Just the other morning I got off of bart in downtown Oakland, 12th street and there was a guy just laid out, unresponsive right on the steps outside the station. He had smoked something out of a can. I stuck with the guy while the paramedics came, but the most tragic part was that he had a plastic "No Allergies" bracelet on. When the paramedics took off his shirt he still had adhesive on his skin from the EKG straps or what not. So he had gotten out of the hospital and then immediately ODed (presumably again).

I'm not sure what we need to do, but if you haven't encountered the epidemic first hand, it's only a matter of time until you do.

The greatest argument against the death penalty is that it's not applied to the people that deserve it the most. Not only did the pharmaceutical industry earn billions by pushing addictive opioids to people but they also charge people up the nose for the injections they need after they OD'ed because they got addicted. People are still getting filthy rich literally over other people's deaths. In the name of health.

I know a lot of people love capitalism here and I think it works pretty great if you apply it to a lot of markets. But health isn't something that can be regulated by capitalism.

You can buy the new iPhone or you don't. It's a decision. You can make a stupid decision and buy it while you really should feed your kids instead but it's still a decision.

Health issues are not. Nobody decides to have cancer next year because this year things look a bit uncertain at work right now. It just hits you.

Free markets only work when somebody is free to decide.

My experience originates in South Africa. All my friends did coke - it took, in some cases, years to get them off of it. One thing I learned is the barrier of "it's a problem." A few quit entirely (citing biological/logical reasons), almost the rest now use it on occasion - I don't give them hell for that. If someone goes on a drug-filled festival for 5 days (think Burning Man), it's a legitimate experience (that I am entirely unfamiliar with).

I think that's the key: shades of grey. At one point I was very seriously alcoholic but pulled myself out of it; I still concede to social situations. It's not a problem, it's a momentary span of blissful negligence followed by a day of sorrow (that I'm fully dreadful of while drunk).

I'm not special in any regard. I was absolutely lucky enough to realize these things internally. Here's the scary thing:

I spent every living weekend at my friends' digs in South Africa, years and years. It took me a long time to learn about their drug habits. The very first friend candidate that I have met in Seattle has guaranteed that he will get me on coke in no time.

It's an epidemic for absolute certainty. I failed to resolve a single friend's addiction and it still haunts me - what am I going to do with thousands of people who are convinced that there is no problem?

Seattle has a big problem. We are telling addicts to come get their fix safely (which I deeply applaud), but are not attempting to understand their motivation.

Is there any charity making an actual difference that I can volunteer at?

Serious questions...if you’ve used an opioid more than once for recreational purposes, I’d like to hear (1) what prompted you to try it (2) how old you were (3) cost (4) where did you get them (5) why did you stop

Treat me like an idiot, I don’t understand this stuff and I’d like to know more.

* obviously feel free to use a burner account if you’d rather not speak publicly.

There was a very good Louis Theroux doco (Dark States) set in Huntington, West Virginia a couple of weeks ago about the opiod epidemic.

It really hit hard with me for some reason, despite never having first hand contact with anyone with this sort of addiction. In particular, a man who was apparently a pentester before having some sort of accident and becoming addicted to prescribed opoids before transitioning onto illegal drugs. It just felt like something that could hit anyone, and not just the standard "junkie" problem.

> Local jails have been overrun with people locked up and in need of treatment

Why. Do. People. End. Up. In. Jail. Seriously this one is beyond my comprehension - they need treatment, not jails filled with hardened criminals, rapists and probably more (and nastier) drugs than on the street.

This is just so sad.

It costs less to prescribe drugs than to diagnose and treat underlying problems. So the American profit-driven medical system relies heavily on drugs, especially for poorer patients. And drug companies love addictive drugs. So we get lots of opiate-addicted patients.

And then there's the "drugs are evil" mindset, which justifies criminalization. Even preventing pain is too much like having fun. So it's better for addicts to OD than get safe drugs. Because they deserve it, or whatever. They should just suck it up, walk it off, ...

So it goes.

This reminds me that the lead singer of GWAR died in Richmond from a heroin overdose in 2014: https://en.wikipedia.org/wiki/Dave_Brockie

The "iron law of prohibition" teaches us this: prohibiting a substance drives out all but the most potent forms of that substance. Back during alcohol prohibition in the US, people made, smuggled, and sold "white lightning" not light beer.

In the case of opiods, the most potent forms are stuff like street fentanyl and oxy 80s pulverized. Milligram mistakes in dosages of this stuff are very dangerous.

The iron law leads to a paradox: decriminalizing a substance makes it safer. Obviously it's more complex than that: addicts need access to safe supplies of the substance. But it's still true.

But keeping opiods criminalized is, basically, makework for law enforcement and public safety people, not to mention people with names like El Chapo.

Switzerland and Portugal are having good success with decriminalization and treatment. Juristictions who don't need anything in the way of foreign aid or other cooperation from the USA are in the best position to do this.

Source: Chasing The Scream, a book by Johann Hari.

One of the Pittsburgh papers just ran an excellent, in-depth article about something very similar, happening in one particular neighborhood of the city: https://newsinteractive.post-gazette.com/riding-od-road/

The opioid epidemic is huge. Legal Cannabis is helping in some places, but it's still illegal at the federal level.

My country had a heroine epidemic in the 80s and early 90s. One of the root causes was a shitty economy and chronic unemployment.

All you can do in the end is try to keep things contained. They opened special places were junkies could use their drugs so that they wouldn't have to OD on the streets.

You can't fix someone unless they WANT to be fixed.

Interesting coincidence that Richmond in Melbourne, Australia, has just been announced as a location for a supervised injecting room. This Richmond is also a hot spot for heroin usage, dealing, and overdoses.

Most of this stems from the overprescription of opioids. I remember when I had surgery for a broken leg the amount of drugs I received after the surgery was astounding. It was almost as if the hospital wanted me to become hooked. I didn't need or ask for the opioids, they were just prescribed for pain killing. A regular Tylenol or Advil would have done the job. Not saying hospitals want people on drugs, but at some point we have hold the people initially prescribing the drugs accountable.

Talk to the leader of any emergency room staff and this is how it works in most cities.

Another reason to charge more for working in a big city, since smaller rural cities don’t have this problem as much - like the middle of nowhere in Montana versus Seattle.

There are many places around the world called Richmond, and even if we assume it's in the US there are still 16 places called Richmond[1].

I wish people were more specific, particularly when reaching an international audience without an innate understanding of places in the US.

[1]: https://en.wikipedia.org/wiki/Richmond

And nothing of value was lost...

PLEASE READ AND PUSH TO THE TOP!! this is a direct result of the war on drugs. the fentanyl and carfentanil coming from china are responsible. before these two were being imported at such high rates opioid deaths were 4,000 per year vs 400,000 for alcohol. Which at first was being blamed on fentanyl being prescribed legally, but was incorrect data. Check the numbers yourself at wonder cdc. attached is the screenshot form cdc data. https://imgur.com/a/fFBTe

Maybe all these drugs being dumped in USA is really part of an evil plan from an enemy nation to destroy this country by destroying its people. Check out this book "Red Cocaine" to see how cocaine traffic started in America.

You argument that nobody decides to have cancer is true but it applies to tons of stuff. You don't decide that your car breaks down. You don't decide that a storm is coming. You don't decide the change in import controls for goods from China. There are literally millions of things that you don't decide.

The very reason we have capitalism is that we have dynamic system that reacts to feedback and finds or at least moves the system towards a new optimal point given the new circumstances.

If there is a operation that exists free market would make that operation as cheap as possible and weather it is your decision to need the operation or not, you will still get a very cheap operation. For the market is irrelevant why the demand exists, but it will attempt to satisfy that demand and we are all better for it.

So the problem with opioids is about demand.

People should trust doctors to give sound advice regarding their opioid consumption, as they do with many other things. The majority of people don't want to be addicted and are happy to comply with measures.

There are a couple problems, first, the doctors primary earn money by selling stuff thanks to the perverse system of intensives that the modern american health care system produces.

Second, there was a actual problem where doctors in the US, by themselves started to over-issue these drugs, and they still do. That is as much a cultural problem as it is anything else. This has to change.

Third, I think its pretty clear that the distribution and demographics about this issue tell a story that is hard to explain by a general 'evil capitalist' pushing pills on people. It is clear that some communities are dis-proportionally effected and that is a more deterministic factor then the price of the pills.

Fourth, if there were actually free markets people would buy high quality product that does not kill you. People who take it might be addicts but you can be high functioning and your chances of recovery are much better then with this disgusting stuff people are forced to consume because of government regulation.

You know this problem is not really prevalent in places with legit healthcare systems, Europe amongst all ? And that we don't pop opiods to all suffering patients, ie we can allow things to hurt a bit sometimes it's not that big a deal, and it's surely better than getting hooked to stuff.

Why blame the pharmaceutical industry. Your practitionners and your patients have a problem.

Our healthcare is commically not a capitalist one. You make a blanket claim that healthcare can't be regulated by capitalism.

I'd argue if the U.S. had a health care market closer to Iran or something it would actually be better. Like, I should be able to sell my organs if I want. I should be able to buy weed instead of opiods. And so on... Then look at all the medical doctors graduating. Their numbers haven't changed since the 90s, because then they make more money due to scarcity.

Can chose to not use heroin and other drugs - like most of society had informed you - and there is infinite amount of data available to anyone looking.

1) In college, I discovered I loved recreational substances. My best friend was a closet heroin addict and convinced me to try it. 2) 19 or 20 3) 90 to 200 USD per gram. Towards the end, I was spending upwards of 3000 a month. 4) Through my friend at first, but I quickly developed a network of dealers. 5) My entire life had been reduced to obtaining and consuming heroin. I didn't stop when my best friend died, I didn't stop after three overdoses throughout the years. It took an indescribable amount of self-loathing, loneliness, financial insecurity, and general misery for me to realize I couldn't go on like this. I sold almost everything I owned and moved a thousand miles away to live with my parents and try to get my shit together (still a work in progress)

1: I had a severe burn on my crotch (FML) and was prescribed. Funny thing is I KNEW I would become dependent. I'm an addict. sober from cocaine and alcohol (was sober from coke for a couple years before pills, ironically opiates helped me quit drinking which was a big struggle for half of my 20s). No hyperbole, every relative on my fathers side of the family is an addict, going back generations. My dad is an alcoholic, my mom has some mental issues which when combined together are a recipe for addiction (I have bipolar 2 and my mom has depression among other things). I purposefully avoided opiate meds because I know my addiction struggles and knew I wouldn't be able to just take a few pills I would end up taking them for a long time. But, god damn that burn fucking hurt and it's hard for an addict to say no especially when I couldn't fucking walk or sleep. I kind of question why my doc prescribed, even though I know she was just trying to help. We literally just got finished talking about cocaine and struggle to get sober and then she prescribed Oxy... I don't blame her and I also think there is nothing to gain by blaming myself, even though yes it was my choice to take that first pill I don't think it was my choice to be an addict if it were that simple I wouldn't be an addict. blame doesn't serve a point, just like blaming oneself for getting cancer or having bipolar disorder. However I do think Docs still need to improve more and just help patients get through pain without take home pills. Weed helps, fuck Tylenol can be very very effective and being in pain for a week is much better than being dependent on a pill for the rest of your life imho.

2) 24 I tink

3) free prescription no co-pay! Then off the street about $1 per mg of oxy, online and in bulk I can get it for about $.66 per mg

4) originally from a doctor. Then from my coke dealer. Then from the dark net.

5) I haven't been able to stop for more than a couple days

I didn't "work my way up" from prescription drugs. I have debilitating depression, to the point where I can't get out of bed most days. I can't say I have much to live for, honestly. I am just functional enough to realize that I am deeply unsatisfied with my life.

I've tried many different antidepressants. My psychiatrist told me that if the next few medications didn't work, he mentioned that I might want to consider electroshock therapy.

I tried heroin with my brother a few years ago, and I got high of course (so my opinion is admittedly skewed,) but it just gave me a couple precious hours of what I imagine it life could be. I work in fintech, so I have to take drug tests, but I've used it off and on since.

I don't want to be high. I just want a life where I actually want to live, an "aspiration" I've had for years.

Maybe my desires are even more skewed due to having gotten high, and knowing that I will forever have a "high bar" for however good it made me feel, but in general it just feels like the quote says, "It gives you a taste of heaven and drags you down to hell." But I was in hell already.

OK, I'll bite.

I take milder prescription opiates just for fun on rare occasion. That's percocet these days, codeine back in the day.

Only opportunistically though, if I have some left over from a medical reason or someone offers me some. Even then, it's very infrequently. I currently have around 12 percocets that have been sitting around, untouched, for a couple of months now.

I usually don't feel like just lying around and staring at the TV with my mouth open, hence I don't take them. One day though I'm sure I will feel exactly like doing that, at which point might as well add some opiates to make it quite a bit more enjoyable. I usually like to take 2 or 3 with a moderate amount of alcohol, they have a synergistic effect together.

I first tried it around 17, and that was almost 20 years ago. We're talking relatively few occasions over all that time: 0-2 occasions most years, some years more like 4-6, and rarely if ever 6+. I've never seeked it out on the black market or anything; the cost would not be close to worth it, I think. I don't know how much exactly, but surely several times more than medical, where I paid $10 for 20 pills.

I didn't stop, I just don't feel like doing them, most of the time. I have had issues with addiction to other things in the past, but not with these.

That being said, they are quite mild compared to OxyContin, which I think is what most addicts are taking. (Same substance, oxycodone, but much lower dose.) Never tried that stuff but I bet it is a LOT easier to get into trouble with those.

1) Because they're fun and I was bored 2) Most of my pill days were when I was in high school. I haven't sought out pills since but have been prescribed them when I've had surgery 3) It was just recreational (a hydro or oxy here or there) so the cost was low ~$1/mg for oxy. Obviously if you're addicted then $30+/day is crazy, but once in a blue moon it's no different than going to the movies or grabbing a cheap dinner 4) My friends/neighbors who sold drugs or from the good ole medicine cabinet 5) I'm not really a big fan of the feeling.

I took opiates and other drugs to mask emotional pain. No doctor prescribed my first dose. No peer pressure was needed. My life had been absent of happiness, the first time I took a drug, it was as though the world rendered itself in colors other than black and gray. I haven't done any drugs other than weed for at least 5 years now. But there was a good 40 plus year period in which I did opiates daily. My biggest mistake was getting on a methadone program, that was a twenty year addiction that made heroin withdrawal look easy. It took 2 years of incarceration to end my methadone addiction.

I first used heroin when I was seventeen in 1972. It was the first time I had tried an opiate. At the time Heroin was pricey at $30 a bag/dose in the Boston area. Around 3 years later, I went to Phoenix where Heroin was $10 a bag. Taking a ride across the border to Nogales lowered the cost to $5. Making approx. $100 a week back then, a habit wasn't possible until I found lower cost drugs. These days I feel happier than I could have imagined. While opiates never really made me happy, They decreased my misery at times. As bad as all this sounds, I thank drug addiction for allowing me to survive until I learned how to live.

1) Technically my first exposure was oxycodone from wisdom tooth surgery. I didn't really appreciate what a lucky windfall it was at the time, but thoroughly enjoyed it all. Afterwords I occasionally bought or traded for synthetics, heroin and opium when it was convenient. Having sampled pretty much the entire family, I would have to say that hydromorphone/oxymorphone are my favorites, and codiene is not worth taking at any dose, unless for diarrhea relief. The heaviest period of use in my life (w/ physical dependence and a mind prone to "addiction logic") was in grad school, and I haven't used any opiates at all for probably 5 years, but I would happily consume opiates if it was something I felt like doing (much like I feel about doing acid, going camping, playing a videogame etc). I occasionally used IV but the risk of systemic infection and the ugly needle tracks are not so nice.

2) 16-18, mid thirties now

3) Rarely too much, but when I did lots of heroin I ate less and paid for less other entertainment so I guess it evens out

4) Wherever convenient, usually through my social network

5) I just don't care enough to go to the effort. Nice high, excellent for doing work and being social if I dose reasonably. But other things are nice too. Regarding being social, I can take e.g. oxycodone for multiple days/events in a day, but I cannot take MDMA several times to any useful effect. Regarding work, it's good for long sustained bouts of work as it is easy to gently daydream about problems for any amount of time and it's easy to work for hours because I feel great and free of distractions. The side effects of constipation (I LOVE pooping), appetite loss (I like eating), bad sleep (it's really good for you) and apathy towards sex (bad, except for those unfortunate periods in life where it's good) are all worth considering. Generally, it's difficult to maintain ones quality of life and also do boatloads of opiates, just like anything else. It is very easy to find out oneself doing boatloads, though. Regarding addiction-- Tolerance and withdrawal are not currently considered necessary and sufficient for "addiction." It's considered a behavioral phenomenon. A bad case of the flu is much much worse than a bad period of withdrawal. Regarding the behavioral stuff and desire-- Dealing with unwanted desires is a good skill to have, I guess, and I'm lucky I don't want it very much. It is more effort to do more than it is to do less. But every step into "addiction" is infinitesimal and reversible, and every step out of "addiction" is equally infinitesimal and reversible, though you might notice it more.

I can only speak to Heroin, not prescription painkillers.

1) I had tried just about every other drug, and I felt at that point like they had been unfairly demonized. A high school friend was doing heroin, and so I wrongfully assumed Heroin would fall into the same category. I was pretty young.

2) 14

3) My usual habit for the ten years of my addiction was around 100-150 a day. I simply couldn't find a way to reliably get more money than that.

4) Drug dealers that I knew or in downtown areas. (West Coast)

5) Life was untenable. I was thrown into a detox for one last time and then six months of rehab. It stuck this time, it's difficult to say why.

I was not, as seems to be the common case these days, drawn to opiates after a major surgery or chronic pain. Nor was Fentanyl / overdose rates nearly as bad as they are today.

Hope this helps?

Took a few at once of my hydrocodone prescription from a wisdom tooth removal (only two of them at once) at 18 to 20 or so, then did the same thing next time when I had the other two removed. No idea what their real cost is besides the copay. Just wanted to see what it was like. I don't think I really got anything out of it besides a bit of a placebo effect. Didn't seem very appealing.

1. novelty, why not?

2. early 20s

3. de minimis. $12-20 total for dozens of doses of kratom, shipped usps.

4. internet sellers.

5. define "stop?" i continue to use them irregularly. opioids have a very nasty side effect of bad constipation (silver lining: it's a strong encouragement to eat lots of vegetables), so it's not really something you can just use every day. at least for me, that kind of makes use self-limiting.

also, opioids just aren't that great. they're very effective at killing pain, but if you aren't in pain, you don't notice that. beyond that, the high is imo really subtle and easy to forget about. in contrast, with weed, alcohol, lsd, shrooms, mdma, adderall, whatever, you know you're high during the experience.

1. Typical prescription route. Thought I'd "never" do heroin. Tolerance grew and grew, and after realizing it was basically morphine (which, I had had prescribed before), it seemed less scary. I didn't seek it out, but literally found a gram on the ground and immediately realized that this was the best ROI for releasing pain (both the physical pain and the pain of living.)

2. 22

3. Currently can get a really good quality (lab tested) gram for $50; this is cartel type pricing

4. Doctor, darknet, in person

5. I haven't. I should, most likely. I should let my tolerance go down but I'm so, so scared to be stuck in bed with pain off the charts combined with the temporary depression.

1. Sounded like a laugh

2. 23 to 25

3. $8 for a packet of paracetamol/codiene plus a few dollars for coffee filters, $10 for 10 tramadols

4. Pharmacy for the codiene, friend gets the tramadol online from India

5. I didn't really get what the whole fuss is about, it wasn't that fun, and I know anything harder than those is a dark dark path that I have no interest in travelling down.

1) I'll try any drug once, all my friends in highschool experimented with a lot of drugs and I enjoyed the shared experiences.

2) It was either senior year of highschool or right after, so around 18

3) Varied, but usually it was $30 for an 8mg dilaudid

4) Everyone I knew had at least one dealer for some drug or other, it was possible to get anything just by asking around

5) Got bored of it

It's mostly people that started medicating for chronic pain.

Like my uncle says, a cop, "what would we do then". Drug & alcohol related arrests are 99% of their work.

In SF and some surrounding areas, all those arrested have their case reviewed prior to arraignment by an agency that will try to place them in a program for recovery; an alternative to jail. SF is doing an OK job funding this effort, and it does make a difference both in outcome and burden to taxpayers (less expensive than jail bed days)

It's a long story. https://en.wikipedia.org/wiki/Deinstitutionalisation#Consequ...

And if a drug addict doesn't want treatment? The elephant in the room is forced intervention requires a form of imprisonment.

Like that one guy weef or weev, the iPad exploits guy, who went to jail and came back as a white supremecist. Was quite surprised to read that, worse thing is he wasn't in prison like 10 hard years or anything extreme, he was in there a minute though. Oddest thing I ever read.

On the other hand... Norway has some of the nicest prisons in the world. Worth checking out prisons in Norway if you never heard of how nice they are.

I suspect it's a result of "blanket" thinking - if we don't punish $illegal_behaviour, then people won't stop doing it. Unfortunately in this case, the punishment is the same as the punishment for just about every other crime and for this particular issue it's less of a punishment and more of a catalyst.

A middle ground would be a good solution IMO - some kind of jail-esque treatment center or set wings in existing jails just for drug users where they undergo some sort of treatment/detox program. I daresay in a lot of cases, voluntary treatment isn't going to work, and I suspect a lot of treatment centers out there now are nowhere near as secure as a jail.

Some of them are probably there for crimes like theft prostitution and selling to sustain their habits. Another significant part would be those who violate parole or drug treatment programs.

War on drugs & big government.

> Why. Do. People. End. Up. In. Jail.

Ask the politicians that own large stakes in (or have ties to) corporate-operated prisons, and you'll find your answer.

Some people do need to end up in jail, but their last name is all over charitable foundations and art galleries worldwide. http://www.esquire.com/news-politics/a12775932/sackler-famil...

Right wing idiots pushing a failed war on drugs. Keep electing republicans, keep getting the same garbage. Can anyone point to a republican who is advocating sane drug policy (genuinely curious?)

It's incredibly easy to get hooked when taking prescription opiates even if you're fully aware of the situation. I had a wisdom tooth extracted last year, and by the time the pain was finally down to the level I could manage with OTC pain relievers I realized I had developed a mild physical addiction to the hydrocodone.

I had no desire to get high off the pain killers, hell, they didn't even do anything for me in that regard - but I could feel the need to take them. I can easily see how someone without the awareness, willpower and a number of other factors could give in and start down the path of self-destruction. It was a terrifying place for me to be in, and as someone who has responsibly taken prescription opiates for multiple other oral surgeries as well as a septoplasty it was one I never thought possible.

What makes you say that? It's trivial to get opioids on the streets and it's common to be introduced to them as a recreational drug, as I know first hand.

In fact, I don't know anyone who got addicted to opioids due to overprescription, but I know several people who didn't get prescribed opioids they needed because of the fears of overprescription, and thus were left in terrible pain. I don't know how you draw the line, but I think it's evil to leave people in pain because you're afraid they'll use the drugs for fun. Most people who take opioids do not get addicted.

If you've been around long enough you'd realize we're come full circle. Prior to the 1990's pain meds were very rarely handed out.

Then a few things happened: (1) more data was collected that suggested when used for severe pain, the addiction potential was low, (2) adequately controlled pain leads to quicker recovery times and (3) there was a lot of untreated pain at the time.

As a result, opioid use when way up. One could argue it went to far with very strong opioids being given for mild or moderate pain.

The sad thing is that we're already seeing doctors get more stingy with opioids. My guess is we'll swing too far in the other direction and in a decade we'll have people with severe, incurable cancer pain being told "you don't need opioids".

For more background on why we've got a dope problem, check out this LA Times piece on Oxycontin's 12-hour Problem:

http://www.latimes.com/projects/oxycontin-part1/

Untrue. this is a direct result of the war on drugs. the fentanyl and carfentanil coming from china are responsible. before these two were being imported at such high rates opioid deaths were 4,000 per year vs 400,000 for alcohol. Which at first was being blamed on fentanyl being prescribed legally, but was incorrect data. Check the numbers yourself at wonder cdc. attached is the screenshot form cdc data. https://imgur.com/a/fFBTe