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The US Drug Enforcement Administration's decision to restrict prescription drugs containing hydrocodone (a popular opioid painkiller) was associated with a 'significant' increase in illicit trading of opioids through online markets, finds a study published by The BMJ today.
In this study, the term opioids refers to drugs that are usually available by prescription but here are sourced illegally through the dark net and are not prescribed by anyone.
The findings show that the proportion of sales of opioids through illicit markets doubled over the study period and sales of more potent opioids also increased. Overdose death rates have quadrupled in the US since 1999, and 40% of all deaths involve prescription opioids, which are primarily used for pain relief.
In October 2014, the US Drug Enforcement Administration decided to move hydrocodone opioids from schedule III to schedule II (a more restrictive category), making it more difficult for patients to access these drugs on prescription and stopping automatic repeat prescriptions.
There is concern that opioid users will source drugs from illegal online markets called 'cryptomarkets' rather than from pharmacies. Users only access these cryptomarkets via the 'darknet', where people can sell and buy drugs anonymously. Although the legitimate supply of opioids may have decreased, overall consumption will remain unchanged if users decide to source them from illicit markets.
So an international research team set out to investigate whether there was a link between the 2014 reclassification of hydrocodone opioids and an increase in trading of illicit prescription drugs on cryptomarkets. Using web crawler software, they compared sales for prescription drugs containing hydrocodone with other prescription drugs and illicit opioids from 31 different cryptomarkets operating from September 2013 to July 2016 (before and after reclassification).
They looked at three pieces of information from each product listing placed by a seller: the drug type on offer, the country from where products would be shipped, and the number of reviews the listing had received, to compare usage in relation to the 2014 reclassification.
The researchers found that the sale of opioids through US cryptomarkets increased after the 2014 reclassification, with no significant changes in sales of sedatives, steroids, stimulants, or illicit opioids.
[...] They also report a change in the type of drugs purchased after reclassification. Oxycodone purchases decreased, and fentanyl (a stronger and potent than hydrocodone) moved from being the least sold product to being the second most popular prescription opioid bought from cryptomarket sellers based in the USA. Fentanyl is currently the leading cause of opioid overdose in the USA.*
The researchers outline some study limitations. For example, there may have been a general increase in demand that was unrelated to the 2014 restriction, and the source and destination of the drugs cannot be independently confirmed.
(Score: 5, Interesting) by anubi on Sunday June 17 2018, @06:33AM (9 children)
About the last thing I am afraid of is a 70 year old grandma hooked on Percoset!
With the technology we have today, we can make damn near unlimited supplies of any chemical we want. If the Percoset works for that woman, I'd just as soon we give her all she needs. I mean, stringing her up like this is like tying someone over an ant hill. I can see no benefit to anyone having someone bear avoidable pain just for the sake of "she may get addicted". If there is a drawback ( like shortening of life expectancy, whatever ), explain that, and let her make an informed decision.
Personally, I would trade ten years of incapacitated pain for one week of happy blissful life with family, to say goodbye, and get it over with. What makes this doubly painful is knowing not only I am incapacitated, but I am also burdening others with my situation, people whose time would be spent far better doing almost anything else but taking care of a dying guy whose gonna die anyway.
"Prove all things; hold fast that which is good." [KJV: I Thessalonians 5:21]
(Score: 2, Interesting) by Anonymous Coward on Sunday June 17 2018, @06:43AM (2 children)
We could really use chemputers under $5k. Print painkillers or recreational drugs on location.
(Score: 2, Interesting) by anubi on Sunday June 17 2018, @07:05AM (1 child)
They are probably coming!
Likely an offshoot of DNA sequencing. They may well use DNA as the assembly agent. And make custom molecular arrangements just like life does.
"Prove all things; hold fast that which is good." [KJV: I Thessalonians 5:21]
(Score: 3, Informative) by Anonymous Coward on Sunday June 17 2018, @07:08AM
https://www.gla.ac.uk/news/headline_568272_en.html [gla.ac.uk]
(Score: 4, Insightful) by Magic Oddball on Sunday June 17 2018, @09:26AM (1 child)
Personally, I'd rather trade ten years of incapacitated pain for ten years of having my pain treated. We're all "going to die anyway" at some point, and people who earn money but leave no mark on others' lives (or worse, a negative one) are in many ways more burdensome & less mourned than those who can't earn money but leave a positive mark in even a small way.
(Score: 1) by anubi on Sunday June 17 2018, @10:48AM
Well said!
"Prove all things; hold fast that which is good." [KJV: I Thessalonians 5:21]
(Score: 2) by sjames on Sunday June 17 2018, @01:10PM (3 children)
Interestingly, even with addiction risk, the painkillers might increase lifespan. People in pain tend to not take care of themselves properly and certain;y tend not to get enough exercise. Not to mention producing too much cortisol and other stress hormones that may slow healing.
As for the overdoses, part of the "increase" is just an accounting trick. It isn't unusual in painful terminal conditions to see patients willingly take potentially unsafe amounts of painkiller for the sake of a somewhat comfortable end of life. We used to say those people died of their underlying condition reasoning that without the pain killers, the stress of the pain would have killed them anyway (after all, they're in a weakened condition) and it would have been a lot less pleasant. Now the DEA wants to call that an opoid death.
In the end, it;s just the latest excuse to put boots on heads.
(Score: 1, Interesting) by Anonymous Coward on Sunday June 17 2018, @02:10PM (2 children)
In the book "Final Exit", Dr. Derek Humphrey illustrated the use of Seconal as a way of insuring that if one decided their time was at hand, it would be a clean way to go. Now, personally, I wonder about a jug of nitrogen released in a closed compartment, like a car. There has to be some way of cleanly shutting down when that time comes. I flat do not want to be strung out by the medical establishment only to be permitted to pass on once the resources I had intended for my offspring to be diverted to hospital charges. I am quite aware the technology exists to keep me "legally" alive damn near indefinitely, even though I died long time ago, and I fear that being used just to wheedle my end of life wishes against my wishes.
(Score: 2) by sjames on Sunday June 17 2018, @03:03PM (1 child)
There is truth in that, but not all opoid overdoses near end of life are necessarily deliberate suicides. Rather, it is accepting a risk of hastening death for the sake of being pain free.
The points aren't entirely unrelated though. If we're stingy with needed opoids, there will be more outright suicides.
(Score: 0) by Anonymous Coward on Monday June 18 2018, @08:03AM
I wonder if any of the anti-painkiller rhetoric is being pushed by life insurance companies. Die of cancer even while taking huge amounts of morphine means they have to pay out. Take away the pain relief and some people will suicide. With many policies, hey presto, no payout for suicide. Asshole Mutual Life is then the big winner.
Given the amount of number crunching they do, they would know exactly how many people would do this, and how much more profit they would make with stricter drug rules, and whether it would be worth the 'lobbying' those laws would cost.