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>Frankly my personal opinion - either drugs have to be fully legalized (even hard one) and sold at groceries or fully and effectively banned like in Singapore.

by tw04 5y ago

>Frankly my personal opinion - either drugs have to be fully legalized (even hard one) and sold at groceries or fully and effectively banned like in Singapore. Anything in the middle creates more misery. As someone who thinks most drugs should be legalized: that's absolute insanity. The only way you are going to safely allow a drug like heroin on the streets is to have it be prescription based and ideally paired with free mental health services. The illegal drug trade will still obviously exist, but with the uptick in fentanyl lacing, I have a feeling folks will seek out "legitimate" sources if available.

pessimizer 5y ago
> The only way you are going to safely allow a drug like heroin on the streets is to have it be prescription based and ideally paired with free mental health services. If that's your standard, it's already a failure. You are never going to "safely" allow heroin on the street. You're never going to "safely" allow children's playgrounds. All prescription heroin is going to be is something that anyone who wants to ever have a better life (free from the record of having taken heroin) will avoid. Imagine if alcohol were only available by prescription, ideally paired with mental health services. In fact, you don't have to, because prescription alcohol was available during prohibition. edit: Hell, prescription opiates are available everywhere, and it turns out to be a bit of a problem.
- tw04 5y ago
  >If that's your standard, it's already a failure. You are never going to "safely" allow heroin on the street. You're never going to "safely" allow children's playgrounds. The rest of the world disagrees with your assessment. https://drugpolicy.ca/our-work/issues/heroin-assisted-treatment/ https://drugpolicy.ca/our-work/issues/heroin-assisted-treatm...
- retrac 5y ago
  Heroin by prescription is already available in Switzerland, Germany, the UK, and Canada, probably a number of other countries. In some places, it is considered the standard of treatment for intractable heroin addiction that has failed other treatments repeatedly. This is not new; the idea has been floated around for about a century and used on-and-off, particularly in the UK. Methadone therapy is basically the same idea but substituting a different opioid due to the stigma associated with diamorphine. Hydromorphone is becoming popular lately for this too. When taken under medical supervision (most programs require the addict to come to a clinic daily for dispensing) the physical and social harms are considerably less than using street heroin. The lack of legal, personal and other chaos from always chasing after the next dose often lets people stabilize their lives and wean themselves off. In one of the more thorough studies on this, in Germany about 15 years ago, almost 40% of participants had voluntarily weaned themselves off with slowly decreasing doses after two years. Nearly all had decreased their use of street drugs. Nearly all were housed, some 60% were employed. Most persons admitted to the program had been homeless and and all were unemployed at the start. The average duration of heroin use was more than 20 years. That is a remarkable result. It led to Germany making maintenance therapy generally available for addicts. And it keeps being repeated. There's a large body of evidence supporting the slow self-guided taper for benzodiazepine addiction as well, and a small but growing body that suggests it may work for a great many kinds of various addictive drugs, including stimulants. If we minimize the social and economic chaos to the addict by simply giving them their drug, that give them the opportunity to choose to stop using it. It's an uncomfortable proposition, counterintuitive to some, but the study results are compelling and must be wrangled with.

by tw04 5y ago

pessimizer 5y ago

> The only way you are going to safely allow a drug like heroin on the streets is to have it be prescription based and ideally paired with free mental health services. If that's your standard, it's already a failure. You are never going to "safely" allow heroin on the street. You're never going to "safely" allow children's playgrounds. All prescription heroin is going to be is something that anyone who wants to ever have a better life (free from the record of having taken heroin) will avoid. Imagine if alcohol were only available by prescription, ideally paired with mental health services. In fact, you don't have to, because prescription alcohol was available during prohibition. edit: Hell, prescription opiates are available everywhere, and it turns out to be a bit of a problem.

tw04 5y ago
>If that's your standard, it's already a failure. You are never going to "safely" allow heroin on the street. You're never going to "safely" allow children's playgrounds. The rest of the world disagrees with your assessment. https://drugpolicy.ca/our-work/issues/heroin-assisted-treatment/ https://drugpolicy.ca/our-work/issues/heroin-assisted-treatm...
retrac 5y ago
Heroin by prescription is already available in Switzerland, Germany, the UK, and Canada, probably a number of other countries. In some places, it is considered the standard of treatment for intractable heroin addiction that has failed other treatments repeatedly. This is not new; the idea has been floated around for about a century and used on-and-off, particularly in the UK. Methadone therapy is basically the same idea but substituting a different opioid due to the stigma associated with diamorphine. Hydromorphone is becoming popular lately for this too. When taken under medical supervision (most programs require the addict to come to a clinic daily for dispensing) the physical and social harms are considerably less than using street heroin. The lack of legal, personal and other chaos from always chasing after the next dose often lets people stabilize their lives and wean themselves off. In one of the more thorough studies on this, in Germany about 15 years ago, almost 40% of participants had voluntarily weaned themselves off with slowly decreasing doses after two years. Nearly all had decreased their use of street drugs. Nearly all were housed, some 60% were employed. Most persons admitted to the program had been homeless and and all were unemployed at the start. The average duration of heroin use was more than 20 years. That is a remarkable result. It led to Germany making maintenance therapy generally available for addicts. And it keeps being repeated. There's a large body of evidence supporting the slow self-guided taper for benzodiazepine addiction as well, and a small but growing body that suggests it may work for a great many kinds of various addictive drugs, including stimulants. If we minimize the social and economic chaos to the addict by simply giving them their drug, that give them the opportunity to choose to stop using it. It's an uncomfortable proposition, counterintuitive to some, but the study results are compelling and must be wrangled with.