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> we seem to have this huge moral hang up in the US about giving addicts drugs For many people, what you're describing all comes down to the law of love. It is

> we seem to have this huge moral hang up in the US about giving addicts drugs For many people, what you're describing all comes down to the law of love. It is not loving to give a person more of the thing that is destroying them. Perhaps free methadone would be a better option? EDIT: care to comment? I'd like to know why people disagree.

wespiser_2018 5y ago
That's a pretty rudimentary analysis, and the "law of love" doesn't really hold much weight when you start looking at the prognosis for various treatment groups for people with opiate dependency. It's really the abstinence only attitude I was talking about: why is it a big deal to give someone medication for the rest of their live if we know it will keep them alive, healthy, and allow them to live a fulfilled life? Addiction is just like any other disease, and it turns out medication assisted therapy is very effective. Methadone works, and so do other medications, but it's only a partial solution. We need a rapid and massive expansion of these programs. We also need programs and medications to target people who go on Methadone, but keep going off. Why not give them Herion, if we can do it safely? What about if there is evidence they can become productive members of society? Again, it's my view that although people OD from drugs, it's really the prohibition of drugs that are killing people through the incredibly unsafe and unreliable drugs people get. Supervised opiates are not dangerous, and unlike other drugs, cocaine, meth, benzos, you can safely be on them for years at a time nearly no long term effects. At least the long term effects of staying on them pale in comparison to the consequences of an OD. 60,000 people OD per year. What we are doing isn't working!
standardUser 5y ago
More often than not, lives are in greater threat of being "destroyed" by the consequences of drug prohibition than the drugs themselves. Addiction is a serious health problem, but impure drugs that lead to overdose deaths, spreading disease through needle use, avoiding medical care for fear of legal consequences, going to jail and having a criminal record, and becoming involved in black market violence are all vastly more common threats to drug users than any drug.
- TimTheTinker 5y ago
  I'm inclined to agree; substance prohibition in any form (except perhaps for nuclear fuel and the like) has a long history of causing an incredibly wide range of societal problems. But removing prohibition is a far cry from providing free heroin to addicts... I understand the argument about removing the black market, but after seeing San Francisco in person it's hard to agree that free drugs and paraphernalia makes things better overall. If my friend became a heroin addict, out of care for him or her I would not provide them with heroin even if I could afford it. Why should I treat other fellow humans worse? Why is it different when we're speaking at a societal level? Love for neighbors should increase, not invert, when the number of individuals concerned increases.
  - ryan_lane 5y ago
    They don't give out free heroin in SF. There are needle exchange programs, and a small number of safe usage sites. Also, you're assuming most of the addicts are heroin addicts. Quite a few of them are meth addicts, who are harder to reach, partially because the type of meth they're getting causes severe psychosis. Giving meth addicts forms of meth that are produced more cleanly would reduce the level of psychosis and would further reduce the price of meth to a point where it may not be profitable to produce (it's already cheap to the point where it's nearly unprofitable - it requires massive volume). Giving addicts access to clean drugs provides you an opportunity to help them, a place to keep them away from others while they're using, a way to ensure they don't die while using, reduces funding to organized crime, and removes their need to commit crimes to fund their habits. You may see it as treating them poorly, but ultimately, you're doing them and the rest of society a benefit.
    - DevoidSimo 5y ago
      Is it impurities in meth that give you psychosis? I was of the impression that often it was due to sleep deprivation due to being on meth and not sleeping for days.
      - ryan_lane 5y ago
WalterSear 5y ago
It's pride, not love. And a pride that is essentially about avoiding shame; shame being the primary currency of those with an authoritarian bent.
- TimTheTinker 5y ago
  > It's pride, not love. And a pride that is essentially about avoiding shame; That has nothing to do with my rationale... I'm curious where you got that. If I give heroin to an addict, the only shame involved to me would be the personal feeling of shame from having caused harm to another human... So I think this response is a straw man that doesn't address my point.
HWR_14 5y ago
What are the loving consequences of not giving them the drugs that you are hoping to achieve? Like, how is that making their life better? Or do you assume that (evidence to the contrary) without you supplying it they'll be unable to find it?
vintermann 5y ago
Free methadone isn't all that much better from that perspective. You come to your doctor and tell him, "I'm useless, my life's hardly worth living, I'll never amount to anything so I might as well take opiates to dull the pain" - is it then the doctors job to basically say, "yes, clinically your life is not worth living", even if it is a milder opiate? It's writing people off as lost cases. And many addicts WANT to be written off as lost cases, because a) they already did so themselves, but feel guilty about it, an official confirmation would be nice and b) it will give them access to painkillers. Which is why I'm very skeptical of involving doctors in the first place in free methadone programs, if such programs should exist. It shouldn't be anyone's job to validate you if you say you're a lost cause.
- Svperstar 5y ago
  Plenty of people get on methadone maintenance and life productive lives. This keeps them from scoring dope in the streets and fueling the drug trade. Judges have demanded people stop taking methadone and some of these people have ended up dead from an OD soon after or in jail when they were fine on methadone. Demonizing methadone programs doesn't help anything.
  - vintermann 5y ago
    I'm not demonizing it, sure it can help many, but it is not a panacea. In Norway, we have a problem that people in the methadone program ask for more than they need (due to tolerance, you pretty much have to just ask them) and sell the excess to people who don't qualify for the program. In some years there have been more methadone overdoses than heroin overdoses. Even in the legal program there are overdoses.
thatcat 5y ago
Its not loving to control another person with draconian measures that further harm them with criminal sanctions that cause economic stress and stigmatize the person socially. Love would be creating a social environment that is capable of providing safer options, therapy, and letting people make their own choice about their health instead of treating them like criminals.
- TimTheTinker 5y ago
  I mostly agree. I was arguing against free heroin, not in favor of prohibition.

wespiser_2018 5y ago

That's a pretty rudimentary analysis, and the "law of love" doesn't really hold much weight when you start looking at the prognosis for various treatment groups for people with opiate dependency. It's really the abstinence only attitude I was talking about: why is it a big deal to give someone medication for the rest of their live if we know it will keep them alive, healthy, and allow them to live a fulfilled life? Addiction is just like any other disease, and it turns out medication assisted therapy is very effective. Methadone works, and so do other medications, but it's only a partial solution. We need a rapid and massive expansion of these programs. We also need programs and medications to target people who go on Methadone, but keep going off. Why not give them Herion, if we can do it safely? What about if there is evidence they can become productive members of society? Again, it's my view that although people OD from drugs, it's really the prohibition of drugs that are killing people through the incredibly unsafe and unreliable drugs people get. Supervised opiates are not dangerous, and unlike other drugs, cocaine, meth, benzos, you can safely be on them for years at a time nearly no long term effects. At least the long term effects of staying on them pale in comparison to the consequences of an OD. 60,000 people OD per year. What we are doing isn't working!

standardUser 5y ago

More often than not, lives are in greater threat of being "destroyed" by the consequences of drug prohibition than the drugs themselves. Addiction is a serious health problem, but impure drugs that lead to overdose deaths, spreading disease through needle use, avoiding medical care for fear of legal consequences, going to jail and having a criminal record, and becoming involved in black market violence are all vastly more common threats to drug users than any drug.

TimTheTinker 5y ago
I'm inclined to agree; substance prohibition in any form (except perhaps for nuclear fuel and the like) has a long history of causing an incredibly wide range of societal problems. But removing prohibition is a far cry from providing free heroin to addicts... I understand the argument about removing the black market, but after seeing San Francisco in person it's hard to agree that free drugs and paraphernalia makes things better overall. If my friend became a heroin addict, out of care for him or her I would not provide them with heroin even if I could afford it. Why should I treat other fellow humans worse? Why is it different when we're speaking at a societal level? Love for neighbors should increase, not invert, when the number of individuals concerned increases.
- ryan_lane 5y ago
  They don't give out free heroin in SF. There are needle exchange programs, and a small number of safe usage sites. Also, you're assuming most of the addicts are heroin addicts. Quite a few of them are meth addicts, who are harder to reach, partially because the type of meth they're getting causes severe psychosis. Giving meth addicts forms of meth that are produced more cleanly would reduce the level of psychosis and would further reduce the price of meth to a point where it may not be profitable to produce (it's already cheap to the point where it's nearly unprofitable - it requires massive volume). Giving addicts access to clean drugs provides you an opportunity to help them, a place to keep them away from others while they're using, a way to ensure they don't die while using, reduces funding to organized crime, and removes their need to commit crimes to fund their habits. You may see it as treating them poorly, but ultimately, you're doing them and the rest of society a benefit.
  - DevoidSimo 5y ago
    Is it impurities in meth that give you psychosis? I was of the impression that often it was due to sleep deprivation due to being on meth and not sleeping for days.
    - ryan_lane 5y ago

WalterSear 5y ago

It's pride, not love. And a pride that is essentially about avoiding shame; shame being the primary currency of those with an authoritarian bent.

TimTheTinker 5y ago
> It's pride, not love. And a pride that is essentially about avoiding shame; That has nothing to do with my rationale... I'm curious where you got that. If I give heroin to an addict, the only shame involved to me would be the personal feeling of shame from having caused harm to another human... So I think this response is a straw man that doesn't address my point.

HWR_14 5y ago

What are the loving consequences of not giving them the drugs that you are hoping to achieve? Like, how is that making their life better? Or do you assume that (evidence to the contrary) without you supplying it they'll be unable to find it?

vintermann 5y ago

Free methadone isn't all that much better from that perspective. You come to your doctor and tell him, "I'm useless, my life's hardly worth living, I'll never amount to anything so I might as well take opiates to dull the pain" - is it then the doctors job to basically say, "yes, clinically your life is not worth living", even if it is a milder opiate? It's writing people off as lost cases. And many addicts WANT to be written off as lost cases, because a) they already did so themselves, but feel guilty about it, an official confirmation would be nice and b) it will give them access to painkillers. Which is why I'm very skeptical of involving doctors in the first place in free methadone programs, if such programs should exist. It shouldn't be anyone's job to validate you if you say you're a lost cause.

Svperstar 5y ago
Plenty of people get on methadone maintenance and life productive lives. This keeps them from scoring dope in the streets and fueling the drug trade. Judges have demanded people stop taking methadone and some of these people have ended up dead from an OD soon after or in jail when they were fine on methadone. Demonizing methadone programs doesn't help anything.
- vintermann 5y ago
  I'm not demonizing it, sure it can help many, but it is not a panacea. In Norway, we have a problem that people in the methadone program ask for more than they need (due to tolerance, you pretty much have to just ask them) and sell the excess to people who don't qualify for the program. In some years there have been more methadone overdoses than heroin overdoses. Even in the legal program there are overdoses.

thatcat 5y ago

Its not loving to control another person with draconian measures that further harm them with criminal sanctions that cause economic stress and stigmatize the person socially. Love would be creating a social environment that is capable of providing safer options, therapy, and letting people make their own choice about their health instead of treating them like criminals.

TimTheTinker 5y ago
I mostly agree. I was arguing against free heroin, not in favor of prohibition.