60 journalists all spend one week covering Cincinnati's battle with heroin • Hacker News Board

Re: 60 journalists all spend one week covering Cincinnati's battle with heroin

#91

Post by BurningFrog » Wed, Sep 13, 2017, 1:54 AM UTC

kolbe wrote: post #17

baldfat wrote: post #4

Let's not forget who to blame for this. Pharmaceutical companies and Doctors. West Virgina is the most effected - http://www.pulitzer.org/winners/eric-eyre These articles shouldn't make you sad but MAD. "In six years, drug wholesalers showered the state with 780 million hydrocodone and oxycodone pills, while 1,728 West Virginians fatally overdosed on those two painkillers" That's 433 pills for every man, woman and ch…

I know everyone pictures the kid with a broken arm getting it set when they hear about socializing medicine, but all I picture is the US paying large corporations to make more people OD on opioids.

One factor is that if you're on disability/Medicaid, you can get $1000 worth of Oxycontin for a $3 copay.

Those pills in turns have a street value of $10,000.

This stream of federal drug money is¹ one big driver of the opioid epidemic. In some parts of the country, a huge part of the population is on disability, and it's hard to say no this kind of money.

¹ Or at least was. The system has probably tightened a bit the last 5-10 years.

Re: 60 journalists all spend one week covering Cincinnati's battle with heroin

#92

Post by amigoingtodie » Wed, Sep 13, 2017, 1:56 AM UTC

snarf21 wrote: post #40

blfr wrote: post #34

Earlier quoted context omitted.

Let's not forget who to blame for this. Pharmaceutical companies and Doctors. It's almost certainly not true. This massive susceptibility to addiction is a larger social problem of alienation, lack of community and purpose, not getting a couple of pills from your doctor. Prohibition worked to some extent and would work tried again but it does not address the root problem.

Not attacking you but do you think cigarette companies are liable for smoking addiction? My biggest problem with Pharma on this is that Oxy is 100x (?) more likely to get someone addicted than Tylenol 3 with Codeine or maybe even Morphine. I think part of selling Oxy should be a mandatory tax that goes to pay for opioid addiction.

A tax on who? The taxpayers that are paying for Medicaid to pay the drug companies?

Healthcare in America is disgustingly perverse.

Re: 60 journalists all spend one week covering Cincinnati's battle with heroin

#93

Post by tcj_phx » Wed, Sep 13, 2017, 2:11 AM UTC

KGIII wrote: post #73

xrd wrote: post #69

Earlier quoted context omitted.

Fascinating and brutally honest comment. Very interesting to see the economic realities and how that moved you to more illicit drugs over time. Do you think the solution is legalization then? If the drugs you needed were cheaper and safer, would that change things? Would the Mexican drug cartels ever permit that?

I am pro legalization. I say we don't give the cartels a choice in the matter. Much of the harm from drug use comes from the illegality of them. Consistent quality supplies would go a long ways. Tax, educate, and treat. I use 'safe' drugs, namely Suboxone. I doubt I'd change back to other opiates because I like the protection Suboxone offers me. Namely, I can pretty much only do it. It then blocks the receptors and d…

I've heard suboxone doctors are difficult to find, because of artificial restrictions... How did you find your suboxone doctor? (Are you in the US?)

My friend was on Methadone when I met her. After six months she realized she "hated everything about Methadone", which I understand has all of the addiction of heroin but none of the thrill. This is my most recent comment about her: https://news.ycombinator.com/item?id=15024780

Re: 60 journalists all spend one week covering Cincinnati's battle with heroin

#94

Post by BoiledCabbage » Wed, Sep 13, 2017, 2:15 AM UTC

leggomylibro wrote: post #88

>Heroin is big business, but not for the Mexican immigrant Reagan is tailing today. He’s just a suspected courier who might make $500 or so. The real money flows to the gangs that control distribution, and to the drug cartels back in Mexico. >When they finally pull him over, police rip up the floor boards and dig through the driver’s back pack. They check the bumpers and the trunk and look for secret compartments in…

> They don't have time to dwell on what went wrong.

But damnmit the bigger issue and what I'm really mad at is people protesting Police abuse! /s

It's absurd how skewed this country has become in the "Police can do no wrong" mentality.

When spoken in the abstract people are quick to say of course there is corruption and things can be improved in policing. But when it comes to specifics or even specific instances popular opinion and the justice system never fails to side with the police.

And no, it's not just the conflict of interest for prosecutors that's at issue. We have a serious issue with the role of Police as public servants in this country.

The (deliberate) pendulum swing to overly idolizing soldiers post-Vietnam, the declaration that police were now in a war against an inanimate object (drugs) including equipment and tactics, and the "otherization" / racial aspect have really made a perfect storm that is has now begun to spread out to society at large.

Re: 60 journalists all spend one week covering Cincinnati's battle with heroin

#95

Post by exikyut » Wed, Sep 13, 2017, 2:20 AM UTC

Wonder if anyone will see this, but I have a general question I might as well ask here.

What if, you put an addicted person in a padded cell, and supply progressively decreasing doses of the drug(s) the person is addicted to?

The dosage gradient could be mathematically computed to find the lowest possible harmful withdrawal effects.

The person would stay in the cell environment until completely past the hardest phases of withdrawal (however long this takes, whether days, weeks, months(?)), but they would be free to move around (within the secure complex) as they please, and have limited access to technology (anything enabling communication would be heavily vetoed, but eg unlimited access to a video library could work well).

It seems that the current models in use depend entirely on the will of a person who is heavily compromised. I honestly have to say, that seems fundamentally and ridiculously broken, and yeah, even suspiciously so: it's so obvious that this approach is not going to work for most, so why does every "treatment center" continue down this path?

The only caveat I can think of with the suggestion above is about the violent phase of withdrawals, and sedating a person enough when in that phase so they can eat/drink/etc. (I'm not sure how long it is - I vaguely recall it's just a couple of days right?)

Also, about the padded room - I'm not talking "psychotically mad-proof" padding, but just enough for this context. Obviously that's going to change per drug and person, and maybe thick padding is what would be required.

I'm just thinking about cost here (cost of sedation and padding), because I know that a) everything health-related in the US seems to attract the most markup and overhead in any field in the world, and b) because (as per my notation that the current model is _suspiciously_ broken) I wouldn't be surprised if anyone who tried this would find it mysteriously hard to get funding.

On the other hand, I must admit that I've never really tried to find out if this idea has been attempted or not. Would/does it not work?

Re: 60 journalists all spend one week covering Cincinnati's battle with heroin

#96

Post by KGIII » Wed, Sep 13, 2017, 2:25 AM UTC

tcj_phx wrote: post #93

KGIII wrote: post #73

Earlier quoted context omitted.

I am pro legalization. I say we don't give the cartels a choice in the matter. Much of the harm from drug use comes from the illegality of them. Consistent quality supplies would go a long ways. Tax, educate, and treat. I use 'safe' drugs, namely Suboxone. I doubt I'd change back to other opiates because I like the protection Suboxone offers me. Namely, I can pretty much only do it. It then blocks the receptors and d…

I've heard suboxone doctors are difficult to find, because of artificial restrictions... How did you find your suboxone doctor? (Are you in the US?) My friend was on Methadone when I met her. After six months she realized she "hated everything about Methadone", which I understand has all of the addiction of heroin but none of the thrill. This is my most recent comment about her: https://news.ycombinator.com/item?id=1…

I was able to find them by casting a wider net. I live in a very, very remote area. He has a practice that he visits that's not too far away. When he is up, he makes the drive to my house and we chat for an hour, usually over a small meal. Sometimes, I go down to see him but he enjoys the drive and coming to visit me.

I am in the US. I am retired in Maine. I am fortunate in that I sold my business and am financially secure. So, I can afford some of the best medical care.

I've since helped to seed another program, at a not terribly distant medical facility, that helps treat others with addiction problems. It's a bit of a money sink, but it makes me feel good. The provider is a different person, however.

I never liked methadone. Of course, when I tried it last, I was using fentanyl and methadone couldn't come close to helping because my tolerance was so high. Suboxone doesn't really get me high, it just keeps me from getting sick. I am allowed to take enough to get high, but I seldom do. My doctor is pretty cool about stuff like that.

Again, the goal is harm reduction and not strict sobriety. Finding a doctor interested in that was key for me. It took some phone calls, some false starts, and some time. I can't stress this enough - it helps to have money. Insurance would not cover much of this. I pay my doctor in cash. I'm pretty sure I spend more now than I usually did when using illegally.

Re: 60 journalists all spend one week covering Cincinnati's battle with heroin

#97

Post by aklemm » Wed, Sep 13, 2017, 2:26 AM UTC

BoiledCabbage wrote: post #94

leggomylibro wrote: post #88

>Heroin is big business, but not for the Mexican immigrant Reagan is tailing today. He’s just a suspected courier who might make $500 or so. The real money flows to the gangs that control distribution, and to the drug cartels back in Mexico. >When they finally pull him over, police rip up the floor boards and dig through the driver’s back pack. They check the bumpers and the trunk and look for secret compartments in…

> They don't have time to dwell on what went wrong. But damnmit the bigger issue and what I'm really mad at is people protesting Police abuse! /s It's absurd how skewed this country has become in the "Police can do no wrong" mentality. When spoken in the abstract people are quick to say of course there is corruption and things can be improved in policing. But when it comes to specifics or even specific instances popu…

It IS absurd and I'm with you in thinking it is a perfect storm. Possibly even a fundamental crisis of freedom. My latest tactic is to label these people "copsuckers". It makes me feel good anyway.

Re: 60 journalists all spend one week covering Cincinnati's battle with heroin

#98

Post by codyb » Wed, Sep 13, 2017, 2:27 AM UTC

BoiledCabbage wrote: post #94

leggomylibro wrote: post #88

>Heroin is big business, but not for the Mexican immigrant Reagan is tailing today. He’s just a suspected courier who might make $500 or so. The real money flows to the gangs that control distribution, and to the drug cartels back in Mexico. >When they finally pull him over, police rip up the floor boards and dig through the driver’s back pack. They check the bumpers and the trunk and look for secret compartments in…

> They don't have time to dwell on what went wrong. But damnmit the bigger issue and what I'm really mad at is people protesting Police abuse! /s It's absurd how skewed this country has become in the "Police can do no wrong" mentality. When spoken in the abstract people are quick to say of course there is corruption and things can be improved in policing. But when it comes to specifics or even specific instances popu…

Hmm, I do agree with you but when I read that I read that as literally meaning "these police officers have no time to dwell on whats wrong".

With that many deaths and overdoses in just one week a lot of these departments are pretty taxed. A lot of these guys are doing the best they can with what little time they have and showing compassion where they can.

Fortunately for those battling these addictions I suspect, this epidemic is touching people the police know and care about. When it's not quite literally a black and white issue (or latino and white), and when the victims look like the officers or their friends or family, I think you see a bit more compassion.

But boy are a lot of these places just plain overrun with calls these days.

Hopefully one day we'll see more compassion for every citizen and I'm hopeful we're slowly but surely moving in that direction. I dunno what it is I just have a decent amount of faith in America's ability to generally move forward over time.

Man, some of those stories were really heartwrenching.

Re: 60 journalists all spend one week covering Cincinnati's battle with heroin

#99

Post by codyb » Wed, Sep 13, 2017, 2:35 AM UTC

codyb wrote: post #98

BoiledCabbage wrote: post #94

Earlier quoted context omitted.

> They don't have time to dwell on what went wrong. But damnmit the bigger issue and what I'm really mad at is people protesting Police abuse! /s It's absurd how skewed this country has become in the "Police can do no wrong" mentality. When spoken in the abstract people are quick to say of course there is corruption and things can be improved in policing. But when it comes to specifics or even specific instances popu…

Hmm, I do agree with you but when I read that I read that as literally meaning "these police officers have no time to dwell on whats wrong". With that many deaths and overdoses in just one week a lot of these departments are pretty taxed. A lot of these guys are doing the best they can with what little time they have and showing compassion where they can. Fortunately for those battling these addictions I suspect, thi…

Also, in a lot of places officers are carrying narcan and saving lots of lives. Maybe that's the best thing these guys have done in a long time.

Re: 60 journalists all spend one week covering Cincinnati's battle with heroin

#100

Post by bsder » Wed, Sep 13, 2017, 2:45 AM UTC

Theodores wrote: post #50

gregmac wrote: post #33

Earlier quoted context omitted.

> Perhaps you could include poverty and despair (and trace back from there to a collapsing education system, ideological pathology...). It's really not about that -- although that certainly contributes to some drug use. "The opioid epidemic began in the 1990s, when doctors became increasingly aware of the burdens of chronic pain. Pharmaceutical companies saw an opportunity, and pushed doctors — with misleading market…

If I was given an infinite supply of free heroin and all the time in the world to sell it to my neighbours, friends, family, workmates and anyone else in the locality then I would struggle to make a sale. My client base would be zero and I would have to go back to the day job. If you rewind America to before the opioid epidemic then that would be the situation for anyone aspiring to sell heroin in normal America. The…

> If I was given an infinite supply of free heroin and all the time in the world to sell it to my neighbours, friends, family, workmates and anyone else in the locality then I would struggle to make a sale.

I suspect you are being naive.

While heroin isn't a popular drug, it's not exactly rare either. Especially among the "artist" community, it has always seemed to be fairly common. Guitar players seem to particularly gravitate to it--and not just the "hard core" ones. (See: Emily Remler http://www.allmusic.com/artist/emily-remler-mn0000800814/bio...)

The war on drugs did NOT help. I remember one musician saying (paraphrased) "They lied to us about pot and it was fine. So we assumed they were lying about heroin--WRONG! Heroin is every bit as addictive and dangerous as they claim."