http://www.stuartmcmillen.com/comic/rat-park/

The gist of it is that yes, rats do get addicted to morphine and prefer it to food, but only if kept in cages.

The rats living in a much less confined space with other rats, allowed to play, nest, have sex and do pretty much all the rat fun things not only did not get addicted to morphine but even waned themselves off of it.

Speaks a lot to the causes which this epidemic is a symptom of and makes me think that addressing it will not be an easy or quick process.

But people still love bringing it up, especially here on HN where people seem to think they know better than the experts on everything to do with medicine.

http://sci-hub.io/10.2466/pr0.1996.78.2.391

https://www.ncbi.nlm.nih.gov/pubmed/2616610

But there are other studies linked that seem to confirm it.

https://www.ncbi.nlm.nih.gov/pubmed/3696469

https://www.ncbi.nlm.nih.gov/pubmed/18463628

Not sure where that leaves us.

But there are very different patterns of prescribing of opioids across the US and eg UK.

Why is this?

Edit: I should add there are a couple post scarcity instances in recent history. Establishment of America, and post WW2. These also coincided with the least income inequality. But those periods don't last.

US inflation adjusted per capita GDP is higher today than at either of those times. While I do not think GDP is a great metric, I cannot think of any metric where we, as a society, have less "stuff" to go around then before.

https://www.google.co.nz/amp/s/www.theatlantic.com/amp/artic...

On a tangent, while I've never had chronic pain, I've had friends who have, and I know it can destroy anyone's life. I don't want to see the abuse of effective pain meds by some lead to difficulties in obtaining pain relief for those who really need it. Someone in chronic pain has enough to handle without worrying about maintaining access to appropriate medication.

One of the traps with pain is the assumption that medication is the answer. It isn’t unfortunately and chronic pain should not be treated with medication alone - at least thats what I took away from discussion with a pain specialist who I happened to be working with on something unrelated. Source required.

I’d say that jobs in the context of survival are useful, but we as human beings also need a sense of accomplishment, of being useful to others beyond the value associated with mere profit.

The problem with opiates (esp in the US) is they ones that are available are too strong and completely unforgiving. Fentanyl is an elephant gun but it's supplanting heroin on streets due to its prevalence (through overuse).

You've got to wonder what a regulated generally-available recreational opiate could do for street safety. It's not just about making sure of the purity, we need help people take the right dose of the right things, so they're not just taking however much of whatever is available.

That, and weaning. I'm sure a lot of these people would prefer not to feel like they do. Quitting opiates cold turkey is not easy.

You imagine going from a numb high... to feeling everything you were blocking out with opiates. Many of these people have legitimate pain. You'd probably not be too happy.

I'd certainly be wary about administering it to a stranger, without their consent and without knowing what their reaction would likely be. It's legally sketchy, especially if the drug is —as it is— not generally available (it's prescription-only in many places). Still, don't let me put you off saving somebody's life from an accidental overdose.

I think you meant "physical pain"

By comparison I think it would be easier to make a self driving car or automated robot that does most of what a heroin addict does.

Sounds terrible don’t care I’m out of sympathy for addicts in society.

Also I have lived in Salem, Oregon look up it's statistics.

Just because my heart doesn't bleed for people who wouldn't do shit to help you doesn't mean I don't understand the problem.

That was about 40 minutes ago.

My sister has been on heroin for probably 8 years now. She will call and ask for money and if anyone says no she spouts this same bullshit about it's not her fault etc. and she's an addict. We send her to rehab, she runs away, can't even tell you how many times I've seen it.

Her 4 kids are taken away from her she doesn't even attempt to visit them in any capacity.

Look close enough at a heroin addict you'll find a regular shitty person underneath it.

But it sounds like you're writing them all off, writing the problem off, as something that's just unavoidable, untreatable. It can be both avoided and treated, it just doesn't always work.

Even if you gave up on sympathy for addicts (and I understand, I was in Portland and have been along that hellish amtrak line) - the problem affects all of us, whether we like it or not.

A friend I grew up with just shot himself to death. He was on a TV show, model and had it all going for him..until the night he tried black tar heroin through a needle, off a spoon. An older friend convinced him and four others to try it one night at a wrap party for the TV show. Grew up affluent but drugs immediately nosedived his life. Ended up in and out of jail, losing it mentally, mental institutions, broke every window at his parents house, just living a really rough existence. The part that got me: the older friend who introduced him to it showed up to his funeral.

The other one of the four is on his third strike for heroin, just got his second DUI trying to "live it up" – drugs i.e. heavy drugs, are a game that you do not win.

Drug potency follows something like an S-curve. As enforcement increases a drug will get increasingly stepped on, until the purity is low enough that the drug gets replaced with a more potent analog. Consumer Reports wrote about this in their guide to drugs from the 70s.

Whoa. Care to further elaborate?

I've come to realize that the concept of gateway drugs is bullshit. Kids are going to try whatever they have available. If heroin suddenly enters the scene, then heroin is what they're going to try. Same thing for meth.

Also, it's a different sort of high. When you want to get drunk, you drink. When you want to feel stupid, you smoke weed. But when you just want to feel like everything is beautiful and nothing is wrong, you try opiates (or amphetamines).

Interesting, this is exactly what weed is giving me, without any nasty effects and addictions of hard drugs. If in nature, this effect is super strong. I came up with most important decisions in my life when high, and they are still solid and best choices possible, even when looking back after 10 years. Different perspective on situations, in some cases really proactive thinking and resolving issues before they arise and so on...

I guess it really affects us differently. I've seen few people get weird/aggressive on it, but then again I would never want to drink with them either. Something badly broken deep inside, with no real chance of fix, ever.

Some people are just attracted to the crazy unknown. Many can’t believe they could become addicts because they’ve never been addicted. Others still don’t care because they’re just one step removed from suicide.

Yes. "Find what you love and let it kill you" somebody said. And most people don't feel safe unless they're living fearfully close to the edge of what is possible for them. In the past men worked till they dropped dead in their 40s to keep their families alive through the winter; women had baby after baby until they died or couldn't otherwise cope.

The strange thing is that, absent those harsh historical conditions, people still want the feeling of an edge, an existential risk. So they gamble, they do drugs, etc.

But these aren't good edges to be on. There are many real, urgent problems the world faces that could benefit from obsessive, risk-seeking commitment to the 'crazy unknown'. Addiction-level commitment. It shouldn't have to be to drugs. How do we funnel ourselves towards these problems?

And once you're in the throes of addiction from smoking it, I'm guessing injection seems less and less objectionable.

Heroin, tried once, is not instantly addictive for most people.

Terrifying stuff. I've had a run-in with it myself, when someone slipped me a cut pill of molly, in my younger or dancing-at-parties days lo these many years ago; luckily I had friends there who realized something was up and looked out for me, or almost missing a flight the next morning would no doubt have been far from the worst consequence. I've never had the urge to go back to that particular well, but what I remember of the experience makes it easy to understand why someone would; there is that about it which, while under its influence, makes it impossible for the world to touch one in any meaningful way. Of course, when not under its influence, the opposite is true and very emphatically so, which I think is in large part what keeps people going back even when they're as dedicated as they can be to the goal of kicking.

Natural. Selection.

Drugs have always been cut. Historically it was just cut with OTCs or detritus, which was a problem that could be solved in most cases by simply doing more.

The problem as of late has become when they lace it with things like fentanyl, which is a cheap filler that actually improves the high (thus encouraging repeat business) but can be lethal in large doses.

Well, until you get a more pure batch and you try to do the same amount you do with the dilute batch.

I lost a relative to drug abuse. I think one of the reasons they got into it was she they were very intolerant to boredom and just scoffed at everything. Nothing was serious, everything got a do over.

If a chemist is reading this, I would love your imput. I was under the assumption fentynl complicated to produce.

That said, my wish is the government would provide generic bupenorpine to any person that wants the drug. It needs to be easily available to anyone. No b.s., just give out the drug. Save all the drama. Give them a long half life drug that will get them off the hard stuff. Let them taper off the bupenorpine when they see fit.

Now--they will say the addict needs counseling, nalaxone, and blah, blah, blah.

Just give out generous bupenorpine. It has a long half life, and you have to be determined to overdose on it.

I will be shocked if anything is done for most addicts.

Hell--when my psychiatrist retires, I honestly don't know what I'm going to do. I'm on two very controlled substances, and so tired of hearing the experts opinion, and their outlandish prices.

So yes, we will see commercials, etc., but just give out bupenorpine. Most addicts don't need extensive counseling--I believe. They are just afraid of widhdrawls. Withdrawals that might be less severe than they imagine?

Imported from China. Wasn't regulated at all there until recently, then the producers started messing with the formula.

Fund recovery centers and programs to rehabilitate users and provide them with ongoing assistance so they can get by and stop using. Most addicts who come out of prison say this because they know they will immediately relapse.

I'm sorry, but we don't have to give spaces for people to be hateful - Reddit banning those assholes was the highlight of my week. I'm not trying to claim that these people should just be ignored, but you're conflating very separate problems.

More importantly, the people being affected by the opioid crisis are predominantly not members of these hateful groups, and I'm pretty frustrated you would conflate them in such a way just so you can have an excuse to talk about the loss of a safe space for hateful rhetoric.

*EDIT: After rereading what the poster wrote a few times, I believe they were attempting to claim that the subreddit bans would encourage more people to head to drug use, rather than vice-versa as I originally interpreted it - it's still pretty off-topic though, and again I'm not very sympathetic to people being sad they no longer have a place to be hateful.

If so, edit your comment to [removed] and I'll delete this one.

Otherwise, I can try to explain my original motives, and what I observed. But it's a tricky conversation to have, and there's a high chance people's tendency to instantly turn to hatred will focus on me. I'd rather pass.

Two days ago, I saw you post something asinine and I tried to respond. You deleted your comment before I could hit the reply button, and I lost the opportunity to quote and refute you.

If this is a recurring problem (that you change your mind about statements on a public forum), think a bit more before posting.

Edit: See what I did there, bud?

You're posting about an accusation you can't even remember with incomplete information and out of context. That's like a trifecta of incivility.

If you can't remember exactly what I did, maybe don't spin a half-told version of it?

The reason I backed out of this subthread is very simple: the first few replies were vaguely insinuating I might somehow be sympathetic to neonazis. That was enough for me to hit the "forget this" button.

Please stop being so defensive. People dog-piled on you because they thought you said something dumb. They're not being "hateful" or "violent". Those words have meanings, and their meanings are actually directly related to why Reddit banned those subreddits. If you can't tell the difference between me saying "Yo your opinion is dumb and here's why" and "You're black you need to leave" then just wow, you may need to take a step away from the Internet for awhile.

I brought up Neo-Nazis and the Alt-Right because they were the main ones affected by the Reddit bans and your comment did not do enough to distance whatever you were talking about from them. Also, the Alt-Right had a large overlap with the subreddits you do seem to be talking about.

If you want to have a conversation about such a thing, I'm happy to engage over private message. But you bringing it up was so tangental, so unrelated, and so odd that I could not resist calling you out on it.

But again, it was just so out of place in a discussion where people are talking about the opioid crisis. The argument you're trying to make is horribly tangental and out of place.

To be especially frank: people are reacting to you so negatively because your comments are completely unrelated and showed an intense desire to discuss the subreddit bans. When we called you out on this, you got extraordinarily defensive and realized the conversation wasn't going to go your way. So you backed down. Welcome to intellectual discourse. If you don't feel confident defending your opinions in such a space...well maybe they're not opinions that you can defend very well.

The point of HN is to be a search for the truth among colleagues, not a verbal barfight. The fact that you wanted to get into one immediately says a lot about both sides of the conversation.

your comment did not do enough to distance whatever you were talking about from them

You didn't even briefly pause to question whether I might be associated with them. Why should I need to distance myself from them when I'm merely talking about them? The causal linkage is backwards here.

Maybe you feel bad about reacting so harshly and are now backpedaling. Either way, you shouldn't get to force the conversation into a private message:

If you want to have a conversation about such a thing, I'm happy to engage over private message. But you bringing it up was so tangental, so unrelated, and so odd that I could not resist calling you out on it.

If I bring up a topic substantively, honestly, and in a way that's a search for the truth, it shouldn't matter whether it's done in public or in private.

Other people are indeed wrong sometimes. But this sort of argumentativeness is no better than what you're criticizing, and at its worst crosses into bullying, though I'm sure unintentionally.

"Black people are stupid, we need a white ethno-state" is hatred.

"You're wrong and your ideas are wrong" isn't hatred.

Calling people out on bad ideas is a necessary part of the discussion, to weed out bad ideas.

I get the feeling this is one of the things that no one wants to discuss, or at least it's a bad idea to try to discuss it.

Note how violent and immediate the reaction was, right when I tried to point to a segment of people who are the most likely to be in the target segment of the original article. I don't feel like martyring myself, so I won't push it further. But suffice to say, it does not seem like we as a society are ready to have hard conversations about why people turn to drugs.

You attempted to claim that such overdoses are in part due to Reddit (and society in general) ostracizing neo-nazis and members of hateful groups. Not only is this just wrong, it implies that many affected by the crisis are members of such groups, which they are not (as someone who has a family member addicted to opioids I'm very annoyed by your comparison).

You just wanted to talk about your Neo-Nazi subreddits getting taken away and people called you out on it. Frankly, a Neo-nazi should be an outcast. A racist, sexist, etc should be excluded. And if they don't like that, then they should stop being a Nazi before turning to drugs.

My point was solely "A certain subreddit got banned. Those people seem to have very few options, and maybe they were using it as a support group. They might turn to drugs now."

The reaction violent and immediate: within 5 minutes of posting the comment, you're now trying to imply some very strange things about me. You're even going so far as to "clarify" things for readers by posting something I did not say.

I'd like to end this conversation, because HN is optimized for good conversation and this isn't heading anywhere productive. Agreed?

I have a family member affected by a similar crisis, though thankfully not quite as intense. I'm sorry that the comparison annoyed you, but I was just searching for answers.

"We need to kick you out of the country" is a violent reaction.

"What are you talking about this is dumb" is not a violent reaction.

You shared your ideas, they obviously weren't taken as good ideas by the group here, and people told you so.

No one called for violence against you, no one called you names (as far as I can tell), just no one agreed with you, and maybe a liiiiittle discourteously.

That's not violence, that's discussion.

I'm not upset about mere disagreement. I'm upset that I was searching openly and honestly for an answer to this crisis that affects all of us, and in exchange I was labeled a neonazi sympathizer. On HN of all places.

The conversation shouldn't be about me and my ideas. That's selfish and counterproductive to HN's aims. The goal is to gratify intellectual curiosity, and the subthread I started here is the opposite of that.

HN isn't a place for ideological battle. The fact that two members of the community decided to immediately call out my bullshit suggests that HN wasn't the appropriate venue for this conversation.

And you've posted you figured it would go like this.

Take the hint you are giving yourself: best re-consider what it is you're about to post, given your past experiences.

Sorry to read about your family situation. That said...

There is an entire field dedicated to this. In the spirit of DRY, let's not spin our wheels with hackneyed theories, thinking we'll do better than the individuals that dedicate their lives to rigorously testing hypothesis and formulating therapies.

The question of whether or not your arguments have merit won’t even get entered upon, nor will the authority ever be able to repeat back your arguments in a form you’d recognize—for even repeating the arguments correctly could invite accusations of secretly agreeing with them. Instead, the sole subject of interest will be you: who you think you are, what your motivations were to utter something so divisive and hateful.

Suffice to say, it wasn't too smart to even broach the topic. It derailed the conversation, for one. For two, it didn't lead anywhere productive.

These are the guys who were elevating Elliot Roger (UCSB killer) to hero status, no?

That's a weak hypothesis not supported by evidence, so it was stupid to bring it up. But given their situation, it didn't seem too far from the truth.

Honestly I wish you hadn't removed your post cause now there isn't any context for understanding all these replies. I'm curious about how close your hypothesis is to mine:

I think the fact that young, white men are finding "solace" in opiods, neo-nazi and other fringe groups (including incels) may share a root cause in being brought up with unrealistic expectations of the world (sense of entitlement) and feelings of failure/disappointment with their current position in a post-recession reality.

I also have no evidence, just an intuition born of reading various things and seeing some people close to me grow up and end up in rehab... no one close to me has died, thankfully.

Anyways, the same intuition leads me to believe you probably made your comment in good faith and if that's true, I hope this community response doesn't discourage you from speaking your mind in the future.

Unpopular speech made in good faith is far better than popular speech in bad faith.

Anyone that gets on drugs b/c their forum is shutoff/blocked has deeper addiction problems. And sitting on Reddit all day being angry isn't helping. It's just avoiding the underlying problem.

Oh my god. I bet you had to stifle tears at this point. It sounds like something you would see in a movie, with the last cut of the scene slowly bringing the bracelet into focus just long enough for you to realize why he was wearing it.