Pet Peeve about opioid epidemic

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ksaves2

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Concerning the "Opioid Epidemic"

So in 2015, 35,092 people died in car wrecks. A "high" or peak of motor vehicles deaths was 54,589 people died on the nation’s roads in 1972.

So, in 2015 13,000 died of heroin overdoses. Last I looked, doctors can’t prescribe smack. (heroin to the babes in the woods out there)

In 2015 the top graph on this page: https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates shows that the deaths from all opioids was under 35,000 roughly if I got that close to correct. O.K., ~ 20,000 were sick with life and killed themselves with non-heroin opioids. That is too bad.

Obviously, this conclusively shows we should outlaw motor vehicles/cars and all of us should ride bicycles or walk cause cars cause as many deaths as narcs!!

Sheesh, the only epidemic is in the minds of the media,lawyers and the ivory tower authorities.

Seeing people get sent home from ER's with legitimate, documented painful conditions that would benefit from a short course of narcotic analgesia is making me sick. (Ever try passing a kidney stone on tramadol?)

Now obviously in the areas where people have a high incidence of heroin addiction there needs to be consideration of some sort of treatment programs. Money or lack thereof is the deal here as is the uninsured and low socioeconomic status of the sufferers.

Q.E.D.
Kurt
 
I really don't get it. Off and on I have had to take both Vicodin and Percocet for recovery for my joint replacements. Months at a time in fact. For me: 100% works for pain but 0% for any high or euphoria of any kind.
 
The epidemic that you speak of, is real. it has become the drug du jour. (Fentanyl is very close behind!) Heroin is the drug of junkies & the down & out. Opioids are pain killers, and most take them as prescribed, but then become hooked.. Seasoned druggies are Turing to them because they are cheaper, the high just as good, and better 'quality controlled'. Not to mentin easier to get than a Kg of smack..

Smack / Heroin has been around for years, decades, centuries. Synthetic opioids for the last decade.. Much steeper curve.. And the deaths you speak of, are most likely from overdoses.. "I can handle my smack". many groups who deal with these people are now carrying Narcan / Naxalone to help the almost once-a-day overdose they encounter..
 
I really don't get it. Off and on I have had to take both Vicodin and Percocet for recovery for my joint replacements. Months at a time in fact. For me: 100% works for pain but 0% for any high or euphoria of any kind.

Probably because you're not wired the same as others. Addiction can be a medical and genetic issue. As for me, I was recently on some serious pain medications for a pretty severe ankle injury this past winter. When the pain subsided there were a few times I took the opioid meds when it probably wasn't needed and frankly...I totally get it. When there wasn't severe pain to control it made me feel gooooooooooodddd. I immediately recognized the issue and switched to over the counter meds for pain. I can completely understand how someone would and could become addicted. I still have half a bottle of the meds in my counter just in case I re-injure my ankle but I haven't touched them since a week or two after my last surgery.
 
When I had the rocket collision, they prescribed me Norco (I think?) for the pain. I took a pill or two. Didn't help with the pain and didn't do anything else for me. They're still sitting on my shelf. :confused2:
 
Sheesh, the only epidemic is in the minds of the media,lawyers and the ivory tower authorities.

You'll be saying that right up until a loved one becomes addicted.

What's wrong with focusing on a problem that is tearing families apart and separating parents from their children etc...? To compare this tragedy to car deaths is a bit absurd. And I can tell you as someone who works for a state highway agency engineers are constantly trying to make roadways safer. That issue is constantly being worked upon...

Go watch about 10-15 episodes of Intervention.

*One of* The solutions is to make opioids harder to get. As I understand it, addicts (and dealers) can go to multiple doctors and get multiple prescriptions for their drugs. There's got to be a way to network pharmacies and medical facilities to prevent this in somehow...So those who are passing kindey stones can still get their much needed painkillers in appropriate amounts and the dealers can't hoard mass quantities for sale.

The other is to educate doctors on signs of opioid dependence which seems to be lacking. Or at least that's my impression...
 
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As someone who has struggled with addiction...
You don't have to understand it. Unless you suffer from it, you really can't. Just, maybe, have some empathy for those that do.
Here's the basic idea... Person gets injured. Person receives legal dope prescribed. Dope stops working. Prescription increases. Repeat. Repeat. Repeat. Dr cuts off person because "that's too much legal dope!" Person needs dope now. Turns to illegal dope. Downward dope spiral continues.
Person could be someone who would never do drugs, but took them willingly because someone in a lab coat said it was okay. Is that person's dope habit really their fault? Really? Once they recognize their addiction, it is their responsibility, but u would argue that the Dr holds some responsibility for not ensuring the health of his patient.
As to the epidemic concept... I'm honestly just going to keep my mouth shut on that side of things because, well, it really doesn't matter what I would say, it's an opinion and therefore volatile. And honestly... When it's your brother, sister, mother, father, son, daughter... Does it matter what the statistics are? So then, doesn't it follow that if there's something simple we can do, as a society, to prevent some of these opiod addictions and deaths, shouldn't we? Especially when there are perfectly safe, viable alternatives to opiod prescriptions anyway... Honestly, follow the money. There are, literally, people and companies getting very wealthy off prescription opiod painkillers that do, in fact, lead to unnecessary deaths. Again, epidemic or not, does it matter the number of cases? If it were your son or daughter, would you care?
Last thought... I'm not sure when compassion left the national discussion on drug abuse. I just know that I often read comments from people who think that willpower alone should be enough to stop an addiction because, "I can stop all on my own, so can they." And well, not everyone is the same, and no one ever got clean because someone else told them to. Ever. Compassion would solve a lot more problems than dictating terms and jail sentences. Even a junkie is a human being deserving of respect and dignity. I've watched respected members of society end up sleeping on the streets (literally). I've watched pure junkies (fitting every stereotype) become very respectable members of society. No matter what we do, we're all human beings and degrading anyone because of a disease simply lacks basic compassion.
...
Rant over. If you or anyone you know struggles with addiction, please feel free to contact me privately. I can help.
 
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You don't have to understand it. Unless you suffer from it, you really can't. Just, maybe, have some empathy for those that do.

You're absolutely right. I overstated myself a bit earlier. Empathy might be a better way of putting it.

Thanks for your rant. I've been fortunate I have not had to deal with addiction up close and personal but it is something I try to educate myself about so reading what you posted is helpful.
 
You're absolutely right. I overstated myself a bit earlier. Empathy might be a better way of putting it.

Thanks for your rant. I've been fortunate I have not had to deal with addiction up close and personal but it is something I try to educate myself about so reading what you posted is helpful.

Yeah... Honestly I didn't even realize that I had clicked on your post as a response, so my rant was more of a general statement on the topic. Good topic, and one I never shy away from. It's such a horrible experience for all involved...
 
I live in Ohio and the Lt Governor recently revealed that both of her sons have struggled with opioid addiction. So this problem affects people from all levels of society, not just "low-life junkies".

I have also read about newborns requiring treatment with Narcan because the mothers were addicts. There was also a cop who forgot to put on gloves before touching the interior of a suspect's car. I believe he came into contact with micrograms of a substance and he required two doses of Narcan. The cost of responding to overdoses is wiping out the budgets of numerous municipalities in Ohio.

A doctor I used to go to about 15 years ago recently lost his license to practice medicine because he was a "pill mill" operation. Essentially, he would crank out prescriptions for opioids and other hard drugs so people could hoard them and sell them.
 
"Now they're calling taking drugs an epidemic - that's 'cause white folks are doing it."

—Richard Pryor


Wish I could find a youtube clip of that.... he said more than that, just that was the truth punchline.

I've been fortunate that on four occasions which come to mind that I had need for some prescription pain medication, I never used them all up. Only took them when I needed to (and boy did I for awhile after breaking my arm), phased them out. Kept some leftovers on hand for a "rainy day" for whatever pain or incident might need more than an Advil but less than a doctor visit (or before being able to do a doctor visit).

Indeed ironically when I broke my arm, it was about midnight and the only pain medication I had at first were some that were left over from a hernia operation about 6 weeks before (no pharmacy near enough was open at 3AM to get the pain medication prescription filled, and I knew I had the leftovers).
 
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<snip>
So in 2015, 35,092 people died in car wrecks. A "high" or peak of motor vehicles deaths was 54,589 people died on the nation&#8217;s roads in 1972.
<snip>
Obviously, this conclusively shows we should outlaw motor vehicles/cars and all of us should ride bicycles or walk cause cars cause as many deaths as narcs!!
<snip>
Sheesh, the only epidemic is in the minds of the media,lawyers and the ivory tower authorities.
<snip>

There's probably a thousand points we could discuss, and we still would miss many important issues.

My take on your comparison is that you may be glossing over all the work that has been done, in relation to automobile safety over time (most of which happened in the 60's & 80's). No, we didn't outlaw it, but the government (as a result of "popular" pressure from the public) mandated manufacturers to provide first seat belts in cars (and then later, airbags), and also passed laws requiring people to use seatbelts.

Even moreso, you are probably familiar with all the laws and requirements for using a child-safety seat...according to this article, there were 9000 children under 12 killed during the 10 year period from 2002-2011, which averages out to about 900 a year. So, when you think about all we are doing to prevent 900 deaths a year, it appears that we aren't concerned about the dollar value of what we are doing, we are more concerned with trying to prevent something that seems to be preventable. See https://www.usatoday.com/story/news/nation/2014/02/04/cdc-too-many-kids-die-unbuckled/5204127/

(My co-worker, who is of a "certain age" told me about how he took his first child home from the hospital in a laundry basket, in the back seat...ya' gotta miss the good old days!)

Automobile safety has a long history...usually of car manufacturer opposition to any government regulations, due to increased cost & whatever, but it seems clear from this graph that all the safety improvements are paying off (but still, we aren't down to zero deaths). See https://en.wikipedia.org/wiki/List_...dia/File:USA_annual_VMT_vs_deaths_per_VMT.png

For some more reading, if you are interested, see
https://en.wikipedia.org/wiki/Unsafe_at_Any_Speed#Reception (read the whole article, but esp. this part)

seat belts required in cars 1968
https://en.wikipedia.org/wiki/Seat_belt_laws_in_the_United_States

graph of deaths
https://en.wikipedia.org/wiki/List_...dia/File:USA_annual_VMT_vs_deaths_per_VMT.png

airbags
https://en.wikipedia.org/wiki/Airbag
https://www.history.com/this-day-in-history/federal-legislation-makes-airbags-mandatory

My final thought is that with car crashes, people typically don't immediately think of "who was right/wrong" (maybe later, some do and go hire lawyers). People typically have a "That could have been me!" reaction. With substance use & dependence, people tend to have the thought that "the addict" was responsible for their own actions, and this greatly influences our response, both individually and collectively as a nation.
 
Kurt,

The difference between dying in a car crash and dying of an addiction is the number of users. I don't know actual stats, but almost every American drives a car. The number of deaths from driving compared to the number of drivers is nowhere near the numbers of deaths from opioids compared to the number of users.

In case I am not making sense, what I mean is this: if there are 275,000,000 drivers, and 54,000 deaths, that's a 0.02% death rate. If there are 35,000,000 opiod users, and 35,000 deaths, then the death rate goes up to 0.1%. So you can't say, "More people die from driving, so ban cars."
 
Most folks missed the last sentence. Problem is no one wants to spend the money on addiction programs to help those so afflicted. If one looks at the "whole" population of the U.S. as "at risk" for opioid addiction then the car crash analogy can hold. That said, there are those who are more prone genetically for addiction
and those who are not. Read the post(s) above of those who took narcs for transient painful conditions, when the condition was relieved they had no
desire to continue. I am fortunately/luckily in that group.

The car crash situation has been dealt with by better engineering of motor vehicles hence the death rate from car crashes is "way" down
relative to the population increase of the U.S.

Also a large number of baby boomers are moving into old age where there are a lot of painful maladies that can so afflict them. Yes there are alternative means besides opioids to treat pain and they need to be utilized. In most alternatives for non-narcotic pain relievers they can cause, kidney/liver failure, stomach ulcers, anemia and adverse interactions with other drugs like anti-depressants. It's sort of a crime to take away Granny's 3 Vicodin/Norco a day for her back pain that
has no other alternative for treatment or she's too frail to undergo the 7 hour operation it's going to take to fuse her back. The non-narcotic pain relievers have their place but they have their own risks that can be acutely life-threatening. Kurt
 
Kurt,

I did go back and re-read your last sentence. By the time I got to it the first time it seemed pretty clear from the previous 6 paragraphs that you were blaming the users of opioids for their problem so it shouldn't be a surprise that most of us missed it, or more likely dismissed it.

I have used prescription narcotics a few times, but like you, I always stopped them as soon as practical. Now I have known people addicted to alcohol and opioids. My mother was an alcoholic; she got drunk every night before going to bed after my father died. I was just starting high school back in the 70's and didn't realize that she was an alcoholic; I just knew she was getting drunk every night.

My brother, now a retired surgeon/anesthesiologist, says he has felt the pull of alcoholism at times in his life, but always fought it off. He was an Army officer and after getting out worked at large hospitals in the Denver region.

Another guy I knew was on opioids for severe back pain, but eventually gave it up as the side effects were more problems than being pain free. The two biggest issues were constipation and he couldn't get a job while on the opioids. A second guy I knew also had severe back pain and was on prescription opioids. I was helping this guy with several hundred dollars a month to get the meds. After about 18 months he confessed that he was burning through the prescription meds in the first two weeks and dulling the pain by getting drunk the other two weeks. He eventually stopped the drinking when he was diagnosed with cirrhosis of the liver and given 6 months to live. That was at least 5 years ago and I think he cleaned up his act and is still alive. We don't talk anymore so I am not sure how he is doing. Again, he was a good guy, but in severe pain most of the time.

I have known quite a few addicts and all of them were good people. I don't know what the best solution to this problem is, but both as a society and individuals I think there are things we can do. Use all medications wisely. When a doctor prescribes something, ask what it does and what it is for. Is it addictive? Are there alternatives if it is addictive? Ignore all those stupid drug ads on TV, radio, print and on the internet. Maybe we should make drug ads illegal again. I believe in the First Amendment, but good grief, I've seen enough drug ads and lawyer ads for 72 lifetimes.

Tough problem and even tougher solution I think.
 
I have been a doctor for 19 years. I typically prescibe it for less than a week. If you need a longer course than 14 days, you need to see someone else. It is just my technique of preventing dependence. I get them to a specialist to help them quit. If they decide they don't want to quit taking them, I help them find another provider.

As far as personal experience, I do not like narcotics. I suffered with ankel pain from a multiple ankel fratures and continue to walk on it for 13 months in a laced up boot to complete my combat tour. Teh injury requried a special form of a complete ankle reconstruction which is one of the most painful surgeries you can have. My recovery was over 12 months and included a post op infection and rehab for 18 months. I took narcotics for 3 days even though they gave me 30 days worth. I felt the dragon's attraction and quit taking them.

If you feel you can take them with becoming addicted, be careful. I have seen the most confident give into the dragons' breath (narcotics are herroin).

There are appropriate usages for them such as cancer pain adn acute pain after surgery, but the use should be for end of life or short period of high levels of pain.
 
There are appropriate usages for them such as cancer pain adn acute pain after surgery, but the use should be for end of life or short period of high levels of pain.

Agreed. Wasn't there a law, previously, that severely restricted the use of opioid painkillers to uses you just described? I think I heard something about that law being overturned within the past 5-10 years (pushed by drug manufacturer lobby groups) due to "new research" (which was funded by drug manufacturers trade groups)...
 
I am not aware of this law. Professional bodies put limits, but I am not aware of any laws.
 
This is a not exactly plain and simple thing and is also full of emotion. Don't know that I will offer any conclusions but I will offer some data points. My eventually ex had become addicted to opioid pain killers. At one residence our apartment manager was eventually caught stealing residents' pain meds as her own health was a mess and she had become addicted to opioids. I my self have a handful of neurological, endocrine, musculoskeletal, diseases which can on occasion become, shall we say, substantially less than comfortable.
I think it is documentable that addiction is a non issue for me - but I have come to see how it is not odd that it could be for some and I do not declare myself too good for it to happen to me, I'm not that arrogant. (I can tend arrogant at times, but not to the point of that much!)
In conversations with neighbors and acquaintances, plus random members of the public in lines and waiting rooms and the like, it has been interesting to observe the nature of responses to when I might say about someone who has fallen to addiction, "That is sad." That phrase seems to be the launch button for rants condemning the addicted. Fascinating, as that sci-fi guy with the pointy ears might have said. Are these sentences data point? Editorial? Observation? All of those?
And now for an obvious editorial--> It seems to me that a foundational element of human nature is a deep-seated psychological and emotional NEED to judge and condemn others, someone, anyone: a human is not complete until they have declared and ordained someone to be lesser than themselves. It would be interesting to know why such divisive and destructive behavior evolved to be necessary to survival; it if was not necessary it would not have evolved, so why is it necessary?
And with that I'm out of words for now.
 
Life's chock full of choices. Some choose poorly. It's ridiculous to continue to make excuses for those who choose that later. That's reality. Please don't give that "until a family member" stuff. Been there done that he choose the drug over life.

Mike
 
Addiction is a family disease.
https://www.nar-anon.org

yup.
dont know if theres any family members of addicts that would chime in to say how the family got pretty sick, but it happens often.


addiction sucks. MANY junkies didnt one day stick a needle in their arm. they started with prescribed meds. no one wakes up one morning and says,"great day to start destroying my life and the lives of those around me.think ill do that by getting some smack."

first you take a drug
then the drug takes a drug
then the drug takes you.



lyrics to "Master Of Puppets"

End of passion play, crumbling away
I&#8217;m your source of self-destruction
Veins that pump with fear, sucking darkest clear
Leading on your death&#8217;s construction
Taste me you will see
More is all you need
You&#8217;re dedicated to
How I&#8217;m killing you

Come crawling faster
Obey your master
Your life burns faster
Obey your master
Master

Master of puppets I&#8217;m pulling your strings
Twisting your mind and smashing your dreams
Blinded by me, you can&#8217;t see a thing
Just call my name, &#8216;cause I&#8217;ll hear you scream
Master
Master
Just call my name, &#8216;cause I&#8217;ll hear you scream
Master
Master

Needlework the way, never you betray
Life of death becoming clearer
Pain monopoly, ritual misery
Chop your breakfast on a mirror
Taste me you will see
More is all you need
You&#8217;re dedicated to
How I&#8217;m killing you

Come crawling faster
Obey your master
Your life burns faster
Obey your master
Master

Master of puppets I&#8217;m pulling your strings
Twisting your mind and smashing your dreams
Blinded by me, you can&#8217;t see a thing
Just call my name, &#8216;cause I&#8217;ll hear you scream
Master
Master
Just call my name, &#8216;cause I&#8217;ll hear you scream
Master
Master

Master, master
Where&#8217;s the dreams that I&#8217;ve been after?
Master, master
You promised only lies
Laughter, laughter
All I hear or see is laughter
Laughter, laughter
Laughing at my cries

Fix me

Hell is worth all that, natural habitat
Just a rhyme without a reason
Never-ending maze, drift on numbered days
Now your life is out of season
I will occupy
I will help you die
I will run through you
Now I rule you too

Come crawling faster
Obey your master
Your life burns faster
Obey your master
Master

Master of puppets I&#8217;m pulling your strings
Twisting your mind and smashing your dreams
Blinded by me, you can&#8217;t see a thing
Just call my name, &#8216;cause I&#8217;ll hear you scream
Master
Master
Just call my name, &#8216;cause I&#8217;ll hear you scream
Master
Master
 
Addiction is a family disease.
https://www.nar-anon.org

Yup, that's so very true as I've had people tell me they don't use alcohol because it runs in the family and they don't want to get hooked.
Same thing with narcs. There are those who avoid it due to genetic tendendies but sometimes they have a transient painful experience, they really need it and as
long as those around them are aware of it, they usually do fine. Sometimes the drive not to go down the same path as relatives is greater
than the genetic predisposition to do so. That can also be seen with family obesity. One member resolves not to get morbidly obese and
they tell me it's a Herculean effort to do so. Kurt
 
Addiction is a family disease.
https://www.nar-anon.org

It is a family disease and it is also based on expectations. A good part of our society believes they should be pain free. That is just not realistic as we age. I do agree that we should not have excessive pain. It is about quality of life.

Toradol and Tramadol are good medications for pain, but they do not work well in a significant number of patients who have prior treatment with narcotics. Demerol is a terrible medication for pain. It is produced a higher level of euphoria and toxic metabolites but patients request it by name so much that many hospitals have removed it from their formulary.

The other problem is that there a lot of folks out there with psychiatric or mental pain that manifests itself as perceived physical pain and narcotics is not the best treatment for this type of pain. Neurologic pain is not optimally treated with narcotics either. The problem is once you have narcotics for them, the better choices may not work optimally.
 
Got a problem with your gut chemistry? Talk about it at the water cooler!

Got a problem with your brain chemistry? You must not be trying.
 
I've got a lot of problems, pain, due to diabetic nerve damage (neuropathy). A few years ago, I was taking 240 or more Norco (hydrocodone) a month for the pain. I was really worried about addiction. I needed that much medication to reduce the pain enough to be able to function. I was having a LOT of trouble stabilizing my blood sugar. I was getting my main diabetic medication for free. That program ended. The doctor put me on a different medication. THIS one really works. With the orher medications, I had borderline pancreatitis (sometimes over the line). That made things even worse. For the past two years or so, I've been able to do fairly well controlling my blood sugar. I've lost a lot of weight. The other big change was with the pain medication. I needed less during the day, but still had a lot of trouble when I lay down to go to sleep. Hydrocodone was actually keeping me from falling asleep. For some reason, my system sees it as a mild stimulant (not what you need at bed time!). After discussion with my doctor, and trying a couple of different formulas, I now take an average of one 30mg morphine at bedtime. Sometimes, for several nights in a row, I don't take any. On rare nights, I need a second after an hour or so. I'm really lucky I've got a doctor that will listen to me and is willing to try different things. He also trusts me not to abuse the trust he puts in me when he prescribes pain medication. If I ever start asking for more than he thinks I should be reasonably taking, I have no doubt that he will stop prescribing them. He is at risk professionally, as I am at risk medically. I wish more were like him, but then we've built a relationship over the past 27 years.

CW - I find your comments about Demerol (meperidine) interesting. I take it on rare occasions for migraines; about twice a year. I've never has any euphoria from it. I've never (that I can remember) had euphoria from the pain meds I've taken. Maybe my brain is broken or wired up wrong. But then I don't have any other habits like smoking or drinking. (not never a drink, but very, very rarely - I just don't have the taste for alcohol).
 
Toradol and Tramadol are good medications for pain, but ...
I'd have to go look up how Toradol is different from other NSAIDs but my body Does Not like that stuff - feels like it got to my insides and 'tore it all' up.
 
I have been a doctor for 19 years. I typically prescibe it for less than a week. If you need a longer course than 14 days, you need to see someone else. It is just my technique of preventing dependence. I get them to a specialist to help them quit. If they decide they don't want to quit taking them, I help them find another provider.

As far as personal experience, I do not like narcotics. I suffered with ankel pain from a multiple ankel fratures and continue to walk on it for 13 months in a laced up boot to complete my combat tour. Teh injury requried a special form of a complete ankle reconstruction which is one of the most painful surgeries you can have. My recovery was over 12 months and included a post op infection and rehab for 18 months. I took narcotics for 3 days even though they gave me 30 days worth. I felt the dragon's attraction and quit taking them.

If you feel you can take them with becoming addicted, be careful. I have seen the most confident give into the dragons' breath (narcotics are herroin).

There are appropriate usages for them such as cancer pain adn acute pain after surgery, but the use should be for end of life or short period of high levels of pain.

My physician has the same approach. When he and I first met, he brought it up as a general introduction message. I think it's the only way to avoid or reduce the problem that CzTeacherMan described.
I've had narcotic pain medication after hearts surgery and also after a severe leg injury. Both times, I was able to understand the lure of those meds. Both times, I stopped taking them on my own.
I will say though that this was with a different physician. I could have gone to him and said I need 90 more pills and I bet he would have given them to me. Those doctors contribute to the problem.
Your approach is helpful while still looking after the needs of the patient.

I live near Vancouver, BC, Canada. People on the streets are abusing Fentanyl. They overdose knowing there is someone there to use a Naloxone kit to save them if they go too far.
Those folks are on the edge of life and death every day. Empathy is indeed important. It's hard to stop a train though. Some of these folks are going to die.
 
I just read in the paper today that one suburb of Dayton, OH is on track to have more overdose deaths this year than in the previous three years combined. They have had 20 overdose deaths this year in the first 6 months. The county Dayton is located in is on track for 800 overdose deaths this year.

Going back to the homeless thread I think this cements my position on never giving money to people begging on the streets. I have to believe a lot of that begged money is being used for substance abuse.
 
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