Tell that to the family of a gambling addict, or an alcoholic. They're vanishingly unlikely to kill themselves, but they leave a similar wake of misery in the lives of everyone around them.
Can I assume you've never had the privilege of knowing a hardcore gambling addict?
I'm not taking about weekend poker players, here... I mean people who've lost their wife, kids, house, and job to a gambling habit. They have zero savings, mountains of debt, and if you lend them $20 to get groceries, they'll go hungry after gambling it away?
Modern video games are designed by highly paid, PHd-level behavioral scientists to be as habit-forming as possible. If you're vulnerable to it, you're going to have the same kind of struggles getting away from video games as a heroin addict would from junk.
The lack of immediately lethal consequences is only part of the problem... Addicts can ruin their lives, and take their families and friends to the point of no return, even without the possibility of something as serious as an overdose.
You are talking about a very specific niche of video games though. Gambling based video games are addictive because of gambling, which you can do without the video game part of it.
Video game addiction still exists and can be bad but it's probably nowhere near as detrimental as gambling addiction.
The most basic harm of an addiction isn't financial. It's caused by an inability to be present in relationships with family & friends. A parent addicted to anything can't be bothered with anybody else's needs. They may hold down a job, and feed their kids 3 meals a day... But an addict won't be emotionally available to anyone around them. When they're actively getting their fix, they're numb to anything outside that experience. And when they're not, they're too busy struggling with their own unmanaged emotions to have room for their kids or spouse.
Video game addiction may not take all your money, but it can definitely devour the person. It'll leave you just as hollowed out and functionlly limited as a drinking problem. It's the core nature of self-medication, regardless of the mechanism of medication.
> I mean people who've lost their wife, kids, house, and job to a gambling habit.
The wifes and kids are secondary victims there. The tragedy is not that the addict lost them. Them leaving is them getting chance at better life.
The tragedy is that wifes and kids were likely mistreated for years and went through hell too. The wifes earnings were lost to addiction too and she did not even had fun playing. The kids were missing school supplies and had to live in tense environment where one parent was addict and other constantly overstressed and very likely cracking.
"I’m not entirely sure the migraines even existed. On a few occasions, Jack admitted to me that he faked being sick to get out of school. It’s plausible that Jack made them up to get out of school or socializing, and his well-meaning but enabling parents let him do it."
Oh come on man, occam's razor. Debilitatingly painful and difficult to treat medical condition in childhood results in social isolation and an opioid addiction. A kid faking being ill once doesn't discount an entire life ruining disability.
>Debilitatingly painful and difficult to treat medical condition in childhood results in social isolation and an opioid addiction
Occams razor: tons of people have social isolation and/or opioid addiction, without "Debilitatingly painful and difficult to treat medical condition in childhood" (and the inverse).
And he didn't say "faking being ill once", he said "n a few occasions", and those are just the ones he admitted to his friend.
They're speculating. The author states many, many times in the article they don't have full facts and are speculating based on inference and the parent's recollections including their own speculation.
> I wish I had a happier note to end this on, but honestly, my biggest takeaway from the whole experience is that maybe some puzzles just can’t be solved. We can try to attribute Jack’s problems to intrinsic biological/psychological issues (social phobia, migraines, etc.) or to environmental causes (super high rate of heroin use and OD in the community), but both sides seem fundamentally lacking in explanatory power. The vast majority of socially anxious people don’t resort to heroin, and despite the problems of these small towns, they are by no means among the worst places to live in America, let alone the world.
Earlier on, the author does speculate about what drove Jack:
> To put it another way, Jack was painfully aware that his future options were, “be a complete loser,” or “be a complete loser who feels really really good for a few hours every day.” He chose the latter.
What's striking about this is how it's possible to live this way without drugs. A brain-numbing job eight hours a day and a life-saving hobby for four. A toxic-family life but wonderful community.
It almost sounds like Tennis could have been this outlet:
> One time when Jack was in middle school, he walked off the tennis court after a well-played match, and his mother asked him how he felt. Jack said something like, “when I’m out there, it’s so nice… it’s like the rest of the world goes away and I don’t have any problems.”
I'm not sure you understand how good heroin feels. Nothing comes close, especially not Tennis or a wonderful community.
I tried heroin once, and I regret it every day, because I am 100% positive that I will never again be as happy as I was that day. If I didn't have what is effectively a dream job I'm sure that I'd be a heroin addict.
Just to throw in my 2c, I’ve had dilaudid a few times for an injury and other opiates for various reasons, and while they feel great, they really never cross my mind much and I don’t hold them close to many sober experiences. Not even as good as other drugs, of which I could list 3-4 I’d consider as or more enjoyable.
The above comment feels like a really dramatic description of opiates. I don’t think most anyone with a moderately stable life is at risk of addiction trying them.
I think people experience the euphoria of opiates differently. Anecdotally - i've never found opiates compelling. I appreciate their ability to numb severe pain, but they don't do anything for me as a mental release.
Whereas a good friend is the opposite, he loves the feeling opiates give him and gets quite a kick out of them. He is very careful around them because he understands that he could easily slip into a full blown addiction with them. BTW - this friend has a stable job, a loving wife and 2 kids.
My wife had chemo and was given oxycodone. She hated it as it just made her nauseous. I had one low dose 5mg pill of hers and suddenly felt as if everything was finally right, the euphoria was there but it was more. ‘I finally feel normal’. It was dramatic and I’ve been battling the temptation ever since.
> feels like a really dramatic description of opiates. I don’t think most anyone with a moderately stable life is at risk of addiction trying them.
A few years back, perhaps close to a decade ago, there was a fairly well known reporter/journalist who said this same thing. Of course, he was cocky enough to test his presumptions & tried either some form of opiate or heroin, can't recall exactly which. He by all means had a happy and successful life/family.
He ended up getting horribly addicted & there was a good writeup/documentation of everything that happened. I'm having issues finding the article right now though.
Also, anesthesiologists, one of the highest paid, disciplined, and well respected jobs you can get, are also one of the highest risk groups for severe drug addiction.
I think your presumptions are quite incorrect and crass.
As I understand it, even mild pain medications like ibuprofen (for women though apparently not for men) and acetominophen can relieve emotional pain as well as physical pain.
That was certainly not my experience, it was an intense physical pleasure but ultimately devoid of mental depth. Having tried most drugs I really think the whole addicted after one dose is bullshit and it's far more about your social economic circumstances.
It's much more tempting to seek out another hit if you have nothing better to do that day.
This seems to rather callously disregard the parent commenter’s lived experience. Perhaps, just maybe, not everyone is like you; it might be different for different people? Just a thought.
That was certainly not my intention, I was trying to say that the idea that these substances will make anyone a helpless addict if they try them once is misleading and completely ignores the social context around addiction.
It seems pretty clear that there's at least some level of genetic component to addiction. It seems likely that this is part of it. Some people, like you I suppose, really genuinely think it's not that big of a deal. Some people, presumably like the grandparent of this thread or the subject of the article, think it's by far the most amazing thing they'll ever experience in their life. Why's that so hard to believe?
It seems pretty likely to me that at least some people really will inevitably go down that road from one dose. Maybe not as many as the hardcore Drug Warriors would like us to think, but at least a few. It's an odd blind spot for the hardcore Libertarians - some people just aren't physically capable of coping with it, and no amount of willpower on their parts will change that.
Addiction and the addictive ness of drugs is a multi factorial gradient. It requires the right psychosocial conditions, the right environment, and the right drug, and a person who might become a heroin addiction one day may not be so at a different point in their life.
Roughly 1-2% of people who try heroin once are done forever; many many try once or twice and aren’t. For cigarettes the rate is about 20-30% who become addicted
I agree with you that social context matters but I want to provide one data point on how psychological setting of that person matter too.
I am an anxious person prone to depression. In one especially bad period of my life I was prescribed Lexaurin (anxiolytic used to handle panic attacks). Taking that was a shocking experience - it made me feel calm, optimistic... and maybe for the first time in my life it made me aware of the ever-present baseline of anxiety that I was living with, like always. Lexaurin made me feel not anxious at all and it felt awesome. I kept asking myself - is that how other people feel all the time? I would give anything to live like that. If I had free access to it all the time, it would be really hard to resist the temptation not to use it. At the same time I can imagine that for many people - like you maybe? - taking Lexaurin would do absolutely nothing, because they live on that anxiety-free baseline their normal lives.
Some people love opiates. Personally, I hate the feel of opiates. My brain feels like it's encased in concrete. This is not a good feeling to me.
I consider myself fortunate that I don't like the feel of opiates as it means that I didn't become addicted to them from the times I needed them medically.
I will, however, point out that musicians almost universally warn other musicians not to do heroin even once. Musicians aren't exactly straight-laced, and, if they're warning you about something, you probably ought to listen.
If I get drunk I become happy and will hug my friends and tell them how much I love and appreciate them. Others become aggressive and start picking fights with random people, or beat up their wives, girlfriends, etc. I don't especially enjoy being drunk though; it's alright once in a while, but there's loads of other activities that are on equal footing as far as I'm concerned.
I tried to smoke weed a few times. I didn't just dislike it but downright hated it every single time. I tried a few other drugs, and responses varied from "I don't really like this" to "meh, so this is it, is it?" Never tried heroin, so I can't speak to that specifically.
Point being: individual responses to drugs vary greatly. I wouldn't say I'm "immune" to becoming an addict, but it'll sure take a lot more than for some other people.
> I really think the whole addicted after one dose is bullshit
When I was ~12 I got nitrous in the dentist's chair.
I remember the thought going through my head: Wow, this is really cool.
However, I didn't have ready access to nitrous! If my parents had a whipped cream maker, would I have started huffing whip-its? Maybe, but at least they aren't addictive. It's not like I would have gone into withdrawl after going through a box.
I think the bigger issue is the physical dependency that opiates have. Once the drug is no longer the "new toy," but the physical dependency is there, it's much harder to stop once the novelty is gone.
This is the scariest thing about heroin IMO. It's basically game over, you've ruined the game of life by using a cheat code and the rest of the game will feel hollow and pointless.
You don't need heroin to reveal this to you. That's in part why burnout is a thing. Just try really hard to do what you think is right, and then be shown that what you put your energy into is basically worthless. Then you start thinking about what ultimate prospects every hypothetical financial reward could result in, and it's pretty bleak out there. Then once you're ready to get back into it after being fired, because you're running out of money, you realize that it takes 4x the effort to do 1x the work for 0.25x the spiritual reward that initially drove you to get into it, and so you turn to heroin or start a farm.
I've been pondering for a while if being at certain points on the bathtub curve of learning/integrating new things (the disorientation phase, the sense of no progress) may create exponential sensitivity to emotional stress (like burnout) and make it feel 100x worse. Reading this, now I'm wondering if maybe a similar bathtub curve effect (specifically the "I can't see the light at the end of the tunnel" part) associated with the open-ended constant mental engagement of looking for work precipitates a similar sort of sensitivity to ROI outcomes (with obvious preferences toward lots of positivity).
If this is the case, then as direct as it is to say - these mechanisms are just that, mental mechanisms, and it just happens that when "low point of bathtub curve" bounces off of "really badly timed negative ROI event" bounce off of each other, it's like the result is amplified almost beyond reason. Long-term the signal value ("this will kill your spirit") is absolutely true, but in the immediate (ultra-short) term, compartmentalizing and ignoring it may be both safe and actively helpful. (Standard internet advice disclaimer applies)
TL;DR: Good luck, and may circumstances and equilibrium materially improve and solidify.
Why is it scary? Heroin isn’t unique in this aspect.
I had a friend tell me “when I had the first drink ever my first thought was ‘I want to feel like this the rest of my life’”. He was sucked in right away and struggled for years to break that hold.
Plenty of people feel that way and practically kill themselves with alcohol, opioids, cocaine and even food.
And plenty of people take opioids equivalent to heroin and say “i felt terrible, nauseous and dizzy, I don’t get it”.
I cant find the source but there was a DEA (?) report a long time ago that noted “80%+ of cocaine users use it less than 5 times per year”.
When drug use gets pushed into the shadows the only examples you see are the ones where it spirals out of control.
Because it has such a strong effect for most people compared to food, sex, alcohol, etc.
Obviously I don't know how strong (and I really really hope I never know, unless I'm on my death bed etc) but by all accounts it is overwhelming. Everything is toxic at the right dosage, and heroin is pure toxic pleasure.
I was spiked with heroin once. It didn't impress me - it made me feel a bit ill.
I've tried coke - good stuff, in good company, for an evening. It didn't impress me much.
I guess I was just lucky. I have an "addictive personality" - I drink way too much, and I'm a heavy smoker. I could easily have fallen into one of those holes, if I'd actually enjoyed those drugs. I found psychedelics much more engaging; but they're generally not addictive - after 3 days of continuous LSD use, no amount of LSD will get you tripping again. It's anti-addictive.
This is correct. You have to work on an alcohol addiction. It takes a few months to develop a dependency severe-enough that withdrawal might result in seizures. Short of that, you can just quit, if you can get time off work for a few days in bed.
You also have to work on a heroin addiction, so I have heard. It simply isn't true that "one dose and you're hooked". People become addicts because they want to be addicts, for whatever reason. Part of it is lifestyle; part of it is the desire to be dependant, so you get to not have to be responsible for yourself.
> You also have to work on a heroin addiction, so I have heard. It simply isn't true that "one dose and you're hooked".
When I looked at it, it is something like 30% of people develop dependence after first one-two usages. Then there are people who can use it casually for a long time before developing it.
I shouldn't have said "you can just quit" - that's medical advice, and I'm no kind of medic. A decent nurse will tell you if you'll be able to just sleep it off.
Sorry for commenting to self, but it's too late to edit.
A physical dependency is not a requirement nor is it necessarily that strong of a motivator for continued use. Psychological dependency is often the harder thing to break. Addiction is defined by continued, compulsive use despite negative consequences in one's life.
And sure, most people don't say "I want to drink forever" when they have their first drink. But that's my point, most people don't say that when they get opioids - remember they are very widely used in medicine. Some small fraction of users actually spiral into a deep addiction.
Now, one could argue the percent that develop a problem is larger than with alcohol - that might be true. That said, it's estimated something like 10% of drinkers have "problems" with their drinking. Again, not everyone ends up a homeless drunk - plenty of functioning alcoholics.
Say you use heroin or have used it in the past. Now you have to go in for some kind of surgery. Guess what? The opiate pain meds won't work for you! I've seen it first hand. It's awful. Hospitals are only allowed to give so much and if you're a user or were a user, the amount they give you won't touch your pain.
Guy who used heroin shattered his hand in a fall off a roof. Had pins put in. When he came around after surgery they had to call the police he was so out of control because his pain couldn't be managed.
Opioid tolerance will absolutely decline if you stop using. it's actually a significant cause of death. People will quit (or go without due to jail, etc) and then relapse with the same dose they has used before and have a fatal overdose.
Morbid but curious question: when tolerance declines, does a de-rated dose (say, 100% of the body's safe mechanical limit) produce the same mental effect as the previous, now way higher dose would? IOW, does the tolerance affect the mental response as well?
(NB. Have integrated the understanding that pushing The Button™ is a generally bad idea. The above is purely intellectual curiosity.)
I mention it because you say you're in a precarious situation. Wouldn't it be good to cultivate a kind of happiness that doesn't depend on a wonderful job or anything else?
Meditating on the six dhyanas (or "janas") is a kind of single-pointed concentration. One of the side-effects is supposedly "bliss" (sukha). It's strong medicine, and if it works, it will alter your mind - that's what it's for.
I have to say I've never tried it; I was warned off it.
If you're doing it for the bliss, your motivation is wrong, and you are at risk of vanity and playing power-games with people. If that happens, you will suffer harm.
If you were asking why I think religion is not for children, well: I think tales about fairies, angels and Santa Claus are not for children. I don't think you should lie to children, nor encourage them to subscribe to superstitious beliefs. By "children", I mean anyone with underdeveloped critical faculties. I read fairy stories to my kids, at bedtime; but I didn't pretend they were true.
Some religious systems present very interesting ways of looking at the world, the mind, and morality. But it's like hard drugs; it affects your mind and your relationships, and not necessarily for the better. I think that tangling with a religious system should only be done with care, and under appropriate supervision. The matter of how to choose a suitable spiritual mentor is an unsolved problem.
I heard a story - can't find the reference now - of a doctor who got addicts to replace their drug addiction with exercise addictions. From what I recall the program was quite successful at making the patients functional, but didn't really do much for the underlying issues - just made the addiction itself less damaging.
Makes sense. I talked about it with a friend of mine, a ex-junky. He said, all people he know from the Methadon-program are dead because they just died on alcohol.
He said, they don't take Heroin because Heroin make addicted, they take Heroin because they needed 'the hammer on the head'.
They switched from Heroin to a more damaging addiction. Why this should not work with less damaging addictions too?
Pretty common on the west coast to hear about people taking suboxone to quell their heroin addiction but doing meth now to get high because its so cheap and available in this part of the country due to the industrialized processes in mexico that came online over the past 10 years.
There is no organ in the body that isn't harmed by alcohol. This is what doctors have told me. The ethanol molecule is tiny, and can pass through any membrane.
That's the "Trainspotting 2" theory: we're all addicts, just replace one addiction for another. Film director and comedian Kevin Smith once said his friend Jay Mewes manages to stay away from his heroin addiction by drinking gallons of energy drinks.
> They knew he would never get drugs when I was there. He wouldn’t shatter the illusion he and his family crafted for me. It wouldn’t be worth it, not even for a fix.
seemed to be something that really worked? albeit for the while
>Then there were the migraines. Even after he died, I never got a straight answer as to the cause or truth of this problem. All I know is that he often complained about getting debilitating migraines that forced him to stay in the quiet dark of his room, sometimes for days straight. Jack’s parents took him to doctors and specialists trying to get to the bottom of it, he tried numerous treatments and medicines, but I don’t think the cause was ever identified.
Migraines are frustrating because there are a thousand different potential causes and no one really understands their physiology. Many people don't respond to medications (outside of opioids, maybe) and even then, a migraine is far more than just pain; it appears to be a general disruption in brain function, possibly related to a phenomenon known as cortical spreading depression, and is often preceded, accompanied, and followed by vague psychological and even gastrointestinal disturbances. What's worse, you may be lucky enough to find a medication to mitigate the pain, but the psychological disturbances generally persist even in the case of a successful abortion. Frequently that means cognitive slowness and emotional disruption that can last for days.
Likely migraines are actually a manifestation of numerous abnormalities which are not always present in all sufferers, and I imagine that makes them particularly difficult to research, especially with first order statistical correlational analysis. Maybe ML will help here with the right data. The only certainty is that a better understanding of and cure for migraines would bring relief to millions of people who suffer unnecessarily.
Would providing free and clean heroin in safe, monitored sites be a solution? Starve the black market of clients, give people support and safety when they need it, as well as the time required to get their life back together enough to take a leap.
I used to believe that — before I lived in a city that effectively decriminalized all drugs.
The result has been a disaster. People on meth run around the streets at night causing chaos. Homeless people on heroin leave needles everywhere. People avoid transit and parks now because there is regularly someone losing his or her mind nearby.
Long sentences aren’t the answer of course. But I do think that sending someone to a Nordic-style prison for a few weeks would be better for these folks than just letting them run free.
By the way, free mental healthcare doesn’t actually work because many of these folks don’t want help and won’t seek it willingly. There needs to be a way to forcefully separate them from the addictive substance for a time, stabilize their drug crisis, and then help them find long term care.
I understand that, although it's difficult to say whether that experiment is indicative of what a nationwide relaxation of drug laws would do. Cities which have decriminalized drugs (removed enforcement) are going to attract a disproportionate number of problematic or homeless addicts from other parts of the country. Cities with a more hospitable climate (in the sense of weather) already have this problem, so I imagine for San Francisco it's a double whammy.
What utter nonsense. Portland has an incredibly inhospitable climate (I mean I live in a lovely house and I find it overbearing). And yet we have more than enough people willing to tough it out in the torrential downpours.
This doesn't contradict what I said. I don't know much about Portland's homelessness problem, but I'd guess that being the largest city in the state, and having famously left-wing laws, might attract people on the margins to come. There are probably a lot of reasons.
I see the same in London, where everything is illegal.
I think it's unrelated to whether drugs are a crime or not - homeless and drug users in general will find a way to get it.
It's a sad reflection on the state of society and our cities.
Personally, after a terrible experience in Paris, I decided I will avoid all big cities.
I think we should do something about it and forcefully throw homeless and drug users out of cities, but it's not a very popular (or easily enforceable, for that matter) point of view.
> I think we should do something about it and forcefully throw homeless and drug users out of cities, but it's not a very popular (or easily enforceable, for that matter) point of view.
Do you also think that we should forcefully push the Sacklers & all of their paid off politicians out of the nation for what they've done?
If you don't mind me asking what incident let to you to taking to such a hardline stance? I don't necessarily disagree or agree I just would love to hear that kind of perspective?
As someone else from the UK, at the start of the pandemic lockdown measures several cities tried to give every homeless person a bed. In every case, the majority ended up leaving the accommodation offered due to the rules around drugs, smoking, antisocial behaviour, whatever.
I'm not sure I agree with the above poster about their solutions to the problem, but "solving" homelessness, or addiction, is a lot harder than making some broad brush laws about decriminilisation.
My cousin is a heroin addict, 12 years running at this point. He's in Dundee, the smack capital of the UK and quite possibly western Europe. Methadone is the worst idea possible for him, because he swaps it with the cancer patients for diazepam and then makes himself a happy cocktail. He's from a genuinely loving, supportive family, but still breaks into their house to steal stuff to pawn for smack money.
The only thing that would probably "help" him is full decriminalisation, but that would not help his victims, or his family, or the already overstressed health service in general, because the whole point of these measures is an expectation that addicts will suddenly "see the error of their ways", rather than thinking "wahay, free smack".
And back to the original point, when you have people actively preferring the street to the fully serviced hotel rooms, then you've probably got a severe structural problem. At which point it's easy to understand the above point of view, especially if you have a home and a family in close proximity to the inevitable social disorder (and I've also lived in Portugal. It is far from the free drug liberal paradise that some imagine it as)
> when you have people actively preferring the street to the fully serviced hotel rooms
We don't have all that many people preferring this. Pretty much all of these and all homeless shelters come with massive catches that are reason for why they are not viable solution for many people. It opens at certain hour and you have to completely leave with everything in the morning. Cant have work tools inside, cant lock doors. Noise.
The shelters themselves do have reasons for all those rules. One of them being homeless do make your mental issues and addition issues worst in addition to these people being overrepresented in the first place. But, framing these places as "fully serviced hotel rooms" as if that was what life in them actually looked like is not accurate.
As a guy (as weird as it may sound) I've been followed and jumped on by a drugged up homeless making sexual advances in an isolated street next to Gare du Nord. There was a small altercation and I ran away.
In the same trip I've experienced several instances of homeless or just economic immigrants from Africa grabbing your arm trying to steal / sell you something.
There is also plenty of homeless peeing and pooping pretty much everywhere in Paris, which is disgusting enough.
I found London to be much better compared to Paris, even if things got way worse in the last few years. 5-10 years ago it was a rare occurrence to see homeless people, now you see homeless people sleeping everywhere and shooting drugs on the street like it's nothing.
I've since moved in the middle of nowhere and I'm definitely not going to raise my kids in a city.
I live in a market town. Small towns are often a magnet for druggies - they're safer than big cities, and they're often much nicer places.
We don't really want all the druggies from the Big City forcibly ejected, so they end up in small towns. Why should townies have to deal with the problems that Big City folk can't be bothered with?
I don't think you should, keep them out in the same way.
If they can't integrate in society, they can go and live in the woods or start their own town, for what I care.
I'm not opposed to helping people with problems: I think we should use voluntary charities (eg. not forcibly taken taxes) to help them - but healthy citizens' lives should not affected because of the problems of a minority.
If that means keeping someone outside of cities, so be it.
If you have no home, it's hard to get a job. But it's hard to get a home if you have no income. So people end up on the street. They then face a choice of a street in a town, near to shops and services; or sleeping in a ditch in the boonies. I've slept in a ditch in the boonies, and I can't recommend it. And Social Services don't patrol ditches in the boonies.
A homeless person can disappear in a big city; it's easier for services to find them and help them in smaller towns. So if I was in a scrape, I'd head out of the city, to a smaller town.
With respect to forcibly taken taxes: they're taken "forcibly" because it's the law that you have to pay taxes. They don't usually come around with guns, to separate you from your belongings. We have a social contract, where I live, that we get free education and health-care and stuff, in exchange for paying taxes.
I was a fairly high earner, until I retired. I've never objected to paying taxes. I do object, very strongly, to corrupt politicians taking the piss with taxpayers' money; but in fact it's a small proportion of tax revenues that get stolen like that (here).
Frankly, I'm OK with the taxpayer paying up so that we don't have an underclass of people who are ill, psychologically troubled, homeless or intellectually challenged, and who are compelled to live under hedges. It could be me that's down on their luck, some day. If I were in that situation, there's a pretty good chance that I'd be resorting to substance abuse.
You're entitled to your views; but it seems pretty harsh to me, to simply declare that those people need to solve their own problems, and leave the taxpayer alone.
Is it perhaps also your view that the only legitimate use for taxpayers funds is to send armies to foreign countries? I'm not in favour of that. And I'm not in favour of taxpayer subsidies for diesel-oil for motor cars. I cough up, because the deal is that I either put up with the way collective taxpayer resources are spent (after making my point at the ballot box), or I leave the country.
As it happens, there's no other place I'd prefer to live. So here I'm is, very comfortable thank you, and I try to be kind to people who have to live on the street. Nobody would choose that if they had an alternative.
Why? Cannabis market thrive is US. More and more people use cannabis every day, making profits for sellers. Some people will switch to hard drugs and die, of course, but car incidents are not stopping car sales.
Cannabis is very very VERY different from heroin and coke in term of dependency creation. Abusers need a totally different level of support from the health system and social services
I've never met somebody informed and for decriminalization that isn't aware that the first few years, perhaps even decades, especially when just in a small region and not an entire nation, are going to be a bit of a shitshow.
Things take time to get better, and as others have mentioned, most places that have decriminalized haven't exactly bolstered all other services that need to be around once decriminalization happens.
It's sort of like the amount of people who are pissed about how Chinese tourists act. Their nation has just recently entered a point in which they're able to be tourists. Americans have had decades to learn how to act and are often still shitty tourists. Things take time.
I feel the same way. I was so excited to see a decriminalization measure on the ballot. A year after it took effect, our drug problems are worse than ever. It turns out that for the Portugal model to work correctly, there needs to be carrot and stick, but Portland only opted to implement the carrot, and the quality of life here has gotten much, much worse in a very short amount of time.
> By the way, free mental healthcare doesn’t actually work because many of these folks don’t want help and won’t seek it willingly. There needs to be a way to forcefully separate them from the addictive substance for a time, stabilize their drug crisis, and then help them find long term care
This is an inconsistent statement. In once sentence you say that free mental healthcare doesn't work, then in the next you posit that imprisoning them, then providing free mental healthcare is the answer. I think at the end of the day, people need to want to stop using drugs and have the help they need to do so. I don't think prison is the magic bullet for bringing about that change that you imagine it to be.
> People on meth run around the streets at night causing chaos. Homeless people on heroin leave needles everywhere. People avoid transit and parks now because there is regularly someone losing his or her mind nearby.
It's not realistic to expect only legalizing drugs to solve all your social problems. Why are there homeless people? Why are people having mental health crises on the street, and the only options are to ignore them, or put them in prison? I'm not sure what is meant by "causing chaos", but if they are committing non-drug crimes, why are they not being arrested?
Not inconsistent; many will refuse treatment if simply asked, but with forced treatment / detox may come through the woods a bit and make a different decision.
It's the same freedom vs. detention debate and we've swung towards full freedom option in the US since the shutdown of mental health prisons and we've offloaded the care for the most difficult cases to police, ER, health workers, and they live on the streets. It's high time the pendulum swung back a bit with some (hopefully humanely administered) compulsory treatment options which is was the other commenter may have been getting at
I work in the ER in a high drug use area - I estimate around 80% of patients who start outpatient "medication assisted treatment" in the ER (outpatient buprenorphine-naloxone to treat the withdrawal symptoms) are there because the judge in their criminal case tells them it's that or go to prison. Some people definitely can't make good decisions for themselves and need to be "forced" to get treatment - and are later often grateful for having been forced to do so if they stay clean.
There's yet another model, which is to think of compulsory actions not in terms of crime, but in terms of competency to make decisions.
So, you deregulate drugs, but for those who fall into addiction, you evaluate their competency to decide whether or not to take drugs, and if someone(s) decide they're not competent (a panel, psychiatrist, psychologist, whatever), you force them into treatment, take away their drugs, etc and so forth. If a drug dealer provides them with drugs, then they're breaking the law for a different reason.
Part of the problem is this "one size fits all" with drugs, and with criminalizing use rather than treating it as a disease. Call it what it is: someone not being competent to make decisions about drug use, period.
I imagine it would help with the fentanyl issue. I don't think that anyone would buy fentanyl if they had access to known real heroin that wasn't expensive.
I wish this was true. Fentanyl has demand, both all on its own, and cut into other substances for the extra kick. I'm reluctantly convinced that a free clinic should have it on the menu.
It's not a menu, it's a place where you go to get a clean, safe fix for your opioid addiction.
You get what you get, the best opioid or analogue that the doctors decide to give you, possibly with a slow release mechanism that avoids the rush but allows you function throughout the day, hold a job, not stick the first AIDS-infected needle in your vein etc.
But how do we get people to choose the slow release over the rush? Buprenorphine and methadone are the slow release analogs you speak of, we already have those, and they are helpful for some. Still, there is a fraction of the addicted that are not interested in slow release.
Anecdotally, a close friend of mine sold his buprenorphine so that he could afford to purchase heroin.
Look, I'm sure you mean well, but it doesn't sound like you understand the behavior of drug users. So let's re-phrase that: I'm going to out-compete the liquor scene with free but watered-down beer.
If you want to help people, you need to meet them where they're at. The moralizing "you get what you get" approach is only going to tide people over for when they can't afford to score the potent stuff.
> out-compete the liquor scene with free but watered-down beer.
Make that: free strong beer versus liquor that has a 2% chance to be mixed with rat poison, is illegal to sell or buy, and costs more to use than the average job pays. A quite compelling offer for any drunk, but, yes, some lost souls will still go for the "real" shit.
I understand the whole "reduce harm, addicts are lab mice caught in a chemical trap" philosophy. But providing ever increasing doses of hard drugs, as most addicts eventually require when left to their own devices, might be an even faster way to the grave.
Let a doctor make the choice minimizes overall harm, not consumer preferences.
Given what we have observed with alcohol, cannibis, and prescription drugs, I think it's safe I expect that decriminalization, legal suppliers, and free drugs would probably not reduce recreational use & abuse of opiates in America... If anything, I would expect usage to increase.
Don't get me wrong: I am absolutely in favor of decriminalization, as well as other radical changes in our society's relationships with drugs, mental health, and addiction. But it would be catastrophically naive to suggest that legalized/decriminalized opiates are some kind of panacea.
If heroin didn't exist, these people would probably plain old alcoholics. The damage caused by an alcoholic is pretty similar to the wake of a heroin addict... It's not identical, but the overlap in causes & effects of abuse is pretty similar between the two drugs.
Ultimately, the problem is that some people reach young adulthood without having developed a robust set of emotional coping mechanisms for handling the stresses of their lives. These folks are a LOT more likely to fall into the larger patterns of self-destructive behavior that drive them back toward drugs, over and over again.
I think legalization is the only real solution, but you bring up a good point about alcohol. The best approach there is preventative, and do things like strictly ban all advertising of all drugs, before there's a strong lobby to prevent that from being enacted. We should really ban advertising of alcohol and prescription drugs too, but there's unfortunately vested interests that make that a hard task.
I think the ideal system is some sort of government-run one that is not out to profit, and keep on suggesting that maybe you don't need any drugs, but will give you some if you insist and are willing to watch a safety video.
There is a big problem with your first sentence, possibly semantic. You said: "I think legalization is the only real solution..." Legalization alone is NOT a solution, and it WILL result in increased rates of abuse, addiction, death, and human misery if other changes are not implemented concurrently with legalization.
I understand why people want to focus on legalization of drugs. It's a simple idea, with precedent in th US and many other countries, and it doesn't require expanding goverment spending or power. But it's just too simplistic to be useful. We cannot limit the harms caused by addictive behavior with pure Libertarian self-interest, because addiction IS a self-interested response to larger problems that the addict lacks the capability to handle, emotionally.
If we want to truly reduce the addiction, death, and suffering, we need to develop real, effective social services that help families and individuals on many, many levels. We need to plug the gaps in our children's emotional upbringings, which means permanently repairing the jagged indifference of our society that inflicts so much harm, in the first place.
In short, we need to let go of our fear of collective social welfare programs, and start truly giving a shit about each other.
I believe we agree. Let me rephrase my first sentence:
Legalization is a necessary component of the overall solution that also includes social services intended to reduce both the need for drug use and mitigate any impacts from it.
I just wanted to emphasize that without legalization, we'd be failing before we started to fix the problem as a society.
> We should really ban advertising of alcohol and prescription drugs too, but there's unfortunately vested interests that make that a hard task.
Around here ads for alcohol has been banned since I don't know when despite having multiple producers, of which at least one classify as large on a national basis.
The last two decades we've also seen laws against tobacco coming into place and - as someone who had friends who smoked since early teenage years or in at least one case even well before that - it is kind of weird to see someone young smoking in public today so the law has obviously worked.
I think it would be better if there was a little more of a barrier, like you had to get a prescription from a doctor or addiction counselor, but it was free. I think we should allow people already addicted to use clean/safe drugs in safe places, but we should be careful about lowering the barrier for those who are not already using.
It would help for sure. My cousin died not because of overdose but because he shared needles and contracted hepatitis which turned into hepatoma. If safe injection sites had been available he might still be alive.
“My cousin died because he made a choice to try heroin, got hooked on it and made a choice to share needles, contracted hepatitis, which turned into hepatoma.”
Fixed that for you. Truly sorry for your loss, but people make choices, and those choices have consequences.
Can we hold these two things to be true at the same time:
1. No one is forcing people to take these drugs. The choice to start is theirs. They are ultimately responsible for their choice to become addicted.
2. We should view an addict’s behavior through the lens of addiction, not the lens of a rational person making destructive choices. Addicts won’t respond to incentives like a normal person will.
We need to find ways to make it extraordinarily costly to start using drugs. This is how you prevent the crisis we’re in currently.
That means prison time for users. Heroin and fentanyl pour across the border due to demand for it. New users dabble in it because the perceived cost is low. If people understand that possessing or using means automatic and significant jail time if caught, then people are much less likely to even dabble.
Ultimately, people will still try it regardless, get hooked, and eventually get caught and sent to prison. And that’s a good thing. That means there are less users who are on a path to homelessness, overdose, and dependency on family, friends, and government programs. It also means less users out there to persuade others to start using. If we’re not going to run mental health hospitals with involuntary commitments, then prison time is what you’re left with.
Prison terms for using are five times as long as it takes to get users clean. Once they get out, if they’re caught again, the sentence is ten times as long as it takes to get clean. Each consecutive offense ratchets upward.
The result is twofold: users have ample opportunity to get clean and stay clean in prison, but most importantly, we create a society in which we simply do not tolerate drug use. It’s really that simple.
We are going to have as much drug addiction and use as we’re willing to pay for. If you lower the cost of using, you get more usage. Free usage sites with free needles and less risk will, and already has, resulted in more usage. The fact that people won’t recognize this is mind boggling.
> We need to find ways to make it extraordinarily costly to start using drugs. This is how you prevent the crisis we’re in currently
For this to work, people need to think about the longer term consequences of their actions. They don’t.
My personal experience has been that life can be so unbearable, you’ll turn to anything to get some relief from the pain of being alive.
I’m fortunate to be high-functioning bipolar. My uncle isn’t and he can’t tolerant medication. It doesn’t surprise me he constantly struggles with alcohol, along with the rest of his father’s family.
The only reason I’m not an alcoholic is alcohol does not have any positive effect for me. It just makes me sick. Same with opioids.
The problem with heroine is not that it isn’t “clean”. It’s that it consumes the person addicted to it, becomes the sole driver of every waking behavior, like food, only more important. It happens with prescription pain medication obtained legally as well, and with alcohol to a segment of the population with a particular disposition towards it. For a drug that ensnares every fourth person who uses it once, it’s hard to imagine making it more available solving the problem.
"What does a scanner see? he asked himself. I mean, really see? Into the head? Down into the heart? Does a passive infrared scanner like they used to use or a cube-type holo-scanner like they use these days, the latest thing, see into me - into us - clearly or darkly? I hope it does, he thought, see clearly, because I can't any longer these days see into myself. I see only murk. Murk outside; murk inside. I hope, for everyone's sake, the scanners do better. Because, he thought, if the scanner sees only darkly, the way I myself do, then we are cursed, cursed again and like we have been continually, and we'll wind up dead this way, knowing very little and getting that little fragment wrong too."
Relevant to your quote, Philip said: The two basic topics which fascinate me are “What is reality?” and “What constitutes the authentic human being?” Over the twenty-seven years in which I have published novels and stories I have investigated these two interrelated topics over and over again. I consider them important topics. What are we? What is it which surrounds us, that we call the not-me, or the empirical or phenomenal world? — from https://urbigenous.net/library/how_to_build.html
Checking in from Northwestern Poland. Lost my dearest cousin and best friend when he turned 27 (yep that age). I don't have any more tears left. Been crying for a decade.
I remember my own decade-long struggles with "failing to thrive" and I can assure one can turn your life around, but as author correctly noticed: "The puzzle of getting Jack <...> onto his feet could never be solved because there was a missing piece – Jack wanting to get better".
Not drugs, but I'm playing out this story right now in my own life. No matter how much I try, I can never find a reason I'd rather wake up in the morning than not.
To me, it rather feels like the opposite, like the "wanting to get better" explanation is a moralistic, post-hoc rationalization. I live a reasonably successful life, but many of the things that made it so are just luck. I was born in a reasonably affluent country, and my parents always provided good care and abundant financial support. I am pretty awkward, but smart enough to get through life. I am naturally interested in programming computers so I don't even need to make an effort to do it, and this happens to match one of the most demanded jobs. I am depressed/anxious but thankfully SSRIs work very well for me. I had no bad influences regarding drugs. To me, it seems those reasons have had a greater influence than "wanting to get better" could ever have. In fact, when you're depressed, there's not even a "wanting to get better" to be had - you're just reflexively pulled to bad feelings.
Good write up. The US is really grappling with diseases of despair, and heroin/fentanyl addition is on of the biggest ones impacting the wellbeing of our society. A massive slice of talent and raw human resource is just dying every year, but the solutions that have worked in other countries are just impossible to implement here due because the the methods that are known to work are politically dead on arrival.
I'm a strong proponent of the US taking the approach the Swiss took to combat their opiate epidemic in the late 80s and early 90s. Anyone that is addicted to drugs can get the drugs they want, they just have to already be addicted first, and accept the drugs in a safe environment. It would be extraordinarily expensive, but cases like Jacks are already costing us much more than just giving him drugs, keeping him alive, then having healthcare professionals be there at exactly the moment he decides he's had enough. The effect on new users would be profound as well: as all the current users naturally age out of wanting to use hard drugs, the majority of drug dealers (other users themselves), won't have the capability to introduce new people to hard drugs.
However, we seem to have this huge moral hang up in the US about giving addicts drugs, even though we know that will save lives and money by reducing crime and lowering overall healthcare costs. For all the money Jack's parents spent on rehab, and hours spent watching him, none of it could prevent them burying their son the day he got a bad bag of heroin. For a case like Jacks, only safe drugs and injection sites would keep him and the millions of people stable before they are ready to move on.
The US is just not prepared to do what it takes to solve the opiate epidemic, and it's so frustrating to what tens of thousands of people die while we aren't anywhere near getting our act together. It's a Vietnam war in OD deaths, every year, and the Sacklers just walked with no criminal liability. Unless we do something drastic to reach these people, the opiate crisis is never going to go away.
> we seem to have this huge moral hang up in the US about giving addicts drugs
For many people, what you're describing all comes down to the law of love. It is not loving to give a person more of the thing that is destroying them.
Perhaps free methadone would be a better option?
EDIT: care to comment? I'd like to know why people disagree.
More often than not, lives are in greater threat of being "destroyed" by the consequences of drug prohibition than the drugs themselves. Addiction is a serious health problem, but impure drugs that lead to overdose deaths, spreading disease through needle use, avoiding medical care for fear of legal consequences, going to jail and having a criminal record, and becoming involved in black market violence are all vastly more common threats to drug users than any drug.
I'm inclined to agree; substance prohibition in any form (except perhaps for nuclear fuel and the like) has a long history of causing an incredibly wide range of societal problems.
But removing prohibition is a far cry from providing free heroin to addicts... I understand the argument about removing the black market, but after seeing San Francisco in person it's hard to agree that free drugs and paraphernalia makes things better overall.
If my friend became a heroin addict, out of care for him or her I would not provide them with heroin even if I could afford it. Why should I treat other fellow humans worse?
Why is it different when we're speaking at a societal level? Love for neighbors should increase, not invert, when the number of individuals concerned increases.
They don't give out free heroin in SF. There are needle exchange programs, and a small number of safe usage sites. Also, you're assuming most of the addicts are heroin addicts. Quite a few of them are meth addicts, who are harder to reach, partially because the type of meth they're getting causes severe psychosis.
Giving meth addicts forms of meth that are produced more cleanly would reduce the level of psychosis and would further reduce the price of meth to a point where it may not be profitable to produce (it's already cheap to the point where it's nearly unprofitable - it requires massive volume).
Giving addicts access to clean drugs provides you an opportunity to help them, a place to keep them away from others while they're using, a way to ensure they don't die while using, reduces funding to organized crime, and removes their need to commit crimes to fund their habits.
You may see it as treating them poorly, but ultimately, you're doing them and the rest of society a benefit.
Is it impurities in meth that give you psychosis? I was of the impression that often it was due to sleep deprivation due to being on meth and not sleeping for days.
All forms of meth give you psychosis, slowly, with continued use. The sleep deprivation adds to that. Meth created via the P2P method is apparently considerably worse for you, and leads to psychosis at a much higher rate than ephedrine methods: https://www.theatlantic.com/magazine/archive/2021/11/the-new...
The long term mental damage from stuff like meth induced psychosis is not something that the state should be furthering, especially when the state isn't even picking up the ball for mental health treatment facilities. If we were serious about addiction, we would heavily crack down on users and send them to detox facilities where they will remain until they are clean and well rather than maintaining the status quo of tolerating increasing levels of open hard drug use on our streets.
Nothing will stop trafficking since its a lucrative product and we live in a capitalist society, but crackdowns at least push drug use out of the open and cause people who get picked up to end up in jail or some facility rather than turned back out to the street where they often continue to commit more crimes. It keeps these chronic hard drug users out of public places like train stations where they are less likely to harm innocent bystanders. I've seen meth users on the train go off in racist tirades and start fights on transit just because someone happened to make eye contact with them. The status quo of not doing anything and shrugging our collective shoulders just leads to more people getting harmed, both the addicts and random other people.
I disagree. Alcohol, being legal, has very few of these problems, and it still causes immense damage to its users - more so than illegal drugs, by many measures.
Which is not to say there aren't humane reasons to fix these problems, especially if they aren't effective at reducing drug use anyway. But yeah, drugs actually are a huge problem and would be even if they were legal and free for all.
Alcohol is legal bc fermentation is easy so restrictions fail, not bc its harmless. Weed is by comparison harmless but easy and lucrative to enforce laws against. The reason for legalization isnt bc drugs are good, its abt the emerging economic dynamic with drug dealers and drug enforcement.
drugs have become a profit center for the state and it has created perverse incentives that do not benefit the end user or society.
OP is saying most of the harms come from illegality.
I'm pointing out that alcohol causes immense harms despite being legal, so likely other drugs too would still cause considerable harms when legal (even though yes, it's likely some, like cannabis, would be less harmful than alcohol almost no matter what total consumption settles on under legalization).
I was not arguing about why things are legal or not, only challenging the assertion that drugs aren't very harmful when legal.
What are the loving consequences of not giving them the drugs that you are hoping to achieve? Like, how is that making their life better? Or do you assume that (evidence to the contrary) without you supplying it they'll be unable to find it?
Free methadone isn't all that much better from that perspective. You come to your doctor and tell him, "I'm useless, my life's hardly worth living, I'll never amount to anything so I might as well take opiates to dull the pain" - is it then the doctors job to basically say, "yes, clinically your life is not worth living", even if it is a milder opiate?
It's writing people off as lost cases. And many addicts WANT to be written off as lost cases, because a) they already did so themselves, but feel guilty about it, an official confirmation would be nice and b) it will give them access to painkillers.
Which is why I'm very skeptical of involving doctors in the first place in free methadone programs, if such programs should exist. It shouldn't be anyone's job to validate you if you say you're a lost cause.
Plenty of people get on methadone maintenance and life productive lives. This keeps them from scoring dope in the streets and fueling the drug trade. Judges have demanded people stop taking methadone and some of these people have ended up dead from an OD soon after or in jail when they were fine on methadone. Demonizing methadone programs doesn't help anything.
I'm not demonizing it, sure it can help many, but it is not a panacea. In Norway, we have a problem that people in the methadone program ask for more than they need (due to tolerance, you pretty much have to just ask them) and sell the excess to people who don't qualify for the program. In some years there have been more methadone overdoses than heroin overdoses. Even in the legal program there are overdoses.
Its not loving to control another person with draconian measures that further harm them with criminal sanctions that cause economic stress and stigmatize the person socially. Love would be creating a social environment that is capable of providing safer options, therapy, and letting people make their own choice about their health instead of treating them like criminals.
That's a pretty rudimentary analysis, and the "law of love" doesn't really hold much weight when you start looking at the prognosis for various treatment groups for people with opiate dependency.
It's really the abstinence only attitude I was talking about: why is it a big deal to give someone medication for the rest of their live if we know it will keep them alive, healthy, and allow them to live a fulfilled life? Addiction is just like any other disease, and it turns out medication assisted therapy is very effective.
Methadone works, and so do other medications, but it's only a partial solution. We need a rapid and massive expansion of these programs. We also need programs and medications to target people who go on Methadone, but keep going off. Why not give them Herion, if we can do it safely? What about if there is evidence they can become productive members of society?
Again, it's my view that although people OD from drugs, it's really the prohibition of drugs that are killing people through the incredibly unsafe and unreliable drugs people get. Supervised opiates are not dangerous, and unlike other drugs, cocaine, meth, benzos, you can safely be on them for years at a time nearly no long term effects. At least the long term effects of staying on them pale in comparison to the consequences of an OD.
60,000 people OD per year. What we are doing isn't working!
“ The effect on new users would be profound as well: as all the current users naturally age out of wanting to use hard drugs, the majority of drug dealers (other users themselves), won't have the capability to introduce new people to hard drugs”
Giving free, safe drugs will depress demand for illegal drugs: most dealers are users, and are pushed to a high risk criminal activity - drug dealing - in order to finance their expensive habit. They take extraordinary risk for this, including actively seeking out new clients.
If you give out free product, you not only kill the primary demand, but most dealers themselves don't have a reason to continue taking risks - because they can benefit from the free product too.
Purely profit oriented dealers will remain in the market, which is now much smaller and even riskier, since they can only sell to recreational users.
The smaller the transaction amount, the larger chance that the dealer is going to have an addiction of their own. It’s easier for one wholesaler to sell to an addict (or several) that distributes small amounts to a bunch of other addicts, vs taking on all the volume yourself. Addicts usually know other addicts and have a strong incentive to sell, they need cash every single day.
I doubt you’ll find a source, but the number of users distributing small amounts is probably larger than the amount of people pushing weight (who usually don’t use)
This is based of my experience buying heroin in a mid-sized US metro area, fortunately far in my past. One without an open-air drug market, so deals were done in cars or alleys.
I also have a hypothesis that if it's freely available and boring then more people are likely to quit. The focus required to get it I think is part of what keeps people addicted - the reward is uncertain.
If addicts can go to a boring clinic and get it daily for free maybe they'll at some point look up and wonder why they're doing what they're doing.
Especially if the clinic has easily available assistance and things that can help people quit.
Even in the worst case where they remain addicts, at least they won't OD and they're not funding organized crime.
Probably not as easy with meth though - it's one thing to be addicted and still responsive to incentives, psychosis is a harder problem to handle.
I'm not sure that market is so much smaller. The "recreational" market includes anyone who couldn't afford to publicly admit their use, including for instance single parents who use amphetamines to try to have energy to do necessary things after a full day's work at the meatpacking plant.
It's just how it works. There are diminishing returns to the common drugs of abuse. If given access to high quality drugs of abuse without negative economic and social consequences the body will adapt, use will plateau, and for the majority eventually phase out. A minority will choice to maintain. There are negative health consequences to long term maintenance but it's not like the reality of obtaining poor quaility street drugs in dangerous situtations. It's data driven and based on medical theory so it's not much of a belief. See Swiss and UK medical heroin programs for evidence.
That doesn't agree with anything I've learned about battling addiction. Do you have any research or studies that support that? Or other programs with a good track record?
Because, unless you are using the term "friction" to be so all-encompassing as to be meaningless, this sounds like a recipe for a lot of failed attempts to fight addiction.
Every addiction treatment effort is to introduce friction, like dumping out your booze in your home into the toilet, getting a new job that doesn't tolerate smoke breaks, or finding new friends that aren't going to peer pressure you into using. If the vice is easy to act upon, you will continue to act upon it indefinitely.
Pareto law effects on the consumption of drugs, and network effects that result from the fact that the majority of street level dealers are doing it for the sole purpose of supporting their habit? No life ruining class A felony is worth the money you get selling drugs, but people do it it all the time because they are sick with a disease and feel they must.
New people will still be introduced to drugs, but there are definitely network effects in opiate addiction that can be mitigated when supply is transferred from an illegal source that requires people to organize and recruit new users with cash, to one that is organized and paid for by the government.
It's not perfect, but even decriminalization has had a pretty remarkable effect on Portugal, at least that's what the latest studies are saying.
It'd be interesting if there were any country wide experiments that are similar to the approach that has been taken with tobacco. Basically legalize it for those over 18, slap it silly with warning labels and then tax the heck out it to make it prohibitively expensive. And raise the tax every year. And then fund ad campaigns and social media campaigns which make it generally look dumb and unfashionable as well as treatments.
But perhaps the addictive qualities and treatment is much greater than tobacco.
I don't know. As a smoker, I m guilty of smoking, Im not really a victim even if one could argue it will be hard to stop - it's a lot of personal responsibility, a bit of laziness and a minority the product itself.
With heroin, I d argue people are definite victims. It's absolutely not like tobacco, the craving is physically painful for long, not just the mild annoyance of tobacco.
To give you a few exemples: it takes me 3 days to a week of being irritated to stop cigarets for a full year, cold turkey. For injected heroin, it's 2 weeks of extreme pain with possibility of hospitalisation, for Subutex, an alternative pill, it's around a month (so many addict complain it s easier to take a break from heroin than the progressively reducing alternative medicine).
My dad is a pharmacist in France where we treat drug addicts who want to recover as victims and help them get alternative subutex or methadone for free: he told me he never saw someone truly stop. They can reduce and live with it, but they cannot possibly stop.
Your increasing tax solution seems unfair, while it seems fair for me with cigarets: it's my fault and I can stop. Not an heroin addict. I dont have a magical solution, in France we focused on stopping the violence due to the craving with free Methadone in pharmacies and it changed the criminal landscape, but destroying the product supply at the source while keeping the last addicts on Methadone seems like the only path, if the goal is to free people from opioids in France.
In the US it's different: opioids became a for profit pharmaceutical entreprise, and most of the crisis there is due to opium sold hidden as painkillers totally legally on a large scale.
> My dad is a pharmacist in France where we treat drug addicts who want to recover as victims and help them get alternative subutex or methadone for free: he told me he never saw someone truly stop. They can reduce and live with it, but they cannot possibly stop. In the US it's different: opioids became a for profit pharmaceutical entreprise, and most of the crisis there is due to opium sold hidden as painkillers totally legally on a large scale.
A refinement might be to tax legal painkillers that pharmaceutical companies, drug distributors and hospitals are prescribing to the populace from which they make profit from. The tax proceeds could then be used to pay for the inevitable rehabilitation of the certain percentage of the populace that is going inevitably get addicted to it.
The refinement is that the general taxpaying populace doesn't have to pay for this out of the general funds, its explicitly the people profiting from the negative externality.
People on meth can have psychotic episodes and hallucinations. It's a common sight today to find shoeless people high on meth yelling incoherent things in traffic. That's the answer to your experiment. In my city in CA, meth is dirt cheap and enforcement on the side of the police is zero. I've seen a shirtless man smoke crystal meth right outside of the train station with metro security not reacting at all. BMWs appear by night to sell meth and pimp out people from homeless encampments, aid workers appear by day to feed people boxed lunches. That sort of environment doesn't lead to people picking themselves up by the bootstraps and stepping into a job and a $2000 1br apartment (going rate in LA). This situation of nothing checking drug use leads to them falling further and further into psychosis until they die in poor health in a bad situation with a necrotic limb or two, as I've seen play out before my own eyes in this city.
I'm not so sure about this. The most recent, and best, evidence we have on getting folks addicted to substances better is to put them on a coordinated treatment overseen by doctors and implemented by a variety of different healthcare professionals.
Interestingly, I think if hard drugs were legal, very few people who don't already use them would go out tomorrow and give them a try, "just because", so its' not like we would have a complete societal meltdown if it happened.
I just think the US should look to other countries, and start off by implementing what works there. Even that is radical!
"Anyone that is addicted to drugs can get the drugs they want, they just have to already be addicted first"
All that does is create a perfect window for new users to use tainted black market drugs and die. It's also essentially a government endorsement of the black market and the violence that comes with it. I think we need to move past those cowardly policies and craft laws that respect the reality that drug use will always be part of society. Playing make-believe that we can stop drug production or sales is too expensive (in cash and life) and has been proven comprehensively ineffective over several generations.
It seriously harms the black market for these drugs. Opioids are an escalating addiction so new users are simply less profitable. Eventually illegal opioids can consume an almost unlimited budget, but shift heavy users to government supply and suddenly it’s a much less profitable business.
The Swiss are roughly 1/10th as likely to use opioids as Americans and of their users ~85% are in rehab. Relatively speaking it’s a tiny illegal drug market.
>A massive slice of talent and raw human resource is just dying every year, but the solutions that have worked in other countries are just impossible to implement here due because the the methods that are known to work are politically dead on arrival.
From the essay, it sounds like Jack was not possessed of any great "talent", or of any particular value as a "raw human resource". He was just a dude, probably easily replaceable from a HR perspective, and these are the sorts who, historically, we are willing to sacrifice in order to honorably lose a war on drugs. (If you want to know what kinds of sacrifices are required to win a war on opiates, Mao is the "best" recent example.)
We live in a cruel economy, where the "losers" are left to find solace in electronic toys and mystery fentanyls sold as heroin. Mostly, the losers are determined ahead of time, and their numbers grow as the middle class shrinks. It's an inhumane system with inhumane outcomes built in.
*I know I'm reading too much into your word choice, it's not meant as a personal attack, it's just useful as a jumping-off point for this post. If I were a better writer I would have figured out how to avoid this impression, but I'm not, so please take my word for it. I think you are basically right about the humane way to handle this.
> From the essay, it sounds like Jack was not possessed of any great "talent", or of any particular value as a "raw human resource". He was just a dude, probably easily replaceable from a HR perspective,
I've seen a lot of smart people fall to drugs. Sure, if they get in too deep too early, they won't have a degree when they die, but they could have had one.
And yes, as an HR person in a comparatively small company, this person is easily replaceable. On a country scale, however, you can't simply replace him - you need the numbers of highly educated smart people and you can't simply "hire" them back from another country. Look at the stereotype of the asian genius - disregarding the other factors, China simply has 3-5 times [0] the population, so they will statistically have 5 times the geniuses to start with. You can't compete when your best bets have a 5% chance to whither away due to drugs.
> If you want to know what kinds of sacrifices are required to win a war on opiates, Mao is the "best" recent example.
How so? I don't know what specifically you're pointing to, but given that other countries handle the situation better with less "sacrifices", I don't think they're necessary.
He waged war like a war. I don't personally recommend waging wars on chemical compounds or the desperate predestined "losers" of the economy, but there's something to be said for winning a war with cruelty vs losing the war with half the cruelty.
"It was the communist revolution that erased opium from mainland China. Mao Zedong , with his political apparatus that reached into every hamlet and home, was able to lay the beast low. He used a mixture of carrot and stick. Addicts were not condemned, but offered medical help and rehabilitation. But those who were unco-operative were sent to labour camps or imprisoned. Dealers were summarily executed, often without trial." [0]
"Smart" people getting hooked on drugs is exactly as tragic as "losers" like Jack, any competition which ignores this is one we should be enormously proud to lose.
Do you have any good sources for info about Mao's approach? Very interested to learn more about this. The wikipedia article seems to corroborate what you have said but provides no sources either :(
Mao's government compelled addicts into rehab and summarily executed drug dealers [0][1]. Drug trafficking is still a capital crime in the PRC. In 2017, 13 traffickers were sentenced to death at a public trial in front of 10,000 spectators [2].
>From the essay, it sounds like Jack was not possessed of any great "talent" ... probably easily replaceable from a HR perspective
I think part of our problem is we put first value on people by their economic output. We need to realize there's more to being a person other than how much money you can make some rich dude.
I am "not a genius, but not dumb either" much like Jack. But for one reason or the other I seem to have an aptitude for this whole programming thing, and technical stuff in general. Is that "talent"? I guess it's not "talent" in the wunderkind sort-of way, but it is "talent" in the sense of "a decent aptitude allowing me to perform better at these kind of tasks than average in the general population".
I was never addicted to drugs, but for the first ~25 years I struggled in life in much the same way. No education, no real job, no real direction, future, or perspective, no real friends, no girlfriend, what's the point? I suppose my situation wasn't quite as hopeless, or maybe I'm just a different person, and it probably also helps that drugs usually just make me feel weird in a bad way and never enjoyed it much.
Plus, I never stopped programming, or lost my interest in it. It just took a long time to scrape together the confidence to actually apply for jobs. For a time I was either jobless and programming stuff at home, or working minimal wage jobs and programming after work. At one place I managed to "hack" the computer used to scan barcodes and during night-shifts (with often hours of nothing to do) I would write some toy programs to pass the time (more fun than smoking weed outside like some of the other people were doing). I sometimes wonder what would have become of me if I hadn't learned programming as a young teenager, or had lost interest somewhere along the way.
Either way, we'll likely never know what "talent" Jack did or did not posses as he never really seems to have developed any due to a combination of his personality, environment, and just "bad luck". Even the most talented and gifted programmers I know don't "just" do it automatically; they still need to apply themselves and develop their talent. For all you know you might have it in you to be a word-class guitar player, actor, soccer star, or some such. But if you've never played guitar, acted, played football, etc. and developed this talent then you'll never know.
Sure, maybe one Jack isn't a big deal, but what about 1000 Jacks? How much economic output would 58,000 thousand early deaths be in a year where we have a labour shortage and a supply chain crisis on our hands?
Jack might not be the best example of "raw human talent", but people like him contribute to the economy that are hard to measure, and of equal worth to anyone else.
I'm of the opinion that we shouldn't compare lives, but I guess we could compare economic value, and for the thousands in lost lives, even working the most menial jobs, that's still tremendous worth in a country where our birth rate is shrinking faster than ever.
The invisible elephant in the US opioid policy discussion is the lacuna between the policy and its implementation.
You have to find a human being to perform the work of enforcing the drug laws. The US has had drug addicts for a hundred years, and the attitude towards opioids hasn't changed very much, but the usage levels go up and down. There's a back-and-forth between "rehabilitation" and " incentivizing" that correlates poorly with the outcome.
What correlates better with opioid use? Recently, the epidemic clearly started with overprescription and then exploded with fentanyl:
It's important to notice that prescription opioid overdoses don't go down until 2017. This problem started with prescriptions and it won't end until the problem is fixed. Pills should be replaced with patches wherever possible.
The other glaring issue is that the meteoric rise of fentanyl was not noticed until it got out of hand. This is a societal problem: drug messageboard users knew about the fentanyl crisis years before the regulators took any action.
The regulatory system, viz. the DEA, has been starved for talent for decades because nobody wants to work for them. The enforcement-for-profit model of the civil asset forfeiture era of policing has driven talented and motivated people away from law enforcement careers. The people who are left are not qualified or motivated for the task at hand. Enforcement should be more proactive than it was. It should focus on real dangers, not culture wars. Opioids and dopaminergic stimulants are the drugs of self-destruction; everything else is a distraction.
The most ironic thing to hear people chanting in an epidemic of poisonings brought on by illegally and irresponsibly manufactured high-potency addictive drugs is "abolish the police!". These people need the police. But nobody trusts the police.
One quote we were all forced to memorize in school was: "A house divided against itself cannot stand."
I don't disagree with your most of your assessment, except that I do think we should abolish the the DEA. The war on drugs has been going on for 50 years. At some point, we have to admit that drugs won, and address the crisis in the most effective way based on the best, most recent information available to us, which is that addiction is a disease and one that can be effectively managed.
20 years ago, sure, who cares about the DEA, they put dope and guns on the table and largely stayed out of peoples way. Now, we have around 60k thousand deaths per year from the opiate crisis that reaches almost everyone in America. Law Enforcement has no solution, just carry around Narcan while drugs come in through every major port and postal facility in the country.
Let the cops do what they are good at: reduce violence, enforce property rights and keep communities safe, but stay out of healthcare. Give the DEA the best grads, and that won't change the fact that they are working in a system where they simply don't have the power to stop two consenting individuals engage in a prohibited behavior.
It's a really complicated problem but one thing that just stands out to me is the role the doctors play: It's not normal to send people home with these massive prescriptions for opiates.
Here in Europe doctors are very, very conservative with that stuff (and meds in general) while it seems to me that in the US if your "medical experience" even entails the slightest bit of discomfort people get all up in arms over it. Doctors are highly educated people who can no longer play the "I didn't know it was addictive" card.
I have a friend in the US who told me they have an app on their phone where they can just tap a button and the next day they can refill their benzo prescription, and it's been like that for years without having seen a doctor again. That's just criminal behavior from the part of the medical establishment.
What's complicated is that it's not really the drugs, it's the fact that people experience their lives in such a miserable way that oblivion through opiates is a better option.
IMHO this is because of alienation, a loss of community, strong personal bonds, lack of goals.
There's a famous experiment that sums it all up perfectly - the one where animals were given an unlimited supply of cocaine and they took it until they basically starved themselves to death. But when they put the animals in a nice stimulating environment with toys and friends to play with they basically ignored the drug supply.
So yes, providing govt run shooting galleries will stop people from dying and you'll make them slightly less miserable but those people will still live lives that you wouldn't want for your children. They have an illness that needs to be cured.
There's a famous experiment that sums it all up perfectly
I think you're referring to the Rat Park experiment (https://en.wikipedia.org/wiki/Rat_Park), and (as always) its conclusions are not as solid as the myth implies. That's not to say its results have been disproven, but they haven't been confirmed with other studies either.
Still relevant though because if you have a medical problem (addiction) and rather than be provided with care you’re treated like a criminal, you’d feel even more isolated and less part of something good.
The amount of pain meds my wife came home with after her c-section was like 100x what she ever used. I’m sure there are some folks who need that much but I doubt it’s the median.
My recent experience in the U.S. has been that, at least at major hospitals, it's flipped to the opposite extreme, and doctors are so worried about the backlash, that they will leave patients in pain and fail to prescribe analgesics sufficient for post-surgical pain control, if they don't have non-opioid options.
My partner had a post-cancer DIEP flap reconstruction last month at a top cancer center in NYC, and due to the nature of the surgery, couldn't take NSAIDs, which are typically most effective for her (they have blood thinning side effects and were banned for 2 weeks post-surgery to avoid risk of hematomas). So she was left with taking over the counter Tylenol plus prescription opioids. They prescribed opioids 2 days of pills at a time, which required me to constantly drive to pick up new prescriptions (since obviously she couldn't drive), and it felt like some kind of interrogation each time she'd call up and report her current pain levels. As if they assumed by default she was lying or was a drug addict or something, versus someone recovering from major surgery that doesn't heal in 2 days, and furthermore is not allowed to take anything else that's effective (NSAIDs). Hours spent writhing in pain trying to get some pills prescribed and picked up. It only got resolved once the two-week NSAID ban was up. Then she stopped calling about the opioid-based analgesic and just started taking large ibuprofen doses instead. Problem solved, since you can buy as much ibuprofen as you want. But a pretty shit two weeks up until that point.
As a result, I strongly dislike a number of aspects of the anti-opioid backlash. It made our lives worse and caused us more suffering.
I had open heart surgery in the US and the doctors refused to give me opiates to take home in the few days after. They gave me opiates while I was in the hospital, quite generously, which was for four or five days, but they would not let me take any home. I even asked for just five pills in case the pain was unbearable (they literally had just broke my ribs and sternum and sawed my chest open).
I don’t respond much to opiates anyways, but I still find it completely ridiculous.
What you experienced is obviously the pendulum swinging too far (in the right direction). Then again, it should just be accepted that major surgery will always involve some discomfort.
There's a big distance between "5 days worth of low dose Tramadol" (+ max dose of Paracetamol) and "2 months worth of Oxycodone". It's really not a hard problem to solve for the medical establishment.
Yup, there are a lot of people with chronic pain, and the only things that reliably treat pain without being really bad for your system are opiates and weed. Paracetemol (and to a lesser degree ibuprofen) are so bad for you they mix it into opiates so that if you take enough to get high the paracetemol sends you to hospital, and weed is stigmatised at best, and still illegal in most of the world. Ketamine in useful doses has too strong side effects, cocaine-derivatives are only really good locally, and also not great for your system. And that's about all we've got.
As a kid I had migraines, and quickly developed an immunity to the pain-relieving aspect of paracetemol, they were basically candy by the time I was a teenager. Luckily they disappeared in my late teens, but now I'm in my 40s and I get weird pains they call "cluster headaches" in my face. I did some tests, got an MRI, and they didn't turn up anything, which is pretty much the end of medicine, pain management is all there is for me. In Australia we need a prescription for any opiates, so I have to be treated like a drug addict to get painkillers the rest of the world can buy over the counter, it's a disgrace.
> I get weird pains they call "cluster headaches" in my face
if you have not already done this, you could consult an "migraine center". There is no cure but there are some effective (for some people at least) options for treating cluster headaches, like triptans and lifestyle changes (regularity in sleep patterns, etc.)
They're very different from migraines (which I had as a kid), in that there's no visual effects or nausea, and seem to be more localised and less "systemic". I'm always trying to work on my sleep, with very little success overall. I've never tried any of the serious sleeping pills, they seem too risky; but a combination of restavit (an antihystamine) and melatonin can get me to sleep pretty reliably, the problem becomes that it sometimes leaves me a bit too slow and stupid in the mornings.
That is very different to when I was at BIDMC for my plastic surgery rotation as a medical student - I was shocked at the quantity of opiates people were going home with for simple things, let along DIEPs. I gave a talk to my team when I left on differences and focused on opiate prescribing (this was in 2013)
As far as I know, there surprisingly aren't other options. I also assumed they would have something else up their sleeve that was stronger than OTC ibuprofen but weaker than a morphine analogue. But, the three classes of analgesics really seem to be Tylenol, NSAIDs, and opioids. A few other things are usable for anesthesia but not something you can prescribe as a pill for at-home pain control. There is also some evidence for cannabinoids, but they're stuck in legal limbo. The other thing that comes to mind is that benzodiazepines can also help in some patients. They don't have a direct analgesic effect, but can help people relax or sleep so as to ignore pain (they can also be habit-forming, but probably not to the same extent as opioids).
There are other painkillers coming and going. In my country, the middle ground was, for years, metamizole. This drug is currently baned in some countries (e.g. USA) for its side effects, while is sold nearly OTC in others (e.g. Mexico). Other drugs like flupirtine or nefopam are about the same: middle ground painkillers, but too bad side effects.
The good thing about opioids is that you can dosage them precisely, and that you have plenty of opiates in a ladder of potency. Tramadol (sold as Ultram in the US) is a middle-ground painkiller despite being an opiate. Same as codeine. Slightly above is tapentadol. Curious thing is despite tapentadol has not been found addictive (at least as addictive as other opiates), it's still an opiate, and so the FDA put it in the same bucket as fentanyl and morphine.
Another analgesic is cannabis. Sadly, it has the same problem as opiates: it was deemed too fun or too good, it seems we must endure pain to make the regulators happy. It turns out people hate pain, so they end up taking fentanyl and heroing under a bridge.
The sad thing about all this is that the regulators decided pain is not a bad thing, so you must endure it. But they decided anxiety is a terrible thing, so you can get as much bromazepam as you need. Even when bromazepan and other benzodiazepines create dependence and tolerance (and the withdrawal is terrible), I'm sure you now at least a dozen people taking it cronically (I do). They are as hooked to that thing as it was heroin but, hey, it's legally prescribed, so no problem here: one pill for breakfast, one before bed, and they are 24/7 high while nobody bats an eye.
You can give Codeine or Tramadol, which are opiates that produce no "high" when taken in standard therapeutic doses. People do abuse them by taking a whole box at once, but you won't end up in a scenario like in OP's story where someone discovers it "solves all their problems" after receiving them for moderate pain from a routine medical procedure, and has them shooting heroin 6 months later.
Pregabalin/Lyrica, I think. It's a seizure medication but as it was explained to me it increases the amount of signal your nerves can take, or it slows the signal, and that reduces pain. It helped me in the past but it makes you tired.
Once, about 10 years ago, I had some mild pain in my shoulder after skiing. It was hardly debilitating, just annoying. I went to the doctor, and within about 15 minutes I walked out with a prescription for 60 Vicodin. I don’t know if things have changed in the states much in that time, as I haven’t had a need to find out. But it still strikes me as odd that they would give me that kind of a pain killer so easily.
I can tell from experience that having to go to doctor, then wait there then having to go to pharmacy then wait there, all in pain massively massively sux.
Having to do it on the regular would be just cruel.
(To start: Just to clarify there's a significant difference between benzodiazepines and opiates.)
> I have a friend in the US who told me they have an app on their phone where they can just tap a button and the next day they can refill their benzo prescription, and it's been like that for years without having seen a doctor again.
Is this the "request a refill" feature that every US pharmacy offers? Granted, benzodiazepines are less restricted than stimulant drugs¹, but a doctor in the US need to at least review a prescription twice a year.
Chronic (daily) of benzodiazepines is bad, and doctors will not² start new patients on this.
There's still a lot of legacy patients who are on chronic benzodiazepine treatments -- doctors should work with them to wean them off, but it's very challenging and disruptive.
Requiring a patient receiving a benzodiazepine at a non-daily level (e.g. for seizures, anxiety, occasional insomnia) to go back to see their doctor when nothing's changed several times a year is just pushing medical costs (money/time) on the disabled.
¹: e.g. Adderall, which can't be refilled
²: Providers are trained not to these days, at least
What's so fascinating to me, is that the current opiate epidemic is largely centered in the US, as we bear the majority of the deaths. That attitude of Drs. over-prescribing, it definitely happened in the US, to various degrees in different places, and not that long ago.
Docs in the US tend to think they are above being marketed to, but Purdue Pharma knew better, and they paid their drugs reps a ton to go out to "everytown US" and convince doctors that they had made a non-addicting opiate. Enough docs bought it, and here we are.
How did they do? Well, 20 years ago drug reps used to be able to take doctors on trips: to sports games, to see the dog races, to museum trips, the price of a day trip with you and one or two loved ones was to sit through an hour (or two) lecture by a rep that convinced you to to prescribe a drug. Not a bad deal!
There were complex reasons why the opiate crisis started, but the environment was ripe for an upstart company like Purdue to come in, reformulate an old opiate, pretend the addiction problem isn't there, then sell a miracle drug because opiates are extremely effective short term analgesics. Long term, we're still paying for it!
I've looked a lot into the opiate crisis, and it's a pretty bad stain on the US medical institution, particularly our medical science. We fucked up.
I mean we spent $300 million a day for 20 years on Afghanistan, it can't be that expensive.
>the Sacklers just walked with no criminal liability
In fact, the media firestorm and the political response made heroin overdoses much worse because they "clamped down" on pills that at least had a dosage on it. Addicts then turned to heroin, which now has fentanyl in it.
>Still many more annual overdoses of prescription pills than illegal drugs.
Not since around 2016, which is around when the panic with pills started and we started cracking down. It did put a small dent in pills but fentanyl is off the charts. We probably would have been better off, at least in terms of deaths, if we had just ignored the "opioid epidemic."
That's right! in 2011 they switched the formulation of OxyContin. The opiate crisis didn't start then, but it got a whole lot worse!
The Sackler decision had a pretty big effect on me. It's hard not to grow up when I did, lose people you know to the opiate crisis, and not feel a deep sense of unfairness and wrong when the people responsible for so much suffering stay out of jail with a million dollars.
As much as you can blame them for that one act, it's the iron law of drug prohibition at play: Meth becomes Crystal, and opiates become more concentrated. Easier to smuggle, better profit margins, it really only goes one direction: the drugs get more potent every year prohibition is in effect.
> The US is really grappling with diseases of despair, and heroin/fentanyl addition is on of the biggest ones impacting the wellbeing of our society.
This is a false narrative. Tobacco use kills 7-8x more every day, week, and month in the USA. That's a legitimate industry, though, so that's not pushed on the news.
Opiates aren't that big an issue, they're just the one the media tells you to care about.
Absolutely ludicrous comparison. The people dying of opiate overdoses are much younger than cigarette deaths, and the smokers don't have their lives debilitated by their addiction.
Really? COPD is an incurable and debilitating illness, almost always caused by smoking. Also, smoking causes death, which I would put in the "debilitating" category.
Well, there's limb loss due to ischemic peripheral vascular disease, lung carcinoma, various other upper airway malignancies, ischemic heart disease, obstructive pulmonary disease...
As a Swiss person who spent a few years in the 90s going to primary school on Langstrasse, watching junkies shoot up, and having to be careful in city parks to not step on the mountains of used needles… that is about the WORST idea I have ever heard.
The Swiss experiment in the 80s and 90s was a complete disaster, and it wasn't until the 2010s that that part of Zurich was finally cleaned up. It attracted the worst junkies from all around Europe, it created a crime wave in a country that was crime-free. It didn't work, either, it just led to more addiction, death, and despair.
FWIW, used needles were a common sight in my childhood and youth in the '80s/'90s in Italy too, and we didn't have such policy.
I've literally not seen a used needle in at least a decade, but again, I'm not sure it's because of policy, it seems more likely that people have just, for the most cases, switched to different drugs.
I grew up in a rural town in NSW and we kids had hardly ever heard of hard drugs let alone ever having been offered any. At best, all we knew of them was that it was an overseas problem and that there were strange opium dens up in Asia somewhere.
We were never warned about drugs in primary and secondary school as there weren't any - with the exception of cigarettes, which some kids tried down behind the school toilet block but that was more a defiance of authority than a real problem. Drugs were never the topic of conversation amongst us at school.
The first time I came across discarded needles and syringes was quite some years later when I was walking around the Colosseum in Rome. It was a bit of a shock to see them in such a renowned place.
I am forever grateful that we kids grew up in such innocence of drugs (that wasn't true of other dangers however).
Tragically, that's ever so true, rural country towns both in the US and Australia are now in the vanguard of the drug epidemic. It's not only ice/meth but also opioids thanks in part to the Sacklers.
Fortunately, my family seems to have escaped the illicit drug problem and I no longer live in a rural area, nevertheless sometimes I wish I had Dr Who's tardis to escape back to a much simpler time - at least for a short respite anyway. :-)
I grew up near the heroin junkie city of The Netherlands (Heerlen) which also attracted a lot of junkies from the Aachen area. I got a fear of needles likely influenced by the needles on the streets. Thanks also to everyone mentioning which cities contain needles on the ground, I forgot about it being a possible thing (I would not visit such a city, and I live/work near Amsterdam, go figure). Getting my COVID-19 shots was a serious hurdle because of my fear of needles. It also likely influenced my disgust of prostitution (a lot of the female heroin junkies turned to prostitution). Most of these people were homeless, too.
They (local gov) tried a lot of things to fix the problem. Play classical music at the gathering area (the train/bus station). Free methadone. Free needles. Free heroin I don't believe was tried. Give the homeless a task like selling a newspaper called 'street journal', watching everyone pass by looking down on the seller. Cynical me would say these people passed away. I met one of them at a work reintegration company, and I recognized him right away. He had HIV. Though this was in ~2006. I let him listen to one of my favourite music at that time, and I remember he enjoyed it.
I learned of the popular drugs in first of high school (age 12), as part of education (alcohol, cannabis, XTC, heroin/cocaine). In my late young adulthood I ended up trying quite some drugs. Mostly psychedelics, never heroin (or cocaine), and amphetamine only once (from which I know how it feels to be an asshole). They are far too addicting, and destroy lives. I've been addicted to nicotine/cigarettes though, but so has 25+% (?) of society. It was tough getting rid of that habit (I am probably still 'addicted to it' just not practicing).
Lots of good movies (and books) were made about heroin addiction. Wir Kinder Von Bahnhof Zoo. Requiem For A Dream. Trainspotting. Just to name a few. The social setting a (young) person is in is going to have a huge influence. Sure, its also a matter of morals and values and parenthood, but how can I affect which friends my children are going to have in school?
When faced with the prospect of losing a child to heroin based on his friend crowd, you can take action. My family moved to a different states to do a friend-group reset for one of my uncles. Kids are worth fighting for. Do whatever you have to.
This puzzles me. The Medication Assisted Treatment (metadone and buprenorphine) started in 1991. The Heroin Assisted Treatment (HAT) started in 1994. People that failed the MAT were enroled into the HAT.
Limited first HAT experiments were found sucessful, and thus expanded in 1999. In 2008 both approaches entered the law.
The opioid/heroin epidemic that hit the whole Europe, took place in the 80's, with AIDS making it worse at later 80's and early 90's, causing all countries in Europe to tackle the problem hard starting in the early 90's. Yet you claim that HAT not only was shutdown in early 90's but that it was the thing that created the mess.
Dates don't add up, sorry. Maybe you are talking about a different swiss experiment, and not the internationally famous HAT.
The first phase of the experiment was to have a free zone in the Platzspitz park, with a needle exchanges, and no interference to drug sales and use. The park became known as "needle park."
They shut it down in '92, which led to junkies spreading throughout the city, particularly on and around Langstrasse.
It wasn't until a real crackdown that things got better. They tried a few approaches like the treatments you mentioned, but that's very different than the laissez-faire decriminalization experiment that blew up in everyone's face.
There's a good documentary or article about the whole thing I meant to recommend but I can't find it at the moment.
When a non-Swiss person talks about "the Swiss heroing/drug experiment", they are referring specifically to the HAT program, and not to a free-for-drug park.
It's obvious that if you put all the junkies of a county in a single park, without even the minimal hygienic measures, you create a mess. That's not laissez-faire, that's a mess, but to their credit at least they tried something different than the cycle "heroin user -> scum to jail or to cemetery". It would happen with anything imaginable: "now all homeless are allowed in the Platzspitz Park and nowhere else", a month later the park is covered with homeless trash to nobody's surprise.
The HAT is a step further (not backward) in decriminalization: you are hooked to heroin, metadone doesn't work. But you are not a criminal, and thus we will take a medical approach.
Yes, the Platzspitz/Letten scenes were awful, but these are not what the post that you were initially were responding to was describing.
> It wasn’t until a real crackdown that things got better.
Yes, there was a crackdown, but it’s not like this hadn’t been done numerous times before, both in Switzerland and in other countries, so this hardly could have been the major cause of the permanent improvement (which I think we both agree did indeed occur around that time).
> They tried […] the treatments you mentioned
And THOSE were the new factor, and THAT is what made the difference. The Heroin assisted treatment is still in force (an article a few years ago mentioned that about 1400 addicts in Switzerland are in the program).
> It attracted the worst junkies from all around Europe, it created a crime wave in a country that was crime-free.
Well, that's the issue. No one area within a zone of free travel can exclusively do this. That is, if Ohio did it, druggies throughout the US would go there.
But, as I understood the idea, the free drugs were required to be consumed on premises under the watch of a professional. So why would any drugs even leave the facility.
They wouldn't need to. Supply follows demand. When you get enough users in one spot, you'll find dealers. I'm strongly anti-prohibition and I think safe supply and safe injection sites are crucial, but there's no silver bullet. Every simple solution will cause knock-on problems.
I've paid more money to drink alcohol in a location I prefer countless times, so I'm sure some paid for the privilege of doing their drugs somewhere more interesting than the clinic.
Same reason you'd go to a bar to have a few drinks rather than pick up a six pack on the way home. There's more to these things than the substances themselves, something silver bullet salesman often forget to point out.
AFAIK, Switzerland wasn't all that free travel until the Schengen agreement.
But yeah, implicit in these free drugs proposals is a good deal of concentration: bring in the addicts from all over the place, and make them take their drugs in this place here. It brings it's own can of worms. Which I guess is why many methadone programs come with no requirement of supervised use. Sure, they ask for too much (given tolerance, there's little way to know how much they need except skiing), and sell the surplus on the illegal market to users who aren't able or willing to join the methadone program... leading to more deaths from methadon overdoses than heroin in many years. But it's not clear the alternatives are any better.
That's fair: I've been to Zurich in 2019 a few times, and I was amazed by how clean it was. Remarkable. Even compared to a US, east coast city, it was much more cleaner than anything I've seen. However that doesn't mean the problems don't exist.
I do think I got the dates wrong. What I'd like the US to do is adopt a similar liberal approach to prescribing medication assisted therapy, and go as far as we need to go in finding the medication that work for people, like is done today in CH. I don't think the "free firezone" approach is a good idea (akin to "hampsterdam" in The Wire), but getting addicts healthcare and a medically supervised substitute is what I meant. The big part of that in the US, IMO, is fighting the social stigma around adopting science based approaches large scale addiction management, and right now the only acceptable solution is to get people off drugs, then have them OD when they get back on. There is a better way!
There is no drugs policy what can reduce drug usage. The only way you can make sure it's not getting out of hand is to have a rich, smart and healthy society.
Yes, I'm attributing the later successes to the early efforts. I did a quick google search when I posted the original comment and got the dates for the start of the program, which started as a mess, not much later when they finally introduced effective measures.
The aspects of the Swiss approach I wish the US would take the most are the willingness to try something fundamentally different. For the Swiss, it took a few tries to ultimately work out, but I don't see why the current solutions to the problem they use wouldn't work in the US.
"...and the Sacklers just walked with no criminal liability."
The fact that they did, has to be amongst the top crimes of the century.
That justice can fail so spectacularly is treason against the citizenry. Not only does it undermine people's belief in rightful justice but it also brings law, order and governance into disrespect.
If you want to sow the seeds of anarchy then this is how to do it.
My condolences to anyone who's lost a friend or relative to addiction - thanks to the human vultures who reap the rewards.
It's possible that by vigorously pursuing and prosecuting the people who can afford to purchase and disseminate hard narcotics - instead of the users and a pusher or two - most of the problem would dry up.
I'm not optimistic about that happening. The little guys are easier to catch, and caps are feathered. Meanwhile, the big guys have contacts and probably political connections.
I lost a sister to a drug OD close to 15 yrs ago. My belief is she suffered from depression, among other things, and self medicated.
That said, the opioid crisis in the USA has been largerly fueled by prescription drugs. If by little guys you mean doctors, and big guys you mean the manufacturers;well there's been some progress on that. But obviously and certainly not enough.
Let's also not overlook the convenient blind eye of regularors (read: government).
Or maybe you could move the other way: treat addiction as a disease and provide free, pharmaceutical grade product or methadone substitutes to all that request it, if they suffer from addiction. It costs essentially nothing.
This will not only kill the bulk of market and force dealers out in the open to find new, high risk recreational customers as opposed to cash cow addicts; but will also give a livable life to the addicts by preventing the financial and personal ruin brought by addiction to a substance that is made artificially scarce and expensive.
Most of the problems with addiction stem from this scarcity, not addiction itself: addicts take up a criminal activities to finance their consumption, lose all property and social capital, the product has high variability in potency and adulterants and is very risky to consume, they have to deal with criminals on a daily basis to get it etc.
At the heart of the opioid epidemic was a company run by medical doctors, with a sales force targeting medical doctors, and a budget to not only buy themselves positive medical literature but also the government agencies that were supposed to watch out for the public, oh and also they had enough wealth to buy themselves immunity from criminal or financial liability.
I am not sure that the solution is a pharmaceutical product…
And I say this as someone who has been pro-science his whole life. It’s just that training people that a pill will solve their problems is a recipe for creating addicts?
Note that they say a free product. It shouldn't be produced by a company, but rather be produced at a loss by the government, so there's not incentives to keep people addicted, but rather to reduce addictions.
After talking to a recovering addict regarding heroin, fentanyl and the such. I did some research and found I could get half a kilo of iso (stronger than fentanyl) by the end of the week. It took me 20 minutes
My point is that stuff is so widely available and easily accessible that no sort of enforcement against the higher ups will do a damn thing
Treating the addict with compassion and diligence will be far more effective than attempting to dry up the supply. It of course won't be easy and actually will require a mental shift regarding users
Instead of headlines of law enforcement patting themselves on the back about some meaningless bust
Potentially we could decriminalize consumption, open treatment centers, but still go after the traffickers. People who sell fentanyl know that they are killing people.
I think this is a great option. It seems quite a few people opposed to decriminalization don't realize that it typically means decriminalization of personal amounts, but still going after the dealers.
I think it's most effective to prevent them from becoming addicts by addressing the hopelessness that drives so many to that (or crime). And through education of the effects for the others, of course.
The US has never tried hardcore drug enforcement against drug dealers (i.e, execution, as many other countries do). It would categorically not solve drug addiction as a whole but it would likely have some effect.
It's not popular here on Hacker News due to its libertarian bent, but I'm of the opinion that we should even more brutal to illegal drug production, trafficking, and selling than what we currently are.
I've lost 2 friends to fentanyl poisoning in the last 3 years, and I lost my brother 10 years ago to chronic meth use. I'm so utterly sick of this.
I don't know, the current penalties can be pretty stiff already. You can also prosecute under both federal and state laws to stack the terms. They just don't care to do that in most cases.
>(Not a libertarian) I get the sentiment, but it's been shown that the war on drugs approach is expensive and ineffective.
Is there really a way to show that if the war on drugs never existed, the same number of drug users would exist, thus making the war ineffective? I'm not sure how one would prove this. It seems possible that without the war on drugs, the impact of drugs could be even greater, but again, hard to prove that.
Just an anecdote but in high school my entire reason for not smoking weed was because it was illegal, even though one of my friend groups was really into it.
It's not popular because it's illogical in the face of all evidence. The highest incarceration rate in the world over several decades and seemingly endless funding for anti-drug efforts failed in every respect (but ruined countless lives in the process).
Also see el Chapo. Did either of those high profile busts make one iota of difference? Did the price of cocaine change (hint, it did not) and I all but guarantee the same can be said for meth, heroin and fentanyl. They all cheap to produce and extremely easy to obtain while still being pretty cheap when it hits the streets
Every user made a choice to use at some point. We need to find ways to make that choice more costly. Punish users. Make examples out of people. Give them long prison sentences. Have the Ad Council run anti-drug ads. If users are in prison, they can’t buy street drugs.
If you destroy demand, you’ll crush the cartel’s bottom line. But that would end the nice gig the DEA, cartels, and drug addicted in this country have going on, so I’m not holding my breath.
The US has waged a war on drug for several generations with virtually unlimited funding and has made no progress on that goal whatsoever. What makes you think it could ever work, despite the mountains and decades of evidence that it has failed?
They’ve been fighting the suppliers. It’s time to go after the demand side, too. Every user bought their drugs from a dealer. Throw them in jail with the dealer.
It seems like every solution in this thread is something other than “punish people who buy or sell drugs.”
Can we at least try ruthless enforcement before we try free drugs for addicts paid for by taxpayers?
Given that law enforcement is quite willing to plant evidence on innocent people, this would just be a terrible idea. I had a cop friend who shared a bit of weed saying 'Can't take it all, its evidence for a case next week'. Free drugs for addicts is often a lot more cost effective. Also, not every drug user is a major addict. Almost everyone I knew (I move in academic circles), has some experimentation with drugs and a fair number will smoke weed every so often and try something like mushrooms a couple of times a year.
What’s more expensive, a few grams of an easy to synthesize pharmaceutical or keeping someone in prison? It sounds like your idea would be a massive waste of taxpayer money serving only to gratify a perverse fantasy of sadism and domination.
Take Jack's story and multiply it by at least a million. That's the cost we're currently paying for it. Throwing a small fraction of those people in jail in order to prevent this epidemic is the humane thing to do.
That you'd rather call a real solution to this issue "perverse" and "sadistic" betrays your own cynical view: you really don't care that much about people like Jack. You'd rather grandstand with your smug, politically correct view than actually help people like him.
Why was it so easy for Jack, a high school kid in a small town in the Northeast, to get his hand on hard drugs like this? The answer: we stopped having the stomach for being tough on anyone connected with drugs, by throwing them in prison, and creating incentives to strongly discourage its use.
We don't hesitate to jail people for decades when we find them with illegal explosives or plans to commit acts of terrorism. If those people are successful, at most they kill hundreds of people. The use and distribution of drugs does much more damage and impacts millions in a massively negative way.
It's almost like you are bragging about your ignorance of the drug war. Ruthless enforcement was the norm for two generations and ruined countless lives. How much more ruthless would you have us be? Asset forfeiture, mandatory minimum sentences and massive violations of privacy rights weren't enough for you?
> There are people and places who specialize in these things. You find them through Google and you use them.
> Maybe a Slate Star Codex/Less Wrong reader would start diving into the efficacy rates of different treatment options and crawl through peer-review studies...
The best evidence based treatment for opioid addiction is Buprenorphine. Sadly you will not hear that from all treatment/rehab providers.
Buprenorphine worked great for me, it gave me the stability I needed to start the process of recovery. I took it for 2 years, tapering off over the last 6 months. I haven’t done opiates in 10 years, and it would’ve been difficult to achieve without suboxone.
"But other kids know from day-one that they have no future."
A lack of hope is a crushing thing. It can lead to drugs, crime, etc. It seems to get worse the more intelligent one gets (why am I a failure if everyone says I'm so smart? Or just being smart enough to know just how hopeless things are). It can be even worse if you know you'll never live up to your parent's level of success (look at all the sons of the older movie stars).
It is not realistic to expect everyone to achieve commercial success greater than her or his parents. A healthier human society would emphasize other priorities.
Fortunately, we don't have to simply accept the priorities of those who surround us.
I’ve just finished reading Empire of Pain: The Secret History of the Sackler Dynasty , and I highly recommend it.
An amazing multi generational history of how the Sacklers inflicted opioids on the US, made a fortune, and got away with no consequence.
It was pretty interesting to read this during pandemic times, and it’s a prime example of how institutions lose legitimacy in the public’s eye. The Sacklers had the FDA in the palm of their hand, as well as the highest reaches of the justice department, as well as large numbers of medical professionals who patients trusted to make decisions that wouldn’t harm them.
What gives me hope? That I can surround myself with people who I can help and who will help me if I need it, not any type of fancy concept or title (Governor Agency, BigCo, professional title etc…).
I wonder what’s being peddled these days as completely safe but survivors will look back on as absolutely foolish.
Probably the wrong place to ask, but is there any information on the social costs for the Sacklers of their criminality? (I'm not excusing it, I'm just interested).
Although they have stuffed Giga$ into their pockets, most people also care deeply about their own social status, so have the Sacklers had severe social repercussions from their peers? Some of their peers or acquaintances of their peers must have been addicted.
Top-tier rehab is a bit like a nice holiday - class-A cuisine, saunas, massages, therapists who are paid to listen to you wibbling on about your childhood, nice beds, nice gardens. I can imagine people falling back into addiction just so they can have another spell in rehab.
The book documents multiple direct instances of Richard Sackler being told that his drugs were affecting people in his community (an anesthesiologist in his kids school told Richard Sackler he would be a modern day Pablo Escobar for example). There is a Sackler family member who had addiction problems and committed suicide. A receptionist an aide to the upper circle of the family/company became addicted.
If there is a positive part to the book it is indeed some very small sense of social justice outside of the legal system (which failed to hold them to account). Nan Goldin is an artist who lead the way in organizing protests and press that would lead to their names being taken off the very museums and universities they had paid to put their name on. They had worked hard, over multiple generations, to have clean name despite their business. Nan and others did a lot of work to make sure that changed.
> Although they have stuffed Giga$ into their pockets
I don't suppose that Giga$ makes you happy. I'm not sure what "social status" is like; is that the same as having friends who own Giga$?
I possess what I'd call "social status" - I'm not a pariah, my neighbours greet me on the street, and my kids and my ex-wives treat me as a friend. I own my home, and I have no debts. That's quite enough "status" for me. I consider myself pretty fortunate.
The author didn't consider than Jack may have committed suicide by heroin. Considering the rest of his analysis about how grim his life was with no hope of it getting better I think that's a reasonable hypothesis.
As bad as it sounds he may have wanted to end the suffering for him and his family
It’s probably a bad forum for this opinion, but I have a relative struggling with addiction and resulting mental issues ( resulting form substance abuse; he was highly functional and threw it all away), and because of this I made a 180 and think some form of prohibition for hard stuff is the only action that would help us. How to put that cat in the bag is anyone’s guess.
I sympathize, but these drugs are already as prohibited as they're going to get. Possession, manufacture and distribution are punished by years and years of prison time. It doesn't make a difference.
Even more - it makes for harder kind of drugs being on the market. It is a known phenomenon - harder prohibition leads to harder stuff on the illegal market. That is why fentanyl is in such a wide use.
It absolutely makes a difference. I live a five minute walk from a camp of meth users. They smoke it and use needles in broad daylight, right in front of law enforcement. Their camps are a hotbed of drug trafficking, rape, theft, assaults, and prostitution. Some cartels run the camps themselves and demand rent from their victims. If this stuff was enforced these camps would be cleared out and people put in jail, but as it is in my county most people are let off bail and go on to commit further crimes sometimes within the same day (usually the case when picked up for catalytic converter theft or grand theft auto)
The fact that it's criminalized causes those sorts of marginalized camps and cartels to form in the first place. Even if they were cleared out, they would simply move elsewhere.
What I'm saying is that its de facto decriminalized and this is the result. If it were criminalized you wouldn't be able to live like this unhindered and unchecked on any particular piece of public land you can find. If it were decriminalized nominally, nothing would change, because people aren't being criminalized for meth use currently.
I'm not sure what you mean, drug possession is still criminalized? Has been for years, and drug use still happens, it just creates conditions which increase crime and unsafe use.
Unless, do you mean that the laws aren't enforced enough, hence the drug use outside law enforcement? I would argue that increased enforcement still doesn't help the problem, and crime and drug harm increase. Not to mention the public costs of enforcing these laws and imprisoning people on small drug charges with mandatory minimum sentences.
It's criminalized but cops don't enforce these laws, because the DA isn't going to prosecute a homeless person for these laws. Police cite them and release them and then you get stories like this (1) where people might get arrested and released for separate crimes three times in one day. I can find dozens and dozens of stories like this, some more tragic like the final crime of the day being a murder of an innocent victim.
Are these policies helping these people get their lives back on track? I'd say its clearly doing the exact opposite. By offering no consequence to bad behavior, bad behavior continues. If this person was arrested and taken into custody vs released, they'd at least be put into a controlled environment where they would be fed and sheltered and have their medical needs attended to, versus let out onto the street with no direction where they end up right back where they started.
There are costs to the public for sheltering and treating addicted and mentally unwell, certainly, but I'd argue the costs to the public of the status quo are much higher if you were to quantify them. All the petty crime, the emotional toll on innocent people victimized, the price of a life when innocent people are murdered by psychotic people on methamphetamine, the price of ER bills passed on to everyone from someone coming far too late on deaths door with zero insurance, versus the much cheaper price on preventative care that would prevent these situations in the first place, is not a cheap price. But by continuing this status quo this is the price we all bear.
Drug trafficking is a capitol crime in China, but China has an epidemic of methamphetamine and ketamine abuse, to give you one counterexample. My claim is that law enforcement is highly effective in all areas at the scale of a city.
there's the laws, then there's enforcement. enforcement is he harder part, and I don't see any easy wins there. you're right though - much is already "prohibited". it still happens.
I don't know how we could make that work in the US. We already tried alcohol prohibition 100 years ago, and that didn't work. Patent medicines were made illegal, and prescriptions are required, for this reason.
We've already recognized that overprescribed prescription opiates in the early 2000's was a deliberate attempt to bypass these protections and get people hooked.
> How to put that cat in the bag is anyone’s guess.
I think it requires a scientific process instead of a political process. IE, the politicians need to encourage medical professionals to keep trying many different approaches until we figure out what works. This will only happen when politicians stop criminalizing addiction.
FYI: All currently legal treatment options in the US HAVE to target ending addiction. Allowing someone to voluntarily maintain an addiction to anything is currently illegal, and means that only people who voluntarily want to stop their addiction are helped.
When I was nine years old, my cousin died of a heroin overdose at nineteen years old. Most of the grownups around me were very sad, but I didn't really know my cousin very well; he lived on the opposite side of the country, and he was a full decade older than me so the times I did see him we didn't really play together, and so I wasn't really able to feel "sad" about it. People I don't know die every day, I can't feel bad for all of them (cold as that might sound) and my cousin dying wasn't terribly different.
Fast forward eleven years, on my twentieth birthday, and I had a realization: my cousin was the first person I had known that I outlived, and I felt this sudden sinking feeling. Why had I been spared when my cousin had been taken so young? Why did I get to spend more time on earth then he did? It's not like I was some sort of cosmically better human than him, I had been a dumb teenager who was just lucky enough to not have friends who were willing to talk me into doing drugs.
I started asking my parents about my cousin, and it made me somehow feel even worse when I found out that my cousin had a bit of a downward cycle with drugs throughout the tail end of high school, tried joining the army in the hope that it might straighten him out, it didn't, and just fell deeper and deeper until he eventually died. Alcoholism seems to run in the males in my family (with the exception of my dad and me, strangely), so this sadly wasn't even really something completely unexpected.
Addiction is tough, I feel really fortunate to have dodged that bullet. I can't even pretend to know what addicts to hard drugs are going through.
I'm a recent teetotaler and my quality of life is massively improved. It took me an unreasonably long time to realize many adult role models in my life (family, and then in my first significant professional workplace) were abusing alcohol. None of them would consider themselves alcoholic. A few of them were dependent at significant cost to their health, which I believe is easily classified as alcoholic.
A few years ago I worked a project with a young foreigner who didn't drink and actively spoke out against it as - in his description - the cause of much dysfunction in his country. Politics aside, I was actually inspired by someone significantly my junior to reconsider my attitudes. What if I took a leaf out of the self-improvement culture and just tried it? It might be too much for a lot of people to simply not drink. Life circumstance counts for a lot, but my life no longer includes socializing in venues where alcohol is served so it actually wasn't too hard to stop.
Good on you. I think it's important for people to understand their own susceptibilities and react according. Interestingly enough, the boomers are the highest drug using generation by far (1) in the US. I wonder what impact this has on society at large. I would guess not a good one.
I stopped drinking because I realized it kept me from accomplishing things I wanted to accomplish. I think (based on my experience, can't speak for others) it's relatively easy to quit once you know why you want to quit.
I don't much regret my drinking days because I had fun and met many people. But then I realized I want to do other things than just get drunk and get a hangover.
I think, based on my experience again, that AA with its confess your sins and label yourself an alcoholic may help some people. But I think it's best to think what you want to do and accomplish, in life. Then do that. No need to keep on repeating you are an alcoholic. You're no more alcoholic than anybody else I would say. It's just that you have decided to drink and keep on drinking. It's your choice.
…which by the way is also an approach Richard Feynman took: He basically stopped drinking because he liked thinking itself way too much to ever let something impair that.
I‘m fortunate enough to be able to keep my drinking level at a point that helps me socialize and enhance enjoyment (the occasional bottle of wine with friends and peers), but not above.
I‘ve also experimented with drugs in the past because I was just too curious, but in the end, I was lucky to not end up some place I didn‘t want to.
By now I’ve experienced that ability wasn‘t just personal strength, but also my predisposition and experiences.
That does‘t excuse anyone from not trying harder, but it was a sober reminder for me to see that addiction is a way steeper slope for some of us.
> It's just that you have decided to drink and keep on drinking. It's your choice.
That's kind of the dividing line, though, isn't it? If it's your choice and you could choose otherwise, then you're not an alcoholic. Some people don't feel like it's a choice.
I can see one could be in a situation where doing cold turkey might be dangerous so in that situation it might be dangerous to stop. But isn't it still their choice? I know this might get easily into deep thinking of whether we have free will or not, so I'm gonna stop
I appreciate your comment. And I found a similar experience in my life quitting smoking: once the decision was firm, and an understanding of the barriers it was erecting between myself and my goals, my resolve was total and quitting was easy. But you're a tad flippant about AA so let me share my thoughts as I have attended it many times - not for myself, but in support of an old school friend who was drinking himself to death some 10 years after we graduated. When he told me about his struggles in recovery I offered some assistance.
The people at AA are by and large deeply broken, and trying to slowly reassemble their lives without crumbling under the weight of the knowledge - largely gained in sobriety - of the massive damage they have done to themselves and others, and returning to hide in addiction. This harm often includes the repeated abuse of their loved ones throughout their addiction, and their guilt is enormous. If they appear stuck, consider that at least they are stuck in a place where they are not drinking, which in most cases is an enormous improvement.
If you do not prefer the religious component what I would say to you depends on whether you are an addict or not. If you are an addict I would say you are in dire need of a serious dose of humility: admitting you are powerless and that you need the help of a higher being fits that requirement. If you are not an addict, you should really not attack an institution whose sole purpose is to help addicts. Just smile and nod.
There's a perspective I feel is sorely missing in this otherwise great piece and the discussion around it: the larger social and even political perspective. We treat it as an individual problem. What could Jack, as an individual, do? In truth, not much. What could the patents do? In truth, not much.
But maybe we can change things on a larger level. Create a society where heroin isn't as appealing by comparison. Where there are spaces for socializing that aren't about social competition, or at least one where there are more distinct and equally good ways to "win". Maybe one where, if you fall, you don't have to carry the guilt that your family will be dragged down with you.
I was lucky enough to grow up with the historical teetotaller community, since my grandfather was a leader of sorts in it. They used to be very adamant on seeing alcohol use (and of course drug use) as a social problem, not an individual one born out of "weakness of will" or genetic factors. They quite deliberately tried to create new social arenas without alcohol, and cultivate a sense of community and common purpose which could make it more than yet another arena for social competition. But they quite literally couldn't keep up with the times. The social venues they made were of types that were extremely popular in their day, but are exotic at best today (e.g. lodges). And along with the rest of society, they gradually embraced AA's medicalized, individualized understanding of alcoholism, turning the message from one of collective self-defense ("we're building this to defend ourselves as a community from the scourge of alcohol") to one of sympathy with the medicalized Other ("We're abstaining out of solidarity with those individuals who will become alcoholics if they touch alcohol").
>What could Jack, as an individual, do? In truth, not much. What could the patents do? In truth, not much.
This is bullshit. People who want to beat their addiction and have the support from their immediate family are the demographic that most readily beats addiction.
When it comes to beating addiction, losing weight and all sorts of other things that require a lot of willpower having some personal motivation to do whatever it is plus a support network who can help you and encourage you is just about the most effective strategy. People care a lot more about doing hard things if they feel their family has a stake in it.
I said not much, not "nothing". It's AFAIK true involving family is one of the most effective things you can do in rehab.
But it can be very costly on a human level, and there's still depressing outcomes.
It's not easy to run such family intervention initiatives. An old friend in my teetotaller org did it for a while, starting up family clubs after the design of a little known Yugoslav/Italian academic, Vladimir Hudolin.
There are things you can do, but they're not very effective and at best they help you and the ones closest to you. I'm saying, I think we should see it as a social problem more than an individual problem, and try to address it at the social level first and foremost. We'll likely always need rehab in some form, for humane reasons, but it's not possible to use it to paper over the deeper problems surrounding drug use. That's like replacing traffic safety with emergency medicine.
What you would call an NGO today, or a civil society organization. It's still around as one of the many national teetotaller organizations today organized under Movendi international, but it's got a tiny fraction of its original membership numbers.
> What could Jack, as an individual, do? In truth, not much.
Literally every step of the way he could have done something. This is an unusually clear cut case of someone's actions leading to the outcome that they experienced.
There are attitudes that a community can express which will help or hinder, but there is no escaping that in this specific situation, to get a different outcome Jack had to make different choices.
I'm relatively neutral on drug addictions as a character flaw, it is very easy for me to believe there are people out there who would be making a logical choice to turn to a few moments of reliable pleasure in an otherwise miserable existence. I wouldn't touch hard drugs myself for fear that I would enjoy them. But, nevertheless, the only person who was in control of the outcomes here is Jack.
You're doing what I wanted to warn against, individualizing something that is at heart a social problem. If there are all these better options to choose on every step of the way, why are there so many Jacks who don't choose them?
But what's the alternative? Coerce Jack and his ilk into rehab, effectively institutionalizing them? That doesn't work either, in the long run, and restricting people's freedom is a heavy thing to do.
I think this is really socialization, surroundings and trivial occasions. My family drinks alcohol, but very rarely so. I studied in another city where alcohol consumption is far more common and I was drunk nearly every weekend (didn't have much training). Now I am back to a beer every two weeks and I don't miss drinking more. I don't consider that self-improvement though, that would be a bit much, although it probably is far more healthy to not regularly intoxicate yourself. I also don't think most people were addicts, at least not yet.
Hearing alcohol addiction, it seems so "unreal" in the sense that, I can see it as a problem but I always feel it can't be that hard.
I think alcohol, tastes disgusting in general. It's fun to mix with other things to have a stronger effect, but I've always enjoyed everclear to accomplish that, which basically is just pure ethanol.
I never understood alcohol culture, bars, going out, etc.
And I always related that to not being "popular" or feeling calm in a new city or such. I think it's so strange to go to a place, have to wait in line, pay admission/cover, to talk to a bar tender that expects tips, and then pay extravagant costs for something that can be purchased cheaply anywhere else (yes, I understand the transaction/food/beverage/hospitality.)
You're not alone, I never got bar/drinking culture either. What was always really weird to me was how homogenous it actually is, like how the nightlife in a city is more or less interchangeable, you just swap out the music and the clothes people wear, but otherwise its the same set of interactions every time. How this was settled upon as THE way to socialize is utterly baffling to me.
He wasn't taken. He took himself. Exercise: Everytime you remove agency, reintroduce it.
"I am depressed". No, you are depressing yourself. "I am helpless". No, you are making yourself helpless. These are active processes. Let's get more controversial: "I am being bullied". No, you are letting people bully you.
I know this is harsh. I know the societal memes and phrases are the warm place. A sigh, the Soma of "Nothing can be done" or "Somebody needs to do something!!" is not a solution but paralysis.
You can read it in the article: The parents did everything for the addict, he did nothing himself. It didn't work out now, did it? Never does.
(Not absolving the Sacklers of their guilt, that is a separate issue)
Never mentioned Crohn's. Why are you bringing that up? Same with the comment above above: Ask yourself, why are you deflecting, why are you removing agency?
Let's say depression is a purely biological problem, the chemical imbalance (it isn't), take a pill and be be healed! Right?
Now who sells that pill? Who lobbied to have depression seen as a disease?
Are you asking why would they bring up a disease in a talk about what is commonly thought of as diseases, or are you asking something else?
> why are you deflecting
This is funny, because you are deflecting in your comment as well. If you feel like folks should not deflect, you should engage with what they say and then tell them to not deflect. Then it becomes more relatable, because it is not hypocritical :)
> chemical imbalance (it isn't)
Depression is a catchall term for many different problems. Some are well understood to be purely chemical (depression unrelated to thoughts, circumstances or environmental factors such as season or food), some are well understood to be environmental: That means "just stop removing agency" could be a way to tackle it, although it famously does not work for most people. Why do you suppose your answer does not suffice for most? Do you feel this is evidence of yet more weakness?
It seems to me you do not enjoy one-dimensional answers to your own thoughts, so why do you insist on having them about other people?
> who sells that pill
You might say the same thing about the smallpox vaccine: Someone sells it. Following your implied point: Perhaps this means that it is not a problem, clearly money changes hands so perhaps there is a profit motive (and potentially this means it is the only motive and potentially that means the requirements are fabricated. That is quite a leap!). While it is reasonable to follow such a thought process, perhaps in this case it does not suffice to follow it, recognise a potential problem and dismiss the original solution entirely. Mostly because if you talked to even-handed professionals (many of whom have similar concerns as yours, if a bit more nuanced by practical experience and what I would hesitantly call empathy), you might find that folks have considered these questions (and do every single day) and to this date they have not been answered in a way that provides a solution for every single case.
> Now who sells that pill? Who lobbied to have depression seen as a disease?
> Who invented the CO2 footprint? BP.
Emacs contains doctor.el which can help with issues like these. Back when I was into conspiracy theories (~2004-2007?), it helped me. One advantage of it is that you can keep your conspiracy theories for yourself.
It’s here that British Petroleum, or BP, first promoted and soon successfully popularized the term “carbon footprint" in the early aughts. The company unveiled its “carbon footprint calculator” in 2004 so one could assess how their normal daily life — going to work, buying food, and (gasp) traveling — is largely responsible for heating the globe. A decade and a half later, “carbon footprint” is everywhere.
“This is one of the most successful, deceptive PR campaigns maybe ever,” said Benjamin Franta, who researches law and history of science as a J.D.-Ph.D. student at Stanford Law School.
The term was popularized by a $250 million advertising campaign by the oil and gas company BP in an attempt to move public attention away from restricting the activities of fossil fuel companies and onto individual responsibility for solving climate change.[3][4]
Your previous comments are dead so I have to respond to multiple posts at once here. Sorry.
> He wasn't taken. He took himself. Exercise: Everytime you remove agency, reintroduce it.
I used the term "taken" as a rhetorical thing to ask a deeper question about cosmic unfairness. It makes no claims of level of responsibility and I feel like you knew this and just wanted to make a bizarre ramble about something you read in a bad self-help book.
> "I am depressed". No, you are depressing yourself. "I am helpless". No, you are making yourself helpless. These are active processes. Let's get more controversial: "I am being bullied". No, you are letting people bully you.
The hell does this have to do with my post exactly? I told a story about my cousin dying from a heroin overdose and you go off on (not even) a tangent about bullying or something.
Also, that's a pretty ridiculous thing to begin with. How are bullied people "letting themselves" be bullied? A kid that's bigger than them decides to physically hurt a kid smaller/weaker than them. What exactly is the smaller kid supposed to do? This isn't the god damn Karate Kid, life isn't a cheesy eighties movie, most of the time the kid just has to be bullied. It's not fair, it sucks, and victim blaming is not helping anything.
> Let's say depression is a purely biological problem, the chemical imbalance (it isn't), take a pill and be be healed! Right?
Depression is a blanket term for a lot of things, and is somewhat overloaded. Sometimes people just feel sad, and maybe telling them to get over it will work, but for people like myself with manic depression, it really isn't that simple. You can do any amount of exercise or dieting trying to suck it up, and everything will still feel hopeless, you'll still blame yourself for everything, you'll still catastrophize everything, you'll still yell at people who don't deserve it, and you'll still have to talk yourself out of bed every morning [1]. When that's the case, what exactly are you supposed to do? Are you disputing that those people exist?
Also, your hypothetical is completely absurd, there are plenty of things that have physiological causes that we can't just take a pill and be healed with. Do you think cancer is just an attitude problem? How about amputees? Are they just so stupid that they don't take a pill and be healed? What a strange and completely misinformed take.
I honestly feel bad for you. Whatever sequence of events led to this strange pseudo-edgelord hardass chud persona must have been tough.
[1] Not all depressed people and not all manic depressives. Describing my symptoms.
I mean, I agree with you, life is harsh and we all need to practice more personal responsibility.
However, there are a lot of cases where things are out of someone's control and they're really helpless.
Like depression. Take a pill? No, it's wade through the medical system trying to find a doctor who will graciously grant you the magic paper. And if you don't find one, tough shit.
Then there's the case of a girl being chained and dying of dehydration, for which the accomplice wife of the ISIS piece of shit who did it got 10 years in prison. Not only was the girl helpless, she wasn't even helped by someone who could.
These two things made me reply. I probably shouldn't have, but whatever, we're all shitposting here.
I started writing out a much longer response to this, but it just got very ranty so I'll cut it short. If you insist on such a reevaluation as to why people aren't in their best state, a one word answer "lazy", "attention seeking" (okay thats two words, you get the idea), "weak" isn't going to cut it. You need to continue to ask yourself why that is the case, why are these people so apparently lazy, that they would allow it to work negatively upon them? I obviously don't buy your argument, I think the expectation of complete agency in a society run on hundreds of thousands of people is a bit of a fantasy, but you could have a point. You just don't have anything yet.
Another argument against it, why not turn the mirror on yourself. Why are you not richer, stronger, more popular, happier? Maybe you are somewhat of all those things already, but a wild guess is that your not the strongest, richest, most famous and happiest person in the world. So why not, are you weak, lazy and shallow? Or, perhaps is the truth a bit more complicated?
I have seen the homeless as people to be pitied and helped. Just weak people, down on their luck. So you help them, right?
I let a homeless man sleep in the hallway of my building. He took a shit in front of my door.
Now if I had seen the homeless as what they actually are, maybe weak, maybe helpless, but still people with agency who can be absolute assholes, that wouldn't have happened.
And I hate that this is overlooked. Maybe if the parents in the article wouldn't have fallen into this trap, their son would still be alive.
The assumption everyone downvoting seems to make is that I don't have compassion or as you do, I see them as "weak", "lazy" or "attention seeking" (notice how you are seeing them as that, not me).
I can have compassion and ask them to do their part. That actually solves the problem.
You don't seem to have much interest in answering the crux of my point, which is the continual asking of why until you get to the true reasons why things are the case. Instead, you've just given another high level example.
To be honest I'm not even sure how this new example relates at all. You're simply saying that people can do bad things, which I guess is true, though I don't see how that supports your argument. I don't think anyone was suggesting people have no agency, and can't possibly make any changes in their life, the suggestion is they don't have complete agency, and their life will always be governed by factors beyond their control. Taking your point, yeh, people can be assholes, but why? "Just because" isn't a proper answer, and if it is the same can be used to dispel your argument just as easily.
> notice how you are seeing them as that, not me
Hmmmm, not quite. Your whole argument rests on people refusing to make changes in their life for no apparent reason, and these are typically the words used. You didn't use them yourself, no, but I think it can be quite easily inferred, not least by the fact you called another commenter a coward. Again, following my argument, ask yourself why I thought you would think of them in those terms.
> That actually solves the problem.
Maybe you're right, maybe you're wrong. I suspect you're right in part, but things tend to be more complicated. Either way, thats not my point. My point is asking why they don't do their part, for example.
They don't do their part because they are not expected to. That is my problem with the "disease" label. That is my problem when talking about homelessness. That is my problem when talking about addiction.
And there are people who make a good living keeping it exactly this way, making bank in the wake of the moral outrage of the "helpers".
Maybe if you had offered him an actual place to sleep and shit instead of being an asshole yourself, you wouldn’t have had to deal with the consequences.
Attacking other people like this will get you banned on HN, regardless of how wrong they are or you feel they are. Maybe you don't feel you owe them better, but you owe this community much better if you're participating here. Please don't do this again. Btw, we're specifically trying to avoid the online callout/shaming culture here (https://hn.algolia.com/?sort=byDate&type=comment&dateRange=a...).
>I have seen the homeless as people to be pitied and helped. Just weak people, down on their luck.
They are. They also tend to have high rates of mental illness, which often is what leads them to live transient lives. Leaving them in your hallway unsupervised, though well intentioned, isn't the way to help them. It didn't backfire because people are assholes, it backfired because you operated on a faulty understanding of the situation
I am not entirely in agreement with parent comment, but I need to call false dichotomy on your second argument. There's a whole range of acceptable states between depressed and happiest.
I don't think it's fair of you to use quotation marks when the person you are responding to didn't use that language.
Not is it productive to misinterpret his comment as perpetuating a tired trope and then launch into an emotional rant against something that literally nobody here is supporting.
GP did make a fair point - learned helplessness does nothing but exacerbate your suffering, and taking agency and responsibility for your own mental state is the most effective way to improve things.
Whether the solution comes through lifestyle changes (leaving toxic environment), a simple change in viewpoint or SSRIs, labelling yourself as depressed or burned out and then succumbing to your new fate is never productive. I know this because I've experienced both.
> I don't think it's fair of you to use quotation marks when the person you are responding to didn't use that language.
Which everyone who reads it can clearly see, and understand that I saw that kind of language as a possible response to my question of "why?". I wouldn't say thats any kind of trickery on my part.
> Not is it productive to misinterpret his comment as perpetuating a tired trope and then launch into an emotional rant against something that literally nobody here is supporting.
Theres an irony to saying I "misinterpreted his comment" and then immediately doing the same to mine. It wasn't an "emotional rant", maybe a bit of a rant, but I'm not going to apologise for that. I'm not sure which tired trope I'm perpetuating.
> and the rest...
I think you're missing my point. Perhaps, to use your own words, I could even go further and saying your misinterpretting it and launching into an emotional rant.
My point isn't that people can't change their circumstances, or that self improvement is pointless. Its that so many factors govern these things that its a fantasy to believe anyone is in complete control.
You're not depressed because you just are and theres nothing more to be done, nor are you depressed because you make yourself depressed. Hence why I argued to keep asking why, if you truly believe that your depression is caused by yourself, ask why you would do that to yourself, and keep doing so until you find the true reason.
Just for what it's worth, I wasn't attacking the content of your argument - mainly just defending GP while attacking the tone of yours. What you said wasn't wrong, but it was in response to an argument nobody was making.
I see. I had a hard (physically manifested) depression episode recently and had to pull myself by hair and stubborness out of it, so your viewpoint seems valid for the ones who do. But it’s not what society feels. Your anger towards “yourselfness” does a good job, but I guess you’ve been helped, at least instructed on some details. That kid may not have had such privilege, spiralling down on his own (you can’t be strong if you don’t realize that you’re vulnerable, if it doesn’t click as “I allow it to happen”). And one can OD by chance while not being anywhere near the end of that slippery slope.
> "I am depressed". No, you are depressing yourself. "I am helpless". No, you are making yourself helpless. These are active processes. Let's get more controversial: "I am being bullied". No, you are letting people bully you.
most people are social animals. it's easy to be an individualist if you have the trait and nigh impossible if you don't.
While advice like this might have been alright if it was in a self-help book where the OP was looking for ways to approach the situation, it is completely uncalled for and inappropriate in this situation.
You need to lay off on the Jordan Peterson. It's more complicated than "clean your room".
> "I am depressed". No, you are depressing yourself.
You're assuming a brain that's in good working order. It's difficult to imagine a different one. Consider that not everyone's window into consciousness works like yours does.
Please don't post in the flamewar style to HN. If you want to make a nuanced point about personal responsibility, ok, but turning it into a big binary polarity and then blaring condemnatory, dismissive rhetoric at the pole you disapprove of is no way to do this.
You say you know it is harsh—that's already a reason not to do it here. Maybe "harsh" can do some good when there's already a strong relational connection with the other person. (Emphasis on maybe, because people who take harsh stances generally are paying more attention to their own ideas than to the person they're commenting on—but no doubt it does happen sometimes.) Here, however, you're broadcasting to thousands of people over the internet, with zero relational connection. In such a context, it's merely provocative and destructive, and one could even say selfish.
I feel as if I did that. Maybe my writing comes across way differently, maybe my comments are not as direct as they could be - but if that is already too upsetting for this crowd, you will never get any actual critical comments. You will never arrive at any traction, at any truth. Too bad, I expected more here. My error.
Case in point:
> Please respond to the strongest plausible interpretation of what someone says
I'm sorry - I don't mean to pile on! - but I don't think you did that. The comment didn't include interesting specific information; it was a moral hectoring. Those do not come across well on the internet.
> Nobody replying to me did that. Amazing.
Not amazing—quite predictable, given the provocation. In cases like this, the root comment bears the most responsibility. Here are some further explanations of what I mean by this, in case you or anyone want more:
> > Please respond to the strongest plausible interpretation of what someone says
> Nobody replying to me did that. Amazing.
You worded everything in absolutes. If you ask people to take the strongest interpretation of that, you're asking them to just concede that you're right.
I think you actually seem to get it that there's something dangerous about identifying with the problem (e.g. I am depressed) but you're jumping to conclusions about agency from there. No one who replied wanted to make that leap, nor did you offer any compelling reason to do so.
> Alcoholism seems to run in the males in my family (with the exception of my dad and me, strangely), so this sadly wasn't even really something completely unexpected.
Indeed, familial alcoholism is suspected to be a complex genetic trait (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4056340/). As for why you and your father seem to have been spared by that... if I may ask, did you two have access to mental health care and use it? A common theory in addiction research is the "self-medication hypothesis" (https://www.psychiatrictimes.com/view/dune-and-the-second-co...) - basically, that people accidentally discover during experimenting with drugs that the drugs help with mental or physical health issues.
> As for why you and your father seem to have been spared by that... if I may ask, did you two have access to mental health care and use it?
Well, we've had health insurance for my entire life so I guess we had "access" to it, but as far as I know my dad never used it, and I didn't see a psychiatrist until I was 26 (and I wasn't drinking much before that, certainly not enough to be considered an alcoholic). He certainly didn't have access to it until he finished school, growing up in a relatively poor family.
I think at least in my dad's case, he saw how much his dad's alcoholism screwed things up, and decided that he was going to try and avoid that fate no matter what, sort of using his dad as an example of "what not to do." As I was growing up, I think I saw my dad drink a grand total of four glasses of wine, all of which were done on different New Years events, and never enough to get "drunk" or anything like that. As he's gotten older (and as his kids have all grown up), he's relaxed on that a bit and I will occasionally see him drink slightly more frequently, but I think that habit of sobriety has been somewhat ingrained into him at this point.
Thank you for sharing, it was very impactful. I think it is a little diminishing to say that a computer repairman has no future or point in living. Life is what you make of it, all our lives are insignificant ultimately
I know someone just like Jack (some of the similarities were shocking). They have a home to go to, a loving family, a large and supportive friend group, opportunities for work. They are not dead yet, but having been through prison, buprenorphine, and multiple expensive rehabs, I begin to wonder what the solution for them is. If there is anyone here who has beat this addiction perhaps it would be insightful for them to post what worked for them.
I haven't personally dealt with addiction, but I work in this space and the most effective treatment we have is Buprenorphine. Try to find a provider who will work with them and not kick them out of their program if they return to use. There are even telehealth options now, which is what my company does.
I would much prefer this story being written by a real friend of the protagonist. Everyone else knew but me" and proceeds to do an analysis. Rather nosy and self-confident the author. Opinions from afar are not very useful. "Some were dumb, some were smart" oh really, wow, what an insight! This guy is piggy-backing on the death of a person he once met a few times. Go and get some real friend, and then write about them. pfft.
I've had two very close friends die of heroin and opiod overdose. Both were very popular people. The type of person you looked up to; wanted to be around. Very different from the person that mattlakman described. I had no idea they were abusing drugs to the point that their lives were endangered until it was too late.
For anyone who wants to read the story of Jason Mewes (from Jay and Silent Bob fame) heroin addiction, told by his best friend Kevin Smith, I would encourage you to read his blog post about it. It's truly heart-wrenching, and filled with some of the saddest stuff you could imagine happening to a person.
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[ 5.7 ms ] story [ 355 ms ] thread(And in places where heroin is legal, addicts rarely die from overdose.)
That said, death is not all that can ruin a life.
I'm not taking about weekend poker players, here... I mean people who've lost their wife, kids, house, and job to a gambling habit. They have zero savings, mountains of debt, and if you lend them $20 to get groceries, they'll go hungry after gambling it away?
Modern video games are designed by highly paid, PHd-level behavioral scientists to be as habit-forming as possible. If you're vulnerable to it, you're going to have the same kind of struggles getting away from video games as a heroin addict would from junk.
The lack of immediately lethal consequences is only part of the problem... Addicts can ruin their lives, and take their families and friends to the point of no return, even without the possibility of something as serious as an overdose.
Video game addiction still exists and can be bad but it's probably nowhere near as detrimental as gambling addiction.
Video game addiction may not take all your money, but it can definitely devour the person. It'll leave you just as hollowed out and functionlly limited as a drinking problem. It's the core nature of self-medication, regardless of the mechanism of medication.
The wifes and kids are secondary victims there. The tragedy is not that the addict lost them. Them leaving is them getting chance at better life.
The tragedy is that wifes and kids were likely mistreated for years and went through hell too. The wifes earnings were lost to addiction too and she did not even had fun playing. The kids were missing school supplies and had to live in tense environment where one parent was addict and other constantly overstressed and very likely cracking.
If this is something you have personal experience with, I'm sorry for what you had to endure, and I hope your life has gone in a better direction.
Oh come on man, occam's razor. Debilitatingly painful and difficult to treat medical condition in childhood results in social isolation and an opioid addiction. A kid faking being ill once doesn't discount an entire life ruining disability.
Occams razor: tons of people have social isolation and/or opioid addiction, without "Debilitatingly painful and difficult to treat medical condition in childhood" (and the inverse).
And he didn't say "faking being ill once", he said "n a few occasions", and those are just the ones he admitted to his friend.
Earlier on, the author does speculate about what drove Jack:
> To put it another way, Jack was painfully aware that his future options were, “be a complete loser,” or “be a complete loser who feels really really good for a few hours every day.” He chose the latter.
What's striking about this is how it's possible to live this way without drugs. A brain-numbing job eight hours a day and a life-saving hobby for four. A toxic-family life but wonderful community.
It almost sounds like Tennis could have been this outlet:
> One time when Jack was in middle school, he walked off the tennis court after a well-played match, and his mother asked him how he felt. Jack said something like, “when I’m out there, it’s so nice… it’s like the rest of the world goes away and I don’t have any problems.”
I tried heroin once, and I regret it every day, because I am 100% positive that I will never again be as happy as I was that day. If I didn't have what is effectively a dream job I'm sure that I'd be a heroin addict.
The above comment feels like a really dramatic description of opiates. I don’t think most anyone with a moderately stable life is at risk of addiction trying them.
I wish I’d never tried it.
A few years back, perhaps close to a decade ago, there was a fairly well known reporter/journalist who said this same thing. Of course, he was cocky enough to test his presumptions & tried either some form of opiate or heroin, can't recall exactly which. He by all means had a happy and successful life/family.
He ended up getting horribly addicted & there was a good writeup/documentation of everything that happened. I'm having issues finding the article right now though.
Also, anesthesiologists, one of the highest paid, disciplined, and well respected jobs you can get, are also one of the highest risk groups for severe drug addiction.
I think your presumptions are quite incorrect and crass.
https://www.sciencedaily.com/releases/2018/02/180206090700.h...
https://www.psychologytoday.com/us/blog/the-courage-our-conn...
It's much more tempting to seek out another hit if you have nothing better to do that day.
It seems pretty likely to me that at least some people really will inevitably go down that road from one dose. Maybe not as many as the hardcore Drug Warriors would like us to think, but at least a few. It's an odd blind spot for the hardcore Libertarians - some people just aren't physically capable of coping with it, and no amount of willpower on their parts will change that.
Roughly 1-2% of people who try heroin once are done forever; many many try once or twice and aren’t. For cigarettes the rate is about 20-30% who become addicted
I am an anxious person prone to depression. In one especially bad period of my life I was prescribed Lexaurin (anxiolytic used to handle panic attacks). Taking that was a shocking experience - it made me feel calm, optimistic... and maybe for the first time in my life it made me aware of the ever-present baseline of anxiety that I was living with, like always. Lexaurin made me feel not anxious at all and it felt awesome. I kept asking myself - is that how other people feel all the time? I would give anything to live like that. If I had free access to it all the time, it would be really hard to resist the temptation not to use it. At the same time I can imagine that for many people - like you maybe? - taking Lexaurin would do absolutely nothing, because they live on that anxiety-free baseline their normal lives.
Some people love opiates. Personally, I hate the feel of opiates. My brain feels like it's encased in concrete. This is not a good feeling to me.
I consider myself fortunate that I don't like the feel of opiates as it means that I didn't become addicted to them from the times I needed them medically.
I will, however, point out that musicians almost universally warn other musicians not to do heroin even once. Musicians aren't exactly straight-laced, and, if they're warning you about something, you probably ought to listen.
I tried to smoke weed a few times. I didn't just dislike it but downright hated it every single time. I tried a few other drugs, and responses varied from "I don't really like this" to "meh, so this is it, is it?" Never tried heroin, so I can't speak to that specifically.
Point being: individual responses to drugs vary greatly. I wouldn't say I'm "immune" to becoming an addict, but it'll sure take a lot more than for some other people.
When I was ~12 I got nitrous in the dentist's chair.
I remember the thought going through my head: Wow, this is really cool.
However, I didn't have ready access to nitrous! If my parents had a whipped cream maker, would I have started huffing whip-its? Maybe, but at least they aren't addictive. It's not like I would have gone into withdrawl after going through a box.
I think the bigger issue is the physical dependency that opiates have. Once the drug is no longer the "new toy," but the physical dependency is there, it's much harder to stop once the novelty is gone.
If this is the case, then as direct as it is to say - these mechanisms are just that, mental mechanisms, and it just happens that when "low point of bathtub curve" bounces off of "really badly timed negative ROI event" bounce off of each other, it's like the result is amplified almost beyond reason. Long-term the signal value ("this will kill your spirit") is absolutely true, but in the immediate (ultra-short) term, compartmentalizing and ignoring it may be both safe and actively helpful. (Standard internet advice disclaimer applies)
TL;DR: Good luck, and may circumstances and equilibrium materially improve and solidify.
I had a friend tell me “when I had the first drink ever my first thought was ‘I want to feel like this the rest of my life’”. He was sucked in right away and struggled for years to break that hold.
Plenty of people feel that way and practically kill themselves with alcohol, opioids, cocaine and even food.
And plenty of people take opioids equivalent to heroin and say “i felt terrible, nauseous and dizzy, I don’t get it”.
I cant find the source but there was a DEA (?) report a long time ago that noted “80%+ of cocaine users use it less than 5 times per year”.
When drug use gets pushed into the shadows the only examples you see are the ones where it spirals out of control.
Obviously I don't know how strong (and I really really hope I never know, unless I'm on my death bed etc) but by all accounts it is overwhelming. Everything is toxic at the right dosage, and heroin is pure toxic pleasure.
I've tried coke - good stuff, in good company, for an evening. It didn't impress me much.
I guess I was just lucky. I have an "addictive personality" - I drink way too much, and I'm a heavy smoker. I could easily have fallen into one of those holes, if I'd actually enjoyed those drugs. I found psychedelics much more engaging; but they're generally not addictive - after 3 days of continuous LSD use, no amount of LSD will get you tripping again. It's anti-addictive.
It's also easier to accidentally OD on heroin compared to cocaine or alcohol.
Also, people dont get addicted to alcohol that fast. It takes a lot more usage to develop physical dependency.
You also have to work on a heroin addiction, so I have heard. It simply isn't true that "one dose and you're hooked". People become addicts because they want to be addicts, for whatever reason. Part of it is lifestyle; part of it is the desire to be dependant, so you get to not have to be responsible for yourself.
When I looked at it, it is something like 30% of people develop dependence after first one-two usages. Then there are people who can use it casually for a long time before developing it.
Sorry for commenting to self, but it's too late to edit.
And sure, most people don't say "I want to drink forever" when they have their first drink. But that's my point, most people don't say that when they get opioids - remember they are very widely used in medicine. Some small fraction of users actually spiral into a deep addiction.
Now, one could argue the percent that develop a problem is larger than with alcohol - that might be true. That said, it's estimated something like 10% of drinkers have "problems" with their drinking. Again, not everyone ends up a homeless drunk - plenty of functioning alcoholics.
Guy who used heroin shattered his hand in a fall off a roof. Had pins put in. When he came around after surgery they had to call the police he was so out of control because his pain couldn't be managed.
(NB. Have integrated the understanding that pushing The Button™ is a generally bad idea. The above is purely intellectual curiosity.)
I think you might be too certain about that. It's possible to train oneself to be happier than most people imagine is possible.
https://library.dhammasukha.org/uploads/1/2/8/6/12865490/the...
I mention it because you say you're in a precarious situation. Wouldn't it be good to cultivate a kind of happiness that doesn't depend on a wonderful job or anything else?
I have to say I've never tried it; I was warned off it.
If you're doing it for the bliss, your motivation is wrong, and you are at risk of vanity and playing power-games with people. If that happens, you will suffer harm.
If you were asking why I think religion is not for children, well: I think tales about fairies, angels and Santa Claus are not for children. I don't think you should lie to children, nor encourage them to subscribe to superstitious beliefs. By "children", I mean anyone with underdeveloped critical faculties. I read fairy stories to my kids, at bedtime; but I didn't pretend they were true.
Some religious systems present very interesting ways of looking at the world, the mind, and morality. But it's like hard drugs; it affects your mind and your relationships, and not necessarily for the better. I think that tangling with a religious system should only be done with care, and under appropriate supervision. The matter of how to choose a suitable spiritual mentor is an unsolved problem.
> They knew he would never get drugs when I was there. He wouldn’t shatter the illusion he and his family crafted for me. It wouldn’t be worth it, not even for a fix.
seemed to be something that really worked? albeit for the while
Migraines are frustrating because there are a thousand different potential causes and no one really understands their physiology. Many people don't respond to medications (outside of opioids, maybe) and even then, a migraine is far more than just pain; it appears to be a general disruption in brain function, possibly related to a phenomenon known as cortical spreading depression, and is often preceded, accompanied, and followed by vague psychological and even gastrointestinal disturbances. What's worse, you may be lucky enough to find a medication to mitigate the pain, but the psychological disturbances generally persist even in the case of a successful abortion. Frequently that means cognitive slowness and emotional disruption that can last for days.
Likely migraines are actually a manifestation of numerous abnormalities which are not always present in all sufferers, and I imagine that makes them particularly difficult to research, especially with first order statistical correlational analysis. Maybe ML will help here with the right data. The only certainty is that a better understanding of and cure for migraines would bring relief to millions of people who suffer unnecessarily.
Can you please elaborate? What kind of data would you need? What would be the learning task?
The result has been a disaster. People on meth run around the streets at night causing chaos. Homeless people on heroin leave needles everywhere. People avoid transit and parks now because there is regularly someone losing his or her mind nearby.
Long sentences aren’t the answer of course. But I do think that sending someone to a Nordic-style prison for a few weeks would be better for these folks than just letting them run free.
By the way, free mental healthcare doesn’t actually work because many of these folks don’t want help and won’t seek it willingly. There needs to be a way to forcefully separate them from the addictive substance for a time, stabilize their drug crisis, and then help them find long term care.
I think it's unrelated to whether drugs are a crime or not - homeless and drug users in general will find a way to get it.
It's a sad reflection on the state of society and our cities.
Personally, after a terrible experience in Paris, I decided I will avoid all big cities.
I think we should do something about it and forcefully throw homeless and drug users out of cities, but it's not a very popular (or easily enforceable, for that matter) point of view.
Do you also think that we should forcefully push the Sacklers & all of their paid off politicians out of the nation for what they've done?
I'm not sure I agree with the above poster about their solutions to the problem, but "solving" homelessness, or addiction, is a lot harder than making some broad brush laws about decriminilisation.
My cousin is a heroin addict, 12 years running at this point. He's in Dundee, the smack capital of the UK and quite possibly western Europe. Methadone is the worst idea possible for him, because he swaps it with the cancer patients for diazepam and then makes himself a happy cocktail. He's from a genuinely loving, supportive family, but still breaks into their house to steal stuff to pawn for smack money.
The only thing that would probably "help" him is full decriminalisation, but that would not help his victims, or his family, or the already overstressed health service in general, because the whole point of these measures is an expectation that addicts will suddenly "see the error of their ways", rather than thinking "wahay, free smack".
And back to the original point, when you have people actively preferring the street to the fully serviced hotel rooms, then you've probably got a severe structural problem. At which point it's easy to understand the above point of view, especially if you have a home and a family in close proximity to the inevitable social disorder (and I've also lived in Portugal. It is far from the free drug liberal paradise that some imagine it as)
We don't have all that many people preferring this. Pretty much all of these and all homeless shelters come with massive catches that are reason for why they are not viable solution for many people. It opens at certain hour and you have to completely leave with everything in the morning. Cant have work tools inside, cant lock doors. Noise.
The shelters themselves do have reasons for all those rules. One of them being homeless do make your mental issues and addition issues worst in addition to these people being overrepresented in the first place. But, framing these places as "fully serviced hotel rooms" as if that was what life in them actually looked like is not accurate.
In the same trip I've experienced several instances of homeless or just economic immigrants from Africa grabbing your arm trying to steal / sell you something.
There is also plenty of homeless peeing and pooping pretty much everywhere in Paris, which is disgusting enough.
I found London to be much better compared to Paris, even if things got way worse in the last few years. 5-10 years ago it was a rare occurrence to see homeless people, now you see homeless people sleeping everywhere and shooting drugs on the street like it's nothing.
I've since moved in the middle of nowhere and I'm definitely not going to raise my kids in a city.
I live in a market town. Small towns are often a magnet for druggies - they're safer than big cities, and they're often much nicer places.
We don't really want all the druggies from the Big City forcibly ejected, so they end up in small towns. Why should townies have to deal with the problems that Big City folk can't be bothered with?
If they can't integrate in society, they can go and live in the woods or start their own town, for what I care.
I'm not opposed to helping people with problems: I think we should use voluntary charities (eg. not forcibly taken taxes) to help them - but healthy citizens' lives should not affected because of the problems of a minority.
If that means keeping someone outside of cities, so be it.
If you have no home, it's hard to get a job. But it's hard to get a home if you have no income. So people end up on the street. They then face a choice of a street in a town, near to shops and services; or sleeping in a ditch in the boonies. I've slept in a ditch in the boonies, and I can't recommend it. And Social Services don't patrol ditches in the boonies.
A homeless person can disappear in a big city; it's easier for services to find them and help them in smaller towns. So if I was in a scrape, I'd head out of the city, to a smaller town.
With respect to forcibly taken taxes: they're taken "forcibly" because it's the law that you have to pay taxes. They don't usually come around with guns, to separate you from your belongings. We have a social contract, where I live, that we get free education and health-care and stuff, in exchange for paying taxes.
I was a fairly high earner, until I retired. I've never objected to paying taxes. I do object, very strongly, to corrupt politicians taking the piss with taxpayers' money; but in fact it's a small proportion of tax revenues that get stolen like that (here).
Frankly, I'm OK with the taxpayer paying up so that we don't have an underclass of people who are ill, psychologically troubled, homeless or intellectually challenged, and who are compelled to live under hedges. It could be me that's down on their luck, some day. If I were in that situation, there's a pretty good chance that I'd be resorting to substance abuse.
You're entitled to your views; but it seems pretty harsh to me, to simply declare that those people need to solve their own problems, and leave the taxpayer alone.
Is it perhaps also your view that the only legitimate use for taxpayers funds is to send armies to foreign countries? I'm not in favour of that. And I'm not in favour of taxpayer subsidies for diesel-oil for motor cars. I cough up, because the deal is that I either put up with the way collective taxpayer resources are spent (after making my point at the ballot box), or I leave the country.
As it happens, there's no other place I'd prefer to live. So here I'm is, very comfortable thank you, and I try to be kind to people who have to live on the street. Nobody would choose that if they had an alternative.
Why? Cannabis market thrive is US. More and more people use cannabis every day, making profits for sellers. Some people will switch to hard drugs and die, of course, but car incidents are not stopping car sales.
Things take time to get better, and as others have mentioned, most places that have decriminalized haven't exactly bolstered all other services that need to be around once decriminalization happens.
It's sort of like the amount of people who are pissed about how Chinese tourists act. Their nation has just recently entered a point in which they're able to be tourists. Americans have had decades to learn how to act and are often still shitty tourists. Things take time.
This is an inconsistent statement. In once sentence you say that free mental healthcare doesn't work, then in the next you posit that imprisoning them, then providing free mental healthcare is the answer. I think at the end of the day, people need to want to stop using drugs and have the help they need to do so. I don't think prison is the magic bullet for bringing about that change that you imagine it to be.
> People on meth run around the streets at night causing chaos. Homeless people on heroin leave needles everywhere. People avoid transit and parks now because there is regularly someone losing his or her mind nearby.
It's not realistic to expect only legalizing drugs to solve all your social problems. Why are there homeless people? Why are people having mental health crises on the street, and the only options are to ignore them, or put them in prison? I'm not sure what is meant by "causing chaos", but if they are committing non-drug crimes, why are they not being arrested?
It's the same freedom vs. detention debate and we've swung towards full freedom option in the US since the shutdown of mental health prisons and we've offloaded the care for the most difficult cases to police, ER, health workers, and they live on the streets. It's high time the pendulum swung back a bit with some (hopefully humanely administered) compulsory treatment options which is was the other commenter may have been getting at
So, you deregulate drugs, but for those who fall into addiction, you evaluate their competency to decide whether or not to take drugs, and if someone(s) decide they're not competent (a panel, psychiatrist, psychologist, whatever), you force them into treatment, take away their drugs, etc and so forth. If a drug dealer provides them with drugs, then they're breaking the law for a different reason.
Part of the problem is this "one size fits all" with drugs, and with criminalizing use rather than treating it as a disease. Call it what it is: someone not being competent to make decisions about drug use, period.
You get what you get, the best opioid or analogue that the doctors decide to give you, possibly with a slow release mechanism that avoids the rush but allows you function throughout the day, hold a job, not stick the first AIDS-infected needle in your vein etc.
Anecdotally, a close friend of mine sold his buprenorphine so that he could afford to purchase heroin.
If you want to help people, you need to meet them where they're at. The moralizing "you get what you get" approach is only going to tide people over for when they can't afford to score the potent stuff.
Make that: free strong beer versus liquor that has a 2% chance to be mixed with rat poison, is illegal to sell or buy, and costs more to use than the average job pays. A quite compelling offer for any drunk, but, yes, some lost souls will still go for the "real" shit.
I understand the whole "reduce harm, addicts are lab mice caught in a chemical trap" philosophy. But providing ever increasing doses of hard drugs, as most addicts eventually require when left to their own devices, might be an even faster way to the grave.
Let a doctor make the choice minimizes overall harm, not consumer preferences.
Don't get me wrong: I am absolutely in favor of decriminalization, as well as other radical changes in our society's relationships with drugs, mental health, and addiction. But it would be catastrophically naive to suggest that legalized/decriminalized opiates are some kind of panacea.
If heroin didn't exist, these people would probably plain old alcoholics. The damage caused by an alcoholic is pretty similar to the wake of a heroin addict... It's not identical, but the overlap in causes & effects of abuse is pretty similar between the two drugs.
Ultimately, the problem is that some people reach young adulthood without having developed a robust set of emotional coping mechanisms for handling the stresses of their lives. These folks are a LOT more likely to fall into the larger patterns of self-destructive behavior that drive them back toward drugs, over and over again.
I think the ideal system is some sort of government-run one that is not out to profit, and keep on suggesting that maybe you don't need any drugs, but will give you some if you insist and are willing to watch a safety video.
I understand why people want to focus on legalization of drugs. It's a simple idea, with precedent in th US and many other countries, and it doesn't require expanding goverment spending or power. But it's just too simplistic to be useful. We cannot limit the harms caused by addictive behavior with pure Libertarian self-interest, because addiction IS a self-interested response to larger problems that the addict lacks the capability to handle, emotionally.
If we want to truly reduce the addiction, death, and suffering, we need to develop real, effective social services that help families and individuals on many, many levels. We need to plug the gaps in our children's emotional upbringings, which means permanently repairing the jagged indifference of our society that inflicts so much harm, in the first place.
In short, we need to let go of our fear of collective social welfare programs, and start truly giving a shit about each other.
Legalization is a necessary component of the overall solution that also includes social services intended to reduce both the need for drug use and mitigate any impacts from it.
I just wanted to emphasize that without legalization, we'd be failing before we started to fix the problem as a society.
Around here ads for alcohol has been banned since I don't know when despite having multiple producers, of which at least one classify as large on a national basis.
The last two decades we've also seen laws against tobacco coming into place and - as someone who had friends who smoked since early teenage years or in at least one case even well before that - it is kind of weird to see someone young smoking in public today so the law has obviously worked.
Fixed that for you. Truly sorry for your loss, but people make choices, and those choices have consequences.
Can we hold these two things to be true at the same time:
1. No one is forcing people to take these drugs. The choice to start is theirs. They are ultimately responsible for their choice to become addicted.
2. We should view an addict’s behavior through the lens of addiction, not the lens of a rational person making destructive choices. Addicts won’t respond to incentives like a normal person will.
We need to find ways to make it extraordinarily costly to start using drugs. This is how you prevent the crisis we’re in currently.
That means prison time for users. Heroin and fentanyl pour across the border due to demand for it. New users dabble in it because the perceived cost is low. If people understand that possessing or using means automatic and significant jail time if caught, then people are much less likely to even dabble.
Ultimately, people will still try it regardless, get hooked, and eventually get caught and sent to prison. And that’s a good thing. That means there are less users who are on a path to homelessness, overdose, and dependency on family, friends, and government programs. It also means less users out there to persuade others to start using. If we’re not going to run mental health hospitals with involuntary commitments, then prison time is what you’re left with.
Prison terms for using are five times as long as it takes to get users clean. Once they get out, if they’re caught again, the sentence is ten times as long as it takes to get clean. Each consecutive offense ratchets upward.
The result is twofold: users have ample opportunity to get clean and stay clean in prison, but most importantly, we create a society in which we simply do not tolerate drug use. It’s really that simple.
We are going to have as much drug addiction and use as we’re willing to pay for. If you lower the cost of using, you get more usage. Free usage sites with free needles and less risk will, and already has, resulted in more usage. The fact that people won’t recognize this is mind boggling.
If that was the case I don't think you would have written what you did.
Until we're able to talk candidly about the decisions that led to those outcomes, we will continue to mourn preventable deaths in the future.
For this to work, people need to think about the longer term consequences of their actions. They don’t.
My personal experience has been that life can be so unbearable, you’ll turn to anything to get some relief from the pain of being alive.
I’m fortunate to be high-functioning bipolar. My uncle isn’t and he can’t tolerant medication. It doesn’t surprise me he constantly struggles with alcohol, along with the rest of his father’s family.
The only reason I’m not an alcoholic is alcohol does not have any positive effect for me. It just makes me sick. Same with opioids.
Relevant to your quote, Philip said: The two basic topics which fascinate me are “What is reality?” and “What constitutes the authentic human being?” Over the twenty-seven years in which I have published novels and stories I have investigated these two interrelated topics over and over again. I consider them important topics. What are we? What is it which surrounds us, that we call the not-me, or the empirical or phenomenal world? — from https://urbigenous.net/library/how_to_build.html
I'm a strong proponent of the US taking the approach the Swiss took to combat their opiate epidemic in the late 80s and early 90s. Anyone that is addicted to drugs can get the drugs they want, they just have to already be addicted first, and accept the drugs in a safe environment. It would be extraordinarily expensive, but cases like Jacks are already costing us much more than just giving him drugs, keeping him alive, then having healthcare professionals be there at exactly the moment he decides he's had enough. The effect on new users would be profound as well: as all the current users naturally age out of wanting to use hard drugs, the majority of drug dealers (other users themselves), won't have the capability to introduce new people to hard drugs.
However, we seem to have this huge moral hang up in the US about giving addicts drugs, even though we know that will save lives and money by reducing crime and lowering overall healthcare costs. For all the money Jack's parents spent on rehab, and hours spent watching him, none of it could prevent them burying their son the day he got a bad bag of heroin. For a case like Jacks, only safe drugs and injection sites would keep him and the millions of people stable before they are ready to move on.
The US is just not prepared to do what it takes to solve the opiate epidemic, and it's so frustrating to what tens of thousands of people die while we aren't anywhere near getting our act together. It's a Vietnam war in OD deaths, every year, and the Sacklers just walked with no criminal liability. Unless we do something drastic to reach these people, the opiate crisis is never going to go away.
For many people, what you're describing all comes down to the law of love. It is not loving to give a person more of the thing that is destroying them.
Perhaps free methadone would be a better option?
EDIT: care to comment? I'd like to know why people disagree.
But removing prohibition is a far cry from providing free heroin to addicts... I understand the argument about removing the black market, but after seeing San Francisco in person it's hard to agree that free drugs and paraphernalia makes things better overall.
If my friend became a heroin addict, out of care for him or her I would not provide them with heroin even if I could afford it. Why should I treat other fellow humans worse?
Why is it different when we're speaking at a societal level? Love for neighbors should increase, not invert, when the number of individuals concerned increases.
Giving meth addicts forms of meth that are produced more cleanly would reduce the level of psychosis and would further reduce the price of meth to a point where it may not be profitable to produce (it's already cheap to the point where it's nearly unprofitable - it requires massive volume).
Giving addicts access to clean drugs provides you an opportunity to help them, a place to keep them away from others while they're using, a way to ensure they don't die while using, reduces funding to organized crime, and removes their need to commit crimes to fund their habits.
You may see it as treating them poorly, but ultimately, you're doing them and the rest of society a benefit.
Learn some history. We tried this. It failed spectacularly, as if in slow motion, for decade after decade.
Which is not to say there aren't humane reasons to fix these problems, especially if they aren't effective at reducing drug use anyway. But yeah, drugs actually are a huge problem and would be even if they were legal and free for all.
I'm pointing out that alcohol causes immense harms despite being legal, so likely other drugs too would still cause considerable harms when legal (even though yes, it's likely some, like cannabis, would be less harmful than alcohol almost no matter what total consumption settles on under legalization).
I was not arguing about why things are legal or not, only challenging the assertion that drugs aren't very harmful when legal.
And a pride that is essentially about avoiding shame; shame being the primary currency of those with an authoritarian bent.
That has nothing to do with my rationale... I'm curious where you got that.
If I give heroin to an addict, the only shame involved to me would be the personal feeling of shame from having caused harm to another human...
So I think this response is a straw man that doesn't address my point.
It's writing people off as lost cases. And many addicts WANT to be written off as lost cases, because a) they already did so themselves, but feel guilty about it, an official confirmation would be nice and b) it will give them access to painkillers.
Which is why I'm very skeptical of involving doctors in the first place in free methadone programs, if such programs should exist. It shouldn't be anyone's job to validate you if you say you're a lost cause.
It's really the abstinence only attitude I was talking about: why is it a big deal to give someone medication for the rest of their live if we know it will keep them alive, healthy, and allow them to live a fulfilled life? Addiction is just like any other disease, and it turns out medication assisted therapy is very effective.
Methadone works, and so do other medications, but it's only a partial solution. We need a rapid and massive expansion of these programs. We also need programs and medications to target people who go on Methadone, but keep going off. Why not give them Herion, if we can do it safely? What about if there is evidence they can become productive members of society?
Again, it's my view that although people OD from drugs, it's really the prohibition of drugs that are killing people through the incredibly unsafe and unreliable drugs people get. Supervised opiates are not dangerous, and unlike other drugs, cocaine, meth, benzos, you can safely be on them for years at a time nearly no long term effects. At least the long term effects of staying on them pale in comparison to the consequences of an OD.
60,000 people OD per year. What we are doing isn't working!
Why do you believe this to be true?
If you give out free product, you not only kill the primary demand, but most dealers themselves don't have a reason to continue taking risks - because they can benefit from the free product too.
Purely profit oriented dealers will remain in the market, which is now much smaller and even riskier, since they can only sell to recreational users.
Source?
I doubt you’ll find a source, but the number of users distributing small amounts is probably larger than the amount of people pushing weight (who usually don’t use)
This is based of my experience buying heroin in a mid-sized US metro area, fortunately far in my past. One without an open-air drug market, so deals were done in cars or alleys.
If addicts can go to a boring clinic and get it daily for free maybe they'll at some point look up and wonder why they're doing what they're doing.
Especially if the clinic has easily available assistance and things that can help people quit.
Even in the worst case where they remain addicts, at least they won't OD and they're not funding organized crime.
Probably not as easy with meth though - it's one thing to be addicted and still responsive to incentives, psychosis is a harder problem to handle.
Because, unless you are using the term "friction" to be so all-encompassing as to be meaningless, this sounds like a recipe for a lot of failed attempts to fight addiction.
New people will still be introduced to drugs, but there are definitely network effects in opiate addiction that can be mitigated when supply is transferred from an illegal source that requires people to organize and recruit new users with cash, to one that is organized and paid for by the government.
It's not perfect, but even decriminalization has had a pretty remarkable effect on Portugal, at least that's what the latest studies are saying.
But perhaps the addictive qualities and treatment is much greater than tobacco.
With heroin, I d argue people are definite victims. It's absolutely not like tobacco, the craving is physically painful for long, not just the mild annoyance of tobacco.
To give you a few exemples: it takes me 3 days to a week of being irritated to stop cigarets for a full year, cold turkey. For injected heroin, it's 2 weeks of extreme pain with possibility of hospitalisation, for Subutex, an alternative pill, it's around a month (so many addict complain it s easier to take a break from heroin than the progressively reducing alternative medicine).
My dad is a pharmacist in France where we treat drug addicts who want to recover as victims and help them get alternative subutex or methadone for free: he told me he never saw someone truly stop. They can reduce and live with it, but they cannot possibly stop.
Your increasing tax solution seems unfair, while it seems fair for me with cigarets: it's my fault and I can stop. Not an heroin addict. I dont have a magical solution, in France we focused on stopping the violence due to the craving with free Methadone in pharmacies and it changed the criminal landscape, but destroying the product supply at the source while keeping the last addicts on Methadone seems like the only path, if the goal is to free people from opioids in France.
In the US it's different: opioids became a for profit pharmaceutical entreprise, and most of the crisis there is due to opium sold hidden as painkillers totally legally on a large scale.
> My dad is a pharmacist in France where we treat drug addicts who want to recover as victims and help them get alternative subutex or methadone for free: he told me he never saw someone truly stop. They can reduce and live with it, but they cannot possibly stop. In the US it's different: opioids became a for profit pharmaceutical entreprise, and most of the crisis there is due to opium sold hidden as painkillers totally legally on a large scale.
A refinement might be to tax legal painkillers that pharmaceutical companies, drug distributors and hospitals are prescribing to the populace from which they make profit from. The tax proceeds could then be used to pay for the inevitable rehabilitation of the certain percentage of the populace that is going inevitably get addicted to it.
The refinement is that the general taxpaying populace doesn't have to pay for this out of the general funds, its explicitly the people profiting from the negative externality.
"It's easy to quit smoking. I've done it scores of times."
Interestingly, I think if hard drugs were legal, very few people who don't already use them would go out tomorrow and give them a try, "just because", so its' not like we would have a complete societal meltdown if it happened.
I just think the US should look to other countries, and start off by implementing what works there. Even that is radical!
All that does is create a perfect window for new users to use tainted black market drugs and die. It's also essentially a government endorsement of the black market and the violence that comes with it. I think we need to move past those cowardly policies and craft laws that respect the reality that drug use will always be part of society. Playing make-believe that we can stop drug production or sales is too expensive (in cash and life) and has been proven comprehensively ineffective over several generations.
The Swiss are roughly 1/10th as likely to use opioids as Americans and of their users ~85% are in rehab. Relatively speaking it’s a tiny illegal drug market.
From the essay, it sounds like Jack was not possessed of any great "talent", or of any particular value as a "raw human resource". He was just a dude, probably easily replaceable from a HR perspective, and these are the sorts who, historically, we are willing to sacrifice in order to honorably lose a war on drugs. (If you want to know what kinds of sacrifices are required to win a war on opiates, Mao is the "best" recent example.)
We live in a cruel economy, where the "losers" are left to find solace in electronic toys and mystery fentanyls sold as heroin. Mostly, the losers are determined ahead of time, and their numbers grow as the middle class shrinks. It's an inhumane system with inhumane outcomes built in.
*I know I'm reading too much into your word choice, it's not meant as a personal attack, it's just useful as a jumping-off point for this post. If I were a better writer I would have figured out how to avoid this impression, but I'm not, so please take my word for it. I think you are basically right about the humane way to handle this.
I've seen a lot of smart people fall to drugs. Sure, if they get in too deep too early, they won't have a degree when they die, but they could have had one.
And yes, as an HR person in a comparatively small company, this person is easily replaceable. On a country scale, however, you can't simply replace him - you need the numbers of highly educated smart people and you can't simply "hire" them back from another country. Look at the stereotype of the asian genius - disregarding the other factors, China simply has 3-5 times [0] the population, so they will statistically have 5 times the geniuses to start with. You can't compete when your best bets have a 5% chance to whither away due to drugs.
> If you want to know what kinds of sacrifices are required to win a war on opiates, Mao is the "best" recent example.
How so? I don't know what specifically you're pointing to, but given that other countries handle the situation better with less "sacrifices", I don't think they're necessary.
[0] Depending on US or EU perspective.
He waged war like a war. I don't personally recommend waging wars on chemical compounds or the desperate predestined "losers" of the economy, but there's something to be said for winning a war with cruelty vs losing the war with half the cruelty.
"It was the communist revolution that erased opium from mainland China. Mao Zedong , with his political apparatus that reached into every hamlet and home, was able to lay the beast low. He used a mixture of carrot and stick. Addicts were not condemned, but offered medical help and rehabilitation. But those who were unco-operative were sent to labour camps or imprisoned. Dealers were summarily executed, often without trial." [0]
"Smart" people getting hooked on drugs is exactly as tragic as "losers" like Jack, any competition which ignores this is one we should be enormously proud to lose.
[0] https://www.scmp.com/article/547678/maos-drug-lesson-world
[0] https://www.scmp.com/article/547678/maos-drug-lesson-world
[1] https://en.wikipedia.org/wiki/History_of_opium_in_China#Unde...
[2] https://www.thesun.co.uk/news/3906319/china-drug-dealer-mass...
I think part of our problem is we put first value on people by their economic output. We need to realize there's more to being a person other than how much money you can make some rich dude.
I was never addicted to drugs, but for the first ~25 years I struggled in life in much the same way. No education, no real job, no real direction, future, or perspective, no real friends, no girlfriend, what's the point? I suppose my situation wasn't quite as hopeless, or maybe I'm just a different person, and it probably also helps that drugs usually just make me feel weird in a bad way and never enjoyed it much.
Plus, I never stopped programming, or lost my interest in it. It just took a long time to scrape together the confidence to actually apply for jobs. For a time I was either jobless and programming stuff at home, or working minimal wage jobs and programming after work. At one place I managed to "hack" the computer used to scan barcodes and during night-shifts (with often hours of nothing to do) I would write some toy programs to pass the time (more fun than smoking weed outside like some of the other people were doing). I sometimes wonder what would have become of me if I hadn't learned programming as a young teenager, or had lost interest somewhere along the way.
Either way, we'll likely never know what "talent" Jack did or did not posses as he never really seems to have developed any due to a combination of his personality, environment, and just "bad luck". Even the most talented and gifted programmers I know don't "just" do it automatically; they still need to apply themselves and develop their talent. For all you know you might have it in you to be a word-class guitar player, actor, soccer star, or some such. But if you've never played guitar, acted, played football, etc. and developed this talent then you'll never know.
Jack might not be the best example of "raw human talent", but people like him contribute to the economy that are hard to measure, and of equal worth to anyone else.
I'm of the opinion that we shouldn't compare lives, but I guess we could compare economic value, and for the thousands in lost lives, even working the most menial jobs, that's still tremendous worth in a country where our birth rate is shrinking faster than ever.
You have to find a human being to perform the work of enforcing the drug laws. The US has had drug addicts for a hundred years, and the attitude towards opioids hasn't changed very much, but the usage levels go up and down. There's a back-and-forth between "rehabilitation" and " incentivizing" that correlates poorly with the outcome.
What correlates better with opioid use? Recently, the epidemic clearly started with overprescription and then exploded with fentanyl:
https://www.cdc.gov/opioids/basics/epidemic.html
It's important to notice that prescription opioid overdoses don't go down until 2017. This problem started with prescriptions and it won't end until the problem is fixed. Pills should be replaced with patches wherever possible.
The other glaring issue is that the meteoric rise of fentanyl was not noticed until it got out of hand. This is a societal problem: drug messageboard users knew about the fentanyl crisis years before the regulators took any action.
The regulatory system, viz. the DEA, has been starved for talent for decades because nobody wants to work for them. The enforcement-for-profit model of the civil asset forfeiture era of policing has driven talented and motivated people away from law enforcement careers. The people who are left are not qualified or motivated for the task at hand. Enforcement should be more proactive than it was. It should focus on real dangers, not culture wars. Opioids and dopaminergic stimulants are the drugs of self-destruction; everything else is a distraction.
The most ironic thing to hear people chanting in an epidemic of poisonings brought on by illegally and irresponsibly manufactured high-potency addictive drugs is "abolish the police!". These people need the police. But nobody trusts the police.
One quote we were all forced to memorize in school was: "A house divided against itself cannot stand."
20 years ago, sure, who cares about the DEA, they put dope and guns on the table and largely stayed out of peoples way. Now, we have around 60k thousand deaths per year from the opiate crisis that reaches almost everyone in America. Law Enforcement has no solution, just carry around Narcan while drugs come in through every major port and postal facility in the country.
Let the cops do what they are good at: reduce violence, enforce property rights and keep communities safe, but stay out of healthcare. Give the DEA the best grads, and that won't change the fact that they are working in a system where they simply don't have the power to stop two consenting individuals engage in a prohibited behavior.
Here in Europe doctors are very, very conservative with that stuff (and meds in general) while it seems to me that in the US if your "medical experience" even entails the slightest bit of discomfort people get all up in arms over it. Doctors are highly educated people who can no longer play the "I didn't know it was addictive" card.
I have a friend in the US who told me they have an app on their phone where they can just tap a button and the next day they can refill their benzo prescription, and it's been like that for years without having seen a doctor again. That's just criminal behavior from the part of the medical establishment.
It's complicated for some people to admit the 'war on drugs' has failed maybe, but that's a different issues all together.
IMHO this is because of alienation, a loss of community, strong personal bonds, lack of goals.
There's a famous experiment that sums it all up perfectly - the one where animals were given an unlimited supply of cocaine and they took it until they basically starved themselves to death. But when they put the animals in a nice stimulating environment with toys and friends to play with they basically ignored the drug supply.
So yes, providing govt run shooting galleries will stop people from dying and you'll make them slightly less miserable but those people will still live lives that you wouldn't want for your children. They have an illness that needs to be cured.
I think you're referring to the Rat Park experiment (https://en.wikipedia.org/wiki/Rat_Park), and (as always) its conclusions are not as solid as the myth implies. That's not to say its results have been disproven, but they haven't been confirmed with other studies either.
My partner had a post-cancer DIEP flap reconstruction last month at a top cancer center in NYC, and due to the nature of the surgery, couldn't take NSAIDs, which are typically most effective for her (they have blood thinning side effects and were banned for 2 weeks post-surgery to avoid risk of hematomas). So she was left with taking over the counter Tylenol plus prescription opioids. They prescribed opioids 2 days of pills at a time, which required me to constantly drive to pick up new prescriptions (since obviously she couldn't drive), and it felt like some kind of interrogation each time she'd call up and report her current pain levels. As if they assumed by default she was lying or was a drug addict or something, versus someone recovering from major surgery that doesn't heal in 2 days, and furthermore is not allowed to take anything else that's effective (NSAIDs). Hours spent writhing in pain trying to get some pills prescribed and picked up. It only got resolved once the two-week NSAID ban was up. Then she stopped calling about the opioid-based analgesic and just started taking large ibuprofen doses instead. Problem solved, since you can buy as much ibuprofen as you want. But a pretty shit two weeks up until that point.
As a result, I strongly dislike a number of aspects of the anti-opioid backlash. It made our lives worse and caused us more suffering.
I don’t respond much to opiates anyways, but I still find it completely ridiculous.
There's a big distance between "5 days worth of low dose Tramadol" (+ max dose of Paracetamol) and "2 months worth of Oxycodone". It's really not a hard problem to solve for the medical establishment.
As a kid I had migraines, and quickly developed an immunity to the pain-relieving aspect of paracetemol, they were basically candy by the time I was a teenager. Luckily they disappeared in my late teens, but now I'm in my 40s and I get weird pains they call "cluster headaches" in my face. I did some tests, got an MRI, and they didn't turn up anything, which is pretty much the end of medicine, pain management is all there is for me. In Australia we need a prescription for any opiates, so I have to be treated like a drug addict to get painkillers the rest of the world can buy over the counter, it's a disgrace.
if you have not already done this, you could consult an "migraine center". There is no cure but there are some effective (for some people at least) options for treating cluster headaches, like triptans and lifestyle changes (regularity in sleep patterns, etc.)
The good thing about opioids is that you can dosage them precisely, and that you have plenty of opiates in a ladder of potency. Tramadol (sold as Ultram in the US) is a middle-ground painkiller despite being an opiate. Same as codeine. Slightly above is tapentadol. Curious thing is despite tapentadol has not been found addictive (at least as addictive as other opiates), it's still an opiate, and so the FDA put it in the same bucket as fentanyl and morphine.
Another analgesic is cannabis. Sadly, it has the same problem as opiates: it was deemed too fun or too good, it seems we must endure pain to make the regulators happy. It turns out people hate pain, so they end up taking fentanyl and heroing under a bridge.
The sad thing about all this is that the regulators decided pain is not a bad thing, so you must endure it. But they decided anxiety is a terrible thing, so you can get as much bromazepam as you need. Even when bromazepan and other benzodiazepines create dependence and tolerance (and the withdrawal is terrible), I'm sure you now at least a dozen people taking it cronically (I do). They are as hooked to that thing as it was heroin but, hey, it's legally prescribed, so no problem here: one pill for breakfast, one before bed, and they are 24/7 high while nobody bats an eye.
Having to do it on the regular would be just cruel.
> I have a friend in the US who told me they have an app on their phone where they can just tap a button and the next day they can refill their benzo prescription, and it's been like that for years without having seen a doctor again.
Is this the "request a refill" feature that every US pharmacy offers? Granted, benzodiazepines are less restricted than stimulant drugs¹, but a doctor in the US need to at least review a prescription twice a year.
Chronic (daily) of benzodiazepines is bad, and doctors will not² start new patients on this.
There's still a lot of legacy patients who are on chronic benzodiazepine treatments -- doctors should work with them to wean them off, but it's very challenging and disruptive.
Requiring a patient receiving a benzodiazepine at a non-daily level (e.g. for seizures, anxiety, occasional insomnia) to go back to see their doctor when nothing's changed several times a year is just pushing medical costs (money/time) on the disabled.
¹: e.g. Adderall, which can't be refilled
²: Providers are trained not to these days, at least
Docs in the US tend to think they are above being marketed to, but Purdue Pharma knew better, and they paid their drugs reps a ton to go out to "everytown US" and convince doctors that they had made a non-addicting opiate. Enough docs bought it, and here we are.
How did they do? Well, 20 years ago drug reps used to be able to take doctors on trips: to sports games, to see the dog races, to museum trips, the price of a day trip with you and one or two loved ones was to sit through an hour (or two) lecture by a rep that convinced you to to prescribe a drug. Not a bad deal!
There were complex reasons why the opiate crisis started, but the environment was ripe for an upstart company like Purdue to come in, reformulate an old opiate, pretend the addiction problem isn't there, then sell a miracle drug because opiates are extremely effective short term analgesics. Long term, we're still paying for it!
I've looked a lot into the opiate crisis, and it's a pretty bad stain on the US medical institution, particularly our medical science. We fucked up.
I mean we spent $300 million a day for 20 years on Afghanistan, it can't be that expensive.
>the Sacklers just walked with no criminal liability
In fact, the media firestorm and the political response made heroin overdoses much worse because they "clamped down" on pills that at least had a dosage on it. Addicts then turned to heroin, which now has fentanyl in it.
Not since around 2016, which is around when the panic with pills started and we started cracking down. It did put a small dent in pills but fentanyl is off the charts. We probably would have been better off, at least in terms of deaths, if we had just ignored the "opioid epidemic."
https://www.drugabuse.gov/drug-topics/trends-statistics/over...
The Sackler decision had a pretty big effect on me. It's hard not to grow up when I did, lose people you know to the opiate crisis, and not feel a deep sense of unfairness and wrong when the people responsible for so much suffering stay out of jail with a million dollars.
As much as you can blame them for that one act, it's the iron law of drug prohibition at play: Meth becomes Crystal, and opiates become more concentrated. Easier to smuggle, better profit margins, it really only goes one direction: the drugs get more potent every year prohibition is in effect.
This is a false narrative. Tobacco use kills 7-8x more every day, week, and month in the USA. That's a legitimate industry, though, so that's not pushed on the news.
Opiates aren't that big an issue, they're just the one the media tells you to care about.
The Swiss experiment in the 80s and 90s was a complete disaster, and it wasn't until the 2010s that that part of Zurich was finally cleaned up. It attracted the worst junkies from all around Europe, it created a crime wave in a country that was crime-free. It didn't work, either, it just led to more addiction, death, and despair.
I've literally not seen a used needle in at least a decade, but again, I'm not sure it's because of policy, it seems more likely that people have just, for the most cases, switched to different drugs.
We were never warned about drugs in primary and secondary school as there weren't any - with the exception of cigarettes, which some kids tried down behind the school toilet block but that was more a defiance of authority than a real problem. Drugs were never the topic of conversation amongst us at school.
The first time I came across discarded needles and syringes was quite some years later when I was walking around the Colosseum in Rome. It was a bit of a shock to see them in such a renowned place.
I am forever grateful that we kids grew up in such innocence of drugs (that wasn't true of other dangers however).
Fortunately, my family seems to have escaped the illicit drug problem and I no longer live in a rural area, nevertheless sometimes I wish I had Dr Who's tardis to escape back to a much simpler time - at least for a short respite anyway. :-)
They (local gov) tried a lot of things to fix the problem. Play classical music at the gathering area (the train/bus station). Free methadone. Free needles. Free heroin I don't believe was tried. Give the homeless a task like selling a newspaper called 'street journal', watching everyone pass by looking down on the seller. Cynical me would say these people passed away. I met one of them at a work reintegration company, and I recognized him right away. He had HIV. Though this was in ~2006. I let him listen to one of my favourite music at that time, and I remember he enjoyed it.
I learned of the popular drugs in first of high school (age 12), as part of education (alcohol, cannabis, XTC, heroin/cocaine). In my late young adulthood I ended up trying quite some drugs. Mostly psychedelics, never heroin (or cocaine), and amphetamine only once (from which I know how it feels to be an asshole). They are far too addicting, and destroy lives. I've been addicted to nicotine/cigarettes though, but so has 25+% (?) of society. It was tough getting rid of that habit (I am probably still 'addicted to it' just not practicing).
Lots of good movies (and books) were made about heroin addiction. Wir Kinder Von Bahnhof Zoo. Requiem For A Dream. Trainspotting. Just to name a few. The social setting a (young) person is in is going to have a huge influence. Sure, its also a matter of morals and values and parenthood, but how can I affect which friends my children are going to have in school?
Limited first HAT experiments were found sucessful, and thus expanded in 1999. In 2008 both approaches entered the law.
All data from here: https://doi.org/10.1186/s12954-020-00412-0 , but you can found it in a lot of papers.
The opioid/heroin epidemic that hit the whole Europe, took place in the 80's, with AIDS making it worse at later 80's and early 90's, causing all countries in Europe to tackle the problem hard starting in the early 90's. Yet you claim that HAT not only was shutdown in early 90's but that it was the thing that created the mess.
Dates don't add up, sorry. Maybe you are talking about a different swiss experiment, and not the internationally famous HAT.
https://en.wikipedia.org/wiki/Platzspitz_park
They shut it down in '92, which led to junkies spreading throughout the city, particularly on and around Langstrasse.
It wasn't until a real crackdown that things got better. They tried a few approaches like the treatments you mentioned, but that's very different than the laissez-faire decriminalization experiment that blew up in everyone's face.
There's a good documentary or article about the whole thing I meant to recommend but I can't find it at the moment.
It's obvious that if you put all the junkies of a county in a single park, without even the minimal hygienic measures, you create a mess. That's not laissez-faire, that's a mess, but to their credit at least they tried something different than the cycle "heroin user -> scum to jail or to cemetery". It would happen with anything imaginable: "now all homeless are allowed in the Platzspitz Park and nowhere else", a month later the park is covered with homeless trash to nobody's surprise.
The HAT is a step further (not backward) in decriminalization: you are hooked to heroin, metadone doesn't work. But you are not a criminal, and thus we will take a medical approach.
Absolutely, it's harm minimization for both the addict and for the rest of society.
> It wasn’t until a real crackdown that things got better.
Yes, there was a crackdown, but it’s not like this hadn’t been done numerous times before, both in Switzerland and in other countries, so this hardly could have been the major cause of the permanent improvement (which I think we both agree did indeed occur around that time).
> They tried […] the treatments you mentioned
And THOSE were the new factor, and THAT is what made the difference. The Heroin assisted treatment is still in force (an article a few years ago mentioned that about 1400 addicts in Switzerland are in the program).
Well, that's the issue. No one area within a zone of free travel can exclusively do this. That is, if Ohio did it, druggies throughout the US would go there.
But, as I understood the idea, the free drugs were required to be consumed on premises under the watch of a professional. So why would any drugs even leave the facility.
They wouldn't need to. Supply follows demand. When you get enough users in one spot, you'll find dealers. I'm strongly anti-prohibition and I think safe supply and safe injection sites are crucial, but there's no silver bullet. Every simple solution will cause knock-on problems.
The best we can do is to aim for harm minimization whilst understanding that the minimum will never be a deep notch but will always be shallow.
But yeah, implicit in these free drugs proposals is a good deal of concentration: bring in the addicts from all over the place, and make them take their drugs in this place here. It brings it's own can of worms. Which I guess is why many methadone programs come with no requirement of supervised use. Sure, they ask for too much (given tolerance, there's little way to know how much they need except skiing), and sell the surplus on the illegal market to users who aren't able or willing to join the methadone program... leading to more deaths from methadon overdoses than heroin in many years. But it's not clear the alternatives are any better.
I do think I got the dates wrong. What I'd like the US to do is adopt a similar liberal approach to prescribing medication assisted therapy, and go as far as we need to go in finding the medication that work for people, like is done today in CH. I don't think the "free firezone" approach is a good idea (akin to "hampsterdam" in The Wire), but getting addicts healthcare and a medically supervised substitute is what I meant. The big part of that in the US, IMO, is fighting the social stigma around adopting science based approaches large scale addiction management, and right now the only acceptable solution is to get people off drugs, then have them OD when they get back on. There is a better way!
I suspect you have your dates wrong, they didn't get a handle on their problems until the late nineties and early 2010s.
https://ssir.org/articles/entry/inside_switzerlands_radical_...
The aspects of the Swiss approach I wish the US would take the most are the willingness to try something fundamentally different. For the Swiss, it took a few tries to ultimately work out, but I don't see why the current solutions to the problem they use wouldn't work in the US.
The fact that they did, has to be amongst the top crimes of the century.
That justice can fail so spectacularly is treason against the citizenry. Not only does it undermine people's belief in rightful justice but it also brings law, order and governance into disrespect.
If you want to sow the seeds of anarchy then this is how to do it.
Recently heard this podcast with Lex Fridman and Carl Hart (author of Drug Use for Grown-Ups) and talk about this
It's possible that by vigorously pursuing and prosecuting the people who can afford to purchase and disseminate hard narcotics - instead of the users and a pusher or two - most of the problem would dry up.
I'm not optimistic about that happening. The little guys are easier to catch, and caps are feathered. Meanwhile, the big guys have contacts and probably political connections.
That said, the opioid crisis in the USA has been largerly fueled by prescription drugs. If by little guys you mean doctors, and big guys you mean the manufacturers;well there's been some progress on that. But obviously and certainly not enough.
Let's also not overlook the convenient blind eye of regularors (read: government).
This will not only kill the bulk of market and force dealers out in the open to find new, high risk recreational customers as opposed to cash cow addicts; but will also give a livable life to the addicts by preventing the financial and personal ruin brought by addiction to a substance that is made artificially scarce and expensive.
Most of the problems with addiction stem from this scarcity, not addiction itself: addicts take up a criminal activities to finance their consumption, lose all property and social capital, the product has high variability in potency and adulterants and is very risky to consume, they have to deal with criminals on a daily basis to get it etc.
https://time.com/6108812/drug-deaths-safe-supply-opioids/
I am not sure that the solution is a pharmaceutical product…
And I say this as someone who has been pro-science his whole life. It’s just that training people that a pill will solve their problems is a recipe for creating addicts?
My point is that stuff is so widely available and easily accessible that no sort of enforcement against the higher ups will do a damn thing
Treating the addict with compassion and diligence will be far more effective than attempting to dry up the supply. It of course won't be easy and actually will require a mental shift regarding users
Instead of headlines of law enforcement patting themselves on the back about some meaningless bust
I've lost 2 friends to fentanyl poisoning in the last 3 years, and I lost my brother 10 years ago to chronic meth use. I'm so utterly sick of this.
That said, I haven't lived your experience, so I can't really know what you're feeling...
Is there really a way to show that if the war on drugs never existed, the same number of drug users would exist, thus making the war ineffective? I'm not sure how one would prove this. It seems possible that without the war on drugs, the impact of drugs could be even greater, but again, hard to prove that.
Just an anecdote but in high school my entire reason for not smoking weed was because it was illegal, even though one of my friend groups was really into it.
https://www.vox.com/2016/5/8/18089368/war-on-drugs-marijuana...
Also see el Chapo. Did either of those high profile busts make one iota of difference? Did the price of cocaine change (hint, it did not) and I all but guarantee the same can be said for meth, heroin and fentanyl. They all cheap to produce and extremely easy to obtain while still being pretty cheap when it hits the streets
If you destroy demand, you’ll crush the cartel’s bottom line. But that would end the nice gig the DEA, cartels, and drug addicted in this country have going on, so I’m not holding my breath.
> If users are in prison, they can’t buy street drugs.
is really the ultimate cherry on top. Do you really think prison contraband is extinct?
It seems like every solution in this thread is something other than “punish people who buy or sell drugs.”
Can we at least try ruthless enforcement before we try free drugs for addicts paid for by taxpayers?
That you'd rather call a real solution to this issue "perverse" and "sadistic" betrays your own cynical view: you really don't care that much about people like Jack. You'd rather grandstand with your smug, politically correct view than actually help people like him.
Why was it so easy for Jack, a high school kid in a small town in the Northeast, to get his hand on hard drugs like this? The answer: we stopped having the stomach for being tough on anyone connected with drugs, by throwing them in prison, and creating incentives to strongly discourage its use.
We don't hesitate to jail people for decades when we find them with illegal explosives or plans to commit acts of terrorism. If those people are successful, at most they kill hundreds of people. The use and distribution of drugs does much more damage and impacts millions in a massively negative way.
> Maybe a Slate Star Codex/Less Wrong reader would start diving into the efficacy rates of different treatment options and crawl through peer-review studies...
The best evidence based treatment for opioid addiction is Buprenorphine. Sadly you will not hear that from all treatment/rehab providers.
A lack of hope is a crushing thing. It can lead to drugs, crime, etc. It seems to get worse the more intelligent one gets (why am I a failure if everyone says I'm so smart? Or just being smart enough to know just how hopeless things are). It can be even worse if you know you'll never live up to your parent's level of success (look at all the sons of the older movie stars).
Fortunately, we don't have to simply accept the priorities of those who surround us.
Terrifying
An amazing multi generational history of how the Sacklers inflicted opioids on the US, made a fortune, and got away with no consequence.
It was pretty interesting to read this during pandemic times, and it’s a prime example of how institutions lose legitimacy in the public’s eye. The Sacklers had the FDA in the palm of their hand, as well as the highest reaches of the justice department, as well as large numbers of medical professionals who patients trusted to make decisions that wouldn’t harm them.
What gives me hope? That I can surround myself with people who I can help and who will help me if I need it, not any type of fancy concept or title (Governor Agency, BigCo, professional title etc…).
I wonder what’s being peddled these days as completely safe but survivors will look back on as absolutely foolish.
Although they have stuffed Giga$ into their pockets, most people also care deeply about their own social status, so have the Sacklers had severe social repercussions from their peers? Some of their peers or acquaintances of their peers must have been addicted.
Rich people can afford the absolute top-tier rehab (and probably can just start doing coke w/o repercussions).
If there is a positive part to the book it is indeed some very small sense of social justice outside of the legal system (which failed to hold them to account). Nan Goldin is an artist who lead the way in organizing protests and press that would lead to their names being taken off the very museums and universities they had paid to put their name on. They had worked hard, over multiple generations, to have clean name despite their business. Nan and others did a lot of work to make sure that changed.
I don't suppose that Giga$ makes you happy. I'm not sure what "social status" is like; is that the same as having friends who own Giga$?
I possess what I'd call "social status" - I'm not a pariah, my neighbours greet me on the street, and my kids and my ex-wives treat me as a friend. I own my home, and I have no debts. That's quite enough "status" for me. I consider myself pretty fortunate.
As bad as it sounds he may have wanted to end the suffering for him and his family
Unless, do you mean that the laws aren't enforced enough, hence the drug use outside law enforcement? I would argue that increased enforcement still doesn't help the problem, and crime and drug harm increase. Not to mention the public costs of enforcing these laws and imprisoning people on small drug charges with mandatory minimum sentences.
Are these policies helping these people get their lives back on track? I'd say its clearly doing the exact opposite. By offering no consequence to bad behavior, bad behavior continues. If this person was arrested and taken into custody vs released, they'd at least be put into a controlled environment where they would be fed and sheltered and have their medical needs attended to, versus let out onto the street with no direction where they end up right back where they started.
There are costs to the public for sheltering and treating addicted and mentally unwell, certainly, but I'd argue the costs to the public of the status quo are much higher if you were to quantify them. All the petty crime, the emotional toll on innocent people victimized, the price of a life when innocent people are murdered by psychotic people on methamphetamine, the price of ER bills passed on to everyone from someone coming far too late on deaths door with zero insurance, versus the much cheaper price on preventative care that would prevent these situations in the first place, is not a cheap price. But by continuing this status quo this is the price we all bear.
1. https://abc7.com/california-zero-bail-prison-overcrowding-gl...
But they execute you if you have over 500 grams of marijuana so a bit extreme.
I don't know how we could make that work in the US. We already tried alcohol prohibition 100 years ago, and that didn't work. Patent medicines were made illegal, and prescriptions are required, for this reason.
We've already recognized that overprescribed prescription opiates in the early 2000's was a deliberate attempt to bypass these protections and get people hooked.
> How to put that cat in the bag is anyone’s guess.
I think it requires a scientific process instead of a political process. IE, the politicians need to encourage medical professionals to keep trying many different approaches until we figure out what works. This will only happen when politicians stop criminalizing addiction.
FYI: All currently legal treatment options in the US HAVE to target ending addiction. Allowing someone to voluntarily maintain an addiction to anything is currently illegal, and means that only people who voluntarily want to stop their addiction are helped.
Fast forward eleven years, on my twentieth birthday, and I had a realization: my cousin was the first person I had known that I outlived, and I felt this sudden sinking feeling. Why had I been spared when my cousin had been taken so young? Why did I get to spend more time on earth then he did? It's not like I was some sort of cosmically better human than him, I had been a dumb teenager who was just lucky enough to not have friends who were willing to talk me into doing drugs.
I started asking my parents about my cousin, and it made me somehow feel even worse when I found out that my cousin had a bit of a downward cycle with drugs throughout the tail end of high school, tried joining the army in the hope that it might straighten him out, it didn't, and just fell deeper and deeper until he eventually died. Alcoholism seems to run in the males in my family (with the exception of my dad and me, strangely), so this sadly wasn't even really something completely unexpected.
Addiction is tough, I feel really fortunate to have dodged that bullet. I can't even pretend to know what addicts to hard drugs are going through.
A few years ago I worked a project with a young foreigner who didn't drink and actively spoke out against it as - in his description - the cause of much dysfunction in his country. Politics aside, I was actually inspired by someone significantly my junior to reconsider my attitudes. What if I took a leaf out of the self-improvement culture and just tried it? It might be too much for a lot of people to simply not drink. Life circumstance counts for a lot, but my life no longer includes socializing in venues where alcohol is served so it actually wasn't too hard to stop.
(1) https://drugabuse.com/featured/drug-and-alcohol-abuse-across...
I don't much regret my drinking days because I had fun and met many people. But then I realized I want to do other things than just get drunk and get a hangover.
I think, based on my experience again, that AA with its confess your sins and label yourself an alcoholic may help some people. But I think it's best to think what you want to do and accomplish, in life. Then do that. No need to keep on repeating you are an alcoholic. You're no more alcoholic than anybody else I would say. It's just that you have decided to drink and keep on drinking. It's your choice.
I‘m fortunate enough to be able to keep my drinking level at a point that helps me socialize and enhance enjoyment (the occasional bottle of wine with friends and peers), but not above.
I‘ve also experimented with drugs in the past because I was just too curious, but in the end, I was lucky to not end up some place I didn‘t want to.
By now I’ve experienced that ability wasn‘t just personal strength, but also my predisposition and experiences.
That does‘t excuse anyone from not trying harder, but it was a sober reminder for me to see that addiction is a way steeper slope for some of us.
That's kind of the dividing line, though, isn't it? If it's your choice and you could choose otherwise, then you're not an alcoholic. Some people don't feel like it's a choice.
The people at AA are by and large deeply broken, and trying to slowly reassemble their lives without crumbling under the weight of the knowledge - largely gained in sobriety - of the massive damage they have done to themselves and others, and returning to hide in addiction. This harm often includes the repeated abuse of their loved ones throughout their addiction, and their guilt is enormous. If they appear stuck, consider that at least they are stuck in a place where they are not drinking, which in most cases is an enormous improvement.
If you do not prefer the religious component what I would say to you depends on whether you are an addict or not. If you are an addict I would say you are in dire need of a serious dose of humility: admitting you are powerless and that you need the help of a higher being fits that requirement. If you are not an addict, you should really not attack an institution whose sole purpose is to help addicts. Just smile and nod.
For that to work, you have to suspend your critical faculties. There are no telepathic aliens. Angels don't exist.
But maybe we can change things on a larger level. Create a society where heroin isn't as appealing by comparison. Where there are spaces for socializing that aren't about social competition, or at least one where there are more distinct and equally good ways to "win". Maybe one where, if you fall, you don't have to carry the guilt that your family will be dragged down with you.
I was lucky enough to grow up with the historical teetotaller community, since my grandfather was a leader of sorts in it. They used to be very adamant on seeing alcohol use (and of course drug use) as a social problem, not an individual one born out of "weakness of will" or genetic factors. They quite deliberately tried to create new social arenas without alcohol, and cultivate a sense of community and common purpose which could make it more than yet another arena for social competition. But they quite literally couldn't keep up with the times. The social venues they made were of types that were extremely popular in their day, but are exotic at best today (e.g. lodges). And along with the rest of society, they gradually embraced AA's medicalized, individualized understanding of alcoholism, turning the message from one of collective self-defense ("we're building this to defend ourselves as a community from the scourge of alcohol") to one of sympathy with the medicalized Other ("We're abstaining out of solidarity with those individuals who will become alcoholics if they touch alcohol").
This is bullshit. People who want to beat their addiction and have the support from their immediate family are the demographic that most readily beats addiction.
When it comes to beating addiction, losing weight and all sorts of other things that require a lot of willpower having some personal motivation to do whatever it is plus a support network who can help you and encourage you is just about the most effective strategy. People care a lot more about doing hard things if they feel their family has a stake in it.
But it can be very costly on a human level, and there's still depressing outcomes.
It's not easy to run such family intervention initiatives. An old friend in my teetotaller org did it for a while, starting up family clubs after the design of a little known Yugoslav/Italian academic, Vladimir Hudolin.
There are things you can do, but they're not very effective and at best they help you and the ones closest to you. I'm saying, I think we should see it as a social problem more than an individual problem, and try to address it at the social level first and foremost. We'll likely always need rehab in some form, for humane reasons, but it's not possible to use it to paper over the deeper problems surrounding drug use. That's like replacing traffic safety with emergency medicine.
Literally every step of the way he could have done something. This is an unusually clear cut case of someone's actions leading to the outcome that they experienced.
There are attitudes that a community can express which will help or hinder, but there is no escaping that in this specific situation, to get a different outcome Jack had to make different choices.
I'm relatively neutral on drug addictions as a character flaw, it is very easy for me to believe there are people out there who would be making a logical choice to turn to a few moments of reliable pleasure in an otherwise miserable existence. I wouldn't touch hard drugs myself for fear that I would enjoy them. But, nevertheless, the only person who was in control of the outcomes here is Jack.
I think alcohol, tastes disgusting in general. It's fun to mix with other things to have a stronger effect, but I've always enjoyed everclear to accomplish that, which basically is just pure ethanol.
I never understood alcohol culture, bars, going out, etc.
And I always related that to not being "popular" or feeling calm in a new city or such. I think it's so strange to go to a place, have to wait in line, pay admission/cover, to talk to a bar tender that expects tips, and then pay extravagant costs for something that can be purchased cheaply anywhere else (yes, I understand the transaction/food/beverage/hospitality.)
Never will get it.
It is very obvious. It lowers inhibitions, causes euphoria, thus increasing the enjoyment of social interactions for many many people.
He wasn't taken. He took himself. Exercise: Everytime you remove agency, reintroduce it.
"I am depressed". No, you are depressing yourself. "I am helpless". No, you are making yourself helpless. These are active processes. Let's get more controversial: "I am being bullied". No, you are letting people bully you.
I know this is harsh. I know the societal memes and phrases are the warm place. A sigh, the Soma of "Nothing can be done" or "Somebody needs to do something!!" is not a solution but paralysis.
You can read it in the article: The parents did everything for the addict, he did nothing himself. It didn't work out now, did it? Never does.
(Not absolving the Sacklers of their guilt, that is a separate issue)
The kids killed in Syria and Afghanistan should've helped themselves.
Lol at bullying being more controversial.
But yeah life is harsh and the world is shit. And death is inevitable.
Nice strawman
> The kids killed in Syria and Afghanistan should've helped themselves
Never mentioned kids in warzones
> But yeah life is harsh and the world is shit. And death is inevitable.
Make an effort, coward.
Let's say depression is a purely biological problem, the chemical imbalance (it isn't), take a pill and be be healed! Right?
Now who sells that pill? Who lobbied to have depression seen as a disease?
Who invented the CO2 footprint? BP.
Are you asking why would they bring up a disease in a talk about what is commonly thought of as diseases, or are you asking something else?
> why are you deflecting
This is funny, because you are deflecting in your comment as well. If you feel like folks should not deflect, you should engage with what they say and then tell them to not deflect. Then it becomes more relatable, because it is not hypocritical :)
> chemical imbalance (it isn't)
Depression is a catchall term for many different problems. Some are well understood to be purely chemical (depression unrelated to thoughts, circumstances or environmental factors such as season or food), some are well understood to be environmental: That means "just stop removing agency" could be a way to tackle it, although it famously does not work for most people. Why do you suppose your answer does not suffice for most? Do you feel this is evidence of yet more weakness?
It seems to me you do not enjoy one-dimensional answers to your own thoughts, so why do you insist on having them about other people?
> who sells that pill
You might say the same thing about the smallpox vaccine: Someone sells it. Following your implied point: Perhaps this means that it is not a problem, clearly money changes hands so perhaps there is a profit motive (and potentially this means it is the only motive and potentially that means the requirements are fabricated. That is quite a leap!). While it is reasonable to follow such a thought process, perhaps in this case it does not suffice to follow it, recognise a potential problem and dismiss the original solution entirely. Mostly because if you talked to even-handed professionals (many of whom have similar concerns as yours, if a bit more nuanced by practical experience and what I would hesitantly call empathy), you might find that folks have considered these questions (and do every single day) and to this date they have not been answered in a way that provides a solution for every single case.
> Who invented the CO2 footprint? BP.
Emacs contains doctor.el which can help with issues like these. Back when I was into conspiracy theories (~2004-2007?), it helped me. One advantage of it is that you can keep your conspiracy theories for yourself.
“This is one of the most successful, deceptive PR campaigns maybe ever,” said Benjamin Franta, who researches law and history of science as a J.D.-Ph.D. student at Stanford Law School.
...
https://mashable.com/feature/carbon-footprint-pr-campaign-sh...
The term was popularized by a $250 million advertising campaign by the oil and gas company BP in an attempt to move public attention away from restricting the activities of fossil fuel companies and onto individual responsibility for solving climate change.[3][4]
...
https://en.wikipedia.org/wiki/Carbon_footprint
I have so many bridges to sell!
> He wasn't taken. He took himself. Exercise: Everytime you remove agency, reintroduce it.
I used the term "taken" as a rhetorical thing to ask a deeper question about cosmic unfairness. It makes no claims of level of responsibility and I feel like you knew this and just wanted to make a bizarre ramble about something you read in a bad self-help book.
> "I am depressed". No, you are depressing yourself. "I am helpless". No, you are making yourself helpless. These are active processes. Let's get more controversial: "I am being bullied". No, you are letting people bully you.
The hell does this have to do with my post exactly? I told a story about my cousin dying from a heroin overdose and you go off on (not even) a tangent about bullying or something.
Also, that's a pretty ridiculous thing to begin with. How are bullied people "letting themselves" be bullied? A kid that's bigger than them decides to physically hurt a kid smaller/weaker than them. What exactly is the smaller kid supposed to do? This isn't the god damn Karate Kid, life isn't a cheesy eighties movie, most of the time the kid just has to be bullied. It's not fair, it sucks, and victim blaming is not helping anything.
> Let's say depression is a purely biological problem, the chemical imbalance (it isn't), take a pill and be be healed! Right?
Depression is a blanket term for a lot of things, and is somewhat overloaded. Sometimes people just feel sad, and maybe telling them to get over it will work, but for people like myself with manic depression, it really isn't that simple. You can do any amount of exercise or dieting trying to suck it up, and everything will still feel hopeless, you'll still blame yourself for everything, you'll still catastrophize everything, you'll still yell at people who don't deserve it, and you'll still have to talk yourself out of bed every morning [1]. When that's the case, what exactly are you supposed to do? Are you disputing that those people exist?
Also, your hypothetical is completely absurd, there are plenty of things that have physiological causes that we can't just take a pill and be healed with. Do you think cancer is just an attitude problem? How about amputees? Are they just so stupid that they don't take a pill and be healed? What a strange and completely misinformed take.
I honestly feel bad for you. Whatever sequence of events led to this strange pseudo-edgelord hardass chud persona must have been tough.
[1] Not all depressed people and not all manic depressives. Describing my symptoms.
However, there are a lot of cases where things are out of someone's control and they're really helpless.
Like depression. Take a pill? No, it's wade through the medical system trying to find a doctor who will graciously grant you the magic paper. And if you don't find one, tough shit.
Then there's the case of a girl being chained and dying of dehydration, for which the accomplice wife of the ISIS piece of shit who did it got 10 years in prison. Not only was the girl helpless, she wasn't even helped by someone who could.
These two things made me reply. I probably shouldn't have, but whatever, we're all shitposting here.
Another argument against it, why not turn the mirror on yourself. Why are you not richer, stronger, more popular, happier? Maybe you are somewhat of all those things already, but a wild guess is that your not the strongest, richest, most famous and happiest person in the world. So why not, are you weak, lazy and shallow? Or, perhaps is the truth a bit more complicated?
I let a homeless man sleep in the hallway of my building. He took a shit in front of my door.
Now if I had seen the homeless as what they actually are, maybe weak, maybe helpless, but still people with agency who can be absolute assholes, that wouldn't have happened.
And I hate that this is overlooked. Maybe if the parents in the article wouldn't have fallen into this trap, their son would still be alive.
The assumption everyone downvoting seems to make is that I don't have compassion or as you do, I see them as "weak", "lazy" or "attention seeking" (notice how you are seeing them as that, not me).
I can have compassion and ask them to do their part. That actually solves the problem.
To be honest I'm not even sure how this new example relates at all. You're simply saying that people can do bad things, which I guess is true, though I don't see how that supports your argument. I don't think anyone was suggesting people have no agency, and can't possibly make any changes in their life, the suggestion is they don't have complete agency, and their life will always be governed by factors beyond their control. Taking your point, yeh, people can be assholes, but why? "Just because" isn't a proper answer, and if it is the same can be used to dispel your argument just as easily.
> notice how you are seeing them as that, not me
Hmmmm, not quite. Your whole argument rests on people refusing to make changes in their life for no apparent reason, and these are typically the words used. You didn't use them yourself, no, but I think it can be quite easily inferred, not least by the fact you called another commenter a coward. Again, following my argument, ask yourself why I thought you would think of them in those terms.
> That actually solves the problem.
Maybe you're right, maybe you're wrong. I suspect you're right in part, but things tend to be more complicated. Either way, thats not my point. My point is asking why they don't do their part, for example.
And there are people who make a good living keeping it exactly this way, making bank in the wake of the moral outrage of the "helpers".
You decided he was not worth as much as you.
There is a reason every single person in their life abandoned them to sleep in the cold.
If you wouldn't mind reviewing https://news.ycombinator.com/newsguidelines.html and taking the intended spirit of the site more to heart, we'd be grateful.
Have you actually done this, and did it solve the problem?
They are. They also tend to have high rates of mental illness, which often is what leads them to live transient lives. Leaving them in your hallway unsupervised, though well intentioned, isn't the way to help them. It didn't backfire because people are assholes, it backfired because you operated on a faulty understanding of the situation
Not is it productive to misinterpret his comment as perpetuating a tired trope and then launch into an emotional rant against something that literally nobody here is supporting.
GP did make a fair point - learned helplessness does nothing but exacerbate your suffering, and taking agency and responsibility for your own mental state is the most effective way to improve things.
Whether the solution comes through lifestyle changes (leaving toxic environment), a simple change in viewpoint or SSRIs, labelling yourself as depressed or burned out and then succumbing to your new fate is never productive. I know this because I've experienced both.
Which everyone who reads it can clearly see, and understand that I saw that kind of language as a possible response to my question of "why?". I wouldn't say thats any kind of trickery on my part.
> Not is it productive to misinterpret his comment as perpetuating a tired trope and then launch into an emotional rant against something that literally nobody here is supporting.
Theres an irony to saying I "misinterpreted his comment" and then immediately doing the same to mine. It wasn't an "emotional rant", maybe a bit of a rant, but I'm not going to apologise for that. I'm not sure which tired trope I'm perpetuating.
> and the rest...
I think you're missing my point. Perhaps, to use your own words, I could even go further and saying your misinterpretting it and launching into an emotional rant.
My point isn't that people can't change their circumstances, or that self improvement is pointless. Its that so many factors govern these things that its a fantasy to believe anyone is in complete control.
You're not depressed because you just are and theres nothing more to be done, nor are you depressed because you make yourself depressed. Hence why I argued to keep asking why, if you truly believe that your depression is caused by yourself, ask why you would do that to yourself, and keep doing so until you find the true reason.
My background is a recovering asshole, partially failing, aka the son in the article.
most people are social animals. it's easy to be an individualist if you have the trait and nigh impossible if you don't.
What about Bipolar and Schizophrenia, do you think about them same as depression?
> "I am depressed". No, you are depressing yourself.
You're assuming a brain that's in good working order. It's difficult to imagine a different one. Consider that not everyone's window into consciousness works like yours does.
You say you know it is harsh—that's already a reason not to do it here. Maybe "harsh" can do some good when there's already a strong relational connection with the other person. (Emphasis on maybe, because people who take harsh stances generally are paying more attention to their own ideas than to the person they're commenting on—but no doubt it does happen sometimes.) Here, however, you're broadcasting to thousands of people over the internet, with zero relational connection. In such a context, it's merely provocative and destructive, and one could even say selfish.
If you wouldn't mind reviewing https://news.ycombinator.com/newsguidelines.html and taking the intended spirit of the site more to heart, we'd be grateful.
I feel as if I did that. Maybe my writing comes across way differently, maybe my comments are not as direct as they could be - but if that is already too upsetting for this crowd, you will never get any actual critical comments. You will never arrive at any traction, at any truth. Too bad, I expected more here. My error.
Case in point:
> Please respond to the strongest plausible interpretation of what someone says
Nobody replying to me did that. Amazing.
I'm sorry - I don't mean to pile on! - but I don't think you did that. The comment didn't include interesting specific information; it was a moral hectoring. Those do not come across well on the internet.
> Nobody replying to me did that. Amazing.
Not amazing—quite predictable, given the provocation. In cases like this, the root comment bears the most responsibility. Here are some further explanations of what I mean by this, in case you or anyone want more:
https://news.ycombinator.com/item?id=28953253
https://news.ycombinator.com/item?id=28932445
https://news.ycombinator.com/item?id=27162386 (<-- long discussion with a user about a similar thing)
https://hn.algolia.com/?dateRange=all&page=0&prefix=true&sor...
> Nobody replying to me did that. Amazing.
You worded everything in absolutes. If you ask people to take the strongest interpretation of that, you're asking them to just concede that you're right.
I think you actually seem to get it that there's something dangerous about identifying with the problem (e.g. I am depressed) but you're jumping to conclusions about agency from there. No one who replied wanted to make that leap, nor did you offer any compelling reason to do so.
> Alcoholism seems to run in the males in my family (with the exception of my dad and me, strangely), so this sadly wasn't even really something completely unexpected.
Indeed, familial alcoholism is suspected to be a complex genetic trait (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4056340/). As for why you and your father seem to have been spared by that... if I may ask, did you two have access to mental health care and use it? A common theory in addiction research is the "self-medication hypothesis" (https://www.psychiatrictimes.com/view/dune-and-the-second-co...) - basically, that people accidentally discover during experimenting with drugs that the drugs help with mental or physical health issues.
Well, we've had health insurance for my entire life so I guess we had "access" to it, but as far as I know my dad never used it, and I didn't see a psychiatrist until I was 26 (and I wasn't drinking much before that, certainly not enough to be considered an alcoholic). He certainly didn't have access to it until he finished school, growing up in a relatively poor family.
I think at least in my dad's case, he saw how much his dad's alcoholism screwed things up, and decided that he was going to try and avoid that fate no matter what, sort of using his dad as an example of "what not to do." As I was growing up, I think I saw my dad drink a grand total of four glasses of wine, all of which were done on different New Years events, and never enough to get "drunk" or anything like that. As he's gotten older (and as his kids have all grown up), he's relaxed on that a bit and I will occasionally see him drink slightly more frequently, but I think that habit of sobriety has been somewhat ingrained into him at this point.
http://kevinsmithstory.blogspot.com/2011/02/me-and-my-shadow...