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Tuesday, June 21, 2022

Overdose in the News

We have spent two years challenged by the latest coronavirus. It has been a reminder of viral infection leaping from other species, See The 1918 Flu in the News (April 2022). In fact, Nature claims scientists are now studying whether there was an amazing coincidence in 2019 when the SARS-CoV-2 virus made such a species-leap twice in a very short time in the same geographical area. It is intriguing that such a seeming coincidence may have occurred at the outset of our COVID-19 experience.

We are troubled that COVID has impacted our lives. And the death toll has been simply tragic. So far, the excess of 6 million worldwide, the deaths is a heavy weight. Not as perilous as the 1918 flu which as rapidly killed tens of millions, the impact of COVID has nonetheless been devastating on many levels. The response of medicine with treatment and vaccination is undoubtedly worthy of praise in this regard. 

The death toll is being compared to other maladies. MSN reported recently in an opinion piece, however, that Fentanyl kills more young Americans than COVID. The underlying causes should worry us all. This notes that "US overdose deaths top 100,000 in one year." I prognosticated regarding that horrible landmark over a year ago in The Time has Come, The Time is Now (April 2021). That is a horrific number. The COVID-19 deaths in 2021 is an even more horrific  415,000 according to NBC News. Details of the U.S. Death rates were recently supplied by the Census Bureau and are sobering. But, the CNN distinction is notable in the "young people" ("COVID death rates in 2021 were highest among older Americans"). 

Is there some reason why death is more troubling in the young? Aren't all ages and other demographics of importance? Reason or not, it is somehow more troubling when the young pass, so full of promise and aspiration. Undoubtedly, the death rate from COVID far exceeds that from overdose. There are defenses against both COVID and overdose. And, there are some that see COVID actually implicating emotional state directly, and thus involved in some volume of overdose, or at least in the precursor drug use. Furthermore, there is some evidence that the social isolation or confinement experienced during the reactions to COVID may have had significant impacts on emotional health. It is a difficult situation with many aspects and concerns. 

The MSN article is focused not on the overdose rate per se, but upon a "mental health crisis facing Americans." The author's contention is that there are two urgencies in America: the pandemic (COVID) and an epidemic (mental health) that each require attention. It cites "a recent analysis of Centers for Disease Control data," and concludes that "fentanyl has become the predominant killer for Americans ages 18 to 45." Though the news is quick to focus us on violence, the sobering reality of overdose is too infrequently in the news. 

Of course, the overall data support that our most predominant threats remain "heart disease, cancer, and COVID-19." And, at 100,000 deaths, overdose would likely be in approximately 8th place among the causes of death in the U.S., according to 2020 figures from the CDC. It would be close to the total for Diabetes, another exploding epidemic. The CDC notes that "the number of people with diabetes is higher than it has ever been." Ten percent of Americans have it, and about 20% of those do not know they have it. It is a pandemic, but we seem to hear little or nothing about it. 

Returning to the Fentanyl, there is no plausible reason for our not being concerned with overdose. The numbers keep rising, and I keep writing these posts. Over 100,000 overdose deaths in a single year. Opioids are a persistent and pernicious killer despite many efforts to address their prevalence and availability. Despite the prescription constraints, the education, the press coverage, and more, the MSN article documents that overdose death is increasing, and in the younger cohort (18-45) the "fentanyl (deaths) have significantly exceeded deaths from COVID-19."

This opinion piece in MSN contends that federal resources for mental health treatment is the (or "a") solution. The author blames fentanyl, which WebMD says now predominantly comes from Mexico and China. But, the contention is that the drug(s) are a symptom of something larger. And, the writer confidently concludes that "attributing addiction to personal moral failures flies in the face of biology and decades of empirical sociological findings." In plainer language, the author contends that it is not the drug user's fault that drugs are used, misused, and abused.

The solution seen by the author of this opinion piece is therefore to assure somehow that society (or perhaps government, the implication is less than clear) "examine the policies and processes that should be nurturing young people’s social and economic prospects as well as overall well-being." This is, perhaps, a deeper topic than it might appear. That is, beyond the social isolation of COVID results or direct impacts of COVID. In total, it seems, the questioned posed is whether and how government is nurturing young people. 

There are a fair few causes cited by the author for young people being fearful, anxious, and even depressed. Notably, the author cites that "economic issues loom large in young people’s fear about the future." There is apparently specific focus on issues that can perhaps be addressed. The specifics include "inflation, the cost of living, and economic inequality among their top concerns." And the author concludes that the COVID-19 pandemic has in some ways "further stratified young Americans’ economic prospects from those of their parents." Particularly cited are "mountains of student loan debt" that "make dreams like homeownership a distant reality." 

It is troubling to see folks in such deep debt, and perhaps I am a wet blanket. However, the student loan debt that is frustrating those people was borrowed by those people. This author's analysis seems to suggest that the solution for people who have borrowed money is to alleviate the impact of their decisions by making others responsible. In other words, the relief for those decisions seems to be to socialize those debts and make them the responsibility of the rest of America that did not borrow inadvisably or even irresponsibly. 

Perhaps, it is worthwhile to examine that more thoroughly? Relieve the decisions of some by more detriment to all. This may illustrates or suggest that relief to some (economic or anxiety) may not reduce anxiety or increase optimism in a vacuum, but merely foist that stress instead on some other segment of society and decrease their own personal or collective optimism about the present or the future. It is possible that some element of the inflation noted by the MSN author (the first concern noted) is too many dollars in the economy. 

The economic pressures cited for young people are in no way in no way limited to that population. Us old folks are also facing inflation. And, the old folks that have retired are doing it on a reasonably fixed income. They did not borrow the student loan debt and yet are seeing their own economic futures (and present) threatened by the rampant inflation, $5.00 per gallon gasoline, unaffordable groceries and more. While the inflationary escalation in minimum wages will likely help wage earners to keep pace with the inflation, the senior citizens are profoundly impacted by this economy, the ready debt, and the cost of living. 

Anything that creates more spending, including "relieving" student load debt, will have both intended and unintended consequences. That word, "relieving," is a euphemism for more government money being given away. The government, however, has no money. It is dependent upon your tax dollars, and all too often on borrowing money. The national debt is over $30 trillion - $30,000,000,000,000. And, it is growing everyday. So, in a world of limited resources, how does the government "relieve" someone of their bad decision? By assuming more debt and foisting it upon everyone else. The stress of debt is not eliminated, but merely transferred.  

The end of the analysis is certainly not achieved in this article. The fears of the young cannot be discounted. We have to accept the perceptions and beliefs of the young, they will outlive us and we need them to succeed. See The Time is Now (April 2022). The role of government in creating anxiety likewise cannot be ignored (were student loans too easy to obtain, risks insufficiently explained, educational institutions insufficiently supervised or disciplined?). Did colleges and universities, which enjoyed the income from tuition and fees paid with such debt play any role? Perhaps similarly the role of government and groups that promote the use of drugs as some solution to each and every human challenge bear some responsibility as well? There are those who blame the Food and Drug Administration, the medication manufacturers, and even the doctors

Incidentally, the opioids became a problem for Florida and the "pill mill" situation brought us much attention. More recently, Marijuana is a hot commodity in Florida according to WJCT.  In another recent report, WTSP noted that:
"There are now 700,000 medical marijuana patients in the state of Florida. That’s more than twice as many as there were at the beginning of the pandemic."
Some cheer that growth, and others perhaps perceive this as reminiscent "of the old pill mill days in Florida." Is the pandemic driving drug use in this context, or is this a coincidental finding? There will perhaps be those who perceive our societal tendency to prescriptions (or in the pot situation "recommendations"). Some, however, perceive broader issues with Marijuana. One lawsuit has been filed contending that Marijuana is "legal," and thus in need of  broader conversations. As a side note, Marijuana is not "legal" in any state for any purpose, and that disconnect is a challenge for many people. See Mischaracterizing Pot Again (February 2020), and Decriminalizing Marijuana (May 2021). Is the failure of characterization of any import in anyone's mental health?

There is some sentiment in this MSN opinion piece that government is not doing enough to help as regards mental health and the overdose rates. But, in the end, government has become a pernicious and repetitious source of aid and comfort. Billions of dollars in borrowed money have flowed from the Vesuvian printing presses in Washington since the so-called "Great Society" was thrust upon the national consciousness in 1964. The intent of government to help, in large part, may have led to the very explosion of student (and other) debt which is now lamented and blamed. I know a fair few who are anxious about the national debt in its own right, and who fear for the future of the country as a result. Theirs is anxiety that may be frustrated in any debt-relief effort to alleviate the anxiety of others.

Can people feel positive about their lives and futures? In fact, they can. However, there will remain economic realities that cannot be legislated away. Resources are scarce. Value is elusive and often fleeting. Evolution is persistent. Change is inevitable. The jobs of today will largely travel into the economy of tomorrow, but may perhaps not thrive or even survive there. This is not new, unique, or unexpected. Positions and career paths have persistently been the victim of technology and change. Reasonably recent examples have included retail employment, typing pools, and more. Have we failed to empower the next generation to study and test economic theory?

The MSN author contends that in some way American society is not listening to the challenges or anxieties of youth. There is accusation that somehow society is responsible for "dehumaniz(ing) or reprimand(ing) them for their pain." Society is perhaps responsible for much. The expectations of life, without doubt, challenge, scare, and make us anxious. The world is a hard place of challenges. It is a place where access to resources drives human behavior. If in doubt, ask Professor Putin about the appropriate method for dividing resources (that was sarcasm, and perhaps untoward, apologies). But, nations actually go to war for resources. There are a multitude of challenges we face, and they implicate us all. 

The reality is that government will not solve all problems, and in fact may periodically be the root cause of problems. In fixing one, we may engender or cause others (unintended consequences). And, the actions of government come to roost on each of our doorsteps. In the end, however, it is time to bring some serious focus to the issues with drugs in this country, and the potentiality or perhaps probabilities of overdose and death. Is our reliance on drugs appropriate? The immutable fact is that too many people are dying, we have enormous capacity for study and action, and it is time we somehow put our shoulders to that wheel. The solutions are not clear, but the outrageous price in human life is all to apparent.