Expert sounds alarm on new wave of US opioids crisis • Hacker News Board

Re: Expert sounds alarm on new wave of US opioids crisis

#171

Post by danny_codes » Sun, Jan 28, 2024, 7:12 PM UTC

rayiner wrote: post #161

nobodyandproud wrote: post #93

Earlier quoted context omitted.

Take this for what you will, but my parents (deceased) and I are immigrants to the US. I sympathize greatly--not exclusively--with the problems facing most of the non-coastal US but you're not doing any favors by not adding any nuance or thought.

I’m also an immigrant. Average Americans outside the coasts (and even many of the people on the coasts, like black people[1]) are not benefiting from immigration. Immigration is generating benefits for the top 10-15% in the form of profits, jobs in knowledge work industries, and cheaper products. It’s not a comment about individual immigrants, it’s a comment about economics and political economy. [1] https://www.phil…

From the article, it seems the issue isn't immigration per-say but a lack of social services (education, housing guarantees, family benefits, healthcare, childcare, vocational training programs, transit accessibility) amongst the poorer strata of Americans.

That is, we could minimize immigration to perhaps produce a constrained labor market (though that would induce negative population growth, which comes with a host of economic issues), or we could simply redirect capitol to turn unskilled workers into skilled workers.

IMO improving economic (and de-facto social) mobility is a much more sensible policy than inducing negative population growth. An added side benefit would be an overall increase in worker productivity and commensurate economic growth.

Re: Expert sounds alarm on new wave of US opioids crisis

#172

Post by rayiner » Sun, Jan 28, 2024, 7:20 PM UTC

danny_codes wrote: post #171

rayiner wrote: post #161

Earlier quoted context omitted.

I’m also an immigrant. Average Americans outside the coasts (and even many of the people on the coasts, like black people[1]) are not benefiting from immigration. Immigration is generating benefits for the top 10-15% in the form of profits, jobs in knowledge work industries, and cheaper products. It’s not a comment about individual immigrants, it’s a comment about economics and political economy. [1] https://www.phil…

From the article, it seems the issue isn't immigration per-say but a lack of social services (education, housing guarantees, family benefits, healthcare, childcare, vocational training programs, transit accessibility) amongst the poorer strata of Americans. That is, we could minimize immigration to perhaps produce a constrained labor market (though that would induce negative population growth, which comes with a host…

You can’t have an economy with only knowledge workers. (Unskilled isn’t a correct term since many of these jobs, like construction, are skilled work.) Your choices are to have an economy with a large class of foreign workers with little political leverage, or an economy with a smaller class of native born workers with more leverage.

Social services don’t fix the underlying economic problems. For example, you can invest in schools, but at the end of the day those kids would have been better off being raised in a two-person family where the parents have access to well-paying jobs that don’t require a college education, than being raised by a single parent receiving a welfare check. Social services can’t replace everything you get from a functioning community where people have meaningful work.

The Great Society programs caused social welfare spending to dramatically increase starting around the same time as the 1965 INS dramatically increased immigration. But during that time, the upward mobility of black Americans in deindustrializing cities (look at Baltimore, Philly, etc.) decreased from what was happening a generation before.

Re: Expert sounds alarm on new wave of US opioids crisis

#173

Post by tremon » Sun, Jan 28, 2024, 7:20 PM UTC

rayiner wrote: post #162

Loughla wrote: post #158

Earlier quoted context omitted.

Immigrants do those gigs because citizens won't. Those are not community sustaining jobs.

Of course they’d do the jobs if immigrants weren’t driving down the floor. Look at European countries where agriculture is done by native born people.

I agree with your overall point, but not a great example: in NL we also import seasonal labour from Eastern European countries, for the exact same reason and with the exact same effect as you pointed out. Even when it's season all-year round (because we have greenhouses).

Re: Expert sounds alarm on new wave of US opioids crisis

#174

Post by danny_codes » Sun, Jan 28, 2024, 7:21 PM UTC

rayiner wrote: post #162

Loughla wrote: post #158

Earlier quoted context omitted.

Immigrants do those gigs because citizens won't. Those are not community sustaining jobs.

Of course they’d do the jobs if immigrants weren’t driving down the floor. Look at European countries where agriculture is done by native born people.

https://www.latimes.com/projects/la-fi-farms-immigration/

That seems unlikely. Americans don't want to do these jobs. And this article suggests that, were wages to rise sufficiently to entice Americans, the economics would justify automation.

Besides, with the rate of progress in robotics, I doubt there will be much labor-intensive farm-work left to do in 10 years anyway.

Re: Expert sounds alarm on new wave of US opioids crisis

#175

Post by vdaea » Sun, Jan 28, 2024, 7:43 PM UTC

BoiledCabbage wrote: post #152

Loughla wrote: post #30

Earlier quoted context omitted.

Bingo. The center of this country (outside of a few major urban/sub-urban areas) is hollow. Between the loss of agriculture as a family job, loss of industrial jobs, and opioid use after decades of methamphetamine use, it's bleak. And no one really cares. As a general rule, we're told, "just move to Chicago (St. Louis, Kansas City, wherever)". That's not a solution, or a possibility for a lot of folks.

> And no one really cares. As a general rule, we're told, "just move to Chicago (St. Louis, Kansas City, wherever)". That's not a solution, or a possibility for a lot of folks. The problem is this is completely untrue. One party had been talking about coal-mining industry ending and promoting job retraining for over a decade if not longer. Federal funds were administered to pre-empt this exact problem that was forese…

Who ended the coal mining industry?

Re: Expert sounds alarm on new wave of US opioids crisis

#176

Post by zdragnar » Sun, Jan 28, 2024, 7:50 PM UTC

devilbunny wrote: post #81

zdragnar wrote: post #60

Earlier quoted context omitted.

A friend of mine was a mechanic in the air Force and took a wrench to the knee. The VA basically prescribed him a giant bottle of benzos and told him to take them as needed. Young man laid up at home with nothing to do but sit on the couch playing video games and drink beer. Add in a big bottle of pain pills to take "as needed" and you've got an addict.

Benzos are not pain meds. Might make you an addict, but if that’s what was prescribed, it wasn’t for pain. Dunk on the VA all you like, but they’re not that bad.

You're right, I got my wires crossed for some reason. Pretty sure it was either for Percocet or the generic equivalent.

When he recounted this to be, he was frustrated that they didn't give him a small prescription to start with, but more or less gave him a large quantity up front and let him dose himself.

He managed to beat the addiction, and when I'd met him it was in a software development gig so it's not like it ruined his life or anything. He certainly wasn't happy with how casually he'd been treated was the jist of the story.

Edit: just realized I had a different friend at the same company who had been on benzos and dealt with the withdrawal... The three of us chatted quite a bit and I imagine that was the context for the conversation but it's been a decade or so.

Re: Expert sounds alarm on new wave of US opioids crisis

#177

Post by itsnotafight » Sun, Jan 28, 2024, 7:51 PM UTC

tpmoney wrote: post #97

itsnotafight wrote: post #72

Earlier quoted context omitted.

> The harm to society of people who need them not getting pain drugs far outweighs the pain to society of those who don’t need them abusing them. I can see the argument here morally (and I agree with it), but in practice I know far more people negatively affected by drug addictions and drug addicts than I know people unable to get pain management medication they need. I imagine my experience may be typical, and so I…

One question to ask yourself though is whether you're experience both confirmation bias and a bias brought about by visibility and/or age. If you're younger, you're less likely to know people with conditions that require pain management. Likewise the people around you suffering from such conditions might not be open about it because either they've already been told they just have to suck it up and live with the pain,…

I was arguing that such a complaint will fall flat with many people if they share the same general experience as me. Not that it’s “objectively” true or false, assuming you can find something objective to measure. In fact I don’t think you can find something useful to measure objectively, and will necessarily fall back on subjective arguments about what is better, more important, more moral.

Re: Expert sounds alarm on new wave of US opioids crisis

#178

Post by itsnotafight » Sun, Jan 28, 2024, 7:54 PM UTC

at_a_remove wrote: post #94

itsnotafight wrote: post #72

Earlier quoted context omitted.

> The harm to society of people who need them not getting pain drugs far outweighs the pain to society of those who don’t need them abusing them. I can see the argument here morally (and I agree with it), but in practice I know far more people negatively affected by drug addictions and drug addicts than I know people unable to get pain management medication they need. I imagine my experience may be typical, and so I…

You'll pardon me for saying something that sounds a little "woo," but what will enlighten you the most is regarding Group B (who get opioids or benzos or whatever and suffer addiction) as a subset of Group A (who need treatment and medication but aren't getting it), namely that Group B is not getting something in their lives which they desperately need. Then you may see the unitary flaw in the system, at perhaps a la…

I don’t disagree that addiction indicates a lack of something broadly related to “care”. I just take issue with claiming “it is necessarily better that people in pain receive care, and addicts do what addicts do”.

If this is indeed a spectrum (certainly debatable), with increased access definitionally increasing addiction, the argument that one side of the spectrum is strictly better is wrong.

Re: Expert sounds alarm on new wave of US opioids crisis

#179

Post by upleft » Sun, Jan 28, 2024, 7:59 PM UTC

adwi wrote: post #166

upleft wrote: post #156

Earlier quoted context omitted.

Having been a cannabis smoker myself for years, I can understand the danger of self-medicating with psychedelics. They aren’t entirely harmless. Any drug with a high is a dopamine button. It’s easy to hit that button instead of doing something else to feel good. It’s easy to stop doing other things in favor of just hitting that button all day. But the effects of that button diminish over time, so you hit it more ofte…

Do you still smoke? If not, how did you quit? Quitting is an interesting grey area for cannabis; culturally and functionally people misusing the drug are able to do so indefinitely, usually not reaching the “rock bottom” emergency state that other drugs (hopefully) convince the user to seek treatment. So it feels like “just weed” isn’t serious enough to warrant a 30 day treatment center, but the behavior patterns can…

I haven’t quit but have pulled back and am using it far more occasionally rather than most of the time.

The sense of increased focus after smoking is a big plus for me, but the decrease in focus after that coupled with the overall disorganized thinking is a big minus. Disorganized thinking can be great if you are trying to generate a variety of ideas, but bad if you are trying to communicate them. Learning more about what is actually happening in my brain with focus, memory, agency, etc has been one of the biggest motivators in pulling back from chronic use. I don’t enjoy it much knowing that I’m avoiding other things or going to be grumpy and depressed later because of it.

Agree about the grey area for quitting. There isn’t a rock bottom, but with chronic use there is a kind of dull limbo where everything feels harder to do, but you’re demotivated to make a change. It is literally a drag - it slows and lessens you overall.

Re: Expert sounds alarm on new wave of US opioids crisis

#180

Post by rayiner » Sun, Jan 28, 2024, 8:05 PM UTC

tremon wrote: post #173

rayiner wrote: post #162

Earlier quoted context omitted.

Of course they’d do the jobs if immigrants weren’t driving down the floor. Look at European countries where agriculture is done by native born people.

I agree with your overall point, but not a great example: in NL we also import seasonal labour from Eastern European countries, for the exact same reason and with the exact same effect as you pointed out. Even when it's season all-year round (because we have greenhouses).

I didn’t say it’s true of all European countries. To my knowledge, France or Italy for example isn’t nearly as reliant on seasonal farm labor. The Netherlands has always been more in the neoliberal side of the line for Europe.