More deaths from opioids than COVID-19 in B.C.

Making people suffer this long under lockdown is something we may someday regret | National Post - Chris Selley:

June 16, 202 - "Last week, the British Columbia coroner’s office reported that 170 people had died in that province from street-drug overdoses in May. It’s the most ever recorded in a single month, and the fourth consecutive month of increase — up from 68 in December. In the first five months of this year, 20-per-cent more people died in B.C. from overdoses than in all of 2019. At time of writing, the official death toll from COVID-19 in British Columbia was 168.

"Advocates for drug law reforms hope that might put things in some perspective. To fight COVID-19 our governments hurled us into a recession and wrote endless blank cheques. For a tiny fraction of that cost, they would say, we could prevent a huge percentage of overdose deaths: By allowing properly run safe-injection sites to open where they’re needed, and by allowing doctors to prescribe pharmaceutical-grade opioids.

"Both remain very controversial — the latter more so than the former. But it’s not an unreasonable hope. Many traditional law-and-order voters will draw a clear line between the two phenomena: COVID-19 sufferers are blameless and incurable, whereas addicts shouldn’t have touched the stuff in the first place, and having gotten themselves addicted should seek treatment. But law-and-order narratives can change rapidly: just ask many conservatives about policing. The opioid addiction epidemic cuts mercilessly across class lines, forcing comfortable and affluent families and their peer groups to confront both the devastating effects and the ignorant facileness of the 'go to treatment' approach: Unless someone is truly ready to kick the habit, and often even then, it simply won’t last.

"B.C.’s grisly overdose toll ought to put the COVID-19 lockdown in stark perspective as well. Experts accurately predicted way back in March that there would be a rise in overdoses, owing to several factors. Border closures were likely to interrupt supply chains and thus alter the composition of street opioids, making them more unpredictable and potentially far more dangerous. Even if safe-injection sites remained open — not all did; others curtailed their hours — the virus safety measures put in place were likely to put off some clients. And the stresses of the lockdown were likely to cause more people to use opioids. And alcohol. And everything else.

"In the coming months and years, we will get an idea of the other tolls the lockdown took on society in the name of saving lives from one specific cause of death. People will almost certainly be found to have died prematurely thanks to delayed or foregone hospital care. Almost from Day One, we had reports from all over the world about spikes in domestic violence. There’s a large, pre-existing body of research linking social isolation with everything from cognitive decline to weakened immune systems and heart disease. 'We’ve seen a year’s worth of suicide attempts in the last four weeks,' a California hospital doctor told ABC News in May. American doctors have reported a spike in anti-anxiety and sleep-aid prescriptions, some of which come with addiction concerns.

"Economic deprivation is also associated with all these negative outcomes, and government intervention certainly won’t save all Canadians from it — not in the short term, and not in the long term when the government of the day decides it’s time to repay our loans. In the long run, most kids will get over losing a few months of school, sports, music, summer camps and everyday social interaction. But that is no small chunk of time in a child’s development. Knowing now (in hindsight, admittedly) that COVID-19 generally treats kids with kid gloves, that needs to be included in the cost-benefit calculation....

"Many bien-pensant Canadians — disproportionately those with backyards, according to my non-peer-reviewed research — are clearly very proud of these extreme lockdown procedures. As the United States reopens and various jurisdictions there endure very significant second waves, their chests seem to swell even more dangerously. They should devote some of their bien-pensing to the collateral damage. In the final analysis, I fear it will not be at all pretty."

Read more: https://nationalpost.com/opinion/chris-selley-making-people-suffer-this-long-under-lockdown-is-something-we-may-someday-regret

Economic shutdown can kill, too

Drugs, Suicide, and Crime: Empirical Estimates of the Human Toll of the Shutdown | American Institute of Economic Research - Audrey Redford & Thomas K. Duncan:

March 28, 2020 - "As the coronavirus pandemic continues across the world, leaders and policymakers have scrambled to respond to the growing health crisis. In the United States, multiple state governors have issued statements urging their citizens to follow social distancing guidelines. Other governors have taken more extreme measures, issuing orders to effectively lock down the entire state economy....

"There have been forecasted estimates of virus-related death totals for the US from as high as 10 million, to 2.2 million, to more conservative estimates.... The models used to estimate the potential death rates are not without criticism and repeated adjustment.... However, as important as it is to get the cost of not shutting down right, it is also important that policymakers properly weigh the cost of the economic shutdowns themselves....

"[T]he ability to operate in a functioning economy is important for the people within it. The economy is the people, and the people are the economy. The ability to continue to function in a market system does matter to individuals within the system, particularly when the inability of business to remain open and continue to employ them is in question.

"We have already started to see some of these human effects as the unemployment has quickly rocketed beyond even the early initial projections. A rise in unemployment is correlated with a number of negative socio-economic effects. For some, these effects can be quite deadly....

"A 2017 NBER paper finds a 3.6% increase in the opioid death rate per 100,000 people for a 1% rise in unemployment. There were 14.6 opioid deaths per 100,000 in the US in 2018. If we use the more conservative estimate of a 20% unemployment rate without a quick return to lower levels, ... there is potential for an additional 28,797 deaths from opioids annually.... Consider that [in] 2018 ... 46,802 deaths were considered an opioid crisis....

"Similarly, Mulia, et al, (2014) connects a rise in alcoholism to economic loss during the Great Recession. The CDC estimates that 2,200 people die in the US just from alcohol poisoning annually.... In 2017 alone, there were also 22,246 deaths resulting from alcoholic liver disease.  As the jobless rate increases and the economic losses continue to mount, these numbers are likely to rise.

"Blakely, et al, (2003) find that being unemployed may also increase the risk of suicide two to threefold. Milner, et al. (2014) similarly finds that unemployment is associated with a higher relative risk of suicide, with prior mental health issues being a key factor in that association. While a study by Kerr, et al, (2018) did not find that unemployment is directly linked to suicides, it did find a significant link between poverty, suicide, and alcoholism.

"Lin and Chen (2018) ... find that unemployment does have a direct impact on older portions of the population, the portion of the population many of the current shutdowns are most meant to protect. Whether it is the direct unemployment effect or the potential poverty produced from the economic shutdown that leads to greater suicides, an increase from the 48,344 suicides and 1,400,000 suicide attempts in the US in 2018 should give decision-makers pause....

"Ajimotokin, et al, (2015) estimate that a one percent change in unemployment will increase the property crime rate by 71.1 per 100,000 people and the violent crime rate by 31.9 per 100,000 people.... Kposowa and Johnson (2016) find that unemployed workers are over 50% more likely to become homicide victims than those who are employed. They also find people not in the labor force to be 1.3 times more likely to be victims than those who are employed....

"The future during such a pandemic is largely uncertain, and misinformation is rampant in the current panic. Policymakers face tough decisions as they navigate the issues of data collection, virus transmission, and economic ramifications of doing too little or too much. It is vitally important, literally life and death, that the proper costs and benefits are weighed with the decision on how much and how long to shut down economic activity through the pandemic."

Read more: https://www.aier.org/article/drugs-suicide-and-crime-empirical-estimates-of-the-human-toll-of-the-shut-down/