Opiods crisis podcast

[Liberty]

Not sure if this should go in politics or general, but I'm putting it here...

 

The Daily: Friday, Oct. 27, 2017

https://overcast.fm/+H9d41OyWw

 

"The opioid crisis in the United States now rivals the Vietnam War in terms of how many Americans have been killed."

[DTEJD1997]

Here in Michigan, the opiod crisis is pretty bad...

 

There are beggars almost everywhere....seemingly able bodied people, people of all races.

 

The other day, I was approached by a woman with a small child, maybe 5-6 years old.  That was the first time that has every happened.

 

Some areas are worse than others...but there are beggars in relatively affluent suburbs now.  I've seen them and have been approached in Troy, St. Clair Shores, even the Grosse Pointe/Detroit border.

 

I've even been approached in sit down restaurants, fast food, Home Depot, Lowes, Wal-Mart, Casinos, Grocery stores.  On the street, some intersections have beggars on every corner.  The end of the off ramp coming off freeways is also a popular spot to steak out.

 

When I was a child/young man, there were beggars about.  Most of them were in Detroit.  Most of them were older, infirm, crippled, or had obvious problems.

 

Now, there are white women (young, middle aged, elderly), black women, white men (20's & 30's even), black men.  Almost everybody is begging now.  It was very rare to see this 35 or 40 years ago.

 

I would wager a large amount of money that the majority of these beggars are on drugs, heroin most likely.

 

Very sad.

 

[Cigarbutt]

Very sad topic and, in a way, difficult to link with a specific investment thesis.

For those interested,

https://en.wikipedia.org/wiki/Opioid_epidemic

 

Recently, the #1 cause of fatalities in the US for younger people has become drug overdose (mostly from "prescribed opioids") over car accidents...

 

Heroin remains a huge problem but is dwarfed now by "prescribed" opioids.

 

The problem is rooted in poverty. Unlikely to be a direct or indirect problem for participants on this board but, if you have a minute, just look for reports on pill mills. Cities and also rural areas. Not only in flyover country. A depressing fact is that the potential "solutions" still appear elusive.

 

https://www.theguardian.com/society/ng-interactive/2016/may/25/opioid-epidemic-overdose-deaths-map

 

And now fentanyl is starting to make its way into statistics.

 

[LC]

The truly sad part is as you say: the opiod epidemic is rooted in poverty.

 

So poverty is the root issue, and how to deal with it is very complicated. We have a society with extreme income and wealth disparity.

[rb]

Sadly it's not confined to the states. I also don't know if it has to do with poverty. Maybe poverty makes it worse without being the root cause.

 

I was driving today and heard on the radio that in Abbotsford BC 5 people died of opioid overdoses within 9 hours. Abbotsford is city of 140,000 people and an outer suburb of Vancouver. Fairly low unemployment, prosperous, high property values. Age range of people who died 40-67. So not dumb kids either.

 

I'll admit that there's a lot of bullshit out there when it comes to drugs. When there was a crack problem it was about thugs and criminals. Now that white people are involved it's an epidemic. Frankly I don't really care about the semantics as long as people get off their ass and do something. But I think that it helps to understand that drugs do not discriminate, they affect rich and boor, black and white just the same. The poor and the black are more likely to get caught with the drugs. But all demographics are just as likely to die from them.

[Cigarbutt]

Haven't been to Vancouver for some time but many stories coming from Vancouver Eastside.

Demographics vary but doubt that the crisis there is due to neighborhood gentrification.

 

[rb]

Haven't been to Vancouver for some time but many stories coming from Vancouver Eastside.

Demographics vary but doubt that the crisis there is due to neighborhood gentrification.

Oh I don't think that the cause to the deaths i referenced is due to gentrification. They were all middle aged to senior in a solidly middle class community. Both men and women. I'd say the cause is more bland. The old, get injured, get prescribed opioids paid for by your drug plan, get addicted, get more opioids/smack, take too many maybe with a side of fentanyl, die.

[Cigarbutt]

Understand your anecdote better now.

I understand that, often, there is a trigger like an injury or a separation.

A frequent offender is job loss.

[DTEJD1997]

Hey all:

 

Word on the street is that heroin is MUCH cheaper than vicodin and other "pain pills".

 

It is my understanding that a lot of people have an injury/problem and are prescribed pain pills.  The doctor takes them off eventually, but the people still want them.  They fool around buying illegal pills for a while...but that is VERY expensive.  Their supplier/pusher then suggest heroin which is cheaper/easier to get.

 

They are hooked, it is all downhill from there.

[Cigarbutt]

Thrown in for some controversy.

 

http://www.npr.org/2015/05/19/404184355/how-heroin-made-its-way-from-rural-mexico-to-small-town-america

 

Whatever the origin, "it's a tough situation we've kind of painted ourselves into."

 

http://www.dw.com/en/rust-belt-democrats-inspired-by-donald-trump/a-36251984

 

From steel mills to pill mills.

 

The "recovery" since the Great Recession has indeed been unequal.

 

[Liberty]

Hey all:

 

Word on the street is that heroin is MUCH cheaper than vicodin and other "pain pills".

 

It is my understanding that a lot of people have an injury/problem and are prescribed pain pills.  The doctor takes them off eventually, but the people still want them.  They fool around buying illegal pills for a while...but that is VERY expensive.  Their supplier/pusher then suggest heroin which is cheaper/easier to get.

 

They are hooked, it is all downhill from there.

 

The interviewee in the podcast confirms this. They used to get pills form Florida where they weren't tracked well. Then that got tightened, so the lower supply led to the street price of pills going up a lot. Many addicts switched over to heroin...

[Cigarbutt]

Stats:

https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates

 

 

[rukawa]

The truly sad part is as you say: the opiod epidemic is rooted in poverty.

 

So poverty is the root issue, and how to deal with it is very complicated. We have a society with extreme income and wealth disparity.

 

Not sure why poverty is assumed to be the root cause. China for instance has growing rates of drug addiction despite massive reductions in poverty. In fact their heroin epidemic in the 1990 coincided with the exact time when there were large reductions in poverty.

 

http://www.aljazeera.com/indepth/features/2016/05/china-opium-wars-battling-addiction-beijing-160516141819379.html

 

If you really believe poverty is the driver of drug use then this would imply that drug use should have massively decreased throughout the western world as poverty rates declined post WW2. It also implies drug use should be declining throughout Asia (China, HK, Singapore, Vietnam) through the 90's to today. I'm not sure that is the case.

 

It seems to me that drug use is very cultural. In the 1920's they used to put cocaine in Coke and a 10 year old could go to a pharmacist and purchase a pound of cocaine. The reason it wasn't a problem was at that time alcohol was the drug of choice. Today marijuana is becoming a drug of choice. In the 1980's cocaine and coke were drugs of choice. These things come in waves.

 

I often go to EDM clubs and I can tell you drug use is rampant. Its just part of the sub-culture. People who go to EDM clubs are NOT poor.

 

The vast majority of drug users never become addicts. There are plenty of people who take heroine, cocaine and marijuana and don't have problems. Addiction is really a matter of psychology. There are many addicts who don't want to change. You won't reach them.

 

In the end I think the only thing you can do is make treatment programs available to the people who do want to quit. I've heard good things about Portugal.

[gfp]

There are plenty of people who take heroine, [...] and don't have problems

 

Do you know any?  I have not witnessed this particular drug being used problem-free.  I have known many cocaine and marijuana users who were very successful in multiple aspects of their lives.  I have never known a Heroin user who didn't go downhill fast.

[LC]

The truly sad part is as you say: the opiod epidemic is rooted in poverty.

 

So poverty is the root issue, and how to deal with it is very complicated. We have a society with extreme income and wealth disparity.

 

Not sure why poverty is assumed to be the root cause. China for instance has growing rates of drug addiction despite massive reductions in poverty. In fact their heroin epidemic in the 1990 coincided with the exact time when there were large reductions in poverty.

 

...

 

In the end I think the only thing you can do is make treatment programs available to the people who do want to quit. I've heard good things about Portugal.

 

That's true, and it's weird. In the US, most studies claim a clear link between poverty and drug use. However the UN's world drug and crime report shows that drug use is essentially a rich person's luxury - the highest income bracket had the highest drug use. To be fair I didn't go really in depth and figure out what the definition of high income of a US study vs. an International study would be.

 

But regardless - I agree on your last (and the most important) point. It's easier to stop someone from murdering (put them in jail) than to stop a drug addict.

[boilermaker75]

There are plenty of people who take heroine, [...] and don't have problems

 

Do you know any?  I have not witnessed this particular drug being used problem-free.  I have known many cocaine and marijuana users who were very successful in multiple aspects of their lives.  I have never known a Heroin user who didn't go downhill fast.

 

That was my understanding, that heroin causes permanent chemical imbalances in the brain.

 

"Flying Machines in pieces on the ground."

[gfp]

Sadly, exactly 50% of the heroin users I have known are still living.  Youngest death was 19, a close friend's younger sister.

 

There are plenty of people who take heroine, [...] and don't have problems

 

Do you know any?  I have not witnessed this particular drug being used problem-free.  I have known many cocaine and marijuana users who were very successful in multiple aspects of their lives.  I have never known a Heroin user who didn't go downhill fast.

 

That was my understanding, that heroin causes permanent chemical imbalances in the brain.

 

"Flying Machines in pieces on the ground."

[rukawa]

Do you know any?  I have not witnessed this particular drug being used problem-free.  I have known many cocaine and marijuana users who were very successful in multiple aspects of their lives.  I have never known a Heroin user who didn't go downhill fast.

 

Not personally. But the Vietnam War can be considered a large scale experiment on what happens when large numbers of people use heroin for a considerable period of time. 20 of Vietnam War Vet were addicted to heroin. When they came back only 5% of the 20% were readdicted. Only 1/20th of the Vietnam War addicts were not able to get rid of their addiction.

 

https://jamesclear.com/heroin-habits

 

Surveys on all drugs including heroin end up seeing the same statistics: you get about 10 times the number who have tried the drug or even are have causually used it for an extended period of time compared to the people who become hardcore users. Basically hard core users are on the order of 1/10th of casual drug users.

 

 

[rukawa]

That was my understanding, that heroin causes permanent chemical imbalances in the brain.

 

"Flying Machines in pieces on the ground."

 

So are you saying that you can distinguish a heroin addicted brain from a non-heroin addicted brain by looking at it chemically. Any studies that show that this possible?

[rukawa]

There are plenty of people who take heroine, [...] and don't have problems

 

Do you know any?  I have not witnessed this particular drug being used problem-free.  I have known many cocaine and marijuana users who were very successful in multiple aspects of their lives.  I have never known a Heroin user who didn't go downhill fast.

 

Yes this is the typical view. I actually think cocaine, heroin, alcohol and marijuana aren't that different in their addictive properties or even their potential for abuse. And that are ideas about these drugs are mostly informed by prejudices and associations that have nothing to do with the effects of these drugs and more to do with anti-drug propaganda and our culture. At one time marijuana was considered to be very dangerous.

 

Now that isn't to say that some drugs are more likely to cause overdose than other drugs. But the overdose issue is really a separate one and could be resolved by better education. For instance the vast majority of heroin overdoses occur when someone combines heroin with alcohol. The solution is to not combine heroin and alcohol. And I suspect even a drug like fentanyl could be consumed safely if it was appropriately prepared. We could probably stop the majority of overdose deaths by legalizing the drugs and developing ways to ensure proper dose. I don't even think it would be that difficult.

 

Almost all this policy is based on a lot of very irrational thinking, fears and prejudice.

[boilermaker75]

That was my understanding, that heroin causes permanent chemical imbalances in the brain.

 

"Flying Machines in pieces on the ground."

 

So are you saying that you can distinguish a heroin addicted brain from a non-heroin addicted brain by looking at it chemically. Any studies that show that this possible?

 

https://www.drugabuse.gov/publications/research-reports/heroin/what-are-long-term-effects-heroin-use

[gfp]

So just to clarify - you are saying that you know people using heroin in moderation whose lives are continuing on productively?  And you are saying that opiates and heroin specifically are no more addictive than cocaine and marijuana?

 

 

There are plenty of people who take heroine, [...] and don't have problems

 

Do you know any?  I have not witnessed this particular drug being used problem-free.  I have known many cocaine and marijuana users who were very successful in multiple aspects of their lives.  I have never known a Heroin user who didn't go downhill fast.

 

Yes this is the typical view. I actually think cocaine, heroin, alcohol and marijuana aren't that different in their addictive properties or even their potential for abuse. And that are ideas about these drugs are mostly informed by prejudices and associations that have nothing to do with the effects of these drugs and more to do with anti-drug propaganda and our culture. At one time marijuana was considered to be very dangerous.

 

Now that isn't to say that some drugs are more likely to cause overdose than other drugs. But the overdose issue is really a separate one and could be resolved by better education. For instance the vast majority of heroin overdoses occur when someone combines heroin with alcohol. The solution is to not combine heroin and alcohol. And I suspect even a drug like fentanyl could be consumed safely if it was appropriately prepared. We could probably stop the majority of overdose deaths by legalizing the drugs and developing ways to ensure proper dose. I don't even think it would be that difficult.

 

Almost all this policy is based on a lot of very irrational thinking, fears and prejudice.

[Charlie]

Denial plays a major role here.

 

I know some addicted persons with a lot of diseases and they think they are in good health conditions....

 

From my Munger Checklist:

 

Pain-Avoiding Psychological Denial:

The reality is too painful to bear, so one distorts the facts until they become bearable. The tendency’s most

extreme outcomes are usually mixed up with love, death, and chemical dependency. In chemical dependency,

wherein morals usually break down horribly, addicted persons tend to believe that they remain in respectable

condition, with respectable prospects. They thus display an extremely unrealistic denial of reality as they go

deeper and deeper into deterioration.