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

[D_W]

Yes, not downplaying that there are some resistant to one approach while others may work, and some who need more than one at a time or that none work for at all.

One on one therapy is standard here. Groups are something we only see on TV or in movies. If you have an issue and you want to go the talk therapy route, you can usually find someone in a matter of days.

 

[Jelly]

Yes, not downplaying that there are some resistant to one approach while others may work, and some who need more than one at a time or that none work for at all.

One on one therapy is standard here. Groups are something we only see on TV or in movies. If you have an issue and you want to go the talk therapy route, you can usually find someone in a matter of days.

That was more of a general commentary than aimed at yourself.

It's nuts that the UK can get acute care for physical ailments to a standard about as good as any other western country (I don't hold with glorifying the NHS, whilst it's well above average worldwide, it only really leads the world in value for money) but mental health coverage is at best inadequate and at worst dismal depending where you live.

I suspect it's because it was something of a tabboo until recently, which meant it was easier politically to cut or freeze budgets in an area no-one talked about; which highlights the one real failing of the NHS for me, that it's been allowed to become a political football where funding decisions can become wholly detached from the realities of service delivery.

 

[John Brown]

TN wrote:

"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."





I thought that was the Thatcher principle. Get rid of all industry and rely on being a "service" provider economy. Which probably works out OK when the global economy is booming, but not so well at other times.

 

[D_W]

There's been a lot of groundwork laid here to get rid of the idea that "mental illness is just ___"

(someone just being unreasonable)

(someone who just needs to go out and take a walk)

(someone who just needs to perk up)

(someone who is just being a burden on other people).

There are a lot of obvious things to bring up when someone says "where was all of this mental illness when I was a kid - we didn't have it"

(yeah, when someone medicated with alcohol and was just straight up nasty because of their life long fear of things we didn't ever come to find out....we just pointed our finger at them being irresponsible. Who needs to solve a problem when you can just blame someone else?).

 

[D_W]

TN wrote:

"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."





I thought that was the Thatcher principle. Get rid of all industry and rely on being a "service" provider economy. Which probably works out OK when the global economy is booming, but not so well at other times.

It works if you can own the manufacturing company and get someone in another country to make things for you and you skim off the top. Like an imperial economy. My point about the socialist track is if you don't mind economic production, soon you sink in weak currency because the rest of the world doesn't put much value on what you produce.

The reality of the united states is that we are highly socialized, but not automatically at every level and we cater to the bits that generate economic value as we're tied into it from end to end. All of the local, state, etc. governments with pension and health care funds need the investment earnings just like anyone else. That means as taxpayers we need it. The rest of the world is waiting to eat your lunch if they can, and no matter what anyone says about quality this or that or principle, when quality is perceived as equal, buyers go for lower cost. I doubt the GDP per capita in the US was greater than britain 100 years ago.

the 2020 estimate is 63k for the US and 39K for britain. What happened? There's no way we work 60% more.

 

[Jelly]

the 2020 estimate is 63k for the US and 39K for britain. What happened? There's no way we work 60% more.

Off the top of my head...

Low Productivity resulting from amongst other things:​

• Decades of underinvestment in infrastructure
• An even greater willingness to tolerate our biggest blue-chip companies being gutted by corporate raiders and sold off piecemeal to make a one-off fast buck (should that be quid?), than the US (which also did a fair bit of that for a time) ever had.
• Privatising large nationalised concerns and then rapidly selling them to their (publicly owned) foreign competitors who proceeded to do the majority of the high value, high skill work required to run the business in their home nation.

Compared to US and European models, our "Austerity" approach to dealing with the 2008 crash has proved ineffective, resulting in a recovery about 20-30% slower than the global average.​

Oh and we've done a couple of things which have undermined global confidence in the UK resulting in rapid devaluations of the pound; but have never put forward any coherent strategy (despite having a whole government department for "Industrial Strategy") to use that devaluation to improve our dire balance of trade position by revitalising the manufacturing sector to boost our exports...​

​

Which was pretty much the only thing we could have done to make up for that sudden decrease in ($US Terms) GDP which was not linked to a change in anything tangible, just the impact of negative market sentiments about decisions the UK made.​

 

[TRITON]

Last time i was laid up with a slipped disc, in truth lying on the floor for 4 days solid did it no good at all, got taken into hospital and was put on oramorph which was explained to me at the time I was only going to get it for 3 days due to it's addictiveness. In the UK, the 'First do no harm' applies to this level of drug, and they prefer you not to end up with more problems than you came in with.
That point aside, I guess it's dependent on how much pain you are in.
The elderly get opioids usually in the form of codeine based painkillers in long term format.

The US is very different, but I guess we all know that.

 

[Phil Pascoe]

... oramorph which was explained to me at the time I was only going to get it for 3 days due to it's addictiveness ...

I took it for several months. Three or four nights of discomfort when I dropped it.

 

[evildrome]

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.

That's how all economies work. Exchange of labour.

I might exchange 3 hours of my labour for 1 hour of the dentists labour & we use currency as the medium of exchange.

Goods are just (labour+commodities), so goods are also an exchange of labour.

This cycle does create wealth, "for ever and ever". This is how economies work.

 

[gregmcateer]

Interesting to see economy discussions. I do try to understand it all, but am a bit of a slow-mo, esp as maths is my weakest suit. So this is handy so far, as it doesn't feel too political, more economic theory. (Even though DW started off the thread as an discussion on addiction!).

Some time ago, I read a book called, I think, The Simpol Solution - about international state cooperation. I can't remember the detailed discussion, but it did seem to be the beginnings of finding a way forward for nations to work together.
(Grabbing hard hat ready for this to be shot down )

 

[D_W]

That kind of thing is great if you ignore that it involves humans who are motivated by incentives.

Most of our progress comes from people who are either selfish or self-fascinated. It doesn't come from idealistic ideas (unless labor is forced) where what people get is based on their efforts.

Below that there is a layer of folks who want to be guaranteed a certain amount of return for their efforts without being responsible for the efforts being viable or useful to others, and below that yet are folks who just want a guarantee that they can get more than they put in.

You can't change human nature, but you can take incentives away and slow overall progress. If you want to solve problems, rather than creating cooperation/collusion, you have to offer incentives (either for ego or money) to solve the problems to draw in people who are competitive risk takers.

Elon Musk is a perfect example of this. What comes out of his efforts and competitive drive? The first really viable electric car, and now pilers on following him - most of those large capital backed who would've done no such thing if he hadn't showed the market to be there. Space flight? Same thing - monstrously cheaper and more efficient than anyone else because he's incentivized to do what he's doing and take risks. Believe that he would do the same thing regardless? I doubt it - he just moved from a state that interferes in his business to one that doesn't. He'd just switch countries, and there would quickly be a non-cooperative country that would attract all of those ventures - it would be easy if there was non-competitive cooperation among all other states - a haven would appear. We can now send hardware and people to space cheaper even than any of the chinese firms can do it. The chinese firms have the advantage of cheap labor and state backing, but they have the stick behind them, not the carrot in front.

 

[evildrome]

" He'd just switch countries"

Why doesn't he go to South Sudan?

Exactly zero government interference. No government at all in fact.

Why don't all these fantastic self made men all move to South Sudan where they can be completely free of Gummint interference?

 

[D_W]

If I thought your question was serious, I'd address it. Give a list of things you'd want if your primary concern was absolute fastest, most efficient, etc. innovation and business development and execution.

 

[Trainee neophyte]

Elon Musk is a fine example of government picking winners. Nancy Pelosi Buys Tesla Calls, Stands To Benefit From New Biden EV Plan

One day we could go back to trying a free market capitalism system, but for the moment, corporatocracy is what we get.

Anyway - back on topic. Drugs. Another sweeping statement: it is my experience that people tend to take the party drugs when times are good, and self - medicate when times are are bad. Recessions boost opiate addictions. There's probably a study on it. (There are lots, and some of them even support my thesis). Assuming that I am correct, coronavirus and associated economic chaos should create many extra addicts over the next few years. If we move to a universal basic income, will this relieve the need for drugs, or will it create an endless underclass of self-medicating jobless poor? Interesting times ahead.

When I was a wippersnapper we only had Heroin to worry about. Fentanyl is even more exciting, and even cheaper, I understand. Not my thing, so I'm only going by Daily Mail and Guardian hyperbole.

 

[D_W]

Free market is long gone. Crony capitalism is in its place, but there are a few like Musk who are looking to innovate and achieve. Comparing money spent on tesla to solyndra and other things that are dead ideas from the start is a no brainer, and our space program (on the spaceX side) is obviously intensely interested in avoiding mistakes and embarrassment far more than they are in achievement or efficiency.

- Can you make a marketable car with a battery? (at the outset, the criticism was "no, the batteries in a tesla cost more than the car". History at this point).
- Can you make a car with a 200 mile range on battery? "no, not that is affordable". wrong again
- How much will it cost to replace the battery? who cares - it hits 90% of its capacity long after most other cars are dead
- Can you make space cargo and people hauling profitable and cheaper than it can be done anywhere else? Yes
- Can you land boosters and reuse them? Of course not, that's absurd - nothing can fly backwards and land............ Oops...

Will you get someone like that to establish a business somewhere that graduates from college feel entitled and every level of government wants to have a stake in making company decisions? No.

What if you virtue shame them and tell them to stay and pay twice as much in taxes as they will somewhere else? They might just move away and take their entire headquarters with them.

We can launch cargo and people to space now cheaper than any chinese or russian company can. Not just better, not just more reliably, cheaper. That's absurd.

 

[D_W]

Elon Musk is a fine example of government picking winners. Nancy Pelosi Buys Tesla Calls, Stands To Benefit From New Biden EV Plan

One day we could go back to trying a free market capitalism system, but for the moment, corporatocracy is what we get.

Anyway - back on topic. Drugs. Another sweeping statement: it is my experience that people tend to take the party drugs when times are good, and self - medicate when times are are bad. Recessions boost opiate addictions. There's probably a study on it. (There are lots, and some of them even support my thesis). Assuming that I am correct, coronavirus and associated economic chaos should create many extra addicts over the next few years. If we move to a universal basic income, will this relieve the need for drugs, or will it create an endless underclass of self-medicating jobless poor? Interesting times ahead.

When I was a wippersnapper we only had Heroin to worry about. Fentanyl is even more exciting, and even cheaper, I understand. Not my thing, so I'm only going by Daily Mail and Guardian hyperbole.

From the charts, fentanyl is the rising killer in the US. I don't know the split of folks who get to opioids recreationally vs. script, but there are definitely script users who get cut off and end up homeless from spending their money on the drugs.

Expect that addicts and deaths will drop here because the supply is monitored now. You can probably bring things in illegally, but the great majority of what was out there before was most likely obtained legally. It's no possible to do that now in huge amounts like it was.

But that's the US. What it means for the rest of the world, I don't know.

Our disability system has its share of younger folks who have drug problems and get full public benefits because they're impoverished due to lack of having ever worked in combination with psychological issues that come along with drug problems (chicken or egg thing here in some cases - the order those occur is likely not the same for the entire group). But, enabling someone with income and no responsibility certainly doesn't reduce users in some cohorts. Disability in the US is a legal process - sometimes the legal side matters more than the medical basis.

 

[finish_that]

Part of what drives the pain killer epidemic in the USA is the health care system, if you cannot afford the insurance payments , or do not have benefits from your employer you are stuck, so instead of treating your problem with a fix , you keep pushing it away with another type of fix and that is addictive and ruins your life one way or another.

 

[Trainee neophyte]

We can launch cargo and people to space now cheaper than any chinese or russian company can. Not just better, not just more reliably, cheaper. That's absurd.

But is it a "fair" price? All the subsidies and government contracts distort the entire operation, and the endless money printing just means someone, somewhere, will have an unpleasant awakening eventually. It is unlikely to be Elon Musk paying the true cost in the end. Much more likely that every American will pay, instead.

 

[Ollie78]

The American health care system is absolutely insane by any standard, the fact that doctors earn more the more they prescribe is fundamentally unsound, as is TV advertising of strong prescription medication to the public. Imagine if you had adverts saying " feeling a bit sore, does your back ache after work, then try heroin it's brilliant" .

This is off topic a bit but I find the amount of gambling ( online casino and betting shops) adverts on uk TV to be disturbing, they never existed until a few years, people are addicted to gambling and losing everything because of it.

Ollie

 

[D_W]

we did find one benefit earlier here -in the US system, unless you hamstring yourself by buying coverage with a huge deductible (such a thing is for folks who don't plan to use coverages), access to providers, mental or physical is pretty much unlimited. This may not be meaningful to some people, but someone seriously in the dumps will find it very useful.

That said, the drug business here is offputting. We develop them, we pay the most for them, the rest of the world gets them at cut rate pricing. Not a fan.

But as a nod to your comment about gambling, I've noticed the same - every single sporting event seems to have main adverts for gambling. Is nothing else valuable enough to advertise? Presumably, such a thing is heavily taxed. It used to be completely forbidden here except for stupid schemes like lotteries run by states, and of course, vegas and indian land. But now, the state is advertising gambling apps on TV. but, no matter. It's ethical now because the state licensed casinos are involved and they have a disclaimer with a number to call after your gambling addiction empties your bank account and you're distraught.

The sale to folks here in my state was that it would lower property taxes, possibly eliminate them. Of course this is a really stupid idea that assumes just the taxes from gambling will equal a thousand or couple of thousand per head. No clue where the tax money went - my property tax bill hasn't changed (it's possible that it's a couple of percent less than it was before, I wouldn't notice - but the promise was of paradise, not pair of percent.