6 ms·

America's ten-year-old fentanyl epidemic is still getting worse

47 points by pama 3y ago

ChrisArchitect 3y ago
Link fix: https://www.economist.com/briefing/2024/02/29/americas-ten-year-old-fentanyl-epidemic-is-still-getting-worse https://www.economist.com/briefing/2024/02/29/americas-ten-y...
- wslh 3y ago
  And... https://archive.is/2024.02.29-152604/https://www.economist.com/briefing/2024/02/29/americas-ten-year-old-fentanyl-epidemic-is-still-getting-worse https://archive.is/2024.02.29-152604/https://www.economist.c...
- pama 3y ago
  Thanks. I don’t seem to have the ability to change the link — maybe the curator can fix it.
deleted 3y ago
[deleted]
teeray 3y ago
One thing I can’t understand about this is why purveyors of drugs would want to lace them with, effectively, a poison. The numbers must work out such that not enough of their customers die for it to make a measurable impact on profits.
- light_hue_1 3y ago
  You're making a lot of assumptions. Like the fact that they could do quality control if they wanted to. Or that they have a steady supply of product. Or that everyone's incentives are aligned. Or that people give a damn about the long term business. Or that users don't also make mistakes. Etc.
- pestatije 3y ago
  everything is a poison depending on the dose...whatever they put there, it is there for its psychoeffects...the dose is a secondary issue, or more likely: the quality control of the dose is a secondary issue
- MilStdJunkie 3y ago
  It's not precisely poison, it's an opioid 100x stronger than morphine that can be had for $.001 a dose coming in giant barrels from China marked SUGAR or MSG or whatever the hell. If I am a dealer, it's extremely tempting to try these waters. Unfortunately, most dealers weren't exactly in AP Chem, so they won't have any theoretical legs when it comes to figuring out how to measure 10-50mcg. The fatalities are strictly from crappy street chemistry, as it does not take much at all to make a "good product" a deadly one. And of course the other temptation is to add it to everything, because man, opioids really are like Pringles. And once they're daily users, it's incredible torture for them to stop. I think the best description of opioid withdrawal . . ok, do you know the fingers on chalkboard sound? The way that feels, sort of a whole-body thing? Imagine that sensation, coming from somewhere inside you, basically all the time. Another thing: the stories about cops dying from fentanyl fumes, or handling the stuff, or punching junkies, or getting licked or whatever - they're crap. They're all crap. Seriously. There's never been a toxicologically proven incidence of it ever passing the skin, ever, and it's too heavy to aerosolize without deliberately weaponizing the stuff. You might note that users have to punch the spike through their skin. It's just cop stories. If you know cops, you know they love their stories.
  - TeaBrain 3y ago
    The upper limit of molecular weight for a substance to be absorbed transdermally is considered to be 500-600 g/mol. Fentanyl has a molecular weight of 336 g/mol, which is plenty low enough to pass through the skin. It also happens to be commonly administered medically through transdermal patches.
    - MilStdJunkie 3y ago
      I should re-phrase that, because like its aerosol military usage[1], yes, the right formulation passes skin tissue. Transdermals take hours or days, and the formulation is geared specifically so that it's carried fluid-to-fluid via fats in the skin layers. Fentanyl wholesale is never anywhere near pure form, and it's locked in crystal structures of other substances. When it's added to other crap, the concentration goes down even more. Should you roll around in giant piles of street grade fentanyl? No. Should you lick your fingers after arresting junkies? Ew, and also, no. Do you get chain overdosed from helping someone to an ambulance or being in the same room as a herd of junkies? Hard nope, but also, check your wallet. [1] Which sucks as "knockout gas", by the way. Real good at "killing the whole elementary school" though.
- gWPVhyxPHqvk 3y ago
  Try giving https://pjvogt.substack.com/p/why-are-drug-dealers-putting-fentanyl https://pjvogt.substack.com/p/why-are-drug-dealers-putting-f... a listen. There are many reasons, some more plausible than others, but most surprising to me is that there’s a heavy amount of demand for it.
  - gopher_space 3y ago
    It's like 90% cheaper than heroin and the high lasts longer. Everyone works towards their numbers, and that's especially important to keep in mind around such an agenda-driven topic.
    - woleium 3y ago
      the fentanyl high is apparently shorter, more rushy than heroin.
wslh 3y ago
It kills 75k people per year, it would be 1m in over a decade. How does it compare to other drugs in history? Opium, etc.
- jart 3y ago
  An even better question is how it overlaps with those other drugs. Does 75k fentanyl deaths mean we've seen 75k fewer heroin deaths because they all switched to the new drug? Or are these things layered.
  - Fricken 3y ago
    I came across a news item in Canada saying Heroin is basically impossible to find now. The lower quality but much cheaper product has replaced it. Clayton Christensen's theory of disruption in action.
  - jprival 3y ago
    There’s a graph in this very article that answers that question. Heroin deaths have declined significantly as fentanyl has displaced heroin on the market, but fentanyl deaths are far higher than heroin deaths ever were, because it’s far easier to OD on.
WarOnPrivacy 3y ago
Meanwhile, the War On Pain Relief is making huge progress on all fronts https://www.goerie.com/story/opinion/voices/2023/01/05/cdc-opioid-guidelines-leave-pain-patients-suffering/10962261002/ https://www.goerie.com/story/opinion/voices/2023/01/05/cdc-o... https://www.sfchronicle.com/health/article/pain-opioid-prescription-medication-17816793.php https://www.sfchronicle.com/health/article/pain-opioid-presc... https://www.painnewsnetwork.org/stories/2024/1/11/nbsp-90-of-us-pain-patients-have-trouble-filling-opioid-prescriptions https://www.painnewsnetwork.org/stories/2024/1/11/nbsp-90-of... https://www.nytimes.com/2023/01/03/opinion/chronic-pain-suicides.html https://www.nytimes.com/2023/01/03/opinion/chronic-pain-suic... https://archive.is/0efUy https://archive.is/0efUy https://www.wtae.com/article/investigation-chronic-pain-patients-denied-life-saving-medicine-because-of-opioid-crackdown/27377991 https://www.wtae.com/article/investigation-chronic-pain-pati... https://www.newsweek.com/2023/05/12/opioid-backlash-addiction-soars-patients-pain-cant-get-their-meds-1797926.html https://www.newsweek.com/2023/05/12/opioid-backlash-addictio... https://www.wired.com/story/opioid-drug-addiction-algorithm-chronic-pain/ https://www.wired.com/story/opioid-drug-addiction-algorithm-... https://thehill.com/opinion/healthcare/583332-the-opioid-crackdown-leaves-chronic-pain-patients-in-limbo/ https://thehill.com/opinion/healthcare/583332-the-opioid-cra... https://ashpublications.org/ashclinicalnews/news/4706/The-Other-Opioid-Epidemic https://ashpublications.org/ashclinicalnews/news/4706/The-Ot... https://washingtonmonthly.com/2021/06/15/the-opioid-crackdown-is-hurting-people-in-pain/ https://washingtonmonthly.com/2021/06/15/the-opioid-crackdow... https://www.unionleader.com/news/health/chronic-pain-patients-urge-cdc-to-change-opioid-rules/article_4e5443f7-9ac5-5f7d-9a2d-21379529a54e.html https://www.unionleader.com/news/health/chronic-pain-patient... https://www.forbes.com/sites/andrewpulrang/2021/03/17/people-with-chronic-pain-are-claiming-a-voice-in-the-opioids-crisis/?sh=25d402c96c27 https://www.forbes.com/sites/andrewpulrang/2021/03/17/people... https://www.washingtonpost.com/graphics/2018/local/impact-of-americas-opioid-crackdown/ https://www.washingtonpost.com/graphics/2018/local/impact-of...
- stop50 3y ago
  Like lp4vn wrote: why are people even going so often to pain meds? Why does someone in the us gets opioids for an headache while in europe he takes an aspirin or something else?
lp4vn 3y ago
And the fentanyl epidemic is just a symptom, the underlying cause is something else. And of course it's much easier to talk about the chemical structure of molecules or about evil cartels than to face the real social problems that make people get addicted.
- s1artibartfast 3y ago
  Yes and no. I know maybe a half dozen people first or 2nd hand who have OD'd on the stuff. All were happy people with accidental deaths from tainted Mdma or miss calibrated doses.
  - tleilaxu 3y ago
    Fentanyl in MDMA, an easily synthesised empathogen stimulant - i.e. the complete opposite of an opioid high? Are dealers just sprinkling it like fairy dust over everything? What on earth is going on over there?
    - kelipso 3y ago
      It's like MSG, sprinkle a bit on to induce addiction.
      - Jerrrry 3y ago
        nope. Accidental or FUD.
  - QuantumGood 3y ago
    Man. Very sorry for your loss.
- geor9e 3y ago
  The molecule really is uniquely more epidemic-causing than previously available molecules. So it is part of the underlying cause, along with social problems.
- stormfather 3y ago
aksidkanab 3y ago
[dead]
schluessel 3y ago
How can I get rid of the paywall?
Jerrrry 3y ago
If anyone's interested in how this actually happens, where it comes from, how it works, or how to fix it, or with any other good-faith questions, feel free to comment.
oglop 3y ago
Modern opium war.

47 points by pama 3y ago

Link fix: https://www.economist.com/briefing/2024/02/29/americas-ten-year-old-fentanyl-epidemic-is-still-getting-worse https://www.economist.com/briefing/2024/02/29/americas-ten-y...

wslh 3y ago
And... https://archive.is/2024.02.29-152604/https://www.economist.com/briefing/2024/02/29/americas-ten-year-old-fentanyl-epidemic-is-still-getting-worse https://archive.is/2024.02.29-152604/https://www.economist.c...
pama 3y ago
Thanks. I don’t seem to have the ability to change the link — maybe the curator can fix it.

deleted 3y ago

[deleted]

teeray 3y ago

One thing I can’t understand about this is why purveyors of drugs would want to lace them with, effectively, a poison. The numbers must work out such that not enough of their customers die for it to make a measurable impact on profits.

light_hue_1 3y ago
You're making a lot of assumptions. Like the fact that they could do quality control if they wanted to. Or that they have a steady supply of product. Or that everyone's incentives are aligned. Or that people give a damn about the long term business. Or that users don't also make mistakes. Etc.
pestatije 3y ago
everything is a poison depending on the dose...whatever they put there, it is there for its psychoeffects...the dose is a secondary issue, or more likely: the quality control of the dose is a secondary issue
MilStdJunkie 3y ago
It's not precisely poison, it's an opioid 100x stronger than morphine that can be had for $.001 a dose coming in giant barrels from China marked SUGAR or MSG or whatever the hell. If I am a dealer, it's extremely tempting to try these waters. Unfortunately, most dealers weren't exactly in AP Chem, so they won't have any theoretical legs when it comes to figuring out how to measure 10-50mcg. The fatalities are strictly from crappy street chemistry, as it does not take much at all to make a "good product" a deadly one. And of course the other temptation is to add it to everything, because man, opioids really are like Pringles. And once they're daily users, it's incredible torture for them to stop. I think the best description of opioid withdrawal . . ok, do you know the fingers on chalkboard sound? The way that feels, sort of a whole-body thing? Imagine that sensation, coming from somewhere inside you, basically all the time. Another thing: the stories about cops dying from fentanyl fumes, or handling the stuff, or punching junkies, or getting licked or whatever - they're crap. They're all crap. Seriously. There's never been a toxicologically proven incidence of it ever passing the skin, ever, and it's too heavy to aerosolize without deliberately weaponizing the stuff. You might note that users have to punch the spike through their skin. It's just cop stories. If you know cops, you know they love their stories.
- TeaBrain 3y ago
  The upper limit of molecular weight for a substance to be absorbed transdermally is considered to be 500-600 g/mol. Fentanyl has a molecular weight of 336 g/mol, which is plenty low enough to pass through the skin. It also happens to be commonly administered medically through transdermal patches.
  - MilStdJunkie 3y ago
    I should re-phrase that, because like its aerosol military usage[1], yes, the right formulation passes skin tissue. Transdermals take hours or days, and the formulation is geared specifically so that it's carried fluid-to-fluid via fats in the skin layers. Fentanyl wholesale is never anywhere near pure form, and it's locked in crystal structures of other substances. When it's added to other crap, the concentration goes down even more. Should you roll around in giant piles of street grade fentanyl? No. Should you lick your fingers after arresting junkies? Ew, and also, no. Do you get chain overdosed from helping someone to an ambulance or being in the same room as a herd of junkies? Hard nope, but also, check your wallet. [1] Which sucks as "knockout gas", by the way. Real good at "killing the whole elementary school" though.
gWPVhyxPHqvk 3y ago
Try giving https://pjvogt.substack.com/p/why-are-drug-dealers-putting-fentanyl https://pjvogt.substack.com/p/why-are-drug-dealers-putting-f... a listen. There are many reasons, some more plausible than others, but most surprising to me is that there’s a heavy amount of demand for it.
- gopher_space 3y ago
  It's like 90% cheaper than heroin and the high lasts longer. Everyone works towards their numbers, and that's especially important to keep in mind around such an agenda-driven topic.
  - woleium 3y ago
    the fentanyl high is apparently shorter, more rushy than heroin.

wslh 3y ago

It kills 75k people per year, it would be 1m in over a decade. How does it compare to other drugs in history? Opium, etc.

jart 3y ago
An even better question is how it overlaps with those other drugs. Does 75k fentanyl deaths mean we've seen 75k fewer heroin deaths because they all switched to the new drug? Or are these things layered.
- Fricken 3y ago
  I came across a news item in Canada saying Heroin is basically impossible to find now. The lower quality but much cheaper product has replaced it. Clayton Christensen's theory of disruption in action.
- jprival 3y ago
  There’s a graph in this very article that answers that question. Heroin deaths have declined significantly as fentanyl has displaced heroin on the market, but fentanyl deaths are far higher than heroin deaths ever were, because it’s far easier to OD on.

WarOnPrivacy 3y ago

Meanwhile, the War On Pain Relief is making huge progress on all fronts https://www.goerie.com/story/opinion/voices/2023/01/05/cdc-opioid-guidelines-leave-pain-patients-suffering/10962261002/ https://www.goerie.com/story/opinion/voices/2023/01/05/cdc-o... https://www.sfchronicle.com/health/article/pain-opioid-prescription-medication-17816793.php https://www.sfchronicle.com/health/article/pain-opioid-presc... https://www.painnewsnetwork.org/stories/2024/1/11/nbsp-90-of-us-pain-patients-have-trouble-filling-opioid-prescriptions https://www.painnewsnetwork.org/stories/2024/1/11/nbsp-90-of... https://www.nytimes.com/2023/01/03/opinion/chronic-pain-suicides.html https://www.nytimes.com/2023/01/03/opinion/chronic-pain-suic... https://archive.is/0efUy https://archive.is/0efUy https://www.wtae.com/article/investigation-chronic-pain-patients-denied-life-saving-medicine-because-of-opioid-crackdown/27377991 https://www.wtae.com/article/investigation-chronic-pain-pati... https://www.newsweek.com/2023/05/12/opioid-backlash-addiction-soars-patients-pain-cant-get-their-meds-1797926.html https://www.newsweek.com/2023/05/12/opioid-backlash-addictio... https://www.wired.com/story/opioid-drug-addiction-algorithm-chronic-pain/ https://www.wired.com/story/opioid-drug-addiction-algorithm-... https://thehill.com/opinion/healthcare/583332-the-opioid-crackdown-leaves-chronic-pain-patients-in-limbo/ https://thehill.com/opinion/healthcare/583332-the-opioid-cra... https://ashpublications.org/ashclinicalnews/news/4706/The-Other-Opioid-Epidemic https://ashpublications.org/ashclinicalnews/news/4706/The-Ot... https://washingtonmonthly.com/2021/06/15/the-opioid-crackdown-is-hurting-people-in-pain/ https://washingtonmonthly.com/2021/06/15/the-opioid-crackdow... https://www.unionleader.com/news/health/chronic-pain-patients-urge-cdc-to-change-opioid-rules/article_4e5443f7-9ac5-5f7d-9a2d-21379529a54e.html https://www.unionleader.com/news/health/chronic-pain-patient... https://www.forbes.com/sites/andrewpulrang/2021/03/17/people-with-chronic-pain-are-claiming-a-voice-in-the-opioids-crisis/?sh=25d402c96c27 https://www.forbes.com/sites/andrewpulrang/2021/03/17/people... https://www.washingtonpost.com/graphics/2018/local/impact-of-americas-opioid-crackdown/ https://www.washingtonpost.com/graphics/2018/local/impact-of...

stop50 3y ago
Like lp4vn wrote: why are people even going so often to pain meds? Why does someone in the us gets opioids for an headache while in europe he takes an aspirin or something else?

lp4vn 3y ago

And the fentanyl epidemic is just a symptom, the underlying cause is something else. And of course it's much easier to talk about the chemical structure of molecules or about evil cartels than to face the real social problems that make people get addicted.

s1artibartfast 3y ago
Yes and no. I know maybe a half dozen people first or 2nd hand who have OD'd on the stuff. All were happy people with accidental deaths from tainted Mdma or miss calibrated doses.
- tleilaxu 3y ago
  Fentanyl in MDMA, an easily synthesised empathogen stimulant - i.e. the complete opposite of an opioid high? Are dealers just sprinkling it like fairy dust over everything? What on earth is going on over there?
  - kelipso 3y ago
    It's like MSG, sprinkle a bit on to induce addiction.
    - Jerrrry 3y ago
      nope. Accidental or FUD.
- QuantumGood 3y ago
  Man. Very sorry for your loss.
geor9e 3y ago
The molecule really is uniquely more epidemic-causing than previously available molecules. So it is part of the underlying cause, along with social problems.
stormfather 3y ago

aksidkanab 3y ago

[dead]

schluessel 3y ago

How can I get rid of the paywall?

Jerrrry 3y ago

If anyone's interested in how this actually happens, where it comes from, how it works, or how to fix it, or with any other good-faith questions, feel free to comment.

oglop 3y ago

Modern opium war.