[okareaman]

> The opioid epidemic was largely caused by the idea of them being non addictive being heavy pushed by the pharmaceuticals industry

That's not true. The new idea was that a manageable addiction was preferred to chronic pain. The theory was that addiction to opioids could be managed. That turned out to be not the case. People started selling pills and buying street heroin and it spiraled out of control.

[raphlinus]

It is true. The claim was that the risk of addiction was extremely small. One of the ways this idea was pushed was cherry-picking a study that showed no addiction among 10k burn victims treated with opioids. Minimizing the risk of addiction was also a major component of the guilty plea and fine.

Obviously any reasonable person with a knowledge of opioids could see that these claims were BS, but it's remarkable what motivated reasoning can do, especially when there's profit involved.

[1]: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2622774/

[okareaman]

> The opioid epidemic was largely caused by the idea of them being non addictive

the parent comment said "non addictive" which I said wasn't true. You said

> The claim was that the risk of addiction was extremely small

which is another way of saying they thought they could manage addiction that did occur. They thought this because they had a time-release pill which made the risk of problematic addiction "extremely small" as you say

[amanaplanacanal]

I thought the new idea was that people who took opioids only for pain relief didn’t get addicted, which in hindsight is absolute nonsense.

[okareaman]

People didn't suddenly forget centuries of experience that narcotics were addictive. They thought that making them time release and long lasting they could manage the addiction. Pharmacies did downplay the cleverness of people when they want to get high. People found they could crush the pills and snort them for a quick rush. Those who weren't addiction prone found they could sell their pills for $80 a pill. It was off to the races after that.

The real crime here wasn't trying to help those in chronic pain with a manageable addiction, it was the incredibly long time it took for pharma companies and govt regulators to do anything about the crisis, even as some pharmacies in Florida and West Virginia were selling millions of pills, far more than their local communities would warrant. The suspicion is that a lot of money was being made, so why rush to intervene.

[pas]

Managing acute pain is different from chronic pain. The 'new idea' you refer to is that people who get opioids in hospitals don't get addicted. Of course, the important difference is that when people get better after surgery their life is generally goin in a good direction. It's easy to stop using opioids when you are finally able to walk, work, move, live, love again.

Chronic pain is basically the opposite. Where depression is almost guaranteed, and susceptibility to addiction is very high.

[monocasa]

No, the messaging to the doctors was that there was essentially no risk of addiction.

> This pain population with no abuse history is literally at no risk for addiction

> There have been studies suggesting that addiction rarely evolves in the setting of painful conditions

https://www.statnews.com/2017/05/31/opioid-epidemic-nejm-let...

[okareaman]

A single letter written 40 years ago did not cause the opiod epidemic. It was part of a movement to reassess the use of pain medication to ease chronic pain. By movement I mean it was part of a change in the zeitgeist among doctors and pharmaceutical companies. No doctor read this letter and said to themselves, well I guess narcotics are not addictive anymore and I can prescribe them without concern. I don't know why people want to make reductive arguments.

[monocasa]

It absolutely did, the article even goes into how new printings of the same journal now come with a public health warning because of the number of times it was cited, how it had subsequently been debunked, and the overall effect it had on the industry.