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What are you talking about? Where was America getting their opioids before The Sacklers? Go ahead and pull a chart of heroin deaths vs. years and draw a vertical bar on where Purdue launched their widespread marketing misinformation and disinformation.

This is the largest and most deadly episode of addictiveness since the tobacco companies were marketing cigarettes as healthy. If this were a fire, you’d be arguing:

“Look, America has always had fires. Sure Purdue started fires in all 50 states that spread into the forest, but they were small when Purdue started them. Now, there is a blaze that has spread uncontrolled across the Continental US. So, obviously there were other parallel organizations starting fires.”

No. That doesn’t follow. Purdue stared the fires. They added tinder with marketing misinformation, then they inhibited any attempt at controlling it with active disinformation campaigns to confuse doctors and regulators about the root cause. Now, it’s a wild uncontrolled inferno, but they started the first fires.

[beaeglebeachedd]

Didn't we also invade the religious nutsos stopping Afghanistan from producing poppies and then prop up a fake regime that let it flourish, massively increasing the supply of natural opiates? If I recall, the timing works out pretty good with illegal opiate use ramping up.

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We sure did. About 60-70% of all of the world's opium was sourced from Afghanistan until 2022. That supply was used to make actual prescriptions in non-OECD countries - like India & China - as well as sold to make heroin in the US, EU, Asia, and Africa.

But be careful about confusing cause & effect. The cause of the Afghani farmers growing opium was the insatiable demand for opium that was developed through legal means. Then, when countries like the US started to restrict access to opiates, addicts and patients alike started to seek alternatives to the scarce prescriptions.

More to the point, why didn't patients use something else? Because there is nothing. Purdue's misinformation actively discouraged the discovery of new non-addictive compounds for decades. No one was looking, and the R&D pipeline ran dry.

By the time enough doctors sounded enough alarms to cause a change in the late 2010s, research in non-addictive pain management solutions was decades behind. No one engaged in it because there was no need for it. Now that we realize it was all a lie and these drugs have killed millions, there are no alternatives. Very few potential compounds are even in Phase 2 clinical trials right now, let alone the half dozen that would be needed in Phase 3 to ensure we have a single alternate choice for pain management in the next five years.

So, the outlook looks bleak. Today, in 2024, we don't have good ways to manage pain that is non-addictive, and certainly no good way to reach the millions who are hopelessly addicted to opioids for pain management. But, very little of this is the patient's fault - and a lot of this is directly related to the monumental efforts of Purdue to misinform for profit.