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I’d argue it’s the opposite. Look at what’s happened since Oxycontin was heavily regulated. Opioid deaths in America have exploded by an order of magnitude.

I’d argue it’s the opposite. Look at what’s happened since Oxycontin was heavily regulated. Opioid deaths in America have exploded by an order of magnitude. There’s a direct correlation between higher regulation of OxyContin and opioid deaths in the U.S. The Sacklers have done illegal stuff. Misrepresenting the addictiveness of their drugs (well, it was immoral and wrong…it’s not clear how illegal it was). But it’s quite clear that America had a parallel opioid crisis going on. By making OxyContin easily available, ie, a slow acting opioid (it had to be crushed to be fast acting) that was produced legitimately and had a legitimate supply chain so people were able to get exactly what they wanted, Purdue Pharma helped keep the number of opioid deaths under control. IOW, the U.S. has had an addiction crisis that is independent of prescription drugs whose cause is not clear yet because everyone has thrown the blame on Oxy instead of researching it. This is the same kind of drug crisis that hit inner cities in the 20th century but has hit rural areas in the 21st century. By providing easy access to regulated and legitimate opioids the Sacklers may have marginally worsened the addiction crisis, but they minimized the number of deaths and severe negative impacts. The moment Oxy and the other opioids were made less easy to get, the underlying drug crisis hadn’t gone anywhere, so instead the people suffering from the crisis had to get their opioids from illicit sources as opposed to the pharmacy, exposing them to all sorts of unregulated drugs that had all sorts of nonsense like Fenranyl mixed in, which causes the actual negative impacts of the drug crisis to explode. The funny thing is that when the entire country was just absolutely united at making the Sacklers the big bad evil, the actual people working on the ground trying to help those who were facing this drug crisis were predicting this exact situation and were asking authorities to not clamp down on Oxy. But they were all ignored and so we have a situation where opioid OD deaths have gone from a consistent 10-15,000/year (a rate which preceded Oxy) to about 50,000/yr now.

sailingparrot 2y ago
Sure, OxyContin is better than Fentanyl, and banning Oxy can push people to way more dangerous opioids. But before painting Purdue as a hero of the people, let’s remember that million of people were pushed to opioids through Oxy when they shouldn’t have in the first place. Purdue played a big part in creating the epidemic in the first place. People that are now pushed to harder drugs because of an addiction they got into for the sake of Purdue making more dough.
- beaeglebeachedd 2y ago
  It's the same shit practically all the way back to opium wars. Always the drug dealers fault. I blame the patient. We've known opiates were bad since at least the 1800s, and really longer than that. What the doc said was just what they needed to hear to lie to themselves, but this is taught in every highschool.
  - voisin 2y ago
    > We've known opiates were bad since at least the 1800s, and really longer than that. What the doc said was just what they needed to hear to lie to themselves, but this is taught in every highschool. I am not sure high schools are teaching people to be distrustful of their doctor’s advice. I think what’s being taught is about the dangers of illicit drugs, not those with a medical expert’s stamp of approval.
    - beaeglebeachedd 2y ago
      On the plus side between oxy and COVID distrust is now at all time highs. People have learned you can't trust the doc anymore than a quik-lube mecanico.
  - tonyarkles 2y ago
    > but this is taught in every high school Here's the thing about what they teach you about drugs in high school: lots of it is bullshit. I don't know if it's still a thing but when I was in school there was a lot of pearl clutching about weed being a Gateway Drug. For a lot of people who smoked weed and didn't progress towards any harder drugs, weed was a prime example of how drug education was a sham. No one went crazy, none of the weed horror stories came true, everyone enjoyed the concert and woke up the next morning feeling better than if they'd been drinking alcohol the night before.
  - com2kid 2y ago
    > I blame the patient. We've known opiates were bad since at least the 1800s, and really longer than that. As a reminder, Oxy was heavily marketed, (to doctors!) as a "not bad" opioid. As in, not as addictive, not as problematic, and something that can be prescribed more easily and with less worries. If a doctor comes up and tell you "don't worry about this one, it isn't addictive like the others", and you are in a ton of pain at the time, you are going to thank modern medicine for its new miracle pain drug and accept the prescription. > but this is taught in every highschool. And as another reminder, most schools, until recently, just taught that "drugs are bad" and kind of left it at that. They exaggerated some of the down sides, and didn't mention any of the positive experiences. IMHO South Park actually did the world's best anti pot ad - "Well, Stan, the truth is marijuana probably isn't gonna make you kill people, and it most likely isn't gonna fund terrorism, but… well, son, pot makes you feel fine with being bored. And it's when you're bored that you should be learning some new skill or discovering some new science or being creative. If you smoke pot you may grow up to find out that you aren't good at anything." - And IMHO messages like that are more useful than what kids are being told. There is also the social contract side of things - Since around 1950s, if people worked hard they things in return from society: A stable job, a house, the opportunity to raise a family. That social contract is shot to shit, and so it should be no surprise that more and more people are choosing to drop out of society via drugs/games/apathy.
api 2y ago
Wasn't Oxycontin kind of the boot loader for the present opioid crisis in that it mainstreamed opioid use and got a huge number of people introduced to it? Then it was taken away and things like illicit fentanyl filled the gap, but that came later.
- MavisBacon 2y ago
  Indeed. At the undergrad college I went to in New England in 2008 it wasn’t uncommon to see people at house parties doing lines of oxycontin out in the open. Was fairly socially acceptable.
kidme5 2y ago
username "addicted" eh?
darth_avocado 2y ago
> But it’s quite clear that America had a parallel opioid crisis going on I don’t think that’s really the case. What happened here was that peddling oxy, created the excess demand that is now met by illicit sources that cause more deaths now that oxy is regulated. But what you’re missing in your understanding is that without oxy, demand wouldn’t exist in the first place. And that’s the harm everyone is talking about. You’re talking about the aftermath of the problem. Parent is talking about the root cause.
- jnovek 2y ago
  You’re saying “created excess demand” like the people that you’re referring to weren’t chronic pain patients. I know some of them were drug-seekers but we decided it was OK to throw chronic pain patients under the bus so we could eliminate those drug-seekers. Now, in addition to dealing with pain every day, I also have to “prove” that I’m not an opioid seeker if I end up in the ER for overwhelming pain. Because saying that you’re hurting is clearly a sign that you’re actually an addict trying to get a fix. This might sound cold-hearted, but as someone who deals with chronic pain I’m fine with some street ODs in exchange for people who are in pain being cared for. Now we just torture patients by doing nothing. Recreational drugs are a choice. My pain was not. Why we punished for others’ bad choices?
  - d4mi3n 2y ago
    > You’re saying “created excess demand” like the people that you’re referring to weren’t chronic pain patients. > I know some of them were drug-seekers but we decided it was OK to throw chronic pain patients under the bus so we could eliminate those drug-seekers. To the GPs point, the cause of the regulation was the abuse of the sale. Many deaths were caused by aggressively selling oxy to folks who weren’t managing pain. The fallout has resulted into harm with people that have a legitimate need for pain management. Both can be true. The Sacklers are the culprits any way you slice it.
  - skellera 2y ago
    Even the chronic pain patients should not have had the amounts prescribed to them that they were. Doctors were incentivized to give as much as possible. Creating addicts in people who may otherwise would not have been. I personally knew people getting more than a cancer patient should’ve been given for day to day chronic pain. I’m sorry if you were personally affected by regulation but that doesn’t mean they didn’t cause the crisis.
throwadobe 2y ago
morally: providing more of something that has no societal good is not commendable. logically: this argument isn't sound at all. looking at what happened since Oxycontin was regulated is not a proper counterfactual. you would have to look at a universe in which it was never introduced to begin with
jnovek 2y ago
As someone who deals with chronic pain, I watched this situation develop: people lost access to their “safer” opioid and switch to whichever one they can get. Or suicide; there were many suicides around this time. Thankfully opioids have never been an appropriate treatment for my pain so I didn’t have to deal with this, but I feel real empathy for the people who switched to street drugs at that time. OD is a risk but considering how consuming pain is many would probably rather be dead than experience that anyway. This is not hyperbole, on pain forums people talk about assisted suicide all the time. We failed pain patients across the board. It took 6 or 7 years for us even start to find therapies that work. To this day doctors have just shoveled handfuls of Gabapentin and muscle relaxers down our throats or sent us for very invasive and painful nerve blocks which both have a high complication rate and need to be repeated as frequently as every three months. Or told us to get more exercise. I’ve always loved that one! I’ve been improving my fitness for three years, but advancement is very slow because if I go too fast it can trigger pain and be a huge setback. Fuck the Sacklers, but fuck whoever decided that pain patients don’t deserve opioids at a rate of 100x. As is always our policy with the disabled in America, our suffering doesn’t matter anywhere near as much as the political moralization that gets people in office Ok, I’ll get off my soapbox. This topic makes me so angry.
- ineedaj0b 2y ago
  The black pill with chronic pain is it’s often better to off yourself depending on the condition. There’s no hope for some things like erythromelalgia.
hn_throwaway_99 2y ago
> a slow acting opioid (it had to be crushed to be fast acting) You seem to just skip over that point in a bit of a blasé fashion, as if OxyContin's slow release formulation is somehow a defense of the Sacklers' behavior, when the exact opposite is true. That is, a primary argument is that Purdue pushed OxyContin because they argued it was safer due to its slow release formula. Except they knew full well that "slow release" was pretty much bullshit because people were getting addicted by simply crushing the pills. Purdue sales people deliberately pushed Oxy with the false promise of additional safety even though they knew this wasn't true.
- zardo 2y ago
  It's much worse than that. In order to protect the big selling point (10hrs between doses, once per nursing shift) they encouraged larger doses which were more likely to cause addiction instead of more frequent doses which were actually appropriate.
skellera 2y ago
Are you one of the lawyers? None of that would’ve happened if they didn’t start the flood of opiates to begin with. It wasn’t a marginally increased issue, they flooded the market with it. People with minor pain were getting massive bottles of OxyContin and selling or using it. This led to pill mills and crooked doctors. You had normal people getting hooked on high dosages. These are not the people who were using opioids before that. Pills made it seem safer. Most users don’t start with heroin, they start with pills because of exactly that. “A doctor prescribed it, must be okay.” This is some insane logic to absolve them of responsibility. I say this as someone who also saw the problem firsthand. Was regulation handled badly? Sure but there’s no way you can say they didn’t start the problem.
- cstejerean 2y ago
  Not only that, some of the problem with addiction were directly caused by the dosage guidelines for oxycontin. They really wanted it to be a 12h drug, but it really isn't and it wears off after about 8 hours. Rather than admitting this and giving a smaller dosage more frequently they doubled down by using a larger dose and trying to keep with the 12h schedule. This combination or larger dose followed by mild withdrawal then results in a higher likelihood to become addicted to opioids. So not only they marketed it heavily and got more people on opioids than necessary, they did it in a way that maximizes the likelihood of addiction. https://www.latimes.com/projects/oxycontin-part1/ https://www.latimes.com/projects/oxycontin-part1/
- dguest 2y ago
  A bartender mocked my brother for getting Aspirin for his broken arm. "man you got nothin', you should get some oxy for that!" I'd been living outside the US and this in my first few hours back on US soil. A few hours later my friend (working in criminal defense) explained how opiates accounted for roughly 1/3rd of his income (other sources: drunk driving and domestic abuse). They all followed the same trajectory: minor condition -> prescribed oxy -> illegally obtained oxy -> heroin when the money ran out. This wasn't normal. It didn't happen anywhere else in the world at the time, or at least not where I was living.
presentation 2y ago
Opinions like this are why I’m glad I don’t live in the USA anymore. Live practically anywhere else, where there is no opioid crisis, and this line of thinking sounds insane. Copy paste for other uniquely American issues like gun violence - the answer is… more guns?
- kyralis 2y ago
  To be fair, it sounds insane to many of us living in the US, too.
ok_computer 2y ago
Lol fentanyl is more toxic by an order or two of magnitude. People would be on prescription opioids, lose a script, get on heroin because that was 4 to 8 times cheaper and more available than black market pills. The fentanyl crisis is a phenomenon between cheap imported precursor and Cartel economics. The synthetic opioid demand in the US was a result of a chain of events including the purposeful stimulation of demand by marketing directly to Drs, lying about abuse potential, lying about withdrawal and addiction potential, and not introducing mediating controls when evidence of abuse and sales not meeting market demographics was clearly evident. Like they imported millions of pills to small towns with over selling pharmacies. Drs would up dosage to adjust to tolerance. But anyway it’s fentanyl that is killing people. I’d argue just let people use opium and regulate that sale. Edit: changed and to an. Chinese precursor to imported precursor bc I honestly don’t know how many different countries are sources of a precursor. Added part about importing to small towns and upping dosage.
0x00_NULL 2y ago
What are you talking about? Where was America getting their opioids before The Sacklers? Go ahead and pull a chart of heroin deaths vs. years and draw a vertical bar on where Purdue launched their widespread marketing misinformation and disinformation. This is the largest and most deadly episode of addictiveness since the tobacco companies were marketing cigarettes as healthy. If this were a fire, you’d be arguing: “Look, America has always had fires. Sure Purdue started fires in all 50 states that spread into the forest, but they were small when Purdue started them. Now, there is a blaze that has spread uncontrolled across the Continental US. So, obviously there were other parallel organizations starting fires.” No. That doesn’t follow. Purdue stared the fires. They added tinder with marketing misinformation, then they inhibited any attempt at controlling it with active disinformation campaigns to confuse doctors and regulators about the root cause. Now, it’s a wild uncontrolled inferno, but they started the first fires.
- beaeglebeachedd 2y ago
  Didn't we also invade the religious nutsos stopping Afghanistan from producing poppies and then prop up a fake regime that let it flourish, massively increasing the supply of natural opiates? If I recall, the timing works out pretty good with illegal opiate use ramping up.
  - 0x00_NULL 2y ago
    We sure did. About 60-70% of all of the world's opium was sourced from Afghanistan until 2022. That supply was used to make actual prescriptions in non-OECD countries - like India & China - as well as sold to make heroin in the US, EU, Asia, and Africa. But be careful about confusing cause & effect. The cause of the Afghani farmers growing opium was the insatiable demand for opium that was developed through legal means. Then, when countries like the US started to restrict access to opiates, addicts and patients alike started to seek alternatives to the scarce prescriptions. More to the point, why didn't patients use something else? Because there is nothing. Purdue's misinformation actively discouraged the discovery of new non-addictive compounds for decades. No one was looking, and the R&D pipeline ran dry. By the time enough doctors sounded enough alarms to cause a change in the late 2010s, research in non-addictive pain management solutions was decades behind. No one engaged in it because there was no need for it. Now that we realize it was all a lie and these drugs have killed millions, there are no alternatives. Very few potential compounds are even in Phase 2 clinical trials right now, let alone the half dozen that would be needed in Phase 3 to ensure we have a single alternate choice for pain management in the next five years. So, the outlook looks bleak. Today, in 2024, we don't have good ways to manage pain that is non-addictive, and certainly no good way to reach the millions who are hopelessly addicted to opioids for pain management. But, very little of this is the patient's fault - and a lot of this is directly related to the monumental efforts of Purdue to misinform for profit.
vikramkr 2y ago
Regulation helped cause the deaths by driving people to more dangerous sources. You're 'forgetting,' however, that the oxycontin and prescribed pills were the source of those addictions in the first place. The regulations didn't kill them. If the regulations had always been there, they would have been fine. They weren't tamping down on some mystical parallel crisis, however convenient that would be to shift the blame. They were creating a new one, using the legitimacy of the medical system and doctors prescriptions to get people hooked, to fatal effect when the regulations finally came down and people facing addiction turned to illicit sources.
idiotsecant 2y ago
There is a lot in this post that is ...questionable in my opinion but I just have to call out as especially creative the praise for a drug that is so safe and slow-acting that it won't have harmful fast acting effects unless you... Apply a small amount of pressure with a hard object. Truly a stupendous point.
neffy 2y ago
I would argue that it is the expected outcome of processes exhibiting: Latency... it takes a few years to actually kill their victims, and Exponential behaviour.. the most damage is done in the last few rounds of the expansion.

sailingparrot 2y ago

Sure, OxyContin is better than Fentanyl, and banning Oxy can push people to way more dangerous opioids. But before painting Purdue as a hero of the people, let’s remember that million of people were pushed to opioids through Oxy when they shouldn’t have in the first place. Purdue played a big part in creating the epidemic in the first place. People that are now pushed to harder drugs because of an addiction they got into for the sake of Purdue making more dough.

beaeglebeachedd 2y ago
It's the same shit practically all the way back to opium wars. Always the drug dealers fault. I blame the patient. We've known opiates were bad since at least the 1800s, and really longer than that. What the doc said was just what they needed to hear to lie to themselves, but this is taught in every highschool.
- voisin 2y ago
  > We've known opiates were bad since at least the 1800s, and really longer than that. What the doc said was just what they needed to hear to lie to themselves, but this is taught in every highschool. I am not sure high schools are teaching people to be distrustful of their doctor’s advice. I think what’s being taught is about the dangers of illicit drugs, not those with a medical expert’s stamp of approval.
  - beaeglebeachedd 2y ago
    On the plus side between oxy and COVID distrust is now at all time highs. People have learned you can't trust the doc anymore than a quik-lube mecanico.
- tonyarkles 2y ago
  > but this is taught in every high school Here's the thing about what they teach you about drugs in high school: lots of it is bullshit. I don't know if it's still a thing but when I was in school there was a lot of pearl clutching about weed being a Gateway Drug. For a lot of people who smoked weed and didn't progress towards any harder drugs, weed was a prime example of how drug education was a sham. No one went crazy, none of the weed horror stories came true, everyone enjoyed the concert and woke up the next morning feeling better than if they'd been drinking alcohol the night before.
- com2kid 2y ago
  > I blame the patient. We've known opiates were bad since at least the 1800s, and really longer than that. As a reminder, Oxy was heavily marketed, (to doctors!) as a "not bad" opioid. As in, not as addictive, not as problematic, and something that can be prescribed more easily and with less worries. If a doctor comes up and tell you "don't worry about this one, it isn't addictive like the others", and you are in a ton of pain at the time, you are going to thank modern medicine for its new miracle pain drug and accept the prescription. > but this is taught in every highschool. And as another reminder, most schools, until recently, just taught that "drugs are bad" and kind of left it at that. They exaggerated some of the down sides, and didn't mention any of the positive experiences. IMHO South Park actually did the world's best anti pot ad - "Well, Stan, the truth is marijuana probably isn't gonna make you kill people, and it most likely isn't gonna fund terrorism, but… well, son, pot makes you feel fine with being bored. And it's when you're bored that you should be learning some new skill or discovering some new science or being creative. If you smoke pot you may grow up to find out that you aren't good at anything." - And IMHO messages like that are more useful than what kids are being told. There is also the social contract side of things - Since around 1950s, if people worked hard they things in return from society: A stable job, a house, the opportunity to raise a family. That social contract is shot to shit, and so it should be no surprise that more and more people are choosing to drop out of society via drugs/games/apathy.

api 2y ago

Wasn't Oxycontin kind of the boot loader for the present opioid crisis in that it mainstreamed opioid use and got a huge number of people introduced to it? Then it was taken away and things like illicit fentanyl filled the gap, but that came later.

MavisBacon 2y ago
Indeed. At the undergrad college I went to in New England in 2008 it wasn’t uncommon to see people at house parties doing lines of oxycontin out in the open. Was fairly socially acceptable.

kidme5 2y ago

username "addicted" eh?

darth_avocado 2y ago

> But it’s quite clear that America had a parallel opioid crisis going on I don’t think that’s really the case. What happened here was that peddling oxy, created the excess demand that is now met by illicit sources that cause more deaths now that oxy is regulated. But what you’re missing in your understanding is that without oxy, demand wouldn’t exist in the first place. And that’s the harm everyone is talking about. You’re talking about the aftermath of the problem. Parent is talking about the root cause.

jnovek 2y ago
You’re saying “created excess demand” like the people that you’re referring to weren’t chronic pain patients. I know some of them were drug-seekers but we decided it was OK to throw chronic pain patients under the bus so we could eliminate those drug-seekers. Now, in addition to dealing with pain every day, I also have to “prove” that I’m not an opioid seeker if I end up in the ER for overwhelming pain. Because saying that you’re hurting is clearly a sign that you’re actually an addict trying to get a fix. This might sound cold-hearted, but as someone who deals with chronic pain I’m fine with some street ODs in exchange for people who are in pain being cared for. Now we just torture patients by doing nothing. Recreational drugs are a choice. My pain was not. Why we punished for others’ bad choices?
- d4mi3n 2y ago
  > You’re saying “created excess demand” like the people that you’re referring to weren’t chronic pain patients. > I know some of them were drug-seekers but we decided it was OK to throw chronic pain patients under the bus so we could eliminate those drug-seekers. To the GPs point, the cause of the regulation was the abuse of the sale. Many deaths were caused by aggressively selling oxy to folks who weren’t managing pain. The fallout has resulted into harm with people that have a legitimate need for pain management. Both can be true. The Sacklers are the culprits any way you slice it.
- skellera 2y ago
  Even the chronic pain patients should not have had the amounts prescribed to them that they were. Doctors were incentivized to give as much as possible. Creating addicts in people who may otherwise would not have been. I personally knew people getting more than a cancer patient should’ve been given for day to day chronic pain. I’m sorry if you were personally affected by regulation but that doesn’t mean they didn’t cause the crisis.

throwadobe 2y ago

morally: providing more of something that has no societal good is not commendable. logically: this argument isn't sound at all. looking at what happened since Oxycontin was regulated is not a proper counterfactual. you would have to look at a universe in which it was never introduced to begin with

jnovek 2y ago

As someone who deals with chronic pain, I watched this situation develop: people lost access to their “safer” opioid and switch to whichever one they can get. Or suicide; there were many suicides around this time. Thankfully opioids have never been an appropriate treatment for my pain so I didn’t have to deal with this, but I feel real empathy for the people who switched to street drugs at that time. OD is a risk but considering how consuming pain is many would probably rather be dead than experience that anyway. This is not hyperbole, on pain forums people talk about assisted suicide all the time. We failed pain patients across the board. It took 6 or 7 years for us even start to find therapies that work. To this day doctors have just shoveled handfuls of Gabapentin and muscle relaxers down our throats or sent us for very invasive and painful nerve blocks which both have a high complication rate and need to be repeated as frequently as every three months. Or told us to get more exercise. I’ve always loved that one! I’ve been improving my fitness for three years, but advancement is very slow because if I go too fast it can trigger pain and be a huge setback. Fuck the Sacklers, but fuck whoever decided that pain patients don’t deserve opioids at a rate of 100x. As is always our policy with the disabled in America, our suffering doesn’t matter anywhere near as much as the political moralization that gets people in office Ok, I’ll get off my soapbox. This topic makes me so angry.

ineedaj0b 2y ago
The black pill with chronic pain is it’s often better to off yourself depending on the condition. There’s no hope for some things like erythromelalgia.

hn_throwaway_99 2y ago

> a slow acting opioid (it had to be crushed to be fast acting) You seem to just skip over that point in a bit of a blasé fashion, as if OxyContin's slow release formulation is somehow a defense of the Sacklers' behavior, when the exact opposite is true. That is, a primary argument is that Purdue pushed OxyContin because they argued it was safer due to its slow release formula. Except they knew full well that "slow release" was pretty much bullshit because people were getting addicted by simply crushing the pills. Purdue sales people deliberately pushed Oxy with the false promise of additional safety even though they knew this wasn't true.

zardo 2y ago
It's much worse than that. In order to protect the big selling point (10hrs between doses, once per nursing shift) they encouraged larger doses which were more likely to cause addiction instead of more frequent doses which were actually appropriate.

skellera 2y ago

Are you one of the lawyers? None of that would’ve happened if they didn’t start the flood of opiates to begin with. It wasn’t a marginally increased issue, they flooded the market with it. People with minor pain were getting massive bottles of OxyContin and selling or using it. This led to pill mills and crooked doctors. You had normal people getting hooked on high dosages. These are not the people who were using opioids before that. Pills made it seem safer. Most users don’t start with heroin, they start with pills because of exactly that. “A doctor prescribed it, must be okay.” This is some insane logic to absolve them of responsibility. I say this as someone who also saw the problem firsthand. Was regulation handled badly? Sure but there’s no way you can say they didn’t start the problem.

cstejerean 2y ago
Not only that, some of the problem with addiction were directly caused by the dosage guidelines for oxycontin. They really wanted it to be a 12h drug, but it really isn't and it wears off after about 8 hours. Rather than admitting this and giving a smaller dosage more frequently they doubled down by using a larger dose and trying to keep with the 12h schedule. This combination or larger dose followed by mild withdrawal then results in a higher likelihood to become addicted to opioids. So not only they marketed it heavily and got more people on opioids than necessary, they did it in a way that maximizes the likelihood of addiction. https://www.latimes.com/projects/oxycontin-part1/ https://www.latimes.com/projects/oxycontin-part1/
dguest 2y ago
A bartender mocked my brother for getting Aspirin for his broken arm. "man you got nothin', you should get some oxy for that!" I'd been living outside the US and this in my first few hours back on US soil. A few hours later my friend (working in criminal defense) explained how opiates accounted for roughly 1/3rd of his income (other sources: drunk driving and domestic abuse). They all followed the same trajectory: minor condition -> prescribed oxy -> illegally obtained oxy -> heroin when the money ran out. This wasn't normal. It didn't happen anywhere else in the world at the time, or at least not where I was living.

presentation 2y ago

Opinions like this are why I’m glad I don’t live in the USA anymore. Live practically anywhere else, where there is no opioid crisis, and this line of thinking sounds insane. Copy paste for other uniquely American issues like gun violence - the answer is… more guns?

kyralis 2y ago
To be fair, it sounds insane to many of us living in the US, too.

ok_computer 2y ago

Lol fentanyl is more toxic by an order or two of magnitude. People would be on prescription opioids, lose a script, get on heroin because that was 4 to 8 times cheaper and more available than black market pills. The fentanyl crisis is a phenomenon between cheap imported precursor and Cartel economics. The synthetic opioid demand in the US was a result of a chain of events including the purposeful stimulation of demand by marketing directly to Drs, lying about abuse potential, lying about withdrawal and addiction potential, and not introducing mediating controls when evidence of abuse and sales not meeting market demographics was clearly evident. Like they imported millions of pills to small towns with over selling pharmacies. Drs would up dosage to adjust to tolerance. But anyway it’s fentanyl that is killing people. I’d argue just let people use opium and regulate that sale. Edit: changed and to an. Chinese precursor to imported precursor bc I honestly don’t know how many different countries are sources of a precursor. Added part about importing to small towns and upping dosage.

0x00_NULL 2y ago

What are you talking about? Where was America getting their opioids before The Sacklers? Go ahead and pull a chart of heroin deaths vs. years and draw a vertical bar on where Purdue launched their widespread marketing misinformation and disinformation. This is the largest and most deadly episode of addictiveness since the tobacco companies were marketing cigarettes as healthy. If this were a fire, you’d be arguing: “Look, America has always had fires. Sure Purdue started fires in all 50 states that spread into the forest, but they were small when Purdue started them. Now, there is a blaze that has spread uncontrolled across the Continental US. So, obviously there were other parallel organizations starting fires.” No. That doesn’t follow. Purdue stared the fires. They added tinder with marketing misinformation, then they inhibited any attempt at controlling it with active disinformation campaigns to confuse doctors and regulators about the root cause. Now, it’s a wild uncontrolled inferno, but they started the first fires.

beaeglebeachedd 2y ago
Didn't we also invade the religious nutsos stopping Afghanistan from producing poppies and then prop up a fake regime that let it flourish, massively increasing the supply of natural opiates? If I recall, the timing works out pretty good with illegal opiate use ramping up.
- 0x00_NULL 2y ago
  We sure did. About 60-70% of all of the world's opium was sourced from Afghanistan until 2022. That supply was used to make actual prescriptions in non-OECD countries - like India & China - as well as sold to make heroin in the US, EU, Asia, and Africa. But be careful about confusing cause & effect. The cause of the Afghani farmers growing opium was the insatiable demand for opium that was developed through legal means. Then, when countries like the US started to restrict access to opiates, addicts and patients alike started to seek alternatives to the scarce prescriptions. More to the point, why didn't patients use something else? Because there is nothing. Purdue's misinformation actively discouraged the discovery of new non-addictive compounds for decades. No one was looking, and the R&D pipeline ran dry. By the time enough doctors sounded enough alarms to cause a change in the late 2010s, research in non-addictive pain management solutions was decades behind. No one engaged in it because there was no need for it. Now that we realize it was all a lie and these drugs have killed millions, there are no alternatives. Very few potential compounds are even in Phase 2 clinical trials right now, let alone the half dozen that would be needed in Phase 3 to ensure we have a single alternate choice for pain management in the next five years. So, the outlook looks bleak. Today, in 2024, we don't have good ways to manage pain that is non-addictive, and certainly no good way to reach the millions who are hopelessly addicted to opioids for pain management. But, very little of this is the patient's fault - and a lot of this is directly related to the monumental efforts of Purdue to misinform for profit.

vikramkr 2y ago

Regulation helped cause the deaths by driving people to more dangerous sources. You're 'forgetting,' however, that the oxycontin and prescribed pills were the source of those addictions in the first place. The regulations didn't kill them. If the regulations had always been there, they would have been fine. They weren't tamping down on some mystical parallel crisis, however convenient that would be to shift the blame. They were creating a new one, using the legitimacy of the medical system and doctors prescriptions to get people hooked, to fatal effect when the regulations finally came down and people facing addiction turned to illicit sources.

idiotsecant 2y ago

There is a lot in this post that is ...questionable in my opinion but I just have to call out as especially creative the praise for a drug that is so safe and slow-acting that it won't have harmful fast acting effects unless you... Apply a small amount of pressure with a hard object. Truly a stupendous point.

neffy 2y ago

I would argue that it is the expected outcome of processes exhibiting: Latency... it takes a few years to actually kill their victims, and Exponential behaviour.. the most damage is done in the last few rounds of the expansion.