Heroin epidemic

z31maniac wrote:

4cylndrfury wrote: Narcan is killing as many people as its saving.

Let's keep the conjecture out of it. If you don't have a solid info to back up that claim I'm calling BS. I'm with Alfa, it's a health issue. And rehab and education are a much more effective and cheaper route than incarcerating non-violent drug offenders. I suggest starting your research with Portugal's decriminlization model.

Fair enough. Youre right, I have no numbers, so I deleted that portion of my post. I cop to overstepping if Im called out. But, its my impression that the assumption of safety leads to more reckless behavior.

Here's a good start:

https://news.vice.com/article/ungass-portugal-what-happened-after-decriminalization-drugs-weed-to-heroin

https://www.washingtonpost.com/news/wonk/wp/2015/06/05/why-hardly-anyone-dies-from-a-drug-overdose-in-portugal/

Do we have a correlation between areas with legal/non criminalized marijuana and areas with heroin problems? There is a group that gets hooked on prescription opioids and moved out to heroin, and that's a problem to solve through the medical community, but for pure recreational users, is having an alternative that is legal and available able to alleviate the problem?

petegossett wrote: [the increase in heroin use] is compounded by the growing despair brought on by trying to survive in an area with few good jobs - especially ones not requiring an education.

facepalm

mazdeuce wrote: Do we have a correlation between areas with legal/non criminalized marijuana and areas with heroin problems? There is a group that gets hooked on prescription opioids and moved out to heroin, and that's a problem to solve through the medical community, but for pure recreational users, is having an alternative that is legal and available able to alleviate the problem?

Curious about this as well. If Johnny and Jane Addict can legally smoke up with no worse side effects than a bad case of the munchies and a burning desire to listen to jam bands, are they actually less likely to chase the dragon?

I'm not seeing opioids over prescribed. Perhaps at one point, but the feds have come down so hard that today physicians won't prescribe narcotics even when warranted. It is probably significantly easier for someone to get a narcotic illegally than to get one legally, even if medically needed.

I've had heroin addict patients. And known people that were addicts in the biker community. I had one patient that was a junkie for something like 20 years, and still had all his veins. One week in the hospital and the nurses managed to blow them all.

I haven't worked an ER is a long time now, so I can't comment on current trending, but those people are not thinking about their own best interests. Clean needles. Right. They don't give a E36 M3 about themselves, why does anyone think that offering free needles will help reduce blood born illness transmission? Like that idiot shooting up with his foot on the brake. Unbelievably stoopid.

Anyway, as I have said before, it should all be decriminalized and given away free. But always give away LD100 quantities, with a warning: "Don't take it all at once, wink wink." The problem will take care of itself. And yes, part of the problem is directly related to Afghanistan. The Taliban had banned opium poppies. World heroin production (and use) was way down. Then we bombed them and put a new regime in that let the heroin flow. Unintended consequences.

In reply to mazdeuce:

I don't have solid numbers, just some experience.

California is still the land of meth and pot. There's a lot of overlap in users from what I saw in my time out there.

But, an 8th ounce of weed at the store is $40-60. "Average" pothead will smoke that in a day, maybe two. That translates to 10-15 stamps of heroin. I don't know how many stamps the average heroin addict uses in a day, but I can't imagine it being cheaper to go back to weed. Let alone the difference in physical effects.

On the other hand, for certain types of people, being able to go to the store to buy weed, in a safety aspect alone, would get them to trade one vice to another, as long as they could afford it.

Kratom, which is currently being hunted down and rescheduled by the dea, is an over the counter drug of some sort(I've smoked it, never noticed any effects, called it crap) that can help withdrawal symptoms supposedly. Ibogaine,a natural plant extract used to treat addiction and problems for hundreds if not thousands of years, is uextremely illegal in this country, but has shown ridiculous results for breaking addictions from nicotine and caffeine to opiates and sex. Often with one use.

Like all things to do with health, there is no money in a cure, only in treatment.

I will take the unpopular opinion that ISIS has to be funded somehow and oil just ain't enough.
Add to that the idea of tackle a society by attacking its weakest members but also gain the added benefit of putting a huge burden on its successful members, the middle and upper class who will be paying for state sponsored healthcare and rehab.

I will ask you this, "are the large heroin marketers really the smartest people in the world?"
I'm not talking street level dealers and users, I'm talking the King Pins; the Tony Montona's and higher of the heroin world.
The reason I ask is because I don't think I have ever heard of significant heroin arrest. An arrest higher than a one city problem.

4cylndrfury wrote: Sorrry to disagree Alfa, but I feel that the proliferation of anti-OD meds has actually given rise to a "saftey net" mentality among users. Im not saying its causing more people to use, but its causing users to feel free-er to use and use more than they had previously. My cousin had a friend who died as a result of reliance on Narcan (sp?). (mods, feel free to delete this next part if Im posting a "how to" for youngsters) The method he used (repeatedly) was: + Score some stuff, and drive to a parking lot of a relatively populated area - strip mall, restaurant etc. + Start the car, put the car into drive with foot on brake + shoot up an amount that he hypothesized was just under his OD limit the idea was that if he shot up too much, he would pass out, foot falls off brake, car rolls into the car ahead/front of a building, without causing a lot of damage due to the slow speed. Enough people would witness the event to get help (Narcan) to him in time to save him. If he didnt OD, and came too, well then, no harm, no foul. Apparently, this procedure is fairly common among the people this kid knew - it was a learned process. One night, this kids foot didnt fall off the brake though, and he OD'd, right there in his car, a block from home. The store manager of whatever store it was he was parked in noticed him sitting in his car as they approached to open in the morning, and they assumed he was just another customer waiting on the store to open. After about 2 hours, the manager noticed him still sitting there, and went out to find him dead inside. I dont have the answer, but I am pretty sure that this situation isnt going to get better by enabling users.

Actually, I agree with your point here. I have heard stories, too, about people being saved from OD'ing, and then going back on it as soon as they can.

What I was trying to figure out was that Law Enforcement was transitioning from enforcing the law to trying to save lives of OD'ers. Which would suggest to me that the law enforcement part of this issue is not as effective as it should be and the officers are finding that preventing death from OD is more important.

Again, I see that as an indication of what kind of problem this is- it's not a law problem, since "anti heroin" actions seem much less effective. It's so very, very bad that people would rather OD, have all the terrible side effects of that, THEN all the terrible side effects of being saved by that, go into treatment, come back out and GO BACK ON Heroin. Lather, rinse, repeat, until they die.

I would suggest that human reactions like that have no care at all about the law.

So the problem needs to be fixed BEFORE people get addicted.

Dr. Hess wrote: I haven't worked an ER is a long time now, so I can't comment on current trending, but those people are not thinking about their own best interests. Clean needles. Right. They don't give a E36 M3 about themselves, why does anyone think that offering free needles will help reduce blood born illness transmission? Like that idiot shooting up with his foot on the brake. Unbelievably stoopid.

Again, an example of what kind of addiction this is. Long term health- doesn't matter. Shooting up in a car does not matter, personal responsibility does not matter, families do not matter, jobs do not matter, laws do not matter.

Guilt and throwing people in jail fix nothing. May get people off the street for a little while.

It's seems to be all about the high.

Prevention is important.

JohnRW1621 wrote: gain the added benefit of putting a huge burden on its successful members, the middle and upper class who will be paying for state sponsored healthcare and rehab.

You are also ignoring the cost of housing a prisoner, clogging up the court systems, etc.

This is a few years old, which means it's likely even more expensive now.

http://www.nytimes.com/2013/08/24/nyregion/citys-annual-cost-per-inmate-is-nearly-168000-study-says.html?_r=0

"The annual average taxpayer cost in these states was $31,286 per inmate."

There seems to be lots of personal opinions in this thread, based on case studies (which do not a generalization make!) vs providing actual data to back up the stance. IE, "I know of this person who did this" and try to imply that all people do.

https://www.addictioncenter.com/rehab-questions/cost-of-drug-and-alcohol-treatment/

Compare the cost of rehabbing someone and helping them become a productive member of society again, thus contributing to the tax base vs locking them up.

Compare the cost of housing a prisoner to what we spend on our students.

http://nces.ed.gov/fastfacts/display.asp?id=66

The problem is that most active users don't want to be "rehabilitated." They want to get high. If they don't want to fix it themselves, nothing you do will fix them. You can dry them out in prison or rehab and they will be right back on it when they get out.

I have had patients that were recovered narcotic addicts. They would not even take an ibuprofen for pain relief. They would rather have the pain (in some cases quite a bit of pain) than have even a mild medication like an NSAID. They stayed clean. They knew what they had to do and they did it.

Dr. Hess wrote: The problem is that most active users don't want to be "rehabilitated." They want to get high. If they don't want to fix it themselves, nothing you do will fix them. You can dry them out in prison or rehab and they will be right back on it when they get out. I have had patients that were recovered narcotic addicts. They would not even take an ibuprofen for pain relief. They would rather have the pain (in some cases quite a bit of pain) than have even a mild medication like an NSAID. They stayed clean. They knew what they had to do and they did it.

This, a guy who was a really good friend of mine in highschool is an addict and will always be because he likes it. His parents have thrown a crapton of money into rehab programs and pills that are supposed to help.

He likes the risk, he likes the high, he doesnt want too stop. Hes told several people that. After jail and rehab stints hes right back on the needle. According to him his life is boring without heroin.

Around here the problem is upper middle class kids/young adults who are bored. Its a party drug too them.

Again, the most effective solution is prevention of starting.

Well since no one wants to debate on facts or back up their position.

Enjoy the echo chamber.

alfadriver wrote: Again, the most effective solution is prevention of starting.

In that regard, we as a society need to do a much better job of teaching people from an early age how to cope with all the bullE36 M3 life dumps on us.

z31maniac wrote: Well since no one wants to debate on facts or back up their position. Enjoy the echo chamber.

So what are you proposing?

petegossett wrote:

alfadriver wrote: Again, the most effective solution is prevention of starting.

In that regard, we as a society need to do a *much* better job of teaching people from an early age how to cope with all the bullE36 M3 life dumps on us.

That, and understanding all the sources of addictions- be it bad situations, left over effects of prescriptions, or just old ones that people abuse from others.

I don't know what gets people started. But given how it's playing out, that would be the more effective path to reduce it's effect.

In reply to alfadriver:

I know & have known many people with substance-abuse problems. Almost all of them use/used it as a coping mechanism, and many of them have/had parents who were the same way. Certainly there are people who become addicted from prescription painkillers, or for other reasons, but that's not what I've seen as the root problem in the rural Midwest.

It's tough though, because teaching young people how to cope with difficulties isn't as straightforward as teaching Math/Science/English/History. Sadly, I don't have the solution either.

Our society as a whole has gotten so good at protecting its weakest members from the effects of "survival of the fittest" that I suspect we have a lot more weak links than used to be.

I wouldn't have survived in the way back times (weak eyes). But my family would also not have been here (grandpa was a C-section baby) anyway. With every advancement we make in medicine we defeat the natural order just that much more and while there are many strong ones out there I think it shows that there are many who aren't.

I say this to get at this. A powerful, addictive, and dangerous drug is going to be the most dangerous to the weakest members of the tribe. As a tribe I'm not certain we're doing the greater whole any favors by saving them from themselves.

A lot of the street availability of heroin is based on decriminalization of weed, not the Afghanistan situation. Mexican and South American cartels are seeing a dramatic loss of revenue from pot. They have switched to heroin as a new profit center, and competition is driving the price down and purity up. Results are easily observed.

When researching, to write a reply to this thread. I got sidetracked by a Google search result.

I ended up opening an account on the Kraft website for the sole reason of telling them one of their recipes is not a real California Cheeseburger.

alfadriver wrote:

z31maniac wrote: Well since no one wants to debate on facts or back up their position. Enjoy the echo chamber.

So what are you proposing?

As I've already mentioned in this thread, stop using case studies as a way to try and create a valid generalization.

Stop with the conjecture and hyperbole.

Provide credible sources to back up your assertions.

I have done all those regarding Portugal and the effects of decriminalization, the cost of housing inmates vs the cost of rehab, a comparison between what we spend on inmates vs our students.

And since it seems to have been lost, I think a long hard look at how Portugal handled the situation and the great affect it's had on usage, overdoses and abuse...........but it seems many people don't like factual evidence that disproves their preconceived notions.

I still have no idea, LITERALLY NO IDEA, how people don't see the parallels between alcohol prohibition (ever heard of that guy Capone?) and drug prohibition.

Make it legal (and deny much of the funding to the cartels and other criminal elements), tax it, regulate it, and spend money on education, prevention, and rehabilitation.

It's bad in Anchorage as well. Theft to fund it is on the rise in a big way.

I'm not sure how commonly the issue of docs prescribing narcotics leads to heroin usage. In my career of fifteen years I've run hundreds of heroin overdoses. We usually get there first on the engine and start a line and juice them back up before the amberlamps even gets on scene. A huge majority of the users and overdoses I've seen are persons less than 20 years old so that lessens the chance that legit medical opoids got them started (I have no empirical evidence of that except that common sense says few otherwise healthy teenagers have had any reason to be significantly exposed to narcotis through legit medical channels) . And, typically when we run a death by heroin overdose, it's after several Narcan saves on our part. The folks just keep on doing it and eventually wind up overdosing when there is no one there to call 911 on their behalf. It winds up being morning coffee time talk between the shifts. "Hey, you know that chick up at XYZ address that overdosed on heroin awhile back ? Well, that ain't gonna happen again. She was cold when we got there last night".