The Opioid Detection Challenge | Hacker News Reader

The Opioid Detection Challenge

opioiddetectionchallenge.com

33 points80mph45 comments

I can't see something like this actually addressing the root causes for the opioid epidemic. In fact, I can only see this further criminalizing addicts- a world where police can 'unobtrusively' detect opioids on a suspect further marginalizes/stigmatizes these people.

nailed it. this is the most backwards thing ever.

But damn, consider the potential lulz. If someone intentionally contaminated the postal system with fentanyl, an appreciable percentage of all packages might show up positive. I vaguely recall that this accidentally happened during the 2003 ricin attacks. One of the letters got ripped in machinery.

Fentanyl is very dangerous to handle. It wouldn't be "lulz" at all.

Well, if their plan is detecting opioid residues on the outsides of packages, they must be aiming for at least nanogram detection limits. Because they're counting on sloppiness in weighing and packaging. And those levels are far below toxicity thresholds, even for fentanyl.

Here's a fatal dose of fentanyl. It's 2mg.

https://www.drugabuse.gov/about-nida/noras-blog/2018/05/true...

Thats a "weaponizeable chemical" kind of scary. I mean, imagine if a dealer dumped something of this into the airduct of a public building or train station to get more customers...

That wouldn't get more customers it would just cause people to get high, sick, or dead. It's not like they would put a big calling card "like how you feel call this number"

One of the root causes is supply. The book Dreamland is a pretty thorough explainer.

But I would assume the receiver is the most likely to be caught by systems like this and not the sender.

It might have been an initial cause, but treating it as a root cause now would exacerbate the problem. Every supply restriction makes it a more lucrative business to be in.

I don't think the goal here is to catch opioid users and criminalize them, but rather to try to cut off the illegal supply of opioids.

Wow, they must be really desperate to think this was a good idea. Maybe it's their last ditch effort to say "we tried everything" before petitioning for a change of laws to open up more packages for inspection.

It's kinda silly, the only sample data is for positive detection of opiods from xray images. They don't give you any examples of things that are false positives or give you dimensions of the packages in the images or details on what was actually in those xray images (like weight or something could be good info?). So yeah, maybe you could set up some machine learning thing to be like "ooh it looks like powder!" but they don't give you info about how long it even takes to take those xray images or the size of those machines or how frequently they get used currently, all of which are appear to be factors in their selection process.

I thought the true purpose of it was the same as drug sniffing dogs - that they don't want detection but search justification for fishing expeditions.

When much of the problem are people getting opioids directly from the pharmacy what good is detecting it in the mail?

Most of the opioids are from illicit sources. Or at least the opioids that are killing people.

It’s a real challenge. 1 gram of fentanyl, which would be easy to disguise in the mail, is equal to 10,000 doses.

Carfentanyl is 50-100x more potent.

This seems to specifically be aimed at detecting fentanyl and its derivatives, which doctors rarely prescribe.

Prohibition is slavery, do not help these assholes.

Prohibition might not be the best idea, but I can't see it being remotely close to slavery.

Before I was aware of the opioid epidemic, I thought decriminalization was the right thing, because it would remove the criminal element (or reduce it), stop criminalizing users. I knew there were some drugs that were deadly. But opioids and now fentanyl are so addictive, so destructive that I think I only favor decriminalizing of less dangerous drugs.

Also the drugs are so powerful, it's yet another weapon of mass destruction - kick some into the air system of a concert or airplanes, you could kill a huge number of people.

I'd love to hear a rationale why decriminalization would make things better in this world of opioids and fentanyl.

I think what you’d want to do in a case like this is make legal the not WMD strength stuff at affordable prices and constant purity.

The idea being that the heroin market could grow and reduce the demand for the fentanyls and carfentanyls.

Hopefully the addicted would want the safer stuff, especially if it was at similar prices or cheaper.

Then you tax it, and use the money raised for public awareness and education to drive down the rate over time and offer out reach programs, counseling, and rehab services to the people buying the stuff.

That seems like the sanest and most humane way to tackle both having these extremely potent and dangerous substances flying through our mail system while limiting damage over time, and helping as many as possible for whom they’ve already become addicted or are on that path.

You lay out a reasonable position where it might work. I salute you. That sounds reasonable and I could see that it might work. If it was cheap enough, anyone could get a prescription, treatment was also available, then it would drive down the price so much that there would be little incentive to use the illegal stuff. Sell controllable amounts, that is better than random death, plus random overdose.

Well if it were done properly purity and dosage could be monitored along with people's condition leading to less fatalities and overall harm. Along with, as you say, removing the criminal element.

Obviously a free for all probably isn't a great idea. But that's kind of what we have now isn't it? With the added bonus of jailing a few randos from time to time and absolutely no control over any of it.

I realize these drugs are dangerous and addictive. Not sure there is an easy answer. If we really could ban them, sure, that would be great, but are we willing to do what it takes to do that? No, people would scream bloody murder, our society isn't set up for that kind of liberty infringement. But apparently it isn't set up for compassionate rational approaches either, so we will continue to pump money into swat teams and other half assed authoritative wack a mole measures which seem unlikely to ever really fix the problem.

Meanwhile society as a whole suffers a plague of junkie fallout and likely winds up paying much more than they would would with a compassionate rational approach.

I feel like I need to say, taking these kind of things in the first place is a bad idea imo, but people are doing it. So what do we do?

I think one good answer for a stop gap is physicians being allowed to perscribe anything with only outright malpractice as a limit without any imposed tautologies.

A physician could say perscribe heroin to help an addict taper off or even to someone new and ask why they want to start and offer healthier doses while still being permitted to dispense according to judgement. For terminal patients or chronic pain cases near suicide it may legitimately be the best option in their case. Medicine is all about "normally it would be a bad idea (amputation) but because the alternative (certainly fatal sepsis pre-antibiotics) is even worse we are doing it".

It would be a radical idea and put more pressure on doctors as a social system admittedly but it could be ideal for practicing medicine without dogmatic insistences codified into law despite evidence being increasingly clear they are wrong.

> I think one good answer for a stop gap is physicians being allowed to perscribe anything with only outright malpractice as a limit without any imposed tautologies.

You know how the US crisis started, right?

That’s how people inadvertently became hooked. The parent is talking about new patients that are already hooked. It’s a different story; you don’t stop being an addict once you’re hooked because your doctor won’t prescribe it.

Sure, but it demonstrates the problem of "let doctors prescribe whatever they want".

Addicts are not helped by ever increasing doses of prescribed opioid medication. There's an argument to be made for maintainance doses until they're ready to stop, and then medically assisted detox, but neither of those are doctors prescribing with no controls.

rationale: check out the result of Portugal decriminalizing all drugs in 2001: https://www.theguardian.com/news/2017/dec/05/portugals-radic...

This is tricky because the opioid crisis starts from legally supplied opioids, and is made worse by lack of access to pain treatment and illegality of drugs.

The continued illegality of drugs causes weird incentives. If a dealer has to smuggle opioids they're going to chose something easier to smuggle. Fentanyl is much easier than heroin to smuggle because you need so much less of it for a dose. Here's a photograph of a fatal dose of fentanyl (2mg): https://www.drugabuse.gov/about-nida/noras-blog/2018/05/true...

What the US needs is a huge increase in provision of specialist pain management treatment, free at the point of delivery. This would reduce the need for opioid prescribing (which mostly doesn't work for long term pain). That would reduce the market for opioids.

The US also needs a huge increase in evidence based addiction treatment. At the moment there is huge amounts of money being spent on detox holiday-camps, which have very poor evidence, and not much at all on medically assisted withdrawal and replacement, which has much better evidence.

The combination of addiction treatment and pain treatment would help remove the illegal market. These can be provided while opioids are illegal, but it's easier to do it if opioids are either decriminalised or legal.

Legalisation does not necessarily mean "sold in Walmart next to the soda". It might mean "available to registered addicts to prevent them getting involved in acquisitive crime".

At some point punishments cease to work. Bigger risks of losing everything also mean bigger incentives to retaliate. A poacher threatened with capital punishment isn't going to stop hunting and turn himself in, he will just shoot the police and anyone who is going to report him, because there is nothing left to lose anyway.

Stricter punishment against drugs means dealers choose drugs that are harder to detect. The smaller the quantity of drugs the better. Higher potency is preferred even if wrong dosage sometimes kills the clients and adding foreign substances like brick dust as cutting agent (which then cause the majority of health issues) becomes practically mandatory.

There is one rhetorical arguement about a shared fundamental - ownership. In this case of your body. If you can't do what you want with it then somebody else owns it. If somebody else owns your body - you aren't free you are a slave." Not owning something isn't necessarily a bad thing - not being able to own the river or air is an acknowledgment of commons - bodies far less so.

Regardless of the merits of the first arguement in the US legal system the Orwellian euphemism "unfree labor" a.k.a. slavery is allowed for convicts certainly qualifies as "close to slavery" in the same sense prebellum Southern plantations are - direct participants. I would call the statement harsh but true contextually.

Slavery is not being forced to work, it's your body being property of somebody who's not you. Ownership means control and the right of exclusion, and prohibition not only of drugs but also voluntary euthanasia and self-defense strips this of us.

As a system, overtaken and rewritten by a virus, i also agree, that virus supression is evil and backwards.

I hope this isn’t a stupid question, but what about dogs? Are dogs fast enough for airports but too slow for mail?

One of their reference links (https://www.dhs.gov/news/2017/05/25/written-testimony-cbp-se...) does mention that they are piloting a study to see if dogs can detect fetanyl, but I'm guessing it's either not going great, or they just want to explore some other options.

Hopefully this doesn't mean they just killed a lot of dogs from inhaled Fentanyl.

Thanks for the link - I greatly appreciate the help!

Aside from signal om demand training issues airtight sealing defeats them - let alone ones which don't have a discernible scent.

This is a crucial point. Vendors these days (at least the good ones) properly package their goods with vapor barrier vacuum-sealed bags. Even better, some use Mylar bags which provide a nice metallic aluminum barrier.

You could hold a Mylar bag of weed up to a well-trained drug dog, and it would not trigger. (Unless commanded to falsely by the officer, of course :)

I will not work on this, because I see it as enabling the violation of our constitution.

You cannot solve a demand-side problem by attempting to reduce the supply.

Market economies simply raise the price, attracting increasingly-devious suppliers.

> You cannot solve a demand-side problem by attempting to reduce the supply.

Of course you can. Works perfectly well for rape and murder, for example. (As well as for traffic violations, for that matter.)

I guess for me that is not clear-cut. Rapes still occur pretty often, and many/most sadly aren't reported. (Legalizing prostitution could reduce them?)

For every traffic violation that is caught, a high multiple more fly by. (Speeding, for example).

The demand for murder is so low that it's hard for me to conceptualize as a market.

If you’re interested in tackling challenges like these, we do this at a much larger scale at Synapse Technology (gun/knife detection in X-ray images at airports, schools, courthouses, etc). Feel free to reach out.

How are people going to test their ideas?

Will they be passing out samples to test on?

I was thinking that too. I looked at the rules, nothing there.

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