Kermit, West Virginia. Population 392. They received over 9 million hydrocodone pills in a two year period.
In a 6 year period, the entire state of WV received 780 million pills. Over 400 pills for every man, woman, and child living in WV.
Seems like attacking the supply is great place to start. WV doesn't need this many pills.
That is what was done, transferring the demand to heroin as opposed to oxy. Also, focusing on the supply side of things is the last 30 years of US policy: it's not worked effectively, and has a concomitant effect of incentivizing black market dealers to be wealthy and power. It'd be better to sell OTC heroin than to fund violent gangs, just in the name of limiting side effects.
Pills were given out like candy, then restricted which caused demand for cheaper alternatives. Had the drug companies been regulated in the first place, we might be OK.
The pills aren't coming from mules or cartels, they are coming from US companies. The pill supply has to lowered.
edit to add: http://www.latimes.com/projects/oxycontin-part1/
However now the US made that mistake, what's the problem with continuing to give out the pills "like candy", although with tighter controls to make sure that they don't go to create new addicts?
For people with short term pain, or who are at the end of life, opioids can be a good choice.
For people with long term pain opioids can, rarely, be a good choice, if other things have been tried first, and if there's a careful package of care.
Most people with long term pain need variations of / combinations of:
1) Access to evidence based pain management specialist clinics
2) Graded strength building exercise (for musculo-skeletal, not for nerve)
3) Medication that isn't opioids
Giving opioids to people with long term pain isn't a good way of controlling their pain (they develop a tolerance) and risks severe harm (on top of addiction).
Here's a website from the English Faculty of Pain Medicine, which is part of the Royal College of Anaesthetists. They explain it far better than I can.
I learned an important lesson, however. Doctors will frequently use the amount of pain someone is experiencing as a diagnostic aid when determining a patient's diagnosis. I had a ruptured eardrum that I saw a doctor for and that doctor misdiagnosed it because I wasn't showing any signs of pain and that injury is supposed to be excruciating. The doctor explained to me that if it was ruptured, I'd be near tears and screaming for pain medication.
https://arstechnica.com/science/2017/03/tweaking-fentanyls-c...
What are you talking about? Everything in medicine is highly regulated. Introducing a new drug is a very expensive process, run in the US by the FDA. It takes all sorts of expensive tests and trials to be allowed to sell a new medicine in the US.
Maybe the process messed up in this case. Sure. Many things are possible. But this was regulated start to finish.
Were they given out without prescription? If not, I feel like MDs have to share some blame on this.
In both cases, mandating a little common sense in how these drugs are used would potentially help a lot of people avoid a life they don't want.
no argument there. :)
The stat though about Kermit, West Virginia example has to be due to fraud and illegal sales, though? Or include vastly more people within the area covered by its pharmacies and/or doctors, which ever the data source used?
Otherwise each person in that town is receiving (on average) 31 pills/day. Maybe I wildly misunderstand hydrocodone prescriptions, but dozens of pills per day seems to be an excess.
I agree that opioid over-prescription is an issue, but I imagine some of these numbers are being inflated by similar "pill mills" run by unscrupulous doctors.
Manufacturer seems to have played a role too by sticking to dosing they knew was ineffective and then pushing for higher doses which lead to big bonuses: http://www.latimes.com/projects/oxycontin-part1/