How do you write about treating opioid addiction and mention prescription heroin (which works! but is difficult to scale) but not prolonged-release injected buprenorphine?
And how the hell do you write about opioid addiction in America and not mention the fact that there was a long and successful campaign by Purdue to get American doctors to prescribe as much opioid as they possibly could without getting writer's cramp?
There is one reference to OxyContin in that Slate article and it is a positive one.
Its been a struggle trying to make it so the opioid settlement money goes to help people recover from substance use disorder rather than padding law enforcement budgets, building new jails, or being spent on various dubious programs focused on DARE-style prevention.
Funding for recovery housing is a big part of the need, especially for women, for whom there are fewer facilities available and who may have child-related needs.
Buprenorphine is only just becoming available in a lot of places in the US because, until the passage of the MAT Act at the end of 2022, it was very difficult for anybody to get approval to provide it.
Did anyone here link to the Reddit guy who was like, "I have willpower, I'm just going to try heroin once and it will be fine"....six months later..."help I'm a drug addict."
Reddit has certainly nurtured worse transformations.
5: Not me, but I know exactly which guy you're talking about.
In a related vein, NYT op-ed "The D.E.A. Needs to Stay Out of Medicine", which is about how restrictions on opioids are hurting patients.
My mom was in the ER after a fall* a couple of months ago and they gave her Fentanyl, and did a lot of hemming and hawing about how it was medical grade and nothing like what you'd get on the street or whatever. It was a bit surprising but I'm not sure what other pain killers were available.
*She's doing fine, fortunately only broke a wrist (now healed) when it could have been much worse. And did not become an addict.
I was in a training from the local fire chief on how to use Narcan to revive someone who is having an overdose. He has a lot of grim stories. In some cases, people are overdosing without even considering that risk because they don't know that fentanyl is in what they are using. College kids think they are taking Adderall and then overdose because that's not what it is. One hopes more people might get in the habit of using fentanyl test strips.
Yeah, a big part of the problem with fentanyl is that it's so cheap that people are putting it in all kinds of drugs, not just other opioids.
The thing about telling people the policy hasn't been working assumes everyone defines "working" in a similar way. The current way works just fine if you want to be sure people using drugs suffer or are last in line for public help.
Fentanyl might make a difference because of the kind of thing mentioned in 11 and 12. But that seems to be boosting Naloxone and testing strips more than it is boosting efforts to treat opiod addiction.
I'm going to stick to alcohol. And maybe the "delta 8" that I'm hearing stuff about.
While we're doing drugs, has anyone here tried rhododendron honey?
I don't like rhododendron. They stab you when you are hiking.
I got used tu seeing them in people's yards and such and was very surprised to go out into the hills and see huge stands of them. I didn't notice at bees.
Because of Duolingo, my phone is now doing Spanish words.
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Unless I missed it, no one here has advised NMM re:Joe Lieberman. But that is quite appropriate, as no one but no one was rubbing one out to that lame motherfucker. I have minor qualms* about speaking ill of the recently dead, but his greatest achievement was taking part in the 2000 hour VP debate with Dick Cheney's member lodged firmly in his mouth throughout. One of the great D mistakes of my lifetime.
*Very, very minor.
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Delta-8 is like delta-9, but with 50% of the enjoyable and interesting parts removed.
22: killed the public option too
Best epitaph I've seen so far from Bill Corbett:
Joe Lieberman is now in heaven, trying to stop good things from happening there.
Also RIP Daniel Kahneman--I believe recently cited in an FPP.
Buprenorphine is only just becoming available in a lot of places in the US
100% on the need for more prescribers. That said, Massachusetts hasn't seen the increase in prescribers that we had hoped for. We still have a long way to go to get addiction treatment integrated into primary care.
There's also the reality that fentanyl is a lot stronger than heroin, and for a lot of people who are addicted, buprenorphine isn't strong enough to fend off cravings. Methadone has the best outcomes, but we make it extremely difficult to be on methadone and live any kind of a normal life. The federal guidelines on take-home doses were relaxed during covid and then extended, but it's still at the discretion of each methadone clinic's medical director. And it turns out that a lot of people running methadone clinics have extremely old-school, stigmatizing, paternalistic approaches to the provision of medication.
Re. Spike in 11: for the most recent data we have in MA, cocaine is present in over 60% of the people who die of opioid overdose. In the progression of the opioid crisis, we've gone from prescription drugs >> heroin >> fentanyl >> tainted non-opioid drug supply.
That Slate article is a little weird when it gets to discussion of treatment options. He jumps straight to "Canada prescribes heroin!!1!" as though there aren't any prescribed agonist options in the U.S. I also wonder about his mention of living in a sober home. Not all sober homes are hostile to MAT, but a lot of them don't allow it and don't consider people on MAT to be "sober" or "clean" or "abstinent". Certainly that's a part of the stigmatizing culture around addiction treatment in this country, but sober homes are mostly unregulated and unfunded.
In scrolling my bluesky feed last night it was notable how much speaking ill of the [powerful] dead has been normalized. I think even five years ago there would have been some "hush, not now" voices but no, just a steady stream of entertaining dunks like 26 and explanations for those who weren't there of how Lieberman used his power to make lives of others worse. Even in my well curated bubble that seems like a very recent change.
I clearly made a mistake and regret not voting in 2000 (my first election, I was a 19-year-old anti-globalization protestor reading a lot of independent media), and will never make the same mistake again, but IN MY DEFENSE Gore's choice of Lieberman as a running mate didn't do a lot to make me feel like the parties were so different on the issues I most cared about.
When I try to encourage faculty job candidates to move to my current state, I now go with the idea that, while the state is dominated by fairly mediocre Democrats, at least the state as a whole is *reliably* mediocre-Democrat-voting, and at this point in the game I will take it. Consistent mediocrity for the win!
The only election I didn't vote in was 2000 also. I had my absentee ballot to vote in Ohio because I thought that would be closer than North Carolina. By the time I realized it would have been criming for me to vote in Ohio (because I moved in October), it was too late to register in North Carolina.
ITIMTHB, but speaking of killing the public option, the closest election I ever voted in was won by Ben Nelson.
I was interning for a progressive think tank that was blackballed for a bit because it loaned the Nader campaign its Lexis Nexis account.
Yeah. His second campaign was a Republican operation.
I don't know enough about his first one to say.
Al Gore continues to baffle me.
It was an honor to stand side-by-side with him on the campaign trail. I'll remain forever grateful for his tireless efforts to build a better future for America.
https://twitter.com/algore/status/1773138413819937002
38: At least Obama said they didn't always agree on things even if he felt the need to eulogize him.
28: Blume, what did you think about the Slate article which mentioned that private equity was getting into substance use treatment and that this could explain some of the support for clinic-based models that aren't adapting.
37: Just figured out what Gore should have tweeted.
Joe! Next to creating the internet, you were my biggest mistake.
OT: did everyone else already know about all this bizarre and horrible stuff coming out about Sean Combs? Car bombs!
I knew there was a raid on his house and he fled the country?
In 2011, Combs discovered that Ventura had had a brief fling with Kid Cudi during a "rough patch" in their relationship. An enraged Combs allegedly beat her and, the next year, told Ventura he was going to blow up Kid Cudi's car, adding that he wanted to make sure the rapper was home when it happened.
Soon after, the rapper's vehicle exploded in his driveway, the suit says. The episode "terrified" Ventura, "as she began to fully comprehend what Mr. Combs was both willing and able to do to those he believed had slighted him."
https://www.thedailybeast.com/randb-singer-cassie-accuses-sean-combs-of-rape-in-bombshell-lawsuit
44: That article is from November 2023, so the answer to 41 is that we should have known.
And I heard about the horrible partner abuse last fall, when the window on the statute of limitations was about to re-close. Some of those were horrific. I didn't hear about a car bomb, though.
Name like that, though, it shouldn't have been surprising.
When Lieberman was announced as Gore's running mate, I actually said out loud 'I guess their analysis is that it's is going to come down to elderly Jewish voters in Florida.' As you all know, it's the kind of half-assed underbaked thought I stupidly utter from time to time. Turns out they were right, but wrong that they shouldn't have also paid a little more attention to ballot design.
I have repeatedly had a timetravel fantasy about papering every bulletin-board and light pole in Palm Beach with "Vote Gore: Third hole down!".
OT: Did a Ohio figure out how to eliminate the need to pee or did they close all the rest areas on I-70 out of a general belief that the government should suck?
Anyway, Zanesville is obviously up to something awful because someone created a parking garage for riding lawnmowers.
50: Big Diaper controls our state government.
I found the Harry and David place but I don't see any pears.
2000 was a weird moment in Democratic politics. Gore felt the political need -- and maybe the moral responsibility -- to distance himself from Bill Clinton's scandals, and Lieberman had (with Clinton's help) positioned himself as the Voice of Decency.
Me, I don't mind a liberal picking a conservative VP, or vice versa. This is traditional ticket-balancing, and there are good reasons for it. And I'm sorry, but Nader voters weren't on the same side as Gore, any more than Republicans were. The available votes were in the center, particularly after Nader decided to run.
I do think it was a tactical mistake for Gore to run away from Clinton, who was quite popular.
I'm fine with that, but the "No Labels" thing is different.
56: If the jeans don't have a designer label, they aren't going on Moby's butt.
55.3: I really think there was something personal going on there.
Al was already married to Tipper, he didn't need Lieberman.
58: Yeah, seems hard to explain otherwise.
Back then, everybody hated blowjobs. It was a different time.
Apparently, someone putting a red hand print on "We Stand with Israel" signs now rates getting in the paper as a rise in antisemitism.
a Ohio
Are they insisting on the indefinite and definite article now?
One of the Ohio State universities, anyway.
If they are going to increase police patrols at night in my neighborhood to fight antisemitic hand prints, I'm worried I'll look suspicious. I do quite a bit of walking around after dark for Pokémon Go. Most of the gyms are Jewish.
It seems like a hand print might be pretty easy to track down to a perpetrator via a fingerprint database or some such.
69: if it's spray-paint or something, probably too much medium to transfer fingerprint lines. Think about covering your hand with paint and pressing it on paper - you don't get a perfect print transfer, you just get a hand-shaped solid blob.
Thru probably just made a hand-shaped stamp. The signs don't look very sturdy.
Talk about rape culture.
he got drunk and raped Merope daughter of Oenopion, the ruler there. In vengeance, Oenopion blinded Orion and drove him away. Orion stumbled to Lemnos where Hephaestus--the smith-god--had his forge. Hephaestus told his servant, Cedalion, to guide Orion to the uttermost East where Helios, the Sun, healed him; Orion carried Cedalion around on his shoulders. Orion returned to Chios to punish Oenopion, but the king hid away underground and escaped Orion's wrath.
I see billboards with red handprints every day, as it's the MMIW iconography. There's a very striking collection of photographs in the county attorney's office. Maybe by this artist? https://www.youtube.com/watch?v=gV-_bcJ6M4U
Genuine badasses make the handprints in their own blood, forensics be damned.