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Comment by version_five | Hacker News Reader

Whatever pharmaceutical companies have done, the drug war is what is directly responsible. Stigma, limiting options for treating addiction, and favoring extremely potent drugs are the big culprits here. Blaming a specific family or industry is a convenient cop out

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I'm assuming you're not some kind of shill, as it should be, and I do think your point has merit. At the same time I can't help myself from thinking this sort of deflective take has at least some roots in the PR efforts of "a specific family" and the industry. All it takes is a few convincing arguments to be made by real shills and taken up by others that "no, we shouldn't blame the Sacklers, because..." That's how PR does its work. That aside, I think it's clear their family got away with profiting off of wrongdoing, even after the fines. Profiting off of wrongdoing is much too common for big businesses. In some sense they can afford not to be held to account.

Thanks for not accusing them of being a shill, but the problem with this sort of wariness is that you can’t make certain arguments, or even ask certain questions, without people thinking you might be a shill.

You can’t figure out what’s really going on in the world by making meta-arguments about who benefits. Meta-arguments aren’t evidence.

(It is true, though, that in a forum where we don’t know each other, there is a lack of trust for good reasons. Which is why it’s good to post links to more trustworthy sources.)

Blaming the owners of Oxycodone for oxycodone overdoses due to overmedication fraudulently prompted by said owners seems to me overly just. Fair. Honest. Exact. Correct.

You name it.

Haven’t most opioid overdoses of the past 5-10 years been fentanyl (or carfentanyl) overdoses?

> Haven’t most opioid overdoses of the past 5-10 years been fentanyl (or carfentanyl) overdoses?

Well, the data [1] is really mixed depending on the year. It looks like fetanyl deaths really exploded in 2016, exceeding the prescription opioid deaths then.

We'd probably have to examine the source data [2], and go back more in time to get a good feel for it.

[1] https://www.drugabuse.gov/drug-topics/trends-statistics/over...

[2] https://www.drugabuse.gov/sites/default/files/Overdose_data_...

It's interesting to note that sharp increases in overdose deaths coincide with increasing restrictions on opioid prescriptions and decreased legal supply.

Exactly. It all comes down to fentanyl and fentanyl derivatives. Moving opiates to the black market heavily incentivizes suppliers to substitute relatively safe traditional opiates for highly dangerous fentanyl concentrates. Because fentanyl can deliver so many more effective doses per unit of mass than traditional opiates, it's far cheaper on the supply side.

Think of it this way. Would you rather smuggle a shipping container filled with heroin or a briefcase filled with carfentanil? You keep wholesale supply as potent and concentrated as possible. Don't dilute until the very last point in the supply chain, at which point you try to pass it off as heroin. The problem is a trap house is not a pharmaceutical grade lab, and unless the product is homogenized perfectly some poor bastard gets an unbroken clump of carfentanil in his hotshot and dies.

The simple solution is to legalize heroin, and make sure the supply is regulated for purity and consistency.

> some poor bastard gets an unbroken clump of carfentanil in his hotshot and dies. The simple solution is

Every problem has simple and easy to understand incorrect solution. I don't understand why society has to carry a burden of preventing an individual from harming oneself.

Imagine if we were making chocolate chip cookies and rat poison in the same factory. Periodically a family would drop dead after buying a bad batch at the grocery store. Reformers loudly cry out "Can we please stop making chocolate chip cookies next to rat poison!"

Skeptics chime in "Well... It's really not that simple. Even without rat poison, chocolate chip cookies are pretty unhealthy. Do we really want to be sending a message that it's okay to eat cookies by not poisoning them. Wouldn't that just encourage more people to try them. These people knew the risk of rat poison when they choose to eat the cookies, why is it our job to protect them?"

> "These people knew the risk of rat poison when they choose to eat the cookies, why is it our job to protect them?"

That is my question. What is the answer?

Compassion for other people? We've evolved to have a society for a reason, stepping over dead or desperate people on our way to work isn't good for us either, even if you don't care about them. There are solutions, specifically access to treatment and "clean" drugs that have a much lower chance of killing, that can actually help people.

Inpatient detox will take up to two weeks. After that there is nothing that will make a person to continue except deliberate choice to do so. So access to treatment is OK. "Clean drugs" and "substitute therapy" is already beyond compassion.

Why not blame both? Pharmaceutical companies did in fact knowingly take actions to increase abuse potential because it made them more money.

Also, the pharmaceutical companies have been lobbying against marijuana legalization. Even if the drug war were entirely at fault, the companies are partially responsible for the drug war.

https://www.google.com/search?q=pharmaceutical+companies+lob...

This is specifically relevant because studies have shown lower opioid use in states with medical marijuana. For example:

https://journals.lww.com/jaaos/Fulltext/2021/02150/State_Med...

The Sacklers have caused more pain in more people because of the "abuse". And the med establishment has only fed onto those fears.

Now, everyone in med is 'deeply concerned' with abuse, that many people with legitimate pain are being denied access. The Sacklers lied about addictivity - seriously, how did the FDA allow a morphine derivative to say 'non-addicting'??? But it's also the whole medical establishment's fault in thinking that all pain should be extremely restricted.

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