[1] https://www.economist.com/graphic-detail/2019/06/25/what-is-...

I don't disagree that there are vary bad sides to drug use, same as for driving, soda pop, cheese, whatever. But we shouldn't pretend in a vacuum that there are not also positives, and short of severe societal consequences (like with some hard drugs, perhaps) people should generally be able to choose for themselves

To non-drinkers who have never drunk alcohol or have not for a long time, it seems these flavours don't work so well, and all wine is quite nasty (this is anecdotal data from observing such folk).

So yes, subjectively I love the taste of a good red, or a well made cocktail, or a fine rum. But the effect of the drug is bound up in my neurological response to it as well as just the flavour.

Granted, the world may fall in on itself and there's a small risk time will stop.

It’s a gastronomic loss that people don’t experience this.

https://en.wikipedia.org/wiki/Indian_states_ranking_by_incid...

> This is a list of states and union territories of India ranked by incidents of human trafficking as of 2016, and is based on the number of convicted cases. The list is compiled from the '2016 Crime in India Report' published by National Crime Records Bureau (NCRB), Government of India.[1]

Of course this kind of data has its own issues (e.g. incidents that don't end in a conviction because of bribery or police/judicial misconduct or that don't get caught by police at all don't end up in it), but it's probably the qualitatively best data you can get.

I like how you phrased this as if it were a meaningful metric. Is "safe for women" more useful than safe for everybody including children?

Do you have perhaps things relating to brawls, muggings, drunk driving arrests and accidents, drunk pedestrian road fatalities, suicide rates as determinants for a safe city? I'd think they're more reasonable than a vague metric as "safest for women"

https://www.ias.org.uk/uploads/pdf/News%20stories/dnutt-lanc...

I would encourage you to read it before marking it as a “narrow view”. It is literally taking a broad view factoring in societal impacts. It is written by highly respected experts.

Alcohol absolutely has severe societal impacts: violence rates are positively correlated to rate of alcohol consumption; clogging up hospitals with self inflicted injuries, driving under the influence, health issues (liver damage), clogging up emergency departments on the weekend etc.

I mean I could literally go on. Of all the drugs alcohol really shouldn’t be as easily available as it is.

Personally I find the argument that it does “good” pretty wishy washy and more driven by societal bias toward it as an accepted medium for socialistion. Alternatives do exist.

My brother died of a heroin overdose many years ago. If it had been legal, pure, and known quality that likely wouldn't have happened (he could still have been affected by addiction like our mother with alcohol, but he wouldn't be dead).

It so easily could be changed, but we are collectively trapped by the delusion that the only route to safety is to make drugs illegal. You'll see it here on HN, in this thread, about how the "dangerous" drugs should not be readily available because people will get hurt if society lets them have legal access.

It's such an easily solvable problem and we collectively support the worst possible way to deal with it -- it's crazy making.

Overdoses on opiates happen even with legal opiates [1] and it's related to tolerance mechanisms. You become tolerant to euphoric effects much faster than you become tolerant to respiratory depression and nausea.

This basically makes opiates much more dangerous than any other drug class.

[1] https://www.cdc.gov/drugoverdose/featured-topics/overdose-de... - prescription opioids alone contribute to 9.2% of overdose deaths excluding alcohol.

Wikipedia is surprisingly thorough on most drug articles. But you may even have seen such pipes for sale in stores... it can be smoked. Smoking various substances is pretty well accepted by society, even.

And needles are not even required

I personally know 3 people that have tried heroin. It quickly has destroyed two of their lives. 0 ability to hold a job, maintain relationships, if not for family they would be homeless. My other friend was able to use it in moderation for a decade but recently going down the same path.

The idea that heroin is less harmful then alcohol is absolutely ludicrous. The reason it has done less economic harm is because it's less accessable, extremely taboo, illegal, etc.

If we don’t let people have access to pure drugs under conditions that limit the risk of harm, then we should also provide them with the mental health supports they need. People will go to great lengths to kill their pain, including risking death and imprisonment. They shouldn’t be forced into choices like that.

I am not saying that’s the only difference. I agree heroin is obviously far more powerful a drug, and far more addictive. So I don’t think it should be fully legalised and sold in shops. But making it legal for addicts to use under medical supervision in special licensed places seems a sensible compromise. It would probably scale down the black market (which reduces drug pushing on new users), it would reduce immediate dangers (heroin is pretty safe when administered properly in a clean environment), and it would probably help addicts get off it and build a new life (it would remove a lot of the chaos from their lives and would expose them to drug counsellors).

this is so dumb, I have no words

If we sold Opiates/Fentanyl to anyone who wanted it it, in whatever quantities, and there were no social stigma, with 80% of teens doing it 'at least a little bit' before age 21, and 97% of the adult population consuming opiates at least on some occasion again with 'easy access' ... the harm would be orders of magnitude greater than alcohol.

[1] https://www.theguardian.com/news/2017/dec/05/portugals-radic...

It doesn't.

>It doesn't.

Absolutely correct. cf. Tobacco smoking.

???

Tobacco indicates to us that the answer is 'absolutely false', not 'absolutely correct'

Smoking is absolutely a socially accepted behaviour.

We ban it in certain areas largely because it's intrusive to others.

It's not fully condoned obviously we don't put it in film or advertise it - but it is a widely consumed product.

If Opiates ever reached the penetration of smoking, we'd have a situation as bad as COVID.

We already have a public health crisis with Opiods, and they are very aggressively suppressed and controlled.

True legalization (i.e. more than decriminalization) would wield some pretty scary problems.

I don't even understand how this is not just a rhetorical argument.

A reasonable point.

However, smoking indoors is illegal because smoking is less 'socially acceptable', not the other way around.

There has been, over the last 30 years or so, a concerted effort (with warnings on US cigarette packs, more dire ones on UK packs, and disgusting photos on packs elsewhere in Europe), as well as marketing/advertising pushes to make smoking less acceptable.

And (in the US, at least, not sure about elsewhere), many fewer people smoke and those who do are often harassed/berated even when they smoke where it's legal to do so.

As such, I'd expect similar results (given similar efforts) for other drugs.

Before/after photos of meth heads/heroin addicts on packaging, marketing/advertising efforts, etc. would likely have a similar effect.

What's more (again, at least in the US, although I'd expect it'd be true wherever such drugs are criminalized), the costs associated with such efforts, as well as treatment programs for those who need them, would be significantly less costly than the monies spent on interdiction, enforcement and incarceration.

Perhaps I'm missing something important here?

No - this is false.

It's illegal because it's harmful to others - and - it's generally a nuisance i.e. it really smells quite a lot.

Chewing tobacco is completely legal 'indoors' and it has many of the same negative effects. It's not even up for consideration in terms of banning. You can chew it on the Subway, at the Office.

"Perhaps I'm missing something important here?"

Yes, you're missing the fact that we already do heavy suppression of Meth/Heroin i.e. teaching kids how terrible it is, featuring it in films as extremely negative, positioning it as 'totally socially taboo and unacceptable behaviour'.

Selling it in stores legally is both an increase in availability, and a significant reduction in social taboo.

This is not even an argument.

Widespread availability and lessening of social taboos of an extremely addictive substance, which addicts develop a tolerance for and quickly move onto more powerful substances (Fentanyl) would yield a major public health crisis. We already have on on our hands.

70 000 dead from OD in the USA in 2019 - and rising 32 000 car accident deaths in the USA 2019 - and going down

It's growing quite a lot in the Midwest.

[1] https://www.cdc.gov/drugoverdose/deaths/2013-2017-increase.h...

>No - this is false.

>It's illegal because it's harmful to others - and - it's generally a nuisance i.e. it really smells quite a lot.

And it was less harmful or a nuisance before it became illegal? And it smelled less too? Please.

Smoking indoors was banned because of the effort to make it less socially acceptable.

If it were otherwise, those bans would have been in place 40 years ago. We knew it was harmful in the 1960s (actually, even before that, but various societies didn't start trying to make it less socially acceptable until the 1970s).

It wasn't until the 1990s/2000s when such bans went into effect. Why? Because smoking had become less socially acceptable -- through conscious efforts[0][1] over decades to make it so.

>Chewing tobacco is completely legal 'indoors' and it has many of the same negative effects. It's not even up for consideration in terms of banning. You can chew it on the Subway, at the Office.

So what? I was (and explicitly said so) talking about smoking, not chew.

You are apparently ignorant of history. Which makes it hard to have a conversation that, for obvious reasons, needs to take that history into account. So let's not.

[0] https://truthinitiative.org/research-resources/tobacco-indus...

[1] https://en.wikipedia.org/wiki/Regulation_of_nicotine_marketi...

>Selling it in stores legally is both an increase in availability, and a significant reduction in social taboo.

Who, exactly are you responding to here? Because it isn't me.

I never even implied that such drugs should be fully legalized/commercialized.

Go and build, then knock down your straw man somewhere else. I'm not interested.

It polled at 54% in favour of the ban in 2004 (and I was slightly off on the date, enacted 2006 taking effect 2007):

https://www.centreforpublicimpact.org/case-study/smoking-ban...

It's only anecdotal, but my point is that I think it's considerably less socially acceptable (indoors or out) now than it was when it came in. And I think as a result. I think a lot of people smoked less and less and many gave up altogether, and the fewer people do something the less acceptable it seems.

Something that is illegal, is by definition a social taboo. The removal of that taboo implies more acceptance. The fact that more people use it will only increase acceptance by word of mouth etc. and that's at minimum.

The only question is by how much will usage increase?

Already, with severe legal restrictions and controls, opioid use is rapidly increasing the US, which is what we call 'extreme product market fit' (i.e. the drugs 'fits' our dopamine pathways) see [1]

The other major factors are 1) addiction / tolerance and 2) self-medication 3) money, i.e. capitalism.

As for 1)

"Roughly 21 to 29 percent of patients prescribed Opioids for chronic pain misuse them"

"An estimated 4 to 6 percent who misuse prescription Opioids transition to heroin." [2]

Those are just simple, top line numbers, and very potent at that.

Even with limited marketing and 'soft non-acceptance / promotion' - I believe it's something that vast numbers of people will seek it out 'just to party' or for 'the Vegas' trip etc. and especially for 2) i.e. as an easy painkiller/mood moderator which will leave a lot of people addicted.

As for 3)

If it's legal and profits can be made, they will be made. Investors at large may be 'moral' but there is always plenty of 'highly amoral' capital to do whatever, and in this case, it'd be producing the product with the most 'product market fit' in existence.

Increased use of opiods etc. will have no upside, only downside. It has to be regulated and controlled, it's best to keep it at a minimum.

In Canada they prescribe them by the pill, not the 1/2 bottle, i.e. you get a single pill for toot surgery because its just so addictive.

[1] https://en.wikipedia.org/wiki/Opioid_epidemic_in_the_United_...

[2] https://www.drugabuse.gov/drug-topics/opioids/opioid-overdos...

They're correlated, but it's not a causative relationship. It's not illegal for a dominatrix to step on your genitals and make you call her mommy. That's taboo, and legal. On the other hand, jaywalking is illegal - and not a taboo.

> The only question is by how much will usage increase?

That is the question, but I think we should be open to the answer being zero or even negative - just as we are open to the answer being positive. How much drug addiction and usage is furthered by throwing addicts into prison where the only escape is more drugs?

How about the folks who make it out of prison but cannot get jobs because of their felony possession charges, who then lose their friends and family, and once again escape into drugs?

This is a multifaceted challenge.

Not really, and this is the problem with this thread and issue in general.

Sure, we should be open to the possibility of certain things, but that doesn't mean they are reasonable or even likely, and it distracts from more obvious and likely scenarios.

When debating issues, people have a tendency to be rhetorical and not pragmatic.

Opiods are not like meth or coke: there is a big, legal market for them (!) so we have lots of exposure to what happens when we prescribe 1/2 a bottle for patients, vs only the 1 or 2 pills for post-surgery.

In those 'mini cases' of increased access i.e. where you have a leftover bottle of Oxycodone, problems are much more likely than otherwise.

It's ridiculous to suggest that someone having a bottle of Oxycodone available (i.e. greater access) is somehow going to be 'less likely' to develop problems than someone who does.

We already have a lot of behavioural science, and the laws of supply and demand to help us out, but even that is pedantic in the face of anyone with exposure to this issue.

To imply that legalization and widespread availability of a highly addictive substance would 'reduce' usage would be to deny everything we understand.

If you lower the cost of something, consumption increases.

There isn't even a decent rhetorical argument for why 'consumption would decrease' in the face of easy access. I suppose that some behaviours that are 'social taboos' make them more attractive, but that's not a strong argument.

Ask a regular doctor or pharmacist who has to prescribe Opioids what they think would happen if we just made them 'over the counter' like Tylenol.

The only group of people who would condone expansion of access, are some healthcare professionals who support harm reduction policies, and even then, that would be very limited access.

We are where we are for the next few decades at least until either powerful new technologies change the game, we develop much more powerful social abilities, or for some reason the substances are just eradicated from common awareness.

Pot isn't all that taboo, yet it is very illegal in some states and illegal at the federal level.

And fwiw: I don't have the article now, but perhaps part of the reason you don't get a bottle for tooth surgery is because a combination of ibuprofen and paracet (tylenol) is generally enough especially if you have time off work to rest.

Norway gives a pre-counted package of 20 that are in blister packs, even though it is addictive.

Even with limited marketing and 'soft non-acceptance / promotion' - I believe it's something that vast numbers of people will seek it out 'just to party' or for 'the Vegas' trip etc. and especially for 2) i.e. as an easy painkiller/mood moderator which will leave a lot of people addicted.

If you say so. I mean, you are acting like we are just going to give folks as many drugs as they want, in an uncontrolled fashion - and it doesn't have to be like that at all. You don't need investors to be 'moral' - because obviously, they probably aren't going to be considering how businesses treat folks now - you just need laws and enforcement to look out for people.

By the way: Upsides are things like being able to have a professional give you a single, proper dose for partying and give folks information - actual, truthful information that isn't a DARE-esque scare tactic ("Its just so addictive..."). A professional does screening. ID required. If we log prescriptions and sudafed, we can do this. We can give information. Folks that are addicted can get maintenance doses and get actual help.

Edit: FWIW: The crisis in the US is more than just drug availability. Being able to get help if you find yourself addicted would help lots. At the same time, things like paid time off to rest after surgeries would help as well.

Heroin doesn't make folks immediately addicted, neither do pills. And with things being illegal, we realistically have no clue how many people take them as a party drug occasionally without ever getting addicted.

They found that most patients did not want to increase their dose of the opioid. They just didn't want to be cut off the meds they were given. It makes so much sence.

I'm to lazy to look it up.

I don't understand this all, or nothing mentality when it comes to drugs.

I truly feel the American Opioid crisis could have been less devastating if government provided patients/addicts with with access to the medication with limits.

Actually, bupenorpine would probally be the better drug to make available to anyone that wanted it.

Ignoring that most people wouldn't try hard drugs even if they were more readily available, the current opiate problem is more like if alcohol was unregulated and made in bathtubs everywhere, and every few beers had methanol in it instead of ethanol.

While I am generally all for harm reduction and even legalization, 19th century history shows what happens when opium becomes readily available to a country with no limitations.

This is something of an assertion. We can certainly anticipate some effects, by looking at countries that have had opium problems in the past. But that would have to be countered by looking at the deaths, physical and mental health consequences, violence and all sorts of other problems caused by alcohol, and doing so honestly.

There is a huge tendency to write it off as "just a beer" and think "I can handle it" and then compare your relationship with alcohol to the worst addicts of another drug, neatly ignoring the many millions who end up on a dark path through booze.

Yeah and it kills more people than nuclear bombs and pet tigers combined. But unlike nuclear gonna, pet tigers and heroin, alcohol is used by perhaps a majority of adults, so the numbers need to be adjusted accordingly.

Because "full legalization" means bringing the full firepower of commercial enterprise to bear in order to create addicts, and then profit from the "personal choices" the addicts were statistically guaranteed to make.

If I advocate for decriminalization and limited sale exclusively through state-run shops forbidden from marketing their products... does that make me a "puritan"?

Though simply having government inspected pure drugs in set pre-sized doses + no ads would be huge for ODs and communicable diseases ('kit' included).

Speaking of religion dominating this debate, lots of southern states and utah have state run or heavily regulated alcohol laws. Maybe similar to that model in that there is still a 'free market' but the middle man is the gov.

On the last. No.

I'm talking about how the base of a lot of addiction services is founded by or based in religion.

How lots of homeless shelters - in some cities the only spaces - are run by religious orgs with mandates to receive services.

When I talk with people who are not in the recovery community I often hear things like, 'i'm not going to give money to that homeless person because they'll just spend it on drugs.'

Or why should they get free housing. They're just going to get high in it. They don't deserve what I consider basic human necessities.

That whole construct - which sounds like maybe you and I have some similar views - drives an us against them frame, instead of looking wider at the commercial 'who' interests.

When housing is a profit driver and artificially limited, it's better for the capital that we fight amongst ourselves instead of pushing that we should all have affordable (in many cases that means free) access to housing.

I also hear similar puritan - in the sense these opinion holders think they are saving, purifying, rebirthing, baptizing to reform whatever.

Like jails & criminalizing behavior & poverty as a vehicle for what they consider fixing peoples lives.

'they are their own maker,' 'god is guiding everything is a lesson tough love,' as addicts are forcefully detoxed in solitary or dangerous jails without medical supervision (which is torture for this convo on opiates. and can be very dangerous for other kinds of gaba drugs).

Elected sheriffs are the worst... Often preaching their own religious beliefs to win elections because that's what their county constituents believe. Arpaio as an example of inhumane and illegal treatment.

Besides, we already have the capitalist exploitation of addicts in the form of rehab.

Having alcohol illegal - or even just simply decriminalized - doesn't stop that. In fact, we were worse off since it allowed violent crime to rise instead of doing stuff like solving domestic abuse (this was one of the arguments for prohibition). Folks died since strength and purity wasn't regulated.

Which realistically hits at the point of the exchange - effects of legalisation.

I'm curious, is there an equivalent with heroin? Can you sustain at casual usage for years without succumbing to addiction?