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Sometimes (from what I've read, I'm also non-US) many people who end up on fentanyl were not even going through any mental or existential issues, at least not o

Sometimes (from what I've read, I'm also non-US) many people who end up on fentanyl were not even going through any mental or existential issues, at least not overtly, but rather were prescribed opiates such as oxycodone after being legitimately diagnosed with more-or-less severe and prolonged pain. When I say they were "legitimately" diagnosed, I mean that the patient didn't fake their ailment nor went to the doctor with the intent of getting opiates—at least not initially. Whether opiates were a reasonable approach to deal with the patient's pain is a whole'nother issue. Over time, as the prescribed opiate painkiller loses effectiveness (as well as its pleasurable side-effects), patients may request a longer or a stronger prescription. Their doctor may or may not oblige. The patient may switch doctors to another who is more accommodating. Then the new prescription loses potency, and the cycle repeats. At some point the patient is not even taking the opiate primarily for their pain, whether they are aware of it or not, but rather for how it makes them feel. Eventually the patient cannot get a stronger prescription, or even prolong the one they had already, for whatever reason—be it financial, insurance, or doctor's refusal. That's when getting a tiny dose of fentanyl will "help". And now they're on fentanyl. Obviously this does not happen in a vacuum. There are many societal, cultural and healthcare issues that make this scenario much more likely in the USA than in other developed countries: a combination of the healthcare system, workplace expectations, and the culture of pulling oneself up from ones own bootstraps.

seanmcdirmid 3y ago
Fent is mostly a street drug. While i guess those cases exist, the problem we are seeing now is mainly a flood of cheap fent on the street from people who have probably never been prescribed opioids before (or indeed, haven’t seen a doctor very much at all in their life). The older middle class people who were/are abusing opioids aren’t the same people on the street who never had much anyways.

seanmcdirmid 3y ago

Fent is mostly a street drug. While i guess those cases exist, the problem we are seeing now is mainly a flood of cheap fent on the street from people who have probably never been prescribed opioids before (or indeed, haven’t seen a doctor very much at all in their life). The older middle class people who were/are abusing opioids aren’t the same people on the street who never had much anyways.