6 ms·

Norway to test free heroin for drug addicts

44 points by smaili 8y ago

gopalv 8y ago
This is such a ridiculous idea that would work very well, because we're talking about addicts (and ignoring the possible moral hazard - government giving a drug out). No intervention is going to motivate a dope-sick zombie to get to a hospital as much as the promise of being relieved of it - "can I talk you into coming in for counseling? there's going to be heroin and a nurse with steady hands." And you entirely cut off the illegal sales market, because the government is never going to provide this service to a non-addict - there's no price at which a dealer survives this market and sells to your kid. An addict should prefer it to the black market, because they don't have to worry about a fentanyl overdose. If addicts are being produced out of legal opioids and switching to heroin, then this catches them before they are entirely beyond help. All in all, this is excellent fiscally as well, because it prevents money flowing out in the dark out of the country (instead, legal imports to doctors) - and possibly, cheaper than ambulances every other week until the inevitable happens.
- chipperyman573 8y ago
  The only argument that you missed that some people may argue is that their taxes (Especially in Norway where taxes are very high) are now going to helping drug addicts get their next hit for free. Some people don't want that to happen, no matter how much good it does otherwise. The rest of your post is spot-on, it's just important to consider arguments from every side. I know there are a lot of good responses to this argument ("you'd be paying for a jail cell anyway", "it's a net benefit to society", etc), but you have to remember that there is a very large portion of society that think drug users are inherently terrible people unworthy of help and won't listen to any logic beyond that. Although HN is made up of people who are willing to think through arguments fully and recognize why this program would result in a net-benefit to society (at least, in theory - it hasn't been tested yet), it's important to remember that people exist outside the HN bubble. To these people, the idea of helping someone obtain drugs (especially the government helping someone obtain drugs) is a terrible idea, hard stop.
  - maxxxxx 8y ago
    Considering that the alternative is to have your taxes pay for free boarding in jail buying drugs is actually a bargain.
    - hnaccy 8y ago
      What if it reduces the disincentives to becoming a heroin addict?
      - maxxxxx 8y ago
        Sending them to jail doesn't work. I think we have learned that during the war on drugs. Maybe send them to therapy or just let them do their thing? I used to know a heroin addict who made enough money to afford his heroin and he held a job successfully. He would sometimes disappear for a few days but I have seen that with heavy drinkers too. I think most drugs can be managed as well or badly as alcoholism.
        fpoling 8y ago
        I have a distant relative in Belarus who is a heroin addict for 25 years. Periodically he is thrown into a jail for stealing stuff. When he is released his close relatives have to watch for their stuff as he tries to still from them. But he only still to pay for heroin. If he will be provided free heroin, he will be harmless and may even do something useful as his mental and physical health AFAIK is still OK.
      - elil17 8y ago
        Being a heroin addict already sucks - the main disencientives are that you will probably die, that you’ll get dope sick, that you’ll lose friends and family. People who get into heroin don’t do it because of some cost benifit analysis, but because they are truely desperate.
  - Nursie 8y ago
    Those people need to realise that more of their taxes would go to apprehend, try and imprison the same individuals. I know some people will still prefer punishing others to helping them, but at that point I don't think their opinion is worth much.
- redisman 8y ago
  Any experiments on how to help drug addicts is great. It's been obvious (in hard data) for decades that wagging our finger and throwing people in jail is not doing anything.
  - lev99 8y ago
    The Rat Park experiment (1981) shows an increase in the standard of living decreases drug use among addicted and non-addicted mice.
    - redisman 8y ago
      Hmm but Norwegians have probably the highest standard of living in the world already. It's a super rich country with a generous welfare state.
- lev99 8y ago
  > If addicts are being produced out of legal opioids and switching to heroin, then this catches them before they are entirely beyond help. I'm unsure if anyone is 'entirely beyond help', but if people suffering from opioid user disorder have a point of no return that point is well after switching to heroin. Many people have recovered from a heroin habit.
majos 8y ago
Slightly less eye-catching, but the actual news seems to be > The Norwegian Directorate for Health and Social Affairs has been tasked with proposing an experimental project to identify patients likely to benefit from the programme, to examine the implementation method, and to calculate the costs...The first treatments under the project will begin in 2020 at the earliest, the health ministry said in a statement. The initiative could benefit up to 400 drug addicts, according to the daily Aftenposten. So it is a small-scale, but still radical, experiment that may begin in a few years. This addresses my first immediate question, which was "why wouldn't this just attract heroin addicts from around Europe and beyond?".
samueldavid 8y ago
could something like this work for California?
- AdamM12 8y ago
  I hope they try just so we can hear from Fox News.
  - dang 8y ago
    Please don't do this here.
    - AdamM12 8y ago
      Sorry. Mere jest.
mrsteveman1 8y ago
Excellent idea. In the U.S. we commonly see waves of "heroin" overdose deaths over the course of a single weekend. I use quotes because it's usually not diacetylmorphine, it's a fentanyl analog. While they're both illegal, fentanyl doesn't require large poppy fields to manufacture, and it can be more easily concealed for smuggling due to the significantly higher potency by weight and volume. And the cause of those overdose deaths is typically a new illegally smuggled batch of it showing up in a specific area that may or may not be diluted correctly, and even if it is diluted correctly, it may or may not be significantly more potent than the batch that was being sold the day before. The "normal" fentanyl that we use to control chronic and postoperative pain, and for anesthesia, is active and easily felt at the 12.5-25mcg level. Some of the fentanyl analogs, including some we use in hospitals, are active at less than 1/100th of that. You simply can't see that or handle it safely, so illicit "heroin" is dry mixed with other, ideally inert, powders. This works fine for things like a cake mix, where the whole thing is going to be further processed with liquids added to it, but for a potentially lethal drug it's extremely dangerous. As a result, people accidentally take 50x or more than they thought they were taking, and first responders like police and EMS are at serious risk of overdose themselves, simply from touching a surface or a plastic bag that looks empty. There is virtually nothing we can do to prevent that unless we move the demand into a regulated channel like a pharmacy. A nice side benefit to distributing the drugs for free, as long as it isn't overly restrictive, is that it can potentially destroy the blackmarket by eliminating the profit motive as well.
emsy 8y ago
These people already suffer from addiction. Anything the government does to punish them just furthers their suffering and doesn’t help in any way as far we can tell. I think it’s time to paint lawmakers that imprison drug addicts as uninformed at best and immoral and evil at worst. The same goes for other drugs which could potentially end suffering of people (MDMA, Cannabis) but are currently dismayed. The war on the war on drugs needs to take up a notch.
AdamM12 8y ago
> "Norway, which has one of the highest deadly drug overdose rates in Europe..." This is the news to me. Anyone know why? My thought is that unlike the US they aren't use to dealing with this so Narcan isn't as prevalent (this is a throw it out there guess backed by no research). I would of guessed Eastern Europe/former communist states (Poland, Bulgaria, Hungary, etc.).
- redisman 8y ago
  It's a pretty interesting statistics. #1 USA, #2 Estonia, #3 Sweden, #4 Norway, #5 Ireland. I don't really know what these countries have in common.
  - psergeant 8y ago
    Excessively shitty grey weather?
  - AdamM12 8y ago
    US wasn't surprising.
    - AdamM12 8y ago
      Not sure why I got down voted for a simple statement but ok.
claydavisss 8y ago
Like needle exchanges, this will be an idea that progressives will eventually realize is outrageously naive and stupid. Sorry. Norway will slowly collect addicts just as SF and LA have collected homeless. They aren't as dumb and helpless as you think, they will gravitate to places where their situation is condoned and supported. Norway should expect a minimum of 50k Americans to scrounge together for a one-way trip...free heroin? That is a fantasy for any addict.
- deathanatos 8y ago
  > just as SF and LA have collected homeless SF conducts a sort of census of their homeless population. One of the questions asked is where the person lived when they became homeless. The majority are from SF[1]: > Sixty-nine percent (69%) of respondents reported they were living in San Francisco at the time they most recently became homeless. Of those, over half (55%) had lived in San Francisco for 10 or more years. The idea that SF "collects" homeless people (from elsewhere) is a myth not supported by data. [1]: http://hsh.sfgov.org/wp-content/uploads/2017/06/2017-SF-Point-in-Time-Count-General-FINAL-6.21.17.pdf http://hsh.sfgov.org/wp-content/uploads/2017/06/2017-SF-Poin...
  - dragonwriter 8y ago
    > The idea that SF "collects" homeless people (from elsewhere) is a myth not supported by data. It is, actually, supported by the data you just posted to refute it, which indicates nearly a third of SF homeless were not in SF when they became homeless.
  - doyoulikeworms 8y ago
    31% of homeless in SF came from elsewhere. This evidence may actually go against your opinion... What are the numbers like for other cities?
    - lev99 8y ago
      > What are the numbers like for other cities? Those numbers aren't collected in a national and standardized way. Even if other cities collected data about this question, please don't compare the numbers without also comparing survey methodology.
jdoliner 8y ago
Universal basic income is so 2017. Universal basic stash is clearly the way forward.
- ratacat 8y ago
  Wholly under rated.
jdoliner 8y ago
What happens when people start claiming to be drug addicts so they can sell the free heroin to real drug addicts?
- lev99 8y ago
  Why wouldn't the real drug addicts go get the free heroin?
  - jdoliner 8y ago
    I was assuming there was some limitation on the amount you could get for free and that some addicts would want more than their allotment.
    - lev99 8y ago
      Big assumption. It might be the case, but it might not be. The first batch of patients start in 2020, with a max size of 400. Let's see if we can help those people, who are probably chosen more carefully then a full program would be, before thinking about the issues scaling up will cause.
- incadenza 8y ago
  Or treat it like methadone where you must consume it on site. Not that hard.
- wetpaws 8y ago
  Why would real addicts buy it if it is available for free?
  - deleted 8y ago
    [deleted]
- elil17 8y ago
  Models for opioid based opioid addiction treatments already exist, such as methodone
tim333 8y ago
This was tried in the UK before with generally positive results eg In 1982 in the Wirral, 400 addicts >...93 per cent drop in theft and burglary. ‘You could see them transform in front of your own eyes,’ Lofts told a newspaper, amazed. ‘They came in in outrageous condition, stealing daily to pay for illegal drugs; and became, most of them, very amiable, reasonable law-abiding people.’ He said elsewhere: ‘Since the clinics opened, the street heroin dealer has slowly but surely abandoned the streets of Warrington and Widnes.’ https://www.spectator.co.uk/2015/05/the-case-for-prescription-heroin/ https://www.spectator.co.uk/2015/05/the-case-for-prescriptio...

44 points by smaili 8y ago

This is such a ridiculous idea that would work very well, because we're talking about addicts (and ignoring the possible moral hazard - government giving a drug out). No intervention is going to motivate a dope-sick zombie to get to a hospital as much as the promise of being relieved of it - "can I talk you into coming in for counseling? there's going to be heroin and a nurse with steady hands." And you entirely cut off the illegal sales market, because the government is never going to provide this service to a non-addict - there's no price at which a dealer survives this market and sells to your kid. An addict should prefer it to the black market, because they don't have to worry about a fentanyl overdose. If addicts are being produced out of legal opioids and switching to heroin, then this catches them before they are entirely beyond help. All in all, this is excellent fiscally as well, because it prevents money flowing out in the dark out of the country (instead, legal imports to doctors) - and possibly, cheaper than ambulances every other week until the inevitable happens.

chipperyman573 8y ago
The only argument that you missed that some people may argue is that their taxes (Especially in Norway where taxes are very high) are now going to helping drug addicts get their next hit for free. Some people don't want that to happen, no matter how much good it does otherwise. The rest of your post is spot-on, it's just important to consider arguments from every side. I know there are a lot of good responses to this argument ("you'd be paying for a jail cell anyway", "it's a net benefit to society", etc), but you have to remember that there is a very large portion of society that think drug users are inherently terrible people unworthy of help and won't listen to any logic beyond that. Although HN is made up of people who are willing to think through arguments fully and recognize why this program would result in a net-benefit to society (at least, in theory - it hasn't been tested yet), it's important to remember that people exist outside the HN bubble. To these people, the idea of helping someone obtain drugs (especially the government helping someone obtain drugs) is a terrible idea, hard stop.
- maxxxxx 8y ago
  Considering that the alternative is to have your taxes pay for free boarding in jail buying drugs is actually a bargain.
  - hnaccy 8y ago
    What if it reduces the disincentives to becoming a heroin addict?
    - maxxxxx 8y ago
      Sending them to jail doesn't work. I think we have learned that during the war on drugs. Maybe send them to therapy or just let them do their thing? I used to know a heroin addict who made enough money to afford his heroin and he held a job successfully. He would sometimes disappear for a few days but I have seen that with heavy drinkers too. I think most drugs can be managed as well or badly as alcoholism.
      - fpoling 8y ago
        I have a distant relative in Belarus who is a heroin addict for 25 years. Periodically he is thrown into a jail for stealing stuff. When he is released his close relatives have to watch for their stuff as he tries to still from them. But he only still to pay for heroin. If he will be provided free heroin, he will be harmless and may even do something useful as his mental and physical health AFAIK is still OK.
    - elil17 8y ago
      Being a heroin addict already sucks - the main disencientives are that you will probably die, that you’ll get dope sick, that you’ll lose friends and family. People who get into heroin don’t do it because of some cost benifit analysis, but because they are truely desperate.
- Nursie 8y ago
  Those people need to realise that more of their taxes would go to apprehend, try and imprison the same individuals. I know some people will still prefer punishing others to helping them, but at that point I don't think their opinion is worth much.
redisman 8y ago
Any experiments on how to help drug addicts is great. It's been obvious (in hard data) for decades that wagging our finger and throwing people in jail is not doing anything.
- lev99 8y ago
  The Rat Park experiment (1981) shows an increase in the standard of living decreases drug use among addicted and non-addicted mice.
  - redisman 8y ago
    Hmm but Norwegians have probably the highest standard of living in the world already. It's a super rich country with a generous welfare state.
lev99 8y ago
> If addicts are being produced out of legal opioids and switching to heroin, then this catches them before they are entirely beyond help. I'm unsure if anyone is 'entirely beyond help', but if people suffering from opioid user disorder have a point of no return that point is well after switching to heroin. Many people have recovered from a heroin habit.

majos 8y ago

Slightly less eye-catching, but the actual news seems to be > The Norwegian Directorate for Health and Social Affairs has been tasked with proposing an experimental project to identify patients likely to benefit from the programme, to examine the implementation method, and to calculate the costs...The first treatments under the project will begin in 2020 at the earliest, the health ministry said in a statement. The initiative could benefit up to 400 drug addicts, according to the daily Aftenposten. So it is a small-scale, but still radical, experiment that may begin in a few years. This addresses my first immediate question, which was "why wouldn't this just attract heroin addicts from around Europe and beyond?".

samueldavid 8y ago

could something like this work for California?

AdamM12 8y ago
I hope they try just so we can hear from Fox News.
- dang 8y ago
  Please don't do this here.
  - AdamM12 8y ago
    Sorry. Mere jest.

mrsteveman1 8y ago

Excellent idea. In the U.S. we commonly see waves of "heroin" overdose deaths over the course of a single weekend. I use quotes because it's usually not diacetylmorphine, it's a fentanyl analog. While they're both illegal, fentanyl doesn't require large poppy fields to manufacture, and it can be more easily concealed for smuggling due to the significantly higher potency by weight and volume. And the cause of those overdose deaths is typically a new illegally smuggled batch of it showing up in a specific area that may or may not be diluted correctly, and even if it is diluted correctly, it may or may not be significantly more potent than the batch that was being sold the day before. The "normal" fentanyl that we use to control chronic and postoperative pain, and for anesthesia, is active and easily felt at the 12.5-25mcg level. Some of the fentanyl analogs, including some we use in hospitals, are active at less than 1/100th of that. You simply can't see that or handle it safely, so illicit "heroin" is dry mixed with other, ideally inert, powders. This works fine for things like a cake mix, where the whole thing is going to be further processed with liquids added to it, but for a potentially lethal drug it's extremely dangerous. As a result, people accidentally take 50x or more than they thought they were taking, and first responders like police and EMS are at serious risk of overdose themselves, simply from touching a surface or a plastic bag that looks empty. There is virtually nothing we can do to prevent that unless we move the demand into a regulated channel like a pharmacy. A nice side benefit to distributing the drugs for free, as long as it isn't overly restrictive, is that it can potentially destroy the blackmarket by eliminating the profit motive as well.

emsy 8y ago

These people already suffer from addiction. Anything the government does to punish them just furthers their suffering and doesn’t help in any way as far we can tell. I think it’s time to paint lawmakers that imprison drug addicts as uninformed at best and immoral and evil at worst. The same goes for other drugs which could potentially end suffering of people (MDMA, Cannabis) but are currently dismayed. The war on the war on drugs needs to take up a notch.

AdamM12 8y ago

> "Norway, which has one of the highest deadly drug overdose rates in Europe..." This is the news to me. Anyone know why? My thought is that unlike the US they aren't use to dealing with this so Narcan isn't as prevalent (this is a throw it out there guess backed by no research). I would of guessed Eastern Europe/former communist states (Poland, Bulgaria, Hungary, etc.).

redisman 8y ago
It's a pretty interesting statistics. #1 USA, #2 Estonia, #3 Sweden, #4 Norway, #5 Ireland. I don't really know what these countries have in common.
- psergeant 8y ago
  Excessively shitty grey weather?
- AdamM12 8y ago
  US wasn't surprising.
  - AdamM12 8y ago
    Not sure why I got down voted for a simple statement but ok.

claydavisss 8y ago

Like needle exchanges, this will be an idea that progressives will eventually realize is outrageously naive and stupid. Sorry. Norway will slowly collect addicts just as SF and LA have collected homeless. They aren't as dumb and helpless as you think, they will gravitate to places where their situation is condoned and supported. Norway should expect a minimum of 50k Americans to scrounge together for a one-way trip...free heroin? That is a fantasy for any addict.

deathanatos 8y ago
> just as SF and LA have collected homeless SF conducts a sort of census of their homeless population. One of the questions asked is where the person lived when they became homeless. The majority are from SF[1]: > Sixty-nine percent (69%) of respondents reported they were living in San Francisco at the time they most recently became homeless. Of those, over half (55%) had lived in San Francisco for 10 or more years. The idea that SF "collects" homeless people (from elsewhere) is a myth not supported by data. [1]: http://hsh.sfgov.org/wp-content/uploads/2017/06/2017-SF-Point-in-Time-Count-General-FINAL-6.21.17.pdf http://hsh.sfgov.org/wp-content/uploads/2017/06/2017-SF-Poin...
- dragonwriter 8y ago
  > The idea that SF "collects" homeless people (from elsewhere) is a myth not supported by data. It is, actually, supported by the data you just posted to refute it, which indicates nearly a third of SF homeless were not in SF when they became homeless.
- doyoulikeworms 8y ago
  31% of homeless in SF came from elsewhere. This evidence may actually go against your opinion... What are the numbers like for other cities?
  - lev99 8y ago
    > What are the numbers like for other cities? Those numbers aren't collected in a national and standardized way. Even if other cities collected data about this question, please don't compare the numbers without also comparing survey methodology.

jdoliner 8y ago

Universal basic income is so 2017. Universal basic stash is clearly the way forward.

ratacat 8y ago
Wholly under rated.

jdoliner 8y ago

What happens when people start claiming to be drug addicts so they can sell the free heroin to real drug addicts?

lev99 8y ago
Why wouldn't the real drug addicts go get the free heroin?
- jdoliner 8y ago
  I was assuming there was some limitation on the amount you could get for free and that some addicts would want more than their allotment.
  - lev99 8y ago
    Big assumption. It might be the case, but it might not be. The first batch of patients start in 2020, with a max size of 400. Let's see if we can help those people, who are probably chosen more carefully then a full program would be, before thinking about the issues scaling up will cause.
incadenza 8y ago
Or treat it like methadone where you must consume it on site. Not that hard.
wetpaws 8y ago
Why would real addicts buy it if it is available for free?
- deleted 8y ago
  [deleted]
elil17 8y ago
Models for opioid based opioid addiction treatments already exist, such as methodone

tim333 8y ago

This was tried in the UK before with generally positive results eg In 1982 in the Wirral, 400 addicts >...93 per cent drop in theft and burglary. ‘You could see them transform in front of your own eyes,’ Lofts told a newspaper, amazed. ‘They came in in outrageous condition, stealing daily to pay for illegal drugs; and became, most of them, very amiable, reasonable law-abiding people.’ He said elsewhere: ‘Since the clinics opened, the street heroin dealer has slowly but surely abandoned the streets of Warrington and Widnes.’ https://www.spectator.co.uk/2015/05/the-case-for-prescription-heroin/ https://www.spectator.co.uk/2015/05/the-case-for-prescriptio...