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lemongrab


				

				

				
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User ID: 2133

lemongrab


				
				
				

				
0 followers   follows 0 users   joined 2023 January 27 03:43:46 UTC

					

No bio...


					

User ID: 2133

Is there any medical specialty or institute that might be able to help me get to the bottom of this?

afaik (not being a medical professional myself) there really isn't. You're doing the thing that's done here -- elimination and reintroduction. There are just conceptual categories that can guide that process to potentially make it more precise and efficient.

Some proposed classes of problems that could lead to having a problem with a wide array of foods include

  • true food "allergies" -- allergies to a large number of different foods sometimes, but not always, involves characteristic patterns of cross-reactivity between specific foods or specific foods and specific environmental substances. For instance, people who are allergic to birch pollen in the air are also often allergic to certain fruits and vegetables that share some similar-looking protein domain. An allergist would know about these patterns, but their tools for diagnosing food allergies are limited -- the gold standard of diagnostics is still 'try it and see if you feel bad' (unlike blood testing for environmental allergies, blood testing for food allergies is so prone to false positives it's basically useless) -- and the treatment is still 'then don't eat it' (or, if dealing with a single severe allergy, perhaps a targeted regimen of gradual desensitization that has to be maintained by eating small amounts of the offending substance indefinitely, but this may as well be voodoo magic for as well as it's really understood).

  • food 'intolerances' that aren't true allergies but are clearly about some particular food -- lactose intolerance and celiac disease being the best known. An allergist would know about these and a couple of the most common intolerances might even sort of have non-challenge-based tests, but when you get into the possibility of having a large number of specific intolerances, medicine seems to lose the thread in terms of a parsimonious explanation.

  • problems with FODMAPs as already suggested -- the research base on this is poor, the lists people compile on the Internet of what foods have higher or lower FODMAP content are poorly sourced and often inconsistent (charitably, because FODMAP contents of foods are actually highly variable within even, say, the growth stage of a given plant), but it's a real thing. However, FODMAPs are plant sugars that aren't present in animal tissues, so if your problem includes salmon, it's definitely not (only) this. Also, you should expect this to present with definite gastrointestinal distress, don't know about connections to skin issues.

  • histamine intolerance -- some people have difficulty degrading histamine that's already present in foods -- most notably highest in aged/fermented foods, or mishandled seafood -- and get a sort of inconsistent-looking pseudo-allergy to a wide variety of foods as a result. It's hard to pin down because often the 'same' foods provoke different levels of reaction depending on how the specific batch was stored or prepared prior to consumption -- for instance, salmon that was immediately frozen after catch and stayed frozen until cooking might be ok, but the same salmon that was only refrigerated for a couple days anywhere in the storage chain might not be. Like with FODMAPs problems, the research base sucks, the lists of potentially problematic foods are somewhat inconsistent, and medicine doesn't generally have much to say about it, but it seems like a real thing with repeatable effects and a plausible biological mechanism.
    I might expect beef to not be good for you if this were your problem, since almost all beef is aged somewhat before sale. Also would be a poor explanation for any problems provoked by, say, fresh vegetables.

  • other issues that, like histamine intolerance and FODMAPs problems, relate to a failure to adequately metabolize some common component that's found in many foods but in different amounts. Gout -- the pathological accumulation of urate, a metabolic end product of purines, is a classic example. Purines are in all unprocessed foods and are also produced endogenously, but the variation in purine content among foods is high enough that diet is an important factor in managing the disease.
    Relevant to acne, maybe something to do with PUFAs? Beef fat is pretty highly saturated and maybe that's helpful for you. Polyunsaturated fats found in fish, pork, seeds, nuts, oils, etc can be relevant to inflammatory disease. How do you do with a predominantly monounsaturated oil like avocado oil vs. a more polyunsaturated oil like peanut oil?

  • issues related to macronutrient composition, rates of absorption, problems with energy storage and retrieval -- diabetes, glycemic index, etc. If you can eat lots of potatoes without issue, it's not a 'carbs are too fast' sort of problem, nor a 'need to maintain ketosis for metabolic signaling reasons' problem, and if you can eat all beef for extended period, it's probably not an issue with the the utilization of fats, amino acid, or ketones. This sort of thing -- especially glycemic index sort of stuff -- seems to have gotten some research attention relating to acne, but I don't know if the results are very promising. This stuff is also going to involve the quantities and timing and ratio composition of meals, beyond just the identity of the components.
    If it already seems like you have a good deal of flexibility on that front among your 'known good' foods, this is probably a waste of time, but it may still be worth challenging with something like a large amount of pure sugar (or better, pure dextrose) which really shouldn't be a problem under any other framework.

Past these categories, venturing well out beyond the scope of 'real medicine', there's a very long tail of increasingly rare, obscure, or dubious possibilities (idiosyncratic metabolic polymorphisms, 'antinutrients', 'mold toxins', etc) where some paradigm might suggest a potential underlying pattern to your problem, but without ultimately providing any shortcuts around the empirical challenge testing you've already been undertaking.

You've probably already considered (and experimentally excluded) flipping the framing to 'is there something I happen to need a lot of from beef that I'm not getting if I cut back the beef?' Maybe you really just need a lot of cholesterol or carnitine or something? Obviously if you get messed up by adding other foods without cutting back the beef, it's not like this, but I mention it for the sake of completeness (somebody will still tell me something I missed, hopefully).

This superficially looks like an uncharitable take by somebody who never read the original 1999 Dunning and Kruger paper. In that paper, the authors explicitly addressed the obvious objection that their finding could be fully explained as a statistical artifact -- they were by no means ironically unaware of this interpretation. They pointed out that the interpretation as a statistical artifact wouldn't account for the asymmetry wherein the overestimation by the unskilled was so much larger than the underestimation by the skilled. That is, the effect is not just about the slopes, but about the intercepts.

Krueger and Mueller (different Kreuger) in 2002 tried to make the case for the effect being artifactual, but acknowledged that something more was required to explain the asymmetry. They claimed the asymmetry came from a generalized bias for people to assess themselves as better than average, which happens to be less wrong for people who are actually better than average than for people who aren't.

Dunning and Kruger (2002) rebutted with claims that further experiments had discredited that explanation, and I lost interest in pursuing the progress of this debate, though Ehrlinger et al (2008) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2702783/ is probably a good next step. Suffice to say though that this is absolutely not some clever new insight that those innumerate psychologists overlooked -- the psychologists have been thinking about it since literally the first paper, and arguing among themselves about it since shortly thereafter.

My vasectomy has spontaneously reversed itself nearly a decade after its confirmed success. I only learned this after my wife became pregnant, which, due to a lifelong pre-existing condition, is a severe hazard to her health.

I know what you're thinking -- what are the odds of a vasectomy spontaneously reversing itself after that long? Isn't there some alternative hypothesis for that positive pregnancy test that you're not considering? No, not the possibility of an hCG-secreting tumor, another alternative hypothesis?

Have no fear, I have confirmed the reversal with my own eyes on my own microscope, on a sample I collected and prepared. There are a multitude of obviously motile sperm where they have no business being. I've been betrayed by my own ballsack, making me some kind of regenerative mutant worthy of my own case study. Lucky me!

We're terminating this miraculous pregnancy with all haste. Even if it had been a full legal person that were putting my wife through the same hell this anonymous homunculus has been putting her through for the past few weeks, I'd be trying my best to kill them too. She's been no stranger to suffering in her life, and this, in light of her condition, has managed to top the list -- she'd likely be in better shape if it were a tumor. The possibility that she could carry this to a successful completion if she wanted to is remote.

Without getting too culture-war, I consider us fortunate to live in a polity where nobody will try to gainsay her decision, and it's been enlightening to see firsthand how narrow a window there is to make it. "Medical" rather than "surgical" abortion is only reliable up to about 10 weeks, and in her case, with a long history of chronically irregular menstruation, the first 6 weeks elapsed before she was unprecedentedly "late". With our low prior on pregnancy in light of my long-confirmed successful vasectomy, it took us another two weeks to nail down that this was actually the most likely cause of the shitshow of bizarre and disabling symptoms she was experiencing. Add one more week from there to procure the actual abortifacients, and the window had almost closed.

I'll be getting a second vasectomy, but I don't know I'll ever trust it again. Life finds a fucking way.

Several of those antisocial behavior examples you listed just seem trashy. I can respect a solid Evil Scheme executed with cunning and deceit, but stealing the snacks from the break room or pushing the limits of return policies ain't it. I imagine myself doing these things and it just feels like it would be embarrassing to stoop so low for something so trivial, and where the social risk of being caught is more "disappointment" than punishment. This is the antisociality of an animal or a machine, that doesn't even have a theory of other human minds and can't understand the disappointment when unaccompanied by punishment. It's more aesthetically depressing than morally repugnant to see this kind of behavior.

I think this is partly just Oregon being Oregon. Oregon has historically been a leader in direct democracy and ballot access (first to use ballot initiatives, first to directly elect Senators, first to use universal vote-by-mail), and as such they sometimes pass half-baked initiative policies that are unwound later (like the initiative-based supermajority requirements on local tax increases).

Fortunately, Oregon seems pretty open to actually testing policy to see how it works -- this is the state that literally A/B tested Medicaid expansion. It was also, surprisingly, the first state to roll back federal covid quarantine requirements, and kept them rolled back after seeing that they were no longer making any difference.

You may be right though that disillusionment is setting in with certain liberal policies. Oregon's green-space-preserving laws that make development outside of cities almost impossible are also coming under attack recently as the housing situation worsens. At least Oregon finally overrode labor interests and its general nanny-state tendencies enough to let residents pump their own gas.

For those here who follow the notoriously obscure Yarvin:

He has this argument that goes, as I understand it, something like "any Power that's accountable to Truth must promote lies -- putting 'scientists' (broadly construed) upstream of policy means that science gets co-opted to the goals of Power and away from the pursuit of Truth, and legitimating Power on popular consent incentivizes Power to manufacture that consent by controlling the people's minds with indoctrination. Therefore, it would be better for Truth and free thought if Power didn't have to act like it was constrained by Truth (or the consent of people who think they know Truth), and was openly free to act more arbitrarily."

But...what's the use of anyone knowing the Truth if Power can't be moved by it? And why would a Power that acts in flagrant ignorance of known Truth deserve the respect of legitimacy? And how can Power ultimately free itself enough from the constraints of Truth to not still fear it and be tempted to try to suppress its knowledge?

Maybe Yarvin thinks that under the current system, we still get Power acting in flagrant ignorance, and also it's harder to know what's True, so the least-bad development would be to "formalize" Power's freedom to act in obviously ignorant and counterproductive ways -- since Power is bound to that either way, but under the proposed alternative where Power doesn't care what anybody thinks, at least the powerless can have a better idea about the Truth...of how Power is fucking everything up?

I could take some black pill that Power is always the Power to do stupid and counterproductive shit to people just because you can, and that's the Power that's always going to be exercised over us, for various intrinsic-to-reality reasons, and our only consolation, as people in even the best possible society, is to be able to think True thoughts ineffectually.

But I don't know think that's what Yarvin is professing to offer. He talks like Power would act more sanely and productively if it were as formally-unconstrained by Truth as possible. Certainly the alternative where it doesn't act more sanely and productively hardly sounds stable -- with everyone better seeing how things could be improved through more Truthfully-guided management but dutifully resigning themselves to be subject to an openly arbitrary and capricious Power. Is he just betting it all on lucking into a short run of a few Good Emperors before it goes back to shit again?

I think I see the problem he's laying out, but I don't see how any of his solutions make sense.

> non_radical_centrist

> doesn't read much of Kulak's stuff

...fair, username checks out.

Kulak's edginess-to-insight ratio is really high, and maybe increasing lately? Contrast him with Zero HP Lovecraft, who's definitely absurdly racist, usually wrong in some way, and also has edgelord tendencies. ZHPL sort of credibly presents himself as a classic philosopher who bravely followed his quest for the wisdom to save society deep down into the blackest abysses of edginess. Kulak presents himself as a guy who wants to watch the world burn, which, to me, makes his forced edginess even more obnoxious.

Given Kulak's recent post about blonde women, I'm disappointed he passed up the opportunity to speculate here about how hundreds of generations of arranged marriage must have relaxed the selective pressures for physical attractiveness on Indians. It would be very on-brand.

What escapes me about all this: where does the moral certainty of the progressive "Modern Puritan" come from/what's it grounded in? What faith are they even evangelizing? To recall a recent topic around here, what's their answer to Nietzsche?

Most charitably we could credit them with a form of liberal humanism -- "we believe in self-actualization, and in the righteousness of removing all the oppressive obstacles to the self-actualization of others". But that seems like weak gruel for the Puritan soul. How to make an orthodoxy of human freedom? How do fanatics whip themselves into frenzies of 'you do you'? Isn't it paradoxical, even more paradoxical than a good religion needs to be?

Not to get all TLP here, but I think we can see the core progressive aesthetic as a fetishization of the self-actualizing process, a kind of social BDSM. The process is understandably more easily fetishized when it manifests in a YA novel trope of a special individual's picturesque struggle against the constraints of societal expectations than when it manifests in a more opaque internal process of self-cultivation. We're seeing now that it's also possible to fetishize an individual's righteous struggle for freedom against the constraints of personal biological reality.

It's the visible struggle against outward restraint that arouses the moral energy, and which draws focus away from the oppressed individual's goal in the struggle. The actual human victim's personal hopes and dreams -- tawdry or outright distasteful as they might be if laid out for sober scrutiny -- can be set aside during the ecstatic spectacle of liberation. But then, the goal achieved, the ropes untied, the scene completed, the post-nut clarity setting in, the unsettling condition of being reasserts after the spasm of vicarious becoming. What will the liberated do now with liberty (ever so exquisitely attained)? Do we really want to know? What, indeed, will we do with ours?

The answer, of course, is clear. Find a new character who can reenact the performance. The emptiness of freedom compels the search for fresh veins of righteous struggle. Better hope oppression is a renewable resource, or sooner or later we'll all have to stand around looking at each other's naked flabby souls in the cold light of full luxury automated gay space communism.

I'm generally not that interested in trans stuff, and haven't really talked to trans people about their subjective experiences of it, but my wife suggested an idea about it the other day that had never occurred to me: I've never heard of a pre-transition trans person express the fear of not 'passing' in the opposite direction -- e.g., a pre-transition trans man, feeling like a man in a woman's body, finds himself in the women's locker room feeling afraid that the other women will detect that he's actually a man, despite his physically gynecoid appearance. If I were to wake up and find my mind 'trapped in a woman's body', I think it would be hard to escape the 'illusion of transparency' -- I'd be paranoid that I'd be found at as not a real woman, no matter how much I looked and sounded like one, because I'm 'essentially' a man. Is this an experience that trans people report?

Why not go all the way like Canada and have MAID for drug addicts?

This feels mostly boo-outgroup. Setting aside both the moral arguments and factual issues of how Canada uses MAID, it's obvious that most of the drug addicts already have access to effective lethal injections if they wanted to use them, so the ones who are alive are probably ones who don't want help dying.

Thank you. Without being religious or a pro-lifer myself, I still hoped it would never come to this, and I did take reasonable measures to try to ensure it would not.

Not being attached to a personhood-from-conception perspective, or ever that invested in the whole controversy in general, I take the normie view of regarding abortion as unfortunate, and getting more uncomfortable with it the later it occurs. Reflecting on that in light of recent events has made me more in favor of removing as many obstacles to early abortion as possible, so it's less likely to come down to a more distasteful later procedure. It seems the more people's inputs are required to authorize it, the later the ones that do happen will happen, even if fewer happen overall. I can see though how for many people with a more "principled" stance, this would be a distinction without difference, and fewer happening overall would be the overriding consideration.

I'm still glad for her sake that there wasn't some long sequence of gatekeepers to argue with about this, having just seen the person I care most for in the world consider taking her own life to get the awfulness here to stop. Thankfully it's lessened since, with some medications that would not be safe for a fetus that we were trying to preserve.

I still find it creepy that there seem to be people who are straightforwardly pro-abortion as though it's a positive good (and those are many of the voices one encounters when actually considering having one). I kind of assume those people are just overcompensating somehow, in a "signalling support for this direction". If it's not that, I don't know where they're coming from, and probably don't want to.

Who could have guessed that a bronze age mindset had been rendered obsolete by technological advance!

I second the suggestion below to ask a dermatologist if this is actually rosacea rather than acne. Rosacea is much better known to respond to dietary triggers, including a class I forgot to mention, 'spicy' stuff -- substances that hit the TRP channels (which can include stuff that's not so obviously spicy -- even broccoli contains some AITC, which hits the TRPA1 channel, for instance -- AITC : wasabi :: capsaicin : chili peppers, and AITC : TRPA1 :: capsaicin : TRPV1).

Also rosacea may be related to the 'niacin flush', which different people have different thresholds for experiencing, and salmon is notably high in niacin. If you can get some niacin -- not niacinamide, which doesn't produce the flush -- you might be able to see if your threshold for this is unusually low.

This from the article,

[...] mere observation of any of the billions of members of other species and subspecies of human.

with accompanying graphic, reminded me of an exchange I had here last month

I've never seen the claim that different human races should be considered sub-species, at least not by anyone who isn't absurdly racist.[...]

Maybe the geneticists are just knocking down a straw man when they say humans don't have subspecies and therefore there aren't biological races of humans, but it is a thing they do. [...]

There are admittedly an handful of absurd racists out there, so at some point I think scientists do have to knock those down. [...]

So here you go, @non_radical_centrist, the subspecies take in the wild. Or was @KulakRevolt already established among the "handful of absurd racists" around here?

I don't think there's anything miraculous about the fact that as we've observed the wondrous variety of natural phenomena, it's been possible to pick out a few aspects that can be reliably approximately explained with reference to simple mathematical rules. It's just selection bias that we hype these singular aspects of nature where it does work well. The vast majority of our observational data has resisted lossless compression -- it's only reasonably predictable through extensive particular knowledge, if at all. Various non-physics authors have drawn attention to this as the "Unreasonable INeffectiveness of Mathematics" in their domains of study. I get suspicious every time somebody holds up the law of gravitation as a "representative" outcome of scientific inquiry.

This looks like it was written by someone talking slightly too much Adderall (I Can Tell by Some of the Pixels and by Having Taken Quite a Few Adderalls in My Day) and the inverted U's being drawn as normal curves when they'd make more sense as parabolas looks like a tip-off that the author is unconsciously pushing a little too hard at that satisfying feeling of fluent-compression of concepts -- but overall this seems reasonable.

My midwit slap-another-axis-on-it extension of that model would be that (for a given task context, but maybe more broadly shared between a variety of task contexts) there's something like a y-axis of "expected reward for effort" superimposed over the x-axis of exploit-explore, or "focus-divergence" (exploit-explore only trade off at a fixed level of task effort). On that graph, I think the effect of Adderall is to push up-and-left -- to increase the expected reward for exploit-effort. This is very performance-enhancing for people who need more exploit-effort, bad for people who actually need more explore-effort, and mixed for people who already have a good explore-exploit balance but just need to put in more overall effort to improve at the task.

In this model, a depressive state is one where, for almost any available task-action context, the expected reward for effort is very low -- and that's why Adderall can sometimes be a decent antidepressant. The classical hyperactive ADHD state would be higher up the y-axis but shifted way the right, while an inattentive ADHD state might not be as far shifted to the right, but lower down below the x. Each might get some benefit from Adderall pushing up-and-left, but in different ways. And of course, some people who look like any of those phenotypes might just need different task-contexts than the ones they're presented with.

I know non-24-hour sleep disorder is a real thing, but since it's most obviously a real thing for blind people, maybe among the sighted it's often something like 'idiosyncratically weak response to day/night lighting cues' -- have you really maxed out the intensity of your day/night cues? Is it as bright as possible in the day and as dark as possible in the night?

I fixed my delayed sleep phase problem (which tended toward non-24-hour during the winters) by being unreasonably aggressive about darkness in the evening. I bought a pack of rechargeable LED candles and if I use no other light source for three hours before I intend to sleep, I reliably sleep at my chosen hour, which is about 4 hours earlier than I'd tend to otherwise, and my sleep time no longer creeps later and later every day like it used to in the winter. Previous attempts at fixing this with super bright lights in the morning, or avoiding blue light in the evening, or avoiding screens in the evening, or using a 'reasonable' degree of dimming in the evenings, all failed. If my evening darkness procedure hadn't been enough, I'd have tried blackout curtains to maximize intensity of nighttime darkness.

Maybe you've already exhausted all your possible gains here, and if you lived in a tent in the woods for a week or two with no artificial lights at all you'd still not entrain with the sun -- but if you haven't tried something roughly that extreme, maybe push harder in that direction.

Been reading some Howard lately -- there's plenty more in the same vein when you run out of Conan -- but Howard's other axe-in-your-face protagonists just aren't the same. The introspective Kull, the melancholy Bran mak Morn, the borderline-unhinged Solomon Kane, the various bitter and vengeful Gaels from Black Turlogh to Donald MacDeesa, they all lack Conan's occasional gigachad jollity. They're all drawn from the same head-breaking tiger-man archetype, but the others just aren't having fun with it.

Have you watched Tartakovsky's Primal? The main characters' names are taken from the title of a Howard story, and it's turned up to 11 to the point that our hero doesn't interrupt his primitive ass-kicking with a single spoken word until the end of the first season.

Sounds like EA should work on better pain relievers so folks like you can spare their livers all those bottles of wine. But for real, is supporting the development of better pain relief an EA priority? There's interesting work to be done there, some recent progress being made on sodium channel blockers I think. On top of the whole "make everything less painful for everyone" angle, there's how most of the ongoing opioid trainwreck could have been averted if we had real painkillers that didn't require escalating doses to keep working.

Yeah I knew it could reverse itself at some point, but I really figured that at nine years post I was safe by now. I have literally seen case studies about late reversals that weren't as late as this.

lol at telling the fetus to git gud -- my wife jokes that she'd be disappointed in this kid from the start from pursuing such a dumb strategy that includes preventing her from holding down any nutrition for either of them. She also jokes that she should apologize to her own mother -- an abusive psychopath -- for having put her through any fraction of this misery as a fetus (she didn't put her mom through anything like this though -- if she'd been a difficult pregnancy, her mom would have absolutely blamed her for it, and in reality she just blamed her for the associated weight gain).

I don't believe they actually did anything wrong -- it did provably work at the time, and continued to work for many years afterward. They performed the procedure about as aggressively as possible -- this was not one of the "open ended" vasectomies that may have a greater probability of recanalization, they definitely clamped and possibly cauterized both ends of the snipped tubes, and I think they removed a pretty long section in between. The guy was really serious about how he was optimizing for efficacy over potential voluntary reversibility.

I'm guessing this freaky occurrence is partly a result of my having it done younger than most men, which means I probably had more regenerative capacity and also a longer window of potential failure while my partner is still fertile. 40-year-old dudes with 40-year-old wives getting vasectomies after their third child or whatever are unlikely to notice if their procedure reverses itself in ten years, cause no pregnancy will likely result anyway.

It looks like it took the police killing at least 6k people, possibly up 12k or even higher, to reduce the number of murders over that period by ~15k cumulatively. Probably a fair bit of "substitution" there, assuming drug gangsters were murdering each other at high rates before -- some of this must be criminal-on-criminal killings being replaced by cop-on-criminal killings. Still, it does look like it was plausibly a net win on that measure -- have to be believe at least that police killings were better targeted at criminal elements than the background murders were. And it sounds like Filipinos broadly supported the effort. Still not sure how much it cut down on the actual drug use, but cutting down on the associated crimes is probably more important.

El Salvador, yeah there it does sound like they made big gains with locking up all the gangsters, don't know if they had to kill a lot of people to do that, or if US accusations that Bukele cut deals gang leaders are true. Easier to know who to go after in a place where the criminals are basically tattooing their criminal affiliations on their faces.

I don't really know about this fuzzier sense of "seeking death". Maybe that is what some of them are doing. Speaking as guy who fully expects to take his eventual death into his own hands but doesn't expect to ever abuse opioids, it's not what I would do if I were seeking death, but I can see how it could be that way for some. Certainly it's not a thing to do if you're unwilling to risk death. Regardless, I don't think most of the ones who are alive are seeking death in the immediate sense -- the sense in which they would actually choose to make use of a MAID kit if it were offered to them.

I grant there's not a bright line between

(1) "refrain from taking away the means for people to kill themselves"

(2) "actively give people the means to kill themselves",

(3) "kill people at their request",

(4) "kill people people at your discretion"

It's appealing to try to erect a fence between (1) and (2), which separates decriminalization of potentially lethal drugs from MAID. A fence between (1) and (2) looks like making it generally permissible to possess but not to distribute. But of course this runs into problems with the presumption of "intent to distribute", and with the substantial overlap between users and distributors.

Personally, I don't care so much if people who want to die actually do so, and don't believe it's possible or desirable to spend a lot of effort to prevent this in general. It is worth spending effort to make people less inclined to self-destruction in the first place, and maybe keeping them from initially getting their hands on substances that set them off down the spiral is an important part of that. Ultimately I just don't know enough about why these people are abusing these drugs in the first place -- hard to believe it's that they don't know what road they're stepping into when they start.

I suspect the root of the problem is that we don't know how to build the "rat park" mentioned elsewhere in this thread, neither can we actually stop the movement of the fentanyl, so none of this going to get "solved" in any way that doesn't look like brutally grinding a bunch of unfortunates under society's heel. It's not surprising that this is unpalatable enough for people to try just looking the other way.

Worth the Candle is unique and memorable, sometimes frustratingly uneven but hard to put down. Much of the kitchen sink world building fell flat for me (but there are some striking inventions); sometimes the story drags (but it rarely feels like the author is losing his grasp on it); some of the characters have odd motivations and aren't especially likeable (but they're consistently and characteristically odd, and their dynamics with each other are well developed, with moments of surprising insight); in all, it's rarely missing on every aspect at the same time, so there's almost always something to keep pulling you along. And the prose is workmanlike throughout, which is saying something because the book just does. not. end. Even the end isn't the end, but if you're still with it by then you won't mind. As the only LitRPG I've read, I can't say with authority that it's way better crafted than most of the genre, but that's certainly the impression I get secondhand, despite it being a Door-Stopping Work of Staggering Self-Indulgence.

There's no evidence for it, given there's no longer any doubt that I could have put this thing there.