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{
"cells": [
{
"cell_type": "markdown",
"metadata": {},
"source": [
"# 95-865: Basic Text Processing with spaCy\n",
"\n",
"Author: George H. Chen (georgechen [at symbol] cmu.edu)"
]
},
{
"cell_type": "markdown",
"metadata": {},
"source": [
"Let's begin by loading in the spaCy package (you have to install spaCy first, including installing spaCy's English model)."
]
},
{
"cell_type": "code",
"execution_count": 1,
"metadata": {},
"outputs": [],
"source": [
"import spacy\n",
"nlp = spacy.load('en_core_web_sm') # load spaCy's built-in English models"
]
},
{
"cell_type": "markdown",
"metadata": {},
"source": [
"In case you want to know what the data type is of any Python object, use the `type` function:"
]
},
{
"cell_type": "code",
"execution_count": 2,
"metadata": {},
"outputs": [
{
"data": {
"text/plain": [
"spacy.lang.en.English"
]
},
"execution_count": 2,
"metadata": {},
"output_type": "execute_result"
}
],
"source": [
"type(nlp)"
]
},
{
"cell_type": "markdown",
"metadata": {},
"source": [
"Next, we load in the text file that we will analyze. I've copy and pasted text from the opioid epidemic Wikipedia page into \"opioid_wikipedia.txt\", which should be placed in the same directory as this Jupyter notebook."
]
},
{
"cell_type": "code",
"execution_count": 3,
"metadata": {
"scrolled": true
},
"outputs": [
{
"name": "stdout",
"output_type": "stream",
"text": [
"The opioid epidemic or opioid crisis is the rapid increase in the use of prescription and non-prescription opioid drugs in the United States and Canada in the 2010s. Opioids are a diverse class of moderately strong painkillers, including oxycodone (commonly sold under the trade names OxyContin and Percocet), hydrocodone (Vicodin), and a very strong painkiller, fentanyl, which is synthesized to resemble other opiates such as opium-derived morphine and heroin. The potency and availability of these substances, despite their high risk of addiction and overdose, have made them popular both as formal medical treatments and as recreational drugs. Due to their sedative effects on the part of the brain which regulates breathing, opioids in high doses present the potential for respiratory depression, and may cause respiratory failure and death.[2]\n",
"\n",
"According to the U.S. Drug Enforcement Administration, \"overdose deaths, particularly from prescription drugs and heroin, have reached epidemic levels.\"[3]:iii Nearly half of all opioid overdose deaths in 2016 involved prescription opioids.[1] From 1999 to 2008, overdose death rates, sales, and substance abuse treatment admissions related to opioid pain relievers all increased substantially.[4] By 2015, annual overdose deaths from heroin alone surpassed deaths from both car accidents and guns, with other opioid overdose deaths also on the rise.[5]\n",
"\n",
"Drug overdoses have since become the leading cause of death of Americans under 50, with two-thirds of those deaths from opioids.[6] In 2016, 62,000 Americans died from overdoses, 19 percent more than in 2015, and had killed more Americans in one year than both the wars in Vietnam and Iraq combined.[7][6] By comparison, the figure was 16,000 in 2010, and 4,000 in 1999. Figures from June 2017 indicate the problem has worsened.[8][9] While death rates varied by state,[10] public health experts estimate that nationwide over 500,000 people could die from the epidemic over the next 10 years.[11]\n",
"\n",
"In March 2017, Larry Hogan, the governor of Maryland, declared a state of emergency to combat the opioid epidemic,[12] and in July 2017 opioid addiction was cited as the \"FDA's biggest crisis.\"[13] CDC director Thomas Frieden said that \"America is awash in opioids; urgent action is critical.\"[14] The crisis has changed moral, social, and cultural resistance to street drug alternatives such as heroin.[15] On August 10, 2017, President Donald Trump agreed with his Commission's report released few weeks earlier and declared the country's opioid crisis a \"national emergency.\"[16][17] On September 1, Trump nominated as \"drug czar\" Tom Marino, whose election campaign had been financed by pharmaceutical distribution companies that had lobbied for, and profited from, legislation co-sponsored by Marino which protected pharmacies suspected of diverting pills.[18]\n",
"\n",
"Contents [hide] \n",
"1 Background in the United States\n",
"1.1 Main causes\n",
"1.2 Effects\n",
"1.3 Fentanyl\n",
"1.4 History of opiate use in the United States\n",
"1.5 Demographics\n",
"1.6 Outside the U.S.\n",
"2 Countermeasures\n",
"2.1 Federal government\n",
"2.2 State and local governments\n",
"2.3 Prescription drug monitoring\n",
"2.4 In the media\n",
"2.5 Solutions for addicts\n",
"2.5.1 Naloxone\n",
"2.5.2 Methadone\n",
"2.5.3 Buprenorphine\n",
"2.5.4 Behavioral treatment options\n",
"3 See also\n",
"4 References\n",
"5 External links\n",
"Background in the United States[edit]\n",
"Main causes[edit]\n",
"What the U.S. Surgeon General calls \"The Opioid Crisis\" likely began with over-prescription of powerful opioid pain relievers in the 1990s, which led to them becoming the most prescribed class of medications in the United States. As of 2016 more than 289 million prescriptions were written for opioid drugs per year.[19]:43In the late 1990s, many Americans were diagnosed with chronic pain, estimated to affect around 100 million people or a third of the U.S. population. This led to a push by drug companies and the federal government to expand the use of painkilling opioids.[10] Between 1991 and 2011, painkiller prescriptions in the U.S. tripled from 76 million to 219 million per year. Among the most common opioids prescribed have been oxycodone (OxyContin and Percocet) and hydrocodone (Vicodin). With the increase in volume, potency of opioids also increased. By 2002, one in six drug users were being prescribed drugs more powerful than morphine; by 2012, the ratio had doubled to one-in-three.[10]\n",
"\n",
"Despite the increased use of painkillers, there has been no change in the amount of pain reported in the U.S.[20][19] This has led to differing medical opinions, with some noting that there is little evidence that opioids are effective for chronic pain not caused by cancer.[21]\n",
"\n",
"Effects[edit]\n",
"When people continue to use opioids beyond what a doctor prescribes, whether to minimize pain or to enjoy the euphoric feelings, it can mark the beginning stages of an opiate addiction, with a tolerance developing and eventually leading to dependence, when a person relies on the drug to prevent withdrawal symptoms.[22]\n",
"\n",
"As the number of opioid prescriptions rose, drug cartels began flooding the U.S. with heroin. For many opioid users, heroin was cheaper, more potent, and often easier to acquire than prescription medications.[8] According to the CDC, tighter prescription policies by doctors did not necessarily lead to this increased heroin use.[21] The main suppliers of heroin to the U.S. have been Mexican transnational criminal organizations.[8] From 2005–2009, Mexican heroin production increased by over 600%, from an estimated 8 metric tons in 2005 to 50 metric tons in 2009.[8] Between 2010 and 2014, the amount seized at the border more than doubled.[23] According to the DEA, smugglers and distributors \"profit primarily by putting drugs on the street and have become crucial to the Mexican cartels.\"[3]:3\n",
"\n",
"\n",
"Opiate self-injection paraphernalia\n",
"The opioid epidemic has since emerged as one of the worst drug crises in American history: more than 33,000 people died from overdoses in 2015, nearly equal to the number of deaths from car crashes, with deaths from heroin alone more than from gun homicides.[24] It has also left thousands of children suddenly in need of foster care after their parents have died from an overdose.[25]\n",
"\n",
"Fentanyl[edit]\n",
"There have always been drug addicts in need of help, but the scale of the present wave of heroin and opioid abuse is unprecedented. In Maryland, the first six months of 2015 saw 121 fentanyl deaths. In the first six months of 2016, the figure rose to 446.\n",
"Christopher Caldwell,\n",
"senior editor The Weekly Standard[15]\n",
"Fentanyl, a newer synthetic opioid painkiller, is 50 to 100 times more potent than morphine and 30 to 50 times more potent than heroin,[15] with only 2 mg becoming a lethal dose. It is pure white, odorless and flavorless, with a potency strong enough that police and first responders helping overdose victims have themselves overdosed by simply touching or inhaling a small amount.[26][27][28] As a result, the DEA has recommended that officers not field test drugs if fentanyl is suspected, but instead collect and send samples to a laboratory for analysis. \"Exposure via inhalation or skin absorption can be deadly,\" they state.[29]\n",
"\n",
"Fentanyl-laced heroin has become a big problem for major cities, including Philadelphia, Detroit and Chicago.[30] Its use has caused a spike in deaths among users of heroin and prescription painkillers, while becoming easier to obtain and conceal. Some arrested or hospitalized users are surprised to find that what they thought was heroin was actually fentanyl.[15] According to CDC director Thomas Frieden:\n",
"\n",
"As overdose deaths involving heroin more than quadrupled since 2010, what was a slow stream of illicit fentanyl, a synthetic opioid 50 to 100 times stronger than morphine, is now a flood, with the amount of the powerful drug seized by law enforcement increasing dramatically. America is awash in opioids; urgent action is critical.[14]\n",
"\n",
"According to the Centers for Disease Control and Prevention (CDC), death rates from synthetic opioids, including fentanyl, increased over 72% from 2014 to 2015.[22] In addition, the CDC reports that the total deaths from opioid overdoses may be under-counted, since they do not include deaths that are associated with synthetic opioids which are used as pain relievers. The CDC presumes[when?] that a large proportion of the increase in deaths is due to illegally-made fentanyl; as the statistics on overdose deaths do not distinguish pharmaceutical fentanyl from illegally-made fentanyl, the actual death rate could therefore be much higher than reported.[31]\n",
"\n",
"Those taking fentanyl-laced heroin are more likely to overdose because they do not know they also are ingesting the more powerful drug.[32] In March 2017, New Jersey police arrested a person possessing nearly 31 pounds (14 kg) of fentanyl (14 kg would yield 7 million lethal doses).[33][34] Among those who died from overdosing on fentanyl was singer Prince.[34][35]\n",
"\n",
"Fentanyl has surpassed heroin as a killer in several locales: in all of 2014 the CDC identified 998 fatal fentanyl overdoses in Ohio, which is the same number of deaths recorded in just the first five months of 2015.[36] In Cleveland, a person was caught selling blue fentanyl pills disguised to look like doses of the milder opioid painkiller oxycodone.[36] The U.S. attorney for Ohio stated:\n",
"\n",
"One of the truly terrifying things is the pills are pressed and dyed to look like oxycodone. If you are using oxycodone and take fentanyl not knowing it is fentanyl, that is an overdose waiting to happen. Each of those pills is a potential overdose death.[36]\n",
"\n",
"In 2016 the medical publication STAT reported that while Mexican cartels are a main source of heroin smuggled into the U.S., Chinese suppliers provide both raw fentanyl and the machinery necessary for its production.[36] In British Columbia, police discovered a lab making 100,000 fentanyl pills each month, which they were shipping to Calgary, Alberta. 90 people in Calgary overdosed on the drug in 2015.[36] In Southern California, a home-operated drug lab with six pill presses was uncovered by federal agents; each machine was capable of producing thousands of pills an hour.[36]\n",
"\n",
"History of opiate use in the United States[edit]\n",
"In the early 1900s, as veterans of the First World War were returning home from overseas, there were few options to help relieve pain, and doctors mainly turned to morphine.[37] Opiates soon became known as a wonder drug and were prescribed for a wide array of ailments, even for relatively minor treatments such as cough relief. Beginning around 1920, however, their addictiveness was recognized and not too long afterwards heroin was made an illegal drug.[37] In the Anti-Heroin Act of 1924, the U.S. Congress banned the sale, importation, or manufacture of heroin.\n",
"\n",
"Around World War II, doctors used opiates in lieu of surgery. This made prescriptions for opiates skyrocket.[37] In the 1950s, heroin addiction was known among jazz musicians, but still fairly unknown by average Americans, many of whom saw it as a frightening condition.[15] The fear extended into the 1960s and 1970s, although it became common to hear or read about drugs such as marijuana and psychedelics, which were widely used at rock concerts like Woodstock.[15] Heroin addiction began to make the news when famous people such as Janis Joplin, John Belushi, Jim Morrison and Lenny Bruce, whom most people did not know were addicted, died from overdoses. During and after the Vietnam War, addicted soldiers returned from Vietnam, where heroin was easily bought. Heroin addiction grew within low-income housing projects during the same time period.[15] In 1971, congressmen released an explosive report on the growing heroin epidemic among U.S. servicemen in Vietnam, finding that ten to fifteen percent were addicted to heroin. \"The Nixon White House panicked,\" wrote political editor Christopher Caldwell and declared drug abuse \"public enemy number one\".[38] By 1973, there were 1.5 overdose deaths per 100,000 people.[15]\n",
"\n",
"In the 1980s, many medical experts did not believe that opioids were addictive. A brief letter published in the New England Journal of Medicine (NEJM) in January 1980, titled \"Addiction Rare in Patients Treated with Narcotics\", was subsequently cited over 600 times to support this position.[39][40] A group of researchers in Canada claim that the letter may have originated and contributed to the opioid crisis.[39] The NEJM published its rebuttal to the 1980 letter in June 2017, pointing out among other things that the conclusions were based on hospitalized patients only, and not on patients taking the drugs after they were sent home.[41] The original author, Dr. Hershel Jick, has said that he never intended for the article to justify widespread opioid use.[39]\n",
"\n",
"In the mid-to-late 1980s the crack epidemic followed widespread cocaine use in American cities. The death rate was worse, reaching almost 2 per 100,000. In 1982, Vice President George H. W. Bush and his aides began pushing for the involvement of the CIA and the U.S. military in drug interdiction efforts, the so-called War on Drugs.[42] By comparison, as of 2016, the present opioid epidemic is killing on average 10.3 people per 100,000. In some states it is far worse: over 30 per 100,000 in New Hampshire and over 40 per 100,000 in West Virginia.[15]\n",
"\n",
"Demographics[edit]\n",
"In the U.S., addiction and overdose victims are mostly white and working-class. Geographically, those living in rural areas of the country have been the hardest hit as a percentage of the national population,[43] Prescription drug abuse has been increasing in teenagers, especially as 12- to 17-year-olds were one-third of all new abusers of prescription drugs in 2006. Teens abuse prescription drugs more than any illicit drug except marijuana, more than cocaine, heroin and methamphetamine combined, per the Office of National Drug Control Policy’s 2008 Report Prescription for Danger.\n",
"\n",
"In Palm Beach County, Florida, overdose deaths went from 149 in 2012 to 588 in 2016.[44]\n",
"\n",
"In Middletown, Ohio, overdose deaths quadrupled in the 15 years since 2000.[45]\n",
"\n",
"There has been a difference in the number of opioid prescriptions written by doctors in different states. In Hawaii, doctors wrote about 52 prescriptions for every 100 people, whereas in Alabama, they wrote almost 143 prescriptions per 100 people. Researchers suspect that the variation results from a lack of consensus among doctors in different states about how much pain medication to prescribe. A higher rate of prescription drug use does not lead to better health outcomes or patient satisfaction, according to studies.[8]\n",
"\n",
"Outside the U.S.[edit]\n",
"Approximately 80 percent of the global pharmaceutical opioid supply is consumed in the United States.[47]\n",
"\n",
"It has also become a serious problem outside the U.S., mostly among young adults.[48] The concern not only relates to the drugs themselves, but to the fact that in many countries doctors are less trained about drug addiction, both about its causes or treatment.[20] According to an epidemiologist at Columbia University: \"Once pharmaceuticals start targeting other countries and make people feel like opioids are safe, we might see a spike [in opioid abuse]. It worked here. Why wouldn’t it work elsewhere?\" [20] The majority of deaths worldwide from overdoses were from either medically prescribed opioids or illegal heroin. In Europe, prescription opioids accounted for three-quarters of overdose deaths among those between ages 15 and 39.[48] Some worry that the epidemic could become a worldwide pandemic if not curtailed.[20] Prescription drug abuse among teenagers in Canada, Australia, and Europe were at rates comparable to U.S. teenagers.[20] In Lebanon and Saudi Arabia, and in parts of China, surveys found that one in ten students had used prescription painkillers for non-medical purposes. Similar high rates of non-medical use were found among the young throughout Europe, including Spain and the United Kingdom.[20]\n",
"\n",
"Countermeasures[edit]\n",
"\n",
"This section is in a list format that may be better presented using prose. You can help by converting this section to prose, if appropriate. Editing help is available. (August 2017)\n",
"Federal government[edit]\n",
"In 2010, the US government began cracking down on pharmacists and doctors who were over-prescribing opioid pain killers. The unintended consequence of this was that users turned to cheaper but illegal heroin, a significantly more potent opioid, as a substitute,[10] including addicted patients who were denied opioid prescriptions as doctors tried to cut back painkiller drug abuse.[15] A 2017 survey in Utah of heroin users found about 80 percent started with prescription drugs.[49] As a result, by 2015 nationwide deaths from prescription opioids had increased by 15% and for heroin users by 23%.[10][50]\n",
"In 2010, the CSA was amended with the Secure and Responsible Drug Disposal Act which allows pharmacies to accept controlled substances from households or long term care facilities in their drug disposal programs or \"take-back\" programs.[51]\n",
"In 2011, the Obama administration released a white paper describing the administration's plan to deal with the crisis. Its concerns have been echoed by numerous medical and government advisory groups around the world.[52][53][54]\n",
"In 2016, the U.S. Surgeon General listed statistics which describe the extent of the problem.[19]\n",
"In July 2016, President Barack Obama signed into law the Comprehensive Addiction and Recovery Act, which expands opioid addiction treatment with buprenorphine and authorizes millions of dollars in new funding for opioid research and treatment.[55]\n",
"In December 2016, the 21st Century Cures Act, which includes $1 billion in state grants to fight the opioid epidemic, was passed by Congress by a wide bipartisan majority (94-5 in the Senate, 392-26 in the House of Representatives),[56] and was signed into law by President Obama.[57]\n",
"As of March 2017, President Donald Trump appointed a commission to deal on the epidemic, chaired by Governor Chris Christie of New Jersey.[58][59][60]\n",
"In June 2017, the FDA asked the manufacturer to remove its injectable form of oxymorphone (Opana ER) from the US market, because the drug's benefits may no longer outweigh its risks, this being the first time the agency has asked to remove a currently marketed opioid pain medication from sale due to public health consequences of abuse.[61]\n",
"In July 2017, FDA commissioner Dr Scott Gottlieb stated that for the first time, pharmacists, nurses, and physicians, would have training made available on appropriate prescribing of opioid medicines, because opioid addiction had become the \"FDA's biggest crisis\".[13]\n",
"On August 10, 2017, President Trump agreed with his Commission's report released few weeks earlier and declared the country's opioid crisis a \"national emergency.\"[16][17]\n",
"On September 1, 2017, Trump nominated Representative Tom Marino as director of the Office of National Drug Control Policy, or \"drug czar\".[62] Pharmaceutical distribution companies had contributed $134,000 to Marino's election campaigns in 2014 and 2016, more than contributions from any other industry. Pharmaceutical distibutors had lobbied for legislation which Marino co-sponsored in 2016, the Ensuring Patient Access and Effective Drug Enforcement Act, which made it harder for the DEA to shut down pharmacies suspected of diverting pills.[18]\n",
"State and local governments[edit]\n",
"In July 2016, governors of most U.S. states and territories entered into a formal \"Compact to Fight Opioid Addiction.\" They agreed that collective action would be needed to end the opioid crisis, and they would coordinate their responses across all levels of government and the private sector, including opioid manufacturers and doctors.[63]\n",
"In March 2017, the Governor of Maryland, as an urgent response to the crisis, declared a State of Emergency to combat the rapid increase in overdoses by increasing and speeding up coordination between the state and local jurisdictions.[64][12] In 2016, about 2,000 people in the state had died from opioid overdoses.[65]\n",
"In March 2017, Delaware, which has the 12th-highest overdose death rate in the country, introduced bills to both limit doctors' ability to over-prescribe painkillers and improve access to treatment. In 2015, 228 people had died from overdose, which increased 35%—to 308—in 2016.[66]\n",
"In March 2017, a similar plan was begun in Michigan, which introduced the Michigan Automated Prescription System (MAPS), allowing doctors to check when and what painkillers have already been prescribed to a patient, and thereby help keep addicts from switching doctors to receive drugs.[67][68]\n",
"During the 2017 General Session of the Utah Legislature, Rep. Edward H. Redd and Sen. Todd Weiler proposed amendments to Utah's involuntary commitment statutes by trying to pass H.B. 299 into law which would allow relatives to petition a court to mandate substance- abuse treatment for adults.[69][49]\n",
"In Maine, new laws were imposed which capped the maximum daily strength of prescribed opioids and which limited prescriptions to seven days. But some doctors were then concerned that patients would turn to using street drugs like heroin to extend their use of painkillers.[15]\n",
"In West Virginia, which leads the nation in overdose deaths per capita, lawsuits seek to declare drug distribution companies a \"public nuisance\" in an effort to place accountability upon the drug industry for the costs associated with the epidemic.[70][71]\n",
"In February 2017, officials in Everett, Washington filed a lawsuit against the manufacturer of OxyContin for negligence by allowing drugs to be illegally trafficked to residents and failing to prevent it. The city wants the company to pay the costs of handling the crisis.[72]\n",
"Prescription drug monitoring[edit]\n",
"In 2016, the CDC published its \"Guideline for Prescribing Opioids for Chronic Pain\", recommending opioids only be used when benefits for pain and function are expected to outweigh risks, and then used at the lowest effective dosage, with avoidance of concurrent opioid and benzodiazepine use whenever possible.[73] Silvia Martins, an epidemiologist at Columbia University, has suggested getting out more information about the risks:\n",
"\n",
"The greater “social acceptance” for using these medications (versus illegal substances) and the misconception that they are “safe” may be contributing factors to their misuse. Hence, a major target for intervention is the general public, including parents and youth, who must be better informed about the negative consequences of sharing with others medications prescribed for their own ailments. Equally important is the improved training of medical practitioners and their staff to better recognize patients at potential risk of developing nonmedical use, and to consider potential alternative treatments as well as closely monitor the medications they dispense to these patients.[48]\n",
"\n",
"As of April 2017, prescription drug monitoring programs (PDMPs) exist in every state.[74] A person on opioids for more than three months has a 15-fold (1,500%) greater chance of becoming addicted.[21] PDMPs allow pharmacists and prescribers to access patients’ prescription histories to identify suspicious use. However, a survey of US physicians published in 2015 found only 53% of doctors used these programs, while 22% were not aware these programs were available.[75] The Centers for Disease Control and Prevention (CDC) was tasked with establishing and publishing a new guideline, and was heavily lobbied.[76][77]\n",
"\n",
"In the media[edit]\n",
"Media coverage has largely focused on law-enforcement solutions to the epidemic, which portray the issue as criminal rather than medical.[78] There has been differential reporting on how white suburban or rural addicts of opioids are portrayed compared to black and Hispanic urban addicts, often of heroin, reinforcing stereotypes of drug users and drug-using offenders.[79] In newspapers, white addicts' stories are often given more space, allowing for a longer backstory explaining how they became addicted, and what potential they had before using drugs. Black and Hispanic addicts are more likely to be dehumanized, portrayed criminally, and mentioned more briefly.[79]\n",
"\n",
"In July 2017, a 400-page report by the National Academy of Science presented plans to reduce the addiction crisis, which it said was killing 91 people each day.[80]\n",
"\n",
"Solutions for addicts[edit]\n",
"Main article: Drug abuse treatment\n",
"The opioid epidemic is often discussed in terms of prevention, but helping those who are already addicts is talked about less frequently.[78] Opioid dependence can lead to a number of consequences like contraction of HIV and overdose. For addicts who wish to treat their addiction, there are two classes of treatment options available: medical and behavioral.[81] Neither is guaranteed to successfully treat opioid addiction. Which, or which combination, is most effective varies from person to person.[82] These treatments are doctor-prescribed and -regulated, but differ in their treatment mechanism. Popular treatments include naloxone, methadone, and buprenorphine, which are more effective when combined with a form of behavioral treatment.[82]\n",
"\n",
"Naloxone[edit]\n",
"Naloxone is used mostly as a rescue medication for opioid overdose. It is an opioid antagonist, meaning it binds to opioid receptors but does not turn them on. It also happens that naloxone binds to opioid receptors more strongly than heroin or any prescription opioids. This means that when someone is overdosing on opioids, naloxone can be administered, allowing it to take the place of the opioid drug in the person's receptors, turning them off. This blocks the effect of the receptors. Naloxone is sometimes administered with other drugs such as buprenorphine, as a way to taper off buprenorphine over time. Naloxone binds to some of the receptors, blocking the effectiveness of some receptors in case of relapse.[82]\n",
"\n",
"Methadone[edit]\n",
"Methadone has been used for opioid dependence since 1964, and studied the most of the pharmacological treatment options.[83] It is a synthetic long acting opioid, so it can replace multiple heroin uses by being taken once daily.[82] It works by binding to the opioid receptors in the brain and spinal cord, activating them, reducing withdrawal symptoms and cravings while suppressing the \"high\" that other opioids can elicit. The decrease in withdrawal symptoms and cravings allow the user to slowly taper off the drug in a controlled manner, decreasing the likelihood of relapse. It is not accessible to all addicts. It is a regulated substance, and requires that each dose be picked up from a methadone clinic daily. This can be inconvenient as some patients are unable to travel to a clinic, or avoid the stigma associated with drug addiction.[82]\n",
"\n",
"Buprenorphine[edit]\n",
"Buprenorphine is used similarly to methadone, with some doctors recommending it as the best solution for medication-assisted treatment to help people reduce or quit their use of heroin or other opiates. It is claimed to be safer and less regulated than methadone, with month-long prescriptions allowed. It is also said to eliminate opiate withdrawal symptoms and cravings in many patients without inducing euphoria.[84]\n",
"\n",
"Unlike methadone treatment, which must be performed in a highly structured clinic, buprenorphine, according to SAMHSA, can be prescribed or dispensed in physician offices.[85] Patients can thereby receive a full year of treatment for a fraction of the cost of detox programs.[84]\n",
"\n",
"Behavioral treatment options[edit]\n",
"It is less effective to use behavioral treatment without medical treatment during initial detoxification. It has similarly been shown that medical treatments tend to get better results when accompanied by behavioral treatment.[81] Popular behavioral treatment options include group or individual therapy, residential treatment centers, and Twelve-step programs such as Narcotics Anonymous.[83] Residential treatment centers allow for a 24-hour drug-free environment to decrease the chances of relapse. These centers allow addicts to be in supportive environments during the difficult time of detox.[86]\n",
"\n",
"Twelve-step programs are one of the most well-known options. The philosophy is that a group of people sharing the same addiction can remain abstinent with the support of and connection to others who empathize and understand. There is also a spiritual, though not religious, component to it, with freedom to believe as one chooses.[87]\n",
"\n",
"See also[edit]\n",
"Crack epidemic\n",
"List of deaths from drug overdose and intoxication\n",
"References[edit]\n",
"^ Jump up to: a b Data Overview. Drug Overdose. CDC Injury Center, Centers for Disease Control and Prevention 2016.\n",
"Jump up ^ \"WHO | Information sheet on opioid overdose\". www.who.int. Retrieved 2017-07-30.\n",
"^ Jump up to: a b \"2015 National Drug Threat Assessment Summary\", DEA, Oct. 2015\n",
"Jump up ^ \"CDC – MMWR – MMWR Publications – MMWR Weekly: Past Volume (2011)\". www.cdc.gov. November 4, 2011 / 60(43);1487–1492. Retrieved 2017-07-30.\n",
"Jump up ^ \"Drug overdoses now kill more Americans than guns\", CBS News, Dec. 9, 2016\n",
"^ Jump up to: a b \"Drug Deaths in America Are Rising Faster Than Ever\", New York Times, June 5, 2017\n",
"Jump up ^ \"In 2016, drug overdoses likely killed more Americans than the entire wars in Vietnam and Iraq\", Vox, July 7, 2017\n",
"^ Jump up to: a b c d e \"How Bad is the Opioid Epidemic?\", PBS, Feb. 23, 2016\n",
"Jump up ^ \"America’s Addiction to Opioids: Heroin and Prescription Drug Abuse\", National Institute on Drug Abuse (NIDA), May 14, 2014\n",
"^ Jump up to: a b c d e \"America’s opioid epidemic is worsening\", the Economist (U.K.) March 6, 2017\n",
"Jump up ^ \"STAT forecast: Opioids could kill nearly 500,000 Americans in the next decade\", STAT, June 27, 2017\n",
"^ Jump up to: a b Turque, B. Maryland governor declares state of emergency for opioid crisis, The Washington Post, March 1, 2017\n",
"^ Jump up to: a b \"FDA's Scott Gottlieb: Opioid addiction is FDA's biggest crisis now\", CNBC, July 21, 2017\n",
"^ Jump up to: a b \"CDC Chief Frieden: How to end America's growing opioid epidemic\", Fox News, Dec. 17, 2016\n",
"^ Jump up to: a b c d e f g h i j k Caldwell, Christoper. \"American Carnage: The New Landscape of Opioid Addiction\", First Things, April 2017\n",
"^ Jump up to: a b \"White House opioid commission to Trump: ‘Declare a national emergency’ on drug overdoses\", Washington Post, July 31, 2017\n",
"^ Jump up to: a b \"Trump says opioid crisis is a national emergency, pledges more money and attention\", Washington Post, August 10, 2017\n",
"^ Jump up to: a b \"Drug Companies Sure Are Cozy With Trump’s Pick to Solve the Opioid Crisis\". Mother Jones. October 13, 2017. Retrieved October 13, 2017.\n",
"^ Jump up to: a b c \"Facing Addiction in America\", U.S. Surgeon General (2016), 413 pp\n",
"^ Jump up to: a b c d e f \"The opioid epidemic could turn into a pandemic if we’re not careful\", Washington Post, Feb. 9, 2017\n",
"^ Jump up to: a b c \"Opioid Prescriptions Fall After 2010 Peak, C.D.C. Report Finds\", New York Times, July 6, 2017\n",
"^ Jump up to: a b \"Why opioid overdose deaths seem to happen in spurts\", CNN, Feb. 8, 2017\n",
"Jump up ^ \"Heroin Production in Mexico and U.S. Policy\", Congressional Research Service report, March 3, 2016\n",
"Jump up ^ \"Heroin deaths surpass gun homicides for the first time, CDC data shows\", Washington Post, Dec. 8, 2016, Retrieved 2017-05-08\n",
"Jump up ^ \"The Children of the Opioid Crisis\", Wall Street Journal, Dec. 15, 2016\n",
"Jump up ^ \"Fentanyl Takes a Deadly Toll on Vermont\", VTDigger, June 4, 2017\n",
"Jump up ^ \"Why fentanyl is deadlier than heroin, in a single photo\", Stat, Sept. 29, 2016\n",
"Jump up ^ \"Fentanyl drug profile\", The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)\n",
"Jump up ^ \"Fentanyl: Preventing Occupational Exposure to Emergency Responders\", CDC\n",
"Jump up ^ \"Orlando man pleads guilty to selling heroin mixed with fentanyl\", Orlando.com, March 20, 2017\n",
"Jump up ^ \"Opioid Data Analysis\", Centers for Disease Control and Prevention (CDC), date?\n",
"Jump up ^ \"Coroner: Franklin County fentanyl deaths hit ‘unprecedented’ rate of one per day\", The Columbus Dispatch, March 16, 2017\n",
"Jump up ^ \"State, feds seize 14 kilos of dangerous opioid fentanyl in N.J.\", NJ.com, March 17, 2017\n",
"^ Jump up to: a b \"Prince's Autopsy Result Highlights Dangers of Opioid Painkiller Fentanyl\", ABC News, June 2, 2016\n",
"Jump up ^ \"Documents highlight Prince’s struggle with opioid addiction\", Seattle Times, April 17, 2017\n",
"^ Jump up to: a b c d e f \"‘Truly terrifying’: Chinese suppliers flood US and Canada with deadly fentanyl\", STAT, April 5, 2016\n",
"^ Jump up to: a b c Moghe, Sonia. \"Opioids: From 'wonder drug' to abuse epidemic\". CNN. Retrieved 11 April 2017.\n",
"Jump up ^ WGBH educational foundation. Interview with Dr. Robert Dupoint. PBS.org (February 18, 1970)\n",
"^ Jump up to: a b c \"Opioid crisis: The letter that started it all\". bbc.co.uk. BBC. 3 June 2017. Retrieved 3 June 2017.\n",
"Jump up ^ Jane Porter and Hershel Jick (10 January 1980). \"Addiction Rare in Patients Treated with Narcotics\". nejm.org. New England Journal of Medicine. Retrieved 3 June 2017.\n",
"Jump up ^ \"A 1980 Letter on the Risk of Opioid Addiction\". nejm.org. New England Journal of Medicine. 1 June 2017. Retrieved 3 June 2017.\n",
"Jump up ^ Scott, Peter Dale; Marshall, Jonathan. Cocaine Politics: Drugs, Armies, and the CIA in Central America, Berkeley, CA: University of California Press (1991) p. 2\n",
"Jump up ^ Sullivan, Andrew.\"The Opioid Epidemic Is This Generation’s AIDS Crisis\", New York Magazine, March 16, 2017\n",
"Jump up ^ \"Patient brokering exacerbates opioid crisis in Florida\", South Bend Tribune, April 2, 2017\n",
"Jump up ^ de La Bruyere, Emily (August 2, 2017). \"Middletown, Ohio, a city under siege: \"Everyone I know is on heroin\"\". Yahoo.\n",
"Jump up ^ \"Vital Signs: Variation Among States in Prescribing of Opioid Pain Relievers and Benzodiazepines — United States, 2012\", CDC, July 4, 2014\n",
"Jump up ^ \"Americans consume vast majority of the world's opioids\", Dina Gusovsky, CNBC, 27 Apr 2016\n",
"^ Jump up to: a b c Silvia S. Martins, Lilian A. Ghandour \"Nonmedical use of prescription drugs in adolescents and young adults: not just a Western phenomenon\", World Psychiatry, Jan. 26, 2017\n",
"^ Jump up to: a b \"Poll: Many Utahns know people who seek treatment for opioid addiction, but barriers remain\", The Salt Lake Tribune, April 3, 2017\n",
"Jump up ^ \"Overdose Death Rates\", US National Institute on Drug Abuse, January 2017\n",
"Jump up ^ Secure and Responsible Drug Disposal Act of 2010 Oct. 12, 2010, Government Publishing Office, 4pp\n",
"Jump up ^ \"Tackling the Opioid Public Health Crisis\", College of Physicians and Surgeons of Ontario, September 8, 2010\n",
"Jump up ^ \"First Do No Harm: Responding to Canada’s Prescription Drug Crisis\", Canadian Centre on Substance Abuse, March 2013\n",
"Jump up ^ \"UK: Task Force offers ideas for opioid addiction solutions\". Delhidailynews.com. 2014-06-11. Retrieved 2016-01-07.\n",
"Jump up ^ Summary of the Comprehensive Addiction and Recovery Act, American Society of Addiction Medicine.\n",
"Jump up ^ Mike DeBonis, Congress passes 21st Century Cures Act, boosting research and easing drug approvals, Washington Post (December 7, 2016).\n",
"Jump up ^ Juliet Eilperin & Carolyn Y. Johnson, paying tribute to Biden and bipartisanship, signs 21st Century Cures Act Tuesday, Washington Post (December 13, 2016).\n",
"Jump up ^ \"Opioid Epidemic: Trump to Set Up Commission on Addiction Crisis\", NBC News, March 29, 2017\n",
"Jump up ^ \"It's time to 'Trump' opioid addiction in the United States\", The Hill, Feb. 27, 2017\n",
"Jump up ^ \"President Trump Hosts an Opioid and Drug Abuse Listening Session\", Real Clear Politics, March 29, 2017\n",
"Jump up ^ Commissioner, Office of the. \"Press Announcements – FDA requests removal of Opana ER for risks related to abuse\". www.fda.gov. Retrieved 2017-06-15.\n",
"Jump up ^ \"Trump to tap Rep. Tom Marino as 'drug czar'\". Politico. September 1, 2017. Retrieved 13 October 2017.\n",
"Jump up ^ \"A Compact to Fight Opioid Addiction\", National Governors Assoc., July 13, 2016\n",
"Jump up ^ \"Hogan-Rutherford Administration Declares State of Emergency, Announces Major Funding to Combat Heroin and Opioid Crisis in Maryland\", Maryland.gov, March 1, 2017\n",
"Jump up ^ \"Gov. Hogan Announces Opioid Epidemic State Of Emergency\", CBS Baltimore, March 1, 2017\n",
"Jump up ^ \"Delaware lawmakers tackle opioid addiction epidemic\", Newsworks, March 23, 2017\n",
"Jump up ^ \"Governor Snyder rolls out plan to fight opioid addiction\", WILX, March 23, 2017\n",
"Jump up ^ \"Snyder: Efforts to stop opioid abuse aren’t working\", Michigan Radio, March 23, 2017\n",
"Jump up ^ \"HB0299\". le.utah.gov. Retrieved 2017-07-27.\n",
"Jump up ^ \"Opioid distributors sued by West Virginia counties hit by drug crisis\". Washington Post. Retrieved 2017-06-27.\n",
"Jump up ^ \"Lawyer Behind West Virginia County Lawsuit Against Opioid Distributors\". NPR.org. Retrieved 2017-06-27.\n",
"Jump up ^ \"U.S. City Sues OxyContin Maker For Contributing To Opioid Crisis\", NPR, Feb. 3, 2017\n",
"Jump up ^ Dowell, Deborah; Haegerich, Tamara; Chou, Roger (March 15, 2016). \"CDC Guideline for Prescribing Opioids for Chronic Pain—United States, 2016\". JAMA. 315: 1624–45. PMID 26977696. doi:10.1001/jama.2016.1464. Retrieved March 18, 2016.\n",
"Jump up ^ Missouri is final state to pass PDMP program; US News & World Report; April 13, 2017\n",
"Jump up ^ Rutkow Lainie; et al. (2015). \"Most primary care physicians are aware of prescription drug monitoring programs, but many find the data difficult to access\". Health Affairs. 34 (3): 484–492. doi:10.1377/hlthaff.2014.1085.\n",
"Jump up ^ Matthew Perrone, Associated Press. \"Painkiller politics: Effort to curb prescribing under fire\". The Washington Times. Retrieved 2017-06-13.\n",
"Jump up ^ Ghorayshi, Azeen. \"Missouri Is The Only State In The US Where Doctors Have No Idea What Prescriptions People Are Getting\". BuzzFeed. Retrieved 11 April 2017.\n",
"^ Jump up to: a b McGinty, E. \"Criminal Activity or Treatable Health Condition? News Media Framing of Opioid Analgesic Abuse in the United States\". Psychiatric Services. 67: 405–411.\n",
"^ Jump up to: a b Netherland, J. (December 2016). \"The War on Drugs That Wasn't: Wasted Whiteness, \"Dirty Doctors,\" and Race in Media Coverage of Prescription Opioid Misuse\". Cult Med Psychiatry. 40 (4): 664–686.\n",
"Jump up ^ \"Major Science Report Lays Out a Plan to Tamp Down Opioid Crisis\", Scientific American, July 13, 2017\n",
"^ Jump up to: a b Veilleux, Jennifer. \"A Review of Opioid Dependence Treatment: Pharmacological and Psychosocial Interventions to Treat Opioid Addiction\". Clinical Psychology Review. 30.2: 155–166.\n",
"^ Jump up to: a b c d e Dixon, David (May 13, 2017). \"Opioid Abuse Treatment and Management: Medical Care\". Medscape.\n",
"^ Jump up to: a b \"WHAT ARE MY TREATMENT OPTIONS?\". TURN TO HELP. June 11, 2017.\n",
"^ Jump up to: a b \"My View: New approach needed for opioid epidemic\", Portland Tribune, July 25, 2017\n",
"Jump up ^ Buprenorphine, SAMHSA\n",
"Jump up ^ \"Heroin Abuse Solutions\". Narconon New Life Retreat. June 12, 2017.\n",
"Jump up ^ \"12 Step Programs for Drug Rehab & Alcohol Treatment\". American Addiction Centers. June 6, 2017.\n"
]
}
],
"source": [
"text = open('opioid_epidemic.txt').read() # open text file of text from opioid epidemic Wikipedia page\n",
"print(text)"
]
},
{
"cell_type": "code",
"execution_count": 4,
"metadata": {},
"outputs": [
{
"data": {
"text/plain": [
"str"
]
},
"execution_count": 4,
"metadata": {},
"output_type": "execute_result"
}
],
"source": [
"type(text)"
]
},
{
"cell_type": "markdown",
"metadata": {},
"source": [
"The processing that spaCy does can be done in one line:"
]
},
{
"cell_type": "code",
"execution_count": 5,
"metadata": {},
"outputs": [],
"source": [
"parsed_text = nlp(text)"
]
},
{
"cell_type": "code",
"execution_count": 6,
"metadata": {},
"outputs": [
{
"data": {
"text/plain": [
"spacy.tokens.doc.Doc"
]
},
"execution_count": 6,
"metadata": {},
"output_type": "execute_result"
}
],
"source": [
"type(parsed_text)"
]
},
{
"cell_type": "markdown",
"metadata": {},
"source": [
"At this point, we can iterate through the variable `parsed_text` using a for loop. Each element of `parsed_text` is a token:"
]
},
{
"cell_type": "code",
"execution_count": 7,
"metadata": {
"scrolled": true
},
"outputs": [
{
"name": "stdout",
"output_type": "stream",
"text": [
"The the DET \n",
"opioid opioid ADJ \n",
"epidemic epidemic NOUN \n",
"or or CCONJ \n",
"opioid opioid ADJ \n",
"crisis crisis NOUN \n",
"is be AUX \n",
"the the DET \n",
"rapid rapid ADJ \n",
"increase increase NOUN \n",
"in in ADP \n",
"the the DET \n",
"use use NOUN \n",
"of of ADP \n",
"prescription prescription NOUN \n",
"and and CCONJ \n",
"non non ADJ \n",
"- - ADJ \n",
"prescription prescription ADJ \n",
"opioid opioid ADJ \n",
"drugs drug NOUN \n",
"in in ADP \n",
"the the DET GPE\n",
"United United PROPN GPE\n",
"States States PROPN GPE\n",
"and and CCONJ \n",
"Canada Canada PROPN GPE\n",
"in in ADP \n",
"the the DET DATE\n",
"2010s 2010s NUM DATE\n",
". . PUNCT \n",
"Opioids opioid NOUN \n",
"are be AUX \n",
"a a DET \n",
"diverse diverse ADJ \n",
"class class NOUN \n",
"of of ADP \n",
"moderately moderately ADV \n",
"strong strong ADJ \n",
"painkillers painkiller NOUN \n",
", , PUNCT \n",
"including include VERB \n",
"oxycodone oxycodone NOUN \n",
"( ( PUNCT \n",
"commonly commonly ADV \n",
"sold sell VERB \n",
"under under ADP \n",
"the the DET \n",
"trade trade NOUN \n",
"names name NOUN \n",
"OxyContin OxyContin PROPN ORG\n",
"and and CCONJ \n",
"Percocet Percocet PROPN ORG\n",
") ) PUNCT \n",
", , PUNCT \n",
"hydrocodone hydrocodone NOUN \n",
"( ( PUNCT \n",
"Vicodin Vicodin PROPN ORG\n",
") ) PUNCT \n",
", , PUNCT \n",
"and and CCONJ \n",
"a a DET \n",
"very very ADV \n",
"strong strong ADJ \n",
"painkiller painkiller NOUN \n",
", , PUNCT \n",
"fentanyl fentanyl NOUN \n",
", , PUNCT \n",
"which which PRON \n",
"is be AUX \n",
"synthesized synthesize VERB \n",
"to to PART \n",
"resemble resemble VERB \n",
"other other ADJ \n",
"opiates opiate NOUN \n",
"such such ADJ \n",
"as as ADP \n",
"opium opium NOUN \n",
"- - PUNCT \n",
"derived derive VERB \n",
"morphine morphine NOUN \n",
"and and CCONJ \n",
"heroin heroin NOUN \n",
". . PUNCT \n",
"The the DET \n",
"potency potency NOUN \n",
"and and CCONJ \n",
"availability availability NOUN \n",
"of of ADP \n",
"these these DET \n",
"substances substance NOUN \n",
", , PUNCT \n",
"despite despite SCONJ \n",
"their their PRON \n",
"high high ADJ \n",
"risk risk NOUN \n",
"of of ADP \n",
"addiction addiction NOUN \n",
"and and CCONJ \n",
"overdose overdose NOUN \n",
", , PUNCT \n",
"have have AUX \n",
"made make VERB \n",
"them they PRON \n",
"popular popular ADJ \n",
"both both PRON \n",
"as as ADP \n",
"formal formal ADJ \n",
"medical medical ADJ \n",
"treatments treatment NOUN \n",
"and and CCONJ \n",
"as as ADP \n",
"recreational recreational ADJ \n",
"drugs drug NOUN \n",
". . PUNCT \n",
"Due due ADP \n",
"to to ADP \n",
"their their PRON \n",
"sedative sedative ADJ \n",
"effects effect NOUN \n",
"on on ADP \n",
"the the DET \n",
"part part NOUN \n",
"of of ADP \n",
"the the DET \n",
"brain brain NOUN \n",
"which which PRON \n",
"regulates regulate VERB \n",
"breathing breathing NOUN \n",
", , PUNCT \n",
"opioids opioid NOUN \n",
"in in ADP \n",
"high high ADJ \n",
"doses dose NOUN \n",
"present present VERB \n",
"the the DET \n",
"potential potential NOUN \n",
"for for ADP \n",
"respiratory respiratory ADJ \n",
"depression depression NOUN \n",
", , PUNCT \n",
"and and CCONJ \n",
"may may AUX \n",
"cause cause VERB \n",
"respiratory respiratory ADJ \n",
"failure failure NOUN \n",
"and and CCONJ \n",
"death.[2 death.[2 X \n",
"] ] X \n",
"\n",
"\n",
" \n",
"\n",
" SPACE \n",
"According accord VERB \n",
"to to ADP \n",
"the the DET ORG\n",
"U.S. U.S. PROPN ORG\n",
"Drug Drug PROPN ORG\n",
"Enforcement Enforcement PROPN ORG\n",
"Administration Administration PROPN ORG\n",
", , PUNCT \n",
"\" \" PUNCT \n",
"overdose overdose NOUN \n",
"deaths death NOUN \n",
", , PUNCT \n",
"particularly particularly ADV \n",
"from from ADP \n",
"prescription prescription NOUN \n",
"drugs drug NOUN \n",
"and and CCONJ \n",
"heroin heroin NOUN \n",
", , PUNCT \n",
"have have AUX \n",
"reached reach VERB \n",
"epidemic epidemic NOUN \n",
"levels level NOUN \n",
". . PUNCT \n",
"\"[3]:iii \"[3]:iii PUNCT \n",
"Nearly nearly ADV CARDINAL\n",
"half half NOUN CARDINAL\n",
"of of ADP \n",
"all all DET \n",
"opioid opioid ADJ \n",
"overdose overdose NOUN \n",
"deaths death NOUN \n",
"in in ADP \n",
"2016 2016 NUM DATE\n",
"involved involved ADJ \n",
"prescription prescription NOUN \n",
"opioids.[1 opioids.[1 PUNCT \n",
"] ] PUNCT \n",
"From from ADP \n",
"1999 1999 NUM DATE\n",
"to to ADP DATE\n",
"2008 2008 NUM \n",
", , PUNCT \n",
"overdose overdose NOUN \n",
"death death NOUN \n",
"rates rate NOUN \n",
", , PUNCT \n",
"sales sale NOUN \n",
", , PUNCT \n",
"and and CCONJ \n",
"substance substance NOUN \n",
"abuse abuse NOUN \n",
"treatment treatment NOUN \n",
"admissions admission NOUN \n",
"related relate VERB \n",
"to to PART \n",
"opioid opioid VERB \n",
"pain pain NOUN \n",
"relievers reliever NOUN \n",
"all all PRON \n",
"increased increase VERB \n",
"substantially.[4 substantially.[4 NUM \n",
"] ] PUNCT \n",
"By by ADP \n",
"2015 2015 NUM DATE\n",
", , PUNCT \n",
"annual annual ADJ \n",
"overdose overdose NOUN \n",
"deaths death NOUN \n",
"from from ADP \n",
"heroin heroin NOUN \n",
"alone alone ADV \n",
"surpassed surpass VERB \n",
"deaths death NOUN \n",
"from from ADP \n",
"both both DET \n",
"car car NOUN \n",
"accidents accident NOUN \n",
"and and CCONJ \n",
"guns gun NOUN \n",
", , PUNCT \n",
"with with ADP \n",
"other other ADJ \n",
"opioid opioid ADJ \n",
"overdose overdose NOUN \n",
"deaths death NOUN \n",
"also also ADV \n",
"on on ADP \n",
"the the DET \n",
"rise.[5 rise.[5 NOUN \n",
"] ] X \n",
"\n",
"\n",
" \n",
"\n",
" SPACE \n",
"Drug Drug PROPN \n",
"overdoses overdose NOUN \n",
"have have AUX \n",
"since since SCONJ \n",
"become become VERB \n",
"the the DET \n",
"leading lead VERB \n",
"cause cause NOUN \n",
"of of ADP \n",
"death death NOUN \n",
"of of ADP \n",
"Americans Americans PROPN NORP\n",
"under under ADP \n",
"50 50 NUM \n",
", , PUNCT \n",
"with with ADP \n",
"two two NUM CARDINAL\n",
"- - PUNCT CARDINAL\n",
"thirds third NOUN CARDINAL\n",
"of of ADP \n",
"those those DET \n",
"deaths death NOUN \n",
"from from ADP \n",
"opioids.[6 opioids.[6 X \n",
"] ] PUNCT \n",
"In in ADP \n",
"2016 2016 NUM DATE\n",
", , PUNCT \n",
"62,000 62,000 NUM CARDINAL\n",
"Americans Americans PROPN NORP\n",
"died die VERB \n",
"from from ADP \n",
"overdoses overdose NOUN \n",
", , PUNCT \n",
"19 19 NUM PERCENT\n",
"percent percent NOUN PERCENT\n",
"more more ADJ \n",
"than than ADP \n",
"in in ADP \n",
"2015 2015 NUM DATE\n",
", , PUNCT \n",
"and and CCONJ \n",
"had have AUX \n",
"killed kill VERB \n",
"more more ADJ \n",
"Americans Americans PROPN NORP\n",
"in in ADP \n",
"one one NUM DATE\n",
"year year NOUN DATE\n",
"than than ADP \n",
"both both CCONJ \n",
"the the DET \n",
"wars war NOUN \n",
"in in ADP \n",
"Vietnam Vietnam PROPN GPE\n",
"and and CCONJ \n",
"Iraq Iraq PROPN GPE\n",
"combined.[7][6 combined.[7][6 PROPN \n",
"] ] PUNCT \n",
"By by ADP \n",
"comparison comparison NOUN \n",
", , PUNCT \n",
"the the DET \n",
"figure figure NOUN \n",
"was be AUX \n",
"16,000 16,000 NUM CARDINAL\n",
"in in ADP \n",
"2010 2010 NUM DATE\n",
", , PUNCT \n",
"and and CCONJ \n",
"4,000 4,000 NUM CARDINAL\n",
"in in ADP \n",
"1999 1999 NUM DATE\n",
". . PUNCT \n",
"Figures figure NOUN \n",
"from from ADP \n",
"June June PROPN DATE\n",
"2017 2017 NUM DATE\n",
"indicate indicate VERB \n",
"the the DET \n",
"problem problem NOUN \n",
"has have VERB \n",
"worsened.[8][9 worsened.[8][9 PROPN \n",
"] ] X \n",
"While while SCONJ \n",
"death death NOUN \n",
"rates rate NOUN \n",
"varied vary VERB \n",
"by by ADP \n",
"state,[10 state,[10 X \n",
"] ] PUNCT \n",
"public public ADJ \n",
"health health NOUN \n",
"experts expert NOUN \n",
"estimate estimate VERB \n",
"that that SCONJ \n",
"nationwide nationwide ADV \n",
"over over ADP CARDINAL\n",
"500,000 500,000 NUM CARDINAL\n",
"people people NOUN \n",
"could could AUX \n",
"die die VERB \n",
"from from ADP \n",
"the the DET \n",
"epidemic epidemic NOUN \n",
"over over ADP \n",
"the the DET DATE\n",
"next next ADJ DATE\n",
"10 10 NUM DATE\n",
"years.[11 years.[11 NOUN DATE\n",
"] ] X \n",
"\n",
"\n",
" \n",
"\n",
" SPACE \n",
"In in ADP \n",
"March March PROPN DATE\n",
"2017 2017 NUM DATE\n",
", , PUNCT \n",
"Larry Larry PROPN PERSON\n",
"Hogan Hogan PROPN PERSON\n",
", , PUNCT \n",
"the the DET \n",
"governor governor NOUN \n",
"of of ADP \n",
"Maryland Maryland PROPN GPE\n",
", , PUNCT \n",
"declared declare VERB \n",
"a a DET \n",
"state state NOUN \n",
"of of ADP \n",
"emergency emergency NOUN \n",
"to to PART \n",
"combat combat VERB \n",
"the the DET \n",
"opioid opioid ADJ \n",
"epidemic,[12 epidemic,[12 X \n",
"] ] PUNCT \n",
"and and CCONJ \n",
"in in ADP \n",
"July July PROPN DATE\n",
"2017 2017 NUM DATE\n",
"opioid opioid ADJ \n",
"addiction addiction NOUN \n",
"was be AUX \n",
"cited cite VERB \n",
"as as ADP \n",
"the the DET \n",
"\" \" PUNCT \n",
"FDA FDA PROPN ORG\n",
"'s 's PART \n",
"biggest big ADJ \n",
"crisis crisis NOUN \n",
". . PUNCT \n",
"\"[13 \"[13 X \n",
"] ] PUNCT \n",
"CDC CDC PROPN ORG\n",
"director director NOUN \n",
"Thomas Thomas PROPN PERSON\n",
"Frieden Frieden PROPN PERSON\n",
"said say VERB \n",
"that that SCONJ \n",
"\" \" PUNCT \n",
"America America PROPN GPE\n",
"is be AUX \n",
"awash awash ADJ \n",
"in in ADP \n",
"opioids opioid NOUN \n",
"; ; PUNCT \n",
"urgent urgent ADJ \n",
"action action NOUN \n",
"is be AUX \n",
"critical critical ADJ \n",
". . PUNCT \n",
"\"[14 \"[14 X \n",
"] ] PUNCT \n",
"The the DET \n",
"crisis crisis NOUN \n",
"has have AUX \n",
"changed change VERB \n",
"moral moral ADJ \n",
", , PUNCT \n",
"social social ADJ \n",
", , PUNCT \n",
"and and CCONJ \n",
"cultural cultural ADJ \n",
"resistance resistance NOUN \n",
"to to ADP \n",
"street street NOUN \n",
"drug drug NOUN \n",
"alternatives alternative NOUN \n",
"such such ADJ \n",
"as as ADP \n",
"heroin.[15 heroin.[15 NOUN \n",
"] ] X \n",
"On on ADP \n",
"August August PROPN DATE\n",
"10 10 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
", , PUNCT \n",
"President President PROPN \n",
"Donald Donald PROPN PERSON\n",
"Trump Trump PROPN PERSON\n",
"agreed agree VERB \n",
"with with ADP \n",
"his his PRON \n",
"Commission Commission PROPN ORG\n",
"'s 's PART \n",
"report report NOUN \n",
"released release VERB \n",
"few few ADJ DATE\n",
"weeks week NOUN DATE\n",
"earlier early ADV DATE\n",
"and and CCONJ \n",
"declared declare VERB \n",
"the the DET \n",
"country country NOUN \n",
"'s 's PART \n",
"opioid opioid ADJ \n",
"crisis crisis NOUN \n",
"a a DET \n",
"\" \" PUNCT \n",
"national national ADJ \n",
"emergency emergency NOUN \n",
". . PUNCT \n",
"\"[16][17 \"[16][17 X \n",
"] ] PUNCT \n",
"On on ADP \n",
"September September PROPN DATE\n",
"1 1 NUM DATE\n",
", , PUNCT \n",
"Trump Trump PROPN ORG\n",
"nominated nominate VERB \n",
"as as ADP \n",
"\" \" PUNCT \n",
"drug drug NOUN \n",
"czar czar NOUN \n",
"\" \" PUNCT \n",
"Tom Tom PROPN PERSON\n",
"Marino Marino PROPN PERSON\n",
", , PUNCT \n",
"whose whose DET \n",
"election election NOUN \n",
"campaign campaign NOUN \n",
"had have AUX \n",
"been be AUX \n",
"financed finance VERB \n",
"by by ADP \n",
"pharmaceutical pharmaceutical ADJ \n",
"distribution distribution NOUN \n",
"companies company NOUN \n",
"that that PRON \n",
"had have AUX \n",
"lobbied lobby VERB \n",
"for for ADP \n",
", , PUNCT \n",
"and and CCONJ \n",
"profited profit VERB \n",
"from from ADP \n",
", , PUNCT \n",
"legislation legislation NOUN \n",
"co co VERB \n",
"- - VERB \n",
"sponsored sponsor VERB \n",
"by by ADP \n",
"Marino Marino PROPN PERSON\n",
"which which PRON \n",
"protected protect VERB \n",
"pharmacies pharmacy NOUN \n",
"suspected suspect VERB \n",
"of of ADP \n",
"diverting divert VERB \n",
"pills.[18 pills.[18 PROPN \n",
"] ] NOUN \n",
"\n",
"\n",
" \n",
"\n",
" SPACE \n",
"Contents content NOUN \n",
" SPACE \n",
"[ [ X \n",
"hide hide VERB \n",
"] ] X \n",
"\n",
" \n",
" SPACE \n",
"1 1 NUM \n",
" SPACE \n",
"Background Background PROPN \n",
"in in ADP \n",
"the the DET GPE\n",
"United United PROPN GPE\n",
"States States PROPN GPE\n",
"\n",
" \n",
" SPACE \n",
"1.1 1.1 NUM CARDINAL\n",
" SPACE \n",
"Main main ADJ \n",
"causes cause NOUN \n",
"\n",
" \n",
" SPACE \n",
"1.2 1.2 NUM CARDINAL\n",
" SPACE \n",
"Effects effect NOUN \n",
"\n",
" \n",
" SPACE \n",
"1.3 1.3 NUM CARDINAL\n",
" SPACE \n",
"Fentanyl Fentanyl PROPN PERSON\n",
"\n",
" \n",
" SPACE \n",
"1.4 1.4 NUM CARDINAL\n",
" SPACE \n",
"History history NOUN \n",
"of of ADP \n",
"opiate opiate ADJ \n",
"use use NOUN \n",
"in in ADP \n",
"the the DET GPE\n",
"United United PROPN GPE\n",
"States States PROPN GPE\n",
"\n",
" \n",
" SPACE \n",
"1.5 1.5 NUM CARDINAL\n",
" SPACE \n",
"Demographics demographic NOUN \n",
"\n",
" \n",
" SPACE \n",
"1.6 1.6 NUM \n",
" SPACE \n",
"Outside outside ADP \n",
"the the DET \n",
"U.S. U.S. PROPN GPE\n",
"\n",
" \n",
" SPACE \n",
"2 2 NUM CARDINAL\n",
" SPACE \n",
"Countermeasures countermeasure NOUN \n",
"\n",
" \n",
" SPACE \n",
"2.1 2.1 NUM CARDINAL\n",
" SPACE \n",
"Federal federal ADJ \n",
"government government NOUN \n",
"\n",
" \n",
" SPACE \n",
"2.2 2.2 NUM CARDINAL\n",
" SPACE \n",
"State State PROPN \n",
"and and CCONJ \n",
"local local ADJ \n",
"governments government NOUN \n",
"\n",
" \n",
" SPACE \n",
"2.3 2.3 NUM CARDINAL\n",
" SPACE \n",
"Prescription Prescription PROPN \n",
"drug drug NOUN \n",
"monitoring monitoring NOUN \n",
"\n",
" \n",
" SPACE \n",
"2.4 2.4 NUM CARDINAL\n",
" SPACE \n",
"In in ADP \n",
"the the DET \n",
"media medium NOUN \n",
"\n",
" \n",
" SPACE \n",
"2.5 2.5 NUM CARDINAL\n",
" SPACE \n",
"Solutions Solutions PROPN \n",
"for for ADP \n",
"addicts addict NOUN \n",
"\n",
" \n",
" SPACE \n",
"2.5.1 2.5.1 PROPN \n",
" SPACE \n",
"Naloxone Naloxone PROPN \n",
"\n",
" \n",
" SPACE \n",
"2.5.2 2.5.2 NUM CARDINAL\n",
" SPACE \n",
"Methadone Methadone PROPN \n",
"\n",
" \n",
" SPACE \n",
"2.5.3 2.5.3 NUM CARDINAL\n",
" SPACE \n",
"Buprenorphine Buprenorphine PROPN \n",
"\n",
" \n",
" SPACE \n",
"2.5.4 2.5.4 NUM \n",
" SPACE \n",
"Behavioral behavioral ADJ \n",
"treatment treatment NOUN \n",
"options option NOUN \n",
"\n",
" \n",
" SPACE \n",
"3 3 NUM CARDINAL\n",
" SPACE \n",
"See see VERB \n",
"also also ADV \n",
"\n",
" \n",
" SPACE \n",
"4 4 NUM CARDINAL\n",
" SPACE \n",
"References References PROPN \n",
"\n",
" \n",
" SPACE \n",
"5 5 NUM CARDINAL\n",
" SPACE \n",
"External external ADJ \n",
"links link NOUN \n",
"\n",
" \n",
" SPACE \n",
"Background Background PROPN FAC\n",
"in in ADP \n",
"the the DET \n",
"United United PROPN \n",
"States[edit States[edit PROPN \n",
"] ] PUNCT \n",
"\n",
" \n",
" SPACE \n",
"Main main ADJ \n",
"causes[edit causes[edit NOUN \n",
"] ] PUNCT \n",
"\n",
" \n",
" SPACE \n",
"What what PRON \n",
"the the DET ORG\n",
"U.S. U.S. PROPN ORG\n",
"Surgeon Surgeon PROPN ORG\n",
"General General PROPN ORG\n",
"calls call VERB \n",
"\" \" PUNCT \n",
"The the DET WORK_OF_ART\n",
"Opioid Opioid PROPN WORK_OF_ART\n",
"Crisis Crisis PROPN WORK_OF_ART\n",
"\" \" PUNCT \n",
"likely likely ADV \n",
"began begin VERB \n",
"with with ADP \n",
"over over ADP \n",
"- - PUNCT \n",
"prescription prescription NOUN \n",
"of of ADP \n",
"powerful powerful ADJ \n",
"opioid opioid ADJ \n",
"pain pain NOUN \n",
"relievers reliever NOUN \n",
"in in ADP \n",
"the the DET DATE\n",
"1990s 1990 NOUN DATE\n",
", , PUNCT \n",
"which which PRON \n",
"led lead VERB \n",
"to to ADP \n",
"them they PRON \n",
"becoming become VERB \n",
"the the DET \n",
"most most ADV \n",
"prescribed prescribed ADJ \n",
"class class NOUN \n",
"of of ADP \n",
"medications medication NOUN \n",
"in in ADP \n",
"the the DET GPE\n",
"United United PROPN GPE\n",
"States States PROPN GPE\n",
". . PUNCT \n",
"As as ADP \n",
"of of ADP \n",
"2016 2016 NUM DATE\n",
"more more ADJ \n",
"than than ADP \n",
"289 289 NUM CARDINAL\n",
"million million NUM CARDINAL\n",
"prescriptions prescription NOUN \n",
"were be AUX \n",
"written write VERB \n",
"for for ADP \n",
"opioid opioid ADJ \n",
"drugs drug NOUN \n",
"per per ADP \n",
"year.[19]:43In year.[19]:43in NOUN \n",
"the the DET DATE\n",
"late late ADJ DATE\n",
"1990s 1990 NOUN DATE\n",
", , PUNCT \n",
"many many ADJ \n",
"Americans Americans PROPN NORP\n",
"were be AUX \n",
"diagnosed diagnose VERB \n",
"with with ADP \n",
"chronic chronic ADJ \n",
"pain pain NOUN \n",
", , PUNCT \n",
"estimated estimate VERB \n",
"to to PART \n",
"affect affect VERB \n",
"around around ADP CARDINAL\n",
"100 100 NUM CARDINAL\n",
"million million NUM CARDINAL\n",
"people people NOUN \n",
"or or CCONJ \n",
"a a DET CARDINAL\n",
"third third NOUN CARDINAL\n",
"of of ADP \n",
"the the DET \n",
"U.S. U.S. PROPN GPE\n",
"population population NOUN \n",
". . PUNCT \n",
"This this PRON \n",
"led lead VERB \n",
"to to ADP \n",
"a a DET \n",
"push push NOUN \n",
"by by ADP \n",
"drug drug NOUN \n",
"companies company NOUN \n",
"and and CCONJ \n",
"the the DET \n",
"federal federal ADJ \n",
"government government NOUN \n",
"to to PART \n",
"expand expand VERB \n",
"the the DET \n",
"use use NOUN \n",
"of of ADP \n",
"painkilling painkille VERB \n",
"opioids.[10 opioids.[10 X \n",
"] ] PUNCT \n",
"Between between ADP DATE\n",
"1991 1991 NUM DATE\n",
"and and CCONJ DATE\n",
"2011 2011 NUM DATE\n",
", , PUNCT \n",
"painkiller painkiller NOUN \n",
"prescriptions prescription NOUN \n",
"in in ADP \n",
"the the DET \n",
"U.S. U.S. PROPN GPE\n",
"tripled triple VERB \n",
"from from ADP \n",
"76 76 NUM CARDINAL\n",
"million million NUM CARDINAL\n",
"to to ADP \n",
"219 219 NUM CARDINAL\n",
"million million NUM CARDINAL\n",
"per per ADP \n",
"year year NOUN \n",
". . PUNCT \n",
"Among among ADP \n",
"the the DET \n",
"most most ADV \n",
"common common ADJ \n",
"opioids opioid NOUN \n",
"prescribed prescribe VERB \n",
"have have AUX \n",
"been be AUX \n",
"oxycodone oxycodone NOUN \n",
"( ( PUNCT \n",
"OxyContin OxyContin PROPN ORG\n",
"and and CCONJ \n",
"Percocet Percocet PROPN ORG\n",
") ) PUNCT \n",
"and and CCONJ \n",
"hydrocodone hydrocodone NOUN \n",
"( ( PUNCT \n",
"Vicodin Vicodin PROPN ORG\n",
") ) PUNCT \n",
". . PUNCT \n",
"With with ADP \n",
"the the DET \n",
"increase increase NOUN \n",
"in in ADP \n",
"volume volume NOUN \n",
", , PUNCT \n",
"potency potency NOUN \n",
"of of ADP \n",
"opioids opioid NOUN \n",
"also also ADV \n",
"increased increase VERB \n",
". . PUNCT \n",
"By by ADP \n",
"2002 2002 NUM DATE\n",
", , PUNCT \n",
"one one NUM CARDINAL\n",
"in in ADP \n",
"six six NUM CARDINAL\n",
"drug drug NOUN \n",
"users user NOUN \n",
"were be AUX \n",
"being be AUX \n",
"prescribed prescribe VERB \n",
"drugs drug NOUN \n",
"more more ADV \n",
"powerful powerful ADJ \n",
"than than ADP \n",
"morphine morphine NOUN \n",
"; ; PUNCT \n",
"by by ADP \n",
"2012 2012 NUM DATE\n",
", , PUNCT \n",
"the the DET \n",
"ratio ratio NOUN \n",
"had have AUX \n",
"doubled double VERB \n",
"to to ADP \n",
"one one NUM CARDINAL\n",
"- - PUNCT \n",
"in in ADP \n",
"- - PUNCT \n",
"three.[10 three.[10 NOUN \n",
"] ] X \n",
"\n",
"\n",
" \n",
"\n",
" SPACE \n",
"Despite despite SCONJ \n",
"the the DET \n",
"increased increase VERB \n",
"use use NOUN \n",
"of of ADP \n",
"painkillers painkiller NOUN \n",
", , PUNCT \n",
"there there PRON \n",
"has have AUX \n",
"been be AUX \n",
"no no DET \n",
"change change NOUN \n",
"in in ADP \n",
"the the DET \n",
"amount amount NOUN \n",
"of of ADP \n",
"pain pain NOUN \n",
"reported report VERB \n",
"in in ADP \n",
"the the DET \n",
"U.S.[20][19 u.s.[20][19 NOUN \n",
"] ] PUNCT \n",
"This this PRON \n",
"has have AUX \n",
"led lead VERB \n",
"to to ADP \n",
"differing differ VERB \n",
"medical medical ADJ \n",
"opinions opinion NOUN \n",
", , PUNCT \n",
"with with ADP \n",
"some some PRON \n",
"noting note VERB \n",
"that that SCONJ \n",
"there there PRON \n",
"is be VERB \n",
"little little ADJ \n",
"evidence evidence NOUN \n",
"that that SCONJ \n",
"opioids opioid NOUN \n",
"are be AUX \n",
"effective effective ADJ \n",
"for for ADP \n",
"chronic chronic ADJ \n",
"pain pain NOUN \n",
"not not PART \n",
"caused cause VERB \n",
"by by ADP \n",
"cancer.[21 cancer.[21 PROPN \n",
"] ] PUNCT \n",
"\n",
"\n",
" \n",
"\n",
" SPACE \n",
"Effects[edit effects[edit NOUN \n",
"] ] PUNCT \n",
"\n",
" \n",
" SPACE \n",
"When when SCONJ \n",
"people people NOUN \n",
"continue continue VERB \n",
"to to PART \n",
"use use VERB \n",
"opioids opioid NOUN \n",
"beyond beyond ADP \n",
"what what PRON \n",
"a a DET \n",
"doctor doctor NOUN \n",
"prescribes prescribe VERB \n",
", , PUNCT \n",
"whether whether SCONJ \n",
"to to PART \n",
"minimize minimize VERB \n",
"pain pain NOUN \n",
"or or CCONJ \n",
"to to PART \n",
"enjoy enjoy VERB \n",
"the the DET \n",
"euphoric euphoric ADJ \n",
"feelings feeling NOUN \n",
", , PUNCT \n",
"it it PRON \n",
"can can AUX \n",
"mark mark VERB \n",
"the the DET \n",
"beginning beginning NOUN \n",
"stages stage NOUN \n",
"of of ADP \n",
"an an DET \n",
"opiate opiate ADJ \n",
"addiction addiction NOUN \n",
", , PUNCT \n",
"with with ADP \n",
"a a DET \n",
"tolerance tolerance NOUN \n",
"developing develop VERB \n",
"and and CCONJ \n",
"eventually eventually ADV \n",
"leading lead VERB \n",
"to to ADP \n",
"dependence dependence NOUN \n",
", , PUNCT \n",
"when when SCONJ \n",
"a a DET \n",
"person person NOUN \n",
"relies rely VERB \n",
"on on ADP \n",
"the the DET \n",
"drug drug NOUN \n",
"to to PART \n",
"prevent prevent VERB \n",
"withdrawal withdrawal PROPN \n",
"symptoms.[22 symptoms.[22 NOUN \n",
"] ] X \n",
"\n",
"\n",
" \n",
"\n",
" SPACE \n",
"As as SCONJ \n",
"the the DET \n",
"number number NOUN \n",
"of of ADP \n",
"opioid opioid ADJ \n",
"prescriptions prescription NOUN \n",
"rose rise VERB \n",
", , PUNCT \n",
"drug drug NOUN \n",
"cartels cartel NOUN \n",
"began begin VERB \n",
"flooding flood VERB \n",
"the the DET \n",
"U.S. U.S. PROPN GPE\n",
"with with ADP \n",
"heroin heroin NOUN \n",
". . PUNCT \n",
"For for ADP \n",
"many many ADJ \n",
"opioid opioid ADJ \n",
"users user NOUN \n",
", , PUNCT \n",
"heroin heroin NOUN \n",
"was be AUX \n",
"cheaper cheap ADJ \n",
", , PUNCT \n",
"more more ADV \n",
"potent potent ADJ \n",
", , PUNCT \n",
"and and CCONJ \n",
"often often ADV \n",
"easier easy ADJ \n",
"to to PART \n",
"acquire acquire VERB \n",
"than than ADP \n",
"prescription prescription NOUN \n",
"medications.[8 medications.[8 PUNCT \n",
"] ] PUNCT \n",
"According accord VERB \n",
"to to ADP \n",
"the the DET \n",
"CDC CDC PROPN ORG\n",
", , PUNCT \n",
"tighter tight ADJ \n",
"prescription prescription NOUN \n",
"policies policy NOUN \n",
"by by ADP \n",
"doctors doctor NOUN \n",
"did do AUX \n",
"not not PART \n",
"necessarily necessarily ADV \n",
"lead lead VERB \n",
"to to ADP \n",
"this this DET \n",
"increased increase VERB \n",
"heroin heroin NOUN \n",
"use.[21 use.[21 X \n",
"] ] X \n",
"The the DET \n",
"main main ADJ \n",
"suppliers supplier NOUN \n",
"of of ADP \n",
"heroin heroin NOUN \n",
"to to ADP \n",
"the the DET \n",
"U.S. U.S. PROPN GPE\n",
"have have AUX \n",
"been be AUX \n",
"Mexican mexican ADJ NORP\n",
"transnational transnational ADJ \n",
"criminal criminal NOUN \n",
"organizations.[8 organizations.[8 PUNCT \n",
"] ] PUNCT \n",
"From from ADP \n",
"2005–2009 2005–2009 NUM DATE\n",
", , PUNCT \n",
"Mexican mexican ADJ NORP\n",
"heroin heroin NOUN \n",
"production production NOUN \n",
"increased increase VERB \n",
"by by ADP \n",
"over over ADP \n",
"600 600 NUM PERCENT\n",
"% % NOUN PERCENT\n",
", , PUNCT \n",
"from from ADP \n",
"an an DET QUANTITY\n",
"estimated estimate VERB QUANTITY\n",
"8 8 NUM QUANTITY\n",
"metric metric ADJ QUANTITY\n",
"tons ton NOUN QUANTITY\n",
"in in ADP \n",
"2005 2005 NUM DATE\n",
"to to ADP \n",
"50 50 NUM QUANTITY\n",
"metric metric ADJ QUANTITY\n",
"tons ton NOUN QUANTITY\n",
"in in ADP \n",
"2009.[8 2009.[8 NUM CARDINAL\n",
"] ] PUNCT \n",
"Between between ADP DATE\n",
"2010 2010 NUM DATE\n",
"and and CCONJ DATE\n",
"2014 2014 NUM DATE\n",
", , PUNCT \n",
"the the DET \n",
"amount amount NOUN \n",
"seized seize VERB \n",
"at at ADP \n",
"the the DET \n",
"border border NOUN \n",
"more more ADJ \n",
"than than ADP \n",
"doubled.[23 doubled.[23 ADJ \n",
"] ] PUNCT \n",
"According accord VERB \n",
"to to ADP \n",
"the the DET \n",
"DEA DEA PROPN ORG\n",
", , PUNCT \n",
"smugglers smuggler NOUN \n",
"and and CCONJ \n",
"distributors distributor NOUN \n",
"\" \" PUNCT \n",
"profit profit VERB \n",
"primarily primarily ADV \n",
"by by ADP \n",
"putting put VERB \n",
"drugs drug NOUN \n",
"on on ADP \n",
"the the DET \n",
"street street NOUN \n",
"and and CCONJ \n",
"have have AUX \n",
"become become VERB \n",
"crucial crucial ADJ \n",
"to to ADP \n",
"the the DET \n",
"Mexican mexican ADJ NORP\n",
"cartels cartel NOUN \n",
". . PUNCT \n",
"\"[3]:3 \"[3]:3 ADJ \n",
"\n",
"\n",
"\n",
" \n",
"\n",
"\n",
" SPACE \n",
"Opiate opiate ADJ \n",
"self self NOUN \n",
"- - PUNCT \n",
"injection injection NOUN \n",
"paraphernalia paraphernalia NOUN \n",
"\n",
" \n",
" SPACE \n",
"The the DET \n",
"opioid opioid ADJ \n",
"epidemic epidemic NOUN \n",
"has have AUX \n",
"since since ADV \n",
"emerged emerge VERB \n",
"as as ADP \n",
"one one NUM \n",
"of of ADP \n",
"the the DET \n",
"worst bad ADJ \n",
"drug drug NOUN \n",
"crises crisis NOUN \n",
"in in ADP \n",
"American american ADJ NORP\n",
"history history NOUN \n",
": : PUNCT \n",
"more more ADJ CARDINAL\n",
"than than ADP CARDINAL\n",
"33,000 33,000 NUM CARDINAL\n",
"people people NOUN \n",
"died die VERB \n",
"from from ADP \n",
"overdoses overdose NOUN \n",
"in in ADP \n",
"2015 2015 NUM DATE\n",
", , PUNCT \n",
"nearly nearly ADV \n",
"equal equal ADJ \n",
"to to ADP \n",
"the the DET \n",
"number number NOUN \n",
"of of ADP \n",
"deaths death NOUN \n",
"from from ADP \n",
"car car NOUN \n",
"crashes crash NOUN \n",
", , PUNCT \n",
"with with ADP \n",
"deaths death NOUN \n",
"from from ADP \n",
"heroin heroin NOUN \n",
"alone alone ADV \n",
"more more ADV \n",
"than than ADP \n",
"from from ADP \n",
"gun gun NOUN \n",
"homicides.[24 homicides.[24 NOUN \n",
"] ] X \n",
"It it PRON \n",
"has have AUX \n",
"also also ADV \n",
"left leave VERB \n",
"thousands thousand NOUN CARDINAL\n",
"of of ADP \n",
"children child NOUN \n",
"suddenly suddenly ADV \n",
"in in ADP \n",
"need need NOUN \n",
"of of ADP \n",
"foster foster PROPN \n",
"care care NOUN \n",
"after after SCONJ \n",
"their their PRON \n",
"parents parent NOUN \n",
"have have AUX \n",
"died die VERB \n",
"from from ADP \n",
"an an DET \n",
"overdose.[25 overdose.[25 NOUN \n",
"] ] X \n",
"\n",
"\n",
" \n",
"\n",
" SPACE \n",
"Fentanyl[edit fentanyl[edit NOUN \n",
"] ] PUNCT \n",
"\n",
" \n",
" SPACE \n",
"There there PRON \n",
"have have AUX \n",
"always always ADV \n",
"been be AUX \n",
"drug drug NOUN \n",
"addicts addict NOUN \n",
"in in ADP \n",
"need need NOUN \n",
"of of ADP \n",
"help help NOUN \n",
", , PUNCT \n",
"but but CCONJ \n",
"the the DET \n",
"scale scale NOUN \n",
"of of ADP \n",
"the the DET \n",
"present present ADJ \n",
"wave wave NOUN \n",
"of of ADP \n",
"heroin heroin NOUN \n",
"and and CCONJ \n",
"opioid opioid ADJ \n",
"abuse abuse NOUN \n",
"is be AUX \n",
"unprecedented unprecedented ADJ \n",
". . PUNCT \n",
"In in ADP \n",
"Maryland Maryland PROPN GPE\n",
", , PUNCT \n",
"the the DET DATE\n",
"first first ADJ DATE\n",
"six six NUM DATE\n",
"months month NOUN DATE\n",
"of of ADP DATE\n",
"2015 2015 NUM DATE\n",
"saw see VERB \n",
"121 121 NUM CARDINAL\n",
"fentanyl fentanyl ADJ \n",
"deaths death NOUN \n",
". . PUNCT \n",
"In in ADP \n",
"the the DET DATE\n",
"first first ADJ DATE\n",
"six six NUM DATE\n",
"months month NOUN DATE\n",
"of of ADP DATE\n",
"2016 2016 NUM DATE\n",
", , PUNCT \n",
"the the DET \n",
"figure figure NOUN \n",
"rose rise VERB \n",
"to to ADP \n",
"446 446 NUM CARDINAL\n",
". . PUNCT \n",
"\n",
" \n",
" SPACE \n",
"Christopher Christopher PROPN PERSON\n",
"Caldwell Caldwell PROPN PERSON\n",
", , PUNCT \n",
"\n",
" \n",
" SPACE \n",
"senior senior ADJ \n",
"editor editor NOUN \n",
"The the DET \n",
"Weekly Weekly PROPN \n",
"Standard[15 standard[15 NOUN \n",
"] ] X \n",
"\n",
" \n",
" SPACE \n",
"Fentanyl Fentanyl PROPN PERSON\n",
", , PUNCT \n",
"a a DET \n",
"newer new ADJ \n",
"synthetic synthetic ADJ \n",
"opioid opioid NOUN \n",
"painkiller painkiller NOUN \n",
", , PUNCT \n",
"is be AUX \n",
"50 50 NUM CARDINAL\n",
"to to PART CARDINAL\n",
"100 100 NUM CARDINAL\n",
"times time NOUN \n",
"more more ADV \n",
"potent potent ADJ \n",
"than than ADP \n",
"morphine morphine NOUN \n",
"and and CCONJ \n",
"30 30 NUM CARDINAL\n",
"to to PART CARDINAL\n",
"50 50 NUM CARDINAL\n",
"times time NOUN \n",
"more more ADV \n",
"potent potent ADJ \n",
"than than ADP \n",
"heroin,[15 heroin,[15 PROPN \n",
"] ] PUNCT \n",
"with with ADP \n",
"only only ADV CARDINAL\n",
"2 2 NUM CARDINAL\n",
"mg mg ADP \n",
"becoming become VERB \n",
"a a DET \n",
"lethal lethal ADJ \n",
"dose dose NOUN \n",
". . PUNCT \n",
"It it PRON \n",
"is be AUX \n",
"pure pure ADJ \n",
"white white ADJ \n",
", , PUNCT \n",
"odorless odorless NOUN \n",
"and and CCONJ \n",
"flavorless flavorless NOUN \n",
", , PUNCT \n",
"with with ADP \n",
"a a DET \n",
"potency potency NOUN \n",
"strong strong ADJ \n",
"enough enough ADV \n",
"that that SCONJ \n",
"police police NOUN \n",
"and and CCONJ \n",
"first first ADJ ORDINAL\n",
"responders responder NOUN \n",
"helping help VERB \n",
"overdose overdose ADJ \n",
"victims victim NOUN \n",
"have have AUX \n",
"themselves themselves PRON \n",
"overdosed overdose VERB \n",
"by by ADP \n",
"simply simply ADV \n",
"touching touching ADJ \n",
"or or CCONJ \n",
"inhaling inhale VERB \n",
"a a DET \n",
"small small ADJ \n",
"amount.[26][27][28 amount.[26][27][28 NOUN \n",
"] ] PUNCT \n",
"As as ADP \n",
"a a DET \n",
"result result NOUN \n",
", , PUNCT \n",
"the the DET \n",
"DEA DEA PROPN ORG\n",
"has have AUX \n",
"recommended recommend VERB \n",
"that that SCONJ \n",
"officers officer NOUN \n",
"not not PART \n",
"field field VERB \n",
"test test NOUN \n",
"drugs drug NOUN \n",
"if if SCONJ \n",
"fentanyl fentanyl ADJ \n",
"is be AUX \n",
"suspected suspect VERB \n",
", , PUNCT \n",
"but but CCONJ \n",
"instead instead ADV \n",
"collect collect VERB \n",
"and and CCONJ \n",
"send send VERB \n",
"samples sample NOUN \n",
"to to ADP \n",
"a a DET \n",
"laboratory laboratory NOUN \n",
"for for ADP \n",
"analysis analysis NOUN \n",
". . PUNCT \n",
"\" \" PUNCT \n",
"Exposure exposure NOUN \n",
"via via ADP \n",
"inhalation inhalation NOUN \n",
"or or CCONJ \n",
"skin skin NOUN \n",
"absorption absorption NOUN \n",
"can can AUX \n",
"be be AUX \n",
"deadly deadly ADJ \n",
", , PUNCT \n",
"\" \" PUNCT \n",
"they they PRON \n",
"state.[29 state.[29 VERB \n",
"] ] X \n",
"\n",
"\n",
" \n",
"\n",
" SPACE \n",
"Fentanyl fentanyl ADJ PERSON\n",
"- - PUNCT \n",
"laced lace VERB \n",
"heroin heroin NOUN \n",
"has have AUX \n",
"become become VERB \n",
"a a DET \n",
"big big ADJ \n",
"problem problem NOUN \n",
"for for ADP \n",
"major major ADJ \n",
"cities city NOUN \n",
", , PUNCT \n",
"including include VERB \n",
"Philadelphia Philadelphia PROPN GPE\n",
", , PUNCT \n",
"Detroit Detroit PROPN GPE\n",
"and and CCONJ \n",
"Chicago.[30 chicago.[30 X \n",
"] ] X \n",
"Its its PRON \n",
"use use NOUN \n",
"has have AUX \n",
"caused cause VERB \n",
"a a DET \n",
"spike spike NOUN \n",
"in in ADP \n",
"deaths death NOUN \n",
"among among ADP \n",
"users user NOUN \n",
"of of ADP \n",
"heroin heroin NOUN \n",
"and and CCONJ \n",
"prescription prescription NOUN \n",
"painkillers painkiller NOUN \n",
", , PUNCT \n",
"while while SCONJ \n",
"becoming become VERB \n",
"easier easy ADJ \n",
"to to PART \n",
"obtain obtain VERB \n",
"and and CCONJ \n",
"conceal conceal VERB \n",
". . PUNCT \n",
"Some some DET \n",
"arrested arrest VERB \n",
"or or CCONJ \n",
"hospitalized hospitalize VERB \n",
"users user NOUN \n",
"are be AUX \n",
"surprised surprised ADJ \n",
"to to PART \n",
"find find VERB \n",
"that that SCONJ \n",
"what what PRON \n",
"they they PRON \n",
"thought think VERB \n",
"was be AUX \n",
"heroin heroin ADJ \n",
"was be AUX \n",
"actually actually ADV \n",
"fentanyl.[15 fentanyl.[15 X \n",
"] ] PUNCT \n",
"According accord VERB \n",
"to to ADP \n",
"CDC CDC PROPN ORG\n",
"director director NOUN \n",
"Thomas Thomas PROPN PERSON\n",
"Frieden Frieden PROPN PERSON\n",
": : PUNCT \n",
"\n",
"\n",
" \n",
"\n",
" SPACE \n",
"As as SCONJ \n",
"overdose overdose NOUN \n",
"deaths death NOUN \n",
"involving involve VERB \n",
"heroin heroin NOUN \n",
"more more ADV \n",
"than than ADP \n",
"quadrupled quadruple VERB \n",
"since since SCONJ \n",
"2010 2010 NUM DATE\n",
", , PUNCT \n",
"what what PRON \n",
"was be AUX \n",
"a a DET \n",
"slow slow ADJ \n",
"stream stream NOUN \n",
"of of ADP \n",
"illicit illicit ADJ \n",
"fentanyl fentanyl NOUN \n",
", , PUNCT \n",
"a a DET \n",
"synthetic synthetic ADJ \n",
"opioid opioid NOUN \n",
"50 50 NUM CARDINAL\n",
"to to PART CARDINAL\n",
"100 100 NUM CARDINAL\n",
"times time NOUN \n",
"stronger strong ADJ \n",
"than than ADP \n",
"morphine morphine NOUN \n",
", , PUNCT \n",
"is be AUX \n",
"now now ADV \n",
"a a DET \n",
"flood flood NOUN \n",
", , PUNCT \n",
"with with ADP \n",
"the the DET \n",
"amount amount NOUN \n",
"of of ADP \n",
"the the DET \n",
"powerful powerful ADJ \n",
"drug drug NOUN \n",
"seized seize VERB \n",
"by by ADP \n",
"law law NOUN \n",
"enforcement enforcement NOUN \n",
"increasing increase VERB \n",
"dramatically dramatically ADV \n",
". . PUNCT \n",
"America America PROPN GPE\n",
"is be AUX \n",
"awash awash ADJ \n",
"in in ADP \n",
"opioids opioid NOUN \n",
"; ; PUNCT \n",
"urgent urgent ADJ \n",
"action action NOUN \n",
"is be AUX \n",
"critical.[14 critical.[14 PROPN \n",
"] ] PUNCT \n",
"\n",
"\n",
" \n",
"\n",
" SPACE \n",
"According accord VERB \n",
"to to ADP \n",
"the the DET ORG\n",
"Centers Centers PROPN ORG\n",
"for for ADP ORG\n",
"Disease Disease PROPN ORG\n",
"Control Control PROPN ORG\n",
"and and CCONJ ORG\n",
"Prevention Prevention PROPN ORG\n",
"( ( PUNCT \n",
"CDC CDC PROPN ORG\n",
") ) PUNCT \n",
", , PUNCT \n",
"death death NOUN \n",
"rates rate NOUN \n",
"from from ADP \n",
"synthetic synthetic ADJ \n",
"opioids opioid NOUN \n",
", , PUNCT \n",
"including include VERB \n",
"fentanyl fentanyl NOUN \n",
", , PUNCT \n",
"increased increase VERB \n",
"over over ADP \n",
"72 72 NUM PERCENT\n",
"% % NOUN PERCENT\n",
"from from ADP \n",
"2014 2014 NUM DATE\n",
"to to ADP \n",
"2015.[22 2015.[22 NUM CARDINAL\n",
"] ] PUNCT \n",
"In in ADP \n",
"addition addition NOUN \n",
", , PUNCT \n",
"the the DET \n",
"CDC CDC PROPN ORG\n",
"reports report VERB \n",
"that that SCONJ \n",
"the the DET \n",
"total total ADJ \n",
"deaths death NOUN \n",
"from from ADP \n",
"opioid opioid ADJ \n",
"overdoses overdose NOUN \n",
"may may AUX \n",
"be be AUX \n",
"under under ADP \n",
"- - PUNCT \n",
"counted count VERB \n",
", , PUNCT \n",
"since since SCONJ \n",
"they they PRON \n",
"do do AUX \n",
"not not PART \n",
"include include VERB \n",
"deaths death NOUN \n",
"that that PRON \n",
"are be AUX \n",
"associated associate VERB \n",
"with with ADP \n",
"synthetic synthetic ADJ \n",
"opioids opioid NOUN \n",
"which which PRON \n",
"are be AUX \n",
"used use VERB \n",
"as as ADP \n",
"pain pain NOUN \n",
"relievers reliever NOUN \n",
". . PUNCT \n",
"The the DET \n",
"CDC CDC PROPN ORG\n",
"presumes[when presumes[when PROPN \n",
"? ? PUNCT \n",
"] ] X \n",
"that that SCONJ \n",
"a a DET \n",
"large large ADJ \n",
"proportion proportion NOUN \n",
"of of ADP \n",
"the the DET \n",
"increase increase NOUN \n",
"in in ADP \n",
"deaths death NOUN \n",
"is be AUX \n",
"due due ADJ \n",
"to to ADP \n",
"illegally illegally ADV \n",
"- - PUNCT \n",
"made make VERB \n",
"fentanyl fentanyl NOUN \n",
"; ; PUNCT \n",
"as as SCONJ \n",
"the the DET \n",
"statistics statistic NOUN \n",
"on on ADP \n",
"overdose overdose NOUN \n",
"deaths death NOUN \n",
"do do AUX \n",
"not not PART \n",
"distinguish distinguish VERB \n",
"pharmaceutical pharmaceutical ADJ \n",
"fentanyl fentanyl NOUN \n",
"from from ADP \n",
"illegally illegally ADV \n",
"- - PUNCT \n",
"made make VERB \n",
"fentanyl fentanyl NOUN \n",
", , PUNCT \n",
"the the DET \n",
"actual actual ADJ \n",
"death death NOUN \n",
"rate rate NOUN \n",
"could could AUX \n",
"therefore therefore ADV \n",
"be be AUX \n",
"much much ADV \n",
"higher high ADJ \n",
"than than ADP \n",
"reported.[31 reported.[31 VERB \n",
"] ] X \n",
"\n",
"\n",
" \n",
"\n",
" SPACE \n",
"Those those PRON \n",
"taking take VERB \n",
"fentanyl fentanyl ADJ \n",
"- - PUNCT \n",
"laced lace VERB \n",
"heroin heroin NOUN \n",
"are be AUX \n",
"more more ADV \n",
"likely likely ADJ \n",
"to to PART \n",
"overdose overdose VERB \n",
"because because SCONJ \n",
"they they PRON \n",
"do do AUX \n",
"not not PART \n",
"know know VERB \n",
"they they PRON \n",
"also also ADV \n",
"are be AUX \n",
"ingesting ingest VERB \n",
"the the DET \n",
"more more ADV \n",
"powerful powerful ADJ \n",
"drug.[32 drug.[32 PROPN \n",
"] ] PUNCT \n",
"In in ADP \n",
"March March PROPN DATE\n",
"2017 2017 NUM DATE\n",
", , PUNCT \n",
"New New PROPN GPE\n",
"Jersey Jersey PROPN GPE\n",
"police police NOUN \n",
"arrested arrest VERB \n",
"a a DET \n",
"person person NOUN \n",
"possessing possess VERB \n",
"nearly nearly ADV QUANTITY\n",
"31 31 NUM QUANTITY\n",
"pounds pound NOUN QUANTITY\n",
"( ( PUNCT \n",
"14 14 NUM QUANTITY\n",
"kg kg NOUN QUANTITY\n",
") ) PUNCT \n",
"of of ADP \n",
"fentanyl fentanyl NOUN \n",
"( ( PUNCT \n",
"14 14 NUM QUANTITY\n",
"kg kg NOUN QUANTITY\n",
"would would AUX \n",
"yield yield VERB \n",
"7 7 NUM CARDINAL\n",
"million million NUM CARDINAL\n",
"lethal lethal ADJ \n",
"doses).[33][34 doses).[33][34 PROPN \n",
"] ] PUNCT \n",
"Among among ADP \n",
"those those PRON \n",
"who who PRON \n",
"died die VERB \n",
"from from ADP \n",
"overdosing overdose VERB \n",
"on on ADP \n",
"fentanyl fentanyl NOUN \n",
"was be AUX \n",
"singer singer NOUN \n",
"Prince.[34][35 Prince.[34][35 PROPN \n",
"] ] X \n",
"\n",
"\n",
" \n",
"\n",
" SPACE \n",
"Fentanyl Fentanyl PROPN PERSON\n",
"has have AUX \n",
"surpassed surpass VERB \n",
"heroin heroin NOUN \n",
"as as ADP \n",
"a a DET \n",
"killer killer NOUN \n",
"in in ADP \n",
"several several ADJ \n",
"locales locale NOUN \n",
": : PUNCT \n",
"in in ADP \n",
"all all PRON \n",
"of of ADP \n",
"2014 2014 NUM DATE\n",
"the the DET \n",
"CDC CDC PROPN ORG\n",
"identified identify VERB \n",
"998 998 NUM CARDINAL\n",
"fatal fatal ADJ \n",
"fentanyl fentanyl ADJ \n",
"overdoses overdose NOUN \n",
"in in ADP \n",
"Ohio Ohio PROPN GPE\n",
", , PUNCT \n",
"which which PRON \n",
"is be AUX \n",
"the the DET \n",
"same same ADJ \n",
"number number NOUN \n",
"of of ADP \n",
"deaths death NOUN \n",
"recorded record VERB \n",
"in in ADP \n",
"just just ADV DATE\n",
"the the DET DATE\n",
"first first ADJ DATE\n",
"five five NUM DATE\n",
"months month NOUN DATE\n",
"of of ADP DATE\n",
"2015.[36 2015.[36 NUM DATE\n",
"] ] PUNCT \n",
"In in ADP \n",
"Cleveland Cleveland PROPN GPE\n",
", , PUNCT \n",
"a a DET \n",
"person person NOUN \n",
"was be AUX \n",
"caught catch VERB \n",
"selling sell VERB \n",
"blue blue ADJ \n",
"fentanyl fentanyl ADJ \n",
"pills pill NOUN \n",
"disguised disguise VERB \n",
"to to PART \n",
"look look VERB \n",
"like like ADP \n",
"doses dose NOUN \n",
"of of ADP \n",
"the the DET \n",
"milder milder NOUN \n",
"opioid opioid ADJ \n",
"painkiller painkill ADJ \n",
"oxycodone.[36 oxycodone.[36 X \n",
"] ] X \n",
"The the DET \n",
"U.S. U.S. PROPN GPE\n",
"attorney attorney NOUN \n",
"for for ADP \n",
"Ohio Ohio PROPN GPE\n",
"stated state VERB \n",
": : PUNCT \n",
"\n",
"\n",
" \n",
"\n",
" SPACE \n",
"One one NUM CARDINAL\n",
"of of ADP \n",
"the the DET \n",
"truly truly ADV \n",
"terrifying terrifying ADJ \n",
"things thing NOUN \n",
"is be AUX \n",
"the the DET \n",
"pills pill NOUN \n",
"are be AUX \n",
"pressed press VERB \n",
"and and CCONJ \n",
"dyed dye VERB \n",
"to to PART \n",
"look look VERB \n",
"like like ADP \n",
"oxycodone oxycodone NOUN \n",
". . PUNCT \n",
"If if SCONJ \n",
"you you PRON \n",
"are be AUX \n",
"using use VERB \n",
"oxycodone oxycodone NOUN \n",
"and and CCONJ \n",
"take take VERB \n",
"fentanyl fentanyl NOUN \n",
"not not PART \n",
"knowing know VERB \n",
"it it PRON \n",
"is be AUX \n",
"fentanyl fentanyl ADJ \n",
", , PUNCT \n",
"that that PRON \n",
"is be AUX \n",
"an an DET \n",
"overdose overdose NOUN \n",
"waiting wait VERB \n",
"to to PART \n",
"happen happen VERB \n",
". . PUNCT \n",
"Each each PRON \n",
"of of ADP \n",
"those those DET \n",
"pills pill NOUN \n",
"is be AUX \n",
"a a DET \n",
"potential potential ADJ \n",
"overdose overdose NOUN \n",
"death.[36 death.[36 NOUN CARDINAL\n",
"] ] X \n",
"\n",
"\n",
" \n",
"\n",
" SPACE \n",
"In in ADP \n",
"2016 2016 NUM DATE\n",
"the the DET \n",
"medical medical ADJ \n",
"publication publication NOUN \n",
"STAT STAT PROPN ORG\n",
"reported report VERB \n",
"that that SCONJ \n",
"while while SCONJ \n",
"Mexican mexican ADJ NORP\n",
"cartels cartel NOUN \n",
"are be AUX \n",
"a a DET \n",
"main main ADJ \n",
"source source NOUN \n",
"of of ADP \n",
"heroin heroin NOUN \n",
"smuggled smuggle VERB \n",
"into into ADP \n",
"the the DET \n",
"U.S. U.S. PROPN GPE\n",
", , PUNCT \n",
"Chinese chinese ADJ NORP\n",
"suppliers supplier NOUN \n",
"provide provide VERB \n",
"both both DET \n",
"raw raw ADJ \n",
"fentanyl fentanyl NOUN \n",
"and and CCONJ \n",
"the the DET \n",
"machinery machinery NOUN \n",
"necessary necessary ADJ \n",
"for for ADP \n",
"its its PRON \n",
"production.[36 production.[36 X \n",
"] ] X \n",
"In in ADP \n",
"British British PROPN GPE\n",
"Columbia Columbia PROPN GPE\n",
", , PUNCT \n",
"police police NOUN \n",
"discovered discover VERB \n",
"a a DET \n",
"lab lab NOUN \n",
"making make VERB \n",
"100,000 100,000 NUM CARDINAL\n",
"fentanyl fentanyl ADJ \n",
"pills pill NOUN \n",
"each each DET DATE\n",
"month month NOUN DATE\n",
", , PUNCT \n",
"which which PRON \n",
"they they PRON \n",
"were be AUX \n",
"shipping ship VERB \n",
"to to ADP \n",
"Calgary Calgary PROPN GPE\n",
", , PUNCT \n",
"Alberta Alberta PROPN GPE\n",
". . PUNCT \n",
"90 90 NUM CARDINAL\n",
"people people NOUN \n",
"in in ADP \n",
"Calgary Calgary PROPN GPE\n",
"overdosed overdose VERB \n",
"on on ADP \n",
"the the DET \n",
"drug drug NOUN \n",
"in in ADP \n",
"2015.[36 2015.[36 NUM CARDINAL\n",
"] ] PUNCT \n",
"In in ADP \n",
"Southern Southern PROPN LOC\n",
"California California PROPN LOC\n",
", , PUNCT \n",
"a a DET \n",
"home home NOUN \n",
"- - PUNCT \n",
"operated operate VERB \n",
"drug drug NOUN \n",
"lab lab NOUN \n",
"with with ADP \n",
"six six NUM CARDINAL\n",
"pill pill NOUN \n",
"presses press NOUN \n",
"was be AUX \n",
"uncovered uncover VERB \n",
"by by ADP \n",
"federal federal ADJ \n",
"agents agent NOUN \n",
"; ; PUNCT \n",
"each each DET \n",
"machine machine NOUN \n",
"was be AUX \n",
"capable capable ADJ \n",
"of of ADP \n",
"producing produce VERB \n",
"thousands thousand NOUN CARDINAL\n",
"of of ADP \n",
"pills pill NOUN \n",
"an an DET \n",
"hour.[36 hour.[36 NOUN \n",
"] ] X \n",
"\n",
"\n",
" \n",
"\n",
" SPACE \n",
"History history NOUN \n",
"of of ADP \n",
"opiate opiate ADJ \n",
"use use NOUN \n",
"in in ADP \n",
"the the DET \n",
"United United PROPN \n",
"States[edit States[edit PROPN \n",
"] ] X \n",
"\n",
" \n",
" SPACE \n",
"In in ADP \n",
"the the DET DATE\n",
"early early ADJ DATE\n",
"1900s 1900 NOUN DATE\n",
", , PUNCT \n",
"as as SCONJ \n",
"veterans veteran NOUN \n",
"of of ADP \n",
"the the DET EVENT\n",
"First First PROPN EVENT\n",
"World World PROPN EVENT\n",
"War War PROPN EVENT\n",
"were be AUX \n",
"returning return VERB \n",
"home home ADV \n",
"from from ADP \n",
"overseas overseas ADV \n",
", , PUNCT \n",
"there there PRON \n",
"were be VERB \n",
"few few ADJ \n",
"options option NOUN \n",
"to to PART \n",
"help help VERB \n",
"relieve relieve VERB \n",
"pain pain NOUN \n",
", , PUNCT \n",
"and and CCONJ \n",
"doctors doctor NOUN \n",
"mainly mainly ADV \n",
"turned turn VERB \n",
"to to ADP \n",
"morphine.[37 morphine.[37 PROPN \n",
"] ] PUNCT \n",
"Opiates opiate NOUN \n",
"soon soon ADV \n",
"became become VERB \n",
"known know VERB \n",
"as as ADP \n",
"a a DET \n",
"wonder wonder NOUN \n",
"drug drug NOUN \n",
"and and CCONJ \n",
"were be AUX \n",
"prescribed prescribe VERB \n",
"for for ADP \n",
"a a DET \n",
"wide wide ADJ \n",
"array array NOUN \n",
"of of ADP \n",
"ailments ailment NOUN \n",
", , PUNCT \n",
"even even ADV \n",
"for for ADP \n",
"relatively relatively ADV \n",
"minor minor ADJ \n",
"treatments treatment NOUN \n",
"such such ADJ \n",
"as as ADP \n",
"cough cough NOUN \n",
"relief relief NOUN \n",
". . PUNCT \n",
"Beginning begin VERB \n",
"around around ADP \n",
"1920 1920 NUM DATE\n",
", , PUNCT \n",
"however however ADV \n",
", , PUNCT \n",
"their their PRON \n",
"addictiveness addictiveness NOUN \n",
"was be AUX \n",
"recognized recognize VERB \n",
"and and CCONJ \n",
"not not PART \n",
"too too ADV \n",
"long long ADJ \n",
"afterwards afterwards ADV \n",
"heroin heroin NOUN \n",
"was be AUX \n",
"made make VERB \n",
"an an DET \n",
"illegal illegal ADJ \n",
"drug.[37 drug.[37 NOUN \n",
"] ] PUNCT \n",
"In in ADP \n",
"the the DET EVENT\n",
"Anti Anti PROPN EVENT\n",
"- - PROPN EVENT\n",
"Heroin Heroin PROPN EVENT\n",
"Act Act PROPN EVENT\n",
"of of ADP \n",
"1924 1924 NUM DATE\n",
", , PUNCT \n",
"the the DET ORG\n",
"U.S. U.S. PROPN ORG\n",
"Congress Congress PROPN ORG\n",
"banned ban VERB \n",
"the the DET \n",
"sale sale NOUN \n",
", , PUNCT \n",
"importation importation NOUN \n",
", , PUNCT \n",
"or or CCONJ \n",
"manufacture manufacture NOUN \n",
"of of ADP \n",
"heroin heroin NOUN \n",
". . PUNCT \n",
"\n",
"\n",
" \n",
"\n",
" SPACE \n",
"Around around ADP \n",
"World World PROPN EVENT\n",
"War War PROPN EVENT\n",
"II II PROPN EVENT\n",
", , PUNCT \n",
"doctors doctor NOUN \n",
"used use VERB \n",
"opiates opiate NOUN \n",
"in in ADP \n",
"lieu lieu NOUN \n",
"of of ADP \n",
"surgery surgery NOUN \n",
". . PUNCT \n",
"This this PRON \n",
"made make VERB \n",
"prescriptions prescription NOUN \n",
"for for ADP \n",
"opiates opiate NOUN \n",
"skyrocket.[37 skyrocket.[37 PROPN \n",
"] ] X \n",
"In in ADP \n",
"the the DET DATE\n",
"1950s 1950 NOUN DATE\n",
", , PUNCT \n",
"heroin heroin NOUN \n",
"addiction addiction NOUN \n",
"was be AUX \n",
"known know VERB \n",
"among among ADP \n",
"jazz jazz NOUN \n",
"musicians musician NOUN \n",
", , PUNCT \n",
"but but CCONJ \n",
"still still ADV \n",
"fairly fairly ADV \n",
"unknown unknown ADJ \n",
"by by ADP \n",
"average average ADJ \n",
"Americans Americans PROPN NORP\n",
", , PUNCT \n",
"many many ADJ \n",
"of of ADP \n",
"whom whom PRON \n",
"saw see VERB \n",
"it it PRON \n",
"as as ADP \n",
"a a DET \n",
"frightening frightening ADJ \n",
"condition.[15 condition.[15 NOUN \n",
"] ] X \n",
"The the DET \n",
"fear fear NOUN \n",
"extended extend VERB \n",
"into into ADP \n",
"the the DET DATE\n",
"1960s 1960 NOUN DATE\n",
"and and CCONJ \n",
"1970s 1970 NOUN DATE\n",
", , PUNCT \n",
"although although SCONJ \n",
"it it PRON \n",
"became become VERB \n",
"common common ADJ \n",
"to to PART \n",
"hear hear VERB \n",
"or or CCONJ \n",
"read read VERB \n",
"about about ADP \n",
"drugs drug NOUN \n",
"such such ADJ \n",
"as as ADP \n",
"marijuana marijuana PROPN PERSON\n",
"and and CCONJ \n",
"psychedelics psychedelic NOUN \n",
", , PUNCT \n",
"which which PRON \n",
"were be AUX \n",
"widely widely ADV \n",
"used use VERB \n",
"at at ADP \n",
"rock rock NOUN \n",
"concerts concert NOUN \n",
"like like ADP \n",
"Woodstock.[15 Woodstock.[15 PROPN \n",
"] ] PUNCT \n",
"Heroin heroin NOUN \n",
"addiction addiction NOUN \n",
"began begin VERB \n",
"to to PART \n",
"make make VERB \n",
"the the DET \n",
"news news NOUN \n",
"when when SCONJ \n",
"famous famous ADJ \n",
"people people NOUN \n",
"such such ADJ \n",
"as as ADP \n",
"Janis Janis PROPN PERSON\n",
"Joplin Joplin PROPN PERSON\n",
", , PUNCT \n",
"John John PROPN PERSON\n",
"Belushi Belushi PROPN PERSON\n",
", , PUNCT \n",
"Jim Jim PROPN PERSON\n",
"Morrison Morrison PROPN PERSON\n",
"and and CCONJ \n",
"Lenny Lenny PROPN PERSON\n",
"Bruce Bruce PROPN PERSON\n",
", , PUNCT \n",
"whom whom PRON \n",
"most most ADJ \n",
"people people NOUN \n",
"did do AUX \n",
"not not PART \n",
"know know VERB \n",
"were be AUX \n",
"addicted addict VERB \n",
", , PUNCT \n",
"died die VERB \n",
"from from ADP \n",
"overdoses overdose NOUN \n",
". . PUNCT \n",
"During during ADP \n",
"and and CCONJ \n",
"after after ADP \n",
"the the DET EVENT\n",
"Vietnam Vietnam PROPN EVENT\n",
"War War PROPN EVENT\n",
", , PUNCT \n",
"addicted addicted ADJ \n",
"soldiers soldier NOUN \n",
"returned return VERB \n",
"from from ADP \n",
"Vietnam Vietnam PROPN GPE\n",
", , PUNCT \n",
"where where SCONJ \n",
"heroin heroin NOUN \n",
"was be AUX \n",
"easily easily ADV \n",
"bought buy VERB \n",
". . PUNCT \n",
"Heroin heroin ADJ \n",
"addiction addiction NOUN \n",
"grew grow VERB \n",
"within within ADP \n",
"low low ADJ \n",
"- - PUNCT \n",
"income income NOUN \n",
"housing housing NOUN \n",
"projects project NOUN \n",
"during during ADP \n",
"the the DET \n",
"same same ADJ \n",
"time time NOUN \n",
"period.[15 period.[15 NOUN \n",
"] ] PUNCT \n",
"In in ADP \n",
"1971 1971 NUM DATE\n",
", , PUNCT \n",
"congressmen congressman NOUN \n",
"released release VERB \n",
"an an DET \n",
"explosive explosive ADJ \n",
"report report NOUN \n",
"on on ADP \n",
"the the DET \n",
"growing grow VERB \n",
"heroin heroin NOUN \n",
"epidemic epidemic NOUN \n",
"among among ADP \n",
"U.S. U.S. PROPN GPE\n",
"servicemen serviceman NOUN \n",
"in in ADP \n",
"Vietnam Vietnam PROPN GPE\n",
", , PUNCT \n",
"finding find VERB \n",
"that that SCONJ \n",
"ten ten NUM PERCENT\n",
"to to PART PERCENT\n",
"fifteen fifteen NUM PERCENT\n",
"percent percent NOUN PERCENT\n",
"were be AUX \n",
"addicted addict VERB \n",
"to to ADP \n",
"heroin heroin NOUN \n",
". . PUNCT \n",
"\" \" PUNCT \n",
"The the DET \n",
"Nixon Nixon PROPN PERSON\n",
"White White PROPN ORG\n",
"House House PROPN ORG\n",
"panicked panic VERB \n",
", , PUNCT \n",
"\" \" PUNCT \n",
"wrote write VERB \n",
"political political ADJ \n",
"editor editor NOUN \n",
"Christopher Christopher PROPN PERSON\n",
"Caldwell Caldwell PROPN PERSON\n",
"and and CCONJ \n",
"declared declare VERB \n",
"drug drug NOUN \n",
"abuse abuse NOUN \n",
"\" \" PUNCT \n",
"public public ADJ \n",
"enemy enemy NOUN \n",
"number number NOUN \n",
"one\".[38 one\".[38 NOUN \n",
"] ] PUNCT \n",
"By by ADP \n",
"1973 1973 NUM DATE\n",
", , PUNCT \n",
"there there PRON \n",
"were be VERB \n",
"1.5 1.5 NUM CARDINAL\n",
"overdose overdose NOUN \n",
"deaths death NOUN \n",
"per per ADP \n",
"100,000 100,000 NUM CARDINAL\n",
"people.[15 people.[15 NOUN \n",
"] ] X \n",
"\n",
"\n",
" \n",
"\n",
" SPACE \n",
"In in ADP \n",
"the the DET DATE\n",
"1980s 1980 NOUN DATE\n",
", , PUNCT \n",
"many many ADJ \n",
"medical medical ADJ \n",
"experts expert NOUN \n",
"did do AUX \n",
"not not PART \n",
"believe believe VERB \n",
"that that SCONJ \n",
"opioids opioid NOUN \n",
"were be AUX \n",
"addictive addictive ADJ \n",
". . PUNCT \n",
"A a DET \n",
"brief brief ADJ \n",
"letter letter NOUN \n",
"published publish VERB \n",
"in in ADP \n",
"the the DET ORG\n",
"New New PROPN ORG\n",
"England England PROPN ORG\n",
"Journal Journal PROPN ORG\n",
"of of ADP ORG\n",
"Medicine Medicine PROPN ORG\n",
"( ( PUNCT \n",
"NEJM NEJM PROPN \n",
") ) PUNCT \n",
"in in ADP \n",
"January January PROPN DATE\n",
"1980 1980 NUM DATE\n",
", , PUNCT \n",
"titled title VERB \n",
"\" \" PUNCT \n",
"Addiction Addiction PROPN WORK_OF_ART\n",
"Rare Rare PROPN WORK_OF_ART\n",
"in in ADP WORK_OF_ART\n",
"Patients patient NOUN WORK_OF_ART\n",
"Treated treat VERB WORK_OF_ART\n",
"with with ADP WORK_OF_ART\n",
"Narcotics narcotic NOUN WORK_OF_ART\n",
"\" \" PUNCT \n",
", , PUNCT \n",
"was be AUX \n",
"subsequently subsequently ADV \n",
"cited cite VERB \n",
"over over ADP \n",
"600 600 NUM CARDINAL\n",
"times time NOUN \n",
"to to PART \n",
"support support VERB \n",
"this this DET \n",
"position.[39][40 position.[39][40 NOUN \n",
"] ] PUNCT \n",
"A a DET \n",
"group group NOUN \n",
"of of ADP \n",
"researchers researcher NOUN \n",
"in in ADP \n",
"Canada Canada PROPN GPE\n",
"claim claim VERB \n",
"that that SCONJ \n",
"the the DET \n",
"letter letter NOUN \n",
"may may AUX \n",
"have have AUX \n",
"originated originate VERB \n",
"and and CCONJ \n",
"contributed contribute VERB \n",
"to to ADP \n",
"the the DET \n",
"opioid opioid ADJ \n",
"crisis.[39 crisis.[39 PROPN \n",
"] ] PUNCT \n",
"The the DET \n",
"NEJM NEJM PROPN ORG\n",
"published publish VERB \n",
"its its PRON \n",
"rebuttal rebuttal NOUN \n",
"to to ADP \n",
"the the DET \n",
"1980 1980 NUM DATE\n",
"letter letter NOUN \n",
"in in ADP \n",
"June June PROPN DATE\n",
"2017 2017 NUM DATE\n",
", , PUNCT \n",
"pointing point VERB \n",
"out out ADP \n",
"among among ADP \n",
"other other ADJ \n",
"things thing NOUN \n",
"that that PRON \n",
"the the DET \n",
"conclusions conclusion NOUN \n",
"were be AUX \n",
"based base VERB \n",
"on on ADP \n",
"hospitalized hospitalize VERB \n",
"patients patient NOUN \n",
"only only ADV \n",
", , PUNCT \n",
"and and CCONJ \n",
"not not PART \n",
"on on ADP \n",
"patients patient NOUN \n",
"taking take VERB \n",
"the the DET \n",
"drugs drug NOUN \n",
"after after SCONJ \n",
"they they PRON \n",
"were be AUX \n",
"sent send VERB \n",
"home.[41 home.[41 NOUN \n",
"] ] PUNCT \n",
"The the DET \n",
"original original ADJ \n",
"author author NOUN \n",
", , PUNCT \n",
"Dr. Dr. PROPN \n",
"Hershel Hershel PROPN PERSON\n",
"Jick Jick PROPN PERSON\n",
", , PUNCT \n",
"has have AUX \n",
"said say VERB \n",
"that that SCONJ \n",
"he he PRON \n",
"never never ADV \n",
"intended intend VERB \n",
"for for SCONJ \n",
"the the DET \n",
"article article NOUN \n",
"to to PART \n",
"justify justify VERB \n",
"widespread widespread ADJ \n",
"opioid opioid ADJ \n",
"use.[39 use.[39 ADJ \n",
"] ] X \n",
"\n",
"\n",
" \n",
"\n",
" SPACE \n",
"In in ADP \n",
"the the DET \n",
"mid mid ADJ \n",
"- - PUNCT \n",
"to to ADP \n",
"- - PUNCT \n",
"late late ADJ \n",
"1980s 1980 NOUN \n",
"the the DET \n",
"crack crack NOUN \n",
"epidemic epidemic NOUN \n",
"followed follow VERB \n",
"widespread widespread ADJ \n",
"cocaine cocaine NOUN \n",
"use use NOUN \n",
"in in ADP \n",
"American american ADJ NORP\n",
"cities city NOUN \n",
". . PUNCT \n",
"The the DET \n",
"death death NOUN \n",
"rate rate NOUN \n",
"was be AUX \n",
"worse bad ADJ \n",
", , PUNCT \n",
"reaching reach VERB \n",
"almost almost ADV CARDINAL\n",
"2 2 NUM CARDINAL\n",
"per per ADP \n",
"100,000 100,000 NUM CARDINAL\n",
". . PUNCT \n",
"In in ADP \n",
"1982 1982 NUM DATE\n",
", , PUNCT \n",
"Vice Vice PROPN \n",
"President President PROPN \n",
"George George PROPN PERSON\n",
"H. H. PROPN PERSON\n",
"W. W. PROPN PERSON\n",
"Bush Bush PROPN PERSON\n",
"and and CCONJ \n",
"his his PRON \n",
"aides aide NOUN \n",
"began begin VERB \n",
"pushing push VERB \n",
"for for ADP \n",
"the the DET \n",
"involvement involvement NOUN \n",
"of of ADP \n",
"the the DET \n",
"CIA CIA PROPN ORG\n",
"and and CCONJ \n",
"the the DET \n",
"U.S. U.S. PROPN GPE\n",
"military military NOUN \n",
"in in ADP \n",
"drug drug NOUN \n",
"interdiction interdiction NOUN \n",
"efforts effort NOUN \n",
", , PUNCT \n",
"the the DET \n",
"so so ADV \n",
"- - PUNCT \n",
"called call VERB \n",
"War War PROPN \n",
"on on ADP \n",
"Drugs.[42 Drugs.[42 NOUN \n",
"] ] PUNCT \n",
"By by ADP \n",
"comparison comparison NOUN \n",
", , PUNCT \n",
"as as ADP \n",
"of of ADP \n",
"2016 2016 NUM DATE\n",
", , PUNCT \n",
"the the DET \n",
"present present ADJ \n",
"opioid opioid ADJ \n",
"epidemic epidemic NOUN \n",
"is be AUX \n",
"killing kill VERB \n",
"on on ADP \n",
"average average ADJ \n",
"10.3 10.3 NUM CARDINAL\n",
"people people NOUN \n",
"per per ADP \n",
"100,000 100,000 NUM CARDINAL\n",
". . PUNCT \n",
"In in ADP \n",
"some some DET \n",
"states state NOUN \n",
"it it PRON \n",
"is be AUX \n",
"far far ADV \n",
"worse bad ADJ \n",
": : PUNCT \n",
"over over ADP CARDINAL\n",
"30 30 NUM CARDINAL\n",
"per per ADP \n",
"100,000 100,000 NUM CARDINAL\n",
"in in ADP \n",
"New New PROPN GPE\n",
"Hampshire Hampshire PROPN GPE\n",
"and and CCONJ \n",
"over over ADP CARDINAL\n",
"40 40 NUM CARDINAL\n",
"per per ADP \n",
"100,000 100,000 NUM CARDINAL\n",
"in in ADP \n",
"West West PROPN \n",
"Virginia.[15 virginia.[15 X \n",
"] ] PUNCT \n",
"\n",
"\n",
" \n",
"\n",
" SPACE \n",
"Demographics[edit Demographics[edit PROPN \n",
"] ] X \n",
"\n",
" \n",
" SPACE \n",
"In in ADP \n",
"the the DET \n",
"U.S. U.S. PROPN GPE\n",
", , PUNCT \n",
"addiction addiction NOUN \n",
"and and CCONJ \n",
"overdose overdose ADJ \n",
"victims victim NOUN \n",
"are be AUX \n",
"mostly mostly ADV \n",
"white white ADJ \n",
"and and CCONJ \n",
"working working NOUN \n",
"- - PUNCT \n",
"class class NOUN \n",
". . PUNCT \n",
"Geographically geographically ADV \n",
", , PUNCT \n",
"those those PRON \n",
"living live VERB \n",
"in in ADP \n",
"rural rural ADJ \n",
"areas area NOUN \n",
"of of ADP \n",
"the the DET \n",
"country country NOUN \n",
"have have AUX \n",
"been be AUX \n",
"the the DET \n",
"hardest hard ADV \n",
"hit hit VERB \n",
"as as ADP \n",
"a a DET \n",
"percentage percentage NOUN \n",
"of of ADP \n",
"the the DET \n",
"national national ADJ \n",
"population,[43 population,[43 X \n",
"] ] X \n",
"Prescription prescription ADJ \n",
"drug drug NOUN \n",
"abuse abuse NOUN \n",
"has have AUX \n",
"been be AUX \n",
"increasing increase VERB \n",
"in in ADP \n",
"teenagers teenager NOUN \n",
", , PUNCT \n",
"especially especially ADV \n",
"as as SCONJ \n",
"12- 12- NUM \n",
"to to PART \n",
"17 17 NUM DATE\n",
"- - PUNCT DATE\n",
"year year NOUN DATE\n",
"- - PUNCT DATE\n",
"olds old NOUN DATE\n",
"were be AUX \n",
"one one NUM CARDINAL\n",
"- - PUNCT CARDINAL\n",
"third third NOUN CARDINAL\n",
"of of ADP \n",
"all all DET \n",
"new new ADJ \n",
"abusers abuser NOUN \n",
"of of ADP \n",
"prescription prescription NOUN \n",
"drugs drug NOUN \n",
"in in ADP \n",
"2006 2006 NUM DATE\n",
". . PUNCT \n",
"Teens teen NOUN \n",
"abuse abuse VERB \n",
"prescription prescription NOUN \n",
"drugs drug NOUN \n",
"more more ADJ \n",
"than than ADP \n",
"any any DET \n",
"illicit illicit ADJ \n",
"drug drug NOUN \n",
"except except SCONJ \n",
"marijuana marijuana PROPN PERSON\n",
", , PUNCT \n",
"more more ADJ \n",
"than than ADP \n",
"cocaine cocaine NOUN \n",
", , PUNCT \n",
"heroin heroin NOUN \n",
"and and CCONJ \n",
"methamphetamine methamphetamine NOUN \n",
"combined combine VERB \n",
", , PUNCT \n",
"per per ADP \n",
"the the DET ORG\n",
"Office Office PROPN ORG\n",
"of of ADP ORG\n",
"National National PROPN ORG\n",
"Drug Drug PROPN ORG\n",
"Control Control PROPN ORG\n",
"Policy Policy PROPN ORG\n",
"’s ’s PART ORG\n",
"2008 2008 NUM DATE\n",
"Report Report PROPN \n",
"Prescription Prescription PROPN \n",
"for for ADP \n",
"Danger Danger PROPN \n",
". . PUNCT \n",
"\n",
"\n",
" \n",
"\n",
" SPACE \n",
"In in ADP \n",
"Palm Palm PROPN GPE\n",
"Beach Beach PROPN GPE\n",
"County County PROPN GPE\n",
", , PUNCT \n",
"Florida Florida PROPN GPE\n",
", , PUNCT \n",
"overdose overdose NOUN \n",
"deaths death NOUN \n",
"went go VERB \n",
"from from ADP \n",
"149 149 NUM CARDINAL\n",
"in in ADP \n",
"2012 2012 NUM DATE\n",
"to to ADP \n",
"588 588 NUM CARDINAL\n",
"in in ADP \n",
"2016.[44 2016.[44 NUM CARDINAL\n",
"] ] X \n",
"\n",
"\n",
" \n",
"\n",
" SPACE \n",
"In in ADP \n",
"Middletown Middletown PROPN GPE\n",
", , PUNCT \n",
"Ohio Ohio PROPN GPE\n",
", , PUNCT \n",
"overdose overdose NOUN \n",
"deaths death NOUN \n",
"quadrupled quadruple VERB \n",
"in in ADP \n",
"the the DET DATE\n",
"15 15 NUM DATE\n",
"years year NOUN DATE\n",
"since since SCONJ \n",
"2000.[45 2000.[45 NUM CARDINAL\n",
"] ] PUNCT \n",
"\n",
"\n",
" \n",
"\n",
" SPACE \n",
"There there PRON \n",
"has have AUX \n",
"been be AUX \n",
"a a DET \n",
"difference difference NOUN \n",
"in in ADP \n",
"the the DET \n",
"number number NOUN \n",
"of of ADP \n",
"opioid opioid ADJ \n",
"prescriptions prescription NOUN \n",
"written write VERB \n",
"by by ADP \n",
"doctors doctor NOUN \n",
"in in ADP \n",
"different different ADJ \n",
"states state NOUN \n",
". . PUNCT \n",
"In in ADP \n",
"Hawaii Hawaii PROPN GPE\n",
", , PUNCT \n",
"doctors doctor NOUN \n",
"wrote write VERB \n",
"about about ADV CARDINAL\n",
"52 52 NUM CARDINAL\n",
"prescriptions prescription NOUN \n",
"for for ADP \n",
"every every DET \n",
"100 100 NUM CARDINAL\n",
"people people NOUN \n",
", , PUNCT \n",
"whereas whereas SCONJ \n",
"in in ADP \n",
"Alabama Alabama PROPN GPE\n",
", , PUNCT \n",
"they they PRON \n",
"wrote write VERB \n",
"almost almost ADV CARDINAL\n",
"143 143 NUM CARDINAL\n",
"prescriptions prescription NOUN \n",
"per per ADP \n",
"100 100 NUM CARDINAL\n",
"people people NOUN \n",
". . PUNCT \n",
"Researchers researcher NOUN \n",
"suspect suspect VERB \n",
"that that SCONJ \n",
"the the DET \n",
"variation variation NOUN \n",
"results result VERB \n",
"from from ADP \n",
"a a DET \n",
"lack lack NOUN \n",
"of of ADP \n",
"consensus consensus NOUN \n",
"among among ADP \n",
"doctors doctor NOUN \n",
"in in ADP \n",
"different different ADJ \n",
"states state NOUN \n",
"about about ADP \n",
"how how SCONJ \n",
"much much ADJ \n",
"pain pain NOUN \n",
"medication medication NOUN \n",
"to to PART \n",
"prescribe prescribe VERB \n",
". . PUNCT \n",
"A a DET \n",
"higher high ADJ \n",
"rate rate NOUN \n",
"of of ADP \n",
"prescription prescription NOUN \n",
"drug drug NOUN \n",
"use use NOUN \n",
"does do AUX \n",
"not not PART \n",
"lead lead VERB \n",
"to to ADP \n",
"better well ADJ \n",
"health health NOUN \n",
"outcomes outcome NOUN \n",
"or or CCONJ \n",
"patient patient ADJ \n",
"satisfaction satisfaction NOUN \n",
", , PUNCT \n",
"according accord VERB \n",
"to to ADP \n",
"studies.[8 studies.[8 X \n",
"] ] PUNCT \n",
"\n",
"\n",
" \n",
"\n",
" SPACE \n",
"Outside outside ADP \n",
"the the DET \n",
"U.S.[edit u.s.[edit NOUN \n",
"] ] X \n",
"\n",
" \n",
" SPACE \n",
"Approximately approximately ADV PERCENT\n",
"80 80 NUM PERCENT\n",
"percent percent NOUN PERCENT\n",
"of of ADP \n",
"the the DET \n",
"global global ADJ \n",
"pharmaceutical pharmaceutical ADJ \n",
"opioid opioid ADJ \n",
"supply supply NOUN \n",
"is be AUX \n",
"consumed consume VERB \n",
"in in ADP \n",
"the the DET \n",
"United United PROPN \n",
"States.[47 States.[47 PROPN \n",
"] ] X \n",
"\n",
"\n",
" \n",
"\n",
" SPACE \n",
"It it PRON \n",
"has have AUX \n",
"also also ADV \n",
"become become VERB \n",
"a a DET \n",
"serious serious ADJ \n",
"problem problem NOUN \n",
"outside outside ADP \n",
"the the DET \n",
"U.S. U.S. PROPN GPE\n",
", , PUNCT \n",
"mostly mostly ADV \n",
"among among ADP \n",
"young young ADJ \n",
"adults.[48 adults.[48 NOUN \n",
"] ] X \n",
"The the DET \n",
"concern concern NOUN \n",
"not not PART \n",
"only only ADV \n",
"relates relate VERB \n",
"to to ADP \n",
"the the DET \n",
"drugs drug NOUN \n",
"themselves themselves PRON \n",
", , PUNCT \n",
"but but CCONJ \n",
"to to ADP \n",
"the the DET \n",
"fact fact NOUN \n",
"that that SCONJ \n",
"in in ADP \n",
"many many ADJ \n",
"countries country NOUN \n",
"doctors doctor NOUN \n",
"are be AUX \n",
"less less ADV \n",
"trained train VERB \n",
"about about ADP \n",
"drug drug NOUN \n",
"addiction addiction NOUN \n",
", , PUNCT \n",
"both both PRON \n",
"about about ADP \n",
"its its PRON \n",
"causes cause NOUN \n",
"or or CCONJ \n",
"treatment.[20 treatment.[20 ADV \n",
"] ] X \n",
"According accord VERB \n",
"to to ADP \n",
"an an DET \n",
"epidemiologist epidemiologist NOUN \n",
"at at ADP \n",
"Columbia Columbia PROPN ORG\n",
"University University PROPN ORG\n",
": : PUNCT \n",
"\" \" PUNCT \n",
"Once once SCONJ \n",
"pharmaceuticals pharmaceutical NOUN \n",
"start start VERB \n",
"targeting target VERB \n",
"other other ADJ \n",
"countries country NOUN \n",
"and and CCONJ \n",
"make make VERB \n",
"people people NOUN \n",
"feel feel VERB \n",
"like like SCONJ \n",
"opioids opioid NOUN \n",
"are be AUX \n",
"safe safe ADJ \n",
", , PUNCT \n",
"we we PRON \n",
"might might AUX \n",
"see see VERB \n",
"a a DET \n",
"spike spike NOUN \n",
"[ [ X \n",
"in in ADP \n",
"opioid opioid ADJ \n",
"abuse abuse NOUN \n",
"] ] PUNCT \n",
". . PUNCT \n",
"It it PRON \n",
"worked work VERB \n",
"here here ADV \n",
". . PUNCT \n",
"Why why SCONJ \n",
"would would AUX \n",
"n’t n’t PART \n",
"it it PRON \n",
"work work VERB \n",
"elsewhere elsewhere ADV \n",
"? ? PUNCT \n",
"\" \" PUNCT \n",
"[ [ X \n",
"20 20 NUM CARDINAL\n",
"] ] PUNCT \n",
"The the DET \n",
"majority majority NOUN \n",
"of of ADP \n",
"deaths death NOUN \n",
"worldwide worldwide ADV \n",
"from from ADP \n",
"overdoses overdose NOUN \n",
"were be AUX \n",
"from from ADP \n",
"either either CCONJ \n",
"medically medically ADV \n",
"prescribed prescribe VERB \n",
"opioids opioid NOUN \n",
"or or CCONJ \n",
"illegal illegal ADJ \n",
"heroin heroin NOUN \n",
". . PUNCT \n",
"In in ADP \n",
"Europe Europe PROPN LOC\n",
", , PUNCT \n",
"prescription prescription NOUN \n",
"opioids opioid NOUN \n",
"accounted account VERB \n",
"for for ADP \n",
"three three NUM CARDINAL\n",
"- - PUNCT CARDINAL\n",
"quarters quarter NOUN CARDINAL\n",
"of of ADP \n",
"overdose overdose NOUN \n",
"deaths death NOUN \n",
"among among ADP \n",
"those those PRON \n",
"between between ADP \n",
"ages age NOUN \n",
"15 15 NUM \n",
"and and CCONJ \n",
"39.[48 39.[48 NUM CARDINAL\n",
"] ] PUNCT \n",
"Some some PRON \n",
"worry worry VERB \n",
"that that SCONJ \n",
"the the DET \n",
"epidemic epidemic NOUN \n",
"could could AUX \n",
"become become VERB \n",
"a a DET \n",
"worldwide worldwide ADJ \n",
"pandemic pandemic NOUN \n",
"if if SCONJ \n",
"not not PART \n",
"curtailed.[20 curtailed.[20 X \n",
"] ] X \n",
"Prescription prescription ADJ \n",
"drug drug NOUN \n",
"abuse abuse NOUN \n",
"among among ADP \n",
"teenagers teenager NOUN \n",
"in in ADP \n",
"Canada Canada PROPN GPE\n",
", , PUNCT \n",
"Australia Australia PROPN GPE\n",
", , PUNCT \n",
"and and CCONJ \n",
"Europe Europe PROPN LOC\n",
"were be AUX \n",
"at at ADP \n",
"rates rate NOUN \n",
"comparable comparable ADJ \n",
"to to ADP \n",
"U.S. U.S. PROPN GPE\n",
"teenagers.[20 teenagers.[20 NOUN \n",
"] ] X \n",
"In in ADP \n",
"Lebanon Lebanon PROPN GPE\n",
"and and CCONJ \n",
"Saudi Saudi PROPN GPE\n",
"Arabia Arabia PROPN GPE\n",
", , PUNCT \n",
"and and CCONJ \n",
"in in ADP \n",
"parts part NOUN \n",
"of of ADP \n",
"China China PROPN GPE\n",
", , PUNCT \n",
"surveys survey NOUN \n",
"found find VERB \n",
"that that SCONJ \n",
"one one NUM CARDINAL\n",
"in in ADP \n",
"ten ten NUM CARDINAL\n",
"students student NOUN \n",
"had have AUX \n",
"used use VERB \n",
"prescription prescription NOUN \n",
"painkillers painkiller NOUN \n",
"for for ADP \n",
"non non ADJ \n",
"- - ADJ \n",
"medical medical ADJ \n",
"purposes purpose NOUN \n",
". . PUNCT \n",
"Similar similar ADJ \n",
"high high ADJ \n",
"rates rate NOUN \n",
"of of ADP \n",
"non non ADJ \n",
"- - ADJ \n",
"medical medical ADJ \n",
"use use NOUN \n",
"were be AUX \n",
"found find VERB \n",
"among among ADP \n",
"the the DET \n",
"young young ADJ \n",
"throughout throughout ADP \n",
"Europe Europe PROPN LOC\n",
", , PUNCT \n",
"including include VERB \n",
"Spain Spain PROPN GPE\n",
"and and CCONJ \n",
"the the DET \n",
"United United PROPN \n",
"Kingdom.[20 Kingdom.[20 PROPN \n",
"] ] PUNCT \n",
"\n",
"\n",
" \n",
"\n",
" SPACE \n",
"Countermeasures[edit countermeasures[edit NOUN \n",
"] ] PUNCT \n",
"\n",
"\n",
" \n",
"\n",
" SPACE \n",
"This this DET \n",
"section section NOUN \n",
"is be AUX \n",
"in in ADP \n",
"a a DET \n",
"list list NOUN \n",
"format format NOUN \n",
"that that PRON \n",
"may may AUX \n",
"be be AUX \n",
"better well ADV \n",
"presented present VERB \n",
"using use VERB \n",
"prose prose NOUN \n",
". . PUNCT \n",
"You you PRON \n",
"can can AUX \n",
"help help VERB \n",
"by by ADP \n",
"converting convert VERB \n",
"this this DET \n",
"section section NOUN \n",
"to to PART \n",
"prose prose VERB \n",
", , PUNCT \n",
"if if SCONJ \n",
"appropriate appropriate ADJ \n",
". . PUNCT \n",
"Editing editing NOUN \n",
"help help NOUN \n",
"is be AUX \n",
"available available ADJ \n",
". . PUNCT \n",
"( ( PUNCT \n",
"August August PROPN DATE\n",
"2017 2017 NUM DATE\n",
") ) PUNCT \n",
"\n",
" \n",
" SPACE \n",
"Federal Federal PROPN \n",
"government[edit government[edit NOUN \n",
"] ] PUNCT \n",
"\n",
" \n",
" SPACE \n",
"In in ADP \n",
"2010 2010 NUM DATE\n",
", , PUNCT \n",
"the the DET \n",
"US US PROPN GPE\n",
"government government NOUN \n",
"began begin VERB \n",
"cracking crack VERB \n",
"down down ADP \n",
"on on ADP \n",
"pharmacists pharmacist NOUN \n",
"and and CCONJ \n",
"doctors doctor NOUN \n",
"who who PRON \n",
"were be AUX \n",
"over over ADV \n",
"- - PUNCT \n",
"prescribing prescribing NOUN \n",
"opioid opioid ADJ \n",
"pain pain NOUN \n",
"killers killer NOUN \n",
". . PUNCT \n",
"The the DET \n",
"unintended unintended ADJ \n",
"consequence consequence NOUN \n",
"of of ADP \n",
"this this PRON \n",
"was be AUX \n",
"that that SCONJ \n",
"users user NOUN \n",
"turned turn VERB \n",
"to to ADP \n",
"cheaper cheap ADJ \n",
"but but CCONJ \n",
"illegal illegal ADJ \n",
"heroin heroin NOUN \n",
", , PUNCT \n",
"a a DET \n",
"significantly significantly ADV \n",
"more more ADV \n",
"potent potent ADJ \n",
"opioid opioid NOUN \n",
", , PUNCT \n",
"as as ADP \n",
"a a DET \n",
"substitute,[10 substitute,[10 NOUN \n",
"] ] PUNCT \n",
"including include VERB \n",
"addicted addicted ADJ \n",
"patients patient NOUN \n",
"who who PRON \n",
"were be AUX \n",
"denied deny VERB \n",
"opioid opioid ADJ \n",
"prescriptions prescription NOUN \n",
"as as SCONJ \n",
"doctors doctor NOUN \n",
"tried try VERB \n",
"to to PART \n",
"cut cut VERB \n",
"back back ADV \n",
"painkiller painkill ADJ \n",
"drug drug NOUN \n",
"abuse.[15 abuse.[15 NOUN \n",
"] ] PUNCT \n",
"A a DET \n",
"2017 2017 NUM DATE\n",
"survey survey NOUN \n",
"in in ADP \n",
"Utah Utah PROPN GPE\n",
"of of ADP \n",
"heroin heroin NOUN \n",
"users user NOUN \n",
"found find VERB \n",
"about about ADV PERCENT\n",
"80 80 NUM PERCENT\n",
"percent percent NOUN PERCENT\n",
"started start VERB \n",
"with with ADP \n",
"prescription prescription NOUN \n",
"drugs.[49 drugs.[49 NOUN \n",
"] ] X \n",
"As as ADP \n",
"a a DET \n",
"result result NOUN \n",
", , PUNCT \n",
"by by ADP \n",
"2015 2015 NUM DATE\n",
"nationwide nationwide ADJ \n",
"deaths death NOUN \n",
"from from ADP \n",
"prescription prescription NOUN \n",
"opioids opioid NOUN \n",
"had have AUX \n",
"increased increase VERB \n",
"by by ADP \n",
"15 15 NUM PERCENT\n",
"% % NOUN PERCENT\n",
"and and CCONJ \n",
"for for ADP \n",
"heroin heroin NOUN \n",
"users user NOUN \n",
"by by ADP \n",
"23%.[10][50 23%.[10][50 NUM \n",
"] ] PUNCT \n",
"\n",
" \n",
" SPACE \n",
"In in ADP \n",
"2010 2010 NUM DATE\n",
", , PUNCT \n",
"the the DET \n",
"CSA CSA PROPN ORG\n",
"was be AUX \n",
"amended amend VERB \n",
"with with ADP \n",
"the the DET ORG\n",
"Secure Secure PROPN ORG\n",
"and and CCONJ ORG\n",
"Responsible Responsible PROPN ORG\n",
"Drug Drug PROPN ORG\n",
"Disposal Disposal PROPN ORG\n",
"Act Act PROPN ORG\n",
"which which PRON \n",
"allows allow VERB \n",
"pharmacies pharmacy NOUN \n",
"to to PART \n",
"accept accept VERB \n",
"controlled control VERB \n",
"substances substance NOUN \n",
"from from ADP \n",
"households household NOUN \n",
"or or CCONJ \n",
"long long ADJ \n",
"term term NOUN \n",
"care care NOUN \n",
"facilities facility NOUN \n",
"in in ADP \n",
"their their PRON \n",
"drug drug NOUN \n",
"disposal disposal NOUN \n",
"programs program NOUN \n",
"or or CCONJ \n",
"\" \" PUNCT \n",
"take take VERB \n",
"- - PUNCT \n",
"back back NOUN \n",
"\" \" PUNCT \n",
"programs.[51 programs.[51 PROPN \n",
"] ] X \n",
"\n",
" \n",
" SPACE \n",
"In in ADP \n",
"2011 2011 NUM DATE\n",
", , PUNCT \n",
"the the DET \n",
"Obama Obama PROPN GPE\n",
"administration administration NOUN \n",
"released release VERB \n",
"a a DET \n",
"white white ADJ \n",
"paper paper NOUN \n",
"describing describe VERB \n",
"the the DET \n",
"administration administration NOUN \n",
"'s 's PART \n",
"plan plan NOUN \n",
"to to PART \n",
"deal deal VERB \n",
"with with ADP \n",
"the the DET \n",
"crisis crisis NOUN \n",
". . PUNCT \n",
"Its its PRON \n",
"concerns concern NOUN \n",
"have have AUX \n",
"been be AUX \n",
"echoed echo VERB \n",
"by by ADP \n",
"numerous numerous ADJ \n",
"medical medical ADJ \n",
"and and CCONJ \n",
"government government NOUN \n",
"advisory advisory ADJ \n",
"groups group NOUN \n",
"around around ADP \n",
"the the DET \n",
"world.[52][53][54 world.[52][53][54 NOUN \n",
"] ] X \n",
"\n",
" \n",
" SPACE \n",
"In in ADP \n",
"2016 2016 NUM DATE\n",
", , PUNCT \n",
"the the DET ORG\n",
"U.S. U.S. PROPN ORG\n",
"Surgeon Surgeon PROPN ORG\n",
"General General PROPN ORG\n",
"listed list VERB \n",
"statistics statistic NOUN \n",
"which which PRON \n",
"describe describe VERB \n",
"the the DET \n",
"extent extent NOUN \n",
"of of ADP \n",
"the the DET \n",
"problem.[19 problem.[19 NOUN \n",
"] ] X \n",
"\n",
" \n",
" SPACE \n",
"In in ADP \n",
"July July PROPN DATE\n",
"2016 2016 NUM DATE\n",
", , PUNCT \n",
"President President PROPN \n",
"Barack Barack PROPN PERSON\n",
"Obama Obama PROPN PERSON\n",
"signed sign VERB \n",
"into into ADP \n",
"law law NOUN \n",
"the the DET ORG\n",
"Comprehensive Comprehensive PROPN ORG\n",
"Addiction Addiction PROPN ORG\n",
"and and CCONJ ORG\n",
"Recovery Recovery PROPN ORG\n",
"Act Act PROPN ORG\n",
", , PUNCT \n",
"which which PRON \n",
"expands expand VERB \n",
"opioid opioid ADJ \n",
"addiction addiction NOUN \n",
"treatment treatment NOUN \n",
"with with ADP \n",
"buprenorphine buprenorphine NOUN \n",
"and and CCONJ \n",
"authorizes authorize VERB MONEY\n",
"millions million NOUN MONEY\n",
"of of ADP MONEY\n",
"dollars dollar NOUN MONEY\n",
"in in ADP \n",
"new new ADJ \n",
"funding funding NOUN \n",
"for for ADP \n",
"opioid opioid ADJ \n",
"research research NOUN \n",
"and and CCONJ \n",
"treatment.[55 treatment.[55 NOUN \n",
"] ] X \n",
"\n",
" \n",
" SPACE \n",
"In in ADP \n",
"December December PROPN DATE\n",
"2016 2016 NUM DATE\n",
", , PUNCT \n",
"the the DET DATE\n",
"21st 21st ADJ DATE\n",
"Century Century PROPN DATE\n",
"Cures Cures PROPN \n",
"Act Act PROPN \n",
", , PUNCT \n",
"which which PRON \n",
"includes include VERB \n",
"$ $ SYM MONEY\n",
"1 1 NUM MONEY\n",
"billion billion NUM MONEY\n",
"in in ADP \n",
"state state NOUN \n",
"grants grant NOUN \n",
"to to PART \n",
"fight fight VERB \n",
"the the DET \n",
"opioid opioid ADJ \n",
"epidemic epidemic NOUN \n",
", , PUNCT \n",
"was be AUX \n",
"passed pass VERB \n",
"by by ADP \n",
"Congress Congress PROPN ORG\n",
"by by ADP \n",
"a a DET \n",
"wide wide ADV \n",
"bipartisan bipartisan ADJ \n",
"majority majority NOUN \n",
"( ( PUNCT \n",
"94 94 NUM CARDINAL\n",
"- - SYM CARDINAL\n",
"5 5 NUM CARDINAL\n",
"in in ADP \n",
"the the DET \n",
"Senate Senate PROPN ORG\n",
", , PUNCT \n",
"392 392 NUM CARDINAL\n",
"- - SYM \n",
"26 26 NUM \n",
"in in ADP \n",
"the the DET ORG\n",
"House House PROPN ORG\n",
"of of ADP ORG\n",
"Representatives),[56 representatives),[56 NOUN ORG\n",
"] ] PUNCT ORG\n",
"and and CCONJ \n",
"was be AUX \n",
"signed sign VERB \n",
"into into ADP \n",
"law law NOUN \n",
"by by ADP \n",
"President President PROPN \n",
"Obama.[57 Obama.[57 PROPN \n",
"] ] X \n",
"\n",
" \n",
" SPACE \n",
"As as ADP \n",
"of of ADP \n",
"March March PROPN DATE\n",
"2017 2017 NUM DATE\n",
", , PUNCT \n",
"President President PROPN \n",
"Donald Donald PROPN PERSON\n",
"Trump Trump PROPN PERSON\n",
"appointed appoint VERB \n",
"a a DET \n",
"commission commission NOUN \n",
"to to PART \n",
"deal deal VERB \n",
"on on ADP \n",
"the the DET \n",
"epidemic epidemic NOUN \n",
", , PUNCT \n",
"chaired chair VERB \n",
"by by ADP \n",
"Governor Governor PROPN \n",
"Chris Chris PROPN PERSON\n",
"Christie Christie PROPN PERSON\n",
"of of ADP \n",
"New New PROPN \n",
"Jersey.[58][59][60 jersey.[58][59][60 NOUN \n",
"] ] X \n",
"\n",
" \n",
" SPACE \n",
"In in ADP \n",
"June June PROPN DATE\n",
"2017 2017 NUM DATE\n",
", , PUNCT \n",
"the the DET \n",
"FDA FDA PROPN ORG\n",
"asked ask VERB \n",
"the the DET \n",
"manufacturer manufacturer NOUN \n",
"to to PART \n",
"remove remove VERB \n",
"its its PRON \n",
"injectable injectable ADJ \n",
"form form NOUN \n",
"of of ADP \n",
"oxymorphone oxymorphone NOUN \n",
"( ( PUNCT \n",
"Opana Opana PROPN ORG\n",
"ER ER PROPN ORG\n",
") ) PUNCT \n",
"from from ADP \n",
"the the DET \n",
"US US PROPN GPE\n",
"market market NOUN \n",
", , PUNCT \n",
"because because SCONJ \n",
"the the DET \n",
"drug drug NOUN \n",
"'s 's PART \n",
"benefits benefit NOUN \n",
"may may AUX \n",
"no no ADV \n",
"longer long ADV \n",
"outweigh outweigh VERB \n",
"its its PRON \n",
"risks risk NOUN \n",
", , PUNCT \n",
"this this PRON \n",
"being be AUX \n",
"the the DET \n",
"first first ADJ ORDINAL\n",
"time time NOUN \n",
"the the DET \n",
"agency agency NOUN \n",
"has have AUX \n",
"asked ask VERB \n",
"to to PART \n",
"remove remove VERB \n",
"a a DET \n",
"currently currently ADV \n",
"marketed market VERB \n",
"opioid opioid ADJ \n",
"pain pain NOUN \n",
"medication medication NOUN \n",
"from from ADP \n",
"sale sale NOUN \n",
"due due ADP \n",
"to to ADP \n",
"public public ADJ \n",
"health health NOUN \n",
"consequences consequence NOUN \n",
"of of ADP \n",
"abuse.[61 abuse.[61 NOUN \n",
"] ] X \n",
"\n",
" \n",
" SPACE \n",
"In in ADP \n",
"July July PROPN DATE\n",
"2017 2017 NUM DATE\n",
", , PUNCT \n",
"FDA FDA PROPN ORG\n",
"commissioner commissioner NOUN \n",
"Dr Dr PROPN PERSON\n",
"Scott Scott PROPN PERSON\n",
"Gottlieb Gottlieb PROPN PERSON\n",
"stated state VERB \n",
"that that SCONJ \n",
"for for ADP \n",
"the the DET \n",
"first first ADJ ORDINAL\n",
"time time NOUN \n",
", , PUNCT \n",
"pharmacists pharmacist NOUN \n",
", , PUNCT \n",
"nurses nurse NOUN \n",
", , PUNCT \n",
"and and CCONJ \n",
"physicians physician NOUN \n",
", , PUNCT \n",
"would would AUX \n",
"have have VERB \n",
"training training NOUN \n",
"made make VERB \n",
"available available ADJ \n",
"on on ADP \n",
"appropriate appropriate ADJ \n",
"prescribing prescribing NOUN \n",
"of of ADP \n",
"opioid opioid ADJ \n",
"medicines medicine NOUN \n",
", , PUNCT \n",
"because because SCONJ \n",
"opioid opioid ADJ \n",
"addiction addiction NOUN \n",
"had have AUX \n",
"become become VERB \n",
"the the DET \n",
"\" \" PUNCT \n",
"FDA FDA PROPN ORG\n",
"'s 's PART \n",
"biggest big ADJ \n",
"crisis\".[13 crisis\".[13 NUM \n",
"] ] PUNCT \n",
"\n",
" \n",
" SPACE \n",
"On on ADP \n",
"August August PROPN DATE\n",
"10 10 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
", , PUNCT \n",
"President President PROPN \n",
"Trump Trump PROPN PERSON\n",
"agreed agree VERB \n",
"with with ADP \n",
"his his PRON \n",
"Commission Commission PROPN ORG\n",
"'s 's PART \n",
"report report NOUN \n",
"released release VERB \n",
"few few ADJ DATE\n",
"weeks week NOUN DATE\n",
"earlier early ADV DATE\n",
"and and CCONJ \n",
"declared declare VERB \n",
"the the DET \n",
"country country NOUN \n",
"'s 's PART \n",
"opioid opioid ADJ \n",
"crisis crisis NOUN \n",
"a a DET \n",
"\" \" PUNCT \n",
"national national ADJ \n",
"emergency emergency NOUN \n",
". . PUNCT \n",
"\"[16][17 \"[16][17 X \n",
"] ] X \n",
"\n",
" \n",
" SPACE \n",
"On on ADP \n",
"September September PROPN DATE\n",
"1 1 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
", , PUNCT \n",
"Trump Trump PROPN ORG\n",
"nominated nominated ADJ \n",
"Representative Representative PROPN \n",
"Tom Tom PROPN PERSON\n",
"Marino Marino PROPN PERSON\n",
"as as ADP \n",
"director director NOUN \n",
"of of ADP \n",
"the the DET ORG\n",
"Office Office PROPN ORG\n",
"of of ADP ORG\n",
"National National PROPN ORG\n",
"Drug Drug PROPN ORG\n",
"Control Control PROPN ORG\n",
"Policy Policy PROPN ORG\n",
", , PUNCT \n",
"or or CCONJ \n",
"\" \" PUNCT \n",
"drug drug NOUN \n",
"czar\".[62 czar\".[62 NOUN \n",
"] ] X \n",
"Pharmaceutical pharmaceutical ADJ \n",
"distribution distribution NOUN \n",
"companies company NOUN \n",
"had have AUX \n",
"contributed contribute VERB \n",
"$ $ SYM \n",
"134,000 134,000 NUM MONEY\n",
"to to ADP \n",
"Marino Marino PROPN PERSON\n",
"'s 's PART \n",
"election election NOUN \n",
"campaigns campaign NOUN \n",
"in in ADP \n",
"2014 2014 NUM DATE\n",
"and and CCONJ \n",
"2016 2016 NUM DATE\n",
", , PUNCT \n",
"more more ADJ \n",
"than than ADP \n",
"contributions contribution NOUN \n",
"from from ADP \n",
"any any DET \n",
"other other ADJ \n",
"industry industry NOUN \n",
". . PUNCT \n",
"Pharmaceutical pharmaceutical ADJ \n",
"distibutors distibutor NOUN \n",
"had have AUX \n",
"lobbied lobby VERB \n",
"for for ADP \n",
"legislation legislation NOUN \n",
"which which PRON \n",
"Marino Marino PROPN PERSON\n",
"co co VERB \n",
"- - VERB \n",
"sponsored sponsor VERB \n",
"in in ADP \n",
"2016 2016 NUM DATE\n",
", , PUNCT \n",
"the the DET ORG\n",
"Ensuring Ensuring PROPN ORG\n",
"Patient Patient PROPN ORG\n",
"Access Access PROPN ORG\n",
"and and CCONJ ORG\n",
"Effective Effective PROPN ORG\n",
"Drug Drug PROPN ORG\n",
"Enforcement Enforcement PROPN ORG\n",
"Act Act PROPN ORG\n",
", , PUNCT \n",
"which which PRON \n",
"made make VERB \n",
"it it PRON \n",
"harder hard ADJ \n",
"for for SCONJ \n",
"the the DET \n",
"DEA DEA PROPN ORG\n",
"to to PART \n",
"shut shut VERB \n",
"down down ADP \n",
"pharmacies pharmacy NOUN \n",
"suspected suspect VERB \n",
"of of ADP \n",
"diverting divert VERB \n",
"pills.[18 pills.[18 PROPN \n",
"] ] PUNCT \n",
"\n",
" \n",
" SPACE \n",
"State State PROPN ORG\n",
"and and CCONJ \n",
"local local ADJ \n",
"governments[edit governments[edit NOUN \n",
"] ] X \n",
"\n",
" \n",
" SPACE \n",
"In in ADP \n",
"July July PROPN DATE\n",
"2016 2016 NUM DATE\n",
", , PUNCT \n",
"governors governor NOUN \n",
"of of ADP \n",
"most most ADJ \n",
"U.S. U.S. PROPN GPE\n",
"states state NOUN \n",
"and and CCONJ \n",
"territories territory NOUN \n",
"entered enter VERB \n",
"into into ADP \n",
"a a DET \n",
"formal formal ADJ \n",
"\" \" PUNCT \n",
"Compact Compact PROPN \n",
"to to PART \n",
"Fight fight VERB \n",
"Opioid Opioid PROPN \n",
"Addiction Addiction PROPN \n",
". . PUNCT \n",
"\" \" PUNCT \n",
"They they PRON \n",
"agreed agree VERB \n",
"that that SCONJ \n",
"collective collective ADJ \n",
"action action NOUN \n",
"would would AUX \n",
"be be AUX \n",
"needed need VERB \n",
"to to PART \n",
"end end VERB \n",
"the the DET \n",
"opioid opioid ADJ \n",
"crisis crisis NOUN \n",
", , PUNCT \n",
"and and CCONJ \n",
"they they PRON \n",
"would would AUX \n",
"coordinate coordinate VERB \n",
"their their PRON \n",
"responses response NOUN \n",
"across across ADP \n",
"all all DET \n",
"levels level NOUN \n",
"of of ADP \n",
"government government NOUN \n",
"and and CCONJ \n",
"the the DET \n",
"private private ADJ \n",
"sector sector NOUN \n",
", , PUNCT \n",
"including include VERB \n",
"opioid opioid ADJ \n",
"manufacturers manufacturer NOUN \n",
"and and CCONJ \n",
"doctors.[63 doctors.[63 NOUN \n",
"] ] X \n",
"\n",
" \n",
" SPACE \n",
"In in ADP \n",
"March March PROPN DATE\n",
"2017 2017 NUM DATE\n",
", , PUNCT \n",
"the the DET GPE\n",
"Governor Governor PROPN GPE\n",
"of of ADP GPE\n",
"Maryland Maryland PROPN GPE\n",
", , PUNCT \n",
"as as ADP \n",
"an an DET \n",
"urgent urgent ADJ \n",
"response response NOUN \n",
"to to ADP \n",
"the the DET \n",
"crisis crisis NOUN \n",
", , PUNCT \n",
"declared declare VERB \n",
"a a DET \n",
"State State PROPN \n",
"of of ADP \n",
"Emergency Emergency PROPN \n",
"to to PART \n",
"combat combat VERB \n",
"the the DET \n",
"rapid rapid ADJ \n",
"increase increase NOUN \n",
"in in ADP \n",
"overdoses overdose NOUN \n",
"by by ADP \n",
"increasing increase VERB \n",
"and and CCONJ \n",
"speeding speed VERB \n",
"up up ADP \n",
"coordination coordination NOUN \n",
"between between ADP \n",
"the the DET \n",
"state state NOUN \n",
"and and CCONJ \n",
"local local ADJ \n",
"jurisdictions.[64][12 jurisdictions.[64][12 X \n",
"] ] PUNCT \n",
"In in ADP \n",
"2016 2016 NUM DATE\n",
", , PUNCT \n",
"about about ADV CARDINAL\n",
"2,000 2,000 NUM CARDINAL\n",
"people people NOUN \n",
"in in ADP \n",
"the the DET \n",
"state state NOUN \n",
"had have AUX \n",
"died die VERB \n",
"from from ADP \n",
"opioid opioid ADJ \n",
"overdoses.[65 overdoses.[65 NOUN ORG\n",
"] ] X \n",
"\n",
" \n",
" SPACE \n",
"In in ADP \n",
"March March PROPN DATE\n",
"2017 2017 NUM DATE\n",
", , PUNCT \n",
"Delaware Delaware PROPN GPE\n",
", , PUNCT \n",
"which which PRON \n",
"has have VERB \n",
"the the DET \n",
"12th 12th ADV ORDINAL\n",
"- - PUNCT \n",
"highest high ADJ \n",
"overdose overdose NOUN \n",
"death death NOUN \n",
"rate rate NOUN \n",
"in in ADP \n",
"the the DET \n",
"country country NOUN \n",
", , PUNCT \n",
"introduced introduce VERB \n",
"bills bill NOUN \n",
"to to AUX \n",
"both both PRON \n",
"limit limit VERB \n",
"doctors doctor NOUN \n",
"' ' PART \n",
"ability ability NOUN \n",
"to to PART \n",
"over over ADV \n",
"- - PUNCT \n",
"prescribe prescribe VERB \n",
"painkillers painkiller NOUN \n",
"and and CCONJ \n",
"improve improve VERB \n",
"access access NOUN \n",
"to to ADP \n",
"treatment treatment NOUN \n",
". . PUNCT \n",
"In in ADP \n",
"2015 2015 NUM DATE\n",
", , PUNCT \n",
"228 228 NUM CARDINAL\n",
"people people NOUN \n",
"had have AUX \n",
"died die VERB \n",
"from from ADP \n",
"overdose overdose NOUN \n",
", , PUNCT \n",
"which which PRON \n",
"increased increase VERB \n",
"35%—to 35%—to PROPN CARDINAL\n",
"308 308 NUM CARDINAL\n",
"— — PUNCT \n",
"in in ADP \n",
"2016.[66 2016.[66 NUM CARDINAL\n",
"] ] X \n",
"\n",
" \n",
" SPACE \n",
"In in ADP \n",
"March March PROPN DATE\n",
"2017 2017 NUM DATE\n",
", , PUNCT \n",
"a a DET \n",
"similar similar ADJ \n",
"plan plan NOUN \n",
"was be AUX \n",
"begun begin VERB \n",
"in in ADP \n",
"Michigan Michigan PROPN GPE\n",
", , PUNCT \n",
"which which PRON \n",
"introduced introduce VERB \n",
"the the DET ORG\n",
"Michigan Michigan PROPN ORG\n",
"Automated Automated PROPN ORG\n",
"Prescription Prescription PROPN ORG\n",
"System System PROPN ORG\n",
"( ( PUNCT \n",
"MAPS MAPS PROPN ORG\n",
") ) PUNCT \n",
", , PUNCT \n",
"allowing allow VERB \n",
"doctors doctor NOUN \n",
"to to PART \n",
"check check VERB \n",
"when when SCONJ \n",
"and and CCONJ \n",
"what what PRON \n",
"painkillers painkiller NOUN \n",
"have have AUX \n",
"already already ADV \n",
"been be AUX \n",
"prescribed prescribe VERB \n",
"to to ADP \n",
"a a DET \n",
"patient patient NOUN \n",
", , PUNCT \n",
"and and CCONJ \n",
"thereby thereby ADV \n",
"help help VERB \n",
"keep keep VERB \n",
"addicts addict NOUN \n",
"from from ADP \n",
"switching switch VERB \n",
"doctors doctor NOUN \n",
"to to PART \n",
"receive receive VERB \n",
"drugs.[67][68 drugs.[67][68 NOUN \n",
"] ] X \n",
"\n",
" \n",
" SPACE \n",
"During during ADP \n",
"the the DET \n",
"2017 2017 NUM DATE\n",
"General General PROPN EVENT\n",
"Session Session PROPN EVENT\n",
"of of ADP \n",
"the the DET \n",
"Utah Utah PROPN \n",
"Legislature Legislature PROPN \n",
", , PUNCT \n",
"Rep. Rep. PROPN \n",
"Edward Edward PROPN PERSON\n",
"H. H. PROPN PERSON\n",
"Redd Redd PROPN PERSON\n",
"and and CCONJ \n",
"Sen. Sen. PROPN \n",
"Todd Todd PROPN PERSON\n",
"Weiler Weiler PROPN PERSON\n",
"proposed propose VERB \n",
"amendments amendment NOUN \n",
"to to ADP \n",
"Utah Utah PROPN GPE\n",
"'s 's PART \n",
"involuntary involuntary ADJ \n",
"commitment commitment NOUN \n",
"statutes statute NOUN \n",
"by by ADP \n",
"trying try VERB \n",
"to to PART \n",
"pass pass VERB \n",
"H.B. H.B. PROPN ORG\n",
"299 299 NUM ORG\n",
"into into ADP \n",
"law law NOUN \n",
"which which PRON \n",
"would would AUX \n",
"allow allow VERB \n",
"relatives relative NOUN \n",
"to to PART \n",
"petition petition VERB \n",
"a a DET \n",
"court court NOUN \n",
"to to PART \n",
"mandate mandate VERB \n",
"substance- substance- NUM \n",
"abuse abuse NOUN \n",
"treatment treatment NOUN \n",
"for for ADP \n",
"adults.[69][49 adults.[69][49 PROPN \n",
"] ] X \n",
"\n",
" \n",
" SPACE \n",
"In in ADP \n",
"Maine Maine PROPN GPE\n",
", , PUNCT \n",
"new new ADJ \n",
"laws law NOUN \n",
"were be AUX \n",
"imposed impose VERB \n",
"which which PRON \n",
"capped cap VERB \n",
"the the DET \n",
"maximum maximum ADJ \n",
"daily daily ADJ DATE\n",
"strength strength NOUN \n",
"of of ADP \n",
"prescribed prescribe VERB \n",
"opioids opioid NOUN \n",
"and and CCONJ \n",
"which which PRON \n",
"limited limit VERB \n",
"prescriptions prescription NOUN \n",
"to to ADP \n",
"seven seven NUM DATE\n",
"days day NOUN DATE\n",
". . PUNCT \n",
"But but CCONJ \n",
"some some DET \n",
"doctors doctor NOUN \n",
"were be AUX \n",
"then then ADV \n",
"concerned concern VERB \n",
"that that SCONJ \n",
"patients patient NOUN \n",
"would would AUX \n",
"turn turn VERB \n",
"to to ADP \n",
"using use VERB \n",
"street street NOUN \n",
"drugs drug NOUN \n",
"like like ADP \n",
"heroin heroin NOUN \n",
"to to PART \n",
"extend extend VERB \n",
"their their PRON \n",
"use use NOUN \n",
"of of ADP \n",
"painkillers.[15 painkillers.[15 NOUN \n",
"] ] PUNCT \n",
"\n",
" \n",
" SPACE \n",
"In in ADP \n",
"West West PROPN GPE\n",
"Virginia Virginia PROPN GPE\n",
", , PUNCT \n",
"which which PRON \n",
"leads lead VERB \n",
"the the DET \n",
"nation nation NOUN \n",
"in in ADP \n",
"overdose overdose NOUN \n",
"deaths death NOUN \n",
"per per ADP \n",
"capita capita NOUN \n",
", , PUNCT \n",
"lawsuits lawsuit NOUN \n",
"seek seek VERB \n",
"to to PART \n",
"declare declare VERB \n",
"drug drug NOUN \n",
"distribution distribution NOUN \n",
"companies company NOUN \n",
"a a DET \n",
"\" \" PUNCT \n",
"public public ADJ \n",
"nuisance nuisance NOUN \n",
"\" \" PUNCT \n",
"in in ADP \n",
"an an DET \n",
"effort effort NOUN \n",
"to to PART \n",
"place place VERB \n",
"accountability accountability NOUN \n",
"upon upon SCONJ \n",
"the the DET \n",
"drug drug NOUN \n",
"industry industry NOUN \n",
"for for ADP \n",
"the the DET \n",
"costs cost NOUN \n",
"associated associate VERB \n",
"with with ADP \n",
"the the DET \n",
"epidemic.[70][71 epidemic.[70][71 PROPN \n",
"] ] X \n",
"\n",
" \n",
" SPACE \n",
"In in ADP \n",
"February February PROPN DATE\n",
"2017 2017 NUM DATE\n",
", , PUNCT \n",
"officials official NOUN \n",
"in in ADP \n",
"Everett Everett PROPN GPE\n",
", , PUNCT \n",
"Washington Washington PROPN GPE\n",
"filed file VERB \n",
"a a DET \n",
"lawsuit lawsuit NOUN \n",
"against against ADP \n",
"the the DET \n",
"manufacturer manufacturer NOUN \n",
"of of ADP \n",
"OxyContin OxyContin PROPN ORG\n",
"for for ADP \n",
"negligence negligence NOUN \n",
"by by ADP \n",
"allowing allow VERB \n",
"drugs drug NOUN \n",
"to to PART \n",
"be be AUX \n",
"illegally illegally ADV \n",
"trafficked traffic VERB \n",
"to to ADP \n",
"residents resident NOUN \n",
"and and CCONJ \n",
"failing fail VERB \n",
"to to PART \n",
"prevent prevent VERB \n",
"it it PRON \n",
". . PUNCT \n",
"The the DET \n",
"city city NOUN \n",
"wants want VERB \n",
"the the DET \n",
"company company NOUN \n",
"to to PART \n",
"pay pay VERB \n",
"the the DET \n",
"costs cost NOUN \n",
"of of ADP \n",
"handling handle VERB \n",
"the the DET \n",
"crisis.[72 crisis.[72 PROPN \n",
"] ] PUNCT \n",
"\n",
" \n",
" SPACE \n",
"Prescription Prescription PROPN \n",
"drug drug NOUN \n",
"monitoring[edit monitoring[edit NOUN \n",
"] ] PUNCT \n",
"\n",
" \n",
" SPACE \n",
"In in ADP \n",
"2016 2016 NUM DATE\n",
", , PUNCT \n",
"the the DET \n",
"CDC CDC PROPN ORG\n",
"published publish VERB \n",
"its its PRON \n",
"\" \" PUNCT \n",
"Guideline Guideline PROPN WORK_OF_ART\n",
"for for ADP WORK_OF_ART\n",
"Prescribing Prescribing PROPN WORK_OF_ART\n",
"Opioids Opioids PROPN WORK_OF_ART\n",
"for for ADP WORK_OF_ART\n",
"Chronic Chronic PROPN WORK_OF_ART\n",
"Pain Pain PROPN WORK_OF_ART\n",
"\" \" PUNCT \n",
", , PUNCT \n",
"recommending recommend VERB \n",
"opioids opioid NOUN \n",
"only only ADV \n",
"be be AUX \n",
"used use VERB \n",
"when when SCONJ \n",
"benefits benefit NOUN \n",
"for for ADP \n",
"pain pain NOUN \n",
"and and CCONJ \n",
"function function NOUN \n",
"are be AUX \n",
"expected expect VERB \n",
"to to PART \n",
"outweigh outweigh VERB \n",
"risks risk NOUN \n",
", , PUNCT \n",
"and and CCONJ \n",
"then then ADV \n",
"used use VERB \n",
"at at ADP \n",
"the the DET \n",
"lowest low ADJ \n",
"effective effective ADJ \n",
"dosage dosage NOUN \n",
", , PUNCT \n",
"with with ADP \n",
"avoidance avoidance NOUN \n",
"of of ADP \n",
"concurrent concurrent ADJ \n",
"opioid opioid ADJ \n",
"and and CCONJ \n",
"benzodiazepine benzodiazepine VERB \n",
"use use NOUN \n",
"whenever whenever SCONJ \n",
"possible.[73 possible.[73 ADJ \n",
"] ] PUNCT \n",
"Silvia Silvia PROPN PERSON\n",
"Martins Martins PROPN PERSON\n",
", , PUNCT \n",
"an an DET \n",
"epidemiologist epidemiologist NOUN \n",
"at at ADP \n",
"Columbia Columbia PROPN ORG\n",
"University University PROPN ORG\n",
", , PUNCT \n",
"has have AUX \n",
"suggested suggest VERB \n",
"getting get VERB \n",
"out out ADP \n",
"more more ADJ \n",
"information information NOUN \n",
"about about ADP \n",
"the the DET \n",
"risks risk NOUN \n",
": : PUNCT \n",
"\n",
"\n",
" \n",
"\n",
" SPACE \n",
"The the DET \n",
"greater great ADJ \n",
"“ \" PUNCT \n",
"social social ADJ \n",
"acceptance acceptance NOUN \n",
"” \" PUNCT \n",
"for for ADP \n",
"using use VERB \n",
"these these DET \n",
"medications medication NOUN \n",
"( ( PUNCT \n",
"versus versus ADP \n",
"illegal illegal ADJ \n",
"substances substance NOUN \n",
") ) PUNCT \n",
"and and CCONJ \n",
"the the DET \n",
"misconception misconception NOUN \n",
"that that SCONJ \n",
"they they PRON \n",
"are be AUX \n",
"“ \" PUNCT \n",
"safe safe ADJ \n",
"” \" PUNCT \n",
"may may AUX \n",
"be be AUX \n",
"contributing contribute VERB \n",
"factors factor NOUN \n",
"to to ADP \n",
"their their PRON \n",
"misuse misuse NOUN \n",
". . PUNCT \n",
"Hence hence ADV \n",
", , PUNCT \n",
"a a DET \n",
"major major ADJ \n",
"target target NOUN \n",
"for for ADP \n",
"intervention intervention NOUN \n",
"is be AUX \n",
"the the DET \n",
"general general ADJ \n",
"public public NOUN \n",
", , PUNCT \n",
"including include VERB \n",
"parents parent NOUN \n",
"and and CCONJ \n",
"youth youth NOUN \n",
", , PUNCT \n",
"who who PRON \n",
"must must AUX \n",
"be be AUX \n",
"better well ADV \n",
"informed inform VERB \n",
"about about ADP \n",
"the the DET \n",
"negative negative ADJ \n",
"consequences consequence NOUN \n",
"of of ADP \n",
"sharing share VERB \n",
"with with ADP \n",
"others other NOUN \n",
"medications medication NOUN \n",
"prescribed prescribe VERB \n",
"for for ADP \n",
"their their PRON \n",
"own own ADJ \n",
"ailments ailment NOUN \n",
". . PUNCT \n",
"Equally equally ADV \n",
"important important ADJ \n",
"is be AUX \n",
"the the DET \n",
"improved improved ADJ \n",
"training training NOUN \n",
"of of ADP \n",
"medical medical ADJ \n",
"practitioners practitioner NOUN \n",
"and and CCONJ \n",
"their their PRON \n",
"staff staff NOUN \n",
"to to PART \n",
"better well ADV \n",
"recognize recognize VERB \n",
"patients patient NOUN \n",
"at at ADP \n",
"potential potential ADJ \n",
"risk risk NOUN \n",
"of of ADP \n",
"developing develop VERB \n",
"nonmedical nonmedical ADJ \n",
"use use NOUN \n",
", , PUNCT \n",
"and and CCONJ \n",
"to to PART \n",
"consider consider VERB \n",
"potential potential ADJ \n",
"alternative alternative ADJ \n",
"treatments treatment NOUN \n",
"as as ADV \n",
"well well ADV \n",
"as as ADP \n",
"closely closely ADV \n",
"monitor monitor VERB \n",
"the the DET \n",
"medications medication NOUN \n",
"they they PRON \n",
"dispense dispense VERB \n",
"to to ADP \n",
"these these DET \n",
"patients.[48 patients.[48 X \n",
"] ] X \n",
"\n",
"\n",
" \n",
"\n",
" SPACE \n",
"As as ADP \n",
"of of ADP \n",
"April April PROPN DATE\n",
"2017 2017 NUM DATE\n",
", , PUNCT \n",
"prescription prescription NOUN \n",
"drug drug NOUN \n",
"monitoring monitoring NOUN \n",
"programs program NOUN \n",
"( ( PUNCT \n",
"PDMPs pdmps NOUN \n",
") ) PUNCT \n",
"exist exist VERB \n",
"in in ADP \n",
"every every DET \n",
"state.[74 state.[74 NOUN \n",
"] ] PUNCT \n",
"A a DET \n",
"person person NOUN \n",
"on on ADP \n",
"opioids opioid NOUN \n",
"for for ADP \n",
"more more ADJ DATE\n",
"than than ADP DATE\n",
"three three NUM DATE\n",
"months month NOUN DATE\n",
"has have VERB \n",
"a a DET \n",
"15 15 NUM CARDINAL\n",
"- - ADJ CARDINAL\n",
"fold fold ADJ CARDINAL\n",
"( ( PUNCT \n",
"1,500 1,500 NUM PERCENT\n",
"% % NOUN PERCENT\n",
") ) PUNCT \n",
"greater great ADJ \n",
"chance chance NOUN \n",
"of of ADP \n",
"becoming become VERB \n",
"addicted.[21 addicted.[21 PROPN \n",
"] ] X \n",
"PDMPs pdmp NOUN \n",
"allow allow VERB \n",
"pharmacists pharmacist NOUN \n",
"and and CCONJ \n",
"prescribers prescriber NOUN \n",
"to to AUX \n",
"access access VERB \n",
"patients patient NOUN \n",
"’ ’ PART \n",
"prescription prescription NOUN \n",
"histories history NOUN \n",
"to to PART \n",
"identify identify VERB \n",
"suspicious suspicious ADJ \n",
"use use NOUN \n",
". . PUNCT \n",
"However however ADV \n",
", , PUNCT \n",
"a a DET \n",
"survey survey NOUN \n",
"of of ADP \n",
"US US PROPN GPE\n",
"physicians physician NOUN \n",
"published publish VERB \n",
"in in ADP \n",
"2015 2015 NUM DATE\n",
"found find VERB \n",
"only only ADV PERCENT\n",
"53 53 NUM PERCENT\n",
"% % NOUN PERCENT\n",
"of of ADP \n",
"doctors doctor NOUN \n",
"used use VERB \n",
"these these DET \n",
"programs program NOUN \n",
", , PUNCT \n",
"while while SCONJ \n",
"22 22 NUM PERCENT\n",
"% % NOUN PERCENT\n",
"were be AUX \n",
"not not PART \n",
"aware aware ADJ \n",
"these these DET \n",
"programs program NOUN \n",
"were be AUX \n",
"available.[75 available.[75 ADJ \n",
"] ] X \n",
"The the DET ORG\n",
"Centers Centers PROPN ORG\n",
"for for ADP ORG\n",
"Disease Disease PROPN ORG\n",
"Control Control PROPN ORG\n",
"and and CCONJ ORG\n",
"Prevention Prevention PROPN ORG\n",
"( ( PUNCT \n",
"CDC CDC PROPN ORG\n",
") ) PUNCT \n",
"was be AUX \n",
"tasked task VERB \n",
"with with ADP \n",
"establishing establish VERB \n",
"and and CCONJ \n",
"publishing publish VERB \n",
"a a DET \n",
"new new ADJ \n",
"guideline guideline NOUN \n",
", , PUNCT \n",
"and and CCONJ \n",
"was be AUX \n",
"heavily heavily ADV \n",
"lobbied.[76][77 lobbied.[76][77 PROPN \n",
"] ] X \n",
"\n",
"\n",
" \n",
"\n",
" SPACE \n",
"In in ADP \n",
"the the DET \n",
"media[edit media[edit NUM \n",
"] ] PUNCT \n",
"\n",
" \n",
" SPACE \n",
"Media Media PROPN \n",
"coverage coverage NOUN \n",
"has have AUX \n",
"largely largely ADV \n",
"focused focus VERB \n",
"on on ADP \n",
"law law NOUN \n",
"- - PUNCT \n",
"enforcement enforcement NOUN \n",
"solutions solution NOUN \n",
"to to ADP \n",
"the the DET \n",
"epidemic epidemic NOUN \n",
", , PUNCT \n",
"which which PRON \n",
"portray portray VERB \n",
"the the DET \n",
"issue issue NOUN \n",
"as as ADP \n",
"criminal criminal ADJ \n",
"rather rather ADV \n",
"than than ADP \n",
"medical.[78 medical.[78 PROPN \n",
"] ] PUNCT \n",
"There there PRON \n",
"has have AUX \n",
"been be AUX \n",
"differential differential ADJ \n",
"reporting reporting NOUN \n",
"on on ADP \n",
"how how SCONJ \n",
"white white ADJ \n",
"suburban suburban ADJ \n",
"or or CCONJ \n",
"rural rural ADJ \n",
"addicts addict NOUN \n",
"of of ADP \n",
"opioids opioid NOUN \n",
"are be AUX \n",
"portrayed portray VERB \n",
"compared compare VERB \n",
"to to ADP \n",
"black black ADJ \n",
"and and CCONJ \n",
"Hispanic hispanic ADJ NORP\n",
"urban urban ADJ \n",
"addicts addict NOUN \n",
", , PUNCT \n",
"often often ADV \n",
"of of ADP \n",
"heroin heroin NOUN \n",
", , PUNCT \n",
"reinforcing reinforce VERB \n",
"stereotypes stereotype NOUN \n",
"of of ADP \n",
"drug drug NOUN \n",
"users user NOUN \n",
"and and CCONJ \n",
"drug drug NOUN \n",
"- - PUNCT \n",
"using using NOUN \n",
"offenders.[79 offenders.[79 NOUN \n",
"] ] PUNCT \n",
"In in ADP \n",
"newspapers newspaper NOUN \n",
", , PUNCT \n",
"white white ADJ \n",
"addicts addict NOUN \n",
"' ' PART \n",
"stories story NOUN \n",
"are be AUX \n",
"often often ADV \n",
"given give VERB \n",
"more more ADJ \n",
"space space NOUN \n",
", , PUNCT \n",
"allowing allow VERB \n",
"for for ADP \n",
"a a DET \n",
"longer long ADJ \n",
"backstory backstory NOUN \n",
"explaining explain VERB \n",
"how how SCONJ \n",
"they they PRON \n",
"became become VERB \n",
"addicted addicted ADJ \n",
", , PUNCT \n",
"and and CCONJ \n",
"what what DET \n",
"potential potential NOUN \n",
"they they PRON \n",
"had have VERB \n",
"before before ADP \n",
"using use VERB \n",
"drugs drug NOUN \n",
". . PUNCT \n",
"Black black ADJ \n",
"and and CCONJ \n",
"Hispanic hispanic ADJ NORP\n",
"addicts addict NOUN \n",
"are be AUX \n",
"more more ADV \n",
"likely likely ADJ \n",
"to to PART \n",
"be be AUX \n",
"dehumanized dehumanize VERB \n",
", , PUNCT \n",
"portrayed portray VERB \n",
"criminally criminally ADV \n",
", , PUNCT \n",
"and and CCONJ \n",
"mentioned mention VERB \n",
"more more ADJ \n",
"briefly.[79 briefly.[79 X \n",
"] ] X \n",
"\n",
"\n",
" \n",
"\n",
" SPACE \n",
"In in ADP \n",
"July July PROPN DATE\n",
"2017 2017 NUM DATE\n",
", , PUNCT \n",
"a a DET \n",
"400 400 NUM CARDINAL\n",
"- - PUNCT \n",
"page page NOUN \n",
"report report NOUN \n",
"by by ADP \n",
"the the DET ORG\n",
"National National PROPN ORG\n",
"Academy Academy PROPN ORG\n",
"of of ADP ORG\n",
"Science Science PROPN ORG\n",
"presented present VERB \n",
"plans plan NOUN \n",
"to to PART \n",
"reduce reduce VERB \n",
"the the DET \n",
"addiction addiction NOUN \n",
"crisis crisis NOUN \n",
", , PUNCT \n",
"which which PRON \n",
"it it PRON \n",
"said say VERB \n",
"was be AUX \n",
"killing kill VERB \n",
"91 91 NUM CARDINAL\n",
"people people NOUN \n",
"each each PRON \n",
"day.[80 day.[80 NOUN \n",
"] ] X \n",
"\n",
"\n",
" \n",
"\n",
" SPACE \n",
"Solutions solution NOUN \n",
"for for ADP \n",
"addicts[edit addicts[edit NOUN \n",
"] ] PUNCT \n",
"\n",
" \n",
" SPACE \n",
"Main main ADJ PRODUCT\n",
"article article NOUN \n",
": : PUNCT \n",
"Drug drug NOUN \n",
"abuse abuse NOUN \n",
"treatment treatment NOUN \n",
"\n",
" \n",
" SPACE \n",
"The the DET \n",
"opioid opioid ADJ \n",
"epidemic epidemic NOUN \n",
"is be AUX \n",
"often often ADV \n",
"discussed discuss VERB \n",
"in in ADP \n",
"terms term NOUN \n",
"of of ADP \n",
"prevention prevention NOUN \n",
", , PUNCT \n",
"but but CCONJ \n",
"helping help VERB \n",
"those those PRON \n",
"who who PRON \n",
"are be AUX \n",
"already already ADV \n",
"addicts addict NOUN \n",
"is be AUX \n",
"talked talk VERB \n",
"about about ADP \n",
"less less ADV \n",
"frequently.[78 frequently.[78 SCONJ \n",
"] ] X \n",
"Opioid opioid ADJ \n",
"dependence dependence NOUN \n",
"can can AUX \n",
"lead lead VERB \n",
"to to ADP \n",
"a a DET \n",
"number number NOUN \n",
"of of ADP \n",
"consequences consequence NOUN \n",
"like like ADP \n",
"contraction contraction NOUN \n",
"of of ADP \n",
"HIV HIV PROPN \n",
"and and CCONJ \n",
"overdose overdose NOUN \n",
". . PUNCT \n",
"For for ADP \n",
"addicts addict NOUN \n",
"who who PRON \n",
"wish wish VERB \n",
"to to PART \n",
"treat treat VERB \n",
"their their PRON \n",
"addiction addiction NOUN \n",
", , PUNCT \n",
"there there PRON \n",
"are be VERB \n",
"two two NUM CARDINAL\n",
"classes class NOUN \n",
"of of ADP \n",
"treatment treatment NOUN \n",
"options option NOUN \n",
"available available ADJ \n",
": : PUNCT \n",
"medical medical ADJ \n",
"and and CCONJ \n",
"behavioral.[81 behavioral.[81 PROPN \n",
"] ] PUNCT \n",
"Neither neither PRON \n",
"is be AUX \n",
"guaranteed guarantee VERB \n",
"to to PART \n",
"successfully successfully ADV \n",
"treat treat VERB \n",
"opioid opioid ADJ \n",
"addiction addiction NOUN \n",
". . PUNCT \n",
"Which which PRON \n",
", , PUNCT \n",
"or or CCONJ \n",
"which which DET \n",
"combination combination NOUN \n",
", , PUNCT \n",
"is be AUX \n",
"most most ADV \n",
"effective effective ADJ \n",
"varies varie NOUN \n",
"from from ADP \n",
"person person NOUN \n",
"to to ADP \n",
"person.[82 person.[82 NOUN \n",
"] ] PUNCT \n",
"These these DET \n",
"treatments treatment NOUN \n",
"are be AUX \n",
"doctor doctor NOUN \n",
"- - PUNCT \n",
"prescribed prescribe VERB \n",
"and and CCONJ \n",
"-regulated -regulated ADJ \n",
", , PUNCT \n",
"but but CCONJ \n",
"differ differ VERB \n",
"in in ADP \n",
"their their PRON \n",
"treatment treatment NOUN \n",
"mechanism mechanism NOUN \n",
". . PUNCT \n",
"Popular popular ADJ \n",
"treatments treatment NOUN \n",
"include include VERB \n",
"naloxone naloxone NOUN \n",
", , PUNCT \n",
"methadone methadone NOUN \n",
", , PUNCT \n",
"and and CCONJ \n",
"buprenorphine buprenorphine NOUN \n",
", , PUNCT \n",
"which which PRON \n",
"are be AUX \n",
"more more ADV \n",
"effective effective ADJ \n",
"when when SCONJ \n",
"combined combine VERB \n",
"with with ADP \n",
"a a DET \n",
"form form NOUN \n",
"of of ADP \n",
"behavioral behavioral ADJ \n",
"treatment.[82 treatment.[82 ADJ \n",
"] ] PUNCT \n",
"\n",
"\n",
" \n",
"\n",
" SPACE \n",
"Naloxone[edit naloxone[edit NOUN \n",
"] ] PUNCT \n",
"\n",
" \n",
" SPACE \n",
"Naloxone naloxone NOUN \n",
"is be AUX \n",
"used use VERB \n",
"mostly mostly ADV \n",
"as as ADP \n",
"a a DET \n",
"rescue rescue NOUN \n",
"medication medication NOUN \n",
"for for ADP \n",
"opioid opioid ADJ \n",
"overdose overdose NOUN \n",
". . PUNCT \n",
"It it PRON \n",
"is be AUX \n",
"an an DET \n",
"opioid opioid ADJ \n",
"antagonist antagonist NOUN \n",
", , PUNCT \n",
"meaning mean VERB \n",
"it it PRON \n",
"binds bind VERB \n",
"to to ADP \n",
"opioid opioid ADJ \n",
"receptors receptor NOUN \n",
"but but CCONJ \n",
"does do AUX \n",
"not not PART \n",
"turn turn VERB \n",
"them they PRON \n",
"on on ADP \n",
". . PUNCT \n",
"It it PRON \n",
"also also ADV \n",
"happens happen VERB \n",
"that that SCONJ \n",
"naloxone naloxone NOUN \n",
"binds bind VERB \n",
"to to PART \n",
"opioid opioid ADJ \n",
"receptors receptor NOUN \n",
"more more ADV \n",
"strongly strongly ADV \n",
"than than ADP \n",
"heroin heroin NOUN \n",
"or or CCONJ \n",
"any any DET \n",
"prescription prescription NOUN \n",
"opioids opioid NOUN \n",
". . PUNCT \n",
"This this PRON \n",
"means mean VERB \n",
"that that SCONJ \n",
"when when SCONJ \n",
"someone someone PRON \n",
"is be AUX \n",
"overdosing overdose VERB \n",
"on on ADP \n",
"opioids opioid NOUN \n",
", , PUNCT \n",
"naloxone naloxone NOUN \n",
"can can AUX \n",
"be be AUX \n",
"administered administer VERB \n",
", , PUNCT \n",
"allowing allow VERB \n",
"it it PRON \n",
"to to PART \n",
"take take VERB \n",
"the the DET \n",
"place place NOUN \n",
"of of ADP \n",
"the the DET \n",
"opioid opioid ADJ \n",
"drug drug NOUN \n",
"in in ADP \n",
"the the DET \n",
"person person NOUN \n",
"'s 's PART \n",
"receptors receptor NOUN \n",
", , PUNCT \n",
"turning turn VERB \n",
"them they PRON \n",
"off off ADP \n",
". . PUNCT \n",
"This this PRON \n",
"blocks block VERB \n",
"the the DET \n",
"effect effect NOUN \n",
"of of ADP \n",
"the the DET \n",
"receptors receptor NOUN \n",
". . PUNCT \n",
"Naloxone naloxone NOUN \n",
"is be AUX \n",
"sometimes sometimes ADV \n",
"administered administer VERB \n",
"with with ADP \n",
"other other ADJ \n",
"drugs drug NOUN \n",
"such such ADJ \n",
"as as ADP \n",
"buprenorphine buprenorphine ADJ \n",
", , PUNCT \n",
"as as ADP \n",
"a a DET \n",
"way way NOUN \n",
"to to PART \n",
"taper taper VERB \n",
"off off ADP \n",
"buprenorphine buprenorphine NOUN \n",
"over over ADP \n",
"time time NOUN \n",
". . PUNCT \n",
"Naloxone naloxone NOUN \n",
"binds bind VERB \n",
"to to ADP \n",
"some some PRON \n",
"of of ADP \n",
"the the DET \n",
"receptors receptor NOUN \n",
", , PUNCT \n",
"blocking block VERB \n",
"the the DET \n",
"effectiveness effectiveness NOUN \n",
"of of ADP \n",
"some some DET \n",
"receptors receptor NOUN \n",
"in in ADP \n",
"case case NOUN \n",
"of of ADP \n",
"relapse.[82 relapse.[82 PROPN \n",
"] ] X \n",
"\n",
"\n",
" \n",
"\n",
" SPACE \n",
"Methadone[edit methadone[edit NOUN \n",
"] ] PUNCT \n",
"\n",
" \n",
" SPACE \n",
"Methadone Methadone PROPN ORG\n",
"has have AUX \n",
"been be AUX \n",
"used use VERB \n",
"for for ADP \n",
"opioid opioid ADJ \n",
"dependence dependence NOUN \n",
"since since SCONJ \n",
"1964 1964 NUM DATE\n",
", , PUNCT \n",
"and and CCONJ \n",
"studied study VERB \n",
"the the DET \n",
"most most ADJ \n",
"of of ADP \n",
"the the DET \n",
"pharmacological pharmacological ADJ \n",
"treatment treatment NOUN \n",
"options.[83 options.[83 NOUN \n",
"] ] X \n",
"It it PRON \n",
"is be AUX \n",
"a a DET \n",
"synthetic synthetic ADJ \n",
"long long ADJ \n",
"acting acting NOUN \n",
"opioid opioid NOUN \n",
", , PUNCT \n",
"so so SCONJ \n",
"it it PRON \n",
"can can AUX \n",
"replace replace VERB \n",
"multiple multiple ADJ \n",
"heroin heroin NOUN \n",
"uses use NOUN \n",
"by by ADP \n",
"being be AUX \n",
"taken take VERB \n",
"once once ADV \n",
"daily.[82 daily.[82 X \n",
"] ] PUNCT \n",
"It it PRON \n",
"works work VERB \n",
"by by ADP \n",
"binding bind VERB \n",
"to to ADP \n",
"the the DET \n",
"opioid opioid ADJ \n",
"receptors receptor NOUN \n",
"in in ADP \n",
"the the DET \n",
"brain brain NOUN \n",
"and and CCONJ \n",
"spinal spinal ADJ \n",
"cord cord NOUN \n",
", , PUNCT \n",
"activating activate VERB \n",
"them they PRON \n",
", , PUNCT \n",
"reducing reduce VERB \n",
"withdrawal withdrawal NOUN \n",
"symptoms symptom NOUN \n",
"and and CCONJ \n",
"cravings craving NOUN \n",
"while while SCONJ \n",
"suppressing suppress VERB \n",
"the the DET \n",
"\" \" PUNCT \n",
"high high ADJ \n",
"\" \" PUNCT \n",
"that that SCONJ \n",
"other other ADJ \n",
"opioids opioid NOUN \n",
"can can AUX \n",
"elicit elicit VERB \n",
". . PUNCT \n",
"The the DET \n",
"decrease decrease NOUN \n",
"in in ADP \n",
"withdrawal withdrawal NOUN \n",
"symptoms symptom NOUN \n",
"and and CCONJ \n",
"cravings craving NOUN \n",
"allow allow VERB \n",
"the the DET \n",
"user user NOUN \n",
"to to PART \n",
"slowly slowly ADV \n",
"taper taper VERB \n",
"off off ADP \n",
"the the DET \n",
"drug drug NOUN \n",
"in in ADP \n",
"a a DET \n",
"controlled control VERB \n",
"manner manner NOUN \n",
", , PUNCT \n",
"decreasing decrease VERB \n",
"the the DET \n",
"likelihood likelihood NOUN \n",
"of of ADP \n",
"relapse relapse NOUN \n",
". . PUNCT \n",
"It it PRON \n",
"is be AUX \n",
"not not PART \n",
"accessible accessible ADJ \n",
"to to ADP \n",
"all all DET \n",
"addicts addict NOUN \n",
". . PUNCT \n",
"It it PRON \n",
"is be AUX \n",
"a a DET \n",
"regulated regulated ADJ \n",
"substance substance NOUN \n",
", , PUNCT \n",
"and and CCONJ \n",
"requires require VERB \n",
"that that SCONJ \n",
"each each DET \n",
"dose dose NOUN \n",
"be be AUX \n",
"picked pick VERB \n",
"up up ADP \n",
"from from ADP \n",
"a a DET \n",
"methadone methadone NOUN \n",
"clinic clinic NOUN \n",
"daily daily ADV DATE\n",
". . PUNCT \n",
"This this PRON \n",
"can can AUX \n",
"be be AUX \n",
"inconvenient inconvenient ADJ \n",
"as as SCONJ \n",
"some some DET \n",
"patients patient NOUN \n",
"are be AUX \n",
"unable unable ADJ \n",
"to to PART \n",
"travel travel VERB \n",
"to to ADP \n",
"a a DET \n",
"clinic clinic NOUN \n",
", , PUNCT \n",
"or or CCONJ \n",
"avoid avoid VERB \n",
"the the DET \n",
"stigma stigma NOUN \n",
"associated associate VERB \n",
"with with ADP \n",
"drug drug NOUN \n",
"addiction.[82 addiction.[82 PROPN \n",
"] ] PUNCT \n",
"\n",
"\n",
" \n",
"\n",
" SPACE \n",
"Buprenorphine[edit buprenorphine[edit NOUN \n",
"] ] PUNCT \n",
"\n",
" \n",
" SPACE \n",
"Buprenorphine Buprenorphine PROPN ORG\n",
"is be AUX \n",
"used use VERB \n",
"similarly similarly ADV \n",
"to to ADP \n",
"methadone methadone NOUN \n",
", , PUNCT \n",
"with with ADP \n",
"some some DET \n",
"doctors doctor NOUN \n",
"recommending recommend VERB \n",
"it it PRON \n",
"as as ADP \n",
"the the DET \n",
"best good ADJ \n",
"solution solution NOUN \n",
"for for ADP \n",
"medication medication NOUN \n",
"- - PUNCT \n",
"assisted assist VERB \n",
"treatment treatment NOUN \n",
"to to PART \n",
"help help VERB \n",
"people people NOUN \n",
"reduce reduce VERB \n",
"or or CCONJ \n",
"quit quit VERB \n",
"their their PRON \n",
"use use NOUN \n",
"of of ADP \n",
"heroin heroin NOUN \n",
"or or CCONJ \n",
"other other ADJ \n",
"opiates opiate NOUN \n",
". . PUNCT \n",
"It it PRON \n",
"is be AUX \n",
"claimed claim VERB \n",
"to to PART \n",
"be be AUX \n",
"safer safe ADJ \n",
"and and CCONJ \n",
"less less ADV \n",
"regulated regulated ADJ \n",
"than than ADP \n",
"methadone methadone NOUN \n",
", , PUNCT \n",
"with with ADP \n",
"month month NOUN DATE\n",
"- - PUNCT DATE\n",
"long long ADJ DATE\n",
"prescriptions prescription NOUN \n",
"allowed allow VERB \n",
". . PUNCT \n",
"It it PRON \n",
"is be AUX \n",
"also also ADV \n",
"said say VERB \n",
"to to PART \n",
"eliminate eliminate VERB \n",
"opiate opiate ADJ \n",
"withdrawal withdrawal NOUN \n",
"symptoms symptom NOUN \n",
"and and CCONJ \n",
"cravings craving NOUN \n",
"in in ADP \n",
"many many ADJ \n",
"patients patient NOUN \n",
"without without ADP \n",
"inducing induce VERB \n",
"euphoria.[84 euphoria.[84 PROPN \n",
"] ] X \n",
"\n",
"\n",
" \n",
"\n",
" SPACE \n",
"Unlike unlike ADP \n",
"methadone methadone NOUN \n",
"treatment treatment NOUN \n",
", , PUNCT \n",
"which which PRON \n",
"must must AUX \n",
"be be AUX \n",
"performed perform VERB \n",
"in in ADP \n",
"a a DET \n",
"highly highly ADV \n",
"structured structured ADJ \n",
"clinic clinic NOUN \n",
", , PUNCT \n",
"buprenorphine buprenorphine ADJ \n",
", , PUNCT \n",
"according accord VERB \n",
"to to ADP \n",
"SAMHSA SAMHSA PROPN ORG\n",
", , PUNCT \n",
"can can AUX \n",
"be be AUX \n",
"prescribed prescribe VERB \n",
"or or CCONJ \n",
"dispensed dispense VERB \n",
"in in ADP \n",
"physician physician NOUN \n",
"offices.[85 offices.[85 NOUN \n",
"] ] PUNCT \n",
"Patients patient NOUN \n",
"can can AUX \n",
"thereby thereby ADV \n",
"receive receive VERB \n",
"a a DET DATE\n",
"full full ADJ DATE\n",
"year year NOUN DATE\n",
"of of ADP \n",
"treatment treatment NOUN \n",
"for for ADP \n",
"a a DET \n",
"fraction fraction NOUN \n",
"of of ADP \n",
"the the DET \n",
"cost cost NOUN \n",
"of of ADP \n",
"detox detox NOUN \n",
"programs.[84 programs.[84 PROPN \n",
"] ] PUNCT \n",
"\n",
"\n",
" \n",
"\n",
" SPACE \n",
"Behavioral behavioral ADJ \n",
"treatment treatment NOUN \n",
"options[edit options[edit NOUN \n",
"] ] PUNCT \n",
"\n",
" \n",
" SPACE \n",
"It it PRON \n",
"is be AUX \n",
"less less ADV \n",
"effective effective ADJ \n",
"to to PART \n",
"use use VERB \n",
"behavioral behavioral ADJ \n",
"treatment treatment NOUN \n",
"without without ADP \n",
"medical medical ADJ \n",
"treatment treatment NOUN \n",
"during during ADP \n",
"initial initial ADJ \n",
"detoxification detoxification NOUN \n",
". . PUNCT \n",
"It it PRON \n",
"has have AUX \n",
"similarly similarly ADV \n",
"been be AUX \n",
"shown show VERB \n",
"that that SCONJ \n",
"medical medical ADJ \n",
"treatments treatment NOUN \n",
"tend tend VERB \n",
"to to PART \n",
"get get VERB \n",
"better well ADJ \n",
"results result NOUN \n",
"when when SCONJ \n",
"accompanied accompany VERB \n",
"by by ADP \n",
"behavioral behavioral ADJ \n",
"treatment.[81 treatment.[81 ADJ \n",
"] ] X \n",
"Popular popular ADJ \n",
"behavioral behavioral ADJ \n",
"treatment treatment NOUN \n",
"options option NOUN \n",
"include include VERB \n",
"group group NOUN \n",
"or or CCONJ \n",
"individual individual ADJ \n",
"therapy therapy NOUN \n",
", , PUNCT \n",
"residential residential ADJ \n",
"treatment treatment NOUN \n",
"centers center NOUN \n",
", , PUNCT \n",
"and and CCONJ \n",
"Twelve twelve NUM CARDINAL\n",
"- - PUNCT \n",
"step step NOUN \n",
"programs program NOUN \n",
"such such ADJ \n",
"as as ADP \n",
"Narcotics Narcotics PROPN \n",
"Anonymous.[83 anonymous.[83 X \n",
"] ] PUNCT \n",
"Residential residential ADJ \n",
"treatment treatment NOUN \n",
"centers center NOUN \n",
"allow allow VERB \n",
"for for ADP \n",
"a a DET \n",
"24 24 NUM TIME\n",
"- - PUNCT TIME\n",
"hour hour NOUN TIME\n",
"drug drug NOUN \n",
"- - PUNCT \n",
"free free ADJ \n",
"environment environment NOUN \n",
"to to PART \n",
"decrease decrease VERB \n",
"the the DET \n",
"chances chance NOUN \n",
"of of ADP \n",
"relapse relapse NOUN \n",
". . PUNCT \n",
"These these DET \n",
"centers center NOUN \n",
"allow allow VERB \n",
"addicts addict NOUN \n",
"to to PART \n",
"be be AUX \n",
"in in ADP \n",
"supportive supportive ADJ \n",
"environments environment NOUN \n",
"during during ADP \n",
"the the DET \n",
"difficult difficult ADJ \n",
"time time NOUN \n",
"of of ADP \n",
"detox.[86 detox.[86 PROPN \n",
"] ] X \n",
"\n",
"\n",
" \n",
"\n",
" SPACE \n",
"Twelve twelve NUM CARDINAL\n",
"- - PUNCT \n",
"step step NOUN \n",
"programs program NOUN \n",
"are be AUX \n",
"one one NUM CARDINAL\n",
"of of ADP \n",
"the the DET \n",
"most most ADV \n",
"well well ADV \n",
"- - PUNCT \n",
"known know VERB \n",
"options option NOUN \n",
". . PUNCT \n",
"The the DET \n",
"philosophy philosophy NOUN \n",
"is be AUX \n",
"that that SCONJ \n",
"a a DET \n",
"group group NOUN \n",
"of of ADP \n",
"people people NOUN \n",
"sharing share VERB \n",
"the the DET \n",
"same same ADJ \n",
"addiction addiction NOUN \n",
"can can AUX \n",
"remain remain VERB \n",
"abstinent abstinent ADJ \n",
"with with ADP \n",
"the the DET \n",
"support support NOUN \n",
"of of ADP \n",
"and and CCONJ \n",
"connection connection NOUN \n",
"to to ADP \n",
"others other NOUN \n",
"who who PRON \n",
"empathize empathize VERB \n",
"and and CCONJ \n",
"understand understand VERB \n",
". . PUNCT \n",
"There there PRON \n",
"is be VERB \n",
"also also ADV \n",
"a a DET \n",
"spiritual spiritual ADJ \n",
", , PUNCT \n",
"though though SCONJ \n",
"not not PART \n",
"religious religious ADJ \n",
", , PUNCT \n",
"component component NOUN \n",
"to to ADP \n",
"it it PRON \n",
", , PUNCT \n",
"with with ADP \n",
"freedom freedom NOUN \n",
"to to PART \n",
"believe believe VERB \n",
"as as ADP \n",
"one one NUM CARDINAL\n",
"chooses.[87 chooses.[87 NOUN \n",
"] ] X \n",
"\n",
"\n",
" \n",
"\n",
" SPACE \n",
"See see VERB \n",
"also[edit also[edit NOUN \n",
"] ] PUNCT \n",
"\n",
" \n",
" SPACE \n",
"Crack crack VERB \n",
"epidemic epidemic NOUN \n",
"\n",
" \n",
" SPACE \n",
"List List PROPN \n",
"of of ADP \n",
"deaths death NOUN \n",
"from from ADP \n",
"drug drug NOUN \n",
"overdose overdose NOUN \n",
"and and CCONJ \n",
"intoxication intoxication NOUN \n",
"\n",
" \n",
" SPACE \n",
"References[edit references[edit NOUN \n",
"] ] PUNCT \n",
"\n",
" \n",
" SPACE \n",
"^ ^ PUNCT \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"to to ADP \n",
": : PUNCT \n",
"a a DET \n",
"b b PROPN \n",
"Data Data PROPN ORG\n",
"Overview Overview PROPN ORG\n",
". . PUNCT \n",
"Drug Drug PROPN \n",
"Overdose Overdose PROPN \n",
". . PUNCT \n",
"CDC CDC PROPN ORG\n",
"Injury Injury PROPN ORG\n",
"Center Center PROPN ORG\n",
", , PUNCT ORG\n",
"Centers Centers PROPN ORG\n",
"for for ADP ORG\n",
"Disease Disease PROPN ORG\n",
"Control Control PROPN ORG\n",
"and and CCONJ ORG\n",
"Prevention Prevention PROPN ORG\n",
"2016 2016 NUM \n",
". . PUNCT \n",
"\n",
" \n",
" SPACE \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"WHO who PRON \n",
"| | NOUN \n",
"Information information NOUN \n",
"sheet sheet NOUN \n",
"on on ADP \n",
"opioid opioid ADJ \n",
"overdose overdose NOUN \n",
"\" \" PUNCT \n",
". . PUNCT \n",
"www.who.int www.who.int NOUN \n",
". . PUNCT \n",
"Retrieved retrieve VERB \n",
"2017 2017 NUM DATE\n",
"- - SYM DATE\n",
"07 07 NUM DATE\n",
"- - SYM DATE\n",
"30 30 NUM DATE\n",
". . PUNCT \n",
"\n",
" \n",
" SPACE \n",
"^ ^ PUNCT \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"to to ADP \n",
": : PUNCT \n",
"a a DET \n",
"b b X \n",
"\" \" PUNCT \n",
"2015 2015 NUM DATE\n",
"National National PROPN EVENT\n",
"Drug Drug PROPN EVENT\n",
"Threat Threat PROPN EVENT\n",
"Assessment Assessment PROPN EVENT\n",
"Summary Summary PROPN EVENT\n",
"\" \" PUNCT \n",
", , PUNCT \n",
"DEA DEA PROPN ORG\n",
", , PUNCT \n",
"Oct. Oct. PROPN DATE\n",
"2015 2015 NUM DATE\n",
"\n",
" \n",
" SPACE \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"CDC CDC PROPN ORG\n",
"– – PUNCT \n",
"MMWR MMWR PROPN ORG\n",
"– – PUNCT \n",
"MMWR MMWR PROPN ORG\n",
"Publications Publications PROPN ORG\n",
"– – PUNCT \n",
"MMWR MMWR PROPN ORG\n",
"Weekly Weekly PROPN ORG\n",
": : PUNCT \n",
"Past Past PROPN \n",
"Volume volume NOUN \n",
"( ( PUNCT \n",
"2011 2011 NUM DATE\n",
") ) PUNCT \n",
"\" \" PUNCT \n",
". . PUNCT \n",
"www.cdc.gov www.cdc.gov VERB \n",
". . PUNCT \n",
"November November PROPN DATE\n",
"4 4 NUM DATE\n",
", , PUNCT DATE\n",
"2011 2011 NUM DATE\n",
"/ / SYM DATE\n",
"60(43);1487–1492 60(43);1487–1492 NUM DATE\n",
". . PUNCT \n",
"Retrieved retrieve VERB \n",
"2017 2017 NUM DATE\n",
"- - SYM DATE\n",
"07 07 NUM DATE\n",
"- - SYM DATE\n",
"30 30 NUM DATE\n",
". . PUNCT \n",
"\n",
" \n",
" SPACE \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"Drug drug NOUN \n",
"overdoses overdose NOUN \n",
"now now ADV \n",
"kill kill VERB \n",
"more more ADJ \n",
"Americans Americans PROPN NORP\n",
"than than ADP \n",
"guns gun NOUN \n",
"\" \" PUNCT \n",
", , PUNCT \n",
"CBS CBS PROPN ORG\n",
"News News PROPN ORG\n",
", , PUNCT \n",
"Dec. Dec. PROPN DATE\n",
"9 9 NUM DATE\n",
", , PUNCT DATE\n",
"2016 2016 NUM DATE\n",
"\n",
" \n",
" SPACE \n",
"^ ^ PUNCT \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"to to ADP \n",
": : PUNCT \n",
"a a DET \n",
"b b X \n",
"\" \" PUNCT \n",
"Drug Drug PROPN \n",
"Deaths Deaths PROPN \n",
"in in ADP \n",
"America America PROPN \n",
"Are be AUX \n",
"Rising rise VERB \n",
"Faster fast ADV \n",
"Than than SCONJ \n",
"Ever ever ADV \n",
"\" \" PUNCT \n",
", , PUNCT \n",
"New New PROPN ORG\n",
"York York PROPN ORG\n",
"Times Times PROPN ORG\n",
", , PUNCT \n",
"June June PROPN DATE\n",
"5 5 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
"\n",
" \n",
" SPACE DATE\n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"In in ADP \n",
"2016 2016 NUM DATE\n",
", , PUNCT \n",
"drug drug NOUN \n",
"overdoses overdose NOUN \n",
"likely likely ADV \n",
"killed kill VERB \n",
"more more ADJ \n",
"Americans Americans PROPN NORP\n",
"than than ADP \n",
"the the DET \n",
"entire entire ADJ \n",
"wars war NOUN \n",
"in in ADP \n",
"Vietnam Vietnam PROPN GPE\n",
"and and CCONJ \n",
"Iraq Iraq PROPN GPE\n",
"\" \" PUNCT \n",
", , PUNCT \n",
"Vox Vox PROPN ORG\n",
", , PUNCT \n",
"July July PROPN DATE\n",
"7 7 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
"\n",
" \n",
" SPACE \n",
"^ ^ PUNCT \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"to to ADP \n",
": : PUNCT \n",
"a a DET \n",
"b b NOUN \n",
"c c NOUN \n",
"d d NOUN \n",
"e e NOUN \n",
"\" \" PUNCT \n",
"How how SCONJ \n",
"Bad bad ADJ PERSON\n",
"is be AUX \n",
"the the DET \n",
"Opioid Opioid PROPN \n",
"Epidemic Epidemic PROPN \n",
"? ? PUNCT \n",
"\" \" PUNCT \n",
", , PUNCT \n",
"PBS PBS PROPN ORG\n",
", , PUNCT \n",
"Feb. Feb. PROPN DATE\n",
"23 23 NUM DATE\n",
", , PUNCT DATE\n",
"2016 2016 NUM DATE\n",
"\n",
" \n",
" SPACE DATE\n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"America America PROPN WORK_OF_ART\n",
"’s ’s PART WORK_OF_ART\n",
"Addiction Addiction PROPN WORK_OF_ART\n",
"to to ADP WORK_OF_ART\n",
"Opioids opioid NOUN WORK_OF_ART\n",
": : PUNCT WORK_OF_ART\n",
"Heroin Heroin PROPN WORK_OF_ART\n",
"and and CCONJ WORK_OF_ART\n",
"Prescription Prescription PROPN WORK_OF_ART\n",
"Drug Drug PROPN WORK_OF_ART\n",
"Abuse Abuse PROPN WORK_OF_ART\n",
"\" \" PUNCT \n",
", , PUNCT \n",
"National National PROPN ORG\n",
"Institute Institute PROPN ORG\n",
"on on ADP ORG\n",
"Drug Drug PROPN ORG\n",
"Abuse Abuse PROPN ORG\n",
"( ( PUNCT \n",
"NIDA NIDA PROPN ORG\n",
") ) PUNCT \n",
", , PUNCT \n",
"May May PROPN DATE\n",
"14 14 NUM DATE\n",
", , PUNCT DATE\n",
"2014 2014 NUM DATE\n",
"\n",
" \n",
" SPACE \n",
"^ ^ PUNCT \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"to to ADP \n",
": : PUNCT \n",
"a a DET \n",
"b b NOUN \n",
"c c NOUN \n",
"d d NOUN \n",
"e e NOUN \n",
"\" \" PUNCT \n",
"America America PROPN GPE\n",
"’s ’s PART \n",
"opioid opioid ADJ \n",
"epidemic epidemic NOUN \n",
"is be AUX \n",
"worsening worsen VERB \n",
"\" \" PUNCT \n",
", , PUNCT \n",
"the the DET \n",
"Economist Economist PROPN PERSON\n",
"( ( PUNCT \n",
"U.K. U.K. PROPN GPE\n",
") ) PUNCT \n",
"March March PROPN DATE\n",
"6 6 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
"\n",
" \n",
" SPACE DATE\n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"STAT STAT PROPN \n",
"forecast forecast NOUN \n",
": : PUNCT \n",
"Opioids opioid NOUN \n",
"could could AUX \n",
"kill kill VERB \n",
"nearly nearly ADV CARDINAL\n",
"500,000 500,000 NUM CARDINAL\n",
"Americans Americans PROPN NORP\n",
"in in ADP \n",
"the the DET DATE\n",
"next next ADJ DATE\n",
"decade decade NOUN DATE\n",
"\" \" PUNCT \n",
", , PUNCT \n",
"STAT STAT PROPN ORG\n",
", , PUNCT \n",
"June June PROPN DATE\n",
"27 27 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
"\n",
" \n",
" SPACE \n",
"^ ^ PUNCT \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"to to ADP \n",
": : PUNCT \n",
"a a DET \n",
"b b NOUN \n",
"Turque Turque PROPN \n",
", , PUNCT \n",
"B. B. PROPN GPE\n",
"Maryland Maryland PROPN GPE\n",
"governor governor NOUN \n",
"declares declare VERB \n",
"state state NOUN \n",
"of of ADP \n",
"emergency emergency NOUN \n",
"for for ADP \n",
"opioid opioid ADJ \n",
"crisis crisis NOUN \n",
", , PUNCT \n",
"The the DET ORG\n",
"Washington Washington PROPN ORG\n",
"Post Post PROPN ORG\n",
", , PUNCT \n",
"March March PROPN DATE\n",
"1 1 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
"\n",
" \n",
" SPACE \n",
"^ ^ PUNCT \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"to to ADP \n",
": : PUNCT \n",
"a a DET \n",
"b b X \n",
"\" \" PUNCT \n",
"FDA FDA PROPN ORG\n",
"'s 's PART \n",
"Scott Scott PROPN PERSON\n",
"Gottlieb Gottlieb PROPN PERSON\n",
": : PUNCT \n",
"Opioid opioid ADJ \n",
"addiction addiction NOUN \n",
"is be AUX \n",
"FDA FDA PROPN ORG\n",
"'s 's PART \n",
"biggest big ADJ \n",
"crisis crisis NOUN \n",
"now now ADV \n",
"\" \" PUNCT \n",
", , PUNCT \n",
"CNBC CNBC PROPN ORG\n",
", , PUNCT \n",
"July July PROPN DATE\n",
"21 21 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
"\n",
" \n",
" SPACE \n",
"^ ^ PUNCT \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"to to ADP \n",
": : PUNCT \n",
"a a DET \n",
"b b X \n",
"\" \" PUNCT \n",
"CDC CDC PROPN ORG\n",
"Chief Chief PROPN \n",
"Frieden Frieden PROPN \n",
": : PUNCT \n",
"How how SCONJ \n",
"to to PART \n",
"end end VERB \n",
"America America PROPN GPE\n",
"'s 's PART \n",
"growing grow VERB \n",
"opioid opioid ADJ \n",
"epidemic epidemic NOUN \n",
"\" \" PUNCT \n",
", , PUNCT \n",
"Fox Fox PROPN ORG\n",
"News News PROPN ORG\n",
", , PUNCT \n",
"Dec. Dec. PROPN DATE\n",
"17 17 NUM DATE\n",
", , PUNCT DATE\n",
"2016 2016 NUM DATE\n",
"\n",
" \n",
" SPACE \n",
"^ ^ PUNCT \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"to to ADP \n",
": : PUNCT \n",
"a a DET \n",
"b b NOUN \n",
"c c NOUN \n",
"d d X \n",
"e e NOUN \n",
"f f PROPN \n",
"g g PROPN \n",
"h h PROPN \n",
"i i PROPN \n",
"j j PROPN \n",
"k k PROPN \n",
"Caldwell Caldwell PROPN \n",
", , PUNCT \n",
"Christoper Christoper PROPN \n",
". . PUNCT \n",
"\" \" PUNCT \n",
"American American PROPN WORK_OF_ART\n",
"Carnage Carnage PROPN WORK_OF_ART\n",
": : PUNCT WORK_OF_ART\n",
"The the DET WORK_OF_ART\n",
"New New PROPN WORK_OF_ART\n",
"Landscape Landscape PROPN WORK_OF_ART\n",
"of of ADP WORK_OF_ART\n",
"Opioid Opioid PROPN WORK_OF_ART\n",
"Addiction Addiction PROPN WORK_OF_ART\n",
"\" \" PUNCT \n",
", , PUNCT \n",
"First First PROPN ORG\n",
"Things Things PROPN ORG\n",
", , PUNCT \n",
"April April PROPN DATE\n",
"2017 2017 NUM DATE\n",
"\n",
" \n",
" SPACE \n",
"^ ^ PUNCT \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"to to ADP \n",
": : PUNCT \n",
"a a DET \n",
"b b X \n",
"\" \" PUNCT \n",
"White White PROPN ORG\n",
"House House PROPN ORG\n",
"opioid opioid ADJ \n",
"commission commission NOUN \n",
"to to ADP \n",
"Trump trump VERB ORG\n",
": : PUNCT \n",
"‘ ' PUNCT \n",
"Declare declare VERB \n",
"a a DET \n",
"national national ADJ \n",
"emergency emergency NOUN \n",
"’ ' PUNCT \n",
"on on ADP \n",
"drug drug NOUN \n",
"overdoses overdose NOUN \n",
"\" \" PUNCT \n",
", , PUNCT \n",
"Washington Washington PROPN ORG\n",
"Post Post PROPN ORG\n",
", , PUNCT \n",
"July July PROPN DATE\n",
"31 31 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
"\n",
" \n",
" SPACE \n",
"^ ^ PUNCT \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"to to ADP \n",
": : PUNCT \n",
"a a DET \n",
"b b X \n",
"\" \" PUNCT \n",
"Trump Trump PROPN ORG\n",
"says say VERB \n",
"opioid opioid ADJ \n",
"crisis crisis NOUN \n",
"is be AUX \n",
"a a DET \n",
"national national ADJ \n",
"emergency emergency NOUN \n",
", , PUNCT \n",
"pledges pledge VERB \n",
"more more ADJ \n",
"money money NOUN \n",
"and and CCONJ \n",
"attention attention NOUN \n",
"\" \" PUNCT \n",
", , PUNCT \n",
"Washington Washington PROPN ORG\n",
"Post Post PROPN ORG\n",
", , PUNCT \n",
"August August PROPN DATE\n",
"10 10 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
"\n",
" \n",
" SPACE \n",
"^ ^ PUNCT \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"to to ADP \n",
": : PUNCT \n",
"a a DET \n",
"b b X \n",
"\" \" PUNCT \n",
"Drug Drug PROPN \n",
"Companies Companies PROPN \n",
"Sure Sure PROPN \n",
"Are be AUX \n",
"Cozy Cozy PROPN \n",
"With with ADP \n",
"Trump Trump PROPN \n",
"’s ’s PART \n",
"Pick pick NOUN \n",
"to to PART \n",
"Solve solve VERB \n",
"the the DET \n",
"Opioid Opioid PROPN \n",
"Crisis Crisis PROPN \n",
"\" \" PUNCT \n",
". . PUNCT \n",
"Mother Mother PROPN PERSON\n",
"Jones Jones PROPN PERSON\n",
". . PUNCT \n",
"October October PROPN DATE\n",
"13 13 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
". . PUNCT \n",
"Retrieved retrieve VERB \n",
"October October PROPN DATE\n",
"13 13 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
". . PUNCT \n",
"\n",
" \n",
" SPACE \n",
"^ ^ PUNCT \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"to to ADP \n",
": : PUNCT \n",
"a a DET \n",
"b b NOUN \n",
"c c NOUN \n",
"\" \" PUNCT \n",
"Facing face VERB WORK_OF_ART\n",
"Addiction Addiction PROPN WORK_OF_ART\n",
"in in ADP WORK_OF_ART\n",
"America America PROPN WORK_OF_ART\n",
"\" \" PUNCT \n",
", , PUNCT \n",
"U.S. U.S. PROPN ORG\n",
"Surgeon Surgeon PROPN ORG\n",
"General General PROPN ORG\n",
"( ( PUNCT \n",
"2016 2016 NUM DATE\n",
") ) PUNCT \n",
", , PUNCT \n",
"413 413 NUM CARDINAL\n",
"pp pp NOUN \n",
"\n",
" \n",
" SPACE \n",
"^ ^ PUNCT \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"to to ADP \n",
": : PUNCT \n",
"a a DET \n",
"b b NOUN \n",
"c c NOUN \n",
"d d X \n",
"e e NOUN \n",
"f f X \n",
"\" \" PUNCT \n",
"The the DET \n",
"opioid opioid ADJ \n",
"epidemic epidemic NOUN \n",
"could could AUX \n",
"turn turn VERB \n",
"into into ADP \n",
"a a DET \n",
"pandemic pandemic NOUN \n",
"if if SCONJ \n",
"we we PRON \n",
"’re be AUX \n",
"not not PART \n",
"careful careful ADJ \n",
"\" \" PUNCT \n",
", , PUNCT \n",
"Washington Washington PROPN ORG\n",
"Post Post PROPN ORG\n",
", , PUNCT \n",
"Feb. Feb. PROPN DATE\n",
"9 9 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
"\n",
" \n",
" SPACE \n",
"^ ^ PUNCT \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"to to ADP \n",
": : PUNCT \n",
"a a DET \n",
"b b NOUN \n",
"c c NOUN \n",
"\" \" PUNCT \n",
"Opioid Opioid PROPN WORK_OF_ART\n",
"Prescriptions Prescriptions PROPN WORK_OF_ART\n",
"Fall fall NOUN WORK_OF_ART\n",
"After after ADP \n",
"2010 2010 NUM DATE\n",
"Peak Peak PROPN PERSON\n",
", , PUNCT \n",
"C.D.C. C.D.C. PROPN \n",
"Report Report PROPN \n",
"Finds find VERB \n",
"\" \" PUNCT \n",
", , PUNCT \n",
"New New PROPN ORG\n",
"York York PROPN ORG\n",
"Times Times PROPN ORG\n",
", , PUNCT \n",
"July July PROPN DATE\n",
"6 6 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
"\n",
" \n",
" SPACE \n",
"^ ^ PUNCT \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"to to ADP \n",
": : PUNCT \n",
"a a DET \n",
"b b X \n",
"\" \" PUNCT \n",
"Why why SCONJ \n",
"opioid opioid ADJ \n",
"overdose overdose NOUN \n",
"deaths death NOUN \n",
"seem seem VERB \n",
"to to PART \n",
"happen happen VERB \n",
"in in ADP \n",
"spurts spurt NOUN \n",
"\" \" PUNCT \n",
", , PUNCT \n",
"CNN CNN PROPN ORG\n",
", , PUNCT \n",
"Feb. Feb. PROPN DATE\n",
"8 8 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
"\n",
" \n",
" SPACE DATE\n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"Heroin Heroin PROPN \n",
"Production Production PROPN \n",
"in in ADP \n",
"Mexico Mexico PROPN GPE\n",
"and and CCONJ \n",
"U.S. U.S. PROPN GPE\n",
"Policy Policy PROPN \n",
"\" \" PUNCT \n",
", , PUNCT \n",
"Congressional Congressional PROPN ORG\n",
"Research Research PROPN ORG\n",
"Service Service PROPN ORG\n",
"report report NOUN \n",
", , PUNCT \n",
"March March PROPN DATE\n",
"3 3 NUM DATE\n",
", , PUNCT DATE\n",
"2016 2016 NUM DATE\n",
"\n",
" \n",
" SPACE DATE\n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"Heroin heroin ADJ \n",
"deaths death NOUN \n",
"surpass surpass NOUN \n",
"gun gun NOUN \n",
"homicides homicide VERB \n",
"for for ADP \n",
"the the DET \n",
"first first ADJ ORDINAL\n",
"time time NOUN \n",
", , PUNCT \n",
"CDC CDC PROPN ORG\n",
"data datum NOUN \n",
"shows show VERB \n",
"\" \" PUNCT \n",
", , PUNCT \n",
"Washington Washington PROPN ORG\n",
"Post Post PROPN ORG\n",
", , PUNCT \n",
"Dec. Dec. PROPN DATE\n",
"8 8 NUM DATE\n",
", , PUNCT DATE\n",
"2016 2016 NUM DATE\n",
", , PUNCT \n",
"Retrieved Retrieved PROPN \n",
"2017 2017 NUM DATE\n",
"- - PUNCT DATE\n",
"05 05 NUM DATE\n",
"- - PUNCT DATE\n",
"08 08 NUM DATE\n",
"\n",
" \n",
" SPACE \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"The the DET WORK_OF_ART\n",
"Children child NOUN WORK_OF_ART\n",
"of of ADP WORK_OF_ART\n",
"the the DET WORK_OF_ART\n",
"Opioid Opioid PROPN WORK_OF_ART\n",
"Crisis Crisis PROPN WORK_OF_ART\n",
"\" \" PUNCT \n",
", , PUNCT \n",
"Wall Wall PROPN ORG\n",
"Street Street PROPN ORG\n",
"Journal Journal PROPN ORG\n",
", , PUNCT \n",
"Dec. Dec. PROPN DATE\n",
"15 15 NUM DATE\n",
", , PUNCT DATE\n",
"2016 2016 NUM DATE\n",
"\n",
" \n",
" SPACE DATE\n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"Fentanyl Fentanyl PROPN WORK_OF_ART\n",
"Takes take VERB WORK_OF_ART\n",
"a a DET WORK_OF_ART\n",
"Deadly Deadly PROPN WORK_OF_ART\n",
"Toll Toll PROPN WORK_OF_ART\n",
"on on ADP \n",
"Vermont Vermont PROPN GPE\n",
"\" \" PUNCT \n",
", , PUNCT \n",
"VTDigger VTDigger PROPN ORG\n",
", , PUNCT \n",
"June June PROPN DATE\n",
"4 4 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
"\n",
" \n",
" SPACE DATE\n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"Why why SCONJ \n",
"fentanyl fentanyl ADJ \n",
"is be AUX \n",
"deadlier deadly ADJ \n",
"than than ADP \n",
"heroin heroin NOUN \n",
", , PUNCT \n",
"in in ADP \n",
"a a DET \n",
"single single ADJ \n",
"photo photo NOUN \n",
"\" \" PUNCT \n",
", , PUNCT \n",
"Stat Stat PROPN ORG\n",
", , PUNCT \n",
"Sept. Sept. PROPN DATE\n",
"29 29 NUM DATE\n",
", , PUNCT DATE\n",
"2016 2016 NUM DATE\n",
"\n",
" \n",
" SPACE DATE\n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"Fentanyl fentanyl ADJ PERSON\n",
"drug drug NOUN \n",
"profile profile NOUN \n",
"\" \" PUNCT \n",
", , PUNCT \n",
"The the DET ORG\n",
"European European PROPN ORG\n",
"Monitoring Monitoring PROPN ORG\n",
"Centre Centre PROPN ORG\n",
"for for ADP ORG\n",
"Drugs Drugs PROPN ORG\n",
"and and CCONJ ORG\n",
"Drug Drug PROPN ORG\n",
"Addiction Addiction PROPN ORG\n",
"( ( PUNCT \n",
"EMCDDA EMCDDA PROPN ORG\n",
") ) PUNCT \n",
"\n",
" \n",
" SPACE \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"Fentanyl fentanyl ADJ WORK_OF_ART\n",
": : PUNCT WORK_OF_ART\n",
"Preventing prevent VERB WORK_OF_ART\n",
"Occupational Occupational PROPN WORK_OF_ART\n",
"Exposure Exposure PROPN WORK_OF_ART\n",
"to to ADP WORK_OF_ART\n",
"Emergency Emergency PROPN WORK_OF_ART\n",
"Responders Responders PROPN WORK_OF_ART\n",
"\" \" PUNCT \n",
", , PUNCT \n",
"CDC CDC PROPN ORG\n",
"\n",
" \n",
" SPACE \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"Orlando Orlando PROPN GPE\n",
"man man NOUN \n",
"pleads plead VERB \n",
"guilty guilty ADJ \n",
"to to ADP \n",
"selling sell VERB \n",
"heroin heroin NOUN \n",
"mixed mix VERB \n",
"with with ADP \n",
"fentanyl fentanyl NOUN \n",
"\" \" PUNCT \n",
", , PUNCT \n",
"Orlando.com Orlando.com PROPN ORG\n",
", , PUNCT \n",
"March March PROPN DATE\n",
"20 20 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
"\n",
" \n",
" SPACE DATE\n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"Opioid Opioid PROPN WORK_OF_ART\n",
"Data Data PROPN WORK_OF_ART\n",
"Analysis Analysis PROPN WORK_OF_ART\n",
"\" \" PUNCT \n",
", , PUNCT \n",
"Centers Centers PROPN ORG\n",
"for for ADP ORG\n",
"Disease Disease PROPN ORG\n",
"Control Control PROPN ORG\n",
"and and CCONJ ORG\n",
"Prevention Prevention PROPN ORG\n",
"( ( PUNCT \n",
"CDC CDC PROPN ORG\n",
") ) PUNCT \n",
", , PUNCT \n",
"date date NOUN \n",
"? ? PUNCT \n",
"\n",
" \n",
" SPACE \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"Coroner coroner NOUN WORK_OF_ART\n",
": : PUNCT WORK_OF_ART\n",
"Franklin Franklin PROPN PERSON\n",
"County County PROPN PERSON\n",
"fentanyl fentanyl ADJ \n",
"deaths death NOUN \n",
"hit hit VERB \n",
"‘ ' PUNCT \n",
"unprecedented unprecedented ADJ \n",
"’ ' PUNCT \n",
"rate rate NOUN \n",
"of of ADP \n",
"one one NUM CARDINAL\n",
"per per ADP \n",
"day day NOUN \n",
"\" \" PUNCT \n",
", , PUNCT \n",
"The the DET ORG\n",
"Columbus Columbus PROPN ORG\n",
"Dispatch Dispatch PROPN ORG\n",
", , PUNCT \n",
"March March PROPN DATE\n",
"16 16 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
"\n",
" \n",
" SPACE DATE\n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"State State PROPN \n",
", , PUNCT \n",
"feds feds PROPN \n",
"seize seize VERB \n",
"14 14 NUM CARDINAL\n",
"kilos kilo NOUN \n",
"of of ADP \n",
"dangerous dangerous ADJ \n",
"opioid opioid ADJ \n",
"fentanyl fentanyl NOUN \n",
"in in ADP \n",
"N.J. N.J. PROPN GPE\n",
"\" \" PUNCT \n",
", , PUNCT \n",
"NJ.com NJ.com PROPN ORG\n",
", , PUNCT \n",
"March March PROPN DATE\n",
"17 17 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
"\n",
" \n",
" SPACE \n",
"^ ^ PUNCT \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"to to ADP \n",
": : PUNCT \n",
"a a DET \n",
"b b X \n",
"\" \" PUNCT \n",
"Prince Prince PROPN \n",
"'s 's PART \n",
"Autopsy Autopsy PROPN \n",
"Result Result PROPN \n",
"Highlights Highlights PROPN \n",
"Dangers Dangers PROPN \n",
"of of ADP \n",
"Opioid Opioid PROPN \n",
"Painkiller Painkiller PROPN \n",
"Fentanyl Fentanyl PROPN \n",
"\" \" PUNCT \n",
", , PUNCT \n",
"ABC ABC PROPN ORG\n",
"News News PROPN ORG\n",
", , PUNCT \n",
"June June PROPN DATE\n",
"2 2 NUM DATE\n",
", , PUNCT DATE\n",
"2016 2016 NUM DATE\n",
"\n",
" \n",
" SPACE DATE\n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"Documents document NOUN \n",
"highlight highlight VERB \n",
"Prince Prince PROPN \n",
"’s ’s PART \n",
"struggle struggle NOUN \n",
"with with ADP \n",
"opioid opioid ADJ \n",
"addiction addiction NOUN \n",
"\" \" PUNCT \n",
", , PUNCT \n",
"Seattle Seattle PROPN ORG\n",
"Times Times PROPN ORG\n",
", , PUNCT \n",
"April April PROPN DATE\n",
"17 17 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
"\n",
" \n",
" SPACE \n",
"^ ^ PUNCT \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"to to ADP \n",
": : PUNCT \n",
"a a DET \n",
"b b NOUN \n",
"c c NOUN \n",
"d d X \n",
"e e NOUN \n",
"f f X \n",
"\" \" PUNCT \n",
"‘ ' PUNCT \n",
"Truly truly ADV \n",
"terrifying terrify VERB \n",
"’ ' PUNCT \n",
": : PUNCT \n",
"Chinese chinese ADJ NORP\n",
"suppliers supplier NOUN \n",
"flood flood VERB \n",
"US US PROPN GPE\n",
"and and CCONJ \n",
"Canada Canada PROPN GPE\n",
"with with ADP \n",
"deadly deadly ADJ \n",
"fentanyl fentanyl NOUN \n",
"\" \" PUNCT \n",
", , PUNCT \n",
"STAT STAT PROPN ORG\n",
", , PUNCT \n",
"April April PROPN DATE\n",
"5 5 NUM DATE\n",
", , PUNCT DATE\n",
"2016 2016 NUM DATE\n",
"\n",
" \n",
" SPACE \n",
"^ ^ PUNCT \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"to to ADP \n",
": : PUNCT \n",
"a a DET \n",
"b b NOUN \n",
"c c NOUN \n",
"Moghe moghe ADJ GPE\n",
", , PUNCT GPE\n",
"Sonia Sonia PROPN GPE\n",
". . PUNCT \n",
"\" \" PUNCT \n",
"Opioids opioid NOUN \n",
": : PUNCT \n",
"From from ADP \n",
"' ' PUNCT \n",
"wonder wonder NOUN \n",
"drug drug NOUN \n",
"' ' PUNCT \n",
"to to PART \n",
"abuse abuse VERB \n",
"epidemic epidemic NOUN \n",
"\" \" PUNCT \n",
". . PUNCT \n",
"CNN CNN PROPN ORG\n",
". . PUNCT \n",
"Retrieved retrieve VERB \n",
"11 11 NUM DATE\n",
"April April PROPN DATE\n",
"2017 2017 NUM DATE\n",
". . PUNCT \n",
"\n",
" \n",
" SPACE \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"WGBH WGBH PROPN ORG\n",
"educational educational ADJ \n",
"foundation foundation NOUN \n",
". . PUNCT \n",
"Interview interview VERB \n",
"with with ADP \n",
"Dr. Dr. PROPN \n",
"Robert Robert PROPN PERSON\n",
"Dupoint Dupoint PROPN PERSON\n",
". . PUNCT \n",
"PBS.org PBS.org PROPN \n",
"( ( PUNCT \n",
"February February PROPN DATE\n",
"18 18 NUM DATE\n",
", , PUNCT DATE\n",
"1970 1970 NUM DATE\n",
") ) PUNCT \n",
"\n",
" \n",
" SPACE \n",
"^ ^ PUNCT \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"to to ADP \n",
": : PUNCT \n",
"a a DET \n",
"b b NOUN \n",
"c c NOUN \n",
"\" \" PUNCT \n",
"Opioid opioid ADJ \n",
"crisis crisis NOUN \n",
": : PUNCT \n",
"The the DET \n",
"letter letter NOUN \n",
"that that PRON \n",
"started start VERB \n",
"it it PRON \n",
"all all PRON \n",
"\" \" PUNCT \n",
". . PUNCT \n",
"bbc.co.uk bbc.co.uk PROPN \n",
". . PUNCT \n",
"BBC BBC PROPN ORG\n",
". . PUNCT \n",
"3 3 NUM DATE\n",
"June June PROPN DATE\n",
"2017 2017 NUM DATE\n",
". . PUNCT \n",
"Retrieved retrieve VERB \n",
"3 3 NUM DATE\n",
"June June PROPN DATE\n",
"2017 2017 NUM DATE\n",
". . PUNCT \n",
"\n",
" \n",
" SPACE \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"Jane Jane PROPN PERSON\n",
"Porter Porter PROPN PERSON\n",
"and and CCONJ \n",
"Hershel Hershel PROPN PERSON\n",
"Jick Jick PROPN PERSON\n",
"( ( PUNCT \n",
"10 10 NUM DATE\n",
"January January PROPN DATE\n",
"1980 1980 NUM DATE\n",
") ) PUNCT \n",
". . PUNCT \n",
"\" \" PUNCT \n",
"Addiction addiction NOUN WORK_OF_ART\n",
"Rare Rare PROPN WORK_OF_ART\n",
"in in ADP WORK_OF_ART\n",
"Patients patient NOUN WORK_OF_ART\n",
"Treated treat VERB WORK_OF_ART\n",
"with with ADP WORK_OF_ART\n",
"Narcotics narcotic NOUN WORK_OF_ART\n",
"\" \" PUNCT \n",
". . PUNCT \n",
"nejm.org nejm.org X \n",
". . PUNCT \n",
"New New PROPN ORG\n",
"England England PROPN ORG\n",
"Journal Journal PROPN ORG\n",
"of of ADP ORG\n",
"Medicine Medicine PROPN ORG\n",
". . PUNCT \n",
"Retrieved retrieve VERB \n",
"3 3 NUM DATE\n",
"June June PROPN DATE\n",
"2017 2017 NUM DATE\n",
". . PUNCT \n",
"\n",
" \n",
" SPACE \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"A a DET WORK_OF_ART\n",
"1980 1980 NUM WORK_OF_ART\n",
"Letter Letter PROPN WORK_OF_ART\n",
"on on ADP WORK_OF_ART\n",
"the the DET WORK_OF_ART\n",
"Risk risk NOUN WORK_OF_ART\n",
"of of ADP WORK_OF_ART\n",
"Opioid Opioid PROPN WORK_OF_ART\n",
"Addiction Addiction PROPN WORK_OF_ART\n",
"\" \" PUNCT \n",
". . PUNCT \n",
"nejm.org nejm.org X \n",
". . PUNCT \n",
"New New PROPN ORG\n",
"England England PROPN ORG\n",
"Journal Journal PROPN ORG\n",
"of of ADP ORG\n",
"Medicine Medicine PROPN ORG\n",
". . PUNCT \n",
"1 1 NUM DATE\n",
"June June PROPN DATE\n",
"2017 2017 NUM DATE\n",
". . PUNCT \n",
"Retrieved retrieve VERB \n",
"3 3 NUM DATE\n",
"June June PROPN DATE\n",
"2017 2017 NUM DATE\n",
". . PUNCT \n",
"\n",
" \n",
" SPACE \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"Scott Scott PROPN PERSON\n",
", , PUNCT \n",
"Peter Peter PROPN PERSON\n",
"Dale Dale PROPN PERSON\n",
"; ; PUNCT \n",
"Marshall Marshall PROPN PERSON\n",
", , PUNCT \n",
"Jonathan Jonathan PROPN PERSON\n",
". . PUNCT \n",
"Cocaine Cocaine PROPN \n",
"Politics Politics PROPN \n",
": : PUNCT \n",
"Drugs drug NOUN \n",
", , PUNCT \n",
"Armies Armies PROPN \n",
", , PUNCT \n",
"and and CCONJ \n",
"the the DET \n",
"CIA CIA PROPN ORG\n",
"in in ADP \n",
"Central Central PROPN LOC\n",
"America America PROPN LOC\n",
", , PUNCT \n",
"Berkeley Berkeley PROPN GPE\n",
", , PUNCT \n",
"CA CA PROPN ORG\n",
": : PUNCT ORG\n",
"University University PROPN ORG\n",
"of of ADP ORG\n",
"California California PROPN ORG\n",
"Press Press PROPN ORG\n",
"( ( PUNCT \n",
"1991 1991 NUM DATE\n",
") ) PUNCT \n",
"p. p. NOUN \n",
"2 2 NUM CARDINAL\n",
"\n",
" \n",
" SPACE \n",
"Jump jump VERB \n",
"up up ADP \n",
"^ ^ PUNCT \n",
"Sullivan Sullivan PROPN PERSON\n",
", , PUNCT \n",
"Andrew Andrew PROPN PERSON\n",
". . PUNCT \n",
"\"The \"The PROPN \n",
"Opioid Opioid PROPN \n",
"Epidemic Epidemic PROPN \n",
"Is be AUX \n",
"This this DET \n",
"Generation generation NOUN \n",
"’s ’s PART \n",
"AIDS AIDS PROPN \n",
"Crisis Crisis PROPN \n",
"\" \" PUNCT \n",
", , PUNCT \n",
"New New PROPN ORG\n",
"York York PROPN ORG\n",
"Magazine Magazine PROPN ORG\n",
", , PUNCT \n",
"March March PROPN DATE\n",
"16 16 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
"\n",
" \n",
" SPACE DATE\n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"Patient patient ADJ \n",
"brokering brokering NOUN \n",
"exacerbates exacerbate VERB \n",
"opioid opioid ADJ \n",
"crisis crisis NOUN \n",
"in in ADP \n",
"Florida Florida PROPN GPE\n",
"\" \" PUNCT \n",
", , PUNCT \n",
"South South PROPN \n",
"Bend Bend PROPN \n",
"Tribune Tribune PROPN \n",
", , PUNCT \n",
"April April PROPN DATE\n",
"2 2 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
"\n",
" \n",
" SPACE DATE\n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"de de X \n",
"La La PROPN \n",
"Bruyere Bruyere PROPN \n",
", , PUNCT \n",
"Emily Emily PROPN PERSON\n",
"( ( PUNCT \n",
"August August PROPN DATE\n",
"2 2 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
") ) PUNCT \n",
". . PUNCT \n",
"\" \" PUNCT \n",
"Middletown Middletown PROPN GPE\n",
", , PUNCT \n",
"Ohio Ohio PROPN GPE\n",
", , PUNCT \n",
"a a DET \n",
"city city NOUN \n",
"under under ADP \n",
"siege siege NOUN \n",
": : PUNCT \n",
"\" \" PUNCT \n",
"Everyone everyone PRON \n",
"I I PRON \n",
"know know VERB \n",
"is be AUX \n",
"on on ADP \n",
"heroin heroin NOUN \n",
"\" \" PUNCT \n",
"\" \" PUNCT \n",
". . PUNCT \n",
"Yahoo Yahoo PROPN \n",
". . PUNCT \n",
"\n",
" \n",
" SPACE \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"Vital vital ADJ \n",
"Signs sign NOUN \n",
": : PUNCT \n",
"Variation Variation PROPN PERSON\n",
"Among among ADP PERSON\n",
"States States PROPN PERSON\n",
"in in ADP \n",
"Prescribing Prescribing PROPN \n",
"of of ADP \n",
"Opioid Opioid PROPN \n",
"Pain Pain PROPN \n",
"Relievers Relievers PROPN \n",
"and and CCONJ \n",
"Benzodiazepines Benzodiazepines PROPN PERSON\n",
"— — PUNCT PERSON\n",
"United United PROPN PERSON\n",
"States States PROPN PERSON\n",
", , PUNCT \n",
"2012 2012 NUM DATE\n",
"\" \" PUNCT \n",
", , PUNCT \n",
"CDC CDC PROPN ORG\n",
", , PUNCT \n",
"July July PROPN DATE\n",
"4 4 NUM DATE\n",
", , PUNCT DATE\n",
"2014 2014 NUM DATE\n",
"\n",
" \n",
" SPACE DATE\n",
"Jump jump VERB \n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"Americans american NOUN NORP\n",
"consume consume VERB \n",
"vast vast ADJ \n",
"majority majority NOUN \n",
"of of ADP \n",
"the the DET \n",
"world world NOUN \n",
"'s 's PART \n",
"opioids opioid NOUN \n",
"\" \" PUNCT \n",
", , PUNCT \n",
"Dina Dina PROPN PERSON\n",
"Gusovsky Gusovsky PROPN PERSON\n",
", , PUNCT \n",
"CNBC CNBC PROPN ORG\n",
", , PUNCT \n",
"27 27 NUM CARDINAL\n",
"Apr Apr PROPN \n",
"2016 2016 NUM DATE\n",
"\n",
" \n",
" SPACE \n",
"^ ^ PUNCT \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"to to ADP \n",
": : PUNCT \n",
"a a DET \n",
"b b NOUN \n",
"c c NOUN \n",
"Silvia Silvia PROPN PERSON\n",
"S. S. PROPN PERSON\n",
"Martins Martins PROPN PERSON\n",
", , PUNCT \n",
"Lilian Lilian PROPN PERSON\n",
"A. a. NOUN PERSON\n",
"Ghandour Ghandour PROPN PERSON\n",
"\" \" PUNCT \n",
"Nonmedical nonmedical ADJ \n",
"use use NOUN \n",
"of of ADP \n",
"prescription prescription NOUN \n",
"drugs drug NOUN \n",
"in in ADP \n",
"adolescents adolescent NOUN \n",
"and and CCONJ \n",
"young young ADJ \n",
"adults adult NOUN \n",
": : PUNCT \n",
"not not PART \n",
"just just ADV \n",
"a a DET \n",
"Western western ADJ \n",
"phenomenon phenomenon NOUN \n",
"\" \" PUNCT \n",
", , PUNCT \n",
"World World PROPN ORG\n",
"Psychiatry Psychiatry PROPN ORG\n",
", , PUNCT \n",
"Jan. Jan. PROPN DATE\n",
"26 26 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
"\n",
" \n",
" SPACE \n",
"^ ^ PUNCT \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"to to ADP \n",
": : PUNCT \n",
"a a DET \n",
"b b X \n",
"\" \" PUNCT \n",
"Poll poll NOUN WORK_OF_ART\n",
": : PUNCT WORK_OF_ART\n",
"Many many ADJ WORK_OF_ART\n",
"Utahns Utahns PROPN WORK_OF_ART\n",
"know know VERB \n",
"people people NOUN \n",
"who who PRON \n",
"seek seek VERB \n",
"treatment treatment NOUN \n",
"for for ADP \n",
"opioid opioid ADJ \n",
"addiction addiction NOUN \n",
", , PUNCT \n",
"but but CCONJ \n",
"barriers barrier NOUN \n",
"remain remain VERB \n",
"\" \" PUNCT \n",
", , PUNCT \n",
"The the DET ORG\n",
"Salt Salt PROPN ORG\n",
"Lake Lake PROPN ORG\n",
"Tribune Tribune PROPN ORG\n",
", , PUNCT \n",
"April April PROPN DATE\n",
"3 3 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
"\n",
" \n",
" SPACE DATE\n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"Overdose Overdose PROPN WORK_OF_ART\n",
"Death Death PROPN WORK_OF_ART\n",
"Rates rate NOUN WORK_OF_ART\n",
"\" \" PUNCT \n",
", , PUNCT \n",
"US US PROPN ORG\n",
"National National PROPN ORG\n",
"Institute Institute PROPN ORG\n",
"on on ADP ORG\n",
"Drug Drug PROPN ORG\n",
"Abuse Abuse PROPN ORG\n",
", , PUNCT \n",
"January January PROPN DATE\n",
"2017 2017 NUM DATE\n",
"\n",
" \n",
" SPACE \n",
"Jump jump VERB \n",
"up up ADP \n",
"^ ^ PUNCT \n",
"Secure secure ADJ ORG\n",
"and and CCONJ ORG\n",
"Responsible Responsible PROPN ORG\n",
"Drug Drug PROPN ORG\n",
"Disposal Disposal PROPN ORG\n",
"Act Act PROPN ORG\n",
"of of ADP \n",
"2010 2010 NUM DATE\n",
"Oct. Oct. PROPN DATE\n",
"12 12 NUM DATE\n",
", , PUNCT DATE\n",
"2010 2010 NUM DATE\n",
", , PUNCT \n",
"Government Government PROPN ORG\n",
"Publishing Publishing PROPN ORG\n",
"Office Office PROPN ORG\n",
", , PUNCT \n",
"4pp 4pp NOUN GPE\n",
"\n",
" \n",
" SPACE GPE\n",
"Jump jump VERB \n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"Tackling tackle VERB WORK_OF_ART\n",
"the the DET WORK_OF_ART\n",
"Opioid Opioid PROPN WORK_OF_ART\n",
"Public Public PROPN WORK_OF_ART\n",
"Health Health PROPN WORK_OF_ART\n",
"Crisis Crisis PROPN WORK_OF_ART\n",
"\" \" PUNCT \n",
", , PUNCT \n",
"College College PROPN ORG\n",
"of of ADP ORG\n",
"Physicians Physicians PROPN ORG\n",
"and and CCONJ ORG\n",
"Surgeons Surgeons PROPN ORG\n",
"of of ADP ORG\n",
"Ontario Ontario PROPN ORG\n",
", , PUNCT \n",
"September September PROPN DATE\n",
"8 8 NUM DATE\n",
", , PUNCT DATE\n",
"2010 2010 NUM DATE\n",
"\n",
" \n",
" SPACE DATE\n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"First First PROPN \n",
"Do do VERB \n",
"No no DET \n",
"Harm harm NOUN \n",
": : PUNCT \n",
"Responding respond VERB \n",
"to to ADP \n",
"Canada Canada PROPN GPE\n",
"’s ’s PART \n",
"Prescription Prescription PROPN EVENT\n",
"Drug Drug PROPN EVENT\n",
"Crisis Crisis PROPN EVENT\n",
"\" \" PUNCT \n",
", , PUNCT \n",
"Canadian Canadian PROPN ORG\n",
"Centre Centre PROPN ORG\n",
"on on ADP ORG\n",
"Substance Substance PROPN ORG\n",
"Abuse Abuse PROPN ORG\n",
", , PUNCT \n",
"March March PROPN DATE\n",
"2013 2013 NUM DATE\n",
"\n",
" \n",
" SPACE DATE\n",
"Jump jump VERB \n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"UK UK PROPN GPE\n",
": : PUNCT \n",
"Task Task PROPN ORG\n",
"Force Force PROPN ORG\n",
"offers offer VERB \n",
"ideas idea NOUN \n",
"for for ADP \n",
"opioid opioid ADJ \n",
"addiction addiction NOUN \n",
"solutions solution NOUN \n",
"\" \" PUNCT \n",
". . PUNCT \n",
"Delhidailynews.com Delhidailynews.com PROPN ORG\n",
". . PUNCT \n",
"2014 2014 NUM DATE\n",
"- - SYM DATE\n",
"06 06 NUM DATE\n",
"- - SYM DATE\n",
"11 11 NUM DATE\n",
". . PUNCT \n",
"Retrieved retrieve VERB \n",
"2016 2016 NUM DATE\n",
"- - SYM DATE\n",
"01 01 NUM DATE\n",
"- - SYM DATE\n",
"07 07 NUM DATE\n",
". . PUNCT \n",
"\n",
" \n",
" SPACE \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"Summary Summary PROPN \n",
"of of ADP \n",
"the the DET ORG\n",
"Comprehensive Comprehensive PROPN ORG\n",
"Addiction Addiction PROPN ORG\n",
"and and CCONJ ORG\n",
"Recovery Recovery PROPN ORG\n",
"Act Act PROPN ORG\n",
", , PUNCT \n",
"American American PROPN ORG\n",
"Society Society PROPN ORG\n",
"of of ADP ORG\n",
"Addiction Addiction PROPN ORG\n",
"Medicine Medicine PROPN ORG\n",
". . PUNCT \n",
"\n",
" \n",
" SPACE \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"Mike Mike PROPN PERSON\n",
"DeBonis DeBonis PROPN PERSON\n",
", , PUNCT \n",
"Congress Congress PROPN ORG\n",
"passes pass VERB \n",
"21st 21st PROPN DATE\n",
"Century Century PROPN DATE\n",
"Cures Cures PROPN \n",
"Act Act PROPN \n",
", , PUNCT \n",
"boosting boost VERB \n",
"research research NOUN \n",
"and and CCONJ \n",
"easing ease VERB \n",
"drug drug NOUN \n",
"approvals approval NOUN \n",
", , PUNCT \n",
"Washington Washington PROPN ORG\n",
"Post Post PROPN ORG\n",
"( ( PUNCT \n",
"December December PROPN DATE\n",
"7 7 NUM DATE\n",
", , PUNCT DATE\n",
"2016 2016 NUM DATE\n",
") ) PUNCT \n",
". . PUNCT \n",
"\n",
" \n",
" SPACE \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ X \n",
"Juliet Juliet PROPN ORG\n",
"Eilperin Eilperin PROPN ORG\n",
"& & CCONJ ORG\n",
"Carolyn Carolyn PROPN ORG\n",
"Y. Y. PROPN ORG\n",
"Johnson Johnson PROPN ORG\n",
", , PUNCT \n",
"paying pay VERB \n",
"tribute tribute NOUN \n",
"to to ADP \n",
"Biden Biden PROPN PERSON\n",
"and and CCONJ \n",
"bipartisanship bipartisanship NOUN \n",
", , PUNCT \n",
"signs sign VERB \n",
"21st 21st ADP DATE\n",
"Century Century PROPN DATE\n",
"Cures Cures PROPN \n",
"Act Act PROPN \n",
"Tuesday Tuesday PROPN DATE\n",
", , PUNCT \n",
"Washington Washington PROPN ORG\n",
"Post Post PROPN ORG\n",
"( ( PUNCT \n",
"December December PROPN DATE\n",
"13 13 NUM DATE\n",
", , PUNCT DATE\n",
"2016 2016 NUM DATE\n",
") ) PUNCT \n",
". . PUNCT \n",
"\n",
" \n",
" SPACE \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"Opioid Opioid PROPN \n",
"Epidemic epidemic NOUN \n",
": : PUNCT \n",
"Trump trump VERB \n",
"to to PART \n",
"Set set VERB ORG\n",
"Up up ADP ORG\n",
"Commission Commission PROPN ORG\n",
"on on ADP ORG\n",
"Addiction Addiction PROPN ORG\n",
"Crisis Crisis PROPN ORG\n",
"\" \" PUNCT \n",
", , PUNCT \n",
"NBC NBC PROPN ORG\n",
"News News PROPN ORG\n",
", , PUNCT \n",
"March March PROPN DATE\n",
"29 29 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
"\n",
" \n",
" SPACE DATE\n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"It it PRON \n",
"'s be AUX \n",
"time time NOUN \n",
"to to PART \n",
"' ' PUNCT \n",
"Trump trump VERB ORG\n",
"' ' PUNCT \n",
"opioid opioid ADJ \n",
"addiction addiction NOUN \n",
"in in ADP \n",
"the the DET GPE\n",
"United United PROPN GPE\n",
"States States PROPN GPE\n",
"\" \" PUNCT \n",
", , PUNCT \n",
"The the DET GPE\n",
"Hill Hill PROPN GPE\n",
", , PUNCT \n",
"Feb. Feb. PROPN DATE\n",
"27 27 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
"\n",
" \n",
" SPACE DATE\n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"President President PROPN \n",
"Trump Trump PROPN PERSON\n",
"Hosts Hosts PROPN PERSON\n",
"an an DET \n",
"Opioid Opioid PROPN \n",
"and and CCONJ \n",
"Drug Drug PROPN \n",
"Abuse Abuse PROPN \n",
"Listening Listening PROPN \n",
"Session Session PROPN \n",
"\" \" PUNCT \n",
", , PUNCT \n",
"Real Real PROPN WORK_OF_ART\n",
"Clear Clear PROPN WORK_OF_ART\n",
"Politics Politics PROPN WORK_OF_ART\n",
", , PUNCT \n",
"March March PROPN DATE\n",
"29 29 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
"\n",
" \n",
" SPACE DATE\n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"Commissioner Commissioner PROPN \n",
", , PUNCT \n",
"Office Office PROPN \n",
"of of ADP \n",
"the the PRON \n",
". . PUNCT \n",
"\" \" PUNCT \n",
"Press Press PROPN ORG\n",
"Announcements announcement NOUN ORG\n",
"– – PUNCT \n",
"FDA FDA PROPN ORG\n",
"requests request VERB \n",
"removal removal NOUN \n",
"of of ADP \n",
"Opana Opana PROPN GPE\n",
"ER ER PROPN \n",
"for for ADP \n",
"risks risk NOUN \n",
"related relate VERB \n",
"to to ADP \n",
"abuse abuse NOUN \n",
"\" \" PUNCT \n",
". . PUNCT \n",
"www.fda.gov www.fda.gov ADJ \n",
". . PUNCT \n",
"Retrieved retrieve VERB \n",
"2017 2017 NUM DATE\n",
"- - SYM DATE\n",
"06 06 NUM DATE\n",
"- - SYM DATE\n",
"15 15 NUM DATE\n",
". . PUNCT \n",
"\n",
" \n",
" SPACE \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"Trump trump VERB WORK_OF_ART\n",
"to to PART \n",
"tap tap VERB \n",
"Rep. Rep. PROPN \n",
"Tom Tom PROPN PERSON\n",
"Marino Marino PROPN PERSON\n",
"as as ADP \n",
"' ' PUNCT \n",
"drug drug NOUN \n",
"czar czar NOUN \n",
"' ' PUNCT \n",
"\" \" PUNCT \n",
". . PUNCT \n",
"Politico Politico PROPN \n",
". . PUNCT \n",
"September September PROPN DATE\n",
"1 1 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
". . PUNCT \n",
"Retrieved retrieve VERB \n",
"13 13 NUM DATE\n",
"October October PROPN DATE\n",
"2017 2017 NUM DATE\n",
". . PUNCT \n",
"\n",
" \n",
" SPACE \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"A a DET WORK_OF_ART\n",
"Compact Compact PROPN WORK_OF_ART\n",
"to to PART WORK_OF_ART\n",
"Fight fight VERB WORK_OF_ART\n",
"Opioid Opioid PROPN WORK_OF_ART\n",
"Addiction Addiction PROPN WORK_OF_ART\n",
"\" \" PUNCT \n",
", , PUNCT \n",
"National National PROPN \n",
"Governors Governors PROPN \n",
"Assoc Assoc PROPN \n",
". . PROPN \n",
", , PUNCT \n",
"July July PROPN DATE\n",
"13 13 NUM DATE\n",
", , PUNCT DATE\n",
"2016 2016 NUM DATE\n",
"\n",
" \n",
" SPACE DATE\n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"Hogan Hogan PROPN ORG\n",
"- - PUNCT ORG\n",
"Rutherford Rutherford PROPN ORG\n",
"Administration Administration PROPN ORG\n",
"Declares declare VERB ORG\n",
"State State PROPN ORG\n",
"of of ADP ORG\n",
"Emergency Emergency PROPN ORG\n",
", , PUNCT \n",
"Announces announce VERB \n",
"Major Major PROPN \n",
"Funding Funding PROPN \n",
"to to ADP \n",
"Combat Combat PROPN \n",
"Heroin Heroin PROPN \n",
"and and CCONJ \n",
"Opioid Opioid PROPN \n",
"Crisis Crisis PROPN \n",
"in in ADP \n",
"Maryland Maryland PROPN GPE\n",
"\" \" PUNCT \n",
", , PUNCT \n",
"Maryland.gov Maryland.gov PROPN ORG\n",
", , PUNCT \n",
"March March PROPN DATE\n",
"1 1 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
"\n",
" \n",
" SPACE DATE\n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"Gov. Gov. PROPN \n",
"Hogan Hogan PROPN PERSON\n",
"Announces announce VERB \n",
"Opioid Opioid PROPN \n",
"Epidemic Epidemic PROPN \n",
"State State PROPN \n",
"Of of ADP \n",
"Emergency Emergency PROPN \n",
"\" \" PUNCT \n",
", , PUNCT \n",
"CBS CBS PROPN ORG\n",
"Baltimore Baltimore PROPN ORG\n",
", , PUNCT \n",
"March March PROPN DATE\n",
"1 1 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
"\n",
" \n",
" SPACE DATE\n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"Delaware Delaware PROPN GPE\n",
"lawmakers lawmaker NOUN \n",
"tackle tackle VERB \n",
"opioid opioid ADJ \n",
"addiction addiction NOUN \n",
"epidemic epidemic NOUN \n",
"\" \" PUNCT \n",
", , PUNCT \n",
"Newsworks Newsworks PROPN PERSON\n",
", , PUNCT \n",
"March March PROPN DATE\n",
"23 23 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
"\n",
" \n",
" SPACE DATE\n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"Governor Governor PROPN \n",
"Snyder Snyder PROPN PERSON\n",
"rolls roll VERB \n",
"out out ADP \n",
"plan plan NOUN \n",
"to to PART \n",
"fight fight VERB \n",
"opioid opioid ADJ \n",
"addiction addiction NOUN \n",
"\" \" PUNCT \n",
", , PUNCT \n",
"WILX WILX PROPN ORG\n",
", , PUNCT \n",
"March March PROPN DATE\n",
"23 23 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
"\n",
" \n",
" SPACE DATE\n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"Snyder snyder NOUN WORK_OF_ART\n",
": : PUNCT WORK_OF_ART\n",
"Efforts effort NOUN WORK_OF_ART\n",
"to to PART \n",
"stop stop VERB \n",
"opioid opioid ADJ \n",
"abuse abuse NOUN \n",
"are be AUX \n",
"n’t n’t PART \n",
"working work VERB \n",
"\" \" PUNCT \n",
", , PUNCT \n",
"Michigan Michigan PROPN ORG\n",
"Radio Radio PROPN ORG\n",
", , PUNCT \n",
"March March PROPN DATE\n",
"23 23 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
"\n",
" \n",
" SPACE DATE\n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"HB0299 hb0299 X WORK_OF_ART\n",
"\" \" PUNCT \n",
". . PUNCT \n",
"le.utah.gov le.utah.gov PROPN \n",
". . PUNCT \n",
"Retrieved retrieve VERB \n",
"2017 2017 NUM DATE\n",
"- - SYM DATE\n",
"07 07 NUM DATE\n",
"- - SYM DATE\n",
"27 27 NUM DATE\n",
". . PUNCT \n",
"\n",
" \n",
" SPACE \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"Opioid opioid ADJ \n",
"distributors distributor NOUN \n",
"sued sue VERB \n",
"by by ADP \n",
"West West PROPN GPE\n",
"Virginia Virginia PROPN GPE\n",
"counties county NOUN \n",
"hit hit VERB \n",
"by by ADP \n",
"drug drug NOUN \n",
"crisis crisis NOUN \n",
"\" \" PUNCT \n",
". . PUNCT \n",
"Washington Washington PROPN ORG\n",
"Post Post PROPN ORG\n",
". . PUNCT \n",
"Retrieved retrieve VERB \n",
"2017 2017 NUM DATE\n",
"- - SYM DATE\n",
"06 06 NUM DATE\n",
"- - SYM DATE\n",
"27 27 NUM DATE\n",
". . PUNCT \n",
"\n",
" \n",
" SPACE \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"Lawyer Lawyer PROPN WORK_OF_ART\n",
"Behind behind ADP WORK_OF_ART\n",
"West West PROPN WORK_OF_ART\n",
"Virginia Virginia PROPN WORK_OF_ART\n",
"County County PROPN WORK_OF_ART\n",
"Lawsuit Lawsuit PROPN WORK_OF_ART\n",
"Against against ADP WORK_OF_ART\n",
"Opioid Opioid PROPN WORK_OF_ART\n",
"Distributors distributor NOUN WORK_OF_ART\n",
"\" \" PUNCT \n",
". . PUNCT \n",
"NPR.org NPR.org PROPN GPE\n",
". . PUNCT \n",
"Retrieved retrieve VERB \n",
"2017 2017 NUM DATE\n",
"- - SYM DATE\n",
"06 06 NUM DATE\n",
"- - SYM DATE\n",
"27 27 NUM DATE\n",
". . PUNCT \n",
"\n",
" \n",
" SPACE \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"U.S. U.S. PROPN GPE\n",
"City City PROPN \n",
"Sues sue VERB \n",
"OxyContin OxyContin PROPN \n",
"Maker Maker PROPN \n",
"For for ADP \n",
"Contributing contribute VERB \n",
"To to ADP \n",
"Opioid Opioid PROPN \n",
"Crisis Crisis PROPN \n",
"\" \" PUNCT \n",
", , PUNCT \n",
"NPR NPR PROPN ORG\n",
", , PUNCT \n",
"Feb. Feb. PROPN DATE\n",
"3 3 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
"\n",
" \n",
" SPACE DATE\n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"Dowell Dowell PROPN PERSON\n",
", , PUNCT \n",
"Deborah Deborah PROPN PERSON\n",
"; ; PUNCT \n",
"Haegerich Haegerich PROPN GPE\n",
", , PUNCT \n",
"Tamara Tamara PROPN GPE\n",
"; ; PUNCT \n",
"Chou Chou PROPN PERSON\n",
", , PUNCT \n",
"Roger Roger PROPN PERSON\n",
"( ( PUNCT \n",
"March March PROPN DATE\n",
"15 15 NUM DATE\n",
", , PUNCT DATE\n",
"2016 2016 NUM DATE\n",
") ) PUNCT \n",
". . PUNCT \n",
"\" \" PUNCT \n",
"CDC CDC PROPN WORK_OF_ART\n",
"Guideline Guideline PROPN WORK_OF_ART\n",
"for for ADP WORK_OF_ART\n",
"Prescribing Prescribing PROPN WORK_OF_ART\n",
"Opioids Opioids PROPN WORK_OF_ART\n",
"for for ADP WORK_OF_ART\n",
"Chronic Chronic PROPN WORK_OF_ART\n",
"Pain Pain PROPN WORK_OF_ART\n",
"— — PUNCT \n",
"United United PROPN GPE\n",
"States States PROPN GPE\n",
", , PUNCT \n",
"2016 2016 NUM DATE\n",
"\" \" PUNCT \n",
". . PUNCT \n",
"JAMA JAMA PROPN PERSON\n",
". . PUNCT \n",
"315 315 NUM CARDINAL\n",
": : PUNCT \n",
"1624–45 1624–45 NOUN CARDINAL\n",
". . PUNCT \n",
"PMID PMID PROPN \n",
"26977696 26977696 NUM \n",
". . PUNCT \n",
"doi:10.1001 doi:10.1001 PROPN GPE\n",
"/ / SYM \n",
"jama.2016.1464 jama.2016.1464 PROPN \n",
". . PUNCT \n",
"Retrieved retrieve VERB \n",
"March March PROPN DATE\n",
"18 18 NUM DATE\n",
", , PUNCT DATE\n",
"2016 2016 NUM DATE\n",
". . PUNCT \n",
"\n",
" \n",
" SPACE \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ CCONJ \n",
"Missouri Missouri PROPN GPE\n",
"is be AUX \n",
"final final ADJ \n",
"state state NOUN \n",
"to to PART \n",
"pass pass VERB \n",
"PDMP PDMP PROPN \n",
"program program NOUN \n",
"; ; PUNCT \n",
"US US PROPN ORG\n",
"News News PROPN ORG\n",
"& & CCONJ ORG\n",
"World World PROPN ORG\n",
"Report Report PROPN ORG\n",
"; ; PUNCT \n",
"April April PROPN DATE\n",
"13 13 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
"\n",
" \n",
" SPACE DATE\n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"Rutkow Rutkow PROPN PERSON\n",
"Lainie Lainie PROPN PERSON\n",
"; ; PUNCT \n",
"et et PROPN \n",
"al al PROPN GPE\n",
". . PUNCT GPE\n",
"( ( PUNCT \n",
"2015 2015 NUM DATE\n",
") ) PUNCT \n",
". . PUNCT \n",
"\" \" PUNCT \n",
"Most Most ADJ \n",
"primary primary ADJ \n",
"care care NOUN \n",
"physicians physician NOUN \n",
"are be AUX \n",
"aware aware ADJ \n",
"of of ADP \n",
"prescription prescription NOUN \n",
"drug drug NOUN \n",
"monitoring monitoring NOUN \n",
"programs program NOUN \n",
", , PUNCT \n",
"but but CCONJ \n",
"many many ADJ \n",
"find find VERB \n",
"the the DET \n",
"data datum NOUN \n",
"difficult difficult ADJ \n",
"to to PART \n",
"access access VERB \n",
"\" \" PUNCT \n",
". . PUNCT \n",
"Health Health PROPN ORG\n",
"Affairs Affairs PROPN ORG\n",
". . PUNCT \n",
"34 34 NUM CARDINAL\n",
"( ( PUNCT \n",
"3 3 NUM DATE\n",
"): ): PUNCT \n",
"484–492 484–492 NUM CARDINAL\n",
". . PUNCT \n",
"doi:10.1377 doi:10.1377 NOUN \n",
"/ / SYM \n",
"hlthaff.2014.1085 hlthaff.2014.1085 PROPN \n",
". . PUNCT \n",
"\n",
" \n",
" SPACE \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"Matthew Matthew PROPN PERSON\n",
"Perrone Perrone PROPN PERSON\n",
", , PUNCT \n",
"Associated Associated PROPN ORG\n",
"Press Press PROPN ORG\n",
". . PUNCT \n",
"\" \" PUNCT \n",
"Painkiller painkiller NOUN \n",
"politics politic NOUN \n",
": : PUNCT \n",
"Effort effort VERB \n",
"to to PART \n",
"curb curb VERB \n",
"prescribing prescribing NOUN \n",
"under under ADP \n",
"fire fire NOUN \n",
"\" \" PUNCT \n",
". . PUNCT \n",
"The the DET ORG\n",
"Washington Washington PROPN ORG\n",
"Times Times PROPN ORG\n",
". . PUNCT \n",
"Retrieved retrieve VERB \n",
"2017 2017 NUM DATE\n",
"- - SYM DATE\n",
"06 06 NUM DATE\n",
"- - SYM DATE\n",
"13 13 NUM DATE\n",
". . PUNCT \n",
"\n",
" \n",
" SPACE \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"Ghorayshi Ghorayshi PROPN PERSON\n",
", , PUNCT \n",
"Azeen Azeen PROPN PERSON\n",
". . PUNCT \n",
"\" \" PUNCT \n",
"Missouri Missouri PROPN GPE\n",
"Is be AUX \n",
"The the DET \n",
"Only only ADJ \n",
"State state NOUN \n",
"In in ADP \n",
"The the DET \n",
"US US PROPN \n",
"Where where SCONJ \n",
"Doctors doctor NOUN \n",
"Have have VERB \n",
"No no DET \n",
"Idea Idea PROPN \n",
"What what PRON \n",
"Prescriptions Prescriptions PROPN \n",
"People People NOUN \n",
"Are be AUX \n",
"Getting get VERB \n",
"\" \" PUNCT \n",
". . PUNCT \n",
"BuzzFeed BuzzFeed PROPN \n",
". . PUNCT \n",
"Retrieved retrieve VERB \n",
"11 11 NUM DATE\n",
"April April PROPN DATE\n",
"2017 2017 NUM DATE\n",
". . PUNCT \n",
"\n",
" \n",
" SPACE \n",
"^ ^ PUNCT \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"to to ADP \n",
": : PUNCT \n",
"a a DET \n",
"b b X \n",
"McGinty McGinty PROPN \n",
", , PUNCT \n",
"E. E. PROPN \n",
"\" \" PUNCT \n",
"Criminal Criminal PROPN \n",
"Activity Activity PROPN \n",
"or or CCONJ \n",
"Treatable Treatable PROPN ORG\n",
"Health Health PROPN ORG\n",
"Condition Condition PROPN ORG\n",
"? ? PUNCT \n",
"News news NOUN \n",
"Media Media PROPN \n",
"Framing Framing PROPN \n",
"of of ADP \n",
"Opioid Opioid PROPN \n",
"Analgesic Analgesic PROPN \n",
"Abuse Abuse PROPN \n",
"in in ADP \n",
"the the DET GPE\n",
"United United PROPN GPE\n",
"States States PROPN GPE\n",
"\" \" PUNCT \n",
". . PUNCT \n",
"Psychiatric Psychiatric PROPN ORG\n",
"Services Services PROPN ORG\n",
". . PUNCT \n",
"67 67 NUM CARDINAL\n",
": : PUNCT \n",
"405–411 405–411 NUM CARDINAL\n",
". . PUNCT \n",
"\n",
" \n",
" SPACE \n",
"^ ^ PUNCT \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"to to ADP \n",
": : PUNCT \n",
"a a DET \n",
"b b PROPN \n",
"Netherland Netherland PROPN GPE\n",
", , PUNCT \n",
"J. J. PROPN PERSON\n",
"( ( PUNCT \n",
"December December PROPN DATE\n",
"2016 2016 NUM DATE\n",
") ) PUNCT \n",
". . PUNCT \n",
"\" \" PUNCT \n",
"The the DET WORK_OF_ART\n",
"War War PROPN WORK_OF_ART\n",
"on on ADP WORK_OF_ART\n",
"Drugs drug NOUN WORK_OF_ART\n",
"That that PRON WORK_OF_ART\n",
"Was be AUX WORK_OF_ART\n",
"n't n't PART WORK_OF_ART\n",
": : PUNCT WORK_OF_ART\n",
"Wasted waste VERB WORK_OF_ART\n",
"Whiteness Whiteness PROPN WORK_OF_ART\n",
", , PUNCT \n",
"\" \" PUNCT \n",
"Dirty dirty ADJ \n",
"Doctors doctor NOUN \n",
", , PUNCT \n",
"\" \" PUNCT \n",
"and and CCONJ \n",
"Race Race PROPN \n",
"in in ADP \n",
"Media Media PROPN \n",
"Coverage Coverage PROPN \n",
"of of ADP \n",
"Prescription Prescription PROPN \n",
"Opioid Opioid PROPN \n",
"Misuse Misuse PROPN \n",
"\" \" PUNCT \n",
". . PUNCT \n",
"Cult Cult PROPN ORG\n",
"Med Med PROPN ORG\n",
"Psychiatry Psychiatry PROPN ORG\n",
". . PUNCT \n",
"40 40 NUM CARDINAL\n",
"( ( PUNCT \n",
"4 4 NUM DATE\n",
"): ): PUNCT \n",
"664–686 664–686 NUM CARDINAL\n",
". . PUNCT \n",
"\n",
" \n",
" SPACE \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"Major Major PROPN \n",
"Science Science PROPN \n",
"Report Report PROPN \n",
"Lays lay VERB \n",
"Out out ADP \n",
"a a DET \n",
"Plan plan NOUN \n",
"to to PART \n",
"Tamp tamp VERB \n",
"Down down ADP \n",
"Opioid Opioid PROPN \n",
"Crisis Crisis PROPN \n",
"\" \" PUNCT \n",
", , PUNCT \n",
"Scientific Scientific PROPN NORP\n",
"American American PROPN NORP\n",
", , PUNCT \n",
"July July PROPN DATE\n",
"13 13 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
"\n",
" \n",
" SPACE \n",
"^ ^ PUNCT \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"to to ADP \n",
": : PUNCT \n",
"a a DET \n",
"b b PROPN \n",
"Veilleux Veilleux PROPN PERSON\n",
", , PUNCT \n",
"Jennifer Jennifer PROPN PERSON\n",
". . PUNCT \n",
"\" \" PUNCT \n",
"A a DET \n",
"Review Review PROPN \n",
"of of ADP \n",
"Opioid Opioid PROPN \n",
"Dependence Dependence PROPN \n",
"Treatment Treatment PROPN \n",
": : PUNCT \n",
"Pharmacological Pharmacological PROPN \n",
"and and CCONJ \n",
"Psychosocial Psychosocial PROPN \n",
"Interventions Interventions PROPN \n",
"to to PART \n",
"Treat treat VERB \n",
"Opioid Opioid PROPN \n",
"Addiction Addiction PROPN \n",
"\" \" PUNCT \n",
". . PUNCT \n",
"Clinical Clinical PROPN ORG\n",
"Psychology Psychology PROPN ORG\n",
"Review Review PROPN ORG\n",
". . PUNCT \n",
"30.2 30.2 NUM CARDINAL\n",
": : PUNCT \n",
"155–166 155–166 NUM CARDINAL\n",
". . PUNCT \n",
"\n",
" \n",
" SPACE \n",
"^ ^ PUNCT \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"to to ADP \n",
": : PUNCT \n",
"a a DET \n",
"b b NOUN \n",
"c c NOUN \n",
"d d NOUN \n",
"e e NOUN \n",
"Dixon Dixon PROPN PERSON\n",
", , PUNCT \n",
"David David PROPN PERSON\n",
"( ( PUNCT \n",
"May May PROPN DATE\n",
"13 13 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
") ) PUNCT \n",
". . PUNCT \n",
"\" \" PUNCT \n",
"Opioid Opioid PROPN WORK_OF_ART\n",
"Abuse Abuse PROPN WORK_OF_ART\n",
"Treatment Treatment PROPN WORK_OF_ART\n",
"and and CCONJ WORK_OF_ART\n",
"Management Management PROPN WORK_OF_ART\n",
": : PUNCT WORK_OF_ART\n",
"Medical Medical PROPN WORK_OF_ART\n",
"Care Care PROPN WORK_OF_ART\n",
"\" \" PUNCT \n",
". . PUNCT \n",
"Medscape medscape NOUN \n",
". . PUNCT \n",
"\n",
" \n",
" SPACE \n",
"^ ^ PUNCT \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"to to ADP \n",
": : PUNCT \n",
"a a DET \n",
"b b X \n",
"\" \" PUNCT \n",
"WHAT what PRON WORK_OF_ART\n",
"ARE be AUX WORK_OF_ART\n",
"MY MY PROPN WORK_OF_ART\n",
"TREATMENT treatment NOUN WORK_OF_ART\n",
"OPTIONS option NOUN WORK_OF_ART\n",
"? ? PUNCT \n",
"\" \" PUNCT \n",
". . PUNCT \n",
"TURN turn VERB \n",
"TO to ADP \n",
"HELP HELP PROPN \n",
". . PUNCT \n",
"June June PROPN DATE\n",
"11 11 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
". . PUNCT \n",
"\n",
" \n",
" SPACE \n",
"^ ^ PUNCT \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"to to ADP \n",
": : PUNCT \n",
"a a DET \n",
"b b X \n",
"\" \" PUNCT \n",
"My my PRON \n",
"View view NOUN \n",
": : PUNCT \n",
"New new ADJ \n",
"approach approach NOUN \n",
"needed need VERB \n",
"for for ADP \n",
"opioid opioid ADJ \n",
"epidemic epidemic NOUN \n",
"\" \" PUNCT \n",
", , PUNCT \n",
"Portland Portland PROPN PERSON\n",
"Tribune Tribune PROPN PERSON\n",
", , PUNCT \n",
"July July PROPN DATE\n",
"25 25 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
"\n",
" \n",
" SPACE DATE\n",
"Jump jump VERB \n",
"up up ADP \n",
"^ ^ X \n",
"Buprenorphine buprenorphine ADJ \n",
", , PUNCT \n",
"SAMHSA SAMHSA PROPN ORG\n",
"\n",
" \n",
" SPACE \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"Heroin Heroin PROPN WORK_OF_ART\n",
"Abuse Abuse PROPN WORK_OF_ART\n",
"Solutions Solutions PROPN WORK_OF_ART\n",
"\" \" PUNCT \n",
". . PUNCT \n",
"Narconon Narconon PROPN ORG\n",
"New New PROPN ORG\n",
"Life Life PROPN ORG\n",
"Retreat Retreat PROPN ORG\n",
". . PUNCT \n",
"June June PROPN DATE\n",
"12 12 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
". . PUNCT \n",
"\n",
" \n",
" SPACE \n",
"Jump jump VERB PERSON\n",
"up up ADP \n",
"^ ^ PUNCT \n",
"\" \" PUNCT \n",
"12 12 NUM CARDINAL\n",
"Step Step PROPN \n",
"Programs Programs PROPN \n",
"for for ADP \n",
"Drug Drug PROPN \n",
"Rehab Rehab PROPN \n",
"& & CCONJ \n",
"Alcohol Alcohol PROPN \n",
"Treatment Treatment PROPN \n",
"\" \" PUNCT \n",
". . PUNCT \n",
"American American PROPN ORG\n",
"Addiction Addiction PROPN ORG\n",
"Centers Centers PROPN ORG\n",
". . PUNCT \n",
"June June PROPN DATE\n",
"6 6 NUM DATE\n",
", , PUNCT DATE\n",
"2017 2017 NUM DATE\n",
". . PUNCT \n"
]
}
],
"source": [
"for token in parsed_text:\n",
" # display the token's orthographic representation, lemma, part of speech, and entity type (which is empty if the token is not part of a named entity)\n",
" print(token, token.lemma_, token.pos_, token.ent_type_)"
]
},
{
"cell_type": "markdown",
"metadata": {},
"source": [
"Again, you can check on some types (this following check's the type for the very last token seen):"
]
},
{
"cell_type": "code",
"execution_count": 8,
"metadata": {},
"outputs": [
{
"data": {
"text/plain": [
"spacy.tokens.token.Token"
]
},
"execution_count": 8,
"metadata": {},
"output_type": "execute_result"
}
],
"source": [
"type(token)"
]
},
{
"cell_type": "code",
"execution_count": 9,
"metadata": {},
"outputs": [
{
"data": {
"text/plain": [
"."
]
},
"execution_count": 9,
"metadata": {},
"output_type": "execute_result"
}
],
"source": [
"token"
]
},
{
"cell_type": "code",
"execution_count": 10,
"metadata": {},
"outputs": [
{
"data": {
"text/plain": [
"False"
]
},
"execution_count": 10,
"metadata": {},
"output_type": "execute_result"
}
],
"source": [
"token == '.'"
]
},
{
"cell_type": "code",
"execution_count": 11,
"metadata": {},
"outputs": [
{
"data": {
"text/plain": [
"True"
]
},
"execution_count": 11,
"metadata": {},
"output_type": "execute_result"
}
],
"source": [
"token.orth_ == '.'"
]
},
{
"cell_type": "code",
"execution_count": 12,
"metadata": {},
"outputs": [
{
"data": {
"text/plain": [
"True"
]
},
"execution_count": 12,
"metadata": {},
"output_type": "execute_result"
}
],
"source": [
"str(token) == '.'"
]
},
{
"cell_type": "code",
"execution_count": 13,
"metadata": {
"scrolled": true
},
"outputs": [
{
"data": {
"text/plain": [
"'PUNCT'"
]
},
"execution_count": 13,
"metadata": {},
"output_type": "execute_result"
}
],
"source": [
"token.pos_"
]
},
{
"cell_type": "code",
"execution_count": 14,
"metadata": {},
"outputs": [
{
"data": {
"text/plain": [
"'.'"
]
},
"execution_count": 14,
"metadata": {},
"output_type": "execute_result"
}
],
"source": [
"token.lemma_"
]
},
{
"cell_type": "markdown",
"metadata": {},
"source": [
"We can iterate through the named entities and print them out:"
]
},
{
"cell_type": "code",
"execution_count": 15,
"metadata": {
"scrolled": true
},
"outputs": [
{
"name": "stdout",
"output_type": "stream",
"text": [
"the United States GPE\n",
"Canada GPE\n",
"the 2010s DATE\n",
"OxyContin ORG\n",
"Percocet ORG\n",
"Vicodin ORG\n",
"the U.S. Drug Enforcement Administration ORG\n",
"Nearly half CARDINAL\n",
"2016 DATE\n",
"1999 to DATE\n",
"2015 DATE\n",
"Americans NORP\n",
"two-thirds CARDINAL\n",
"2016 DATE\n",
"62,000 CARDINAL\n",
"Americans NORP\n",
"19 percent PERCENT\n",
"2015 DATE\n",
"Americans NORP\n",
"one year DATE\n",
"Vietnam GPE\n",
"Iraq GPE\n",
"16,000 CARDINAL\n",
"2010 DATE\n",
"4,000 CARDINAL\n",
"1999 DATE\n",
"June 2017 DATE\n",
"over 500,000 CARDINAL\n",
"the next 10 years.[11 DATE\n",
"March 2017 DATE\n",
"Larry Hogan PERSON\n",
"Maryland GPE\n",
"July 2017 DATE\n",
"FDA ORG\n",
"CDC ORG\n",
"Thomas Frieden PERSON\n",
"America GPE\n",
"August 10, 2017 DATE\n",
"Donald Trump PERSON\n",
"Commission ORG\n",
"few weeks earlier DATE\n",
"September 1 DATE\n",
"Trump ORG\n",
"Tom Marino PERSON\n",
"Marino PERSON\n",
"the United States GPE\n",
"1.1 CARDINAL\n",
"1.2 CARDINAL\n",
"1.3 CARDINAL\n",
"Fentanyl PERSON\n",
"1.4 CARDINAL\n",
"the United States GPE\n",
"1.5 CARDINAL\n",
"U.S. GPE\n",
"2 CARDINAL\n",
"2.1 CARDINAL\n",
"2.2 CARDINAL\n",
"2.3 CARDINAL\n",
"2.4 CARDINAL\n",
"2.5 CARDINAL\n",
"2.5.2 CARDINAL\n",
"2.5.3 CARDINAL\n",
"3 CARDINAL\n",
"4 CARDINAL\n",
"5 CARDINAL\n",
"Background FAC\n",
"the U.S. Surgeon General ORG\n",
"The Opioid Crisis WORK_OF_ART\n",
"the 1990s DATE\n",
"the United States GPE\n",
"2016 DATE\n",
"289 million CARDINAL\n",
"the late 1990s DATE\n",
"Americans NORP\n",
"around 100 million CARDINAL\n",
"a third CARDINAL\n",
"U.S. GPE\n",
"Between 1991 and 2011 DATE\n",
"U.S. GPE\n",
"76 million CARDINAL\n",
"219 million CARDINAL\n",
"OxyContin ORG\n",
"Percocet ORG\n",
"Vicodin ORG\n",
"2002 DATE\n",
"one CARDINAL\n",
"six CARDINAL\n",
"2012 DATE\n",
"one CARDINAL\n",
"U.S. GPE\n",
"CDC ORG\n",
"U.S. GPE\n",
"Mexican NORP\n",
"2005–2009 DATE\n",
"Mexican NORP\n",
"600% PERCENT\n",
"an estimated 8 metric tons QUANTITY\n",
"2005 DATE\n",
"50 metric tons QUANTITY\n",
"2009.[8 CARDINAL\n",
"Between 2010 and 2014 DATE\n",
"DEA ORG\n",
"Mexican NORP\n",
"American NORP\n",
"more than 33,000 CARDINAL\n",
"2015 DATE\n",
"thousands CARDINAL\n",
"Maryland GPE\n",
"the first six months of 2015 DATE\n",
"121 CARDINAL\n",
"the first six months of 2016 DATE\n",
"446 CARDINAL\n",
"Christopher Caldwell PERSON\n",
"Fentanyl PERSON\n",
"50 to 100 CARDINAL\n",
"30 to 50 CARDINAL\n",
"only 2 CARDINAL\n",
"first ORDINAL\n",
"DEA ORG\n",
"Fentanyl PERSON\n",
"Philadelphia GPE\n",
"Detroit GPE\n",
"CDC ORG\n",
"Thomas Frieden PERSON\n",
"2010 DATE\n",
"50 to 100 CARDINAL\n",
"America GPE\n",
"the Centers for Disease Control and Prevention ORG\n",
"CDC ORG\n",
"72% PERCENT\n",
"2014 DATE\n",
"2015.[22 CARDINAL\n",
"CDC ORG\n",
"CDC ORG\n",
"March 2017 DATE\n",
"New Jersey GPE\n",
"nearly 31 pounds QUANTITY\n",
"14 kg QUANTITY\n",
"14 kg QUANTITY\n",
"7 million CARDINAL\n",
"Fentanyl PERSON\n",
"2014 DATE\n",
"CDC ORG\n",
"998 CARDINAL\n",
"Ohio GPE\n",
"just the first five months of 2015.[36 DATE\n",
"Cleveland GPE\n",
"U.S. GPE\n",
"Ohio GPE\n",
"One CARDINAL\n",
"death.[36 CARDINAL\n",
"2016 DATE\n",
"STAT ORG\n",
"Mexican NORP\n",
"U.S. GPE\n",
"Chinese NORP\n",
"British Columbia GPE\n",
"100,000 CARDINAL\n",
"each month DATE\n",
"Calgary GPE\n",
"Alberta GPE\n",
"90 CARDINAL\n",
"Calgary GPE\n",
"2015.[36 CARDINAL\n",
"Southern California LOC\n",
"six CARDINAL\n",
"thousands CARDINAL\n",
"the early 1900s DATE\n",
"the First World War EVENT\n",
"1920 DATE\n",
"the Anti-Heroin Act EVENT\n",
"1924 DATE\n",
"the U.S. Congress ORG\n",
"World War II EVENT\n",
"the 1950s DATE\n",
"Americans NORP\n",
"the 1960s DATE\n",
"1970s DATE\n",
"marijuana PERSON\n",
"Janis Joplin PERSON\n",
"John Belushi PERSON\n",
"Jim Morrison PERSON\n",
"Lenny Bruce PERSON\n",
"the Vietnam War EVENT\n",
"Vietnam GPE\n",
"1971 DATE\n",
"U.S. GPE\n",
"Vietnam GPE\n",
"ten to fifteen percent PERCENT\n",
"Nixon PERSON\n",
"White House ORG\n",
"Christopher Caldwell PERSON\n",
"1973 DATE\n",
"1.5 CARDINAL\n",
"100,000 CARDINAL\n",
"the 1980s DATE\n",
"the New England Journal of Medicine ORG\n",
"January 1980 DATE\n",
"Addiction Rare in Patients Treated with Narcotics WORK_OF_ART\n",
"600 CARDINAL\n",
"Canada GPE\n",
"NEJM ORG\n",
"1980 DATE\n",
"June 2017 DATE\n",
"Hershel Jick PERSON\n",
"American NORP\n",
"almost 2 CARDINAL\n",
"100,000 CARDINAL\n",
"1982 DATE\n",
"George H. W. Bush PERSON\n",
"CIA ORG\n",
"U.S. GPE\n",
"2016 DATE\n",
"10.3 CARDINAL\n",
"100,000 CARDINAL\n",
"over 30 CARDINAL\n",
"100,000 CARDINAL\n",
"New Hampshire GPE\n",
"over 40 CARDINAL\n",
"100,000 CARDINAL\n",
"U.S. GPE\n",
"17-year-olds DATE\n",
"one-third CARDINAL\n",
"2006 DATE\n",
"marijuana PERSON\n",
"the Office of National Drug Control Policy’s ORG\n",
"2008 DATE\n",
"Palm Beach County GPE\n",
"Florida GPE\n",
"149 CARDINAL\n",
"2012 DATE\n",
"588 CARDINAL\n",
"2016.[44 CARDINAL\n",
"Middletown GPE\n",
"Ohio GPE\n",
"the 15 years DATE\n",
"2000.[45 CARDINAL\n",
"Hawaii GPE\n",
"about 52 CARDINAL\n",
"100 CARDINAL\n",
"Alabama GPE\n",
"almost 143 CARDINAL\n",
"100 CARDINAL\n",
"Approximately 80 percent PERCENT\n",
"U.S. GPE\n",
"Columbia University ORG\n",
"20 CARDINAL\n",
"Europe LOC\n",
"three-quarters CARDINAL\n",
"39.[48 CARDINAL\n",
"Canada GPE\n",
"Australia GPE\n",
"Europe LOC\n",
"U.S. GPE\n",
"Lebanon GPE\n",
"Saudi Arabia GPE\n",
"China GPE\n",
"one CARDINAL\n",
"ten CARDINAL\n",
"Europe LOC\n",
"Spain GPE\n",
"August 2017 DATE\n",
"2010 DATE\n",
"US GPE\n",
"2017 DATE\n",
"Utah GPE\n",
"about 80 percent PERCENT\n",
"2015 DATE\n",
"15% PERCENT\n",
"2010 DATE\n",
"CSA ORG\n",
"the Secure and Responsible Drug Disposal Act ORG\n",
"2011 DATE\n",
"Obama GPE\n",
"2016 DATE\n",
"the U.S. Surgeon General ORG\n",
"July 2016 DATE\n",
"Barack Obama PERSON\n",
"the Comprehensive Addiction and Recovery Act ORG\n",
"authorizes millions of dollars MONEY\n",
"December 2016 DATE\n",
"the 21st Century DATE\n",
"$1 billion MONEY\n",
"Congress ORG\n",
"94-5 CARDINAL\n",
"Senate ORG\n",
"392 CARDINAL\n",
"the House of Representatives),[56] ORG\n",
"March 2017 DATE\n",
"Donald Trump PERSON\n",
"Chris Christie PERSON\n",
"June 2017 DATE\n",
"FDA ORG\n",
"Opana ER ORG\n",
"US GPE\n",
"first ORDINAL\n",
"July 2017 DATE\n",
"FDA ORG\n",
"Dr Scott Gottlieb PERSON\n",
"first ORDINAL\n",
"FDA ORG\n",
"August 10, 2017 DATE\n",
"Trump PERSON\n",
"Commission ORG\n",
"few weeks earlier DATE\n",
"September 1, 2017 DATE\n",
"Trump ORG\n",
"Tom Marino PERSON\n",
"the Office of National Drug Control Policy ORG\n",
"134,000 MONEY\n",
"Marino PERSON\n",
"2014 DATE\n",
"2016 DATE\n",
"Marino PERSON\n",
"2016 DATE\n",
"the Ensuring Patient Access and Effective Drug Enforcement Act ORG\n",
"DEA ORG\n",
"State ORG\n",
"July 2016 DATE\n",
"U.S. GPE\n",
"March 2017 DATE\n",
"the Governor of Maryland GPE\n",
"2016 DATE\n",
"about 2,000 CARDINAL\n",
"overdoses.[65 ORG\n",
"March 2017 DATE\n",
"Delaware GPE\n",
"12th ORDINAL\n",
"2015 DATE\n",
"228 CARDINAL\n",
"35%—to CARDINAL\n",
"308 CARDINAL\n",
"2016.[66 CARDINAL\n",
"March 2017 DATE\n",
"Michigan GPE\n",
"the Michigan Automated Prescription System ORG\n",
"MAPS ORG\n",
"2017 DATE\n",
"General Session EVENT\n",
"Edward H. Redd PERSON\n",
"Todd Weiler PERSON\n",
"Utah GPE\n",
"H.B. 299 ORG\n",
"Maine GPE\n",
"daily DATE\n",
"seven days DATE\n",
"West Virginia GPE\n",
"February 2017 DATE\n",
"Everett GPE\n",
"Washington GPE\n",
"OxyContin ORG\n",
"2016 DATE\n",
"CDC ORG\n",
"Guideline for Prescribing Opioids for Chronic Pain WORK_OF_ART\n",
"Silvia Martins PERSON\n",
"Columbia University ORG\n",
"April 2017 DATE\n",
"more than three months DATE\n",
"15-fold CARDINAL\n",
"1,500% PERCENT\n",
"US GPE\n",
"2015 DATE\n",
"only 53% PERCENT\n",
"22% PERCENT\n",
"The Centers for Disease Control and Prevention ORG\n",
"CDC ORG\n",
"Hispanic NORP\n",
"Hispanic NORP\n",
"July 2017 DATE\n",
"400 CARDINAL\n",
"the National Academy of Science ORG\n",
"91 CARDINAL\n",
"Main PRODUCT\n",
"two CARDINAL\n",
"Methadone ORG\n",
"1964 DATE\n",
"daily DATE\n",
"Buprenorphine ORG\n",
"month-long DATE\n",
"SAMHSA ORG\n",
"a full year DATE\n",
"Twelve CARDINAL\n",
"24-hour TIME\n",
"Twelve CARDINAL\n",
"one CARDINAL\n",
"one CARDINAL\n",
"Jump PERSON\n",
"Data Overview ORG\n",
"CDC Injury Center, Centers for Disease Control and Prevention ORG\n",
"Jump PERSON\n",
"2017-07-30 DATE\n",
"Jump PERSON\n",
"2015 DATE\n",
"National Drug Threat Assessment Summary EVENT\n",
"DEA ORG\n",
"Oct. 2015 DATE\n",
"Jump PERSON\n",
"CDC ORG\n",
"MMWR ORG\n",
"MMWR Publications ORG\n",
"MMWR Weekly ORG\n",
"2011 DATE\n",
"November 4, 2011 / 60(43);1487–1492 DATE\n",
"2017-07-30 DATE\n",
"Jump PERSON\n",
"Americans NORP\n",
"CBS News ORG\n",
"Dec. 9, 2016 DATE\n",
"Jump PERSON\n",
"New York Times ORG\n",
"June 5, 2017\n",
" DATE\n",
"Jump PERSON\n",
"2016 DATE\n",
"Americans NORP\n",
"Vietnam GPE\n",
"Iraq GPE\n",
"Vox ORG\n",
"July 7, 2017 DATE\n",
"Jump PERSON\n",
"Bad PERSON\n",
"PBS ORG\n",
"Feb. 23, 2016\n",
" DATE\n",
"Jump PERSON\n",
"America’s Addiction to Opioids: Heroin and Prescription Drug Abuse WORK_OF_ART\n",
"National Institute on Drug Abuse ORG\n",
"NIDA ORG\n",
"May 14, 2014 DATE\n",
"Jump PERSON\n",
"America GPE\n",
"Economist PERSON\n",
"U.K. GPE\n",
"March 6, 2017\n",
" DATE\n",
"Jump PERSON\n",
"nearly 500,000 CARDINAL\n",
"Americans NORP\n",
"the next decade DATE\n",
"STAT ORG\n",
"June 27, 2017 DATE\n",
"Jump PERSON\n",
"B. Maryland GPE\n",
"The Washington Post ORG\n",
"March 1, 2017 DATE\n",
"Jump PERSON\n",
"FDA ORG\n",
"Scott Gottlieb PERSON\n",
"FDA ORG\n",
"CNBC ORG\n",
"July 21, 2017 DATE\n",
"Jump PERSON\n",
"CDC ORG\n",
"America GPE\n",
"Fox News ORG\n",
"Dec. 17, 2016 DATE\n",
"Jump PERSON\n",
"American Carnage: The New Landscape of Opioid Addiction WORK_OF_ART\n",
"First Things ORG\n",
"April 2017 DATE\n",
"Jump PERSON\n",
"White House ORG\n",
"Trump ORG\n",
"Washington Post ORG\n",
"July 31, 2017 DATE\n",
"Jump PERSON\n",
"Trump ORG\n",
"Washington Post ORG\n",
"August 10, 2017 DATE\n",
"Jump PERSON\n",
"Mother Jones PERSON\n",
"October 13, 2017 DATE\n",
"October 13, 2017 DATE\n",
"Jump PERSON\n",
"Facing Addiction in America WORK_OF_ART\n",
"U.S. Surgeon General ORG\n",
"2016 DATE\n",
"413 CARDINAL\n",
"Jump PERSON\n",
"Washington Post ORG\n",
"Feb. 9, 2017 DATE\n",
"Jump PERSON\n",
"Opioid Prescriptions Fall WORK_OF_ART\n",
"2010 DATE\n",
"Peak PERSON\n",
"New York Times ORG\n",
"July 6, 2017 DATE\n",
"Jump PERSON\n",
"CNN ORG\n",
"Feb. 8, 2017\n",
" DATE\n",
"Jump PERSON\n",
"Mexico GPE\n",
"U.S. GPE\n",
"Congressional Research Service ORG\n",
"March 3, 2016\n",
" DATE\n",
"Jump PERSON\n",
"first ORDINAL\n",
"CDC ORG\n",
"Washington Post ORG\n",
"Dec. 8, 2016 DATE\n",
"2017-05-08 DATE\n",
"Jump PERSON\n",
"The Children of the Opioid Crisis WORK_OF_ART\n",
"Wall Street Journal ORG\n",
"Dec. 15, 2016\n",
" DATE\n",
"Jump PERSON\n",
"Fentanyl Takes a Deadly Toll WORK_OF_ART\n",
"Vermont GPE\n",
"VTDigger ORG\n",
"June 4, 2017\n",
" DATE\n",
"Jump PERSON\n",
"Stat ORG\n",
"Sept. 29, 2016\n",
" DATE\n",
"Jump PERSON\n",
"Fentanyl PERSON\n",
"The European Monitoring Centre for Drugs and Drug Addiction ORG\n",
"EMCDDA ORG\n",
"Jump PERSON\n",
"Fentanyl: Preventing Occupational Exposure to Emergency Responders WORK_OF_ART\n",
"CDC ORG\n",
"Jump PERSON\n",
"Orlando GPE\n",
"Orlando.com ORG\n",
"March 20, 2017\n",
" DATE\n",
"Jump PERSON\n",
"Opioid Data Analysis WORK_OF_ART\n",
"Centers for Disease Control and Prevention ORG\n",
"CDC ORG\n",
"Jump PERSON\n",
"Coroner: WORK_OF_ART\n",
"Franklin County PERSON\n",
"one CARDINAL\n",
"The Columbus Dispatch ORG\n",
"March 16, 2017\n",
" DATE\n",
"Jump PERSON\n",
"14 CARDINAL\n",
"N.J. GPE\n",
"NJ.com ORG\n",
"March 17, 2017 DATE\n",
"Jump PERSON\n",
"ABC News ORG\n",
"June 2, 2016\n",
" DATE\n",
"Jump PERSON\n",
"Seattle Times ORG\n",
"April 17, 2017 DATE\n",
"Jump PERSON\n",
"Chinese NORP\n",
"US GPE\n",
"Canada GPE\n",
"STAT ORG\n",
"April 5, 2016 DATE\n",
"Jump PERSON\n",
"Moghe, Sonia GPE\n",
"CNN ORG\n",
"11 April 2017 DATE\n",
"Jump PERSON\n",
"WGBH ORG\n",
"Robert Dupoint PERSON\n",
"February 18, 1970 DATE\n",
"Jump PERSON\n",
"BBC ORG\n",
"3 June 2017 DATE\n",
"3 June 2017 DATE\n",
"Jump PERSON\n",
"Jane Porter PERSON\n",
"Hershel Jick PERSON\n",
"10 January 1980 DATE\n",
"Addiction Rare in Patients Treated with Narcotics WORK_OF_ART\n",
"New England Journal of Medicine ORG\n",
"3 June 2017 DATE\n",
"Jump PERSON\n",
"A 1980 Letter on the Risk of Opioid Addiction WORK_OF_ART\n",
"New England Journal of Medicine ORG\n",
"1 June 2017 DATE\n",
"3 June 2017 DATE\n",
"Jump PERSON\n",
"Scott PERSON\n",
"Peter Dale PERSON\n",
"Marshall PERSON\n",
"Jonathan PERSON\n",
"CIA ORG\n",
"Central America LOC\n",
"Berkeley GPE\n",
"CA: University of California Press ORG\n",
"1991 DATE\n",
"2 CARDINAL\n",
"Sullivan PERSON\n",
"Andrew PERSON\n",
"New York Magazine ORG\n",
"March 16, 2017\n",
" DATE\n",
"Jump PERSON\n",
"Florida GPE\n",
"April 2, 2017\n",
" DATE\n",
"Jump PERSON\n",
"Emily PERSON\n",
"August 2, 2017 DATE\n",
"Middletown GPE\n",
"Ohio GPE\n",
"Jump PERSON\n",
"Variation Among States PERSON\n",
"Benzodiazepines — United States PERSON\n",
"2012 DATE\n",
"CDC ORG\n",
"July 4, 2014\n",
" DATE\n",
"Americans NORP\n",
"Dina Gusovsky PERSON\n",
"CNBC ORG\n",
"27 CARDINAL\n",
"2016 DATE\n",
"Jump PERSON\n",
"Silvia S. Martins PERSON\n",
"Lilian A. Ghandour PERSON\n",
"World Psychiatry ORG\n",
"Jan. 26, 2017 DATE\n",
"Jump PERSON\n",
"Poll: Many Utahns WORK_OF_ART\n",
"The Salt Lake Tribune ORG\n",
"April 3, 2017\n",
" DATE\n",
"Jump PERSON\n",
"Overdose Death Rates WORK_OF_ART\n",
"US National Institute on Drug Abuse ORG\n",
"January 2017 DATE\n",
"Secure and Responsible Drug Disposal Act ORG\n",
"2010 Oct. 12, 2010 DATE\n",
"Government Publishing Office ORG\n",
"4pp\n",
" GPE\n",
"Tackling the Opioid Public Health Crisis WORK_OF_ART\n",
"College of Physicians and Surgeons of Ontario ORG\n",
"September 8, 2010\n",
" DATE\n",
"Jump PERSON\n",
"Canada GPE\n",
"Prescription Drug Crisis EVENT\n",
"Canadian Centre on Substance Abuse ORG\n",
"March 2013\n",
" DATE\n",
"UK GPE\n",
"Task Force ORG\n",
"Delhidailynews.com ORG\n",
"2014-06-11 DATE\n",
"2016-01-07 DATE\n",
"Jump PERSON\n",
"the Comprehensive Addiction and Recovery Act ORG\n",
"American Society of Addiction Medicine ORG\n",
"Jump PERSON\n",
"Mike DeBonis PERSON\n",
"Congress ORG\n",
"21st Century DATE\n",
"Washington Post ORG\n",
"December 7, 2016 DATE\n",
"Jump PERSON\n",
"Juliet Eilperin & Carolyn Y. Johnson ORG\n",
"Biden PERSON\n",
"21st Century DATE\n",
"Tuesday DATE\n",
"Washington Post ORG\n",
"December 13, 2016 DATE\n",
"Jump PERSON\n",
"Set Up Commission on Addiction Crisis ORG\n",
"NBC News ORG\n",
"March 29, 2017\n",
" DATE\n",
"Jump PERSON\n",
"Trump ORG\n",
"the United States GPE\n",
"The Hill GPE\n",
"Feb. 27, 2017\n",
" DATE\n",
"Jump PERSON\n",
"Trump Hosts PERSON\n",
"Real Clear Politics WORK_OF_ART\n",
"March 29, 2017\n",
" DATE\n",
"Jump PERSON\n",
"Press Announcements ORG\n",
"FDA ORG\n",
"Opana GPE\n",
"2017-06-15 DATE\n",
"Jump PERSON\n",
"Trump WORK_OF_ART\n",
"Tom Marino PERSON\n",
"September 1, 2017 DATE\n",
"13 October 2017 DATE\n",
"Jump PERSON\n",
"A Compact to Fight Opioid Addiction WORK_OF_ART\n",
"July 13, 2016\n",
" DATE\n",
"Jump PERSON\n",
"Hogan-Rutherford Administration Declares State of Emergency ORG\n",
"Maryland GPE\n",
"Maryland.gov ORG\n",
"March 1, 2017\n",
" DATE\n",
"Jump PERSON\n",
"Hogan PERSON\n",
"CBS Baltimore ORG\n",
"March 1, 2017\n",
" DATE\n",
"Jump PERSON\n",
"Delaware GPE\n",
"Newsworks PERSON\n",
"March 23, 2017\n",
" DATE\n",
"Jump PERSON\n",
"Snyder PERSON\n",
"WILX ORG\n",
"March 23, 2017\n",
" DATE\n",
"Jump PERSON\n",
"Snyder: Efforts WORK_OF_ART\n",
"Michigan Radio ORG\n",
"March 23, 2017\n",
" DATE\n",
"Jump PERSON\n",
"HB0299 WORK_OF_ART\n",
"2017-07-27 DATE\n",
"Jump PERSON\n",
"West Virginia GPE\n",
"Washington Post ORG\n",
"2017-06-27 DATE\n",
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"Sentence number 0 : The opioid epidemic or opioid crisis is the rapid increase in the use of prescription and non-prescription opioid drugs in the United States and Canada in the 2010s.\n",
"Sentence number 1 : Opioids are a diverse class of moderately strong painkillers, including oxycodone (commonly sold under the trade names OxyContin and Percocet), hydrocodone (Vicodin), and a very strong painkiller, fentanyl, which is synthesized to resemble other opiates such as opium-derived morphine and heroin.\n",
"Sentence number 2 : The potency and availability of these substances, despite their high risk of addiction and overdose, have made them popular both as formal medical treatments and as recreational drugs.\n",
"Sentence number 3 : Due to their sedative effects on the part of the brain which regulates breathing, opioids in high doses present the potential for respiratory depression, and may cause respiratory failure and death.[2]\n",
"\n",
"\n",
"Sentence number 4 : According to the U.S. Drug Enforcement Administration, \"overdose deaths, particularly from prescription drugs and heroin, have reached epidemic levels.\"[3]:iii\n",
"Sentence number 5 : Nearly half of all opioid overdose deaths in 2016 involved prescription opioids.[1]\n",
"Sentence number 6 : From 1999 to 2008, overdose death rates, sales, and substance abuse treatment admissions related to opioid pain relievers all increased substantially.[4]\n",
"Sentence number 7 : By 2015, annual overdose deaths from heroin alone surpassed deaths from both car accidents and guns, with other opioid overdose deaths also on the rise.[5]\n",
"\n",
"Drug overdoses have since become the leading cause of death of Americans under 50, with two-thirds of those deaths from opioids.[6]\n",
"Sentence number 8 : In 2016, 62,000 Americans died from overdoses, 19 percent more than in 2015, and had killed more Americans in one year than both the wars in Vietnam and Iraq combined.[7][6]\n",
"Sentence number 9 : By comparison, the figure was 16,000 in 2010, and 4,000 in 1999.\n",
"Sentence number 10 : Figures from June 2017 indicate the problem has worsened.[8][9]\n",
"Sentence number 11 : While death rates varied by state,[10] public health experts estimate that nationwide over 500,000 people could die from the epidemic over the next 10 years.[11]\n",
"\n",
"\n",
"Sentence number 12 : In March 2017, Larry Hogan, the governor of Maryland, declared a state of emergency to combat the opioid epidemic,[12] and in July 2017 opioid addiction was cited as the \"FDA's biggest crisis.\n",
"Sentence number 13 : \"[13]\n",
"Sentence number 14 : CDC director Thomas Frieden said that \"America is awash in opioids; urgent action is critical.\n",
"Sentence number 15 : \"[14]\n",
"Sentence number 16 : The crisis has changed moral, social, and cultural resistance to street drug alternatives such as heroin.[15] On August 10, 2017, President Donald Trump agreed with his Commission's report released few weeks earlier and declared the country's opioid crisis a \"national emergency.\n",
"Sentence number 17 : \"[16][17]\n",
"Sentence number 18 : On September 1, Trump nominated as \"drug czar\" Tom Marino, whose election campaign had been financed by pharmaceutical distribution companies that had lobbied for, and profited from, legislation co-sponsored by Marino which protected pharmacies suspected of diverting pills.[18]\n",
"\n",
"Contents [hide] \n",
"1 Background in the United States\n",
"1.1 Main causes\n",
"1.2 Effects\n",
"1.3 Fentanyl\n",
"1.4 History of opiate use in the United States\n",
"1.5 Demographics\n",
"1.6 Outside the U.S.\n",
"2 Countermeasures\n",
"2.1 Federal government\n",
"2.2 State and local governments\n",
"2.3 Prescription drug monitoring\n",
"2.4 In the media\n",
"2.5 Solutions for addicts\n",
"2.5.1 Naloxone\n",
"2.5.2 Methadone\n",
"2.5.3 Buprenorphine\n",
"2.5.4 Behavioral treatment options\n",
"3 See also\n",
"4 References\n",
"5 External links\n",
"Background in the United States[edit]\n",
"Main causes[edit]\n",
"What the U.S. Surgeon General calls \"The Opioid Crisis\" likely began with over-prescription of powerful opioid pain relievers in the 1990s, which led to them becoming the most prescribed class of medications in the United States.\n",
"Sentence number 19 : As of 2016 more than 289 million prescriptions were written for opioid drugs per year.[19]:43In the late 1990s, many Americans were diagnosed with chronic pain, estimated to affect around 100 million people or a third of the U.S. population.\n",
"Sentence number 20 : This led to a push by drug companies and the federal government to expand the use of painkilling opioids.[10] Between 1991 and 2011, painkiller prescriptions in the U.S. tripled from 76 million to 219 million per year.\n",
"Sentence number 21 : Among the most common opioids prescribed have been oxycodone (OxyContin and Percocet) and hydrocodone (Vicodin).\n",
"Sentence number 22 : With the increase in volume, potency of opioids also increased.\n",
"Sentence number 23 : By 2002, one in six drug users were being prescribed drugs more powerful than morphine; by 2012, the ratio had doubled to one-in-three.[10]\n",
"\n",
"Despite the increased use of painkillers, there has been no change in the amount of pain reported in the U.S.[20][19]\n",
"Sentence number 24 : This has led to differing medical opinions, with some noting that there is little evidence that opioids are effective for chronic pain not caused by cancer.[21]\n",
"\n",
"Effects[edit]\n",
"When people continue to use opioids beyond what a doctor prescribes, whether to minimize pain or to enjoy the euphoric feelings, it can mark the beginning stages of an opiate addiction, with a tolerance developing and eventually leading to dependence, when a person relies on the drug to prevent withdrawal symptoms.[22]\n",
"\n",
"As the number of opioid prescriptions rose, drug cartels began flooding the U.S. with heroin.\n",
"Sentence number 25 : For many opioid users, heroin was cheaper, more potent, and often easier to acquire than prescription medications.[8]\n",
"Sentence number 26 : According to the CDC, tighter prescription policies by doctors did not necessarily lead to this increased heroin use.[21]\n",
"Sentence number 27 : The main suppliers of heroin to the U.S. have been Mexican transnational criminal organizations.[8]\n",
"Sentence number 28 : From 2005–2009, Mexican heroin production increased by over 600%, from an estimated 8 metric tons in 2005 to 50 metric tons in 2009.[8]\n",
"Sentence number 29 : Between 2010 and 2014, the amount seized at the border more than doubled.[23]\n",
"Sentence number 30 : According to the DEA, smugglers and distributors \"profit primarily by putting drugs on the street and have become crucial to the Mexican cartels.\n",
"Sentence number 31 : \"[3]:3\n",
"\n",
"\n",
"Opiate self-injection paraphernalia\n",
"The opioid epidemic has since emerged as one of the worst drug crises in American history: more than 33,000 people died from overdoses in 2015, nearly equal to the number of deaths from car crashes, with deaths from heroin alone more than from gun homicides.[24]\n",
"Sentence number 32 : It has also left thousands of children suddenly in need of foster care after their parents have died from an overdose.[25]\n",
"\n",
"Fentanyl[edit]\n",
"There have always been drug addicts in need of help, but the scale of the present wave of heroin and opioid abuse is unprecedented.\n",
"Sentence number 33 : In Maryland, the first six months of 2015 saw 121 fentanyl deaths.\n",
"Sentence number 34 : In the first six months of 2016, the figure rose to 446.\n",
"\n",
"Sentence number 35 : Christopher Caldwell,\n",
"senior editor The Weekly Standard[15]\n",
"Fentanyl, a newer synthetic opioid painkiller, is 50 to 100 times more potent than morphine and 30 to 50 times more potent than heroin,[15] with only 2 mg becoming a lethal dose.\n",
"Sentence number 36 : It is pure white, odorless and flavorless, with a potency strong enough that police and first responders helping overdose victims have themselves overdosed by simply touching or inhaling a small amount.[26][27][28]\n",
"Sentence number 37 : As a result, the DEA has recommended that officers not field test drugs if fentanyl is suspected, but instead collect and send samples to a laboratory for analysis.\n",
"Sentence number 38 : \"Exposure via inhalation or skin absorption can be deadly,\" they state.[29]\n",
"\n",
"Fentanyl-laced heroin has become a big problem for major cities, including Philadelphia, Detroit and Chicago.[30]\n",
"Sentence number 39 : Its use has caused a spike in deaths among users of heroin and prescription painkillers, while becoming easier to obtain and conceal.\n",
"Sentence number 40 : Some arrested or hospitalized users are surprised to find that what they thought was heroin was actually fentanyl.[15]\n",
"Sentence number 41 : According to CDC director Thomas Frieden:\n",
"\n",
"As overdose deaths involving heroin more than quadrupled since 2010, what was a slow stream of illicit fentanyl, a synthetic opioid 50 to 100 times stronger than morphine, is now a flood, with the amount of the powerful drug seized by law enforcement increasing dramatically.\n",
"Sentence number 42 : America is awash in opioids; urgent action is critical.[14]\n",
"\n",
"According to the Centers for Disease Control and Prevention (CDC), death rates from synthetic opioids, including fentanyl, increased over 72% from 2014 to 2015.[22]\n",
"Sentence number 43 : In addition, the CDC reports that the total deaths from opioid overdoses may be under-counted, since they do not include deaths that are associated with synthetic opioids which are used as pain relievers.\n",
"Sentence number 44 : The CDC presumes[when?] that a large proportion of the increase in deaths is due to illegally-made fentanyl; as the statistics on overdose deaths do not distinguish pharmaceutical fentanyl from illegally-made fentanyl, the actual death rate could therefore be much higher than reported.[31]\n",
"\n",
"Those taking fentanyl-laced heroin are more likely to overdose because they do not know they also are ingesting the more powerful drug.[32]\n",
"Sentence number 45 : In March 2017, New Jersey police arrested a person possessing nearly 31 pounds (14 kg) of fentanyl (14 kg would yield 7 million lethal doses).[33][34]\n",
"Sentence number 46 : Among those who died from overdosing on fentanyl was singer Prince.[34][35]\n",
"\n",
"Fentanyl has surpassed heroin as a killer in several locales: in all of 2014 the CDC identified 998 fatal fentanyl overdoses in Ohio, which is the same number of deaths recorded in just the first five months of 2015.[36]\n",
"Sentence number 47 : In Cleveland, a person was caught selling blue fentanyl pills disguised to look like doses of the milder opioid painkiller oxycodone.[36]\n",
"Sentence number 48 : The U.S. attorney for Ohio stated:\n",
"\n",
"One of the truly terrifying things is the pills are pressed and dyed to look like oxycodone.\n",
"Sentence number 49 : If you are using oxycodone and take fentanyl not knowing it is fentanyl, that is an overdose waiting to happen.\n",
"Sentence number 50 : Each of those pills is a potential overdose death.[36]\n",
"\n",
"In 2016 the medical publication STAT reported that while Mexican cartels are a main source of heroin smuggled into the U.S., Chinese suppliers provide both raw fentanyl and the machinery necessary for its production.[36] In British Columbia, police discovered a lab making 100,000 fentanyl pills each month, which they were shipping to Calgary, Alberta.\n",
"Sentence number 51 : 90 people in Calgary overdosed on the drug in 2015.[36]\n",
"Sentence number 52 : In Southern California, a home-operated drug lab with six pill presses was uncovered by federal agents; each machine was capable of producing thousands of pills an hour.[36]\n",
"\n",
"History of opiate use in the United States[edit]\n",
"In the early 1900s, as veterans of the First World War were returning home from overseas, there were few options to help relieve pain, and doctors mainly turned to morphine.[37] Opiates soon became known as a wonder drug and were prescribed for a wide array of ailments, even for relatively minor treatments such as cough relief.\n",
"Sentence number 53 : Beginning around 1920, however, their addictiveness was recognized and not too long afterwards heroin was made an illegal drug.[37]\n",
"Sentence number 54 : In the Anti-Heroin Act of 1924, the U.S. Congress banned the sale, importation, or manufacture of heroin.\n",
"\n",
"\n",
"Sentence number 55 : Around World War II, doctors used opiates in lieu of surgery.\n",
"Sentence number 56 : This made prescriptions for opiates skyrocket.[37]\n",
"Sentence number 57 : In the 1950s, heroin addiction was known among jazz musicians, but still fairly unknown by average Americans, many of whom saw it as a frightening condition.[15]\n",
"Sentence number 58 : The fear extended into the 1960s and 1970s, although it became common to hear or read about drugs such as marijuana and psychedelics, which were widely used at rock concerts like Woodstock.[15]\n",
"Sentence number 59 : Heroin addiction began to make the news when famous people such as Janis Joplin, John Belushi, Jim Morrison and Lenny Bruce, whom most people did not know were addicted, died from overdoses.\n",
"Sentence number 60 : During and after the Vietnam War, addicted soldiers returned from Vietnam, where heroin was easily bought.\n",
"Sentence number 61 : Heroin addiction grew within low-income housing projects during the same time period.[15]\n",
"Sentence number 62 : In 1971, congressmen released an explosive report on the growing heroin epidemic among U.S. servicemen in Vietnam, finding that ten to fifteen percent were addicted to heroin.\n",
"Sentence number 63 : \"The Nixon White House panicked,\" wrote political editor Christopher Caldwell and declared drug abuse \"public enemy number one\".[38]\n",
"Sentence number 64 : By 1973, there were 1.5 overdose deaths per 100,000 people.[15]\n",
"\n",
"In the 1980s, many medical experts did not believe that opioids were addictive.\n",
"Sentence number 65 : A brief letter published in the New England Journal of Medicine (NEJM) in January 1980, titled \"Addiction Rare in Patients Treated with Narcotics\", was subsequently cited over 600 times to support this position.[39][40] A group of researchers in Canada claim that the letter may have originated and contributed to the opioid crisis.[39]\n",
"Sentence number 66 : The NEJM published its rebuttal to the 1980 letter in June 2017, pointing out among other things that the conclusions were based on hospitalized patients only, and not on patients taking the drugs after they were sent home.[41]\n",
"Sentence number 67 : The original author, Dr. Hershel Jick, has said that he never intended for the article to justify widespread opioid use.[39]\n",
"\n",
"In the mid-to-late 1980s the crack epidemic followed widespread cocaine use in American cities.\n",
"Sentence number 68 : The death rate was worse, reaching almost 2 per 100,000.\n",
"Sentence number 69 : In 1982, Vice President George H. W. Bush and his aides began pushing for the involvement of the CIA and the U.S. military in drug interdiction efforts, the so-called War on Drugs.[42]\n",
"Sentence number 70 : By comparison, as of 2016, the present opioid epidemic is killing on average 10.3 people per 100,000.\n",
"Sentence number 71 : In some states it is far worse: over 30 per 100,000 in New Hampshire and over 40 per 100,000 in West Virginia.[15]\n",
"\n",
"Demographics[edit]\n",
"In the U.S., addiction and overdose victims are mostly white and working-class.\n",
"Sentence number 72 : Geographically, those living in rural areas of the country have been the hardest hit as a percentage of the national population,[43] Prescription drug abuse has been increasing in teenagers, especially as 12- to 17-year-olds were one-third of all new abusers of prescription drugs in 2006.\n",
"Sentence number 73 : Teens abuse prescription drugs more than any illicit drug except marijuana, more than cocaine, heroin and methamphetamine combined, per the Office of National Drug Control Policy’s 2008\n",
"Sentence number 74 : Report Prescription for Danger.\n",
"\n",
"\n",
"Sentence number 75 : In Palm Beach County, Florida, overdose deaths went from 149 in 2012 to 588 in 2016.[44]\n",
"\n",
"In Middletown, Ohio, overdose deaths quadrupled in the 15 years since 2000.[45]\n",
"\n",
"There has been a difference in the number of opioid prescriptions written by doctors in different states.\n",
"Sentence number 76 : In Hawaii, doctors wrote about 52 prescriptions for every 100 people, whereas in Alabama, they wrote almost 143 prescriptions per 100 people.\n",
"Sentence number 77 : Researchers suspect that the variation results from a lack of consensus among doctors in different states about how much pain medication to prescribe.\n",
"Sentence number 78 : A higher rate of prescription drug use does not lead to better health outcomes or patient satisfaction, according to studies.[8]\n",
"\n",
"Outside the U.S.[edit]\n",
"Approximately 80 percent of the global pharmaceutical opioid supply is consumed in the United States.[47]\n",
"\n",
"It has also become a serious problem outside the U.S., mostly among young adults.[48]\n",
"Sentence number 79 : The concern not only relates to the drugs themselves, but to the fact that in many countries doctors are less trained about drug addiction, both about its causes or treatment.[20]\n",
"Sentence number 80 : According to an epidemiologist at Columbia University: \"Once pharmaceuticals start targeting other countries and make people feel like opioids are safe, we might see a spike [in opioid abuse].\n",
"Sentence number 81 : It worked here.\n",
"Sentence number 82 : Why wouldn’t it work elsewhere?\"\n",
"Sentence number 83 : [20] The majority of deaths worldwide from overdoses were from either medically prescribed opioids or illegal heroin.\n",
"Sentence number 84 : In Europe, prescription opioids accounted for three-quarters of overdose deaths among those between ages 15 and 39.[48]\n",
"Sentence number 85 : Some worry that the epidemic could become a worldwide pandemic if not curtailed.[20] Prescription drug abuse among teenagers in Canada, Australia, and Europe were at rates comparable to U.S. teenagers.[20]\n",
"Sentence number 86 : In Lebanon and Saudi Arabia, and in parts of China, surveys found that one in ten students had used prescription painkillers for non-medical purposes.\n",
"Sentence number 87 : Similar high rates of non-medical use were found among the young throughout Europe, including Spain and the United Kingdom.[20]\n",
"\n",
"\n",
"Sentence number 88 : Countermeasures[edit]\n",
"\n",
"This section is in a list format that may be better presented using prose.\n",
"Sentence number 89 : You can help by converting this section to prose, if appropriate.\n",
"Sentence number 90 : Editing help is available.\n",
"Sentence number 91 : (August 2017)\n",
"\n",
"Sentence number 92 : Federal government[edit]\n",
"In 2010, the US government began cracking down on pharmacists and doctors who were over-prescribing opioid pain killers.\n",
"Sentence number 93 : The unintended consequence of this was that users turned to cheaper but illegal heroin, a significantly more potent opioid, as a substitute,[10] including addicted patients who were denied opioid prescriptions as doctors tried to cut back painkiller drug abuse.[15]\n",
"Sentence number 94 : A 2017 survey in Utah of heroin users found about 80 percent started with prescription drugs.[49] As a result, by 2015 nationwide deaths from prescription opioids had increased by 15% and for heroin users by 23%.[10][50]\n",
"\n",
"Sentence number 95 : In 2010, the CSA was amended with the Secure and Responsible Drug Disposal Act which allows pharmacies to accept controlled substances from households or long term care facilities in their drug disposal programs or \"take-back\" programs.[51]\n",
"In 2011, the Obama administration released a white paper describing the administration's plan to deal with the crisis.\n",
"Sentence number 96 : Its concerns have been echoed by numerous medical and government advisory groups around the world.[52][53][54]\n",
"In 2016, the U.S. Surgeon General listed statistics which describe the extent of the problem.[19]\n",
"In July 2016, President Barack Obama signed into law the Comprehensive Addiction and Recovery Act, which expands opioid addiction treatment with buprenorphine and authorizes millions of dollars in new funding for opioid research and treatment.[55]\n",
"\n",
"Sentence number 97 : In December 2016, the 21st Century Cures Act, which includes $1 billion in state grants to fight the opioid epidemic, was passed by Congress by a wide bipartisan majority (94-5 in the Senate, 392-26 in the House of Representatives),[56] and was signed into law by President Obama.[57]\n",
"\n",
"Sentence number 98 : As of March 2017, President Donald Trump appointed a commission to deal on the epidemic, chaired by Governor Chris Christie of New Jersey.[58][59][60]\n",
"In June 2017, the FDA asked the manufacturer to remove its injectable form of oxymorphone (Opana ER) from the US market, because the drug's benefits may no longer outweigh its risks, this being the first time the agency has asked to remove a currently marketed opioid pain medication from sale due to public health consequences of abuse.[61]\n",
"In July 2017, FDA commissioner Dr Scott Gottlieb stated that for the first time, pharmacists, nurses, and physicians, would have training made available on appropriate prescribing of opioid medicines, because opioid addiction had become the \"FDA's biggest crisis\".[13]\n",
"On August 10, 2017, President Trump agreed with his Commission's report released few weeks earlier and declared the country's opioid crisis a \"national emergency.\n",
"Sentence number 99 : \"[16][17]\n",
"On September 1, 2017, Trump nominated Representative Tom Marino as director of the Office of National Drug Control Policy, or \"drug czar\".[62] Pharmaceutical distribution companies had contributed $134,000 to Marino's election campaigns in 2014 and 2016, more than contributions from any other industry.\n",
"Sentence number 100 : Pharmaceutical distibutors had lobbied for legislation which Marino co-sponsored in 2016, the Ensuring Patient Access and Effective Drug Enforcement Act, which made it harder for the DEA to shut down pharmacies suspected of diverting pills.[18]\n",
"State and local governments[edit]\n",
"In July 2016, governors of most U.S. states and territories entered into a formal \"Compact to Fight Opioid Addiction.\"\n",
"Sentence number 101 : They agreed that collective action would be needed to end the opioid crisis, and they would coordinate their responses across all levels of government and the private sector, including opioid manufacturers and doctors.[63]\n",
"In March 2017, the Governor of Maryland, as an urgent response to the crisis, declared a State of Emergency to combat the rapid increase in overdoses by increasing and speeding up coordination between the state and local jurisdictions.[64][12]\n",
"Sentence number 102 : In 2016, about 2,000 people in the state had died from opioid overdoses.[65]\n",
"In March 2017, Delaware, which has the 12th-highest overdose death rate in the country, introduced bills to both limit doctors' ability to over-prescribe painkillers and improve access to treatment.\n",
"Sentence number 103 : In 2015, 228 people had died from overdose, which increased 35%—to 308—in 2016.[66]\n",
"In March 2017, a similar plan was begun in Michigan, which introduced the Michigan Automated Prescription System (MAPS), allowing doctors to check when and what painkillers have already been prescribed to a patient, and thereby help keep addicts from switching doctors to receive drugs.[67][68]\n",
"During the 2017 General Session of the Utah Legislature, Rep. Edward H. Redd and Sen. Todd Weiler proposed amendments to Utah's involuntary commitment statutes by trying to pass H.B. 299 into law which would allow relatives to petition a court to mandate substance- abuse treatment for adults.[69][49]\n",
"In Maine, new laws were imposed which capped the maximum daily strength of prescribed opioids and which limited prescriptions to seven days.\n",
"Sentence number 104 : But some doctors were then concerned that patients would turn to using street drugs like heroin to extend their use of painkillers.[15]\n",
"In West Virginia, which leads the nation in overdose deaths per capita, lawsuits seek to declare drug distribution companies a \"public nuisance\" in an effort to place accountability upon the drug industry for the costs associated with the epidemic.[70][71]\n",
"In February 2017, officials in Everett, Washington filed a lawsuit against the manufacturer of OxyContin for negligence by allowing drugs to be illegally trafficked to residents and failing to prevent it.\n",
"Sentence number 105 : The city wants the company to pay the costs of handling the crisis.[72]\n",
"Prescription drug monitoring[edit]\n",
"\n",
"Sentence number 106 : In 2016, the CDC published its \"Guideline for Prescribing Opioids for Chronic Pain\", recommending opioids only be used when benefits for pain and function are expected to outweigh risks, and then used at the lowest effective dosage, with avoidance of concurrent opioid and benzodiazepine use whenever possible.[73] Silvia Martins, an epidemiologist at Columbia University, has suggested getting out more information about the risks:\n",
"\n",
"The greater “social acceptance” for using these medications (versus illegal substances) and the misconception that they are “safe” may be contributing factors to their misuse.\n",
"Sentence number 107 : Hence, a major target for intervention is the general public, including parents and youth, who must be better informed about the negative consequences of sharing with others medications prescribed for their own ailments.\n",
"Sentence number 108 : Equally important is the improved training of medical practitioners and their staff to better recognize patients at potential risk of developing nonmedical use, and to consider potential alternative treatments as well as closely monitor the medications they dispense to these patients.[48]\n",
"\n",
"As of April 2017, prescription drug monitoring programs (PDMPs) exist in every state.[74]\n",
"Sentence number 109 : A person on opioids for more than three months has a 15-fold (1,500%) greater chance of becoming addicted.[21] PDMPs allow pharmacists and prescribers to access patients’ prescription histories to identify suspicious use.\n",
"Sentence number 110 : However, a survey of US physicians published in 2015 found only 53% of doctors used these programs, while 22% were not aware these programs were available.[75] The Centers for Disease Control and Prevention (CDC) was tasked with establishing and publishing a new guideline, and was heavily lobbied.[76][77]\n",
"\n",
"\n",
"Sentence number 111 : In the media[edit]\n",
"Media coverage has largely focused on law-enforcement solutions to the epidemic, which portray the issue as criminal rather than medical.[78] There has been differential reporting on how white suburban or rural addicts of opioids are portrayed compared to black and Hispanic urban addicts, often of heroin, reinforcing stereotypes of drug users and drug-using offenders.[79]\n",
"Sentence number 112 : In newspapers, white addicts' stories are often given more space, allowing for a longer backstory explaining how they became addicted, and what potential they had before using drugs.\n",
"Sentence number 113 : Black and Hispanic addicts are more likely to be dehumanized, portrayed criminally, and mentioned more briefly.[79]\n",
"\n",
"In July 2017, a 400-page report by the National Academy of Science presented plans to reduce the addiction crisis, which it said was killing 91 people each day.[80]\n",
"\n",
"Solutions for addicts[edit]\n",
"Main article: Drug abuse treatment\n",
"\n",
"Sentence number 114 : The opioid epidemic is often discussed in terms of prevention, but helping those who are already addicts is talked about less frequently.[78] Opioid dependence can lead to a number of consequences like contraction of HIV and overdose.\n",
"Sentence number 115 : For addicts who wish to treat their addiction, there are two classes of treatment options available: medical and behavioral.[81]\n",
"Sentence number 116 : Neither is guaranteed to successfully treat opioid addiction.\n",
"Sentence number 117 : Which, or which combination, is most effective varies from person to person.[82]\n",
"Sentence number 118 : These treatments are doctor-prescribed and -regulated, but differ in their treatment mechanism.\n",
"Sentence number 119 : Popular treatments include naloxone, methadone, and buprenorphine, which are more effective when combined with a form of behavioral treatment.[82]\n",
"\n",
"Naloxone[edit]\n",
"Naloxone is used mostly as a rescue medication for opioid overdose.\n",
"Sentence number 120 : It is an opioid antagonist, meaning it binds to opioid receptors but does not turn them on.\n",
"Sentence number 121 : It also happens that naloxone binds to opioid receptors more strongly than heroin or any prescription opioids.\n",
"Sentence number 122 : This means that when someone is overdosing on opioids, naloxone can be administered, allowing it to take the place of the opioid drug in the person's receptors, turning them off.\n",
"Sentence number 123 : This blocks the effect of the receptors.\n",
"Sentence number 124 : Naloxone is sometimes administered with other drugs such as buprenorphine, as a way to taper off buprenorphine over time.\n",
"Sentence number 125 : Naloxone binds to some of the receptors, blocking the effectiveness of some receptors in case of relapse.[82]\n",
"\n",
"Methadone[edit]\n",
"Methadone has been used for opioid dependence since 1964, and studied the most of the pharmacological treatment options.[83] It is a synthetic long acting opioid, so it can replace multiple heroin uses by being taken once daily.[82] It works by binding to the opioid receptors in the brain and spinal cord, activating them, reducing withdrawal symptoms and cravings while suppressing the \"high\" that other opioids can elicit.\n",
"Sentence number 126 : The decrease in withdrawal symptoms and cravings allow the user to slowly taper off the drug in a controlled manner, decreasing the likelihood of relapse.\n",
"Sentence number 127 : It is not accessible to all addicts.\n",
"Sentence number 128 : It is a regulated substance, and requires that each dose be picked up from a methadone clinic daily.\n",
"Sentence number 129 : This can be inconvenient as some patients are unable to travel to a clinic, or avoid the stigma associated with drug addiction.[82]\n",
"\n",
"Buprenorphine[edit]\n",
"\n",
"Sentence number 130 : Buprenorphine is used similarly to methadone, with some doctors recommending it as the best solution for medication-assisted treatment to help people reduce or quit their use of heroin or other opiates.\n",
"Sentence number 131 : It is claimed to be safer and less regulated than methadone, with month-long prescriptions allowed.\n",
"Sentence number 132 : It is also said to eliminate opiate withdrawal symptoms and cravings in many patients without inducing euphoria.[84]\n",
"\n",
"Unlike methadone treatment, which must be performed in a highly structured clinic, buprenorphine, according to SAMHSA, can be prescribed or dispensed in physician offices.[85]\n",
"Sentence number 133 : Patients can thereby receive a full year of treatment for a fraction of the cost of detox programs.[84]\n",
"\n",
"Behavioral treatment options[edit]\n",
"It is less effective to use behavioral treatment without medical treatment during initial detoxification.\n",
"Sentence number 134 : It has similarly been shown that medical treatments tend to get better results when accompanied by behavioral treatment.[81] Popular behavioral treatment options include group or individual therapy, residential treatment centers, and Twelve-step programs such as Narcotics Anonymous.[83]\n",
"Sentence number 135 : Residential treatment centers allow for a 24-hour drug-free environment to decrease the chances of relapse.\n",
"Sentence number 136 : These centers allow addicts to be in supportive environments during the difficult time of detox.[86]\n",
"\n",
"Twelve-step programs are one of the most well-known options.\n",
"Sentence number 137 : The philosophy is that a group of people sharing the same addiction can remain abstinent with the support of and connection to others who empathize and understand.\n",
"Sentence number 138 : There is also a spiritual, though not religious, component to it, with freedom to believe as one chooses.[87]\n",
"\n",
"See also[edit]\n",
"Crack epidemic\n",
"List of deaths from drug overdose and intoxication\n",
"References[edit]\n",
"^\n",
"Sentence number 139 : Jump up to: a b Data Overview.\n",
"Sentence number 140 : Drug Overdose.\n",
"Sentence number 141 : CDC Injury Center, Centers for Disease Control and Prevention 2016.\n",
"\n",
"Sentence number 142 : Jump up ^\n",
"Sentence number 143 : \"WHO | Information sheet on opioid overdose\".\n",
"Sentence number 144 : www.who.int.\n",
"Sentence number 145 : Retrieved 2017-07-30.\n",
"\n",
"Sentence number 146 : ^\n",
"Sentence number 147 : Jump up to: a b \"2015 National Drug Threat Assessment Summary\", DEA, Oct. 2015\n",
"Jump up ^\n",
"Sentence number 148 : \"CDC – MMWR – MMWR Publications – MMWR Weekly: Past Volume (2011)\".\n",
"Sentence number 149 : www.cdc.gov.\n",
"Sentence number 150 : November 4, 2011 / 60(43);1487–1492.\n",
"Sentence number 151 : Retrieved 2017-07-30.\n",
"\n",
"Sentence number 152 : Jump up ^\n",
"Sentence number 153 : \"Drug overdoses now kill more Americans than guns\", CBS News, Dec. 9, 2016\n",
"^\n",
"Sentence number 154 : Jump up to: a b \"Drug Deaths in America Are Rising Faster Than Ever\", New York Times, June 5, 2017\n",
"Jump up ^\n",
"Sentence number 155 : \"In 2016, drug overdoses likely killed more Americans than the entire wars in Vietnam and Iraq\", Vox, July 7, 2017\n",
"^\n",
"Sentence number 156 : Jump up to: a b c d e \"How Bad is the Opioid Epidemic?\n",
"Sentence number 157 : \", PBS, Feb. 23, 2016\n",
"Jump up ^\n",
"Sentence number 158 : \"America’s Addiction to Opioids: Heroin and Prescription Drug Abuse\", National Institute on Drug Abuse (NIDA), May 14, 2014\n",
"^\n",
"Sentence number 159 : Jump up to: a b c d e\n",
"Sentence number 160 : \"America’s opioid epidemic is worsening\", the Economist (U.K.) March 6, 2017\n",
"Jump up ^\n",
"Sentence number 161 : \"STAT forecast:\n",
"Sentence number 162 : Opioids could kill nearly 500,000 Americans in the next decade\", STAT, June 27, 2017\n",
"^\n",
"Sentence number 163 : Jump up to: a b Turque, B. Maryland governor declares state of emergency for opioid crisis, The Washington Post, March 1, 2017\n",
"\n",
"Sentence number 164 : ^\n",
"Sentence number 165 : Jump up to: a b \"FDA's Scott Gottlieb:\n",
"Sentence number 166 : Opioid addiction is FDA's biggest crisis now\", CNBC, July 21, 2017\n",
"^\n",
"Sentence number 167 : Jump up to: a b \"CDC Chief Frieden: How to end America's growing opioid epidemic\", Fox News, Dec. 17, 2016\n",
"^\n",
"Sentence number 168 : Jump up to: a b c d e f g h\n",
"Sentence number 169 : i j k Caldwell, Christoper.\n",
"Sentence number 170 : \"American Carnage: The New Landscape of Opioid Addiction\", First Things, April 2017\n",
"^\n",
"Sentence number 171 : Jump up to: a b \"White House opioid commission to Trump: ‘Declare a national emergency’ on drug overdoses\", Washington Post, July 31, 2017\n",
"^\n",
"Sentence number 172 : Jump up to: a b \"Trump says opioid crisis is a national emergency, pledges more money and attention\", Washington Post, August 10, 2017\n",
"\n",
"Sentence number 173 : ^\n",
"Sentence number 174 : Jump up to: a b \"Drug Companies Sure Are Cozy With Trump’s Pick to Solve the Opioid Crisis\".\n",
"Sentence number 175 : Mother Jones.\n",
"Sentence number 176 : October 13, 2017.\n",
"Sentence number 177 : Retrieved October 13, 2017.\n",
"\n",
"Sentence number 178 : ^\n",
"Sentence number 179 : Jump up to: a b c \"Facing Addiction in America\", U.S. Surgeon General (2016), 413 pp\n",
"^\n",
"Sentence number 180 : Jump up to: a b c d e\n",
"Sentence number 181 : f\n",
"Sentence number 182 : \"The opioid epidemic could turn into a pandemic if we’re not careful\", Washington Post, Feb. 9, 2017\n",
"^\n",
"Sentence number 183 : Jump up to: a b c \"Opioid Prescriptions Fall After 2010 Peak, C.D.C. Report Finds\", New York Times, July 6, 2017\n",
"^\n",
"Sentence number 184 : Jump up to: a b \"Why opioid overdose deaths seem to happen in spurts\", CNN, Feb. 8, 2017\n",
"Jump up ^\n",
"Sentence number 185 : \"Heroin Production in Mexico and U.S. Policy\", Congressional Research Service report, March 3, 2016\n",
"Jump up ^\n",
"Sentence number 186 : \"Heroin deaths surpass gun homicides for the first time, CDC data shows\", Washington Post, Dec. 8, 2016, Retrieved 2017-05-08\n",
"Jump up ^\n",
"Sentence number 187 : \"The Children of the Opioid Crisis\", Wall Street Journal, Dec. 15, 2016\n",
"Jump up ^\n",
"Sentence number 188 : \"Fentanyl Takes a Deadly Toll on Vermont\", VTDigger, June 4, 2017\n",
"Jump up ^\n",
"Sentence number 189 : \"Why fentanyl is deadlier than heroin, in a single photo\", Stat, Sept. 29, 2016\n",
"Jump up ^\n",
"Sentence number 190 : \"Fentanyl drug profile\", The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)\n",
"Jump up ^\n",
"Sentence number 191 : \"Fentanyl: Preventing Occupational Exposure to Emergency Responders\", CDC\n",
"Jump up ^\n",
"Sentence number 192 : \"Orlando man pleads guilty to selling heroin mixed with fentanyl\", Orlando.com, March 20, 2017\n",
"Jump up ^ \"Opioid Data Analysis\", Centers for Disease Control and Prevention (CDC), date?\n",
"Jump up ^\n",
"Sentence number 193 : \"Coroner: Franklin County fentanyl deaths hit ‘unprecedented’ rate of one per day\", The Columbus Dispatch, March 16, 2017\n",
"Jump up ^\n",
"Sentence number 194 : \"State, feds seize 14 kilos of dangerous opioid fentanyl in N.J.\", NJ.com, March 17, 2017\n",
"^ Jump up to: a b \"Prince's Autopsy Result Highlights Dangers of Opioid Painkiller Fentanyl\", ABC News, June 2, 2016\n",
"Jump up ^\n",
"Sentence number 195 : \"Documents highlight Prince’s struggle with opioid addiction\", Seattle Times, April 17, 2017\n",
"^\n",
"Sentence number 196 : Jump up to: a b c d e f \"‘Truly terrifying’: Chinese suppliers flood US and Canada with deadly fentanyl\", STAT, April 5, 2016\n",
"^\n",
"Sentence number 197 : Jump up to: a b c Moghe, Sonia.\n",
"Sentence number 198 : \"Opioids: From 'wonder drug' to abuse epidemic\".\n",
"Sentence number 199 : CNN.\n",
"Sentence number 200 : Retrieved 11 April 2017.\n",
"\n",
"Sentence number 201 : Jump up ^\n",
"Sentence number 202 : WGBH educational foundation.\n",
"Sentence number 203 : Interview with Dr. Robert Dupoint.\n",
"Sentence number 204 : PBS.org (February 18, 1970)\n",
"\n",
"Sentence number 205 : ^\n",
"Sentence number 206 : Jump up to: a b c \"Opioid crisis: The letter that started it all\".\n",
"Sentence number 207 : bbc.co.uk.\n",
"Sentence number 208 : BBC. 3 June 2017.\n",
"Sentence number 209 : Retrieved 3 June 2017.\n",
"\n",
"Sentence number 210 : Jump up ^\n",
"Sentence number 211 : Jane Porter and Hershel Jick (10 January 1980).\n",
"Sentence number 212 : \"Addiction Rare in Patients Treated with Narcotics\".\n",
"Sentence number 213 : nejm.org.\n",
"Sentence number 214 : New England Journal of Medicine.\n",
"Sentence number 215 : Retrieved 3 June 2017.\n",
"\n",
"Sentence number 216 : Jump up ^\n",
"Sentence number 217 : \"A 1980 Letter on the Risk of Opioid Addiction\".\n",
"Sentence number 218 : nejm.org.\n",
"Sentence number 219 : New England Journal of Medicine.\n",
"Sentence number 220 : 1 June 2017.\n",
"Sentence number 221 : Retrieved 3 June 2017.\n",
"\n",
"Sentence number 222 : Jump up\n",
"Sentence number 223 : ^\n",
"Sentence number 224 : Scott, Peter Dale; Marshall, Jonathan.\n",
"Sentence number 225 : Cocaine Politics: Drugs, Armies, and the CIA in Central America, Berkeley, CA: University of California Press (1991)\n",
"Sentence number 226 : p. 2\n",
"Jump up ^\n",
"Sentence number 227 : Sullivan, Andrew.\n",
"Sentence number 228 : \"The Opioid Epidemic Is This Generation’s AIDS Crisis\", New York Magazine, March 16, 2017\n",
"Jump up ^\n",
"Sentence number 229 : \"Patient brokering exacerbates opioid crisis in Florida\", South Bend Tribune, April 2, 2017\n",
"Jump up ^ de La Bruyere, Emily (August 2, 2017).\n",
"Sentence number 230 : \"Middletown, Ohio, a city under siege: \"Everyone I know is on heroin\"\".\n",
"Sentence number 231 : Yahoo.\n",
"Jump up ^\n",
"Sentence number 232 : \"Vital Signs: Variation Among States in Prescribing of Opioid Pain Relievers and Benzodiazepines — United States, 2012\", CDC, July 4, 2014\n",
"Jump up ^\n",
"Sentence number 233 : \"Americans consume vast majority of the world's opioids\", Dina Gusovsky, CNBC, 27 Apr 2016\n",
"^\n",
"Sentence number 234 : Jump up to: a b c Silvia S. Martins, Lilian A. Ghandour \"Nonmedical use of prescription drugs in adolescents and young adults: not just a Western phenomenon\", World Psychiatry, Jan. 26, 2017\n",
"^\n",
"Sentence number 235 : Jump up to: a b \"Poll: Many Utahns know people who seek treatment for opioid addiction, but barriers remain\", The Salt Lake Tribune, April 3, 2017\n",
"Jump up ^\n",
"Sentence number 236 : \"Overdose Death Rates\", US National Institute on Drug Abuse, January 2017\n",
"Jump up ^\n",
"Sentence number 237 : Secure and Responsible Drug Disposal Act of 2010 Oct. 12, 2010, Government Publishing Office, 4pp\n",
"Jump up ^\n",
"Sentence number 238 : \"Tackling the Opioid Public Health Crisis\", College of Physicians and Surgeons of Ontario, September 8, 2010\n",
"Jump up ^\n",
"Sentence number 239 : \"First Do No Harm: Responding to Canada’s Prescription Drug Crisis\", Canadian Centre on Substance Abuse, March 2013\n",
"Jump up ^\n",
"Sentence number 240 : \"UK: Task Force offers ideas for opioid addiction solutions\".\n",
"Sentence number 241 : Delhidailynews.com.\n",
"Sentence number 242 : 2014-06-11.\n",
"Sentence number 243 : Retrieved 2016-01-07.\n",
"\n",
"Sentence number 244 : Jump up ^\n",
"Sentence number 245 : Summary of the Comprehensive Addiction and Recovery Act, American Society of Addiction Medicine.\n",
"Jump up ^\n",
"Sentence number 246 : Mike DeBonis, Congress passes 21st Century Cures Act, boosting research and easing drug approvals, Washington Post (December 7, 2016).\n",
"\n",
"Sentence number 247 : Jump up ^ Juliet Eilperin & Carolyn Y. Johnson, paying tribute to Biden and bipartisanship, signs 21st Century Cures Act Tuesday, Washington Post (December 13, 2016).\n",
"\n",
"Sentence number 248 : Jump up ^\n",
"Sentence number 249 : \"Opioid Epidemic: Trump to Set Up Commission on Addiction Crisis\", NBC News, March 29, 2017\n",
"Jump up ^\n",
"Sentence number 250 : \"It's time to 'Trump' opioid addiction in the United States\", The Hill, Feb. 27, 2017\n",
"Jump up ^\n",
"Sentence number 251 : \"President Trump Hosts an Opioid and Drug Abuse Listening Session\", Real Clear Politics, March 29, 2017\n",
"Jump up ^\n",
"Sentence number 252 : Commissioner, Office of the.\n",
"Sentence number 253 : \"Press Announcements – FDA requests removal of Opana ER for risks related to abuse\".\n",
"Sentence number 254 : www.fda.gov.\n",
"Sentence number 255 : Retrieved 2017-06-15.\n",
"Jump up ^ \"Trump to tap Rep. Tom Marino as 'drug czar'\".\n",
"Sentence number 256 : Politico.\n",
"Sentence number 257 : September 1, 2017.\n",
"Sentence number 258 : Retrieved 13 October 2017.\n",
"\n",
"Sentence number 259 : Jump up ^\n",
"Sentence number 260 : \"A Compact to Fight Opioid Addiction\", National Governors Assoc., July 13, 2016\n",
"Jump up ^\n",
"Sentence number 261 : \"Hogan-Rutherford Administration Declares State of Emergency, Announces Major Funding to Combat Heroin and Opioid Crisis in Maryland\", Maryland.gov, March 1, 2017\n",
"Jump up ^\n",
"Sentence number 262 : \"Gov. Hogan Announces Opioid Epidemic State Of Emergency\", CBS Baltimore, March 1, 2017\n",
"Jump up ^\n",
"Sentence number 263 : \"Delaware lawmakers tackle opioid addiction epidemic\", Newsworks, March 23, 2017\n",
"Jump up ^\n",
"Sentence number 264 : \"Governor Snyder rolls out plan to fight opioid addiction\", WILX, March 23, 2017\n",
"Jump up ^\n",
"Sentence number 265 : \"Snyder: Efforts to stop opioid abuse aren’t working\", Michigan Radio, March 23, 2017\n",
"Jump up ^\n",
"Sentence number 266 : \"HB0299\".\n",
"Sentence number 267 : le.utah.gov.\n",
"Sentence number 268 : Retrieved 2017-07-27.\n",
"\n",
"Sentence number 269 : Jump up ^\n",
"Sentence number 270 : \"Opioid distributors sued by West Virginia counties hit by drug crisis\".\n",
"Sentence number 271 : Washington Post.\n",
"Sentence number 272 : Retrieved 2017-06-27.\n",
"Jump up ^\n",
"Sentence number 273 : \"Lawyer Behind West Virginia County Lawsuit Against Opioid Distributors\".\n",
"Sentence number 274 : NPR.org.\n",
"Sentence number 275 : Retrieved 2017-06-27.\n",
"Jump up ^\n",
"Sentence number 276 : \"U.S. City Sues OxyContin Maker For Contributing To Opioid Crisis\", NPR, Feb. 3, 2017\n",
"Jump up ^\n",
"Sentence number 277 : Dowell, Deborah; Haegerich, Tamara; Chou, Roger (March 15, 2016).\n",
"Sentence number 278 : \"CDC Guideline for Prescribing Opioids for Chronic Pain—United States, 2016\".\n",
"Sentence number 279 : JAMA. 315: 1624–45.\n",
"Sentence number 280 : PMID 26977696.\n",
"Sentence number 281 : doi:10.1001/jama.2016.1464.\n",
"Sentence number 282 : Retrieved March 18, 2016.\n",
"\n",
"Sentence number 283 : Jump up ^\n",
"Sentence number 284 : Missouri is final state to pass PDMP program; US News & World Report; April 13, 2017\n",
"Jump up ^\n",
"Sentence number 285 : Rutkow Lainie; et al. (2015).\n",
"Sentence number 286 : \"Most primary care physicians are aware of prescription drug monitoring programs, but many find the data difficult to access\".\n",
"Sentence number 287 : Health Affairs.\n",
"Sentence number 288 : 34 (3): 484–492.\n",
"Sentence number 289 : doi:10.1377/hlthaff.2014.1085.\n",
"Jump up ^\n",
"Sentence number 290 : Matthew Perrone, Associated Press.\n",
"Sentence number 291 : \"Painkiller politics: Effort to curb prescribing under fire\".\n",
"Sentence number 292 : The Washington Times.\n",
"Sentence number 293 : Retrieved 2017-06-13.\n",
"Jump up ^\n",
"Sentence number 294 : Ghorayshi, Azeen.\n",
"Sentence number 295 : \"Missouri Is The Only State In The US Where Doctors Have No Idea What Prescriptions People Are Getting\".\n",
"Sentence number 296 : BuzzFeed.\n",
"Sentence number 297 : Retrieved 11 April 2017.\n",
"\n",
"Sentence number 298 : ^\n",
"Sentence number 299 : Jump up to: a b McGinty, E. \"Criminal Activity or Treatable Health Condition?\n",
"Sentence number 300 : News Media Framing of Opioid Analgesic Abuse in the United States\".\n",
"Sentence number 301 : Psychiatric Services.\n",
"Sentence number 302 : 67: 405–411.\n",
"^\n",
"Sentence number 303 : Jump up to: a b Netherland, J. (December 2016).\n",
"Sentence number 304 : \"The War on Drugs That Wasn't: Wasted Whiteness, \"Dirty Doctors,\" and Race in Media Coverage of Prescription Opioid Misuse\".\n",
"Sentence number 305 : Cult Med Psychiatry.\n",
"Sentence number 306 : 40 (4): 664–686.\n",
"Jump up ^\n",
"Sentence number 307 : \"Major Science Report Lays Out a Plan to Tamp Down Opioid Crisis\", Scientific American, July 13, 2017\n",
"^\n",
"Sentence number 308 : Jump up to: a b Veilleux, Jennifer.\n",
"Sentence number 309 : \"A Review of Opioid Dependence Treatment: Pharmacological and Psychosocial Interventions to Treat Opioid Addiction\".\n",
"Sentence number 310 : Clinical Psychology Review.\n",
"Sentence number 311 : 30.2: 155–166.\n",
"^\n",
"Sentence number 312 : Jump up to: a b c d e Dixon, David (May 13, 2017).\n",
"Sentence number 313 : \"Opioid Abuse Treatment and Management: Medical Care\".\n",
"Sentence number 314 : Medscape.\n",
"\n",
"Sentence number 315 : ^\n",
"Sentence number 316 : Jump up to: a b \"WHAT ARE MY TREATMENT OPTIONS?\".\n",
"Sentence number 317 : TURN TO HELP.\n",
"Sentence number 318 : June 11, 2017.\n",
"\n",
"Sentence number 319 : ^\n",
"Sentence number 320 : Jump up to: a b \"My View: New approach needed for opioid epidemic\", Portland Tribune, July 25, 2017\n",
"Jump up ^ Buprenorphine, SAMHSA\n",
"Jump up ^\n",
"Sentence number 321 : \"Heroin Abuse Solutions\".\n",
"Sentence number 322 : Narconon New Life Retreat.\n",
"Sentence number 323 : June 12, 2017.\n",
"\n",
"Sentence number 324 : Jump up ^\n",
"Sentence number 325 : \"12 Step Programs for Drug Rehab & Alcohol Treatment\".\n",
"Sentence number 326 : American Addiction Centers.\n",
"Sentence number 327 : June 6, 2017.\n"
]
}
],
"source": [
"idx = 0\n",
"for sentence in parsed_text.sents:\n",
" print('Sentence number', idx, ':', sentence)\n",
" idx += 1"
]
},
{
"cell_type": "markdown",
"metadata": {},
"source": [
"Note that the above code can be written more concisely using Python's built-in `enumerate` function:"
]
},
{
"cell_type": "code",
"execution_count": 21,
"metadata": {},
"outputs": [
{
"name": "stdout",
"output_type": "stream",
"text": [
"Sentence number 0 : The opioid epidemic or opioid crisis is the rapid increase in the use of prescription and non-prescription opioid drugs in the United States and Canada in the 2010s.\n",
"Sentence number 1 : Opioids are a diverse class of moderately strong painkillers, including oxycodone (commonly sold under the trade names OxyContin and Percocet), hydrocodone (Vicodin), and a very strong painkiller, fentanyl, which is synthesized to resemble other opiates such as opium-derived morphine and heroin.\n",
"Sentence number 2 : The potency and availability of these substances, despite their high risk of addiction and overdose, have made them popular both as formal medical treatments and as recreational drugs.\n",
"Sentence number 3 : Due to their sedative effects on the part of the brain which regulates breathing, opioids in high doses present the potential for respiratory depression, and may cause respiratory failure and death.[2]\n",
"\n",
"\n",
"Sentence number 4 : According to the U.S. Drug Enforcement Administration, \"overdose deaths, particularly from prescription drugs and heroin, have reached epidemic levels.\"[3]:iii\n",
"Sentence number 5 : Nearly half of all opioid overdose deaths in 2016 involved prescription opioids.[1]\n",
"Sentence number 6 : From 1999 to 2008, overdose death rates, sales, and substance abuse treatment admissions related to opioid pain relievers all increased substantially.[4]\n",
"Sentence number 7 : By 2015, annual overdose deaths from heroin alone surpassed deaths from both car accidents and guns, with other opioid overdose deaths also on the rise.[5]\n",
"\n",
"Drug overdoses have since become the leading cause of death of Americans under 50, with two-thirds of those deaths from opioids.[6]\n",
"Sentence number 8 : In 2016, 62,000 Americans died from overdoses, 19 percent more than in 2015, and had killed more Americans in one year than both the wars in Vietnam and Iraq combined.[7][6]\n",
"Sentence number 9 : By comparison, the figure was 16,000 in 2010, and 4,000 in 1999.\n",
"Sentence number 10 : Figures from June 2017 indicate the problem has worsened.[8][9]\n",
"Sentence number 11 : While death rates varied by state,[10] public health experts estimate that nationwide over 500,000 people could die from the epidemic over the next 10 years.[11]\n",
"\n",
"\n",
"Sentence number 12 : In March 2017, Larry Hogan, the governor of Maryland, declared a state of emergency to combat the opioid epidemic,[12] and in July 2017 opioid addiction was cited as the \"FDA's biggest crisis.\n",
"Sentence number 13 : \"[13]\n",
"Sentence number 14 : CDC director Thomas Frieden said that \"America is awash in opioids; urgent action is critical.\n",
"Sentence number 15 : \"[14]\n",
"Sentence number 16 : The crisis has changed moral, social, and cultural resistance to street drug alternatives such as heroin.[15] On August 10, 2017, President Donald Trump agreed with his Commission's report released few weeks earlier and declared the country's opioid crisis a \"national emergency.\n",
"Sentence number 17 : \"[16][17]\n",
"Sentence number 18 : On September 1, Trump nominated as \"drug czar\" Tom Marino, whose election campaign had been financed by pharmaceutical distribution companies that had lobbied for, and profited from, legislation co-sponsored by Marino which protected pharmacies suspected of diverting pills.[18]\n",
"\n",
"Contents [hide] \n",
"1 Background in the United States\n",
"1.1 Main causes\n",
"1.2 Effects\n",
"1.3 Fentanyl\n",
"1.4 History of opiate use in the United States\n",
"1.5 Demographics\n",
"1.6 Outside the U.S.\n",
"2 Countermeasures\n",
"2.1 Federal government\n",
"2.2 State and local governments\n",
"2.3 Prescription drug monitoring\n",
"2.4 In the media\n",
"2.5 Solutions for addicts\n",
"2.5.1 Naloxone\n",
"2.5.2 Methadone\n",
"2.5.3 Buprenorphine\n",
"2.5.4 Behavioral treatment options\n",
"3 See also\n",
"4 References\n",
"5 External links\n",
"Background in the United States[edit]\n",
"Main causes[edit]\n",
"What the U.S. Surgeon General calls \"The Opioid Crisis\" likely began with over-prescription of powerful opioid pain relievers in the 1990s, which led to them becoming the most prescribed class of medications in the United States.\n",
"Sentence number 19 : As of 2016 more than 289 million prescriptions were written for opioid drugs per year.[19]:43In the late 1990s, many Americans were diagnosed with chronic pain, estimated to affect around 100 million people or a third of the U.S. population.\n",
"Sentence number 20 : This led to a push by drug companies and the federal government to expand the use of painkilling opioids.[10] Between 1991 and 2011, painkiller prescriptions in the U.S. tripled from 76 million to 219 million per year.\n",
"Sentence number 21 : Among the most common opioids prescribed have been oxycodone (OxyContin and Percocet) and hydrocodone (Vicodin).\n",
"Sentence number 22 : With the increase in volume, potency of opioids also increased.\n",
"Sentence number 23 : By 2002, one in six drug users were being prescribed drugs more powerful than morphine; by 2012, the ratio had doubled to one-in-three.[10]\n",
"\n",
"Despite the increased use of painkillers, there has been no change in the amount of pain reported in the U.S.[20][19]\n",
"Sentence number 24 : This has led to differing medical opinions, with some noting that there is little evidence that opioids are effective for chronic pain not caused by cancer.[21]\n",
"\n",
"Effects[edit]\n",
"When people continue to use opioids beyond what a doctor prescribes, whether to minimize pain or to enjoy the euphoric feelings, it can mark the beginning stages of an opiate addiction, with a tolerance developing and eventually leading to dependence, when a person relies on the drug to prevent withdrawal symptoms.[22]\n",
"\n",
"As the number of opioid prescriptions rose, drug cartels began flooding the U.S. with heroin.\n",
"Sentence number 25 : For many opioid users, heroin was cheaper, more potent, and often easier to acquire than prescription medications.[8]\n",
"Sentence number 26 : According to the CDC, tighter prescription policies by doctors did not necessarily lead to this increased heroin use.[21]\n",
"Sentence number 27 : The main suppliers of heroin to the U.S. have been Mexican transnational criminal organizations.[8]\n",
"Sentence number 28 : From 2005–2009, Mexican heroin production increased by over 600%, from an estimated 8 metric tons in 2005 to 50 metric tons in 2009.[8]\n",
"Sentence number 29 : Between 2010 and 2014, the amount seized at the border more than doubled.[23]\n",
"Sentence number 30 : According to the DEA, smugglers and distributors \"profit primarily by putting drugs on the street and have become crucial to the Mexican cartels.\n",
"Sentence number 31 : \"[3]:3\n",
"\n",
"\n",
"Opiate self-injection paraphernalia\n",
"The opioid epidemic has since emerged as one of the worst drug crises in American history: more than 33,000 people died from overdoses in 2015, nearly equal to the number of deaths from car crashes, with deaths from heroin alone more than from gun homicides.[24]\n",
"Sentence number 32 : It has also left thousands of children suddenly in need of foster care after their parents have died from an overdose.[25]\n",
"\n",
"Fentanyl[edit]\n",
"There have always been drug addicts in need of help, but the scale of the present wave of heroin and opioid abuse is unprecedented.\n",
"Sentence number 33 : In Maryland, the first six months of 2015 saw 121 fentanyl deaths.\n",
"Sentence number 34 : In the first six months of 2016, the figure rose to 446.\n",
"\n",
"Sentence number 35 : Christopher Caldwell,\n",
"senior editor The Weekly Standard[15]\n",
"Fentanyl, a newer synthetic opioid painkiller, is 50 to 100 times more potent than morphine and 30 to 50 times more potent than heroin,[15] with only 2 mg becoming a lethal dose.\n",
"Sentence number 36 : It is pure white, odorless and flavorless, with a potency strong enough that police and first responders helping overdose victims have themselves overdosed by simply touching or inhaling a small amount.[26][27][28]\n",
"Sentence number 37 : As a result, the DEA has recommended that officers not field test drugs if fentanyl is suspected, but instead collect and send samples to a laboratory for analysis.\n",
"Sentence number 38 : \"Exposure via inhalation or skin absorption can be deadly,\" they state.[29]\n",
"\n",
"Fentanyl-laced heroin has become a big problem for major cities, including Philadelphia, Detroit and Chicago.[30]\n",
"Sentence number 39 : Its use has caused a spike in deaths among users of heroin and prescription painkillers, while becoming easier to obtain and conceal.\n",
"Sentence number 40 : Some arrested or hospitalized users are surprised to find that what they thought was heroin was actually fentanyl.[15]\n",
"Sentence number 41 : According to CDC director Thomas Frieden:\n",
"\n",
"As overdose deaths involving heroin more than quadrupled since 2010, what was a slow stream of illicit fentanyl, a synthetic opioid 50 to 100 times stronger than morphine, is now a flood, with the amount of the powerful drug seized by law enforcement increasing dramatically.\n",
"Sentence number 42 : America is awash in opioids; urgent action is critical.[14]\n",
"\n",
"According to the Centers for Disease Control and Prevention (CDC), death rates from synthetic opioids, including fentanyl, increased over 72% from 2014 to 2015.[22]\n",
"Sentence number 43 : In addition, the CDC reports that the total deaths from opioid overdoses may be under-counted, since they do not include deaths that are associated with synthetic opioids which are used as pain relievers.\n",
"Sentence number 44 : The CDC presumes[when?] that a large proportion of the increase in deaths is due to illegally-made fentanyl; as the statistics on overdose deaths do not distinguish pharmaceutical fentanyl from illegally-made fentanyl, the actual death rate could therefore be much higher than reported.[31]\n",
"\n",
"Those taking fentanyl-laced heroin are more likely to overdose because they do not know they also are ingesting the more powerful drug.[32]\n",
"Sentence number 45 : In March 2017, New Jersey police arrested a person possessing nearly 31 pounds (14 kg) of fentanyl (14 kg would yield 7 million lethal doses).[33][34]\n",
"Sentence number 46 : Among those who died from overdosing on fentanyl was singer Prince.[34][35]\n",
"\n",
"Fentanyl has surpassed heroin as a killer in several locales: in all of 2014 the CDC identified 998 fatal fentanyl overdoses in Ohio, which is the same number of deaths recorded in just the first five months of 2015.[36]\n",
"Sentence number 47 : In Cleveland, a person was caught selling blue fentanyl pills disguised to look like doses of the milder opioid painkiller oxycodone.[36]\n",
"Sentence number 48 : The U.S. attorney for Ohio stated:\n",
"\n",
"One of the truly terrifying things is the pills are pressed and dyed to look like oxycodone.\n",
"Sentence number 49 : If you are using oxycodone and take fentanyl not knowing it is fentanyl, that is an overdose waiting to happen.\n",
"Sentence number 50 : Each of those pills is a potential overdose death.[36]\n",
"\n",
"In 2016 the medical publication STAT reported that while Mexican cartels are a main source of heroin smuggled into the U.S., Chinese suppliers provide both raw fentanyl and the machinery necessary for its production.[36] In British Columbia, police discovered a lab making 100,000 fentanyl pills each month, which they were shipping to Calgary, Alberta.\n",
"Sentence number 51 : 90 people in Calgary overdosed on the drug in 2015.[36]\n",
"Sentence number 52 : In Southern California, a home-operated drug lab with six pill presses was uncovered by federal agents; each machine was capable of producing thousands of pills an hour.[36]\n",
"\n",
"History of opiate use in the United States[edit]\n",
"In the early 1900s, as veterans of the First World War were returning home from overseas, there were few options to help relieve pain, and doctors mainly turned to morphine.[37] Opiates soon became known as a wonder drug and were prescribed for a wide array of ailments, even for relatively minor treatments such as cough relief.\n",
"Sentence number 53 : Beginning around 1920, however, their addictiveness was recognized and not too long afterwards heroin was made an illegal drug.[37]\n",
"Sentence number 54 : In the Anti-Heroin Act of 1924, the U.S. Congress banned the sale, importation, or manufacture of heroin.\n",
"\n",
"\n",
"Sentence number 55 : Around World War II, doctors used opiates in lieu of surgery.\n",
"Sentence number 56 : This made prescriptions for opiates skyrocket.[37]\n",
"Sentence number 57 : In the 1950s, heroin addiction was known among jazz musicians, but still fairly unknown by average Americans, many of whom saw it as a frightening condition.[15]\n",
"Sentence number 58 : The fear extended into the 1960s and 1970s, although it became common to hear or read about drugs such as marijuana and psychedelics, which were widely used at rock concerts like Woodstock.[15]\n",
"Sentence number 59 : Heroin addiction began to make the news when famous people such as Janis Joplin, John Belushi, Jim Morrison and Lenny Bruce, whom most people did not know were addicted, died from overdoses.\n",
"Sentence number 60 : During and after the Vietnam War, addicted soldiers returned from Vietnam, where heroin was easily bought.\n",
"Sentence number 61 : Heroin addiction grew within low-income housing projects during the same time period.[15]\n",
"Sentence number 62 : In 1971, congressmen released an explosive report on the growing heroin epidemic among U.S. servicemen in Vietnam, finding that ten to fifteen percent were addicted to heroin.\n",
"Sentence number 63 : \"The Nixon White House panicked,\" wrote political editor Christopher Caldwell and declared drug abuse \"public enemy number one\".[38]\n",
"Sentence number 64 : By 1973, there were 1.5 overdose deaths per 100,000 people.[15]\n",
"\n",
"In the 1980s, many medical experts did not believe that opioids were addictive.\n",
"Sentence number 65 : A brief letter published in the New England Journal of Medicine (NEJM) in January 1980, titled \"Addiction Rare in Patients Treated with Narcotics\", was subsequently cited over 600 times to support this position.[39][40] A group of researchers in Canada claim that the letter may have originated and contributed to the opioid crisis.[39]\n",
"Sentence number 66 : The NEJM published its rebuttal to the 1980 letter in June 2017, pointing out among other things that the conclusions were based on hospitalized patients only, and not on patients taking the drugs after they were sent home.[41]\n",
"Sentence number 67 : The original author, Dr. Hershel Jick, has said that he never intended for the article to justify widespread opioid use.[39]\n",
"\n",
"In the mid-to-late 1980s the crack epidemic followed widespread cocaine use in American cities.\n",
"Sentence number 68 : The death rate was worse, reaching almost 2 per 100,000.\n",
"Sentence number 69 : In 1982, Vice President George H. W. Bush and his aides began pushing for the involvement of the CIA and the U.S. military in drug interdiction efforts, the so-called War on Drugs.[42]\n",
"Sentence number 70 : By comparison, as of 2016, the present opioid epidemic is killing on average 10.3 people per 100,000.\n",
"Sentence number 71 : In some states it is far worse: over 30 per 100,000 in New Hampshire and over 40 per 100,000 in West Virginia.[15]\n",
"\n",
"Demographics[edit]\n",
"In the U.S., addiction and overdose victims are mostly white and working-class.\n",
"Sentence number 72 : Geographically, those living in rural areas of the country have been the hardest hit as a percentage of the national population,[43] Prescription drug abuse has been increasing in teenagers, especially as 12- to 17-year-olds were one-third of all new abusers of prescription drugs in 2006.\n",
"Sentence number 73 : Teens abuse prescription drugs more than any illicit drug except marijuana, more than cocaine, heroin and methamphetamine combined, per the Office of National Drug Control Policy’s 2008\n",
"Sentence number 74 : Report Prescription for Danger.\n",
"\n",
"\n",
"Sentence number 75 : In Palm Beach County, Florida, overdose deaths went from 149 in 2012 to 588 in 2016.[44]\n",
"\n",
"In Middletown, Ohio, overdose deaths quadrupled in the 15 years since 2000.[45]\n",
"\n",
"There has been a difference in the number of opioid prescriptions written by doctors in different states.\n",
"Sentence number 76 : In Hawaii, doctors wrote about 52 prescriptions for every 100 people, whereas in Alabama, they wrote almost 143 prescriptions per 100 people.\n",
"Sentence number 77 : Researchers suspect that the variation results from a lack of consensus among doctors in different states about how much pain medication to prescribe.\n",
"Sentence number 78 : A higher rate of prescription drug use does not lead to better health outcomes or patient satisfaction, according to studies.[8]\n",
"\n",
"Outside the U.S.[edit]\n",
"Approximately 80 percent of the global pharmaceutical opioid supply is consumed in the United States.[47]\n",
"\n",
"It has also become a serious problem outside the U.S., mostly among young adults.[48]\n",
"Sentence number 79 : The concern not only relates to the drugs themselves, but to the fact that in many countries doctors are less trained about drug addiction, both about its causes or treatment.[20]\n",
"Sentence number 80 : According to an epidemiologist at Columbia University: \"Once pharmaceuticals start targeting other countries and make people feel like opioids are safe, we might see a spike [in opioid abuse].\n",
"Sentence number 81 : It worked here.\n",
"Sentence number 82 : Why wouldn’t it work elsewhere?\"\n",
"Sentence number 83 : [20] The majority of deaths worldwide from overdoses were from either medically prescribed opioids or illegal heroin.\n",
"Sentence number 84 : In Europe, prescription opioids accounted for three-quarters of overdose deaths among those between ages 15 and 39.[48]\n",
"Sentence number 85 : Some worry that the epidemic could become a worldwide pandemic if not curtailed.[20] Prescription drug abuse among teenagers in Canada, Australia, and Europe were at rates comparable to U.S. teenagers.[20]\n",
"Sentence number 86 : In Lebanon and Saudi Arabia, and in parts of China, surveys found that one in ten students had used prescription painkillers for non-medical purposes.\n",
"Sentence number 87 : Similar high rates of non-medical use were found among the young throughout Europe, including Spain and the United Kingdom.[20]\n",
"\n",
"\n",
"Sentence number 88 : Countermeasures[edit]\n",
"\n",
"This section is in a list format that may be better presented using prose.\n",
"Sentence number 89 : You can help by converting this section to prose, if appropriate.\n",
"Sentence number 90 : Editing help is available.\n",
"Sentence number 91 : (August 2017)\n",
"\n",
"Sentence number 92 : Federal government[edit]\n",
"In 2010, the US government began cracking down on pharmacists and doctors who were over-prescribing opioid pain killers.\n",
"Sentence number 93 : The unintended consequence of this was that users turned to cheaper but illegal heroin, a significantly more potent opioid, as a substitute,[10] including addicted patients who were denied opioid prescriptions as doctors tried to cut back painkiller drug abuse.[15]\n",
"Sentence number 94 : A 2017 survey in Utah of heroin users found about 80 percent started with prescription drugs.[49] As a result, by 2015 nationwide deaths from prescription opioids had increased by 15% and for heroin users by 23%.[10][50]\n",
"\n",
"Sentence number 95 : In 2010, the CSA was amended with the Secure and Responsible Drug Disposal Act which allows pharmacies to accept controlled substances from households or long term care facilities in their drug disposal programs or \"take-back\" programs.[51]\n",
"In 2011, the Obama administration released a white paper describing the administration's plan to deal with the crisis.\n",
"Sentence number 96 : Its concerns have been echoed by numerous medical and government advisory groups around the world.[52][53][54]\n",
"In 2016, the U.S. Surgeon General listed statistics which describe the extent of the problem.[19]\n",
"In July 2016, President Barack Obama signed into law the Comprehensive Addiction and Recovery Act, which expands opioid addiction treatment with buprenorphine and authorizes millions of dollars in new funding for opioid research and treatment.[55]\n",
"\n",
"Sentence number 97 : In December 2016, the 21st Century Cures Act, which includes $1 billion in state grants to fight the opioid epidemic, was passed by Congress by a wide bipartisan majority (94-5 in the Senate, 392-26 in the House of Representatives),[56] and was signed into law by President Obama.[57]\n",
"\n",
"Sentence number 98 : As of March 2017, President Donald Trump appointed a commission to deal on the epidemic, chaired by Governor Chris Christie of New Jersey.[58][59][60]\n",
"In June 2017, the FDA asked the manufacturer to remove its injectable form of oxymorphone (Opana ER) from the US market, because the drug's benefits may no longer outweigh its risks, this being the first time the agency has asked to remove a currently marketed opioid pain medication from sale due to public health consequences of abuse.[61]\n",
"In July 2017, FDA commissioner Dr Scott Gottlieb stated that for the first time, pharmacists, nurses, and physicians, would have training made available on appropriate prescribing of opioid medicines, because opioid addiction had become the \"FDA's biggest crisis\".[13]\n",
"On August 10, 2017, President Trump agreed with his Commission's report released few weeks earlier and declared the country's opioid crisis a \"national emergency.\n",
"Sentence number 99 : \"[16][17]\n",
"On September 1, 2017, Trump nominated Representative Tom Marino as director of the Office of National Drug Control Policy, or \"drug czar\".[62] Pharmaceutical distribution companies had contributed $134,000 to Marino's election campaigns in 2014 and 2016, more than contributions from any other industry.\n",
"Sentence number 100 : Pharmaceutical distibutors had lobbied for legislation which Marino co-sponsored in 2016, the Ensuring Patient Access and Effective Drug Enforcement Act, which made it harder for the DEA to shut down pharmacies suspected of diverting pills.[18]\n",
"State and local governments[edit]\n",
"In July 2016, governors of most U.S. states and territories entered into a formal \"Compact to Fight Opioid Addiction.\"\n",
"Sentence number 101 : They agreed that collective action would be needed to end the opioid crisis, and they would coordinate their responses across all levels of government and the private sector, including opioid manufacturers and doctors.[63]\n",
"In March 2017, the Governor of Maryland, as an urgent response to the crisis, declared a State of Emergency to combat the rapid increase in overdoses by increasing and speeding up coordination between the state and local jurisdictions.[64][12]\n",
"Sentence number 102 : In 2016, about 2,000 people in the state had died from opioid overdoses.[65]\n",
"In March 2017, Delaware, which has the 12th-highest overdose death rate in the country, introduced bills to both limit doctors' ability to over-prescribe painkillers and improve access to treatment.\n",
"Sentence number 103 : In 2015, 228 people had died from overdose, which increased 35%—to 308—in 2016.[66]\n",
"In March 2017, a similar plan was begun in Michigan, which introduced the Michigan Automated Prescription System (MAPS), allowing doctors to check when and what painkillers have already been prescribed to a patient, and thereby help keep addicts from switching doctors to receive drugs.[67][68]\n",
"During the 2017 General Session of the Utah Legislature, Rep. Edward H. Redd and Sen. Todd Weiler proposed amendments to Utah's involuntary commitment statutes by trying to pass H.B. 299 into law which would allow relatives to petition a court to mandate substance- abuse treatment for adults.[69][49]\n",
"In Maine, new laws were imposed which capped the maximum daily strength of prescribed opioids and which limited prescriptions to seven days.\n",
"Sentence number 104 : But some doctors were then concerned that patients would turn to using street drugs like heroin to extend their use of painkillers.[15]\n",
"In West Virginia, which leads the nation in overdose deaths per capita, lawsuits seek to declare drug distribution companies a \"public nuisance\" in an effort to place accountability upon the drug industry for the costs associated with the epidemic.[70][71]\n",
"In February 2017, officials in Everett, Washington filed a lawsuit against the manufacturer of OxyContin for negligence by allowing drugs to be illegally trafficked to residents and failing to prevent it.\n",
"Sentence number 105 : The city wants the company to pay the costs of handling the crisis.[72]\n",
"Prescription drug monitoring[edit]\n",
"\n",
"Sentence number 106 : In 2016, the CDC published its \"Guideline for Prescribing Opioids for Chronic Pain\", recommending opioids only be used when benefits for pain and function are expected to outweigh risks, and then used at the lowest effective dosage, with avoidance of concurrent opioid and benzodiazepine use whenever possible.[73] Silvia Martins, an epidemiologist at Columbia University, has suggested getting out more information about the risks:\n",
"\n",
"The greater “social acceptance” for using these medications (versus illegal substances) and the misconception that they are “safe” may be contributing factors to their misuse.\n",
"Sentence number 107 : Hence, a major target for intervention is the general public, including parents and youth, who must be better informed about the negative consequences of sharing with others medications prescribed for their own ailments.\n",
"Sentence number 108 : Equally important is the improved training of medical practitioners and their staff to better recognize patients at potential risk of developing nonmedical use, and to consider potential alternative treatments as well as closely monitor the medications they dispense to these patients.[48]\n",
"\n",
"As of April 2017, prescription drug monitoring programs (PDMPs) exist in every state.[74]\n",
"Sentence number 109 : A person on opioids for more than three months has a 15-fold (1,500%) greater chance of becoming addicted.[21] PDMPs allow pharmacists and prescribers to access patients’ prescription histories to identify suspicious use.\n",
"Sentence number 110 : However, a survey of US physicians published in 2015 found only 53% of doctors used these programs, while 22% were not aware these programs were available.[75] The Centers for Disease Control and Prevention (CDC) was tasked with establishing and publishing a new guideline, and was heavily lobbied.[76][77]\n",
"\n",
"\n",
"Sentence number 111 : In the media[edit]\n",
"Media coverage has largely focused on law-enforcement solutions to the epidemic, which portray the issue as criminal rather than medical.[78] There has been differential reporting on how white suburban or rural addicts of opioids are portrayed compared to black and Hispanic urban addicts, often of heroin, reinforcing stereotypes of drug users and drug-using offenders.[79]\n",
"Sentence number 112 : In newspapers, white addicts' stories are often given more space, allowing for a longer backstory explaining how they became addicted, and what potential they had before using drugs.\n",
"Sentence number 113 : Black and Hispanic addicts are more likely to be dehumanized, portrayed criminally, and mentioned more briefly.[79]\n",
"\n",
"In July 2017, a 400-page report by the National Academy of Science presented plans to reduce the addiction crisis, which it said was killing 91 people each day.[80]\n",
"\n",
"Solutions for addicts[edit]\n",
"Main article: Drug abuse treatment\n",
"\n",
"Sentence number 114 : The opioid epidemic is often discussed in terms of prevention, but helping those who are already addicts is talked about less frequently.[78] Opioid dependence can lead to a number of consequences like contraction of HIV and overdose.\n",
"Sentence number 115 : For addicts who wish to treat their addiction, there are two classes of treatment options available: medical and behavioral.[81]\n",
"Sentence number 116 : Neither is guaranteed to successfully treat opioid addiction.\n",
"Sentence number 117 : Which, or which combination, is most effective varies from person to person.[82]\n",
"Sentence number 118 : These treatments are doctor-prescribed and -regulated, but differ in their treatment mechanism.\n",
"Sentence number 119 : Popular treatments include naloxone, methadone, and buprenorphine, which are more effective when combined with a form of behavioral treatment.[82]\n",
"\n",
"Naloxone[edit]\n",
"Naloxone is used mostly as a rescue medication for opioid overdose.\n",
"Sentence number 120 : It is an opioid antagonist, meaning it binds to opioid receptors but does not turn them on.\n",
"Sentence number 121 : It also happens that naloxone binds to opioid receptors more strongly than heroin or any prescription opioids.\n",
"Sentence number 122 : This means that when someone is overdosing on opioids, naloxone can be administered, allowing it to take the place of the opioid drug in the person's receptors, turning them off.\n",
"Sentence number 123 : This blocks the effect of the receptors.\n",
"Sentence number 124 : Naloxone is sometimes administered with other drugs such as buprenorphine, as a way to taper off buprenorphine over time.\n",
"Sentence number 125 : Naloxone binds to some of the receptors, blocking the effectiveness of some receptors in case of relapse.[82]\n",
"\n",
"Methadone[edit]\n",
"Methadone has been used for opioid dependence since 1964, and studied the most of the pharmacological treatment options.[83] It is a synthetic long acting opioid, so it can replace multiple heroin uses by being taken once daily.[82] It works by binding to the opioid receptors in the brain and spinal cord, activating them, reducing withdrawal symptoms and cravings while suppressing the \"high\" that other opioids can elicit.\n",
"Sentence number 126 : The decrease in withdrawal symptoms and cravings allow the user to slowly taper off the drug in a controlled manner, decreasing the likelihood of relapse.\n",
"Sentence number 127 : It is not accessible to all addicts.\n",
"Sentence number 128 : It is a regulated substance, and requires that each dose be picked up from a methadone clinic daily.\n",
"Sentence number 129 : This can be inconvenient as some patients are unable to travel to a clinic, or avoid the stigma associated with drug addiction.[82]\n",
"\n",
"Buprenorphine[edit]\n",
"\n",
"Sentence number 130 : Buprenorphine is used similarly to methadone, with some doctors recommending it as the best solution for medication-assisted treatment to help people reduce or quit their use of heroin or other opiates.\n",
"Sentence number 131 : It is claimed to be safer and less regulated than methadone, with month-long prescriptions allowed.\n",
"Sentence number 132 : It is also said to eliminate opiate withdrawal symptoms and cravings in many patients without inducing euphoria.[84]\n",
"\n",
"Unlike methadone treatment, which must be performed in a highly structured clinic, buprenorphine, according to SAMHSA, can be prescribed or dispensed in physician offices.[85]\n",
"Sentence number 133 : Patients can thereby receive a full year of treatment for a fraction of the cost of detox programs.[84]\n",
"\n",
"Behavioral treatment options[edit]\n",
"It is less effective to use behavioral treatment without medical treatment during initial detoxification.\n",
"Sentence number 134 : It has similarly been shown that medical treatments tend to get better results when accompanied by behavioral treatment.[81] Popular behavioral treatment options include group or individual therapy, residential treatment centers, and Twelve-step programs such as Narcotics Anonymous.[83]\n",
"Sentence number 135 : Residential treatment centers allow for a 24-hour drug-free environment to decrease the chances of relapse.\n",
"Sentence number 136 : These centers allow addicts to be in supportive environments during the difficult time of detox.[86]\n",
"\n",
"Twelve-step programs are one of the most well-known options.\n",
"Sentence number 137 : The philosophy is that a group of people sharing the same addiction can remain abstinent with the support of and connection to others who empathize and understand.\n",
"Sentence number 138 : There is also a spiritual, though not religious, component to it, with freedom to believe as one chooses.[87]\n",
"\n",
"See also[edit]\n",
"Crack epidemic\n",
"List of deaths from drug overdose and intoxication\n",
"References[edit]\n",
"^\n",
"Sentence number 139 : Jump up to: a b Data Overview.\n",
"Sentence number 140 : Drug Overdose.\n",
"Sentence number 141 : CDC Injury Center, Centers for Disease Control and Prevention 2016.\n",
"\n",
"Sentence number 142 : Jump up ^\n",
"Sentence number 143 : \"WHO | Information sheet on opioid overdose\".\n",
"Sentence number 144 : www.who.int.\n",
"Sentence number 145 : Retrieved 2017-07-30.\n",
"\n",
"Sentence number 146 : ^\n",
"Sentence number 147 : Jump up to: a b \"2015 National Drug Threat Assessment Summary\", DEA, Oct. 2015\n",
"Jump up ^\n",
"Sentence number 148 : \"CDC – MMWR – MMWR Publications – MMWR Weekly: Past Volume (2011)\".\n",
"Sentence number 149 : www.cdc.gov.\n",
"Sentence number 150 : November 4, 2011 / 60(43);1487–1492.\n",
"Sentence number 151 : Retrieved 2017-07-30.\n",
"\n",
"Sentence number 152 : Jump up ^\n",
"Sentence number 153 : \"Drug overdoses now kill more Americans than guns\", CBS News, Dec. 9, 2016\n",
"^\n",
"Sentence number 154 : Jump up to: a b \"Drug Deaths in America Are Rising Faster Than Ever\", New York Times, June 5, 2017\n",
"Jump up ^\n",
"Sentence number 155 : \"In 2016, drug overdoses likely killed more Americans than the entire wars in Vietnam and Iraq\", Vox, July 7, 2017\n",
"^\n",
"Sentence number 156 : Jump up to: a b c d e \"How Bad is the Opioid Epidemic?\n",
"Sentence number 157 : \", PBS, Feb. 23, 2016\n",
"Jump up ^\n",
"Sentence number 158 : \"America’s Addiction to Opioids: Heroin and Prescription Drug Abuse\", National Institute on Drug Abuse (NIDA), May 14, 2014\n",
"^\n",
"Sentence number 159 : Jump up to: a b c d e\n",
"Sentence number 160 : \"America’s opioid epidemic is worsening\", the Economist (U.K.) March 6, 2017\n",
"Jump up ^\n",
"Sentence number 161 : \"STAT forecast:\n",
"Sentence number 162 : Opioids could kill nearly 500,000 Americans in the next decade\", STAT, June 27, 2017\n",
"^\n",
"Sentence number 163 : Jump up to: a b Turque, B. Maryland governor declares state of emergency for opioid crisis, The Washington Post, March 1, 2017\n",
"\n",
"Sentence number 164 : ^\n",
"Sentence number 165 : Jump up to: a b \"FDA's Scott Gottlieb:\n",
"Sentence number 166 : Opioid addiction is FDA's biggest crisis now\", CNBC, July 21, 2017\n",
"^\n",
"Sentence number 167 : Jump up to: a b \"CDC Chief Frieden: How to end America's growing opioid epidemic\", Fox News, Dec. 17, 2016\n",
"^\n",
"Sentence number 168 : Jump up to: a b c d e f g h\n",
"Sentence number 169 : i j k Caldwell, Christoper.\n",
"Sentence number 170 : \"American Carnage: The New Landscape of Opioid Addiction\", First Things, April 2017\n",
"^\n",
"Sentence number 171 : Jump up to: a b \"White House opioid commission to Trump: ‘Declare a national emergency’ on drug overdoses\", Washington Post, July 31, 2017\n",
"^\n",
"Sentence number 172 : Jump up to: a b \"Trump says opioid crisis is a national emergency, pledges more money and attention\", Washington Post, August 10, 2017\n",
"\n",
"Sentence number 173 : ^\n",
"Sentence number 174 : Jump up to: a b \"Drug Companies Sure Are Cozy With Trump’s Pick to Solve the Opioid Crisis\".\n",
"Sentence number 175 : Mother Jones.\n",
"Sentence number 176 : October 13, 2017.\n",
"Sentence number 177 : Retrieved October 13, 2017.\n",
"\n",
"Sentence number 178 : ^\n",
"Sentence number 179 : Jump up to: a b c \"Facing Addiction in America\", U.S. Surgeon General (2016), 413 pp\n",
"^\n",
"Sentence number 180 : Jump up to: a b c d e\n",
"Sentence number 181 : f\n",
"Sentence number 182 : \"The opioid epidemic could turn into a pandemic if we’re not careful\", Washington Post, Feb. 9, 2017\n",
"^\n",
"Sentence number 183 : Jump up to: a b c \"Opioid Prescriptions Fall After 2010 Peak, C.D.C. Report Finds\", New York Times, July 6, 2017\n",
"^\n",
"Sentence number 184 : Jump up to: a b \"Why opioid overdose deaths seem to happen in spurts\", CNN, Feb. 8, 2017\n",
"Jump up ^\n",
"Sentence number 185 : \"Heroin Production in Mexico and U.S. Policy\", Congressional Research Service report, March 3, 2016\n",
"Jump up ^\n",
"Sentence number 186 : \"Heroin deaths surpass gun homicides for the first time, CDC data shows\", Washington Post, Dec. 8, 2016, Retrieved 2017-05-08\n",
"Jump up ^\n",
"Sentence number 187 : \"The Children of the Opioid Crisis\", Wall Street Journal, Dec. 15, 2016\n",
"Jump up ^\n",
"Sentence number 188 : \"Fentanyl Takes a Deadly Toll on Vermont\", VTDigger, June 4, 2017\n",
"Jump up ^\n",
"Sentence number 189 : \"Why fentanyl is deadlier than heroin, in a single photo\", Stat, Sept. 29, 2016\n",
"Jump up ^\n",
"Sentence number 190 : \"Fentanyl drug profile\", The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA)\n",
"Jump up ^\n",
"Sentence number 191 : \"Fentanyl: Preventing Occupational Exposure to Emergency Responders\", CDC\n",
"Jump up ^\n",
"Sentence number 192 : \"Orlando man pleads guilty to selling heroin mixed with fentanyl\", Orlando.com, March 20, 2017\n",
"Jump up ^ \"Opioid Data Analysis\", Centers for Disease Control and Prevention (CDC), date?\n",
"Jump up ^\n",
"Sentence number 193 : \"Coroner: Franklin County fentanyl deaths hit ‘unprecedented’ rate of one per day\", The Columbus Dispatch, March 16, 2017\n",
"Jump up ^\n",
"Sentence number 194 : \"State, feds seize 14 kilos of dangerous opioid fentanyl in N.J.\", NJ.com, March 17, 2017\n",
"^ Jump up to: a b \"Prince's Autopsy Result Highlights Dangers of Opioid Painkiller Fentanyl\", ABC News, June 2, 2016\n",
"Jump up ^\n",
"Sentence number 195 : \"Documents highlight Prince’s struggle with opioid addiction\", Seattle Times, April 17, 2017\n",
"^\n",
"Sentence number 196 : Jump up to: a b c d e f \"‘Truly terrifying’: Chinese suppliers flood US and Canada with deadly fentanyl\", STAT, April 5, 2016\n",
"^\n",
"Sentence number 197 : Jump up to: a b c Moghe, Sonia.\n",
"Sentence number 198 : \"Opioids: From 'wonder drug' to abuse epidemic\".\n",
"Sentence number 199 : CNN.\n",
"Sentence number 200 : Retrieved 11 April 2017.\n",
"\n",
"Sentence number 201 : Jump up ^\n",
"Sentence number 202 : WGBH educational foundation.\n",
"Sentence number 203 : Interview with Dr. Robert Dupoint.\n",
"Sentence number 204 : PBS.org (February 18, 1970)\n",
"\n",
"Sentence number 205 : ^\n",
"Sentence number 206 : Jump up to: a b c \"Opioid crisis: The letter that started it all\".\n",
"Sentence number 207 : bbc.co.uk.\n",
"Sentence number 208 : BBC. 3 June 2017.\n",
"Sentence number 209 : Retrieved 3 June 2017.\n",
"\n",
"Sentence number 210 : Jump up ^\n",
"Sentence number 211 : Jane Porter and Hershel Jick (10 January 1980).\n",
"Sentence number 212 : \"Addiction Rare in Patients Treated with Narcotics\".\n",
"Sentence number 213 : nejm.org.\n",
"Sentence number 214 : New England Journal of Medicine.\n",
"Sentence number 215 : Retrieved 3 June 2017.\n",
"\n",
"Sentence number 216 : Jump up ^\n",
"Sentence number 217 : \"A 1980 Letter on the Risk of Opioid Addiction\".\n",
"Sentence number 218 : nejm.org.\n",
"Sentence number 219 : New England Journal of Medicine.\n",
"Sentence number 220 : 1 June 2017.\n",
"Sentence number 221 : Retrieved 3 June 2017.\n",
"\n",
"Sentence number 222 : Jump up\n",
"Sentence number 223 : ^\n",
"Sentence number 224 : Scott, Peter Dale; Marshall, Jonathan.\n",
"Sentence number 225 : Cocaine Politics: Drugs, Armies, and the CIA in Central America, Berkeley, CA: University of California Press (1991)\n",
"Sentence number 226 : p. 2\n",
"Jump up ^\n",
"Sentence number 227 : Sullivan, Andrew.\n",
"Sentence number 228 : \"The Opioid Epidemic Is This Generation’s AIDS Crisis\", New York Magazine, March 16, 2017\n",
"Jump up ^\n",
"Sentence number 229 : \"Patient brokering exacerbates opioid crisis in Florida\", South Bend Tribune, April 2, 2017\n",
"Jump up ^ de La Bruyere, Emily (August 2, 2017).\n",
"Sentence number 230 : \"Middletown, Ohio, a city under siege: \"Everyone I know is on heroin\"\".\n",
"Sentence number 231 : Yahoo.\n",
"Jump up ^\n",
"Sentence number 232 : \"Vital Signs: Variation Among States in Prescribing of Opioid Pain Relievers and Benzodiazepines — United States, 2012\", CDC, July 4, 2014\n",
"Jump up ^\n",
"Sentence number 233 : \"Americans consume vast majority of the world's opioids\", Dina Gusovsky, CNBC, 27 Apr 2016\n",
"^\n",
"Sentence number 234 : Jump up to: a b c Silvia S. Martins, Lilian A. Ghandour \"Nonmedical use of prescription drugs in adolescents and young adults: not just a Western phenomenon\", World Psychiatry, Jan. 26, 2017\n",
"^\n",
"Sentence number 235 : Jump up to: a b \"Poll: Many Utahns know people who seek treatment for opioid addiction, but barriers remain\", The Salt Lake Tribune, April 3, 2017\n",
"Jump up ^\n",
"Sentence number 236 : \"Overdose Death Rates\", US National Institute on Drug Abuse, January 2017\n",
"Jump up ^\n",
"Sentence number 237 : Secure and Responsible Drug Disposal Act of 2010 Oct. 12, 2010, Government Publishing Office, 4pp\n",
"Jump up ^\n",
"Sentence number 238 : \"Tackling the Opioid Public Health Crisis\", College of Physicians and Surgeons of Ontario, September 8, 2010\n",
"Jump up ^\n",
"Sentence number 239 : \"First Do No Harm: Responding to Canada’s Prescription Drug Crisis\", Canadian Centre on Substance Abuse, March 2013\n",
"Jump up ^\n",
"Sentence number 240 : \"UK: Task Force offers ideas for opioid addiction solutions\".\n",
"Sentence number 241 : Delhidailynews.com.\n",
"Sentence number 242 : 2014-06-11.\n",
"Sentence number 243 : Retrieved 2016-01-07.\n",
"\n",
"Sentence number 244 : Jump up ^\n",
"Sentence number 245 : Summary of the Comprehensive Addiction and Recovery Act, American Society of Addiction Medicine.\n",
"Jump up ^\n",
"Sentence number 246 : Mike DeBonis, Congress passes 21st Century Cures Act, boosting research and easing drug approvals, Washington Post (December 7, 2016).\n",
"\n",
"Sentence number 247 : Jump up ^ Juliet Eilperin & Carolyn Y. Johnson, paying tribute to Biden and bipartisanship, signs 21st Century Cures Act Tuesday, Washington Post (December 13, 2016).\n",
"\n",
"Sentence number 248 : Jump up ^\n",
"Sentence number 249 : \"Opioid Epidemic: Trump to Set Up Commission on Addiction Crisis\", NBC News, March 29, 2017\n",
"Jump up ^\n",
"Sentence number 250 : \"It's time to 'Trump' opioid addiction in the United States\", The Hill, Feb. 27, 2017\n",
"Jump up ^\n",
"Sentence number 251 : \"President Trump Hosts an Opioid and Drug Abuse Listening Session\", Real Clear Politics, March 29, 2017\n",
"Jump up ^\n",
"Sentence number 252 : Commissioner, Office of the.\n",
"Sentence number 253 : \"Press Announcements – FDA requests removal of Opana ER for risks related to abuse\".\n",
"Sentence number 254 : www.fda.gov.\n",
"Sentence number 255 : Retrieved 2017-06-15.\n",
"Jump up ^ \"Trump to tap Rep. Tom Marino as 'drug czar'\".\n",
"Sentence number 256 : Politico.\n",
"Sentence number 257 : September 1, 2017.\n",
"Sentence number 258 : Retrieved 13 October 2017.\n",
"\n",
"Sentence number 259 : Jump up ^\n",
"Sentence number 260 : \"A Compact to Fight Opioid Addiction\", National Governors Assoc., July 13, 2016\n",
"Jump up ^\n",
"Sentence number 261 : \"Hogan-Rutherford Administration Declares State of Emergency, Announces Major Funding to Combat Heroin and Opioid Crisis in Maryland\", Maryland.gov, March 1, 2017\n",
"Jump up ^\n",
"Sentence number 262 : \"Gov. Hogan Announces Opioid Epidemic State Of Emergency\", CBS Baltimore, March 1, 2017\n",
"Jump up ^\n",
"Sentence number 263 : \"Delaware lawmakers tackle opioid addiction epidemic\", Newsworks, March 23, 2017\n",
"Jump up ^\n",
"Sentence number 264 : \"Governor Snyder rolls out plan to fight opioid addiction\", WILX, March 23, 2017\n",
"Jump up ^\n",
"Sentence number 265 : \"Snyder: Efforts to stop opioid abuse aren’t working\", Michigan Radio, March 23, 2017\n",
"Jump up ^\n",
"Sentence number 266 : \"HB0299\".\n",
"Sentence number 267 : le.utah.gov.\n",
"Sentence number 268 : Retrieved 2017-07-27.\n",
"\n",
"Sentence number 269 : Jump up ^\n",
"Sentence number 270 : \"Opioid distributors sued by West Virginia counties hit by drug crisis\".\n",
"Sentence number 271 : Washington Post.\n",
"Sentence number 272 : Retrieved 2017-06-27.\n",
"Jump up ^\n",
"Sentence number 273 : \"Lawyer Behind West Virginia County Lawsuit Against Opioid Distributors\".\n",
"Sentence number 274 : NPR.org.\n",
"Sentence number 275 : Retrieved 2017-06-27.\n",
"Jump up ^\n",
"Sentence number 276 : \"U.S. City Sues OxyContin Maker For Contributing To Opioid Crisis\", NPR, Feb. 3, 2017\n",
"Jump up ^\n",
"Sentence number 277 : Dowell, Deborah; Haegerich, Tamara; Chou, Roger (March 15, 2016).\n",
"Sentence number 278 : \"CDC Guideline for Prescribing Opioids for Chronic Pain—United States, 2016\".\n",
"Sentence number 279 : JAMA. 315: 1624–45.\n",
"Sentence number 280 : PMID 26977696.\n",
"Sentence number 281 : doi:10.1001/jama.2016.1464.\n",
"Sentence number 282 : Retrieved March 18, 2016.\n",
"\n",
"Sentence number 283 : Jump up ^\n",
"Sentence number 284 : Missouri is final state to pass PDMP program; US News & World Report; April 13, 2017\n",
"Jump up ^\n",
"Sentence number 285 : Rutkow Lainie; et al. (2015).\n",
"Sentence number 286 : \"Most primary care physicians are aware of prescription drug monitoring programs, but many find the data difficult to access\".\n",
"Sentence number 287 : Health Affairs.\n",
"Sentence number 288 : 34 (3): 484–492.\n",
"Sentence number 289 : doi:10.1377/hlthaff.2014.1085.\n",
"Jump up ^\n",
"Sentence number 290 : Matthew Perrone, Associated Press.\n",
"Sentence number 291 : \"Painkiller politics: Effort to curb prescribing under fire\".\n",
"Sentence number 292 : The Washington Times.\n",
"Sentence number 293 : Retrieved 2017-06-13.\n",
"Jump up ^\n",
"Sentence number 294 : Ghorayshi, Azeen.\n",
"Sentence number 295 : \"Missouri Is The Only State In The US Where Doctors Have No Idea What Prescriptions People Are Getting\".\n",
"Sentence number 296 : BuzzFeed.\n",
"Sentence number 297 : Retrieved 11 April 2017.\n",
"\n",
"Sentence number 298 : ^\n",
"Sentence number 299 : Jump up to: a b McGinty, E. \"Criminal Activity or Treatable Health Condition?\n",
"Sentence number 300 : News Media Framing of Opioid Analgesic Abuse in the United States\".\n",
"Sentence number 301 : Psychiatric Services.\n",
"Sentence number 302 : 67: 405–411.\n",
"^\n",
"Sentence number 303 : Jump up to: a b Netherland, J. (December 2016).\n",
"Sentence number 304 : \"The War on Drugs That Wasn't: Wasted Whiteness, \"Dirty Doctors,\" and Race in Media Coverage of Prescription Opioid Misuse\".\n",
"Sentence number 305 : Cult Med Psychiatry.\n",
"Sentence number 306 : 40 (4): 664–686.\n",
"Jump up ^\n",
"Sentence number 307 : \"Major Science Report Lays Out a Plan to Tamp Down Opioid Crisis\", Scientific American, July 13, 2017\n",
"^\n",
"Sentence number 308 : Jump up to: a b Veilleux, Jennifer.\n",
"Sentence number 309 : \"A Review of Opioid Dependence Treatment: Pharmacological and Psychosocial Interventions to Treat Opioid Addiction\".\n",
"Sentence number 310 : Clinical Psychology Review.\n",
"Sentence number 311 : 30.2: 155–166.\n",
"^\n",
"Sentence number 312 : Jump up to: a b c d e Dixon, David (May 13, 2017).\n",
"Sentence number 313 : \"Opioid Abuse Treatment and Management: Medical Care\".\n",
"Sentence number 314 : Medscape.\n",
"\n",
"Sentence number 315 : ^\n",
"Sentence number 316 : Jump up to: a b \"WHAT ARE MY TREATMENT OPTIONS?\".\n",
"Sentence number 317 : TURN TO HELP.\n",
"Sentence number 318 : June 11, 2017.\n",
"\n",
"Sentence number 319 : ^\n",
"Sentence number 320 : Jump up to: a b \"My View: New approach needed for opioid epidemic\", Portland Tribune, July 25, 2017\n",
"Jump up ^ Buprenorphine, SAMHSA\n",
"Jump up ^\n",
"Sentence number 321 : \"Heroin Abuse Solutions\".\n",
"Sentence number 322 : Narconon New Life Retreat.\n",
"Sentence number 323 : June 12, 2017.\n",
"\n",
"Sentence number 324 : Jump up ^\n",
"Sentence number 325 : \"12 Step Programs for Drug Rehab & Alcohol Treatment\".\n",
"Sentence number 326 : American Addiction Centers.\n",
"Sentence number 327 : June 6, 2017.\n"
]
}
],
"source": [
"for idx, sentence in enumerate(parsed_text.sents):\n",
" print('Sentence number', idx, ':', sentence)"
]
},
{
"cell_type": "markdown",
"metadata": {},
"source": [
"Next, we build up a histogram (as a dictionary) from scratch. A key conceptual thing to be aware of is that tokens are represented as fancy objects with many attributes, and in particular, they aren't just something as simple as a string. However, for the purposes of building up the dictionary, we want to convert the tokens to strings."
]
},
{
"cell_type": "code",
"execution_count": 22,
"metadata": {},
"outputs": [],
"source": [
"histogram = {}\n",
"for token in parsed_text:\n",
" original_token_text = token.orth_ # `token` itself is not a string; `token.orth_` gives the string representation of `token`\n",
" if original_token_text not in histogram: # if the token text is not already a key in the dictionary, create it and set its value to 1\n",
" histogram[original_token_text] = 1\n",
" else: # the token text is already a key in the dictionary so increase its value by 1\n",
" histogram[original_token_text] += 1\n"
]
},
{
"cell_type": "code",
"execution_count": 23,
"metadata": {},
"outputs": [
{
"name": "stdout",
"output_type": "stream",
"text": [
"{'The': 36, 'opioid': 67, 'epidemic': 19, 'or': 23, 'crisis': 15, 'is': 49, 'the': 224, 'rapid': 2, 'increase': 4, 'in': 113, 'use': 17, 'of': 152, 'prescription': 20, 'and': 142, 'non': 3, '-': 66, 'drugs': 17, 'United': 12, 'States': 9, 'Canada': 5, '2010s': 1, '.': 190, 'Opioids': 6, 'are': 26, 'a': 110, 'diverse': 1, 'class': 3, 'moderately': 1, 'strong': 3, 'painkillers': 6, ',': 476, 'including': 7, 'oxycodone': 4, '(': 34, 'commonly': 1, 'sold': 1, 'under': 5, 'trade': 1, 'names': 1, 'OxyContin': 4, 'Percocet': 2, ')': 30, 'hydrocodone': 2, 'Vicodin': 2, 'very': 1, 'painkiller': 5, 'fentanyl': 22, 'which': 26, 'synthesized': 1, 'to': 186, 'resemble': 1, 'other': 8, 'opiates': 4, 'such': 7, 'as': 34, 'opium': 1, 'derived': 1, 'morphine': 4, 'heroin': 36, 'potency': 3, 'availability': 1, 'these': 5, 'substances': 3, 'despite': 1, 'their': 13, 'high': 4, 'risk': 2, 'addiction': 21, 'overdose': 25, 'have': 14, 'made': 7, 'them': 5, 'popular': 1, 'both': 6, 'formal': 2, 'medical': 11, 'treatments': 6, 'recreational': 1, 'Due': 1, 'sedative': 1, 'effects': 1, 'on': 30, 'part': 1, 'brain': 2, 'regulates': 1, 'breathing': 1, 'opioids': 22, 'doses': 2, 'present': 3, 'potential': 5, 'for': 54, 'respiratory': 2, 'depression': 1, 'may': 6, 'cause': 2, 'failure': 1, 'death.[2': 1, ']': 143, '\\n\\n': 39, 'According': 6, 'U.S.': 20, 'Drug': 20, 'Enforcement': 2, 'Administration': 2, '\"': 188, 'deaths': 27, 'particularly': 1, 'from': 38, 'reached': 1, 'levels': 2, '\"[3]:iii': 1, 'Nearly': 1, 'half': 1, 'all': 7, '2016': 35, 'involved': 1, 'opioids.[1': 1, 'From': 3, '1999': 2, '2008': 2, 'death': 7, 'rates': 5, 'sales': 1, 'substance': 2, 'abuse': 12, 'treatment': 19, 'admissions': 1, 'related': 2, 'pain': 12, 'relievers': 3, 'increased': 8, 'substantially.[4': 1, 'By': 5, '2015': 10, 'annual': 1, 'alone': 2, 'surpassed': 2, 'car': 2, 'accidents': 1, 'guns': 2, 'with': 36, 'also': 9, 'rise.[5': 1, 'overdoses': 11, 'since': 6, 'become': 6, 'leading': 2, 'Americans': 9, '50': 5, 'two': 2, 'thirds': 1, 'those': 6, 'opioids.[6': 1, 'In': 48, '62,000': 1, 'died': 7, '19': 1, 'percent': 4, 'more': 27, 'than': 23, 'had': 12, 'killed': 2, 'one': 9, 'year': 4, 'wars': 2, 'Vietnam': 5, 'Iraq': 2, 'combined.[7][6': 1, 'comparison': 2, 'figure': 2, 'was': 24, '16,000': 1, '2010': 9, '4,000': 1, 'Figures': 1, 'June': 15, '2017': 78, 'indicate': 1, 'problem': 3, 'has': 22, 'worsened.[8][9': 1, 'While': 1, 'varied': 1, 'by': 32, 'state,[10': 1, 'public': 5, 'health': 3, 'experts': 2, 'estimate': 1, 'that': 35, 'nationwide': 2, 'over': 11, '500,000': 2, 'people': 17, 'could': 5, 'die': 1, 'next': 2, '10': 5, 'years.[11': 1, 'March': 23, 'Larry': 1, 'Hogan': 3, 'governor': 2, 'Maryland': 5, 'declared': 5, 'state': 6, 'emergency': 6, 'combat': 2, 'epidemic,[12': 1, 'July': 13, 'cited': 2, 'FDA': 7, \"'s\": 17, 'biggest': 3, '\"[13': 1, 'CDC': 17, 'director': 3, 'Thomas': 2, 'Frieden': 3, 'said': 4, 'America': 8, 'awash': 2, ';': 11, 'urgent': 3, 'action': 3, 'critical': 1, '\"[14': 1, 'changed': 1, 'moral': 1, 'social': 2, 'cultural': 1, 'resistance': 1, 'street': 3, 'drug': 43, 'alternatives': 1, 'heroin.[15': 1, 'On': 4, 'August': 5, 'President': 7, 'Donald': 2, 'Trump': 12, 'agreed': 3, 'his': 3, 'Commission': 3, 'report': 5, 'released': 4, 'few': 3, 'weeks': 2, 'earlier': 2, 'country': 4, 'national': 5, '\"[16][17': 2, 'September': 4, '1': 9, 'nominated': 2, 'czar': 2, 'Tom': 3, 'Marino': 6, 'whose': 1, 'election': 2, 'campaign': 1, 'been': 13, 'financed': 1, 'pharmaceutical': 3, 'distribution': 3, 'companies': 4, 'lobbied': 2, 'profited': 1, 'legislation': 2, 'co': 2, 'sponsored': 2, 'protected': 1, 'pharmacies': 3, 'suspected': 3, 'diverting': 2, 'pills.[18': 2, 'Contents': 1, ' ': 1, '[': 3, 'hide': 1, '\\n': 152, ' ': 20, 'Background': 2, '1.1': 1, 'Main': 3, 'causes': 2, '1.2': 1, 'Effects': 1, '1.3': 1, 'Fentanyl': 8, '1.4': 1, 'History': 2, 'opiate': 4, '1.5': 2, 'Demographics': 1, '1.6': 1, 'Outside': 2, '2': 7, 'Countermeasures': 1, '2.1': 1, 'Federal': 2, 'government': 5, '2.2': 1, 'State': 7, 'local': 3, 'governments': 1, '2.3': 1, 'Prescription': 9, 'monitoring': 3, '2.4': 1, 'media': 1, '2.5': 1, 'Solutions': 3, 'addicts': 11, '2.5.1': 1, 'Naloxone': 4, '2.5.2': 1, 'Methadone': 2, '2.5.3': 1, 'Buprenorphine': 3, '2.5.4': 1, 'Behavioral': 2, 'options': 5, '3': 9, 'See': 2, '4': 5, 'References': 1, '5': 4, 'External': 1, 'links': 1, 'States[edit': 2, 'causes[edit': 1, 'What': 2, 'Surgeon': 3, 'General': 4, 'calls': 1, 'Opioid': 30, 'Crisis': 10, 'likely': 4, 'began': 5, 'powerful': 4, '1990s': 2, 'led': 3, 'becoming': 4, 'most': 7, 'prescribed': 10, 'medications': 4, 'As': 7, '289': 1, 'million': 5, 'prescriptions': 10, 'were': 24, 'written': 2, 'per': 11, 'year.[19]:43In': 1, 'late': 2, 'many': 7, 'diagnosed': 1, 'chronic': 2, 'estimated': 2, 'affect': 1, 'around': 3, '100': 5, 'third': 2, 'population': 1, 'This': 8, 'push': 1, 'federal': 2, 'expand': 1, 'painkilling': 1, 'opioids.[10': 1, 'Between': 2, '1991': 2, '2011': 4, 'tripled': 1, '76': 1, '219': 1, 'Among': 3, 'common': 2, 'With': 2, 'volume': 1, '2002': 1, 'six': 4, 'users': 8, 'being': 3, '2012': 3, 'ratio': 1, 'doubled': 1, 'three.[10': 1, 'Despite': 1, 'there': 5, 'no': 2, 'change': 1, 'amount': 3, 'reported': 2, 'U.S.[20][19': 1, 'differing': 1, 'opinions': 1, 'some': 7, 'noting': 1, 'little': 1, 'evidence': 1, 'effective': 5, 'not': 20, 'caused': 2, 'cancer.[21': 1, 'Effects[edit': 1, 'When': 1, 'continue': 1, 'beyond': 1, 'what': 5, 'doctor': 2, 'prescribes': 1, 'whether': 1, 'minimize': 1, 'enjoy': 1, 'euphoric': 1, 'feelings': 1, 'it': 15, 'can': 11, 'mark': 1, 'beginning': 1, 'stages': 1, 'an': 13, 'tolerance': 1, 'developing': 2, 'eventually': 1, 'dependence': 3, 'when': 7, 'person': 6, 'relies': 1, 'prevent': 2, 'withdrawal': 4, 'symptoms.[22': 1, 'number': 6, 'rose': 2, 'cartels': 3, 'flooding': 1, 'For': 3, 'cheaper': 2, 'potent': 4, 'often': 4, 'easier': 2, 'acquire': 1, 'medications.[8': 1, 'tighter': 1, 'policies': 1, 'doctors': 15, 'did': 3, 'necessarily': 1, 'lead': 3, 'this': 5, 'use.[21': 1, 'main': 2, 'suppliers': 3, 'Mexican': 4, 'transnational': 1, 'criminal': 2, 'organizations.[8': 1, '2005–2009': 1, 'production': 1, '600': 2, '%': 6, '8': 4, 'metric': 2, 'tons': 2, '2005': 1, '2009.[8': 1, '2014': 7, 'seized': 2, 'at': 7, 'border': 1, 'doubled.[23': 1, 'DEA': 4, 'smugglers': 1, 'distributors': 2, 'profit': 1, 'primarily': 1, 'putting': 1, 'crucial': 1, '\"[3]:3': 1, '\\n\\n\\n': 1, 'Opiate': 1, 'self': 1, 'injection': 1, 'paraphernalia': 1, 'emerged': 1, 'worst': 1, 'crises': 1, 'American': 6, 'history': 1, ':': 67, '33,000': 1, 'nearly': 3, 'equal': 1, 'crashes': 1, 'gun': 2, 'homicides.[24': 1, 'It': 15, 'left': 1, 'thousands': 2, 'children': 1, 'suddenly': 1, 'need': 2, 'foster': 1, 'care': 3, 'after': 3, 'parents': 2, 'overdose.[25': 1, 'Fentanyl[edit': 1, 'There': 4, 'always': 1, 'help': 6, 'but': 10, 'scale': 1, 'wave': 1, 'unprecedented': 2, 'first': 7, 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'VTDigger': 1, 'deadlier': 1, 'single': 1, 'photo': 1, 'Stat': 1, 'Sept.': 1, '29': 3, 'profile': 1, 'European': 1, 'Monitoring': 1, 'Centre': 2, 'Drugs': 3, 'EMCDDA': 1, 'Preventing': 1, 'Occupational': 1, 'Responders': 1, 'Orlando': 1, 'man': 1, 'pleads': 1, 'guilty': 1, 'mixed': 1, 'Orlando.com': 1, 'Analysis': 1, 'date': 1, 'Coroner': 1, 'Franklin': 1, 'day': 1, 'Columbus': 1, 'Dispatch': 1, '16': 2, 'feds': 1, 'seize': 1, 'kilos': 1, 'dangerous': 1, 'N.J.': 1, 'NJ.com': 1, 'Prince': 2, 'Autopsy': 1, 'Result': 1, 'Highlights': 1, 'Dangers': 1, 'Painkiller': 2, 'ABC': 1, 'Documents': 1, 'highlight': 1, 'struggle': 1, 'Seattle': 1, 'Truly': 1, 'Moghe': 1, 'Sonia': 1, '11': 4, 'WGBH': 1, 'educational': 1, 'foundation': 1, 'Interview': 1, 'Robert': 1, 'Dupoint': 1, 'PBS.org': 1, '18': 2, '1970': 1, 'bbc.co.uk': 1, 'BBC': 1, 'Jane': 1, 'Porter': 1, 'nejm.org': 2, 'Letter': 1, 'Risk': 1, 'Peter': 1, 'Dale': 1, 'Marshall': 1, 'Jonathan': 1, 'Cocaine': 1, 'Politics': 2, 'Armies': 1, 'Central': 1, 'Berkeley': 1, 'CA': 1, 'Press': 3, 'p.': 1, 'Sullivan': 1, 'Andrew': 1, '\"The': 1, 'Is': 2, 'Generation': 1, 'AIDS': 1, 'Magazine': 1, 'brokering': 1, 'exacerbates': 1, 'South': 1, 'Bend': 1, 'Tribune': 3, 'de': 1, 'La': 1, 'Bruyere': 1, 'Emily': 1, 'siege': 1, 'Everyone': 1, 'I': 1, 'Yahoo': 1, 'Vital': 1, 'Signs': 1, 'Variation': 1, 'Relievers': 1, 'Benzodiazepines': 1, 'consume': 1, 'vast': 1, 'world': 1, 'Dina': 1, 'Gusovsky': 1, 'Apr': 1, 'S.': 1, 'Lilian': 1, 'A.': 1, 'Ghandour': 1, 'Nonmedical': 1, 'adolescents': 1, 'adults': 1, 'Western': 1, 'phenomenon': 1, 'Psychiatry': 2, 'Jan.': 1, 'Poll': 1, 'Many': 1, 'Utahns': 1, 'barriers': 1, 'Salt': 1, 'Lake': 1, 'Death': 1, 'Rates': 1, '12': 3, 'Government': 1, 'Publishing': 1, '4pp': 1, 'Tackling': 1, 'Public': 1, 'Health': 3, 'College': 1, 'Physicians': 1, 'Surgeons': 1, 'Ontario': 1, 'Do': 1, 'No': 2, 'Harm': 1, 'Responding': 1, 'Canadian': 1, 'Substance': 1, '2013': 1, 'UK': 1, 'Task': 1, 'Force': 1, 'offers': 1, 'ideas': 1, 'Delhidailynews.com': 1, '06': 5, '01': 1, 'Society': 1, 'Mike': 1, 'DeBonis': 1, 'passes': 1, 'boosting': 1, 'easing': 1, 'approvals': 1, 'Juliet': 1, 'Eilperin': 1, '&': 3, 'Carolyn': 1, 'Y.': 1, 'Johnson': 1, 'paying': 1, 'tribute': 1, 'Biden': 1, 'bipartisanship': 1, 'signs': 1, 'Tuesday': 1, 'Set': 1, 'Up': 1, 'NBC': 1, 'Hill': 1, 'Hosts': 1, 'Listening': 1, 'Real': 1, 'Clear': 1, 'Commissioner': 1, 'Announcements': 1, 'requests': 1, 'removal': 1, 'www.fda.gov': 1, 'tap': 1, 'Politico': 1, 'Governors': 1, 'Assoc': 1, 'Rutherford': 1, 'Declares': 1, 'Announces': 2, 'Major': 2, 'Funding': 1, 'Combat': 1, 'Maryland.gov': 1, 'Gov.': 1, 'Of': 1, 'Baltimore': 1, 'lawmakers': 1, 'tackle': 1, 'Newsworks': 1, 'Snyder': 2, 'rolls': 1, 'WILX': 1, 'Efforts': 1, 'stop': 1, 'Radio': 1, 'HB0299': 1, 'le.utah.gov': 1, 'sued': 1, 'counties': 1, 'Lawyer': 1, 'Behind': 1, 'Lawsuit': 1, 'Against': 1, 'Distributors': 1, 'NPR.org': 1, 'City': 1, 'Sues': 1, 'Maker': 1, 'Contributing': 1, 'To': 1, 'NPR': 1, 'Dowell': 1, 'Deborah': 1, 'Haegerich': 1, 'Tamara': 1, 'Chou': 1, 'Roger': 1, 'JAMA': 1, '315': 1, '1624–45': 1, 'PMID': 1, '26977696': 1, 'doi:10.1001': 1, 'jama.2016.1464': 1, 'Missouri': 2, 'final': 1, 'PDMP': 1, 'program': 1, 'Rutkow': 1, 'Lainie': 1, 'et': 1, 'al': 1, 'Most': 1, 'primary': 1, 'Affairs': 1, '34': 1, '):': 2, '484–492': 1, 'doi:10.1377': 1, 'hlthaff.2014.1085': 1, 'Matthew': 1, 'Perrone': 1, 'Associated': 1, 'politics': 1, 'Effort': 1, 'curb': 1, 'fire': 1, 'Ghorayshi': 1, 'Azeen': 1, 'Only': 1, 'Where': 1, 'Doctors': 2, 'Have': 1, 'Idea': 1, 'People': 1, 'Getting': 1, 'BuzzFeed': 1, 'McGinty': 1, 'E.': 1, 'Criminal': 1, 'Activity': 1, 'Treatable': 1, 'Condition': 1, 'Framing': 1, 'Analgesic': 1, 'Psychiatric': 1, 'Services': 1, '67': 1, '405–411': 1, 'Netherland': 1, 'J.': 1, 'That': 1, 'Was': 1, \"n't\": 1, 'Wasted': 1, 'Whiteness': 1, 'Dirty': 1, 'Race': 1, 'Coverage': 1, 'Misuse': 1, 'Cult': 1, 'Med': 1, '664–686': 1, 'Lays': 1, 'Out': 1, 'Plan': 1, 'Tamp': 1, 'Down': 1, 'Scientific': 1, 'Veilleux': 1, 'Jennifer': 1, 'Review': 2, 'Dependence': 1, 'Treatment': 3, 'Pharmacological': 1, 'Psychosocial': 1, 'Interventions': 1, 'Treat': 1, 'Clinical': 1, 'Psychology': 1, '30.2': 1, '155–166': 1, 'Dixon': 1, 'David': 1, 'Management': 1, 'Medical': 1, 'Care': 1, 'Medscape': 1, 'WHAT': 1, 'ARE': 1, 'MY': 1, 'TREATMENT': 1, 'OPTIONS': 1, 'TURN': 1, 'TO': 1, 'HELP': 1, 'My': 1, 'View': 1, 'approach': 1, 'Portland': 1, '25': 1, 'Narconon': 1, 'Life': 1, 'Retreat': 1, 'Step': 1, 'Programs': 1, 'Rehab': 1, 'Alcohol': 1}\n"
]
}
],
"source": [
"print(histogram)"
]
},
{
"cell_type": "markdown",
"metadata": {},
"source": [
"At this point, recall that we can also convey the information contained by a dictionary in terms of a list of tuples:"
]
},
{
"cell_type": "code",
"execution_count": 24,
"metadata": {},
"outputs": [
{
"data": {
"text/plain": [
"[('The', 36),\n",
" ('opioid', 67),\n",
" ('epidemic', 19),\n",
" ('or', 23),\n",
" ('crisis', 15),\n",
" ('is', 49),\n",
" ('the', 224),\n",
" ('rapid', 2),\n",
" ('increase', 4),\n",
" ('in', 113),\n",
" ('use', 17),\n",
" ('of', 152),\n",
" ('prescription', 20),\n",
" ('and', 142),\n",
" ('non', 3),\n",
" ('-', 66),\n",
" ('drugs', 17),\n",
" ('United', 12),\n",
" ('States', 9),\n",
" ('Canada', 5),\n",
" ('2010s', 1),\n",
" ('.', 190),\n",
" ('Opioids', 6),\n",
" ('are', 26),\n",
" ('a', 110),\n",
" ('diverse', 1),\n",
" ('class', 3),\n",
" ('moderately', 1),\n",
" ('strong', 3),\n",
" ('painkillers', 6),\n",
" (',', 476),\n",
" ('including', 7),\n",
" ('oxycodone', 4),\n",
" ('(', 34),\n",
" ('commonly', 1),\n",
" ('sold', 1),\n",
" ('under', 5),\n",
" ('trade', 1),\n",
" ('names', 1),\n",
" ('OxyContin', 4),\n",
" ('Percocet', 2),\n",
" (')', 30),\n",
" ('hydrocodone', 2),\n",
" ('Vicodin', 2),\n",
" ('very', 1),\n",
" ('painkiller', 5),\n",
" ('fentanyl', 22),\n",
" ('which', 26),\n",
" ('synthesized', 1),\n",
" ('to', 186),\n",
" ('resemble', 1),\n",
" ('other', 8),\n",
" ('opiates', 4),\n",
" ('such', 7),\n",
" ('as', 34),\n",
" ('opium', 1),\n",
" ('derived', 1),\n",
" ('morphine', 4),\n",
" ('heroin', 36),\n",
" ('potency', 3),\n",
" ('availability', 1),\n",
" ('these', 5),\n",
" ('substances', 3),\n",
" ('despite', 1),\n",
" ('their', 13),\n",
" ('high', 4),\n",
" ('risk', 2),\n",
" ('addiction', 21),\n",
" ('overdose', 25),\n",
" ('have', 14),\n",
" ('made', 7),\n",
" ('them', 5),\n",
" ('popular', 1),\n",
" ('both', 6),\n",
" ('formal', 2),\n",
" ('medical', 11),\n",
" ('treatments', 6),\n",
" ('recreational', 1),\n",
" ('Due', 1),\n",
" ('sedative', 1),\n",
" ('effects', 1),\n",
" ('on', 30),\n",
" ('part', 1),\n",
" ('brain', 2),\n",
" ('regulates', 1),\n",
" ('breathing', 1),\n",
" ('opioids', 22),\n",
" ('doses', 2),\n",
" ('present', 3),\n",
" ('potential', 5),\n",
" ('for', 54),\n",
" ('respiratory', 2),\n",
" ('depression', 1),\n",
" ('may', 6),\n",
" ('cause', 2),\n",
" ('failure', 1),\n",
" ('death.[2', 1),\n",
" (']', 143),\n",
" ('\\n\\n', 39),\n",
" ('According', 6),\n",
" ('U.S.', 20),\n",
" ('Drug', 20),\n",
" ('Enforcement', 2),\n",
" ('Administration', 2),\n",
" ('\"', 188),\n",
" ('deaths', 27),\n",
" ('particularly', 1),\n",
" ('from', 38),\n",
" ('reached', 1),\n",
" ('levels', 2),\n",
" ('\"[3]:iii', 1),\n",
" ('Nearly', 1),\n",
" ('half', 1),\n",
" ('all', 7),\n",
" ('2016', 35),\n",
" ('involved', 1),\n",
" ('opioids.[1', 1),\n",
" ('From', 3),\n",
" ('1999', 2),\n",
" ('2008', 2),\n",
" ('death', 7),\n",
" ('rates', 5),\n",
" ('sales', 1),\n",
" ('substance', 2),\n",
" ('abuse', 12),\n",
" ('treatment', 19),\n",
" ('admissions', 1),\n",
" ('related', 2),\n",
" ('pain', 12),\n",
" ('relievers', 3),\n",
" ('increased', 8),\n",
" ('substantially.[4', 1),\n",
" ('By', 5),\n",
" ('2015', 10),\n",
" ('annual', 1),\n",
" ('alone', 2),\n",
" ('surpassed', 2),\n",
" ('car', 2),\n",
" ('accidents', 1),\n",
" ('guns', 2),\n",
" ('with', 36),\n",
" ('also', 9),\n",
" ('rise.[5', 1),\n",
" ('overdoses', 11),\n",
" ('since', 6),\n",
" ('become', 6),\n",
" ('leading', 2),\n",
" ('Americans', 9),\n",
" ('50', 5),\n",
" ('two', 2),\n",
" ('thirds', 1),\n",
" ('those', 6),\n",
" ('opioids.[6', 1),\n",
" ('In', 48),\n",
" ('62,000', 1),\n",
" ('died', 7),\n",
" ('19', 1),\n",
" ('percent', 4),\n",
" ('more', 27),\n",
" ('than', 23),\n",
" ('had', 12),\n",
" ('killed', 2),\n",
" ('one', 9),\n",
" ('year', 4),\n",
" ('wars', 2),\n",
" ('Vietnam', 5),\n",
" ('Iraq', 2),\n",
" ('combined.[7][6', 1),\n",
" ('comparison', 2),\n",
" ('figure', 2),\n",
" ('was', 24),\n",
" ('16,000', 1),\n",
" ('2010', 9),\n",
" ('4,000', 1),\n",
" ('Figures', 1),\n",
" ('June', 15),\n",
" ('2017', 78),\n",
" ('indicate', 1),\n",
" ('problem', 3),\n",
" ('has', 22),\n",
" ('worsened.[8][9', 1),\n",
" ('While', 1),\n",
" ('varied', 1),\n",
" ('by', 32),\n",
" ('state,[10', 1),\n",
" ('public', 5),\n",
" ('health', 3),\n",
" ('experts', 2),\n",
" ('estimate', 1),\n",
" ('that', 35),\n",
" ('nationwide', 2),\n",
" ('over', 11),\n",
" ('500,000', 2),\n",
" ('people', 17),\n",
" ('could', 5),\n",
" ('die', 1),\n",
" ('next', 2),\n",
" ('10', 5),\n",
" ('years.[11', 1),\n",
" ('March', 23),\n",
" ('Larry', 1),\n",
" ('Hogan', 3),\n",
" ('governor', 2),\n",
" ('Maryland', 5),\n",
" ('declared', 5),\n",
" ('state', 6),\n",
" ('emergency', 6),\n",
" ('combat', 2),\n",
" ('epidemic,[12', 1),\n",
" ('July', 13),\n",
" ('cited', 2),\n",
" ('FDA', 7),\n",
" (\"'s\", 17),\n",
" ('biggest', 3),\n",
" ('\"[13', 1),\n",
" ('CDC', 17),\n",
" ('director', 3),\n",
" ('Thomas', 2),\n",
" ('Frieden', 3),\n",
" ('said', 4),\n",
" ('America', 8),\n",
" ('awash', 2),\n",
" (';', 11),\n",
" ('urgent', 3),\n",
" ('action', 3),\n",
" ('critical', 1),\n",
" ('\"[14', 1),\n",
" ('changed', 1),\n",
" ('moral', 1),\n",
" ('social', 2),\n",
" ('cultural', 1),\n",
" ('resistance', 1),\n",
" ('street', 3),\n",
" ('drug', 43),\n",
" ('alternatives', 1),\n",
" ('heroin.[15', 1),\n",
" ('On', 4),\n",
" ('August', 5),\n",
" ('President', 7),\n",
" ('Donald', 2),\n",
" ('Trump', 12),\n",
" ('agreed', 3),\n",
" ('his', 3),\n",
" ('Commission', 3),\n",
" ('report', 5),\n",
" ('released', 4),\n",
" ('few', 3),\n",
" ('weeks', 2),\n",
" ('earlier', 2),\n",
" ('country', 4),\n",
" ('national', 5),\n",
" ('\"[16][17', 2),\n",
" ('September', 4),\n",
" ('1', 9),\n",
" ('nominated', 2),\n",
" ('czar', 2),\n",
" ('Tom', 3),\n",
" ('Marino', 6),\n",
" ('whose', 1),\n",
" ('election', 2),\n",
" ('campaign', 1),\n",
" ('been', 13),\n",
" ('financed', 1),\n",
" ('pharmaceutical', 3),\n",
" ('distribution', 3),\n",
" ('companies', 4),\n",
" ('lobbied', 2),\n",
" ('profited', 1),\n",
" ('legislation', 2),\n",
" ('co', 2),\n",
" ('sponsored', 2),\n",
" ('protected', 1),\n",
" ('pharmacies', 3),\n",
" ('suspected', 3),\n",
" ('diverting', 2),\n",
" ('pills.[18', 2),\n",
" ('Contents', 1),\n",
" (' ', 1),\n",
" ('[', 3),\n",
" ('hide', 1),\n",
" ('\\n', 152),\n",
" (' ', 20),\n",
" ('Background', 2),\n",
" ('1.1', 1),\n",
" ('Main', 3),\n",
" ('causes', 2),\n",
" ('1.2', 1),\n",
" ('Effects', 1),\n",
" ('1.3', 1),\n",
" ('Fentanyl', 8),\n",
" ('1.4', 1),\n",
" ('History', 2),\n",
" ('opiate', 4),\n",
" ('1.5', 2),\n",
" ('Demographics', 1),\n",
" ('1.6', 1),\n",
" ('Outside', 2),\n",
" ('2', 7),\n",
" ('Countermeasures', 1),\n",
" ('2.1', 1),\n",
" ('Federal', 2),\n",
" ('government', 5),\n",
" ('2.2', 1),\n",
" ('State', 7),\n",
" ('local', 3),\n",
" ('governments', 1),\n",
" ('2.3', 1),\n",
" ('Prescription', 9),\n",
" ('monitoring', 3),\n",
" ('2.4', 1),\n",
" ('media', 1),\n",
" ('2.5', 1),\n",
" ('Solutions', 3),\n",
" ('addicts', 11),\n",
" ('2.5.1', 1),\n",
" ('Naloxone', 4),\n",
" ('2.5.2', 1),\n",
" ('Methadone', 2),\n",
" ('2.5.3', 1),\n",
" ('Buprenorphine', 3),\n",
" ('2.5.4', 1),\n",
" ('Behavioral', 2),\n",
" ('options', 5),\n",
" ('3', 9),\n",
" ('See', 2),\n",
" ('4', 5),\n",
" ('References', 1),\n",
" ('5', 4),\n",
" ('External', 1),\n",
" ('links', 1),\n",
" ('States[edit', 2),\n",
" ('causes[edit', 1),\n",
" ('What', 2),\n",
" ('Surgeon', 3),\n",
" ('General', 4),\n",
" ('calls', 1),\n",
" ('Opioid', 30),\n",
" ('Crisis', 10),\n",
" ('likely', 4),\n",
" ('began', 5),\n",
" ('powerful', 4),\n",
" ('1990s', 2),\n",
" ('led', 3),\n",
" ('becoming', 4),\n",
" ('most', 7),\n",
" ('prescribed', 10),\n",
" ('medications', 4),\n",
" ('As', 7),\n",
" ('289', 1),\n",
" ('million', 5),\n",
" ('prescriptions', 10),\n",
" ('were', 24),\n",
" ('written', 2),\n",
" ('per', 11),\n",
" ('year.[19]:43In', 1),\n",
" ('late', 2),\n",
" ('many', 7),\n",
" ('diagnosed', 1),\n",
" ('chronic', 2),\n",
" ('estimated', 2),\n",
" ('affect', 1),\n",
" ('around', 3),\n",
" ('100', 5),\n",
" ('third', 2),\n",
" ('population', 1),\n",
" ('This', 8),\n",
" ('push', 1),\n",
" ('federal', 2),\n",
" ('expand', 1),\n",
" ('painkilling', 1),\n",
" ('opioids.[10', 1),\n",
" ('Between', 2),\n",
" ('1991', 2),\n",
" ('2011', 4),\n",
" ('tripled', 1),\n",
" ('76', 1),\n",
" ('219', 1),\n",
" ('Among', 3),\n",
" ('common', 2),\n",
" ('With', 2),\n",
" ('volume', 1),\n",
" ('2002', 1),\n",
" ('six', 4),\n",
" ('users', 8),\n",
" ('being', 3),\n",
" ('2012', 3),\n",
" ('ratio', 1),\n",
" ('doubled', 1),\n",
" ('three.[10', 1),\n",
" ('Despite', 1),\n",
" ('there', 5),\n",
" ('no', 2),\n",
" ('change', 1),\n",
" ('amount', 3),\n",
" ('reported', 2),\n",
" ('U.S.[20][19', 1),\n",
" ('differing', 1),\n",
" ('opinions', 1),\n",
" ('some', 7),\n",
" ('noting', 1),\n",
" ('little', 1),\n",
" ('evidence', 1),\n",
" ('effective', 5),\n",
" ('not', 20),\n",
" ('caused', 2),\n",
" ('cancer.[21', 1),\n",
" ('Effects[edit', 1),\n",
" ('When', 1),\n",
" ('continue', 1),\n",
" ('beyond', 1),\n",
" ('what', 5),\n",
" ('doctor', 2),\n",
" ('prescribes', 1),\n",
" ('whether', 1),\n",
" ('minimize', 1),\n",
" ('enjoy', 1),\n",
" ('euphoric', 1),\n",
" ('feelings', 1),\n",
" ('it', 15),\n",
" ('can', 11),\n",
" ('mark', 1),\n",
" ('beginning', 1),\n",
" ('stages', 1),\n",
" ('an', 13),\n",
" ('tolerance', 1),\n",
" ('developing', 2),\n",
" ('eventually', 1),\n",
" ('dependence', 3),\n",
" ('when', 7),\n",
" ('person', 6),\n",
" ('relies', 1),\n",
" ('prevent', 2),\n",
" ('withdrawal', 4),\n",
" ('symptoms.[22', 1),\n",
" ('number', 6),\n",
" ('rose', 2),\n",
" ('cartels', 3),\n",
" ('flooding', 1),\n",
" ('For', 3),\n",
" ('cheaper', 2),\n",
" ('potent', 4),\n",
" ('often', 4),\n",
" ('easier', 2),\n",
" ('acquire', 1),\n",
" ('medications.[8', 1),\n",
" ('tighter', 1),\n",
" ('policies', 1),\n",
" ('doctors', 15),\n",
" ('did', 3),\n",
" ('necessarily', 1),\n",
" ('lead', 3),\n",
" ('this', 5),\n",
" ('use.[21', 1),\n",
" ('main', 2),\n",
" ('suppliers', 3),\n",
" ('Mexican', 4),\n",
" ('transnational', 1),\n",
" ('criminal', 2),\n",
" ('organizations.[8', 1),\n",
" ('2005–2009', 1),\n",
" ('production', 1),\n",
" ('600', 2),\n",
" ('%', 6),\n",
" ('8', 4),\n",
" ('metric', 2),\n",
" ('tons', 2),\n",
" ('2005', 1),\n",
" ('2009.[8', 1),\n",
" ('2014', 7),\n",
" ('seized', 2),\n",
" ('at', 7),\n",
" ('border', 1),\n",
" ('doubled.[23', 1),\n",
" ('DEA', 4),\n",
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" ('military', 1),\n",
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" ('Hampshire', 1),\n",
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" ('West', 4),\n",
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" ('Demographics[edit', 1),\n",
" ('mostly', 3),\n",
" ('working', 2),\n",
" ('Geographically', 1),\n",
" ('living', 1),\n",
" ('rural', 2),\n",
" ('areas', 1),\n",
" ('hardest', 1),\n",
" ('hit', 3),\n",
" ('percentage', 1),\n",
" ('population,[43', 1),\n",
" ('teenagers', 2),\n",
" ('especially', 1),\n",
" ('12-', 1),\n",
" ('17', 4),\n",
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" ('2006', 1),\n",
" ('Teens', 1),\n",
" ('any', 3),\n",
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" ('methamphetamine', 1),\n",
" ('combined', 2),\n",
" ('Office', 4),\n",
" ('National', 7),\n",
" ('Policy', 3),\n",
" ('’s', 7),\n",
" ('Report', 4),\n",
" ('Danger', 1),\n",
" ('Palm', 1),\n",
" ('Beach', 1),\n",
" ('County', 3),\n",
" ('Florida', 2),\n",
" ('went', 1),\n",
" ('149', 1),\n",
" ('588', 1),\n",
" ('2016.[44', 1),\n",
" ('Middletown', 2),\n",
" ('15', 7),\n",
" ('years', 1),\n",
" ('2000.[45', 1),\n",
" ('difference', 1),\n",
" ('different', 2),\n",
" ('Hawaii', 1),\n",
" ('52', 1),\n",
" ('every', 2),\n",
" ('whereas', 1),\n",
" ('Alabama', 1),\n",
" ('143', 1),\n",
" ('Researchers', 1),\n",
" ('suspect', 1),\n",
" ('variation', 1),\n",
" ('results', 2),\n",
" ('lack', 1),\n",
" ('consensus', 1),\n",
" ('how', 3),\n",
" ('medication', 4),\n",
" ('prescribe', 2),\n",
" ('does', 2),\n",
" ('better', 5),\n",
" ('outcomes', 1),\n",
" ('patient', 2),\n",
" ('satisfaction', 1),\n",
" ('according', 2),\n",
" ('studies.[8', 1),\n",
" ('U.S.[edit', 1),\n",
" ('Approximately', 1),\n",
" ('80', 2),\n",
" ('global', 1),\n",
" ('supply', 1),\n",
" ...]"
]
},
"execution_count": 24,
"metadata": {},
"output_type": "execute_result"
}
],
"source": [
"list(histogram.items())"
]
},
{
"cell_type": "markdown",
"metadata": {},
"source": [
"Working with a dictionary (rather than a list of tuples) can be beneficial when we want fast access to, in this case, the specific raw count for a word of interest. For example, if we wanted to know how many times the word \"opioid\" appears, we can write `histogram['opioid']`, whereas if we only had the list of tuples, we would have to do a for loop over the list to find where the word `opioid` appears before we can output its count."
]
},
{
"cell_type": "markdown",
"metadata": {},
"source": [
"Representing the tokens and their counts in terms of a list of tuples is useful if we want to sort the tokens by their raw counts in decreasing order. We do this next:"
]
},
{
"cell_type": "code",
"execution_count": 25,
"metadata": {},
"outputs": [],
"source": [
"from operator import itemgetter\n",
"\n",
"sorted_token_count_pairs = sorted(histogram.items(),\n",
" reverse=True,\n",
" key=itemgetter(1))\n",
"# Some notes:\n",
"# - reverse=True tells Python to sort in reverse order, so largest to smallest rather than smallest to largest\n",
"# - itemgetter(1) says that we should sort by the 1-st entry of each tuple (recall that Python starts counting\n",
"# from the 0th entry); here the tuples are of the form (token, raw count)\n",
"# - if you're familiar with the Python `lambda` function for creating anonymous functions, `itemgetter(1)` is\n",
"# the same as `lambda x: x[1]`"
]
},
{
"cell_type": "code",
"execution_count": 26,
"metadata": {},
"outputs": [
{
"data": {
"text/plain": [
"[(',', 476),\n",
" ('the', 224),\n",
" ('.', 190),\n",
" ('\"', 188),\n",
" ('to', 186),\n",
" ('of', 152),\n",
" ('\\n', 152),\n",
" (']', 143),\n",
" ('and', 142),\n",
" ('in', 113),\n",
" ('a', 110),\n",
" ('up', 89),\n",
" ('^', 87),\n",
" ('Jump', 87),\n",
" ('2017', 78),\n",
" ('opioid', 67),\n",
" (':', 67),\n",
" ('-', 66),\n",
" ('for', 54),\n",
" ('is', 49),\n",
" ('In', 48),\n",
" ('drug', 43),\n",
" ('\\n\\n', 39),\n",
" ('from', 38),\n",
" ('The', 36),\n",
" ('heroin', 36),\n",
" ('with', 36),\n",
" ('2016', 35),\n",
" ('that', 35),\n",
" ('(', 34),\n",
" ('as', 34),\n",
" ('by', 32),\n",
" (')', 30),\n",
" ('on', 30),\n",
" ('Opioid', 30),\n",
" ('b', 28),\n",
" ('deaths', 27),\n",
" ('more', 27),\n",
" ('are', 26),\n",
" ('which', 26),\n",
" ('overdose', 25),\n",
" ('was', 24),\n",
" ('were', 24),\n",
" ('or', 23),\n",
" ('than', 23),\n",
" ('March', 23),\n",
" ('fentanyl', 22),\n",
" ('opioids', 22),\n",
" ('has', 22),\n",
" ('addiction', 21),\n",
" ('prescription', 20),\n",
" ('U.S.', 20),\n",
" ('Drug', 20),\n",
" (' ', 20),\n",
" ('not', 20),\n",
" ('epidemic', 19),\n",
" ('treatment', 19),\n",
" ('use', 17),\n",
" ('drugs', 17),\n",
" ('people', 17),\n",
" (\"'s\", 17),\n",
" ('CDC', 17),\n",
" ('be', 17),\n",
" ('Retrieved', 17),\n",
" ('crisis', 15),\n",
" ('June', 15),\n",
" ('it', 15),\n",
" ('doctors', 15),\n",
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" ('they', 13),\n",
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" ('pain', 12),\n",
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" ('Trump', 12),\n",
" ('New', 12),\n",
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" ('over', 11),\n",
" (';', 11),\n",
" ('addicts', 11),\n",
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" ('2015', 10),\n",
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" ('100,000', 6),\n",
" ('News', 6),\n",
" ('d', 6),\n",
" ('e', 6),\n",
" ('27', 6),\n",
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" ('under', 5),\n",
" ('painkiller', 5),\n",
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" ('them', 5),\n",
" ('potential', 5),\n",
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{
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]
}
],
"source": [
"for token, count in sorted_token_count_pairs:\n",
" print(token, \":\", count)"
]
},
{
"cell_type": "markdown",
"metadata": {},
"source": [
"You should see that the most frequently occurring tokens are punctuation or words that should be stop words. We will look at how to remove these shortly."
]
},
{
"cell_type": "markdown",
"metadata": {},
"source": [
"A more concise way to write the code to build up the histogram is to use Python's `Counter` object. A `Counter` object is a fancier dictionary that lets you not have to explicitly account for keys that are not already in the counter. In particular, missing keys are assumed to have count 0. Moreover, it has a `most_common()` function that does the sorting for you."
]
},
{
"cell_type": "code",
"execution_count": 28,
"metadata": {},
"outputs": [
{
"name": "stdout",
"output_type": "stream",
"text": [
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"the : 224\n",
". : 190\n",
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"\n",
" : 152\n",
"] : 143\n",
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": : 67\n",
"- : 66\n",
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"\n",
"\n",
" : 39\n",
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"( : 34\n",
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") : 30\n",
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" : 20\n",
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"' : 8\n",
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"? : 6\n",
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"e : 6\n",
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"report : 5\n",
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"effective : 5\n",
"what : 5\n",
"this : 5\n",
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"Centers : 5\n",
"rate : 5\n",
"pills : 5\n",
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"better : 5\n",
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"allow : 5\n",
"methadone : 5\n",
"Feb. : 5\n",
"06 : 5\n",
"increase : 4\n",
"oxycodone : 4\n",
"OxyContin : 4\n",
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"released : 4\n",
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"companies : 4\n",
"opiate : 4\n",
"Naloxone : 4\n",
"5 : 4\n",
"General : 4\n",
"likely : 4\n",
"powerful : 4\n",
"becoming : 4\n",
"medications : 4\n",
"2011 : 4\n",
"six : 4\n",
"withdrawal : 4\n",
"potent : 4\n",
"often : 4\n",
"Mexican : 4\n",
"8 : 4\n",
"DEA : 4\n",
"There : 4\n",
"months : 4\n",
"times : 4\n",
"30 : 4\n",
"if : 4\n",
"while : 4\n",
"Disease : 4\n",
"Prevention : 4\n",
"know : 4\n",
"14 : 4\n",
"Ohio : 4\n",
"STAT : 4\n",
"each : 4\n",
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"long : 4\n",
"illegal : 4\n",
"letter : 4\n",
"published : 4\n",
"Journal : 4\n",
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"1980 : 4\n",
"states : 4\n",
"West : 4\n",
"17 : 4\n",
"new : 4\n",
"Office : 4\n",
"Report : 4\n",
"medication : 4\n",
"less : 4\n",
"found : 4\n",
"December : 4\n",
"risks : 4\n",
"Emergency : 4\n",
"allowing : 4\n",
"’ : 4\n",
"behavioral : 4\n",
"07 : 4\n",
"– : 4\n",
"Dec. : 4\n",
"Times : 4\n",
"Epidemic : 4\n",
"23 : 4\n",
"11 : 4\n",
"non : 3\n",
"class : 3\n",
"strong : 3\n",
"potency : 3\n",
"substances : 3\n",
"present : 3\n",
"From : 3\n",
"relievers : 3\n",
"problem : 3\n",
"health : 3\n",
"Hogan : 3\n",
"biggest : 3\n",
"director : 3\n",
"Frieden : 3\n",
"urgent : 3\n",
"action : 3\n",
"street : 3\n",
"agreed : 3\n",
"his : 3\n",
"Commission : 3\n",
"few : 3\n",
"Tom : 3\n",
"pharmaceutical : 3\n",
"distribution : 3\n",
"pharmacies : 3\n",
"suspected : 3\n",
"[ : 3\n",
"Main : 3\n",
"local : 3\n",
"monitoring : 3\n",
"Solutions : 3\n",
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"— : 3\n",
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"26977696 : 1\n",
"doi:10.1001 : 1\n",
"jama.2016.1464 : 1\n",
"final : 1\n",
"PDMP : 1\n",
"program : 1\n",
"Rutkow : 1\n",
"Lainie : 1\n",
"et : 1\n",
"al : 1\n",
"Most : 1\n",
"primary : 1\n",
"Affairs : 1\n",
"34 : 1\n",
"484–492 : 1\n",
"doi:10.1377 : 1\n",
"hlthaff.2014.1085 : 1\n",
"Matthew : 1\n",
"Perrone : 1\n",
"Associated : 1\n",
"politics : 1\n",
"Effort : 1\n",
"curb : 1\n",
"fire : 1\n",
"Ghorayshi : 1\n",
"Azeen : 1\n",
"Only : 1\n",
"Where : 1\n",
"Have : 1\n",
"Idea : 1\n",
"People : 1\n",
"Getting : 1\n",
"BuzzFeed : 1\n",
"McGinty : 1\n",
"E. : 1\n",
"Criminal : 1\n",
"Activity : 1\n",
"Treatable : 1\n",
"Condition : 1\n",
"Framing : 1\n",
"Analgesic : 1\n",
"Psychiatric : 1\n",
"Services : 1\n",
"67 : 1\n",
"405–411 : 1\n",
"Netherland : 1\n",
"J. : 1\n",
"That : 1\n",
"Was : 1\n",
"n't : 1\n",
"Wasted : 1\n",
"Whiteness : 1\n",
"Dirty : 1\n",
"Race : 1\n",
"Coverage : 1\n",
"Misuse : 1\n",
"Cult : 1\n",
"Med : 1\n",
"664–686 : 1\n",
"Lays : 1\n",
"Out : 1\n",
"Plan : 1\n",
"Tamp : 1\n",
"Down : 1\n",
"Scientific : 1\n",
"Veilleux : 1\n",
"Jennifer : 1\n",
"Dependence : 1\n",
"Pharmacological : 1\n",
"Psychosocial : 1\n",
"Interventions : 1\n",
"Treat : 1\n",
"Clinical : 1\n",
"Psychology : 1\n",
"30.2 : 1\n",
"155–166 : 1\n",
"Dixon : 1\n",
"David : 1\n",
"Management : 1\n",
"Medical : 1\n",
"Care : 1\n",
"Medscape : 1\n",
"WHAT : 1\n",
"ARE : 1\n",
"MY : 1\n",
"TREATMENT : 1\n",
"OPTIONS : 1\n",
"TURN : 1\n",
"TO : 1\n",
"HELP : 1\n",
"My : 1\n",
"View : 1\n",
"approach : 1\n",
"Portland : 1\n",
"25 : 1\n",
"Narconon : 1\n",
"Life : 1\n",
"Retreat : 1\n",
"Step : 1\n",
"Programs : 1\n",
"Rehab : 1\n",
"Alcohol : 1\n"
]
}
],
"source": [
"from collections import Counter\n",
"\n",
"histogram = Counter()\n",
"for token in parsed_text:\n",
" original_token_text = token.orth_\n",
" histogram[original_token_text] += 1\n",
" # note: a shorter way to write the line above is: histogram[original_token_text] += 1\n",
"\n",
"sorted_token_count_pairs = histogram.most_common()\n",
"for token, count in sorted_token_count_pairs:\n",
" print(token, \":\", count)"
]
},
{
"cell_type": "markdown",
"metadata": {},
"source": [
"Now we build a histogram using only tokens that are not stop words, not punctuation, and not spaces. Moreover, what we actually add to the histogram is the lemma of a token and not the token itself."
]
},
{
"cell_type": "code",
"execution_count": 29,
"metadata": {
"scrolled": true
},
"outputs": [
{
"name": "stdout",
"output_type": "stream",
"text": [
"opioid : 123\n",
"jump : 87\n",
"drug : 82\n",
"2017 : 78\n",
"heroin : 44\n",
"overdose : 42\n",
"prescription : 39\n",
"addiction : 36\n",
"death : 35\n",
"2016 : 35\n",
"use : 33\n",
"fentanyl : 30\n",
"treatment : 29\n",
"- : 27\n",
"crisis : 26\n",
"epidemic : 23\n",
"march : 23\n",
"u.s. : 20\n",
"abuse : 20\n",
"state : 19\n",
"doctor : 19\n",
"people : 18\n",
"cdc : 17\n",
"new : 17\n",
"retrieve : 16\n",
"increase : 15\n",
"pain : 15\n",
"june : 15\n",
"patient : 15\n",
"b : 15\n",
"july : 13\n",
"addict : 13\n",
"united : 12\n",
"medical : 12\n",
"trump : 12\n",
"report : 12\n",
"national : 12\n",
"prescribe : 12\n",
"painkiller : 11\n",
"include : 11\n",
"rate : 11\n",
"time : 11\n",
"allow : 11\n",
"c : 11\n",
"opiate : 10\n",
"2015 : 10\n",
"emergency : 10\n",
"washington : 10\n",
"states : 9\n",
"lead : 9\n",
"2010 : 9\n",
"declare : 9\n",
"1 : 9\n",
"3 : 9\n",
"user : 9\n",
"help : 9\n",
"act : 9\n",
"april : 9\n",
"13 : 9\n",
"accord : 8\n",
"americans : 8\n",
"die : 8\n",
"america : 8\n",
"buprenorphine : 8\n",
"medication : 8\n",
"find : 8\n",
"control : 8\n",
"know : 8\n",
"program : 8\n",
"post : 8\n",
"high : 7\n",
"risk : 7\n",
"war : 7\n",
"fda : 7\n",
"president : 7\n",
"2 : 7\n",
"government : 7\n",
"naloxone : 7\n",
"methadone : 7\n",
"begin : 7\n",
"2014 : 7\n",
"american : 7\n",
"white : 7\n",
"turn : 7\n",
"news : 7\n",
"15 : 7\n",
"receptor : 7\n",
"substance : 6\n",
"cause : 6\n",
"kill : 6\n",
"public : 6\n",
"health : 6\n",
"governor : 6\n",
"country : 6\n",
"marino : 6\n",
"pharmaceutical : 6\n",
"behavioral : 6\n",
"option : 6\n",
"million : 6\n",
"effective : 6\n",
"person : 6\n",
"number : 6\n",
"% : 6\n",
"month : 6\n",
"law : 6\n",
"pill : 6\n",
"like : 6\n",
"100,000 : 6\n",
"long : 6\n",
"1980 : 6\n",
"prescribing : 6\n",
"e : 6\n",
"27 : 6\n",
"canada : 5\n",
"present : 5\n",
"potential : 5\n",
"50 : 5\n",
"year : 5\n",
"vietnam : 5\n",
"10 : 5\n",
"maryland : 5\n",
"august : 5\n",
"commission : 5\n",
"company : 5\n",
"main : 5\n",
"4 : 5\n",
"general : 5\n",
"write : 5\n",
"100 : 5\n",
"synthetic : 5\n",
"result : 5\n",
"city : 5\n",
"centers : 5\n",
"prevention : 5\n",
"press : 5\n",
"stat : 5\n",
"world : 5\n",
"letter : 5\n",
"publish : 5\n",
"medicine : 5\n",
"treat : 5\n",
"plan : 5\n",
"feb. : 5\n",
"06 : 5\n",
"class : 4\n",
"strong : 4\n",
"oxycodone : 4\n",
"oxycontin : 4\n",
"morphine : 4\n",
"dose : 4\n",
"enforcement : 4\n",
"administration : 4\n",
"nearly : 4\n",
"gun : 4\n",
"percent : 4\n",
"big : 4\n",
"street : 4\n",
"release : 4\n",
"september : 4\n",
"suspect : 4\n",
"history : 4\n",
"federal : 4\n",
"monitoring : 4\n",
"5 : 4\n",
"likely : 4\n",
"powerful : 4\n",
"chronic : 4\n",
"2011 : 4\n",
"dependence : 4\n",
"withdrawal : 4\n",
"potent : 4\n",
"policy : 4\n",
"mexican : 4\n",
"8 : 4\n",
"dea : 4\n",
"bad : 4\n",
"need : 4\n",
"care : 4\n",
"30 : 4\n",
"deadly : 4\n",
"major : 4\n",
"disease : 4\n",
"14 : 4\n",
"ohio : 4\n",
"illegal : 4\n",
"journal : 4\n",
"group : 4\n",
"contribute : 4\n",
"effort : 4\n",
"west : 4\n",
"17 : 4\n",
"office : 4\n",
"county : 4\n",
"work : 4\n",
"consequence : 4\n",
"sign : 4\n",
"december : 4\n",
"fight : 4\n",
"pass : 4\n",
"physician : 4\n",
"access : 4\n",
"solution : 4\n",
"bind : 4\n",
"center : 4\n",
"07 : 4\n",
"dec. : 4\n",
"times : 4\n",
"23 : 4\n",
"11 : 4\n",
"non : 3\n",
"sell : 3\n",
"potency : 3\n",
"popular : 3\n",
"effect : 3\n",
"sale : 3\n",
"relate : 3\n",
"reliever : 3\n",
"surpass : 3\n",
"figure : 3\n",
"problem : 3\n",
"estimate : 3\n",
"hogan : 3\n",
"combat : 3\n",
"director : 3\n",
"frieden : 3\n",
"urgent : 3\n",
"action : 3\n",
"agree : 3\n",
"early : 3\n",
"tom : 3\n",
"distribution : 3\n",
"pharmacy : 3\n",
"outside : 3\n",
"local : 3\n",
"surgeon : 3\n",
"2012 : 3\n",
"prevent : 3\n",
"rise : 3\n",
"cartel : 3\n",
"flood : 3\n",
"supplier : 3\n",
"criminal : 3\n",
"seize : 3\n",
"distributor : 3\n",
"caldwell : 3\n",
"police : 3\n",
"recommend : 3\n",
"associate : 3\n",
"illegally : 3\n",
"7 : 3\n",
"happen : 3\n",
"columbia : 3\n",
"congress : 3\n",
"addicted : 3\n",
"grow : 3\n",
"house : 3\n",
"england : 3\n",
"january : 3\n",
"crack : 3\n",
"cocaine : 3\n",
"hit : 3\n",
"young : 3\n",
"concern : 3\n",
"university : 3\n",
"start : 3\n",
"safe : 3\n",
"majority : 3\n",
"europe : 3\n",
"survey : 3\n",
"list : 3\n",
"available : 3\n",
"pharmacist : 3\n",
"utah : 3\n",
"disposal : 3\n",
"research : 3\n",
"21st : 3\n",
"century : 3\n",
"cures : 3\n",
"manufacturer : 3\n",
"scott : 3\n",
"michigan : 3\n",
"virginia : 3\n",
"lawsuit : 3\n",
"cost : 3\n",
"guideline : 3\n",
"media : 3\n",
"portray : 3\n",
"reduce : 3\n",
"symptom : 3\n",
"craving : 3\n",
"decrease : 3\n",
"clinic : 3\n",
"step : 3\n",
"mmwr : 3\n",
"/ : 3\n",
"york : 3\n",
"d : 3\n",
"6 : 3\n",
"october : 3\n",
"29 : 3\n",
"tribune : 3\n",
"12 : 3\n",
"& : 3\n",
"rapid : 2\n",
"percocet : 2\n",
"hydrocodone : 2\n",
"vicodin : 2\n",
"despite : 2\n",
"formal : 2\n",
"brain : 2\n",
"respiratory : 2\n",
"reach : 2\n",
"level : 2\n",
"1999 : 2\n",
"2008 : 2\n",
"car : 2\n",
"iraq : 2\n",
"comparison : 2\n",
"expert : 2\n",
"nationwide : 2\n",
"500,000 : 2\n",
"cite : 2\n",
"thomas : 2\n",
"awash : 2\n",
"change : 2\n",
"social : 2\n",
"alternative : 2\n",
"donald : 2\n",
"week : 2\n",
"czar : 2\n",
"election : 2\n",
"campaign : 2\n",
"lobby : 2\n",
"profit : 2\n",
"legislation : 2\n",
"co : 2\n",
"sponsor : 2\n",
"divert : 2\n",
"pills.[18 : 2\n",
"background : 2\n",
"1.5 : 2\n",
"solutions : 2\n",
"states[edit : 2\n",
"1990 : 2\n",
"late : 2\n",
"push : 2\n",
"expand : 2\n",
"1991 : 2\n",
"common : 2\n",
"volume : 2\n",
"differ : 2\n",
"develop : 2\n",
"cheap : 2\n",
"easy : 2\n",
"production : 2\n",
"600 : 2\n",
"metric : 2\n",
"ton : 2\n",
"thousand : 2\n",
"child : 2\n",
"parent : 2\n",
"unprecedented : 2\n",
"christopher : 2\n",
"editor : 2\n",
"weekly : 2\n",
"lethal : 2\n",
"victim : 2\n",
"send : 2\n",
"analysis : 2\n",
"exposure : 2\n",
"lace : 2\n",
"spike : 2\n",
"arrest : 2\n",
"hospitalize : 2\n",
"quadruple : 2\n",
"illicit : 2\n",
"statistic : 2\n",
"31 : 2\n",
"kg : 2\n",
"killer : 2\n",
"identify : 2\n",
"2015.[36 : 2\n",
"look : 2\n",
"painkill : 2\n",
"truly : 2\n",
"thing : 2\n",
"chinese : 2\n",
"lab : 2\n",
"calgary : 2\n",
"california : 2\n",
"home : 2\n",
"return : 2\n",
"wonder : 2\n",
"wide : 2\n",
"ailment : 2\n",
"recognize : 2\n",
"average : 2\n",
"extend : 2\n",
"1970 : 2\n",
"marijuana : 2\n",
"low : 2\n",
"believe : 2\n",
"nejm : 2\n",
"rare : 2\n",
"narcotic : 2\n",
"support : 2\n",
"researcher : 2\n",
"claim : 2\n",
"dr. : 2\n",
"hershel : 2\n",
"jick : 2\n",
"article : 2\n",
"widespread : 2\n",
"h. : 2\n",
"cia : 2\n",
"40 : 2\n",
"rural : 2\n",
"hard : 2\n",
"teenager : 2\n",
"combine : 2\n",
"florida : 2\n",
"middletown : 2\n",
"different : 2\n",
"variation : 2\n",
"80 : 2\n",
"consume : 2\n",
"epidemiologist : 2\n",
"target : 2\n",
"20 : 2\n",
"worldwide : 2\n",
"pandemic : 2\n",
"similar : 2\n",
"section : 2\n",
"prose : 2\n",
"appropriate : 2\n",
"try : 2\n",
"secure : 2\n",
"responsible : 2\n",
"term : 2\n",
"obama : 2\n",
"describe : 2\n",
"deal : 2\n",
"comprehensive : 2\n",
"recovery : 2\n",
"funding : 2\n",
"$ : 2\n",
"26 : 2\n",
"ask : 2\n",
"remove : 2\n",
"form : 2\n",
"opana : 2\n",
"er : 2\n",
"market : 2\n",
"benefit : 2\n",
"outweigh : 2\n",
"commissioner : 2\n",
"gottlieb : 2\n",
"training : 2\n",
"industry : 2\n",
"compact : 2\n",
"end : 2\n",
"response : 2\n",
"delaware : 2\n",
"introduce : 2\n",
"limit : 2\n",
"' : 2\n",
"receive : 2\n",
"session : 2\n",
"rep. : 2\n",
"daily : 2\n",
"day : 2\n",
"seek : 2\n",
"place : 2\n",
"february : 2\n",
"pay : 2\n",
"opioids : 2\n",
"silvia : 2\n",
"martins : 2\n",
"information : 2\n",
"great : 2\n",
"misuse : 2\n",
"share : 2\n",
"nonmedical : 2\n",
"dispense : 2\n",
"chance : 2\n",
"pdmp : 2\n",
"aware : 2\n",
"task : 2\n",
"coverage : 2\n",
"black : 2\n",
"hispanic : 2\n",
"science : 2\n",
"mean : 2\n",
"administer : 2\n",
"block : 2\n",
"taper : 2\n",
"pharmacological : 2\n",
"relapse : 2\n",
"regulated : 2\n",
"pick : 2\n",
"similarly : 2\n",
"samhsa : 2\n",
"residential : 2\n",
"environment : 2\n",
"difficult : 2\n",
"remain : 2\n",
"data : 2\n",
"summary : 2\n",
"oct. : 2\n",
"cbs : 2\n",
"9 : 2\n",
"institute : 2\n",
"cnbc : 2\n",
"prescriptions : 2\n",
"cnn : 2\n",
"datum : 2\n",
"centre : 2\n",
"16 : 2\n",
"prince : 2\n",
"18 : 2\n",
"politics : 2\n",
"psychiatry : 2\n",
"tackle : 2\n",
"idea : 2\n",
"announce : 2\n",
"snyder : 2\n",
"sue : 2\n",
"missouri : 2\n",
"review : 2\n",
"2010s : 1\n",
"diverse : 1\n",
"moderately : 1\n",
"commonly : 1\n",
"trade : 1\n",
"synthesize : 1\n",
"resemble : 1\n",
"opium : 1\n",
"derive : 1\n",
"availability : 1\n",
"recreational : 1\n",
"sedative : 1\n",
"regulate : 1\n",
"breathing : 1\n",
"depression : 1\n",
"failure : 1\n",
"particularly : 1\n",
"half : 1\n",
"involved : 1\n",
"admission : 1\n",
"substantially.[4 : 1\n",
"annual : 1\n",
"accident : 1\n",
"rise.[5 : 1\n",
"62,000 : 1\n",
"19 : 1\n",
"combined.[7][6 : 1\n",
"16,000 : 1\n",
"4,000 : 1\n",
"indicate : 1\n",
"worsened.[8][9 : 1\n",
"vary : 1\n",
"years.[11 : 1\n",
"larry : 1\n",
"critical : 1\n",
"moral : 1\n",
"cultural : 1\n",
"resistance : 1\n",
"heroin.[15 : 1\n",
"nominate : 1\n",
"finance : 1\n",
"protect : 1\n",
"] : 1\n",
"content : 1\n",
"hide : 1\n",
"1.1 : 1\n",
"1.2 : 1\n",
"1.3 : 1\n",
"1.4 : 1\n",
"demographic : 1\n",
"1.6 : 1\n",
"countermeasure : 1\n",
"2.1 : 1\n",
"2.2 : 1\n",
"2.3 : 1\n",
"2.4 : 1\n",
"medium : 1\n",
"2.5 : 1\n",
"2.5.1 : 1\n",
"2.5.2 : 1\n",
"2.5.3 : 1\n",
"2.5.4 : 1\n",
"references : 1\n",
"external : 1\n",
"link : 1\n",
"causes[edit : 1\n",
"prescribed : 1\n",
"289 : 1\n",
"year.[19]:43in : 1\n",
"diagnose : 1\n",
"affect : 1\n",
"population : 1\n",
"painkille : 1\n",
"triple : 1\n",
"76 : 1\n",
"219 : 1\n",
"2002 : 1\n",
"ratio : 1\n",
"double : 1\n",
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"opinion : 1\n",
"note : 1\n",
"little : 1\n",
"evidence : 1\n",
"cancer.[21 : 1\n",
"effects[edit : 1\n",
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"feeling : 1\n",
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"tolerance : 1\n",
"eventually : 1\n",
"rely : 1\n",
"symptoms.[22 : 1\n",
"acquire : 1\n",
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"necessarily : 1\n",
"transnational : 1\n",
"2005–2009 : 1\n",
"2005 : 1\n",
"2009.[8 : 1\n",
"border : 1\n",
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"homicides.[24 : 1\n",
"leave : 1\n",
"suddenly : 1\n",
"foster : 1\n",
"overdose.[25 : 1\n",
"fentanyl[edit : 1\n",
"scale : 1\n",
"wave : 1\n",
"121 : 1\n",
"446 : 1\n",
"senior : 1\n",
"standard[15 : 1\n",
"heroin,[15 : 1\n",
"mg : 1\n",
"pure : 1\n",
"odorless : 1\n",
"flavorless : 1\n",
"responder : 1\n",
"simply : 1\n",
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"inhale : 1\n",
"small : 1\n",
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"officer : 1\n",
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"test : 1\n",
"instead : 1\n",
"collect : 1\n",
"sample : 1\n",
"laboratory : 1\n",
"inhalation : 1\n",
"skin : 1\n",
"absorption : 1\n",
"state.[29 : 1\n",
"philadelphia : 1\n",
"detroit : 1\n",
"obtain : 1\n",
"conceal : 1\n",
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"think : 1\n",
"actually : 1\n",
"involve : 1\n",
"slow : 1\n",
"stream : 1\n",
"dramatically : 1\n",
"critical.[14 : 1\n",
"72 : 1\n",
"2015.[22 : 1\n",
"addition : 1\n",
"total : 1\n",
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]
}
],
"source": [
"from collections import Counter\n",
"\n",
"histogram_with_some_filtering = Counter()\n",
"for token in parsed_text:\n",
" lemma = token.lemma_.lower()\n",
" # there's a part of speech 'X' that stands for \"other\" and consists of mostly junk\n",
" if not (nlp.vocab[lemma].is_stop or token.pos_ == 'PUNCT' or token.pos_ == 'SPACE' or token.pos_ == 'X'):\n",
" histogram_with_some_filtering[lemma] += 1\n",
"\n",
"sorted_lemma_count_pairs = histogram_with_some_filtering.most_common()\n",
"for lemma, count in sorted_lemma_count_pairs:\n",
" print(lemma, \":\", count)"
]
},
{
"cell_type": "code",
"execution_count": 30,
"metadata": {},
"outputs": [],
"source": [
"manual_stop_words = {'jump', 'b', '-', 'c'}"
]
},
{
"cell_type": "code",
"execution_count": 31,
"metadata": {},
"outputs": [],
"source": [
"histogram_filtered_twice = Counter({lemma: count\n",
" for lemma, count in histogram_with_some_filtering.items()\n",
" if lemma not in manual_stop_words})"
]
},
{
"cell_type": "code",
"execution_count": 32,
"metadata": {},
"outputs": [
{
"name": "stdout",
"output_type": "stream",
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"2013 : 1\n",
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"ease : 1\n",
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". : 1\n",
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]
}
],
"source": [
"twice_filtered_sorted_lemma_count_pairs = histogram_filtered_twice.most_common()\n",
"for lemma, count in twice_filtered_sorted_lemma_count_pairs:\n",
" print(lemma, \":\", count)"
]
},
{
"cell_type": "markdown",
"metadata": {},
"source": [
"Finally, we plot the top 20 most frequently occurring lemmas:"
]
},
{
"cell_type": "code",
"execution_count": 33,
"metadata": {},
"outputs": [
{
"name": "stderr",
"output_type": "stream",
"text": [
"/var/folders/ms/yzwxs7r54nx0q978svcpsnbh0000gn/T/ipykernel_85303/2402961951.py:3: MatplotlibDeprecationWarning: The seaborn styles shipped by Matplotlib are deprecated since 3.6, as they no longer correspond to the styles shipped by seaborn. However, they will remain available as 'seaborn-v0_8-<style>'. Alternatively, directly use the seaborn API instead.\n",
" plt.style.use('seaborn') # prettier plots (for example, use 'ggplot' instead of 'seaborn' for plots like in R)\n"
]
},
{
"data": {
"text/plain": [
"Text(0, 0.5, 'Raw count')"
]
},
"execution_count": 33,
"metadata": {},
"output_type": "execute_result"
},
{
"data": {
"image/png": 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"text/plain": [
"<Figure size 800x550 with 1 Axes>"
]
},
"metadata": {
"image/png": {
"height": 544,
"width": 692
}
},
"output_type": "display_data"
}
],
"source": [
"%matplotlib inline\n",
"import matplotlib.pyplot as plt\n",
"plt.style.use('seaborn') # prettier plots (for example, use 'ggplot' instead of 'seaborn' for plots like in R)\n",
"%config InlineBackend.figure_format = 'retina' # if you use a Mac with Retina display\n",
"\n",
"num_top_lemmas_to_plot = 20\n",
"top_lemmas = [lemma for lemma, count in twice_filtered_sorted_lemma_count_pairs[:num_top_lemmas_to_plot]]\n",
"top_counts = [count for lemma, count in twice_filtered_sorted_lemma_count_pairs[:num_top_lemmas_to_plot]]\n",
"plt.bar(range(num_top_lemmas_to_plot), top_counts)\n",
"plt.xticks(range(num_top_lemmas_to_plot), top_lemmas, rotation=90)\n",
"plt.xlabel('Lemma')\n",
"plt.ylabel('Raw count')"
]
}
],
"metadata": {
"kernelspec": {
"display_name": "Python 3 (ipykernel)",
"language": "python",
"name": "python3"
},
"language_info": {
"codemirror_mode": {
"name": "ipython",
"version": 3
},
"file_extension": ".py",
"mimetype": "text/x-python",
"name": "python",
"nbconvert_exporter": "python",
"pygments_lexer": "ipython3",
"version": "3.11.5"
}
},
"nbformat": 4,
"nbformat_minor": 1
}
The opioid epidemic or opioid crisis is the rapid increase in the use of prescription and non-prescription opioid drugs in the United States and Canada in the 2010s. Opioids are a diverse class of moderately strong painkillers, including oxycodone (commonly sold under the trade names OxyContin and Percocet), hydrocodone (Vicodin), and a very strong painkiller, fentanyl, which is synthesized to resemble other opiates such as opium-derived morphine and heroin. The potency and availability of these substances, despite their high risk of addiction and overdose, have made them popular both as formal medical treatments and as recreational drugs. Due to their sedative effects on the part of the brain which regulates breathing, opioids in high doses present the potential for respiratory depression, and may cause respiratory failure and death.[2]
According to the U.S. Drug Enforcement Administration, "overdose deaths, particularly from prescription drugs and heroin, have reached epidemic levels."[3]:iii Nearly half of all opioid overdose deaths in 2016 involved prescription opioids.[1] From 1999 to 2008, overdose death rates, sales, and substance abuse treatment admissions related to opioid pain relievers all increased substantially.[4] By 2015, annual overdose deaths from heroin alone surpassed deaths from both car accidents and guns, with other opioid overdose deaths also on the rise.[5]
Drug overdoses have since become the leading cause of death of Americans under 50, with two-thirds of those deaths from opioids.[6] In 2016, 62,000 Americans died from overdoses, 19 percent more than in 2015, and had killed more Americans in one year than both the wars in Vietnam and Iraq combined.[7][6] By comparison, the figure was 16,000 in 2010, and 4,000 in 1999. Figures from June 2017 indicate the problem has worsened.[8][9] While death rates varied by state,[10] public health experts estimate that nationwide over 500,000 people could die from the epidemic over the next 10 years.[11]
In March 2017, Larry Hogan, the governor of Maryland, declared a state of emergency to combat the opioid epidemic,[12] and in July 2017 opioid addiction was cited as the "FDA's biggest crisis."[13] CDC director Thomas Frieden said that "America is awash in opioids; urgent action is critical."[14] The crisis has changed moral, social, and cultural resistance to street drug alternatives such as heroin.[15] On August 10, 2017, President Donald Trump agreed with his Commission's report released few weeks earlier and declared the country's opioid crisis a "national emergency."[16][17] On September 1, Trump nominated as "drug czar" Tom Marino, whose election campaign had been financed by pharmaceutical distribution companies that had lobbied for, and profited from, legislation co-sponsored by Marino which protected pharmacies suspected of diverting pills.[18]
Contents [hide]
1 Background in the United States
1.1 Main causes
1.2 Effects
1.3 Fentanyl
1.4 History of opiate use in the United States
1.5 Demographics
1.6 Outside the U.S.
2 Countermeasures
2.1 Federal government
2.2 State and local governments
2.3 Prescription drug monitoring
2.4 In the media
2.5 Solutions for addicts
2.5.1 Naloxone
2.5.2 Methadone
2.5.3 Buprenorphine
2.5.4 Behavioral treatment options
3 See also
4 References
5 External links
Background in the United States[edit]
Main causes[edit]
What the U.S. Surgeon General calls "The Opioid Crisis" likely began with over-prescription of powerful opioid pain relievers in the 1990s, which led to them becoming the most prescribed class of medications in the United States. As of 2016 more than 289 million prescriptions were written for opioid drugs per year.[19]:43In the late 1990s, many Americans were diagnosed with chronic pain, estimated to affect around 100 million people or a third of the U.S. population. This led to a push by drug companies and the federal government to expand the use of painkilling opioids.[10] Between 1991 and 2011, painkiller prescriptions in the U.S. tripled from 76 million to 219 million per year. Among the most common opioids prescribed have been oxycodone (OxyContin and Percocet) and hydrocodone (Vicodin). With the increase in volume, potency of opioids also increased. By 2002, one in six drug users were being prescribed drugs more powerful than morphine; by 2012, the ratio had doubled to one-in-three.[10]
Despite the increased use of painkillers, there has been no change in the amount of pain reported in the U.S.[20][19] This has led to differing medical opinions, with some noting that there is little evidence that opioids are effective for chronic pain not caused by cancer.[21]
Effects[edit]
When people continue to use opioids beyond what a doctor prescribes, whether to minimize pain or to enjoy the euphoric feelings, it can mark the beginning stages of an opiate addiction, with a tolerance developing and eventually leading to dependence, when a person relies on the drug to prevent withdrawal symptoms.[22]
As the number of opioid prescriptions rose, drug cartels began flooding the U.S. with heroin. For many opioid users, heroin was cheaper, more potent, and often easier to acquire than prescription medications.[8] According to the CDC, tighter prescription policies by doctors did not necessarily lead to this increased heroin use.[21] The main suppliers of heroin to the U.S. have been Mexican transnational criminal organizations.[8] From 2005–2009, Mexican heroin production increased by over 600%, from an estimated 8 metric tons in 2005 to 50 metric tons in 2009.[8] Between 2010 and 2014, the amount seized at the border more than doubled.[23] According to the DEA, smugglers and distributors "profit primarily by putting drugs on the street and have become crucial to the Mexican cartels."[3]:3
Opiate self-injection paraphernalia
The opioid epidemic has since emerged as one of the worst drug crises in American history: more than 33,000 people died from overdoses in 2015, nearly equal to the number of deaths from car crashes, with deaths from heroin alone more than from gun homicides.[24] It has also left thousands of children suddenly in need of foster care after their parents have died from an overdose.[25]
Fentanyl[edit]
There have always been drug addicts in need of help, but the scale of the present wave of heroin and opioid abuse is unprecedented. In Maryland, the first six months of 2015 saw 121 fentanyl deaths. In the first six months of 2016, the figure rose to 446.
Christopher Caldwell,
senior editor The Weekly Standard[15]
Fentanyl, a newer synthetic opioid painkiller, is 50 to 100 times more potent than morphine and 30 to 50 times more potent than heroin,[15] with only 2 mg becoming a lethal dose. It is pure white, odorless and flavorless, with a potency strong enough that police and first responders helping overdose victims have themselves overdosed by simply touching or inhaling a small amount.[26][27][28] As a result, the DEA has recommended that officers not field test drugs if fentanyl is suspected, but instead collect and send samples to a laboratory for analysis. "Exposure via inhalation or skin absorption can be deadly," they state.[29]
Fentanyl-laced heroin has become a big problem for major cities, including Philadelphia, Detroit and Chicago.[30] Its use has caused a spike in deaths among users of heroin and prescription painkillers, while becoming easier to obtain and conceal. Some arrested or hospitalized users are surprised to find that what they thought was heroin was actually fentanyl.[15] According to CDC director Thomas Frieden:
As overdose deaths involving heroin more than quadrupled since 2010, what was a slow stream of illicit fentanyl, a synthetic opioid 50 to 100 times stronger than morphine, is now a flood, with the amount of the powerful drug seized by law enforcement increasing dramatically. America is awash in opioids; urgent action is critical.[14]
According to the Centers for Disease Control and Prevention (CDC), death rates from synthetic opioids, including fentanyl, increased over 72% from 2014 to 2015.[22] In addition, the CDC reports that the total deaths from opioid overdoses may be under-counted, since they do not include deaths that are associated with synthetic opioids which are used as pain relievers. The CDC presumes[when?] that a large proportion of the increase in deaths is due to illegally-made fentanyl; as the statistics on overdose deaths do not distinguish pharmaceutical fentanyl from illegally-made fentanyl, the actual death rate could therefore be much higher than reported.[31]
Those taking fentanyl-laced heroin are more likely to overdose because they do not know they also are ingesting the more powerful drug.[32] In March 2017, New Jersey police arrested a person possessing nearly 31 pounds (14 kg) of fentanyl (14 kg would yield 7 million lethal doses).[33][34] Among those who died from overdosing on fentanyl was singer Prince.[34][35]
Fentanyl has surpassed heroin as a killer in several locales: in all of 2014 the CDC identified 998 fatal fentanyl overdoses in Ohio, which is the same number of deaths recorded in just the first five months of 2015.[36] In Cleveland, a person was caught selling blue fentanyl pills disguised to look like doses of the milder opioid painkiller oxycodone.[36] The U.S. attorney for Ohio stated:
One of the truly terrifying things is the pills are pressed and dyed to look like oxycodone. If you are using oxycodone and take fentanyl not knowing it is fentanyl, that is an overdose waiting to happen. Each of those pills is a potential overdose death.[36]
In 2016 the medical publication STAT reported that while Mexican cartels are a main source of heroin smuggled into the U.S., Chinese suppliers provide both raw fentanyl and the machinery necessary for its production.[36] In British Columbia, police discovered a lab making 100,000 fentanyl pills each month, which they were shipping to Calgary, Alberta. 90 people in Calgary overdosed on the drug in 2015.[36] In Southern California, a home-operated drug lab with six pill presses was uncovered by federal agents; each machine was capable of producing thousands of pills an hour.[36]
History of opiate use in the United States[edit]
In the early 1900s, as veterans of the First World War were returning home from overseas, there were few options to help relieve pain, and doctors mainly turned to morphine.[37] Opiates soon became known as a wonder drug and were prescribed for a wide array of ailments, even for relatively minor treatments such as cough relief. Beginning around 1920, however, their addictiveness was recognized and not too long afterwards heroin was made an illegal drug.[37] In the Anti-Heroin Act of 1924, the U.S. Congress banned the sale, importation, or manufacture of heroin.
Around World War II, doctors used opiates in lieu of surgery. This made prescriptions for opiates skyrocket.[37] In the 1950s, heroin addiction was known among jazz musicians, but still fairly unknown by average Americans, many of whom saw it as a frightening condition.[15] The fear extended into the 1960s and 1970s, although it became common to hear or read about drugs such as marijuana and psychedelics, which were widely used at rock concerts like Woodstock.[15] Heroin addiction began to make the news when famous people such as Janis Joplin, John Belushi, Jim Morrison and Lenny Bruce, whom most people did not know were addicted, died from overdoses. During and after the Vietnam War, addicted soldiers returned from Vietnam, where heroin was easily bought. Heroin addiction grew within low-income housing projects during the same time period.[15] In 1971, congressmen released an explosive report on the growing heroin epidemic among U.S. servicemen in Vietnam, finding that ten to fifteen percent were addicted to heroin. "The Nixon White House panicked," wrote political editor Christopher Caldwell and declared drug abuse "public enemy number one".[38] By 1973, there were 1.5 overdose deaths per 100,000 people.[15]
In the 1980s, many medical experts did not believe that opioids were addictive. A brief letter published in the New England Journal of Medicine (NEJM) in January 1980, titled "Addiction Rare in Patients Treated with Narcotics", was subsequently cited over 600 times to support this position.[39][40] A group of researchers in Canada claim that the letter may have originated and contributed to the opioid crisis.[39] The NEJM published its rebuttal to the 1980 letter in June 2017, pointing out among other things that the conclusions were based on hospitalized patients only, and not on patients taking the drugs after they were sent home.[41] The original author, Dr. Hershel Jick, has said that he never intended for the article to justify widespread opioid use.[39]
In the mid-to-late 1980s the crack epidemic followed widespread cocaine use in American cities. The death rate was worse, reaching almost 2 per 100,000. In 1982, Vice President George H. W. Bush and his aides began pushing for the involvement of the CIA and the U.S. military in drug interdiction efforts, the so-called War on Drugs.[42] By comparison, as of 2016, the present opioid epidemic is killing on average 10.3 people per 100,000. In some states it is far worse: over 30 per 100,000 in New Hampshire and over 40 per 100,000 in West Virginia.[15]
Demographics[edit]
In the U.S., addiction and overdose victims are mostly white and working-class. Geographically, those living in rural areas of the country have been the hardest hit as a percentage of the national population,[43] Prescription drug abuse has been increasing in teenagers, especially as 12- to 17-year-olds were one-third of all new abusers of prescription drugs in 2006. Teens abuse prescription drugs more than any illicit drug except marijuana, more than cocaine, heroin and methamphetamine combined, per the Office of National Drug Control Policy’s 2008 Report Prescription for Danger.
In Palm Beach County, Florida, overdose deaths went from 149 in 2012 to 588 in 2016.[44]
In Middletown, Ohio, overdose deaths quadrupled in the 15 years since 2000.[45]
There has been a difference in the number of opioid prescriptions written by doctors in different states. In Hawaii, doctors wrote about 52 prescriptions for every 100 people, whereas in Alabama, they wrote almost 143 prescriptions per 100 people. Researchers suspect that the variation results from a lack of consensus among doctors in different states about how much pain medication to prescribe. A higher rate of prescription drug use does not lead to better health outcomes or patient satisfaction, according to studies.[8]
Outside the U.S.[edit]
Approximately 80 percent of the global pharmaceutical opioid supply is consumed in the United States.[47]
It has also become a serious problem outside the U.S., mostly among young adults.[48] The concern not only relates to the drugs themselves, but to the fact that in many countries doctors are less trained about drug addiction, both about its causes or treatment.[20] According to an epidemiologist at Columbia University: "Once pharmaceuticals start targeting other countries and make people feel like opioids are safe, we might see a spike [in opioid abuse]. It worked here. Why wouldn’t it work elsewhere?" [20] The majority of deaths worldwide from overdoses were from either medically prescribed opioids or illegal heroin. In Europe, prescription opioids accounted for three-quarters of overdose deaths among those between ages 15 and 39.[48] Some worry that the epidemic could become a worldwide pandemic if not curtailed.[20] Prescription drug abuse among teenagers in Canada, Australia, and Europe were at rates comparable to U.S. teenagers.[20] In Lebanon and Saudi Arabia, and in parts of China, surveys found that one in ten students had used prescription painkillers for non-medical purposes. Similar high rates of non-medical use were found among the young throughout Europe, including Spain and the United Kingdom.[20]
Countermeasures[edit]
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Federal government[edit]
In 2010, the US government began cracking down on pharmacists and doctors who were over-prescribing opioid pain killers. The unintended consequence of this was that users turned to cheaper but illegal heroin, a significantly more potent opioid, as a substitute,[10] including addicted patients who were denied opioid prescriptions as doctors tried to cut back painkiller drug abuse.[15] A 2017 survey in Utah of heroin users found about 80 percent started with prescription drugs.[49] As a result, by 2015 nationwide deaths from prescription opioids had increased by 15% and for heroin users by 23%.[10][50]
In 2010, the CSA was amended with the Secure and Responsible Drug Disposal Act which allows pharmacies to accept controlled substances from households or long term care facilities in their drug disposal programs or "take-back" programs.[51]
In 2011, the Obama administration released a white paper describing the administration's plan to deal with the crisis. Its concerns have been echoed by numerous medical and government advisory groups around the world.[52][53][54]
In 2016, the U.S. Surgeon General listed statistics which describe the extent of the problem.[19]
In July 2016, President Barack Obama signed into law the Comprehensive Addiction and Recovery Act, which expands opioid addiction treatment with buprenorphine and authorizes millions of dollars in new funding for opioid research and treatment.[55]
In December 2016, the 21st Century Cures Act, which includes $1 billion in state grants to fight the opioid epidemic, was passed by Congress by a wide bipartisan majority (94-5 in the Senate, 392-26 in the House of Representatives),[56] and was signed into law by President Obama.[57]
As of March 2017, President Donald Trump appointed a commission to deal on the epidemic, chaired by Governor Chris Christie of New Jersey.[58][59][60]
In June 2017, the FDA asked the manufacturer to remove its injectable form of oxymorphone (Opana ER) from the US market, because the drug's benefits may no longer outweigh its risks, this being the first time the agency has asked to remove a currently marketed opioid pain medication from sale due to public health consequences of abuse.[61]
In July 2017, FDA commissioner Dr Scott Gottlieb stated that for the first time, pharmacists, nurses, and physicians, would have training made available on appropriate prescribing of opioid medicines, because opioid addiction had become the "FDA's biggest crisis".[13]
On August 10, 2017, President Trump agreed with his Commission's report released few weeks earlier and declared the country's opioid crisis a "national emergency."[16][17]
On September 1, 2017, Trump nominated Representative Tom Marino as director of the Office of National Drug Control Policy, or "drug czar".[62] Pharmaceutical distribution companies had contributed $134,000 to Marino's election campaigns in 2014 and 2016, more than contributions from any other industry. Pharmaceutical distibutors had lobbied for legislation which Marino co-sponsored in 2016, the Ensuring Patient Access and Effective Drug Enforcement Act, which made it harder for the DEA to shut down pharmacies suspected of diverting pills.[18]
State and local governments[edit]
In July 2016, governors of most U.S. states and territories entered into a formal "Compact to Fight Opioid Addiction." They agreed that collective action would be needed to end the opioid crisis, and they would coordinate their responses across all levels of government and the private sector, including opioid manufacturers and doctors.[63]
In March 2017, the Governor of Maryland, as an urgent response to the crisis, declared a State of Emergency to combat the rapid increase in overdoses by increasing and speeding up coordination between the state and local jurisdictions.[64][12] In 2016, about 2,000 people in the state had died from opioid overdoses.[65]
In March 2017, Delaware, which has the 12th-highest overdose death rate in the country, introduced bills to both limit doctors' ability to over-prescribe painkillers and improve access to treatment. In 2015, 228 people had died from overdose, which increased 35%—to 308—in 2016.[66]
In March 2017, a similar plan was begun in Michigan, which introduced the Michigan Automated Prescription System (MAPS), allowing doctors to check when and what painkillers have already been prescribed to a patient, and thereby help keep addicts from switching doctors to receive drugs.[67][68]
During the 2017 General Session of the Utah Legislature, Rep. Edward H. Redd and Sen. Todd Weiler proposed amendments to Utah's involuntary commitment statutes by trying to pass H.B. 299 into law which would allow relatives to petition a court to mandate substance- abuse treatment for adults.[69][49]
In Maine, new laws were imposed which capped the maximum daily strength of prescribed opioids and which limited prescriptions to seven days. But some doctors were then concerned that patients would turn to using street drugs like heroin to extend their use of painkillers.[15]
In West Virginia, which leads the nation in overdose deaths per capita, lawsuits seek to declare drug distribution companies a "public nuisance" in an effort to place accountability upon the drug industry for the costs associated with the epidemic.[70][71]
In February 2017, officials in Everett, Washington filed a lawsuit against the manufacturer of OxyContin for negligence by allowing drugs to be illegally trafficked to residents and failing to prevent it. The city wants the company to pay the costs of handling the crisis.[72]
Prescription drug monitoring[edit]
In 2016, the CDC published its "Guideline for Prescribing Opioids for Chronic Pain", recommending opioids only be used when benefits for pain and function are expected to outweigh risks, and then used at the lowest effective dosage, with avoidance of concurrent opioid and benzodiazepine use whenever possible.[73] Silvia Martins, an epidemiologist at Columbia University, has suggested getting out more information about the risks:
The greater “social acceptance” for using these medications (versus illegal substances) and the misconception that they are “safe” may be contributing factors to their misuse. Hence, a major target for intervention is the general public, including parents and youth, who must be better informed about the negative consequences of sharing with others medications prescribed for their own ailments. Equally important is the improved training of medical practitioners and their staff to better recognize patients at potential risk of developing nonmedical use, and to consider potential alternative treatments as well as closely monitor the medications they dispense to these patients.[48]
As of April 2017, prescription drug monitoring programs (PDMPs) exist in every state.[74] A person on opioids for more than three months has a 15-fold (1,500%) greater chance of becoming addicted.[21] PDMPs allow pharmacists and prescribers to access patients’ prescription histories to identify suspicious use. However, a survey of US physicians published in 2015 found only 53% of doctors used these programs, while 22% were not aware these programs were available.[75] The Centers for Disease Control and Prevention (CDC) was tasked with establishing and publishing a new guideline, and was heavily lobbied.[76][77]
In the media[edit]
Media coverage has largely focused on law-enforcement solutions to the epidemic, which portray the issue as criminal rather than medical.[78] There has been differential reporting on how white suburban or rural addicts of opioids are portrayed compared to black and Hispanic urban addicts, often of heroin, reinforcing stereotypes of drug users and drug-using offenders.[79] In newspapers, white addicts' stories are often given more space, allowing for a longer backstory explaining how they became addicted, and what potential they had before using drugs. Black and Hispanic addicts are more likely to be dehumanized, portrayed criminally, and mentioned more briefly.[79]
In July 2017, a 400-page report by the National Academy of Science presented plans to reduce the addiction crisis, which it said was killing 91 people each day.[80]
Solutions for addicts[edit]
Main article: Drug abuse treatment
The opioid epidemic is often discussed in terms of prevention, but helping those who are already addicts is talked about less frequently.[78] Opioid dependence can lead to a number of consequences like contraction of HIV and overdose. For addicts who wish to treat their addiction, there are two classes of treatment options available: medical and behavioral.[81] Neither is guaranteed to successfully treat opioid addiction. Which, or which combination, is most effective varies from person to person.[82] These treatments are doctor-prescribed and -regulated, but differ in their treatment mechanism. Popular treatments include naloxone, methadone, and buprenorphine, which are more effective when combined with a form of behavioral treatment.[82]
Naloxone[edit]
Naloxone is used mostly as a rescue medication for opioid overdose. It is an opioid antagonist, meaning it binds to opioid receptors but does not turn them on. It also happens that naloxone binds to opioid receptors more strongly than heroin or any prescription opioids. This means that when someone is overdosing on opioids, naloxone can be administered, allowing it to take the place of the opioid drug in the person's receptors, turning them off. This blocks the effect of the receptors. Naloxone is sometimes administered with other drugs such as buprenorphine, as a way to taper off buprenorphine over time. Naloxone binds to some of the receptors, blocking the effectiveness of some receptors in case of relapse.[82]
Methadone[edit]
Methadone has been used for opioid dependence since 1964, and studied the most of the pharmacological treatment options.[83] It is a synthetic long acting opioid, so it can replace multiple heroin uses by being taken once daily.[82] It works by binding to the opioid receptors in the brain and spinal cord, activating them, reducing withdrawal symptoms and cravings while suppressing the "high" that other opioids can elicit. The decrease in withdrawal symptoms and cravings allow the user to slowly taper off the drug in a controlled manner, decreasing the likelihood of relapse. It is not accessible to all addicts. It is a regulated substance, and requires that each dose be picked up from a methadone clinic daily. This can be inconvenient as some patients are unable to travel to a clinic, or avoid the stigma associated with drug addiction.[82]
Buprenorphine[edit]
Buprenorphine is used similarly to methadone, with some doctors recommending it as the best solution for medication-assisted treatment to help people reduce or quit their use of heroin or other opiates. It is claimed to be safer and less regulated than methadone, with month-long prescriptions allowed. It is also said to eliminate opiate withdrawal symptoms and cravings in many patients without inducing euphoria.[84]
Unlike methadone treatment, which must be performed in a highly structured clinic, buprenorphine, according to SAMHSA, can be prescribed or dispensed in physician offices.[85] Patients can thereby receive a full year of treatment for a fraction of the cost of detox programs.[84]
Behavioral treatment options[edit]
It is less effective to use behavioral treatment without medical treatment during initial detoxification. It has similarly been shown that medical treatments tend to get better results when accompanied by behavioral treatment.[81] Popular behavioral treatment options include group or individual therapy, residential treatment centers, and Twelve-step programs such as Narcotics Anonymous.[83] Residential treatment centers allow for a 24-hour drug-free environment to decrease the chances of relapse. These centers allow addicts to be in supportive environments during the difficult time of detox.[86]
Twelve-step programs are one of the most well-known options. The philosophy is that a group of people sharing the same addiction can remain abstinent with the support of and connection to others who empathize and understand. There is also a spiritual, though not religious, component to it, with freedom to believe as one chooses.[87]
See also[edit]
Crack epidemic
List of deaths from drug overdose and intoxication
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Jump up ^ Mike DeBonis, Congress passes 21st Century Cures Act, boosting research and easing drug approvals, Washington Post (December 7, 2016).
Jump up ^ Juliet Eilperin & Carolyn Y. Johnson, paying tribute to Biden and bipartisanship, signs 21st Century Cures Act Tuesday, Washington Post (December 13, 2016).
Jump up ^ "Opioid Epidemic: Trump to Set Up Commission on Addiction Crisis", NBC News, March 29, 2017
Jump up ^ "It's time to 'Trump' opioid addiction in the United States", The Hill, Feb. 27, 2017
Jump up ^ "President Trump Hosts an Opioid and Drug Abuse Listening Session", Real Clear Politics, March 29, 2017
Jump up ^ Commissioner, Office of the. "Press Announcements – FDA requests removal of Opana ER for risks related to abuse". www.fda.gov. Retrieved 2017-06-15.
Jump up ^ "Trump to tap Rep. Tom Marino as 'drug czar'". Politico. September 1, 2017. Retrieved 13 October 2017.
Jump up ^ "A Compact to Fight Opioid Addiction", National Governors Assoc., July 13, 2016
Jump up ^ "Hogan-Rutherford Administration Declares State of Emergency, Announces Major Funding to Combat Heroin and Opioid Crisis in Maryland", Maryland.gov, March 1, 2017
Jump up ^ "Gov. Hogan Announces Opioid Epidemic State Of Emergency", CBS Baltimore, March 1, 2017
Jump up ^ "Delaware lawmakers tackle opioid addiction epidemic", Newsworks, March 23, 2017
Jump up ^ "Governor Snyder rolls out plan to fight opioid addiction", WILX, March 23, 2017
Jump up ^ "Snyder: Efforts to stop opioid abuse aren’t working", Michigan Radio, March 23, 2017
Jump up ^ "HB0299". le.utah.gov. Retrieved 2017-07-27.
Jump up ^ "Opioid distributors sued by West Virginia counties hit by drug crisis". Washington Post. Retrieved 2017-06-27.
Jump up ^ "Lawyer Behind West Virginia County Lawsuit Against Opioid Distributors". NPR.org. Retrieved 2017-06-27.
Jump up ^ "U.S. City Sues OxyContin Maker For Contributing To Opioid Crisis", NPR, Feb. 3, 2017
Jump up ^ Dowell, Deborah; Haegerich, Tamara; Chou, Roger (March 15, 2016). "CDC Guideline for Prescribing Opioids for Chronic Pain—United States, 2016". JAMA. 315: 1624–45. PMID 26977696. doi:10.1001/jama.2016.1464. Retrieved March 18, 2016.
Jump up ^ Missouri is final state to pass PDMP program; US News & World Report; April 13, 2017
Jump up ^ Rutkow Lainie; et al. (2015). "Most primary care physicians are aware of prescription drug monitoring programs, but many find the data difficult to access". Health Affairs. 34 (3): 484–492. doi:10.1377/hlthaff.2014.1085.
Jump up ^ Matthew Perrone, Associated Press. "Painkiller politics: Effort to curb prescribing under fire". The Washington Times. Retrieved 2017-06-13.
Jump up ^ Ghorayshi, Azeen. "Missouri Is The Only State In The US Where Doctors Have No Idea What Prescriptions People Are Getting". BuzzFeed. Retrieved 11 April 2017.
^ Jump up to: a b McGinty, E. "Criminal Activity or Treatable Health Condition? News Media Framing of Opioid Analgesic Abuse in the United States". Psychiatric Services. 67: 405–411.
^ Jump up to: a b Netherland, J. (December 2016). "The War on Drugs That Wasn't: Wasted Whiteness, "Dirty Doctors," and Race in Media Coverage of Prescription Opioid Misuse". Cult Med Psychiatry. 40 (4): 664–686.
Jump up ^ "Major Science Report Lays Out a Plan to Tamp Down Opioid Crisis", Scientific American, July 13, 2017
^ Jump up to: a b Veilleux, Jennifer. "A Review of Opioid Dependence Treatment: Pharmacological and Psychosocial Interventions to Treat Opioid Addiction". Clinical Psychology Review. 30.2: 155–166.
^ Jump up to: a b c d e Dixon, David (May 13, 2017). "Opioid Abuse Treatment and Management: Medical Care". Medscape.
^ Jump up to: a b "WHAT ARE MY TREATMENT OPTIONS?". TURN TO HELP. June 11, 2017.
^ Jump up to: a b "My View: New approach needed for opioid epidemic", Portland Tribune, July 25, 2017
Jump up ^ Buprenorphine, SAMHSA
Jump up ^ "Heroin Abuse Solutions". Narconon New Life Retreat. June 12, 2017.
Jump up ^ "12 Step Programs for Drug Rehab & Alcohol Treatment". American Addiction Centers. June 6, 2017.
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