The real issue here that people don't seem to want to face is the WHY. Why do so many people want to check out of life completely by abusing medicine? If we don't address that nothing is going to stop the drug abuse let alone the relapse and overdose. I'm not talking about "more 12 step" here but more of a Frommian psychoanalytic approach. You are broken because society is broken. You have the ability to change yourself and subsequently society. A lot more empowering than just "submit to a higher power" which is clearly not working for the majority of users.
> The real issue here that people don't seem to want to face is the WHY. Why do so many people want to check out of life completely by abusing medicine
People start using drugs for different reasons. It's not correct to say that everyone starts abusing drugs as a form of pure escapism. A lot of drug users start because they're simply seeking recreation and someone is nearby to make drugs available to them. It's as simple as that.
> You are broken because society is broken.
Variations of this concept are frequently used by drug addicts to justify continued behavior. "It's not my fault, it's society's fault!". Taking ownership of actions and consequences is one of the key pivot points in helping people get control.
I think quite a lot of people ended up addicted to opioids against their will, by starting with being over prescribed highly addictive pain medication which then ended up making them addicted to opioids, and then later on ended up trying to feed that habit from the streets once the easy access to pain meds dried up.
Personally I've been avoiding oxycontin like the plague for that reason. I had two surgeries where the doctors wanted to give me oxy to manage the pain afterwards and I refused to take them. It turned out in both cases the pain was manageable with less addictive options, so I'm not clear why they reached straight for prescribing opioids in the first place.
They’re adding Fentanyl to everything now. I have Burning Man-adjacent friends who take ecstasy once a year at festivals, and they’re terrified of getting a tainted dose.
This affects many more people than just those addicted to opiates.
My fentanyl experiences have entirely been as part of surgery: it's part of the balanced triad of anaesthesia and I "recently" injured myself quite badly, resulting in three operations. After one of these, I spent about 36 hours on a fentanyl infusion and more than a month on oral morphine of various doses with my leg in an orthopaedic brace while I was bed-bound. I should point out that the alternative was a lot of screaming: visceral pain of the variety I cannot describe – I had a panicked, "help me" expression on my face and just felt utterly, utterly desperate. I was in a lot of pain and medically the drugs were appropriate, given the injuries I sustained.
I totally get why some people become addicted to drugs. Diazepam made me both in less pain and care less that I was in it. The opiates produced this warm, fuzzy haze of vivid dreams and imaginations and made a difficult time bearable. Fentanyl made me feel less than human but not able to suffer, and it was a necessity at the time.
Of all of them though, diazepam was the most dangerous. It just felt – well, nice. I didn't care that things were bad. I needed it medically to stop neurogenic muscle spasms and it made me both able to sleep well and feel OK about life in a way that is really hard to put into words. I have some in a bag, prescribed for me, in case I need it. Part of me – a small part of me, but a part nonetheless – wants to use it, a lot, when I don't need it. There's a little voice that just says "this makes you feel like you've been tucked up into bed nicely". I really can't explain it, but I know that voice is a temptation and a gateway to something that I don't want to have – but at the same time, I know that that drug both saves me from agony and helps me medically if I need it. I'm really not sure how I feel about that. I haven't had any in months, but the psychological aspect remains.
I can only imagine what "real" drug addicts go through. It must be incredibly hard, and individual's range of experiences will be very broad indeed.
I think you assume folks want to check out of life because they think fentanyl is a better choice, when instead fentanyl makes folks check out of life. Have you ever spoken with an addict who wants to get clean? It's bleak, they're basically enslaved by the substance. Having a vaccine to break the cycle is a huge boon.
I guess I'm a bit torn on this. Even if we had an extremely fair and equitable society with growth I imagine there'd still be plenty of people who feel rejected or lonesome at times. Or just like the feeling that these drugs give them above normal drugs.
I drink alcohol a couple times a week and do edibles once a month. I'm sure some would argue I'm not fulfilled but I think the easier explanation is that a lot of times doing mind-altering drugs is...fun? And can be social.
> Why do so many people want to check out of life completely by abusing medicine?
This isn’t how it works.
Few people, if any, want to “check out.” What happens is that people are exposed to opiods via one of two channels (they are prescribed painkillers, or they party with someone who has acquired them) and they quickly get hooked because these drugs are cripplingly addictive.
So the only “why” questions we have to ask are:
1) Why do people take opiods the first time
2) Why do people continue
The answer to 1 is either because their doctor said so, or because they like to party and have no foresight. The answer to 2 is because if they stop, they experience the worst sickness imaginable.
Society is not broken and we don’t need weird conspiratorial explanations for any of this.
Sometimes the simple answers are the most likely. Even if you have a great life, it’s tempting to have such experiences.
Sure, a lot of people use it as an escape though. But I imagine my dumbass brother in law died because he was trying to have fun, not check out of life. Miss him.
I think you presume that human behavior must seem to have a cognitive reason for the "why", when it's entirely possible that the "why" is simply physiological/neurological. In the case of intense opiates, which have a profound effect on human neurology, it would be bizarre to not consider that in the "why".
I think this undermines the issue a bit. A lot of people get addicted to these substances completely by accident and aren't initially seeking to "check out of life." But once you are hooked, it can be a devastatingly difficult road to get off. For sure there are plenty of people who go out looking for escapes and I do agree it is something that needs to be addressed.
Usually the "society" issue is framed as some sort of welfare crisis. I have a more-than-one-hand-full of friends and acquaintances from earlier in life who ruined or ended their life with drugs. And so I don't know anything statistically, but I have seen what caused the people near me to fall into it, and it wasn't some welfare crisis.
The number 1 reason I experienced is because some social circles fetishized it. It was a very cool, tough, and a superior lifestyle. Anyone who didn't do drugs was a loser, drugs were for winners.
When there is a strong cultural-current of this attitude, it can draw people in and ruin their lives by the time they realize it's all wrong.
> The real issue here that people don't seem to want to face is the WHY. Why do so many people want to check out of life completely by abusing medicine?
I don't do powders, opioids, etc but I do have some friends within tech and the festival scene that do. My observation is that most people that die from fentanyl don't know they're taking it. They think they're doing cocaine, ketamine, heroin, or some other substance. Fentanyl presence is usually a case of cross contamination when the particular substance is being cut at each hierarchial level of the drug food chain. That's not to say that there isn't some small subset of dealers who don't purposefully drop in some fentanyl, but largely that'd be a stupid decision. The users life expectancy shrinks and their risks skyrocket when they come in contact with fentanyl, this is known.
If you want to stop the deaths, then you have to allow drug distribution that comes from clean rooms. At present, everyone should be using test kits, but fentanyl in particular is hard to test for because a single grain hiding in a mound can get and overdose a user.
If you want people to stop using drugs, well, I have less to say. The history of humanity is using intoxicants whether it be for recreation, psychological well-being, or medical necessity. We've only recently in the history of humanity gone on moral crusades to villainize it.
Chemically addictive substances are a little more challenging. Things like heroin, cocaine, and methamphetamine aren't drugs you can benefit from, but people still do them. Largely, it's because they got hooked on pain killers or some other "numbing" medication. Better availability to harm reduction resources, therapy, social safety nets, etc would improve metrics across the board in the chemically addictive substances category.
> The real issue here that people don't seem to want to face is the WHY.
Drugs get you high. Ants get drunk, goats chase psychedelic lichen, and dolphins pass around puffer fish like a dutchie.
> Why do so many people want to check out of life completely by abusing medicine
The short term benefits always outweigh the short term costs, but we're moving to a point in history where even it even seemingly outweighs the long term costs. There's no real disincentive anymore.
I think a case can be made that Martin vs. Boise had the most to do with this. That ruling was meant to push cities into creating the necessary facilities and number of beds to correctly address their homelessness problem; instead, it seems that many cities have used it as a way to entirely ignore the issue.
Instead of building the facilities, they're just throwing up their hands and allowing the kind of "public camping" that quickly turns into public open-air drug markets. Unsurprisingly, the population and markets grew.
> A lot more empowering than just "submit to a higher power" which is clearly not working for the majority of users.
The twelve steps are about quite a bit more than "just" that. They're also targeted towards a person that is at a specific stage of addiction _and_ willingness to address it. It's not general purpose and you can't force people into it, particularly when their drug of choice is so easily available and socially acceptable.
You have to reduce the inflow of drugs. You have to stop drug markets from forming. You have to convince addicts to seek treatment.
On the last point, I think the most effective strategy would be confiscation. If you are caught with drugs for personal use, they should be taken and destroyed, and you should be given information and transportation to a treatment center if you desire. Otherwise, you should be free to go. If the state doesn't interject itself at some level then I don't think you stand a chance.
Fixing society doesn't increase revenue. The opposite, actually.
For example: The more people are depressive, the more pills can be sold. If people kill themselves due to depression, that's too bad, but they didn't buy any pills to begin with.
Diabetes is great, because people depend on insulin. A never-ending money maker! Fat people are great! They eat more, thus spend more! Some of them get their fat surgically sucked out of their bodies, which also pays! When they get more and more sick, they need more and more medicine, which pays even more!
The transhumanism movement is awesome, because transitioned people require pills! Every day!
Sadness? There's a pill for that!
Drug addicts? Lets invent a vaccine for that!
Fantastic!
Society isn't getting fixed, because nobody actually has any interest in that. Those in power/money certainly don't give a fuck and rather want more money, while the actual people are mostly too stupid to figure out that the whole system needs changing.
Instead they whine, complain and protest and go voting, without realizing that it does basically nothing. Yes, voting actually does nothing. We didn't get to this point because voting helps anything. We got here, because voting doesn't matter.
Decades of evidence lay in front of everyone out there to see, yet for some reason every couple years people actually believe their button-pressing/their X-making actually gives them power over what's going to happen!
There's no vote allowing you to change who pays all the money to the politicians, law makers and judges. There's no vote that allows you to change the underlying corruption that's going on. There's no vote that enables you to decide what actually happens with your money.
You're fucking hilarious. You're not wrong per se, but also hilarious.
"Society needs fixing!!!111" well then get together with enough people and fucking fix it.
Politicians won't do it for you.
Better get your guns ready, btw, because it's definitely not going to happen peacefully.
A good metaphor for addiction is speeding. You're driving down and empty highway, you want to get where you're going faster. You're not going to actively look down at your speedometer. You know you're probably breaking the prescribed limit a bit, but who cares. The when you finally are faced with looking at the speedometer, say when you get to windy section or a speed trap, you look down and you're going 25mph over the limit and you have no idea how you ended up going so fast, but by that time, you're brakes are squealing or worse.
I would ask a different 'why', which is 'why is fentanyl so easily accessible?'. We know where it's made, how it gets into the US, a long list of reasons for why people start taking it. But why hasn't the supply of fentanyl to the US been restricted?
Given how many lives this destroys, how many people it takes out of the potential workforce, how many social problems this causes (crime, homelessness, exasperated mental health issues) - why isn't there the political will to change this?
Do you really think that Michael Jackson and Prince wanted to "check out"?
My assessment is that if even people at that level of wealth and success can get addicted to opioids and die, pretty much anyone can.
Addiction, whether alcohol, drugs, cigarettes, etc., is something that is a genuine medical issue needing treatment. Thankfully, the medical community seems to be shaking off the social stigma about addiction and treating it properly now, but progress has been very slow.
While I agree with you, at the same time, I can't help but think having someone take a pill or shot weekly/monthly/etc is whole lot simpler and easier than fixing the homeless problem, the cost of medical care, and training up (and paying) hundreds of thousands of new mental health professionals, among the dozens and dozens of different reasons people turn to drugs like this to 'escape'.
There’s also the medical systems unwillingness to help certain people and medicate; then people end up on the street getting more dangerous drugs in an uncontrolled fashion.
Something else I wonder is how have we managed to convince generations that smoking is not only horrible to your health and frowned upon but alcohol is acceptable?
It's provocative in rats, but there's lessons from similar attempts that need to be considered. Cocaine-specific vaccines have been in development for years, and they haven't been successful. The biggest problem is that you need people to maintain an enormous concentration of antibodies against the drug so that even minute quantities are captured within seconds of entering the blood stream. Even if you can achieve an initial therapeutic levels, you need to constantly boost the vaccine to maintain high antibody titer. All of these attempts have targeted people with cocaine use disorder and are able to focus on shots every few weeks to months. We're nowhere close to developing something that would work as a routine preventative vaccination.
We do have a once a month injection of naltrexone that can block all opioids, which can be effective in the right person. A targeted approach to fentanyl alone would probably work in people who don't have an opioid use disorder (and therefore wouldn't be as prone to substitution with an alternative opioid). This is an interesting step, but our understanding of immunology is far too limited to make this realistic in the near term.
Someone in my family died from fentanyl at 26. I knew him since he was a little kid. We don't know if they were aware of the presence of that substance, but they certainly were in a higher risk situation. They had a decent life and a loving, if imperfect, family. They just happened to fall into a rougher crowd in middle school and, despite more than a decade of support and help and money, never really broke out of it.
One of my last conversations with this individual: they were excited to go to some convention in Minneapolis that was all about mushrooms and psychedelics. What struck me was how excited they were, how into that community they were. I couldn't relate. I thought to myself, isn't there anything in your life more exciting than this? Rewind 12 years, and I also have a memory of his fascination with tagging buildings on YouTube. The art of it aside, I was so struck by his ignorance to the fact that you're damaging someone else's personal property without their consent.
To deepen the mystery: I grew up in an unstable household, suffered emotional abuse and physical abuse on one occasion. I remember sleeping at a friend's house for a week and begging them not to call the police. When I look at this deceased person's life, whatever grievances they had, it really pales in comparison to my experience. And yet I never touched drugs. It makes me think some choices are not our own - and if it is predestined in some way at birth, well then yes, more compassion is necessary.
Whatever your personal views, it is objectively true that a vaccine would prevent some people from dying, so it's likely a good on balance.
I appreciate you sharing your experience, but keep in mind two things:
1. It's unclear what your family member was going through. Your own experience is much more salient to you, but battles are more and more invisible to external viewers, so it makes sense that you would characterize your experience as more difficult. It can be true that you had a horrible experience, and so did this person. There's a reason the "walk to school uphill both ways" meme exists.
2. Your sample size here is very small. Even if it is true that your experience was worse (we can't know for sure), your actions in that circumstance shouldn't be generalized to people-in-general, and the same applies for your family member.
> It makes me think some choices are not our own - and if it is predestined in some way at birth, well then yes, more compassion is necessary.
I'd encourage you to challenge whether predestination / loss of control is the qualifier for compassion. How can we know, for certain, why people make the choices they do? If you were predestined or not, we don't currently have a way to know.
Would people deserve compassion if everything they go through is a direct and pure result of their choices and nothing else?
> they were excited to go to some convention in Minneapolis that was all about mushrooms and psychedelics. What struck me was how excited they were, how into that community they were. I couldn't relate. I thought to myself, isn't there anything in your life more exciting than this?
Are you always this judgmental of others’ interests? Do you have these feelings towards someone excited about e.g. a new video game or a programming conference?
> "a vaccinated person would still be able to be treated for pain relief with other opioids [such as morphine]"
Good to hear, but at its worst, my pain was only relieved by fentanyl (administered by a professional in a hospital). Noticeably better than Dilaudid (hydromorphone).
Is morphine a reliable replacement for fentanyl? Fentanyl is used quite often in palliative care because it lacks the side effects of morphine, is this correct?
Does this prevent death or just the perceived effects of the drug? This could be very dangerous for users who relapse. There is a known pattern of users who get off opioids then relapse and die because their bodies can no longer tolerate the doses that they were used to taking before they quit. This could have a similar effect where users take the drug, don't feel it, and then increase their dose to lethal levels hoping that they can get high again or believing that the drugs they purchased are diluted or ineffective.
This is kind of strange. Is it really fentanyl-specific, or does it effect all opioids? Problems either way; if just fentanyl, then, duh, that's not the only way to get high. If all opioids... So it makes opioids no longer available for pain relief... forever? ("vaccine"?). (Major surgery and recovery without opioids is no walk in the park, it's PTSD-inducing excruciating pain).
It claims to block the ability to get high -- does it also block overdose potential? Or is this just going to lead to lots of people OD'ing as they try to take enough to get high?
One way or another, it seems likely to lead to even greater harm as addicted people look for something else that does work.
Honestly seems like a bad idea overall, based on wrong and unuseful ideas about the nature of addiction.
Oh boy, the pharmaceutical companies can sell a new product to help solve the mess that one of their previous products created.
An opioid that's more potent, more addictive, and more deadly than heroin should never have gone to market in the first place. It speaks of enormous corruption and a complete lack of ethics when regulators didn't see an issue with fentanyl and let it move forward.
The "but people are in pain" argument doesn't hold up very well when heroin is safer and has less potential for abuse but they already made illegal in the US.
I can imagine such a thing being a double-edged sword, in that it blocks the analgesic effects of the drug as well as the high. Doubly so if this one is a success and they make similar versions targeting other addictive painkillers.
I can imagine people taking the vaccine proactively (the normal way people think about vaccines, after all) from the perspective of, "I don't want to become an addict, I better take this!" and then later regretting their choice when their options are limited in terms of pain management.
However, if you limit the vaccine to people in recovery, then the harm reduction itself is blunted because the initial adverse event (addiction) has already happened, and this would only affect secondary harms (relapse).
I guess it's better to have more tools in the toolbox, at least, but I'm a bit concerned that these tools might be used injudiciously once they exist.
Interesting, but since it's brain chemistry we should be wary of getting too excited about the likelihood that this chemical pathway works similarly enough in rats and humans to allow for the drug to be translated (many pathways do! But many don't, and the more complex the system the less likely it translates without deleterious side-effects).
This article doesn't mention whether it prevents the cardiovascular depression that actually kills most people exposed to fentanyl. If the vaccine doesn't prevent that, it's useless. A vaccine that makes fentanyl less "fun" doesn't do anything for the people who ingest it thinking that it's something entirely different.
As someone who's not a drug addict or around people who use substances that might be tainted with it, I don't want this. If I'm in a car accident or a serious condition where I need immensely powerful pain-killers I sure as you know what want Fentanyl to work.
Seems like there is a lot of unwarranted criticism of this, and I think it is from a misunderstanding of how it would be used. This is meant to be a treatment targeted to people who are addicted to opioids. It would prevent overdose deaths due to heroin and pills which have unexpectedly large amounts of fentanyl (e.g. due to mistakes made when the supplier cut the drug). If taken in combination with proposed heroin and oxy vaccines, it could prevent many opioids from being effective - that could be a tool someone uses to help stop themselves from relapsing in the future. Someone taking this would have to way the benefits against the risks of not being able to take fentanyl when needed (e.g. for surgery).
I was just about to create a new account anyway and my stephangaphy evidently is uncorrelatable, so may as well signoff with a likely-in-vain AMA:
Ask a daily Fentanyl user/addict anything?
Irony.
The kids trying to play it safest are the ones who end of dying.
A friends 5mg Percocet or 7.5 Vicodin Pills feel nice. Not really the first time, but the second? You're a little happier. a somehow pure, happy blissful moment. pure satisfaction. the world is exactly as it should be - youre at a party in high school! and youre doing the cool stuff!. things change slow, sometimes fast. depends on the money involved, and where and how the pills originate. but once they originate, they are analogous to a social endemic.
Pills feel nice, but they do eventually creep up, financially and tolerantly and socially, until you really need that one girls brother to be at KMart by 5:50 or your stomach will hurt Tuesday. All friendships are simply transactional, ledgers of who gave who what when, and, but "she owed me!"? But those people are dead now, because they were smart, and better. The were just doing medication. They weren't doing actual, yanno, _drug_ _drugs, like heroin or meth. Only dumbasses did that.
The dumbasses like myself - we did the math - the $dollar per / dopamine! we werent the dumb ones. Why buy 4x Perc30s for $60e each to barely feel a nod when a $5bump of H will do that and more....But we were the rest able to ride the dovetails of the last bit of domestic heroin import. Because of that, our tolerance and slow unremarkable experience and slow taper into being Fent intake saved the ultimate mortal moment, and prevented our inevitable unexpected encounter with the substance being our last mistake - yet.
Do I get high anymore? Only because I went without, and got relief. Sometimes my eyes feel droopy, or the two top most contexts in my stack of a RAM were just swapped, leading me uncontrollably to say something I was thinking about a moment ago.
Did I ever get high? Surely this year of continuous, continual odding had to be enjoyable.
I didn't do that math too accurately recently - felt too good for too long. Better refrain slightly tomorrow. Lest a lapse - and we can't have that, can we?
I used to follow Naltrexone trials: blocks opioids by having higher affinity in brain receptors), in principle it can work as a one month injection, but the results were also pretty poor. Even in well functioning medical professionals with opioid addiction, adherence was pretty poor. The hypothesis I remember was that the drug didn't have any tangible benefit, so it was hard to continue using it.
I can't see this being a good or sustainable idea.
First it will probably just lead people to find other means
of getting high. (if they want to).
Second it might well make drug cartels reformulate the drugs to
try to "bypass" the "locks" the vaccine placed.
and that might mean even more dangerous versions flooding the market.
This is an utterly horrible idea. People are so caught up in the fear mongering that they forget that fentanyl is used in pain management in end of life care.
Vaccinating yourself against the effects of pain meds is as stupid as it gets. And it gets really vicious once you start pushing this on people.
[+] [-] shaunxcode|3 years ago|reply
[+] [-] PragmaticPulp|3 years ago|reply
People start using drugs for different reasons. It's not correct to say that everyone starts abusing drugs as a form of pure escapism. A lot of drug users start because they're simply seeking recreation and someone is nearby to make drugs available to them. It's as simple as that.
> You are broken because society is broken.
Variations of this concept are frequently used by drug addicts to justify continued behavior. "It's not my fault, it's society's fault!". Taking ownership of actions and consequences is one of the key pivot points in helping people get control.
[+] [-] cstejerean|3 years ago|reply
https://www.doj.nh.gov/news/2022/20220303-settlement-purdue-...
Personally I've been avoiding oxycontin like the plague for that reason. I had two surgeries where the doctors wanted to give me oxy to manage the pain afterwards and I refused to take them. It turned out in both cases the pain was manageable with less addictive options, so I'm not clear why they reached straight for prescribing opioids in the first place.
[+] [-] kstrauser|3 years ago|reply
This affects many more people than just those addicted to opiates.
[+] [-] azalemeth|3 years ago|reply
I totally get why some people become addicted to drugs. Diazepam made me both in less pain and care less that I was in it. The opiates produced this warm, fuzzy haze of vivid dreams and imaginations and made a difficult time bearable. Fentanyl made me feel less than human but not able to suffer, and it was a necessity at the time.
Of all of them though, diazepam was the most dangerous. It just felt – well, nice. I didn't care that things were bad. I needed it medically to stop neurogenic muscle spasms and it made me both able to sleep well and feel OK about life in a way that is really hard to put into words. I have some in a bag, prescribed for me, in case I need it. Part of me – a small part of me, but a part nonetheless – wants to use it, a lot, when I don't need it. There's a little voice that just says "this makes you feel like you've been tucked up into bed nicely". I really can't explain it, but I know that voice is a temptation and a gateway to something that I don't want to have – but at the same time, I know that that drug both saves me from agony and helps me medically if I need it. I'm really not sure how I feel about that. I haven't had any in months, but the psychological aspect remains.
I can only imagine what "real" drug addicts go through. It must be incredibly hard, and individual's range of experiences will be very broad indeed.
[+] [-] candiddevmike|3 years ago|reply
[+] [-] fasthands9|3 years ago|reply
I drink alcohol a couple times a week and do edibles once a month. I'm sure some would argue I'm not fulfilled but I think the easier explanation is that a lot of times doing mind-altering drugs is...fun? And can be social.
[+] [-] dlkf|3 years ago|reply
This isn’t how it works.
Few people, if any, want to “check out.” What happens is that people are exposed to opiods via one of two channels (they are prescribed painkillers, or they party with someone who has acquired them) and they quickly get hooked because these drugs are cripplingly addictive.
So the only “why” questions we have to ask are:
1) Why do people take opiods the first time
2) Why do people continue
The answer to 1 is either because their doctor said so, or because they like to party and have no foresight. The answer to 2 is because if they stop, they experience the worst sickness imaginable.
Society is not broken and we don’t need weird conspiratorial explanations for any of this.
[+] [-] sillysaurusx|3 years ago|reply
Sometimes the simple answers are the most likely. Even if you have a great life, it’s tempting to have such experiences.
Sure, a lot of people use it as an escape though. But I imagine my dumbass brother in law died because he was trying to have fun, not check out of life. Miss him.
[+] [-] beebmam|3 years ago|reply
[+] [-] athorax|3 years ago|reply
[+] [-] HEmanZ|3 years ago|reply
The number 1 reason I experienced is because some social circles fetishized it. It was a very cool, tough, and a superior lifestyle. Anyone who didn't do drugs was a loser, drugs were for winners.
When there is a strong cultural-current of this attitude, it can draw people in and ruin their lives by the time they realize it's all wrong.
[+] [-] kodah|3 years ago|reply
I don't do powders, opioids, etc but I do have some friends within tech and the festival scene that do. My observation is that most people that die from fentanyl don't know they're taking it. They think they're doing cocaine, ketamine, heroin, or some other substance. Fentanyl presence is usually a case of cross contamination when the particular substance is being cut at each hierarchial level of the drug food chain. That's not to say that there isn't some small subset of dealers who don't purposefully drop in some fentanyl, but largely that'd be a stupid decision. The users life expectancy shrinks and their risks skyrocket when they come in contact with fentanyl, this is known.
If you want to stop the deaths, then you have to allow drug distribution that comes from clean rooms. At present, everyone should be using test kits, but fentanyl in particular is hard to test for because a single grain hiding in a mound can get and overdose a user.
If you want people to stop using drugs, well, I have less to say. The history of humanity is using intoxicants whether it be for recreation, psychological well-being, or medical necessity. We've only recently in the history of humanity gone on moral crusades to villainize it.
Chemically addictive substances are a little more challenging. Things like heroin, cocaine, and methamphetamine aren't drugs you can benefit from, but people still do them. Largely, it's because they got hooked on pain killers or some other "numbing" medication. Better availability to harm reduction resources, therapy, social safety nets, etc would improve metrics across the board in the chemically addictive substances category.
[+] [-] encoderer|3 years ago|reply
[+] [-] akira2501|3 years ago|reply
Drugs get you high. Ants get drunk, goats chase psychedelic lichen, and dolphins pass around puffer fish like a dutchie.
> Why do so many people want to check out of life completely by abusing medicine
The short term benefits always outweigh the short term costs, but we're moving to a point in history where even it even seemingly outweighs the long term costs. There's no real disincentive anymore.
I think a case can be made that Martin vs. Boise had the most to do with this. That ruling was meant to push cities into creating the necessary facilities and number of beds to correctly address their homelessness problem; instead, it seems that many cities have used it as a way to entirely ignore the issue.
Instead of building the facilities, they're just throwing up their hands and allowing the kind of "public camping" that quickly turns into public open-air drug markets. Unsurprisingly, the population and markets grew.
> A lot more empowering than just "submit to a higher power" which is clearly not working for the majority of users.
The twelve steps are about quite a bit more than "just" that. They're also targeted towards a person that is at a specific stage of addiction _and_ willingness to address it. It's not general purpose and you can't force people into it, particularly when their drug of choice is so easily available and socially acceptable.
You have to reduce the inflow of drugs. You have to stop drug markets from forming. You have to convince addicts to seek treatment.
On the last point, I think the most effective strategy would be confiscation. If you are caught with drugs for personal use, they should be taken and destroyed, and you should be given information and transportation to a treatment center if you desire. Otherwise, you should be free to go. If the state doesn't interject itself at some level then I don't think you stand a chance.
[+] [-] MrYellowP|3 years ago|reply
For example: The more people are depressive, the more pills can be sold. If people kill themselves due to depression, that's too bad, but they didn't buy any pills to begin with.
Diabetes is great, because people depend on insulin. A never-ending money maker! Fat people are great! They eat more, thus spend more! Some of them get their fat surgically sucked out of their bodies, which also pays! When they get more and more sick, they need more and more medicine, which pays even more!
The transhumanism movement is awesome, because transitioned people require pills! Every day!
Sadness? There's a pill for that!
Drug addicts? Lets invent a vaccine for that!
Fantastic!
Society isn't getting fixed, because nobody actually has any interest in that. Those in power/money certainly don't give a fuck and rather want more money, while the actual people are mostly too stupid to figure out that the whole system needs changing.
Instead they whine, complain and protest and go voting, without realizing that it does basically nothing. Yes, voting actually does nothing. We didn't get to this point because voting helps anything. We got here, because voting doesn't matter.
Decades of evidence lay in front of everyone out there to see, yet for some reason every couple years people actually believe their button-pressing/their X-making actually gives them power over what's going to happen!
There's no vote allowing you to change who pays all the money to the politicians, law makers and judges. There's no vote that allows you to change the underlying corruption that's going on. There's no vote that enables you to decide what actually happens with your money.
You're fucking hilarious. You're not wrong per se, but also hilarious.
"Society needs fixing!!!111" well then get together with enough people and fucking fix it.
Politicians won't do it for you.
Better get your guns ready, btw, because it's definitely not going to happen peacefully.
[+] [-] scoofy|3 years ago|reply
[+] [-] bArray|3 years ago|reply
Given how many lives this destroys, how many people it takes out of the potential workforce, how many social problems this causes (crime, homelessness, exasperated mental health issues) - why isn't there the political will to change this?
[+] [-] bsder|3 years ago|reply
My assessment is that if even people at that level of wealth and success can get addicted to opioids and die, pretty much anyone can.
Addiction, whether alcohol, drugs, cigarettes, etc., is something that is a genuine medical issue needing treatment. Thankfully, the medical community seems to be shaking off the social stigma about addiction and treating it properly now, but progress has been very slow.
[+] [-] briffle|3 years ago|reply
[+] [-] musicale|3 years ago|reply
Painkillers can provide relief for emotional pain as well as physical pain.
Even something like Tylenol can help people going through painful breakups.
Unfortunately opioids are addictive and users build up tolerance, which is bad for people with chronic pain of any variety.
[+] [-] TYPE_FASTER|3 years ago|reply
[+] [-] jasonhansel|3 years ago|reply
Do you have any evidence that that works better than (say) buprenorphine or naloxone, which target the underlying neurological problem?
[+] [-] fIREpOK|3 years ago|reply
I doubt that it's always a "choice". But it wouldn't surprise if there was many main causes.
[+] [-] P_I_Staker|3 years ago|reply
[+] [-] miguel-muniz|3 years ago|reply
[+] [-] mrhands556|3 years ago|reply
[+] [-] electric_mayhem|3 years ago|reply
Also, this: https://www.dailymotion.com/video/x305n83
[+] [-] awill88|3 years ago|reply
[+] [-] euthymiclabs|3 years ago|reply
We do have a once a month injection of naltrexone that can block all opioids, which can be effective in the right person. A targeted approach to fentanyl alone would probably work in people who don't have an opioid use disorder (and therefore wouldn't be as prone to substitution with an alternative opioid). This is an interesting step, but our understanding of immunology is far too limited to make this realistic in the near term.
[+] [-] mrcwinn|3 years ago|reply
One of my last conversations with this individual: they were excited to go to some convention in Minneapolis that was all about mushrooms and psychedelics. What struck me was how excited they were, how into that community they were. I couldn't relate. I thought to myself, isn't there anything in your life more exciting than this? Rewind 12 years, and I also have a memory of his fascination with tagging buildings on YouTube. The art of it aside, I was so struck by his ignorance to the fact that you're damaging someone else's personal property without their consent.
To deepen the mystery: I grew up in an unstable household, suffered emotional abuse and physical abuse on one occasion. I remember sleeping at a friend's house for a week and begging them not to call the police. When I look at this deceased person's life, whatever grievances they had, it really pales in comparison to my experience. And yet I never touched drugs. It makes me think some choices are not our own - and if it is predestined in some way at birth, well then yes, more compassion is necessary.
Whatever your personal views, it is objectively true that a vaccine would prevent some people from dying, so it's likely a good on balance.
I'm sorry for those impacted by this.
[+] [-] jcutrell|3 years ago|reply
1. It's unclear what your family member was going through. Your own experience is much more salient to you, but battles are more and more invisible to external viewers, so it makes sense that you would characterize your experience as more difficult. It can be true that you had a horrible experience, and so did this person. There's a reason the "walk to school uphill both ways" meme exists.
2. Your sample size here is very small. Even if it is true that your experience was worse (we can't know for sure), your actions in that circumstance shouldn't be generalized to people-in-general, and the same applies for your family member.
> It makes me think some choices are not our own - and if it is predestined in some way at birth, well then yes, more compassion is necessary.
I'd encourage you to challenge whether predestination / loss of control is the qualifier for compassion. How can we know, for certain, why people make the choices they do? If you were predestined or not, we don't currently have a way to know.
Would people deserve compassion if everything they go through is a direct and pure result of their choices and nothing else?
[+] [-] ngai_aku|3 years ago|reply
Are you always this judgmental of others’ interests? Do you have these feelings towards someone excited about e.g. a new video game or a programming conference?
[+] [-] CerieXerox|3 years ago|reply
Good to hear, but at its worst, my pain was only relieved by fentanyl (administered by a professional in a hospital). Noticeably better than Dilaudid (hydromorphone).
Is morphine a reliable replacement for fentanyl? Fentanyl is used quite often in palliative care because it lacks the side effects of morphine, is this correct?
[+] [-] wdhilliard|3 years ago|reply
[+] [-] jrochkind1|3 years ago|reply
It claims to block the ability to get high -- does it also block overdose potential? Or is this just going to lead to lots of people OD'ing as they try to take enough to get high?
One way or another, it seems likely to lead to even greater harm as addicted people look for something else that does work.
Honestly seems like a bad idea overall, based on wrong and unuseful ideas about the nature of addiction.
[+] [-] calibas|3 years ago|reply
An opioid that's more potent, more addictive, and more deadly than heroin should never have gone to market in the first place. It speaks of enormous corruption and a complete lack of ethics when regulators didn't see an issue with fentanyl and let it move forward.
The "but people are in pain" argument doesn't hold up very well when heroin is safer and has less potential for abuse but they already made illegal in the US.
[+] [-] orblivion|3 years ago|reply
* You could identify fentanyl passed off as heroin, cocaine, etc because they don't work as well.
* "Damn this cocaine is weak. Maybe I need to take more" - I could imagine this leading to more fentanyl overdoses.
* Something like this happened in neuromancer.
[+] [-] m0llusk|3 years ago|reply
[+] [-] JackFr|3 years ago|reply
[+] [-] hwbehrens|3 years ago|reply
I can imagine people taking the vaccine proactively (the normal way people think about vaccines, after all) from the perspective of, "I don't want to become an addict, I better take this!" and then later regretting their choice when their options are limited in terms of pain management.
However, if you limit the vaccine to people in recovery, then the harm reduction itself is blunted because the initial adverse event (addiction) has already happened, and this would only affect secondary harms (relapse).
I guess it's better to have more tools in the toolbox, at least, but I'm a bit concerned that these tools might be used injudiciously once they exist.
[+] [-] shadowgovt|3 years ago|reply
... and, indeed, the uh.edu article only tangentially indicates that the actual study (https://www.mdpi.com/1999-4923/14/11/2290/htm) has only been conducted in rats at this time.
Interesting, but since it's brain chemistry we should be wary of getting too excited about the likelihood that this chemical pathway works similarly enough in rats and humans to allow for the drug to be translated (many pathways do! But many don't, and the more complex the system the less likely it translates without deleterious side-effects).
[+] [-] languagehacker|3 years ago|reply
[+] [-] 71a54xd|3 years ago|reply
[+] [-] elil17|3 years ago|reply
[+] [-] shadowtree|3 years ago|reply
[+] [-] Jerrrry|3 years ago|reply
Ask a daily Fentanyl user/addict anything?
Irony.
The kids trying to play it safest are the ones who end of dying.
A friends 5mg Percocet or 7.5 Vicodin Pills feel nice. Not really the first time, but the second? You're a little happier. a somehow pure, happy blissful moment. pure satisfaction. the world is exactly as it should be - youre at a party in high school! and youre doing the cool stuff!. things change slow, sometimes fast. depends on the money involved, and where and how the pills originate. but once they originate, they are analogous to a social endemic.
Pills feel nice, but they do eventually creep up, financially and tolerantly and socially, until you really need that one girls brother to be at KMart by 5:50 or your stomach will hurt Tuesday. All friendships are simply transactional, ledgers of who gave who what when, and, but "she owed me!"? But those people are dead now, because they were smart, and better. The were just doing medication. They weren't doing actual, yanno, _drug_ _drugs, like heroin or meth. Only dumbasses did that.
The dumbasses like myself - we did the math - the $dollar per / dopamine! we werent the dumb ones. Why buy 4x Perc30s for $60e each to barely feel a nod when a $5bump of H will do that and more....But we were the rest able to ride the dovetails of the last bit of domestic heroin import. Because of that, our tolerance and slow unremarkable experience and slow taper into being Fent intake saved the ultimate mortal moment, and prevented our inevitable unexpected encounter with the substance being our last mistake - yet.
Do I get high anymore? Only because I went without, and got relief. Sometimes my eyes feel droopy, or the two top most contexts in my stack of a RAM were just swapped, leading me uncontrollably to say something I was thinking about a moment ago.
Did I ever get high? Surely this year of continuous, continual odding had to be enjoyable.
I didn't do that math too accurately recently - felt too good for too long. Better refrain slightly tomorrow. Lest a lapse - and we can't have that, can we?
[+] [-] inasio|3 years ago|reply
[+] [-] ThinkBeat|3 years ago|reply
First it will probably just lead people to find other means of getting high. (if they want to).
Second it might well make drug cartels reformulate the drugs to try to "bypass" the "locks" the vaccine placed. and that might mean even more dangerous versions flooding the market.
[+] [-] cf141q5325|3 years ago|reply
Vaccinating yourself against the effects of pain meds is as stupid as it gets. And it gets really vicious once you start pushing this on people.