Addiction is the root issue, not overdosing. It's not enough to just stop people from dying, you need to actually give them quality of life.

"The homeless people thing is a failure of our healthcare and housing systems."

This is the result of drug addiction not the cause.

"Many (not all) of those things were results of the criminalization of drugs"

Don't agree, alcohol is perfectly legal and one of highest percentage addictions there is. Opioids are a legal prescription and also out of control.

Yes, but often the root issue of addiction is mental health issues (and not only the drug itself). There are many people who occasionaly take drugs without strong addiction.

It depends a bit on the drug to be fair. Like you cant "occasionaly" smoke cigarettes, either you are addicted or not. You can occasionaly drink a beer and not become an alcoholic.

The people who become alcoholics almost always have some personal problems / mental health issues as a trigger.

But the world wide drug policy doesnt make any sense, because even a "evil" and highly addictive drug like cocaine is actually less addicting than smoking.

> Like you cant "occasionaly" smoke cigarettes, either you are addicted or not.

I was an occasional smoker for 20+ years. Could go weeks without a cigarette. Or smoke a few daily when stressed at work. Or smoke an entire pack on a night out.

Recently went through some personal hell and now I'm on 10-15 cigs a day and find it hard to stop. Absolutely because of the recent stress and trauma.

It is without a doubt one of the most pointless drugs in existence.

> I was an occasional smoker for 20+ years. Could go weeks without a cigarette.

I think you are a very rare minority then.

Quit smoking is painfull (went through it multiple times). For me it feels so much better since I finally got it.

And since then my behaviour regarding other drugs also got a lot better, because you dont have that "hunger" to take s.th. from smoking.

> It is without a doubt one of the most pointless drugs in existence.

It doesnt even make you high lol.

"Like you cant "occasionaly" smoke cigarettes" I know several endurance sportsmen (no ladies were met, that I knew about) who will smoke an occasional cigarette. As an ex-smoker (took up endurance sports), I was astonished when I saw super-fit people casually smoking.

> It is without a doubt one of the most pointless drugs in existence.

I don't know about this one. Cigarettes specifically certainly have enough chronic downsides to outweigh their upsides for me, but nicotine in general serves as a pretty good, light dopamine hit, with relatively few acute downsides. You don't intoxicated, it doesn't take long to ingest, and it's available enough to not become life-consuming. It's not a coincidence that it's a very common habit.

I say this as someone who used to use cigarettes, but took up vaping nicotine instead when I realized it didn't make my clothes reek and scratched the same itch. Everybody has habits around dopamine management. Some people snack, some people spend too much time on social media, some people gamble (in casinos or in brokerages). Personally, I'm prone to snacking, and I eventually realized I could either smoke and be attractive, or snack and get fat. It was an easy enough choice.

"Like you cant "occasionaly" smoke cigarettes, either you are addicted or not."

I don't think there's any factual evidence for this at all. I occasionally smoke cigars (like 1-2 times a year) and I'm not addicted to them. Multiple friends/family members do the same.

"Yes, but often the root issue of addiction is mental health issues (and not only the drug itself)."

Agree, but not everyone who has mental illness issues resorts to drugs for help so there are many other factors to consider.

> Addiction is the root issue, not overdosing

What is the root of addiction? This is the best book on it.

https://drgabormate.com/book/in-the-realm-of-hungry-ghosts/

Ooh, unexpected and interesting reference to one of the "realms" of human experience (in the terminology / model of Buddhism, in particular, to me).

"Hungry ghosts" is exactly it (as I've learned / come to view the meaning), speaking from personal experience with drives at various times morphing into the ... unhealthy.

Humans have all sorts of axes - behaviorally, environmentally, genetically. It's interesting to look at these, and look at how traits complement and contrast ... how subtle tweaks and changes in parameters can be the difference between, say, a high-performing researcher with a solid career, and a ... someone who falls off the map to greater or lesser degrees [1].

One thing I am quite familiar with, these days, is: the very traits that set people up for "(very) high performance", also set people up for addictions and other issues. AA and other related groups are quite enriched in, in my experience, high performers (as well as very interesting / idiosyncratic / "exceptional" people*) of various types. The tendency to get sucked into things ... to become obsessive, to push boundaries, "openness to experience", etc. easily contribute to someone becoming a "star" and/or a "strung-out junkie".

The Buddhist, AA (rooted in "Oxford Group" / "early Christian" ideas), etc. ideas about "spirit" and a sort of "middle way" and all of that, provide practical guidance (and practices) that can really help balance out the serious negatives that can come out of some traits / mixtures of traits.

I'll look into this book further when I have a moment. Thanks for pointing it out!

[1] https://en.wikipedia.org/wiki/John_Forbes_Nash_Jr. - not necessarily the best example, here, but, apt enough and what comes to mind this moment ... representing, to some extent, disparate outcomes in one individual (take that, dualism!)

* Note: none of this should be taken as any kind of "value judgment" - specifically, 'positive' or 'negative' ... these terms can be quite positive or negative, as reflected in almost anyone I've met, as well as myself

The tl;dr is that a lot of addiction comes from unresolved trauma. Drugs, particularly opioids, give the sensation of returning to the mother's womb. They are comforting in the moment but it passes quickly and never quite get back to the satisfaction of that first high.

>"The homeless people thing is a failure of our healthcare and housing systems."

>This is the result of drug addiction not the cause.

Not always: lose job, lose house, get offered cheap accommodation, meet some people...seen it happen.

Or, because of how things in cities are right now: Your rent increased but your pay didn't. Now you are homeless because it's impossible to pay rent with money you aren't getting. Now you have your job and car but no home, and are homeless, and now people want to treat you as lazy even though you work 60 hours a week for jobs you've been in for a decade.

Rent has gone up almost double in the city I live in (a small city you won't think of) and nobody's jobs decided to double their pay, so there's a lot of people who literally can't afford just to have a legal place to sleep.

> This is the result of drug addiction not the cause.

Where'd you get that? Studies I've seen of homeless addicts show that a simple majority were not addicted when they became homeless. Certainly it's a common cause of homelessness but still only accounts for a minority.

I don't agree at all. Most addicts on the streets were addicts beforehand and the reason they're homeless has a lot do with their addiction and being unable to maintain a working lifestyle.

It's DEFINITELY not a minority. They don't just randomly end up on the streets from some random cause and then turn into addicts. That rarely happens, there are too many opportunities in this country to just become completely homeless from bad luck.

It’s not a matter of opinion though look it up.

There's no scientific basis for what you're saying, so it is in fact an opinion you're spouting off.

The only way to do a study on this would be to ask. They're not tracking people throughout their lives to see if they're suddenly becoming homeless and turning into drug addicts afterwards.

Use some critical thinking please. Just because some media outlet says it's so doesn't make it true.

I think your argument is a bit shaky if you take into consideration alcohol in society.

alcohol consumption is perfectly acceptable, very well-regulated, “safe”, and alcoholics receive plenty of support and sympathy from public health, yet that doesn’t stop alcoholism ripping through society with countless victims (and victims of victims).

You can even make the argument that many alocholics wouldn’t be so if alcohol was less normalised in society

The argument has been made before. It didn't turn out all that well, not least because methanol is neurotoxic.

I think you meant "ethanol", methanol is fatal to drink even in small doses.

No, I meant methanol. It's an easy contaminant to produce through improper distillation practice, and the most common of several contaminants which produced unfortunate outcomes among drinkers of illegal liquor during prohibition.

Right, thanks, I missed your point.

Methanol specifically is produced during the distillation process. The methanol vapors and ethanol vapors reside next to each other in the distillation column, making it a common impurity that is brought over in the distillation process. Great care needs to be taken to avoid collecting the methanol.

This simple fact is the greatest argument for distillation having much higher legal barriers than the simple brewing involved in beer/wine/mead.

Distilling doesn't produce jack-diddly-squat. It just concentrates. Methanol is a side effect of the fermentation process, and only common with exotic carbohydrates. In a normal beer, wine, or wash, you'll find less methanol than in your morning glass of orange juice.

I don't know what "exotic" means in the context of moonshine, but I've known some mountain men who weren't clever or careful about it and would ferment damn near anything - which is why I've drunk moonshine exactly once, and intend that to remain the case for the balance of my life.

Poking around the web, it seems as if making liquor at home has become popular among booze nerds. That's great and all, but I wouldn't call it moonshine, and I'd be very hesitant about how much I reasoned based on what well-informed people do today about the practices of a century ago, or indeed about the practices of today among those for whom making moonshine is more a family tradition than a hobby.

If it vaguely, and I mean vaguely resembles starch or sugar, you're not getting methanol. It's substantially harder to convert long polysacharides into ethanol/methanol than it is to convert starches and simple sugars, to the point that the less informed a person is, in the off chance they succeeded in making alcohol, the less likely there's going to be substantial methanol levels.

The vast majority of moonshine stills were just churning out unaged corn whiskey from animal feed corn. There is no risk of methanol poisoning in that scenario.

Speaking technically, methanol isn't produced during distillation, it's concentrated. Since it boils at a lower point than ethanol, it disproportionately comes out in the "heads" of a distillation run. The source wine/beer/mash already has all the methanol in it, it's just it's not a problem when present in the small quantities in a non-distilled drink, alongside with a much greater amount of ethanol. (Ethanol can actually act as an antidote to methanol since your body processes it first and can then excrete much of the methanol unmetabolized)

The risk of methanol poisoning in moonshine is grossly overrated. Simply put, you have to do some stupid shit to end up with dangerous amounts of methanol. The methanol content in a beer, wine, or mash precursor to liquor production will be absolutely trivial, unless you are are doing something ridiculous like trying to make liquor from tree bark (the Greeks have a drink like this, it's heavily warned against in home distilling circles).

So why was methanol poisoning common during the Prohibition? Renatured fuel alcohol. To stop people from drinking fuel ethanol, the government poisoned the supply with methanol. People tried to come up with jerry-rigged solutions to remove the methanol, and more often than not failed. Some less scrupulous experimenters sold their results anyway, where it worked its way into the black market supply chain.

Not that ethanol isn't also neurotoxic (to a much lesser degree), but bootleg moonshines common during prohibition often contained trace amounts of methanol, the number of people irreversibly injured by methanol poisoning greatly exceeded the number who died.

By 1926, according to Prohibition, by Edward Behr, 750 New Yorkers perished from such poisoning and hundreds of thousands more suffered irreversible injuries including blindness and paralysis. [0]

[0] https://content.time.com/time/specials/packages/article/0,28...

Didn't the government also add methanol to non-consumption alcohol products as well, contributing to those poisoning numbers?

This was likely the cause of the vast majority of methanol poisonings during the prohibition. You have to use exotic, hard to break down carbohydrates in your beer, wine, or mash (the pre-distillation fermented product), like tree bark, to end up with significant quantities of methanol.

Most of the methanol poisonings were from poorly "re"natured fuel alcohol.

Yeah, industrial alcohols were (and still are) "denatured" with additives to make them toxic or unpalatable and industrial alcohol was often used as a precursor for bootleg spirits during prohibition. I think modern denaturants lean more towards unpalatable than toxic.

I think GP was referring to the increase in methanol poisoning during prohibition.

Prohibition reduced american alcohol consumption by about a third according to most estimates, and before it, americans were drinking insane amounts of hard liquor. Like the equivalent of multiple drinks a day.

It also promoted a lot of organized crime. Just like today (but worse, because now we have narco-states vs just gangs.

I lost a mother to alcohol and a brother to heroin. Both are technically quite safe when used appropriately and lethal when not. And they're going to be used regardless of legality, so let's make it safer for those that do as well as stop funding the cartels.

I am sorry about your loss. However, if you want to talk technically, then the science over the last two decades has moved almost decisively to saying there is no safe level of alcohol consumption.

There's also no safe level of organized crime.

Yeah, alcohol is not healthy for people. But by safe I'm talking about a glass of wine with dinner or other low intake/healthy contexts.

But my point stands: people are going to do it regardless of the law, so let's stop criminalizing it. Being overweight is unhealthy too, should we arrest every fat person in the country "for their own good"?

I'm not in favor of banning alcohol. I just want to dispel the false notion that prohibition didn't "work", when it empirically did.

We shouldn't ban alcohol because it's a hamfisted way to reduce alcoholism and harms from alcohol abuse. However, the 1910s didn't exactly have functioning rehabilitation programs.

It might have worked if you squinted right. There was still plenty of alcohol for those of means.

Again, it came at a cost of organized crime. It was not a win.

We don't really have a functioning rehabilitation program now. The rates of failure and relapse are not exactly low. There are also often a bunch of hoops to jump through to even get access to them, most people are more interested in being "tough on crime" which really means "authoritarian".

Heroin, in a pure form, is non-toxic and as long as you don’t mix it with things and do too much you should be OK. Proper dosing is the huge part. But you could still easily die from slowing your heart down too much so I would not say “safe”. Non-toxic, let’s stick with that.

> You can even make the argument that many alocholics wouldn’t be so if alcohol was less normalised in society

Didn't American and European prohibition vehemently disprove this theory?

Prohibition actually worked relatively well.

It reduced harm until it started to increase harm.

At the end of the day human vice isn't going away.

It's not useful to judge prohibition in a single dimension of "work well" to "didn't work". Sure, cirrhosis rates went down significantly but organized crime (a disease of its own) was gifted a torrent of money to fuel other activities.

It was a "loud minority" type of thing. The average person simply stopped drinking, which was fine.

In today's market, 10% of the drinkers consume 90% of the alcohol. So the efforts of the 10% and the people serving the 10%, and the efforts of law enforcement to stop them, resulted in many very high profile, violent events, which made it seem like it wasn't worth the effort.

Full disclosure, I'm an alcoholic in recovery and I'd be fine with alcohol being illegal. My main beef is that the laws are not internally consistent: THC is by far a milder drug than alcohol but alcohol is legal while THC is still mostly illegal in the US (federally).

Either legalize THC completely or ban alcohol if you want to be consistent.

Also worth noting, THC (at less than 0.3% which is plenty for gummies) and many very very close, but naturally occurring (in infinitesimal amounts) are technically legal federally and companies like 3CHI are exploiting those loopholes. You can buy a vape containing things like HHC, THC-P, THC-O, etc which is virtually indistinguishable from Delta-9 THC, so obviously the days of THC being illegal are numbered.

But the people who are the problem drinkers still end up finding a source of alcohol. So now moderate drinkers have been prevented from having their drink or two, alcoholics are drinking just as much, but are more likely to be poisoned, and you’ve created a massive cash cow for organized crime. How is that anything but a total failure?

There are even better loopholes than that.

If anyone can explain the THCA loophole, it'd explain how they are shipped directly to consumer.

It's the wild west but across the US. How is this possible, and will it be open until it's legalized federally?

"Why even get a license" is the incentive this creates.

On the other hand, you can look at the vast majority of society that drinks in perfectly reasonable moderation. Teetotalers make up a tiny fraction of society, yet civilization hasn't crumbled to barbarism. If a community is experiencing alcoholism at such a rate that it's "ripping through society", then that suggests to me that there's a greater root evil than the bottle.

Actually, you'd be surprised to learn that 20–40% of Americans don't drink. There are all different ways to define it leading to the ambiguous statistics (e.g. once a year, never, include/exclude under 21 year olds), but either way I found it very surprising how many people don't actually drink alcohol.

> “safe”

No idea of why you quote the word. Alcohol consumption is demonstrably unsafe. The estimate is that alcohol kills around 140 000 people per year in the USA. It's just legal because criminalisation was tried and proven to be not only useless but actually more harmful to society through its side effects, a situation similar to the one we are still having with all the other drugs which are still illegal basically.

How are cities with a safe-injection sites doing at the moment? Over the last decade supporting drug use in transient (homeless) populations hasn’t had a positive effect on that population.

Legalization (or decriminalization) is a possible pathway to supporting people, but the current method of helping people with myriad issues stay in their current state in life (or worse, encourage more to enter it) is one of the biggest public health disasters facing urban areas. Major cities are being gutted by this failed line of thinking.

Have you looked much at the situation in Portugal? I've only heard good reports about their efforts there.

There are many places that are doing better than the US (which is 4ᵀᴴ from the bottom). Addressing affordable housing close to places of employment seems to be pretty helpful most places it’s tried. AFAICT, NIMBYism prevents that in most large cities (though why a tent city is preferable is beyond my understanding). I agree with decriminalization, but also that individuals should be able to function within a social framework. For those that can’t (not those who won’t), services should be provided to allow that person to thrive in the capacity that they can in the most minimally invasive way possible.

> AFAICT, NIMBYism prevents that in most large cities (though why a tent city is preferable is beyond my understanding).

It's no different than "banning abortions to reduce the amount of abortions". It doesn't work that way in reality, and rather than face reality, they dig in deeper, stick fingers in their ears and go LALALALA CAN'T HEAR YOU. Except that NiMBYism goes strongly across both major political parties.

Though there's plenty to say about "affordable housing", many have argued we just need drastically more housing rather than a lot of government regulated housing prices. We're just not building enough in places people want to live, specifically because zoning (looping back to NiMBYism). [Andrew Price](https://andrewalexanderprice.com/blog20210125.php) and Strong Towns have plenty to say about this.

Your understanding of the situation is pretty poor.

The reason cities are struggling with homeless populations isn't because "treat them like people with dignity" doesn't work, but rather that there are MOUNTAINS more homeless people than most cities fund helping. This is exacerbated by housing being stupidly more expensive than it has been in the past in cities. Homeless people don't have a home. Plenty of them have jobs they are desperately trying to keep. But when the average income in your city is less than the average housing cost, you inevitably get way more homeless people.

Also, the point of decriminalization of drugs is just to reduce unnecessary harm, since our justice system sees anyone in it as expendable and unwanted. If you want to actually help homeless people get off the street and back into society proper, you need to fund enough shelter beds for them, enough social workers such that they know these people by name and have the time to actually work for them, and some sort of jobs or education or enrichment programs.

Cities with expanded funding for homeless populations are the ones with the issues. When I moved from Phoenix to Seattle in 2009 I was surprised by the level of homelessness there. The major difference: lots of support for urban homeless. I moved back and Phoenix has adopted many of the same concepts, and guess what? The homeless population is exploding here now as well.

I’m all for affordable housing and work programs and other things that allow those who have fallen on hard times ways to help themselves out. I’m also for psychiatric care for those who have mental health issues that won’t be able to help themselves. None of that involves safe spaces for recreational drug use. That only keeps people on their state or drags them down and provides incentive for others to follow (as evidenced by Seattle, Portland, SF, LA, etc.).

There are lots or organizations that will give people a place to stay, especially woman and children. The good ones will also have educational help and employment services as well. None of that needs to include trip sitters, needle exchanges, narcan, or paraphernalia vending machines.

> there are MOUNTAINS more homeless people than most cities fund helping

Last time I checked San Francisco spends something like $50,000 per year per homeless person. It's not a lack of funding in some places.

San fransisco is up shit creek because even a cardboard box on the street fetches a $500 a month rent. The best option for them is probably a bus ticket to a much smaller city and a giant donation to that city's homeless funds, but what homeless person is going to take that offer when the other city might have a climate where you get to die from exposure?