Lack of understanding isn't the issue. Most fentanyl deaths are accidental poisoning. Mexican drug cartels are manufacturing counterfeit prescription drugs like Xanax and Oxycodone but substituting fentanyl for the active ingredient because it's cheaper. They have bad quality control and sometimes put in a fatal dose.
Fentanyl is administered daily by medical professionals in all sorts of situations. If "not understanding it's strength" is not what causes people to overdose on it, then why aren't millions of people dying from its administration in a medical setting?
The claim upthread is that regulation in labeling would materially curb fentanyl deaths. It would not. Materially restricting access to high-test opiates might, but we have ample experience from well-labeled high-test opiates to suggest that uncontrolled access to any of them is likely to be deadly.
If by "regulation" you mean "restriction", then, sure, I buy that, stipulating that it's somehow possible to restrict access. But what the preceding commenter meant by "regulation" was labeling. No, that won't work.
Because we had (and still do have) an epidemic of fatal abuse of labeled, regulated opioids. I'm not saying restriction works either; I'm rejecting the pat solutionism of the original comment and acknowledging how difficult the problem is. Maybe legalization is a good idea, maybe not; what it certainly isn't is a solution to opioid deaths.
And I believe the problem isn't so much that those legal opioids are dangerous, because in theory you still have a medical system to curb access. It is that they are addictive, and that users who get addicted will either abuse them or switch to illegal drugs if they can't access them.
I am not against drug legalisation, on libertarian grounds. If you want to kill yourself, kill yourself, it's your life not mine. But I don't buy that banning drugs results in more harm that making them freely available.
And it's very paradoxical for liberal societies to want to ban or heavily control the use of alcohol and cigarettes and to consider legalising hard drugs at the same time.
I'm not advocating for legalization. I'm pushing back on what I felt was a too-pat appeal to legalization and labeling as a cure-all for opioid deaths.
I don't have to. We've had a nationwide epidemic of deaths from regulated, labeled opiates, which is a fact that refutes your argument without requiring me to provide an alternative.
The overdoses per abuser from regulated, labeled opiates is on the order of at least 100x lower than illicit opioids. The consistent formulation is hugely safer than street drugs with inconsistent dose.
Sure. But I am responding to you, not that guy upthread.
Your implied claim, as I read it, is that "opioid-ness" is "why fentanyl kills," and there's nothing special going on because we had a bunch of deaths from licit opioids in the early 2000s. But I think that there's actually something special about illicit fentanyl in particular, as opposed to regulated opioids, and dose inconsistency is one plausible difference.
Anyway, you could just share what your thoughts are more explicitly, and that would be interesting and maybe harder to misunderstand.
I was responding to a particular argument. I've lost track of what we would be arguing about here. My point was pretty straightforward: high-test opiates don't simply kill because they're unregulated; they do a very good job of killing simply by being widely available at all.
They are not at all meaningfully controlled. There are drive-thru markets for this stuff with people doing traffic control in Chicago, and presumably in every other major market.
I don't believe it much matters. The death stats on oxycodone are staggering. I'm sure the street drugs are much more dangerous dose-for-dose, but given free access to oxycodone, you're just as likely to die, perhaps on a marginally longer schedule (there are survivor high-functioning maintenance addicts on both natural and synthetic/street opioids, obviously). Remember as well that a great many street fentanyl deaths were pts started on regulated, labeled opioids who spun off into addiction; they transitioned to fentanyl because it was easier to get, not because it was stronger.
Remember as well that a great many street fentanyl deaths were pts started on regulated, labeled opioids
Primis, this is an unbacked claim. Secundo, why didn't they die from prescription opiods?
The truth is fentanyl has a low safety index which makes the dose more important.
"The calculated safety index (ORantinociception/ORrespiratory depression) for fentanyl of 1.20 suggests that fentanyl has a low safety margin, implicating that fentanyl needs to be titrated with caution."
Now you're way off the map. The originem claim was that controlled fentanyl dose would decrease overdoses. It wasn't about oxycodone being 'safe' (even though I gave you stats that showed 80% of deaths of from combining drugs), it wasn't about oxycodone vs heroin. Not to mention that way more people take oxycodone than heroin, so even from a stats 101 angle this doesn't make sense. Really, what is the point of a reply like this?
I don't think I am. The subtext of the original comment was that making opiates more widely available but more carefully regulated as to content and dosage would save lives. It pretty clearly would not do that. The high order bit of this problem is the number of people that start habitually using opiates; I think basically nothing else matters.
Clear according to what? You gave no statistics and made nothing but unbacked claims. Most of what you did say is directly contradicted by the CDC.
Fentanyl is extremely potent and has a very narrow window between therapeutic dose and an overdose that kills you. Other opiate cause deaths overwhelmingly only when combined with other drugs.
Everything you have said about increased use or more deaths is an assumption not based on data. Why won't you source your claims?
You are making a claim then saying you don't have to back it up while making another dubious claim.
Among synthetic opioid–involved overdose deaths in 2016, almost 80% involved another drug or alcohol, such as: another opioid, heroin, cocaine, prescription opioids, benzodiazepines, alcohol, psychostimulants, and antidepressants.
FWIW, 2016 is somewhat dated as far as fentanyl goes. It has really exploded since that time.
> In 2021, nearly 71,000 drug overdose deaths involving synthetic opioids (other than methadone) occurred in the United States, which is more deaths than from any other type of opioid. Synthetic opioid-involved death rates increased by over 22% from 2020 to 2021 and accounted for nearly 88% of all opioid-involved deaths in 2021. The number of overdose deaths involving synthetic opioids in 2021 was nearly 23 times the number in 2013.
What I posted wasn't about fentanyl. They implied that overdoses happen just as much with prescription pain killers that have consistent doses and what I posted shows that people aren't overdosing on known doses, they die when they combine drugs.
I would recommend https://podcasts.apple.com/us/podcast/why-are-drug-dealers-p... , but the TL;DR is roughly "drug addicts are highly motivated by their addiction to find the most powerful drugs they can, to get the most powerful high they can get. Fentanyl being so strong that people overdose is, in this regard, a selling point"
Fentanyl is legal. It’s part of most epidurals given during childbirth, used for palliative care, and for all kinds of pain relief in medical settings.
