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This blog post over at SAMHSA is insane: https://blog.samhsa.gov/2018/10/03/for-beating-the-opioid-crisis-america-has-better-weapons-than-fentanyl-test-strips/#.W7cP-GgzY_4
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Oct 5, 2018 11:59
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https://twitter.com/nytimes/status/1068016048295821314?s=19 CDC notes overdose deaths were leveling off in early 2018.
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Nov 29, 2018 15:32
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I know this would just be nibbling at the edges for various practical reasons even if it "worked", but: is there a consumer version of a ventilator mask that people could just strap on before they shoot up, or is intubation necessary for that approach?
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Nov 29, 2018 15:45
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pangstrom posted:I know this would just be nibbling at the edges for various practical reasons even if it "worked", but: is there a consumer version of a ventilator mask that people could just strap on before they shoot up, or is intubation necessary for that approach? If the needle is dirty, there's basically nothing you can do short of injecting its contents into something that sterilizes the contents (probably destroying the organic compounds you're injecting), and then into a clean needle.
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Nov 29, 2018 16:37
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I meant so people could pre-emptively (and hypothetically) treat the respiratory depression if/when they OD.
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Nov 29, 2018 16:46
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I guess one could strap-into a CPAP, but every time I have ODed, I've been found in the hallway outside whatever space I used to get off. Dunno if a mask would remain on my head in those instances.
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Nov 29, 2018 17:52
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OhFunny posted:https://twitter.com/nytimes/status/1068016048295821314?s=19 “Leveling off” being it only increased 10% as opposed to 20%. The most effective thing right now is giving Narcan kits to users.
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Nov 29, 2018 18:48
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Alameda County's Health Care for the Homeless has street medicine teams that provide overdose kits at various encampments.
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Nov 29, 2018 21:02
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FFS just let everybody prescribe bupes and remove the patient caps that'll go a loooong way toward fixing this poo poo
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Nov 29, 2018 22:09
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The_Book_Of_Harry posted:I guess one could strap-into a CPAP, but every time I have ODed, I've been found in the hallway outside whatever space I used to get off. Dunno if a mask would remain on my head in those instances. Depressed respiratory status is a hard contraindication to non-invasive positive-pressure ventilation, because it just provides pressure to blow up your stomach with air and make you more likely to vomit, and then to push the regurgitated stomach contents down the unprotected airway. If you want to prevent vomit from entering the airway, you need an endotracheal tube through the cords with the balloon up. Just give everyone naloxone inhalers and encourage people to take care of one another if they're going to use, and legislate to remove barriers to effective treatment for narcotic addiction.
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Nov 30, 2018 15:09
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AFAIK the majority of OD cases in supervised injecting facilities are dealt with using a bag valve mask. Obviously not a precaution you can take if you are on your own.
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Dec 1, 2018 01:29
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shame on an IGA posted:FFS just let everybody prescribe bupes and remove the patient caps that'll go a loooong way toward fixing this poo poo Yeah... I get the concern behind limiting it, but I feel like the sort of person who might get buprenorphine for the "wrong" reasons would just be using street drugs otherwise (and at the very least I don't get why you'd limit prescription of it but not other opioids). Also, as a suboxone patient the topic of my doctor suddenly being hospitalized or something (or not being able to do an appointment for some other reason) is a significant source of anxiety. Because of the kinda strict limits on when you can get it prescribed, you're not exactly left much wiggle room if something happens and you can't get your prescription on time for whatever reason.
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Dec 1, 2018 06:47
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Swiss 👏 Heroin 👏 Policy 👏
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Dec 1, 2018 07:26
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sea of losers posted:Swiss what is it?
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Dec 2, 2018 14:57
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It's the "British System" of leaving the decision of whether to substitute, taper, or maintain with prescription diamorphine to doctors and patients, rather than cops or judges, except the British don't do that anymore because the DEA kept leaning on the government and because one doctor in London was abusing it which gave a convenient excuse to shut down the whole thing.
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Dec 2, 2018 16:54
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Mooseontheloose posted:what is it? cops roaming around to make sure you aren't using dirty needles, giving you clean ones, being sure you know where centres are. you go to a clinic to get your clean heroin and trained staff moniter your first few doses to acclimatise you to a consistent strength; opiates don't kill people in large numbers if it's within the therapeutic range of your tolerance, and deaths are usually related to inconsistent strength/contamination of your supply. The findings are that people quickly get back into working life with the proper support, since exactly-dosed opiates at plateau aren't as incapacitating as many other drugs, and then get clean within two years average. So do that, and then bring the full force of the war on drugs against the Sackler family and Purdue.
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Dec 2, 2018 17:13
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Spangly A posted:cops roaming around to make sure you aren't using dirty needles, giving you clean ones, being sure you know where centres are. Oh like Portugal, the least harm method. A few cities have talked about opening safe in major cities in the US. Seattle, New York, and Boston I know have talked about this. The only issue I can see is other locations shipping the heroin addicts to these states because they don't want to deal with it.
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Dec 2, 2018 17:21
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Safe injection sites, while helpful, are not enough because if you're forced to obtain the drugs illegally, they're still of an unknown strength, and expensive enough that you'll likely need to resort to bad things in order to obtain them.
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Dec 3, 2018 00:31
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Hell, forget unknown strength, unknown drug. A few weeks after Santa Muerte, which was fentanyl laced with K2, we got The NICK. That was heroin, fentanyl, acetyl-fentanyl, a synthetic cannabinoid, and xylazine. People would stop breathing, at which point someone would give naloxone, and then they were just plain out of their loving minds until the synthetic cannabinoid and the xylazine wore off. It was a mess.
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Dec 3, 2018 01:34
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Mooseontheloose posted:what is it? https://www.youtube.com/watch?v=Cco4BT-KDK8
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Dec 3, 2018 01:44
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wrong thread jfc
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Dec 3, 2018 01:45
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Government policies have clearly not worked. It's time to legalize opiods and allow capitalists to profit from them. Overdose deaths will drop ten-fold within two years because keeping your customer alive is profitable.
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Dec 3, 2018 02:13
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PT6A posted:Safe injection sites, while helpful, are not enough because if you're forced to obtain the drugs illegally, they're still of an unknown strength, and expensive enough that you'll likely need to resort to bad things in order to obtain them. It may be starting up at some point in Alberta, but who the gently caress knows what'll happen if the UCP wins the election. My clinic wanted to look into this, but Alberta Health Services declined to provide funding and is trying to set up their own program.
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Dec 3, 2018 03:19
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qkkl posted:Government policies have clearly not worked. It's time to legalize opiods and allow capitalists to profit from them. Overdose deaths will drop ten-fold within two years because keeping your customer alive is profitable. No, capital must not be allowed to enter the market. There should be no profit motive in the provision of drugs. We've already seen the harm this has done with alcohol and tobacco, and we might soon see it with marijuana, and arguably the only reason those substances should remain as regulated free markets is that there are qualitative differences between brands/products beyond the active chemicals. Albino Squirrel posted:Oh hey so there's some clinics in Vancouver that provide prescription heroin, as well as prescription hydromorphone, to be used in combination with safe injection sites. So the drugs are free, designed to be injected, and of known potency. The concept is frequently referred to as SIOAT (Supervised Injectable Opioid Agonist Therapy). Really? That's cool and good (not the part about Alberta being dreadful, the other bit).
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Dec 3, 2018 04:27
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PT6A posted:No, capital must not be allowed to enter the market. There should be no profit motive in the provision of drugs. We've already seen the harm this has done with alcohol and tobacco, and we might soon see it with marijuana, and arguably the only reason those substances should remain as regulated free markets is that there are qualitative differences between brands/products beyond the active chemicals. Retail weed's been going in the US for a while now, nothing bad has happened from it.
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Dec 3, 2018 04:29
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fishmech posted:Retail weed's been going in the US for a while now, nothing bad has happened from it. Yeah, I don't think it's going to be a collapse of society thing by any means, but I think it's valid to have concerns about people making profits from addictive products -- weed, booze, tobacco, gambling, or anything else that can cause problems like that. As a big fan of all of those except weed*, I struggle with the conflict between wanting those things to be available and dealing with the social harms they can cause. * I think weed legalization is great and I support anyone who wants to use it, but I'm still not allowed to use it even after general legalization, so it's not a personal thing for me like it is with the others.
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Dec 3, 2018 04:53
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Society manages to create greater social harms from prohibition than from free availability, so.
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Dec 3, 2018 11:35
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Ghost Leviathan posted:Society manages to create greater social harms from prohibition than from free availability, so. Seriously. The only thing the war on drugs has succeeded at is putting an absolute gently caress load of people in jail. Criminalizing drugs has also led to a hell of a lot of gang and cartel violence. Banning drugs just plain doesn't work. It should all be legalized. All of it. It should be regulated as well; no drug advertisements, no pushing pills. Fund rehab and proper drug education if you want use to go down. Treat addiction like the medical condition it is. Most drug users aren't addicts.
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Dec 3, 2018 14:42
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tetrapyloctomy posted:Hell, forget unknown strength, unknown drug. A few weeks after Santa Muerte, which was fentanyl laced with K2, we got The NICK. That was heroin, fentanyl, acetyl-fentanyl, a synthetic cannabinoid, and xylazine. People would stop breathing, at which point someone would give naloxone, and then they were just plain out of their loving minds until the synthetic cannabinoid and the xylazine wore off. It was a mess. thats the kinda poo poo in an entry that makes me nervous when i go on ecstasy-data
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Dec 4, 2018 03:19
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The US Department of Justice have released a statement on supervised injecting facilities:quote:these facilities actually increase public safety risks. Just like so-called crack houses, these facilities will attract drug dealers, sexual predators, and other criminals, ultimately destroying the surrounding community. More importantly, the government-sanctioned operation of these facilities serves only to normalize serious drug usage – teaching adults and children alike that so-called “safe” drug usage is somehow appropriate or can actually be done “safely.” The type of drug use contemplated here is always life-threatening behavior https://www.justice.gov/usao-co/pr/joint-statement-us-attorney-s-office-and-denver-field-office-drug-enforcement
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Dec 7, 2018 06:33
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KingEup posted:The US Department of Justice have released a statement on supervised injecting facilities: -Me, a actual doctor
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Dec 7, 2018 07:14
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The DEA (who were almost certainly the drivers, there, they just got DoJ to sign on to make the legal parts clear) are basically in that "salary/purpose depends on not understanding" zone when it comes to drug policy.
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Dec 7, 2018 16:27
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ToxicSlurpee posted:Most drug users aren't addicts. I'm not sure if this is true of non-medical opiate users. I think even opiates should be decriminalized and high quality, regulated opiates should be offered at those stations/clinics other countries have tried, but actually making them legal to sell...as an addict it would make it difficult mentally if I could easily buy safe drugs. I'm currently fortunate in that the stuff I was addicted to is a sort of grey market thing that became difficult to acquire in recent years, so I can't really mess up my pseudo-sobriety (I'm on suboxone) with a bad impulse (I imagine people who can just call up their dealer or whatever have a much harder time with this). Loosening buprenorphine (and I guess methadone?) prescription requirements would also help with the patients who just want to manage dependence and avoid withdrawals.
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Dec 8, 2018 18:28
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The problem with the USA legalizing opioids for prescription only is that prescription opioids could end up more expensive than the street stuff. As far as I know this has already happened, with people who became addicted to legal painkillers turning to street heroin and fentanyl because it's cheaper. The solution would work much better in countries with universal or affordable health care.
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Dec 8, 2018 18:44
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BarbarianElephant posted:The problem with the USA legalizing opioids for prescription only is that prescription opioids could end up more expensive than the street stuff. As far as I know this has already happened, with people who became addicted to legal painkillers turning to street heroin and fentanyl because it's cheaper. Oh for sure, I think any talk of legalizing them in this way kind of requires that it also not be financially difficult. It's already ludicrous that many (if not most) of the people who need suboxone don't have the sort of insurance that will cover it, and it costs a ton otherwise (unless something changed in the past couple years; I remember people talking about paying like $400 a month in the past). Even with insurance, the total cost of the doctor appointment and prescription is about $210 a month, and that's with really good insurance.
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Dec 9, 2018 21:48
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Ytlaya posted:I'm not sure if this is true of non-medical opiate users. I think even opiates should be decriminalized and high quality, regulated opiates should be offered at those stations/clinics other countries have tried, but actually making them legal to sell...as an addict it would make it difficult mentally if I could easily buy safe drugs. I'm currently fortunate in that the stuff I was addicted to is a sort of grey market thing that became difficult to acquire in recent years, so I can't really mess up my pseudo-sobriety (I'm on suboxone) with a bad impulse (I imagine people who can just call up their dealer or whatever have a much harder time with this). Most people who use drugs are partiers who otherwise lead what you'd call a pretty normal life. That can lead to addiction but it doesn't always. One very interesting thing I read is that most people who have major surgery actually don't get addicted to the morphine at all. One reason that addiction is going up is because in contemporary society we're increasingly isolated. Lacking social and emotional support leads to other ways of venting bad emotions. That can at times lead to addiction; so somebody mostly living in isolation gets a script for some opiates then things progress and...yeah. Addiction is obviously a complex issue but one thing I read that was very interesting is that only a single digit percentage of people who try cocaine ever get addicted. Mostly it's just something people do occasionally at parties. Opiates are obviously more addicting but even then most people don't get addicted. The argument you make though, that can be used to argue in favor of banning alcohol again. We see how that worked in history. Yeah it isn't easy if it's available everywhere but really, the war on drugs is a horrible thing. Punishing addiction isn't helping.
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Dec 10, 2018 02:59
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ToxicSlurpee posted:Most people who use drugs are partiers who otherwise lead what you'd call a pretty normal life. That can lead to addiction but it doesn't always. One very interesting thing I read is that most people who have major surgery actually don't get addicted to the morphine at all. This turned out to be both untrue and a major driver of the opioid addiction crisis.
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Dec 10, 2018 03:08
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ToxicSlurpee posted:One very interesting thing I read is that most people who have major surgery actually don't get addicted to the morphine at all. BarbarianElephant posted:This turned out to be both untrue and a major driver of the opioid addiction crisis. Wrong. 5% of people prescribed opioids for surgery use them in the long term. An even smaller percentage become addicted. quote:1 of every 20 opioid-naive patients continues to require opioids long after their surgical care is complete. https://journals.lww.com/annalsofsurgery/Fulltext/2017/04000/Iatrogenic_Opioid_Dependence_in_the_United_States_.18.aspx As this Cochrane review of long term opioid use says: quote:Many minor adverse events (like nausea and headache) occurred, but serious adverse events, including iatrogenic opioid addiction, were rare. https://www.aafp.org/afp/2010/0701/p40.html The vast majority of people who became addicted to prescription opioids were using opioids that weren't prescribed for them and had a history of illicit drug use. The vast majority of people are dying from non-medical use because of prohibitionist drug policy i.e. the refusal to distribute naloxone, the refusal to fund NSP the refusal to fund supervised injecting facilities (and other harm reduction services), the reformulation of prescription opioids to be 'abuse deterrant', the iron law of prohibition and the criminalisation of all forms of non-medical opioid use including the use of opium. Drugs to not cause addiction: https://sencanada.ca/content/sen/committee/371/ille/presentation/alexender-e.htm KingEup fucked around with this message at 05:36 on Dec 10, 2018 |
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Dec 10, 2018 05:22
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What Toxic Slurpee said is totally true. The problem with the "prescriptions not driving" take is the base rates. You give ~58 prescriptions for every 100 americans and, even with low addiction "hit" rates, you've got an epidemic. The control group is the rest of the loving world.
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Dec 10, 2018 05:34
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pangstrom posted:What Toxic Slurpee said is totally true. The problem with the "prescriptions not driving" take is the base rates. You give ~58 prescriptions for every 100 americans and, even with low addiction "hit" rates, you've got an epidemic. The control group is the rest of the loving world. Yeah, over prescription of opiods isn't helping and from what I've read synthetic opiates are way more addictive than natural ones. Even so, the leading cause of addiction isn't the substances it's our hosed up society. You can get addicted to basically anything and addiction rates in general are going up.
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Dec 10, 2018 05:40
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