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Nineteen people a week overdose in Richmond, dozens are dying, hundreds revived

141 points by iamjeff 9y ago

AdmiralAsshat 9y ago
This reminds me that the lead singer of GWAR died in Richmond from a heroin overdose in 2014: https://en.wikipedia.org/wiki/Dave_Brockie https://en.wikipedia.org/wiki/Dave_Brockie
PatientTrades 9y ago
Most of this stems from the overprescription of opioids. I remember when I had surgery for a broken leg the amount of drugs I received after the surgery was astounding. It was almost as if the hospital wanted me to become hooked. I didn't need or ask for the opioids, they were just prescribed for pain killing. A regular Tylenol or Advil would have done the job. Not saying hospitals want people on drugs, but at some point we have hold the people initially prescribing the drugs accountable.
- ellyagg 9y ago
  What makes you say that? It's trivial to get opioids on the streets and it's common to be introduced to them as a recreational drug, as I know first hand. In fact, I don't know anyone who got addicted to opioids due to overprescription, but I know several people who didn't get prescribed opioids they needed because of the fears of overprescription, and thus were left in terrible pain. I don't know how you draw the line, but I think it's evil to leave people in pain because you're afraid they'll use the drugs for fun. Most people who take opioids do not get addicted.
  - munk-a 9y ago
    People generally say that over-prescription leads to harder opioid usage because it does. I have had co-workers familiar with the neurological effects of the drugs they've been given balk at it. I've also known community members who had injuries slide into the obscurity of addiction. A very real factor of this crisis is the pain aversion, people working in dentistry have higher rates of depression and suicide due to the psychological effects of inflicting pain on people (unless the dentist is played by steve martin ofc) and it's a problem without clear solutions. Legalization of marijuana would probably help reduce the mild-moderate pain classes in a non-addictive manner, but for extreme pain there isn't a good solution. Anyways... there are plenty of first-hand accounts and plenty of studies showing the connection here, please do a little research before posting unsupported claims.
    - incadenza 9y ago
      It's important to note that the epidemic that people refer to is the overdose epidemic, often labelled the opiate epidemic for whatever reason. I haven't seen any evidence that actual rates of heroin abuse increasing year over year. Just wealthier people dying from poorly cut drugs at a more alarming rate. This was the most recent report I could find: https://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1-2014.pdf https://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2...
    - loverofcode 9y ago
      That is not true, first dentist have a higher suicide rate not because of the pain on people but because so many people hate to see them. It is never a pleasant experience. You also should be aware of the suicide rate in pain patients because their pain cannot be under control. this is a direct result of the war on drugs. the fentanyl and carfentanil coming from china are responsible. before these two were being imported at such high rates opioid deaths were 4,000 per year vs 400,000 for alcohol. Which at first was being blamed on fentanyl being prescribed legally, but was incorrect data. Check the numbers yourself at wonder cdc. attached is the screenshot form cdc data. https://imgur.com/a/fFBTe https://imgur.com/a/fFBTe
  - gebeeson 9y ago
    I went through open heart surgery two years ago April and opioid over-prescription was already a concern. After discharge I received a six day script for the lowest dose of fentanyl and a month of Lyrica. I have a freakishly high pain tolerance so I managed to 'stretch' the fentanyl patches out to nearly one month (each patch lasted roughly three days). Hindsight being what it is - I obviously made it through. Being down in it though, it was far far less than pleasant. Especially that I was supposed to be active and all the usual recovery stuff. It was a bit of no joke as far as pain load goes. I didn't expect to be completely pain free as that isn't life as far as I am concerned, it would have been nice to have taken a little bit more of the edge off. Round the pain off some.
    - hiram112 9y ago
      Agreed. I too have had a major surgery several years ago. I was given morphine and than Oxycodone when discharged, but not at high enough dosage for adequate relief - 3 or 4 days of pure misery. There is no reason, when short-term opiate use is easily available, for patients to suffer like this. It seems like the medical establishment was really pushing opiates for years, even when they probably weren't needed. Now they're swung too far in the other direction: under-prescribing them for fear of overdosage, addiction, and even punishment by the DEA and government. Wish we could find some middle ground.
  - nickik 9y ago
    What makes him say that is that it is a well documented problem. Many other people recognize it and treat it accordingly. My father is a Anthologist and they are very careful with how much they give. It is a major issue. For some reason, the US, including doctors, have developed a anti-pain philosophy where they oversubscribe these drugs and it is know to cause addiction.
- snuxoll 9y ago
  It's incredibly easy to get hooked when taking prescription opiates even if you're fully aware of the situation. I had a wisdom tooth extracted last year, and by the time the pain was finally down to the level I could manage with OTC pain relievers I realized I had developed a mild physical addiction to the hydrocodone. I had no desire to get high off the pain killers, hell, they didn't even do anything for me in that regard - but I could feel the need to take them. I can easily see how someone without the awareness, willpower and a number of other factors could give in and start down the path of self-destruction. It was a terrifying place for me to be in, and as someone who has responsibly taken prescription opiates for multiple other oral surgeries as well as a septoplasty it was one I never thought possible.
  - loverofcode 9y ago
    There is a difference between dependence and addiction. People who are in pain 24/7 rely on these medications and are being thrown into the streets because of the DEA, when if fact this is a direct result of the war on drugs. the fentanyl and carfentanil coming from china are responsible. before these two were being imported at such high rates opioid deaths were 4,000 per year vs 400,000 for alcohol. Which at first was being blamed on fentanyl being prescribed legally, but was incorrect data. Check the numbers yourself at wonder cdc. attached is the screenshot form cdc data. https://imgur.com/a/fFBTe https://imgur.com/a/fFBTe
    - snuxoll 9y ago
      Don’t take my anecdote to mean I’m against prescription opiates, there’s no way in hell I would have been able to manage my pain after these procedures without them - in fact I think we’re steering the ship far too hard away from their use in a reactionary move to combat these deaths. But I don’t have any doubt many people have become physically dependent on these drugs and are now turning to the black market - it very well could have been me in another life. The war on drugs really needs to come to an abrupt end, people who need opioids to manage their pain should have them, people who are hopelessly addicted should have access in a controlled and safe manner, and for crying out loud can we just legalize weed already?
- adfm 9y ago
  For more background on why we've got a dope problem, check out this LA Times piece on Oxycontin's 12-hour Problem: http://www.latimes.com/projects/oxycontin-part1/ http://www.latimes.com/projects/oxycontin-part1/
  - refurb 9y ago
    That article was written by someone not that familiar with the pharma market. It would be illegal for Purdue to promote on any other than 12 hours. It's called off-label promotion and companies pay multi-billion dollar fines for it.
    - firebones 9y ago
      While it is factually true that it would be illegal for Purdue to promote off-label, they also need to be held accountable for playing fast and loose with the research studies (even altering the definitions used in the trials) in order to be able to claim 12h coverage when nearly half the patients weren't getting 12h coverage. This, combined with the recommendation to push higher doses to achieve 12h coverage, combined with the gap in coverage, drove a lot of people into a cycle of unhealthy and deadly dependency. At the very least it's a case of consumer product safety liability and negligence fueled by profit motive.
      - refurb 9y ago
        Shouldn't the FDA be held accountable? They approved the trial design and overall application.
        firebones 9y ago
        I wish regulators could be perfect, and if they were, we'd reduce harm a lot. But since we know they're not, we can, as participants in society, be as Caesar's wife--above suspicion--and avoid these situations entirely. A lot of capitalism's woes would be overcome should that standard be applied.
- deleted 9y ago
  [deleted]
- refurb 9y ago
  If you've been around long enough you'd realize we're come full circle. Prior to the 1990's pain meds were very rarely handed out. Then a few things happened: (1) more data was collected that suggested when used for severe pain, the addiction potential was low, (2) adequately controlled pain leads to quicker recovery times and (3) there was a lot of untreated pain at the time. As a result, opioid use when way up. One could argue it went to far with very strong opioids being given for mild or moderate pain. The sad thing is that we're already seeing doctors get more stingy with opioids. My guess is we'll swing too far in the other direction and in a decade we'll have people with severe, incurable cancer pain being told "you don't need opioids".
- loverofcode 9y ago
  Untrue. this is a direct result of the war on drugs. the fentanyl and carfentanil coming from china are responsible. before these two were being imported at such high rates opioid deaths were 4,000 per year vs 400,000 for alcohol. Which at first was being blamed on fentanyl being prescribed legally, but was incorrect data. Check the numbers yourself at wonder cdc. attached is the screenshot form cdc data. https://imgur.com/a/fFBTe https://imgur.com/a/fFBTe
jrowley 9y ago
Just the other morning I got off of bart in downtown Oakland, 12th street and there was a guy just laid out, unresponsive right on the steps outside the station. He had smoked something out of a can. I stuck with the guy while the paramedics came, but the most tragic part was that he had a plastic "No Allergies" bracelet on. When the paramedics took off his shirt he still had adhesive on his skin from the EKG straps or what not. So he had gotten out of the hospital and then immediately ODed (presumably again). I'm not sure what we need to do, but if you haven't encountered the epidemic first hand, it's only a matter of time until you do.
- nathancahill 9y ago
  Yep. My uncle died from an OD earlier this year. Drugs cut with fentanyl. It's truly a terrible epidemic.
  - deleted 9y ago
    [deleted]
  - TaylorGood 9y ago
    Sorry to hear. Partaking in heavy drugs to any degree invites those dark unknowns. The number of hands these drugs pass through to reach the end-user is more than a couple. I recall on average it's 8 different turnovers. Each time, likely being cut down. They operate a margin business without concern for where it ends up. It's likely safe to say that a vast majority of drugs are cut these days. A friend I grew up with just shot himself to death. He was on a TV show, model and had it all going for him..until the night he tried black tar heroin through a needle, off a spoon. An older friend convinced him and four others to try it one night at a wrap party for the TV show. Grew up affluent but drugs immediately nosedived his life. Ended up in and out of jail, losing it mentally, mental institutions, broke every window at his parents house, just living a really rough existence. The part that got me: the older friend who introduced him to it showed up to his funeral. The other one of the four is on his third strike for heroin, just got his second DUI trying to "live it up" – drugs i.e. heavy drugs, are a game that you do not win.
    - 9y ago
jenkstom 9y ago
The opioid epidemic is huge. Legal Cannabis is helping in some places, but it's still illegal at the federal level.
mschuster91 9y ago
> Local jails have been overrun with people locked up and in need of treatment Why. Do. People. End. Up. In. Jail. Seriously this one is beyond my comprehension - they need treatment, not jails filled with hardened criminals, rapists and probably more (and nastier) drugs than on the street.
- King-Aaron 9y ago
  > Why. Do. People. End. Up. In. Jail. Ask the politicians that own large stakes in (or have ties to) corporate-operated prisons, and you'll find your answer.
- Danihan 9y ago
  War on drugs & big government.
  - knowaveragejoe 9y ago
    Realistically it starts with the race to the bottom WRT being "tough on crime".
    - Danihan 9y ago
      Being tough on real crimes with victims is just fine. Being tough on victimless crimes is absurd. It's truly very black and white.
      - usrusr 9y ago
        Being tough on real crimes and the outcome of competing in toughness on crime have surprisingly little in common. In a game of "tough on crime"-oneupmanship, when you can't get any tougher you make up new crimes to beat the other guy.
- sp332 9y ago
  It's a long story. https://en.wikipedia.org/wiki/Deinstitutionalisation#Consequences https://en.wikipedia.org/wiki/Deinstitutionalisation#Consequ...
mustacheemperor 9y ago
Queue moralizing arguments that the overdoses would go away if we stopped reviving hundreds. The characterizations people make of the victims of opioid addictions are saddening and astoundingly cruel.
jcmoscon 9y ago
Maybe all these drugs being dumped in USA is really part of an evil plan from an enemy nation to destroy this country by destroying its people. Check out this book "Red Cocaine" to see how cocaine traffic started in America.
- craftyguy 9y ago
  or, maybe some folks just want an escape from stress / real life. or, maybe they got hooked after being perscribed painkillers for an injury or, maybe they're suffering from some mental illness or, literally any number of other reasons besides some evil nation flooding the US with drugs and somehow 'forcing' citizens to take them. The point is, you can choose to go after the suppliers, but the underlying problem is still there. Until that's addressed (mental healthcare, serious punishment for over-perscription, etc), we'll just see a new drug take the place of the old.
- nkrisc 9y ago
  Even if that was true, they're only supplying the match; we built the bonfire.
iambateman 9y ago
Serious questions...if you’ve used an opioid more than once for recreational purposes, I’d like to hear (1) what prompted you to try it (2) how old you were (3) cost (4) where did you get them (5) why did you stop Treat me like an idiot, I don’t understand this stuff and I’d like to know more. * obviously feel free to use a burner account if you’d rather not speak publicly.
- miguelrochefort 9y ago
  It's mostly people that started medicating for chronic pain.
  - jstarfish 9y ago
    That's not recreational use.
    - yosyp 9y ago
      That's just the problem isn't it? People are prescribed a drug for medicinal purposes that is so addictive and so readily distributed for minor ailments that medicinal use inevitably turns to recreational use after the prescription runs out. Louis Theroux's "Dark States: Heroin Town" is a good account of how these addictions progress in the US, and some of the reasons for the growing numbers we are seeing.
      - loeg 9y ago
        Opioid prescription has tripled from 1999 to 2015. Meanwhile, deaths only started to skyrocket very recently (starting in 2010-2011), probably mostly due to cheap heroin being adulterated with fentanyl. Opioid abuse is mostly flat or (among youth) decreasing: https://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1-2014.pdf https://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2... http://www.monitoringthefuture.org/pubs/monographs/mtf-overview2014.pdf http://www.monitoringthefuture.org/pubs/monographs/mtf-overv... There is no actual link between opioid prescription and subsequent heroin use shown by any research. https://grokinfullness.blogspot.com/2017/09/debunking-standard-narrative-on-opioid.html https://grokinfullness.blogspot.com/2017/09/debunking-standa...
billturner 9y ago
One of the Pittsburgh papers just ran an excellent, in-depth article about something very similar, happening in one particular neighborhood of the city: https://newsinteractive.post-gazette.com/riding-od-road/ https://newsinteractive.post-gazette.com/riding-od-road/
askvictor 9y ago
Interesting coincidence that Richmond in Melbourne, Australia, has just been announced as a location for a supervised injecting room. This Richmond is also a hot spot for heroin usage, dealing, and overdoses.
beefsack 9y ago
There are many places around the world called Richmond, and even if we assume it's in the US there are still 16 places called Richmond[1]. I wish people were more specific, particularly when reaching an international audience without an innate understanding of places in the US. [1]: https://en.wikipedia.org/wiki/Richmond https://en.wikipedia.org/wiki/Richmond
- QuercusMax 9y ago
  It appears this is Richmond, VA.
- sevenfive 9y ago
  Richmond, VA is the biggest and most important Richmond. Anyone who has heard of Richmond, VA will likely assume that is the Richmond being referenced. Anyone who hasn't heard of Richmond, VA gains no additional understanding from knowing which state it's in.
  - azernik 9y ago
    If you're in the Bay Area, as HN commenters disproportionally are, your mind is likely to jump first to Richmond, CA in the northern East Bay.
- sumobob 9y ago
  Richmond, CA has a similar problem, I assumed VA, but they both work in this context
  - Kluny 9y ago
    The one in Canada as well.
loverofcode 9y ago
PLEASE READ AND PUSH TO THE TOP!! this is a direct result of the war on drugs. the fentanyl and carfentanil coming from china are responsible. before these two were being imported at such high rates opioid deaths were 4,000 per year vs 400,000 for alcohol. Which at first was being blamed on fentanyl being prescribed legally, but was incorrect data. Check the numbers yourself at wonder cdc. attached is the screenshot form cdc data. https://imgur.com/a/fFBTe https://imgur.com/a/fFBTe
joshschreuder 9y ago
There was a very good Louis Theroux doco (Dark States) set in Huntington, West Virginia a couple of weeks ago about the opiod epidemic. It really hit hard with me for some reason, despite never having first hand contact with anyone with this sort of addiction. In particular, a man who was apparently a pentester before having some sort of accident and becoming addicted to prescribed opoids before transitioning onto illegal drugs. It just felt like something that could hit anyone, and not just the standard "junkie" problem.
- fsloth 9y ago
  "It just felt like something that could hit anyone" That's why addiction is a problem. Once the central nervous system is compromised by addictive substances, it's no longer only a matter of personal life choices. It does not matter whether the addiction was started by a leisurely experimentation or by a medicine prescribed by a doctor.
zamalek 9y ago
My experience originates in South Africa. All my friends did coke - it took, in some cases, years to get them off of it. One thing I learned is the barrier of "it's a problem." A few quit entirely (citing biological/logical reasons), almost the rest now use it on occasion - I don't give them hell for that. If someone goes on a drug-filled festival for 5 days (think Burning Man), it's a legitimate experience (that I am entirely unfamiliar with). I think that's the key: shades of grey. At one point I was very seriously alcoholic but pulled myself out of it; I still concede to social situations. It's not a problem, it's a momentary span of blissful negligence followed by a day of sorrow (that I'm fully dreadful of while drunk). I'm not special in any regard. I was absolutely lucky enough to realize these things internally. Here's the scary thing: I spent every living weekend at my friends' digs in South Africa, years and years. It took me a long time to learn about their drug habits. The very first friend candidate that I have met in Seattle has guaranteed that he will get me on coke in no time. It's an epidemic for absolute certainty. I failed to resolve a single friend's addiction and it still haunts me - what am I going to do with thousands of people who are convinced that there is no problem? Seattle has a big problem. We are telling addicts to come get their fix safely (which I deeply applaud), but are not attempting to understand their motivation. Is there any charity making an actual difference that I can volunteer at?
mirimir 9y ago
This is just so sad. It costs less to prescribe drugs than to diagnose and treat underlying problems. So the American profit-driven medical system relies heavily on drugs, especially for poorer patients. And drug companies love addictive drugs. So we get lots of opiate-addicted patients. And then there's the "drugs are evil" mindset, which justifies criminalization. Even preventing pain is too much like having fun. So it's better for addicts to OD than get safe drugs. Because they deserve it, or whatever. They should just suck it up, walk it off, ... So it goes.
- justinjlynn 9y ago
  I honestly don't understand what kind of solution you're proposing. Would you mind briefly expanding on your statements?
  - mirimir 9y ago
    1) Properly treat people's medical problems, rather than just prescribing drugs. 2) Give safe drugs to addicts. Anonymously. Offer help, but don't force anything.
    - Shivetya 9y ago
      Well I think for #1 we need to understand how many got on this path from a medical provider. We cannot just assume the epidemic is the result of bad diagnoses. The numbers are just too high. It is just more likely that the price point reached for this strong of a drug and the ability to get it to users reached critical mass. with regards to #2, it would good to know death rates and severe medical incident numbers in any localities to see how much of an effect such an approach is having. #3 should be requiring all police departments having the training and recovery drugs necessary to pull someone out of an overdose along with no charges being filed for any parties involved in such a call. this problem has been around a long time and only recently was it even addressed at the highest levels. it seemed like the problem everyone wanted to ignore
- nickik 9y ago
  It has nothing to do with profit driven. The problem is about intensives. The perverse US health care system with all its regulation has made it so that doctors primary make money by giving away pills. There were other models where people would basically have subscription to clinics and those would have a intensive to keep you healthy. The problem is that all alternative models are literally illegal. Check out this podcast: http://www.econtalk.org/archives/2017/06/christy_ford_ch.html http://www.econtalk.org/archives/2017/06/christy_ford_ch.htm... They talk about this book: Ensuring America's Health: The Public Creation of the Corporate Health Care System
Double_a_92 9y ago
And nothing of value was lost...
Feniks 9y ago
My country had a heroine epidemic in the 80s and early 90s. One of the root causes was a shitty economy and chronic unemployment. All you can do in the end is try to keep things contained. They opened special places were junkies could use their drugs so that they wouldn't have to OD on the streets. You can't fix someone unless they WANT to be fixed.
- nickik 9y ago
  Many places that did not have bad economies had heroine epidemics in those times as well. Can you actually show statistically that bad overall economy and heroine epidemics are in any way linked?
dep_b 9y ago
The greatest argument against the death penalty is that it's not applied to the people that deserve it the most. Not only did the pharmaceutical industry earn billions by pushing addictive opioids to people but they also charge people up the nose for the injections they need after they OD'ed because they got addicted. People are still getting filthy rich literally over other people's deaths. In the name of health. I know a lot of people love capitalism here and I think it works pretty great if you apply it to a lot of markets. But health isn't something that can be regulated by capitalism. You can buy the new iPhone or you don't. It's a decision. You can make a stupid decision and buy it while you really should feed your kids instead but it's still a decision. Health issues are not. Nobody decides to have cancer next year because this year things look a bit uncertain at work right now. It just hits you. Free markets only work when somebody is free to decide.
- krisives 9y ago
  Can chose to not use heroin and other drugs - like most of society had informed you - and there is infinite amount of data available to anyone looking.
  - fapjacks 9y ago
    Now, now. Are you implying everyone is always making decisions purely intellectually with no other inputs? People make stupid decisions for stupid reasons all the time. In fact most of the time. That doesn't make it any less of a choice.
    - krisives 9y ago
      It's as much of your choice to use a heroin needle as it is to buy an iPhone is my point.
      - mercer 9y ago
        I've been a teenager and I've known a lot of teenagers. I can totes see a teenager get into heroin for all sorts of stupid reasons. Because teenagers are idiots [1]. I prefer a society where a stupid decision at that age can be corrected for at a later time. I prefer it over a society that oversimplifies all this to 'choice', going against so much of what we've learned about human nature over the past decades. [1]: Adults are also idiots. People are idiots. Rationality is our weapon against it, but it's so effective precisely because we're so irrational by 'default'. I'm baffled how people can still hold a worldview where 'choice' is somehow a simple concept.
krisives 9y ago
Talk to the leader of any emergency room staff and this is how it works in most cities. Another reason to charge more for working in a big city, since smaller rural cities don’t have this problem as much - like the middle of nowhere in Montana versus Seattle.
OliverJones 9y ago
The "iron law of prohibition" teaches us this: prohibiting a substance drives out all but the most potent forms of that substance. Back during alcohol prohibition in the US, people made, smuggled, and sold "white lightning" not light beer. In the case of opiods, the most potent forms are stuff like street fentanyl and oxy 80s pulverized. Milligram mistakes in dosages of this stuff are very dangerous. The iron law leads to a paradox: decriminalizing a substance makes it safer. Obviously it's more complex than that: addicts need access to safe supplies of the substance. But it's still true. But keeping opiods criminalized is, basically, makework for law enforcement and public safety people, not to mention people with names like El Chapo. Switzerland and Portugal are having good success with decriminalization and treatment. Juristictions who don't need anything in the way of foreign aid or other cooperation from the USA are in the best position to do this. Source: Chasing The Scream, a book by Johann Hari.

141 points by iamjeff 9y ago

This reminds me that the lead singer of GWAR died in Richmond from a heroin overdose in 2014: https://en.wikipedia.org/wiki/Dave_Brockie https://en.wikipedia.org/wiki/Dave_Brockie

PatientTrades 9y ago

Most of this stems from the overprescription of opioids. I remember when I had surgery for a broken leg the amount of drugs I received after the surgery was astounding. It was almost as if the hospital wanted me to become hooked. I didn't need or ask for the opioids, they were just prescribed for pain killing. A regular Tylenol or Advil would have done the job. Not saying hospitals want people on drugs, but at some point we have hold the people initially prescribing the drugs accountable.

ellyagg 9y ago
What makes you say that? It's trivial to get opioids on the streets and it's common to be introduced to them as a recreational drug, as I know first hand. In fact, I don't know anyone who got addicted to opioids due to overprescription, but I know several people who didn't get prescribed opioids they needed because of the fears of overprescription, and thus were left in terrible pain. I don't know how you draw the line, but I think it's evil to leave people in pain because you're afraid they'll use the drugs for fun. Most people who take opioids do not get addicted.
- munk-a 9y ago
  People generally say that over-prescription leads to harder opioid usage because it does. I have had co-workers familiar with the neurological effects of the drugs they've been given balk at it. I've also known community members who had injuries slide into the obscurity of addiction. A very real factor of this crisis is the pain aversion, people working in dentistry have higher rates of depression and suicide due to the psychological effects of inflicting pain on people (unless the dentist is played by steve martin ofc) and it's a problem without clear solutions. Legalization of marijuana would probably help reduce the mild-moderate pain classes in a non-addictive manner, but for extreme pain there isn't a good solution. Anyways... there are plenty of first-hand accounts and plenty of studies showing the connection here, please do a little research before posting unsupported claims.
  - incadenza 9y ago
    It's important to note that the epidemic that people refer to is the overdose epidemic, often labelled the opiate epidemic for whatever reason. I haven't seen any evidence that actual rates of heroin abuse increasing year over year. Just wealthier people dying from poorly cut drugs at a more alarming rate. This was the most recent report I could find: https://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1-2014.pdf https://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2...
  - loverofcode 9y ago
    That is not true, first dentist have a higher suicide rate not because of the pain on people but because so many people hate to see them. It is never a pleasant experience. You also should be aware of the suicide rate in pain patients because their pain cannot be under control. this is a direct result of the war on drugs. the fentanyl and carfentanil coming from china are responsible. before these two were being imported at such high rates opioid deaths were 4,000 per year vs 400,000 for alcohol. Which at first was being blamed on fentanyl being prescribed legally, but was incorrect data. Check the numbers yourself at wonder cdc. attached is the screenshot form cdc data. https://imgur.com/a/fFBTe https://imgur.com/a/fFBTe
- gebeeson 9y ago
  I went through open heart surgery two years ago April and opioid over-prescription was already a concern. After discharge I received a six day script for the lowest dose of fentanyl and a month of Lyrica. I have a freakishly high pain tolerance so I managed to 'stretch' the fentanyl patches out to nearly one month (each patch lasted roughly three days). Hindsight being what it is - I obviously made it through. Being down in it though, it was far far less than pleasant. Especially that I was supposed to be active and all the usual recovery stuff. It was a bit of no joke as far as pain load goes. I didn't expect to be completely pain free as that isn't life as far as I am concerned, it would have been nice to have taken a little bit more of the edge off. Round the pain off some.
  - hiram112 9y ago
    Agreed. I too have had a major surgery several years ago. I was given morphine and than Oxycodone when discharged, but not at high enough dosage for adequate relief - 3 or 4 days of pure misery. There is no reason, when short-term opiate use is easily available, for patients to suffer like this. It seems like the medical establishment was really pushing opiates for years, even when they probably weren't needed. Now they're swung too far in the other direction: under-prescribing them for fear of overdosage, addiction, and even punishment by the DEA and government. Wish we could find some middle ground.
- nickik 9y ago
  What makes him say that is that it is a well documented problem. Many other people recognize it and treat it accordingly. My father is a Anthologist and they are very careful with how much they give. It is a major issue. For some reason, the US, including doctors, have developed a anti-pain philosophy where they oversubscribe these drugs and it is know to cause addiction.
snuxoll 9y ago
It's incredibly easy to get hooked when taking prescription opiates even if you're fully aware of the situation. I had a wisdom tooth extracted last year, and by the time the pain was finally down to the level I could manage with OTC pain relievers I realized I had developed a mild physical addiction to the hydrocodone. I had no desire to get high off the pain killers, hell, they didn't even do anything for me in that regard - but I could feel the need to take them. I can easily see how someone without the awareness, willpower and a number of other factors could give in and start down the path of self-destruction. It was a terrifying place for me to be in, and as someone who has responsibly taken prescription opiates for multiple other oral surgeries as well as a septoplasty it was one I never thought possible.
- loverofcode 9y ago
  There is a difference between dependence and addiction. People who are in pain 24/7 rely on these medications and are being thrown into the streets because of the DEA, when if fact this is a direct result of the war on drugs. the fentanyl and carfentanil coming from china are responsible. before these two were being imported at such high rates opioid deaths were 4,000 per year vs 400,000 for alcohol. Which at first was being blamed on fentanyl being prescribed legally, but was incorrect data. Check the numbers yourself at wonder cdc. attached is the screenshot form cdc data. https://imgur.com/a/fFBTe https://imgur.com/a/fFBTe
  - snuxoll 9y ago
    Don’t take my anecdote to mean I’m against prescription opiates, there’s no way in hell I would have been able to manage my pain after these procedures without them - in fact I think we’re steering the ship far too hard away from their use in a reactionary move to combat these deaths. But I don’t have any doubt many people have become physically dependent on these drugs and are now turning to the black market - it very well could have been me in another life. The war on drugs really needs to come to an abrupt end, people who need opioids to manage their pain should have them, people who are hopelessly addicted should have access in a controlled and safe manner, and for crying out loud can we just legalize weed already?
adfm 9y ago
For more background on why we've got a dope problem, check out this LA Times piece on Oxycontin's 12-hour Problem: http://www.latimes.com/projects/oxycontin-part1/ http://www.latimes.com/projects/oxycontin-part1/
- refurb 9y ago
  That article was written by someone not that familiar with the pharma market. It would be illegal for Purdue to promote on any other than 12 hours. It's called off-label promotion and companies pay multi-billion dollar fines for it.
  - firebones 9y ago
    While it is factually true that it would be illegal for Purdue to promote off-label, they also need to be held accountable for playing fast and loose with the research studies (even altering the definitions used in the trials) in order to be able to claim 12h coverage when nearly half the patients weren't getting 12h coverage. This, combined with the recommendation to push higher doses to achieve 12h coverage, combined with the gap in coverage, drove a lot of people into a cycle of unhealthy and deadly dependency. At the very least it's a case of consumer product safety liability and negligence fueled by profit motive.
    - refurb 9y ago
      Shouldn't the FDA be held accountable? They approved the trial design and overall application.
      - firebones 9y ago
        I wish regulators could be perfect, and if they were, we'd reduce harm a lot. But since we know they're not, we can, as participants in society, be as Caesar's wife--above suspicion--and avoid these situations entirely. A lot of capitalism's woes would be overcome should that standard be applied.
deleted 9y ago
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refurb 9y ago
If you've been around long enough you'd realize we're come full circle. Prior to the 1990's pain meds were very rarely handed out. Then a few things happened: (1) more data was collected that suggested when used for severe pain, the addiction potential was low, (2) adequately controlled pain leads to quicker recovery times and (3) there was a lot of untreated pain at the time. As a result, opioid use when way up. One could argue it went to far with very strong opioids being given for mild or moderate pain. The sad thing is that we're already seeing doctors get more stingy with opioids. My guess is we'll swing too far in the other direction and in a decade we'll have people with severe, incurable cancer pain being told "you don't need opioids".
loverofcode 9y ago
Untrue. this is a direct result of the war on drugs. the fentanyl and carfentanil coming from china are responsible. before these two were being imported at such high rates opioid deaths were 4,000 per year vs 400,000 for alcohol. Which at first was being blamed on fentanyl being prescribed legally, but was incorrect data. Check the numbers yourself at wonder cdc. attached is the screenshot form cdc data. https://imgur.com/a/fFBTe https://imgur.com/a/fFBTe

jrowley 9y ago

Just the other morning I got off of bart in downtown Oakland, 12th street and there was a guy just laid out, unresponsive right on the steps outside the station. He had smoked something out of a can. I stuck with the guy while the paramedics came, but the most tragic part was that he had a plastic "No Allergies" bracelet on. When the paramedics took off his shirt he still had adhesive on his skin from the EKG straps or what not. So he had gotten out of the hospital and then immediately ODed (presumably again). I'm not sure what we need to do, but if you haven't encountered the epidemic first hand, it's only a matter of time until you do.

nathancahill 9y ago
Yep. My uncle died from an OD earlier this year. Drugs cut with fentanyl. It's truly a terrible epidemic.
- deleted 9y ago
  [deleted]
- TaylorGood 9y ago
  Sorry to hear. Partaking in heavy drugs to any degree invites those dark unknowns. The number of hands these drugs pass through to reach the end-user is more than a couple. I recall on average it's 8 different turnovers. Each time, likely being cut down. They operate a margin business without concern for where it ends up. It's likely safe to say that a vast majority of drugs are cut these days. A friend I grew up with just shot himself to death. He was on a TV show, model and had it all going for him..until the night he tried black tar heroin through a needle, off a spoon. An older friend convinced him and four others to try it one night at a wrap party for the TV show. Grew up affluent but drugs immediately nosedived his life. Ended up in and out of jail, losing it mentally, mental institutions, broke every window at his parents house, just living a really rough existence. The part that got me: the older friend who introduced him to it showed up to his funeral. The other one of the four is on his third strike for heroin, just got his second DUI trying to "live it up" – drugs i.e. heavy drugs, are a game that you do not win.
  - 9y ago

jenkstom 9y ago

The opioid epidemic is huge. Legal Cannabis is helping in some places, but it's still illegal at the federal level.

mschuster91 9y ago

> Local jails have been overrun with people locked up and in need of treatment Why. Do. People. End. Up. In. Jail. Seriously this one is beyond my comprehension - they need treatment, not jails filled with hardened criminals, rapists and probably more (and nastier) drugs than on the street.

King-Aaron 9y ago
> Why. Do. People. End. Up. In. Jail. Ask the politicians that own large stakes in (or have ties to) corporate-operated prisons, and you'll find your answer.
Danihan 9y ago
War on drugs & big government.
- knowaveragejoe 9y ago
  Realistically it starts with the race to the bottom WRT being "tough on crime".
  - Danihan 9y ago
    Being tough on real crimes with victims is just fine. Being tough on victimless crimes is absurd. It's truly very black and white.
    - usrusr 9y ago
      Being tough on real crimes and the outcome of competing in toughness on crime have surprisingly little in common. In a game of "tough on crime"-oneupmanship, when you can't get any tougher you make up new crimes to beat the other guy.
sp332 9y ago
It's a long story. https://en.wikipedia.org/wiki/Deinstitutionalisation#Consequences https://en.wikipedia.org/wiki/Deinstitutionalisation#Consequ...

mustacheemperor 9y ago

Queue moralizing arguments that the overdoses would go away if we stopped reviving hundreds. The characterizations people make of the victims of opioid addictions are saddening and astoundingly cruel.

jcmoscon 9y ago

Maybe all these drugs being dumped in USA is really part of an evil plan from an enemy nation to destroy this country by destroying its people. Check out this book "Red Cocaine" to see how cocaine traffic started in America.

craftyguy 9y ago
or, maybe some folks just want an escape from stress / real life. or, maybe they got hooked after being perscribed painkillers for an injury or, maybe they're suffering from some mental illness or, literally any number of other reasons besides some evil nation flooding the US with drugs and somehow 'forcing' citizens to take them. The point is, you can choose to go after the suppliers, but the underlying problem is still there. Until that's addressed (mental healthcare, serious punishment for over-perscription, etc), we'll just see a new drug take the place of the old.
nkrisc 9y ago
Even if that was true, they're only supplying the match; we built the bonfire.

iambateman 9y ago

Serious questions...if you’ve used an opioid more than once for recreational purposes, I’d like to hear (1) what prompted you to try it (2) how old you were (3) cost (4) where did you get them (5) why did you stop Treat me like an idiot, I don’t understand this stuff and I’d like to know more. * obviously feel free to use a burner account if you’d rather not speak publicly.

miguelrochefort 9y ago
It's mostly people that started medicating for chronic pain.
- jstarfish 9y ago
  That's not recreational use.
  - yosyp 9y ago
    That's just the problem isn't it? People are prescribed a drug for medicinal purposes that is so addictive and so readily distributed for minor ailments that medicinal use inevitably turns to recreational use after the prescription runs out. Louis Theroux's "Dark States: Heroin Town" is a good account of how these addictions progress in the US, and some of the reasons for the growing numbers we are seeing.
    - loeg 9y ago
      Opioid prescription has tripled from 1999 to 2015. Meanwhile, deaths only started to skyrocket very recently (starting in 2010-2011), probably mostly due to cheap heroin being adulterated with fentanyl. Opioid abuse is mostly flat or (among youth) decreasing: https://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1-2014.pdf https://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2... http://www.monitoringthefuture.org/pubs/monographs/mtf-overview2014.pdf http://www.monitoringthefuture.org/pubs/monographs/mtf-overv... There is no actual link between opioid prescription and subsequent heroin use shown by any research. https://grokinfullness.blogspot.com/2017/09/debunking-standard-narrative-on-opioid.html https://grokinfullness.blogspot.com/2017/09/debunking-standa...

billturner 9y ago

One of the Pittsburgh papers just ran an excellent, in-depth article about something very similar, happening in one particular neighborhood of the city: https://newsinteractive.post-gazette.com/riding-od-road/ https://newsinteractive.post-gazette.com/riding-od-road/

askvictor 9y ago

Interesting coincidence that Richmond in Melbourne, Australia, has just been announced as a location for a supervised injecting room. This Richmond is also a hot spot for heroin usage, dealing, and overdoses.

beefsack 9y ago

There are many places around the world called Richmond, and even if we assume it's in the US there are still 16 places called Richmond[1]. I wish people were more specific, particularly when reaching an international audience without an innate understanding of places in the US. [1]: https://en.wikipedia.org/wiki/Richmond https://en.wikipedia.org/wiki/Richmond

QuercusMax 9y ago
It appears this is Richmond, VA.
sevenfive 9y ago
Richmond, VA is the biggest and most important Richmond. Anyone who has heard of Richmond, VA will likely assume that is the Richmond being referenced. Anyone who hasn't heard of Richmond, VA gains no additional understanding from knowing which state it's in.
- azernik 9y ago
  If you're in the Bay Area, as HN commenters disproportionally are, your mind is likely to jump first to Richmond, CA in the northern East Bay.
sumobob 9y ago
Richmond, CA has a similar problem, I assumed VA, but they both work in this context
- Kluny 9y ago
  The one in Canada as well.

loverofcode 9y ago

PLEASE READ AND PUSH TO THE TOP!! this is a direct result of the war on drugs. the fentanyl and carfentanil coming from china are responsible. before these two were being imported at such high rates opioid deaths were 4,000 per year vs 400,000 for alcohol. Which at first was being blamed on fentanyl being prescribed legally, but was incorrect data. Check the numbers yourself at wonder cdc. attached is the screenshot form cdc data. https://imgur.com/a/fFBTe https://imgur.com/a/fFBTe

joshschreuder 9y ago

There was a very good Louis Theroux doco (Dark States) set in Huntington, West Virginia a couple of weeks ago about the opiod epidemic. It really hit hard with me for some reason, despite never having first hand contact with anyone with this sort of addiction. In particular, a man who was apparently a pentester before having some sort of accident and becoming addicted to prescribed opoids before transitioning onto illegal drugs. It just felt like something that could hit anyone, and not just the standard "junkie" problem.

fsloth 9y ago
"It just felt like something that could hit anyone" That's why addiction is a problem. Once the central nervous system is compromised by addictive substances, it's no longer only a matter of personal life choices. It does not matter whether the addiction was started by a leisurely experimentation or by a medicine prescribed by a doctor.

zamalek 9y ago

My experience originates in South Africa. All my friends did coke - it took, in some cases, years to get them off of it. One thing I learned is the barrier of "it's a problem." A few quit entirely (citing biological/logical reasons), almost the rest now use it on occasion - I don't give them hell for that. If someone goes on a drug-filled festival for 5 days (think Burning Man), it's a legitimate experience (that I am entirely unfamiliar with). I think that's the key: shades of grey. At one point I was very seriously alcoholic but pulled myself out of it; I still concede to social situations. It's not a problem, it's a momentary span of blissful negligence followed by a day of sorrow (that I'm fully dreadful of while drunk). I'm not special in any regard. I was absolutely lucky enough to realize these things internally. Here's the scary thing: I spent every living weekend at my friends' digs in South Africa, years and years. It took me a long time to learn about their drug habits. The very first friend candidate that I have met in Seattle has guaranteed that he will get me on coke in no time. It's an epidemic for absolute certainty. I failed to resolve a single friend's addiction and it still haunts me - what am I going to do with thousands of people who are convinced that there is no problem? Seattle has a big problem. We are telling addicts to come get their fix safely (which I deeply applaud), but are not attempting to understand their motivation. Is there any charity making an actual difference that I can volunteer at?

mirimir 9y ago

This is just so sad. It costs less to prescribe drugs than to diagnose and treat underlying problems. So the American profit-driven medical system relies heavily on drugs, especially for poorer patients. And drug companies love addictive drugs. So we get lots of opiate-addicted patients. And then there's the "drugs are evil" mindset, which justifies criminalization. Even preventing pain is too much like having fun. So it's better for addicts to OD than get safe drugs. Because they deserve it, or whatever. They should just suck it up, walk it off, ... So it goes.

justinjlynn 9y ago
I honestly don't understand what kind of solution you're proposing. Would you mind briefly expanding on your statements?
- mirimir 9y ago
  1) Properly treat people's medical problems, rather than just prescribing drugs. 2) Give safe drugs to addicts. Anonymously. Offer help, but don't force anything.
  - Shivetya 9y ago
    Well I think for #1 we need to understand how many got on this path from a medical provider. We cannot just assume the epidemic is the result of bad diagnoses. The numbers are just too high. It is just more likely that the price point reached for this strong of a drug and the ability to get it to users reached critical mass. with regards to #2, it would good to know death rates and severe medical incident numbers in any localities to see how much of an effect such an approach is having. #3 should be requiring all police departments having the training and recovery drugs necessary to pull someone out of an overdose along with no charges being filed for any parties involved in such a call. this problem has been around a long time and only recently was it even addressed at the highest levels. it seemed like the problem everyone wanted to ignore
nickik 9y ago
It has nothing to do with profit driven. The problem is about intensives. The perverse US health care system with all its regulation has made it so that doctors primary make money by giving away pills. There were other models where people would basically have subscription to clinics and those would have a intensive to keep you healthy. The problem is that all alternative models are literally illegal. Check out this podcast: http://www.econtalk.org/archives/2017/06/christy_ford_ch.html http://www.econtalk.org/archives/2017/06/christy_ford_ch.htm... They talk about this book: Ensuring America's Health: The Public Creation of the Corporate Health Care System

Double_a_92 9y ago

And nothing of value was lost...

Feniks 9y ago

My country had a heroine epidemic in the 80s and early 90s. One of the root causes was a shitty economy and chronic unemployment. All you can do in the end is try to keep things contained. They opened special places were junkies could use their drugs so that they wouldn't have to OD on the streets. You can't fix someone unless they WANT to be fixed.

nickik 9y ago
Many places that did not have bad economies had heroine epidemics in those times as well. Can you actually show statistically that bad overall economy and heroine epidemics are in any way linked?

dep_b 9y ago

The greatest argument against the death penalty is that it's not applied to the people that deserve it the most. Not only did the pharmaceutical industry earn billions by pushing addictive opioids to people but they also charge people up the nose for the injections they need after they OD'ed because they got addicted. People are still getting filthy rich literally over other people's deaths. In the name of health. I know a lot of people love capitalism here and I think it works pretty great if you apply it to a lot of markets. But health isn't something that can be regulated by capitalism. You can buy the new iPhone or you don't. It's a decision. You can make a stupid decision and buy it while you really should feed your kids instead but it's still a decision. Health issues are not. Nobody decides to have cancer next year because this year things look a bit uncertain at work right now. It just hits you. Free markets only work when somebody is free to decide.

krisives 9y ago
Can chose to not use heroin and other drugs - like most of society had informed you - and there is infinite amount of data available to anyone looking.
- fapjacks 9y ago
  Now, now. Are you implying everyone is always making decisions purely intellectually with no other inputs? People make stupid decisions for stupid reasons all the time. In fact most of the time. That doesn't make it any less of a choice.
  - krisives 9y ago
    It's as much of your choice to use a heroin needle as it is to buy an iPhone is my point.
    - mercer 9y ago
      I've been a teenager and I've known a lot of teenagers. I can totes see a teenager get into heroin for all sorts of stupid reasons. Because teenagers are idiots [1]. I prefer a society where a stupid decision at that age can be corrected for at a later time. I prefer it over a society that oversimplifies all this to 'choice', going against so much of what we've learned about human nature over the past decades. [1]: Adults are also idiots. People are idiots. Rationality is our weapon against it, but it's so effective precisely because we're so irrational by 'default'. I'm baffled how people can still hold a worldview where 'choice' is somehow a simple concept.

krisives 9y ago

Talk to the leader of any emergency room staff and this is how it works in most cities. Another reason to charge more for working in a big city, since smaller rural cities don’t have this problem as much - like the middle of nowhere in Montana versus Seattle.

OliverJones 9y ago

The "iron law of prohibition" teaches us this: prohibiting a substance drives out all but the most potent forms of that substance. Back during alcohol prohibition in the US, people made, smuggled, and sold "white lightning" not light beer. In the case of opiods, the most potent forms are stuff like street fentanyl and oxy 80s pulverized. Milligram mistakes in dosages of this stuff are very dangerous. The iron law leads to a paradox: decriminalizing a substance makes it safer. Obviously it's more complex than that: addicts need access to safe supplies of the substance. But it's still true. But keeping opiods criminalized is, basically, makework for law enforcement and public safety people, not to mention people with names like El Chapo. Switzerland and Portugal are having good success with decriminalization and treatment. Juristictions who don't need anything in the way of foreign aid or other cooperation from the USA are in the best position to do this. Source: Chasing The Scream, a book by Johann Hari.