7 ms·

A community on the front lines of the opioid epidemic

56 points by iamjeff 10y ago

wallace_f 10y ago
Meanwhile yearly marijuana overdoses stay at a constant zero every year, while enforcement of marijuana prohibition kills untold numbers of convincingly innocent people.
- btian 10y ago
  How much political donation did marijuana growers make vs. Purdue Pharma?
  - jameskegel 10y ago
    One could also argue that MJ growers are fighting to pay taxes just to legitimize the industry, meanwhile Big Pharma has entire departments of professionals working to minimize those contributions, instead preferring to pay out via private incentives to our elected leaders. You choose which is worse.
    - rfrank 10y ago
      Some do, some don't. The emerald triangle has traditionally opposed legalization efforts in CA, it negatively impacts their bottom line.
    - mindslight 10y ago
      Encouraging a corrupt system to moderate its oppression of human rights as a profit center is definitely worse.
- drawkbox 10y ago
  Just recently Insys, the company that makes fentanyl[3] and gave 500k to help defeat legalized marijuana on Arizona[1], got approval/classification (Schedule II) for a synthetic THC/cannabinoid, Syndros, that does have the potential for overdose[2]. So not only are they killing opioid addicted users, now they are starting this. Somehow synthetic THC is Schedule II while natural/real cannabis is Schedule I. Fentanyl, synthetic opioid, was the cause of most of the ODs in the article, synthetics are a worse problem than the natural versions. But police suspect the heroin here was mixed with fentanyl, a synthetic opioid that is many times more potent than heroin. A wave of fatal overdoses signaled fentanyl’s arrival in Huntington in early 2015, and now some stashes aren’t heroin laced with fentanyl, but “fentanyl laced with heroin,” said Police Chief Joe Ciccarelli. [1] https://www.leafly.com/news/politics/fentanyl-maker-insys-give-500k-defeat-legalization https://www.leafly.com/news/politics/fentanyl-maker-insys-gi... [2] http://www.thecannabist.co/2017/03/23/synthetic-thc-drug-insys-therapeutics-dronabinol-syndros/76030/ http://www.thecannabist.co/2017/03/23/synthetic-thc-drug-ins... [3] https://www.statnews.com/2016/09/29/fentanyl-heroin-photo-fatal-doses/ https://www.statnews.com/2016/09/29/fentanyl-heroin-photo-fa...
  - c0nducktr 10y ago
    I seriously can't understand how someone could work for that company in clear conscience.
    - noonespecial 10y ago
      Its easy. Just add bills and take away options until your conscience is the least of your worries. When you're choosing between falling another month behind on rent on the apartment you were "so lucky" to get and getting a throbbing cavity filled at the dentist, you might not think too much about it.
      - c0nducktr 10y ago
        There are a lot of people working there who aren't close to falling a month behind on rent, and those people were who my comment was addressing. There are a lot of business out there which make a lot of their money in some very unethical ways, and people who choose to be part of that... I just don't understand. I couldn't live with myself. I know several people who have died of overdoses, so I'm probably biased, but I'm truly disgusted by what is going on.
        exolymph 10y ago
        People rationalize their positions. Human morality / ethics is very flexible. "It is difficult to get a man to understand something, when his salary depends on his not understanding it." — Upton Sinclair
        wallace_f 10y ago
        It's different for different people. Some people are dirtbags, some people are saints, and everyone else is in-between.
    - averagewall 10y ago
      Most people contribute to something they think is wrong but are just a cog in the machine so they don't think much about it. Pay tax to the US government? You're funding murder in the middle east. Have clients that are suppliers to service providers to this drug company? You're helping them too. Even professionals want a salary and a job.
gm-conspiracy 10y ago
From August, 2016.
- rhizome 10y ago
  ...and "this city" is Huntington, W. Va.
mirimir 10y ago
So what would it cost to distribute safe heroin? I mean, restricting availability of Oxycontin etc clearly hasn't worked. Edit: My point is that the Drug War is immoral.
- gragas 10y ago
  I think 1. We need more radical ideas like distributing heroin. 2. I'm not by any means convinced that distributing heroin will actually solve the problem. Clearly, nothing we've done so far has worked. Perhaps this will work. 3. There is some good sentiment behind the drug war. Still, there are a lot of evil pharmaceutical companies which have no good intentions. 4. Pharma firms inherently gravitate towards evil because more money lies there. Perhaps there are a few truly evil execs at these companies, but I think the sith-like aura comes from the sum of many only slightly evil actions. If we remove the money, we remove the problem. But how?
  - mirimir 10y ago
    The core problems here are profit-driven corporations and advertising. Without those, there would be no need for anti-drug laws. Back in the day, only corporations with public-interest charters were legal. And "get everyone addicted to oxycodone" was never going to make it as a public-interest charter. But those days are gone, so corporations are fighting with each other about which drugs it's OK to addict people to, and which it's not.
- stagbeetle 10y ago
  But is the drug war more efficient than legalizing the majority of drugs? If people had unstigmatized access to heavy depressants, like heroin (as opposed to "light" marijuana), would that really have a better net than if they weren't available at all? What comes to mind in this situation is reminiscent of dystopian neo-Tokyo in movies, where everything is grim and the people have reclused from life in their cramped cities, into daily drug escapes. Genuinely curious as to what the end-game is for legalization of controlled substances. Perhaps there's a middle ground (a moderate position if you will) that could be more efficient? ETA: I think it could work well if it was paired with something, say an educational program and increased mental help resources (two places in which the U.S is lacking and thus a poor place to pioneer open-drug policies) so it doesn't divulge into a free-for-all after drugs flood the market.
revmoo 10y ago
Gonna get worse once they ban kratom. Brace yourselves.
gragas 10y ago
So what can be done? I usually update my theory about the situation when I read new articles, but now I'm really at a loss. I'd love to help these people, but I can't see a fool-proof solution. Some questions come to mind: - Is it the role of the government to keep people safe from themselves? If so, how? - Would harsher drug laws make things better or worse? - How big of a role does purported economic opportunity have to do with drug abuse? My theory used to be that structural unemployment was the root of this epidemic; those born into the quickly receding middle class---those who relied on low-knowledge/low-skill jobs for a modest living---are hit the hardest since they did not anticipate such a shortage of low-skill jobs. - What does religion have to do with this? - What does culture have to do with this? - Are members of the military more or less affected by opiod drug abuse? - Does providing safe places to take drugs alleviate the problem, or does it make it worse?
- yaacov 10y ago
  One thing that would help is making Suboxone more freely available. It's a pretty safe drug that effectively treats the physical symptoms of heroin withdrawal, making quitting a lot more possible. For no good reason whatsoever, the FDA makes it really, really hard to get. Here's an article by a psychiatrist about the way Suboxone is regulated now: https://slatestarcodex.com/2015/02/02/practically-a-book-review-dying-to-be-free/ https://slatestarcodex.com/2015/02/02/practically-a-book-rev...
  - rincebrain 10y ago
    I wouldn't say "no good reason" - suboxone is, itself, a habit-forming opioid.
- mirimir 10y ago
  What can be done? Well, there are lots of naive junkies out there. You can wait for them to kill themselves. Or you can stabilize them, and help them break their addiction. That works. The evidence is clear. Religion? Well, addiction is perceived rather like possession by the Devil. Or at least, weakness. Lack of faith. Really, as Bill basically said, those dirty addicts deserve to die. It's just that Purdue Pharma managed to addict lots of people by rewarding doctors to over-prescribe, and flooding distribution chains in the southeastern US. Maybe economic collapse is part of the problem. But there's a good chance that things will be manageable after the Purdue mess has been handled. Edit: In a dead comment, revmoo mentioned kratom, a natural opiate analog. The DEA decided last year not to ban it, after massive public comment. Advocates claim that it helps addicts break their addictions. https://www.theguardian.com/us-news/2016/oct/14/kratom-dea-ban-reversal-culture-shift https://www.theguardian.com/us-news/2016/oct/14/kratom-dea-b...
touchofevil 10y ago
It seems like the real problem causing the overdoses is that fentanyl and carfentinal are getting mixed into the heroin. At the minimum, the US should provide a program where heroin addicts can get heroin from government clinics, which is what they offer in the Netherlands[1] where addicts can get heroin three times a day and apparently rarely overdose presumably because the heroin is pure. But at this point, I'd rather see most drugs legalized and the tax money poured into addiction recovery programs, government clinics for supervised drug use, and drug use prevention. [1] https://news.vice.com/article/only-in-the-netherlands-do-addicts-complain-about-free-government-heroin https://news.vice.com/article/only-in-the-netherlands-do-add...
- mirimir 10y ago
  If morphine was legal, probably about ~10-20% of the population would be addicts. In 1900, 2-5% were morphine addicts.[0] And advertising was pretty lame back then. 0) http://www.druglibrary.org/olsen/dpf/whitebread02.html http://www.druglibrary.org/olsen/dpf/whitebread02.html
  - elchief 10y ago
    90% of (US) men used to smoke, now 15% do...
  - culot 10y ago
    Upside: the laxative industry would boom.
    - arthur_pryor 10y ago
      actually, they are selling something for that... https://www.drugs.com/movantik.html https://www.drugs.com/movantik.html https://en.wikipedia.org/wiki/Naloxegol https://en.wikipedia.org/wiki/Naloxegol
  - touchofevil 10y ago
    I'm not sure where you are getting your estimate that 10-20% of the population would be addicted to morphine if most drugs were legalized in the USA today. If you look at the stats on Portugal, you'll see that drug use and drug related deaths have declined since the country legalized all drugs[1]. Also, morphine was only invented around 1818 and its addictive properties were not understood until much later[2]. For example, "...initially morphine was also marketed as a non-addictive cure for addiction to both alcohol and opium..." That was happening in 1853, nearly 40 years after the invention of morphine. In the article you linked to, the author states that many of the morphine addicts of the 1900s were people in rural communities who were sold "elixirs" by traveling "doctors" and these potions were often 50% morphine. Which causes the author to state: "...if you look at drug addiction in 1900, what's the number one way in which it is different than drug addiction today? Answer: Almost all addiction at the turn of the century was accidental." If drugs were legalized, consumers would not be getting accidentally addicted to morphine as they were in the 1900s, because they would be able to know for certain what drugs they were buying and ingesting. [1] https://mic.com/articles/110344/14-years-after-portugal-decriminalized-all-drugs-here-s-what-s-happening#.ldEGEaPU2 https://mic.com/articles/110344/14-years-after-portugal-decr... [2] http://www.todayifoundout.com/index.php/2014/09/invented-morphine/ http://www.todayifoundout.com/index.php/2014/09/invented-mor...
goldenkey 10y ago
The problem isn't opiates. It's larger doses than necessary combined with synthetic drugs that are much more powerful than the natural poppy alkaloids. Quick rundown: The poppy plant has two main alkaloids that make up the majority of its analgesic activity: codeine and morphine. Codeine works following being broken down by the liver into morphine. It's essentially the same drug but requires larger doses due to the inefficient pathway. I have had a chronic pain condition for many years now and take 30mg morphine sulfate tablets twice daily. Instant release taken often works far better than extended release drugs because the total dose is much less, which keeps tolerance levels low, thereby lower dependence. Oxycodone is 1.5 to 2x as strong as morphine. [1] Oxymorphone is 7-8x times as strong as morphine. [1] Fentanyl is 50-100x times as strong as morphine. [1] Of course this is referring to gram for gram, and these substances do have different molecular weights. But even so, the potency has much to do with bonding length between the drug and the body's receptors. Bonding length is correlated with bonding strength, also correlated with addictive qualities. For low to moderate pain, Tramadol[2] is the best analgestic. For moderate to severe pain, Tapentadol[3] (Nucynta) is by far, the most therapeutic and least addictive. I used to take it until I lost my insurance. Unfortunately it costs $1500 a bottle. It's a newer drug. The same company Depomed that created Tramadol kept going and made a better and stronger version. Having tried gabapentin, muscle relaxers, all kinds of stuff, pretty much everything out there, I will say, Tapentadol is really an amazing drug. It's unfortunate its so expensive and not covered by many insurances though. So in summary, if a person has the insurance, the doctor should prescribe them Tapentadol or Tramadol. As a last resort, prescribe Codeine and/or Morphine. Not these crazy synthetics with ridiculous addiction profiles and bonding strengths. Hope this helps anyone who ever has a pain condition. [1] https://en.wikipedia.org/wiki/Equianalgesic https://en.wikipedia.org/wiki/Equianalgesic [2] https://en.wikipedia.org/wiki/Tramadol https://en.wikipedia.org/wiki/Tramadol [3] https://en.wikipedia.org/wiki/Tapentadol https://en.wikipedia.org/wiki/Tapentadol
alasdair_ 10y ago
My daughter died from a fentanyl overdose a couple of months ago. Like many of the people on this site, I am a software engineer working for a top-tier tech firm in SF. Money isn't a serious problem in our lives. Total time from "maybe our daughter is doing drugs?" to death was less than three months. We sent her to rehab in that time because she was abusing cocaine and asked to go. I am not some ignorant parent - I've tried plenty of things and k ow the signs well. Please, if you have kids, tell them about fentanyl. It is SO much more potent than heroin and can kill on the first dose. She went to a party, someone offered her some "coke", she snorted some and she died soon after. Turns out the coke was fentanyl or at least had some in it. The autopsy of my daughter showed that there were no injection marks. She had a career and in no way fit the stereotype of an addict. One day she existed, the next she did not. I am neither pro nor ani drug. I don't care about that. All i care about is telling people the story of my daughter. Fentanyl is so much more potent than heroin and it is sweeping the entire nation. If you have kids, please tell them tbat it exists and that people are selling it right now claiming its something different.
- mirimir 10y ago
  That is just so sad. I can't help but think of all the street drugs I've ingested in one way or another. It's just that, in those days, there wasn't stuff out there that would kill you so easily.
- TheSpiceIsLife 10y ago
  I watched a friend start to lose consciousness and start to lose colour from extremely shallow breathing after taking more Heroin that he should have. Fortunately I knew what to do. We kept him breathing till the ambulance arrived and got him breathing and back to a reasonable level of consciousness again using nasally administered Naloxone (Narcan) solution. As far as I'm aware Fentanyl overdose can be treated the same way: Give breathes until an ambulance arrives. What saddens me most about these stories is that no one present had the knowledge necessary to keep someone alive long enough for help to arrive. Never use along, never dose at the same time as your buddy / buddies. Make sure your buddy / buddies know what to do. If in doubt half the dose.
addict_gt 10y ago
I'm reluctantly commenting, throwaway account. I had spent an hour writing this huge note, but don't think it was constructive. Check out the reddit description of opiates and heroin, the youtube spoken word video will help non-addicts understand the power of these drugs and the control they have over your life and your brain chemistry and how easy it is to become dependent. I am an addict. I have been all of my life, and will be until the day I die (hopefully at an old age and happy). I'm also business owner, young and I would say very successful compared to others in my age group. Ironically, I actually credit Oxy for getting sober from alcohol (coming on 3 years), and I've been sober from cocaine for probably around 3.5 years (don't remember, very blurry). However I'm currently dependent on opiate pills and I feel very lucky that I can afford my addiction, at least for now. I'm afraid to get sober. I'm afraid to tell the truth to the ones I love who supported and congratulated me on getting sober from alcohol and cocaine. Instead of telly a long story, I wanted to offer some ideas to this community, from the perspective of an addict and entrepreneur, a few of these could even be successful startups that save lives: 1) doctors need to stop prescribing. I am very open with my Doctor, it is written on the front page of the screen that shows my health record: previously cocaine dependent, alcoholic. Yet when I went in for a bad burn, they prescribed Percocet. I went to the doctors seeking some numbing cream and to ensure I didn't get an infection. But I got pills, and I'm an addict. I KNEW 100% I would become addicted. It didn't happen over night of course, but here I am. Replacement therapy is called liquid handcuffs for a reason: methadone is dangerous and deadly, Sub withdrawal I hear is worse than oxy/heroin withdrawal. I would love to see an experiment long term between traditional replacement therapy, compared to actually supplying addicts with pure drugs. 2) make a reliable and widely available and free test kit to detect Fent and other deadly synthetic and powerful opiates. 3) make a cheap wearable fitbit like device. It will detect slowed/stopped breathing and alert either authorities or maybe an app that has listed contacts who are trained and have access to naloxone, like a rape or danger alert sent to your designated contacts and if no response 911. It would have to have little monetary value so it's not sold, but maybe could help save some lives. 4) make an implant that can detect slow breathing/overdose and administer naloxone during an overdose internally. Like a diabetes monitor/pump. 5) sue Purdue and change our countries addiction to prescription pain killers. To me this is the big tobacco of our time. They spent millions and millions advertising and buying doctors telling them this is a non-addictive 12 hour pain reliever. Pain in the past was rarely medicated. Purdue changed this and made billions. The truth is Percocet/Oxy usually lasts only 6-8 hours, maybe 10 if you're lucky. Each individual is unique. Purdue advertised 12 hours non-addictive and that's how doctors prescribed. so when the pain comes back before 12 hours or you start getting sick you take the next pill. And you use your entire script before the next refill. They MUST have known this. Profiting on addiction is shameful. Marketing a product to purposefully create addicts to sell more pills is criminal an I hope that somebody can leak or a prosecutor can make this case and bring some justice, and badly needed funding to aid in recovery, research, and alternative replacement options.
michaelhoney 10y ago
Serious question: would it not be better to make opioid painkillers available again, rather that have people substitute with heroin or worse?

56 points by iamjeff 10y ago

Meanwhile yearly marijuana overdoses stay at a constant zero every year, while enforcement of marijuana prohibition kills untold numbers of convincingly innocent people.

btian 10y ago
How much political donation did marijuana growers make vs. Purdue Pharma?
- jameskegel 10y ago
  One could also argue that MJ growers are fighting to pay taxes just to legitimize the industry, meanwhile Big Pharma has entire departments of professionals working to minimize those contributions, instead preferring to pay out via private incentives to our elected leaders. You choose which is worse.
  - rfrank 10y ago
    Some do, some don't. The emerald triangle has traditionally opposed legalization efforts in CA, it negatively impacts their bottom line.
  - mindslight 10y ago
    Encouraging a corrupt system to moderate its oppression of human rights as a profit center is definitely worse.
drawkbox 10y ago
Just recently Insys, the company that makes fentanyl[3] and gave 500k to help defeat legalized marijuana on Arizona[1], got approval/classification (Schedule II) for a synthetic THC/cannabinoid, Syndros, that does have the potential for overdose[2]. So not only are they killing opioid addicted users, now they are starting this. Somehow synthetic THC is Schedule II while natural/real cannabis is Schedule I. Fentanyl, synthetic opioid, was the cause of most of the ODs in the article, synthetics are a worse problem than the natural versions. But police suspect the heroin here was mixed with fentanyl, a synthetic opioid that is many times more potent than heroin. A wave of fatal overdoses signaled fentanyl’s arrival in Huntington in early 2015, and now some stashes aren’t heroin laced with fentanyl, but “fentanyl laced with heroin,” said Police Chief Joe Ciccarelli. [1] https://www.leafly.com/news/politics/fentanyl-maker-insys-give-500k-defeat-legalization https://www.leafly.com/news/politics/fentanyl-maker-insys-gi... [2] http://www.thecannabist.co/2017/03/23/synthetic-thc-drug-insys-therapeutics-dronabinol-syndros/76030/ http://www.thecannabist.co/2017/03/23/synthetic-thc-drug-ins... [3] https://www.statnews.com/2016/09/29/fentanyl-heroin-photo-fatal-doses/ https://www.statnews.com/2016/09/29/fentanyl-heroin-photo-fa...
- c0nducktr 10y ago
  I seriously can't understand how someone could work for that company in clear conscience.
  - noonespecial 10y ago
    Its easy. Just add bills and take away options until your conscience is the least of your worries. When you're choosing between falling another month behind on rent on the apartment you were "so lucky" to get and getting a throbbing cavity filled at the dentist, you might not think too much about it.
    - c0nducktr 10y ago
      There are a lot of people working there who aren't close to falling a month behind on rent, and those people were who my comment was addressing. There are a lot of business out there which make a lot of their money in some very unethical ways, and people who choose to be part of that... I just don't understand. I couldn't live with myself. I know several people who have died of overdoses, so I'm probably biased, but I'm truly disgusted by what is going on.
      - exolymph 10y ago
        People rationalize their positions. Human morality / ethics is very flexible. "It is difficult to get a man to understand something, when his salary depends on his not understanding it." — Upton Sinclair
        wallace_f 10y ago
        It's different for different people. Some people are dirtbags, some people are saints, and everyone else is in-between.
  - averagewall 10y ago
    Most people contribute to something they think is wrong but are just a cog in the machine so they don't think much about it. Pay tax to the US government? You're funding murder in the middle east. Have clients that are suppliers to service providers to this drug company? You're helping them too. Even professionals want a salary and a job.

gm-conspiracy 10y ago

From August, 2016.

rhizome 10y ago
...and "this city" is Huntington, W. Va.

mirimir 10y ago

So what would it cost to distribute safe heroin? I mean, restricting availability of Oxycontin etc clearly hasn't worked. Edit: My point is that the Drug War is immoral.

gragas 10y ago
I think 1. We need more radical ideas like distributing heroin. 2. I'm not by any means convinced that distributing heroin will actually solve the problem. Clearly, nothing we've done so far has worked. Perhaps this will work. 3. There is some good sentiment behind the drug war. Still, there are a lot of evil pharmaceutical companies which have no good intentions. 4. Pharma firms inherently gravitate towards evil because more money lies there. Perhaps there are a few truly evil execs at these companies, but I think the sith-like aura comes from the sum of many only slightly evil actions. If we remove the money, we remove the problem. But how?
- mirimir 10y ago
  The core problems here are profit-driven corporations and advertising. Without those, there would be no need for anti-drug laws. Back in the day, only corporations with public-interest charters were legal. And "get everyone addicted to oxycodone" was never going to make it as a public-interest charter. But those days are gone, so corporations are fighting with each other about which drugs it's OK to addict people to, and which it's not.
stagbeetle 10y ago
But is the drug war more efficient than legalizing the majority of drugs? If people had unstigmatized access to heavy depressants, like heroin (as opposed to "light" marijuana), would that really have a better net than if they weren't available at all? What comes to mind in this situation is reminiscent of dystopian neo-Tokyo in movies, where everything is grim and the people have reclused from life in their cramped cities, into daily drug escapes. Genuinely curious as to what the end-game is for legalization of controlled substances. Perhaps there's a middle ground (a moderate position if you will) that could be more efficient? ETA: I think it could work well if it was paired with something, say an educational program and increased mental help resources (two places in which the U.S is lacking and thus a poor place to pioneer open-drug policies) so it doesn't divulge into a free-for-all after drugs flood the market.

revmoo 10y ago

Gonna get worse once they ban kratom. Brace yourselves.

gragas 10y ago

So what can be done? I usually update my theory about the situation when I read new articles, but now I'm really at a loss. I'd love to help these people, but I can't see a fool-proof solution. Some questions come to mind: - Is it the role of the government to keep people safe from themselves? If so, how? - Would harsher drug laws make things better or worse? - How big of a role does purported economic opportunity have to do with drug abuse? My theory used to be that structural unemployment was the root of this epidemic; those born into the quickly receding middle class---those who relied on low-knowledge/low-skill jobs for a modest living---are hit the hardest since they did not anticipate such a shortage of low-skill jobs. - What does religion have to do with this? - What does culture have to do with this? - Are members of the military more or less affected by opiod drug abuse? - Does providing safe places to take drugs alleviate the problem, or does it make it worse?

yaacov 10y ago
One thing that would help is making Suboxone more freely available. It's a pretty safe drug that effectively treats the physical symptoms of heroin withdrawal, making quitting a lot more possible. For no good reason whatsoever, the FDA makes it really, really hard to get. Here's an article by a psychiatrist about the way Suboxone is regulated now: https://slatestarcodex.com/2015/02/02/practically-a-book-review-dying-to-be-free/ https://slatestarcodex.com/2015/02/02/practically-a-book-rev...
- rincebrain 10y ago
  I wouldn't say "no good reason" - suboxone is, itself, a habit-forming opioid.
mirimir 10y ago
What can be done? Well, there are lots of naive junkies out there. You can wait for them to kill themselves. Or you can stabilize them, and help them break their addiction. That works. The evidence is clear. Religion? Well, addiction is perceived rather like possession by the Devil. Or at least, weakness. Lack of faith. Really, as Bill basically said, those dirty addicts deserve to die. It's just that Purdue Pharma managed to addict lots of people by rewarding doctors to over-prescribe, and flooding distribution chains in the southeastern US. Maybe economic collapse is part of the problem. But there's a good chance that things will be manageable after the Purdue mess has been handled. Edit: In a dead comment, revmoo mentioned kratom, a natural opiate analog. The DEA decided last year not to ban it, after massive public comment. Advocates claim that it helps addicts break their addictions. https://www.theguardian.com/us-news/2016/oct/14/kratom-dea-ban-reversal-culture-shift https://www.theguardian.com/us-news/2016/oct/14/kratom-dea-b...

touchofevil 10y ago

It seems like the real problem causing the overdoses is that fentanyl and carfentinal are getting mixed into the heroin. At the minimum, the US should provide a program where heroin addicts can get heroin from government clinics, which is what they offer in the Netherlands[1] where addicts can get heroin three times a day and apparently rarely overdose presumably because the heroin is pure. But at this point, I'd rather see most drugs legalized and the tax money poured into addiction recovery programs, government clinics for supervised drug use, and drug use prevention. [1] https://news.vice.com/article/only-in-the-netherlands-do-addicts-complain-about-free-government-heroin https://news.vice.com/article/only-in-the-netherlands-do-add...

mirimir 10y ago
If morphine was legal, probably about ~10-20% of the population would be addicts. In 1900, 2-5% were morphine addicts.[0] And advertising was pretty lame back then. 0) http://www.druglibrary.org/olsen/dpf/whitebread02.html http://www.druglibrary.org/olsen/dpf/whitebread02.html
- elchief 10y ago
  90% of (US) men used to smoke, now 15% do...
- culot 10y ago
  Upside: the laxative industry would boom.
  - arthur_pryor 10y ago
    actually, they are selling something for that... https://www.drugs.com/movantik.html https://www.drugs.com/movantik.html https://en.wikipedia.org/wiki/Naloxegol https://en.wikipedia.org/wiki/Naloxegol
- touchofevil 10y ago
  I'm not sure where you are getting your estimate that 10-20% of the population would be addicted to morphine if most drugs were legalized in the USA today. If you look at the stats on Portugal, you'll see that drug use and drug related deaths have declined since the country legalized all drugs[1]. Also, morphine was only invented around 1818 and its addictive properties were not understood until much later[2]. For example, "...initially morphine was also marketed as a non-addictive cure for addiction to both alcohol and opium..." That was happening in 1853, nearly 40 years after the invention of morphine. In the article you linked to, the author states that many of the morphine addicts of the 1900s were people in rural communities who were sold "elixirs" by traveling "doctors" and these potions were often 50% morphine. Which causes the author to state: "...if you look at drug addiction in 1900, what's the number one way in which it is different than drug addiction today? Answer: Almost all addiction at the turn of the century was accidental." If drugs were legalized, consumers would not be getting accidentally addicted to morphine as they were in the 1900s, because they would be able to know for certain what drugs they were buying and ingesting. [1] https://mic.com/articles/110344/14-years-after-portugal-decriminalized-all-drugs-here-s-what-s-happening#.ldEGEaPU2 https://mic.com/articles/110344/14-years-after-portugal-decr... [2] http://www.todayifoundout.com/index.php/2014/09/invented-morphine/ http://www.todayifoundout.com/index.php/2014/09/invented-mor...

goldenkey 10y ago

The problem isn't opiates. It's larger doses than necessary combined with synthetic drugs that are much more powerful than the natural poppy alkaloids. Quick rundown: The poppy plant has two main alkaloids that make up the majority of its analgesic activity: codeine and morphine. Codeine works following being broken down by the liver into morphine. It's essentially the same drug but requires larger doses due to the inefficient pathway. I have had a chronic pain condition for many years now and take 30mg morphine sulfate tablets twice daily. Instant release taken often works far better than extended release drugs because the total dose is much less, which keeps tolerance levels low, thereby lower dependence. Oxycodone is 1.5 to 2x as strong as morphine. [1] Oxymorphone is 7-8x times as strong as morphine. [1] Fentanyl is 50-100x times as strong as morphine. [1] Of course this is referring to gram for gram, and these substances do have different molecular weights. But even so, the potency has much to do with bonding length between the drug and the body's receptors. Bonding length is correlated with bonding strength, also correlated with addictive qualities. For low to moderate pain, Tramadol[2] is the best analgestic. For moderate to severe pain, Tapentadol[3] (Nucynta) is by far, the most therapeutic and least addictive. I used to take it until I lost my insurance. Unfortunately it costs $1500 a bottle. It's a newer drug. The same company Depomed that created Tramadol kept going and made a better and stronger version. Having tried gabapentin, muscle relaxers, all kinds of stuff, pretty much everything out there, I will say, Tapentadol is really an amazing drug. It's unfortunate its so expensive and not covered by many insurances though. So in summary, if a person has the insurance, the doctor should prescribe them Tapentadol or Tramadol. As a last resort, prescribe Codeine and/or Morphine. Not these crazy synthetics with ridiculous addiction profiles and bonding strengths. Hope this helps anyone who ever has a pain condition. [1] https://en.wikipedia.org/wiki/Equianalgesic https://en.wikipedia.org/wiki/Equianalgesic [2] https://en.wikipedia.org/wiki/Tramadol https://en.wikipedia.org/wiki/Tramadol [3] https://en.wikipedia.org/wiki/Tapentadol https://en.wikipedia.org/wiki/Tapentadol

alasdair_ 10y ago

My daughter died from a fentanyl overdose a couple of months ago. Like many of the people on this site, I am a software engineer working for a top-tier tech firm in SF. Money isn't a serious problem in our lives. Total time from "maybe our daughter is doing drugs?" to death was less than three months. We sent her to rehab in that time because she was abusing cocaine and asked to go. I am not some ignorant parent - I've tried plenty of things and k ow the signs well. Please, if you have kids, tell them about fentanyl. It is SO much more potent than heroin and can kill on the first dose. She went to a party, someone offered her some "coke", she snorted some and she died soon after. Turns out the coke was fentanyl or at least had some in it. The autopsy of my daughter showed that there were no injection marks. She had a career and in no way fit the stereotype of an addict. One day she existed, the next she did not. I am neither pro nor ani drug. I don't care about that. All i care about is telling people the story of my daughter. Fentanyl is so much more potent than heroin and it is sweeping the entire nation. If you have kids, please tell them tbat it exists and that people are selling it right now claiming its something different.

mirimir 10y ago
That is just so sad. I can't help but think of all the street drugs I've ingested in one way or another. It's just that, in those days, there wasn't stuff out there that would kill you so easily.
TheSpiceIsLife 10y ago
I watched a friend start to lose consciousness and start to lose colour from extremely shallow breathing after taking more Heroin that he should have. Fortunately I knew what to do. We kept him breathing till the ambulance arrived and got him breathing and back to a reasonable level of consciousness again using nasally administered Naloxone (Narcan) solution. As far as I'm aware Fentanyl overdose can be treated the same way: Give breathes until an ambulance arrives. What saddens me most about these stories is that no one present had the knowledge necessary to keep someone alive long enough for help to arrive. Never use along, never dose at the same time as your buddy / buddies. Make sure your buddy / buddies know what to do. If in doubt half the dose.

addict_gt 10y ago

I'm reluctantly commenting, throwaway account. I had spent an hour writing this huge note, but don't think it was constructive. Check out the reddit description of opiates and heroin, the youtube spoken word video will help non-addicts understand the power of these drugs and the control they have over your life and your brain chemistry and how easy it is to become dependent. I am an addict. I have been all of my life, and will be until the day I die (hopefully at an old age and happy). I'm also business owner, young and I would say very successful compared to others in my age group. Ironically, I actually credit Oxy for getting sober from alcohol (coming on 3 years), and I've been sober from cocaine for probably around 3.5 years (don't remember, very blurry). However I'm currently dependent on opiate pills and I feel very lucky that I can afford my addiction, at least for now. I'm afraid to get sober. I'm afraid to tell the truth to the ones I love who supported and congratulated me on getting sober from alcohol and cocaine. Instead of telly a long story, I wanted to offer some ideas to this community, from the perspective of an addict and entrepreneur, a few of these could even be successful startups that save lives: 1) doctors need to stop prescribing. I am very open with my Doctor, it is written on the front page of the screen that shows my health record: previously cocaine dependent, alcoholic. Yet when I went in for a bad burn, they prescribed Percocet. I went to the doctors seeking some numbing cream and to ensure I didn't get an infection. But I got pills, and I'm an addict. I KNEW 100% I would become addicted. It didn't happen over night of course, but here I am. Replacement therapy is called liquid handcuffs for a reason: methadone is dangerous and deadly, Sub withdrawal I hear is worse than oxy/heroin withdrawal. I would love to see an experiment long term between traditional replacement therapy, compared to actually supplying addicts with pure drugs. 2) make a reliable and widely available and free test kit to detect Fent and other deadly synthetic and powerful opiates. 3) make a cheap wearable fitbit like device. It will detect slowed/stopped breathing and alert either authorities or maybe an app that has listed contacts who are trained and have access to naloxone, like a rape or danger alert sent to your designated contacts and if no response 911. It would have to have little monetary value so it's not sold, but maybe could help save some lives. 4) make an implant that can detect slow breathing/overdose and administer naloxone during an overdose internally. Like a diabetes monitor/pump. 5) sue Purdue and change our countries addiction to prescription pain killers. To me this is the big tobacco of our time. They spent millions and millions advertising and buying doctors telling them this is a non-addictive 12 hour pain reliever. Pain in the past was rarely medicated. Purdue changed this and made billions. The truth is Percocet/Oxy usually lasts only 6-8 hours, maybe 10 if you're lucky. Each individual is unique. Purdue advertised 12 hours non-addictive and that's how doctors prescribed. so when the pain comes back before 12 hours or you start getting sick you take the next pill. And you use your entire script before the next refill. They MUST have known this. Profiting on addiction is shameful. Marketing a product to purposefully create addicts to sell more pills is criminal an I hope that somebody can leak or a prosecutor can make this case and bring some justice, and badly needed funding to aid in recovery, research, and alternative replacement options.

michaelhoney 10y ago

Serious question: would it not be better to make opioid painkillers available again, rather that have people substitute with heroin or worse?