this post was submitted on 09 Dec 2025
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I know this question is odd, but unfortunately we have a lot of unhoused addicted people in my city. I often see them sitting on a bench bent at the waist in half like a rag doll, or standing somewhere half bent over, like stooped over nodding out I guess? I don't really know anything about substance use, but it's such a strange sight, what substances cause them to bend over like this?

Poor souls. The mayors of big cities here have asked the provincial government to declare a state of emergency due to homelessness and addiction being so rampant, but Doug Ford doesn't give a shit about them.

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[–] Apytele@sh.itjust.works 41 points 4 days ago* (last edited 4 days ago) (1 children)

It's the fent fold / bent / drop / lean. Most likely fentanyl or carfentanyl, but almost definitely some kind of opiate (of which they're the most potent). Some of it might be neuromuscular / specifically opiate related but there's also just the practicality of it. The drug might be cut / mixed with another sedative for potency such as a benzo or barbiturate, but it also might be mixed with with a stimulant such as methamphetamine or cocaine to counteract the sedation.

You'd want to counteract the sedation either to increase enjoyment (similarly to the relaxed buzz of a caffeinated alcoholic beverage) or because they feel too much distress from being sober / unsedated but also know that they're in an unsafe area to be sedated. Even if it's not cut with a stimulant they may still be forcing themselves to stay awake either because they know they've taken enough that they might stop breathing, or because, as I said, they know they'll get mugged or otherwise attacked if they relax into the high.

Being homeless / generally in poverty is often too emotionally stressful to tolerate sober, but too unsafe to be navigated zonked, so they just put themselves into a never sleeping but never really awake haze until they either intentionally or unintentionally die or almost die or experience psychosis, in which case they either go to a morgue or to meet up with me on the psych unit.

[–] mech@feddit.org 14 points 4 days ago (3 children)

That sounds like actual hell.

[–] Apytele@sh.itjust.works 13 points 4 days ago* (last edited 3 days ago)

Just because it would be a significant change to the comment you upvoted:

We had a patient who was consistently verbally abusive and otherwise unpleasant during a long stay and completed after discharge and the most emotion I could summon was a melancholic relief that their pain had ended. We did not have the resources they truly needed and neither did anyone else. They were so deep in that despite being cognitively intact they were unable to meaningfully interact with anyone socially.

They would have needed extensive social support and interpersonal skill building to be properly rehabilitated and nobody does that. Most of what we do for that type of patient is to get them sober and give them a second chance to seek help. Even that takes a lot of resources so we don't really have the resources to do more than point them in the right direction if we can even find a decent place for them to go. Many get sobered up and discharged to the bus stop with a month of pills and directions to a shelter that's probably at capacity.

That was this person's only way out and I honestly respect their decision. At this point I've contented myself with caring for homeless people who are faking or exaggerating suicidal ideation of psychosis for 3 hots and a cot. Some of them are obvious but ultimately I don't want to be responsible for deciding who is and who isn't, and the deeper truth is that I'd probably do it too. And 3 hots and a cot is more and better care than I could give them pretty much anywhere else in this current system.

[–] Apytele@sh.itjust.works 12 points 4 days ago* (last edited 4 days ago)

An inability to cope with people who don't get it and don't care to is a significant part of my social isolation.

[–] DarkSpectrum@lemmy.world 4 points 4 days ago (1 children)

Theres only one way to find out and there aint no ctrl-z

[–] jerkface@lemmy.ca 4 points 4 days ago* (last edited 4 days ago)

It sounds like you think these people are homeless because they are addicts, but it is the other way around. Taking fent or even becoming addicted won't turn you into a homeless person living in hell.

[–] FatVegan@leminal.space 75 points 5 days ago (2 children)

There is a thing called "fentanyl fold", when fent users bend over at the waist. So my guess would unfortunately be fentanyl

[–] ultranaut@lemmy.world 55 points 5 days ago (3 children)

It's not just fentanyl, it's opioids in general. Junkies have been doing this long before fentanyl was available.

[–] FatVegan@leminal.space 20 points 5 days ago

True, but fentanyl is really popular right now.

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[–] BonesOfTheMoon@lemmy.world 45 points 5 days ago (1 children)

Ohhhhh! I didn't know that was a thing! Thank you. Fentanyl is a real problem here so of course that would be it.

These poor people. It's absolutely dreadful what's happening.

[–] JoeBigelow@lemmy.ca 39 points 5 days ago (1 children)

It's refreshing to find somebody with even an ounce of compassion for those folks, let alone the genuine care you have. Thanks for caring.

[–] BonesOfTheMoon@lemmy.world 17 points 4 days ago (1 children)

I really do. It's terrible. I acknowledge that there is a public nuisance and safety aspect that they bring to the community because of addiction and why people on the other side get frustrated by it, but nobody goes out in life and thinks "I'll be a homeless drug addict, that's the way to live". It's a product of multiple factors, poverty, etc. And it's absolutely terrible to try and get clean off substances, especially when you have no home to go to when you're done.

This is what happens when you have conservative governments. They're absolutely fine letting these poor people rot.

[–] BarneyPiccolo@lemmy.today 3 points 4 days ago (1 children)

That sounds a lot like empathy, and there's an Executive Order that prohibits that. Off to an El Salvador torture prison with you.

[–] BonesOfTheMoon@lemmy.world 1 points 2 days ago (1 children)

I'm just a bleeding heart lefty I guess. Thankfully I'm Canadian.

[–] BarneyPiccolo@lemmy.today 2 points 2 days ago

Thankfully I'm Canadian

For now. -MAGA

[–] evergreen@lemmy.world 61 points 5 days ago* (last edited 5 days ago) (4 children)

It is most likely Fentanyl, or some other form of opiate. Prolonged abuse causes them to lose control of their muscles around their core and this is the result.

I used to work near a hot spot for homelessness and drug use in San Francisco and witnessed it everyday. The things these people go through with that addiction are downright horrendous and the "Fentanyl Fold" or "Fent Bent" is actually one of the lesser symptoms. The skin infections, kidney problems, and digestive issues can become pretty severe. I've seen quite a few screaming in agony because their kidneys are messed up and they can't urinate. People with infected swollen hands or feet. You can literally smell them rotting. Too much to list here honestly. It is a terrible drug that does permanent damage to people at best, and is just a slow agonizing death at worst.

[–] Dasus@lemmy.world 25 points 4 days ago* (last edited 4 days ago) (4 children)

Casual reminder that the Sackler family pretty much single-handedly manufactured the American opioid-crisis.

Dopesick this is basically as much of a documentary as "Chernobyl" was. Highly based in real events, but still a dramatizatio so not everything is 100% accurate, but the large lines are.

Sure opioids get used a bit elsewhere as well but I live in the worst part of my city and while there is opioid abuse in Finland, it's mostly "just" buprenorphin addicts. Buprenorphin is to fentanyl what hard cider is to moonshine, more or less. Yes you can technically kill yourself with both and definitely have a problem with the substance and ruin your life, but the stronger one seems to do that quite a bit more.

bits of Richard Sackler's actual deposition, acted out by your choice of the following: Bryan Kranston, Michael Keaton, Richard Kind and Michael K. Williams

[–] evergreen@lemmy.world 2 points 3 days ago (1 children)

"Yes you can technically kill yourself with both and definitely have a problem with the substance and ruin your life, but the stronger one seems to do that quite a bit more."

100% agree. This is a huge part of the issue that I feel many people just don't get. 3mg of this stuff is enough to kill an average sized adult male. That would easily fit under your fingernail with room to spare. 50 - 100 times more potent than morphine. Pretty crazy.

Interesting about buprenorphin in Finland, I had never heard of it. Is it a recent thing there?

[–] Dasus@lemmy.world 1 points 3 days ago

Interesting about buprenorphin in Finland, I had never heard of it. Is it a recent thing there?

Depends on how you define recent I think, but in most senses of the word, no, not that recent.

We had a bit of a heroin problem in the 90's apparently (I wasn't yet in any sort of drug rings as a kid so wouldn't know myself) and the legend is that actual organised crime in Finland got fed up with heroin and the decided it won't be sold in Finland anymore. There still is heroin definitely but it's genuinely fucking rare, especially compared to weed, speed, lsd, etc.

An definitely subutex, which is the buprenorphin. It's only a partial agonist and there's narcan in it as well, so it's impossible/extremely hard to od on it fatally.

In France they cost like 1e a pill here you can sell them for 80. Then you see oxys being sold sometimes, they go for about 1e/mg, so if you buy a mild 10mg it's a tenner but an 80mg pill would be 80e.

The bupre junkies do get nasty though in health and share needles and all that is still a risk for them, but they won't accidentally od unlike someone shooting up heroin or fentanyl

Some of them made movie about their life. Then like 6 years later the "protagonist" of that movie was found dead hanging by an extension cord somewhere in Thailand. Suicide or drug debt no-one knows.

If you don't like seeing people actually inject themselves, with all the "reversing" as well (idk what the term is in English, but junkies sometimes draw back on the needle, so blood shoots back to the syringe and then push again, to flush every little bit of the drug from the syringe).

Reindeerspotting - Escape from Santaland 2010

This documentary tells the story of Jani, a 19-year-old drug addict living on social welfare among with his friends. Tired of his life in a remote city in Rovaniemi, he decides to travel by train to various parts of Europe ...

[–] lechekaflan@lemmy.world 6 points 4 days ago* (last edited 4 days ago) (5 children)

Sacklers. Just as the worst as cocaine cartels. Their properties should be expropriated to destroy fentanyl, and those bastards should be in supermax.

[–] Apytele@sh.itjust.works 10 points 4 days ago* (last edited 4 days ago) (3 children)

I'm actually pretty pissed off that people are trying to take fentanyl off the market completely. It needs to be a highly controlled substance but to take it away from the burn ICUs and hospice units is wildly inhumane.

[–] krooklochurm@lemmy.ca 10 points 4 days ago

The supply of fentanyl out there isn't coming from legitimate use. It's all from overseas labs. So taking the legal stuff off the market would be a mistake.

[–] evergreen@lemmy.world 2 points 3 days ago

Agree 100%. In a controlled setting it is a highly effective drug and a legitimate advancement for healthcare.

[–] Cethin@lemmy.zip 4 points 4 days ago (3 children)

Honestly, in my opinion, even the "illegal" use should be legal. I'm not a drug addict (besides caffeine), but I have a very progressive opinion of drugs. People are going to use them whether it's legal or not. All that making it illegal does is pushes it into the shadows. Instead we should be providing education and testing, and helping people who choose (or have gotten stuck) using the drug to use it safely.

Fentanyl isn't evil. It's just a particularly strong opiate. It has the potential to at least be a cheaper option for people using opiates to self medicate, and, at least with testing kits, they could get whatever fix they want more safely. The biggest issue with fentanyl is that other drugs are laced with it, and you don't know what, or how much, you're getting.

[–] Apytele@sh.itjust.works 7 points 4 days ago* (last edited 4 days ago)

Yah NIMBYs really don't seem to understand that their neighborhood almost definitely already has a safe consumption site for one of the most addictive and dangerous drugs known to man. While opiate withdrawl can have fatal side effects, withdrawal from this drug can actually kill a person outright with nervous system dysfunction and continuous seizures until the person suffocates. And these locations actually distribute the drug in addition to supervising it's use. We call them "bars."

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[–] BonesOfTheMoon@lemmy.world 10 points 4 days ago (1 children)

I was downtown today and saw at least 6 people doing it. It's just infected everything in the city, not just the people who are addicted and suffering, but the public nuisance and safety aspect because of them too. The library today felt so sketchy.

My neighbour who works downtown told me she flat out hates them, she goes outside to smoke and they're screaming at her to give them one and threatening her when she says no. It's terrible on both sides.

[–] evergreen@lemmy.world 3 points 4 days ago (1 children)

I had 3 coworkers who were chased and threatened on different occasions, luckily nobody was harmed. One barely made it into the building before the guy chasing him could reach him. He quit like a month later, sucks. It is a sanitary and public safety hazard for sure. Everyone on all sides here just loses. Except for the dealers and manufacturers I guess?

[–] Candice_the_elephant@lemmy.world 3 points 4 days ago (2 children)

Well if we treated it as a public health issues rather than a law enforcement issue, the addicts could get the help & support they need and being a public nuisance would drop right off.

[–] evergreen@lemmy.world 2 points 3 days ago

I don't know about other cities, but here in San Francisco it is mostly treated as a public health issue. Users are not arrested or penalized. There are many treatment centers, shelters, clean injection sites etc. The help and support is definitely available but the public nuisance definitely does not just drop right off.

The problem that I see here is that there are people who are just too far gone to help due to the destruction Fentanyl causes. They will likely require fulltime care or stwardship for the rest of their lives. Many outright just refuse any help. Many go right back to using again after treatment because it's all they know. I've spoken with a few that straight up told me they don't care if they die doing this. While sad, it is their right to slowly kill themselves if they want I guess, but meanwhile they're sprawled out on the sidewalk covered in their own diarrhea with everyone one else having to walk in the bike lane to avoid them. Society as a whole is losing here. Since 2023 about 1.5 people are known to die from Fentanyl per day in this city.

San Francisco deals with more than its fair share because people come here from across the country due to the mild climate and many services available, so maybe all of our facilities are just overloaded. Perhaps they are also I'll equipped to deal with something like this because the physical and mental destruction that Fentanyl causes is just so severe. It's not like the common drugs of the past.

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[–] mojofrododojo@lemmy.world 8 points 4 days ago (1 children)

Fentanyl Fold

saw a guy stumble into traffic bent over like this. they're just conscious enough to stay upright but have no idea where the fuck they are or what's happening around them. shit is horrible.

[–] evergreen@lemmy.world 4 points 4 days ago

Yeah that's another part of it. It seems like their higher mind is basically gone and the body is just on some sort of crippled autopilot. Basically zombies. I've called the city's crisis response team numerous times for the ones that start going into traffic. They're pretty effective at least for helping the ones that are in immediate physical danger.

[–] fizzle@quokk.au 9 points 4 days ago

God that sounds horrific. I had no idea.

[–] LyD@lemmy.ca 23 points 4 days ago* (last edited 4 days ago) (1 children)

I have a distressing memory about this from a party I went to a couple of years ago. It was mostly people in their mid 20s. One of the people I talked to was a 27 year old girl who was really into indie games. I handed her my phone with my Steam library and we chatted for 20 minutes about the games we'd been playing as she scrolled through it.

Later in the night I found her standing slumped over in the hallway. I didn't recognize what was happening and I got very worried. I asked "excuse me, excuse me, are you okay??"

Still folded over, she cocked her head up to look at me. The expression on her face was somewhere between dazed and starry-eyed. She said "YOU'RE BEAUTIFUL", reached her arms up and tried to grab my face. I ducked out of the way and left.

Someone told me that she got like that at every party.

The memory is seared into my brain. I still think about it and worry about her. I've seen fent folding in unhoused people before, but seeing it happen to someone I never would have expected really got to me.

[–] BonesOfTheMoon@lemmy.world 5 points 4 days ago

Ooh that's awful.

[–] Nemo@slrpnk.net 27 points 5 days ago (1 children)

Heroin or other opioids. It's a problem where I live, too.

[–] BonesOfTheMoon@lemmy.world 17 points 5 days ago

Aww. It's so terrible to see them this way, especially because it's been an exceptionally cold December.

[–] DarrinBrunner@lemmy.world 23 points 5 days ago (3 children)

Fentanyl Fold

Research has not yet pinpointed what exactly causes the fenty fold, as fentanyl use is not known to directly affect the spine. Instead, it’s becoming clear that it is a neuromuscular side effect of synthetic opioids like fentanyl. Studies from the Journal of Applied Physiology and the Harm Reduction Journal highlighted similar findings that fentanyl use can lead to severe and widespread muscle rigidity, particularly in the trunk muscles, which restricts respiration and affects posture and mobility.

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[–] bran_buckler@lemmy.world 15 points 5 days ago (2 children)

I’ve known it as the heroin nod, where they are literally falling asleep on their feet.

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[–] ohlaph@lemmy.world 11 points 5 days ago (1 children)

I heard they stand to try to stay awake and not sleep through their high, but I could be wrong.

[–] BonesOfTheMoon@lemmy.world 13 points 5 days ago (2 children)

It's apparently a neuromuscular reaction to the drug in the spine. Called the fentanyl fold, someone told me in another comment. I wonder what the long term damage neurologically is.

[–] snoons@lemmy.ca 9 points 5 days ago* (last edited 5 days ago)

It reminds me of a condition owls get sometimes where certain muscles in their neck become overstressed and can't be used, so you have an owl that can't stand straight. The way to treat it is a full body cast so the muscles can relax. (IIRC)

Like this i gess :D

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[–] Bristlecone@lemmy.world 9 points 5 days ago (1 children)

I've heard it called the "lean" locally. I've been told it's from Heroin. Seems Fentanyl is also a contributor

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[–] SoftestSapphic@lemmy.world 7 points 5 days ago* (last edited 5 days ago)

Thats the fent zombie bow

They're in another world

[–] Supervisor194@lemmy.world 6 points 5 days ago (1 children)

Not mentioned here but there was some other drug, a tranquilizer called xylazine that was being used to cut fentanyl that I heard was largely to blame.

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