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We're not responsible for being obese?
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janejellyroll wrote: »lemurcat12 wrote: »There was a good interview on the history of the painkiller epidemic between Russ Roberts (of EconoTalk) and Sam Quinones (who wrote Dreamland, which I've been meaning to read for a while), and it seems there is a transcript of some sections, at least. The first part is on the heroin issue, but scroll down to get to Oxy et al. (you have to scroll to get to the transcript of the interview first).
http://www.econtalk.org/archives/2017/01/sam_quinones_on.html
Beginning:
"Russ Roberts: So, let's switch gears. Let's talk about painkillers. How did painkillers become a problem? It seems like there was this great new set of painkillers out, oxycontin and others. Why did they end up getting misused and abused?
Sam Quinones: Yeah. That was the--I backed into this story. Because of my background in Mexico, I really focused first on the heroin traffickers. But then, of course, I was left with the question: Why is it that they have so much new demand? Because they were now, by then, by the time I doing it, they were now in Ohio, West Virginia, places like that. And so that got me on to this other story that was really the first story, a really far larger story. And that begins, really, in the 1980s as well, about the same time, when pain management is just beginning to be kind of a new discipline within medicine that you study, and a whole group of pain specialists began to form a collective consciousness and believe that we were not treating pain correctly--that there were these pills, opiate painkillers out there, and doctors all across the country were unwilling to use these, and that this was not a reasonable proposition. That these pills ought to be far more liberally used. And at first they made the argument, 'We need to use these for hospice care folks, people dying of cancer, whatnot, in order to improve their last months on earth. What does it matter if they are addicted to these pills? Who cares if they are addicted to these pills if they also live the last 3 months of their lives pain-free?' And that made a lot of sense. That was a very logical argument: that folks would die in utter pain because doctors were afraid they would be addicted. But these folks made a different argument. They, however, kept pushing; and that's why we're here today. They didn't stop with just hospice care. They began to make the argument that virtually all of these pills, 'We now know--science now knows--that, you know, 5000 years of experience with the opium poppy be damned, we now know that these pills are virtually non-addictive when used to treat pain.' And they began to push. They were joined in this after a while by certain pharmaceutical companies who were producing some of these pills, main one being Purdue Pharma, which makes the pill Oxycontin. And they took up the call of these guys. I had one doctor say, 'If it hadn't been for the pain specialists, the pharmaceutical companies would have had nobody to footnote, to use to say this is why we're doing these, we're producing these pills.' But had it not been for the pharmaceutical companies, these pain specialists would have been without a megaphone. And so the combination of those two together, particularly as the 1990s progressed, becomes very, very potent....
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Russ Roberts: And as you point out, millions of people, who were in horrible pain weren't any more. So that was the good side. The bad side was the promised non-addictive aspect of oxycontin, which was the slow-release part--the idea that oxycontin was continuous was supposed to dampen the addictive part. Two things happened. One, people figured out a way to get around that by sucking off the coating that slowed the release; or hitting it with a hammer. So that was problem Number One. Problem Number Two is--I think; correct me if I'm wrong--that there were people who got addicted anyway, even though it was slow-release.
Sam Quinones: Yes. Right. They were following doctors' orders and they would still get addicted. And part of the problem, too, was that along with the idea that these pills were no longer addictive when used to treat pain, came the corollary which was then that there was no limit on dose. So, you began to see all across the country doctors prescribing enormous quantities of these pills for patients to take home with them after acute surgery, for acute pain after surgery. Now, this is pain that is probably going to last you, oh, no more than 3-5 days. If it lasts more than 5 days there's something else wrong. But, they would prescribe 30 days' worth of Vicodin or Oxycontin--these are common--Vicodin is another common opiate painkiller. And so what happened is--and then--and this was happening all across the country--an enormous new supply of opiates was created across the country; and a fair amount of that, a good amount of that leaked out into the black market. I believe this--when I was in Mexico, I believed that all drug stories were demand-driven, and that drug scourges were created by demand for those drugs. Now, when I did this book, this changed my mind, honestly: I came to think that really most drug problems begin because of excess supply--easy, cheap availability of a drug. And that's exactly what happened here. We have a new, a massive new supply of opiate painkillers from coast to coast, all across the country, because it's doctors who buy in to this idea. A couple of generations of doctors buy into the idea that they now need to very aggressively prescribe these things to treat our pain. And some are pushed or pressured. Legally you have to do this: If you don't treat pain, you can be sued. Some, it's insurance pressures; if we don't push people through our clinic we won't be able to reimburse enough to keep the lights on. But, whatever the case, doctors all across the country come to this idea that they need to do this. And that is what creates a massive and continuous new supply of opiate painkillers for the last 20 years, from coast to coast...."
That point about the 30-days supply for a few days of pain hits home. The prescription I mentioned above (when my husband broke his wrist) was for 15 days worth of painkiller. He was able to manage his pain with regular Tylenol for 3-4 days then he stopped taking that. At least in his case, 15 days of rx painkiller for a broken bone was total overkill.
Totally agree. Twice in my life I have been prescribed pain killers that were unnecessary *for me* in that situation. First after a car accident and second after I had my son. Both times were for Percocet and both times I declined to take it. The day after the car accident sucked and I took a regular strength Tylenol or two, and I just toughed it out after birth for a few days and was fine. I probably have a high pain tolerance.
I feel like doctors should be more cautious and wait to see if patients really need the meds and then prescribe something. But then there are issues with people getting back in to see the doc or people suing saying they are in pain (they may be) and really need the meds and can’t get them. It all has to come down to personal responsibility, I suppose.
Which leads me back to the original topic. If obese people can blame society for their weight issues, it’s that easy to throw your hands up and say there’s nothing you can do about it. That’s what I did for many years being obese. I’m afraid I know a lot of obese people who feel completely helpless because they’ve bought into the “society caused it” lie.0 -
It would be so easy to blame my eighteen year drug addiction on oh let’s see, my father, my mother, society, social services, my ex and then my subsequent obesity as an after effect.
There’s only one person who is responsible here. That’s me. I look at it as Survival of the Fittest. No one made me use and no one made me stop. No one made me overeat and no one is making me stop. It’s up to ME.15 -
My own opinion - there's blame for people, and blame for corporations.
Yes, we make our own decisions. Of course.
But I'd also say that our society is complex enough that people pretty much need to have experts that they rely on to help them make their decisions about what is healthy/safe and what is not. And those experts rely on further experts to help THEM make decisions. So if the top experts are essentially falsifying or misrepresenting information in order to make a profit for a corporation at the expense of people's health and well being, and people DO have health problems due to some of the decisions they make based on this information, is that completely the people's fault, or is the corporation at fault too.
I think the corporation is at fault at least to some extent. I don't know how much, but they sure aren't pure as driven snow, here. Heck, even in small ways they make it difficult to find out the information needed to MAKE right choices, especially for busy people who only have a limited amount of time to explore their world before making a decision.
For example, People may be trying to watch their calories, so they're looking at calories. When looking at fifty different things during a shopping trip, it's easy to not pay attention to the serving size. And knowing this, companies have deliberately lowered the servings sizes to give the false impression that their product's calories are lower and 'better' for you (one example is how pop tarts come in packages of two, but the serving size info is 1 pop tart).
Not to mention how companies do what they can to obfuscate or hide what you are actually getting. Great example - high fructose corn syrup. We know it does some bad things, potentially, so people look out for it. And corporations KNOW they look out for it. So they ensured that, with a corn syrup that has even MORE fructose than HFCS (the new one called HFCS-90, I believe), that it could legally be called a different name on labels: fructose or fructose syrup. Even better, companies can even say that their product has 'no high fructose corn syrup' because it doesn't, officially. It just has a corn syrup with even higher amount of fructose than the HFCS.
And then there's the job of advertising psychologist or consumer psychologist - their jobs are to help companies advertise, package, and promote products in ways that are most likely to impact people and make them want to buy and use them. In the case of video games, they even help companies figure out ways to make games as addictive as possible - I'm sure that has an impact on people's health due to lack of physical activity, wouldn't you say?.
(https://theconversation.com/the-business-of-addiction-how-the-video-gaming-industry-is-evolving-to-be-like-the-casino-industry-83361 )
Seriously, I don't see how we can hold companies blameless for obesity issues when they go out of their way to hide the unhealthiness of food choices from consumers and promote addictive behaviors that reduce the activity levels of their consumers.
Again, yes, we are making our own choices. But when we are given false data, or when false impressions of healthiness are deliberately fostered, or companies are deliberately making games that are aimed at addicting our teens and adults into a games that have little to no physical activity? That's wrongdoing by the people (corporations) trying to con us, not the people who get conned. And I do think they bear some responsibility for what happens when they succeed in their con.
But also re: the pain killers, specifically, because this is REALLY a hot button issue
Institutional response to the opioid epidemic is, IMHO, pretty much hysterical overreaction and lack of understanding of the core problem that will, ultimately, result in pain and suffering (which seems a bit par for the course for the medical community, IMHO).
Because the medical community has, so far, been pretty crap at helping most people who actually DO need pain meds, on average. Women's pain is often attributed to stress or depression and ignored (This is a perfect, and horrifying, example of actually pretty common treatment of women and pain - https://www.theatlantic.com/health/archive/2015/10/emergency-room-wait-times-sexism/410515/ ).
The elderly are often ignored or treated as though pain in old age is normal, so it doesn't need treatment (http://www.asaging.org/blog/not-doctors-only-ageism-healthcare).
And let's not forget that if you aren't white -or even not an adult - you're even less likely to get pain meds. (like is talked about here. https://www.nbcnews.com/health/kids-health/black-kids-get-less-pain-medication-white-kids-er-n427056 )
And even worse, the original issue - people who were in constant, severe pain, and are dying and desperately need pain relief? Or those who have constant, severe, chronic pain that may last years, and who just as desperately need pain relief?
That seems to have been completely ignored. It's treated as if the problem never existed in the first place, so there are no real standards in place to ensure THESE people still get the pain meds they need. New rules being put into place, and the pressure on the doctors, are making doctors deny these people good pain meds as well. So we're back to ignoring people in severe pain, for fear of making a mistake and potentially getting someone addicted.
I have a disease that can cause some members chronic, debilitating pain. The kind that has people curled in a ball on the floor, trying not to scream, every minute they are off of pain pills. And I am active in support groups for this disease, and SO many of the folks with this have had their pain meds cut off by doctors in the last year, because they'd been 'taking it too long.' Never mind that they have a condition that will NEVER stop causing pain. We must think of the possibility of addiction...and nothing else, I guess.
This is happening to folks all over the country. Many of them are already housebound and unable to drive due to their condition, so taking meds isn't going to affect that. They are not responsible for anyone else. They are not mobile, in many cases.
And many are contemplating suicide, the pain is so bad, and nothing but opioids do a thing. And now doctors are denying them that.
So you can understand why, when I see folks talking about the opioid crisis and how we need to stop it...I get a little frustrated. And I don't know what it says about our society and people's responsibility for their own actions - are we acting like people who are addicted are not responsible for their own actions, and so we need to keep this drug from EVERYONE's hands, like we're all children who can't make their own decisions?
I've heard that said, but honestly...I think in this case it may be more a case of doctors being woefully bad at actually identifying pain in their patients. So people who don't need pain meds are given it, or given too much, and many times the people who actually need the pain meds are denied it. So over-prescribing opioids is less an issue than doctors having poor methods for diagnosing pain which results in improper prescribing of opioids to individuals.
...and, yeah, it's really late...and I may come back later and realize it makes no sense at all. But, to sum up, I don't think we can attribute problems to only the individual or to societal or cultural (or corporate) influences. They're usually both influential in a problem.
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Stay off the news. It's garbage. I have every news feed, channel and website blocked. Worry about you. Keep yourself healthy. You can't change much that is outside your circle of influence, so why get upset or enraged? It's toxic.
People can blame who ever they want. It's not going to help when a) they're living a crappy life. b) they get sick because of their fast food/over processed lifestyle.15 -
lporter229 wrote: »Big corporations are in business to make money. They make the most money when they figure out what we collectively really, really want - not what we say we want, but what we really want - and sell it to us cheaply in massive amounts.
When I was in MBA school, the marketing profs made it clear that marketing's magic formula was to figure out what people en masse truly want, then advertise it to us as being what we think we ought to want. This is the explanation of 800-calorie crispy chicken salads (with Newman's Own charity-enhanced dressing) and nutrition-sparse chocolate chip marshmallow caramel nutty granola bars. If they make those ubiquitous, super convenient and cheap enough for us to buy plenty, we will.
A few decades back, there was public compassionate pressure to relax restrictions on strong pain relievers, because it was felt that people with chronic pain were being cruelly under-treated. Pain clinics sprang up, some regs were relaxed. Now we have an opioid crisis. Unrelated?
Walt Kelly, way, way back, got it right in a vintage Pogo comic strip: "We have met the enemy, and he is us."
Individual decisions and actions create the large social forces, as well as being shaped by them. We have substantial control; we have no *baby feline* idea how to wield that force for good.
Fantastic post
It was the Russians that once said "America will self destruct from within one day." It will happen. No country goes on forever. We might be witnessing that now. The beginning of the end.5 -
I read every single post (except the really long ones), because this topic is so interesting! I agree with you all! Jerry's post especially interesting, I'll check out that story!
I just wanted to chime in with my take (having never taken pain meds), is it possible that the pain meds dull emotional pain as well as physical? For me personally, my overeating feels like an addiction. And it's precisely when I'm feeling strong, difficult emotions that I want to gorge myself and feel the comfort of a full belly to deal with the sadness/guilt/anxiety. Do the opioids dull the emotional pain too?
So I guess my take is: there's a void and emptiness that opioids, food, or any escapism can never fill, which is the basic search for happiness in life! We yearn for interior peace, and fulfillment which a self indulgent and selfish life will never find, and only God can satisfy.5 -
artbyrachelh wrote: »I read every single post (except the really long ones), because this topic is so interesting! I agree with you all! Jerry's post especially interesting, I'll check out that story!
I just wanted to chime in with my take (having never taken pain meds), is it possible that the pain meds dull emotional pain as well as physical? For me personally, my overeating feels like an addiction. And it's precisely when I'm feeling strong, difficult emotions that I want to gorge myself and feel the comfort of a full belly to deal with the sadness/guilt/anxiety. Do the opioids dull the emotional pain too?
So I guess my take is: there's a void and emptiness that opioids, food, or any escapism can never fill, which is the basic search for happiness in life! We yearn for interior peace, and fulfillment which a self indulgent and selfish life will never find, and only God can satisfy.
In my experience, yes they do. In grand fashion. And you’re correct in that the void needs to be filled. It takes quite a bit of insight and healing, along with completely tearing down and renovating. So many people aren’t able to find the way.
Yes there’s an opioid crisis. Probably many addicts began with prescription pills, as many obese began with what? Eating emotions? I can’t say as we are all different. I don’t think not giving people pain relief is going to change a damn thing. One of the reasons, we were coached in therapy and treatment, we stay actively using is the inability to accept responsibility for our own actions.
So say we rely on an outside source, say a Higher Power. For ME, that just gave me something else to blame when I used. It all ultimately came down to holding myself responsible for using. Cake or heroin. Same addiction, different substance.
It’s taken me five years to apply the same methods of recovery to overeating. It took years to figure out how to quit using. I’m on the right path. And at this point I know better than to trust in anything but my own experience and research.
Now this is all MY experiences and we all find and learn differently.
And Gods help those who help themselves. And that takes a looong time.
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Basically: I'm not {overweight, jobless, balding, etc} I'm just a victim!...and not only that, the world has to change to suit MEEEEE, not the other way around!
Side note: A friend of mine lost her husband to painkillers/heroin. He wrecked his back on a construction job, doc handed the painkillers out like candy, he was so outta his mind that the doc just cut him off cold turkey, then he looked for an alternative- heroin...it wrecked their marriage, he ended up bouncing in/out of rehab, and eventually OD'd on a tainted batch of smack. This could've all been avoided if 1. The docs didn't just throw drugs at it and instead proscribed surgery/rehab 2. He admitted to having a drug problem! As my dad says: "It takes TWO to tango!"6 -
There is a wide-spread, systemic failure in the profession of journalism. I can't think of a single journalist/reporter who doesn't deserve to be run out of their profession for good.
The fact that it takes them 4-5 years to learn how to do a job that any intelligent person could learn in 30 minutes should speak volumes to us all. And the fact that so few of them can do their jobs professionally or honestly has made me distrust them to the point where I spend more time reading the comments after the articles rather than the articles themselves.
They've so woven their own uninformed and uneducated thoughts and opinions into what should be simple reporting, and in many cases pass off factual errors as difference of opinion. And, above and beyond that, there is no shortage of 'opinion journalists' and commentators telling us what to think about what we've already been told to think.
I'm fed up with journalists and their profession, and it seems I'm not the only one.17 -
When I was in MBA school, the marketing profs made it clear that marketing's magic formula was to figure out what people en masse truly want, then advertise it to us as being what we think we ought to want. This is the explanation of 800-calorie crispy chicken salads (with Newman's Own charity-enhanced dressing) and nutrition-sparse chocolate chip marshmallow caramel nutty granola bars. If they make those ubiquitous, super convenient and cheap enough for us to buy plenty, we will.
A few decades back, there was public compassionate pressure to relax restrictions on strong pain relievers, because it was felt that people with chronic pain were being cruelly under-treated. Pain clinics sprang up, some regs were relaxed. Now we have an opioid crisis. Unrelated?
Correlation is not causation, as I'm sure you are aware. In fact, I would suggest there is a stronger correlation between what you mentioned about marketing and the opioid than with relaxing the DEA's heavy handedness in dealing with people in pain and the doctors who treat them. Many people are self-medicating to deal with their empty, meaningless lives, and much of that is caused by companies pushing trinkets and baubles as solutions to a lack of opportunities, relationships, and a sense of community.1 -
.... Pain clinics sprang up, some regs were relaxed. Now we have an opioid crisis. Unrelated?...
Pain clinics are not the problem, and neither is the existence of opioids. The problem is abuse by people who use the drugs, then abuse them, then look for ways to feed their habits. It's the bad choices of the abusers that have caused the epidemic, not the existence of pain clinics.
Pain clinics use a variety of techniques to help people manage chronic pain: biofeedback, cognitive behavioral therapy, hypnotherapy, massage, meditation. They're not pill pushing stations and it does a disservice to those who work at pain clinics to blame them for the situation society finds itself in.16 -
Good_Morning_Glory wrote: »It would be so easy to blame my eighteen year drug addiction on oh let’s see, my father, my mother, society, social services, my ex and then my subsequent obesity as an after effect.
There’s only one person who is responsible here. That’s me. I look at it as Survival of the Fittest. No one made me use and no one made me stop. No one made me overeat and no one is making me stop. It’s up to ME.
+1
It may seem easier to blame others for your situation but at the end of the day the only power everyone else has over your life is what you give them. I'm glad you were able to take your power back and gain control.3 -
JillianRumrill wrote: »Basically: I'm not {overweight, jobless, balding, etc} I'm just a victim!...and not only that, the world has to change to suit MEEEEE, not the other way around!
Side note: A friend of mine lost her husband to painkillers/heroin. He wrecked his back on a construction job, doc handed the painkillers out like candy, he was so outta his mind that the doc just cut him off cold turkey, then he looked for an alternative- heroin...it wrecked their marriage, he ended up bouncing in/out of rehab, and eventually OD'd on a tainted batch of smack. This could've all been avoided if 1. The docs didn't just throw drugs at it and instead proscribed surgery/rehab 2. He admitted to having a drug problem! As my dad says: "It takes TWO to tango!"
At the risk of coming across as a cold hearted *kitten*, this still falls to personal responsibility. I could blame my dope dealer for my addiction but how would that lead to the necessary enlightenment needed for recovery?
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JillianRumrill wrote: »Basically: I'm not {overweight, jobless, balding, etc} I'm just a victim!...and not only that, the world has to change to suit MEEEEE, not the other way around!
Side note: A friend of mine lost her husband to painkillers/heroin. He wrecked his back on a construction job, doc handed the painkillers out like candy, he was so outta his mind that the doc just cut him off cold turkey, then he looked for an alternative- heroin...it wrecked their marriage, he ended up bouncing in/out of rehab, and eventually OD'd on a tainted batch of smack. This could've all been avoided if 1. The docs didn't just throw drugs at it and instead proscribed surgery/rehab 2. He admitted to having a drug problem! As my dad says: "It takes TWO to tango!"
Easy to say if you have never been addicted. Esp with opioids, some of the more common drugs prescribed are qualitatively more powerful and more physically addictive than ever before. That can’t be dismissed, no matter how inconvenient it is for those who want simple solutions.
Addiction is a complex issue—physically, emotionally, behaviorally, etc. The cost to society is tremendous and dealing with it requires multifaceted interventions. Personal responsibility is one component, but to reduce it to only that is unproductive.11 -
I am over weight and it's nobody's fault but mine. Poor food choice, mindless snacking, and no portion control. All of these are things within my control.
I do not believe in fad diets so recently I pledged to myself to eat in moderation, stop snacking while driving, and layoff white rice, potatoes, and bread. I also substituted my go to morning muffin to a bowl of Harvest Crunch and the weekly calorie saving are 1000+.
Blaming the people who make the junk food is just another excuse.11 -
JillianRumrill wrote: »Basically: I'm not {overweight, jobless, balding, etc} I'm just a victim!...and not only that, the world has to change to suit MEEEEE, not the other way around!
Side note: A friend of mine lost her husband to painkillers/heroin. He wrecked his back on a construction job, doc handed the painkillers out like candy, he was so outta his mind that the doc just cut him off cold turkey, then he looked for an alternative- heroin...it wrecked their marriage, he ended up bouncing in/out of rehab, and eventually OD'd on a tainted batch of smack. This could've all been avoided if 1. The docs didn't just throw drugs at it and instead proscribed surgery/rehab 2. He admitted to having a drug problem! As my dad says: "It takes TWO to tango!"
Easy to say if you have never been addicted. Esp with opioids, some of the more common drugs prescribed are qualitatively more powerful and more physically addictive than ever before. That can’t be dismissed, no matter how inconvenient it is for those who want simple solutions.
Addiction is a complex issue—physically, emotionally, behaviorally, etc. The cost to society is tremendous and dealing with it requires multifaceted interventions. Personal responsibility is one component, but to reduce it to only that is unproductive.
I am going to have to disagree. All the intervention on the planet isn’t going to stop an addict from using. On the other hand, all the intervention on the planet isn’t going to stop an addict from recovery. It takes personal choices and personal responsibility.
I agree it’s a tremendous drain. Policy for reform is *kitten* up.
As a recovering addict, I’m in a bit of a unique position here. I MOSTLY know (eighteen years of spending lots of ‘quality time’ with other addicts) where the mindset is in the case of an active user. I say let natural selection take its course instead of throwing good money after bad. Is that the right way to term that quote?
The obesity crisis is a bit of a parallel situation.
It’s going to take personal responsibility and personal change. Yes get help. But there will come a time (multiple times of intervention and draining the system) in which it’s going to take personal responsibility and the realization that it takes YOU doing the work. The system can only help so much.
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.... Pain clinics sprang up, some regs were relaxed. Now we have an opioid crisis. Unrelated?...
Pain clinics are not the problem, and neither is the existence of opioids. The problem is abuse by people who use the drugs, then abuse them, then look for ways to feed their habits. It's the bad choices of the abusers that have caused the epidemic, not the existence of pain clinics.
Pain clinics use a variety of techniques to help people manage chronic pain: biofeedback, cognitive behavioral therapy, hypnotherapy, massage, meditation. They're not pill pushing stations and it does a disservice to those who work at pain clinics to blame them for the situation society finds itself in.
I think I've not clearly communicated what I think (but your initial ellipsis does serve your point better than it fairly presents mine).
I believe in pain clinics, and know first-hand about the importance of non-drug modalities (I've benefitted). At the same time, I strongly support appropriate availability of opioid drugs for acute, chronic or terminal-illness pain.
I was grateful that when my 45 y/o husband was in profound pain, dying in our living room of esophageal cancer, I had access to ample Fentanyl patches, plus additional liquid opioids I could administer through his stomach tube, because all of this was happening after the crazy-tight rein on opioids had been relaxed.
My point was the pendulum swings in public opinion and how those drive policy, how we collectively contribute to that via our individual opinions and actions. We often get the system we clamor for, and it has unintended consequences. Our clamor is a relevant causal factor.
Out of the anti-drug extremes of the post WW2 period (roughly), when people with severe pain were cruelly undertreated, came a liberalizing swing in the other direction, which brought solutions (such as mainstream pain clinics). But it also introduced a willingness across our medical systems to be generous with pain drugs because "people with pain don't become addicted". (@lemurcat12 posted insightfully about that, quite a few posts above). It also brought the reflex over-prescribing of strong drugs for routine pain that some others above have described.
And, yes, the drug companies whipped the horses pulling that bandwagon when they could, partly cynically, partly because individuals in those companies shared the common perspective that pain drugs should be widely available for compassionate reasons, while underestimating risks. (Corporations are "us", too, as "we" are employees and shareholders (individually or through institutions like unions, etc.) as wel as customers.)
That liberalizing pendulum swing brought us where we are now, with too many opioid deaths, too much opioid addiction, and leaving me (and others) concerned that hysterical over-correction, fueled in part by public outrage, may again leave people in unnecessary pain through too-tight restriction.
That was my point: That we, in the form of "society," drive these swings in significant measure, as well as being harmed by them at the extremes (becoming their "victims", if we must use that term).
Again, repeating Walt Kelly's Pogo: " We have met the enemy, and he is us." <<<<<==== Main point.
You, @vingogly, didn't say/imply this next bit, but others did - and I am changing sub-topics here:
I'm not very sympathetic to the idea that we first-world moderns have uniquely meaningless lives, and that that's a reason/excuse for addiction. It's a simple explanation, therefore likely incomplete at best.
I suspect my peasant ancestors, sleeping in insect-ridden hovels and scrabbling for food while half their babies died in infancy, had pretty meaningless lives. Perhaps that mere struggle to survive and breed brought sufficient meaning and purpose to their lives, but few among us would trade our easier "meaningless" lives for their lot in life.
They didn't expect much expect "self actualization", I'd speculate. They didn't expect a fulfilling job or a comfortable life. Perhaps it's that we modern first-worlders came to implicitly expect that life would deliver, to our increasingly passive spectator selves, not only a higher-than-peasant-level standard of living, but also purpose and meaning.
But I admit I haven't thought about that part very much. Speaking only for myself now, I find purpose and meaning overrated.
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.... Pain clinics sprang up, some regs were relaxed. Now we have an opioid crisis. Unrelated?...
Pain clinics are not the problem, and neither is the existence of opioids. The problem is abuse by people who use the drugs, then abuse them, then look for ways to feed their habits. It's the bad choices of the abusers that have caused the epidemic, not the existence of pain clinics.
Pain clinics use a variety of techniques to help people manage chronic pain: biofeedback, cognitive behavioral therapy, hypnotherapy, massage, meditation. They're not pill pushing stations and it does a disservice to those who work at pain clinics to blame them for the situation society finds itself in.
I agree with this.
@AnnPT77 I’d hope that if I were in a terminal situation, I’d have access to opiates. I’ll be honest, there are situations in which it has its place. I’m so sorry for your loss.
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While I agree that there is some government responsibility to help educate people I 100% believe that we are responsible for our OWN actions. I gained 25 lbs. during my pregnancy, but no one made me gain more weight or kept me from losing the weight but myself and my own choices. It was my own stupid decisions.2
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Good_Morning_Glory wrote: ».... Pain clinics sprang up, some regs were relaxed. Now we have an opioid crisis. Unrelated?...
Pain clinics are not the problem, and neither is the existence of opioids. The problem is abuse by people who use the drugs, then abuse them, then look for ways to feed their habits. It's the bad choices of the abusers that have caused the epidemic, not the existence of pain clinics.
Pain clinics use a variety of techniques to help people manage chronic pain: biofeedback, cognitive behavioral therapy, hypnotherapy, massage, meditation. They're not pill pushing stations and it does a disservice to those who work at pain clinics to blame them for the situation society finds itself in.
I agree with this.
@AnnPT77 I’d hope that if I were in a terminal situation, I’d have access to opiates. I’ll be honest, there are situations in which it has its place. I’m so sorry for your loss.
With the way the pendulum is swinging, you may not.3 -
Again, I think some people are conflating two different types of questions.
Do you have a problem (whether with drugs or obesity or something else)? Best to realize you can do something about it and take control, of course.
Can we, as "society" make choices that will affect how common particular problems are? And, if so, is that worth discussing and understanding? IMO, yes to that too.5 -
lemurcat12 wrote: »Again, I think some people are conflating two different types of questions.
Do you have a problem (whether with drugs or obesity or something else)? Best to realize you can do something about it and take control, of course.
Can we, as "society" make choices that will affect how common particular problems are? And, if so, is that worth discussing and understanding? IMO, yes to that too.
Yeah, I don't feel we have the stark "either/or" situation here that (some) posts seem to be referencing.4 -
Good_Morning_Glory wrote: ».... Pain clinics sprang up, some regs were relaxed. Now we have an opioid crisis. Unrelated?...
Pain clinics are not the problem, and neither is the existence of opioids. The problem is abuse by people who use the drugs, then abuse them, then look for ways to feed their habits. It's the bad choices of the abusers that have caused the epidemic, not the existence of pain clinics.
Pain clinics use a variety of techniques to help people manage chronic pain: biofeedback, cognitive behavioral therapy, hypnotherapy, massage, meditation. They're not pill pushing stations and it does a disservice to those who work at pain clinics to blame them for the situation society finds itself in.
I agree with this.
@AnnPT77 I’d hope that if I were in a terminal situation, I’d have access to opiates. I’ll be honest, there are situations in which it has its place. I’m so sorry for your loss.
I should've said explicitly: I mostly agree with @vingogly's point, too. I certainly do about pain clinics!
I wouldn't go quite as far in the "all the abuser's fault" direction as I'm perceiving you each going. I think it's a complicated , multifactor situation, of which abusers' will and character is one factor - and I believe that each of our characters are both in our control, and shaped by things outside our control. Nothing is simple!
Thank you for the sympathy . . . but I hope you can understand that I mentioned it to sharpen my point that my concern about pain drugs is far from theoretical, much like your experience with addiction.
Past is past, now. We are here, not there.
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lemurcat12 wrote: »Again, I think some people are conflating two different types of questions.
Do you have a problem (whether with drugs or obesity or something else)? Best to realize you can do something about it and take control, of course.
Can we, as "society" make choices that will affect how common particular problems are? And, if so, is that worth discussing and understanding? IMO, yes to that too.
I 100% agree with both pieces.
Pithy summation from you, as is so often the case.
Thanks for that - and for that earlier bit of history from econtalk, too, BTW.1 -
I don’t think it’s an either/or, myself. They both happen to be related in my situation. Whether or not there is someone or something to blame regarding addiction AND obesity. I’ve experience with both. Turns out it was all me lol.
I don’t think it’s a ‘fault’ situation. I was just sharing what I know in regards to whether or not we can or should place blame elsewhere. I’m only going on my own education and experience regarding both obesity and addiction. Different situations produce differing reactions. It’s relative.
I’m so glad I’m neither using nor obese these days. Farther from the using than the obesity though. Work in progress. 4 -
lemurcat12 wrote: »Again, I think some people are conflating two different types of questions.
Do you have a problem (whether with drugs or obesity or something else)? Best to realize you can do something about it and take control, of course.
Can we, as "society" make choices that will affect how common particular problems are? And, if so, is that worth discussing and understanding? IMO, yes to that too.
Thank you. I keep reading replies thinking to myself... "There's plenty of blame/responsibility to go around, on both sides of the issue" and thought I was missing something.0 -
The only "choice" made in drug addiction is the choice to use the drug in the first place. Because physiological addiction is an overriding demand that the brain convinces the body that it MUST HAVE the drug or the person will die. It's a compulsion far beyond good or bad choices.
And opioids are really addictive. But pain is really awful, too. So we play a dangerous game of roulette with addiction. It turns out the gamble was built on a poor premise. "If you're in pain you can't get addicted" was wrong. It was biochemically wrong. The receptors in your nervous system are altered by the presence of opioids. We are only in the infancy of understanding the neurobiology of this but it appears that opioids act in a widely distributed manner throughout the brain, activating multiple pathways.
Yes, addicts can make choices that will make staying away from the addictive substances more possible (I hesitate to say "easier"). But once you're addicted, your brain is going to tell you that you need that drug or you will die. It doesn't matter how rationally untrue you know this to be. It becomes one of the most compelling biological drives.
And yet, again, pain is tremendously bad. Chronic pain can make life difficult or even impossible. The prescription of opiods for pain was, I believe, rooted in compassion and a lack of good alternatives.
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Good_Morning_Glory wrote: »JillianRumrill wrote: »Basically: I'm not {overweight, jobless, balding, etc} I'm just a victim!...and not only that, the world has to change to suit MEEEEE, not the other way around!
Side note: A friend of mine lost her husband to painkillers/heroin. He wrecked his back on a construction job, doc handed the painkillers out like candy, he was so outta his mind that the doc just cut him off cold turkey, then he looked for an alternative- heroin...it wrecked their marriage, he ended up bouncing in/out of rehab, and eventually OD'd on a tainted batch of smack. This could've all been avoided if 1. The docs didn't just throw drugs at it and instead proscribed surgery/rehab 2. He admitted to having a drug problem! As my dad says: "It takes TWO to tango!"
Easy to say if you have never been addicted. Esp with opioids, some of the more common drugs prescribed are qualitatively more powerful and more physically addictive than ever before. That can’t be dismissed, no matter how inconvenient it is for those who want simple solutions.
Addiction is a complex issue—physically, emotionally, behaviorally, etc. The cost to society is tremendous and dealing with it requires multifaceted interventions. Personal responsibility is one component, but to reduce it to only that is unproductive.
I am going to have to disagree. All the intervention on the planet isn’t going to stop an addict from using. On the other hand, all the intervention on the planet isn’t going to stop an addict from recovery. It takes personal choices and personal responsibility.
I agree it’s a tremendous drain. Policy for reform is *kitten* up.
As a recovering addict, I’m in a bit of a unique position here. I MOSTLY know (eighteen years of spending lots of ‘quality time’ with other addicts) where the mindset is in the case of an active user. I say let natural selection take its course instead of throwing good money after bad. Is that the right way to term that quote?
The obesity crisis is a bit of a parallel situation.
It’s going to take personal responsibility and personal change. Yes get help. But there will come a time (multiple times of intervention and draining the system) in which it’s going to take personal responsibility and the realization that it takes YOU doing the work. The system can only help so much.
I suspect the more we discussed this topic, we would agree more than disagree. As in most of these discussion, we are emphasizing those aspects of the issue we feel are most important. That emphasis doesn’t mean I don’t disagree entirely with your thoughts.
I would just say that, from my reference point, in the long run, the cost of non-intevention is much, much higher than “throwing the good money” at a very, very difficult problem. Not everything can be solved by “willing” it to be so.2 -
I am normally not a big conspiracy person, and I am not an expert on this subject by any means. But with the opioid epidemic, I do think there have been some larger forces at work that make this more than a “weak people making bad choices” issue.
Here is one story for reference: http://www.businessinsider.com/opioid-crisis-conspiracy-2017-9
I also don’t think you can make the blanket assertion that because Person X was able to “recover” from their addiction, and Person Y was not, Person X is automatically “better” and Person Y is a weak person who deserves their fate. Some people are just broken. I completely understand if you are a friend or a family member and you get to the point where you just have to cut the person off. I have never had to live for extended periods with someone who was addicted (my sister died two years ago of conditions associated with opioid overuse, but she was a recluse who I only communicated with a few times in the last 25 years). I can imagine if you have that first-hand experience, you might have a different view. But I also think that, as a society, we can take a larger view and continue to work to improve things, even if it seems hopeless at times.4 -
I never said that anyone who isn’t able to overcome addiction is weak or deserves their fate. I don’t think I’m better than the people I care about who are still out there using. I just didn’t have any more blame to give or excuses to make. I’m no better than anyone. No worse either.
Edited to say: Again I only shared my experience and education to stand by my conviction that there is no one to blame for something that I did to myself. And I’m not alone.2
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