> “The tranq dope literally eats your flesh,” she said. “It’s self-destruction at its finest.”
> She unrolled a bandage from elbow to palm. Beneath patches of blackened tissue, exposed white tendons and pus, the sheared flesh was hot and red. To stave off xylazine’s excruciating withdrawal, she said, she injects tranq dope several times a day. Fearful that injecting in a fresh site could create a new wound, she reluctantly shoots into her festering forearm.
> The only person who would let her use a cellphone was a guy whose arm and leg had been amputated because of his tranq wounds. He was still injecting into his leg stump.
If a drug that literally turns you into a melting, oozing zombie with flesh dripping off your bones doesn't make you find a different drug - not even quit, I mean, find a different drug to get fucked up on - I think that person is suicidal. This is some morbid shit right here.
> If a drug that literally turns you into a melting, oozing zombie with flesh dripping off your bones doesn't make you find a different drug - not even quit, I mean, find a different drug to get fucked up on - I think that person is suicidal.
I think you have not even the most basic understanding of addiction, or (perhaps most relevant to this case) specifically withdrawal. If you are addicted, you can’t simply choose a substitute, and particularly you can’t avoid withdrawal from one drug just by choosing another, except for some very special cases.
Xylazine is not an opiate and has its own withdrawal effects. Also people are often not well educated on drugs or even know what is in the drugs they take. It is an adulterant and it is a street drug, so switching to 'another opiate' without an adulterant in it isn't going to be easy. Even pills are fake nowadays.
There is absolutely no valid reason we can't treat people with suboxone, which will allow them to maintain their addiction without getting high. However it needs a prescription and doctors usually won't just prescribe it to addicts, especially for extended time periods.
This could all be 'fixed' if people didn't have a subconscious need to make people 'pay' for doing things they feel are wrong.
A good example of this is when I got a complete workup done by a liver specialist, having been a very hard drinker earlier in life. Upon telling a close family member that everything came up fine and there were no lasting effects they commented 'that shouldn't be right' as if I had cheated society somehow by not having health consequences for being an alcoholic.
> There is absolutely no valid reason we can't treat people with suboxone
You're absolutely 100% right about this. This should be the first part of any treatment, to make it easier to separate the druggie from the drug camp and then come off, if possible, at a reasonable time as decided on by them and their team. This is one of the cores of the Portuguese system, to use some drugs to wean people off the dangerous ones.
> This could all be 'fixed' if people didn't have a subconscious need to make people 'pay' for doing things they feel are wrong.
I know some people like this, but I see more people saying this in that we shouldn't forgive the violent and non-drug related crimes people committed while resisting being removed from the streets. They don't want them not treated, but they want them jailed instead of released once they're clean. It's hard to argue - I've personally helped two old female shopkeepers chase thieves out of their store. Threatening and obviously disrespectful and non-needs related thieves too, not someone simply trying to take a bottle of water and food.
>they commented 'that shouldn't be right' as if I had cheated society somehow by not having health consequences for being an alcoholic.
That's not my interpretation of it, which is that "that shouldn't be right" refers to an unexpected outcome given the assumptions, rather than some sort of sense of justice being violated.
> There’s people creating drugs that turn people into zombies
Because there is no safe, above-ground supply chain for those drugs with actual quality control and penalties for contaminated supply.
> there’s people taking drugs where they don’t even know what’s in the drugs
It's not like those addicts have a choice of walking into a pharmacy and being able to buy a safe drug manufactured by a reputable pharma company with a datasheet of exactly what's in it.
Both of these problems are caused by the stupid "war on drugs".
I doubt most addicts would have the means to buy high quality substances. And of those who had, some may still chose the cheaper street stuff. And this is where society often is asked to pick up the bill. With guaranteed payment out of tax dollars the pharmacy company producing the substitute now has an incentive to get people on it. The problem will never be solved but now it is even more expensive. This is a misallocation of tax money in my opinion.
Singapore doesn’t seem to have a huge drug problem, and they went all in on what you call “the war on drugs”. So maybe there is a winning strategy there, at least for Singapore?
What works for Singapore works for Singapore; the US is a very different country. As for the failings of the "War on Drugs" in the US, these have been well documented by multiple levels of social research.
1) there will always be demand for drugs, thus fulfiling that demand legally will reduce the harm caused by low-quality/tainted drugs, the side-effects of the underground drug trade (violence, weapons smuggling and gangs branching out into other crime) and can be offset by taxation (as long as the total price including tax is still lower than what the black market offers).
2) existing users who are addicted can't just quit cold-turkey, they will need a certain dose of the original drug or an adequate medical substitute for a period of time - that dose can be lowered over time as part of a recovery/rehab program but cutting those users off forcibly will hurt them physically and force them to seek out black-market sources.
You are misunderstanding my point. It isn't 'let them have all the drugs they want', it's 'what do we do when they want to stop'. It would be easy to give them access to drugs that allow them maintain their addiction, even for the rest of their lives, with no withdrawals (for the opiates, anyway).
Even without that, the process for getting clean is not easy. You can't walk into a hospital with withdrawals and expect to be admitted -- unless it is alcohol or benzos they won't do anything at all for you.
We should as a society stop saying 'they chose their fate' and instead give them options for a softer landing when they decide that they had enough.
What the bible says and how christendom are observed to behave are very, very different things.
While I'm sure you could point out this is true for other beliefs, they aren't being followed by virtually everyone in government where this is happening.
I somewhat agree with your point - there is a lot of Old Testament morality going around - enough being spouted from various confused people (especially in the US, where your point may be truer) that it then confuses the antis into attacking Christians on the spurious grounds of eating shellfish or whatever.
Not to mention he became co emperor of the universe and got to go back and hang out with his dad / self.
I can't imagine crucifixion feels good, but this "sacrifice" pales in comparison to what the parents of CMH recipients endure; let alone what the recipients themselves did to save their friends.
They knew they risked death and torture with no foreknowledge they would be worshipped by billions for all eternity.
> Perhaps you'd like to attack Judaism instead, but that isn't as fashionable, is it
Judaism (as a religion) is largely unconcerned with the behaviour of non-Jewish people. The "gentiles" are not expected in any way to follow the laws of the old testament, and also don't benefit from doing so in any way
Well, the Noachide laws at least. Sorry, comment wasn't aimed at Judaism, more that Christianity explicitly overturned the concept of atonement so the original comment could literally be no more wrong.
This is obviously not true - or at least, not true across the board. There might be some that don't do punishment.
But... we have places like the Salvation Army that would rather have folks die instead of giving a trans person shelter and help.
There are abusive homeless shelters peppered across the US, some of which have forced church, forced drug classes, and forced work. Some of these will take away your possessions or turn away a man with children because the shelter that allows children has a strict "no man" policy.
Right this very moment, people are passing laws to ban trans folks and take rights away from queer people in general.
It doesn't really matter what you think the point is, it obviously either isn't shared or doesn't show in people's actions. There are plenty of examples of christians actively doing harm in real time.
It really isn't "obviously untrue". I can't speak for the Salvation Army but they need to examine themselves if they aren't unconditionally offering help to those in need.
I appreciate that I'm in danger of doing a "No True Scotsman" fallacy here, but my original point stands. This is evidence of a lack of the core precept of Christianity.
It doesn't really matter what you think the core precept of Christianity is. It is great if you practice differently. I know some people do try to be kind.
As I said, "At least it isn't true across the board".
It is very obvious that folks aren't unconditionally offering help to those in need, using the banner of Christianity to justify it. And to justify homophobia, racism, misogyny, and a slew of other things.
And what I've seen very little of is other folks speaking out. I see folks protesting comprehensive sex ed and birth control, while these shelters (and others) get no pushback.
Do better if you want views like this to change. Be loud and help folks.
The original point was about a desire for drug users to "atone" for their behaviour in order to get help. It's utterly unchristian, literally flies in the face of the core Christian value.
There are a bunch of noisy people in the southern states of the US who don't understand why the Old Testament is included in the Bible. It's a huge problem, and it's showing up in this conversation.
The thing is that so much atrocities has been done under the banner of Christianity that it delutes the good people who seem honestly committed to the core value “love your neighbor”
Often that tenet is being absolutely debased by making it “love your neighbor, except if he is gay, trans, woke, liberal, communist, black, fill in the blank”
Jesus himself proclaimed “love god and love your neighbor” to be the core and heart of his teaching, yet instead you have people fighting over the stupidest things in the bible just to be “right”, creating tons of denominations that make no sense at all.
If Jesus values are just, they should be universal values. And his core teaching does echo tenets of reciprocation.
> yet instead you have people fighting over the stupidest things in the bible just to be “right”, creating tons of denominations that make no sense at all.
Isn't that what we want? People laying our their reasoning and their ideology on paper, and leaving a parent group whose actions they can't condone? This is the calling them out. Compare and contrast to ideologies and areas where people who published these opinions would be killed for their heresy.
No doubt many/most of the sects are stupider than what they broke away from, but sometimes, critically, they are vastly superior. I'm not religious but for example I can recognize the value of Martin Luther's reformation.
I see where you are coming from. I think the distinction is either whether to look at it from an ideological or core tennet perspective or a more political/ organizational perspective.
So arguing from the second perspective the problem with the breakaway reformations we have seen is that they often tend to deal with the “true scotsman” fallacy, where they double down on rules and regulations in the bible just to be worthy and a “true” Christian, sometimes coupled with a “holier than thou” attitude. (Obviously generalizing centuries of history here)
Instead of the movement to a more universal “love thy neighbor” seems a more fitting approach, if it’s truly universal as Christianity claims.
> the problem with the breakaway reformations we have seen is that they often tend to deal with the “true scotsman” fallacy, where they double down on rules and regulations in the bible just to be worthy and a “true” Christian ... Instead of the movement to a more universal “love thy neighbor” seems a more fitting approach
It feels that's exactly what you did though. Pick a favored feature and declare that people not doing it predominantly that way are wrong.
> if it’s truly universal as Christianity claims.
Even if they believe that you should love the sinner I don't see where their traditions say they should lay down and let themselves be victimized because they can't regulate people they "love".
> “true” Christian, sometimes coupled with a “holier than thou” attitude. (Obviously generalizing centuries of history here)
Those centuries of history led to here, where in a country founded largely by Christians on Christian principles, you're allowed to say you don't think any of them are doing right. And you and I - total heathens, receive no threats, no hate.
I like to focus on your first remark, in order not to digress too much, I was raised in a Christian environment and even got some affirmations in them, and I had a few teachers who studied theology. Only later I left that environment as I became an adult.
“Love thy neighbor” is not just a favored feature, it’s the pivotal commandment that Jesus himself stressed after being asked “ One of the teachers of the law came and heard them debating. Noticing that Jesus had given them a good answer, he asked him, “Of all the commandments, which is the most important?”
As how we should execute that command is a different discussion I feel, and what kind of societal impact it would have. So my core argument is that this commandment hasn’t always received the proper adherence (imo)
I think both of you are right. Core concept of christianity is universal love, just like all other religions regardless what mass media make you believe.
But all of them fall pretty damn hard when meeting reality of (heavily) flawed humans, who ride most of their lives much more on emotions rather than being rational. So we have folks like Mother Theresa refusing help to people with leprosis because suffering is good and brings you closer to christian God (kind of pointless for hindus), or due to refusing to convert to christianity. How can such a person be celebrated is beyond my understanding, even ignoring those millions of dollars that disappeared under her management, that is kind of tradition in nonprofits.
I've seen personally horrible treatment by self-entitled people very deep in christianity, considering all others unworthy beings and treating them as such. Those tend to behave in very subpar manners while shroudinging themselves in righteousness that goes against the core principles of any religion, and rather stand as an insult to it.
Or to put it in a different way, if existence would end according to christianity heaven would be pretty empty place, most people are failing 10 commandements pretty hard (since sins are sins and they stand through the times, no priest has any actual right or ability to manage those, so plenty of rituals are utterly pointless if you think about them a bit).
Religions are weird, simple great core ideas consistently twisted into obscure made up rules and absolutely pointless power structures. Always go against personal responsibility, critical thinking, and are hopelessly beyond modern morals. Maybe enough for simpler minds but mental gymnastics that smart people have to constantly do to stay true believers while accepting modern science understanding is quite a burden, and most fail there
Are non-religious homeless shelters any better/worse? Obiously not all christians are saints and not everyone who calls himself a christian follows christ.
Most homeless shelters that I'm familiar with are in the US, and most of those are Christian. I really couldn't tell you. I stopped hearing so much about them when I moved to Northern Europe. I don't know if it is a language barrier, the culture, or if they are better.
I'm not going to distinguish between the folks that "follow christ" and who does not - many are going to claim it and I'm not really willing to engage some of these folks to see if they are "true" or not. Living in the US, there wasn't a big outcry against folks discriminating. You were told to just be normal. Don't be gay. (I'm bisexual). In the 90s and before, a lot of folks used it to justify outright racism. And there isn't enough outcry now or then.
Granted, this isn't just Christianity. But I'm not going to give Christianity a break because they aren't special when folks are glossing over the harms.
> Are non-religious homeless shelters any better/worse?
Well, I have worked with organisations here that originated from the communist party (in a Western country without a "complicated" history with communism) and they just don't discriminate at all. Not even against people who might be "not poor enough" to actually need them. It seems to me quite better indeed than Christians denying help to trans or gay persons.
Ah, well each new brand of communism comes with its own group of people who are more equal than others. It seems to always turn into some sort of horror story eventually, once they get free rein to implement their utopia. I would view that with a strong dose of skepticism.
Name one. One single such law. The proposed laws are to return to enforcing sex-based policies. Males weren't welcome in female washrooms, sports, shelters, or prisons before but were forced in by the intentional conflation of identity with physicality.
If you mean bills enforcing no drugging or surgery of minors, well we're being assured that doesn't happen so the laws obviously don't matter.
> and take rights away from queer people in general
Again, name one. What right?
There's a lot of conflation going on, claiming parents want to ban drag shows when they want to ban all sexual shows - burlesque as well - in public places where children might go. Nobody is coming for the drag queens, etc.
But, thank you for being clear that you're talking about TQ+ laws and rights, instead of tying them to LGB sex-based rights as if the rainbow is monolithic in politics. Lesbians face street violence for saying that lesbianism is female and demanding the right to male-free spaces.
You're already living in it, killer. Caffeine, for example, is a pretty powerful stimulant. Ditto for nicotine.
Alcohol is everywhere. Alcohol consumption correlates heavily, like crazy heavily, with assaults, rape, murder, domestic violence, accidents, and serious or fatal car crashes.
Weed is now legal or legal-ish in many places, essentially all of the big population centers in N. America. Edibles and vapes mean you don't even have to smell it.
And let's not forget all of those articles about SV wunderkunds "micro-dosing".
The addicts that the OP was discussing have serious withdrawal issues and are, compared to things like booze or marijuana, trivial in terms of overall population.
They're already doing it. At least this way they won't have as many horrible skin ulcers. The situation is inhumane.
Consider the principles from another perspective. The leading causes of death in the US are diabetes, heart disease and obesity related conditions. Should we prohibit fast-food franchises, TV dinners and sedentary lifestyles?
As you said, "Do you want to live in an obese society?"
Logically, opposing prohibition isn't the same as endorsing obesity or drug abuse. There is an important distinction here.
It's the world we already live in. Continuation of the war on drugs mentality just leads to horrific outcomes like the one being discussed. And those outcomes have a wildly outsized impact on people who were born into unfortunate circumstances.
It impacts us all as members of society. Adulterated drugs are killing US addicts in record numbers.
There is a direct social cost in terms of health care, law enforcement, crimes committed to obtain drugs, fallout from broken families resulting in further dysfunction and more.
Then there is also the unseen cost of lost productivity. If users, deceased users, imprisoned users, distributors, deceased distributors, imprisoned distributors, and law enforcement personnel were not engaged in these activities, their efforts could be focused on more productive areas of the economy. We all pay for this policy socially and economically.
Same concerns about anti-depressants, which commonly make you unable to cry, have sex and are associated with increase frequency of mass shootings and suicide?
Why would they be cheaper? Lab quality would require lab grade testing and safety, and lab grade ingredients, not to mention taxes on recreational drugs are usually astronomical.
And I doubt it would be easier to get either since they're unlikely to hand out an unlimited quantity to anyone who pays for it even if it were legal.
1. You can buy shopping carts full of alcohol at one time if you want. I've watched people purchase thousands of cigarettes in one purchase. Having essentially unlimited access to addictive drugs wouldn't be out of the social norm.
2. I think some drugs would become cheaper, and other drugs would become more expensive. Drugs with limited supply would become cheaper as more production/supply chains open up. Think cocaine, heroin, and some pharmaceuticals without large overseas labs. There are inefficiencies in the illegal drug trade that legal trade could smooth over as well: better payment methods, more open price negotiations, legal settlement for disputes, reduced employee churn from violence/arrest, reduced bribes/corruption related charges.
3. Regardless of the price of drugs, the overall price would be smaller, as illegal drug use has huge externalized costs. Everything from corrupt governments to increased health care utilization to wasted law enforcement resources to destroyed human capital.
4. The existence of an available quality tested market would force the black market to compete more on quality.
You do know that xylazine is an adulterant? It is put in there because it is tough to get cheap heroin and fentanyl tends to kill their client base a lot faster than tranq.
Tranq is cheaper because it is available for animals, and not 'seizing and destroying something while putting the people who possess it in prison' is a great market force for lowering prices.
Ergo, don't criminalize heroin and tranq stops appearing in it.
Industrial small-molecule chemistry is extremely efficient. All of these drugs could be produced by the kiloton for small amounts of money if that was the objective. It would not require anything special.
We already see this with alcohol. Most liquor is tarted-up industrial ethanol, delivered by train tankers to the bottling plants, with some marketing and branding wrapped around it. Industrial ethanol is very inexpensive to produce, around $1/liter; the price of consumption alcohol is downstream of excise taxes and branding.
Cost is not a relevant factor. We can produce all of these chemicals for so little that it is a rounding error. This is a matter of policy.
Actually I'd argue you dont even understand the basics of addiction.
I found out Omega 3's are used to get people off opioid and alcohol addiction.
Why is this?
The DHA part of Omega 3's is one of the main raw "ingredients"/chemicals in the brain and it helps with learning (brain plasticity), but it takes time, in kids it takes a few months before improvements are seen and in adults it can be longer because their bodies are larger. Ironically if you have an out of control teen, dosing them up on omega3's should help rein them in, whilst putting them in good standing for a longer healthy lifespan because of what they do to oesteoclasts.
Omega 3's also down regulate oesteoclasts, these are cells that destroy the bone and release it into the blood stream. Why does that happen? Because the calcium amplifies the effect of the catcholamines (andrenaline/noraandrenaline/dopamine). You can find catcholamines in a coup of tea which probably explains the extreme nature of the British! Its ironic that in old age, we end up literally but mildly out of our faces on the chemicals that are illegal!
If you are an adult, take several grams of omega3's for about a week or two and then feel your aches and pains. Err towards the two weeks if you are older and/or have really partied in your younger years. It will make you feel old, but this is a classic example of no pain no gain because whilst your bones are dissolving into your bloodstream helping to mask the pain and stimulate you in ways reminiscent of cocaine, speed or plain old off the shelf sudafed, they are a step closer to repairing themselves. The other step is increasing oesteoblast activity, the bone building cells, which is a different conversation, but if you feel wired at night when you want to get some sleep vitamin K2-MK4 is an excellent sedative in 5/10/15 milligram amounts!
Omega 3's also increase the size of the neutrophils, these make up a large part of our immune system cells and are the first line of defence. They go after pathogens, like most bacteria, some viruses, alien pathogens like plastics from bottles, nylon from toothbrushes, polysterene from fast food outlets, polution from vehicles like brake dust and emissions and other crap in our body.
So omega3's help our body stay healthier for longer.
Its not the only chemical that helps, beta alanine is another chemical which can make people quit addictive substances but you'll feel nauseous on it. However considering inflammation is reduced on a calorie restricted diet because the immune system doesnt have to attack as much food, it breaks down into a variety of chemicals which stimulate glucagon that increase blood sugar so you feel satiated for longer, so its a cheap alternative to semaglutide the Hollywood weight loss injection chemical and some of the Sulfonamide chemicals which were invented by a Nazi scientist (prontosil) that helped Winston Churchill and Franklin Roosevelt Jr, which are sulfur based antibiotics. It also gets desposited rapidly into the olfactory bulb so your sense of smell comes back rapidly and it also helps people with hearing loss to work out the words and sounds more quickly reducing the number of times they have to ask a speaker to repeat themselves. But by being able to smell better which is another of those creeping aging losses, you get to smell how bad things are.
When thinking of where pathogens are likely to enter the body, it seems logical from an evolutionary perspective to have a chemical beta alanine making up the sensing and detecting of pathogens which can also become a sulfur based antibiotic! In fact is this what gave Gerhard Domagk the idea to investigate and develop them? We shall never know, but I do know one thing and this comes out when looking at historical medicine, the medicine that worked from the 1800's and early 1900's still hold their own in todays world especially with antibiotic resistance. Keep the pathgens at bay your live a longer less stressful life.
So how much are pathogens and poor diet contributing to addiction, considering the above? People consume chemicals to seek solace. So addiction like this needs to be treated as a health condition, and the medical experts need to up their game and be less schadenfreude about it.
Is the refusal of experts to recognise the above, a stealth form of exploitation to keep their high paychecks and "respected" position in society?
There are chemicals and pathogens (bacteria and virus) to make people do nearly any behaviour. Once this is recognised, most problems with society become a health care issue.
Suicidal is probably too strong a term. Addiction is a total mind f#*k because you can be totally rational, full of regret walking home from the ER and then think “hey a cold beer would be really delicious right now”. Then coming out of a blackout later like “hey, what happened?”
It’s more of a head space where you don’t care whether or not you are alive tomorrow, and I definitely shouldn’t be doing this, but that’s a problem for tomorrow.
If there’s even a brief moment of contemplation it is no match for the physical withdrawal that takes over from your rational mind, like a totally different person carjacking your your body at gunpoint with a sensible plan to save the day. The negotiation lasts less than one second.
Recovery is not easy. It’s obviously a lot more complicated than “don’t do that, dummy!”, considering that message combined with gangrene loses the argument with the carjacker nine times out of ten.
Someone doing this stuff isn't thinking of the endgame any more than an alcoholic is thinking about cirrhosis. They just want to get high. They're not at the opiod buffet picking their fave. They're doing the best stuff their dealer has that they can afford.
I don't think you lose much tolerance within the week or so the acute withdrawal symptoms last.
I think the danger is from relapses long after withdrawal when both tolerance and knowledge of the supply has been lost. In some ways, withdrawal is the easy the bit - brutal but something to fight that gets easier as time passes. The nagging empty hole in your soul with sobriety is harder to fill and drags you back.
I'm just saying, would being an alcoholic of rock-bottom spirits be that much more expensive? I'd rather be a shaking alcoholic than have my arm fall off my body as I inject drugs into my festering stump. But that's just me.
Nothing about addiction has anything to do with what the addict would _rather_ be addicted to. They'd mostly prefer to not have a problem at all.
Highs aren't fungible in the way you're describing. Don't mistake "I begrudgingly took a worse opiod because I couldn't get the one I want" for "I'm fine with anything"
Without previous experience of what kind of high strong opioids (or other heavy drugs) gives you, it's hard to imagine people taking the risks of using them. But some of them really are that fucked up on your psyche, that you'll do anything to continue using them after you've used them for just a short while. It's really easy to get addicted and really hard to get out of there.
You’re failing to appreciate the harshness of the addictive spell these users are under.
It’s not to say being an alcoholic is easier per se, but whatever specific substance a person is abusing is going to be what their body demands to feel relief. If you’re addicted to pain meds, alcohol intoxication isn’t going to be the sensation your body will fiendishly crave.
No opioid addict can beat opioid addiction using alcohol. Lots of addicts end up abusing alcohol on top anyway.
And by the way, the equivalent death of an alcoholic (happens to millions of people every day) would be an agonizing death with gastrointestinal bleeding, maybe cirrhosis, maybe a long period of disability before (which effectivel can mean death if you're homeless)...
As others have already said, you pretend to understand problems which you obviously have not experienced or witnessed at close yourself.
Your "I'd rather be" sounds like "They should rather eat pie" to any person with any kind of empathy or emotional connection to addicted humans.
That being said, yeah, I'll too rather not be addicted, as addiction to hard drugs (including alcohol) means pure agony. Why does anyone "choose" agony then?
Overcoming any serious addiction is a personal, social and medical problem requiring lots resources, luck and extreme willpower.
I'd say, a form of willpower that people comparing addiction to sheer indulgence cannot even grasp.
Beating addiction is not simply a decision, although an individual decision is of course required. Seeing that as the root of the problem is a flawed view from outside that contradicts everything we know about how human brains (and lifes) work.
I feel like if you’ve never used or been addicted to real drugs, your opinion is effectively useless here. It’s like listening to a non-programmer trying to help an engineer debug their code - “why don’t you just use a different variable?”
Stick to crypto Monero, I think your talents will be better suited there.
> The drug is not the problem. \n The social net / missing social network is.
The drug is the problem, and so are the suppliers -- they are killing people. Addicts and people who need psychiatric care are harming themselves. If the criminal suppliers were supplying contraband woolen socks instead, there might only be a trade dispute and a loss of retail tax income.
That said, users of harmful drugs fall into two sacrifice zones: SZ1) the purveyors of the harmful drugs don't care much if you die, and SZ2) the rest of society doesn't care if you die, but doesn't want you dying in a business district.
Government is willing to be in some "dealing" businesses, such as tobacco and alcohol, because by far most users of these substances can keep working and paying taxes. The economic advantage of government involvement is clear.
There is only so much that the levels of government will invest to reduce (palliate) the suffering of users of harmful drugs. Local government is directly motivated to not have its community (revenue base) supplanted by drug zones. Citizens don't want that either. So the minimal mitigation is what you would expect.
When we say something is a social problem, we often mean that we wish humans were kinder to humans.
> People with good choices and support primarily choose non self harming activities.
That’s not true. People in the west have so many more choices than people in my dad’s village in Bangladesh. But it’s people in the west who are destroying themselves with drug and other vices.
I think you’re speaking too broadly and applying it to all of Americans. America has the capacity for shocking levels of poverty and economic entrapment.
Additionally, just from a cursory google, it looks like addiction is also on an alarming rise in Bangladesh, especially in the youth. I don’t see evidence addiction is isolated to “the West”.
No poverty I’ve seen in America is shocking to me. I remember sleeping in my dad’s village with hurricane lamps at night because at that point (late 1980s) they didn’t have electricity. By your logic, people would be killing themselves left and right because they were so poor and life was so hard. But poverty isn’t what causes drug addiction.
Addiction is rising in Bangladesh—but as it’s getting richer and more westernized. But even then, to put it into context, the drug overdose rate in the US is 20 times higher adjusted for population.
I'd go even further, modern society is an anti-safety net. It seems the nicest way to live is to get slightly away from most of urban life as thought since post-ww2 era.
USA might be above others but even in France and other western countries I sense a similar sense of senseless running around toxic everything and the state struggles to maintain protections since problems accrete.
> a drug that literally turns you into a melting, oozing zombie with flesh dripping off your bones
Reminds me of Krokodil [1].
That said, I just finished listening to an episode of Radiolab [2] describing how unsubstantiated claims about fentanyl causing overdoses through contact may have triggered episodes of mass psychogenic illness [3]. So I'm inclined to take these gory images with a grain of salt, e.g. these may be a wounds that were neglected due to drug use versus unavoidably caused by it.
>I'm inclined to take these gory images with a grain of salt
The mechanism in play for Xlyazine is that it's a relatively powerful vasoconstrictor. So the repeated use leads to decreased perfusion/flow/oxygen in the injection site. Which means wounds in the area don't heal.
So, yes, there's neglect involved, but the cycle is mentioned in the article. They get one abscess, have heard of this side effect, and become scared to inject anywhere other than the wound site for fear of a second abscess. Then that area gets infected, tissue necrosis, etc, and they finally start ruining another area.
I thought of Krokodil also. Considering that tiny amounts of impurities can cause terrible consequences. MPTP impurities in MPPP caused parkinson's, and bad commercial synthesis of tryptophan by Showa Denko caused EMS, it seems likely that this is real.
I thought of that drug as well. The thing I remember most about that is if the addict missed the vein and injected it into the tissue, it would basically destroy the area. Addiction to drugs like this is horrible way to end one's life.
Important to remember that the alternative to shooting up is, often, to be cold, and miserable, alone, on the street, with no sleep.
One possibility potentiates the other.
Horrifically, you could even think of drug use as an attempt to adapt to loss of housing.
The backdrop for urban drug use, here in Vancouver, is a profound housing crisis and shortage, and a complete, thoroughgoing failure on the part of multiple levels of government to do anything about it.
Tho photos of the damage are incredible. It was tricky to find a source I trust not to exaggerate too much for ideological reasons but I think a professional dermatology association has the right incentives towards accuracy:
By legalizing most drugs and providing the supply legally they could simply put an end to a lot of problems. Drugs aren’t expensive to produce, they get expensive on the black market due to being illegal so the government wouldn’t even need to spend too much, probably a lot less than cleaning up this mess. Of course they should only allow addicts to get their daily fix in special centers so as to not allow these drugs freely on the streets.
> legalizing it and providing the supply legally they could simply put an end to a lot of problems
To underscore this, the reason we have a heroin epidemic is because our solution to the preceding prescription opioid epidemic was to take away the pills.
> Is this true? Congress made heroin illegal in 1924, 99 years ago, and the “heroin epidemic” didn’t really start until maybe 2010
Yes [1].
Law-abiding Americans became addicted to prescription opioids (wave 1). We clamped down on their distribution, particularly prescription, and left those addicted with no legal choices. They turned to heroin (wave 2). So we clamped down on its distribution, particularly import, and so got concentrated (easier to ship) and synthetic (no unique precursors) fentanyl (wave 3).
You may not agree with the solution chosen but it seems as a society we've decided on death as the long term strategy. Eventually these addicts will simply die off.
I'm sure having some of your family die off because everyone else seemingly deemed them as a worthless junkie whose only use is dying before they take up too much resource won't drive others to be miserable and start consuming drugs...
Thing is drug abusers will turn to the next thing and the next thing. You can only get abusers clean if you take them through a system that enables it. Decriminalizing doesn't improve it either. Like any drug there will be new inventions and flavors circulating.
Criminalization of drugs, but not of all substances is a must. Alcohol and marajuana are certainly okay. But again criminalization is the only way to ensure people get the attention they need. We just need to change the way we jail people.
In Thailand you get two options go to jail or go to a temple and get clean.
So far their hasn't been much desire to FORCE these addicts into treatment (your last caveat).Portland is a disaster. They had 238 OD deaths in 2019. They're already up to 400 in 2023 and had 742 in 2022...When the bodies pile up it strains the local health system and creates backlogs with the coroner's office. I had a family member that lost their child to undiagnosed low-blood-sugar (MCAD) and I missed the funeral because the state had to hold onto the body for longer than anticipated because of these opioid deaths (I couldn't change my flight plans). They either have to force these people into treatment centers (European model) or they need to be thrown into jail. If that's not possible than dispense with the pleasantries and throw them into mass graves.
I've known a few addicts and recovering addicts over the years. Telling them to "just stop, you're hurting yourself" does about as much good as telling someone suffering from depression to "just be happy, you're hurting yourself".
Maybe more about the dealer's profit margin rather than the user's ability to pay. Fent is everywhere and not a choice. Celebrities are dying from Fent overdoes e.g. Michael K. Williams and Coolio.
Throwaway to share some thoughts from my first hand experience.
They're not suicidal. Addiction is a pathological state. I've been an addict, with some long periods of sobriety and/or healthy moderation, since my late teens and I'm in my 40s now. Opioids is what got me started but it doesn't matter the substance. They change. At the moment I'm trying really hard to get clean from a serious cocaine and ketamine addiction.
I'm also a successful business owner and CEO, I'm Very High Net Worth, I have a loving partner and a loving family. I had no significant traumas growing up. I have access to the highest level of care possible. Between my psychiatrist and my addiction specialist and all the various coaches and providers I spend hours a week working on this problem.
And yet I cannot stop taking drugs. I cannot stop by will alone. Having been through the ups and downs so many times I know I have to attack this problem from like 20 different angles 20 different times before I'll stop. I've been through this so many times now.
I went to rehab a year ago and then I maintained sobriety for a few weeks until the unexpected death of someone very close to me triggered me to relapse. Life stressors tend to be triggers. That's why I say I've been an addict for 20 something years. Even though I was clean many of those years, it's just an illness in remission. The struggle never ends it just waxes and wanes.
Now I'm trying to make arrangements in my affairs so I can go away to rehab again.
My point was, I'm not suicidal. I'm terrified of death. I'm not even depressed. I love the life that I've built. Yet I continue to use, compulsively, drugs that are causing me physical health problems and that have a high risk of ultimately killing me.
Addiction is a pathological state. Full genetic sequencing recently told me I have a D2 receptor subtype that is associated with a higher risk for addiction. Confirmed what I already knew.
It's a compulsion. It feels like a tic. There's a button in my brain that needs to be pressed, an itch that needs to be scratched, and only taking certain substances will do it.
I'm all for the decriminalization of drugs. No one should be incarcerated for this. It's reprehensible that our society does that. But full legalization of all substances? That's a position born of ignorance. These substances are not evil but they are biologically dangerous. Any chemicals that directly activate the reward pathways in the brain are inherently dangerous. Addicts are created they are not born. You shouldn't be able to buy heroin from the heroin store anymore than you should be able to buy sarin gas from the sarin gas store.
I've read all the articles about tranq. My heart aches for these addicts. My heart aches for all the friends I've lost to addiction. Welcome to Coming of Age in the Opioid Epidemic.
A proposal for upgrading these “safe use sites” (if we’re going to have them, might as well have good ones):
The use site has a (24/7 guarded) attached pharmacy with government-produced clean heroin, meth, etc. Users can trade in their drug, the pharmacist runs it through a mass spec analyzer and dispenses back to them an amount of pharmaceutical-grade drug of interest, the amount dispensed being equal to the fraction that is present in whatever cut/mixed drug sample they handed in.
In addition to the obvious safety benefits of only consuming guaranteed-pure drugs, the drug user gets an on-the-spot and very salient piece of information about the quality of the drug they purchased. This creates a lot of precise and accurate drug quality information and feeds it back into the drug abuse cycle. A user buys from a dealer, and right before their first hit they get a purity score to evaluate their dealer with - and maybe some information about what other drugs their dealer just tried to poison them with.
(To avoid some obvious risks: the tested drug sample should be immediately ejected from the analyzer into a denaturing bath and regularly incinerated, so that handed-in drugs are not a theft or recycling target. You probably need to mandate they can trade in only the dose they are about take, and they have to take it on the spot, so that government supplies do not leak back into the streets. There are certainly other failure modes too, a close eye should be kept on this and further processes brought in as needed.)
> dispenses back to them an amount of pharmaceutical-grade drug of interest, the amount dispensed being equal to the fraction that is present in whatever cut/mixed drug sample they handed in
If you're distributing drugs just distribute the drugs. Why cut in the dealers and cartels?
There is no such thing as "a safe supply of drugs". Whether the street drugs are produced in a quality-controlled way or not, it is well-known that use of the substances has negative outcomes in health and occupational functioning.
Direct sale of street narcotics would only be another harm reduction practice, similar to "safe use sites". But no harm reduction practice makes the harm "safe".
The political double-speak around this is very similar to "clean coal"; it implies a strong position ("coal is clean") while offering an escape hatch if challenged ("coal pollution mitigation, otherwise known as clean coal, reduces greenhouse emissions when coal is used as a fuel"). Similarly as there is no "clean coal" in reality, there is no "safe supply of drugs".
When we take deceiving loaded words like "safe" out of the equation, it becomes harder to argue against substance control, even if seen as prohibition. While it is evident that street drug crisis in the US has been mishandled, if restricting the access of these substances (or "prohibition") was done correctly, it would benefit society. Particularly, the prohibition would benefit society more if it was not mainly enforced through criminalization of street drugs, but instead through teaching, rehabilitation, and prevention.
In contrast, "safe" drug harm is an oxymoron. And it's very ineffective to even discuss anything on a double-speak premise. We should instead focus on fixing the root problem of drug use, rather than be distracted by harm reduction, especially when it's been politicized so much.
When I buy a beer from the store that is a "safe" regulated supply of a substance purchased by a government regulated supplier that will ultimately cause liver damage and cancer.
An un-safe supply of alcohol would be the sort of stuff that was common during prohibition, the sort of home brewed moonshine that poisoned people and made them blind.
We already do harm reduction and safe supply of many drugs in our society because we recognize the alternatives of adhoc illegal supply is dramatically worse.
Using opioids like heroin (boy if one could even get heroin at this point) is obviously not "safe."
These sort of concerns around safety are at this point however irrelevant because the reality is that people are chemically addicted to these harmful substances and the issue is how to best get them un-addicted or manage that addiction.
Anyone attempting to get off a chemical drug addiction can be absolutely be expected to relapse at some point (many points most likely!) along the journey to ultimately kicking the addiction for good.
The point of harm reduction is so that when someone relapses they do not die from street drugs that are so incredibly toxic there is no known safe dose and that they have yet another opportunity to try to wean themselves off their harmful addiction.
The context of this discussion around street drugs is about the unregulated street drugs that are so cut with various unknown chemicals that it is impossible to have a dose that yields any sort of expected results. This is what is resulting in an incredible spike in overdose deaths.
There is a clear difference between harm reduction and rehabilitation, although both are beneficial to society. However, we should not use double-speak terms like "safe use", as all efforts to facilitate continuous narcotics use are not safe, and it is counter-productive to imply otherwise. To see my point of view more clearly, consider whether it would be beneficial for any user or potential user to truly believe it is genuinely safe to use narcotics as a part of a harm reduction program.
We should be educating people about the dangers of narcotics addiction, and helping those who are already addicted through rehabilitation programs. They should have access to the narcotics for reduction therapy/tapering. But they also need a lot more — counselling, withdrawals management, relapse management, replacement therapy, group support, and other effective measures.
I suppose the core of what I am trying to say is this: harm reduction is not addressing the core issue effectively enough, and calling any part of harm "safe" communicates a wrong message and is damaging. Harm reduction efforts are important, but are not enough alone; continued narcotics use not be sold by politicians as "safe". There is a subtle but distinct difference between "safe" and "safer", the latter of which is appropriate in harm reduction efforts, but not the former.
Coffee in regular amounts, nicotine not by burning, a beer or two now and then... shouldn't be controversial. Less obvious but still true: opiates at maintanance levels under supervision, regular amphetamine in moderate dosages, MDMA or ketamine on occasion. Loads of drugs in loads of usage scenarios really are "safe".
But just because supervised heroin won't kill you doesn't mean it's somehow good, actually. That's a separate judgement.
There's surely no upside. It's overwhelmingly likely to make you less healthy and less happy. But so will too much bacon and sitting.
Chairs are still safe though, by any sane definition.
Alcohol consumption is proven unsafe to health[1], but it's not controversial. Adults have the right to choose risky behaviors, just like they do in fire fighting, coal mining, underwater welding, or mountain climbing. In some cases, we admire those who choose them for their bravery.
Let's not confuse "unsafe" with "controversial" or "unquestionably bad." But let's remember that "safe" has a clear definition, which does not describe current "safe use" narcotics harm reduction programs. Harm reduction by definition means that harm is involved. Someone safe from street narcotics is someone who is not using them, at least in the way that they are generally used recreationally.
The core issue is a series of failed policies originally implemented to address the problem of white women hanging around black and Chinese men. I don’t think the world would end if we sold Vyvanse and Nucynta ER over the counter at CVS. Let the people predisposed to be addicts just be addicts instead of wrecking their lives and the lives of those around them with failed program after failed program.
The most important part is to not get people into substance abuse in the first place.
Many people start with light drugs (weed or subscription drugs) and then go to heavier stuff. If it is easy to get light drugs and easy to get heavy stuff then more people will be doing drugs. If it is legal to carry around drugs for personal use and if it is considered accepted, then more people will be using drugs.
These findings are consistent with the idea of marijuana as a "gateway drug." However, the majority of people who use marijuana do not go on to use other, "harder" substances. Also, cross-sensitization is not unique to marijuana. Alcohol and nicotine also prime the brain for a heightened response to other drugs51 and are, like marijuana, also typically used before a person progresses to other, more harmful substances.
It is important to note that other factors besides biological mechanisms, such as a person’s social environment, are also critical in a person’s risk for drug use. An alternative to the gateway-drug hypothesis is that people who are more vulnerable to drug-taking are simply more likely to start with readily available substances such as marijuana, tobacco, or alcohol, and their subsequent social interactions with others who use drugs increases their chances of trying other drugs. Further research is needed to explore this question.
I think drawing a line between light and heavy drugs (high risk of overdose/harm/very addictive)
If you have to buy your weed from a dealer who also sells other stuff the chances that you might decide to try something more harmful one days are much higher than if you can get your weed in a legal store.
>Whether the street drugs are produced in a quality-controlled way or not, it is well-known that use of the substances has negative outcomes in health and occupational functioning.
No, the problem is that this is an urban myth. There have been drug clinics that let trained staff inject people with clinical heroin and other drugs with no adverse health effects and often the controlled dosage ended up so low that the drug users maintained self awareness and the high wasn't present or extremely weak.
The clinic was shut down after twenty years of success because people were jealous of drug addicts without health consequences.
A single digit number of people died from overdoses on street dugs within a week of closing the clinic. I wouldn't call that harm reduction.
The truth is that most of the drugs that people want to take voluntarily are perfectly safe and it is the illegal distribution system that adds unsafe cutting agents with severe health consequences.
While I agree that adulteration of street drugs contributes significantly to them being unsafe, it is proven beyond doubt that illicit narcotics cause addiction with negative health and social outcomes:
Even sustained use of quality-controlled narcotics is detrimental and harmful to health and social cohesion. And you do not need to read these studies that prove it, you can simply ask drug users to speak on the topic.
In contrast, actual measures taken to legalize (if not make widely available) and focus on safety actually work to reduce issues and use.
With many drugs, actually quitting via tapering is a valid approach. How the heck do you propose to do that otherwise than having safe use?
By making it legal and say requiring ID to get, you can actually track and find who has a problem and deliver help to them.
That also requires the pharmacy and doctors to not be drug pushers, a tough sell in USA.
That easy. Worked pretty well in one or two countries.
I do not disagree with medication-assisted treatment (MAT) rehabilitation which involves tapering/dose reduction. I do disagree with the implementation of "safe use" Western countries have now, which is ineffective for rehabilitation.
Drug rehab programs regularly go much further to be effective, and include group counselling, individual counselling, substance replacement, medication to reduce withdrawal symptoms, relapse management, and similar.
On the other hand, harm reduction is a completely different effort that does not constitute safe use in my opinion, because it facilitates continuous use, which is very harmful, even if the harm is reduced. Even in rehabilitation centres, the use of controlled substances is not considered safe by all medics. It is rather more agreeable to call it safer use.
By the way, which are the countries that you mention where legalizing narcotics and selling them in pharmacies yielded positive results, and what were the results?
If you are talking about legalizing cannabis in some US states and Canada, it is far too early to see the long-term results, although preliminarily, it seems like the use of cannabis has increased. This might be acceptable as a trade-off, as legalizing cannabis will lead to less social stigma for the users, fewer engagements with law enforcement, and safe access. For the producers and distributors, it will mean safer working conditions and labor protections. All for a 10-15% growth in known cannabis use. And cannabis is a relatively safe narcotic.
If you are talking about Portugal's decriminalization of drug possession about 20 years ago, the distribution there is still not facilitated by pharmacies, and those in possession of hard narcotics are required to seek treatment, education, or other interventions as prescribed by drug commissions case-by-case. Portugal has not decriminalized narcotics fully, it was more of a shift from punitive measures to rehabilitation measures for the users. The laws surrounding distribution remain generally in line with Western countries.
You speak as if you've never read about the US opioid epidemic and how we got here. Do realize, this makes you sound like a religious prohibitionist extremist..
Your proposal is bunk. Someone who became addicted to prescription opiates does not deserve to play roulette with their life by being forced to buy street drugs after their own physician arbitrarily decides not to provide any more.
A prescribed drug, mind you, where one of the known side effects (of opiate consumption) is addiction, but the physicians prescribing aren't responsible for curing the addicts they create. Because <regulations, guidelines, prescribing practices, etc> mandate they cut patients off. This is "Just say No" all over again, but now it's the doctors saying "No."
What utter BS..
And to think that possession of fentanyl testing equipment is illegal in dozens of US States. It's as if the laws are designed to funnel humans to be slaughtered by adulterated product. Under the revenge-ethics banner of "they deserve it".
The US system:
- humans that are too poor to pay an expensive private doctor get to buy street drugs.
- Rich folks get private doctors that will prescribe what they physically depend on.
Ex:
Prince didn't accidentally die from taking Fentanyl-poisoned street drugs. He was adequately supplied with whatever he needed, for years. Years! While also functioning!
Prince was a functioning human, while also being addicted. There, I said it.
What harm to society was he? Why must we eliminate all addicts as you suggest?
I am not only aware of the opioid epidemic, but my family is strongly involved in rehabilitation clinic work in Europe.
My proposal is to reduce use through education, rehabilitation (including tapering/MAT), and not facilitating continued use. I also propose not using language such as "safe use". Please see the approach Portugal took in 2001 where narcotics possession was legalized but interventions such as rehabilitation were enforced — this is my proposal. The approach can be supplemented by harm reduction, but harm reduction alone is ineffective and selling it as a "safe" alternative to rehabilitation programs is malicious, as can be very evidently seen in the US.
I am saying exactly this. Fixing the root problem through rehabilitation can be supplemented by harm reduction efforts. But harm reduction does not by itself eliminate harm, and should not be called "safe". It could be called "safer". A rehabilitated person is safe from drug use. One using hard narcotics through legalized means is not.
It seems like some people are very strong supporters of "safe use" though, it is difficult to argue that there is another more sustainable approach to the narcotics problem.
Arguably the cycle of police aggressively confiscating drugs from users induces more petty theft as the police confiscations become a new sink to drain drug user wealth. Those chemically addicted to drugs need to replace the confiscated drugs, which creates a new need to find something to sell to get enough money to once again buy drugs on the illegal market.
A safe supply of regulated drugs breaks this cycle.
It would be great to destroy the criminal economy. However, I fear the drug trade is too useful to the likes of the CIA to ever be abolished. Those with power who seriously try to fix the drug problem would probably be assassinated. This is why no US leaders have actually tried to end the drug war.
Replacing individual drug doses with clean versions at the point of consumption is not “distributing drugs” in any sense except rhetorical, so I should simply reject that comparison.
But in the spirit of discussion, I will instead say: why compete when you could regulate?
This proposal would essentially introduce a tax on cutting drugs that is exactly proportionate to the amount of cutting done. Further processes could emulate other forms of regulation: if the drug dose contains enough of some adulterant that it would have been acutely lethal (for example, way too much fentanyl accidentally mixed in), you could withhold the dose or otherwise induce the user to give up the dealer to the police - not as hard of a sell as you might think, given that the pharmacist literally just saved the user from dying in the next 30 minutes - and now you have something sort of like safety and QA regulations that impose jail time penalties for improper manufacturing.
> Replacing individual drug doses with clean versions at the point of consumption is not “distributing drugs” in any sense except rhetorical, so I should simply reject that comparison
I pay a dealer for a ticket. I take it to the dispensary. They clip the ticket and give me new drugs. Now replace “ticket” with “tainted drugs.”
The street-purchase requirement is totally performative. The dispensary is selling drugs with extra steps, with the bonus of sending their revenue to the dealers.
The street purchase requirement is not totally performative. It requires dealers to be standing around on the street carrying books of tickets that are highly illegal to possess, thus allowing police intervention. Under the extra step proposal, police can continue to arrest ticket-sellers, hypothetically reducing the ticket availability towards zero. Without the extra steps, there is just the user and the dispensary, there’s nobody for the police to arrest and law enforcement loses their lever for pressuring and reducing the illicit drug trade.
> hypothetically reducing the ticket availability towards zero
This is prohibition with extra steps. Granted, you deal with the problem of tainted drugs. But that isn’t the chief issue, and creating a giant hole in the budget aimed exclusively at that harm seems political suicide.
In case it’s not clear, I am in favor of prohibition! The exact lesson I draw from the failure of alcohol prohibition is that drug harm isn’t a major factor in drug users’ choices; you can’t (ethically) reduce demand by making drugs more harmful, and more modern evidence seems to show that making drugs less harmful doesn’t increase use by much either. I believe that drug distribution should be illegal, and drug consumption should be as safe as practical.
If we’re talking about political feasibility, I think replacing harmful street drugs with their pure versions at the point of consumption is politically much closer to “safe injection sites” than it is to “government agents with the job title of Drug Dealer”.
Because there are other reasons extremely valid reasons why we shouldn't drug dealers and organized crime besides that they drugs they sell are ussually adulterated?
I mean you couldn't even get these legal/clean drugs directly before buying something from a street dealer under this scheme? Why? IMHO that's just beyond absurd we might just as well provide direct cash subsidies to drug cartels instead if that's your goal.
The government also can't compete on potency. We'd be dispensing safe drugs, but the street dealers always win: they're always going to have stronger, riskier stuff. Addicts want the stronger stuff.
An example is the supply arms race with research chemicals/designer drugs (RC). Every month, a new RC hits the streets with greater potency and skirting any previously-established regulations. The drug dealers will always be winning the potency race because they're on the bleeding edge, using the latest formulas and cutting it with experimental/unsafe/word-of-mouth additives.
The only way to win is making them free. And even then, the potency race continues. It's a ginormous value edge that the dealers have, and sadly, it preys on the most vulnerable sufferers.
Potency only means that you need a smaller quantity of a substance to attain the same effect. It has nothing to do with the maximum attainable effect. Users don't care about potency.
If anything, users care about speed of crossing the blood-brain barrier, which causes the pleasurable "rush" of rapidly increasing effects. The major drugs like heroin and methamphetamine are already pretty optimal in this regard.
On the other hand, drug suppliers care about potency because they can transport more doses in the same weight.
The only people who care about RCs are people trying to skirt the law, and drug nerds.
https://en.m.wikipedia.org/wiki/Potency_(pharmacology)
> Potency only means that you need a smaller quantity of a substance to attain the same effect.
Semantics, misused a term there.
> The major drugs like heroin and methamphetamine are already pretty optimal in this regard.
In a world where this was true, cutting drugs with fentanyl wouldn’t be a thing. It’s not just a cost optimization, it’s also because it gets you the best high on the block.
> The only people who care about RCs are people trying to skirt the law, and drug nerds.
“Spice”, as one example, has destroyed many communities. Legal highs and designer drugs are everywhere as of the past decade. “Bath salts” (cathinones), synthetic cannabinoids, etc.
Not exactly designer, but the isomerization process to extract delta-8 from hemp is a novel technique that’s being done underground by labs everywhere and distributed widely across America. We have no idea what’s in this stuff, even testing labs usually report XX% of unknown substances, reaction residues and cannabinoids in samples.
Research chemicals are everywhere. This arms race has touched millions.
You have it backwards. The only reason for novel compounds is their lack of regulation or that their potency makes smuggling easier. It's definitely not a demand-side thing.
If the government is going to give out drugs, then they should just run some pharmacies similar to state run liquor stores. No need to force users to buy from dealers, that makes no sense at all.
I'm not sure I understand completely or agree with it, but if the drugs could be reliably tested to avoid gaming the system, then in theory we could continue to try to curtail the illegal drug trade on one end while replacing adulterated drugs with clean ones on the other, net zero increase of availability.
If it worked well. There are probably many problems with this idea.
I've always said anyone who likes should be offered the choice of a free ticket to Swain's Island, which could be stocked with barrel fulls of absolutely pure and pharmaceutical grade hard drugs to the heart's delight of the new resident.
Let anyone who wants it buy fentanyl, and let natural selection do its work.
This is suggested semi-facetiously, but at the same time, feels like there's something to it.
Decriminalize, tax, regulate, and focus enforcement efforts on black market dealers.
The waste of human effort and life that has gone into the last 60 years of drug policy is insane to consider. We have got to try _something_ other than what we're doing now with prohibition.
I think the framing of "let natural selection do the work" is self sabotaging if you're really trying to make the argument persuasive. It makes your position sound on some level likes it's casually dismissing the loss of life when what is really being argued, to me when I read your post at least, is that we need to accept that in dealing with this kind of topic lives are going to be ruined/lost either way and that when we/governments take responsibility as distributors that at least allows us more control over the situation and from that position we might at least be able to diminish the risk/harm to addicts even if we can't actually convert them into non-addicts.
I'd add that I think more explanation around the black market angle could probably help the argument further since atm the state of legalization advocacy in the US tends to be "But think about the tax revenue!" which is fine for less problematic drugs like weed but which is going to stall fast when you get to things like heroine. Emphasizing legalization and government regulation/distribution as a way to take money out of the hands of gangs and street dealers would be compelling to a lot of people imo if framed in the right way.
100% fair, and also right. I started writing that as a kind of dismissive jokey, maybe slightly trolling, thing and then ended up a little more serious as I continued thinking - probably not my most well-argued or empathetic post.
If you follow that line of thought then allowing fentanyl is equivalent to the capital punishment. You can't consciously rely on this to manage society.
The problem with this approach is that it is impossible. There is no "general chemical analyzer" that can consistently detect the quantity of a substance in any sample. You may as well suggest that a wizard uses his magic wand to purify the heroin.
Not to mention that users will begin to bring in all kinds of crap to see if they can get heroin from it — notably, their own excrement. Drug sellers likewise may decide it is unnecessary to recrystallize their products to remove solvents, since your suggestion makes no distinction between the sample contaminated with acetic anhydride and the one that was cut with mannitol. So there is still plenty of moral hazard.
I’m pretty sure a mass spectrometer will actually do what we want here, we don’t need a magic wand.
Drug dealers leaving solvents in because this suggestion makes no distinction between different cutting compounds? I propose that we do draw a distinction, then.
Drug users trying to hand us a baggie of their shit and call it heroin? I propose that, uh, we say no?
To be frank, none of your objections seem like very difficult obstacles to overcome.
This was debated when Vancouver first introduced safe injection sites, but was not put into place, as I understand it, because the government didn't want to become the drug dealer.
According to https://harmreductionjournal.biomedcentral.com/articles/10.1... mass spec machines are between $5000 and $1m, and commercial labs offer services for between $5 and $100 per sample. Presumably the capital investment of buying a mass spec machine and hiring a technician drop the cost per sample drop lower than $5, as it seems businesses are able to stay profitable charging that amount.
According to Wikipedia, the budget for the safe injection site in the article is $1.2m initial investment and $500k/year operating cost to handle 175k injections per year. Even at $5 a sample that’s $875k a year. So mass spec is actually completely plausible, in both capital investment and operating cost, for the budget of a single injection site at the volume that injection site handles. https://en.m.wikipedia.org/wiki/Insite
That the conservative estimates and some upper bounds for gold standard mass spec are within the actual budgets of individual injection sites is, I feel, justification enough for my glib “cheap enough!” quip above. Of course, we may not need the gold standard. For the limited scope of identifying pharmaceutical chemicals in small doses, there may be cheaper processes that function just as effectively.
Significantly depends on what kind of MS we are talking. Single quad can be had for well under $100k. Top of the line Orbitrap is ~$1.2 million. Depending on the analytical constraints, I think you could get by with a mid-range triple quad for $200-300k. Although, if you need to do exploratory work, I think everyone should just buy a QE as it is a solid workhorse that can fit most any role.
When a lot of that equipment gets aged out from industrial uses it will be given to universities in still-working order. Biotechs going bust can also be a boon to the second-hand market where state of the art equipment can be had for a song. I know one lab which acquired a piece of equipment that had been used in a background shot of a Jurassic Park movie.
I mean sure, but does it makes sense that a high school would have $1-2M worth of mass spectrometers?
Keep in mind there is significant expense in their upkeep as well.
That's why I guessed they were probably gas chromatographers with wavelength or FID detectors. Those are pretty cheap (gas source, injector and column).
(In case it’s not clear, I’m not actually a fan of illicit drug use. I view this proposal as roughly about as dystopian as the current practice of safe injection sites where trained professionals watch users inject whatever tainted drugs they bring with them, and try to treat overdoses without knowing what the person put in their system. I see it as proposing Brave New World vs the current 1984.)
Pretty shocking to read that the worker in the safe site was also a daily IV meth user, I’m pretty shocked anyone can hold down a job with a daily IV meth habit.
I’m an Iraq war vet. I’ve lost friends to drugs, suicide, incredibly reckless behavior to the point it might as well be suicide. Once you’re in a cohort of people that are close to death, the mental strain of losing your friends has a way of squaring the circle for you. It takes an extraordinary amount of self control, and daily effort to change your circumstances. Being at arms distance all day from IV drug use is not going to do it. Previously I’ve been all for harm reduction centers, and safe places to test and use drugs, because I don’t believe that heavy handed prohibition solves anything. I’ve never seen a motivated human stopped from doing anything self destructive by threatening them with more self destruction. I hadn’t considered the mental tax on the employees that work in these centers. I think it’s still a net positive, but wow.
I couldn't tell if “now” meant now-now, or then-now, as in at that point in their life (as a child when they were progressing from drug to drug). I also can't imagine anyone functioning when injecting meth daily.
Article quotes "We know that xylazine is a veterinary tranquilizer, but we’re not sure how the drug dealers are getting it from clinics."
DEA says "A kilogram of xylazine powder can be purchased online from Chinese suppliers with common
prices ranging from $6-$20 U.S. dollars per kilogram. At this low price, its use as an adulterant
may increase the profit for illicit drug traffickers, as its psychoactive effects allows them to reduce the amount of fentanyl or heroin used in a mixture. It may also attract customers looking for a
longer high since xylazine is described as having many of the same effects for users as opioids,
but with a longer-lasting effect than fentanyl alone."
There are indications that alpha-2 antagonists can reverse or mitigate xylazine's effects.
Yohimbine, a very popular dietary supplement, is an alpha-2 antagonist. It reverses the sedative and cardiac effects of xylazine in animals [1], and should be quite well-tolerated in humans. It's also available in pure form via Amazon.com and millions of other places.
So it's not as though xylazine has no antidote in principle...
[1] - Spoerke, D. G., Hall, A. H., Grimes, M. J., Honea, B. N., & Rumack, B. H. (1986). Human overdose with the veterinary tranquilizer xylazine. The American Journal of Emergency Medicine, 4(3), 222–224. doi:10.1016/0735-6757(86)90070-7
From Wikipedia: "In veterinary medicine, the alpha-2 antagonist atipamezole is used to reverse the effects of xylazine or the related drug dexmedetomidine, but while this has been tested in humans in Phase I trials, it is not an approved medical treatment for xylazine overdose.
"Not approved" simply because it hasn't gone through the drug approval process -- because, among other reasons, xylazine isn't approved for use in humans in the first place. Not because it doesn't necessarily work or would necessarily be harmful.
Granted, atipamezole seems somewhat "cleaner" than yohimbine, which is a natural product with quite a few off-target effects.
Does it really matter if it hasn't gone through any testing? Have we forgotten about the Covid shot not going through any trials? We have people dropping dead left and right due Narcan not reversing the effects. The FDA NEEDS to come up with something that acts both like Narcan and Atipamezole, so we can start saving lives!
Also probably not approved because of a lack of randomized, double blind studies. But it would be really hard to run a study for a treatment like this. I can’t even imagine trying to get informed consent to try and enroll someone on the trial. So, without that, the best you could do would be to find a drug that is approved for something else that can be used off label.
> So, without that, the best you could do would be to find a drug that is approved for something else that can be used off label.
Xylazine has a very rapid onset and a short half-life. So, as it can take >40 minutes for orally-administered drugs to be absorbed, there are really only two options that _might_ be legal and effective.
1) Administer an FDA-approved alpha-2 antagonist intravenously. There are no good options here. AFAIK, the only FDA-approved alpha-2 antagonist that's available as an intravenous injection is Thorazine -- and it does a hell of a lot besides counteract alpha-2 adrenoceptor activation. It's also an alpha-1 antagonist, dopamine antagonist, serotonin antagonist, and more. This likely makes it a little bit unpredictable in drug overdose scenarios.
2) Sidestep FDA approval with a fast-acting yohimbine nasal spray, administered as a "dietary supplement."
The FDA process is a terrible roadblock in situations like this. Intravenous atipamezole, which would be much better than either of the two options above, is available for veterinary use, but would be totally illegal for use in humans. (Like xylazine itself!)
Ah, the result of war on drugs. People want to change their state of consciousness. People also self-medicate when facing issues, like chronic pains, or chronic mental stress.
Why don't we take a look at each category of drugs (benzos, opiates, stimulants, psychedelics, ...) and make the least harmful one or two of those legal? Regulate it, control it, make it safe. Create clinics where people can get educated about safe use, and where people can get clean, medical-grade drugs that they'll buy off of random dude in the suburbs otherwise.
People are going to use drugs. Alternatively, they'll get addicted to other things, like gambling, which can be just as destructive.
Stop making drug addiction a moral failure. It's not. It's a part of life, and a very human thing. I wonder how many wall street traders still regularly do coke nowadays.
We should look at why our society has such high levels of mental illness, stress, and dysfunction. Putting a bandaid on a gunshot wound or having self medication become standard isn't a real solution, the underlying problems persist. If it's something about modern lifestyles, philosophies, or social environments, then fixing those could lead to much better mental health outcomes. We can do studies on which groups have the best mental health outcomes and encourage those.
What I'm saying is that to a certain level, humanity will always want to change their consciousness. This has nothing to do with suffering in the world.
Of course, suffering then leads to people seeking out quick fixes. But you know what? If you're suffering from chronic pains, and medical experts can't help you (as has been the case for many people), taking some of these drugs (like THC) is highly preferable to not having anything.
I wouldn't really call it changing consciousness but rather just escapism. A lot of people will do drugs because they are trying to escape their lives. Once addicted they are then trying to escape withdrawal.
I grew up in the 80s in the San Fernando valley. I was in the center of DARE, in the middle of the Crips and the Bloods and their narco-fueled civil war. The biggest drug bust in history (to that point) occured 7 blocks from my house. I rolled my eyes ever since...
And then...
I lost college friends to drug overdoses. I saw some of the best and brightest of my university program permanently addle their brains, I saw friends in their 40s, with amazing baby children, commit suicide after years of fighting opiates (the completely legal ones). I saw the CEO in waiting of a fortune 500 company destroy his life with heroin. Now the very first of my children's schoolmates and friends are dying to Fentanyl.
Drugs are more and more powerful. The bar to them is less and less. Some people (including myself) have issues with addictive behavior. True enough. But thoose don't melt the skin off your body.
That’s the point of harm reduction. If we stop focusing on treating those with drug addictions as criminals, they can potentially contribute to our society instead of having their lives destroyed by criminal convictions and medical issues from unsafe drug usage. Instead of being further cast out of society they can live with some level of dignity even if they cannot overcome their addiction.
I found it surprising too, on the basis of, it could pose perceived or actual conflicts of interest in their work. And of course the performance and/or liability risk on the org.
But you skipped the part of the quote where he's been abusing drugs since age 11 - it'd certainly be more alarming if he was sober but after working at the clinic for a bit, started taking up IV meth. But yes, still surprising, however there are benefits to serving the people that you can relate most to.
> was a daily meth user before he was in harm Reduction
These stories usually feature someone who went clean. That it's someone who still using and contributing to society makes it unexpected. (I hadn’t considered the possibility of a functional meth addict.)
Probably as many as functional Tylenol users are injecting. In my meth days I knew of 2 people that injected. It was always smoked or, less commonly, taken orally.
Adderall generally comes in a fixed quantity of lower potency than meth, and in beads designed to spread the release out over time. It's supposedly not easy to smoke it either.
Then there's just the nature of addiction. Some people seem predisposed to it. The Vietnam war is a good example. High percentage of heroin use there by US soldiers, but a much smaller percentage of the in-country users returned home with a habit. Another example is the high occurrence of addiction following bariatric surgery, with people who didn't have the issue prior.
7% seems high. Googling shows ~40 million prescriptions dispensed in 2021. Since CSA disallows refills and 90-day fills are extremely rare, that’s about 40/12=3 million patients, or roughly 1–2%.
I would be curious if other knowledgeable folks agree that pure meth isn’t that much different from Adderall on dimensions that are likely to be relevant.
Adderall is regular (non-methylated) amphetamine, specifically a mixture of levo-amphetamine and dextro-amphetamine. There are minor differences in effect profile between methamphetamine and amphetamine, the biggest of these minor differences being in neuroprotectivity (it’s been a while since I’ve done the research but iirc amphetamine is mildly neuroprotective while meth is neutral or mildly negative, due to meth interrupting some metabolizing process). The major difference is that milligram-for-milligram, meth is 2-5x more potent than regular amphetamine.
The perception that they are very different is valid, though, because amphetamine is usually consumed therapeutically (lower doses, guaranteed purity, controlled dosing schedule, safer administration route) while meth is usually consumed recreationally (higher doses, unknown and often dubious purity, erratic dosing schedule, riskier administration routes). Injecting a quarter of a gram of street meth over a three day binge is much more harmful than taking 40mg Adderall extended release formulation by mouth every morning.
Adderall will have me overly focusing on one thing if I take a bit too much. Meth will have me sitting at the computer for 8 hours knowing I have other obligations if I take a bit too much. I'm also much more distracted and likely to hop to new random things on meth, versus hyper focusing on one thing.
tldr; pretty different in practice, trust your doctor, all that good stuff.
On some level, it is similar as they are both stimulants and nearly the same chemical. But my own research suggests the methyl group has a significant effect on how the body metabolizes the drug.
The methyl group makes it fat-soluble which allows it to cross the blood brain barrier. Apparently this causes it to have an effect on dopamine and serotonin receptors which it would otherwise not - hence the euphoric effect. It also cleaves into amphetamine in the blood stream which gives it a significantly higher half-life.
How you administer a drug is important, which is self explanatory. Most newer ADHD stimulants are made in such that they must be metabolized through the stomach.
Additionally, the dosage is important. Meth is not only more potent, but when abused is likely to be taken in 10x (or more) amount than a therapeutic dose.
So.. safe to say they are chemically similar but different in practice. This info is from my quick googling. I’m on a therapeutic dose of Adderall, and given its effect on my blood pressure I would be concerned taking meth due to all of the above. And this is why I have a doctor to help me with all of this.
There's another ADHD medicine called Desoxyn which is methamphetamine. Adderal is a mix of amphetamine salts, but it's still fair to say they're not very different. The main difference is in the common dosage.
Eh, it's more like an obese doctor treating obese patients. The goal isn't become thin, but to reduce harm. Yes, the doctor should tell the patient they should lose weight. But in cases where that's unrealistic, there are second-best options before abandonment.
I used to believe that these safe injection sites were an okay idea, but now I'm vehemently against them. These people need help, and should be FORCED into addiction relief programs. They shouldn't be left to continue their addictions unabated. That isn't freedom, it's slavery to drugs and drug dealers.
After seeing the absolute mess that SF has become, what I've come to realize is that these "supporters" of drug addicts are doing NOTHING to help them break their addiction. They are letting them accelerate their addiction, and they are doing nothing to help them get rid of their addiction.
If you look at all of these "progressive" programs, they look like insidious plots to hurt those they claim to want to help.
"Safe injection" sites actually keep addicts addicted for longer and don't help them conquer their addiction.
Education activists that want to drop education requirements because they are too hard to achieve for Black and Brown students don't help them learn, in fact they leave them uneducated by the time they graduate high school.
Mental health/homeless activists don't help homeless people solve the problems that lead to homelessness (usually mental health or drug addiction), instead they give band aid solutions that keep them homeless in perpetuity. The number of homeless people passed out on SF sidewalks and using the streets as their bathrooms have skyrocketed even though homeless funding is $600 million a year.
"Restorative justice" programs cause crime to skyrocket because criminals take advantage of these laws and commit crimes with no fear. Alameda County DA Pamela Price cares more about freeing criminals than helping her constituents get any modicum of justice or to keep their streets safe. She is doing the opposite of what she should be doing.
Everything that was promised by these far-left progressive policies have failed in the real world, and the fact they continue pushing them in the face of their failures is indication that they don't care about science or data, all their care about is dogma.
When you introduce safe injection sites more people end up surviving their addiction which makes it look like the addiction problem is getting worse when it is getting better.
This is a lie. It only proliferates addiction and does nothing to help those addicts out of addiction. If you look at SF, people are dying of drug overdoses at an epic rate. More people died from drug overdoses in SF than did from COVID. Think about that.
I disagree completely. I'm seeing a common thread among all of these neo-progressive efforts. They defy reality and have a feeling of insidiousness to them. They are hurting the people that they purport to want to help, and they are all destroying the communities that implement them.
SF is a perfect example, because there has been decades of left wing politics in charge and there's no Republican boogeyman to blame. And it's been nothing but failure and failure, and things are getting worse and worse.
Education is the thing that really makes me the most angry, because the fact that 50% of Black and Brown students are "graduating" from high school barely able to read [1] is 100% the fault of the progressives. They claim to care about equity, yet all they are producing is generations of students unable to compete in the real world. Lowell is/was a top 100 high school in the US, and the progressives gutted the admissions because too many Asians got in, so they changed it to a lottery system. All that did was admit kids who were unprepared and flunked classes. The number of flunks classes tripled in a single year after merit-based admissions was cut [2].
All of these things are related. The progressive policies since the 60s have produced fantastic policies that are important for freedom. Gays and trans deserve the right to live in safety and be treated like everyone else. Drug addicts should not be criminalized, they are addicts that need help. Mental health problems should not be stigmatized. Racism against any group should never be tolerated. Lower-income neighborhoods need to be lifted up, and yes at the expense of richer neighborhoods.
But the policies we are seeing these days go too far and are damaging the people that they purport to help.
BTNX now supplies test strips for Xylazine, I just ordered the first batch for the harm reduction outreach group my friends and I run. If you are interested in helping street drug users in NYC consider donating at https://opencollective.com/dont-forget-the-streets all of our funds go directly to supplies. We also table at local DIY shows, supply bars and clubs with Fentanyl test strips, and host narcan trainings.
Drug users have been banging the drum about the dangers here for years now. All the drugs are toxic. There is no safe dosage. There is no opioid crisis. There are no opioids. It's all a toxic mess of unknown chemicals in the street drugs. This is a core reason why the death rate has been spiking upwards.
Really good to see more reporting about this, but also alarming at the delay from when the problem started and when mainstream press is starting to talk about it.
Advocacy groups have achieved a bit of traction of getting some media to correctly call this a "toxic drug" crisis, but here we see an example of a major national media outlet while thankfully still ploddingly coming around to reporting on the issue, still framing things in the deprecated terms of an "opioid crisis" framework that is years out of date.
The harm reduction activist claims the individual dealer isn’t at “fault” if the supply was laced after being passed around amongst other dealers. In that case, it would be more accurate to speak of the dealer’s intention, rather than responsibility.
I don’t know about that line of logic, the dealer is responsible whether they laced the supply themsleves or not, if not fully at least partly for passing the drugs along. They could claim not knowing but that doesn’t make then any less responsible.
I may have worded it in a misleading way. What I meant was, if you’re sympathizing then speak of intent, since the dealer is still responsible, as you noted.
I can't find an example of an individual store being liable for unknowingly selling a preprepared item that causes illness, though my search has hardly been thorough. Plenty of examples where they're selling in-house prepared deli items, but that'd be the equivalent of the dealer adding filler themselves.
And I've never heard of a seller being targeted for smoking related lawsuits.
I asked chatGPT for a “ example of an individual store being liable for unknowingly selling a preprepared item that causes illness” and it gave me a non hallucinated one
Imo because it's a waste of thread space but here you go.
One example of a grocery store being held liable for unknowingly selling a pre-prepared item that caused illness is the case of In Re: King Soopers Listeria Outbreak Litigation. In this case, a number of people became ill with listeriosis, a serious and potentially life-threatening bacterial infection, after consuming pre-packaged deli meats sold at various King Soopers grocery store locations in Colorado.
The outbreak was traced back to contaminated meat produced by a third-party supplier, and a number of people filed lawsuits against King Soopers alleging that the store was liable for selling the contaminated meat. The lawsuits alleged that King Soopers had a duty to ensure that the food it sold was safe for consumption and that it had breached that duty by selling the contaminated meat.
The case ultimately settled for an undisclosed sum, with King Soopers agreeing to compensate those who became ill as a result of consuming the contaminated meat.
This case illustrates how grocery stores can be held liable for selling pre-prepared food items that cause illness, even if the store was unaware of the contamination at the time of sale. It also highlights the importance of ensuring that food safety measures are in place throughout the supply chain, from the producers of the food to the stores that sell it to the public.
This seems to be an invented combination of several real events. King Sooper was sued for selling prepared cantaloupe with listeria, and there was an event where deli meat and cheese sold elsewhere was contaminated with listeria, but I can't find anything like what is described.
This is what happens when criminals produce drugs. Drugs of abuse should be legally produced by professionals and made available to adults, e.g. tobacco, cannabis, alcohol.
>we spoke to Kali Sedgemore, a long-time harm-reduction expert in Vancouver’s Downtown Eastside who also works with Vancouver Coastal Health
I'm not shocked the article is from BC and even less that it was Downtown Eastside.. I think all Canadians know about the Downtown Eastside. Even here on the opposite coast I know its reputation.
YouTube suggested a video just a few days ago to me of a Vancouver fire hall located in the Downtown Eastside. Most fire halls in Vancouver average 600 calls per month but Fire hall 2 they get 1,600 calls per month!
A side effect of having so many calls for drug users in distress is that those services aren’t available to immediately respond to other types of medical emergencies that are life threatening, such as a heart attack for example.
Ketamine-xylazine is the drug combo given to rats when I worked in a lab doing animal studies. It is approved to make them go to sleep and feel nothing before death by exsanguination.
The Anglo West's approach to drugs has absolutely failed. Rehab the abusers, lock up and punish the dealers (some countries use the death penalty to strong results), and secure your borders properly.
Instead, we get kvetching and hand-wringing about "what can be done", and tittering discussions on online message boards, while society decays even further.
Who are you asking to do this? Daddy government? The federal government and its industry masters fucking love drugs. Caffeine and alcohol in every town, adderall-fueled tech and finance, FDA-approved Sackler opiates, US-guarded Afghan poppy fields, the CIA's LSD-based involuntary mind control experimentation on US citizens, the tobacco industry, the sugar lobby. You want these organizations to tell us what we can and can't put in our bloodstream?
Criminalizing street drug use and distribution will probably fail so long as there is strong and inelastic demand — the kind created by addiction. This is why it is important to remove demand by effectively rehabilitating the users, educating those not using, and not facilitating continued use. There is no "safe use" in reality; all use of controlled narcotic substances leads to addiction, and poor health and occupational functioning outcomes.
On the supply side, even the death penalty can be priced in when the demand is strong. The narcotics business is one of death, not just due to the criminality and the death penalty in some regions, but also due to no labor protections, prevalent drug use among the producers and distributors, and clashes with law enforcement and rival criminal orgs. This has deterred neither the suppliers nor consumers. When even the probability of death isn't a good deterrent, a probability of imprisonment won't work either.
Speaking of death not being a deterrent to lucrative business, the narcotics industry is not an outlier. Industries involving underwater operations like welding, oil rig work, coal mining, logging, high-rise maintenance, stunt performance, mercenary work, experimental aircraft piloting, and similar all exploit death for large profits. It's just capitalism. So a solution to the drugs crisis needs to work within a capitalist world.
I’m not sure why you are being downvoted. It’s a perfectly acceptable solution and has been tried with great results in El Salvador. I would argue that El Salvador is safer than SF and has a way more friendly tax policy. And the government is not trying to actively punish you for crimes you never committed, in the case of reparations.
Because unfortunately, ideology trumps reality on anonymous message boards. Too many posters here, despite the high end white collar work they do, cannot seem to apply similar smarts to managing society, instead falling back on their own biases and personal preferences. Harsh punishments are not "good", but living in a decaying drug-infested society with no solution is worse.
Stop the dumb policy of letting drugs free.
This needs to end, and the government must intervene and put an end to every drug dealer, and seriously find a way to deal with addicts.
This is literally the policy that got us here and has failed us every single step of the way. Doing more of it is how things keep getting worse.
The correct answer is to decriminalize everything and improve public health programs like Portugal did 20+ years ago. They saw extremely good outcomes. [1]
Your understanding is wrong. In Portugal you are forced to go into addiction therapy or go to jail. You're not allowed to just continue to take drugs on the streets like in SF.
We shouldn't criminalize addiction but we certainly shouldn't let it proliferate. Forced drug rehab is an essential part of the equation. Without forced rehab, you get open air drug markets like SF which is making things worse, not better.
Today a drug addicted woman gave birth to a baby on the street in SF. It's all over Twitter. It's worse than a 3rd world country in this so-called utopia of progressive freedom. It's sick and disgusting.
> Your understanding is wrong. In Portugal you are forced to go into addiction therapy or go to jail. You're not allowed to just continue to take drugs on the streets like in SF.
So my understanding is correct then. I'm familiar with what I'm advocating.
Then you knowingly left out the most important part of the whole program. Portugal doesn't let people remain addicted, the way all the progressive programs are doing like in SF, Portland, etc. Simply legalizing drugs is evil, it's benefiting the drug dealers and so-called harm-reduction advocates that benefit financially from letting addicts continue to live in slavery. We need forced rehabilitation as part of the equation, otherwise it doesn't work at all. I don't believe addicts should be criminalized, but locking them up in jail is the second best solution, to what we have right now, which is the worst of any scenario. It's a complete failure and downright evil what is going on right now in SF.
Hardly, I linked to an article which covers all of that.
I also didn't say legalize, I said decriminalize. These are two different concepts. Legalize weed and psychedelics, sure. Decriminalize hard drugs. And improve public health programs, like I said, including mandatory rehab (which I left out - not for any particular reason - but support for addicts).
> It's a complete failure and downright evil what is going on right now in SF.
How many years did Portugal’s approach take to work?
Oregon decriminalized personal possession of basically all of these drugs in 2021. As of today, a large swathe of downtown Portland is basically one highly dangerous open air drug market. It’s going to end up like the Tenderloin and Civic Center in SF. The cannabis tax money flooding into addiction treatment businesses seems to be not making a dent. Between lower quality of life and some of the highest tax burdens in the US, Oregon is decreasing in population every year now.
> Portugal’s policy rests on three pillars: one, that there’s no such thing as a soft or hard drug, only healthy and unhealthy relationships with drugs; two, that an individual’s unhealthy relationship with drugs often conceals frayed relationships with loved ones, with the world around them, and with themselves; and three, that the eradication of all drugs is an impossible goal.
> “The national policy is to treat each individual differently,” Goulão told me. “The secret is for us to be present.”
If you want to learn more the article I linked is very good. It goes into great detail and I think covers how long it took to work.
But the reality is it's not just enough to decriminalize, you also have to provide appropriate care. Oregon didn't do what Portugal did - they only did part of it.
Portugal didn't decriminalize the way Vancouver decriminalized drugs or SF decriminalized shoplifting. They merely stopped giving criminal records to people who chose and completed rehab, but they still certainly use the police to apprehend any public drug user.
No, they decriminalized. They didn't legalize. It's the subtitle of the article I linked, and if you google for five seconds, you'll see that's what everyone else calls it too. You're welcome to call it whatever you want I guess.
And yet the architect of the Portuguese anti-drug response explains how the courts and police are used to enforce this "decriminalized" system.
Vancouver has taken away the police's ability to confiscate a drug that has just killed someone, or to arrest the dealer. This is directly opposite of what Portugal does, dishonestly borrowing the words without their original meaning or critically the other 90% of the Portuguese response like actual rehab in a drug-free society.
That's great, you should take it up with them. Like I said you can call it whatever you want, but to quibble with the common name and the one used it all references to it - you're probably fighting the wrong fight, or at least with the wrong target.
It's the common lie, not the common name. I can't get the politicians or the newspaper to change, imho because they don't want it to, but I'll take it up with whoever uses it by showing them how it's not true. Once you realize Portugal uses the law to enforce their "decriminalization" you can't in good faith keep supporting or even repeating the lie yourself. It only takes that first recognition of being mislead before you can find your own references and see what the street-level reality is.
Our cities, SF, Vancouver, Portland, Seattle, LA, Victoria, etc know they're distorting the meaning by claiming it's what Portugal does. They've been told that they're wrong in this by journalists with experience in Portugal and by the very architect of the Portuguese system and they refuse to choose other language or admit that they are in actuality enacting the exact opposite to Portugal.
46.7% of the state's population is in the Portland metro area as of the last census. Multnomah County has the second highest tax burden in the country for top earners. If a new capital gains tax proposal is passed this year, it will have the highest. There are many reasons why the state lost population starting in 2022, but taxes are definitely one of them.
Oregon has the 31st highest tax burden of all states, across its whole population. Even if the tax burden is high for high earners, that’s not driving a significant population exodus because high earners aren’t a significant population to start with.
People who have the highest disposable income also have the most opportunity for mobility. It’s entirely possible that a disproportionate percentage of those moving away are people who care more about high property and income taxes vs. lack of a state sales tax.
Note that I said the decline is multi-factorial though. A significant part of it isn’t even outward migration, but excess deaths due to COVID combined with a low birth rate and a lack of inward migration. (Here again though, who do you think has the most opportunity to move to a new state and what kind of tax policy deters them?)
I would be considered a "high earner" according to Portland tax law. I recently moved. Portland originally was in my top 5 choice of cities to move to, but the tax liability deterred me from moving.
That is funny how people would like their governments/officials do something to tackle issues while at the same time trying to evade at all cost giving any money needed to actually do something.
I think you are making a generalized statement, but it is in response to a personal tidbit so the generalization feels personal. I'll just say, I don't think including taxation as a consideration when relocating is irresponsible or evasive.
One could argue that paying a lot of tax could be considered as wealth as you typically get something in return. It can be in different forms: better infrastructure, or a safety net / insurance from the government when something bad happen.
I feel a kind of duality when I look at the US from outside. People seems to be trying at all costs to avoid taxes but if someone get seriously hurt or have a serious disease one of the immediate response is to start a gofundme and ask to pass the word for charity and a lot of people are happy to donate. On one hand it is kind of touching to see that people are willing to donate for someone they sometimes barely know, on the other hand shouldn't everybody seek a society where everybody is happy to donate but nobody has to ask for charity from his community because gov takes care of that through that tax money.
I don't know if I am alone, maybe people will make fun of me for that but I am kind of proud of paying a lot of taxes. I know governments don't always take the best decisions, some money is sometimes plainly stolen or badly used and I may not agree with all decisions but I feel it is part of being a citizen and it makes me also more responsible and eager to vote and try to make a difference when I can.
Yeah sure, that's why countries which take a hard stance with actual enforcement like the UAE have no open drug markets.
The problem is enforcement, as long as there are open drug markets, then the issue isnt the laws its the joke of a police that pretends to do anything, or rather idiots trying to sympathies with drug users and dealers keeping the police from doing their work.
And yet, that's the approach that has completely failed. I suggest you allow data to drive the discussion instead of silly failed moralizations. As a peer comment pointed out, Japan's drug policy is the most strict in the developed world - and it has a massive under-reported meth problem. I suspect the Emirates is similar and lower headline numbers come from lack of reporting - not lack of issues. Do you have some evidence to suggest your approach works? To my knowledge there really isn't any.
Maybe it's time to start sympathizing with the drug users if you want to get rid of shady dealers and narcos. We've tried it your way. It sucks.
And to be clear I don't have a problem with helping drug addicts leave drugs, the difference is they should never be allowed to be left using them without any intervention.
So the police gets them, and gets the dealer then they either get treated or prisoned depending if its their first time or they are actually addicted.
Addiction is a mental and physical health issue. Why on earth are the police involved in the first place? That's not what they're for.
But a lot of what you're describing is literally the Portuguese model, which you can find out if you read the article. They can require you go to rehab depending on if it's your first time or if you're addicted. It's just not a criminal matter, it's a public health matter. Which means you have less stigma, you avoid prison, a record - and you are more likely to ask for help.
We know for a fact prison is a place you can get drugs, and going there leaves you more likely to be addicted, not less, because you look to those same drugs as an escape from your prison situation.
> Addiction is a mental and physical health issue. Why on earth are the police involved in the first place? That's not what they're for.
The police is going to be the first one to interact with addicts because they should be working on dismantling the entire drug network and working on catching dealers, through catching addicts/buyers.
> The police is going to be the first one to interact with addicts because they should be working on dismantling the entire drug network and working on catching dealers, through catching addicts/buyers.
Isn’t that what we’ve been doing for the last 50 years? How did that work out?
> 5he police is going to be the first one to interact with addicts because they should be working on dismantling the entire drug network and working on catching dealers.
Dealers aren't users or addicts. Different people. The police would not be the first to respond to them in 99% of cases.
And you can dismantle the network by making it uncompetitive. Let the state sell drugs, who cares? Then the narcos die off and the network dismantles itself.
Nah, the state already taxes drugs. Same thing. It also sells alcohol while taxing the ever loving crap out of it. Nobody's going to say the state is endorsing cigarettes, alcohol and gambling. They're minimizing harm through controlled, regulated and taxed distribution.
The thing is we've provided all sorts of ways for you to achieve your goal of not seeing zombies on the street without the cruelty. And yet you continue to try and find ways to invent problems. It seems like the cruelty of your suggestion may be the point?
There's a lot to like about those places, but their approach is antithetical to at least the way the US and Canada likes to represent themselves. Decriminalization seems far more in line with western ideology. Freedom and personal responsibility combined with liberty. What's not to like? Especially since it works.
Shall we solve the stuck gum under park benches with caning too? Smacking people with sticks does solve problems, but I'm not sure that's the kind of society I want to advocate for. Despite very much enjoying my time in Singapore. The benevolent authoritarianism model of Singapore is unique and interesting - and attempts to replicate it elsewhere have failed. Including a famous attempt in China where Deng Xiaoping and Lee Kwan Yew gave it a real college try in the early 90s. Worth reading about. [1]
Singapore offers another approach that seems to work ok. Probably the real lesson is that half assed measures don't work. And you have to go all the way. No matter the direction.
Edit: Joke aside - i am fine with marijuana, and some forms of cocaine being kinda ok-ish, but a death sentence for every person that distributes fentanyl and carfentanil won't extract too much tears from me.
Some vices should be entertained - but there should be hard limits somewhere.
You can buy drugs in every high school in America. Same for every prison. You can buy drugs on death row. We have a higher percentage of our population in prison than the soviets, china or Iran. So how far down the police state road do you think the USA needs to go before you figure out this isn't working?
The policy has (so far) been the opposite, try to punish drug use as much as possible, intervene with police and go after every small time drug dealer between heaven and hell.
It doesn't seem to be working. What if we try the opposite instead?
What? You seriously call the way western governments deal with drugs "punishment" or as if there any kind of enforcement?, if there was, there wouldn't be any addicts and drugs being sold openly on the street.
Dubai actually enforces these laws and the result? No addicts on the streets and no public drug dealers.
Agreed. Let’s send the government thugs to your home first, to deal with the dangerous ethanol and/or caffeine molecules you’re no doubt stashing in mass quantities.
Easily accomplished by letting doctors prescribe this stuff, available in monthly doses, from a pharmacist at state expense until they can break their habit by whatever means works for them.
The number of deaths isn’t the whole story though. Smoking might take 20-30 years off your life. These drugs are killing people in their teens and 20s. The affects on their life are also not the same. We don’t see smokers trying to inject nicotine into rotting flesh. Nicotine is a choice that has little effect on anyone else besides second hand smoke. The drug crisis is destroying people/families/cities.
My uncle has smoked 2-3 packs a day from when he was 15 years old. He is 70 now. Somewhere between one and two million cigarettes in his lifetime. Many health issues, of course, but could you eat million burgers or drink a million cans of coke in a lifetime and end up with less health issues? (No, you couldn’t: that’s something like 8,000 calories a day every day for 80 years, you die of obesity by age 35. I’m not even completely sure you could drink that many cups of water, 3 packs a day is 90 cups of water or 5.5 gallons, perilously close to the ~6 gallon maximum rate of healthy kidneys working 24/7.)
My point is not that smoking is better for you than heroin or soft drinks or burgers or coffee or water. It’s that the dose makes the poison, and we tend to legislate based as much on “lethal dose” as on “total attributable deaths”.
In addition to what others have said, I'm skeptical of the 7,300 number. People getting a substance that kills them which they believed were opioids, may not be counted towards that number.
But if your argument is that opioids should also be sold by the government in a program that ensures we have a safe supply, then I agree with you.
Decriminalizing drugs was just a quick way to ensure the drug economy kept going.
I think criminalization of drugs is essential, what isn't is the method of jailing individuals under the influence. Jail doesn't make them clean and it puts them with the sort of people who enable their habits.
We need a more diverse system that helps people get passed the subtance abuse.
There's a cycle here where once you have a conviction record, you're very unemployable. That didn't used to be the case in the US...back in the 80's and prior, only really big employers could do thorough background checks, more undocumented jobs/work, etc. It's also not the case in other countries where the government just gives employers a yes/no of a candidate/job pairing based on the offense. Chronic unemployment is underrated as a one of the underlying problems.
We demonize people who have been through the criminal system which is entirely wrong. Being convicted shouldn't prevent you from work. Be convicted of something that conflicts with your occupation yes.
I don't disagree with you. It is just that we need a better model.
The black and white, night and day. Non-flexible meanings in criminalization and rehabilitation are problematic.
Is that any different than being on drugs? Added effect of stealing.
Not being in control of yourself is no different than be on drugs, but one adds a layer of support providing we can implement a system to aid and clean a person.
The problem with criminalizing comes with the negative connotation of being unemployable. The benefit is that it obligates that the drug abuser to be processed through our system.
Fundamentally it is the no flexibility in our legal system.
Canada provided an exemption to allow decriminalization of small amounts of opioids, crack/cocaine, methamphetamine, and MDMA in British Columbia (where, as it relates to the article, Vancouver is located). It came into effect at the beginning of this year.
Ah so the federal government allowed the provincial gov to pass that exemption? Or was it unilaterally decriminalized by BC, while still being federally illegal like it is in some US states?
> “The tranq dope literally eats your flesh,” she said. “It’s self-destruction at its finest.”
> She unrolled a bandage from elbow to palm. Beneath patches of blackened tissue, exposed white tendons and pus, the sheared flesh was hot and red. To stave off xylazine’s excruciating withdrawal, she said, she injects tranq dope several times a day. Fearful that injecting in a fresh site could create a new wound, she reluctantly shoots into her festering forearm.
> The only person who would let her use a cellphone was a guy whose arm and leg had been amputated because of his tranq wounds. He was still injecting into his leg stump.
If a drug that literally turns you into a melting, oozing zombie with flesh dripping off your bones doesn't make you find a different drug - not even quit, I mean, find a different drug to get fucked up on - I think that person is suicidal. This is some morbid shit right here.