Overdose deaths have fallen for six months | Hacker News Reader

Overdose deaths have fallen for six months

statnews.com

75 pointsdanso92 comments

The most important take-away from this article is the Science paper by Jalal et al., "Changing dynamics of the drug overdose epidemic in the United States from 1979 through 2016" [1].

In that paper, the authors conclude:

> The overall mortality rate for unintentional drug poisonings in the United States grew exponentially from 1979 through 2016. This exponentially increasing mortality rate has tracked along a remarkably smooth trajectory (log linear R2 = 0.99) for at least 38 years. By contrast, the trajectories of mortality rates from individual drugs have not tracked along exponential trajectories.

The authors also suggest that we should attempt to "understand the forces that are holding multiple subepidemics together onto a smooth exponential trajectory", and suggest a double-whammy of increased supply (due to improved communication, transportation, and manufacture) and increase demand (despair, loss of purpose, and dissolution of communities) that cuts across both demographics and geographic regions.

[1] http://science.sciencemag.org/content/361/6408/eaau1184

For heroin specifically, I looked into usage rates a few years ago, unfortunately I can't find my notes so no sources here (and it is really hard to find such data).

But from what I recall, usuage rates of heroin in the population in the late 60s and early 70s was comparable to recent years, then fell a bit and remained more or less stable through the early 2000s. The return of addicted GIs from Vietnam prompted the start of the war on drugs by Nixon [1]

The big problem with heroin is what they are cutting it with. Prescription opioids, different ball of wax.

[1] https://www.presidency.ucsb.edu/documents/special-message-th...

So drugs aren't getting deadlier, it's just that more of us are using more of them? (Or more among us are using deadlier drugs than before?)

Drugs are still getting stronger and deadlier and much cheaper. This is obvious when you look at the a spike in Fentanyl use compared to other narcotics. While the amount needed to get high is lower, the potency is much higher. In addition to this, these packages are getting stepped on—where dealers cut it with another substance—a hundred times over before it ends up in someone’s veins with anything and everything.

The most important part to note is that fentanyl analogs are being used along with other inert substance to increase the mass and potency at street level. The problem with this is people easily underestimate the potency and use too much on top of the issue of varying amounts of fentanyl used to cut increasing risk.

>The problem with this is people easily underestimate the potency and use too much on top of the issue of varying amounts of fentanyl used to cut increasing risk.

this is especially dangerous amongst users who are relapsing and initially using their old dose amounts when starting again and their bodies aren’t able to handle it

unfortunately, that's a risk with an untampered supply as well. things are made EVEN WORSE with the fentanyl problem

one of the problems with Fentanyl is how our hands are tied when it comes to inbound shipments. Rogue laboratories in China are a pill-mill for these synthetic drugs.

>Over the last decade, federal officials say, the Zheng group mailed and shipped fentanyl and similar illicit chemicals to customers in more than 25 countries and 35 U.S. states. U.S. officials say the syndicate’s success, laid bare in a recent federal indictment[1], partly helps explain America’s skyrocketing death toll from drug overdoses. [2]

[1]https://www.justice.gov/opa/pr/two-chinese-nationals-charged... [2]http://www.latimes.com/politics/la-na-pol-china-fentanyl-201...

So something they briefly touch on is new research chemicals. What they don't mention is what happened earlier this year.

FOSTA has slaughtered many avenues of sourcing research chemicals. It is significantly more difficult to get them from a reliable source then it was this time last year. While this doesn't stop anyone sufficiently determined, it's harder to get a source of say fentanyl or U-47770 to cut with.

The US has been cracking down on producers of these in China, and many chinese or US based resellers have either ceased to exist or changed their operation (US seems to be heavily targeting opioids, China seems to be going after ketamine and analogs) . In addition the Darknet Markets have taken a big hit from Operation Bayonet. It's not to say that DNMs or their vendors or customers are gone, just they're finding it harder to regroup. Though there have been a number of high profile busts from the data of Operation Bayonet

This applies to more then just opioids though. Other drugs with overdose potential, like stimulants are just harder to get a hold of. Most US domestic sellers seem to focus on benzodiazepine analogs.

We'll see how long this lasts though, I doubt that whole scene is truly gone but it might just be in hibernation for a bit.

Would I be right in thinking that these changes would raise the price? I can’t find any data fine grained enough, and am just getting yearly data points. I’d also assume that there is big regional differences which make any trend hard to generalise. The price does seem to be trending ever lower over time though. https://www.unodc.org/wdr2018/prelaunch/7.5_Standardized_pri...

I can't attest to street price.

At a certain point people just stop buying drugs unless they're heavily addicted. The thing about research chems is that the ones that tended to stick around dose in the sub 50mg range. The cost per dose is still low since they're produced in multikg batches, resold in fraction to multi gram increments.

Just wait until we stop subsidizing chinese epacket shipments. I bet those illegal drugs coming in with fall off of a cliff assuming china doesn't renegotiate the terms.

There's way too much profit for shipping costs to be any sort of factor in this.

Spend a few hundred (even after losing a few shipments) and you can still easily make it back with one good shipment getting through.

Honestly, I think that the bombs getting sent to government officials is going to hurt things for them more than shipping costs would.

we'll see what the future holds though.

It's not the cost, it's the tracking. China epacket is not tracked, every other form of shipping inbound to the US is. So it will be a lot easier to get caught.

I agree with you on that bombs thing. Currently USPS mail is very underscreened. All (or almost all) drugs in the US and coming in use USPS mail due the fact they need a warrant to open your package.

They currently have greatly stepped up their screening game though, mostly due to fentanyl. But that doesn't mean you have to ship straight to the US in bulk. A common route for fake pressed xanax was alprazolam powder to canada where it was pressed and either reshipped or smuggled into the US.

Your argument would work better if the EU wasn't also source for this sort of thing. Though the availability on that end has gone down due to a Russian lab being busted earlier this year that turned out to be behind two of the bigger source sites.

>FOSTA has slaughtered many avenues of sourcing research chemicals

FOSTA was the "Fight Online Sex Trafficking Act," and the bill seemed solely focused on that topic. I'm also not seeing any other bill that would obviously lead to that happening, but I only looked at the titles.

My guess is that if you have a place to illegally sell research chemicals online, that place could also be used to facilitate sex trafficking and will be used that way. So without explicitly targeting drug markets, FOSTA can still indirectly affect them as black markets in general.

Not generally an overlap there. As far as I'm aware there's no real one stop shop. Darknet markets have never had escort services to my knowledge.

No you're right but what it lead to it was sites like Reddit closing down things like /r/darknetmarkets, and /r/rcsources which are both review and sourcing subreddits. It made other forums scared to touch the idea of sourcing because the act can be used against any illegal activity.

Here's the announcement of Reddit banning said subs along with many others: https://www.reddit.com/r/announcements/comments/863xcj/new_a...

And the supply channels (basically a free for all using the US postal system) all dried up pretty much the moment trump went into office. say what you will about the regime, they absolutely did crack down on the thousands of kilos of research chemicals that were being tossed around

Are you suggesting people can overdose on ketamine?

I am not, you'd pass out before you got to a lethal dose. Especially with tolerance.

However China has been cracking down on it (and analogs like Deschloroketamine).

https://www.vice.com/en_us/article/vdxqk4/why-is-the-chinese...

And the list of people who died due to ketamine related things: https://erowid.org/chemicals/ketamine/ketamine_death.shtml

The latter is a rather predictable list of people dying while doing stupid things on ketamine and/or mixing it with depressants

> "and cocaine and stimulants — a group that includes methamphetamine — are each now killing more than 10,000 people a year, a threshold they only crossed in the past few years."

I understand why people use drugs like heroin and fentanyl, but why methamphetamine? Why do they not just use Adderall or pure amphetamine? What is the gain? Amphetamine and Adderall in particular are not neurotoxic at normal doses, and are very safe if used responsibly. Methamphetamine seems to be inherently neurotoxic. Why risk your health when amphetamines and Adderall are just as good?

I think it comes down to availability, and anyways it's probably a wash danger-wise considering that people who are dying from using these aren't taking normal doses. Methamphetamine is a prescribable drug (at least in the US) itself, so I imagine there's a "safe" dose for that too.

I think some people have listened to hysteria about softer drugs like marijuana or psychedelics or softer uppers and looked at the histrionic warnings and contrasted those things to their own experiences, realized that some of the 'you're going to die instantly if you try this ___ once' fearmongering is false, and then assumed that all drugs have had the same overblown fearmongering. So they say 'well if marijuana isn't actually that harmful to me and I can control myself and not overdo it, then cocaine probably isn't that unhealthy or addictive to try once'. And after they get used to the idea of taking cocaine or MDMA in a more casual manner and feel they have control and can take it sparingly, they might end up with the same conclusion that 'this isn't that bad right?' and then decide the warnings about something like meth or heroin are probably overblown.

Huh, I always assumed that like crack, the issue with meth is that it is usually laced with heroin.

Literally no parts of the statement are accurate. Crack is freebase cocaine, which is dangerous for a number of reasons, none of which involve lacing it with another (often more expensive) drug. Meth is also a strong and addictive stimulant and comes with its own bundle of problems; lacing it with a opioid/depressant doesn't make a ton of sense.

People do combine heroin and cocaine/heroin and meth, but the issues with cocaine and meth absolutely do not come from them being laced with heroin.

No, the issue with meth -- from my understanding of it, as I've never tried it -- is that it is the epitome of the phrase "too much of a good thing."

I almost mistook your statement as an ironic statement of hysteria mentioned by parent. IOW, what I was hearing thirty years ago: "you never know what it's laced with". My experience says, "yeah, I do: nothing." I'll suffix that never tried heroin, which I understand to commonly be cut.

But PCP-laced pot? Never, and I can understand that someone isn't going to sprinkle free value-add on there. Cocaine will be laced with baking soda to increase profits, not more pricey drugs. I just never did figure out where people got that idea. Sure, sounds like heroin is getting cut with fentanyl (again, profits). But crack will get you plenty high, and addicted, on its own; there's no need for additives.

Here's a guide to what street drugs are cut with. From 2013, from the UK.

http://www.cph.org.uk/wp-content/uploads/2012/08/cut-a-guide...

For cocaine and crack cocaine, lidocaine is one common adulterant, sugars are another.

That's not entirely true. Thirty dollars of shit coke turns a $100 bag of weed into a $200 bag of weed.

"dippers" are extremely common.

It's cheap, widely available and addictive?

If you understand why people use potent opioids, why don't you believe that the same reasoning -- economics and a desire for stronger effects -- holds for potent stimulants?

If you want to know what cocaine is like, chug 3 or 4 red bulls kinda quick. This may not be any healthier but it is legal and cheap.

Cocaine usage I get, though it's awfully unsustainable for your heart.

The thing about methamphetamine is that from what I understand it is neurotoxic at normal doses, and you have a much safer drug that's not going to be much more expensive available to purchase.

> The thing about methamphetamine is that from what I understand it is neurotoxic at normal doses

Uh, we give it to old people in dosages around 1/80 of a normal user's high. I forget exactly what for.

> and you have a much safer drug that's not going to be much more expensive available to purchase.

Around here (Australia) there is a huge difference in price, cocaine is hugely expensive and meth can be cheaper than legal cigarettes. I've heard of cocaine being much cheaper in the US but maybe that's regional? I think there are also supply issues, something that can be produced in a home lab is going to be around much more consistently.

Don’t do this. You’ll just feel like shit and it’ll be nothing like cocaine.

> but why methamphetamine? [...] Why risk your health when amphetamines and Adderall are just as good?

The phenomenon is called the "iron law of prohibition" [0]:

  The iron law of prohibition is a term 
  coined by Richard Cowan in 1986 which 
  posits that as law enforcement becomes 
  more intense, the potency of prohibited 
  substances increases. Cowan put it this 
  way: "the harder the enforcement, the 
  harder the drugs."
  
  This law is an application of the Alchian–
  Allen effect; Libertarian judge James P. 
  Gray calls the law the "cardinal rule of 
  prohibition", and notes that is a powerful 
  tool for the legalization of drugs.
  It is based on the premise that when drugs 
  or alcohol are prohibited, they will be 
  produced in black markets in more 
  concentrated and powerful forms, because 
  these more potent forms offer better 
  efficiency in the business model—they take 
  up less space in storage, less weight in 
  transportation, and they sell for more 
  money. Economist Mark Thornton writes that 
  the iron law of prohibition undermines the 
  argument in favor of prohibition, because 
  the higher potency forms are less safe for 
  the consumer.

I learned this term from Johann Hari's book, Chasing the Scream: The First and Last Days of the War on Drugs [1].

The "epidemic" of opioid overdose deaths would be ended instantly by giving the addicts all the pure heroin they need. ("I think I've mentioned this here before... uhm, 'Switzerland'..., found it").

A response to my comment [2] said "drug overdose deaths fell by about two thirds between 1995 (Heroin prescriptions started in about 1994) and 2012:" [3].

Meth amphetamine is basically an anti-depressant - people don't need even Adderall, they need safe anti-depressants (!SSRI)[4], and help finding stability [5].

[0] https://en.wikipedia.org/wiki/Iron_law_of_prohibition

[1] http://chasingthescream.com/

[2] https://news.ycombinator.com/item?id=14782416

[3] https://news.ycombinator.com/item?id=14783800

[4] https://news.ycombinator.com/item?id=18211048 (my comment about coca leaf's anti-depressant effects. Amphetamines are somewhat similar.)

[5] https://news.ycombinator.com/item?id=17997852

(edit: added [5], moved [4] to after "!SSRI") (Edit2: moved all the references [] from inline to the bottom of the comment.)

I had never heard this 'law' before, but it makes total sense. In college, alcohol was effectively prohibited in the dorms. Off-campus parties were often broken up by 10 or 11pm. So prepartying became extremely important in order to attain the requisite buzz, particularly when you factor in weak party beer and long lines at the keg.

Of course, you had to secretly store potent enough alcohol, (potent enough to easily hide in quantity) and consume it quickly, to limit the likelihood of being found drinking in the dorms.

So, everyone bought 20oz soda bottles from the vending machines, knew their personal taste/tolerance in terms of how much soda to consume from the bottle, before filling it back up with their choice of rum or vodka, to be consumed quickly before departing for the evening.

    "Economist Mark Thornton writes that 
    the iron law of prohibition undermines the 
    argument in favor of prohibition, because 
    the higher potency forms are less safe for 
    the consumer. "

Except the US govt hasn't cared about saving people who they deem breaking the law.

In fact, they've helped kill people doing so. http://time.com/3665643/deadly-drinking/

The vast majority of adverse effects are a result of the drug being illegal rather than the effect of the drug itself.

With proper dosage and pure uncut drugs most addictions won't ruin the user's life unless of course they have to spend all their money on drugs because they cost so much. This leads to people becoming drug dealers to finance their habits. They start cutting the drugs with cement dust or other shit that is going to ruin the health of drug users downstream and smoke the drug for free.

I think methamphetamine is only a little more neurotoxic for an equivalent dose.

Methamphetamine is more potent because it more easily crosses the blood brain barrier, but the effects are almost identical. It's also prescribed for ADHD, i.e. Desoxyn.

> the effects are almost identical

This has been my experience too. I don't think I could tell them apart if I was drugged with an equivalent dose and not told which was which. I think the appeal behind meth is mainly the better value, its ability to be smoked, and the difficulty in adulterating it (since it is typically sold in crystalline form, whereas amphetamine is often sold as a powder or paste).

This is why we need to be a bit careful about the "there are no problems if it's legal" message. Yes, being illegal does cause considerable harm, but legalisation doesn't eliminate all harm.

Some people would like to have a little bit of legal amphetamine every now and again. Some people just want to get off their fucking gourd. At the moment it's hard to tell the two groups apart until they start using.

For the same reason they use heroin instead of morphine: it’s what they can get

As far as I know it is a different high that some people prefer. I think the reason it is more neurotoxic is also the reason why some people prefer it, you want that serotonin and euphoria that follows.

I've had few friends who tried methamphetamine. Two of them were completely turned off by it but one got addicted and very quickly disappeared (we still wonder what happened to him). They were all just hardcore dudes from bad homes hanging out with other hardcore dudes from bad homes.

It seems like the young folks who try meth do it because they know someone attractive or otherwise fun to be around who is doing it. It is my completely uneducated guess that the first person to get addicted to meth, had it perscribed by a medical doctor.

What you do mean disappeared? Like stopped hanging out with you or went missing?

As someone who has used all of them in my days in the rave scene, they’re very similar but not the same — in particular, adderall doesn’t give the same sense of euphoria. If you’re trying to be productive, sure they’re all about equally good. If you want to party adderall is strictly inferior.

Also as someone who dabbled with them and who had lots of friends who were like really into it, I saw the negative consequences first hand, but they’re subtle and take quite a bit of time to manifest. By the time it becomes obvious to you that there’s a problem, most of your non drug using friends have known for a while. But of course you don’t really hang out with your drug using friends any more.

It’s not the immediate horror show you’d expect from the movies or from watching Cops. You only see the worst of the worst. For every drug casualty you’ve met, there are probably dozens of people who do the casually for a few years, maintain jobs and relationships, get bored and then quit. That was at least the case for most of the people i went to raves with back in the day. Almost all of them settled down with families and careers and very few of them had trouble quitting.

I don’t recommend doing any of those things, I just think that people have a skewed idea of what it’s like.

You may have rose tinted glasses on. Meth was introduced to the rave scene much like crack was introduced into black communities in the 80s, to the same catastrophic effect.

I was there. It sucked all the joy out of the scene eventually. But it wasn’t like immediate. It was a slow gradual thing.

The biggest difference between Adderall and crystal meth, in terms of safety, is purely that one is manufactured by pharmaceutical companies and the other is manufactured in "meth lab" conditions. (Also the consumption pattern; people don't generally smoke their ADD meds.)

Adderall is a combination of two amphetamines; dextroamphetamine and levoamphetamine. If you don't react well to Adderall, the next step is to try the constituent amphetamines separately. Dextroamphetamine is widely available by itself; levoamphetamine, until recently, was not. Fortunately, a close analogue to levoamphetamine is Desoxyn, which is just methamphetamine. Medicinal methamphetamine is legal in the United States.

Desoxyn, like Adderall, is a controlled substance kept in safes in pharmacies, and so it's a lot easier for your average junkie to settle for Uncle Jethro's crystal meth than to try to get his hands on real pharmaceutical-grade amphetamines, whether that's Desoxyn or Adderall, just like it's easier for your average junkie to get black tar heroin than to get Oxycodone.

Not everyone has the same access to the health care system you do. For the price of a doctor visit and a script you can easily buy over 3 grams of pure methamphetamine

I know that in many states where there are serious problems they have provided narcan to all first responders. I'm wondering if this is a bit of a false positive in the data. The addiction levels could be the same, just fewer people dying of overdose because more access to narcan. HN WDYT?

> Many public health experts point to campaigns in Rhode Island, Vermont, and Massachusetts as models for addressing addiction, and all three states reported decreases in overdose deaths from March 2017 to March 2018 — declines that many of their neighbors did not see.

> “The states that have been comprehensive and have gone after evidence-based methods are seeing the declines,” said Brandon Marshall, a Brown University epidemiologist.

A good friend of mine is a cop in Massachusetts. He carries Narcan.

Deaths are falling, but are overall drug usage and overdose rates falling? Could this very well just be increased access and availability to Narcan, along with increased familiarity with the symptoms to get access to treatment quickly?

>Could this very well just be increased access and availability to Narcan

Without looking up data right now: yes

edit: whoever claimed my comment is inaccurate should look at the stats for Naxolene usage on opioid users (https://www.health.ny.gov/statistics/opioid/data/pdf/nys_jul...). In one (1) county, they administered Naxolene to over 6,000 users. With that information, arguing there is no correlation between the wide spread availability of reversal drugs and the drop in deaths is just.. wrong.

The main graph in the article is printed twice as wide as tall. Take the same axes and print twice as tall as wide, and the trend and change are much more obvious.

Isn't it just the usual logistical curve scenario? Rapid growth to meet the desired need, until market saturation and users are dying off faster than they can be born?

From a creationist standpoint all people are equally likely to become addicted so you can use economic/cultural data as a proxy for susceptibility, however in the real evolutionary based world we have been brutally selecting for non addiction susceptible genetics and small scale culture for a long time, so at some point you'd expect a crash in addiction rates.

Something like cig smoking can't be bred out because the addicts die horribly in their 60s long after reproducing, but every teenage heroin overdose for the last couple decades is a permanent culling of the herd of people who can't handle their chemicals responsibly.

From a cultural standpoint I'm old enough that "Heroin just is not something our people do" works pretty well until it doesn't anymore, its interesting the study quotes seem to imply a grasp at any straw other than making heroin culturally unacceptable again, which ironically is probably the only thing that will work long term.

Seems to me this is entirely due to a better economy. If you have a job and money, you don't need to escape your life via drugs.

There can be other issues in life, such as interpersonal issues or stress reactivity that lead to addiction probably far more often than a lack of a job or money. See Michael Jackson, Prince, Demi Lovato, Philip Seymour Hoffman, Tom Petty... the list is endless. Virtually anyone can become addicted if they try these drugs and are dealing with stress.

I think the more accurate common denominator of the people you listed above is past-peak career entertainers, not wealth

Agreed. Not that many drugs aren't inherently risky, but stress/despair/loss of purpose cuts across lines (pun intended) of wealth and is a guarantor of increased addiction potential.

I think the more accurate common denominator is "entertainer". Some of those were pretty damn popular when they died.

The issue is that drugs tend to be available and encouraged for rockers and actors.

Heroin, in particular, seems to have an unnatural appeal to guitarists and rockers and has claimed way more than it's fair share of them.

I really wish we would legalize some of these drugs even if we still keep them behind a prescription. Legalizing the drugs would certainly help as then the dosages would be controlled.

I don’t think this is a fair statement. Many of those listed were people suffering from physical injuries or mental health issues, making them more vulnerable. Prince started on opioids because of performance related injuries.

Or access to legal/medical marijuana. If you have a pain killer that is impossible/incredibly difficult to overdose on, you don't need to escape your pain via more dangerous drugs.

I'd guess it's a combination of many different factors.

The economy has been getting better for close to a decade now, and we have seen the opioid use rate skyrocket during that time. If it was tied to the economy, why were those two trend lines moving in the same direction?

I think (without bothering to do any research to source my claim beyond my personal experience as a paramedic, and the sources available in the article) that the widespread availability of Naloxone (and other harm reduction based policies) are far more likely to be the cause of the decrease.

Staggering numbers of dead, a major policy failure.

Awaiting the hour of reprisal, your time slips away.

Slayer lyrics?

Of course the overdose deaths are falling: you can die only once.

This comment has the subtle implication that you are "too good" to get addicted to opioids. You should reconsider that attitude before it's too late.

It's very crudely stated, but there's a bit of a truth to it.

Suppose that "susceptibility to opioid abuse" is a trait that's distributed throughout the population; some people are very susceptible, and some people are not very susceptible, but there's still an independent, individual factor that is separate from e.g. cultural/economic/social angst/uncertainty/etc., the availability of opioids, and so forth.

When there is a breakthrough in one of these external social factors--either opioids become a lot cheaper and more available, people slip into greater levels of despair, whatever--more people are going to abuse opioids. Fair enough. But not everyone is equally likely to abuse opioids even given the exact same circumstances, so most of this increase in opioid abuse will be concentrated in the chunk of the population that was more susceptible to it all along.

Once the opioid epidemic goes on for a few years, the people most likely to abuse opioids--and, for that matter, the people most likely to die from opioid abuse--will die. And so, if the underlying social causes of opioid abuse stay the same, you're going to see fewer opioid deaths, because the people who would have died already have.

Since this isn't necessarily a genetic trait, we probably wouldn't see this effect persist on the order of generations, but on the order of months to years there's definitely a survivor bias, so to speak.

There isn't necessarily any moral judgment in here, either. I mean, there can be, if you're a jerk about it, but the math itself doesn't work out any differently for "susceptibility to opioid addiction" than it does for "susceptibility to flu", and so if there's an epidemic of either one of those, odds are that, barring intervention, the epidemic is going to kill whoever it's going to kill and then move on. (This isn't cause for complacency, either! Some epidemics can kill huge supermajorities of the population if you just let them play themselves out, which is the true story of how the West[ern Hemisphere] was won.)

No, I wasn't implying that, not even considering it. Sure, I was not cool enough to belong to any group in school during the late 90s (hence never smoked) and I'm European (barely got pain killers subscribed) but I do know that even me, when pushed hard enough to the edge, could fall into drugs or just plain suicide. Anyone can be.

What's the "career path" of an addict? How many years before they are likely to overdose? Does that coincide with economic struggles of the recent years, military returning and suffering from PTSD? It might take drug addicts take more time to "progress" on their career than it does take new, deadlier drugs to kill them off. It sounds harsh, I know, but it's a possibility.

I sincerely hope the fall is due to less fentanyl being imported and parts of the darknet shutdown (I like how the netherland police once took over a darknet market).

Government has no incentive to do anything about this. They would prefer disgruntled, jobless people keep themselves in a drug induced stupor to people getting angry at their government stabbing them in the back for multi-national corporations.

In reality these drugs coming in from foreign countries should be treated as an act of war, we've already lost significantly more Americans to this epidemic than Vietnam, the long term economic cost is probably in the hundreds of billions. If another country did that kind of damage via bombing we would retaliate, but these deaths from drugs don't have a big enough emotional impact to get citizens angry

Right, because dead people pay such awesome tax rates.

Clearly this is the fault of those nameless multi-national corporations who are gleefully clasping their hands while laughing madly.

Obviously these drug addicts having major problems and injecting themselves with illegally acquired, addictive drugs is exactly the same as bombing innocent people, and we should retaliate by having the marines storm the lobby of Pfizer.

Majority of deaths are caused by fentanyl produced in foreign countries and shipped into the US to be cut into low quality drugs. So sanctioning those countries would be a good first step

The initial addiction though is due to doctor's and drug companies. There's plenty of evidence of drug companies pushing doctors to prescribe these drugs when they really aren't needed. Fine the companies, arrest the doctors and executives who push this stuff in the name of profit.

As for government, if you think the average congressmen cares about long term tax revenue vs that sweet pharma lobby money today, you're naive.

Draconian enforcement against illegal drugs have been tried extensively. Up to and including labeling exporting countries "narco states" and invading them. It doesn't work. Someone else takes up the slack.

That death rate is insane. How can republicans do effectively nothing about this public health disaster? I am singling out republicans rather than the political class generally as right now they have control of most state legislatures and governorships, control of congress, control of the senate, control of the supreme court, and control of the presidency. If they wanted to do something to address this, they can do it. Evidently they would rather people just die.

Have you looked at the dates on the chart?

https://www.statnews.com/wp-content/uploads/2018/10/CDC-Over...

Congressional elections:

2016: 246-194 Republican

2014: 247-188 Republican

2012: 234-201 Republican

Six year incumbency.

What about the other elections?

Senate:

2016: 52-46 Republican

2014: 54-44 Republican

2012: 53-45 Republican

2010: 51-47 Republican

8 years incumbency

https://www.whitehouse.gov/opioids/ ?

wouldn't the article suggest exactly the opposite of what you're saying? as in, since they control all branches, the crisis has started to improve?

I think it's just too easy to write "republicans" in a comment. For a good chunk of the population that's enough to convince them that it's "republicans". Even for the author of the comment, once it's written it has to be defended and you can only become adamant about defending what you said not too long ago.

Please don't take HN threads into political flamewars. Those are all the same, therefore boring; plus we don't want this place to burn.

https://news.ycombinator.com/newsguidelines.html

I'm sorry. Next time I'm be more indirect.

First, the chart is showing the number of deaths in the previous 12 month period.

Second, this isn’t a political football. This is something that every American can look at and agree that we need to be bringing powerful tools (regulatory, legal, policy, aid, EMS, hospital, pharmacy, education, volunteer, etc.) in a concerted and coordinated effort to fix this.

Third, any efforts are obviously going to take time to show up in the death rate, but even if we are turning a corner will need to be sustained across administrations.

One could sensibly make the argument that the root of the problem is the carving out of the middle class and manufacturing base of the country that occurred solidly during Obama’s years as a result of the push toward globalization. The massive economic improvement as a result of the tax cuts and deregulation since Trump’s election has helped get people whose jobs were “never coming back” to become gainfully employed again and motivated to face the hard fight against opioid dependence.

But in the end it’s just finger pointing / and falsely ascribing causation to correlation to try to score political points or demonize the “other side”.

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