Trigger Warning What triggered the opioid epidemic in the US

[fuckabout89]

It was the war on prescription opiods that caused the pain issues. I am a pain patient for around a decade. I know how bad it sucks. The obama administration went after prescription opiods, even for those of us who really need them.

I can't take really anything but pure opiods( no Tylenol ones) Oxycodone I have control over. Chronic pancreatitis and liver problems means one thing.

Opiods( prescribed ) or suffer. This is an issue that came during Obamas war on opiods.
The real victims are not the people who used oxycodone to get high and died.

It is people like us who have no other options but to take them or suffer. There is nothing I can take but strong pure opiods that will esae t h e pain enough to want to keep on living.

I stopped taking Morphine( I was on both) because the pain greatly lessened. I was not pressured or cut off.

I didn't need it so I did a taper after 6+ years of 24/7 morphine and used comfort meds.

My doctor was shocked that I told him I am tapering and need comfort meds because I no longer needed the morphine.

He helped me and I kept my low dose of oxycodone and was even given a small bump.

The war on drugs and the war on pain patients are two different things. This is not about recreational use. It is about not suffering as much.

Obama's war on opiods only made it worse for all. Millions of pain patients suffer and then they only had the streets. At about the same time, fent replaced heroin in America is about when the pain patients were really made to suffer.

True pain patients who are responsible; are not the same as those just trying to get high. But they are the real victims. The government can't legislate pain away.
They can only lessen it by letting doctors do their job without fear of Big Brother.

Yup and people would rather go to the streets then kill themselves.

 

[notsmokeymcpot42088]

^Of course they would.

You think going to the streets is a fate worse than death? I mean I guess if you buying russian roulette dope perhaps........Definitely remember a time when I would go to the streets way quicker than attempt to deal with the financial hurdle and bureacracy of the medical system.

If I was a little better with tech I prolly still would feel that way --- the 'streets' being the darkweb now or w/e

 

[fuckabout89]

^Of course they would.

You think going to the streets is a fate worse than death? I mean I guess if you buying russian roulette dope perhaps........Definitely remember a time when I would go to the streets way quicker than attempt to deal with the financial hurdle and bureacracy of the medical system.

If I was a little better with tech I prolly still would feel that way --- the 'streets' being the darkweb now or w/e

I wonder how many of the overdose deaths are from people in legitimate pain vs actual addicts. Man I had to wait over 2 years to get my teeth pulled! And I was getting constant infection after infection and was suffering so much from the pain. I could see the pain in the doctor's face only giving me shitty Tylenol and Ibuprofen and the DEA is a bitch in my state, my psychiatrist hated having to deal with them. I was luckily enough though when caught myself on fire and burned my back up and got Dilaudid lol.

 

[notsmokeymcpot42088]

Damn --- Well the leading cause of death between 18-35 went from car crashes to fentanyl overdose so I am gunna say addicts make up the vast majority. (Unregulated mystery powder at this point!)

I had a dentist who once said he was going to get me painpills, left the room, came back like he was 007 and left a manilla envelope on my lap. I open it carefully to find TWO TYLENOL EXTRA STRENGTH INSIDE. "Hey man you want your tylenol back!" -- he didnt like that....

I had a relative who got 1L 1mg/ml dilaudid a month, 10mg fent patches, and percocet for breakthrough (Terminal)

The first time I went on probation I got a bottle of codeine for a bad flu (I actually had one, but I kept that bottle extra long) ... Than I had my wisdom teeth pulled so I had a bottle of hydros. (I was already opiate dependant and had a plan for when that shit happened)

 

[HeadphonesandLSD]

Damn --- Well the leading cause of death between 18-35 went from car crashes to fentanyl overdose so I am gunna say addicts make up the vast majority. (Unregulated mystery powder at this point!)

The leading cause of death among 18-40 year olds in America has been suicide for a long time. Maybe the list you're looking at doesn't include that as a cause of death. I imagine a lot of the fent. overdoses are suicide attempts as well. Usually, suicide isn't reported as cause of death in a lot of suicide cases since the family doesn't want everyone to know someone off'd themself.

I once attended a close casket funeral where the person had blown their own head off with a 12 gauge shotgun. The cause of death was listed as "accident".

 

[fuckabout89]

Damn --- Well the leading cause of death between 18-35 went from car crashes to fentanyl overdose so I am gunna say addicts make up the vast majority. (Unregulated mystery powder at this point!)

I had a dentist who once said he was going to get me painpills, left the room, came back like he was 007 and left a manilla envelope on my lap. I open it carefully to find TWO TYLENOL EXTRA STRENGTH INSIDE. "Hey man you want your tylenol back!" -- he didnt like that....

I had a relative who got 1L 1mg/ml dilaudid a month, 10mg fent patches, and percocet for breakthrough (Terminal)

The first time I went on probation I got a bottle of codeine for a bad flu (I actually had one, but I kept that bottle extra long) ... Than I had my wisdom teeth pulled so I had a bottle of hydros. (I was already opiate dependant and had a plan for when that shit happened)

Theres no way that could be measured accurately figuring out which OD is an addict and which one is a guy suffering in pain. I'll tell you this family is the last people you want ask regarding that shit they'll lie or come up with copes as to why something like that happen.

 

[Espeon]

I'm not sure it will ever be more obvious that the US government, both parties, are the problem, not immigrants and foreigners.

The government and the billionaires that control it are the terrorists, and they are to blame for all of the chaos and deteriorating material conditions.

^^^^ We've tried the drug war and arrests for drug consumption for literally decades and decades, its not working. Privatized healthcare is profiting off of the pain of dope users so why would we see a change anytime soon. My dead friends, Your dead friends, they mean nothing to the bone crushing machinery of capitalist exploitation. We are less than nothing to them, until we push back and then we're mosquitos to be swatted or flies for them to pull the wings off of and tie a little string to. Sick entertainment for the pigs and dogs who hold the reins of western exploitation.

The average persons material circumstances suck, people like to numb that reality and when they do if they can't afford expensive drugs they'll use fentanyl if they're desperate enough. Overdoses are greater amongst those in poverty, and don't even get me started on healthcare. How are people supposed to get clean if they can't afford the medical detox programs and prescriptions and if their material circumstances suck and they're just getting clean to be a more productive wage slave to bitch-made Jeff Bezos, why would they even want to. Defunding of harm reduction programs and profiteering. Its a lot of things sure, but a lot of those things individually can be traced back to the POWERS THAT BE, aka the Bourgeoisie Dogs and filthy rich capitalists directing the money and lobbying the gov.

 

[Espeon]

20 mgs is 2 tens thats not so high (well for me at least...)

Yea it is hard enough to not become one of the people that die! Z drugs are a no go for me because of the horrible blackouts -- the metal taste wasnt great either but marginal compared to blackouts.

Shit I know a girl I went to elementary all the way through college with, became a doctor (Had her shit way more together than most of us if that wasnt implied) than fell down a staircase and died. Shocks me to this day --- idk if substances were involved.

I have seen alot of people go but like you see with those people, there is usually a period you see it coming, try and talk em back off the ledge....get told to fuck off and than just kinda wait and hope it works out...and it doesn't. This one hit different. Not because of her education btw, the Dr dont mean shit but an example of the type of person.....couldnta been more than 35

I had a doctor friend I used to smoke heroin with, the self control on that girl, Jesus christ lol. She would only smoke it with me every few weeks or months and then just go back to work the next day. Couldn't be me, i'm probably 80% fentanyl at this point

 

[Espeon]

If we want the illicit opiate supply to stop killing so many people, we need to take the illicit factor out of it. Supervised consumption sites/ Overdose Prevention Sites, comprehensive narcan distribution and training programs, compassionate housing not predicated upon sobriety where people aren't being patted down for drugs in order to enter their gov subsidized housing.

People would stop having to spend their time committing crimes to fund addictions and get a place to sleep with safe supply and compassionate housing, would not have criminal records holding them back, would have access to mental health care, housing, wound care, psychiatric support, and would feel like they have dignity and matter enough to make those changes, then those who have been failed by our broken system might be able to get a handle on their lives. Especially if we provided a compassionate safe supply program for those who are not ready to quit, which there are many of, and I don't blame them.. I am one of them. Safe supply means predictable dosing because no contaminated supply, less money in organized crime leading to less violence to control supply chains, a lot of people would stop slipping through the cracks to die on the streets, but those people don't actually matter to those in charge. And I fear the only way we would see this realized is if the privatized healthcare system could profit enough of the addictions that they should be helping people with. It would only work if we had true universal healthcare I feel like, but it doesn't mean we shouldn't try while people are dying.

"In the Safer Opioid Supply (SOS) program, clients are provided with a prescription for pharmaceutical opioids to replace street-acquired substances from the unregulated drug market. SOS medications are generally provided as a daily-dispensed prescription for take-home dosing by clients. In addition to the provision of pharmaceutical medications, all SOS program clients are also offered comprehensive health and social services by an interdisciplinary team consisting of primary care physicians, nurse practitioners, nurses, systems navigators, outreach workers, and care facilitators" (Kolla et al., 2021).

 

[tryptakid]

I worked in MAT programs for over a decade (got clean from dope in 08, went back to school in 2010 for Social Work and Public Health so I could try to help others struggling with opioids) - my first job was in a suboxone program in a health center in 2012 as that was where the funding was going to expand access to substance use services. I left community health in 2024.

At the time I started as a clinician, fentanyl was still mostly just diverted patches and lollipop, but within a year or so of beginning to work with opioid users we started seeing fetty.... I could talk at length about seeing this stuff from the other side, as a clinician. It was always strange being a person who used drugs but working on the clinical side. I did my best to try to influence the way that doctors, nurses, and counselors thought about, talked to, and overall treated people like us. I'd like to think I had some positive influence on a small scale - got brought in to train bupe prescribers and even helped to do community outreach/education geared towards normalizing talking with friends/family/neighbors about drug use. I also lost so many fucking people to death from this shit - hundreds easily.

One of the things that always got to me was how easily people could get onto suboxone, and how difficult it was to get off. As long as you can figure out the precipiated withdrawals, you could go from a daily habit to getting enough bupe to get yourself sorted plus have extras left over to share, sell, or save up. Problem was that it left a lot of people stuck somewhere between sick and clean - not clean enough for NA, but not high enough for the street... just this grey in-between world.

I was glad I never took to suboxone personally - it always made me feel kind of sick, so I just did a methadone taper in detox and residential treatment/12-step meetings when first getting clean. Coming up on 18 years this November. My recovery can vote/buy scratchies.

There's no one right way to recover. It was always important to me to help people find what worked for them and not to only listen to either the 12-step abstinence only path, OR the "you should piss in a cup and take suboxone forever" path. People get institutionalized from that life, and like you said - the money keeps flowing to big pharma and police.

 

[Espeon]

I worked in MAT programs for over a decade (got clean from dope in 08, went back to school in 2010 for Social Work and Public Health so I could try to help others struggling with opioids) - my first job was in a suboxone program in a health center in 2012 as that was where the funding was going to expand access to substance use services. I left community health in 2024.

At the time I started as a clinician, fentanyl was still mostly just diverted patches and lollipop, but within a year or so of beginning to work with opioid users we started seeing fetty.... I could talk at length about seeing this stuff from the other side, as a clinician. It was always strange being a person who used drugs but working on the clinical side. I did my best to try to influence the way that doctors, nurses, and counselors thought about, talked to, and overall treated people like us. I'd like to think I had some positive influence on a small scale - got brought in to train bupe prescribers and even helped to do community outreach/education geared towards normalizing talking with friends/family/neighbors about drug use. I also lost so many fucking people to death from this shit - hundreds easily.

One of the things that always got to me was how easily people could get onto suboxone, and how difficult it was to get off. As long as you can figure out the precipiated withdrawals, you could go from a daily habit to getting enough bupe to get yourself sorted plus have extras left over to share, sell, or save up. Problem was that it left a lot of people stuck somewhere between sick and clean - not clean enough for NA, but not high enough for the street... just this grey in-between world.

I was glad I never took to suboxone personally - it always made me feel kind of sick, so I just did a methadone taper in detox and residential treatment/12-step meetings when first getting clean. Coming up on 18 years this November. My recovery can vote/buy scratchies.

There's no one right way to recover. It was always important to me to help people find what worked for them and not to only listen to either the 12-step abstinence only path, OR the "you should piss in a cup and take suboxone forever" path. People get institutionalized from that life, and like you said - the money keeps flowing to big pharma and police.

Its amazing the amount of influence that one person can have. I had a psychiatrist who was the first mental healthcare provider i've seen to actually listen to me and not reduce me to a list of diagnosis and potential career pitfalls. The only time I managed to stay sober for any extensive amount of time was under his care. He had to stop seeing me because he went to go do pro-bono work in a prison and he was already working with MAPS and I relapsed pretty much right afterwards.

I too have lost so many friends to this disease. Since I moved to the sf bay area at 17 I have lost around a dozen close friends to fentanyl overdoses. Basically all of them were around my age, hardly older than kids, a couple still were kids. It seems like the only response those with power are willing to try is "arrest the dope fiends" or "tolerate the dope fiends as long as they aren't homeless, but to hell with providing adequate evidence backed services to them on any adequate scale"

I did the suboxone thing for a while, suboxone is a different beast with street fentanyl though. You're halfway through the withdrawal before you can even take it without PWD and fent withdrawal is absolute hell. And as a 25 year old more than half my teeth are crowns and I'm missing 3 molars because of the suboxone acidity. I was taking 3 strips a day. I used to have tough teeth, didnt get a single cavity until 18, and then they just fell apart after I did a year and a half or so on suboxone at 20. My teeth were like sugarcubes when you put water on them, just dissolving with little holes left melting apart everywhere. I went from a 18-19 year old who was doing modeling and promoting for nightclubs and just building some self confidence for the first time in my life to being on heroin and then fentanyl and feeling trapped as hell, opiate addiction is rough as all hell, i'm still a daily fentanyl user but thankfully i've gotten off the streets like a year and a half ago and i'm in college, I'm actually pulling straight a's on a full time courseload.

When I tried subs I thought the suboxone was going to make things better, and it certainly can, but it was pitched to me like something you can just stay on forever, in reality it kind of just keeps that bug in the back of your mind waiting for things to get worse and then you want to scratch the itch which subs don't do they just keep you from feeling the w/d. I do wish I had just used it to get off the fent, it really messed up my teeth. Theyre better now with the crowns but I had big black holes in most of them before I got the dental work done. And so many people can't afford the dental work, I atleast live in cali where its covered and had family to help with the copays.

U sound like a great person, I wish that there were more out there investing blood sweat and tears to remediating this crisis. Actually extending a hand to those in these positions of futility.

 

[tryptakid]

Its amazing the amount of influence that one person can have. I had a psychiatrist who was the first mental healthcare provider i've seen to actually listen to me and not reduce me to a list of diagnosis and potential career pitfalls. The only time I managed to stay sober for any extensive amount of time was under his care. He had to stop seeing me because he went to go do pro-bono work in a prison and he was already working with MAPS and I relapsed pretty much right afterwards.

One of the hardest things as a clinician that I ever had to deal with was when I would get offered a better paying position at another health center or hospital. Believe me when I say that I wasn't making a whole lot of money, and at the same time I was paying 500-800 $/month in student loan payments every month on top of living in the Boston area. I worked for 3 organizations during my career in public service, and the only way to have a shot at a pay increase meant leaving one clinic for another. The hardest part of it was knowing that it meant I had to stop working with my existing patients. It was hard not to worry about whether someone might struggle to connect with a new therapist, and there were definitely times that finding someone else to take on the cases was really difficult. I worked with a lot of people dealing with homelessness and for some, I was one of the few people they'd been able to trust and open up to - that shit was tough.

I too have lost so many friends to this disease. Since I moved to the sf bay area at 17 I have lost around a dozen close friends to fentanyl overdoses. Basically all of them were around my age, hardly older than kids, a couple still were kids. It seems like the only response those with power are willing to try is "arrest the dope fiends" or "tolerate the dope fiends as long as they aren't homeless, but to hell with providing adequate evidence backed services to them on any adequate scale"

I am sorry to hear that. Most people have no clue how much grief and sadness we've endured. That stuff really saps your soul.

I did the suboxone thing for a while, suboxone is a different beast with street fentanyl though. You're halfway through the withdrawal before you can even take it without PWD and fent withdrawal is absolute hell. And as a 25 year old more than half my teeth are crowns and I'm missing 3 molars because of the suboxone acidity. I was taking 3 strips a day. I used to have tough teeth, didnt get a single cavity until 18, and then they just fell apart after I did a year and a half or so on suboxone at 20. My teeth were like sugarcubes when you put water on them, just dissolving with little holes left melting apart everywhere. I went from a 18-19 year old who was doing modeling and promoting for nightclubs and just building some self confidence for the first time in my life to being on heroin and then fentanyl and feeling trapped as hell, opiate addiction is rough as all hell, i'm still a daily fentanyl user but thankfully i've gotten off the streets like a year and a half ago and i'm in college, I'm actually pulling straight a's on a full time courseload.

I was lucky in that fetty wasn't really around when I was getting high. It popped up for a summer back in 2006 which I'm almost certain was a beta-test to see how the markets would respond to fentanyl instead of heroin. I've worked with prescribing physicians on a variety of methods to get people acclimated onto bupe from fetty. Apparently the new injectables (Brixadi) have shown a ton of promise with induction in a way that's much more tolerable than the old microdose titrations. A former colleague and good friend of mine has been prescribing bupe since 2008 and we talk a lot about how he's trying to use it to help get people on more comfortably. You might be familiar with this but here's an overview of the DTI guidelines: https://media.api.sf.gov/documents/Direct_to_Inject_Buprenorphine_Guideline.cleaned.pdf

When I tried subs I thought the suboxone was going to make things better, and it certainly can, but it was pitched to me like something you can just stay on forever, in reality it kind of just keeps that bug in the back of your mind waiting for things to get worse and then you want to scratch the itch which subs don't do they just keep you from feeling the w/d. I do wish I had just used it to get off the fent, it really messed up my teeth. Theyre better now with the crowns but I had big black holes in most of them before I got the dental work done. And so many people can't afford the dental work, I atleast live in cali where its covered and had family to help with the copays.

Yeah you get stuck in a world where you are reminded on a weekly/monthly basis that even though you're not getting high, you're still "one of those patients" who has to get a urine cup when they show up for an appointment, and who knows all of the nurses and medical assistants on a first name basis.... you get institutionalized to being a bupe patient which is obviously better than being strung out on fetty, but it's hard to disconnect from addiction completely. Also, it keeps you dependent indefinitely, and still fucks with things like dental health, testosterone levels, and your liver. Getting people onto bupe is much easier than getting someone off of it.

U sound like a great person, I wish that there were more out there investing blood sweat and tears to remediating this crisis. Actually extending a hand to those in these positions of futility.

Thank you! I really care about service work as a part of my own recovery, and I'm grateful to have had the privilege to do the work I've been able to do over the years. I've met some really phenomenal people through this work and obviously it's also been pretty traumatic at times. I appreciate your kind words - reach out if you ever feel the need and keep me posted on how things are going.