5 ms·

> Obviously we want to restrict access as much as possible to particular drugs, such as heroin or methamphetamine, which are so harmful and addictive that nobod

> Obviously we want to restrict access as much as possible to particular drugs, such as heroin or methamphetamine, which are so harmful and addictive that nobody should be using them, or GHB, where the potential for fatal overdose is so high. I dont understand this part. The potential for overdose on alcohol is high as well. I can go buy a plastic handle for $10 and if i drink the whole thing tonight i'll probably die. I think the right path is full legalization similar to OTC medicine in the US. You have FDA verification you are actually taking what you think you're taking, no weird fentanyl substitutes or cuttings. You put warning labels on describing dosages and limits. You let people use them and get treatment if they abuse it. It's the same way we treat alcohol, just we are conditioned to think alcohol is somehow way more safe than something like heroin. There are responsible drinkers and responsible heroin users out there. I know it may sound scary but I don't think there's a major inherent harm to having methamphetamine available over the counter. Some people will abuse it. Some people are already abusing it.

y4mi 8y ago
its way easier to overdose on hard drugs than alcohol. with alcohol, its a slow progress. you keep drinkng and most people pass out / lose their will to drink after they've had enough. hard drugs are generally a single portion and once its in your blood, its too late. you cant say 'hey, i've got enough for today' once you feel it hitting you. You're already doomed if you've chosen the wrong dosage from the start. > There are responsible drinkers and responsible heroin users out there I cant say i've ever heard of anyone ever using heroine responsibly. I'd have to take your word for it, but thats hard, considering how brutal the effects of heroine are on their users.
- c22 8y ago
  On the other hand, even if you don't die right away alcohol's no slouch in the finding ways to kill you and ruining lives department.
- foolfoolz 8y ago
  I think a lot of this can be attributed to these drugs being used in a completely ad hoc manner. There's no usage guidelines on a bag of cocaine. There's no 'Active Ingredient' percentage listed. You dont know what it is. You can't compare it to another until you've had it. Any pill that's an upper is called 'molly' Somehow the vast majority of people who take legal hard drugs such as vicodin or dilaudid, don't overdose on them. There's a culture built around taking these drugs responsibly according to their directions. We have that very strongly ingrained in our culture about alcohol. I think that same culture would develop if your cocaine came in a box from CVS with proper instructions on when you can take it and what side effects to look for. Of course people are going to make mistakes. They are going to abuse drugs. But that is happening today. Trying to solve that by keeping the drugs away sounds like the same policies in the war on drugs that we are saying aren't working and leading to legalization
  - TheSpiceIsLife 8y ago
    As a (former? never say never) injecting drug user of Heroin, methamphetamine, and quite a few other water soluble substances, I fully agree with the parent comment. I never bothered getting addicted to Heroin. You have to stick to the rules: never use more than two days in a row and don’t use it consistently, if in doubt half your dose, and never use alone but always with at least one other who knows how to administer breathing assistance until paramedics arrive. Don’t take your dose at the same time as your buddy, wait to see if the first user has trouble staying conscious, 15 to 20 minutes should do it. Edit: fixed a word
    - jjgreen 8y ago
      Sensible and honest advice like this saves lives
      - TheSpiceIsLife 8y ago
        Yes! And it works in practice: A friend overdose in my loungeroom one evening. He’d taken a lot of Valium, a little bit of a alcohol, and then half the heroin I sold him. After a 15 minute argument he took the rest of the Heroin. I tried to tell him he’d already taken some but couldn’t remember. Anyway, he started going a bit blue: Cyanosis. Became progressively and rapidly more difficult for him to speak and stay alert. Called the ambulance, put him in the stable side position, watched his breathing, he was ok. Ambulance arrived, started administering breathing assistance and naltrexone. They commented he required a lot of naltrexone. He came to, they took him to hospital for observation over night. I rode with him in the ambulance and sat with him in hospital for a few hours. No long term harm. Still friends, and I like to joke he owes me his life. Friends don’t let friends die from overdosing on opiates.
- saulrh 8y ago
  Tylenol aka paracetamol. Take one every six hours, as directed, and you'll be fine. Take two every six hours and you die painfully over the course of the next month. 500 deaths a year in the US alone... despite basically every house in the developed world having a bottle of it in a drawer. And it doesn't even have huge black warning labels with skulls and poison symbols! Street-quality Tylenol would kill people the way street-quality fentanyl does. Probably more.
- merinowool 8y ago
  I disagree. You can easily overdose alcohol with spirits and "pushing the tempo". Many teenagers died during stupid drinking games. If you drink "normally" it would be difficult, but that is the same with other drugs. If you stick to guidelines you should be fine. Problem with other drugs is that you don't know purity and even what's really in them, as each dealer in the chain adds something to get more weight.
- ssijak 8y ago
  I know a person who used Heroin occasionally. He is well and fine, was first officer on some large ship and is now finishing for masters degree which would allow him to work on land related to shipping.
- ada1981 8y ago
  Something like 10% of users will be addicted to any given drug (less for psychedelics which can actually free people of addiction by helping release the underlying trauma). The majority of drug users of any substance are not addicts. Overdose is most common from adulterants and from not knowing the dosage one is taking due to lack of purity information. If your goal is to stop ODs, allowing cheap access to taxed pharma grade Drugs is your first step. The next step is using the taxes to make access to trauma healing / education free. Trauma is the root cause of addiction, so healing frees one of the need for the addictive behavior. Somatic based therapies, psychedelic therapy, and an environment that supports healthy living. I work with people regularly who are able to gently walk away from addictions because they’ve healed the underlying trauma. The benefit of this is that we will also rid ourselves of the problems we face from other addictive behaviors like sex addiction, status / money addiction, religious righteousness, etc. (See the book The Perfect Pandemic for a detailed breakdown of the various dopamine triggers we humans use).
- collyw 8y ago
  > I cant say i've ever heard of anyone ever using heroine responsibly. I don't think its the sort of thing people will advertise. Apparently only around 10% of users become addicts
  - olalonde 8y ago
    Do you have a source for that? I recall reading it was about as addictive as nicotine which I'm sure gets well over 10% of smokers addicted.
mmt 8y ago
> I dont understand this part. The potential for overdose on alcohol is high as well. I think that the point about GHB that most people miss is the concept of therapeutic index, a term borrowed from the medical world (I've also seen it called "safety ratio" in the context of recreational drugs, especially since they're not being used therapeutically). That is, the amount of GHB required to get the desired effect is very close to the amount necessary for an overdose. > I can go buy a plastic handle for $10 and if i drink the whole thing tonight i'll probably die Merely being easy to obtain doesn't make it easy to overdose, though. That "if I drink the whole thing" is an important part. You do not, for example, need to drink 90% of that bottle just to get "buzzed". I suspect that the average person would feel sufficiently drugged well before making it halfway through (as even a fifth, even spread over an evening, is a lot of booze). With drugs like GHB or ketamine, one needs to do the equivalent of drinking the vast majority of that overdose-quantity-bottle just to get high enough, so it's very easy to go too far accidentally. What's worse, what that amount is, and what that overdose amount is, are weight-dependent, and they can vary at different rates. That's not to say there's no way of alleviating that risk, or at least reducing the possible harm (like maybe only allowing them in clubs adjacent to hospitals), but simply ignoring the legitimate increased accidental OD risk is unlikely to help.
- samatman 8y ago
  I assure you, you haven't a clue what you're talking about. The therapeutic index for GHB is more than adequate, and ketamine is legitimately difficult to kill yourself with, to the point where the deaths I'm aware of were from drowning. An issue with GHB is that it's distributed in a liquid form that can vary greatly in the amount of water present. When it was available over the counter in the 80s, issues were practically unheard of.
- GuB-42 8y ago
  AFAIK, the biggest problem with GHB is its synergy with alcohol. Most GHB related deaths also involve alcohol. GHB therapeutic index (8) is just slightly lower than alcohol (10). However, being an illegal substance, you don't really know how potent your stuff is. Ketamine is rather high (38). And BTW, THC (cannabis) as a therapeutic index over 9000. LSD and psylocibin (magic mushrooms) are at 1000, which also makes them virtually impossible to overdose.
andyjohnson0 8y ago
> I can go buy a plastic handle for $10 and if i drink the whole thing tonight i'll probably die. I'm intrigued by what a "plastic handle" is, and google isn't helping for obvious reasons. I assume its a slang term but I've never heard or read it before. (I'm in the UK.) Care to elaborate?
- mattbessey 8y ago
  A handle is a bottle size in the US, 1.75L. Often made of plastic since its so big it would weigh more in glass, and perhaps because the kind of booze you buy in that quantity ain't luxury.
  - mseebach 8y ago
    And, pertinent to the name, such a bottle will often have a handle built in. https://siestaspirits.com/products/jim-beam-kentucky-straight-bourbon-whiskey-1-75l https://siestaspirits.com/products/jim-beam-kentucky-straigh...
    - Shengbo 8y ago
      Thanks, never seen anything like that in Europe.
Nasrudith 8y ago
Related I think some of the risk factor is vector related along with bodily reactions. Drinking too much leads to vomitting - while in the wrong circumstance potentially lethal it is expelled. One can't sneeze out cocaine or shoot heroin out of your veins autonomously if the body had too much. Dose standardization does clearly help judging by the nasty side effects of overdosd deaths spiking after pill mills were shut down. It is not a panacea however - tolerance varies as well. It is why trying to get clean can be ironically dangerous. Things start going south and they try their old "standard dose" again after losing tolerance when it is enough to kill a 300lb man with no tolerance built up. I wonder if legalizing weaned rehab would help. Like say cutting their dose by 25% repeatedly. On a related note I wonder what role genetics play with it. It would be nice if susceptibility could be read from a genetic test so they could say "Don't worry about restricting opiates for him - he'll get weakened and would always want to get off them asap anyway but he shouldn't drink alcohol when stressed or take cough syrup but should avoid stimulants for their personal addictive potential." I know personally from legitimate medical usage there are high potential for abuse drugs that for me have me wondering how anyone could consider it fun.
- chillingeffect 8y ago
  > sneeze out cocaine or shoot heroin out of your veins autonomously It's an extremely complex system, but notice that prohibition has actually altered the way we consume drugs. For example, coca leaves can be consumed rather harmlessly. But for smuggling purposes, it's concentrated into powder. Then, its black market status makes it a sign of the wealthy and well-connected. This doesn't hold for all substances, but it's worth remembering. You do see a portion of e.g. pot smokers who have to push it really far and do dabs of highly concentrated THC. But then again, many users of pot just vape a little concentrate to minimize lung damange. > legalizing weaned rehab absolutely. If people want help getting off drugs, we ought to facilitate it essentially like healing a broken leg. We kind of do this with methadone, but laws make it risky and far from perfect. > genetics it is known that certain genes increase likelihood of alcohol addiction. It's probably the same for many other substances, too. > high potential for abuse drugs that for me have me wondering how anyone could consider it fun. ugh same here. Had to take hydrocodone after surgery for a week. That was one messed-up high for me.
digianarchist 8y ago
GHB is a tricky drug. Not enough and you feel 100% normal. Too much and you pass out and become unresponsive for several hours. It's very hard to dose.

y4mi 8y ago

its way easier to overdose on hard drugs than alcohol. with alcohol, its a slow progress. you keep drinkng and most people pass out / lose their will to drink after they've had enough. hard drugs are generally a single portion and once its in your blood, its too late. you cant say 'hey, i've got enough for today' once you feel it hitting you. You're already doomed if you've chosen the wrong dosage from the start. > There are responsible drinkers and responsible heroin users out there I cant say i've ever heard of anyone ever using heroine responsibly. I'd have to take your word for it, but thats hard, considering how brutal the effects of heroine are on their users.

c22 8y ago
On the other hand, even if you don't die right away alcohol's no slouch in the finding ways to kill you and ruining lives department.
foolfoolz 8y ago
I think a lot of this can be attributed to these drugs being used in a completely ad hoc manner. There's no usage guidelines on a bag of cocaine. There's no 'Active Ingredient' percentage listed. You dont know what it is. You can't compare it to another until you've had it. Any pill that's an upper is called 'molly' Somehow the vast majority of people who take legal hard drugs such as vicodin or dilaudid, don't overdose on them. There's a culture built around taking these drugs responsibly according to their directions. We have that very strongly ingrained in our culture about alcohol. I think that same culture would develop if your cocaine came in a box from CVS with proper instructions on when you can take it and what side effects to look for. Of course people are going to make mistakes. They are going to abuse drugs. But that is happening today. Trying to solve that by keeping the drugs away sounds like the same policies in the war on drugs that we are saying aren't working and leading to legalization
- TheSpiceIsLife 8y ago
  As a (former? never say never) injecting drug user of Heroin, methamphetamine, and quite a few other water soluble substances, I fully agree with the parent comment. I never bothered getting addicted to Heroin. You have to stick to the rules: never use more than two days in a row and don’t use it consistently, if in doubt half your dose, and never use alone but always with at least one other who knows how to administer breathing assistance until paramedics arrive. Don’t take your dose at the same time as your buddy, wait to see if the first user has trouble staying conscious, 15 to 20 minutes should do it. Edit: fixed a word
  - jjgreen 8y ago
    Sensible and honest advice like this saves lives
    - TheSpiceIsLife 8y ago
      Yes! And it works in practice: A friend overdose in my loungeroom one evening. He’d taken a lot of Valium, a little bit of a alcohol, and then half the heroin I sold him. After a 15 minute argument he took the rest of the Heroin. I tried to tell him he’d already taken some but couldn’t remember. Anyway, he started going a bit blue: Cyanosis. Became progressively and rapidly more difficult for him to speak and stay alert. Called the ambulance, put him in the stable side position, watched his breathing, he was ok. Ambulance arrived, started administering breathing assistance and naltrexone. They commented he required a lot of naltrexone. He came to, they took him to hospital for observation over night. I rode with him in the ambulance and sat with him in hospital for a few hours. No long term harm. Still friends, and I like to joke he owes me his life. Friends don’t let friends die from overdosing on opiates.
saulrh 8y ago
Tylenol aka paracetamol. Take one every six hours, as directed, and you'll be fine. Take two every six hours and you die painfully over the course of the next month. 500 deaths a year in the US alone... despite basically every house in the developed world having a bottle of it in a drawer. And it doesn't even have huge black warning labels with skulls and poison symbols! Street-quality Tylenol would kill people the way street-quality fentanyl does. Probably more.
merinowool 8y ago
I disagree. You can easily overdose alcohol with spirits and "pushing the tempo". Many teenagers died during stupid drinking games. If you drink "normally" it would be difficult, but that is the same with other drugs. If you stick to guidelines you should be fine. Problem with other drugs is that you don't know purity and even what's really in them, as each dealer in the chain adds something to get more weight.
ssijak 8y ago
I know a person who used Heroin occasionally. He is well and fine, was first officer on some large ship and is now finishing for masters degree which would allow him to work on land related to shipping.
ada1981 8y ago
Something like 10% of users will be addicted to any given drug (less for psychedelics which can actually free people of addiction by helping release the underlying trauma). The majority of drug users of any substance are not addicts. Overdose is most common from adulterants and from not knowing the dosage one is taking due to lack of purity information. If your goal is to stop ODs, allowing cheap access to taxed pharma grade Drugs is your first step. The next step is using the taxes to make access to trauma healing / education free. Trauma is the root cause of addiction, so healing frees one of the need for the addictive behavior. Somatic based therapies, psychedelic therapy, and an environment that supports healthy living. I work with people regularly who are able to gently walk away from addictions because they’ve healed the underlying trauma. The benefit of this is that we will also rid ourselves of the problems we face from other addictive behaviors like sex addiction, status / money addiction, religious righteousness, etc. (See the book The Perfect Pandemic for a detailed breakdown of the various dopamine triggers we humans use).
collyw 8y ago
> I cant say i've ever heard of anyone ever using heroine responsibly. I don't think its the sort of thing people will advertise. Apparently only around 10% of users become addicts
- olalonde 8y ago
  Do you have a source for that? I recall reading it was about as addictive as nicotine which I'm sure gets well over 10% of smokers addicted.

mmt 8y ago

> I dont understand this part. The potential for overdose on alcohol is high as well. I think that the point about GHB that most people miss is the concept of therapeutic index, a term borrowed from the medical world (I've also seen it called "safety ratio" in the context of recreational drugs, especially since they're not being used therapeutically). That is, the amount of GHB required to get the desired effect is very close to the amount necessary for an overdose. > I can go buy a plastic handle for $10 and if i drink the whole thing tonight i'll probably die Merely being easy to obtain doesn't make it easy to overdose, though. That "if I drink the whole thing" is an important part. You do not, for example, need to drink 90% of that bottle just to get "buzzed". I suspect that the average person would feel sufficiently drugged well before making it halfway through (as even a fifth, even spread over an evening, is a lot of booze). With drugs like GHB or ketamine, one needs to do the equivalent of drinking the vast majority of that overdose-quantity-bottle just to get high enough, so it's very easy to go too far accidentally. What's worse, what that amount is, and what that overdose amount is, are weight-dependent, and they can vary at different rates. That's not to say there's no way of alleviating that risk, or at least reducing the possible harm (like maybe only allowing them in clubs adjacent to hospitals), but simply ignoring the legitimate increased accidental OD risk is unlikely to help.

samatman 8y ago
I assure you, you haven't a clue what you're talking about. The therapeutic index for GHB is more than adequate, and ketamine is legitimately difficult to kill yourself with, to the point where the deaths I'm aware of were from drowning. An issue with GHB is that it's distributed in a liquid form that can vary greatly in the amount of water present. When it was available over the counter in the 80s, issues were practically unheard of.
GuB-42 8y ago
AFAIK, the biggest problem with GHB is its synergy with alcohol. Most GHB related deaths also involve alcohol. GHB therapeutic index (8) is just slightly lower than alcohol (10). However, being an illegal substance, you don't really know how potent your stuff is. Ketamine is rather high (38). And BTW, THC (cannabis) as a therapeutic index over 9000. LSD and psylocibin (magic mushrooms) are at 1000, which also makes them virtually impossible to overdose.

andyjohnson0 8y ago

> I can go buy a plastic handle for $10 and if i drink the whole thing tonight i'll probably die. I'm intrigued by what a "plastic handle" is, and google isn't helping for obvious reasons. I assume its a slang term but I've never heard or read it before. (I'm in the UK.) Care to elaborate?

mattbessey 8y ago
A handle is a bottle size in the US, 1.75L. Often made of plastic since its so big it would weigh more in glass, and perhaps because the kind of booze you buy in that quantity ain't luxury.
- mseebach 8y ago
  And, pertinent to the name, such a bottle will often have a handle built in. https://siestaspirits.com/products/jim-beam-kentucky-straight-bourbon-whiskey-1-75l https://siestaspirits.com/products/jim-beam-kentucky-straigh...
  - Shengbo 8y ago
    Thanks, never seen anything like that in Europe.

Nasrudith 8y ago

Related I think some of the risk factor is vector related along with bodily reactions. Drinking too much leads to vomitting - while in the wrong circumstance potentially lethal it is expelled. One can't sneeze out cocaine or shoot heroin out of your veins autonomously if the body had too much. Dose standardization does clearly help judging by the nasty side effects of overdosd deaths spiking after pill mills were shut down. It is not a panacea however - tolerance varies as well. It is why trying to get clean can be ironically dangerous. Things start going south and they try their old "standard dose" again after losing tolerance when it is enough to kill a 300lb man with no tolerance built up. I wonder if legalizing weaned rehab would help. Like say cutting their dose by 25% repeatedly. On a related note I wonder what role genetics play with it. It would be nice if susceptibility could be read from a genetic test so they could say "Don't worry about restricting opiates for him - he'll get weakened and would always want to get off them asap anyway but he shouldn't drink alcohol when stressed or take cough syrup but should avoid stimulants for their personal addictive potential." I know personally from legitimate medical usage there are high potential for abuse drugs that for me have me wondering how anyone could consider it fun.

chillingeffect 8y ago
> sneeze out cocaine or shoot heroin out of your veins autonomously It's an extremely complex system, but notice that prohibition has actually altered the way we consume drugs. For example, coca leaves can be consumed rather harmlessly. But for smuggling purposes, it's concentrated into powder. Then, its black market status makes it a sign of the wealthy and well-connected. This doesn't hold for all substances, but it's worth remembering. You do see a portion of e.g. pot smokers who have to push it really far and do dabs of highly concentrated THC. But then again, many users of pot just vape a little concentrate to minimize lung damange. > legalizing weaned rehab absolutely. If people want help getting off drugs, we ought to facilitate it essentially like healing a broken leg. We kind of do this with methadone, but laws make it risky and far from perfect. > genetics it is known that certain genes increase likelihood of alcohol addiction. It's probably the same for many other substances, too. > high potential for abuse drugs that for me have me wondering how anyone could consider it fun. ugh same here. Had to take hydrocodone after surgery for a week. That was one messed-up high for me.

digianarchist 8y ago

GHB is a tricky drug. Not enough and you feel 100% normal. Too much and you pass out and become unresponsive for several hours. It's very hard to dose.