FDA advisers recommend approval of over-the-counter naloxone(statnews.com)
statnews.com
FDA advisers recommend approval of over-the-counter naloxone
https://www.statnews.com/2023/02/15/naloxone-otc-opioisa-fda-panel-recommends/
161 comments
The number of opioid deaths in the USA is crazy! The article says that the number of overdose deaths is 110,000 per year. The EU has 1.5 times as many inhabitants as the US and has only 5000 drug related deaths per year!
> The article says that the number of overdose deaths is 110,000 per year.
For comparison NHTSA recorded just under 43,000 car accident deaths in the US in 2021. That’s also very close to the 2020 death by suicide number of 45,000.
That’s 25% more opioid deaths per year than our both cars and suicides COMBINED.
In fact we could add in the 19,000 Americans who were killed with guns in homicides in 2020.
Cars + Gun Homicides + Suicides = 107,000. Still less than opioid deaths by a few thousand.
It’s bad out there.
For comparison NHTSA recorded just under 43,000 car accident deaths in the US in 2021. That’s also very close to the 2020 death by suicide number of 45,000.
That’s 25% more opioid deaths per year than our both cars and suicides COMBINED.
In fact we could add in the 19,000 Americans who were killed with guns in homicides in 2020.
Cars + Gun Homicides + Suicides = 107,000. Still less than opioid deaths by a few thousand.
It’s bad out there.
Keep in kind, some of the opioid deaths are effectively suicide. They might not be classified as such but rest assured plenty of those people reach their limit and take their own lives.
So yeah, it's *really* bad out there.
So yeah, it's *really* bad out there.
We’ve all heard for many years how horrible the opioid crisis is. I’ve probably heard that 110,000 number at some point. But without putting it in context of the big (non-medical) causes of death it’s hard to understand just how crazily big that number really is.
Are Americans just permanently zonked on powerful prescription painkillers 24/7? Hard to understand how doctors are legitimately prescribing enough of this medicine to kill this many people.
I don’t mean to be a bummer, but walking around a Walmart in a lower income area shows you just how bleak the situation is in the United States.
My wife and I recently went to a Walmart near a “not good area” and it was depressing. Just about everyone was overweight. Many were hobbling or needed the use of the electric scooters. Looking into their eyes often resulted in a near zombie stare that went right through you. People looked at Walmart’s relatively low prices in desperation and despair as they mentally tried to grasp how they’d be able to handle the bill for the mass produced garbage they were trying to buy to save money (compared to fresh meat and produce). My wife and I paid for our stuff and headed to our basic SUV (one of the nicest cars in the parking lot) and you could see rundown cars on the edge of the parking lot with blankets up to block the sunlight (aka homeless people).
Things are not good over here.
Edit: I didn’t directly address your question, but it’s all tied together. People are drugged up and just trying to get by. For many Americans, day-to-day life is nothing short of a nightmare.
My wife and I recently went to a Walmart near a “not good area” and it was depressing. Just about everyone was overweight. Many were hobbling or needed the use of the electric scooters. Looking into their eyes often resulted in a near zombie stare that went right through you. People looked at Walmart’s relatively low prices in desperation and despair as they mentally tried to grasp how they’d be able to handle the bill for the mass produced garbage they were trying to buy to save money (compared to fresh meat and produce). My wife and I paid for our stuff and headed to our basic SUV (one of the nicest cars in the parking lot) and you could see rundown cars on the edge of the parking lot with blankets up to block the sunlight (aka homeless people).
Things are not good over here.
Edit: I didn’t directly address your question, but it’s all tied together. People are drugged up and just trying to get by. For many Americans, day-to-day life is nothing short of a nightmare.
This is patronizing hyperbole to the point of absurdity.
Complaining about mass produced garbage instead of fresh meat and produce is just silly. Walmart has plenty of all three.
Complaining about mass produced garbage instead of fresh meat and produce is just silly. Walmart has plenty of all three.
Walmart has all three, but it doesn’t mean that every customer can afford it. If you are broke, you are going to skip out on some of the healthier stuff.
Meat and produce are very often cheaper than processed food. People just prefer the processed food/don’t want to cook
Yes there are people without kitchens. But don’t tell me you think that’s most of the poor people at Walmart.
Yes there are people without kitchens. But don’t tell me you think that’s most of the poor people at Walmart.
I don’t think that’s most poor people at Walmart.
I do think that most poor people at Walmart are so worn down and tired that cooking a healthy meal can be difficult. Especially when there’s a box that only needs water and a few zaps from the microwave.
I do think that most poor people at Walmart are so worn down and tired that cooking a healthy meal can be difficult. Especially when there’s a box that only needs water and a few zaps from the microwave.
[deleted]
Meat and produce are very often cheaper than processed food.
I went on Walmart's website. Per ounce, name brand fish sticks were cheaper than the cheapest fresh fish, tilapia. Pre made, microwavable burgers were the same price as just 80/20 ground beef. Jurassic Park white meat dino nuggets are the same price as Perdue chicken breast.
I went on Walmart's website. Per ounce, name brand fish sticks were cheaper than the cheapest fresh fish, tilapia. Pre made, microwavable burgers were the same price as just 80/20 ground beef. Jurassic Park white meat dino nuggets are the same price as Perdue chicken breast.
Ok, and how much does it cost to make fish sticks or Dino nuggets, knowing that they are mostly breading?
Is this a rhetorical question? It costs the cost of labor multiplied by the time that they take to make? So obviously fresh food will always be more expensive, given you need to invest time into actually cooking it
The content of fish and beef in those fish sticks/burgers is relatively low, the rest is just fillers which I don't think you took into account at all..
All due respect I don't think you've been poor. They don't care if it has fillers. They want a full stomach. They're going to optimize for the cheapest ways to fill those calories. You know what's subsidized? It's not the fresh fruit or veggies. Even my middle class friends in sleepy Colorado Springs didn't know what a proper home cooked meal was until they came over to my house. Some were even astonished we ate meals together as a family consistently rather than send everyone to their own rooms with TV dinner trays.
Those kids that didn't grow up with cooked meals are very unlikely to cook for themselves or their own eventual children. They're going to stick to 90 second rice pouches, ramen packs, mac n cheese, "salad kits". I can tell you right now a Kraft Mac n cheese cup is cheaper than what I would spend on pasta & the cheeses to make a roux. Easier to prepare, too.
I don't see people in Walmart buying produce. If they wanted that they'd go to one of the Latino grocery stores or the farmer market. If they wanted pantry staples (flour, bread, eggs, milk) they generally go to Costco. Who goes to Walmart to buy anything fresh?
Those kids that didn't grow up with cooked meals are very unlikely to cook for themselves or their own eventual children. They're going to stick to 90 second rice pouches, ramen packs, mac n cheese, "salad kits". I can tell you right now a Kraft Mac n cheese cup is cheaper than what I would spend on pasta & the cheeses to make a roux. Easier to prepare, too.
I don't see people in Walmart buying produce. If they wanted that they'd go to one of the Latino grocery stores or the farmer market. If they wanted pantry staples (flour, bread, eggs, milk) they generally go to Costco. Who goes to Walmart to buy anything fresh?
> All due respect I don't think you've been poor. They don't care if it has fillers. They want a full stomach.
All I'm saying is just that buying the components separately would probably be cheaper and result in a healthier meal.
But yeah you're right about many people not liking to cook due to lack of time or other reasons.
> I don't see people in Walmart buying produce
Well they wouldn't sell if people didn't buy it. I do see your point of course.
All I'm saying is just that buying the components separately would probably be cheaper and result in a healthier meal.
But yeah you're right about many people not liking to cook due to lack of time or other reasons.
> I don't see people in Walmart buying produce
Well they wouldn't sell if people didn't buy it. I do see your point of course.
The point was there's many people that can't afford to buy food from those sections.
[deleted]
People on Metafilter used to make up similar stories about Walmart and fast food, including the fanciful details about the dead eyes and making up inner thoughts.
phpisthebest(3)
This seems to be a uniquely Walmart experience. I don’t experience it anywhere else in the States.
I no longer shop there and I know of many people who feel the same way. It’s the only store I avoid because of “the feeling of human suffering.” Walmart’s stores are cold and uninviting, the employees don’t look happy to be there, and the shoppers don’t either.
I don’t believe the people inside a Walmart are a representative sample of Americans, the store self selects for people who are willing to shop at a Walmart.
I no longer shop there and I know of many people who feel the same way. It’s the only store I avoid because of “the feeling of human suffering.” Walmart’s stores are cold and uninviting, the employees don’t look happy to be there, and the shoppers don’t either.
I don’t believe the people inside a Walmart are a representative sample of Americans, the store self selects for people who are willing to shop at a Walmart.
It is not even a Walmart experience. It is a Online Walmart tall tale.
I shop at walmart all the time, in all area's poor, rich, middle class, are there fat people, sure. Are they "Dead zombies looking hobbled to their mobility scooters" .... I think the OP fancies themselves a fiction writer..
I shop at walmart all the time, in all area's poor, rich, middle class, are there fat people, sure. Are they "Dead zombies looking hobbled to their mobility scooters" .... I think the OP fancies themselves a fiction writer..
I wish I was lying. Multiple people almost bumped into me and I did the Midwestern “oop my bad,” and these people didn’t even flinch or acknowledge my existence. I just felt so bad for them.
This. And the demographics change wildly depending on what day of the week and time you go.
It's funny how nice one Walmart is in a nicer area, compared to one in a not-bad but not-great area just 15 miles away (the bad areas don't even have them)
One is clean and the other looks like a bomb went off. Dirty floors, merchandise laying all over, employees nowhere to be found...
Doesn't even seem like the nice one is a Walmart.
One is clean and the other looks like a bomb went off. Dirty floors, merchandise laying all over, employees nowhere to be found...
Doesn't even seem like the nice one is a Walmart.
The nicer Walmarts usually have more checkout lanes open too. The lower-income Walmart near me has one open lane and then 15-20 uScans.
> This seems to be a uniquely Walmart experience. I don’t experience it anywhere else in the States.
Literally 95% of the US shops at Walmart, so... you might be in a very small bubble
Literally 95% of the US shops at Walmart, so... you might be in a very small bubble
> Literally 95% of the US shops at Walmart, so... you might be in a very small bubble
Possibly. But your statistic tells me nothing about the foot traffic in a Walmart. 95% shop at Walmart, of that cohort how many shop there regularly? How many shop there for occasional purchases vs treating it as their primary store for staple items? On a random sample of days, how representative of that 95% is the foot traffic you’ll find there?
Personally I share OPs view of Walmarts, I don’t go in them because they make me feel bad about the world. I don’t get that feeling other places.
Possibly. But your statistic tells me nothing about the foot traffic in a Walmart. 95% shop at Walmart, of that cohort how many shop there regularly? How many shop there for occasional purchases vs treating it as their primary store for staple items? On a random sample of days, how representative of that 95% is the foot traffic you’ll find there?
Personally I share OPs view of Walmarts, I don’t go in them because they make me feel bad about the world. I don’t get that feeling other places.
> On a random sample of days, how representative of that 95% is the foot traffic you’ll find there?
Very, since the more likely someone is to be a regular shopper there, the more likely you are to run into them on any given visit. That is simply an artifact of statistics.
> Personally I share OPs view of Walmarts, I don’t go in them because they make me feel bad about the world. I don’t get that feeling other places.
Do you get that feeling at the DMV? Maybe at the doctor's office or pharmacy? You are bumping into a true cross-section of the US population. Take note of the feelings you get and why, and understand that this is what the US is, not just what you see in the bubble
Very, since the more likely someone is to be a regular shopper there, the more likely you are to run into them on any given visit. That is simply an artifact of statistics.
> Personally I share OPs view of Walmarts, I don’t go in them because they make me feel bad about the world. I don’t get that feeling other places.
Do you get that feeling at the DMV? Maybe at the doctor's office or pharmacy? You are bumping into a true cross-section of the US population. Take note of the feelings you get and why, and understand that this is what the US is, not just what you see in the bubble
[deleted]
For a large amount of rural America, it’s the only option.
That or a Dollar General with its bountiful selection of bananas and limes.
That or a Dollar General with its bountiful selection of bananas and limes.
Why do you insist on lying?
Walmart is rarely the Only option. Where there is a Walmart, 90% of the time there is a Kroger (or Kroger Brand) Store, or Mejier (if in the Midwest), or some other store close by...
Walmart is rarely the Only option. Where there is a Walmart, 90% of the time there is a Kroger (or Kroger Brand) Store, or Mejier (if in the Midwest), or some other store close by...
A solid chunk of the US population lives in a food desert. They're lucky to even have a Walmart within driving distance. You've clearly never had to walk a few miles on highway to reach the nearest grocery store. I can tell you from experience it's not particularly fun.
Not sure why you're minimizing this reality. 1 in 6 Americans don't know where their next meal is coming from. https://www.ers.usda.gov/webdocs/publications/42711/12716_ap...
Not sure why you're minimizing this reality. 1 in 6 Americans don't know where their next meal is coming from. https://www.ers.usda.gov/webdocs/publications/42711/12716_ap...
I am not reading a 600 page, 15 year old report of out dated info, however a search of the report shows zero references to "1 in 6 Americans " nor "next meal"
So if you have a source to back that actual claim I would be happy to look at it, and likely refute why it is cherry picking data
>>A solid chunk of the US population lives in a food desert.
Food Deserts are a political term, largely attributed to urban not rural area's and ever every study you find talking about Food Deserts I can find at least 1 if not more refuting that actual data.
So if you have a source to back that actual claim I would be happy to look at it, and likely refute why it is cherry picking data
>>A solid chunk of the US population lives in a food desert.
Food Deserts are a political term, largely attributed to urban not rural area's and ever every study you find talking about Food Deserts I can find at least 1 if not more refuting that actual data.
Why do you insist on being rude?
Because you are spreading misinformation and FUD for no reason.
[deleted]
I don't think most people are ODing from prescription abuse. It is fentanyl. I'd be interested to know how many are being poisoned by fentanyl-laced drugs, vs. fentanyl addicts who OD. Maybe that stat would be too hard to come by?
Tangentially related but it has been my experience (I knew several people who died from opioid overdose) and also in literature[1] that overdoses frequently occur after rehab. Due to a drop in tolerance.
"The clustering of the deaths from overdose in the group of patients who had successfully completed treatment is counterintuitive and illogical—unless it derives from loss of tolerance and consequent unpredictability of resumed heroin use."
[1]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC153851/
"The clustering of the deaths from overdose in the group of patients who had successfully completed treatment is counterintuitive and illogical—unless it derives from loss of tolerance and consequent unpredictability of resumed heroin use."
[1]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC153851/
That study is from 2003. Fentanyl is a much more recent phenomenon.
opiates definitely arent though.
Can confirm from my own firsthand observation. Sober people relapse, often after years of being clean, and misjudge how strong the stuff has gotten. Instant OD
But for a lot prescription meds is the gateway drug to cheaper stuff
Yes and no. Very few people get started with a legitimate prescription. The typical opioid OD happens to someone who had other substance abuse and mental health problems and at some point started taking resold/stolen prescription opioids. Until fentanyl flooded the market most ODs were multi-substance and often(some 85%+ in places where coroners checked if memory serves) involved a LOT of alcohol. Now, its often just fentanyl, which is hard to dose correctly especially if you've recently tried to quit.
A lot of people who die from fentanyl ODs are just casual drug users who are buying some other drug that happens to be laced with fentanyl. They die before they even know what's happening. It takes surprisingly little to kill someone and the illegal drug manufacturers are not that great with quality control when they cut the drugs they sell. I'm aware of people who used to take recreational drugs from time to time, but have quit completely because of the risk of accidentally overdosing because the dealers put fentanyl in almost everything now.
Most people who die from fentanyl ODs are opioid addicted. They are not getting it in other drugs - that happens (I test all my drugs for fentanyl) but is not any where near a majority of fentanyl deaths.
> test all my drugs for fentanyl
How?
How?
https://dancesafe.org/product/fentanyl-test-strips-box-of-10...
Searching Google for "fentanyl test kit" + location (eg Denver) will connect you with your local dept of public health, which often (in non puritanical, harm-reduction states, which includes Texas) has free/low cost options. They often also have Narcan to distribute after teaching you how to use it.
Searching Google for "fentanyl test kit" + location (eg Denver) will connect you with your local dept of public health, which often (in non puritanical, harm-reduction states, which includes Texas) has free/low cost options. They often also have Narcan to distribute after teaching you how to use it.
[deleted]
You can buy eat kits online.
do you have source for that?
Yes. Its a deadly combo. Tons of cheap opioids flowing in from Mexico made with Chinese chemicals. There is no way to stop it. Flood the EU with tons of cheap fentanyl for a fair comparison.
> There is no way to stop it.
Isn't this what "the wall" and securing the borders was supposed to be for?
Isn't this what "the wall" and securing the borders was supposed to be for?
Fentanyl makes a mockery of something like border control. You can fit an absurd number of doeses into a package the size of a standard letter envelope. The demand for Fentanyl is directly related to the vice grip of the DEA on prescription opioids.
Case in point:
~21 million doses worth found in a backpack of a guy trying to cross the border into Arizona
https://twitter.com/BillFOXLA/status/1625936055047426048
> So far in FY23, we have seized over 476 lbs. of Fentanyl between the ports of entry along our southwest border. That's enough to kill 100 million people.
https://twitter.com/BillFOXLA/status/1625936055047426048
> So far in FY23, we have seized over 476 lbs. of Fentanyl between the ports of entry along our southwest border. That's enough to kill 100 million people.
The wall was pure political theatre. Near as I can tell, it didn’t even slow down people on foot, and drugs are coming in via freight anyway.
I agree that it would not stop the drug trade... but the wall was never built so calling it "political theatre" is incorrect as well, as it was completely opposed by congress, and faced all kinds of lawsuits that stopped building several times.
"The Wall" as envisioned by the proponents was never completed
"The Wall" as envisioned by the proponents was never completed
Plenty of parts of a wall for photo ops were completed!
The whole thing doesn’t need to exist for political theater, in fact I’d say its lack of actual completion makes it even more a theatrical construction than if it actually was done!
The whole thing doesn’t need to exist for political theater, in fact I’d say its lack of actual completion makes it even more a theatrical construction than if it actually was done!
Yea but that doesn't work because that's not where its coming through
And it’s everywhere. It’s used as the “razzle dazzle” to add a kick to highs. Fake pills, heroin.
There’s even been a rash of fentanyl overdoses in nyc from marijuana (as reported by the victims). It’s thought that mass produced weed is being grown with plant growth regulators. These make the plant grow big, dense buds. It also makes the plant produce less thc. It’s believe that the plants are then being dusted with fentanyl to replace the lost thc.
There’s even been a rash of fentanyl overdoses in nyc from marijuana (as reported by the victims). It’s thought that mass produced weed is being grown with plant growth regulators. These make the plant grow big, dense buds. It also makes the plant produce less thc. It’s believe that the plants are then being dusted with fentanyl to replace the lost thc.
Any references to the marijuana fentanyl problem? I’ve heard versions of this story repeated every few years since the mid 2010s but have never been able to find actual evidence for it.
Frankly, it’s what I’ve heard my delivery weed service carriers. I live in nyc.
my background is in harm reduction and as far as I know there is no credence to these tales. There are people in the U.S. overblowing the fentanyl situation either to stoke fear for some personal or political benefit or sometimes it's just well-meaning undereducated folks spreading these tales.
fentanyl has generally speaking only made its way into the supply of non-opioids like cocaine as the result of contamination, not intentional adulteration. When we talk about fentanyl, in reality what's out there is perhaps some true fentanyl but a lot of fentanyl analogues that are much more potent (lethal dose in the mcg range). Often the people moving heroin are also moving cocaine and other drugs, and using shared surfaces to weigh and cut the product for street use. They aren't properly cleaning surfaces and instruments and thus fentanyl is ending up in all sorts of powdered drugs
fentanyl on weed has probably happened in some instances of intentional poisoning of an individual but I'd file this under similar in risk to your child being given an edible, or candy with a razor blade on halloween
fentanyl has generally speaking only made its way into the supply of non-opioids like cocaine as the result of contamination, not intentional adulteration. When we talk about fentanyl, in reality what's out there is perhaps some true fentanyl but a lot of fentanyl analogues that are much more potent (lethal dose in the mcg range). Often the people moving heroin are also moving cocaine and other drugs, and using shared surfaces to weigh and cut the product for street use. They aren't properly cleaning surfaces and instruments and thus fentanyl is ending up in all sorts of powdered drugs
fentanyl on weed has probably happened in some instances of intentional poisoning of an individual but I'd file this under similar in risk to your child being given an edible, or candy with a razor blade on halloween
Buuulllllshiiiiiiit. If anything, people would be adding things like jwh18 or newer stuff like delta 8 or 10
Big Fent is more potent/cheaper than those.
I know. It has been for a decade. But it doesn't make sense
> It’s believe that the plants are then being dusted with fentanyl to replace the lost thc.
Bah, apocryphal.
Bah, apocryphal.
not anymore, in certain parts of the country there is actually an issue of under-prescription of narcotics as an overreaction to the opioid crisis we are facing, with painkillers of course being the most difficult to access. Chronic severe pain patients and people with horrendous neurological conditions are going without the medications they need because prescribers are now terrified of heavy-handed medical boards
that said, 20 or so years ago prescribers in the U.S. were in various ways made to believe that painkillers such as oxycodone were not addictive and were these magical drugs that helped pain patients regain their lives in ways we had never seen before. Ended up in so many homes, lots of excess prescription opioids hanging around and as a result a lot of people ended up abusing them. For a significant number of people that led to heroin use, and then fentanyl came into the picture in 2015ish; so that's how we got here. heroin on its own when injected isn't actually that easy to accidentally overdose on- fentanyl however, is.
that said, 20 or so years ago prescribers in the U.S. were in various ways made to believe that painkillers such as oxycodone were not addictive and were these magical drugs that helped pain patients regain their lives in ways we had never seen before. Ended up in so many homes, lots of excess prescription opioids hanging around and as a result a lot of people ended up abusing them. For a significant number of people that led to heroin use, and then fentanyl came into the picture in 2015ish; so that's how we got here. heroin on its own when injected isn't actually that easy to accidentally overdose on- fentanyl however, is.
2000 I had alot of tooth pain, I could get all kind of good pain killers for that...
About a year ago I had an infected tooth... Nothing more than 600mg advil was on the table... take that at suffer through the rest of the pain...
About a year ago I had an infected tooth... Nothing more than 600mg advil was on the table... take that at suffer through the rest of the pain...
It used to be even worse.
In 2012 the Opioid dispensing rate was 81 per 100 people.
https://www.cdc.gov/drugoverdose/rxrate-maps/index.html
This doesn't even include antidepressants/ssri and such.
In 2012 the Opioid dispensing rate was 81 per 100 people.
https://www.cdc.gov/drugoverdose/rxrate-maps/index.html
This doesn't even include antidepressants/ssri and such.
That's 81 prescriptions dispensed per 100 people. If each prescription is for three months of pills that's 20 people-years of opioid dispensed per 100 people.
>For this database, a prescription is a new or refill prescription dispensed at a retail pharmacy in the sample and paid for by commercial insurance, Medicaid, Medicare, cash or its equivalent, and other third-party coverage. This database does not include mail order prescriptions.
>For the calculation of dispensing rates, numerators are the projected total number of opioid prescriptions dispensed annually at the state, county, or national level. Annual resident population denominators were obtained from the U.S. Census Bureau.
Am I reading this right? They're counting scripts and then dividing that over the population? So if we imagine a state with a population of 12 people, one of whom is a chronic pain patient or cancer patient with an opioid prescription, that would show as 100 dispenses per 100 population (1 patient, 12 scripts)? That seems almost worthless as a metric.
>For the calculation of dispensing rates, numerators are the projected total number of opioid prescriptions dispensed annually at the state, county, or national level. Annual resident population denominators were obtained from the U.S. Census Bureau.
Am I reading this right? They're counting scripts and then dividing that over the population? So if we imagine a state with a population of 12 people, one of whom is a chronic pain patient or cancer patient with an opioid prescription, that would show as 100 dispenses per 100 population (1 patient, 12 scripts)? That seems almost worthless as a metric.
Good catch. Still nuts, especially if you layer it with antidepressants.
Some states were 107< per 100 for the opioids. How does that impact the movement of the Overton window over the last decade+ I wonder?
Some states were 107< per 100 for the opioids. How does that impact the movement of the Overton window over the last decade+ I wonder?
Some people stay on the meds after a legitimate need. Some doctors misprescribe meds (in part misled by pharma reps) or are not aware of alternatives (if you're on some meds for 1 month it can take 1 year to safely taper off of them). There are some doctors who basically sell prescriptions (Netflix has a documentary on this).
The biggest issue is the lack of hope. Most people turn to these because they're tired of their shitty life and don't see any realilistic hope for improvement.
I mean, I got good grades, I worked hard, I'm an employed (not highly paid) software dev and I'm so disillusioned I completely get why some people turn to these things. I'm supposed to be at least in the top 25% of the current generation/my age group. Yet I feel like I'm barely making it to the same level that my parents were able to. Don't get me wrong, we aren't on assistance, we have good groceries, we have private/employer healthcare. But it's tough trying to save for retirement, healthcare, and stuff. There's no way 50% of the population will be able to retire at all, pay for Healthcare, etc as they get older or aren't able to work.
The biggest issue is the lack of hope. Most people turn to these because they're tired of their shitty life and don't see any realilistic hope for improvement.
I mean, I got good grades, I worked hard, I'm an employed (not highly paid) software dev and I'm so disillusioned I completely get why some people turn to these things. I'm supposed to be at least in the top 25% of the current generation/my age group. Yet I feel like I'm barely making it to the same level that my parents were able to. Don't get me wrong, we aren't on assistance, we have good groceries, we have private/employer healthcare. But it's tough trying to save for retirement, healthcare, and stuff. There's no way 50% of the population will be able to retire at all, pay for Healthcare, etc as they get older or aren't able to work.
The problem isn't pain killers it is massive quantities of fentanyl being brought into the country. Made worse by it being so cheap it is basically pressed into pill shape and sold as other less lethal substances like Xanax, Percocet, MDMA etc. People are also just selling it as cocaine. There have been several stories of people thinking they bought cocaine and overdosing because it was or contained fentanyl.
http://archive.today/jbMxb
https://www.vox.com/2020/4/15/21214734/deaths-of-despair-cor...
(First link fixed)
https://www.vox.com/2020/4/15/21214734/deaths-of-despair-cor...
(First link fixed)
clicking the first article and right after reading the words "Why Americans Are Dying From Despair", I got a modal with the title:
"You've Run Out"
with a graphic of a person's arm trapped in an elevator door
https://i.imgur.com/fZp2eaG.png
"You've Run Out"
with a graphic of a person's arm trapped in an elevator door
https://i.imgur.com/fZp2eaG.png
[deleted]
It is a money maker https://youtu.be/KAJ-lTtt4yk
That's the answer to all weird things in US. It makes someone money.
Is it though? I remember having some opioids prescribed by dentist after a major procedure and I was on them for a week or two. Withdrawal was painful and I am saying that as a person, who dealt with bad headaches before. That was after 2 weeks. I can't even begin to imagine what people who have to take them longer ( surgeries, chronic pain and so on ). Those are still a useful tool, but the risk of addiction comes from several fronts and it is easy to get caught in a rather vicious circle.
It's crazy how eager American doctors are to prescribe opioids. Over the last few years, Ive gotten narcotic painkillers for serious stuff like surgery, but also for more minor stuff like dental work or joint injections. In most of those circumstances I would take one or two of these pills and then be just fine with non-narcotic over the counter pain medicine. But every time, I am highly encouraged to take the narcotics "just in case" the pain gets bad.
> But every time, I am highly encouraged to take the narcotics "just in case" the pain gets bad.
Being unfamiliar with the actual practice, how much are you typically prescribed, days or weeks worth, maybe even more?
Being unfamiliar with the actual practice, how much are you typically prescribed, days or weeks worth, maybe even more?
Depending on the severity, its not unusual to get 8 doses for the most minor of cases, like a root canal.
I know it's not the same as opiates, but a crappy dentist in suburban Illinois once gave me a Vicodin prescription after a root canal. I was so confused
Your comment makes me confused. Vicodin is an opiate, and it seems like a perfectly reasonable thing to prescribe for moderate pain stemming from a minor surgery or procedure. Presumably you were prescribed only a few days worth too. What was confusing about it to you? If anything, what worries me about this is that people are duped by the D.A.R.E.-like propaganda that suggests an addiction is likely from a prescription like this.
Not OP, but I was prescribed Percocet after dental surgery. I didn't even feel any pain, so I was a little confused about why I was automatically prescribed such heavy duty stuff when I didn't even need OTC Tylenol. Shortly after this, I found out I was living with a recovering addict (who got hooked on prescription pain killers after a knee surgery), so I ended up flushing the pills at their request.
I had my wisdom teeth removed and also did not need the prescription percocet I was given. I was prescribed 3 days worth (2-3 pills per day), but never needed them.
I’m glad they gave me the percocet as a precautionary though because I absolutely would not want to have to go fill the prescription after the fact with mouth pain intense enough to then need the prescription.
When a surgeon does dozens of these procedures a month and most cases require a certain painkiller, it makes a lot of sense to plan ahead and prepare the patient when the alternative is intense pain.
I’m glad they gave me the percocet as a precautionary though because I absolutely would not want to have to go fill the prescription after the fact with mouth pain intense enough to then need the prescription.
When a surgeon does dozens of these procedures a month and most cases require a certain painkiller, it makes a lot of sense to plan ahead and prepare the patient when the alternative is intense pain.
It really doesn't make sense to automatically go straight to percocet for wisdom teeth being removed. I think you're making a leap when you say most cases require a certain painkiller - over-prescription of opioids is one of the issues of our current epidemic. The NHS suggests OTC Ibuprofen for pain management after wisdom teeth removal.
https://www.nhs.uk/conditions/wisdom-tooth-removal/recovery/...
https://www.nhs.uk/conditions/wisdom-tooth-removal/recovery/...
For real, filling a prescription with mouth pain is not such tragedy people are making it out to be.
Not to be a dick, but I find it very interesting that people expect to go through life without experiencing pain.
Not to be a dick, but I find it very interesting that people expect to go through life without experiencing pain.
Root canal (the garden variety kind) is not really dental surgery. Root canal is not painful after the procedure, because the procedure removes the nerve that feels pain.
The injury to surrounding tissue is so minor (a hole of about 1.5mm in diameter for every nerve) that you don't really feel it.
It is orders of magnitude less invasive than an extraction and some people don't need anything more than OTC Tylenol for those.
I think it's quite obscene to prescribe Vicodin for a root canal. Because it won't do anything for the pain you don't actually have, but you will have other side effects. it's kind of like bringing a fighter jet to a knife fight if you will.
People tend to trust doctors when they are prescribed things, so how many people ended up taking the Vicodin prescribed to them only to feel nauseated and drowsy and "out of commission" for a few days after the root canal? Hell, even you thinking that it's reasonable or necessary points to how far we've gone
It is orders of magnitude less invasive than an extraction and some people don't need anything more than OTC Tylenol for those.
I think it's quite obscene to prescribe Vicodin for a root canal. Because it won't do anything for the pain you don't actually have, but you will have other side effects. it's kind of like bringing a fighter jet to a knife fight if you will.
People tend to trust doctors when they are prescribed things, so how many people ended up taking the Vicodin prescribed to them only to feel nauseated and drowsy and "out of commission" for a few days after the root canal? Hell, even you thinking that it's reasonable or necessary points to how far we've gone
Many years ago I had all four wisdom teeth removed at once at the Mayo Clinic. No, I wasn't fancy and didn't fly there, I was an employee.
They gave me 10 or 20 Vicodin pills and, despite some pain, my choice was to take no more than one or two. So it's not just crappy dentists that gave those out. On the other end, someone else might have taken the whole bottle, so perhaps individual behavior is still the key factor.
They gave me 10 or 20 Vicodin pills and, despite some pain, my choice was to take no more than one or two. So it's not just crappy dentists that gave those out. On the other end, someone else might have taken the whole bottle, so perhaps individual behavior is still the key factor.
Even if they did take the whole bottle, no one is going to become an addict by taking “10-20 pills” (which translates to 3-6 days worth). There’s more or less a “reefer madness” going on now, just with opiates. Yes, opiates can be dangerous. No, a few low doses are not going to make you an addict.
Of course, cue someone responding with something along the lines of “my sister once took an opiate and she immediately started shooting heroin and had withdrawals for 2 years.”
Of course, cue someone responding with something along the lines of “my sister once took an opiate and she immediately started shooting heroin and had withdrawals for 2 years.”
OTC ibuprofen works just fine for a lot of these cases btw.
People think that opiates is like the only way to relieve pain.
I don't think what I am sayin here is that you will get addicted after taking 10 Vicodins, of course not.
But what about 30? 45? There is a point when it becomes dangerous. And here is where this mentality becomes problematic. If you need to take opiates for 3 days after a root canal, surely you'll need to take them after you broke your arm, or after any other procedure and for longer. And you didn't have a problem after taking it for 3 days, so what's the harm?
I don't think what I am sayin here is that you will get addicted after taking 10 Vicodins, of course not.
But what about 30? 45? There is a point when it becomes dangerous. And here is where this mentality becomes problematic. If you need to take opiates for 3 days after a root canal, surely you'll need to take them after you broke your arm, or after any other procedure and for longer. And you didn't have a problem after taking it for 3 days, so what's the harm?
perhaps individual behavior is still the key factor
I strongly disagree given that we're talking about addictive substances and the power of doctors coupled with the DOJ finding manufacturers guilty of kickback schemes.
I strongly disagree given that we're talking about addictive substances and the power of doctors coupled with the DOJ finding manufacturers guilty of kickback schemes.
how is wisdom teeth removal the same as a root canal?
Teeth extraction is orders of magnitude more painful in recovery.
Vicodin is indeed an opiate.
In the US many opiod makers of things like fentanyl spray and Oxycontin bribed doctors to prescribe it so a lot of those deaths are a direct cause of that, sources: https://www.justice.gov/usao-ma/pr/founder-and-former-chairm... https://www.voanews.com/a/us-states-purdue-pharma-reach-new-...
Harm reduction policies work.
But going beyond opioid deaths, Europe in general has a) decent medical coverage b) meaningful employment protections and c) better overall social safety net
Apparently the poor are most at-risk from this crisis according to a large study [1] - so maybe the fix isn't just harm reduction, but alleviating the existential crisis we put people of lower income in the US - making them more susceptible to drug addiction & death
[1] https://www.nhlbi.nih.gov/news/2020/large-study-links-lower-...
Apparently the poor are most at-risk from this crisis according to a large study [1] - so maybe the fix isn't just harm reduction, but alleviating the existential crisis we put people of lower income in the US - making them more susceptible to drug addiction & death
[1] https://www.nhlbi.nih.gov/news/2020/large-study-links-lower-...
Also, Europe doesn't have a fentanyl crisis because we have cheap, pure heroin. The Afghani-Europe heroin pipeline is so old, tightly organized, and efficient that there is little need for an alternative.
By comparison, shipping heroin across the Pacific is costly risky business, because it's easier to detect and seize. Hence the need for fentanyl which is orders of magnitude stronger and can be created in impromptu labs.
This gets particularly dicey for every "party drug" users in the states, because a white powder that would be relatively harmless is subject to accidental cross-contamination. [edit based upon reading comments below: Yeah, if you live in the US and your friends take coke or ketamine, you should have Narcan.]
Opiate users are addicts but they're not stupid. Nearly all greatly prefer reliable heroin to the risk of OD'ing. Hence why fentanyl hasn't become a thing in Europe. A reputation for killing your customers is bad for business.
Bonus question: Why does Europe not have a methaphetamine crisis?
By comparison, shipping heroin across the Pacific is costly risky business, because it's easier to detect and seize. Hence the need for fentanyl which is orders of magnitude stronger and can be created in impromptu labs.
This gets particularly dicey for every "party drug" users in the states, because a white powder that would be relatively harmless is subject to accidental cross-contamination. [edit based upon reading comments below: Yeah, if you live in the US and your friends take coke or ketamine, you should have Narcan.]
Opiate users are addicts but they're not stupid. Nearly all greatly prefer reliable heroin to the risk of OD'ing. Hence why fentanyl hasn't become a thing in Europe. A reputation for killing your customers is bad for business.
Bonus question: Why does Europe not have a methaphetamine crisis?
I'm completely talking out of my ass here but I feel like how relatively uncommon meth is in EU compared to US has to do with ingredients being a lot harder to get in the EU area. Crystal is common in the US while in EU that is extremely rare, the meth on eu market is usually powder or rock.
I'm assuming most of crystal meth in the US comes from mexico and they don't bother to ship that much of it overseas as stuff like cocaine has higher profits and a bigger market.
I'm assuming most of crystal meth in the US comes from mexico and they don't bother to ship that much of it overseas as stuff like cocaine has higher profits and a bigger market.
> Bonus question: Why does Europe not have a methaphetamine crisis?
I've always thought that it was because all the precursors for meth get used to make MDMA.Though it's probably more of a culture/economic thing. Europe definitely has some meth in it.
I've always thought that it was because all the precursors for meth get used to make MDMA.Though it's probably more of a culture/economic thing. Europe definitely has some meth in it.
> Bonus question: Why does Europe not have a methaphetamine crisis?
Not enough free space. It takes a lot of room to make meth because anyone nearby can easily tell.
It is going to change soon because Afghanistan is starting to make it.
Not enough free space. It takes a lot of room to make meth because anyone nearby can easily tell.
It is going to change soon because Afghanistan is starting to make it.
Because cocaine is easily available?
>Bonus question: Why does Europe not have a methaphetamine crisis?
Because it has an amphetamine crisis?
Because it has an amphetamine crisis?
I thought all the kids do ketamine now.
Ummm... Canada has universal health, lots of employment protection and a better social safety net.
And opioid overdoses are similar to the US per capita.
British Colombia had 2,306 deaths in 2022, and adjusted by population that's 132,000, so more than the US.
And opioid overdoses are similar to the US per capita.
British Colombia had 2,306 deaths in 2022, and adjusted by population that's 132,000, so more than the US.
As far as I understood it so far, it was actually companies that pushed (legal) opioid consumption in the US? They influenced doctors to prescribe lots of opioids, and then people get addicted and start buying it off the streets.
Years ago (2017 ish) I remember reading an article where they interviewed some French public health or law enforcement people about whether they were concerned about the opioid problem coming there, and they basically said no, we have lots of treatment options here (which I understood to mean more legal access to opiates) so it's not a problem. The drug way is entirely the cause of all of this. I'm generally right wing but when I see the nonsense about the illegal immigration / border crossing being in any way related to the overdose problem, I find it idiotic. Its squarely a problem with how we've handled drug prohibition
Several societies (incl France) offer codeine over the counter and have much lower opioid usage rates.
I think there would be a lot of benefit to legalizing at least one molecule in each drug class for OTC recreational use, chosen based on harm reduction standards like toxicity, therapeutic index, and duration. I think so much of the drug war's ills could be headed off by making codeine and vyvanse OTC - destroying demand for dirtier more dangerous drugs would do enough good to offset the increased abuse rate for these particular chemicals.
I think there would be a lot of benefit to legalizing at least one molecule in each drug class for OTC recreational use, chosen based on harm reduction standards like toxicity, therapeutic index, and duration. I think so much of the drug war's ills could be headed off by making codeine and vyvanse OTC - destroying demand for dirtier more dangerous drugs would do enough good to offset the increased abuse rate for these particular chemicals.
Vyvanse might be tough to OTC. It's still quite possible to get increasing need to take more and more and get psychosis.
France has plenty of other drug problems, the most obvious being crack cocaine. You can walk around the parts of Paris to most obviously see this yourself, if you're curious. In fact a huge amount of violence in the banlieues relates to drugs.
That’s such a big difference, is there perhaps a difference in the ways these things are counted?
China is purposefully funneling fentanyl into the US to create this opioid catastrophe. Fentanyl overdose is the leading cause of death of young people these days. It's pretty shocking and sickening that this is happening and you see very little being done about it.
China exports precursor chemicals which are manufactured into fentanyl in Mexico and then smuggled in. I don't think it's that big of a scandal that some chemicals are exported from a country that does manufacturing for most of the world. We should focus on our own culture and society that has resulted in young people destroying their lives for a drug.
China also has a hand in building the Mexican labs and training the people there how to make fent
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Most of the fentanyl is now made in Mexico. The China pharma labs could all be closed now and it wouldn’t do a thing. The cat is out of the bag.
Guess who taught the Mexicans how to make it?...
I always have Narcan on me when I go to parties or shows just in case. Feels like something that should be in every first aid kit at this point.
> I always have Narcan on me when I go to parties or shows just in case.
Is the just in case there's any problems with drugs you take voluntarily? (no judgement, been there)
or to have it on hand in case someone else ODs?
or for the worst case scenario of someone drugging you (spiking a drink, etc).?
Is the just in case there's any problems with drugs you take voluntarily? (no judgement, been there)
or to have it on hand in case someone else ODs?
or for the worst case scenario of someone drugging you (spiking a drink, etc).?
The intention is more so for my friends and anyone else around me, but all of that I guess.
I see people OD pretty frequently at music festivals, and while there is medical around, minutes matter when it comes to fentanyl overdoses, and it can take a while for someone to get out, notify medical, and get medical back into the middle of a 10 thousand person crowd.
I wish the US would follow Canada's lead and allow for drug testing tents to legally exist :/
I see people OD pretty frequently at music festivals, and while there is medical around, minutes matter when it comes to fentanyl overdoses, and it can take a while for someone to get out, notify medical, and get medical back into the middle of a 10 thousand person crowd.
I wish the US would follow Canada's lead and allow for drug testing tents to legally exist :/
Read up on a twitter thread where someone had an anecdote where one of their family members was ODing, the ER first responders didn't have narcan, and a homeless person came up, asked if the person was OD, administered narcan and disappeared before anyone could thank them.
So all of it.
So all of it.
I would guess it's in case there's fentanyl mixed with other substances, there have been instances of people doing cocaine, ketamine, and other substances, dying from opioid overdose. I volunteer with harm reduction services and many of us carry naloxone, and we advocate for drug testing with fentanyl testing kits, pill testing, and educating people on reagent testing. Unfortunately we can't actually sell or administer these tests at festivals.
Narcan/Naloxone won't help drink spiking, that's usually done with other substances as far as I'm aware.
Narcan/Naloxone won't help drink spiking, that's usually done with other substances as far as I'm aware.
Why can't you sell drug testing kits at festivals?
The RAVE act was passed in 2003 (introduced by Joe Biden funnily enough) and made venues / event organizers liable "for knowingly leasing, renting, using, or profiting from a space where illicit drugs are being stored, manufactured, distributed, or used." with up to a $250,000 fine or "2 times the gross receipts, either known or estimated, that were derived from each violation that is attributable to the person", whichever is greater.
So providing drug testing kits or providing a drug testing station in any official capacity would put the venue / festival officially on the hook for a potentially obscene amount of money because of that pesky darn "knowingly".
Given the current state of the opioid epidemic, I honestly can't understand how this draconian piece of legislation is still law. It is the exact opposite of harm reduction and literally kills people.
So providing drug testing kits or providing a drug testing station in any official capacity would put the venue / festival officially on the hook for a potentially obscene amount of money because of that pesky darn "knowingly".
Given the current state of the opioid epidemic, I honestly can't understand how this draconian piece of legislation is still law. It is the exact opposite of harm reduction and literally kills people.
Yeah, the naive idea was that this would somehow make drug parties nonexistent. Seems to have worked just as well as the rest of the drug laws.
Did some digging - it was killed in 2002 but "Biden reincarnated the legislation (now called the Illicit Drug Anti-Proliferation Act) and inserted it into the Prosecutorial Remedies and Other Tools to End the Exploitation of Children Today (PROTECT) Act -- the home of feel-good laws like the measure creating a national Amber Alert system. President George W. Bush signed the PROTECT Act into law on April 30."
Nothing more classic than government overreach sneaking into legislation marketed as protecting kids.
Nothing more classic than government overreach sneaking into legislation marketed as protecting kids.
If you're passed out from a fentanyl overdose, there's no way you can administer narcan on yourself, so carrying narcan is for saving someone else.
People dealing with you might find your personal supply of narcan and administer it to you. The protective effect of your narcan on you is significantly more than the zero you seem to be implying.
Yep. I keep it as accessible as possible and tell all my friends where it is ahead of time to prevent any slowdowns just in case.
Let's focus on the second one for plausible deniability, not the sort of data trail most people would want to follow them.
I'm sure the likelihood of opioid ODs happening at shows and festivals is very high in some places, wouldn't be too surprised if some shows have dozens. Very good-samaritan kind of thing to carry if you go to crowded places.
I'm sure the likelihood of opioid ODs happening at shows and festivals is very high in some places, wouldn't be too surprised if some shows have dozens. Very good-samaritan kind of thing to carry if you go to crowded places.
There is no more heroin on the street in the US, it is all fentanyl. There is starting to be fent in a lot of coke as well, and of course counterfeit oxy, it's really not good and I always recommend people test new supply
May I ask you if not doing drugs is an option for your people? If not, why not?
d) all the above
naloxone was patented in 01961 and known to prevent death from opiate overdose by 01971
how many people have been killed in the usa by its prescription-only status over the last 52 years
for that matter, how many opiate overdose deaths would be avoided if you could buy pure, safe heroin of known concentration over the counter instead of depending on organized crime not to put too much fentanyl in it
how many people have been killed in the usa by its prescription-only status over the last 52 years
for that matter, how many opiate overdose deaths would be avoided if you could buy pure, safe heroin of known concentration over the counter instead of depending on organized crime not to put too much fentanyl in it
I can't help but wonder about the leading zero on your 5 digit years
By the time I had read "naloxone was patented in 01961" I thought it was some sort of patent identifier, so I was really confused when they said that it was "known to prevent death from opiate" in some other patent. I was thinking, patents don't have anything to do with researc- oh, it's a date.
I remember seeing someone else on HN use a five digit date years ago, giving the reasoning that it gives us a bigger perspective on our timeline and society.
I like the idea, but it muddies the message since we use standards for a reason. For example, if someone writes "In 13 I tried..." it's a bit confusing, but if they write "In '13 I tried..." it makes immediate sense since we have expectations about communicating dates.
I remember seeing someone else on HN use a five digit date years ago, giving the reasoning that it gives us a bigger perspective on our timeline and society.
I like the idea, but it muddies the message since we use standards for a reason. For example, if someone writes "In 13 I tried..." it's a bit confusing, but if they write "In '13 I tried..." it makes immediate sense since we have expectations about communicating dates.
It's to throw the bots off by coaxing them into parsing dates in octal
Thinking ahead for the y10k bug! /s
In the far future, when everyone has switched to a y10k-compatible dating system, your comments will be the only data from our era that makes it through the data quality filter in the web crawling system. The models will be overfitted to believe anything you say about this time. Use your power wisely.
> for that matter, how many opiate overdose deaths would be avoided if you could buy pure, safe heroin of known concentration over the counter
Since 2000, 75% of US opiate users started with prescription drugs[1]. So my guess is overdoses would be substantially worse if any opiate was freely available over the counter.
[1] - https://nida.nih.gov/publications/research-reports/prescript...
Since 2000, 75% of US opiate users started with prescription drugs[1]. So my guess is overdoses would be substantially worse if any opiate was freely available over the counter.
[1] - https://nida.nih.gov/publications/research-reports/prescript...
presumably you would have more opiate addicts
but the rate of overdoses from prescription opiates is, as i understand it, very low, because the dosage is predictable
a lot more old people needing regular enemas would be kind of shitty but not nearly as bad as millions of people dying from overdoses
but the rate of overdoses from prescription opiates is, as i understand it, very low, because the dosage is predictable
a lot more old people needing regular enemas would be kind of shitty but not nearly as bad as millions of people dying from overdoses
> but the rate of overdoses from prescription opiates is, as i understand it, very low, because the dosage is predictable
Over time, addicts do not get the same high from the same dose of opiates. They require higher dosages, until such a point where they have to turn to illicit narcotics (which are also cheaper). Prescription drug abusers are 40x more likely of becoming heroin abusers.
This is all in the article I linked above (click on the subheadings).
Over time, addicts do not get the same high from the same dose of opiates. They require higher dosages, until such a point where they have to turn to illicit narcotics (which are also cheaper). Prescription drug abusers are 40x more likely of becoming heroin abusers.
This is all in the article I linked above (click on the subheadings).
if they could buy whatever dosage they needed over the counter, instead of trying to wheedle a prescription out of doctors who are under threat of criminal prosecution, they wouldn't have much of an incentive to switch to different opiates, or to rely on dangerously unstable supply chains operated by organized crime
this would increase the risk of suicide, but it would have to rise a lot to exceed the current usa rate of accidental overdose deaths
this would increase the risk of suicide, but it would have to rise a lot to exceed the current usa rate of accidental overdose deaths
Opiods have a network effect and naloxone keeps people addicted.
It is certainly true that death cures the addiction for good. You may be onto something here.