There are probably ways to distribute a legal and safe mixture of recreational opioids with some portion being an opioid antagonist that would prevent abuse at the levels that lead to gross addiction (see suboxone). Or some novel molecule that has those properties. Raw opium wouldn't be that though.

Oregon tried it, and it failed.

So no, not they way they did it.

https://www.pbs.org/newshour/politics/oregon-governor-signs-...

Oregon legalized it and then skipped doing any of the other stuff that was advertised as coming with it, like free addiction treatment, social programs, etc. It's a 'we've done nothing and we're all out of ideas' approach consistent with the state's approach to homelessness at various levels, where agencies won't even spend the money they already have because they don't even know roughly how many homeless people there are per county.

The argument was that the drug problem was caused by prohibition, but obviously that wasn’t the whole of it. The argument that the public should pay a bunch of money to deal with drug problems is a different argument.

> argument was that the drug problem was caused by prohibition

To be fair, Oregon never reached the point of legal sales channels for drugs. Drug users still had to purchase drugs from a dealer. Their supply chains were the same as in other states.

Actual legalisation would establish a legal purchase channel. That would come with quality controls, et cetera.

Fair point. We should have Purdue make fentanyl.

Oxy is a pretty good example of the pros and cons of legalizing it.

Deaths from prescriptions were relatively rare - but it created a huge number of addicts with escalating tolerances.

Then as progressive efforts were made to reduce distribution, pill-mills and secondary markets appeared (i.e. crime). Then with further restrictions, addicts moved off oxy entirely, onto heroin, and then fentanyl flooded in - and bodies piled up.

Just "legalizing" might reduce the harm, but would increase number of addicts. Prescriptions for existing addicts is good for them - but dealers aren't just going to give up, they'll focus on creating new users.

I don't think I've ever seen a perfect solution - but things like distributing naloxone or creating supervised places to self-administer seem like no-brainers in the meantime. Resistance seems to come from a somewhat ugly place where people see users dying as the problem being solved.

Some people say we should legalize drugs and then spend billions on drug addiction treatment, because somehow people should feel free to try and get addicted to drugs, because society will pay the bill to make them better afterwards? Either people should take responsibility for their own actions, or we should disallow the actions, I’m not sure how allowing the actions without personal responsibility for the consequences was ever going to workout from a moral hazard standpoint.

The problem with local approaches to dealing with the homeless crisis is that the better you do, the worse your problem becomes. Portland doesn’t just grow homeless on trees, they have one of the busiest greyhound stations in the country, and everyone else is just so much at dealing with the problem.

Drug addiction is a social problem

Criminalising drug users does nothing about the social problems, and makes them worse

Are we at the "real legalization has never been tried" stage already?

Oregon decriminalized simple possession by end users. You would still need to purchase the drugs from the exact illicit supply chain the DEA is profiling here, so it's no surprise it didn't solve the overdose crisis. Under legalization you could buy an exact dose from a licensed supplier.

I’m not sure legalization would change much: fentanyl is so popular as a street drug because it is so cheap. Providing a much more expensive alternative isn’t going to suck away demand from the illicit version

These are not intrinsically expensive chemicals. A small charity could give it away for free. I would wager dysfunctional drug addicts don't value their time too highly, and wouldn't be put out by having to talk to someone every day to get their fix. Meanwhile it's a great place to push interventions. It's obvious fundamentalist prohibition is straight up not working.

If you gave it away for free, how would the OD rate not go up? You will still have the street market if you are at least somewhat restrictive however; that is unless we start enforcing laws against dealers again, but that isn’t going to happen without any leverage over users.

At best what we can achieve is what Portugal achieved, which is mixed success that no one is really happy about.

How would the OD rate go up? I'd say that most overdoses are caused by people not knowing exactly what they're taking. The pathological case being someone buying pills they expect to contain no opioids, but yet still ending up being cut with fentanyl because it's cheap to smuggle and provides a stand-in psychoactive effect.

Also I don't see why there needs to be leverage over users to enforce laws against dealers. Does buying food need to be illegal in order for the government to regulate food safety? Of course those laws for dealers need to be sensible like only selling pills made with Good Manufacturing Practices and other quality control, otherwise we're right back to draconian prohibition.

There is dumb high school kid OD, the drug they think is safe is actually laced with too much fent. I assume you aren’t going to let these kids buy from legit sources anyways, so I’m not sure how they are avoiding buying from the homeless encampment next to their city bus stop (something that actually happened here in Seattle). Then there are people that don’t care, and do as much drugs as they can get their hands on, the people who are in crisis all the time.

If you can’t go after the users, you have to find some other way to get to the dealers. Portugal has that problem, since they can’t go after use, the police aren’t finding an effective way to go after dealers either.

How many high school kids buy alcohol and cigarettes from homeless encampments? And when they do, how much of that is dodgy hand-crafted mixtures of unknown provenance, versus sealed packages directly from the regulated supply chain?

There's never money for treatment, but there's always money for police and prison.

https://www.washingtonpost.com/world/2023/07/07/portugal-dru...

> After years of economic crisis, Portugal decentralized its drug oversight operation in 2012. A funding drop from 76 million euros ($82.7 million) to 16 million euros ($17.4 million) forced Portugal’s main institution to outsource work previously done by the state to nonprofit groups, including the street teams that engage with people who use drugs.

"We had a great success. Then we defunded it and it quit working."--Cue shocked Pikachu face

There is always money for treatment, actually, just never enough money for an ever expanding problem. And it’s all locally allocated, while the problem is national, can Portland or even Oregon solve a problem that spans several states? Vancouver nearby (BC not WA) has similar problems, better funding (and more federal help as well), but it is still far from enough.

I don't believe what I read. Giving away fentanyl for free?

You have a romantic view on drugs. In such, you either are really young (and still idealistic, which is good but lacking life's experiences) or you never drink more than a beer and don't really have contact to the addicted.

The aim should be to get them off this, so they stop doing EVERYthing just for getting the next high. The aim is not to even supply more of these highs to them.

You have to take it away and to help the people. Or they will take something away from you (just as it is meant in EVERYthing for the next high..)

I say no. I'm not agreeing here.

Where did I say the goal was to "supply more of these highs" ?

You say "take it away" like there is a magic wand that hasn't been waved, and just needs to be waved to make drugs disappear from existence. But rather this idea is actually just the widespread approach of prohibition, which has been tried for the past five decades, with its main result of causing great personal and societal harm.

Currently, we already have plenty of addicted people seeking out their next high, and they will have very little problem getting it. If there is a problem getting it, it's simply a lack of money - which means it can be straightforwardly solved by stealing. Their dealer, in the best case, wants to keep them alive and addicted rather than ever pushing them to seek help. And every fix they get has a high chance of outright killing them due to lack of quality control and standards.

So no, I don't buy into this vague handwaving that the current highly corrosive and grossly ineffective legal regime deserves any credit for keeping the problem from being somehow worse. At this point we've had five decades of fundamentalist prohibition, and it is responsible for the current state of affairs.

I can understand you, but I'm thinking it doesn't have anything to do with prohibition. If it were so, then the addicted to opiates would be distributed evenly through All countries. It's not the case with, I'm from Germany, in Germany. We have drug addicts too, but it's not a problem here. You know why?

Because opiates are forbidden and you have to fear your freedom if you handle them with lack.

For example it's not possible to get them prescribed easily. If you got them prescribed, it's an act of getting it. We have the BTM law where everything is written down.

Instead, America's physicians prescribed that to easily in former times and still doing it (pain killers on oxy basis?). The drugs and addiction epidemic started much earlier. And now it's already full swinging.

It's not the problem of prohibition, it's the problem of way too easy to get access and hands onto. And you call it prohibition.. I name it regulation. There is a difference between these both two words. So, America should regulate it much more. Each world's country should regulate this the much the people can't by compounds or ready for usage stuff. This is the case for addictive drugs, which in my eyes includes alcohol too.

But, may be I'm wrong in here and I don't see the true "why" But I'm thinking, I'm not wrong in here though.

https://nida.nih.gov/publications/drugfacts/prescription-opi...

So what you want basically is to open the market, to talk to people not to do it (so they educated enough to decide on what they want) and then hope that the abuse of drugs won't get more and even sink? And that with highly effective and addictive stuff? NO, H3LL!

You seem to have absolutely no experience with drugs. Absolutely No Experience with opiates. I have, I one got it in the hospital and I remember it as a wonderful time. I would like to repeat that experience, but I know, if I do , I might get into big trouble and am strong enough not to touch it. But if one would give me 1 pill. I would take it because it was high pleasure experience. There my drug addiction career would have started.

You talk about quality controls and standards. I'm talking about ban it completely, make everything unreachable for everyone. Make it highly regulated. That's the only way not to have people easy try it and get hooked on the feeling, like me. You can think what ever you want, but I'm happy that we're living on a democracy and laws are for each and every ;) and there are still enough people who so No, like me :) I do it out of experiences.

> So no, not they way they did it.

I am advocating legalisation, not decriminalisation.

Oregon legalized it and then never funded ANY of the treatment programs it was supposed to.

Um, yeah, that's not gonna work ...

It also doesn't help that many of these drugs are still illegal at the federal level. Consequently, you cannot create a legal manufacturer who can sell drugs of a known quality since the Feds can kick their door in at any point in time.

Legalize it in what manner? Fentanyl is legal - it’s used by hospitals all over the country. Should you be able to buy opium at the corner store? I’m not sure that would be good for almost anyone given the dependence you build on it very quickly.

What’s the Bull case for more people having easy access to opium products ?

The pragmatic argument is to have a regulated and legally accountable supply chain that results in predictable dosing with known substances and amounts. How many people are overdosing on known good prescription pain pills compared to random shit mixed by street dealers?

When you legalize something you get more of it. Gotta be mindful of that.

More drugs? Why is that bad?

Because we simultaneously give people the freedom to do whatever they want to do, and also catch them when they suffer the consequences of their actions. IMO, you either have freedom and responsibility, or control and care. I'd be ok legalizing drugs tomorrow if non-drug users do not need to subsidize the care for drug users.

The problem is that responsibility comes from reason, and drugs like Fentanyl are a direct attack on your faculties of reason. A lot of Enlightenment ideals fall down when faced with hyper addictive things IMO, and we just keep inventing new ones.

> and drugs like Fentanyl are a direct attack on your faculties of reason

Alcohol is a much more serious attacker of reason

good, if we want to have healthcare, then limit alcohol consumption

> then limit alcohol consumption

Prohibit it?

Yeah, nah!

Provide safe alternatives

MDMA for example

A large group of people partying on MDMA is a wonderful thing.

Close to True Bliss

I highly recommend it

If you think society has an obligation to you to give you a cradle to grave safety net (and I do), then you have to accept the reciprocal responsibility of maintaining yourself as a productive member of that society. It’s antisocial in a very specific sense of the term—reducing your capacity to take care of someone else who might need the help for reasons outside their control.

For the users' health, for the user's mental health, for society that has to tolerate these less-functioning persons, for their families, friends, relatives, employees, and so on.

How many people feel great about their heroin habit?

Are you being purposefully obtuse?

Some time ago, when I was a young man with right-wing persuasions, I listened to the arguments of left-wingers like John Oliver in favour of legalization. I was convinced. Let the free market sort itself out, I thought.

Boy did ever I take a sharp turn towards the political center on this in the years since. Some regulations have a very high return on investment, and controlling/banning the crap out of fentanyl is one of those.

Because street fentanyl is currently illegal, it has zero quality control, and people wind up dead taking doses that they didn't intend. Because it contaminates other drugs, people who don't intend to take fentanyl sometimes wind up dead from it.

We would be better off if people could purchase drugs legally from places that have stringent quality control so doses could be properly controlled.

that's what i've been saying for a long time, the problem isn't the pharamustical grade fentanyl, it's the street fentanyl thats problem, essentially because drug dealers have no quality control. Also cold comfort that the Scientist are with me. There's no drug that has ever become safer by ceding the market to criminals by way of prohibition. Every single one of them has gotten worse under such a regime. Look at Krokodil, that's the result of the inability to afford the real thing, and largely because of regulations on the chemical precursors.

Just because a drug doesn't kill you physically, doesn't mean it doesn't harm you in other deeply profound ways. Related: Nuggets[1]

1. https://www.youtube.com/watch?v=HUngLgGRJpo

Opiates, and many classes of illegal drugs, do very little harm.

Addiction is the main feature, and if the substance has no artificial scarcity, addiction is easy to manage.

There is no basis on harm reduction for the drug policies being pursued in most of the world

Tell this to the addicts who live on my sidewalk. Many of them got started on pain killers, and now they're permanently bent over in the fentanyl flop; I'd be astounded if any of them ever get better.

Worik's argument appears to be, if people had an unlimited supply of drugs, things would be better than a limited supply. It sounds a lot like the perspective of someone who has never listened to a recovering addict.

> sounds a lot like the perspective of someone who has never listened to a recovering addict.

Many

I came of age in a culture awash with herion

I have first hand knowledge of the harms done to drug addicts by criminalising them

The definition of harm is context-dependent. I think you mean that opiates and other drugs, addictive or not, when “taken at a safe dose in a health young adult” will not significantly degrade basic body function.”

But opiates taken over a relatively short time can and often do greatly impair CNS neurotransmitter systems and downstream behaviors—-in some cases causing almost irremediable dysfunction. This happens to a sizable subpopulation of humans; more than 10% of physician-prescribed oxycontin users. Genetics and social context modulate vulnerability.

This is definitely not “little harm”.

> opiates taken over a relatively short time can and often do greatly impair CNS neurotransmitter systems

That is untrue

https://en.m.wikipedia.org/wiki/William_Stewart_Halsted is a counter example

"Throughout his professional life, he was addicted to cocaine and later also to morphine...."

You link for support for your opinion thar all drugs are benign to a Wiki entry if a scientist who died in 1922—-before there was a field of neuroscience?

My rejoinder could be 10,000 peer-reviewed papers in this millennium.

> You link for support for your opinion thar all drugs are benign to a Wiki entry if a scientist who died in 1922

Who pioneered keyhole surgery

> rejoinder could be 10,000 peer-reviewed papers in this millennium.

Nonsense.

Long-term opiate use can really mess up your bowels. Matthew Perry nearly died of a perforated colon a couple years before he finally died from other drugs.

Legalizing opiates is silly. It only takes a handful of times to get hooked and people currently use alcohol for months on end to get through hard times. Anyone with even a slight propensity for substance abuse would be an addict within a year. Contrary to the popular narrative it’s not super simple to get opiates and honestly it’s not on most people’s radars to even seek it out.

A lot of people are taking fentanyl thinking it's something else. It's pervasive in the drug supply. Kids who are being served ads for ketamine on social media are buying street K (obviously with a confidence boost from the advertising big tech allows) and boom, fentanyl. People who have been prescribed xanax, and got a little addicted and then buy it on the street because the pharmacist and doctor are onto their misues... It's not as simple as calling it an opiate thing, and even then, opiate addicts in my book deserve to like live. We have to rethink our approach to drugs, because this isn't the same game as even a decade ago. I think legalizing and deshaming to the point of exhaustion makes sense, but I'm not sure my thought is right.

The US effectively had legalized opiates during the Oxycontin era. Many people were addicted to these drugs under order of their doctor. Then their supply was cutoff and they started seeing illicit sources. Enter: Fentanyl.

So a little bit of control early on (at the doctor stage) would have cut the head off this particular dragon then.

> Anyone with even a slight propensity for substance abuse would be an addict within a year

There is no evidence for that.

The evidence is that drug addiction has more to do with social issues than chemistry.

The book https://chasingthescream.com/ is a good read on this issue.

Both! Sure: little risk when there are few or no drugs in a specific social setting, and no peers are using drugs. So it is true that social setting can be determinative in extreme cases. But if drugs are available and some peers are users then genetic variation definitely modulates risk of addiction to drugs that greatly degrade function and even mortality risk. I am sure you know last year’s excess death attributable to opiates and ilk—-now well over 100,000 in 2023— four-fold higher than in 1990. Team Sackler/Purdue Pharma, lax regulation, and greed all around, get lots of opprobrium but no jail time.

And just to admit:

Alcohol and tobacco both have much higher burdens in terms of disability-adjusted life years.

For alcohol see this plot: https://ourworldindata.org/grapher/dalys-from-alcohol-use-di...

For other drugs of abuse (excluding tobacco) see

https://www.paho.org/en/enlace/burden-drug-use-disorders

Synthetic opiates are particularly lethal

Raw opium is much harder to kill yourself with.

For an addict herion overdose is almost unknown. True. It does not suppress the breathing reflex like morphine and synthetics.

Putting powerful deadly drugs in an easy to swallow pill is not a sensible approach to recreational drugs

Opium lounges are a much better idea. I am keen on those.

Most people grow out of drug usage by 25.

Having drugs that don't kill people before they grow out of them would be a good thing.

And, if even Michael Jackson or Prince can die of an overdose, there is something very, very wrong with our entire system.

> Legalizing opiates is silly. It only takes a handful of times to get hooked...

Wrong

Cigarettes are already legal despite killing 7x as many in the US as all opioids combined every day, week, month, and year.

US drug policy is not about harm reduction or life saving, and never has been.

Cigarette users don't nearly always spiral into behaviors that are both self-destructive, heartbreaking to family, and sometimes violently criminal toward the innocent bystanders nearby.

>Cigarettes are already legal despite killing 7x as many in the US as all opioids combined every day, week, month, and year.

That's because they do it after at least decades of use and for a much smaller percentage (if opioids were used by the same number of people, we'd be knee-deep on corspes in the streets), and they don't affect nowhere near as much (if at all) the general functioning or mental health of their users.

Even the average user's health is not really that affected, unless they get C after decades of use. There are much worse offenders (like eating and a sedentary lifestyle).

> Cigarettes are already legal despite killing 7x as many in the US as all opioids combined

Is that true? I am not denying it, but the opiate overdose rate is staggering.

Yeah it's somewhere near half a million people per year in the US die from diseases caused by cigarette smoking. Fent's body count last I checked was like 77,000.

Whether they are a fair comparison I'm not sure. It might be more accurate to say that while fentanyl can kill you, cigarettes make you live less long, rather than to say they kill you. No one drops dead from lighting a cigarette. Meanwhile, if it weren't for unreliable dosing due to black market pressures, I'm not sure regular, reliably dosed opiate usage would kill you slow the way cigarettes do.[citation needed] Anecdotally, I've noticed that ex junkies often look ten years younger than they have any right to.

Cigarettes are a slow poison and mild stimulant at worst. It really doesn’t modify a person’s day to day behavior in any significant way.

Sends them out to stand in the rain several times a day....

But not with opium. Please not .

Everything "natural" that can make you addicted to, is the same as synthetically made stuff that makes you addicted to.

The problem is here not in the market or lacking regulations. The problem is that you have personality changing, highly addictive, dangerous stuff. Mary Jane, alcohol and tacos is enough of regulated.

Advocating here doesn't take into account that the advocatee kills. It's not harmless.

> Advocating here doesn't take into account that the advocatee kills. It's not harmless.

Opium is not a great killer

It is not a fast killer, but it kills you. Like tobacco, Alcohol, and the regulated Heroin and all the other drugs too.

The dangerousness comes from the speed of getting addicted to and the damage it causes: health, sociological and financial.

You arguing like opium is like weed. Hell. No! Get your experiences.

> but it kills you. Like tobacco, Alcohol, and the regulated Heroin and all the other drugs too.

That is untrue

Opiates have few long-term health detrimental effects, exciting addiction

(Amd, reportedly, constipation)

It's a f*ing addictive making drug. You don't have experience with that it seems and thinking it's romantic or something? The addicts suffer a lot, they can't work high but can't be not be high. And that kills. First it kills your social life. Then it kills you. If it's not the cancer it might cause, then it's not necessary the overdoses of other drugs which you take instead. All addictive making stuff should be banned.

https://monographs.iarc.who.int/news-events/volume-126-opium...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9159125/

Just YouTube a little bit around and take a look at your "that's not true". Look how addicts living a wonderful life. Picture you living sich a wonderful life :)

Drugs are bad. Whatever makes you addicted, should be banned and highly regulated. Not the opposite.

When you take weed as example - that's not a problem because it doesn't make your body addicted to (but your brain, which is really not that big problem). I'm consuming that since 25y (in average daily) and comparable lot with 5-10J per day. If I'm about to be empty, I start to get nervous because I don't want not to smoke. But if I decide to stop it, I have 2 weeks where I'm really not a good guy. But that's all. It's more the nicotine. If I can't smoke, I search for a solution so I can.

If you smoke opium, try to do that:) if you take fentanyl, try to do it. So you basically have no experience and talking about "it should be allowed because it's just obstipation and a little addiction" in my eyes.. to naive look. The same I see with the young people who are against prohibition by the state but for self decisions.. LOL. they're the first one getting hooked on it.

> s a f*ing addictive making drug. You don't have experience with that it seems and thinking it's romantic or something? The addicts suffer a lot, they can't work high but can't be not be high.

Steady on, no need to swear

I have extensive experience of addiction

Opiate addicts cab easily be useful productive members of society

It is how herion addiction was treated in England until the 1970s when the Americans threatened them into stopping

People who are at rock bottom are often drug addicts to, but in most cases it is not the drugs that get them there, and it is the police, law, and stigma that keep them there

Ok I'm sorry. You're right, no need to swear. I'm with you in the means drug addicts can also be a driving force.. not necessary they are completely useless. And yes, it's stigmatizing and it's done by the laws.

But I think it's better not to let the addiction even start, what would inadvertently happen if the handling of such substances is not regulated (not necessary completely unregulated in the means letting it up to the people to decide whether they want to try it or not)

Because it's the beginning, and the possibilities are very high that people start to like it and can't handle such freedom.

The same discussion is right about in Germany. From the 1st of April, weed ist partially legalized. So we have had people who did consume before (like me) and who now start to try it and - in between this both groups - people who did not consume frequently, but start to consume at higher levels (not like me, daily, but more often then once, twice a month..).

In Portugal (fully) and Spain (some kind of fully legalized) weed has been legalized since a long enough time for them to get the counts. O don't have sources by hand, but they tell statistically, around 30 percent more consumption and around 30 percent more of psychological problems emerged since legalization.

I don't care the numbers, except there was a rise since deregulation. I believe it's more than 30 percent. With me personally nothing changed really. So I think this 30 percent are from people consuming irregularly (now regularly) and new starters. The old consumers won't change their behavior much, because it was already at high levels before. So I'm thinking, if stronger things are not regulated anymore, then we will have a lot of addicts .. and with a stuff, that makes you strong addicted to, it's not fun anymore.

So that's why I'm arguing against it.

I don't believe some education will stop people from doing it. Nowadays we have like a really strong education on this topic. Each one knows what drugs do - bit still people try it. And they switch to even harder drugs if they can't get theirs...

Just look at the alcoholics. Of they don't have booze, they drink others like perfume (in the end, it's just alc).. or they try crocodile (the Russian horror drug) for example.

So we don't know how the people will behave and I'm thinking mostly negative about that, as you already got it punched in the face by me. Sorry for that mate.