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Comment by tims33 | Hacker News Reader

I hope the DoJ is successful. Taxpayers and families are bearing an incredible cost and toll from the damage they've done.

It is also important that the government reflect on its on role in letting this get as bad as it did.

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I definitely think your latter point is very important but also very likely to get lost in the noise and the circus of the public.

Is the cost that incredible?

Tobacco kills 7x as many people as opiates in the USA every day/week/month.

Is the loss of human life from the sale (without a prescription!) of tobacco in the usa a credible figure?

Maybe both are incredible?

I think you make a good point that is worth talking about but also it seems unfair to compare the two, in that manner at least. Both are awful but the way that opiates kill and really destroy lives, relationships, families, etc. is really on a different time span and level.

It is a really fair question. I think there are two lenses. Tobacco does kill people in large numbers although it seems to largely cause issues at the end of their lives. Tobacco also reduces life expectancy, but not as much as opiod users. What I saw said a heavy smoker loses ~13 years and a heroin user ~18 years. Not sure about lighter smokers.

The issue with oxycontin is it helped create a massive generation of addicts who have all sorts of other things associated with them like: rehab, homelessness, and crime. So I'm not sure of the total impact, but likely much higher per person.

From everything I've heard, Purdue Pharma knew about the street abuse and at best did nothing, from their end, it probably drove up their sales too. People going through their legit Rx slightly faster because some of their pills were resold (yes, illegally) refilled sooner. Plus, let's not forget Purdue Pharma marketed these as not as addictive - which likely created and sustained the street markets. Also, just because something else (tobacco) is more deadly doesn't mean we should turn a blind eye to everything to that is less deadly.

My point is that the tobacco companies did all of this stuff, too, including the marketing-via-doctors route.

They're still around, operating, and legitimate, and causing 7x the destruction of human life of this so-called "epidemic".

Either both are wrong, or neither are.

Personally I have an extremely unpopular opinion regarding culpability for the damage here, but I'll be satisfied if we as a society can simply agree that both are wrong, or neither are, but if one is wrong, then so must the other be.

If they're both wrong, we should be at least 7x as angry and actionable against big tobacco (but rationally, quite a bit more, as they have been killing people, including those nearby who don't choose to consume the drug, at a higher rate for a much longer period of time).

If neither of them are wrong (and cigarettes should still be available for sale) then we should put down the Purdue pitchforks.

I think you have a valid point - I guess you could argue that Big Tobacco, while still in existence and still a huge enterprise did have somewhat of a reckoning in the 1990s. With that in mind, Purdue Pharma did this after the legal boundaries had been tested and defined by prior caselaw. I also don't believe cigarettes can kill you or make your life and the lives of those around horrible as fast as opiates can. There are many offramps for cigarettes. But, to your point, I don't know that that should make a difference.

Tobacco addiction cannot be compared to something like opiates. The cost is often on the individual as smokers normally work. Opiates make people spiral out of control quickly and the dependency is so high they will literally do anything for the next pill. They often become homeless and without any health insurance. They overdose multiple times ending up in critical care/ICU.

A better legal drug to compare could be alcohol, however, your doctor wasn't marketed to give you vodka for your back pain. There was a time were doctors were giving out opiates like candy, this opiate epidemic has been created by big pharma and doctors. I was prescribed opiates for muscle strains and the first few times you take them it feels so good. However, tolerance builds really quickly and people who have a tendency to abuse substances will instantly get hooked.

It’s worth pointing out that tobacco use is currently declining. It kills a lot of people yes, but most of the deaths are distributed towards older populations. Combine these two factors, and you’d expect tobacco deaths to slide in the next few decades as we start running out of older smokers and newer generations smoke less on average than their parents did.

On the other hand opiate addiction came out of nowhere, and surpassed vehicle related deaths before anyone noticed. It kills much more randomly, and the problem seems to be getting worse. Expecting opioid death numbers to get worse in the near future isn’t unreasonable. It wouldn’t surprise me if opioids end up killing more per capita than nicotine does in the near future.

Also, there’s a pretty stark difference between the impact on life of these two substances aside from the mortality risk. While smoking does reduce quality of life, not many people end up in jail or homeless because of their nicotine addiction.

Yes. I do think the cost is really incredible. even if we were to get their entire 11 billion immediately it wouldn't begin to cover the costs (pisses me off the most they get many years on this proposal to pay it, they'll likely make more profit from investments than they will pay back....)

Opiates do kill too many people but there are more social externalities than tobacco. I think (hopefully) the 2nd hand smoking effects have diminished, though I'm sure kids in homes are still exposed.

But opiates touch everyone that knows an addict or is related to one.

And the cost of theft, homelessness, HIV/hep infections, blood infections, huge amount of overdose calls.

But I agree the costs of tobacco are huge. And the costs of the oil & gas industry's behavior are even bigger than all of these combined.

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