*Fentanyl, Inc.*, by Ben Westhoff

The slightly misleading subtitle is How Rogue Chemists are Creating the Deadliest Wave of the Opioid Epidemic.  Why misleading?  So many substance abuse books are a mix of hysterical in tone and a disappointing “paint by numbers” in their execution, but this one really stands out for its research, journalism, and overall analysis.  To give just one example, it is also a great book on China, and how China and the Chinese chemicals industry works, backed up by extensive original investigation.

Start with this:

Americans take more opioids per capita — legitimate and illegitimate uses combined — than any other country in the world.  Canada is second, and both far outstrip Europe.  Americans take four times as many opioids as people do in the United Kingdom.

And this:

For many years, Chinese organized-crime groups known as triads have been involved in the international meth trade.  But experts familiar with triads say their influence appears to be waning in the fentanyl era.  “They’re a shadow of their former selves,” said Justin Hastings, an associate professor in international relations and comparative politics at the University of Sydney…Though ad hoc criminal organizations continue to move drugs in China, major trafficking organizations are rare there, and cartels basically nonexistent.  This leaves the market wide open for Chinese chemical companies, who benefit from an air of legitimacy.

As for marijuana and cocaine, they are used by only about one in every forty thousand individuals in China.  But the book covers the entire U.S. history as well.

Definitely recommended, this will be making my year-end “best of” list for non-fiction.  And yes I did go and buy his earlier book on West Coast rap music.

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'So many substance abuse books are a mix of hysterical in tone and a disappointing “paint by numbers” in their execution'

What, you mean a book titled 'Fentanyl, Inc.' would not be considered a love letter to the free market, extolling the virtues of unregulated growth?

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Americans take more opioids than other countries because they expect the highest standards in health. This is one area in healthcare where we are the best and we provide cost effective treatments for those who need it. The fact that it hurts organized crime is just icing on the cake.

You are most likely a pretty fat troll, but nonetheless:
Highest standarts of health? No. Scandinavian countries have those (as well as higher average life), and they don't use as many opioids. Being high (and therefore pain-free and happy) seems like a good thing, but only in the short term, long term it's shit. This is the same as treating every cough with antibiotics, sure we are helping now, but we are shooting ourselves in the leg in the long-term (antibiotic-resistant bacteria are on the rise).
And it sure as hell doesn't hurt organized crime (you might have not read the quotes accurately), the organized crime is also on the rise, it's just that older types of crime cartels (that prefer meth and cocaine) are out-competed in this new market. Just recently I have read a news article, maybe it was here, maybe somewhere else (don't remember), that opiod related chemicals seized by government has grown by 500-fold in recent years.

As an example:
https://www.reuters.com/article/us-arizona-opioids-seizure/largest-ever-u-s-border-seizure-of-fentanyl-made-in-arizona-officials-idUSKCN1PP35J
Just to understand how much there was: 115-kg is enough to kill 57 millions of people (2mg is lethal for most people).

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Also, according to wikipedia (dunno how accurate), 1600kg of fentanyl was used globally in year 2015. So this one drug-bust was around 14% of that. And I don't believe that this is the only one and it was stopped (probably many more were not caught).

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Hey Thiago, why aren't you using 'generic' American names like before? This new gig you got going with job titles is kinda weird.

I am writng from the normal middle sized American city Tacoma sitauted on the west coast, to ask What are you talking about?

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China 150 years was forced at gunpoint by the British to flood their streets with opioids to keep the balance of payments between the two countries (the British wanted more Chinese goods than the other way around). There's an amazing symmetry in today's trade war with events past. The more things change ....

Yeah, that was going to be my comment.

Aside from the Chinese connection, I wonder what fentanyl has done to the demand for poppy cultivation in Afghanistan. Has it undercut that market just as the Chinese meth dealers have been hit? Or do the illegal opioid markets outside the US still prefer heroin over fentanyl; it seems to be a safer drug to abuse although that of course is relative.

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"55 Days in Peking" was an entertaining Hollywood adventure film set during the Boxer Rebellion and starring Charlton Heston, David Niven, and Ava Gardner. It has clear parallels with another Heston vehicle, "Khartoum" in which a small European garrison and their local allies is besieged by a massive anti-European mob/crusade. But more broadly it has parallels with other 1960s movies set in foreign lands with multinational characters ("Around the World in 80 Days", "Those Magnificent Men in Their Flying Machines", "Grand Prix" plus historical dramas such as "Lawrence of Arabia" and even "The Alamo").

China lacks the naval and military power to colonize the US the way that western countries occupied China or Britain occupied the Sudan but I wonder if in the near future someone in China will make a film about plucky Chinese adventurers -- or businessmen -- who find themselves stranded in the US and facing attacks from the locals, maybe just cultural and bureaucratic or political rather than military.

“I wonder if in the near future someone in China will make a film about plucky Chinese adventurers -- or businessmen -- who find themselves stranded in the US and facing attacks from the locals, maybe just cultural and bureaucratic or political rather than military.”

Lol, plucky beleaguered would-be Ivy League STEM applicants who can’t get into University?

"55 Days in Harvard Admissions"

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You have never heard of Wolf Warrior, Wolf Warrior 2, or Operation Red Sea? They are often on Netflix.

There is also a love story about a girl who flies to America to have a baby here.

Haven't seen those, but from the plot summaries the last two, Wolf Warrior 2 and Operation Red Sea, definitely do fit the genre of civilized heroes wandering into barbarian regions to save countrymen.

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From the Wikipedia article on Fentanyl:

"Fentanyl patches for cancer pain are on the WHO List of Essential Medicines, which lists the most effective and safe medicines needed in a health system."

Sometimes we seem to lose sight of the core use case.

'Sometimes we seem to lose sight of the core use case.'

Considering how much lower European use is,apparently Sure is correct about how European health care systems are run by rationing, compared to the U.S.

But a lot of the rationing in Europe is done by euthanasia, which makes rationing much easier, to say the least. That's not practiced in the US, although there are attempts to introduce it, see for example the controversy over death panels.

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Last year my wife was dying from cancer. The obstacles I had to work around to fill her narcotics prescriptions left me with the impression that feeding an addiction with prescribed drugs would be a lot of work.

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IAW the US Constitution, it is the solemn duty of Congress to decide what chemicals Americans may inject/inhale/ingest and to decide the detailed circumstances of health care in America.

Current overall U.S. availability, distribution, and consumption of Fentanyl is ultimately the result of our Congressional public servants' decisions.
Europe and China rely upon their own genre of public servants; YMMV.

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China and Cuba are innocent... right.

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So many of the books you review are months away from being published.

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