Thursday, January 5, 2017

Math Thursday:
The math of life and death, part 3
Death by overdose

A major culprit in the increasing death rate are drug overdoses. This study from the CDC follows the number of deaths over the five year period from 2010 to 2014 for ten drugs: Six opioids (fenatyl, heroin, hydrocodone, oxycodone, methadone and morphine), two stimulants (cocaine and methamphetamine) and two benzodiapazines (Alprazolam and Diazepam). The rate of deaths from these causes, which are difficult to separate in many overdose cases, rose from 12.4 per 100,000 in 2010 to 14.8 per 100,000 in 2014. The drugs listed separately as causes all have been under 2.0 per 100,000 except for heroin, which rose steadily throughout the five year study from 1.0 per 100,000 in 2010 to 3.5 per 100,000 in 2014. In 2015, the numbers for heroin continued to rise and for the first time in any recent year, more people died from heroin overdose than from gun homicides, though the difference in the reported numbers - 12,989 to 12,979 - could be over-turned on a recount.

What's going on? Let me be the first to say I don't really know, but the old, often discredited idea of a "gateway drug" is re-surfacing here. It is assumed that the prescription opioids are introducing people to the opiate experience and they are more likely to take heroin after experiencing Oxycontin or some other doctor prescribed painkiller. I have no personal experience of this phenomenon, so I was surprised to find that heroin is much cheaper than the prescription drugs. We have assumed illegal drugs were an urban phenomenon for maybe a century now, but the deaths we are seeing now are definitely not limited to the cities or even the suburbs. When Rush Limbaugh was outed as an Oxycontin abuser, I first learned of its nickname Hillbilly Heroin. Obviously, some enterprising job creator has been able to introduce real heroin to real hillbillies.

The epidemic is most prevalent among whites and is also seen in the African American male demographic.  It is much less common among African American females and both genders of the Latino community. The current prevailing assumption is doctors prescribing pain relief in ways that show both racial and sexual bias, which actually hurts white males by this measurement rather than helps them. Many commentators linked these death statistics to the alleged spring of Trump's victory, the set upon white working class. We now get a four year experiment, possibly longer though I certainly hope not, as to whether having a guy in the White House who is "on their side" will see a drop in these numbers. Given that heroin is the leading edge of the problem, my assumption is that no slogans or cheering rallies or increased policing will make much difference. Like with the numbers in the early 1990s at the height of the AIDS epidemic, the at risk population is going to have to figure out how to pull out of this tailspin by themselves.

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