A man walked into a meeting with a fent sucker in his mouth treating it like a toothpick and I had to hold back my alarm so that everyone else did not ask why I knew exactly what it was. At that time no one outside of post-op, end of life cancer, or major pain management were really aware of this stuff. But to see a guy just stroll in on fentanyl like it was nothing at all was a watershed moment.
Now an addict does not need to steal from a ped surgery floor. You can buy fentanyl straight from China in a properly wrapped packet. Dosage is the problem, mixing dry is not easy, hence the street deaths.
I carried narcan back in the day because some of my friends were heroin users. But I never came across a fent addict, now I can only imagine how much of this stuff is floating out there.
Average people have no idea what this stuff feels like, what the pull is like. In reality you never get away from it; it is always there in the back of your mind but you have to tell yourself that it will destroy you.
sorry for the disjoint mess but I am being hit with the thoughts of those I knew who were lost to black.
I had interventional radiology brain surgery three times. I got a decent medical dose of fentanyl. I was strapped onto a surgery table awake because I had to hold my breath every time they put tools into my brain. I could see the x-ray image of the tools going into my brain in the corner of my eye on the screen above the table. With fentanyl the world was right as rain, however, I didn't feel any desire to have it again after. The feeling wasn't happy, sad, high, speedy, or low. It was just everything was ok.
> The feeling wasn't happy, sad, high, speedy, or low. It was just everything was ok.
Sounds similar to codeine (medical use, moderate to high dose). It has no particular strong feeling in and of itself, but if I'm doing something I already enjoy it makes things feel a notch better (vs. if I'm bored/annoyed etc. it's hardly noticeable other than being in less pain).
The most unsettling moment of the whole situation is when I first had the operation and the doctor handing me the consent form says that the procedure itself kills 1 in 400 people. I said those odds are shitty thinking about the one time I had 4 aces in Texas Hold'em and lost to a royal flush and all the other times I had a bad beat. The doctor said for someone off the street those are bad odds but my odds of surviving without the procedure are probably much worse. I didn't have any family there with me. My friends had no idea that I was in that situation. I was a chef for a long time and said what I would say to the cooks before a busy night. We are all human, we all make mistakes, I just ask you do your personal best. I survived. The feeling I had on fentanyl under those conditions was the same the night I was in the hot baths at Esalon looking at the expansive milky way while the waves crashed on the rocks below. Awe and wonder and it's all ok.
Maybe it is one of those things where I should take Bill Murray's advice and I can't tell anyone because nobody is going to believe me. It is possible at 1 in 165 million odds. http://imgur.com/a/Kb9Oa
How is this unsettling? They didn't develop Fentanyl to make people's lives worse, they developed it to relieve severe pain and prevent dangerous instinctive reactions to surgeries like these; most of the time that Fentanyl is used, it is used for the right reasons.
The oral version is purportedly amazing, it is basically an off switch for pain, exactly the sort of thing you'll want if some day you get shot or stabbed, or fall over onto a hard surface and break something.
Sometimes the brain is not well equipped to handle exceptional scenarios which none of our ancestors would have survived anyway. For those scenarios, there's Fentanyl.
Ahh, fair enough. I completely missed that angle, I've never been squeamish about descriptions of surgical procedures, except when they involve cutting the eye. I'm probably the weird one here.
The scenarios you describe are excellent use cases for Ketamine which is an incredibly strong hypnotic.
French EMT-equivalents use it for severe out-of-hospital cases while opioid derivates are used for diagnosed, chronic needs.
What are the economics or pharmacology that make fent apparently widely used in US medicine?
> What are the economics or pharmacology that make fent apparently widely used in US medicine?
Let me say that I am not qualified to answer that directly, but I can point to some things that I am led to believe.
> French EMT-equivalents use it for severe out-of-hospital cases while opioid derivates are used for diagnosed, chronic needs.
First of all, I don't think EMTs are regularly administering fentanyl at the scene. I could be wrong about that.
Ketamine can keep producing (a very wide range of) primary and side effects for a good 24 hours after it's administered, whereas with Fentanyl you get a lot more control since it comes on and wears off rather quickly. I know people who have used Ketamine recreationally, and the types of intense hallucinations they report seem like they would be pretty incompatible with restraints or some forms of surgery.
Other than that, I think the U.S. seems to have deployed it more quickly because the patients and their insurers are not as cost sensitive as in single payer systems. Common forms of Ketamine are not new to anyone, whereas the most common fentanyl products are from the '90s or later. People say Americans pay a lot for health care, and this is true, but they also get most of the cool new toys, drugs, and procedures first; and so take the first-mover advantages with the first-mover disadvantages.
That said, I don't think the (local) medical uses of fentanyl are particularly important to the abuse problem. I live in Canada, and I don't think we use fentanyl medically as much, but there's a lot of it on the street. It seems to be mostly coming from independent producers rather than theft or fraud against the pharmaceutical companies that package it for use in the U.S. and Canada.
> First of all, I don't think EMTs are regularly administering fentanyl at the scene. I could be wrong about that.
I'm a paramedic in New York. We carry both fentanyl and ketamine.
Fentanyl is my preferred choice for analgesia (over morphine). It acts faster, is more effective for acute pain, and has fewer side effects.
Ketamine is used for sedation, not analgesia. It's also rarely my first choice (Versed is generally my go-to for sedation, as benzos are much safer in a prehospital setting).
Also, your claim about how the high cost of the US healthcare system is worth it because the "cool new toys, drugs, and procedures" is a common myth... Fentanyl, for instance, was developed by a Belgian company.
>Also, your claim about how the high cost of the US healthcare system is worth it because the "cool new toys, drugs, and procedures" is a common myth... Fentanyl, for instance, was developed by a Belgian company.
This is incredibly misleading. Most pharmaceutical and medical research companies make the bulk of their revenue from the US market, either directly or indirectly, regardless of where they are based.
The US market is the primary funding source for medical research, even for drugs which are developed by foreign companies.
Where the drugs are developed, where the funding comes from, and where they are first made available are three completely separate questions.
If it makes you feel any better I had fentanyl administered as a part of an endoscopy, but because it was paired with an amnesia drug (used to keep me from moving, as I was awake but unaware during the procedure), I have no memory of its effects, and obviously no desire to use it or any other opioid, so fentanyl is not exactly an absolute evil that latches into your brain and never legs go regardless of the circumstances.
Still, lot of heroin addicts around where I live. Most you wouldn't even recognize as addicts, but they're there.
For most people driven to addiction, having something that guarantees you will feel that "everything was ok" is exactly the draw, I think. It gets worse as you become more and more addicted and have more and more to hide from as you let other parts of your life you cared about continue to slide.
I got Vicodin and prescription Ibuprofen after oral surgery. I preferred the Ibuprofen because it felt more effective for keeping the pain away, and the Vicodin made me intensely sleepy. So... I never experienced anything that would make me want to keep taking it. I kind of avoided it because I didn't want to be sleeping all day.
At least here in upstate New York, there aren't really 'fent addicts'. There are opioid addicts in general, but even the hardcore users are generally seeking heroin, not fentanyl.
And they should be. Two employees at my local hospital died sitting on the can in the bathroom, with a fentanyl Patch lying on the ground.
One was a nurse, and the other a janitor. (They took the used patches out of the garbage.).
(That said, we should legalize at least bupenorpine, the generic version. Addicts would have an alternative to street drugs, and doctors who just charge too much. Plus--drug education should be taught early in school. And tell the truth. Like for nine months, the drugs will work. Then you will spend years just trying to feel the way you did before you took opiates:; if you're lucky.)
I'm not sure what you mean by "the generic version". Fentanyl _is_ the generic name (the brand name is Fentora (plus a bunch of brand names for patches).
Buprenorphine and fentanyl are _very_ different drugs.
Like many other medications, there is a reason this requires a prescription.
It has a half-life of a few days, people die from overdoses like any other opioid and sometimes they make the mistake of having a drink (or a few) while it is in their system, which could kill them as well.
Overdoses of buprenorphine require exorbitant amounts of Naloxone to keep a patient breathing because of its half-life.
Nalaxone has a half-life of an hour or two in a healthy adult. Right now, a single metered and prepared dose of Nalaxone is roughly $4,500. [1]
> doctors who just charge too much
I agree. Suboxone is a racket, doctors need special licensing to prescribe it and they know they can charge desperate, dying people enormous amounts of money to treat them.
Because it's a partial agonist, it is almost impossible to overdose from buprenorphine alone. Narcan can be purchased OTC at many pharmacies for around $100.
Buprenorphine is not the 'generic' version of fentanyl. Fentanyl is the generic name for various brand-name medications such as Sublimaze. Buprenorphine is the generic name for Suboxone, Butrans, etc., and is an entirely different medication used for different purposes from fentanyl.
> A man walked into a meeting with a fent sucker in his mouth...You can buy fentanyl straight from China in a properly wrapped packet.
Talking about OTFC lollipops? You can get those in the mail from China? I'm guessing these are disjoint cases.
> Dosage is the problem, mixing dry is not easy, hence the street deaths.
I feel like the bad rap it gets is mostly about dosage, ultimately it is the market at work despite the law, producing ever more potent and compact (concealable) fixes as customers demand. If caffeine were a controlled substance, people would buy it more often in the (hazardously potent) powdered form. When booze was prohibited, it was regularly distributed in 180/190 proof.
The demand is the part you can improve, the supply is the part you think you can solve.
I'm scared I may have to advise close friends to start carrying Narcan. It doesn't really make sense how horrifying opiates are until they start ripping away people you've known for years...
I'm in the process of recovering from a serious addiction to furanyl-fentanyl. I don't really care to get too into it, I really can't explain the pain that stuff has caused me. I've been through a lot in life, but I've never been through anything so traumatic.. This stuff is a nightmare like you can't possibly understand without being there yourself, I hope none of you ever find yourself in that position.. I've been in a methadone program for the past 6 months now. We really need to put money into treatment, the program that I'm in literally saved my life. I'm lucky enough to have insurance that actually covers most of the cost, but most people in my situation don't have that luxury.
I was actually addicted to methadone, only used heroin a couple times in my life. I used it because I could work and get stuff done for days on end while being high. I knew people who died because they forgot you can't drink alcohol when you're on it, but I was delusional enough to think I was better when I was on it.
It ended for me when I got old enough to notice the kids at these places I was going to by my drugs, just to do my dirt and leave. The last straw was when I stumbled into a bedroom while trying to find a bathroom at a dealers house. I walked into a room with 6 or 7 kids under 10 years old wearing big bubble coats and gloves, all huddled together in the middle of the room trying to stay warm. It was winter, and it hadn't dawned on me that the house had no heat. I've never been able to forget how I'd been contributed to their situation, my actions rippled out to affect many people beyond myself. Relying on drugs started to feel like a very selfish, narcissistic way of life
> I'm in the process of recovering from a serious addiction to furanyl-fentanyl.
> This stuff is a nightmare like you can't possibly understand without being there yourself
From someone who hasn't been there themselves, but just lost my best friend to fentanyl, I hope you stick with recovery. She was actually in a very nice recovery program, but managed to sneak a cell phone in. Point is, it only takes one bad decision that I hope you don't make.
Im glad to hear you're doing better. Keep at it. I didn't get into opioids personally but grew up in and lived in that type of environment for years and had my own addiction issues. I've seen alot of good people get caught up in it. We need more programs for addiction and mental health. It's wrong that things are the way they are. No one should have to live like that. We need to find a better way.
Fentanyl is nothing compared to carfentanil - some 100x stronger, which is 10,000x stronger than morphine, gram for gram.
So much so that first responders are suffering serious overdose from inhaling bags of it accidently.
More crazy was the fact it's for sale on the darknet markets for as little as $150/gram. Worldwide legal use is about 50g a year.
This is what prohibition does - inctentivizes strength per unit mass. It's much easier to import 1g of carfentanil than 10kg of heroin. And I think it will just get worse and worse.
Carfentanil is terrifying. Wound up in a Wikipedia hole looking that up. 10,000 times as potent as morphine. Only recently illegal in China. Therapeutic dose of one microgram. May have been the way the Russians subdued the Moscow Theater Attack (https://en.wikipedia.org/wiki/Moscow_theater_hostage_crisis#...) by just spraying it over the crowd. It seems that many people died of asphyxiation when they passed out and flopped over. It's considered a chemical weapon.
Consider the mixing requirements of carfentanil: one insufficiently ground grain of the chemical is lethal. And the people making the end-product are amateurs.
One kilo from China was confiscated in Canada. Certainly a bit hyperbolic, but "According to the Canada Border Services Agency, the shipment contained 50 million lethal doses of the drug, more than enough carfentanil to wipe out the entire population of the country[...]". Divide that by ten and it's still terrifying. Dump a small bag over NYC Times Square or Mumbai and you'd create mass casualties.
This isn't some crazy, Bethesda-managed super-bug or insecticide. It's a bog standard, synthetic opioid.
I remember when I first learned of Carfentanil years ago under the name Wildnil, very large game tranquilizer. What I remember most was the speech we got about handling is and how little time we have if we were exposed, how much reversal agent will be needed in the reversal agent was always to be had whenever carfentanil was to be handled.
The idea of humans actually trying to get high on the stuff is insane and terrifying.
Wow, I didn't realise that had hit the illegal drug trade. That's insane. Carfentanil has been used to knock out elephants, and it's always package alongside naloxone, just in case the vet accidentally gets themselves.
Genuinely quite scary that it's out there as a drug of abuse.
It seems carfentanil has been made a controlled drug in China recently, which probably stem the flow somewhat.
Still, the ease with which I just found vendors offering bulk fentanyl analogues for not a lot of money (<$10K/KG) is alarming. I knew sites offering so-called 'research chemicals' (mostly barely tested analogues of existing drugs AFAIK) were a thing, but I hadn't expected something as potent as fentanyl to be (seemingly) so readily available.
I knew fentanyl analogue were out there, I was fairly plugged into the RC scene a couple of years back. While most of it was filth, some of the hallucinogens were genuinely interesting and exciting.
I could not read past this without imagining a random corpse in Fallout 4 or Skyrim stretching its limbs out to infinity and dancing and twisting around in the sky like some crazy, drunk harvestman-fairy.
But this is undoubtedly referring to level-4 containment at the National Institutes of Health, which keeps samples of diseases that would potentially be useful for biological warfare.
That is insane. Part of what's so awful about this is how these can just be mixed into other powder drugs and nobody is the wiser. Like, doing coke now just seems crazy to me, where in the past it didn't seem a big deal at all. But the lethal doses of these things are so tiny that it seems not worth the risk.
Fentanyl is a wonderful, miraculous, lifesaving drug when used by doctors and paramedics. In a hospital setting, it's a much better drug than morphine for acute pain management in most cases. It's also -- no question -- really freaking dangerous when abused. I worry about stories like this painting such a one-sided picture that Fentanyl will be demonized out of existence.
Paramedic here... I agree wholeheartedly. I see both the best and worst of fentanyl. I have woken up plenty of folks who took a much bigger dose than they expected (because it was cut with more fentanyl than usual), and pronounced more than a couple people dead for the same reason...
That being said, it's my go-to tool for analgesia. It acts a lot faster than morphine, and wears off faster as well (which is a useful property in the event of an adverse reaction). Before we carried fentanyl, it would not be uncommon for some patient's pain to remain untouched by morphine. I've yet to have that happen with fentanyl.
Carrying fentanyl means the difference between "Let's get some pain medication in place before we manipulate your broken leg in order to splint it" vs "Morphine is gonna take 20 minutes to reach a meaningful therapeutic effect, and we don't have time for that, so just grit your teeth and we'll try to be quick".
That I understand, The fentanyl lollipop has completely changed battlefield pain relief, it's also been used for cancer patients. Morphine can take 15-20 minutes to kick in, and needs to be injected into muscle, whereas the fentanyl citrate lollipops take considerably less time and can be administered and removed abruptly by putting it in or taking it out of the mouth. It also lacks some of the unpleasant side effects of morphine.
Morphine can be administered IV too, in which case its effects will be felt immediately. If taken orally, it generally takes around 40 minutes to be felt, the same as for most opioids when taken orally. Do you have a source for fentanyl lollipops acting faster than that?
Also, you say it lacks some of the side effects of morphine - do you have a source for that too? Morphine causes respiratory depression, histamine release, constipation, nausea, loss of libido, inability to orgasm;
actually, any opioid that doesn't recruit beta-arrestin (such as mitragynine) will have much the same side effects.
Searching "Fentanyl vs morphine for acute pain" will give plenty of studies comparing the two. At a quick glance through a few of them, it appears the main differences are faster onset, shorter duration, lower incidence of side-effects (primarily nausea), and less histamine release.
It is super fast. A while ago when I went to the ER with a broken arm they gave me fentanyl as an injection. As I remember it, it took less than ten seconds to go from extreme pain to not caring.
Legalizing heroin and regulating it like alcohol would save so many lives.
Not sure where everyone here is from, but in Connecticut we've seen hundreds of people die from fentanyl overdoses in just the past few years.
In an overwhelming majority of the cases, they were sold what they thought was heroin.
Why should we keep forcing drug addicts to buy from dangerous and expensive dealers? Not only would legalizing heroin save millions of lives, it would bring in trillions of dollars in tax revenue
Not only that, the response to the opiate epidemic has negative impacts on people actually in pain.
My girlfriend, who has lupus and constant pain, was recently denied pain medication because the doctor was concerned that continuing to write prescriptions for opiates would cost him his license. So my girlfriend has been in excruciating, 9/10 pain for the last month because doctors are too concerned about over-prescribing because every soccer mom is suddenly concerned that responsible adults in pain are suddenly going to turn into opiate crazed monsters.
As much as addicts need help, the feeling of the general population is that it's better for someone in pain to suffer than for someone to get a safe, known, pure quantity of opiates without having a good enough reason.
Librarians in Philadelphia have started keeping naloxone in their desks so when the next addict OD's in the grass in front of the library they can bring them back to life.
I'm not sure the intent behind your quote, but that's very true. Used in a clinical setting, fentanyl is generally the best choice for acute pain management (post-op, traumatic injury, etc).
No, it's a business problem. There's too much money tied up in the infrastructure that criminalizes it, too many people invested and making a lot of money on the status quo.
There's also a lot of money to be made in keeping addicts hooked. In South Florida, there's a huge issue where opioid addicts are put into "treatment centers" that use them to defraud insurance carriers. The victims don't get treatment but instead get the exact opposite - handlers who make money by feeding the addiction.
I live in South Florida, in Palm Beach County, where the bulk of these centers are. You see a lot of addicts. I don't know of any success stories to come out of them. But its a bit unsettling to be driving down I95 and see a billboard: "IMAGINE BEING SOBER". It's really sad and scary. Delray Beach used to be a nice place before the treatment centers came in, too.
I was looking for an apartment on Craigslist here not too long ago. More than half the rooms for rent I saw were "sober living" half way houses.
This is a super simplistic view. This is not like pot. This is not a drug that you can eve use casually. There is no moral legal framework in which these drugs can be freely bought. After you are on these drugs, you are no longer able to make free choices.
I agree that users should be receiving treatment. But anyone selling or importing these drugs absolutely deserves to be punished harshly -- they are destroying millions of lives.
After you are on these drugs, you are no longer able to make free choices.
I don't buy it. I heard exactly this being said about cocaine, heroin, methamphetamine, ecstasy, and yes marijuana in the 80s. Reefer Madness was not a parody movie, and let's not forget that pot is still officially Schedule I in the US.
I'm not saying that all drugs require equal amounts of care - carfentanyl sounds more like a chemical weapon, and for that reason alone should be heavily regulated. But folks tend to overreact with panic every single time a new drug comes up, and I've watched this excuse ("no longer able to make free choices!") used to justify ratcheting up the drug war every time.
This particular claim doesn't pass the obvious sniff test - if fentanyl was so compulsive, heroin addicts would be seeking it out instead of trying to avoid it. Yeah, these powerful new drugs are killing people - and we should lay the blame square where it belongs, with the prohibition of milder alternatives.
If you take a look at forums for drug users, such as Blue Light, you will see most prefer heroin to fentanyl. Apparently the euphoria from fentanyl isn't as great as with other opioids.
Most addicts preferring heroin shouldn't be surprise to anyone. Fentanyl was developed as an alternative to existing opioids that acts faster, goes out of your system faster and has less side effects (with the pain relief being the only wanted effect). The fact that it is very strong (easy to overdose) isn't really that much of an issue in clinical use.
The pharmaceutical industry is a major part of the problem. Keep in mind morphine and oxytocin were in response to the control of heroin.
Adderall is not so different than methamphetamine.
The well of do these drugs legally and can afford rehab. Many of the people I've know that struggled with opium addiction could not afford to join treatment programs, many of which cost $2k ~ $15k.
There is a lot of money being made in all sides of this game and it's disturbing.
Treating it like a criminal problem works extremely well for Singapore. If you sell drugs, you get executed. If you have any amount drugs, you almost certainly go to prison. Police have extraordinary powers to investigate and prosecute drug crimes, including compelling drug tests of suspected users. As a result, there is effectively no drug use or trafficking in Singapore.
So this oft-repeated mantra that the penal code cannot solve drug problems is frankly bs. I'm not suggesting that we should throw drug addicts in prison for a dozen years, but I'd have no problem letting a fentanyl dealer rot in prison for the rest of their lives. Maybe start sending commandos to kidnap cartel leaders from Mexico to bring them to the US to face charges, for trafficking drugs and for murder. Let's run sting operations with cops posing as drug-seeking addicts to catch doctors handing them out like candy.
There are other countries that have stupidly harsh penalties for drug dealing and use (e.g. Thailand, Indonesia, Philippines). Hasn't really done much there. Only works in Singapore because it's already a police state. So perhaps you can solve the drug problem with police if you're already in a police state, but that doesn't strike me as a sensible approach.
I don't think you have any idea what you are talking about.
I am an American who has lived in Thailand for several years.
The US has a huge drug problem and SE Asia doesn't even come close. The local population does not abuse drugs at all. Nearly all of the drug trade caters to American/European tourists. Which is incidentally why the punishment is so harsh, they do not tolerate foreigners poisoning their society.
There's another possibility. Is there a cultural difference at work here? Does Asian culture have more respect for authority and less patience for things like drug abuse?
I feel like if crazy penalties like that were levied in America we would take it as a challenge. We have a long history of that.
If the drug trade caters to foreigners, then isn't it plausible that locals are selling to foreigners?
In this case, how would foreigners be responsible for "poisoning their society"?
To me this sounds a lot like what you here in the West concerning drugs... America claims its' foreign traders with "terrorist connections" who do drug sales (e.g. all the talk about Colombian drug cartels, or Mexican drug wars).
"Even prior to announcing his candidacy for the May 2016 presidential election, Duterte was already very clear about his intention to eliminate crime by eliminating criminals: “If by chance that God will place me there, watch out because the 1,000 [people allegedly executed while Duterte was mayor of Davao City] will become 100,000. You will see the fish in Manila Bay getting fat. That is where I will dump you.”"
The massacre of 100,000 people would put Duerte well into the "crimes against humanity" league.
Please tell me, how many marijuana dealers would you have been willing to execute in the 80s? How many brewers would you have been comfortable executing in the 20s? How many homosexuals in the 50s?
I for one am very happy not to be living in an all-powerful police state. What's obviously "moral and good" seems to be awfully fluid across history.
So I'm not arguing that we should completely emulate Singapore and other Asian countries here. Life-ending punishments for low-level dealing of soft drugs is too harsh and incompatible with our vision for society. Likewise for imprisoning addicts.
But I think enforcement can work if we're willing to do what must be done. People exporting and importing large quantities of hard drugs into the United States get no sympathy from me.
We already do this. Large level dealers/kingpins are prosecuted to the fullest extend of the law and often receive extremely long sentences. However, as has been proven, it doesn't work.
Your point about Singapore is taken though, you raise a strong point. I think the issue though is that there are two effective ways to deal with drugs:
1. Totalitarian-police-state-type of enforcement (lets call it the Singapore model) where even low level offenders are hit were severe sentences.
2. The end of prohibition. This destroys the current economic framework supporting the drug industry; this would severely reduce the violence associated with the illicit drug trade.
What doesn't work is this sort of middle-of-the-road approach that we currently have.
Obviously, these two are at exact opposite ends of one another. I think we should pick the one that is more fitting with our national character and purported values of life, liberty, and individualism (the 2nd option...)
Maybe when large poppy and coca fields were needed enforcement could have worked had it been pursued vigorously. But we apparently really didn't want to do that and it was mostly all lip service.
But now? Super powerful chemicals being continually adjusted. A zillion e-packets zipping around the world. Forget about full enforcement. That is no longer possible if we "just try hard enough". Unless maybe you want to stop the mail and bomb 35 countries into smithereens. And incarcerate even more people than the ridiculous number we already have. We can still "discourage" with occasional busts (and probably should for deadly drugs for now) but maybe it's time to sit down and rethink rather than continuing to playing wack-a-mole.
Make better drugs. Less harmful ones. That's the eventual answer I think.
That most prisoners are serving for merely drug offenses is a myth. A huge percent have drugs on the list of crimes they were convicted for, but almost all of them have a violent crime on there as well. Mass incarceration is due to high rates of violent crime and strong punishments for them, not drug enforcement.
But perhaps it's all related. Violent crime occurs because it's fueled by an illegal cash cow in the form of drugs. People don't just murder or assault people without being driven to do so. They have an economic incentive.
The government south of the border has failed. The cartels have more control over large swaths of Mexico than the Mexican government does. America should not tolerate that situation. The security of our people demands the pacification of the cartels.
The Mexican government won't solve the problem because a large chunk of the Mexican populace is in denial about the nature of the problem. For example, every time the Mexican government tries to pass laws to more effectively wage war on the cartels--and war is the truth of the situation--you have mass civil liberties protests in Mexico City. Further, the government is partially controlled by, and even more terrified of, the cartels too. And it certainly doesn't help that the Mexican government is poor, while the cartels are raking in profits from the largest drug market in the world, the United States.
"International law" does not exist. In international affairs, there is only power. If the security of our people depends on resolving some situation in another country, then we must do it. Some worthless piece of paper with no realistic enforcement mechanism (i.e. not law) be damned.
Singapore is always held up as an example for larger countries but it's really just a small city that doesn't offer much in the way of example for actual countries. We've already tried police brutality in the war on drugs and all it has gotten us is pain and misery. And epidemic after epidemic of drug abuse over the years.
And we'd have to send your commandos into China as well as Mexico if we truly want to stop the opioid epidemic. That's where all this fentanyl and carfentanil is coming from.
the law is a piece of the puzzle. I think that would be a tough approach in u.s. culture as you present it. For one, all it takes to get someone executed is a dishonest officer. Also, planting drugs on someone or their property seems like an "easy" way to get rid of them without a conspirator.
I see how that can work in some cultures and countries. I just think that approach wouldn't be very effective in the US. Probably not effective in countries larger than a few thousand square miles even with strong cultural support.
I lived in Singapore as an expat back in 2012, and from my experience, getting drugs (either online or through friend contacts) was not that hard. The penalties stop most people but the stuff still exists.
Now an addict does not need to steal from a ped surgery floor. You can buy fentanyl straight from China in a properly wrapped packet. Dosage is the problem, mixing dry is not easy, hence the street deaths.
I carried narcan back in the day because some of my friends were heroin users. But I never came across a fent addict, now I can only imagine how much of this stuff is floating out there.
Average people have no idea what this stuff feels like, what the pull is like. In reality you never get away from it; it is always there in the back of your mind but you have to tell yourself that it will destroy you.
sorry for the disjoint mess but I am being hit with the thoughts of those I knew who were lost to black.
Apparently fent is the new black.