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This is legitimately dangerous reporting. Heroin is ranked in the top 3 of addictive chemicals and all this article reports about is this anecdotal nonsense. I'

This is legitimately dangerous reporting. Heroin is ranked in the top 3 of addictive chemicals and all this article reports about is this anecdotal nonsense. I've too many friends to Heroin to know the reality of the drug.

capableweb 6y ago
I think you're missing the point of the article a bit. Everyone knows Heroin is dangerous and it's iterated on in the article as well. Only responsible and healthy individuals should self-use drugs, generally speaking. Then you can also argue that you might not have lost your friends only because of Heroin the substance, but also how people with heroin addiction is "treated" and frowned upon in society. I think what the article is trying to say is that harm reduction is a much more human and possibly effective approach to fighting real addition. Compared to other ways, which some of them include "there is no such thing as responsible drug use, it's all addiction" and treating people as such.
- rovr138 6y ago
  I think the tone of the article is dangerous. That coupled with the fact of how heroin is treated in society makes it worse. On top of that, add that not everyone that uses it is healthy and responsible, makes it even worse providing some bad validation. And then, not everyone is capable of making the distinction between fun or addiction early on when an addiction is starting. I too think it's dangerous.
  - capableweb 6y ago
    The tone is dangerous? What does that even mean? The article is an interview with a Heroin user. It's as dangerous as an interview with a sex-worker. The interviewer even seems to bring up some interesting counter-points to the interviewee. In the end, the interview is just providing a voice for the person getting interviewed. Are you saying that interviewing people who might do harm to world is dangerous?
    - sillysaurusx 6y ago
      Well, after all, interviewing a sex worker is dangerous too. People might have a bunch of sex and catch some nasty diseases. I think that's the logic, anyway. It's ironic that most people here are in the camp of "decriminalize drugs! Oh wait, no, not these drugs, just some drugs."
      - coryrc 6y ago
        As Portugal shows, decriminalizing drugs reduces their use. The position you are mocking is actually consistent.
        sillysaurusx 6y ago
        Fair point. But, if something isn't criminal, then it should be fine to read about people doing that thing –– which is all that this article is. Railing against it like it's somehow an affront to post it seems neither productive nor fair.
        throwaway0a5e 6y ago
        Portugal has a much more comprehensive set of programs to get people off hard drugs than any of the US jurisdictions that have decriminalized (or stopped enforcing through executive action) hard drugs.
        jboog 6y ago
        I'm not sure we can take the results of a single experiment in an incredibly homogenous tiny country in Europe to mean an outcome is replicable across the world.
        capableweb 6y ago
        Indeed. The "experiment" in Portugal is not proving it works everywhere, but shows it can work, which indicates we should study it further and possibly deploy it in more countries across the world, to see if it works elsewhere and if we could possibly make it even more effective. While Portugal is probably the most famous example of decriminalizing working in humans favor, it's not the only example, it has been employed in other states too. Netherlands has de-facto decriminalized all drugs (in practice, not in law), Czech Republic has decriminalized all (most?) drugs as well.
  - valuearb 6y ago
    Heroin isn’t dangerous. Illegal heroin is very dangerous.
  - mdip 6y ago
    > That coupled with the fact of how heroin is treated in society makes it worse. So this is sort of a problem with treating the thing "Heroin" as bad, versus treating the Heroin Addict as bad. Society makes it worse, mainly, by tossing addicts in jail and I'm generally against drug laws as they stand[0]. But making "everything legal" doesn't reduce the impact of the law on drug users as much as you'd expect. At least, anecdotally, every addict that I've known personally has had run-ins with law enforcement because of their drug use but having nothing to do with the drugs, themselves. In one case, a friend ended up with an "impeding traffic" charge when he fell asleep in the left-turn lane at an intersection. The story, as it was told to me, was that he chased a few Vicodin with a single beer, which resulted in him registering a 0.03, but he fell asleep in an intersection with his foot on the brake pedal. Despite this, he passed the field sobriety test, but the officer judged him to be intoxicated, and he was arrested. Apparently he was supposed to get a blood test; he was taken in early on Saturday and held until Monday, but they didn't do the test until he was "on his way out". It turned up nothing and he got out with a lawyer bill. [0] I'm convinced that things are so bad/ineffective right now, that I'm pretty close to support of all-out decriminalization (of possession), simply because it reduces the impact of addiction on the addicted.
- dfsegoat 6y ago
  They all work by increasing dopamine. But 'Addictive potential' does vary by drug, and by the person [1]. 'All substances of abuse self-administered by humans that can result in addiction are believed to exert their reinforcing effects by increasing DA in the nucleus accumbens (NAc)' https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3050051/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3050051/
- lazide 6y ago
  Who decides that someone is a responsible and healthy adult? Do we have any data on how many responsible and healthy adults try heroin? Anecdata and broad brush strokes of course - In my experience anyway, the actually responsible and heathy adults I know haven’t felt the need to use heroin. The people who somehow are able to delude themselves into thinking they are responsible and healthy while obviously in crippling mental and/or physical pain, have - and it’s been devastating to them. I’ve had prescription opioids before (hydrocodone, codeine, morphine) during medical emergencies. The feeling of peace and calm is amazing - which is exactly why it attracts people in pain and suffering, destructively so in many cases. It is difficult to know if that feeling is going to be magnetic or repulsive to you until you try it. It happens to be repulsive in my case (I know it’s a trap), thankfully. It’s a complicated story of course, and bad outcomes tend to get the press. Better treatment (including in many cases mental health treatment) is definitely needed. It is not the only substance like this - alcohol, tobacco, amphetamines, and others have track records of similar problems. Pretending that anyone and everyone could self evaluate and go for it without a decent percent of them having major problems for them and those around them is unfortunately just not a good idea.
  - capableweb 6y ago
    > Who decides that someone is a responsible and healthy adult? You do. It's not up to someone to decide, you're responsible for your own body and your own decisions to improve/harm it. I don't think they are saying advising governments to setup some sort of screening process for this. It's more for the people who are interested in the drugs themselves. When I first started getting interested in drugs, many pushed the idea that I should be psychologically healthy first (mostly because my first interest was psychedelics and I have good and well-meaning friends). I think that's what the article is trying to signal here.
    - jessebro 6y ago
      The problem with that attitude is when the body count gets high enough, there is incredible pressure to 'do something' - because enough people are terrible at judging this (or don't have the right friend group, or whatever) that we end up with huge crime problems, destroyed lives, and other social ills. The libertarian 'you can do what you want and it's your own responsibility' is great until the people who obviously made the wrong decision stop quietly owning the results of their decisions and start murdering random people for money to fund their habit. An argument can be made that the answer is free heroin and mental health treatment of course, and maybe it is the right answer. It seems hard for societies to accept however, outside of some very niche locations (Netherlands) though.
- hackermailman 6y ago
  Anybody who thinks this harm reduction strategy works should go visit cities that have employed it for years like Vancouver, Canada where there are legal shooting galleries everywhere, no arrests for personal amounts, and prescribed heroin that thousands of drug addicts have been on for 10 years now and the problem gets worse everyday. There used to just be a contained area of people passed out all over the street now it extends to the rest of the city. There is even a drug takers union that demanded treatment options be removed from drug taking clinics as 'it shamed drug users'. So if you create an accomodating and encouraging area for taking heroin you will find it surges in population when heroin is freely available and detox discouraged. Everybody points to the European model but they must have done something different than just harm reduction, like proactive policing breaking up open air drug markets and shutting down slums teeming with addicts forcing them into detox.
  - valuearb 6y ago
    Heroin is still illegal in Vancouver. Only a handful of addicts get free heroin. And because it’s illegal most addicts have to pay high prices for heroin of unknown potency, and frequent laced with Fentanyl. That directly leads to overdoses and hundreds of deaths, along with street crime to fund expensive habits.
    - hackermailman 6y ago
      It's been decrim unofficially for personal use for 5 years now, now officially decriminalized https://www.rcinet.ca/en/2020/11/28/vancouver-votes-to-decriminalize-all-drugs-a-first-for-canada/ https://www.rcinet.ca/en/2020/11/28/vancouver-votes-to-decri... Every bus stop since March last year in the drug slums also has instructions where to get prescribed opiates. Area only got worse
      - slavik81 6y ago
        From your link: > The Vancouver motion however for the moment has no force in law. A municipality doesn't have the authority to decriminalize drugs. They're just requesting the Federal government to act. It's not official, though it could eventually be.
- duxup 6y ago
  What is the success rate of folks who use heroin with some effort to not be addicted ... and what is the cost of getting them out of the cycle of addition? and what is even the success rate of getting them out of that cycle? The impact of failure to somehow prevent yourself from being addicted can be catastrophic ... even if you are successful in getting them out of the cycle of addition. And that impact can extend WAY beyond the individual. I'm open to the possibility that some drugs really can't be used responsibly by enough people that they absolutely should not be legal.
- mannykannot 6y ago
  > Only responsible and healthy individuals should self-use drugs, generally speaking. This not a very helpful observation, as we all know that this is far from what happens and is not going to become the norm. Furthermore, quite a lot of people became addicted to opiates through acting seemingly responsibly (at least initially taking the drugs under the supervision of a doctor whom they could reasonably assume was looking out for their best interests) and in the persuit of better health. I should add that Hart himself punted on this issue when the interviewer touched on it. In the interview, he does this a lot - for example, when the interviewer raised the question of physical addiction, Hart merely discussed the physiological basis, without touching the obvious issues it raises for the concept of responsible use. It may be telling that, in his description of himself as a responsible user, he avoided saying anything about this particular issue. > Then you can also argue that you might not have lost your friends only because of Heroin the substance, but also how people with heroin addiction is "treated" and frowned upon in society. This is also rather beside the point, as, while the way addiction is treated is also a problem, it is not an issue except where there is already a problem with addiction. That aside, there is such a thing as responsible addictive-drug use (including, but not necessarily limited to, people with chronic pain that only responds to such drugs) and the way we respond to addiction today is in many ways ineffective and in some ways very harmful. One cannot make a very good argument for reform, however, on the basis that some people can use some of these drugs responsibly.
- kgwgk 6y ago
  > Only responsible and healthy individuals should self-use drugs, generally speaking. Exposing oneself to developing a heroin addiction seems a somewhat irresponsible and unhealthy thing to do.
  - Barrin92 6y ago
    Exactly. I always thought of myself as responsible and healthy (and I basically was). I never overused alcohol, never binge-drank etc. I absolutely had no understanding how people could not regulate drug use because I had no problem with it. A few years ago I had a lot of stress and started drinking to help me sleep. After only a few months I felt kind of agitated without a nightcap. I immediately stopped and now I just don't drink when I'm stressed. So maybe in one sense I was right about being responsible, but on the other hand it could have very easily become a habit and now I understand how people slowly slide into addiction. It's arrogant to assume anyone knows how they'll respond to a drug as habit forming as heroin.
- ordu 6y ago
  > Only responsible and healthy individuals should self-use drugs, generally speaking. The funny thing I've been reading the article and the tone of it reminded me of heroin addicts who was not hit by their addiction heavily yet. I mean, Carl Hart thinks he is a responsible user, that he have an ability to decide for himself. It doesn't seem so for me. It is hard to tell, having as a data only one interview with him. But... you know, I'm an addict also, a nicotine one. I know how it is. First ten years of my addiction I though that there is nothing wrong with that, it costs some money and gives an urge to smoke sometimes, but it brings some benefits too. A few years ago I stopped smoking, after a month of abstinence I saw no benefits in smoking at all. My abstinence lasted for a couple of years, now I'm smoking again. Seeing no benefits at all. I know what I'm speaking about, I know the signs, I see the signs, and I see Carl Hart as a fellow addict, though with a different substance. I drink alcohol sometimes, and I know that I'm not an addict. Even despite the fact that sometimes I want to drink. A wish to drink is a warning sign of course, but I see no other signs. Like a despair coming with the thought that now it is not the good time to drink for some reasons. I have no ideas about benefits of being drunk: it is a funny state of mind, but mostly annoying, I'm really stupid when drunk, I see my stupidity and can do nothing to it. An addiction is a special state of mind, I believe one (i.e. me) could feel it as distinct from other states. Though it takes some learning, one needs to become an addict and to stop using an addictive substance of his choice. If Carl Hart wanted to prove that he is not an addict, he should stop using heroin for a couple of years, and then try to state his freedom from an addiction with a straight face. While he is using heroin for just five years and didn't tried to stop, I'd never believe his words that he is not an addict. When it would be 10-15 years or 5 years of abstinence, I'll probably believe his word on it.
  - cirgue 6y ago
    > The funny thing I've been reading the article and the tone of it reminded me of heroin addicts who was not hit by their addiction heavily yet. Having known someone who was a responsible, highly educated adult with a fantastic career who died of a heroin overdose, this whole article sounded eerily familiar.
    - shmageggy 6y ago
nimbius 6y ago
Fully agree. Carl is a white collar professor. The worst thing that can happen if his drug indulgence becomes a problem is he knocks over the water cooler or loses his job. I work a blue collar job servicing heavy diesel engines. Casual hard drug users are aggravatingly cavalier to work alongside. They forget important things constantly. They show up late and lose things often. You'll spend all day repeating things they'll never retain and at the end of the month they will lose a finger or toe or suffer a massive back injury and get fired. The back injury usually turns the casual heroin into constant endless heroin. Drug tests exist in my field for a really valid reason and it has nothing to do with having a problem but becoming one.
- Grustaf 6y ago
  Well, how many people will see this headline and rush off to a back alley to buy a shot of heroin from some junkie?
  - jboog 6y ago
    That's not the problem though. The issues is "drug decriminalization" people treating addictions like it's not a real problem for many people. Many of these folks want it to get to a point where you can quite easily buy heroin and suffer no legal consequences. I'm not saying our drug laws are just or can't be reformed but the fact that heroin is illegal prevents a LOT of people from using it. How many people will then use, aided by these pronouncements that "Heroin isn't actually that addictive!" and ruin their lives? We already have an opioid epidemic in this country that has destroyed communities. There's a middle ground between our terrible war on drugs and the naive "make it all legal and experiment with heroin!"
    - rflrob 6y ago
      > I'm not saying our drug laws are just or can't be reformed but the fact that heroin is illegal prevents a LOT of people from using it. How many people will then use, aided by these pronouncements that "Heroin isn't actually that addictive!" and ruin their lives? Do you know a lot of people who have expressed to you that they would use heroin recreationally if only it were legal? My gut is that the number isn’t large. My impression of the evidence from places that have tried decriminalization (eg Portugal) is that the number of people who use and then are able to get their lives back on the rails is higher than the extra people who use because it’s decriminalized.
boomboomsubban 6y ago
>all this article reports about is this anecdotal nonsense. I've too many friends to Heroin to know the reality of the drug The experiences of your friends is anecdotal. This article discusses the mechanisms of the drug, both the physical and personal cause of addiction, the common factors that lead to death, and the rate of users that end up addicted.
varispeed 6y ago
The dangers of the drug mostly come from its legal status and that it is being adulterated with various substances in the unregulated market. People also don't get a leaflet that they can consult on the strength or dosage so often they overdose. Medical grade heroin is not as dangerous as people supporting prohibition would like it to be. You can take clean heroin for decades and be perfectly fine. This would rather not apply to alcohol or other legal drugs.
- tanseydavid 6y ago
  >> You can take clean heroin for decades and be perfectly fine. This seems to me to be a excessively myopic way of thinking about it. To the point of amounting to rationalization.
  - varispeed 6y ago
    If you suffer from chronic pain, that's your only option if everything else fails. Opiates plus cannabis can make one's life bearable. Unfortunately many people would like them to suffer instead just to satisfy their own morals - for them someone else's suffering is a virtue.
- johnyzee 6y ago
  I would say the main danger is the crippling physical addiction (as well as psychological, but that is harder to quantify) it causes in a substantial amount of users.
  - varispeed 6y ago
    Yes, the downside is that you have to take it every so often, but after a while it becomes a second nature so you won't be even notice apart from occasional situations where "medication" is not possible.
maybelsyrup 6y ago
Sorry, I call BS. First, ranked by whom? Besides internet listicles, I mean. Second, those rankings, valid or not, are always a mix of legal and illegal drugs, with legal ones like alcohol, nicotine, and benzodiazepines sitting above heroin, morphine, and opium. Not to mention caffeine, which we begin feeding to children at extremely young ages alongside the amphetamines we pump them full of if they have trouble paying attention when locked in a classroom all day. Third, as someone else says below, stories about your friends are also anecdotes. (I'm sorry, genuinely, that they died.) You don't know "the reality" of heroin because there are a litany of such realities - and here's a scientist telling you about his. The thousands (more?) who use heroin like my aunt uses a snifter of brandy at Christmas don't appear on anyone's radar because they're not dying and they're not rocking the boat. I could go on and on about the lives lost or ruined by alcohol in my family tree alone, let alone just "people I know", but I'm not terrified and calling to ban alcohol. Finally, that so many people on a web forum whose userbase is wealthier, whiter, and way more privileged than the population at large rushing breathlessly into a post to call a black man (from the ghetto of Miami FL, no less) who uses small amounts of opiates "dangerous" is, excuse me, pretty effing rich. I thought tech-libertarians were supposed to be less reactionary.
- fnordsensei 6y ago
  I know that the EU and WHO at least rank drugs by harmfulness. On the WHO lists, alcohol ranks below heroin and the like, but not far below, and certainly not as low as cannabis. Harmfulness seems largely irrelevant for legislation.
ajkdhcb2 6y ago
You just threw out your own anecdotal nonsense. Responsible drug users are invisible to society and to judgemental people like you. You have no data to discredit it.
- vntok 6y ago
  Responsible drug users sounds like an oxymoron. Is there any data that shows those people even exist?
  - boomboomsubban 6y ago
    The article mentions ~70% of users of any drug are not addicts, and surely you know somebody who is both responsible and drinks alcohol.
  - ericol 6y ago
    Obviously this is highly anecdotal, but for the 5 years that I lived in Spain, I was a regular drug user. With the exception made of MDMA & speed (That I'll consume both on occasions) I was consuming weed, hash and mushrooms on a weekly basis. And everybody on a certain group of friends was doing the same. We had a surplus of mushrooms, as we had somebody in our group (A neurobiologist) growing them. 13 years ago I came back to Argentina, and then stopped consuming cold turkey.
  - sdeep27 6y ago
    How about the 150 million people every day that drink a cup of coffee and head to work?
  - bserge 6y ago
    I am one. I have used a lot of stuff, anything I could get my hands on (not "just 'cause", I'm trying to find something to fix specific problems). And in the end, it's only alcohol and nicotine that have me firmly in their grasp. Perhaps it's just the ease of access. I believe I could quit nicotine, but not alcohol. I don't even drink a lot. But I do, regularly. I've used way more addictive stuff, and I could go out and buy it tomorrow, but I don't. Kind of funny how it works.
frakkingcylons 6y ago
It’s not anecdotal, and he’s not just talking about heroin. He’s been involved in pharmacology studies for over 20 years. I wish people didn’t dismiss Carl Hart immediately out of hand. Prohibition has never been a successful strategy. People are going to buy drugs no matter what. The biggest problem we have with drugs in the US is that people are uninformed about safe drug use and they are unable to easily verify the purity of the drugs they buy.
4eor0 6y ago
Yes, let’s have your anecdotal experience be the basis for curbing speech. I’ve lost dozens of friends and family to alcoholism and drunk driving. I can’t really get behind the cherry picking; society is being damaged in other real ways to a much greater extent than heroin, yet we find the ennui to overlook them; freedom of choice, speech, too expensive to bother, political authority... Portugal has the model we should adopt and let this be as solved a problem it can be.
lucideer 6y ago
> dangerous Stigma around drug use is dangerous. This is extremely evident from the state of treatment of heroin addiction in society today. I don't really see how challenging this stigma is more dangerous than pandering to the status quo here.
andrei_says_ 6y ago
May I recommend the rat park experiment and possibly the work of Gabor Mate as a way of establishing context for addiction.
SubiculumCode 6y ago
Hard agree. I've lost some loved ones to meth, and it tears up whole communities. When I was young I was lax about drugs, but after seeing the same story over and over...drug addiction is real and it hurts.
yibg 6y ago
Is it just a matter of degrees though? Lots of people have ruined lives (sometimes ended lives) due to alcohol as well. We expect people to use alcohol responsibly, and there is social stigma and other consequences when it's not used responsibly. But we accept that people are free to choose to use alcohol if they want to. Why don't we have the same attitude towards other drugs?

capableweb 6y ago

I think you're missing the point of the article a bit. Everyone knows Heroin is dangerous and it's iterated on in the article as well. Only responsible and healthy individuals should self-use drugs, generally speaking. Then you can also argue that you might not have lost your friends only because of Heroin the substance, but also how people with heroin addiction is "treated" and frowned upon in society. I think what the article is trying to say is that harm reduction is a much more human and possibly effective approach to fighting real addition. Compared to other ways, which some of them include "there is no such thing as responsible drug use, it's all addiction" and treating people as such.

rovr138 6y ago
I think the tone of the article is dangerous. That coupled with the fact of how heroin is treated in society makes it worse. On top of that, add that not everyone that uses it is healthy and responsible, makes it even worse providing some bad validation. And then, not everyone is capable of making the distinction between fun or addiction early on when an addiction is starting. I too think it's dangerous.
- capableweb 6y ago
  The tone is dangerous? What does that even mean? The article is an interview with a Heroin user. It's as dangerous as an interview with a sex-worker. The interviewer even seems to bring up some interesting counter-points to the interviewee. In the end, the interview is just providing a voice for the person getting interviewed. Are you saying that interviewing people who might do harm to world is dangerous?
  - sillysaurusx 6y ago
    Well, after all, interviewing a sex worker is dangerous too. People might have a bunch of sex and catch some nasty diseases. I think that's the logic, anyway. It's ironic that most people here are in the camp of "decriminalize drugs! Oh wait, no, not these drugs, just some drugs."
    - coryrc 6y ago
      As Portugal shows, decriminalizing drugs reduces their use. The position you are mocking is actually consistent.
      - sillysaurusx 6y ago
        Fair point. But, if something isn't criminal, then it should be fine to read about people doing that thing –– which is all that this article is. Railing against it like it's somehow an affront to post it seems neither productive nor fair.
      - throwaway0a5e 6y ago
        Portugal has a much more comprehensive set of programs to get people off hard drugs than any of the US jurisdictions that have decriminalized (or stopped enforcing through executive action) hard drugs.
      - jboog 6y ago
        I'm not sure we can take the results of a single experiment in an incredibly homogenous tiny country in Europe to mean an outcome is replicable across the world.
        capableweb 6y ago
        Indeed. The "experiment" in Portugal is not proving it works everywhere, but shows it can work, which indicates we should study it further and possibly deploy it in more countries across the world, to see if it works elsewhere and if we could possibly make it even more effective. While Portugal is probably the most famous example of decriminalizing working in humans favor, it's not the only example, it has been employed in other states too. Netherlands has de-facto decriminalized all drugs (in practice, not in law), Czech Republic has decriminalized all (most?) drugs as well.
- valuearb 6y ago
  Heroin isn’t dangerous. Illegal heroin is very dangerous.
- mdip 6y ago
  > That coupled with the fact of how heroin is treated in society makes it worse. So this is sort of a problem with treating the thing "Heroin" as bad, versus treating the Heroin Addict as bad. Society makes it worse, mainly, by tossing addicts in jail and I'm generally against drug laws as they stand[0]. But making "everything legal" doesn't reduce the impact of the law on drug users as much as you'd expect. At least, anecdotally, every addict that I've known personally has had run-ins with law enforcement because of their drug use but having nothing to do with the drugs, themselves. In one case, a friend ended up with an "impeding traffic" charge when he fell asleep in the left-turn lane at an intersection. The story, as it was told to me, was that he chased a few Vicodin with a single beer, which resulted in him registering a 0.03, but he fell asleep in an intersection with his foot on the brake pedal. Despite this, he passed the field sobriety test, but the officer judged him to be intoxicated, and he was arrested. Apparently he was supposed to get a blood test; he was taken in early on Saturday and held until Monday, but they didn't do the test until he was "on his way out". It turned up nothing and he got out with a lawyer bill. [0] I'm convinced that things are so bad/ineffective right now, that I'm pretty close to support of all-out decriminalization (of possession), simply because it reduces the impact of addiction on the addicted.
dfsegoat 6y ago
They all work by increasing dopamine. But 'Addictive potential' does vary by drug, and by the person [1]. 'All substances of abuse self-administered by humans that can result in addiction are believed to exert their reinforcing effects by increasing DA in the nucleus accumbens (NAc)' https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3050051/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3050051/
lazide 6y ago
Who decides that someone is a responsible and healthy adult? Do we have any data on how many responsible and healthy adults try heroin? Anecdata and broad brush strokes of course - In my experience anyway, the actually responsible and heathy adults I know haven’t felt the need to use heroin. The people who somehow are able to delude themselves into thinking they are responsible and healthy while obviously in crippling mental and/or physical pain, have - and it’s been devastating to them. I’ve had prescription opioids before (hydrocodone, codeine, morphine) during medical emergencies. The feeling of peace and calm is amazing - which is exactly why it attracts people in pain and suffering, destructively so in many cases. It is difficult to know if that feeling is going to be magnetic or repulsive to you until you try it. It happens to be repulsive in my case (I know it’s a trap), thankfully. It’s a complicated story of course, and bad outcomes tend to get the press. Better treatment (including in many cases mental health treatment) is definitely needed. It is not the only substance like this - alcohol, tobacco, amphetamines, and others have track records of similar problems. Pretending that anyone and everyone could self evaluate and go for it without a decent percent of them having major problems for them and those around them is unfortunately just not a good idea.
- capableweb 6y ago
  > Who decides that someone is a responsible and healthy adult? You do. It's not up to someone to decide, you're responsible for your own body and your own decisions to improve/harm it. I don't think they are saying advising governments to setup some sort of screening process for this. It's more for the people who are interested in the drugs themselves. When I first started getting interested in drugs, many pushed the idea that I should be psychologically healthy first (mostly because my first interest was psychedelics and I have good and well-meaning friends). I think that's what the article is trying to signal here.
  - jessebro 6y ago
    The problem with that attitude is when the body count gets high enough, there is incredible pressure to 'do something' - because enough people are terrible at judging this (or don't have the right friend group, or whatever) that we end up with huge crime problems, destroyed lives, and other social ills. The libertarian 'you can do what you want and it's your own responsibility' is great until the people who obviously made the wrong decision stop quietly owning the results of their decisions and start murdering random people for money to fund their habit. An argument can be made that the answer is free heroin and mental health treatment of course, and maybe it is the right answer. It seems hard for societies to accept however, outside of some very niche locations (Netherlands) though.
hackermailman 6y ago
Anybody who thinks this harm reduction strategy works should go visit cities that have employed it for years like Vancouver, Canada where there are legal shooting galleries everywhere, no arrests for personal amounts, and prescribed heroin that thousands of drug addicts have been on for 10 years now and the problem gets worse everyday. There used to just be a contained area of people passed out all over the street now it extends to the rest of the city. There is even a drug takers union that demanded treatment options be removed from drug taking clinics as 'it shamed drug users'. So if you create an accomodating and encouraging area for taking heroin you will find it surges in population when heroin is freely available and detox discouraged. Everybody points to the European model but they must have done something different than just harm reduction, like proactive policing breaking up open air drug markets and shutting down slums teeming with addicts forcing them into detox.
- valuearb 6y ago
  Heroin is still illegal in Vancouver. Only a handful of addicts get free heroin. And because it’s illegal most addicts have to pay high prices for heroin of unknown potency, and frequent laced with Fentanyl. That directly leads to overdoses and hundreds of deaths, along with street crime to fund expensive habits.
  - hackermailman 6y ago
    It's been decrim unofficially for personal use for 5 years now, now officially decriminalized https://www.rcinet.ca/en/2020/11/28/vancouver-votes-to-decriminalize-all-drugs-a-first-for-canada/ https://www.rcinet.ca/en/2020/11/28/vancouver-votes-to-decri... Every bus stop since March last year in the drug slums also has instructions where to get prescribed opiates. Area only got worse
    - slavik81 6y ago
      From your link: > The Vancouver motion however for the moment has no force in law. A municipality doesn't have the authority to decriminalize drugs. They're just requesting the Federal government to act. It's not official, though it could eventually be.
duxup 6y ago
What is the success rate of folks who use heroin with some effort to not be addicted ... and what is the cost of getting them out of the cycle of addition? and what is even the success rate of getting them out of that cycle? The impact of failure to somehow prevent yourself from being addicted can be catastrophic ... even if you are successful in getting them out of the cycle of addition. And that impact can extend WAY beyond the individual. I'm open to the possibility that some drugs really can't be used responsibly by enough people that they absolutely should not be legal.
mannykannot 6y ago
> Only responsible and healthy individuals should self-use drugs, generally speaking. This not a very helpful observation, as we all know that this is far from what happens and is not going to become the norm. Furthermore, quite a lot of people became addicted to opiates through acting seemingly responsibly (at least initially taking the drugs under the supervision of a doctor whom they could reasonably assume was looking out for their best interests) and in the persuit of better health. I should add that Hart himself punted on this issue when the interviewer touched on it. In the interview, he does this a lot - for example, when the interviewer raised the question of physical addiction, Hart merely discussed the physiological basis, without touching the obvious issues it raises for the concept of responsible use. It may be telling that, in his description of himself as a responsible user, he avoided saying anything about this particular issue. > Then you can also argue that you might not have lost your friends only because of Heroin the substance, but also how people with heroin addiction is "treated" and frowned upon in society. This is also rather beside the point, as, while the way addiction is treated is also a problem, it is not an issue except where there is already a problem with addiction. That aside, there is such a thing as responsible addictive-drug use (including, but not necessarily limited to, people with chronic pain that only responds to such drugs) and the way we respond to addiction today is in many ways ineffective and in some ways very harmful. One cannot make a very good argument for reform, however, on the basis that some people can use some of these drugs responsibly.
kgwgk 6y ago
> Only responsible and healthy individuals should self-use drugs, generally speaking. Exposing oneself to developing a heroin addiction seems a somewhat irresponsible and unhealthy thing to do.
- Barrin92 6y ago
  Exactly. I always thought of myself as responsible and healthy (and I basically was). I never overused alcohol, never binge-drank etc. I absolutely had no understanding how people could not regulate drug use because I had no problem with it. A few years ago I had a lot of stress and started drinking to help me sleep. After only a few months I felt kind of agitated without a nightcap. I immediately stopped and now I just don't drink when I'm stressed. So maybe in one sense I was right about being responsible, but on the other hand it could have very easily become a habit and now I understand how people slowly slide into addiction. It's arrogant to assume anyone knows how they'll respond to a drug as habit forming as heroin.
ordu 6y ago
> Only responsible and healthy individuals should self-use drugs, generally speaking. The funny thing I've been reading the article and the tone of it reminded me of heroin addicts who was not hit by their addiction heavily yet. I mean, Carl Hart thinks he is a responsible user, that he have an ability to decide for himself. It doesn't seem so for me. It is hard to tell, having as a data only one interview with him. But... you know, I'm an addict also, a nicotine one. I know how it is. First ten years of my addiction I though that there is nothing wrong with that, it costs some money and gives an urge to smoke sometimes, but it brings some benefits too. A few years ago I stopped smoking, after a month of abstinence I saw no benefits in smoking at all. My abstinence lasted for a couple of years, now I'm smoking again. Seeing no benefits at all. I know what I'm speaking about, I know the signs, I see the signs, and I see Carl Hart as a fellow addict, though with a different substance. I drink alcohol sometimes, and I know that I'm not an addict. Even despite the fact that sometimes I want to drink. A wish to drink is a warning sign of course, but I see no other signs. Like a despair coming with the thought that now it is not the good time to drink for some reasons. I have no ideas about benefits of being drunk: it is a funny state of mind, but mostly annoying, I'm really stupid when drunk, I see my stupidity and can do nothing to it. An addiction is a special state of mind, I believe one (i.e. me) could feel it as distinct from other states. Though it takes some learning, one needs to become an addict and to stop using an addictive substance of his choice. If Carl Hart wanted to prove that he is not an addict, he should stop using heroin for a couple of years, and then try to state his freedom from an addiction with a straight face. While he is using heroin for just five years and didn't tried to stop, I'd never believe his words that he is not an addict. When it would be 10-15 years or 5 years of abstinence, I'll probably believe his word on it.
- cirgue 6y ago
  > The funny thing I've been reading the article and the tone of it reminded me of heroin addicts who was not hit by their addiction heavily yet. Having known someone who was a responsible, highly educated adult with a fantastic career who died of a heroin overdose, this whole article sounded eerily familiar.
  - shmageggy 6y ago

nimbius 6y ago

Fully agree. Carl is a white collar professor. The worst thing that can happen if his drug indulgence becomes a problem is he knocks over the water cooler or loses his job. I work a blue collar job servicing heavy diesel engines. Casual hard drug users are aggravatingly cavalier to work alongside. They forget important things constantly. They show up late and lose things often. You'll spend all day repeating things they'll never retain and at the end of the month they will lose a finger or toe or suffer a massive back injury and get fired. The back injury usually turns the casual heroin into constant endless heroin. Drug tests exist in my field for a really valid reason and it has nothing to do with having a problem but becoming one.

Grustaf 6y ago
Well, how many people will see this headline and rush off to a back alley to buy a shot of heroin from some junkie?
- jboog 6y ago
  That's not the problem though. The issues is "drug decriminalization" people treating addictions like it's not a real problem for many people. Many of these folks want it to get to a point where you can quite easily buy heroin and suffer no legal consequences. I'm not saying our drug laws are just or can't be reformed but the fact that heroin is illegal prevents a LOT of people from using it. How many people will then use, aided by these pronouncements that "Heroin isn't actually that addictive!" and ruin their lives? We already have an opioid epidemic in this country that has destroyed communities. There's a middle ground between our terrible war on drugs and the naive "make it all legal and experiment with heroin!"
  - rflrob 6y ago
    > I'm not saying our drug laws are just or can't be reformed but the fact that heroin is illegal prevents a LOT of people from using it. How many people will then use, aided by these pronouncements that "Heroin isn't actually that addictive!" and ruin their lives? Do you know a lot of people who have expressed to you that they would use heroin recreationally if only it were legal? My gut is that the number isn’t large. My impression of the evidence from places that have tried decriminalization (eg Portugal) is that the number of people who use and then are able to get their lives back on the rails is higher than the extra people who use because it’s decriminalized.

boomboomsubban 6y ago

>all this article reports about is this anecdotal nonsense. I've too many friends to Heroin to know the reality of the drug The experiences of your friends is anecdotal. This article discusses the mechanisms of the drug, both the physical and personal cause of addiction, the common factors that lead to death, and the rate of users that end up addicted.

varispeed 6y ago

The dangers of the drug mostly come from its legal status and that it is being adulterated with various substances in the unregulated market. People also don't get a leaflet that they can consult on the strength or dosage so often they overdose. Medical grade heroin is not as dangerous as people supporting prohibition would like it to be. You can take clean heroin for decades and be perfectly fine. This would rather not apply to alcohol or other legal drugs.

tanseydavid 6y ago
>> You can take clean heroin for decades and be perfectly fine. This seems to me to be a excessively myopic way of thinking about it. To the point of amounting to rationalization.
- varispeed 6y ago
  If you suffer from chronic pain, that's your only option if everything else fails. Opiates plus cannabis can make one's life bearable. Unfortunately many people would like them to suffer instead just to satisfy their own morals - for them someone else's suffering is a virtue.
johnyzee 6y ago
I would say the main danger is the crippling physical addiction (as well as psychological, but that is harder to quantify) it causes in a substantial amount of users.
- varispeed 6y ago
  Yes, the downside is that you have to take it every so often, but after a while it becomes a second nature so you won't be even notice apart from occasional situations where "medication" is not possible.

maybelsyrup 6y ago

Sorry, I call BS. First, ranked by whom? Besides internet listicles, I mean. Second, those rankings, valid or not, are always a mix of legal and illegal drugs, with legal ones like alcohol, nicotine, and benzodiazepines sitting above heroin, morphine, and opium. Not to mention caffeine, which we begin feeding to children at extremely young ages alongside the amphetamines we pump them full of if they have trouble paying attention when locked in a classroom all day. Third, as someone else says below, stories about your friends are also anecdotes. (I'm sorry, genuinely, that they died.) You don't know "the reality" of heroin because there are a litany of such realities - and here's a scientist telling you about his. The thousands (more?) who use heroin like my aunt uses a snifter of brandy at Christmas don't appear on anyone's radar because they're not dying and they're not rocking the boat. I could go on and on about the lives lost or ruined by alcohol in my family tree alone, let alone just "people I know", but I'm not terrified and calling to ban alcohol. Finally, that so many people on a web forum whose userbase is wealthier, whiter, and way more privileged than the population at large rushing breathlessly into a post to call a black man (from the ghetto of Miami FL, no less) who uses small amounts of opiates "dangerous" is, excuse me, pretty effing rich. I thought tech-libertarians were supposed to be less reactionary.

fnordsensei 6y ago
I know that the EU and WHO at least rank drugs by harmfulness. On the WHO lists, alcohol ranks below heroin and the like, but not far below, and certainly not as low as cannabis. Harmfulness seems largely irrelevant for legislation.

ajkdhcb2 6y ago

You just threw out your own anecdotal nonsense. Responsible drug users are invisible to society and to judgemental people like you. You have no data to discredit it.

vntok 6y ago
Responsible drug users sounds like an oxymoron. Is there any data that shows those people even exist?
- boomboomsubban 6y ago
  The article mentions ~70% of users of any drug are not addicts, and surely you know somebody who is both responsible and drinks alcohol.
- ericol 6y ago
  Obviously this is highly anecdotal, but for the 5 years that I lived in Spain, I was a regular drug user. With the exception made of MDMA & speed (That I'll consume both on occasions) I was consuming weed, hash and mushrooms on a weekly basis. And everybody on a certain group of friends was doing the same. We had a surplus of mushrooms, as we had somebody in our group (A neurobiologist) growing them. 13 years ago I came back to Argentina, and then stopped consuming cold turkey.
- sdeep27 6y ago
  How about the 150 million people every day that drink a cup of coffee and head to work?
- bserge 6y ago
  I am one. I have used a lot of stuff, anything I could get my hands on (not "just 'cause", I'm trying to find something to fix specific problems). And in the end, it's only alcohol and nicotine that have me firmly in their grasp. Perhaps it's just the ease of access. I believe I could quit nicotine, but not alcohol. I don't even drink a lot. But I do, regularly. I've used way more addictive stuff, and I could go out and buy it tomorrow, but I don't. Kind of funny how it works.

frakkingcylons 6y ago

It’s not anecdotal, and he’s not just talking about heroin. He’s been involved in pharmacology studies for over 20 years. I wish people didn’t dismiss Carl Hart immediately out of hand. Prohibition has never been a successful strategy. People are going to buy drugs no matter what. The biggest problem we have with drugs in the US is that people are uninformed about safe drug use and they are unable to easily verify the purity of the drugs they buy.

4eor0 6y ago

Yes, let’s have your anecdotal experience be the basis for curbing speech. I’ve lost dozens of friends and family to alcoholism and drunk driving. I can’t really get behind the cherry picking; society is being damaged in other real ways to a much greater extent than heroin, yet we find the ennui to overlook them; freedom of choice, speech, too expensive to bother, political authority... Portugal has the model we should adopt and let this be as solved a problem it can be.

lucideer 6y ago

> dangerous Stigma around drug use is dangerous. This is extremely evident from the state of treatment of heroin addiction in society today. I don't really see how challenging this stigma is more dangerous than pandering to the status quo here.

andrei_says_ 6y ago

May I recommend the rat park experiment and possibly the work of Gabor Mate as a way of establishing context for addiction.

SubiculumCode 6y ago

Hard agree. I've lost some loved ones to meth, and it tears up whole communities. When I was young I was lax about drugs, but after seeing the same story over and over...drug addiction is real and it hurts.

yibg 6y ago

Is it just a matter of degrees though? Lots of people have ruined lives (sometimes ended lives) due to alcohol as well. We expect people to use alcohol responsibly, and there is social stigma and other consequences when it's not used responsibly. But we accept that people are free to choose to use alcohol if they want to. Why don't we have the same attitude towards other drugs?