Sam Quinones says he knows the solution to the fentanyl crisis. I was eager to hear it, but it turned out to be this:
It is hard to believe that two nations that have negotiated complex free-trade agreements cannot come to some deeper collaboration on drugs, upheld across presidential administrations and sustained despite distracting conflicts elsewhere in the world.
Quinones isn't even pretending to have a solution. He just can't believe that other people aren't able to come up with one.
But just to state the obvious, sustained crackdowns on illicit drugs have a dubious track record. And the whole problem with fentanyl is that it's used in microscopic quantities that make it a harder law enforcement problem than traditional opioids like heroin or cocaine.
I don't know the answer, myself. If I had to take a crack at it, I'd say that the only chance of long-term success is to reduce demand for opioids, which means . . . something. I don't know what. Because opioids are so addictive, the only solution is to stop people from even wanting to try them in the first place, and decades of efforts have produced no plausible way to do that.
Maybe science could save us? Is it really impossible to develop something with the effect of an opioid that isn't addictive? No one's done it so far, but that doesn't mean it's impossible. Maybe some future AI will do it for us.
Isn't the real problem pain?
We live in a society that creates an abundance of physical and psychological pain and people use opioids as a way to alleviate it. And let's not blame it all on "the system." A lot of us eat crap and don't take care of our bodies and while it may be something you can get away with when you're younger, once you hit a certain age you either change your ways or live the rest of your life in chronic pain.
Even without pain, drugs can just feel really really good.
The words of the Dread Pirate Roberts come to mind: https://youtu.be/ThDwS79HPhs
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Perhaps this is a solution.
https://magazine.washington.edu/uw-medicine-researchers-test-vaccines-for-opioid-addiction/
Methadone as a substitute for heroin didn't work. I can't say exactly why but the same factors will probably operate if some drug or drugs are legalized to get away from exposure to fentanyl.
Methadone was tremendously successful when paired with ongoing support in other ways, which was usually not provided.
GOP lawmakers, such as Rep. Dan Crenshaw and Sen. Lindsey Graham, are talking about military intervention in Mexico.
Maggie Haberman writes in her new book that Trump repeatedly asked former Defense Secretary Mark Esper if the U.S. could bomb drug labs in Mexico to help halt the flow of drugs across the border. According to Esper, Trump thought he could fire missiles into Mexico and we could blame it on another country. "No one would know it was us."
Isolationists my ass. They are better described as belligerent unilateralists.
Psychedelics seem to hold promise as a treatment.
"Psychedelic use is associated with reduced daily opioid use among people who use illicit drugs in a Canadian setting"
Hippie filmmakers knew that more than 50 years ago and soundtracked it to Pink Floyd
https://www.imdb.com/title/tt0064694/
There are some papers looking at opiod like drugs that relieve pain but dont cause respiratory depression so the risk of death is greatly reduced. I think that may be possible. Less certain about making them non-addictive. Would likely need a new class of drugs.
Steve
"traditional opioids like heroin or cocaine"
Cocaine is not an opioid, although it is frequently used in tandem with opioids and can also contribute to opioid-related overdose deaths.
My reading of the article was that he was talking about limiting precursors which was effective with Quaaludes, but nothing else ever. The problem with this approach is that with the money the cartels have they will learn how to make the precursors themselves, and you can't eliminate precursors because they are used in many legitimate processes.
You go back to the rat experiment where the rat would choose cocaine over food and eventually kill themselves, but when you built a rat friendly habitat for the rat they would try the cocaine and then move on.
It would be interesting to see what the statistics are on how many prisoners have been released from prison over the last 10 years compared to other times. We had the great lock up in the 90's and warehoused those people for a couple of decades and then let them out with no chance of participating in society at all. They went from prison to dystopian tent cities awash in meth and opiates, and we wonder why we are having a problem.
I've read Quinones book on this subject, Dreamland.
It's a tremendously good book but it has a lot of naivete about the goodness and effectiveness of law enforcement, and it seems to work hard to elide the logical conclusions presented by the data it outlines, which is "OF COURSE opioid abuse shot up when communities became completely hollowed out and other stressors dropped on people like a ton of bricks. If you want to deal with the opioid crisis then the addicts need something to go to after they get cleaned that isn't a fucking wasteland."
Legalizing the weaker opiate codeine would allow the distressed and discontent of society to treat their maladies without risk of accidental overdose. Saving lives is not the goal of those seeking to solve the American crisis of alleviating pain or the amelioration of failure through the use of drugs. Recovering the labor lost so these people can continue to earn surplus wealth for others is the primary reason why drugs are banned and is the reason why so many become sick and seek to self-medicate. As every subject knows, they are solely responsible for their outcomes and they act accordingly even if they must risk taking black market supplied medicine, which provides them a sense of well being, even if costly and fleeting, their society cannot.
Well, they keep outlawing the good stuff...it was nice seeing Quaaludes mentioned, the great 714's! Ahh, the 1970's and 80s' were greater for the plentiful Quaaludes.
America refuses to discuss or acknowledge that people like to get high. Morphine is good, a fine warm high, (though it does make you puke). Overseas I thought that an actual opium ball mixed with hashish was very good also, especially because it did not involve any needle work. (I hate needles!)
I don't much like marijuana, it just makes me go to sleep or cocaine which only raddles me, but I am already pretty raddled all the time anyhow....so all speedy stuff is just verboten for me.
Alas, for the past couple of decades I've been too busy to practice these finer arts...maybe later if I am ever less busy....lol...I do miss a good high, but I have no time for it. Never had time for Oxy so I don't know if it was any good or not.
Which maybe is an answer? Stay busy & productive.
A blogger I enjoy reading once wrote that the opioid addiction crisis is the first drug crisis in US history to be promoted by a large corporate marketing department. We should acknowledge that this situation wouldn't be nearly as bad if it weren't for that.
Could naltrexone be of help?
How did we manage the great shift away from tobacco? It's a monumental change in my lifetime. It seems like a good example of how to decrease demand for a bad product.
We taxed it and stigmatized it. Of course it’s not dead yet…
I think the doc gave me fentanyl for a procedure. It was the best shit I ever experienced. If that is everybody's experience, no way Jose it will be stopped.
dilbert dogbert:
Exactly!
The answer is simple and obvious and brings to mind Clausewitz's observation on war: "in war, everything is simple, but even simple things are very difficult".
The simple, but very difficult, answer to the opiate overdose issue is to legalize all of them. When people are getting pharmaceutically pure drugs in known strengths, overdoses are rare; not unheard of by any means, but rare. The reason why there are so many fatal fentanyl overdoses is because the users often don't know that there is fentanyl in the drugs they are buying, usually represented as heroin. Legalize heroin so that people can get drugs of known strength and composition, and most of the problem goes away. For those who actually want fentanyl, again if it's legal it will be pharmaceutically pure and of known strength, and overdoses will be rare.
What lawnorder said. Legalize drugs. It's been the only viable solution since I first looked at the issue in the late '60's. Sometimes you only have a choice between a bad solution and an even worse solution.
Peter Attia has a fascinating podcast interview with a sheriff's deputy about the fentanyl crisis, episode 243. (Search for Peter Attia Drive podcast).
This is not so hard.
Look at the stats for addiction by class, economic insecurity, economic opportunity, neighborhood poverty, and unemployment.
I know what you 'll find. So do you! Addiction targets the vulnerable and throttles them. We have let the working class die a slow death and addiction is one of the assassins.
If you decide to make jobs your first (and second and third...) priority, jobs with good wages and benefits, union jobs then OVER TIME the addiction problem would decline.
Drugs would not be the escape route for millions of hopeless people. Yes, those addicted today will continue to die. It's hard to get and stay clean.
I think the concern about the addiction crisis is a lot of hot air.
We've been crushing the non-college working class for decades and then we "act surprised" when they finish the job themselves.
Wasn't there a tiny kerfuffle about "deaths of despair" a few moons ago? Right. That topic disappeared into a black hole.
Humans want to matter to other humans. If society is saying "you don't matter," it hurts. How someone responds is unpredictable. Nelson Mandela and MLK had the same response. Others turn to substance abuse.
To end substance abuse, all society has to do is change the message from "you don't matter" to "everyone matters." Easy to say and do. Step 1: try. Step 2: don't give up.
Beef up the IRS and go after the money flow.
Stuff is addicting because it feels so good. If you invent something to replace fentanyl that makes people feel as good as fentanyl does, it will, de facto, be just as addictive.
Addiction isn't the issue in the fentanyl crisis. Death is.
@lawnorder
Point taken. But it's the addictive qualities that make people want to use it, and then they die.
FYI, I am on the side of the "legalize it" folks. There is no way to stop the use of recreational drugs, no matter how dangerous they are, so the substances themselves should be made less dangerous. Even with legalization there will be basement chemists making bad product, but at least there would be a clean, safe supply.
Unknown quality and quantity is the issue in the fentanyl 'crisis.' If users were able to purchase fentanyl from pharmacies, accidental overdose deaths would be minimal. The issue is not death but having a surplus labor force ready and able to create surpluses for capital when the opportunity arises. Prohibition is a tool of state capitalism.