Anecdotal: I have had many exposures to the illicit drug markets in my areas throughout the years. The symptom of many underlying unresolved issues I am sure, but that is not relevant. What I wish to say is that I have seen many pressed counterfeit tablets in my lifetime and have had the luxury and wherewithal to test a majority of them before usage. I have personally never identified fentanyl in a product that was not marketed as an opioid. With illicitly manufactured oxycontin and its ilk you will come across it a majority of the time. But with other things such as MDMA, ketamine and such it's incredibly rare to see. That is not to say it doesn't happen however, there have been instances of things containing fentanyl which had no business doing so. Despite this I echo GP's claim that it's largely due to inadvertant cross contamination than it is some intentional reason. The supply chains for these drugs are very long and windy once they are finalized for consumer use inside the US as well, with many middlemen making a few dollars to facilitate a transaction. Each of those hand-offs is one more opportunity for the new seller to say "I bought X, but could sell much more if I said it was Y", and that ends up killing people occasionally too.
Hypothesis: There is a number of factors at play here that add to the death toll. There is the occasional unintended cross contamination during production. It's also worth noting that individuals who import bulk drugs from overseas for their own sales often order multiple different substances and craft them for sale, further increasing the chance for that contamination during production. There is the fact that fentanyl and a majority of it's analogues are active at shockingly low doses relative to more classical opioids, which makes improper distribution of active ingredients into the final pill mixture highly likely when you consider they are usually not created with the best quality control procedures or equipment. There is the fact that younger users (I would argue they are more experimenters than users per se) of opioid drugs have less physical tolerance to these chemicals. We should also consider that youths also have less practical experience, and not knowing the "lay of the land" with these substances can kill you very easily. And then of course the obvious increase in the average American's listlissness, hopelessness, economic uncertainty, fear of the future and so on. The ground under our feet is shifting and drugs are a temporary respite from that, if harmful long term.
Add to this the fact that we have a very drugs-illiberal society on the whole, whose governments oftentimes think the best way to address this problem is simply banning substances or once in a while executing operations to damage the supply chain, while completely avoiding the idea that perhaps most usage of these substances is symptomatic of a problem and not the problem itself? And you end up with an firehose of drug analogues that can escape easy regulation and restriction juuuuust long enough to gain a foothold in the market and shift the consumer culture of a particular drug. It's not a problem you can legislate your way out of, and it never will be.
All of this is to say I expect US overdoses per capita, the "never-before-seenness" (and by extension lack of medical knowledge surrounding it) of the drug analogues on the market, and the overall appetite for drugs of dependency, all to continue increasing for the forseeable future. I wish it wasn't this way. But like most of the US' modern cultural issues we enjoy arguing about what could offer relief far more than we do finding a bipartisan way to address them.
> With illicitly manufactured oxycontin and its ilk you will come across it a majority of the time. But with other things such as MDMA, ketamine and such it's incredibly rare to see
To anyone reading: Please don't take this at face value. The article itself has a story of someone who OD'ed on fentanyl that was present in their "xanax".
From reading the results from the harm reduction tent at a nearby music festival it's in all the drugs, not just opiates
That is absolutely horrific. I cannot fathom what reasons would compel someone to sell product tainted that way. Especially at a music festival; most of those consumers know their drugs and I imagine would not be the market at which to try selling that kind of shit. The long term money, customer base and word of mouth all benefit more from having non-opiate products sans fentanyl. Even if you're just trying to make a few grand at a music festival. hell, a hit and run business at a music festival with totally inactive products seems a better option than something like dumping fentanyl into (counterfeit) xanax bars.
And yeah, don't take what I say at face value. I'm a nobody on the internet with one story out of billions. Test everything. Every single time.
Just too drive home this point a little deeper. I personally know 2 people who died last year from fentanyl poisoning. One of them thought they were taking MDMA, the other thought they were taking Xanax. Both are terrible, needless deaths but the one who was taking Xanax had actually been prescribed Xanax previously for GAD, but was having trouble getting/affording a doctor to prescribe it to them.
I offer as many condolences to you as my internet connection can carry. Reading that you lost someone who was merely trying to take care of themselves really, really hurts.
I graduated high school in the mid 00's. When I last ran the numbers in 2018, my graduating class of ~250 had lost roughly 4% of its people over the years due to OD.
I deeply want this set of problems to get better, but I cannot convince myself that it will during my lifetime.
The person selling drugs at a festival is extremely far removed from the illicit manufacturer. They almost certainly have no idea the quality of drugs they sell or what’s really in them.
When it comes to festivals, the persons walking about selling hand to hand are some distance removed, the person who decided to sell at Glastonbury (for example) or other festivals aquired supply by the van load, acquired a crew of runners, pushed back against others wanting target the same festival, and is considerably closer to the upstream source and has a damn good idea of the quality of the bulk amount they sourced for that market.
> But like most of the US' modern cultural issues we enjoy arguing about what could offer relief far more than we do finding a bipartisan way to address them.
Puzzling over how we reach bipartisan without ever getting to the agreement part.
Of the (generally) many things those specific types of consumers are ignorant about, their own ignorance is usually one of them.
Whereas I read "Unsatisfied! I did not read the listing!", they feel they wrote "Unsatisfied! Seller did not explain the item in the listing!" to the benefit of the other consumers in their same category. In a perverse way I could see it actually curbing those unwanted purchases in the future, but sadly at the expense of the seller.
We come from similar eras. I never made the transition to 7, permanently moving to ubuntu 5.10 thanks to the CDs they sent out in the mail. Ubuntu for over a decade until late 2020, then arch and arch-likes since
Just a couple weeks ago I was backing up some scripts and adding some arcane linux lore to my obsidian database when it occurred to me that I haven't re-installed my OS in 2.5 years. That felt pretty wild to think about, especially when I consider all the scripts, packages and late night pamac hammering I occasionally do when I find a curious piece of software. While I tinkere with my linux installs far more than windows, they seem to have held up over time far better. Whether this is a consequence of the software itself, my behavior changing, or whatever, I cannot say for sure. But it's been a far more pleasurable experience using and maintaining my linux systems than windows installs.
I think there is a distinct difference between people who compute for the sake of computing versus people who compute as the means to an end. One is a person who uses tools at least partially for the joy of tool usage itself, while the other a person who uses tools to complete tasks, the other . I cannot fault the latter for just using whatever works, if they are happy in doing so. But I think those of us who fit into the former category are far more likely to engage with linux and its brethren. My computer is a machine which, largely, I demand does what I instruct it to do. I prefer an OS that will do so and then get out of my way and I will accept idiosyncracies in exchange for this. So long as a laundry list of dependencies doesn't explode overnight from a goofball update or my nvidia drivers don't just disappear because they feel like it, linux meets those needs very well.
The enzyme responsible is CYP1A2 if I understand correctly. Here is the paper I found that supports increased risk of a specific cardiac event to slow metabolizers. I'm not the most adept at reading medical papers so I can't verify if it claims the risk is doubled, but I think it's possible.
Coffee, CYP1A2 Genotype, and Risk of Myocardial Infarction
Marilyn C. Cornelis, BSc; Ahmed El-Sohemy, PhD; Edmond K. Kabagambe, PhD; et al Hannia Campos, PhD
JAMA. 2006;295(10):1135-1141. doi:10.1001/jama.295.10.1135
I too have had pretty good experiences with motorola lately. In early '21 I wanted a decent and metaphorically disposable phone so I got an unlocked moto G play from the local Target. I expected it to, like seemingly all others, have a locked bootloader and/or completely prevent root access. But I was pleasantly surprised! With a visit to motorola's website IMEI in hand and a couple hours of pulling up XDA pages (like the good old days) I had my device the way I wanted it.
It would be nice if mine didn't ship with the amount of bloatware that it did given that I couldn't find a replacement ROM at the time. But after some filesystem scouring and ADB commands it was cleaned up enough for me.
When I end up needing another new phone I'll likely hunt down another motorola, and probably the g100 given your positive experience; thanks for sharing it
Speaking for the US, yes indeed. Loperamide is technically an opioid and available OTC, though that's rarely a sought after compound unless one is in dire straits.
Codeine is available with a pharmacist's approval alone in my state. So while it may not technically OTC by that definition (or is, I don't know how OTC is defined), it can be had without a prescription by visiting a participating pharmacy and simply requesting codeine+guaifenesin. Done it a few times myself.
Codeine + cough syrup is so popular in Texas that it spawned an entire subculture dedicated to its use. See DJ Screw in Houston (https://en.m.wikipedia.org/wiki/DJ_Screw).
Lest you think this is no longer the case - “lean”, as it is known by Houstonites (due to your tendency to lean on things while under the influence) was a major plot point of a recent mostly autobiographical Netflix series centered around Houston that was released late last year: https://www.keranews.org/arts-culture/2022-08-25/houston-ooz...
Vice released an excellent short piece on Houstonian screw & slab culture years back. Might still be on youtube! It was an excellent piece at the time, but I haven't seen it in quite a while.
For clarity, loperamide, sold under the brand name Imodium, is an anti diarrhea medication. It is an opioid; however, it does not readily cross the blood-brain barrier. It only acts on the opioid receptors in the large intestine and slows the movement of food. In very high concentrations it may get into the brain.
"A pharmacist's approval" is a prescription, just one that happens to be written by the same person who fills it. So no, not OTC, which specifically refers to medications you can get without a prescription.
I suspect this is location specific though. In the UK my migraine medication was available over the counter, I still had to have a discussion with the pharmacist every time I bought it. Conversely when ever I've needed an actual prescription medication, in an emergency or whatever, that has always had to go through my doctor to get the prescription sorted.
My go-to pain-relief used to be a product called Codis, which was soluble aspirin+codeine. It used to be available OTC, until about 8 years ago, then it disappeared. You can still buy paracetamol+codeine OTC ("Paracodol?). My understanding is that aspirin causes vasodilation, which causes more rapid absorption of codeine. Supposedly that's why Codis worked better than Paracodol.
I don't know why they took it off the shelves. There was no announcement; it just disappeared.
Codis was effective for both migraines and period pains, as reported to me (I'm not a woman, and I don't suffer from migraines).
This was migraleve it didn't have any painkilling element in the first tablet (it was 2 parts) not much point anyway as by that point I was throwing up.
Well, sure, countries will have their own laws over this or anything. Ours are defined at the federal level and thus apply the same everywhere in the country; since GGP and I are both USian, that's the basis on which I replied. (I don't know enough about any other country's such laws to speak to them!)
I enjoy watching the occasional political twitch/youtube streamer or speaker. I couldn't tell you why; I don't feel that most of them leave me feeling any wiser after the conversations end. But the times I come across positions that I haven't traditionally considered or agreed with being well-stated and expounded upon is really enjoyable and usually makes it worth the minutes or hours burned having it playing lightly in the background. Very much in the spirit of this post, like the author I too enjoy being "wrong" or losing debates. The rush of new insight is thrilling. Vaush and Douglas Murray come to mind as some of the recent ones that have said things I find very compelling.
Not long ago as I was exploring those circles I kept hearing this name repeated. A streamer named Destiny. So I started consuming some of his material. And it was absolutely insufferable. This person treated every single statement as a drawn battle line that is to be defended by every last ounce of mustered anger and blood. No matter how infinitesmal or semantical the focal point of discussion was it was torn apart to shreds. There was no intent to learn, no hoping for new perspectives. It was solely a sport about feeling correct. It was awful to listen to.
I was shocked to see how popular this person is (given their streams and subscribers). Not only because I felt that overall they were a garbage person to have a parasocial relationship with but because if I found him as awful to listen to as I did, surely a large amount of others would feel the same. And while no doubt others feel like me about him, on the other hand I must be neglecting something. There must be a cadre of people that find (arguably) well defended positions thrilling and almost narcotic. I do not associate with many of those types of people in meatspace and I suppose I had slowly forgotten that there's a significant number of them out there.
But yeah, I'm right there with you. I'm here to learn, and there's others that aren't and will knowingly or otherwise prey upon that willingness by digging their heels in on the most miniscule of points. Makes no sense to me. If the only purpose served by me opening my mouth was to convince the world of my correctness, I would just assume everyone else was as obsinate as myself and wouldn't bother to open my mouth in the first place. Save the calories.
Totally agree re. Destiny. Between him, Vaush, Hasan (ugh), and the rest of them, I feel like we’re intellectually stunting an entire generation of teenagers.
I had a friend in NYC who used to read a tonne load of books but now just watches the 3h Hasan stream every day and then parrots every take the video game streamer says as if it’s gospel. I ended up cutting him out of my life because he just grew so tiring to be around; any conversation had to be directed to how idiotic the other side (code for republicans) is. As a non-American, it grew really old hearing rant about how stupid 40% of their fellow countrymen are.
Listening to someone pretend to get angry and punching down on people less educated isn’t intellectually nourishing, it’s reddit prison slop.
What's interesting to me is how I've started to really dislike people in that mindset/space even when they offer points that I agree with. Take Hasan for example. He says a number of things I agree with when I hear them. But the delivery of them is awful, to the point that it corrodes the foundation on which he stands. It's hard for me to accept that you promote a position of shared empowerment and broad equality when you reject a large contingency of people (based solely on their beliefs no less) as borderline sub-human. Those two things don't mesh. I, like him, am often left bewildered by the positions his opponents sometimes take. But that bewilderment is a sign that I'm lacking information and context, not a sign that I'm dealing with a person who isn't to be treated with at least a modicum of respect.
It reminds me of an exchange between Neil Degrasee Tyson and Richard Dawkins in which Neil tells Dawkins that, while he makes good points, perhaps he should soften his delivery? Because it's hard for the realm of science to pull in new defenders when their staunchest proponents are telling its detractors they are imbeciles. And dawkins fires back with [...]"Science is interesting, and if you don't like it, you can fuck off". EDIT: This exchange must have been in the mid 00's? The birth of the Four-Horsemen-of-Atheism era. The absolutist cultural debate position has a rich history.
There's a time and place to cut ties and not waste time interacting with people that disagree with you. Sometimes the right move is to reject an ideology or group outright. But it seems like the modern concept of that time and place is very skewed.
Reads like these streamers are the left-wing equivalent of conservative AM radio and about half of Fox News' air time. Interesting. I didn't know we had those sorts on "our" side (Maddow and such are a bit similar, but the tone's still not quite like a Shapiro or a Levin or even a Limbaugh). But then, I've spent a grand total of maybe 15 minutes on Twitch, ever. I didn't even know there was political commentary on there.
Since those folks (the AM radio / unhinged Fox News guys) have been wildly successful at getting people to vote a certain way and swing rhetoric hard in the direction they promote, I'm torn on whether or not to be upset about this. If it eventually gets us a developed-world healthcare system and typical-in-most-of-the-rest-of-the-OECD worker protections and benefits, I guess I don't care if shitty psychological manipulation is what does it, if the alternative is that we continue not to manage to achieve those for several more decades. It'd be cool if my elementary-aged kids could have some nice things before they're middle-aged—I've only got 30-40 years left, probably, so have given up hope on any of this happening before I'm ancient, but maybe my kids' kids will fully reap the benefits, on the back half of this century.
This is quite interesting, because I find Vaush to be a perfect match for your description: absolutely insufferable debate bro and a hypocrite (the whole "living your values" discussion was very showing).
And Destiny to be a fairly reasonable mostly good-faith debater.
Honestly I will probably use the term Ship of Thaddeus moving forward. It embodies the concept in a way I find deeply funny. I don't know if the author intended to write it that way or not (the uncertainty of which only serving to make it funnier) but I thank them for their contribution to my pool of available humor
I'm right there with you. Google's DeepDream I think?
That first week of DeepDream images flooding the web showed me that someone had snuck a can of worms onto the table, and while they had graciously not opened it immediately, they had maybe cracked the lid just a bit
Anecdotal: I have had many exposures to the illicit drug markets in my areas throughout the years. The symptom of many underlying unresolved issues I am sure, but that is not relevant. What I wish to say is that I have seen many pressed counterfeit tablets in my lifetime and have had the luxury and wherewithal to test a majority of them before usage. I have personally never identified fentanyl in a product that was not marketed as an opioid. With illicitly manufactured oxycontin and its ilk you will come across it a majority of the time. But with other things such as MDMA, ketamine and such it's incredibly rare to see. That is not to say it doesn't happen however, there have been instances of things containing fentanyl which had no business doing so. Despite this I echo GP's claim that it's largely due to inadvertant cross contamination than it is some intentional reason. The supply chains for these drugs are very long and windy once they are finalized for consumer use inside the US as well, with many middlemen making a few dollars to facilitate a transaction. Each of those hand-offs is one more opportunity for the new seller to say "I bought X, but could sell much more if I said it was Y", and that ends up killing people occasionally too.
Hypothesis: There is a number of factors at play here that add to the death toll. There is the occasional unintended cross contamination during production. It's also worth noting that individuals who import bulk drugs from overseas for their own sales often order multiple different substances and craft them for sale, further increasing the chance for that contamination during production. There is the fact that fentanyl and a majority of it's analogues are active at shockingly low doses relative to more classical opioids, which makes improper distribution of active ingredients into the final pill mixture highly likely when you consider they are usually not created with the best quality control procedures or equipment. There is the fact that younger users (I would argue they are more experimenters than users per se) of opioid drugs have less physical tolerance to these chemicals. We should also consider that youths also have less practical experience, and not knowing the "lay of the land" with these substances can kill you very easily. And then of course the obvious increase in the average American's listlissness, hopelessness, economic uncertainty, fear of the future and so on. The ground under our feet is shifting and drugs are a temporary respite from that, if harmful long term.
Add to this the fact that we have a very drugs-illiberal society on the whole, whose governments oftentimes think the best way to address this problem is simply banning substances or once in a while executing operations to damage the supply chain, while completely avoiding the idea that perhaps most usage of these substances is symptomatic of a problem and not the problem itself? And you end up with an firehose of drug analogues that can escape easy regulation and restriction juuuuust long enough to gain a foothold in the market and shift the consumer culture of a particular drug. It's not a problem you can legislate your way out of, and it never will be.
All of this is to say I expect US overdoses per capita, the "never-before-seenness" (and by extension lack of medical knowledge surrounding it) of the drug analogues on the market, and the overall appetite for drugs of dependency, all to continue increasing for the forseeable future. I wish it wasn't this way. But like most of the US' modern cultural issues we enjoy arguing about what could offer relief far more than we do finding a bipartisan way to address them.