How the opioid crackdown is backfiring

[moriah]

49. I don't know, truthfully.

I had the questionable benefit of having a dire warning very close to home (if you can't have a shining example...), combined with the unquestionable benefits from early talks with other children of alcoholics and addicts in rooms where you went by your first name and shared your experience, strength, and hope. I had enough education to know the "escape" from emotional pain substances bring is temporary, and often isn't even an escape at all.

The difficulty of overcoming the view that you're "turning in" someone vs potentially saving their lives, the amount of pain being at the crossroads of that decision brings, is why I felt compelled to affirm (even if you already knew, there are some things that bear repeating) you did the right thing.

As far as systemic drivers for diversion, though, as you said, selling is more the issue than theft -- even if you don't follow through, saying that you're going to have to go down to the police station and file a report that *someone* stole them might be a first-time solution if you know a teen has been sneaking pills. During various injuries, I did keep a decoy bottle in my medicine cabinet after realizing one of my friends apparently had a problem because my pill count was off, identified the friend by watching the decoy bottle's count, and told them to get help if they felt they had to steal. Safes/locks/etc. Usually people who need, and especially people who really like, their pills will protect them after theft is noticed, unless they are incapable of protecting themselves (which is why I'm more concerned about policing caregivers than little old ladies themselves).

The population most likely to sell any prescription for subsistence are low-income disability beneficiaries -- the population that likely needs the meds the most, but also needs to pay the electric bill. Most disabled people eligible for public or subsidized housing (expected to pay only 30% of their income for housing) are paying substantially more because the basic funds aren't there in the programs that are supposed to help them, the waiting lists are full, etc. States run out of LIHEAP money. Addressing those gaps in financial assistance to people likely being prescribed "good shit" IMHO *will* lower the amount of routinely diverted prescription drugs we see. And improve their quality of life, so they aren't having to sacrifice functionality for lights.

I admit I'm in the camp of believing non-acute pain requiring routine opiates should be managed by a specialist. But in their efforts to lower diversion, perhaps less should be spent on monthly urinalysis to make sure they are taking the medication (random would probably be just as effective), and more on hiring a social worker to coordinate assistance to make sure people aren't in the position of having to divert even a few of the high-street value meds they need to be taking, not selling. Would definitely make for happier patients, too -- many may desperately need such case management assistance and can't get it.