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Drug addiction: The great American relapse (economist.com)
107 points by lxm on Nov 25, 2014 | hide | past | favorite | 68 comments



I'm an upper-middle-class, white, software developer with a CS degree from a top university. I do not drink a drop; I do not "get high."

But I used to be a heroin addict.

Before then, I used Oxycontin - crushed up and snorted - which was a great kick and very, very easy to fall in love with when you first try it.

The Oxycontin pill formula switch had ominous effect. In short, my pusher had no clients anymore and switched straight to heroin. Turned from kids snorting pills for highs into a shooting gallery almost overnight. The last "classic" Oxycontin I remember hearing about went for $160 a pill.

Like Scudo, I started with brown heroin. Snorting it also. And under the same delusion that somehow snorting it made me "not a heroin addict."

Nothing like the cognitive dissonance of a dozen middle-class white kids making their first casual acquaintances with heroin.

But drug has a noxious, subtle allure. One night, with only a few $20s in my pocket and the ATM just out of walking distance, I chased down a bit more rush. Someone showed me how to shoot it.

"You put the needle in your arm." Casually as ever. Like explaining how to pull a good espresso. "You're new to this so your veins are easy to find. Not like mine. When you pull back the plunger - like this," drawing blood, "you know you've found it." Had it done for me, because I was scared and couldn't hit.

I threw up a lot and felt better than uninitiated will ever comprehend.

Months passed. Then something started happening, something I hadn't dealt with before: People started dying. Kids who had futures started dying.

I won't bore you with the howls of addiction and disaster that followed, nor with my own personal triumph of escape. But I will leave with one point:

This article is spot-on; the elephant in the room for many a community of parents who can't stomach much longer watching more of their kids die.

Heroin is not just in the underbelly of the world anymore. We need to stop treating it like a pariah and start actually trying to fix it.


It's always seemed to me the fix is technically quite easy even if politicians find it hard to vote for - provide safe heroin or similar to addicts for free / low cost at addiction treatment centres while at the same time keep supplying drugs on the open market illegal. That way the dealers lose most of their income and get other jobs, the addicts are at least safe and the general public don't get their stuff nicked. I don't know why it's so hard to get that implemented. It has been done in the past in the UK and it works.


I'm generally in favour of drug legalization and I think we should carefully experiment with even legalizing heroine/opiates.

However, I don't think this is a "fix" any more than legal alcohol is a fix for alcoholism. Legal or not, there will be user and there will be addicts. Legality might be an improvement but it doesn't solve the problem.

I don't know if there is a solution. An effective treatment for addiction is the only thing I can think of. We don't even have effective treatments for eating disorders.


The critical point in my suggestion above is that heroin at any rate is not legalised in general. It is only made legal for it to be supplied to support addicts at registered non profit treatment centres. This is actually pretty much the law at the moment in the UK - heroin can be prescribed legally by doctors, but there are still issues in getting it done. The alternate policy of tolerating illegal heroin use such as practiced in Amsterdam at times has many problems - you get the criminal dealers, the parks full of junkies who steal stuff to buy the drugs and so on.


> However, I don't think this is a "fix" any more than legal alcohol is a fix for alcoholism.

Is it too much of a stretch to suggest that legal alcohol IS a fix for alcoholism, at least if you're speaking of the sort of alcoholism that might exist is a world where alcoholics are all destitute and social pariahs? I think we live in a world where many functional alcoholics exist, for better or for worse. But I would rather have more functional alcoholism and legality, than live in a society that views alcoholics as criminals and condemns them to destitution.

In the same way, while i dont necessarily want more heroin addicts, i think i want to live in society where functional heroin addicts can lead the semblance of a normal life as we coolectively sort out how to help them recover.


> Is it too much of a stretch to suggest that legal alcohol IS a fix for alcoholism, at least if you're speaking of the sort of alcoholism that might exist is a world where alcoholics are all destitute and social pariahs?

Prohibition doesn't make all addicts destitute social pariahs. There are plenty of rich & popular addicts of illegal drugs now, just as there were plenty of rich & popular people who were also alcoholics when alcohol was the subject of Prohibition.

It does make more addicts destitute social pariahs, though, and the stigmatization complicates treating addiction.


What's interesting is that the USA has very high rates of drug abuse, illegal and prescription drug abuse, despite having very strict laws and harsh punishments for drugs (it varies by state, but generally).

The lesson is that the harsh punishments don't solve the problem.

Drug addictions should not be blamed on the addict, there is still a huge problem here. I think they can be treated if they are accepted, the addiction approached like a mental disease, with counseling and honesty.


A quote I like to fall back on is the one from Portugal, which no longer has (edited) criminalized substances.

"If you realize addiction is simply a symptom of a deeper underlying mental illness. Treat the illness, you solve the addiction."

But yes there will be addicts.


While I think it's a huge improvement to see addiction something other than a 'crime', I think assuming it's a symptom of a deeper underlying mental illness is still not ideal. It's too simple.

Consider addiction to smoking. There are plenty of people who picked up smoking for no other reason than 'fitting in' or 'curiosity'. Which I'd hardly call a mental illness. Many of these people kept smoking, and sadly probably many of them died from smoking.

Similarly, I suspect there are many alcoholics who slowly became so because they entered a culture of alcohol.

Addiction is a powerful thing in itself, and while the solution to many might be uncovering the underlying mental illness, for many it might 'just' be a matter of unlearning a powerful, destructive habit.

Of course in both cases professional help is necessary, but treating an 'underlying mental illness' in cases where there are none can also have bad consequences.

Among the many addicts and ex-addicts I've known, there have been more than a few that were actively treating a 'deeper underlying mental illness' that I suspected didn't really exist in the first place. And while that's probably better than being an addict, it's still not good.

in fact, this is one reason I have issues with the approach Alcoholics Anonymous. They seem to treat all alcoholics as sufferers of a lifelong disease, and I cannot help but wonder if being constantly reminded of a thing you don't want to do anymore is a good solution for all people. For some, sure. Some people might have the 'alcoholism gene'. But I don't think that's always the case.


There is a difference between chemical and psychological addiction you completely overlook. I was generalizing the later, as it can be dealt with, with consoling.

The former can be very nasty and serious. It didn't mean to belittle it, or people who've fallen prey to it.


There's a difference, but it's not black and white, and I find it hard to imagine that most chemical addictions we know are bad enough in themselves to cause the extreme behavior that addicts exhibit.

Regardless, I was primarily thinking about the psychological side of addiction in the above post, and I think my point still stands. There are many examples of (almost) purely psychological addictions that people suffer from, and also in those cases I think it can be an interplay of habit formation, personality characteristics, and environment, that 'maintain' it, and not always 'deeper issues' (although I suppose one could consider environment a deeper issue...).


Recreational drug possession is decriminalized in Portugal, but still illegal. You will still be fined if caught, and if you possess over a certain amount, charged with a crime. That being said, addiction has declined since the decriminalization.


If caught consuming (under a certain amount), the drug will be apreend and you can be required to present yourself before a comitte formed by a lawyer, a doctor and a social worker. It's possible to be fined but that it's not the primary objective.


But legal alcohol did work to make it far less dangerous and remove the organized crime effect


This is spot on, prescribing heroin wouldn't necessarily help addicts to recover but it would go a long way to making the disease itself more bearable for individuals and society.


There is a difference: alcohol can kill you in various ways, both acute and long term. Heroin can too, but by knowing what you're getting and your own tolerance you can avoid overdoses and then the side effects are pretty mild (constipation).


If misery causes drug abuse, like it seems to do, then obviously making misery more rare is the solution. Legality is one easy step towards that goal, other steps include societal acceptance (i.e. drug users not immediately being regarded as worse people) and increased wealth.


Switzerland and the Netherlands have done just that, with promising results: http://www.economist.com/news/united-states/21595963-how-mak...


Don't forget Canada.


Australia too


Also Portugal


> It's always seemed to me the fix is technically quite easy even if politicians find it hard to vote for - provide safe heroin or similar to addicts for free / low cost at addiction treatment centres while at the same time keep supplying drugs on the open market illegal. That way the dealers lose most of their income and get other jobs, the addicts are at least safe and the general public don't get their stuff nicked.

It seems to me the whole problem stems from a misunderstanding of what needs to be prevented.

What you don't want is people addicted to drugs. Allowing heroin to be sold at Walmart for $1 would be no problem whatsoever if nobody was using it. Where the stupidity comes in is that the laws and law enforcement are targeted at sale and distribution rather than consumption, the theory apparently being that if people can't buy drugs then they can't use them.

Which, of course, doesn't work, and instead leads to the rise of organized crime and violence.

What we need is for sale and possession to be legal, which kills the drug cartels instantly, but then do everything we can to discourage usage. Make the penalty for drug use a fine and instant mandatory rehab, and make drug possession legal but probable cause for a drug test.

The idea is to make distribution legal and therefore unprofitable, and make usage as safe as possible but so inconvenient that nobody wants to do it. And then use the revenue generated from taxing it to pay to help the people who are already addicted.


I've thought similar things but came to a slightly different conclusion.

Let people buy and use heroin legally, but make the process like the DMV or a welfare office. That is to say, it takes hours, it's boring and uncomfortable, you can't play on your phone, and is so lacking in romance or mystique that it could be a synonym for mundane inanity. Plus they can only get a limited amount at a time and there is a cooldown period.


> It's always seemed to me the fix is technically quite easy

You're absolutely, 100% right in that sentence alone.

The solution to heroin addiction is technically quite easy, and it's called Iboga.


thanks for sharing your story. based on your experience, what do you think can be done to address the situation?


Social stigma is a huge problem. The people who won't get help because "A bum sitting under a bridge with a needle in his arm, robbing houses to feed his addiction," c.f. the article, is what people think of when they think of heroin. There are people who won't seek help out of fear they will be thrown away by society. Nobody wants to stop being who they are and start being "an addict."

Part of what can help this is education. To most people, heroin is a mythical creature. It's either glamorized or demonized, but neither of these things have any grounds in reality. There's obviously nothing glamorous about being so broken that you need to turn to powerful opiates to solve it. And there's obviously nothing so demonic about it, either: it's some sort of cognitive or emotional failure on the user's part, but it's not evil.

While I share some of the concerns of others about it, I think "safe heroin or similar to addicts for free / low cost at addiction treatment centres" is still worth consideration. I think "not heroin" is the reasonable choice, though picking something (eg opiate replacements) completely devoid of pleasure fails to solve the real problem.

People tend to neglect that money is a big part of the reason that drugs turn up in a community. We're a society built on money and illicit drugs are a profit area that huge corporations, by law, cannot capitalize upon. But that doesn't mean that people won't, and those people have profit motives to do things that encourage use of their product.

It's clear that killing these people or putting them in prisons doesn't help. This is why the "war on drugs" is a failure: it just opens up the market for new players.

In truth, heroin is no more strange or evil than alcohol. In fact, they're fairly similar: they both feel good, hobble your senses, and dull "pain." But drugs carry with them certain cultures, and the culture of alcohol is a reasonable one. An obscure and "dangerous" substance like heroin carries with it an obscure and dangerous drug market. That is what's truly dangerous; moreso than even the drug.

So some combination of (1) educating the public in a sane way rather than fearmongering and (2) using the newly-earned social support to open doors for tactics that destroy the black market are my idea of a solution.

I could be wrong, though. I'm just one data point.


The point on stigma is a hard one.

On one hand, I see your point. There's a lot of merit in allowing various mental and emotional illnesses to be treated as illnesses rather than moral failings.

On the other, this seems orthogonal to the AA/NA approach. "I am an addict. I am no different from other addicts." Own the problem. Make it your primary mission. Many members give "recovering addict" a very central place in their identity.

Do you think it's better to encourage addicts embrace the label or allow them to wear it lightly?

Also, regarding the "drug culture." I don't know much about the heroin culture but the prescription painkiller culture seems to be very different. Recreational users seem to treat it like a party drug. A lot of addicts seem to treat it like medicine. There's an obvious compulsiveness to it, but it's not incompatible with a normal life the way heroine seems to be. I don't know if it's mostly stigma and culture or properties of the actual substance, but using heroin and going to work and then picking up the kids seems like a total contradiction.

I know as a smoker that smoking and exorcise (and healthy eating) feel incompatible. If you do this self destructive thing 10-20 time a day, going into a gym or playing soccer seems ridiculous. This is something that changed over the last generation. In the 50s, you could see professional athletes take smoke breaks between training sessions. But now, with the current cultural treatment of cigarettes, relapsing on smoking usually means relapsing on exercise too.

Again, I think there's a contradiction between AA/NA approach and another approach. One is to encourage the oxy culture in heroin. Shooting heroin doesn't mean your whole life is derelict. The NA/AA approach is the other way, oxy addicts need to see that they're addicts just like the bum with a needle in his arm. Thoughts?


I think that in the same way that depression can have many causes, and that different solutions might apply to each of them, addiction is not one 'thing' either. I tried to explain my view elsewhere: https://news.ycombinator.com/item?id=8658316


> Social stigma is a huge problem. The people who won't get help because "A bum sitting under a bridge with a needle in his arm, robbing houses to feed his addiction," c.f. the article, is what people think of when they think of heroin. There are people who won't seek help out of fear they will be thrown away by society.

True, and as a side point it's sad that people are willing to discard the person under the bridge any more than the person in their middle-class neighborhood. The person under the bridge is far more vulnerable and more likely to need help.


I've had leftover opioid painkillers from surgeries and I can see how easily this could turn into a gateway. I often feel simply lucky that oxy et al wasn't prevalent when I was 16-24yrs old, as I'm sure I would have encountered it. And as a new father I am also worried what kids will be up to in 10-15 years if we can't learn from experiences like yours. So again, thank you - I really appreciate your story.


Ibogaine (http://en.wikipedia.org/wiki/Ibogaine) reportedly works for some people to get rid of their additions.


Thanks for telling your story. I have an odd question. How do you feel about the way current members of the military and veterans are treated w/r/t painkillers like Oxycontin?


This site provides much help and information about dealing with heroin: http://www.heroinhelper.com/


Thank you for sharing.


I'm not so sure that enforcement-led mechanisms won't work, at least, if there is global coordination focused on production.

The Taliban, for all its faults, was able to effectively eliminate opium production back in 2001, and Afghanistan is 80% of world supply:

http://www.nytimes.com/2001/05/20/world/taliban-s-ban-on-pop...

After 14 years of US intervention in Afghanistan, we have succeeded on at least one metric - all-time record opium production:

http://time.com/3580627/opium-afghanistan-record-high-united...

It stands to reason - if our foreign partners are able to resist local corruption, we could stamp out production. (So far, only religious fanatics seem to be able to resist.)


Production can be reduced locally, but that doesn't mean much.

The world is big and the market is global. Most of the cost (value add?) is in consumer country transit not production costs. If the price of crude opium in Afghanistan tripled wouldn't affect the street price in Denver or Berlin much. The best understood and studied market for ilicit drugs is the South America to North America cocaine trade. The markups are huge.

The reality is that political problems imperfect systems non cooperation of belligerent or dysfunctional countries is part of the package. Even if it wasn't the price of precursors in poor countries is so inelastic that this kind of enforcement is pissing in the wind. Even if it wasn't the substitute for drug A not non-consumption, it's a different drug. Synthetics are impossible to put a dent in with enforcement. You don't need fields for meth.

There has been 40 years of incredible effort put into enforcement, the war on drugs. An unfathomable amount of resources all over the world. More international cooperation than on any other issue. The results suck.

On one hand we have very dubious benefits in terms of the availability of drugs. Basically, quality suffers. Price increases. If consumption is lower than it otherwise would be, it's not by much.

On the other hand we have clear and inarguable costs. The financial cost of the actual war is immense. Drugs are impure and more dangerous. More dangerous and addiction-prone delivery methods are more common, injecting. People are in jail. Criminals control enormous markets. If drugs were legal, revenue from crime would drop by a huge amount. This money creates dangerous criminal empires big enough to endanger whole states. Mexico is in danger of failing as a state. Body counts in the hundreds of thousands. Poorer treatment for addicts (it's hard to treat and prosecute simultaneously).

I would also argue that there's a basic violation of human freedom too. IE, if you choose to take drugs and don't harm anyone, that should be your right as an adult. Locking you up for it is immoral. Not all drugs a heroin, but even heroin is a choice.

We know the costs (huge) and the benefits (eery small) of prohibition. To think that after 40+ years of failure the war on drugs will improve its performance is insane. I really don't see how people can fall on the other side of this debate.


Maybe the fact that the Taliban ("for all its faults", indeed) is one of the only regimes on record to significantly reduce opium production should tell us something?


That if we use the same tactics as the Taliban we too could stomp out drug use? I'm not sure you're going to get a lot of support there; it sounds like a cure worse than the disease. http://abcnews.go.com/International/taliban-behead-17-singin...


I thought this was the point of US going to war in Afghanistan.

US went in Irak to build the infamous oil pipeline and Afghanistan to restore opium production after the reserves that lead to a drop in price were depleted. At least this is what was reported here in Europe by the alternative medias.


It seems with all the media that's been produced about heroin addiction (movies like Requiem for a Dream, Trainspotting, Traffic, etc...) that the risks of shooting up are fairly well known.

Yet, people still continue to use and get addicted to the drug. I feel a great deal of pity for the people whose lives have been destroyed by heroin, not just because of their addiction, but because of the underlying pain that must have been there for them to get to that point.


I think the public at large thinks heroin is much more dangerous than it actually is. The rate of addiction is about 23%[1], compared to alcohols 15%. You don't get addicted just by shooting up one time. And opiates aren't actually that destructive on the body either, the lifestyle of a junkie is though.

[1]: Comparative Epidemiology of Dependence on Tobacco, Alcohol, Controlled Substances, and Inhalants: Basic Findings From the National Comorbidity Survey (http://www.umbrellasociety.ca/web/files/u1/Comp_epidemiology...)


15% of people who drink alcohol become alcoholics? That seems steep...


Not really, but it depends on your definition of alcoholism a lot. For example, if you treat every alcoholic as "alcoholic for life, with some of them sober" it makes sense.


I took a look at the study and indeed they defined it as Alcohol dependent at one time in life.


This is sort of the key point. There's nothing especially inherently dangerous about heroin, but because of the way it's marketed it attracts people who have been basically rejected by society who don't really care much whether they live or die.

If you marketed caffeine the same way you would see the same patterns of behaviors around coffee, the fact that it's heroin where we see these issues is fairly arbitrary.


Don't care whether they live or die? Kind of moralizing a bit there.

I don't think my brother had a death wish when he was introduced to heroin. He had an addictive personality and quickly became an addict. When he OD'd it likely was not a suicide but an attempt to get high. He apparently had progressed from having others shoot him up to doing it solo.

Yes, heroin is more medically benign than alcohol if used correctly, but the addictive power of all opiates is something that makes it dangerous for abuse.

It should be legal and well regulated, and drug education should be shifted to awareness of addiction and how to avoid it.


> Don't care whether they live or die? Kind of moralizing a bit there.

I mean if you look at the research, it's the same childhood factors that predict both drug abuse and suicide, e.g. the Adverse Childhood Experience study.


The prescription-to-addiction pathway is an unforced error.

If someone is prescribed opiates for long term pain the risk of addiction is serious. If 5% of patients had strokes, doctors would cut down prescriptions to immediately life threatening use only. I don't know what duration/dose gets you to 5%, but I suspect whatever it is you will find those are not as uncommon as they should be.

To generalize, doctors misunderstand and underestimate addiction in a lot of way. Maybe treating addiction is not their domain but this is a violation of their basic creed.

Palliative care. Post trauma emergency care. Short term post op recovery. These are reasonable uses of opiates. An open ended prescription for chronic back pain is dangerous.


It's quite telling that the heroine chose to sell her oxycontin and buy heroin instead of telling her doc she's hooked and suffering withdrawal.



> It doesn't just kill physical pain like ibuprofen, it also kills psychological pain, emotional pain and the pain caused by social phobias.

Huh. I've tried quite a few different meds in the search for a chemical cure for social phobia, and always, somebody eventually suggests opiates as the only thing that will truly act as an "off" switch. (Accompanied by the usual dire warnings.)

I don't think I'll ever risk it though. But I can see why some people do. I wish the pain killing component could be separated from the addictive part.

That reddit link was a very interesting read.


>Huh. I've tried quite a few different meds in the search for a chemical cure for social phobia, and always, somebody eventually suggests opiates as the only thing that will truly act as an "off" switch. (Accompanied by the usual dire warnings.)

I've gone from mild social anxiety to serene confidence in social settings. No drugs.

What helped was treating it as a skill like any other. I was anxious because frankly, I sucked at social interactions. I didn't know how to make small talk, eye contact, and the very fact that I worried about how I was doing made people enjoy talking with me less.

So one by one I identified skills I lacked, and worked to acquire them in small, incremental steps.

For instance, talking to strangers. Start by asking a stranger the time. Then do it a few times. Notice that everything goes well. Once you've done that a few times, you've now got that as a skill.

Interacting with strangers. When you're at a store, make a comment to the cashier about something in the environment. They'll respond. Then you respond with something. Note how they react. Do this a bunch of times and it'll become natural.

Etc, etc. Look at people who are good at social interactions. What are they doing differently? What skills can be isolated and learned?

Anxiety itself can be approached laterally, with meditation. I don't recommend this route, but what worked for me was a major health crisis that forced me to confront death and loss. After that, social difficulties paled in comparison, and I'm not afraid of any social interactions anymore. Mindfulness was what let me get through that time of trouble by growing, rather than shrinking into misery.

What's good about social difficulties is that they are very easy to practice. All around you every day are thousands of opportunities to interact with others. If a skill can be practice, and you can get feedback, then that skill can be learned.


Yep. While Im sure there are a lot of people with medical issues that make them become socially inept, I think that social skills in general are just that: skills. You can't start programming like a pro from day one, it takes years of effort. And so does this skill.


Yes, Opiates can, amongst other things, Make you feel strong and confident, a state of mind free of social phobia. Opiates can also have quite a lot of side effects, such as a drunken, drowsy feeling, nausea etc.

There are drugs that may what you want. MDMA in particular can really reduce social phobia significantly. In some cases MDMA can even cure social Phobia. It does have side effects too. Amphetamines also lower inhibitions, as well as stimulate dialogue.

I believe addiction potential is more closely related to your reason for doing the drug and your economic status. If you are doing a drug to escape from a bad situation for example, you are likely to become dependent.


When under the influence of MDMA my social phobia completely vanished, in fact it turned me into the Bizarro version of myself, I became the life of the party. It's no way a long term solution, but I recommend taking MDMA one or two times in your life, as it has a "psychedelic life changing effect", the first couple of times you take it, it seems to hit a reset button on your brain, changing your perceptive on life.

Amphetamines in my experience are superior to opiates for social phobia as well as providing cognitive enhancement, but they come with more side effects. They're psychologically addictive, if you stop taking them, you're in a worst place then you started, tired, anxiety, depression,..etc. Amphetamines are also hard on your body, can cause psychosis, paranoia, delusions, mania, can completely change your personality. Amphetamine psychosis is the worst thing I've experienced in life, it's equivalent of experiencing severe schizophrenia, blurring the line between reality and hallucinations.


I read a series of anecdotal reports about someone who tried to treat his social anxiety by misting an aqueous solution of oxytocin into his nasal cavity.

Reportedly, it worked beyond expectations once the effective dose was found, but it only lasted for about 10-15 minutes. So he used it before entering a social situation, it lasted long enough to break the ice, and then it stopped working.

While the experiment was to test a single drug, if the initial spray of oxytocin were combined with MDMA, the guy probably could have felt almost like a normal person for the whole evening.


heya, just as a personal message, and not knowing your situation at all, I just want to encourage you to be creative and practice going from social anxiety to typical amounts of social comfort without meds... There are dozens of techniques out there, so give them all a try, from meditation to exercise, encouraging youtube videos, to diet changes, etc. Above all, don't be afraid to make mistakes... it's rather a trap for many of us to cease taking the small risks that lead to mistakes once we attain a niveau of success, but small mistakes are the propulsion that maintains that success.

For example, I've been huffing and puffing about learning Javascript since it first came out, mocking it, only seeing the bad sides. Then I got stuck in the loop of hoping it would go away and trying to rationalize not knowing it. When I started to come around, I felt embarrassed because I knew my code would be baby code and I would do lots of dumb things. But I'm pressing forward, trying to modify mapHighlight to do what I need it to do and I no longer give a shit about haters.

Yes, maybe someday people will make fun of me, but by that time, I'll be skilled enough that I'll have thicker skin. When you take the long view, you see that people mocking you is just a test to see where you are. In the case of bullying, it goes too far, but in general, testing one another to see if we're still emotionally sensitive to our failures from long ago is part of how human social bonding works. And fear of not being able to stand up to the test can motivate us to take those chances, write that crappy JS code, embarrass ourselves a little bit in front of our co-workers or potential mates.

And finally, most people are astonishingly forgiving and forgetful. Much more than we deserve. Every now and then you'll have that psycho (a trope the media and movies love to push to keep everyone in fear and anxiety) who remembers some slight for his entire life and uses it to levy revenge on someone, but in actual life, no one simply has the energy and desire to sustain a revenge campaign. They're too busy living their own lives. No one cares if I wrote some sloppy C code in 2004 and in 2024, no one will care if my JS is crummy now. And even if someone says anything to me then, it will just be a big joke in the past to me.

So that's my spiel, friend. If you want any more encouragement, it's $400/hour :)


Thanks for the message. To the others too, who commented.


Law enforcement in many rural areas feels under seige from heroin. Around Ithaca NY a few weeks ago they found a dead black guy floating face down in a ditch behind Walmart and then the next week a white kid od'd. So there is a very real body count here.


The body count is far higher from the number of people jailed or "forced" to become criminals because of the illegality of a relatively side effect free drug.


People who mix opiates with alcohol or benzodiazepines face serious risk of death. 9 times out of 10 you find a person like this face down on the floor and you rouse them and they are a bit discombubulated for a few minutes. Sometimes you can't rouse them but they will wake up when the chemicals wear off. Sometimes they don't wake up.

And yes, the illegal status of opiates and the criminal network enforced by that is a part of the problem, but the fact is that first responders and ordinary citizens are facing collapses like the one above today.


The path to addiction via prescription is ironic given how surgical procedures have gotten less invasive.

Wonder if the numbers will regress over time now that new entrants to the hospitals will get less access to opioids


Based on this article, it seems that one answer might be further research on non-opioid painkillers. Sure, there will still be experimenters/thrill seekers who wind up with problems, but the people exposed through the prescription system (most?) will greatly be reduced.


Can someone provide a mirror link to the article ? this fails to load on both my 3 browser, blocked at some explicit consent page: http://i.imgur.com/Ui4ARZe.png


> Now that heroin addiction is no longer a disease only of the urban poor, however, attitudes are changing.

I wonder how much society would be different if reactionary assumptions like this weren't the norm.


If you're thinking about what is the culprit here, then consider that the whole of our economic system is flawed, because capitalism encourages the creation of addictive goods.

It is the world we live in that transforms us into addicts.


People have used chemical mood enhancers in all kinds of society and economic systems.


[deleted]


It is not clear if he knew what the shots were and it is not clear if he opposed capitalism.




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