Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Bleak New Estimates in Drug Epidemic: A Record 72,000 Overdose Deaths in 2017

nytimes.com

Post reply on HN
Print view View original

141–150 of 217 posts

Re: Bleak New Estimates in Drug Epidemic: A Record 72,000 Overdose Deaths in 2017

#141

Post by mercer »

toomanybeersies wrote: post #130
dominotw wrote: post #113

Earlier quoted context omitted.

> 2 months worth of oxy for getting wisdom teeth pulled kind of thing I saved mine after wisdom tooth/root canal combo and used them as mood enhancer later. I am not sure I am addicted to them though. I find this theory hard to believe that opioid overdose is an end result of series of missteps starting from wisdom tooth oxy prescription.

Most of the population drinks alcohol. Most of the population are not alcoholics. I haven't abused opioids for recreational purposes, but I know people who have saved their prescribed codeine and gotten fucked up on it. They aren't addicted. I also walk to the supermarket every day, past the safe injection centre filled with smackheads. I've seen dead heroin addicts wheeled into the ambulance. Not everyone is as susc…

that's a very important point. I've had a number of friends who struggle with addiction (whether alcohol, cigarettes, or other things), and a smaller number of friends who seemed almost entirely impervious to addiction. It's been quite frustrating to find that the latter would simply not understand the former. Some of them would suspend judgment, but others just concluded that those who were addicted simply "didn't try hard enough".

To some extent, I can understand this rather uncharitable conclusion. It's like explaining being in love to someone who hasn't been. Addiction is difficult to explain without having experienced it.

Nonetheless, what makes me side with the addicts, so to speak, and their helplessness, is that when I look at the 'whole' of their person, many of them clearly don't lack willpower or discipline in other areas of their lives. I've either seen the addiction infect the rest of their lives, or seen them being functional, even successful, in other areas despite the addiction. The only conclusion I can draw is that some (most?) people are just unusually susceptible to certain vices.

Re: Bleak New Estimates in Drug Epidemic: A Record 72,000 Overdose Deaths in 2017

#143

Post by Nursie »

austincheney wrote: post #140
Nursie wrote: post #69

Earlier quoted context omitted.

Different stimulants have different methods of action on the various receptors in the brain. As such they have very varying addiction profiles. I think the blanket statement "Stimulants are physically addictive" is wrong (some, like MDMA or exotics like methiopropamine have a fairly low addiction rate), and the idea that somehow depressants as a class don't have this property is bizarre. I'm not quite sure what you m…

I can accept bizarre. I think it is safe to say all drugs modify the physiology of the user in some way. The difference is if that change to the body is what induces a craving for more from a cellular level. There is no indication that depressants, as a class, achieve addiction purely in response to cell modification. You mention cocaine versus opiates. A major difference there is that cocaine doesn't require repeate…

I don't think that section in wikipedia, or the paper it comes from, says what you think it says. It certainly doesn't claim that a single use is addictive, only gives the rates of continued use (to the point of dependency) a certain number of years after the first dose. I imagine one could come up with similar numbers for opiates.

Further, you've contradicted your own point in your spiel about nicotine.

I really don't think your ideas are supportable.

(edit: in fact you can find figures for the percentage of people who, having tried heroin once, go on to develop dependency - it's around 23%, far higher than for cocaine.)

Re: Bleak New Estimates in Drug Epidemic: A Record 72,000 Overdose Deaths in 2017

#144

Post by ensignavenger »

zolthrowaway wrote: post #88
free652 wrote: post #81

Earlier quoted context omitted.

For wisdom teeth I got 25 tablets - that's like around a week worth. So other "patients" ask upfront for more tablets?

Yes, many people will take the largest script the doctor will prescribe. Insurance generally helps cover the cost of the prescription, so reselling them can be really lucrative. Even in your scenario, 25 pills seems like a lot. Many people will be totally pain free in 2-3 days. No one needs 8 pills a day for wisdom teeth. Let's say they take 4 a day for 3 days, that's still 13 pills leftover. Go to any manual labor j…

Since the insurance charges the same for a large prescription versus a small one, even if you aren't planning on selling them, it makes sense from a financial perspective to get the extra pills, just in case you do need them. (If there are complications, or if something else happens, etc.)

Re: Bleak New Estimates in Drug Epidemic: A Record 72,000 Overdose Deaths in 2017

#145

Post by Nursie »

austincheney wrote: post #137
RGamma wrote: post #79

Earlier quoted context omitted.

Please watch this before making other plainly wrong and unsubstantiated comments like this: https://www.youtube.com/playlist?list=PL150326949691B199 The stimulant/depressant dichotomy doesn't hold by the way. For instance alcohol's effect on the brain is not only very non-specific but also not very well understood whatsoever (see https://en.wikipedia.org/wiki/Alcohol_(drug)#Pharmacology or the lecture). Or more preci…

The physically addictive quality of alcohol has more to do with the liver and less to do with the brain even though alcohol is known to cause brain damage. The primary damage from excessive continuous alcohol consumption over a period of 8 years or more is in the liver resulting in a variety of metabolic and processing disorders. In some cases sudden severe withdrawal can be harmful and possibly fatal as the liver is…

You appear to be confusing addiction, which is happening in the brain and is to do with the GABA and other receptors, with the nature of the withdrawal symptoms.

Re: Bleak New Estimates in Drug Epidemic: A Record 72,000 Overdose Deaths in 2017

#146

Post by mrguyorama »

ams6110 wrote: post #94
stef25 wrote: post #55

Earlier quoted context omitted.

The doctors. Anyone who spends the better part of a decade studying medicine can't be ignorant about opioids and addiction, regardless of what the slimy Purdue representative tells them. The only excuse they have for the blatant over prescribing of opioids (2 months worth of oxy for getting wisdom teeth pulled kind of thing) is that if they don't do it, the patient will just go to another doctor. But how can you just…

> 2 months worth of oxy for getting wisdom teeth pulled kind of thing Surely this is not the norm? My son had his wisdom teeth out a few years ago, they gave him about a day's worth of hydrocodone and told him to take Tylenol after that. And all the doctors my family has seen for the past couple of decades have been pretty conservative about prescribing anything narcotic for pain.

Both my sister and I received A few days worth of Hydros despite being particularly gentle wisdom teeth removals, in her case eating solid food hours later. I took one and probably didn't even need that. This was a very drug prone and poor area.

If they wanted to, they could have gotten away with "take extra strength Ibuprofen", but what is their incentive to do that? They don't want patients telling the next guy "It hurt a lot" after.

Re: Bleak New Estimates in Drug Epidemic: A Record 72,000 Overdose Deaths in 2017

#147

Post by prolikewh0a »

Someguywhatever wrote: post #105
pjc50 wrote: post #41

Earlier quoted context omitted.

My own preferred hypothesis is that this is the result of despair : https://www.theatlantic.com/health/archive/2017/04/joblessne... Someone will no doubt reply that US unemployment is falling, and therefore so should the opiates crisis, but it's not a simple matter of economics and statistics, it's a question of what people believe about the world and their future in it. Someone who gets a bad, painful job with no ag…

>My own preferred hypothesis is that this is the result of despair I agree with you, I would also throw in nihilism and purposelessness, the general lack of vision for the future from government and elites.

It's an easy out to the reality a lot of people with no economic success or vision for their future because of economic circumstances. The country is really not great for a whole lot of people. 50% of the entire population is poor or low income [1].

[1] https://kairoscenter.org/wp-content/uploads/2017/02/Poverty-...

Re: Bleak New Estimates in Drug Epidemic: A Record 72,000 Overdose Deaths in 2017

#148

Post by glbrew »

akuji1993 wrote: post #2

When I opened this, I thought they meant 72000 on the whole world. Nope, it's just the US. That's an unbelievably high number to me.

It really is huge. It is so high experts describe it as a "demographic change," It is literally changing the demographics and population distribution of the US.

Re: Bleak New Estimates in Drug Epidemic: A Record 72,000 Overdose Deaths in 2017

#149

Post by tigershark »

armitron wrote: post #95
yters wrote: post #73

Earlier quoted context omitted.

The prior question is: what is causing overdoses? My understanding is the opioids are already regulated, controlled, and dosed appropriately, since most are acquired through medical prescription. Why so many overdoses, then? My hypothesis is the drugs are addictive, and it takes more to get the same high each time, which eventually leads to accidental overdose. Additionally, drug use can lead to feeling trapped and h…

Your hypothesis is entirely wrong. Overdoses happen because desperate people get their drugs from the black market where purity fluctuates. Read the article again. Fentanyl getting mixed into heroin, cocaine and methamphetamine. This is what kills people, not some mystical property of "opioids" that makes people consume more and more. The US has a well-documented, multi-year history of legalized Opium (and later) her…

It’s incredible how every time there is a discussion over opioid mortality there are people saying that it is the same as alcohol or tobacco and eulogise the functioning heroin addicts...

Re: Bleak New Estimates in Drug Epidemic: A Record 72,000 Overdose Deaths in 2017

#150

Post by Alex3917 »

toomanybeersies wrote: post #18

As a comparison, the road toll in the USA is 33,000 per year. Firearms kill about the same number (including 20,000 suicides). 3,000 people were killed in the 9/11 attacks. 72,000 overdose deaths is just a staggeringly large number.

> 72,000 overdose deaths is just a staggeringly large number.

It's still only a drop in the bucket compared to overall drug-related deaths though. Tobacco-related deaths alone account for 500k deaths annually, and that's not even counting deaths related to third-hand smoke.

Post reply on HN