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> Decades of research prove that these programmes curtail disease. Junkies are in fact less prone to sharing needles when they get free ones. That sharply decre
by ryzvonusef 4y ago
> Decades of research prove that these programmes curtail disease. Junkies are in fact less prone to sharing needles when they get free ones. That sharply decreases rates of blood-borne illnesses. In 2014 an analysis found that every dollar spent on syringe exchanges spares the government around $7 in HIV-related health-care costs. Needle exchanges opened across America and Europe. For years no one detected the feared rise in substance abuse.
> That was before the opioid crisis plagued America and economists started looking into the trade-offs. A new study by Analisa Packham published in the Journal of Public Economics uncovers an uncomfortable truth: this particular harm-reduction tool does lots of harm. Ms Packham compares how drug users fared in counties that opened syringe exchanges between 2008 and 2016 with those in counties that did not. Before the clinics opened, upticks in HIV diagnoses or overdoses in one set of counties were mirrored in the other. Once a syringe exchange came to town, outcomes diverged. Rates of HIV fell by 15% in counties with the new programme. But deaths soared. On average syringe-exchange programmes led to a 22% spike in opioid-related mortality.
> Simply lowering the risks of getting sick—and the costs of paraphernalia, as Flaco from the Bronx articulated—could also incentivise drug use. Distributing PrEP, an HIV-prevention medication, has been shown to make gay men less inclined to use condoms during sex. So too could harm-reduction tools make addicts use drugs more incautiously. In a study published in 2018 Jennifer Doleac and Anita Mukherjee found that when states legalised naloxone, a medication that reverses overdoses, opioid abuse increased. Though lauded by public-health advocates, naloxone did not save lives as intended. In some regions, fewer addicts died; in others, more did.
- ryzvonusef 4y agoseems like people would rather suppress the truth rather than let research be allowed to stand scrutiny on it's own merit > These works have been met with anger. Their findings upset harm-reduction defenders who consider their efforts already besieged by critics. The experience was so miserable that Ms Doleac, who studies crime, has decided never to write another health paper. > Leo Beletsky, a former drug dealer, now at Northeastern University, deems Ms Packham’s findings “nonsensical” and thinks her paper should not have been published. Don Des Jarlais, at New York University, argues that addicts do not respond to incentives like others do, making the moral-hazard effect inconceivable. Susan Sherman of Johns Hopkins University says she doubts that new evidence that harm reduction does more bad than good would convince her to disregard previous research demonstrating otherwise. > A barrage of complaints led the editors of the International Journal of Drug Policy to retract a meta-analysis that found that safe-injection sites, where users do drugs in supervised settings, did not decrease rates of deadly overdose. “Retractions used to be reserved for fraud,” says Keith Humphreys of Stanford University, a former drug-policy adviser for the Obama administration. No longer, it seems.
- slowmovintarget 4y ago> “Retractions used to be reserved for fraud,” says Keith Humphreys of Stanford University... Science denial has many forms. This appears to be one of the older ones.
- version_five 4y agoPeople are really bad at accepting information that superficially contradicts something they want, and react by disputing the information instead of taking it into consideration while still pushing for the ends they want to achieve. In this case, I'd speculate that harm reduction advocates aim is to (tautologically) reduce the (physical/health) harm of drug use so that it's one less problem users face. One aspect of this may be safe consumption, which this article says doesn't work on it's own. Another aspect is overdoses form Fentanyl et al, (which I would argue is largely a byproduct of a drug war that has made heroin too hard to import, and no safe medical supply options for treatment). So the focus could shift to addressing this (which in tandem with safe injection sites could still produce better overall outcomes). My point is that it's not productive to dispute the studies, better to accept on balance of probabilities and look at how it fits with your overall aim. (Climate change is very similar. People dispute the studies because they don't like the political rhetoric about how we should react, not because deep down they think all the research is flawed)
- hooverd 4y agoI think some drug warriors become harm advocates. If drug users can't overcome their moral failures, before they suffocate on their vomit than be resuscitated with naloxone.
- the_only_law 4y agoWhat? This isn’t even a sentence. It’s a collection of sentence fragments and I can’t tell what the hell it’s trying to say.
- hooverd 4y ago
- f38zf5vdt 4y agoIn terms of burdening the already dysfunctional healthcare and criminal justice systems of the US, it sounds like it works great. If the junkies no longer exist and less frequently get HIV, their cost to society is less than if they were alive, disease spreading, and committing crime.
- giraffe_lady 4y agoThis comment is an excellent example of how you can openly call for violence against the vulnerable on HN without censure or consequence as long as you do it in a certain tone.
- throwayyy479087 4y agoSaying that we shouldn’t enable certain behavior is not violence. Violence is violence, stop messing with the meaning of words.
- giraffe_lady 4y agoWhat is the meaningful difference between killing someone yourself and letting them die when it's in your power to prevent it? Saying that a certain population should die because of their criminal nature and high "cost to society" is straight up nazi shit. What's the policy implementation of that opinion just curious? It really doesn't get more clear than this.
- ROTMetro 4y agoI am sure you currently work with or have family members who secretly are addicts. Labeling them as a cost to society, disease spreading, and committing crime and justifying their death instead of talking about them as people in pain is definitely disgusting and not the type of discourse I would have expected from this site. But hey, keep on with your reductionism as justification for complicity in peoples deaths. Also remember, they can't get needles not because they don't want to buy them but because it is illegal to sell them.
- moistly 4y ago
- aqme28 4y agoThe article is paywalled, but this suggests to me we go further in harm-reduction. The problem is specifically opioid overdoses, so we should have more supervised-injection sites.
- dmix 4y agoYeah there’s still plenty of solutions here within the current system.
- the-printer 4y agoHelping the drug users get off the drugs could reduce plenty of harm, I reckon, but when that fails why is the alternative helping them stay on?
- cwmma 4y agoEasy because if you fail to get them to quit, then the goal is to keep them alive so you can help them quit latter.
- aqme28 4y agoWhy are those mutually exclusive? We should help drug users get off drugs, but we shouldn't make it deadlier for them if we fail.
- the-printer 4y agoBecause making it “less deadly” somehow equates to enabling them. I think that people are more concerned with opioid death statistics than opioid addiction itself. And there is a shattering sense of defeat, which is normal, that is associated with realizing that you cannot help anyone who doesn’t want to help themselves. And if they don’t want to help themselves, then they may go down a collision course that will be their undoing. In this case that often means death.
- aqme28 4y ago> people are more concerned with opioid death statistics than opioid addiction itself. I feel strongly this way, or maybe I'm missing your point. Addiction is terrible, but death is clearly worse than addiction. Addiction is survivable.
- croes 4y agoAnd how many are these 15% and 22%?