Imagine this: Federal Decade of pain law … could have contributed to our perceived “opiate crisis”

Here is a conclusion of this study on opiate OD’s

The study also found a correlation between fatal overdoses and mental and physical distress using surveys of physically and mentally unhealthy days. Mental distress increases the relative risk of dying from a drug overdose by as much as 39%.

Here is a chart on all the comorbidity issues aggravated or caused by under/untreated pain.  Pay particular attention to line THREE CARDIOVASCULAR and the LAST LINE – QOL could under/untreated pain be a underlying issues of ODing?

Here is another poignant fact… At the beginning of the epidemic it was heroin. By 2010 it switched to prescription opiates.”

Does anyone remember what changed in 2010 ?  the Decade of Pain Law expired and was not renewed.  So after 10 yrs of pain being referred to as the 5th VITAL SIGN and practitioners being encouraged to treat pain and the Joint Commission making it a MAJOR STANDARD for hospitals to get credentialed.. each pt when discharged was asked on a survey “how was your pain treated” ?

The Joint Commission quickly disclaimed any ownership of THE FIFTH VITAL SIGN and was no longer a major standard for hospitals to meet.

In Jan 2009, we had two new attorneys in the White House and a new Governor & AG in Florida. All seemed to have an intent to tackle the “opiate epidemic ”  Florida was well known as having – it is claimed – a couple of hundred “Oxy docs”.

At the beginning of the epidemic it was heroin. By 2010 it switched to prescription opiates.” The ” pharma opiate epidemic ” had a 10 yr run up.  Over the next 5 yrs we had bureaucrats trying to – at least – slow down the prescribing of opiates and Rx opiates peaked in 2011-2012…  The DEA started reducing the pharma opiate production quota.. eventually reducing the opiate production quotas by 50%+.  Then in 2016, the CDC published their opiate dosing guidelines and the DEA and Veterans Hospitals jumped on those GUIDELINES with BOTH FEET and making statements that the GUIDELINES were ACTUALLY LAWS… and that 90 MME/day was the LIMIT FOR EVERYONE… even though there was provisions in the guidelines that exempt many chronic health issues from those daily limits.

UC opioid study identifies at-risk populations in America

Fatal overdoses are linked to high rates of mental distress

https://www.uc.edu/news/articles/2021/05/uc-opioid-study-identifies-at-risk-populations-in-america.html

The opioid epidemic is taking a deadly toll on people in disproportionate clusters, according to a new national study by the University of Cincinnati.

Fatal opiate overdoses are most prevalent among six states: Ohio, Pennsylvania, Kentucky, West Virginia, Indiana and Tennessee. But researchers identified 25 hot spots of fatal opioid overdoses nationwide using data from the Centers for Disease Control and Prevention.

Published today in the journal PLOS One, the study demonstrates how both widespread and localized the problem of substance use disorders can be, UC assistant professor and co-author Diego Cuadros said.

Diego Cuadros stands in front of a colorful projected map of America.

Epidemiologist Diego Cuadros is director of UC’s Health Geography and Disease Modeling Lab where he has studied HIV, malaria and COVID-19. Photo/Andrew Higley/UC Creative + Brand

Cuadros is director of UC’s Health Geography and Disease Modeling Laboratory, which applies geographical information, perspectives and methods to the study of health, disease and health care. As an epidemiologist, he studies the impacts of diseases such as malaria, HIV and COVID-19.

“Not everyone is similarly at risk,” Cuadros said. “We wanted to identify characteristics that put people at higher risk of a fatal overdose.”

Health interventions for opiates have focused largely on treatments such as the distribution of naloxone and other lifesaving remedies. But Cuadros said prevention could be effective if vulnerable populations can be identified. To that end, researchers found that white males ages 25 to 29 were most at risk of fatal opioid overdose followed by white males ages 30 to 34. The study also identified an increasing risk to black males ages 30 to 34.

What’s happening now is we’re more than a year into a pandemic. Mental health has deteriorated for the entire population, which means we’ll see a surge in opiate overdoses.

Diego Cuadros,UC’s Health Geography and Disease Modeling Lab

The study also found a correlation between fatal overdoses and mental and physical distress using surveys of physically and mentally unhealthy days. Mental distress increases the relative risk of dying from a drug overdose by as much as 39%.

“We saw a strong association with mental health and substance abuse disorders, particularly opiates,” Cuadros said. “What’s happening now is we’re more than a year into a pandemic. Mental health has deteriorated for the entire population, which means we’ll see a surge in opiate overdoses.”

Researchers are trying to understand why men are more likely than women to suffer a fatal overdose and what it is about the period of life between age 30 and 45 that makes people more susceptible to the epidemic.

“Maybe you have more responsibilities, financial responsibilities or stress at that time. Maybe there are physiological changes or changes in our brain that we don’t know yet,” Cuadros said. 

A map of the lower 48 states shows the spatial distribution of relative risk for death from substance use disorder in 25 clusters researchers identified.

A map of the contiguous United States shows the spatial distribution of relative risk for fatal overdoses from substance use disorder in 25 identified clusters. Graphic/UC

“This is a complex epidemic. For HIV we have one virus or agent. Same with malaria. Same with COVID-19. It’s a virus,” Cuadros said. “But with opioids, we have several agents. At the beginning of the epidemic it was heroin. By 2010 it switched to prescription opiates.”

Now states are seeing more overdoses from synthetic opioids such as fentanyl.

The study also tracked the migration of overdoses between 2005 and 2017 from Southwest states to the Northeast. Many of the clusters UC identified in the Southwest and Northeast had comparatively higher levels of physical and mental distress.

Andres Hernandez sits at a computer with a map of Ohio on the screen.

UC College of Arts and Sciences graduate Andres Hernandez identified national clusters where the opiate epidemic has had a disproportionate impact. Photo/Jay Yocis/UC Creative + Brand

Co-author Neil MacKinnon, former dean of UC’s James L. Winkle College of Pharmacy, said the analysis could help health policymakers and clinicians by identifying individual and community-level factors associated with an increased risk of death due to substance use disorder. He is provost now at Augusta University, Georgia.

“We hope the risk factors we identified in this analysis will be used by agencies like RecoveryOhio to plan proactive strategies and allocate resources to address this epidemic,” MacKinnon said.

Previously, UC researchers identified 12 regions in Ohio that had disproportionately high rates of fatal overdoses from opioids.

“We started in Ohio. We know that in this state we’re suffering one of the highest burdens of the problem,” Cuadros said.

Likewise, he said it would be worthwhile to study populations in the United States where opioids are not exacting a horrible toll on families to understand the problem.

“Sometimes we focus too much on where the problem is focused. It’s useful to look at the areas where the problem is not as pressing,” Cuadros said.

One Response

  1. This will undoubtedly be used as fuel for the anti-opioid hysterics. Even if/when there are zero opioids being prescribed, I’m sure the OD rates will continue to increase, & the AOHs will still blame prescription meds. Their motto clearly is, “What we’re doing isn’t helping the problem, so let’s do it more & harder.” And we all know what Einstein reputedly said about that course of action…

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