> "And so we wait to see what amount of death will be tolerable in America as the price of retaining prohibition. Is it 100,000 deaths a year? More? At what point does a medical emergency actually provoke a government response that takes mass death seriously? Imagine a terror attack that killed over 40,000 people. Imagine a new virus that threatened to kill 52,000 Americans this year. Wouldn’t any government make it the top priority before any other?"
This is a very good point and really puts it into perspective. Overall this is an excellent essay. I also really like how he addresses the physical affects of opioids, rather than just saying it gets you "high".
In the grand scheme of things, 100,000 deaths is a non-event for a government representing over 300,000,000 constituents. Almost 6 times that many people die from both cancer and heart disease each year. Where it becomes a problem for governments is when there's bad PR. They focus their attention on terrorism because it commands the national attention, not because it's a significant threat. While the abuse of opioids is no doubt a problem, it's getting government attention now because of media scrutiny, not because it absolutely needs to be solved by government.
Humans are terrible at estimating risk. We seem to do it by attributing it to the ease which we can recall an incidence of something similar happening. This may have worked well when we were part of small tribes, but it's terribly adapted to a world where every unusual, capricious event is is broadcast nationally and the mundane, common dangers receive very little media attention.
You can see this with the current debate over guns. Now I favor the liberal position of drastically increasing gun control, but only around 11,000 people are murdered with guns each year and another 22,000 or so kill themselves. That's around a 1/30,000 chance of being the victim of gun violence. Those deaths may be largely unnecessary, but we should still have the perspective to realize that they're not a significant threat to our health.
In America, the distribution of deaths has an (at least) equally significant effect as the number of deaths, at least up to a point where the number gets particularly huge.
The distribution effect is often ignored by non-US reporting about various "social maladies" (stupid term, but gets the idea across) in the country: the US is surprisingly internally divided not just in politics, but in empathy. There's often a nation-tribalist effect of "people are dying not in my (city|town|state|area|demographic|politcal party); I consider those deaths sad, but no sadder than someone dying in another country", which I think is important and often overlooked.
It's actually a foolish quote. What can the government do in the face of tens of thousands of people essentially choosing to kill themselves? It could jail them, but our culture is moving towards one where doing that to drug users is frowned upon. So what option does it have?
Putting the onus on the government to solve this problem goes against the very essence of this piece. If social fragmentation is truly the cause of the opioid crisis, then government intervention will by like putting a mud wall in front of a raging river.
Do you intend to say that the Scandinavian countries' deliberate policies against social fragmentation since about 1950 haven't had any effect? Or that they wouldn't have any effect elsewhere? Or that they don't exist?
Scandinavian countries don't have social fragmentation on the scale of the US because they are not the US. Not nearly as diverse, or large. They have much more history and common ancestry and culture and community. There is very little of use that can be gained from comparing Scandinavian countries to the US.
It’s not clear to me that’s true. What is clear is that I don’t know any US governments willing to test it, because they think they already know what addiction is.
Which parts of GP aren't clearly true? That those countries are smaller, more homogenous, have much more history and common ancestry and culture and community than the US, which is often literally called the "melting pot" [of immigrants from varied backgrounds]?
Not referring to that (which is true), but referring to the next idea that being a melting pot precludes social intervention strategies that treat addiction as a mental health problem instead of a crime, implied by “There is very little of use that can be gained from comparing Scandinavian countries to the US”
That I’m not sure is true, in fact I’m pretty sure it’s false.
Edit: I mean, further up the chain we are saying this method is partly inspired by studying rats! Because Scandinavia has a more homogenous culture we’re too different to learn anything? But Scandinavia can learn from rats?
What's not true is his synecdoche. He says they are more X, Y and Z, but then he slides eloquently to assume that they always were and that the degree of difference always was significant.
Except the article mentions successful approaches to reducing the problem other governments have used, so I don’t know, maybe read the article?
One of the few proven ways to reduce overdose deaths is to establish supervised injection sites that eventually wean users off the hard stuff while steering them into counseling, safe housing, and job training.
After the first injection site in North America opened in Vancouver, deaths from heroin overdoses plunged by 35 percent. In Switzerland, where such sites operate nationwide, overdose deaths have been cut in half. By treating the addicted as human beings with dignity rather than as losers and criminals who have ostracized themselves, these programs have coaxed many away from the cliff face of extinction toward a more productive life.
This is a very good point and really puts it into perspective. Overall this is an excellent essay. I also really like how he addresses the physical affects of opioids, rather than just saying it gets you "high".