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Comment by jmyeet | Hacker News Reader

So we all know that continued use increases your resistance to drugs. With opiates in particular this can reach the point of there being a very small window between chasing the high you want and a lethal dose. You'll note that most opiate deaths are of experienced users for this reason. Being stepped on exacerbates this because you really don't know how much of the drug is actually there.

Fentanyl has become a relatively cheap way of upping the strength of whatever opiate you're selling. It used to be that no one knew how to illegally make fentanyl. Those dogs are long gone.

But there's another aspect to this: if someone overdoses (even dies) from something you as a drug dealer have sold then (as dark as it sounds) that's actually good marketing. That means you have the good stuff. It's shown to increase demand.

The moral of the story is don't get addicted to opiates.

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But I'm hearing cases of drugs like Cocaine being cut with it, I would say the desired effect of cocaine and opiates is somewhat diametrically opposed

Long before fentanyl we had speedballs, which were a mix of cocaine and heroin. This isn't my area of expertise but there seems to be a demand for mixing uppers and lowers like this.

Not quite opposed because neither make you feel sober and sad. Users are accepting of a substitute that still induces euphoria, but by a different mechanism

I don't believe dealers are intentionally cutting fentanyl with cocaine. It's more likely a case of cross-contamination.

"National data show that a relatively low percentage of the cocaine tested by law enforcement contains fentanyl, although the mixture has become more common. Less than 1% of the cocaine samples tested by the Drug Enforcement Administration in 2016 contained synthetic opioids, according to figures provided to NPR; in 2020, it was up to 3.3%."

3.3% is a lot higher than I expected, though I wonder if there is a selection bias going on there.

Great point. The crux of the pure physical addiction, separate from the psychological groundwork that leads you to it, is that you just need more and more of that stuff.

Fentanyl is a synthetic opioid that is up to 50 times stronger than heroin and 100 times stronger than morphine.

^ Imagine needing more and more of that stuff to get your usual high. You’re dead.

"The moral of the story is don't get addicted to opiates."

That's not how addiction works.

What I mean is don't use opiates recreationally and use opiate painkillers sparingly.

As an aside, the US has a cultural problem with painkillers it seems. Like the expectation seems to be that painkillers completely remove pain but that's not how it works. Or at least if it does you're overusing painkillers. Painkillers are largely to make pain bearable and manageable not remove it completely.

This attitude seems to be a factor in the overprescription of opiates. I think I read once that if you're still taking painkillers 2 weeks after whatever incident led you to be taking them, there's a 50% chance you'll be taking them in a year.

I've had knee surgery and basically just got given oxycodone and valium. I took them for 2 days and then just used Tylenol (you don't take ibuprofen after surgery apparently).

That's really what I mean by "don't get addicted to opiates". Treat them as dangerous because they are.

I agree. Its important to remember that some types of pain have the biological purpose of preventing you from overusing an injured part of your body. Masking that with painkillers can give you a fall sense of confidence to continue using parts of your body that in reality should be at rest.

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