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Comment by pascalxus | Hacker News Reader

Where do they get the money to afford all those opoids? Most people with jobs can barely afford to make ends meat, so how are the growing ranks of unemployed able to afford that, year after year after year?

Why wouldn't they rather spend the money on things that mattered? like shelter/rent or food.

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Fentanyl has been a major accelerant in the opioid crisis. It's extremely potent and extremely cheap to manufacture. This has driven prices down, brought drug strength up, and shot overdoses through the roof.

> Why wouldn't they rather spend the money on things that mattered?

Opioids are incredibly addictive. Once you're hooked, you don't think rationally about how you spend your money.

At Uni, I smoked and I would select smokes over food or rent any day. I guess not having a job wouldn't make me feel any different.

What good is a tin of beans compared to killing the craving for a smoke for an hour? No contest.

I'm finishing the book Dreamland, by Sam Quinones, which directly addresses your questions (with a particular focus on addiction in middle america/appalachia)

Q1: Medicaid co-pay for $1000 worth of OxyContin was (as of ~2014, might still be) on the order of $3-5. Those unable to get prescriptions fence stolen goods, primarily from rural WalMarts

Q2: Opiods are chemically similar to heroin. Addiction is severe and enslaving. Someone who wouldn't get off the couch to throw out the trash will walk miles in a snowstorm to get their fix.

    > Where do they get the money to afford all those opoids?

They can't afford them forever. When the money runs out, they switch to heroin which is MUCH cheaper than the abused prescription drugs which got them addicted in the first place.

"Shelter", when someone hits the bottom, consists of a flop-house or couch-surfing.

I should probably use a throwaway, but I am not scaed.

During the peak of my very long addiction, post retirement, I was spending $250/day - not counting the habits of friends that I helped to feed.

The only difference between what people call a junkie and myself is that I can afford it. That's also the reason why I was able to get adequate assistance to minimize the harmful behaviors. Err... I am on Suboxone, and probably will be for a very long time. I used for 35 years.

Anyhow, it can be expensive. Users equate use with life. Life always finds a way.

The only difference between you and what people call a junkie is people are being polite to your face. If you're on subs and have used opiates for 35 years, it seems pretty clear to me.

Pretty much. I can afford to maintain an air of functionality. I was a functional addict, for much of that time. When I sold and retired, I no longer needed to function. Things escalated quickly.

Nobody calls a guy a junkie, if said guy drives a new BMW and has a big house.

^This! I used to think "who in their right mind would decide to inject heroin to get high" then I realized most people who transition from oral prescription drug--->all the way to--->IV heroin/fentanyl/opiate use are not in their right mind, and usually are resorting to IV use as a cost effective solution to bring them out of terrible, debilitating withdrawal symptoms, often one step past them switching to nasal inhalation of the same prescription-->then-->street drugs.

shelter is way more expensive than opioids.

> Why wouldn't they rather spend the money on things that mattered?

addicts aren't addicted to things that matter. they can want to spend their money on things to better their situation and be completely unable to do so. addiction is really hard to beat and is best treated with compassion, not judgement about irrational financial decisions.

I have a friend that has chosen the pursuit of crack cocaine all the way down. The job went a few months ago and yet the dedication to crack cocaine continues.

Note how the crack cocaine is the drug here, after an unknown time on normal cocaine the nose got so bad that crack was the only way. Next there will be the mix with heroin, if this has not started yet. Then payment - said friend is blessed with a vagina so along with everything else this will be rented out for crack cocaine.

Coupled with this costs go up. As the addiction continues more crack cocaine is needed to get to baseline normal.

Along the way all friends and family get reamed out. Borrowed money is not returned. Then every line of credit is used, e.g. payday loans.

Moving in to a lover's pad means no rent and food doesn't matter by then.

There are jobs in the black economy for instance babysitting, for your dealer, for crack cocaine as payment, what could go wrong?

I have desperately tried to change the outcome for my friend but know I have as much luck with that as praying for my mum's arthritis to get better. I enabled too, I did lend her money to move flat share before I knew of the problem.

My friend does come from a background of poor single parenting and that gives rise to the so called addictive personality. All it took was to meet the allegedly cool crowd and get partying. It was great at the start but the price was addiction.

This is how a typical drug junkie should be - childhood narcissistic harm due to a lack of love. But we have not got that in America with the pill epidemic, that was a culture of greedy over prescribing by doctors. It has been a stupid epidemic, creating drug addicts. These people just get caught up in it like my friend and end up doing things they would never do just to pay for this descent into hell. It is just a matter of time.

My friend had a good job with great prospects, a lovely flat, a car, many things. Everything is gone. Paving the streets with gold would not have changed things. Making the drugs free would speed up the decline but I think this stuff is a lot cheaper than beer in a restaurant for your minimum next hit requirements. Begging can cover that, eventually.

It is easy to blame social economic matters but that is to miss the mark. The opioid crisis is a really bad deal and I believe that the numbers in the article are acceptable guesses as to the harm done.

I am sorry for your friend and I hope this doesn't come off the wrong way because I really don't know - what stops you from holding down your friend and getting her help?

I'm lucky to never had to deal with this, but if someone I'm close to is addicted I would get them checked into rehab even if I had to physically detain them.

> Why wouldn't they rather spend the money on things that mattered?

This is the difference between an addiction and a hobby.

Drug-dependent people can very, very efficiently wield time and capital to serve that need.

One hypothesis is that there was a movement out of restricted unemployment programs into disability support programs and that would potentially provide funding for opioids ..

http://apps.npr.org/unfit-for-work/

You won't believe the things people will do just to get enough of their drug of choice to stay well for a few hours.

To answer your first question: Burglary, assault and theft, fraud, prostitution and drug dealing.

> Why wouldn't they rather spend the money on things that mattered? like shelter/rent or food.

Get hooked on opioids and they ARE the only thing that matters.

> Most people with jobs can barely afford to make ends meat

Source?

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