In this market, a better high for less money will attract lots of customers, even if it is less healthy than the alternative.
So, if you’re in the business of selling the somewhat healthier product, and one supplier starts to supply the otherwise superior product, that’s not good for business, either. You will lose customers.
Now, do you accept that, saying “I won’t sell that”, do you fight to outlaw the product (will be hard given at you’re not selling healthy products, either), do you fight the suppliers of the new product (a gang war) or do you add the product to your inventory?
There often isn’t a clear choice; each option has its pros and cons.
"less healthy" is a bit of an understatement; they're not selling cigarettes that will kill you in the long term (or even the medium or short term). Fentanyl will kill you the first time you're exposed to it.
Increasing the potency of some drug with fentanyl is an interesting choice, because by the time the user *knows* how strong it is, there's some likelihood they're already dead.
> Fentanyl will kill you the first time you're exposed to it.
Its lethal dose is a lot smaller than that of heroin, but it isn’t guaranteed to kill. If it were, why is it used so much in medicine?
<a href="https://en.wikipedia.org/wiki/Fentanyl" rel="nofollow">https://en.wikipedia.org/wiki/Fentanyl: “Fentanyl is a highly potent synthetic opioid of the piperidine family, used primarily as pain medication
[…]
In 2015, 1,600 kilograms (3,500 pounds) were used in healthcare globally.
It is on the World Health Organization's List of Essential Medicines.”
Thanks. That is alarming. I wonder what the long-term side effects would be even for one time, which my kid underwent. She is not the same anymore. She used to be so joyous.
Mine was an honest question because I was concerned about my kid. She recently udnerwent a 30-min GA, even so, her behaviour has considerably changed. Her personality as well. So, I am not sure why it was being downvoted, and the snark in your comment is also undeserved.
Everytime you deal with nominal professionals you should be concerned, because their professional ability is not granted. People who deal with bodies deal with an immensely complex and subtle mechanism: they do not know it as well as needed, and their regard is easily not too different from that of Robert Liston in their evaluation of compromises - your due diligence does realistically involve verifying that values are aligned (otherwise they may decide that they can sacrifice something that for you is critically vital).
> I am not sure why it was being downvoted
Neither do I - I did not. (I did take the implied into account.)
> snark
Good: since we are here, can you kindly explain what "snark" is, because I find the term in the guidelines, I have no idea how to interpret it, I asked it a few times and I got downvoted for the question?
Sometimes, text gives off a different vibe than intended. for instance:
"Pharmacology is the discipline that deals with drugs" is a very obvious statement that anyone with a primary grade education should know. So, if an obvious statement is stated, it constitutes a snark, <as if the other person is too stupid to realize that>. But given your new comment, it appears you didn't mean that.
(You were probably downvoted because supposing that a specific drug could have been a cause of damage, when potential causes of damage abound, may not sound sensible.)
I think you now understood that with «Pharmacology is the discipline that deals with drugs» what was meant is "If we interpret your questions as "could they have administered anything toxic", the answer would be "what they do is administering substances relevant to toxicity"".
I would approach the situation (just "my two cents") by trying to redirect towards health by maximizing healthy conditions. They do not sell "health pills" - but when one has had to take them, try to counterbalance that "compromise" with healthier lifestyle.
Yes, you require analgesics for general anesthesia, it’s not optional.
The reason synthetic opioids like fentanyl are used is because they actually have less side effects. Opioids can cause a histamine response, digestive issues and constipation. Newer synthetic and hybrid opioids cause that less, so they’re preferred in hospital settings.
There’s essentially no long term risk with the small doses required during surgery. The main risk is, of course, acute respiratory depression, which kills you. This is how opioid overdoses happen. This doesn’t happen under GA because the dose is tightly controlled, and your airway is supported anyway; you’re intubated.
There's always a continuity there ("the dose makes the poison"), there's no known substance that will reliably kill you if you're exposed to a single molecule of it.
The issue with potency is that the more potent a substance, the more precise equipment and quality control you need to stay on the safe side. With fentanyl, healthcare and pharmaceutical industry can handle the precision and QC demands (which includes guarantees and maintaining public trust). Criminal enterprises cannot.
Even with prions, there evidence that the body (and probably more so with some people than others) has some level of ability to resist, slow, or sometimes prevent a prion infection.
See these:
- The influence of PRNP polymorphisms on human prion disease susceptibility: an update [1]
- A naturally occurring variant of the human prion protein completely prevents prion disease | Nature [2]
1.53 × 10¹⁵ molecules per 1mcg. Which is 15 orders of magnitude larger than a single molecule. If 2mg of fentanyl is considered potentially lethal that would place carfentanyl at 20mcg, though I’ve heard conflicting reports on potency with some placing it at 10x not 100x. So roughly 16-17 orders of magnitudes.
I don’t take fentanyl but I regularly take signaling peptides where the doses are typically in the mcg range and still rather potent - though with signaling peptides the response curve typically flattens out so bigger doses don’t necessarily mean stronger effects - they can be saturated. Depends on what you’re signaling though.
I had correctly predicted my hypersensitivity to semaglutide (ozempic) so started using it for treating autoimmune issues at a dose of 25mcg and I still ended up with temporary gastroparesis.
bilekas · · focus · HN ↗
Someone · · focus · HN ↗
So, if you’re in the business of selling the somewhat healthier product, and one supplier starts to supply the otherwise superior product, that’s not good for business, either. You will lose customers.
Now, do you accept that, saying “I won’t sell that”, do you fight to outlaw the product (will be hard given at you’re not selling healthy products, either), do you fight the suppliers of the new product (a gang war) or do you add the product to your inventory?
There often isn’t a clear choice; each option has its pros and cons.
bigfishrunning · · focus · HN ↗
Increasing the potency of some drug with fentanyl is an interesting choice, because by the time the user *knows* how strong it is, there's some likelihood they're already dead.
Someone · · focus · HN ↗
Its lethal dose is a lot smaller than that of heroin, but it isn’t guaranteed to kill. If it were, why is it used so much in medicine?
<a href="https://en.wikipedia.org/wiki/Fentanyl" rel="nofollow">https://en.wikipedia.org/wiki/Fentanyl: “Fentanyl is a highly potent synthetic opioid of the piperidine family, used primarily as pain medication
[…]
In 2015, 1,600 kilograms (3,500 pounds) were used in healthcare globally.
It is on the World Health Organization's List of Essential Medicines.”
jan_m_savage · · focus · HN ↗
for kids?
bigfishrunning · · focus · HN ↗
jan_m_savage · · focus · HN ↗
mdp2021 · · focus · HN ↗
That a dose not too different from adult posology of paracetamol can be lethal?
Maybe you did not know that "heroin" was developed at Bayer (the informal name came out of the trials after the reports from the testers)...
Pharmacology is the discipline that deals with drugs.
jan_m_savage · · focus · HN ↗
mdp2021 · · focus · HN ↗
Everytime you deal with nominal professionals you should be concerned, because their professional ability is not granted. People who deal with bodies deal with an immensely complex and subtle mechanism: they do not know it as well as needed, and their regard is easily not too different from that of Robert Liston in their evaluation of compromises - your due diligence does realistically involve verifying that values are aligned (otherwise they may decide that they can sacrifice something that for you is critically vital).
> I am not sure why it was being downvoted
Neither do I - I did not. (I did take the implied into account.)
> snark
Good: since we are here, can you kindly explain what "snark" is, because I find the term in the guidelines, I have no idea how to interpret it, I asked it a few times and I got downvoted for the question?
jan_m_savage · · focus · HN ↗
Sometimes, text gives off a different vibe than intended. for instance:
"Pharmacology is the discipline that deals with drugs" is a very obvious statement that anyone with a primary grade education should know. So, if an obvious statement is stated, it constitutes a snark, <as if the other person is too stupid to realize that>. But given your new comment, it appears you didn't mean that.
mdp2021 · · focus · HN ↗
I think you now understood that with «Pharmacology is the discipline that deals with drugs» what was meant is "If we interpret your questions as "could they have administered anything toxic", the answer would be "what they do is administering substances relevant to toxicity"".
I would approach the situation (just "my two cents") by trying to redirect towards health by maximizing healthy conditions. They do not sell "health pills" - but when one has had to take them, try to counterbalance that "compromise" with healthier lifestyle.
dranudin · · focus · HN ↗
jan_m_savage · · focus · HN ↗
preg_match · · focus · HN ↗
The reason synthetic opioids like fentanyl are used is because they actually have less side effects. Opioids can cause a histamine response, digestive issues and constipation. Newer synthetic and hybrid opioids cause that less, so they’re preferred in hospital settings.
There’s essentially no long term risk with the small doses required during surgery. The main risk is, of course, acute respiratory depression, which kills you. This is how opioid overdoses happen. This doesn’t happen under GA because the dose is tightly controlled, and your airway is supported anyway; you’re intubated.
jan_m_savage · · focus · HN ↗
jan_m_savage · · focus · HN ↗
TeMPOraL · · focus · HN ↗
The issue with potency is that the more potent a substance, the more precise equipment and quality control you need to stay on the safe side. With fentanyl, healthcare and pharmaceutical industry can handle the precision and QC demands (which includes guarantees and maintaining public trust). Criminal enterprises cannot.
throwdown7653 · · focus · HN ↗
prmph · · focus · HN ↗
See these:
- The influence of PRNP polymorphisms on human prion disease susceptibility: an update [1]
- A naturally occurring variant of the human prion protein completely prevents prion disease | Nature [2]
[1] <a href="https://pubmed.ncbi.nlm.nih.gov/26022925/" rel="nofollow">https://pubmed.ncbi.nlm.nih.gov/26022925/
[2] <a href="https://www.nature.com/articles/nature14510?utm_source=chatgpt.com" rel="nofollow">https://www.nature.com/articles/nature14510?utm_source=chatg...
RajT88 · · focus · HN ↗
Micrograms (yes still many molecules) could be lethal
cjbgkagh · · focus · HN ↗
I don’t take fentanyl but I regularly take signaling peptides where the doses are typically in the mcg range and still rather potent - though with signaling peptides the response curve typically flattens out so bigger doses don’t necessarily mean stronger effects - they can be saturated. Depends on what you’re signaling though.
I had correctly predicted my hypersensitivity to semaglutide (ozempic) so started using it for treating autoimmune issues at a dose of 25mcg and I still ended up with temporary gastroparesis.