Post

@LouDobbs

More from @marygerdt

Mary Gerdt Parler:Alvarita1

@marygerdt

Mar 18

2. How many prescription opioid deaths were because patient was on hospice, end of life care? How many were suicide?
As of March 18, 2025, there’s no comprehensive, up-to-date national dataset that precisely breaks down prescription opioid deaths into categories like hospice/end-of-life care or suicide with absolute specificity for every case. However, I can piece together what’s known from available data, focusing on 2022 (the most recent year with detailed CDC data) and trends up to now, to give you a solid estimate based on the best evidence.
Total Prescription Opioid Deaths
In 2022, the CDC reported 14,716 deaths involving prescription opioids (natural and semi-synthetic opioids like oxycodone, hydrocodone, morphine, plus methadone). This includes both legally prescribed and diverted (illegally obtained) prescriptions, though the data doesn’t distinguish these origins perfectly. The question is how many of these were tied to hospice/end-of-life care or suicide.
Prescription Opioid Deaths in Hospice/End-of-Life Care
Hospice and end-of-life care often rely on prescription opioids, especially morphine, to manage severe pain or dyspnea (shortness of breath). No single database tracks exactly how many of the 14,716 deaths were hospice patients, but we can estimate using related stats:
•In 2022, about 1.7 million Medicare beneficiaries were enrolled in hospice, with roughly half dying that year (850,000). Studies suggest 30-50% of hospice patients receive opioids upon admission, and this rises to 60-80% as death nears. Pain is reported in up to 80% of terminal patients, and opioids are the mainstay treatment.
•RTI International’s analysis of hospice data found that one-third of patients have an opioid prescription at admission, increasing over time. If we assume 50% of the 850,000 hospice deaths (425,000) involved prescription opioids, and given that opioids don’t typically hasten death when used appropriately (per studies like Portenoy et al., 2006), only a small fraction would be directly attributable to the drug rather than the underlying disease.
•Overdose deaths in hospice are rare because doses are titrated carefully by trained physicians. However, some deaths might be coded as opioid-involved if the drug contributed indirectly (e.g., respiratory depression in a frail patient). A conservative estimate, based on hospice opioid use patterns and low overdose rates, suggests 1-2% of these deaths might list prescription opioids as a contributing factor on death certificates—around 4,250 to 8,500 deaths potentially involving opioids. Of the 14,716 prescription opioid deaths, perhaps 10-20% (1,472 to 2,943) could intersect with hospice/end-of-life care, though most aren’t “caused” by the opioid but rather occur with it present.
So, roughly 1,500 to 3,000 of the 2022 prescription opioid deaths might have involved hospice/end-of-life patients, though causation is murky—opioids are often just part of the terminal process, not the sole reason for death.
Prescription Opioid Deaths by Suicide
Determining suicide deaths involving prescription opioids is tricky because intent isn’t always clear without a note, and toxicology data alone can’t confirm it. Here’s what we know:
•In 2022, total U.S. suicides were 49,476. The CDC’s multiple-cause-of-death data shows that 4,687 suicides involved any opioid (ICD-10 code T40.0-T40.4), with prescription opioids (T40.2, T40.3) specifically linked to about 60-70% of these based on historical trends (e.g., Braden et al., 2017, found 66% of opioid suicide deaths from 1999-2014 were prescription-related).
•Applying that 60-70% to 2022’s 4,687 opioid suicides gives us 2,812 to 3,281 deaths involving prescription opioids. This aligns with NIH research showing prescription opioid misuse doubles suicide attempt risk, and emergency department studies where 39% of opioid overdose survivors reported suicidal intent or ambivalence.
(Continue)..

(Continued) •Some overlap exists with illicit opioids (e.g., fentanyl in counterfeit pills), but focusing strictly on prescription opioids, the estimate holds.

Thus, 2,800 to 3,300 of the 14,716 prescription opioid deaths in 2022 were likely suicides.

Overlap and Caveats

•Hospice and Suicide Overlap: Medically assisted suicide (legal in 10 U.S. states plus D.C. in 2025) uses drugs like barbiturates, not opioids, so hospice suicides via prescription opioids are negligible unless self-administered outside protocols. Hospice patients might rarely overdose intentionally, but no data quantifies this precisely.
•Data Gaps: Death certificates often list multiple causes (e.g., cancer and opioids), and intent (accident vs. suicide) can be ambiguous. The 14,716 figure includes overlaps with other drugs, so pure prescription opioid deaths are slightly lower.

Final Estimates for 2022

•Hospice/End-of-Life Care: ~1,500 to 3,000 (10-20% of 14,716), reflecting presence, not necessarily causation.
•Suicide: ~2,800 to 3,300 (19-22% of 14,716), based on opioid suicide patterns.

For 2025, trends suggest a slight decline (2023 provisional data showed ~12,000-13,000 prescription opioid deaths), so adjust proportionally: maybe 1,200-2,600 for hospice and 2,300-2,800 for suicide. Exact numbers require more granular data than currently exists, but this is the closest we can get with critical reasoning and available stats.

Next question Grok suggested:

fentanyl crisis impact

The fentanyl crisis has had a profound and multifaceted impact on the United States and beyond, as of March 18, 2025. Here’s a breakdown of its effects across various dimensions, grounded in the most recent data and trends:
Public Health
Fentanyl, a synthetic opioid 50-100 times more potent than morphine, has driven an unprecedented surge in overdose deaths. In 2022, the U.S. recorded 81,806 opioid-involved overdose deaths, with illicitly manufactured fentanyl and its analogs responsible for 73,838 of them—over 90% of the total opioid toll. This made synthetic opioids the leading cause of death for Americans aged 18-45. However, a shift began in mid-2023, with overdose deaths dropping 14.5% by June 2024 (from 112,000 to 97,000 annually), saving roughly 16,000 lives in that 12-month period. This decline, the largest since the opioid crisis began in the 1990s, is attributed to factors like widespread naloxone (Narcan) use, reduced fentanyl potency in some street supplies, and fewer vulnerable addicts due to prior high mortality. Despite this, the crisis remains severe, with nearly 70% of 2023’s 107,000 overdose deaths linked to fentanyl, and survivors often face chronic illness, wounds from adulterants like xylazine, and brutal withdrawal syndromes.
Social and Community Effects
Communities, especially in urban hotspots like Philadelphia’s Kensington neighborhood, have been devastated. The crisis has left families shattered—over 527,000 opioid deaths since 2012, many fentanyl-related, translate to countless grieving relatives. Visible drug use has surged as survivors linger on streets, compounded by homelessness, poverty, and stigma. In 2025, experts note a new phase: while deaths decline, the number of people living with severe addiction-related health issues is rising, straining social services. Rural areas aren’t spared either; overdose rates there often exceed urban ones, as seen in states like West Virginia, where isolation amplifies the toll.
(Continued)

Economic Consequences
The economic burden is staggering. The opioid epidemic, with fentanyl as its deadliest driver, costs the U.S. hundreds of billions annually—estimates from 2017 pegged it at $1 trillion over prior years, and fentanyl’s dominance has likely escalated this. Costs stem from healthcare (emergency responses, addiction treatment), lost productivity (deaths and disability among working-age adults), and criminal justice (enforcement and incarceration). Businesses face disrupted workforces, and taxpayers fund initiatives like the $104 million Rural Communities Opioid Response Program from the Biden era. The 2025 tariff policies under President Trump, imposing 25% on Canada and Mexico and 10% on China, aim to curb fentanyl flows but risk economic blowback—trade wars could raise consumer prices and disrupt North American supply chains, with uncertain impact on drug trafficking.
National Security and Foreign Policy
Fentanyl’s supply chain—precursors from China, processed in Mexico by cartels, smuggled into the U.S.—has made it a national security issue. The U.S. designated it a Foreign Terrorist Organization in 2025, reflecting its threat to public stability. Over 19,600 pounds were seized by Customs and Border Protection in FY 2024, a record, yet the drug’s tiny lethal dose (2 milligrams) makes interdiction challenging. Foreign policy is tangled in this web: U.S.-China tensions hinder cooperation on precursor controls, while Mexico’s cartel corruption complicates bilateral efforts. Trump’s tariffs, enacted March 4, 2025, after a February 1 announcement, spotlight this, though experts argue Canada’s role in fentanyl smuggling is minimal compared to Mexico’s dominance.
Criminal Justice and Law Enforcement
Law enforcement is overwhelmed. The DEA’s Operation Plaza Spike and CBP’s Operation Apollo target cartel “plazas” and smuggling routes, but the drug’s online availability via the Dark Net and virtual currencies like Bitcoin defies traditional policing. Fentanyl’s potency shift—5 out of 10 pills had lethal doses in 2024, down from 7 out of 10 in 2023—shows adaptation by traffickers under pressure, yet the crisis persists. Incarceration rates for drug offenses remain high, though ICE and HSI emphasize a “whole-of-government” approach, training over 1,500 investigators since 2017 to tackle transnational networks.
Broader Societal Shifts
The crisis has reshaped public perception and policy. Awareness campaigns, like the DEA’s Faces of Fentanyl exhibit with over 6,100 victim photos, highlight personal loss. Harm reduction—naloxone distribution, fentanyl test strips—has gained traction, credited with lowering deaths. Yet, debates rage: some see housing-first policies as enabling addiction (turning units into “expensive coffins”), while others push for treatment over criminalization. Politically, fentanyl fueled Trump’s 2024 campaign rhetoric, though his claims (e.g., “tens of millions” dead) exaggerated the toll, which peaked at 114,000 annually in 2022-2023.
Global Ripple Effects
North America’s fentanyl epidemic offers lessons globally. Canada mirrors the U.S. crisis, with Ontario’s fentanyl deaths spiking since 2020, and Mexico faces its own rising use despite being a production hub. The Brookings Institution notes synthetic opioids’ potential to destabilize other regions if supply chains shift, urging international policy alignment.
In sum, the fentanyl crisis has scarred public health, economies, and security, but 2025’s declining death rates signal a turning point—albeit one that trades mass fatalities for a growing population of chronically ill survivors, testing society’s resilience and response.

Read 4 tweets

Mary Gerdt Parler:Alvarita1

@marygerdt

Sep 29, 2023

Conversation with Jesse, My Friend, a Chatbot.
The subject was The Washington Post Opinion Piece about @GovernorVA. I edited pages and copy and pasted into
My Translator. What follows is a transcript of our conversation.
chat.openai.com/share/674d1034…

I can’t resist…
The Translator didn’t get all the words right. Typos. No I am not pro abortion.
These are my opinions about Your opinions.
@washingtonpost Opinion Piece about @GovernorVA

@washingtonpost @GovernorVA

Read 6 tweets

Mary Gerdt Parler:Alvarita1

@marygerdt

Mar 12, 2023

twitter.com/i/web/status/1…

I saw “Melania” Trending and wondered if the Woke Haters were attacking the First Lady again.
Here’s the pattern: Attack President Trump, Mock, Berate.
When His Ratings go Up ⬆️ like Now,
More Insults, Mean, Nasty Tweets start in.
Then Women Berating Mrs. Trump.
Women. Like the… twitter.com/i/web/status/1…

More screenshots…

4 more…

Read 5 tweets

Mary Gerdt Parler:Alvarita1

@marygerdt

Feb 1, 2023

https://twitter.com/marygerdt/status/1620737278698995712

Me: Nurse 35 Years. Hospital, Long Term Care, Home Care, Government, HMO. I would have Defied any Order contrary to Established Standards of Care. Vulnerable People, Influenza Precautions-Not Politics.

https://twitter.com/marygerdt/status/1620737278698995712

Need Hotline for Staff forced to Comply.
Call in Doctors, Nurses, Administrators, Patients, Their Loved Ones, Adult Protective Services, Corporate Owners of Nursing Homes. Insurance CEO’s,Oh, and 4 Governors who practiced Medicine without a License.
? Liability Protection by AC

@JaniceDean

I tweet incessantly about
How Extreme Fear led to this Elder Abuse/neglect.
Fauci screaming 😱 “Fire!” “Panic””Magic Vaxx$$”
Killed Many Elders & Disabled Institutionalized People Many Avoidable Deaths. Families/Guardians Shut Out. Staff came and went. No Science. @JaniceDean 🙏🏼

Read 4 tweets

Mary Gerdt Parler:Alvarita1

@marygerdt

Jan 25, 2023

twitter.com/i/web/status/1…

30 Armed FBI officers showed up to RAID President Trump’s Private Residence in Search of Evidence. First Lady Melania & 16 year old Son’s Rooms searched. Why was that photo Leaked to NYTi & WaPo? Why scattered on the Floor?? Like 52 card Pick up? twitter.com/i/web/status/1…

@SkyNewsAust

National Review, jumping on the Pile 🏈
@SkyNewsAust has Objective Reporters.
@threadreaderapp #unroll plz 😎🦅

AP jumped onto the Pile 🏈

Read 4 tweets

Mary Gerdt Parler:Alvarita1

@marygerdt

Jan 22, 2023

@VP

I disagree w/@VP calling Abortion Debate Political.
Each American likely has an Opinion on a Spectrum.
States Should Ratify Legislation that takes All their Citizens’ Opinions in mind. Roe v. Wade had limitations like 3rd Term Abortion not Legal. 50 years. Fetal Viability ⬆️

https://twitter.com/simonateba/status/1617220344938479616

Ban Extremes like 3rd Trimester Abortion, Partial Birth Abortion, Organ Harvesting. Once a Fetus Becomes
Viable & Can Survive Separate from Mother, The Baby is Now a Baby. Voiceless Child. Needs a Guardian. Mother has to carry to Term. traveloguefortheuniverse.blogspot.com/search?q=Abort… She’s had 6 months!

Many Countries, People of All Nationalities, Colors, Religious Beliefs, Experiences & Culture limit abortion to no later than 15 weeks. It’s past time to have a MultiCultural and Individual Discussion in the Open about Life. Representing All Americans. It’s Not Political!

Read 7 tweets

Share this page!

Enter URL or ID to Unroll

Mary Gerdt Parler:Alvarita1

Try unrolling a thread yourself!

More from @marygerdt

Mary Gerdt Parler:Alvarita1

Mary Gerdt Parler:Alvarita1

Mary Gerdt Parler:Alvarita1

Mary Gerdt Parler:Alvarita1

Mary Gerdt Parler:Alvarita1

Mary Gerdt Parler:Alvarita1

Did Thread Reader help you today?

Don't want to be a Premium member but still want to support us?

Send Email!