EPIDEMIC AND LETHAL CURE – PREDICTED OUTCOMES CONFIRMED: NO EVIDENCE FOR SOCIAL ISOLATION EFFECTS IN PANDEMIC OPIOID OD DEATHS

Also as predicted: the fabricated social isolation effect – necessary and never subjected to critical thought – became manufactured Truth without evidence

by Clark Miller

Published May 17, 2022

There is an Opioid Paradox, tied to relentlessly mounting opioid deaths over COVID pandemic conditions. But not the one you’ve heard about, read about, been mass messaged. That “opioid paradox” – asserting as an inscrutable mystery that opioid deaths would continue to increase while amounts of medically prescribed opioids have decreased over past years – turns out to be an artefact and exposure of one of many necessary fabrications. Necessary to attempt to hide and distract attention from what is increasingly clear, from all lines of relevant evidence: that opioid deaths have continued to mount, predictably, as fueled by the established lethal effects of failed systems of care and treatment approaches, including medication assisted treatment, MAT. 

The real Opioid Paradox is not paradox, but complex deception with clear and established, yet inconvenient and hidden explanations for a question. Why have opioid related deaths continued to climb over months, now years, of pandemic conditions despite protective factors as part of those conditions, the predicted protective effects for problem opioid users of reduced exposure  to established risk factors: current, “gold standard” substance use “treatments” that predict no benefit and participation in the associated religious subculture that is established as predicting return to problem substance use at a failure rate of 85 to 95 percent

One of the fabrications necessary for the distraction and never supported by evidence is the Social Isolation Effect. Let’s take a look. 

The assurances, forming a consensus that Goes Without Saying –

are that it’s been pandemic-forced social isolation, the physical social distancing causing isolation, that has generated acceleration of overdoses and deaths that would otherwise have been prevented. 

Right. Did that ever make sense?

On the street, in the camps, in the parks, sitting, huddling, using opioids 6 feet away from others instead of 4 feet, or 3 feet away? That created significant changes in risk of not being observed as in trouble and responded to when needed? 2 or 3 feet?

What about users who are not homeless, that is they have a home, apartment, a room with a bed somewhere. Pre- and during pandemic, their behavior and location for using would change? If users were pre-pandemic in social work settings or at treatment centers, is that when and where they would administer opioids in ways that placed them at risk of overdose? Such that whereas pre-pandemic, significantly higher numbers of overdoses could be responded to because users were using in risky ways in those settings – in the office cubicle next to yours, at the treatment center – instead of other settings where they could use without risk of detection or jeopardizing work or program status? Instead of the same settings they would continue to use in during pandemic stay-in-place restrictions? That makes sense?

Fortunately, there is objective evidence allowing evaluation of these unsupported claims that by repetition and group think became “truth”, became consensus precisely by virtue of their necessity as distractions.

Like this observation serving as objective evidence,

based on data from a regional public health service, chief coroner’s office, and forensic pathology service contributing to the report that examined opioid deaths in 2019 and 2020. Between March 2020 and December of 2019 opioid deaths surged, increasing by about a thousand, compared to the same time period in 2019 — an increase of just over 75 per cent. And, based on the report, “about three-quarters of people die of opioid overdoses alone — a statistic that has not changed during the pandemic”.

“a statistic that has not changed during the pandemic”

 

“It’s alarming because these increases in overdose deaths are continuing unabated,” said Tara Gomes, a co-author of the report. “Historically we haven’t seen an urgency of action by governments to address this, but we need that.”

. . .

Gomes said about three-quarters of people die of opioid overdoses alone — a statistic that has not changed during the pandemic.

Again, from the report, comparing pre-pandemic with pandemic periods, no difference in the proportion of persons dying alone

There were also no differences comparing pre-pandemic period with pandemic in opioid OD deaths occurring in private spaces including private residence (a statistically significant decrease during pandemic period); motel, hotel or inn; shelter/supported living; or rooming house. In contrast, more lethal opioid overdoses occurred outdoors during pandemic compared to pre-pandemic.  

The same disconfirmation of social isolation

tied to increased OD deaths is evidenced in this study, published late last year in JAMA. 

But first, here’s how it was spun by media reporting on it. 

The important trends to note from these data were the increasing percentage of nonwhite and older decedents as well as the ever increasing presence of fentanyl in overdose deaths, the investigators wrote.

Turns out the important trends, actually,

are entirely different from those and are here in the report’s only Table – 

Here’s what data in this table tells us

This is a study of correlates of opioid overdose deaths, pre- and during COVID pandemic periods, in Illinois. 

Take some time to look at and think about the information in the table. 

Note that comparing pandemic period to outside of pandemic period: there were no differences in:

Own home overdose

Bystander present

Type of relationship of bystander

Bystander was defined as: 

“Bystander: A bystander is an individual who was physically nearby either during or shortly preceding a drug overdose who potentially had an opportunity to intervene and respond to the overdose. First responders or medical professionals called to the scene are not considered bystanders. Because a bystander must be an individual with an opportunity to intervene, a cutoff at the minimum age of 11 years old is used.”

That is – there were no differences comparing pandemic to pre-pandemic periods to support the consensus, the universally accepted truth, that social isolation or any form of social disconnection contributed to the surge in opioid overdose deaths that continues through pandemic years and as pandemic related restrictions have been moderated. 

Despite the best efforts of America’s Media/Medical collusion to create  – fabricate – a COVID pandemic-social isolation-overdose death connection, research-generated evidence for the general population has not been cooperative. 

As reported in this piece from NPR – 

When the pandemic hit, mental health professionals predicted lockdowns and social distancing would result in a wave of loneliness. But researchers who study loneliness say that hasn’t happened.

. . .

ANGELINA SUTIN: There was a lot of fear early on because we are social animals, and we want to be around other people. We want to be together.

SILBERNER: But when they checked back with the survey participants in late March and late April, when many were under lockdown, they were surprised.

SUTIN: The thing that everybody thought was going to happen didn’t happen.

SILBERNER: While some people did report being lonelier, others reported being less lonely. And there was no overall increase in loneliness. They published their results in the journal American Psychologist and repeated the survey in July – again, no jump in loneliness. Sutin says it looks to her like the efforts people made to stay connected – dance parties at a distance, Zoom charts, singing from balconies and porches – made a difference. A new survey from the University of Michigan did find feelings of isolation among people 50 to 80 years old. But other researchers looking into loneliness during the pandemic are not seeing an increase.

JONATHAN KANTER: Our topline result is that we didn’t see this massive wave of loneliness that was predicted.

SILBERNER: That’s University of Washington psychologist Jonathan Kanter. He and his team have been surveying people in Seattle and around the country, and a government survey in the United Kingdom and a national survey by the University of Southern California are also failing to find a loneliness pandemic. But there’s something unusual going on here. Depression and anxiety are definitely increasing. Many studies have confirmed that, and those mood disorders have long been linked to loneliness. Sandro Galea is dean of the School of Public Health at Boston University. He found Sutin’s surveys to be well done but perplexing. He says there could be a lot that this pandemic can teach us about the link between loneliness, depression and anxiety.

SANDRO GALEA: The relationship between social isolation, physical distancing, loneliness, how that mediates or does not mediate a relationship with depression or anxiety. I think that’s a really interesting set of questions and one from which we can learn quite a bit.

SILBERNER: The role of the digital world in mitigating loneliness may be worth exploring, he says. Meanwhile, back in San Francisco, Dana Amarisa and her mom plan to continue with their dance parties…

 

But that’s the general population. Surely things have been different for problem opioid users, we can be sure of that because it Goes Without Saying, is mass-messaged in corporate/mass/social media as Truth, captured by the dictum that, 

“Addiction is a disease of isolation”

Here, for example – 

It’s especially scary because “addiction is a disease of isolation,” as RASE Project’s Director of Residential Services Chrystal McCorkel said.

“Do I think that there has been a lot of changes, absolutely. Do I think that I have seen a higher increase in relapse, yes. Do I believe it’s because of isolation and it’s because of routines that are off track and everything like that, absolutely,” McCorkel said.

Who could doubt it? 

And yet, . . . it’s just that there’s the evidence. From the same report – 

In recovery homes, relapses aren’t expected but they happen.

“Generally speaking, one or two a month is about right,” said Mark Weitkamp, owner of The Last Resort Recovery Homes in York. “I mean unfortunately first of all we’re dealing with human beings, right, and that’s unpredictable enough, but when you’re dealing with sick human beings, that just compounds the problems.”

Weitkamp said he has not seen an increase in relapses at his recovery homes, but others in the region did see a slight increase with virus restrictions.

The RASE Project, which has three recovery homes in Carlisle, Harrisburg and Lancaster, had three relapses and one overdose death.

“It was when the structures were taken away so it’s when their routines, their jobs, were taken away, their sense of purpose. And I think especially early on, that’s really important to have a sense of purpose, because it just seems like every minute lasts an hour, every hour seems like eternity and you really feel like you’re gonna feel like that forever,” McCorkel said.

Hmm . . . well now it’s getting more complicated and a bit confusing. Is it the isolation, or the “structures”, or employment and income, or something entirely different explaining any increase in OD deaths in recovery homes? Or were there real increases? Once these halfway house professionals complete their clinical interviews of their clients, organize and analyze the data, and publish it, we’ll have the solid evidence supporting the mass-messaged Truths that “addiction is a disease of isolation” and  isolation accounts for pandemic surges in opioid OD deaths. 

Won’t we?

While there was much instability in the beginning of the pandemic, recovery home members seem to be doing better and adjusting to the “new normal.”

“I think that they’re all like adjusting pretty well at this point. I also think they think it’s going to be over soon so like, there’s that hope,” McCorkel said.

And while outside interactions are limited, recovery home owners say that many members are getting closer and connecting in this shared experience.

“These homes have gotten a lot tighter, like these guys are working together, and they’ve gotten to know each other better. Before this, everybody was going in different directions, off to their separate jobs and off with their sponsors or whatever was going on in their lives, going on their overnight visits, and so everybody was just kind of doing their own thing,” Hess said.

But . . . the isolation? The overdoses? 

In Missouri: But the American Medical Association says so – 

The American Medical Association said that 30 states reported an uptick in opioid-related fatalities. The AMA had Missouri as one of the states reporting an uptick in that category.

That may not have been the case here in St. Joseph according to the the Family Guidance Center.

. . . 

“We have not seen anymore or any less in opioid misuse than what we were used to seeing before the COVID-19 pandemic,” Kristina Hannon, co-CEO of the Family Guidance Center, said.

That does not mean that the area did not see an increase in substance abuse though during the months of the lockdown. In fact there was a spike people misusing other substances.

And from reports for St. Louis, Missouri – 

Swoop, 43, says he’s been homeless for about nineteen months, and that he uses heroin to self-medicate for chronic depression.

“The depression makes you want to get high,” he says. “You have no job. Nobody wants to give you a job because of your appearance and what you’re doing.”

Occasionally, Swoop earns money from odd jobs in the neighborhood. But when he gets home, it’s still the same story, he says.

“We still sitting around,” he says. “We get to come back to an abandoned building. We look around, and it’s depressing as soon as you walk in the door. So the first thing we do, we got money in our pockets, we get high.”

. . .

Hoffman, himself a recovering opiate user, says he wants to bring more resources to north St. Louis residents struggling with drug dependance and homelessness. Which is why he takes the MoNetwork van to the spots around St. Louis where he knows they’re likely to find unhoused people.

About the time he went into recovery a couple years ago, Hoffman says, the market for illegal opiates went from prescription painkillers to much more powerful opiates, such as heroin and fentanyl.

“Things have kind of changed … the supply had changed, and the drugs had changed, but the people hadn’t,” Hoffman says. “And being able to give people the supplies they need, like Naloxone, to reverse overdoses for their friends and loved ones, to keep people safe and to keep people out of hospitals and to keep people informed, is something I’m really passionate about.”

. . .

Another new consequence of isolating in place is the fact that more drug overdoses are occurring at home, and concerned family members are now more likely to seek help for loved ones with a suspected drug problem, Costerison says.

“Because it used to be, people were able to hide their use by using with a friend,” he explains. “But now that they are quarantined at home and in more contact with family, people are starting to see these things that are odd or coming across as concerning a lot more commonly. Family and friends are starting to see, ‘Oh, this person might have a problem with substance abuse.'”

Those reports and others like them – anecdotal of course and not definitive or generalizable – again point to lack of evidence for social isolation effects. 

To summarize so far, 

The necessary fabrication attributing increasing pandemic period opioid overdose deaths to types of isolation due to restrictions that would result in decreased emergency and naloxone revival responses became universal Truth, as needed, without objective evidence and in defiance of critical thought. 

Emerging objective evidence disconfirms the fabrication, as do on-the-ground accounts over the period. 

first responder holding naloxone

There’s another large, existing body of objective evidence –

Consider calls to emergency responders for apparent overdose, with response and administration of naloxone for revival. Think about it just a minute. How frequently are those calls for help made by the opioid user herself or himself in distress – with loss of alertness and attentiveness sufficient to require an EMR overdose response – almost never of course.

Made by others, others nearby enough to perceive a user is in need of emergency response. If social isolation is a  explanation for the surge in OD overdose deaths, that would be reflected in a temporal stalling of prevalence of calls to emergency response for apparent overdose, or a decrease, and corresponding closely in time to onset of pandemic social and physical restrictions. Certainly not an increase in numbers of calls for emergency response, representing increases in social detection of opioid users in distress and invalidating the necessary fabrication of social isolation as explanatory.

What do you think that has looked like pre- and during pandemic conditions? There’s plenty of data out there. It’s been available for months and longer.

Here’s one example, from a report from Florida, where opioid overdose calls were “up 40% during COVID-19 pandemic”. 

Here’s another, from Vancouver, B.C. – 

There are many more reports like those. And they are consistent. 

 

More to come. 

Why A Critical Discourse?

Because an uncontrolled epidemic of desperate and deadly use of pain-numbing opioid drugs is just the most visible of America’s lethal crises of drug misuse, suicide, depression, of obesity and sickness, of social illness. Because the matrix of health experts and institutions constructed and identified by mass media as trusted authorities – publicly funded and entrusted to protect public health – instead collude to fabricate false assurances like those that created an opioid crisis, while promising medical cures that never come and can never come, while epidemics worsen. Because the “journalists” responsible for protecting public well-being have failed to fight for truth, traded that duty away for their careers, their abdication and cowardice rewarded daily in corporate news offices, attempts to expose that failure and their fabrications punished.

Open, critical examination, exposure, and deconstruction of their lethal matrix of fabrications is a matter of survival, is cure for mass illness and crisis, demands of us a critical discourse.

Crisis is a necessary condition for a questioning of doxa, but is not in itself a sufficient condition for the production of a critical discourse.

Pierre Bourdieu - Outline of a Theory of Practice 1972

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