I audit a lot of these Fentanyl API (Active Pharma Ingredient) factories in China. Its noticeable to me when I go through the warehouses as to how much product is going to Mexico. Other segments go to India for legal fill finishing prior to North America, while other small shipments are going to compounding facilities across the US. I always thought FDA might want to relay this information to homeland security, because its pretty easy for FDA inspectors to sneakily gather information during site inspections. At quite number of sites I often run into a mix of legal and nefarious activity at these massive API sites
The phrase "leading cause of death" has circular reference there. Each article is pointing to the other. I wanted to see where they got that figure. At the bottom of the current article it says "in a provisional tally seven months ago, [The Centers for Disease Control and Prevention] calculated the overall number of drug overdoses at 107,622. Two-thirds were due to fentanyl."<p>So fentanyl is the drug most people overdose on, or is it killing more people than heart diseases, traffic accidents, etc do?
It’s important to note a significant percentage of these deaths are cases in which other substances with trace amounts of fentanyl are consumed unbeknownst to the user. Dealers often use the same scales, which is one risk factor for cross-contaminating supply.<p>My mother is a physician, she just last night told me about a case she saw over the weekend in which a young 20-something nearly OD’d on fentanyl from taking ecstasy. She survived, but with life-altering brain trauma rendering her unable to remember who she is. She needs tubes for her food supply, and a ventilator to breathe.<p>Here you can see a few images of what is a lethal dose of fentanyl: <a href="https://www.dea.gov/galleries/drug-images/fentanyl" rel="nofollow">https://www.dea.gov/galleries/drug-images/fentanyl</a><p>Scary stuff, and maybe there’s an argument there to be made in favor of legalizing current black-market drugs. Definitely a PSA to test your drugs.<p>CDC on cross-contamination: <a href="https://www.cdc.gov/drugoverdose/deaths/other-drugs.html" rel="nofollow">https://www.cdc.gov/drugoverdose/deaths/other-drugs.html</a>
Sort-of-related, for Americans reading this, from a Brit, when I watch US TV programmes, the inclusion of drugs (prescription and illegal) in scripts is so matter-of-fact, it's actually shocking. Comparing like-for-like programs (police dramas, hospital dramas, thrillers), the UK version will invariably have entirely different plots. Sure the US != UK, but it's so weird.<p>Isn't the USA the only country other than NZ that allows advertising of drugs on TV? Also sales reps from drugs companies isn't a thing we have here either (largely because the NHS is <i>The Buyer</i> of all drugs in the UK).
Operational question, why do the DEA and ATF exist? It seems that they are A. Failures* and B. Lack any distinctive law enforcement mission. Couldn't we just roll their missions up into the FBI? Perhaps the Secret Service as well? This feels far more efficient than several fragmented failures occurring simultaneously.<p>*Eyeballing success by the number of murders with illegal firearms and drug deaths.
<i>Why</i> are people using Fentanyl? Maybe tackle that instead of further marginalizing people who use it?<p>Are they using it to escape the grinding anxiety and desperation of their shitty lives?<p>Are they using it instead of alcohol, again as escapism from reality? Is this use any different from how people used alcohol in past decades?<p>I guess the point I'm poorly trying to make is that people aren't suddenly different to those in the 1970s, 1920s, or the 1800s. They have a similar environment with similar anxieties, pains, responsibilities, etc etc.<p>I'm very, very biased on this subject. I suffer from constant pain, this comment being written while I sit down to recover from walking my dog. I've been given Morphine and Vicodin, Suboxone and Lyrica. Currently I'm lucky enough to be on Zubsolv, which is a better formulation of Suboxone that doesn't disrupt my sleep as much nor give me horrible muscle spasms. I've tried edibles, as I live in Michigan which has legalized Marijuana. Unfortunately I tolerate them way too fast and they just send me to sleep.<p>People I know across the USA have wildly different results to seeing a doctor for pain relief. Some can't even see a doctor who will even <i>discuss</i> pain with them. Others, like me, have been accused of drug seeking. Or ripped off by hospitals promising to help with nerve abrading, injections, implants, etc. Those hospitals eager to help are also very proficient at billing to extract the most money from insurance and patient.<p>If I were 16 again, armed with what I know now, I'd go into medical research. Specifically tolerance, because in my opinion that's the keystone of the building that is drug dependence. People get tolerant of their drug of choice, take more to get the same effect, chasing that dragon around and around not noticing that the circle has become a downward spiral. Plus so many overdoses are from people taking an old high dose that used to work, when they've been off the drug for a while and are no longer as tolerant.<p>There has to be a way of factory resetting people's tolerance for drugs without harming the person. I wish that could be found and added to opiates especially.<p>My apologies for the rambling rant. Just realize that these statistics you read about are all people. All lives that may have tried to feel better about themselves and ended up drowning in their dependence. Please don't write us all off as junkies who deserve punishment for stumbling in life.
Black market opiate & opioid users need to get off the danger train and start taking kratom. It may not get you quite as 'high', but it can stave off cravings and withdrawal symptoms, and help you find stability. Harm reduction is a viable solution.
This would be solved if drugs were decriminalized and testing kits were very easy to use and come by but I guess a lot more people have to die before society as a whole acquires common sense
And yet marijuana is still illegal in my state.<p>The impact of legislation like Citizens United and the outsized influence of large institutions on American politics is really unfortunate.
We have 2 options for dangerous things:
1) Regulate.
2) Criminalize.<p>If lots of people do it, (1) is better, even though it normalizes the danger, because we get seat belts and pharmaceutical controls and the ability to innovate and discuss changes in public.<p>If the people involved can be cast as lower moral status / other, then it becomes a problem of "Dealing with THEM", and we get (2). This is correct if the primary activity is a real, moral crime (theft, extortion rackets), which changing consciousness and numbing pain aren't. This is almost NEVER correct in the case of voluntary economic transactions (for which the societal benefits of regulation have proven to be enormous), unless those interactions are inherently theftlike/extortionate/exploitative-involuntary, because it creates a spiral of violence.<p>So the questions are: Should pain numbing / consciousness altering be the province of organized crime? Should we devote substantial societal resources to a failed project of stopping people from altering consciousness and numbing pain, or change to make that fact less damaging? Should one part of society get to impose the violence-filled option on everyone else?
Human: Write me the longest possible article on the dangers of drugs while obfuscating around the living and working conditions that make fentanyl seem like a viable aternative to life.
Washington (democrats and republicans, including Obama and Trump) did as they were paid to do. The Sackler family did this on purpose, as their parents did with Benzos and other painkillers. They purposely increased the addictiveness then lied about it. Then the government gave them immunity after their deadly product killed hundreds of thousands to millions of Americans.
Orthopedic surgeon Dr. Chris Raynor recently released a video explaining how doctors use fentanyl in hospital environments and why it's so dangerous in other contexts. It's worth watching to understand the basic pharmacology involved.<p><a href="https://youtu.be/VguWPDPg3sU" rel="nofollow">https://youtu.be/VguWPDPg3sU</a>
Getting a needle inserted for blood draw sucks. Getting one of the fatter ones that can inject things into a vein hurts! How good could the high be that it's worth that, if you're not suffering from a serious injury or disease that would warrant painkillers?
This seems like a huge problem to solve. Anyone know of anyone going after solving it from interesting new angles? Are there any VCs funding ideas like this?<p>I can think of at least a few angles that might be interesting since I'm too uninformed to know any better:<p>Is it possible to create mRNA vaccine that block opioid receptors?<p>What happened to the scanning tech mentioned in the post? That thread seems to just stop with "failure to innovate". We have ML that feels like it could do that now. There's that open robotics repository of scanned objects -- it sounds silly, but why not scan every single car (maybe with some help from automakers) so there's a reference and train with that?<p>As far as the physical problem of scanning, can we scan cars/trucks/containers/etc with sonar rather than visually and let a computer figure it out?
The fact that vivitrol is both rare and stupidly expensive is a tradgedy. Like, if the goverment just forced pharma companies to supply the stuff for free or extremely cheap it would help addicts immensely.
Also why not hit people with the vivitrol shot the second they get caught with opioids or show up in the emergency room because of an OD? Don't bother with criminal charges or forced rehab, just mandate the person comes in and gets the shot for a few months, free of charge.
I know vivitrol isn't perfect but it's the closest thing we have to a vaccine for opiod addiction, we should be giving it out like a flu shot.
Is this somehow different fentanyl for the stuff that in the UK gets handed out in litre bottles to old ladies with dodgy hips?<p>Because the whole point of fentanyl is the massive therapeutic window and difficulty of overdosing.
All drugs should be legalized. That is the only solution.<p>You should be able to buy cocaine, heroin, fentanyl at the local grocery store. No question asked. Maybe even subsidize it for poor people who can't afford market prices.<p>The local pharmacy should provide training on how to inject/consume them safely and give for free the associated consumables.
The US would really benefit from a strong southern border. That's obviously a politically loaded statement, but just take it at face value. There is such a thing as borders. The US needs to stop the flow of illegal shit across the southern border. I know this won't solve 100% of the fentanyl issues. Low hanging fruit, and all that. Start somewhere.
Since Washington's only response to drug problems has been to try to literally destroy everyone involved, this sounds like a massive improvement in public policy to me. Seriously though, this is a white person's problem and they aren't going to attack the white community like they did the black community during the crack epidemic. But they don't know how to do anything actually helpful either (new skills are hard for the elderly I hear), so they just sit there and stare at it. I just don't see the zeal to lock these people in cages forever that I'm used to. Funny how that works.
I thought ycombinator tried to stay away from political stuff? I've been around for years and that was usually the case. Why is there a popular post about drug addiction and the response from "Washington"? This isn't tech related.<p><a href="https://news.ycombinator.com/newsguidelines.html#comments" rel="nofollow">https://news.ycombinator.com/newsguidelines.html#comments</a><p>I'll quote the guidelines here:<p>"Please don't use Hacker News for political or ideological battle. That tramples curiosity."<p>Most comments here are political. Did I miss a blog post that says to be politicans?