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

• 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.
          • anon291 4y ago
            I've spoken with many democrats (since I live in a democrat controlled city in a democrat controlled state, it's hard to avoid) and what they say they want and who they vote for are completely divergent. I mean... If you vote to let violent criminals out of jail in the hopes violent crime will go down, something is missing up there. This has been my universal experience with democrat voters. It is what drove me away from the party. They'll trust 'experts' ridiculous advice over their own common sense. Most of them are extremely partisan, and will quickly label any independent candidate as a Republican, which is enough reason to not vote for them. Either way, democrats have been in charge of cities for years in this country and it simply hasn't turned out well. I often align with democrats on fiscal policy, but the voting bases inability to use common sense reasoning and their overuse of the cliche of everything being 'complicated' has driven me away
        • lmm 4y ago
          Migration is absolutely a partisan issue in France.
        • seszett 4y ago
          As part of the EU, France's borders are basically wide open (except for the relatively small or less important borders with the UK, Suriname, Brazil and more surprisingly the border with the Netherlands). Border security is very much a partisan issue, with the far-right being very much opposed to freedom of movement.
          • qsi 4y ago
            France has a border with the Netherlands? I guess if you count St. Maarten that's correct but that border is wide open. Is there another one I'm missing?
            • seszett 4y ago
              I though it was not totally open since I've heard for a long time about some difficulty to get to some agreement on border control, but apparently it's only for the airports, so the border itself is open indeed.
      • concordDance 4y ago
        Can I have a citation here? Can't find your 90% number with a quick Google.
      • pantalaimon 4y ago
        Are you seriously suggesting TikTok is responsible for fentanyl overdose? (TikTok is also available in France btw)
      • lenkite 4y ago
        https://www.cbsnews.com/news/fentanyl-seizures-rise-u-s-mexico-border-heres-why/ https://www.cbsnews.com/news/fentanyl-seizures-rise-u-s-mexi... Even with the CBS "slant" for migrant support, they do say this: "According to the DEA, most of the fentanyl is smuggled over land across the U.S.-Mexico border. Smaller amounts are smuggled by air from China."
        • yeahsure22 4y ago
          [dead]
    • refurb 4y ago
      France has an overland connection to the heroin trade. Most of the heroin in the US either flows from Europe or Asia. With a steady supply of heroin, there is no demand for synthetics like fentanyl, and dealers dont need to sell fake heroin - they can sell the real thing.
      • nradov 4y ago
        Fentanyl is much cheaper than heroin, and produces a stronger high. Dealers would still be pushing fentanyl even with a ready supply of heroin.
        • refurb 4y ago
          But they arent in Europe, which has a plentiful synthetic drug pipeline. So the question is why? I argue it’s because heroin is so plentiful there is no need and if you try and sell fentanyl people will stop buying from you.
          • herbst 4y ago
            I would argue it's also the users. PCP never got big, gashits are not very popular in most of Europe, GHB never got that big either. Essentially unsafe drugs aren't popular. Available but not mainstream. Here in Switzerland they get clean heroin from the state, not surprised fentanyl is still a niche phenomenon.
            • refurb 4y ago
              How can it be the users when you cant tell what drug is in that tablet of knock-off “Xanax” you bought?
              • herbst 4y ago
                Why are they buying knock-off Xanax from a unreputable source in the first place? Darknet works like Amazon, but unlike Amazon reviews are usually real. Bad actors get blamed. If they do, and there is a known risk, why did nobody in the distribution chain use a $15 test kit to verify the quality? Someone must have bought a few hundred pills at once to redistribute them, $15 and 5 minutes wouldn't matter. Or general save drug use. You have a pill you haven't tried yet. No way to check properly. So you only take a bit and see if it turns out as expected. This fentanyl thing is new and wasn't a thing when I popped pills. However there have always been dangerous pills. We've checked them, online, at labs, in person and small doses. If they were shit we throw them. I believe the main difference is culture. We were aware of the dangers, we had mobile labs at parties and flyers about the current bad pills. (Other than that Xanax and prescription drugs are nowhere as popular in Europe than they appear in the US)
• dmix 4y ago
  Suboxone is handed out like candy in downtown Toronto and East Hastings Vancouver to any addict who wants it and is willing to show up at a pharmacy daily until they build trust with a doctor to get it on long term prescriptions. This is part of the solution which is sorely lacking in many US states but it’s not some catch-all solution to drugs. It’s basically a better version of Methadone which has been available widely in the US since the 1980s. I recently watched Sid and Nancy about Sid Vicious and him and his girlfriend are getting Methadone at a pharmacy in 1980s NYC before he later relapsed and offed himself. https://www.imdb.com/title/tt0091954/ https://www.imdb.com/title/tt0091954/ It’s important no doubt but moving beyond the prohibition drug war approach (which is failing in places going hard as it is weak like Canada) to dealing with this requires a serious reckoning and public investment that we aren’t ready to accept yet but will be imposed on us whether we like it or not.
  • seanmcdirmid 4y ago
    > It’s important no doubt but moving beyond the prohibition drug war approach (which is failing in places going hard as it is weak like Canada)to dealing with this requires a serious reckoning and public investment that we aren’t ready to accept yet but will be imposed on us whether we like it or not. There are lots of contradictions here. Voters don't understand how they can be asked to liberalize hard drug use (and even decriminalize dealing) on the one hand, and are asked for billions of dollars for drug addiction treatment on the other. In Seattle, we have a particularly bad mess, where the biggest thing now is trying to fentanyl smoking off of public buses and light rail. They are even talking about studying the dangers of second hand fentanyl smoke to bus drivers. Hopefully we can learn something from our neighbors up north, but frankly it doesn't seem to be that much better in Vancouver.
    • lazyasciiart 4y ago
      It's pretty deliberate failure to understand, in my opinion, driven by a core belief that bad things happen to bad people and they need to be punished out of it, not helped. The goal for many people is absolutely not reducing deaths, or even getting rid of fentanyl smoke on buses. It is expelling fentanyl users from society and expecting that will stop new users appearing. That's why they don't want to spend money on treatment or services. They think enabling the existence and recovery of existing users will encourage more.
• kerkeslager 4y ago
  It's also quite easy to obtain Buprenorphine in NYC and the problem has only worsened in NYC. I strongly doubt that Buprenorphine was the sole cause of France's improvements, and given its already-wide availability in NYC I strongly doubt it will solve the problem. Buprenorphine just makes opiate dependence more manageable. It doesn't make you not dependent on opiates and it doesn't make you stop wanting to change how you feel. And given it also doesn't much change how you feel, if you want to change how you feel, you'll stop taking it. Addiction is a predictable outcome of inequality and lack of social safety net in the US. If you don't give people any way to solve their problems they'll settle for feeling better about their problems. We only help people if it's profitable to do so. The war on drugs just gives people more problems. The changes we'd have to make to fix the opiate epidemic are a lot more fundamental than giving people more manageable opiates.
  • haskellandchill 4y ago
    > it doesn't make you stop wanting to change how you feel that's actually one of the things buprenorphine and methadone help with, but as you point out it's easier for that part to work if you have a good life already
  • dminor 4y ago
    > Buprenorphine just makes opiate dependence more manageable. "More manageable" is a very creative way of saying less deadly, I congratulate you on your turn of phrase. In all seriousness though, buprenorphene has a number of benefits aside from being difficult to overdose on. It lasts much longer and lacks the euphoric effects of other opioids. People on buprenorphene tend to get their life back together, and if you're truly concerned about getting someone off opioids that's a much better starting point.
  • bhawks 4y ago
    > Addiction is a predictable outcome of inequality and lack of social safety net in the US. If you don't give people any way to solve their problems they'll settle for feeling better about their problems. Opiate addiction doesn't give a damn about the size of your bank account, your social class, or how loving your family is. The president's own son has struggled with addiction. Heck go back in history and you'll find the roots of the Opium war in China are tied to the emperor's own son dieing from an opium overdose. Opiates destroy people at the neural level. Yes there needs to be medical interventions for addicts. There also needs to be enforcement actions to reduce the supply of the drugs in the first place. Don't just target street dealers either, this crisis started with Perdue and other big pharma players. They shouldn't be able to wash their hands of responsibility simply by writing a big check.
• onetimeusename 4y ago
  Buprenorphine hasn't been as effective as hoped[1] for addiction treatment specifically for people who have taken fentanyl. [1]: https://www.statnews.com/2022/11/16/fentanyl-isnt-just-causing-overdoses-its-making-it-harder-to-start-addiction-treatment/ https://www.statnews.com/2022/11/16/fentanyl-isnt-just-causi...
  • dminor 4y ago
    That's a very good point, although we've recently discovered that narcan can help here: https://www.boulder.care/quickstart https://www.boulder.care/quickstart (I work for Boulder)
    • bb88 4y ago
      That's interesting. It surely deserves a study rather than relying on anecdotal evidence.
      • incone123 4y ago
        the way the programme works is using established medications with well-understood mechanisms of action. Your reference to anecdotal evidence seems to disparage the programme and makes your call for a study look like a bad faith position.
        • zamnos 4y ago
          Who cares about an argument on some random Internet forum? Doing a study and then publishing a paper on the efficacy of using Narcan to treat OUD would open up that treatment to more people, saving lives.
          • incone123 4y ago
            Perhaps you misunderstood me. I don't think this needs any further study because the drugs are already licensed and in use. Just needs publicity and for other places to adopt the treatment protocol.
• kaitai 4y ago
  France also has much lower homelessness and supports child care and health care to a greater extent. In the US the most prominent cause of bankruptcy is medical debt, rents are up an extraordinary amount, homelessness is up quite a lot. Child mortality in the US is the highest in the developed world, from a combo of our terrible infant mortality stats and gun accidents. What are drugs for? For most people, it's not as much chasing the high as pushing away the pain. Look at your own drinking for example (not necessarily you, dminor, but many readers). Mind-altering chemicals are overwhelmingly used in the US to numb oneself and push away the pain of daily living. Folks start with a little to take the edge off, dull the fear & give themselves a bit of mental space, not have to think about the bills, and then...
  • rayiner 4y ago
    [flagged]
    • germinalphrase 4y ago
      What is your perspective on the cause?
      • deleted 4y ago
        [deleted]
    • kibwen 4y ago
      > Yet life is better on pretty much every material metric you list. [...] You think Americans dealing with bills need drugs more than subsistence farmers in Bangladesh? This is irrelevant. When it comes to using drugs, all that matters is the user's own perception of their life. The fact that we have a mental health crisis among young people clearly indicates that, despite any measurable increase to their material quality of life, these young people are increasingly likely to perceive their lot as being dismal. Look at the article and see how many of these kids thought they were taking Xanax, which is an anti-anxiety medication. They weren't even trying to get high, they were seeking something to help them make it through the day. Finding and addressing the cause of this anxiety is, alas, more complicated than just beheading anyone who gets caught popping a pill.
• pixelpoet 4y ago
  Suboxone, particularly from France, seems to have come with big problems of its own, as is candidly shown in the film/docu Reindeerspotting - Escape from Santaland: https://imdb.com/title/tt1584813/ https://imdb.com/title/tt1584813/
• ant_li0n 4y ago
  Most of these kids are not addicts, they bought what they thought was a Xanax from some dude on Snapchat, and it turned out to be fentanyl. I somehow feel that maybe the pharmaceutical marketing machine, which has successfully turned drugs into name brands that are recognized by kids, might have something to do with the problem. But what do I know?
  • nradov 4y ago
    Correct. Recreational drug users are being poisoned by counterfeit prescription drugs manufactured by Mexican drug cartels that contain fatal doses of fentanyl. https://peterattiamd.com/anthonyhipolito/ https://peterattiamd.com/anthonyhipolito/
    • galaxyLogic 4y ago
      That is a bit like during Prohibition there was a lot of illegal alcohol much of which was bad quality containing methanol instead of ethanol, making people blind or dead https://www.pastemagazine.com/drink/alcohol-history/prohibition-history-methanol-poisoning-bootlegging-alcohol https://www.pastemagazine.com/drink/alcohol-history/prohibit... "Suffice to say, the public didn’t take too kindly to that kind of “it’s their own damn fault they’re dead” reasoning, and it fanned the flames of the growing movement to repeal Prohibition. "
      • TedDoesntTalk 4y ago
        Are you suggesting to legalize fentanyl so it can be purchased over the counter like aspirin?
        • pcthrowaway 4y ago
          Don't be silly. You should probably restrict it to people over the age of 18 like cigarettes
        • achenet 4y ago
          https://en.wikipedia.org/wiki/Systembolaget https://en.wikipedia.org/wiki/Systembolaget if the market is a government monopoly, you'll likely have fewer problems than if t's run by violent criminals.
• rhaway84773 4y ago
  Exactly! Like most problems the US faces, we know exactly what to do to reduce the impact, even if we can’t entirely eliminate it. This should be patently evident from the fact that other countries don’t face similar issues. The U.S. is simply not willing to do what it knows it must do. And worse, the public, using US exceptionalism, simply ignore the fact that the rest of the world doesn’t face the same problems, and so excuses the politicians who tell them that nothing can be done.