How does fentanyl get into the US?

>Addicts literally carry around fent testing kits so they can _avoid_ this synthetic opioid.

Its my understanding that heroin and street pharmaceuticals aren't really around anymore. Its ALL fentanyl now and everyone knows it.

> Addicts literally carry around fent testing kits so they can _avoid_ this synthetic opioid.

Choosy addicts choose...is something I never thought I'd read. I'd suggest they weren't addicting right if they are choosy. When you can find your fix of choice, you just fix with what's available.

If your comment were accurate, fent sales would plummet and the problem would fix itself. This is clearly not the case.

That's true to an extent. But we can also reduce the incidence of opioid addiction by prescribing them only for really severe pain, and in smaller quantities. This is already happening. Back in 2007 an oral surgeon gave me a prescription (which I never filled) after a minor procedure but today that probably wouldn't happen.

> Arguably a lot more people got hooked on opium than ever before because something legalized has less stigma attached

Growing up in the 70s and 80s, I know that by the 80s heroin had a bad stigma attached to it even by other drug users, and it was rarely seen in the circles I knew. Coke, pot and meth did not have that at the time.

Oxycontin was overprescribed for pain, it's not available for recreational use.

Possibly it's just too potent for legalization to be viable.

100%.

There is already some compelling anecdata that warrants studying.

Rat park is one, and the doctor who prescribed heroin in the 60s is another.

The jist of it was that addicts stopped abusing when there was something better to live for. In the absence of community, opportunity, and hope, abuse abounded.

The reality of some people's experiences though is that while euphoric in the beginning, long term use leads to an unpleasurable mental haze. The lack of clarity becomes its own hell.

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The potential solution is likely unpopular and likely difficult to implement. Investing into communities that promote community along with incentives for economically depressed areas to be rebuilt, IMO would likely reduce opioid abuse.

But that's not nearly as popular as the moral displacement schadenfreude the people get by being able to point the finger at the drug abusers.

I'll drink to that!

Seriously, it feels like society has drifted too far away from the idea of small, local communities. So much of modern life separates people either physically or technologically. Though I would like to blame modern marketing and consumerism, I think these problems have been brewing for centuries.

From a sociological perspective, I do see the benefits of small conservative communities that effectively serve as a guarding or protective mechanism, shielding the more vulnerable from potentially destructive influences.

That's very true. The drug issue is a very complex problem, and I was only addressing a very narrow aspect of it, namely the root cause for the proliferation of hyperpotent opioids in black/grey markets.

The legal side of it is just that; one side. It's important, yes, but just legalising opium won't automagically solve the opioid crisis on its own. We also need to address societal causes of opioid addiction. At least in the US, overprescription from doctors corrupted by big pharma(especially purdue), is one major contributing factor that's been thoroughly exposed in recent years. Obviously the role of money in medicine needs to be changed.

The deeper issue though is that more people are becoming vulnerable to developing addiction. Speaking as an addict myself, one of the root causes of addiction at an individual level can be untreated mentall illness. Drugs can often provide a temporary reprieve from mental illness, and unfortunately is often more easily available than good treatment options. In many western countries, funding for mental health treatment programs has been reduced. This is contributing to a rise in unmanaged mental health issues.

I think spending a ton more on mental health, especially in youth, is essential to reducing the prevalence of addiction.

Other issues include poverty, unemployment, housing. The thread through all of this is that more people lead miserable lives, and that makes drugs more tempting.

But let me circle back to the legalisation issue and why it's so important. The main health risks with opioids are overdose in the short term, infections(hepatitis, HIV, endocarditis) from dirty needles and organ damage from dirty drugs in the longer term. Legalisation can address all of these things. Any addict will tell you the main reason overdoses are so common is there's no consistency to the potency of their drugs. Even when it was still heroin, the constant battle with LE meant the purity would fluctuate wildly. Add to that synergistic adulterants, and now these hyperpotent drugs, and you get addicts dying like flies. Legalising the drugs would allow regulating them and providing consistent dosages, eliminating harmful adulterants, and mandating that doses be sold alongside clean user equipment. This would greatly limit the health impact of these drugs on its users. It's obvious that recovering from addiction would be a lot easier if your body hadn't been destroyed by it before you even enter a treatment programme.

In addition, remember what I said about funding for mental health declining? How much money is spent futilely fighting the war on drugs? I haven't done the tedious task of adding up federal, state and police budgets for the US, but the budget for the DEA alone is in the billions, so it's safe to assume once you do the math it'll be in the tens of billions for LE alone. And that's without accounting for the courts, prisons, and all the money being funneled away from the legitimate economy by criminal gangs. This is money that should be spent elsewhere. On mental health and addiction treatment, housing, social programmes. But instead it's essentially being piled up and lit on fire.

So at least for me, that's why I keep saying "let them take drugs".

This argument is too dismissive for me to bother spending time on it except to say this: try to think about other factors than just availability, because it's not the only thing that matters.

Here's an exercise for you to do just that. Alcohol is legal and extremely available in the west. It has an even stronger addiction potential than opioids do. And the majority of people in the west drink at varying rates. But the rate of addiction is generally under 5%(in the west). Why do you think that is?

So, they were half-right since that's tantamount to "corruption in the US"

There is no commerce crossing the DMZ. There are no tourists crossing the DMZ. Hundreds of millions of people cross the southern US border every year. You cannot compare these two borders in any realistic way.

Edit: also, landmines

I do not think it makes sense to scale national borders based on population size. It is what it is, you can choose to invest resources on the entire length, but there is no mathematical averaging out.

For anyone else that was curious, the Korean DMZ is 150 miles long. US Mexico border is 1950.

Your comparison doesn't even make sense. SK and NK have no relation and no border crossings. It is the easiest border to patrol.

Seemingly, the major failure there was having the one part (decriminalization) without the other - crucial - part (treatment and support).

The support and treatment structures have remained essentially unchanged since Measure 110 passed, with holdups to funding and logistics at almost every level of the state's government. Oregon was already ranked almost dead last in addiction treatment, and that hasn't budged. I can't see how it would work without this other critical piece.

Oregon Public Broadcasting (OPB) has some good coverage about this failure from the first couple years (which was never really rectified): https://www.opb.org/article/2022/05/24/oregons-measure-110-i...

Also worth noting is that research has found no association with with Measure 110 and crime, and crime has been steadily falling since the measure was passed. (along with most other metro areas in the USA) https://www.opb.org/article/2024/01/24/portland-crime-violen...

It wasn't Portland. Voters in Oregon as a whole passed Measure 110 in 2020 that replaced criminal penalties for possession of small amounts of drugs with $100 fines.

Then in April of 2024 House Bill 4002 made possession once again a misdemeanor but kept most of the other provisions of Measure 110 and still focuses on "deflecting" people who possess out of the criminal justice system and into treatment programs.

So Measure 110 is still mostly in effect. They just made it so you do in fact have something on your record if you're caught with possession.

Decriminalization is step the first step. The obvious result is going to be that a problem _sometimes_ hidden becomes more prevalent. What failed in the Portland experiment was a lack of stable housing coupled with a public space system that was never designed for use by those afflicted by addiction.

The deterioration of our public spaces is not caused by our drug epidemic, it's the logical outcome when the state fails to provide services to the most vulnerable. People literally have nowhere else to go.

I haven't been to Portland since 2018, but I have been to and seen LA and San Francisco downtowns. They didn't decriminalize, but their downtowns are pretty unpleasant too.

I wonder to what degree Portland is a product of its local policy (like this decriminalization/recriminalization) vs the national trends that are seen across the USA.

Decriminalization seems to lead to negative outcomes in every respect, including prostitution. I expect legalization is what's required as that would allow for optimal regulation and tax.

You could go the way of East Asia. That would be very difficult, but easy access to narcotics could lead to disastrous results.

I once saw a drug addict shoot up what looked like heroin in plain view of a police officer in Seattle. The officer did absolutely nothing. Needless to say downtown Seattle is also an extremely unpleasant place. In fact I'd say Seattle as a whole is gradually turning into a SF-like shithole. The only real solution to this is to make the decision makers experience the consequences of their luxury beliefs. How to do that in Seattle is not entirely clear, aside from that solitary case when a bunch of CHOP thugs marched to the mayor's home in 2020.

decriminalizing is a half assed way to try to help. The only issue with drug use isnt that you'll get arrested for possesion.

You need access to safe and clean drugs. Support systems need to be in place. The look of downtown isn't the only way to measure success. How many people aren't dying because there isn't a stigma around drug use, where clean and predictable drug doses (like alcohol) can be had, drug testing kits, safe pieces to use with, safe places to be etc

The "war on drugs" has been waged for more than 40+ years. It seems like it takes more than a few years, most of which was during the worst public health crisis in generations, to succeed.

Most incarceration is about helping those who aren't the ones suffering (evidenced by "... a very unpleasant place"). Not attacking you for your comment, just pointing out the paradigm we as a society have.

it’s always a little weird to me how out of touch this comments section is, especially on the topic of certain social ills that people wish to normalize. I really think the constant pressure on these subjects has been counterproductive to that goal.

Maybe the problem is doctors giving fentanyl to patients constantly.

> People making decisions around drugs have no experience with drugs and users.

Just wait until you see who's making decisions about women's health.

This is something that is ignored: the companies not affected by tariffs will raise their prices. Any intimation that they will keep prices the same is disingenuous. Leaving money on the table would be anti-capitalist.

I do find it interesting that the articles almost never mention the direction the drugs were moving in …

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The point is that it is almost entirely manufactured in Mexico using Chinese and Indian precursor chemicals. The amount crossing the US-Canada border is negligible by comparison.

Yes, and 4.8 billion fatal doses were intercepted at the US-Mexico border. Fentanyl is potent.

A 10% tariff on China won’t stop globalization. Even an 100% tariff wouldn’t. American goods aren’t 10% more expensive, a lot of them are 10x more expensive.

Look for American made kitchen knives. You will be lucky to spend less than $2k on a block of Made in USA knives. Meanwhile you can get a pretty good set made in China for under $200.

If you wanted American companies to compete, you would need a 10x tariff to make that $200 knife set cost $2000.

You guys tried everything but the things other countries that do well are doing. But hey, let’s try to stop globalization as a single country.