Quote:
Originally Posted by Jonesy55
There was a documentary here in the UK on the radio a few weeks back about the opiate epidemic in British Colombia, Canada. Apparently it's a big thing there too with hundreds dying during 2016 in that province alone because of synthetic opiods like fentanyl.
What is causing this?
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Fentanyl is used to boost the strength of street heroin. A little goes a long way, so it's easier to smuggle, plus it's synthetic so it can come from somewhere closer than the growing regions.
As to why more people are using, it's a mix of over-prescription of prescription opioids, poor doctor education on the addictive properties of newer opioids, and large groups of people being disenfranchised by the economy.
Quote:
Originally Posted by giallo
The cheap cost of fentanyl is causing it, I guess. It's easy to cut in to the dope. I know of one person personally and a brother of a friend that have both died from fentanyl-laced heroin in the last two years.
The OD crisis in BC is indeed terrible. Besides trying fentanyl distributors for murder, I don't really know what to do to scare people away from mixing it. Safe injection sites that can test the drug before the user takes it could ease the tide of ODs, I suppose. Problem is, it's now showing up in cocaine as well.
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A significant percentage of opiate/opioid overdoses are from synthetic opioids like fentanyl and its derivatives, some of which are even stronger like carfentanil, which is designed for *elephants* and is 200-1000 times as strong as fentanyl, which is itself 10-25 times as strong as heroin, which is 4 times as strong as orally consumed morphine.
Even in addicts with significant tolerance, it's easy to overdose with a product orders of magnitude stronger than heroin.
Quote:
Originally Posted by pdxtex
ive never even heard of fentanyl before. maybe that would explain the proliferation of tents all over Portland. everytime we do a hobo camp cleanup, it always littered with syringes among other things. i always thought they were just plain old junkies, using plain old dope. guess not based on this thread. maybe tents make perfect dope house, especially if cops aren't bothering most "campers".....ok, back to the murder....
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They would have been 'plain old junkies,' because fentanyl is almost never sold as such - it's still called heroin. That's the problem, people don't know that they're getting fenanyl and so they're at the mercy of the dealer mixing proportions correctly so that 1 bag of cut fentanyl has the same strength as 1 bag of heroin. And sometimes dealers will treat just a few bags with fenanyl because overdose deaths morbidly drive sales up as junkies seek out dealers with stronger doses both for the high and for the possible cost savings.
Quote:
Originally Posted by Flyers2001
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The city and country for that matter have no real fight against this epidemic.
*if you sell laced bags and it causes an over dose, Murder charges should be on the table.
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I believe in Illinois you can be charged with homicide for selling to someone who overdoses no matter whether they overdose on pure heroin or laced "heroin."
The country needs to make legal maintenance of opiate addiction easier. It would remove the vast majority of associated social costs.
Currently if you are an opiate addict who is incapable of maintaining sobriety, you have two legal options:
1) Methadone maintenance. This is cheap and, at least in cities, there are a lot of clinics to enroll in. But, on the downside, in the beginning (lasting for months), the patient has to go in person to the clinic every single day to be "dosed." The clinics usually have hours like 4am-3pm so that people with early-start jobs can make it in. This is fairly effective at stabilizing patients but because of the Feds fear of a methadone secondary market and general distrust of addicts, it's inconvenient to have to go in almost every day. The only time every patient gets a take-home dose is for holidays and (usually) for Sundays when most clinics are closed (at least in Chicago). Methadone strongly mimics heroin's euphoria, but because it's administered orally it doesn't have the "rush" of injection. It lasts a long time, with a half-life of about 24 hours in most people (heroin has a half-life of 4-6 hours), so patients have a more stable blood level. Almost everyone who tolerates heroin tolerates methadone just fine.
2) Buprenorphine maintenance. This is getting less expensive but still costs at least double what methadone does, and sometimes as much as 4 times as much on a monthly basis. This is usually prescribed in a formulation that combines it with the overdose-stopping naloxone so that it won't be injected. It can be prescribed by the month and the prescription filled at most pharmacies like any other medicine. The problems with this are that doctors need special certifications to prescribe it. Again, that's because the Feds are scared and distrustful about it. And a significant minority of patients don't tolerate buprenorphine very well. It may interfere with their sleep, it may cause significant nausea, or other side-effects.
In my opinion, doctors should have more leeway in dealing with addicts. I understand the government doesn't want doctors creating addicts, but it seems to me that with a little bit of supporting process and documentation it should be possible to allow doctors to prescribe any opiate to an addict who requires opiate maintenance, in 30-day or even 90-day amounts. It's a complex world out there, but if addicts could get their drug of choice from a legal, reliable source, they wouldn't need to steal, they could live a normal life just needing to buy cheap painkillers to maintain. In my opinion, you could even certify addicts and then just let pharmacies sell them a certain amount of their drug of choice every month. There are very rarely complications with legal, medical-grade opiates in addicts. The monthly appointments for buprenorphine aren't medical checkups, they're just a brief counselling appointment. There is really no reason, in my opinion, to have to involve a doctor at all once a patient has been certified as actually being an addict.
So the feds have options, they just choose to ignore them out of fear and suspicion.
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