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Why is opioid addiction almost absent in countries with OTC opioids but rampant in the west?

LucidSDreamr

LucidSDreamr

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In like half the world tramadol and codiene (at least) are OTC. South American countries, carribean, Southeast Asia. All OTC. No heroin or fentanyl epidemics.

Why is the west so fucked despite the restrictions? Is it because of the restrictions? Or are there more issues at play like culture and socioeconomics?

This issue is not discussed in the academic research based on my searching.

You could also say the same for benzos.
 
When they're not a commodity it's not as fun. Kinda like just a more nuanced alcohol alternative. Also might have something to do with a lack of feeling the need to "stalk up" when you have the opportunity, as you can always get them
 
I’d say the United States is indivorcibld from its appetite for heroin because so much of our culture loves and celebrates how good heroin is. Which if true and great and yes hew for horse. But opium transport to China was a major source of wealth in early America and when China said don’t bring us anymore we went ahead and brought it to the big cities of the northeast. People could buy pharmacists preparations of opiates or just buy opium. Likewise in the west many immigrants brought with them a taste for opium. This led to one of the first drug laws in the country when San Francisco made illegal opium and only permitted its use by prescription.

The long and short is that a lot of the gentry in the United States participate in actively addicting certain neighborhoods and regions. There likely aren’t forces in these countries whom use the poppy as a means of control like here in the USA. We’ve been slinging brown for a long time.

Yee haw I love me some haroon.
 
By the way, economically, it makes sense for any criminal enterprise to proffer opiates in the United States because they’re illegal everywhere. Easy money.

If every junky in America could access a safe supply of codeine I think that would probably help people a bit.

This is America.

It’s not this way to help people. It’s to hurt people. But we’re only hurting each other for money.
 
helpingout said:
By the way, economically, it makes sense for any criminal enterprise to proffer opiates in the United States because they’re illegal everywhere. Easy money.

If every junky in America could access a safe supply of codeine I think that would probably help people a bit.

This is America.

It’s not this way to help people. It’s to hurt people. But we’re only hurting each other for money.
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what really bothers me is that if you talk to about 99% of Americans they believe that the alleged existence of pharmaceutical opioids (which are basically totally unavailable now) is the reason everyone is on fentanyl. They are misinformed in that 1) they think pharmaceutical opioids are even accessible in america; and 2) that their availability directly results in increased fentanyl use.

its very frustrating and makes you even question your own views when like 99% of the population disagrees.
 
LucidSDreamr said:
what really bothers me is that if you talk to about 99% of Americans they believe that the alleged existence of pharmaceutical opioids (which are basically totally unavailable now) is the reason everyone is on fentanyl. They are misinformed in that 1) they think pharmaceutical opioids are even accessible in america; and 2) that their availability directly results in increased fentanyl use.

its very frustrating and makes you even question your own views when like 99% of the population disagrees.
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Yes, I don't get that shit. People must just parrot shit they see on the news.

Of course my intro to opioids was hydrocodone after a wisdom tooth removal and I experienced my first nod when my mother gave me an extra 10mg she had stashed and I was only scripted 10 days of 5mg, and I ran out but was still in pain. It's one of my favorite memories in life, one of the first moments I truly felt like, "It's all gonna be okay."

I don't use street dope and never have. Kinda wish I coulda tried heroin but then I'd just be bummed it's gone. Always told myself that it was too dangerous to fuck with street dope. I've bought a lot of pills off of cancer patients via druggies who know people though.

So I mean, if the good stuff is easy to get, it encourages use for me. But also I've always had the smarts to avoid fent entirely and by the time I knew I wanted heroin it didn't exist.

I saw that my state was considering banning kratom this year and I thought heavily about trying to get into some sort of low dose pain management program via my doctor but I don't think he'd throw dope on top of the 2.5mg alprazolam I get daily.

Maybe it's the culture. We all hate ourselves and each other and dope is all that seems to fix it.
 
Just a couple hypotheses:

- There is more social alienation in the west, and the US in particular. In many other places, families stay together and support each other, leading to less homelessness and abject poverty, which is a major factor in drug use

- Many people won't graduate to harder opioids if they have steady access to a useful opioid that works for whatever physical or emotional condition they are likely self medicating for

- There are probably less statistics taken regarding addiction in other parts of the world. Less people trust doctors or seek care for these things.

----- these are sort of generalizations, and I understand that these claims aren't universal or relatable to every country or every person that uses drugs, but yeah just a couple of my thoughts on it.
 
I think in the west the culture is to dislike young adults and for them to be ejected from the family home at a much younger age than in poorer countries, as deficit says there is less family support and less family input to influence those young people.

So problematic drug use could be used as one among many measures that could track how broken a society is.

Another possible reason is simply that people in the west tend to have access to more money and can afford to buy, therefore are more reliable to sell to.
 
LucidSDreamr said:
In like half the world tramadol and codiene (at least) are OTC. South American countries, carribean, Southeast Asia. All OTC. No heroin or fentanyl epidemics.

Why is the west so fucked despite the restrictions? Is it because of the restrictions? Or are there more issues at play like culture and socioeconomics?
This issue is not discussed in the academic research based on my searching.

You could also say the same for benzos
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facts Look at how big America is and look how much we bank from big pharma,
Also look how many drugs are accessible legally or not, the different types
I've also heard that alot of OTC in other countries where they are selling something worth a damn it isn't like the U.S. version exactly
I also feel like the west feels like "we can do anything we want attitude" and our government kinda knows this and is like yeah we probably need blinders for our horse in this race lol
So just the environment and abundance of drugs engrained in our culture is why we battle addiction in my GUESS
 
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As soon as we replace some of these whiteheads and baldheads from office, things will change in the favor of humanity.
 
LucidSDreamr said:
what really bothers me is that if you talk to about 99% of Americans they believe that the alleged existence of pharmaceutical opioids (which are basically totally unavailable now) is the reason everyone is on fentanyl. They are misinformed in that 1) they think pharmaceutical opioids are even accessible in america; and 2) that their availability directly results in increased fentanyl use.

its very frustrating and makes you even question your own views when like 99% of the population disagrees.
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Depending on where you are, codeine, dihydrocodeine, tramadol, viminol and 'opium extract' are all [P] medications. Likely more - I'm only listing what I have seen. Same with certain benzodiazepines (but in many places not all) - again, just my experience.

In most of the world people simply cannot afford to visit a doctor so pharmacists are the de facto source of medicines.

But cost, social structure, availability and a host of other factors all play their part.

IF you can legally purchace dihydrocodeine, it's entirely possible to undertake a DIY detox so even IF someone becomes dependent on opioids, they can usually solve the issue without ever coming to the notice of the authorities.

In India people in remote regions grow their own opium poppies and go on to produce their own opium. An Indian BLer mentioned that opium was deceptively nasty in terms of AWS. But unless someone develops a truly huge dependence, DHC offers a way out.

I figure people use opioids as self-medication for various health issues but when you read forensic journals to discover people died After consuming 250-300mg of loperamide, it sort of suggests that people have few options in some nations. At the end of the day, if methadone clinics charge $17.88/day (on average) while the methadone costs about 10¢ per day - someone is making a profit.
 
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4DQSAR said:
methadone clinics charge $17.88/day
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That’s nuts. Even for take homes when you get to that stage you still get charged for the days you don’t have to come in?

That’s over $500 per month; some someone unemployed or disabled can afford usually. Going to an actual primary care medical doctor to get a script and paying out of pocket is cheaper
 
Well methadone as an API sells for anywhere between $226/Kg and $1425/Kg. In the UK it's $345/Kg, in Canada $278/Kg.

That whole take home thing is a scam. Because it's considered as seven seperate prescriptions, pharmacists can charge as such.

You know my view on this. We KNOW that the best outcomes are people who are prescribed 90-95mg/day. I know, it's a lot. But it seems that it's the dose below which people will still buy off the street. But even at 30¢/day, it's the best outcome for the patient and society as a whole. If it were even $1/day, I THINK most people could swing that but the middlemen ALL want a cut of the profit.

I know in Russia, there is a brisk trade in black market methadone in the form of yellow crystals (yellow?) but clearly, in that form, it can still feed the needle. Sellers are not doing the consumers any favours. It's all about the money. Just give it to people. But hey - that would see so many people lose their incomes... insurance companies, law enforcement agencies, testing labs, wholesalers. It would impact them all.
 
I did some loose math on how much the US government makes off of MAT Methadone for 400,000 patients. I know the cost varies from out of pocket to insurance picking up the tab.

In the early 2000's (2004), the Methadone clinic charged $50 per week out of pocket. At this time the rate, my junkie math for 400,000 patients on Methadone alone comes to
$960,000,000 gross yearly.

Mentioned above currently the clinic is charging $17.88/per day. That comes up to $2,574,720,000 gross yearly for 400,000 patients. This does not include the cost for the odds and ends to run the place. Suboxone's rates are not included in this.

My 30-day Methadone Rx from my small independent pharmacy costs $42.15 out-of-pocket. They charge me the same for 90qty to 150qty for Mallinckrodt 10mg tablets.
At this rate if my Rx was doubled to 100mg per day and the monthly cost out-of-pocket doubled, I would be paying $2.81 per day for 10qty Mallinckrodt 10mg tablets. However, my pharmacy would not double the cost for me. It would be around $72 out-of-pocket for 300qty 10mg.

Basically this means MAT marks up their Methadone by 550-636% compared to what it really costs outside of their program. This is based on $17.88/per day.
 
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Well, I refuse to recalculate those number to confirm, but it sounds about right.

But to be clear, my prices referred to the bulk API. Even so, be it tablets or linctus, it's still pennies extra. But if you have a for-profit medical system filled with middlemen all taking their bit.

It's a captive market and a monopoly all rolled into one.
 
4DQSAR said:
It's a captive market and a monopoly all rolled into one.
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Grossing those figures from MAT Methadone & Suboxone, the racket of felony drug charge fines in court, the racket of sending addicts to jail, court based drug program fees, and paying the government & city workers their salaries -- all adds up to whats the rush to remove Fentanyl, Tranq-Dope, etc. The longer the fentanyl nightmare goes on, it is more money for their pockets. At some point the US will wonder where did all the prime military stock go.
 
I would say pharm to tv advertising has a bit to do with it. On my FB I use to get sub ads, ketamine therapy, mushroom therapy.

After that I would say the stigma is probably alot less. Extra time, money? Idk all speculatory

Do we even know less people per capita are using there or is this theoretical?
 
Them Witches said:
I did some loose math on how much the US government makes off of MAT Methadone for 400,000 patients. I know the cost varies from out of pocket to insurance picking up the tab.

In the early 2000's (2004), the Methadone clinic charged $50 per week out of pocket. At this time the rate, my junkie math for 400,000 patients on Methadone alone comes to
$960,000,000 gross yearly.

Mentioned above currently the clinic is charging $17.88/per day. That comes up to $2,574,720,000 gross yearly for 400,000 patients. This does not include the cost for the odds and ends to run the place. Suboxone's rates are not included in this.

My 30-day Methadone Rx from my small independent pharmacy costs $42.15 out-of-pocket. They charge me the same for 90qty to 150qty for Mallinckrodt 10mg tablets.
At this rate if my Rx was doubled to 100mg per day and the monthly cost out-of-pocket doubled, I would be paying $2.81 per day for 10qty Mallinckrodt 10mg tablets. However, my pharmacy would not double the cost for me. It would be around $72 out-of-pocket for 300qty 10mg.

Basically this means MAT marks up their Methadone by 550-636% compared to what it really costs outside of their program. This is based on $17.88/per day.
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This really puts things in perspective. This is content for some sort of media article and vice or somewhere that would publish this. I hadn’t realize PUBLIC “addiction treatment” was so massively profitable. This isn’t even private rehab that gets ppl clean that is lobbying government this is government itself selling dope more addictive than heroin and locking them on it for life.

So the government actually loves the opioid epidemic and creating addicts and has fooled the entire population into thinking they are against it.

Also makes sense why they prosecute and prohibit any independent psychiatrists from prescribing methadone.

This shit has the makings of a huge conspiracy theory (but it’s real) like “the government did 9/11”. They certainly killed way more ppl and destroyed way more lives than 9 11 did
 
LucidSDreamr said:
So the government actually loves the opioid epidemic and creating addicts and has fooled the entire population into thinking they are against it.
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It sounds like a stretch I know, however we have the world's best and complex military sub-divisions like the Delta Force, Navy Seals, CIA Paramilitary, and others military groups including the regular Army, Navy, and Marines that could parachute into Mexico and wipe out the Mexican Cartel's illicit Fentanyl production. Parachuting is for stealth missions. The US could do a coordinated bomb strike and wipe the Mexican Cartel out completely. Yet it the smuggling & production of illicit Fentanyl continues at a mind-blowing rate with no end in sight. The US declares a "Fentanyl Crisis" daily, the overdose rates climb at the equivalent of a full 747 passenger plane crashing daily, and still they choose to do honestly nothing about it.

At some point people are going to have to wake up and wonder if there a sinister plan at play. The US is either condoning a coordinated strike from China sending precursor chemicals to the Mexican Cartel to weaken our military stock or the US government has sold out the rights to the country carefully making last provisions. I do not know honestly, I am just making speculations because the whole thing wreaks of slime, filth, and lies and clearly there is some serious writing on the wall. It is time the public citizens read the white on the page.

Now close to 3-billion dollars does not seem like a lot over the span of a year. However, MAT drug programs are not designed for a year and the patients basically are borderline lifers and 85-90% of them will not successfully stay clean. Especially with the "new dope" they are doing they stand little to no chance. Once the totals are figured from all the rackets that come along with this issue, the figures are much more than 3-billion dollars per year.

I thought if I shared with everyone how much I actually pay for Mallinckrodt Methadone 10mg tablets, this might make more sense. Since Methadone equals 3% of the Rx pain prescriptions in the US and a good number of these patients do not get in the fold with a small local independent pharmacy. I get amazing prices out-of-pocket on Mallinckrodt Methadone 10mg tablets and the monthly cost is dramatically lower than a large commercial chain pharmacy. Because of this the actual mark-up taking place MAT does is going basically unnoticed to public citizens, I mean 3% of total Rx pain killer prescriptions is very low.

Someone needs to take a public position by researching this further to dial in the actual gross profit. After that they need to publicly speak out what is really going on here in the US. I am may not be 100% correct on my yearly gross profit but I am extremely close because I am paying basically a small bit over wholesale on my Mallinckrodt Methadone 10mg tablets. The pharmacy and I have a close relationship for reasons I cannot disclose publicly. Just know I know how much it basically costs to buy if a small local independent pharmacy purchases monthly orders from the major supplies on the East Coast.
 
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