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The Solution to Opiate Fentanyl Deaths

2017 December 18
by Ian Welsh

Why have opiate deaths spiked?

In the last half of 2016, fentanyl, a synthetic opioid 50 to 100 times more potent than morphine, was detected in 56.3 percent of the opioid overdose deaths in the ten states that make up the CDC’s Enhanced State Opioid Overdose Surveillance program…

How do you solve this? You make available for purchase legal, reasonably priced, pure drugs. You make help getting off drugs available to anyone who wants it, free. (Tapering works in almost all cases.)

This is not a hard problem to solve. It is an easy problem to solve. It is also true that demonizing opiates, in particular, means that a lot of people don’t get the pain relief they need, especially chronic pain sufferers, whose nervous systems change over time so that they are more susceptible to pain.

We do not solve this problem because we are a bunch of moral hysterics who want to force our morals on other people, when their actions are less harmful than our prohibition is.

We also refuse to look at the actual cause of the opiate epidemic, which is fairly clearly economic despair and hopeless lives. Indeed, most drugs aren’t particularly addictive to people who have happy lives and things they want to do.

If you want to end at least half the deaths caused by opiate addiction, make it legally available (it will be more than half, because its illegality drives much of the behaviour that leads to death, beyond just adulteration.)

If you want people to get off opiates, create a society and economy which values them and treats them well. The policies to do this are fairly simple: Updated to deal with racism, sexism and environmental concerns, they are approximately the policies which ran the developed world in the post-war period until the ’70s. Tax the rich brutally, support high wages, have near-free tertiary education, make sure that jobs (or money) are so available that employers have to treat employees well, because employees who walk can always find another job.

This stuff can be complicated in the details, but it’s easy conceptually and hard only in the sense that you have to have the political will and to stay on top of it.

As for opiates and other drugs, just make them legal, regulate them, and make addiction treatment available.

The dead frustrating issue about most of our social problems is that the solutions are more or less known, we just don’t, actually, want to solve them. We prefer the problems to the solutions, or enough of us, combined with enough oligarchs, do.

We can fix our economy, our society, and our drug problem any time we want. Sadly, that is no longer true for the environment, but we can mitigate that damage.

Perhaps one day we’ll decide to do so. Much of this suffering is by choice, and as a society, we’re choosing it.

The results of the work I do, like this article, are free, but food isn’t, so if you value my work, please DONATE or SUBSCRIBE.


149 Responses
  1. Webstir permalink
    December 22, 2017

    metamars: upon what do you base your not so humble opinion that “there is kneejerk-internalized-paradigm-projection in evidence”
    Or, was that just a kind of intellectual sounding belch?

  2. Webstir permalink
    December 22, 2017

    Otherwise, I think we’re on the same page. The capitalist-run-amok profiteers of the insurance and pharm industry sounds like another way of saying (1) Because markets, and (2) Go die. Those being the defining rules of neoliberalism.

  3. Willy permalink
    December 22, 2017

    rc does have a cow. It has a rhinestone cowbell. Don’t ask what it’s doing in his bedroom. But that’s his business, lol de frickin lol. Speaking of revolution…

    I’ve had a black ninja suit and ied-making supplies gathering dust on the kitchen table for over ten months now waiting for you geniuses to come up with a plan. Last time we had a “serious” revolution discussion rc got his feelings hurt and we had to sit through dozens of back and forth insults that had nothing to do with anything.

    We’ve gotta be tougher than this if we’re gonna be successful revolutionaries.

  4. Webstir permalink
    December 22, 2017

    ^^ 🙂 ^^

  5. Ché Pasa permalink
    December 22, 2017


    Basically, Case and Deaton reject any criticism of their work because they’ve reached the conclusion they wish.

    This doesn’t invalidate their study, but it does subject it to reasonable skepticism — which in some ways is too bad because there are genuine issues regarding opioids, overdoses, and declining life expectancies — among the rabble, not among the high and the mighty. Simply attributing it to the despair of the white working class (male aspect) misses the mark. As Gelman shows, deaths are rising among females, not so much among males in the study cohort.

    In other words, the issue is far more complex and the problems run much deeper than Case-Deaton (and Lambert) allow for.

    As to the question of the proper role of government, that’s been a subject of debate for some centuries now, hasn’t it? Clearly the US government and most state governments do not necessarily see themselves in the proposed role of providing concrete benefits that improve the lives of the underclasses. Instead they are organized to defend and protect the interests of the Overclass against the demands and needs of everyone else. It has ever been thus.

    If that means that from time to time government does provide or enable those concrete benefits that improve lives of the lesser people, so be it. But let’s not fool ourselves about why that sometimes happens. It isn’t for the benefit of the lower orders. It is to protect and defend the Overclass from the untermenschen.

    Our neoliberal rulers believe the rabble already receive too many concrete benefits as it is and they are working diligently on their program to remove as many of those benefits as they can without risking a rebellion that would result in their heads on pikes or other unpleasant inconvenience to themselves.

    Changing that state of affairs becomes more difficult day by day. Whatever the case, positive change is unlikely to come through elections.

  6. realitychecker permalink
    December 22, 2017

    I’ll just call you out for being the dry drunk you are. 🙂

  7. realitychecker permalink
    December 22, 2017

    Willy, I told you to take your hand off your penis when talking about me!!!!

    You just can’t quit me lol. 🙂

  8. Peter permalink
    December 22, 2017


    That 0.1% apparent drop in lifespan looks ominous but is meaningless for most of our 330million people. The groups who are causing the numerical anomoly are known and unless you belong to these groups of junkies and illegal pill poppers your lifespan is unchanged. No one’s lifespan is shortened by someone elses bad personal habiits.

  9. Webstir permalink
    December 22, 2017

    rc: I find it amusing that I substantively dismantle your B.S. on a regular basis, and your only response is to name call. Does that make me troll, too?
    I can’t say it any better than Samuel L. Jackson in Pulp Fiction …

  10. Webstir permalink
    December 22, 2017

    Follow up link:

    Your claims are looking more and more tenuous.

  11. realitychecker permalink
    December 22, 2017

    @ Webbie

    The fact that you obsessively ‘dismantle’ me in your fantasies is just more data supporting the conclusion that you are stuck in your dry drunk syndrome.

    Keep it up. It’s instructive. 🙂

  12. Webstir permalink
    December 22, 2017

    Oh, it would seem the commentariat agrees with me. But, whatevs.

  13. realitychecker permalink
    December 22, 2017

    Your ‘commentariat’ is Webbie, Willy, and Willy’s willy. 🙂

    Dry drunk syndrome. Google it at the AA website, or many other places.

    How long since your last meeting?

    I don’t want to be the thing that makes you start drinking again.


    Ask your ‘pretty smart’ wife what you should do next.

  14. realitychecker permalink
    December 22, 2017

    Another part of your ‘commentariat,’ I assume?

    highrpm permalink
    December 22, 2017

    @webster & anon,
    what planet are you folks from?

    Really, go to a meeting.

  15. December 22, 2017

    The plot thickens. A user name “Tristan” commented on the breitbart article “Jeff Sessions Creates ‘Opioid Tsar’ as Overdose Deaths Surpass Those from Breast Cancer” @

    “This is all a big farce! The FDA announced a Public Warning earlier this month on a Monday regarding a plant called Kratom. The alkaloid in this plant has the exact same effect on the opioid receptors as pills. However, it is not addictive and it is impossible to OD on it. People have been using it with a great deal of success to get off of heroin, pills, methadone, suboxin, plus vets have been using it for PTSD and having great success where other meds failed them.

    Using faulty data, data that has been proven wrong and shown to the FDA/DEA etc, the FDA issued this warning that those using it to come off of the addictive drugs are doing so at their peril. . . a clear lie.

    Three days later on the following Thursday, guess what the FDA announced? “FDA Approves Merck’s Opiod Withdrawal Apparatus” This is all a scam and the Federal government doesn’t even try to hide how dirty they are anymore. In fact, they flaunt it!”

  16. December 22, 2017

    Jeff Sessions is, to use Ross Perot’s colorful favorite phrase, “squirrelly”. His drug policy is not consistent with candidate Trump, and his benign tolerance of shenanigans by the Clinton cabal, while his boss got continually smeared based on apparently non-existent crimes with “the Russians”. See “Jason Chaffetz: Jeff Sessions ‘worse’ than Loretta Lynch” @

  17. Peter permalink
    December 22, 2017


    You are a clever devil using mockery and manipulation to prod these Igors onto the revolutionary road. Witless Willy has already braged about his ied’s so it’s good they have a lawyer in the band, they are going to need one or more.

  18. realitychecker permalink
    December 22, 2017

    @ Peter

    Just trying to keep the chihuahuas off of my ankles. 🙂

    But I’ll tell you something, Peter: With an army of troops like these guys behind me, I could conquer an anthill.

  19. Willy permalink
    December 22, 2017

    rc’s revolution talk is his way of blowharding the “politically incorrect”. You’re the only one who takes it seriously. He couldn’t lead a hill of ants to honey.

  20. realitychecker permalink
    December 23, 2017

    I don’t think anyone has EVER seen me say or suggest that I wanted to ‘lead’ anything. Only a true mental defective could distill that from my suggestions that maybe we ought to DISCUSS the general topics around revolution.

    I learn a lot about folks by seeing what they are AFRAID to think or talk about.

    I don’t like group dynamics enough to ever want to lead one. Or really be trapped in one, either, for that matter lol.

    Those who will get to live the future, ought to be the ones who take the lead in fighting for that future.

    That’s not me.

    I just don’t want to watch all the history of the ages crumble before the social media/corporatocracy wave.

    Morons like Willy may own the future. I won’t have to suffer through that future.

    Winning (sigh)

  21. realitychecker permalink
    December 23, 2017

    Edit: Meant to type “the wisdom of the ages.”

    Meaning that we seem to be losing much of it already.

  22. Ché Pasa permalink
    December 23, 2017


    I don’t think I ever indicated there wasn’t a serious problem with opioid addiction and overdose deaths. There is and has been a serious, growing problem for years, one that has not been and won’t soon be addressed appropriately.

    I question the conclusions of the Case-Deaton study and the focus on “deaths of despair” (primarily of middle aged working class white men) that is shared so widely among media outlets as the core of the problem. I submit it is one aspect but not the core aspect of the opioid problem.

    When it leads to the belief that the only way to address the issue is with “expanded access to hope (and jobs, and affordable housing, and universal medical care, and and and)” (quoting Lambert) then quite literally you are condemning tens of thousands, perhaps millions of people to untimely death (and millions more to addiction) because there is no way that these solutions — if they are solutions — will be implemented under the current or any likely future regime.

    Even if the Revolution were to come, there’s no certainty that the opioid crisis would be more than a side issue.

    As for declining life expectancies, I’m sure you are aware that life expectancy is closely correlated with status and wealth. The life expectancy of the poor and working classes has been flat or in decline for too many years, while the life expectancy of the rich and the overclass has been increasing for even longer. Lower life expectancy is partly due to poor medical care provided to the lower classes as well as alarming levels of infant mortality, gun violence and other factors. Combine that with the effects of unmanaged drug addiction and alcoholism and you have a recipe for the declining average life expectancies we see. It’s not a mystery, it’s a policy.

  23. Willy permalink
    December 23, 2017

    @about rc’s “wisdom”

    Pooter doesn’t respond to punishment. I don’t either. Has rc ever responded to punishment? Why the hell do you expect Jihadists to respond to punishment?

  24. realitychecker permalink
    December 23, 2017

    It’s not MY wisdom, you jerkoff, it’s the collective wisdom of civilized mankind I’m concerned about. Disappearing fast, and morons like you don’t even seem to comprehend what you are losing.

    Ya know, the really basic things, like honesty. Like balance. Like critical thinking. Like excellence. Like freedom. Like reason. Like rule of law.

    Don’t bother yourself, feces-flinger. Being obnoxious to me is where your personal Peter Principle kicks in, apparently.

  25. Willy permalink
    December 23, 2017

    morons like you don’t even seem to comprehend what you are losing

    Prove it.

  26. Willy permalink
    December 23, 2017

    Gracians Art of Worldly Wisdom targets the kind of thinkers who frequent blogs like this one. You have never read it. You have also never read, quite obviously, Dale Carnegie either.

  27. realitychecker permalink
    December 23, 2017


    Prove that you’re not sexually obsessed with me. Go ahead, prove it!

    And take your hand off your penis!!!!

  28. Willy permalink
    December 23, 2017

    But you’ve obviously visited a lot of gay porn sites.

  29. Steeleweed permalink
    December 23, 2017

    Countries such as Portugal have done the right thing. It’s working there. If it doesn’t work here it will be because the Drug Business per se and War On Drugs are too profitable to abandon. I have commented here and elsewhere about the many issues regarding drugs, so let me just say Ian is correct that 90% of the problem is economic & social.

  30. realitychecker permalink
    December 23, 2017

    ” Willy permalink
    December 23, 2017

    But you’ve obviously visited a lot of gay porn sites.”

    I can’t believe you actually made such a homophobic remark. Your conservative family you always talk about must have taught you well about hating gays.

    Don’t address me again, please. I think you’ve shown yourself to be a disgusting, bigoted human being.

    Therapy may be able to help you with your conflicts. It’s worth a try.

  31. Peter permalink
    December 23, 2017


    You are conflating two different problems in the US and Portugal. Portugal doesn’t have a fentanyl caused spike in OD deaths. Their smugglers bring in higher quality heroin than the black tar our smugglers supply. They are saving money and have healthier junkies because of free needles. Their claims about reducing drug use or curing more addicts are vague but they do admit to no reduction in pot use.

    Our fentanyl OD deaths are caused by poor quality control by the dealers because they are lazy or just don’t care. A pinhead amount of fentanyl will kill you. The improper doses have been found in heroin and counterfit painkiller pills. Decriminalizing the use of these drugs won’t have any effect on the people who mix and sell them.

  32. Willy permalink
    December 24, 2017

    If you don’t troll anybody here again, I’ll quit being a “disgusting bigoted human being”.

  33. Webstir permalink
    December 25, 2017

    RC: I know you’re a little thick, but “whatevs” means you are again on the persona non grata list. Bye now.

  34. Webstir permalink
    December 25, 2017

    @Che: Did you actually read Lambert’s post? He isn’t trying to solve the “white working class despair” issue. He is using the Case-Deaton study to highlight the fact that progressives need to use markers of health generally as a wedge issue because it cuts hard across political divides. To focus on the markers of health, he suggests reorienting — from the 10% establishment Democrat base’s identity issues — to the issues at the bottom of Maslow’s heirarchy that truly concern the 90%.

    There should be no disagreement here between us and I’m pretty sure the only reason one exists is because either: (1) you didn’t read the post, or (2) you dislike Lambert personally for whatever reason and are just picking nits — which is understandable b/c he can be a twat but it doesn’t mean he isn’t pretty fucking bright.

  35. Webstir permalink
    December 25, 2017

    Oh, and rc, this doesn’t mean I’m not going to land on you occasionally. It just means I won’t be interacting with you once I’ve pointed out your lazy thinking.

  36. Webstir permalink
    December 25, 2017

    And finally rc —
    Were it true that I’m a “dry drunk” I’d be perfectly ok with that. Every day without a drink is a good day. If anyone in my life beside you ever calls me one … I’ll think about working on it. You, however, a just a nasty little asshole. Pretty sure there’s no cure for that.

  37. realitychecker permalink
    December 25, 2017

    You guys are a pair of open wounds. So nice to see you bleed.

    Willy who slurs with “gay porn sites.”

    Webstir who slurs with “twat.”

    Yeah you guys are the ones we should all be striving to emulate.

    Willy, get your hands off your damn penis!!!

    Webstir, go look up “dry drunk,” and tell me which symptoms you don’t exhibit.

    Two nothings, thinking they are somethings. The wave of the future.

  38. Webstir permalink
    December 25, 2017

    Hypocrisy: The practice of claiming to have moral standards or beliefs to which one’s own behavior does not conform; pretense.

  39. realitychecker permalink
    December 25, 2017

    Daddy issues and alcoholism frequently combine to make a very nasty package. You show a stunning lack of self-awareness, and I am quite sure you have not understood anything I have every typed here.

    Your compulsive inability to stop seeking me out is psychologically telling.

    You are also a great example of the frog in a small pond syndrome. You could never survive in a larger pond than your little two-grocery town, where you can pretend to be the town genius. That is a major dry drunk symptom, btw. You should look it up. Everybody should, in fact, if you are going to continue to try and dominate these threads with your insipid nonsense, encouraged and abetted by/abetting your feces-flinging friend Willy, who also seems unable to stop seeking me out.

    Your joint efforts have destroyed this place as a venue for careful good faith analysis and dialogue. I hope you are happy with your ‘achievement.’

  40. Willy permalink
    December 25, 2017

    There’s no way this isn’t either a seriously messed up kid in his moms basement,

    or a legacy neocon.

  41. realitychecker permalink
    December 26, 2017

    A neocon lol???

    Too many little green worms running around inside that psychological wound you call a brain, sonny.

    And keep your hands off your damned penis as you think about me! Too creepy.

  42. Willy permalink
    December 26, 2017

    One needn’t be so insecure. My heart will only ever belong to the cranky old misanthropic troll who talks the most, about my penis.

  43. realitychecker permalink
    December 26, 2017

    Perhaps you’d be willing to ex[lain to us exactly what your problem is with “gay porn sites”?

    Reminder–This is YOU, Willy-boy:

    ” Willy permalink
    December 23, 2017

    But you’ve obviously visited a lot of gay porn sites.”


    I don’t think homophobes get a lot of cred around here. I note you say you come from a VERY conservative family.

    And I don’t think anyone has missed your obvious obsession with me.

    You just can’t quit me.

    Now get your hand off your penis!!!!!

  44. Mojave Wolf permalink
    December 26, 2017

    @RC — In the spirit of the holiday season, whatever it is you think you are doing, please stop. I say this in a genuine Spirit of Goodwill because I used to quite like and enjoy reading a lot of your comments a long time ago and you still sometimes say something good but when you do it’s surrounded by so much really cringe-inducing stuff that I wonder if you are deliberately trying to discredit any point you advocate. If that is not what you are doing please For the Love of All That is Holy rethink your approach. (And if that is what you are doing, again, please rethink your approach.)

    Apologies for the drive-by request. I have been overwhelmed by circumstances lately. I usually don’t have the right combination of time and energy to comment but I do try to keep up with reading the blog and the threads. Best wishes to all.

  45. realitychecker permalink
    December 27, 2017

    @ MW

    I respect and like you, and I hear you.

    There are difficulties in dealing with determined online stalkers, and Willy is mine. If you haven’t witnessed it, I know it looks messy. In person, I would have dealt with a coward like this long ago, in private. And the coward depends on that, of course.

    I don’t believe in censorship, so I would never ask to ban him. But ignoring him carries its own difficulties, because our cred is all we have online, and slanders and false attacks that go unchallenged get believed by many who just don’t want to debate the points I might raise.

    We are in a place where departures from dogma are deplored and attacked, but the dogma, unchallenged, is clearly delivering us into dystopia. That is the fight I am trying to fight, and it is a fucking lonely fight, Wolf, let me tell you.

    I wish you would come around more with your reasonable voice, and your good faith approach to things. I never have a problem with reasonable folks like you, do I? Your voice is always a good influence, IMO.

    Best to you.

  46. MojaveWolf permalink
    December 27, 2017

    Thanks RC, I appreciate you taking the comment in the spirit it was offered. I don’t have much else to say right now; for why see comment in Merry Christmas thread immediately forthcoming.

  47. MojaveWolf permalink
    December 27, 2017

    Scrap that. I had written something lengthy about my mother passing away this morning but decided it was inappropriate for a Merry Christmas thread. But that is why I have not much else to say right now. Peace to you.

  48. realitychecker permalink
    December 27, 2017

    @ MW

    I’m very sorry to hear that. There’s nothing like losing your mother. You have all my sympathy, empathy, and fond best wishes as you deal with all that comes along with it.

    Please take good care of yourself, amigo.

  49. Mojave Wolf permalink
    December 30, 2017

    Appreciate it, RC. You as well.

Comments are closed.