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.

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?

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. :-)

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!

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).

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.

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.

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.)

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.

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.

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 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

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.

Having to do it on the regular would be just cruel.

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

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.

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.

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.

[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...

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.

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.

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.

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.

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.

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.

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.

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.

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...

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.

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!

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.

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.

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.

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.

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.

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.

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!

"It's easy to quit smoking. I've done it scores of times."

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.