6 ms·

I don't see how forcing addicts to purchase heroin on the street is safer than getting it prescribed by a doctor. People wouldn't overdose if they knew exactly

• TerminalJunkie 10y ago
  If you were able to get drugs from a pharmacy or dispensary or a regulated service, there would't (hopefully) be a black market to supply the drugs which creates untold violence. I have a completely untested theory that the number of deaths would be less with a well regulated legalization of drugs than with an unregulated black market where gangs and organized crime supply the demand for illicit substances.
  • bluedino 10y ago
    >> If you were able to get drugs from a pharmacy or dispensary or a regulated service, there would't (hopefully) be a black market Medical marijuana is legal where I live, you can buy it at a regulated service, however there are plenty of people who still buy it on the street or produce more than they are legally able to and sell the excess.
    • toolz 10y ago
      Yeah, then the black market goes from some cartel pipeline to someone in your neighborhood. There's a huge difference in regards to funding violence.
      • nannal 10y ago
        Except Joe who grows weed in his cupboard isn't really capable of producing heroin let alone the extraordinarily dangerous opium derivatives that pharmaceutical are pushing on doctors.
        • nyolfen 10y ago
          welcome to our grim cyberpunk (near-)future: https://www.wired.com/2015/08/dont-try-home-scientists-brew-opiates-yeast/ https://www.wired.com/2015/08/dont-try-home-scientists-brew-...
        • nnfy 10y ago
          If Joe can grow weed in his cupboard, he absolutely can grow poppies and produce opium. The process is not complex.
          • narrowrail 10y ago
            The required acreage to yield opium in significant quantities is way beyond a closet (or even a basement). Not to mention that heroin is ~1% of total opium weight.
            • nnfy 10y ago
              If we're talking about Joe's personal use, a single poppy plant produces multiple doses, according to this[1] reference and some anecdotal drug forum dose suggestions, on the order of tens of mg. 1.https://erowid.org/archive/rhodium/chemistry/opium.html https://erowid.org/archive/rhodium/chemistry/opium.html
              • narrowrail 10y ago
                >produces multiple doses Could you tell me what number "multiple" is and what a "dose" looks like? Are we talking about raw plant material that is opium, or refined heroin/morphine/codeine? The conflation of the word drugs and plant material seems like the most absurd gorilla in the room. Off to do some coffee...
  • arprocter 10y ago
    Portugal decriminalized in 2001 and guess what happened[0] [0]https://www.washingtonpost.com/news/wonk/wp/2015/06/05/why-hardly-anyone-dies-from-a-drug-overdose-in-portugal/?utm_term=.a2a535945f50 https://www.washingtonpost.com/news/wonk/wp/2015/06/05/why-h...
  • qbrass 10y ago
    There's already a black market for prescription drugs. Because there's still a barrier to access, providing a way around it still provides profit.
    • NotSammyHagar 10y ago
      There's a black market because most people can't just get a prescription from a doctor, they have to lie or get someone else's drugs, there isn't enough legal availability to rule it out.
• zzalpha 10y ago
  Absolutely. There's one sure way to control an epidemic like this: education. That means educating the populace on just how addictive and dangerous these drugs are, educating law enforcement to treat addicts as people who are sick instead of simply stigmatizing criminality, and educating the medical community so that these drugs aren't handed out so casually, and in cases where they are appropriate, that patients are closely monitored for signs of addiction. And the latter would benefit greatly from the US restricting drug company advertising and lobbying (this crisis was helped along significantly because of Purdue's marketing of Oxy in the 90s) so that medical decisions are made based on science and not marketing... but we know what the odds are of that happening.
  • ipnon 10y ago
    I think most people know heroin is dangerous. They start taking it because they don't have an incentive not to. A lot of people in places hit worst by the opioid epidemic don't have much of a reason to get up in the morning, whether that be for lack of job opportunities, a weak social network, or some more general malaise. If there life is already disappointing, there's no reason to not take heroin. The worst that can happen is that there life becomes bad, but it already is.
    • zzalpha 10y ago
      Many many people don't start with heroin, nor do they turn to drugs for the reasons you cite. They start with back pain due to a workplace injury, for which a doctor immediately prescribes them a powerful opiod (and perhaps a companion drug to deal with the resultant constipation). Because it's "medicine", these people don't fully understand the risk of addiction nor do they recognize the signs of addiction and tolerance as they develop. Meanwhile, the doctor shirks their duty by not remaining in constant contact with the patient to manage any dependency should it occur. These individuals eventually become addicted because the drugs lose efficacy over time (and in the case of Oxy, don't actually work for as long a period of time in the body as claimed, forcing people to up their own dosage). And thus the spiral of addiction begins. Because of the lack of public awareness and the shame and stigma of addiction, people don't seek out help. Instead they try to manage the problem themselves. Ultimately, once addicted they turn to street drugs because they're a) cheaper, and b) more readily available.
• lightedman 10y ago
  " People wouldn't overdose if they knew exactly how strong the drugs they injected were" Opiates are highly unpredictable. The exact same 'homogenized' batch can kill you at any time. One dose you can slam half a syringe, next dose a day or two later, you can do 1/4 that amount and die.
  • nnfy 10y ago
    Right, that's why people are dropping dead left and right from prescription opioids, hospital injections of morphine, opioid patches... No drug has this kind of unpredictable physiological profile, you're spreading nonsense. I suspect you're confused by stories of relapsing users returning immediately to large doses, but there's nothing unpredictable about that.
    • darpa_escapee 10y ago
      People do drop dead from prescription opioids. Hospital injections of morphine are done under close supervision by trained staff. Fentanyl patches do kill. > I suspect you're confused by stories of relapsing users returning immediately to large doses, but there's nothing unpredictable about that. That is an inherently unpredictable situation. We cannot predict or measure the subjective and changing tolerance a patient has to opioids.
      • nnfy 10y ago
        The comment implied that repeated doses to a given person are wildly unpredictable. This is false. Further, you absolutely can approximate how long tolerance lasts, but my point was that you can predict that your tolerance is reduced after abstinence, as opposed to the original comment which suggested that all dosing was unpredictable.
        • darpa_escapee 10y ago
          > The comment implied that repeated doses to a given person are wildly unpredictable. This is false. I didn't imply that repeated doses are unpredictable. Regular repeated dosages can be predictable as long as the patient remains stable with regards to infection/health and other drugs they ingest. Initial dosages, dosage increases and returning to a previously safe repeated-dose after cessation are not at all predictable. This is why I mentioned titration in a previous comment: subjective response to drugs and subjective tolerance cannot be accurately predicted or measured. This is also why drugs like Subutex are titrated when beginning suboxone treatment: a doctor cannot accurately measure tolerance to determine how much of the drug is needed to keep a person out of withdrawals. > you absolutely can approximate how long tolerance lasts Naloxone or naltrexone induced withdrawal rapidly diminishes tolerance faster than it would naturally. This suggests that there's a function that can accurately output a safe and effective dose of opioids based on the variables of previous dosage and time since cessation. I'm arguing that there is a missing variable that's unable to be measured accurately: each person's subjective tolerance. That subjective tolerance depends on a multitude of factors that cannot be determined clinically.
• cowmoo728 10y ago
  The other common cause of OD is relapse. 30 day drug programs are not very good at getting people to quit, but they are good at lowering tolerance enough to make their previous doses life-threatening. This is another reason medical supervision of addicts saves lives.
• darpa_escapee 10y ago
  > People wouldn't overdose if they knew exactly how strong the drugs they injected were This is not how tolerance works. The same dose can have vastly different effects depending on how long it was since your last dose, other drugs in your system and your body's natural tolerance that might be diminished by exhaustion or infection. The dose someone uses to feel baseline today might have them completely dysfunctional in a few days or kill them after a couple of weeks.
  • nnfy 10y ago
    Everything you said outside of tolerance is exceedingly rare. If you're not taking one of a handful of herbal supplements, you are extremely unlikely to have a measurably different response to the same dosage of opioid. And the effects will not be vastly different. Just varied in intensity.
    • darpa_escapee 10y ago
      > If you're not taking one of a handful of herbal supplements, you are extremely unlikely to have a measurably different response to the same dosage of opioid. If you've taken any common CNS depressant, such as alcohol, benzodiazepines, psychiatric drugs, drugs that are metabolized by the same pathways as opioids, even blood pressure medication or sedatives including antihistamines, you are going to potentiate the CNS depression from opioids. > And the effects will not be vastly different. Just varied in intensity. The scale of intensity of effects from a dose of an opioid varies from: enough to get a patient out of withdrawals to completely stopping breathing. Titration of dose is the only way to more accurately determine a safe and effective dosing schedule for opioids.
      • nnfy 10y ago
        I concede that I neglected drug interactions; however when you said vastly different effects, I interpreted it as meaning unique effects based on dosage, similar to something like DXM, as opposed to two ends of a relatively linear scale of analgesia->sedation->death. Which is untrue.
• jmngomes 10y ago
  Agreed, and this has been tried in Switzerland with positive results; to quote just one: "The cost-benefit analysis showed a considerable reduction in costs for medical care and law enforcement; the benefits per day and patient amount to the double of the daily treatment costs in HAT (Frey et al 2000)." in https://sencanada.ca/content/sen/committee/371/ille/presentation/ucht1-e.htm https://sencanada.ca/content/sen/committee/371/ille/presenta...
• gjmacd 10y ago
  Agree. Control it, regulate it, distribute it. We do this with alcohol. It doesn't prevent people from getting addicted, but it certainly prevents people from having to resort to crimes to get the product because it's illegal.
  • actsasbuffoon 10y ago
    The article isn't about committing crimes in order to get drugs, it's about people dying because pharma companies got greedy. Additionally, alcohol kills more people than opiates every year, so I'm not sure that's a good sign for the effects of legalization.
• EnFinlay 10y ago
  Article: > and legal painkillers are still linked to most opioid overdose deaths. Your comment: > People wouldn't overdose if they knew exactly how strong the drugs they injected were Is your comment a knee jerk reaction to an anti-legalization headline because it doesn't appear to be related to the actual content or points raised in the article.
• dontreact 10y ago
  The problem is that it has been proven that it is easy for large pharmaceutical companies to deceptively represent these drugs. Oxycontin has been marketed as being effective at managing pain for 12 or sometimes even 24 hours, but this is not the case in many users and this is a big factor in why the drug is so addictive. http://www.latimes.com/projects/oxycontin-part1/ http://www.latimes.com/projects/oxycontin-part1/ What about the Portugese model described in the article (legal for consumption, illegal to commercialize), with some of the funds spent on controlling drug related violence instead being turned towards treatment centers where addicts can get something like Methadone?
  • actsasbuffoon 10y ago
    I strongly agree. I'm as anti-drug as it gets, but locking up non-violent drug users with rapists and murderers doesn't make sense. If our goal is to help drug addicts get clean, prison is a terrible strategy. There's a kind of despair spiral that kicks in for some addicts. Life isn't going well, so they turn to drugs to ease the pain. Then they get arrested, sent to prison, and get labelled as a felon. Now they can't get a job or have a stable living arrangement and they turn back to drugs to get through the despair. For these people, we need to break the cycle if we're ever going to help them get clean. Making their lives worse will only further entrap them.
• jimbokun 10y ago
  But the opioid epidemic did not stem from addicts purchasing heroin on the street, but from doctors prescribing them, backed by government efforts to encourage their use, and industry lobbying and advertising. That's a lot more powerful formula for starting a drug epidemic, than people buying heroin illegally off the street. At least there's no confusion about "experts" and "science" and "doctors" promoting something as safe and effective.
  • snarf21 10y ago
    Right this is the problem. We need to ban all opioid prescriptions. 80% of heroin addicts got addicted because of the opioid prescriptions obtained legally. According to the documentary on HBO, drug companies made $5B on opioids in 2014 but the economic costs were $55B. If people have chronic pain, we need to be more progressive and allow medical marijuana everywhere. (There are also quite a few studies that show that chronic pain is not helped with opioids anyway.) If people are in the hospital or end-of-life/hospice, then give them morphine or whatever they need but we need zero prescribable opioids.
    • thesmallestcat 10y ago
      For painkilling, MMJ may as well be aspirin when compared to powerful opiates. Over-prescription of powerful opiates is the issue. Banning all opiate prescriptions would be cruel, forcing people to the black market at best.
    • bdavisx 10y ago
      Yeah, banning opioids isn't the solution, unless you think people should needlessly suffer. I've had a hernia surgery and my wife had throat surgery, and I don't think that marijuana would have been the answer for the first several days after either surgery.
      • DanBC 10y ago
        >> If people have chronic pain Chronic pain refers to long term pain. Your hernia surgery is short term pain. No-one credible is suggesting preventing using opioids for short term (such as post operative) pain (although it does seem that Drs in the US prescribe too much for this type of pain).