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

America’s opioid epidemic is worsening

economist.com

Post reply on HN
Print view View original

301–310 of 321 posts

Re: America’s opioid epidemic is worsening

#301

Post by [deleted] »

jessaustin wrote: post #267
mos_basik wrote: post #211

Earlier quoted context omitted.

while we're talking about the orthagonality of people's comments, I have one to contribute! This is the second of your posts I've read in an hour with a b^) (checking your history shows at least one more) and now I'm curious. I've never seen that face before. The first time, I assumed it was a carelessly-executed B^) "2cool4you sunglasses wearer grinning sarcastically," but I guess it's not. My best guess is that it'…

My right eye is missing and I normally wear a patch over that socket. I've used that smiley for decades; my offline friends usually get it but it's understandable that that someone who's never met me would be uncertain...

[deleted]

Re: America’s opioid epidemic is worsening

#302

Post by golergka »

mholmes680 wrote: post #293
golergka wrote: post #270

Earlier quoted context omitted.

> And, now capitalism has made all margins of businesses so slim that there's no real way to enter a business and still have a safety net in case you fail. You either need to disrupt an industry, create a marketplace, find a niche, or fail hard. While this is true, phrasing it like a critique of capitalism seems very, very weird. As if in a socialist or communist society starting a business is supposed to be easier a…

Fair enough, I think I mean distribution of wealth. Capitalism is VERY good at moving money up. But, lately, in America, there's been not enough ways to get money going back down.

> Capitalism is VERY good at moving money up.

You're phrasing it as if you're comparing it with something. Have you ever lived in a communist country? I have yet to see a "redistribution of wealth" system that actually distributes more wealth than it lives for itself.

Re: America’s opioid epidemic is worsening

#303

Post by M_Grey »

chillydawg wrote: post #277
M_Grey wrote: post #203

Earlier quoted context omitted.

Up to a point, yes. Then it becomes a mess for everyone.

If there's more crime, that means you can shout louder about law and order next election cycle. It doesn't matter that the crime was your fault and that you're going to make it worse. What matters is that you buy the police more guns and shake hands with local police chiefs a lot.

Eventually you end up facing a guillotine.

Re: America’s opioid epidemic is worsening

#304

Post by thomasz »

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?

> The same argument could be made for bank and home invasion robbers - if money were freely available she of the violence would go away.

You say that as if it's a completely crazy line of thought. Social Security works. It's cheaper than prison, too.

Re: America’s opioid epidemic is worsening

#305

Post by tylersmith »

cmdrfred wrote: post #188
tylersmith wrote: post #177

Earlier quoted context omitted.

I've been taking opioids for nearly a year and they still work fine. Not sure how long-term you mean.

Stop taking them for a few days and you'll see what I mean. Many studies have shown that patients who do not consume opioid medications have better long term outcomes than those who do. It simply isn't effective in managing pain long term, and also is not indicated for use in that manner.

When I stop taking them I'm in pain again. I think what you're trying to get at is the opioids don't solve the underlying problem. But to say they're not effective for managing pain is wrong. I use them to manage pain every day. I get regular steroidal-epidural injections to solve the issue.

Re: America’s opioid epidemic is worsening

#306

Post by refurb »

ucaetano wrote: post #196
refurb wrote: post #190

Earlier quoted context omitted.

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 inflamma…

Thanks for digging up the references. My only thought is there is evidence that the peripheral effect is either weak or non-existent. Loperamide is a great example. mu-opioid agonist that doesn't penetrate the brain-blood barrier. Will constipate you (by acting on GI opioid receptors), but has no analgesic effect.

Re: America’s opioid epidemic is worsening

#307

Post by oxide »

distances wrote: post #294
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.

> Amphetamine will be abused by college students. I found this a very peculiar claim. Is amphetamine misuse in colleges a big thing in the US? Edit: never mind, I see this was already discussed.

Yeah, it's all over. Prescription stimulants get diverted, resold at a markup, etc.

The demand is high and the supply is there. Low doses of oral methamphetamine arent entirely uncommon either. Meth is cheaper, more potent and more widely available.

Re: America’s opioid epidemic is worsening

#308

Post by runamok »

magic_beans wrote: post #271
trome wrote: post #256

Earlier quoted context omitted.

Uhh, hate to break it to ya, but even with insurance its not all roses and sunshine in the USA, you can easily go 6 months waiting for a knee replacement here. Watched a family member go through 4 over the past decade, and its a slow process no matter the insurance provider. Plus, hospitals here on the West Coast have amped up doing a bunch of skeezy stuff recently, you could easily end up with a non-functional leg a…

How does one person need 4 knee replacements in 10 years?

Because American health care payments are based on quantity and not quality? ;-)

Re: America’s opioid epidemic is worsening

#309

Post by pnathan »

programmarchy wrote: post #236
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…

Have you heard of the Rat Park study? It attributed addiction to living conditions (e.g. rats in "Rat Park" had less addicts than rats in laboratory cages) rather than addictive properties of the drug. For humans, I think it goes beyond physical living conditions, and into the mental realm. A perhaps related topic is Attachment Theory [2] which models interpersonal relationships imprinted on children by primary careg…

I'm familiar with both. Generally I don't think either of the conclusions/theories they establish are supported by history and the breadth of human culture, even today. Attachment theory is particularly notorious for being misunderstood.

Re: America’s opioid epidemic is worsening

#310

Post by goatsi »

DanBC wrote: post #280
goatsi wrote: post #181

Earlier quoted context omitted.

Artificial cannabinoids are also highly used in homeless populations because of how cheap and powerful they are. https://www.vice.com/en_ca/article/synthetic-weed-is-a-scour...

Sure, but that's the US, not the UK.

The vice video rwmj posted is all about homeless spice users in the the UK.
Post reply on HN