Let's Talk About The Opioid Problem

[SumJongGuy]

Legal opioids would probably also be pretty cheap, if the environment was competitive. Look at how cheap fentanyl is.

How much des heroin cost where it's legal? Some places were giving it away for free to prevent exactly these problems.

[Trackhead]

alcohol and alcoholism ain’t cheap and if you think it is, stfu.

1L of whisky a day is ~$3600, and there are plenty of beer only boozers

Well maybe the solution to the addiction crisis is free whiskey and opioids?

I’m very well aware there are many 12-18pk per day alcoholics. I’ve seen and treated full spectrum addiction in both ER, primary care.

[dunfree]

Well maybe the solution to the addiction crisis is free whiskey and opioids?

I’m very well aware there are many 12-18pk per day alcoholics. I’ve seen and treated full spectrum addiction in both ER, primary care.

as a medical you see the end, not the production, fool, and I doubt you see 12pks much more likely way beyond that

Now keep moralizing

[SumJongGuy]

Case a day is not all that uncommon, but 12 pack a day is pretty standard normal day for a practicing alcoholic... with a couple shots when available.

There are also alcoholics how go days and weeks and months without drinking then binge for a day or three then off it again.

Not all alcoholics are daily drinkers. It's not how often someone drinks.. it's what happens when they do..

[Trackhead]

as a medical you see the end, not the production, fool, and I doubt you see 12pks much more likely way beyond that

Now keep moralizing

I see the beginning and the end. The living and the dead, and the dying. Thx for the constructive conversation.

[dunfree]

I see the beginning and the end. The living and the dead, and the dying. Thx for the constructive conversation.

There’s nothing productive possible with you. So again, stfu. You don’t understand and you can’t


Jfc a 12-pk of standard beer?

[Trackhead]

Gotcha. What’s your proposition for the current debate?

[CarlMega]

Opioids sold in convenient 12 cooch packs? Everyone's happy.

[Trackhead]

Opioids sold in convenient 12 cooch packs? Everyone's happy.

I say yeah let’s do it. See how many polypharm overdoses we can get a week. Opioid naive kids who go to a party, do some shots, take some opioids….puke, aspirate, hypoventilate, and ultimately just stop breathing. Shit I can’t wait for that in the ER….

I’m not moralizing. Go wild on it.

[Core Shot]

Gotcha. What’s your proposition for the current debate?

Don’t let the fucktards get you down.

It’s different on the inside. No ivory towers for you.

[Dantheman]

If your kid wants to get high he’s going to, legal or not. The same is true of all addicts.

Prohibition pushes people to not be open about their struggles, forces them to pursue lower quality product (when is the last time someone went blind or died from bad alcohol purchased at a bar in the United States?), and criminalizes addicts when they seek help. We need a more supportive society, not a nanny state.

Agreed. Drugs were never easier to get than in high school and surely that hasn't changed.

People don’t disintegrate their lives over just cost, they disintegrate due to becoming 100% obsessed and addicted and non-functional in society.

A major reason people become completely obsessed is that they can never be sure they'll be able to get their fix even if they have money. Their dealer might get busted, their dealer can cut them off or blackmail them, they might have to move or travel. Removing that source anxiety goes a long way. You'd see a lot fewer drug seekers in the ER if people with OUD just had a script they could refill online.

With opioids there are no safer “less potent” alternatives. That’s why alcoholics typically end up drinking a liter of cheap whiskey a day because it’s impractical/impossible to consume the equivalent alcohol in beer. Give someone less potent narc legally and eventually they’ll seek the big guns. Plays out every day in the ER. People demand dilaudid not morphine. They demand Percocet not Hydrocodone.

Less potent in the strict medical sense. Fent is literally 100x more potent than morphine. Morphine in known dosage is far less likely to lead to an OD.

No one really wanted to use spice, either. No one bothers with that shit anymore that weed is legal for most people.

Some drugs, in my opinion, are best left illegal. I’m sure we can all agree they legalized the wrong drug (alcohol) 100 or whatever years ago.

One thing's for sure, no other drug is anywhere near as overtly poisonous as ethanol.

[Dantheman]

I say yeah let’s do it. See how many polypharm overdoses we can get a week. Opioid naive kids who go to a party, do some shots, take some opioids….puke, aspirate, hypoventilate, and ultimately just stop breathing. Shit I can’t wait for that in the ER….

I’m not moralizing. Go wild on it.

Sounds like a pretty average Friday night at my high school. Except now the pills are counterfeit and made with fentanyl so ODs are far more likely.

[SumJongGuy]

Bring back Four Loco!

[AK47bp]

I have 5 seven year old girl’s sleeping over at my house tonight.


Is there anything stronger than fentanyl?

[MagnificentUnicorn]

My conclusion that conservation of energy is the solution to obesity? Or my conclusion that you cannot be healthy at any size? Or my conclusion that opioid addiction is far more destructive and dangerous than obesity? Or my conclusion that obesity should not be celebrated? Which one?

You don’t work in healthcare. Obesity is far more destructive and costly for everyone than opioid addiction. Most of our patients are obese or very overweight and very few are strictly addicts.

The attitudes expressed here in this thread support my original statement that this isn’t opioid issue it’s a societal and cultural problem. Ignorance, intolerance, judgment, religion, tribalism etc.


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[MagnificentUnicorn]

Perhaps, but buying opioids from a dispensary is not something I’d like to see society make possible. After working ER for 26 years and seeing the suffering from so many addictions, it’s hard to see open use opioid as something that has any benefit for society.

I’m not a sociologist, but adding another drug to the legal opportunity that is highly physiologically and psychologically addictive seems like a very very bad idea.

I would argue that the toll of addiction that we see is a result of the drug being illegal. There’s millions of functioning abusers and addicts in our society that seem totally normal.


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[Trackhead]

I would argue that the toll of addiction that we see is a result of the drug being illegal. There’s millions of functioning abusers and addicts in our society that seem totally normal.


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How does that explain alcohol? In Alaska, most of the homeless are alcoholics, not heroin users.

Again, I’m not a sociologist, just view the world from my personal experiences which shapes our viewpoints.

I’ve coded a dead coworker who over dosed, had a couple others die. . I’ve pulled dead kids out of hotel bath tubs full of ice with another dead kid on the bed (when I was a medic). Seen plenty of people with half a face from a shotgun blast while drunk depressed. Taken care of endless twenty somethings dead in the ER from polypharm OD. Pulled a drunk out of a trash pile in a landfill who fell asleep in a dumpster, all crushed up with ravens flying overhead. Plenty of completely wrecked Alaska and native Americans completely destroyed by alcohol, generations. Could go on and on…..haven’t seen much positive in the world from alcohol, heroin, meth.

That’s my life experience, I’ve seen enough, don’t think legalizing it will make the world a better place. Feel free to disagree. We all have our position in life.

[MagnificentUnicorn]

How does that explain alcohol? In Alaska, most of the homeless are alcoholics, not heroin users.

Again, I’m not a sociologist, just view the world from my personal experiences which shapes our viewpoints.

I’ve coded a dead coworker who over dosed, had a couple others die. . I’ve pulled dead kids out of hotel bath tubs full of ice with another dead kid on the bed (when I was a medic). Seen plenty of people with half a face from a shotgun blast while drunk depressed. Taken care of endless twenty somethings dead in the ER from polypharm OD. Pulled a drunk out of a trash pile in a landfill who fell asleep in a dumpster, all crushed up with ravens flying overhead.

That’s my life experience, I’ve seen enough, don’t think legalizing it will make the world a better place. Feel free to disagree. We all have our position in life.

I’ve worked in healthcare 35 years. There’s a lot of terrible shit that I’ve witnessed during that time. So I get your perspective.

The homeless drunk in AK is that way because of a fucked up family life and socioeconomic status that likely goes back generations. https://en.wikipedia.org/wiki/Alcoho...tive_Americans

We see the worst results of our society but that’s a very small fraction of the population. It’s tragic but it’s life.

Edit to add. Yeah, I’m about done too. I’ll probably retire from healthcare completely in five years at 60. It’s a tough job and it takes its toll physically and mentally

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[Trackhead]

Dude I don’t need Wiki links to understand generational trauma native Americans face. I’ve worked tribal healthcare or with Alaska Natives for a very long time. I’ve seen more horrible shit there than in any other society.

I see the worst in the ER, but primary care I see the progression from normal to wrecked. It’s another view.

[SumJongGuy]

Addicts/alcoholics aren't big on routine healthcare visits. It's easier to avoid doctors, dentists, etc than go there knowing they're going to lecture you about your drinking/drugging or at least roll their eyes when you lie to them about your habits.

[MagnificentUnicorn]

Dude I don’t need Wiki links to understand generational trauma native Americans face. I’ve worked tribal healthcare or with Alaska Natives for a very long time. I’ve seen more horrible shit there than in any other society.

I see the worst in the ER, but primary care I see the progression from normal to wrecked. It’s another view.

Again, I don’t doubt your experience. I’ve seen the results of bad decisions by people in the ED and OR for decades. I’ve been at this since I was 20. I’m burnt out and jaded but I know that it’s our dysfunctional society that’s the root of most of the problems in regards to addiction. There will always be addicts, it’s how we as a society views, treats and accepts them that will change the worst of the ills of addiction


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[Trackhead]

Addicts/alcoholics aren't big on routine healthcare visits. It's easier to avoid doctors, dentists, etc than go there knowing they're going to lecture you about your drinking/drugging or at least roll their eyes when you lie to them about your habits.

What are your suggestions to improve health outcomes in those presenting in the primary care setting with alcoholism? FWIW, yes, many alcoholics do have routine annual visits.

[Trackhead]

Again, I don’t doubt your experience. I’ve seen the results of bad decisions by people in the ED and OR for decades. I’ve been at this since I was 20. I’m burnt out and jaded but I know that it’s our dysfunctional society that’s the root of most of the problems in regards to addiction. There will always be addicts, it’s how we as a society views, treats and accepts them that will change the worst of the ills of addiction


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Yup agree. Society is so fucked up. If it was utopian we could have legal everything and enjoyment maybe in moderation.

[MagnificentUnicorn]

Addicts/alcoholics aren't big on routine healthcare visits. It's easier to avoid doctors, dentists, etc than go there knowing they're going to lecture you about your drinking/drugging or at least roll their eyes when you lie to them about your habits.

So I would argue that millions of alcoholics and addicts go to the doctor/dentist all the time. If there functional and have a home and job.

Let’s say that they avoid healthcare because of their addiction though. Why would that be? Is it because they’re judged and looked down on as weak? I mean you’ve answered that question. It’s the stigma that’s a barrier. There’s many people dependent on prescription drugs and legal alcohol and weed but the stigma isn’t as bad or absent altogether. We only judge those people when it gets bad enough that it’s outwardly apparent. But why? They’re all abusers/addicts.


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[MagnificentUnicorn]

Yup agree. Society is so fucked up. If it was utopian we could have legal everything and enjoyment maybe in moderation.

That’s why I don’t blame the addicted, it’s our problem and we choose to do nothing that’s meaningful. We’re fucked in that regard


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