That’s the tail end of the problem. Drug companies claimed that newer versions of opioids weren’t addictive, and produced bogus research that backed those claims.

So the protocols changed, and doctors in many areas of practice started treating opioids like ibuprofen. Hydrocodone or oxy isn’t the best choice for chronic pain, and as chronic users take it, their tolerance increases and their ability to get an effective, legal prescription slowly goes away.

The black market offered cheaper, but more dangerous alternatives.

I feel like this also suggests that doctors suck. If engineers couldn't interpret the information coming from the security community and due to their inability to deal with their own industry inputs they got thousands of people killed per year, it would be a far more serious deal. As far as I know, Google isn't getting thousands of people killed, but nobody is talking about reigning in the medical community.

Somehow there's no egg on the medical community's face. Is medically checking the doctor now the responsibility of patients?

> As far as I know, Google isn't getting thousands of people killed per year,

At google's scale it doesn't take much bureaucratic indifference to have an outsized effect.

I would be surprised if google wasn't-- but it's spread out over thousands of distinct causes. Like maps effectively directing people to turn onto railroad tracks and google being unwilling to do anything about it (https://www.theverge.com/2019/8/12/20802036/google-apple-mic...), or maps and especially waze directing highway level flows of traffic through residential neighborhoods.

I feel that even a bad luck spike in death by the thousands would be noticed, but you are suggesting that thousands might be dying for years and nobody notices.

People are dying. People did notice-- though not of quite as many as thousands. Action is not being taken to do anything about it, various states are considering passing laws to force google to take action as a result.

This is exactly what's happened in Australia. Over-the-counter opioids (codeine, primarily) were banned last year. People were destroying their livers and stomachs due to overdosing on the adulterants (paracetomol/acetaminophen and ibuprofen) that were specifically put in to stop people taking them in bulk.

Now ordinary people with ordinary aches and pains can't get effective painkillers without visiting a doctor (or a quick trip to NZ where they're still available).

If your "ordinary" aches and pains require medication with adverse effects as significant as addiction, maybe they're not that ordinary ?

Is the threshold for visiting a doctor that high in Australia ? From my European perspective, seeing your GP is a routine and cheap thing to do, and definitely warranted before starting an addictive drug.

Ibuprofen always worked for my ordinary aches. I find it justified to require a visit to a doctor if the pain doesn't react to Ibuprofen.

Ibuprofen fucks my stomach. Paracetamol does nothing for me for pain (as predicted by the literature). Mild opiates like codeine kill it dead. And taking it once isn't an addiction problem.

I know people that moved from prescription opioids to street opioids. The jump from treating pain to addiction/simply enjoying the high is surprisingly small.

PS: That’s not to say it’s purely the drug companies issue. While recovering from surgery in the hospital and on an clicker IV drip I had a doctor suggest I try ‘upping my dose’ for the fun of it.

It seems making it harder to get oxycodone actually increase the amount of people buying opiates on the street. There is a strong correlation between increase use of street opiates and the creation of opiate tracking DBs and crack down on pill mills.