In short: pharma companies for misrepresenting an editorial in the 80s about addiction rates, medical industry calling pain the fifth vital sign, and enterprising drug dealers setting up Domino's like delivery services for heroin.
> Opioids do not generally cause a person to transition from healthy to unhealthy (they are prescribed to treat a preexisting condition).
This is a very naive view.
People start taking opioids in many different paths, legal and illegal. Some lie to get the prescription, no one can prove you don't have back pain. Some get a prescription after surgery and get addicted that week.
The super informative and well written book to read is Dreamland: https://www.amazon.com/Dreamland-True-Americas-Opiate-Epidem...
It is really well written and researched and lays out the several separate events and trends that converged to make this perfect storm happen when and where it did:
Opioid pain prescriptions used to be very limited and carefully monitored because of the perceived risk of addiction. The prevailing wisdom on this danger was changed because of some low quality papers on the risk that were pushed by drug companies.
Another big driver has been a more effective opioid selling due to some Mexican drug sellers. Interestingly, these sellers are much less violent than previous opioid sellers.
These reasons are outlined in the excellent book 'Dreamland'
Long interview podcast (~1hr) with the author to listen to or read the transcript of here:
There are a multitude of reasons to explain how this happened but to quickly sum up an excellent book:
- Purdue created the whole "sell-direct-to-doctor" phenomena that is now the norm in the US medical profession
- One bad study that showed opiates for pain relief are NOT addictive and this study kept being cited by sales people
- Mexican drug dealers from a very tiny area in Mexico importing black tar heroin
- A prevailing idea in the US that people should never be in pain and managing it through lifestyle changes is not acceptable; a quick fix is needed
- economic depression in the Midwest and Appalachia regions
But really, read the book. It's eye opening and well written.
This book has more of a focus on American pharma industry but still has lots of interesting insider insights.
Except it wasnt.
Very worthy your time listening to this guy if you are interested in the topic.
Very readable and educational. I couldn't put it down, and it tied together a lot of disparate threads that I have noticed over the past two decades but which I was unable to connect myself.
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