I write a lot of things in wiki nowadays, and it’s good. I think better in there, and get away from the web’s echo chamber of endless reactions to reactions.
But occasionally wiki is a bit too under the radar. About a year ago I started following a thread of stories on opioid addiction in America. As one thing led to another, one statistic to an even more shocking one, and it seemed amazing it was not being covered more broadly.
I think it’s now out in the open, now a bigger story, but for various reasons, I want to link to some of that work here today, the place where people actually read.
The story, in short, is this. Pharmaceutical companies (in particular a company named Purdue Pharma) began to market new classes of opioid based painkillers to people in the mid-1990s. Despite the fact these were known to be highly addictive and prone to tampering they continued to market them. Purdue Pharma spent a massive effort pushing these drugs, and suddenly “pain management” was all the rage — you couldn’t go into the doctor’s office for a booster shot without being asked to rate your pain on a scale of red sad face to yellow happy face, and drugs were the follow-up should you answer wrong.
Weird things happened in small and medium-sized towns all over the U.S. Suddenly there was a heroin epidemic everywhere at once, particularly in the Northeast, but other places as well. The assumption was that it was like previous epidemics, a cyclical wave of addiction, that occasionally pops up when younger folks are far enough away from previous waves to have forgotten what a heroin addict looks like when they hit bottom.
Except it wasn’t like previous waves. It was bigger, and weirdly ubiquitous. There seemed, apart from whiteness, to be very few predictors to who was becoming addicted. What was happening behind the scenes? People were becoming addicted through an entirely new route: their doctors. For the first time in history, the vast majority of heroin addicts were becoming addicted initially through pills prescribed to them by a doctor. When the prescriptions got cut off, they went to heroin, the cheaper alternative.
“There aren’t a lot of people saying, ‘Hm, heroin sounds like a fun drug to try!’ The people who are using heroin are people who have opioid addiction,” said Kolodny, who is also a senior scientist at Brandeis University’s Heller School for Social Policy & Management. “Some develop [a painkiller addiction] for taking drugs exactly as they were prescribed.” See Route to Heroin Abuse and 80% of Heroin Users Started with Painkillers
Even when addicts stayed with painkillers, they put themselves at huge risks, with opioid pills surpassing all other drugs in terms of death count. While this toll was increasing, Purdue Pharma was using big data to find and target doctors writing the majority of prescriptions — not to turn them in, but to market to them more heavily.
And overdoses were not the only impact. In fact, far more people may be dying from the associated forms of liver disease and depression caused by addiction. The combined effects are so large that it has played a large part in reversing decreases in all-cause mortality in a number of demographics, a trend not seen in modern times. Though just one of the causes of increases in white mortality, the combined effect (along with alcohol and suicide) is so large that researchers say the closest thing they can compare it to is the AIDS epidemic in the 1980s and 1990s. Drug overdoses are now surpassing traffic accidents as a cause of death in the U.S. See Opioids, Alcohol, Suicide
In short, it’s the biggest health crisis in the U.S., created not by a bunch of curious kids, but by the pharmaceutical industry. It is touching all ages, all incomes. And yet I still find people that do not know this crisis exists, people who think they are alone in their struggle, people who blame themselves or others for an crisis that is as corporate-created as Deep Horizon. And as our friends in the activist community said in the 1980s so succinctly, Silence = Death.
So this is me trying not to be silent, and letting people know that if you or someone you know is struggling with this, you’re not alone. This is part of a bigger story, bigger than any one person and bigger than any series of individual choices. And to get out of this we need more than individual action and willpower — we need group awareness and collective action, we need to talk about this a lot, and we need to call out the series of actions that got us here. We need to recognize this as an epidemic, and remove the shame and the silence and the personal guilt and get things done.
At some later point I’ll try to pull some of the older pieces I wrote on this subject off of federated wiki and on to Wikity, and maybe even put them into a centralized stand alone resource. Until then this will have to do.