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The invisible elephant in the US opioid policy discussion is the lacuna between the policy and its implementation. You have to find a human being to perform th
by scythe 5y ago
The invisible elephant in the US opioid policy discussion is the lacuna between the policy and its implementation.
You have to find a human being to perform the work of enforcing the drug laws. The US has had drug addicts for a hundred years, and the attitude towards opioids hasn't changed very much, but the usage levels go up and down. There's a back-and-forth between "rehabilitation" and " incentivizing" that correlates poorly with the outcome.
What correlates better with opioid use? Recently, the epidemic clearly started with overprescription and then exploded with fentanyl:
https://www.cdc.gov/opioids/basics/epidemic.html https://www.cdc.gov/opioids/basics/epidemic.html
It's important to notice that prescription opioid overdoses don't go down until 2017. This problem started with prescriptions and it won't end until the problem is fixed. Pills should be replaced with patches wherever possible.
The other glaring issue is that the meteoric rise of fentanyl was not noticed until it got out of hand. This is a societal problem: drug messageboard users knew about the fentanyl crisis years before the regulators took any action.
The regulatory system, viz. the DEA, has been starved for talent for decades because nobody wants to work for them. The enforcement-for-profit model of the civil asset forfeiture era of policing has driven talented and motivated people away from law enforcement careers. The people who are left are not qualified or motivated for the task at hand. Enforcement should be more proactive than it was. It should focus on real dangers, not culture wars. Opioids and dopaminergic stimulants are the drugs of self-destruction; everything else is a distraction.
The most ironic thing to hear people chanting in an epidemic of poisonings brought on by illegally and irresponsibly manufactured high-potency addictive drugs is "abolish the police!". These people need the police. But nobody trusts the police.
One quote we were all forced to memorize in school was: "A house divided against itself cannot stand."
- wespiser_2018 5y agoI don't disagree with your most of your assessment, except that I do think we should abolish the the DEA. The war on drugs has been going on for 50 years. At some point, we have to admit that drugs won, and address the crisis in the most effective way based on the best, most recent information available to us, which is that addiction is a disease and one that can be effectively managed. 20 years ago, sure, who cares about the DEA, they put dope and guns on the table and largely stayed out of peoples way. Now, we have around 60k thousand deaths per year from the opiate crisis that reaches almost everyone in America. Law Enforcement has no solution, just carry around Narcan while drugs come in through every major port and postal facility in the country. Let the cops do what they are good at: reduce violence, enforce property rights and keep communities safe, but stay out of healthcare. Give the DEA the best grads, and that won't change the fact that they are working in a system where they simply don't have the power to stop two consenting individuals engage in a prohibited behavior.