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posted by Fnord666 on Sunday January 28 2018, @04:10PM   Printer-friendly
from the the-gray-web dept.

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
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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

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  • (Score: 5, Interesting) by sjames on Sunday January 28 2018, @09:25PM (22 children)

    by sjames (2882) on Sunday January 28 2018, @09:25PM (#629582) Journal

    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.

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  • (Score: 0) by Anonymous Coward on Sunday January 28 2018, @09:58PM (6 children)

    by Anonymous Coward on Sunday January 28 2018, @09:58PM (#629599)

    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)

      by sjames (2882) on Sunday January 28 2018, @11:42PM (#629633) Journal

      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)

        by Anonymous Coward on Monday January 29 2018, @04:51AM (#629702)

        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)

          by sjames (2882) on Monday January 29 2018, @07:11AM (#629734) Journal

          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 []. 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

            by Anonymous Coward on Tuesday January 30 2018, @04:27AM (#630186)

            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)

        by Anonymous Coward on Monday January 29 2018, @11:53AM (#629788)

        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.

        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

          by sjames (2882) on Monday January 29 2018, @04:05PM (#629845) Journal

          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)

    by JoeMerchant (3937) on Sunday January 28 2018, @10:33PM (#629616)

    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.

    🌻🌻 []
    • (Score: 5, Insightful) by sjames on Sunday January 28 2018, @11:58PM (13 children)

      by sjames (2882) on Sunday January 28 2018, @11:58PM (#629636) Journal

      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)

        by JoeMerchant (3937) on Monday January 29 2018, @03:17AM (#629682)

        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.

        🌻🌻 []
        • (Score: 4, Interesting) by sjames on Monday January 29 2018, @05:35AM (8 children)

          by sjames (2882) on Monday January 29 2018, @05:35AM (#629712) Journal

          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)

            by JoeMerchant (3937) on Monday January 29 2018, @01:43PM (#629798)

            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: [] and I believe there are many other levels of that which aren't as well described in the literature.

            🌻🌻 []
            • (Score: 2) by sjames on Monday January 29 2018, @05:09PM (6 children)

              by sjames (2882) on Monday January 29 2018, @05:09PM (#629878) Journal

              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)

                by JoeMerchant (3937) on Monday January 29 2018, @05:37PM (#629898)

                We don't even have a way to objectively measure it.

                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.

                🌻🌻 []
                • (Score: 2) by sjames on Monday January 29 2018, @06:21PM (4 children)

                  by sjames (2882) on Monday January 29 2018, @06:21PM (#629919) Journal

                  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)

                    by JoeMerchant (3937) on Monday January 29 2018, @06:37PM (#629928)

                    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.

                    🌻🌻 []
                    • (Score: 2) by sjames on Monday January 29 2018, @08:16PM (2 children)

                      by sjames (2882) on Monday January 29 2018, @08:16PM (#630003) Journal

                      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)

                        by JoeMerchant (3937) on Monday January 29 2018, @09:01PM (#630021)

                        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.

                        🌻🌻 []
                        • (Score: 2) by sjames on Tuesday January 30 2018, @02:03AM

                          by sjames (2882) on Tuesday January 30 2018, @02:03AM (#630145) Journal

                          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)

        by Anonymous Coward on Monday January 29 2018, @04:54AM (#629704)

        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: []

        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)

          by sjames (2882) on Monday January 29 2018, @06:34AM (#629726) Journal

          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

            by Anonymous Coward on Tuesday January 30 2018, @04:32AM (#630188)

            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.