T he pricing and availability of drugs — legal and illegal — illuminate how markets chase profits and reward innovation. A comparison of heroin and other illicit opioids with naloxone, the lifesaving antidote for opioid overdoses, offers a devastating peek into the overdose epidemic that is ravaging the United States. And prices continue to fall with the introduction of new and more powerful synthetic opioids, such as fentanyl.
Compared to heroin, which requires lengthy cultivation of poppy plants and cumbersome processing, fentanyl and its ilk are relatively cheap to make.
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Humans have been growing poppies and harvesting opium for at least 6, years ; manufacturing has historically been constrained by the day growth cycle of the opium poppy plant and the distant geography in which it grows. Today, fentanyl and other illicit opioids are being rapidly mass produced. Much of the supply is coming from China, though Mexico and small U. Naloxone is near miraculous in its ability to reverse an opioid overdose within minutes. Prompt access to it could prevent some or all of the opioid overdose deaths that occur in the United States every day.
Naloxone is cheap to make, and has been off patent since Given the ongoing devastation of the opioid crisis, you might expect that naloxone would be widely available at a low price. Not so. Market forces are working from opposite directions to boost the death count from opioids. In the midst of this crisis, lethally potent street drugs are increasingly affordable and available, while their lifesaving antidote, naloxone, is increasingly expensive and difficult to obtain.
The aggressive marketing and sales of highly potent prescription opioids, combined with price-lowering innovations in the production and distribution of heroin, illicit opioids, and fentanyl, have not been matched by innovations in the legal market for naloxone. Its high price and restricted availability — despite its low production costs and excellent safety and effectiveness records — betray our collective ambivalence about the millions of Americans with opioid use disorder. This is essentially a prescription for everyone that makes it possible to obtain naloxone from a pharmacist without first having to visit your own doctor and get a prescription.
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We offer a different solution: Make naloxone available over the counter, in much greater quantities and at lower prices. The FDA approved naloxone for use by prescription inand could easily transition the drug from prescription to over-the-counter status. If How much is a dose of heroin pharmaceutical companies are unable to see past their bottom lines to make naloxone available over the counter and at a low cost, then a nonprofit should step in and do just that, eliminating the exorbitant markups.
This is what Civicaa nonprofit generic drug company launched by several hospital systems, aims to do to fight rising drug costs and chronic shortages. FDA Commissioner Scott Gottlieb recently announced plans for a December meeting to discuss how to improve the availability of naloxone products. With a concerted national effort, this can be a solvable problem. The opioid epidemic is a tragic consequence of multiple forces — the aggressive marketing of potent prescription opioids, increased availability and decreased costs of illicit opioids, and insufficient access to medications that can quickly reverse overdoses as well as those that can treat opioid dependence.
Increased access to inexpensive naloxone alone will not solve the opioid crisis. But individuals dependent on opioids must be kept alive if they are ever to have the opportunity to recover. The pharmacoeconomics of the opioid epidemic are not on our side. But let us hope that common sense is. In a sane world, naloxone should be at least as available and affordable as heroin.
Michael Hufford, Ph. Donald S. Burke, M. Hilton, I am a research chemist is pharma. There is a simple test for clandestine and analogues of fentanyl in heroin.
It is available in a simple flex-able vial similar to field tests for cocaine and methamphetamine. The chemicals that cause the color reaction are in the vial. Simple add a small amount of heroin and crush. The bright color develops immediately.
The cost is about 15 to 20 dollars depending on quantity purchased. Unfortunately they are only available to forensic chemists with DEA clearance and law enforcement. So if someone is going to use heroin, tainting can be verified before use. These should also be made available not only to users but to those severe chronic pain patients that have lost their medications due to scared physicians.
Come on, folks!
I totally agree with Rex D. Suggesting Narcan as a viable solution to opioid addiction is ludicrous. Might as well require everyone become a stepper too. Maybe we should solve drive by shootings and gun deaths by requiring everyone to wear a bullet-proof vest? I agree.
We act like there is a cure for addiction despite evidence of a genetic predisposition in a tiny sliver of the gene pool, and despite multi-morbidity especially psychiatric being the norm, and despite relapse being the norm.
I have seen anecdotal reports from EMTs that they Nalaxone the same people repeatedly until one day they arrive too late.
I keep saying that a genetic modification is the likely hope for a cure. Alas, we still do not know enough to prevent or blunt opioid highs without disrupting the dopamine and related systems.
Narcan was another highly successful marketing campaign by pharma. They created brand recognition, and increased sales of their expensive product. At the same time the availability of this product, made it appear that they were doing something.
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The opioid reversal products do help in limited circumstances, but that was all that they did. This problem goes back toif you believe the current false narrative. In that time they have done little or nothing, but market expensive programs, for the well insured.
The fact that the reality stars were dying, after discharge from these expensive programs, did not matter. People like Dr Kieth Ablow, made a lot of money, and spread a lot of lies. This serious social problem, is nothing more than a genocidal marketing campaign. Even communities that had problems prior to Perdues deceptive marketing campaign, have still not tackled the problem. Not all addicts are the stereotype in your mind.
You sound ignorant when you try and speak for all. Just not as smart as you think. For one, this fentanyl is painful to inject. It seems to be doing a lot of damage to the person doing it. It burns like hell then destroys the vein. It appears to be damaging the muscle too. Its very scary when they try and quit.
Feels like there going to die they say. So yes, a lot of them would like to know what the heck they are putting in there bodies. They are people too. Some of them are tax paying job holders, some are people who have unmanageable pain.
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Some are people with mental illness. Can you shed some light on the effects that fentanyl is doing to them? This is not the way anyone should die. And last, I know several people who lived because overdose meds were available. I know many integrative Doctors here in Nevada. Each of them is required to also be certified and d as medical practitioners.
Dear M. At least try to pretend you have an objective mind. Acupuncture has an extraordinary of studies now demonstrating its efficacy for pain relief. For people like Mavis Johnson below, who may not be at all familiar with research, a review study provides a much higher level of evidence than a single study.
How do people use heroin?
When the NIH allowed the Acupuncture and Quacks industries to use their site for marketing purposes, they lost a lot of crediblity. These acupuncture studies are deceptive, unscintific, and biased. They actually prove that accupuncture does not work. This is really simple: 1.