America’s opioid epidemic is worsening • Hacker News Board

Re: America’s opioid epidemic is worsening

#241

Post by edblarney » Tue, Mar 07, 2017, 9:11 AM UTC

tptacek wrote: post #30

padobson wrote: post #12

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 expensi…

In Canada they are very strict.

After a minor operation I got exactly one oxycontin pill :)

Re: America’s opioid epidemic is worsening

#242

Post by mirimir » Tue, Mar 07, 2017, 9:39 AM UTC

tptacek wrote: post #30

padobson wrote: post #12

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 expensi…

That's not really a counterargument. Sure, Purdue and other opiate pushers got people addicted, and tweaked distribution to get around regulation. Then governments freaked, and locked down prescription opiates. So addicts have turned to heroin. But they're naive about heroin, so they tend to fuck up and overdose. And then there's the problem that dealers boost unpredictably with Fentanyl. And about user violence, you don't want hungry junkies around. They will do whatever it takes.

Re: America’s opioid epidemic is worsening

#243

Post by cryptarch » Tue, Mar 07, 2017, 9:42 AM UTC

dep_b wrote: post #169

cryptarch wrote: post #110

Earlier quoted context omitted.

Magic truffles have the same effects as magic mushrooms and are legal. Magic mushroom products are still sold at some smartshops, but not legal. Weed is not legal, but you can buy it in dispensaries ("koffieshops") and carry up to 5 grams without being fined or arrested. You can smoke publicly as long as you're not bothering anyone (like with alcohol). I think that's pretty sweet. You can have up to 5 plants at your…

> You can have up to 5 plants at your home I think that's an urban myth actually. I know people that got kicked out of their house for having just three plants just growing outdoor so no tampering with electricity or fire risk. They used to be more lenient but people tended to burn their house down with illegal indoor plantations. It's weird how in a liberal country like The Netherlands where everybody wants full leg…

That sounds like a renters' agreement thing? Here's what the police says themselves on the matter:

https://www.vraaghetdepolitie.nl/drank-en-drugs/drugs-en-str...

So it's not legal but if you have at most 5 plants and let them be taken away you won't be prosecuted.

Re: America’s opioid epidemic is worsening

#244

Post by seanp2k2 » Tue, Mar 07, 2017, 9:43 AM UTC

pfortuny wrote: post #227

peteretep wrote: post #224

Earlier quoted context omitted.

> the healthcare is free and high-quality > Pretty much like the rest of fantasy > Europe. Isn't high-quality healthcare that's "free at the point of use" available in most of real Western Europe too?

Well, as long as you are willing to wait about six months for knee surgery, yes, it is free. Or for any other type of intervention.

Vs in the US where specialists just tell you that your problems are chronic, are pre-existing so not covered by insurance, and that nothing can be done for you.

Re: America’s opioid epidemic is worsening

#245

Post by mirimir » Tue, Mar 07, 2017, 9:44 AM UTC

dep_b wrote: post #64

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.

Addicts in The Netherlands get free heroin. Without the daily hustle to find the next high people have time to think instead. A lot of them find the peace to actually quit. Actually it's really hard to keep the program going as the government doesn't like to be associated with free heroin.

Saying "next high" is just wrong. It's avoiding withdrawal aka your own personal hell.

Re: America’s opioid epidemic is worsening

#246

Post by simonh » Tue, Mar 07, 2017, 9:49 AM UTC

djrogers wrote: post #168

delhanty wrote: post #59

Earlier quoted context omitted.

Isn't there something in common there: drug dealers make money pushing heroin etc. and (some) doctors make money pushing Oxycontin? Maybe if all these drugs were freely available at least some of the violence would go away and the incentives to push them would go away too ...

The same argument could be made for bank and home invasion robbers - if money were freely available she of the violence would go away. The question is, what costs (both financial and societal) are we willing to bear to support addicts?

What costs (both financial and societal) are we willing to bear to support the complete and utter failure of the 'war on drugs'?

Re: America’s opioid epidemic is worsening

#247

Post by codecamper » Tue, Mar 07, 2017, 10:15 AM UTC

johan_larson wrote: post #122

devopsproject wrote: post #16

Earlier quoted context omitted.

Here are some alternative facts. Red means bad: https://www.brighthearthealth.com/wp-content/uploads/OpioidA...

Wonder why the northern great plains are so resistant to this problem?

It's too cold, your veins just disappear.

Re: America’s opioid epidemic is worsening

#248

Post by noir_lord » Tue, Mar 07, 2017, 10:16 AM UTC

peteretep wrote: post #226

zkms wrote: post #212

Earlier quoted context omitted.

> Maybe the answer isn't to make heroin available OTC at Walgreens Actually, in UK you can get actual opioids (as co-codamol) behind the counter, without a prescription. Funny how they don't seem to have a disastrous and deadly opioid epidemic like the US has. I'd so much rather live where people can get cheap pharmaceutical grade heroin at the pharmacy than where people who need opioids end up smashing windows to st…

> Actually, in UK you can get actual > opioids (as co-codamol) behind the > counter, without a prescription. > Funny how they don't seem to have a > disastrous and deadly opioid epidemic > like the US has. Cocodamol is 8mg of codeine to 500mg of paracetemol. To get 240mg of codeine -- equivalent to 10mg of oral oxycodone -- you'd need to take 30 cocodamol pills, which is 15g of paracetemol. If you present at a hospit…

You can buy 32x12.8mg codeine/200mg ibuprofen for ~6 quid at boots.

While large amounts of ibuprofen aren't great for your stomach they won't kill you as fast as paracetamol.

All that assumes you aren't doing a cold water extraction.

Re: America’s opioid epidemic is worsening

#249

Post by grondilu » Tue, Mar 07, 2017, 10:44 AM UTC

> The opioid epidemic has its roots in the explosive growth of prescription painkillers. Between 1991 and 2011, the number of opioid prescriptions (selling under brand names like Vicodin, Oxycontin, and Percocet) supplied by American retail pharmacies increased from 76m to 219m. As the number of pain pills being doled out by doctors increased, so did their potency. In 2002 one in six users took a pill more powerful than morphine. By 2012 it was one in three.

I find this absolutely outrageous. I'm not American, but I stumble upon articles mentioning this, and I do watch enough American TV series and movies to have an idea of how acute the problem is (it's crazy how often in TV series doctors seem to give pain killers like it's candy).

I have the impression that in Europe, painkillers are much less used but I would not be surprised if the American trend were to contaminate medical practice here.

Pain is a minor consequence of disease or trauma. Pain won't kill you, so why would you risk become addicted to very dangerous drugs just to relieve it?

Re: America’s opioid epidemic is worsening

#250

Post by pjc50 » Tue, Mar 07, 2017, 10:54 AM UTC

grondilu wrote: post #249

> The opioid epidemic has its roots in the explosive growth of prescription painkillers. Between 1991 and 2011, the number of opioid prescriptions (selling under brand names like Vicodin, Oxycontin, and Percocet) supplied by American retail pharmacies increased from 76m to 219m. As the number of pain pills being doled out by doctors increased, so did their potency. In 2002 one in six users took a pill more powerful t…

> Pain is a minor consequence of disease

There speaks someone young and healthy. Some conditions are extremely painful in the long term.

"It is estimated that more than 100 million people suffer from chronic pain in this country,[11] and for some of them, opioid therapy may be appropriate. The bulk of American patients who need relief from persistent, moderate-to-severe non-cancer pain have back pain conditions (approximately 38 million) or osteoarthritis (approximately 17 million)."

Source: https://www.drugabuse.gov/about-nida/legislative-activities/...

"aggressive marketing by pharmaceutical companies"

"United States their biggest consumer globally, accounting for almost 100 percent of the world total for hydrocodone (e.g., Vicodin) and 81 percent for oxycodone (e.g., Percocet)"

That does make it sound like a problem created by pharma drug pushing on TV. But that doesn't mean the pain isn't real either.

Really the whole thing needs to be seen as a widespread public and social health problem - which is exactly the sort of thing the US system is set up to avoid seeing. Healthcare is not just a matter of individual responsibility or a contract between someone and their employer.