3 ms·

As someone who's studied the topic quite heavily, here's my issue with no-holds-barred legalization (I consider "legal" to mean "can manufacture and distribute"

by kortex 6y ago

As someone who's studied the topic quite heavily, here's my issue with no-holds-barred legalization (I consider "legal" to mean "can manufacture and distribute" in this regard, like tobacco). Drugs that couple very tightly to the VTA (brain's behavior-reward circuit) actually can lead to lasting changes after few or single exposures. This is amplified by rapid absorption routes - injection, insufflation and inhalation. The main players here are heroin (DEA sched 1), meth (2), cocaine (2), GHB/Xyrem (3), some benzos (4), tobacco (legal), and analogs therein. It's hard to have a casual habit with these drugs, as they manipulate the brain's behavioral calculus itself. Note that the DEA schedules are all over the board. The current schedule system has barely any correlation with harm (see work by David Nutt). But we are also in a weird place where access to two of the most destructive drugs in real measurable effects - alcohol and tobacco - are legal. At bare minimum we need to overhaul the schedule system, legalize drugs with low/moderate addiction potential (weed, psychedelics, ketamine, phenethylamines, the Shulginoids), and legalize everything in personal possession quantities, and for scientific/medical research. High-addiction drugs should probably be medically gated in some way.

lotsofpulp 6y ago
> The main players here are heroin (DEA sched 1), meth (2), cocaine (2), GHB/Xyrem (3), some benzos (4), tobacco (legal), and analogs therein. It's hard to have a casual habit with these drugs, as they manipulate the brain's behavioral calculus itself. Would caffeine and sugar also fall in this list?
- kortex 6y ago
  Caffeine, possibly. I have a pretty strong caffeine addiction myself. But the harm level of caffeine vs alcohol, tobacco, or anything else harder, is far far less. Sugar, no, it doesn't bind to transduction receptors in the same way (it is rewarding, but not like "drugs" are).
vidarh 6y ago
The problem with this thinking is that these drugs are not medically gated today. In fact, the "gating" of heroin through law enforcement is so poor that the difficulty and cost in scoring oxy once people face medical gating due to drug seeking behaviour is now one of the larger recruiting avenues to heroin use. It's easier and cheaper for people to get heroin as a substitute than it is to continue to use a safer, cleaner supply of oxy. If you want to medically gate these in a manner that does not increase harm it needs to be at the kind of level that e.g. paracetamol/acetaminophen is restricted in places like the UK (limits on quantity in a single purchase, but nothing that stops you popping to the next pharmacy over and buying more, or coming back the following day) or that e.g. some non-prescription drugs are sold (under the counter, pre-requisite information given out by a pharmacist and possibly some basic questions). You can maybe push it to a non-aggressive push towards treatment, but if you start denying access you're right back to creating a black market you'll have no control over. The exact threshold probably needs to differ per drug, but it the level of gating we're currently at even for legal prescription drugs like oxy is actively harmful.

by kortex 6y ago

lotsofpulp 6y ago

> The main players here are heroin (DEA sched 1), meth (2), cocaine (2), GHB/Xyrem (3), some benzos (4), tobacco (legal), and analogs therein. It's hard to have a casual habit with these drugs, as they manipulate the brain's behavioral calculus itself. Would caffeine and sugar also fall in this list?

kortex 6y ago
Caffeine, possibly. I have a pretty strong caffeine addiction myself. But the harm level of caffeine vs alcohol, tobacco, or anything else harder, is far far less. Sugar, no, it doesn't bind to transduction receptors in the same way (it is rewarding, but not like "drugs" are).

vidarh 6y ago

The problem with this thinking is that these drugs are not medically gated today. In fact, the "gating" of heroin through law enforcement is so poor that the difficulty and cost in scoring oxy once people face medical gating due to drug seeking behaviour is now one of the larger recruiting avenues to heroin use. It's easier and cheaper for people to get heroin as a substitute than it is to continue to use a safer, cleaner supply of oxy. If you want to medically gate these in a manner that does not increase harm it needs to be at the kind of level that e.g. paracetamol/acetaminophen is restricted in places like the UK (limits on quantity in a single purchase, but nothing that stops you popping to the next pharmacy over and buying more, or coming back the following day) or that e.g. some non-prescription drugs are sold (under the counter, pre-requisite information given out by a pharmacist and possibly some basic questions). You can maybe push it to a non-aggressive push towards treatment, but if you start denying access you're right back to creating a black market you'll have no control over. The exact threshold probably needs to differ per drug, but it the level of gating we're currently at even for legal prescription drugs like oxy is actively harmful.