True, but the graph show lots of people dying in their 20s and 30s. So if I was born in 1940s and became a heroin addict there's a good chance I die before 1979. So those born before 1950's are unlikely to die of a drug overdose between 1979-2016 because to do so they would have needed to become in contact with heroin for the first time well into their 30s instead of their teens and 20s.
Is there anywhere in the world where all drugs are legalized?
I know Portugal (and maybe others) have decriminalized drugs and results are pretty good but going from decriminalization to legalization feels like a big step.
Drug possession has been decriminalized in Uruguay since the mid 1970s. As you mention, Portugal also decriminalized all drugs in 2001. Switzerland provides safe injection rooms and needle exchanges for harm reduction
The same thing that happens now, except medics could know you're overdosing on pure diacetylmorphine (or whatever is sold), rather than heroin mixed with fentanyl mixed with baby formula powder mixed with your dealers skin sells mixed with whatever other garbage street drugs get cut with. Not to mention the money saved from being wasted on the war on drugs and gained from the sale of drugs could go towards mental health and other medical services to actual address the root of the issue rather than wasting even more money by throwing addicts in prison
What's your stance on antibiotics? Or did you only mean "recreational" drugs?
The reason why I bring this up is that antimicrobial resistance is an externality of widespread antibiotic usage. Unfettered access to all drugs would probably accelerate antimicrobial resistance, because people tend to overuse/abuse antibiotics when they have the freedom to.
(Not trying to be mean/inflammatory/pedantic, I'm genuinely curious how HN would reconcile these stances.)
Vast quantities of antibiotics are used by agriculture in the US, with little regulation or control. The stuff is in our water and food supply, whatever additional increases allowing people to purchase/use antibiotics without a prescription seem pretty small by comparison.
You're certainly correct. But in this case it might bolster human specific pathogens. I know there is some overlap between human an animal pathogens, but unfettered access to antibiotics might accelerate the problem for humans specifically (which is probably worse than the current prescription only policy in the US).
My understanding is that resistance to human pathogens is driven by waste water contamination. Human excrement combined with industrial quantities of antibiotics.
I'm sure there is a smaller scale problem of human use, but that petri dish is the one that's causing the problems, is my understanding.
I don't think most drug legalization types intend to advocate for unrestricted access to antibiotics, but it's certainly worth discussing.
antibiotics are less effective for everyone the more they are used, so you can conceptualize the effectiveness of antibiotics as a common resource that can be spent down. if I abuse antibiotics, I am directly harming you.
there are arguments that drug abuse also harms others, but I find them somewhat less compelling. usually they follow the pattern of "I feel compelled to help you in X situation, so you are harming me by putting yourself in X situation". not an entirely illegitimate argument, but much more debatable imo. there's also the common "we have to protect people from their own poor choices" which I consider incompatible with free society.
Decriminalized yes, the question of legalization is more complicated.
When it comes to opioids, legalized alone opium would alleviate vast swathes of death and suffering. Many of the same arguments made for cannabis legalization also apply to opium. It's difficult to unintentionally overdose on, there are no serious long term health detriments aside from dependency and constipation (and testosterone decrease). The poppy has been cultivated by humans for as long as wheat has, it is only recently recently it became so demonized.
And most importantly, it would largely eliminate the demand for black market heroin/fentanyl. Opium is a combination of 3 alkaloids, morphine, codeine, thebaine. Heroin is just acetylated morphine which allows for more total morphine to cross the BBB, it's still morphine which produces most of the effect users desire.
And most importantly, it allows opioid users a strong, easy to access, cheap, legal alternative to being sick.
Even though there would still be some demand, black market suppliers could not compete price wise, so the black market would be eliminated very quickly. The DRAMATIC price reduction will also make the financial effects of opioid dependency much less devastating.
> When it comes to opioids, legalized alone opium would alleviate vast swathes of death and suffering. Many of the same arguments made for cannabis legalization also apply to opium. It's difficult to unintentionally overdose on,
While I agree with the general thrust of your argument, this point is incorrect. It's not difficult to unintentionally overdose on Opium. Not at all.
That comment struck me too. Perhaps there is a difference between Opium overdose and Opioid overdose?
When I think consuming opium, I conjure images of old chinese artwork where they are smoking it in a hookah type instrument.
The Opioid overdoses are mostly Fentanyl and other extracts from opium. I'm not an expert, but if I am understanding correctly, it seems easier access to Opium which may be, according to the GP, hard to OD on, would reduce the Opioid OD epidemic.
That may be what the OP was thinking, but it's not the case. You can very much OD on regular Opium. It is even easier to OD on its extracts (specifically morphine), and even easier still to OD on its synthetic analogues (fentanyl). However, you can absolutely OD and die on pure opium.
The dude said 'unintentionally' overdose on opium. This article covering Laudanum (opium + alcohol tincture) deaths in the 1800s sounds like the overdoses were largely intentional or one where an adult dose was given to a child. https://www.apnews.com/910654effffe42f985ebe01f299407f5
As long as the strength is known most addicts will measure the dose or titrate up safely.
I'm aware, I repeated his 'unintentional'. Unintentional overdose deaths on Opium are certainly less common than fentanyl. But they are nowhere near as difficult to achieve as Marijuana, which is basically impossible.
>That may be what the OP was thinking, but it's not the case. You can very much OD on regular Opium
Read above. Orally, it's a strong emetic. Unless a user takes vastly more than a normal dose for their body weight, they will vomit and be fine. Opium, when smoked, is even safer as users pass out well before overdose.
It is easier to overdose on acetaminophen, and many other things you can pick up over the counter at your local pharmacy.
> It is even easier to OD on its extracts (specifically morphine)
Yes, but this is why I am using the word opium, and not morphine.
> its synthetic analogues (fentanyl).
Fentanyl is not an analog of anything found in opium, it's an entirely different molecule with no relationship whatsoever to the traditional opiates.
I'm aware of all that. People still overdose on opium frequently. Users that are more tolerant to the opioid nausea will not vomit as readily when ODing. The emetic effect is not as strong or as universal as you seem to think it is.
>Perhaps there is a difference between Opium overdose and Opioid overdose?
Opium has three primary constituents, morphine, codeine, thebaine. An opioid, roughly, is anything which agonizes opioid receptors, which are mu, delta, and kappa. mu-receptor agonists specifically are usually what people are referring to when they use the term 'opioid'.
Morphine, which is an opiate (an opioid, but one that is derived from opium), is what usually produces death during an opium overdose (it also happens to be alkaloid which produces most of the desirable effect).
You can look up morphine ld50 numbers to get an idea of how much morphine it would take to kill somebody. While morphine is the principal opioid at work in opium, it is still only a tiny % of the opium's total volume.
>When I think consuming opium, I conjure images of old chinese artwork where they are smoking it in a hookah type instrument.
It being smoked also makes it considerably safer. Users pass out before overdose.
>The Opioid overdoses are mostly Fentanyl and other extracts from opium.
Correct. Morphine is a somewhat strong opioid in its own right, but it doesn't even hold a candle to the more powerful opioids science has discovered. Not even close.
The strength of an opioid is often described in morphine equivalents, that is how much of x is comparable to the same amount of morphine.
Fentanyl is roughly 50x as powerful as morphine, which makes it a rather dangerous compound for untrained people to handle, especially to inject. That being said, as long as the dosages are measured correctly, fentanyl is not significantly more dangerous than any other commonly used opioid. It's the black market dynamics which make it particularly prone to kill users.
Fentanyl is also nowhere near the most powerful opioid being sold on the street either. The literature has opioids that are, roughly, several thousand times as powerful as morphine.
Meaning if it takes on average 1g of pure morphine to kill a human, less than a single mg of some of the stronger fentanyl analogs can be sufficient enough to kill. Much lower if injected.
This is what is killing everybody. Some fentanyl analogs are close to chemical weapons in terms of potency, and drug dealers with a 3rd grade equivalent education are handling it like they would cocaine or similar.
Fentanyl is more like 100x the potency of morphine. And while it's true that morphine is the strongest opiate directly present in opium, codeine is converted into morphine by cytochrome P450 in the liver, increasing the effective morphine dose. Here's some citations:
Fatally overdosing on opium is more difficult than overdosing on acetaminophen, or many other OTC drugs you can pick up from your local pharmacy.
The alkaloids in opium are STRONG emetics. While it is certainly possible to fatally overdose, it is far more likely one would vomit for a few hours and be fine, assuming they did not consume far above a 'normal' amount for their bodyweight.
My reservation with complete legalization. Is that I think there is a strong conflict of interest, in any corporation being allow to sell, advertise, and market any highly addictive substance.
You could argue that there will be rules and restrictions, but lets not forget that the current opiod crisis, was caused directly by those corporations corrupting the supervisory body (Doctors) in place to stop it happening.
The supervision needs fixing (which I trust it can as it seems to be a uniquely US problem), but if you lifted it all together, I believe the floodgates would be open for corporate exploitation.
But, its taken 100 years of legislation to get there, in the meantime, cigarette companies have funded research that claims their product isnt dangerous, and targeted children, etc etc.
Opiods are a whole different game. Combine that with teams of data scientists trying to boost addictions. I could even see blends being developed that meant you couldent easily switch to a competitors drugs.
There are probably a lot of factors: New Mexico is the second poorest state in terms of poverty rates. It's a drug smuggling gateway from Mexico. Very high Native American population, which itself, struggles disproportionately with addiction. Mostly rural isolated populations where drugs offer a means of escape and long wait times for an ambulance to arrive in the case of an overdose situation.
As an aside, looking at those charts, no wonder Breaking Bad was set there.
I call this a betrayal of America by US politicians. The overdose rate has apparently doubled over the past 10 years and congress did not even start talking about opioids until, what, 2017? No one jailed until 2019? 3 years beyond the charts in this report. 47,000 Americans died from opioid overdoses in the last 12 months.
Is it coincidence that by far the biggest spender on congressional lobbying is Pharma/Healthcare? $284,000,000 in 2018 alone. That is $531,000 per congressperson in one year, and only for Pharma/Healthcare. Or, another way to look at it, $5,985.25 per opioid death.
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[ 2.2 ms ] story [ 113 ms ] threadYou should be able to buy opioids/heroin/cannabis at the local pharmacy with no prescription or questions asked.
This war on drugs only kills people and makes the Purdue family rich.
I know Portugal (and maybe others) have decriminalized drugs and results are pretty good but going from decriminalization to legalization feels like a big step.
So if thats it we have no real data on how that would work.
The reason why I bring this up is that antimicrobial resistance is an externality of widespread antibiotic usage. Unfettered access to all drugs would probably accelerate antimicrobial resistance, because people tend to overuse/abuse antibiotics when they have the freedom to.
(Not trying to be mean/inflammatory/pedantic, I'm genuinely curious how HN would reconcile these stances.)
I'm sure there is a smaller scale problem of human use, but that petri dish is the one that's causing the problems, is my understanding.
antibiotics are less effective for everyone the more they are used, so you can conceptualize the effectiveness of antibiotics as a common resource that can be spent down. if I abuse antibiotics, I am directly harming you.
there are arguments that drug abuse also harms others, but I find them somewhat less compelling. usually they follow the pattern of "I feel compelled to help you in X situation, so you are harming me by putting yourself in X situation". not an entirely illegitimate argument, but much more debatable imo. there's also the common "we have to protect people from their own poor choices" which I consider incompatible with free society.
When it comes to opioids, legalized alone opium would alleviate vast swathes of death and suffering. Many of the same arguments made for cannabis legalization also apply to opium. It's difficult to unintentionally overdose on, there are no serious long term health detriments aside from dependency and constipation (and testosterone decrease). The poppy has been cultivated by humans for as long as wheat has, it is only recently recently it became so demonized.
And most importantly, it would largely eliminate the demand for black market heroin/fentanyl. Opium is a combination of 3 alkaloids, morphine, codeine, thebaine. Heroin is just acetylated morphine which allows for more total morphine to cross the BBB, it's still morphine which produces most of the effect users desire.
And most importantly, it allows opioid users a strong, easy to access, cheap, legal alternative to being sick.
Even though there would still be some demand, black market suppliers could not compete price wise, so the black market would be eliminated very quickly. The DRAMATIC price reduction will also make the financial effects of opioid dependency much less devastating.
While I agree with the general thrust of your argument, this point is incorrect. It's not difficult to unintentionally overdose on Opium. Not at all.
When I think consuming opium, I conjure images of old chinese artwork where they are smoking it in a hookah type instrument.
The Opioid overdoses are mostly Fentanyl and other extracts from opium. I'm not an expert, but if I am understanding correctly, it seems easier access to Opium which may be, according to the GP, hard to OD on, would reduce the Opioid OD epidemic.
Read above. Orally, it's a strong emetic. Unless a user takes vastly more than a normal dose for their body weight, they will vomit and be fine. Opium, when smoked, is even safer as users pass out well before overdose.
It is easier to overdose on acetaminophen, and many other things you can pick up over the counter at your local pharmacy.
> It is even easier to OD on its extracts (specifically morphine)
Yes, but this is why I am using the word opium, and not morphine.
> its synthetic analogues (fentanyl).
Fentanyl is not an analog of anything found in opium, it's an entirely different molecule with no relationship whatsoever to the traditional opiates.
Opium has three primary constituents, morphine, codeine, thebaine. An opioid, roughly, is anything which agonizes opioid receptors, which are mu, delta, and kappa. mu-receptor agonists specifically are usually what people are referring to when they use the term 'opioid'.
Morphine, which is an opiate (an opioid, but one that is derived from opium), is what usually produces death during an opium overdose (it also happens to be alkaloid which produces most of the desirable effect).
You can look up morphine ld50 numbers to get an idea of how much morphine it would take to kill somebody. While morphine is the principal opioid at work in opium, it is still only a tiny % of the opium's total volume.
>When I think consuming opium, I conjure images of old chinese artwork where they are smoking it in a hookah type instrument.
It being smoked also makes it considerably safer. Users pass out before overdose.
>The Opioid overdoses are mostly Fentanyl and other extracts from opium.
Correct. Morphine is a somewhat strong opioid in its own right, but it doesn't even hold a candle to the more powerful opioids science has discovered. Not even close.
The strength of an opioid is often described in morphine equivalents, that is how much of x is comparable to the same amount of morphine.
Fentanyl is roughly 50x as powerful as morphine, which makes it a rather dangerous compound for untrained people to handle, especially to inject. That being said, as long as the dosages are measured correctly, fentanyl is not significantly more dangerous than any other commonly used opioid. It's the black market dynamics which make it particularly prone to kill users.
Fentanyl is also nowhere near the most powerful opioid being sold on the street either. The literature has opioids that are, roughly, several thousand times as powerful as morphine.
Meaning if it takes on average 1g of pure morphine to kill a human, less than a single mg of some of the stronger fentanyl analogs can be sufficient enough to kill. Much lower if injected.
This is what is killing everybody. Some fentanyl analogs are close to chemical weapons in terms of potency, and drug dealers with a 3rd grade equivalent education are handling it like they would cocaine or similar.
https://www.oregonpainguidance.org/wp-content/uploads/2018/0...
The alkaloids in opium are STRONG emetics. While it is certainly possible to fatally overdose, it is far more likely one would vomit for a few hours and be fine, assuming they did not consume far above a 'normal' amount for their bodyweight.
Which, by the way, is true of alcohol as well.
We are tricked into discussing drug prohibition as if it is intended to protect the public. It never was and never will be.
The fact that we sell alcohol and tobacco ends any discussion over "safe" drug use.
Legalize it. Regulate it. Tax it.
Anything else is misguided misery at best.
You could argue that there will be rules and restrictions, but lets not forget that the current opiod crisis, was caused directly by those corporations corrupting the supervisory body (Doctors) in place to stop it happening.
The supervision needs fixing (which I trust it can as it seems to be a uniquely US problem), but if you lifted it all together, I believe the floodgates would be open for corporate exploitation.
Just ban advertising of drugs then. In Canada, cigarette ads are banned for example.
But, its taken 100 years of legislation to get there, in the meantime, cigarette companies have funded research that claims their product isnt dangerous, and targeted children, etc etc.
Opiods are a whole different game. Combine that with teams of data scientists trying to boost addictions. I could even see blends being developed that meant you couldent easily switch to a competitors drugs.
https://science.sciencemag.org/content/sci/361/6408/eaau1184...
As an aside, looking at those charts, no wonder Breaking Bad was set there.
Is it coincidence that by far the biggest spender on congressional lobbying is Pharma/Healthcare? $284,000,000 in 2018 alone. That is $531,000 per congressperson in one year, and only for Pharma/Healthcare. Or, another way to look at it, $5,985.25 per opioid death.
[0] https://www.opensecrets.org/lobby/top.php?showYear=a&indexTy...