because American Patients do not accept the "live with the pain" treatment you get from Government run care where they refuse to provide pain killers unless you are screaming in pain, and even then they give you a Advil and tell you to "suck it up butter cup"
There are all kinds of people that cant not get the medication they have a legitimate medical need for because the these new crack downs on Opiate based pain killers, now these people are having to live with chronic pain because the doctor fear being sent to prison by the DEA, because the DEA knows more about medicine than a doctor does clearly
In your Hypothetical from Prescription to Heroin you blame the doctor, I blame the DEA. The artificial limits and constraints the DEA is placing on medical professionals is interfering with patient care, and causing some patients to turn on street drugs instead of proper medication
Contrary to what the DEA thinks, combating Drug abuse is not a police matter, it is a medical matter and should be left in the hand of medical doctors not the legal system
The first, and perhaps most important, is that you think opioids are a suitable treatment for long term pain. They aren't. There is little evidence of efficacy of opioids for treatment of long term pain. Your suggestion - that we treat pain using opioids - i) doesn't treat pain, and ii) creates addicts.
More information here: https://www.fpm.ac.uk/faculty-of-pain-medicine/opioids-aware
> "live with the pain" treatment you get from Government run care where they refuse to provide pain killers unless you are screaming in pain
Quite clearly nonsense.
> The artificial limits
No, these are evidence based restrictions.
Further in typical UK practice they claim it is not helpful but offer no alternative treatments, claiming it should be discontinued even if there are no alternative.
basically what I said "Suck it up buttercup" but they state it in a more PC and nanny government terminology
>Quite clearly nonsense.
"You may also be referred for complementary therapy to see if that helps with the pain. You should be offered advice on how to better manage your pain on a day-to-day basis, such as by using self-help techniques."
Again, No pain Killer, just walk it off or deal with it. That is the UK policy on long term chronic Pain. Suck it up and learn to live with it.
>No, these are evidence based restrictions.
No infact they are not, not in the case of the DEA/US Drug Control Policy anyway
There is not a single drug control policy in the US that is "evidence based" most of is not even about the actual drugs, it is about power, control, money, and about 100 other things but not public safety or drugs
And yet, oddly, you frittered away the opportunity to identify even one piece of “incorrect crap” to instead go off on a rant about the DEA. At least I think that’s what you’re on about.
1. I addressed how the OP blamed the doctors as the source of people becoming addicted to herion, I believe that to be false
2. I address why in a few limited cases where person starts out on prescriptions and ends up on heroin they are likely there due to aggressive and unethical Drug Control Policy enforced by the DEA
3. The OP implied that Opaties are Over proscribed, i disagree. Further would like to know if the OP has ever suffered or know anyone to suffer from Chronic Plain, and if they would enjoy seeing their loved on suffer daily because of the Actions of the DEA.
You are correct it is a Rant ont eh DEA however, I am 1000000000% opposed to the war on drugs, I feel it is single largest source of freedom in the nation. it is directly lead to the erosion on almost all constitutional rights, has put doctors having to choose between what is best for themselves (i.e staying out of jail) and what is best for the patient (i.e proper pain medication) and has been an abject failure in reducing drug us.
You believe based on what evidence? Have you done any research into this or is it just a 'gut feeling'? To put it another way, what do you find misleading about the following video?
Poverty and the lack of opportunities to participate constructively in society do really fucked up things to human psychology. The current wave of opiate addiction frequently occurs as the result of prescribed pain medication.
>Why even try it? I feel in the media everywhere it is said how terrible it is.
The signals people pick up from their peer groups have a much larger impact on their behavior than media ever could.
This just begs the question. Why did the peers do it? Surely you see someone clearly messed up after doing drugs. Why go in follow them? There are other mindless things you could do like play video games to achieve a similar effect.
I also wonder why you are so certain that video games are a substitute for drug use. Do you also not play video games?
You may not start to see the negative impact of drug use until years later. By then it's too late.
In 2009 0.57% of the population between 15 and 64 took opiates (products of the poppy such as opium or heroin) and 5.9% of the same population took opioids, of which 5.6% were prescribed opioids.
It's got much worse since then.
Roughly 10% of people taking opioid medication will become addicted to them. (Mostly people taking it long term).
> Since 2002, prescription drug deaths have outpaced those of cocaine and heroin combined. Abuse of controlled prescription drugs is higher than that of cocaine, methamphetamine, heroin, MDMA, and PCP combined.
*Not quite true, I have several hobbies, including designing games
As for how they get started, I've been prescribed a large bottle of powerful painkillers for having my wisdom teeth removed. It's not hard to get exposure under doctor's orders in the US.
2. Desperation and a sense of inescapable hopelessness can make a whole lot of people do things they never thought they'd consider doing.
>Krueger’s study linked county prescription rates to labor force data from the past 15 years
Also, probably boredom.
You have to understand what middle America looks like today. It used to be vibrant, now it's nothing but shells of ghost towns. This happened for a few reasons:
1. Walmartization killed all the independent shops.
2. Agribusiness made family farming untenable.
3. Out of country manufacturing.
1. Walmart - always lower prices (people want cheap crap)
2. So...cheap food means scale it up really big (agrabusiness)
3. And cheap non-food mean outsourced manufacturing (because people want big salaries to buy lots of cheap crap)
...and perhaps that's where it started, that last bit:
People want big salaries (or paychecks, or pay - whatever), so they can buy more stuff (there's also the whole "easy credit" thing - but that's another discussion). They want that stuff cheaper. So businesses searched for ways to make it cheaper: Scale stuff up, have fewer employees (or pay them less), and outsource manufacturing.
Classic death spiral.
/I know I am over-simplifying things here...
What the media shows you is the consequences irresponsible use. You dont need to go shoot up laced heroin in a back alley to understand. I am always amused when people correlate drug use with poverty or some other nonsense, implying that white collar professionals dont do drugs. Successful people are just less likely to be caught and/or open about use, I think.
Oh, by the way, alcohol is a drug. Caffeine is a drug. The distinction between legal and illegal drugs is entirely arbitrary and in many cases unconstitutional.