Most opioid addicts are recreational users, not those who started on prescription pain medication and continued to have pain and migrated to illegal routes when doctors behaved ethically and shut them off. It just makes people feel good. It is no surprise that opioids are involved in far more deaths each year than guns. If opiods were legally available without a prescription, they'd be in the same category as alcohol when it comes to lifestyle killers. That is what addiction does.

The top recreational drug is fentanyl. There are treatments that can combat it, but people must want to use them. Unfortunately, addicts often don't want to change. A new analysis of those who abuse opioids found that only 22 percent used buprenorphine for a year. Most dropped it after a month.

The authors say the cost of medication is a factor but that is in defiance of everything known about addictive behavior - it suggests a cheaper cost would solve the problem yet users find money for drugs. Spending $120 a month is not causing someone to go back to using fentanyl while spending $30 a month keeps them on a treatment program, such thinking infantalizes people and denies them any agency. Obamacare's preventive drug list, which would require no cost-sharing, won't help, it is just another subsidy for pharmaceutical companies and will cost taxpayers more. Since 78 percent won't take it at all, we're already going to be paying for the health care of 100,000, and more costs added on to the billions of dollars we're already forced to subsidize have little value.

Citation: Leech AA, McNeer E, Roberts AW, et al. Buprenorphine Out-of-Pocket Costs and Discontinuation in Privately Insured Adults With Opioid Use Disorder. JAMA Intern Med. Published online August 07, 2023. doi:10.1001/jamainternmed.2023.2826. The lead author of the Letter is a statistical reviewer for JAMA.