FDA advisers recommend approval of over-the-counter naloxone
statnews.com
statnews.com
For comparison NHTSA recorded just under 43,000 car accident deaths in the US in 2021. That’s also very close to the 2020 death by suicide number of 45,000.
That’s 25% more opioid deaths per year than our both cars and suicides COMBINED.
In fact we could add in the 19,000 Americans who were killed with guns in homicides in 2020.
Cars + Gun Homicides + Suicides = 107,000. Still less than opioid deaths by a few thousand.
It’s bad out there.
So yeah, it's *really* bad out there.
My wife and I recently went to a Walmart near a “not good area” and it was depressing. Just about everyone was overweight. Many were hobbling or needed the use of the electric scooters. Looking into their eyes often resulted in a near zombie stare that went right through you. People looked at Walmart’s relatively low prices in desperation and despair as they mentally tried to grasp how they’d be able to handle the bill for the mass produced garbage they were trying to buy to save money (compared to fresh meat and produce). My wife and I paid for our stuff and headed to our basic SUV (one of the nicest cars in the parking lot) and you could see rundown cars on the edge of the parking lot with blankets up to block the sunlight (aka homeless people).
Things are not good over here.
Edit: I didn’t directly address your question, but it’s all tied together. People are drugged up and just trying to get by. For many Americans, day-to-day life is nothing short of a nightmare.
Complaining about mass produced garbage instead of fresh meat and produce is just silly. Walmart has plenty of all three.
Yes there are people without kitchens. But don’t tell me you think that’s most of the poor people at Walmart.
I do think that most poor people at Walmart are so worn down and tired that cooking a healthy meal can be difficult. Especially when there’s a box that only needs water and a few zaps from the microwave.
I went on Walmart's website. Per ounce, name brand fish sticks were cheaper than the cheapest fresh fish, tilapia. Pre made, microwavable burgers were the same price as just 80/20 ground beef. Jurassic Park white meat dino nuggets are the same price as Perdue chicken breast.
Those kids that didn't grow up with cooked meals are very unlikely to cook for themselves or their own eventual children. They're going to stick to 90 second rice pouches, ramen packs, mac n cheese, "salad kits". I can tell you right now a Kraft Mac n cheese cup is cheaper than what I would spend on pasta & the cheeses to make a roux. Easier to prepare, too.
I don't see people in Walmart buying produce. If they wanted that they'd go to one of the Latino grocery stores or the farmer market. If they wanted pantry staples (flour, bread, eggs, milk) they generally go to Costco. Who goes to Walmart to buy anything fresh?
All I'm saying is just that buying the components separately would probably be cheaper and result in a healthier meal.
But yeah you're right about many people not liking to cook due to lack of time or other reasons.
> I don't see people in Walmart buying produce
Well they wouldn't sell if people didn't buy it. I do see your point of course.
I no longer shop there and I know of many people who feel the same way. It’s the only store I avoid because of “the feeling of human suffering.” Walmart’s stores are cold and uninviting, the employees don’t look happy to be there, and the shoppers don’t either.
I don’t believe the people inside a Walmart are a representative sample of Americans, the store self selects for people who are willing to shop at a Walmart.
I shop at walmart all the time, in all area's poor, rich, middle class, are there fat people, sure. Are they "Dead zombies looking hobbled to their mobility scooters" .... I think the OP fancies themselves a fiction writer..
One is clean and the other looks like a bomb went off. Dirty floors, merchandise laying all over, employees nowhere to be found...
Doesn't even seem like the nice one is a Walmart.
Literally 95% of the US shops at Walmart, so... you might be in a very small bubble
Possibly. But your statistic tells me nothing about the foot traffic in a Walmart. 95% shop at Walmart, of that cohort how many shop there regularly? How many shop there for occasional purchases vs treating it as their primary store for staple items? On a random sample of days, how representative of that 95% is the foot traffic you’ll find there?
Personally I share OPs view of Walmarts, I don’t go in them because they make me feel bad about the world. I don’t get that feeling other places.
Very, since the more likely someone is to be a regular shopper there, the more likely you are to run into them on any given visit. That is simply an artifact of statistics.
> Personally I share OPs view of Walmarts, I don’t go in them because they make me feel bad about the world. I don’t get that feeling other places.
Do you get that feeling at the DMV? Maybe at the doctor's office or pharmacy? You are bumping into a true cross-section of the US population. Take note of the feelings you get and why, and understand that this is what the US is, not just what you see in the bubble
That or a Dollar General with its bountiful selection of bananas and limes.
Walmart is rarely the Only option. Where there is a Walmart, 90% of the time there is a Kroger (or Kroger Brand) Store, or Mejier (if in the Midwest), or some other store close by...
Not sure why you're minimizing this reality. 1 in 6 Americans don't know where their next meal is coming from. https://www.ers.usda.gov/webdocs/publications/42711/12716_ap...
So if you have a source to back that actual claim I would be happy to look at it, and likely refute why it is cherry picking data
>>A solid chunk of the US population lives in a food desert.
Food Deserts are a political term, largely attributed to urban not rural area's and ever every study you find talking about Food Deserts I can find at least 1 if not more refuting that actual data.
"The clustering of the deaths from overdose in the group of patients who had successfully completed treatment is counterintuitive and illogical—unless it derives from loss of tolerance and consequent unpredictability of resumed heroin use."
How?
Searching Google for "fentanyl test kit" + location (eg Denver) will connect you with your local dept of public health, which often (in non puritanical, harm-reduction states, which includes Texas) has free/low cost options. They often also have Narcan to distribute after teaching you how to use it.
Isn't this what "the wall" and securing the borders was supposed to be for?
https://twitter.com/BillFOXLA/status/1625936055047426048
> So far in FY23, we have seized over 476 lbs. of Fentanyl between the ports of entry along our southwest border. That's enough to kill 100 million people.
"The Wall" as envisioned by the proponents was never completed
The whole thing doesn’t need to exist for political theater, in fact I’d say its lack of actual completion makes it even more a theatrical construction than if it actually was done!
There’s even been a rash of fentanyl overdoses in nyc from marijuana (as reported by the victims). It’s thought that mass produced weed is being grown with plant growth regulators. These make the plant grow big, dense buds. It also makes the plant produce less thc. It’s believe that the plants are then being dusted with fentanyl to replace the lost thc.
fentanyl has generally speaking only made its way into the supply of non-opioids like cocaine as the result of contamination, not intentional adulteration. When we talk about fentanyl, in reality what's out there is perhaps some true fentanyl but a lot of fentanyl analogues that are much more potent (lethal dose in the mcg range). Often the people moving heroin are also moving cocaine and other drugs, and using shared surfaces to weigh and cut the product for street use. They aren't properly cleaning surfaces and instruments and thus fentanyl is ending up in all sorts of powdered drugs
fentanyl on weed has probably happened in some instances of intentional poisoning of an individual but I'd file this under similar in risk to your child being given an edible, or candy with a razor blade on halloween
Bah, apocryphal.
that said, 20 or so years ago prescribers in the U.S. were in various ways made to believe that painkillers such as oxycodone were not addictive and were these magical drugs that helped pain patients regain their lives in ways we had never seen before. Ended up in so many homes, lots of excess prescription opioids hanging around and as a result a lot of people ended up abusing them. For a significant number of people that led to heroin use, and then fentanyl came into the picture in 2015ish; so that's how we got here. heroin on its own when injected isn't actually that easy to accidentally overdose on- fentanyl however, is.
About a year ago I had an infected tooth... Nothing more than 600mg advil was on the table... take that at suffer through the rest of the pain...
In 2012 the Opioid dispensing rate was 81 per 100 people.
https://www.cdc.gov/drugoverdose/rxrate-maps/index.html
This doesn't even include antidepressants/ssri and such.
>For the calculation of dispensing rates, numerators are the projected total number of opioid prescriptions dispensed annually at the state, county, or national level. Annual resident population denominators were obtained from the U.S. Census Bureau.
Am I reading this right? They're counting scripts and then dividing that over the population? So if we imagine a state with a population of 12 people, one of whom is a chronic pain patient or cancer patient with an opioid prescription, that would show as 100 dispenses per 100 population (1 patient, 12 scripts)? That seems almost worthless as a metric.
Some states were 107< per 100 for the opioids. How does that impact the movement of the Overton window over the last decade+ I wonder?
The biggest issue is the lack of hope. Most people turn to these because they're tired of their shitty life and don't see any realilistic hope for improvement.
I mean, I got good grades, I worked hard, I'm an employed (not highly paid) software dev and I'm so disillusioned I completely get why some people turn to these things. I'm supposed to be at least in the top 25% of the current generation/my age group. Yet I feel like I'm barely making it to the same level that my parents were able to. Don't get me wrong, we aren't on assistance, we have good groceries, we have private/employer healthcare. But it's tough trying to save for retirement, healthcare, and stuff. There's no way 50% of the population will be able to retire at all, pay for Healthcare, etc as they get older or aren't able to work.
"You've Run Out"
with a graphic of a person's arm trapped in an elevator door
Being unfamiliar with the actual practice, how much are you typically prescribed, days or weeks worth, maybe even more?
I’m glad they gave me the percocet as a precautionary though because I absolutely would not want to have to go fill the prescription after the fact with mouth pain intense enough to then need the prescription.
When a surgeon does dozens of these procedures a month and most cases require a certain painkiller, it makes a lot of sense to plan ahead and prepare the patient when the alternative is intense pain.
https://www.nhs.uk/conditions/wisdom-tooth-removal/recovery/...
Not to be a dick, but I find it very interesting that people expect to go through life without experiencing pain.
It is orders of magnitude less invasive than an extraction and some people don't need anything more than OTC Tylenol for those.
I think it's quite obscene to prescribe Vicodin for a root canal. Because it won't do anything for the pain you don't actually have, but you will have other side effects. it's kind of like bringing a fighter jet to a knife fight if you will.
People tend to trust doctors when they are prescribed things, so how many people ended up taking the Vicodin prescribed to them only to feel nauseated and drowsy and "out of commission" for a few days after the root canal? Hell, even you thinking that it's reasonable or necessary points to how far we've gone
They gave me 10 or 20 Vicodin pills and, despite some pain, my choice was to take no more than one or two. So it's not just crappy dentists that gave those out. On the other end, someone else might have taken the whole bottle, so perhaps individual behavior is still the key factor.
Of course, cue someone responding with something along the lines of “my sister once took an opiate and she immediately started shooting heroin and had withdrawals for 2 years.”
I don't think what I am sayin here is that you will get addicted after taking 10 Vicodins, of course not.
But what about 30? 45? There is a point when it becomes dangerous. And here is where this mentality becomes problematic. If you need to take opiates for 3 days after a root canal, surely you'll need to take them after you broke your arm, or after any other procedure and for longer. And you didn't have a problem after taking it for 3 days, so what's the harm?
I strongly disagree given that we're talking about addictive substances and the power of doctors coupled with the DOJ finding manufacturers guilty of kickback schemes.
Apparently the poor are most at-risk from this crisis according to a large study [1] - so maybe the fix isn't just harm reduction, but alleviating the existential crisis we put people of lower income in the US - making them more susceptible to drug addiction & death
[1] https://www.nhlbi.nih.gov/news/2020/large-study-links-lower-...
By comparison, shipping heroin across the Pacific is costly risky business, because it's easier to detect and seize. Hence the need for fentanyl which is orders of magnitude stronger and can be created in impromptu labs.
This gets particularly dicey for every "party drug" users in the states, because a white powder that would be relatively harmless is subject to accidental cross-contamination. [edit based upon reading comments below: Yeah, if you live in the US and your friends take coke or ketamine, you should have Narcan.]
Opiate users are addicts but they're not stupid. Nearly all greatly prefer reliable heroin to the risk of OD'ing. Hence why fentanyl hasn't become a thing in Europe. A reputation for killing your customers is bad for business.
Bonus question: Why does Europe not have a methaphetamine crisis?
I'm assuming most of crystal meth in the US comes from mexico and they don't bother to ship that much of it overseas as stuff like cocaine has higher profits and a bigger market.
I've always thought that it was because all the precursors for meth get used to make MDMA.Though it's probably more of a culture/economic thing. Europe definitely has some meth in it.
Not enough free space. It takes a lot of room to make meth because anyone nearby can easily tell.
It is going to change soon because Afghanistan is starting to make it.
Because it has an amphetamine crisis?
And opioid overdoses are similar to the US per capita.
British Colombia had 2,306 deaths in 2022, and adjusted by population that's 132,000, so more than the US.
I think there would be a lot of benefit to legalizing at least one molecule in each drug class for OTC recreational use, chosen based on harm reduction standards like toxicity, therapeutic index, and duration. I think so much of the drug war's ills could be headed off by making codeine and vyvanse OTC - destroying demand for dirtier more dangerous drugs would do enough good to offset the increased abuse rate for these particular chemicals.
Is the just in case there's any problems with drugs you take voluntarily? (no judgement, been there)
or to have it on hand in case someone else ODs?
or for the worst case scenario of someone drugging you (spiking a drink, etc).?
I see people OD pretty frequently at music festivals, and while there is medical around, minutes matter when it comes to fentanyl overdoses, and it can take a while for someone to get out, notify medical, and get medical back into the middle of a 10 thousand person crowd.
I wish the US would follow Canada's lead and allow for drug testing tents to legally exist :/
So all of it.
Narcan/Naloxone won't help drink spiking, that's usually done with other substances as far as I'm aware.
So providing drug testing kits or providing a drug testing station in any official capacity would put the venue / festival officially on the hook for a potentially obscene amount of money because of that pesky darn "knowingly".
Given the current state of the opioid epidemic, I honestly can't understand how this draconian piece of legislation is still law. It is the exact opposite of harm reduction and literally kills people.
Nothing more classic than government overreach sneaking into legislation marketed as protecting kids.
I'm sure the likelihood of opioid ODs happening at shows and festivals is very high in some places, wouldn't be too surprised if some shows have dozens. Very good-samaritan kind of thing to carry if you go to crowded places.
how many people have been killed in the usa by its prescription-only status over the last 52 years
for that matter, how many opiate overdose deaths would be avoided if you could buy pure, safe heroin of known concentration over the counter instead of depending on organized crime not to put too much fentanyl in it
I remember seeing someone else on HN use a five digit date years ago, giving the reasoning that it gives us a bigger perspective on our timeline and society.
I like the idea, but it muddies the message since we use standards for a reason. For example, if someone writes "In 13 I tried..." it's a bit confusing, but if they write "In '13 I tried..." it makes immediate sense since we have expectations about communicating dates.
Since 2000, 75% of US opiate users started with prescription drugs[1]. So my guess is overdoses would be substantially worse if any opiate was freely available over the counter.
[1] - https://nida.nih.gov/publications/research-reports/prescript...
but the rate of overdoses from prescription opiates is, as i understand it, very low, because the dosage is predictable
a lot more old people needing regular enemas would be kind of shitty but not nearly as bad as millions of people dying from overdoses
Over time, addicts do not get the same high from the same dose of opiates. They require higher dosages, until such a point where they have to turn to illicit narcotics (which are also cheaper). Prescription drug abusers are 40x more likely of becoming heroin abusers.
This is all in the article I linked above (click on the subheadings).
this would increase the risk of suicide, but it would have to rise a lot to exceed the current usa rate of accidental overdose deaths