UPDATE Opioid Crisis:

More Evidence that Buprenorphine and Methadone Opioid Substitution Treatment (OST) is Worsening Lethal Epidemics – Colorado

by Clark Miller

June 15, 2019

The medical model substitute opioid cure for the medically generated worsening lethal opioid crisis has failed, predictably. It was manufactured, branded and promoted on fabricated evidence for effectiveness just as generation of the crisis was, its failure not explained away by the emergence of fentanyl and constituting a fraudulent diversion of public healthcare funds away from longstanding evidence-based therapies for the non-medical condition of compulsive substance use.

shutterstock opioid pills in bottles cropped

The evidence, critically and competently examined, establishes that the medical “fix” provides no benefit for high-risk opioid use or overdose rates, instead worsening lethal epidemics, and the “evidence” for reduced OD deaths attributable to OST (MAT) used to market the “treatment” doesn’t hold up, never has, instead points to Naloxone as the effective factor in moderating OD deaths. Meanwhile diversion and abuse fueled by a runaway national “dose” of substitute addictive opioids – as in generation of the crisis – is integral to national high-risk opioid use economies – diversion and abuse of addictive opioids driving a street and prison economy; diversion and abuse of public healthcare funds driving a professional supplier economy constructed as “medical treatment”.

The new evidence from Colorado

is part of a consistent, invalidating, predictable pattern that disconfirms benefit attributable to OST. That expanding pattern is described in detail in multiple posts at A Critical Discourse for locales within and outside the U.S.

IN COLORADO

 

“The number of new admissions at highly regulated opioid treatment programs in Colorado increased from 1,388 in 2013 to 3,566 in fiscal year 2017. According to federal numbers cited by The Denver Post, there were more than 5,000 methadone patients across the state as of last week.”

By additional measures, provision of the medical substitute opioid “treatment” increased over that time frame – number of waivered (approved) prescribers of substitute opioids buprenorphine or methadone had been increasing, to 702 in 2017.

And the average daily census of opioid dependent patients treated with substitute opioids in Opioid Treatment Programs (OTP) was expanding rapidly

Over that same period of expanded provision of the medical substitute opioid “fix” for the medically generated opioid crisis, opioid-involved overdose deaths were also increasing, including for heroin as distinct from OD deaths attributed to fentanyl.

That is, as is consistently evidenced in other locales, emergency responders are saving lives, often repeatedly, by reversing opioid overdoses, accounting for all moderation in lethality trends, leaving none to attribute to OST, while the invalidated medical “treatment” continues to fuel street economies of high-risk opioid use.

The mounting, consistently invalidating pattern was predictable, all along, because there has never been credible evidence to support effectiveness for OST, instead all lines of evidence disconfirm effectiveness and point to increasing harm.

SAMSHA bupe client trends2

The more medical cure provided to the diseased brains, the more deaths mount.

Overdose deaths US trend The Guardian

And it’s a pattern – as we’ll see and despite efforts of popularizers of the failed medical OST “treatment” – that is not explained away by the known risks of fentanyl.

 

Recent post at A Critical Discourse:

Fentanyl is the New Purdue Pharma – A Necessary Distraction from the Forces Driving Worsening Lethal Epidemics