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?

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 ;)

If it's below the noise floor, then you didn't really detect it, did you.

"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.

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.

That was deliberate. I don't think a casual reader, like most are, would have understood the nuance and the post would have been another casualty of indignation culture. I got downvotes as it was!

Feels like they caught up to internet archive being used to circumvent paywalls. Unfortunate.

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

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

Might want to look at the cigarette industry

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 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

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.

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?

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.

Fentanyl will kill you the first time you're exposed to it.

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?

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?

Carfentanil has got to be closer to that. It is said to be up to 100x more powerful than fentanyl.

Micrograms (yes still many molecules) could be lethal

There were rumors that that the "Chapitos" in Sinaloa purportedly banned the production and sale of fentanyl in their territories.

There were signs warning of this and if I remember correctly, they murdered two major fentanyl cooks, put their bodies on the side of a road, along with a warning sign and two huge piles of the drug around the bodies.

Drugs are a lot more geopolitical than people realize. Who brings drugs in and why drugs are coming into your country are important questions that nations have to ask.

CIA, Oliver North and Reagan would like a word.

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 ;)

CCP = Chinese Communist Party? ROC = Taiwan?

Can’t be, right?

ROC is the Rest of Canada

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!

Since this is the "footnotes" branch,

There's dozens of us!

~~ Arrested Development (the "Never Nude" syndrome)

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.

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!!!

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...

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.

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.

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.

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?

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's not murder?

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 criminal 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).

Look up extreme indifference murder or depraved heart murder - I think you’ll find it exactly fits the context of this discussion

Also I think they charged people in the ford pinto case with reckless homicide but they got off.

Why do we assume as a fact that the kind of person who becomes a fentanyl dealer wouldn't also take great pleasure in killing their clients?

You'd have the accused prove their innocence rather than the state prove their guilt?

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.

but what would you think if organized crime in a neighboring country was murdering 50,000 to 70,000 of your countrymen per year?

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.

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?

I'd blame myself for giving them that market, and then I'd start pushing hard for a drug policy that actually makes sense, as opposed trying to continue a policy of drug prohibition which has spent the last 100+ years [0] completely failing to do anything but give money to criminals whilst having almost no effect on actual drug consumption.

The government's job is to protect its taxpayers. If the taxpayers have a demand for drugs, which is clearly the case with the US, then the government should stop cosplaying a pearl-clutching 19th-century Victorian housewife and start regulating the drug trade properly, the way it does with alcohol and cigarettes.

Will this solve all problems? No. So long there is misery in the world, there will be people trying to escape that misery.

But at least American opiate addicts will have fewer overdoses, and therefore hopefully contribute more to tax revenue.

[0] https://en.wikipedia.org/wiki/Prohibition_in_the_United_Stat...

based on documentary style interviews I've seen of drug addicts in Lithuania, there's supposedly no more old school heroin left on the streets, it's been pushed out by fent.

It's very appealing to smugglers because its ultra-high potency means that a massive amount of doses is very, very tiny.

Thus, no surprise that it shows up elsewhere.

It must be appealing to people who want to get high, and heroin seems vastly superior in the same general category.

If it can happen to Americans, then why do you think it can't happen to you? What's the differentiating factor?

Unpredictable market forces the black market is subjected to. Europe doesn't have as much fentanyl for the same sorts of reasons America doesn't have as much ketamine.

From what I’ve read online Ndrangheta are much more powerful than the mafia in Italy.

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.

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).

Fantanyl 'customers' have munch higher risk of sudden-death and then stop being customers

The Mafia kills people directly. That's a sudden-death right there.

https://www.bbc.com/news/articles/c39mr81j2j1o

"The Mafia" is... many different things. From self-defense post-war southern-italian village organisations to pure-evil predatory psycho-clans, to anything in between.

For starters: - https://en.wikipedia.org/wiki/Gomorrah_(film) - https://www.youtube.com/watch?v=3o44Zv4DY64

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.

Cocaine and pot are horrible

citation needed

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.

Hardware has been improving a lot since the low point of butterfly keyboards and no ports. Jony Ive went out the door and things improved. Then on the software side they course corrected recently after Alan Dye left. I have hope the software improvements will start to accellerate.

Ternus and Cue are full bore on increasing the number of ads shown in apps and otherwise scattered through their devices. This is explicitly the opposite of Apple’s philosophy until recently and Schiller is stepping back reputedly due to his opposition to this approach.

The idea appears to be to sell the devices as a vehicle for showing ads (incremental ARR) over selling them for their intrinsic customer value. You expect this kind of thing from shitty industries like cars or Google or Facebook. But this used to be an explicit “no go” for Apple.

That is too bad - how do you get the reins of a company that size with something antithesis to their product and identity? I hope he doesn't start trying to monetize privacy.

Ternus and Cue are full bore on increasing the number of ads shown in apps and otherwise scattered through their devices

There’s zero indication Ternus is onboard with that - Cue yes, but Ternus was not CEO when any of the stuff that is happening now was being developed

with Apple’s new CEO, the early signs are that commitment is headed for the ash heap as well

He’s been CEO less than a month and everything that’s happening right now has been in the works for multiple years….

that doesn't mean the early signs aren't here that that commitment is headed for the ash heap.

What, specifically, do you find to be an early sign pointing in that direction?

IN “The Godfather”, Don Vito Corleone refuses to engage in the heroin trade because he considers it “a dirty business”.

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.)

A better representation of real Italian mafia in movies is offered by the TV show Gomorrah.

It's a strong antidote to those romanticizing crime.

In US it should be available on HBO Max.

https://en.wikipedia.org/wiki/Gomorrah_(TV_series)

The first two seasons are great, watch it with subtitles (fun fact: in Italy it was also shown in tv with subs because most people cannot understand neapolitan dialect).

it is absolutely critical to watch Gomorrah in Italian. The English dubs are comically poor quality (think of how MS Word used to emotionlessly read text aloud).

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."

Well, I don't buy the "principled" part either, not at scale.

But it is organized, and there's not that much fundamental difference between corporations and criminal enterprises, not in the ways they are run. The details boil down to different trade-offs taken wrt. risk vs. reward related to staying on the good side of the law. A lot of the violence (particularly the "principled"-looking one) seems to stem from the fact that a criminal org needs to built its own layer of coordination and enforcement, since by definition it cannot rely on public services of law enforcement and the legal system.

There is not that much difference between the state and a mafia. The fact that the mafia has successfully managed to keep out fentanyl shows just how much democratically elected states are failing their citizens. This outcome is not surprising.

It’s way easier to keep fentanyl out of drugs when you are distributing the drugs.

The government can’t regulate a black market.

The government can’t regulate a black market, but they could stop the charade of illegal drugs, convert the black market into a regular market, and regulate that. Suddenly you get less fentanyl overdoses, better outcomes for addicts (they're not criminals anymore), AND you remove the power of drug cartels (they'll still exist, but will compete with each other through less murder-y means, like any other capitalist company). Plus, stabilize a lot of third world countries where illegal drug production and export is a big part of the economy, which is what allows the cartels to fight and corrupt the state.

Or, just keep doing what they're doing. It's bound to work eventually, right? Drug cartels are definitely growing less powerful every year, the war of drugs is being won, rate of addiction is going down.

This is a bit of a straw man “do the ends justify the means” statement, with hints of anarchism read between the lines.

Western democracies haven’t really prioritized “war on drugs” (for lack of a better term) over the last probably 10ish years. Yeah there’s still funding and initiatives and some lip service.

Instead the focus has been largely infighting and major political factions fighting for political power in the next generation (“tech bros” political class for one)

So it’s no surprise state-sponsored (and just demand driven) drug trafficking into the US hasn’t received much action.

There is some hope though. With rare earth mineral access being a major national security priority, and many cartels controlling those areas in SA, the converging interests may produce some net positive. Background: https://youtu.be/q_n-74ifBZs?is=nw5g-mmPmKphGH2W

The Singapore model is to execute all the dealers.

And heavily punish the users (which is the only way to actually win a war on drugs)

The Singapore model is also to be a 750km^2 microstate island. American laws around drugs have always been punitive and you could fit Singapore inside your average county.

Public healthcare is keeping illegal Fentanyl out of Italy: there's no incentive to obtain contraband painkillers, which are not considered fun drugs.

You go to the hospital, you get the medications you need (and no more) for as long as you need them, and then you stop (or you deal with chronic conditions under medical control).