Thanks for the research.
The use of the VAS is not very useful to assess pain especially chronic pain, functional assessments are of course much better.
However, most of these studies involve hospital based treatment, post op care, cancer, hospital stays for various illnesses.
The claim the government has made for a while is that the increased opioid overdose rate and death rate correlates with the increased total mg opioids prescribed which mostly comprises outpatient prescriptions for chronic pain. The dogma is that correlation equals causation. But recent analysis of CDC data indicates that the increased overdose rate is due to illicit drugs. There has been some slight recent improvement in overdose deaths (but not overdose attempts) because of narcan. However, with the sharp reduction in prescription opiates of more than 30% we should have seen a greater reduction in overdose deaths and overdose attempts and we have not.
The anti-opioid faction counters by saying that more exposure to opioids causes more addiction. But even that is likely not true becuse addiction rates for opiates and other substances have been essentially stable for years. Trying to completely eliminate exposure to opiates, which is the only way to avoid addiction, is nearly impossible. Even banning its use for cancer and postoperative pain would not likely eliminate exposure in the illicit market.
The same thing was tried 100 years ago with alcohol prohibition and there was very little decrease in alcoholism at the time.
I think the problem here is that suicide rates are up. Opioids are one means of accomplishing that act. However, everyone knows that there are many ways to commit suicide.
So based on this experience, the government should force people to abstain from alcohol and ban opiates. People should convert to Mormon, Islam or Amish, and we need to strengthen families by forbidding divorce.
As they say, abstinence is a virtue, but prohibition is a tyranny.
Actually, there was a dramatic decrease in overall alcoholism rates(in terms of dysfunctional persons and shattered families) with prohibition but over all use remained unchanged.
Many got off the booze and stayed off after the restrictions were lifted.
But recent analysis of CDC data indicates that the increased overdose rate is due to illicit drugs.
But you’re right, a lot is probably related to suicide (some certainly is). I suspect more is just related to a greater supply-chain making it more available.
Regardless, unless the drug companies are selling off-book, I don’t see that this is their responsibility.