Having grown up in suburbia with a number of friends who have gone the heroin route, from my experience the biggest issue is young kids don't associate their Mom's painkillers in the medicine cabinet with heroin.<p>Oxycontin is viewed like a fun drug. It's legal, so it must be okay...<p>Once they're addicted and out of money they eventually turn to heroin(something they would have never touched prior).
As a former heroin addict who used to buy from these guys, this article is spot on. They were always polite, fair and non-threatening. They were usually (relatively) on time. They really did have a great customer experience relative to the alternatives (which I also used from time to time). The thing about them keeping business hours is also accurate and was amusing to me at the time, except of course when I ran afoul of the deadline.<p>As I recall, they even engaged in some network marketing. The group I bought from had a standing offer of a free balloon in exchange for bringing them a new customer.
In the US, Methadone also keeps people tethered to a daily drive to a Methadone clinic, followed by a relatively long wait in line. When someone is trying to hang on to a job and get their life back together, this can be a significant drag on the process. Buprenorphine (with or without added naloxone) has no such restriction, and can be dispensed from a normal pharmacy in 30-day supplies. However, the DEA limits the number of patients a buprenorphine-licensed physician can take on, which leads to shortages of available care (or very high prices) in a lot of areas of the US.<p>The article seems to blame the drug, and the delivery service, and the people selling it. But many of the people in the bottom 20% income bracket in the US are sick, isolated, have no access to health care (at least without winning their $6,250 out-of-pocket maximum on a lottery ticket), are poor enough to have to prioritize rent over food, and have little to no opportunity for social or economic advancement. As the <a href="http://en.wikipedia.org/wiki/Rat_Park" rel="nofollow">http://en.wikipedia.org/wiki/Rat_Park</a> guy said, "severely distressed animals, like severely distressed people, will relieve their distress pharmacologically if they can."
I have a very close friend who this article described perfectly. None of us grew up in a great environment, so when his friends suggested Oxycontin it wasn't abnormal or even strange to do it. But it's been 9 years since and after being homeless, a methadone patient (it's hard to call it treatment when they themselves are so predatory), and endless amounts of family support he is slipping into the harder street drugs that are cheaper and more abundant to find.<p>Growing up in that world has given me an appreciation for the very slight difference between obsession, which drives us to be great and addiction which drives us into the ground and I wonder why I got one and he got the other.
Let's not forget about the shameful inclusion of acetaminophen (at least partially, explicitly) as a harmful deterrent against opioid abuse. Serial abusers mostly know about this (and have strategies to mitigate it), but kids popping their mom's Percocet with a Bud Light have no idea how harmful that combintaion is. That it's unnecessarily, intentionally harmful is, again, shameful policy.<p><a href="http://healthland.time.com/2011/01/13/fda-cuts-acetaminophen-dose-in-opioid-painkillers/" rel="nofollow">http://healthland.time.com/2011/01/13/fda-cuts-acetaminophen...</a>
There should also be some discussion about why the US uses more prescription narcotics than any other country. Some interesting data and charts here on global consumption and how it's changed over time.<p><a href="http://www.painpolicy.wisc.edu/global" rel="nofollow">http://www.painpolicy.wisc.edu/global</a>
Interesting business model for sure. Very impressed to hear they actually did customer surveys and follow ups. The next step is an app over SSL. Choose the quantity you want and your unique customer identifier and you will be SMS'd a Google Maps link to a pickup location.<p>What a horrible problem this is. I was hooked for a very long time on this stuff and have had many friends die as a result. It is a nasty habit to kick.
I hate when heroin is described as some terrible extremely dangerous drug, when in fact it is quite the opposite - it is very gentle and relatively harmless drug. Of course I am talking about medical grade pure heroin, not that Mexican black tar shit or white heroin mixed with god knows what. Even with street shitty heroin, 90% overdoses can be so easy avoidable: just don't mix with it alcohol or benzos, and have someone in your shooting gallery with shot of Naloxone.<p>I am not even talking about medical grade morphine/heroine, which is gentle and safe as milk (I mean constipation and some temporary hormone imbalance is the worst you can get, compare it with side affects of otc NSAID, which includes renal failure, myocardial infarction, Gastrointestinal bleeding).<p>And the solution is so simple - just provide addicts with pure heroin, other countries, like Switzerland do this with great success.
Parts of this story are not ringing true to me.<p>Do dealers really drive around with balloons in their mouths, prepared to swallow them if stopped? Do buyers really receive calls from dealers asking them whether they're satisified? Do buyers really announce their intention to quit using or switch dealers, and get free heroin?<p>I don't have a lot of experience with stuff like this, but it sounds so bogus.
"But instead of pursuing more complicated pain solutions, which might include eating better, exercising more and, thus, feeling better, too many saw doctors as car mechanics endowed with powers to fix everything quickly."<p>And what's wrong with that? Opiates have a <i>very</i> low side effect profile, compared to other popular medications (like mood stabilizers, antidepressants). Why should someone unfortunate to have a pain issue also need to change diet and exercise if there's another option?<p>As far as doctors being mechanics -- eh, almost. This unfair system of medicine licensing means that you need to get paid approval before taking medicine of your choosing. And even then, unless you're wealthy enough to demand service, you're entirely left to the doctor's personal whims. Many of which include an anti-addict narrative influencing their decisions.<p>This story is rather Luddite in its views. Don't use medicine, find your inner strength; be <i>American</i>!
This is why I tend to roll my eyes when people advocate legalizing all drugs, no matter what. All the talk about giving up on the failed war on drugs starts to matter a whole lot less when it's your loved ones who you're not sure you're ever going to see alive again on a day to day basis.<p>I'm completely willing to grant that keeping certain drugs (like marijuana) illegal isn't effective or necessary from a public safety standpoint compared to legalization/regulation. But for dealers of heroin and other hard drugs like these, I support extremely, extremely harsh penalties and much stronger enforcement. Far harsher and much stronger than what we currently have.<p>At least that's my (likely unpopular) opinion.