Monday, July 31, 2017

Trying to Make Sense of The Opioid "Epidemic" - Part II

I spent a really long time writing the first part of this, first intending to put it up Saturday, but giving up after a little over two hours.  Yesterday I spent more time, perhaps another four hours.

Why?  After a while researching, I started feeling like I was being played.  Like the whole thing was a scam designed by someone for some unknown purpose (but that probably involved getting lots of government money).  It wasn't until I found that graph from the CDC data that I started to think maybe something really is there and there really is an increase in overdose deaths.

I find that getting away from the computer, picking up a guitar and playing some scales and mindless exercises will allow my mind to wander in more productive ways than sitting here.  Blogging isn't exactly a high-stress life, but I find that my brain will follow more idea trails when I'm not trying to put together a post.  It wasn't until after I posted it and sat down to play that the realization occurred to me that just because there really may be more heroin overdose deaths, that doesn't mean we're not being played.  Someone could be taking advantage of a situation that developed on its own. 

Cui bono?  Who benefits?  As always, start by asking that.

Thankfully, while I was playing guitar, Mrs. Graybeard (who can be a much better search engine weenie than me) started asking some questions.  It starts with a simple observation: have you noticed the push for every cop, every paramedic and every rescue group in the country to carry naloxone?  There was even a story about librarians administering it to addicts to save their lives.  Have you heard that the price of naloxone has gone up at least 17 fold in the last few years?  And isn't it interesting how everyone has heard the complaints that the makers of (epinephrine) epi pens, Mylan, hiked their prices 4x but no one seems to complain that naloxone has gone up 17x?

Going down that rabbit hole leads directly to Hillary Clinton and the Obama administration.  This is according to the Wikileaks emails found here.  You should read the whole thing.  Someone sleuthing around in the Wikileaks archive posted this (there are grammatical and other errors in here, but I've left the author's words as found):
There seems to be money flowing into the Clinton Foundation from big pharma. The CEOs are donating to Hillary's campaign. On the campaign trail I've seen Bill Clinton name drop the drug naloxone. The recent emails on wikileaks confirms that the one of the goals of the Clinton Foundation is to make this drug be everywhere. One of the manufactures of this drug is Hospira, a company recently bought by Pfizer. 
There seems to be serious conflicts on interest. been the campaign and the companies. For example Clinton wants to give these campaigns 7.5 billion dollars through federal programs. This is an OP-Ed from Hillary from last year:

Today I’m releasing a strategy to confront the drug and alcohol addiction crisis. My plan sets five goals: empower communities to prevent drug use among teenagers; ensure every person suffering from addiction can obtain comprehensive treatment; ensure that all first responders carry naloxone, which can stop overdoses from becoming fatal; require health care providers to receive training in recognizing substance use disorders and to consult a prescription drug monitoring program before prescribing controlled substances; and prioritize treatment over prison for low-level and nonviolent drug offenders, so we can end the era of mass incarceration.
The call for Naloxone by name was echoed by Tim Kaine - before he became her running mate in the last election - and by John Podesta.  Call it crony capitalism or crony socialism, either way it's corrupt to the core.

The drug isn't under patent, so there can be generics.  Hospira/Pfizer is one of only a few manufacturers and they've all jacked their prices up.  The defense seems to be "but we don't charge as much as the other guys".  Are the prices a function of supply and demand or "get it while the gettin's good"?

The states are jumping on the bandwagon, too - along with first aid instructors and even gun bloggers.  Everybody is trying to get first responders to carry naloxone or the narcan nasal spray.

Conspicuous in its absence is that none of the governments seem to be pushing anti-addiction treatments and therapies, just the drugs.  Admittedly when someone is comatose and ready to die from their OD, they don't benefit from counseling, but without breaking the addiction cycle they're probably going to need more of the drug someday.

It could be that the cartels are supplying heroin more cheaply than before and usage patterns are shifting to the cheaper heroin.  When the cartels cut their heroin with cheaper fentanyl, it's easier for addicts to overdose and die.  But the heroin overdose problem is not the myth that it's prescription drugs and it's entirely possible that a bump in heroin deaths is being exploited all the way around.

Invoking the specter of prescription drugs being used improperly appears to be an attempt to lump heroin and prescription drugs together as one massive problem which makes people who are taking prescription drugs for post-surgery pain afraid of becoming addicts or overdosing.  They're different problems.  There was a National Survey on Drug Use and Health (NSDUH)  run by the department of Health and Human Services (HHS) that said: 
According to NSDUH, only a quarter of people who take opioids for nonmedical reasons get them by obtaining a doctor's prescription. Hence the sequence that many people imagine -- a patient takes narcotics for pain, gets hooked, and eventually dies of an overdose -- is far from typical of opioid-related deaths.
According to that linked article, opioid-related deaths are rare even for patients who take narcotics every day for years. The CDC cites "a recent study of patients aged 15-64 years receiving opioids for chronic noncancer pain" who were followed for up to 13 years. The researchers found that "one in 550 patients died from opioid-related overdose," which is a risk of less than 0.2 percent. (I would assume from how that's worded that the study was not just on 550 patients, but on a bigger number.  A study of 550 people would be too small). 

So what do I think is going on?  First the disclaimer: bear in mind that I'm a paranoid old man (although not as paranoid as some of y'all!).   Conclusion, we are being played.  We're being played by the makers of naloxone, and those few drugs used to treat addicts and ODs.  We're also being played by the "addiction treatment industry" and recreational drug lobby that want to normalize heroin (like these folks, I think).  They're  scaremongering.  If they can convince Soccer Mom Suzy that heroin from the Mexican cartels is like the pain pills that she gets when she gets a wisdom tooth pulled, they can scare her.  They can use a death from a heroin overdose to get Suzy to advocate more money for addiction and overdose treatments.  I wouldn't hesitate too much to say we're being played by the CDC, as part of the general thing we see in every agency, loosely translated as "Don't cut us! We're valuable!"

That entire paragraph seems to describe byproducts of the WoD, so completely tossing our WoD and all its infrastructure would profoundly change all of it.  But like I said yesterday, that's just not gonna happen.  Far too many cronies and Deep State swamp creatures make a living off the WoD.  They will protect that turf and I don't see much chance that the WoD goes away.  If the country economically collapses and has to reset, maybe it will be too low priority to worry about the WoD.  For a while.  
Another way of visualizing what all the noise is about, again from the CDC.  Between 2006 and 2014, deaths from "opioid analgesics" went from 4 to 6 people per 100,000.  That's .0006 %.  Are we making mountains out of statistical molehills?


  1. Rent seekers show up wherever government spending or government grants show up. It's everywhere and it seems the science is settled. indyjonesouthere

  2. The CDC graph from yesterday looks just like the fake climate change hockey stick graph.

  3. Conclusion, we are being played

    Always thus.

  4. Hillary has a whole lotta room to talk about fighting alcohol addiction, doesn't she?

    She must be speaking from experience.....

  5. Heinlein's Mrs. Grundy may send a policeman over to prevent you from using heroin, having sex, saving for retirement, or buying a higher MPG automobile with less crash safety. "Freedom begins when you tell Mrs. Grundy to go fly a kite."

    Current retirees have less than four years to vote the country so libertarian the principals of the Whiskey Rebellion wouldn't recognize it. If they don't, Medicare price increases will crush all government budgets, and with them all the Mrs. Grundys depending on them.

  6. Of course we're being played.

    That's nearly always why there are government studies, and why both Big Pharma and SJWs manning the counseling/treatment failtopia are salivating at the trough for more programs, grant money, and tax breaks. Their rent money is at stake.

    The only people crying at opiate deaths are the cartels, because they have to work that much harder to recruit legions of new users. Heroin junkies used to be the longest-lived and hardest to lose addicts in the pipeline, but the fentanyl-laced crap is killing off the customer base way ahead of standard junkie actuarial tables.

    Prices will have to be cut, and distribution increased, to make up the shortfall.
    Capitalism always wins.

    1. If the addicts are dying because they cut the heroin with fentanyl in order to stretch their supply of heroin, they need to use less fentanyl. More expensive in the short term, cheaper in the long term.

    2. They aren't doing it to stretch the supply of heroin, they're doing it to give a bigger "high" to junkies for the same size bag of dope.
      Opiates create habituation, and it takes larger and larger doses to get the same effect, over time.

      Adding fentanyl was theoretically going to be like putting a nitrous boost on a car engine, except they put on a space shuttle SRB instead.

      The problem is that because acetyl fentanyl (homebrew designer version) is so much more potent than ordinary pharmaceutical fentanyl, and orders of magnitude more so when combined with heroin, they've created a one-hit high: One hit, and you're dead.

      There's no way to use less of something that's so potently toxic; it's like trying to cut down VX nerve gas.
      You can do it, but you have to put one drop into a giant storage tank of diluent.

      And again, it's not like homebrew chemists and dope dealers are either precise, nor particularly concerned with the customer.

      Hence the spike in OD deaths among opiate users, and nothing to do with using vicodin/Norco/etc.

      I've even had patients state flat out that they don't even try to get Norco anymore, because it's so controlled and tracked, whereas the street price of heroin makes it vastly simpler to get smack instead.

      So we're seeing more "shooter's abscesses", bone infections, etc., and there'll also be a downstream spike in Hep C and AIDS in due time from the increased use of shared and dirty needles.

      One of the unintended consequences of cracking down on Rx opiate pill over-prescription.

      Not saying that they should have done that, but squeezing that handful of jello means it's going to squirt out somewhere else.

    3. Aesop, in spite of the ludicrous post before from Anon, I can tell from what you have written that you do indeed have expertise in this area.

      Between what you have written and what SiG has written, and my own bit of experience in law enforcement (before my final "career" as an RN in the VA system), I am guessing that the heroin in getting stepped-on at the local level (just above street level), rather than cartel distribution.

      I have no idea where the fentanyl is coming from. Is it easy to synthesize? Even if the cartels were initially responsible for the addition of fentanyl, they would be smart enough to stop once they began losing customers. So, if it is continuing, it has to be happening after the heroin has gotten down somewhere between the cartel distribution and the street.

      However, I have long believed that our Congress is involved financially in not supporting some form of legalization because the cartels would lose the incredible income they receive from the whole process. Law enforcement, from federal on down to local would experience either shutdown - think DEA - to a loss of major income, via the loss of asset forfeiture, if not simply in the subsidies that enable keeping large numbers of fed, state, and local cops employed.

      The naloxone situation is a side issue, but I can very easily see it being pushed by scum like the Clintons because they would stand to enrich themselves further by their involvement with the pharma companies who manufacture naloxone. Hell, they may be playing both ends, by being involved with whoever is producing legal or illicit fentanyl, then reaping further gains from the sale of naloxone, to counter the supposed increase in opioid fatalities. They are so vile I wouldn't be surprised to discover they are involved in the distribution of illicit drugs themselves.

    4. I have long believed that our Congress is involved financially in not supporting some form of legalization because the cartels would lose the incredible income they receive from the whole process. Law enforcement, from federal on down to local would experience either shutdown - think DEA - to a loss of major income, via the loss of asset forfeiture, if not simply in the subsidies that enable keeping large numbers of fed, state, and local cops employed.


      If you don't believe that cartel money permeates congress and the Law Enforcement agencies, I have some choice Florida land to sell you. Let's just say the view of the Atlantic is better than from the tip of Cape Canaveral.

      How much? Don't know, but I'm convinced that with the billions the cartels are making, there's plenty to spread around DC to protect themselves. We know the cartels are tied to the Too Big To Fail banks, too.

    5. I can't address the ease of synthesizing it, but it's being made, and not at the corporate level. Acetyl fentanyl is entirely coming from back-room synthesis, as it has no pharmaceutical use whatsoever. It is, literally, designer faux-fentanyl.

      I think your suspicions of where it's originating and being added are correct: it's getting added one or at most two levels above the street-level distribution network, not at the source point or initial manufacture. Everyone wants the better mousetrap, to expand their personal market share.

      I doubt the cartels will care, as long as their profits don't suffer, and I also have no doubt they are well-entrenched at every level in the current system from beat cops to senators and cabinet-level appointments.

      Plomo o plata has always been their basic business model, everywhere. Guys with money meet whores for money is a match made in heaven.

  7. Sig, thanks to you and the Missus for the great sleuthing. You confirmed my sense that something was going on and it wasn't really about addictions. My bet is the CDC type agencies have foisted this on all of us, including Pres. Trump because he has bought into to it hook, line and sinker.

    We will see if Tom Price, Secty of HHS, allows this to go on and the CDC to escape the housecleaning that "should" be due. No one in the FedGov is beyond the need for major overhaul. I will write in to the White House and comment on this. I hope everyone else does too.

  8. It's really a shame that it's gotten to the point that whenever you hear some item on the news for any period of time that you have to figure you're getting played for more money, but it sure seems like the rule.

    It's relatively easy to find the family of someone who died of a heroin addict, and I suppose it always has been. They're going to be the sob story that sucks you in - because there's always an emotional angle. It's going to be a good looking kid who just made "one mistake" and now they're gone, and if only someone would do something.

    With this story, though, the big sources seem to be people like an Ohio county sheriff, the CDC, and other people we ordinarily expect to be objective. (shrug) Maybe they are. It just seems the reaction is all wrong.

    I used to hold the CDC up as completely above reproach. Not anymore.

    1. Should have been "someone who died of a heroin overdose"

    2. The CDC went into irrelevance when they began their "gun control" studies. Then they even blew the Ebola preparations. Transfer the facilities to the military and fire all the employees. indyjonesouthere

    3. Remember when they exposed workers to anthrax? I thought they mishandled smallpox, too, but that was the NIH.

    4. The CDC was the entire reason Ebola got here in 2014.
      Without them to tell us it would never happen, and that we could handle it, even HopeyDopey might have been less willing to play Russian roulette with the entire country.
      Their utter incompetence brought us with 2 BL-IV beds of becoming Liberia.

      Ohio officials in this case, I suspect, are mainly sucking around for federal grants and subsidies to help with the sudden increase in dead junkies; autopsies and cremations cost money.
      And if CDC gets it labeled an "epidemic", I suspect they get more funding next FY. That's how this rolls.

    5. Especially since the CDC became so obviously politicized with the whole "guns are a disease" meme. Frankly, I am surprised they weren't on the bandwagon for "global warming" being due to an "epidemic" (sic) of excessive carbon production.

      Of course they would lose total credibility if they complained about carbon dioxide production, since our bodies could not exist without the proper percentage of carbon dioxide in the air we breathe, and there would be insufficient O2 in the air if there wasn't sufficient CO2 for trees and marine phytoplankton to live on, producing the O2 we need.

      The CDC needs to return to being a scientific agency, rather than a political mouthpiece for the LEFT. Maybe someday.

  9. While I tend to agree that we are being played, it also appears that the increases in opioid deaths are not evenly distributed geographically, so while the numbers seem insignificant when looked at against the population as a whole, they are much more significant in some locations.

    That said, I would prefer to legalize drugs to end the war on drugs and its associated abuses and moral corrosion in our law enforcement community. I would also cut off social benefits for people who choose to abuse them and certainly not require first responders to keep saving the "frequent flyers" they run across. At some point, the drug users need to be allowed to reap the consequences of their choices.

    1. I'm not sure I could look at the maps and not say it's not a random distribution without some statistical legerdemain - with numbers I don't have. A long-winded way of saying I don't really know one way or the other. Certainly the conventional story is that the problem is worse in economically depressed areas.

      OTOH, I read one police chief who brought what I think is the best point on whether or not to carry syringes of naloxone. He said they don't carry insulin to rescue diabetics and don't carry epinephrine to rescue bee sting victims, so why this and why now?

    2. Big Pharma strikes again! Crony capitalism.

    3. I'll play.

      Let's assume you had a magic wand, and could revoke the entire socialized medicine and safety net that's hedged up around a formerly free republic, and only then you legalized drugs.

      1) What do you do when junkies can't afford more and more and more, and theft and robbery increase because they need their fix? More cops, more courts, more prisons? Which is different from, exactly?

      2) With more drugs out there overall after legalization, how do you deal with the inevitable more kids on drugs?

      3) For that matter, once the legal restraint on using is gone, what do you do with the increase in adults using, many to the point of traffic accidents, loss of jobs, etc.?

      Any imaginary savings from legalization is burned up tenfold with the increased cost of second- and third-order consequences. You double or triple your user base, and the costs to society increase, and faster and higher than the current paradigm.

      Throwing out all of the moral calculus, legalization appears to me to be a fool's errand from strictly economic and utilitarian reasons.

      But if you can repeal every bit of social welfare enacted since 1933, I'll subscribe to your newsletter and cheer your parade.

    4. Aesop - I don't think you addressed that to me, but let me take a couple of pokes at it.

      1 - The people selling legalization bring up Portugal all the time, and numbers (which, of course, I can't vouch for) that show they're not crawling in more and more addicts. The rate of deaths from overdose is the second lowest in the EU. Portugal didn't legalize drugs, they decriminalized individual use. They still prosecute traffickers (among others) but users are sent to treatment. The taxpayers pay for the counseling and drug addiction treatment. The pro-legalization crowd argues drug abuse and the costs to society have gone down, not up. What you bring up is basically why I said we're not going to save much money, back in part 1. Would it be cheaper than the WoD? Probably.

      2 and 3, I really don't think that anyone who wants drugs now can't get them. It's part of the argument that if the WoD was doing any good, drugs would be getting more expensive instead of cheaper. I figure the number of users goes up maybe a few percent because people that don't do drugs because it's illegal will try it, not the "double or triple your user base" that you think. I can't justify that "few percent" estimate based on some study, just the observations on the price and availability now. I would hope they don't go to heroin, but go to something weaker. Come to think of it, I've never seen heroin described as an entry drug.

      So yeah, we treat driving while impaired the same no matter the substance: alcohol, pot, heroin or anything. Pull their licenses, make them walk or ride a bike with the handlebars in the wrong position (cyclists refer to riding a bike in the "DUI position"). Loss of jobs? How about "sucks to be you"? How about "lose your job due to drug impairment, then no welfare for you?" Could people learn responsibility? I like to think so. Ben Franklin said (mangling the quote) "I'm all for helping the poor, and the best thing we can do for them is to make them uncomfortable in their poverty." Maybe there's a model there to follow.

      I've said in both pieces that I simply don't think legalization will happen. Too many vested interests making too much money off the WoD. Think of all the drug squads in all the police departments in the country suddenly out of work. Think of the layers in the DOJ that would have to go get real jobs. Think of the intelligence agencies that fund their operations with sales of drugs. Think of all the police departments and state prosecutors making money on civil asset forfeiture. They'd fight legalization tooth and nail, digging up dirt on the politicians by the front-end loader full. Or manufacturing dirt, like the media does now. Would you be surprised if someone had political opposition killed?

      I'm not as sure that decriminalization couldn't happen, as long as those forces got to keep their jobs, but I still don't see it happening.

      Like I've said all along. There is no good answer. It's just a search for the least awful solution.


      We don't have to guess, we know what addiction in America was like before the Harrison Narcotics Act. It didn't match your dire predictions. Addicts were, for the most part, more functional. Without government price controls, the price of drugs drops hugely. Organized crime decreases, just like it did when goverment price price controls on alcohol ("prohibition") was repealed. Aesop, please update your treatment protocols in light of this new data.

    6. It was, indeed, in reply to Mike, not you SiG.

      That said, to your points:

      1) Rate of deaths staying static is nice. But it's a ratio. If the population is growing, the absolute whole number of deaths is going up YoY.
      And which wholly overlooks the problems of non-deaths.
      What's the rate of drug use doing?
      How many junkies are there before v. after?
      What about the DUI rate?
      The sick rate?
      The lost worktime and workplace accident rate?
      The rate of underage use/abuse?
      If nobody dies, but you create a nation of drugged out zombies, what profiteth a nation to decriminalize everything, but end up stoned by the side of the road?

      2 and 3 Granted. Every body who is willing to break the law now, will.
      The problem is, how many more people want illegal drugs now, versus how many will want to try them post-decriminalization?
      If we decriminalized, e.g.. murder, robbery, theft, etc., would those rates stay the same, decrease, or increase?
      My sense of human nature says that just because stupid kids will play with matches doesn't mean you give out lighters in kindergarten. So even noting that adults are treated like adults, there is a non-zero likelihood that decriminalization expands the user base. Including to any prohibited class, like those who actually are underage, thus increasing second- and third-order unintended consequences.

      As to the "drugs would be getting cheaper" argument, it overlooks one obvious factor: The enemy gets a vote.
      maqke drugs harder to get, and increase penalties, and they will produce more, and drop the price, to widen their penetration, and offset whatever you can prune back with enforcement. Cloward-Piven on a national scale. Given the absolute pittance of total resources the cartels face by comparison, and that's the simple way out. WalMart marketing kicks in here: If I can make $1,000,000 a kilo, and you seize it, I lose $1M. But if I make only $50 kilo, and make 100,000 kilos, you can seize half of it, and I make $2,500,000. And currently, the in-the-know estimate is that we seize less than 10% of all illicit drugs at any point between harvest and street sales. It's probably more like <5%. The fact that they can drop $1M@ to make disposable single-use drug semi-submersibles, each one of which brings in tens of millions of dollars of dope profit, underlines the economy of scale being fought. They can lose half of them all day long, and only become as rich as Trump or Bill Gates. demand doesn't have to reach 100% for them, but the cheaper the supply, the more dope you can sell. And with esp. with opiates, once you're hooked, you aren't quitting, pretty much ever. In at least 95% of cases. Unless you kick your oxygen addiction first.


    7. (cont.)
      As for the rest, more responsibility should absolutely be tried, but it's unlikely, and squeezing jello.
      Unlikely, because if you required a clean urine test to get welfare checks, the BLM crowd would burn your houses down.
      And that'd just be for openers.
      Squeezing jello, because lose your job, no welfare? Okay, cool. So I'll steal your stuff to pay for my habit. Crime skyrockets. (Of course, we know junkies would stay inside the lines if you legalized their dope, right? Right? Oh, and now you have anywhere from a few percent to 300% more of them. With no jobs, and no welfare.
      Instead, you'll be treating them with more cops, more courts, more prisons. They wouldn't need asset forfeiture; they'd be making 300% of base salaries just on overtime.
      Ask you homeowner's insurance company what your deductible and premiums would be. And then calculate your property's simultaneous loss of resale value, and increased property taxes to pay for more of The Man.
      They wouldn't be going after dopers; they'd be going after thieves, robbers, crack hookers, fences, car theft rings, chop shops, and kingpins.

      After you decriminalize it, who has the supply pipeline in place to exploit that gift?

      Drug cartels. That will work, exactly?
      What happens when their turf wars move to the 'burbs?
      And the schoolyards in the 'burbs?
      (Of course, we know dealers would never sell drugs tio kids, because it would still be illegal. Whoops. Guess the cops will still be going after dope dealers. So, where did that war on drugs go after you decriminalize them for adults, and why would they still be fighting it?
      Look up teen booze and tobacco pot use now, and tell me there'll be less teen meth, crack, and heroin abuse when those are in a lot more homes too, 24/7/365.

      But I too doubt anyone will go for "more responsible", granting the many vested interest in the current paradigm, which I regard as exactly the least bad alternative (and which I would still wish for hordes of changes to, along strict constructionist Constitutional standards. Like giving us back the Fourth and Fifth and Sixth Amendments, for starters.

    8. (cont. - last one, I swear)
      And Anonymous, if you're going to bring in fairytales and songs, please, print the sheet music. Your point is not without merit, it's simply been overtaken by history. to wit, the people who lived in America prior to the Harrison Act aren't the folks of today. Period. Full stop.

      And when the Harrison Act was passed, you didn't have the current cradle-to-grave nanny state safety net of socialism we have now.

      Prove me wrong: end welfare, remove the safety net first (as if such were remotely possible, ever in ten lifetimes), show me a nation as responsible for its choices, wise and foolish, as was the case a century ago, and then decriminalize drugs, and we can talk.

      Just like illegal immigration: deport the hordes we have, cut all benefits to illegals, and build a wall that's nigh impenetrable, and then ask me how many people a year is a good number to let in, based on actual needs.

      The people arguing for legalization the other way around (that would be 99.9999%) are just as much closet junkies itching for a fix, (or libertarians who are statistically challenged) as the Chamber of Commerce is junkies for cheap illegals to exploit for labor.

      Everybody wants more dope for me first, and we'll talk about taking more responsibility next Tuesday - which never comes.

      Legalizing drugs is easy; the problem is getting back to the society and culture where you actually could try, without catastrophic consequences.

      The person who ever wants to start with the legalization end is like the guy who tells me that making Whale Casserole is easy, and his recipe starts out
      "First, catch a whale."

      Give a holler when you reel one in.


  10. I've heard heroin is an agricultural product, and based on the amount of processing it receives it should cost about the same as granulated sugar. Therefore I'd like to see inexpensive heroin sold in known concentrations with no adulterants in tamper-resistant sterile packages bearing counterfeit-resisting holographic stickers. Include the needles so there's less motivation to share them. Make the needle covers spring-loaded to re-close if they are simply dropped after use. Each carton of single-use applicators should include one treatment's amount of narcan, and a handgun so the user can defend their drugs from people who want to take them away by force. Semi-disposable weapons will encourage liberty. An inexpensive, easily serviced 60 MPG car should come with a suppressed bullpup clipped in a ceiling mount, and should not come with a license plate holder. An inexpensive Katrina cottage (mobile home with permanent house build quality) should come with a mine under the doormat. Why, soon there will be a child-resistant gun case next to the automatic defibrillator in populous spaces.

    Long ago in the dark ages, unruly college student Pat Buchanan could unjustly punch a DC policeman, and receive a proportional and effective correction. Today, the legal system acts like universal default for credit cards. Throw one rock through one party headquarters window, and have your ordinary life ruined. This suppression of dissent allows the spring of higher expectations to wind tighter, which shrinks the time in which the inevitable snap-back will occur. This will cause more overshoot. Imagine the French Revolution if they had cheap drones with pistols.

  11. Technology is shifting the military balance of power strongly in favor of defense. Crime will no longer pay. There will no longer be monopolies, because they will be financially impractical. A monopoly in one sector of economic activity will not be able to subsidize itself from monopolies in other areas. There will be a stalemate of MAD; the name for that situation is "peace". The thug who sees gay sex on the front lawn and mutters "there ought to be a law" will be overheard and tracked for later droning. Some of these outrageous activities will be bait, to identify the criminals by getting them to represent. The way to fight pirates is by making 10% of the shipping vessels hidden gunships.

    The book _Snow Crash_ wasn't audacious enough, notice how few drones there were. Reality will be even wilder than that. The book _Diamond Age_ is a fantasy, not science fiction, not extrapolation from current events. The author had to posit gun control for molecular manufacturing in order to contain the plot, otherwise it would have been post-singularity and hard to imagine.

    War is a process where rulers cooperate to decimate their middle classes, who compete with them, and enrich their arms-making cronies. War is the ultimate big government program. I'm sure the Chinese, Russians, North Koreans, etc. won't want to make war against the crazy gun collectors at Knob Creek, now freed to own and operate submarines launching inexpensive cruise missiles. Hundreds or thousands of independent groups, and no federalized rulers at the top to sell out.