With Google, Bitcoins, and USPS, Feds realize it's stupid easy to buy fentanyl
A congressional report released Wednesday lays out just how easy it is for Americans to buy the deadly opioid fentanyl from Chinese suppliers online and have it shipped to them via the government's own postal service. The report also lays out just how difficult the practice will be to stop.
After Googling phrases such as "fentanyl for sale," Senate investigators followed up with just six of the online sellers they found. This eventually led them to 500 financial transaction records, accounting for about $766 million worth of fentanyl entering the country and at least seven traceable overdose deaths.
[...] "Thanks to our bipartisan investigation, we now know the depth to which drug traffickers exploit our mail system to ship fentanyl and other synthetic drugs into the United States," Republican Senator Rob Portman of Ohio said in a statement. "The federal government can, and must, act to shore up our defenses against this deadly drug and help save lives."
Related: Opioid Addiction is Big Business
Heroin, Fentanyl? Meh: Carfentanil is the Latest Killer Opioid
Tip for Darknet Drug Lords: Don't Wear Latex Gloves to the Post Office
Cop Brushes Fentanyl Off Uniform, Overdoses
Congress Reacts to Reports that a 2016 Law Hindered DEA's Ability to go after Opioid Distributors
Opioid Crisis Official; Insys Therapeutics Billionaire Founder Charged; Walgreens Stocks Narcan
Related Stories
The recent uptick in heroin and opioid addiction along with new laws are making addiction treatment an attractive target for investors:
Every crisis presents an opportunity, as the saying goes. And when it comes to opioid addiction, investors and businesses are seeing a big opportunity in addiction treatment. Places like [Gosnold on Cape Cod] are being gobbled up by private equity companies and publicly-traded chains looking to do what is known in Wall Street jargon as a roll-up play. They take a fragmented industry, buy up the bits and pieces and consolidate them into big, branded companies where they hope to make a profit by streamlining and cutting costs.
One company that advises investors listed 27 transactions in which private equity firms or public companies bought or invested in addiction treatment centers and other so-called behavioral health companies in 2014 and 2015 alone. Acadia Healthcare is one national chain that has been on a shopping spree. In 2010 it had only six facilities, but today it has 587 across the country and in the United Kingdom.
What's driving the growth? The opioid addiction crisis is boosting demand for treatment and two relatively recent laws are making it easier to get insurers to pay for it. The Mental Health Parity Act of 2008 requires insurers to cover mental health care as they would cover physical health care. "Mental health parity was the beginning. We saw a big benefit. And then the Affordable Care Act was very positive for our industry," says Joey Jacobs, Acadia's CEO. He spoke at an investor conference last month.
Marketplace has an article about how data and new databases are being used to track and prevent addiction. It cites the following report from Health Affairs:
Prescription Drug Monitoring Programs Are Associated With Sustained Reductions In Opioid Prescribing By Physicians (DOI: 10.1377/hlthaff.2015.1673)
When customers want a longer-lasting high, heroin dealers respond by augmenting their products with drugs like carfentanil:
A powerful drug that's normally used to tranquilize elephants is being blamed for a record spike in drug overdoses in the Midwest. Officials in Ohio have declared a public health emergency, and the U.S. Drug Enforcement Administration says communities everywhere should be on alert for carfentanil. The synthetic opioid is 100 times more potent than fentanyl, the prescription painkiller that led to the death earlier this year of the pop star Prince. Fentanyl itself can be up to 50 times more deadly than heroin.
In the past few years, traffickers in illegal drugs increasingly have substituted fentanyl for heroin and other opioids. Now carfentanil [alt link] is being sold on American streets, either mixed with heroin or pressed into pills that look like prescription drugs. Many users don't realize that they're buying carfentanil. And that has deadly consequences.
"Instead of having four or five overdoses in a day, you're having these 20, 30, 40, maybe even 50 overdoses in a day," says Tom Synan, who directs the Hamilton County Heroin Coalition Task Force in Southwest Ohio. He's also the police chief in Newtown, Ohio. Synan says carfentanil turned up in Cincinnati in July. At times, the number of overdoses has overwhelmed first responders. "Their efforts are truly heroic, to be going from call to call to call," he says. "One district alone had seen 14 in one shift, so they were nonstop."
First responders and emergency room workers are being told to wear protective gloves and masks. That's because carfentanil is so potent, it can be dangerous to someone who simply touches or inhales it. This was devastatingly clear back in 2002, after a hostage rescue operation in Moscow that went wrong. To overpower Chechen terrorists who'd seized control of a theater, Russian Special Forces sprayed a chemical aerosol into the building. More than 100 hostages were overcome and died. Laboratory tests by British investigators later revealed [open, DOI: 10.1093/jat/bks078] [DX] that the aerosol included carfentanil.
In the article about the DEA adding kratom to Schedule I, I mentioned an "unprecedented" amount of "heroin" overdoses in Cincinnati. The carfentanil-cut heroin boosted the overdose tally to 174 in 6 days (225 in Ohio, Indiana, Kentucky, and New Jersey):
Deaths have not spiked along with the overdose reports because police officers or emergency medical technicians are immediately administering naloxone, sometimes in more than one dose, to bring heroin users back to consciousness and start them breathing.
Delivery is the weakest link in the "dark web" drug trade: the postal habits of a large-scale trader have led to his undoing.
Chukwuemeka Okparaeke is accused of dealing in very nasty stuff: Fentanyl, a high-strength synthetic opioid the Centre for Disease Control says is 50 times the potency of heroin and was responsible for nearly 10,000 deaths in the US in 2015.
Okparaeke may have been a capable Tor user, but his logistical clue needed work: he was caught not because someone linked him to his handle ("Fentmaster", on a site called the AlphaBay Marketplace), but because wearing latex gloves while depositing large numbers of packages at US post offices got the attention of staff.
He was seen at several post offices in the Middletown area of New York, and because he was bulk-buying priority delivery stamps, staff had also viewed his driver's licence.
-- submitted from IRC
http://www.cnn.com/2017/05/16/health/police-fentanyl-overdose-trnd/
A police officer in East Liverpool, Ohio, collapsed and was rushed to the hospital after he brushed fentanyl residue off his uniform, allowing the drug to enter his system through his hands. The officer had apparently encountered the opioid earlier in the day while making a drug bust.
"This is scary. He could have walked out of the building and left and he could have passed out while he was driving. You don't even know it's there on his clothes," East Liverpool Police Chief John Lane told CNN.
Congress has responded strongly to a joint investigation by CBS and The Washington Post (archive) about Drug Enforcement Administration (DEA) employees becoming lobbyists for the pharmaceutical industry, and the passage of a bill in 2016 hobbling the DEA's ability to go after opioid distributors and suspicious drug sales:
Lawmakers and the Drug Enforcement Administration are facing tough questions following an explosive joint investigation by "60 Minutes" and The Washington Post that says Congress helped disarm the DEA.
Drug overdose deaths in the United States have more than doubled over the past decade. The CDC says 188,000 people have died from opioid overdoses from 1999 to 2015.
Joe Rannazzisi used to run the DEA's diversion control. He told "60 Minutes" correspondent Bill Whitaker that the opioid crisis was aided in part by Congress, lobbyists and the drug distribution industry. The DEA says it has taken actions against far fewer opioid distributors under a new law. A Justice Department memo shows 65 doctors, pharmacies and drug companies received suspension orders in 2011. Only six of them have gotten them this year.
[...] [The] DEA's efforts may have been undermined by the so-called "revolving door" culture in Washington. At least 46 investigators, attorneys and supervisors from the DEA, including 32 directly from the division that regulates the drug industry, have been hired by the pharmaceutical industry since the scrutiny on distributors began.
From The Washington Post:
The chief advocate of the law that hobbled the DEA was Rep. Tom Marino, a Pennsylvania Republican who is now President Trump's nominee to become the nation's next drug czar. Marino spent years trying to move the law through Congress. It passed after Sen. Orrin G. Hatch (R-Utah) negotiated a final version with the DEA.
"The best way to prevent drug addiction and overdose is to prevent people from abusing drugs in the first place. If they don't start, they won't have a problem." – President Donald J. Trump
President Trump has declared the "Opioid Crisis" a nationwide public health emergency. This action will allow for "expanded access to telemedicine services" to remotely prescribe medicines for substance abuse, allow the Department of Health and Human Services to "more quickly make temporary appointments of specialists with the tools and talent needed to respond effectively to our Nation's ongoing public health emergency", allow the Department of Labor to issue dislocated worker grants for those "displaced from the workforce" due to the Opioid Crisis, and will help people with HIV/AIDS to receive substance abuse treatment. The press release lists several actions that the Trump Administration has taken to respond to the Opioid Crisis, including the July 2017 law enforcement action against AlphaBay.
The declaration has been criticized for not requesting any funds to respond to the Crisis. The "nationwide public health emergency" declaration is also distinct from a promised "national emergency declaration", which would have freed up money from the Disaster Relief Fund to be spent on the Crisis. 14 Senate Democrats have introduced a bill that would authorize $45 billion to address the Opioid Crisis. The Obama Administration called on Congress last year to pass just over $1 billion in funding for opioid treatment programs nationwide. This funding was included in the 21st Century Cures Act.
The Department of Justice has arrested and charged the founder and majority owner of Insys Therapeutics Inc., John Kapoor, along with other executives from his company. Kapoor is accused with leading a nationwide conspiracy to bribe doctors and illegally distribute the company's fentanyl spray, intended for cancer patients, so that it could be prescribed for non-cancer patients. Kapoor stepped down as CEO of Insys in January. Acting U.S. Attorney William D. Weinreb said, "Mr. Kapoor and his company stand accused of bribing doctors to overprescribe a potent opioid and committing fraud on insurance companies solely for profit. Today's arrest and charges reflect our ongoing efforts to attack the opioid crisis from all angles. We must hold the industry and its leadership accountable - just as we would the cartels or a street-level drug dealer." Six former Insys executives and managers were charged in December.
[takyon: a262 would like you to know that Insys Therapeutics donated $500,000 to help defeat Arizona's 2016 ballot initiative that would have legalized recreational use of cannabis.]
One Woman Got Facebook to Police Opioid Sales On Instagram (archive)
Eileen Carey says she has regularly reported Instagram accounts selling opioids to the company for three years, with few results. Last week, Carey confronted two executives of Facebook, which owns Instagram, about the issue on Twitter. Since then, Instagram removed some accounts, banned one opioid-related hashtag and restricted the results for others.
Searches for the hashtag #oxycontin on Instagram now show no results. Other opioid-related hashtags, such as #opiates, #fentanyl, and #narcos, surface a limited number of results along with a message stating, "Recent posts from [the hashtag] are currently hidden because the community has reported some content that may not meet Instagram's community guidelines." Some accounts that appeared to be selling opioids on Instagram also were removed.
The moves come amid increased government concern about the role of tech platforms in opioid abuse, and follow years of media reports about the illegal sale of opioids on Instagram and Facebook, from the BBC, Venturebeat, CNBC, Sky News and others. Following the BBC probe in 2013, Instagram blocked searches of terms associated with the sale of illegal drugs.
[...] Carey is now the CEO of Glassbreakers, a startup maker of software to support workforce diversity. But she worked on illegal drug sales in her previous job at MarkMonitor, a company that protects brands like pharmaceutical companies from online counterfeiting, piracy, and fraud. In a Mar. 30 tweet to Rob Leathern, Facebook's director of product management, Carey wrote, "The historical response that users can report abuse and moderators will review hasn't changed in 4 years." She asked him to "Please hold leadership accountable."
#StopSnitching.
Also at CNN.
See also: Facebook Needs to Do More to Stop the Online Opioid Market, Says FDA Chief
Related: Senate Investigators Google Their Way to $766 Million of Fentanyl
U.S. Surgeon General Urges More Americans to Carry Naloxone
U.S. Life Expectancy Continues to Decline Due to Opioid Crisis
Record US fentanyl bust 'enough to kill 26 million people'
Nearly 120lbs (54kg) of fentanyl, a powerful synthetic painkiller, has been seized by police in Nebraska - one of the largest busts in US history.
The drugs, seized last month, could kill over 26 million people, according to estimates by the US Drug Enforcement Administration (DEA). Police found the fentanyl in a fake compartment of a lorry. The driver and a passenger were arrested.
[...] It was the largest seizure of fentanyl in state history, Nebraska State Patrol said in a Twitter post on Thursday.
[...] Just 2mg of fentanyl - or a few grains of table salt - is a lethal dosage for most people, and even exposure can cause a fatal reaction, according to the DEA.
Another estimate: they could make 260 million people pain-free for a day.
Bonus story:
Mussels test positive for opioids in Seattle's Puget Sound
Scientists at the Washington State Department of Fish and Wildlife have found that mussels in Seattle's waters are testing positive for opioids. The finding suggests "a lot of people" are taking oxycodone in the Puget Sound, researchers say.
Also at the Puget Sound Institute.
Related: Opioid Addiction is Big Business
Heroin, Fentanyl? Meh: Carfentanil is the Latest Killer Opioid
Cop Brushes Fentanyl Off Uniform, Overdoses
Opioid Crisis Official; Insys Therapeutics Billionaire Founder Charged; Walgreens Stocks Narcan
U.S. Life Expectancy Continues to Decline Due to Opioid Crisis
Senate Investigators Google Their Way to $766 Million of Fentanyl
"Synthetic Opioids" Now Kill More People than Prescription Opioids in the U.S.
British Medical Journal Calls for Legalizing All Drugs
Fentanyl is the deadliest drug in America, CDC confirms
Fentanyl is now the most commonly used drug involved in drug overdoses, according to a new government report. The latest numbers from the US Centers for Disease Control and Prevention's National Center for Health Statistics say that the rate of drug overdoses involving the synthetic opioid skyrocketed by about 113% each year from 2013 through 2016.
The number of total drug overdoses jumped 54% each year between 2011 and 2016. In 2016, there were 63,632 drug overdose deaths.
[...] In 2016, over 18,000 overdose deaths involved fentanyl, and 16,000 fatalities were due to heroin.
China recently agreed to reclassify fentanyl as a controlled substance to curb sales to the U.S. Will that agreement hold given ongoing trade war tensions?
Also at CBS.
Related: U.S. Life Expectancy Continues to Decline Due to Opioid Crisis
Senate Investigators Google Their Way to $766 Million of Fentanyl
"Synthetic Opioids" Now Kill More People than Prescription Opioids in the U.S.
120 Pounds (54 kg) of Fentanyl Seized in Nebraska
U.S. House of Representatives Passes Opioid Legislation; China Will Step Up Cooperation
The Dutch Supply Heroin Addicts With Dope and Get Better Results Than USA
U.S. Opioid Deaths May be Plateauing
(Score: 3, Interesting) by fustakrakich on Sunday January 28 2018, @04:15PM (4 children)
Only in contraband will you find the true free market. Stores are always open. Operators are standing by.
La politica e i criminali sono la stessa cosa..
(Score: 4, Interesting) by JoeMerchant on Sunday January 28 2018, @10:25PM (3 children)
Didn't we figure out in the 1920s that it's better to make a substance legal, and regulated, instead of banning it and lose all control?
🌻🌻 [google.com]
(Score: 4, Insightful) by c0lo on Monday January 29 2018, @12:23AM (1 child)
Apparently not.
https://www.youtube.com/watch?v=aoFiw2jMy-0 https://soylentnews.org/~MichaelDavidCrawford
(Score: 2) by Freeman on Monday January 29 2018, @05:42PM
The war on drugs has definitely proven that. The relatively few deaths due to the Opioid Crisis don't compare to the overall numbers of people hurt / killed by drugs. I'm not a fan of recreational illegal drug use, but I'm also not a fan of Alcohol or Tobacco. The war on drugs doesn't seem to be working. Just like Prohibition didn't work. People like their fun stuff, don't take it away, otherwise you're going to have a mess. A well regulated drug trade that made sure kids can't get any would be an acceptable alternative in my opinion. Probably won't happen for another generation or two. Unless someone can convince at least some of the conservatives that Regulated Drugs are the safer way to go about dealing with the situation.
Joshua 1:9 "Be strong and of a good courage; be not afraid, neither be thou dismayed: for the Lord thy God is with thee"
(Score: 0) by Anonymous Coward on Monday January 29 2018, @08:06PM
i don't agree with this either/or proposition. how about the (US) government do what it is actually authorized to do (very few things) and stay out of things that are none of it's business, like telling people what medicine they can use, possess or produce?
(Score: 0) by XivLacuna on Sunday January 28 2018, @04:26PM (29 children)
The problem with fentanyl is education on proper dosage. There is no need to liquify it and inject into veins, which lowers the spread of disease since people won't be sharing needles to get release from whatever pains them into using it.
Once we educate degenerate drug users on the proper dosage of fentanyl, there will be less of them showing up in the morgue.
The societal problems that drive drug use aren't being solved so the best we can do is lower the death rate.
(Score: 1, Insightful) by Anonymous Coward on Sunday January 28 2018, @05:19PM (3 children)
lower the death rate
Why? If the death penalty reduces crime, why not let overdoses reduce drug use amongst the living? The message should be "DON'T USE DRUGS!", not this mamby pamby "oh you poor little snowflake".. Otherwise the whole world will become filled with addicts and other mental cripples. What better (and cheaper) way is there to control the growth of that segment of society than to simply let them die off? Society needs to practice more tough love for its people. Amputate the diseased parts before they infect the whole. Only then can it be healthy and flourish.
(Score: 2) by Gaaark on Sunday January 28 2018, @05:29PM
What is Darwin for $1000 Alex?
--- Please remind me if I haven't been civil to you: I'm channeling MDC. ---Gaaark 2.0 ---
(Score: 2) by JoeMerchant on Sunday January 28 2018, @10:28PM
Because, it's not just the poor and stupid who get hooked on illegal painkillers. It's also the rich and stupid [nytimes.com], and they need protection from themselves.
🌻🌻 [google.com]
(Score: 2, Insightful) by lars on Monday January 29 2018, @01:36AM
What crime? The crime produced is due to it being illegal in the first place.
All that's left is DUI/public intoxication. DUI will be a thing of the past with self driving cars. Public intoxication isn't much of an issue, as well as being something that can be prevented effective with enforcement as it already is.
(Score: 1, Informative) by Anonymous Coward on Sunday January 28 2018, @05:24PM (23 children)
The problem with fentanyl is that it's extremely potent and lethal in small dosages. You've got people dying of overdoses from the stuff just by touching it without gloves.
It's not something that should be out there being prescribed, at a certain point, people need to be provided with effective pain management strategies. Drugging people with something this addictive and this easily overdosed on is just asking for problems.
(Score: 5, Interesting) by sjames on Sunday January 28 2018, @09:25PM (22 children)
So, other than suggesting to patients that screaming and crying inconsolably 24/7 while the pain blots out conscious thought might take their mind off of it, what's your suggestion?
The reason people use fentanyl on the streets is that it's easier to smuggle past the DEA. Fentanyl use is a product of the war on some drugs. Otherwise they'd use cheap clean and relatively safer heroin.
(Score: 0) by Anonymous Coward on Sunday January 28 2018, @09:58PM (6 children)
Sometimes, you just can't do anything. We existed for millennia before these drugs were invented.
You can't just look at the patients and ignore the lives destroyed by drug abuse and conclude that it's a necessary evil when people have existed for so long without it. Especially when there's so little research into the safety and efficacy of these drugs. The opioid crises is mainly the result of providing people with strong pain killers and inadequate abuse prevention.
At a certain point the quality of life isn't there and it would make more sense to just prescribe ever increasing amounts of pain killers in the case of the terminally ill.
(Score: 2) by sjames on Sunday January 28 2018, @11:42PM (5 children)
The people who abuse drugs and die made their own choice. It's great to try to mitigate that harm, but not at the expense of people who actually do need those drugs. Why should they suffer?
We did exist before fentanyl. We also had more pain patients commit suicide. Although not strictly legal, we DO prescribe ever greater quantities of pain killer to terminally ill people in pain. It does eventually kill them, but at least they don't die in agony. The official cause of death is inevitably complications of whatever it was that was killing them in the first place. It's not exactly a lie.
(Score: 0) by Anonymous Coward on Monday January 29 2018, @04:51AM (2 children)
This ignorance is reprehensible. People don't choose to become addicted to substances. People don't just wake up one day and decide that they want to try fentanyl. That's ludicrous.
What about that woman that died of an overdose just coming into contact with the powder while cleaning up after her son that had just died of a fentanyl overdose? Or the people who will die waiting for EMTs with appropriate training to show up because the police don't know what the powder in the room is?
And yes, people probably did commit suicide more often due to pain. But, you still haven't justified exposing people to such a dangerous drug just so that the terminally ill can exist for a few more months in barely contained agony.
It's a sucky situation, but creating new drugs that are so incredibly dangerous that just coming into contact with the powder can lead to a fatal overdose isn't a worthwhile trade.
(Score: 3, Informative) by sjames on Monday January 29 2018, @07:11AM (1 child)
There are already many such substances out there. It's just that most of them aren't abused. I personally would advise treating opoid addiction as a medical problem and telling law enforcement to but the hell out. If that was done, then people would likely stick to heroin. I wouldn't call that safe, but it's certainly safer.
As for waiting for EMTs, I would suggest better police training and equiping them with narcan (it's already being done in some places).
You might want to note that mere contact is not actually sufficient to OD on fentanyl, even if you have no tolerance. You've fallen for the FUD. You would have to swallow or inhale some of the powder to even get a noticeable dose.
Fentanyl isn't just for the terminally ill. It is used post-op quite frequently. It is also a last resort for people with chronic pain who might well live for YEARS with some reasonable quality of life as a result. I DARE you to go to such a person and their loved ones and tell them to just eat a gun. I have already told a drug addict that they will eventually die if they use fentanyl.
There are actually MUCH more powerful opiates out there but they're only used for large animals such as elephants since the human dose is too small to reliably measure out. I'm guessing that if fentonyl actually disappears from the streets (unlikely since people are now manufacturing fentonyl like they manufacture meth), some dinbulb will steal a load of it and kill a lot of people. Actually now that I look, it's already happened [arstechnica.com]. Cut that off and watch people die from krokodil. The answer is treatment so people won't resort to the worst of all options, you'll never make the drugs go away.
(Score: 0) by Anonymous Coward on Tuesday January 30 2018, @04:27AM
How do you explain the cases where that happened? It's hardly just the incident I referenced earlier, there are other cases. If it's not that potent, then how do you explain people dying of overdoses that weren't doing the drug?
As far as those loved ones go, I would have absolutely no problem whatsoever telling them that. This whole bullshit about people in that situation being used to rationalize the availability of unnecessarily dangerous drugs without giving equal consideration to the lives that are ultimately lost as a result is reprehensible.
(Score: 0) by Anonymous Coward on Monday January 29 2018, @11:53AM (1 child)
Until that drug addict comes along and clobbers you in the head to get your wallet so they can satisfy their next hit? You wouldn't give a fuck about either, right?
Harm reduction is NOT only to the drug user. It's the cost of the entire society that matters in policies like that.
(Score: 2) by sjames on Monday January 29 2018, @04:05PM
If proper treatment programs are in place, an addict won't need my wallet to get the next hit. Opiates are actually pretty cheap once you get law enforcement out of it.
(Score: 2) by JoeMerchant on Sunday January 28 2018, @10:33PM (14 children)
There's actually some professionally delivered "pain therapy" that more or less trains the victims to "man up" and work through the pain. Lots of people have extreme pain that doesn't really indicate a problem, it's just defective pain messaging, and if they learn to ignore it they can get on with their lives. This kind of "mind control" therapy should be effective on any kind of pain that a pain blocker drug is indicated for.
Other times, pain is telling you about a real, physical problem that you're going to make worse by ignoring it - and whether with pills or will-power, gutting through that kind of pain will debilitate you further - the advantage of the will power method is that you have some kind of chance to recognize a new and different pain, whereas pain masked with a drug like Fentanyl will mask it all.
🌻🌻 [google.com]
(Score: 5, Insightful) by sjames on Sunday January 28 2018, @11:58PM (13 children)
That mind control can only go so far. I'm actually fairly good at it, right up until it breaks through and I grey out or black out. It can certainly help you need less pain killers, but it can only go so far. Thankfully, the pain that blacked me out was temporary. I can only imagine how much worse it would have been if I hadn't known it would go away.
Don't forget that one popular use of fentanyl is for post-operative pain. Good pain control actually helps the patient to recover faster (and so need less pain killers over all). Every day you lie still in bed adds 3 more days to the final recovery. If fentanyl can allow the physical therapist to get the patient sitting up or perhaps standing twice a day, I'm all for it.
(Score: 2) by JoeMerchant on Monday January 29 2018, @03:17AM (9 children)
Whatever they gave me for post-op pain control (oxy, I think) worked really well on the conscious level pain, but when the therapists were pulling half-dissolved stitches out of my thumb-tip, I could sit and not flinch, but I was sweating bullets and about to pass out.
🌻🌻 [google.com]
(Score: 4, Interesting) by sjames on Monday January 29 2018, @05:35AM (8 children)
Oxy can certainly do that. But of course, there are much more painful conditions that the oxy can't even put a dent in.
An interesting thing about blocking pain through meditation and other mindfulness techniques is that even while you may tolerate the "mental aversiveness" of the pain, your body may still react to it if it's severe enough. Shakes, sweats, fatigue, shock, etc.
Once you've experienced black out level pain, you understand that a paper cut isn't even a 1 out of 10. It seems that the people who suggest not making strongest possible opoids available to people in chronic severe pain think a paper cut is a 9. If they knew what a real 9 is, they'd change their tune, but I wouldn't wish that on them.
(Score: 2) by JoeMerchant on Monday January 29 2018, @01:43PM (7 children)
Physician friend of mine went to China, they showed him all sorts of things, including a (successful) open heart surgery performed with only accupuncture and heavy mental preparation.
There's all kinds of perception of pain, ways to get through it, pain that can't be blocked, etc. and it depends as much on the person as the pain. There's this: https://en.wikipedia.org/wiki/Congenital_insensitivity_to_pain [wikipedia.org] and I believe there are many other levels of that which aren't as well described in the literature.
🌻🌻 [google.com]
(Score: 2) by sjames on Monday January 29 2018, @05:09PM (6 children)
There are a lot of components to it. Some seem to be matter of mental training while others seem to be inherited traits. Also there is more than one variety of pain. In addition to the obvious and dramatic cases of congenital insensitivity (which can be quite a problem), there seem to be people who are inherantly able to dismiss pain with ease and others who simply can't. Others can easily learn to dismiss pain, while others have only limited success.
There really seems to be something to acupuncture, fMRI has even demonstrated activity in relevant areas of the brain when skilled acupuncturists work on some conditions but not when the subject receives a similar sham treatment. Western medicine has very little information on how, why, or when acupuncture works. It's worth a try when someone is in pain.
For something that is so obviously real and is such a part of everyone's life, we really don't have much scientific grasp of it. We don't even have a way to objectively measure it. For that reason, we need to be careful with decisions about what people who are not ourselves need and don't need WRT pain management. I know what I can deal with, but even if you have a similar condition, I really don't know if you are experiencing more or less pain nor if it is more or less troubling for you. Techniques that may (or may not) reduce the need for opiates are very much worth a try but when you try them, only you can tell me if it worked well enough for you. When I try them, only I can tell you if I still need opiates or not.
For all of those reasons, we need law enforcement and legislators to quit practicing medicine without a license and without even examining the patient. We need better education for actual medical personnel including alternative pain management techniques and in MANY cases, sensitivity training (not the same sort corporate HR likes, I just don't know what else to call it). But I do not think opiates, including very strong ones, can just be dispensed with any time soon.
(Score: 2) by JoeMerchant on Monday January 29 2018, @05:37PM (5 children)
Oh, but, hey, that doesn't stop the ER staff from asking the question: "Rate your level of pain on a scale from 1 to 10?"
As for opiates, they too have a widely varied response curve. When my wife was given morphine post-partum, it did nothing for her pain or blood pressure, but it did give her very disturbing hallucinations and respiratory depression. My grandfather (on the other side) decided to pull out a catheter from his femoral artery the first night they gave him morphine - that resulted in an additional two weeks in the hospital, and a change of pain meds.
The M.D.s I have known all seem too wrapped up with "treating real problems" to worry about pain, except perhaps as it might affect the vitals they are attempting to control (like BP). Personally, I think we need to work out a way to increase the number of people allowed to practice medicine at the M.D. level, so this artificial scarcity of the doctors' time can go away, and they can start spending time treating the whole patient instead of high paying little specialty sub-systems of the patients.
🌻🌻 [google.com]
(Score: 2) by sjames on Monday January 29 2018, @06:21PM (4 children)
The staff have to use rate your pain. It's the only measure they have. In many ways it's better than an objective measure, it's the subjective pain that must be treated in order to help the patient improve. It would help though if they really understood what might affect the patient's subjective measure. For example, if the patient presses the call button to request pain meds and it takes an hour to get them, their future pain rating (and their subjective sense of pain) will go up. The sinking feeling that you may not get needed help is like that. OTOH, if the patient knows relief will be prompt, they may decide that 5 is more like a 3.
If the MDs were REALLY doing their job, they'd know that adequate pain control will actually improve the patient's objective condition as well as their compliance with medical instructions.
In many places, P.A.s and R.N.s are assuming greater responsibility, but they seem to be in short supply as well. Part of it is that we've let the costs of medical school increase out of control.
(Score: 2) by JoeMerchant on Monday January 29 2018, @06:37PM (3 children)
Don't get me wrong, I know several good doctors - it's just a shame that they're in the minority.
Cost of med school is one thing, but on top of that, cost no object there's a limited number of seats in the program every year. In the US they explain this by pointing to a limited number of seats in the post-graduate rotations programs - and I call BS on that. By limiting availability of seats in the program, they allow the price of the program to climb sky-high, and justify the cost of the program with "ROI" from insane specialist compensation levels on graduation. Plenty of people who are intelligent and motivated enough to become M.D.s are kept out by either the cost of school, or the arbitrary pre-med weed-out and MCAT process.
Doctors with limited rotations experience, give them a new title and limited responsibilities. Let them fulfill rotations requirements as apprentices with existing M.D.s as lesser-partners in practice... there are hundreds of possible solutions, but the only one the AMA pursues is limited supply.
🌻🌻 [google.com]
(Score: 2) by sjames on Monday January 29 2018, @08:16PM (2 children)
There are good doctors out there, I know a few as well. They sometimes have a hard time applying that when time is short and student bills are huge though, so I suspect many could do better given half a chance.
This is one reason I would like to see a single payer system. It would provide the leverage needed to hopefully put the U.,S. healthcare on par with western Europe.
(Score: 2) by JoeMerchant on Monday January 29 2018, @09:01PM (1 child)
1990 Dusseldorf, actual case of blood poisioning presented on my left wrist. Walked to the desk of the hostel I was staying at and asked where is the nearest hospital? "oh, you're kind of in a bad spot here, halfway between two" - they were both ~10 minutes walk. I walk in to the E.R. "oh, we're very sorry, the doctor is with someone else right now, it will just be a few minutes" - literally less than 5 minutes later, I had the full attention of a doctor and nurse for the next 90 minutes, no other patients arrive (because of all the other open hospitals, maybe?) while they meticulously cleaned the wound, obtained and administered both antibiotics and a tetanus series, applied a plaster cast, schwester Silke asked if she could join me and my friend for a beer later, the bill was 35DM, but I only had 20s and 10s, they rounded down to 30, and the followup visit to remove the cast and check healing was free.
2010 Gainesville, Florida, suspected case of blood poisioning presented on my left wrist at 4:30pm Sunday. Called around to the "doc-in-a-boxes" but they were all closed or closing before I could get there, E.R. is the only option. Self-drive to the E.R. - have to park in the crowded out-lot then walk across the empty access restricted lot with one Mercedes and one Porsche parked up front. Present at the window, explain "blood poisioning, see the red streak on the wrist?" yeah, yeah, take a seat over by the apparent TB case. Oh, look, it's football playoffs and they just kicked off. Not one single, patient is taken back for anything but financial consultation or B.S. preliminary X-rays and other pump-up-the-billing with non-MD staff work. The waiting room is stacked full by the 4th quarter, car wreck victim on a stretcher moaning in pain. Patriots score and wrap up the game with less than a minute to play: BOOM, patients being taken back to see the M.D.s one every 3 minutes. I get glance at the red streak, a script for antibiotics, but, sorry, the on-site pharmacy is closed, you'll have to go across town to fill this at this hour... Total bill for this abuse started negotiations at $3500, came to about $150 out of pocket.
🌻🌻 [google.com]
(Score: 2) by sjames on Tuesday January 30 2018, @02:03AM
Sounds about typical, sadly. If the urgent care was anything like the one near me, it's just as well. Apparently they can't do an IV and if you look even vaguelky dehydrated, they'll send you to the ER. Yeah, paramedics can do it by the roadside, it can be done in the clubhouse at an MLB game, but it's beyond "urgent" care. 8 hour wait (so much for any sense of urgency). Bill from collection agency arrives before bill from the ER does (months later). Yes, they sent it to collections before even trying to bill it.
(Score: -1, Troll) by Anonymous Coward on Monday January 29 2018, @04:54AM (2 children)
Not really, pain isn't a real thing, it's an interpretation of nerve impulses. People have used hypnosis for full on surgeries with success in the past, so to claim that there are limits is rather silly.
For example: https://www.cbsnews.com/news/hypnosis-no-anesthetic-for-mans-surgery/ [cbsnews.com]
I personally use visualization exercises for pain management and I can't remember the last time I touched any sort of pain killer. The pills are just not worth it as they all have significant side effects.
(Score: 2) by sjames on Monday January 29 2018, @06:34AM (1 child)
You can call it silly if you like, but it is a personal experience I had and so I have to accept it as true. Pain may be just a signal, but the human physiology responds to that signal.
You should note that "hypnosurgery" still includes receiving a local, you just don't get rendered unconscious.
I'm not a fan of opoids myself, I generally don't need them for pain management. But, I'm not in chronic severe pain either.
Have you considered that you simply haven't encountered severe enough pain to make the observations I have made? I note you didn't say YOU had surgery using only visualization or hypnosis.
(Score: 0) by Anonymous Coward on Tuesday January 30 2018, @04:32AM
Have you considered the fact, that we're not all girly men? I've encountered real pain, it's just that as a recovered alcoholic, I have a greatly reduced set of painkillers available to me. I used to live with what doctors would consider debilitating pain. At first it really hurt, but with practice and effort the pain got to be bearable and eventually subsided completely.
These days, the issue I have more often is not feeling pain that I should have. I've even had minor surgery with no anesthetic at all and was just fine.
If our species was as weak as it is now even a couple thousand years ago, there's no way we'd still be around. Humans are resilient, but you don't get to be resilient by constantly chickening out of it.
(Score: 2) by c0lo on Monday January 29 2018, @12:27AM
When the "degenerate drug users" are undesirable even in the morgue... (grin)
(yes, I know, in gratuitously cynical in this instance. Sorry for that)
https://www.youtube.com/watch?v=aoFiw2jMy-0 https://soylentnews.org/~MichaelDavidCrawford
(Score: 3, Insightful) by Dr Spin on Sunday January 28 2018, @04:39PM (4 children)
we now know the depth to which drug traffickers exploit our mail system to ship fentanyl
Ban the mail system Now!
Warning: Opening your mouth may invalidate your brain!
(Score: 5, Interesting) by ben_white on Sunday January 28 2018, @05:08PM (1 child)
I know you jest, but it is the long term goal of many conservatives in congress to privatize or eliminate the postal service. They have driven them into financial crisis by making them unique among all federal agencies that they have to pre-fund retirement plans 100%. This has put approx $5 billion dollars of expense a year onto the service beyond what is required to keep it solvent. Congress has also limited the postal service's ability to move into other potentially lucrative businesses as revenue from dead tree mail have been falling. The restraints on revenue coupled with ridiculously high expenses to pre-fund the retirement of workers that have not even been hired yet makes the postal service look like it is a failing entity. This is by design.
Here are some links:
https://www.uspsoig.gov/blog/be-careful-what-you-assume [uspsoig.gov]
https://mronline.org/2011/09/23/the-manufactured-financial-crisis-of-the-u-s-postal-service/ [mronline.org]
(Score: 2, Interesting) by Anonymous Coward on Sunday January 28 2018, @08:46PM
You're kind of half-right about it.
The small-government types who wanted to privatise the USPS wanted the whole thing out, and run as a business. This would mean renegotiating lots of items, including pensions, to be in line with the rest of the industry.
They couldn't pass that law as such.
To get around that, they rolled in a bunch of progressive wishlist items that some people thought were poison pills, and others thought would be a shining beacon that would prove how corporations were all bloodsucking monsters for not fully funding all sorts of benefits - pensions among them.
Fast forward a couple of decades, and the USPS is caught between an insane burden that arguably was never intended to happen, and insane restrictions on what they can actually do.
It's a poster child for what happens if you privatise, skip all the benefits of privatisation, and retain the burdens of not having privatised.
Go figure.
(Score: 2) by requerdanos on Sunday January 28 2018, @07:29PM
I read that original alarmist!! assertion!!!! as "Congressional investigators conducted a deep investigation on how so many drugs could possibly be mailed, and their exclusive conclusion was that the items were mailed... by mail!!! Lead investigator Capt. Obvious was quoted as saying..."
Which brings us to the surprise meter for that particular finding...
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(Score: 0) by Anonymous Coward on Monday January 29 2018, @08:17PM
no, but they're using the ~40k deaths a year (out of 400 million people. that's aprox. .0001 percent...) to totally clamp down on the global mail system. we'll have to route around the official mail services as you can bet more and more things will be on the naughty list over time. some people need CBD for their vaccine damaged kids, already. god forbid you want locally produced raw milk. call in the pigs motherfucker!
(Score: 5, Interesting) by fadrian on Sunday January 28 2018, @04:59PM (4 children)
Talk to the Chinese. That's where all of it comes from. And the notion that the Chinese government couldn't stop this in a couple days with the threat of prosecution is laughable.
That is all.
(Score: 3, Insightful) by PocketSizeSUn on Sunday January 28 2018, @05:03PM (3 children)
The Opium Wars is how the British East India company extracted Hong Kong from China and forced them into a trade agreement.
China plays the long game...
(Too bad they aren't just restricting themselves to the UK).
(Score: 2) by Gaaark on Sunday January 28 2018, @05:36PM (1 child)
The Apple Wars is how God kept Adam & Eve from paradise and forced them into a horrible life of living a life they didn't want (God created Adam forcefully, then created Eve forcefully, both being without their consent).
God plays the long game...
(Too bad God isn't just restricting himself to the believers.... he's fucking everyone else as well, from those who have led a good life, to even the smallest child being molested by pedophiles or being starved to death through no fault of their own: even through allowing the creation of drugs with which we can kill ourselves or others).
--- Please remind me if I haven't been civil to you: I'm channeling MDC. ---Gaaark 2.0 ---
(Score: 2) by Bot on Sunday January 28 2018, @11:29PM
> The Apple Wars is how God kept Adam & Eve from paradise and forced them into a horrible life of living
well, being the ones just before the ultimate expression of creation has its drawbacks, meatbags. Deal with it.
Account abandoned.
(Score: 4, Insightful) by Ethanol-fueled on Sunday January 28 2018, @06:30PM
I think it's a sense of humor and poetic justice rather than just playing the long game.
Anyway, they are right to equally distrust all White Devils, the existence of the Five Eyes justifies their mentality.
(Score: 3, Funny) by Anonymous Coward on Sunday January 28 2018, @05:39PM (10 children)
Cigarette packages (at least in Canada) are branded with awful imagery to remind people of the dangers of smoking. I don't know how effective they are, but perhaps requiring couriers to include some standard "public service announcement" (in this case, on the dangers of opioids) to every parcel shipped (as part of the shipping label) may have some effect.
(Score: 0) by Anonymous Coward on Sunday January 28 2018, @05:57PM (1 child)
Wait ... these suppliers are shipping illegal drugs and you expect them to abide by some kind of packing insert requirements? Really?
(Score: 2) by requerdanos on Sunday January 28 2018, @07:33PM
Yes. Sort of like RFC 3514 [ietf.org].
(Score: 0) by Anonymous Coward on Sunday January 28 2018, @06:34PM (7 children)
How many people do you know who stopped smoking because of the images on a cigarette pack?
As a smoker (and only two cigarettes a day at that), I can tell you how it works: you pull a pack out of your pocket and a cigarette out of the pack, all without looking. The pack disappears back in your pocket, and the lighter comes out of your other pocket, all without looking. The first thing you see is the flame at the tip of the cigarette, because you do everything else unconsciously. You never see the packet or any image on it.
(Score: 2) by HiThere on Sunday January 28 2018, @07:05PM (1 child)
Actually, IIRC, requiring cigarette packages to not have blatantly distinctive packaging did reduce the amount of cigarettes sold in Austrailia? New Zealand? Something like that. Granted this is different from requiring a skull and bones on the front of the package, but it is an argument against your argument. (OTOH, I don't know *how* effective it was, or even whether there was any long term effect. And it may have operated by reducing the advantage for manufacturers to advertise.)
Javascript is what you use to allow unknown third parties to run software you have no idea about on your computer.
(Score: 3, Informative) by c0lo on Monday January 29 2018, @01:00AM
Yes [health.gov.au] a whooping "0.55 percentage points between December 2012 and September 2015" from the "smokers prevalence". More precisely:
https://www.youtube.com/watch?v=aoFiw2jMy-0 https://soylentnews.org/~MichaelDavidCrawford
(Score: 2) by requerdanos on Sunday January 28 2018, @07:36PM (3 children)
As a multi-decade former smoker, I can also tell you that sometimes "how it works" is that you are bored when you happen to decide to smoke a cigarette, and you not only read but carefully examine every detail of the pack, the lighter, the unsmoked cigarettes, the one you are smoking, etc.
(Score: 0, Troll) by frojack on Sunday January 28 2018, @07:44PM (2 children)
As a never-smoker, I look at both you and the AC as utterly insane individuals.
But I bet you are both in favor of free government supplied health care.
No, you are mistaken. I've always had this sig.
(Score: 2) by requerdanos on Sunday January 28 2018, @09:35PM
Smoking was not an activity arrived at by an excess of sanity on my part. I did finally stop.
Well, sure, if a government somewhere is sitting on a huge free supply of health care, then I am all for them releasing it.
I suspect not, however.
(Score: 0) by Anonymous Coward on Monday January 29 2018, @12:35AM
Fuck you and your high puppy you are riding on.
On a second thought, I'll let the puppy alone and fuck you twice. With a jackhammer.
(Score: 2) by TheRaven on Monday January 29 2018, @11:38AM
sudo mod me up
(Score: 0) by Anonymous Coward on Sunday January 28 2018, @06:11PM (1 child)
And had them shipped illegally? Sounds like the Senate investigators need some jail time for breaking laws... Or do they have immunity from the law?
(Score: 2) by JoeMerchant on Sunday January 28 2018, @11:48PM
In the context of an investigation, do you even have to ask?
🌻🌻 [google.com]
(Score: 5, Insightful) by hoeferbe on Sunday January 28 2018, @07:00PM (1 child)
Unsurprisingly, U.S. Senators Rob Portman (R-OH) and Tom Carper (D-DE)'s statement includes gems like:
...which all point to more money (from you and me) being taken to fund more programs to delve deeper into tracking the populace's actions, unwarranted investigations into those actions and greater control & power by Federal agencies.
If I recall correctly, the federal government cannot keep drugs out of their federal prisons -- which are small, isolated, tightly controlled areas whose residents have lost much of their Constitutional freedoms. Yet, we are supposed to believe we can eradicate the drug problem in our expansive, inter-connected "land of the free" with just more government power!
I feel, as much as the next person, for those facing drug additions. That is why we need to get off this kick of expanding governmental control and reach into the lives of ~326 million United States residents to `save` (in Portman & Carper's statement's example) 42 thousand (0.0129% of the population) from opioids. In a news story about the actual subcommittee meeting [linns.com], I was glad to read Carper at least acknowledge expanding government power isn't enough:
(Score: 2) by frojack on Sunday January 28 2018, @07:47PM
Beagles. Cheap. Cute.
No, you are mistaken. I've always had this sig.
(Score: 0) by Anonymous Coward on Sunday January 28 2018, @09:22PM
Fentanyl is one helluva opioid. That's why it's given out to terminal cancer patients.
(Score: 2) by Bot on Sunday January 28 2018, @09:57PM
> $766 Million of Fentanyl
This explains the laws they pass.
Account abandoned.
(Score: 5, Insightful) by Anonymous Coward on Sunday January 28 2018, @11:07PM (2 children)
The feds and states must stop protecting us from everything. Make it all legal, tax it, and focus on education campaigns. Anything prescription should have specific requirements for proper risk discussions between doctor and patient but nothing more. How many billions of tax dollars have been poured into the legacy war on drugs and how well has that worked out? As a tax payer I don't want my portion going toward ruining lives and over-protecting me from myself. Portugal decriminalized drugs with excellent results and we could do the same.
(Score: 0) by Anonymous Coward on Sunday January 28 2018, @11:58PM (1 child)
We could, but "drugs" is one thing you can say to a conservative that will make him ask for big government.
Maybe we could call them global drugging alarmists.
(Score: 2) by Pslytely Psycho on Monday January 29 2018, @10:54AM
Drugs, immigrant, gay, terrorist, liberal....yeah, they all pretty much work that way.
Alex Jones lawyer inspires new TV series: CSI Moron Division.
(Score: 0) by Anonymous Coward on Monday January 29 2018, @06:43PM
"bipartisan investigation"
That is, we Googled the thing...