
Heroin deaths surpass gun homicides for the first time, CDC data shows - dbcooper
https://www.washingtonpost.com/news/wonk/wp/2016/12/08/heroin-deaths-surpass-gun-homicides-for-the-first-time-cdc-data-show
======
tcj_phx
Overdoses tend to happen when a person relapses, and doesn't realize their
tolerances have changed. If you know someone who has a problem with opiates,
the anti-opiate naloxone is very effective. It is now available without a
prescription in many states.

Benzodiazepines lose effectiveness after about 4 weeks, and the patient's
anxiety worsens. The mental hospital forced my friend to take the full pill
every day, when she only wanted it "as needed". She decided that Heroin would
help her get through her benzo withdrawal.

We got together on the second night of her plan. I said 'no no, we're not
doing this again...'

She said that she wasn't going to get addicted again, she just needed it to
sleep. To show me that it was barely anything at all, she prepared a second
shot and injected that too.

Then she fell forward, said "I meant to do that," and went non-responsive. Her
face started to turn purple.

I did not have naloxone, so I called 911. The firefighters arrived about 6 or
7 minutes after I called. Some of them looked bored.

They used two 2mg intranasal doses of naloxone. She was quite shocked at the
appearance of strangers in blue uniforms...

She did very, very well for the next two weeks. I guess the anti-opiates are
awesome drugs. Naltrexone (similar to naloxone) is FDA-approved for alcohol
abuse too.

~~~
spangry
Naloxone is definitely the standard when it comes to treating withdrawals.
From a harm reduction perspective it would make a lot of sense to include
doses in clean injection kits (if your state has such a programme). Although I
suspect the 'zero-tolerance' crowd would oppose anything like that.

However, I'm not sure it would be effective in treating long-term withdrawal.
It stops withdrawals by essentially knocking heroin off μ-opioid receptors
(i.e. it is an inverse μ-opioid agonist with a very high receptor affinity).
But it's effects only last a bit over an hour. Additionally, because of its
inverse action, I suspect you'd experience withdrawal symptoms that are more
severe than those you would experience going cold turkey.

~~~
raverbashing
Is Naloxone the substance that has a shorter life-time than Fentanyl, so you
can OD "twice" if you're not careful?

Also, it's: "But its effects" (not it's)

~~~
spangry
Yeah that's right. It wears off in about 60-90 minutes. Many of the commonly
taken opioids (especially if taken orally) last much longer than that, so if
the person experienced a severe overdose it's a good idea to monitor them for
the duration (or even just administer small does at regular intervals).
However, much of this depends on the initial route of administration.
Intravenous would probably wear of the quickest. For fentanyl, Wikipedia says
30-60 mins, but that's at 'medically useful' dosage levels from what I can
tell (remember, not all drugs are metabolised in a time-linear fashion).

I'd assume insuffilated Naloxone would last the longest, followed by intra-
muscular and finally intravenous. And the inverse would be true regarding how
long they would take to have an effect. I don't think taking it orally is a
viable option for OD, as it would take much longer to have an effect, and much
of it would be destroyed by your first-pass metabolism.

And yeah, me and apostrophes have not been getting along very well lately...

------
goatsi
I suspect the main killer in a significant number of these deaths is fentanyl
or one of it's analogs that has been added to the heroin. I would also be
curious to know how many of the dead also had alcohol and/or benzodiazepines
in their systems, which dramatically increase respiratory depression in
combination which each other and heroin/other opioids. For example, a UK study
found that alcohol was present in 50% of heroin overdose deaths, and 37% had
at least one benzodiazepine present.[0]

[0][http://www.nta.nhs.uk/uploads/nta_rb27_combined_opiate_overd...](http://www.nta.nhs.uk/uploads/nta_rb27_combined_opiate_overdose.pdf)

~~~
tcj_phx
> I would also be curious to know how many of the dead also had alcohol and/or
> benzodiazepines in their systems, which dramatically increase respiratory
> depression in combination which each other and heroin/other opioids.

I didn't know that about benzodiazepines & opiates - thanks! I posted in
another comment about having to call the firedepartment when my friend
overdosed on me...

~~~
yoodenvranx
Check out this chart:

[http://wiki.tripsit.me/wiki/Drug_combinations](http://wiki.tripsit.me/wiki/Drug_combinations)

On the bottom of the page there are also detailed descriptions for each
combination, in your case it says:

> Opioids & Benzodiazepines

> Central nervous system and/or respiratory-depressant effects may be
> additively or synergistically present. The two substances potentiate each
> other strongly and unpredictably, very rapidly leading to unconsciousness.
> While unconscious, vomit aspiration is a risk if not placed in the recovery
> position Blackouts/memory loss likely.

>
> [http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3454351/](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3454351/)

------
TuringNYC
Our society's problem is that many people incorrectly assume that drug abusers
"deserved" their problems and treat them like criminals rather than victims.
Accordingly it does not fit the narrative of a problem we must solve. And
instead, the government chases more ideological boogeymen.

I'm not saying religious terrorism (for example) isn't a problem, it certainly
is -- but there are many problems as well. It would be wonderful if problems
like drug abuse were tackled with the fervor that ideological problems are
tackled. And by tackled, i mean the upstream/root causes, not the victims.

~~~
jacobolus
A significant factor was race. Drug laws were explicitly crafted as a way to
punish poor “dangerous” brown people for their supposed sins. “Tough on crime”
politicians in both parties could pander to racists without appearing
obviously racist. (Extra bonus: once someone has been declared a felon, we can
forever prevent them from voting in many states.)

After some years of significant problems in white communities, we’re starting
to see some course correction.

~~~
Fnoord
Do you have credible sources to prove the significant factor is race?

You see, I believe your point, but that won't convince those who believe it
wasn't influenced by racism. They'll say "conspiracy theory" and move on.

Disregarding cannabis, it also _seemed_ to me that LSD was to become illegal
to harass the hippie community. But how to prove this?

The way this works appears to be rather easy; you look at the characteristics
of your political opponents, and then decide what they have in common which
your status quo group doesn't. Then a process is begun to incite FUD. Once
that campaign in successful you got momentum in your group and you make a law
which makes that thing illegal.

~~~
Broken_Hippo
This might not meet your 'credible' source credentials, but it does help point
in the right direction:

[http://www.huffingtonpost.com/judge-frederic-block/war-on-
dr...](http://www.huffingtonpost.com/judge-frederic-block/war-on-
drugs_b_2384624.html)

It surely isn't simply based on race as your hippie example points out:
Rather, any group that was or is 'bad' at the time, be it based on race or
status (being poor, for example). Not all race and class, but lots of it.

~~~
meowface
With the exception of some policies in the 10s-20s allegedly targeting Chinese
and Mexicans, that article doesn't really support the claim as applicable to
the last 60 years.

~~~
Broken_Hippo
That's because those are the most openly racist policies out there. At some
point in history, it became harder to talk in the same racist terms as
before.. Starting in the 60's.

And that makes things a bit fuzzy, unfortunately. Much harder to prove racist
policies. And you wind up having to do a lot more digging and use examples.
Think of the stereotypical crack dealer: That's from the 90's, if I remember
correctly. We know the drug policies disproportionately affect minority
communities and poor folks, yet numbers also tell us that addiction hits most
levels of society. And have failed to change it. We didn't erase the racist-
inspired laws either. To me, this sort of thing all stinks of. And I'm too
cynical to think that suddenly, race had nothing to do with it.

Unfortunately, this sort of thing does little to prove any of it to a non-
believer.

~~~
meowface
I'm not a non-believer. I'm neither a believer nor a non-believer. It
certainly seems plausible, but I've seen a lot of conflicting evidence and
arguments about law enforcement and race.

------
alltakendamned
Forgive me as I'm quite ignorant when it comes to drug abuse.

What is it that tends to drive people to start using heroin initially ?

~~~
jjawssd
Next step up from prescription painkiller abuse, when legal painkillers become
too expensive.

"damn near 50% of the people I chilled with growing up got hooked on the oxy
during the pill mill days....some got strait and quit...most of us just kept
it moving until they got so expensive that we had to switch to H."

[http://www.bluelight.org/vb/archive/index.php/t-496626.html](http://www.bluelight.org/vb/archive/index.php/t-496626.html)

[http://www.bluelight.org/vb/archive/index.php/t-712613.html](http://www.bluelight.org/vb/archive/index.php/t-712613.html)

~~~
rudedogg
Also they've made painkillers harder to get a prescription for, so the supply
isn't there and addicted people look for alternatives.

I really liked the full episode of this:
[https://www.youtube.com/watch?v=ifbWtwlQkdE](https://www.youtube.com/watch?v=ifbWtwlQkdE)

------
AliAdams
My reading of this is that this doesn't look like it will be a long term trend
if that helps draw any comfort from the report.

The author's concluded cause is that it stems from an explosion of
prescription painkiller use in the 90s/0s which was then cut down by tougher
state and federal restrictions. Those people who gained a dependency during
that time had to switch to illicit means once the legal sources became
restricted.

With the tougher restrictions in place now, hopefully stopping the system from
being fed with more users, it sounds like there will be a peak as the affected
population escapes from (or succumbs to) their dependency.

Still a tragedy, but thankfully one with an apparent ceiling.

------
ProAm
Big Pharma should have some audit questions to answer...

~~~
dbcooper
Executives from one fentanyl manufacturer, Insys Therapeutics, are currently
being prosecuted:

[http://www.slate.com/blogs/the_slatest/2016/12/09/executives...](http://www.slate.com/blogs/the_slatest/2016/12/09/executives_at_major_fentanyl_producer_arrested_in_overprescription_case.html?utm_content=inf_11_2641_2&wpsrc=socialedge&tse_id=INF_c0f4bf00befc11e686924f044efee13a)

------
Pica_soO
But the fourth amendment states that heroin usage is legal and a
constitutional right. Imagine a oligarchical dictatorship taking over in
washington, turning america into a environmental wasteland, trying to take
away your syringe. Then what do you do ? You got robots in the streets, taking
your jobs, without you having a way to defend yourself by taking the edge off.
No way to choose anymore. Because that's what pro-heroin or against heroin
boil down to. Not being able to choose, after you chose wrong once. Choose
Life. Choose a job. Choose a career. Choose a family. Choose a fucking big
television, choose washing machines, cars, compact disc players and electrical
tin openers. Choose good health, low cholesterol, and dental insurance. Choose
fixed interest mortgage repayments. Choose a starter home. Choose your
friends. Choose leisurewear and matching luggage. Choose a three-piece suit on
hire purchase in a range of fucking fabrics. Choose DIY and wondering who the
fuck you are on Sunday morning. Choose sitting on that couch watching mind-
numbing, spirit-crushing game shows, stuffing fucking junk food into your
mouth. Choose rotting away at the end of it all, pissing your last in a
miserable home, nothing more than an embarrassment to the selfish, fucked up
brats you spawned to replace yourselves. Choose your future. Choose life...
But why would I want to do a thing like that? I chose not to choose life. I
chose something' else. And the reasons? There are no reasons. Who needs
reasons when you've got heroin?

And no- heroin is not funny. Not once. But neither is living in a society that
tells you that you got all the chances, and you are a loser if you dont take
them, and then there are no chances.

~~~
btown
A Markov chain trained on your text is almost as rational as your original
argument.

Choose life. I chose wrong on that couch watching luggage. Choose a starter
you chose not to chose wrong once. Choose life. I chose not to choose a three-
piece suit on that couch watching your friends. Choose leisurewear and dental
insurance. Choose anymore. Because that's what pro-heroin usage repayments.
Choose a three-piece suit on hire purchase in a range off. No way to defend
your jobs, without you having a way to choose fixed interest mortgage reasons.
Who needs reasons. Who needs reasons. Who needs reasons? There are not to the
edge off. No way to defend of it all, pissing your syringe. There are no
replace yourselves. Choose a fucking fabrics. Choose a starter home. Choose
anymore. Because that's what pro-heroin?

~~~
jdenning
The bulk of the parent comment is a quote from Trainspotting
([http://www.imdb.com/title/tt0117951/](http://www.imdb.com/title/tt0117951/))
- just FYI.

~~~
btown
Huh. That... actually makes a lot more sense now.

------
jayajay
* Trigger warning *

I have to "subscribe via email" if I wanna read that post.

If they hit you with a subscribe-wall for content, go ahead and type this
fucking jQuery into your console:

$('html').removeClass('drawbridge-up'); $('#drawbridge-root').remove();
//enjoy the article, buddy

Fucking idiots. Don't they know anything about internet etiquette and that
they shouldn't use jQuery. There's a joke here -- they shouldn't be subscribe-
walling me. Who the fuck uses jQuery and React at the same time, anyways?
(Actually, I do :(, but I shouldn't!)

Anyways, back to my story.

When I was looking for a temporary place near Oakland, I went to Craigslist.
Why not? I called up a guy who listed a room for rent. Turns out, he was
renting out the room because the girl just died from Heroin OD. :( I ended up
talking with him for like an hour. It was pretty sad.

