Re: Guest post: not particularly on the the unbearable whiteness of heroin use

But drug court and family court share a physical location and so it's been amazing for me to see while waiting around for hearings over the years that either there's total segregation and users of color go elsewhere to some other session or drug court here is for white people.

That's really depressing.

I've heard the complaint that, "people only care about the opioid epidemic because white people are affected." I have thought that is overstated, and that the problem is large enough that it would attract attention regardless. But hearing that the support systems being set up might literally only help white addicts is much worse than I would have thought.

Posted by: NickS | Link to this comment | 09-12-17 6:06 PM
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I don't KNOW. That is honestly just my impression from sitting in the waiting room. It's entirely possible that race-neutral cocaine group comes in on Thursdays and I've only been there for the Tuesday heroin crowd or whatever. But I would really, really like to see stats on populations served, especially since for instance we are a region where disproportionate arrests of black citizens for marijuana offenses were so high the ACLU was getting involved, that would seem like an obvious group who could use diversion. But I really and truly don't know.

Posted by: Thorn | Link to this comment | 09-12-17 6:22 PM
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I don't KNOW.

I realize that, but even the thought is depressing.

Posted by: NickS | Link to this comment | 09-12-17 7:02 PM
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I don't really have anything helpful to add, except that I've seen these charts several times and they remain jaw-dropping.

I have to say that nothwithstanding the horrible human toll of the epidemic, fentanyl scares me personally a bit, since so few grains are apparently deadly via apparently minimal skin contact, and Philadelphia continues to be a destination city (ugh ugh ugh) for heroin users. For the first time I'm thinking twice about taking my youngest niece and nephew on the subway in a few weeks. (I haven't seen people USING on the subway in years, but that could just be because I've stopped riding during the most kooky times of day. And our subways aren't very clean to begin with.)

We have also some heroic librarians who got guerilla training in Narcan. After their multiple lifesaving efforts went viral thanks to a local reporter, the library system (not mine) is looking into formal training for staff. It's crazy and sad and impressive all at the same time.

Posted by: Witt | Link to this comment | 09-12-17 8:04 PM
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That's roughly 10 times Ohios murder rate.

Posted by: Asteele | Link to this comment | 09-12-17 9:23 PM
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In an earlier thread I had been puzzled by the sudden spike in fentanyl overdose deaths, since fentanyl is hardly a new drug.

Earlier this week I was talking with a colleague whose research specialty involve opiates. According to him, people have been spiking heroin with fentanyl since forever. Over the years, especially if you live in/near a large city, you've probably seen the occasional story about how an "ultra-pure" batch of heroin (or alternatively, "tainted" heroin) had reached the streets and was causing a surge in overdose deaths. According to my colleague, 95% of the time, it was actually heroin laced with fentanyl.

It didn't get reported because fentanyl wasn't one of the standard drugs to screen for, and when some one is brought in dead of respiratory arrest and their system is full of heroin, the cause of death isn't considered to be much of a mystery.

The pattern has changed in that in more recent years more people are taking fentanyl straight instead of mixed with heroin.

Posted by: AcademicLurker | Link to this comment | 09-13-17 4:22 AM
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5: Because they're too high to aim.

Posted by: Moby Hick | Link to this comment | 09-13-17 4:56 AM
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6 is interesting - thanks.

Posted by: ajay | Link to this comment | 09-13-17 5:01 AM
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6 fits with what I've heard, though I really only know fentanyl stuff through the news and not anecdotal. And it's obscene that there isn't public Narcan training in Philadelphia. I still haven't gotten trained although now that I'm home during the day I'm thinking about it but I would have no trouble managing to get trained without having to justify my connection let alone if I were someone on the front lines.

Posted by: Thorn | Link to this comment | 09-13-17 5:10 AM
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So, I looked it up and PA's overdose death rate appears to be about the same. if not a little higher on a per capital basis than Ohio. In 2016 there were 4,600 overdose deaths out of 13 million people. But I can't find a new graph so I don't know if the history is different.

Posted by: Moby Hick | Link to this comment | 09-13-17 5:10 AM
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I was wondering if Ohio was truly a huge outlier or if it was just that we had the same problems but shittier newspapers.

Posted by: Moby Hick | Link to this comment | 09-13-17 5:18 AM
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Not that I see many people looking like addicts around here. That's mostly on the other side of the tunnel, I think

Posted by: Moby Hick | Link to this comment | 09-13-17 6:07 AM
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I guess this is the thread to say I saw two people preparing to shoot heroin (presumably? could be anything injected) at noon on my walk to work. Genuinely conflicted about whether to call the cops. In the end I didn't. Feels like I should do something, but it's not clear that the cops are the right thing. And it's not like the cops don't already know where to find people doing heroin. These people weren't at the usual place for it, which kinda makes me think I should have called, but also makes me think it's weird to enforce at gunpoint that you can do as much heroin as you want so long as no one has to see you.

Posted by: Unfoggetarian: "Pause endlessly, then go in." (9) | Link to this comment | 09-13-17 9:18 AM
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Maybe it's like with gum at school. If you didn't bring enough for everybody, you have to make sure nobody sees you inject it.

Posted by: Moby Hick | Link to this comment | 09-13-17 9:27 AM
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13 is a weird position to be in. Having never known someone on heroin, let me offer my well-informed opinion: it seems like there are a few key windows where intervention is effective for the addict, and mostly lots of times where intervention is completely uneffective. So most likely intervening wouldn't have helped?

Posted by: heebie-geebie | Link to this comment | 09-13-17 10:54 AM
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Also, Robert Carlyle might have stabbed you with a knife.

Posted by: Mossy Character | Link to this comment | 09-13-17 11:14 AM
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Using heroin seems more sensible than scrapbooking and I bet you know somebody who scrapbooks. Just take the same response and tone it down a bit.

Posted by: Moby Hick | Link to this comment | 09-13-17 11:14 AM
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In 2015, the five states with the highest rates of death due to drug overdose were West Virginia (41.5 per 100,000), New Hampshire (34.3 per 100,000), Kentucky (29.9 per 100,000), Ohio (29.9 per 100,000), and Rhode Island (28.2 per 100,000).

PA is sixth and only barely trails KY and OH and MA surprisingly is seventh. It's very clearly centered in Appalachia and New England.

Posted by: F | Link to this comment | 09-13-17 11:52 AM
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6 is like that bizarre thing where almost all of the cocaine in the US was cut with levamisole, a deworming agent with no known narcotic effects.

Posted by: F | Link to this comment | 09-13-17 11:53 AM
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Where's the cocaine in rural Alabama when you need it?

Posted by: heebie-geebie | Link to this comment | 09-13-17 12:42 PM
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20: exactly.

I may attempt to say more about this later. My deep thought right now is that apparently I'm never going to get "Black Tar" out of my head, so I'm holding Alison Mosshart personally responsible for the overdoses and whiteness.

Posted by: lurid keyaki | Link to this comment | 09-13-17 1:57 PM
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6: in the 90s heroin spiked with fentanyl was totally already a thing, although it was usually described as "unusually pure" or "90% pure" rather than laced, but sometimes the latter. a brand called "poison" caused six or so deaths with fentanyl-laced heroin within a week and lines sprung up around the block. I would give it five stars on yelp. just like heroin, but moreso. I did almost OD on fentanyl and heroin one time and that wasn't very nice though. I was just snorting it and I can certainly see how you might kill yourself in a trice shooting up. when I was shooting up it was, indeed, black tar heroin, west coast stylee.

Posted by: alameida | Link to this comment | 09-13-17 6:30 PM
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