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The real question we should be asking is why can't these poor people get access to proper medicine and treatment? Instead they have to resort to playing Russia

The real question we should be asking is why can't these poor people get access to proper medicine and treatment? Instead they have to resort to playing Russian roulette every time they use. Decriminalisation and regulation are the biggest harm reduction measures that could be taken and it would have the added bonus of freeing up space in the prisons and reducing the power of the cartels. There wouldn't be a fent problem at all if sufferers could get reliable access to real meds. It's absurd that we're even still having these types of discussions in this day and age.

DantesKite 4y ago
Decriminalisation doesn’t seem to be working in San Francisco.
- rjbwork 4y ago
  Decrim without legalization or free supply to addicts doesn't do a lot for the poverty side of things. People are still going to spend every cent they can scrape together on their drug. We could supply the entire country's heroin/fent supply for probably 1/1000 what the average street user is paying for their doses, and we could prevent overdoses since there would be a chemically pure version of the drug with a labeled dosage available. Until we, as a society, get over our desire to punish people for getting inebriated, addicts will continue to dwell in abject poverty while funding violent drug distribution organizations. This is a choice that we have made, and we're going to live with the consequences until we reverse course.
  - Gigachad 4y ago
    Why would we want to accept normal people taking drugs which will fry their brains? Yes, only homeless addicts use these drugs because normal working people don't want to destroy their lives for a minor bit of fun.
    - deleted 4y ago
      [deleted]
    - humbleguy 4y ago
      This is a very misguided view. Majority of drug users are all around you, regular people who have families and hold jobs - your friends, your relatives, your coworkers. Just like majority of people who drink alcohol aren't alcoholics, majority of drug users aren't addicts.
      - lostmsu 4y ago
        Somehow I doubt that majority of drug users are from healthy families with kids.
        xkcd-sucks 4y ago
        Just considering it, it seems unlikely that the incredible economic volume of the hard-drugs industry is drivem by homeless people collecting change and redeeming cans. Anecdotally, I know (or knew if they died) several people from PhD programs adjacent to my own who were habitual users of heroin (or stuff branded as such). I have significant experience with it (originating with friends in academia!!!), and it is very nice, but it just so happens that I like pooping more than I like opioids, which apparently is a stroke of luck
        orwin 4y ago
        Most drug user I've seen were in private clubs in Paris or Nice/Monaco where the entry ticket was north of 150 euros I also saw about 12 different heroin addicts in the streets next to my home, but tbh they were a lot less loud, aggressive and/or obnoxious than the alcoholics.
        humbleguy 4y ago
        That could be because you probably assume that any drug use leads to addiction and despair. More often than not, despair leads to drug use as means for temporary escape and relief.
  - grapeskin 4y ago
    Free supply won’t really be a solution and I can’t imagine why it would. Would making junk food and soda free food end the obesity epidemic? Making it free will only make that area a hub for people seeking to get high. Portland, Seattle, and SF are already hot spots where people actively come because they know they can get high easily. Making it completely free is just an even bigger invitation. I think one of America’s greatest successes has been with tobacco. For the most part, Americans don’t want to smoke and find the idea disgusting—that’s a massive turnaround from a couple decades ago and even completely different from many countries in Europe or Asia. It’s also getting harder and harder to purchase tobacco in many places, but what kept me and much of my generation from ever touching a cigarette was media campaigns in the 90s that depicted cigarette smokers as vile, disgusting people. Other anti-drug programs try fear mongering with saying one dose of weed will kill you or whatever and people saw through that. But telling kids that they’re gross losers who everyone hates if they use a substance? That has a bit more effect. But for people who are active addicts, treatment is hard. There are countless interviews with addicts on YouTube, and the conclusion every single one of them presents is “I could’ve gotten help, but I didn’t want it.” You need to make people want to overcome their addiction. Feeding it won’t do anything.
    - freedomben 4y ago
      I don't think GP was arguing for free drugs (that would indeed be crazy). I think they were making a point about how our current policy is an intentional choice to drive drug users into poverty by making drugs wildly expensive.
      - rjbwork 4y ago
        I'm not necessarily opposed to the idea of distributing it totally free of cost, along with needle exchanges, etc. But yeah, I was speaking more about difference between what an addict pays for fentanyl and the actual cost to produce it.
    - HWR_14 4y ago
      Making it free keeps people from needing to break everyone's windows to get their next fix. It also allows them to use their money on food/rent/etc so they are less likely to wind up homeless. It also means that they congregate in one area, so it's easier to provide resources if they decide to seek help. It also prevents, you know, fentanyl from getting into the supply, having people get more addicted to a stronger drug.
  - ta988 4y ago
    This is not as simple as labelled doses. This would reduce some overdoses but not all of them.
  - PragmaticPulp 4y ago
    > We could supply the entire country's heroin/fent supply for probably 1/1000 what the average street user is paying for their doses Nonsense. It's not that cheap to manufacture (under regulated conditions) and distribute opioids like that. 1/1000th of the price? Even the cheapest, most easily manufactured commercial opioid medications aren't coming anywhere near that after decades of optimization the manufacturing processes.
    - _jal 4y ago
      This is the worst sort of hn pedantry, but I have to agree. The security premium paid by cartels down through street dealers is indeed real, but QC and regulatory compliance would eat a lot of that savings. And the executive tax at cartels is probably similar to public firms.
    - heavyset_go 4y ago
      Fentanyl is dirt cheap to manufacture, and people on the street are paying tens of thousands of dollars per gram of it, given that a dose for an equivalent amount of heroin can be much lower than a milligram. The actual cost to manufacture that much would be several orders of magnitude less than what it drug users are paying for it.
  - starkd 4y ago
    So now the government has to buy people their drugs? We don't do that for alcoholics. There's a very strong moral hazard argument against doing that, but it's just plain cruel to the very population you think you are helping.
    - dragonwriter 4y ago
      > So now the government has to buy people their drugs? We don't do that for alcoholics. GP said “legalization or free supply”, and for alcohol we have legalization. So, yes, we do what the GP actually suggested, though not your strawman, for alcoholics.
    - Tiktaalik 4y ago
      We do create a safe supply of drugs and a safe, monitored use site for alcoholics. We call them bars. We don't provide this for other drugs. There's a handful of safe injection sites for drugs in some cities around the world (such as Vancouver) but the drugs are still toxic. It's good that people are on hand to handle the inevitable overdoses and other issues. This saves lives. The further necessary solution however is a safe supply of drugs, so that people can actually know what they're using. This is the core problem that is driving so many deaths. Imagine if there was no such thing as legal liquor or bars and alcoholics just drank some stuff that some guy made. There'd be a lot more deaths and poisonings from this.
- Tiktaalik 4y ago
  Decriminalization is part of solution, but there's a lot more that needs to be done. Probably a lot more than two issues here, but two significant ones are that: 1) the real problem is that the drugs are toxic and no one knows what they're taking. Maybe the dose is wrong or maybe it's not even fentanyl, and just a bunch of crazy shit (eg. benzos). The drugs aren't what people expect and people die. The fastest way to end deaths would be to create a safe supply of drugs so people know what they're taking. 2) "Decriminalization" doesn't necessarily mean and end to police harassment, drug confiscation, and related issues that all make life hard for drug users and create barriers to them getting the real help they need. While under decriminalization you may not end up in jail for having drugs, you are still able to have them confiscated and get a ticket (or summons to some thing), and then you're back at square one, needing to find more money to get drugs again. No wonder petty theft is such an issue in some places. High policing and confiscation of drugs from drug users just helps the dealers sell more illegal product. Circling back to point one again, a real safe supply of prescribed drugs handles this issue well in dealing with the money issue. But beyond this if we're going to allow people to have a safe supply of drugs, we also need to let people hold drugs too and not be harassed by police. Ideally there's not just a safe supply of drugs but also a safe use site as well where medical staff can monitor and help people. These sorts of sites can be touch points where people can build relationships and help people when they're ready to move to some further stage of recovery.
Vladimof 4y ago
> why can't these poor people get access to proper medicine and treatment? Maybe the Government doesn't like the type of people that get addicted to drugs... a friend of mine just died this week from overdose... maybe from Fentanyl but I don't know.
- monkeybutton 4y ago
  There's people out there whose opinions are that addiction is a problem that "eventually solves itself". When I first heard that I just tried to change topics as quick as possible, it was just a conversational dead end. I still don't know what to say.
  - Vladimof 4y ago
    What we need is the scientific community to come together like they did for Covid vaccines... we need an addiction vaccine for drugs and alcohol... It probably killed a lot more people then Covid-19...
    - monkeybutton 4y ago
      There is actually research in that area! Apparently one can make a vaccine that trains the immune system to attack and remove drugs. But it could interfere with medical procedures because of the overlap with recreational drugs. Also the huge ethical and moral questions it poses like who gets final say over what you do with your own body. Unlike a viral disease, getting high isn't contagious and doesn't directly and immediately affect those around you.
      - Vladimof 4y ago
        > Unlike a viral disease, getting high isn't contagious and doesn't directly and immediately affect those around you. I'm pretty sure that most heavily addicted people would voluntary get such a vaccine... unless there's a major downside
        4y ago
xrd 4y ago
I'm from Portland which recently decriminalized drugs. I'm worried that this has the effect that dealers feel there is no prosecution for selling, and that this has led to a difficult situation for addicts. I'm of the opinion that without good mental health treatment options, this is an idea that creates more addicts who have no way to recover. I would love to understand if I'm wrong, and I know the pandemic is a context unlike anything we've ever seen, but the downtown streets of Portland look like they have many people in shocking states of crisis that to me look like unfettered access to drugs.
- alostpuppy 4y ago
  As I understand it they only decriminalized it for small amounts.
  - xrd 4y ago
    True. And, I've also heard that basically the police have said that there is no point in enforcing any kind of trade because dealers can always find a way to make it look like the amounts are under the limit. So dealers are operating in a completely laissez faire environment. I suspect the police are collaborating on that story to avoid dealing with arresting drug dealers until public sentiment changes, but that is just my own biased opinion.
wahern 4y ago
> The real question we should be asking is why can't these poor people get access to proper medicine and treatment? Well, here in San Francisco you can access both relatively easily. But it turns out that people with substance abuse addictions tend not to exhibit strong executive functioning (at least contemporaneously) as compared to the average non-abuser. So when you remove all coercive policies whatsoever (because of abstract academic arguments that equivocate all policies short of giving out free drugs and free money and turning a blind eye to dealers), you manifestly end up nurturing a base of hard-core, long-term addicts. Also, fentanyl is cheaper and some users have even begun preferring fentanyl for its unique effect. Here in San Francisco fentanyl is becoming (or has already become) less an adulterant and more the drug you're knowingly buying. Plenty of people--users and public service workers--do carry naloxone, though. So that's something.
- guerrilla 4y ago
  > So when you remove all coercive policies whatsoever (because of abstract academic arguments that equivocate all policies short of giving out free drugs and free money and turning a blind eye to dealers), you manifestly end up nurturing a base of hard-core, long-term addicts. Except that's not at all what happened in Portugal (or in other European programs)...?
  - PragmaticPulp 4y ago
    > Except that's not at all what happened in Portugal (or in other European programs)...? The Portugal narrative hasn't actually been as positive as initially reported by the Cato papers that were based on the first few years following the policy change. More recent data has shown an uptick of lifetime drug use and an increasing trend of drug deaths that doesn't really support the initially successful picture of their program. One of the challenges with interpreting the Portugal data is that they had relatively low drug use to begin with. The initial declarations of victory for their decriminalization programs were based on relatively small numbers and sample sizes that wouldn't pass muster in more rigorous analysis. I know the narrative about Portugal was set years ago by the Cato papers and a few authors, but it isn't really the success story that it's made out to be. It did, however, reduce the number of drug-related prosecutions, though that's an obvious downstream effect of removing a class of drug-related offenses.
bsedlm 4y ago
I have my suspicions that prior American governments intended (with full knowledge) for the cartels to get more powerful (by means of increasing corruption and letting only those kinds of crime-willing people to service the outlawed black markets) I recall reading about an economist who based on studying the failure of the prohibition, tried to warn about the futility of 'war on drugs'; from this I thought that if some economist knew it'd fail, so could the government have known....
PragmaticPulp 4y ago
> Decriminalisation and regulation are the biggest harm reduction measures that could be taken It's not actually a solution to the Fentanyl problem. Fentanyl ends up in drugs because it's extremely cheap (among other reasons). The price difference between fentanyl-laced illicit narcotics and the actual substance these people are seeking is actually massive, and end-user cost becomes a huge motivator for people dependent on constant daily intake of opioids. Even in a hypothetical world where regulated opioids were available over the counter, you'd still have significant inflows of illicit and potentially contaminated drugs. Decriminalization and regulation have been floated as magic bullets, yet even when it comes to drugs like Marijuana in states like California and Colorado we have multiple estimates suggesting that the majority of marijuana sales are still illicit rather than via regulated channels ( http://www.cahcc.com/Portals/0/ADE%20Cannabis%20Report%20_8-6-20.pdf?ver=2020-08-11-125659-360 http://www.cahcc.com/Portals/0/ADE%20Cannabis%20Report%20_8-... ). > The real question we should be asking is why can't these poor people get access to proper medicine and treatment? There is no one, singular "real question" we should be asking. This needs to be addressed on every level. Even in a theoretically idealized world there would still be a need for fentanyl test strips. Experimenting with "research chemicals" (aka obscure drugs synthesized in clandestine labs) is an increasingly common hobby even among people with access to common drugs. There isn't really a scenario where we just flip the decriminalization switch and all of these problems go away.
- dendriti 4y ago
  Why does it matter if decriminalization and regulation are floated as "magic bullets" or not? The Nirvana fallacy so often shows up in discussions of drug policy. It literally does not matter if decriminalization is "only 5% effective" (in whatever metric you're using to measure success, which here is just marijuana sales?). Sane polities implement laws that don't have 100% effectiveness.
13of40 4y ago
> why can't these poor people get access to proper medicine and treatment? Speaking of the US, one of the issues is that drug treatment and mental health care are for-profit businesses, so someone reaching out for help is likely to get grifted even if they have insurance or can pay for the treatment on their own.
- heavyset_go 4y ago
  There's also perpetual waiting lists, forcing some people who need help to wait six months or longer to get care. Then that care can potentially cost more than a four year degree. Many treatment programs will leave their patients dependent on maintenance drugs that can costs hundreds of dollars a month to fill, and require regular appointments with expensive specialists to get. Those specialists have months long waiting lists, as well
whatever1 4y ago
You live in a country that does not consider Healthcare a right even for the moral, law abiding citizens. Why would they care about the "illegals" (immigrants, addicts etc) or "immorals" (women or transgender who want control over their body) ?

DantesKite 4y ago

Decriminalisation doesn’t seem to be working in San Francisco.

rjbwork 4y ago
Decrim without legalization or free supply to addicts doesn't do a lot for the poverty side of things. People are still going to spend every cent they can scrape together on their drug. We could supply the entire country's heroin/fent supply for probably 1/1000 what the average street user is paying for their doses, and we could prevent overdoses since there would be a chemically pure version of the drug with a labeled dosage available. Until we, as a society, get over our desire to punish people for getting inebriated, addicts will continue to dwell in abject poverty while funding violent drug distribution organizations. This is a choice that we have made, and we're going to live with the consequences until we reverse course.
- Gigachad 4y ago
  Why would we want to accept normal people taking drugs which will fry their brains? Yes, only homeless addicts use these drugs because normal working people don't want to destroy their lives for a minor bit of fun.
  - deleted 4y ago
    [deleted]
  - humbleguy 4y ago
    This is a very misguided view. Majority of drug users are all around you, regular people who have families and hold jobs - your friends, your relatives, your coworkers. Just like majority of people who drink alcohol aren't alcoholics, majority of drug users aren't addicts.
    - lostmsu 4y ago
      Somehow I doubt that majority of drug users are from healthy families with kids.
      - xkcd-sucks 4y ago
        Just considering it, it seems unlikely that the incredible economic volume of the hard-drugs industry is drivem by homeless people collecting change and redeeming cans. Anecdotally, I know (or knew if they died) several people from PhD programs adjacent to my own who were habitual users of heroin (or stuff branded as such). I have significant experience with it (originating with friends in academia!!!), and it is very nice, but it just so happens that I like pooping more than I like opioids, which apparently is a stroke of luck
      - orwin 4y ago
        Most drug user I've seen were in private clubs in Paris or Nice/Monaco where the entry ticket was north of 150 euros I also saw about 12 different heroin addicts in the streets next to my home, but tbh they were a lot less loud, aggressive and/or obnoxious than the alcoholics.
      - humbleguy 4y ago
        That could be because you probably assume that any drug use leads to addiction and despair. More often than not, despair leads to drug use as means for temporary escape and relief.
- grapeskin 4y ago
  Free supply won’t really be a solution and I can’t imagine why it would. Would making junk food and soda free food end the obesity epidemic? Making it free will only make that area a hub for people seeking to get high. Portland, Seattle, and SF are already hot spots where people actively come because they know they can get high easily. Making it completely free is just an even bigger invitation. I think one of America’s greatest successes has been with tobacco. For the most part, Americans don’t want to smoke and find the idea disgusting—that’s a massive turnaround from a couple decades ago and even completely different from many countries in Europe or Asia. It’s also getting harder and harder to purchase tobacco in many places, but what kept me and much of my generation from ever touching a cigarette was media campaigns in the 90s that depicted cigarette smokers as vile, disgusting people. Other anti-drug programs try fear mongering with saying one dose of weed will kill you or whatever and people saw through that. But telling kids that they’re gross losers who everyone hates if they use a substance? That has a bit more effect. But for people who are active addicts, treatment is hard. There are countless interviews with addicts on YouTube, and the conclusion every single one of them presents is “I could’ve gotten help, but I didn’t want it.” You need to make people want to overcome their addiction. Feeding it won’t do anything.
  - freedomben 4y ago
    I don't think GP was arguing for free drugs (that would indeed be crazy). I think they were making a point about how our current policy is an intentional choice to drive drug users into poverty by making drugs wildly expensive.
    - rjbwork 4y ago
      I'm not necessarily opposed to the idea of distributing it totally free of cost, along with needle exchanges, etc. But yeah, I was speaking more about difference between what an addict pays for fentanyl and the actual cost to produce it.
  - HWR_14 4y ago
    Making it free keeps people from needing to break everyone's windows to get their next fix. It also allows them to use their money on food/rent/etc so they are less likely to wind up homeless. It also means that they congregate in one area, so it's easier to provide resources if they decide to seek help. It also prevents, you know, fentanyl from getting into the supply, having people get more addicted to a stronger drug.
- ta988 4y ago
  This is not as simple as labelled doses. This would reduce some overdoses but not all of them.
- PragmaticPulp 4y ago
  > We could supply the entire country's heroin/fent supply for probably 1/1000 what the average street user is paying for their doses Nonsense. It's not that cheap to manufacture (under regulated conditions) and distribute opioids like that. 1/1000th of the price? Even the cheapest, most easily manufactured commercial opioid medications aren't coming anywhere near that after decades of optimization the manufacturing processes.
  - _jal 4y ago
    This is the worst sort of hn pedantry, but I have to agree. The security premium paid by cartels down through street dealers is indeed real, but QC and regulatory compliance would eat a lot of that savings. And the executive tax at cartels is probably similar to public firms.
  - heavyset_go 4y ago
    Fentanyl is dirt cheap to manufacture, and people on the street are paying tens of thousands of dollars per gram of it, given that a dose for an equivalent amount of heroin can be much lower than a milligram. The actual cost to manufacture that much would be several orders of magnitude less than what it drug users are paying for it.
- starkd 4y ago
  So now the government has to buy people their drugs? We don't do that for alcoholics. There's a very strong moral hazard argument against doing that, but it's just plain cruel to the very population you think you are helping.
  - dragonwriter 4y ago
    > So now the government has to buy people their drugs? We don't do that for alcoholics. GP said “legalization or free supply”, and for alcohol we have legalization. So, yes, we do what the GP actually suggested, though not your strawman, for alcoholics.
  - Tiktaalik 4y ago
    We do create a safe supply of drugs and a safe, monitored use site for alcoholics. We call them bars. We don't provide this for other drugs. There's a handful of safe injection sites for drugs in some cities around the world (such as Vancouver) but the drugs are still toxic. It's good that people are on hand to handle the inevitable overdoses and other issues. This saves lives. The further necessary solution however is a safe supply of drugs, so that people can actually know what they're using. This is the core problem that is driving so many deaths. Imagine if there was no such thing as legal liquor or bars and alcoholics just drank some stuff that some guy made. There'd be a lot more deaths and poisonings from this.
Tiktaalik 4y ago
Decriminalization is part of solution, but there's a lot more that needs to be done. Probably a lot more than two issues here, but two significant ones are that: 1) the real problem is that the drugs are toxic and no one knows what they're taking. Maybe the dose is wrong or maybe it's not even fentanyl, and just a bunch of crazy shit (eg. benzos). The drugs aren't what people expect and people die. The fastest way to end deaths would be to create a safe supply of drugs so people know what they're taking. 2) "Decriminalization" doesn't necessarily mean and end to police harassment, drug confiscation, and related issues that all make life hard for drug users and create barriers to them getting the real help they need. While under decriminalization you may not end up in jail for having drugs, you are still able to have them confiscated and get a ticket (or summons to some thing), and then you're back at square one, needing to find more money to get drugs again. No wonder petty theft is such an issue in some places. High policing and confiscation of drugs from drug users just helps the dealers sell more illegal product. Circling back to point one again, a real safe supply of prescribed drugs handles this issue well in dealing with the money issue. But beyond this if we're going to allow people to have a safe supply of drugs, we also need to let people hold drugs too and not be harassed by police. Ideally there's not just a safe supply of drugs but also a safe use site as well where medical staff can monitor and help people. These sorts of sites can be touch points where people can build relationships and help people when they're ready to move to some further stage of recovery.

Vladimof 4y ago

> why can't these poor people get access to proper medicine and treatment? Maybe the Government doesn't like the type of people that get addicted to drugs... a friend of mine just died this week from overdose... maybe from Fentanyl but I don't know.

monkeybutton 4y ago
There's people out there whose opinions are that addiction is a problem that "eventually solves itself". When I first heard that I just tried to change topics as quick as possible, it was just a conversational dead end. I still don't know what to say.
- Vladimof 4y ago
  What we need is the scientific community to come together like they did for Covid vaccines... we need an addiction vaccine for drugs and alcohol... It probably killed a lot more people then Covid-19...
  - monkeybutton 4y ago
    There is actually research in that area! Apparently one can make a vaccine that trains the immune system to attack and remove drugs. But it could interfere with medical procedures because of the overlap with recreational drugs. Also the huge ethical and moral questions it poses like who gets final say over what you do with your own body. Unlike a viral disease, getting high isn't contagious and doesn't directly and immediately affect those around you.
    - Vladimof 4y ago
      > Unlike a viral disease, getting high isn't contagious and doesn't directly and immediately affect those around you. I'm pretty sure that most heavily addicted people would voluntary get such a vaccine... unless there's a major downside
      - 4y ago

xrd 4y ago

I'm from Portland which recently decriminalized drugs. I'm worried that this has the effect that dealers feel there is no prosecution for selling, and that this has led to a difficult situation for addicts. I'm of the opinion that without good mental health treatment options, this is an idea that creates more addicts who have no way to recover. I would love to understand if I'm wrong, and I know the pandemic is a context unlike anything we've ever seen, but the downtown streets of Portland look like they have many people in shocking states of crisis that to me look like unfettered access to drugs.

alostpuppy 4y ago
As I understand it they only decriminalized it for small amounts.
- xrd 4y ago
  True. And, I've also heard that basically the police have said that there is no point in enforcing any kind of trade because dealers can always find a way to make it look like the amounts are under the limit. So dealers are operating in a completely laissez faire environment. I suspect the police are collaborating on that story to avoid dealing with arresting drug dealers until public sentiment changes, but that is just my own biased opinion.

wahern 4y ago

> The real question we should be asking is why can't these poor people get access to proper medicine and treatment? Well, here in San Francisco you can access both relatively easily. But it turns out that people with substance abuse addictions tend not to exhibit strong executive functioning (at least contemporaneously) as compared to the average non-abuser. So when you remove all coercive policies whatsoever (because of abstract academic arguments that equivocate all policies short of giving out free drugs and free money and turning a blind eye to dealers), you manifestly end up nurturing a base of hard-core, long-term addicts. Also, fentanyl is cheaper and some users have even begun preferring fentanyl for its unique effect. Here in San Francisco fentanyl is becoming (or has already become) less an adulterant and more the drug you're knowingly buying. Plenty of people--users and public service workers--do carry naloxone, though. So that's something.

guerrilla 4y ago
> So when you remove all coercive policies whatsoever (because of abstract academic arguments that equivocate all policies short of giving out free drugs and free money and turning a blind eye to dealers), you manifestly end up nurturing a base of hard-core, long-term addicts. Except that's not at all what happened in Portugal (or in other European programs)...?
- PragmaticPulp 4y ago
  > Except that's not at all what happened in Portugal (or in other European programs)...? The Portugal narrative hasn't actually been as positive as initially reported by the Cato papers that were based on the first few years following the policy change. More recent data has shown an uptick of lifetime drug use and an increasing trend of drug deaths that doesn't really support the initially successful picture of their program. One of the challenges with interpreting the Portugal data is that they had relatively low drug use to begin with. The initial declarations of victory for their decriminalization programs were based on relatively small numbers and sample sizes that wouldn't pass muster in more rigorous analysis. I know the narrative about Portugal was set years ago by the Cato papers and a few authors, but it isn't really the success story that it's made out to be. It did, however, reduce the number of drug-related prosecutions, though that's an obvious downstream effect of removing a class of drug-related offenses.

bsedlm 4y ago

I have my suspicions that prior American governments intended (with full knowledge) for the cartels to get more powerful (by means of increasing corruption and letting only those kinds of crime-willing people to service the outlawed black markets) I recall reading about an economist who based on studying the failure of the prohibition, tried to warn about the futility of 'war on drugs'; from this I thought that if some economist knew it'd fail, so could the government have known....

PragmaticPulp 4y ago

> Decriminalisation and regulation are the biggest harm reduction measures that could be taken It's not actually a solution to the Fentanyl problem. Fentanyl ends up in drugs because it's extremely cheap (among other reasons). The price difference between fentanyl-laced illicit narcotics and the actual substance these people are seeking is actually massive, and end-user cost becomes a huge motivator for people dependent on constant daily intake of opioids. Even in a hypothetical world where regulated opioids were available over the counter, you'd still have significant inflows of illicit and potentially contaminated drugs. Decriminalization and regulation have been floated as magic bullets, yet even when it comes to drugs like Marijuana in states like California and Colorado we have multiple estimates suggesting that the majority of marijuana sales are still illicit rather than via regulated channels ( http://www.cahcc.com/Portals/0/ADE%20Cannabis%20Report%20_8-6-20.pdf?ver=2020-08-11-125659-360 http://www.cahcc.com/Portals/0/ADE%20Cannabis%20Report%20_8-... ). > The real question we should be asking is why can't these poor people get access to proper medicine and treatment? There is no one, singular "real question" we should be asking. This needs to be addressed on every level. Even in a theoretically idealized world there would still be a need for fentanyl test strips. Experimenting with "research chemicals" (aka obscure drugs synthesized in clandestine labs) is an increasingly common hobby even among people with access to common drugs. There isn't really a scenario where we just flip the decriminalization switch and all of these problems go away.

dendriti 4y ago
Why does it matter if decriminalization and regulation are floated as "magic bullets" or not? The Nirvana fallacy so often shows up in discussions of drug policy. It literally does not matter if decriminalization is "only 5% effective" (in whatever metric you're using to measure success, which here is just marijuana sales?). Sane polities implement laws that don't have 100% effectiveness.

13of40 4y ago

> why can't these poor people get access to proper medicine and treatment? Speaking of the US, one of the issues is that drug treatment and mental health care are for-profit businesses, so someone reaching out for help is likely to get grifted even if they have insurance or can pay for the treatment on their own.

heavyset_go 4y ago
There's also perpetual waiting lists, forcing some people who need help to wait six months or longer to get care. Then that care can potentially cost more than a four year degree. Many treatment programs will leave their patients dependent on maintenance drugs that can costs hundreds of dollars a month to fill, and require regular appointments with expensive specialists to get. Those specialists have months long waiting lists, as well

whatever1 4y ago

You live in a country that does not consider Healthcare a right even for the moral, law abiding citizens. Why would they care about the "illegals" (immigrants, addicts etc) or "immorals" (women or transgender who want control over their body) ?