As opioid overdoses exact a higher price, communities ponder who should be saved • Hacker News Board

Re: As opioid overdoses exact a higher price, communities ponder who should be saved

#51

Post by Clubber » Sun, Jul 16, 2017, 4:35 PM UTC

tcj_phx wrote: post #9

Clubber wrote: post #3

Earlier quoted context omitted.

I don't know how long this country can survive with this rampant corruption and profiteering. When do we hit a breaking point, and what does that look like? I mean I read your response and think, "wow, that's horrible." Then realize absolutely nothing is going to be done about it.

100 years ago, politicians were tricked into trusting organized crime to tend to the health of people who are drawn to opiates. Those politicians are dead & gone, but we're still stuck with their mistake. My mother broke her wrist 6 months ago, and was given opiates to deal with the pain of having a plate put in her wrist. She did not become an opiate addict. I presume she managed to avoid becoming a junky because sh…

When the drug war started, politicians had a problem: banning someone from ingesting wasn't something the US government had the power to do. We were a free country after all. They had to bend the constitution by implementing a tax rather than a ban, and simply never issued tax stamps. Fast forward 100 years, the federal, state and local governments can ban anything they damn well please with little to no resistance, confiscate our property with no recourse and a myriad of other things we accept as normal.

Where would we be if they hadn't circumvented the constitution and just let people use the drugs they wanted? We would probably (maybe) have more drug deaths, but we wouldn't have this 1984 like society. I think I want a do-over.

Re: As opioid overdoses exact a higher price, communities ponder who should be saved

#52

Post by tcj_phx » Sun, Jul 16, 2017, 4:35 PM UTC

tptacek wrote: post #44

tcj_phx wrote: post #22

Earlier quoted context omitted.

> It'd be far more cost-effective to reduce the need for acute care by providing access to addiction treatment before things get to this point. Easier said than done I suppose. Johann Hari has pointed out that it's very effective to just give heroin addicts pure heroin and a safe place to inject it. Switzerland has 'essentially' [edit] eliminated opiate deaths with this strategy: [edit: added 'essentially' in respons…

In reports about the Swiss strategy and in this story about Hari I see plausible claims that Switzerland has eliminated deaths due to needle-borne HIV, but no claims anywhere that prescribing heroin has eliminated all opiate fatalities. Can you cite a more rigorous source?

> but no claims anywhere that prescribing heroin has eliminated all opiate fatalities. Can you cite a more rigorous source?

I have edited the comment above to add a word.

The friend who taught me about her opiate addiction knew how to manage her dose pretty well. Then the mental health industry got her addicted to benzodiazepines, which changed her tolerance. She overdosed on me when trying to get off the benzos. The fire department revived her, then disappeared into the night. Those two doses of Naloxone stabilized her for about 2 weeks...

A lot of the deaths in the United States' present opiate overdose epidemic has to do with contamination of the heroin supply with more powerful synthetic opiates. When the supply includes elephant opiates, addicts don't know how much to use.

Re: As opioid overdoses exact a higher price, communities ponder who should be saved

#53

Post by tptacek » Sun, Jul 16, 2017, 4:45 PM UTC

tcj_phx wrote: post #52

tptacek wrote: post #44

Earlier quoted context omitted.

In reports about the Swiss strategy and in this story about Hari I see plausible claims that Switzerland has eliminated deaths due to needle-borne HIV, but no claims anywhere that prescribing heroin has eliminated all opiate fatalities. Can you cite a more rigorous source?

> but no claims anywhere that prescribing heroin has eliminated all opiate fatalities. Can you cite a more rigorous source? I have edited the comment above to add a word. The friend who taught me about her opiate addiction knew how to manage her dose pretty well. Then the mental health industry got her addicted to benzodiazepines, which changed her tolerance. She overdosed on me when trying to get off the benzos. The…

I see credible claims that Switzerland has reduced overdose deaths from opiates with this strategy, but none saying they've "effectively eliminated" them. I didn't look very hard, and you see familiar with the subject. Can you point me to a resource establishing this?

The thing I see reports saying Switzerland has effectively eliminated is deaths due to needle contamination. That's not hard to believe (but then, you could get that effect by giving addicts clean needles).

In the article you posted, I see Hari saying that Switzerland's practices have eliminated wounds and abscesses he attributes to drug contamination. That, too, is very plausible. But most opiate fatalities are not caused by injection site wounds; they're caused by overdose.

I think there might be some confusion. Switzerland itself claims that nobody has died from overdose of officially prescribed heroin. That, too, is totally plausible. But Switzerland still has a street opiate drug market problem!

Re: As opioid overdoses exact a higher price, communities ponder who should be saved

#54

Post by hrehhf » Sun, Jul 16, 2017, 4:47 PM UTC

Clubber wrote: post #3

tcj_phx wrote: post #2

(this article can be read by searching for the title on http://twitter.com/ , then opening the link in a private window) > Two doses of an injectable form of naloxone, Evzio, cost $4,500, up from $690 in 2014. The price of other forms of the drug, including the nasally administered Narcan, typically range from $70 to $150 per dose, officials say. The cost of naloxone [1] is an insignificant part of the cost of revivi…

I don't know how long this country can survive with this rampant corruption and profiteering. When do we hit a breaking point, and what does that look like? I mean I read your response and think, "wow, that's horrible." Then realize absolutely nothing is going to be done about it.

> I don't know how long this country can survive with this rampant corruption and profiteering.

So far it has been 241 years.

Re: As opioid overdoses exact a higher price, communities ponder who should be saved

#55

Post by zanny » Sun, Jul 16, 2017, 4:48 PM UTC

joshlemer wrote: post #8

Clubber wrote: post #3

Earlier quoted context omitted.

I don't know how long this country can survive with this rampant corruption and profiteering. When do we hit a breaking point, and what does that look like? I mean I read your response and think, "wow, that's horrible." Then realize absolutely nothing is going to be done about it.

I guess one way it could play out is that as the corruption becomes more and more obvious, together with increasing differences in political ideology between red and blue states, an appetite for seceding from the United States could develop in some states, and if that sentiment becomes common enough, it could become a reality?

The problem is that the stratified cultures that form the arbitrary two sided political dichotomies (see Britain for another great example - given current norms it would make perfectly good sense for Scotland, London, and Northern Ireland to secede from the more conservative England and Wales).

But they are arbitrary. The talk radio in the rural conservative parts and the Internet circlejerks in the liberal ones have divided peoples way worse than they were a hundred years ago by putting the soft-reds and soft-blues into echo chambers of the most ardent idealogues and turning many into adherents that place their personal identity into their politics.

The other problem is those of us guilty of that - the framing of our identity on high-brow concepts like ideology - don't want to change. Who wants to revert back to ignorance on how you personally think the world is best ordered?

The rift will only grow until dissolution does happen unless all participants admit that they want to preserve solidarity in society. They will not be able to change themselves, but they can train future generations to not base themselves so heavily in politics such that they do not segregate themselves such. But it would take everyone agreeing on something nobody wants to have happen. So... yeah right.

Re: As opioid overdoses exact a higher price, communities ponder who should be saved

#56

Post by shams93 » Sun, Jul 16, 2017, 4:50 PM UTC

Clubber wrote: post #3

tcj_phx wrote: post #2

(this article can be read by searching for the title on http://twitter.com/ , then opening the link in a private window) > Two doses of an injectable form of naloxone, Evzio, cost $4,500, up from $690 in 2014. The price of other forms of the drug, including the nasally administered Narcan, typically range from $70 to $150 per dose, officials say. The cost of naloxone [1] is an insignificant part of the cost of revivi…

I don't know how long this country can survive with this rampant corruption and profiteering. When do we hit a breaking point, and what does that look like? I mean I read your response and think, "wow, that's horrible." Then realize absolutely nothing is going to be done about it.

Rather than a revolutionary movement you see mass implosion, addiction, suicide and people falling apart under the weight of triple time hours or being excluded from work altogether .

Re: As opioid overdoses exact a higher price, communities ponder who should be saved

#57

Post by chaosbutters314 » Sun, Jul 16, 2017, 4:51 PM UTC

Clubber wrote: post #3

tcj_phx wrote: post #2

(this article can be read by searching for the title on http://twitter.com/ , then opening the link in a private window) > Two doses of an injectable form of naloxone, Evzio, cost $4,500, up from $690 in 2014. The price of other forms of the drug, including the nasally administered Narcan, typically range from $70 to $150 per dose, officials say. The cost of naloxone [1] is an insignificant part of the cost of revivi…

I don't know how long this country can survive with this rampant corruption and profiteering. When do we hit a breaking point, and what does that look like? I mean I read your response and think, "wow, that's horrible." Then realize absolutely nothing is going to be done about it.

You mean unregulated Capitlism? It will wake up when we realize we need some middle ground between Capitalism and Socialism.

Re: As opioid overdoses exact a higher price, communities ponder who should be saved

#58

Post by FireBeyond » Sun, Jul 16, 2017, 4:51 PM UTC

traviscj wrote: post #25

Alex3917 wrote: post #18

Earlier quoted context omitted.

Naloxone is already generic and basically free, government officials just like buying the branded version so they can get kickbacks while complaining about the cost.

Ugh. That is sickening. Since it seems like you have some expertise in the area, is this antipattern actually codified In regulations, or more of a de-facto/status quo thing?

A similar thing happened in Washington (but seems to be on the way out), that all ambulances were mandated to carry EpiPens. Not epinephrine, but an EpiPen. Even those that carry vials and syringes.

Re: As opioid overdoses exact a higher price, communities ponder who should be saved

#59

Post by laser » Sun, Jul 16, 2017, 4:51 PM UTC

Why is ibogaine [1] still a fringe treatment for opiod addiction? It seems like a heroin -> methadone -> ibogaine treatment could get the vast majority of addicts cured. Instead, on one end of our medical system's pipeline we get people addicted to opiods, and on the other end we've created so many addicts we have to save them from overdosing. In this domain our "medical" pipeline is actually a disease-creating pipeline that's clogging itself up at the end... Research is still ongoing, but it seems likely that even the majority of opioid painkiller prescriptions can be replaced with cannabis.

It seems then, that we can empty the pipeline by adding less opiod addicts in, by prescribing cannabis when possible instead of opiods, and clear out the end by actually effectively treating addicts.

Unfortunately, our federal government is so out of touch with reality that it classifies both ibogaine and cannabis as Schedule I drugs, substances with "high potential for abuse", "no accepted medical use", and "lack of accepted safety for use under medical supervision". The irony is devastating, and it's ruining countless lives.

[1] http://ww.iceers.org/docs/science/iboga/Alper%20et%20al_1999...

[2] https://www.theatlantic.com/health/archive/2016/11/a-new-tes...

Re: As opioid overdoses exact a higher price, communities ponder who should be saved

#60

Post by zanny » Sun, Jul 16, 2017, 4:53 PM UTC

Alex3917 wrote: post #32

traviscj wrote: post #25

Earlier quoted context omitted.

Ugh. That is sickening. Since it seems like you have some expertise in the area, is this antipattern actually codified In regulations, or more of a de-facto/status quo thing?

> is this antipattern actually codified In regulations, or more of a de-facto/status quo thing? A lot of drug purchasing things are codified. For example, Medicare is banned from negotiating drug pricing with manufactures. So even though they're buying billions of dollars worth of drugs in bulk, they're literally paying the retail price, which is just whatever the Pharma companies ask for. In terms of why they're buy…

> why they're buying the branded version in the first place

Probably doesn't take a psychic to see its because the brand bought the right politicians at the right time.