it also shows how the average Doctor, nurse, hospitals and the FDA were complicit in that colossal mess
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I don't have any podcast recommendations. The Hulu "Dopesick" series is based on the book, I believe.
bigbill: In undoing of the opioid crisis, at least in the book, "Dopesick" doctor's were advised and began reducing opioid prescriptions for routine pain (tooth extractions etc.) from 30 day supplies to 3 days. Less potential for addiction and fewer pills to sell to addicts.
theflashunc is correct: the book "Dopesick" lays out the multiple factors contributing to the crisis. The causes are numerous, and the solutions are not singular. And they all interact.
I think a lot of what happens also is that homeless people are going to move if they encounter stiff resistance from one community and there's another community down the road that's quite a bit more permissive.
It isn't dissimilar from local gun laws being viewed as ineffective. Yeah, there are a lot of hand guns in Chicago despite the restrictions with purchasing one inside the city...but it's pretty easy to get across the border into Indiana.
I'd agree with this. I think a lot of cities have taken on harm reduction policies like not pursuing charges for simple possession, running needle exchanges or methadone clinics, have paramedics equipped with naloxone, etc. but simply don't have the resources for the kinds of drug rehab and community reinvestment programs they need to really put a dent in the issue. Still, keeping people from dying I think is a good first step.
The unfortunate downside to fewer pills being prescribed is that it drives up the price of second hand pills. That encourages those already addicted to shift from pharmacy sourced dope that if nothing else is consistent in quality and dose to street drugs that vary dramatically in potency. Addicts are very "practical" people when it comes to feeding their addiction.
It's a tough balance to find. Relatively few addicts just start out with heroin. When the pills were readily available you had guys grabbing a handful at a party to let loose and a percentage of that group would eventually end up as long term users. But by cracking down on the supply you'll reduce the number of future addicts at the expense of forcing current addicts into a much more dangerous situation.
I still think that at the core, an awful lot of people just aren't satisfied with their lives and (initially) drugs are seen as a low cost way to escape reality for a bit. I don't know what the solution is but in all kinds of communities I'm seeing the same trend: people from all classes, political leanings, and backgrounds are getting into serious substance abuse issues and causing problems for those around them. I know a couple posters have called out "progressive cities" for being a problem but let me tell you, the rural and conservative community my grandma lives in has all the same issues. Well, maybe not homelessness since there are enough abandoned houses that no one is going to sleep on the street.
As a side note, I had a perscription for vicodin when I was recovering from a collarbone surgery. Maybe it's because my dose was non-recreational but I definitely didn't like the way it made me feel and I certainly didn't enjoy the constipation.
Dispatch from a city set to vote on abolishing its police department in two weeks:
Cities are in a bad spot, but particularly cities on the receiving end of the Second Great Migration that never really integrated socially or economically, like Minneapolis and Chicago.
We have massive inequality; we use heavy-handed police to maintain an unequal peace; the mostly-white ruling class wants the inequality to be maintained without individually owning the methods; and the urban underclass has now begun to exploit polite society's unwillingness to police them.
Where do we go from here?
The mostly-white ruling class just wants crime/inequality/structural racism to quietly go away. They don't want to have to support the police, they just want the police to do the job, like the building janitors that do their work unnoticed between midnight and 4am. Magically, the building and society are clean.
For their part, the police feel vulnerable, marginalized, and culturally disaffected from the urban centers they police. They don't want to be relegated to being cities' janitors; they want not just pay, but also dignity and social respect/position. Their unions are trying to flex on their cities, but the ends are pretty uncertain (see Chicago right now).
And what of the hopeless? They'll do what they can to feel good today, because who knows about tomorrow.
There are ways to alleviate these dynamics, but we aren't willing to own/fund them. One way, the way that's been used for the past 30 years, is a broken windows based surveillance state that gives way to mass incarceration and its aftermath (recidivism, fatherless homes, etcetera). The other is to address the root causes of economic opportunity, mental illness, educational inequality, marital inequality, wealth inequality, etcetera. And we're sure has heck not going to do that, because it would mean leveling society. Downright un'merican.
So if we're not going to police, and we're not going to really address inequality broadly, are cities going to be governable going forward?
The pessimistic side of me says we're headed for another generational cycle of white flight -> urban renewal -> gentrification.
Mine was for the appendectomy which was really painful for about 3-4 days afterward. Just the first night with the Vicodin then I switched to straight Tylenol to avoid the side effects. The thought of constipation after abdominal surgery made the switch much easier. I need to find a place locally to dispose of the remaining pills. My son's opioid pain killer from his broken arm surgery is in the pantry as well.
My ex took opioids if she could get them prescribed or get them from someone. I had Vicodin after my back surgery but tried my best to just use Tylenol. Day three after surgery I did a little too much and was in so much pain I couldn't sleep. My Vicodin were all gone. I have my son's leftover meds to keep them away from his mom.
The collarbone actually didn't hurt before surgery. but it was a big incision. Once the nerve block wore off in the evening it felt like I was being stabbed. I was on vicodin for the next day and a half. Just long enough to get my digestive tract in a tizzy. fortunately the pain subsided quickly.
my local police department has an unused medication collection box in their lobby. it's a converted USPS metal box. Skookum enough to keep out even the most desperate pill addled criminal. I dropped the pills off pretty quickly because I just wanted them out of the house. It's less common in my neighborhood than where my parents live, but it isn't unheard of for someone to break into a house looking for meds.
Your local police department has a prescription drug drop box, as do many police departments. Take a bike ride down there and drop them off.
I spent significant time this year with two recovering(ered) meth addicts. Six weeks working in Yamhill, OR alongside a guy who was on the street at nine, addicted to meth by late teens, then five years in prison for smuggling during which he got sober. Working with him was a daily challenge because I had no idea who I would encounter. But I figured it out well enough that my work wasn't affected. The other is the brother of a friend, whose life is proscribed by her care of him. He is super-bright, and in many ways normal- at least to my eye no more weird than many- and functional. He got clean by hiking the PCT two years ago solo, but addiction is a constant problem for him. The stories are comical if you aren't at the receiving end: my friends came home one night to find three hookers wanting to be paid in their apartment, and Peter apologetic. Etc.
I lived in NYC for 27 years, and the crack epidemic was as devastating as AIDS in many ways. Talk about an equal opportunity employer. Two guys on my skating team hit the streets hard. Gifted athletes.
Oregon was strange to me. Weed culture there is so much more pervasive than here in Western MA. I hope we are not headed in that direction. The people I was working for and with were such huge consumers, hitting the bong at breakfast and going all day. Then there were days off when it got even more strange.
An article in the Times about the Squid Game prompted many comments of people who talked about the rage they felt which was ameliorated by watching the show. Six hundred million guns in this country. Oh boy.
Year over year we are going to see change on an unprecedented scale, I'm afraid.
My wife won't get vaccinated. I am so glad we don't live together any more. Visiting friends a week ago they told me they've never seen me like this. "It's like you had a toothache and now you don't." I never took meds. My doctor tells me I have an exceptionally high pain threshold. Thank you cycling. You learn to suck it up and suffer.
I need to check that out. I have new stuff and old stuff around the house from various events. I have a bottle of stuff they said I'd need during radiation for larynx cancer so I could swallow food but they said I wouldn't be able to taste the food so many nights were "Hey this is good" shortly followed by 'Ow, son of a bitch." Better that way.
The whole P2P is new? Choctaw Bingo, James McMurtry... "he likes the money, don't mind the smell..."
It's easy to not have homeless camps when a city/suburb can simply push the problem to the metro center. The surveys show that the vast majority of the homeless camping in seattle are not from the city of seattle. They may be from 5 miles away, or 1000 miles. A city with 350,000 households is then paying the costs for people nomadically moving to the best benefits they can find. I don't mind paying, I simply wish to pay my share.
True story: I do a lot of work with local police departments. In the adjacent town, the police chief was against having a drug drop box located at the police station; an article about the drop boxes, with the chief's opinion, was in the newspaper.
So I go to the PD one day to service the chief's car shortly after the article was written. I was outside with the police captain and I joked to him that we should put all the prescription meds in the chief's trunk instead of a drop box. The captain about died laughing!
When I underwent surgery for a broken femur after a bad bike crash (please skip the experiment and trust me when I tell you the car always wins), opiods so scared me that all I took was ibuprofen. That was with a titanium rod in my leg. I assume before the actual surgery there was something magic in my saline drip, but when the choice was mine I chose the nonnarcotic option.
Everything is so much closer in a city. It kind of makes economic sense if you're going to be very down on your luck (for whatever reason) to be nearer to various resources if possible. In addition, larger locales have enough more services of various kinds (even if they are badly overburdened) that the odds of finding a bed or getting into a rehab program are going to be higher.
Of course. It's more of a payment question, whether it is fair that if you live on 144th avenue you pay for the services for people arriving from around the country but you don't have to pay if you live on 146th avenue? Is it fair that those in the city are burdened by tents, crime, violence, inability to use parks because of needles, and those who live 100 miles away or 1000 miles away do not have these burdens because their homeless moved to the city (sometimes with the assistance of the sending town's officials)?
It's a matter of math. 350,000 households in Seattle cannot afford to support those moving from elsewhere in the state (8 million people) or the country (330 million people). If the residents are forced to pay for the nomadic, then the residents will move and the cities will look like they did in the 1970s, hollowed out and crumbling. Making a few warm cities the dumping ground is not the solution.