I know this question is odd, but unfortunately we have a lot of unhoused addicted people in my city. I often see them sitting on a bench bent at the waist in half like a rag doll, or standing somewhere half bent over, like stooped over nodding out I guess? I don’t really know anything about substance use, but it’s such a strange sight, what substances cause them to bend over like this?
Poor souls. The mayors of big cities here have asked the provincial government to declare a state of emergency due to homelessness and addiction being so rampant, but Doug Ford doesn’t give a shit about them.
It’s the fent fold / bent / drop / lean. Most likely fentanyl or carfentanyl, but almost definitely some kind of opiate (of which they’re the most potent). Some of it might be neuromuscular / specifically opiate related but there’s also just the practicality of it. The drug might be cut / mixed with another sedative for potency such as a benzo or barbiturate, but it also might be mixed with with a stimulant such as methamphetamine or cocaine to counteract the sedation.
You’d want to counteract the sedation either to increase enjoyment (similarly to the relaxed buzz of a caffeinated alcoholic beverage) or because they feel too much distress from being sober / unsedated but also know that they’re in an unsafe area to be sedated. Even if it’s not cut with a stimulant they may still be forcing themselves to stay awake either because they know they’ve taken enough that they might stop breathing, or because, as I said, they know they’ll get mugged or otherwise attacked if they relax into the high.
Being homeless / generally in poverty is often too emotionally stressful to tolerate sober, but too unsafe to be navigated zonked, so they just put themselves into a never sleeping but never really awake haze until they either intentionally or unintentionally die or almost die or experience psychosis, in which case they either go to a morgue or to meet up with me on the psych unit.
That sounds like actual hell.
An inability to cope with people who don’t get it and don’t care to is a significant part of my social isolation.
Just because it would be a significant change to the competent you upvoted:
We had a patient who was consistently verbally abusive and otherwise unpleasant during a long stay and completed after discharge and the most emotion I could summon was a melancholic relief that their pain had ended. We did not have the resources they truly needed and neither did anyone else. They were so deep in that despite being cognitively intact they were unable to meaningfully interact with anyone socially.
They would have needed extensive social support and interpersonal skill building to be properly rehabilitated and nobody does that. Most of what we do for that type of patient is to get them sober and give them a second chance to seek help. Even that takes a lot of resources so we don’t really have the resources to do more than point them in the right direction if we can even find a decent place for them to go. Many get sobered up and discharged to the bus stop with a month of pills and directions to a shelter that’s probably at capacity.
That was this person’s only way out and I honestly respect their decision. At this point I’ve contented myself with caring for homeless people who are faking or exaggerating suicidal ideation of psychosis for 3 hots and a cot. Some of them are obvious but ultimately I don’t want to be responsible for deciding who is and who isn’t, and the deeper truth is that I’d probably do it too. And 3 hots and a cot is more and better care than I could give them pretty much anywhere else in this current system.
Theres only one way to find out and there aint no ctrl-z
It sounds like you think these people are homeless because they are addicts, but it is the other way around. Taking fent or even becoming addicted won’t turn you into a homeless person living in hell.
I have a distressing memory about this from a party I went to a couple of years ago. It was mostly people in their mid 20s. One of the people I talked to was a 27 year old girl who was really into indie games. I handed her my phone with my Steam library and we chatted for 20 minutes about the games we’d been playing as she scrolled through it.
Later in the night I found her standing slumped over in the hallway. I didn’t recognize what was happening and I got very worried. I asked “excuse me, excuse me, are you okay??”
Still folded over, she cocked her head up to look at me. The expression on her face was somewhere between dazed and starry-eyed. She said “YOU’RE BEAUTIFUL”, reached her arms up and tried to grab my face. I ducked out of the way and left.
Someone told me that she got like that at every party.
The memory is seared into my brain. I still think about it and worry about her. I’ve seen fent folding in unhoused people before, but seeing it happen to someone I never would have expected really got to me.
Ooh that’s awful.
It is most likely Fentanyl, or some other form of opiate. Prolonged abuse causes them to lose control of their muscles around their core and this is the result.
I used to work near a hot spot for homelessness and drug use in San Francisco and witnessed it everyday. The things these people go through with that addiction are downright horrendous and the “Fentanyl Fold” or “Fent Bent” is actually one of the lesser symptoms. The skin infections, kidney problems, and digestive issues can become pretty severe. I’ve seen quite a few screaming in agony because their kidneys are messed up and they can’t urinate. People with infected swollen hands or feet. You can literally smell them rotting. Too much to list here honestly. It is a terrible drug that does permanent damage to people at best, and is just a slow agonizing death at worst.
Casual reminder that the Sackler family pretty much single-handedly manufactured the American opioid-crisis.
Dopesick this is basically as much of a documentary as “Chernobyl” was. Highly based in real events, but still a dramatizatio so not everything is 100% accurate, but the large lines are.
Sure opioids get used a bit elsewhere as well but I live in the worst part of my city and while there is opioid abuse in Finland, it’s mostly “just” buprenorphin addicts. Buprenorphin is to fentanyl what hard cider is to moonshine, more or less. Yes you can technically kill yourself with both and definitely have a problem with the substance and ruin your life, but the stronger one seems to do that quite a bit more.
“Yes you can technically kill yourself with both and definitely have a problem with the substance and ruin your life, but the stronger one seems to do that quite a bit more.”
100% agree. This is a huge part of the issue that I feel many people just don’t get. 3mg of this stuff is enough to kill an average sized adult male. That would easily fit under your fingernail with room to spare. 50 - 100 times more potent than morphine. Pretty crazy.
Interesting about buprenorphin in Finland, I had never heard of it. Is it a recent thing there?
Sacklers. Just as the worst as cocaine cartels. Their properties should be expropriated to destroy fentanyl, and those bastards should be in supermax.
I’m actually pretty pissed off that people are trying to take fentanyl off the market completely. It needs to be a highly controlled substance but to take it away from the burn ICUs and hospice units is wildly inhumane.
Agree 100%. In a controlled setting it is a highly effective drug and a legitimate advancement for healthcare.
The supply of fentanyl out there isn’t coming from legitimate use. It’s all from overseas labs. So taking the legal stuff off the market would be a mistake.
Honestly, in my opinion, even the “illegal” use should be legal. I’m not a drug addict (besides caffeine), but I have a very progressive opinion of drugs. People are going to use them whether it’s legal or not. All that making it illegal does is pushes it into the shadows. Instead we should be providing education and testing, and helping people who choose (or have gotten stuck) using the drug to use it safely.
Fentanyl isn’t evil. It’s just a particularly strong opiate. It has the potential to at least be a cheaper option for people using opiates to self medicate, and, at least with testing kits, they could get whatever fix they want more safely. The biggest issue with fentanyl is that other drugs are laced with it, and you don’t know what, or how much, you’re getting.
Yah NIMBYs really don’t seem to understand that their neighborhood almost definitely already has a safe consumption site for one of the most addictive and dangerous drugs known to man. While opiate withdrawl can have fatal side effects, withdrawal from this drug can actually kill a person outright with nervous system dysfunction and continuous seizures until the person suffocates. And these locations actually distribute the drug in addition to supervising it’s use. We call them “bars.”
Do you think it should still be legal if it were proven that repeated use causes irreparable brain or body damage? I know one can make the same argument against other legal drugs, sure. But the Fentanyl family of opiates are just so powerful and so easily severely damaging. I see people that have abused long term and its pretty obvious they will never be functional again even if they get clean. At what point does individual freedom to damage one’s body or mind become too destructive to society as a whole? What would happen if everybody did it? What happens when the addicted wants more than their legally allowed dosage? Now we’re back to square 1 with illegal markets. It’s a super complex and tough issue for sure and I’m not saying I have any answers, but it really makes me question if there is a safe way for society to sustainably recreationally use Fentanyl. It’s just such a slippery slope.
Yeah, I think it should still be legal. I don’t think the government should be given the responsibility (and authority) to be people’s doctors. We need laws that prevent you from doing harm to others, like DUI laws, but them determining if it’ll harm yourself? I don’t think that should be for them to decide. If we do that then you end up with Puritans saying something like “clouding your mind is causing harm to yourself” or something like that and it’s all illegal.
Not everyone is going to do it. That’s a slippery slope fallacy. Regardless, it’s going to be done anyway. Making it illegal only pushes it underground and makes it more dangerous. I’d rather it be done openly where people can make informed decisions and not feel endangered by asking for help.
I think they’re actually worse than the cartels. Are the cartels more violent and scary? For sure. Do they pull off heinous crimes? Yeah.
But…
Do they have to, in order to stay in business? Yes. Did Purdue Pharma have to? Not in the slightest.
What I mean by that is that Purdue made all it’s money at least somewhat legally. A doctor who took bribes from them and pushed Oxycontin knowing it wasn’t actually as legit — as in “doesn’t cause addiction”, pushing the medication to pretty much whoever from teenagers to grandparents, unsuspecting people in need of medical advice — is arguably of poorer moral character than a dealer selling cocaine to people who know they’re buying cocaine.
And what I mean by the cartels having no choice is that whilst I definitely don’t agree with the violence, I can understand that without it, they’d have practically no control over the trade. If however, they were given the option of actually doing it legally, I think they might give up the violence. Or at least the trade would shift away from it, because it would mean that legit cocaine traders would have the justice system and law on their side. Currently it doesn’t mean much in South-America I think, because the cartels are just so big, powerful and violent. But with time.
Responsible people should even be allowed to use those drugs. But like with alcohol, there should be products which aren’t just as pure as they can get. Like I compared earlier, buprenorphin is to hard cider as fentanyl is to moonshine.
It’s very different having a few beers which are 5% alc than downing a glass of moonshine. Same with so called “hard drugs”. I wouldn’t fuck with opiates too much, but with the proper regulation, I think even those should be allowed, and if they were, they’d eat the legal market of poisons away. Ask yourself, when’s the last time you had a chance to buy illegally made alcohol? It’s not too often that that happens. But illegally made class A drugs? Can get them about anywhere in the world.
And especially for drugs like cocaine, milder versions would be fantastic, as people could still have plenty, just wouldn’t get as affected. Like how you wouldnt’ really be able to kill yourself by drinking 4% beer. It’s just incredibly hard to get an alcohol poisoning from that because how mild it is. But with wine, it’s possible yet unlikely, but with something like 40% vodka/whisky/rum, it’s almost probable if you don’t know how much you should drink and you’re a teenager or something and with moonshine it’s almost inevitable if you actually force yourself to drink the stuff.
So for cocaine I’d say something which is perhaps a bit stronger than just coca leaves, or equivalent, but nowhere near pure face-numbing cocaine.
Bring back real Coke! Original recipe! (Coca-Cola Company is btw the largest legal producer of cocaine in the world, they still make it during the process but just sell it off to… ‘pharmaceutical companies’, or that’s what I’ve heard.)
edit sorry for the essay I just saw your reply after taking a half an ambien so I rambled a bit
The main reason moonshine is illegal is to do with taxes and historical reasons. Not because home distilling is actually dangerous. You don’t have to make moonshine to be any stronger than something you would buy in a supermarket. You can legally buy 90% spirits that are stronger anyway.
You can legally buy 90% spirits that are stronger anyway.
You can, but for instance here in the Nordics, it’s every much harder than just getting a bottle of 40-50%abv from the store.
Estonia sells quite a lot of high abv vodka, but we Finns really don’t have everclear or an equivalent of that, and that’s common in of populations that got hard booze later. As in actually drinkable hard liquor is only about 500 or so years old, although some exited for medical purposes almost 700 years ago.
So if I walk into an Alko in Finland, I won’t find anything stronger than 60%, and those in very small bottles. The strongest drinks in larger bottles are like at most 50-55%.
But you can order rums that are up to 72% and something like 80% vodka perhaps.
But no, Nordics mostly can’t actually legally purchase quality 90% ethanol. And it’s because the stronger drinks came here later which is why we have a bit more alcoholism. It’s just evolution honestly. That’s why also a lot of native American populations have problems with alcohol, because it was introduced relatively recently and the fast evolution is yet to cull out the worst drunks. Sounds super racist but it’s true for us Nords as well, we only got hard liquor properly like 200 years ago when anglosaxons had it for around five centuries.
So Tldr the point is regulation does matter quite a lot. It doesn’t completely prevent and whatnot. But neither does banning murder prevent murder yet we’re alright.
People want to get inebriated, but not lose control. So if the regulations help with that, there’s less losing control, ie less abuse.
Just imagine how horrible it would be if there’s was no regulations in traffic, licenses to drive, etc,
And usually watching US traffic I am kinda horrified by the people you allowed to drive — and don’t even have regulations to have studded tires in winter or winter tyres without studs,
We have to drive on a soap-oil course / water-ice course to get our licences.
So while I disliked bureaucracy and authorities currently in power and whatnot, I can see the benefit of regulations.
Edit today i haven’t taken ambien, just rum and glög
I’m going to disagree here. Blaming the sacklers is a copout.
People use drugs because they are unfulfilled, repressed, etc. our situation and culture is fucked up.
People are NOT going to start, or stop, using drugs due to the actions of some scapegoat. Frankly dr prescribed opiates from the pharmacy are likely our best bet. They/we(I am in recovery) are going to use something because we WANT to. Not because you are selling it. You are selling it because I want it.
Watch what happens when they pull Kratom and 7oh. Another wave of death as people turn to the streets. A new scapegoat for the capitalists sucking our lives away for their benefit. 8 hour work, they own your lunch too pretty much so that’s 9. Commute and hour each way. That’s 11. Pick up the kids cook dinner and do it all again. Just do subsist and breed the next gen of sheep to be sheared. THATS who you blame.
There is no reward doing that for someone else so we seek out a way to stimulate our reward pathway.
Just compare the US to literally everywhere else in the developed world and try saying again blaming the Sacklers is “a copout”.
to use something because we WANT to.
That’s addiction. Addiction and dependence are two different things. I’ve used literally all the drugs there are and never had a proper problems with any of them. Abused a few on rare occasion but never anything too problematic.
Regulation is key to controlling what addicts are allowed.
Thats why it’s good that the liquor store doesn’t sell you a gallon of vodka when you’ve been drunk for a week and can’t stand on your feet.
Pick up the kids cook dinner and do it all again. Just do subsist and breed the next gen of sheep to be sheared. THATS who you blame.
That’s LITERALLY who the Sacklers are blaming, not me.
“We have to hammer on the abusers in every way possible. They are the culprits and the problem. They are recklessly criminals.” - Richard Sackler in his deposition.
I don’t blame the abusers. I blame the system which allows people like the Sacklers to pull shit like this. None of this shit is going away before all drugs are legalised in a properly regulated way.
Fentanyl Fold
saw a guy stumble into traffic bent over like this. they’re just conscious enough to stay upright but have no idea where the fuck they are or what’s happening around them. shit is horrible.
Yeah that’s another part of it. It seems like their higher mind is basically gone and the body is just on some sort of crippled autopilot. Basically zombies. I’ve called the city’s crisis response team numerous times for the ones that start going into traffic. They’re pretty effective at least for helping the ones that are in immediate physical danger.
I was downtown today and saw at least 6 people doing it. It’s just infected everything in the city, not just the people who are addicted and suffering, but the public nuisance and safety aspect because of them too. The library today felt so sketchy.
My neighbour who works downtown told me she flat out hates them, she goes outside to smoke and they’re screaming at her to give them one and threatening her when she says no. It’s terrible on both sides.
I had 3 coworkers who were chased and threatened on different occasions, luckily nobody was harmed. One barely made it into the building before the guy chasing him could reach him. He quit like a month later, sucks. It is a sanitary and public safety hazard for sure. Everyone on all sides here just loses. Except for the dealers and manufacturers I guess?
Well if we treated it as a public health issues rather than a law enforcement issue, the addicts could get the help & support they need and being a public nuisance would drop right off.
I don’t know about other cities, but here in San Francisco it is mostly treated as a public health issue. Users are not arrested or penalized. There are many treatment centers, shelters, clean injection sites etc. The help and support is definitely available but the public nuisance definitely does not just drop right off.
The problem that I see here is that there are people who are just too far gone to help due to the destruction Fentanyl causes. They will likely require fulltime care or stwardship for the rest of their lives. Many outright just refuse any help. Many go right back to using again after treatment because it’s all they know. I’ve spoken with a few that straight up told me they don’t care if they die doing this. While sad, it is their right to slowly kill themselves if they want I guess, but meanwhile they’re sprawled out on the sidewalk covered in their own diarrhea with everyone one else having to walk in the bike lane to avoid them. Society as a whole is losing here. Since 2023 about 1.5 people are known to die from Fentanyl per day in this city.
San Francisco deals with more than its fair share because people come here from across the country due to the mild climate and many services available, so maybe all of our facilities are just overloaded. Perhaps they are also I’ll equipped to deal with something like this because the physical and mental destruction that Fentanyl causes is just so severe. It’s not like the common drugs of the past.
Exactly. It’s absolutely horrible the government doesn’t.
God that sounds horrific. I had no idea.
There is a thing called “fentanyl fold”, when fent users bend over at the waist. So my guess would unfortunately be fentanyl
It’s not just fentanyl, it’s opioids in general. Junkies have been doing this long before fentanyl was available.
True, but fentanyl is really popular right now.
junkies have been doing junkie things for sure. the fold is something unique; have seen heroin addicts, meth addicts and other kinds but never seen them fold themselves in half while staying upright. they do it for so long it leads to serious muscle issues in the lower spine. https://sfist.com/2024/07/17/doctors-and-users-explain-why-fentanyl-users-are-slouched-over-so-often/
It might be more prevalent with fentanyl but it’s not unique to it, I remember seeing the fold happening decades before fentanyl was around. I do think it is unique to opioids though, there’s a similar thing that can happen with dissociates but it’s got a different character to the movement and poses.
Ohhhhh! I didn’t know that was a thing! Thank you. Fentanyl is a real problem here so of course that would be it.
These poor people. It’s absolutely dreadful what’s happening.
It’s refreshing to find somebody with even an ounce of compassion for those folks, let alone the genuine care you have. Thanks for caring.
I really do. It’s terrible. I acknowledge that there is a public nuisance and safety aspect that they bring to the community because of addiction and why people on the other side get frustrated by it, but nobody goes out in life and thinks “I’ll be a homeless drug addict, that’s the way to live”. It’s a product of multiple factors, poverty, etc. And it’s absolutely terrible to try and get clean off substances, especially when you have no home to go to when you’re done.
This is what happens when you have conservative governments. They’re absolutely fine letting these poor people rot.
That sounds a lot like empathy, and there’s an Executive Order that prohibits that. Off to an El Salvador torture prison with you.
Research has not yet pinpointed what exactly causes the fenty fold, as fentanyl use is not known to directly affect the spine. Instead, it’s becoming clear that it is a neuromuscular side effect of synthetic opioids like fentanyl. Studies from the Journal of Applied Physiology and the Harm Reduction Journal highlighted similar findings that fentanyl use can lead to severe and widespread muscle rigidity, particularly in the trunk muscles, which restricts respiration and affects posture and mobility.
That’s fucking awful.
I really wish we had very harsh punishment for drug dealers here.
What would that serve to accomplish but make the struggle for both the dealers and the addicts even worse? People need to target the root causes of the addiction. 95% of the time it’s homelessness in my experience, but it’s always suffering being blanketed by substances at the end of the day.
You don’t fix suffering by adding more into the world.
Won’t someone think of the poor drug dealers poisoning the people around them and their communities
Heroin or other opioids. It’s a problem where I live, too.
Aww. It’s so terrible to see them this way, especially because it’s been an exceptionally cold December.
I’ve known it as the heroin nod, where they are literally falling asleep on their feet.
I’m continually afraid they’re going to topple over.
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I’ve heard it called the “lean” locally. I’ve been told it’s from Heroin. Seems Fentanyl is also a contributor
The Dope Fiend Lean
I heard they stand to try to stay awake and not sleep through their high, but I could be wrong.
It’s apparently a neuromuscular reaction to the drug in the spine. Called the fentanyl fold, someone told me in another comment. I wonder what the long term damage neurologically is.
It reminds me of a condition owls get sometimes where certain muscles in their neck become overstressed and can’t be used, so you have an owl that can’t stand straight. The way to treat it is a full body cast so the muscles can relax. (IIRC)
Oh interesting! Thanks for the information.
Not mentioned here but there was some other drug, a tranquilizer called xylazine that was being used to cut fentanyl that I heard was largely to blame.
That’s awful. Holy shit.
Thats the fent zombie bow
They’re in another world
Fentanyl.
opiates
there’s many street names for it but basically “the nods” makes the most sense. They are literally falling asleep
“La chimique”. A variable, super seedy blend of lab thc, alhocol-infused tobacco and who knows what else
Sounds dope, where can I get some of that?? /S
