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Within my brothers circle of friends / former friends etc, amongst those that participate in recreational drug use, there have been a crazy number of Fentanyl r

Within my brothers circle of friends / former friends etc, amongst those that participate in recreational drug use, there have been a crazy number of Fentanyl related deaths. They're all between the ages of 25 - 30. I can't help but wonder how much this has an impact.

PragmaticPulp 5y ago
All of the non-COVID deaths I’ve heard of among younger people (<60) from my extended social circle and their family/friends have been drug related. Working from home can remove a lot of the accountability that keeps addicts in check. When your coworkers can’t see you, it’s much easier to be inebriated or otherwise suffering from addiction-related issues without feeling social pressure to correct it.
- tomcam 5y ago
  Thank you for saying < 60 is young!
- jeffbee 5y ago
  That's pretty normal, at least for the last few decades of American life. There is not a major natural cause of death for people 18-65. They die of suicide, accidental overdoses, and car crashes.
  - stavros 5y ago
    When we say "overdoses", doesn't it sound like the person's fault, when it was probably that they were sold a poisoned/cut batch? I wonder how many "overdoses" would have been avoided if you could buy drugs at a pharmacy.
    - prirun 5y ago
      A lot of times an overdose occurs if a person got clean for a while then went back to using. They tend to start using at their previous levels even though their body is no longer used to that level, so it's a sudden jolt that kills them. So I've read - I have zero experience with drugs, luckily.
      - stavros 5y ago
        Yeah, I've read that too, but I have no idea which is more frequent. I'd assume the tainted drugs are more frequent, just because getting tainted product is more frequent than getting clean and relapsing, but I don't know. I'll definitely recommend LSD or mushrooms, though. They are lots of fun.
    - worik 5y ago
      Almost all, if there were some sensible regulation. People do not die from smoking opium, much. But die a lot from popping pills. Concentrated synthetic opioids are deadly.
- woodruffw 5y ago
  > Working from home can remove a lot of the accountability that keeps addicts in check. This is a cruel twist, given that suicide deaths actually decreased in 2020[1], probably for the reason you've mentioned: spending nearly all of your time with others makes you accountable and removes opportunities for self-harm. [1]: https://www.cdc.gov/nchs/data/vsrr/VSRR016.pdf https://www.cdc.gov/nchs/data/vsrr/VSRR016.pdf
  - abyssin 5y ago
    I’m not a native speaker, but there seems to be something inappropriately judgmental about the wording of “keeping in check”. Loneliness is hard for many and causes suffering, and drugs are sometimes used to try to manage suffering. More use is linked to more accidents.
    - MathCodeLove 5y ago
      It's not judgemental - it just is. Many addicts in recovery themselves use similar language. I spend a lot of time with recovering addicts and alcoholics and accountability is an important component of treatment.
    - woodruffw 5y ago
      I can see the judgemental interpretation, but I don't think that's what the GP intended. I read it as "most people suffering from addiction benefit from accountability, one form of which is the in-person responsibilities of work."
  - kirse 5y ago
    spending nearly all of your time with others makes you accountable and removes opportunities for self-harm. Never would have seen it coming that encouraging people to stay isolated for years at a time and actively fearing their own proximity to one another would be detrimental.
    - woodruffw 5y ago
      I think you mis-read my comment. The irony is that people are actually closer than ever to their family (or house-mates) due to COVID, which is pushing suicide rates down.
- romanovcode 5y ago
  > Working from home can remove a lot of the accountability that keeps addicts in check. Not only that but the lockdowns making people low-key depressed which would also be a reason for using addictive substances since they often go hand-in-hand together. I could be pretty much classified an alcoholic during most of 2019-2020 because a six-pack a day keeps the boredom away.
  - danielheath 5y ago
    That’s… a substantial way past “pretty much”.
    - romanovcode 5y ago
      I just realized that I was not a real alcoholic when I stopped drinking altogether without any withdrawal symptoms or anything like that. But yeah, it's a slippery slope for sure.
      - molyss 5y ago
        Maybe you didn’t fit the addiction part of aloholism, but when it comes to consumption, a 6-pack a day definitely puts you in that category, along with associated psysical and psychological risks. I’d definitely mention that level of alcohol consumption to my GP and get all relevant blood tests
        willcipriano 5y ago
        Alcoholism is defined by it's consequences, not by how much you drink. It is the the state of drinking despite dramatic negative life consequences.
      - danielheath 5y ago
        IIRC, on average it takes a month or two of having alcohol every day to start getting physiologically addicted (but - like most of biology - it can be faster or slower). For anyone reading who thinks that may apply to them: Talk to your doctor. "Cold Turkey" alcohol withdrawals can kill.
- jdavis703 5y ago
  Coincidentally all the natural cause deaths in my circle were “natural” diseases like cancer and COVID-19. I’m in my 30s now, and no longer really hang out with (non-functional) drug addicts anymore though. YMMV.
- syshum 5y ago
  This is one of the problem with all the people focusing on "excess deaths" as a metric for COVID Deaths.
- alienthrowaway 5y ago
  > Working from home can remove a lot of the accountability that keeps addicts in check. COVID countermeasures reduced the number of safe recreational activities, and was a horrible for mental health overall. Additionally, America offers very little support for mental health distress, so I imagine this triple threat has been devastating to drug addicts. I'm only guessing as a teetotaler who got addicted to video games and Twitter in that time (and I used to scoff at Twitter-addicts since I had a small, curated list of accounts I followed) [edit]A fourth factor - drug overdoses (and other "less serious" medical issues) also got less medical care because it was being hogged by respiratory patients.
deleted 5y ago
[deleted]
nerdbaggy 5y ago
Correct! “ The synthetic and highly addictive drug has claimed more lives than COVID-19, auto crashes, gun violence, cancer and suicide in the year 2020.” https://www.abc12.com/news/fentanyl-number-one-cause-of-death-for-adults-18-45-recent-government-data-says/article_ed0bfe28-5f79-11ec-8aa0-af3f6cbff03c.html https://www.abc12.com/news/fentanyl-number-one-cause-of-deat...
- jeffbee 5y ago
  No byline. No sources. Bad article. The article appears to attribute all accidental poisoning to fentanyl. That seems like an error.
  - mlyle 5y ago
    > The article appears to attribute all accidental poisoning to fentanyl. That seems like an error. I don't think it does. Sure, they throw out the 100k overdoses number at the end, which isn't specific to fentanyl, but the other numbers they cite are around 40k/year and a run rate of 64k/year by Deceber 2021. Current data is here: https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm It's about 62k deaths from synthetic opioids/year (excluding methadone) at the end of the series-- the vast majority of these are fentanyl. Plus a bunch of heroin deaths which are rapidly becoming "really fentanyl" deaths. And that's up to April, not December.
    - jeffbee 5y ago
      That data is for all ages. If you go to WISQARS and filter for ages 18-45, which is the subject of the news site's article, it looks to me like the numbers they are giving in the article are the same as the total number of accidental poisoning.
      - mlyle 5y ago
        They're pulling from this fact sheet: https://drive.google.com/file/d/1S0szR2Ua9v0Sr91YhDD7gPrXsDkHxDvP/view https://drive.google.com/file/d/1S0szR2Ua9v0Sr91YhDD7gPrXsDk... Topic 1 is on ages 18-45: more deaths from fentanyl than from... The later topics are on all ages. The fact sheet attributes 24k deaths in the age range to fentanyl in 2019. WISQARS accidental injuries from poisoning in the age range were 38k in 2019. 2/3rds in that age range being fentanyl is totally plausible. https://wonder.cdc.gov/controller/datarequest/D157;jsessionid=7A04C7DC8D17F0A5FA2103363BB7 https://wonder.cdc.gov/controller/datarequest/D157;jsessioni... has the broken down data. They have 36,907 deaths in 2020 from 18-45 with T40.4-- "other synthetic opioids excluding methadone". FAF is calling all deaths from synthetic opioids fentanyl, which isn't quite true but it's very likely close to true.
3maj 5y ago
Probably a big one. Drug overdoses have killed more 18-54 year olds in Canada than Covid has. Hell, in British Columbia there have been more drug overdoses than Covid deaths across all ages.
exdsq 5y ago
I read fentanyl killed more people than Covid in SF last year - don’t think there were any age brackets on that either
dillondoyle 5y ago
And it's not just opiate users. People buying coke & 'molly' are overdosing too from fent and analogues too. Why in the world would a dealer put fent into coke. I guess a speedball feels great but the average weekend partier doing a bump or a pill are not looking to walk that death tightrope. Just sad all around and we still have a long way to go with stigma and science based treatment. If you happen to be in that scene might be a good idea to start carrying naloxone.
- worik 5y ago
  A very powerful argument for legalising forms of those drugs for recreational use.
  - dillondoyle 5y ago
    Yea please! Decriminalizing would be a great first step but won't cut out the cartels and gangs and adulteration (kind word for poisoning..) Would also love to see over the counter narcan. suboxone for any who wants it without the compliance burden.
    - slapshot 5y ago
      Narcan is available "behind the counter" in most states. You have to ask for it, but a prescription isn't required.[1] [1] https://www.cvs.com/content/prescription-drug-abuse/save-a-life https://www.cvs.com/content/prescription-drug-abuse/save-a-l...
      - dillondoyle 5y ago
        I know there were a few people organizing on reddit too where they would ship it if you can't access it easily too! I think it was a lady on /r/opiates
- Tiktaalik 5y ago
  Yep. It's not an opioid epidemic or crisis, it's a toxic drug crisis. The drugs are poisoned. No one knows what's in them. There's a drug test site in my city that regularly posts examples of what they find on twitter. Totally random ultra dangerous poisons in party drugs. All the time. Here's an example: a drug not safe for humans in a test sample of MDMA. https://twitter.com/GYDTcanada/status/1477444546480984065?s=20 https://twitter.com/GYDTcanada/status/1477444546480984065?s=... People are dying because they're doing some thing and they have no idea what it is. It's impossible to use drugs safely in such a situation.
joe_the_user 5y ago
US has had both a drug-addiction epidemic, a diabetes epidemic and an obesity epidemic. Each these conditions doesn't just reduce lifespan. They also put people in a more fragile life-situation where they need more support. And the US hasn't been at maintaining those kinds of support during the epidemic. Edit: The US life expectancy decline relative to other advanced nations is relevant. Take a look at the following chart in detail. US life expectancy was set back twenty years. No other nation was set by more than ten years. https://www.healthsystemtracker.org/chart-collection/u-s-life-expectancy-compare-countries/ https://www.healthsystemtracker.org/chart-collection/u-s-lif...
- throwawayboise 5y ago
  And makes people more vulnerable when they contract other diseases. COVID hits harder if you are diabetic and/or obese, for example. The people who try to promote body positivity are doing a disservice to the overweight. You cannot be healthy and fat, and we should not pretend otherwise to spare hurt feelings.
  - syshum 5y ago
    Body Positivity movement started out with a good goal, but went off the rails with the obesity == healthy BS. However if you want to solve obesity, especially the morbid obesity shamming will never resolve that as chances are the obesity is cased by an underlying metal or medical issue. most often an anxiety disorder of some kind, and socially shaming someone that suffers from anxiety is not going to cure them, and in fact will most likely make their eating disorder worse.
    - thebooktocome 5y ago
      The primary cause of obesity — in my experience, as a midwesterner — is a lack of access to affordable, healthy food. What people can afford (in terms of money/time/opportunity cost) is primarily overprocessed garbage. It’s mostly impossible to maintain a healthy weight in such an environment. Yes, I’m aware of the twinkie diet guy. Most people aren’t the twinkie diet guy.
reaperducer 5y ago
At least the people you know are rational enough to admit it. A tangential relative died a couple of months ago from a drug overdose. Her immediate family tells everyone she died from the COVID vaccine. Apparently now it's a thing among families who can't come to grips with a drug death to blame the new vaccines. I wonder if this is where the conspiracy theorists get their ammunition.
Jansen312 5y ago
But those died due to illegal drugs won't be elligible for insurance claim. It is strange the article only showing 40% increase in deaths. I would like to see the breakdown. Is it mostly due to heart-related deaths like stroke or cardiac arrest? How many of them has been vaccinated? How many due to natural and unnaturql causes. What I have heard was some deaths due to cardiac arrests in young people. And these are routinely classified as "natural". I like to see numbers backing that. We know vaccine caused heart inflammations and deaths. What we don't see is numbers refuting that and strange for our pharma to wait 75 years to disclose their findings. Do they need to edit the reports that already submitted to FDA?
raxxorrax 5y ago
So glad that drug isn't yet popular in my country. Although last summer it already surfaced to a noticeable degree.

PragmaticPulp 5y ago

All of the non-COVID deaths I’ve heard of among younger people (<60) from my extended social circle and their family/friends have been drug related. Working from home can remove a lot of the accountability that keeps addicts in check. When your coworkers can’t see you, it’s much easier to be inebriated or otherwise suffering from addiction-related issues without feeling social pressure to correct it.

tomcam 5y ago
Thank you for saying < 60 is young!
jeffbee 5y ago
That's pretty normal, at least for the last few decades of American life. There is not a major natural cause of death for people 18-65. They die of suicide, accidental overdoses, and car crashes.
- stavros 5y ago
  When we say "overdoses", doesn't it sound like the person's fault, when it was probably that they were sold a poisoned/cut batch? I wonder how many "overdoses" would have been avoided if you could buy drugs at a pharmacy.
  - prirun 5y ago
    A lot of times an overdose occurs if a person got clean for a while then went back to using. They tend to start using at their previous levels even though their body is no longer used to that level, so it's a sudden jolt that kills them. So I've read - I have zero experience with drugs, luckily.
    - stavros 5y ago
      Yeah, I've read that too, but I have no idea which is more frequent. I'd assume the tainted drugs are more frequent, just because getting tainted product is more frequent than getting clean and relapsing, but I don't know. I'll definitely recommend LSD or mushrooms, though. They are lots of fun.
  - worik 5y ago
    Almost all, if there were some sensible regulation. People do not die from smoking opium, much. But die a lot from popping pills. Concentrated synthetic opioids are deadly.
woodruffw 5y ago
> Working from home can remove a lot of the accountability that keeps addicts in check. This is a cruel twist, given that suicide deaths actually decreased in 2020[1], probably for the reason you've mentioned: spending nearly all of your time with others makes you accountable and removes opportunities for self-harm. [1]: https://www.cdc.gov/nchs/data/vsrr/VSRR016.pdf https://www.cdc.gov/nchs/data/vsrr/VSRR016.pdf
- abyssin 5y ago
  I’m not a native speaker, but there seems to be something inappropriately judgmental about the wording of “keeping in check”. Loneliness is hard for many and causes suffering, and drugs are sometimes used to try to manage suffering. More use is linked to more accidents.
  - MathCodeLove 5y ago
    It's not judgemental - it just is. Many addicts in recovery themselves use similar language. I spend a lot of time with recovering addicts and alcoholics and accountability is an important component of treatment.
  - woodruffw 5y ago
    I can see the judgemental interpretation, but I don't think that's what the GP intended. I read it as "most people suffering from addiction benefit from accountability, one form of which is the in-person responsibilities of work."
- kirse 5y ago
  spending nearly all of your time with others makes you accountable and removes opportunities for self-harm. Never would have seen it coming that encouraging people to stay isolated for years at a time and actively fearing their own proximity to one another would be detrimental.
  - woodruffw 5y ago
    I think you mis-read my comment. The irony is that people are actually closer than ever to their family (or house-mates) due to COVID, which is pushing suicide rates down.
romanovcode 5y ago
> Working from home can remove a lot of the accountability that keeps addicts in check. Not only that but the lockdowns making people low-key depressed which would also be a reason for using addictive substances since they often go hand-in-hand together. I could be pretty much classified an alcoholic during most of 2019-2020 because a six-pack a day keeps the boredom away.
- danielheath 5y ago
  That’s… a substantial way past “pretty much”.
  - romanovcode 5y ago
    I just realized that I was not a real alcoholic when I stopped drinking altogether without any withdrawal symptoms or anything like that. But yeah, it's a slippery slope for sure.
    - molyss 5y ago
      Maybe you didn’t fit the addiction part of aloholism, but when it comes to consumption, a 6-pack a day definitely puts you in that category, along with associated psysical and psychological risks. I’d definitely mention that level of alcohol consumption to my GP and get all relevant blood tests
      - willcipriano 5y ago
        Alcoholism is defined by it's consequences, not by how much you drink. It is the the state of drinking despite dramatic negative life consequences.
    - danielheath 5y ago
      IIRC, on average it takes a month or two of having alcohol every day to start getting physiologically addicted (but - like most of biology - it can be faster or slower). For anyone reading who thinks that may apply to them: Talk to your doctor. "Cold Turkey" alcohol withdrawals can kill.
jdavis703 5y ago
Coincidentally all the natural cause deaths in my circle were “natural” diseases like cancer and COVID-19. I’m in my 30s now, and no longer really hang out with (non-functional) drug addicts anymore though. YMMV.
syshum 5y ago
This is one of the problem with all the people focusing on "excess deaths" as a metric for COVID Deaths.
alienthrowaway 5y ago
> Working from home can remove a lot of the accountability that keeps addicts in check. COVID countermeasures reduced the number of safe recreational activities, and was a horrible for mental health overall. Additionally, America offers very little support for mental health distress, so I imagine this triple threat has been devastating to drug addicts. I'm only guessing as a teetotaler who got addicted to video games and Twitter in that time (and I used to scoff at Twitter-addicts since I had a small, curated list of accounts I followed) [edit]A fourth factor - drug overdoses (and other "less serious" medical issues) also got less medical care because it was being hogged by respiratory patients.

deleted 5y ago

[deleted]

nerdbaggy 5y ago

Correct! “ The synthetic and highly addictive drug has claimed more lives than COVID-19, auto crashes, gun violence, cancer and suicide in the year 2020.” https://www.abc12.com/news/fentanyl-number-one-cause-of-death-for-adults-18-45-recent-government-data-says/article_ed0bfe28-5f79-11ec-8aa0-af3f6cbff03c.html https://www.abc12.com/news/fentanyl-number-one-cause-of-deat...

jeffbee 5y ago
No byline. No sources. Bad article. The article appears to attribute all accidental poisoning to fentanyl. That seems like an error.
- mlyle 5y ago
  > The article appears to attribute all accidental poisoning to fentanyl. That seems like an error. I don't think it does. Sure, they throw out the 100k overdoses number at the end, which isn't specific to fentanyl, but the other numbers they cite are around 40k/year and a run rate of 64k/year by Deceber 2021. Current data is here: https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm It's about 62k deaths from synthetic opioids/year (excluding methadone) at the end of the series-- the vast majority of these are fentanyl. Plus a bunch of heroin deaths which are rapidly becoming "really fentanyl" deaths. And that's up to April, not December.
  - jeffbee 5y ago
    That data is for all ages. If you go to WISQARS and filter for ages 18-45, which is the subject of the news site's article, it looks to me like the numbers they are giving in the article are the same as the total number of accidental poisoning.
    - mlyle 5y ago
      They're pulling from this fact sheet: https://drive.google.com/file/d/1S0szR2Ua9v0Sr91YhDD7gPrXsDkHxDvP/view https://drive.google.com/file/d/1S0szR2Ua9v0Sr91YhDD7gPrXsDk... Topic 1 is on ages 18-45: more deaths from fentanyl than from... The later topics are on all ages. The fact sheet attributes 24k deaths in the age range to fentanyl in 2019. WISQARS accidental injuries from poisoning in the age range were 38k in 2019. 2/3rds in that age range being fentanyl is totally plausible. https://wonder.cdc.gov/controller/datarequest/D157;jsessionid=7A04C7DC8D17F0A5FA2103363BB7 https://wonder.cdc.gov/controller/datarequest/D157;jsessioni... has the broken down data. They have 36,907 deaths in 2020 from 18-45 with T40.4-- "other synthetic opioids excluding methadone". FAF is calling all deaths from synthetic opioids fentanyl, which isn't quite true but it's very likely close to true.

3maj 5y ago

Probably a big one. Drug overdoses have killed more 18-54 year olds in Canada than Covid has. Hell, in British Columbia there have been more drug overdoses than Covid deaths across all ages.

exdsq 5y ago

I read fentanyl killed more people than Covid in SF last year - don’t think there were any age brackets on that either

dillondoyle 5y ago

And it's not just opiate users. People buying coke & 'molly' are overdosing too from fent and analogues too. Why in the world would a dealer put fent into coke. I guess a speedball feels great but the average weekend partier doing a bump or a pill are not looking to walk that death tightrope. Just sad all around and we still have a long way to go with stigma and science based treatment. If you happen to be in that scene might be a good idea to start carrying naloxone.

worik 5y ago
A very powerful argument for legalising forms of those drugs for recreational use.
- dillondoyle 5y ago
  Yea please! Decriminalizing would be a great first step but won't cut out the cartels and gangs and adulteration (kind word for poisoning..) Would also love to see over the counter narcan. suboxone for any who wants it without the compliance burden.
  - slapshot 5y ago
    Narcan is available "behind the counter" in most states. You have to ask for it, but a prescription isn't required.[1] [1] https://www.cvs.com/content/prescription-drug-abuse/save-a-life https://www.cvs.com/content/prescription-drug-abuse/save-a-l...
    - dillondoyle 5y ago
      I know there were a few people organizing on reddit too where they would ship it if you can't access it easily too! I think it was a lady on /r/opiates
Tiktaalik 5y ago
Yep. It's not an opioid epidemic or crisis, it's a toxic drug crisis. The drugs are poisoned. No one knows what's in them. There's a drug test site in my city that regularly posts examples of what they find on twitter. Totally random ultra dangerous poisons in party drugs. All the time. Here's an example: a drug not safe for humans in a test sample of MDMA. https://twitter.com/GYDTcanada/status/1477444546480984065?s=20 https://twitter.com/GYDTcanada/status/1477444546480984065?s=... People are dying because they're doing some thing and they have no idea what it is. It's impossible to use drugs safely in such a situation.

joe_the_user 5y ago

US has had both a drug-addiction epidemic, a diabetes epidemic and an obesity epidemic. Each these conditions doesn't just reduce lifespan. They also put people in a more fragile life-situation where they need more support. And the US hasn't been at maintaining those kinds of support during the epidemic. Edit: The US life expectancy decline relative to other advanced nations is relevant. Take a look at the following chart in detail. US life expectancy was set back twenty years. No other nation was set by more than ten years. https://www.healthsystemtracker.org/chart-collection/u-s-life-expectancy-compare-countries/ https://www.healthsystemtracker.org/chart-collection/u-s-lif...

throwawayboise 5y ago
And makes people more vulnerable when they contract other diseases. COVID hits harder if you are diabetic and/or obese, for example. The people who try to promote body positivity are doing a disservice to the overweight. You cannot be healthy and fat, and we should not pretend otherwise to spare hurt feelings.
- syshum 5y ago
  Body Positivity movement started out with a good goal, but went off the rails with the obesity == healthy BS. However if you want to solve obesity, especially the morbid obesity shamming will never resolve that as chances are the obesity is cased by an underlying metal or medical issue. most often an anxiety disorder of some kind, and socially shaming someone that suffers from anxiety is not going to cure them, and in fact will most likely make their eating disorder worse.
  - thebooktocome 5y ago
    The primary cause of obesity — in my experience, as a midwesterner — is a lack of access to affordable, healthy food. What people can afford (in terms of money/time/opportunity cost) is primarily overprocessed garbage. It’s mostly impossible to maintain a healthy weight in such an environment. Yes, I’m aware of the twinkie diet guy. Most people aren’t the twinkie diet guy.

reaperducer 5y ago

At least the people you know are rational enough to admit it. A tangential relative died a couple of months ago from a drug overdose. Her immediate family tells everyone she died from the COVID vaccine. Apparently now it's a thing among families who can't come to grips with a drug death to blame the new vaccines. I wonder if this is where the conspiracy theorists get their ammunition.

Jansen312 5y ago

But those died due to illegal drugs won't be elligible for insurance claim. It is strange the article only showing 40% increase in deaths. I would like to see the breakdown. Is it mostly due to heart-related deaths like stroke or cardiac arrest? How many of them has been vaccinated? How many due to natural and unnaturql causes. What I have heard was some deaths due to cardiac arrests in young people. And these are routinely classified as "natural". I like to see numbers backing that. We know vaccine caused heart inflammations and deaths. What we don't see is numbers refuting that and strange for our pharma to wait 75 years to disclose their findings. Do they need to edit the reports that already submitted to FDA?

raxxorrax 5y ago

So glad that drug isn't yet popular in my country. Although last summer it already surfaced to a noticeable degree.