Categories
Harm Reduction Internet

How Online Drug Reporting Yields Better Harm Reduction

When I used to regularly browse Reddit’s r/Opiates subreddit, I’d sometimes see posts titled “Fentanyl Warning: (City, State).” Even though the site isn’t that active in hosting such warnings, sharing reports on drug forums like fentanyl warnings is an effective harm reduction practice.

Screenshot of the header of opioid-centered drug forum r/Opiates, a subreddit of Reddit.com.
r/Opiates’ header

The most recent fentanyl warning on r/Opiates is three months old. Looking back on other “fentanyl warnings,” they’re few and far between — there seems to be no more than two per month over the last year. Jynxies Natural Habitat is a Blogspot-based website dedicated to sharing the owner’s own stamp reports and relaying submissions from readers, though it’s been defunct for a half-decade. Reddit’s r/Glassine, too, was dedicated to stamp reports prior to its closure over two years ago. Free-standing sites like the now-defunct Opiophile, Drugs-Forum, and Bluelight have also been home to similar reports — though the latter two sites aren’t defunct, they’re not as active in subjective drug experience reporting as we’d like them to be.

While I’m not privy to all online subjective drug experience reporting platforms, something I am sure of is that we’d all benefit from having access to readily-accessible, active drug experience reporting websites.

The Need for Drug Reporting Sites Comes From the “Black” Part of the Black Market

All across the United States — hell, even across your county — the quality of illicit, unregulated drugs varies. As drug users, we never know what we’re getting.

Ever heard of that myth that fentanyl sometimes finds its way into the meth supply? It’s not a myth — it’s 100% true! Fentanyl has been found in non-opioid drugs like cocaine, and, of course, illicit opioids like heroin and counterfeit pharmaceutical opioid tablets.

Roughly 25 fake Mallinckrodt oxycodone pills, marked M 30, that contain fentanyl.
Fentanyl-laced counterfeit opioid tablets made to look like Mallinckrodt’s 30-milligram, instant-release oxycodone tablets. Courtesy of DEA.

We all know, as active American drug users, that fentanyl can very well be in any sack of dope you get. The concern with fentanyl is that there’s a relatively small threshold between an active dose and a potentially-fatal one. Another problem is that, due to the unregulated nature of the illicit drug market, manufacturers don’t use pharmaceutical-quality manufacturing processes — in other words, this results in “hot spots,” or areas of varied strength across batches of illegal drugs.

Keep in mind that we don’t need drug reporting websites or other platforms solely because of fentanyl. Rather, we need drug reporting sites because of the nature of the black market — without the often-pesky regulatory bodies that oversee commerce, the market lacks even a shred of accountability.

Dark Net-Based Illicit Drug Markets, in a Way, Act as Drug Reporting Sites

In the “real world,” of course, we don’t have to do any drug reporting. However you may get drugs, you’re not required to leave any reviews or reports of batches you come across.

On “the onions” — the phrase colloquially refers to dark net markets that can be visited via the Tor Browser, the logo of which is an onion — you’re incentivized to leave reviews.

With most modern platforms, the more, the better, and the more accurate reviews bring you more value in the eyes of vendors. Vendors like doing business with people who’re both motivated and thorough in leaving reviews, as better reviews stand the chance of boosting business.

If you didn’t already know, the path to success on any dark net market is to pull in great reviews on a consistent basis who are also well-reviewed themselves. On an above-ground peer-to-peer sales platform like eBay, for example, we can take accusations of theft to police and — who knows? — maybe even to court. We can leave reviews on other platforms, too, even if we have’t done business on them.

With dark net markets, you’re not taking any complaints to police or industry regulators — unless you like going to jail, not passing go, nor collecting $200 (yes, that’s a Monopoly joke). You might not be able to leave reviews on other platforms because the vendor might not be active on them. Also, with all dark net markets, you have to buy something from vendors in order to have the opportunity to review them. You can post on forums, naming-and-shaming vendors that’ve done you wrong, but that’s about it in the line of recourse.

The Importance of Drug Checking

If you don’t know what you’re consuming, you can’t truly be safe. Also, if you don’t know how pure your drugs are, you face similar safety issues. Drug checking helps people make better decisions.

Drug checking also gets people involved in harm reduction.

Here in Northwest Tennessee, most fellow drug users aren’t familiar with rapid fentanyl test strips — or, I should say, at least they weren’t familiar with them before I put them on game. These test strips are the most popular, in-demand supply I give out. I wish I had more, as they get more people interested in harm reduction in general. Hell, they make people more interested in taking care of themselves.

Thirdly, drug checking boosts “public health surveillance and response strategies to prevent harms associated with illicit drug use,” says a 2018 International Journal of Drug Policy study.

By extension, online drug experience reporting accomplishes similar results — it improves drug users’ decision-making, boosts involvement and interest in harm reduction, aids public health surveillance, and helps build well-rounded, effective public health responses.

Drug checking, defined by DanceSafe as “a harm reduction service that helps drug users avoid ingesting unknown and potentially more dangerous adulterants found in street drugs,” varies from drug experience reports in several ways:

  • Drug checking objectively, empirically determines what samples contain and (though not very often) in what proportions; experience reports don’t.
  • Experience reports are often entirely subjective in nature. Sometimes, reporters do use rapid fentanyl test strips or reagent tests, for example.
  • The primary focus of drug experience reports is on people’s personal experiences with drugs, not their guesses as to what to what they’ve consumed contains.
  • Lastly, drug experience reports are typically shared in real-time, whereas there’s often a several-day delay in the empirical chemical analyses reported by outlets like DrugsData.org.

Are There Any Widely-Used, Go-To Platforms for Finding and Leaving Drug Reports?

DanceSafe, for example, is one of the largest drug-checking entities in the world. The non-profit organization also creates and distributes educational material; at festivals and other events, the entity offers water, earplugs, condoms, peer counseling services, and event patrol oversight (i.e., making sure dance floors are clear of potential hazards). DanceSafe doesn’t publish its results, unfortunately, but the group said “we are hoping to when [Fourier-transform infrared spectroscopy] has been more widely introduced” in a Facebook message dated Monday, April 20th.

The Erowid Center runs DrugsData.org, which happens to be “the best option for test results right now,” according to DanceSafe. DrugsData.org’s list of samples of often-illicit drugs that have been tested via gas chromatography–mass spectrometry, or GC-MS for short.

While this organization is good at what it does, tests can be downright expensive, ranging anywhere from $40 for whole, pressed ecstasy tablets; research chemical samples, any non-pressed ecstasy, and blotter costs $100. Testing herbal supplements and pharmaceutical tablets, powders, and capsules costs $150.

To get an idea of how active the site is, it’s got two entries from April 17th, 15 from April 8th, 23 from March 22nd, two from March 20th, six from March 13th, 38 from March 9th, and four from March 6th. I believe this resource is the best publicly-available aggregation of empirically-tested drug samples on the Internet right now.

Just one glance at DrugsData.org and it’s easy to see that the Erowid Center project isn’t the type of resource to host drug users’ personal, anecdotal experiences — again, keep in mind DrugsData.org is for drug checking, not subjective drug experience reports. While Erowid, also an Erowid Center property, hosts these subjective drug experience reports, they don’t feature images or location.

At least in my experience, people tend not to turn to Erowid for location- or batch-specific drug experience reports — “stamp reports,” in other words. It seems like many drug users in my area, especially those that are the most disadvantaged or at the highest risk of experiencing drug-related problems, aren’t aware of web-based drug resources. Of course, they aren’t too keen on sifting through lengthy personal accounts of drug use.

Don’t get it twisted — Erowid is a solid resource. We just don’t have any active online platforms for sharing short-form, readily-digestible drug experience reports. Also, of those that do exist, none of them — to my knowledge, and please correct me if I’m wrong — condone location sharing. And I think location-sharing is very important in sharing drug experience reports and empirical drug-checking results.

The Importance of Location in Online Drug Experience Reporting

On Reddit’s r/Opiates subreddit, for example, community members aren’t allowed to share their location. Moderators are incentivized to discourage such sharing and actively censor such posts out of self-preservation. Reddit doesn’t want to help people find illicit drugs. By avoiding location, r/Opiates stands a much better chance of avoiding a swift banhammer strike.

For example, in March 2018, Reddit banned r/DarkNetMarkets for “a violation of Reddit’s policy against transactions involving prohibited goods or services.” Countless other drug-related subreddits have been dismantled for similar reasons. 

I agree, we’re better off with a r/Opiates subreddit that doesn’t allow location-sharing than without one at all. However, we need somewhere that facilitates location-specific sharing.

Batches of illicit drugs vary wildly by location — this is why location-specific drug experience reporting is so important. For example, in Philadelphialots of street heroin contains xylazine, known colloquially as “sleep cut.” Also, due to a lack of regulation, illegal drug markets’ batches similarly vary wildly.

The Issue With These Tests

Remember how expensive getting a DrugsData.org test is? The layperson can’t readily afford these tests.

Also, these tests aren’t performed instantly. In the real world, how often are drug users like me willing to wait after copping drugs?

Oh so often, we use drugs within minutes or hours of buying them. Many of us can’t afford to wait to use — well, it’s more appropriate for me to say that we’re not willing to wait to use, whether we’re just impatient or we want to send withdrawal symptoms packing.

Lastly, chemical analyses might not always match up with subjective drug experience reports. Although these breakdowns identify what substances drugs contain, we can’t always predict how people will react to them.

In other words, DrugsData.org-style analyses just aren’t practical. They’re important, yeah — don’t get me wrong. They’re just not readily available or practical for the vast majority of active drug users like me.

Virtually Anybody Can Get Involved

In order for an online drug experience reporting website to have utility, it needs to be readily-accessible. In other words, for it to be worth half a shit, it needs to be easy to access.

In my experience, people who use drugs in rural West and Middle Tennessee aren’t generally aware of web-based drug resources, whether it be Erowid, a drug-related subreddit, or a mail-based safe drug use supply distributor like NEXT Distro.

When People Get Active in Harm Reduction, They’re More Likely to Support Harm Reduction

Used rapid fentanyl test strips (FTS). One line, as shown in the left, represents a positive result, whereas two lines, as shown in the right, represents a negative result.
Used fentanyl test strips (positive result on the right, negative result on the left)

Like I already mentioned, around here, people are usually blown away by how “cool” fentanyl test strips are. Some people have been impressed by the small, already-balled-up, perfectly-sized cottons I distribute.

These people are more friendly to accepting syringes, naloxone, and other safe drug use supplies; solicit advice about proper injection practices and general drug-related best practices; and becoming interested in what we call “harm reduction.”

Platforms that allow people to share subjective drug experience reports will similarly get people, particularly active drug users, interested in harm reduction — even if they don’t know what “harm reduction” is.

Drug-Checking Websites Aren’t a Bad Thing

Don’t think that drug-checking result sites like DrugsData.org are a bad thing — they’re great!

What I am saying is that we don’t have a sufficient means of readily sharing subjective drug experience reports with others. And, while DrugsData.org is drug-related, subjective drug experience report-sharing is an entirely different thing.

What Does Sufficient Drug Experience Reporting Look Like?

I’ll be the first to tell you — I don’t know. I don’t know what the ideal drug experience reporting hub or framework would look like. I don’t know what problems might arise in creating or operating one.

I’d imagine that creating such a platform is risky because of its tie to illicit drugs. What if you get accused of helping people buy or sell illicit drugs? What if someone sources drugs from someone they met through your website and experiences a fatal overdose — don’t you think you could potentially be implicated?

Also, again, drug-checking reports from DrugsData.org and company are beneficial to our cause as harm reductionists. We don’t need to get rid of any existing sites to bring about a better world of subjective drug experience reporting.

Categories
Chronic Pain From Personal Experience Internet

Using Opioid Equianalgesic Charts to Determine Equivalent Doses of Different Kinds of Opioids

No, I’m not a physician. I’m not into pharmacology. But, I do know what “equianalgesic” means. I don’t usually use medical or pharmacological terms like this, but it’s necessary for what I’m about to explain.

What Does “Equianalgesic” Mean?

”Equi-“ is a prefix that means “equal.” “Analgesic” is a complete word on its own and is simply a fancy, proper way of saying “pain reliever.”

When we put these together, what do we get?

Equal pain reliever!

Okay, that doesn’t make any sense…

Anyways, the World Wide Web is home to several reliable charts that make it easy to determine equal dosages of different opioids. When combined with simple math, we can do just this.

Keep in mind that I’m not a physician. I’ve never been professionally trained in medicine. My advice is not a substitute for advice from a professional clinician.

Let’s Head on Over to Wikipedia

The equianalgesic chart I, personally, prefer to use is quite comprehensive, at least for comparing mainstream opioids, and can be found on Wikipedia’s “Equianalgesic” page.

I encourage you to head over there now to build up some hands-on, practical experience with using this chart.

When Might Equianalgesic Conversions Come in Handy?

Physicians often use equianalgesic calculators or charts when switching patients over to new opioids for pain relief.

In my world, and likely yours, too, you may find utility from knowing how to perform equianalgesic conversions when trying out opioids that you don’t have much experience with.

Note: before going any further, know that simply using an equianalgesic chart is not sufficient if you plan on using routes of administration that aren’t covered on basic equianalgesic charts.

Take a shot for every time you read “equianalgesic chart” — doesn’t that sound like a fun game! Anyways, let’s get into crunching numbers and making sense of converting the potency of one opioid to another.

Example 1 — Converting Morphine to Hydromorphone

We’ll be assuming that all opioids will be consumed orally at first, then we’ll break out the bioavailability data. Keep in mind that most such charts — both equianalgesic and bioavailability charts for opioids — will feature slight differences. These differences are typically immaterial.

First, find “morphine.” Now, find the value in the second column. It should read 1. Now, take a visit to “Hydromorphone” Lane — you’ll see a value of 4.

This means hydromorphone is four times stronger than morphine when taken orally.

Use this conversion to determine how many milligrams of morphine are equal to 32 mg of hydromorphone.

I would solve this problem by multiplying 32 by four, the “exchange rate” from hydromorphone to morphine. We’d end up with 128 mg of oral (PO) morphine — “PO,” by the way, is an abbreviation for “oral” used in medicine.

For this problem, we used this conversion: PO H/PO M.

Let’s mix things up a bit.

Example 2 — Introducing Bioavailability Into the Mix

Bioavailability refers to how well the human body absorbs drugs based on how they’re administered. Intravenous administration (IV) is always 100%. As such, other routes of administration (RoA) are expressed in proportion to IV administration.

How many milligrams of intravenous hydromorphone is equivalent to oral morphine?

Before going further, let’s pull out our bioavailability chart. I will be using one found on the sidebar of r/Opiates, a subreddit dedicated to — you guessed it! — all things opioid-related.

We’re dealing with IV hydromorphone, which is absorbed by our bodies entirely — aka 100%. PO (by mouth) hydromorphone’s BA is just 35%.

Let’s convert 16 milligrams of IV hydromorphone — which just might be enough for an elephant — to oral morphine. First, I would divide 16 mg IV by 0.35, resulting in roughly 45.7 mg PO hydromorphone.

Just like above, we’ll multiply this figure by four, the factor by which hydromorphone is stronger than morphine, to get 182.8 mg PO morphine.

We’ve made the following conversions: IV H/PO H then PO H/PO M.

Example 3 — Let’s Go Double on the Bioavailability Stuff

It’s time to convert 18 mg of IV hydromorphone into an equivalent dosage of intranasal (IN) morphine. First, I’d divide 18 mg IV by the oral bioavailability of hydromorphone, 0.35, to get 51.43 mg PO hydromorphone.

Using Wikipedia’s handy-dandy chart, I’d then multiply 51.43 PO hydromorphone by a factor of four to get 205.72 mg PO morphine.

Now, all we need to do is account for the intranasal bioavailability of morphine, which, according to the BA chart I’ve linked above, is between 25 and 30 percent.

Since the oral BA of morphine is already 30 percent, we don’t have to do anything to get the lower range of this answer — 205.72 mg IN morphine.

I’d multiply 205.72 mg IN morphine by 0.3 and divide the result by 0.25. What results is 246.86 mg IN morphine. Since it is greater than 205.72 mg, we can deduce that this number is the lower bound, whereas 246.86 mg is the upper bound.

Nobody really snorts morphine — the FDA found just 4% of morphine users to sniff the drug — but, this is just an example.

Again, here’s the conversions we’ve made: IV H/PO H then PO H/PO M then PO M/IN M.

Am I a Physician?

No! I’m not a clinician in any capacity. You shouldn’t be making dose adjustments by yourself.

However, unfortunately, since illicit drug users often aren’t given any assistance by clinicians, it’s useful for us to have information like this available on the Internet.

People are going to use drugs whether or not they’re offered help by healthcare or pharmacological experts — better understanding opioid equianalgesia is a solid harm reduction practice.

Do not take any information I’ve written herein as a substitute for professional advice from a licensed healthcare expert.

Categories
Drug User Advocacy Harm Reduction Internet

How the Deep Web’s Illicit Drug Markets Promote Safe Drug Use

Most of us have heard about the dreaded, oh-so-evil “dark web,” as well as the seemingly-interchangeable term “deep web.”

The dark web is the collection of websites that require advanced, specialized configurations and setups to access. The deep web is simply all websites that cannot be found on Google, which includes companies’ in-house web-based tools and applications. To help you better understand them, remember that the dark web fits within the greater deep web — kinda like how rectangles are squares but squares aren’t rectangles.

Believe it or not, the majority of the Internet takes the form of the deep web.

How Do People Access the Dark Web?

In the modern world, most Internet users who access the dark web do so via the Tor Browser, where “Tor” is short for The Onion Router. Tor, which contains the Tor Browser — all these things with Tor in their names are made by The Tor Project — helps people engage in anonymous communication. Tor is entirely free to both download and use; it’s also open-source software.

Using Tor Browser itself isn’t enough to protect your identity while browsing the dark web, though it’s a great start. Downloading the Tor Browser Bundle is as easy as making a quick google search — better yet, it’s a quick download.

One of the most common websites on the modern dark web is those that help people sell and purchase illicit goods and services. These operate similar to eBay, in that such sites simply act as an intermediary between buyers and sellers. AlphaBay Market, for example, was one of the largest online darknet markets before being shut down in mid-July 2017.

Drug Users Benefit From Exchanging Illicit Drugs on Tor-Based Websites

In real life, very, very few drug users are familiar with any local area’s list of dealers. Buyers often know anywhere from one to a few local dealers, but usually never all of them. Assume that you know all the dealers in Joshuatown.

You can shop among this network of dealers and potentially leverage one dealer’s offer against another. However, while you, personally, might be able to peruse your fully-unlocked menu of illicit drug salesmen, almost everybody else in your locality will not.

I bring this up because if they were able to, they’d likely pay less for drugs due to increased competition among vendors.

Provides Access to Legitimate Forms of Drugs That Are Sometimes Hard to Get

Darknet markets make it easy for drug users around the world to get their hands on drugs of higher quality than they could get among their real-life drug connections, drugs they couldn’t otherwise purchase within their localities, and to shop for the safest, most highly-reviewed goods on such digital storefronts.

Wider competition forces vendors to offer up their most potent, least-adulterated substances. Also, because people in other parts of the world who str able to access drugs that are hard to find in other people’s lives, they’re incentivized to register on these illicit eBay-like websites and capitalize on their valuable sources of sought-after drugs.

Many drug users who are familiar with dark web markets know how seriously useful they are in obtaining these harder-to-find psychoactive substances. Since only people with legitimately high-quality sources are likely to even begin to succeed on the market, they’re not likely to proffer illegitimate drugs.

Reviews Form the Backbone of E-Commerce-Based Illicit Drug Markets

Reviews mean the world to the participants of the dark web’s drug markets. Just two or three bad reviews in a row can mean significant business declines for these Internet-based dealers.

On these types of markets, since users’ identifies are safeguarded, the only way to gauge how much users mean to others is by turning to their reviews and other means of gauging reputation.

What’s so good about these reviews? Most sites anonymize identifying information about reviewers, such as the exact times that they made purchases, their usernames, or the exact amount of dollars spent. As such, in most cases, they can freely leave reviews on vendors without having to worry about facing repercussions.

Reviews are typically posted within a few minutes or hours of their publication. This is done for user safety.

Less Violence Is Associated With This Mode of Purchasing and Selling Drugs

Drug dealers and other criminals engage in violence to assert dominance over competitors. One such application of violence by a drug dealer or a group of like-minded dealers is to perform a drive-by shooting if a member of a rival gang or group of drug dealers. The intended result of such violent activity is to dissuade those rival gang members or dealers, ultimately resulting in more business for the party who shot.

This is one way drug users can find themselves on the receiving end of violent crime.

It’s safe to say that everybody who has used drugs for any stretch has been robbed of or taken advantage of for drugs at least once. We know all too well that users and dealers alike are prone to gather up weapons and other criminals’ help to rob others of money or illicit drugs.

If someone does, in fact, manage to get over on you in real life, you may be inclined to act violently to the perpetrator(s), ranging from a sucker punch to point-blank sprays of gunfire. That’s right — violence here, violence there, violence everywhere in the world of drugs.

Unless you arrange to meet a buyer or seller in real life — something you should never do — you’ll almost certainly never find yourself victimized by violence as a result of drug deals going bad or other criminal behavior.

You Don’t Have to Leave the Comfort of Your Home

Purchasing drugs without having to leave your home — or wherever you order them from — is safer than having to drive or otherwise meet your dealer and venturing back to your place of residence.

Life is risky. You never know when a car accident could take place, for example. Not having to get out reduces the risks of such real-yet-unlikely threats.

Law enforcement agencies stress the importance of carrying out traffic stops to the best of their government-given abilities. Pulling drivers over leads to so many other things for law enforcement officers, such as finding drugs or drug paraphernalia. This is a risk that drug users like me have to face.

Eventually, we’ll all get pulled over or apprehended by law enforcement. Put simply, the less you drive in sourcing your drugs of choice, the less likely you are to experience interference from law enforcement.

If Done Correctly, Curious Government Officials Will Almost Entirely Be Unable to Intercept Mailed Packages Containing Illicit Drugs

When it comes to mailing things within and outside of the United States, the three couriers that we Americans have access to are FedEx, UPS, and USPS.

FedEx and UPS are both private businesses. By paying for postage, you’re agreeing to several terms and conditions that ultimately give workers employed by UPS or FedEx, to look inside any and all packages that make their way through these two companies’ facilities.

USPS — also known as the United States Postal Servicemust obtain a search warrant before searching any packages or parcels that have any of its workers, facilities, or vehicles. As such, illicit goods are almost always shipped via USPS as a best practice.

What About the Legal Statutes Violated by People Buying and Selling Drugs via the Internet and the Mail System?

As you might imagine, the laws people violate for buying and selling drugs via mail within the United States carry much more harsh punishments than small-time drug possession and drug paraphernalia possession charges.

Federal crimes like narcotics trafficking, money laundering, and computer hacking are three of many examples of punishments that can stem from selling drugs via the Internet and the mail.

I’m not an attorney, so I don’t know exactly how many more years in jail that buying or selling drugs online might bring as compared to doing so in traditional, face-to-face form; however, it’s safe to say that, in most cases, using the mail and the Internet to engage in these activities hold serious sentences.

Also, because darknet markets are relatively new, U.S. law enforcement agencies are more than willing to make examples out of people caught up in this stuff.

Bringing All the Loose Ends Together

Am I telling you to purchase or sell illicit drugs online? No!

I am simply recognizing the handful of very real benefits to drug users that can be derived from using Tor-based websites to purchase and sell illicit drugs.

Also, because it’s possible to safeguard your identity when using darknet markets, drug policy reform and harm reduction advocates can engage in darknet-market-based commercial activity related to illicit drugs without standing very much of a chance of risking their freedom.

People who are unwilling to come out as drug users, such as how I have, due to the obvious potential consequences associated with it, might find utility in Tor-based markets that oversee the sale and purchase of illegal drugs. In other words, they might prefer to engage in advocacy on this level as opposed to being active in the real world.

Categories
Internet Kratom

Finding Reputable, Reliable Kratom Vendors

Finding a good kratom vendor is just like shopping for anything else, right? Although you might think things would be as simple as shopping for anything else that’s legal, American kratom consumers often pay more than they should and purchase mismarketed kratom. Further, the way many kratom sellers treat kratom gives political opponents ammunition in the fight on kratom.

Let’s go ahead and dig into a few strategies anybody can use to seek out reliable, reputable, fair kratom vendors here in the United States.

Reduce Variations Between Batches by Trusting the Industry’s Largest Companies

Kratom’s effects and overall quality are affected by things such as the time of year when leaves were harvested — the monsoon season in Indonesia has a tangible effect on the outcome of kratom. By purchasing major shipments of kratom to use as inventory at once, vendors effectively fill their stocks to the brim.

What’s cool about this is that it means you can expect greater consistency between batches of particular varieties of kratom whenever vendors purchase inventory relatively few times per year and purchase more pounds of kratom per shipment than their counterparts.

Stay Away From Head Shops and Gas Stations

Kratom, in addition to the dozens, if not hundreds, of web-based kratom vendors that operate within the United States, is often found in gas stations, head shops, and convenience stores.

There are a few downsides to sourcing kratom from these types of establishments. These business entities are more likely to store kratom is less favorable conditions. For example, products will typically be exposed to bright lights for the majority of their days waiting to be sold. Also, to make potential sales, clerks are often asked by prospective buyers to inspect such kratom products’ packages. These both reduce the likely quality of kratom purchased from these types of retail storefronts.

Typically, real-life, brick-and-mortar retail facilities that engage in the sale of kratom only do so as a small portion of their overall forms of income generation. There are few places to buy kratom across the United States — retail, brick-and-mortar storefronts, that is — that make most or all of their money from selling kratom as opposed to other revenue-capturing opportunities. This results in gas stations, c-stores, and head shops typically holding their inventory for longer than businesses specializing as kratom vendors.

The Biggest Are Simply on the Internet

The way the modern domestic kratom market operates is largely in an e-commerce capacity. As you probably know, this simply means that vendors carry out financial transactions via their official, very own websites. After that, these vendors ship batches of kratom to buyers through the mail, typically through the likes of the United States Postal Service, also known as USPS.

I am normally an advocate of shopping at smaller industry competitors, as opposed to their largest corporate participants such as Walmart, for example. However, on the current kratom market, people regularly receive subpar product that takes too long to get to them and is far more expensive than better options found all over the World Wide Web.

I want you to establish trust for an online kratom vendor, ultimately. As such, I want you to simply go for the big guys as a means of drastically increasing your likelihood of receiving quality kratom leaves.

See New Names of Strains That Are Unique to a Vendor? It’s All a Marketing Gimmick

Marketing is an important business function, after all. If not for the practice, businesses wouldn’t be able to create intangible brand value. All considered, they’d simply sell a lot less goods and services than they do today — the economy would be a lot slower, in other words.

In general, kratom varieties are marketed as “strains” that follow a two-step naming convention, much like first and last names in the modern Western world. The first name is the color, which can be white, green, red, yellow, and others; the second name is the purported geological location of that batch’s harvest.

I know that most kratom comes from Indonesia — almost certainly at least 95 percent, if not upwards of 99 percent in terms of how much the — specifically the island of Borneo. Indonesia owns about three-quarters of Borneo — it’s among the top three largest islands in the world in terms of land mass — and is called Kalimantan. Most kratom comes from Pontianak, West Kalimantan.

Further, the bulk of kratom leaves are red-veined at harvest. This simply refers to the color of the central vein that runs underneath every kratom leaf. Leaves are said to be be supported by white, red, or green central veins — they can be each of these colors, though most of it is red-veined.

As such, why isn’t the market overflowed with Red Borneo and/or Red Kalimantan?

This is one reasonable way that I can prove to you that different kratom “strains” are simply blends of various batches of kratom. These batches differ based on when they were harvested and how they were dried and processed. When combined, kratom wholesalers in Indonesia slap largely-bogus “strain names” on batches.

These strain names are simply the names of recipes that vendors have developed over the time they’ve spent as kratom processors and harvesters. At least some kratom vendors in Indonesia likely share recipes among one another.

However, considering that it’s currently generally unfeasible to secure consistency in the alkaloid contents of the “raw ingredients” — the kratom inputs used to whip up the recipes mentioned above — the outcome of blending batches together is usually slightly-different kratom.

Although, with as much focus that the average American kratommite places on bogus strain names, you’d think that people would be able recognize even the most minute of details between batches of kratom. However, most people in the general community of the United States’ end-users of kratom wouldn’t even begin to be able to reliably, meaningfully differentiate between these batches.

Kratom Can Only Get So Good

In my experience as both a kratom vendor and user, I’ve come to find that many people are comfortable with paying relatively exorbitant amounts for kratom that isn’t worth as much as it’s being sold for. Such vendors are typically able to take advantage of proper marketing practices for the kratom industry.

Rather than being enticed by more expensive vendors’ claims that their kratom is so much better than the rest of the pack’s, I urge you to seek out the cheapest kratom among reliable vendors.

In my experience, kratom can currently be found for $80 per kilogram when purchasing single kilograms at a time. Many people pay up to — if not even greater than this, in some situations — $1.00 per gram of kratom, or $1,000 per kilogram, in other words.

Find a few of the cheapest, halfway-reputable sources of kratom online. Order relatively small batches from each of them. Determine whether they’re of standard kratom quality or not in comparison to one another. If you generally perceive them all to be of the same quality, that’s a good sign that each of the vendors you bought from have acceptable product quality.

Look to Other Customers’ Anecdotal Experiences

Don’t trust websites that exist solely to sell people things. These often contain highly-inflated ratings of the things they’re trying to get rid of. Rather than trusting such ratings, which are common across the kratom industry — this happens because it’s unregulated and so young that rules of thumb simply haven’t been discovered by American kratom consumers.

Look to web forums, such as Reddit, for example, in seeking out reports of others’ experiences in dealing with kratom vendors you’re potentially interested in to help you make good decisions about sourcing kratom from domestic vendors.

This Is a Legal Industry — Don’t Stand for Shady Behavior in Kratom’s Retail Sale

Legal industries are regulateakad by government agencies and other organizations. Because of their legality, they can be improved through administrative oversight — also known as regulation — something that does not persist on American illicit drug markets.

In my experience, it seems that most people who use kratom have used some other recreational drugs in their lifetimes. I feel that drug-using habits among kratom-consuming populations are far more prevalent than when in normal society.

If you come across vendors who treat retail kratom sale like selling illegal drugs ranging from cannabis to street heroin, don’t be afraid to seek out another one! After all, thanks to the fact that kratom is legal in most jurisdictions throughout the country, finding new sources isn’t something you have to settle for, such as with your connections to purchasing illicit drugs.

On illegal markets, vendors are generally unable to market their products like legal goods and services might be marketed. Black-market economy competitors don’t get nearly as much utility out of marketing as they otherwise would.

People who treat selling kratom in this way do a disservice to kratom’s legality in the United States and general acceptance by most people across our society. Countless thousands of kratom users — just laypeople who happen to use kratom — have advocated for keeping kratom legal across dozens of jurisdictions on local and state levels all over the United States. If not for the leadership of these advocates’ efforts exercised by the American Kratom Association for more than a few years now, the current legal and societal status of kratom in Northwest Tennessee would be far less favorable.

Opioid Replacements Are Often Expensive

For myself and countless other regular opioid users, kratom has worked as a suitable replacement to opioids, going as far as ceasing opioid withdrawals after having not consumed other opioids for 12 to 18 hours, roughly, if not a day or longer.

Buprenorphine, in my personal experience, costs $800 a month for me since having enrolled in a medication-assisted treatment program since mid-September 2019. Methadone is also expensive, though I don’t have any personal experience with this form of government-approved opioid replacements — I can’t reliably be sure about methadone’s price, then.

Many people stop using opioids with help from kratom. It works well for so many people — including satisfying the opioid withdrawal symptoms presented by both prescribed, strictly-analgesic use or recreational, self-medicating use.

As such — this is my personal opinion and may not be correct — these people are generally more willing to pay more for kratom.

Further, I’d also think that people who are switching from regularly using illicit drugs, which, due to their black-market nature, which are much more expensive than they would be on regulated, legalized markets, would be more willing to pay more for kratom.

You Can Turn to Indonesia, Too

Although I think it’s a better idea to search for safe, reliable kratom vendors by looking for domestic e-commerce retailers, your options aren’t limited to the United States — feel free to seek out vendors in Indonesia, who offer lower prices and typically stock fresher kratom, though their shipping takes anywhere from two to four weeks to arrive in the United States from Indonesia.

These Indonesian vendors will require you to spend a higher minimum dollar amount than likely all Internet-based kratom resellers based in the United States, which makes the threat of getting ripped off by a scammer even greater because the incentives are higher.

Also, you may be able to develop strong relationships with Indonesian vendors. Although unlikely, you may kindle genuine friendships through which you can source insider information from Indonesian kratom professionals, giving you a leg up on the domestic kratom market.

Categories
Chronic Pain Advocacy From Personal Experience Internet

How ProPublica’s Prescriber Checkup Helps Chronic Pain Sufferers

ProPublica is a non-profit, primarily-investigative journalism organization that’s been serving society at large since 2007.

One of the outfit’s best works comes in the form of an interactive web-based tool that lets the general public compare drug prescribing rates of drugs on an individual, physician-to-physician basis. ProPublica’s Prescriber Checkup allows you to sort for physicians by name, zip code, city of practice, or state.

You can both look at physicians’ most commonly-prescribed drugs using this tool. It also comes equipped with comparisons of doctors both within their specialty and among many other physicians across the cities or municipalities they compete in, such as relative opioid and antibiotic prescribing rates.

How Is Prescriber Checkup Fueled?

Prescribing data comes solely from people who have filled prescriptions using their Medicare Part D coverage. This means that, just because a physician prescribed one or more medications, they’re not represented on ProPublica’s insightful gadget unless they’re filled at a pharmacy and paid in part or in full by Part D coverage.

How Did Checking on Prescribers Like This Come About?

In 2013, ProPublica’s first rendition of the Prescriber Checkup tool was published. A federal law known as the Freedom of Information Act, or FOIA for short, allowed the entity to get a hold of information such as physicians’ prescribing histories and share them with the American public.

Without getting into the details of FOIA, the bill provides a way for the American public to gain collective access to once-secret documents, files, or data. Prescriber Checkup is one of many successful applications of the endless heaps of useful, long-desired information that the FOIA played an instrumental role in obtaining.

Who All Is Covered by ProPublica’s Free Internet Tool?

ProPublica’s proprietary, one-of-a-kind tool is useful in the following ways:

  • Why waste time paying physicians for appointments when you’re not sure if they’ll prescribe something you feel you need?
  • Determine whether you want to visit certain physicians based on your personal experience with the things.
  • Compare how two or more physicians might tend to use medication or other treatments.
  • See where most of many individual prescription drugs are prescribed.
  • Check physicians’ receipt histories of monies from pharmaceutical companies and other lobbyists or influencers to determine how they might act.
  • Learn how likely physicians are to prescribe name-brand drugs on both an objective, general basis and on an individual, drug-by-drug basis.

Not all physicians show up on ProPublica’s Prescriber Checkup, however; only doctors and other prescribers who have both prescribed lots of drugs overall, as well as lots of particularl types of drugs.

The most important determining factor is what proportion of physicians’ patients are using Medicare Part D coverage to pay for prescriptions. If not enough people do this, physicians won’t have any data available about them regarding their prescribing habits.

ProPublica’s tool requires each and every physician to write 50 or more prescriptions for one or more drugs — not 50 prescriptions in total, but at least one category of medicine on a physician’s profile would tally 50 or greater prescriptions.

In 2015, says the organization, just under 450,000 American physicians, nurse practitioners, physicians’ assistants, and other prescribers were in active practice.

Also, patients are safe and are not mentioned anywhere else on this proprietary tech tool. There’s no reason for journalists to have an interest in the names of patients and what medicines they’ve been prescribed; this tool isn’t for physicians, it’s for the American public.

Here Are a Few Real-World Ways That People Might Use Prescriber Checkup

Everybody will use Prescriber Checkup differently. Since there’s no guide out there about the various ways to pull utility from ProPublica’s Internet-based tool, not everyone will use this application and its contents for good.

To Increase Their Chances of Receiving Prescriptions That They Purposefully Seek Out

Physicians across the 50 states now prescribe opioids far less openly than they used to.

Since there are fewer opioid prescriptions being given out today, people will have to set up appointments with more doctors than they would before in order to successfully receive the prescriptions they’ve got an eye on.

Assume that you have been prescribed a drug for 10 years. Your now-former long-term primary care provider passed away and now you struggle to find another prescriber to give you access to that drug again.

There’s a reason that we go to doctors — they understand how to apply the best treatments in nearly every situation. People who suffer from substance use disorder often self-medicate with common recreational drugs such as cannabis, opioids, or benzodiazepines, for example.

Self-medication comes hand-in-hand with being at high risk for various major side effects such as worsening people’s existing mental health issues. This is just a rule of thumb, however, and doesn’t always end up like this.

Modern Medicine Says Some Drugs Are Inherently Riskier – That’s Why These Categories Stick Out

Antibiotics have countless applications in dealing with infections caused by bacteria, which are present on and in our bodies to the tune of countless trillions. However, when misprescribed, they can negatively affect the cultures of good bacteria in our bodies. We also cause existing bacteria to build up stronger antibiotic resistance to modern antibiotics commonly prescribed both here in the United States and all over the world.

Antipsychotics are another type of risky drug that the nationwide class of American physicians has been known to prescribe in inappropriate conditions fairly regularly. In most cases of antipsychotic misuse, older people in nursing homes are prescribed them with the simple goal of sedating them, ostensively for nursing homes to make dealing with patients systemically easier. Their use can also result in serious harm and even death.

Opioids are the third special class of drugs on our list. They have great utility as painkillers, especially to improve otherwise-lagging quality of life in people’s older years and in people who suffer from serious bouts of chronic pain. People who are interested in purposefully seeking out an opioid prescription from a doctor can serve themselves well by looking at all prescribers in the area(s) you’re thinking about setting up an appointment in. With this tool, you can save money and time in your efforts to receive opioids from one or more prescribers,

On ProPublica’s Prescriber Checkup, there are three other important areas of prescribing that are found on the same row as antipsychotics, antibiotics, and opioids, which are the average rate at which doctors prescribe brand-name drugs, the average price of their prescriptions at pharmacies, and prescriptions per patient.

Don’t just stop here in learning about the ups and downs of these classes of drugs and finding out the utility of the other three metrics mentioned above — look across the World Wide Web, far and wide, to better understand how to take advantage of these things.

It’s Useful in Reducing How Much Average Physician Appointments Cost

We all want to go to a doctor that will take care of us correctly the first time around. However, many people throughout Northwest Tennessee simply don’t have enough money to go visit with multiple physicians.

Given that you use this tool correctly, you can effectively shave down the costs necessary to be seen by a physician and otherwise fill their prescription(s).

A Reason to Support Prescriber Checkup

Many people are curious about what goes on behind all sorts of closed doors. While some topics deserve to be kept private, others could benefit society at large. For example, the American public generally believes that they should be served by transparent societal systems and government agencies, preventing stuff like gross financial conflicts in medicine.

We deserve to know which physicians in the areas we live are more responsible than others for prescribing drugs too widely or not often enough. Also, for example, the U.S. federal government has made a handful of proclamations over the past few years that have ultimately resulted in the systematic change of opioid prescribing practices. Since physicians should be prescribing fewer opioid prescriptions today than they did, say, 10 years ago, the public stands to benefit from having access to Prescriber Checkup’s simple comparison tools.

Whether You Use It or Not, at Least You Know About It Now

I don’t expect everyone to have a use for ProPublica’s Prescriber Checkup tool. However, everyone should at least be exposed to information such as its uses, where to find it, and ways you can benefit from it.

Good thing you know at least a little more than you used to — I hope that’s the case, at least!