[HN Gopher] Overdose deaths are falling in America because of a ...
___________________________________________________________________
Overdose deaths are falling in America because of a 'supply shock':
study
Author : marojejian
Score : 205 points
Date : 2026-01-10 19:54 UTC (1 days ago)
(HTM) web link (www.economist.com)
(TXT) w3m dump (www.economist.com)
| marojejian wrote:
| archive: https://archive.is/C0Y0G#selection-1303.143-1303.175
|
| this is my best guess for the research cited (paywalled):
| https://www.science.org/doi/10.1126/science.aea6130
|
| If true, the next question is what caused the supply shock?
| Analemma_ wrote:
| I thought this was already well-established public information?
| That fentanyl came mostly from China was never in doubt, what
| people were arguing about was whether this was happening with the
| tacit approval of the Chinese government. Then in 2023 China
| cracked down on it, and supplies dried up. Whether that was
| because it was a big enough issue to get their attention, or it
| was on purpose and they decided it was no longer serving their
| interests I suspect we'll never know, but I definitely read
| multiple articles in 2023 about the fentanyl crackdown in China.
| defrost wrote:
| Biden era cooperation with China on the issue was at the heart
| of this.
|
| It wasn't about the direct supply of Fentanyl, or even (by that
| stage) the direct supply of Fentanyl precursor drugs .. (that
| gangs used to industrial shed chem lab into Fentanyl) ... this
| was cutting back and limiting bulk supply of the precursor
| precursors to shady onselling networks to starve the labs.
|
| Was going well (as per the paper) until US / China relations
| went in the toilet.
|
| Some of this is covered in _The Hidden Cost of Trump's Trade
| War on China_ (March 18, 2025) -
| https://www.nytimes.com/2025/03/18/opinion/trump-china-trade...
|
| written by a former deputy assistant secretary for US
| international narcotics and law enforcement affairs.
|
| ADDENDUM: 20 page PDF of data, graphs, suppleentary material
| from the _original_ 8th January 2026 Science paper
|
| _Did the illicit fentanyl trade experience a supply shock?_
| Kasey Vangelov et al (doi /10.1126/science.aea6130)
|
| here:
| https://www.science.org/doi/suppl/10.1126/science.aea6130/su...
| alephnerd wrote:
| Mexico also began enacting extremely heavy handed tariffs
| against China and other Asian exporters like South Korea,
| India, and Vietnam in 2023 onwards [0][1][2][3] in order to
| protect their domestic manufacturing capacity against an
| export-driven supply shock, which hit Mexico really badly in
| the 2000s [4].
|
| > Was going well (as per the paper) until US / China
| relations went in the toilet
|
| Yep, but as long as Mexico continues to enact trade barriers
| to protect against an Asian export shock, the APIs needed for
| synthesis will remain difficult for organized crime to
| acquire.
|
| Already, cartels have begun tariff arbitraging by targeting
| the CEE and the Balkans as a new base for synthetic opioid
| operations [5][6][7], especially because Romanian [8] and
| other CEE gangs had been collaborating with Mexican organized
| crime on financial and human trafficking crimes _in_ Mexico
| for over a decade now.
|
| [0] - https://www.whitecase.com/insight-alert/mexico-imposes-
| tempo...
|
| [1] - https://www.whitecase.com/insight-alert/mexico-
| reinstates-ta...
|
| [2] - https://www.whitecase.com/insight-alert/mexico-
| proposes-sign...
|
| [3] - https://www.whitecase.com/insight-alert/mexico-
| formalizes-an...
|
| [4] - http://international-economy.com/TIE_Sp03_Rosen.pdf
|
| [5] - https://www.europol.europa.eu/media-
| press/newsroom/news/larg...
|
| [6] - https://balkaninsight.com/2024/07/24/fentanyl-central-
| europe...
|
| [7] - https://www.brookings.edu/articles/the-foreign-
| policies-of-t...
|
| [8] - https://www.occrp.org/en/project/how-a-crew-of-
| romanian-crim...
| defrost wrote:
| That absolutely played a part also.
|
| The biggest takeaway that deserves stressing over and over
| again is that _Things Take Time_ .. it generally takes 18
| months and longer to substantially impact global flows.
|
| The work has to be put in early, kept up in practice, and
| results are often credited to political actors down the
| road of time.
|
| TTT - Piet Hein - https://www.circlepublications.net/grooks
| alephnerd wrote:
| Absolutely!
| stevenwoo wrote:
| Different articles confirming this with multiple approaches
| and data points
|
| https://www.npr.org/2026/01/08/nx-s1-5661523/biden-made-
| big-...
|
| https://www.psypost.org/sudden-drop-in-fentanyl-overdose-
| dea...
| cyberax wrote:
| No, it was in doubt.
|
| Now fentanyl is produced from readily available precursors in
| Mexico. In underground labs:
| https://www.nytimes.com/2024/12/29/world/americas/inside-fen...
|
| Fentanyl is so potent that just one lab can easily satisfy all
| the US demand with it, around 10kg a day. That's also why it's
| ridiculously hard to fight, one smuggled barrel of pure product
| can supply the entire US for months.
|
| So no, there is no "supply shock". There's just more free
| Narcan (naloxone).
| cogman10 wrote:
| Cocaine death decreases is the hard thing to explain with
| either theory, supply or naloxone. Fentanyl supply doesn't
| affect cocaine in any way and naloxone doesn't work on a
| cocaine OD.
|
| Maybe some percentage of cocaine deaths are misattributed
| fentanyl deaths?
|
| I also wonder if there's any link to the Oxycontin reforms.
| Perhaps now that prescription is reigned in, we are seeing a
| lot fewer oxy->fent cases which has cut back on the deaths.
|
| Or maybe it's actually that the drug dealers have gotten more
| careful. Drug dealers don't want to kill their clients, so
| maybe they've been purposefully diluting to make sure they
| get repeat customers.
| jddj wrote:
| In Europe the per kg price of cocaine has apparently
| halved.
|
| If that's the case in the US as well, it could be that as a
| result there's more cocaine in the cocaine and fewer
| adulterants.
| mjanx123 wrote:
| People don't have the money to buy drugs, deaths go down
| and price as well (albeit slower).
| zdragnar wrote:
| For addicts, the drug is the last thing they cut back on
| when money is tight.
| herbst wrote:
| Prices in Europe went down but quality also went way up,
| so they "consumer" numbers
| 20after4 wrote:
| > Perhaps now that prescription is reigned in, we are
| seeing a lot fewer oxy->fent cases which has cut back on
| the deaths.
|
| This is definitely part of the story. When your primary
| source of new addicts is prescription opioids and you cut
| down on the prescriptions then over time, as people die off
| from OD, then the OD rate is bound to drop.
|
| The most tragic part of it, to me, is that it's usually the
| people who got clean who eventually OD. Once they've been
| clean for a short time then their tolerance for the drug
| drops drastically, then if they break down and do "just one
| dose" they make the fatal mistake of thinking they can
| still handle the same amount they were used to doing
| before. This exact scenario happened to multiple more or
| less close acquaintances of mine, even people who were
| aware of tolerance and should have known better. I'm fairly
| sure that it's extremely common.
| greygoo222 wrote:
| This theory predicts a significant decrease in addiction
| rates. Is there any evidence of that?
| greygoo222 wrote:
| I believe they're using CDC data, which states:
|
| "Drug overdose deaths may involve multiple drugs;
| therefore, a single death might be included in more than
| one category when describing the number of drug overdose
| deaths involving specific drugs."
| https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm
|
| Someone who overdosed after taking cocaine contaminated
| with fentanyl would be counted as a cocaine ODD.
|
| The Oxycontin "reforms" caused the fentanyl crisis to begin
| with. People often moved onto heroin and fentanyl because
| pharmaceuticals were no longer accessible. The massive
| spike in overdose deaths begun after the decline in opioid
| prescriptions. See the Opioid Prescriptions & Opioid
| Overdose Deaths graph here
| https://drugabusestatistics.org/opioid-epidemic/
| cyberax wrote:
| Pure cocaine overdose deaths are relatively rare. Only
| around 5% of cocaine deaths involved pure cocaine, it's
| almost always mixed with something else.
|
| > I also wonder if there's any link to the Oxycontin
| reforms. Perhaps now that prescription is reigned in, we
| are seeing a lot fewer oxy->fent cases which has cut back
| on the deaths.
|
| Prescription pills have been a non-issue for a decade by
| now.
|
| > Or maybe it's actually that the drug dealers have gotten
| more careful. Drug dealers don't want to kill their
| clients, so maybe they've been purposefully diluting to
| make sure they get repeat customers.
|
| Yup. I think that's exactly it.
|
| The major reason for fentanyl deaths was not unintentional
| overdose because of poor pill quality. It was way too easy
| to end up with 1mg instead of 500mcg during pill mixture
| preparation. So _reducing_ the amount of fentanyl per pill
| results in a better safety margin. And users can just smoke
| another pill if one pill was not enough to get high, after
| all.
|
| And yeah, it's just possible that the more reckless drug
| users are just dead by now. But to be clear, it's still
| absolutely horrible. We're still above the 2021 level.
| SilverElfin wrote:
| So presumably Venezuela is not a factor, as the
| administration claimed?
| 20after4 wrote:
| Of course it isn't.
| tehjoker wrote:
| Trump said it's about the oil himself.
|
| https://www.dropsitenews.com/p/trump-maduro-venezuela-
| darfur...
| CraigJPerry wrote:
| Revealed preferences suggest otherwise and that matters
| because he says a lot of things, often contradictory.
|
| Is it just another Epstein diversion maybe?
|
| Oil story doesn't stack up though: -
| it's heavy sour oil, the tar like substance isn't
| economically extractable without an almost doubling in
| barrel price - cheaper (existing infra) sour
| supply chain with Canada already meets US shale light
| sweet oil blending needs for a long time -
| decided on maintaining stability of existing Venezuelan
| regime over supporting regime change
|
| One thing that lines up so far is it does seem to be
| disproportionately effective at displacing column inches
| spent on the pending bringing to justice of Epstein
| entangled elites. Disproportionately because that pursuit
| of justice seems quite resilient in resisting
| partisanship breakdown.
| tehjoker wrote:
| People are always talking about this precusor from China, but I
| have no idea what this precursor is. Are they chemicals that
| are useful for lots of things or is it only useful for this?
| Because if it is the former, then China is just selling regular
| ass legal chemicals because they are the worlds number 1
| supplier of manufactured goods.
| defrost wrote:
| The challenge in international drug operations was not to get
| China to stop selling bricks to house builders to but get
| China to cooperate in stopping the sale of bricks to groups
| that only use bricks to throw through windows and at heads.
| OneDeuxTriSeiGo wrote:
| Fun fact: The "traditional" way of making it was extracting
| piperine from black pepper and reacting that with nitric
| acid. Nowadays it's made in other more industrial scalable
| ways.
|
| https://en.wikipedia.org/wiki/Piperidine#List_of_piperidine_.
| ..
|
| But yes, the same base precursors (and their siblings) are
| used to manufacture ADHD meds (ritalin/concerta),
| antidepressants (paxil), insect repellents
| (picaridin/bayrepel), hair loss medications (rogaine),
| allergy meds (claritin), anti-psychotics (haldol), anti-
| diarrhea meds (imodium), and many others. And also PCP.
|
| So it's non-trivial to prevent. The core of the issue is that
| the one pot Gupta method came about in the 2000s and it made
| it extremely easy to manufacture fentanyl using these basic
| building blocks for so much of the pharma industry. Not only
| just making it easier to source ingredients but it took out
| all the steps and made the process easy as hell as well.
| mythrwy wrote:
| "Supply shock" might not be the only, or even primary cause. As
| far as I know fentanyl is still widely available and inexpensive.
|
| My guess is only a subset of the population is willing to both A)
| Use a substance like street fentanyl with known lethality. and B)
| Do so in a risky and unsafe manner (alone, no narcan, shooting
| instead of smoking, etc. etc.).
|
| That subset of the population has already been decimated to the
| point we are seeing a decrease, and survivors have become more
| educated on how to use without dying.
| kayodelycaon wrote:
| A major factor is Narcan being far more available and usable by
| people who are not trained.
| DoctorOetker wrote:
| Is there a graph of the decline in overdoses with time?
|
| Your explanation suggests an exponential decay (ignoring
| aggravating conditions, like seasonal temperature, violence,
| ...)
| maxbond wrote:
| In the article, yes. https://d9258mdc7ql01n.archive.is/C0Y0G/
| 696eb2f917764f004c5f...
| diego_moita wrote:
| That seems the most plausible explanation.
|
| The article says something along these lines. Every pandemic
| has a peak point when people become alarmed, and there is a
| clear way to avoid contamination.
|
| It happened with AIDS when people began stopping having risky
| relations. It is only natural that it would also happen in drug
| addiction when everyone sees its devastating effects.
|
| The same thing might be happening to tobacco and alcohol
| consumption.
|
| Deaths for lack of vaccines (e.g. measles) will also behave the
| same way. When people see very explicitly that risky behaviour
| has consequences, they think twice before doing it.
| 20after4 wrote:
| > When people see very explicitly that risky behaviour has
| consequences
|
| With much emphasis on the "very explicitly" part.
|
| It seems to only work that way when it is very explicit and
| rapid consequences. Abstract consequences far in the future
| are not very effective at deterring [ entertaining |
| desirable | fashionable | profitable ] behavior.
| jasonfarnon wrote:
| "The same thing might be happening to tobacco and alcohol
| consumption."
|
| I believe the data on smoking was the opposite. Showing
| people the terrible consequences of smoking (including very
| graphic images) turns out to have minimal or no effect. There
| was a large randomized trial in the pacific northwest some
| decades ago. A lot of people now point to taxes as the main
| driver in the decrease.
| Aloha wrote:
| I'm skeptical of that last one.
|
| My dad was a heroin addict, and while he eventually got
| (mostly) clean, he wryly joked to me once "you know there
| aren't a ton of old heroin users for a reason"
|
| Using street drugs kills - we can put people on opiates if done
| in a controlled way, for the rest of their lives, we instead
| have gone down the road of prohibition, closing off pathways
| for people to get maintenance dosing of opiates.
| pengaru wrote:
| Just a different form of supply shock - to the supply of users.
|
| Living in downtown SF for the last two years has made it
| painfully obvious those using fent on the streets are not long
| for this world. It'd an inherently self-solving problem, grim
| but true.
| appplication wrote:
| There is also a never ending supply of destitute and
| destined-to-be-destitute in America. The people may change
| but the problem persists.
| 20after4 wrote:
| Not all (probably not even most) destitute people become
| opiate addicts. People become destitute because they are
| opiate addicts, it's not the other way around.
| dilyevsky wrote:
| > to the supply of users
|
| I think there is a word for this...
| bsder wrote:
| > fentanyl powder and pills were losing potency just as
| overdose deaths were falling
|
| Combined with the already dead, does this not explain things?
|
| Illegal drug suppliers don't make money by killing their
| customers. Consequently, they finally got control over the
| potency throughout their supply chain.
|
| Although, I'm more interested in the _standard deviation_ of
| the potency than the absolute value of the potency. I suspect
| that is _much_ more correlated with OD deaths.
| dopa42365 wrote:
| If the cost didn't go up, it can't have been a supply shortage.
| Even at its US peak, there wasn't much of a "fentanyl epidemic"
| in Mexico either.
|
| The overprescription of opioids in the US (especially in the
| past) is hardly a secret.
| conformist wrote:
| "Even as quality worsens, prices in drug markets are sticky, so
| the decreasing potency probably meant people were taking less
| fentanyl."
| lazarus01 wrote:
| >> Researchers have pondered what could have caused this sudden
| turnaround, pointing to the end of the covid-19 pandemic or a
| rise in drug treatment. A new article, published in Science on
| January 8th, suggests, instead, that a supply shock drove the
| decrease.
|
| The supply shock sounds right.
|
| I was volunteering at a state run institution, who had an
| addiction data science team, at the peak of the opioid crisis. I
| was developing ml models to predict patient dropout early in a 32
| week program. The data and funding for such research was very
| scarce and it didn't go anywhere.
|
| Treatment for opioid use disorder with medication is highly
| effective for 50% - 90% who respond well to treatment. The
| problem with the bottom 50% was early dropout, due to the lack of
| dissemination of proper treatment protocols and stigma attached
| to medication for treatment (methadone). I stopped following the
| work, I became too sensitive, it was pretty depressing.
|
| The pandemic coupled with the increase in illicit fentanyl was
| just tragic in what it did to people. I remember reading the DEA
| research, where the precursor for fentanyl came from china and
| was manufactured and distributed from mexico. Mexico was also
| manufacturing high quality meth and displaced most of the meth
| labs in america, coming with increases in meth overdose during
| the same period. The fentanyl was so cheap compared to
| traditional heroin manufacturing.
|
| I'm glad the supply seems to have dried up. It was nuts, what was
| going on a few years ago.
| 20after4 wrote:
| I think that many methadone clinics are operating very
| unethically, to the point I would call it fraudulent. Certainly
| it's cruel to the patients. They essentially set up the patient
| to be a lifetime methadone addict. This may be an improvement
| over getting your fix on the street but it's still addiction
| dependence and it's expensive (profitable!). I'm unsure if it's
| just a few or a large fraction of them that operate this way.
| Maybe my data point is a unique outlier but here's what I saw:
|
| I had a friend who was going through the program in Springfield
| Missouri, approximately 10 years ago, and the clinic literally
| increased his dose every week or two. They also had strict
| controls to make sure the patients actually take the full dose
| (because otherwise they might sell some of it on the street).
| So they were left with just 2 options, either drop out of the
| program and find their fix elsewhere, or accept a gradually
| increasing dose of methadone, forever. It's a sick program that
| is set up to make sure patients gradually descend deeper into
| addiction while they rake in huge profits. It's not really any
| different from what the drug dealers on the street are doing
| except that it's even more exploitative and dishonest. The
| doctors had zero plan for weaning people off of the methadone
| and some people had been on the program for years, with
| correspondingly huge doses doled out to them every time they
| came in. This was 10 years ago, at the time it cost something
| like $50 per visit, paid by the patient or possibly medicaid.
|
| Edited slightly for clarity.
| deepsun wrote:
| Well, addiction or not, the main question is what medics call
| "quality of life" -- whether a patient can life their life to
| the full potential.
|
| There are millions of people addicted to caffeine, the most
| popular psychoactive substance in the world, but as it
| usually doesn't prevent them to live their life and "be a
| productive member of society", no one cares of treating
| caffeine addiction, save for religious societies.
|
| My point is -- is methadone addiction "better" than fentanyl
| in that regard? If yes, than that's ok.
| lazarus01 wrote:
| Agreed.
|
| Methadone is effective because it comes with lower
| respiratory fatigue.
|
| If you have a nasty addiction, methadone is the gold
| standard for treatment. It's really all that's available to
| ween people down.
|
| There are other medications for maintenance like
| buprenorphine and naltrexone. But you can't take those if
| you're in the throws of heavy addiction, you can die.
| 20after4 wrote:
| My complaint was about the forced increasing of dosage.
| They literally would not allow the patient to wean off of
| it. So yes, it might be an improvement over the shit on the
| street but it's diabolical that they force patients to
| continually increase their dose rather than gradually
| decreasing it.
|
| I have no idea if this is common or just this one shady
| clinic but my data point of 1 still stands. If there is
| one, then given that this would be very profitable, it's
| highly likely that there are other clinics with similarly
| unethical policies.
| antonvs wrote:
| Was there some stated rationale for the dose increase?
| 20after4 wrote:
| Not that I'm aware of, it seemed rather arbitrary. The
| people who had been going to that clinic for a while all
| had massive doses, almost to a ridiculous degree. My
| perception was that it was to keep them hopelessly
| addicted. I was only peripherally involved as it was my
| friend who was the patient. He was very fortunate to have
| family with influence in the Mormon church - his family
| had the church send some local missionaries to help him -
| and they genuinely did help him escape that terrible
| situation.
| 20after4 wrote:
| It's possible my friend wasn't telling me the whole story
| or just misunderstood the program. I don't think he was
| actually trying to stay addicted though because after a
| few weeks on methadone (with increasing doses and doctors
| telling him that he would always be an addict for life)
| he decided to take the more extreme route of getting
| clean by quitting cold turkey. He moved to a different
| state and cut ties with every possible source he had to
| acquire the drugs.
| XorNot wrote:
| Did it work? Is he clean?
| 20after4 wrote:
| Yes it worked.
| antonvs wrote:
| This is certainly possible, but it sounds more like what
| AA tells its clients. Doctors are less likely to say
| things like this, because it can have consequences for
| them.
|
| Going cold turkey like you're saying he did is fine if
| (1) it doesn't kill you and (2) you're able to do it. For
| many people, it's just not very practical.
|
| I don't think it's a good idea to demonize medical
| professionals for doing their jobs to the best of their
| abilities in the face of enormous challenges. That's the
| kind of thing that the conspiracy theorist and anti-
| science Robert F. Kennedy Jr. does, and it's not helping
| the US in any way at all.
| idiotsecant wrote:
| And yet, you're comfortable accusing the people _trying
| to cure addicts_ of some diabolical plot to ensnare them
| into permeant addiction in order to make money off them
| forever. Maybe next time you 'll think before you
| propagate nonsense.
| antonvs wrote:
| To answer my own question: what you described sounds like
| part of the standard recommended protocol, and it seems
| likely your friend misunderstood or misrepresented that.
|
| I'll explain with liberal quotes from the document linked
| below. Dosages start out low to avoid risk to the
| patient, because "the most common reason for death or
| non-fatal overdose from methadone treatment is overly
| aggressive prescribing/dose-titration during the first
| two weeks of treatment."
|
| Because of this, "methadone induction and titration MUST
| be approached slowly and cautiously. It may take several
| weeks to address opioid withdrawal effectively. It is
| important to be upfront with patients about this
| requirement and to discuss ways to cope with ongoing
| withdrawal and cravings, to maintain engagement in
| treatment."
|
| The dose increase is described in the following
| paragraph:
|
| "...methadone can be initiated without the prerequisite
| presence of opioid withdrawal. This may be preferential
| for some patients. The patient's dose should be titrated
| with a "start low and go slow" approach, based on regular
| clinical assessment, until initial dose stability is
| reached - see specific recommendations below. A stable
| dose is achieved when opioid withdrawal is eliminated or
| adequately suppressed for 24 hours to allow patients to
| further engage in ongoing medical and psychosocial
| treatment. The ultimate goal is to work toward clinical
| stability."
|
| In other words, for patients who are continuing to take
| other opioids, the methadone dose is increased over time
| to make it easier for the patient to reduce that other
| intake. Dosage is based on interviews with the patient.
|
| Addicts are very good at subconsciously coming up with
| rationales for remaining addicted. It's much more likely
| that your friend found himself in that trap, than that he
| was going to an unethical clinic trying to keep him
| addicted "forever". That would be a major violation of
| the law and breach of medical ethics, and would be likely
| to come to the attention of regulators if it was a
| recurring pattern.
|
| https://cpsm.mb.ca/assets/PrescribingPracticesProgram/Rec
| omm...
| patmorgan23 wrote:
| > They literally would not allow the patient to wean off
| of it
|
| If true that clinic needs to be reported. Patients have a
| right to taper down and exit treatment.
|
| When a patient enters treatment at an OTP (Methadone
| clinic) they start with a small initial dose that is
| increased over the initial 30-60 days of treatment. Some
| clinics do this somewhat aggressively because they are
| trying to get the patient up to a "protective" dose.
| Methadone blocks the 'euphoric' effects of other opioids
| and protects patients who may still be taking other
| substance outside of their prescribed treatment program
| from overdose. Getting to a protective dose faster ends
| up saving patients lives.
|
| So that maybe why the clinic was firm about trying to
| increase you friends dose.
|
| OTPs are also required to offer counseling, the idea
| being methodone is used to address the physical aspects
| of addiction, and counseling is use to address the
| psychological/emotional side of addiction. Help patients
| build coping skills, figuring out what their triggers
| are, and find ways to stay out of those situations, etc.
| Some patients are instrested in that and eventually
| getting off of Methadone, some aren't. Some clinics
| provide really great counseling, some don't. The "dose
| and go" clinics are definitely a problem in the industry.
|
| https://www.samhsa.gov/substance-
| use/treatment/options/metha...
| vladvasiliu wrote:
| > Methadone blocks the 'euphoric' effects of other
| opioids and protects patients who may still be taking
| other substance outside of their prescribed treatment
| program from overdose. Getting to a protective dose
| faster ends up saving patients lives.
|
| How does this work? Naively, I'd expect addicts to up the
| dose of the "other substances" if they can't reach their
| high. Or does methadone outright "block" the other
| substances' effects?
| herbst wrote:
| In Switzerland there is state grown heroin because it
| should be even less quality of life inferencing than most
| other alternatives. They do this for a long while now and
| it works, most people have jobs and you couldn't tell they
| get daily heroin in the best quality you could imagine (for
| free)
| vixen99 wrote:
| And no one bothers much about these either: 'A Neglected
| Link Between the Psychoactive Effects of Dietary
| Ingredients and Consciousness-Altering Drugs.' https://www.
| frontiersin.org/journals/psychiatry/articles/10....
| scotty79 wrote:
| > no one cares of treating caffeine addiction
|
| If people were aware in how many ways caffeine messes up a
| lot of people there would be. Exhaustion, migranes,
| anxieties, twitching, insomnia, mental issues to name a
| few. Most never attributed to caffeine but mysteriously
| going away after a person manges to kick the habit.
| kakacik wrote:
| Dude, caffeine ain't no heroin. I drink 2-3 coffees a day
| and skipping this (ie traveling on vacation, easily for a
| week or two) does 0 to my body, mind or sleep. I just don't
| feel the effect at all, I drink it purely for the taste.
|
| There is no human in this world who could say something
| similar about heroin.
| SkyPuncher wrote:
| Your argument seems to be missing the fact that methadone
| clinics are serving people with an existing addiction. They
| didn't create that addiction, but they can fill the desire
| created by that addiction in a safe manner.
|
| The ideal situation is the client leverages methadone into a
| recovery/remission from addiction - but that can be
| incredibly hard for them to do.
| Lord-Jobo wrote:
| If someone is addicted to ice cream, and the most effective
| treatment is to replace that addiction with
| spinach(scientifically supported), would anyone have this
| problem? I doubt it. People's knee jerk reaction to any
| kind of """"drug enabling"""" treatment is infuriating. I
| know multiple people personally who have had their life
| saved by methadone. Yes that makes me biased but it also
| justifies the bias (alongside the many medical
| professionals advocating for it)
| AndrewKemendo wrote:
| Even still today there is no reliable place to source black tar
| or China White or any of the traditional opium derivatives
| without having a fentanyl cut.
| t-3 wrote:
| Isn't this more because the supply of poppy was cut off when
| the US pulled out of Afghanistan? Users want the good stuff,
| dealers buy the cheap and available stuff and pretend it's
| real.
| metalman wrote:
| poppy/opium/heroin production has shifted to myanmar, but
| there has been less production, and the synthetics are much
| cheaper ,so that reduces profitability for poppy
| Afganistan, have set up addiction centers, where addicts
| are put, but it's cold turkey. Opium poppy production is
| bieng eradicated in Afganistan ,and penaltiys for drug
| smugglers and dealers will escalate, but a quick search
| shows the increadable synicism of the western press who are
| spinning it as "hardship for Afganinstans farmers"
| lukan wrote:
| "hardship for Afganinstans farmers"
|
| Isn't it hardship when people with guns come to you and
| burn your fields?
| metalman wrote:
| ok, lets talk about Palestine ,if thats what you want.
| HPsquared wrote:
| I wonder how this compares to the common western
| situation of livestock culls. Presumably there is
| compensation in some cases and not in others (poppy
| cultivation being illegal). I suppose it's at opposite
| ends of a scale.
| t-3 wrote:
| Oh, woe is me, the government burned down my illegal drug
| manufacturing operation! Where is the justice?!
| greygoo222 wrote:
| The initial spike in overdose deaths were largely caused by
| government crackdowns on pharma drugs.
| monero-xmr wrote:
| You can live with a sustained opioid addiction permanently
| without major issues. That's the entire basis of methadone
| clinics - controlled dispersement of opioids at a level that
| solves cravings and allows the addict to be functional. It is
| very sad we don't allow pharmaceutical grade opioids to be
| given to addicts in a controlled way, it would eliminate the
| purity variance that causes overdoses, and prevent the poison
| mixed in to increase street profits from destroying bodies
| (tranq, etc)
| specproc wrote:
| Methadone is available in the UK, on the NHS. I know at
| least one person who has been on it for decades.
|
| https://www.nhs.uk/medicines/methadone/
| herbst wrote:
| In Switzerland they can get actual, state grown, heroin.
| Clean heroin is one of the least problematic substances
| appearantly, less problematic and more "everyday friendly"
| than Methadon even.
|
| And you don't SEE any issues like in the US (or UK) around
| here at all.
| monero-xmr wrote:
| Imagine you are sitting in a room. Your child is in front
| of you. A scary man sits next to them. The man says:
|
| "Your child is a drug addict. They are addicted to
| opioids. I am the devil, without any care in the world
| other than making money. The choice is yours. Would you
| rather they inject clean heroin made by a pharmaceutical
| company in your country, or banish them forever as street
| addicts slavishly doing what it takes to score their
| fix?"
|
| When facing the devil I'm voting for my tax dollars to
| give them clean heroin made by my country. That is what
| every parent wants when faced with an addicted child
| lolive wrote:
| I switched from my Twitter addiction to a Bluesky
| addiction. Still scrolling to death, but now my opinion
| is mine again. #dontDoGrok
| znpy wrote:
| That's a fake dichotomy btw, a sadly very common logical
| fallacy.
|
| You (wrongly) assume there's no way out of an addiction,
| for example.
| acessoproibido wrote:
| Its definitely easier to beat addiction if you aren't
| living on the street, selling everything you have and are
| injecting one of the most horrible shit substances but
| instead you are using a clean, safe alternative that is
| provided by the state together with prevention programs
| (which is usually the model for this) - how is it a false
| dichotomy?
|
| Or are you someone who assumes you just need to "use
| willpower" and "stop" being an addict? I assure you its
| not so easy with opiates.
| imtringued wrote:
| Usually the fastest and most effective way out of an
| addiction is medication assisted treatment, which means
| having a doctor control your dosage with a clean supply
| of the drug or a less addictive substitute that targets
| the same receptors.
| solumunus wrote:
| They never made such an assumption.
| Tom1380 wrote:
| I live in Zurich. I spent 5 minutes waiting at a bus stop
| in Langstrasse and I was offered cocaine and marijuana by
| a thug
| herbst wrote:
| Sounds like you have easy options for some common drugs.
| Not a bad thing perse and sounds like they didn't offer
| any opioids
| fennecbutt wrote:
| Lmao as a kiwi living in UK it's definitely a bad thing.
| Can't go on a night out in London without half dozen
| dudes trying to sell you coke. Same dudes who are waiting
| in alleys waiting to mug people when they get the chance.
|
| If you ever see >1 person just standing around and not
| walking somewhere in London early in the morning just
| stay the fuck away from them. And if they start heading
| your way, run.
| herbst wrote:
| I know how annoying this can be, especially in some
| countries this behaviour is often directly associated
| with criminality. Here in Switzerland dealers are often
| (not always) just that, they make enough to not bother
| with anything else. They don't look like "dirty" junkies,
| they don't bother stealing from tourists, they basically
| don't look for any extra attention when the business is
| rolling anyway.
| scotty79 wrote:
| When I was in Amsterdam people were offering hard drugs
| on the street but "no, thank you" was perfectly
| sufficient response
| herbst wrote:
| This. Same in Switzerland. Feels different in for example
| Prague, Vienna, ...
| seanmcdirmid wrote:
| Survival bias: the police would come down on them on hard
| if they were scene as disrupting social order. They have
| to not look dirty to survive, Swiss police are no joke.
| alimw wrote:
| You've only told us that you're scared of being mugged by
| dealers! That doesn't even count as anecdotal evidence
| that it's likely.
| comice wrote:
| The comment was about heroin. Were you offered heroin?
|
| Is cocaine and marijuana available from the government
| too? If not, what relevance is your comment?
|
| Was this the first and only time you were waiting at a
| bus stop in Switzerland? If so, perhaps a notable story,
| if not then we'll need more information to conclude how
| bad this thug problem really is in Switzerland.
| zhdc1 wrote:
| Langstrasse is as close to a red-light district as you'll
| find in Zurich.
|
| It's gotten a lot better over the last couple of years,
| but stating that you were offered drugs there is like
| being offended that you walked past a casino in Vegas.
| johnisgood wrote:
| The problem is definitely with adultered products. Never
| accept anything from a random "thug".
| zhdc1 wrote:
| "waiting at a bus stop in Langstrasse" -> what were you
| expecting?
| jacquesm wrote:
| Probably a bus?
| Etheryte wrote:
| If you think cocaine and marijuana are
| comparable/interchangeable with heroin, you might want to
| educate yourself on the topic a bit more before trying to
| make a quip.
| kakacik wrote:
| Is it too long, too little or what? Red light districts,
| official or not are _the_ place to get drugs in european
| towns. Langstrasse is basically an official place for
| that, at least the most official Zurich has.
| Aurornis wrote:
| > Clean heroin is one of the least problematic substances
| appearantly, less problematic and more "everyday
| friendly" than Methadon even.
|
| Least problematic is too strong of wording. Consistent
| opioid use will take a large toll on the body and mind. A
| therapeutic level of dosing could possibly be better than
| severe chronic pain depending on the situation, but even
| chronic pain patients have to deal with a range of
| negatives and side effects that are only tolerable
| because they're less bad than their severe chronic pain.
|
| Chronic opioid use induces a lot of changes in the body
| and mind. The initial euphoria isn't sustainable, as
| everyone knows, but long term use induces even further
| changes that predispose users to deeper depression and
| can even begin to augment pain signals.
|
| Opioids are in a class of drugs that are unusually
| deceptive because users who more or less control their
| dosing will talk themselves into thinking they can do
| this forever without real negatives. They can go for
| years before the cumulative negatives become too obvious
| to ignore.
|
| For addicts deep in cycles of rehab-relapse extremes,
| going to a maintenance program and achieving stability is
| definitely better than continuing the cycle indefinitely.
| However it comes with a high price relative to sobriety.
| I think it's important to not downplay the effects of
| being on opioids for years and years.
| mmooss wrote:
| > You can live with a sustained opioid addiction
| permanently without major issues.
|
| To me that seems to say cause of the opiod crisis doesn't
| exist, which probably isn't what you mean. But what do you
| mean?
| monero-xmr wrote:
| The problem is not the opioids themselves as a chemical.
| They are tolerated well and have minimal side effects.
| The main issue is that street opioids are of uncertain
| purity, and cut with toxic chemicals. This causes
| overdoses when a batch is too strong, and various health
| issues from the harsh toxins.
|
| A properly managed opioid addiction can be permanent. For
| a decade millions of Americans were addicted to opioids
| (OxyContin, Vicodin, etc.) prescribed by doctors. When
| the state cracked down they were forced to go on the
| street to get their medicine, which is when the opioid
| crisis exploded
| Veliladon wrote:
| And we learned zero from the change after shutting down
| the Purdues. The electorate just wants to see drug users
| punished, not treated. Even though treating cheaper, more
| humane, and has way better outcomes.
| gruez wrote:
| >When the state cracked down they were forced to go on
| the street to get their medicine, which is when the
| opioid crisis exploded.
|
| What's the data corroborating this theory?
| cavisne wrote:
| Channel 5 did a good piece on "Tranq" which lets China skip the
| Mexican part of the supply chain as they can mail the finish
| product straight to the US.
|
| Since the article suggests there must have been a change in
| china to cause this it seems likely they just moved from
| fentanyl to tranq.
|
| https://www.youtube.com/watch?v=925wmb-4Yr4&t=1623s&pp=ygUPY...
| _DeadFred_ wrote:
| Lots of people were getting fent analogs straight from China.
| Which had me wondering. The guys that I knew that
| ordered/distributed it (ex-marines that had pill addictions
| after Iraq/Afghanistan) would get different analogs randomly
| I guess, and would test each batch on themselves. Some were
| way more sketchy than others, and they ultimate caught a case
| with a body from a new batch. Could the less deaths be
| because of the analogs in production at the time?
| idoubtit wrote:
| The reporter rightly queried other researchers about this
| article, and all of them were skeptical that a "supply shock"
| could be the cause, or even the main cause. My own skepticism is
| because the death rate went down many months before any sign of
| shortage appeared.
|
| I haven't read the paywalled Science paper, but The Economist
| extracted a graph which shows that the purity of Fentanyl pills
| was stable till the first months of 2024, then dropped sharply.
| The purity of the powder peaked in 2023, then went down in 2024,
| back to its older levels. They suppose that it proves the supply
| was short, but another researcher even states that the supply of
| Fentanyl precursors didn't change until the end of 2024.
|
| Anyway, the epidemic plateaued by the start of 2022, then went
| down after August 2023; Source
| https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm
|
| Why did the death rate slow down for one year, then go down many
| months before any sign of supply changes?
| jfengel wrote:
| The article says that deaths peaked in mid 2023. Narcan was
| approved for over the counter use in March 2023.
|
| That suggests a plausible alternative cause.
| SV_BubbleTime wrote:
| What is your supposition here? That addicts are keeping
| narcan around just in case? That good friends of addicts are
| standing by with the spray in case it is needed? That your
| local opium den had staff with it on hand?
|
| Narcan should be available, but short of a few users that
| know they need to keep it around, I don't buy that making it
| available has meant a significant change in total outcomes
| because of timely deployment.
| swamp_donkey wrote:
| First responders would carry narcan or equivalent. I am
| sure it is readily available in areas where people are
| dying daily from overdoses.
| squigz wrote:
| Some of those ... absolutely, yes?
|
| You might have got some at a rehab centre, or someone might
| live with a non-addict friend or partner. Community
| outreach workers (in cities that have embraced this stuff)
| might carry some around to administer.
|
| I would be surprised if widespread availability to Narcan
| didn't decrease ODs.
| fc417fc802 wrote:
| Yes to all of the above. I knew of addicts who managed to
| get their hands on it many years ago when it required a
| prescription. Most weren't that resourceful though.
| patmorgan23 wrote:
| See as you can buy narcan out of a vending machine now, yes
| it's wider distribution probably has a downward effect on
| opioid deaths.
| greygoo222 wrote:
| The claim that fentanyl death rates are decreasing because
| fentanyl products are less pure does not make much sense. Even on
| their provided charts, deaths dropped months before purity did.
|
| The article points to a 50% decrease in purity, which a habitual
| user would compensate for by taking twice as much. Lower average
| purity also increases the risk of inconsistent purity, where rare
| batches are unexpectedly strong and carry high accidental
| overdose risk. Less pure fentanyl floating around might mean
| lower chances of unsuspecting non-fentanyl drug users being
| poisoned with it, but it's hard to see how this could cut into
| overall overdose cases.
| sheepscreek wrote:
| > article points to a 50% decrease in purity, which a habitual
| user would compensate for by taking twice as much
|
| I'll be first to admit I'm generally pretty ignorant on this
| topic but I've heard a plausible explanation for how Fentanyl
| is actually used.
|
| A medical professional shared with me that Fentanyl is too
| potent to be consumed as is. So generally, dealers use it as an
| additive. They lace other drugs with trace amounts of to make
| them more addictive. It's the MSG of drugs.
|
| So while ODing on say, drug A is possibly with 5 uses at once.
| When laced with Fentanyl, a person might OD in just 3 uses
| (because Fentanyl is much more potent than the actual drug the
| user bought).
|
| Hence, less Fentanyl = less chance of ODing.
| sneak wrote:
| Fentanyl isn't too potent to be consumed as-is, but the
| dosage is very very small. The amount of fentanyl that will
| kill you is literally invisible. The LD50 appears to be well
| under 0.01mg/kg (that is, a milligram will kill a 220lb
| person).
| fc417fc802 wrote:
| > I've heard a plausible explanation
|
| To be blunt it was total bullshit. Pharmaceuticals have an
| extremely wide range of dosages. Fentanyl is on the extreme
| low end, benadryl an adult might take 25 mg or 50 mg, tylenol
| an adult might take 500 mg, and something like amoxicillin an
| adult might take as much as 3000 mg for a severe infection.
| There are standard, extremely reliable ways to prepare pills
| that contain the correct dosage regardless of the potency of
| the pure chemical.
|
| Obviously fentanyl (or its precursor) is imported (ie
| smuggled) in highly pure form in order to minimize the size
| of the shipment. Obviously it can't be consumed in that form.
|
| The combination of being potent and cheap to smuggle lends
| itself nicely to cutting other (more expensive) products with
| it. That's false advertising but it won't typically kill you
| in and of itself.
|
| When laymen who don't know what they're doing, don't have
| access to proper facilities, and certainly can't set up
| proper quality controls process something that potent it's no
| wonder that things go wrong and people die. If (for example)
| the same victims had purchased fentanyl from a pharmacy (as
| opposed to whatever it was they thought they were consuming)
| they almost certainly would not have had any issues. Almost
| no one ODs intentionally.
|
| The point is that it's not "fentanyl is toxic so you OD" it's
| "the person compounding the pill messed up the dosage, you
| took more than you thought, so you OD". This could happen
| just as easily with any other drug. The danger here is due to
| pills not containing the dosage that the consumer believes
| them to.
| jmalicki wrote:
| Other drugs aren't dosed in micrograms. It's pretty
| believable that street labs don't having the precision to
| get reliable dosing in such small quantities. 50/100mcg is
| the typical ambulance dosing of fentanyl (where it's often
| used as the primary painkiller) - so at 500 times smaller
| than that of benadryl, it would take a reasonably high-end
| lab (at least by mid-level drug dealer standards) to not
| wildly mess up the dosing all the time - even if you mixed
| at larger scales, that still doesn't easily guarantee a
| uniform blend.
|
| It couldn't happen "just as easily" with any other drug.
| fc417fc802 wrote:
| That's "pretty believable" but it's also complete
| bullshit. Why do you feel it necessary to comment in an
| authoritative manner when you don't know what you're
| talking about? It's literally spreading misinformation.
|
| The relevant technique is called "serial dilution" and
| it's regularly practiced in intro level chemistry and
| molecular biology classes. An otherwise untrained
| undergrad, using only a pipette and a volumetric flask,
| can consistently and reliably dilute samples to nanogram
| per liter levels. The error accumulates as some
| (exceedingly small) percentage of the target value per
| dilution step so even after 10 or more steps the error
| will remain well within manageable range.
|
| The issue is not fentanyl having a power level over 9000
| or whatever other nonsense. It's people who don't know
| what they're doing, don't have access to a proper setup,
| and have no realistic way to implement a proper quality
| control regime manufacturing pharmaceuticals.
|
| Fentanyl didn't kill all these people. Objectively poor
| public policy indirectly led to the deaths of those who
| violated the law just as it did during prohibition.
| herbst wrote:
| LSD is an even smaller dose and I never heard of
| extremely strong LSD on the streets. Dealers manage to do
| their work properly.
| zipy124 wrote:
| LSD is dropped onto paper in solution though. So to
| control dose is easy since you can easy halve a dose by
| doubling the volume of solution. Dosing a powder/crystal
| is much more difficult, especially if you need to get it
| back out of solution.
| sva_ wrote:
| LSD is a powder/crystal (a salt). People just don't
| consume opioids orally, usually. There's something
| similar though: skin patches, since (other than LSD)
| fentanyl can be absorbed through the skin.
| cap11235 wrote:
| Blotters.
| jmalicki wrote:
| In context, we're talking about pills cut with fentanyl,
| in which case it is often consumed orally, mixed in at a
| very small concentration compared to the other
| ingredients.
|
| Powedered drugs like cocaine mixed with fentanyl are even
| more horrible, since there is absolutely nothing to keep
| the concentration of fentanyl homogeneous throughout as
| it is handled.
| herbst wrote:
| Fentanyl can be dropped onto a paper. As others said LSD
| is a salt, something will also dissolve fenta.
| 15155 wrote:
| Why do you think fentanyl is typically distributed in patch
| form (transdermal delivery) or highly dilute injection in a
| hospital setting?
| topspin wrote:
| It makes a great deal of sense.
|
| > deaths dropped months before purity did
|
| That's a plausible lag: credible purity figures are not sourced
| from Mexican drug cartels. They come from laboratories at the
| end of a long chain of custody complicated by legal
| machinations, dealing with contraband having no provenance
| beyond its date of seizure. That it takes only "months" to wend
| its way though the byzantine and corrupt legal system, and the
| bankers hours academic process of laboratory professionals, is
| actually admirable.
|
| > which a habitual user would compensate for by taking twice as
| much
|
| Habitual users are operating in a market, seeking value. They
| _cannot afford_ to simply double their spend, and I 'll give
| you one guess as to how quickly purity drops are reflected by
| price drops in the narcotics business, because that's all a
| person of sound mind should need.
|
| No, when the purity dropped, users paid the same and got less,
| and died less. Believe me, I understand why this finding is
| unwelcome: it serves to put arrows in the "drug war" quiver,
| and that is anathema, in my mind as well. But knee-jerk
| thinking, ultimately, isn't helpful. Further, I have complete
| faith that the ability of drug dealers and drug users of
| America to produce disturbing body counts will not be
| diminished for long.
| john-h-k wrote:
| > They come from laboratories at the end of a long chain of
| custody complicated by legal machinations, dealing with
| contraband having no provenance beyond its date of seizure.
| That it takes only "months" to wend its way though the
| byzantine and corrupt legal system, and the bankers hours
| academic process of laboratory professionals, is actually
| admirable.
|
| But... this relies on the idea that the purity numbers are
| based on "time of test" not "date of seizure". This seems
| like a pretty obvious thing they would have accounted for. Do
| you have any evidence that the published data for purity
| levels is delayed by several months?
| topspin wrote:
| > this relies on the idea that the purity numbers are based
| on "time of test" not "date of seizure"
|
| No, the idea doesn't rely on "time of test" vs "date of
| seizure". There is no real provenance for any of this.
| There is no auditable trail for when any given batch of
| narcotics was manufactured, when it appeared in the US, how
| long it took to disseminate to domestic dealers, when it
| may have been further cut by domestic dealers, when it was
| sold, and when it was actually used. Even the seizure dates
| are dubious, given haphazard and inconsistent law
| enforcement handling and record keeping. There are also
| sampling biases, because some legal jurisdictions and law
| enforcement organizations are more or less cooperative than
| others.
|
| All I claimed was that a delay was plausible. I am not
| obligated to become a narcotics market researcher in
| defense of my modest claim, and given the nature of all
| this, no amount of such effort is likely to be sufficient
| for you in any case.
| awakeasleep wrote:
| What happened to the theory that the deaths were decreasing
| because we burned through our buffer of people susceptible to
| deaths of despair? That always seemed reasonable to me.
| quixoticelixer- wrote:
| well if you read to the end of the article you might find out.
| GrowingSideways wrote:
| Surely as time goes on and wealth inequality increases, the
| number of people "susceptible" to deaths of despair will only
| increase.
|
| But this attitude smells an awful lot like the stupid person's
| eugenics. Let's not cater to it.
| xvector wrote:
| Wealth inequality doesn't cause this kind of despair. We have
| the greatest wealth inequality in history, but also the
| objectively best quality of life in history by most metrics
| (extreme poverty, hunger, starvation, death from disease,
| infant mortality...)
|
| It does not matter to me if Elon Musk makes another billion
| dollars if I am making more as well. That does not cause
| "despair" to a well adjusted person.
|
| Extreme poverty on the other hand (which has been decreasing)
| does cause these deaths. When people have nowhere left to go
| and no hope, they to turn to drugs.
|
| Mental illness is another cause. I wonder if we should have
| gotten rid of asylums.
| seabrookmx wrote:
| Surely you mean extreme poverty has been decreasing as a
| percentage of population, not in real numbers?
| xvector wrote:
| Yes of course.
| nathan_compton wrote:
| If bothers me if he spends that money exerting an outsized
| influence on my political institutions, though. Wealth
| inequality isn't really about wealth so much as _power_. I
| really don 't care if Musk or anyone else lives more
| comfortably than me, but I do care if they have more than
| one figurative vote in how my society functions.
| cryptonector wrote:
| But that does not address whether the wealth inequality
| in question causes _despair_ (it almost certainly does
| not).
| GrowingSideways wrote:
| What makes you think wealth inequality doesn't cause
| despair? Despair strikes me as the expected and desired
| effect.
| GrowingSideways wrote:
| What do you mean by "objectively"? This smells like pinker-
| esque spinelesness. Like a "you can buy a smartphone if you
| ignore the world is dying" tone.
|
| Yes, you can buy a smartphone. But most of what makes us
| care for each other has died. Why not kill yourself today,
| Sisyphus? There are fewer reasons than ever.
| whimsicalism wrote:
| I feel like actual material wealth matters much more than
| relative wealth or inequality for this metric.
| GrowingSideways wrote:
| Eh. Most costs that matter scale to relative wealth, and
| the cost scales accordingly, and we have more homeless
| people than any rich country on earth, and we have no
| community worth a damn--we have snap, medicaid, and section
| 8, and our kind neighbors are rabid to end them all. This
| is, in most ways, the worst country on earth to be poor in.
| If i were poor in cincinnati suburbs I'd kill myself too.
|
| Perhaps there's another place where poverty is a greater
| curse, though. But I would rather be poor in Burundi or
| Haiti than Ohio--at least I can sleep outside without dying
| and my neighbor won't fucking shoot me for existing. But
| this is what i get for living in the us, the place with the
| most evil people to have ever lived.
| AngryData wrote:
| I would postulate that people learning how to more safely handle
| and dose fentanyl would be the biggest reason for ODs to drop.
| defrost wrote:
| How would you explain the increase in hospitalisation,
| Emergency Services deployments, and fentanyl drug purity in Q1
| 2025 then?
|
| Sudden unlearning of aquired knowledge seems unlikely.
|
| See: Figure 1 graph set page 4 -
| https://www.science.org/action/downloadSupplement?doi=10.112...
| AngryData wrote:
| Changes in purity, especially when unknown to users, is going
| to affect hospitalizations and such no doubt, but the people
| using it also adapt to the purity of a drug over a longer
| timespan.
|
| Even if people wanted to its not like they can all just bring
| a sample of their old heroin and a sample of their stronger
| high fentanyl laced heroin and test their purity and
| calculate dosages. Which is part of the problem of the war on
| drugs, many methods of harm mitigation and recovery are
| barred from users and 90% of their drug information is based
| on hearsay or personal experience.
| defrost wrote:
| > part of the problem of the war on drugs, many methods of
| harm mitigation and recovery are barred from users
|
| That is a problem for the US, sure. Australia, where I
| live, has supervised shooting galleries and more of an
| addiction as health issue approach.
|
| That said, if you had a chance to look at the US graphs
| linked above - there was a plateau period of high deaths in
| the US of some three and half years showing no much
| evidence of users learning to "safely handle and dose
| fentanyl" followed by a sharp decrease in deaths that
| corresponds more with a change in policy than an increase
| in user knowledge.
|
| I would suggest this may be a somewhat more complex and
| multivariate issue than your initial upthread postulate
| acknowledges.
| Tiktaalik wrote:
| British Columbia declared the toxic drug crisis an epidemic in
| 2016, with the amount of deaths amounting to 6-7 a day through
| this period until now.
|
| The article's theory is compelling but given the incredible
| amount of deaths, thousands upon thousands of deaths in BC alone,
| I wonder if the rate of death is declining simply because we're
| running out of people to kill with our indifference.
| hattmall wrote:
| Killing addicts more quickly than creating new ones would
| indeed eventually lead to a decrease in drug related deaths. I
| would really believe this because I know of multiple people
| that died from ODs in a fairly short window 4-5 years and that
| spans a range of about 12 years of people. As in to say
| everyone I know age 24-36 about half of those people that were
| opiate users died from about 2019-2023 due to fent. All of them
| that I know the details of were from fake pills too, so very
| much related to fentanyl.
| gleenn wrote:
| Long term you couldn't kill more than existed, asymptotically
| the maximum number of ODs per unit time would be exactly
| equal to the number created, impossible to be more.
| cryptonector wrote:
| By allowing fentanyl to kill so many so fast we might be
| (almost certainly are) selecting for those who are less
| susceptible for whatever reason (less susceptible to
| addition, less susceptible to even beginning to go down
| that road, more surrounded by loved ones willing to act,
| more biologically resistant to the killing effects of ODs,
| etc.).
| fc417fc802 wrote:
| > running out of people to kill with our indifference.
|
| I wouldn't call it indifference. It's the drug policies that
| we've very intentionally adopted in the west that result in
| people purchasing from the black market. It's about as
| indifferent as the deaths due to denatured alcohol poisoning
| during prohibition when the additive was silently switched.
| mmooss wrote:
| We know these policies result in mass deaths; we know other
| policies result in many fewer deaths; we choose the former
| policies.
|
| I think that is partly because enough people consider those
| addicted to drugs to be subhuman - enough don't care much
| what happens to the addicted people. IMHO in that's because
| we a large political movement encourages indifference to
| those different from us, whether the difference is race,
| politics, gender/sexuality, nationality, or anything else.
| whimsicalism wrote:
| What policies? Not legalizing heroin or other opioids?
|
| I am not convinced we can claim what you think with any level
| of confidence.
| paganel wrote:
| The article does allude to that as possibility towards the end,
| even though it's not included in the paper on which its primary
| focus is.
| diogenescynic wrote:
| And when supply catches up, overdoses will spike because addicts
| tolerance will have decreased.
| wtcactus wrote:
| So, statistics clearly show that limiting drugs supply actually
| works, unlike what the hard left has been saying to us (backed by
| social "sciences") since the 2000s?
|
| If we just listened to common sense instead of these people,
| society would be saved from a lot of pain.
| lazyeye wrote:
| Perhaps the closure of the southern border a year ago might have
| played some role in this.
| zzrrt wrote:
| I wonder if Trump pardoning multiple drug dealers will also
| help. MAGA doctors must have figured out that drugs from
| political allies or "donors" are doubleplusgood for Americans.
| /s
| cm2012 wrote:
| 2025 is not even in the dataset so no
| bdauvergne wrote:
| Maybe they completely reversed the causality, it's a demand shock
| not a supply shock. There are less users because they died, and
| they died pretty fast compared to previous opioid users. As
| demand diminished there was over supply and to maintain their
| margins provider had to lower the supply. QED.
|
| As it's a pretty simple hypothesis to test and that it was not
| maybe imply that the conclusion is politically motivated. Supply-
| shock imply that something was done and it worked, but that the
| problem solved itself is not as palatable for someone politically
| motivated like an administration.
| cryptonector wrote:
| > As it's a pretty simple hypothesis to test
|
| How would one test it?
| jimnotgym wrote:
| This suggests to me that the government could reduce this even
| further by simply outcompeting with illegal sources.
|
| One problem mentioned was that other drugs were being laced with
| fentanyl. Simply supply a licensed, guaranteed clean version
| through a legal source at a lower price?
|
| Then people who want actual fentanyl, supply that in the same way
| too.
| whimsicalism wrote:
| And how do you know this wouldn't result in significantly
| expanding the number/frequency of drug consumers?
| jimnotgym wrote:
| Coffee is legal in my country, but I don't drink it. Alcohol
| is legal, but I drink it infrequently and in moderation. I
| can get codeine over the counter, but I don't take it every
| day.
| whimsicalism wrote:
| i don't find this a compelling argument and i think it
| undermines the case for the policy you are proposing.
| jimnotgym wrote:
| Could this effect actually be more of a customer service effect?
|
| Drug dealers were lacing things with fentanyl to make them more
| addictive. They were putting too much in and killing people by
| accident. This was bad for business in 3 ways
|
| 1) they could have saved money by using less fentanyl
|
| 2) they were killing their customers, as well as reducing the
| customer base this has a reputational risk.
|
| 3) They were attracting too much public interest in their
| activities
|
| Therefore they found that they make more money by putting less
| in.
|
| Not a drug expert, don't live in US, never took fentanyl. I just
| picked these 'facts' out of the comments. Before anyone says,
| 'you don't know what to you are talking about' in the sweet way
| that has crept into hn, I really don't, and don't claim to.
| christina97 wrote:
| The problem with fentanyl is not that people are putting in too
| much. It's that it's extremely potent so it's too easy to
| accidentally put too much in.
| hobom wrote:
| So the problem IS that people are putting in too much (even
| if accidentally) ?
| 15155 wrote:
| The problem is that the typical delivery mechanism for this
| drug is a highly-dilute injection or transdermal patch -
| not 'geometric' dilution into pills in Jose's basement with
| questionable fillers.
|
| The substance is too potent per physical unit of weight and
| volume to be conveniently dosed through other means.
| saidnooneever wrote:
| maybe all the addicts are running out? know it sounds like a
| troll but with very high death rates on newer drugs... is it
| really a crazy idea?
| topranks wrote:
| I wonder if the eradication of the heroin supply from Afghanistan
| following the Taliban takeover has had an effect?
|
| Possibly re-directed some of the fentanyl to other markets where
| addicts could no longer get heroin? Thus reducing supply
| elsewhere?
| ciropantera wrote:
| At least in Europe the heroin gap was mostly filled with crack
| from Latin America.
| phtrivier wrote:
| How good is overdose _deaths_ as an indicator of the epidemic of
| drug consumption ?
|
| My point being : killing your customer en masse is bad business
| practice in the long run. (Or even in the medium run.)
|
| So, the drug dealer's best interest is to reduce the potency of
| the drug, therefore limiting the overdoses but keeping the
| customers alive, and willing to get the next dose.
|
| If it happens when the prices are high, and you're able to cut
| your product and see it with a higher margin, it's even more
| value for the sharehol... Sorry, wrong analogy.
|
| Anyway, is the number of people _using_ fentanyl also going down
| ? Where are the quarterly sales number published ? What's the
| trend ? When is the IPO ?
| asah wrote:
| Drug trade participants don't consider the long run.
| bitmasher9 wrote:
| Some drug trade participants do consider the long term.
| Specifically production and bulk transportation benefits from
| large long term investments.
| simianparrot wrote:
| Gee I wonder why. Maybe controlling your borders actually helps
| prevent illicit goods from entering your country? Crazy take I
| know, can't be true because it's the T man that's behind it
| _bohm wrote:
| The reasons stated in the article have nothing to do with
| border enforcement, and observed supply shock started before
| 2024. The most recent year of data mentioned in the article
| ended in April 2025. But by all means, if you have information
| these researchers don't, feel free to share it here.
| seanalltogether wrote:
| This has been talked about lately, the drop has nothing to do
| with trump. The data in this chart goes up to Oct 2024, several
| months before trumps took office.
|
| https://cdn.jamanetwork.com/ama/content_public/journal/jaman...
| sigwinch wrote:
| Right, these are Biden's policies. Biden was superior on
| border and immigration issues.
| lostlogin wrote:
| Yeah, he never got anyone shot in the face.
| simianparrot wrote:
| That's good then the situation ought to be even better now.
| mb7733 wrote:
| > Canada has a similar opioid epidemic but a different supply
| chain, largely skipping over Mexico. Because Canada saw similar
| falls in fentanyl strength, the researchers hypothesise that
| the supply shock was caused by something changing in China.
| newsclues wrote:
| It's nice when the government has a leader committed to keeping
| drugs out of the country
| croes wrote:
| It started 2023. who was the leader back then?
| srean wrote:
| And offer presidential pardons to those who sell it inside,
| illegally
| sigwinch wrote:
| I can't tell if GP is wry about Biden, or committing Type I
| error over Trump.
|
| But yes today the questions are about how we treat
| politically-connected smugglers. What are the odds on a
| Justin Salsburey pardon?
| cramcgrab wrote:
| Stop taking drugs, get out and enjoy life. It's really pretty
| simple. Most of society works that way.
| grantith wrote:
| Black & white thinking is easy. Nuance is hard though and might
| even lead to empathy.
| realo wrote:
| Some drugs, like opioids, create a physical addiction. Their
| body cannot function without the chemicals.
|
| Saying "Stop taking the drug" to those people is equivalent to
| saying "Stop eating". The body cannot physically function then.
|
| Nicotine is also a chemical that induces a physical addiction.
|
| Surprisingly, THC (marijuana) does not, apparently... Someone
| can stop cold with no physical issues, only psychological ones.
| hwguy45 wrote:
| The kneejerk explanation would be the more strict border and law
| enforcement under the current administration. But the chart peaks
| in Dec 2023 and drops in 2024, so it cannot be that.
|
| Perhaps, then, it was Kamala Harris' success as border czar under
| Biden.
| _fat_santa wrote:
| Enshittification sucks but turns out a very certain type of
| enshittification is actually good for society.
| indrora wrote:
| Discussion by an author on the paper:
| https://unrollnow.com/status/2009340857909170395
|
| Original:
| https://x.com/KeithNHumphreys/status/2009340857909170395
| amai wrote:
| tldr; "China began warning chemical/pharma companies, closing
| down websites & tightening chemical controls in 2023. It is
| likely if not certain that China's actions disrupted the fentanyl
| trade in both the US and Canada"
|
| https://unrollnow.com/status/2009340857909170395
| znnajdla wrote:
| That example of "shrinkflation" sounds like plain old fraud to
| me. Having a dimple at the bottom of a peanut butter container so
| it looks like it has more than it does should be illegal fraud,
| plain and simple.
| whimsicalism wrote:
| the containers say how much volume they have and usually are
| sold with a unit price as well. seems like a much simpler and
| general solution than defining some legal shape of jars
| yatopifo wrote:
| The real issue is that those dimples prevent you from getting
| the last bit. I also find it very annoying that in Canada
| quantity is often reported in ounces. Aside from the troy
| ounce, i have absolutely no idea how much an ounce is and
| whether it measures volume or mass. The only reason we still
| have ounces is because of trade with the US. Since no
| Canadian should be buying US made stuff, we should just ban
| most non metric units at this point.
| whimsicalism wrote:
| moral Canadians should probably also refrain from
| participating in any American-run website like HN
| nathan_compton wrote:
| I don't know - its very easy to buy what looks like the same
| jar and find it has less. The consumer should not be expected
| to be some fucking food detective, constantly working to make
| sure that they aren't being ripped off. Packaging should be
| simple enough that the volume presented to the purchaser is
| the actual volume.
| whimsicalism wrote:
| unit costs should be larger on the label. as large as the
| standard price
| cmiles8 wrote:
| tl;dr blowing up boats in the Caribbean and other aggressive
| actions, while controversial, has probably done more to address
| the drug pandemic than other things tried.
| mrkramer wrote:
| From what I've seen homeless people overdose the most with
| fentanyl and homelessness level increased during COVID so they
| were the ones overdosing. Also everybody knows by now that one
| pill can kill you so that's good enough deterrent.
|
| The opioid epidemic was caused by COVID pandemic and its
| devastating economic effects and also by cheapness of the
| fentanyl pills which were going as low as $1 a pop on the
| streets.
___________________________________________________________________
(page generated 2026-01-11 23:01 UTC)