Live data from Hacker News

The lucrative business of America’s opioid crisis

nytimes.com

131–140 of 211 posts

Re: The lucrative business of America’s opioid crisis

#131
post #99

Earlier quoted context omitted.

America has plenty of successful examples of government programs; the problem is ideological blinders rather than a uniquely ineffectual government.

I think there is a lot of reason to believe that we have a uniquely ineffectual government. Excluding defense expenditures, and counting all levels of government, Canada spends less public money per capita, while having cheaper healthcare, education, better transit, etc. For example, we spend more per capita on education than any OECD country except Switzerland, and get worse results. Our federal system (where states…

In at least one case, we have problems in part due to insufficient regulation, rather than excessive regulation. Pharmaceutical companies spend over $5 billion per year on direct-to-consumer advertising in the US; this practice is effectively illegal in Canada, although the regulations surrounding it are poorly enforced.

That $5 billion advertising spend is going to get paid for elsewhere in the health industry ecosystem, and probably several times over once all of the associated costs are considered.

There's also all of the various forms of pharmaceutical marketing aimed at doctors (with figures around $22 billion per year) and incentives for prescriptions (https://www.npr.org/sections/health-shots/2016/03/17/4706794...).

I wonder some days just how much economic damage will have to be done, just how many millions of lives will need to be ruined, before the American public starts to accept that unregulated capitalism is dangerous in almost every market.

Re: The lucrative business of America’s opioid crisis

#132

Earlier quoted context omitted.

I don't know, dude. If you are talking of using camnnabis for medical use, I'm gonna want a dosage guideline and strength/purity promises. I'm pretty sure for medical use, it will more closely resemble ibuprofen or cough medicine if it is without prescription. With prescription it'll be more like generics. It might still be a monopoly, since these drugs have to go through all the FDA testing. Heck, if you want fluori…

It's a freaking plant. Why should it be more regulated than parsley?

So's digitalis.

Re: The lucrative business of America’s opioid crisis

#133

Earlier quoted context omitted.

> Actually the opposite. Government regulations... I'm from the Netherlands so you won't hear me disagree with the argument that criminalizing cannabis and drugs is not the solution[0]. Having said that, the typical undertone on HN of "regulation is bad by definition" really irks me. I can imagine that if the only perspective one has is a dysfunctional government, one might think that, but please take a look abroad a…

I've always observed that HN leans pro-regulation.

They are, HN is very liberal. That's why bitcoin catches so much hate around here.

Re: The lucrative business of America’s opioid crisis

#134
post #52

Capitalism is sinister like this. It doesn't intentionally do it, because capitalism isn't a person, but when everything is monetized by our creative entrepreneurs, it grows; our problems being no exception. Once someone makes money, they want more of it. Capitalism demands more of it. And we stretch every line of the law, even cross it, just to get more from where that came from. Unfortunately one person suppressing…

I'm not so sure Capitalism is the correct term for this (it's the most misused "'ism"). If there was a free market for drugs (legalization), I suspect we would not be in a crisis.

That's the scary question. Legal opioids would flood the street with cheap, safe (comparatively speaking), legal morphine.

What's worse? Morphine flooding a our society as a recreational drug? Think how easily highschoolers can get beer and cigarettes, but with opioids...

But our current approach has lead to the widespread adoption of the cheapest, most concentrated, and most dangerous opioid imaginable: Fentanyl. This which has rapidly become the continent's foremost public health plague as it kills a terrifying number of people every year.

Would freely available morphine or heroin be better?

Re: The lucrative business of America’s opioid crisis

#135

Earlier quoted context omitted.

I'm not so sure Capitalism is the correct term for this (it's the most misused "'ism"). If there was a free market for drugs (legalization), I suspect we would not be in a crisis.

Drug and free market seems like a nasty bet IMO; too much money, too much immaturity and decrease of rationality. My bet is that most 80% of the time it will degenerate into gangs and cartels.

Legalization eliminates the gangs and cartels. The problem is that it makes abuse and misuse into a public health crisis. There are no more gangs of liquor runners - instead we have InBev. People don't go blind from bad bathtub brews anymore, but they kill themselves with overconsumption or even kill others with driving drunk.

So legal opioids would presumably mean the same: more abuse, more misuse, but safer and without the cartels.

Re: The lucrative business of America’s opioid crisis

#136

Earlier quoted context omitted.

I'm not so sure Capitalism is the correct term for this (it's the most misused "'ism"). If there was a free market for drugs (legalization), I suspect we would not be in a crisis.

Drug and free market seems like a nasty bet IMO; too much money, too much immaturity and decrease of rationality. My bet is that most 80% of the time it will degenerate into gangs and cartels.

I don't understand. What purpose would gangs/cartels serve if drugs were brought into the general legal framework?

Re: The lucrative business of America’s opioid crisis

#137
post #124
post #99

Earlier quoted context omitted.

I think there is a lot of reason to believe that we have a uniquely ineffectual government. Excluding defense expenditures, and counting all levels of government, Canada spends less public money per capita, while having cheaper healthcare, education, better transit, etc. For example, we spend more per capita on education than any OECD country except Switzerland, and get worse results. Our federal system (where states…

I think you are on to something looking at state governments but I don't find the answer completely satisfying because a lot of US States are similarly sized to European countries. Why should we expect the State of NY (~20M people) to have a worse government than the Netherlands (~17M people)? I don't have a great answer to this question. Perhaps it's just the separation of government in general. People can only pay…

I never fully realized it until now, but the US, with it's federated structure is putting itself at a competitive disadvantage to other countries.

It's the worst of both worlds, where states have a flaccid independence (they can legislate but not control their borders, thus cannot avoid the free-rider problem). Nation-wide standards that don't fall under the commerce clause have to be bribed into half-ass existence, and then only for a political season.

We're structurally incapable of benefiting from economies of scale or standardization in government.

Re: The lucrative business of America’s opioid crisis

#138

Earlier quoted context omitted.

Few people actually have the resources to pursue legal remedies and given the demographics of those affected by opioid addiction, I'm completely unsurprised.

Isn't this a perfect situation to use class action?

I'm not sure how you'd identify participants. Medical privacy rules would prevent you from taking the typical "this consumer product causes warts so we'll find everyone on record of having bought one" approach.

Re: The lucrative business of America’s opioid crisis

#139
post #9

Heroin is a Schedule I (in the US) which means no medical benefit, and its a 20 year felony for distributing it. There is also the Federal Analogue Act, 21 U.S.C. § 813, which is supposed to group similar drugs in the same category. So, how do these companies get away with selling analogs of heroin? Shouldn't the people who work there and make money off these opioid drugs be arrested? Why haven't they?

If that is a serious question its because the drug analog act explicitly excludes certain drugs from being defined as a drug analog including drugs approved by the FDA.

> (C) Such term does not include - (i) a controlled substance; (ii) any substance for which there is an approved new drug application; (iii) with respect to a particular person any substance, if an exemption is in effect for investigational use, for that person, under section 355 of this title to the extent conduct with respect to such substance is pursuant to such exemption; or (iv) any substance to the extent not intended for human consumption before such an exemption takes effect with respect to that substance.

Re: The lucrative business of America’s opioid crisis

#140
post #72

Earlier quoted context omitted.

Not exactly. If money speaks than the cannabis would be generally accessible in every state because it brings in huge amount of tax to government and income for companies.

That's theoretical, infirect future money, not real tangibld, here and now money provided by companies who profit off the war on drugs.

Totally: http://fortune.com/2016/12/13/colorado-billion-legal-marijua...
Post reply on HN