I don't find this too hard to believe. Even today we see a push to either reformulate narcotic painkiller medications to make abuse difficult/impossible, or bundle them with acetaminophen/paracetamol. The problem is that when drugs like Oxycontin are reformulated to make abuse difficult ("Oxycontin OP") addicts are driven to attempt abuse of other narcotic painkillers which get them the desired affects... but with a potentially deadly dose of acetaminophen.
So instead of attempting to help these people while providing them with a safer alternative (methadone clinics exist, but for the most part they really are not targeted towards the middle-class/middle-aged prescription painkiller addict crowd), we are pushing to eliminate drugs that are safe to abuse. This move seems based in the plainly idiotic attitude of "well if an addict can't do something safely, he'll just give it up".
The thesis of the War on Drugs is pretty much that there are abstract, amorphous dangers to recreational drug use, and the proper role of government is to provide immediate, concrete dangers so that people will stop.
It does have a certain twisted logic to it, if you ignore every piece of empirical evidence generated over the last hundred years.
Mixing Tylenol with oxy is twisted in a different way, because it replaces an abstract danger (if you take some amount in some period of time, you might become dangerously dependent) with a somewhat less abstract danger (if you take some smaller amount in some shorter period of time, you might die).
When I first saw this ad series I was stunned by the hollow, almost cynical reasoning on display, only to then be even more stunned by the lack of reaction in others. Your one-sentence summary of the War On Some Drugs, however, provides an insightful context to the campaign.
When I first saw this ad series I was stunned by the hollow, almost cynical reasoning on display, only to then be even more stunned by the lack of reaction in others.
There's a substantial cohort of the population[1] that thinks If something is illegal it must be wrong. They wouldn't make it illegal unless it was. Getting through to these people, in my experience, is almost impossible.
[1] Probably not on HN. But we're not representative of the country at large.
The thesis of the War on Drugs is that we can expand police power, persecute minorities with impunity, give hand-outs to well-connected industries (pharma, alcohol, tobacco, prison operators, etc.), and generally terrify the population into submission. There has never been any other goal, all the way back to cocaine first being made illegal a century ago.
Or that the role of the US Government, as presently practiced is to do anything other than funnel tax money to crony capitalists. Take it form the middle class and give it to the plutocrats.
I guess the logic is not much different from the one used to burn people at the stake for their sins. If you smoke weed, it's bad for you, so we will put you in jail, which is 100 times worse, but at least your soul is cleansed by the government now.
Forcing oxycodone with acetaminophen has caused thousands of deaths. I recall reading a study that did the statistical analysis and got more precise numbers but can't find it with a five minute search.
This reminds me of the result of the abstinence argument. Namely, even if you believe all premarital sex is immoral, it's still important to realize that safe immoral sex is better for the man and woman than unsafe immoral sex. When the government forces what society believes to be "right," as opposed to what is effective (in regards to health, purse or morality), it can have harsh consequences.
Oxycontin OP is just Oxycontin in a "tamper-proof" pill. It only increases the effort needed to take a recreational dose; it doesn't increase the danger.
What you're talking about is a real problem, but you'd better pick a better example.
Both things like Oxycontin OP and drug clinics seem like good ideas to me. I don't know why you seem to be saying it's one or the other and we're making the wrong choice. I don't think that's a valid representation of the decision space.
Opiate abuse is damaging enough. Increasing the danger does nothing to slow abuse among the addicted and is incredibly unethical. It's like building a car that disables it's own airbags when you start speeding.
Worse actually. Speeding is not a physically addicting activity, merely psychologically addicting.
Withdrawing an abusable drug is not the same as deliberately poisoning people. I know they are in the narrative you wove for yourself, but I just wrote a post about how I don't buy that narrative.
Narcotic pain killers containing acetaminophen have a lower risk of addiction than the equivalent opiate. That is the whole reason why they're so readily available. A dentist prescribing Vicodin is unlikely to create another addict. As a person who has had two root canals, one for a severely infected tooth, I am glad that this is the situation.
Oxycontin, as a time-release opiate, is another drug intended to maximize the painkilling:abuse potential ratio. You are implying that things like Oxycontin OP are an attempt to poison drug users. I reject this weird-ass conspiracy theory, and submit that perhaps things like Oxycontin OP are designed to do exactly what they say--lower risk of abuse. Nobody wakes up one day and says "I am going to become an addict today", it happens in cumulative moments of weakness.
Edit: now people are saying that the point of Vicodin is to kill people who overdose on it. Nonsense. It's an effective painkiller with reduced addiction risk; reason enough for its existence if you care at all about consumer freedom. But whether or not Vicodin should exist is not even what this subthread is about. I give up.
Despite the assertions of low abuse potential, the reality is that people do become addicted to narcotic pain killers. Vicodin abuse is massively widespread, you are entirely ignorant in this subject if you think otherwise.
When the original, "higher abuse potential" (read: safer) Oxycontin formulation was replaced by Oxycontin OP, addicts were driven to abusing high-acetaminophen narcotics anyway (attempting cold water extraction if they knew enough), or to more dangerous sources of a fix: black market original formulation Oxycontin or, often, street heroin.
No addict wakes up one day and says "Oh, my painkillers have acetaminophen? Guess it's a good day to quit".
Why? Because they are addicts.
Creating slow-releasing narcotic painkillers to reduce accidental addiction is fine. Removing all safe narcotic painkillers from the market damages addicts and is unethical. Oxycontin OP was not invented in a vacuum, it replaced the traditional Oxycontin in a misguided attempt to stop deliberate abuse (the differences are not merely limited to slower release).
Creating narcotic painkillers that are purposely deadly when abused is never fine.
I honestly don't know how an MD would permit himself to be involved in the Vicodin/Percocet crime. There had to be hundreds of doctors involved in development and approval. It kills people, completely unnecessarily, in the name of the drug war.
(if I ever get a painkiller from my dentist, I ask specifically for vicoprofen, anyway)
>submit that perhaps things like Oxycontin OP are designed to do exactly what they say--lower risk of abuse.
They do so by attempting to deter abuse via threat of poison. People die from acetaminophen poisoning from this tactic.
>Nobody wakes up one day and says "I am going to become an addict today", it happens in cumulative moments of weakness.
You don't know what you're talking about. The Vicodin comment was bad enough. It's widely known to be abused and it often leads to abuse of other painkillers.
edit: I'm worried I've misunderstood. I got the impression from the context that Oxycontin OP had acetaminophen in it. If it doesn't, why are we even talking about it?
500 people die annually due to acetaminophen poisoning, mostly from attempting to take too many painkillers which include both opiates and acetaminophen. The acetaminophen is included for the express purpose of "dissuading abuse."
So many people I know in their 20s only use Tylenol and especially after drinking binges nobody I know uses Aspirin, zero.
Tylenol the worst thing to take with alcohol after binge drinking it's terribly hard on your liver.
It's worse for women who can't process ethanol ("alcohol") as well as men due to women's bodies producing less dehydrogenase which breaks down the ethanol.
From what I understand alcohol and acetaminophen (Tylenol) are processed by the liver in the same way so ingesting both overloads the liver, more so in women.
I think liver failure is going to be common in a few years in the 30-something crowd.
I'm not a doctor and not involved in any way in the medical field just a concerned citizen.
Liver failure is a concern in 30something crowds. Not from properly used paracetamol, which is a very safe effective med when used correctly. Certainly from paracetamol overdoses (which are easy to achieve) and also from excessive regular drinking. People have little idea how much alcohol they actually drink, nor how much they could drink safely.
The current understanding of paracetamol and alcohol is confused - some people think there may be a protective effect from the alcohol; other people think the combination may be more harmful than the sum of the paracetamol and alcohol; others think it's only a problem with pre-existing liver damage.
Aspirin is harmful to the stomach lining, and I personally would not like to take aspirin after heavy alcohol use.
I can't speak for everyone, but I used Tylenol essentially out of habit as a young adult, because my parents gave me Tylenol as a child. This makes sense (I think), I am told aspirin should not be given to children.
So, it's probably just an education thing. Tylenol seems fine at what it does, and it isn't like people are misled. I bet you the label warns against mixing alcohol with Tylenol, and people really should know not to mix alcohol with other drugs.
Not misled but unaware or ignorant and also the binge drinking is a big part of it.
I can't recall where I read it but I remember reading how a person should not use Tylenol even three days after drinking since the liver is still dealing with it. I'm not sure if that's true for any drink or just binge drinking.
College students who bing, take Tylenol, next weekend bing and so on are probably the ones who will suffer the most liver damage.
The liver is an amazing organ it's the only organ that can repair itself and regrow due to physical damage but not systemic damage.
Speaking of aspirin, a friend had a headache last week, took some, and headache went away. He felt good, so went to his paintball game. You should see him a week later. He is basically yellow and purple.
Regarding aspirin it should also be mentioned in young adults i.e. late teens to about age 20. Reye's syndrome should be something people are aware of.
Correct. There are times when you do want the anti-inflammatory properties of acetaminophen. Using only opioids for inflammatory pain, or muscle aches requires a higher dosage than if it was mixed with acetaminophen.
I usually take muscle relaxants (Soma) with Naproxen for back pain, and avoid the opioid pain meds or acetaminophen.
It's kind of crazy that acetaminophen gets added to so many drug cocktails prescribed by doctors. When your liver is already handling a bunch of other stuff, do you really want to throw one of those most liver-toxic medications out there on top?
Apparently I'm not the only one who feels this way. According to wikipedia:
On June 30, 2009, a U.S. Food and Drug Administration (FDA) advisory panel voted by a narrow margin to advise the FDA to remove Vicodin and another painkiller, Percocet, from the market because of "a high likelihood of overdose from prescription narcotics and acetaminophen products". The panel cited concerns of liver damage from their acetaminophen component, which is also the main ingredient in commonly-used nonprescription drugs such as Tylenol.[8] Each year, acetaminophen overdose is linked to about 400 deaths and 42,000 hospitalizations.
There are a lot of drugs that contain >1 ingredients that work together. What makes you think it must
be a poisoning conspiracy? The paracetamol+opiates combined
effect is widely documented in medical literature,
and many of the most common painkillers are combinations
of paractamol along with a mild optiate like codeine.
I have to weigh in here. It does not stop the abuse. Separating opiates from acetaminophen is extremely simple (look up cold water extraction). All it does is kill people who aren't aware of the danger or the alternatives.
There are many good reasons not to abuse oxycodone. The government doesn't need to add to the damage of people who are only hurting themselves.
Actually I think that poster was being slightly facetious and meant that it does stop that abuse for those 500 people a year because a dead person can't abuse drugs.
"mostly from attempting to take too many painkillers which include both opiates and acetaminophen"
Brief Google returns 31%. Still a large percentage but nothing like the number of people who die from prescription opiate abuse (the better part of 15K). Powerful drugs sometimes result in the death of user, news at 11.
The danger posed by abusing narcotic painkillers is disputed by nobody. The issue being discussed here is the practice of making the abuse more dangerous to 'discourage' abuse.
I know it is hard for a lot of people to identify with drug users/addicts/fiends, so imagine we tried to apply the same sort of 'solution' to, say, speeding. Make all cars disable driver-side airbags once you go, say, 15% over the national speed limit. Speeding sometimes results in the death of the driver, news at 11.
They don't put acetaminophen in opiates to poison people, they put it in because it's an effective painkiller and the natural check for abuse makes the powerful opiate more easily available than it otherwise would be.
"Make all cars disable driver-side airbags once you go, say, 15% over the national speed limit."
I'll suggest a better analogy. People have to wear seatbelts/motorcycle helmets. Unfortunately this does kill some people but on the whole it does far more good than harm.
> They don't put acetaminophen in opiates to poison people, they put it in because it's an effective painkiller and the natural check for abuse makes the powerful opiate more easily available than it otherwise would be.
> They don't put acetaminophen in opiates to poison people
> natural check for abuse
The "natural check for abuse" is a threat of poisoning. If acetaminophen did not poison, it would provide no "check for abuse".
Seatbelts are not a deterrent to anything. Your analogy is terrible.
As a Canadian I laughed at "steep taxes" when I go to the US alcohol is ridiculously cheap and sometimes given out free (e.g. casinos).
Especially hard liquor and wine, I rarely drink but it's interesting to see such a huge difference: 6 pack $15, 1 liter Captain Morgan rum $40, Sauvignon Blanc wine $15
Probably worth noting that prices and regulations vary wildly on a state-by-state basis.
In Pennsylvania all liquor and wine can only be purchased from state stores, and beer can only be purchased from licensed beer distributors (never grocery stores or the like, with very rare 'technicality' exceptions). (Restaurants and bars also sell beer, so in practice most people who buy beer in Pennsylvania will buy a six-pack from the local bar or restaurant, often at rather steep prices).
In Utah, chances are you won't be able to buy that same $15 six-pack of beer; alcohol content is limited to 3.2 ABV (very low, for those not versed) unless the establishment is also licensed to sell liquor.
Then you get into the whole local government regulations/taxes situation. There are hundreds of "dry counties" in the US where you simply cannot buy alcohol at all. "Blue Laws" seem to be more common than not, even in cities.
It's a complex situation. In some places in the US alcohol will flow like water (Such as Vegas, as you eluded to), but in other places alcohol laws will make Canada appear liberal in that respect.
And it's still done today. Denatured or methylated alcohol is a common product used around the world as a common solvent. Instead of using denatured alcohol to mix shellac I just get 190 proof grain alcohol since it's cheaper, but it's available in very few states.
That makes sense though. I think we generally agree as a country that we don't want to make alcohol freely availible to minors- so what do you do about industrial usage? Do you want to be carded to buy solvents? Should a teenager be prevented from buying solvents for painting?
"I think we generally agree as a country that we don't want to make alcohol freely available to minors"
And this is one of your main problems as a country. When I was a kid in Spain I had access to as much alcohol as I wanted, so with all my family and friends and school partners (hundreds of people). We had very few problems with that, being a "borracho" was bad seen by society but moderate consumption was normal.
There is nothing wrong for a kid drinking some wine or Sider or Cava for lunch, in fact a lot of families continue giving their children access to low grade alcoholic drinks as it was done since the Romans(before water filtering 100 years ago drinking water alone meant death by water microorganisms).
Later they forbid it, and "botellon" appeared. It was cool to do something against the law, "borracho" was replace with "pedo" without the negative connotations, and our young people started drinking like there was not tomorrow.
190 proof alcohol, which is what is used as a solvent, is also really, really bad for you. I know it's available as a In few US states, but what is the availability in other countries?
It's not particularly any worse for you than twice the quantity of 95-proof alcohol or four times the quantity of 47-proof, although of course any kind of alcohol is pretty bad. 96% pure alcohol (192 proof) is universally available in grocery stores and pharmacies here in Argentina, and most brands bear a notice stating that it is suitable for food use; a few of them also carry methylated spirits at a slightly lower price. I use the pure alcohol for cleaning and fuel.
> I think we generally agree as a country that we don't want to make alcohol freely availible to minors
Hey kid; don't take the car out without my permission. And just in case you get any ideas while mom and I are out this weekend, I've rigged the brakes to fail 15 minutes after you start the car. Be good!
Man, I'm glad you ain't my daddy.
>Do you want to be carded to buy solvents? Should a teenager be prevented from buying solvents for painting?
Most places (in the sacramento area?.. I haven't bought spraypaint in a while.) card you when buying spraypaint. I have certainly been carded for buying solvents that one could potentially huff. It's certainly not as consistent or as well-enforced as alcohol, but it's done.
"I think we generally agree as a country that we don't want to make alcohol freely availible to minors"
Really? I was thinking more along the lines of "lower the drinking age and raise the driving age." I would rather see teenagers drinking than teenagers driving.
Other [denaturing formulas] used bitter-tasting compounds that were less lethal, designed to make the alcohol taste so awful that it became undrinkable.
This approach was also applied to non-industrial alcohol products, leading to another round of mass poisoning:
Which bears an eerie resemblance to the problems we have with methamphetamine today. Much of the damage caused by methamphetamine abuse is the result of adulterants in the drug, which is produced under poorly controlled conditions. Pharmaceutical methamphetamine -- the kind that doctors sometimes prescribe to children -- causes far less damage to its users and even to those who abuse it (not to deny that abusing it is dangerous even without the adulterants).
Did they find materials that cause the "victim" to age slower in maturity or increase the efficiency of perception and processing? Because if so, those seem unambiguously good (though the others seem pretty unambiguously bad).
Maybe this is why people associate bootleg alcohol with danger these days. Of course, it doesn't surprise me they did this in the 30s. We also used to have involuntary sterilization here.
With these kinds of historical examples you sort of have to understand the people who think that mass shootings are orchestrated by the government to move public opinion on gun control.
OK, before the conspiracy theorists on this board start coming out of the woodwork, let's try to keep this in perspective: they were drunks -- they deserved it!
Two trips to Auschwitz this year, my friend. I was responding -- in a perverse and ironic fashion -- to this meme that I hear oft repeated that the US gov't wouldn't conspire to kill its own people ...
40 years! I will never wrap my brain around this one. And no, I don't mean to say "that's just as bad as the Nazis". But still. 40 years. So much for rather hideous crap being impossible to keep secret, right? I can't help but think, if something like this can stay secret for 40 years, real horrid geopolitical stuff involving sending people to war based on deception, and pluging a country into debt to fleece them, would stay secret for much longer EZ PZ. Which doesn't prove anything of course, other than that "something like this is impossible to keep secret" seems to be wishful thinking.
While the Tuskegee experiment followed the natural progression of syphilis in those already infected, in Guatemala [US Public Health Service] doctors deliberately infected healthy people (having just defeated the Nazis).
speaking of nazis: I guess they would have been delighted to see the way for example people with Down's syndrome get removed before they are even born. And the way it is done voluntarily. Same disrespect, new wrapping. Instead of "to the greater good of the people" it is now "their parents right to decide."
(Startup lesson: Don't underestimate marketing. It might be the difference between "hero" and "villain".)
So instead of attempting to help these people while providing them with a safer alternative (methadone clinics exist, but for the most part they really are not targeted towards the middle-class/middle-aged prescription painkiller addict crowd), we are pushing to eliminate drugs that are safe to abuse. This move seems based in the plainly idiotic attitude of "well if an addict can't do something safely, he'll just give it up".