The deaths are a subset (or perhaps an 'outgrowth') of the larger epidemic. The epidemic is the addiction and the high-availability. And folks are addicted to, and OD'ing on ... opioids in general, not just Heroin.
Broadly speaking, one could say opioids fall into these categories:
Rx-Meds that were legally prescribed to the person
Rx-Meds diverted from legit patients to Friends/Family, or the Street
Illegal - Heroin (with or without adulterants like Fentanyl), or fake Rx-looking pills that are usually made with Fentanyl rather than what they're represented as, typically hydro or oxycodone.
People are hooked on one or more of the above in particularly large numbers right now, and IIRC it started around 2000, when there was (I believe) some kind of federal law change that made doctors legally obligated to treat your pain (esp. chronic pain).
Believe it or not a plurality (if not a majority) of doctors were and still are of the opinion that managing chronic pain with opioids is a BAD idea, except in certain palliative situations.
This widespread belief is what directly led to the laws re: opioid distribution being so strict prior to around 2000. 5mg Vicodin (hydrocodone) or 5mg Percocet (oxycodone) with a big wallop of liver-killing acetaminophen were all you were getting outside hospital and even then often only when you had something very visibly painful like a broken arm, or when you went home from surgery.
Now they make up to 30mg instant release oxycodone that's pure dope, basically. And up to 80mg oxycontin that's 12 hr time-release (nowadays the formulation is difficult to tamper with, but from like 2000-2006 one could simply chew up and swallow, or crush the pill and sniff it, to defeat the mechanism).
Dilaudid (instant release hydromorphone) and Opana (time-release oxymorphone), again pure dope, no tylenol ... which are both just WICKED euphoric, and hence highly addictive, drugs ... are also being Rx'd to people with 'chronic pain', in fairly large numbers. Docs almost never gave those drugs out prior to around 2000 ... unless you were literally dying of cancer.
Basically, prior to around 2000, you might get 60 x 5mg Percocets a month if you found an understanding doctor, to take if and only if ... the pain gets really bad.
IOW, strong opioids were basically never given for 'chronic pain' symptoms to be taken round the clock ... something changed around 2000 (like I say I think there was some law change that brought it about), while at the same time, giving us WAY stronger Rx drugs/formulations and 'time release/pure opioid' pills that the Drug makers claimed wouldn't addict most people (just because of the time release? Yeah ... wrong.).
PLENTY of people OD on these newer formulations (Opana and Oxycontin being most common) and die ... probably not as many as w/heroin but it absolutely does happen. Because there's lots of dumb people out there. JimBob who's been hooked on pills for years and has massive tolerance hands little bro BillyJoe one of the Oxy 80's that he pops like candy. Now, BillyJoe has never had any dope before, he chews up the pill like his big bro does it, washes it down with a couple beers, and next thing you know the 16 percocets worth of Oxycodone in a OC80 hits him at once, mixed with the booze ... and he dies. This type of scenario plays out more than you'd think.
In the years prior to 2000, the main 'objection' to the idea of usage for managing chronic pain is that basically opioids don't work for very long before you have to increase dosages for comparable pain relief. After only a year or two (in some cases), people can end up on dosages that would kill a small roomful of opioid-naive people. Eventually they just plain don't work anymore at all for killing the pain.
At that point the patient is extremely physically (and probably psychologically) dependent on them, looking at horrible withdrawals unless they're very slowly weaned down, and even then, the final 'step' of quitting is very unpleasant.
Often times doctors will just suddenly decide they see signs of such patients being 'addicts' and then just cut 'em off cold. They then often then end up on heroin, or copping pills on the street or from family/friends. IOW, they proceed to act like an addict, whether they really 'are' one ... or not.
Whatever happened around 2000, big pharma got themselves a huge gift, and they've made Billion$ (maybe hundreds of them) off of the change that occurred, whilst basically creating a whole generation of addicts.
At least they were nice enough though in 2000 to add an allowance for another methadone-ish opioid, buprenorphine, which could be Rx'd by regular doctors (after a simple cert process) in an office setting for treating opioid addiction, unlike is the case with methadone.
It's ALMOST like they foresaw the epidemic, and their solution to that would be ... MORE OPIOID$! Woo-hoo! This one doesn't get you high, and blocks other opioids from getting you high, and requires a MASSIVE amount to OD and die from. But it's still packs a NASTY withdrawal esp. if you don't wean your dose down really low before quitting.
= new reply since forum marked as read
