
Changing dynamics of the drug overdose epidemic in the US, 1979-2016 - Hooke
https://science.sciencemag.org/content/361/6408/eaau1184
======
persistent
Interesting that there seems to be a consistent age cohort born before (I
guess from the heat maps) 1950 that just aren't into this stuff.

~~~
doctorpangloss
Or addicts die before they’re 70+ years old.

~~~
persistent
But that's not what the graphs show. There is a diagonal that clearly tracks a
birth year cohort, not an age.

~~~
spamizbad
True, but the graph show lots of people dying in their 20s and 30s. So if I
was born in 1940s and became a heroin addict there's a good chance I die
before 1979. So those born before 1950's are unlikely to die of a drug
overdose between 1979-2016 because to do so they would have needed to become
in contact with heroin for the first time well into their 30s instead of their
teens and 20s.

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ebg13
Anyone know wtf is going on with New Mexico? It's seriously disproportionately
represented in every map.

[https://science.sciencemag.org/content/sci/361/6408/eaau1184...](https://science.sciencemag.org/content/sci/361/6408/eaau1184/F4.large.jpg?width=800&height=600&carousel=1)

~~~
anon1m0us
There are probably a lot of factors: New Mexico is the second poorest state in
terms of poverty rates. It's a drug smuggling gateway from Mexico. Very high
Native American population, which itself, struggles disproportionately with
addiction. Mostly rural isolated populations where drugs offer a means of
escape and long wait times for an ambulance to arrive in the case of an
overdose situation.

As an aside, looking at those charts, no wonder Breaking Bad was set there.

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11thEarlOfMar
I call this a betrayal of America by US politicians. The overdose _rate_ has
apparently doubled over the past 10 years and congress did not even start
talking about opioids until, what, 2017? No one jailed until 2019? 3 years
beyond the charts in this report. 47,000 Americans died from opioid overdoses
in the last 12 months.

Is it coincidence that by far the biggest spender on congressional lobbying is
Pharma/Healthcare? $284,000,000 in 2018 alone. That is $531,000 _per
congressperson_ in one year, and only for Pharma/Healthcare. Or, another way
to look at it, $5,985.25 per opioid death.

[0]
[https://www.opensecrets.org/lobby/top.php?showYear=a&indexTy...](https://www.opensecrets.org/lobby/top.php?showYear=a&indexType=i)

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refurb
Not surprised that as prescription opioid supply is tightened up, users move
to heroin.

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sunkenvicar
Chinese fentanyl is to heroin what vodka is to near beer.

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freeonioire
All drugs should be legalized in US.

You should be able to buy opioids/heroin/cannabis at the local pharmacy with
no prescription or questions asked.

This war on drugs only kills people and makes the Purdue family rich.

~~~
cc-d
Decriminalized yes, the question of legalization is more complicated.

When it comes to opioids, legalized alone opium would alleviate vast swathes
of death and suffering. Many of the same arguments made for cannabis
legalization also apply to opium. It's difficult to unintentionally overdose
on, there are no serious long term health detriments aside from dependency and
constipation (and testosterone decrease). The poppy has been cultivated by
humans for as long as wheat has, it is only recently recently it became so
demonized.

And most importantly, it would largely eliminate the demand for black market
heroin/fentanyl. Opium is a combination of 3 alkaloids, morphine, codeine,
thebaine. Heroin is just acetylated morphine which allows for more total
morphine to cross the BBB, it's still morphine which produces most of the
effect users desire.

And most importantly, it allows opioid users a strong, easy to access, cheap,
legal alternative to being sick.

Even though there would still be some demand, black market suppliers could not
compete price wise, so the black market would be eliminated very quickly. The
DRAMATIC price reduction will also make the financial effects of opioid
dependency much less devastating.

~~~
darawk
> When it comes to opioids, legalized alone opium would alleviate vast swathes
> of death and suffering. Many of the same arguments made for cannabis
> legalization also apply to opium. It's difficult to unintentionally overdose
> on,

While I agree with the general thrust of your argument, this point is
incorrect. It's not difficult to unintentionally overdose on Opium. Not at
all.

~~~
anon1m0us
That comment struck me too. Perhaps there is a difference between Opi _um_
overdose and Opi _oid_ overdose?

When I think consuming opium, I conjure images of old chinese artwork where
they are smoking it in a hookah type instrument.

The Opioid overdoses are mostly Fentanyl and other extracts _from_ opium. I'm
not an expert, but if I am understanding correctly, it seems easier access to
Opium which may be, according to the GP, hard to OD on, would reduce the
Opioid OD epidemic.

~~~
darawk
That may be what the OP was thinking, but it's not the case. You can very much
OD on regular Opium. It is even easier to OD on its extracts (specifically
morphine), and even easier still to OD on its synthetic analogues (fentanyl).
However, you can absolutely OD and die on pure opium.

~~~
idDriven
The dude said 'unintentionally' overdose on opium. This article covering
Laudanum (opium + alcohol tincture) deaths in the 1800s sounds like the
overdoses were largely intentional or one where an adult dose was given to a
child.
[https://www.apnews.com/910654effffe42f985ebe01f299407f5](https://www.apnews.com/910654effffe42f985ebe01f299407f5)
As long as the strength is known most addicts will measure the dose or titrate
up safely.

~~~
darawk
I'm aware, I repeated his 'unintentional'. Unintentional overdose deaths on
Opium are certainly less common than fentanyl. But they are nowhere near as
difficult to achieve as Marijuana, which is basically impossible.

