[HN Gopher] Fentanyl vaccine tested in rats
___________________________________________________________________
Fentanyl vaccine tested in rats
Author : ca98am79
Score : 96 points
Date : 2023-01-23 15:41 UTC (7 hours ago)
(HTM) web link (uh.edu)
(TXT) w3m dump (uh.edu)
| fckgnad wrote:
| Nothing wrong with this being on the front page. Just posting
| this here as a question. Is the reason why this is on the front
| page because a good number of software engineers addicted? Maybe
| you don't have the numbers but you yourself who's reading this
| may be personally interested in a vaccine?
| birdyrooster wrote:
| I think it's more about interest in the system, threat and the
| mitigation. The technical nature of biochemistry attracts many
| to this forum. Biohackers if you will.
| agentwiggles wrote:
| Additionally I think a lot of hacker types are just
| interested in drugs and drug policy. There are lots of back
| and forths on here about "legalize all drugs" and stuff like
| that. There's a lot of hacker-related threads running through
| drug topics - there's the whole "hacking your mind" /
| psychonaut angle, there's the sorta libertarian intersection
| with the law, there's the counter-culture ideas and
| historical interest.
|
| Even as a kinda drug-interested guy though, I've always
| thought of opioids as strictly off limits recreationally,
| just too many downsides and they don't have the same "expand
| your mind" appeal as psychedelics or even weed. (Not really
| endorsing the idea of mind expansion, I think it's oversold,
| but it's part of the culture).
| fragmede wrote:
| Not necessarily addicts, but where fentanyl is poisoning the
| illegal street market, even those once a month cocaine or
| illegal ketamine or mdma users are at risk, not just oxycontin
| addicts. Even purchasers of Adderall have to be careful these
| days. And vaccines are just cool technology. Why wouldn't I
| take this thing that makes me immune to as certain type of
| poisoning. It may not be for iocaine power but I'll take that
| vaccine as soon as it comes out!
| dougmwne wrote:
| Hacker News is for any kind of intellectual curiosity. It's
| right there in the community guidelines.
|
| And who knows, maybe this bit of creative immune system hacking
| will inspire a security researcher.
| gwbas1c wrote:
| Not me personally, but I distanced myself from some close
| college friends when I figured out they were using heroin. Both
| later cleaned up, one relapsed, and I bumped into the other at
| the funeral.
|
| So, yeah, the opiate problem effects more than just users.
| sillysaurusx wrote:
| It would've saved my brother in law. That's mostly why I'm
| interested.
| euthymiclabs wrote:
| 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.
| cf141q5325 wrote:
| 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.
| bragr wrote:
| You wouldn't give this to the general population, only to
| addicts that couldn't get clean otherwise.
| cf141q5325 wrote:
| Those might need the end of life pain management one day. Its
| what makes it so vicious. They are in no position to think
| the horrible consequences through.
|
| edit: Lets lot sugarcoat this. This is not a new idea. If you
| push this on somebody, you might as well torture them to
| death yourself. Its that bad of an idea and your motivation
| doesnt change the outcome.
|
| There are a whole lot of worse fates then being an addict and
| being in excruciating pain because of a preventable lack of
| end of life pain meds is one of them. You can look around,
| large parts of the world are doomed to this because of a
| merciless crusade against pain meds by people who couldnt
| deal with their loved ones choosing a drug. And i will be
| damned if its because nobody wanted to hurt their feelings by
| explaining this to them.
| ortusdux wrote:
| As I understand it, this would have significant negative impact
| on anesthesia.
| elil17 wrote:
| Although fentanyl is used for anesthesia, especially for deep
| sedation, it is not the only option. From the article:
|
| "The anti-fentanyl antibodies were specific to fentanyl and a
| fentanyl derivative and did not cross-react with other opioids,
| such as morphine. That means a vaccinated person would still be
| able to be treated for pain relief with other opioids," said
| Haile
|
| So they could still use other opioids for anesthesia.
| ortusdux wrote:
| https://www.reddit.com/r/science/comments/yvnr4n/comment/iwg.
| ..
|
| "So I'm an anesthesiologist. This vaccine would wreak havoc
| with surgery. Fentanyl is the go-to opioid for surgery. If
| you can't use fentanyl then sufentanil can be used instead.
| Both are desirable because they have durations of under an
| hour which allows for surgical analgesia but still waking the
| patient after the procedure. The abstract here says the
| vaccine blocks both fentanyl and sufentanil. They don't
| mention alfentanyl or remifentanil which would be the
| remaining options. Morphine, hydromorphone, codeine etc are
| all inappropriate for short surgical cases as the sole opioid
| because their durations of action are closer to 4 hours."
| elil17 wrote:
| Of course fentanyl is the preferred opioid for a reason.
| Using other options could increase surgical risks. But that
| seems pretty insignificant for anyone with OUD given how
| likely they are to die from overdose vs. other causes.
| tpmoney wrote:
| Proposal, people with "opioid use disorders" are more
| than likely suffering in some way that needs evaluation
| and treatment. Many of them were probably on something
| and then cut off suddenly from the supply of that
| something, leading them to seek illicit sources instead
| and leaving them in the position of both unregulated
| treatment, and being unable to get proper regulated
| treatment because they are labeled either addicts by
| people who know about their illicit use, or "drug
| seeking" by people who don't that they ask for access to
| their drug of choice and almost all sources of proper
| health will refuse to treat them without them first
| continuing to insist they stop their use entirely.
| Cutting them off suddenly again by simply making their
| drug of choice stop working does nothing at all to
| address the underlying reason why they think or do need
| the drug and treatment in the first place. Given that our
| medical system often gives you a drug and then kicks you
| out the door to deal with it and its effects on your own,
| this "vaccine" seems more likely to exacerbate the larger
| drug problem, even if the specific "opioid" problem is
| solved. More likely rather than getting someone off their
| drug habit, this will simply drive users its forced on
| into seeking out other drugs to get the same results,
| possibly at higher and even more unsafe dosages.
|
| Drug use is a symptom, and until our medical community
| wises up to that fact, the fight against any "drug use
| disorder" is going to continue to be a losing fight.
| CerieXerox wrote:
| > _" 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?
| calibas wrote:
| 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.
| floor2 wrote:
| >sell a new product to help solve the mess that one of their
| previous products created
|
| That's gotta describe like 75% of US healthcare budget, right?
|
| Red Dye #40, BPA, preservatives, emulsifiers, PFAS -> ADHD,
| Anxiety, Depression -> Adderall, Xanax, Prozac
|
| Sugar, seed oils, preservatives, endocrine-disrupting chemicals
| in food, water & air -> Obesity, hypertension, diabetes ->
| Lipitor, Insulin
|
| Alcohol, smoked/grilled meat, tobacco, microplastics, pesticide
| residues, air pollution from cars & factories -> cancer
| l33t233372 wrote:
| I don't think there's a reputable link between red dye #40,
| BPA, preservatives, emulsifiers(?!) and ADHD, anxiety, and
| depression.
|
| Further, are you claiming meat, tobacco, and alcohol are
| products of the US pharmaceutical industry?
| floor2 wrote:
| Literally everything on this list is supported by publicly
| available, peer-reviewed papers that could be found by 30
| seconds of googling, but people downvote instead of being
| curious and learning something.
|
| Here's a layman-friendly article that covers several papers
| on red dye #40: https://www.verywellhealth.com/red-
| dye-40-adhd-5220957
|
| Here's a page from Columbia university on BPA:
| https://www.publichealth.columbia.edu/research/columbia-
| cent... with quote "Researchers have linked BPA to
| developmental and health problems in children, including
| learning and behavior conditions like Attention Deficit
| Hyperactive Disorder (ADHD), anxiety and depression"
| noptd wrote:
| You're getting downvoted for making a strong causal claim
| without initially citing any sources, and the citations
| in this comment don't even support your claim. From your
| first link:
|
| >It's important to note that artificial food colors do
| not cause ADHD.8 One study found that removing artificial
| food colors from the diet had a statistically significant
| effect on ADHD symptoms, however. The authors noted that
| the improvements were modest but still statistically
| significant.9
| kstrauser wrote:
| If I fall off a ladder and break my leg, I want the good stuff.
| I've found old bottles of expired Vicodin and such around that
| I was prescribed but never finished. I have zero interest in
| recreationally using opiates. I also have zero interest in
| bravely tolerating agonizing pain if I don't have to.
| LarryMullins wrote:
| It's easy to say this when you already know that you,
| personally, can resist the temptation of abusing drugs like
| Vicodin.
|
| Personally, I refuse all pain killers except OTC and local
| anesthetics like novocaine. I rather risk biting through my
| tongue than getting addicted to that shit.
| kstrauser wrote:
| I get that, but that doesn't mean there's no room for
| powerful painkillers for the situations that call for them.
| If someone dying from cancer wants to be stoned out of
| their minds to avoid the pain, I'm all for letting them.
| You and I don't want that because our current circumstances
| don't call for it. Someday, they might. If that day comes,
| I wouldn't want to live in a world without access to strong
| analgesics.
| SketchySeaBeast wrote:
| I think that the palliative care of a cancer patient is
| slightly different than a broken leg. Only one of these
| lead to the opioid crises.
| kstrauser wrote:
| I don't know about that. The immediate post-trauma care
| of something like a broken leg would reasonably involve
| strong narcotics. You're not going to be sent home with a
| batch of it, but may get some on your way to surgery.
| LarryMullins wrote:
| > _You 're not going to be sent home with a batch of it,_
|
| You might, that's the issue. Maybe doctors are more
| hesitant to prescribe such pills now, but for instance
| they tried to prescribe Vicodin (iirc) to me after I had
| my wisdom teeth removed (which required general
| anesthesia to my chagrin.) I refused and took the max
| recommended dose of over the counter acetaminophen for a
| few days instead. I was in pain but it was tolerable, the
| pills they tried to push on me were totally unnecessary.
|
| That sort of post-op pain is only temporary, but a pill
| addiction could last the rest of your short life.
| kstrauser wrote:
| I'm not sure why you're bringing this up. I'm not
| advocating for everyone to get Vicodin if they stub their
| toe. My point is that narcotics, even the strongly
| addictive ones, have their place in short term or
| terminal pain management. It would be unconscionable to
| make them unavailable to _everyone_.
|
| Some people huff nitrous oxide. That sucks and I wish
| they didn't do it. I'd still opt in for general
| anesthesia if I were having surgery done. In my opinions,
| having those things as options vastly outweigh the cons
| of their abuse potential.
| yyyyyyy wrote:
| > An opioid that's more potent, more addictive, and more deadly
| than heroin should never have gone to market in the first
| place.
|
| This is a little misplaced. Fentanyl is a medically useful
| drug. Fentanyl had years of use as an anesthetic agent (and
| still does - it is an essential ICU medication) before the idea
| of marketing it for other purposes occurred.
|
| And without defending the pharma industry and their role one
| bit. The vast majority of fentanyl these days is not from big
| pharma, and it's arguable what relative role fentanyl played vs
| all the other drugs
|
| Specifically, the demand for illegitimate fentanyl today was
| mostly driven due to addictions from other medications that
| were NOT fentanyl - such as oxy, hydrocodone and even the
| "safe" tramadol.
|
| Having said that, it's going to be a hard sell that all opioids
| should be banned. There is some middle ground between reserving
| for palliative and acute critical illness and having PCPs
| prescribe for simple back pain.
|
| > heroin is safer
|
| It is a smidge more complex. Fentanyl has some pharmacologic
| properties that make it safer for controlled use in sick
| patients. Heroin has similar metabolite related side effects as
| morphine.
| at_a_remove wrote:
| Eh. I'm an an antique Schedule II drug. The literature notes
| that people with my condition don't seem to end up addicted to
| said drug (or its pals). Probably because we're just glad to
| take the edge off the pain. It's already rather potent, as
| painkillers go, as it previously was given to women in labor.
|
| However, as my condition becomes more severe, a time will come
| when I will have to "graduate" to something stronger. The end
| of that choo-choo train looks like fentanyl or something very
| much like it, assuming I don't just up and die first. I'm glad
| that there is something there.
|
| A friend of mine, his mother died of the same thing many years
| ago, when it was poorly understood and largely untreated. She
| was kept in a distant corner of the house so that the screams
| were less bothersome. Raving in pain, she would curse his name
| for not helping her to die. That's what it looks like at the
| end when there's not enough painkillers.
|
| So I guess if you get your way, can I bunk at your place?
|
| I joke, but only a little. You don't have a lot of skin in this
| particular game. Consequences are far away, third-order at
| best. I dunno, maybe listening to someone howling away might
| bring it home, maybe not.
|
| To someone like me, it looks like someone who won't really be
| affected at all just trying to yank one of the few solutions I
| have left away, and for no good reason at all.
| htag wrote:
| > 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.
|
| Do you think there would be a meaningful difference in the
| volume of illicit fentanyl if it was never approved by the FDA?
| calibas wrote:
| If the manufacturers and regulators were more concerned with
| human lives than making money, they would have quietly buried
| the research. It may have entered the illegal market
| eventually, but there wouldn't be factories producing large
| quantities of the drug like there are now.
|
| They should have known that an opioid 50 times more potent,
| deadlier, and more addictive than heroin would be responsible
| for the worst drug epidemic the world has ever seen.
| htag wrote:
| I think we fundamentally disagree here. There might be some
| 20:20 hindsight way to completely avoid the opioid crisis
| (especially with the behavior of Purdue Pharma), but from
| my perspective if Fentanyl (or other potent synthetic
| opioid) reaches illicit manufacturing it almost always
| becomes a dominate force in the black market. The cost,
| strength, and ease of smuggling are big perks. Regulators
| have little impact on what black market drug labs produce.
| exabrial wrote:
| I would suggest becoming actually educated before developing
| strong opinions.
|
| The drug is extremely useful and saves lives in a clinical
| setting; chances are it will save your life or someone you know
| and love. It's literally used _every hour_ around the clock in
| ERs.
|
| Nearly all problematic Fentanyl in the US is illegally imported
| and created by third parties overseas. It is not manufactured
| by those big bad US Pharma companies.
| CuriouslyC wrote:
| Yup, people don't realize but whereas a brick of heroin is a
| lot, a brick of fentanyl can supply a decent sized city.
| Because small amounts are so valuable, it's super easy to
| smuggle, and for a long time the Chinese would produce and
| sell it at rock bottom prices (I'm guessing that was state
| sponsored as a finger to the west for opium and the opium
| wars, which they're still very sore about)
| calibas wrote:
| Yes, most of the fentanyl that's abused comes from illegal
| sources. However, like cocaine, methamphetamine and heroin, I
| put some of the responsibility on the people who created it
| and promoted its use in the first place.
|
| It's naive to think we could make "super heroin" and it would
| stay restricted to safe, controlled medical environments. I'm
| not convinced the good it does in certain cases outweighs the
| enormous harm it's also responsible for.
| yyyyyyy wrote:
| > I put some of the responsibility on the people who
| created it and promoted it's use in the first place.
|
| While there was a little bit of questionable marketing
| around some forms of fentanyl it was mostly around for the
| ride - the real blockbuster drugs leading to the medical
| establishment opioid crisis were hydrocodone, oxycodone and
| tramadol. Making fentanyl a scapegoat is misplaced.
|
| The opioid epidemic did not need a "super heroin".
|
| > It's naive to think we could make "super heroin" and it
| would stay restricted to safe, controlled medical
| environments
|
| It's naive to think organized crime cartels would not have
| figured it out anyway.
| calibas wrote:
| I'm not making fentanyl a scapegoat, just look at the US
| drug overdose statistics, especially the huge jump around
| 2020. Fentanyl is eclipsing every other opioid, synthetic
| or otherwise. It alone is responsible for what is quickly
| becoming the deadliest drug epidemic of all time.
|
| There's good reason for my harsh criticism, and I don't
| think most people truly realize how bad the situation is.
| yyyyyyy wrote:
| > There's good reason for my harsh criticism, and I don't
| think most people truly realize how bad the situation is.
|
| No. I'm saying, as someone that understands the nuances
| better than you that, focusing on the fentanyl statistic
| is misleading.
|
| > It alone is responsible for what is quickly becoming
| the deadliest drug epidemic of all time.
|
| No it is not "alone" responsible. All the other stuff:
| oxy, hydro, tramadol, heroin, morphine is _more_
| responsible for the current mess. People didn 't
| routinely end up with opioid addictions due to fentanyl
| as much as all these other medications (and illicit
| heroin, not all addictions are the doing of big pharma)
|
| The fact that they are now seeking out illegal suppliers
| and that invariably these end up being fentanyl based due
| to the convenience for that organized criminal enterprise
| is why fentanyl shows up so much.
|
| It's not the root cause though. And the forces that make
| it appealing in the illegal market would be present
| regardless of its legal status as a prescription
| medication.
| TillE wrote:
| > "super heroin"
|
| The whole problem with fentanyl is that it sucks, the high
| isn't very good, which makes it extremely dangerous if you
| think that it might be a good idea to try to take more.
| It's the _opposite_ of super heroin. It 's a garbage
| substitute for the actual fun stuff.
|
| Yeah in its pure form it's a very strong opioid by weight,
| but that's of minimal relevance in practice.
| cwkoss wrote:
| I don't think academic pharmacologists should try to avoid
| discovering drugs that have potential for abuse. They
| should be following medical efficacy - and it seems like
| generally they are.
|
| Nobody was 'contracted to invent super heroin', they
| modified molecules with medical efficacy and tested to see
| which ones were also effective. Drug discovery is a much
| less deliberate process than you are making it sound.
| whoomp12342 wrote:
| its not only that, the vaccine will create issues for people
| when they want to have a surgery so it CREATES NEW ISSUES
| bt1a wrote:
| While fentanyl is amazingly effective in a controlled
| environment like an operating room, it's not the only option
| at their disposal. I suppose if this vaccine took off and you
| got it, it'd be good to keep an electronic medical ID on you.
| ceejayoz wrote:
| It's the option they tend to select _for a reason_ ,
| though.
| Waterluvian wrote:
| A memory that un-repressed itself about a year ago was being a
| teenager and hearing my mom wailing, "I can't do it anymore.
| I'm done." in the later stages of her cancer treatment.
| Apparently shortly after that they had a fairly significant
| intervention with the physicians and she got fentanyl patches.
| I got about another year with her.
|
| I completely agree that there's a ton of recklessness in the
| history of opioid prescription. It's been a horrible plague on
| society that will have generations of lasting impact. But
| there's uses for it. I dunno, maybe heroin patches could have
| become a thing?
| JackFr wrote:
| Wait - do I not know what the word 'vaccine' means?
| orblivion wrote:
| I thought it seemed like a stretch to use that word, but from
| the article it sounds like the immune system literally attacks
| the fentanyl as if it's a pathogen.
| bobleeswagger wrote:
| [flagged]
| cantSpellSober wrote:
| The COVID vaccine was designed to reduce the spread of an
| infectious disease, seems to fit the definition. Is there a
| different vaccine you refer to?
| porkbeer wrote:
| It used to mean something that actually gave you immunity
| to something. Like Polio.
| ceejayoz wrote:
| No, it didn't. That's "sterilizing immunity", which is a
| feature of some but not all vaccines. Flu shots, for
| example, have never given full immunity to the flu, but
| they've always been vaccines.
|
| In fact, some forms of the polio vaccine can _give you
| polio_.
| https://www.cdc.gov/vaccines/vpd/polio/hcp/vaccine-
| derived-p...
| Izkata wrote:
| Those can give people around you polio while you remain
| immune.
| ceejayoz wrote:
| If you're shedding active virus, you're infected with
| polio, even if it's an asymptomatic infection.
| cantSpellSober wrote:
| No, I think it _still_ meant something that reduces the
| spread infectious diseases. Like the COVID and Flu
| vaccines, the Polio vaccine does not provide 100%
| immunity to 100% of recipients.
|
| https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4974751/
| Izkata wrote:
| > something that reduces the spread infectious diseases.
| Like the COVID
|
| That one doesn't do that though.
| cantSpellSober wrote:
| don't forget the microchips amirite?!
| bobleeswagger wrote:
| The COVID vaccine was designed to make an astronomical
| amount of money in a time of extreme inflation.
|
| If it made society better by "preventing infectious
| disease" that was a side-effect.
| cantSpellSober wrote:
| Opioid addiction is a malignant disease, what's wrong with the
| usage here?
| CoastalCoder wrote:
| We usually think of vaccines as medicines that train the
| immune system to attack unwelcome molecules / microbes.
|
| Perhaps the parent was asking if this technique actually uses
| the immune system?
|
| (From skimming the article, I think the answer is yes.)
| cantSpellSober wrote:
| In the 8th sentence it says the vaccine will "generate
| anti-fentanyl antibodies" with the goal of preventing
| mental illness.
| neuronexmachina wrote:
| The study's intro explains the use of the term:
| https://www.mdpi.com/1999-4923/14/11/2290/htm
|
| > OUD [Opioid Use Disorder] is a chronic disorder that even
| with maintenance therapy has relapse rates approaching 90%
| largely due to poor medication compliance with current agents
| [17,18]. Immunotherapy using vaccines can reduce this
| compliance problem by requiring less frequent administration.
| Vaccine immunotherapy targets small molecule antigens such as
| opioid compounds consisting of the antigen (hapten) linked to
| an immunogenic carrier protein that stimulates the immune
| system to generate antibodies. An adjuvant is often added to
| the formulation to increase immunogenicity (antibody formation)
| against the hapten. After vaccination, when an opioid is
| consumed, antibodies bind to the target opioid in the periphery
| and prevent it from getting into the brain or affecting other
| organs. The kidneys subsequently eliminate bound drug from the
| body. Numerous pre-clinical studies targeting a broad range of
| opioids have demonstrated vaccine efficacy [16,19,20,21,22].
|
| > Recent studies testing various formulations of anti-FEN
| vaccines show efficacy in attenuating the behavioral and lethal
| effects of FEN and its derivatives [23,24,25] including
| findings from our group [26]. Our vaccine formulation is
| composed of a FEN-like hapten containing a linker with a
| carboxyl moiety suitable for carbodiimide coupling chemistry to
| form amide bonds to lysine residues on the carrier protein
| CRM197, a genetically deactivated diphtheria toxin contained in
| several FDA-approved conjugate vaccines. We combined our
| conjugate (FEN-CRM) with an adjuvant derived from heat-labile
| enterotoxins from E. coli (LT) named dmLT or LT(R192G/L211A)
| that has been combined with other vaccines in several human
| clinical trials
| 71a54xd wrote:
| 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.
| plusminusplus wrote:
| > _you know what want Fentanyl to work_ [sic]
|
| Your concerns are addressed in the article you're commenting on
| Perenti wrote:
| Not really. There are people for whom Fentanyl is the only
| real choice for use _during_ surgery. I'm one of them, and I
| don't want doctors mucking about inside my chest without
| ample pain relief.
| plusminusplus wrote:
| Interesting, can you explain why fentanyl is the only real
| choice, instead of alternatives, please?
| ThinkBeat wrote:
| 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.
| shaunxcode wrote:
| 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.
| kstrauser wrote:
| 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.
| htag wrote:
| I think this highlights the importance of addressing the
| _why_ even more. Most people are terrified of accidental
| fentanyl exposure. Some people seek it out. Why is that?
| bostonsre wrote:
| Why some people try it out is different than why people
| keep using it. Why people try it out can range from getting
| addicted after being prescribed something legal to wanting
| to escape life. Why people keep seeking it out/why they are
| addicted is hard to rationalize and understand and is like
| answering the question why do people like sex? You can't
| peer into your own mind, determine how its working and how
| you can manually change it. After addiction there usually
| needs to be some adverse event or events where people
| realize that the pain is greater than the pleasure, but
| there are still other people where even majorly adverse
| events don't change their rationale. Why people use
| fentanyl over other opiates is kind of simple. It is
| cheaper than everything else, there is a high supply of it,
| and it is stronger than everything else.
| P_I_Staker wrote:
| It's important to some people's culture and religion.
| gruez wrote:
| > Some people seek it out.
|
| who's seeking it out? The article doesn't mention it, and
| the parent poster explicitly say that people are NOT
| seeking it out.
| kris_wayton wrote:
| People that are already addicted may seek out the lowest
| cost opiate.
| Jerrrry wrote:
| Yup.
|
| Heroin will barely make some feel well.
|
| Fent burns the Mu-opioid receptors, once normalized, H
| will barely get you high.
|
| and, of course, you literally must have it - especially,
| to sleep.
| hammock wrote:
| Test strips: https://dancesafe.org/
|
| Or on amazon
| notch656c wrote:
| Test strips are just as or almost as illegal as the drug
| themselves in many state. Except without the huge profit
| margins to incentivize dealers to carry them.
| kstrauser wrote:
| That's idiotic. I put it right up their with "let's
| reduce pregnancy by making it hard for teens to get
| condoms so that they don't have sex".
| hammock wrote:
| Why are they illegal?
| notch656c wrote:
| "Paraphernalia."
|
| IN my state it is a felony have a reagent that say tests
| for THC whereas ownership of the THC itself is legal.
| makestuff wrote:
| They give these out in NYC, but make a point to say that
| the test strips won't catch everything. So still be really
| careful if you go this route.
| hammock wrote:
| Yea it's like skiing in avalanche terrain. Forecast and
| observation don't remove the risk
| kstrauser wrote:
| Yep. I've seen bowls of those available for free at various
| events. Even if I'm not going to partake of stuff that
| would need those, I'm happy to see them passed around
| freely.
| P_I_Staker wrote:
| It's not always added intentionally. I think a huge number of
| those deaths are complete accidents
| Jerrrry wrote:
| The two chemicals are made in the same superlabs in Mexico,
| with the LD-50 (lethal dose in half of average users) of
| one being 4 magnitudes (1,000) the other.
| t433 wrote:
| Legalize everything and produce it pharmaceutically, and this
| problems pretty much disappears.
| newsclues wrote:
| MDMA became dangerous after it was made illegal.
|
| When it was legal, it was made by chemists in labs who
| cared.
|
| The problem with legalizing drugs is ensuring the greedpigs
| don't take over the industry and actually dealing with the
| root causes of addiction.
| hammock wrote:
| >produce it pharmaceutically
|
| They are... in Mexico... with expert training from China...
| AngriestLettuce wrote:
| With no consequences for chemically altering their
| products... or getting people killed...
| hammock wrote:
| Doesn't sound too different from Big Pharma in the US, at
| least in certain drug categories...
| SpeedilyDamage wrote:
| Yeah, and a whole host of other problems show up...
| hasmolo wrote:
| can you elaborate?
| SpeedilyDamage wrote:
| " Illegal drugs increase crime, partly because some users
| turn to crime to pay for their habits and partly because
| some users are stimulated by certain drugs to act more
| violently. Legalization, however, will not affect
| addiction and its effects on the propensity to violence.
| Instead of legalizing drugs, better treatment, education,
| and research are needed to curb dependency on drugs and
| the adverse health and social effects of drug use."[0]
|
| [0] https://www.ojp.gov/ncjrs/virtual-
| library/abstracts/against-...
| cmyr wrote:
| 'illegal drugs' is a pretty broad brush, and treating
| opiods and psychedelics equivalently is silly. Surely
| treatment, education and research would all be far easier
| alongside decriminalization?
| hutzlibu wrote:
| "Illegal drugs increase crime, partly because some users
| turn to crime to pay for their habits "
|
| If all drugs would be illegal, then they would be mostly
| so cheap that this argument falls apart very quickly.
| Drugs are only expensive because they are illegal. Poppy
| and coca are not hard to grow and neither is hemp. And
| the chemical drugs are way more cheap to produce. So very
| high quality stuff would remain expensive, the same way a
| fine wine is expensive, but just to get drunk is cheap
| (even with taxes).
|
| "and partly because some users are stimulated by certain
| drugs to act more violently."
|
| And yes, that is true, but one of the most famous and
| widespread drug that makes people aggressive is already
| legal - alcohol.
|
| "Legalization, however, will not affect addiction"
|
| And this is up for debate, for some it will be easier to
| get help, because the stigma and criminalisation is gone,
| but yes, some might start it, because it becomes
| avaiable. And I did not look in the recent numbers, but
| back then when I did - in the netherlands for example,
| drug use decreased, after marijuhana was legalised. It is
| quite complex - some people are afraid of anything
| illegal, some are appealed by it, mainly teenagers who
| are in most danger of becoming addicts/developing brain
| damage.
|
| "better treatment, education, and research are needed to
| curb dependency on drugs and the adverse health and
| social effects of drug use."
|
| But this is true. And better, than jail people who simply
| need help.
| anonymouskimmer wrote:
| - The black market is always cheaper.
|
| - Even in a legal market how many people are always
| buying their own?
|
| - If everything is legal then it's even easier for people
| to spike drinks and the like.
|
| - Purdue Pharma marketing issue writ large.
|
| - Patients pressuring their doctors to prescribe, or
| alternatively feeling pressured by their doctors to use a
| particular drug.
|
| - If it's legal it's easier to purposefully or
| accidentally overdose (e.g. alcohol today). Especially if
| it's also cheaper.
|
| Off the top of my head.
| cmyr wrote:
| > - The black market is always cheaper.
|
| anecdata: I'm in canada, which has legalized marijuana
| recently. The black market _is_ cheaper, but all but the
| most die-hard stoners I know like to buy government weed,
| because the product is consistent and you know what you
| 're getting.
|
| > - Even in a legal market how many people are always
| buying their own?
|
| Maybe I'm misunderstanding, but in a legal market even if
| I don't buy something directly at least I have _vastly_
| increased faith that i know what something is.
|
| > - If everything is legal then it's even easier for
| people to spike drinks and the like.
|
| Who knows, but I strongly doubt that there is a large
| pool of potential rapists at large who are currently
| stymied primarily due to the difficulty in acquiring GHB.
|
| > - Purdue Pharma marketing issue writ large. > -
| Patients pressuring their doctors to prescribe, or
| alternatively feeling pressured by their doctors to use a
| particular drug.
|
| There are definitely a bunch of social and policy
| questions that would need to be addressed when
| considering legalization, sure.
|
| > - If it's legal it's easier to purposefully or
| accidentally overdose (e.g. alcohol today). Especially if
| it's also cheaper.
|
| Almost certainly not, as the majority of overdoses are
| the consequence of people not knowing what they're
| taking, or not knowing how to take it.
| Spivak wrote:
| Hell even in states where it's illegal people prefer to
| drive to a state where it is legal or get it shipped
| compared to "street weed." This isn't to say that the
| market has dried up or anything but it's clearly an
| inferior good in the economic sense. As soon as as an
| alternative of comparable price entered the market people
| immediately switched.
| notch656c wrote:
| Die-hards make up the most volume for recreational
| substances. Alcoholics by far consume the majority of
| alcohol sales, for instance.
| kstrauser wrote:
| That bit about Purdue resonates with me. I'm not firmly
| against legalization of harder drugs, but that's a case
| where average people given legal access to
| pharmaceutical-grade medicine through proper legal venues
| has been absolutely catastrophic. If I were making a case
| against legalization, that would be my Exhibit A.
| buzzert wrote:
| A better way to frame the drug legalization issue is,
| "should pharmaceutical companies be allowed to profit from
| incredibly addictive drugs?"
|
| Does that framing change your mind at all? Sure, small-time
| drug dealers are currently allowed to profit from it. Once
| they get big enough though, they're usually stopped by the
| DEA.
|
| The idea of giving this enormous profit incentive to multi-
| million dollar corporations with huge advertising budgets
| is absolutely terrifying to me.
| MaxfordAndSons wrote:
| This is an inaccurate understanding of the drug economy.
| The drug cartels that supply the street dealers are multi
| billion dollar businesses rivaling the size of the big
| pharma corporations. And the DEA absolutely is not
| "usually stopping" them. They disrupt low and mid level
| arms of their operations with some regularity, but it
| does little to stem the rivers of money flowing towards
| the groups controlling the illicit drug trade at a high
| level.
|
| Even if we presume that big pharma is a very corrupt
| industry and that allowing advertising of narcotics would
| increase drug use in some populations, bringing the
| production and distribution into a moderately well
| regulated market would likely cause a net reduction of
| usage and overall harm.
| buzzert wrote:
| > bringing the production and distribution into a
| moderately well regulated market would likely cause a net
| reduction of usage and overall harm
|
| I don't understand how adding a profit incentive somehow
| _reduces_ the usage. Because the government would force
| less consumption somehow?
| bostonsre wrote:
| Didn't we kind of already try this out some with opiates?
| Didn't big pharma already push opiates and cause millions
| of people to become addicted and cause an untold number
| of deaths and didn't that contribute to the current
| situation that we are in now with opiate addiction?
|
| I don't see how legalizing it completely where anyone who
| wants it without a prescription could possibly turn into
| anything but an absolute mess. How many millions of
| people will say "O, the government legalized it and I can
| buy it in a store, it must not be so bad, I might as well
| try it out", become addicted and have their lives ruined?
| People can't rationalize their way out of addiction of
| this stuff easily.
| hnav wrote:
| Not exactly, hence the rise of fentanyl. Prior to the
| rise of fentanyl, new addicts often went from
| prescription pills like oxycodone to heroin as their
| lives unraveled because prescription drugs are expensive
| and hard to get. Some enterprising drug dealers started
| enhancing their cut heroin with fentanyl which can be
| imported from China and is extremely dense compared to
| other opiates, which matters because smuggling is most of
| the cost. Downward pressure on the prices changed the
| ratio until you were left with pure fentanyl, so in
| effect prescription pills were not available enough and
| drug dealers were able to capture the market with more
| dangerous but cheaper product.
| anigbrowl wrote:
| That's very confusing to me. Criminal drug dealers of course
| want to lower their costs and maximize repeat business, even
| if that hurts their customers. But people consume different
| drugs for different reasons, and I don't see the economic
| benefit in giving them something orthogonal or opposite to
| what they're actually looking for, when it would be cheaper
| and safer to just dilute with some inactive filler material.
| philwelch wrote:
| A likely explanation is that China is using the cartels to
| wage a 21st century opium war. (The obvious link to China
| being that China produces most of the chemical precursors
| to fentanyl, and until recently produced most of the
| fentanyl itself.) The average American drug user isn't the
| customer; he, or rather his eventual death or disability,
| is the product.
| dirtyid wrote:
| More parsimonious explanation is that the PRC bureaucracy
| isn't going to waste resources cracking down on precursor
| producers for legal medicine ingredients when it doesn't
| cause domestic issues, or issues in the majority of
| countries, including other eight nation alliance members
| that have exploited China far more than the US. Like why
| wage 21st century opium war against only 1/8 of historic
| grudges. The primary incentive to assist the US med
| system driven opiate crisis prior during periods of
| better relations was because it was politically
| worthwhile to waste PRC resources to cooperate on US war
| on drugs. If PRC really wants to be nefarious, she would
| engineer less lethal drugs that keep victims alive longer
| to drain more American resources. And she would move back
| to actual drug production instead of maintaining olive
| branch precursor production. In so much as working with
| cartels on state level, IMO PRC benefits more from
| intelligence / influence of triad + cartel relations as
| they try to make headway into the Americas. The actual
| killing Americans is incidental because Americans will
| reliably find other ways to OD.
| carlmr wrote:
| It's accidental, the deadly doses are so low that just not
| separating them perfectly when weighing or packing might
| contaminate the other.
| kodah wrote:
| > 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.
| beebmam wrote:
| 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".
| dlkf wrote:
| > 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.
| amw wrote:
| "investigating systems in their totality rather than focusing
| on isolated interactions within them" is not inherently
| conspiratorial. It's far weirder to suggest that "more people
| want to party for no particular reason" or "more doctors
| prescribe pain meds for no particular reason" than it is to
| suggest reasons that might contribute (say, "more people are
| suffering from chronic pain than before as the disparity
| between productivity and wage has widened" or "pharmaceutical
| companies are naturally incentivized to sell as much of their
| product as possible and those incentives may occasionally
| drive morally dubious decisions").
| dlkf wrote:
| You make a good point regarding incentive structures in
| pharma - but this is nothing like what OP was saying. OP is
| asking for a "Frommian psychoanalytic approach," whatever
| that is.
|
| Your point about chronic pain increase is totally
| implausible. Automation of manual labor should result in
| less chronic pain, not more. The problem here is
| overprescription, and it's my fault that my comment didn't
| make that clear.
|
| As regards:
|
| > It's far weirder to suggest that "more people want to
| party for no particular reason"
|
| I never said that. The number of people who want to party
| and have no foresight has remained constant. But access to
| opiods (and their normalization) has skyrocketed, due to
| aforeforementioned over-prescription.
| iskander wrote:
| >Society is not broken and we don't need weird conspiratorial
| explanations for any of this.
|
| Life expectancy plummeting through deaths of despair,
| juxtaposed with widespread addiction (as much to drugs
| without physical dependence as opiates).
| nicoburns wrote:
| I think it's
|
| > 1) Why do people take opiods the first time
|
| that the GP is getting at. While doctors over-prescribing
| opiates is definitely a thing (esp. in the US), I'm not
| convinced that many people get hooked on opiates due to
| partying. I think it's more commonly:
|
| "Used as an escape from a life that is unmanagable for some
| reason"
|
| That's not conspirational. There's good evidence to show that
| life circumstances have a big effect on both initially
| becoming addicted and success when attempting recovery. The
| answer to this might look like a better welfare state or
| similar.
| kodah wrote:
| I think it'd be more likely that someone discovers opioids
| mask their pain while using them for legitimate purposes.
| After that is when gaming the doctor, street buys, and
| finally substitutions take place.
| dotnet00 wrote:
| There are plenty of other fairly common reasons that don't
| involve simple escapism, with young people it's just as
| likely to be simple peer pressure or experimentation. It
| also doesn't help that it's common to treat drug highs as
| some sort of enlightening experience that needs to be
| experienced to understand.
| cf141q5325 wrote:
| Except that its nonsense. People know what opiates are. If
| you keep taking them and dont stop, you get physical
| withdrawal. That wont happen over night and its not "the
| worst sickness imaginable". And unless you did something even
| more stupid like switching to methadone it will be over in a
| few days.
|
| It is quite simple, at some point, you decided to continue
| taking them despite knowing this to be problematic.
|
| I would also like to add, that i have met very few addicts
| who blame the drug. Its most of the time relatives who like
| the story of their loved one getting tricked.
|
| If it was only the fear of withdrawal, the opioid crisis
| would be solved next week. Literally. But the unfortunate
| problem is that people relapse. Because what ever made them
| take opioids every day didnt get fixed with a withdrawal. And
| if your life still sucks, its very easy to go back.
| Jerrrry wrote:
| The party to addiction pathway is very regional, only
| affluent or hard-working teens can transverse that.
| encoderer wrote:
| Humans were not evolved to resist these kinds of poisons.
| Nothing like this exists in nature. It's an extremely potent
| chemical.
| pixl97 wrote:
| I'd say the opposite, nature creates all kinds of powerful
| attractants and poisons. There are plenty of things that will
| kill you at the micrograms dose. There are plenty of natural
| things that are horribly physically addictive.
| anonymouskimmer wrote:
| It's not that nothing like this exists in nature, it's that
| evolutionarily speaking nothing like this existed in the
| areas human first evolved. Or if they did, we either evolved
| to resist them, thus no longer see them as toxic, or we're
| still in an arms race with the life that produces them (which
| means they would be much less toxic than fentanyl, but still
| toxic).
|
| Plants (and fungi, and animals) evolved to create noxious
| chemicals that keep animals from eating them, keep animals
| from breeding, or outright kill the animals. The Golden
| Poison frog's toxin is about 40 times more lethal than
| fentanyl.
| encoderer wrote:
| The golden poison frog looks pretty scary to me. The yellow
| color. The big eyes. I would not try to eat it. But a white
| powder or pill that is equally lethal doesn't ring any
| evolutionary alarm bells.
| athorax wrote:
| 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.
| candiddevmike wrote:
| 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.
| PragmaticPulp wrote:
| > 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.
| schwartzworld wrote:
| Many people get addicted to drugs after being prescribed them
| following surgery or injury. I know someone this happened to
| exactly. They gave him a bunch of opiates for pain management
| and he took them as directed and wound up an addict. I think
| a lot fewer people "choose" to get addicted to medicine in
| this way than either you or the GP are implying.
| bitL wrote:
| Tell them to take NAD+ boosters like NR or NMN, or even the
| good old vitamin B3 in large quantities (1g/day). Addiction
| is often a sign of NAD+/FAD+ depletion in the brain.
| Larrikin wrote:
| You keep posting this over and over again with no source.
| If addiction to opiates was as simple as taking vitamin
| B3 and solved easily with the information in an internet
| comment there would be multiple studies and I suspect all
| over the news.
| bitL wrote:
| Maybe if you looked it up ("NAD therapy"), you'd have
| found it, like this one:
|
| https://www.webmd.com/mental-health/addiction/nad-
| therapy-ad...
| AndrewDavis wrote:
| When I was a teenager I was prescribed tramadol after a
| surgery.
|
| I was in considerable pain so I took it as directed. It was
| hell a strong stuff and I basically slept 18 hours a day.
|
| A week later I was still in pain, but less. I reduced my
| dosage below the prescription to only take a dose before
| bed to make it easier to stay asleep.
|
| Well, did I notice the effects of dependence. It was subtle
| but throughout the day I'd have intrusive thoughts along
| the lines of "I haven't had a painkiller yet, I should have
| one"
|
| If I'd taken the prescribed dose till completion I'd hate
| to think what my brain would have done.
|
| That scared me enough at the right age that I've never
| taken illicit drugs. And any time I'm prescribed
| painkillers Ive ignored the dosage and take just enough to
| manage.
| Guthur wrote:
| And now big pharma will "cure" them of the disease they
| pushed.
|
| Also how is it a vaccine?
| UniverseHacker wrote:
| > 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 don't think these are mutually exclusive. Society wide
| problems cause a huge fraction of the population to
| experience severe emotional trauma, and the process of
| addiction largely seems to be an experience of trying to
| escape the feelings associated with that. If you can
| understand this process, you can take ownership of it, and
| have a path to beating the addiction itself.
|
| Ultimately, there is a lot of disagreement about what
| addiction is and how it really works, but I think this
| emotional trauma aspect is a key part of explaining why one
| person can use a drug recreationally or for medical purposes
| without addiction, and another can't. It explains a lot of
| weird observations that just didn't make sense with the
| classical chemical/neutrotransmitter model of addiction.
|
| These links I think help explain this better than I can:
|
| How Childhood Trauma Leads to Addiction - Gabor Mate
| https://www.youtube.com/watch?v=BVg2bfqblGI
|
| Comic explaining the Rat Park research on addiction
| https://www.stuartmcmillen.com/comic/rat-park/
|
| These ideas have explained why I personally have never been
| able to fight addictions through willpower alone, but have
| been able to eliminate addiction with other techniques that
| seem unrelated- therapy, meditation, exercise, hobbies,
| friends, ending bad relationships, etc. It seems that while
| chemical/physical addiction is a thing, emotionally and
| mentally healthy people don't experience opioids as a
| positive thing, such that the effect of the drug itself
| actually discourages it's use, and even motivates the
| experience of withdrawal.
| dsfyu404ed wrote:
| >Society wide problems cause a huge fraction of the
| population to experience severe emotional trauma and the
| process of addiction largely seems to be an experience of
| trying to escape the feelings associated with that.
|
| So then why weren't addiction problems more widespread
| historically, like say 1900-1960? Life tended to have a lot
| more of what are generally considered traumatic experiences
| back then.
| PragmaticPulp wrote:
| Attempts to replicate the Rat Park experiment have failed:
| https://en.wikipedia.org/wiki/Rat_Park#Criticisms
|
| It gets cited in a lot of pop-science and podcasts, but
| it's not actually the groundbreaking, universally-accepted
| study that people think it is.
|
| Likewise Gabor Mate is more of a podcast, pop-science guy,
| not a real researcher. Take his podcast and YouTube content
| with a grain of salt.
| kerkeslager wrote:
| > 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.
|
| Let's be clear here: someone's stated reason for using
| opiates might be recreation, but nobody starts shooting
| heroin for recreation without some pre-existing reason for
| self-destruction. It's not a secret that opiates are
| dangerous. People with normal self-preservation instincts
| find other ways to recreate.
|
| > > 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.
|
| What this boils down to is that the addict has to understand,
| "Society isn't going to help you, so you have to help
| yourself." That's important for addicts to understand because
| it is, unfortunately, true. But if we lived in a society
| which actually gave enough of a shit about its citizens to
| help them when they have problems, the importance of
| understanding that society won't help them would obviously
| take a smaller role.
|
| I want to be absolutely clear here: there is not effective
| help for the causes of addiction. For example, a common cause
| of addiction is homelessness. Contrary to HN opinion, the
| solution to homelessness is simple. _The solution to
| homelessness is homes._ Not shelters--don 't embarrass
| yourself with the "I don't know what the word 'home' means"
| argument. The fact is, 1% of the US military budget would
| build a home for everyone in the US. It's not difficult: the
| reason it hasn't happened is that there are a lot of people
| opposed to it. Instead, we build shelters where nobody has
| any privacy or feels safe or can have a pet or storage for
| their belongings (that's just like a home, right!?), and only
| in places where they don't inconvenience anyone society cares
| about, and then blame the homeless for being hard to help
| when they choose not to pretend that our half-assed solution
| does anything to solve their problems.
| EricDeb wrote:
| There's absolutely some truth to that though. People do not
| fall into addiction at the same rate in all societies.
| kris_wayton wrote:
| That's tricky though, as access to the drugs varies by
| society also.
| DenisM wrote:
| > Variations of this concept are frequently used by drug
| addicts to justify continued behavior.
|
| Think about it as a policy maker. You have a choice whom to
| blame - an individual or their environment.
|
| If you blame the individual there is nothing you can do - we
| can't change other people.
|
| If you blame the environment now there's something you can
| do. You can try to reduce supply by making it illegal (only
| works to a point) or you can try to reduce demand by
| increasing overall quality of life - housing, healthcare, and
| generally a way to escape the clutches of the rat race that
| is life in America for so many.
| asveikau wrote:
| I feel like your first paragraph and your second one
| contradict each other.
|
| They start for various reasons, like your example of "seeking
| recreation" and having a certain person nearby.
|
| They don't stop because _they cannot stop_ due to a physical
| addiction. I do not think personal responsibility is the
| right topic for that once it has gotten to that point. They
| 've entered a state of physical dependence in which the
| reason they started is kind of irrelevant, and it's very
| difficult to quit, through no fault of their own.
| PragmaticPulp wrote:
| > They don't stop because they cannot stop due to a
| physical addiction.
|
| What you wrote here is actually the issue I was trying to
| communicate: The notion that addicts are helpless and that
| the drug and/or society has already determined their
| outcome is the problem. This sets up a defeatist attitude
| where people feel like they shouldn't even _try_ to
| overcome addiction because their contribution to the
| equation is 0%.
|
| Different addiction programs handle this in a different
| way. AA/NA famously have the "submitting to a higher power"
| concept that is very divisive, but appears to work for many
| people. Other programs basically teach the user that they
| _do_ have some control over their life, and that they need
| to start exercising little bits of control to move in the
| right direction (even if they can 't choose to end their
| addiction tomorrow).
|
| What doesn't work is telling people "it's not your fault"
| or trying to comfort people by blaming their problems on
| purely exterior sources. Addiction treatment specialists
| refer to this as "rescuing behavior" and will go out of
| their way to discourage it from support groups and in
| friends and family.
|
| This is the problem with addiction explanations that try to
| shift the blame to society: They give the user an excuse to
| continue believing that they are 100% victim with no
| control over navigating their way out of their situation.
| 8note wrote:
| There's a division between mitigation, where empowering
| people to get rid of their addiction, and root cause,
| around changing society to stop pushing people into
| addiction.
|
| Not looking more broadly means youll never fix problems
| like doctors over prescribing pain killers, especially
| without explaining their risks
|
| It's two separate conversations, for different purposes
| skinnymuch wrote:
| Thinking it's not my fault worked for me. Your argument
| is a conservative argument.
| P_I_Staker wrote:
| Addiction treatment specialists are basically witch
| doctors
| bitL wrote:
| Why don't addicts get large doses of intravenous NAD+ by
| default? That would alleviate 90% of their addiction
| inside brain as they are typically brutally NAD+ depleted
| and on the hunt for anything that raises NAD+/FAD+ in the
| brain.
| amw wrote:
| Conflating a holistic approach that acknowledges the
| material effect of the context around a person with the
| assertion that those things existing nullifies the
| contribution of said person's agency is one of the very
| stupidest contributions of individualism to society.
| Things can materially make abuse more likely. Actions can
| be taken _by society_ that will make any particular
| _individual_ abuse less likely, whatever the specifics in
| each individual situation. It is still largely effort by
| an abuser and their closest contacts that will make
| _specific, individual_ abuse less likely in the future.
| None of these analyses contradict.
| jvickers wrote:
| Society encouraging people to take ownership of their actions
| and consequences is also part of how that would take place.
| nicoburns wrote:
| > A lot of drug users start because they're simply seeking
| recreation and someone is nearby to make drugs available to
| them
|
| This is true for drugs in general, but not many people are
| stupid enough to take opiods recreationally.
| GeekyBear wrote:
| Perhaps we should start being honest about which
| recreational drugs present the greatest dangers of
| addiction and harm.
|
| At least when I was in school, we were still teaching kids
| that pot was just as bad as opioids. You can't expect kids
| to find out that you're lying about the dangers of pot,
| while expecting them to take the warning about opioids
| seriously.
|
| I know the UK did research a decade ago to rank which drugs
| were the most harmful for the drug user and for how the
| drug user treated those around them.
|
| https://www.bbc.com/news/uk-11660210
| PragmaticPulp wrote:
| > but not many people are stupid enough to take opiods
| recreationally.
|
| Recreational opioid use is extremely common. People seek
| out opioids for their recreational value, including drug-
| naive users.
| somethingreen wrote:
| >abusing drugs as a form of pure escapism
|
| >start because they're simply seeking recreation
|
| These are the same thing. Happy people don't seek to drown
| every waking moment in constantly escalating recreation, they
| got things to lose and when they are out having fun and an
| opportunity comes around to do drugs they are surrounded by
| friends and loved ones who care for them enough to not let
| them ruin their life for lolz.
| anigbrowl wrote:
| While these points are valid, it's also a highly
| individualistic perspective. Social bodies have complexities
| and dynamics of their own. The obsessive pursuit of financial
| and political resources could also be seen as a kind of
| addiction, optimizing for one thing to an unhealthy degree
| while refusing to contemplate the negative consequences.
| There are certainly big payoffs to be had this way, but
| foreclosure of other possibilities can eventually lead to a
| dead end. A more harmonious, proportionate approach may not
| be as dramatic or impressive, but endure better.
| P_I_Staker wrote:
| You shouldn't dismiss people's opinions because they're
| addicts... I agree with this hypothetical addict that you
| think should be ignored.
| cstejerean wrote:
| 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.
|
| 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.
| P_I_Staker wrote:
| Medication management is a clusterfuck, same with ADHD meds.
| arghnoname wrote:
| You're not wrong, but addiction is not a certain outcome.
| Most people who use a substance that can lead to addiction
| don't become addicted. The question is why can two people,
| for example, abuse alcohol for a period of their youth, but
| both don't become addicts?
|
| We need to look at this holistically. Overprescribing is a
| problem, but we shouldn't be needlessly afraid of these
| substances. Personally I've been prescribed these
| medications, I took some and when it stopped hurting I
| stopped taking them and the bottle sat in my medical cabinet
| in case I injured myself later. Eventually it expired and I
| threw it away. It wasn't an issue of will power or anything
| like that. I just didn't feel the compulsion. I'm the same
| way with alcohol and other drugs. I enjoy it when
| appropriate, but I feel no compulsion whatsoever. I, in fact,
| prefer mental clarity.
|
| But I have people in my life who develop very strong
| compulsions and become addicted to anything that distracts
| them from their psychological torments. Reducing access
| helps, but reducing other circumstances in their life that
| they may feel the need to numb has to be part of the
| solution.
| shortlived wrote:
| > but addiction is not a certain outcome
|
| Not certain but chances are very high with the new class of
| opioids.
| dotnet00 wrote:
| Yep I've seen similar in various countries with a parent.
| They were prescribed large doses of some opioid pain killers
| and despite them being aware of the risk of addiction and
| thus being very careful about dosing (often skipping doses if
| the pain was tolerable and asking doctors to minimize the
| dose), in the end they still had a difficult time coming off
| them. They didn't end up trying to feed that habit from
| elsewhere, but it was still a lesson in how quickly a
| dependency can be formed.
| cstejerean wrote:
| I think skipping doses might actually increase the
| likelihood of addiction.
|
| One of the things I recall that made oxycontin so
| problematic was Purdue's insistence to prescribe it as a
| 12-hour dose. There was an article I recall reading on the
| topic:
|
| https://www.latimes.com/projects/oxycontin-part1/
|
| > Experts said that when there are gaps in the effect of a
| narcotic like OxyContin, patients can suffer body aches,
| nausea, anxiety and other symptoms of withdrawal. When the
| agony is relieved by the next dose, it creates a cycle of
| pain and euphoria that fosters addiction, they said.
|
| > Peter Przekop, a neuroscientist and physician who
| oversees the treatment of painkiller addicts at the Betty
| Ford Center in Rancho Mirage, said that repeated episodes
| of withdrawal from OxyContin "absolutely" raise the risk
| that patients will abuse the medication
|
| To me skipping doses is likely to create those repeated
| episodes of withdrawal which even when minor can end up
| screwing with the brain's addiction centers. This is why
| I'd rather take other options that maybe only work for 5-6
| hours instead of 12, but don't build this vicious cycle of
| addiction like oxy does.
| Jerrrry wrote:
| Someone people just like to get high; painkillers to H to F
| seems far fetched but when you are chasing that original
| euphoria, its a much shorter timeframe than most expect.
| TYPE_FASTER wrote:
| It's not that simple: https://www.wcvb.com/article/ex-cop-
| describes-descent-from-h...
| theGnuMe wrote:
| Because it is there.
| awill88 wrote:
| Whoa, you're so out of touch with reality. Yikes.
| patientplatypus wrote:
| I'm homeless and living in the Tenderloin in San Francisco.
|
| People here want you to
|
| - Be in a gang (or a prostitute, thief, ex-con and so forth) -
| Be on drugs (or in rehab for drugs) - Have a mental illness (so
| you can go to therapy) - Be disabled - Find religion
|
| There isn't a position for "I ran out of money and my family
| wouldn't support me, and at some point finding web development
| work became too hard as the technology became more
| complicated." People want you to "get better." I don't do
| drugs, I don't smoke, I don't drink, I don't steal or assault
| anyone.
|
| I just don't have any money.
|
| But people here are morons. They need to have a reason for why
| someone is poor other than "I'm a person of average
| intelligence that doesn't know how to find a paying job in this
| society." I don't want to be psychoanalyzed, be put into rehab,
| go to church or join any number of the lonely people who have
| to have a support group because society is awful. I don't have
| problems other than being poor - if you managed to buy into the
| crypto ponzi scheme at the right time then no one is asking you
| to "find god" or "get better".
|
| People are social animals. If you put them in a position where
| those are the options (jail, crime, drugs, psychoanalysis,
| religion, disability) they'll take the least unpalatable.
| There's a whole lot of people who walk around here with canes
| they don't need because otherwise the San Francisco General
| Assistance office won't spring for them to have housing. Also
| known as an apartment with a bed and a door that locks.
|
| If I make more than 1500 dollars I lose my health insurance
| through Medi-cal.
|
| And I'm no defender of a lot of these people. The bastards that
| set up tents on the sidewalk and smoke meth are just awful. But
| on the other hand, I have absolutely no idea how to get a job.
| None. I've done construction before and all I ended up with was
| bad memories and scarred hands. I could work "security" by
| putting on a t-shirt and standing outside a soup kitchen, but
| that's just bullshit make work the charities give out so the
| poor can buy shoes and feel special about themselves. Real
| security jobs outside of bars are a good way to get killed. And
| that's about it. I'm staying at a homeless shelter and have the
| clothes on my back so how am I supposed to get a job?
|
| There's your why.
|
| So let me give you a when. When, not if, your industry is
| automated or the code becomes too complicated for you to
| understand anymore you'd better have enough savings or a social
| network so you don't become homeless. Or you'll have to crawl
| into one of the buckets that allows society to make sense of
| you.
|
| And today I'm sitting in the San Francisco library looking to
| make a contribution to a software project for free and I just
| don't know that I care anymore. And if you tell me it'll get
| better, then I have to ask if you're about to be laid off or
| not and what _your_ plans are.
| notch656c wrote:
| I've been homeless and I think part of that is just for
| someone with no problems it doesn't make sense to be inner-
| urban homeless in these crim-ridden areas. I assume those
| people are all fucked up for one reason and therefore as a
| sane person I don't want to be around them.
|
| I had a very strict rule when I was homeless. Stay away from
| other homeless people. Camp on the edge of town. Ride the bus
| into rural areas.
|
| How did I get a job with just the clothes on my back? I
| hitch-hiked to north dakota in the oil fields where a man is
| a man and they don't give a fuck what you look like. They
| hired me to do day labor, and once you have enough money for
| a van or a short stay airbnb it only gets easier from there.
|
| Get the fuck out of tenderloin, and san francisco at all
| costs. Hitch-hike if you must. If you want guaranteed housing
| you can also look into doing seasonal harvesting work for
| fisheries in alaska. They'll pay your flight from seattle and
| then cover your food/shelter while you're working.
| spangeanon wrote:
| Yeah, this right here.
|
| Fishery: paid for transportation to the job, free housing
| and food on the job, and at the end of it you have a couple
| grand that hasn't been blown on anything -- free to do
| whatever you want with.
|
| Tough work. You're on a boat for 1-2 months. You work 12ish
| hours a day. If your body is able (or you can make it
| able), it's good.
|
| Next up is getting housing and cleaning yourself up for
| greener pastures. Oil fields is one. Lineman/tower climber
| is another.
|
| Easy six figures. After a year of doing nothing but work,
| figure out what you want to do from there.
|
| The work will distract you from your problems, and the
| change in environment will reset your mindset.
|
| Lots of well-paid trades work in Washington for people that
| don't have anything to lose.
| cmyr wrote:
| Thank you for sharing. I'm sorry.
| kodah wrote:
| I can't guarantee that I can help you find a new job or
| master skills but I'm willing to try. My email is
| kodah@pull.dev.
| mise_en_place wrote:
| I'm sorry for your situation, but you also have to realize,
| things are partly your fault. You mention you could be a
| bouncer at a bar, but you would have to go to the gym to
| develop enough muscle. And possibly start using chemicals to
| alter your bone density and muscle mass. In your situation,
| I'd say you have to go "all in" on something, whatever it is.
| If you just half ass it and complain that the world is
| against you, you will not go anywhere. That's just how it is.
| unsupp0rted wrote:
| You've explained this much more clearly than I've seen done
| before. Maybe because I hear my voice in yours.
|
| Skip the web dev and be a writer. Surely other HNers can hire
| patientplatypus for this?
| not1ofU wrote:
| If you check the comment history it is unlikely that anyone
| here wants to listen to what this person has to say, let
| alone provide them with work. I have skimmed through a few
| of the comments and IMO there is nothing in there that
| warrents the downvotes / dead comments, which appear to not
| even get replies (tut tut HN, breaking your own "rules"
| again)
|
| I do wish this person well however, I hope luck smiles down
| on them soon.
|
| This comment will go the way of the dodo soon enough .!..
| :-)
| the_only_law wrote:
| I'm not sure why it's getting praised. The guy hijacked a
| thread discussing drug addiction so he could get on a
| personal soapbox and drone on about his own problems
| while trying to diminish others.
| not1ofU wrote:
| It was in response to this comment:
|
| "The real issue here that people don't seem to want to
| face is the WHY."
|
| They provided an answer to "why?". I think thats fair.
| Maybe I am wrong. I checked further on the comment
| history, it appears to me someone has it out for this
| person, as the other topics are not soapboxing at all,
| and most or dead without comments.
|
| Care to discuss further?
| the_only_law wrote:
| Upon second reading, I misinterpreted GP and I don't
| think they had any bad intent. So apologies to them for
| that.
|
| As for the shadowbanning I'm not sure either. It's not
| particularly new and like you kinda mentioned they don't
| really say anything egregious, at least that I saw. Some
| accounts seems to be shadow banned at creations and the
| user doesn't seem super active, but I'm not sure how all
| that works under the hood. I guess it's even possible the
| GP comment was already dead, and was later vouched.
| unsupp0rted wrote:
| It seems relevant to me in a discussion of a vaccine to
| prevent people inadvertently getting addicted to drugs
| and having their lives spiral out of control for someone
| to bring up what it's like when you're not addicted to
| drugs and have your life spiral out of control.
|
| GP mentioned that it's expected he'd be addicted to drugs
| because then the system would be able to categorize and
| address his needs better.
|
| It's not a 1:1 match for the article topic, but I come to
| HN for the comments, especially ones that engage my
| curiosity, like GP's did.
| fasthands9 wrote:
| 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.
| HEmanZ wrote:
| I have known quite a few friends from earlier in my life who
| became serious addicts and ruined their lives or ended their
| lives by it. I would not describe a single one as having
| started using because they were mad at society, sad, or
| lonesome. It was always some strange kind of strange,
| arrogant fetishization of drug-life and crime-life. There is
| an almost "drug life is THE life, and everyone else is lame"
| attitude in many circles, and I got a little too close to
| comfort to falling into it at one point in my life.
|
| This doesn't mean there aren't a hundred reasons people get
| trapped in drugs. But a very real one is just because many
| people come to believe it's cool and tough, and end up
| fetishizing it until it's too late to get out. And like I
| said, in my hometown, this was the predominant reason.
| Apocryphon wrote:
| Were they bored, did they not have exciting career or
| family prospects, was it ennui? Low-grade emotions can lead
| to addictive behaviors, not only high intensity trauma. The
| decision to subscribe to a malignant anti-authority
| lifestyle still shows that _something_ is wrong, if it
| becomes so attractive an alternative to forsake one 's life
| for.
| HEmanZ wrote:
| Reading HN, I get the strong suspicion many people didn't
| grow up around drugs.
|
| People don't always think they are throwing away their
| lives. They think "this makes me cool" and "it's no big
| deal" and "anyone who's anyone does it". Often there's
| the confident assertion "this ruins other peoples lives
| but I'm too good/special for that". And often they don't
| even realize it's a problem, even when they've hit rock
| bottom, even when they've ruined their families lives for
| their drug addiction.
|
| I'm not claiming other, much sadder reasons don't exist.
| Or that we shouldn't do something to help people survive
| and recover, like this vaccine that could mean thousands
| of lives saved, thousands of fewer mothers crying at
| funerals.
|
| But there is also a lot of personal responsibility
| involved, and we can't make this claim, that I see so
| many people on HN try to make, that people who have
| ruined their life (and more importantly, often their
| families lives) thru their own choices have no
| responsibility. That it's all fault of vague "society"
| and if we just ban together with <vague handwavy
| socialist/utopian/whatever vision>, that people will stop
| making bad decisions about their lives.
| newsclues wrote:
| That sounds like a healthy amount of drugs. For people with
| self control like that, I think it would be healthy to trip
| once or twice a year and use stimulants (cocaine) for a party
| once a year.
|
| A heroin vacation to an opium den on occasion sounds
| wonderful.
|
| I certainly have used drugs socially (LSD in clubs or
| concerts can be fun), but also use them cannabis alone
| frequently.
| arghnoname wrote:
| This is the crazy thing about this whole issue. Some people
| can use drugs that are extremely harmful responsibly. It's
| a once-in-a-while excursion away from ordinary life.
| There's nothing wrong with having a scary drug, like
| heroin, a few times a year...except that for some people it
| leads to their entire life unraveling.
|
| This idea that we're all the same and because drugs are
| physically addictive (i.e., sustained use leads to
| withdrawal of use ceases) means everyone would become
| addicts if they tried it is a D.A.R.E. style falsehood.
| It's true for some, but seemingly not most.
|
| Even drugs/activities that don't seem physically very
| addictive, like pot and gambling, seem to have their
| addicts. I question what proportion of addiction is
| chemical and what is something deeper going on.
|
| It's a pity though. I don't think I'm prone to addiction,
| but for the sake of my fellow humans and a functioning
| society I reluctantly accept that these things shouldn't be
| widely accessible. I've become much more of a
| prohibitionist as I've gotten older.
| elektrontamer wrote:
| I appreciate the selflessness and pragmatism. Many
| responsible users are much more dismissive of
| prohibition.
| notch656c wrote:
| It seems selfless but not pragmatic. Prohibition doesn't
| seem to make the opiate problem smaller, it just makes it
| more dangerous for users, the public, and the people
| selling it.
| musicale wrote:
| > Why do so many people want to check out of life completely by
| abusing medicine?
|
| 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.
| HEmanZ wrote:
| 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.
| d4mi3n wrote:
| I've seen some of this as well, though through my own
| anecdotal experience people in my life I've seen struggle
| with drugs do or did so because:
|
| 1. Ongoing health issues they can't afford to resolve.
| Chronic pain. Mental health issues. Sleep disorders.
|
| or
|
| 2. Inability to cope with high levels of stress due to
| financial insecurity, bad relationships, or loneliness.
|
| I think the cultural attitudes you describe may have some
| relation to other problems. Most people I've encountered seek
| escapism when their life experience is poor and they're
| unable to change their circumstances or unaware of ways to
| change their circumstances.
| HEmanZ wrote:
| I think my point is that it can be both. There is a lot we
| can do to help in the cases you point out. But I just don't
| think the problem is entirely solvable, or even mostly
| solvable, without changing a destructive sub-culture, which
| we can't do in any way I can think of.
|
| At least we are working on things like this vaccine to save
| lives. That's something.
| P_I_Staker wrote:
| 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.
| electric_mayhem wrote:
| "It is no measure of health to be well adjusted to a profoundly
| sick society."
|
| Also, this: https://www.dailymotion.com/video/x305n83
| akira2501 wrote:
| > 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.
| pixl97 wrote:
| >You have to reduce the inflow of drugs.
|
| And this is how we get fentanyl. Why import 2 tons of drugs
| when you can import 2 ounces with the same power.
|
| Attempting to reduce the inflow has just created a violent
| black market and a dangerous police state.
| scoofy wrote:
| 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.
| azalemeth wrote:
| 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.
| wise0wl wrote:
| Once you actually don't need it anymore, throw it far away
| and do not look back. Benzos and opiates ruin lives because
| of that little voice. That voice will be strong enough one
| day that if you have those close by you will take a few,
| because why not?
|
| That voice is the voice of addiction. Once it starts it never
| fully goes away. It just gets less frequent.
| crucialfelix wrote:
| My mother spent 6 weeks sedated with Fentanyl, on top of
| Alzheimer's. After a few days I realized she would survive.
| But she was in a hellish state for over a year, hallucinating
| and constructing parallel realities.
|
| Ironically, she worked on the UK medical trial for Fentanyl
| when it was first introduced for surgery.
| lr1970 wrote:
| Fentanyl is strong but short acting opiate mostly used
| during surgeries. I am curious why it was used for such a
| long duration as 6 weeks.
| sillysaurusx wrote:
| Probably because it feels good.
|
| 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.
| khazhoux wrote:
| > Probably because it feels good.
|
| This is the dirty little secret of 1980's-style approach to
| keeping people off drugs: they feel _great_.
|
| The old (current?) approach suffers from intellectual
| dishonesty of ignoring the physical pleasure.
| briffle wrote:
| 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'.
| jcutrell wrote:
| Do we have a clear picture for where we want this to go in
| the future? Though not exactly the same, does this start to
| walk the path towards a "soma" equivalent?
| armatav wrote:
| Watch this therapy disable the painkilling potential of every
| opioid in the body, including natural opioids.
| elil17 wrote:
| The article actually discusses this:
|
| "The anti-fentanyl antibodies were specific to fentanyl and a
| fentanyl derivative and did not cross-react with other opioids,
| such as morphine. That means a vaccinated person would still be
| able to be treated for pain relief with other opioids," said
| Haile.
| Perenti wrote:
| What about twilight anesthesia? With my cardiac problem, I
| can't have general anesthetics, but I can have
| Fentanyl/Midazolam to sedate and numb up a bit. Saying "it's
| specific to fentanyl" doesn't help those for whom fentanyl is
| a life saving drug.
|
| The reply above that the real issue is WHY Americans like
| fentanyl so much is on the money in my opinion.
| elil17 wrote:
| Well the idea is not for everyone to get OUD vaccines. They
| would be targeted to people with OUD. If you did have OUD,
| this treatment would unfortunately probably not work for
| you due to your cardiac problem. However, depending on the
| severity of OUD and how effective this vaccine turns out to
| be, it might be worth forgoing the possibility of surgery.
| smm11 wrote:
| I'm waiting for the vaccine booster V4 myself.
| qikInNdOutReply wrote:
| Synthetic depression pill developed just wouldnt have that
| headline.
| miguelazo wrote:
| This is good news, but the epidemic clearly has other major
| causes we're still not addressing. A pharmaceutical to combat an
| epidemic created by another blockbuster pharmaceutical seems
| very... dystopian.
| shadowgovt wrote:
| This is a good time to remind people that
| https://twitter.com/justsaysinrats exists for a reason.
|
| ... 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).
| pazimzadeh wrote:
| Isn't the whole point of doing it in rats that it's way more
| similar to humans than say Drosophila flies?
|
| Somewhat related: has the result from the Rat Park experiment
| been debunked or shown not to apply in humans?
| https://en.wikipedia.org/wiki/Rat_Park
| slowking2 wrote:
| The link you posted says that the original rat park
| researcher's own graduate student was unable to replicate the
| original experiment when he tried reducing the confounds.
| That seems like the most favorable possible situation for a
| replication to me. It also says that one confound was that
| morphine consumption wasn't measured in the same way between
| conditions in the original experiment. That seems pretty bad
| to me. Linked article also mentions that other researchers
| have had trouble replicating the results fully.
|
| Rat park doesn't consistently apply to rats, so why should
| its results be considered particularly informative about
| humans?
|
| Has someone done a much better study on rats since then?
| Significantly larger N, always taking measurements the same
| way across conditions, genetics carefully controlled or at
| least measured? I'm not an animal behavior researcher, so I'm
| sure there could be other things important to handle.
|
| Rats are certainly more similar to humans that flies are, but
| that doesn't mean any particular study is informative about
| humans.
| pazimzadeh wrote:
| Just saying, since neither humans nor rodents typically
| live in cages, maybe rodent experiments would be more
| predictive of human behavior if they weren't forced into
| living in small cages.
| shadowgovt wrote:
| _looks around his cubicle_
|
| I must be in the control group. ;)
| mrcwinn wrote:
| 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'm sorry for those impacted by this.
| ngai_aku wrote:
| > 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?
| mrcwinn wrote:
| Actually, no. Had he been drawn to a programming conference,
| I wouldn't have been able to draw a line between the dangers
| he'd been near and those interests. But when you see someone
| in a situation, and see them drawn to the wrong things for
| the wrong reasons, yes of course it triggers at least
| concern. I wish a lot I had been wrong.
| jcutrell wrote:
| 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?
| lazyeye wrote:
| Fentanyl is Chinese greyzone warfare.
| tristor wrote:
| You are correct, and I'm surprised at the backlash. Nearly all
| of the illegal fentanyl in the country has an origin in China,
| when captured and traced. Personally, it doesn't surprise me,
| as I imagine it's China getting back at the West over the Opium
| Wars. As horrible as it is, there is a certain amount of logic
| to the act, especially if considered from the perspective of
| societal scale destabilization.
|
| The US has done similar things in the past, including against
| our own citizens. The CIA helped cartels traffick cocaine and
| started the crack epidemic amongst black communities in the US.
| It shouldn't surprise anyone that a state actor is involved in
| driving and deepening the opioid epidemic.
| lazyeye wrote:
| You make good points. It would be interesting to compare the
| rate of fentanyl fatalities inside China to countries across
| the ocean where you have that extra layer of challenges
| getting the illegal precursor chemicals over oceans, across
| borders etc.
|
| What is astonishing to me is the almost seeming complete
| apathy on this problem within the US. An average of 300
| deaths a day you would have thought would be elevated to the
| highest level. I mean, for example, why would you allow a
| country that is facilitating this kind of carnage to run
| their social media businesses within your borders?
| chitowneats wrote:
| No, it's a miracle painkiller used by doctors all over the
| world. Just like oxycontin it has a legitimate medical use.
| cinntaile wrote:
| Please don't do this, it's very tiring to discuss like this.
| He's obviously talking about illegal fentanyl use.
| chitowneats wrote:
| I agree, it is very tiring when people suggest that
| medicine was invented and manufactured by the Chinese so
| that specifically Americans would abuse it. "Grey zone
| warfare".
|
| This is a wild conspiracy theory. It's on par with the
| Chinese conspiracy theory that COVID was an American
| bioweapon.
| chimineycricket wrote:
| It's not a conspiracy. China makes fentanyl, ships some
| to Mexican cartels, and actually helps the cartels
| launder their money through Chinese bank accounts. No US
| jurisdiction there.
| lazyeye wrote:
| Really? I think a country like China could shutdown the
| export of Fentanyl precursor chemicals to bad actors
| almost overnight if they chose too. Im not suggesting the
| CCP is manufacturing it themselves but that they are
| happy to stand aside and do nothing. Not a conspiracy
| theory at all.
| lazyeye wrote:
| "was invented and manufactured by the Chinese so that
| specifically Americans would abuse it."
|
| Nobody has suggested this. Who invented it and for what
| original purpose is irrelevant.
| pessimizer wrote:
| It takes effort to discuss things with people who don't
| already agree with you.
| AlexTWithBeard wrote:
| Dear pharma, please (please, please!) make something to fight
| food addiction?
| plusminusplus wrote:
| Bulimia or similar? Treatment options already exist.
|
| (Unless this is a joke about eating disorders)
| 1attice wrote:
| Wegovy?
| AlexTWithBeard wrote:
| Will it stop me getting high on food?
|
| If so, it's a blessing.
| 1attice wrote:
| I believe so. But do please recall that your consciousness
| supervenes on a maschine made of meat, and spent several
| billion years wiring itself to get a dopamine hit from,
| yes, nutrients.
|
| It's called walking the gradient ;D There's no cure, alas,
| for being a neural network
| whoomp12342 wrote:
| the fashion industry tried and failed
| inasio wrote:
| 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.
| Jerrrry wrote:
| I am curious and have been researching this chemical and
| related structures recently.
| orblivion wrote:
| Flash reactions:
|
| * 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.
| sterlind wrote:
| actually have a friend who nearly died from snorting fentanyl
| passed off as cocaine. fortunately an ambulance got there in
| time and saved him with narcan. his doctor friend also snorted
| coke with him, was carrying narcan in her purse and managed to
| Pulp Fiction herself on the way down.
|
| fentanyl is scary stuff.
| version_five wrote:
| > Something like this happened in neuromancer.
|
| Right, and Case bought betaphenethylamine instead of speed
| which was way harsher. That's exactly what is going to happen,
| some more potent drug that escapes the vaccine is going to get
| more popular. It's a bandaid solution that ignores the root
| cause (drug prohibition)
| actionfromafar wrote:
| Wait, what? Selling fentanyl as candy in every street corner
| shop is going to fix this?
| 2OEH8eoCRo0 wrote:
| Yeah. Since alcohol became legal nobody has died from it.
| hackeraccount wrote:
| You left off the /s ?
| freedomben wrote:
| I really don't undertand this binary thinking regarding
| drugs. It seems like there's at least a third option in
| there somewhere between "ban it all and everything related
| and lock people up for decades if they touch the stuff" and
| "put it in a Pez dispenser and give every elementary school
| student a 12 tab slider with lunch every day."
|
| We don't do that with alcohol or weed, I don't see why
| that's the first (and often only) option that comes to
| people's minds when suggesting some form of legalization.
| Spivak wrote:
| I think the middle ground is, "medically supervised with
| informed consent" like we do with every other
| prescription medication. You wanna drop acid, take molly,
| pop an addy, or k-hole yourself, have a blast. Get a
| doctor to sign off that you know how it works, how to
| take it safely, what to do in an emergency or overdose
| situation, and that you don't have any complications with
| your health or other prescriptions.
|
| It would at least be a safer and more honest policy about
| what the current state of recreational drug use is like
| in the US.
| agentwiggles wrote:
| Well, even as a legalization sympathetic person, I can
| _sorta_ see the argument when you look at how marijuana
| legislation has gone. Dispensaries all over the damn
| place and the endless variety of products and general
| "mainstreaming" of weed use... I'm not opposed in
| principle but as sympathetic as I am I can't help
| wondering if some of it has gone a little far.
|
| That said though, I totally agree that "legalize all
| drugs" doesn't have to imply that we would do the same
| super fun dispensary thing that we do for weed for
| something like fentanyl, or even something more benign
| like mushrooms. I imagine legal fentanyl would be more
| like a freely available prescription or similar, where
| you can be dispensed a certain amount under reasonable
| conditions as opposed to just walking into the fentanyl
| dispensary and picking your favorite strain in a colorful
| container.
| wyre wrote:
| I wonder if there is a correlation between an
| accessibility of cannabis and alcohol-related incidents.
| Cannabis is much safer than alcohol. Would my friends and
| I have drank as much as we did when I was younger if
| cannabis was cheap and accessible?
|
| Methadone is accessible for people dealing with opioid
| addiction, but that doesn't provide a high so it doesn't
| actually solve the problem of addicts choosing to
| continue opioid use.
|
| Keeping fentanyl illegal evidentially can't stop the
| problem of it ending up in street drugs causing
| overdoses. I concur a prescription for fentanyl patches
| would likely be the best approach.
| klyrs wrote:
| There is a _broad_ gulf between selling something like
| candy and criminalizing its possession. You need to be of-
| age to buy beer. Sudafed is sold OTC but with strict
| limits. You need a prescription to get many
| pharmaceuticals.
| amalcon wrote:
| The _reason_ for the strict limits on pseudoephedrine is
| because of its use in the manufacture of (prohibited)
| methamphetamine, so that 's a poor example. Prescription
| drugs are also a bad example because fentanyl (and most
| other opioids) are _already_ available with a
| prescription in most of the world.
|
| Alcohol and nicotine are the only real middle ground in
| the US (maybe cannabis, but that's in a paradoxical legal
| status right now). Neither really seems to be in a
| "solved" state. Though I concede that at least alcohol
| and nicotine seem to be in a better state than fentanyl.
| elil17 wrote:
| Opioid overdoses are typically due how opioids effect the
| brain, so this would prevent fentanyl from contributing to and
| overdose.
| orblivion wrote:
| Yeah that did cross my mind. I wonder if it really blocks it
| at the same level that you're talking about.
| pessimizer wrote:
| Opioid overdoses are typically due to overestimation of one's
| tolerance or underestimation of the strength of the drug
| being taken, and what you are responding to is a way that a
| weakened fentanyl effect could lead to that.
| elil17 wrote:
| You could still OD, but it would not be a fentanyl OD,
| because the fentanyl in the drug would not be able to
| interact with the brain. If you took this vaccine, it seems
| like you would be just as likely to OD from heroin as you
| would from fentanyl+heroin.
| wdhilliard wrote:
| 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.
| wswope wrote:
| Can you elaborate on your point of confusion? The mechanism of
| action was explained in the article.
| orblivion wrote:
| That's strange that they describe the selling point as being
| that you can't get high anymore. If it's really attacking and
| neutralizing the chemical per se, and if it's truly
| neutralized in every way, that would mean it would stop
| overdoses. That seems like a much bigger selling point.
| wdhilliard wrote:
| Exactly. Hard to treat someone who is dead
| cwkoss wrote:
| If the vaccine only suppresses opioid euphoria, users would
| continue dosing assuming they needed a higher dose to feel
| the effects leading to overdose and have possible respiratory
| failure.
| wdhilliard wrote:
| My point of confusion is still my initial question. It was
| actually the description of the mechanism, as given, that had
| me questioning it's effects on the overall toxicity/danger of
| ingesting the drug.
|
| "Our vaccine is able to generate anti-fentanyl antibodies
| that bind to the consumed fentanyl and prevent it from
| entering the brain, allowing it to be eliminated out of the
| body via the kidneys. Thus, the individual will not feel the
| euphoric effects and can 'get back on the wagon' to
| sobriety," said the study's lead author Colin Haile"
|
| They clarify that this causes a user to not feel the positive
| effects of the drug, but I would assume that if the drug was
| also able to prevent overall mortality, they would be excited
| enough to mention it.
| wswope wrote:
| That helps clarify a lot, thank you.
|
| To answer your question: yes, it does stop mortality. The
| general cause of death from opioid overdose is respiratory
| suppression when the brainstem is too "sedated" to continue
| sending signals to the rest of the body to breathe, so by
| stopping the fentanyl from entering the brain, this vaccine
| also blocks mortality.
|
| Hard to do this justice without writing a full essay, but
| this vaccine need not be seen as an antabuse-like
| "restriction" on drug users. E.g. for the stereotypical*
| case of a user who unknowingly gets heroin cut with
| fentanyl, this would protect them from the fentanyl without
| blocking the euphoric effects of the heroin. Its most
| promising utility is in preventing users of other drugs
| from unintentional exposure to fentanyl via contaminated
| supply.
|
| *(Yes, I know most street dope is Fentanyl-based these
| days.)
|
| E: And to elaborate on why they might be putting emphasis
| on the fact it blocks the effects of fentanyl in their
| explanation, it might help prevent "unintended" addiction
| to fentanyl when users are unknowingly consuming it in
| conjunction with other drugs.
| isaacg wrote:
| The abstract of the underlying research paper:
| https://www.mdpi.com/1999-4923/14/11/2290/htm contains the
| quote "Vaccination prevented decreases on physiological
| measures (oxygen saturation, heart rate) and reduction in
| overall activity following FEN administration in male rats."
| These physiological measures are the precursors to overdose,
| which occurs when low oxygen saturation becomes hypoxia and
| becomes fatal.
|
| To summarize, yes, this vaccine prevents overdose, as well as
| the other drug effects.
| elil17 wrote:
| 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).
| m0llusk wrote:
| Legalized cocaine would be tested for fentanyl and other
| potential contaminants.
| aliqot wrote:
| It's already legalized, requires prescription or license to
| administer.
| hwbehrens wrote:
| 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.
| joecot wrote:
| If we limit it to people who are using non-prescription drugs,
| without judgement, this will be the Game Changer they describe.
| First Heroin, but now cocaine, and even black market cannabis,
| are being tainted with fentanyl. For that set of people,
| stopping an accidental poisoning is much more important than
| potential complications with pain medication later.
| LarryMullins wrote:
| > _even black market cannabis, are being tainted with
| fentanyl_
|
| I've heard claims like this for decades, it was and probably
| still is a frequent claim made by cops and teachers giving
| DARE presentations in American public schools. It doesn't
| make much sense and never did, why would weed dealers be
| giving people more drugs than they actually paid for?
|
| It sounds like a cope excuse people come up with on the spot
| when they don't want to admit what drugs they were actually
| taking. Ask an alcoholic after a car accident how many drinks
| they had: _" I only had one beer, I don't know how this could
| have happened!"_ Ask a fent-head after the OD what happened:
| _" I don't know, I only smoked a little weed!"_ Yeah right.
|
| inb4 _" dealers do it to get people addicted"_; it's _weed_ ,
| it sells itself.
| freedomben wrote:
| This seems utterly insane to me as a solution compared to
| just making it possible (without facing extreme criminal
| penalties) to buy what you think you are buying. I haven't
| checked but I would guess that the number of fentanyl deaths
| for people who buy cannabis from legal businesses don't
| typically get product that is contaminated.
| dylan604 wrote:
| > and this would only affect secondary harms (relapse).
|
| But this is a _HUGE_ step. If you could drop the relapse rate,
| that would be a major accomplishment.
| shadowtree wrote:
| Pray you then never get cancer or other nasty shit that requires
| proper painkillers.
| sandermvanvliet wrote:
| The article mentions that it's specifically targeted at
| fentanyl and doesn't interact with other opioids such as
| morphine
| freedomben wrote:
| Fentanyl is preferred for cancer patients and end-of-life
| patients for a reason. Morphine is difficult to administer
| efficaciously at those levels of suffering, and has some very
| undesirable side effects (so I've been told. IANA
| Anesthesiologist).
| ceejayoz wrote:
| And fentanyl specifically exists because of the downsides of
| other opioids such as morphine.
| jrochkind1 wrote:
| 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.
| bt1a wrote:
| This is an incredible opportunity to save lives. You need to
| familiarize yourself with accidental opioid overdose deaths.
| Most people who die from a fentanyl overdose were not intending
| to ingest fentanyl. Fentanyl is often used to boost the
| strength of more expensive opioids sold on the street. Fentanyl
| is very cheap to produce compared to heroin or whatever is the
| flavor of the month pressed pill. People die because the
| recreational dose for an opioid like heroin isn't many orders
| of magnitude away from the LD50
| jrochkind1 wrote:
| I see what you mean, but:
|
| "Once feared, illicit fentanyl is now a drug of choice for
| many opioid users: People with opioid-use disorder are
| increasingly seeking out illicit fentanyl, often smoking it."
|
| https://www.nbcnews.com/health/health-news/feared-illicit-
| fe...
|
| (I really do know that everything you read in popular media
| about drug use in general, and opioid use specifically,
| cannot necesssarily be trusted. But my understanding from
| several sources is that this is so. The fact that fentanyl is
| cheaper for the effect is a reason a user might choose it
| too, or it may simply be what is available, or affordable)
|
| Whether users are intentionally seeking and/or aware of
| getting fentanyl or not, I am saying that the consequences of
| making someone's dose not have the effect they are looking
| for can often be that they take more (getting more of all of
| the substances that were in the dose, known or unknown), or
| that they switch to an alternate supply/substance. Either of
| which can have very dangerous outcomes.
|
| I won't tell you what you need to familiarize yourself with,
| or assume I know what you are or are not familiar with.
| adam-a wrote:
| > "The anti-fentanyl antibodies were specific to fentanyl and a
| fentanyl derivative and did not cross-react with other opioids,
| such as morphine. That means a vaccinated person would still be
| able to be treated for pain relief with other opioids," said
| Haile.
|
| Not really clear if it prevents ODing but the article says:
|
| > Our vaccine is able to generate anti-fentanyl antibodies that
| bind to the consumed fentanyl and prevent it from entering the
| brain, allowing it to be eliminated out of the body via the
| kidneys.
| gwbas1c wrote:
| > Major surgery and recovery without opioids is no walk in the
| park, it's PTSD-inducing excruciating pain
|
| I had rather major surgery. Once I was sent home, the opioids
| just weren't worth it. (I was surprised.) Ibuprofen actually
| worked a lot better.
|
| Granted, I don't think I'd want to undergo surgery without
| opioids during the first few days of recovery.
| ivanbakel wrote:
| >This is kind of strange. Is it really fentanyl-specific, or
| does it effect all opioids?
|
| This is answered in the article.
|
| >"The anti-fentanyl antibodies were specific to fentanyl and a
| fentanyl derivative and did not cross-react with other opioids,
| such as morphine. That means a vaccinated person would still be
| able to be treated for pain relief with other opioids," said
| Haile.
|
| >Problems either way; if just fentanyl, then, duh, that's not
| the only way to get high.
|
| Yes, but fentanyl is considerably more dangerous than most of
| those other methods. Mis-judging your poorly-cut heroin dose by
| a milligram at least doesn't kill you. That's part of the point
| of targeting fentanyl itself with a vaccine - it would be
| accepted by the drug-taking public, because most of them don't
| want to be taking fentanyl in the first place: there are other
| ways to get high.
| jrochkind1 wrote:
| Does the vaccine make fentanyl less dangerous then, does it
| keep you from OD'ing on it?
| bastardoperator wrote:
| Or just make fentanyl very hard to prescribe? We are getting
| dumber by the minute.
| [deleted]
| friedman23 wrote:
| The problem is not fentanyl prescriptions, it's fentanyl being
| slipped into other drugs. I imagine for a drug user this could
| be a life saver.
| sterlind wrote:
| nearly all the fentanyl on the street is illegally
| manufactured, not diverted from prescriptions.
|
| fentanyl is ideal for smuggling because of how potent it is,
| and ideal for clandestine manufacture because it doesn't
| require opium as a starting material.
| nyolfen wrote:
| most fentanyl is manufactured in clandestine labs in mexico and
| distributed by drug gangs
| cantSpellSober wrote:
| Most fentanyl is manufactured in China, most _illicit_
| fentanyl is produced in Mexico. (nitpick)
| nyolfen wrote:
| i suspect illicit fentanyl greatly outweighs legitimate at
| this point
| cantSpellSober wrote:
| any reason but speculation? If so, please inform the DEA!
|
| https://www.dea.gov/sites/default/files/2020-03/DEA_GOV_D
| IR-...
| ok_dad wrote:
| The drug war proved that making it harder to get things doesn't
| help.
| languagehacker wrote:
| 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.
| mdanger007 wrote:
| A vaccine doesn't work unless it helps the tiny fraction of
| fentenyl deaths who unintentnially take the drug? How about
| this: You're less likely to come in contact with the drug if
| there are fewer users getting high off it.
| ARandomerDude wrote:
| And how do you propose we get all the users vaccinated with
| the fentanyl jab? Another round of mass vaccinations? Make
| all the kids in school do it? Forced vaccinations for anyone
| in jail or rehab? Honestly, all of those seem like bad ideas.
| Ekaros wrote:
| Didn't we already do it? Ban people from working if they
| don't take it, maybe take away any benefits too. Don't
| allow them to public places?
| factsarelolz wrote:
| > Ban people from working if they don't take it, maybe
| take away any benefits too. Don't allow them to public
| places?
|
| Over a one's own choice to not have a medical procedure?
|
| Should we do the same to those whom have abortions?
|
| Who gets to make a choice on what medical procedures a
| population should have? Why is it not the individuals
| decision?
| [deleted]
| ARandomerDude wrote:
| This is a frighteningly totalitarian comment.
| KMag wrote:
| If the government subscribed wholly to utilitarian ethics,
| it's arguable that it would be an ethical imperative to
| contaminate the fentanyl supply with vaccine.
|
| I don't agree, and think it's immoral and unethical to
| subject citizens to such medical treatment without informed
| consent. However, under some ethical systems, the
| improvement in aggregate health makes in an ethical
| necessity.
| freedomben wrote:
| The US government has actually done similar things
| before, such as poisoning bootlegged alcohol with
| methanol. It's good that you bring it up because at some
| point somebody in power will.
| D13Fd wrote:
| Yeah but my understanding is that most of the overdosing are
| from people seeking something else. In some cases it's akin
| to a contamination problem.
| kjkjadksj wrote:
| We are at the point in the fentanyl epidemic where most
| users are specifically seeking out fentanyl or fentanyl
| laced drugs.
| factsarelolz wrote:
| Because fentanyl is way cheaper by itself. Why mix in
| more expensive drugs? The issue is China, full stop.
| amanaplanacanal wrote:
| I suspect most people looking for cocaine or
| methamphetamine or mdma are not looking for fentanyl.
| noptd wrote:
| Citation needed.
| adamsmith143 wrote:
| Is there some group of people who are taking fentanyl en
| masse intentionally?
|
| I know a few people who have died after taking what they
| thought were bars or ecstasy and died because it was laced
| with fentanyl. I know 0 who go out of their way to find and
| take fentanyl.
| KMag wrote:
| Right. My understanding is that it's very common to have
| fake oxycodone or heroine that's fentanyl or carfentanyl,
| and the short half-life of fentanyl and carfentanyl means
| that addicts will get withdrawl symptoms in just a few
| hours. My understanding is that heroine and oxycodone have
| long enough half-lives that many people can hold down jobs
| and generally be pretty functional by taking small doses
| before work (and maybe mid-shift, not sure). My
| understanding is that it's nearly impossible to do
| something similar with fentanyl/carfentanyl.
|
| Though, I have little exposure to hard drug culture, and
| get most of my information from headlines.
| kjkjadksj wrote:
| I would say most users now are taking the drug
| intentionally. I know of people who do seek out fent or
| fent laced drugs specifically. Its a lot cheaper to buy
| than heroin or any other opioid these days.
| denimnerd42 wrote:
| Yes people take fentanyl intentionally.
|
| The real heroin, the real opioid pills, and other forms of
| opioids have mostly dried up. Now we get fentanyl and
| fentanyl analogs, and other potent synthetic opioids that
| aren't well tracked. The reason is that it's extremely
| potent so it's easier to smuggle from China, Mexico,
| wherever it's being made.
|
| So now you get "pressies" [homemade pressed pills] which is
| diluted fentanyl. Everyone knows it's fentanyl. Everyone
| knows you can't get real heroin in the US anymore. They
| know these fake pills aren't real. Even worse, when the
| fentanyl dries up they start cutting it with xylazine and
| other bullshit that narcan doesn't even work on.
|
| Research areas such as Kensington and the blighted areas of
| Baltimore. There's videos on youtube showing just how many
| users are out on the streets. You can imagine how many more
| are still not down to that level yet. You can also look at
| the opioid and drug subreddits. It's all fent and everyone
| wishes they could get their impure crappy brown heroin
| back.
| Alex3917 wrote:
| > The reason is that it's extremely potent so it's easier
| to smuggle from China, Mexico, wherever it's being made.
|
| Which is also why this won't work. Even 100% of the
| population were vaccinated against fentanyl, the end
| result would just be even more deaths because dealers
| would switch to using carfentanyl.
| rcpt wrote:
| Would this be solved by legalizing and regulating
| opiates?
| denimnerd42 wrote:
| You would think. But FDA is going opposite direction
| making legal opiates even harder to get by putting
| pressure on doctors.
| rcpt wrote:
| Yeah. The way I understand it is that most users would
| prefer natural opiates but they're getting more and more
| expensive while synthetics are cheaper than ever. And,
| because the market is unregulated, even if you try to buy
| heroin you'll end up getting fentanyl mixed in anyway.
| denimnerd42 wrote:
| Yeah "heroin" can often be this weird brown product they
| mix in mexico. who knows what they add. whatever opiate
| like drug they have their hands on.
| agentwiggles wrote:
| Wildly anecdotal, this is like thirdhand info, so take with
| a bunch of salt. But I have heard before that heroin/opioid
| addicts have begun to deliberately seek fentanyl because
| it's cheaper and more potent.
|
| It makes at least some sense given the common narrative of
| the pipeline from painkiller addiction to heroin (i.e. it's
| the same relationship - people who are addicted to
| painkillers may transition to heroin because it's cheaper
| and more powerful).
| KMag wrote:
| I've heard it's cheaper, but the half-life is so short
| that just to keep the withdrawal symptoms at bay, addicts
| need to dose more often than if they're using heroine,
| oxycodone, etc.
| pazimzadeh wrote:
| late stage cancer patients are often prescribed it
| DiabloD3 wrote:
| Let's go another way with this: You are extremely unlikely to
| ever come across a fentanyl user, even if you work for law
| enforcement, even if you're a LEO in a major metro.
|
| 10x people died of heart attacks than any opioid, not only
| fentenyl, over the past few years. Almost as many people died
| of cancer as heart attacks, and half as many people died of
| COVID as cancer.
|
| Obviously, you can't equate research with other research;
| research and the drive to do research as a researcher is not
| a fungible item, but if we're spending tax payer money on it,
| why not a vaccine for foods that are low in fat, low in
| sodium, low in nutrition, and high in simple and processed
| carbs? That could save 700k+ lives a year in the US, more
| worldwide; and given that is also linked to cancer as the
| primary driver of it outside of smoking and drinking, another
| 600k+.
| eddsh1994 wrote:
| Fentanyl is the leading cause of death for those aged 18 to
| 45 in the US. Seems pretty important to me. We can also
| look at the things you suggested, it's not like there's an
| Obesity OR Fentanyl choice here.
| DiabloD3 wrote:
| > it's not like there's an Obesity OR Fentanyl choice
| here
|
| Thats kind of my point. If they managed to make a working
| vaccine, good on them. It doesn't necessarily take away
| from efforts into other things, as two parents above me
| were casually implying.
| klyrs wrote:
| > You are extremely unlikely to ever come across a fentanyl
| user,
|
| ... unless you walk around downtown in many major cities,
| where you will come across dozens in the space of a city
| block. People who work in downtown Vancouver often carry
| naloxone kits, not because they're ever going to use, but
| because they don't want to watch somebody die on the
| street. You don't even need to know how to use the naloxone
| -- if somebody is in distress and you say "hey I've got a
| naloxone kit" you're already a hero because everybody else
| knows how to use it.
| SkyPuncher wrote:
| > You are extremely unlikely to ever come across a fentanyl
| user, even if you work for law enforcement, even if you're
| a LEO in a major metro.
|
| Since you're using ancedata, I'll use ancedata as well. I
| don't care to find the actual data.
|
| Fentanyl is showing up in a huge amount of urinary drug
| screens right now. Unfortunately, much of this is the
| result of other drugs being cut with Fentanyl.
| spywaregorilla wrote:
| > Let's go another way with this: You are extremely
| unlikely to ever come across a fentanyl user, even if you
| work for law enforcement, even if you're a LEO in a major
| metro.
|
| I'm gonna need a citation for that outrageous claim
|
| > Obviously, you can't equate research with other research;
| research and the drive to do research as a researcher is
| not a fungible item, but if we're spending tax payer money
| on it, why not a vaccine for foods that are low in fat, low
| in sodium, low in nutrition, and high in simple and
| processed carbs? That could save 700k+ lives a year in the
| US, more worldwide; and given that is also linked to cancer
| as the primary driver of it outside of smoking and
| drinking, another 600k+.
|
| Because that is nonsense. We don't have that technology.
| rrdharan wrote:
| > Because that is nonsense. We don't have that
| technology.
|
| https://www.theringer.com/2023/1/20/23562871/america-
| isnt-re...
| spywaregorilla wrote:
| That is nothing like a "vaccine for junk food"
| nyolfen wrote:
| > You are extremely unlikely to ever come across a fentanyl
| user, even if you work for law enforcement, even if you're
| a LEO in a major metro.
|
| is this a joke?
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