Unhelpful Numbers Create Misleading Political Statements
“Lies, Damned Lies, and Statistics”
Benjamin Disraeli reportedly said that there are three types of lies: “lies, damned lies, and statistics.” He may have been right.
The Washington Post recently published an article titled, “Companies shipped 1.6 billion opioids to Missouri from 2012 to 2017, report says.” The story references a report released by Senator Claire McCaskill (D-Mo.) that says “drug distributors Cardinal Health, McKesson Corp. and Amerisource Bergen funneled the equivalent of about 260 opioid pills for every person in Missouri in the six-year period.”
Taken at face value, that quantity of opioids does sound huge. But what does the number mean? Does it suggest that dispensing fewer pills would have been better? Of course, 260 pills for every person in Missouri in a six-year period is 43 pills per year. While that’s still a lot of pills, the number is not quite as shocking.
Another way to spin numbers is illustrated in this slide. It shows the number of pills reportedly dispensed in various milligram amounts. We can see that 1.6 billion 5 mg pills are equal to 266 million 30 mg pills. If reducing the number of dispensed pills were the goal, that could easily be accomplished by increasing the strength of pills. However, that might be riskier to patients.
Statistics Can Be Twisted to Prove Anything
Statistics can be misleading. As Cracked pointed out, “Even innocent statistics can be twisted to support any nefarious thing you want to prove.” It offers these examples.
- New York State’s roads supposedly are “death traps,” because there were 966 traffic-related deaths in 2015. By comparison, there were only 190 fatal crashes in Wyoming. But what the statistics don’t mention is that, in 2015, New York State had a population of 20 million people, and Wyoming had a population of fewer than 600,000. Therefore, Wyoming actually had more deaths on a per capita basis than New York State.
- It is said that 50% of marriages end in divorce, and that is true if you compare the rates of all marriages with the numbers of all divorces. But those figures do not show that the trend has dramatically shifted downward, and that most of the “50% of divorces” apply to people who were married in the 1970s and 1980s rather than those who were married in the 1990s and 2000s.
A more recent startling example is the CNN headline, “Drug deaths rose 8,370% in some US counties over 34 years.” Why look back 34 years? What does that increase in drug deaths mean? And why choose select counties? The only plausible explanation is that it provided data that would shock readers.
When they are taken out of context, figures — particularly those involving large numbers — can be used to make false arguments and to mislead people. That seems to have happened with the Washington Post article about opioids.
A few decades ago, most people didn’t know what opioids were. With the onset of the opioid crisis, many people — and Senator McCaskill is among them – appears to have come to see opioids as wholly negative.
What Do Statistics Tell Us About the Opioid Crisis in Missouri?
It seems to me that the 1.6 billion figure is a political statement rather than a helpful statistic. It comes from a 6-year rather than a 1-year period, and that inflates the figure. Obviously, the longer the time period the report covers, the greater the number would be.
More importantly, we have no idea how the number relates to the needs of Missourians. How well is pain managed in the state, and who is receiving the medication? Are opioids used mostly for palliative care, or are people receiving far more medication than they need following surgery?
Perhaps a few doctors wrote most of the prescriptions for opioids. Or perhaps there are more operations and people with chronic pain in Missouri than in other parts of the country. We don’t have the breakdown of information, so we have no way of knowing whether the number of opioids dispensed was appropriate or not. To imply that anyone in the opioid distribution chain has been guilty of wrongdoing on the basis of the gross number of pills dispensed is not responsible.
This is not to say that an appropriate number of opioids has been dispensed. It is hard to make a judgment without more information.
But the article’s out-of-context headline troubles me. It is misleading. It can lead to harmful political statements that can affect the health and well-being of Missourians, specifically, and people living in the United States, generally.
I believe it was done as a scare tactic. Politicians think they’re using Opioids for political gain trying to convince the American people that they can actually fix something that doesn’t exist. In which they can’t fix Anything, they never have. They’re GREAT at creating Problems.
What they are achieving is harm to innocent people by getting all the Legitimate pain patients cut off their medications.
Now, What rest of Americans dont realize is that THEY too will be caught up in these LIES and End up having to suffer as well at some point.
Here’s a true story;
My dog is getting chronic pain care with opioids for her DDD, Arthritis from her doctor. The Vet says she can have this medicine for the rest of her life because the NSAIDS we’re harming her liver.
Here’s the proof in the pudding that I see;
The dog can’t walk down the stairs to get outside to urinate without this Medicine or she urinates in the house. In all honesty this is all the scientific proof that these Medications do in fact work long term. We don’t need to do any further studies on this.
***Because Dogs don’t FAKE pain or Pain RELIEF!****
So WHY are certain people ( doctors, Politicians and Beaurocrats) LYING about long term use of Opioids being effective? Because it is LIES.
Now we need to find out why are they saying all these lies?
Interestingly, according to data published by the CDC itself, the opioid analgesic prescribing rates for Missouri in 2016 (80.4 per hundred population) were exceeded in ten other States. However the rates of opioid-related mortality in that State (23 deaths per hundred thousand population) were exceeded in 18 other States. Thus we see that not only are the number of prescriptions being misrepresented, but the number of overdose deaths is also substantially lower than would be expected if prescribing was a significant cause of overdose.
Thank you, Lynn Webster, M.D, and Richard Lawhern for putting a politician’s bogus and misleading statements into proper perspective and context.
Journalists lie every time they use big numbers to shock and awe people. I just looked at what percentage of the population may have chronic pain…..seems to be about 20% anywhere; so there could be 1,200,000 people there with chronic pain. If even a quarter of them took 2 pain pills a day there’s 22,500,000 ‘doses’ per year or 1.35 billion in 6 years. Add a few for acute pain and you’ve explained the 1.6 billion in 6 years. And of course the actual dosage didn’t matter to them either. Fact is they didn’t even try to explain those numbers, just tried to bamboozle people with that huge number. I know someone is trying to lie every time they try to shock and awe people just using numbers. Just like they tell us how many prescriptions were written in a year but ignore how many people have chronic pain and acute pain. Well you can pretty well tell every single article in the MSM is lying about opioids. .
Thank you Dr. Webster! This type of misinformation is so dangerous, and it scare people. Here’s a link to a paper I wrote in response to the same type of statement about the number of prescriptions in Louisiana: http://bit.ly/2NDuGoa.
Thanks for all you do,
Henry
Thank you Dr Webster.
I have been treated with pain medication for the last 18 years since my kidney operation left me damaged from the procedure and Staph infections. My condition ended up in RSD/CRPS II during the first year.
I was off work for 4yrs but insisted on returning to work in 2004. I have worked all my life and still am, thanks to the help I received and continue to receive at my pain clinic.
I have stopped all steroid related procedures these last several years due to personal concerns. All I take now is one opiate Rx to manage my pain. It has been difficult but I manage as best I can. I’m 68yrs old and still working at the same job for 35yrs. My pain keeps me down more than I’d like but I wish to keep working even though I was approved for disability 18yrs ago. I am trying to stay gainfully employed but if the govt keeps interfering and they succeed in taking this opiate prescription from me then I fear I will slip through the cracks and be an invalid for sure.
I live with this pain every moment of every day and my legs are getting worse but I am still struggling to work, get exercise and contribute as best as I can.
I have never, in all these 18yrs, every been early on my medication or broken any rules. Even though I am randomly drug tested at work and have never had a negative issue at work on my medication I feel it is only a matter of time before they stop people like me from coming to work because I am on an opiate. Due to this hype and fear they keep adding medications to the list that are banned. I feel like I am bring penalized for working!
I am proof that one can be on opiates long term if need be. I do not increase my dosage or take anything else. It is very difficult but manageable. I do acupuncture, research what diets are best to aid in controlling my pain and rest. I am barely hanging on but I am doing the best I can.
Dr Webster, if there is anything we as patients can do to help you either in your research or with your fight against this ignorance on a political level then sign me up!
I am forever grateful to you for treating me so many years ago and saving my life.
Thank you,
Sandy Root