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America’s opioid epidemic is worsening

economist.com

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Re: America’s opioid epidemic is worsening

#191

Post by stagbeetle »

DanBC wrote: post #142
microtherion wrote: post #127

Earlier quoted context omitted.

> too many people are non-functional opioid addicts Experience here in Switzerland would suggest that if the state takes dirty needles, expensive supply, and highly variable purity out of the equation, opioid addicts can lead a life that is, while far from ideal, considerably more functional than before. My impression is that drugs like Heroin, taken in correct dosage, do not inherently cause massive health damage. I…

> It's not clear how deregulation would work with drugs like meth, which DOES seem to inherently cause health damage. Pure clean meth causes harm. Dirty street meth obtained using the methods addicts use would be more harmful to the addict and to society.

There is prescription meth called Desoxyn.

Re: America’s opioid epidemic is worsening

#192

Post by Clubber »

glangdale wrote: post #102
Clubber wrote: post #88

Earlier quoted context omitted.

Where do you see any evidence of that?

Everywhere. I don't know if you were around in the 80s and 90s but the contrast in rhetoric about drug use is amazing. Both sides of politics were tripping over themselves to be tougher on drug crime back when it was perceived as a non-white problem. http://www.pbs.org/newshour/bb/there-was-no-wave-of-compassi... This not to say that harm minimization is now successfully mainstream, but the shift in attitudes and rhe…

I was, and I think the penalties and number of people in "the system" for drug offenses is significantly higher than it was in the 80s and 90s. We now have more people (not percentage of people) incarcerated than any other country, even China. The rhetoric may be softer, but I don't think the judges are.

Here is a year over year incarceration map.

http://www.businessinsider.com/how-the-war-on-drugs-changed-...

Here's prison population by country:

http://news.bbc.co.uk/2/shared/spl/hi/uk/06/prisons/html/nn2...

Incarcerate is the only hammer many of our state governments will even consider using for most social problems.

Re: America’s opioid epidemic is worsening

#193

Post by stagbeetle »

ucaetano wrote: post #48

And a potential solution to it: https://arstechnica.com/science/2017/03/tweaking-fentanyls-c... For their chemical makeover, the researchers noted that when tissue is damaged and hurting, it becomes inflamed and more acidic. The pH drops from approximately 7.4—what’s seen in normal, healthy tissue—to between 5 and 7. Fentanyl can work regardless of the pH, so it’s active throughout the nervous system no matter what.…

> But, if it was altered to only work at the lower pH, then it could target just the pain source at the peripheral nerves, the researchers hypothesized.

Do you know how this interacts with anti-inflammatory drugs?

Re: America’s opioid epidemic is worsening

#195

Post by kilroy123 »

maxerickson wrote: post #135
kilroy123 wrote: post #125

My sister is a heroin addict. To say this has devastated her life is an understatement. Her body is wrecked. She looks way older than she is, she has a pacemaker / defibrillator installed in her chest. And doctors keep saying she will die soon if she doesn't stop. Here is the most frustrating part. She has wanted to go to rehab a few times, but since she is poor and unemployed, she has no health insurance for rehab.…

Is Medicaid an option?

Sadly she only has Medi-Cal. Which only covers care for when she is detoxing. No rehab.

Re: America’s opioid epidemic is worsening

#196

Post by ucaetano »

refurb wrote: post #190
ucaetano wrote: post #48

And a potential solution to it: https://arstechnica.com/science/2017/03/tweaking-fentanyls-c... For their chemical makeover, the researchers noted that when tissue is damaged and hurting, it becomes inflamed and more acidic. The pH drops from approximately 7.4—what’s seen in normal, healthy tissue—to between 5 and 7. Fentanyl can work regardless of the pH, so it’s active throughout the nervous system no matter what.…

But, if it was altered to only work at the lower pH, then it could target just the pain source at the peripheral nerves, the researchers hypothesized. It's been a while since I took a pharmacology class, but opioids work centrally - that is, the pain relief is due to their action in the brain. That's why an opioid like loperamide (can't cross the CNS barrier) doesn't have an analgesic effect, only constipating. If fe…

It seems opioids work centrally and peripherally.

From WP:

Opioids act by binding to opioid receptors, which are found principally in the central and peripheral nervous system and the gastrointestinal tract.

Recent investigations discovered opioid receptors on peripheral sensory neurons.A significant fraction (up to 60%) of opioid analgesia can be mediated by such peripheral opioid receptors, particularly in inflammatory conditions such as arthritis, traumatic or surgical pain. Inflammatory pain is also blunted by endogenous opioid peptides activating peripheral opioid receptors.

Here are some of the studies mentioned:

* https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4565585/

* https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4173362/

* http://www.nature.com/nm/journal/v9/n8/full/nm908.html

PS: I have no idea of what I'm talking about, just doing some basic research, so take it all with a lot of salt.

Re: America’s opioid epidemic is worsening

#197

Post by cmdrfred »

thearn4 wrote: post #185
devopsproject wrote: post #29

Earlier quoted context omitted.

Mostly wrong. Pills were given out like candy, then restricted which caused demand for cheaper alternatives. Had the drug companies been regulated in the first place, we might be OK. The pills aren't coming from mules or cartels, they are coming from US companies. The pill supply has to lowered. edit to add: http://www.latimes.com/projects/oxycontin-part1/

> Had the drug companies been regulated in the first place Were they given out without prescription? If not, I feel like MDs have to share some blame on this.

MD's are often compensated based on patient assessments. "Rate your doctor" sort of things. How do you think opioid addicts rate doctors who tell them they have had enough?

Re: America’s opioid epidemic is worsening

#198

Post by parr0t »

I'll never understand locking people up for having an addiction and treating them like criminals. I'm not too educated on how it's handled in America but in Australia you can go to your doctors and get signed up to a methadone program without worrying about any legal repercussions.

My fiancé works at a pharmacy in Melbourne, Australia and says some of the most lovely and friendly people who just want to get themselves together come in regularly to get their $5 dose and it's saddening to see how badly society judges them.

Re: America’s opioid epidemic is worsening

#200

Post by astrodust »

dsmithatx wrote: post #67
jbooth wrote: post #51

Earlier quoted context omitted.

If you give them free H, they'll be a lot less desperate and a lot less violent, presumably. And.. why not? I've got multiple friends in my age group prematurely dead from overdose. It's not like prohibition is accomplishing anything.

Checkout Denmark. They had a huge problem with robberies and started giving legal pure Heroin shots to users. They also helped them find jobs. No more deaths and no more black market for Heroin. Hence burglaries also went away. It looks like our current President is looking at cracking down on pot again though so, I don't imagine we'll have a sensible drug policy anytime soon. Only one motivated by profits.

Some supervised injection sites are also able to test the drugs to make sure they're not adulterated in some way that could be harmful. That means fewer trips to the emergency room, less police paperwork, not to mention there's an opportunity to mitigate drug use with therapy and treatment.
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