"Fentanyl Americans have a RIGHT to Naloxone, don't @ me" - a respectable journalist

32  2019-05-17 by itsnotmyfault

Our story starts with https://twitter.com/jenniferdoleac/status/1129396662156353538

Actual email exchange I was part of (paraphrased):

Journalist from fairly well-known outlet: Dear heartless researchers, I am writing a story about a strawman argument & cite your paper as a source. You are probably too busy murdering puppies, but would you like to comment? 1/2

Us: Um, that’s not what our paper is about. And the article seems like more of an op-ed.

J: Do you have any actual comments for the article, or just critiques? I don’t know how you could possibly defend yourselves, but am required to give you a chance to comment.

Us: 🤨

2/2

Doleac refuse to name the outlet, saying "I don't want to give it any additional traffic."

So, we dig around for a bit and find this VICE story: https://www.vice.com/en_us/article/qv7jmp/heroin-overdose-parties-are-a-dehumanizing-myth

which begins

By the time I was first dosed with naloxone—the drug that can reverse an opioid overdose—I had been using heroin daily for a year and a half. Not only was I psychologically addicted, I was also physically dependent. Being dependant on an opioid meant that when the naloxone hit, I wasn’t just able to breathe again; I had also been jolted into withdrawal.

So, clearly, the writer has no personal stake in this story that could be construed as a conflict of interest or get in the way of their objectivity at all.

Doleac comes in here, at "controversial paper":

Yet the rumors have persisted. Narcan parties even made it into a controversial paper, published earlier this year, in which a pair of economists argue that from a quantitative perspective, “while naloxone has great potential as a harm-reduction strategy...it encourages riskier behaviors with respect to opioid abuse.” Like other recent reports of these parties, the paper acknowledges the lack of evidence supporting this rumor, but continues to argue that these parties represent a dangerous trend in which naloxone promotes criminal behavior and reckless drug use.

To people who favor this kind of thinking, reviving this particular population—drug users—means promoting continued criminality, since people who are addicted to illegal opioids are likely to keep using illegal opioids. Furthermore, the argument goes, naloxone makes the use of opioids more appealing because it decreases the likelihood of fatal overdose. Overall, there’s an underlying implication that the lives of drug users are not worth saving.

The authors of the paper claim that some of the areas that distribute naloxone at higher rates are actually seeing an uptick in overdose deaths, a figure they argue is not mere correlation but actual causation. These conclusions indicate that users feel safer using drugs more recklessly, and doing things like throwing Narcan parties—“though it is unclear if or how often such parties actually occur” because of the increased availability of naloxone. From their report, it could be gathered that naloxone is linked to crime and death (the authors of the paper declined to provide comments for this story).

TL;DR Author is mad that Doleac's research devalues and dehumanizes addicts. Doleac is supposedly suggesting that addicts that don't die of overdoses (and know that science will keep them from dying of overdoes) are encouraged and enabled to continue to use drugs and commit other crimes.

Read the paper yourself if you're a nerd. Here's the abstract:

The U.S. is experiencing an epidemic of opioid abuse. In response, states have implemented a variety of policies including increased access to naloxone, a drug that can save lives when administered during an overdose. However, widespread naloxone access may lead to increased opioid abuse by reducing the risk of death per use, thereby enabling continued or riskier opioid use. By increasing the demand for opioids, naloxone access may also impact crime, especially theft. In this paper, we use the staggered timing of state-level naloxone access laws as a natural experiment to measure the effects of broadening access to this lifesaving drug. We find that broadened access led to more opioid-related emergency room visits and more opioid-related theft, with no reduction in opioid-related mortality. These effects are driven by urban areas and vary with local access to substance abuse treatment. We find the most detrimental effects in the Midwest, including a 14% increase in opioid-related mortality in that region. While naloxone has great potential as a harm-reduction strategy, our analysis supports the concern that it encourages riskier behaviors with respect to opioid abuse.

Feel free to debate amongst yourselves if the Nazi scientists is the problem, the Fentanyl Americans are the problem, the Journalists are the problem, or if it's the Gamers.

14 comments

Heroin is a God given right for Americans. I learned that from my posting days at bluelight.

Big fan of your work keeping reddit safe

Thanks sweaty.

Probably gamers. They’re the reason their parents are on opioids.

Vice had really gone to shit hasn't it?

Not even a few pages into the paper is it acknowledged that the veracity of these reported narcan parties is in question:

Stories about naloxone parties—where attendees use heroin and prescription painkillers knowing that someone nearby hasnaloxone in case they overdose—have worried legislators, though it is unclear if or how often such parties actually occur.1

With the footnote:

1 Examples of concerned legislators: “With Narcan [the brand name of naloxone], ‘kids are having opioidparties with no fear of overdose,’ Sen. Lisa Boscola, D-Northampton, said Tuesday at a public hearing in theAllegheny County Courthouse conducted by a House-Senate task force exploring solutions to opioid abuse.... ‘I can tell you, drug dealers are throwing Narcan parties,’ said Rep. Daniel McNeill, D-Lehigh County”(Siegelbaum, 2016).

Yes, in the "Introduction" section of an empirical econ paper, it's standard practice to explain how people (rightly or wrongly) perceive something to be a problem, which in turn explains why the research you're presenting about whether or not that thing really IS a problem has value and should be published in a fancy econ journal.

Whether or not specific anecdotes about opioid users are true has no bearing on the authors' statistical analysis of high-level aggregate data.

https://www.vice.com/en_us/contributor/elizabeth-brico-2

A broad selection of headlines from this journalist:

  • My Baby Was Born With A Drug Dependence

An addict with 9 overdoses and a drug-addicted kid. This person should be in jail

  • I Got Addicted to the Needle Even When There Was Nothing to Shoot Up

Subtitle is "When there wasn't any heroin left, I shot up random crap."

  • I Have a Pathological Fear of Being Happy

Donald Trump should take the National Guard and forcibly shut down 95% of news outlets

I would take some junkie on the street a lot more seriously than one who writes for Vice.

this is why I'm hoarding Narcan

Hmmmm, who should I trust on this topic? The people with PhD's and professorships who painstakingly analyzed reams of statistical data, or the junkie dumb enough to overdose nine times?

I don't care if people use drugs, but can we get a law providing for long prison sentences for those who try to write about economics without knowing anything about it?

rural Americans aren't people

rurals aren't people