MORE EVIDENCE THAT BUPRENORPHINE AND METHADONE OPIOID SUBSTITUTION TREATMENT (OST) IS WORSENING LETHAL EPIDEMICS – MISSISSIPPI
by Clark Miller
Published June 19, 2019
Updated April 13, 2021
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.
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 Mississippi
is part of a consistent, invalidating, predictable pattern that disconfirms benefit attributable to OST. That expanding pattern is described in detail in multiple posts for locales within and outside the U.S.
And in Mississippi
That’s an overtly false headline,
because as in other communities, states, and nationally, opioid prescription rates have increased markedly – prescription of the substitute opioids, like Suboxone and methadone, that constitute opioid substitute treatment (OST) or medication assisted treatment (MAT) – those opioids predictably diverted, abused, and functioning as consumable and currency in street economies of illicit drug use.
“Opioid-related hospital stays and ER visits increased by 26.2% and 50.7%, respectively, from 2014 to 2017. Initiatives such as Stand Up, Mississippi seek to discourage those trends by focusing on education, prevention and treatment policies and partnerships around treating opioid addiction.”
A gain of 450 new waivered prescribers (= approved medical dispensers of substitute opioids including buprenorphine) over 2002 – 2019 almost certainly represents an expansion in access to and provision of OST (= opioid agonist treatment, OAT) in Mississippi.
That is, over that same period that the medical substitute opioid “fix” for the medically generated opioid crisis had been expanding, opioid-involved ED visits and hospital stays – measures of high-risk opioid use – continued to increase.
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.
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.