<div dir="ltr">"Dreamland" by Sam Quinones has a good description of the history of our current epidemic. Highly recommended.<div><br></div><div>Estimates vary by source, but fraction of opioid deaths that are suicide is around 20-30%</div></div><br><div class="gmail_quote"><div dir="ltr">On Wed, Jan 2, 2019 at 11:01 AM Marcus Daniels <<a href="mailto:marcus@snoutfarm.com">marcus@snoutfarm.com</a>> wrote:<br></div><blockquote class="gmail_quote" style="margin:0px 0px 0px 0.8ex;border-left-width:1px;border-left-style:solid;border-left-color:rgb(204,204,204);padding-left:1ex">
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<p class="MsoNormal"><a href="http://theconversation.com/suicide-nation-whats-behind-the-need-to-numb-and-to-seek-a-final-escape-98137" target="_blank">http://theconversation.com/suicide-nation-whats-behind-the-need-to-numb-and-to-seek-a-final-escape-98137</a><u></u><u></u></p>
<p class="MsoNormal"><u></u> <u></u></p>
<p class="MsoNormal">“Americans stand out from people in other countries with respect to their focus on individualism. Americans believe that success is determined by our own control and that it is very important to work hard to get ahead in life. Perhaps it
is this focus on our own achievements, successes and work culture that have created an environment that is no longer sustainable – it has become too stressful.”<u></u><u></u></p>
<p class="MsoNormal"><u></u> <u></u></p>
<p class="MsoNormal"><i><a href="https://en.wikipedia.org/wiki/Apoptosis" target="_blank">Apoptosis</a></i> is the word that comes to mind.<u></u><u></u></p>
<p class="MsoNormal"><u></u> <u></u></p>
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<p class="MsoNormal"><b><span style="font-size:12pt;color:black">From: </span></b><span style="font-size:12pt;color:black">Friam <<a href="mailto:friam-bounces@redfish.com" target="_blank">friam-bounces@redfish.com</a>> on behalf of Marcus Daniels <<a href="mailto:marcus@snoutfarm.com" target="_blank">marcus@snoutfarm.com</a>><br>
<b>Reply-To: </b>The Friday Morning Applied Complexity Coffee Group <<a href="mailto:friam@redfish.com" target="_blank">friam@redfish.com</a>><br>
<b>Date: </b>Wednesday, January 2, 2019 at 10:45 AM<br>
<b>To: </b>The Friday Morning Applied Complexity Coffee Group <<a href="mailto:friam@redfish.com" target="_blank">friam@redfish.com</a>><br>
<b>Subject: </b>Re: [FRIAM] Statistical poser (aka fact checking is hard)<u></u><u></u></span></p>
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<p class="MsoNormal"><u></u> <u></u></p>
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<p class="MsoNormal">Dumb question: Is there anything behind this besides an burst of legal prescriptions that created a self-reinforcing trend?<u></u><u></u></p>
<p class="MsoNormal">Or are people actually going crazy?<u></u><u></u></p>
<p class="MsoNormal"> <u></u><u></u></p>
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<p class="MsoNormal"><b><span style="font-size:12pt;color:black">From: </span></b><span style="font-size:12pt;color:black">Friam <<a href="mailto:friam-bounces@redfish.com" target="_blank">friam-bounces@redfish.com</a>> on behalf of Robert Holmes <<a href="mailto:robert@robertholmes.org" target="_blank">robert@robertholmes.org</a>><br>
<b>Reply-To: </b>The Friday Morning Applied Complexity Coffee Group <<a href="mailto:friam@redfish.com" target="_blank">friam@redfish.com</a>><br>
<b>Date: </b>Wednesday, January 2, 2019 at 10:16 AM<br>
<b>To: </b>The Friday Morning Applied Complexity Coffee Group <<a href="mailto:friam@redfish.com" target="_blank">friam@redfish.com</a>><br>
<b>Subject: </b>[FRIAM] Statistical poser (aka fact checking is hard)</span><u></u><u></u></p>
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<p class="MsoNormal"> <u></u><u></u></p>
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<p class="MsoNormal">Early this week I came across a recent press release from NM Dept of Health:
<a href="https://nmhealth.org/news/information/2018/12/?view=728" target="_blank">"Governor Martinez Announces Continued Improvement in Drug Overdose Death Rankings"</a>. I've been tinkering round with opioid statistics, so thought it might be worth fact checking the release.
The results were… interesting. If nothing else they've shown me how difficult it must be to communicate public health statistics.<u></u><u></u></p>
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<p class="MsoNormal"> <u></u><u></u></p>
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<p class="MsoNormal">So here are some of the key figures from the release:<u></u><u></u></p>
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New Mexico’s national ranking has improved from the second highest death drug overdose death rate in the United States in 2014 to 17th highest in 2017<u></u><u></u></li><li class="MsoNormal">
New Mexico previously reported a 4 percent decline in death rates in 2017 due to overdose of commonly prescribed opioids such as oxycodone compared to 2016. In addition, deaths due to heroin decreased by 9 percent and deaths due to synthetic opioids such as
fentanyl decreased by 6 percent over the same time period.<u></u><u></u></li></ul>
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<p class="MsoNormal">The first of these claims passed my sniff test: I know NM's ranking has been improving, even though individual counties rank the wort in the nation. And sure enough, if you pull<a href="https://wonder.cdc.gov/mcd.html" target="_blank"> the underlying CDC
data</a> you can confirm these exact numbers (ignoring DC).<u></u><u></u></p>
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<p class="MsoNormal"> <u></u><u></u></p>
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<p class="MsoNormal">The second claim is the one that gave me pause. Those reductions in individual opioids look kinda high. Yes, NM's ranking is improving but it's because our rate is essentially stable while other states rocket past. And when I check the
above CDC data, yes the reduction in death rate appears to be about 2%<u></u><u></u></p>
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<p class="MsoNormal"> <u></u><u></u></p>
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<p class="MsoNormal">So there's the poser: if NM's reduction in opioid deaths (2016-2017) is 2%, how can this be consistent with individual opioid reductions of 9% (heroin), 4% (natural & semi synthetic, inc. oxycodone), and 6% (synthetic, inc. fentanyl)?<u></u><u></u></p>
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<p class="MsoNormal"> <u></u><u></u></p>
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<p class="MsoNormal">—Robert<u></u><u></u></p>
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<p class="MsoNormal"> <u></u><u></u></p>
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<p class="MsoNormal">P.S. I'll post my best guess later. Oh, and it's not that they omitted methadone: deaths due to that are down 19% in the same period.<u></u><u></u></p>
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