Tornado Alley (PROG)

[fuagf]

The opioid issue has been seen as both a political issue and an American issue going on 30 years. It's a very complex public health issue.

Related: restripe, Biden is not to blame for fentanyl deaths. That post of yours is crass political partisanship.
[...]""Fuck you and the Ukraine war fentanyl deaths per year in the US you and Biden are morons" "
See also:
I think 1M American Covid dead due to politicization of mitigation and vaxxes......mostly Trump supporters in that number.....is a bigger deal.
P - Anyway, just as with the unvaxxed the overdose deaths are ravaging mostly red states and the red parts of a few blue states

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"Thanks anyway, some of your links include search.....Looks like its turning
into a political issue since its border related....Instead of an American one...."

For some stupid reason i thought because i created the search links you could use them. Hope it's the biggest error of my 2023.
Back to drugs, it has been seen both as a political and an American issue for years, what in US politics isn't these days.

Yes, it is big business for cartels. Thanks largely to American guns and thanks most primarily to American opioid usage.

"Big business for the cartels and they handle like one now....Counterfeiting
prescription drugs and so on..
P - Turning into a major cause of death now too.....One I would think dems of old
would make fentanyl an issue of theirs....Too border related I suppose
P - Cartels are making a killing down there and in the process"

The extent of your stickiness to your partisan conservationism is partially reflected in your "dems of old"
comment. Dems have made fentanyl an issue. And much comes from China through Canada:

Trump Is Freaking Out About the Wrong Border: Killer Fentanyl Is Coming From Canada
""100% of heroin/fentanyl epidemic is because we don't have a WALL."
— Ann Coulter on Tuesday, January 30th, 2018 in a tweet"
While Trump raged about building a wall on the southern border, a lab in Calgary was pumping
out 18,000 counterfeit OxyContin per hour. Inside the new threat north of the border.
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Fentanyl Flow to the United States January 2020
[...]Executive Summary
The flow of fentanyl into the United States in 2019 is more diverse compared to the start of the fentanyl crisis in 2014, with new source countries and new transit countries emerging as significant trafficking nodes. This is exacerbating the already multi-faceted fentanyl crisis by introducing additional source countries into the global supply chain of fentanyl, fentanyl-related substances, and fentanyl precursors. Further, this complicates law enforcement operations and policy efforts to stem the flow of fentanyl into the United States. While Mexico and China are the primary source countries for fentanyl and fentanyl-related substances trafficked directly into the United States, India is emerging as a source for finished fentanyl
powder and fentanyl precursor chemicals.
[...]Currently, China remains the primary source of fentanyl and fentanyl-related substances trafficked through international mail and express consignment operations environment, as well as the main source for all fentanyl-related substances trafficked into the United States. Seizures of fentanyl sourced from China average less than one kilogram in weight, and often test above 90 percent concentration of pure fentanyl.
https://www.dea.gov/sites/default/files/2020-03/DEA_GOV_DIR-008-20%20Fentanyl%20Flow%20in%20the%20United%20States_0.pdf

The Origin and Causes of the Opioid Epidemic
Posted: August 14, 2018
[...]
Civil War Usage

The use of opioids to treat pain first became prevalent in the United States in the early 1860s as a way to treat wounded soldiers. These soldiers were treated with morphine, and many developed dependencies and addictions to the drug in the years following the war.

The Advent of Heroin

In 1898, the Bayer Company first introduced heroin .. https://www.cnn.com/2016/05/12/health/opioid-addiction-history/index.html .. onto the scene, with the claim that it was less habit-forming than morphine.

Restrictions on Narcotics Passed

Throughout the 1910s-1920s, the U.S. placed restrictions on opioids and narcotics, requiring that formal prescriptions be written as well as outlawing heroin.

Controlled Substances Law

Flash-forward to the 1970s, the Controlled Substances Act .. https://www.dea.gov/druginfo/csa.shtml .. is passed, which divides groups into different groupings based on likelihood for abuse and imposes regulations depending on the class.

OxyContin Appears on the Scene

In 1995, Purdue Pharma introduced OxyContin, a version of oxycodone, which was introduced as a gentler and less-addictive opioid pill. Over the next two decades, doctors would increasingly prescribe this and other opioids to treat pain, thus increasing the number of people who develop an addiction.

A State of Crisis

Despite measures and law suits taken against Purdue Pharma, opioids have continued to be heavily prescribed, resulting in more and more addicts and deaths by overdose.

As of October 2017, the U.S. was officially declared to be in a public health crisis and measures are being taken to fight against the opioid crisis.

Recent Causes of the Opioid Crisis



Over-Prescribing

The roots of the opioid epidemic can be traced back to the over-prescribing of these drugs to treat pain by doctors rather than seeking alternative treatments. These types of pills are generally more covered by insurance policies rather than alternative treatments and therapies, making the drugs essentially an easy alternative.

Targeted Marketing

Drug companies have aggressively marketed their opioid products, such as Purdue Pharma, a non-habit inducing and moderate, despite there being little to no research to back up these claims.

But their marketing has worked, especially that targeted toward doctors—recent studies from Jama Internal Medicine .. https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2681059 .. show that the more free meals doctors receive from a drug company, the more likely doctors are to prescribe their drugs.

The Need for Reeducation

Professional medical experts such as Dr. Marc Siegel are now calling for medical students to be taught to prescribe opioids more carefully ..
http://www.foxnews.com/opinion/2018/07/07/dr-marc-siegel-opioid-crisis-has-solution-here-it-is.html.

This education process includes training the up-coming doctors how to properly identify pain and the best treatment for it, and then teaching how to apply for waivers so that they are able to prescribe alternative treatments and therapies to opioids.
https://www.georgetownbehavioral.com/blog/origin-and-causes-of-opioid-epidemic

As you know your conservatives, thanks largely to Rufo have made CRT a central social issue. Instead of accepting the worth of a better educated American public (thanks to the curiosity and innate goodness of America's young that is occurring in spite of regressive American conservative thought) they have turned CRT into a cold partisan political issue. See below (i'lll put it in red) another example of how race is institutionally embedded in America.

For fucking conix's benefit, as seen in many of of my posts, that unsatisfactory situation is
little different in Australia. So to the shame of American conservatives (including conix) again:

The GOP’s ‘Critical Race Theory’ Obsession
[...]
If a single person bears the most responsibility for the surge in conservative interest in critical race theory, it is probably Christopher Rufo. Last summer, Rufo, a 36-year-old senior fellow at the Manhattan Institute, a libertarian think tank, received a tip from a municipal employee in Seattle. (Rufo had lived in the city and, in 2018, ran unsuccessfully for city council.) According to the whistleblower, the city was conducting “internalized racial superiority” training sessions for its employees. Rufo submitted a Freedom of Information Act request and wrote about his findings for the institute’s public-policy magazine.
P - “In conceptual terms,” Rufo wrote, “the city frames the discussion around the idea that black Americans are reducible to the essential quality of ‘blackness’ and white Americans are reducible to the essential quality of ‘whiteness’—that is, the new metaphysics of good and evil.” The training was rampant, he wrote, infecting every part of the city’s municipal system. “It is part of a nationwide movement to make this kind of identity politics the foundation of our public discourse. It may be coming soon to a city or town near you.” His article—which did not include the phrase critical race theory—inspired a rush of whistleblowers from school districts and federal agencies, who reached out to him complaining about diversity training they had been invited to attend or had heard about.
P - A month later, Rufo employed the term for the first time in an article.
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One on the politics

April 01 2020 - Introduction: The Politics of the Opioid Epidemic

Susan L. Moffitt
J Health Polit Policy Law (2020) 45 (2): 171–175.
https://doi.org/10.1215/03616878-8004838

Opioids' impacts in the United States over the past two decades have been vast, profound, and complex. High death rates, overdose rates, and addiction rates manifested across varied geographies, ages, and racial and ethnic groups (CDC n.d.; Scholl et al. 2019). Opioids impaired economic productivity, strained health care systems, created new demands on the criminal justice system, and burdened family and community networks (NIDA n.d.-a). Varied forms of opioids—prescription drugs, heroin, fentanyl—contributed to the epidemic, emerged from different distribution sources, and presented different implications for various parts of public health systems.

Medical scholarship has made considerable strides in learning about the mechanisms that underlie opioid addiction, the correlates for its incidence, and promising forms of medical interventions (Williams et al. 2013; Walley et al. 2013; Schwartz et al. 2013). Public health scholarship has revealed aspects of medical policy and practice that contributed to the opioid epidemic, including physicians' prescribing practices and weak regulatory oversight from the Food and Drug Administration (Hadlad et al. 2017, 2019; Zettler, Riley, and Kesselheim 2018). Yet, we know much less about the roles that politics and governments at all levels of the system have played in abetting the epidemic. What has US policy and practice done in response to the current predicament, and what are key lessons for policy and practice moving forward? The director of the National Institutes for Health and the director of the National Institute on Drug Abuse have called for “all scientific hands on deck” to effectively address opioid addiction and its impact (Volkow and Collins 2017a, 2017b). This special issue of the Journal of Health Politics, Policy and Law represents a political science “all hands on deck” approach to understand the complex governmental and political terrain in which the opioid epidemic has unfolded. Underlying medical problems reside in political representation problems, social and economic inequality problems, and bureaucratic adaptation problems. By bringing together scholars from different theoretical perspectives and by examining different levels of government engagement with opioids, this issue considers how addressing questions about opioids also provides new insights on enduring features of US politics and policy, including the power of race, the development of the conservative welfare state, and the challenge of crafting interventions that work on the frontlines.

The politics of race have figured prominently in national responses to opioids. Since death rates associated with opioid use have been higher among whites than other groups (CDC 2018; NIDA n.d.-b), have legislators been more likely to pursue less punitive, more public health–oriented policies in response to opioids in contrast to more punitive criminal justice policies pursued for other drug epidemics? To start this special issue, Jin Woo Kim, Evan Morgan, and Brendan Nyhan compare the opioid era with the crack cocaine era to test whether the policy response to opioids has been less punitive than the response to crack, and whether differences in policy responses are associated with race. Using original data on district-level drug-related deaths and (co)sponsorship of legislation in the House of Representatives on illegal drugs, they find policy makers were more likely to introduce punitive drug-related bills during the crack era and were more likely to introduce treatment-oriented bills in the opioid era. Their results also suggest the relationship between district-level drug deaths and subsequent sponsorship of treatment-oriented legislation is greater for opioid deaths than for cocaine-related deaths and for white victims than for black victims. Their results demonstrate the persistence of racial inequalities and double standards in US drug policy.

The next question this issue addresses is, Does this trend that emerges in Congress of less punitive, more public health approaches for opioids relative to other epidemics also extend to media coverage? Carmel Shachar, Tess Wise, Gali Katznelson, and Andrea Louise Campbell provide additional evidence on racial inequalities through differences in the ways that media have portrayed the opioid and crack epidemics. Drawing on newspapers from across the country and over time, they systematically evaluate how each epidemic was framed in public discourse. They find that articles on the opioid epidemic are more likely to use medical terminology while articles on the crack cocaine epidemic used criminal justice terms more frequently. The differences in how the media have framed the two epidemics reveal additional ways in which race may play a role in public policy responses and outreach.

Racial politics also emerge in public opinion on policy alternatives. By assessing individuals who perceive themselves to be health policy losers, Sarah E. Gollust and Joanne M. Miller depart from and extend conventional scholarship that focuses on perceptions of being a political loser. Gollust and Miller find that whites who perceive themselves to be on the losing side of public health had less empathetic responses to the opioid crisis. Perceiving oneself to be a political loser, however, was unrelated to attitudes about addressing opioids. Their findings suggest how perceptions that one's racial group has lost ground in the public health context could have down-stream political consequences.

How has partisanship played a role in responses to the opioid epidemic, and what do these responses reveal about the development of the conservative welfare state in America? Colleen M. Grogan, Clifford S. Bersamira, Phillip M. Singer, Bikki Tran Smith, Harold A. Pollack, Christina M. Andrews, and Amanda J. Abraham take up these questions and offer new insights on the conservative welfare state. Their analysis of the intersection of state Medicaid policies and opioid assistance reveals that actions in Republican-led state policy do not mirror Republican oppositional rhetoric and proposals at the federal level. Challenging conventional theories of welfare state retrenchment, their findings suggest conservatives rely on program fragmentation to both expand and retrench benefits, not only to retrench programs.

Given the scope and complexity of the opioid epidemic, where do we go from here? Information campaigns constitute a commonly used policy approach to public health problems. Yet, Paul F. Testa, Susan L. Moffitt, and Marie Schenk demonstrate how experimental approaches that assess the impact of information campaigns may misestimate their effects by failing to account for respondents' willingness to receive new information, policy, and research. Using a doubly randomized survey experiment, Testa and his colleagues examine how willingness to seek new information shapes the way members of the public update their preferences about policies related to the opioid epidemic. Among those respondents likely to receive information, treatment has a large positive effect on increasing support for policies to address the opioid epidemic. Among those who would avoid this information, preferences appear to be unmoved by treatment. These effects would be missed by standard experimental designs and highlight the importance of access to and receptiveness toward new information.

Yet, information campaigns constitute only one component of addressing complex policy problems, like the opioid epidemic. Patricia Strach, Katie Zuber, and Elizabeth Pérez-Chiqués develop the concept of an illusion of services, demonstrating the disconnect between what the state perceives as the problem (information) and what frontline service providers and constituents perceive as the problem (structural barriers). Policies may fail not because they are poorly designed or poorly implemented, but because the policies fail to address the actual underlying problem. In the case of opioids, misplaced solutions can hide evidence of the underlying problem and exacerbate the issue that policy makers strive to fix.

The evolving terrain of opioid drug abuse renders this epidemic complex for policy and practice. While much attention has focused on opioid use among young white men in rural areas, recent estimates suggest growth in the opioid death rate among black individuals, individuals over the age of 65, and individuals who live in mid-sized metropolitan areas (Scholl et al. 2019). The collision of an evolving terrain with enduring political, regulatory, and health care structures reveals ways in which the US political process operates to yield inequities, inefficiencies, and ineffectiveness. Lessons from opioids—about racial politics, about the complexities of service delivery, about manifestations of partisan politics—extend well beyond this epidemic and reveal fundamental structural challenges embedded in US politics and policy.

Initial drafts of the articles that appear in this special issue were presented at the Politics of the Opioid Epidemic conference convened at Brown University in February 2019. The conference was supported by the Watson Institute for International and Public Affairs, the Taubman Center for American Politics and Policy, and the Journal of Health Politics, Policy and Law. We are grateful to Jennifer Costanza for her work organizing and implementing the conference proceedings.

References - https://read.dukeupress.edu/jhppl/article/45/2/171/143967/Introduction-The-Politics-of-the-Opioid-Epidemic