14 ms·

The war on drugs has failed: doctors should lead calls for drug policy reform

361 points by randomname2 10y ago

droopyEyelids 10y ago
Couldn't read the article, but I think the issue is that doctors aren't directly more qualified to call for drug policy reform than anyone else. Hear me out: Doctors are aware of the side effects and dangers of drugs, and the harm they cause people who take enough drugs to require medical help. However, a doctor isn't specifically informed about the cost of prison, the damage imprisoning someone does to their families, and their communities, and their prospects for rehabilitation. Drug policy reform calls for a comparison of the impact of softening drug law against the social impact of imprisoning the people we enforce drug laws on. There just isn't a profession with credible authority in that specific area. It's sort of like what a public policy think tank should make a recommendation based on. But I don't think any corporate interests align with the message enough to fund that sort of research/lobbying.
- FullMtlAlcoholc 10y ago
  From the abstract: >>But the effectiveness of prohibition laws, colloquially known as the “war on drugs,” must be judged on outcomes. And too often the war on drugs plays out as a war on the millions of people who use drugs, and disproportionately on people who are poor or from ethnic minorities and on women. >There just isn't a profession with credible authority in that specific area. It's sort of like what a public policy think tank should make a recommendation based on. But I don't think any corporate interests align with the message enough to fund that sort of research/lobbying. You don't need a particular profession to label the war on drugs an abject failure. Just examine the results. The war on drugs has not made one dent in the demand or the supply. It has led to ever more potent drugs with lower prices and profits going to violent criminals. It's a joke
  - loeg 10y ago
    > The war on drugs has not made one dent in the demand or the supply. While I am also opposed to the war on drugs, let's not make overbroad claims. There is evidence that alcohol prohibition actually reduced demand. Not 100%, but significantly. From Wikipedia: > The Prohibition was effective in reducing per-capita consumption, and consumption remained lower for a quarter-century after Prohibition had been repealed.[34] 34: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1470475/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1470475/ From that article: > Nevertheless, once Prohibition became the law of the land, many citizens decided to obey it. Referendum results in the immediate post-Volstead period showed widespread support, and the Supreme Court quickly fended off challenges to the new law. Death rates from cirrhosis and alcoholism, alcoholic psychosis hospital admissions, and drunkenness arrests all declined steeply during the latter years of the 1910s, when both the cultural and the legal climate were increasingly inhospitable to drink, and in the early years after National Prohibition went into effect. They rose after that, but generally did not reach the peaks recorded during the period 1900 to 1915. After Repeal, when tax data permit better-founded consumption estimates than we have for the Prohibition Era, per capita annual consumption stood at 1.2 US gallons (4.5 liters), less than half the level of the pre-Prohibition period.32 32. Miron Jeffrey A. and Jeffrey Zwiebel, “Alcohol Consumption During Prohibition,” American Economic Review 81 (1991): 242–247; Dills and Miron, “Alcohol Prohibition and Cirrhosis”; NIAAA, “Apparent per Capita Ethanol Consumption.” The figure is for 1935.
    - pstuart 10y ago
      Perhaps it reduced demand, but at what cost? The part where people were freaked out because the government intentionally poisoned alcohol for distribution? If you want to be honest about this discussion, you have to go back to the question of "what is the legitimacy of this action"?
      - loeg 10y ago
        I am not arguing that the benefits of prohibition outweighed the costs.
    - trhway 10y ago
      > There is evidence that alcohol prohibition actually reduced demand. no. The decrease of consumption in US that you posted is pretty much similar to the decrease in consumption during the same time in England for example - from 1900s to 1920s-1930s the consumption decreased 2-3 times and similar to the US it stayed that low until 1960s : http://www.historyandpolicy.org/images/etimated-overall-consumption-1800-1935.jpeg http://www.historyandpolicy.org/images/etimated-overall-cons... (from here http://www.historyandpolicy.org/opinion-articles/articles/the-highs-and-lows-of-drinking-in-britain http://www.historyandpolicy.org/opinion-articles/articles/th...) The Prohibition had no noticeable effect on consumption. The 2 World Wars and state of economy between the wars were the major factors what affected the consumption. Saying that Prohibition in US reduced consumption is just like saying that Giuliani's "broken windows" policing and "stop and frisk" caused decrease in crime in New York - it actually didn't as the decrease in crime in New York followed the same trajectory as in other cities where weren't such policies applied. Or like it is frequently said on HN - "correlation isn't necessary causation".
lawpoop 10y ago
This call seems problematic. Doctors suffer from a kind of bias-- not sure the name of it-- but they only see people when they have problems. The only time doctors encounter the human experience of LSD, magic mushrooms, etc. is when something has gone wrong. Unless the doctor has spent a lot of time at music festivals, burning man, etc. they Sure, alcohol is a very dangerous drug, and causes all kinds of ill health, chronic conditions, emergency room visits, accidents, etc. But, because most doctors have had a typical experience with alcohol, from trying it as a teenager, binge drinking at college, and now social/casual drinking, they think it's safe, because they've had lots of experiences that didn't end with someone going to the hospital. I'm not sure what the best route is for this, but asking doctors to take lead on this doesn't seem like an effective campaign.
- akiselev 10y ago
  That may have been true in the past but the situation has rapidly changed over the last decade. Amphetamine and opioid abuse stemming from over-prescription is becoming far too common and doctors are now experiencing the full spectrum from people genuinely in pain to high-risk heroin addicts. When the latest public health scare is a drug abuse epidemic attributed to the medical system instead of the black market, it's far harder to ignore the futility of the war on drugs.
  - icantdrive55 10y ago
    I'm not so sure amphetamine, and opioid abuse are the result of over-prescribing. I honestly think people are genuinely misserable. They are given a drug that makes them feel just better. Some just want to feel better. Of course, it's easy to blame it on a medication, but if it's not that prescribed pain killer, it will be something else. We need to stop saying we are "The greatest nation on earth." For some, it might ring true, but for the vast majority of us it isn't. It's just a country, with a lot of laws, and becomming very hard to make a living. We are thrown into a society, and just expected to "make it". We were brought up being told; you can do anything if you work hard enough. So many of us are just completely dissalusioned. I won't get into all the reasons. Oh, the reasons. No, we aren't starving to death, but the pressure to live up to the success of past generations is stiffling. We got some hope with the invention of heterocyclic drugs. (Prozac, etc). They failed spectacularly. Doctors went from "The boy geniuses--to mechanics." I look at the average Doctor, as just a luckey guy who got accepted to med. school, and slightly more ethical than the typical lawyer. Hell--I never had a mechanic say this while under my vechicle, "It's an art too?" Yea, I'm no fan of the golden boys. So now, on so many levels Doctors shouldn't be the ones deciding policy. They are just too tied to the money their profession that extorts from us. Extortion might be harsh? It's more like being held hostage? We need to pay them in order to prevent disease, or feel better? (The AMA is basically a huge lobby group. They don't want patients doing anything other than making a office visit, and getting a script.) Do I have a better system? No. That's the problem. That said, I would like to take the power away from doctors. I would like to see a Federal Statute put into place. It would be this: If any patient has been on a drug(maintance drugs mainly--blood pressure drugs, drugs that control diabetes, many psychiatric medications, pain meds, etc) for longer than five years; that person should be able to obtain the same dose of medication without seeing a doctor. Of course antibiotics would be off limits to everyone. And patients would have to provide any required blood work their medication requires. I would further like to see all street drugs decriminalized. Something on the lines of what Portugal did. Thats it. Will it happen? Probally never. We will go on spending a fortune on locking people up for just wanting to feel better, or have more energy. I would rather see that money go into free education, free housing, and free medical care.
karmelapple 10y ago
Chasing the Scream is a fantastic book on this very topic. Highly recommended.
deleted 10y ago
[deleted]
jayajay 10y ago
It's amazing that we just still live in a system where the people who methodically know nothing about something can end up controlling the majority share.
rosege 10y ago
Here's a great speech on the topic that I recommend to anyone interested https://www.youtube.com/watch?v=Nsu_4zsfp2M&index=3&list=PLKKWbWvkO0GAGTVufsIQcg-CA7PfA4dq6 https://www.youtube.com/watch?v=Nsu_4zsfp2M&index=3&list=PLK...
ImTalking 10y ago
The war on drugs was never about health, but was about racism. One poster talked of Chasing the Scream which details this. So the idea that doctors should be advocates for the ending of the WoD just continues the false rationalisation that health is at the heart of the WoD. I can ask 1 question which will show that health has nothing to do with it: why is hemp illegal? What is at the heart of ending the WoD is human rights; a topic which doctors have no more knowledge than anyone else.
- dikdik 10y ago
  Why physicians? Because the proletariat still have a little bit of say on policy in this country. If you ask citizens with strong anti-drug stances why they support tough drug laws, very few (if any) will say "because I hate minorities." So we've got to change the minds of the voting base. Physicians are highly respected in this country and to have them come out en masse and state that drug addiction is a health issue and not a criminal issue would do a lot to change the minds of voters...which could then slightly change the minds of our lawmakers.
  - ImTalking 10y ago
    I think that the LEAP organisation will have more clout than physicians to end the WoD, and certainly more clout with the proletariat, as you say. Ex-law enforcement officers who have been in the trenches and understand exactly the societal damage caused by the WoD would be better advocates than doctors. And your point about "doctors come out en masse and state that drug addiction is a health issue" may be a double-edged sword for them since we all know that the opiate epidemic and subsequent heroin use increase are issues created, by a large part, by doctors.
    - dikdik 10y ago
      I do think you are correct about LEAP, but I don't believe a large percentage of the police force would ever condemn anti-drug laws. Don't bite that hand that feeds and all that. I don't think physicians are primarily responsible for our heroin epidemic, in my opinion that prize belongs to the pharmaceutical industry and our politicians...but I'm open to any evidence that proves me wrong.
highprofit 10y ago
There are enormous industries around WoD and we know what happens when unintended industries form in a capitalist society.
jmspring 10y ago
Ok, end the war on drugs. Force the ACLU and legislatures to enact laws allowing for forcing adults into mandatory detox and/or mental/rehab programs based on their drug use. Live in a liberal area sometime and experience the excuses and lack of action around heroin addicts and meth heads and their criminal activities for the next fix or based off their current hit... Or the long term mental effects.
- Johnny555 10y ago
  Live in a liberal area sometime and experience the excuses and lack of action around heroin addicts and meth heads and their criminal activities for the next fix or based off their current hit... Don't those same problems exist in conservative areas too? I grew up in a small town in a pretty conservative state and I saw many more serious drug problems up close there than I ever see now in a mid-sized city in a very liberal state.
  - jmspring 10y ago
    My point, didn't make it clear enough, if you point out issues like tracking needles (county exchange or pharmacy -- done through county ordering such), requesting enforcement of laws, etc. you end up being lectured that the city/county embraces best practices... Question mental issues -- nothing we can do.
- razakel 10y ago
  >Force the ACLU and legislatures to enact laws allowing for forcing adults into mandatory detox and/or mental/rehab programs based on their drug use. I'm very uncomfortable with the notion of forcing someone to accept medical treatment without an extremely good reason. If we're going to entertain the notion, it should require a warrant to be obtained from a federal court. Even the power to detain someone for psychiatric evaluation is used sparingly, and that has checks and balances to protect patients.
- Broken_Hippo 10y ago
  "Ok, end the war on drugs. Force the ACLU and legislatures to enact laws allowing for forcing adults into mandatory detox and/or mental/rehab programs based on their drug use." Or, you know, actually look at facts instead of only the percentage of folks that have a major issue. I'd not force a person to give up their daily evening pot habit any more than I'd force a person to give up their two-glass-a-day wine habit. I don't freaking care if a couple sends the kids away to the grandparents for a weekend so they can drop some acid. I don't care if someone does cocaine twice a year (Yes, I've met some folks like this). Most concerning, however, is the US's general policy of using AA or NA as the standard program for detox or rehab. While it works for a few, it is really lacking in substance - even for folks that aren't actually addicted, merely get caught with some drugs during a traffic stop. Sure, it works for some folks, but I'd personally never be able to follow through due to my lack of belief in some "higher power" (in other words, god) nor do I believe that everyone is an addict for life.
rdtsc 10y ago
Private Prisons (through their lobbyists) are likely one of the main opposers of loosening the War on Drugs. We don't know clearly what they lobby for - they would never admit it publicly, but it is not hard to guess. Stopping the War on Drugs would be a cut to their profit margins. Snopes dissected this a bit: http://www.snopes.com/drug-law-lobbying-by-corrections-corporation-of-america/ http://www.snopes.com/drug-law-lobbying-by-corrections-corpo...
- brighton36 10y ago
  Bitcoiners too, it should be noted.
haberman 10y ago
And yet Jeff Sessions, Trump's nominee for Attorney General, is one of the most notorious anti-drug (particularly anti-pot) politicians around: http://www.csmonitor.com/USA/Justice/2016/1122/As-Trump-s-AG-how-might-Sessions-crack-down-on-recreational-marijuana http://www.csmonitor.com/USA/Justice/2016/1122/As-Trump-s-AG...
- lamontcg 10y ago
  Yep, good luck with that for the next 4 years. I'd wager a guess Trump snorted his share of blow in the 1980s, but congressional republicans and the private prison industry are going to be calling the shots on the drug war for the next 4 years.
  - reddytowns 10y ago
    Private prisons are being phased out: http://www.bbc.com/news/world-us-canada-37124183 http://www.bbc.com/news/world-us-canada-37124183
    - Broken_Hippo 10y ago
      Only at the federal level, which is a much smaller portion of the prisons in the us. From the first thing I found, there are more people simply sitting in a jail waiting for trial than there are in federal prisons [1]. Which is an issue considering the lobbying the businesses do [2] - they are very much invested in keeping their businesses going and keeping folks in jail. [1] https://www.prisonpolicy.org/reports/pie.html https://www.prisonpolicy.org/reports/pie.html [2]https://en.wikipedia.org/wiki/Private_prison#Lobbying https://en.wikipedia.org/wiki/Private_prison#Lobbying
- AngrySkillzz 10y ago
  A man who literally said the worst thing about the KKK was that they smoke weed.
- int_19h 10y ago
  https://www.facebook.com/int19h/posts/10209935398253997 https://www.facebook.com/int19h/posts/10209935398253997
mvindahl 10y ago
We don't need doctors to point out that the War on Drugs is bound to perpetual failure. Don't even need a scholar. Anyone with two eyes wired to a working brain would reach the same conclusion. That being said, the more people speak up, the closer draws the day where we may transition drug policy into a saner state. It's all rooted in good intentions, of course, as was the US ban on alcohol a century ago. But sometimes the road to mafias and murderous drug cartels is paved with good intentions. Time to wake up.
- ImTalking 10y ago
  For those who started and perpetuated the WoD, it's been a resounding success.
pgnas 10y ago
HAHA! Doctors? they are the reason for the failure. Doctors were directly responsible for the overdose and death of my wife. The epidemic of drug abuse which starts by over the counter addiction is perpetuated by DOCTORS. Citizens need to lead for calls of drug policy reform. We are the masters of our destiny, The problems surrounding drug abuse directly affect US, the people who live in our communities. Start going to your local city council meetings and take a stand, voice your opinion. This isnt going to be solved by Doctors! The majority of Doctors are direct beneficiaries to this abuse. I am not saying EVERY doctor is bad, I am saying that they are part of a business and drugs are a high margin product.
- beedogs 10y ago
  My cousin nearly lost her home and everything she had due to an opioid painkiller addiction -- from drugs she was prescribed by a doctor after major surgery. This has become a silent epidemic, and a gigantic one, and it's ruining lives more and more every day. My condolences on your loss. I wish there were an easy way to put an end to this horrific and needless suffering, but I fear things will only get worse before they get any better.
  - HarryHirsch 10y ago
    This is weird reasoning, you don't wake up one morning and are suddenly addicted to opioids, all involuntary and without your doing. Becoming so addicted to the drug of your choice that you can't quit is a process, and it requires a conspicuous absence of introspection, if not conscious choice. I'm saying this because I have seen close relatives turn into alcoholics. The mental illness/disease angle doesn't do the addiction dynamics justice, and you know that when you have seen other relatives develop genuine mental illness. There's a difference between drinking too much for several evenings in a row without a real reason and not getting worried about it the following morning and losing touch with reality due to developing schizophrenia. There are living conditions that make it understandable why someone would like to choose not to be sober but leaving personal responsibility out of the picture, saying it's the doctors fault or it's all in your genes, is infantilizing.
deleted 10y ago
[deleted]
disordinary 10y ago
The alcohol and tobacco lobbyists will be dead set against the removal of prohibition. Although alcohol and other drugs tend to go together when binging, the amount of alcohol consumed will likely be less. Additionally a mild drug like Marijuana will likely be preferred by some people who would traditionally have a glass of wine or beer every day after work instead of a stronger and more dangerous drug like Alcohol.
- GunboatDiplomat 10y ago
  That seems doubtful. The glass of wine or beer is, firstly, more palatable than marijuana, secondly, you can do it indoors without everything smelling like weed, and thirdly, the mild depressant effect of one alcoholic beverage is way more pleasant than getting high. Not to mention the cost.
  - disordinary 10y ago
    Your comment is 100% opinion - I think it's very obvious that different people have different opinions. That is why I said "some people" not "all people". Vaporisors and edibles are odorless, and the price would surely come down if it was grown in commercial quantities.
  - iamatworknow 10y ago
    >The glass of wine or beer is, firstly, more palatable than marijuana, Your personal opinion. >secondly, you can do it indoors without everything smelling like weed, Vaporizers diminish the smell to a point where it's almost unnoticeable, and edibles don't smell at all. >thirdly, the mild depressant effect of one alcoholic beverage is way more pleasant than getting high Again, your personal opinion. >Not to mention the cost. "The average price per gram, they found, was $6.81; the average joint was $3.50." http://www.nytimes.com/2016/07/15/science/how-much-weed-is-in-a-joint-pot-experts-have-a-new-estimate.html http://www.nytimes.com/2016/07/15/science/how-much-weed-is-i... I think for most people an entire joint by themselves is going to take care of them for the entire night (or longer if it's snuffed out and re-lit). How many beers or mixed drinks are you getting for $3.50?
dfsegoat 10y ago
We (the US) are in the middle of an opioid addiction epidemic. The surgeon general has just made this his highest priority - and physicians are now expected to take a soft stance on drug use? While I am all for reform - there seems to be a major disconnect here.
- Nursie 10y ago
  Firstly, the epidemic of opioid prescription and addiction is not as profound in all parts of the world. The BMJ is international but UK based and the authors of this piece seem to be British. Secondly, how in the hell id the position "The war on drugs has failed, we need policies that promote harm reduction and ethics over failed punitive actions" taking a soft stance? That's part of the whole reason we fail so hard and keep failing, that people have this weird idea that actually tackling the problem is 'soft' and presumably continuing to beat our collective heads against the wall, despite a continuing lack of it acheiving anything, is what? Tough? Hard? It's fucking stupid is what it is...
  - dfsegoat 10y ago
    I've published letters in The BMJ so I am familiar with the audience, which is worldwide - particularly the letters / editorials. I don't disagree in any way that policy reform is badly needed and the war on drugs has failed: My point was more that the messaging seems to be very conflicted these days for physicians in the United State. To me - as a layman - there appears to be no "middle ground" for both policy reform and bringing the opioid addiction under wraps. That is the disparity I am trying to point out and what I find to be conflicting / frustrating. If there is a middle ground I'd love to hear it.
    - Nursie 10y ago
      I'm afraid I'm really not sure I see a conflict between "we need a new approach on drugs, the war has failed to reduce harm" and "we are causing harm with our prescription policies and should probably stop handing out hardcore opiates like candy" Unless you are subject to the sort of black and white thinking that means any change in policy necessarily means a completely open market for all drugs, that is. Many middle ways are possible - legalise and regulate access to less harmful drugs like cannabis (as is happening in much of the US), and offer maintenance and treatment to addicts of more harmful and addictive substances without criminalising them. Not a scenario that requires giving out oxys by the fistful.
yomly 10y ago
Our laws on drugs are really quite arbitrary. In the UK people have factual evidence showing that drugs such as MDMA causes both less physiological and social harm than alcohol[0] so it's not really that we are trying to prevent harm rather than can't prohibit a behaviour that is now deeply ingrained in society. Humans love intoxication. It's as old as time, with mountain people chewing coca leaves or brewing mescaline tea. Even in cultures where alcohol is banned such as the middle east, they simply found alternatives like coffee and tobacco. [0]https://www.google.co.uk/amp/s/amp.theguardian.com/politics/2009/oct/29/nutt-drugs-policy-reform-call https://www.google.co.uk/amp/s/amp.theguardian.com/politics/...
- yomly 10y ago
  Where do you even draw the line? Once you appreciate that everything is a "chemical" does binge-eating sugary foods count as intoxication? It's excessive by its definition and is harmful to the body and society. Should we start cracking down on "donut junkies"? What about activities which release dopamine like gambling and videogames? The treatment of the law on drugs is outdated and mainly political / social now more than it is actually in the interests of society. Don't take my word for it, here is an ex undercover policeman who turned his back on the fight against drugs[0] and HN discussion[1] [0] https://www.google.co.uk/amp/s/amp.theguardian.com/society/2016/aug/26/neil-woods-undercover-cop-who-abandoned-the-war-on-drugs https://www.google.co.uk/amp/s/amp.theguardian.com/society/2... [1]https://news.ycombinator.com/item?id=12365667 https://news.ycombinator.com/item?id=12365667
  - int_19h 10y ago
    Any sort of rational approach would start with legalizing use, and possession in amounts that are clearly intended for personal consumption, of any drug, excepting those that have immediate effects that are highly likely to be harmful to those in the vicinity (e.g. drugs that consistently induce violent hallucinations). We can discuss transfer, sale and other forms of distribution on a case by case basis, depending on how harmful the drug in question is. And we can say that possession of significant quantities, clearly beyond personal consumption, should be considered evidence of intent to distribute (although it should really be rebuttable - i.e. the person should get a chance to present counter-evidence to prove that there was no intent to distribute, and the judge or jury should decide on the balance of probabilities). But there's no rational reason whatsoever to punish consumption of anything.
meira 10y ago
Has it really failed to all parties envolved? In a war, if only one side profit from it, it may not be a failure.
gotthemwmds 10y ago
My dad recently retired after 30 years of practicing oncology and hematology in a private practice ran with a female colleague, located in an office building adjacent to a very large regional hospital. He also worked a supervising shift in the ER every Thursday night, simply because he found it easier to be in the ER since so many of his patients visited it while he was oncall, sometimes forcing him to go in anyway. I guess you could say I enjoy recreational drugs and have done them all and my dad generally knows this and we've talked quite a bit about drugs, specifically the insane amount of opiates and benzos he used to prescribe to his cancer patients. I've sort of gotten the impression the DEA was a hassle in his life and he would not want any attention gained by publicly saying anything but "drugs are bad" (aka the failed war on drugs). There would be no incentive for him to do this on a day to day basis; in fact, there would only be disincentives, at least in the short term. One day in the early 00s, the DEA showed up at his practice unannounced and wanted to start auditing him on the spot. They told him he was in the top 10 opiate prescribers in his area and they were concerned. They had absolutely no paperwork, so my dad kicked them out of his office, and later the building via security. He told them to come back with a warrant. They never did. What struck me about this story is how visibly upset he got at the idea of the DEA depriving people of comfort when they are in pain. When he told me this he said, very emotionally, "These people are dying and in pain and they want to look at paperwork?" I can only imagine how pissed off he was when it happened. This anecdote is all to say I think that doctors probably take one look at any effort to delegitimize the war on drugs and say Nope. What's the point? To help society? Like they do every day as doctors? I just have never felt much of a "let's rock the boat" attitude from any doctors I've known personally regarding drug laws (keep in mind they live in a bubble where all of the drugs are available to them via an Rx pad -- this is very relevant to the enthusiasm drought IMO). Based on a lifetime of being around doctors as personal and family friends (my mom is a medical doctor too), I don't think doctors are going to pick up this cause enthusiastically, even if it makes sense on paper.
- j_s 10y ago
  If you can still edit, I recommend you move the last sentence to the start of your incredibly insightful anecdote: Based on a lifetime of being around doctors as personal and family friends (my mom is a medical doctor too), I don't think doctors are going to pick up this cause enthusiastically, even if it makes sense on paper.
GirlsCanCode 10y ago
When a non-doctor tells a doctor what to do, that's sort-of trying to practice medicine without the requisite training, skills, and license.
GirlsCanCode 10y ago
We should worry more about Obesity, which kills 300,000 people each ear in the U.S. alone, and costs nothing to treat. Just eat less. Start taxing fat people and make money until the problem is solved.
squozzer 10y ago
I think doctors are too tightly bound to the status quo to take the kinds of professional risk by speaking out against any law, no matter how heinous.
OliverJones 10y ago
This pub is f/k/a the British Medical Journal. They're addressing a worldwide audience of physicians and health-care professionals. It seems a bit narrowminded to interpret their suggestions in a US-only context. There's plenty of evidence supporting the position of this editorial. Various nations have tried some form of decriminalization. The effects have been generally positive in places like Portugal, Switzerland, and the Netherlands. It may be time for some of these nations to propose, and sign off on, an alternative to the 1951 anti-drug treaty. https://en.wikipedia.org/wiki/Single_Convention_on_Narcotic_Drugs https://en.wikipedia.org/wiki/Single_Convention_on_Narcotic_... Maybe physicians can lead the way in some nations. But, of course, if drug users are the face of sentient evil, then decriminalizing the drugs is the same as failing to resist evil. This is why selling the idea in the US is very difficult. We've been taught for generations that drug users are inherently evil, and treating them is, at best, a waste of time. US physicians have enough trouble with the federal government as it is. The US government has a century-long history of making the professional lives of dissenting physicians very difficult indeed. It's unreasonable to expect many of them to embrace this cause with public speech. Here in Massachusetts USA, the voters recently chose to end the prohibition on cannabis (following the lead of Colorado and Washington state). The Roman Catholic church (Boston diocese) chose to compel their clergy to speak against this initiative from their pulpits on the Sunday before election. (Huh! I thought electioneering from the pulpit was prohibited. I guess not for the RCs.) I know a couple of law-enforcement leaders who privately supported the end of prohibition, but didn't dare speak publicly. The end of prohibition has to come from voters in the US. Physicians can't do it: the government can revoke their licenses. Legislatures can't do it; they're much too beholden to the military-industrial complex that fights the war on drugs. Religious leaders can't do it: to declare that certain behaviors aren't evil erodes their worldly authority, which comes mostly from the ability to condemn "those" people, whoever they are. It will take a generation, or more.
- TTPrograms 10y ago
  It's reassuring that policy can change due to voter interest in spite of the resistance of career politicians - it demonstrates that American democracy has yet to fail absolutely. Perhaps the focus of people interested in new policies should be directed at state reform rather than federal? Ballot propositions seem to have been rather effective recently, and they encourage the education of constituents rather than the few legislators currently in power who may have conflicts of interest. Then nationwide reform no longer has the excuse of "that wouldn't work in America!", and people impacted significantly at least have the option of moving to those states (i.e. MA and CA for gay marriage a few years ago).
zanethomas 10y ago
Where did the government get the authority to tell adults which drugs they can take?
anngrant 10y ago
From my own experience, doctors are the biggest drug fiends on the planet. But it definitely depends on the type of a doctor. When it comes to buying drugs, almost all of them are available via http://www.rx-discountcoupons.com/pharmacies/pharm-store-com/ http://www.rx-discountcoupons.com/pharmacies/pharm-store-com... without prescription.

361 points by randomname2 10y ago

Couldn't read the article, but I think the issue is that doctors aren't directly more qualified to call for drug policy reform than anyone else. Hear me out: Doctors are aware of the side effects and dangers of drugs, and the harm they cause people who take enough drugs to require medical help. However, a doctor isn't specifically informed about the cost of prison, the damage imprisoning someone does to their families, and their communities, and their prospects for rehabilitation. Drug policy reform calls for a comparison of the impact of softening drug law against the social impact of imprisoning the people we enforce drug laws on. There just isn't a profession with credible authority in that specific area. It's sort of like what a public policy think tank should make a recommendation based on. But I don't think any corporate interests align with the message enough to fund that sort of research/lobbying.

FullMtlAlcoholc 10y ago
From the abstract: >>But the effectiveness of prohibition laws, colloquially known as the “war on drugs,” must be judged on outcomes. And too often the war on drugs plays out as a war on the millions of people who use drugs, and disproportionately on people who are poor or from ethnic minorities and on women. >There just isn't a profession with credible authority in that specific area. It's sort of like what a public policy think tank should make a recommendation based on. But I don't think any corporate interests align with the message enough to fund that sort of research/lobbying. You don't need a particular profession to label the war on drugs an abject failure. Just examine the results. The war on drugs has not made one dent in the demand or the supply. It has led to ever more potent drugs with lower prices and profits going to violent criminals. It's a joke
- loeg 10y ago
  > The war on drugs has not made one dent in the demand or the supply. While I am also opposed to the war on drugs, let's not make overbroad claims. There is evidence that alcohol prohibition actually reduced demand. Not 100%, but significantly. From Wikipedia: > The Prohibition was effective in reducing per-capita consumption, and consumption remained lower for a quarter-century after Prohibition had been repealed.[34] 34: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1470475/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1470475/ From that article: > Nevertheless, once Prohibition became the law of the land, many citizens decided to obey it. Referendum results in the immediate post-Volstead period showed widespread support, and the Supreme Court quickly fended off challenges to the new law. Death rates from cirrhosis and alcoholism, alcoholic psychosis hospital admissions, and drunkenness arrests all declined steeply during the latter years of the 1910s, when both the cultural and the legal climate were increasingly inhospitable to drink, and in the early years after National Prohibition went into effect. They rose after that, but generally did not reach the peaks recorded during the period 1900 to 1915. After Repeal, when tax data permit better-founded consumption estimates than we have for the Prohibition Era, per capita annual consumption stood at 1.2 US gallons (4.5 liters), less than half the level of the pre-Prohibition period.32 32. Miron Jeffrey A. and Jeffrey Zwiebel, “Alcohol Consumption During Prohibition,” American Economic Review 81 (1991): 242–247; Dills and Miron, “Alcohol Prohibition and Cirrhosis”; NIAAA, “Apparent per Capita Ethanol Consumption.” The figure is for 1935.
  - pstuart 10y ago
    Perhaps it reduced demand, but at what cost? The part where people were freaked out because the government intentionally poisoned alcohol for distribution? If you want to be honest about this discussion, you have to go back to the question of "what is the legitimacy of this action"?
    - loeg 10y ago
      I am not arguing that the benefits of prohibition outweighed the costs.
  - trhway 10y ago
    > There is evidence that alcohol prohibition actually reduced demand. no. The decrease of consumption in US that you posted is pretty much similar to the decrease in consumption during the same time in England for example - from 1900s to 1920s-1930s the consumption decreased 2-3 times and similar to the US it stayed that low until 1960s : http://www.historyandpolicy.org/images/etimated-overall-consumption-1800-1935.jpeg http://www.historyandpolicy.org/images/etimated-overall-cons... (from here http://www.historyandpolicy.org/opinion-articles/articles/the-highs-and-lows-of-drinking-in-britain http://www.historyandpolicy.org/opinion-articles/articles/th...) The Prohibition had no noticeable effect on consumption. The 2 World Wars and state of economy between the wars were the major factors what affected the consumption. Saying that Prohibition in US reduced consumption is just like saying that Giuliani's "broken windows" policing and "stop and frisk" caused decrease in crime in New York - it actually didn't as the decrease in crime in New York followed the same trajectory as in other cities where weren't such policies applied. Or like it is frequently said on HN - "correlation isn't necessary causation".

lawpoop 10y ago

This call seems problematic. Doctors suffer from a kind of bias-- not sure the name of it-- but they only see people when they have problems. The only time doctors encounter the human experience of LSD, magic mushrooms, etc. is when something has gone wrong. Unless the doctor has spent a lot of time at music festivals, burning man, etc. they Sure, alcohol is a very dangerous drug, and causes all kinds of ill health, chronic conditions, emergency room visits, accidents, etc. But, because most doctors have had a typical experience with alcohol, from trying it as a teenager, binge drinking at college, and now social/casual drinking, they think it's safe, because they've had lots of experiences that didn't end with someone going to the hospital. I'm not sure what the best route is for this, but asking doctors to take lead on this doesn't seem like an effective campaign.

akiselev 10y ago
That may have been true in the past but the situation has rapidly changed over the last decade. Amphetamine and opioid abuse stemming from over-prescription is becoming far too common and doctors are now experiencing the full spectrum from people genuinely in pain to high-risk heroin addicts. When the latest public health scare is a drug abuse epidemic attributed to the medical system instead of the black market, it's far harder to ignore the futility of the war on drugs.
- icantdrive55 10y ago
  I'm not so sure amphetamine, and opioid abuse are the result of over-prescribing. I honestly think people are genuinely misserable. They are given a drug that makes them feel just better. Some just want to feel better. Of course, it's easy to blame it on a medication, but if it's not that prescribed pain killer, it will be something else. We need to stop saying we are "The greatest nation on earth." For some, it might ring true, but for the vast majority of us it isn't. It's just a country, with a lot of laws, and becomming very hard to make a living. We are thrown into a society, and just expected to "make it". We were brought up being told; you can do anything if you work hard enough. So many of us are just completely dissalusioned. I won't get into all the reasons. Oh, the reasons. No, we aren't starving to death, but the pressure to live up to the success of past generations is stiffling. We got some hope with the invention of heterocyclic drugs. (Prozac, etc). They failed spectacularly. Doctors went from "The boy geniuses--to mechanics." I look at the average Doctor, as just a luckey guy who got accepted to med. school, and slightly more ethical than the typical lawyer. Hell--I never had a mechanic say this while under my vechicle, "It's an art too?" Yea, I'm no fan of the golden boys. So now, on so many levels Doctors shouldn't be the ones deciding policy. They are just too tied to the money their profession that extorts from us. Extortion might be harsh? It's more like being held hostage? We need to pay them in order to prevent disease, or feel better? (The AMA is basically a huge lobby group. They don't want patients doing anything other than making a office visit, and getting a script.) Do I have a better system? No. That's the problem. That said, I would like to take the power away from doctors. I would like to see a Federal Statute put into place. It would be this: If any patient has been on a drug(maintance drugs mainly--blood pressure drugs, drugs that control diabetes, many psychiatric medications, pain meds, etc) for longer than five years; that person should be able to obtain the same dose of medication without seeing a doctor. Of course antibiotics would be off limits to everyone. And patients would have to provide any required blood work their medication requires. I would further like to see all street drugs decriminalized. Something on the lines of what Portugal did. Thats it. Will it happen? Probally never. We will go on spending a fortune on locking people up for just wanting to feel better, or have more energy. I would rather see that money go into free education, free housing, and free medical care.

karmelapple 10y ago

Chasing the Scream is a fantastic book on this very topic. Highly recommended.

deleted 10y ago

[deleted]

jayajay 10y ago

It's amazing that we just still live in a system where the people who methodically know nothing about something can end up controlling the majority share.

rosege 10y ago

Here's a great speech on the topic that I recommend to anyone interested https://www.youtube.com/watch?v=Nsu_4zsfp2M&index=3&list=PLKKWbWvkO0GAGTVufsIQcg-CA7PfA4dq6 https://www.youtube.com/watch?v=Nsu_4zsfp2M&index=3&list=PLK...

ImTalking 10y ago

The war on drugs was never about health, but was about racism. One poster talked of Chasing the Scream which details this. So the idea that doctors should be advocates for the ending of the WoD just continues the false rationalisation that health is at the heart of the WoD. I can ask 1 question which will show that health has nothing to do with it: why is hemp illegal? What is at the heart of ending the WoD is human rights; a topic which doctors have no more knowledge than anyone else.

dikdik 10y ago
Why physicians? Because the proletariat still have a little bit of say on policy in this country. If you ask citizens with strong anti-drug stances why they support tough drug laws, very few (if any) will say "because I hate minorities." So we've got to change the minds of the voting base. Physicians are highly respected in this country and to have them come out en masse and state that drug addiction is a health issue and not a criminal issue would do a lot to change the minds of voters...which could then slightly change the minds of our lawmakers.
- ImTalking 10y ago
  I think that the LEAP organisation will have more clout than physicians to end the WoD, and certainly more clout with the proletariat, as you say. Ex-law enforcement officers who have been in the trenches and understand exactly the societal damage caused by the WoD would be better advocates than doctors. And your point about "doctors come out en masse and state that drug addiction is a health issue" may be a double-edged sword for them since we all know that the opiate epidemic and subsequent heroin use increase are issues created, by a large part, by doctors.
  - dikdik 10y ago
    I do think you are correct about LEAP, but I don't believe a large percentage of the police force would ever condemn anti-drug laws. Don't bite that hand that feeds and all that. I don't think physicians are primarily responsible for our heroin epidemic, in my opinion that prize belongs to the pharmaceutical industry and our politicians...but I'm open to any evidence that proves me wrong.

highprofit 10y ago

There are enormous industries around WoD and we know what happens when unintended industries form in a capitalist society.

jmspring 10y ago

Ok, end the war on drugs. Force the ACLU and legislatures to enact laws allowing for forcing adults into mandatory detox and/or mental/rehab programs based on their drug use. Live in a liberal area sometime and experience the excuses and lack of action around heroin addicts and meth heads and their criminal activities for the next fix or based off their current hit... Or the long term mental effects.

Johnny555 10y ago
Live in a liberal area sometime and experience the excuses and lack of action around heroin addicts and meth heads and their criminal activities for the next fix or based off their current hit... Don't those same problems exist in conservative areas too? I grew up in a small town in a pretty conservative state and I saw many more serious drug problems up close there than I ever see now in a mid-sized city in a very liberal state.
- jmspring 10y ago
  My point, didn't make it clear enough, if you point out issues like tracking needles (county exchange or pharmacy -- done through county ordering such), requesting enforcement of laws, etc. you end up being lectured that the city/county embraces best practices... Question mental issues -- nothing we can do.
razakel 10y ago
>Force the ACLU and legislatures to enact laws allowing for forcing adults into mandatory detox and/or mental/rehab programs based on their drug use. I'm very uncomfortable with the notion of forcing someone to accept medical treatment without an extremely good reason. If we're going to entertain the notion, it should require a warrant to be obtained from a federal court. Even the power to detain someone for psychiatric evaluation is used sparingly, and that has checks and balances to protect patients.
Broken_Hippo 10y ago
"Ok, end the war on drugs. Force the ACLU and legislatures to enact laws allowing for forcing adults into mandatory detox and/or mental/rehab programs based on their drug use." Or, you know, actually look at facts instead of only the percentage of folks that have a major issue. I'd not force a person to give up their daily evening pot habit any more than I'd force a person to give up their two-glass-a-day wine habit. I don't freaking care if a couple sends the kids away to the grandparents for a weekend so they can drop some acid. I don't care if someone does cocaine twice a year (Yes, I've met some folks like this). Most concerning, however, is the US's general policy of using AA or NA as the standard program for detox or rehab. While it works for a few, it is really lacking in substance - even for folks that aren't actually addicted, merely get caught with some drugs during a traffic stop. Sure, it works for some folks, but I'd personally never be able to follow through due to my lack of belief in some "higher power" (in other words, god) nor do I believe that everyone is an addict for life.

rdtsc 10y ago

Private Prisons (through their lobbyists) are likely one of the main opposers of loosening the War on Drugs. We don't know clearly what they lobby for - they would never admit it publicly, but it is not hard to guess. Stopping the War on Drugs would be a cut to their profit margins. Snopes dissected this a bit: http://www.snopes.com/drug-law-lobbying-by-corrections-corporation-of-america/ http://www.snopes.com/drug-law-lobbying-by-corrections-corpo...

brighton36 10y ago
Bitcoiners too, it should be noted.

haberman 10y ago

And yet Jeff Sessions, Trump's nominee for Attorney General, is one of the most notorious anti-drug (particularly anti-pot) politicians around: http://www.csmonitor.com/USA/Justice/2016/1122/As-Trump-s-AG-how-might-Sessions-crack-down-on-recreational-marijuana http://www.csmonitor.com/USA/Justice/2016/1122/As-Trump-s-AG...

lamontcg 10y ago
Yep, good luck with that for the next 4 years. I'd wager a guess Trump snorted his share of blow in the 1980s, but congressional republicans and the private prison industry are going to be calling the shots on the drug war for the next 4 years.
- reddytowns 10y ago
  Private prisons are being phased out: http://www.bbc.com/news/world-us-canada-37124183 http://www.bbc.com/news/world-us-canada-37124183
  - Broken_Hippo 10y ago
    Only at the federal level, which is a much smaller portion of the prisons in the us. From the first thing I found, there are more people simply sitting in a jail waiting for trial than there are in federal prisons [1]. Which is an issue considering the lobbying the businesses do [2] - they are very much invested in keeping their businesses going and keeping folks in jail. [1] https://www.prisonpolicy.org/reports/pie.html https://www.prisonpolicy.org/reports/pie.html [2]https://en.wikipedia.org/wiki/Private_prison#Lobbying https://en.wikipedia.org/wiki/Private_prison#Lobbying
AngrySkillzz 10y ago
A man who literally said the worst thing about the KKK was that they smoke weed.
int_19h 10y ago
https://www.facebook.com/int19h/posts/10209935398253997 https://www.facebook.com/int19h/posts/10209935398253997

mvindahl 10y ago

We don't need doctors to point out that the War on Drugs is bound to perpetual failure. Don't even need a scholar. Anyone with two eyes wired to a working brain would reach the same conclusion. That being said, the more people speak up, the closer draws the day where we may transition drug policy into a saner state. It's all rooted in good intentions, of course, as was the US ban on alcohol a century ago. But sometimes the road to mafias and murderous drug cartels is paved with good intentions. Time to wake up.

ImTalking 10y ago
For those who started and perpetuated the WoD, it's been a resounding success.

pgnas 10y ago

HAHA! Doctors? they are the reason for the failure. Doctors were directly responsible for the overdose and death of my wife. The epidemic of drug abuse which starts by over the counter addiction is perpetuated by DOCTORS. Citizens need to lead for calls of drug policy reform. We are the masters of our destiny, The problems surrounding drug abuse directly affect US, the people who live in our communities. Start going to your local city council meetings and take a stand, voice your opinion. This isnt going to be solved by Doctors! The majority of Doctors are direct beneficiaries to this abuse. I am not saying EVERY doctor is bad, I am saying that they are part of a business and drugs are a high margin product.

beedogs 10y ago
My cousin nearly lost her home and everything she had due to an opioid painkiller addiction -- from drugs she was prescribed by a doctor after major surgery. This has become a silent epidemic, and a gigantic one, and it's ruining lives more and more every day. My condolences on your loss. I wish there were an easy way to put an end to this horrific and needless suffering, but I fear things will only get worse before they get any better.
- HarryHirsch 10y ago
  This is weird reasoning, you don't wake up one morning and are suddenly addicted to opioids, all involuntary and without your doing. Becoming so addicted to the drug of your choice that you can't quit is a process, and it requires a conspicuous absence of introspection, if not conscious choice. I'm saying this because I have seen close relatives turn into alcoholics. The mental illness/disease angle doesn't do the addiction dynamics justice, and you know that when you have seen other relatives develop genuine mental illness. There's a difference between drinking too much for several evenings in a row without a real reason and not getting worried about it the following morning and losing touch with reality due to developing schizophrenia. There are living conditions that make it understandable why someone would like to choose not to be sober but leaving personal responsibility out of the picture, saying it's the doctors fault or it's all in your genes, is infantilizing.

deleted 10y ago

[deleted]

disordinary 10y ago

The alcohol and tobacco lobbyists will be dead set against the removal of prohibition. Although alcohol and other drugs tend to go together when binging, the amount of alcohol consumed will likely be less. Additionally a mild drug like Marijuana will likely be preferred by some people who would traditionally have a glass of wine or beer every day after work instead of a stronger and more dangerous drug like Alcohol.

GunboatDiplomat 10y ago
That seems doubtful. The glass of wine or beer is, firstly, more palatable than marijuana, secondly, you can do it indoors without everything smelling like weed, and thirdly, the mild depressant effect of one alcoholic beverage is way more pleasant than getting high. Not to mention the cost.
- disordinary 10y ago
  Your comment is 100% opinion - I think it's very obvious that different people have different opinions. That is why I said "some people" not "all people". Vaporisors and edibles are odorless, and the price would surely come down if it was grown in commercial quantities.
- iamatworknow 10y ago
  >The glass of wine or beer is, firstly, more palatable than marijuana, Your personal opinion. >secondly, you can do it indoors without everything smelling like weed, Vaporizers diminish the smell to a point where it's almost unnoticeable, and edibles don't smell at all. >thirdly, the mild depressant effect of one alcoholic beverage is way more pleasant than getting high Again, your personal opinion. >Not to mention the cost. "The average price per gram, they found, was $6.81; the average joint was $3.50." http://www.nytimes.com/2016/07/15/science/how-much-weed-is-in-a-joint-pot-experts-have-a-new-estimate.html http://www.nytimes.com/2016/07/15/science/how-much-weed-is-i... I think for most people an entire joint by themselves is going to take care of them for the entire night (or longer if it's snuffed out and re-lit). How many beers or mixed drinks are you getting for $3.50?

dfsegoat 10y ago

We (the US) are in the middle of an opioid addiction epidemic. The surgeon general has just made this his highest priority - and physicians are now expected to take a soft stance on drug use? While I am all for reform - there seems to be a major disconnect here.

Nursie 10y ago
Firstly, the epidemic of opioid prescription and addiction is not as profound in all parts of the world. The BMJ is international but UK based and the authors of this piece seem to be British. Secondly, how in the hell id the position "The war on drugs has failed, we need policies that promote harm reduction and ethics over failed punitive actions" taking a soft stance? That's part of the whole reason we fail so hard and keep failing, that people have this weird idea that actually tackling the problem is 'soft' and presumably continuing to beat our collective heads against the wall, despite a continuing lack of it acheiving anything, is what? Tough? Hard? It's fucking stupid is what it is...
- dfsegoat 10y ago
  I've published letters in The BMJ so I am familiar with the audience, which is worldwide - particularly the letters / editorials. I don't disagree in any way that policy reform is badly needed and the war on drugs has failed: My point was more that the messaging seems to be very conflicted these days for physicians in the United State. To me - as a layman - there appears to be no "middle ground" for both policy reform and bringing the opioid addiction under wraps. That is the disparity I am trying to point out and what I find to be conflicting / frustrating. If there is a middle ground I'd love to hear it.
  - Nursie 10y ago
    I'm afraid I'm really not sure I see a conflict between "we need a new approach on drugs, the war has failed to reduce harm" and "we are causing harm with our prescription policies and should probably stop handing out hardcore opiates like candy" Unless you are subject to the sort of black and white thinking that means any change in policy necessarily means a completely open market for all drugs, that is. Many middle ways are possible - legalise and regulate access to less harmful drugs like cannabis (as is happening in much of the US), and offer maintenance and treatment to addicts of more harmful and addictive substances without criminalising them. Not a scenario that requires giving out oxys by the fistful.

yomly 10y ago

Our laws on drugs are really quite arbitrary. In the UK people have factual evidence showing that drugs such as MDMA causes both less physiological and social harm than alcohol[0] so it's not really that we are trying to prevent harm rather than can't prohibit a behaviour that is now deeply ingrained in society. Humans love intoxication. It's as old as time, with mountain people chewing coca leaves or brewing mescaline tea. Even in cultures where alcohol is banned such as the middle east, they simply found alternatives like coffee and tobacco. [0]https://www.google.co.uk/amp/s/amp.theguardian.com/politics/2009/oct/29/nutt-drugs-policy-reform-call https://www.google.co.uk/amp/s/amp.theguardian.com/politics/...

yomly 10y ago
Where do you even draw the line? Once you appreciate that everything is a "chemical" does binge-eating sugary foods count as intoxication? It's excessive by its definition and is harmful to the body and society. Should we start cracking down on "donut junkies"? What about activities which release dopamine like gambling and videogames? The treatment of the law on drugs is outdated and mainly political / social now more than it is actually in the interests of society. Don't take my word for it, here is an ex undercover policeman who turned his back on the fight against drugs[0] and HN discussion[1] [0] https://www.google.co.uk/amp/s/amp.theguardian.com/society/2016/aug/26/neil-woods-undercover-cop-who-abandoned-the-war-on-drugs https://www.google.co.uk/amp/s/amp.theguardian.com/society/2... [1]https://news.ycombinator.com/item?id=12365667 https://news.ycombinator.com/item?id=12365667
- int_19h 10y ago
  Any sort of rational approach would start with legalizing use, and possession in amounts that are clearly intended for personal consumption, of any drug, excepting those that have immediate effects that are highly likely to be harmful to those in the vicinity (e.g. drugs that consistently induce violent hallucinations). We can discuss transfer, sale and other forms of distribution on a case by case basis, depending on how harmful the drug in question is. And we can say that possession of significant quantities, clearly beyond personal consumption, should be considered evidence of intent to distribute (although it should really be rebuttable - i.e. the person should get a chance to present counter-evidence to prove that there was no intent to distribute, and the judge or jury should decide on the balance of probabilities). But there's no rational reason whatsoever to punish consumption of anything.

meira 10y ago

Has it really failed to all parties envolved? In a war, if only one side profit from it, it may not be a failure.

gotthemwmds 10y ago

My dad recently retired after 30 years of practicing oncology and hematology in a private practice ran with a female colleague, located in an office building adjacent to a very large regional hospital. He also worked a supervising shift in the ER every Thursday night, simply because he found it easier to be in the ER since so many of his patients visited it while he was oncall, sometimes forcing him to go in anyway. I guess you could say I enjoy recreational drugs and have done them all and my dad generally knows this and we've talked quite a bit about drugs, specifically the insane amount of opiates and benzos he used to prescribe to his cancer patients. I've sort of gotten the impression the DEA was a hassle in his life and he would not want any attention gained by publicly saying anything but "drugs are bad" (aka the failed war on drugs). There would be no incentive for him to do this on a day to day basis; in fact, there would only be disincentives, at least in the short term. One day in the early 00s, the DEA showed up at his practice unannounced and wanted to start auditing him on the spot. They told him he was in the top 10 opiate prescribers in his area and they were concerned. They had absolutely no paperwork, so my dad kicked them out of his office, and later the building via security. He told them to come back with a warrant. They never did. What struck me about this story is how visibly upset he got at the idea of the DEA depriving people of comfort when they are in pain. When he told me this he said, very emotionally, "These people are dying and in pain and they want to look at paperwork?" I can only imagine how pissed off he was when it happened. This anecdote is all to say I think that doctors probably take one look at any effort to delegitimize the war on drugs and say Nope. What's the point? To help society? Like they do every day as doctors? I just have never felt much of a "let's rock the boat" attitude from any doctors I've known personally regarding drug laws (keep in mind they live in a bubble where all of the drugs are available to them via an Rx pad -- this is very relevant to the enthusiasm drought IMO). Based on a lifetime of being around doctors as personal and family friends (my mom is a medical doctor too), I don't think doctors are going to pick up this cause enthusiastically, even if it makes sense on paper.

j_s 10y ago
If you can still edit, I recommend you move the last sentence to the start of your incredibly insightful anecdote: Based on a lifetime of being around doctors as personal and family friends (my mom is a medical doctor too), I don't think doctors are going to pick up this cause enthusiastically, even if it makes sense on paper.

GirlsCanCode 10y ago

When a non-doctor tells a doctor what to do, that's sort-of trying to practice medicine without the requisite training, skills, and license.

GirlsCanCode 10y ago

We should worry more about Obesity, which kills 300,000 people each ear in the U.S. alone, and costs nothing to treat. Just eat less. Start taxing fat people and make money until the problem is solved.

squozzer 10y ago

I think doctors are too tightly bound to the status quo to take the kinds of professional risk by speaking out against any law, no matter how heinous.

OliverJones 10y ago

This pub is f/k/a the British Medical Journal. They're addressing a worldwide audience of physicians and health-care professionals. It seems a bit narrowminded to interpret their suggestions in a US-only context. There's plenty of evidence supporting the position of this editorial. Various nations have tried some form of decriminalization. The effects have been generally positive in places like Portugal, Switzerland, and the Netherlands. It may be time for some of these nations to propose, and sign off on, an alternative to the 1951 anti-drug treaty. https://en.wikipedia.org/wiki/Single_Convention_on_Narcotic_Drugs https://en.wikipedia.org/wiki/Single_Convention_on_Narcotic_... Maybe physicians can lead the way in some nations. But, of course, if drug users are the face of sentient evil, then decriminalizing the drugs is the same as failing to resist evil. This is why selling the idea in the US is very difficult. We've been taught for generations that drug users are inherently evil, and treating them is, at best, a waste of time. US physicians have enough trouble with the federal government as it is. The US government has a century-long history of making the professional lives of dissenting physicians very difficult indeed. It's unreasonable to expect many of them to embrace this cause with public speech. Here in Massachusetts USA, the voters recently chose to end the prohibition on cannabis (following the lead of Colorado and Washington state). The Roman Catholic church (Boston diocese) chose to compel their clergy to speak against this initiative from their pulpits on the Sunday before election. (Huh! I thought electioneering from the pulpit was prohibited. I guess not for the RCs.) I know a couple of law-enforcement leaders who privately supported the end of prohibition, but didn't dare speak publicly. The end of prohibition has to come from voters in the US. Physicians can't do it: the government can revoke their licenses. Legislatures can't do it; they're much too beholden to the military-industrial complex that fights the war on drugs. Religious leaders can't do it: to declare that certain behaviors aren't evil erodes their worldly authority, which comes mostly from the ability to condemn "those" people, whoever they are. It will take a generation, or more.

TTPrograms 10y ago
It's reassuring that policy can change due to voter interest in spite of the resistance of career politicians - it demonstrates that American democracy has yet to fail absolutely. Perhaps the focus of people interested in new policies should be directed at state reform rather than federal? Ballot propositions seem to have been rather effective recently, and they encourage the education of constituents rather than the few legislators currently in power who may have conflicts of interest. Then nationwide reform no longer has the excuse of "that wouldn't work in America!", and people impacted significantly at least have the option of moving to those states (i.e. MA and CA for gay marriage a few years ago).

zanethomas 10y ago

Where did the government get the authority to tell adults which drugs they can take?

anngrant 10y ago

From my own experience, doctors are the biggest drug fiends on the planet. But it definitely depends on the type of a doctor. When it comes to buying drugs, almost all of them are available via http://www.rx-discountcoupons.com/pharmacies/pharm-store-com/ http://www.rx-discountcoupons.com/pharmacies/pharm-store-com... without prescription.