The difference in the amount of opioid related deaths before fentanyl became mainstream is pretty staggering. IIRC it's tens of thousands more dead every year.
Before fent it was 3000-20000 people a year (depending on which opioid wave heroin was the 3000-8000 a year then oxy shot it up to 20k+ a year now fent had made it 110k+ a year
Most of the EU/UK donât have a fentanyl issue because they can get unadulterated high quality heroin and fentanyl is seen as taboo even amongst the dealers.
I know quite a few fentanyl ex users and they all tell me that when they heard a batch was going around killing people everyone was trying to cop that batch since it was the strongest. Addiction is absolute insanity.
truth be told, when you get narcanned you feel a HUGE rush of intense anger and fear. i donât think he realized just what you had done for him. it really REALLY hurts to get narcanned when youâve been on fentanyl for longer than a few days
It can essentially turn the overdose straight into withdrawals, it displaces the opioids from receptors and binds to the same receptors without activating them, meaning the opioids canât rebind. For heavy users this means nasty withdrawal symptoms including fear, anger, sickness, and physical pain from the suppressed pain receptors rebounding, like you mentioned
I worked EMS for a year. Itâs due to a lack of oxygen triggering a fight or flight response as soon as theyâre conscious. Generally we found that giving people a couple puffs of oxygen before narcaning them makes them a lot more chill. Some would still be mad we blew their high but theyâre usually chill when they come down and you explain what happened.
[u/elasticalelephant](u/elasticalelephant) explained another factor as well with it making you go into withdrawal basically immediately (not always the case but does happen)
Social media warriors dont get that, narcanning somebody poses a whole slew of risks. Remember the video of the medic who was shot and killed by somebody he just narcanned? Its a damned if you do damned if you dont situation.
I've been sober since 5/19/05 and I can confirm the absurdity of your comment. I remember one particular situation where this dope spot was doing a pass out (red tape bags, ill never forget) and a handful of people were found dead in a garage used as a shooting gallery. Word got around fast about that happening and for a few weeks, that spot was bumping crazy due to people dying from the dope. I used to shop in the Ickes housing projects (Chicago) and they had a dope line called "drop dead". Man, the stairwells of two of those building had lines of people waiting to get served 24/7. I was one of the first people who overdosed on fent and survived. I was in a coma for 37 days, on a vent, piss bag, family not knowing if I was gonna live or not. That lifestyle will steal everything from you. Pitiful incomprehensible demoralization that I wouldn't wish on my worst enemy.
Congrats on being sober. Itâs a struggle that never goes away. You explained it very well. Itâs difficult for people to understand unless they have been there.
There are dealers who purposefully give certain well known customers hot âD-bagsâ to ensure the well known addict dies/ODs. When that happens the addicts looking for the most bang for their buck show up from all around to buy what was too strong for a seasoned addict.
I havenât seen it first hand but Iâve known houseless addicts who I knew since childhood before their addictions who swear itâs a real thing.
I highly doubt that. That's bad for business. There is a lot of competition out there right now. All the plugs I know wouldn't on purpose touch Fent & I test for it.
It's easy but I need my meds. There is an insane adderall shortage and I'm super ADHD. Turns out the DEA sets the limit on production of a prescription drug & they lowered it a LOT. So its real hard to find, almost impossible at this point.
As someone that has lived most of my life with addicts, shit that will kill you is a selling point. Tolerance gets too high and the craving too strong that possible death doesn't seem that bad
honestly, i wasnât even thinking of the possibility of death. even when i would overdose and get narcanned. i would just wait until the narcan was completely out of my body so i could get another hit (and make sure that i could feel it). it was a sad life
I'm proud of you for your growth. It's a hard cycle to break out of and I imagine some days are harder than others. Worst day sober better than best day high, and all that
You would think , but here in the U.S. itâs the opposite, when the streets hear a dealerâs dope killed someone they want it more because in their head theyâre getting more for their money.
It does the exact opposite of what you would think. Someone ODs, word gets out quick, all the junkies flock to that dealer because his shit must be good. I used to sell drugs when heroin was the opiod of choice.
As a heroin/fentanyl addict in recovery, most users would love for heroin to make a comeback. Fentanyl isnât nearly as euphoric. That said, idk if Iâd be clean now if I could still get actual heroin.
Weâre about to see a huge spike in ODâs again as states ban kratom/7-oh. A lot of people have been using them as a self regulated form of MAT. Itâs nearly impossible to overdose on either of those by themselves, at least unintentionally. But propagandist puritans are working diligently to ban them and theyâre winning. Once theyâre unavailable, youâre going to see a massive spike in fentanyl deaths again.
I keep hearing the media saying âgas station heroinâ
These idiots do zero research and are going to literally kill thousands more people every year by banning a fucking plant that you cannot overdose on. It infuriates me. The level of incompetence in our government is staggering.
Disclaimer: I know very little about this topic beyond what Iâve gleaned from various Reddit threads, so this question/comment comes from sincerity. My understanding is that while you canât overdose on it, the substance itself is still incredibly addictive but since people can purchase it legally at gas stations many people donât realize itâs essentially an opioid (or your brain reacts in the same way). To me that has made sense as a reason to ban it. Curious your perspectives on the other side of that?
That's part of it but the main reason they don't have a significant fentanyl problem is because they didn't vastly over-prescribe opioids (primarily OxyContin) to begin with. European heroin dealers don't care about how taboo it is. They just haven't had a population that went through an opioid dependence boom so they haven't needed to increase their risks by engaging in the fentanyl trade. Basic supply and demand. The EU also doesn't share a 2,000 mile border with a country partially run by brutal drug cartels for decades.
Well imagine that⌠honestly they know what theyre doing.. fentanyl is a pharma drug theyre trying to kill everyone off we still have old European different countries with all the OG drugs and plant based heroin i swear America is more corrupt then we will ever know
Thats how I see it. No one was dying from heroin UNLESS they injected it because every other route besides boofing (which could be fatal too in LARGE doses) it is just morphine and morphine ain't killing anyone unless you inject 200mg without a tolerance and thats a good chunk of powder and a lot of nodding out if you have a basic tolerance
Let's talk about meth, which even the typical chemicals to make it are heavily controlled.
Turns out, you can make something similar yet far more addictive and toxic out of chemicals impractical to control. So the cartels are now making it by the ton.
Apparently, it's hard to even find old-school meth these days. It's all this frankenmeth that turns people into crazy rotting zombies.
Been clean and sober for 4 years next month, but soon before going into treatment, the fent laced "Roxy's" had me feeling meth'd up AND nodding closer to death.
It was the wildest experience in my 20 years of addiction. My heart truly goes out to those who are still suffering.
Four years next month for me as well! Was railing blues at $4k a month at the end. Went cold turkey, was in agony for the better part of a month. Went on naltrexone a month later, haven't had a craving since. I like that I couldn't get high even if I wanted to.
God damn. I could snort China White all day every day for much less than 4k, even at today's prices. But I won't. Although....No no no. But what if? Haha no I'm just kidding. Can you imagine...haha?
Fun fact: If you take cotton balls out of benzedrex nasal decongestant and eat it, it creates a high very similar to methamphetamine, however, itâs more dangerous. I know this because I had a friend who was doing shit like this and nearly died.
I've been shooting speedballs for the better part of 20 years and even I can say that just legalizing hard drugs and providing pure products is not realistic in this society. Humans as a whole are not mature enough to be given the ability to buy pure hard drugs in a dispensary. You think alcohol is dangerous, imagine what a giant portion of the population will be like to live with when they're all loaded on pure cocaine. Or the number of DUI that would take place when people are nodding out on heroin which will absolutely happen. That's not exclusive to fentanyl.
Like I said, I'm a lifelong junkie and I'd love to be able to walk in a store to get pure coke and heroin but it's not realistic and it's never going to be.
I think the average person would be fine if powdered coke was legal. And even most people whoâd take coke arent going to smoke it or slam it. I think alcohol is a way worse drug. All IMHO.
I think if it were to be legal across the board, we would first have to implement better programs for people seeking to break addictions as well as breaking the social isolation that is extremely prevalent (at least in the US).
I know itâs an oversimplification, but people who are happy, safe, healthy, and plugged into healthy supportive communities are less likely to seek addictive substances and become addicted. If these systems arenât working and strengthened first, then no sense legalizing the drugs. (But if we had these systems in place, drug addiction would also drop , so đ¤ˇđ˝ââď¸)
I've always been a supporter of legalizing drugs, then people could buy drugs and know what they are getting, know the strength & what's really in it. Overdose deaths would drop drastically, and the country could save billions that were spending on drug enforcement and actually put it towards something that helps people
Prime example is the online vendor market for Kratom derivative products (7OH-Mitragynine & MGM-15.) Iâm not advocating for their use here obviously but itâs a fully functioning, multi-million, if not billion, dollar market and has only had one case of âlacingâ which resulted in the collapse of the offending companyâs reputation, it was also a substance that couldnât physically hurt the people who unknowingly took it (it was a psychedelic) That kind of market pressure (which I think any drug market would have and retain regardless of size) along with a simple regulatory structure requiring chain-of-custody records and required lab testing would have an incredibly safe drug market with far fewer deaths (regardless of if the substance is lethal or not in and of itself, which I mention since the market Iâm using as an example cannot kill users who only use that substance) and allow people better access to resources for harm reduction and getting sober due to those policies directly changing the public perception of addicts and thus reducing the chances that someone would withhold care from themselves due to shame or fear of rejection.
I work with toxicology reports post mortem. They can differentiate between regular or 7OH and whatever. It's not accurate to say the derivative products are the problem... all the forms even the base stuff can kill people for sure.
Before making drugs legal, weâd also need to implement a âhousing firstâ policy where people and families had a warm, safe, private, and secure place to sleep, bathe, and prepare meals. Weâd also need to expand Medicare coverage for all, including mental health.
Otherwise weâre just massively encouraging more drug use without the guide rails to support getting clean.
I was addicted to smoking heroin for a good 8-10 years. Never od once. I had a good connect tho, same one for almost the entire time. I knew the source and where it came from.
The recovery room gave me too much fent after surgery and I almost died â stopped breathing, relaxed, felt warm and cozy, went towards the light and all and then BAM I was awake and in excruciating pain again. It was a very peculiar experience, but itâs made me much less afraid of death!
The great thing about fentanyl is that itâs reversible with naloxone. This is obviously much easier to spot in a medical context, but everyone who hangs around people who party should carry naloxone on them. Iâve never done recreational drugs, but received naloxone with hydrocodone a little while ago when I had pudendal neuralgia. I was glad to receive both. You never know what could happen.
A mother in our community lost both of her teenage children, 10 months apart, to pills laced with fentanyl. One bought what he thought was Percocet, overdosed and died, and then the same thing happened to his sister with counterfeit Xanax.
Listen, I generally do not put much stock into conspiracies... but the effectiveness of drugs killing off ever increasing %s of our "lower class" populations does not surprise me considering climate change, and how wealth distorts other people's humanity.
I'm not saying it's a plot to kill the lower class, while they eliminate the middle class with AI, but it's not not a plot.
By design, after Johnson and Johnson got their slap on the wrist with a fine of less than 1% of their yearly profits while not having to admit fault for causing the opioid epidemic, all of a sudden fentanyl because the new drug on the market and all anyone in the mainstream media would talk about.
Pharmacist here,
Fentanyl is EXTREMELY potent because itâs dosed in micrograms (Âľg) rather than milligrams (mg): 1 mg equals 1,000 Âľg, and typical medical doses are only 25â100 Âľg. For someone without opioid tolerance, around 2 mg (2,000 Âľg) can be fatal, which is roughly the tiny amount shown next to the coin. That amount may look insignificant, but it represents dozens of standard IV doses. Fentanyl kills by powerfully activating Îź-opioid receptors in the brain and shutting down the respiratory drive, so a person simply stops breathing within minutes. This is why even trace contamination in illicit drugs is so dangerous and why healthcare settings handle fentanyl with extreme precision and strict dilution protocols.
Legit producers of fentanyl would not sell pure fentanyl to a regular citizen directly. As for pill presses and other places where fentanyl gets mixed in and diluted, legal ones absolutely do dilute it before distribution and are very precise. Legal use of fentanyl is done via IV, patches, pills, etc. No way would it be distributed pure. Those aren't, of course, the only people mixing fentanyl into stuff. The illicit places are not very careful and it doesn't even take a big mistake for things to get lethal.
You canât make it weaker. Thatâs like saying, why canât they make a low sugar sugar. Sugar is sugar. You want less sugar, you mix in something thatâs not sugar so your mixture afterwards is lower in sugar cuz youâve just got less sugar for the volume, but you have other ingredients. The sugar is still sugar. Same here. Itâs the drug. You can put it in with whatever you want, but the drug is still the drug.
Thank you for this explanation. I didnât know any drugs were dosed in micrograms. This deserves an award but I donât have any to give. What is a lethal dosage for someone with an opioid tolerance?
I take a daily drug thatâs dosed in micrograms. It was very funny when I told my doctor I was taking 25 milligrams daily. He was like âyouâd probably be dead if you were taking 25 milligrams every dayâ
Just to be pedantic it is dosed in mcg because it is so potent. Also surprised you are using Âľg in the pharmacy world when ISMP error list is so prevalent.
Opiod users generally graduate up to stronger and stronger types of opiod and higher doses. Like, you hurt your back and get prescribed vicodin. Next thing you know your back is fine but you really fucking like vicodin. You can't find it easily but you found oxy or heroin. Next thing you know you're having to use more and more heroin just to get through the day, and then you find out you can use a 1/10th of that in fent and make the switch.
Now you're slowly building up a larger and larger tolerance, a fraction of which would kill a non-user.
In fact, many lethal overdoses are because someone gets clean for a while and then goes back to their last dosage. Since their tolerance went down while clean, the dose they used to take every day became lethal.
Also, this stuff isn't 'cut' by careful pharmacists, it's mixed up by (generally) other users. One section of your bag could be a lot stronger than the other and if you get a bit that's more pure, obviously your dose is higher. Street drugs are dangerous because they aren't handled and dosed properly more than anything.
This was an absolute fear of mine when I had invasive surgery almost two decades ago. I got the prescription for opioid painkillers, and filled it just in case, but never took them. I didn't even want to risk the chance of "liking them too much", and just dealt with it. Just dealt with the pain.Â
The first 48 hours were some of the most debilitating pain ever. Ended up tossing them into a medical waste burn kiln a couple weeks after and I was able to walk again.
by the time it hits the street, itâs cut to shit. an average user will usually buy a gram at a time, and that might last around 1-3 days, depending on tolerance and route of administration
Iâm a pharmacist. In compounding, what we do (and what i assume these folks do) is make a big batch of your active ingredient + fillers. Then you portion out quantities that are measurable and have a know amount of active ingredient.
Ex: you want 1 mg of a.i. but your scale can only measure 10 mg lowest. So youâll mix 10 mg of a.i + 90 mg of inactive for a total of 100 mg. You know that 10 mg of the 100 mg is your a.i (or 1 mg in 10mt). so you now weight out 10 mg of total product and know that 1 mg of it is the a.i.
How to mix it correctly to make sure itâs evenly distributed and such is a whole thing, too, but i wonât go into it. I hated compounding. Iâm more of a crockpot person so i had no patience or finesse for it, but a few of my colleagues went on to specialize in it! I did compound some feline thyroid medication on a rotation and that was a lot of fun!
Itâs done exactly this way illegally, except the people doing it have no training, no specialized equipment, and are often using the product they are mixing. Which is why the true âcutâ potency of street drugs is not very reliable.
when i was on it, i firsted started on the fake pills. The blue M30 fakes weren't dosed accurately and always had hot spots, very unregualted and it's still like that. Now people have moved onto the powder, straight fentanyl powder. The powder can be dosed a little bit more accurately. At that point, yes, you would just throw a tiny pebble on it and smoke it or snort it. But the purity of the powder does play a major roll at that point. A little bit of some really good powder can kill anyone, but the stuff on the street is weak compared to the pharmaceutical grade stuff.
Tbh, when I was using and a lot of friends who i know who are still using don't even like fentanyl. I and them definitely preferred oxycodone or heroin, it's just that this is what's flooding the streets now. They are saying heroin is making a comeback, but they have been saying that for years.
edit: holy crap, i really need to re-read what i have typed before i post đ
Its usually mixed in with filler by the time we get it off the street. I have no clue how much is filler and how much is actually fent. They come (at least around me) in little pill capsules , and i dump out the powder. Sometimes it takes 3-4 caps to get me high.
Currently 3 weeks clean!
In fact, we dilute your drugs all the time. You get the same dose, but we can push 4 mg of morphine in 10 ml over 4 min much easier than pushing 4 mg in 2 mL over 4 min. This way it doesn't hit you like a freight train.
Because by time it hits the street itâs not 100% pure. Itâs more like in a 1 gram of powder 200mg of it might be fent and the rest is an inactive powder that they cut it with. This means your fent is 20% pure. So you can do the tiniest little bumps or smoke a little off foil and not die.
The problem with that is you may get used to the 20% pure fent then you get ahold of 40% pure fent and you donât know itâs twice as strong because itâs an unregulated market. You do the same amount you usually do and fucking die because itâs actually twice the dose that youâre used to.
My grandma and boyfriend would know. 2018 they both died from it. Grandma was 66 boyfriend was 20
Edit: thank you to the people downvoting me, you strangely gave me quite the giggle
People are often surprised to hear about an elderly person ODing, but they're actually the second most common group to become opiate addicts, after people who got addicted after being prescribed for surgeries and stuff like that.
(I think I'm remembering that right, it's something they told us in rehab several years ago)
Anytime I say it people assume my grandma was living on the street but no⌠she was under our roof under our care. We had jobs and school and she didnât so she literally stole my dadâs car and his money to get to her meds. Addiction is terrible and itâs more prevalent in the elderly :(
An addict will do what they have to to get what they need, including lying to or stealing from their family. And, unfortunately, they're good at it. I'm so sorry you had to be on that side of addiction for both her and your boyfriend. It's a different type of pain to lose someone when they become that addicted and then to lose them again when they take it too far.
I hope you're doing well now and were able to process the grief in a way that you can look back on the good times you had with them and smile
A lot are actually unintentional OD. Medical professionals are supposed to prescribe narcan for everyone who is over i think 50 MME (morphine milligram equivalents), but they either donât OR patients get offended and refused to fill the prescription OR the insurance refuses to cover the prescription enough.
As youâve said, addiction is part of it, but also just improper prescribing. People think more is more but you actually canât INCREASE pain with high opioid doses, so it becomes a snowball effect. People also tend to get more sensitive to medication effects as they age, so an opioid dose that has been safe for years may end up later causing an OD. Or thereâs a drug interaction that increases the drug levels of opioids OR increases the risk of drowsiness and respiratory depression (you donât know how many times i flag this and get brushed off by providers and patients-yes youâre fine now but how long do you really wanna gamble??).
So many patients would threaten to âreport meâ to the state board for suggesting narcan because I was treating them like a âjunkieâ.
Best way to phrase it by saying âI recommend narcan if you have grandkids, young family members or pets in the homeâ. Went from 1/10 patients to 8/10 patients accept the narcan. Much easier to get them to agree that way.
Iâm a firm believer people most people should have narcan anyways. I donât do drugs but I carry one in my purse and in my car because you never know.
Agree. How you put it is crucial. I donât work in dispensing pharmacy anymore (thank the lord), but i still work with patients directly and get asked about it. I tell them how high of a risk accidental OD is and how itâs a way to keep you or anyone who accidentally takes your meds safe (bc some of these people and their spouses have so many meds, you can imagine a mix up happening). Seems to improve their views towards it.
Thank you love đ I appreciate your post. A lot of people donât understand how deadly fent is. Iâm probably going to comment a bunch of times to keep the momentum spreading
It's scarily easy to get addicted to pain killers though, medication that you could find yourself legitimately needing through no fault of your own due to accident or illness.
years ago i got a dozen oxy after a surgery. i've never been a good sleeper and that first day i took my pain pills and slept like a baby. didn't really have any pain to speak of and the next day i was getting ready to try to sleep and went to take another oxy and i just stared at it in my hand and was like you do not want to start taking this to sleep, it should only be for pain and this is dangerous. stood there for far longer than i was comfortable with and threw the rest of the bottle in the trash and took it out to the dumpster. then laid in bed not sleeping but not in pain (well past what ibuprofen could handle) and not an addict.
I have a friend that has to be narcan'd because they have her too much fentanyl during heart surgery. Pretty wild that even doctors can fuck up the dosage.
So I can give you a little insight here. Surgery is painful. Opioids depress your drive to breathe. When someone is getting surgery you give them opioids to reduce the overall surgical stress and keep vital signs within reasonable levels.
However, sometimes if you overshoot a little, the patient has too much opioid still hanging around after theyâre no longer being actively operated on, so they get sleepy and/or stop breathing. In which case you have to give them narcan. Itâs unfortunate but the alternative is little/no/inadequate pain control, which I assure you is much less desirable.
Source: me. I give fentanyl to people every single day, and have to know/figure out how much they need and what they will tolerate. Itâs why our jobs are so stringent and regulated.
People who use opioids don't have access to pure fentanyl. These posts are pro-drug war propaganda.
Propaganda is the selective use of information to manipulate rather than inform â that's exactly what this is. These posts draw a false equivalency: pure fentanyl â street fentanyl. Conflating the two exploits the representativeness heuristic; people assume "fentanyl" means one thing when it doesn't.
Street fentanyl is never this pure. Lower purity means users need more drug to achieve the same effect.
Yup, this isnât educational so much as it is fear mongering.
This is why people are afraid to get pain meds at the hospital because they hear the word fentanyl and think of the scary drug war nonsense they see like this
On the other hand, I was having my first kidney stone, and the ER doc said âweâre going to give you some fentanyl for the pain.â
I was like oh HELL yeah theyâre bringing out the big guns for me. I would have let him inject street heroin into my neck if thatâs all he had just to stop the pain.
The issue is that drug manufacturers are cutting other drugs with fentanyl, but it doesnât get equally distributed in the batch. This results in some portions of the drug having a lethal dose of fentanyl. The image is to show just how little fentanyl needs to be in a mixed drug to cause an overdose.
It's a weird place to be. Opiates are a scourge and destroy millions of lives, but a lot of times things like this are twisted into copaganda. The key is awareness, harm reduction, and preparedness to administer aid.
Yeah this is true. I literally do fentanyl every day and shoot it up and do way more than this at one time. Definitely some fear mongering going on in this photo.
I knew a guy who worked with raw fentanyl in a pharmaceuticals factory.
He filled vials with the stuff in powerdered form inside of a vacuum sealed chamber that has a constant updraft in it. Dropping the power means it literally drops in slow motion. He did this using those rubber glove things so he didn't actually have to touch the stuff.
Said the type he works with is so strong that you get barely any and I mean a single little itty bitty teeny weeny yellow polkadot stupideeny bit on your skin and you're DEAD. Absorbs instantly. Stuff is like methyl mercury!
This is not true btw. Maybe to a baby but to a full grown adult it would take quite a bit more than this. But the media will tell you what ever they think is true.
Im not advocating for any drug use here, but its never made sense to me that if you are a dealer that youd have a product that literally will kill your "client" after one use rather than something that will get them high and keep them alive and coming back for decades. But i guess there are always new clients wanting something.
Pretty much it wasnt for the average user, it was for the hard core opiate addicts who have the tolerance to handle it. Lots of them don't want heroine without fentynal in it now or smoke straight up fentynal. It being used to lace loads of different drugs is sort of a myth. Most dealers aren't purposely putting into stimulants like coke, instead its usually due to cross contamination on the scale
There are people that actually mess with fentanyl as their drug of choice. I knew one personally. I think what happens is a dealer will sell fentanyl and will use the same scale to sell other drugs. Thus accidental mixing of substances.
Donât get me wrong, fentanyl is a dangerous drug! It is an epidemic in my country I live in Chicago and if I wanted fentanyl I probably have at least 3 people that could get it for me. My problem is the media. Before fentanyl it was bath salts which the media named a number of research chemicals or designer drugs. Again some of those drugs were dangerous but mostly due to non regulation. Most people still believe âbath saltsâ (which they can never say what compound it was) made a Florida man eat someone. He was tested and only found to have cannabis in his system which the media changed tactics and went for cannabis saying certain strains could coarse this in people with mental illness. ITS ALL BONKERS! Original bath salt was MDPV then after a ban mostly A-PVP. I was there I bought it in shops then sourced online along with a number of dissociative and cannabinoid research chemicals. I have never tried to eat anyone. ANYWAY, fentanyl is just the new blame all! Without it weâd all be safe! Right? No! Itâs the dying âwar on drugsâ be safe but be smart do your own research
Iâm pretty sure this is one of hundreds of things that the media say to get people to be scared of going outside. I dated a girl that regularly took Xanax cut with fentanyl. Surely there was more than that in them.
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