Rebuilding Place in the Urban Space

"A community’s physical form, rather than its land uses, is its most intrinsic and enduring characteristic." [Katz, EPA] This blog focuses on place and placemaking and all that makes it work--historic preservation, urban design, transportation, asset-based community development, arts & cultural development, commercial district revitalization, tourism & destination development, and quality of life advocacy--along with doses of civic engagement and good governance watchdogging.

Wednesday, December 20, 2017

The opiod epidemic is more of an issue that I realized

In DC it's not so bad, and not all that visible in most parts of the city.  But I happened to be reading the Sunday Philadelphia Inquirer, and columnist Mike Newall wrote about his experience giving Narcan to an overdose victim in the Kensington neighborhood ("On Kensington Avenue, strangers with Narcan").

In the course of the article, where he mentioned how the city has gotten agencies on the same page in terms of responding to the problem, and has "deputized" the community, including addicts, by widely distributing the overdose revival drug Narcan, aiming to reduce overdose deaths, he mentioned that:

The City of Philadelphia projects that there will be 1,250 drug overdose deaths in 2017, most due to opiods.

That's 10 times DC's murder rate and drug overdose rate, and 4.5 times Philadelphia's 2016 number of homicides.  Philadelphia has about 2.5 times the population of DC -- 1.57 million to 681,000.

Which puts the problem in perspective.

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At 10:00 AM, Anonymous charlie said...

Guess I'm really not in the Christmas spirit, because I'm seeing it a bit differently.

I'd make three points:

1) There has been a huge push on civil ligation against drug companies and distributers. Modeled on the tobacco settlement. I think they are making progress and would not be socked to see a deal. Think $100B in a fund. The hidden context is the only way to fund that program is continue to sell opiopds, rather than look at alternatives.

2) The state governments basically want Medicaid (feds) to pay for treatment options for addicts. You'll notice the volume of stories dropped off tremendously after Trump announced his emergency measures that said CMS will study that issue.

3) The "epidemic" is a bad terms, and weak thinking. Measures taken have made it worse. Banning doctors from prescribing means formerly legitimate users have to turn to the street. That crackdown means it is easier to ship elephant tranquilizer form (in a small envelope), make 100,000 doses with varying quality, and then find you got it wrong as a massive overdose. And Narcan is also part of the problem. Classic case of risk.

I'm not discounting the dead bodies, the tragedy is here, but we've taken a simple problem (doctors writing too many RX for pain) and turned it into a major one. And there is a lot of money on the table.

At 11:42 AM, Blogger Richard Layman said...

I haven't tried to drill down into the issue. And of course in rural areas, meth is an issue too. (Drugs have touched members of Suzanne's extended family in significant ways.)

It's not my issue.

But 1,250 overdose deaths in Philadelphia alone is a staggering number. And it's deserving of being called an epidemic.

But with your point about doctors, obviously a lot of the illegal use of opioids is separate from ever having legal prescriptions, and then addiction as a result of chronic pain.

At 6:55 PM, Anonymous charlie said...

RE: illegal use, and RX

I'd argue it is the opposite -- that the majority of illegal use started with prescription drugs, and they moved on the street use.

(84 percent in 2005, 51 percent in 2015).

We've cut painkillers off too much, and people went to illegal use. Obamacare and high deductible plans haven't helped.


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