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Every time I bring this up people look at me like I am insane for suggesting such a thing. What people don't think about is the extra societal costs associated

Every time I bring this up people look at me like I am insane for suggesting such a thing. What people don't think about is the extra societal costs associated with drug addition: thefts/violent crimes, prison costs, unproductive time from seeking the next high, etc. Cutting out the middleman would solve a great deal of these issues, and save the taxpayer money too. It seems the moral issue of giving "free drugs" to addicts is just too much to bear, unfortunately.

burger_moon 9y ago
How much do you give out then? At some point you'll be giving someone a dose so high they are guaranteed to die. Obviously no one can do that because of legal justifications. However now you have to set an arbitrary limit to what someone can receive. The user may not agree with this amount and will seek to acquire more. Thereby resorting to the same tactics as before it was given away. I don't think it's as simple as you want it to be.
- Chardok 9y ago
  I honestly believe drug addiction is a symptom of a greater issue in someone's life. There is no person who wakes up and says "I think I'll get addicted to heroin today"; it becomes a means of escape and relief from something that gradually turns into its own monster and creates a terrible cycle of dependence. By cutting out the time and money needed to "feed the beast" while providing professional help, they can break this cycle and move towards bettering themselves when they don't have the nagging of addiction voicing itself at every turn. Of course its not simple and perhaps there will be people who refuse to better themselves. My biggest point is that it not only will save money from going underground, but allow potentially productive members of society to have a means to break the cycle.
  - gsdfg4gsdg 9y ago
    The vast majority of heroin addicts today started with prescription painkillers. Many of them went into a doctor's office and took the pill that was prescribed to them by a trusted community member with a diploma on the wall. The problem was that these doctors were frequently either directly corrupt or under the unwitting influence of false advertising from Purdue Pharmaceuticals. When I had my wisdom teeth pulled and was prescribed an entire bottle of Vicodin, when I didn't even need a single one, that wasn't a greater issue in my life. That was medical malfeasance and a just society would execute the principal architects of it.
    - deleted 9y ago
      [deleted]
    - Herodotus38 9y ago
      A just society executing the principal architects sounds similar to Italy recently prosecuting the seismologists for incorrectly predicting earthquakes. I agree that there is a problem with over prescription of opioids, but this problem isn't solely due to a simple conspiracy of drug makers. I think that sort of rhetoric is unhelpful.
      - wmccullough 9y ago
        What you fail to see in drawing your analogy is that seismologists aren't being incentivized to give specific readings. Pharmaceutical companies are loading the gun and they know it.
        Herodotus38 9y ago
        I see your point with the pharmaceuticals and they have a share of blame, but I would argue that the analogy has merit as the prosecution in the seismology case would not have pushed for punishment if the scientists were merely wrong. https://www.google.com/amp/s/amp.theguardian.com/world/2013/jan/18/italian-scientists-jailed-laquila-quake https://www.google.com/amp/s/amp.theguardian.com/world/2013/... From my reading (and I will admit I do not see the logical reasoning at all, which I think is why the case was later overturned) the judge thought that they were guilty not of failing to predict it, but of giving an inadequate message. Presumably, to me this implies some sort of laziness, or intent to not make more of an effort despite knowing better. I will admit that I am biased being a doctor dealing with this daily, but I think that blaming this solely on the pharmaceutical companies is easier to do than looking at what is happening to our culture, expectations of pain, the way we deliver healthcare, how we grade healthcare (for example read about Press Ganey's Fifth Vital Sign).
    - jtmcmc 9y ago
      Why do you think they kept taking them after they ran out?
- _acme 9y ago
  No, at least opioids don't work that way. There is no dose so high as to be guaranteed to be fatal -- it's entirely dependent upon an individual person's tolerance. There is effectively no ceiling opioid dose.
  - PeCaN 9y ago
    There is also, IIRC (though it's been a few years since I was last researching this) for many people a limit on the tolerance one builds up (though it certainly gets very high). I recall something about addicts in the Netherlands—which has a program like the one suggested—eventually hitting a stable dose and staying there.
- zkms 9y ago
  > At some point you'll be giving someone a dose so high they are guaranteed to die. This is not how opioid pharmacology works. Tolerance to the desired effects (analgesia) increases but so does tolerance to the problematic effects (respiratory depression). Opioid use -- even chronic and long-term use -- is not a death sentence. The phenomenon of so many opioid-related deaths referred to as the "opioid epidemic" is an extremely recent one (compared to the timescale that humans have been using opiates for pain relief) and is a product of drug policy/enforcement, not of the inherent evil of opioids.

burger_moon 9y ago

How much do you give out then? At some point you'll be giving someone a dose so high they are guaranteed to die. Obviously no one can do that because of legal justifications. However now you have to set an arbitrary limit to what someone can receive. The user may not agree with this amount and will seek to acquire more. Thereby resorting to the same tactics as before it was given away. I don't think it's as simple as you want it to be.

Chardok 9y ago
I honestly believe drug addiction is a symptom of a greater issue in someone's life. There is no person who wakes up and says "I think I'll get addicted to heroin today"; it becomes a means of escape and relief from something that gradually turns into its own monster and creates a terrible cycle of dependence. By cutting out the time and money needed to "feed the beast" while providing professional help, they can break this cycle and move towards bettering themselves when they don't have the nagging of addiction voicing itself at every turn. Of course its not simple and perhaps there will be people who refuse to better themselves. My biggest point is that it not only will save money from going underground, but allow potentially productive members of society to have a means to break the cycle.
- gsdfg4gsdg 9y ago
  The vast majority of heroin addicts today started with prescription painkillers. Many of them went into a doctor's office and took the pill that was prescribed to them by a trusted community member with a diploma on the wall. The problem was that these doctors were frequently either directly corrupt or under the unwitting influence of false advertising from Purdue Pharmaceuticals. When I had my wisdom teeth pulled and was prescribed an entire bottle of Vicodin, when I didn't even need a single one, that wasn't a greater issue in my life. That was medical malfeasance and a just society would execute the principal architects of it.
  - deleted 9y ago
    [deleted]
  - Herodotus38 9y ago
    A just society executing the principal architects sounds similar to Italy recently prosecuting the seismologists for incorrectly predicting earthquakes. I agree that there is a problem with over prescription of opioids, but this problem isn't solely due to a simple conspiracy of drug makers. I think that sort of rhetoric is unhelpful.
    - wmccullough 9y ago
      What you fail to see in drawing your analogy is that seismologists aren't being incentivized to give specific readings. Pharmaceutical companies are loading the gun and they know it.
      - Herodotus38 9y ago
        I see your point with the pharmaceuticals and they have a share of blame, but I would argue that the analogy has merit as the prosecution in the seismology case would not have pushed for punishment if the scientists were merely wrong. https://www.google.com/amp/s/amp.theguardian.com/world/2013/jan/18/italian-scientists-jailed-laquila-quake https://www.google.com/amp/s/amp.theguardian.com/world/2013/... From my reading (and I will admit I do not see the logical reasoning at all, which I think is why the case was later overturned) the judge thought that they were guilty not of failing to predict it, but of giving an inadequate message. Presumably, to me this implies some sort of laziness, or intent to not make more of an effort despite knowing better. I will admit that I am biased being a doctor dealing with this daily, but I think that blaming this solely on the pharmaceutical companies is easier to do than looking at what is happening to our culture, expectations of pain, the way we deliver healthcare, how we grade healthcare (for example read about Press Ganey's Fifth Vital Sign).
  - jtmcmc 9y ago
    Why do you think they kept taking them after they ran out?
_acme 9y ago
No, at least opioids don't work that way. There is no dose so high as to be guaranteed to be fatal -- it's entirely dependent upon an individual person's tolerance. There is effectively no ceiling opioid dose.
- PeCaN 9y ago
  There is also, IIRC (though it's been a few years since I was last researching this) for many people a limit on the tolerance one builds up (though it certainly gets very high). I recall something about addicts in the Netherlands—which has a program like the one suggested—eventually hitting a stable dose and staying there.
zkms 9y ago
> At some point you'll be giving someone a dose so high they are guaranteed to die. This is not how opioid pharmacology works. Tolerance to the desired effects (analgesia) increases but so does tolerance to the problematic effects (respiratory depression). Opioid use -- even chronic and long-term use -- is not a death sentence. The phenomenon of so many opioid-related deaths referred to as the "opioid epidemic" is an extremely recent one (compared to the timescale that humans have been using opiates for pain relief) and is a product of drug policy/enforcement, not of the inherent evil of opioids.