Changing dynamics of the drug overdose epidemic in the US, 1979-2016

https://science.sciencemag.org/content/361/6408/eaau1184

by Hooke • 7 years ago

45 41 7 years ago

science.sciencemag.org

persistent2• 7 years ago

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• 7 years ago

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

persistent2• 7 years ago

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

refurb• 7 years ago

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

freeonioire• 7 years ago

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.

maverick2007• 7 years ago

Is there anywhere in the world where all drugs are legalized?

I know Portugal (and maybe others) have decriminalized drugs and results are pretty good but going from decriminalization to legalization feels like a big step.

authoritarian2• 7 years ago

Drug possession has been decriminalized in Uruguay since the mid 1970s. As you mention, Portugal also decriminalized all drugs in 2001. Switzerland provides safe injection rooms and needle exchanges for harm reduction

avocado4• 7 years ago

What happens if you buy heroin, overdose, and pass out on the street with permanent brain damage?

not2personal• 7 years ago

What happens now?

authoritarian2• 7 years ago

The same thing that happens now, except medics could know you're overdosing on pure diacetylmorphine (or whatever is sold), rather than heroin mixed with fentanyl mixed with baby formula powder mixed with your dealers skin sells mixed with whatever other garbage street drugs get cut with. Not to mention the money saved from being wasted on the war on drugs and gained from the sale of drugs could go towards mental health and other medical services to actual address the root of the issue rather than wasting even more money by throwing addicts in prison

rectangletangle2• 7 years ago

What's your stance on antibiotics? Or did you only mean "recreational" drugs?

The reason why I bring this up is that antimicrobial resistance is an externality of widespread antibiotic usage. Unfettered access to all drugs would probably accelerate antimicrobial resistance, because people tend to overuse/abuse antibiotics when they have the freedom to.

(Not trying to be mean/inflammatory/pedantic, I'm genuinely curious how HN would reconcile these stances.)

fiftyfifty• 7 years ago

Vast quantities of antibiotics are used by agriculture in the US, with little regulation or control. The stuff is in our water and food supply, whatever additional increases allowing people to purchase/use antibiotics without a prescription seem pretty small by comparison.

leetcrew• 7 years ago

I don't think most drug legalization types intend to advocate for unrestricted access to antibiotics, but it's certainly worth discussing.

antibiotics are less effective for everyone the more they are used, so you can conceptualize the effectiveness of antibiotics as a common resource that can be spent down. if I abuse antibiotics, I am directly harming you.

there are arguments that drug abuse also harms others, but I find them somewhat less compelling. usually they follow the pattern of "I feel compelled to help you in X situation, so you are harming me by putting yourself in X situation". not an entirely illegitimate argument, but much more debatable imo. there's also the common "we have to protect people from their own poor choices" which I consider incompatible with free society.

cc-d4• 7 years ago

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.

JamesBarney• 7 years ago

If it's not legalized who are the black market suppliers not able to compete against on price?

darawk6• 7 years ago

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.

pstuart• 7 years ago

No. Sorry. Legalize them all.

We are tricked into discussing drug prohibition as if it is intended to protect the public. It never was and never will be.

The fact that we sell alcohol and tobacco ends any discussion over "safe" drug use.

Legalize it. Regulate it. Tax it.

Anything else is misguided misery at best.

tengbretson• 7 years ago

What if you're wrong though? What if full legalization leads to our country becoming a drug addled hellscape? Do we return to the status quo?

jackpeterfletch3• 7 years ago

My reservation with complete legalization. Is that I think there is a strong conflict of interest, in any corporation being allow to sell, advertise, and market any highly addictive substance.

You could argue that there will be rules and restrictions, but lets not forget that the current opiod crisis, was caused directly by those corporations corrupting the supervisory body (Doctors) in place to stop it happening.

The supervision needs fixing (which I trust it can as it seems to be a uniquely US problem), but if you lifted it all together, I believe the floodgates would be open for corporate exploitation.

gerbilly• 7 years ago

[...] I think there is a strong conflict of interest, in any corporation being allow to sell, advertise, and market any highly addictive substance.

Just ban advertising of drugs then. In Canada, cigarette ads are banned for example.

circlefavshape• 7 years ago

Last winter in San Francisco I saw a billboard with the ad "Hello marijuana, goodbye anxiety"

ebg13• 7 years ago

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...

anon1m0us2• 7 years ago

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.

11thEarlOfMar• 7 years ago

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...

sunkenvicar• 7 years ago

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

Changing dynamics of the drug overdose epidemic in the US, 1979-2016

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