
Nineteen people a week overdose in Richmond, dozens are dying, hundreds revived - iamjeff
http://www.richmond.com/news/virginia/nineteen-people-a-week-overdose-in-richmond-dozens-are-dying/article_34e7d5e9-3cb1-5c31-9775-3cfb4864ee14.html
======
jrowley
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.

~~~
sillysaurus3
[removed]

~~~
spaceseaman
You're implying the opioid epidemic is in part due to Reddit banning
subreddits filled with hateful speech?* Or what? You're also making some odd
as hell "both sides"-ish argument somewhere in there that I can't even parse.

I'm sorry, but we don't have to give spaces for people to be hateful - Reddit
banning those assholes was the highlight of my week. I'm not trying to claim
that these people should just be ignored, but you're conflating very separate
problems.

More importantly, the people being affected by the opioid crisis are
predominantly not members of these hateful groups, and I'm pretty frustrated
you would conflate them in such a way just so you can have an excuse to talk
about the loss of a safe space for hateful rhetoric.

*EDIT: After rereading what the poster wrote a few times, I believe they were attempting to claim that the subreddit bans would encourage more people to head to drug use, rather than vice-versa as I originally interpreted it - it's still pretty off-topic though, and again I'm not very sympathetic to people being sad they no longer have a place to be hateful.

~~~
sillysaurus3
I'd appreciate it if you'd remove your comment since I tried to back out
immediately from that line of conversation. Would you mind agreeing?

If so, edit your comment to [removed] and I'll delete this one.

Otherwise, I can try to explain my original motives, and what I observed. But
it's a tricky conversation to have, and there's a high chance people's
tendency to instantly turn to hatred will focus on me. I'd rather pass.

~~~
alsetmusic
> I'd appreciate it if you'd remove your comment since I tried to back out
> immediately from that line of conversation. Would you mind agreeing?

Two days ago, I saw you post something asinine and I tried to respond. You
deleted your comment before I could hit the reply button, and I lost the
opportunity to quote and refute you.

If this is a recurring problem (that you change your mind about statements on
a public forum), think a bit more before posting.

~~~
heartbreak
I see Silly doing this everywhere. Asking people to remove their comments.

Edit: See what I did there, bud?

~~~
sillysaurus3
_If I recall correctly Silly accused me of slandering some app developer
because I posted a negative article._

You're posting about an accusation you can't even remember with incomplete
information and out of context. That's like a trifecta of incivility.

If you can't remember exactly what I did, maybe don't spin a half-told version
of it?

------
dep_b
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.

~~~
nickik
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.

~~~
dep_b
A car analogies, the best ones!

If your car breaks down there are other means of transportation like getting a
Uber, renting a car, carpooling, riding a bicycle or even walking. This is the
typical "infinite" possibilities situation where capitalism really blossoms. I
personally don't own a car because exactly all of those reasons, so I chose to
never have a car that I need to repair. I _hate_ things to maintain.

Now imagine a situation where you are only allowed to go to your work in a
car, nothing else. If you don't go to your work you will be fired and you will
never find another job again (i.e. dead). And the spare part you need for it
to get it working again is only available through one source that for some
reason charges about 100 times more than it takes to manufacture the part
itself. You are not allowed to have any other car than the one you currently
own, not even the same one new.

Now _that 's_ how having cancer works in the field of choice.

People _choose_ to live near volcanoes, mountains, oceans. Places where
tornadoes are frequent. There's a good reason most people on Earth never saw
one.

Though I agree somewhat on most of your points. Actually one of the biggest
problems is that nor the legal opioids nor heroin are freely available towards
consumers. A lot of people are killed because impurities or more unhealthy
alternatives. Again, mixing pure capitalism without the real choice makes
things really ugly.

But there's a huge incentive to make money not on the best solution for the
patient but based on the largest kickback for the doctor and the biggest
profit margins for the industry.

------
zamalek
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?

------
iambateman
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.

~~~
drug_uesr_throw
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

~~~
loverofcode
Tylonel accounts for a large number of deaths. Chronic pain patients have to
take medications for the rest of their lives, it is safer to consume opiates
than acetaminophen long term. Best would be nothing, but as long as there is a
slow increase opiates can go on up and up. Where the acenimphen will destroy
your liver and kill you fast. Furthermore, 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](https://imgur.com/a/fFBTe)

~~~
drug_uesr_throw
My point was that over prescription is a problem. Just a couple days ago this
study showed the power of apap/ibuprofen equal to opiate in extremity pain:
[https://jamanetwork.com/journals/jama/article-
abstract/26615...](https://jamanetwork.com/journals/jama/article-
abstract/2661581) Yeah apap is dangerous in really high doses but it isn't
super fatal w NAC intervention.

But more people die from opiates than apap nih:
[https://www.ncbi.nlm.nih.gov/pubmed/16294364](https://www.ncbi.nlm.nih.gov/pubmed/16294364)

------
joshschreuder
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.

~~~
fsloth
"It just felt like something that could hit anyone"

That's why addiction is a problem. Once the central nervous system is
compromised by addictive substances, it's no longer only a matter of personal
life choices. It does not matter whether the addiction was started by a
leisurely experimentation or by a medicine prescribed by a doctor.

------
mschuster91
> 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.

~~~
ransom1538
Like my uncle says, a cop, "what would we do then". Drug & alcohol related
arrests are 99% of their work.

~~~
dragontamer
Its not a cop's job. Its a social worker's job.

I do recognize that cops are just "trying to help", and that no one cares
about social workers. Cops are in an advantaged position in the USA because
they are relatively well respected by most mainstream members of the
population. So the fact that they want to help is good.

But Cops aren't given the right training to deal with medical problems or
other problems (ie: Fire hazards. In theory, cops could be the ones to inspect
Fire Hazards in buildings, but realistically, its better for Firemen to do
it).

There are lots of social work jobs in America. A big problem, a seriously big
one... is that we expect Cops to do any job. Erm... no. Have drug specialists
deal with the drug problem. Cops really shouldn't shoulder the burden of
everything in the country.

\-------

Cops should focus on the distribution of drugs. Not on the users of the drugs.
The users need treatment, mental treatment that cops do not have the abilities
to give.

These drug abusers need nurses and social workers to check up on them every
few hours. Not cops.

~~~
porfirium
Drug users usually turn violent and can be a hazard to themselves or others.
Somebody trained to deal with such situations is required. This is, a cop.

~~~
dragontamer
As do people who are infected with Rabies. Or rare forms of violent
schizophrenia. Indeed, violent offenders are often not users of drugs, but
from my understanding: the cutthroat underground distributors.

Which is why cops should continue to focus on the violent distributors of
drugs. But social workers and hospital workers should step up their
responsibility and start treating drug abusers better.

Or perhaps, more programs need to be made so that hospital workers / social
workers are paid to fix this drug problem.

Hint: throwing drug USERS in jail, where they only get more underground
connections and better learn to become a criminal, will start a cycle where
they have to end up in jail again. Jail is just about the worst place you can
put a person.

~~~
jstarfish
> Hint: throwing drug USERS in jail, where they only get more underground
> connections and better learn to become a criminal, will start a cycle where
> they have to end up in jail again

What is: the most profitable outcome you can hope for when your prison system
is privately owned?

~~~
icebraining
The US prison system is not privately owned. Less than 20% of prisoners are in
private jails.

------
mirimir
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.

~~~
nickik
It has nothing to do with profit driven. The problem is about intensives.

The perverse US health care system with all its regulation has made it so that
doctors primary make money by giving away pills.

There were other models where people would basically have subscription to
clinics and those would have a intensive to keep you healthy.

The problem is that all alternative models are literally illegal.

Check out this podcast:
[http://www.econtalk.org/archives/2017/06/christy_ford_ch.htm...](http://www.econtalk.org/archives/2017/06/christy_ford_ch.html)

They talk about this book: Ensuring America's Health: The Public Creation of
the Corporate Health Care System

~~~
UncleMeat
This explains why countries with more regulation (to the point of state run
medicine in England) don't have nearly the same problem with opioid addiction,
right?

~~~
nickik
Well not necessarily. You can also have a stat run system that can have the
same intensive problem. I don't know how Britain handles these things.

It really just depends on the individual institutional setup, and it depends
on the culture of the doctors.

------
AdmiralAsshat
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](https://en.wikipedia.org/wiki/Dave_Brockie)

------
OliverJones
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.

------
billturner
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/](https://newsinteractive.post-gazette.com/riding-od-road/)

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

------
Feniks
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.

~~~
nickik
Many places that did not have bad economies had heroine epidemics in those
times as well. Can you actually show statistically that bad overall economy
and heroine epidemics are in any way linked?

------
askvictor
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.

------
PatientTrades
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.

~~~
ellyagg
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.

~~~
munk-a
People generally say that over-prescription leads to harder opioid usage
because it does. I have had co-workers familiar with the neurological effects
of the drugs they've been given balk at it. I've also known community members
who had injuries slide into the obscurity of addiction.

A very real factor of this crisis is the pain aversion, people working in
dentistry have higher rates of depression and suicide due to the psychological
effects of inflicting pain on people (unless the dentist is played by steve
martin ofc) and it's a problem without clear solutions. Legalization of
marijuana would probably help reduce the mild-moderate pain classes in a non-
addictive manner, but for extreme pain there isn't a good solution.

Anyways... there are plenty of first-hand accounts and plenty of studies
showing the connection here, please do a little research before posting
unsupported claims.

~~~
incadenza
It's important to note that the epidemic that people refer to is the overdose
epidemic, often labelled the opiate epidemic for whatever reason.

I haven't seen any evidence that actual rates of heroin abuse increasing year
over year. Just wealthier people dying from poorly cut drugs at a more
alarming rate.

This was the most recent report I could find:
[https://www.samhsa.gov/data/sites/default/files/NSDUH-
FRR1-2...](https://www.samhsa.gov/data/sites/default/files/NSDUH-
FRR1-2014/NSDUH-FRR1-2014.pdf)

------
krisives
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.

------
beefsack
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](https://en.wikipedia.org/wiki/Richmond)

~~~
sevenfive
Richmond, VA is the biggest and most important Richmond. Anyone who has heard
of Richmond, VA will likely assume that is the Richmond being referenced.
Anyone who hasn't heard of Richmond, VA gains no additional understanding from
knowing which state it's in.

~~~
azernik
If you're in the Bay Area, as HN commenters disproportionally are, your mind
is likely to jump first to Richmond, CA in the northern East Bay.

------
Double_a_92
And nothing of value was lost...

------
loverofcode
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](https://imgur.com/a/fFBTe)

------
jcmoscon
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.

~~~
craftyguy
or, maybe some folks just want an escape from stress / real life.

or, maybe they got hooked after being perscribed painkillers for an injury

or, maybe they're suffering from some mental illness

or, literally any number of other reasons besides some evil nation flooding
the US with drugs and somehow 'forcing' citizens to take them.

The point is, you can choose to go after the suppliers, but the underlying
problem is still there. Until that's addressed (mental healthcare, serious
punishment for over-perscription, etc), we'll just see a new drug take the
place of the old.

