America’s opioid epidemic is worsening • Hacker News Board

Re: America’s opioid epidemic is worsening

#281

Post by senorjazz » Tue, Mar 07, 2017, 1:22 PM UTC

goatsi wrote: post #167

pnathan wrote: post #146

Earlier quoted context omitted.

I'm kind of interested in the funnel prior to the addiction. How to make heroin etc uninteresting ...

Heroin clinics can be very helpful for that. By providing the heroin and requiring that it be used on site they take it out of the community. Nobody sees their friends using and gets offered a bit to try. Starting drug use is often a very social phenomenon, generally people are introduced to them by friends. From a study on the Swiss clinics [0] >*New Use Rates: Slightly lower than expected. 1) As reported in the Lan…

I think this is mostly it. There are no new drug users coming up. Those you are addicted are maintained, those who are not too far gone are helped to reduce (most at this stage probably want off and they can see how it has destroyed / is destroying their life but don't know how)

As the market is disrupted, dealers move onto other drugs as there is no profit there, so is not so easy to find any more on the illicit market.

The situation is different to the US, whose current problems seem to be mostly from over prescription of pain pills, then when that was closed the flooding of the country with heroin and fentanyl to an already addicted population.

Purely anecdotally, the US does / did seem to prescribed lots more pain meds than any other country. When I used to use drugs (recreationally) and frequent drug forums in the early 2000s pain pills were regularly mentioned by those who used drugs recreationally for parties and were mentioned the same as party drugs, whereas in Europe they did not exist (outside the heroin scene).

Now, I live in tropical South Amercia, ,where quite a few US based expats move to each year, one of the biggest problems they have is getting their medication here. A large percentage are on a huge amount of strong medication. The expats from Europe are not. I don't think the lifestyle back home was that different, I don't think US people feel pain more than others, just that the Drs prescribe lots and lots of medication. Or perhaps European Drs just under prescribe due to public health systems and not wanting to fund the medication. Or perhaps the counter, there is more profit for the US Drs to prescribe more. Whatever the cause, there is a vast difference between the two

Re: America’s opioid epidemic is worsening

#282

Post by senorjazz » Tue, Mar 07, 2017, 1:25 PM UTC

DougN7 wrote: post #19

pnathan wrote: post #10

So what is the answer here? Like another poster said, there's a demand problem. How do we as a society address this? I've seen a lot of mumbles about dealing with supply problems, dealing with overdose problems, but it'd be good to head the problems off at the pass before they descend into major trouble. I should also note, this is a burgeoning problem in the Puget Sound/Seattle region. It's not just rural people dyi…

Preventing that first time is probably the secret. It's got to be so much harder to resist once you know what you're missing. And it's not like you're rational about it and considering long term consequences when you're confronted with a second opportunity. Unfortunately, we live in a society where it's all good, live free, don't judge, do what feels good, etc. That leads to things that feel extremely good... I'm gra…

Not at all. The first time you use heroin it is nothing special. If it is strong, you will vomit, a lot.

The high isn't even that great. If you are in pain when you take it, then sure. If you are dope sick from other opiates, then sure.

Addition to opiates doesn't happen from that first hit, it takes effort and dedication. You need to be using multiple times, daily for over a week before you'll get sick and even then it won't be so bad.

Re: America’s opioid epidemic is worsening

#283

Post by mattbrewsbytes » Tue, Mar 07, 2017, 1:26 PM UTC

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.…

An idea to help with this would be to call your senator/congressperson and ask that mental health and drug rehab be added to affordable care act. I'm not sure if that type of coverage is there but if they can get it added to the revamped legislation then maybe people in your sisters situation would have some avenue of hope.

Re: America’s opioid epidemic is worsening

#284

Post by joosters » Tue, Mar 07, 2017, 1:33 PM UTC

zkms wrote: post #212

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…

> 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.

Because it is sold over the counter, buyers have to first talk to a pharmacist to get it. This will likely involve discussing what you're suffering from, so that the assistant is sure that what you're buying is appropriate. Finally, they aren't going to sell you ten packets of pills at once, you'll get just one pack containing a few pills.

So, to get an addict's amount of codeine, you're going to have to visit all the pharmacies in town and give each of them a story about terrible dental pain or some such rubbish. It's just not going to be practical.

Re: America’s opioid epidemic is worsening

#285

Post by disgruntledphd2 » Tue, Mar 07, 2017, 1:33 PM UTC

DanBC wrote: post #89

oxide wrote: post #40

Earlier quoted context omitted.

I've gone ahead and edited my comment, not because of your comment, but just because I felt like I wasn't making a clear point. Kratom is not even mentioned anymore, sorry. While kratom is habit forming and can "fuck you up" if you have no tolerance, the true value is for the person already addicted to opiates looking to get clean. If you want to keep drugs out of the hands of kids, make them all legal and watch the…

> If you want to keep drugs out of the hands of kids, make them all legal and watch the usage numbers fall. Doesn't the UK experience with alcohol counter this? (I am strongly in favour of legalisation of all drugs).

I don't think so, as the Economist believe that that event occurred in 2006 (http://www.economist.com/node/3536168) and consumption fell from then until 2013 http://www.ias.org.uk/Alcohol-knowledge-centre/Consumption/F...

The extent to which this can be said to be driven by changes in the licensing regime versus changes in the population structure can't really be determined from this data.

Re: America’s opioid epidemic is worsening

#286

Post by hvidgaard » Tue, Mar 07, 2017, 1:35 PM UTC

ekianjo wrote: post #279

hvidgaard wrote: post #233

Earlier quoted context omitted.

There is a 3 month gurantee. If they have not diagnosed you, and started treatment within that periode, you're free to go to a private clinic or hospital, free of charge.

for certain conditions 3 months wait can be very serious.

Yes, but this is a general trentment gurantee. If you get cancer the times have to be shorter, and are shorter usually messured in weeks. It's better but still not good. If there is suspected cancer, you should get diagnosis started the same or next day, and treatment/surgery within a week.

Re: America’s opioid epidemic is worsening

#287

Post by cryptarch » Tue, Mar 07, 2017, 1:41 PM UTC

dep_b wrote: post #261

cryptarch wrote: post #243

Earlier quoted context omitted.

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.

So you can't have any plants at all but if you have more than five you will always be persecuted. Perhaps the renter that got kicked out had violated some kind of agreement. It was social housing though, which is really common in The Netherlands, so I imagine a lot of people are facing the same problem.

Yeah, but why would the police ever see your plants at all?

Also keep in mind that the police in the Netherlands is not as trigger happy as American police by a long shot. You're not getting swatted for having a few plants because our police is not militarized at all, we have a separate branch of LE that does riots and SWAT-like tasks and they're mostly used for large drug operations and soccer riots.

AFAIK as long as you're not using high-powered lighting (and not the modern LEDs or sunlight), tapping the neighbors' electricity and therewith creating a fire hazard you're fine.

Plantations are usually found either by the electricity company or because a helicopter with IR vision (or regylar vision on a snowy day) happens to find a house with an unusually hot roof.

Re: America’s opioid epidemic is worsening

#288

Post by pjc50 » Tue, Mar 07, 2017, 1:42 PM UTC

foldr wrote: post #264

oxide wrote: post #117

Earlier quoted context omitted.

Amphetamine will be abused by college students. Alcohol will be abused by highschool kids. It's a given. The allure of stuff like cocaine, with the "what else was I lied to about, what am I missing out on" mindset goes out the window when you stop lying and start letting people make their own choices.

>Alcohol will be abused by highschool kids. It's a given But in the UK it's not even regarded as "abuse". It's perfectly normal for 15 year olds to drink alcohol with their friends. (And not against the law, if they are doing it in private.) There may be benefits to legalizing drugs, but the idea that it will reduce usage of them is a fantasy.

It's in that strange area between normal and looked down on that depends on the class background of the observer. It is a problem, but a slowly declining one: http://www.bbc.co.uk/news/health-31452735

And it seems that US drug legalisation has resulted in small decreases of use: https://www.scientificamerican.com/article/colorado-s-teen-m...

The only thing that's clear is that viewing drug and alcohol usage strictly as a crime problem rather than a health one doesn't work.

Re: America’s opioid epidemic is worsening

#289

Post by mtanski » Tue, Mar 07, 2017, 1:43 PM UTC

gozur88 wrote: post #130

mmanfrin wrote: post #31

Earlier quoted context omitted.

The root cause was the never-allow-pain mantra of the 90s when it came to proscribing painkillers like Oxy; this was followed years later by a later tightening of prescription policy that led many to look to Heroin as an alternative.

You have to understand the context of what you call "the never-allow-pain mantra". The drug warriors had gotten us to the point where you couldn't get treatment for pain. Doctors were harassed out of prescribing opiates and would give you Tylenol for back surgery. People in hospice were allowed to spend their final days in terrible pain. And now we're heading back in that direction. For some reason we can't seem to s…

> For some reason we can't seem to stop in the middle somewhere.

After observing this country 20+ years I have concluded that extremes rule. Nothing ever ends up done via a measured and calculated approach, always extremes. You can see that in politics, economic distributions, rules and lack of there of (deregulation). It's not just today; I've been reading a fair amount of history and it's like in the DNA of the country.

Re: America’s opioid epidemic is worsening

#290

Post by mholmes680 » Tue, Mar 07, 2017, 1:43 PM UTC

glangdale wrote: post #97

mholmes680 wrote: post #41

Earlier quoted context omitted.

I think its more dissatisfaction with life in general, with unemployment maybe being one of many triggers. You're probably right about addressing at the demand level. But, I see the problem being more societal - think no one really understands everything. You take away self-reliance of people (whether they realize it or not) at many levels... its cheaper to get some good-enough quality food at 13 places near my home,…

Postman's book is now 32 years old! I read it as a teenager, which dates me... I'm not sure about the Amusing Ourselves To Death stuff or the tut-tutting about cooking and gardening, but overall, though, I think you're on the right track. I'm sure that between automation of both manufacturing and services, big-box retailers and the fact that the covering of the 'long tail' is done very well by web-based business. It'…

>>cooking and gardening

two examples of many, admittedly probably too personal. Others: technology obsolescence, and the move toward not actually OWNing anything so nothing to learn to repair.

>>If you even half-believe the 'technological unemployment' worry, the scary part is that the non-automatable jobs that involved providing goods and services to those displaced by technology will also suffer.

Yes... My context is now that as a parent, I'm seeing windows closing for the kids' future that I had. I mean programming (maybe; I hope) and robot repair will be very lucrative. So will professions like plumbing and electricians.