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America’s opioid epidemic is worsening

economist.com

21–30 of 321 posts

Re: America’s opioid epidemic is worsening

#21
In the UK it appears that there's a Spice epidemic. It's often called "synthetic cannabis" or "(formerly) legal highs", but it in reality it's all kinds of research chemicals sprayed onto leaves to be smoked. It has some pretty hideous side effects, and seems very addictive (https://video.vice.com/en_uk/video/the-hard-lives-of-britain...)

Oh, and the government just handed the whole market over to illegal drug dealers, with fairly predictable results.

Re: America’s opioid epidemic is worsening

#24
Maintenance treatments with long-acting opioids like methadone tend to come with a withdrawal that lasts for months.

Meanwhile, short-acting opiates like heroin have a withdrawal period that lasts about a week. Is it any wonder methadone patients switch back to heroin when they try to quit for good?

Mark my words, this isn't going away or getting any better. You can prosecute doctors, regulate all you want, burn fields of poppies. None of it will affect the demand nor the supply. You can't price or regulate someone out of an addiction.

If people get cut off wholesale from their prescriptions because doctors are being prosecuted for prescribing pain medication, they'll turn to heroin. Which will be available, regardless of all the opium seized, regardless of cartels dismantled.

Just like when Oxycontin went under a formulation change making it resistant to abuse, which also caused the price to spike to a dollar per milligram.

People turned to heroin because it was cheaper, more potent, and much more widely available than pharmaceuticals could ever be.

If you think pill junkies are bad, wait until you look down an alley to see a heroin junkie injecting another junkie in the jugular because all her veins are blown out. Watch your step, though, lest you get a syringe in your foot.

Re: America’s opioid epidemic is worsening

#25

I live in Trumbull County in Ohio, the dark red county in North East Ohio. We recently had 23 (non-fatal) overdoses in a two-day period[0]. That's roughly .01% of the county's total population - so yeah, it's getting bad here. There were recently two shootings within a mile of my house. Several people dead. Both shootings were drug related. I can't help but look around and believe that the needs these folks are tryin…

In The Netherlands, supervised injection sites exist for ~30 years now. Also, The Netherlands provide methadone.

It seems to have worked / be working. Our heroine epidemic is far behind us, the addicts are dying out.

Re: America’s opioid epidemic is worsening

#26

I live in Trumbull County in Ohio, the dark red county in North East Ohio. We recently had 23 (non-fatal) overdoses in a two-day period[0]. That's roughly .01% of the county's total population - so yeah, it's getting bad here. There were recently two shootings within a mile of my house. Several people dead. Both shootings were drug related. I can't help but look around and believe that the needs these folks are tryin…

My understanding is that the reintroduction of prescription opioids is a major source of new addicts. Once the prescription lapses, people have often become addicted and seek out other sources.

It's clear that we need to do a lot more to help these problems, as you suggest. We can also do a lot to keep people from getting addicted in the first place, by choosing (and regulating) better options for pain relief.

Re: America’s opioid epidemic is worsening

#27
I _wondered_ what the political & law enforcement community was going to do, with the clear failure of the War on Drugs and growing demands for legal marijuana.

Never fear! Here's the latest Demon Drug, which we can use to whip up popular support for another round of failed prohibition-mentality policies. No need to worry about budget cuts, reduction in the availability of military weapons, drones, etc. to law enforcement. There will still be a viable career in persecuting some of the most vulnerable members of society.

Those in favour of harm minimisation need to fight for legalisation, or at the very least decriminalisation as a strating point. Not just for _their_ favourite drug, but for those causing the most harm right now.

Re: America’s opioid epidemic is worsening

#28

Hard to believe there is really an "epidemic" beyond typical fearmongering and political noise. People have always used drugs, this is nothing new. Unfortunately all the hype and noise is having significantly negative consequences to the medical community, doctors, and patients who actually need these things.

'People have always done x' is the stupidest response possible to this sort of problem. Of course people have always done drugs, but the RATIO of people doing them to not fluctuates. There is a huge difference between 1% of the people doing opiates and 100% of the people, and to act like there isn't is disingenuous and dangerous.

Re: America’s opioid epidemic is worsening

#29
post #20

Earlier quoted context omitted.

> Fighting the "epidemic" at the supply level seems like a losing battle Kermit, West Virginia. Population 392. They received over 9 million hydrocodone pills in a two year period. In a 6 year period, the entire state of WV received 780 million pills. Over 400 pills for every man, woman, and child living in WV. Seems like attacking the supply is great place to start. WV doesn't need this many pills.

> Seems like attacking the supply is great place to start. That is what was done, transferring the demand to heroin as opposed to oxy. Also, focusing on the supply side of things is the last 30 years of US policy: it's not worked effectively, and has a concomitant effect of incentivizing black market dealers to be wealthy and power. It'd be better to sell OTC heroin than to fund violent gangs, just in the name of lim…

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/

Re: America’s opioid epidemic is worsening

#30

I live in Trumbull County in Ohio, the dark red county in North East Ohio. We recently had 23 (non-fatal) overdoses in a two-day period[0]. That's roughly .01% of the county's total population - so yeah, it's getting bad here. There were recently two shootings within a mile of my house. Several people dead. Both shootings were drug related. I can't help but look around and believe that the needs these folks are tryin…

Isn't the counterargument to this to point out the Oxycontin abuse epidemic? Doctors are prescribing years worth of opiates to patients. There have been suggestions that Purdue Pharma's formulation of Oxy practically guarantees dependence, because of the way it's dosed. Are the people dying of heroin overdoses in white rural Ohio starting on heroin, or transitioning to it after prescription opioids become too expensive?

Sam Quinones suggests that the actual trade in Mexican heroin is distinctively less violent than in other drugs; there's a pipeline of supply and distribution designed to be low-key and customer-service driven. If violence is coming from addicts and not from suppliers, increasing supply isn't going to make those people any less desperate or violent.

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