Thread by @urbanfatbiker

@headdock @Nashkitty66 @Canada_NV @hope411adcock @Chronic_FLKeys @bluelilly40 @Deeenst @ThomasKlineMD @StopBadDocs @HR4peopleinpain @chattyknana @maryann19711 @SpicyPurritos @Vlynx5 @SweetDeals16 @secondchances09 @Royalacresrod @Sarahkirk40 @soofriends @DebM01279692 @onnaroll66 @EbCummings1 @russell90367011 @CContrarus @eullrich11 @aander1987 @life_is_art___ @fightpaindaily @Kazeself @JustWinks @JoshBloomACSH @RepKatiePorter @NPR @NPRHealth @JeffreyFudin @drcarlhart @BethDarnall @twebber02 Fentalogues were around, it may be disputable how much, but it was a problem for DEA in 2005, an issue with unexplained deaths in east coast ERs in 1991, a 'new twist in an ongoing crisis' as early as 1981.

That is also history, poorly captured by coroners.

@headdock @Nashkitty66 @Canada_NV @hope411adcock @Chronic_FLKeys @bluelilly40 @Deeenst @ThomasKlineMD @StopBadDocs @HR4peopleinpain @chattyknana @maryann19711 @SpicyPurritos @Vlynx5 @SweetDeals16 @secondchances09 @Royalacresrod @Sarahkirk40 @soofriends @DebM01279692 @onnaroll66 @EbCummings1 @russell90367011 @CContrarus @eullrich11 @aander1987 @life_is_art___ @fightpaindaily @Kazeself @JustWinks @JoshBloomACSH @RepKatiePorter @NPR @NPRHealth @JeffreyFudin @drcarlhart @BethDarnall @twebber02 There are reports of fentalogues in heroin going back as far as 1976.

Heroin itself became pure, sortable, and being used by upper middle-class kids by mid-90s, and undoubtably some of those deaths included fentalogues.

Heroin quadrupled production in 2000s.
Someone used it...

@headdock @Nashkitty66 @Canada_NV @hope411adcock @Chronic_FLKeys @bluelilly40 @Deeenst @ThomasKlineMD @StopBadDocs @HR4peopleinpain @chattyknana @maryann19711 @SpicyPurritos @Vlynx5 @SweetDeals16 @secondchances09 @Royalacresrod @Sarahkirk40 @soofriends @DebM01279692 @onnaroll66 @EbCummings1 @russell90367011 @CContrarus @eullrich11 @aander1987 @life_is_art___ @fightpaindaily @Kazeself @JustWinks @JoshBloomACSH @RepKatiePorter @NPR @NPRHealth @JeffreyFudin @drcarlhart @BethDarnall @twebber02 ...and it's clear from DEA pleading with Congress about fentalogue precursor regulations in 2007 it was a problem.

Couple that with exaggerated climb in 2000s prescribing, factoring OUT parallel quadrupling of major skeletal surgery increases, cancer survival advances...

@headdock @Nashkitty66 @Canada_NV @hope411adcock @Chronic_FLKeys @bluelilly40 @Deeenst @ThomasKlineMD @StopBadDocs @HR4peopleinpain @chattyknana @maryann19711 @SpicyPurritos @Vlynx5 @SweetDeals16 @secondchances09 @Royalacresrod @Sarahkirk40 @soofriends @DebM01279692 @onnaroll66 @EbCummings1 @russell90367011 @CContrarus @eullrich11 @aander1987 @life_is_art___ @fightpaindaily @Kazeself @JustWinks @JoshBloomACSH @RepKatiePorter @NPR @NPRHealth @JeffreyFudin @drcarlhart @BethDarnall @twebber02 ...you end up with a history quite different than Kaloopy's 'first wave' garbage coupling all opioid prescribing increases to parallel rise in OD death.

Made easy by CDC counting all those fentalogue deaths as rx pain meds.

History was already rewritten.
We have to fix that.

@headdock @Nashkitty66 @Canada_NV @hope411adcock @Chronic_FLKeys @bluelilly40 @Deeenst @ThomasKlineMD @StopBadDocs @HR4peopleinpain @chattyknana @maryann19711 @SpicyPurritos @Vlynx5 @SweetDeals16 @secondchances09 @Royalacresrod @Sarahkirk40 @soofriends @DebM01279692 @onnaroll66 @EbCummings1 @russell90367011 @CContrarus @eullrich11 @aander1987 @life_is_art___ @fightpaindaily @Kazeself @JustWinks @JoshBloomACSH @RepKatiePorter @NPR @NPRHealth @JeffreyFudin @drcarlhart @BethDarnall @twebber02 "Since 1979, the potent narcotic analgesic fentanyl and its analogs have been synthesized in clandestine laboratories and sold as heroin substitutes."

Coroners didn't test for it.
No one cared until rich white kids started snorting it in the 90s.

astm.org/DIGITAL_LIBRAR…

@headdock @Nashkitty66 @Canada_NV @hope411adcock @Chronic_FLKeys @bluelilly40 @Deeenst @ThomasKlineMD @StopBadDocs @HR4peopleinpain @chattyknana @maryann19711 @SpicyPurritos @Vlynx5 @SweetDeals16 @secondchances09 @Royalacresrod @Sarahkirk40 @soofriends @DebM01279692 @onnaroll66 @EbCummings1 @russell90367011 @CContrarus @eullrich11 @aander1987 @life_is_art___ @fightpaindaily @Kazeself @JustWinks @JoshBloomACSH @RepKatiePorter @NPR @NPRHealth @JeffreyFudin @drcarlhart @BethDarnall @twebber02 We could blame Purdue for quadrupling rx (ignoring marketing for major skeletal surgeries now possible, also quadrupling by millions)...

But the best marketing for Oxycontin was China White!

Was there unscrupulous profiteering? Always.
But we blame supply.
Ignore demand!

@headdock @Nashkitty66 @Canada_NV @hope411adcock @Chronic_FLKeys @bluelilly40 @Deeenst @ThomasKlineMD @StopBadDocs @HR4peopleinpain @chattyknana @maryann19711 @SpicyPurritos @Vlynx5 @SweetDeals16 @secondchances09 @Royalacresrod @Sarahkirk40 @soofriends @DebM01279692 @onnaroll66 @EbCummings1 @russell90367011 @CContrarus @eullrich11 @aander1987 @life_is_art___ @fightpaindaily @Kazeself @JustWinks @JoshBloomACSH @RepKatiePorter @NPR @NPRHealth @JeffreyFudin @drcarlhart @BethDarnall @twebber02 One big irony of war against Sacklers is Nan Goldin. She rallies warriors against evil Oxycontin which hooked her.

Yet, in late 90s, anti-drug warriors ranted about 'Heroin Chic' glorifying heroin use in fashion and upper middle class youth.

And they BLAMED Nan Goldin.

@headdock @Nashkitty66 @Canada_NV @hope411adcock @Chronic_FLKeys @bluelilly40 @Deeenst @ThomasKlineMD @StopBadDocs @HR4peopleinpain @chattyknana @maryann19711 @SpicyPurritos @Vlynx5 @SweetDeals16 @secondchances09 @Royalacresrod @Sarahkirk40 @soofriends @DebM01279692 @onnaroll66 @EbCummings1 @russell90367011 @CContrarus @eullrich11 @aander1987 @life_is_art___ @fightpaindaily @Kazeself @JustWinks @JoshBloomACSH @RepKatiePorter @NPR @NPRHealth @JeffreyFudin @drcarlhart @BethDarnall @twebber02 So, my history take is this:

Profiteers captured an existing market, shifting wealthier people with access, from an increasingly dangerous heroin supply, to a safer pharmaceutical option, and made out like bandits.

While poor still died from fentanyl.
Which CDC labeled rx.

@headdock @Nashkitty66 @Canada_NV @hope411adcock @Chronic_FLKeys @bluelilly40 @Deeenst @ThomasKlineMD @StopBadDocs @HR4peopleinpain @chattyknana @maryann19711 @SpicyPurritos @Vlynx5 @SweetDeals16 @secondchances09 @Royalacresrod @Sarahkirk40 @soofriends @DebM01279692 @onnaroll66 @EbCummings1 @russell90367011 @CContrarus @eullrich11 @aander1987 @life_is_art___ @fightpaindaily @Kazeself @JustWinks @JoshBloomACSH @RepKatiePorter @NPR @NPRHealth @JeffreyFudin @drcarlhart @BethDarnall @twebber02 Interesting CDC report from 2006 regarding NPF (non-pharmaceutical fentanyl).

Disturbing in light of how CDC later quantified all NPF OD as prescription opioid.

cdc.gov/mmwr/preview/m…

@headdock @Nashkitty66 @Canada_NV @hope411adcock @Chronic_FLKeys @bluelilly40 @Deeenst @ThomasKlineMD @StopBadDocs @HR4peopleinpain @chattyknana @maryann19711 @SpicyPurritos @Vlynx5 @SweetDeals16 @secondchances09 @Royalacresrod @Sarahkirk40 @soofriends @DebM01279692 @onnaroll66 @EbCummings1 @russell90367011 @CContrarus @eullrich11 @aander1987 @life_is_art___ @fightpaindaily @Kazeself @JustWinks @JoshBloomACSH @RepKatiePorter @NPR @NPRHealth @JeffreyFudin @drcarlhart @BethDarnall @twebber02 More pre-2012 fentanyl history...this covers 2005-2006 Cook County IL.

"Epidemics related to illicit fentanyl abuse have been reported and the potential exists for a national epidemic associated with high mortality."

pubmed.ncbi.nlm.nih.gov/18584361/

@headdock @Nashkitty66 @Canada_NV @hope411adcock @Chronic_FLKeys @bluelilly40 @Deeenst @ThomasKlineMD @StopBadDocs @HR4peopleinpain @chattyknana @maryann19711 @SpicyPurritos @Vlynx5 @SweetDeals16 @secondchances09 @Royalacresrod @Sarahkirk40 @soofriends @DebM01279692 @onnaroll66 @EbCummings1 @russell90367011 @CContrarus @eullrich11 @aander1987 @life_is_art___ @fightpaindaily @Kazeself @JustWinks @JoshBloomACSH @RepKatiePorter @NPR @NPRHealth @JeffreyFudin @drcarlhart @BethDarnall @twebber02 NBC 2008 take on the epidemic of fentanyl poisonings.

"National health statistics show the death rate from unintentional drug poisonings — most of them illicit drug overdoses — roughly doubled from 1999 to 2005."

nbcnews.com/health/health-…

@headdock @Nashkitty66 @Canada_NV @hope411adcock @Chronic_FLKeys @bluelilly40 @Deeenst @ThomasKlineMD @StopBadDocs @HR4peopleinpain @chattyknana @maryann19711 @SpicyPurritos @Vlynx5 @SweetDeals16 @secondchances09 @Royalacresrod @Sarahkirk40 @soofriends @DebM01279692 @onnaroll66 @EbCummings1 @russell90367011 @CContrarus @eullrich11 @aander1987 @life_is_art___ @fightpaindaily @Kazeself @JustWinks @JoshBloomACSH @RepKatiePorter @NPR @NPRHealth @JeffreyFudin @drcarlhart @BethDarnall @twebber02 'resulting investigation was unusual, because health officials have been reluctant to spend time and energy investigating deaths related to illicit drugs..."

"tally covers only two states — New Jersey, Delaware — and cities of Chicago, Detroit, Philadelphia and St. Louis."