There's been a lot of work done on the effects of long-term unemployment -- I'd wager that a lack of purpose drives opioid use rather than the other way around...
In my personal case, using opiates, specifically, heroin, was the only thing that let me keep my job (well, until I quit my job to get off of that shit). Working 12 hour day, 6-7 days a week in a brutal and miserable work environment (finance), the only thing I could do to survive was heroin. I would get like 4-5 hours a night and just felt like shit and really depressed everyday. Consequently, I started doing heroin for that extra "pep" (it's a common misnomer that heroin makes you fall asleep, it actually wakes you up). With heroin, I could work non-stop, sometimes for even 24 hours at a time while feeling sort of okay, provided I had a steady supply of heroin.
I do however think that heroin/opiates use decreases the ability to rejoin the workforce. I fortunately was making a great salary so I could afford an expensive heroin habit ($200-$300 a day). But your average blue-collar worker probably isn't making as much money, and therefore, there state is much more unstable. Oscillating between getting high, going into withdrawals, running out of money, etc etc. When you are in this state, it is very hard to plan for the future (the only thing you are thinking about is how to not go into horrible pain in 3-4 hours) and, therefore, get a job.
> US unemployment is falling, and therefore so should the opiates crisis
For most people, once addicted, it's very difficult to stop. It's no longer about numbing your despair, it's a physical dependency with very unpleasant withdrawal symptoms.
It works both directions. I'll give you a pretty common example for my neck of the woods. A good friend of mine worked in a machine shop and had a great job for rural America ran his own small lawn-care business on his days off. One day he hurt his back bad, he didn't have time or money for physical therapy (who else would pay the bills) which would've probably been best instead the doctor prescribed opioids and insurance paid. So he went for a few months and it got worse, which was probably just him building up a tolerance, rinse and repeat a few times and he was a fully burned out addict. Couldn't hold his job because of how fried he was.
This isn't an isolated incident it's an all too common pattern I've seen. The cycle works: you go to work and work as hard as you can, you get hurt, you can't afford the best care option, you take the cheaper meds so you can continue working, tolerance builds up, you can't perform, then you're let go. In the end you're left broke, hurting, unemployed, and addicted.
I would assume there's a high correlation between experiencing long term pain and opioid use.
It also seems there would be a large degree of overlap between people experiencing difficult to treat long-term pain and people who commit suicide.
therefore, while it's certainly not an advertisement for the effectiveness of opioids for the treatment of long term pain, it seems unsurprising that there would be a great deal of correlation between opioid use and suicide, even if opioid use didn't cause suicide.
I mean, there are several mechanisms wherein opioid use could be the causative factor, sure; I'm just saying that even if opioids mostly worked as designed and never made anything worse, I would expect there to be a lot of overlap between the people who are prescribed opioids over long periods of time and people who commit suicide.
More likely the converse. A person with a decent middle-class income who becomes addicted to opioids can end up unable to keep his job, lose his income, fall behind on debts, and end up evicted.
I was under the impression that MOST opioid addictions are caused by an opioid prescription. This would have nothing to do with your current job status.
“Around my area, I believe a lot of people use [opioids] out of boredom. There’s no jobs, no way to have fun besides video games and riding four-wheelers and motorcycles. There’s nowhere to go except a run-down mall over in another county.”
Sizable numbers of people get into opiates out of boredom? I thought this was driven by people with chronic pain.
Ignoring the recreational pipeline, opioid addiction usually comes from chronic pain.
You're a manual laborer. Your body gets slowly worn down by the job, and over time you get more and more dramatic joint and muscle pains but you don't have enough money to retire. At first NSAIDs are enough, but then you start slowing down again, and finally someone offers something that works better - but you still can't stop working, so you injure your body more and more while numbing the pain.
You're a sex worker. Violent sex (at times indistinguishable from sexual violence) has become a de facto cultural norm. Your clients are increasingly brutal, not even necessarily in seriously injuring you, just in their indifference to your comfort. In order to keep up with their appetites, and to keep a roof over your head, you resort to some chemical escapism - it feels good, and it makes it feel less bad when you're working. It also relaxes your body, so that the unbelievably incompetent sex can actually happen.
You're in a car accident, or get injured playing school sports, or are born in a body that just hurts all the time, for any or no reason. You're on a controlled, calculated, sustainable regimen of prescription opioids. Then you lose your health insurance, or your provider retires, or pharmacies stop being willing to fill your prescriptions because their role in the opioid crisis has shown them they have liability and they refuse to actually make judgment calls. You are in constant, excruciating pain, you're suffering from sudden, involuntary, unpredictable withdrawal, and there's no legal recourse.
Pain is the most fundamentally unpleasant experience there is. You might think you have a high pain tolerance, and you might even be right, but...have you ever had a headache that lasted a whole day, or just been sore from something for a solid 8 hours? If you have, you know how quickly you get worn thin, irritable, incapable of rationality. Imagine if you were in pain at all times.
The opioid receptors and their corresponding endorphins are truly beautiful. A work of art in its own right.
I think the epidemic here is not one of public health, but of the socioeconomic variety. If you are unemployed and don't have meaningful relationships, you will naturally try to escape your reality. Heroin is the quintessential drug of choice for those who want to dream.
This is what I've seen firsthand from the treatment facility I've volunteered at. Long term use becomes a problem for many patients and eventually they have pain even with dangerously high doses of opiodes.
oddly enough a most people don't want to spend their entire lives addicted to opioids. When given access to things like a stable supply and clean places to satisfy their addiction, many are able to hold down jobs, take steps to get clean and become productive members of society.
There are plenty of people who really do want to spend their entire lives addicted to opioids. LA's homeless "crisis" is proof of that; there are literally thousands of shelter beds that go unused each night because almost all of LA's homeless shelters are sober facilities which do not allow alcohol, drugs, or related contraband, and the addicts would rather be on the streets using drugs than have shelter, food, and stability.
The study that most people reference in this setting[1] simply associates days of opioid usage to likelihood of using opioids in the long term. A simple (and very likely) explanation is that people who need opioids for ten days are likely suffering from chronic pain.
I think opportunities might help people avoid taking the drug in the first place, but from observations, even folks with seemingly great jobs and families often fall to opioids once they try them.
There's causation between homelessness and fentanyl use. Being homeless is absolutely hellish in this country; if your life has fallen apart that you're truly living on the street then there's little support and a lot of danger. Opioids might be one of the only options for you to actually feel happy when the rest of your life is terrible and you've run out of options.
It certainly happens that people get addicted to opioids and then their lives fall apart as a result of addiction but it's important to consider how despair itself can lead to addiction.
I agree, drug withdrawal is painful with opioids and unbearably hellish is GABAergics, and quitting can be very hard. But having purpose in life is what defines if one will stay clean forever or will relapse time after time. I can also add that some people no matter of their actual conditions just don't have any meaning in life and they don't have any drive to participate in the routine and maintain proper life because they either have poor chances for good life or simply because they never asked to be born. Probably the strongest urge to use a drug comes, in fact, from boredom. Some people just need to kill time. To get by from the morning till the evening, when they can go to bed and sleep.
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