Sci + Society,

#180: The Ongoing Opiate Crisis

May 12, 2017

Here’s an alarming number:  in recent years the use of oxycodone has risen by 500% in the US.  In fact, America consumed more opiates than any other country.

But it’s not because we’re suffering from more pain or accidents than anywhere else.  These drugs are simply overprescribed.

Drs. Eike Blohm and Maria Steiner talk to Jesse about the legitimate medical uses of opiates and why they’re so easy to abuse.

Opiates and Pain Management

Opiates are great at treating pain, at a time when doctors are focusing more concerned with pain than ever before.

Pain is often treated as a “fifth vital sign” and emergency room doctors’ salaries are sometimes based on client satisfaction, which often hinges on significantly reducing pain.

Opiates are very good are alleviating pain temporarily, although can make pain worse over the long run via opiate-induced hyperalgesia.

Doctors are then faced with the choice of doing the “right” thing or the easy thing.

The Opiate Epidemic

The current opiate addiction epidemic is killing more people per year than AIDS at the height of the crisis.  And it affects people across socioeconomic lines.

Addiction is not a choice; it’s a disease that affects brain chemistry.  Nobody wakes up and says, “I want to be an addict.”

Opiates are highly addictive, and prescribed more frequently than ever, creating a deadly cycle.  Opiate addicts often first become addicted from a prescription but move to heroin because it’s cheaper and easier to get.

Just how serious is the addiction crisis?  According to some estimates, a typical heroin user will overdose between one and ten times each year.  Deaths from overdose have overtaken deaths from car accidents in the US.

Treating Opiate Addiction

Whatever you think of addicts, reducing overdoses makes financial sense.  Treating addiction before addicts need to be admitted to a hospital due to overdose cuts health care costs and enables some people to get clean and return to being functional members of society.

There’s still a stigma to addiction; we associate drug use with a moral failing but that’s not the case.  Addiction is caused by a change in brain anatomy that changes our reward circuit in a way that’s hard to get out of.

PS:  Our weekly emails aren’t physically addictive, but they will reward your brain.

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One comment

  1. ben says:

    I would have liked more details of the mu/dopamine mechanism, but overall lot’s of cool info — Tooth to Tattoo ratio, and Mega-dosing on OTC anti-diarrhea drug (Loperamide diarrhea)?!

    It’s scary how opium addiction is within anyone’s reach… not just the stereotypical movie junkie. Once the brain starts to change, I wonder if there’s a point of no return that can be detected with a brain scanner.

    On the question of overdose economics, ‘This American Life’ had a great episode a while back about how Philip Morris funded a study that showed how it was economically a good thing that smokers die young since most of the government healthcare spending is on retirees, with something like 50% is spent to extend life in the last year!

    Regarding techniques to restore breathing after an overdose, is the scene in Pulp Fiction (American Boy A Profile of Steven Prince), where they inject adrenaline right into the heart, legit?

    Speaking of movies, I’m not a fan of ‘They Live’ either, as mentioned in the RLRG, but interesting that Slavoj Zizek always references this film as a good example of the ideology all around us that we are unconsciously unaware of! I recommend the ‘Information Avoidance’ episode of the You Are Not So Smart podcast.

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