I believe this to be quite self-evident. A heroin addict can be quite a succesful and functioning member in society, provided that she can maintain her habit, without the hassle that comes with bad quality drugs and the stress (and invariably crime), which is required to maintain the addiction.
That all falls away when the drug is made available cheaply, regularely and even paid for by health insurance.
(1) The drugs shouldn't have been prescribed in the first place. This system was creating the cycle of dependence, not attempting to manage it.
(2) Oxy and other opiates were prescribed for specific medical issues rather than recreationally. That leads to drug-seeking behavior once the normal course of treatment wears off, and eventually when cut off from legitimate supply, illicit alternatives.
The oxycontin crazy created opiate addicts in droves because it was given out virtually unchecked to non addicts.
This doesn't deter. Besides, most folks don't intend to get addicted and only a portion do. Many more can use opiates medicinally or recreationally without addiction.
It seems decriminalisation works. Safety nets help. Offering free, medical-based addiction help would help. Prudent disussions with doctors when using opiate main meds would help - you know, what to watch out for with addiction, help if it happens, and not treating folks like criminals the rest of their lives if it happens.
I'd personally advocate legalisation of most drugs, even if I wouldn't do them, just to keep folks safe.
It seems hard to argue that supporting someone's heroin habit wouldn't incur a higher than normal cost for healthcare?
> The painful truth
You're immediately claiming truth. That blocks other viewpoints. Also 'painful' which is a weasel word.
> people who actively use drugs
as opposed to passively use them?
> and decimate their bodies
you presuppose what they do 'decimate' their bodies. Maybe they do but it's a bit short on facts innit. And related, does taking copious amounts of alcohol (which I agree does damage bodies) count, what with alcohol being legal and socially acceptable?
> when provided a steady supply of drugs will simply die sooner?
A presumption, although one I'd have real trouble disputing. But facts are needed here.
> It seems hard to argue
dude, more weasel words!
> that supporting someone's heroin habit wouldn't incur a higher than normal cost for healthcare
The article gives examples of higher healthcare (and police) costs for not supporting them. Quite explicitly.
Also
"when provided a steady supply of drugs will simply die sooner" and "incur a higher than normal cost for healthcare" may be incorrect - they may die sooner thus saving the NHS money because pensions and extended healthcare due to old age are avoided. I understand this argument has been made for smoking; smokers are claimed to cost less than non-smokers. I'll see if I can find a proper study for this.
> you presuppose what they do 'decimate' their bodies. Maybe they do but it's a bit short on facts innit. And related, does taking copious amounts of alcohol (which I agree does damage bodies) count, what with alcohol being legal and socially acceptable?
It's pretty hard to get Hepatitis C, AIDS, pulmonary infections, or collapsed veins from a few mixed drinks or beers...
> It's pretty hard to get Hepatitis C, AIDS, pulmonary infections, or collapsed veins from a few mixed drinks or beers...
I won't argue with the collapsed veins I guess, I don't know if there's a way to avoid that. I didn't know that pulmonary infections were associated with heroin, thanks for the info.
The other stuff is - I presume, and you may disagree - a product not of the drug but of the contaminants and circumstances. Hep & aids from shared needles (and see my other comment, <https://news.ycombinator.com/item?id=20165469> actually I presume it was shared needles, she was female so it may have been from prostitution). A proper needle exchange facility will fix that, perhaps.
Bad stuff certainly can happen from booze, stories like this <https://www.latimes.com/world/asia/la-fg-poisonous-mix-in-in... keep cropping up over the years from India. It's the contaminants which kill. There may have been similar stories from US prohibition but I can only find this <http://www.1920-30.com/prohibition/prohibition-poison.html> but it's actually from that age so its honesty may be suspect.
Regarding the debating style, it comes with practice - keep it up and all the best!
Society saves money with heroin programs, see "Chapter 4: Economic evaluation of supervised injectable heroin treatment" of http://www.emcdda.europa.eu/attachements.cfm/att_154996_EN_H...
My guess is that since we already have studies where people are given heroin as a form of rehabilitation, there should also be some studies about the cost of such programs. Wish someone could share some of them.
Why would ?
Look up Purdue Pharma and their colleagues. Pay attention to the shenagigans they applied to get millions of Americans hooked.
Argueably the only difference between that lot and your average street dealer is that the street dealer doesn't buy himself a bunch of politicians.
You really don't. You seem like a straight-laced individual, if I told you heroin were legal in the US tomorrow would you go get some? I seriously doubt it. Anyone who wants it can already get it. Anyone not using isn't going to start due to legalization.
You know what legal thing I hear is fun but bad for you? Autoerotic asphyxiation -- but you don't see me hanging from the ceiling fan.
I urge you to research the Portuguese model, where all drugs were decriminalized to massive success [1].
[1] https://www.theguardian.com/news/2017/dec/05/portugals-radic...
Also, don't forget to mention that Norway is currently running a test program to give free heroin to its addicts.[0]
[0] https://www.foxnews.com/world/norway-to-test-free-heroin-pro...
(2) As of October 2018 (shortly before legalization) 47% of all Canadians have tried pot. [2] Now that it's legal, people are just more willing to fess up to it. Again, it's nothing they couldn't get before if they'd wanted it. Further [3] shows that the percentage of people smoking pot in Canada did not in fact increase after legalization.
[1] https://www.vox.com/2015/2/24/8094759/alcohol-marijuana
[2] https://www.statista.com/statistics/587689/marijuana-consump...
[3] https://www.countable.us/articles/21403-statistics-show-cana...
[1] https://www150.statcan.gc.ca/n1/daily-quotidien/190207/dq190...
I understand that about 60% of heroin users can use it recreationally in the way you or I would have a few drinks then stop because we know our limit.
That figure came from a letter in mewscientist mag but I can't find it, so treat with skepticism. I get the impression its reputation for certain and terrible addiction is the from anti-drugs campaigns and they aren't reliable, by design.
The constipation?
I can guarantee you that if this were to be attempted in SF, they would have to have the drugs administered by medical staff. They couldn't just hand heroin and crack to the patients. Pimps and dealers would send in mules to get drugs that could be resold for cash. That would also probably cause human trafficking to surge.
Portugal's efforts to reduce addiction and homelessness sound great too, but those won't work here either. We need to find solutions that are workable for our culture... or wait for our culture to change.
As they do in the UK I believe. I was once in a branch of boots IIRC (boots is a UK pharmacist) in a midlands city where there was plenty of drugs problem. A rattily-dressed guy came in and they gave him half a measuring cup of some thick green liquid which he drank in half a minute, while he chatted with them. They were watching him carefully, 2 of the pharmacists.
I dunno but I guess that was methadone.
There's no reason to assume that they'd simply hand out the stuff, and if it was by medical staff who expected to be taken as they watched, that's ok I think.
I can guarantee you that if this were to be attempted in SF, they would have to have the drugs administered by medical staff. They couldn't just hand heroin and crack to the patients.
I'm not sure about the logistics, but don't think they're that complicated. Getting into those programs is tied to quite stringent conditions. Like a certain age barrier and a number of attempts to go clean. I'd wager that there's more prescribed Ritalin resold on the black market than heroin obtained through those programs.
In one sense I believe it was fundamentally successul: It turned the drug from having a "hero image" in the 70s and 80s into a complete loser drug.
Harm reduction is one of the pillars in treatment of addiction, which now is widely and generally accepted. Proven by two referendums in which the public had a say on the issue. And harm reduction is unarguably a good thing, when it comes to addiction.
Who they are going to resell them to?
He functioned more or less fine all things considered, but used to get a little more than he needed and would trade the excess for weed with a guy who used occasionally.
They were only small amounts, and it was methadone rather than heroin so all of those caveats apply, but the situation seemed harmless enough to me at the time.
I remember that sometimes he'd be a little more out of it than normal, though, and it was when he'd have his supervised "usual" dose as a part of the program rather than the takeaway prescription.
Not sure why the weed dealer didn't get on the program himself, but I don't know what's involved -- maybe he really was one of the mythical recreational users, or maybe he was selling it on (seems unlikely in such small amounts, but that would depend on how many people he had that same arrangement with).
Give out only some milligrams of decent, even "organic" stuff per person, once every day - and the logistics will make it impossible to export any amount worth it, even at the todays prices.
Drugs are recreational. By outlawing, or otherwise restricting drugs, a government admits to a decision to not provide environment and opportunities for recreation, or any other affordable opportunity for fullfillment.
By not removing those restrictions entirely, it admits it still desires the resulting oppression. So it's pointless.
This isn't an excuse to do the right thing, though. I'm sure they've said it about gay marriage, integration of schools, and marriage between "races", women voting, and so on. Culture will move forward.
https://www.foxnews.com/world/norway-to-test-free-heroin-pro...
That would be because Dr Marks can't see himself. The difference between a high functioning, long term heroin addict and everyone else is that the heroin addicts require large support staffs that keep them high functioning.
Not really. They require their regular fixes, but are then able to be quite functional, if highly addicted.
Where the requirement for significant resources come in is initially, vetting an addict for eligeability to enter the program.
After that it's only a question of controling the distribution. Pharmacies can function quite well as gate keepers in the process.
These do not constitute such a large portion of the population that you can say that folks who do not require them are rare. If anything it's the opposite.
The point I make is that heroin addicts require everything that everyone else requires, plus medical support staff that provide them with cheap and safe sources to feed their addiction. Equating this with the tools of the trade of medical professionals is absurd.
Pharmacies serve quite well and rather cost efficient for this purpose. It's not really that far away of their core business of dispensing prescrition drugs. The substance is different, but the logistics are exactly the same.
You may think that pharmacy robberies are a concern, but it's not really an issue. I accept that this may not universally be the case.
These systems are already in place. Maybe I'm being presumptuous but they have pharmacies where you come from, right?
If they didn't need to rob for their habit then the large 'support staff' of police is reduced.
You seem to have ignored the facts in the article. That, or there's more about your position that is not obvious, perhaps you know or have worked with some addicts and have additional experience I haven't?
Is there any doubt, then, about who is bankrolling support for prohibition and why?
A short read, a couple of pages. Extract:
" The [heroin] addicts on prescriptions, by contrast, looked like the nurses or receptionists or Dr Marks himself. As a group, you couldn’t tell.
Faced with this evidence, Marks was beginning to believe that many ‘of the harms of drugs are to do with the laws around them, not the drugs themselves’. In the clinic, as Russell Newcombe tells me, they started to call the infections and abscesses and amputations ‘drug war wounds’. So Dr Marks began to wonder: if prescription is so effective, why don’t we do it more? He expanded his heroin prescription programme from a dozen people to more than 400.
The first people to notice an effect were the local police. Inspector Michael Lofts studied 142 heroin and cocaine addicts in the area, and he found there was a 93 per cent drop in theft and burglary. ‘You could see them transform in front of your own eyes,’ Lofts told a newspaper, amazed. ‘They came in in outrageous condition, stealing daily to pay for illegal drugs; and became, most of them, very amiable, reasonable law-abiding people.’ He said elsewhere: ‘Since the clinics opened, the street heroin dealer has slowly but surely abandoned the streets of Warrington and Widnes.’
One day a young mother called Julia Scott came into Dr Marks’s surgery and explained she had been working as a prostitute to support her habit. He wrote her a prescription, and she stopped sex work that day. "
Just a perspective, not saying right or wrong.
Edit: added this:
" And something nobody predicted took place. The number of heroin addicts in the area actually fell. Research published by Dr Marks in the Proceedings of the Royal College of Physicians of Edinburgh compared Widnes, which had a heroin clinic, to the very similar Liverpool borough of Bootle, which didn’t — and found Widnes had 12 times fewer addicts. "