I think it's critical to appreciate that Physician Regulations, the AMA, etc. are the main culprits here. How they avoid getting properly blamed for things like the opioid epidemic, I have no idea.
The ama lobbies aggressively against national medical record standardization etc.
At the end of the day, it's about whether the person making decisions has good incentives. And that's not the case in the present system.
I wish society was mature enough for full legalization, but often those pushing for legalization underplay the negative problems associated with drug use. Particularly for that 'harmless plant' marijuana. A university acquaintance went acute schizophrenic shortly after developing a pot habit, that could be a coincidence but the timing is suspicious. A second cousin became mentally retarded immediately after smoking a joint. He's now a 30 year old who can't tie his own shoes.
Big businesses already have enough power to shape politics, we're still in the process of stamping out cigarettes. I've noticed a lot of smoking on Netflix so clearly they're still working on a comeback. How long until they put coke back into Coca-Cola and funding scientific studies about how a bump a day is actually good for you.
Then there is the seriousness of surreptitiously giving someone an addictive substance, to put the hook into them, which I consider to be interfering to the working of the brain and akin to murder. At the moment the focus is around the drug being illegal as opposed to the deleterious effect it can have. Criminal gangs use this tactic fairly frequently as an alternative to killing someone but I believe it should solicit the same punishment.
Early adulthood is when mental illness often sets in, especially illness like Schizophrenia. You're implying cause one way without considering the other likely alternatives:
1) Your acquaintance started smoking a lot of pot because of the onset of early schizophrenia symptoms as a coping mechanism.
2) They are unrelated and early adulthood is just when people experiment more with drugs, and also when conditions like Schizophrenia start to manifest.
> A second cousin became mentally retarded immediately after smoking a joint. He's now a 30 year old who can't tie his own shoes.
I don't know what to say to this other than nobody's ever established an even remotely plausible link between these two things, assuming you aren't being hyperbolic.
A friend of my 2nd cousin smoked a joint from the same stash and no such effect so it's clearly a combination of marijuana and the individual. Unfortunately such experiments are hardly repeatable in a clinical setting, he's not the only one, it's happened to number of people. One of the other mothers was collecting stories to try to turn into a book, give me a minute and I'll try to find it.
This one’s simple: unless they, or someone they know, grew the plant themselves, there is no practical way to know what really went into the joint. I’ve witnessed people having hallucinations after a joint, which seems unlikely with cannabis.
But those problems already exist and are amplified by the prohibition.
I don’t understand how prohibitionists still believe that the ban on drugs would make drug use disappear when the last 80 years of prohibition completely failed at that.
It’s clear that prohibition does not work. But if we just try long enough it might? That’s not science, that’s ideology.
As someone who consumes quite a large amount of gray and black market medicine I'm actually pro-legalization of all drugs. I hate the medical monopoly and the overbearing government. But I also think people need to be very honest and frank about the consequences of legalization.
My concern, beyond what happens to other people, is that I'll have to check the ingredient label for a longer list of substances I don't want in my body. We have enough food fraud as it is with suppliers lying about the content, I want it to be an extremely serious crime to add drugs to food.
And when people talk about legalization, they are not saying get rid of the entire doctor supervision & prescribing system, which creates a legal outlet.
Yes, absolutely.
But the fact that things can cause negative consequences is not sufficient reason to ban them. The obvious example here is alcohol - it is beyond clear from data that alcohol is incredibly harmful. It is beyond clear that it is more harmful than at least some banned substances (marijuana, LSD, MDMA). It is likely that it is more harmful than harder substances like cocaine, but with less data on those we can't say for sure.
So yes, there are negative consequences, but as a society we have decided that we allow people to do things that cause negative consequences (as evidenced by the legality of alcohol). There are limits on that, but with alcohol as a line by which to judge those limits, it's clear that to have any kind of coherent public policy, marijuana should be legal. Or, of course, alcohol could be made illegal. The point is that if you think that alcohol should be legal but other drugs should not, you're just engaging in hypocrisy.
I think alcohol is a bad example as alcohol for most people has a way of punishing abuse on its own and quickly thereby maintaining a tight association between the high and the hangover. The aversion to the hangover means that for most people it's a self correcting problem. Most other drugs don't come with this and the association between the high and negative consequences are more remote and infrequent.
I think alcohol, despite the obvious and extensive damage it causes, is a great training drug that teaches most people moderation through first hand experience and encourages caution with other drugs.
Using alcohol as an example kinda makes the case for prohibiting alcohol as opposed to legalizing other drugs.
You will be much more effective if you simply try to enjoy the conversation than trying to call out people for having "dangerous opinions".
There are times when people can have valid, personal opinions and times when there's just objective reality. Some people these days say that their opinion is that the 2020 election was stolen. That's not a valid opinion - it's just wrong. Saying that hangovers make alcohol self-regulating when >10M people in the US are alcoholics (for whom it is, as a point of fact, untrue that alcohol is a self-regulating substance) is not a valid opinion - it's a misunderstanding of reality.
As someone who knows people who have been very severely negatively affected by alcoholism, I do not enjoy conversations with people who make points about alcohol that are totally uninformed and suggest that we should base policy around those uninformed thoughts.
No offense to you, but who named you the arbitrator of "valid opinions"? I doubt you are that arrogant in person, but you sure are coming off that way.
Either we should accept a certain threshold of danger around drug use and allow all drugs under that threshold to be used (with appropriate regulation), or we should not accept the use of dangerous drugs and should outlaw them.
Right now, US drug policy is that a fairly dangerous drug (alcohol) is not legal, while other clearly less dangerous drugs (marijuana, most hallucinogens, MDMA, etc.) are not legal. It should be changed to be a rational policy in which everything less dangerous than alcohol is legal or a policy in which alcohol is not legal.
I’m pretty pro legalization, I think it’s probably best handled at the cultural level, but until society matures there is going to a fair bit of collateral damage and I think we should be honest about that.
* it’s a generalization… obviously it doesn’t work out this way for everyone.
But we have had a coherent policy around drugs in the US:
1. Identify a potential issue with a particular drug;
2. Investigate the issues and examine the evidence;
3. Create a set of policy solutions to address the issues;
4. Pick the least effective, most harmful policy solution and implement that.
5. Profit!
All you have to do is look at all the major drug legislation over the past 130 years or so to see that such is, in fact, the case.
I'm convinced the only reason alcohol is legal is because it is culturally embedded. If it were being introduced anew, it would be prohibited. Its far worse than most illegal drugs.
Alcohol has a complex set of biochemical effects, but note that part of the issue is that it's similar to opiates, i.e. it triggers the release of an endorphin-like molecule that people get addicted to in the same way as with morphine or heroin.
I still don't think alcohol should be made illegal, but in terms of long-term medical effects, it's certainly more dangerous than cannabis/THC and psychedelic drugs like mushrooms/psilocybine. It really belongs in the same class with amphetamines, cocaine, benzos, and opiates.
Alcohol is very bad for your health and it is a horrible thing to be addicted to but it is not very addictive.
We tried that[0] in the United States, and it was an unmitigated disaster.
[0] https://constitution.congress.gov/constitution/amendment-18/
I think this could be managed with an appropriate regularity framework that I think should probably apply to psychoactive drugs as well. This would be some sort of licensing system. Anyone can get a license to buy antibiotics but it requires taking class and passing a test that demonstrates you understand the risks and agreeing to follow certain rules and procedures. A procedure for antibiotics might be that you agree you'll only purchase them if you have tested positive for a bacterial infection. All drugs should only be purchased for yourself (unless you have a distribution license which should be more difficult to get). If you get caught breaking any of those rules, you lose your license for some period of time and are subject to other penalties.
I think for something like antibiotics, no one would bother getting licenses as it's not worth the time of getting and keeping your license up to date (licenses would likely require annual renewal and continuing education). You'd just go through your doctor the couple times a decade you need them. But this could be hugely beneficial for a diabetic person that doesn't want to go to a doctor once a month to get their insulin prescription renewed. Or women that want birth control without paying doctor fees. Yes, it would result in less revenue going to our medical system but that seems like a plus side in those cases.
I don't deny that some drugs are incredibly dangerous but our society allows a lot of dangerous activities. If I want to buy a BASE jumping rig, I could do that and then start legally jumping off of cliffs with it as soon as it arrived. My chances of dying doing that are far higher than my chances of dying while taking most drugs (maybe some like fentanyl are exceptions). Would you consider whoever sold me the rig a murderer? Or do you think I'm an adult and should be allowed to make my own decisions as long as they're well informed?
i.e. it was something done to you without informing you. To use your analogy it would be like blind folding someone and pushing them off a cliff (with base jumping gear on) if they lived I'd consider that at least attempted murder. But with secretly giving drugs to someone there is no way to avoid interference with the workings of a sound mind so that I think is on par with murder.
Are you actually talking about something more akin to date rape? I'm really not sure if I understand how that might work. You slip someone opioids without them knowing until they're addicted and then you stop but reveal to them they're addicted to opioids hoping they continue that addiction? Or do you stop once they're addicted and just hope they figure it out? Or you just keep feeding their addiction without them knowing until you feed them a dose they OD on?
Criminal gangs tend to take the more active holding people down and injecting people with drugs approach than the slow sneaky process. But once addicted the addict is now reliant on the gang for their continued supply and can be controlled. The real life instances I’m aware of was done on people who were preparing to testify against their family members in a gang. It was a speedball injection. But is has been depicted in fiction such as in the move ‘the town’.
My relatives were involved in sheltering them to get them clean, but as soon as they went home the gang found them and got them addicted again.
All that would still be very illegal (I imagine injecting someone with even a completely safe saline solution without their consent would be considered assault in most jurisdictions). The type of people that are comfortable doing that clearly don't care about the law. I just don't see drugs being illegal as a limiting factor on crimes of that nature in today's society.
I'd also like to mention that a major source of funding for many criminal gangs is the black market sale of drugs. If we legalized and regulated drugs, they'd lose that source of money and I'd personally expect to see a decline in organized crime.
It’s the action of adding chemicals to your brain that can and likely do have harmful long term effects, not limited to addiction, and many still unknown. If such an act was done to me I would consider it within my rights to kill that person in retribution.
I’m less confident on the expected drop in organized crime as taxes on the drugs usually means there is now money in tax evasion. Without tax it may become so cheap that other problems start to dominate.
As for illegal drug sales persisting despite legalization, how many people are still buying illegal moonshine? It does exist, I've seen it, but it's not nearly the problem it was during prohibition.
I’m more worried about organized crime/political corruption than I am about freely available drugs, but organized crime has all sorts of ways to make money so I don’t think we’ll be rid of it that easily. I think people underestimate the prevalence of how much corruption still exists. I even think it’ll get worse as fewer non-compromised people want to take police jobs.
Also prohibition ended 1933 but the major crackdown on gangsters was in 1970 due to a long period of federal government inaction.
I think legalisation ought to be driven largely evidence of harm, not just by abuse of the drugs, but systemic harm both of legalisation vs. criminalization, but with a reasonably high level of ability to take personal risk.
E.g. for drugs where we know addiction drives crime, even fairly substantial harm from the drug itself might still mean legalisation is a net gain. Heroin might fit in that bucket (a small UK trial with prescribing it saw offending rates for those in the trial drop dramatically, and so reducing net harm to society).
At the same time high risk may justify a high degree of regulation of specific drugs to ensure people are at least aware of the dangers, and aim to reduce recruitment.
That particular cat is well out of the bag as, according to the WHO[0], full 1/3 of antibiotics users obtained their last doses without a prescription. In fact, many countries (unlike the US) don't require prescriptions for antibiotics.
Which really sucks, as antibiotic resistance will (barring some serious scientific breakthrough(s)) likely be a huge problem over the next century or so.
I don't have a good answer WRT that, but agree with much of what you wrote.
[0] https://www.who.int/europe/news/item/21-11-2022-1-in-3-use-a...
But yes, we need to be much more careful with how we use antibiotics than we currently are and I also don't have a good answer for how that happens.
Do you seriously think this is why medication is regulated?
In most developed countries prescribing and dispensing are separated (doctor/pharmacy) in part to prevent this. Japan is a notable exception and guess what: more drugs are prescribed per capita there than the rest of the OECD.
That's the age most people find out they're schizophrenic
This sort of reductionist, simplistic "reasoning" is going to be the death of us all.
Trying to find a moral failing in every human weakness, every human ignorance, every human desperation? It's just disgusting.
This is an extreme example of “correlation does not equal causation”
The regulation came from the expanding popularity of these drugs. It didn’t cause it. They weren’t just arbitrarily regulating a drug that nobody was using, after which it became popular.
> Regulations and limited availability don’t cause more people to use drugs.
All else held equal, all this does is increase the price of doing drugs.
There are arguments to be made about the history of the demand for drugs. I think we can safely say, though, that it stays at a stable 'Some people really want to do them'. Whether or not that means growing a plant or potentially getting shot depends on the regulations.
Even if you disagree with my stance, I think it would be a grave mistake to not acknowledge that different drugs have different capacities for harm, and the fact is that the addictive nature of meth makes its harm potential astronomical.
People who use amphetamines 'recreationally' seem to mix it with alcohol, with very bad long-term effects on health. It also seems to drive people towards reckless and poorly-considered behavior, which is similar to the effect cocaine has on many people.
It's a wise life decision to not associate with cocaine and amphetamine addicts, certainly. However it is also curious that people in treatment for ADHD also develop a dependency on the drug, although perhaps in a more controlled manner due to it being prescribed, yet few people in the medical-pharmacological world seem to be that concerned about it.
Dose makes the difference. The kind of dependency people with ADHD develop on their meds is closer to the kind a person with mobility issues develops on their wheelchair after spending some time using it.
Again, have you any decent experience with drugs?
The comparison to meth “addicts” is absurd. People with ADHD are not taking Grams of prescribed amphetamine pills to get high like some one blasting their brain with a bag of street meth with the intent of feeling euphoria.
This is actually not true of the non-stimulant ADHD drugs like Intuniv; you have to taper that one off over a few weeks or unpleasant things happen to your heart rate.
And, of course, ADHD patients constantly forget to take their drugs, and the system where you have to get a new prescription every month isn't even something they can reliably do, being ADHD patients.
If you believe the propaganda - memes are not a quality source of information. You need to be less willing to repeat what you've heard sand more willing to dig out the facts. The same is said of crack ("one hit and you're hooked") but it's a lie. I've spent several full evenings smoking it and I am not going back to it. To some people, maybe one shot and then doom, but to most it's an incremental downward slope depending on many factors. Not denying crack is a bastard and I would probably not support legalising it either, but please don't parrot back rubbish you've been told.
If this is still the level of HN debate ion drugs, to repeat soundbite anti-drug propaganda, I feel we're getting nowhere and burning a lot of fuel doing it.
I'm not arguing these anecdotes are data, but for me personally they are enough to highlight the unequal danger of meth.
My understanding is that most people whose lives are in ruin and use drugs, use drugs because their lives were already ruined in some way or other.
Yes, I am. They weren't ruined immediately, but the addiction quickly ruined them.
> My understanding is that most people whose lives are in ruin and use drugs, use drugs because their lives were already ruined in some way or other.
I think your understanding is woefully incorrect, almost to fall into the caricature of what "bad drug users" look like. Many people (myself included) like to use drugs because they make you feel good. Just look at, for example, the popularity of pubs in England - do you really think that all alcoholics only became alcoholics after their lives were already shitty?
Questionasble. There's a good asrticle in the spectator asbout this I can't find now, am at work. It suggests a very different interpretation.
https://www.walesonline.co.uk/news/wales-news/doctor-heroin-...
> I think your understanding is woefully incorrect, almost to fall into the caricature of what "bad drug users" look like
Well, my experience.
Used to buy a bottle (700 CC) of spirits and it would last about 2 weeks. Became seriously mentally ill a few years ago, started drinking equivalent of 450 to 500 CC of spirits per evening (~1/2 litre), every evening, for a long time until the cash fortunately ran out. At least I could feel something, anything, when I drank.
When I got better the drinking subsided, almost back to my baseline again.
QV also soldiers on heroin in the vietnam war, when out of the stress of war they typically just gave it up iirc.
http://en.wikipedia.org/wiki/Giffen_good
Methamphetamine wasn't the only drug being regulated in the '50s and '60s. The other stimulants, like cocaine, were restricted at the same time. But methamphetamine is by far the hardest drug to regulate, so its relative prevalence increases.
>Solution: Just make every kind of drug legal to produce, but regulate the purity.
This is suboptimal. Recreational stimulants are not all the same level of dangerous. (Which would be an incredible coincidence.) The better solution is to find the safer stimulants (possibly variants of methylphenidate) and allow those to be used recreationally, hopefully cutting into the demand for the really bad stuff.
HN is full of smart people who (wrongly I think) assume that because they have the self-control and discipline to either avoid drugs or to use them relatively safely that the rest of the population does too. This does not seem true in my experience. I forget the exact stats but roughly 1 in 20 Americans is an alcoholic, and that's with a drug that humans have been consuming for thousands of years and that has established social rituals around consumption. It seems likely to me that increasing access to and decreasing stigma of highly addictive drugs like opioids or amphetamines will lead to substantial increases in addiction rates.
Do you have any evidence of this? I don't believe this to be true from general reading, but can't back it up. My rcollection is that the workers would work hard during the day then smoke opium in the evenings.
They don't specifically mention work output but I find it hard to believe that opium addicts were particularly productive in most jobs. I don't think China was very industrialized at the time so I doubt what we would today conceptualize as a "worker" was a substantial fraction of the population at that time.
I also found this, which may disagree: https://academic.oup.com/book/32900/chapter-abstract/2766221...
The ‘Problem’ of Opium Smoking in Canton Virgil K.Y. Ho
Abstract
Both the causes of opium consumption, and the allegedly calamitous social, political, economic, and cultural impact of opium smoking on Cantonese society were greatly exaggerated in official propaganda and scholarly writings. Opium served Canton and its urban inhabitants many positive social, cultural, economic, and political purposes, making it difficult to over-simplify the phenomenon of opium smoking as nothing but pernicious.
"but I find it hard to believe that opium addicts were particularly productive in most jobs"
well maybe, but do you have any experience with this other than feeling? Same has been said of dope smokers, but many are productive. Also in china a few centuries ago there was no welfare state and for most, no work = no food = beg or starve. So as a non-productive person, you didn't live too long
Abit more, from https://en.wikipedia.org/wiki/Opium#Recreational_use_in_Chin... that suggests something very different:
It is important to note that "recreational use" of opium was part of a civilized and mannered ritual, akin to an East Asian tea ceremony, prior to the extensive prohibitions that came later.[50] In places of gathering, often tea shops, or a person's home servings of opium were offered as a form of greeting and politeness. [...] The image of seedy underground, destitute smokers were often generated by anti-opium narratives and became a more accurate image of opium use following the effects of large scale opium prohibition in the 1880s.[50][51]
Not with opium smokers but I have some familiarity with opioid users and they are generally not good workers. Of course maybe there are tons of opioid users who pass as totally functional people and so I don't recognize them, but I doubt that. Marijuana is also clearly not addictive in the same way as opioids are (perhaps it is slightly addictive and maybe more so now that it has become stronger). It seems to be more like caffeine where its use is ritualized but people don't have a very hard time with cessation if forced to. I would bet daily users of cannabis are significantly less productive than the average population, but I know a couple in high performance jobs, so it's certainly not guaranteed.
I imagine in the China of the early 1900s many of the opium users did die just as many heroin/fentanyl users today do. I have talked to addicts who expect to die of their drug addiction and openly say so.
Edit: I thought about it a bit more and I am aware of some functional addicts addicted to (legally proscribed) pain meds. So I suppose it is possible opium users/addicts were more like this group. I doubt it though because China went to extreme lengths to eradicate opium from the country after the communists came to power.
You're missing something vital, that those social rituals are often supportive of alcohol consumption. In the UK "beer or queer" (= drink up or there's summat wrong with you"). Alcohol abuse is as much an embedded social problem as a personal one. Who hasn't tried to force another drink on someone who's clearly had too much? To my regret even I have.
On top of that, just look at alcohol advertising everywhere. It should be banned.
IMHO, that's a little reductive. The primary issue isn't use/abuse of such substances. Rather, it's the criminalization of use/abuse that's the biggest problem.
I say that because putting someone in jail because they have a problem with substance abuse doesn't make any sense. I'd add that providing comprehensive treatment for those who have such issues would be less than half the cost of interdiction, enforcement and incarceration.
What's more, both the substance abuse and legal issues/incarceration limits the economic potential of those who have resolved their issues due to stigmatization of those with criminal records.
I'll go even farther and say that drug prohibition (as we saw with the 18th Amendment[0]) creates black markets, and since there are no legal avenues to address disputes, and begets violence on a wide scale, further depressing economic output and social cohesion.
I don't disagree that substance abuse brings misery to many -- but penalizing those who use such substances without them negatively impacting their lives with legal issues and potential violence seems way too extreme.
If we invested USD$10-15 billion a year (as compared with ~USD$50 billion on "drug enforcement") into the resources required to provide treatment for anyone who wants/needs it, and legalize/regulate all "drugs", will save money, increase economic output and improve social cohesion.
It's a win/win/win if you ask me.
I don't think there is much evidence for that (nor against it). One country that has tried something like that is Portugal and from what I can tell it has worked moderately but not spectacularly well. The problem with assuming that the US would have the same outcome is that the US shares a porous border with a part of the world heavily involved in drug trafficking and the US is a much larger country and larger consumer of narcotics, so the demand effects are hard to compare with Portugal.
~0.2% of Americans had ever used marijuana when it was first made illegal, whereas ~90% of American adults have used it now.
Tax it, regulate it, educate on it.
Society is okay with harmful recreational drugs (i.e., alcohol and tobacco), so let's start having grown up conversations about the other ones too.
Yes, they can and will be abused but that is a health issue, not a criminal one.
Absolutely. As is made pretty obvious here[0][1].
[0] https://www.nytimes.com/2023/01/07/health/fentanyl-xylazine-...
[1] Archive link: https://archive.is/Sv27y
My step-mother noted that she was prescribed amphetamines during all three of her pregnancies (late 50s, early 60s) for "weight control."
Which, these days, seems crazy.
That said, I'd note that none of my step-brothers seem to have been negatively affected by in-utero exposure to amphetamines.
Solution: Just make every kind of drug legal to produce, but regulate the purity. Be very explicit about the dangers. The only thing prohibition does is make drug consumption and production dangerous and needlessly expensive.