Crackdowns on "pill mills" and "overprescribing doctors" is what denies people a safe and legal source of pharmaceutical-grade opioids and forces them onto the black market of illegal, overpriced, and fentanyl-contaminated opioids.
Also crackdowns on "over-prescribing" invariably lead to people who experience chronic pain being denied medical access (or being subjected to extremely invasive and degrading treatment to weed out "drug seekers").
The DEA cracking skulls over opioids and investigating doctors is literally the only reason illicit fentanyl even is a thing. I am so very doubtful that skull-cracking and door-kicking will miraculously work after decades of it not working.
Do you want even nastier and even more potent (per unit volume) opioids than fentanyl? Because more prohibition (and yes, investigating and prosecuting doctors is absolutely a component of opioid prohibition) is just gonna give that result.
Supposedly, Weed is like the ground beef of drug sales.
On the more potent point, almost(?) all of the more potent opioids are derivatives of fentanyl and iirc use fentanyl in the synthesis so probably won't become a street drug. Also they're so potent they really are only good for killing people. (Honestly I'm suprised fentanyl is a thing because the active dose is like tens of micrograms and requires expensive equipment to measure safely. But I doubt drug cartels care if they're customers are poisoned by their product.)
You're alas wrong here. There's already derivatives of fentanyl being made illicitly and appearing in the illicit drugs markets. Not just any analogues of fent either -- there's been carfentanil (an opioid so potent that it's been successfully used as a chemical weapon) in product sold as heroin.
https://en.wikipedia.org/wiki/Carfentanil
> Honestly I'm suprised fentanyl is a thing because the active dose is like tens of micrograms and requires expensive equipment to measure safely
Ah, but a tiny active dose means that for a given quantity of raw material, lots of (very diluted) doses for end users can be made. This is the deadly "iron law of prohibition" at work here -- the harder the enforcement, the more potent the drugs.
For a unit volume (so, for a unit risk of ending up in a concrete box) of uncut/active material, you want to be able to sell the most diluted/cut doses to end-users. Of course people will want their chemist to synthesise carfentanil (over regular fentanyl), because you can supply the the same number of end-user doses with 10,000 times less active material.
They are both over and under-prescribed. Pain is both over and undertreated every day in every state in the country. There are pill mills, there are stingy ER's and clinics, it goes both ways. It isn't one or the other.
On one hand, you have doctor shopping.
On the other, you have legitimate chronic pain sufferers turning to the street to make ends meet.
My grandparents bought pills from the black market at black market prices to fill the gap of under treatment. At the same time, people were paying cash-only pain management clinics for prescriptions which they were filling multiple times.
There will always be abusers, lawmakers and activists need to realize that you can't regulate or price someone out of an addiction (or a dependency.)
There is a staggering difference between addiction (which usually involves abuse) and dependency (which usually involves no abuse)
Addiction to prescription opiates leads to one of two roads. The problem road is heroin. For example:
Let's say you get addicted because you abuse the pills prescribed to you after surgery. You continue to maintain your addiction with drugs purchased from the street, then at some point you remember that heroin exists and is dirt cheap compared to the dollar per milligram you were paying for oxycodone. Suddenly, heroin doesn't seem so evil. Now you have a new perspective about heroin, mainly that it's cheaper and more potent than prescription pills.
Dependency, meanwhile, can be maintained under a doctors supervision for years. Pain can be managed with prescription opiates safely and effectively, increasing the quality of life of someone who suffers from pain every single day.
It's a multi-faceted issue with many variables, you can't really reduce it down to one sentence or another. There is no easy solution, either. You can't under-prescribe or prosecute doctors, that just hurts the people suffering the most.
I know what the solution isn't, though: banning fucking kratom. this entire thing is a complete and total structure fire, and the DEA is trying to immediately move to Schedule I a powdered leaf that stops withdrawals for addicts. For the opiate naive, taking powdered kratom leaf results in a light buzz. For an opiate addict, it's no buzz + immediate relief of withdrawal symptoms.
There is always methadone and suboxone, but these drugs are extremely long-acting. Meaning that if and when you come off of them, you will be in withdrawals for weeks or even months. For comparison, short-acting opiates like heroin withdrawals last about a week, maybe two.
Now that you know this, it might not surprise you to hear that methadone patients often switch back to shorter-acting drugs like heroin to attempt to get clean.
Ironic, isn't it?
