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> Does Bangladesh have a systemic prescription opiate problem? If you want to talk about the impact of opiates on Bangladeshi poverty today, you should go bac

> Does Bangladesh have a systemic prescription opiate problem? If you want to talk about the impact of opiates on Bangladeshi poverty today, you should go back much further in history. Bengal opium, being much higher quality than the product found in China and Afghanistan, was the major impetus behind the British annexing the territory back in 1757. They used this monopoly to extract exorbitant taxes from Bengal, causing widespread man-made famines which killed tens of millions of people. They then used this tax money and the opium to flood the Chinese market with cheap, high-quality opium, against the Chinese rulers' will, in an attempt to undermine the Chinese government as well by creating a widespread opiate epidemic. China did not come under explicit colonial rule the way Bengal did, but it came very close. Over this time period, Bengal went from being the richest region in the second-richest empire/region in the world (next to China) to one of the poorest, which it still is today, despite its rapid growth in recent years. This strategy isn't over, by the way. The opiate market was (and still is) a part of the US military strategy in Afghanistan - balancing the desire to "crack down" on heroin production and smuggling against the desire to provide Afghani civilians with an agricultural economy that doesn't rely on Taliban support. Bangladesh doesn't have a synthetic opiate problem, simply because people there are generally too poor to purchase synthetic opiates in the first place. Raw opium is still used in these areas due to its widespread availability, but it's much less addictive than the synthetic opiates, because pharmaceutical synthetics are obviously designed to be highly concentrated and potent. As for the raw numbers, 0.3% of Bangladeshis consume opiates at least once per year, compared to 0.57% in the US, 0.8% in Italy, 2.65% in Afghanistan (the highest) and 0.004% in Singapore (the lowest).

thrownblown 10y ago
>Bangladesh doesn't have a synthetic opiate problem I feel that's the key here. That oxycontin was over prescribed for about a decade. We are talking people getting in a car wreck and waking up in a hospital addicted to opiates. I'm assuming we are in agreement that the pharmaceutical opiates are way more addictive than their illegal analogs. Snorting a pill is way less work than shooting up or "chasing the dragon" but once you're addicted and your brain tells you need dope to live, you'll do whatever you need to do to live. >As for the raw numbers, 0.3% of Bangladeshis consume opiates at least once per year, compared to 0.57% in the US. I wonder what the opiate use rate is amongst the Appalachian population. A few days ago there was a map posted of heroin overdoses in the US and West Virginia was the hottest hot spot. Anecdotes of OD's and pill heads in WVA abound. When I showed the map to one of my friends, he told me has had 12(!) people that he went to high school with die of pills and/or heroin. I can't help but feel that the pharmaceutical companies and their executives are complicit in the current US opiate epedemic. Thanks Obama(care)!
- chimeracoder 10y ago
  > I'm assuming we are in agreement that the pharmaceutical opiates are way more addictive than their illegal analogs. Actually, that's... a complicated question. Pharmaceutical opiates are definitely more addictive than raw opium (that's like asking if eating white sugar is sweeter than cane sugar). But once you're comparing heroin available on the street to prescribed opiates, there are enough variables (variable quality of product, means of ingestion, the different situations under which a person chooses one over the other, etc.) that there isn't a straightforward answer.
  - thrownblown 10y ago
    >there isn't a straightforward answer. We have to acknowledge the biological component of addiction, that some people are predisposed to certain addictions. There is a physical, chemical component that comes into play. I, for example, smoked my first cigarette at 12 y/o. I continued to smoke cigarettes socially for the better part of the next decade, often buying my own packs of smokes. I never understood the "need" to smoke that many of my fellows expressed. I enjoyed the nicotine high, but never once felt it necessary to smoke tobacco to live a "normal" life. I stopped smoking one day after college and never felt the urge to smoke again. Even after long-term repeated exposure to nicotine I never developed a physical dependancy. The "William Shatner seat" article posted yesterday sent me down a rabbit hole of Shatner talk shows (in "Aftermath" he interviews Bernie Goetz and it is amazing) ending on his "Raw Nerve" interview with Rush Limbaugh where Rush goes into great detail regarding his own painkiller habit. Contrasting how he speaks about opiates about how his body told him he needed pills like he needs food or water to my own personal experiences with opiates and nicotine only reinforces this belief that some people just have the right brain chemistry to get addicted. My next thought is that the chemistry of the brain changes over time, under stress or when exposed to other chemicals. Ergo, at some point, people may be more prone to particular addictions than at other times.
pizzetta 10y ago
I think Appalachian malaise predates the opiate problem. I think it would be worthwhile investigating the cultural aspects which allow an extremely poor population in a poor country fare better than a merely poor population in a developed country where some aspects of lives are subsidized by commonwealth.
miraj 10y ago
opiate addiction may not be that prevalent in Bangladesh; but from what I understand Methamphetamine (popularly known as 'Yaba') is a significant problem. http://www.dhakatribune.com/bangladesh/crime/2016/12/19/students-top-consumer-yaba/ http://www.dhakatribune.com/bangladesh/crime/2016/12/19/stud... https://news.vice.com/article/yaba-the-madness-drug-is-finding-new-routes-into-bangladesh https://news.vice.com/article/yaba-the-madness-drug-is-findi... the history of 'Bengal Opium', especially its production & distribution is indeed a fascinating one. The historical fiction by Amitav Ghosh in his "Ibis Trilogy" is very illuminating: https://www.goodreads.com/series/59478-ibis-trilogy https://www.goodreads.com/series/59478-ibis-trilogy
- thrownblown 10y ago
  Thanks for the reading suggestions, I'm pretty intrigued by this topic. The opioid epidemic is seriously bad here in the US and its negative effects are definitely magnified by the Appalachian malaise that existed before oxycontin. I mean, they have recently run out of morgue space in South Eastern Ohio (also Appalachean).

thrownblown 10y ago

>Bangladesh doesn't have a synthetic opiate problem I feel that's the key here. That oxycontin was over prescribed for about a decade. We are talking people getting in a car wreck and waking up in a hospital addicted to opiates. I'm assuming we are in agreement that the pharmaceutical opiates are way more addictive than their illegal analogs. Snorting a pill is way less work than shooting up or "chasing the dragon" but once you're addicted and your brain tells you need dope to live, you'll do whatever you need to do to live. >As for the raw numbers, 0.3% of Bangladeshis consume opiates at least once per year, compared to 0.57% in the US. I wonder what the opiate use rate is amongst the Appalachian population. A few days ago there was a map posted of heroin overdoses in the US and West Virginia was the hottest hot spot. Anecdotes of OD's and pill heads in WVA abound. When I showed the map to one of my friends, he told me has had 12(!) people that he went to high school with die of pills and/or heroin. I can't help but feel that the pharmaceutical companies and their executives are complicit in the current US opiate epedemic. Thanks Obama(care)!

chimeracoder 10y ago
> I'm assuming we are in agreement that the pharmaceutical opiates are way more addictive than their illegal analogs. Actually, that's... a complicated question. Pharmaceutical opiates are definitely more addictive than raw opium (that's like asking if eating white sugar is sweeter than cane sugar). But once you're comparing heroin available on the street to prescribed opiates, there are enough variables (variable quality of product, means of ingestion, the different situations under which a person chooses one over the other, etc.) that there isn't a straightforward answer.
- thrownblown 10y ago
  >there isn't a straightforward answer. We have to acknowledge the biological component of addiction, that some people are predisposed to certain addictions. There is a physical, chemical component that comes into play. I, for example, smoked my first cigarette at 12 y/o. I continued to smoke cigarettes socially for the better part of the next decade, often buying my own packs of smokes. I never understood the "need" to smoke that many of my fellows expressed. I enjoyed the nicotine high, but never once felt it necessary to smoke tobacco to live a "normal" life. I stopped smoking one day after college and never felt the urge to smoke again. Even after long-term repeated exposure to nicotine I never developed a physical dependancy. The "William Shatner seat" article posted yesterday sent me down a rabbit hole of Shatner talk shows (in "Aftermath" he interviews Bernie Goetz and it is amazing) ending on his "Raw Nerve" interview with Rush Limbaugh where Rush goes into great detail regarding his own painkiller habit. Contrasting how he speaks about opiates about how his body told him he needed pills like he needs food or water to my own personal experiences with opiates and nicotine only reinforces this belief that some people just have the right brain chemistry to get addicted. My next thought is that the chemistry of the brain changes over time, under stress or when exposed to other chemicals. Ergo, at some point, people may be more prone to particular addictions than at other times.

pizzetta 10y ago

I think Appalachian malaise predates the opiate problem. I think it would be worthwhile investigating the cultural aspects which allow an extremely poor population in a poor country fare better than a merely poor population in a developed country where some aspects of lives are subsidized by commonwealth.

miraj 10y ago

opiate addiction may not be that prevalent in Bangladesh; but from what I understand Methamphetamine (popularly known as 'Yaba') is a significant problem. http://www.dhakatribune.com/bangladesh/crime/2016/12/19/students-top-consumer-yaba/ http://www.dhakatribune.com/bangladesh/crime/2016/12/19/stud... https://news.vice.com/article/yaba-the-madness-drug-is-finding-new-routes-into-bangladesh https://news.vice.com/article/yaba-the-madness-drug-is-findi... the history of 'Bengal Opium', especially its production & distribution is indeed a fascinating one. The historical fiction by Amitav Ghosh in his "Ibis Trilogy" is very illuminating: https://www.goodreads.com/series/59478-ibis-trilogy https://www.goodreads.com/series/59478-ibis-trilogy

thrownblown 10y ago
Thanks for the reading suggestions, I'm pretty intrigued by this topic. The opioid epidemic is seriously bad here in the US and its negative effects are definitely magnified by the Appalachian malaise that existed before oxycontin. I mean, they have recently run out of morgue space in South Eastern Ohio (also Appalachean).