Is the opioid death toll a thing in all of western society?

[Phil Pascoe]

Americans need perpetual growth to fund their retirement accounts, whereas many European states have social funds that provide for old age.

How do you imagine the "social funds" work without perpetual growth?

 

[Trainee neophyte]

Most of Europe is heavily socialist compared to you. I don't see any failed states here.

Umm...Greece probably takes the podium position, but remember the PIIGS? Just because someone said they were fixed, it doesn't mean that anything actually was fixed. The borrowing is now stupendous, and can not be repaid. Not that it ever is repaid, because the fiat money system demands ever increasing debt, because debt is money. If you repay debt, you destroy money, which is bad.

Inflation is our future, unless it all goes wrong. Currently no western country can finance its debt unless interest rates stay at zero. Once the currencies have been debased sufficiently, the debt becomes trivial and interest rates can increase again. Until then, expect zombie economic conditions, and galloping inflation, even if the official metrics deny all knowledge.

 

[Jelly]

Agree on the antidepressants. Their efficacy vs. passage of time is something like +15% (resolution of depression, etc). Most other approaches tried independently (exercise/talk) are more effective, but the latter are secondary approaches here and the former initial primary - presumably due to cost. It's cheaper to put someone on a generic antidepressant than it is for the care system to send someone to talk therapy.

Not glossing over folks who have "bad wiring" who can't get right no matter what, but rather the folks who can by addressing their issues head on.

The NICE guidance on treatment of depressive illnesses is entirely in agreement with that sentiment:

"1.4.4.1 - Do not use antidepressants routinely to treat persistent subthreshold depressive symptoms or mild depression because the risk–benefit ratio is poor"​

The evidence seems to suggest that in most cases where they're warranted, antidepressants work best as an intervention to get people into the right frame of mind to make best use of "Talking Therapies" which are then much more effective than they would be alone (whilst anti-depressants alone are not nearly as effective)

I think the issue the UK suffers from in this regard, is that we historically haven't taken mental health seriously enough, so there simply aren't enough trained therapists, psychologists and/or psychiatrists available within both the public and private systems (because the NHS will buy capacity from private where public is unavailable); so it falls on primary care physicians to bridge a waiting lists of 12-18 month or more with patients who are slowly having their depressive symptoms get worse until the GP finally puts them on anti-depressants because it will at least stabilise things whilst they're waiting.

The disparity between the quality of and access to mental health services (regardless of whether you're talking about "free at the point of need" or private) compared to physical health remains pretty dire.

 

[doctor Bob]

TBF , I've seen more lads ruined by alcohol. Sad.

Indeed, secret addiction of society.

 

[billw]

How do you imagine the "social funds" work without perpetual growth?

Social funds are funded by real money, private ones by share prices and the timely buying and selling thereof. Public pensions come from tax revenues and/or borrowing, not from whatever the market feels like valuing a company at on a particular day. The government isn't reliant on market valuations to pay pensions.

 

[billw]

The disparity between the quality of and access to mental health services (regardless of whether you're talking about "free at the point of need" or private) compared to physical health remains pretty dire.

The chance of being seen by someone is slim at best, and even when it's available it's a long wait to go through a limited program (often 6 to 12 weeks) which is more of a tick box exercise than a genuine attempt to deal with the individual issue.

"Anxiety? Sure, CBT will cure you....." Nah, it really won't. It's just a way of palming people off because of chronic underfunding.

 

[Phil Pascoe]

. Public pensions come from tax revenues and/or borrowing...

and as the need for more money grows year on year that depends upon others making more money ............ growth.

 

[billw]

and as the need for more money grows year on year that depends upon others making more money ............ growth.

Tangible growth that requires real money to be paid over in tax, not the folly of the stock market.

 

[D_W]

Most of Europe is heavily socialist compared to you. I don't see any failed states here. Your opening statement says a lot - Americans need perpetual growth to fund their retirement accounts, whereas many European states have social funds that provide for old age. I wonder what will happen in the US when big corporations run out of global expansion possibilities? Or the Chinese beat them to it? Economic liberalisation occurred because it was in the US national interest to push their domestic corporations outside their own market to facilitate the need for perpetual growth. What happens when you run out of countries to suck into the system? Pray for the return of Atlantis? Colonise Mars?

We need real economic growth, that's all. my point with asset appreciation is that it only occurs at rates above underlying economic growth if efficiency is found. Most of the things that we enjoy (in terms of disposable income, etc) are not the result of allocating resources, they're the result of private enterprise.

As far as socialism goes, we are highly socialist in the United States, too. We had this discussion recently. Our entitlements paid each year are greater than most economies. Folks who are indigent and children of irresponsible parents become wards of the states, and even the irresponsible parents generally do if they are willing to seek assistance (the case now is that assistance will seek them).

A society that's more socialist in nature without subject states to draw from typically results in lower productivity, but an overall uniformity that a state like the US doesn't have. You have to choose what you want. When I say we're running the experiment now, I mean that we don't have very many states that are as socialist as they are now with more than a few decades of life. That's not very long.

 

[Trainee neophyte]

Sort of on topic: 'They broke my mental shackles': could magic mushrooms be the answer to depression?

Magic mushrooms are illegal, but may be a huge help with depression.

 

[D_W]

I wonder what will happen in the US when big corporations run out of global expansion possibilities? O

This message came about 15 years ago. "the economy is out of gas. there's no way to keep things up. The future looks bleak.".

And we have a completely different cash rich high demand sector that didn't exist in any similar format at the time - amazon, facebook, netflix, gogle, apple, etc. As much as people said for a long time that there's no real staple to their services and no real long term potential, I doubt there's much chance that they'll go away now. Make fun of them if you want for doing things like running web ads ,but they make more money with web ads than someone did making plastic containers.

To assume that "we're just out of potential down the road" assumes that we have a basket of things now and it won't change. This isn't very historically accurate, or we'd be riding horses and playing in banjo bands using tar buckets to lube the wheels on our wagons.

Anyone here doing bobbin lace?

 

[billw]

Sort of on topic: 'They broke my mental shackles': could magic mushrooms be the answer to depression?

Magic mushrooms are illegal, but may be a huge help with depression.

I'm pretty sure being on a permanent trip isn't going to help with everyday functioning.

“It removes any barriers and allows you to process what you need to in an almost seductive way. You are inevitably and irresistibly drawn into it.”

Sooooo.....it's addictive and haluciogenic. Awesome mix. Citalopram is positively boring in comparison.

 

[D_W]

Tangible growth that requires real money to be paid over in tax, not the folly of the stock market.

This is a dopey comment - where do you think stock appreciation goes? It's claimed as real income, quite often the high flyers are short term gains paid at a high tax rate, and the same market appreciation funds pension benefits and retirement which....

....is received as regular income, spent in the open economy to make more income, and each level generates tax revenue.

 

[doctor Bob]

Sort of on topic: 'They broke my mental shackles': could magic mushrooms be the answer to depression?

Magic mushrooms are illegal, but may be a huge help with depression.

I remember as a young lad sharing a house with mates, partying the night before and getting up for work with a mouth like the bottom of a parrot cage. As I left there was a cold cup of black tea on the side and I just necked it down, 20 minutes later I felt like I was having a physcotic episode, very very scary at the time but just couldn't stop laughing. Good stuff those MM's if you know whats coming bloody terrifying if you dont.

 

[Trainee neophyte]

Someone once suggested to me that our current service economy works on the basis that if I cut your hair, and you mow my lawn, we will all miraculously be wealthier for ever and ever.

Hard to see how that works in the long term. Perhaps magic mushrooms might help.

 

[Nigel Burden]

I remember as a young lad sharing a house with mates, partying the night before and getting up for work with a mouth like the bottom of a parrot cage. As I left there was a cold cup of black tea on the side and I just necked it down, 20 minutes later I felt like I was having a physcotic episode, very very scary at the time but just couldn't stop laughing. Good stuff those MM's if you know whats coming bloody terrifying if you dont.

I remember reading about the effects of magic mushrooms a few years ago. Apparently it is possible to have flash backs up to three months after the initial ingestion. The danger being that the effects will then echo you current mood, not the high that you were intending when you originally took them.

Nigel.

 

[D_W]

"Anxiety? Sure, CBT will cure you....." Nah, it really won't. It's just a way of palming people off because of chronic underfunding.

CBT is more effective than medication in anything other than the immediate term....It's probably something every single person could stand to work through on a regular basis. It's (CBT based therapy) much more expensive here, too, than generic scripts.

 

[Phil Pascoe]

I wonder how people addicted to opiates/opioids cope with the awful constipation that goes with it. For many months I was on pregabalin, nortriptyline, tramadol, gabapentin, codeine, dihydrocodeine and morphine, bith liquid and slow release. Often any perm of four or five at a time. I was glad to get off them, I had the cold sweats and shakes for a few days but came away unscathed - possibly because I never felt anything from the morphine, even when taking too much. I never felt anything when they gave me fentanyl either, which is just as well, maybe. My pill count at one time for a couple of weeks was forty three a day.

 

[RobinBHM]

A burglar broke in and stole my anti depressants.

All I can say is: "I hope it makes him happy"

 

[Jelly]

CBT is more effective than medication in anything other than the immediate term....It's probably something every single person could stand to work through on a regular basis. It's (CBT based therapy) much more expensive here, too, than generic scripts.

One of the big issues with effectively treating depression is that some people don't respond at all to certain types of talking therapy, and some are wholly unresponsive to all talking therapies.

CBT is widely available at least, but it's a postcode lottery in the UK as to whether you'll get regular 1-1 sessions focused on your needs, or wait a year to get a few generic group sessions as part of a strictly time limited process which may help if they suit you.

Access to alternative types of talking therapies is even more patchy, and it's not even a case of going private, there's whole areas where those therapies simply aren't available full stop.



Irrespective of local healthcare arrangements, I feel particularly for people the world over with severe refractory depression which is unresponsive to talking therapy and SSRI/SSNI anti-depressants as they're left with the choice between:

• Old-school (very powerful) anti-depressants with weird impacts on their ability to maintain appropriate emotional responses, awful side effects and potential for lethally dangerous drug/food interaction.
• Electro-convulsive therapy every couple of months, which is substantially less unpleasant now than it was when it was invented, but still has a side effect of upto a few days of short-term amnesia and confusion.
• Feel so awful they can barely (or can't) function.