
Lethal Opiates Delivered by Mail from China, Killing Addicts in the U.S - happy-go-lucky
http://www.npr.org/2017/03/11/519649096/can-china-ban-on-deadly-opioid-save-lives-in-the-u-s
======
zkms
Ah, if the trend toward nastier and more potent fentanyl analogues was an
expected and predicted consequence of opioid prohibition. That would have been
nice to know!

Before opioid prohibition deaths from opioid use were quite rare. You ever
heard a pothead drone on about "it's nearly impossible to overdose from
smoking marijuana"? The same thing applies to smoking opium. It's nearly
impossible to overdose on that. But prohibition has pushed us from opium
smoking and oral laudanum to injectable heroin to fentanyl and now we're at
_carfentanil_.

The current USian "opioid crisis" is another manifestation of opioid
prohibition pushing people from safer, cheaper, less disruptive and deadly
drugs to more deadlier ones. Two decades ago some USian opioid users could go
to pill mills and get prescriptions for pharmaceutical grade opioids but the
DEA kicked down doctor's doors a bunch and that ended up pushing people to the
illicit market. Maybe next time you see those scary increasing graphs of
opioid deaths vs time, give that a thought? Sum up all those deaths (compared
to the baseline, prior to the increased LEA focus on "pill mills) and ask
yourself: are all those needless deaths worth it?

For a unit volume (so, for a unit risk of ending up in a concrete box as a
consequence of shipping/making raw product) of uncut/active material, you want
to be able to sell the most diluted/cut doses to end-users. __Of course
__people will want their chemist to synthesise carfentanil (over regular
fentanyl), because you can supply the the same number of end-user doses with
10,000 times less active material. The harder the enforcement, the more potent
this selection pressure
gets:[https://en.wikipedia.org/wiki/Iron_law_of_prohibition](https://en.wikipedia.org/wiki/Iron_law_of_prohibition)

~~~
Alex3917
> Before opioid prohibition deaths from opioid use were quite rare.

Maybe in the U.S., less so in China where ~25% of adult males were opium
addicts in the early 1900s. The war on drugs isn't a success by any means, but
at least the problems that exist aren't on that scale.

A better example of prohibition backfiring is with marijuana, where before
prohibition ~0% of Americans were marijuana users, whereas today ~85% of
American adults have used marijuana.

~~~
zkms
My argument isn't that opioid use in the time of opium dens was harmless, nor
that opioids can be used willy-nilly without any harms. I am well familiar
with some of the dangers of opioid use and do not wish to discount them at
all. My argument is that opioid prohibition in the 21st century in the US is a
legal regime that _amplifies those dangers_ \-- it kills lots of people quite
effectively (and keeps killing more every year).

The number of people who use opioids regularly is a second-order concern (if
only because fent-laced heroin certainly gets that number down) to me, frankly
-- reducing morbidity and mortality due to drug use is a lot more important.
With a decent medical infrastructure, addicts should be able to get opioid
maintenance therapy with the right drugs and dosage and be able to lead actual
interesting lives beyond trying to score the next hit.

I'd so much rather live in a country where people who want to get high on
opioids can buy cheap, pure, precisely metered opioids that won't kill them
rather than smashing car windows to be able to pay for overpriced fentanyl-
laced drugs sold by criminals that might overdose them in the street (which
will cause even more expense and load on the already-awful USian medical
system).

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deftnerd
Some of these synthetic opiates are a bit terrifying. There are some research
chemicals available that are hundreds or thousands of times more potent than
fentanyl and they're still technically legal.

It's so hard to work with these that even the drug boards say it's suicide to
try to work with them without a clean room and a hazmat suit. If you inhale
just a little bit of the drug dust in the air it will kill you.

It's gotten to the point where some of these respiratory depressant drugs can
be used as a chemical weapon if inhaled.

For instance:

Heroin = 2.5x potency of morphine

Hydromorphone = 7.5x potency of morphine

Fentanyl = 120x potency of morphine

Carfentanyl = 5000x to 7500x the potency of morphine

Methoxyacetylfentanyl = 30,000x the potency of morphine

A lethal dose of Methoxyacetylfentanyl is so small it's not even visible to
the naked eye. Some powdered methoxyacetylfentanyl released from a drone over
a crowd would be disastrous.

~~~
jemfinch
Is there any reason to treat these as drugs instead of just poisons?

We sell all kinds of poisons on the regular basis and don't bat an eye. Are
these any more interesting because they're opiates?

~~~
Scoundreller
It's the dose that makes the poison. This is 16th century toxicology:
[https://en.wikipedia.org/wiki/Paracelsus#Contributions_to_to...](https://en.wikipedia.org/wiki/Paracelsus#Contributions_to_toxicology)

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pnathan
This is a yellow journalism headline. Hearst would be proud.

As I've remarked before, the war on drugs and getting tough on crime is not
working out too well for us, so it's time to change our plan.

I don't advocate off the shelf heroin or any of the cluster of ideas that
suggest that. I do advocate focusing on the funnel that leads to addiction,
homelessness, and death. Part of that is significantly amping up mental
healthcare spending; part of that is having legally controlled drugs available
in pharmacies for reasonable prices; part of that is supporting better schools
(giving a window into a better world, and a way to climb through); part of
that is supporting jobs programs. All of those relate in one way or another to
the problem, some years and years earlier in the funnel.

No one is born choosing to be an addict in their later life; a series of
choices and pressures put them there. The pressures from society can be
changed, which shapes the set of choices visible.

~~~
scurvy
I live next door to a rich heroin junkie. She has no job. What's left of her
family has basically cut her off. She can afford all of the care in the world,
but chooses heroin over treatment instead. Why? Heroin don't care.

The city of San Francisco took her dog away (twice) and declared her place a
health hazard for a while, but ultimately it never forced her to get treatment
and is tacitly approving of her heroin use. She hasn't paid her property taxes
in years and the police come out about once a month, but the US has no ASBO
laws so it's catch and release in hippie dippie SF.

She's got the money for the dope, and heroin don't care.

PS> She got the dog back both times.

~~~
idiot_stick
> _She 's got the money for the dope, and heroin don't care._

So you what do you propose as a solution for this (likely unrepresentative)
anecdote? Lock her up?

~~~
scurvy
I don't have a solution, but my point was that not all addicts are victims.
For some, it's a conscious decision about choosing heroin over life (insert
Trainspotting ending here).

Unless the US adopts some sort of ASBO laws, there's not much you can do about
forced treatment for someone who doesn't choose treatment.

Also, you could substitute heroin here with any other equally damaging
substance like alcohol and the situation wouldn't change.

~~~
deelowe
How about we just let addicts be addicts while we figure the rest out. That's
certainly better than today's situation where we make extra sure we ruin their
lives to, ya know, protect them from themselves.

~~~
scurvy
The problem is they create a wake of destruction in their path of addiction.

~~~
toomuchtodo
The cost of a free society.

Keep that ASBO trash on the other side of the pond.

~~~
scurvy
How about charging them for their public costs? If you get rescued by
helicopter because you went skiing out of bounds at a resort and got lost,
don't they send you a bill? How about that for people with money who abuse the
system while abusing other things?

~~~
toomuchtodo
Like how the Japanese will send a bill to the family of someone who commits
suicide on a train line?

I prefer my government to absorb the cost of human despair rather than bill
for it. Don't write policy based on outliers.

~~~
friedman23
> absorb

You are very good at using language. The reality is that government doesn't
'absorb' anything. Other people, some of whom can't afford to, pay for it.

~~~
toomuchtodo
All economics are redistribution, it's simply the details that change with the
methods. It is unrealistic to want a world where each person pays exactly for
what they consume or are liable for.

~~~
friedman23
Maybe you are right but I cannot understand or agree with this idea that has
taken hold among some on the internet that we should be happy to pay taxes
because the government will go and solve problems with that money. Beyond the
fact that the government is horrible at allocating resources and using them
efficiently, every tax is a dollar being taken from the economy that could
have gone to people that produce things of value not what some bureaucrat
decided was of value.

~~~
maxerickson
_every tax is a dollar being taken from the economy_

Government turns around and spends those dollars in the economy. They are
reallocated, not removed.

~~~
friedman23
Individuals are significantly better at allocating resources than a central
authority.

------
moxious
This reads like a thousand other articles over decades, like moral panic.
There's always some new drug that's coming along, whether meth, this, bath
salts, whatever.

When will culture come to its senses and realize that humans like to get high
and that this will never stop?

Let's just focus on giving users accurate information and pathways out of
usage, and skip the moral panics and claims that X is "sweeping the nation".

~~~
ChuckMcM
You do a great disservice to the people overdosing with such a middling
dismissal. This is not a 'moral panic' this is a medical disaster unfolding in
slow motion.

The combination of the technology to synthesize these drugs from unconstrained
pre-cursors, the intensity of their effect, the lack of education on the part
of consumers, and a tracking/enforcement system which responds more slowly
than conditions change is leading to a situation where tens of thousands of
people are going to die essentially at their own hand.

It is not a question of 'people like to get high' it is that 'people getting
high on arbitrary things will kill themselves'.

I understand that you're approaching this from a legalization standpoint, and
on that we agree. But the overdose rate is "actually" sweeping the country now
and that is born out by the available reports of emergency rooms around the
country. And between your "regulated and safe" future and now, there is a
large pile of unnecessarily dead people.

~~~
myowncrapulence

       the lack of education on the part of consumers
    

You realize if drugs were legal and regulated people wouldn't need to seek out
desperate and risky online orders to satisfy their addiction?

When weed was legalized in Oregon, I immediately knew exactly what
strain/THC%/CBD% I was buying. This was not available on the black market.

Education and security come from acceptance and regulation.

~~~
ChuckMcM
I do realize this, and agree that a saner drug policy is to legalize them and
regulate them rather than the prohibition we have today. My point is that
between the time we can get to that point, and now, a lot of people are going
to end up dead unnecessarily and that they are worth trying to save. Sometimes
this sort of 'look how horrible it is' type of article can help with that.

~~~
iopq
But "look how horrible" actually prevents decriminalization/legalization
efforts.

------
personjerry
It seems like an ironic reversal of sorts in Sino-western opium relations,
given the Opium Wars[0], which if I understood correctly, forced China to
accept opium trade from the British.

[0]
[https://en.wikipedia.org/wiki/Opium_Wars](https://en.wikipedia.org/wiki/Opium_Wars)

------
zhengiszen
Looks like irony ...
[https://en.wikipedia.org/wiki/Boxer_Rebellion](https://en.wikipedia.org/wiki/Boxer_Rebellion)

~~~
jlarocco
Definitely ironic.

Some of the earliest drug laws in the United States were enacted to
discriminate against (primarily Chinese) opium users.

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bluedino
It's amazing what isn't legal to buy or sell in the USA, but you can easily
buy from China and have delivered in the mail. $100 of testosterone powder
which you can re-constitute and sell for $20,000 on the street here. Some of
the more sophisticated resellers will even pack your order inside of a less
conspicuous object.

~~~
jacquesm
Better be prepared to calculate in a lot of $ for lab testing of what you
think is worth $20,000 before you kill a bunch of people.

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jacquesm
If you order anything at all for consumption from China be aware that you may
get anything and everything besides the product that you ordered. White powder
of any kind is an easy substitute for white powder of any other kind.

~~~
agumonkey
I don't know how much is psychology/paranoia, but every package I get from
there smells chemically bad. One stupid plastic case for a laptop dvd drive
gave me headache I had to throw the thing out.

That said, I also bought an old FP book from the US and got a similar smell.

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coretx
Yellow journalism just attacked your postal secret, your democracy ; this by
means of using your disdain for junkies and drugs. Who else besides the
mentioned politician and a large chunk of the logistics sector profits ? Put
their heads on a pike, show the world how utilitarian their true face is.

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ramblenode
This is the text of the STOP act mentioned in the article:
[https://www.congress.gov/bill/114th-congress/house-
bill/6045...](https://www.congress.gov/bill/114th-congress/house-
bill/6045/text)

IANAL but would be interested to hear from one about the privacy and financial
implications of this bill. For example, (d)(1) seems to suggest a $1
processing fee for non-letter class mail originating outside the US.

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spraak
I wonder as an analogy what markets would develop if caffeine sources were
illegal. Caffeine isn't as harmful as other drugs but it is very addictive. By
the same extension, this is why I think getting any drug should be eaiser.
It's safer

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bfuller
I've used many grams of these substances. AMA

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s-
and you thought only legitimate businesses had a customer attrition problem...

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undersuit
>A better example of prohibition backfiring is with marijuana, where before
prohibition ~0% of Americans were marijuana users, whereas today ~85% of
American adults have used marijuana.

No a better example was when Alex3917 made up shit, and then tried to
legitimize his shit by comparing regular "users" to the population that has
had at least one use. Wait that's not a better example, I'm just calling you
out.

Cannabis use was alive and well before Federal Prohibition, Alcohol and
Marijuana. ~0% of Americans were users? Maybe in the early 1400s.

~~~
Alex3917
Harry Anslinger estimated that there were 100,000 marijuana users when
marijuana was banned 1937, when the U.S. population was ~129 million. In other
words, a little less than 0.08%, or ~0%. Fail.

~~~
TylerE
Getting your drug "facts" from Anslinger is like trusting what Jerry Falwell
says about homosexuality.

~~~
Alex3917
Sure, but he wasn't exactly known for underestimating the scope of any drug-
related problems. A better analogy would be that if Falwell says that gay
marriage isn't responsible for causing hurricanes, you can probably take his
word for it.

