# The US Opioid Epidemic

#### Nice Squirrel

##### Contributor
Okay, I've decided to rename this thread as most politicians are occupied with other things, and the president is uninterested in doing anything beyond lip service.

Last year we had over 60,000 die of overdoses.
https://www.nytimes.com/interactive...rdose-deaths-are-rising-faster-than-ever.html

Drug overdose deaths in 2016 most likely exceeded 59,000, the largest annual jump ever recorded in the United States, according to preliminary data compiled by The New York Times.

The death count is the latest consequence of an escalating public health crisis: opioid addiction, now made more deadly by an influx of illicitly manufactured fentanyl and similar drugs. Drug overdoses are now the leading cause of death among Americans under 50.
'

Now the FDA is asking to pull a drug off the market because it is too addictive.
http://www.nbcnews.com/storyline/am...y-pull-its-opioid-opana-because-abuse-n770121

“Today, the U.S. Food and Drug Administration requested that Endo Pharmaceuticals remove its opioid pain medication, reformulated Opana ER (oxymorphone hydrochloride), from the market,” the FDA said in a statement.

“After careful consideration, the agency is seeking removal based on its concern that the benefits of the drug may no longer outweigh its risks. This is the first time the agency has taken steps to remove a currently marketed opioid pain medication from sale due to the public health consequences of abuse.”

CBS News Opioid Epidemic page: http://www.cbsnews.com/opioid-epidemic/

#### Elixir

Opioid Crisis Now Leading Cause of Death for Americans Under 50: https://www.democracynow.org/2017/6/7/worst_epidemic_in_us_history_opioid

So how do we stop this?

Send the B-52's over Afghanistan and dump as much Napalm as we can on the poppy fields....

Why not MOABs?
We have been providing some NARCAN kits to CBP et al, and you wouldn't even believe the kind of regs and scrutiny that has put us under. Almost as if someone "up there" wants people to die if they overdose on heroin or related drugs. Seems consistent with the administration's tacit policy to let the unfortunate suffer - invest nothing in protecting them from themselves, and pocket the savings.

#### dismal

##### Contributor
Send the B-52's over Afghanistan and dump as much Napalm as we can on the poppy fields....

Why not MOABs?
We have been providing some NARCAN kits to CBP et al, and you wouldn't even believe the kind of regs and scrutiny that has put us under. Almost as if someone "up there" wants people to die if they overdose on heroin or related drugs. Seems consistent with the administration's tacit policy to let the unfortunate suffer - invest nothing in protecting them from themselves, and pocket the savings.

The administration that has been in power for the last 4 months? Or the administration that was in power in 2016 when those 60,000 people died?

#### whichphilosophy

##### Contributor
Okay, I've decided to rename this thread as most politicians are occupied with other things, and the president is uninterested in doing anything beyond lip service.

Last year we had over 60,000 die of overdoses.
https://www.nytimes.com/interactive...rdose-deaths-are-rising-faster-than-ever.html

'

Now the FDA is asking to pull a drug off the market because it is too addictive.
http://www.nbcnews.com/storyline/am...y-pull-its-opioid-opana-because-abuse-n770121

“Today, the U.S. Food and Drug Administration requested that Endo Pharmaceuticals remove its opioid pain medication, reformulated Opana ER (oxymorphone hydrochloride), from the market,” the FDA said in a statement.

“After careful consideration, the agency is seeking removal based on its concern that the benefits of the drug may no longer outweigh its risks. This is the first time the agency has taken steps to remove a currently marketed opioid pain medication from sale due to the public health consequences of abuse.”

CBS News Opioid Epidemic page: http://www.cbsnews.com/opioid-epidemic/

Your correct, nobody is doing anything about it even though we've known for a number of years

Manufacturers should cease using opiates in pain killers where I am sure there are a lot of alternatives.

The abuse of and addiction to opioids such as heroin, morphine, and prescription pain relievers is a serious global problem that affects the health, social, and economic welfare of all societies. It is estimated that between 26.4 million and 36 million people abuse opioids worldwide,[1] with an estimated 2.1 million people in the United States suffering from substance use disorders related to prescription opioid pain relievers in 2012 and an estimated 467,000 addicted to heroin.[

#### Elixir

Why not MOABs?
We have been providing some NARCAN kits to CBP et al, and you wouldn't even believe the kind of regs and scrutiny that has put us under. Almost as if someone "up there" wants people to die if they overdose on heroin or related drugs. Seems consistent with the administration's tacit policy to let the unfortunate suffer - invest nothing in protecting them from themselves, and pocket the savings.

The administration that has been in power for the last 4 months? Or the administration that was in power in 2016 when those 60,000 people died?

Both. The main difference is that the current administration is acting in contradiction to - or is impotent to fulfill - its promise.
BTW, opioid-related deaths are up in 2017 so far...

#### dismal

##### Contributor
The administration that has been in power for the last 4 months? Or the administration that was in power in 2016 when those 60,000 people died?

Both. The main difference is that the current administration is acting in contradiction to - or is impotent to fulfill - its promise.
BTW, opioid-related deaths are up in 2017 so far...

The data in the article you linked appears to stop at 2015 on my computer. Maybe there's something wrong with it.

But given recent trends it would be somewhat surprising if it did not go up some in 2017:

#### braces_for_impact

##### Veteran Member
The way see it, there's a lot of blame to go around for this, and like most social problems, there's no easy answer. Doctors, pharma companies, insurance companies, and patients themselves should all claim their fair share of what's going on. Each industry would have to have a reformation and frankly, give up on some money because their current practices are harming patients. Unfortunately there's a lot of finger pointing going on by each of these groups, and no real changes taking place. The only change that has taken place (eliminating pill mills, new regulations for pain clinics, etc.) has been enacted by government, but there's little funding to make changes, and most on are on the state level.

There's also the matter of changing the circumstances of patient's lives. When your life sucks and you have nowhere to turn, a hit of opioids can make it feel like it's not so bad, and it helps you cope. Often, "addiction specialists" kick the crutches out from underneath you, and do nothing to help about your broken leg.

#### southernhybrid

##### Contributor
Okay, I've decided to rename this thread as most politicians are occupied with other things, and the president is uninterested in doing anything beyond lip service.

Last year we had over 60,000 die of overdoses.
https://www.nytimes.com/interactive...rdose-deaths-are-rising-faster-than-ever.html

'

Now the FDA is asking to pull a drug off the market because it is too addictive.
http://www.nbcnews.com/storyline/am...y-pull-its-opioid-opana-because-abuse-n770121

CBS News Opioid Epidemic page: http://www.cbsnews.com/opioid-epidemic/

Your correct, nobody is doing anything about it even though we've known for a number of years

Manufacturers should cease using opiates in pain killers where I am sure there are a lot of alternatives.

The abuse of and addiction to opioids such as heroin, morphine, and prescription pain relievers is a serious global problem that affects the health, social, and economic welfare of all societies. It is estimated that between 26.4 million and 36 million people abuse opioids worldwide,[1] with an estimated 2.1 million people in the United States suffering from substance use disorders related to prescription opioid pain relievers in 2012 and an estimated 467,000 addicted to heroin.[

Unfortunately, there are not currently any drugs other than opiates that are effective in treating moderate to severe acute or chronic pain. I have worked as a health care professional for over forty years and there are many people, primarily older adults, that suffer greatly from chronic pain. Currently the few other drugs like NSAIDS, which are sometimes effective in treating inflammatory diseases, have their own set of severe side effects if used on a regular basis. They can cause severe GI bleeds as well as renal failure. I personally know of a truck drive that died of liver failure from taking acetaminophen ( tylenol ) for chronic back pain. Drugs such as gabapentin are sometimes effective in treating neuropathy, but they also have a lot of side effects, and they aren't always effective. I've read books on pain control and experienced severe pain myself. Narcotic pain killers were the only thing that helped me. Fortunately my severe pain was acute and I only needed these drugs for a short period of time.

My biggest concern is that those who need these drugs the most, including about five of my current patients, will not have access to them due to increasingly draconian regulations, which haven't been effective in reducing the misuse of these drugs. These regulations which include physicians no longer be able to write refills for any of these control drugs, have caused a lot of hardship for these folks.

I think the addiction problem is probably a lot more complicated than some seem to think. It may be partially due to many nonrelated societal problems. Making it harder for people to obtain legally written pain Rxs. is not going to fix this problem. Drugs like fentanyl are now being illegally manufactured and obtained in countries like China, for example. I don't know what the solution is to this problem but I'm very sure that the answer isn't to deprive those who need these drugs the most from living more comfortable lives.

#### Elixir

When your life sucks and you have nowhere to turn, a hit of opioids can make it feel like it's not so bad, and it helps you cope.

Opioids make me sick. I have bottles of accumulated painkillers that I've been prescribed and have either never taken or have only taken one or two out of the bottle. Most came from dentists. But as an example, I had some hip pain past year and couldn't see my primary care doc. Got in to see his PA instead. She gave me the referral to PT that I wanted, and a prescription for Vicodin. I filled the prescription... the bottle seemed to be a bit large, but that's nothing unusual, But then I opened it - she had given me THIRTY pills! I took 1½ of them over the next 2 days, then went to ibuprofen. The rest remain in a bottle in a drawer, awaiting the rueful day when I experience pain that is more unpleasant than what that shit does to me.

IMHO there's no excuse for handing out THIRTY Vicodin for someone's pain coming from an un-diagnosed source.

#### LordKiran

##### Veteran Member
When your life sucks and you have nowhere to turn, a hit of opioids can make it feel like it's not so bad, and it helps you cope.

Opioids make me sick. I have bottles of accumulated painkillers that I've been prescribed and have either never taken or have only taken one or two out of the bottle. Most came from dentists. But as an example, I had some hip pain past year and couldn't see my primary care doc. Got in to see his PA instead. She gave me the referral to PT that I wanted, and a prescription for Vicodin. I filled the prescription... the bottle seemed to be a bit large, but that's nothing unusual, But then I opened it - she had given me THIRTY pills! I took 1½ of them over the next 2 days, then went to ibuprofen. The rest remain in a bottle in a drawer, awaiting the rueful day when I experience pain that is more unpleasant than what that shit does to me.

IMHO there's no excuse for handing out THIRTY Vicodin for someone's pain coming from an un-diagnosed source.

I'm the same way and have to wonder how much of it is doctors not ensuring that their patients can't go hog wild on what they hand out. Perhaps instead of handing them out in one lump sum, there could be a delivery service which supplies them 2-4 at a time?

#### Elixir

Send the B-52's over Afghanistan and dump as much Napalm as we can on the poppy fields....

The problem is we should be targeting prescription drugs for alternatives

No Captain Obvious Award for that one, WP. A more opaque post would be hard to find. What do you mean by "targeting" and "alternatives"?

#### funinspace

##### Don't Panic
Humor/sarcasm fail...

Send the B-52's over Afghanistan and dump as much Napalm as we can on the poppy fields....

The problem is we should be targeting prescription drugs for alternatives

So you want the US Air Force to bomb pharmaceutical companies...well that makes about as much sense as much of what you write.

#### funinspace

##### Don't Panic
Opioids make me sick. I have bottles of accumulated painkillers that I've been prescribed and have either never taken or have only taken one or two out of the bottle. Most came from dentists. But as an example, I had some hip pain past year and couldn't see my primary care doc. Got in to see his PA instead. She gave me the referral to PT that I wanted, and a prescription for Vicodin. I filled the prescription... the bottle seemed to be a bit large, but that's nothing unusual, But then I opened it - she had given me THIRTY pills! I took 1½ of them over the next 2 days, then went to ibuprofen. The rest remain in a bottle in a drawer, awaiting the rueful day when I experience pain that is more unpleasant than what that shit does to me.

IMHO there's no excuse for handing out THIRTY Vicodin for someone's pain coming from an un-diagnosed source.

I'm the same way and have to wonder how much of it is doctors not ensuring that their patients can't go hog wild on what they hand out. Perhaps instead of handing them out in one lump sum, there could be a delivery service which supplies them 2-4 at a time?
I was given a 7-10 day supply of Vicodin and something else, one time when I had a nasty bout of vertigo...guess I had a stingy doctor. Didn't like either drug, but I did need them for 3ish days.

#### Deepak

##### Veteran Member
Doctors, pharma companies, insurance companies, and patients themselves should all claim their fair share of what's going on.

I would say Pharmaceutical manufacturers bear the lion's share (Purdue Pharma especially), then doctors, then patients - but I'm not really sure how much blame should go to insurance companies. I think the ideal case is that insurance companies don't interfere with the specifics of the treatment plan a doctor recommends for their patient, and if anything they're incentivized to not pay for a prescription.

#### Elixir

The problem is we should be targeting prescription drugs for alternatives

So you want the US Air Force to bomb pharmaceutical companies...well that makes about as much sense as much of what you write.

Now that I think about it... it makes more sense (assuming your translation is accurate) than most WP screeds.

#### whichphilosophy

##### Contributor
The problem is we should be targeting prescription drugs for alternatives

No Captain Obvious Award for that one, WP. A more opaque post would be hard to find. What do you mean by "targeting" and "alternatives"?

We can't leave patients in pain because opiates have long term effects but must see what alternatives can be researched into.

There are still a lot of alternatives to be looked into and more rigid controls on testing but the WHO report on acupuncture may be of interest

http://www.evidencebasedacupuncture.org/who-official-position/

In the UK Acupuncture is under the British Medical Association (The British Medical Acupuncture Society)

http://www.medical-acupuncture.co.uk/

The BMA own report can be found here

http://web.bma.org.uk/pressrel.nsf/...0083a901e4c072498025692100346d5e?OpenDocument

The BMA has commented that more research is required but many people use this as an alternative to medication.

#### whichphilosophy

##### Contributor
The problem is we should be targeting prescription drugs for alternatives

So you want the US Air Force to bomb pharmaceutical companies...well that makes about as much sense as much of what you write.

We can't bomb them; it'll cause too much damage in the surrounding areas.

#### Playball40

##### Veteran Member
The way see it, there's a lot of blame to go around for this, and like most social problems, there's no easy answer. Doctors, pharma companies, insurance companies, and patients themselves should all claim their fair share of what's going on. Each industry would have to have a reformation and frankly, give up on some money because their current practices are harming patients. Unfortunately there's a lot of finger pointing going on by each of these groups, and no real changes taking place. The only change that has taken place (eliminating pill mills, new regulations for pain clinics, etc.) has been enacted by government, but there's little funding to make changes, and most on are on the state level.

There's also the matter of changing the circumstances of patient's lives. When your life sucks and you have nowhere to turn, a hit of opioids can make it feel like it's not so bad, and it helps you cope. Often, "addiction specialists" kick the crutches out from underneath you, and do nothing to help about your broken leg.
yup

#### LordKiran

##### Veteran Member
So you want the US Air Force to bomb pharmaceutical companies...well that makes about as much sense as much of what you write.

We can't bomb them; it'll cause too much damage in the surrounding areas.

Says who?

#### Playball40

##### Veteran Member
Your correct, nobody is doing anything about it even though we've known for a number of years

Manufacturers should cease using opiates in pain killers where I am sure there are a lot of alternatives.

The abuse of and addiction to opioids such as heroin, morphine, and prescription pain relievers is a serious global problem that affects the health, social, and economic welfare of all societies. It is estimated that between 26.4 million and 36 million people abuse opioids worldwide,[1] with an estimated 2.1 million people in the United States suffering from substance use disorders related to prescription opioid pain relievers in 2012 and an estimated 467,000 addicted to heroin.[

Unfortunately, there are not currently any drugs other than opiates that are effective in treating moderate to severe acute or chronic pain. I have worked as a health care professional for over forty years and there are many people, primarily older adults, that suffer greatly from chronic pain. Currently the few other drugs like NSAIDS, which are sometimes effective in treating inflammatory diseases, have their own set of severe side effects if used on a regular basis. They can cause severe GI bleeds as well as renal failure. I personally know of a truck drive that died of liver failure from taking acetaminophen ( tylenol ) for chronic back pain. Drugs such as gabapentin are sometimes effective in treating neuropathy, but they also have a lot of side effects, and they aren't always effective. I've read books on pain control and experienced severe pain myself. Narcotic pain killers were the only thing that helped me. Fortunately my severe pain was acute and I only needed these drugs for a short period of time.

My biggest concern is that those who need these drugs the most, including about five of my current patients, will not have access to them due to increasingly draconian regulations, which haven't been effective in reducing the misuse of these drugs. These regulations which include physicians no longer be able to write refills for any of these control drugs, have caused a lot of hardship for these folks.

I think the addiction problem is probably a lot more complicated than some seem to think. It may be partially due to many nonrelated societal problems. Making it harder for people to obtain legally written pain Rxs. is not going to fix this problem. Drugs like fentanyl are now being illegally manufactured and obtained in countries like China, for example. I don't know what the solution is to this problem but I'm very sure that the answer isn't to deprive those who need these drugs the most from living more comfortable lives.
The draconian measures you speak of have only INCREASED the incidence of death from drug overdoses. Why? Because people are turning to heroin and "online" fentanyl from China. Also, many of these overdoses are pain medication in CONJUNCTION with alcohol or anti-anxiety medications. We need to figure out how to prevent those from being prescribed together as the combination is deadly.

- - - Updated - - -

Uh that's you. Not everyone responds the same way you know.
When your life sucks and you have nowhere to turn, a hit of opioids can make it feel like it's not so bad, and it helps you cope.

Opioids make me sick. I have bottles of accumulated painkillers that I've been prescribed and have either never taken or have only taken one or two out of the bottle. Most came from dentists. But as an example, I had some hip pain past year and couldn't see my primary care doc. Got in to see his PA instead. She gave me the referral to PT that I wanted, and a prescription for Vicodin. I filled the prescription... the bottle seemed to be a bit large, but that's nothing unusual, But then I opened it - she had given me THIRTY pills! I took 1½ of them over the next 2 days, then went to ibuprofen. The rest remain in a bottle in a drawer, awaiting the rueful day when I experience pain that is more unpleasant than what that shit does to me.

IMHO there's no excuse for handing out THIRTY Vicodin for someone's pain coming from an un-diagnosed source.

- - - Updated - - -

It's not the pain medication by itself.
Doctors, pharma companies, insurance companies, and patients themselves should all claim their fair share of what's going on.

I would say Pharmaceutical manufacturers bear the lion's share (Purdue Pharma especially), then doctors, then patients - but I'm not really sure how much blame should go to insurance companies. I think the ideal case is that insurance companies don't interfere with the specifics of the treatment plan a doctor recommends for their patient, and if anything they're incentivized to not pay for a prescription.

#### braces_for_impact

##### Veteran Member
Doctors, pharma companies, insurance companies, and patients themselves should all claim their fair share of what's going on.

I would say Pharmaceutical manufacturers bear the lion's share (Purdue Pharma especially), then doctors, then patients - but I'm not really sure how much blame should go to insurance companies. I think the ideal case is that insurance companies don't interfere with the specifics of the treatment plan a doctor recommends for their patient, and if anything they're incentivized to not pay for a prescription.

I absolutely agree. As far as insurance companies, often they won't pay for a corrective procedure, but you're still in pain. So, you're stuck on opiates for years for no good reason other to save some insurance company money.

#### braces_for_impact

##### Veteran Member
As far as the insurance and doctor problems go, I'll share a personal anecdote.

I had been on tramadol for about 3 years because of neck joint degeneration and a bone spur which presses on a nerve. I wasn't happy about taking opiates for so long, but I sought treatment because life was getting miserable for me, and an MRI showed my problem. I took the medication as directed, and the meds made life bearable again. I could sleep, and I could function at work and at home with my two kids.

Then I lost my job and lost my insurance. Our opiate laws here in Florida mandate the doctor see their patients in person every month - and are also subject to random drug testing on a regular basis. I suddenly went from managing my pain, to dope sick when my meds ran out. I mean sick and completely miserable. Now not only was I in pain, but my body and my brain made me feel worse than anything I had ever experienced. There was also a deep depression that set in. I was unable to cope with anything. I very suddenly understood the desperation that junkies must feel. If someone had come into my home with a needle and heroine, I can't honestly say I would have turned it down. I felt as if I would do anything to get me out of feeling like I did. So, I thought, OK, this will last for a few days and I'll sweat it out and be over it. TWO WEEKS passed, I was worse, not better.

Someone I knew recommended kratom. I went to a nearby kratom bar. I was skeptical and sick and just a grumpy asshole. My girlfriend almost literally had to drag me there. I had a drink. I felt something, and my symptoms started to go away, like within a half hour. I had a second drink and felt good, like really actually good. Not the same as tramadol, that warm fuzzy feeling it gave me, but good as in having hope again. Also, the constant muscle spasms, and burning associated with my condition lessened substantially. My mood lifted, my sickness went away and I went shopping and stayed out of the house all day. Fucking amazing. I went home with some in baggie and learned how to make tea with it. Many states have banned kratom and we just fought off them trying to do so here in Florida for a third year in a row. You may have also heard recently that we fended off a DEA measure that wanted to make kratom a schedule 1 substance, which is ridiculous. Many of the states that have enacted measures against kratom also have pharmaceutical research going on with kratom. Coincidence? There's a lot of misinformation about kratom everywhere you look, and I support research into it for pain relief and getting people off of opiates. I would support measures to regulate kratom (not ban it) so that you can be assured of potency, purity, and make it safer.

I'm still unemployed, and I take a few tablespoons of kratom every day to manage my pain, and help with my depression, which it does wonders for, when I had tried several depression meds that didn't work for me or had intolerable side effects.

In many ways I consider myself lucky. Who knows what I would have done to avoid that dope sickness, had I the connections or know how to get a hold of street stuff. I'm not proud of saying that, and I have no history of alcohol or other drug abuse. I've had vicodin and similar drugs before after surgeries, sometimes for a few months, and had very little difficulty after my medical rotation was finished. It seems that Tramadol also has an ssri component to it, which is scary. As I looked around online, it seems Tramadol was marketed as a less addictive type of opiate. But, from what I have been able to find, like many drugs as of late, it's turning out to be the opposite of that.

#### Loren Pechtel

##### Super Moderator
Staff member
I think the addiction problem is probably a lot more complicated than some seem to think. It may be partially due to many nonrelated societal problems. Making it harder for people to obtain legally written pain Rxs. is not going to fix this problem. Drugs like fentanyl are now being illegally manufactured and obtained in countries like China, for example. I don't know what the solution is to this problem but I'm very sure that the answer isn't to deprive those who need these drugs the most from living more comfortable lives.

I think making the stuff available by prescription to the addicts would go a long ways towards addressing the issue. Sure, they would be hooked but they wouldn't be facing unknown purity and thus unknowingly taking too much.

#### Thomas II

##### Contributor
When your life sucks and you have nowhere to turn, a hit of opioids can make it feel like it's not so bad, and it helps you cope.

Opioids make me sick. I have bottles of accumulated painkillers that I've been prescribed and have either never taken or have only taken one or two out of the bottle. Most came from dentists. But as an example, I had some hip pain past year and couldn't see my primary care doc. Got in to see his PA instead. She gave me the referral to PT that I wanted, and a prescription for Vicodin. I filled the prescription... the bottle seemed to be a bit large, but that's nothing unusual, But then I opened it - she had given me THIRTY pills! I took 1½ of them over the next 2 days, then went to ibuprofen. The rest remain in a bottle in a drawer, awaiting the rueful day when I experience pain that is more unpleasant than what that shit does to me.

IMHO there's no excuse for handing out THIRTY Vicodin for someone's pain coming from an un-diagnosed source.

I agree 100%.

#### Playball40

##### Veteran Member
And opioids are way less lethal without alcohol and benzodiazepines.

Because alcohol and benzodiazepines are much less lethal without the opioids.

- - - Updated - - -

Also keep in mind that when they count up prescription opioid abuse, they count street use of heroin as well.
Street fentanyl as well - typically comes from China through Mexico and is cut with who knows what.

#### braces_for_impact

##### Veteran Member
Opioids make me sick. I have bottles of accumulated painkillers that I've been prescribed and have either never taken or have only taken one or two out of the bottle. Most came from dentists. But as an example, I had some hip pain past year and couldn't see my primary care doc. Got in to see his PA instead. She gave me the referral to PT that I wanted, and a prescription for Vicodin. I filled the prescription... the bottle seemed to be a bit large, but that's nothing unusual, But then I opened it - she had given me THIRTY pills! I took 1½ of them over the next 2 days, then went to ibuprofen. The rest remain in a bottle in a drawer, awaiting the rueful day when I experience pain that is more unpleasant than what that shit does to me.

IMHO there's no excuse for handing out THIRTY Vicodin for someone's pain coming from an un-diagnosed source.

I agree 100%.

I can understand on how this is risky, but you also have to understand how shitty our health care system is...and again, that's part of the problem. When my symptoms first started I still lived in Indiana. It started as a numbness going down my left arm, a very strong feeling you get like when a limb falls asleep. Thinking that maybe I pulled something, I didn't do anything about it. Then my left hand would get numb enough that I would drop stuff now and then. That's when I got really worried. Then my store closed shop because of a corporate merger. Oops,no more health insurance.

#### T.G.G. Moogly

I thought benzos were in fact opioids. My doc would not prescribe the original dosage, said it's too dangerously addictive. I have a good doc.

#### untermensche

##### Contributor
And opioids are way less lethal without alcohol and benzodiazepines.

You are right.

The root problem is the way people increase the dosage of their pain medication without medical advise.

But this would be less of a problem without the combination of other drugs that suppress brain function.

#### southernhybrid

##### Contributor
I think the addiction problem is probably a lot more complicated than some seem to think. It may be partially due to many nonrelated societal problems. Making it harder for people to obtain legally written pain Rxs. is not going to fix this problem. Drugs like fentanyl are now being illegally manufactured and obtained in countries like China, for example. I don't know what the solution is to this problem but I'm very sure that the answer isn't to deprive those who need these drugs the most from living more comfortable lives.

I think making the stuff available by prescription to the addicts would go a long ways towards addressing the issue. Sure, they would be hooked but they wouldn't be facing unknown purity and thus unknowingly taking too much.

I don't disagree with you. In fact, I support the legalization or at least decriminalization of all recreational drugs. ETOH is legal and it kills a lot of people, or makes them dysfunctional. Any drug can be abused. When drugs are legal or at least decriminalzied, you eliminate a lot of the problem such as increased incarceration, and over doses might become less frequent. If someone wants to self destruct, they will find a way, so I tend to be libertarian when it comes to things like drugs.

And, speaking of benzos, all of my patients that currently use narcotics for their pain on a regular basis, also take benzos at least twice a day. But they are all living in a long term care environment so there is less likely hood of abuse. My late father used to tell me that his anti anxiety drug helped him more than his narcotics. He took methadone and hydrocodone for about 15 years prior to his death as the age of 87. A lot of people with chronic pain also suffer from anxiety. Sometimes antidepressants help with anxiety, but sometimes they are useless for that problem.

#### LordKiran

##### Veteran Member
I think making the stuff available by prescription to the addicts would go a long ways towards addressing the issue. Sure, they would be hooked but they wouldn't be facing unknown purity and thus unknowingly taking too much.

I don't disagree with you. In fact, I support the legalization or at least decriminalization of all recreational drugs. ETOH is legal and it kills a lot of people, or makes them dysfunctional. Any drug can be abused. When drugs are legal or at least decriminalzied, you eliminate a lot of the problem such as increased incarceration, and over doses might become less frequent. If someone wants to self destruct, they will find a way, so I tend to be libertarian when it comes to things like drugs.

And, speaking of benzos, all of my patients that currently use narcotics for their pain on a regular basis, also take benzos at least twice a day. But they are all living in a long term care environment so there is less likely hood of abuse. My late father used to tell me that his anti anxiety drug helped him more than his narcotics. He took methadone and hydrocodone for about 15 years prior to his death as the age of 87. A lot of people with chronic pain also suffer from anxiety. Sometimes antidepressants help with anxiety, but sometimes they are useless for that problem.

Alternatively, a secondary prison system that focuses on the rehabilitation of drug addicts would probably be a more sound social investment.

#### whichphilosophy

##### Contributor
I saw this report of some initial studies which suggests there is a much needed safe alternative to opiate pain killers

https://www.ncbi.nlm.nih.gov/pubmed...e-alternative-to-opiates-may-have-been-found/

Conclusion

This experimental study identified a new compound, PZM21, and investigated its effectiveness and safety in mice compared to morphine and TRV130. This research hopes
to aid the development of an effective alternative to morphine that has none of the drawbacks, such as respiratory depression, constipation and addiction.[/I]

NB obviously given there is very little else on this, successful replicated studies are required.

#### southernhybrid

##### Contributor
Drug sales on the dark web is another reason why this epidemic will never end, and it makes more sense to legalize the shit. People are going to use dangerous substances, legal or not, and the widespread availability of narcotic drugs these days makes it extremely easy to purchase them. Legalization would allow for regulations and state sponsored sales centers. That's the only thing that makes sense to me. Making draconian laws that punish users, fill up prisons etc. doesn't ever solve this problem. Selling them legally would keep the price below that of illegal sales, and allow for taxation which could be used for rehab for those that want to try and change their behavior. Blaming the problem on Rx. opiods is stupid, imo.

https://www.wired.com/2015/08/crackdowns-havent-stopped-dark-webs-100m-yearly-drug-sales/

AFTER MORE THAN four years and two giant law enforcement busts, the Dark Web's drug market is still just as robust as it was during the Silk Road's heyday. In fact, according to a new study, it's now moving well over $100 million of illegal substances a year, and it's recovering from every new scam-induced setback and government crackdown faster than the last one. Those are a few of the lessons from a deep-dive study into Dark Web black market sales statistics that a pair of Carnegie Mellon researchers plan to present at the Usenix Security conference Wednesday. From 2013 to early 2015, they used automated software to "scrape" the visible contents of 35 Dark Web markets, counting the number of feedback ratings that the major drug sites require buyers to leave after each sale and then multiplying them by the purchased item's listed price to gauge total sales volumes. The result is the most comprehensive—if still not fully complete—picture of how contraband narcotics sales have waned and waxed during the short history of the Dark Web's online economy. The researchers' findings, which extend to January of this year, describe a market that's no longer explosively growing, as it did in the early days of Silk Road. Read the rest of the link for more details. #### Crazy Eddie ##### Veteran Member I'm sure at least 20 people have beaten me to it by now... But I love how rich and middle class drug addicts are "victims" of an "epidemic" but poor people in the ghettos and the trailer parks are enemy combatants in the "war on drugs." It's actually a little bit refreshing in a way... our knee-jerk reaction is to try and shoot our way out all our problems, unless the problem affects us PERSONALLY, and then suddenly we expect people to deal with us with compassion and sensitivity. #### Playball40 ##### Veteran Member And opioids are way less lethal without alcohol and benzodiazepines. You are right. The root problem is the way people increase the dosage of their pain medication without medical advise. But this would be less of a problem without the combination of other drugs that suppress brain function. No sir, the root of the problem is WHY some people feel the need to increase their dosage. If we could get to that, we may be able to solve the problem. #### Playball40 ##### Veteran Member I have always thought it needs to be dealt with compassionately. But you're right. Cocaine was the rich man's addiction, but somehow crack <cheaper smokable version of cocaine> had stiffer penalties than powder cocaine. I'm sure at least 20 people have beaten me to it by now... But I love how rich and middle class drug addicts are "victims" of an "epidemic" but poor people in the ghettos and the trailer parks are enemy combatants in the "war on drugs." It's actually a little bit refreshing in a way... our knee-jerk reaction is to try and shoot our way out all our problems, unless the problem affects us PERSONALLY, and then suddenly we expect people to deal with us with compassion and sensitivity. #### funinspace ##### Don't Panic Drug sales on the dark web is another reason why this epidemic will never end, and it makes more sense to legalize the shit. People are going to use dangerous substances, legal or not, and the widespread availability of narcotic drugs these days makes it extremely easy to purchase them. Legalization would allow for regulations and state sponsored sales centers. That's the only thing that makes sense to me. Making draconian laws that punish users, fill up prisons etc. doesn't ever solve this problem. Selling them legally would keep the price below that of illegal sales, and allow for taxation which could be used for rehab for those that want to try and change their behavior. Blaming the problem on Rx. opiods is stupid, imo. https://www.wired.com/2015/08/crackdowns-havent-stopped-dark-webs-100m-yearly-drug-sales/ AFTER MORE THAN four years and two giant law enforcement busts, the Dark Web's drug market is still just as robust as it was during the Silk Road's heyday. In fact, according to a new study, it's now moving well over$100 million of illegal substances a year, and it's recovering from every new scam-induced setback and government crackdown faster than the last one.
Those are a few of the lessons from a deep-dive study into Dark Web black market sales statistics that a pair of Carnegie Mellon researchers plan to present at the Usenix Security conference Wednesday. From 2013 to early 2015, they used automated software to "scrape" the visible contents of 35 Dark Web markets, counting the number of feedback ratings that the major drug sites require buyers to leave after each sale and then multiplying them by the purchased item's listed price to gauge total sales volumes. The result is the most comprehensive—if still not fully complete—picture of how contraband narcotics sales have waned and waxed during the short history of the Dark Web's online economy.
The researchers' findings, which extend to January of this year, describe a market that's no longer explosively growing, as it did in the early days of Silk Road.

Are you crazy!!! 16 years after Portugal decriminalized drug use, the country is a complete disaster....
https://www.washingtonpost.com/news...-overdose-in-portugal/?utm_term=.d637a4b73608

#### Loren Pechtel

##### Super Moderator
Staff member
I'm sure at least 20 people have beaten me to it by now...

But I love how rich and middle class drug addicts are "victims" of an "epidemic" but poor people in the ghettos and the trailer parks are enemy combatants in the "war on drugs."

It's actually a little bit refreshing in a way... our knee-jerk reaction is to try and shoot our way out all our problems, unless the problem affects us PERSONALLY, and then suddenly we expect people to deal with us with compassion and sensitivity.

Nah, you love strawmen.

Addicts are victims. Dealers are akin to enemy combatants.

What muddies the waters is that poor addicts tend to turn to criminal ways to get the money to afford drugs. This leaves them sort of wearing two hats.

#### Loren Pechtel

##### Super Moderator
Staff member
I have always thought it needs to be dealt with compassionately. But you're right. Cocaine was the rich man's addiction, but somehow crack <cheaper smokable version of cocaine> had stiffer penalties than powder cocaine.

It actually makes sense.

Cocaine is a rich man's drug. Said rich man probably can afford his cocaine. He harms his own health but it's unlikely that he harms anyone else.

Crack is a poor man's drug. A crack addict generally can't afford his crack on what he can earn. Thus he turns to crime, often things like mugging. Lots of others get harmed.

Look around. How many voters were harmed by cocaine? Very few. How many were harmed by crack? Lots and lots. Is it any wonder the politicians vote for tougher penalties for crack than for cocaine?

#### Crazy Eddie

##### Veteran Member
I'm sure at least 20 people have beaten me to it by now...

But I love how rich and middle class drug addicts are "victims" of an "epidemic" but poor people in the ghettos and the trailer parks are enemy combatants in the "war on drugs."

It's actually a little bit refreshing in a way... our knee-jerk reaction is to try and shoot our way out all our problems, unless the problem affects us PERSONALLY, and then suddenly we expect people to deal with us with compassion and sensitivity.

Nah, you love strawmen.

Addicts are victims. Dealers are akin to enemy combatants.
Uh huh...

Federal lawmakers enacted mandatory minimum sentencing guidelines for drug offenses in 1986 in an attempt to target high-level distributors, although they also impact lower-level drug defendants. Most states have adopted a similar approach to drug sentencing. These fixed sentences are based on the type of drug, the weight of the drug and the number of prior convictions.

For example, Kentucky, which has adopted similar mandatory minimum sentencing guidelines, has some of the toughest provisions. For simple possession, first offenders get 2 to 10 years in prison and a fine of up to $20,000. In contrast, California has some of the lightest drug possession sentences: between$30 and $500 in fines and/or 15 to 180 days in jail. And: possession of a controlled substance is a felony offense, which means the sentence is one year or more incarceration. The typical possession of a controlled substance charge is a Class 4 felony offense for possession of cocaine, although heroin is becoming much more prevalent recently. A Class 4 felony has a possible sentence of 1-3 years in the Department of Corrections (prison). The fine can be$25,000. Most Class 4 felony drug charges permit the court to sentence the defendant to probation and substance abuse treatment.

All controlled substances are classified by the Act as either Schedule I, Schedule II, Schedule III or Schedule IV substances.

A Schedule I controlled substance is defined as a substance that: 1) has high potential for abuse; and 2) has no currently accepted medical use in treatment in the United States or lacks accepted safety for use in treatment under medical supervision. See 720 ILCS 570/203.

The coup de grace:
Finally, possession of opiates is a felony criminal offense. OxyContin is the common name of the opiate oxycodone. Possession of oxycodone without a prescription is a felony offense.
And this has been the case for the last 15 years at least. The rhetoric from the "tough on crime" crowd is that opioid abusers are just as bad as cocaine users and that they should be charged as felons just like everyone else.

Now all of a sudden they're "victims" of an "epidemic" and the problem is the drugs, not the users.

What muddies the waters is that poor addicts tend to turn to criminal ways to get the money to afford drugs. This leaves them sort of wearing two hats.
And if it was just the criminality of drug addicts that was the problem, we wouldn't be having this discussion. But drug possession ITSELF is considered a felony punishable by up to 15 years of prison time, and I'm not even talking about possession with intent to sell.

Don't even try to spin this one. America is FAMOUS for setting a drug policy specifically designed to punish drug users. Now opioid abuse is becoming more widespread, and because it's affecting a higher class of citizens, those policies no longer seem like such a good idea.

#### Playball40

##### Veteran Member
No. Possession of crack garnered a stiffer penalty than possession of powdered cocaine. I'm not talking about ancillary crimes.

And do you REALLY want to ask me how many people were harmed by powder cocaine?? Really?? I grew up in Miami in the 80's!
I have always thought it needs to be dealt with compassionately. But you're right. Cocaine was the rich man's addiction, but somehow crack <cheaper smokable version of cocaine> had stiffer penalties than powder cocaine.

It actually makes sense.

Cocaine is a rich man's drug. Said rich man probably can afford his cocaine. He harms his own health but it's unlikely that he harms anyone else.

Crack is a poor man's drug. A crack addict generally can't afford his crack on what he can earn. Thus he turns to crime, often things like mugging. Lots of others get harmed.

Look around. How many voters were harmed by cocaine? Very few. How many were harmed by crack? Lots and lots. Is it any wonder the politicians vote for tougher penalties for crack than for cocaine?