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85% of excess deaths in NYC are now drugs. That includes deaths from homocide, suicide, cars, everything - 85% of those are drugs. https://nytimes.com/2023/02/

85% of excess deaths in NYC are now drugs. That includes deaths from homocide, suicide, cars, everything - 85% of those are drugs. https://nytimes.com/2023/02/20/nyregion/sudden-deaths-overdoses-fentanyl-nyc.html https://nytimes.com/2023/02/20/nyregion/sudden-deaths-overdo... It's the most serious issue facing the country, and we have 0 idea what to do. It's 30 9/11s a year worth of death and misery. https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2021/20211117.htm https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2021/...

treeman79 4y ago
[flagged]
- LapsangGuzzler 4y ago
  Texas would do well to at least pretend to care about kids mental health. From the article: > Directing blame at Mexico is also a way to avoid looking at how Texas fails children. A 2022 report from the nonprofit Mental Health America ranked the state last in the nation in access to mental-health care; nearly three-quarters of Texas youth who had a major depressive episode did not receive mental-health treatment, the worst rate in the country, according to the report. Choosing to spend billions building a wall and next to nothing on mental health access for children is the epitome of Texas thinking.
  - dang 4y ago
    Please don't take HN threads further into partisan flamewar. It's not what this site is for, and destroys what it is for. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
- dang 4y ago
  Please don't take HN threads into partisan flamewar. It's not what this site is for, and destroys what it is for. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
dminor 4y ago
On the contrary, we have medication (buprenorphene) that is remarkably effective for opioid addiction. France liberalized access to it and overdose deaths fell 80% between 1994 and 2002.
- throwayyy479087 4y ago
  What about since? That's ancient history in drug terms
  - Retric 4y ago
    It’s stayed low. France had 0.6 OD deaths per 100,000 people in 2020. The US had 27.9 OD deaths per 100,000 people. In other words the US numbers are roughly 50x as bad.
    - google234123 4y ago
      Just to be clear, france doesn't have mexico on its boarder. The illegal drug trade in France is ~3b, in the US it is ~150 billion
    - tristor 4y ago
      France is not targeted by the 2nd largest economy in the world through an act of social warfare to knock them off the top rung so that their adversary (China) can take over. More than 90% of the fentanyl on the streets of the US originated in China.
      - anon291 4y ago
        And I doubt border security is a partisan issue in France whereas one of the two parties seems hell bent on open borders here.
        rnk 4y ago
        I'm sure you are blaming democrats here. It's not true in practice. Dems don't want endless crime, they don't want open borders for fentanyl to come through. It's a lazy, incorrect statement.
temp_account_32 4y ago
https://archive.is/okksn https://archive.is/okksn
runnerup 4y ago
> It's the most serious issue facing the country, and we have 0 idea what to do https://substanceabusepolicy.biomedcentral.com/articles/10.1186/s13011-021-00394-7 https://substanceabusepolicy.biomedcentral.com/articles/10.1...
- pclmulqdq 4y ago
  We know what to do, but we don't want to do it because it would be deeply unpopular with people. Thailand, Singapore, and other nearby countries have demonstrated how to stop the flow of highly addictive drugs - by using a culture of shame and highly punitive measures around possession and distribution. China learned this lesson during the opium wars, too. They couldn't stop the flow of opium because it would have been terribly unpopular with the people. The script has been flipped with Fentanyl (and to a lesser extent, TikTok). It remains to be seen whether we actually care about the drugs, though. Simply ignoring their presence may be a legitimate strategy.
  - runnerup 4y ago
    You say Thailand has figured it out but 4% of Thais have used illegal drugs in the past year. Which is pretty close to the 5-6% of Asians in the USA who have used illegal drugs in the past year. Interesting that two very different national legal policies have such similar outcomes among Asians. Phillipines has experimented with allowing anyone to murder anyone else they suspect of using drugs. That hasn’t significantly decreased the rate of illegal drug use in the country. This is despite making payments to people to summarily execute drug addicts. Thousands have been executed across the Phillipines. I can’t find any evidence that drug use in the Philippines has decreased in the past 5 years.
    - pclmulqdq 4y ago
      > 4% of Thais have used illegal drugs in the past year. Care to wager on the fraction of US users of illegal drugs? https://www.fmprc.gov.cn/mfa_eng/wjbxw/202302/t20230209_11022554.html https://www.fmprc.gov.cn/mfa_eng/wjbxw/202302/t20230209_1102... > In 2021, findings by NCDAS show about 19.4 percent of Americans have used illegal substances at least once. Out of the 280 million aged 12 and older, 31.9 million are drug users, with 11.7 percent on illegal substances and 19.4 percent either having consumed illicit drugs or misused prescription drugs in 2020. If alcohol and tobacco users are included, the number of people in the United States who are abusing substances totals 165 million. > During the past 12 months, 48.2 million Americans over the age of 18 consumed cannabis at least once. > During the past 12 months, 10.1 million Americans have consumed opium at least once.
pigsty 4y ago
It’s really well past time to start considering overdose deaths amongst addicts as suicide. Yes, there are accidental overdoses where someone takes too much of a prescribed drug without realizing it or accidentally combines it with someone that amplifies the effect and results in death. That’s a different matter. Many opiate addicts who die of overdose are essentially (oftentimes even openly) accepting they’ll die due to the drug someday. We treat PTSD-affected soldiers as humans who need assistance in pulling through their difficulties before making an irreversible mistake. But we treat drug addiction as a problem regarding the addiction itself, and not that people with troubled circumstances fall into drug addiction out of despair or other difficulties in life. But I think attitudes regarding this won’t change because the US will instantly shoot ahead of the world in suicide death statistics—in a shame-based society that’s all about saving face like the US, that’s simply not going to happen.
- zamnos 4y ago
  Okay, we wave a magic wand and now they're suicide-by-fentanyl deaths when that is the case. How does that repositioning change things? There's life, liberty, and the pursuit of happiness, but what if there's no happiness to go after? There're no jobs to be had, the Earth is dying, Wall Street is taking all the money. Doing heroin is way easier than fixing capitalism.
  - speakfreely 4y ago
    https://noahpinion.substack.com/p/dont-be-a-doomer https://noahpinion.substack.com/p/dont-be-a-doomer
    - zamnos 4y ago
      you could at least have responded with your own words, but you chose not to. Anyway, yes absolutely don't be a doomer. I'm not, despite how I presented above. Life's not even worth living with that attitude. But if you're unable to even sympathize with someone else's plight, what are you even doing? How can you help them out of their pit if you can't see it?
- 4y ago
8note 4y ago
Sounds like good news - it's not COVID anymore
- cj 4y ago
  This has been going on since before Covid. Covid did a great job of brushing a lot of problems under the rug which are now inevitably popping back up.
- logicalmonster 4y ago
  Not Covid, but indirectly from the reaction to Covid. I'm not sure how this could ever be measured objectively, but I think a lot of the extra social malaise that exists today originated from the absolutely horrendous and devastating Covid policies especially for the young. And these deaths occurring among the young are far more tragic than any conceivable Covid deaths among the elderly. I personally think that we're going to be paying the consequences for short-sighted policies for a long time and that ultimately the attempts to fix Covid will have harmed far more people than were helped.
cwkoss 4y ago
We've known how to solve opioid addiction for decades: give people opportunity, hope and community and they won't choose to escape reality. Rat park generalized to humans. Our politicians would rather feed the drug-incarceration-industrial complex than serve our society at the expense of their rent seeking patrons. We don't have zero idea what to do: the solution is just something that people who are part of this machine refuse to grok.
- throwayyy479087 4y ago
  Fun Fact: Rat Park has never replicated, and is now considered bunk: https://en.wikipedia.org/wiki/Rat_Park#Replication https://en.wikipedia.org/wiki/Rat_Park#Replication
  - cwkoss 4y ago
    One graduate student failing to replicate does not support the assertion that it 'is now considered bunk'
    - eurasiantiger 4y ago
      You’re being disingenuous. ”There has been little subsequent interest in replicating the studies due to several methodological issues present in the originals”
      - phendrenad2 4y ago
        A paper with many egregious methodological issues is, at worst, a paper that should be ignored, as though it never happened. We cannot say that it is "wrong" or "incorrect" or "bunk" because it's a nothing, a non-argument. Until the experiments are repeated, sans egregious methodological issues, we can't logically make that determination.
        eurasiantiger 4y ago
        So if it’s generally accepted that the world is flat, we shouldn’t listen to anyone claiming otherwise?
ck2 4y ago
Based on what we've done for covid deaths, nothing, absolutely nothing will be done. Also people need to stop having kids if they are only going to raise them while cute babies and then say "oh well I tried" when they are teens.
- rnk 4y ago
  I have kids and my wife is a teacher. The past years of covid time caused a lot of damage to kids and the educational institutions (and other adults). Everyone is hurting and struggling. It's not happening because parents just aren't trying.
dendrite9 4y ago
A while ago I listened to an interview about drugs and drug manufacturing where one of the participants, and I wish I remembered who it was, said we probably should think about what is going on with fentanyl and the various other synthetic opiates through the lens of what happened with the Opium war. It didn't sound like fearmongering to me, but rather someone trying to describe to other people what he saw in his reporting or public health work. I'll try to look at what I've listened to tomorrow and see if I can find it.
andrei_says_ 4y ago
If we consider increased drug use a natural response to increasingly adversarial and stressful environment, could we use this as an inspiration to maybe reverse some of the forces behind the stressors?
tenpies 4y ago
> we have 0 idea what to do We have plenty of ideas. The most obvious one is to begin controlling the areas of the border through which these drugs are entering the country. Unfortunately that would require an admission by the current US administration that there is a catastrophic crisis at the southern border - one encompassing human, financial, drug, cartel, Chinese, terrorist, human trafficking, and a myriad of other elements. This harsh admission of reality is a current impossibility for the Biden administration and US Democrats. And just to be clear, the southern border isn't the only point of entry, but it is the largest and most elaborate. There is an entire industry set up exclusively for opioids. Ignoring the human trafficking, slavery, coyotes, and other elements: just the fentanyl trade alone involves at least two cartels, and an international supply chain that includes India, China, and MexicoS[1][2]. The US would be the fourth sovereign participant in that it facilitates a degree of free trade that would make anyone else incredibly jealous. --- [1] https://www.dea.gov/sites/default/files/2020-03/DEA_GOV_DIR-008-20%20Fentanyl%20Flow%20in%20the%20United%20States_0.pdf https://www.dea.gov/sites/default/files/2020-03/DEA_GOV_DIR-... Note this is from 2020, and as predicted, the bulk of fentanyl did in fact shift to entering through Mexico, even if the precursors arrive from China and India to Mexico. [2] https://www.wilsoncenter.org/article/briefing-senate-foreign-relations-committee-countering-illicit-fentanyl-trafficking-hearing https://www.wilsoncenter.org/article/briefing-senate-foreign...
- rnk 4y ago
  The problem didn't start when Biden was inaugurated. It has been getting worse during the previous administration. It doesn't feel like Biden did anything about it, but neither did Trump. Trump made false claims about closing the border and said his work would reduce the problems. It did not. We don't know what to do to stop it, and both parties in the us have no real solution.
  - nwienert 4y ago
    He tried pretty hard but was thwarted by Democrats. This line of argument is disingenuous - for example, Biden has many plans he strongly fights for like expanding healthcare, but that he can't get through, due to the Republicans. It would be very unfair to say the equivalent of your comment about Biden/healthcare.
bb88 4y ago
> It's the most serious issue facing the country I disagree. Gun deaths are. Children don't choose to use guns typically. Bullets are forced into them by others. https://www.kff.org/global-health-policy/issue-brief/child-and-teen-firearm-mortality-in-the-u-s-and-peer-countries/ https://www.kff.org/global-health-policy/issue-brief/child-a...
- paperwasp42 4y ago
  > I disagree. Gun deaths are. I'm not convinced these things are mutually exclusive. When you break down the statistics, 61 kids between the ages of 0-11 were killed so far in 2023 by gun violence (just typing that makes my stomach hurt...). In comparison, 355 teenagers (ages 12-17) were killed. (1) That's 6x the amount of death in an age bracket half the size. The huge spike in death rate is largely linked to gang violence. Gangs often start recruiting around the age kids hit puberty. Take a look at the Gun Violence Archive's incident reports on mass shootings, and you find a huge percentage are tagged as "gang violence" and resulted in dead or injured teenagers. (2) When you hear about "school shootings" happening in America, very few are Columbine style events. Most are gang related, and impact the most vulnerable and poverty-stricken student populations who have the least resources to deal with the resulting trauma. There is a reason poor, inner-city schools are usually the ones with metal detectors at their doors. Gangs are still fueled by drug sales. Drugs and gun violence go hand in hand. I don't think we can solve one without solving the other. We desperately need resources and reforms poured into both issues. But I think if we treat them as unrelated problems, we're doomed to fail. 1) https://www.gunviolencearchive.org https://www.gunviolencearchive.org 2) https://www.gunviolencearchive.org/mass-shooting https://www.gunviolencearchive.org/mass-shooting
- dsfyu404ed 4y ago
  Decrease the size of the industry that can't access state violence via the courts to solve it's petty business disputes (i.e. the illegal drug industry). A huge amount of violent crime of all types in the US is a figment of drug distributors and dealers, and to some extent users robbing, shooting and beating each other to settle scores. Hell, just making possession completely legal (none of this "civil infraction" bullshit) so that people can go to the cops when they're robbed instead of getting revenge on who they think done it would be a huge step forward.
JumpCrisscross 4y ago
Do most fentanyl overdoses come from people taking opiates? Or people taking something random laced with fentanyl? The solution to the latter would seem to be test kits, too.
Helmut10001 4y ago
archive.org link [1] [1]: https://web.archive.org/web/20230330052658/https://www.newyorker.com/news/letter-from-the-southwest/the-horrifying-epidemic-of-teen-age-fentanyl-deaths-in-a-texas-county https://web.archive.org/web/20230330052658/https://www.newyo...
the_mitsuhiko 4y ago
> It's the most serious issue facing the country, and we have 0 idea what to do. If only there was a thing to learn from other countries. That already starts with the basics such as in which amounts pills are available over the counter. From a European's perspective the entire idea that you get pills in a bottle is so wild.
0xAFFFF 4y ago
0 idea what to do? Switzerland [1] has implemented a successful strategy that revolves around one key point: treating the drug problem as healthcare instead of criminality. The "War on Drugs" is the most ineffective strategy when it comes to dealing with addiction. [1]: https://www.opensocietyfoundations.org/publications/mountaintops https://www.opensocietyfoundations.org/publications/mountain...
- yodsanklai 4y ago
  Is it that simple though? There are probably other factors that make people in the US more prone to drug addiction (e.g. poverty, lack of opportunities...).
  - bakuninsbart 4y ago
    Lack of healthcare coverage and over-prescription of opioids are both factors as well. People are self-medicating due to not getting the pain medication they need because they lack healthcare. Or they have untreated mental issues. or, if they do have healthcare, they might very well get prescribed super addictive drugs over a long period of time.
    - Clubber 4y ago
      >because they lack healthcare. I'm convinced the "crackdown" on pills is what led to where we are today. Many doctors won't prescribe pain medication because they're afraid to lose their license or have a DEA raid. People find what they want in heroin and now fentanyl. Why we keep fighting the drug war this way is beyond me. >if they do have healthcare, they might very well get prescribed super addictive drugs over a long period of time. I think this is also why we are here today.
  - beepbooptheory 4y ago
    Having healthcare accessible in general would at least be a step towards a greater public wealth for individuals. Even a little less poverty has got to do some good.
  - 4y ago
gregwebs 4y ago
We don’t know what to do because we have no idea what the root cause of the problem is. Gabor Mate worked with those dealing with addiction for many years. In his book, Hungry Ghosts, he explains that addiction is an escape from deep psychological pain usually caused by childhood trauma. The solution, then, is psychological help – something we do very poorly with for addiction right now. This is in part because psychologists often don’t understand the nature of addiction either. And we can avoid making the problem worse by not trying to punish away pain and instead implementing harm reduction strategies.
- bakuninsbart 4y ago
  I think it is dangerous to look at addicts who lost everything or most things and derive your definition of Addiction from that. Andrew Huberman in his podcast defines addiction as a "progressive narrowing of things that bring us pleasure", which I think hits the mark quite a lot more. If you google things like "When does someone have a drinking problem?", the vast majority of sites will use a really weird and vague definition like "If you answer yes to more than 3 of these 7 statements, you might have a problem". I think this is because we want to draw a (pretty arbitrary) line between what we consider normal drug use and addiction, when in reality it makes more sense to say that everyone who drinks or smokes semi-regularly has a light addiction. Most people manage to more-or-less stagnate on this light addiction, although from my limited experience, I feel like people generally drink ever slightly more as they age, so it is just a very slow increase in addiction, others don't. The reason why I think this is really important is because a) it reduces stigma; Most of us are more or less in the same boat and b) addicts don't have a fundamental different psychology or life experience. Yes, if you have trauma or a generally bad life experience, you are more likely to binge on drugs, but the reasons for this are quite obvious given the definition above: The narrowing of pleasure comes both from addiction as well as external circumstances. I agree with you on the solutions though, we need more empathic care and therapy, harm reduction plans, and reduce poverty and the causes of extreme psychological trauma where possible.
  - gregwebs 4y ago
    Mate explains addiction as a sliding scale. He worked with those whose lives were in complete toil. But he also worked on his own addictions which made his life worse but are not comparable in terms of severity of consequence. Similarly trauma is also on a sliding scale. Agreed that low-level addiction, even in cases that it may similarly be a form of escapism, is not necessarily caused by trauma. But I think that's actually why addicts are stigmatized. I just need a little more willpower today- a good night's sleep and some exercise is often enough- to avoid addictive behaviors. But for those suffering from severe addiction it's not helpful to think with that mindset. Understanding the root cause has opened me up to truly empathizing to those with addiction- something often lacking in our society.
stevespang 4y ago
[dead]
dsfyu404ed 4y ago
Call me cynical but: Nothing is getting done because the deaths are concentrated among populations that a) don't pay a lot of taxes b) don't have a lot of wealth c) can't easily be manipulated as a homogeneous blob of political pawns. Basically there's little upside to solving the problem for government, big business, moralizing ideologues and the rest of the usual suspects who weigh in on these sorts of things.
scottLobster 4y ago
We know exactly what to do, it's just that nobody's willing to pay for it. The poor don't have any money by definition, the middle class, particularly in New York, is already at or near its limit, the rich are too busy being the main character to bother, and the political class is entrenched enough that this issue alone won't produce enough political force to dislodge them or move them to significant action. Addicts typically aren't very motivated voters, and most of them probably didn't have a supportive family to begin with. So I guess we're back to the tried-and-true approach of charities putting as many band-aids on the broken leg as they can, politicians spouting empty rhetoric with crocodile tears around election season, and cops policing the affluent neighborhoods while largely leaving the rest to rot. How do we fix all of this, that might have a chance of actually happening? Capital controls. Make TVs, mixers and smart toasters expensive again, but made in America. We need a full economic ladder, not just the top rungs. College degrees should not be required to enter the middle class, in their current state many degrees don't even provide that anymore.
- dash2 4y ago
  What leads you to be confident that (we already know that) making society more equal will reduce the fentanyl epidemic?
  - scottLobster 4y ago
    Because for many (most?) addicts drug use starts as a coping mechanism. So the question is what are people coping with that's so bad it causes them to turn to drugs, despite all the readily available information about how bad they are? Lack of economic opportunity among the lower classes is a big one. There are certainly other causes of addiction, but at the end of the day a lot of rehab programs fail because even if the addict gets clean, they're immediately sent back to the living situation that got them addicted in the first place. This is especially true for the homeless, "congrats you're free of heroin, now go back to your tent under the bridge where you live in constant fear of rape from other drugged-out homeless people and no employer will touch you! You're free!"
    - 4y ago
brightball 4y ago
There's a reason that Texas legislators keep talking about border security and the drugs trade and human trafficking that comes with it. I get it, a lot of people don't like Texas but it doesn't make them wrong.
devwastaken 4y ago
Fentanyl use is synonymous with suicide. People use fentanyl to die. So what we are seeing is a massive amount of suicides (overwhelmingly men). Yet this is never shown in media, it's not in line with the current political posturing.

treeman79 4y ago

[flagged]

LapsangGuzzler 4y ago
Texas would do well to at least pretend to care about kids mental health. From the article: > Directing blame at Mexico is also a way to avoid looking at how Texas fails children. A 2022 report from the nonprofit Mental Health America ranked the state last in the nation in access to mental-health care; nearly three-quarters of Texas youth who had a major depressive episode did not receive mental-health treatment, the worst rate in the country, according to the report. Choosing to spend billions building a wall and next to nothing on mental health access for children is the epitome of Texas thinking.
- dang 4y ago
  Please don't take HN threads further into partisan flamewar. It's not what this site is for, and destroys what it is for. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
dang 4y ago
Please don't take HN threads into partisan flamewar. It's not what this site is for, and destroys what it is for. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html

dminor 4y ago

On the contrary, we have medication (buprenorphene) that is remarkably effective for opioid addiction. France liberalized access to it and overdose deaths fell 80% between 1994 and 2002.

throwayyy479087 4y ago
What about since? That's ancient history in drug terms
- Retric 4y ago
  It’s stayed low. France had 0.6 OD deaths per 100,000 people in 2020. The US had 27.9 OD deaths per 100,000 people. In other words the US numbers are roughly 50x as bad.
  - google234123 4y ago
    Just to be clear, france doesn't have mexico on its boarder. The illegal drug trade in France is ~3b, in the US it is ~150 billion
  - tristor 4y ago
    France is not targeted by the 2nd largest economy in the world through an act of social warfare to knock them off the top rung so that their adversary (China) can take over. More than 90% of the fentanyl on the streets of the US originated in China.
    - anon291 4y ago
      And I doubt border security is a partisan issue in France whereas one of the two parties seems hell bent on open borders here.
      - rnk 4y ago
        I'm sure you are blaming democrats here. It's not true in practice. Dems don't want endless crime, they don't want open borders for fentanyl to come through. It's a lazy, incorrect statement.

temp_account_32 4y ago

https://archive.is/okksn https://archive.is/okksn

runnerup 4y ago

> It's the most serious issue facing the country, and we have 0 idea what to do https://substanceabusepolicy.biomedcentral.com/articles/10.1186/s13011-021-00394-7 https://substanceabusepolicy.biomedcentral.com/articles/10.1...

pclmulqdq 4y ago
We know what to do, but we don't want to do it because it would be deeply unpopular with people. Thailand, Singapore, and other nearby countries have demonstrated how to stop the flow of highly addictive drugs - by using a culture of shame and highly punitive measures around possession and distribution. China learned this lesson during the opium wars, too. They couldn't stop the flow of opium because it would have been terribly unpopular with the people. The script has been flipped with Fentanyl (and to a lesser extent, TikTok). It remains to be seen whether we actually care about the drugs, though. Simply ignoring their presence may be a legitimate strategy.
- runnerup 4y ago
  You say Thailand has figured it out but 4% of Thais have used illegal drugs in the past year. Which is pretty close to the 5-6% of Asians in the USA who have used illegal drugs in the past year. Interesting that two very different national legal policies have such similar outcomes among Asians. Phillipines has experimented with allowing anyone to murder anyone else they suspect of using drugs. That hasn’t significantly decreased the rate of illegal drug use in the country. This is despite making payments to people to summarily execute drug addicts. Thousands have been executed across the Phillipines. I can’t find any evidence that drug use in the Philippines has decreased in the past 5 years.
  - pclmulqdq 4y ago
    > 4% of Thais have used illegal drugs in the past year. Care to wager on the fraction of US users of illegal drugs? https://www.fmprc.gov.cn/mfa_eng/wjbxw/202302/t20230209_11022554.html https://www.fmprc.gov.cn/mfa_eng/wjbxw/202302/t20230209_1102... > In 2021, findings by NCDAS show about 19.4 percent of Americans have used illegal substances at least once. Out of the 280 million aged 12 and older, 31.9 million are drug users, with 11.7 percent on illegal substances and 19.4 percent either having consumed illicit drugs or misused prescription drugs in 2020. If alcohol and tobacco users are included, the number of people in the United States who are abusing substances totals 165 million. > During the past 12 months, 48.2 million Americans over the age of 18 consumed cannabis at least once. > During the past 12 months, 10.1 million Americans have consumed opium at least once.

pigsty 4y ago

It’s really well past time to start considering overdose deaths amongst addicts as suicide. Yes, there are accidental overdoses where someone takes too much of a prescribed drug without realizing it or accidentally combines it with someone that amplifies the effect and results in death. That’s a different matter. Many opiate addicts who die of overdose are essentially (oftentimes even openly) accepting they’ll die due to the drug someday. We treat PTSD-affected soldiers as humans who need assistance in pulling through their difficulties before making an irreversible mistake. But we treat drug addiction as a problem regarding the addiction itself, and not that people with troubled circumstances fall into drug addiction out of despair or other difficulties in life. But I think attitudes regarding this won’t change because the US will instantly shoot ahead of the world in suicide death statistics—in a shame-based society that’s all about saving face like the US, that’s simply not going to happen.

zamnos 4y ago
Okay, we wave a magic wand and now they're suicide-by-fentanyl deaths when that is the case. How does that repositioning change things? There's life, liberty, and the pursuit of happiness, but what if there's no happiness to go after? There're no jobs to be had, the Earth is dying, Wall Street is taking all the money. Doing heroin is way easier than fixing capitalism.
- speakfreely 4y ago
  https://noahpinion.substack.com/p/dont-be-a-doomer https://noahpinion.substack.com/p/dont-be-a-doomer
  - zamnos 4y ago
    you could at least have responded with your own words, but you chose not to. Anyway, yes absolutely don't be a doomer. I'm not, despite how I presented above. Life's not even worth living with that attitude. But if you're unable to even sympathize with someone else's plight, what are you even doing? How can you help them out of their pit if you can't see it?
4y ago

8note 4y ago

Sounds like good news - it's not COVID anymore

cj 4y ago
This has been going on since before Covid. Covid did a great job of brushing a lot of problems under the rug which are now inevitably popping back up.
logicalmonster 4y ago
Not Covid, but indirectly from the reaction to Covid. I'm not sure how this could ever be measured objectively, but I think a lot of the extra social malaise that exists today originated from the absolutely horrendous and devastating Covid policies especially for the young. And these deaths occurring among the young are far more tragic than any conceivable Covid deaths among the elderly. I personally think that we're going to be paying the consequences for short-sighted policies for a long time and that ultimately the attempts to fix Covid will have harmed far more people than were helped.

cwkoss 4y ago

We've known how to solve opioid addiction for decades: give people opportunity, hope and community and they won't choose to escape reality. Rat park generalized to humans. Our politicians would rather feed the drug-incarceration-industrial complex than serve our society at the expense of their rent seeking patrons. We don't have zero idea what to do: the solution is just something that people who are part of this machine refuse to grok.

throwayyy479087 4y ago
Fun Fact: Rat Park has never replicated, and is now considered bunk: https://en.wikipedia.org/wiki/Rat_Park#Replication https://en.wikipedia.org/wiki/Rat_Park#Replication
- cwkoss 4y ago
  One graduate student failing to replicate does not support the assertion that it 'is now considered bunk'
  - eurasiantiger 4y ago
    You’re being disingenuous. ”There has been little subsequent interest in replicating the studies due to several methodological issues present in the originals”
    - phendrenad2 4y ago
      A paper with many egregious methodological issues is, at worst, a paper that should be ignored, as though it never happened. We cannot say that it is "wrong" or "incorrect" or "bunk" because it's a nothing, a non-argument. Until the experiments are repeated, sans egregious methodological issues, we can't logically make that determination.
      - eurasiantiger 4y ago
        So if it’s generally accepted that the world is flat, we shouldn’t listen to anyone claiming otherwise?

ck2 4y ago

Based on what we've done for covid deaths, nothing, absolutely nothing will be done. Also people need to stop having kids if they are only going to raise them while cute babies and then say "oh well I tried" when they are teens.

rnk 4y ago
I have kids and my wife is a teacher. The past years of covid time caused a lot of damage to kids and the educational institutions (and other adults). Everyone is hurting and struggling. It's not happening because parents just aren't trying.

dendrite9 4y ago

A while ago I listened to an interview about drugs and drug manufacturing where one of the participants, and I wish I remembered who it was, said we probably should think about what is going on with fentanyl and the various other synthetic opiates through the lens of what happened with the Opium war. It didn't sound like fearmongering to me, but rather someone trying to describe to other people what he saw in his reporting or public health work. I'll try to look at what I've listened to tomorrow and see if I can find it.

andrei_says_ 4y ago

If we consider increased drug use a natural response to increasingly adversarial and stressful environment, could we use this as an inspiration to maybe reverse some of the forces behind the stressors?

tenpies 4y ago

> we have 0 idea what to do We have plenty of ideas. The most obvious one is to begin controlling the areas of the border through which these drugs are entering the country. Unfortunately that would require an admission by the current US administration that there is a catastrophic crisis at the southern border - one encompassing human, financial, drug, cartel, Chinese, terrorist, human trafficking, and a myriad of other elements. This harsh admission of reality is a current impossibility for the Biden administration and US Democrats. And just to be clear, the southern border isn't the only point of entry, but it is the largest and most elaborate. There is an entire industry set up exclusively for opioids. Ignoring the human trafficking, slavery, coyotes, and other elements: just the fentanyl trade alone involves at least two cartels, and an international supply chain that includes India, China, and MexicoS[1][2]. The US would be the fourth sovereign participant in that it facilitates a degree of free trade that would make anyone else incredibly jealous. --- [1] https://www.dea.gov/sites/default/files/2020-03/DEA_GOV_DIR-008-20%20Fentanyl%20Flow%20in%20the%20United%20States_0.pdf https://www.dea.gov/sites/default/files/2020-03/DEA_GOV_DIR-... Note this is from 2020, and as predicted, the bulk of fentanyl did in fact shift to entering through Mexico, even if the precursors arrive from China and India to Mexico. [2] https://www.wilsoncenter.org/article/briefing-senate-foreign-relations-committee-countering-illicit-fentanyl-trafficking-hearing https://www.wilsoncenter.org/article/briefing-senate-foreign...

rnk 4y ago
The problem didn't start when Biden was inaugurated. It has been getting worse during the previous administration. It doesn't feel like Biden did anything about it, but neither did Trump. Trump made false claims about closing the border and said his work would reduce the problems. It did not. We don't know what to do to stop it, and both parties in the us have no real solution.
- nwienert 4y ago
  He tried pretty hard but was thwarted by Democrats. This line of argument is disingenuous - for example, Biden has many plans he strongly fights for like expanding healthcare, but that he can't get through, due to the Republicans. It would be very unfair to say the equivalent of your comment about Biden/healthcare.

bb88 4y ago

> It's the most serious issue facing the country I disagree. Gun deaths are. Children don't choose to use guns typically. Bullets are forced into them by others. https://www.kff.org/global-health-policy/issue-brief/child-and-teen-firearm-mortality-in-the-u-s-and-peer-countries/ https://www.kff.org/global-health-policy/issue-brief/child-a...

paperwasp42 4y ago
> I disagree. Gun deaths are. I'm not convinced these things are mutually exclusive. When you break down the statistics, 61 kids between the ages of 0-11 were killed so far in 2023 by gun violence (just typing that makes my stomach hurt...). In comparison, 355 teenagers (ages 12-17) were killed. (1) That's 6x the amount of death in an age bracket half the size. The huge spike in death rate is largely linked to gang violence. Gangs often start recruiting around the age kids hit puberty. Take a look at the Gun Violence Archive's incident reports on mass shootings, and you find a huge percentage are tagged as "gang violence" and resulted in dead or injured teenagers. (2) When you hear about "school shootings" happening in America, very few are Columbine style events. Most are gang related, and impact the most vulnerable and poverty-stricken student populations who have the least resources to deal with the resulting trauma. There is a reason poor, inner-city schools are usually the ones with metal detectors at their doors. Gangs are still fueled by drug sales. Drugs and gun violence go hand in hand. I don't think we can solve one without solving the other. We desperately need resources and reforms poured into both issues. But I think if we treat them as unrelated problems, we're doomed to fail. 1) https://www.gunviolencearchive.org https://www.gunviolencearchive.org 2) https://www.gunviolencearchive.org/mass-shooting https://www.gunviolencearchive.org/mass-shooting
dsfyu404ed 4y ago
Decrease the size of the industry that can't access state violence via the courts to solve it's petty business disputes (i.e. the illegal drug industry). A huge amount of violent crime of all types in the US is a figment of drug distributors and dealers, and to some extent users robbing, shooting and beating each other to settle scores. Hell, just making possession completely legal (none of this "civil infraction" bullshit) so that people can go to the cops when they're robbed instead of getting revenge on who they think done it would be a huge step forward.

JumpCrisscross 4y ago

Do most fentanyl overdoses come from people taking opiates? Or people taking something random laced with fentanyl? The solution to the latter would seem to be test kits, too.

Helmut10001 4y ago

archive.org link [1] [1]: https://web.archive.org/web/20230330052658/https://www.newyorker.com/news/letter-from-the-southwest/the-horrifying-epidemic-of-teen-age-fentanyl-deaths-in-a-texas-county https://web.archive.org/web/20230330052658/https://www.newyo...

the_mitsuhiko 4y ago

> It's the most serious issue facing the country, and we have 0 idea what to do. If only there was a thing to learn from other countries. That already starts with the basics such as in which amounts pills are available over the counter. From a European's perspective the entire idea that you get pills in a bottle is so wild.

0xAFFFF 4y ago

0 idea what to do? Switzerland [1] has implemented a successful strategy that revolves around one key point: treating the drug problem as healthcare instead of criminality. The "War on Drugs" is the most ineffective strategy when it comes to dealing with addiction. [1]: https://www.opensocietyfoundations.org/publications/mountaintops https://www.opensocietyfoundations.org/publications/mountain...

yodsanklai 4y ago
Is it that simple though? There are probably other factors that make people in the US more prone to drug addiction (e.g. poverty, lack of opportunities...).
- bakuninsbart 4y ago
  Lack of healthcare coverage and over-prescription of opioids are both factors as well. People are self-medicating due to not getting the pain medication they need because they lack healthcare. Or they have untreated mental issues. or, if they do have healthcare, they might very well get prescribed super addictive drugs over a long period of time.
  - Clubber 4y ago
    >because they lack healthcare. I'm convinced the "crackdown" on pills is what led to where we are today. Many doctors won't prescribe pain medication because they're afraid to lose their license or have a DEA raid. People find what they want in heroin and now fentanyl. Why we keep fighting the drug war this way is beyond me. >if they do have healthcare, they might very well get prescribed super addictive drugs over a long period of time. I think this is also why we are here today.
- beepbooptheory 4y ago
  Having healthcare accessible in general would at least be a step towards a greater public wealth for individuals. Even a little less poverty has got to do some good.
- 4y ago

gregwebs 4y ago

We don’t know what to do because we have no idea what the root cause of the problem is. Gabor Mate worked with those dealing with addiction for many years. In his book, Hungry Ghosts, he explains that addiction is an escape from deep psychological pain usually caused by childhood trauma. The solution, then, is psychological help – something we do very poorly with for addiction right now. This is in part because psychologists often don’t understand the nature of addiction either. And we can avoid making the problem worse by not trying to punish away pain and instead implementing harm reduction strategies.

bakuninsbart 4y ago
I think it is dangerous to look at addicts who lost everything or most things and derive your definition of Addiction from that. Andrew Huberman in his podcast defines addiction as a "progressive narrowing of things that bring us pleasure", which I think hits the mark quite a lot more. If you google things like "When does someone have a drinking problem?", the vast majority of sites will use a really weird and vague definition like "If you answer yes to more than 3 of these 7 statements, you might have a problem". I think this is because we want to draw a (pretty arbitrary) line between what we consider normal drug use and addiction, when in reality it makes more sense to say that everyone who drinks or smokes semi-regularly has a light addiction. Most people manage to more-or-less stagnate on this light addiction, although from my limited experience, I feel like people generally drink ever slightly more as they age, so it is just a very slow increase in addiction, others don't. The reason why I think this is really important is because a) it reduces stigma; Most of us are more or less in the same boat and b) addicts don't have a fundamental different psychology or life experience. Yes, if you have trauma or a generally bad life experience, you are more likely to binge on drugs, but the reasons for this are quite obvious given the definition above: The narrowing of pleasure comes both from addiction as well as external circumstances. I agree with you on the solutions though, we need more empathic care and therapy, harm reduction plans, and reduce poverty and the causes of extreme psychological trauma where possible.
- gregwebs 4y ago
  Mate explains addiction as a sliding scale. He worked with those whose lives were in complete toil. But he also worked on his own addictions which made his life worse but are not comparable in terms of severity of consequence. Similarly trauma is also on a sliding scale. Agreed that low-level addiction, even in cases that it may similarly be a form of escapism, is not necessarily caused by trauma. But I think that's actually why addicts are stigmatized. I just need a little more willpower today- a good night's sleep and some exercise is often enough- to avoid addictive behaviors. But for those suffering from severe addiction it's not helpful to think with that mindset. Understanding the root cause has opened me up to truly empathizing to those with addiction- something often lacking in our society.

stevespang 4y ago

[dead]

dsfyu404ed 4y ago

Call me cynical but: Nothing is getting done because the deaths are concentrated among populations that a) don't pay a lot of taxes b) don't have a lot of wealth c) can't easily be manipulated as a homogeneous blob of political pawns. Basically there's little upside to solving the problem for government, big business, moralizing ideologues and the rest of the usual suspects who weigh in on these sorts of things.

scottLobster 4y ago

We know exactly what to do, it's just that nobody's willing to pay for it. The poor don't have any money by definition, the middle class, particularly in New York, is already at or near its limit, the rich are too busy being the main character to bother, and the political class is entrenched enough that this issue alone won't produce enough political force to dislodge them or move them to significant action. Addicts typically aren't very motivated voters, and most of them probably didn't have a supportive family to begin with. So I guess we're back to the tried-and-true approach of charities putting as many band-aids on the broken leg as they can, politicians spouting empty rhetoric with crocodile tears around election season, and cops policing the affluent neighborhoods while largely leaving the rest to rot. How do we fix all of this, that might have a chance of actually happening? Capital controls. Make TVs, mixers and smart toasters expensive again, but made in America. We need a full economic ladder, not just the top rungs. College degrees should not be required to enter the middle class, in their current state many degrees don't even provide that anymore.

dash2 4y ago
What leads you to be confident that (we already know that) making society more equal will reduce the fentanyl epidemic?
- scottLobster 4y ago
  Because for many (most?) addicts drug use starts as a coping mechanism. So the question is what are people coping with that's so bad it causes them to turn to drugs, despite all the readily available information about how bad they are? Lack of economic opportunity among the lower classes is a big one. There are certainly other causes of addiction, but at the end of the day a lot of rehab programs fail because even if the addict gets clean, they're immediately sent back to the living situation that got them addicted in the first place. This is especially true for the homeless, "congrats you're free of heroin, now go back to your tent under the bridge where you live in constant fear of rape from other drugged-out homeless people and no employer will touch you! You're free!"
  - 4y ago

brightball 4y ago

There's a reason that Texas legislators keep talking about border security and the drugs trade and human trafficking that comes with it. I get it, a lot of people don't like Texas but it doesn't make them wrong.

devwastaken 4y ago

Fentanyl use is synonymous with suicide. People use fentanyl to die. So what we are seeing is a massive amount of suicides (overwhelmingly men). Yet this is never shown in media, it's not in line with the current political posturing.