Personal responsibility, nope, never heard of it

Don’t blame addicts for America’s opioid crisis. Here are the real culprits
Chris McGreal

America’s opioid crisis was caused by rapacious pharma companies, politicians who colluded with them and regulators who approved one opioid pill after another

This is to believe that opiod addiction is some incredible physical addiction. It ain’t.

Sure, cold turkey ain’t pleasant, akin to a proper dose of the ‘flu. But in physical terms that’s pretty much what it is. It’s nowhere near as bad, for example, as a proper full blown alcoholic trying to go cold turkey. That can and sometimes does kill.

The mental addiction is something different of course. Opiods feel wonderful, it’s the desire to feel that wonderful which is the rather more difficult part of the addiction. We rather learnt all this, or at least should have done, in the aftermath of Vietnam. Usage, or addiction if you prefer, rates in theatre was massive, 15 and 25%, some estimates higher. Get home and they drop by 95% or more. MD Stanton has had a lot to say about this.

The rest of the complaint is somehow that government caused this therefore it’s the drug companies to blame.


Most street opiates (including heroin) are now laced or replaced with fentanyl – the drug that killed the singer Prince – and its analogues, far more powerful than heroin and so cheap that drug-dealing profits are skyrocketing at about the same rate as overdose deaths. The UK’s National Crime Agency said that traces of fentanyl have been found in 46 people who died this year. Users don’t know what they’re getting and they take too much. Fentanyl is recognised as a primary driver of the overdose epidemic.

Yep, fentanyl has a very much smaller “dose gap” (used because I don’t know the real phrase), that space between getting high and being dead. Variable amounts in illegal supplies therefore often kill.

Entirely true, quite right, fentanyl is killing people.

But the peculiar appeal of opioids tells us more about ourselves as a society, as a culture, than the tumultuous ups and downs of addiction statistics. Today’s young people come of age and carve out their adult lives in an environment of astronomical uncertainty. Corporations that used to pride themselves on fairness to their employees now strive only for profit. The upper echelons of management are as risk-infected as the lowest clerks. Massive layoffs rationalised by the eddies of globalisation make long-term contracts prehistoric relics. I ask the guys who come to the house to deliver packages how they like their jobs. They can’t say. They get up to three six-month contracts in a row and then get laid off so the company won’t have to pay them benefits.

People pour out of universities with all manner of degrees, yet with skills that are rapidly becoming irrelevant. But people without degrees are even worse off. They find themselves virtually unemployable, because there are so many others in the same pool, and employers will hire whoever comes cheapest. The absurdly low minimum wage figures in the US clearly exacerbate the situation. As hope for steady employment fizzles, so does the opportunity to connect with family, friends and society more broadly, and there is way too much time to kill. Opioids can help reduce the despair.

But you’ve just told us it’s the dosage problem with fentanyl which is causing it all!

I wonder

Nine people died from fentanyl opioid overdoses in the Canadian city of Vancouver in just the past 24 hours, Mayor Gregor Robertson said Friday.

Perhaps this will play out like the crack cocaine epidemic did.

PJ O’Rourke has a doctor in one of his essays saying it will burn out naturally. Because the people who take it will be dead.

The problem with fentanyl being twofold. It’s very, very powerful. And the gap between a decent high and dead is not large. The two combine to make measurement of doses – and obviously it’s worse for an illegal product – difficult and thus lots of people die.

Don’t know much about chemistry

But this would seem to be a problem that cannot be solved:

The network often avoids efforts to stop it by trading not only in finished fentanyl but related products subject to little or no regulation in China or internationally. These include some copies of fentanyl known as analogs, as well as the chemical ingredients and pill presses used to produce the drug, according to the documents and interviews.

The China Food and Drug Administration declined to comment on the sale and production of fentanyl and referred questions to the Ministry of Public Security, which didn’t respond.

The problem that cannot be solved being that fentanyl is an entirely synthetic opioid.

Costing perhaps $800 for the chemicals to make a batch and fetching, as pills, some $800,000. A gross mark up of 1000 x (no, not 1,000%, sales are 1,000 x cost of raw materials).

Can’t see that trying to prevent this will work. And OK, so they’re calling for the precursors to be controlled. But it’s all entirely synthetic. So producers can just keep going on down the line if they feel so inclined. In theory at least you could start with a bunch of black pepper and some water and get there. Yes, OK, slightly hyperbolic but still.

Banning this shit just isn’t going to work.

People still aren’t getting this right

Shkreli, who hit the headlines last year after he hiked the price a life-saving drug often given to people with HIV or cancer from $13.50 to $750 a pill, is accused of defrauding investors in hedge funds he ran.

It’s not often given. There’s some 750 or so patients a year last I recall.

And the scandal here isn’t Shkreli, it’s the absurd FDA regulatory system which means he was able to game it as he did. It’s the FDA which needs the reform….

Well, no, he didn’t really, did he?

A man who smuggled £300,000 worth of cocaine through Gatwick Airport in a secret compartment in a suitcase has been jailed for six years.

Hudson Kenuet Rohan Prescod, from the Caribbean island of St Vincent, was stopped by Border Force officers last month, after arriving on a flight from St Lucia.

A sharp probe inserted into the base of a suitcase revealed a white paste substance, which later tested positive for cocaine.

More than 2kg of cocaine were found to be concealed within the false bottom of the suitcase.

It would be rather truer to say that A man who smuggled £300,000 worth of cocaine to Gatwick Airport in a secret compartment in a suitcase has been jailed for six years.

The pressures of academia

The other thing I hadn’t expected was the scale of the workload. The teaching commitment was high – about 10 contact hours per week (double what I had experienced before). During term time, I was spending the whole working week either teaching or preparing to teach, with no time for research.

Drove the poor dear to heroin it did. Admittedly, exposure to students for 10 hours a week might do that to me too but still, hardly a horrible workload is it?

And that is only in term time, what, 26 weeks a year even at the Polys?

Sharapova not taking coke shocker

Meldonium, which Sharapova said she had legally taken throughout her career, was placed on the banned list by the World Doping Anti-Agency (WADA) at the beginning of the year following “evidence of its use by athletes with the intention of enhancing performance”.

Some readers come over all lascivious at the thought of Ms. Sharapova. And why not: but would it enhance that reputation if she were a coke snorting party blonde?

Or just some performance enhancing stuff.

Err, performance enhancing, fnarr fnarr.

Facebook is cocaine!

Facebook addiction ‘activates same part of the brain as cocaine’

Internet addiction activates the same areas of the brain as drugs such as cocaine, but is much easier to quit, a study suggests

Or, as we might rewrite the story.

Things that humans enjoy doing light up the parts of human brains that register the things that humans enjoy doing.

Drug trials do their job

One person is brain dead and five others are seriously ill after taking part in a drug trial for an unnamed pharmaceutical firm at a clinic in north-west France.

But wait!

The ministry did not say what the new medicine was intended to be used for, but a source close to the case told AFP that the drug was a painkiller containing cannabinoids, an active ingredient found in cannabis plants.

Cannabinoids cause brain death? Well, doesn’t that explain a lot of the 1960s then?