West Virginia fact of the day

The state of West Virginia has paid for so many burials for indigent people who have died from drug overdoses that the funding has run out five months before the end of the current fiscal year on June 30.

Kitchen said there have been so many drug overdose deaths in West Virginia, it often takes two to three weeks for the state medical examiner to complete the required autopsies. He said families then have the added stress of not being able to carry out a funeral for weeks after a death occurs.

Here is the article, via Anecdotal.  Here is a good Christopher Caldwell piece on opioids.

Comments

When does the continued classification of marijuana -- especially in light of studies showing the decrease of opioid abuse in states where medical marijuana is available -- as a Schedule I drug go from being recognized as just a form of stodgy idiocy to that of straight-up, deliberate evil?

No one here is stupid enough to not understand the influence that Big Pharma and Big Alcohol have upon federal marijuana policy, are they?

BTW, I don't believe that getting high every day is a good idea, but it's obvious that it's better than shooting heroin or taking oxys.

Here in the Netherlands marijuana use and sale is legal and there are (just from headlines, I don't follow this closely) only minor problems with addiction and abuse. Like: some teenagers getting bad school results because of hemp use.

The incredible stupidity here is that use and sales are legal - but large scale growing is still illegal. This leads to a huge hemp growing criminal underground. Municipalities in the agrarian provinces clamor for legalization, because they could earn good money growing hemp. But I see no legal change in the near future.

I'm not inclined to believe in a pharma-alcohol conspiracy, I think it's just the common stupidity of politicians.

I am not arguing for a big-pharma or pharma/alcohol conspiracy, but at this point, I must say that the structure of the big pharma markets is quite markedly in favor of very skewed end results. And big pharma, as a group, fight very hard to maintain those structural components to lead to outrageous profits. It is all based on monopoly profits. "Big Pharma" companies spin off non-monopoly products.

"Big Pharma" goes for patent based monopoly products exclusively. Any moral imperative "to aid humankind" is trumped by the primary consideration: monopoly level high profits. Any salesman will tell you that a pharm-sales job is a cherry win - big bucks.

As for generic level products, as is obvious from recent news in the US (past couple of years), some of those generic level products achieve monopoly status through regulation. And then proceed to abuse it, or use it, as you may argue. Problem is, barriers to entry are very very high, due to said regulations.

Either way, consumer loses. Pharma profits, and some in the medical field profit, as well, by riding the monopoly drug coattails.

Problem opiate products being most abused are the product of pharma, not nature (opium), nor the illegal drug traffic industry (first generation distillation, e.g. heroin). Therefore, while I doubt that there is a conspiracy, I would NOT doubt that there is a systemic action, or lack of action, that would oppose legalization of marijuana.

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Any actual evidence that either big pharma or big alcohol have put a lot of money into fighting marijuana legalization?

Opioids are generally generic drugs which means there's not much profit margin for pharma. Newer opioids with 'abuse resistant' features do have patent protection and higher margins but even so how much of pharma's overall revenue comes from opioids?

As one who worked in 'Big Pharma,' I don't believe that there is any conspiracy here. We were asked by FDA back in 2008 to help convene a work group on abuse potential and control of opioids. We ended up not getting involved in this as almost all the opioids other than the newer formulations are generic drugs. These drugs have been around a long time as has addiction. It's not only the 'pharma' opioids but also black tar heroin derived from poppies that are grown outside the traditional production area of Afghanistan. Some people are always going to abuse drugs and alcohol and efforts on prohibition and criminal penalties really have never worked. Of course the Republican healthcare bill that is doing away with the drug treatment money that was in the ACA is not a good thing.

Agreed, also pot laws have relaxed greatly over the last decade. While it isn't legal it's def. more accepted than previously. What evidence do we have this has caused opioid use to decline? If not then what incentive is there for 'big pharma' to be fighting pot legalization?

Lots of evidence that pharma doesn't like encroachment on their customers.
https://www.theguardian.com/sustainable-business/2016/oct/22/recreational-marijuana-legalization-big-business

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@Philip Crawford - The Guardian story is a mixed bag. The companies that contributed were a very small subset of the whole pharma industry. Also, I don't know why they mentioned PhRMA at all. I worked at PhRMA until my retirement several years ago and while they spend a lot of money on lobbying they were never involved in this issue at all.

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It's still Schedule I, which means it cannot even be studied (barring a tiny number of exceptions) to find any therapeutic benefits for its more than 100 active ingredients.

As far as the evidence you asked for, how about the NY Times: http://www.nytimes.com/roomfordebate/2016/04/26/is-marijuana-a-gateway-drug/overdoses-fell-with-medical-marijuana-legalization

Here's a quote from the article:

"... the annual rate of opioid overdose deaths decreased substantially — by 25 percent on average — following the passage of medical marijuana laws, compared to states that still had bans."

This is because most people can get all the pain relief they need from marijuana, without the physical addiction and risk of overdose.

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read DREAMLAND by Quinones, then get back to me on the role of 'big pharma'

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Evidence? Why is it still Schedule I? Find out their lobbying numbers. Follow the money.

And, as for "abuse resistant' opioids, why not just Marijuana which is practically impossible to overdose on while having zero physical addiction?

There's your proof: it cannot be profited from. Does not Big Pharma's fiduciary responsibility REQUIRE them to fight against legalization? Of course it does, and they do, via PACs.

You are either full of the horse kind or the bull kind.

If you do not understand the level at which our country's lawmakers are bought and sold, then you have no business commenting here.

Is pot not addictive? Anecdotally the people I know who smoked pot did so regularly and predictably. Perhaps not technically addictive but then it may have been their lifestyle that was addictive.

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http://www.denverpost.com/2016/07/15/study-why-pharma-companies-are-fighting-medical-pot/

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The article implied that the reason 52,000 people overdosed on heroin is because doctors are too quick to prescribe Oxycontin. This just isn't true. If you take Oxycontin or Oxycodone as prescribed you don't become addicted. In fact you must not follow the prescription to become addicted. It is common that addicts take numerous pills and grind them up to get a high. Oxycontin dones't give you a high when taken as prescribed. It doesn't do much at all except very slowly reduce the pain over about a half an hour or so. No high, no addiction, no feeling of euphoria. Nothing.

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In a small town in KY last year, after hearing of a rash of overdoses or reaction from bad batch swamping the town's ER (about 15 in one night) I learned that the distribution and marketing of heroine is much "consumerized" vs. what I had expected. The drug apparently now comes from the dealer already loaded in individualized syringes. I guess in one way this reduces the concerns about dirty needles, but at the same time, it makes it much easier - more accessible.

Normally, I don't comment much on spelling, but 'heroine' stands out, because the English subtitled version of 'Diva' I watched yesterday had the same mistake, easily dating from 3 decades ago.

Autocorrect.

Well, that was the point about the subtitles on a 35 year old French movie - that misspelling was not due to autocorrecting.

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This seems inefficient. Can't they just cremate the bodies in a coal plant? It would reduce electricity bills.

yes, inefficiency is the hallmark of government -- looks like the professional funeral homes in West Virginia make a nice profit in this area ( at least those who are politically connected)

The stated $1250 per "funeral" is at least double what it should be.

Paupers/Potters Fields have been commonplace forever; this is first time I ever heard of a modern local government finding it unaffordable.
Fatal drug overdoses are a self-correcting problem, saving the government much money longer term

"Paupers/Potters Fields have been commonplace forever; this is first time I ever heard of a modern local government finding it unaffordable."

As Mr. Will Rogers would have put it, America is the first country to go to the pauper fields in an automobile.

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Fatal drug overdoses are a self-correcting problem, saving the government much money longer term

Choice crowd here today.

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The city of Detroit (or maybe it was Wayne County) ran out of money for indigent burials severs years ago at the height of the Great Recession.

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Well, that certainly makes West Virginia sound like heaven compared to living (or more accurately, dying) in Bangladesh.

You are my hero.

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Such is live - and death - in today's America. Lots of desperate people see death and, even after succeding, they are tortured by their tormentors.

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I'm reminded of this lawyer joke: the town was so small it had only one lawyer, and he didn't have enough work to stay busy. Then another lawyer moved to town, and they couldn't handle all the work. And I'm reminded of this Yogiism from Yogi's teammate: if I had known I would live this long, I would've taken better care of myself. Too many doctors and hospitals and pharmaceutical companies promoting snake oil and too many people willing to consume the snake oil.

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Interesting one of the previous victims of earlier opioid epidemics were 'upper class housewives'. In other words, a class of people in an earlier age who existed with stuff but little actual work they could do (lower class wives, of course had housework but if you could afford servants you were really trapped back then with not much to fill your day with unless you invented stuff).

Here we have an opioid epidemic hitting areas with chronic unemployment driven perhaps by the 'average is over' economy where we simply do not need a majority of people to be working to supply all the stuff we want to consume. Therefore we have more people who have enough to exist but literally not much to do.

+1 Idle hands....

+ 1.

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https://www.nytimes.com/2017/03/12/us/opioid-epidemic-rural-farm.html?emc=eta1

These guys seem like they had plenty to do. Someone should get Charles Murray on the line, figure out if there is a genetic component to why these people like dope so much.

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While I certainly did not expect one iota of sympathy for these victims from the enlightened folks at MR -- after all, these people died out in the woods -- jokes about burning their bodies for electricity is certainly a new level of hate.

I do thank you for not trying to hide it. I'm not certain exactly how many Trump voters you've reassured that they did the right thing, but it's a few.

What sympathy do you have for these victims? It sounds like you are more obsessed with finding things to be offended at.

At least enough to not joke about burning their bodies.

True, no jokes in poor taste or worse have ever been documented coming from the ranks of Trump supporters.

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This seems appropriate:

http://reason.com/blog/2017/03/01/moral-outrage-is-self-serving

You know, I think that fails to make the full arc, to utilitarian action.

It asks us to stop, and believe "the feels" are all there ever were, all there ever will be.

https://en.m.wikipedia.org/wiki/Living_High_and_Letting_Die

Ah, the lesser Unger...

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It is convenient to argue that moral arguments are simply invalid and only serve to advance the interests of the person making them. It allows one to discharge any responsibility to fulfill his own moral obligations as well as those he feels are unfairly placed on him by society.

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The convenient argument is an improvement over the ad homs we usually get from you people, so be happy.

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Yes, Art, someone you think disagrees with you apparently made an ad hominem attack at some point on this blog, so that invalidates an actual argument I just made.

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It is convenient to argue that moral arguments are simply invalid and only serve to advance the interests of the person making them. It allows one to discharge any responsibility to fulfill his own moral obligations as well as those he feels are unfairly placed on him by society.

(Meant to respond to Slocum and not Rags.)

The "reason" article is a crippled analysis for a crippled morality.

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That's not the point. The 'coal fired plant' was a poorly attempt at black humor. The idea that it represents 'a new level of hate' is silly moral preening. Has 'The Other Jim' -- have you -- ever watched South Park and laughed? If so, count yourselves among the moral monsters, since I'm not sure there's a single episode lacking jokes or situations more offensive than the idea of using a coal plant as crematorium.

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Or here:

https://www.youtube.com/watch?v=EF6IShnqPY0

Funny? Or 'a new level of hate' that only the depraved could possibly find amusing?

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I assume Jim has a high level of dead body reverence, and possibly belongs to a religion with strict burial rites.

(We must be of a generation, this brought to mind the same Monty Python skit. But obviously that plays with reverence.)

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Having little attachment to my physical shell, I would not mind going in the power plant .. but it would probably be rough on plant employees, and require new regulations for biological safety.

The more serious omission in comments so far is that they only kibitz about pot and safety, and do not offer any serious, targeted, or immediate remedies for West Virginia.

As I read the news, West Virginia will get less help out of Congress, on a number of fronts.

About "pot and funerals"

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Meh. I thought it was more self-depreciating, making fun of our obsession with government efficiency rather than making fun of those who died.

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Accidents and suicide in this country accounted for 6.4% of all deaths in 1980, 5.4% in 1995, and 6.8% in 2014. The crude death rate from accidents and suicide is almost precisely the same as it was 35 years ago. You think all this chuffering about opiods might be a trifle overdone?

Can you link to the data? My 12 second google search didn't find me anything of quality.

CDC publishes annual data: https://www.cdc.gov/nchs/fastats/deaths.htm

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What do the death rates look like if you separate accidents and suicides?

Roughly a quarter are suicides.

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Since the topic we are discussing is opioid overdose deaths, why don't we pull some data on opioid overdose deaths? The number of heroin overdose deaths increased 6.2-fold since 2002 while deaths from all opioids increased 2.8-fold.

https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates

I don't know Ricardo, that's a great question. Probably has something to do with putting things into context, instead of acting like a local news station: kids are now hopped up on toads and sugar !

There's a certain y % of the population that's clearly susceptible to self destruction in x% libertine nature of society. As we move among the x axis, the % of people who will self implode will rise. Everyone knows this. Whether it's dying of AIDS for liberals or white trash dying of opioids the mechanism is the same.

This is a libertarian victory. People should have the freedom to kill themselves and ruin their lives. All I ask is don't send me the bill.

This is a libertarian victory. People should have the freedom to kill themselves and ruin their lives. All I ask is don’t send me the bill.

Fun facts: "In her 2005 book The Sociopath Next Door, psychologist Martha Stout warned that sociopaths make up four percent of the U.S. population." And "During the 2016 presidential election, Gary Johnson and vice-presidential candidate Bill Weld received a record percentage of 3.28% of the popular vote."

The sociopaths are winning by a hair.

Does that mean Trump supporters are non-sociopaths who voted for a sociopath?

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"There's no such thing as a unpaid bill". Since we are talking about indigent people here those bills will transfer automatically to the rest of us. You might as well try to annul gravity.

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I think there were a lot more traffic accidents and industrial accidents back then. Not 100% sure.

Traffic accidents per capita, and per miles driven, are lower today: Safer cars, better designed roads, less tolerance for drunk driving.

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"it often takes two to three weeks for the state medical examiner to complete the required autopsies."

Why should an autopsy be required for every case of death? Perhaps it's because every death is potentially a homicide. Maybe it's to identify the presence of communicable diseases in the population. Since everyone dies at some point, is there really a justification for the expense of determining the cause of every death, especially obvious ones.

The coroner does not determine the cause of 'every single death'. Health departments issue death certificates, but only deaths which occur in a discrete set of circumstances are subject to a coroner's determination.

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In order to ensure one of the few growing job markets in West Virginia: Medical Examiner

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The state is paying for religious rituals.

Disposal of human corpses is not a religious rite. It's a basic duty of public sanitation. We also do something with animal corpses in populous areas.

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Abuse or dependence on opioids affects approximately 2 million Americans.

Chronic, debilitating pain affects over 30 million Americans. Many more have chronic pain. We also need to consider the impact of our policies that result in undertreatment of pain for these patients. Here's a link to an IOM report on the matter. http://tinyurl.com/z4mrzk2

The key word is 'affects'. It's useful if you want to pad the numbers by including everyone in someone's household.

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They can complain at the mid-term elections if they want. This is what democracy means.

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They are white so they should check their privilege

Indeed. If one is principled again Obamacare, but has to tag along because SCOTUS and POTUS said so, I respect him/her. But people who conspired to take sick people's coverage and will, after they themselves are hit, beg for "entitlements". Well, I have no respect for them and the sooner they go under, the better. If they liked their Obamacare, they could keep it - they didn't, that is it.

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They are white so they should check their privilege

So to paraphrase Kanye West, you are saying "Donald Trump hates white people." Perhaps.

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Why hasn't the Kentucky conservatives privatized dealing with the dead and dying?

There is a demand for bodies for medical students, for organ tissue, for feeding captive animals. Why not get rid of the government involvement with dead people and let the private sector do "creative destruction" and make a profit disposing of the dead, just like towing companies do dealing with cars the owners can't pay to deat with?

Why not feed some of the dead to zoos? Or safari animal farms so tourists can see nature's scavengers in action?

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didn't read nothin', just wanted to say, dreamy place to live your life

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Is the opioid epidemic being over blown?

"Opioid addiction is driving this epidemic, with 20,101 overdose deaths related to prescription pain relievers, "

http://www.asam.org/docs/default-source/advocacy/opioid-addiction-disease-facts-figures.pdf

"Excessive alcohol use led to approximately 88,000 deaths and 2.5 million years of potential life lost (YPLL) each year in the United States from 2006 – 2010,"

https://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm

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