Comment by zkms | Hacker News Reader

Comment by zkms | Hacker News Reader

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Except people only started dying when crackdowns intensified on legal, pharmaceutical, sources and prescribers of opioids.

Crackdowns on "pill mills" and "overprescribing doctors" is what denies people a safe and legal source of pharmaceutical-grade opioids and forces them onto the black market of illegal, overpriced, and fentanyl-contaminated opioids.

Also crackdowns on "over-prescribing" invariably lead to people who experience chronic pain being denied medical access (or being subjected to extremely invasive and degrading treatment to weed out "drug seekers").

The DEA cracking skulls over opioids and investigating doctors is literally the only reason illicit fentanyl even is a thing. I am so very doubtful that skull-cracking and door-kicking will miraculously work after decades of it not working.

Do you want even nastier and even more potent (per unit volume) opioids than fentanyl? Because more prohibition (and yes, investigating and prosecuting doctors is absolutely a component of opioid prohibition) is just gonna give that result.

It saddens me greatly to know that the majority of people in this world would rather let people die from overdose than allow them to get high... Is it really such a big deal? So they like doing drugs. In the grand scheme of things, isn't the more humane thing to do just allowing them to use while pursuing more humane options for getting them off drugs (rehab and education)?

That's one take. I've also heard that marijuana decriminalization is taking the margin out of many drug operations.

Supposedly, Weed is like the ground beef of drug sales.

Fentanyl is a thing also because it's easier to make than heroin because the reactants needed are easier to get your hands on, therefore cheaper for the dealer's/cartel's/gang's chemists to make.

On the more potent point, almost(?) all of the more potent opioids are derivatives of fentanyl and iirc use fentanyl in the synthesis so probably won't become a street drug. Also they're so potent they really are only good for killing people. (Honestly I'm suprised fentanyl is a thing because the active dose is like tens of micrograms and requires expensive equipment to measure safely. But I doubt drug cartels care if they're customers are poisoned by their product.)

> On the more potent point, almost(?) all of the more potent opioids are derivatives of fentanyl and iirc use fentanyl in the synthesis so probably won't become a street drug.

You're alas wrong here. There's already derivatives of fentanyl being made illicitly and appearing in the illicit drugs markets. Not just any analogues of fent either -- there's been carfentanil (an opioid so potent that it's been successfully used as a chemical weapon) in product sold as heroin.

https://en.wikipedia.org/wiki/Carfentanil

> Honestly I'm suprised fentanyl is a thing because the active dose is like tens of micrograms and requires expensive equipment to measure safely

Ah, but a tiny active dose means that for a given quantity of raw material, lots of (very diluted) doses for end users can be made. This is the deadly "iron law of prohibition" at work here -- the harder the enforcement, the more potent the drugs.

For a unit volume (so, for a unit risk of ending up in a concrete box) of uncut/active material, you want to be able to sell the most diluted/cut doses to end-users. Of course people will want their chemist to synthesise carfentanil (over regular fentanyl), because you can supply the the same number of end-user doses with 10,000 times less active material.

If you care about this issue you should really read the book, which addresses all of the points you raise in detail.

I just finished it last week, there were a lot of 'holy shit' moments along the way.

I just finished it last week, there were a lot of 'holy shit' moments along the way.

Looks like prescription medicine is rife with opportunity for some kind of ML analysis to find abuse and be more "just" (make better decisions) about restricting distribution and use.

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