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The real issue here that people don't seem to want to face is the WHY. Why do so many people want to check out of life completely by abusing medicine? If we don

The real issue here that people don't seem to want to face is the WHY. Why do so many people want to check out of life completely by abusing medicine? If we don't address that nothing is going to stop the drug abuse let alone the relapse and overdose. I'm not talking about "more 12 step" here but more of a Frommian psychoanalytic approach. You are broken because society is broken. You have the ability to change yourself and subsequently society. A lot more empowering than just "submit to a higher power" which is clearly not working for the majority of users.

P_I_Staker 4y ago
There’s also the medical systems unwillingness to help certain people and medicate; then people end up on the street getting more dangerous drugs in an uncontrolled fashion.
fasthands9 4y ago
I guess I'm a bit torn on this. Even if we had an extremely fair and equitable society with growth I imagine there'd still be plenty of people who feel rejected or lonesome at times. Or just like the feeling that these drugs give them above normal drugs. I drink alcohol a couple times a week and do edibles once a month. I'm sure some would argue I'm not fulfilled but I think the easier explanation is that a lot of times doing mind-altering drugs is...fun? And can be social.
- newsclues 4y ago
  That sounds like a healthy amount of drugs. For people with self control like that, I think it would be healthy to trip once or twice a year and use stimulants (cocaine) for a party once a year. A heroin vacation to an opium den on occasion sounds wonderful. I certainly have used drugs socially (LSD in clubs or concerts can be fun), but also use them cannabis alone frequently.
  - arghnoname 4y ago
    This is the crazy thing about this whole issue. Some people can use drugs that are extremely harmful responsibly. It's a once-in-a-while excursion away from ordinary life. There's nothing wrong with having a scary drug, like heroin, a few times a year...except that for some people it leads to their entire life unraveling. This idea that we're all the same and because drugs are physically addictive (i.e., sustained use leads to withdrawal of use ceases) means everyone would become addicts if they tried it is a D.A.R.E. style falsehood. It's true for some, but seemingly not most. Even drugs/activities that don't seem physically very addictive, like pot and gambling, seem to have their addicts. I question what proportion of addiction is chemical and what is something deeper going on. It's a pity though. I don't think I'm prone to addiction, but for the sake of my fellow humans and a functioning society I reluctantly accept that these things shouldn't be widely accessible. I've become much more of a prohibitionist as I've gotten older.
    - elektrontamer 4y ago
      I appreciate the selflessness and pragmatism. Many responsible users are much more dismissive of prohibition.
      - notch656c 4y ago
        It seems selfless but not pragmatic. Prohibition doesn't seem to make the opiate problem smaller, it just makes it more dangerous for users, the public, and the people selling it.
- HEmanZ 4y ago
  I have known quite a few friends from earlier in my life who became serious addicts and ruined their lives or ended their lives by it. I would not describe a single one as having started using because they were mad at society, sad, or lonesome. It was always some strange kind of strange, arrogant fetishization of drug-life and crime-life. There is an almost "drug life is THE life, and everyone else is lame" attitude in many circles, and I got a little too close to comfort to falling into it at one point in my life. This doesn't mean there aren't a hundred reasons people get trapped in drugs. But a very real one is just because many people come to believe it's cool and tough, and end up fetishizing it until it's too late to get out. And like I said, in my hometown, this was the predominant reason.
  - Apocryphon 4y ago
    Were they bored, did they not have exciting career or family prospects, was it ennui? Low-grade emotions can lead to addictive behaviors, not only high intensity trauma. The decision to subscribe to a malignant anti-authority lifestyle still shows that something is wrong, if it becomes so attractive an alternative to forsake one's life for.
    - HEmanZ 4y ago
      Reading HN, I get the strong suspicion many people didn’t grow up around drugs. People don’t always think they are throwing away their lives. They think “this makes me cool” and “it’s no big deal” and “anyone who’s anyone does it”. Often there’s the confident assertion “this ruins other peoples lives but I’m too good/special for that”. And often they don’t even realize it’s a problem, even when they’ve hit rock bottom, even when they’ve ruined their families lives for their drug addiction. I’m not claiming other, much sadder reasons don’t exist. Or that we shouldn’t do something to help people survive and recover, like this vaccine that could mean thousands of lives saved, thousands of fewer mothers crying at funerals. But there is also a lot of personal responsibility involved, and we can’t make this claim, that I see so many people on HN try to make, that people who have ruined their life (and more importantly, often their families lives) thru their own choices have no responsibility. That it’s all fault of vague “society” and if we just ban together with <vague handwavy socialist/utopian/whatever vision>, that people will stop making bad decisions about their lives.
electric_mayhem 4y ago
“It is no measure of health to be well adjusted to a profoundly sick society.” Also, this: https://www.dailymotion.com/video/x305n83 https://www.dailymotion.com/video/x305n83
sillysaurusx 4y ago
Probably because it feels good. Sometimes the simple answers are the most likely. Even if you have a great life, it’s tempting to have such experiences. Sure, a lot of people use it as an escape though. But I imagine my dumbass brother in law died because he was trying to have fun, not check out of life. Miss him.
- khazhoux 4y ago
  > Probably because it feels good. This is the dirty little secret of 1980’s-style approach to keeping people off drugs: they feel great. The old (current?) approach suffers from intellectual dishonesty of ignoring the physical pleasure.
kstrauser 4y ago
They’re adding Fentanyl to everything now. I have Burning Man-adjacent friends who take ecstasy once a year at festivals, and they’re terrified of getting a tainted dose. This affects many more people than just those addicted to opiates.
- t433 4y ago
  Legalize everything and produce it pharmaceutically, and this problems pretty much disappears.
  - SpeedilyDamage 4y ago
    Yeah, and a whole host of other problems show up…
    - hasmolo 4y ago
      can you elaborate?
      - SpeedilyDamage 4y ago
        “ Illegal drugs increase crime, partly because some users turn to crime to pay for their habits and partly because some users are stimulated by certain drugs to act more violently. Legalization, however, will not affect addiction and its effects on the propensity to violence. Instead of legalizing drugs, better treatment, education, and research are needed to curb dependency on drugs and the adverse health and social effects of drug use.”[0] [0] https://www.ojp.gov/ncjrs/virtual-library/abstracts/against-legalization-drugs-1 https://www.ojp.gov/ncjrs/virtual-library/abstracts/against-...
        cmyr 4y ago
        'illegal drugs' is a pretty broad brush, and treating opiods and psychedelics equivalently is silly. Surely treatment, education and research would all be far easier alongside decriminalization?
candiddevmike 4y ago
I think you assume folks want to check out of life because they think fentanyl is a better choice, when instead fentanyl makes folks check out of life. Have you ever spoken with an addict who wants to get clean? It's bleak, they're basically enslaved by the substance. Having a vaccine to break the cycle is a huge boon.
briffle 4y ago
While I agree with you, at the same time, I can't help but think having someone take a pill or shot weekly/monthly/etc is whole lot simpler and easier than fixing the homeless problem, the cost of medical care, and training up (and paying) hundreds of thousands of new mental health professionals, among the dozens and dozens of different reasons people turn to drugs like this to 'escape'.
- jcutrell 4y ago
  Do we have a clear picture for where we want this to go in the future? Though not exactly the same, does this start to walk the path towards a "soma" equivalent?
encoderer 4y ago
Humans were not evolved to resist these kinds of poisons. Nothing like this exists in nature. It’s an extremely potent chemical.
- anonymouskimmer 4y ago
  It's not that nothing like this exists in nature, it's that evolutionarily speaking nothing like this existed in the areas human first evolved. Or if they did, we either evolved to resist them, thus no longer see them as toxic, or we're still in an arms race with the life that produces them (which means they would be much less toxic than fentanyl, but still toxic). Plants (and fungi, and animals) evolved to create noxious chemicals that keep animals from eating them, keep animals from breeding, or outright kill the animals. The Golden Poison frog's toxin is about 40 times more lethal than fentanyl.
  - encoderer 4y ago
    The golden poison frog looks pretty scary to me. The yellow color. The big eyes. I would not try to eat it. But a white powder or pill that is equally lethal doesn’t ring any evolutionary alarm bells.
  - emiliobumachar 4y ago
    Could you please link to or expand about plants producing toxins that specifically keep animals from breeding? It's news to me, and a web search has failed me. Is that long-term pest control, or something else?
    - anonymouskimmer 4y ago
      The term you want to search for is "phytoestrogens". From wikipedia: "It has been hypothesized that plants use a phytoestrogen as part of their natural defence against the overpopulation of herbivore animals by controlling female fertility.[3][4]" Though wikipedia also says: "These compounds in plants are an important part of their defense system, mainly against fungi.[19]" So it could be that plants are principally targeting fungi for the most part, and just serendipitously targeting animals as well.
patientplatypus 4y ago
I'm homeless and living in the Tenderloin in San Francisco. People here want you to - Be in a gang (or a prostitute, thief, ex-con and so forth) - Be on drugs (or in rehab for drugs) - Have a mental illness (so you can go to therapy) - Be disabled - Find religion There isn't a position for "I ran out of money and my family wouldn't support me, and at some point finding web development work became too hard as the technology became more complicated." People want you to "get better." I don't do drugs, I don't smoke, I don't drink, I don't steal or assault anyone. I just don't have any money. But people here are morons. They need to have a reason for why someone is poor other than "I'm a person of average intelligence that doesn't know how to find a paying job in this society." I don't want to be psychoanalyzed, be put into rehab, go to church or join any number of the lonely people who have to have a support group because society is awful. I don't have problems other than being poor - if you managed to buy into the crypto ponzi scheme at the right time then no one is asking you to "find god" or "get better". People are social animals. If you put them in a position where those are the options (jail, crime, drugs, psychoanalysis, religion, disability) they'll take the least unpalatable. There's a whole lot of people who walk around here with canes they don't need because otherwise the San Francisco General Assistance office won't spring for them to have housing. Also known as an apartment with a bed and a door that locks. If I make more than 1500 dollars I lose my health insurance through Medi-cal. And I'm no defender of a lot of these people. The bastards that set up tents on the sidewalk and smoke meth are just awful. But on the other hand, I have absolutely no idea how to get a job. None. I've done construction before and all I ended up with was bad memories and scarred hands. I could work "security" by putting on a t-shirt and standing outside a soup kitchen, but that's just bullshit make work the charities give out so the poor can buy shoes and feel special about themselves. Real security jobs outside of bars are a good way to get killed. And that's about it. I'm staying at a homeless shelter and have the clothes on my back so how am I supposed to get a job? There's your why. So let me give you a when. When, not if, your industry is automated or the code becomes too complicated for you to understand anymore you'd better have enough savings or a social network so you don't become homeless. Or you'll have to crawl into one of the buckets that allows society to make sense of you. And today I'm sitting in the San Francisco library looking to make a contribution to a software project for free and I just don't know that I care anymore. And if you tell me it'll get better, then I have to ask if you're about to be laid off or not and what your plans are.
beebmam 4y ago
I think you presume that human behavior must seem to have a cognitive reason for the "why", when it's entirely possible that the "why" is simply physiological/neurological. In the case of intense opiates, which have a profound effect on human neurology, it would be bizarre to not consider that in the "why".
athorax 4y ago
I think this undermines the issue a bit. A lot of people get addicted to these substances completely by accident and aren't initially seeking to "check out of life." But once you are hooked, it can be a devastatingly difficult road to get off. For sure there are plenty of people who go out looking for escapes and I do agree it is something that needs to be addressed.
PragmaticPulp 4y ago
> The real issue here that people don't seem to want to face is the WHY. Why do so many people want to check out of life completely by abusing medicine People start using drugs for different reasons. It's not correct to say that everyone starts abusing drugs as a form of pure escapism. A lot of drug users start because they're simply seeking recreation and someone is nearby to make drugs available to them. It's as simple as that. > You are broken because society is broken. Variations of this concept are frequently used by drug addicts to justify continued behavior. "It's not my fault, it's society's fault!". Taking ownership of actions and consequences is one of the key pivot points in helping people get control.
- _yb2s 4y ago
  > Variations of this concept are frequently used by drug addicts to justify continued behavior. "It's not my fault, it's society's fault!". Taking ownership of actions and consequences is one of the key pivot points in helping people get control. I don't think these are mutually exclusive. Society wide problems cause a huge fraction of the population to experience severe emotional trauma, and the process of addiction largely seems to be an experience of trying to escape the feelings associated with that. If you can understand this process, you can take ownership of it, and have a path to beating the addiction itself. Ultimately, there is a lot of disagreement about what addiction is and how it really works, but I think this emotional trauma aspect is a key part of explaining why one person can use a drug recreationally or for medical purposes without addiction, and another can't. It explains a lot of weird observations that just didn't make sense with the classical chemical/neutrotransmitter model of addiction. These links I think help explain this better than I can: How Childhood Trauma Leads to Addiction - Gabor Maté https://www.youtube.com/watch?v=BVg2bfqblGI https://www.youtube.com/watch?v=BVg2bfqblGI Comic explaining the Rat Park research on addiction https://www.stuartmcmillen.com/comic/rat-park/ https://www.stuartmcmillen.com/comic/rat-park/ These ideas have explained why I personally have never been able to fight addictions through willpower alone, but have been able to eliminate addiction with other techniques that seem unrelated- therapy, meditation, exercise, hobbies, friends, ending bad relationships, etc. It seems that while chemical/physical addiction is a thing, emotionally and mentally healthy people don't experience opioids as a positive thing, such that the effect of the drug itself actually discourages it's use, and even motivates the experience of withdrawal.
cstejerean 4y ago
I think quite a lot of people ended up addicted to opioids against their will, by starting with being over prescribed highly addictive pain medication which then ended up making them addicted to opioids, and then later on ended up trying to feed that habit from the streets once the easy access to pain meds dried up. https://www.doj.nh.gov/news/2022/20220303-settlement-purdue-pharma-sacklers.htm https://www.doj.nh.gov/news/2022/20220303-settlement-purdue-... Personally I've been avoiding oxycontin like the plague for that reason. I had two surgeries where the doctors wanted to give me oxy to manage the pain afterwards and I refused to take them. It turned out in both cases the pain was manageable with less addictive options, so I'm not clear why they reached straight for prescribing opioids in the first place.
- arghnoname 4y ago
  You're not wrong, but addiction is not a certain outcome. Most people who use a substance that can lead to addiction don't become addicted. The question is why can two people, for example, abuse alcohol for a period of their youth, but both don't become addicts? We need to look at this holistically. Overprescribing is a problem, but we shouldn't be needlessly afraid of these substances. Personally I've been prescribed these medications, I took some and when it stopped hurting I stopped taking them and the bottle sat in my medical cabinet in case I injured myself later. Eventually it expired and I threw it away. It wasn't an issue of will power or anything like that. I just didn't feel the compulsion. I'm the same way with alcohol and other drugs. I enjoy it when appropriate, but I feel no compulsion whatsoever. I, in fact, prefer mental clarity. But I have people in my life who develop very strong compulsions and become addicted to anything that distracts them from their psychological torments. Reducing access helps, but reducing other circumstances in their life that they may feel the need to numb has to be part of the solution.
  - shortlived 4y ago
    > but addiction is not a certain outcome Not certain but chances are very high with the new class of opioids.
- dotnet00 4y ago
HEmanZ 4y ago
Usually the "society" issue is framed as some sort of welfare crisis. I have a more-than-one-hand-full of friends and acquaintances from earlier in life who ruined or ended their life with drugs. And so I don't know anything statistically, but I have seen what caused the people near me to fall into it, and it wasn't some welfare crisis. The number 1 reason I experienced is because some social circles fetishized it. It was a very cool, tough, and a superior lifestyle. Anyone who didn't do drugs was a loser, drugs were for winners. When there is a strong cultural-current of this attitude, it can draw people in and ruin their lives by the time they realize it's all wrong.
- d4mi3n 4y ago
  I've seen some of this as well, though through my own anecdotal experience people in my life I've seen struggle with drugs do or did so because: 1. Ongoing health issues they can't afford to resolve. Chronic pain. Mental health issues. Sleep disorders. or 2. Inability to cope with high levels of stress due to financial insecurity, bad relationships, or loneliness. I think the cultural attitudes you describe may have some relation to other problems. Most people I've encountered seek escapism when their life experience is poor and they're unable to change their circumstances or unaware of ways to change their circumstances.
  - HEmanZ 4y ago
    I think my point is that it can be both. There is a lot we can do to help in the cases you point out. But I just don’t think the problem is entirely solvable, or even mostly solvable, without changing a destructive sub-culture, which we can’t do in any way I can think of. At least we are working on things like this vaccine to save lives. That’s something.
akira2501 4y ago
> The real issue here that people don't seem to want to face is the WHY. Drugs get you high. Ants get drunk, goats chase psychedelic lichen, and dolphins pass around puffer fish like a dutchie. > Why do so many people want to check out of life completely by abusing medicine The short term benefits always outweigh the short term costs, but we're moving to a point in history where even it even seemingly outweighs the long term costs. There's no real disincentive anymore. I think a case can be made that Martin vs. Boise had the most to do with this. That ruling was meant to push cities into creating the necessary facilities and number of beds to correctly address their homelessness problem; instead, it seems that many cities have used it as a way to entirely ignore the issue. Instead of building the facilities, they're just throwing up their hands and allowing the kind of "public camping" that quickly turns into public open-air drug markets. Unsurprisingly, the population and markets grew. > A lot more empowering than just "submit to a higher power" which is clearly not working for the majority of users. The twelve steps are about quite a bit more than "just" that. They're also targeted towards a person that is at a specific stage of addiction _and_ willingness to address it. It's not general purpose and you can't force people into it, particularly when their drug of choice is so easily available and socially acceptable. You have to reduce the inflow of drugs. You have to stop drug markets from forming. You have to convince addicts to seek treatment. On the last point, I think the most effective strategy would be confiscation. If you are caught with drugs for personal use, they should be taken and destroyed, and you should be given information and transportation to a treatment center if you desire. Otherwise, you should be free to go. If the state doesn't interject itself at some level then I don't think you stand a chance.
- pixl97 4y ago
  >You have to reduce the inflow of drugs. And this is how we get fentanyl. Why import 2 tons of drugs when you can import 2 ounces with the same power. Attempting to reduce the inflow has just created a violent black market and a dangerous police state.
  - akira2501 4y ago
    There is so much reductive thinking in this thread, it is painful. Fentanyl has been on the market since the 1960. The deaths started spiking in 2014. Did we step up enforcement majorly in 2014? Or did something else start this rise? Why import anything if you could produce it domestically? Is it possible that basic enforcement has obvious impact? If we allowed labs to produce it domestically, do you think we would see more, or less? What mechanism drives that outcome? What if this is already starting to happen? The creation of the DEA has had a negative value outcome with respect to the amount of drugs in our society, I'll grant you, but I have a feeling that's due to it being setup as a paramilitary organization as opposed to a knowledge and tactical care based organization focused on the ground level issues surrounding actual users and user/dealers.
kodah 4y ago
> The real issue here that people don't seem to want to face is the WHY. Why do so many people want to check out of life completely by abusing medicine? I don't do powders, opioids, etc but I do have some friends within tech and the festival scene that do. My observation is that most people that die from fentanyl don't know they're taking it. They think they're doing cocaine, ketamine, heroin, or some other substance. Fentanyl presence is usually a case of cross contamination when the particular substance is being cut at each hierarchial level of the drug food chain. That's not to say that there isn't some small subset of dealers who don't purposefully drop in some fentanyl, but largely that'd be a stupid decision. The users life expectancy shrinks and their risks skyrocket when they come in contact with fentanyl, this is known. If you want to stop the deaths, then you have to allow drug distribution that comes from clean rooms. At present, everyone should be using test kits, but fentanyl in particular is hard to test for because a single grain hiding in a mound can get and overdose a user. If you want people to stop using drugs, well, I have less to say. The history of humanity is using intoxicants whether it be for recreation, psychological well-being, or medical necessity. We've only recently in the history of humanity gone on moral crusades to villainize it. Chemically addictive substances are a little more challenging. Things like heroin, cocaine, and methamphetamine aren't drugs you can benefit from, but people still do them. Largely, it's because they got hooked on pain killers or some other "numbing" medication. Better availability to harm reduction resources, therapy, social safety nets, etc would improve metrics across the board in the chemically addictive substances category.
azalemeth 4y ago
My fentanyl experiences have entirely been as part of surgery: it's part of the balanced triad of anaesthesia and I "recently" injured myself quite badly, resulting in three operations. After one of these, I spent about 36 hours on a fentanyl infusion and more than a month on oral morphine of various doses with my leg in an orthopaedic brace while I was bed-bound. I should point out that the alternative was a lot of screaming: visceral pain of the variety I cannot describe – I had a panicked, "help me" expression on my face and just felt utterly, utterly desperate. I was in a lot of pain and medically the drugs were appropriate, given the injuries I sustained. I totally get why some people become addicted to drugs. Diazepam made me both in less pain and care less that I was in it. The opiates produced this warm, fuzzy haze of vivid dreams and imaginations and made a difficult time bearable. Fentanyl made me feel less than human but not able to suffer, and it was a necessity at the time. Of all of them though, diazepam was the most dangerous. It just felt – well, nice. I didn't care that things were bad. I needed it medically to stop neurogenic muscle spasms and it made me both able to sleep well and feel OK about life in a way that is really hard to put into words. I have some in a bag, prescribed for me, in case I need it. Part of me – a small part of me, but a part nonetheless – wants to use it, a lot, when I don't need it. There's a little voice that just says "this makes you feel like you've been tucked up into bed nicely". I really can't explain it, but I know that voice is a temptation and a gateway to something that I don't want to have – but at the same time, I know that that drug both saves me from agony and helps me medically if I need it. I'm really not sure how I feel about that. I haven't had any in months, but the psychological aspect remains. I can only imagine what "real" drug addicts go through. It must be incredibly hard, and individual's range of experiences will be very broad indeed.
- wise0wl 4y ago
  Once you actually don't need it anymore, throw it far away and do not look back. Benzos and opiates ruin lives because of that little voice. That voice will be strong enough one day that if you have those close by you will take a few, because why not? That voice is the voice of addiction. Once it starts it never fully goes away. It just gets less frequent.
- crucialfelix 4y ago
  My mother spent 6 weeks sedated with Fentanyl, on top of Alzheimer's. After a few days I realized she would survive. But she was in a hellish state for over a year, hallucinating and constructing parallel realities. Ironically, she worked on the UK medical trial for Fentanyl when it was first introduced for surgery.
theGnuMe 4y ago
Because it is there.
scoofy 4y ago
A good metaphor for addiction is speeding. You're driving down and empty highway, you want to get where you're going faster. You're not going to actively look down at your speedometer. You know you're probably breaking the prescribed limit a bit, but who cares. The when you finally are faced with looking at the speedometer, say when you get to windy section or a speed trap, you look down and you're going 25mph over the limit and you have no idea how you ended up going so fast, but by that time, you're brakes are squealing or worse.
dlkf 4y ago
> Why do so many people want to check out of life completely by abusing medicine? This isn’t how it works. Few people, if any, want to “check out.” What happens is that people are exposed to opiods via one of two channels (they are prescribed painkillers, or they party with someone who has acquired them) and they quickly get hooked because these drugs are cripplingly addictive. So the only “why” questions we have to ask are: 1) Why do people take opiods the first time 2) Why do people continue The answer to 1 is either because their doctor said so, or because they like to party and have no foresight. The answer to 2 is because if they stop, they experience the worst sickness imaginable. Society is not broken and we don’t need weird conspiratorial explanations for any of this.
- nicoburns 4y ago
  I think it's > 1) Why do people take opiods the first time that the GP is getting at. While doctors over-prescribing opiates is definitely a thing (esp. in the US), I'm not convinced that many people get hooked on opiates due to partying. I think it's more commonly: "Used as an escape from a life that is unmanagable for some reason" That's not conspirational. There's good evidence to show that life circumstances have a big effect on both initially becoming addicted and success when attempting recovery. The answer to this might look like a better welfare state or similar.
  - kodah 4y ago
    I think it'd be more likely that someone discovers opioids mask their pain while using them for legitimate purposes. After that is when gaming the doctor, street buys, and finally substitutions take place.
  - dotnet00 4y ago
    There are plenty of other fairly common reasons that don't involve simple escapism, with young people it's just as likely to be simple peer pressure or experimentation. It also doesn't help that it's common to treat drug highs as some sort of enlightening experience that needs to be experienced to understand.
- cf141q5325 4y ago
TYPE_FASTER 4y ago
It's not that simple: https://www.wcvb.com/article/ex-cop-describes-descent-from-hero-to-addict/8223633 https://www.wcvb.com/article/ex-cop-describes-descent-from-h...
awill88 4y ago
Whoa, you’re so out of touch with reality. Yikes.
musicale 4y ago
> Why do so many people want to check out of life completely by abusing medicine? Painkillers can provide relief for emotional pain as well as physical pain. Even something like Tylenol can help people going through painful breakups. Unfortunately opioids are addictive and users build up tolerance, which is bad for people with chronic pain of any variety.
mrhands556 4y ago
Do you think at any point in the last 100 years if drugs were readily available uptake would be low?
bsder 4y ago
Do you really think that Michael Jackson and Prince wanted to "check out"? My assessment is that if even people at that level of wealth and success can get addicted to opioids and die, pretty much anyone can. Addiction, whether alcohol, drugs, cigarettes, etc., is something that is a genuine medical issue needing treatment. Thankfully, the medical community seems to be shaking off the social stigma about addiction and treating it properly now, but progress has been very slow.
jasonhansel 4y ago
> I'm not talking about "more 12 step" here but more of a Frommian psychoanalytic approach. Do you have any evidence that that works better than (say) buprenorphine or naloxone, which target the underlying neurological problem?
fIREpOK 4y ago
>The real issue here that people don't seem to want to face is the WHY. I doubt that it's always a "choice". But it wouldn't surprise if there was many main causes.
miguel-muniz 4y ago
Something else I wonder is how have we managed to convince generations that smoking is not only horrible to your health and frowned upon but alcohol is acceptable?
MrYellowP 4y ago
Fixing society doesn't increase revenue. The opposite, actually. For example: The more people are depressive, the more pills can be sold. If people kill themselves due to depression, that's too bad, but they didn't buy any pills to begin with. Diabetes is great, because people depend on insulin. A never-ending money maker! Fat people are great! They eat more, thus spend more! Some of them get their fat surgically sucked out of their bodies, which also pays! When they get more and more sick, they need more and more medicine, which pays even more! The transhumanism movement is awesome, because transitioned people require pills! Every day! Sadness? There's a pill for that! Drug addicts? Lets invent a vaccine for that! Fantastic! Society isn't getting fixed, because nobody actually has any interest in that. Those in power/money certainly don't give a fuck and rather want more money, while the actual people are mostly too stupid to figure out that the whole system needs changing. Instead they whine, complain and protest and go voting, without realizing that it does basically nothing. Yes, voting actually does nothing. We didn't get to this point because voting helps anything. We got here, because voting doesn't matter. Decades of evidence lay in front of everyone out there to see, yet for some reason every couple years people actually believe their button-pressing/their X-making actually gives them power over what's going to happen! There's no vote allowing you to change who pays all the money to the politicians, law makers and judges. There's no vote that allows you to change the underlying corruption that's going on. There's no vote that enables you to decide what actually happens with your money. You're fucking hilarious. You're not wrong per se, but also hilarious. "Society needs fixing!!!111" well then get together with enough people and fucking fix it. Politicians won't do it for you. Better get your guns ready, btw, because it's definitely not going to happen peacefully.
bArray 4y ago
I would ask a different 'why', which is 'why is fentanyl so easily accessible?'. We know where it's made, how it gets into the US, a long list of reasons for why people start taking it. But why hasn't the supply of fentanyl to the US been restricted? Given how many lives this destroys, how many people it takes out of the potential workforce, how many social problems this causes (crime, homelessness, exasperated mental health issues) - why isn't there the political will to change this?
- defrost 4y ago
  I answered this at length in a forum some months back and sadly can't find the text (for now). The abridged version is: there too much money to be made. Fentanyl has gone from direct primary import (which was blocked) to banning of exporting precursor drugs from bulk suppliers in China (to slow down | stop Mexican drug labs from mixing them to make Fentanyl) to where things are today ... relatively mobile "popup" drug lab networks that start with bulk pre precursor drugs to make the precursor drugs that are funneled to final product labs. It's a hell of a whack a mole game across Mexico, the USofA and Canada with a process that's tough to break, the initial drugs used are too useful for too many things to ban outright and the production aspect is broken down into many replaceable parts. ( I had references to most of those stages in the original comment, apologies for not having them to hand ).
  - bArray 4y ago
    Appreciated, the context is useful.

P_I_Staker 4y ago

There’s also the medical systems unwillingness to help certain people and medicate; then people end up on the street getting more dangerous drugs in an uncontrolled fashion.

fasthands9 4y ago

I guess I'm a bit torn on this. Even if we had an extremely fair and equitable society with growth I imagine there'd still be plenty of people who feel rejected or lonesome at times. Or just like the feeling that these drugs give them above normal drugs. I drink alcohol a couple times a week and do edibles once a month. I'm sure some would argue I'm not fulfilled but I think the easier explanation is that a lot of times doing mind-altering drugs is...fun? And can be social.

newsclues 4y ago
That sounds like a healthy amount of drugs. For people with self control like that, I think it would be healthy to trip once or twice a year and use stimulants (cocaine) for a party once a year. A heroin vacation to an opium den on occasion sounds wonderful. I certainly have used drugs socially (LSD in clubs or concerts can be fun), but also use them cannabis alone frequently.
- arghnoname 4y ago
  This is the crazy thing about this whole issue. Some people can use drugs that are extremely harmful responsibly. It's a once-in-a-while excursion away from ordinary life. There's nothing wrong with having a scary drug, like heroin, a few times a year...except that for some people it leads to their entire life unraveling. This idea that we're all the same and because drugs are physically addictive (i.e., sustained use leads to withdrawal of use ceases) means everyone would become addicts if they tried it is a D.A.R.E. style falsehood. It's true for some, but seemingly not most. Even drugs/activities that don't seem physically very addictive, like pot and gambling, seem to have their addicts. I question what proportion of addiction is chemical and what is something deeper going on. It's a pity though. I don't think I'm prone to addiction, but for the sake of my fellow humans and a functioning society I reluctantly accept that these things shouldn't be widely accessible. I've become much more of a prohibitionist as I've gotten older.
  - elektrontamer 4y ago
    I appreciate the selflessness and pragmatism. Many responsible users are much more dismissive of prohibition.
    - notch656c 4y ago
      It seems selfless but not pragmatic. Prohibition doesn't seem to make the opiate problem smaller, it just makes it more dangerous for users, the public, and the people selling it.
HEmanZ 4y ago
I have known quite a few friends from earlier in my life who became serious addicts and ruined their lives or ended their lives by it. I would not describe a single one as having started using because they were mad at society, sad, or lonesome. It was always some strange kind of strange, arrogant fetishization of drug-life and crime-life. There is an almost "drug life is THE life, and everyone else is lame" attitude in many circles, and I got a little too close to comfort to falling into it at one point in my life. This doesn't mean there aren't a hundred reasons people get trapped in drugs. But a very real one is just because many people come to believe it's cool and tough, and end up fetishizing it until it's too late to get out. And like I said, in my hometown, this was the predominant reason.
- Apocryphon 4y ago
  Were they bored, did they not have exciting career or family prospects, was it ennui? Low-grade emotions can lead to addictive behaviors, not only high intensity trauma. The decision to subscribe to a malignant anti-authority lifestyle still shows that something is wrong, if it becomes so attractive an alternative to forsake one's life for.
  - HEmanZ 4y ago
    Reading HN, I get the strong suspicion many people didn’t grow up around drugs. People don’t always think they are throwing away their lives. They think “this makes me cool” and “it’s no big deal” and “anyone who’s anyone does it”. Often there’s the confident assertion “this ruins other peoples lives but I’m too good/special for that”. And often they don’t even realize it’s a problem, even when they’ve hit rock bottom, even when they’ve ruined their families lives for their drug addiction. I’m not claiming other, much sadder reasons don’t exist. Or that we shouldn’t do something to help people survive and recover, like this vaccine that could mean thousands of lives saved, thousands of fewer mothers crying at funerals. But there is also a lot of personal responsibility involved, and we can’t make this claim, that I see so many people on HN try to make, that people who have ruined their life (and more importantly, often their families lives) thru their own choices have no responsibility. That it’s all fault of vague “society” and if we just ban together with <vague handwavy socialist/utopian/whatever vision>, that people will stop making bad decisions about their lives.

electric_mayhem 4y ago

“It is no measure of health to be well adjusted to a profoundly sick society.” Also, this: https://www.dailymotion.com/video/x305n83 https://www.dailymotion.com/video/x305n83

sillysaurusx 4y ago

Probably because it feels good. Sometimes the simple answers are the most likely. Even if you have a great life, it’s tempting to have such experiences. Sure, a lot of people use it as an escape though. But I imagine my dumbass brother in law died because he was trying to have fun, not check out of life. Miss him.

khazhoux 4y ago
> Probably because it feels good. This is the dirty little secret of 1980’s-style approach to keeping people off drugs: they feel great. The old (current?) approach suffers from intellectual dishonesty of ignoring the physical pleasure.

kstrauser 4y ago

They’re adding Fentanyl to everything now. I have Burning Man-adjacent friends who take ecstasy once a year at festivals, and they’re terrified of getting a tainted dose. This affects many more people than just those addicted to opiates.

t433 4y ago
Legalize everything and produce it pharmaceutically, and this problems pretty much disappears.
- SpeedilyDamage 4y ago
  Yeah, and a whole host of other problems show up…
  - hasmolo 4y ago
    can you elaborate?
    - SpeedilyDamage 4y ago
      “ Illegal drugs increase crime, partly because some users turn to crime to pay for their habits and partly because some users are stimulated by certain drugs to act more violently. Legalization, however, will not affect addiction and its effects on the propensity to violence. Instead of legalizing drugs, better treatment, education, and research are needed to curb dependency on drugs and the adverse health and social effects of drug use.”[0] [0] https://www.ojp.gov/ncjrs/virtual-library/abstracts/against-legalization-drugs-1 https://www.ojp.gov/ncjrs/virtual-library/abstracts/against-...
      - cmyr 4y ago
        'illegal drugs' is a pretty broad brush, and treating opiods and psychedelics equivalently is silly. Surely treatment, education and research would all be far easier alongside decriminalization?

candiddevmike 4y ago

I think you assume folks want to check out of life because they think fentanyl is a better choice, when instead fentanyl makes folks check out of life. Have you ever spoken with an addict who wants to get clean? It's bleak, they're basically enslaved by the substance. Having a vaccine to break the cycle is a huge boon.

briffle 4y ago

While I agree with you, at the same time, I can't help but think having someone take a pill or shot weekly/monthly/etc is whole lot simpler and easier than fixing the homeless problem, the cost of medical care, and training up (and paying) hundreds of thousands of new mental health professionals, among the dozens and dozens of different reasons people turn to drugs like this to 'escape'.

jcutrell 4y ago
Do we have a clear picture for where we want this to go in the future? Though not exactly the same, does this start to walk the path towards a "soma" equivalent?

encoderer 4y ago

Humans were not evolved to resist these kinds of poisons. Nothing like this exists in nature. It’s an extremely potent chemical.

anonymouskimmer 4y ago
It's not that nothing like this exists in nature, it's that evolutionarily speaking nothing like this existed in the areas human first evolved. Or if they did, we either evolved to resist them, thus no longer see them as toxic, or we're still in an arms race with the life that produces them (which means they would be much less toxic than fentanyl, but still toxic). Plants (and fungi, and animals) evolved to create noxious chemicals that keep animals from eating them, keep animals from breeding, or outright kill the animals. The Golden Poison frog's toxin is about 40 times more lethal than fentanyl.
- encoderer 4y ago
  The golden poison frog looks pretty scary to me. The yellow color. The big eyes. I would not try to eat it. But a white powder or pill that is equally lethal doesn’t ring any evolutionary alarm bells.
- emiliobumachar 4y ago
  Could you please link to or expand about plants producing toxins that specifically keep animals from breeding? It's news to me, and a web search has failed me. Is that long-term pest control, or something else?
  - anonymouskimmer 4y ago
    The term you want to search for is "phytoestrogens". From wikipedia: "It has been hypothesized that plants use a phytoestrogen as part of their natural defence against the overpopulation of herbivore animals by controlling female fertility.[3][4]" Though wikipedia also says: "These compounds in plants are an important part of their defense system, mainly against fungi.[19]" So it could be that plants are principally targeting fungi for the most part, and just serendipitously targeting animals as well.

patientplatypus 4y ago

I'm homeless and living in the Tenderloin in San Francisco. People here want you to - Be in a gang (or a prostitute, thief, ex-con and so forth) - Be on drugs (or in rehab for drugs) - Have a mental illness (so you can go to therapy) - Be disabled - Find religion There isn't a position for "I ran out of money and my family wouldn't support me, and at some point finding web development work became too hard as the technology became more complicated." People want you to "get better." I don't do drugs, I don't smoke, I don't drink, I don't steal or assault anyone. I just don't have any money. But people here are morons. They need to have a reason for why someone is poor other than "I'm a person of average intelligence that doesn't know how to find a paying job in this society." I don't want to be psychoanalyzed, be put into rehab, go to church or join any number of the lonely people who have to have a support group because society is awful. I don't have problems other than being poor - if you managed to buy into the crypto ponzi scheme at the right time then no one is asking you to "find god" or "get better". People are social animals. If you put them in a position where those are the options (jail, crime, drugs, psychoanalysis, religion, disability) they'll take the least unpalatable. There's a whole lot of people who walk around here with canes they don't need because otherwise the San Francisco General Assistance office won't spring for them to have housing. Also known as an apartment with a bed and a door that locks. If I make more than 1500 dollars I lose my health insurance through Medi-cal. And I'm no defender of a lot of these people. The bastards that set up tents on the sidewalk and smoke meth are just awful. But on the other hand, I have absolutely no idea how to get a job. None. I've done construction before and all I ended up with was bad memories and scarred hands. I could work "security" by putting on a t-shirt and standing outside a soup kitchen, but that's just bullshit make work the charities give out so the poor can buy shoes and feel special about themselves. Real security jobs outside of bars are a good way to get killed. And that's about it. I'm staying at a homeless shelter and have the clothes on my back so how am I supposed to get a job? There's your why. So let me give you a when. When, not if, your industry is automated or the code becomes too complicated for you to understand anymore you'd better have enough savings or a social network so you don't become homeless. Or you'll have to crawl into one of the buckets that allows society to make sense of you. And today I'm sitting in the San Francisco library looking to make a contribution to a software project for free and I just don't know that I care anymore. And if you tell me it'll get better, then I have to ask if you're about to be laid off or not and what your plans are.

beebmam 4y ago

I think you presume that human behavior must seem to have a cognitive reason for the "why", when it's entirely possible that the "why" is simply physiological/neurological. In the case of intense opiates, which have a profound effect on human neurology, it would be bizarre to not consider that in the "why".

athorax 4y ago

I think this undermines the issue a bit. A lot of people get addicted to these substances completely by accident and aren't initially seeking to "check out of life." But once you are hooked, it can be a devastatingly difficult road to get off. For sure there are plenty of people who go out looking for escapes and I do agree it is something that needs to be addressed.

PragmaticPulp 4y ago

> The real issue here that people don't seem to want to face is the WHY. Why do so many people want to check out of life completely by abusing medicine People start using drugs for different reasons. It's not correct to say that everyone starts abusing drugs as a form of pure escapism. A lot of drug users start because they're simply seeking recreation and someone is nearby to make drugs available to them. It's as simple as that. > You are broken because society is broken. Variations of this concept are frequently used by drug addicts to justify continued behavior. "It's not my fault, it's society's fault!". Taking ownership of actions and consequences is one of the key pivot points in helping people get control.

_yb2s 4y ago
> Variations of this concept are frequently used by drug addicts to justify continued behavior. "It's not my fault, it's society's fault!". Taking ownership of actions and consequences is one of the key pivot points in helping people get control. I don't think these are mutually exclusive. Society wide problems cause a huge fraction of the population to experience severe emotional trauma, and the process of addiction largely seems to be an experience of trying to escape the feelings associated with that. If you can understand this process, you can take ownership of it, and have a path to beating the addiction itself. Ultimately, there is a lot of disagreement about what addiction is and how it really works, but I think this emotional trauma aspect is a key part of explaining why one person can use a drug recreationally or for medical purposes without addiction, and another can't. It explains a lot of weird observations that just didn't make sense with the classical chemical/neutrotransmitter model of addiction. These links I think help explain this better than I can: How Childhood Trauma Leads to Addiction - Gabor Maté https://www.youtube.com/watch?v=BVg2bfqblGI https://www.youtube.com/watch?v=BVg2bfqblGI Comic explaining the Rat Park research on addiction https://www.stuartmcmillen.com/comic/rat-park/ https://www.stuartmcmillen.com/comic/rat-park/ These ideas have explained why I personally have never been able to fight addictions through willpower alone, but have been able to eliminate addiction with other techniques that seem unrelated- therapy, meditation, exercise, hobbies, friends, ending bad relationships, etc. It seems that while chemical/physical addiction is a thing, emotionally and mentally healthy people don't experience opioids as a positive thing, such that the effect of the drug itself actually discourages it's use, and even motivates the experience of withdrawal.

cstejerean 4y ago

I think quite a lot of people ended up addicted to opioids against their will, by starting with being over prescribed highly addictive pain medication which then ended up making them addicted to opioids, and then later on ended up trying to feed that habit from the streets once the easy access to pain meds dried up. https://www.doj.nh.gov/news/2022/20220303-settlement-purdue-pharma-sacklers.htm https://www.doj.nh.gov/news/2022/20220303-settlement-purdue-... Personally I've been avoiding oxycontin like the plague for that reason. I had two surgeries where the doctors wanted to give me oxy to manage the pain afterwards and I refused to take them. It turned out in both cases the pain was manageable with less addictive options, so I'm not clear why they reached straight for prescribing opioids in the first place.

arghnoname 4y ago
You're not wrong, but addiction is not a certain outcome. Most people who use a substance that can lead to addiction don't become addicted. The question is why can two people, for example, abuse alcohol for a period of their youth, but both don't become addicts? We need to look at this holistically. Overprescribing is a problem, but we shouldn't be needlessly afraid of these substances. Personally I've been prescribed these medications, I took some and when it stopped hurting I stopped taking them and the bottle sat in my medical cabinet in case I injured myself later. Eventually it expired and I threw it away. It wasn't an issue of will power or anything like that. I just didn't feel the compulsion. I'm the same way with alcohol and other drugs. I enjoy it when appropriate, but I feel no compulsion whatsoever. I, in fact, prefer mental clarity. But I have people in my life who develop very strong compulsions and become addicted to anything that distracts them from their psychological torments. Reducing access helps, but reducing other circumstances in their life that they may feel the need to numb has to be part of the solution.
- shortlived 4y ago
  > but addiction is not a certain outcome Not certain but chances are very high with the new class of opioids.
dotnet00 4y ago

HEmanZ 4y ago

Usually the "society" issue is framed as some sort of welfare crisis. I have a more-than-one-hand-full of friends and acquaintances from earlier in life who ruined or ended their life with drugs. And so I don't know anything statistically, but I have seen what caused the people near me to fall into it, and it wasn't some welfare crisis. The number 1 reason I experienced is because some social circles fetishized it. It was a very cool, tough, and a superior lifestyle. Anyone who didn't do drugs was a loser, drugs were for winners. When there is a strong cultural-current of this attitude, it can draw people in and ruin their lives by the time they realize it's all wrong.

d4mi3n 4y ago
I've seen some of this as well, though through my own anecdotal experience people in my life I've seen struggle with drugs do or did so because: 1. Ongoing health issues they can't afford to resolve. Chronic pain. Mental health issues. Sleep disorders. or 2. Inability to cope with high levels of stress due to financial insecurity, bad relationships, or loneliness. I think the cultural attitudes you describe may have some relation to other problems. Most people I've encountered seek escapism when their life experience is poor and they're unable to change their circumstances or unaware of ways to change their circumstances.
- HEmanZ 4y ago
  I think my point is that it can be both. There is a lot we can do to help in the cases you point out. But I just don’t think the problem is entirely solvable, or even mostly solvable, without changing a destructive sub-culture, which we can’t do in any way I can think of. At least we are working on things like this vaccine to save lives. That’s something.

akira2501 4y ago

> The real issue here that people don't seem to want to face is the WHY. Drugs get you high. Ants get drunk, goats chase psychedelic lichen, and dolphins pass around puffer fish like a dutchie. > Why do so many people want to check out of life completely by abusing medicine The short term benefits always outweigh the short term costs, but we're moving to a point in history where even it even seemingly outweighs the long term costs. There's no real disincentive anymore. I think a case can be made that Martin vs. Boise had the most to do with this. That ruling was meant to push cities into creating the necessary facilities and number of beds to correctly address their homelessness problem; instead, it seems that many cities have used it as a way to entirely ignore the issue. Instead of building the facilities, they're just throwing up their hands and allowing the kind of "public camping" that quickly turns into public open-air drug markets. Unsurprisingly, the population and markets grew. > A lot more empowering than just "submit to a higher power" which is clearly not working for the majority of users. The twelve steps are about quite a bit more than "just" that. They're also targeted towards a person that is at a specific stage of addiction _and_ willingness to address it. It's not general purpose and you can't force people into it, particularly when their drug of choice is so easily available and socially acceptable. You have to reduce the inflow of drugs. You have to stop drug markets from forming. You have to convince addicts to seek treatment. On the last point, I think the most effective strategy would be confiscation. If you are caught with drugs for personal use, they should be taken and destroyed, and you should be given information and transportation to a treatment center if you desire. Otherwise, you should be free to go. If the state doesn't interject itself at some level then I don't think you stand a chance.

pixl97 4y ago
>You have to reduce the inflow of drugs. And this is how we get fentanyl. Why import 2 tons of drugs when you can import 2 ounces with the same power. Attempting to reduce the inflow has just created a violent black market and a dangerous police state.
- akira2501 4y ago
  There is so much reductive thinking in this thread, it is painful. Fentanyl has been on the market since the 1960. The deaths started spiking in 2014. Did we step up enforcement majorly in 2014? Or did something else start this rise? Why import anything if you could produce it domestically? Is it possible that basic enforcement has obvious impact? If we allowed labs to produce it domestically, do you think we would see more, or less? What mechanism drives that outcome? What if this is already starting to happen? The creation of the DEA has had a negative value outcome with respect to the amount of drugs in our society, I'll grant you, but I have a feeling that's due to it being setup as a paramilitary organization as opposed to a knowledge and tactical care based organization focused on the ground level issues surrounding actual users and user/dealers.

kodah 4y ago

> The real issue here that people don't seem to want to face is the WHY. Why do so many people want to check out of life completely by abusing medicine? I don't do powders, opioids, etc but I do have some friends within tech and the festival scene that do. My observation is that most people that die from fentanyl don't know they're taking it. They think they're doing cocaine, ketamine, heroin, or some other substance. Fentanyl presence is usually a case of cross contamination when the particular substance is being cut at each hierarchial level of the drug food chain. That's not to say that there isn't some small subset of dealers who don't purposefully drop in some fentanyl, but largely that'd be a stupid decision. The users life expectancy shrinks and their risks skyrocket when they come in contact with fentanyl, this is known. If you want to stop the deaths, then you have to allow drug distribution that comes from clean rooms. At present, everyone should be using test kits, but fentanyl in particular is hard to test for because a single grain hiding in a mound can get and overdose a user. If you want people to stop using drugs, well, I have less to say. The history of humanity is using intoxicants whether it be for recreation, psychological well-being, or medical necessity. We've only recently in the history of humanity gone on moral crusades to villainize it. Chemically addictive substances are a little more challenging. Things like heroin, cocaine, and methamphetamine aren't drugs you can benefit from, but people still do them. Largely, it's because they got hooked on pain killers or some other "numbing" medication. Better availability to harm reduction resources, therapy, social safety nets, etc would improve metrics across the board in the chemically addictive substances category.

azalemeth 4y ago

My fentanyl experiences have entirely been as part of surgery: it's part of the balanced triad of anaesthesia and I "recently" injured myself quite badly, resulting in three operations. After one of these, I spent about 36 hours on a fentanyl infusion and more than a month on oral morphine of various doses with my leg in an orthopaedic brace while I was bed-bound. I should point out that the alternative was a lot of screaming: visceral pain of the variety I cannot describe – I had a panicked, "help me" expression on my face and just felt utterly, utterly desperate. I was in a lot of pain and medically the drugs were appropriate, given the injuries I sustained. I totally get why some people become addicted to drugs. Diazepam made me both in less pain and care less that I was in it. The opiates produced this warm, fuzzy haze of vivid dreams and imaginations and made a difficult time bearable. Fentanyl made me feel less than human but not able to suffer, and it was a necessity at the time. Of all of them though, diazepam was the most dangerous. It just felt – well, nice. I didn't care that things were bad. I needed it medically to stop neurogenic muscle spasms and it made me both able to sleep well and feel OK about life in a way that is really hard to put into words. I have some in a bag, prescribed for me, in case I need it. Part of me – a small part of me, but a part nonetheless – wants to use it, a lot, when I don't need it. There's a little voice that just says "this makes you feel like you've been tucked up into bed nicely". I really can't explain it, but I know that voice is a temptation and a gateway to something that I don't want to have – but at the same time, I know that that drug both saves me from agony and helps me medically if I need it. I'm really not sure how I feel about that. I haven't had any in months, but the psychological aspect remains. I can only imagine what "real" drug addicts go through. It must be incredibly hard, and individual's range of experiences will be very broad indeed.

wise0wl 4y ago
Once you actually don't need it anymore, throw it far away and do not look back. Benzos and opiates ruin lives because of that little voice. That voice will be strong enough one day that if you have those close by you will take a few, because why not? That voice is the voice of addiction. Once it starts it never fully goes away. It just gets less frequent.
crucialfelix 4y ago
My mother spent 6 weeks sedated with Fentanyl, on top of Alzheimer's. After a few days I realized she would survive. But she was in a hellish state for over a year, hallucinating and constructing parallel realities. Ironically, she worked on the UK medical trial for Fentanyl when it was first introduced for surgery.

theGnuMe 4y ago

Because it is there.

scoofy 4y ago

A good metaphor for addiction is speeding. You're driving down and empty highway, you want to get where you're going faster. You're not going to actively look down at your speedometer. You know you're probably breaking the prescribed limit a bit, but who cares. The when you finally are faced with looking at the speedometer, say when you get to windy section or a speed trap, you look down and you're going 25mph over the limit and you have no idea how you ended up going so fast, but by that time, you're brakes are squealing or worse.

dlkf 4y ago

> Why do so many people want to check out of life completely by abusing medicine? This isn’t how it works. Few people, if any, want to “check out.” What happens is that people are exposed to opiods via one of two channels (they are prescribed painkillers, or they party with someone who has acquired them) and they quickly get hooked because these drugs are cripplingly addictive. So the only “why” questions we have to ask are: 1) Why do people take opiods the first time 2) Why do people continue The answer to 1 is either because their doctor said so, or because they like to party and have no foresight. The answer to 2 is because if they stop, they experience the worst sickness imaginable. Society is not broken and we don’t need weird conspiratorial explanations for any of this.

nicoburns 4y ago
I think it's > 1) Why do people take opiods the first time that the GP is getting at. While doctors over-prescribing opiates is definitely a thing (esp. in the US), I'm not convinced that many people get hooked on opiates due to partying. I think it's more commonly: "Used as an escape from a life that is unmanagable for some reason" That's not conspirational. There's good evidence to show that life circumstances have a big effect on both initially becoming addicted and success when attempting recovery. The answer to this might look like a better welfare state or similar.
- kodah 4y ago
  I think it'd be more likely that someone discovers opioids mask their pain while using them for legitimate purposes. After that is when gaming the doctor, street buys, and finally substitutions take place.
- dotnet00 4y ago
  There are plenty of other fairly common reasons that don't involve simple escapism, with young people it's just as likely to be simple peer pressure or experimentation. It also doesn't help that it's common to treat drug highs as some sort of enlightening experience that needs to be experienced to understand.
cf141q5325 4y ago

TYPE_FASTER 4y ago

It's not that simple: https://www.wcvb.com/article/ex-cop-describes-descent-from-hero-to-addict/8223633 https://www.wcvb.com/article/ex-cop-describes-descent-from-h...

awill88 4y ago

Whoa, you’re so out of touch with reality. Yikes.

musicale 4y ago

> Why do so many people want to check out of life completely by abusing medicine? Painkillers can provide relief for emotional pain as well as physical pain. Even something like Tylenol can help people going through painful breakups. Unfortunately opioids are addictive and users build up tolerance, which is bad for people with chronic pain of any variety.

mrhands556 4y ago

Do you think at any point in the last 100 years if drugs were readily available uptake would be low?

bsder 4y ago

Do you really think that Michael Jackson and Prince wanted to "check out"? My assessment is that if even people at that level of wealth and success can get addicted to opioids and die, pretty much anyone can. Addiction, whether alcohol, drugs, cigarettes, etc., is something that is a genuine medical issue needing treatment. Thankfully, the medical community seems to be shaking off the social stigma about addiction and treating it properly now, but progress has been very slow.

jasonhansel 4y ago

> I'm not talking about "more 12 step" here but more of a Frommian psychoanalytic approach. Do you have any evidence that that works better than (say) buprenorphine or naloxone, which target the underlying neurological problem?

fIREpOK 4y ago

>The real issue here that people don't seem to want to face is the WHY. I doubt that it's always a "choice". But it wouldn't surprise if there was many main causes.

miguel-muniz 4y ago

Something else I wonder is how have we managed to convince generations that smoking is not only horrible to your health and frowned upon but alcohol is acceptable?

MrYellowP 4y ago

Fixing society doesn't increase revenue. The opposite, actually. For example: The more people are depressive, the more pills can be sold. If people kill themselves due to depression, that's too bad, but they didn't buy any pills to begin with. Diabetes is great, because people depend on insulin. A never-ending money maker! Fat people are great! They eat more, thus spend more! Some of them get their fat surgically sucked out of their bodies, which also pays! When they get more and more sick, they need more and more medicine, which pays even more! The transhumanism movement is awesome, because transitioned people require pills! Every day! Sadness? There's a pill for that! Drug addicts? Lets invent a vaccine for that! Fantastic! Society isn't getting fixed, because nobody actually has any interest in that. Those in power/money certainly don't give a fuck and rather want more money, while the actual people are mostly too stupid to figure out that the whole system needs changing. Instead they whine, complain and protest and go voting, without realizing that it does basically nothing. Yes, voting actually does nothing. We didn't get to this point because voting helps anything. We got here, because voting doesn't matter. Decades of evidence lay in front of everyone out there to see, yet for some reason every couple years people actually believe their button-pressing/their X-making actually gives them power over what's going to happen! There's no vote allowing you to change who pays all the money to the politicians, law makers and judges. There's no vote that allows you to change the underlying corruption that's going on. There's no vote that enables you to decide what actually happens with your money. You're fucking hilarious. You're not wrong per se, but also hilarious. "Society needs fixing!!!111" well then get together with enough people and fucking fix it. Politicians won't do it for you. Better get your guns ready, btw, because it's definitely not going to happen peacefully.

bArray 4y ago

I would ask a different 'why', which is 'why is fentanyl so easily accessible?'. We know where it's made, how it gets into the US, a long list of reasons for why people start taking it. But why hasn't the supply of fentanyl to the US been restricted? Given how many lives this destroys, how many people it takes out of the potential workforce, how many social problems this causes (crime, homelessness, exasperated mental health issues) - why isn't there the political will to change this?

defrost 4y ago
I answered this at length in a forum some months back and sadly can't find the text (for now). The abridged version is: there too much money to be made. Fentanyl has gone from direct primary import (which was blocked) to banning of exporting precursor drugs from bulk suppliers in China (to slow down | stop Mexican drug labs from mixing them to make Fentanyl) to where things are today ... relatively mobile "popup" drug lab networks that start with bulk pre precursor drugs to make the precursor drugs that are funneled to final product labs. It's a hell of a whack a mole game across Mexico, the USofA and Canada with a process that's tough to break, the initial drugs used are too useful for too many things to ban outright and the production aspect is broken down into many replaceable parts. ( I had references to most of those stages in the original comment, apologies for not having them to hand ).
- bArray 4y ago
  Appreciated, the context is useful.