We could cut the opioid death rate by 50% – but we’re not
As more and more people die, drug companies keep reaping in a massive profit.
Maia Szalavitz is widely viewed as one of the premier American journalists covering addiction and drugs. A neuroscience writer for TIME.com and a former cocaine and heroin addict, she understands the science and its personal dimensions in a way that few others can. is the first book-length exposé of the "tough love" business that dominates addiction treatment. Her newest book is Unbroken Brain: A Revolutionary New Way of Understanding Addiction.
Maia Szalavitz: Well, I think like in terms of—seeing famous people that we love die from drugs should make us question why we so stigmatize and attack people with addictions. I mean some of our most beloved artists, musicians, writers have been addicted. I mean I find it kind of interesting that we don't see addiction as a "white problem" when you have like William Burroughs and Lou Reed and Kurt Cobain—and I could list 20 other heroin addicted rock stars. So, this is a condition that can affect not just anybody, but people who are in some sort of emotional pain. Addiction kicks people who are already down. And it doesn't look like celebrities should be that kind of person. But I think that a lot of the drive and the grit and the, you know, what you need in order to achieve great success is also a risk for addiction. Because in order to be a successful rock star you have to process despite rejection a lot and you need to be able to just keep going and keep going. And if that kind of drive and passion gets focused on a drug it is particularly destructive.
So, I think in order to help deal with opioid addiction, for one we need to have naloxone in every first aid kit. There is absolutely no reason why people who are surrounded by other people should ever die of an overdose. If you are injecting and other people are there—which is the case 50 to 60 percent of the time—naloxone should be there. And this is not going to encourage more drug use, because it's an awful experience to get awakened with naloxone, but it will save lives. And so that's one way we can turn the tide on this. The other way that I think we can turn the tide on opioid addiction is we really need to provide greater access to drugs like methadone and Suboxone, which is also called buprenorphine.
Those two drugs taken indefinitely, i.e. potentially for life, are the only thing that cut the death rate by 50 percent. And if we really want to solve this problem we could get rid of half of it if we could enroll many more people in these maintenance programs. Now there's a lot of the barriers to that. One is that we only allow doctors prescribing buprenorphine to see a hundred patients—now they just raised it to 200—this is ridiculous. They can prescribe opioids for pain to 10,000 patients but you can only prescribe for addiction to a hundred patients? This is really silly. We also have this idea that you can't provide these medications without also providing counseling. And we don't to do that for any other medical service. We don't say, "You can only get your insulin if you do X counseling on diet," or whatever. We realize that people need the tools to stay alive regardless of if they are improving as quickly as we would like them to do. And forced counseling doesn't actually help anyway. So what we should do is we should have different thresholds for treatment. So with buprenorphine some people may just want to show up and get a dose, and that's it. And that will work as sheer harm reduction. That should be available in emergency rooms.
You need to register people so that you don't end up with people getting multiple doses, and you need to be a little more careful with methadone than with buprenorphine because there is a big overdose risk for patients who are naïve to methadone, and it's a difficult drug to prescribe. So that needs to be a little more controlled, but we have it way too controlled and isolate it from the rest of medicine in a way that we don't do with any other drug. So, we have the tools to dramatically reduce the death toll for celebrities and for everybody else—we're just not using them.
- Drug companies make huge profits by flooding the market with overly powerful — and highly addictive — drugs.
- Some high profile deaths over the last several years have brought this problem to the headlines. It's everyone, not just middle America, who is getting hooked.
- Why do we let Big Pharma rule over? Journalist and author Maia Szalavitz investigates.
Unbroken Brain: A Revolutionary New Way of Understanding AddictionList Price: $18.00New From: $10.81 in StockUsed From: $10.94 in Stock
- Opioids: Things your doctor should tell you before prescribing ›
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What would happen if you tripled the US population? Join Matthew Yglesias and Charles Duhigg at 1pm ET on Monday, September 28.
New experiments find weird quantum activity in supercold gas.
Quantum Mechanics, Onions, and a Theory of Everything<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="036ae7b8dd661df2d125a3421a0299ba"><iframe type="lazy-iframe" data-runner-src="https://www.youtube.com/embed/bcVruA0AJ-o?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span>
Dominique Crenn, the only female chef in America with three Michelin stars, joins Big Think Live.
Having been exposed to mavericks in the French culinary world at a young age, three-star Michelin chef Dominique Crenn made it her mission to cook in a way that is not only delicious and elegant, but also expressive, memorable, and true to her experience.
Researchers say that moral self-licensing occurs "because good deeds make people feel secure in their moral self-regard."
Books about race and anti-racism have dominated bestseller lists in the past few months, bringing to prominence authors including Ibram Kendi, Ijeoma Oluo, Reni Eddo-Lodge, and Robin DiAngelo.
Astronomers spot an object heading into Earth orbit.
Minimoons<p>Scientists have confirmed just two prior minimoons. One was <a href="https://en.wikipedia.org/wiki/2006_RH120" target="_blank">2006 RH120</a>, which orbited us from September 2006 to June 2007. The other was <a href="https://en.wikipedia.org/wiki/2020_CD3" target="_blank">2020 CD3</a>, which got stuck in the 2015–2016 timeframe, and is believed to gotten away in May 2020.</p><p>2020 SO, the new kid on the block, is expected to arrive in October 2020 and pop out of orbit in May 2021.</p><div id="37962" class="rm-shortcode" data-rm-shortcode-id="f4c0fc8a2cba6536ea4cd960ebed3e6e"><blockquote class="twitter-tweet twitter-custom-tweet" data-twitter-tweet-id="1307729521869611008" data-partner="rebelmouse"><div style="margin:1em 0">Asteroid 2020 SO may get captured by Earth from Oct 2020 - May 2021. Current nominal trajectory shows shows capture… https://t.co/F5utxRvN6Z</div> — Tony Dunn (@Tony Dunn)<a href="https://twitter.com/tony873004/statuses/1307729521869611008">1600621989.0</a></blockquote></div>
Identifying 2020 SO<p>The first clue 2020 SO isn't your ordinary asteroid is its exceptionally low velocity. It's traveling much more slowly that a typical asteroid — their <a href="https://www.lpi.usra.edu/exploration/training/illustrations/craterMechanics/" target="_blank">average rate of travel</a> <a href="https://www.lpi.usra.edu/exploration/training/illustrations/craterMechanics/" target="_blank" rel="noopener noreferrer"></a>is 18 kilometers (58,000 feet) per second. Even <a href="https://en.wikipedia.org/wiki/Moon_rock" target="_blank">moon rocks</a> sent careening into Earth orbit by impacts on the lunar surface outpace pokey 2020 SO.</p><p>For another thing, 2020 SO has an orbital path very similar to Earth's, lasting about one Earth year. It's also just slightly less circular than our own orbit, from which it's barely tilted off-axis.</p><p>So, what is it? <a href="https://cneos.jpl.nasa.gov/ca/" target="_blank">NASA estimates</a> that the object has dimensions very reminiscent of a discarded Centaur rocket stage from the <a href="https://en.wikipedia.org/wiki/Surveyor_2" target="_blank" rel="noopener noreferrer">Surveyor 2 mission</a> that landed an unmanned craft on the moon. Back in the day, rocket stages were jettisoned as craft were aimed toward their desired position. This stuff, if released high enough, remains in space. It appears that this Centaur rocket, launched in September 1966, is now making its way back homeward, at least for a little bit.</p><p>When 2020 SO arrives at its closest point in December, the rocket is expected to be about 50,000 kilometers from Earth. Its next closest approach is much further: 220,000 kilometers, in February 2010.</p><img type="lazy-image" data-runner-src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yNDQzMDk3NC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYyODg1MTQ1MX0.HGknDwqp0GmeuczKY_AS7vrPG7KMFUc_XO95tNoI2xo/img.jpg?width=980" id="e5cda" class="rm-shortcode" data-rm-shortcode-id="85eb1f790d8c3ee5b261f7ba13eaa5e1" data-rm-shortcode-name="rebelmouse-image" alt="Centaur rocket stage" />
Centaur rocket stage
What we may be able to learn<p>Earthly space programs being as young as they are, scientists would love to know what's happened to our rocket during a half century in space.</p><p>While 2020 SO won't get close enough to drop into our atmosphere, its slow progress has scientists hopeful that they'll still get some kind of a decent look at it.</p><p>Spectroscopy may be able to reveal what the rocket's surface is like now — has any of its paint survived, for example? Of course, being out in space, it's likely to have been hit by lots of dust and micrometeorites, so the current state of its surfaces is also of interest. Experts are curious to know how reflective the rocket is at this point, valuable information that can help planners of future long-term missions anticipate how well a craft out in space for extended periods will remain able to reflect sunlight.</p>
Yet 80 percent of respondents want to reduce their risk of dementia.
- A new MDVIP/Ipsos survey found that only 35 percent of Americans know the symptoms of Alzheimer's disease.
- Eighty percent of respondents said they want to reduce their risks.
- An estimated 7.1 million Americans over the age of 65 will suffer from Alzheimer's by 2025.
Credit: logika600 / Shutterstock<p>Remaining healthy requires regular screenings. Here again we see a disassociation between risk reduction and proactivity. Seventy-seven percent of respondents don't talk to their doctors about lifestyle habits that support brain health; 51 percent have never been screened for depression; 44 percent have never had a neurological exam; and 32 percent have never been screened for hearing problems. </p><p>Common early warning signs of dementia, <a href="https://news.yahoo.com/americans-worry-alzheimers-disease-survey-140644803.html" target="_blank" rel="noopener noreferrer">according to</a> Dr. Jason Karlawish, co-director of the Penn Memory Center, include repetitive questions and stories, difficulties with complex daily tasks, and trouble with orientation. </p><p>In terms of intervention, <a href="https://bigthink.com/21st-century-spirituality/does-lack-of-exercise-lead-to-dementia" target="_self">exercise</a>, <a href="https://bigthink.com/surprising-science/obesity-dementia" target="_self">diet</a>, building a <a href="https://bigthink.com/mind-brain/brain-reserve" target="_self">brain reserve</a>, and challenging your brain (such as learning a new language or musical instrument) are all proven methods for staving off the ravages of Alzheimer's. Oxytocin has also <a href="https://bigthink.com/mind-brain/alzheimers-oxytocin" target="_self">showed promise</a> in brain-addled mice, while researchers found positive results for a <a href="https://bigthink.com/mind-brain/intermittent-fasting" target="_self">group of intermittent fasters</a> in promoting neurogenesis. </p><p>Epidemiologist Bryan James says that dementia is <a href="https://www.npr.org/sections/health-shots/2013/04/15/176920391/how-exercise-and-other-activities-beat-back-dementia" target="_blank">not an inevitable result</a> of aging. </p><p style="margin-left: 20px;">"It's simply not pre-destined for all human beings. Lots of people live into their 90s and even 100s with no symptoms of dementia." </p><p>Professor of neurology at Boston University School of Medicine, Andrew Budson, <a href="https://news.yahoo.com/americans-worry-alzheimers-disease-survey-140644803.html" target="_blank" rel="noopener noreferrer">recommends</a> aerobic exercise and the Mediterranean diet. As has long been known, whole grains, fruits and vegetables, fish and shellfish, and healthy fasts like nuts and olive oil seem to have brain-boosting properties. </p><p>To learn more, take the <a href="https://www.mdvip.com/brain-health-iq-quiz" target="_blank">Brain Health IQ quiz</a>.</p><p><span></span>--</p><p><em>Stay in touch with Derek on <a href="http://www.twitter.com/derekberes" target="_blank">Twitter</a>, <a href="https://www.facebook.com/DerekBeresdotcom" target="_blank">Facebook</a> and <a href="https://derekberes.substack.com/" target="_blank" rel="noopener noreferrer">Substack</a>. His next book is</em> "<em>Hero's Dose: The Case For Psychedelics in Ritual and Therapy."</em></p>