Thank you, this is extremely helpful! I will dive into this.
Nicholas Reville
Karma: 124
The Market Failure that Will Force Doctors to Keep Writing Opioid Prescriptions
Addiction is largest cause of death and DALYs in the USA… and maybe worldwide?
Well the theory of change here actually includes the pharma companies in trying to develop treatments. I don’t trust pharma to do anything other than profit maximize, but I think the dynamics are such that this effort won’t be in opposition to their interests and the FDA has already clamped down hard on new medications with addictive potential.
The government probably should have put the Sackler settlement money towards development of non-addictive painkillers.
Thank you, these are very helpful!
Quick update to let you know that we just launched a new substack: https://curingaddiction.substack.com/
Hope you will subscribe!
New org + substack focused on breakthrough treatments for addiction and solving market failures in drug policy
Hiring Part-time Researcher for Addiction Medication Policy Initiative
A new, yet unnamed, Emerging Addiction Medicine Policy Initiative, is looking to hire a Part-Time Researcher, Biomed and Data.
We are a new, as yet unnamed, non-profit project focused on the opiate crisis and potential breakthrough treatments for addiction and overdose. Our thesis is that development of new medicines for substance use disorders is radically underfunded relative to the scale of the negative health and social impacts.
We are currently a nearly full-time founder with experience in public policy, tech, science, and investing, and a part-time data scientist who is creating charts for the project.
We are looking to build ongoing research capacity to develop a strong analytical argument for the public, the industry, and policy makers. We are currently seeking a part-time research assistant with experience in biology, medicine, or the biomed industry and with some understanding of data science.
We want someone who is excited to dive into an important and complex research arena, learn as much as possible, stay on top of new developments and debates in the field, and bring an open-minded approach to everything we examine, driven by facts and logic. We are non-ideological and are looking for real answers. We are largely US-oriented because of the scale of the crisis in the US and because most of the research and pharma resources are based in the US. That being said, we have non-US collaborators and we are interested in global solutions.
This will be our first paid research position and it is something of an experiment for us. Responsibilities and time per week may shift a bit.
Skills, Experience, and ResponsibilitiesExperience or knowledge in biology, medicine, or biomed.
PhD level training would be excellent but even someone outside these fields who can demonstrate deep knowledge and ability could work.
Must be able to read and understand scientific medical publications and social science research papers with a high level of granularity.
Must be extremely organized and good at organizing.
You will help us develop some workflows for studying the field and keeping up with new developments and potentially restructuring our current research process.
Skilled writing and editing abilities. You will collaborate on research, writing, and editing for Substack and other outlets.
Knowledge and interest in AI research tools, analysis services, etc.
Optional Bonus Skills
Interest in outreach to experts, scientists, and writers in the area.
Personal experiences or interest in the field of addiction or drug abuse.
Interest in promotional activities to grow the project, including contacting people and participating in online or in person discussion groups.
Graphic design experience of any kind.
Fun to work with!
Pay rate: $30 - $50 per hour, depending on experience.
Time: 10-20 hours a week.
To Apply: email us at addictionpolicyinitiative@gmail.com and include your resume and a message about your experience and why you are interested in the position.
Thank you!
Hi—I just posted a paid part-time research position for this project, in case you know anyone!
https://docs.google.com/document/d/1STK_E23WneUAT416cKSruCWNVm4SNVI-yP58oSQOdIo/edit?pli=1
Thanks Toby! Could be perfect @tobytrem
Great, I’ll DM you and we can stay in touch.
My goal is to first build the case that the space is underfunded, and assuming that it feels convincing to me and others, try to push for more awareness and funding in the space. This could mean creating a formal or informal organization or it could just mean creating some kind of movement, momentum, etc. I’d love to get some of the leading researchers onto the popular health podcasts, help them create more powerful presentations for the public, talk to NIH researchers, politicians, and more. I think there’s a lot of low (and high) hanging fruit here.
But definitely starting humbly, trying to get the science and the facts right and going from there.
OK, I will! Thanks!
totally agree—i think fentanyl is rightly understood as a huge a new threat, but i dont think there’s a realization generally that fentanyl is essentially a technological advancement. much stronger, much smaller, cheaper. makes efforts to prevent drug trafficking much harder and makes harm reduction and social interventions much more difficult as well. we beat cigarettes largely with price increases, fentanyl is a price decrease. also it has shorter half life than heroin so people use it more often every day, which creates all sorts of other risks. all of this is to say—yes, fentanyl seems more likely to spread to countries that have been ok so far.
Thanks Stan, I really appreciate it! I have several short articles that I’m writing covering various aspects of this and will reach out to get your feedback when I’m closer.
On question 3-- yes, I think there is reason for optimism that the new treatments under development can work, including vaccines, non-opiate painkillers, addiction reducers, etc. Il’l be writing about this very soon and also looking for experienced pharma folks for thoughts on pipeline to market timing and obstacles.
Whether these treatment will be game-changers or useful additions to our limited toolbox remains to be seen. And whether they will take 15 years to get to market or 5 is what I’m hoping to influence. But there are some human trials already in progress on exciting stuff.
Thanks! More soon...
I certainly will! Hoping to get a substack going in the next month or so.
I don’t know of any head to head comparisons. It’s comparable to Vicodin according to the studies. It seems likely that it can be safely combined with acetaminophen which would make it more effective.
And yes, opioid over-prescribing is more of a US problem than most other places, but eventually getting opioids out of all medical systems over time will help reduce opioid addiction globally.