Wikipedia:Reference desk/Archives/Science/2019 April 18

= April 18 =

illegal street drugs causing death
In the news there's always stories of somebody taking an illegal drug and dying, obviously that doesn't happen in the vast majority of cases, but what illegal drugs are least/most likely to cause death when bought on the street. Including cases where the person buying the drug gets a tainted supply, which I assume is more likely for certain drugs. — Preceding unsigned comment added by Xcarry (talk • contribs) 10:53, 18 April 2019 (UTC)


 * That's going to be a complicated question to answer. Is a drug more lethal because it frequently kills quickly or because it creates chronic users who die slowly? Many users also combine drugs in various ways or use different drugs at different times for different effects. When they die, is it due to the last drug they took, weakness from the stronger drugs' effects, or the combination? Our article at Drug overdose is a reasonable place to start and see also the references cited and external links. Matt Deres (talk) 13:35, 18 April 2019 (UTC)


 * Here are drug factsheets from the United States Drug Enforcement Agency.
 * Beware of the incredible power of conditional probability when comparing diverse different things that are more- or less- likely.
 * Nimur (talk) 15:10, 18 April 2019 (UTC)
 * I'm more talking about if a normal amount is taken just one time, what drugs are least/most likely to cause death, either because the type of drug is often tainted or because some people just have bad reactions to it. — Preceding unsigned comment added by Xcarry (talk • contribs) 15:58, 18 April 2019 (UTC)
 * The class of synthetic opioids including fentanyl and its various analogues is often cited for being particularly deadly; the opioid crisis has lots of numbers on the deadliness of these drugs. See File:US timeline. Deaths involving other synthetic opioids, predominately Fentanyl.jpg for some data.  -- Jayron 32 16:14, 18 April 2019 (UTC)

An interesting side issue is whether they would be more or less deadly if legal. Before heroin was made illegal, many heroin addicts held down jobs and pretty much lived a normal life. During alcohol prohibition in the US many people went blind from bad booze, but that never happens today (alcohol still kills a bunch of people every year, but they don't go blind). The government adding poison and letting the poisoned booze re-enter the market didn't help... Tobacco kills many people in the long run, but overdoses are rare. Tylenol is legal and nonaddictive, but paracetamol hepatotoxicity is by far the most common cause of acute liver failure in both the United States and the United Kingdom and Paracetamol overdose results in more calls to poison control centers in the US than overdose of any other pharmacological substance. It's complicated. --Guy Macon (talk) 16:49, 18 April 2019 (UTC)
 * Clarification for North American readers: paracetamol is another name for acetaminophen, the active ingredient in Tylenol. --76.69.46.228 (talk) 07:15, 19 April 2019 (UTC)


 * The question of whether the legal system and criminalization of drug use is the correct tool to improve health outcomes from drug use is indeed an issue. We only have the data we have today; however you do see that in places where drug use is treated as a health issue rather than a criminality issue, you do see decreased fatality rates.  Here is a good article with lots of data on the effect of the changes to the drug policy of Portugal; the numbers are rather stark; it is almost alone among Western nations do see a decrease in opioid-based fatalities during the opioid crisis.  It is only one data point, but it does seem to bear out that making drugs illegal makes them more deadly.  -- Jayron 32 17:12, 18 April 2019 (UTC)


 * N.b. Jayron's claim about Portugal compared with other Western conutries may or may not be true, but it doesn't seem to appear in the article cited. The implication that Western nations other than the US have recently been suffering an opioid crisis also does not seem to be supported by our article. HenryFlower 17:37, 18 April 2019 (UTC)
 * Our article does not do a good job of showing the worldwide perspective on it, it is very US centric, but the article I cited (which itself has many connections and citations to the research) does make the case that Portugal's trends on negative health outcomes due to drug use have gone in the opposite direction from those countries that have maintained a criminality-as-treatment for drug use. You can see some data here and here for example.  Portugal consistently ranks very low in comparison to other countries (for example, less than 1/3 the death rate for the EU average, and about 1/10th that of the US)  Other countries with low drug death rates like Italy and the Netherlands have also, to some extent, deal with drug users differently than those countries with higher death rates like the US and Canada.  Generally, those countries that treat drug users with prison have higher death rates, and those that use other methods (such as court-enforced medical treatment or therapy) have lower rates.  -- Jayron 32 18:14, 18 April 2019 (UTC)
 * I see nothing in either of those charts about a decrease in Portugal's opioid-based fatalities, nor about the changes in other Western countries. HenryFlower 21:00, 18 April 2019 (UTC)


 * Paraquat sprayed on marijuana crops also may have made it more dangerous. It's bizarre how the original intent of the law, to protect people from a supposed dangerous chemical (THC), was perverted to intentionally expose people to a definitely dangerous chemical (paraquat). Those living in the areas sprayed would have been the main victims, but those who consumed it may also have been affected.SinisterLefty (talk) 19:08, 18 April 2019 (UTC)
 * As described at your link, the paraquat scare was brief. The fear of chemical contamination was never really substantiated.  In general, the intent of the War on Drugs is not to stop drug use, but to raise the price of drugs as high as possible, and control who is able to sell them with impunity, so as to deliver as much profit as possible into the hands of selected organizations.  Anything that potentially interferes with the market -- whether it be detectable herbicide residues, domestic sales of methamphetamine precursors usable by local "cooks", or sales of fake drugs by cheaters who would ruin the drive-through drug markets of the inner cities -- will be quickly suppressed. Wnt (talk) 23:19, 19 April 2019 (UTC)


 * Portugal is a poor country.  Do its citizens have the wherewithal to expend large sums of money on drugs?   The obvious place to look for information on this topic is pt:wp (e.g. this article: pt:Legalização de drogas).   A skim through this article reveals the following:

"Na legislação internacional, existem iniciativas a tal prática na Holanda, Canadá, Argentina, Chile, Inglaterra e Portugal. Observa-se que a política de redução de danos nesses países vem acompanhada de um esquema para tratar o usuário crônico por meio de um sistema de saúde."

There are inline citations. The translation is:

''In the international legislation, there exist initiatives to such practice in Holland, Canada, Argentina, Chile, England and Portugal. It is observed that the policy of reduction of damages in these countries comes accompanied by a scheme to treat the chronic user by means of a system of health''.

It has been noted that the inhabitants of countries which have access to health services live longer than those who don't. 2A00:23A8:830:A600:3089:80E0:7D9B:95DA (talk) 11:59, 19 April 2019 (UTC)


 * At around US$30K annual income, Portugese citizens can certainly afford drugs: . SinisterLefty (talk) 22:00, 19 April 2019 (UTC)


 * One reason why opioid deaths have gone up in the US is the push by Big Pharma to have pain level considered as "vital sign": .  Prior to this, pain management was considered incidental to treatment, meaning they would give pain killers such as opiods only when the patient requested them. But now in many places patients are asked what their pain level is on a scale of 0-10, and if it's not zero, they are offered those drugs. And many patients assume the medical staff knows what is best, so take those drugs, which they wouldn't have, if they had to request them. The problem, then, is that a certain percentage of people given opioids become addicted. They can continue to get prescriptions for some time, but when they are eventually "cut off", they often turn to the illegal varieties. This process can take years, but often leads to death. The long period between the two has obfuscated the link. SinisterLefty (talk) 22:28, 19 April 2019 (UTC)


 * Also note that opioids while having the potential to cause problems via addiction, also have health benefits relative to using NSAIDs, as the latter type of drugs can cause fatal stomach bleeding, while using PPIs to prevent such side effects has been linked to cardiovascular disease, reduced kidney function and dementia. These side effects of PPIs seem to be caused by the PPIs inhibiting the function of lysosomes. Less people dying due to opioid overdose if many more people switch to NSAIDs may then cause a net increase in the number of deaths due to stomach bleeds, heart attacks, strokes, kidney failure and we may not even notice such an increase. Count Iblis (talk) 18:19, 20 April 2019 (UTC)


 * Sounds like we need to explore non-pharma solutions to pain, like acupressure, aromatherapy, meditation instead of medication, etc. At least those don't tend to kill the patient. Also, we may need to toughen up.  I've had back pain so severe I couldn't move, but I just wait until it subsides enough that I can crawl into bed, and let the injury heal for a few days, when it's down to a level where I can walk carefully, and over a week or so after that it goes away.  I don't take pain killers because of all the probs they cause, but also because they would allow me to further injure my back, when my body is trying to tell me not to risk moving. SinisterLefty (talk) 23:27, 21 April 2019 (UTC)

Odd TV antenna behavior
I have a TV antenna with a splitter, connected to 2 TVs. The reception on a certain channel is poor when TV B is on only. But when I turn TV A on and put it on the same channel, then TV B all of a sudden has better reception on that same channel. The two TVs are different brands (Samsung for B and Element for A) and are about a meter apart. TV A is connected directly to the antenna splitter while TV B is connected via an Ematic brand digital video recorder. Can anyone explain this ? SinisterLefty (talk) 19:23, 18 April 2019 (UTC)
 * I don't have an answer, but is it possible for you to swap the two TVs' connections to the splitter? If the phenomenon also swaps it will indicate that it's internal to the splitter. {The poster formerly known as 87.81.230.195} 2.122.2.132 (talk) 19:47, 18 April 2019 (UTC)
 * One possibility: see our article on characteristic impedance. Basically, the signal moves down the cable. If the cable is infinitely long, it never bounces back. If it stops at a TV that has the same impedance as the cable, it doesn't bounce back. If, however, the end of the cable is either shorted or open (unplugged) the signal bounces back. See Signal reflection and Reflections of signals on conducting lines. What may be happening is that the impedance at at the frequency of the TV channel is changing as you change channels.
 * Another possibility: the TV is actually generating an interfering signal and feeding it back down the cable, and the interfering signal changes as you change channels
 * Or it could be something weird happening in the splitter. Splutters are cheap, somitbmight be worth trying to replace tyhe splitter and see if the problem gets better. --Guy Macon (talk) 22:21, 18 April 2019 (UTC)


 * Signal reflections sounds like the most likely explanation so far. Thanks. SinisterLefty (talk) 00:11, 19 April 2019 (UTC)