Comment by thrmsforbfast | Hacker News Reader

Comment by thrmsforbfast | Hacker News Reader

The most important take-away from this article is the Science paper by Jalal et al., "Changing dynamics of the drug overdose epidemic in the United States from 1979 through 2016" [1].

In that paper, the authors conclude:

> The overall mortality rate for unintentional drug poisonings in the United States grew exponentially from 1979 through 2016. This exponentially increasing mortality rate has tracked along a remarkably smooth trajectory (log linear R2 = 0.99) for at least 38 years. By contrast, the trajectories of mortality rates from individual drugs have not tracked along exponential trajectories.

The authors also suggest that we should attempt to "understand the forces that are holding multiple subepidemics together onto a smooth exponential trajectory", and suggest a double-whammy of increased supply (due to improved communication, transportation, and manufacture) and increase demand (despair, loss of purpose, and dissolution of communities) that cuts across both demographics and geographic regions.

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[1] http://science.sciencemag.org/content/361/6408/eaau1184

For heroin specifically, I looked into usage rates a few years ago, unfortunately I can't find my notes so no sources here (and it is really hard to find such data).

But from what I recall, usuage rates of heroin in the population in the late 60s and early 70s was comparable to recent years, then fell a bit and remained more or less stable through the early 2000s. The return of addicted GIs from Vietnam prompted the start of the war on drugs by Nixon [1]

The big problem with heroin is what they are cutting it with. Prescription opioids, different ball of wax.

[1] https://www.presidency.ucsb.edu/documents/special-message-th...

So drugs aren't getting deadlier, it's just that more of us are using more of them? (Or more among us are using deadlier drugs than before?)

Drugs are still getting stronger and deadlier and much cheaper. This is obvious when you look at the a spike in Fentanyl use compared to other narcotics. While the amount needed to get high is lower, the potency is much higher. In addition to this, these packages are getting stepped on—where dealers cut it with another substance—a hundred times over before it ends up in someone’s veins with anything and everything.

The most important part to note is that fentanyl analogs are being used along with other inert substance to increase the mass and potency at street level. The problem with this is people easily underestimate the potency and use too much on top of the issue of varying amounts of fentanyl used to cut increasing risk.

>The problem with this is people easily underestimate the potency and use too much on top of the issue of varying amounts of fentanyl used to cut increasing risk.

this is especially dangerous amongst users who are relapsing and initially using their old dose amounts when starting again and their bodies aren’t able to handle it

unfortunately, that's a risk with an untampered supply as well. things are made EVEN WORSE with the fentanyl problem

one of the problems with Fentanyl is how our hands are tied when it comes to inbound shipments. Rogue laboratories in China are a pill-mill for these synthetic drugs.

>Over the last decade, federal officials say, the Zheng group mailed and shipped fentanyl and similar illicit chemicals to customers in more than 25 countries and 35 U.S. states. U.S. officials say the syndicate’s success, laid bare in a recent federal indictment[1], partly helps explain America’s skyrocketing death toll from drug overdoses. [2]

[1]https://www.justice.gov/opa/pr/two-chinese-nationals-charged... [2]http://www.latimes.com/politics/la-na-pol-china-fentanyl-201...

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