76 Billion Pills

This is a stunning piece of reporting in the Washington Post:

America’s largest drug companies saturated the country with 76 billion oxycodone and hydrocodone pain pills from 2006 through 2012 as the nation’s deadliest drug epidemic spun out of control, according to previously undisclosed company data released as part of the largest civil action in U.S. history.

The information comes from a database maintained by the Drug Enforcement Administration that tracks the path of every single pain pill sold in the United States — from manufacturers and distributors to pharmacies in every town and city. The data provides an unprecedented look at the surge of legal pain pills that fueled the prescription opioid epidemic, which has resulted in nearly 100,000 deaths from 2006 through 2012.

Just six companies distributed 75 percent of the pills during this period: McKesson Corp., Walgreens, Cardinal Health, AmerisourceBergen, CVS and Walmart, according to an analysis of the database by The Washington Post. Three companies manufactured 88 percent of the opioids: SpecGx, a subsidiary of Mallinckrodt; ­Actavis Pharma; and Par Pharmaceutical, a subsidiary of Endo Pharmaceuticals.

I’m assuming most people are like me, who have used pain pills like these, but mostly after a major incident or surgery. I have not been prescribed a pain pill since my shoulder accident and surgery, and that was in 2009-2010. Prior to that, I don’t remember anything for at least a decade. So over the course of a 20 year period, I was probably prescribed 100 pills, if that. And again, I am assuming that most people are like me or have had even fewer scripts. Then you have chronic pain sufferers, who obviously need the meds. But again, I would suspect that while there are probably more people you know who have consistent chronic pain, it is nowhere near accounting for this number of pills.

You also have to take into account how people deal with pain. My shoulder hurts every single day. At least 2-3 times every night I wake up with it locked in place, causing sharp stabbing feelings until I can slowly move it and loosen it up and fall back asleep. I’m eventually going to have another surgery to deal with it. But there are a number of reasons why I don’t ask for or take anything for it, not even otc stuff. I have an addictive personality, I am already an alcoholic, so I just don’t think it is wise for me to introduce a powerful narcotic into my daily life. Second, I don’t like how they make me feel. I feel groggy and cloudy (I remember brushing my teeth with soft soap a couple of times confusing it with toothpaste), I get a horrible histamine effect after a couple days and am itchy and sweaty, they make me constipated, and I found after surgery years ago they don’t actually make the pain go away so much as just get me stoned so that I am not focusing on it. Third, I don’t NEED to be pain free. I’m not digging ditches or lifting boxes for a living- were I exposing myself to that sort of labor every day, like, say, a coal miner with a bad back or an auto worker with bad knees, I might think differently. Fourth, I have found that other things help more- a hot shower, stretching, etc. Finally, and I guess this is just me, but life isn’t pain free. I’m almost 50. I’ve fallen off roofs, been through windshields twice, fallen off of tanks, slipped on ice, beaten up in street brawls, hit over the head with a bottle, played contact sports for two decades, etc. Some things are just going to fucking hurt no matter what I do.

Having said all that, I still find the number of pills to be MIND BOGGLING. The geographic distribution is interesting, too:

Again, that is pain pills PER YEAR. That can not all be explained away by manual labor and populations that have higher numbers of dangerous vocations. It appears (and I am just making shit up here- I have nothing to back this up) that pain pills were dumped in places in lieu of social policies. Again, just amazing.

Insulin Insanity

These stories are becoming more and more frequent:

As their minivan rolled north, they felt their nerves kick in — but they kept on driving.

At the wheel: Lija Greenseid, a rule-abiding Minnesota mom steering her Mazda5 on a cross-border drug run.

Her daughter, who is 13, has Type 1 diabetes and needs insulin. In the United States, it can cost hundreds of dollars per vial. In Canada, you can buy it without a prescription for a tenth of that price.

So, Greenseid led a small caravan last month to the town of Fort Frances, Ontario, where she and five other Americans paid about $1,200 for drugs that would have cost them $12,000 in the United States.

For profit medicine is a fucking disaster. The “profit” of a good medical system is a healthy and productive populace, a society where people can allocate their resources to productive things rather than being gouged for medicine and medical procedures, and where people are not miserable and stressed out about medical bills.

I am not god emperor, but if I were, the very first fucking thing I would do is mandate single payer, nationalize the production of critical drugs in which there is no research and development being done to improve the drugs but just straight up price gouging, and ban health insurance for anything but elective procedures. Because it’s been my experience that a large and vocal portion of the medical community are entitled whiny ass titty babies who think they deserve millions of dollars per year and will do anything to preserve their wealth and status, a belief in part created by the ridiculous costs of medical school and the absolutely insane practice of grueling residencies, I would nationalize medical school, too, and then cap salaries. I’d also expand the number of nurses and technicians who do the actual bulk of the work in the medical industry.

This will displace a bunch of people in the insurance industry and medical admistration and elsewhere, and that’s just fucking fine- we will need a robust regulatory community to keep an eye out for fraud and abuse. That should create a few jobs. And the flunky pretty boy douchebags and their cheerleader counterparts who flocked to pharmaceutical sales will just have to find honest work somewhere.

And don’t come at me bashing the VA saying this would be no better- veterans love the VA. A few fucking loudmouths don’t.

The end. There’s your fucking marching orders. Make it happen.

To the Repubs, Women Aren’t People

(Support the artist / get your swag here)

The only tiny sliver of consolation is that the GOP may have ham-fisted themselves firmly into ‘Be Careful What You Wish For’ territory. Dahlia Lithwick, at Slate“SCOTUS was all teed up to quietly gut America’s abortion rights. Then Alabama happened”:

There are easy and near invisible ways for the high court to end Roe. That has always been, and remains, the logical trajectory. As Mark Joseph Stern has shown, when Brett Kavanaugh came onto the court, with his dog whistles and signaling around reproductive rights, it became clear that he would guide the court to simply allow states to erect more and more barriers to abortion access (dolphin-skin window coverings on every clinic!). The five justices in the majority would do it all while finding ways to say that such regulations were not an “undue burden” on a woman’s right to choose. The courts and state legislatures could continue their lilting love songs to the need for the states to protect maternal health and to help confused mommies make good choices, and nobody need dirty their hands by acknowledging that the three decades’ worth of cumbersome clinic regulations and admitting privileges laws were just pretexts for closing clinics and ending abortion altogether.

But the state of Alabama runs now to the Supreme Court with its mask of tender solicitude for women and their health askew. The briefest look at the debate as Alabama on Tuesday passed the cruelest and most punitive abortion regulation in modern American history shows exactly how much concern they have for the health of pregnant women or the suffering of future children…

Why, then, do I feel sorry for John Roberts? Because what keeps the Supreme Court in business is often the polite subterfuge of complex legal doctrine. We don’t so much suppress minority votes as protect the dignity of the states. We don’t so much enable dark money to corrupt elections as invite free speech. And we don’t so much punish women for bearing children as celebrate God and babies. This is all the kind of democracy-suppressive language the justices can get behind. It’s why Americans don’t riot on the streets…

Just as President Obama’s election exacerbated, and exposed, the ugliest racist undercurrents of modern America, Hillary Clinton winning the popular vote in 2016 unleashed the never-very-hidden misogyny and sexual terrors of entirely too many of our fellow citizens. Sunlight is not the swiftest disinfectant, but we can’t cure the rot until we can see how deeply it’s embedded.
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From A Commentor: Medicare-Related Bleg

Commentor Aliasofwestgate:

I’m an irregular commentor here since about 2009ish, but I’ve always loved the place.

My Mom has been in and out of the hospital since November. At the moment she’s in a rehab facility nearby for physical and occupational therapy. I’m in Michigan, which has some pretty crazy Medicaid laws. But mostly the fact that I’ve been denied help with bills that should have been taken care of but was unable to due to things being pending in applying and stuff I know they outright won’t cover, and rehab facility fees for her being even a temporary resident.

There’s also the fact that Mom’s an immigrant. She may be a Permanent Resident and has been for nigh on 40 years, but I’ve been denied from pretty much any place I’ve applied to for help.

I mostly need some extra money to fund a possible hospital bed copayment (lowball estimate $500), and wheelchair bus rides to and from the facility, which is definitely not covered right now with her supplemental or Medicare. I’m planning on getting her a Rollator style walker for home, and have some equipment already in the house to be installed soon. But the walker is the one thing I’m planning on, along with the bed for sure. My very lowball estimate of $1500 should take care of the worst of it.

I’m a freelance transcriptionist myself, but the money is not that good. Especially since i’m not a professionally trained one.

I have a ko-fi at http://ko-fi.com/A5533LVN , which works something like Patreon, but not as structured.

My paypal address is aliasofwestgate@yahoo.com.

Oh, we also have a tubby, goofball minpin/JRT mix called Lady who misses Mom a lot. We know she’s coming home, but it’s gonna be a while yet.

Excellent (Horrifying) Read: “The True Dollar Cost of the Anti-Vaccine Movement”

From the reliably excellent Maryn McKenna, at Wired:

Every grave illness and death is an individual tragedy, but the cost of vaccine hesitancy also enforces a shared public toll.

Consider the ongoing measles outbreak in Washington State, which is centered in Clark County, on the Oregon border. In January, when it had racked up 26 cases, the state governor declared a public health emergency. Since then, the case count has almost tripled, to 74.

To figure out who might have been put at risk, the state health department has interviewed 4,652 people and closely monitored 812 of them. It has reassigned staff from across its divisions, borrowed public health workers from other states, sent people who would normally be at desks out into the field, performed hundreds of lab tests that would not normally be necessary. So far, it has spent $1.6 million…

The funding to support that work isn’t being conjured out of the air. It’s coming from the budgets of public agencies, which have already been facing years of cuts and have no secret stashes of discretionary money to spend.

“There are substantial public health responses that go into mitigating an outbreak, and we should pursue those, because they prevent larger outbreaks or broader social disruption,” says Saad Omer, a physician and epidemiologist at Emory University and the senior author of a recent paper on the “true cost” of measles outbreaks. “But it does result in a lot of costs that can be pretty substantial. And we don’t measure the further indirect costs to the community.”

In Washington State, those indirect costs include the other work that doesn’t get done while the outbreak proceeds. The state health department was forced to appropriate a portion of its poison control center’s work hours to handle the calls made by people worried they had been exposed to measles. In Clark County, the local health department reassigned to measles the home-visit nurses who take care of risky pregnancies, and also the investigators who track down victims of sexually transmitted diseases and foodborne illnesses…

Those costs are being paid by state governments, and by federal agencies such as the CDC that give states grants and loan them personnel. State and federal budgets are public money—which means those necessary bills for unnecessary outbreaks are being paid by all of us. The toll of illness may be confined to individuals, but the cost of responding to outbreaks related to vaccine refusal is a bill that we are all being compelled to pay.

And you know the privileged parents now telling each other, Really, it’s only measles, we all got them back in the day and *I* never had any problems will sue everyone from the suspected source to their local government to the FDA if their little darling has to so much as miss a school recital or family vacation because of a quarantine, too. Mah RIGHTS!!!

Sometimes I find myself wishing that this kind of stupidity physically hurt its possessors, and not just their victims, because that seems to be the only way to reach some people.