[HN Gopher] The main thing about Phenylacetone meth is that ther...
___________________________________________________________________
The main thing about Phenylacetone meth is that there's so much of
it
Author : dynm
Score : 172 points
Date : 2021-10-28 15:32 UTC (7 hours ago)
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(TXT) w3m dump (dynomight.net)
| monkmartinez wrote:
| The reason Meth use is going up is not due to Meth itself. It
| counter balances the effects of Fentanyl. I regularly go to
| Fentanyl overdoses where the bystanders tell me they ran out of
| "G" or "Glass" and simply overdid it with the "M30's"... Its a
| fucking nightmare.
|
| It used to be "meth" users would say..."At least I am not a dope
| junky using H." Heroin users would say... "At least I am not a
| tweaker." Now they are one in the same when I see them, which is
| generally cyanotic, apneic, and have been down for a while. We
| don't have enough Narcan to counter a bad batch of "M30" pills.
| Talk to your kids and tell them not to use any pills, not even
| once.
| elliekelly wrote:
| Sorry, for someone who knows next to nothing about drugs can
| you clarify? I'm assuming "glass" is the meth and the "M30"
| pills are fentanyl? Or maybe the other way around? And, if you
| don't mind, can you explain what you mean by "counterbalance"?
| I'm assuming it's like drinking a red bull with vodka? Does it
| actually "counterbalance" chemically so someone could "safely"
| (for lack of a better word) take more fentanyl without
| overdosing if they took meth along side it? Or does it create
| the sensation of counterbalancing to make users take less
| fentanyl in the first place?
|
| I guess what I'm asking is, is taking meth + fentanyl
| marginally safer than taking just fentanyl? I know neither is
| safe. I'm just curious how the two interact and what you mean
| by counterbalance.
|
| I'm also curious if, somewhat counter-intuitively, fentanyl
| addicts could be "treated" with adderall to make their drug use
| safer? At the very least adderall has to be safer than street
| meth?
|
| The entirety of my knowledge of street drugs came from D.A.R.E.
| and Breaking Bad so apologies if these are ridiculous
| questions.
| cwkoss wrote:
| > I'm assuming "glass" is the meth and the "M30" pills are
| fentanyl?
|
| Correct. M30's are opiates pressed to look like percocet -
| when from the street, typically fentanyl or another potent
| opioid.
| okareaman wrote:
| The short answer is that opiates kill by suppressing the
| breathing reflex. Anything that stimulates breathing can be
| used to counter act the effect of opiates. In the 70's people
| would force people to go on walks until their lips weren't
| blue from 02 deprivation, even if they had to support them
| while they walked.
| JumpCrisscross wrote:
| > _counter balances the effects of Fentanyl_
|
| Could this explain the falling prices described in the article?
| Fentanyl is the money maker. Meth is being priced to encourage
| more opioid use?
| e40 wrote:
| > Talk to your kids and tell them not to use any pills, not
| even once.
|
| Can you elaborate? I have no idea what this is about. I thought
| meth was smoked.
| __blockcipher__ wrote:
| Meth doesn't have to be smoked, you can just eat the crystals
| orally, but meth abusers uusally don't do that because it's
| not nearly as fun.
|
| The pills they're referring to, 30 M
| (https://www.drugs.com/imprints/30-m-8232.html), are
| oxycodone pills (a powerful opioid), but he's likely actually
| specifically referring to pressed fent (or fent analogue)
| pills that are made to look like real oxycodone pills. Or
| perhaps a mixture of meth and fentanyl, such as what George
| Floyd was taking the day he died (see https://interactive.kar
| e11.com/pdfs/Autopsy_2020-3700_Floyd.... as well as the other
| evidence around the case)
|
| There's a big problem where, now that the government has
| really cracked down on so-called "pill mills" - which like
| all of the war on drugs was the worst thing they could have
| done, because now the demand is being filled by fentanyl and
| fentanyl analogues that are pressed to look like oxy pills,
| but aren't. Oxy alone can be dangerous, but fent is another
| beast (particularly illicit).
|
| As one anecdote I just had a friend-of-a-friend (I didn't
| know them personally) die of an overdose earlier this year.
| They took "oxys" orally which were actually pure fent
| analogue, and now they're dead. They are yet another fatality
| of the war on drugs (and also the war on COVID since the
| lockdowns were the proximate cause of them picking up their
| opioid habit again)
|
| --
|
| Oh, and to elaborate on the GP's point about overdoses being
| the result of running out of meth, methamphetamine increases
| respiration rate, which will theoretically counteract the
| respiratory depression induced by opioids (which are how
| opioids always kill, with the one exception that fent and
| related analogues can possibly kill by an addition mechanism
| of action known as wooden chest syndrome)
| e40 wrote:
| > but he's likely actually specifically referring to
| pressed fent (or fent analogue) pills that are made to look
| like real oxycodone pills
|
| That sounds like a really, really bad idea. Wow.
| cyberbanjo wrote:
| Bad in terms of "public health" or bad in terms of "I
| sold the rest of my drugs"?
| __blockcipher__ wrote:
| Yeah that and the general inclusion of fent hotspots in
| Heroin and the like is why overdoes have skyrocketed over
| the last 5+ years. And then COVID [lockdowns] in my
| opinion cranked the growth in ODs even higher. It was
| growing at something like 11% in 2019 and then in 2020 it
| spiked like 30% to something like 70,000 overdose deaths
| in the US
| [deleted]
| goatsi wrote:
| From the context I assume he is talking about counterfeit
| pain pills (a M30 is an oxycodone pill) that are made with
| fentanyl (often in very high or uneven doses). Though
| counterfeit Adderall pills made with meth are now starting to
| show up.
| crate_barre wrote:
| This all sounds like high octane speed-ball (used to be just
| mixing some basic speed with something like Vicodin, or an
| Adderral/Ritalin + Vicodin/Percocet), but mixing Meth/Fentanly
| sounds beyond risky.
| toolz wrote:
| while I genuinely agree with your intent, I don't think
| abstinence has been very good at achieving the outcome we're
| hoping for.
|
| Education, not fear is what allows people to decide for
| themselves if they want to try/use something and it seems more
| likely that if/when they try these substances they'll at least
| be prepared for the consequences and be more likely to be
| responsible with their use.
|
| Anecdotally I have many friends who were taught abstinence.
| Once they got into weed they realized just how much of a lie
| abstinence teaching was, they then graduated to trying other
| drugs, but not responsibly, because they had no idea how these
| other drugs worked. They had no idea what an OD might look like
| or what the risk of getting poor quality drugs might do. e.g.
| look at cocaine - how many people have any clue what that is
| cut with? I'd imagine almost every single one of my friends
| couldn't tell you what north american cocaine is predominantly
| cut with and they couldn't tell you what to do in the event of
| an OD, or what the exact symptoms of a cocaine OD even are! The
| lack of education is terrifying, really.
| stcredzero wrote:
| _I don 't think abstinence has been very good at achieving
| the outcome we're hoping for._
|
| Not all abstinence is the same. Just because one is free to
| try _anything_ , it doesn't mean people have to try
| _everything_.
|
| _Once they got into weed they realized just how much of a
| lie abstinence teaching was, they then graduated to trying
| other drugs_
|
| The problem isn't abstinence. The problem is the _lie_. Give
| people the proper, accurate information, and many will simply
| decide to abstain themselves. I think you and I would agree
| on this point about information.
|
| _The lack of education is terrifying, really._
|
| That's ultimately the result of lies, deliberate obscurity,
| and attempts at thought control. It's far better to trust
| people with accurate information and let them decide for
| themselves.
| okareaman wrote:
| I think the same analogy can be made for social media. We had
| Myspace and Friendster, but social networks didn't become a
| problem until we had so much of it - always internet connected
| little computers with us every waking hour.
| crazy_horse wrote:
| I know Vince Gilligan did his research prior to Breaking Bad but
| st strikes me how on the nose it was. BB came out in 2008 and
| must have been in production a few years earlier but the increase
| in actual purity pretty much matches the show coming out.
|
| I also recall the show depicting meth users having all those
| problems - Jesse is paranoid the missionaries are bikers, there's
| that guy digging a hole in his front yard, Spooe and his head,
| etc
|
| Seems like the drug was fucking people up way prior to the last
| few years in fiction.
| __blockcipher__ wrote:
| > I also recall the show depicting meth users having all those
| problems - Jesse is paranoid the missionaries are bikers,
| there's that guy digging a hole in his front yard, Spooe and
| his head, etc
|
| > Seems like the drug was fucking people up way prior to the
| last few years in fiction.
|
| Meth has always, always, always been known to cause those
| behaviors/effects since it first became widespread. Breaking
| bad shows those behaviors because they're classic tweaker
| behaviors. The scene where Jesse distracts the guy by digging
| is super spot on. Brilliant scene.
|
| So yep, the paranoia, hallucinations etc have nothing to do
| with "new meth", they're just what happens when someone abuses
| sufficient amounts of meth. And the more potent the meth, the
| easier it is to get to that threshold. But note that you still
| need to be smoking or injecting quite a bit. The people
| exhibiting psychosis and the like are using hundreds of
| milligrams per session.
| d23 wrote:
| I happen to be re-watching this right now, and it blew my mind
| to see those graphs and _not_ see the show lagging a few years
| behind the reality. How is this possible? It borderline seems
| like the background research for the show must have actually
| talked to the mass manufacturers of the stuff...
| throwaway103954 wrote:
| Fascinating read! I really appreciated the graphs, which give
| insight to market dynamics that are often quite opaque to us
| outsiders.
|
| If you're curious, read up on some of the synthesis methods for
| P2P. Chemists are continually honing their craft to provide
| superior purity and price:
|
| https://erowid.org/archive/rhodium/chemistry/phenylacetone.h...
|
| _Aside from the often amateurish reduction of (pseudo)ephedrine
| to methamphetamine, the most popular precursor to amphetamine and
| methamphetamine is phenyl-2-propanone (also called P2P, BMK,
| Benzyl Methyl Ketone or Phenylacetone). There is an astounding
| array of synthetic routes to this compound, both due to the
| relative simple structure of the compound, and also because of
| its popularity. [...] Here is a collection of some of the
| possible methods of synthesizing phenyl-2-propanone, ranging from
| simple one-step methods to elaborate multi-step variants, and
| from the very easy to the very complicated. Welcome to the world
| of P2P._
|
| Once you've got P2P, the end product isn't too far behind:
|
| https://www.erowid.org/archive/rhodium/chemistry/p2p-meth.ht...
| Factorium wrote:
| From a societal POV, we need a Government-regulated drug harder
| than Alcohol or Tobacco. Similar in function to Soma. Maybe
| marijuana can fit the bill.
|
| It doesn't make sense to 'outsource' production of narcotics to
| antagonistic nations or criminal enterprises.
| netizen-936824 wrote:
| What, exactly, in a drug's pharmacology or chemical structure
| makes it "hard"?
| semanticjudo wrote:
| it's a good question - I avoided it in my own response with
| the clever use of quotation marks.
|
| But to answer, I think the term is used colloquially all of
| the time and of course is open to interpretation.
|
| I would suggest it has nothing to do with a drug's
| pharmacology or chemical structure but rather the degree to
| which a drug when taken in easily-consumed quantities can
| shape our perceptions of the world, the likelihood of
| negative externalities due to consumer behavior and the
| probability of becoming addicted to the drug.
|
| A mixture of those things makes a drug "hard" in
| conversational language e.g. something that dramatically
| changes a persons perceptions, frequently has negative
| externalities and can cause addiction with short-term
| sustained use is a "hard drug". Like alcohol.
|
| When addicted to such a drug, the negative externalities
| typically expand in scope and severity and if the use scales
| to a significant portion of the population would generally be
| regarded as an undesirable state for society to be in.
| vinceguidry wrote:
| Good question. If you were to go by relative effects on
| consciousness, alcohol is a far harder drug than cannabis.
| Lots of illegal drugs are, alcohol is much worse than we
| believe.
| bluejellybean wrote:
| Society does, it's called Oxycodone. The results of it have
| been quite devastating.
| asdff wrote:
| You can get edibles now that are dosed at 5mg increments and
| are the size of an antihistamine.
| semanticjudo wrote:
| By just about any measure alcohol is a "harder" drug than
| marijuana but certainly more broadly acceptable.
| tomjen3 wrote:
| Having never done weed, if I smoke one will I preform worse
| at cognitive tasks than I would if I had a beer?
|
| I know, comparing uppers and downers, not the same effects,
| etc.
| mdpye wrote:
| It's difficult to say what an equivalent dose might be and
| this is just my experience, but...
|
| Definitely cognitive tasks would be considered more
| impaired by weed than beer, at "roughly equivalent to a
| pint" level. Likely neither would be a big deal.
|
| Weed is neither upper, nor downer really, it an
| hallucinogen.
|
| That means less ordered thinking. Quite possibly an
| increase in creativity and lateral concept matching (say,
| making or appreciating witty comments) but also an
| impairment to short term memory and direct logical
| reasoning.
|
| For motor skills and reaction times, beer definitely hits
| harder.
| mdpye wrote:
| Oh, and on dosage, I'm from the UK. In my experience in
| the US a single joint is rolled to a potency I'd consider
| equivalent to "a mug full of whisky", not a pint of beer!
| semanticjudo wrote:
| Depends on a few factors like what task, innate ability,
| etc. Which is not a non-answer - it is THE answer: in my
| experience, some things are easier on one than the other
| and vice versa.
|
| FWIW, here's my definition of a "hard" drug:
| https://news.ycombinator.com/item?id=29028924
| colinmhayes wrote:
| They're not really comparable. It mostly comes down to
| dosage, if you have a beer I don't think you'll be much
| worse than if you were sober.
| foolfoolz wrote:
| i have had a theory for years if you sold any drug like meth
| or cocaine in an advil bottle with a label on the side saying
| "take at most 1 tablet every 4 hours, do not exceed 6 tablets
| in one day. do not use for more than 2 days in a row" etc
| then the vast majority of people would not have any issue
| with it. the people who are already abusing it would continue
| to abuse it. most people can be around hard addictive drugs
| ingrained in society like alcohol and do just fine
| crate_barre wrote:
| Meth in a bottle is called Adderral.
|
| https://www.reddit.com/r/askscience/comments/94rk1a/how_is_
| m...
| goatsi wrote:
| Meth in a bottle is called Desoxyn (methamphetamine
| hydrochloride). https://www.rxlist.com/desoxyn-drug.htm
| crate_barre wrote:
| Hah, and it's prescribed for ADHD, and all the other
| stimulants are amphetamine derivatives. Who are people
| kidding?
| goatsi wrote:
| Methylphenidate is a non amphetamine derivatived
| stimulant, and is widely used for ADHD treatment.
| dkdk8283 wrote:
| And us socially acceptable in the bay area to be
| dependent
| __blockcipher__ wrote:
| > Meth in a bottle is called Adderral.
|
| No, it's not. Please stop spreading this age-old myth*.
| You can literally buy prescription meth in a bottle, and
| it's called Desoxyn.
|
| Adderall is extremely similar, because amphetamine is
| quite similar to meth (just an inferior version IME).
| D-meth is probably 20-30% more potent than d-amp dose for
| dose, but with somewhat reduced unwanted peripheral
| (body) side effects. The other main differences are meth
| releases some serotonin (not nearly as much as MDMA)
| while amp releases almost none, and that for whatever
| reason methamphetamine takes 3-3.5 hours to reach peak
| blood concentration when taken orally, whereas
| amphetamine peaks much sooner.
|
| * I get it, the point isn't literally that it's meth,
| just that it's similar. But it's silly thing to say
| rhetorically when you can literally get prescription
| d-methamphetamine in the US under the brand name Desoxyn.
| crate_barre wrote:
| I think the answer is in the middle. I don't want to
| propagate a myth, but I do want to shed light on the fact
| that this isn't a benign drug. It's an amphetamine, many
| people want to sugar coat it like it's this particularly
| saint-like medication (I mean the damn thing let's you
| get a high salary job - don't you disparage my Addy).
| Adderral and Vyvanse do have added ingredients that
| thwart abuse (mostly slows it down, can never truly stop
| abuse on such an addictive substance).
|
| In any case, high dosage of Adderral (or consistent use)
| has very similar effects to Meth use (obviously not
| methhead no-teeth level stuff, but definitely euphoria,
| delusions of grandeur, paranoia, insomnia, drastic
| appetite suppression, irritability). Psychosis can also
| occur on Adderral.
|
| A nicer version of Adderral without all the anti-abuse
| stuff is Dexedrine, you get a more pure amphetamine and
| is generally smoother since it doesn't have the
| Levoamphetamine that creates the characteristic
| 'lethargic' feeling after the initially speedy-rush.
|
| The funny thing about all of this is that it's legal, and
| I shit you not, me and my doctor would speak about
| finding 'smoother' meds (imagine two crackheads
| discussing what would be a nicer high), all totally legal
| and not frowned upon.
|
| One hell of a PR job by team 'legal speed' :) Glad I'm
| off that shit because I really did feel and act like a
| Meth-head by the end of it.
| __blockcipher__ wrote:
| You're right on most of that but off on some details.
|
| Only Vyvanse is anti-abuse, because the dextroamphatamine
| is bound to a lysine molecule. The body must cleave the
| lysine before it becomes active so snorting it doesn't
| give the instant rush.
|
| Adderall has no such countermeasures. You're probably
| getting confused by the fact that it comes in both IR and
| XR formulations (instant release vs extended release). So
| if someone has XR adderall, it's not as snortable as IR.
| But it's still more snortable than Vyvanse is, and you
| can just get IR adderall which is totally abusable. (BTW
| X milligrams of XR is really just X/2 mg instant release
| and X/2 mg delayed release beads that take on average 4
| hours to activate. So it's roughly equivalent to two X/2
| mg IR doses split 4 hours apart) And finally the XR can
| be countered by crushing the beads up, although it's a
| bit laborious.
|
| Amphetamine obviously has its risks, and particularly
| when prescribing to children doctors seem to write some
| ridiculously high dosage prescriptions without fully
| understanding what the drug is like. But you can just say
| that rather than doing the juvenile "it's really just
| meth in a bottle" shtick when there is literally already
| actual meth in a bottle that you can (with great
| difficulty) get prescribed. And that fact - that
| methamphetamine exists as a drug that can be prescribed -
| is much more interesting and surprising to people, given
| that the lay public is completely unaware that
| methamphetamine has any pharmaceutical uses.
| goatsi wrote:
| Most Adderall formulations have no anti-abuse
| precautions, unless you could extended release
| mechanisms. Vyvanse also doesn't generally have any
| ingredients added to it, it's a prodrug that is inactive
| until it is metabolized (which happens in the blood, not
| the liver so you can still snort it).
| [deleted]
| kevinmchugh wrote:
| https://www.latimes.com/projects/oxycontin-part1/
| cyounkins wrote:
| Can anyone comment on how producers could be isolating the the
| 'd' enantiomer? Are they using enzymes?
|
| Steve Mould has a great video [1] on homochirality in nature and
| says, "Why are all the sugar molecules that you buy from the
| shops right-handed? ... If you were to make some sugar for
| yourself in a chemistry lab by mixing some chemicals together,
| you would get a 50/50 mix of left-handed sugar and right-handed
| sugar." He goes on to describe how enzymes in nature exclusively
| make homochiral molecules, and since all our sugar is made by
| enzymes, all our sugar is homochiral.
|
| Later in the video he describes how you can filter enantiomers by
| finding an enzyme in nature that 'eats' the undesired enantiomer,
| finding the DNA for it, and coercing bacteria into producing that
| enzyme. This seems quite complicated and potentially out of reach
| for a clandestine drug-making operation. Is there another way?
|
| [1] https://www.youtube.com/watch?v=SKhcan8pk2w
| gavinray wrote:
| Methamphetamine synthesized from pseudoephedrine gives
| enantiomerically pure Dextro-methamphetamine.
|
| Phenylacetone synthesis yields racemic methamphetamine.
|
| You can actually use a laptop screen, and polarized sunglass
| lenses to check the optical rotation at home, cheap
| polarimeter.
|
| As far as purifying enantiomer with amphetamine and
| methamphetamine goes:
|
| It can be done relatively easily with just D-tartaric Acid.
|
| Look up _" Procedures for the Resolution of Racemic
| Amphetamines"_
|
| https://erowid.org/archive/rhodium/chemistry/amphetamine.res...
|
| I do not believe this practice is in use in illicit drug
| manufacture. There's no economic incentive and it requires some
| braincells.
|
| From _" Selective Crystallization of Methamphetamine with
| d-Tartaric Acid:"_ Phenylisopropylmethylamine
| was resolved by treatment with 0.4-6 moles of dextro tartaric
| acid in water or aqueous ethanol containing 0.4-6 moles
| hydrogen chloride. A mixture of
| phenylisopropylmethylamine 150, d-tartaric acid 82.5, and H2O
| 330 g was treated with HCl to pH 4 to deposit 120 g
| L-phenylisopropylmethylamine-d-tartrate salt, which gave 88 g
| L-phenylisopropylmethylamine. The D-enantiomer (58 g as the HCl
| salt) was isolated from the filtrate.
| gpcr1949 wrote:
| They are most likely using resolution via the Pope-Peachey
| Method. There was supporting evidence found in a laboratory in
| Guadalajara[0].
|
| It is possible to do asymmetric reductive amination using
| enzymes but this is out of the scope of clandestine producers.
| Likewise a chemical and not enzymatic asymmetric reductive
| amination would be easy in a bench lab, probably to expensive
| and impractical in a clandestine setting.
|
| [0] Joseph S. Bozenko, "Clandestine Enantiomeric Enrichment of
| d-Methamphetamine via Tartaric Acid Resolution", JCLIC, 2008,
| vol.3 (not publicly accessible but you can find this if you
| know where to look)
| gavinray wrote:
| I did not know it had a name. TIL.
|
| I will back the Tartaric Acid hypothesis. If it's being done,
| this is the only way it makes sense. It requires nearly
| nothing but the D-Tartaric Acid and Ethanol/Methanol + basic
| glassware.
|
| Disclaimer: Am not a chemist.
| throwaway81523 wrote:
| In the article, "P2P" is an abbreviation for Phenylacetone, a
| precursor to meth (the drug). It's not "peer to peer" so that
| solved a lot of puzzling over what the headline could mean.
| dylan604 wrote:
| Clearly, anyone questioning peer-to-peer has not watched
| Breaking Bad
| DarmokJalad1701 wrote:
| When I read the headline, the idea I had in my head was of some
| kind of crowdsourced meth production system.
| stcredzero wrote:
| I thought someone had decided to be edgy, and named their
| project, "meth"!
| __blockcipher__ wrote:
| On MacOS I use an app called Amphetamine to prevent my
| computer from sleeping. I got a real kick out of that. I
| got a further kick when I learned that Amphetamine was the
| successor to the earlier version, which was called
| Caffeine.
| lamontcg wrote:
| Apple, of course, was not amused by that name:
|
| https://news.ycombinator.com/item?id=25618245
| dang wrote:
| Thanks - we've put Phenylacetone in the title above.
| littlestymaar wrote:
| Thanks. My brain kind of parsed it as "p2p mesh" but I was a
| little bit confused still ...
| agumonkey wrote:
| the p2p drug would be ocytocine I guess
| Enginerrrd wrote:
| Technically, P2P is an abbreviation for phenyl-2-propanone
| which can also be called phenylacetone depending on the naming
| convention used.
| fitzn wrote:
| > There's an impressive project in Europe to measure drug use
| from biomarkers in sewage.
|
| There's actually a US company doing this as well:
| https://biobot.io/
| Synaesthesia wrote:
| Meth is just a very harmful drug, which can cause psychosis. I
| don't know if I buy this theory that it's a different drug.
| rkk3 wrote:
| This article seems to be fundamentally mistaken/misrepresenting
| Sam Quinones's Theory. P2P Meth started after Ephedrine was
| banned in Mexico in 2008 not 2017.
|
| > He suggests that new meth might be chemically different in a
| way that caused people to go crazy, starting around 2017
|
| 2017 is not a significant year, it's just the year of one of his
| anecdotes. A small town in West Virginia didn't have a meth
| problem and then in 2017 it had a meth problem and a mental
| health problem. "Southwest Virginia hadn't seen
| much meth for almost a decade when suddenly, in about 2017, "we
| started to see people go into the state mental-hospital system
| who were just grossly psychotic" [1]
|
| He has other anecdotes from much earlier.
| "Susan Partovi has been a physician for homeless people in Los
| Angeles since 2003. She noticed increasing mental illness--
| schizophrenia, bipolar disorder--at her clinics around the city
| starting in about 2012" [1]
|
| [1] https://www.theatlantic.com/magazine/archive/2021/11/the-
| new...
| elliekelly wrote:
| The Mental Health Parity and a Addiction Equity Act increased
| access to this kind of treatment. The first interim rules under
| the Act went into effect for new plan years starting on or
| after July 2010. Many insurance plans (particularly Medicare
| and Medicaid plans in certain states) dragged their feet in
| implementing the required changes. This was problematic
| because, despite being a federal law, state insurance
| regulators are the primary enforcers.
|
| In 2016 the Centers for Medicare and Medicaid finally started
| to crack down with their investigations and enforcement and
| issued compliance guidance and toolkits to help states fully
| implement the required coverage.
|
| Is it possible the upticks don't represent a new group of
| addicts so much as they represent a new group of people who are
| eligible for affordable treatment? It doesn't seem terribly
| far-fetched to me that CA would have implemented the required
| coverage in their Medicare & Medicaid plans fairly quickly
| while West Virginia's plans would have waited as long as
| possible to comply.
| perardi wrote:
| Bit of a tangential rant: meth is actually truly really bad, and
| I wish our drug education growing up hadn't painted this nebulous
| concept of "drugs", because there's gradations of harm.
|
| I'm approaching 40. _(Ugh, I hate to admit that.)_ I grew up
| during the D.A.R.E. era. Just Say No. Cartoon All-Stars to the
| Rescue. "Drugs" were this boogeyman, and whatever they were, they
| would turn you into a junkie instantly.
|
| I have no idea how you'd study this, as I think this was a pretty
| much cross-cultural message, but I wonder what would have
| happened if we could have educated teenagers that, well, "we know
| you're going to do drugs, they all have side effects, but some
| are not that bad, and some will absolutely ruin you."
|
| Because: I have done a lot drugs in my 30s. Pretty much the full
| club drug buffet, with the exception of meth and opiates. _(Also
| never smoked a cigarette yet.)_ And you know what? There are
| varying degrees of bad. There's this jaded sense that you build
| up, that you're a bit bitter that you wasted quite a lot of your
| childhood education in D.A.R.E. I wonder if we could have
| possibly successfully pulled off harm reduction education in
| drugs, and given people a better set of mental tools to
| understand what drugs are _truly_ bad, namely meth and opiates,
| and which drugs are quite honestly far less deleterious than
| vodka. _(You cannot tell me, with a straight face, that weed is
| physically and socially more harmful than drinking.)_
| brighton36 wrote:
| Contemporary social policy as a whole appears to be a cycle of
| reaction and hysteria. There's very little substance to this
| process, in the form of empiricism or evidenced-based feedback.
| This cycle appears to be a by-product of our modern information
| mediums. I think that generations prior to ours (I too am
| approaching 40) weren't as vulnerable to the whims of society's
| most easily frightened and manipulated members. I think the
| only solution is to vote with our feet, and leave the hysterics
| behind. I suspect this process is well underway, now that the
| more educated members of society have the ability to work from
| home.
| __blockcipher__ wrote:
| Oh wow. I saw the title and was ready to explain how the cartels
| had perfected p2p synths such that they yield almost exclusively
| pure d-methamphetamine, but before explaining that I was going to
| need to explain the general concept of chirality and enantiomers,
| and the fact that for amphetamines (especially meth) the
| d-entantiomer is always the "one you want" and the l-entantiomer
| is always the less desirable, less powerful form that causes
| peripheral stimulation but no cerebral effects, and as an
| anecdote I was going to mention that vics vapo inhaler (commonly
| used at raves, although people don't actually know what they're
| inhaling) is levomethamphetamine, and I was even going to mention
| the humorous fact that they label it "levmetamfetamine" to make
| the spelling as distinct as possible.
|
| Then imagine my surprise when I open the article and it literally
| covers every one of those points, section by section. Brilliant.
|
| I guess the only minor thing I'd add is that the way the cartels
| (and others) are getting pure d-meth is by bubbling through
| d-tartaric acid or the like at the end of the process, which
| separates the racemic meth into its l and d enantiomers
| respectively.
|
| I'm glad this article debunked the fallacious "new meth" article
| that cropped up here the other day.
|
| ---
|
| EDIT:
|
| Oh and one more thing. There's a common myth among tweakers about
| "n-iso", which is structurally very similar to methamphetamine -
| similar enough that it will join the crystal lattice - but it is
| at best inert, but might actually cause undesirable side effects.
| The fact that n-iso exists is real, but if you look online you'll
| see tons of tweakers convinced that they've been smoking n-iso
| and that it's why they smoke meth and just get a headache and
| other bad physical side effects but don't get the stimulation or
| the pleasurable rush. What's actually happening is that they've
| spiked their tolerance so high that they're getting almost
| exclusively the bad effects. It's analogous to how if someone
| takes MDMA for 4 days straight, by the end of it they're not
| going to "roll" at all because they've acutely downregulated
| their serotonin (and dopamine) receptors, and furthermore that
| they've literally (almost) exhausted their current pool of
| neurotransmitters, which need to be re-synthesized by the body.
|
| When looking at the DEA seizure data it's clear that meth is one
| of the most pure and potent (wrt methamphetamine, the dea defines
| purity as what % of the compound is meth, meaning either levo or
| dextro methamphetamine, whereas potency only factors in the
| d-meth content, since d-meth is the enantiomer that actually gets
| you cerebrally high) street drugs out there. By comparison,
| cocaine is one of the most disgusting, cut at the source level
| with stuff like levamisole (which is thought to be disastrous to
| health, ie it's not just inert), and then further cut every step
| down the chain, albeit usually with inert cuts (baby powder,
| baking soda, glucose, creatine, that kinda stuff) the lower down
| the chain you get. Seriously kids, don't do cocaine. It's
| overhyped and a waste of money.
|
| So anyway, as I said two paragraphs above, n-iso is real but the
| idea that there's tons of n-iso crystal floating around is just
| an urban legend promulgated by tweakers who spiked their
| tolerance the moon and refuse to see that fact.
| JumpCrisscross wrote:
| > _peripheral stimulation but no cerebral effects_
|
| What does this mean?
| __blockcipher__ wrote:
| Sorry for the confusing terminology. "Peripheral stimulation"
| means unwanted stimulation of the body itself, such as
| suppressed appetite, general jitteriness, and the like.
| Whereas the cerebral effects are the actual cognitive effects
| of improved attention/focus/alertness/scanning behavior,
| euphoria, and that kind of thing.
|
| In general when taking amphetamines for ADHD-type symptoms,
| you want to maximize the cerebral stimulation while
| minimizing the peripheral stimulation, because the latter
| causes [most of] the unpleasant side effects like inability
| to eat/sleep. Note that some degree of peripheral stimulation
| is unavoidable regardless of whether one is taking pure
| d-methamphetamine or not, and also probably some amount of
| peripheral stimulation is desirable because ADHD is not just
| difficulty in maintaining focus/attention but also getting
| the kick in the ass to start tasks in the first place. But in
| my experience relying on the peripheral stimulation (which,
| for example, Adderall produces more of than Vyvanse) simply
| doesn't work long-term, and just makes appetite regulation
| and the like get totally out of whack.
| scythe wrote:
| One very strong reason to doubt that heavy metals, such as lead
| or mercury, play a large role in the meth crisis, is that heavy
| metal poisoning has telltale signs and symptoms that would not go
| unnoticed. Furthermore, we have excellent methods for the
| determination of Pb and Hg in the bloodstream, and there simply
| isn't any corresponding epidemic of heavy metal poisoning.
|
| Also, a nitpick: the author refers to the condensation product of
| benzaldehyde and nitroethane, which is phenyl-2-nitropropene,
| abbreviated P2NP, incorrectly. He calls it "nitrostyrene (NTS)",
| which is the one-carbon-shorter homolog.
|
| The other thing to keep in mind is that higher production volumes
| mean longer supply chains, and with illegal drugs longer supply
| chains mean more cuts (usually sugars, _rarely_ toxic per se),
| and more cuts means an increased variance in the potency of the
| retail product, and variance in potency leads to users
| accidentally taking more than they intended to. The toxic effects
| of most drugs have a supralinear dose-response relationship, so
| these unexpectedly high doses can lead to problems that don 't
| "average out". Often we over-focus on toxic fillers, but forget
| the risks created even by nontoxic fillers.
| dynm wrote:
| > Also, a nitpick: the author refers to the condensation
| product of benzaldehyde and nitroethane, which is
| phenyl-2-nitropropene, abbreviated P2NP, incorrectly. He calls
| it "nitrostyrene (NTS)", which is the one-carbon-shorter
| homolog.
|
| Can you give a bit more detail about what's wrong here, and how
| it might be fixed? Are all mentions to nitrostyrene/NTS
| incorrect? This is used repeatedly in the cited papers, so I'm
| confused if they are also wrong, or the post has mangled usage,
| or what.
| scythe wrote:
| "Nitrostyrene" is sometimes used to refer to the whole class
| of chemicals featuring the phenyl-ethylene-nitro linkage. So
| it's not wrong to call it "the nitrostyrene method". But the
| specific nitrostyrene that is a precursor to methamphetamine
| is 1-phenyl-2-nitro-propene, while the parent compound
| "nitrostyrene" is 1-phenyl-2-nitro-ethene.
| JudasGoat wrote:
| From what I read, the P2P method isn't new. "Preisler, who works
| at an electroplating factory and has been arrested twice in the
| U.S. for his work with methamphetamine, says he isn't surprised
| traffickers have turned to P2P.
|
| "P2P is old school," he said. "Hell, I used to cook by that route
| circa 1980."
|
| The fight has come full circle. In the 1980s, the U.S. government
| severely restricted access to P2P seeking to curtail
| methamphetamine production. Meth makers shifted to ephedrine,
| which could be found in common cold remedies. When authorities
| cracked down on ephedrine, they switched to pseudoephedrine, the
| active ingredient in Sudafed and other decongestants."
| https://www.cleveland.com/world/2009/12/old_school_meth_meth...
| cwkoss wrote:
| Priesler goes by "Uncle Fester", and wrote "Secrets of
| Methamphetamine Manufacture" - he's effectively the expert on
| clandestine meth manufacturing. He writes some interesting, and
| kind of terrifying, books.
|
| https://wikileaks.org/gifiles/attach/130/130179_Secrets_of_M...
| bteitelb wrote:
| A curious footnote: Sam Quinones argues that P2P meth is part of
| the explanation for the proliferation of tents in homeless
| encampments, because it causes users withdraw socially in ways
| that earlier meth didn't. This is what he means by it "brought
| you inside". Users want to be alone (i.e. in a tent) with their
| paranoid schizophrenic hallucinations.
| notJim wrote:
| That's a bizarre argument. All humans need shelter, whether
| it's a tent or a house.
| stcredzero wrote:
| What's cheaper than a tent? 1/2 or 1/3rd of a tent. That's
| enough if shelter is the only issue. If there is a need for
| the poorest to have solitude, there's going to be a
| proliferation in the number of tents.
| MikeBVaughn wrote:
| Anecdata: I'm not on meth and I strongly prefer an entire
| tent to a partial tent.
| throwaway2331 wrote:
| I think he means that when you're tweaking on the "old meth,"
| you'd be more likely to go outside and interact with people
| (many times, with hostility and aggression), while the "new
| meth" is more likely to make you want to stay inside, and
| withdraw from society.
|
| In my opinion, this is a plausible hypothesis.
| debacle wrote:
| I've looked into the logistics of "cooking" meth and it is a
| complex process that, were I not an expert, wouldn't create
| something I would be comfortable putting into my body.
|
| How is meth "industrially" produced? Is it Walter White-esque
| clandestine factories? Is it clever people in their garages? Is
| it done over the border?
| 323 wrote:
| The cartels are hiring professional chemists:
|
| > The chemist, a burly man with a master's degree in
| biochemical engineering described the industry's
| transformation, as the pair worked at an outside table.
|
| https://www.theguardian.com/world/2020/dec/08/mexico-cartel-...
| perardi wrote:
| The Atlantic has a decent summary. (If a bit of an over-the-top
| headline.)
|
| https://www.theatlantic.com/magazine/archive/2021/11/the-new...
| eoinbmorg wrote:
| The thing with cooking meth is that you don't have to be
| comfortable putting it in your body. You just have to be
| comfortable selling it to someone else who will put it in their
| body! Unfortunately, for many meth producers/dealers that bar
| is not very high.
| throwawayyy181 wrote:
| Maybe at the top of the food chain, but a lot of lower level
| people are addicts working to support a habit by pinching
| from wholesale
| dynm wrote:
| Around a week ago, I came across this link here on HN that
| suggested that there's a new form of meth:
|
| https://news.ycombinator.com/item?id=28938888
|
| The theory is that new meth is based on a synthesis using a
| chemical called P2P rather than the old synthesis that used
| ephedrine. There are claims that this new form of meth is
| chemically different in some what that started creating
| schizophrenia around 2017.
|
| However, when I looked into it, there doesn't seem to be much
| support for this idea. Current meth is more pure than ever
| before. Some people suggest that the use of lead could be
| responsible, but not all P2P syntheses use that, and it wasn't
| common in 2017. Instead, it seems like the explanation is just
| the obvious one: P2P synthesis has resulted in people doing much,
| much more meth than ever before.
| curryst wrote:
| The author does bring up l-meth. I'm taking them at their word
| that l-meth is an isomer of d-meth and is created in P2P
| synthesis, but that seems at least plausible.
|
| It doesn't seem to be common in the legal markets, and
| especially not at the kind of doses addicts would be exposed
| to.
|
| From Wikipedia on Levomethamphetamine:
|
| > In larger doses (more than 20 mg/day), it loses its
| specificity for MAO-B and also inhibits MAO-A, which increases
| serotonin and norepinephrine levels in the brain.
|
| So there is a difference in response at higher doses. I would
| expect that addicts could be exposed to much more than
| 20mg/day, which begs the question of whether we even know what
| several hundred milligrams a day could do.
|
| That's without getting into method of consumption. I'm not a
| chemist, but would we expect both isomers to break down under
| heat the same way? Or is the l-meth potentially being converted
| to something different than d-meth when smoked?
|
| If the issue is the quantity, I would have expected
| schizophrenia to be constantly present. There's a fixed upper
| limit on how much people can do in a day, and overdoses have
| always existed, so there have always been people teetering on
| the edge. The amount heavy users use hasn't changed, there's
| just more heavy users and more users in general.
|
| There doesn't seem to be debate that P2P processes create
| l-meth and d-meth, and that l-meth was less common in earlier
| versions.
|
| I also don't think there's a debate that l-meth and d-meth have
| different effects. They're both used in prescription drugs, and
| those drugs are not interchangeable. You can't treat ADHD with
| l-meth, and you can't use d-meth in segiline.
|
| None of that is conclusive. It could still be the quantity, or
| even something we haven't though of like an interaction between
| meth and fentanyl (which started its rise around 2015). I just
| don't think the evidence is so weak that we can discard the
| potential that l-meth is involved.
| __blockcipher__ wrote:
| > I'm not a chemist, but would we expect both isomers to
| break down under heat the same way? Or is the l-meth
| potentially being converted to something different than
| d-meth when smoked?
|
| Methamphetamine is very, very stable. It stays as
| methamphetamine when it's vaporized, regardless of whether
| we're talking d-meth or l-meth.
|
| > There doesn't seem to be debate that P2P processes create
| l-meth and d-meth, and that l-meth was less common in earlier
| versions.
|
| Not quite. p2p done naively creates racemic meth, yes, but
| the modern methods, which have been used for years, purify
| that to enantiopure d-methamphetamine. They do this by
| bubbling d-tartaric acid through the racemic mixture, which
| separates the two enantiomers thus yielding the desired pure
| d-meth.
|
| Furthermore, historically racemic meth was much more common.
| AFAIK the infamous "shake and bake" technique creates racemic
| meth. I do know that there is a pseudofed route that yields
| d-meth, but I think it's different than shake and bake. So
| don't quote me on this paragraph, but at a minimum we know
| that in the last several years, almost all meth seized in the
| US is highly pure/potent d-methamphetamine. There is less
| l-meth than ever.
|
| > I just don't think the evidence is so weak that we can
| discard the potential that l-meth is involved.
|
| On the contrary, the evidence is so weak that we literally
| can discard that l-meth is involved. First of all l-meth is
| better studied than you say. I would bet to approve the
| l-methamphetamine-based vics vapo inhaler they had to at
| least do animal models with large amounts of pure l-meth.
|
| Second of all, and this is what blows the giant hole in your
| argument, there is no surge of l-meth. There is less l-meth
| than there has ever been in the history of methamphetamine.
|
| Thirdly - this ties into the second point - you seem to thikn
| that getting racemic methamphetamine is something particular
| to the p2p method. It's not. As a general rule, synthesis of
| _any_ compound yields the racemic version (if we 're talking
| a compound with two enantiomers). This is definitely true for
| meth, where almost every method yields racemic meth. AFAIK
| there's a pseudoephedrine route that yields straight d-meth,
| but like I mentioned above the current state of the art is
| just to do a big p2p synth route and then separate out the d
| enantiomer specifically.
| s1artibartfast wrote:
| It seems to me that the Elephant in the room is not the
| racemic composition of meth, or purity, but composition and
| nature of the remaining impurities.
|
| Do you know if these are well understood and tracked over
| time?
| kortex wrote:
| I can't rule it out, but it's unlikely. Unless the meth
| cooks are doing something really bizarre, it's unlikely
| anything in the synthesis route produced as a side
| product is going to be as biologically potent as the meth
| itself. (This is not true for other street drugs, see
| MPTP). P2P Meth synthesis is pretty simple and
| straightforward if you have the reagents, it's Organic
| Chem 2xx-3xx level stuff. And it is really easy to
| crystallize to high purity.
|
| I think it's actually the opposite of impurities. The
| tech and supply chains have gotten so good, the purity
| had gone way up and the cost down, that people are just
| using way more of it.
| gpcr1949 wrote:
| > AFAIK the infamous "shake and bake" technique creates
| racemic meth
|
| the shake and bake method uses "sudafed"/pseudoephedrine.
| therefore, it will produce d meth
|
| > This is definitely true for meth, where almost every
| method yields racemic meth
|
| not quite true, because the main precursor pseudoephedrine
| already had the correct stereochemistry in place. you would
| actually have to do effort to racemize that asymmetric
| carbon. But it is true that if your precursors are
| racemates or not asymmetric and you are not using some
| fancy asymmetric catalysis or tedious resoltuion your
| product will be racemic. An example of a racemic meth
| synthesis that does not involve P2P is direct amination of
| allylbenzene.
| __blockcipher__ wrote:
| Thanks so much for your correction/insight here. My
| chemistry knowledge is pretty weak - and extra rusty - so
| that was very helpful.
| rkk3 wrote:
| > There are claims that this new form of meth is chemically
| different in some what that started creating schizophrenia
| around 2017.
|
| You are off by 8+ years ... P2P made meth became mainstream
| after 2008 because that is when Ephedrine was banned in Mexico
| [1].
|
| [1.]https://www.justice.gov/archive/ndic/pubs31/31379/meth.htm#
| :....
| loeg wrote:
| OP is debunking the same claim you are.
| edgyquant wrote:
| I saw a similar post that claimed the new meth caused psychosis
| and hallucinations, etc. I don't know much about meth itself
| but I do know about Adderall. When you take the normal dose
| (10-30mg) it can cause some euphoria but for the most part it
| helps you focus, gives energy (makes you more happy,
| talkative.) But when it is abused (60+mg) it can cause serious
| psychosis with all kinds of mental side effects. I image than
| the new meth is just extremely strong and so for people who are
| used to doing (or seeing others do) a weaker type it would seem
| to be a completely different drug. At least this is my theory,
| since as you said there isn't any evidence there is a new type
| of meth, just a stronger type.
| __blockcipher__ wrote:
| Yeah it's all very straightforward when you look at usage
| patterns. Often meth abusers will smoke multiple points
| across a day (a point = 100mg). As a result they stay awake
| for days straight, don't eat, and often will engage in
| enormously risky sexual behavior (this is the dirty secret of
| AIDS btw...it arose in the context of the "party and play"
| gay subculture where people would smoke meth or other drugs
| and have sex for hours and hours and hours straight with
| many, many different partners...but I digress)
|
| The infamous "meth mouth"? That's caused by not sleeping and
| by just overall letting one's life go to shit. Amphetamines
| do suppress saliva production, so they aren't great for
| teeth, but it's 95% the lack of sleep and other associated
| behavior patterns.
|
| I've taken pharmaceutical adderall (which is 75% d-amp and
| 25% l-amp btw), and pharmaceutical dextroamphetamine (100%
| d-amp), and illicit, presumably cartel-sourced, and
| presumably very pure d-methamphetamine. When taken orally,
| d-meth is, in my opinion, simply a superior ADHD drug (it is
| much more dopaminergic than amphetamine, yet causes _less_
| peripheral stimulation, so you get a much more favorable
| ratio of positive cognitive effects to negative peripheral
| effects).
|
| However, the moment someone starts taking (especially
| smoking, since the RoA of any drug makes a massive difference
| in addiction, doubly so for meth) hundreds of milligrams, it
| becomes a completely different drug. It becomes super
| deleterious to health through the sleep deprivation and risky
| behaviors alone. Furthermore meth has a unique property that
| amphetamine apparently doesn't, which is that it can become
| directly neurotoxic in large doses (meth has some serotonin
| release, like a much, much weaker form of MDMA, whereas
| amphetamine has virtually none, so it's possible that that's
| the mechanism). This is why in the research literature
| there's a lot about methamphetamine "neurotoxicity", but the
| papers conveniently omit that if taking oral doses comparable
| to what's given for ADHD, it's not neurotoxic whatsoever (and
| frankly may be neuroprotective, especially against traumatic
| brain injury).
|
| So yeah, your analogy to Adderall is spot on. I've often seen
| people derisively refer to Adderall or other amphetamines by
| saying "we're basically giving kids meth!". Which is true in
| a sense, except it's really the other way around: meth is
| really not very different from Adderall. If someone were to
| smoke 100mg+ of amphetamine, their body would break down the
| same way it does in a meth user, except possibly for the
| direct neurotoxicity effect I mentioned.
| wswope wrote:
| Great writeup!
|
| Just adding on: Other key differentiator between
| recreational and therapeutic amphetamine usage is the
| pharmacokinetics: Vyvanse is the best in this regard - it's
| actually an amphetamine prodrug that gets converted to
| amphetamine in the bloodstream over the course of ~2 hours,
| giving a very smooth release. Adderall achieves a similar
| end (to a lesser degree) by combining equal ratios of four
| different amphetamine salts with various absorption rates
| to smooth out the serum concentration curve. Dexedrine and
| Desoxyn I believe are both single salt compounds, and thus
| have a slightly higher risk of dependency due to their
| sharper peaks. Of course, other RoAs like smoking or
| injecting amphetamines recreationally take the effect to a
| whole new level with even sharper curves, dramatically
| raising the chances of addiction and negative side effects.
| __blockcipher__ wrote:
| Totally agreed. Expanding a bit on some of the stuff you
| mentioned:
|
| Vyvanse hits C_max around 3 to 3.5 hours. But you'll hit
| the maximum "acceleration" (as opposed to "velocity")
| around 1-2 hours like you said.
|
| Fun fact: Vyvanse was basically designed to have more
| meth-like pharmacokinetics, since meth also takes about
| 3-3.5 hours to peak in the blood. Having done both
| lisdexamfetamine and d-methamphetamine orally, the C_max
| numbers in the literature are definitely correct because
| those numbers line up perfectly with when I subjectively
| peak.
|
| > Adderall achieves a similar end (to a lesser degree) by
| combining equal ratios of four different amphetamine
| salts with various absorption rates to smooth out the
| serum concentration curve.
|
| Yup, and I forget the exact mechanism but I have seen a
| paper arguing that the 75:25 ratio actually does improve
| the efficacy. Although I can't remember what the
| mechanism actually was...
|
| > Dexedrine and Desoxyn I believe are both single salt
| compounds, and thus have a slightly higher risk of
| dependency due to their sharper peaks
|
| Correct, both are 100% d-enantiomer, and both due have
| somewhat sharper peaks as a result. Although to elaborate
| AFAIK Vyvanse is really the only super unique one.
| Adderral does/should have a slightly smoother peak but
| largely the levoamphetamine seems to serve to up the
| norepinephrine-y effects (that is to say, the "I need to
| be doing something right now" effects, whereas dopamine
| is moreso the "once I start something I can keep doing
| it" effects).
|
| Also methamphetamine in particular when taken orally is
| very vyvanse-like, as I mentioned above. So it's really
| exclusively with the fast RoAs like smoking or injecting
| it where you get the really crazy instant spike. (That
| last sentence is just from my general understanding, I've
| never taken meth in a non-oral RoA so I can't speak from
| experience)
| throwaway2331 wrote:
| Adding on: the problem with vyvanse is that there's no
| way to mess around with the dosage to get it "just
| right."
|
| It's like a more strict version of extended release (EX)
| and timed release formulations (there's a difference!).
|
| Vyvanse is metabolized to d-amphetamine in your blood
| cells (the specific mechanism escapes me right now),
| unlike the regular non-prodrug versions which get
| "metabolized" first in your stomach and intestinal tract,
| and then your liver.
|
| However, there is a set speed that vyvanse gets converted
| into free-circulating d-amphetamine, determined by how
| quickly (or slowly) your blood cells metabolize it.
| Unlike regular d-amphetamine, where the speed, and
| effect, can be "messed" with (or rather "tuned") on a
| variety of factors, such as:
|
| 0. Carbohydrate intake (regular, non-fructan and non-
| galactin, carbs get released into the bloodstream and
| trigger an insulin release response, which also happens
| to dull the effect of excitory neurotransmitters)
|
| 1. Stomach pH (acidicity == lesser effect, basicity ==
| higher effect. E.g. drinking orange juice with
| d-amphetamine will lessen its effect, while taking tums
| will increase its effect, many times TOO much)
|
| 2. Certain liver enzyme inhibitors (mainly those in black
| pepper and grapefruit/pomegranate) will decrease the rate
| of amphetamine clearance, thereby intensify its effects
|
| 3. Caffeine (will potentiate amphetamine)
|
| 4. Personal physiology (not much you can do except play
| around with dosage and the aforementioned 4 factors)
|
| Now, with the regular IR version, you can take more or
| less (1-5mg here and there) depending on your specific
| circumstances to get into the "right" spot where you're
| not overly or under stimulated, but just enough to be in
| that Goldilocks zone of flow.
|
| However, with the ER version you lose the ability to get
| your "Goldilocks Dosage." You can still play around with
| the aforementioned factors, but this time you're
| restricted to a specific dosage now (say 5mg) and a
| specific dosage in some set amount of time later (say
| another 5mg, about 4-6 hours later).
|
| Yet, with vyvanse you get even less of an ability to play
| around with the dosage. Take 60mg, and your body will
| slowly metabolize it to a set amount per hour, regardless
| of almost anything you can control. If that amount/hour
| rate doesn't coincide with your Goldilocks zone, you're
| shit out of luck -- and Vyvanse will not "work" for you.
|
| There's so much more that goes into this, but I've
| frankly written way too much of an essay at this point.
| coolspot wrote:
| Thank you for in-depth explanation. Is there a book or
| some website where all this knowledge of ADHD medication
| usage nuances is collected in one place? Like a missing
| ADHD manual?
| throwaway2331 wrote:
| Ironically, erowid and other "drug" related forums
| contain the best "practical" knowledge and nuances of
| actually having to take the medication. They're not
| scientific or robust, but they are empirical. That's why
| most pharmacists and prescription-writing physicians will
| look at you funny (or get combative) if you tell them
| generic brand X isn't as effective/good as generic brand
| Z for you.
|
| On paper, each generic must pass some bio-equivalency
| test with the FDA. Most of the time all that means is "we
| at generic brand X ran our own experiments and concluded
| that we show similar blood concentrations of drug A, to
| Brand-Name Z." And then every professional involved in
| that supply chain writes it off as "basically the same,"
| excluding all the little implementation/manufacturing
| details that go into each specific producer, much less
| factory (quality control is frankly disturbing in many of
| these plants).
|
| You won't find a lot of practical information written
| within scientific literature, aside from basic
| chemistry/biology (the low-level details). Most of the
| time the researchers running these experiments have done
| less research and have less hands on experience than the
| people who have to use this medication on a daily basis.
| Many times reading the scientific literature is just a
| rabbit hole that leads to nowhere, except feeling like
| "you're on to something."
|
| Apologies for the rant.
| __blockcipher__ wrote:
| Not that I know of. One of the side effects of
| amphetamine usage is compulsively researching details
| about amphetamine, so that's where my knowledge comes
| from :)
|
| Certainly need to read some of the research literature
| and places like /r/DrugNerds (that community is super
| legit). The public health/doctor-y type websites are the
| worst for actually getting info since they never go into
| details and often give bad advice, so I'd stay away from
| the "traditional" resources if you're trying to go deep
| soylentcola wrote:
| Yep. It's why I switched from Vyvanse (lisdexamfetamine -
| basically just d-amp bound to lysine which is then
| metabolized into d-amp during digestion) to IR generic
| Adderall (a mix of d-amp and l-amp).
|
| Any unwanted effects (insomnia if I take it too late,
| etc) are almost entirely due to the l-amp, but the slow
| release of Vyvanse made it essentially impossible to
| titrate and my options were either to take a dose so low
| it wasn't effective or deal with regular insomnia due to
| lingering amphetamine effects into the evening.
|
| I guess ideally I'd have IR d-amp but I assume it's
| considered too "abusable" so it's rarely prescribed.
| Meanwhile, my whole goal is to get useful effects without
| taking enough to feel like I'm tweaked out or high.
| throwaway2331 wrote:
| I had the same experience with vyvanse. Insomnia and ADHD
| medication are a dangerous combo -- one that's hardly
| recognizable until it's too late.
|
| In my experience, I've had to run the gamut on all the
| "other" ADHD drugs (ritalin, adderall, d-amphetamine ER,
| etc.) and then prove they weren't effective, for my
| insurance to finally approve it. I've heard of some
| people even going so far as to get prescription meth
| (desoxyn) because nothing else would work! Strange world.
|
| I've stopped taking meds entirely. I don't know if it's
| because I'm getting old, and even a "low" dosage (5-10mg)
| makes me feel very uncomfortable, or if it's because I've
| used a lot of different slavic nootropics and neuro-
| regenerative peptides (e.g. semax/NASA, BPC-500, etc.),
| but I just do not have any tolerance for it anymore.
|
| Fortunately, this loss of tolerance coincided with the
| ability for me to function very well on simple caffeine
| alone.
| dr_dshiv wrote:
| > slavic nootropics and neuro-regenerative peptides (e.g.
| semax/NASA, BPC-500,
|
| more info?
| cwkoss wrote:
| > Vyvanse is metabolized to d-amphetamine in your blood
| cells
|
| Do you have any more information about this? Can't find
| it on google - would be very interesting if its true but
| I'm a bit skeptical - I've never heard about blood cells
| being a primary site of drug metabolism.
|
| A search turned up:
|
| > "Lisdexamfetamine dimesylate is converted to
| dextoamphetamine and L- lysine, which is believed to
| occur by first-pass intestinal and/or hepatic
| metabolism."
|
| (https://www.accessdata.fda.gov/drugsatfda_docs/label/200
| 7/02...)
|
| According to this, sounds like its mostly intestines and
| liver, which is much more typical for drug metabolisms.
| lookalike74 wrote:
| The 'dirty secret' you refer to (1) is mostly wrong because
| partying with LSD was popular in the early 80s, not meth,
| and (2) the gay community is and always has been very up
| front about risky behaviors and how to minimize the risks.
| Just because you're unaware of something doesn't make it a
| secret.
| elzbardico wrote:
| All other literature have told me exactly the contrary in
| terms of attitudes concerning risk. So, do you have a non
| politicized source for your statements?
| SkittyDog wrote:
| In the American urban gay community, neither LSD nor meth
| were nearly as popular as prescription amphetamines
| (pills) until the 1990s, when bathtub meth (crank)
| manufacturing really took off. They were all always
| available, but the pills were so cheap & easily
| obtainable that they were a natural favorite.
| cronix wrote:
| MDMA/"Ecstasy" was quite popular in the 80s ("mollie"
| today), as well as Amyl Nitrite/"poppers"/"rush". The
| club drugs.
| NikolaeVarius wrote:
| Meth causes your mouth to produce to less saliva which
| removes the bacteria moderating ability of your mouth.
|
| Combine that with also constricting the blood vessels of
| your gums, and you get a great mix of infection of dying
| tissue.
| SkittyDog wrote:
| It's a myth. I have met hundreds, maybe thousands of long
| term addicts of meth, crack, and heroin... Lifestyle
| addicts suffer from massive tooth decay & dental
| problems, in similar proportions, regardless of which
| drug they were using.
|
| Whatever the pharmacological impact of meth usage on oral
| health, it's pretty clear to me that it's a much smaller
| factor than the general gone-to-hell life of a full time
| addict.
| orangepurple wrote:
| Amphetamines also cause capillary vasoconstriction which
| eventually kills off your gums
| SkittyDog wrote:
| Pharmacologically, amphetamines are no worse on your
| mouth than regular nicotine or caffeine usage. And while
| cigs & coffee aren't necessarily good for your oral
| health, they also don't generally cause major gum disease
| and tooth loss.
|
| "Meth mouth" is mostly caused by neglect, not the
| biological effects of amphetamines. Long-term heroin &
| crack users suffer the same kind of severe tooth decay as
| meth addicts. If you smoke meth every day, but still
| somehow manage to brush & floss your teeth every day,
| your oral health won't be any worse than the average
| American.
| actually_a_dog wrote:
| That's incorrect, at least in the case of cigarettes.
| According to the CDC, you have twice the risk of gum
| disease if you smoke versus nonsmokers. They also state
| that the more you smoke and the longer you smoke, the
| greater your risk. That doesn't directly imply a causal
| link, but it sure winks really obviously in the direction
| of one.
|
| https://www.cdc.gov/tobacco/campaign/tips/diseases/period
| ont...
| theragra wrote:
| My somewhat large reading about this and some real life
| knowledge says this is a very true POV.
| actually_a_dog wrote:
| > When you take the normal dose (10-30mg) it can cause some
| euphoria but for the most part it helps you focus, gives
| energy (makes you more happy, talkative.) But when it is
| abused (60+mg) it can cause serious psychosis with all kinds
| of mental side effects.
|
| Background: I'm prescribed 20mg/day of extended release
| Adderall, via a legitimate ADHD diagnosis. If we take the
| article's "meth is 2x as potent as Adderall" statement at
| face value, that would mean I'm taking 10mg equivalent of
| meth per day.
|
| Now, since part of the reason I take this medication is to
| remember to take my medication (a joke, yes, but not without
| its kernel of truth!), I've accidentally double dosed myself
| before. I've also done the same previously when I was
| prescribed instant release Adderall. In either case, I've
| never experienced anything like a euphoric high, but I have
| experienced the kind of "uselessly driven"/tweaker sort of
| side of it. And, let me tell you, I do not like it when that
| happens. Although I'm in no hurry to find out, I honestly
| find it hard to imagine what the high must actually be like
| in order for people to voluntarily subject themselves to the
| negative effects of this drug. And, I don't even exceed the
| therapeutic range when this happens!
|
| I wish there was some way to actually understand why people
| abuse meth without actually smoking meth myself, which I'm
| unwilling to do, for obvious reasons.
| pessimizer wrote:
| This "new meth" thing seems like a PR push by government
| contractors. It's redolent of the UK "skunk" scare (it's not
| the pot you used to smoke, mommies and daddies - it's special
| pot that will definitely make your children think they can
| fly and jump out of windows, and become prostitutes to pay
| for more.)
| elliekelly wrote:
| > government contractors
|
| I'm not sure I follow? I know drug fear-mongering is a
| favorite tactic of politicians but I'm not sure I
| understand what government contractors have to do with it.
| Are you alluding to private prisons? Or perhaps some other
| piggy-back industry that I'm unaware of?
| cronix wrote:
| It sounds like someone just watched Breaking Bad.
| asdff wrote:
| More that breaking bad was picking up the story that was
| taking place at the time when sourcing their material.
| There's been a lot written about the superlabs in Mexico
| that produce hundreds of pounds of pure product a batch.
| There are probably thousands of facilities like this now
| making this P2P cook at industrial scales.
| arcticfox wrote:
| What makes you say that?
|
| I'm not 100% sold on it yet, but my city has always been
| "welcoming" to homeless folks and it has never been a huge
| problem. Now it looks like an actual zombie apocalypse out
| there in some parts, and there are periodically meth busts
| of hundreds of pounds in just random apartments, not even
| kingpin types.
|
| Combined with the anecdotal evidence from social workers,
| there's a whole lot of smoke out there that the "new meth"
| theory might explain.
| goatsi wrote:
| As the article points out, the big change is in the
| production levels and the price. If meth is cheap and
| every dealer is flooded with it, more people are going to
| be using it and in higher quantities that will produce
| more visible (and negative) effects.
|
| The random apartments are probably stash houses used for
| storage of bulk quantities that would be broken down and
| distributed to dealers.
| edgyquant wrote:
| Yes because what people are taking now is super pure and
| potent where before what was common was "dirty" meth.
| Enginerrrd wrote:
| It's even more silly a claim because P2P based syntheses have
| been in common use for many decades. They were especially
| popular amongst the Hells Angels' chemists. I'm not sure what
| their final reductive amination step was, but I'd guess Al-Hg
| amalgam & methylamine.
| 55555 wrote:
| Extremely good analysis. I was also skeptical of the original
| podcast.
| kayodelycaon wrote:
| From what I've read of schizophrenia[1] it is highly inherited
| and unlikely that any drug would cause it. A sufficient amount
| of stress is known to trigger or quicken the emergence of
| schizophrenia in people already predisposed to it.
|
| When it comes to studying this, you have to separate out:
|
| * The high rates of drug abuse by people with mental illness.
|
| * The correlation drug use with other sources of stress. Drug
| use may not be the source, but a result of the source. (But I
| think we can all agree drugs probably aren't happening
| matters.)
|
| * Misdiagnosis of temporary drug-induced psychosis as a
| permanent, incurable mental health illness.
|
| * Race, sex, age, and location, since this all affect the
| normal rates of schizophrenia for each population group.
|
| OR:
|
| * Show a significant increases in rates that can't be explained
| by the above. (If this rate tripled, it's pretty clear
| something bad is happening.)
|
| Very few studies do this, because it is very difficult and
| there is little incentive to do high quality research.
|
| 1: I'm bipolar which is sometimes considered to be on the same
| spectrum
| jac241 wrote:
| Maybe it doesn't cause permanent psychosis but people do
| become psychotic due to it and need to spend the night
| cooling off in the psych ED.
| dcolkitt wrote:
| Much of the effects of any intoxicant are culturally
| constructed. Alcohol is widely known for causing aggression,
| but this effect doesn't seem to exist in cultures without that
| association. Nor does it exist in double-blind studies, yet the
| placebo group becomes more aggressive.
|
| You can start with two chemically identical intoxicants, and
| either by marketing or random path dependencies one gains a
| reputation in the subculture for making people go crazy. You
| can bet that large number of people are going to act wild on
| it.
|
| This is no different than the reputation different types of
| alcohol have garnered. Gin makes people mean. Whisky makes
| people emotional. Tequila makes people party like crazy. It's
| all ethanol, but those cultural preconceptions become self-
| fulfilling prophecies.
|
| In many ways that makes these rumor filled, science light,
| unsubstantiated media stories about "this is the most dangerous
| drug ever" incredibly irresponsible. The stories themselves
| create the cultural preconditions around encouraging more self-
| destructive behavior among users. This isn't even just drugs.
| Look at the moral panic over Four Loko. The same cocktail of
| ethanol and caffeine has been consumed as amaro and coffee by
| rich women since time immemorial. Yet it never caused moral
| panic until the "wrong type of people" started consuming it.
| wayoutthere wrote:
| > Look at the moral panic over Four Loko. The same cocktail
| of ethanol and caffeine has been consumed as amaro and coffee
| by rich women since time immemorial. Yet it never caused
| moral panic until the "wrong type of people" started
| consuming it.
|
| You're not entirely wrong, but a splash of liqueur into a
| small cup of coffee is pretty different from dissolving
| caffeine pills in tall boys of malt liquor.
| [deleted]
| twofornone wrote:
| You are probably right in your assertion regarding alcohol,
| however I suspect it may be possible that there are other
| compounds unique to various flavors of liquor which may
| influence the overall effects in various ways. These
| compounds may not be perceptably psychoactive on their own.
|
| The same goes for strains of marijuana, beyond THC and CBD
| other psychoactive compounds are inconsistently present with
| uncertain psychoactive effects (if any). Further there may be
| complex nonlinear interactions (e.g. two compounds produce no
| effect but adding a third can change the experience,
| particularly if you consider reaction products from
| combustion).
|
| In any case the uncertainty is good for marketing.
| R0b0t1 wrote:
| Did they separate the culture link from a potential genetic
| link? Maybe the association exists in a culture because it is
| a real effect, it just differs between groups.
| tyingq wrote:
| I agree that the gin->mean, whisky->emotional, etc, is all
| bunk. But I'm still convinced there's a link between alcohol
| and violence. If nothing else, the lowered cognitive function
| and reduced inhibition would mean more opportunity to be
| angry, and less self control.
|
| Like, a drunk person might misinterpret someone accidentally
| bumping into them as aggression. And would be less likely to
| suppress the urge to respond in kind.
| trgn wrote:
| You're describing the stereotype of a mean drunk. In
| reality, there's also the happy or the sentimental drunk.
| They might just laugh it off or smile big and hug the
| person bumping into them.
|
| For sure, alcohol reduces inhibitions. If you're a
| naturally chip-on-the-shoulder kind of person, alcohol will
| turn you into a certified jerk. Alcohol can turn other
| kinds of people into lovable fools as well though.
| tyingq wrote:
| I didn't think the bar was to describe something that was
| true for everyone. I suspect what I described is true for
| many, across many cultures. I've also seen people I would
| have characterized as mild-mannered act much differently
| with alcohol in them. I don't think it's just strictly
| amplifying existing traits.
| jdavis703 wrote:
| I'm just a sample of one, but I'm way more likely to flip
| my shit when sober -- all my fights or verbal altercations
| I have in fact been sober.
|
| Granted, I've been diagnosed with various mental health
| disorders related to emotional regulation, so perhaps this
| is dependent on individual brain function.
| olyjohn wrote:
| Of course. Not everybody is going to get violent. And it
| won't affect everybody the same. But it does feel like it
| really brings out the violence in people who maybe are
| already prone to that type of behavior. In your case it
| may do the opposite.
| wirrbel wrote:
| Reduced inhibition does not support the thesis of increased
| agression, unless you define aggression to refer to
| "aggression shown".
|
| But I'd overall turn the 'cultural' aspect a little further
| even. I think I have observed a couple of times people to
| consume alcohol in order to be able to transgress cultural
| norms because the cultural norms themselves are
| 'parametrised' for the sober-drunk states.
|
| I.e. get into a fight sober? Could be unacceptable even to
| someone who wants to get into a fight. After 4 beers? May
| be perfectly fine for your peer group. Same goes to other
| things, like dancing, approaching strangers, etc.
|
| What I really found interesting for example is, in my
| abroad term in Canada. The sober Canadian society was
| overall friendly and polite, definitely friendlier than in
| my German home. People held up doors for me (a 20 something
| man, felt really weird and unexpected), you got compliments
| for what you wore (never happened to me in Germany), etc.
| pp. But this radically changed in the 'drunken space' where
| people were a lot more aggressive and fights were much more
| the norm.
| tyingq wrote:
| >Reduced inhibition does not support the thesis of
| increased agression, unless you define aggression to
| refer to "aggression shown".
|
| I mean overall increased opportunity for violence. Less
| inhibition might mean I'm more likely to say "fuck off"
| to someone rather than just think it. Which could lead
| somewhere.
| seigando wrote:
| That's indicative of underlying aggression and can't be
| extrapolated to other cultures.
| tyingq wrote:
| I guess, but I'm curious what culture has no aggression
| at all.
| seigando wrote:
| Probably depends on how specific you get with the term
| aggression
| tyingq wrote:
| It sounds like there's a suggestion that cultures where
| alcohol has no notable effect on overall violence. I'm
| curious what culture that is.
| seigando wrote:
| idk maybe mormon culture?
| tigershark wrote:
| > In many ways that makes these rumor filled, science light,
| unsubstantiated media stories about "this is the most
| dangerous drug ever" incredibly irresponsible. The stories
| themselves create the cultural preconditions around
| encouraging more self-destructive behavior among users. <
|
| What about krokodile?
| girvo wrote:
| What about it?
|
| Desomorphine is not any more inherently dangerous than
| other opioids (so, still quite dangerous of course).
|
| The synthesis pathway that Krokodil producers used are
| quite bad and unrefined, but quite surprisingly do work and
| does appear to produce desomorphine.
|
| The problem was the producers were usually addicts who then
| injected the reactions solvent mixture, rather than
| extracting their product.
| e9 wrote:
| It's also possible that the impurities themselves were making
| it easier on the body(for whatever reason they could signal
| liver to produce more enzymes that were the ones to break down
| meth or clear it's harmful metabolites etc)
| seattle_spring wrote:
| Really interesting read. Thank you for sharing. For some reason
| this sort of information about street drugs and science/culture
| surround it fascinates me.
| rolph wrote:
| you might enjoy this then:
|
| https://en.wikipedia.org/wiki/Hamilton%27s_Pharmacopeia
| realce wrote:
| Xylene episode shook me to my core
| philg_jr wrote:
| You must mean the Xenon episode.
| cwkoss wrote:
| RE: Quantity section. I wonder if the pharmaceutical amphetamines
| and/or novel 'research chemical' amphetamines metabolize into the
| same compounds that are being quantified in sewage. Are they
| detecting 'meth' specifically or amphetamines generally?
|
| > only $1k per pound now.
|
| Wow that's crazy. An equivalent quantity of generic adderall
| would cost ~$20k. Meth is effectively at commodity-level prices,
| if true - the drug war premium seems gone.
|
| I'm skeptical about overdose rates being attributed to meth. Meth
| is fairly hard to OD on - it'll ruin your life and brain, but
| rarely kills acutely. I suspect meth being used as an adulterant
| mixed with other drugs (esp opioids), or novel non-meth
| psychostimulants, play a significant role in the increase of
| psychostimulant ODs by ~9x over the last 10 years.
|
| I think a lot of this data is getting mixed up with the (at the
| time quasi-legal) pyrovalerones and cathinones that were widely
| available through the clearnet over the past 5 years. Those have
| much greater acute risks and were highly accessible to people
| without drug connections.
|
| ---
|
| However, I'm skeptical of the initial premise of the article:
|
| > Ephedrine meth was like a party drug. [...] You could normally
| kind of more or less hang onto your life. You had a house, you
| had a job. [...] P2P meth was nothing like that. It was a very
| sinister drug.
|
| Tweakers have been around for decades, I suspect this is just
| misleading anecdata.
| kens wrote:
| The article mentions the ban in 2006 of over-the-counter sales of
| Sudafed (pseudoephedrine). One of my favorite satirical articles
| is "A simple and convenient synthesis of pseudoephedrine from
| N-methylamphetamine". (The joke being that Sudafed is now hard to
| purchase while meth is readily available.)
|
| https://www.improbable.com/airchives/paperair/volume19/v19i3...
| kortex wrote:
| The ironic thing is the sheer drop in price is probably due in
| part to the P2P route taking over. It's a more involved process
| than Sudafed meth, but it's easier to scale, since you aren't
| bottlenecked by the pharmaceutical supply.
|
| Once you establish the facility and pipeline, you can crank out
| industrial amounts of crank. The precursors are cheap and used
| in huge quantities by legitimate labs.
| Zarathust wrote:
| In Canada you can still buy that over the counter. You get id-
| ed and they keep a record of your purchases, but since it's now
| generic pills it is now much cheaper than it was before
| wirrbel wrote:
| I grew up in Germany in a household that never used nasal
| decongestants, probably out of some fear that they might be
| dangerous.
|
| When in Canada a doctor told me to buy some pseudoephedrine
| pills to treat a clotted ear and I found the experience so
| nice, that when back in Germany I walked into a pharmacy to
| get some.
|
| The looks...
| gunfighthacksaw wrote:
| I didn't get IDed either of the times I've bought a box.
|
| First time was in 2019: I went to Walmart for something for
| my ears on flights, after some back and forth the pharmacist
| recommended me pseudoephedrine.
|
| Second time was in Sobeys last month (can fly again, yaaay)
| and I asked for it directly. The pharmacist had some trouble
| finding it, but sold it to me with no further issue.
| Scoundreller wrote:
| A bit of a change was that it became pharmacy-only in many
| (most?all?) provinces. But pharmacies are everywhere, so
| not a huge deal.
|
| Sad thing is many products were reformulated with
| phenylephrine, an uncontrolled similarly structured
| molecule that's completely junk as a decongestant.
| ceejayoz wrote:
| It's the same in the US; you can buy it without a
| prescription, but you have to have your ID logged.
| Rebelgecko wrote:
| There's also an age minimum. My freshman year of college I
| had the sniffles and a bad cough. I went to the pharmacy to
| get some Sudafed but couldn't purchase since I was still
| 17. Went to the school's health center where the doctor
| happily prescribed me opioids (the infamous purple drank).
| HideousKojima wrote:
| And there's a limit on how much you can buy at a time, you
| can only get 15 24-hour pills every 15 days, which means
| you need a regular pharmacy trip
| Scoundreller wrote:
| FDA pressured loperamide manufacturers to stop selling
| large quantity bottles because people thought eating a
| whole bottle was a good idea.
|
| Problem: taking massive amounts of loperamide to get an
| opiate effect is a myth
|
| Of course, the manufacturers were all happy to fall in
| line anyway and dramatically raise per-tablet prices (and
| packaging!)
|
| Except one manufacturer.
|
| Several years ago, I bought a 200-ct bottle for US$9
| shipped to Canada. Now it's US$36.
| girvo wrote:
| It's not a myth so much as it's not particularly
| effective: large doses of it (dangerously so, I might
| add, people should not do this) are quite effective in
| getting rid of opioid withdrawals -- and not just the
| peripheral effects.
|
| In extremely large doses it has a distinctly weird
| feeling. I wouldn't call it getting high, so I'd suppose
| that is indeed a myth, but gosh it _feels_ hard on your
| heart at those doses.
|
| Typically it's addicts trying to avoid withdrawals (and
| who felt they did not have access to other opioid
| replacement therapies for various reasons) that tried
| that. Some died.
| HarryHirsch wrote:
| Tell me who needs 200-ct bottles of imodium. People who
| observe proper hygiene have food poisoning maybe once in
| 10 years (and whether a motility agent is a good idea in
| such cases is another question).
| Scoundreller wrote:
| People that ignore expiry dates. And at least in our
| household's case, a clinically ignored case of
| endometriosis.
| PontiacParade wrote:
| We'll be there soon. You still need a prescription in
| Oregon until Jan 1, 2022.
| sneak wrote:
| A few pharmacies weren't set up to take either a foreign ID
| _or_ a US passport when the program started.
|
| I ended up just buying it on Postmates, delivered, no ID
| check.
| novok wrote:
| I'm guessing your courier got ID checked.
| throwawayyy181 wrote:
| Is shake and bake easy? Seems pretty trivial
| rjsw wrote:
| Can still buy it over the counter in the UK too.
| adolph wrote:
| In the below podcast an author of a book about recent meth
| developments talks about the ban of Sudafed entirely in Mexico
| lead to a change in the market toward fentanyl.
|
| _Author and journalist Sam Quinones talks about his book, The
| Least of Us, with EconTalk host Russ Roberts. Quinones focuses
| on the devastation caused by methamphetamine and fentanyl, the
| latest evolution of innovation in the supply of mind-altering
| drugs in the United States. The latest versions of meth, he
| argues, are more emotionally damaging than before and have
| played a central role in the expansion of the homeless in tent
| encampments in American cities. The conversation includes an
| exploration of the rising number of overdose deaths in the
| United States and what role community and other institutions
| might play in reducing the death toll._
|
| https://www.econtalk.org/sam-quinones-on-meth-fentanyl-and-t...
| 1MachineElf wrote:
| More about the impact of P2P meth:
| https://www.hmpgloballearningnetwork.com/site/ap/news/stimul...
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