My experience of losing a friend to heroin (2020) • Hacker News Board

Re: My experience of losing a friend to heroin (2020)

#491

Post by wespiser_2018 » Mon, Nov 01, 2021, 5:09 AM UTC

Clubber wrote: post #130

wespiser_2018 wrote: post #24

Good write up. The US is really grappling with diseases of despair, and heroin/fentanyl addition is on of the biggest ones impacting the wellbeing of our society. A massive slice of talent and raw human resource is just dying every year, but the solutions that have worked in other countries are just impossible to implement here due because the the methods that are known to work are politically dead on arrival. I'm a…

>It would be extraordinarily expensive I mean we spent $300 million a day for 20 years on Afghanistan, it can't be that expensive. >the Sacklers just walked with no criminal liability In fact, the media firestorm and the political response made heroin overdoses much worse because they "clamped down" on pills that at least had a dosage on it. Addicts then turned to heroin, which now has fentanyl in it.

That's right! in 2011 they switched the formulation of OxyContin. The opiate crisis didn't start then, but it got a whole lot worse!

The Sackler decision had a pretty big effect on me. It's hard not to grow up when I did, lose people you know to the opiate crisis, and not feel a deep sense of unfairness and wrong when the people responsible for so much suffering stay out of jail with a million dollars.

As much as you can blame them for that one act, it's the iron law of drug prohibition at play: Meth becomes Crystal, and opiates become more concentrated. Easier to smuggle, better profit margins, it really only goes one direction: the drugs get more potent every year prohibition is in effect.

Re: My experience of losing a friend to heroin (2020)

#492

Post by wespiser_2018 » Mon, Nov 01, 2021, 5:18 AM UTC

TimTheTinker wrote: post #42

wespiser_2018 wrote: post #24

Good write up. The US is really grappling with diseases of despair, and heroin/fentanyl addition is on of the biggest ones impacting the wellbeing of our society. A massive slice of talent and raw human resource is just dying every year, but the solutions that have worked in other countries are just impossible to implement here due because the the methods that are known to work are politically dead on arrival. I'm a…

> we seem to have this huge moral hang up in the US about giving addicts drugs For many people, what you're describing all comes down to the law of love. It is not loving to give a person more of the thing that is destroying them. Perhaps free methadone would be a better option? EDIT: care to comment? I'd like to know why people disagree.

That's a pretty rudimentary analysis, and the "law of love" doesn't really hold much weight when you start looking at the prognosis for various treatment groups for people with opiate dependency.

It's really the abstinence only attitude I was talking about: why is it a big deal to give someone medication for the rest of their live if we know it will keep them alive, healthy, and allow them to live a fulfilled life? Addiction is just like any other disease, and it turns out medication assisted therapy is very effective.

Methadone works, and so do other medications, but it's only a partial solution. We need a rapid and massive expansion of these programs. We also need programs and medications to target people who go on Methadone, but keep going off. Why not give them Herion, if we can do it safely? What about if there is evidence they can become productive members of society?

Again, it's my view that although people OD from drugs, it's really the prohibition of drugs that are killing people through the incredibly unsafe and unreliable drugs people get. Supervised opiates are not dangerous, and unlike other drugs, cocaine, meth, benzos, you can safely be on them for years at a time nearly no long term effects. At least the long term effects of staying on them pale in comparison to the consequences of an OD.

60,000 people OD per year. What we are doing isn't working!

Re: My experience of losing a friend to heroin (2020)

#493

Post by wespiser_2018 » Mon, Nov 01, 2021, 5:24 AM UTC

somethoughts wrote: post #80

wespiser_2018 wrote: post #24

Good write up. The US is really grappling with diseases of despair, and heroin/fentanyl addition is on of the biggest ones impacting the wellbeing of our society. A massive slice of talent and raw human resource is just dying every year, but the solutions that have worked in other countries are just impossible to implement here due because the the methods that are known to work are politically dead on arrival. I'm a…

It'd be interesting if there were any country wide experiments that are similar to the approach that has been taken with tobacco. Basically legalize it for those over 18, slap it silly with warning labels and then tax the heck out it to make it prohibitively expensive. And raise the tax every year. And then fund ad campaigns and social media campaigns which make it generally look dumb and unfashionable as well as tre…

I'm not so sure about this. The most recent, and best, evidence we have on getting folks addicted to substances better is to put them on a coordinated treatment overseen by doctors and implemented by a variety of different healthcare professionals.

Interestingly, I think if hard drugs were legal, very few people who don't already use them would go out tomorrow and give them a try, "just because", so its' not like we would have a complete societal meltdown if it happened.

I just think the US should look to other countries, and start off by implementing what works there. Even that is radical!

Re: My experience of losing a friend to heroin (2020)

#494

Post by wespiser_2018 » Mon, Nov 01, 2021, 5:36 AM UTC

stef25 wrote: post #124

wespiser_2018 wrote: post #24

Good write up. The US is really grappling with diseases of despair, and heroin/fentanyl addition is on of the biggest ones impacting the wellbeing of our society. A massive slice of talent and raw human resource is just dying every year, but the solutions that have worked in other countries are just impossible to implement here due because the the methods that are known to work are politically dead on arrival. I'm a…

It's a really complicated problem but one thing that just stands out to me is the role the doctors play: It's not normal to send people home with these massive prescriptions for opiates. Here in Europe doctors are very, very conservative with that stuff (and meds in general) while it seems to me that in the US if your "medical experience" even entails the slightest bit of discomfort people get all up in arms over it.…

What's so fascinating to me, is that the current opiate epidemic is largely centered in the US, as we bear the majority of the deaths. That attitude of Drs. over-prescribing, it definitely happened in the US, to various degrees in different places, and not that long ago.

Docs in the US tend to think they are above being marketed to, but Purdue Pharma knew better, and they paid their drugs reps a ton to go out to "everytown US" and convince doctors that they had made a non-addicting opiate. Enough docs bought it, and here we are.

How did they do? Well, 20 years ago drug reps used to be able to take doctors on trips: to sports games, to see the dog races, to museum trips, the price of a day trip with you and one or two loved ones was to sit through an hour (or two) lecture by a rep that convinced you to to prescribe a drug. Not a bad deal!

There were complex reasons why the opiate crisis started, but the environment was ripe for an upstart company like Purdue to come in, reformulate an old opiate, pretend the addiction problem isn't there, then sell a miracle drug because opiates are extremely effective short term analgesics. Long term, we're still paying for it!

I've looked a lot into the opiate crisis, and it's a pretty bad stain on the US medical institution, particularly our medical science. We fucked up.

Re: My experience of losing a friend to heroin (2020)

#495

Post by wespiser_2018 » Mon, Nov 01, 2021, 5:43 AM UTC

skyechurch wrote: post #110

wespiser_2018 wrote: post #24

Good write up. The US is really grappling with diseases of despair, and heroin/fentanyl addition is on of the biggest ones impacting the wellbeing of our society. A massive slice of talent and raw human resource is just dying every year, but the solutions that have worked in other countries are just impossible to implement here due because the the methods that are known to work are politically dead on arrival. I'm a…

>A massive slice of talent and raw human resource is just dying every year, but the solutions that have worked in other countries are just impossible to implement here due because the the methods that are known to work are politically dead on arrival. From the essay, it sounds like Jack was not possessed of any great "talent", or of any particular value as a "raw human resource". He was just a dude, probably easily r…

Sure, maybe one Jack isn't a big deal, but what about 1000 Jacks? How much economic output would 58,000 thousand early deaths be in a year where we have a labour shortage and a supply chain crisis on our hands?

Jack might not be the best example of "raw human talent", but people like him contribute to the economy that are hard to measure, and of equal worth to anyone else.

I'm of the opinion that we shouldn't compare lives, but I guess we could compare economic value, and for the thousands in lost lives, even working the most menial jobs, that's still tremendous worth in a country where our birth rate is shrinking faster than ever.

Re: My experience of losing a friend to heroin (2020)

#496

Post by wespiser_2018 » Mon, Nov 01, 2021, 6:02 AM UTC

scythe wrote: post #118

wespiser_2018 wrote: post #24

Good write up. The US is really grappling with diseases of despair, and heroin/fentanyl addition is on of the biggest ones impacting the wellbeing of our society. A massive slice of talent and raw human resource is just dying every year, but the solutions that have worked in other countries are just impossible to implement here due because the the methods that are known to work are politically dead on arrival. I'm a…

The invisible elephant in the US opioid policy discussion is the lacuna between the policy and its implementation. You have to find a human being to perform the work of enforcing the drug laws. The US has had drug addicts for a hundred years, and the attitude towards opioids hasn't changed very much, but the usage levels go up and down. There's a back-and-forth between "rehabilitation" and " incentivizing" that corre…

I don't disagree with your most of your assessment, except that I do think we should abolish the the DEA. The war on drugs has been going on for 50 years. At some point, we have to admit that drugs won, and address the crisis in the most effective way based on the best, most recent information available to us, which is that addiction is a disease and one that can be effectively managed.

20 years ago, sure, who cares about the DEA, they put dope and guns on the table and largely stayed out of peoples way. Now, we have around 60k thousand deaths per year from the opiate crisis that reaches almost everyone in America. Law Enforcement has no solution, just carry around Narcan while drugs come in through every major port and postal facility in the country.

Let the cops do what they are good at: reduce violence, enforce property rights and keep communities safe, but stay out of healthcare. Give the DEA the best grads, and that won't change the fact that they are working in a system where they simply don't have the power to stop two consenting individuals engage in a prohibited behavior.

Re: My experience of losing a friend to heroin (2020)

#497

Post by galaxyLogic » Tue, Nov 02, 2021, 4:15 AM UTC

taneq wrote: post #364

galaxyLogic wrote: post #219

Earlier quoted context omitted.

I stopped drinking because I realized it kept me from accomplishing things I wanted to accomplish. I think (based on my experience, can't speak for others) it's relatively easy to quit once you know why you want to quit. I don't much regret my drinking days because I had fun and met many people. But then I realized I want to do other things than just get drunk and get a hangover. I think, based on my experience again…

> It's just that you have decided to drink and keep on drinking. It's your choice. That's kind of the dividing line, though, isn't it? If it's your choice and you could choose otherwise, then you're not an alcoholic. Some people don't feel like it's a choice.

I can see one could be in a situation where doing cold turkey might be dangerous so in that situation it might be dangerous to stop. But isn't it still their choice? I know this might get easily into deep thinking of whether we have free will or not, so I'm gonna stop