13 ms·

Lethal Opiates Delivered by Mail from China, Killing Addicts in the U.S

96 points by happy-go-lucky 10y ago

moxious 10y ago
This reads like a thousand other articles over decades, like moral panic. There's always some new drug that's coming along, whether meth, this, bath salts, whatever. When will culture come to its senses and realize that humans like to get high and that this will never stop? Let's just focus on giving users accurate information and pathways out of usage, and skip the moral panics and claims that X is "sweeping the nation".
- bigdubs 10y ago
  Common sense doesn't sell ads though, and news sites need to hype fear to drive viewership / readership.
- M_Grey 10y ago
  Just from the headline, it strikes me like a sound argument for an end to prohibition.
- sergers 10y ago
  Drugs are being cut with synthetic opiodes, so potent that literally an extra flake in your drug of choice will kill you, unbeknownst to the end user. This affects junkies to occasional/recreational drug users. Not sure about the US, but there has been significant overdoses and fatalities relating to fentanyl and other related. It's a word of caution, you don't know what's in your drugs, it can kill you more than ever.
  - deleted 10y ago
    [deleted]
  - bluedino 10y ago
    >> It's a word of caution, you don't know what's in your drugs, it can kill you more than ever. People aren't very selective at what they stick up their nose or in their veins. Your average cocaine end-user is the 14th person who's had their hands on that particular drug. Chances are it's been cut with who the heck knows what at every step along the way, since everyone wants to maximize their profits. When you get a package of what-should-be drugs from China or Colombia or anywhere, who's to say what's actually in it? The FDA isn't testing that stuff. If you think it's heroin and there's even a little fentanyl mixed in it, your last use could be fatal.
    - mjevans 10y ago
      I never finished watching Breaking Bad, but the season or two that I did watch did make me think: How much safer would 'recreational users' be if they had a legal, clean (pure), supply and a place to use it where they are monitored? As the parent posts have said, the above combined with help for getting out of the hole in the same place would probably be more effective. It would /ALSO/ be the most effective way of defeating the criminals that make money off of the drugs; by depriving them of sales.
      - geoffmcc 10y ago
        > How much safer would 'recreational users' be if they had a legal, clean (pure), supply and a place to use it where they are monitored? I don't have any stats to provide, but if your interested (as far as heroin) check out the Netherlands. Last i knew they had a program. Edit: I believe the Netherlands have had their program since sometime in the 90's, so there should be data available.
      - ncocacola 10y ago
        This has already been implemented in some European countries, I know they opened what's called a "salle de shoot" ("supervised injection site" in English) last year in Paris. I don't think there's any data out yet, but the idea was to prevent overdoses, but also provide clean syringes to avoid HIV transmission.
        jdc 10y ago
        There's a decent amount of research based out of the site in Vancouver. https://scholar.google.ca/scholar?q=insite+vancouver https://scholar.google.ca/scholar?q=insite+vancouver
      - goatsi 10y ago
        Much safer. This Swiss have implemented this and have published the results. There were large improvements in almost every public health/safety issue caused by heroin use [0]. >Crime Issues: 60% drop in felony crimes by patients (80% drop after one year in the program). 82% drop in patients selling heroin. >Death Rates: No one has died from a heroin overdose since the inception of the program. The heroin used is inspected for purity and strength by technicians. >Disease Rates: New infections of Hepatitis and HIV have been reduced for patients in the program. >New Use Rates: Slightly lower than expected. 1) As reported in the Lancet June 3, 2006, the medicalisation of using heroin has tarnished the image of heroin and made it unattractive to young people. 2) Most new users are introduced to heroin by members of their social group and 50% of users also deal to support their habit. Therefore, with so many users/sellers in treatment, non-users have fewer opportunities to be exposed to heroin, especially in the rural areas. >*Cost Issues: 48 dollars/day: Patient costs are covered by national health insurance agency. Patients pay 700 dollars/year for the compulsory insurance. Note: The Swiss save about 38 dollars per day per patient mostly in lowered costs for court and police time, due to less crime committed by the patients. [0] http://www.citizensopposingprohibition.org/resources/swiss-heroin-assisted-treatment-1994-2009-summary/ http://www.citizensopposingprohibition.org/resources/swiss-h...
  - geoffmcc 10y ago
    > Not sure about the US, but there has been significant overdoses and fatalities relating to fentanyl and other related. Same here in the US. I live in a heavily effected area and its always the same thing fentanyl. People are used to taking a certain dose so that's what they do not knowing fentanyl is in there and it usually results in a death unless someone has or can get narcan there quickly. Part of me wonders why they don't just do a little first and then do more, but I guess I get it- they are addicted and they just want their fix ASAP.
    - Nugem_ 10y ago
      It would seem logical to use a little to test the potency of a new batch especially. Unfortunately, as an ex user, when you're sick, you're going to do your usual shot or more. I've lost a few friends that were coming down to hard to care about a little to get well first. Big shot, dead.
      - sergers 10y ago
        That's the thing though, a difference of smaller than a grain of salt would be a death sentence. So if you try a small sample, or a large one, it doesn't matter.. it could be the next hit you try has that extra microgram of fentanyl. I have had friends with brothers who died from taking a all night study aid in university, that happened to have Carfentanyl in it. Always caution on the side of safe regardless of what type of illicit drug is, or if it's your first time, once in a lifetime. They just don't make illicit drugs like they use to... They could definately kill u always, but now the potency of a microgram difference can and that's pretty scary.
        bsder 10y ago
        > They just don't make illicit drugs like they use to... They could definately kill u always, but now the potency of a microgram difference can and that's pretty scary. Actually, this has kind of always been true. http://everything2.com/title/Heroin%252C+MPTP%252C+and+the+key+to+Parkinson%2527s+Disease http://everything2.com/title/Heroin%252C+MPTP%252C+and+the+k... The problem is that an illegal drug has no quality control. If you want to stop this kind of stuff, legalizing it is one of the few (possibly only) useful solutions.
- zhengiszen 10y ago
  Some would say it is just karma or blow back for all the unjust wars the US of America keep on waging to keep its monopoly on resources, be it oil, drugs or human resources...
  - cnnsucks 10y ago
    Indeed, "some" do. Also, some would have you take your Blame America First group-think elsewhere instead of shitting up HN with it.
- mtdewcmu 10y ago
  I didn't find it to be sensationalized, at least not when judged relative to other media. I think carfentanil actually poses a unique challenge, because it's extremely potent and it's hard to accurately portion out such small doses.
- tcj_phx 10y ago
  > When will culture come to its senses and realize that humans like to get high and that this will never stop? People who become addicts don't like the highs and lows of the emotional roller coaster they're on, but it's the only way they know to cope with their emotional/physiological angst. I've met someone who'd used cocaine 'recreationally'. His attitude was "been there, done that, don't need to use again." Most of the street pharmacy's customers are self-medicating emotional pain. My mom didn't get hooked on the opiates her doctor recently gave her for her broken arm because she has a supportive environment. The friend (who I've written about here before) relapsed on cocaine because she was depressed. Then she relapsed on heroin, supposedly to treat the high blood pressure cocaine gave her (but probably more because she needed something to 'numb' emotional pain). This was the summer before she met me. Really I think she just must've been lonely. This week I found a copy of a book she gave me for my birthday after we met. She inscribed it, in part, "my heart melted the moment I first heard you speak." I think I've successfully bullied her current court-ordered mental health providers into recognizing the mistaken diagnosis made by their colleagues in the other county. The earlier psychiatrists just thought she was "persistently disabled" because they didn't try to figure out why she'd become psychotic in the first place (doctor-administered depo provera birth control injections made her suicidal -> street pharmacy -> psychosis).
  - swift 10y ago
    To add to what you're saying, many users aren't just self-medicating emotional pain, but serious psychiatric illnesses. This can be for a number of reasons: lack of insurance coverage, difficulty navigating the medical system (which can be very challenging for someone with mental illness), and unfortunately, the fact that modern medical science just does not have effective treatments available for some of these conditions. Branding these people as criminals and throwing them in prison is outright cruel.
    - tcj_phx 10y ago
      > and unfortunately, the fact that modern medical science just does not have effective treatments available for some of these conditions. I suspect that many psychiatric illnesses are indicative of metabolic disorders, and/or malnourishment. An effort to apply the findings of physiology to psychiatric practice would certainly lead to an Understanding that would allow effective treatments to become mainstream. > Branding these people as criminals and throwing them in prison is outright cruel. In the future the 'war on plants' will certainly be recognized as a crime against humanity, or at least as society's autoimmune disease.
- ChuckMcM 10y ago
  You do a great disservice to the people overdosing with such a middling dismissal. This is not a 'moral panic' this is a medical disaster unfolding in slow motion. The combination of the technology to synthesize these drugs from unconstrained pre-cursors, the intensity of their effect, the lack of education on the part of consumers, and a tracking/enforcement system which responds more slowly than conditions change is leading to a situation where tens of thousands of people are going to die essentially at their own hand. It is not a question of 'people like to get high' it is that 'people getting high on arbitrary things will kill themselves'. I understand that you're approaching this from a legalization standpoint, and on that we agree. But the overdose rate is "actually" sweeping the country now and that is born out by the available reports of emergency rooms around the country. And between your "regulated and safe" future and now, there is a large pile of unnecessarily dead people.
  - myowncrapulence 10y ago
    the lack of education on the part of consumers You realize if drugs were legal and regulated people wouldn't need to seek out desperate and risky online orders to satisfy their addiction? When weed was legalized in Oregon, I immediately knew exactly what strain/THC%/CBD% I was buying. This was not available on the black market. Education and security come from acceptance and regulation.
    - hackuser 10y ago
      > When weed was legalized That is far less dangerous than opiates; I don't think it's comparable.
      - nedwin 10y ago
        If we had similar labelling for opiates, and distributed them in the same way we distribute booze or marijuana, surely they could be consumed more safely / appropriately. It seems the overdoses are not necessarily thrill seekers, but where the consumer doesn't know that they're taking a 5000x dose of morphine vs a 2.5x dose.
- deleted 10y ago
  [deleted]
bluedino 10y ago
It's amazing what isn't legal to buy or sell in the USA, but you can easily buy from China and have delivered in the mail. $100 of testosterone powder which you can re-constitute and sell for $20,000 on the street here. Some of the more sophisticated resellers will even pack your order inside of a less conspicuous object.
- elastic_church 10y ago
  > Some of the more sophisticated resellers will even pack your order inside of a less conspicuous object. Or like every merchant on Alphabay? lol, @ "some"
- jacquesm 10y ago
  Better be prepared to calculate in a lot of $ for lab testing of what you think is worth $20,000 before you kill a bunch of people.
zhengiszen 10y ago
Looks like irony ... https://en.wikipedia.org/wiki/Boxer_Rebellion https://en.wikipedia.org/wiki/Boxer_Rebellion
- jlarocco 10y ago
  Definitely ironic. Some of the earliest drug laws in the United States were enacted to discriminate against (primarily Chinese) opium users.
- seanmcdirmid 10y ago
  Note that it was primarily the UK, not the USA, who were the ones started pushing opium on Qing China (and were the most successful, it would be more ironic if they were sending opium to the UK). Also, the boxer rebellion comes long after the opium wars. Anyways, if that many opiates are being exported to to the US, one has to wonder how many are sloshing around inside China itself.
jacquesm 10y ago
If you order anything at all for consumption from China be aware that you may get anything and everything besides the product that you ordered. White powder of any kind is an easy substitute for white powder of any other kind.
- agumonkey 10y ago
  I don't know how much is psychology/paranoia, but every package I get from there smells chemically bad. One stupid plastic case for a laptop dvd drive gave me headache I had to throw the thing out. That said, I also bought an old FP book from the US and got a similar smell.
personjerry 10y ago
It seems like an ironic reversal of sorts in Sino-western opium relations, given the Opium Wars[0], which if I understood correctly, forced China to accept opium trade from the British. [0] https://en.wikipedia.org/wiki/Opium_Wars https://en.wikipedia.org/wiki/Opium_Wars
zkms 10y ago
Ah, if the trend toward nastier and more potent fentanyl analogues was an expected and predicted consequence of opioid prohibition. That would have been nice to know! Before opioid prohibition deaths from opioid use were quite rare. You ever heard a pothead drone on about "it's nearly impossible to overdose from smoking marijuana"? The same thing applies to smoking opium. It's nearly impossible to overdose on that. But prohibition has pushed us from opium smoking and oral laudanum to injectable heroin to fentanyl and now we're at carfentanil. The current USian "opioid crisis" is another manifestation of opioid prohibition pushing people from safer, cheaper, less disruptive and deadly drugs to more deadlier ones. Two decades ago some USian opioid users could go to pill mills and get prescriptions for pharmaceutical grade opioids but the DEA kicked down doctor's doors a bunch and that ended up pushing people to the illicit market. Maybe next time you see those scary increasing graphs of opioid deaths vs time, give that a thought? Sum up all those deaths (compared to the baseline, prior to the increased LEA focus on "pill mills) and ask yourself: are all those needless deaths worth it? For a unit volume (so, for a unit risk of ending up in a concrete box as a consequence of shipping/making raw product) of uncut/active material, you want to be able to sell the most diluted/cut doses to end-users. Of course people will want their chemist to synthesise carfentanil (over regular fentanyl), because you can supply the the same number of end-user doses with 10,000 times less active material. The harder the enforcement, the more potent this selection pressure gets: https://en.wikipedia.org/wiki/Iron_law_of_prohibition https://en.wikipedia.org/wiki/Iron_law_of_prohibition
- Alex3917 10y ago
  > Before opioid prohibition deaths from opioid use were quite rare. Maybe in the U.S., less so in China where ~25% of adult males were opium addicts in the early 1900s. The war on drugs isn't a success by any means, but at least the problems that exist aren't on that scale. A better example of prohibition backfiring is with marijuana, where before prohibition ~0% of Americans were marijuana users, whereas today ~85% of American adults have used marijuana.
  - zkms 10y ago
    My argument isn't that opioid use in the time of opium dens was harmless, nor that opioids can be used willy-nilly without any harms. I am well familiar with some of the dangers of opioid use and do not wish to discount them at all. My argument is that opioid prohibition in the 21st century in the US is a legal regime that amplifies those dangers -- it kills lots of people quite effectively (and keeps killing more every year). The number of people who use opioids regularly is a second-order concern (if only because fent-laced heroin certainly gets that number down) to me, frankly -- reducing morbidity and mortality due to drug use is a lot more important. With a decent medical infrastructure, addicts should be able to get opioid maintenance therapy with the right drugs and dosage and be able to lead actual interesting lives beyond trying to score the next hit. I'd so much rather live in a country where people who want to get high on opioids can buy cheap, pure, precisely metered opioids that won't kill them rather than smashing car windows to be able to pay for overpriced fentanyl-laced drugs sold by criminals that might overdose them in the street (which will cause even more expense and load on the already-awful USian medical system).
deftnerd 10y ago
Some of these synthetic opiates are a bit terrifying. There are some research chemicals available that are hundreds or thousands of times more potent than fentanyl and they're still technically legal. It's so hard to work with these that even the drug boards say it's suicide to try to work with them without a clean room and a hazmat suit. If you inhale just a little bit of the drug dust in the air it will kill you. It's gotten to the point where some of these respiratory depressant drugs can be used as a chemical weapon if inhaled. For instance: Heroin = 2.5x potency of morphine Hydromorphone = 7.5x potency of morphine Fentanyl = 120x potency of morphine Carfentanyl = 5000x to 7500x the potency of morphine Methoxyacetylfentanyl = 30,000x the potency of morphine A lethal dose of Methoxyacetylfentanyl is so small it's not even visible to the naked eye. Some powdered methoxyacetylfentanyl released from a drone over a crowd would be disastrous.
- RcouF1uZ4gsC 10y ago
  https://en.m.wikipedia.org/wiki/Equianalgesic https://en.m.wikipedia.org/wiki/Equianalgesic for more information
- jemfinch 10y ago
  Is there any reason to treat these as drugs instead of just poisons? We sell all kinds of poisons on the regular basis and don't bat an eye. Are these any more interesting because they're opiates?
  - Scoundreller 10y ago
    It's the dose that makes the poison. This is 16th century toxicology: https://en.wikipedia.org/wiki/Paracelsus#Contributions_to_toxicology https://en.wikipedia.org/wiki/Paracelsus#Contributions_to_to...
  - zkms 10y ago
    > Is there any reason to treat these as drugs instead of just poisons? because they have useful medical effects, a safe dose, and a decent therapeutic index. They have accepted uses in human and animal medicine. That the effective (and lethal) doses are both very small (and thus hard to precisely meter and dispense) only becomes a problem for people who can't access pharmaceutical-grade opioids.
pnathan 10y ago
This is a yellow journalism headline. Hearst would be proud. As I've remarked before, the war on drugs and getting tough on crime is not working out too well for us, so it's time to change our plan. I don't advocate off the shelf heroin or any of the cluster of ideas that suggest that. I do advocate focusing on the funnel that leads to addiction, homelessness, and death. Part of that is significantly amping up mental healthcare spending; part of that is having legally controlled drugs available in pharmacies for reasonable prices; part of that is supporting better schools (giving a window into a better world, and a way to climb through); part of that is supporting jobs programs. All of those relate in one way or another to the problem, some years and years earlier in the funnel. No one is born choosing to be an addict in their later life; a series of choices and pressures put them there. The pressures from society can be changed, which shapes the set of choices visible.
- hackermailman 10y ago
  From anecdotes of living beside the biggest open air drug market in Canada for a decade, and from watching my own friend's behavior growing up it seems to me the biggest problem is being unable to do anything when somebody you know or a family member becomes an addict. You can't force them into treatment, you can't even get the police to find them if they disappear into the streets, and the cycle in and out of jail just makes them career addicts as any chance of normal life seems over to them at that point. Here if they check into detox, even if you are direct family you can't visit them or bring them anything because detox will deny they are there. You can't ask detox to call when they are released so you can pick them up and they don't end up released back on the streets. Another problem is the waiting times for treatment. Real treatment is a long commitment sometimes living for years in a halfway house being supported by other peers to remain sober. An addict should be able to check into treatment and immediately commit themselves instead of waiting for months for a spot to open. Lack of any facility for police to just dump out of control users and have them treated by doctors and addiction specialists is another issue. Often there are mentally ill with secondary addictions or other problems, and the police don't know what to do with them and money is wasted having them ferry around doctors to look at these addicts in jails or playing catch and release after a weekend in jail. A one stop sober shop and treatment option is always requested by police here but it never materializes. Of course all of this costs money nobody will get elected with this spending platform on junkies until the synthetic opiates problem is so large the political will exists to do this. All the addicts I've talked to including 2 of my friends who had a bad addiction for a few years, they all ended up addicts by becoming successful and partying to celebrate it. Anybody who lives in Vancouver if you go to VANDU and listen to one of their meetings sometime this is the same story you will hear: I was successful, I started drinking and partying, I used drugs to help regulate my sleep, or to get sober (cocaine sobers you up) or stay awake to function, I ended up an addict and lost everything here I am living in the dumpster or flop hotel being enabled by other addicts because I stole from every family member/friend and burned all those bridges.
spraak 10y ago
I wonder as an analogy what markets would develop if caffeine sources were illegal. Caffeine isn't as harmful as other drugs but it is very addictive. By the same extension, this is why I think getting any drug should be eaiser. It's safer
ramblenode 10y ago
This is the text of the STOP act mentioned in the article: https://www.congress.gov/bill/114th-congress/house-bill/6045/text https://www.congress.gov/bill/114th-congress/house-bill/6045... IANAL but would be interested to hear from one about the privacy and financial implications of this bill. For example, (d)(1) seems to suggest a $1 processing fee for non-letter class mail originating outside the US.
bfuller 10y ago
I've used many grams of these substances. AMA
bfuller 10y ago
I've used many grams of these substances. AMA
undersuit 10y ago
>A better example of prohibition backfiring is with marijuana, where before prohibition ~0% of Americans were marijuana users, whereas today ~85% of American adults have used marijuana. No a better example was when Alex3917 made up shit, and then tried to legitimize his shit by comparing regular "users" to the population that has had at least one use. Wait that's not a better example, I'm just calling you out. Cannabis use was alive and well before Federal Prohibition, Alcohol and Marijuana. ~0% of Americans were users? Maybe in the early 1400s.
- Alex3917 10y ago
  Harry Anslinger estimated that there were 100,000 marijuana users when marijuana was banned 1937, when the U.S. population was ~129 million. In other words, a little less than 0.08%, or ~0%. Fail.
  - TylerE 10y ago
    Getting your drug "facts" from Anslinger is like trusting what Jerry Falwell says about homosexuality.
    - Alex3917 10y ago
      Sure, but he wasn't exactly known for underestimating the scope of any drug-related problems. A better analogy would be that if Falwell says that gay marriage isn't responsible for causing hurricanes, you can probably take his word for it.
- dang 10y ago
  Comments that argue in an uncivil and personal way are not allowed on HN, regardless of how wrong someone else is. Please don't post like this here. We detached this subthread from https://news.ycombinator.com/item?id=13847157 https://news.ycombinator.com/item?id=13847157 and marked it off-topic.
coretx 10y ago
Yellow journalism just attacked your postal secret, your democracy ; this by means of using your disdain for junkies and drugs. Who else besides the mentioned politician and a large chunk of the logistics sector profits ? Put their heads on a pike, show the world how utilitarian their true face is.
s- 10y ago
and you thought only legitimate businesses had a customer attrition problem...

This reads like a thousand other articles over decades, like moral panic. There's always some new drug that's coming along, whether meth, this, bath salts, whatever. When will culture come to its senses and realize that humans like to get high and that this will never stop? Let's just focus on giving users accurate information and pathways out of usage, and skip the moral panics and claims that X is "sweeping the nation".

bigdubs 10y ago
Common sense doesn't sell ads though, and news sites need to hype fear to drive viewership / readership.
M_Grey 10y ago
Just from the headline, it strikes me like a sound argument for an end to prohibition.
sergers 10y ago
Drugs are being cut with synthetic opiodes, so potent that literally an extra flake in your drug of choice will kill you, unbeknownst to the end user. This affects junkies to occasional/recreational drug users. Not sure about the US, but there has been significant overdoses and fatalities relating to fentanyl and other related. It's a word of caution, you don't know what's in your drugs, it can kill you more than ever.
- deleted 10y ago
  [deleted]
- bluedino 10y ago
  >> It's a word of caution, you don't know what's in your drugs, it can kill you more than ever. People aren't very selective at what they stick up their nose or in their veins. Your average cocaine end-user is the 14th person who's had their hands on that particular drug. Chances are it's been cut with who the heck knows what at every step along the way, since everyone wants to maximize their profits. When you get a package of what-should-be drugs from China or Colombia or anywhere, who's to say what's actually in it? The FDA isn't testing that stuff. If you think it's heroin and there's even a little fentanyl mixed in it, your last use could be fatal.
  - mjevans 10y ago
    I never finished watching Breaking Bad, but the season or two that I did watch did make me think: How much safer would 'recreational users' be if they had a legal, clean (pure), supply and a place to use it where they are monitored? As the parent posts have said, the above combined with help for getting out of the hole in the same place would probably be more effective. It would /ALSO/ be the most effective way of defeating the criminals that make money off of the drugs; by depriving them of sales.
    - geoffmcc 10y ago
      > How much safer would 'recreational users' be if they had a legal, clean (pure), supply and a place to use it where they are monitored? I don't have any stats to provide, but if your interested (as far as heroin) check out the Netherlands. Last i knew they had a program. Edit: I believe the Netherlands have had their program since sometime in the 90's, so there should be data available.
    - ncocacola 10y ago
      This has already been implemented in some European countries, I know they opened what's called a "salle de shoot" ("supervised injection site" in English) last year in Paris. I don't think there's any data out yet, but the idea was to prevent overdoses, but also provide clean syringes to avoid HIV transmission.
      - jdc 10y ago
        There's a decent amount of research based out of the site in Vancouver. https://scholar.google.ca/scholar?q=insite+vancouver https://scholar.google.ca/scholar?q=insite+vancouver
    - goatsi 10y ago
      Much safer. This Swiss have implemented this and have published the results. There were large improvements in almost every public health/safety issue caused by heroin use [0]. >Crime Issues: 60% drop in felony crimes by patients (80% drop after one year in the program). 82% drop in patients selling heroin. >Death Rates: No one has died from a heroin overdose since the inception of the program. The heroin used is inspected for purity and strength by technicians. >Disease Rates: New infections of Hepatitis and HIV have been reduced for patients in the program. >New Use Rates: Slightly lower than expected. 1) As reported in the Lancet June 3, 2006, the medicalisation of using heroin has tarnished the image of heroin and made it unattractive to young people. 2) Most new users are introduced to heroin by members of their social group and 50% of users also deal to support their habit. Therefore, with so many users/sellers in treatment, non-users have fewer opportunities to be exposed to heroin, especially in the rural areas. >*Cost Issues: 48 dollars/day: Patient costs are covered by national health insurance agency. Patients pay 700 dollars/year for the compulsory insurance. Note: The Swiss save about 38 dollars per day per patient mostly in lowered costs for court and police time, due to less crime committed by the patients. [0] http://www.citizensopposingprohibition.org/resources/swiss-heroin-assisted-treatment-1994-2009-summary/ http://www.citizensopposingprohibition.org/resources/swiss-h...
- geoffmcc 10y ago
  > Not sure about the US, but there has been significant overdoses and fatalities relating to fentanyl and other related. Same here in the US. I live in a heavily effected area and its always the same thing fentanyl. People are used to taking a certain dose so that's what they do not knowing fentanyl is in there and it usually results in a death unless someone has or can get narcan there quickly. Part of me wonders why they don't just do a little first and then do more, but I guess I get it- they are addicted and they just want their fix ASAP.
  - Nugem_ 10y ago
    It would seem logical to use a little to test the potency of a new batch especially. Unfortunately, as an ex user, when you're sick, you're going to do your usual shot or more. I've lost a few friends that were coming down to hard to care about a little to get well first. Big shot, dead.
    - sergers 10y ago
      That's the thing though, a difference of smaller than a grain of salt would be a death sentence. So if you try a small sample, or a large one, it doesn't matter.. it could be the next hit you try has that extra microgram of fentanyl. I have had friends with brothers who died from taking a all night study aid in university, that happened to have Carfentanyl in it. Always caution on the side of safe regardless of what type of illicit drug is, or if it's your first time, once in a lifetime. They just don't make illicit drugs like they use to... They could definately kill u always, but now the potency of a microgram difference can and that's pretty scary.
      - bsder 10y ago
        > They just don't make illicit drugs like they use to... They could definately kill u always, but now the potency of a microgram difference can and that's pretty scary. Actually, this has kind of always been true. http://everything2.com/title/Heroin%252C+MPTP%252C+and+the+key+to+Parkinson%2527s+Disease http://everything2.com/title/Heroin%252C+MPTP%252C+and+the+k... The problem is that an illegal drug has no quality control. If you want to stop this kind of stuff, legalizing it is one of the few (possibly only) useful solutions.
zhengiszen 10y ago
Some would say it is just karma or blow back for all the unjust wars the US of America keep on waging to keep its monopoly on resources, be it oil, drugs or human resources...
- cnnsucks 10y ago
  Indeed, "some" do. Also, some would have you take your Blame America First group-think elsewhere instead of shitting up HN with it.
mtdewcmu 10y ago
I didn't find it to be sensationalized, at least not when judged relative to other media. I think carfentanil actually poses a unique challenge, because it's extremely potent and it's hard to accurately portion out such small doses.
tcj_phx 10y ago
> When will culture come to its senses and realize that humans like to get high and that this will never stop? People who become addicts don't like the highs and lows of the emotional roller coaster they're on, but it's the only way they know to cope with their emotional/physiological angst. I've met someone who'd used cocaine 'recreationally'. His attitude was "been there, done that, don't need to use again." Most of the street pharmacy's customers are self-medicating emotional pain. My mom didn't get hooked on the opiates her doctor recently gave her for her broken arm because she has a supportive environment. The friend (who I've written about here before) relapsed on cocaine because she was depressed. Then she relapsed on heroin, supposedly to treat the high blood pressure cocaine gave her (but probably more because she needed something to 'numb' emotional pain). This was the summer before she met me. Really I think she just must've been lonely. This week I found a copy of a book she gave me for my birthday after we met. She inscribed it, in part, "my heart melted the moment I first heard you speak." I think I've successfully bullied her current court-ordered mental health providers into recognizing the mistaken diagnosis made by their colleagues in the other county. The earlier psychiatrists just thought she was "persistently disabled" because they didn't try to figure out why she'd become psychotic in the first place (doctor-administered depo provera birth control injections made her suicidal -> street pharmacy -> psychosis).
- swift 10y ago
  To add to what you're saying, many users aren't just self-medicating emotional pain, but serious psychiatric illnesses. This can be for a number of reasons: lack of insurance coverage, difficulty navigating the medical system (which can be very challenging for someone with mental illness), and unfortunately, the fact that modern medical science just does not have effective treatments available for some of these conditions. Branding these people as criminals and throwing them in prison is outright cruel.
  - tcj_phx 10y ago
    > and unfortunately, the fact that modern medical science just does not have effective treatments available for some of these conditions. I suspect that many psychiatric illnesses are indicative of metabolic disorders, and/or malnourishment. An effort to apply the findings of physiology to psychiatric practice would certainly lead to an Understanding that would allow effective treatments to become mainstream. > Branding these people as criminals and throwing them in prison is outright cruel. In the future the 'war on plants' will certainly be recognized as a crime against humanity, or at least as society's autoimmune disease.
ChuckMcM 10y ago
You do a great disservice to the people overdosing with such a middling dismissal. This is not a 'moral panic' this is a medical disaster unfolding in slow motion. The combination of the technology to synthesize these drugs from unconstrained pre-cursors, the intensity of their effect, the lack of education on the part of consumers, and a tracking/enforcement system which responds more slowly than conditions change is leading to a situation where tens of thousands of people are going to die essentially at their own hand. It is not a question of 'people like to get high' it is that 'people getting high on arbitrary things will kill themselves'. I understand that you're approaching this from a legalization standpoint, and on that we agree. But the overdose rate is "actually" sweeping the country now and that is born out by the available reports of emergency rooms around the country. And between your "regulated and safe" future and now, there is a large pile of unnecessarily dead people.
- myowncrapulence 10y ago
  the lack of education on the part of consumers You realize if drugs were legal and regulated people wouldn't need to seek out desperate and risky online orders to satisfy their addiction? When weed was legalized in Oregon, I immediately knew exactly what strain/THC%/CBD% I was buying. This was not available on the black market. Education and security come from acceptance and regulation.
  - hackuser 10y ago
    > When weed was legalized That is far less dangerous than opiates; I don't think it's comparable.
    - nedwin 10y ago
      If we had similar labelling for opiates, and distributed them in the same way we distribute booze or marijuana, surely they could be consumed more safely / appropriately. It seems the overdoses are not necessarily thrill seekers, but where the consumer doesn't know that they're taking a 5000x dose of morphine vs a 2.5x dose.
deleted 10y ago
[deleted]

bluedino 10y ago

It's amazing what isn't legal to buy or sell in the USA, but you can easily buy from China and have delivered in the mail. $100 of testosterone powder which you can re-constitute and sell for $20,000 on the street here. Some of the more sophisticated resellers will even pack your order inside of a less conspicuous object.

elastic_church 10y ago
> Some of the more sophisticated resellers will even pack your order inside of a less conspicuous object. Or like every merchant on Alphabay? lol, @ "some"
jacquesm 10y ago
Better be prepared to calculate in a lot of $ for lab testing of what you think is worth $20,000 before you kill a bunch of people.

zhengiszen 10y ago

Looks like irony ... https://en.wikipedia.org/wiki/Boxer_Rebellion https://en.wikipedia.org/wiki/Boxer_Rebellion

jlarocco 10y ago
Definitely ironic. Some of the earliest drug laws in the United States were enacted to discriminate against (primarily Chinese) opium users.
seanmcdirmid 10y ago
Note that it was primarily the UK, not the USA, who were the ones started pushing opium on Qing China (and were the most successful, it would be more ironic if they were sending opium to the UK). Also, the boxer rebellion comes long after the opium wars. Anyways, if that many opiates are being exported to to the US, one has to wonder how many are sloshing around inside China itself.

jacquesm 10y ago

If you order anything at all for consumption from China be aware that you may get anything and everything besides the product that you ordered. White powder of any kind is an easy substitute for white powder of any other kind.

agumonkey 10y ago
I don't know how much is psychology/paranoia, but every package I get from there smells chemically bad. One stupid plastic case for a laptop dvd drive gave me headache I had to throw the thing out. That said, I also bought an old FP book from the US and got a similar smell.

personjerry 10y ago

It seems like an ironic reversal of sorts in Sino-western opium relations, given the Opium Wars[0], which if I understood correctly, forced China to accept opium trade from the British. [0] https://en.wikipedia.org/wiki/Opium_Wars https://en.wikipedia.org/wiki/Opium_Wars

zkms 10y ago

Ah, if the trend toward nastier and more potent fentanyl analogues was an expected and predicted consequence of opioid prohibition. That would have been nice to know! Before opioid prohibition deaths from opioid use were quite rare. You ever heard a pothead drone on about "it's nearly impossible to overdose from smoking marijuana"? The same thing applies to smoking opium. It's nearly impossible to overdose on that. But prohibition has pushed us from opium smoking and oral laudanum to injectable heroin to fentanyl and now we're at carfentanil. The current USian "opioid crisis" is another manifestation of opioid prohibition pushing people from safer, cheaper, less disruptive and deadly drugs to more deadlier ones. Two decades ago some USian opioid users could go to pill mills and get prescriptions for pharmaceutical grade opioids but the DEA kicked down doctor's doors a bunch and that ended up pushing people to the illicit market. Maybe next time you see those scary increasing graphs of opioid deaths vs time, give that a thought? Sum up all those deaths (compared to the baseline, prior to the increased LEA focus on "pill mills) and ask yourself: are all those needless deaths worth it? For a unit volume (so, for a unit risk of ending up in a concrete box as a consequence of shipping/making raw product) of uncut/active material, you want to be able to sell the most diluted/cut doses to end-users. Of course people will want their chemist to synthesise carfentanil (over regular fentanyl), because you can supply the the same number of end-user doses with 10,000 times less active material. The harder the enforcement, the more potent this selection pressure gets: https://en.wikipedia.org/wiki/Iron_law_of_prohibition https://en.wikipedia.org/wiki/Iron_law_of_prohibition

Alex3917 10y ago
> Before opioid prohibition deaths from opioid use were quite rare. Maybe in the U.S., less so in China where ~25% of adult males were opium addicts in the early 1900s. The war on drugs isn't a success by any means, but at least the problems that exist aren't on that scale. A better example of prohibition backfiring is with marijuana, where before prohibition ~0% of Americans were marijuana users, whereas today ~85% of American adults have used marijuana.
- zkms 10y ago
  My argument isn't that opioid use in the time of opium dens was harmless, nor that opioids can be used willy-nilly without any harms. I am well familiar with some of the dangers of opioid use and do not wish to discount them at all. My argument is that opioid prohibition in the 21st century in the US is a legal regime that amplifies those dangers -- it kills lots of people quite effectively (and keeps killing more every year). The number of people who use opioids regularly is a second-order concern (if only because fent-laced heroin certainly gets that number down) to me, frankly -- reducing morbidity and mortality due to drug use is a lot more important. With a decent medical infrastructure, addicts should be able to get opioid maintenance therapy with the right drugs and dosage and be able to lead actual interesting lives beyond trying to score the next hit. I'd so much rather live in a country where people who want to get high on opioids can buy cheap, pure, precisely metered opioids that won't kill them rather than smashing car windows to be able to pay for overpriced fentanyl-laced drugs sold by criminals that might overdose them in the street (which will cause even more expense and load on the already-awful USian medical system).

deftnerd 10y ago

Some of these synthetic opiates are a bit terrifying. There are some research chemicals available that are hundreds or thousands of times more potent than fentanyl and they're still technically legal. It's so hard to work with these that even the drug boards say it's suicide to try to work with them without a clean room and a hazmat suit. If you inhale just a little bit of the drug dust in the air it will kill you. It's gotten to the point where some of these respiratory depressant drugs can be used as a chemical weapon if inhaled. For instance: Heroin = 2.5x potency of morphine Hydromorphone = 7.5x potency of morphine Fentanyl = 120x potency of morphine Carfentanyl = 5000x to 7500x the potency of morphine Methoxyacetylfentanyl = 30,000x the potency of morphine A lethal dose of Methoxyacetylfentanyl is so small it's not even visible to the naked eye. Some powdered methoxyacetylfentanyl released from a drone over a crowd would be disastrous.

RcouF1uZ4gsC 10y ago
https://en.m.wikipedia.org/wiki/Equianalgesic https://en.m.wikipedia.org/wiki/Equianalgesic for more information
jemfinch 10y ago
Is there any reason to treat these as drugs instead of just poisons? We sell all kinds of poisons on the regular basis and don't bat an eye. Are these any more interesting because they're opiates?
- Scoundreller 10y ago
  It's the dose that makes the poison. This is 16th century toxicology: https://en.wikipedia.org/wiki/Paracelsus#Contributions_to_toxicology https://en.wikipedia.org/wiki/Paracelsus#Contributions_to_to...
- zkms 10y ago
  > Is there any reason to treat these as drugs instead of just poisons? because they have useful medical effects, a safe dose, and a decent therapeutic index. They have accepted uses in human and animal medicine. That the effective (and lethal) doses are both very small (and thus hard to precisely meter and dispense) only becomes a problem for people who can't access pharmaceutical-grade opioids.

pnathan 10y ago

This is a yellow journalism headline. Hearst would be proud. As I've remarked before, the war on drugs and getting tough on crime is not working out too well for us, so it's time to change our plan. I don't advocate off the shelf heroin or any of the cluster of ideas that suggest that. I do advocate focusing on the funnel that leads to addiction, homelessness, and death. Part of that is significantly amping up mental healthcare spending; part of that is having legally controlled drugs available in pharmacies for reasonable prices; part of that is supporting better schools (giving a window into a better world, and a way to climb through); part of that is supporting jobs programs. All of those relate in one way or another to the problem, some years and years earlier in the funnel. No one is born choosing to be an addict in their later life; a series of choices and pressures put them there. The pressures from society can be changed, which shapes the set of choices visible.

hackermailman 10y ago
From anecdotes of living beside the biggest open air drug market in Canada for a decade, and from watching my own friend's behavior growing up it seems to me the biggest problem is being unable to do anything when somebody you know or a family member becomes an addict. You can't force them into treatment, you can't even get the police to find them if they disappear into the streets, and the cycle in and out of jail just makes them career addicts as any chance of normal life seems over to them at that point. Here if they check into detox, even if you are direct family you can't visit them or bring them anything because detox will deny they are there. You can't ask detox to call when they are released so you can pick them up and they don't end up released back on the streets. Another problem is the waiting times for treatment. Real treatment is a long commitment sometimes living for years in a halfway house being supported by other peers to remain sober. An addict should be able to check into treatment and immediately commit themselves instead of waiting for months for a spot to open. Lack of any facility for police to just dump out of control users and have them treated by doctors and addiction specialists is another issue. Often there are mentally ill with secondary addictions or other problems, and the police don't know what to do with them and money is wasted having them ferry around doctors to look at these addicts in jails or playing catch and release after a weekend in jail. A one stop sober shop and treatment option is always requested by police here but it never materializes. Of course all of this costs money nobody will get elected with this spending platform on junkies until the synthetic opiates problem is so large the political will exists to do this. All the addicts I've talked to including 2 of my friends who had a bad addiction for a few years, they all ended up addicts by becoming successful and partying to celebrate it. Anybody who lives in Vancouver if you go to VANDU and listen to one of their meetings sometime this is the same story you will hear: I was successful, I started drinking and partying, I used drugs to help regulate my sleep, or to get sober (cocaine sobers you up) or stay awake to function, I ended up an addict and lost everything here I am living in the dumpster or flop hotel being enabled by other addicts because I stole from every family member/friend and burned all those bridges.

spraak 10y ago

I wonder as an analogy what markets would develop if caffeine sources were illegal. Caffeine isn't as harmful as other drugs but it is very addictive. By the same extension, this is why I think getting any drug should be eaiser. It's safer

ramblenode 10y ago

This is the text of the STOP act mentioned in the article: https://www.congress.gov/bill/114th-congress/house-bill/6045/text https://www.congress.gov/bill/114th-congress/house-bill/6045... IANAL but would be interested to hear from one about the privacy and financial implications of this bill. For example, (d)(1) seems to suggest a $1 processing fee for non-letter class mail originating outside the US.

bfuller 10y ago

I've used many grams of these substances. AMA

bfuller 10y ago

I've used many grams of these substances. AMA

undersuit 10y ago

>A better example of prohibition backfiring is with marijuana, where before prohibition ~0% of Americans were marijuana users, whereas today ~85% of American adults have used marijuana. No a better example was when Alex3917 made up shit, and then tried to legitimize his shit by comparing regular "users" to the population that has had at least one use. Wait that's not a better example, I'm just calling you out. Cannabis use was alive and well before Federal Prohibition, Alcohol and Marijuana. ~0% of Americans were users? Maybe in the early 1400s.

Alex3917 10y ago
Harry Anslinger estimated that there were 100,000 marijuana users when marijuana was banned 1937, when the U.S. population was ~129 million. In other words, a little less than 0.08%, or ~0%. Fail.
- TylerE 10y ago
  Getting your drug "facts" from Anslinger is like trusting what Jerry Falwell says about homosexuality.
  - Alex3917 10y ago
    Sure, but he wasn't exactly known for underestimating the scope of any drug-related problems. A better analogy would be that if Falwell says that gay marriage isn't responsible for causing hurricanes, you can probably take his word for it.
dang 10y ago
Comments that argue in an uncivil and personal way are not allowed on HN, regardless of how wrong someone else is. Please don't post like this here. We detached this subthread from https://news.ycombinator.com/item?id=13847157 https://news.ycombinator.com/item?id=13847157 and marked it off-topic.

coretx 10y ago

Yellow journalism just attacked your postal secret, your democracy ; this by means of using your disdain for junkies and drugs. Who else besides the mentioned politician and a large chunk of the logistics sector profits ? Put their heads on a pike, show the world how utilitarian their true face is.

s- 10y ago

and you thought only legitimate businesses had a customer attrition problem...