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Did wastewater drug monitoring for a while, and the annoying bit was fentanyl metabolites sitting near the detection limit, so absence isn't proof.
Was that because there wasn't much fentanyl use or because fentanyl metabolites are somehow harder to detect?
I assume drugs that are potent in tiny quantities leave less metabolites.
From what I understand this uses overdose numbers. They should also not be assumed to be comparable across countries (recording practices vary widely), but if they tell the same story as wastewater monitoring there may be something to it.
Does wastewater drug monitoring account / offset for constipation caused by drug use?
There isn't anything to measure if the poop is unable to leave the end-user.
I believe it's urine based.
Either way, the constipation would affect different users at different times, so I don't think it would matter to the data. In other words, your idea stinks ;)
Drugs are detected in urine, not feces.
If it's below the noise floor, then you didn't really detect it, did you.
Statistics can detect a lot of things below the noise floor given enough samples. However there are a lot of questions when it attempts this.
"For years I paid my people extra so they wouldn't do that kind of business. Somebody comes to them and says, 'I have powders; if you put up three, four thousand dollar investment, we can make fifty thousand distributing.' So they can't resist. I want to control it as a business, to keep it respectable. I don't want it near schools! I don't want it sold to children! That's an infamia."
When AI can write screenplays like this one, then it's game over.
the internet is full of let-me-tell-you-a-quick-story like this one. so AI can and nothing is over, ma dude. nothing will ever be over.
Expand? This is part of plot to The Godfather. Not what you'd call exotic, I'd think?
It's just considered one of the best movies and screenplays of all time. My quote is a relevant line in said movie.
Feels like they caught up to internet archive being used to circumvent paywalls. Unfortunate.
Can anybody share a non-paywalled link?
I'm no expert, but I've always thought that adding much more risk to the lives of your customers unnecessarily is not good for business.
Soon after John Stewart Mill we assessed that markets are not perfect.
Accelerations in the different directions of bounded incentives create as-if Brownian motions, - not the stability towards optimality of a perfect organic model.
Or: what you write is rational, but people are easily not... The supply side should disappear from the market when irrational, but changes are slow..
Did we? Because while seemingly obvious nowadays it is not a settled matter in orthodox econ academia.
When the risk is the benefit things get weird
They still traffic heroin though, which is not stellar for customer's life expectancy.
Tell this to junk food manufacturers...
Junk food dont have a chance to kill a person on first try or high chances to kill them withih a year or so.
I think you are right, but doesn't that mean the consequences of fentanyl do not weigh in on society as badly as junk food? Dead people do not cause extra costs for the rest of society
I was going to make a joke about how it depends on how fast you eat it but you're absolutely right.
Tobacco is incredibly damaging but because it doesn't kill you right away we tolerate it.
There's probably a rather grim metric that defines time to death ratio for addictive substances somewhere in a government report.
If its cheap enough to be worth letting a few customers churn, then profits will be positive
Might want to look at the cigarette industry
Kills you very late, gives all the time to reap.
Curiously, this is still relevant to my comment nearby about "slow effect models" ( https://news.ycombinator.com/item?id=49842956 ).
You just need to keep your customers alive long enough.
70% of food in the supermarket is ultra processed. But as long as people make it to 65 years old they are still good customers. That is still 50 years of sales.
And: shaking the scene in a way that will attracts too much attention, including crackdowns, is very bad for business.
Almost like it's not really about "business" at all and something more is going on for all the parties involved
Yes, internal destabilizing of the oppossition is a tried and well working oractice of inter empire warfare..
The rest of the economics behind fentanyl are great for drug producers vs heroin though, so it probably doesn't matter?
For big pharma it is great business! Life long debiliating condition, that requires medication to manage... acceptable risk to customers is around 5% yearly mortality rate!
Helthy people do not contribute to big pharma!
Oxycontin was built on the idea of turning a drug (MS Contin) for the terminally ill (too small a market) to a lifelong dependency for as many people as possible, and each taking as many milligrams as possible.
I know several doctors who mourn the addiction issues with Oxycontin because it was so useful for a lot of cases. Give someone some Oxycontin, then you can address the root problems, and then get them off - works very well... Now they won't give it to anybody - those addicted know exactly what to say to sound like the people who really need it.
When there are enough customers, individual customers do not matter.
Making it up with volume
Maybe the mafia saw the population curves and realized how precious each customer is now and will be in the future. Something tech companies would be wise to think about...
https://www.macrotrends.net/global-metrics/countries/ita/ita...
And the curve is the same across almost all the world. Italy is 1.3, you need 2.1 to even tread water and keep the population you have. Who buys the stocks and fentanyl when each year you have less and less buyers?
https://freesound.org/people/PicassoCT/sounds/848731/
In this market, a better high for less money will attract lots of customers, even if it is less healthy than the alternative.
So, if you’re in the business of selling the somewhat healthier product, and one supplier starts to supply the otherwise superior product, that’s not good for business, either. You will lose customers.
Now, do you accept that, saying “I won’t sell that”, do you fight to outlaw the product (will be hard given at you’re not selling healthy products, either), do you fight the suppliers of the new product (a gang war) or do you add the product to your inventory?
There often isn’t a clear choice; each option has its pros and cons.
"less healthy" is a bit of an understatement; they're not selling cigarettes that will kill you in the long term (or even the medium or short term). Fentanyl will kill you the first time you're exposed to it.
Increasing the potency of some drug with fentanyl is an interesting choice, because by the time the user *knows* how strong it is, there's some likelihood they're already dead.
This was the way it worked up here (in QC) with the 81s. If you sold shit that could draw attention to you, your organization or suppliers, you were swiftly taught not to. They had decent quality control, but as their grip slipped so did quality. Now we get fentanyl overdoses weekly.
81 = Hells Angels
Who these days are more a front org for the CCP/triads who seem to be running much of the criminal underworld in Canada with their network of smuggling and money laundering.
My theory is that the CCP/triads leveraged drug addiction within the HA and killed anyone that objected, and everyone else got rich...
There's been a criminal civil war raging between HAs and every other smaller org that wants to expand (look at Blood Family Mafia specifically, Arab Power as well). HAs have lost some feathers in pretty gruesome ways. They're all older and neglected to replenish the ranks in order to preserve prestige. Street gangs didn't. If I'm competing in that world, I'm funding the underdogs until leadership trembles, then we make a deal. I believe we're at that point now. All those groups - including the Sicilians - have all been slowly invalidated and Angels are appearing more stable/powerful these days (even though we just outlawed their colours - but even that gives them prestige).
Montreal and Quebec is only one part of the criminal world in Canada.
Ontario is different, East Coast is different, prairies are different and the West Coast is it's own beast.
HA uses puppet gangs, so while their power may be diminished, they are still lurking in the background, as key nodes for drugs, money and guns.
The power lost by the HA and traditional mafia has largely been taken over by CCP/triads groups. The Indian and Iranian OC are under the Chinese, who have deep into the government and economy as major developers. Read Sam Cooper.
Of course, of course. As a Quebecer, I never speak for the ROC ;)
I googled so y'all don't have to: "QC" means Quebec. 81 means Hell's Angels as per sister comment.
I'll be honest, this was helpful for me even as someone who lives about 2km from the Quebec border. I was uncertain as you don't often see it in the Hacker News context.
We gotta take back the letter Q man, it's either us or Qatar and I don't see them campaigning. There's dozens of us!
Why not goverment "is keeping fentanyl out of italy"?
If you would sell unaproved medication during covid, you would get several years in prison.
Why someone who sells unapproved medication without prescription, gets released and can keep selling this stuff? Medication thst kills people!!!
I'm afraid some crime syndicates have found out they can just steal it from hospitals, some 80 vials went missing from the ospedale israelitico in Rome during the summer and there are already reports of an increase of users in the outskirts of the city..
And who is keeping it out of the other European countries?
Fentanyl is made by Mexican cartels from Chinese precursors. I suppose there aren't many Mexico's with massive organized crime networks in Europe to pour deadly drugs into their countries.
what do you think where europe gets their cocaine from...
The same place Mexico gets them; Colombia, Bolivia, Nicaragua. Mexico just isn't "on the way" in the same way for Europe.
I always assumed this was an america-only drug that no one actually does or at least not to the excess that it's claimed by the publications using it for the normal fear journalism purposes.
2/3 of all ODs in US. More deaths per year than gun violence and car collisions combined, which are both quite high in US. Seventh most common cause of death overall. Over a quarter million people dead since 2018.
No one "does" fentanyl, it's a highly addictive additive that is secretly added to other things. Even so, 50,000 - 70,000 Americans per year die to it (more than suicide and gun violence many other things).
This is an "American" thing because fent primarily comes from Mexican cartels (Sinaloa and Jalisco New Generation).
They buy precursors from China, they produce it in labs in Mexico, and then smuggle it into America where they kill 50,000 to 70,000 Americans per year.
Not getting political here -- but what would you think if organized crime in a neighboring country was murdering 50,000 to 70,000 of your countrymen per year?
But who buys these drugs with fentanyl and why? There might a link I'm missing, sorry! :)
Tiny bits of fentanyl are added to a variety of recreational drugs used extensively by all kinds of people, rich and poor. They add it to cocaine, heroin, meth and even marijuana. They imitate oxy, percocet, vicodin, xanax and adderal using fent laced pills as well.
As much as 20% of Americans use these recreational drugs. Europeans on average use recreational drugs like half as much as Americans, maybe 10% use them.
Yeah but there's always the alternative of not doing coke, heroin, meth or even marijuana.
It is typically laced into other drugs. A small amount of fentanyl is highly powerful, so if you mix it into heroine, you get a different buzz. But if you (a drug dealer, not a chemist) mess up and drop too much, then your customer will accidentally OD.
It's incorporated into pills that appear to be equivalent to prescribed opioids like Oxycodone. From buyer perspective it's just a cheap opioid pill.
Here’s reporting on the fentanyl crisis, covering who buys the drugs and why
https://youtu.be/925wmb-4Yr4
It's not murder. People are not forced to take fentanyl... Wouldn't these people get into a different drug if it wasn't fentanyl?
A lot of times people think they're getting a different drug that happens to be laced
So if you bought a bottle of water, and inside of that water was a poison that kills you, intentionally added by a criminal because it makes them more profit, that's not murder?
Those people were doing a line of coke, they had no idea they were about to overdose on an opioid.
With the minor difference that water is a dangerous, illegal substance.
That I would see as extreme recklessness leading to somebody dying, might be called murder in the US. I wasn't aware this is happening on a larger scale. The solution could be to vote for politicians that legalize drugs so users can get them safely
As Arturo Salazar said, "Addicts? They treat themselves... they overdose, and there is one less to worry about." Dark movie
While I agree that "murder" is the wrong word, there is an angle that you are missing.
Drug dealers will lace "normal" drugs with fentanyl. It gives a "different buzz". The customer knows they are buying "normal" drugs, and there is no quality control, so lacing happens. If the dealer messes up how much they lace, it is easy to add too much (because a small amount t of fentanyl goes a long way), and your customer ODs.
I was indeed missing that angle. Thanks for mentioning it
Well obviously I would think it's highly racist to take any action against them or try to secure the border in any way.
I would argue that fent became an issue only after the oxycontin et al. peddling was slowly curtailed; together with fent precursors becoming absurdly cheap to procure and process, compared to other opiates. Users originally hooked on the pills needed a replacement, and as suddenly the chemistry got much cheaper, everyone switched to fent. The physical volume of illicit substance you need to smuggle is also lower with fentanyl, so I'm sure that would have played into this trend as well.
If you want to find where to point the finger to, the systems that let prescription opiates be prescribed with such reckless abandon is a good superficial target. Getting political here - if you want to find the very root cause of all this, I would present the institutions that prevent the implementation or otherwise erode preexisting social safety-nets as the culpable party.
I’m open to being corrected, but I thought fentanyl was a direct byproduct of the “drug war”. Compared with heroin it is easy to smuggle because it’s high potency, doesn’t require trade routes from Afghanistan, etc. So it’s basically an adaptation to the US law enforcement environment.
I’m sure there are other factors too, but if there had been good “clean” opiate availability I suspect things would look different presently.
Some things to correct here:
- While drugs laced with fentanyl are also a problem, lots of people _do_ knowingly consume fentanyl. In fact, it has replaced Heroin in the US 'market', for example. It is also a contaminant in other drugs (cocaine, meth), due to how easy it is for fentanyl to stay in crevices, etc. It is also 'snuck in' to counterfeit pills, which is the only aspect you mention.
- The traffickers physically moving fentanyl into the country are overwhelmingly Americans. Pre 2019 traffickers used to get this straight from China, but stricter controls in China have shifted things to be staged in Mexico instead.
- The demand and traffickers are still largely American, and it is a "symbiotic" problem. US drug demand is empowering Mexican cartels and making everyday Mexicans less safe (the cartels also get most of their guns from the US). At the same time, powerful Mexican cartels mean it is much easier to "stage" fentanyl in Mexico then import it into the US than the older model of importing it directly from China.
Its gaining popularity in the UK and is starting to show up sporadically, but the opiod epidemic provided pretty extreme fuel to start the fire in America. No idea if itll ever take off here to the extent heroin did, depends on the economy I guess.
From what I’ve read online Ndrangheta are much more powerful than the mafia in Italy.
That’s arguably true, but nowadays Mafia or the plural “le Mafie” (the Mafias) is often used as a catch all term for such organised crime groups in Italy, with the Sicilians referred to as the Cosa Nostra.
Totally different healthcare systems, and no sane doctor will commit the same mistake again.
It’s CLV (customer lifetime value): the integral of the MRR. Something most companies mentioned on HN should understand though it feels like Apple is the only one that takes it seriously
(And with Apple’s new CEO, the early signs are that commitment is headed for the ash heap as well, but it seems the Mafia may have a longer horizon)
What do you see as signs? I was hopeful that Ternus’s hardware background was a positive.
Maybe this https://news.ycombinator.com/item?id=49801939
Not in their own backyard!