Who profits?
The US is unusual among developed countries in that its life expectancy has gone down in the last few years.
In most high-income countries, life expectancy has been increasing, gradually but steadily, for decades. The last time that life expectancy in the United States showed a similar decline was in 1915–18, as a result of military deaths in the First World War and the 1918 influenza pandemic.
This time, the culprit has been a surge of drug overdoses and suicides, both linked to the use of opioid drugs. The death rate from drug overdoses more than tripled between 1999 and 2017, and that from opioid overdoses increased almost sixfold during the same period.
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This crisis is often referred to as the opioid epidemic and, just like an infectious-disease epidemic, it has a distinct natural history. In the United States, the country most severely affected, it arose through a confluence of well-intentioned efforts to improve pain management by doctors and aggressive — even fraudulent — marketing by pharmaceutical manufacturers.
Managing pain is obviously desirable. Marketing drugs, not so much.
Prescriptions for opioids increased gradually throughout the 1980s and early 1990s. But it wasn’t until the mid-1990s, when pharmaceutical companies introduced new opioid-based products — and, in particular, OxyContin, a sustained-release formulation of a decades-old medication called oxycodone, manufactured by Purdue Pharma in Stamford, Connecticut — that such prescriptions surged and the use of opioids to treat chronic pain became widespread.
Purdue Pharma and other companies promoted their opioid products heavily. They lobbied lawmakers, sponsored continuing medical-education courses, funded professional and patient organizations and sent representatives to visit individual doctors. During all of these activities, they emphasized the safety, efficacy and low potential for addiction of prescription opioids.
And they did all this not as disinterested medical experts but as people flogging a product for profit.
In fact, opioids are not particularly effective for treating chronic pain; with long-term use, people can develop tolerance to the drugs and even become more sensitive to pain. And the claim that OxyContin was less addictive than other opioid painkillers was untrue — Purdue Pharma knew that it was addictive, as it admitted in a 2007 lawsuit that resulted in a US$635 million fine for the company. But doctors and patients were unaware of that at the time.
Painkillers are not the only drugs that get marketed heavily.
Good thing it’s managed to avoid all that socialist health-care stuff all those other countries are struggling with.
*tears hair*
We started to see an uptick in pharmaceutical opiod abuse here. The response was to make it harder to prescribe opioids, educate doctors why over prescription was dangerous and to pull all opiod over the counter medications completely. Because the ability to advertise direct to consumer for pharmaceuticals is limited here, and products not supplied via Pharmac are very expensive, that has put the brakes on the trend, although not completely eliminated the problem obviously.
No system is perfect, but socialised medicine all the way every day frankly. The US system is just barbaric nonsense frankly.
This may be old news to the rest of you, but a while back I heard a talk by this guy:
https://www.neura.edu.au/staff/prof-lorimer-moseley/
which completely blew my mind. His point is that pain isn’t really a physical objective thing–it’s a way our nerves are ‘requesting attention’ from our brain, so we can do something to protect whatever the nerves are embedded in. (In other words, we don’t feel pain because something is being physically damaged–we feel pain before the damage begins, and if the damage is too great for the brain to activate anything that can protect our body part we won’t feel pain.) He talked about lots of experiments that manipulate our perception of pain–e.g. the same pressure hurts more when accompanied by a red light than by a blue light, and violinists feel more pain from the same stimulus on their ‘important’ fingering hand. He encourages us to think of pain as a warning, or as a ‘virtual cast’ around a fragile body part. Now that I get this, I have to look a bit more askance at therapies that treat ‘pain’ as a) something that comes from an injury and b) something that is a measured objective ‘thing’.
Nothing is.
Um…1915-18? The U.S. didn’t even declare war until April, 1917. And it took a year before American troops were actually engaged in major land battles. So what was killing Americans between ’15 and ’17?