26 points

This has been posted to a bunch of different communities, and I’m gonna be a stick in the mud each time.

I’m a process chemist. I do this for a living. I’ve made kilo-scale batches of pharmaceuticals at work that have gone through the regulatory process and made it into people. I went to school for ten years to do this.

This is a colossally dangerous thing.

Every time you run a chemical synthesis, you generate impurities. Slightly different temperatures, concentrations, reagent quality, and a million other things will vary the identities and concentrations of those impurities in your product.

The nature of biochemistry is that most compounds, even at very small concentrations, can have effects. Usually bad ones. So drugs have tight specs on how much of each potential impurity can be present. Usually it’s in the 0.1% range, but sometimes a lot lower.

Detection of impurities at that level cannot be done with ‘hacker’ gear in your garage. So if you do this, you’re going to be taking unknown quantities of unknown impurities.

There are trade-offs. If you’re definitely gonna die without the medicine, then the worst that can happen is you die faster, or more painfully. If it’s medicine to maintain quality of life, then you might die fast and painfully.

I’m not saying the current system is good at all. Medicine is too expensive. It shouldn’t be limited by right wing nutjobs. Those things are true. Those things require a solution.

This is not a good solution.

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7 points

I appreciate your warning, and would like to echo it, from a safety perspective.

I would also like to point out that we should be approaching this, as every risk, from a harm reduction standpoint. A drug with impurities that could save your life or prevent serious harm is better than no drug and death. People need to be empowered to make the best decisions they can, given the available resources and education.

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3 points

make the best decisions they can

I would recommend an HPLC and a competent analytical chemist to gather data and decide whether or not a batch is safe to consume.

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5 points

That scares me greatly but I can’t just stop taking my medicine, so what can I do but accept the risk?

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4 points
*

It seems ostensibly like it would be as easy as having an understanding enough of e.g. distilling, so that if you try to distill your own spirits, you know to discard the head and tail to avoid methanol poisoning. But this is so much more complex than that.

I think what it feels like is something akin to being trans and not having access to HRT, so you get hormones on the black market vs. trying to synthesize the hormones yourself from raw materials. I would support the former (though with a lot of research and making sure you’re getting reputable supplies), but think the latter incredibly fraught for a layperson.

I think the real answer isn’t DIY pharmaceuticals, but rather universal healthcare, informed consent, and a medical system (both physicians and pharmaceutical manufacturers) that puts patient care above any kind of profit motive

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4 points

I think the real answer isn’t DIY pharmaceuticals, but rather universal healthcare, informed consent, and a medical system (both physicians and pharmaceutical manufacturers) that puts patient care above any kind of profit motive

I think just about everyone here agrees. But the question is what to do until that becomes available. We need something in the interim; dangerous as this all is, I can’t find it in me to shun it when the alternative is letting people suffer without access to anything as they desperately wait for a better society to emerge in some unknowable, possibly distant future.

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1 point

What can be used to detect impurities at those level? Maybe there is an additional machine needed that can also be built in a garage.

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2 points

The industry standard is HPLC (high performance liquid chromatography). Those things go for tens of thousands of dollars up front, plus maintenance and consumables.

If there was a less costly way of doing it, you bet companies would have settled on that by now.

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10 points

Just the thought of DIY medicine scares me, and honestly, it’s sad that such a thing has to exist.

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8 points

I would gladly go to a doctor and have my issues dealt with if I could.

I have good insurance.

I have money, although not a lot, but enough to go to the goddamn hospital.

Every time I go to the hospital with a complaint, they basically told me it’s all in my head and send me on my way without running any diagnostic tests, analyzing the specific issues that I’m talking about, or finding out any more information than whether or not I have insurance.

Then when it’s all said and done, I get a bill for $1,000.

This has happened to me the last three times I went to the doctor.

I have nodules in my throat. I have giant lumps under my skin, my urine smells like maple syrup even though my blood sugar is Rock fucking solid. I have issues with losing weight that aren’t directly related to my diet.

I have depression, I have skin issues with fucking eczema that do not respond to any over-the-counter treatment. I have a deviated septum. My xiphoid process is literally broken and free-floating in my chest. My coccyx is the size of a fucking grape.

I have an entire litany of issues and I have told multiple doctors about this in person and asked for help and assistance, and not once has a single doctor ever offered to do so much as draw my fucking blood for a test.

If I do not DIY my own medicine I cannot receive treatment for any of my issues. No matter how many times I have asked for help, my pleas for help have always been ignored and I’ve been charged $1,000 for them on top of insurance three different times.

If you know how to fix this where I can get qualified competent medical assistance with my issues before they snowball together and murder me, please tell me how because I cannot solve this.

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7 points

If you know how to fix this where I can get qualified competent medical assistance with my issues before they snowball together and murder me, please tell me how because I cannot solve this.

I wish I did, man.

Stories like yours are what I think of every time someone tries to tell me we have “access” to health care, when the reality is we were all sold as a commodity to the health industry by people we elected to protect us.

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3 points

I’m sorry to hear that. I’m just grabbing this out of thin air, but have you ever considered medical tourism?

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4 points

Yep. I have been working on that for my next vacation, get an MRI and some actual diagnoses to bring to my PCP so that they’ll actually do something.

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7 points

(Disclaimer: haven’t read the article yet, definitely going to get to it later today.)

This is kind of thing where I am so torn between philosophy and pragmatism.

  1. Morally, bodily autonomy is very important. Framing this as “right to repair for your own body” is a fascinating way of thinking about it, and makes a clear, ethical argument in favor or DIY medicine. And that’s on top of the fact that we shouldn’t have to rely on giant corporations for our health.
  2. The potential consequences of this are terrifying, not just for misinformed people, but their children as well.

On a meta note, 404media continues to be the best subscription I’ve ever paid for.

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