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Comment by JshWright | Hacker News Reader

I've come to hate fentanyl... In the past couple years it has become significantly more widespread, and in the completely insidious way you describe. People think they're buying heroin (or worse, cocaine, at least if they're a heroin user, they have some tolerance to opioids), and it's laced (or completely replaced) with fentanyl.

I'm a paramedic in a nice suburban area. I've been doing this a little over a decade now. I managed to make it a good long while without having to deliver life changing news to a parent. In the past two years I've done it way too many times.

I'm so sorry for your loss. I have witnessed your pain in others, and I know that it's beyond my comprehension...

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Please do not hate Fentynal, hate the people choosing to use it. As a person who suffers from chronic severe pain due to a near fatal illness, I can tell you that For people like us Fentynal is a life saver as far as the quality of life it provides to those who need it. It is one of the few medications I can take as it does not metabolize in the liver, if any does it is a tiny amount. Fentynal also does not come in a powdered form they are taking a liquid version and mixing it into powders, other then that one form all other preparations are majorly tamper resistant being either in a matrix that almost makes it impossible to even be affective in the system or on a patch which breaks down over time to slowly release in the body. Of course there are exceptions, but please do not hate the drug, hate this sick bastards that are using it to increase their illegal sales! (my apologies to the OP for hijacking their question.)

I totally agree with you and hope many of us too.

When I say I hate fentanyl, I mean I hate the illicit and recreational use of fentanyl. I'm well aware of its legitimate uses (it's my go-to analgesic in the back of the ambulance). The drug itself isn't 'good' or 'bad', it's just a chemical... it's amoral.

All fentanyl, legal or otherwise, starts out as a powder (generally as the salt, fentanyl citrate, though illicit labs produce a number of variations...). You're right that there is no powdered form sold legally, but most of the illicit sales come from labs in Mexico and China, and is indeed in powdered form.

I am close to someone in your exact situation who was able to switch to medical marijuana from fentynal and other opioids after dealing with near fatal withdrawal effects. By no means hate fentynal, but perhaps save a bit of hate for regulators who criminalize or perpetuate the criminalization of non-addictive, inexpensive alternatives to opioids to protect pharmaceutical company profits.

My pet hate as a phrase, "I know what you're going through", and variations - "I understand how you feel"...

Far better: "I cannot pretend to understand how you're feeling", "I can't imagine...". Perhaps with "I can only appreciate how difficult it may be", and so on.

One thing remains the same, it's always my least favorite task as a paramedic.

President Lincoln said it best:

"I feel how weak and fruitless must be any word of mine which should attempt to beguile you from the grief of a loss so overwhelming."

Though he had the "luxury" of writing it in a letter. He did not have to come up with it in a terrible moment of grief. Well-said, nonetheless.

From a harm reduction perspective, what would the minimum testing kit to differentiate fentanyl from other physically similar-appearing drugs look like?

It would look like this:

http://www.sirchie.com/nark20033-fentanyl-reagent.html#.V8uE...

The problem is, it's a destructive test, which makes it unattractive to both dealers and users, as it requires wasting at least some of the product.

An additional problem is it says only police are allowed to buy the kit.

Seems strange, when tests for other drugs are available.

It probably uses a marquis reagent, which could theoretically be made at home, as it is just a mixture of formaldehyde and sulfuric acid[0]. There are also websites[1] that have a key describing the colors that a number of substances produce on reaction with various reagents.

[0] https://en.wikipedia.org/wiki/Marquis_reagent

[1] https://dancesafe.org/testing-kit-instructions/

When I was an active heroin addict, I would do a small test shot of new product before doing a normal dose. If it was too strong, then the match-head sized shot would get me off, and I would know to go easy on it. If nothing happened, I would wait 5 minutes and then raise the dose, until I was where I wanted to be. I somehow managed to avoid overdosing in the 8 or so years I was using. I don't know what part of that can be attributed to caution or luck, but there was probably a lot of luck involved. Either way, that chapter of my life is over, and I am grateful to have come out alive.

>In the past couple years it has become significantly more widespread

That will hopefully be changing soon (at least in the US): http://www.wsj.com/articles/u-s-china-reach-agreement-to-ste...

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