[yters]

The prior question is: what is causing overdoses?

My understanding is the opioids are already regulated, controlled, and dosed appropriately, since most are acquired through medical prescription. Why so many overdoses, then?

My hypothesis is the drugs are addictive, and it takes more to get the same high each time, which eventually leads to accidental overdose.

Additionally, drug use can lead to feeling trapped and hopeless, and that might cause people to either carelessly or intentionally overdose.

[leetcrew]

> what is causing overdoses?

overdoses can happen in many ways. sometimes it is genuine user error; ie, the person goes overboard and simply takes too much, or they don't properly account for the drop in tolerance after a period of abstinence.

> most are acquired through medical prescription

this might be true overall, but i'm not sure it's true of illegal/abusive use of the drugs. i can't easily find precise numbers, but prescription drugs appear to account for less than half of total opioid overdose deaths [1].

this brings us to the next (and as far as i can tell, primary) cause of overdose deaths: variance in purity. the purity of heroin varies wildly, anywhere from 10-60% strength on the street. add fentanyl hotspots to the mix, and suddenly addicts are overdosing on what they consider conservative "tester" doses.

[1] https://talbottcampus.com/prescription-drug-abuse-statistics...

[emiliobumachar]

"the purity of heroin varies wildly, anywhere from 10-60% strength on the street"

That's a sixfold increase. This is the key to understand overdoses. Keep in mind the last time you went a little overboard with alcohol, coffee, or even sugar. What would have happened if, unknown to you, you had actually taken six times as much?

[armitron]

Your hypothesis is entirely wrong. Overdoses happen because desperate people get their drugs from the black market where purity fluctuates. Read the article again. Fentanyl getting mixed into heroin, cocaine and methamphetamine. This is what kills people, not some mystical property of "opioids" that makes people consume more and more.

The US has a well-documented, multi-year history of legalized Opium (and later) heroin usage. Bored housewives would order heroin kits from Sears mail-order catalogues. There were no mass deaths due to overdoses. Political propaganda that was aimed against the Chinese immigrants of the time was used to vilify Opium and led to the passing of the very strict drug laws that continue on today.

The solution is simple: Legalize Opium and let people smoke it as they see fit. It's addictive, yes, but no more than alcohol or tobacco and much less destructive than street heroin or synthetics. Another point: Functioning heroin addicts that keep down a job are not exactly unheard of, today. Most of them have good enough salaries to afford premium heroin and they manage to blend in.

[tigershark]

It’s incredible how every time there is a discussion over opioid mortality there are people saying that it is the same as alcohol or tobacco and eulogise the functioning heroin addicts...

[armitron]

Read what I wrote again, carefully this time before you jump to conclusions. Consuming Opium is arguably a lot less harmful in terms of OD deaths/cancer/accidents than black market "opioids"/alcohol/tobacco. This is historic fact, as we have hundreds of years of extensive Opium use to inform us. People didn't suddenly drop dead when they smoked refined Chinese/Indian Opium. They kept their habits for decades. Addiction was also mostly limited to the lower-classes that did not have the means to smoke high-quality Opium ("chandu") and smoked the "dross" or lower quality Opium that was heavily morphine-ladden.

Opium is not heroin but nevertheless, I'd go as far as claim that consuming pharmaceutical-grade heroin, as has been done legally for decades in the US in the past [1], does not lead to a massive increase in OD deaths. Addiction, sure, but again people don't drop like flies. Historic fact.

"Opioid" mortality has nothing to do with consuming Opium or pharma-grade legalized heroin, and everything to do with synthetic chemicals controlled by drug cartels, black markets and varying, unpredictable street substance purity.

[1] http://old.puaro.lv/media/images/Dzeltena_zemudene/nar3.gif

[LeftTurnSignal]

> My understanding is the opioids are already regulated, controlled, and dosed appropriately, since most are acquired through medical prescription. Why so many overdoses, then?

There's more people who use opiates than are prescribed here. Much Much more. OD's here happen because they can't get those drugs anymore, and go towards the black market. They don't bother testing anything from there, so they never know what theyre getting. That's the recipe for disaster here.

(may not be everywhere, but it's definitely at a lot of places)