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This opioid epidemic has made me question my position on legalization of drugs. I had believed that, in general, legalization of drugs would be a good policy --

This opioid epidemic has made me question my position on legalization of drugs. I had believed that, in general, legalization of drugs would be a good policy -- it worked fine for marijuana where it has been tried, and I doubted that very many people who don't take hard drugs would start doing so if they were legalized. Now, I'm not so sure. It seems to be the case that some opioid addicts transition from using prescribed medication to illegally obtained medication, which is sometimes illegally produced and adulterated with other drugs. So, it seems that legalizing the recreational use of opiates would enable people to use the "authentic" version of the drug, which is safer. On the other hand, there are tons of overdoses from prescribed opiates, which are legally obtained; and the overdoses are increasing. Contra my earlier belief, it seems that as access to opiates became easy and legal (via prescriptions), the number of addicts increased dramatically. This seems to be a situation in which tens of thousands of people will die every year via ingestion of legal drugs unless some kind of intervention is made to remove their access to those drugs. It's hard to see how legalization or decriminalization would make a big difference.

michaelchisari 9y ago
I think there are a lot of different ways to "legalize", and the particulars of how you do it amplifies the results when it comes to hard drugs, especially highly addictive opiates. Putting aside the more libertarian approach to legalization where hard drugs are left to the market and profits are made off of their sale, there are other options. For instance, where drug use is legal, manufacture is illegal, and addicts are able to get free doses while under the supervision of medical staff. The free availability undercuts any potential black market, supervision severely reduces the potential for overdose, and the medical staff is able to have a regular conversation with the patient about options for getting clean. Moreover, by turning drug use into a medical and welfare issue, it's my belief that it will prevent addiction by removing the "romance" of hard drug use for first time users. Marijuana is a totally different story, it's benign enough that market legalization works just fine. But for opiates and amphetamines and the like, you need a very different approach. That said, the opiate epidemic has shown that we have a problem of overprescription that stems from the pharmaceutical industry, and that's something we'd have to address if we were ever to move towards this approach.
- droopyEyelids 9y ago
  I agree with you but consider what capital industry has done to food: the very safest thing people get addicted to. It has been transmuted into hyper addictive nutritionless junk and it’s marketed with all the strength of humanity’s brightest, with no regard to the legions who now suffer obesity related disability, diabetes, etc. When that same marketing machine gets its hands on marijuana, I’m sure it’ll make the world suffer. And if you think to use alcohol as a counter example, think twice because the USA regulates it harder than most. GB is closer to laissez faire, and their alcoholism rates’ increase resembles our obesity.
njarboe 9y ago
If you read up on Oxycontin, it was formulated and prescribed in a particular way that created many addicts[1]. In particular it was claimed to work for 12 hours when in some people worked for much less. Being on an opiate for pain and then having it wear off and being forced to wait in pain for sometime before taking it again, is a recipe for creating addiction. Many people also were less wary of taking the opiates when prescribed by their doctors. I'm not sure if the opiate overdoes epidemic is a clear strike against legalization, but it is surely a cautionary tale about supporting a system of all drugs being open sale of unlimited quantities and unlimited advertising. I support some form of drug legalization but, unlike food that is controlled for content but not much else, legal drugs will need more regulation. [1] http://www.latimes.com/projects/oxycontin-part1/ http://www.latimes.com/projects/oxycontin-part1/
- greggarious 9y ago
  I have zero background in chemistry, so this may be a dumb question: but if the issue is it not lasting 12 hours, why can't doctors halve the dose and prescribe it twice as often per day?
  - othersideofcoin 9y ago
    Because the 12 hr formula was part of a huge marketing push to reduce doctors' "opiphobia" and get them to prescribe more. Doctors were likely unaware of the roller coaster ride of withdrawal they were sending patients on.
    - hansthehorse 9y ago
      I believe the patent extension to keep it from going generic was predicated on the 12 hour, slow release, dosage.
owens99 9y ago
IMO this is a drastic over-simplification of the issue. Legalization is one of many variables here.
arjie 9y ago
Why shouldn't we let them die? One in six base jumpers will die young while jumping. We don't make that illégal. I mean, everyone knows you can overdose. So that makes it a conscious choice, and we should preserve people's ability to make an informed choice to put themselves in danger.
- mschuster91 9y ago
  > Why shouldn't we let them die? One in six base jumpers will die young while jumping. We don't make that illégal. Well, a base jumper is, well, dead when the parachute fails. You maybe need someone to scrape the remains off the ground, but that's it. Drug addictions and ODs, as well as the side effects from criminalization (prison/judicial costs, drug related crime) end up costing a boatload of money, plus a highly aggressive user of coke, meth or multiple drugs is often enough a public danger.
  - arjie 9y ago
    Ah, the problem is that they don't, in fact, die. That's fair.
- cottonflop 9y ago
  Should we then also legalize all forms of suicide, so long as the person has made an informed choice?
  - arjie 9y ago
    Yes. And I think we will, in my lifetime.
- emp44 9y ago
  Come on, these are real people. Have some respect. Addiction changes the brain, there may have been a day when they made a choice but soon it was made for them. Several of my former classmates have died from heroin/fentanyl. They were looking for help, they were trying to get clean, they were good kids. It destroyed their families and has put enormous strain on our police and ems. Talk about legalization, fine, but "let them die" is just callous.
monort 9y ago
If opioids could be sold for recreational use, I think they would be sold with a naloxone in one package, reducing the number of deaths from overdose.
- SomeStupidPoint 9y ago
  Similarly, regulated drug dens (like regulated brothels) are a perfectly tennable idea. There are middle ground solutions between "ban everything!" and "sell it everywhere!" It's surprisingly hard to OD with a clean supply, measured dosing, and emergency services on site. I don't think that clean, supervised drug use is actually any more dangerous than say... skydiving or bungee-jumping. (It's actually hard to fatally OD with just one vaguely sober person an nasal naloxone, but that's more specific to opiates.)
  - vasilipupkin 9y ago
    If opioids were sold for recreational purposes, companies would compete to invent an opioid that you simply can't OD on, or it's very difficult to OD on. Maybe, that version could be the legalized version and every other version banned. Other than the risk of overdose, does opioid use generate any more health problems than say alcohol use?
justinmk 9y ago
> On the other hand, there are tons of overdoses from prescribed opiates, which are legally obtained; So what? Nothing is worse than the prison system. Literally, nothing. Risk of death by overdose does not justify shoveling people into the horrific US correctional system. > tens of thousands of people will die every year via ingestion of legal drugs unless some kind of intervention is made to remove their access to those drugs. Thousands of deaths per year? That's your justification for giving the prison system more chum? (500k per year: https://en.wikipedia.org/wiki/United_States_incarceration_rate#Drug_sentencing_laws https://en.wikipedia.org/wiki/United_States_incarceration_ra... ) I don't mean to be emotional, but: I'm curious if you've ever known anyone who spent time in prison, and have heard their candid description of it.
- golergka 9y ago
  This kind of argument could be used to argue for legalization of absolutely everything.
  - justinmk 9y ago
    Not "absolutely everything", but certainly many things. It's on you to make the case that "saving a drug user's life" is achieved by sending them to the worst place on earth.
    - droopyEyelids 9y ago
      (Which ruins their families lives)
    - golergka 9y ago
      Why is it on me? I'm not arguing for any position here, just analyzing your arguments.
walterstucco 9y ago
The problem is not legalization, is the US society that's particularly vulnerable to addiction. Look at EU, the situation is totally different even where drugs are legal (Holland) or addiction is treated like a disease (Portugal) Everywhere else you don't hear about "opioid epidemic"
perpetualcrayon 9y ago
Legalization doesn't just enable people to "do the drugs". It also lowers the barrier the government has in obtaining data about the phenomenon. With additional data, government can be more proactive in preventing addiction in the first place.
greggarious 9y ago
>This opioid epidemic has made me question my position on legalization of drugs. You know what? I am too. If you spoke to me years ago, I'd say much of the danger from opiates comes from not knowing what dose you're taking. Much of the crime comes from the price (due to it being black market). Much of the crime comes from addicts who can't afford their fix (due to the price) or rival dealer (who can't settle disputes in the courts). Now I think maybe a decriminalization for hard drugs would be better. Purchasing / possessing is not criminalized (or subject to a small fine, like smoking a joint in public is treated in weed-legal states. (I'm also in support of the states that have ramped up their age to buy tobacco to 21)
tqkxzugoaupvwqr 9y ago
Legalization should be accompanied by a comprehensive public health program. The goal should be to eliminate addiction. In particular it should be done like this: When a drug is legalized, it must only be dispensed by licensed health centers / clinics. Anyone can obtain the drug there but must go through public health workers that will help you find treatments. Basically, make addicts come to you so you can keep an eye on their health and help them get better. Fewer addicts also mean greater safety for society due to less criminality.

michaelchisari 9y ago

I think there are a lot of different ways to "legalize", and the particulars of how you do it amplifies the results when it comes to hard drugs, especially highly addictive opiates. Putting aside the more libertarian approach to legalization where hard drugs are left to the market and profits are made off of their sale, there are other options. For instance, where drug use is legal, manufacture is illegal, and addicts are able to get free doses while under the supervision of medical staff. The free availability undercuts any potential black market, supervision severely reduces the potential for overdose, and the medical staff is able to have a regular conversation with the patient about options for getting clean. Moreover, by turning drug use into a medical and welfare issue, it's my belief that it will prevent addiction by removing the "romance" of hard drug use for first time users. Marijuana is a totally different story, it's benign enough that market legalization works just fine. But for opiates and amphetamines and the like, you need a very different approach. That said, the opiate epidemic has shown that we have a problem of overprescription that stems from the pharmaceutical industry, and that's something we'd have to address if we were ever to move towards this approach.

droopyEyelids 9y ago
I agree with you but consider what capital industry has done to food: the very safest thing people get addicted to. It has been transmuted into hyper addictive nutritionless junk and it’s marketed with all the strength of humanity’s brightest, with no regard to the legions who now suffer obesity related disability, diabetes, etc. When that same marketing machine gets its hands on marijuana, I’m sure it’ll make the world suffer. And if you think to use alcohol as a counter example, think twice because the USA regulates it harder than most. GB is closer to laissez faire, and their alcoholism rates’ increase resembles our obesity.

njarboe 9y ago

If you read up on Oxycontin, it was formulated and prescribed in a particular way that created many addicts[1]. In particular it was claimed to work for 12 hours when in some people worked for much less. Being on an opiate for pain and then having it wear off and being forced to wait in pain for sometime before taking it again, is a recipe for creating addiction. Many people also were less wary of taking the opiates when prescribed by their doctors. I'm not sure if the opiate overdoes epidemic is a clear strike against legalization, but it is surely a cautionary tale about supporting a system of all drugs being open sale of unlimited quantities and unlimited advertising. I support some form of drug legalization but, unlike food that is controlled for content but not much else, legal drugs will need more regulation. [1] http://www.latimes.com/projects/oxycontin-part1/ http://www.latimes.com/projects/oxycontin-part1/

greggarious 9y ago
I have zero background in chemistry, so this may be a dumb question: but if the issue is it not lasting 12 hours, why can't doctors halve the dose and prescribe it twice as often per day?
- othersideofcoin 9y ago
  Because the 12 hr formula was part of a huge marketing push to reduce doctors' "opiphobia" and get them to prescribe more. Doctors were likely unaware of the roller coaster ride of withdrawal they were sending patients on.
  - hansthehorse 9y ago
    I believe the patent extension to keep it from going generic was predicated on the 12 hour, slow release, dosage.

owens99 9y ago

IMO this is a drastic over-simplification of the issue. Legalization is one of many variables here.

arjie 9y ago

Why shouldn't we let them die? One in six base jumpers will die young while jumping. We don't make that illégal. I mean, everyone knows you can overdose. So that makes it a conscious choice, and we should preserve people's ability to make an informed choice to put themselves in danger.

mschuster91 9y ago
> Why shouldn't we let them die? One in six base jumpers will die young while jumping. We don't make that illégal. Well, a base jumper is, well, dead when the parachute fails. You maybe need someone to scrape the remains off the ground, but that's it. Drug addictions and ODs, as well as the side effects from criminalization (prison/judicial costs, drug related crime) end up costing a boatload of money, plus a highly aggressive user of coke, meth or multiple drugs is often enough a public danger.
- arjie 9y ago
  Ah, the problem is that they don't, in fact, die. That's fair.
cottonflop 9y ago
Should we then also legalize all forms of suicide, so long as the person has made an informed choice?
- arjie 9y ago
  Yes. And I think we will, in my lifetime.
emp44 9y ago
Come on, these are real people. Have some respect. Addiction changes the brain, there may have been a day when they made a choice but soon it was made for them. Several of my former classmates have died from heroin/fentanyl. They were looking for help, they were trying to get clean, they were good kids. It destroyed their families and has put enormous strain on our police and ems. Talk about legalization, fine, but "let them die" is just callous.

monort 9y ago

If opioids could be sold for recreational use, I think they would be sold with a naloxone in one package, reducing the number of deaths from overdose.

SomeStupidPoint 9y ago
Similarly, regulated drug dens (like regulated brothels) are a perfectly tennable idea. There are middle ground solutions between "ban everything!" and "sell it everywhere!" It's surprisingly hard to OD with a clean supply, measured dosing, and emergency services on site. I don't think that clean, supervised drug use is actually any more dangerous than say... skydiving or bungee-jumping. (It's actually hard to fatally OD with just one vaguely sober person an nasal naloxone, but that's more specific to opiates.)
- vasilipupkin 9y ago
  If opioids were sold for recreational purposes, companies would compete to invent an opioid that you simply can't OD on, or it's very difficult to OD on. Maybe, that version could be the legalized version and every other version banned. Other than the risk of overdose, does opioid use generate any more health problems than say alcohol use?

justinmk 9y ago

> On the other hand, there are tons of overdoses from prescribed opiates, which are legally obtained; So what? Nothing is worse than the prison system. Literally, nothing. Risk of death by overdose does not justify shoveling people into the horrific US correctional system. > tens of thousands of people will die every year via ingestion of legal drugs unless some kind of intervention is made to remove their access to those drugs. Thousands of deaths per year? That's your justification for giving the prison system more chum? (500k per year: https://en.wikipedia.org/wiki/United_States_incarceration_rate#Drug_sentencing_laws https://en.wikipedia.org/wiki/United_States_incarceration_ra... ) I don't mean to be emotional, but: I'm curious if you've ever known anyone who spent time in prison, and have heard their candid description of it.

golergka 9y ago
This kind of argument could be used to argue for legalization of absolutely everything.
- justinmk 9y ago
  Not "absolutely everything", but certainly many things. It's on you to make the case that "saving a drug user's life" is achieved by sending them to the worst place on earth.
  - droopyEyelids 9y ago
    (Which ruins their families lives)
  - golergka 9y ago
    Why is it on me? I'm not arguing for any position here, just analyzing your arguments.

walterstucco 9y ago

The problem is not legalization, is the US society that's particularly vulnerable to addiction. Look at EU, the situation is totally different even where drugs are legal (Holland) or addiction is treated like a disease (Portugal) Everywhere else you don't hear about "opioid epidemic"

perpetualcrayon 9y ago

Legalization doesn't just enable people to "do the drugs". It also lowers the barrier the government has in obtaining data about the phenomenon. With additional data, government can be more proactive in preventing addiction in the first place.

greggarious 9y ago

>This opioid epidemic has made me question my position on legalization of drugs. You know what? I am too. If you spoke to me years ago, I'd say much of the danger from opiates comes from not knowing what dose you're taking. Much of the crime comes from the price (due to it being black market). Much of the crime comes from addicts who can't afford their fix (due to the price) or rival dealer (who can't settle disputes in the courts). Now I think maybe a decriminalization for hard drugs would be better. Purchasing / possessing is not criminalized (or subject to a small fine, like smoking a joint in public is treated in weed-legal states. (I'm also in support of the states that have ramped up their age to buy tobacco to 21)

tqkxzugoaupvwqr 9y ago

Legalization should be accompanied by a comprehensive public health program. The goal should be to eliminate addiction. In particular it should be done like this: When a drug is legalized, it must only be dispensed by licensed health centers / clinics. Anyone can obtain the drug there but must go through public health workers that will help you find treatments. Basically, make addicts come to you so you can keep an eye on their health and help them get better. Fewer addicts also mean greater safety for society due to less criminality.