I presume the main reason for the controversy is the prevailing dogma "Drugs are evil".
This dogma has been used to enact countless bills of legislation in most rich countries, which in turn have encumbered the justice and police system, which in turn have put thousands upon thousands of people into to the
correctional system for years.
After all that busywork, lives destroyed and taxpayer money wasted, it is really hard to suddenly jump ship and say "Nah, you know what... after all these lives destroyed and billions of tax money spent ... you know, we were wrong, let's rethink this".
Drug abuse should be handled as a public health issue, not a criminal issue. And it takes time and effort to rebalance the current status quo to a more humane and sane approach.
This vox article discsusses the political history of war on drugs:
I would argue it goes beyond "drugs are evil" for many people and is more of a vestige of the country's backwards puritanical past. It has little to do with medicine and is more closely related to the idea that pleasure is wrong and pulls one away from devotion to the church, tithing, etc. If presented with a hypothetical recreational drug with no side effects, people with this perspective will immediately say it should be banned, or that taking it would be morally wrong. As long as people can derive enjoyment, even as a side effect, they will oppose. This is the ideological appeal used by them pharma industry to, for example, highly process medicinal Marijuana products to ensure no one might inadvertently enjoy them.
Blaming puritanical opposition to fun seems like a 'just so' narrative that fits some of the apparent facts, but is contradicted by others. For instance, American culture glorifies caffeine, particularly coca cola which is portrayed in corporate propaganda as a 'fun' drink. When it comes to commercial products like that, there seems to be no hint of an anti-fun bias, ...except perhaps in the Mormons.
While anti-fun attitudes probably play some role, I think it mostly comes down to a pro-productivity mindset. Caffeine is generally understood to enhance productivity, and for that reason may as well be a revered god in the American pantheon. Alcohol is borderline; it's a known quantity that generally seems to leave productivity intact except in cases of alcoholism (alcoholism is consequently seen as shameful). Alcohol bans have been attempted, and are still intact today in remote regions of Alaska where the productivity impairment alcohol induces is seen as a particularly concerning matter. Cannabis remains maligned because it's seen as making people lazy and content, not because it might be fun. And amphetamines are legalized in circumstances where doctors say it will cure productivity impairing disorders.
The Prohibition was driven primarily by organizations like the Methodist Church and the Anti-Saloon League which were explicit about their religious convictions so it's hard to argue that it's just a "just so" story.
Prohibition was also advanced by suffragettes who were tired of being beaten by drunk men. The truth is multifaceted. As I said, anti-fun was probably part of it, but taking that kernel of truth as a simple narrative is misguided.
Furthermore anti-fun is not the sole religious motivation in play. Puritanism / American protestantism is also associated with the glorification of productivity that I describe above.
That fact provides a crucial context. It's easy to come away with the narrative that Prohibition failed so people just gave up. It also coincides with women achieving a lot more political and power, which gave them more options for getting away from abusive alcoholics. That played at least some part in the end of the drive to eliminate alcohol.
You bring another good angle, but you also seem to dismiss the OPs seemingly good angle as well. In my opinion, both of those are probably a part of it, there's a lot of people in a country, not everyone will justify their feelings the same way. It's very possible some are opposed due to puritanism, and some are due to impact on social productivity, and some on both, and some others on completely other basis.
We could have some survey based study that tries to ask respondent questions whose answer could maybe begin to give us a little understanding of how much each of these angle might be at play in a given population. That would already avoid a lot of this "I think" "You think" debate.
I think alcohol fits into the puritanical framework pretty well actually. hangovers are built-in retribution for people who consume to excess. I suspect puritan types find it particularly upsetting when drugs do not punish their users the next morning.
I suppose, though alcohol seems most fun when consumed in moderation, which avoids the hangover, avoids (major) productivity impairment, and is encouraged by our culture.
>I presume the main reason for the controversy is the prevailing dogma "Drugs are evil".
Eh, I think this is too dismissive of some pretty deep ethical and philosophical considerations. Effectively they are giving drugs that alter ones perception of reality and then judging their effectiveness on the patients perspective. But since they alter their perception of reality it's tough to rely on patient reports.
Anecdotally speaking, there's a lot of people in this world that think drugs make their lives better when an objective observer would pretty strongly disagree. That raises a lot of difficult questions. Most notably, do we give someone a drug that will make their life worse but also make them think their life is better.
It seems that as we live in a classically liberal society, we treat other adults' right to make what look to us like bad choices as absolute. Anything that changes our fellow man's perception of reality complicates the matter because we're no longer sure it's 'them' making the decision.
Did any of your anecdotal cases have terminal cancer? And did they take the drugs in a professional therapeutic context?
In a medical context, we can evaluate this as objectively as we evaluate painkillers or antidepressants. We can use our normal tests for anxiety and depression, run studies where we watch outcomes, etc. From what I've seen, the effects have been very positive for these patients.
My aunt died of cancer a couple of years ago. She took an unorthodox treatment of extremely high doses of marijuana, which her husband encouraged. It was frustrating for the rest of the family since it was impossible to have a coherent and meaningful conversation with her in her final months. My dad and I had some doubt about it, but the decision was entirely in the hands of her husband because she was too inebriated to think for herself. I’m not saying it was a wrong choice necessarily, but there are downsides.
Cancer is just a bad illness. I too have had the experience of trying to interact with family members in the terminal stages. Neither of them were using marijuana, and they were often not coherent (when they were even awake).
Not to diminish your grief, but your aunt might not have been any more available if she had been using other pain management methods. It's just a terrible, overwhelming thing to happen to the body, and it saps a huge amount of the sufferer's energy.
Unfortunately, there has been quite a few deaths in my family in the last decade, and most were on some form of pain management. They weren't always lucid, but none were as perpetually loopy as my aunt was in the last few months of her life. Someone in the forum accused me of being self-centered for simply mentioning this, but her incoherence did add to my, and particularly, my father's (her brother) grief.
How so? I was respectful of her decision -- although I suspect it was more her husband's decision -- but I wouldn't have made the same myself. It seemed like there was a lot she had to say, but couldn't in that state due to the drug. I suppose she thought she was making sense, but objectively wasn't.
You say you respect her decision, but then in the same breadth go on to say you think it wasn't her decision at all. You've written much in this thread to strangers on the internet about how you believe it was a wrong decision. You have a peculiar way of respecting others' opinions.
My aunt passed away a few years ago now. Her husband will never read this. The rest of the family agrees with me as far as I know. I don't see who I'm disrespecting by publicly and semi-anonymously questioning those decisions in retrospect.
Maybe cancer was giving her bigger challenges to deal with than making sense to you which lead to extreme measures like high drug doses (chemotherapy, marijuana, opioids).
To me it sounds like complaining that your friend with cancer is objectively a worse friend because he doesn't feel like playing Mario with you anymore after taking his cancer drugs or painkillers. He thought he was a good friend, but he objectively wasn't >:(.
Maybe there's reasoning behind the trade-offs they chose that involves more than you?
As I said, I respected her decision. But I question whether it was the right one because it left her unable to communicate despite an obvious desire to do so. I’ve had conversations with people on high doses of opiates, and while they were far from their full mental capacity, they were intelligible. My dad tried to convince her husband to use conventional painkillers, which I supported, but he wouldn’t hear of it.
So that's entirely different from what the article is talking about. Psychedelic treatments for terminal patients often involve a single large dose of psilocybin in a clinic, and that's the end of it. In the article, the first case study is like that, just one dose and three months later the patient still felt profoundly changed.
> Anecdotally speaking, there's a lot of people in this world that think drugs make their lives better when an objective observer would pretty strongly disagree.
what does it even mean to "objectively observe" whether drugs make someone's life better? we can look at a crack addict living in squalor and plainly see how their addiction inhibits material success. we can also imagine how deeply unhappy we would be to live in such circumstances. but if we want to know how that individual person experiences their own life, all we can do is ask them.
I agree that "objective observation" doesn’t mean much.
However there is no doubt people under destructive addiction are very well aware that their condition sucks. It doesn’t mean they can overcome the addiction and the urge of scoring.
I think the parent was related to behaviours such as "pot makes me more creative when playing music" or "cocaine makes me a better dancer" or "alcohol makes me funnier". All of which can be externally appreciated with a different opinion.
> However there is no doubt people under destructive addiction are very well aware that their condition sucks. It doesn’t mean they can overcome the addiction and the urge of scoring.
agreed, and most of them will freely admit this, as long as they trust you not to use that information "against" them.
> I think the parent was related to behaviours such as "pot makes me more creative when playing music" or "cocaine makes me a better dancer" or "alcohol makes me funnier". All of which can be externally appreciated with a different opinion.
I can also agree with this, as long as we are limiting the observation to extrinsic qualities.
maybe I read too much into GP's comment. I am wary of these sorts of statements, because they are often a jumping-off point to advocate for compulsory treatment of mental health issues.
This is the kind of post that appears when drugs come up. It's personal opinion, without any facts, strong on unfounded typically assertions and word-weaseling ("..when an objective observer...") and ignores what has been done over a thousand times before, with answers. Answering posts like these is a treadmill for everyone and an ascent for none.
Effectively they are giving drugs that alter ones perception of reality
Like over the self painkillers do? Personally I don't see the philosophical difference in alleviating physical pain from alleviating psychological pain.
Of course, if the psychological pain is caused by a condition that can be fixed the fixing the condition itself is of course better. But in many cases of depression and anxiety there is no clear root cause that could be fixed.
Anecdotally speaking, there's a lot of people in this world that think drugs make their lives better when an objective observer would pretty strongly disagree.
Substance abuse and addiction are a problem, sure.
But that is entirely a different thing from providing substances that reduce anxiety and depression.
Painkillers are temporary. The drugs we are talking about are meant to effect a permanent change on the user.
And pain killers, at least OTC ones, don't alter someone's psyche. We can, more or less, rely on their judgment that painkillers are helpful. You can't necessarily say the same for mind altering drugs.
> The drugs we are talking about are meant to effect a permanent change on the user.
You'd only say someones judgement about themselves is unreliable if they will contradict themselves later. But if it is a permanent change, then you are talking to the "new" person who is capable of judging this as well as anyone.
The problem is we are talking about something that is orthogonal to the effect. An example is more like getting prescribed anti-depressants for back pain. I hear it helps with the pain, but you are getting personality alteration as a side effect with it.
Like if im suffering pain, I don't want to get drug-induced quasi religious epiphanies from psychedelics. I Just want the pain managed. And what's really annoying about LSD is how it keeps getting promoted as a wonder drug here.
What happens when docs start prescribing it for back pain too?
It's not just about pain management - it's about accepting and making peace with dying. If there's a possibility that a drug can make this process easier for terminally ill patients, why would you object to its use by people who choose it?
There's an undercurrent of corporatism that powers the status quo. It's not that all drugs are evil, it's that the _wrong_ drugs are evil. The ones you can make on your own have an air of illegitimacy about them, while those that are manufactured and administered by professionals are "ok".
If there were a real war on drugs, pharma companies would be the nuclear superpowers.
Drug are "evil" in the sense that they could put at risk the money interested groups make off of the prohibition. When someone says "drugs are evil", just add "to you" to reveal the true intent.
I believe there is some sort of nonsequitur on the proposed argument.
You can stop the war on drugs and keep the "drugs are evil" narrative. It's called decriminalization. Stop bothering people for possessing, producing or using drugs, do as you want with those trafficking, and keep them illegal. This could be done progressively without loss of face by government. Oh wait, that's what the article is about!
Drugs, including alcohol, tobacco and pharmaceuticals are dangerous, and utmost caution should be had if using. If you can brew your own beer or grow your own cannabis, you probably have learnt a thing or two about caution. Either that or a professional cautious-person (doctor) will do the administration.
Decriminalisation keeps many of the worst aspects of the war on drugs in place. Aspects that are damaging and immoral in that they cause far more harm than they prevent.
Even drugs like heroin should be fully legalised. Subject to prescription, maybe. But the harm from a clean, consistent heroin supply is vastly lower than the harm caused by the manufacture and smuggling alone, and decriminalisation of possession does not address that. Decriminalisation also does not address the cost issue which is a major problem with many drugs. A medical grade supply for a typical heroin user costs in the $10-$20 range (we know because e.g. the UK NHS buys heroin for hospital use; if you're given diamorphine for post-op pain, that's heroin).
But the biggest problem with the "drugs are evil" narrative is that it has damages serious discourse about which drugs are lower or higher risk.
LSD and psilocybin for example are certainly vastly lower risk than e.g. heroin and cocaine.
In fact, there's a famous case of a group of patients checking in after having snorted what they thought was cocaine, but which turned out to be LSD. Their blood levels suggest they would have ingested hundreds to thousands of normal recreational doses. They all walked out of there with no lasting harm.
In terms of other drugs, some drugs exists largely for time-limited circumvention of drug laws or because they're easier to create or smuggle, and would see their demands crash if less dangerous alternatives were legalised.
As someone who's studied the topic quite heavily, here's my issue with no-holds-barred legalization (I consider "legal" to mean "can manufacture and distribute" in this regard, like tobacco). Drugs that couple very tightly to the VTA (brain's behavior-reward circuit) actually can lead to lasting changes after few or single exposures. This is amplified by rapid absorption routes - injection, insufflation and inhalation. The main players here are heroin (DEA sched 1), meth (2), cocaine (2), GHB/Xyrem (3), some benzos (4), tobacco (legal), and analogs therein. It's hard to have a casual habit with these drugs, as they manipulate the brain's behavioral calculus itself.
Note that the DEA schedules are all over the board. The current schedule system has barely any correlation with harm (see work by David Nutt).
But we are also in a weird place where access to two of the most destructive drugs in real measurable effects - alcohol and tobacco - are legal.
At bare minimum we need to overhaul the schedule system, legalize drugs with low/moderate addiction potential (weed, psychedelics, ketamine, phenethylamines, the Shulginoids), and legalize everything in personal possession quantities, and for scientific/medical research.
High-addiction drugs should probably be medically gated in some way.
The problem with this thinking is that these drugs are not medically gated today.
In fact, the "gating" of heroin through law enforcement is so poor that the difficulty and cost in scoring oxy once people face medical gating due to drug seeking behaviour is now one of the larger recruiting avenues to heroin use.
It's easier and cheaper for people to get heroin as a substitute than it is to continue to use a safer, cleaner supply of oxy.
If you want to medically gate these in a manner that does not increase harm it needs to be at the kind of level that e.g. paracetamol/acetaminophen is restricted in places like the UK (limits on quantity in a single purchase, but nothing that stops you popping to the next pharmacy over and buying more, or coming back the following day) or that e.g. some non-prescription drugs are sold (under the counter, pre-requisite information given out by a pharmacist and possibly some basic questions).
You can maybe push it to a non-aggressive push towards treatment, but if you start denying access you're right back to creating a black market you'll have no control over.
The exact threshold probably needs to differ per drug, but it the level of gating we're currently at even for legal prescription drugs like oxy is actively harmful.
> The main players here are heroin (DEA sched 1), meth (2), cocaine (2), GHB/Xyrem (3), some benzos (4), tobacco (legal), and analogs therein. It's hard to have a casual habit with these drugs, as they manipulate the brain's behavioral calculus itself.
Caffeine, possibly. I have a pretty strong caffeine addiction myself. But the harm level of caffeine vs alcohol, tobacco, or anything else harder, is far far less.
Sugar, no, it doesn't bind to transduction receptors in the same way (it is rewarding, but not like "drugs" are).
I see your point, and I think is valid. But I disagree.
I think the harm of legalization is only slightly below the war on drugs. Legalization means another vector of government control in my life, most likely outsourced to big pharma.
All the issues you are pointing can be solved by decriminalization are solved by individual responsibility and boils down to answering the question: Can you trust your source? If you can't answer the question you probably need help through a government sponsored damage control program.
To be precise, I used MDMA couple of times in my youth. My source sent every batch to a lab, we knew exactly what we were taking. Then he retired, and my MDMA use with him, cause I have no trusted source.
No amount of government control will substitute for cautious and responsible use. It might even hinder it, see alcohol, see tobacco, see opioid epidemic in the US.
The evidence is strongly that you can't trust your source.
But lack of legalisation also leaves drug cartels and murderous supply lines, high prices and reason to carry out crime to finance those high prices intact.
do as you want with those trafficking, and keep them illegal.
If you keep them illegal then you lose control. If they are made available from your local chemist then you can legislate for quality and strength.
Keeping them illegal also has a massive unwanted side effect in terms of encouraging criminal gangs and violence. All that would go away if customers could just stroll down to their local Boots and buy a packet of spliffs.
Yes, no government control is exactly the point of no legalization.
Violence and gangs and ridiculous prices are a symptom of criminalization. If in order to produce and consume you face several years prison, gangsters happen. If nobody cares if you produce, your neighbor might start producing, he might have a surplus and accept some cheese in exchange.
I’m pretty glad that the government is involved (in a regulatory/oversight fashion) in the chain of events that results in me having a bottle of $0.02 vitamin D3 pills in my cabinet.
I know they’re safe; I know what’s in them; a year’s supply costs less than a meal in an inexpensive restaurant.
I don’t care if someone wants to make their own, but it seems like harm is minimized if these chemical substances that alter your body are treated similarly to other such substances.
> I’m pretty glad that the government is involved (in a regulatory/oversight fashion) in the chain of events that results in me having a bottle of $0.02 vitamin D3 pills in my cabinet.
it works pretty well in the case of supplements. there's no guarantee the supplement actually helps with your issue, but at least you can be confident that the bottle contains what it says it does.
the problem with legalization of recreational drugs is that the government can't seem to resist slapping on a huge tax and/or imposing arbitrary restrictions on the supply side. it is my understanding that there is still a thriving black market in most legal/medical states in the US, due to the high price and varying quality of the legal/medical buds. this is despite most MMJ practices being the weed equivalents of pill mills. it's kind of absurd that a legal supply chain can't compete with an illicit one on price/quality.
> If you can brew your own beer or grow your own cannabis, you probably have learnt a thing or two about caution
The idea that selling drugs is something special misses and should remain illegal seems to only partially consider the implications of what that means.
One side of safety concerns is consumption safety. An at home production facility is of lower quality, exemplified by many more cases of methanol poisoning during the US Prohibition era [0]. Another is production safety, cooking methamphetamines is real chemistry —- I would much prefer to have a factory doing that rather than my residential neighbours. Finally, we have access, growing plants indoors is non-trivial and processing them into something resembling a finished product also so. Given this, I’m convinced that limiting illegality to trafficking doesn’t stop the war on drugs, because it has always been about trafficking — the hard part is moving the product and selling it to people. If the “do as you want” resolves to making trafficking legal, then it seems the drugs are simply legal.
This doesn't really address their point that opioids are somehow accepted in the public eye as a legitimate medicine but other drugs with both recreational and medical uses are not
On the other hand, knowing first-hand of some screwed up lives plus collateral damage, some drugs might just be evil. Thing is, it's hard to tell in the beginning where things are going so people might lump them all in together.
>knowing first-hand of some screwed up lives plus collateral damage, some drugs might just be evil.
Criminalization and stigmatization cause more harm in the long-term than drugs do.
Are all drugs as innocous as cannabis or psilocybin? Gosh no.
Does criminalization and stigmization of drug use make the problem 10,000x worse? Very.
Imagine if the US followed Oregon's lead and decriminalized all personal use. Drug users can seek out help and get harm reduction (eg: needle exchanges, advice, etc) and get them participating in the medical system where we can help them out of addiction, no families will be destroyed because of a little weed (or heck, meth), we save a bunch of money on drug enforcement, we could close private prisons, etc.
I am not saying utopia, but maybe we should look at drug use as something besides a personal moral failing. No one wakes up and decides to be a drug addict... no one _wants_ to be an addict.
This idea that drug users are burn-outs who chose that life is absurd.
Most people I know simply conflate which drug does what. Even formal education against drug [ab]use is filled with anecdotes that are often no more than urban legends.
The super human PCP user. The window-jumping LSD user.
This dogma has been used to enact countless bills of legislation in most rich countries, which in turn have encumbered the justice and police system, which in turn have put thousands upon thousands of people into to the correctional system for years.
After all that busywork, lives destroyed and taxpayer money wasted, it is really hard to suddenly jump ship and say "Nah, you know what... after all these lives destroyed and billions of tax money spent ... you know, we were wrong, let's rethink this".
Drug abuse should be handled as a public health issue, not a criminal issue. And it takes time and effort to rebalance the current status quo to a more humane and sane approach.
This vox article discsusses the political history of war on drugs:
https://www.vox.com/2016/3/29/11325750/nixon-war-on-drugs