NEWLY FUNDED COVID/OPIOID CRISIS STUDY PROVIDES ITS CONCLUSIONS BEFORE RESEARCH STARTS
The $3.5 million grant will fund lies to protect invalidated fabrications linking pandemic stressors to surging opioid crisis harms – to hide from exposure evidence establishing medical practice as the real cause
by Clark Miller
Published November 20, 2022
If there’s any doubt about what that “How” in the headline means, it’s clarified –
A new $3.5 million grant will examine how the economic, social, and health care disruptions caused by COVID worsened the nation’s opioid epidemic. Co-led by University of Rochester economist Elaine Hill, Ph.D. and Meredith Adams, M.D. of Wake Forest University School of Medicine, the study will seek to determine how the response to the COVID pandemic impacted opioid use disorder in different communities and whether the progress made in recent years can be recovered.
The COVID pandemic ushered in a sharp reversal in the trend of opioid-related deaths, as the number jumped by more than 28 percent in the first year of the pandemic. In fact, the scope of opioid deaths during this period was likely an undercount, as Hill’s prior research has shown that the actual number of opioid deaths is probably significantly higher than reported figures.
So, it’s not only clear already, before any of that 3.5 million needs to be spent, that COVID pandemic associated changes per se – by their direct effects – caused worsened high-risk opioid use and associated illness, overdose and deaths, but also how that happened – by the effects on opioid users of “the economic, social, and health care disruptions caused by COVID”.
All that’s left is to use the research funds to select data and research that illustrates those conclusions.
That’s going to be a problem, as we’ll soon see.
But it’s important to understand, first, how profoundly, desperately important constructing that evidence base would be if it were possible.
That importance is directly tied to the fabricated “sharp reversal in the trend of opioid related deaths” ushered in by the pandemic, messaged in the release for the research project. There are, actually, two vitally important fabrications there. One is that pandemic increases in opioid OD deaths took the form of a “sharp” reversal “ushered in” causally by pandemic conditions – a supposition which would have required in order to support causality that increases be synchronous with stressors presumed to and required to explain causality, those stressors peaking in March and April as uncertainty generated anxiety along with disruptions due to quarantine orders, employment and income loss, associated stressors. What is apparent instead in the substantial body of evidence is that OD deaths did not significantly surge above historical trends generally until later – late April, May and June, when uncertainty, insecurity and associated stressors were being addressed and moderated, for example by unemployment benefits, measures to re-establish services, and other supports. The timing does not support causality. Not for the presumed stressors.
The second lie is the widely messaged fabricated consensus that any moderation or downturn over pre-pandemic months – roughly in 2018 to 2019 – of decades of a worsening, increasingly lethal opioid crisis could be attributed to gains made against high-risk opioid use by medical treatment (“medication assisted treatment”, MAT) and existing standard substance use treatment programming (“rehab”, “addiction treatment“) over that period. It’s established that, in fact, any such moderation was directly attributable to campaigns to increase distribution and use of the lethal OD reversing opioid antagonist naloxone (Narcan).
Direct evidence for that inconvenient truth has been provided in multiple (many) posts here, each providing data on trends in actual naloxone saves in various locales and nationally – establishing that those saves have been more than enough to directly account for any reduced mortality – leaving no reductions that can be attributed to MAT or other treatments. Of course, those increasing naloxone saves, each one representing an incidence of near-lethal (= high-risk) opioid use, represent a worsening crisis, not moderation. Exactly as if increasing trends in deaths by heart attack were moderated by increased distribution, accessibility and use of AEDs, a change that would not point to gains against prevalence of heart disease, instead the opposite.
It’s important to digress here to make this critical point clear –
The more deaths mount, the more pressure mounts to divert public healthcare resources to the unvalidated medical model provision of addictive, diverted and abused substitute opioids. Perversely, tragically, and criminally, it seems, because it has been established that provision of American Medicine’s fix for American Medicine’s opioid crisis predicts, rather than harm reduction or saved lives, worsening of increasingly lethal epidemics.
That’s established partly because trends in opioid-related overdose deaths are not a meaningful measure of effectiveness of OST (MAT).
For reasons discussed in this post and additional posts – each post with detailed explanation linking to primary research and other sources.
There is no body of evidence with results that control for the most likely of confounding explanations for any slowing of mortality – increased availability and use of the OD death-reversing drug naloxone.
On analysis of the evidence, naloxone use – its reduction of deaths acting and measured directly, unlike presumed benefit from OST – directly accounts for all apparent changes (= decreases) in opioid-related overdose deaths. This result holds when results are available on a local level (e.g. here, here, here, and here) and when national data are examined.
Attributing benefit to OST requires evidence of reduced high-risk use of opioids.
As described in detail in this, this, and other posts, that is the mechanism by which OST could possibly provide benefit.
When outcomes are critically analyzed, the evidence points consistently to provision of the medical model fix or “treatment” for problem opioid use worsening, not protective for, high-risk use and associated harms including opioid-related mortality. Because high-risk use, measured as non-lethal overdose incidence (eliminating the confounding, established effects of expanding naloxone use and campaigns) has increased nationally and consistently in multiple locales where data are available as dose of the medical cure increases.
As explained and established by multiple lines of evidence in this new post, emergence over past years of the potent opioid fentanyl in street economies of illicit opioid use does not qualify those invalidating results – fentanyl cannot explain away the failure of increased provision of the medical “treatment” to reduce high-risk opioid use
Another direct measure of high-risk use of opioids
is incidence of opioid injection-related infective disease, like endocarditis
Think about it – incidence of infective diseases caused by injection of opioids. That use of opioids is high-risk. If OST provides benefit to at-risk users, the mechanism is by reducing risk and associated problems related to opioid use.
Trends of decreased incidence of an injection-related infectious disease could be attributed to a variety of factors including: changes in public health, prevention, or medical interventions; decrease in high-risk opioid use including use by injection; clean needle exchanges; behavioral health treatments; others. Identifying the factor(s) any decreases could be confidently attributed to would require that multiple congruent, well-designed studies and other lines of evidence point to those factors and not others.
Increases in incidence, like those we’re seeing, are different. If increases of significant magnitude occur over the same time period that an intervention, like the medical OST fix, hypothesized to be a “treatment” or protective factor has also increased, then that constitutes strong evidence against that intervention as beneficial in reducing high-risk use.
As we would predict from everything we know about problem substance use and the failure of medical approaches to provide benefit for that non-medical problem, those diseases are increasing in prevalence.
Those are the lies that desperately have needed and still need to be constructed: that at a cost of $billions in public healthcare funds and decades into the increasingly lethal, iatrogenic opioid crisis, American Medicine’s “fix“, its “gold standard”, “proven” “anti-addiciton drugs” were providing some benefit, benefit that unfortunately was undone by COVID pandemic stressors. That’s the necessary lie, and any alternative would be impossible, unacceptable, would be . . . would have to be buried, covered by the types of fabrications, lies that America’s Medical/Media collusion is already practiced at – like those used to enable the runaway provision by prescription of opioids for the non-medical condition of common chronic pain, creating the opioid crisis.
That necessity, against all evidence and reason, has required confabulation and flights of fiction by American media, medicine, expert class, and social media popularizers with telling outcomes. For example, emergence of the Woke meme that explains the failure of America’s gold standard, proven medical and addiction treatment services to even slow mounting opioid deaths over decades by attracting, retaining and providing benefit to high-risk opioid users by the deterring effects of those users feeling stigmatized by language, for example, being referred to as an “opioid user” or drug user instead of “person with opioid use disorder” (POUD) or in an “opioid substitute treatment” program rather than “medication for opioid use disorder” MOUD.
It’s always important to avoid stigmatizing and demeaning language, and important to avoid constructing bogus rationalizations for lethal, failed treatment systems fueling drug use epidemics. At the same time this particular stigmatization rationalization was emerging, a mass and social media consensus emerged to explain continued and surging opioid crisis high-risk use and deaths over pandemic years as attributable to the tragic loss of access to in-person meetings of the religious subcultures AA and NA. Subcultures where those Persons with a Substance Use Disorder would have been: required to repeatedly utter, “I am an addict”; required to focus on their shameful harm to others and their defects of character rather than strengths and skills; and encouraged and socially reinforced at those meetings in shared use of arguably the most lethal and addictive substance known – also an established gateway back to alcohol and opioid use – nicotine by cigarette smoking. That is, If only access to the beneficial treatment value of religious subculture meetings had not been disrupted, high risk opioid use and associated harms would have continued to be moderated by our effective medical treatments.
That consensus failed to provide explanation for the glaring contradiction of decades of a surging, lethal opioid crisis – along with alcohol, methamphetamine, other substances – while those subculture meetings were available in every sizable community in the country, every day, multiple meetings each day, for that critically important support and benefit. Or explanation for lack of any moderating effects now a year into return to unlimited access to the subculture meetings.
That is to say, America’s expert/media/apologist class tied itself up in knots with desperate, inane rationalizations in the face of deaths mounting the more their treatments are provided.
The funded lies are predictable because they are necessary to protect multi-billion dollar budgets and grants to systems of power and control of public healthcare funds that pay for social and professional positions of status, authority, and dominance – comprising cultural capital to ensure messaging of the fabrications needed to perpetuate the constructed status and control.
Predictable as necessary because from the beginning – exactly as in the fabrications generating the crisis – there has never been an evidence base to support benefit from medical or medication treatments for problem opioid use or any substance use problem. Instead, medical approaches for treating the non-medical problem of compulsive substance use were predicted to fail from the onset.
That’s how it works. Lethal lies, raging lethal epidemics, more lies for coverup, crafted by highly regarded experts, rewarded apologists, and other useful idiots.
COVID pandemic was a natural experiment
One of multiple, independent invalidations of the necessary fabrications is a natural experiment. COVID pandemic restrictions and social effects that were presumed to be causally linked to pandemic surges in high-risk opioid use, overdose, and deaths have dissipated, beginning nearly a year ago. And predictably – because it is established that medical approach (MAT) and traditional substance use treatments not just fail but fuel and worsen problem opioid use – with those factors removed America’s opioid crisis continues to worsen. That’s established now. Somebody could save their $3.5 million.
It was all predictable.
Partly because the rationalizations – fabricated by consensus, mass messaging, and groupthink – never made sense, not from the beginning – explained here. And here, for example, for the “social isolation effect”.
Treatment access effects? Imposed by pandemic conditions? More necessary lies. As America’s medical treatment experts assure us, their substitute opioid proven cure is, as a standalone treatment, effective in drastically cutting opioid deaths.
Right. Except . . . 1) there’s never been evidence for that (it was naloxone), 2) those medical cures increased in availability and use over pandemic years while deaths surged instead of decreased, and 3) now post-pandemic, with presumed pandemic stressors dissipated, and with MAT opioid provision increasing – high-risk use and deaths continue to surge. Fabrication-invalidating points 2 and 3 are established for Delaware, for St. Louis, also for Maine, and in W. Virginia where injection-related HIV is increasing too.
That “natural experiment” over the past year has independently invalidated – exposed the lie of – fabricated cover stories for America’s persistently surging, increasingly lethal opioid epidemic after the fictional pandemic causal factors have been factored out.
Independently definitive are the results (linked to above) from locales like Delaware, W. Virginia, Maine and St. Louis where in each case deaths have surged with increased provision of American’s expert consensus gold standard opioid crisis cure. While pandemic effects dissipated.
Additional posts tie increased provision of American Medicine’s substitute opioid (MAT) cures to lethal economies of prescription and illicit opioid use, in detail here –
Upcoming posts will add new evidence and detail:
NO EVIDENCE FOR PANDEMIC OPIOID CRISIS EFFECTS DUE TO LACK OF ACCESS TO TREATMENT
Predictably, overdose and deaths remained within historical trends or decreased over first pandemic months likely due to protective, reduced exposure to established harms of American “gold standard” treatments
THE DEMONSTABLE LIE OF COVID TREATMENT SCARCITY DRIVING A CONTINUOUSLY WORSENING LETHAL OPIOID CRISIS
American “gold standard” treatments for problem opioid use – Suboxone and the prescriptions of the religious subcultures AA and NA – have over decades of increasingly lethal epidemic continuously been in unlimited supply in communities and on the street
COVID TIMELINE CONGRUENT WITH ESTABLISHED HARMS OF MEDICAL OPIOID “TREATMENT” DRIVING OVERDOSE AND DEATHS, NOT WITH STRESS
Overdoses and deaths did not surge at time of peak mental and emotional stress instead months later, after the diverted, abused medically dispensed opioids established as fueling the crisis were dispensed more recklessly
More to come.