If “proven” MAT works, per expert consensus, to reduce high-risk opioid use, why is injection-related disease surging the more it’s provided? 

by Clark Miller

Published December 11, 2022

It’s been established that over years and decades of America’s increasingly lethal opioid crisis incidence of opioid injection related infectious disease, like endocarditis, has trended up as American Medicine’s “proven“, “gold standard” cure for high-risk opioid use has increased in availability and provision. 

New data, predictably, is consistent with those trends. We know why. More here about that. 

Young adults’ risk of dying from a devastating infection of the heart has doubled to tripled in the United States during the past two decades, a new study reports.

Researchers ascribe the increase in fatal heart infections to the growing number of people between 15 and 44 who are injecting opioid drugs.

“We found that people who inject drugs comprise a bigger percentage of the deaths from infective endocarditis, compared to 20 years ago,” said senior researcher Dr. Polydoros Kampaktsis, an assistant professor with Columbia University’s division of cardiology, in New York City.

It’s critical  to understand the importance of this type of evidence

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.

It’s established, as well, that the necessary, fabricated rationalizations that attributed to COVID pandemic stressors and effects the persistent, increasingly lethal opioid crisis are invalidated. More here about that. 

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.

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