Thursday, April 6, 2017

Why Wypipo Are Dying

I've been reading this deeply flawed Brookings study (60 pg pdf) on morbidity and mortality in the 21st Century. It has so many problems it's almost useless, but it nicely fits the narrative of suffering, despairing rural white folks -- who elected Trump in their misery -- that it's become something of a go-to "proof" that white folks are dying in their multitudes (ostensibly from despair at their future-less lives.)

The statistics do not support the conclusion. The  simple facts don't. But don't let that stand in the way of a good narrative.

The primary issue for the authors is the increase in opioid addiction leading to overdose deaths in rural America -- even though it is not the leading cause of death, but so what. It involves drugs, and everyone knows drugs are eeeeeevil.

There have been any number of reports that parts of rural (white) America have been flooded with prescription opioid pain killers; millions and millions of doses sent to pharmacies in areas that have populations in the tens of thousands if that. Surprisingly, these areas then experience a spike in opioid addiction and overdose death. How interesting.

The authors of the Brookings study, however, are careful to hold harmless the prescription drug manufacturers, pharmacies and doctors in those areas. The problems associated with opioids are entirely on the shoulders of the patients who, apparently, falsely claim to be in pain in order to procure a scrip, then trade the meds among themselves. Or something.

It really doesn't make sense given the already restricted access to opioids and other narcotic pain medications. And at least 9 times out of 10, patients presenting with pain are in pain, not "despair," real, physical pain, and the medication is intended and used for pain relief.

Yet the narrative says, "No, no! These people are not in physical pain. They suffer from Wypipo-despair!"


Interestingly, in other drug abuse frenzies (the crack epidemic, the crank era) nobody cared a whit about the why of such drug use. They wanted to see the users and their unpleasantness eradicated forthwith.

And so it was with the ever-present War on (some) Drugs and (some) Drug Users.

Now, though, the issue is Salt of the Earth Wypipo in rural communities who voted for Trump and all of a sudden, treatment, love and compassion for the despairing victim-users is the general  attitude toward the Unfortunates.

No war on these people and their drug use at all. No sirree.


Well, there is an exception. What is being proposed and in some cases enacted are further tightening of the restrictions on the prescription and dispensing of opioid pain medications.

In other words, the point is not to "help" the victims -- poor, rural Wypipo that they are -- the point is to make it difficult or impossible for people in pain to legally obtain opioids for pain relief. There. That should solve the problem, right?


In some areas it is already nearly impossible for people in pain to legally obtain opioid or other narcotic pain relief medication because doctors are terrified of the DEA and refuse to prescribe it -- or any effective medication for pain.

They refuse outright and patients are left on their own to find medications to deal with their pain -- or just live with it. Too bad, so sad. The proposed additional restrictions and prohibitions will simply mean that more people in pain will be refused medications to alleviate their suffering.

I think that's the point of the narrative. "Suffering is good for the soul," right?

Whatever else Our Rulers want to do, they want to impose sufficient suffering on the Rabble to keep them in line, and they want to punish anyone who gets out of line.

That's Doctrine.

Of course I have a personal interest in these things. Until recently, pain associated with my condition was fairly well controlled without specific medications for pain. But about two weeks ago, I started having what they call a "flare," something that hasn't happened since before I started treatment, and it lasted a good long time, despite attempts to mitigate/control the pain with steroids. I received no pain medication at all.

Steroids alone were supposed to be enough to control the pain, but they weren't. What was happening was that generalized joint pain would concentrate in one joint or pair of joints and at one point I could not walk because of the intensity of pain. Standard pain killers like Aleve had no effect.

As it happened, I had some left-over pain medication from a previous bout of sciatica, and sure enough, within minutes of taking it, the pain was controlled.

But it's an opioid, and it was never offered by my doctor -- nothing was -- for pain relief, only the steroids, which did not control the concentrated joint pain that made basic functioning impossible.

According to what I'm being told, my condition has "evolved" into a new and more serious phase that requires more aggressive treatment with stronger immunosuppressants an other drugs that can have serious or fatal side effects. But that's how it goes. I'm not as concerned about that as I am about being stuck in a painful situation (another "flare" for example) without access to effective relief.

Given the urge of policy-makers to further restrict or prohibit the use of opioids for pain relief, I wouldn't be surprised...

[This Politico article explores some of the criticism of the Brookings study. Still, the general thrust of it is accepted.]

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