>A perfect storm of prescription opioids, government prohibition, and cheap/plentiful Chinese and Mexican fentanyl.
I think it's actually the fact that the war on opioids has translated into a war on prescription pain drugs, in general.
So, when you're a chronic pain sufferer and have gone without and you get ahold of something - anything - to remediate the pain, you're far more likely to take a little extra just to get the pain to STFU for a while so you can do things like sleep through the night for the first time in seemingly forever.
I've heard tales of American veterans (through the VA) being referred to things like yoga to manage their chronic pain, when it's entirely due to neurological damage and things like yoga will do fuck-all to help with that.
Is it any wonder then that people might be more liable to OD when they obtain something to try to manage the pain that otherwise never ceases?
I'd say it is a fundamental issue in American society (the war on opioids translating into no pain management medications whatsoever) with callous indifference - rather than anything else.
I think it is also the lack of sick leave for many Americans so they take a quick pill to recover. Sometimes your body can recover by itself if only given time and physical therapy.
I had some excruciating peroneal tendonitis that made it hard for me to walk on rough surfaces. Foot doctor said the best treatment was a walking cast, rest and daily exercise. Fortunately my employer allows me to work from home as needed so I could give my foot a rest for a few weeks. But not everyone has access to that. Imagine if you are a server at a restaurant on your foot all day.
I used self guided physical therapy to improve a chronic nerve pain issue. I'm glad I had very moderate pain and a moderate accompanying physical issue, and I wouldn't want it to be the only option in a more severe situation, but it's not useless either.
Simple economics: expensive legal prescription drugs drives people to source cheaper alternatives. Unfortunately, the cheaper alternative is also much more lethal.
I think there's a narrative that is the opioid crisis is driven by addiction, when it seems to be, and has historically has been, inefficient drug pricing.
The dirty little secret that no one talks about: Many of the Miracles of Modern Medicine that save lives don't restore you to full functioning. It's often a miserable existence with no hope of really getting your life back.
And it's not a small number. Up to 20% of people identify as handicapped while another 40% of the population has a milder degree of impairment and actively eschews the stigmatizing label of handicapped.
Whats really interesting is you can go to mexico and get tramadol over the counter ( which has almost no side affect i know i take it for chronic nerve pain ) but doctors here want to use narcotics for pain management. demerol percocet vicodin etc etc
Several drug manufacturers flooded the market with pills exposing way too many people to opioids in a casual way. Once folks are addicted it’s very very difficult to break the addiction.
The Washington post has an excellent series on the topic if you are interested.
From what I have read OxyContin was sold as needing only two doses a day. At that level it’s not that addictive. But it soon turned out that two times a day is not enough so people took more to avoid crashing in between. With that amount it became very addictive but companies still kept selling the two doses a day although they knew that people would quickly take more.
The whole point of OxyCotin was that it was a long acting dose. So if they admitted it didn't last that long it would cause loss of business. This cause a lot of patients to be undertreated and seek alternatives.
Pain relief induced by pleasure and physical dependence - constipation too. I am almost off morphine. 15mg a day now.
I have lost 30 lbs over 3 months. Chronic pain sucks but I despise opioids. They are seductive at first until one realizes their body is literally rotting away..
I was lifting 125lb dumbells before I got on morphine. Now I am feeble and haven't worked out in months. It kills your endogenous drive. If you care about your future self, please don't use opiates more than sparingly...
My mom said that, when recovering in the hospital from a certain operation, she was prescribed morphine for pain, and when she had some, "colors looked brighter, the air smelled sweeter, and everything just felt nicer"; when it wore off, she said, "Wooooow. So that's how drugs can be addictive." She refused all morphine after that.
Some people get that joy while others get nauseous upon first introduction to opioids. In any case, it's short lived, the honeymoon phase. Good on your mom - we will eventually get non-opioid, effective pain relievers. I am subbed to /r/drugnerds and there is a bit going on in the R and D of that area.
Thank you. Tapering at _just_ the right dose to not interfere with the grades in the master degree I am doing is quite tough.
Which makes me wonder...there's common regimens like the Ashton scale and whatnot for benzos but it's very boilerplate.
Unicorn Idea:
Quantitative Withdrawal
User enters dosage each time they use. Datetime is auto filled, but can be altered for dosages that are entered belatedly.
ML is used to show charts with sliders based on speed of taper and severity of side effects. A time series showing the reduction in withdrawal effects over time with an ETA and other statistics. With labeled sections for certain parts of the withdrawal that are more severe (think a phase change diagram.) Seizure/epilespy zone would be clearly large on a configuration where the user chooses a ridiculously fast taper. The app would show a color, red in this case, warning of these symptoms and recommending against it. Baseline taper recommendations could be based on the medical literature out there with clinical trials. There is plenty of labeled data especially from the NIH.
The user can log their current symptoms to help the model learn their individual brain chemistry.
And vitals like HR, pulse, and o2 that are easily measured via pleasant APIs like Healthkit on iOS and Android. (Would be by proxy optionally compatible with iWatch, FitBit and other such sensors.)
These vitals are great features that the model can learn from.
The user can answer questions regarding the current state of their withdrawal symptoms, providing the model with labeled data to learn from.
Models can be pretrained on an individual in close proximity to the MLE on the distribution of human neurochemistry. And thus would work out of the box pretty well before the users input and vitals start to vastly improve it until it helps the user maintain AND gain :-)
