
Inside an L.A. OxyContin ring that pushed more than 1M pills - spking
http://www.latimes.com/projects/la-me-oxycontin-part2/
======
seibelj
I have yet to meet one single person who can logically explain to me why drugs
should be 100% illegal. I've heard, "Would you want cocaine available at
7/11?" No, I don't want cocaine available at 7/11.

But if you can already buy any drug on the street, a doctor should be able to
prescribe medicinal heroin to an addict and get them into the system to
monitor them for treatment, with the end goal of getting them off of drugs.
Putting unknown chemicals of varying strength and quality into their vein is
what kills addicts. They do not typically OD because they are suicidal, it's
because they unknowingly bought an extra strong stamp and then die.

I grew up in Massachusetts, and had a high school graduating class of around
300 people, and 6 people have died of overdoses in the last 10 years. One of
the most popular girls in my class died a few months ago. I firmly believe
that allowing her (and everyone else) to get her opioids prescribed would at
the minimum keep her from overdosing, and let people who care know she has a
problem. Dying on a toilet with a needle still in your arm is a terrible,
useless way to die.

~~~
brady8
I'm a physician. Unfortunately, most of our overdoses in North America are
from prescribed opiates. They are very addictive, and despite best efforts to
control and monitor dosing and schedules, these opiates are often either
purposefully overdosed (suicide attempts), diverted, or accidentally ingested.
My worst memory in pediatrics was a 7 year old who was brain-dead after
ingesting only one (!!!) tablet of her grandfather's high-strength Oxy
prescription that she thought was Tylenol.

Opiates are bad news, and physicians unfortunately were duped into prescribing
way too much for the last ~15 years.

~~~
seibelj
I don't follow your logic. A 7 year old swallows drain cleaner, so we should
ban drain cleaner? A shame that happened, but irrelevant to the discussion.

You think that by banning opiates no one will get opiates? The methadone
clinic two blocks from my apartment, and the people who panhandle around it
and the subway station, and the needles I walk past when I cut through the
tennis court, do not show the government's laws are solving the problem. As a
physician you may see the emotional side, but logically I would love to hear
your solutions to the problem.

~~~
pacala
The point of laws is not to make an undesirable behaviors disappear. The point
of laws is to discourage undesirable behaviors, and, hopefully, reduce their
incidence. There are still thieves and murderers and rapists and pedophiles
out there. Yet we don't just throw our hands in despair and claim that we
should just remove all laws off the books because some people break the law.
True, some people will get opiates even if opiates are banned. However,
overall fewer people will get opiates, and overall fewer opiates will be sold.

Logically, I would love to hear your solution to the problem...

~~~
seibelj
Yes, my logic is simple: stop trying to ban victimless crimes like drug use. A
grown adult wants to inject himself with heroin? Let him. By banning the drug
you create a black market, and all of the crimes that entails. The USA tried
to ban alcohol, and the bootleggers won. Take all of the money we put into the
war on drugs and redirect it to treatment, and tax the shit out of the drugs
to pay for our schools.

Banning stealing, rape, and child pornography is _nothing_ like banning drugs.
Completely, totally, 100% unrelated and by trying to loop all of them together
you disregard logic and sane, rational arguments.

~~~
HighPlainsDrftr
The best I can explain it, drugs are like rewiring your brain to need
something, like food, water, air, sexual reproduction, etc.

If you go without eating for a day or two, your brain really drives you to
find something to eat. Same thing happens with some drugs - within varying
degrees.

When I tried to give up smoking cigarettes hundreds of times, my body really
felt like it was dying by not having the nicotine around. I eventually got
passed it. I haven't had one in 8 years.

The drug laws do nothing more than make addicts bad people. It makes it harder
for them to get jobs when they get busted. These guys were just trying to
survive - their brains rewired to do that.

They really need to get rid of the drug war. Take that $50 billion a year and
spend it on mental health/addiction research - instead of killing a bunch of
people on the border. Provide some treatment centers. Let people be anonymous
when attending. Get the courts and criminal records out of the equation.

I've known some very smart addicts over the years. The tragedy is they get
worse and worse - and they have no way out without getting a very negative
stigma attached to them. Some end up unable to get jobs. It all because of our
laws.

We would be much better off educating our population honestly on drugs (think
of how dishonest the refer madness propaganda was). Keep the drugs available,
in clean, reliable doses. Help people addicted get off the drugs. Learn about
the cycle. This is much better than the system we have now.

~~~
pacala
These are some great points. In particular, we need to reduce the stigma on
addicts, especially those that [try to] recover. Mind you, reducing the stigma
is hard, because the stigma doesn't come from a void, or from laws, it comes
from the cumulative experience people have with addicts, which are less than
great. In another piece from the same story,
[http://www.latimes.com/projects/la-me-oxycontin-
everett/](http://www.latimes.com/projects/la-me-oxycontin-everett/), read on
Brandon Smith, who ended up spending all his savings and belongings on drugs,
ultimately resorting to robberies. Personally, the first addict I ever met
ended up stealing my winter jacket within 3 month of working in the same
building, in the middle of a heavy winter. Robbing and stealing are not great
ways to build sympathy or trust.

I happen to share the experience to shrugging off nicotine addiction. It was
very easy to get hooked [peer pressure played a role], and surprisingly hard
to get rid of. In my case, took a few weeks of fighting my body with reason.
From what I hear, opioid addiction is stronger, thus I'm having a really
really hard time believing that having over-the-counter opioids that anyone
can "try a few times" is going to be anything but a major disaster.

The best strategy for most people is to never use opioids. Simply not worth
the risk of ruining one's life for a very short time gratification. Given the
reality of rebellious teenagers / young adults, I'd much rather have no easy
legal path for opioids. Sorry, no opioids in a supermarket locker that you can
get by just showing your driver license. On the flip side, I believe we should
still crack down hard on dealers, to keep pressure on the supply side.

Which leaves us with the people caught in the opioid trap. While we already
fund addiction research, see
[https://www.drugabuse.gov/international/research-funding-
lan...](https://www.drugabuse.gov/international/research-funding-landing), we
probably could do more. We already have rehab clinics where at least some form
of palliative care is to be found, though we should seek to make rehab and
rehab clinics a better experience. Whether that includes availability of
drugs, I frankly haven't seen any relevant research indicating that's a good
idea, and I see some evidence [prescription abuse, see the original article]
that it is rather dangerous.

------
prklmn
This is peanuts compared what was going on in Florida several years ago
[http://www.bloomberg.com/news/articles/2012-06-06/american-p...](http://www.bloomberg.com/news/articles/2012-06-06/american-
pain-the-largest-u-dot-s-dot-pill-mills-rise-and-fall)

> Over 20M pills prescribed, wreaking havoc far beyond just Florida.

Many of the people that were taking these pills have resorted to heroine now
that Florida has enacted better oversight

~~~
oxide
That's because once you've gotten deep enough into the hole of opiate
dependence, your perspective on heroin shifts drastically.

Suddenly that little green pill that barely gets you off anymore looks a lot
less appealing for $1/mg. Especially once you discover how cheap and widely
available heroin truly is. A $10 purchase of heroin gets you exponentially
more bang for your buck.

It's not a long journey, especially once you've walked half way. You can't
regulate or price someone out of an addiction.

------
discardorama
FTA:

> More than 194,000 people have died since 1999 from overdoses involving
> opioid painkillers, including OxyContin.

Wow, that's about 12,000 per year. :(

~~~
twilightfog
Statements like that immediately make me suspect the integrity of the article.
Instead of reporting the actual figures of Oxycontin related overdoses, they
bundle it with ALL overdoses over a year (which obviously would be a large
enough number). Why didn't they mention the % of overdoses directly related to
Oxy ? My assumption is that it would be significantly smaller number which
didn't serve the article's purpose. Personally, I don't think its the Pharma's
job to track if the pills are illegally prescribed. Just like its not an ISP's
job to track if the internet is getting used for illegal downloads. They are
absolutely right to assert that they "at all times complied with the law." and
any conduct "did not interfere with legitimate patients getting medication".
Moral arguments apart, they are simply not in the business of reporting their
patients to law enforcement, nor they ever should.

~~~
jonknee
> Why didn't they mention the % of overdoses directly related to Oxy ? My
> assumption is that it would be significantly smaller number which didn't
> serve the article's purpose.

Most likely because the statistics aren't available.

> Moral arguments apart, they are simply not in the business of reporting
> their patients to law enforcement, nor they ever should.

Why should they be allowed to be in business at all when their product is so
destructive?

~~~
dave_sullivan
> Why should they be allowed to be in business at all when their product is so
> destructive?

I don't think it's that simple.

If you're going to start doing heroin--which you shouldn't--oxy is a much
safer form than street level heroin where you have no idea what you're
getting.

Phillip Seymour Hoffman ODed and died because he didn't know what he was
getting. Heroin is actually pretty safe, but it destroys your soul and you
never really "cure" the addiction. Even still, I'd rather have oxy out there
than tar heroin from Mexican drug cartels. And I'd rather spend government
resources on something else.

~~~
rhizome
_Phillip Seymour Hoffman ODed and died because he didn 't know what he was
getting._

Is this true?

~~~
sanswork
I've read what happens often is that when heroin addicts relapse they often
don't account for the dropped tolerance while they were sober and they start
back at the same levels as when they were using and because of that OD. I'm
pretty sure I saw that this was what happened with Hoffman.

~~~
s_q_b
One reason for overdose is that dealers increase the potency of their product
by cutting it with Fentanyl, and other synthetic opioids.

These opiates, while easy to produce in a lab, are active in very small
amounts (at the microgram level.)

As a result, if a batch of heroin isn't fully mixed, you end up with "hot
spots" in some doses, where the fentanyl content is high enough to kill you.

This is how one of the first young women I met at university died. We grew
apart, and one day she stopped responding to my text messages. A few days
later I found out via Facebook.

------
revelation
So you can't buy effective decongestant or other medicine that isn't spiked
with caffeine or painkillers because you might try and turn it into a meager
amount of a controlled substance, or more likely burn yourself in the process.

But nobody is monitoring when a doctor prescribes tons of opioids. Prescribing
something seems like a privilege granted by the state, so clearly it should be
the DEA monitoring this, but apparently this article is more keen to blame the
salespeople at the manufacturer?!

~~~
knowaveragejoe
> But nobody is monitoring when a doctor prescribes tons of opioids.
> Prescribing something seems like a privilege granted by the state, so
> clearly it should be the DEA monitoring this, but apparently this article is
> more keen to blame the salespeople at the manufacturer?!

That's exactly what the article describes, though. I feel like you didn't read
it. They detail, at length, a system for keeping track of doctors and
pharmacies who over-prescribe and over-order Oxycontin.

~~~
FireBeyond
And then proceed to do nearly nothing with that information other than in one
or two of the most egregious instances "reducing supply" and "instructing
sales people that they shouldn't promote Oxy".

It's almost like they did the bare minimum, enough to have some plausible
deniability, but not enough to actually be responsible. Oh, and then only
after they knew the doctors were out of business (read "already arrested,
charged, sent to trial") did they belatedly say "oh hey, you might want to
look at them".

When it would do nothing to harm profit, but so no-one could say "you did
nothing".

~~~
knowaveragejoe
Oh, I totally agree. That's the real shocker in the article, that they had the
information necessary to stop a lot of this _years_ ago. I was just pointing
out that the above's comment seems to have missed the point.

------
feklar
There's a heroin shooting gallery here staffed by nurses and it proves keeping
narcotics illegal is a complete farce. Out front at any given time of the day
is a row of dealers openly selling junk to the junkies. Once in a while a new
group of dealers will try to violently jack this lucrative business by causing
a massive street gang war where countless people end up shot in the crossfire.
Should just sell and distribute the drugs legally.

~~~
pacala
I hear this argument a lot in young liberal circles, can't wrap my head around
it. In particular given how much well deserved flak the tobacco industry has
gotten, industry also driven by addiction. Drugs are addictive, messing up
people's rewards path and inducing self-destructive and asocial behavior.
Priorities are:

1\. Keep as many innocent people as possible away from drugs.

2\. Help as many junkies recover as possible.

3\. Fuck the dealers.

Legalizing drugs seems to reduce the risk for dealers, now having their posh
addiction-driven business at the mall, while increasing the availability of
drugs for the untainted population and for the junkies. Are we really that
concerned by dealer's quality of life that we willing to tradeoff the lives of
our neighbors, friends or even family?

~~~
aianus
> Legalizing drugs seems to reduce the risk for dealers, now having their posh
> addiction-driven business at the mall

The margins on legal good are a whole lot less than illegal ones. You'd be
putting most dealers out of business overnight by legalizing.

~~~
titanomachy
I've heard this argument, and it makes sense -- medical morphine costs
basically nothing compared to street heroin or oxycontin, so it seems like
switching to legal supply of drugs could basically delete the profitability of
the trade. Instead of a criminal gang making ~$75 from the sale of an oxy
pill, some pharmacy makes $1-2 and society makes some taxes we can use to fund
rehabilitation programs.

Question, though -- why does legal pot cost the same as illegal pot used to in
places like WA? It seems there is still a large amount of profit to be made
from growing and selling pot, although I guess (pretty much by definition)
that money is no longer going towards criminal enterprise. Is it just high
taxes?

------
marcoperaza
This is pretty disgusting. The lack of accountability is especially troubling.

For a long time, I believed that we're better off legalizing all drugs and
making them available to anyone who wants to buy them. But I've had a change
of heart recently.

People simply aren't in control of themselves when they're addicted to these
substances. The crooked doctors, the pain clinics, and all the complicit
organizations in the supply chain profit, while millions of people lose their
human agency to a chemical that alters their mind and transforms them into
irrational drug addicts. It is very difficult for them to recover, and very
easy to relapse. It is a human tragedy of enormous proportions. It tears apart
families, ruins childhoods, and creates poverty. And at its worst, it takes
lives.

We have to take care of our people.

~~~
topspin
The key thing to remember when you allow your empathy to command your thinking
is that your drug war didn't prevent this. Everything in this story is about
illegal activity; all of this is already illegal, as is the importation,
manufacture, distribution and abuse of a litany of other drugs that are also
still imported, manufactured, distributed and abused by people that can't
"control themselves."

So all your drug war has accomplished is to compound the abuse problem with a
horrible criminal underclass, a vast and militant law enforcement regime to
contend with it and an insidious corruption of people and institutions
throughout our society. Despite all of this real damage your drug war doesn't
actually save people; millions have been killed through drug abuse and
millions are addicted today despite your drug war and the huge amounts of
treasure spent to wage it.

Is it conceivably possible to conduct your drug war so vigorously that it
actually stops the bulk of this criminal activity and actually saves people
from abuse? Yes. It is possible. You're going to need a GULAG system and a
near total elimination of your civil rights because you will need to inflict
enough misery and suffering on a large enough fraction of the population to
generate sufficient fear to make the rest comply. The trade of valuable,
easily concealable products in a liberal market economy is impossible to stop
without such measures, which is why your drug war will never work, no matter
how badly you feel about the tragedy of abusers.

So please, reassert your rational mind; your drug war is doing more harm than
good.

~~~
marcoperaza
You make a very fair point.

The drug war _has_ been a total disaster. It's thrown much of Latin America
into chaos, with their governments unable to contend with the sophistication
and brutality of drug cartels that rake in billions from the most lucrative
drug market in the world, the United States. It's also a massive source of
revenue for the criminal gangs that plague our cities within our country.

The laughable propaganda from the government has also totally undermined
important anti-drug messages. The ridiculous claims about the dangers of weed,
for example. The reefer madness stuff. The DEA's insistence on keeping weed
Schedule I. It's actually given rise to an equally ridiculous myth: that weed
is totally harmless. But more importantly, it's undermined the message against
harder drugs. If the government is lying about weed and shrooms, then people
will think they're lying about other drugs as well.

If we don't win the cultural battle against drug use being acceptable, then
all is lost. You're right that no amount of law enforcement can change that in
a liberal democracy. But assuming that battle can be won, this is what I think
needs to happen on the legal and military end:

I say legalize weed and other drugs with lower abuse potential; this will
immediately destroy the largest segment of the illegal drug market. For hard
drugs, stop _imprisoning_ people for possession. Withhold the first arrest for
simple possession from the public record, so it doesn't show up on background
checks and destroy people's ability to get a job. This will create the public
support for what must come next: come down like an iron fist on the weakened
organized crime groups that have lost their largest source of revenue. Exploit
internal strife caused by dwindling revenues, turn some people into
informants, and then put away the rest for a very long time.

The second biggest drug market is cocaine. Almost all of it comes from
Colombia. Once the current peace process falls through or fails to stick, the
US needs to help Colombia finish off the FARC completely. Unconditional
surrender should be the only acceptable outcome. A complete commitment to
ending mass coca production in Colombia should then be a condition of their
friendly standing with the United States.

~~~
topspin
To what degree has legal alcohol offset the abuse of more powerful drugs? I
don't know. I doubt such a thing is credibly calculable. What I am certain of
is that it isn't 'enough'; despite legal alcohol, abuse of many other drugs
continues to thrive. I don't believe legal marijuana is going to provide a
sufficient substitute for more powerful narcotics either.

Marijuana is easy to obtain and cheap almost everywhere in the US, and in some
places it's even legal, yet people still abuse a panoply of other drugs. Here
one may read a recent story about growing methamphetamine abuse in Colorado, a
state that has had legal and extremely high quality marijuana for several
years now:

[http://www.cpr.org/news/story/meth-use-colorado-has-
police-a...](http://www.cpr.org/news/story/meth-use-colorado-has-police-and-
outreach-groups-scrambling)

No, we need to accept the fact that some fraction of us are going to hurt
ourselves, whether with liquor, stimulants, hallucinogens, etc., help them as
we can, and stop self-inflicting the damage and costs of our doomed attempts
to control things that are inherently uncontrollable in a free country.

I don't want any "iron fists" in our justice system on behalf of the "drug
war." Those that would ruin themselves with legal drugs are a far smaller
problem than the extreme violence, endemic corruption and law enforcement
embiggening we've self-inflicted trying to save them from themselves.

I care. I have family members that I grew up with that have ruined their own
lives with drugs. But I never forget that every one of them was born after we
declared our "drug war" and it didn't do them one damn bit of good.

~~~
marcoperaza
I'm not saying that legalizing weed will divert usage. I'm saying it will deal
a severe blow to the finances and internal stability of these drug gangs and
massively weaken them for the final blow. It's also not worth banning in the
first place, the result of moral panic not rational analysis, and not to
mention that it's a lost battle culturally.

Drugs will always be with us, but not like this. We can reverse the tide of
destruction. There are entire communities being ravaged by the current heroin
and prescription opiate epidemic. I refuse to accept that this is just the
price of modernity. America wasn't like this before and it doesn't have to be
like this in the future. We can build a better society for our children.

------
panic
Why do we allow people to make a profit selling habit-forming drugs? The
system that protects Purdue's profits also creates this horrible incentive.

~~~
_acme
Do you have a way of treating severe pain (such as cancer pain or post-
surgical pain) that is not habit-forming?

~~~
panic
Maybe my comment wasn't clear; I think these drugs are fine, and I think drug-
related patents are at least somewhat defensible as a way to fund R&D, but in
this case they're really not working very well. There shouldn't be such a huge
profit incentive to ruin people's lives like this.

------
MichaelGG
These people should be seen as heroes. They are fighting a corrupt, anti-
liberty system. Laws that require official permission (papers please!) to buy
and use medication. You can get anything you want, from meth to morphine, if
you can afford enough medical consultants, or are deemed worthy. If not, or if
some medical-related person deems you an addict, enjoy your pain.

Run PSAs, perhaps require a waiver before sale. But people are in pain (both
mentally and physically) and opiates are by far the most effective treatment.
(Sure, they don't work for everyone, etc. etc.)

This abstinence mindset is as harmful as it is in sex education.

