Thursday, August 29, 2013

"Even if it is not very solid data...

"... we can say definitely that there are drug problems in most parts of the world," said Theo Vos, of the Institute for Health Metrics and Evaluation at the University of Washington, the study's senior author."
LONDON (AP) — Marijuana is the most popular illegal drug used worldwide, but addictions to popular painkillers like Vicodin, Oxycontin and codeine kill the most people, according to the first-ever global survey of illicit drug abuse.
In addition to cannabis and opioid painkillers, scientists analyzed abuse of cocaine and amphetamines in 2010, largely based on previous studies. Ecstasy and hallucinogens weren't included, because there weren't enough data. The researchers found that for all the drugs studied, men in their 20s had the highest rates of abuse. The worst-hit countries were Australia, Britain, Russia and the U.S. The study was published online Thursday in the journal, Lancet.
But there were few concrete numbers to rely on and researchers used modeling techniques to come up with their estimates.
Global burden of disease attributable to illicit drug use and dependence: findings from the Global Burden of Disease Study 2010

Background:
No systematic attempts have been made to estimate the global and regional prevalence of amphetamine, cannabis, cocaine, and opioid dependence, and quantify their burden. We aimed to assess the prevalence and burden of drug dependence, as measured in years of life lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life years (DALYs).
Skipping all the way down...

Funding:
Australian National Health and Medical Research Council, Australian Government Department of Health and Ageing, Bill & Melinda Gates Foundation.

31 comments:

rcocean said...

Yeah illegal drugs can be a killer.

Just ask Len Bias.

XRay said...

Bill and Melinda Gates are doing some smart projects. Their philanthropy of a more certain, concrete, and useful nature versus, I guess, the founding of libraries, art museums and the overthrow of American institutions such as practiced by other foundations, Rockefeller, Ford, etc.

The Dude said...

Yeah, cocaine can be a bit toxic when your first bump is an ounce.

ricpic said...

And the point is what? that millions of people need an out from reality? Cavalry gubmint to the rescue!

deborah said...

This is your brain. This is your brain on tags.

edutcher said...

Sorry about that, but anything with Bill Gates' name on it draws a lot of skepticism from me.

deborah, make sure we have some throw pillows scattered cause nd is gonna keel over when he reads this.

Palladian said...

We're born to escape this world, one way or another.

yashu said...

I can't & won't speak for nd, but I don't think there's anything here that would surprise him (or that surprises me).

What's the news here? That drug use is rampant throughout the world, regardless of drugs' legality or illegality. That, as a matter of fact, addictions to "legal" drugs-- painkillers like Vicodin & Oxycontin-- kill the most people. Marijuana is "the most popular illegal drug used worldwide," yet (objectively) among the most harmless.

None of the data reported here, by itself, supports prohibition or legalization of drugs.

virgil xenophon said...

Well, "Caribbean Girl" :) have you seen the latest report the neo-prohibitionists over at the CDC have put out about alcohol? Don't be too sanguine about anything like something minor like indeterminate data keeping ideologically driven bureaucratic zealots from acting.

ndspinelli said...

RX painkiller abuse in the US has been epidemic for @ least 2 decades. From 1991 to 2010 the number or RX prescriptions painkillers in the US tripled. We make up less than 5% of the world's population but we consume 80% of the RX painkillers worldwide. Here's a stat that might surprise you, maybe not. The most @ risk demographic for OD on RX painkillers is 45-54, w/ women being a higher risk for OD in all demographics. Historically, women are generally pill poppers, men are smokers, snorters and shooters. The companies that manufacture RX painkillers are one of the biggest money lobbyists for keeping cannabis a Schedule 1 illegal drug. Hmmmm?

The Gates foundation does a lot of work that I support. They are leading the fight to take back our schools, supporting charter schools and accountability. The unions hate him so you know he's doing right! They also spend a lot of money on eradicating malaria, polio, etc. I don't like Gates. But, I support what he's doing w/ his Foundation.

ndspinelli said...

yashu, Correct, no surprises.

ndspinelli said...

Palladian, Archeologists have found paintings and sketches from cave dwellers 40,000 years ago showing they used hallucinogenic plants/mushrooms in their spiritual rituals.

yashu said...

Heh, virgil, I'd never underestimate the ability of ideologically driven bureaucratic zealots to find justification in the flimsiest of pretexts.

yashu said...

PS I haven't seen or heard about the CDC report on alcohol; I'll look it up.

Joe Biden, America's Putin said...

Speaking of warped minds - MSNBC - The hack network.

Palladian said...

Palladian, Archeologists have found paintings and sketches from cave dwellers 40,000 years ago showing they used hallucinogenic plants/mushrooms in their spiritual rituals.

I'm not surprised. I used to be staunchly anti-drug, because I saw how drugs destroyed my family.

But then I realized that that is like blaming guns for gun violence.

And I also realized that I wouldn't be here if not for the transformative, transportive power of one drug or another.

Palladian said...

Don't be too sanguine about anything like something minor like indeterminate data keeping ideologically driven bureaucratic zealots from acting.

The most addictive and lethal drug is power. Unfortunately the overdose usually kills the rest of us rather than the user.

Michael Haz said...

One of my neighbors is a rather quiet guy. Pleasant, friendly, but quiet-ish. He's a MD PhD.

I didn't know what he did until at a neighborhood party one guy prattled on about how drugs should be legalized. Then the quiet neighbor gave us 15 minutes of utterly brilliant discourse about what happens to the human brain when illegal drugs or legal opiates are ingested.

He's a researcher at Medical College of Wisconsin and has spent 20+ years working on the problem of why a brain becomes addicted. It was frightening. Ruined brains, failed synapses, necessary chemicals and compounds that the brain simply stopped making.

It was quiet as he finished. Then he said to the guy who wanted legalization: "But I could be wrong and you could be wrong, so let's do our own research using your kids. I'll write prescriptions for medical marijuana, hydrocodone and oxycontin for you, and you give a handful of pills and a bag of weed to your teenagers every morning. If you're right, nothing bad happens. If I'm right, your kids die. You in?"

There was an uncomfortable silence for a moment until someone else said something about the Packers.

yashu said...

have you seen the latest report the neo-prohibitionists over at the CDC have put out about alcohol?

If Bloomberg can ban large sodas, then this would certainly give another Bloomberg grounds to prohibit restaurants and bars from serving more than a certain amount of alcohol to a single individual. For example.

Especially once Obamacare kicks in. Then your health is, literally, their (the government's) business.

Palladian said...

Then the quiet neighbor gave us 15 minutes of utterly brilliant discourse about what happens to the human brain when illegal drugs or legal opiates are ingested.

It doesn't matter. I do not trust the government to make such decisions for me, nor do I trust them with the power to presume to make such decisions for me.

But the presumption of such power, the usurpation of the power to make such decisions for me, has already happened. It's irreversible.

ndspinelli said...

Haz, Interesting the doc didn't mention the deadliest of all drugs, alcohol.

Anonymous said...

Then the quiet neighbor gave us 15 minutes of utterly brilliant discourse about what happens to the human brain when illegal drugs or legal opiates are ingested.

Ho-hum. Sounds like a smart guy buying the pot by flashing a lot of knowledge.

That discussion, if honest, goes right to long, detailed discussions about specific drugs, specific dosages, and specific damages balanced against all sorts of social, political, and personal issues.

Time alone is damaging the brain everyday too, if you don't know, and you will die eventually whether you take drugs or not.

It's all trade-offs. Treating all drugs and drug usage as if they were equal is dishonest.

Anonymous said...

yashu: From the pizza discussion, I gather you are in the Bay Area somewhere. If so, would you like to meet? I'm in SF near Twin Peaks.

rcocean said...

Everyone knows Cocaine, Heroin, Crack, Morphine, Meth, are dangerous unhealthy drugs, and very addictive. And everyone knows there are supermen out there, who can take them and NOT get addicted and know when to quit, and how much to take.

All hail the Drug Supermen!

So what about the other 90% of drug users. I'd love to say, let evolution take its course and lets weed out all loser druggies. However, we have a welfare state and we pay for druggies who can't work and get sick.

So you find a way for me - and people like me - to get out paying for your druggie loser behavior and I'll support legalization.

Anonymous said...

"But I could be wrong and you could be wrong, so let's do our own research using your kids. I'll write prescriptions for medical marijuana, hydrocodone and oxycontin for you, and you give a handful of pills and a bag of weed to your teenagers every morning. If you're right, nothing bad happens. If I'm right, your kids die. You in?"

This is such a bad strawman argument I have to quote it again. Not even advocates of legalizing all drugs want to give kids an assortment of uppers, downers, painkillers, and weed every morning. Just as no one in favor or repealing prohibition wanted to start children off with a couple of vodka martinis first thing in the morning.

I'm not in favor of legalizing all drugs. Not at all. On the other hand I would note that just about all drugs are legal in some circumstances and illegal in others. Any real drug policy will look like that.

What's involved are all the specific discussions about which drugs and which circumstances and what damages balanced against various social and personal concerns.

I am in favor of honest, realistic, non-polemical discussion about drugs.

yashu said...

Hi creeley! That was home base for a while, but I'm not there right now. Likely to move back eventually, or in any case stop by, since half my stuff's in storage there-- and my heart's still there :). If/ when I do, may drop you a line. Your livejournal email works, yes?

Michael Haz said...

Okay, I'll be non-polemical. Let's look at the research.

"Although a person might have a positive reaction to an opiate, addiction usually doesn't happen the first time they use a drug. Opiates are considered extremely addictive and this addiction can affect the structure and function of the brain. Opiates can alter the brain and affect one's motivation and emotions. The brain changes over time and hence a person's behavior changes. Moreover, if one uses a high enough dose of drugs, frequently enough, and over a long period of time, the drugs can change the way the brain works. The way in which the nerve cells communicate are changed so a compulsive, out of control use develops despite experiencing some of the many side effects. More specific effects of opiates on the brain include changes in the synapses and shapes of brain cells. Chronic use is linked with structural changes in the size and shape of specific neurons. That is to say that there is a difference noticed in the brain between a chronic opiate user and an occasional user."

Anonymous said...

yashu: My LiveJournal email does not work. That's a premium feature for paying customers. Somehow I am loathe to give my credit card info to a web service based in Russia.

But I can activate a free two-week trial at any time. So drop me a message here and I'll activate it.

In the meantime I'll think about a better way to handle this, given my preference for privacy.

Anonymous said...

Michael Haz: First off, that's not research. That's a vague layman's explanation.

The full cite for the quote is apparently from Jennifer Hagaman (link here), who is not a doctor, cites no research and only offers bare links to PBS, the DEA and the Society for Neuroscience.

I don't doubt that "Moreover, if one uses a high enough dose of drugs, frequently enough, and over a long period of time, the drugs can change the way the brain works." But what exactly does that mean?

How much is "frequently enough" and how long is "a long period of time"? These details matter. If the answers are "every day" and "for sixty years" we can pretty much not worry about opioid effects on the brain.

Perhaps more to the point, how do the brain changes caused by opiates compare with those caused by alcohol?

Ask your MD/PhD neighbor whether the repeal of prohibition was based on a collective decision that alcohol really wasn't neurotoxic.

No, it was not. Prohibition was repealed in spite of alcohol's unquestioned toxic properties because people balanced that damage against the ability of the majority to use alcohol pleasurably and responsibly (though even then alcohol still kills brain cells) and the disruption caused by making alcohol the province of organized crime.

One word: trade-offs.

Michael Haz said...

Creeley - We're not going to agree on illegal drug use. Good luck and God bless.

Anonymous said...

Michael Haz: No, we are not going to agree 100% on illegal drug use. But then we are probably not going to agree 100% on anything.

You might be surprised at how much we do agree upon, but you seem to insist on 100% or nothing.

My overall point, though, is that 100% black/white thinking is not useful in most human realms, whatever the issue and especially about drugs. It all comes down to specifics and trade-offs.