Once a patient is properly tapered off of the drug on which they have become physically dependent, they do not feel a craving or compulsion to return to the drug. It is seen for example with many antidepressants, such as fluoxetine (Prozac) and sertraline (Zoloft), and with beta blockers like atenolol and propranolol, used to treat a variety of conditions including hypertension and migraines. Physical dependence is seen with many categories of drugs besides drugs commonly abused. Physical dependence represents an adaptation to the drug such that abrupt cessation or tapering off too rapidly can precipitate a withdrawal syndrome, which in some cases can be life‐threatening. There is a big difference, as I point out here. The standard explanation of the overdose crisis is also based upon a tendency to conflate physical dependency on a drug with drug addiction. The standard explanation of the overdose crisis is wrong, and the policies it has inspired are not only ineffective, but harmful. However, as Mencken observed, “There is always a well‐known solution to every human problem” that is “neat, plausible, and wrong”. However, policymakers and the media tend to favor simple explanations and solutions for complex problems, and the opioid overprescribing narrative is no exception. ![]() The rising incidence of drug‐related deaths among nonmedical users also indicates that they are facing bigger risks today, probably because potency has become more difficult to predict and possibly because doses have increased and drug mixtures have become more reckless. Some of this drug use may represent self‐medication in response to anxiety, depression, alienation, and despair. ![]() In 2020, 83 percent of opioid‐related overdose deaths involve fentanyl and its analogs.Īs my co‐authors and I pointed out in the Journal of Pain Research in 2019:Īmericans increasingly have been engaging in the non‐medical use of licit and illicit drugs since the late 1970s. By 2012, as opioid prescribing started dropping, making fewer prescription pills available for diversion to the black market, non‐medical users moved to heroin. In the late 1990s and early 2000s the drugs of choice for non‐medical users were “diverted” prescription opioids like Ox圜ontin. And researchers at the University of Pittsburgh provide clear evidence that overdoses from non‐medical drug use have been growing exponentially since at least the 1970s, long before the Food and Drug Administration approved Ox圜ontin in 1996, with different drugs predominating among the overdoses at different points in time. Government data show no evidence of any correlation between the number of opioids prescribed and the non‐medical use of opioids or of opioid addiction. ![]() Meanwhile, pain patients suffer from pain and mental anguish-especially veterans-as doctors abruptly taper or deny opioids to treat their pain. ![]() Almost simultaneously the overdose rate has surged from roughly 40,000 in 2012 to 93,000 in 2020. Prescriptions of opioids per 100 persons have dropped nearly 50 percent since 2012. State and federal policymakers embarked on a concerted effort to reduce opioid prescribing, hoping this would stem the rising tide of overdose deaths. Now the streaming service Hulu comes out with a new miniseries, based on the 2018 book Dopesick, threatening to breathe new life into this false and dying narrative.īeth Macy’s 2018 powerful book, along with 2019’s Dreamlandby Sam Quinones, caused policymakers to adopt the false narrative that America’s overdose crisis is the direct result of doctors over‐treating their pain patients with opioids and turning them into “addicts.” Federal policymakers are finally starting to rethink their failed opioid policies that are based on the mistaken narrative that America’s overdose crisis is the direct result of doctors overtreating their pain patients with opioids, condemning them to a life of addiction.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |