9 ms·

Sounds a bit like Zurich in the 80s and 90s[1] The problem was, while not solved, massively improved by providing heroin to hardcore addicts[2] The only argum

Sounds a bit like Zurich in the 80s and 90s[1] The problem was, while not solved, massively improved by providing heroin to hardcore addicts[2] The only argument against it, really, is that it's morally wrong to hand out drugs to addicts. Leaving this argument aside the approach was (and is) widely successful. Not only for the city, as such, but also for the addicts who get a chance to stabilize their lifes, are much healthier and actually can hold down appartments and jobs. [1] https://www.tagesanzeiger.ch/extern/storytelling/needletrauma/chapter1/ https://www.tagesanzeiger.ch/extern/storytelling/needletraum... [2] https://www.pri.org/stories/2016-02-12/us-can-learn-lot-zurich-about-how-fight-its-heroin-crisis https://www.pri.org/stories/2016-02-12/us-can-learn-lot-zuri...

tempguy9999 7y ago
Further <https://www.spectator.co.uk/2015/05/the-case-for-prescription-heroin/> https://www.spectator.co.uk/2015/05/the-case-for-prescriptio... A short read, a couple of pages. Extract: " The [heroin] addicts on prescriptions, by contrast, looked like the nurses or receptionists or Dr Marks himself. As a group, you couldn’t tell. Faced with this evidence, Marks was beginning to believe that many ‘of the harms of drugs are to do with the laws around them, not the drugs themselves’. In the clinic, as Russell Newcombe tells me, they started to call the infections and abscesses and amputations ‘drug war wounds’. So Dr Marks began to wonder: if prescription is so effective, why don’t we do it more? He expanded his heroin prescription programme from a dozen people to more than 400. The first people to notice an effect were the local police. Inspector Michael Lofts studied 142 heroin and cocaine addicts in the area, and he found there was a 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.’ One day a young mother called Julia Scott came into Dr Marks’s surgery and explained she had been working as a prostitute to support her habit. He wrote her a prescription, and she stopped sex work that day. " Just a perspective, not saying right or wrong. Edit: added this: " And something nobody predicted took place. The number of heroin addicts in the area actually fell. Research published by Dr Marks in the Proceedings of the Royal College of Physicians of Edinburgh compared Widnes, which had a heroin clinic, to the very similar Liverpool borough of Bootle, which didn’t — and found Widnes had 12 times fewer addicts. "
- wang_li 7y ago
  > ... looked like the nurses or receptionists or Dr Marks himself. That would be because Dr Marks can't see himself. The difference between a high functioning, long term heroin addict and everyone else is that the heroin addicts require large support staffs that keep them high functioning.
  - leetcrew 7y ago
    what do you mean by this? it sounds like Dr marks's approach is quite resource efficient. many people are served by each clinician.
  - derefr 7y ago
    You mean all the people who make and prescribe and administer the heroin? If that’s your meaning, then “everyone else” has much the same problem: it’s a rare person in our society who isn’t dependent on some part of the pharmaceuticals / medical equipment / biochemical industry to keep their life together. You can’t just stop taking SSRIs if you’re on them, insulin if you’re diabetic, antibiotics in the middle of a regimen, immunosuppressants if you’ve had an organ transplant... and you could never be a doctor (without immediately causing a life-threatening incident) without a constant supply of scrub and pre-sterilized instruments.
    - wang_li 7y ago
      >You can’t just stop taking SSRIs if you’re on them, insulin if you’re diabetic, antibiotics in the middle of a regimen, immunosuppressants if you’ve had an organ transplant... These do not constitute such a large portion of the population that you can say that folks who do not require them are rare. If anything it's the opposite. The point I make is that heroin addicts require everything that everyone else requires, plus medical support staff that provide them with cheap and safe sources to feed their addiction. Equating this with the tools of the trade of medical professionals is absurd.
      - CaptainZapp 7y ago
14 7y ago
I completely agree. I have told this to people for years. You have this population addicted to this drug we would produce for pennies and instead of working with them we make it illegal and challenge them through theft, prostitution, and street dealing just so they can supply their habit. Furthermore, I heard that in the countries that started the dealers dry up and new heroin addicts are simply few and far in between. I suspect that laws were not originally designed to help these people but rather to exert control over them. On a side note, with all the problems alcohol causes it amazes me we sell it but worry so much about others such as marijuana.
darkpuma 7y ago
I don't think it should be assumed that the homelessness is caused by the addiction, rather than both being comorbid to some third condition. Certainly some homelessness is caused by addiction, but for some a mental illness could be the cause of the homelessness and the drug-use may be an attempt to self-medicate that mental illness. In that scenario, providing clean and safe heroin would improve their quality of life, but wouldn't address the underlying condition or the subsequent homelessness. The family living next to the tent city will probably still feel pretty upset about the state of things.
- Scoundreller 7y ago
  The family living next to the tent city will be much happier without its property being constantly broken into ($300 window repair for the sin of leaving $5 in change in the cup holder), or the other acts that the opioid-dependent are willing to do to avoid withdrawals.
  - darkpuma 7y ago
    Happier is relative; living next to a tent city is still awful, even if there aren't any associated burglaries.
ttul 7y ago
Patiently waiting for this to expand into a mainstream program here in Vancouver... Meanwhile, the streets near where I work are literally mayhem 24/7. Take the Tenderloin district of San Francisco, enlarge, enhance, and shittify and you're only part way to how bad parts of downtown Vancouver are these days.

tempguy9999 7y ago

Further <https://www.spectator.co.uk/2015/05/the-case-for-prescription-heroin/> https://www.spectator.co.uk/2015/05/the-case-for-prescriptio... A short read, a couple of pages. Extract: " The [heroin] addicts on prescriptions, by contrast, looked like the nurses or receptionists or Dr Marks himself. As a group, you couldn’t tell. Faced with this evidence, Marks was beginning to believe that many ‘of the harms of drugs are to do with the laws around them, not the drugs themselves’. In the clinic, as Russell Newcombe tells me, they started to call the infections and abscesses and amputations ‘drug war wounds’. So Dr Marks began to wonder: if prescription is so effective, why don’t we do it more? He expanded his heroin prescription programme from a dozen people to more than 400. The first people to notice an effect were the local police. Inspector Michael Lofts studied 142 heroin and cocaine addicts in the area, and he found there was a 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.’ One day a young mother called Julia Scott came into Dr Marks’s surgery and explained she had been working as a prostitute to support her habit. He wrote her a prescription, and she stopped sex work that day. " Just a perspective, not saying right or wrong. Edit: added this: " And something nobody predicted took place. The number of heroin addicts in the area actually fell. Research published by Dr Marks in the Proceedings of the Royal College of Physicians of Edinburgh compared Widnes, which had a heroin clinic, to the very similar Liverpool borough of Bootle, which didn’t — and found Widnes had 12 times fewer addicts. "

wang_li 7y ago
> ... looked like the nurses or receptionists or Dr Marks himself. That would be because Dr Marks can't see himself. The difference between a high functioning, long term heroin addict and everyone else is that the heroin addicts require large support staffs that keep them high functioning.
- leetcrew 7y ago
  what do you mean by this? it sounds like Dr marks's approach is quite resource efficient. many people are served by each clinician.
- derefr 7y ago
  You mean all the people who make and prescribe and administer the heroin? If that’s your meaning, then “everyone else” has much the same problem: it’s a rare person in our society who isn’t dependent on some part of the pharmaceuticals / medical equipment / biochemical industry to keep their life together. You can’t just stop taking SSRIs if you’re on them, insulin if you’re diabetic, antibiotics in the middle of a regimen, immunosuppressants if you’ve had an organ transplant... and you could never be a doctor (without immediately causing a life-threatening incident) without a constant supply of scrub and pre-sterilized instruments.
  - wang_li 7y ago
    >You can’t just stop taking SSRIs if you’re on them, insulin if you’re diabetic, antibiotics in the middle of a regimen, immunosuppressants if you’ve had an organ transplant... These do not constitute such a large portion of the population that you can say that folks who do not require them are rare. If anything it's the opposite. The point I make is that heroin addicts require everything that everyone else requires, plus medical support staff that provide them with cheap and safe sources to feed their addiction. Equating this with the tools of the trade of medical professionals is absurd.
    - CaptainZapp 7y ago

14 7y ago

I completely agree. I have told this to people for years. You have this population addicted to this drug we would produce for pennies and instead of working with them we make it illegal and challenge them through theft, prostitution, and street dealing just so they can supply their habit. Furthermore, I heard that in the countries that started the dealers dry up and new heroin addicts are simply few and far in between. I suspect that laws were not originally designed to help these people but rather to exert control over them. On a side note, with all the problems alcohol causes it amazes me we sell it but worry so much about others such as marijuana.

darkpuma 7y ago

I don't think it should be assumed that the homelessness is caused by the addiction, rather than both being comorbid to some third condition. Certainly some homelessness is caused by addiction, but for some a mental illness could be the cause of the homelessness and the drug-use may be an attempt to self-medicate that mental illness. In that scenario, providing clean and safe heroin would improve their quality of life, but wouldn't address the underlying condition or the subsequent homelessness. The family living next to the tent city will probably still feel pretty upset about the state of things.

Scoundreller 7y ago
The family living next to the tent city will be much happier without its property being constantly broken into ($300 window repair for the sin of leaving $5 in change in the cup holder), or the other acts that the opioid-dependent are willing to do to avoid withdrawals.
- darkpuma 7y ago
  Happier is relative; living next to a tent city is still awful, even if there aren't any associated burglaries.

ttul 7y ago

Patiently waiting for this to expand into a mainstream program here in Vancouver... Meanwhile, the streets near where I work are literally mayhem 24/7. Take the Tenderloin district of San Francisco, enlarge, enhance, and shittify and you're only part way to how bad parts of downtown Vancouver are these days.