UPDATE Opioid Crisis:

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

by Clark Miller

August 21, 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 Wisconsin

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 Wisconsin

 

“Hospital emergency room visits for opioid-related overdoses in Wisconsin increased from 2014 to 2018 by 64%.”

Over the same period opioid-related overdose deaths climbed steadily including those attributed to heroin.

As in other locales consistently, over that same period of increasing high-risk use of opioids with associated mortality and other costs, medical provision of the “gold standard” medical “treatment” for high-risk opioid risk was significantly increasing.

“Statewide, 10,626 patients were treated at the 18 methadone clinics in operation last year, up from 6,319 in 2013.”

Figures in the table represent medical provision of both methadone and buprenorphine.

For the most recent recording period – 2018 compared to 2017 – opioid related OD deaths decreased by about 10 percent. As in other locales consistently, any apparent moderation in increasing trend of opioid-induced OD deaths can be attributed to the directly acting and observed life-saving effects of increasing distribution and use of naloxone (Narcan).

Increased emergency use of the overdose death preventing antagonist naloxone, of course, represents continuation or worsening of prevalence of high-risk opioid use and worsening of the iatrogenic and lethal opioid crisis.

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 gold standard medical treatment 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 posts at A Critical Discourse:

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

And

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