Tag Archives: drugs

U.S. life expectancy down again

The U.S. Centers for Disease Control has released statistics on life expectancy and causes of death for 2016. Some interesting findings:

  • Overall average life expectancy fell by 0.1 year, from 78.7 to 78.6 years.
  • The average masks the finding that for women, life expectancy held steady at 81.1 years while for men, it decreased by 0.2 years from 76.3 to 76.1 years.
  • Deaths from disease were down in almost every category. The increases come from “unintentional injury” and suicide. Unintentional injury sounds like car accidents and falling off a ladder, and it does include those things. But dig a little bit and it includes “poisoning”, and poisoning in turn includes drug overdose.

The Guardian explains that life expectancy has fallen two years in a row and how unusual that is:

Drug overdoses killed 63,600 Americans in 2016, an increase of 21% over the previous year, researchers at the National Center for Health Statistics found.

Americans can now expect to live 78.6 years, a decrease of 0.1 years. The US last experienced two years’ decline in a row in 1963, during the height of the tobacco epidemic and amid a wave of flu.

“We do occasionally see a one-year dip, even that doesn’t happen that often, but two years in a row is quite striking,” said Robert Anderson, chief of the mortality statistics branch with the National Center for Health Statistics. “And the key driver of that is the increase in drug overdose mortality.”

The article goes on to explain that the last time we saw three years of decline was during the Spanish flu epidemic 100 years ago.

Comparing any two years could easily be a statistical blip, as any climate science denier could tell you. But it seems clear that over time the U.S. is losing ground to its peers in the developed world. The solution our elected politicians have identified, of course, is to take away health care and mental health coverage from the working class.

FDA has approved trials of Ecstasy to treat post-traumatic stress disorder

This is according to Science:

In people with PTSD, a small sensory trigger such as a sound or a smell can bring a traumatic memory rushing back. “The disabling element of PTSD is the fact that when the memory starts, the emotions completely override you and overwhelm the brain,” Nutt says. Studies suggest that MDMA can dampen the emotional response to the memory, allowing people to relive their trauma and work through it, he says. The MDMA-treatment consists of several sessions of psychotherapy, some conducted while the patient is under the influence of the drug…

A small U.S. study that first suggested MDMA could help treat PTSD was published in 2011. Since then, researchers in Canada, Israel, and the United States have jointly carried out larger phase II trials funded by MAPS; their results, which remain unpublished but have been reviewed by the FDA, were very good, says Doblin. Overall, 107 participants who had suffered from PTSD for an average of 17.8 years were treated in the phase II trials, Doblin says. Of the 90 patients who were available to be studied 12 months later, 61 no longer had PTSD.

In late July, says Doblin, MAPS and FDA agreed on how the coming phase III trials—usually the last hurdle before seeking a drug’s approval from regulators—should be conducted.

910 drug overdose deaths in Philadelphia last year

910 deaths from drug overdoses last year. That’s the depressing stat in the video below. This is a way bigger problem than homicides (278 in 2016).

To put this number in a little more context, I looked up some statistics on all causes of death in Philadelphia – the most recent year I could find was 2015. Here are a few highlights:

  • “diseases of heart”: 3,418
  • “nontransport accidents”: 823 (I imagine this includes everything from drowning to falling off a ladder to kids playing with guns – it’s a surprisingly large number of people, but possibly also the hardest category to do something about)
  • “diabetes mellitus”: 365
  • homicide: 291
  • “intentional self harm (suicide)”: 160 (the teen rate is relatively low, then suicides reach a pretty steady rate for people in their 20s through 50s)
  • “motor vehicle accidents”: 98 (I’m surprised this isn’t higher, but still, most of these should be preventable. It doesn’t tell us how many of these are pedestrians and bicyclists.)
  • HIV: 67 (the majority are deaths are people in their 50s and 60s)
  • “all other causes”: 2,542

It’s not that I enjoy thinking about death. But if you were looking for public policies to help people and politics and institutional baggage were not issues, you would look at the causes that kill the most people the youngest, and the ones where policy is likely to have the greatest impact. Getting people on maintenance medications to control blood pressure, diabetes, and cholesterol is obviously important – perhaps some sort of universal health care program could be considered. Dealing with drug overdoses and the underlying economic and mental health issues would be crucial. Dealing with mental health in a serious way would also help with the suicide problem.

opioid law suits

The Ohio attorney general is suing pharmaceutical companies over their role in the opioid crisis. Who knows if it goes anywhere, but if it does I can imagine this being as big as the tabacco lawsuits, and eventually every state will want a piece. In other words, the argument would be that massive highly profitable companies are making their profits by killing their customers, are well aware of it, and are hiding it. Unlike cigarettes though, there are clearly legitimate uses of the drugs, they are prescribed by doctors, and there are all kinds of warnings printed on the labels.

This also reminded me of the very long expose from the LA Times called Oxycontin’s 12-Hour Problem. I admit I haven’t read the whole thing, but the basic problem is they tell people in excruciating pain the drug will work for 12 hours, only it doesn’t, so they take it more often to help with the excruciating pain, but it is only safe to take it every 12 hours.

new studies about drugs

Here are a bunch of new studies on drugs, both legal and illegal. Now, I am not advocating drug use. I am just advocating being aware of scientific research and making responsible decisions that reflect one’s personal risk tolerance. I would also point out that some legal drugs, like alcohol, tobacco, and prescription pain killers, are absolutely proven to cause harm to a lot of people, while some illegal drugs are not. I don’t take illegal drugs personally, because the idea of not knowing where they came from or what is in them is too scary for me. Nonetheless, here we go.

Recent studies have found that:

  • There is no association between marijuana use and heart disease.
  • There is a strong association between common pain killers, including ibuprofen, and heart disease, in “high doses”. I do not know if high doses include the Extra Strength Advil I can buy over the counter.
  • There is no clear link between marijuana use by pregnant women and any adverse effects on babies, although there is the “theoretical potential“. There is a strong link between alcohol and adverse effects on babies – I won’t even bother citing studies, they are easy to find.
  • “Magic mushrooms” are considered nontoxic, but they can have profound psychological effects. People who already have suicidal tendencies somewhat frequently attempt suicide while taking them, which is disturbing.

So I think there are pretty clear reasons to support medical use of marijuana and hallucinogens, and any side effects of recreational use should probably be treated as social or medical problems rather than law enforcement ones. I wouldn’t be surprised to see a gradual trend toward legalization, and eventual co-opting of access to these drugs by the mainstream government and corporate world. And next time I have a headache, I think I will just drink a glass of wine and go to bed rather than reaching for the ibuprofen bottle.

JFK and drugs

Has there ever been a case where a politician used drugs to improve their performance in a debate? Well, according to a 2013 story in the New York Post:

The night of the first Kennedy-Nixon debate, Kennedy met with Jacobson just a few hours before he took the stage. The senator was “complaining in a voice barely above a whisper of extreme fatigue and lethargy,” the authors write. Jacobson plunged a needle “directly into Kennedy’s throat and pumped methamphetamine into his voice box.”

The result was clear within minutes, and an artificially energized Kennedy changed American history that night by upstaging Nixon.

this is Michael Pollan’s brain on drugs

Michael Pollan has written an enormous article in the New Yorker on medical research into psychedelics. They were banned in the U.S. in 1970 as having no legitimate medical uses, but that is changing now with some researchers are using them to treat depression, post-traumatic stress, and to ease suffering near the end of life. It’s so long I don’t know what part of it to quote.

I had a relatively common, relatively easily curable form of cancer when I was a kid. And with apologies to people out there who have far more horrible, deadly forms of cancer, it was hell. Beyond all the physical pain and psychological stress involved for me and my parents, the worst parts were sheer boredom (hours of waiting, followed by hours of hydration, followed by hours of intravenous drip for a routine out-patient chemotherapy session every other week), and extreme nausea that lasted for days which they had absolutely no effective drugs for (this was 1987, and I think the situation has improved today.) But the idea that there might be effective and low-risk ways to reduce that suffering, like controlled doses of marijuana or LSD under a doctor’s supervision for example, and that these treatments have been denied suffering people for decades, is shameful.

Holmes and cocaine

Still reading some of the early Sherlock Holmes stuff (I’ve moved on to The Sign of the Four), I’m a little surprised by descriptions of his drug use. The implication is that his brain had no “off” switch. He had to be always thinking and analyzing. Human relations really held no interest for him. Mental idleness led to extreme depression, which he would temporarily self-treat with drugs, music, or a combination of the two. I’m nowhere near this extreme, and I’m not into drugs, but I can sympathize somewhat. I am more interested in quiet contemplation, and less interested in spending time with other human beings, than the average person, I think. I don’t dabble in drugs (because I am interested in living for a long time) but I definitely enjoy a good stiff drink as a way to maximize the recharging power of my alone time.

Sherlock Holmes took his bottle from the corner of the mantel-piece and his hypodermic syringe from its neat morocco case. With his long, white, nervous fingers he adjusted the delicate needle, and rolled back his left shirt-cuff. For some little time his eyes rested thoughtfully upon the sinewy forearm and wrist all dotted and scarred with innumerable puncture-marks. Finally he thrust the sharp point home, pressed down the tiny piston, and sank back into the velvet-lined arm-chair with a long sigh of satisfaction.

Three times a day for many months I had witnessed this performance, but custom had not reconciled my mind to it. On the contrary, from day to day I had become more irritable at the sight, and my conscience swelled nightly within me at the thought that I had lacked the courage to protest. Again and again I had registered a vow that I should deliver my soul upon the subject, but there was that in the cool, nonchalant air of my companion which made him the last man with whom one would care to take anything approaching to a liberty. His great powers, his masterly manner, and the experience which I had had of his many extraordinary qualities, all made me diffident and backward in crossing him.

Yet upon that afternoon, whether it was the Beaune which I had taken with my lunch, or the additional exasperation produced by the extreme deliberation of his manner, I suddenly felt that I could hold out no longer.

“Which is it to-day?” I asked,—”morphine or cocaine?”

He raised his eyes languidly from the old black-letter volume which he had opened. “It is cocaine,” he said,—”a seven-per-cent. solution. Would you care to try it?”

“No, indeed,” I answered, brusquely. “My constitution has not got over the Afghan campaign yet. I cannot afford to throw any extra strain upon it.”

He smiled at my vehemence. “Perhaps you are right, Watson,” he said. “I suppose that its influence is physically a bad one. I find it, however, so transcendently stimulating and clarifying to the mind that its secondary action is a matter of small moment.”

“But consider!” I said, earnestly. “Count the cost! Your brain may, as you say, be roused and excited, but it is a pathological and morbid process, which involves increased tissue-change and may at last leave a permanent weakness. You know, too, what a black reaction comes upon you. Surely the game is hardly worth the candle. Why should you, for a mere passing pleasure, risk the loss of those great powers with which you have been endowed? Remember that I speak not only as one comrade to another, but as a medical man to one for whose constitution he is to some extent answerable.”

He did not seem offended. On the contrary, he put his finger-tips together and leaned his elbows on the arms of his chair, like one who has a relish for conversation.

“My mind,” he said, “rebels at stagnation. Give me problems, give me work, give me the most abstruse cryptogram or the most intricate analysis, and I am in my own proper atmosphere. I can dispense then with artificial stimulants. But I abhor the dull routine of existence. I crave for mental exaltation.

what’s new with drugs

Drugs are not immune from the current wave of seemingly accelerating innovation (from Pacific Standard Magazine):

New psychoactive substances are coming out so quickly that it’s not possible to ban them fast enough to keep up, let alone police or scientifically understand them. When one substance is outlawed, another is born, just chemically distinct enough from the last one to evade its ban…

Not since the 19th century—when an earlier wave of globalization rapidly accelerated the spread of opium, cocaine, marijuana, and hazily defined “patent medicines”—has there been such a burgeoning and unregulated pharmacopeia. And by all indications, the future promises only more acceleration. Last year, a research lab at Stanford demonstrated that it’s possible to produce opioid drugs like morphine using a genetically modified form of baker’s yeast. Soon, even the production of traditional illegal drugs or illicit versions of pharmaceuticals could become a highly decentralized cottage industry, posing the same kind of regulatory challenge that the specter of 3-D printed firearms poses to the project of gun control.

In 2013, the U.N.’s World Drug Report summed up the global situation this way: “The international drug control system is floundering, for the first time, under the speed and creativity of the phenomenon known as new psychoactive substances.” Testifying before Congress that same year, the DEA’s Joseph Rannazzisi said that his agency could not keep up with “the clandestine chemists and traffickers who quickly and easily replace newly controlled substances with new, non-controlled substances.”

New Zealand is starting to regulate recreational drugs more like food: with labeling, consumer notices, and so on. Sometimes I wonder how long this will stay a mom and pop business – once it’s legal, won’t big drug and chemical companies try to get in on the game? It’s a brave new world.