Fentanyl Dangers

You can’t force people to undergo or comply with medical treatment. I was in family practice for 24 years. I wish I could have made my patients take their blood pressure meds, diabetes meds, depression meds, antibiotics, and other meds. They would have been far better off and suffered a lot less if they had but it doesn’t work that way. Substance abuse treatment is no different. Even if you can get someone to agree to enter a Suboxone treatment plan, you still can’t force them to take the pills every day and attend the therapy sessions and avoid the people in their lives who are enabling their disease.

Another issue is that treatment is expensive and often not covered by insurance. Patients may need to pay hundreds of dollars per month for outpatient treatment and inpatient treatment can cost thousands.
One family member actually got herself off the Suboxone after years of trying by slowly reducing the dosage over time. She could not get insurance to pay the $400+ per month prescription fee and $100 per month required doctor visits. But she got there and is doing quite well.
 
One family member actually got herself off the Suboxone after years of trying by slowly reducing the dosage over time. She could not get insurance to pay the $400+ per month prescription fee and $100 per month required doctor visits. But she got there and is doing quite well.
That’s fantastic. There are certainly success stories out there. But how many people can afford the $6,000+/yr out of pocket like that for years on end? If substance use is a disease, then why aren’t insurance companies required to cover treatment? They cover Norvasc for blood pressure or metformin for diabetes or Prozac for depression but not Suboxone for opiate dependence.
 
Buying street drugs has always been a risky thing, as the drugs have always been cut/enhanced with something and the seller doesn't care or even know what was added.

Sad story, but it's been happening for many decades with all sorts of drugs.

+1

For example, I recall when I was a child, living in a bad neighborhood where it was common to see junkies on the street strung out at any time of the day, hearing about heroin being cut/enhanced with rat poison, or it being mixed into joints. Many times the sellers themselves might be strung out. Being on the lower rung of the drug business, they really did not care about what happened to their "clients", they could always find new ones.
 
That’s fantastic. There are certainly success stories out there. But how many people can afford the $6,000+/yr out of pocket like that for years on end? If substance use is a disease, then why aren’t insurance companies required to cover treatment? They cover Norvasc for blood pressure or metformin for diabetes or Prozac for depression but not Suboxone for opiate dependence.
Seems odd. The generic Suboxone (Buprenorphine / Naloxone) shows as a tier 1 drug (low copay) under my insurance and that you should be able to get it for $50/mo even if insurance doesn't cover. Suboxone brand name is tier 3. I don't take it, but checked out of curiosity after reading the posts here.
 
Last edited:
Personally know 3 families that have lost a son in their teens or twenties to Fentanyl. These are upper middle class families that are not economically disadvantaged. However, almost all of my kids friends have some kind of "anxiety" issues. I think social media puts a lot of pressure on young minds. Did my share of stupid in high school, but seems to be much more serious today. Overdose deaths are 100k+ per year so something different is definitely going on.

+1

We live in a nice neighborhood, almost no crime, schools with high ratings - but all of our kids (age range 38 to 29) have already lost at least one friend they had since elementary school to drugs. The "crime waves" of breakins our neighborhood experienced from time to time have always been due to addicts from neighborhood families seeking things to pay for their drugs.

Our youngest DS recently showed me a picture of him in high school with 5 other friends, kids he had classes with and played with on sports teams since 1st grade, and that DW and knew well enough to have them in our house or have conversations when we ran into them in various places. 3 are now dead, 1 from a motorcycle accident, 2 from drugs. One of the drug deaths was the son of a well known politician in our area who is also a real estate multi-millionaire.

I also agree that social media adds pressure, as there is no escape from things that make one anxious, particularly any type of teasing/bullying. Before social media it was much easier to escape that, or for others to forget about it over time, or to simply go to another area and have no one know about it. Now, that follows one everywhere, and embarrassment can be seen worldwide. In addition, there is probably more advocating of illegal drug use on social media than warnings against not using them. And social media companies are more interested in making money off of it, in some way, shape, or fashion, than protecting people.
 
Seems odd. The generic Suboxone (Buprenorphine / Naloxone) shows as a tier 1 drug (low copay) under my insurance and that you should be able to get it for $50/mo even if insurance doesn't cover. Suboxone brand name is tier 3. I don't take it, but checked out of curiosity after reading the posts here.
This was before the Affordable Care Act (1990's). I paid the freight for much of this and later on I believe she got some coverage after she married. It was my daughter, and now she is 44 and doing very well. It's a long story and I lost one older daughter to drugs at 22 years of age due to drugs.

I know more about this bad stuff than probably most anyone here as my family has lived it for 25+ years. It's a miracle we only had to bury one child.

I guess my parenting job as a divorced Dad was not as good as most families, but this crap can happen to anyone, especially these days.
 
This was before the Affordable Care Act (1990's). I paid the freight for much of this and later on I believe she got some coverage after she married. It was my daughter, and now she is 44 and doing very well. It's a long story and I lost one older daughter to drugs at 22 years of age due to drugs.

I know more about this bad stuff than probably most anyone here as my family has lived it for 25+ years. It's a miracle we only had to bury one child.

I guess my parenting job as a divorced Dad was not as good as most families, but this crap can happen to anyone, especially these days.
As I mentioned earlier, my only sibling, my older brother, died of an overdose in 1987. He was 28. And we dealt with the drug issues for probably 10 years before that. The theft, the wrecked cars, the hospitalizations. The whole deal.
 
Seems odd. The generic Suboxone (Buprenorphine / Naloxone) shows as a tier 1 drug (low copay) under my insurance and that you should be able to get it for $50/mo even if insurance doesn't cover. Suboxone brand name is tier 3. I don't take it, but checked out of curiosity after reading the posts here.
That's great if there is a cheaper generic now. It's been almost 7 years since I left my practice and haven't really had much contact with the treatment field since then.

As for insurance coverage, it's not uncommon for insurance plans to only cover Suboxone when it is being prescribed for pain management but not if it's for substance use disorder. I think that's still the case but I'm not sure.

I also suspect that the doctor visits are more costly than they were years ago so you may be looking at $200 or more per month for that even if the drug is cheaper. And if there is other therapy involved, like a psychologist, you've got that cost too. My daughter's therapist (not for substance abuse) is about $500/mo out of pocket. Many don't take any insurance.
 
If there is genetic element, these tragic deaths are removing from the gene pool people with a tendency for addiction and risk taking. Continuation of that trend for a long time will result in a change in average human behavior.
 
If there is genetic element, these tragic deaths are removing from the gene pool people with a tendency for addiction and risk taking. Continuation of that trend for a long time will result in a change in average human behavior.
Really.??....maybe you are not aware that drugs made to create addiction have been a problem for thousands of years on this planet?

It's just recently that chemists have been able to make new and old drugs even more potent and more addictive. I doubt very much that addicted people dying from this problem, whether the drug is prescribed or bought on the street, is going to make the general behavior of the world population change.
 
That's great if there is a cheaper generic now. It's been almost 7 years since I left my practice and haven't really had much contact with the treatment field since then.

As for insurance coverage, it's not uncommon for insurance plans to only cover Suboxone when it is being prescribed for pain management but not if it's for substance use disorder. I think that's still the case but I'm not sure.
I didn't realize the cost comment was from quite a few years back. Looks like Subonxone was available as a generic first in 2018, so I know that changes things.

In my insurance plan's drug tier list, it lists them under a section titled, "Anti-Addiction / Substance Abuse Treatment Agents". That's a Health Alliance ACA plan.

The Blue Cross marketplace drug list I have has a section that says, "Note: Covered substance use disorder drugs (those FDA-approved for treatment of opioid drug abuse, alcohol abuse and to quit tobacco use) may be in the lowest tiers. Substance use disorder brand drugs may be in the lowest brand tier and generic drugs in the lowest generic tier, based on your benefit plan. These drugs are those with such active ingredients as buprenorphine- naloxone, naltrexone, disulfiram, Acamprosate, bupropion (smoking deterrent), varenicline and nicotine replacement therapy."
 
Last edited:
I didn't realize the cost comment was from quite a few years back. Looks like Subonxone was available as a generic first in 2018, so I know that changes things.

In my insurance plan's drug tier list, it lists them under a section titled, "Anti-Addiction / Substance Abuse Treatment Agents".
That’s good to hear. Hopefully more insurers are starting to cover treatment.
 
If there is genetic element, these tragic deaths are removing from the gene pool people with a tendency for addiction and risk taking. Continuation of that trend for a long time will result in a change in average human behavior.
So you think everyone with an addiction just needs to die and all will be right in the world? Do you realize that there are an estimated 380 million people in the world with alcoholism? Would you like to start by eliminating them and then move onto the people with other substance use disorders? The planet will certainly be a lot less crowded by the time you’re done. Heck that’s more than the entire population of the US. And that’s just alcohol.
 
I doubt very much that addicted people dying from this problem, whether the drug is prescribed or bought on the street, is going to make the general behavior of the world population change.

That's the way genetics are believed to operate, but if you have evidence that's wrong, it may be worth your while to publish a paper.
 
If there is genetic element, these tragic deaths are removing from the gene pool people with a tendency for addiction and risk taking. Continuation of that trend for a long time will result in a change in average human behavior.

Did you read this thread? Did you even think before you hit send on this comment? If not, I suggest a change in that human behavior might not go amiss.

Some of the people you so callously refer to as being "removed from the gene pool" (as if that were a net positive) were beloved family members of other people actually posting here.
 
Last edited:
A difficult topic for all, especially for those affected by tragic loss. Let’s give each other the benefit of then doubt and not get into a debate or argument.
 
If there is genetic element, these tragic deaths are removing from the gene pool people with a tendency for addiction and risk taking. Continuation of that trend for a long time will result in a change in average human behavior.
Wow! Maybe if we remove people with cancer from the genetic pool, there will be no cancer. Or short people! Let's remove short people from the gene pool, then we'll have tall people. Brilliant!
 
Let’s please not make this personal. I think it’s admirable some people can talk about the personal tragedies they have suffered resulting from addiction.

Folks that have had the good fortune to not be touched by this terrible circumstance need to be more circumspect and considerate.
 
What to do about self destructive drug addicts is one of the thorniest moral issues of our time. On the one hand, we recognize that they are people just like us who have a disease, and we believe we should attempt to cure them, or at least alleviate their symptoms. On the other hand, there is always the issue of self determination. If human agency is to have any meaning, it means one should have the power to choose the time, place and manner of one's own demise. I have neither the right nor the responsibility to prevent another person from choosing to end their life. I believe that most of the people who take these drugs are well aware of the consequences, and they are, in effect, choosing slow (and unpredictable) suicide. Who am I to say they're not allowed to make that choice?
Yes. Mild spoiler about the movie "Leaving Las Vegas". That's basically the theme of the movie. It is a difficult movie to watch, but quite real about alcoholism, and those who know they are going down a path of slow suicide. The lead character was very aware.
 
What to do about self destructive drug addicts is one of the thorniest moral issues of our time. On the one hand, we recognize that they are people just like us who have a disease, and we believe we should attempt to cure them, or at least alleviate their symptoms. On the other hand, there is always the issue of self determination. If human agency is to have any meaning, it means one should have the power to choose the time, place and manner of one's own demise. I have neither the right nor the responsibility to prevent another person from choosing to end their life. I believe that most of the people who take these drugs are well aware of the consequences, and they are, in effect, choosing slow (and unpredictable) suicide. Who am I to say they're not allowed to make that choice?

I understand the need for personal freedoms. But in my opinion, drug abuse is a societal problem, not just an individual problem. Everyone benefits from a society with little or no drug abuse. And everyone suffers to some extent from the drug abuse of others.

And I understand that drug addicts make the decision to live their lives as they see fit. But they often make that decision without a clear mind. And they often don't recognize or care about the consequences of their actions.

I've seen addicts who were forced into rehab. And made a full recovery. And glad that they were forced into coming clean.

We will never see a decrease in illegal drugs entering the US unless demand for drugs decreases. And other crimes generally follow the illegal drug trade. So it's in the best interest of our society to eliminate the influx of illegal drugs, and one way to do it is to reduce demand by cleaning up our addicts.
 
I understand the need for personal freedoms. But in my opinion, drug abuse is a societal problem, not just an individual problem. Everyone benefits from a society with little or no drug abuse. And everyone suffers to some extent from the drug abuse of others.

And I understand that drug addicts make the decision to live their lives as they see fit. But they often make that decision without a clear mind. And they often don't recognize or care about the consequences of their actions.

I've seen addicts who were forced into rehab. And made a full recovery. And glad that they were forced into coming clean.

We will never see a decrease in illegal drugs entering the US unless demand for drugs decreases. And other crimes generally follow the illegal drug trade. So it's in the best interest of our society to eliminate the influx of illegal drugs, and one way to do it is to reduce demand by cleaning up our addicts.
Your counterpoint is a good one, and that's why it's so difficult. We see that tension in a lot of public health measures, such as mental health commitments. Exactly when and where do the needs and desires of the many outweigh the needs and desires of the few or the one? I struggle to find a principled way to decide that question.
 
Back
Top Bottom