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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 ;)
Well if the user dies of constipation the poop never enters the sewer :)
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.
You missed the kicker at the end where he says just sell it to the blacks, they're animals anyways. Leaving that out makes it sound noble.
Feels like they caught up to internet archive being used to circumvent paywalls. Unfortunate.
Can anybody share a non-paywalled link?
If you look at the page with Bypass Paywalls Clean, it shows a service blocked error. They seem to be cracking down hard.
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.
Yes. Everybody here should be or get acquainted with Herbert Simon - he is both "Logic Theory Machine" and "General Problem Solver" and "linked lists", and "bounded rationality" and "satisficing".
Herbert Simon - https://en.wikipedia.org/wiki/Herbert_A._Simon
People would benefit from learning some control theory too. A little tinkering with (even abstract) PID controllers can quickly disabuse one of the notion that feedback loops settle instantly.
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 can understand where is your cynical take comes from, but even from that perspective I would say you're wrong. Having people around who are burden to their families, friends and society is a "good" thing.
When you grow up in a society and see results of gambling, tabacco, alcohol and drug addictions around you that usually deter you from a getting into it. It does not deter everyone, but society actually sees the consequences.
Same with junk food and obesity - when you have people in your family struggle with weight, diabetis and tons of related health issues that's give you more healthy outlook on life.
This is why drugs that kill people fast are so dangerous - because you dont see addicts around you who sttugle to find meaning in life for years because heroine burned their brain. People just start to use and die, fast.
It's not even just about food or drugs. This is how Russia wage a war for 5 years with 400,000 people dead via mercenary army. Society dont see the scale of war because almost no one returns so people keep selling their life for $50,000 thinking its a good way to make money or get rid of debts.
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.
Yes. And 70% of Earth atmosphere is nitrogen.
The two figures have about the same relevance to health.
And: shaking the scene in a way that will attract 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.
Its lethal dose is a lot smaller than that of heroin, but it isn’t guaranteed to kill. If it were, why is it used so much in medicine?
https://en.wikipedia.org/wiki/Fentanyl: “Fentanyl is a highly potent synthetic opioid of the piperidine family, used primarily as pain medication
[…]
In 2015, 1,600 kilograms (3,500 pounds) were used in healthcare globally.
It is on the World Health Organization's List of Essential Medicines.”
is it used in general anesthesia?
for kids?
I don't know about kids, but yes it is used in general anesthesia.
There's always a continuity there ("the dose makes the poison"), there's no known substance that will reliably kill you if you're exposed to a single molecule of it.
The issue with potency is that the more potent a substance, the more precise equipment and quality control you need to stay on the safe side. With fentanyl, healthcare and pharmaceutical industry can handle the precision and QC demands (which includes guarantees and maintaining public trust). Criminal enterprises cannot.
prions perhaps?
I guess if you’re the mafia you just murder the competitors. Can’t have stronger regulation than that!
Fentanyl is not a better high. It's decidedly less euphoric than traditional opioids. It's just dirt cheap, ridiculously potent so it's easier to traffic, and doesn't have any agricultural footprint. The market pressure for fent is completely on the supply side.
Now we have the unions, we have the gambling - and they're the best things to have - but narcotics is the thing of the future. Now if we don't get a piece of that action, we risk everything we have. I mean, not now, but ten years from now.
I think it’s what customers want though as it gets you higher and closer to that high they’re always chasing. That it can kill you is a marketing feature if anything.
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!
Plus it’s a weird abbreviation! Like Ontario isn’t “OO”. Or does the C in Quebec stand for Canada? That’s kinda weird too tbh.
them's fighting words
Saskatchewan is SK and Manitoba is MB if you want weird
https://en.wikipedia.org/wiki/Provinces_and_territories_of_C...
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!!!
Of course it's illegal, as always with the drug war the problem is finding people who sell it.
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 it; Colombia, Bolivia, Nicaragua. Mexico just isn't "on the way" in the same way for Europe.
Not Mexico. Cocaine is a South American product and there is a direct route to Europe (or, sometimes, indirect via e.g. Guinea-Bissau).
Guinea-bissau is basically a narco state, much more so than Mexico, and has deep ties with latin-american cartels. They transport their drugs in the sahel with the help of jihadists. The same jihadists get funding from moroccans to smuggle their hash. These networks got deep networks within Europe (e.g. in Belgium and Netherlands). It might not be as bad yet but could turn worse quickly.
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.
ok so you are just spreading FUD
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
Oh my... Thank you for the link but I couldn't bear to watch it so I just read the summary. It hurts to watch these people.
Sorry, I should’ve provided a warning. It is sad that something so distressing is just the daily reality for thousands of Americans.
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.
Quite a few fent deaths are people coming in secondary contact with it.
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
Well, that depends on the legal definition of murder where you live.
In lots of places, intent matters. You said the pill was added with the intent to make more money. If there was no intent to kill, then in lots of places that isn't murder but might be some other kind of homicide.
For example, people at Ford made the decision to sell the Pinto with a dangerous defect to make more money and people died as a direct consequence of that product decision. The people who made that decision were not charged with murder (or anything as far as I recall).
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
Manslaughter is the word you are looking for, they don't intend for the person to die.
I’ve heard from an HSI friend that a lot more of the fentanyl deaths happen from accidental exposure in their drugs from shared surfaces. For example, somebody buying cocaine that was cut up on a table that was previously used to cut up fent and not properly sanitized.
Well obviously I would think it's highly racist to take any action against them or try to secure the border in any way.
Is this the phenomenon you try to refer to?
https://www.theguardian.com/us-news/2026/sep/01/milo-yiannop...
Action must be surgical. Even with mosquitoes - with humans, you figure.
I am shocked at how you can suppose you can propose zero quality like that here.
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.
No, the pain pill debacle of the early aughts actually led to heroin usage.
What caused the rise of fentanyl was the US getting out of Iraq and Afghanistan and the Taliban (or whoever took over) burning the poppy fields.
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.
They’re not coming here and forcibly injecting people. Maybe we should be asking ourselves why so many are choosing the oblivion offered by drugs similar to and including fentanyl.
The only reason they’re selling it is because people are buying it.
It’s an American problem.
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.
it’s an issue in that not everyone using it even knows they are using it. maybe you think your plug is a great hookup for grey market pharmaceuticals. or are they?
selling “oxycodone”? maybe don’t bother acquiring oxycodone at all—press fentanyl into a convincing little blue pill and sell that instead.
selling “adderall”? methamphetamine is cheaper. counterfeit xanax? who knows what benzo is actually in it.
customer might not find out. customer might not even live.
mafia seems delightfully old school about this. they know business. this is bad business.
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
Yes, this is the problem I was referring to. There is internal opposition but the exec team will clearly turn over in the next few years (due to retirement) which will inherently bring in a team more aligned with the CEO’s objectives.
People will complain but ultimately won't actually move away from the Apple ecosystem for it to matter to Apple.
The Mafia may also have shorter horizon: - Fantanyl 'customers' have munch higher risk of sudden-death and then stop being customers. - Fentanyl is a much more debilitating drug than heroin and much cheaper. So Fentanyl customers are less able to gather the money for the next fix, and don't need as much (less revenue).
The Mafia kills people directly. That's a sudden-death right there.
https://www.bbc.com/news/articles/c39mr81j2j1o
though this is controlled and planned, I assume. As opposed to random numbers of customers dropping dead whenever they feel like it.
More than simply being alive, they want customers who can stay employed and so continue to pay higher prices over a greater number of years. Cocaine and pot are horrible but their users can maintain a working life for years or decades, making them more profitable drugs in the long term.
Wait what are the signs that the new Apple CEO commitment is headed for the heap? Seriously asking
To be a bit critical, haven’t Apple software and hardware quality been getting worse for years even before the new CEO?
Apple Silicon was the exception, that was truly transformative. But other things, like how polished and snappy the OS feels, seems to have been getting steadily worse.
Not in their own backyard!
Humanity is being poisoned from all sides. The scariest part is that people willingly go along with it.
The movie was well-planned by Francis - but the mafia is a mass-murder organisation, without exception. Japan finally got the better of Yakuza for the most part (it is nowhere near as powerful as it was once); Italy still struggles, in particular with regards to Ndrangheta. So any article that attempts to white-wash the mafia in Italy - nope, sorry, not even good movies such as the godfather should disguise the mass-murder organisation. See how they bombed Giovanni Falcone to death, let's not forget that; and more recently how Ndrangheta executed women (2026; see https://www.bbc.com/news/articles/c39mr81j2j1o) who stopped being silent about the genocidal activities of Ndrangheta. Let's put it short: the mafia needs to be eliminated completely. It's not easy since they infiltrated so much in Italy and in parts elsewhere (just study how Capone in the USA got big, then you realise that the USA has an even bigger problem here - plus, fentanyl too), but it has to be done. There is no alternative unless you want organisations to undermine the state and continue its genocidal tendencies. You can be sure they are also involved in smuggling weapons, thus contributing to genocide outside of Italy directly as well.
Please no more white-washing articles of the mafia as glorious heroes "because they keep fentanyl out of Italy". (Besides, this is not even correct to begin with; fentanyal at the least right now, plays a very small role in Europe at best; in the USA this is different. See how Trump tries to blame Canadians for Fentanyl, smuggled via eggs, which is another one of his non-stop lies about Canadians.)
Thank you. I said the same thing in another comment.
https://www.fbi.gov/news/stories/the-pizza-connection-35th-a...
— Orson Welles
The Godfather overly romanticized the mafia and made them out to be "violent but in a principled way" people and nothing could be further from the truth.
It's complete fantasy that the mafia didn't deal hard drugs.
https://www.fbi.gov/news/stories/the-pizza-connection-35th-a...
Orson Welles said it best:
"'The Godfather' was the glorification of a bunch of bums who never existed."