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Don’t we need better drugs? Like, people have a natural desire for what drugs do. Can’t we satisfy that in a way that is more positive? Some of that is surely

Don’t we need better drugs? Like, people have a natural desire for what drugs do. Can’t we satisfy that in a way that is more positive? Some of that is surely cultural. So ideally, you combine a growing and vibrant positive drug culture with good drugs. The Netherlands has essentially done this. There are basically soft-legal dealers (via WhatsApp) that widely sell most illegal drugs at high purity — but you won’t ever find opiates on the menu. So then people are happy getting their ketamine and mdma and coke and ghb and lsd and 2cb etc — and the police are surely monitoring to make sure that the dealers don’t cause problems. That means they allow the good dealers and shut down the dealers that cause problems (sell bad drugs or sell to people who cause problems). This is combined with a positive drug culture that shuns opiates but embraces party drugs and music culture.

vidarh 3y ago
Sure, there are drugs that are worse than others, and seeking to redirect use where possible would be good. Especially when dealing with addicts. Some people do seek out opiates especially because of its specific effects, and I don't think you can entirely prevent that, though you may be able to reduce it with better mental health support, but even then you could also redirect use to safer options, and also segmenting out those seeking opiates from those seeking party drugs etc. so that you don't create pathways between them might well be beneficial. To stick with my heroin example, I don't know where specifically heroin sits relative to opiates that would actually satisfy existing addicts and that's part of the challenge, but heroin itself is also nowhere near the worst opiate, and one of the negative effects of the current way we're handling this is that we've created a pathway towards more dangerous ones. E.g. a frequent pathway to heroin use today is from oxycodone, to oxycodone on the black market after you lose your prescription, to heroin. But then it gets worse: Dealers cutting heroin with fentanyl or even carfentanyl. Getting users nudged gently or not so gently towards the safest options that will satisfy them would in itself likely help a lot, and of course, a black market dealer has no incentive to do that unless there's a very severe difference in how they're treated by law enforcement. Perhaps a variant of what you described would be a good first step in many places not ready for more decriminalization: Much more aggressively segmented drug sentencing by the harm of the worst drug a dealer can be connected to, and perhaps even explicitly punish "crossover" between drugs with differ harm profiles to reduce the pathways between them. But that means being honest about the abuse potential, and not politicizing it, and that is in itself an uphill battle in many places.
- pbronez 3y ago
  Is it possible to keep an addict satisfied with a lower tier drug? Genuine question. My understanding is that opiates become less effective over time as your body adapts, so you seek out stronger drugs in larger doses.
  - vidarh 3y ago
    It really depends both on what you mean by "lower tier" drug, and what people are seeking, and how frequent users they are. But I suspect a reliable potency alone would do a lot for slowing the upward creep than shunting people to a drug dealer who might decide you'll be a more profitable customer if they raise your expectations of the high to seek by selling you "heroin" without telling you it's not pure heroin but cut with fentanyl (tens of times as strong) or carfentanil (thousands of times the potency). Even with an upwards creep, there are vastly different strength levels and harm profiles for different opioids, and a strategy of what is available focused on slowing advancement and steering around the most dangerous options might well allow for keeping people on far milder options for far longer and/or give more options for shunting people onto interventions if they want to stop. The first step is really to accept it's a healthcare problem, and recognise that it's a worse healthcare problem if people go to drug dealers because you refuse them. If so, the question becomes not necessarily about a free for all, but about how many hoops you can get people to jump through to shunt as many as possible in a healthier direction without making too many decide it's easier to buy from a dealer.
  - alephnullshabba 3y ago
    Larger doses yes, but the opiates being consumed are almost entirely a result of cost/availability. Genuine prescription pills are by far the most desirable choice amongst opiate addicts, but tight control on supply post opiate-crisis has made them practically nonexistent in illegal drug markets. The extent of prescription opiates desirability is somewhat evidenced by most "street" fentanyl being consumed in counterfeit oxycodone/vicodin pressed-pills. And then of course there is cost--why smuggle 50 packages of heroin when a single package of fentanyl contains an equivalent number of opiate doses and can be manufactured far more efficiently/discretely? But in general the opiate market is defined by the practical constraints of cost and availability. Fentanyl is a synthetic opioid that has been used in hospitals for decades, but its emergence as a street drug in recent times is the result of precursors and synthesis methodology becoming very accessible
K0balt 3y ago
This is as good a solution as is likely to be found, but it hardly exists in a vacuum. The culture in which this fragile status quo is imbedded ensures its relative success. Try to transplant it into other cultures, and the myriad potential perverse incentives would turn it into just plain old police running the drugs business, with murders and all the other fun stuff that comes along with that. Some cultures are able to maintain fragile systems such as this because civic responsibility and collective good are strongly valued. Unfortunately, most cultures are not that responsible.
lo_zamoyski 3y ago
“people have a natural desire for what drugs do” Define “natural”. I don’t think any mature, temperate, and healthy human being desires to use or abuse drugs, and even if they have a genetic predisposition to abuse (like some alcoholics), they know to avoid the so-called near occasions of sin that put them at serious risk of using. Obviously, I don’t mean everything with psychoactive properties is bad. Having some chamomile tea or a cup of coffee or a beer is fine in moderation. But drug use as we commonly mean it is drug abuse by definition, as the corruption and distortion of mental faculties for a thrill (or to escape) is intentional and intrinsic. So I find the very notion of a “vibrant positive drug culture with good drugs” in this context incoherent, or subject to such a restrictive notion of “good drugs” (which is also partly a matter of dosage) that it becomes as banal as pipe smoking forums or beer clubs.
- nataliste 3y ago
  I'm curious: are you formally Catholic? And if so, how did you arrive there?
- radlad 3y ago
  I do not understand how you could say "I don’t think any mature, temperate, and healthy human being desires to use or abuse drugs, and even if they have a genetic predisposition to abuse" followed by "Having some chamomile tea or a cup of coffee or a beer is fine in moderation." Caffeine - and especially alcohol - are absolutely addictive drugs. Alcohol especially has many negative effects on society, and is in a similar class as GHB, benzodiazepines and even opiates. Drinking alcohol IS using drugs, even if society has accepted this drug. Coffee is a stimulant, just like Adderall (i.e. speed) and meth. Weed is another pervasive drug that's used by many mature, temperate and healthy humans. And frankly, I would argue the same of psychedelics and MDMA. I don't know how you could even argue otherwise besides "no true Scottsman."
  - Auracle 3y ago
    A lot of people are incapable of realizing other people are different from them. If you could give the entire population each their own “happy button” a significant portion would be hitting it all day long, ignoring everything else in their life. Those on HN are largely not the same type of people.
alephnerd 3y ago
> positive drug culture The same mafias setting up that drug supply chain for your dealer in the Netherlands are the same one who are attempting to assasinate the crown princess, prime minister, and justice minister [0] and have caused over 100 bombings and shootings in Rotterdam by mid-2023 alone in a city where stuff like this was almost unheard of 30 years ago [1] > embraces party drugs and music culture. Party drugs like XTC are smuggled as well, leading to a massive gang war in Israel in the 2000s [2], where most XTC in Europe is synthesized. (Side note - most of the Israeli mafia are ethnic Moroccans just like their Dutch compatriots) [0] - https://www.lemonde.fr/en/international/article/2022/10/15/dutch-crown-princess-and-prime-minister-threatened-by-drug-mafia_6000465_4.html https://www.lemonde.fr/en/international/article/2022/10/15/d... [1] - https://nltimes.nl/2023/07/27/100-explosions-shootings-rotterdam-year-already-political-leaders-express-sadness https://nltimes.nl/2023/07/27/100-explosions-shootings-rotte... [2] - https://www.latimes.com/archives/la-xpm-2009-jan-06-fg-israel-mafia6-story.html https://www.latimes.com/archives/la-xpm-2009-jan-06-fg-israe...
- dr_dshiv 3y ago
  The drug supply in Amsterdam is heavily regulated by the police. They have closing hours at 11 on weekdays and at 1 on weekends. There are arrangements where some people make money so other people don’t. A few years ago, all the encryption for dealers was broken [1]. Many of them agreed to continue under certain circumstances. It’s a reasonable balance. During Covid, they shut down all the coffee shops selling weed — and that lasted a day. Because they realized the black market would step in. Keeping things flowing in a regulated market is always preferred to a completely illegal (unregulated) market. [1] https://apnews.com/article/encrypted-phones-crime-encrochat-drugs-arrests-3ccc15ef095c201eb9fe55837bfdd886 https://apnews.com/article/encrypted-phones-crime-encrochat-...
  - alephnerd 3y ago
    None of that actually disproves my point. If a "regulated" market can still have players explicitly target heads of state, cabinet members, and the future monarch of a country for extrajudicial killings and saw a dramatic increase in violence, then by definition the light touch regulation used is failing. All my examples happened in 2022. You can try to rationalize, but at the end of the day it is a dirty business and even regulation would not clean it up (eg. Oklahoma's attempt at legalizing Marijuana cultivation lead to an influx of Chinese organized crime players [0] because of high taxes on legal marijuana) There is a happy path between harm reduction, decriminalization, and legalization, but imo the Dutch system is clearly not it. [0] - https://www.propublica.org/article/chinese-organized-crime-us-marijuana-market https://www.propublica.org/article/chinese-organized-crime-u...

vidarh 3y ago

Sure, there are drugs that are worse than others, and seeking to redirect use where possible would be good. Especially when dealing with addicts. Some people do seek out opiates especially because of its specific effects, and I don't think you can entirely prevent that, though you may be able to reduce it with better mental health support, but even then you could also redirect use to safer options, and also segmenting out those seeking opiates from those seeking party drugs etc. so that you don't create pathways between them might well be beneficial. To stick with my heroin example, I don't know where specifically heroin sits relative to opiates that would actually satisfy existing addicts and that's part of the challenge, but heroin itself is also nowhere near the worst opiate, and one of the negative effects of the current way we're handling this is that we've created a pathway towards more dangerous ones. E.g. a frequent pathway to heroin use today is from oxycodone, to oxycodone on the black market after you lose your prescription, to heroin. But then it gets worse: Dealers cutting heroin with fentanyl or even carfentanyl. Getting users nudged gently or not so gently towards the safest options that will satisfy them would in itself likely help a lot, and of course, a black market dealer has no incentive to do that unless there's a very severe difference in how they're treated by law enforcement. Perhaps a variant of what you described would be a good first step in many places not ready for more decriminalization: Much more aggressively segmented drug sentencing by the harm of the worst drug a dealer can be connected to, and perhaps even explicitly punish "crossover" between drugs with differ harm profiles to reduce the pathways between them. But that means being honest about the abuse potential, and not politicizing it, and that is in itself an uphill battle in many places.

pbronez 3y ago
Is it possible to keep an addict satisfied with a lower tier drug? Genuine question. My understanding is that opiates become less effective over time as your body adapts, so you seek out stronger drugs in larger doses.
- vidarh 3y ago
  It really depends both on what you mean by "lower tier" drug, and what people are seeking, and how frequent users they are. But I suspect a reliable potency alone would do a lot for slowing the upward creep than shunting people to a drug dealer who might decide you'll be a more profitable customer if they raise your expectations of the high to seek by selling you "heroin" without telling you it's not pure heroin but cut with fentanyl (tens of times as strong) or carfentanil (thousands of times the potency). Even with an upwards creep, there are vastly different strength levels and harm profiles for different opioids, and a strategy of what is available focused on slowing advancement and steering around the most dangerous options might well allow for keeping people on far milder options for far longer and/or give more options for shunting people onto interventions if they want to stop. The first step is really to accept it's a healthcare problem, and recognise that it's a worse healthcare problem if people go to drug dealers because you refuse them. If so, the question becomes not necessarily about a free for all, but about how many hoops you can get people to jump through to shunt as many as possible in a healthier direction without making too many decide it's easier to buy from a dealer.
- alephnullshabba 3y ago
  Larger doses yes, but the opiates being consumed are almost entirely a result of cost/availability. Genuine prescription pills are by far the most desirable choice amongst opiate addicts, but tight control on supply post opiate-crisis has made them practically nonexistent in illegal drug markets. The extent of prescription opiates desirability is somewhat evidenced by most "street" fentanyl being consumed in counterfeit oxycodone/vicodin pressed-pills. And then of course there is cost--why smuggle 50 packages of heroin when a single package of fentanyl contains an equivalent number of opiate doses and can be manufactured far more efficiently/discretely? But in general the opiate market is defined by the practical constraints of cost and availability. Fentanyl is a synthetic opioid that has been used in hospitals for decades, but its emergence as a street drug in recent times is the result of precursors and synthesis methodology becoming very accessible

K0balt 3y ago

This is as good a solution as is likely to be found, but it hardly exists in a vacuum. The culture in which this fragile status quo is imbedded ensures its relative success. Try to transplant it into other cultures, and the myriad potential perverse incentives would turn it into just plain old police running the drugs business, with murders and all the other fun stuff that comes along with that. Some cultures are able to maintain fragile systems such as this because civic responsibility and collective good are strongly valued. Unfortunately, most cultures are not that responsible.

lo_zamoyski 3y ago

“people have a natural desire for what drugs do” Define “natural”. I don’t think any mature, temperate, and healthy human being desires to use or abuse drugs, and even if they have a genetic predisposition to abuse (like some alcoholics), they know to avoid the so-called near occasions of sin that put them at serious risk of using. Obviously, I don’t mean everything with psychoactive properties is bad. Having some chamomile tea or a cup of coffee or a beer is fine in moderation. But drug use as we commonly mean it is drug abuse by definition, as the corruption and distortion of mental faculties for a thrill (or to escape) is intentional and intrinsic. So I find the very notion of a “vibrant positive drug culture with good drugs” in this context incoherent, or subject to such a restrictive notion of “good drugs” (which is also partly a matter of dosage) that it becomes as banal as pipe smoking forums or beer clubs.

nataliste 3y ago
I'm curious: are you formally Catholic? And if so, how did you arrive there?
radlad 3y ago
I do not understand how you could say "I don’t think any mature, temperate, and healthy human being desires to use or abuse drugs, and even if they have a genetic predisposition to abuse" followed by "Having some chamomile tea or a cup of coffee or a beer is fine in moderation." Caffeine - and especially alcohol - are absolutely addictive drugs. Alcohol especially has many negative effects on society, and is in a similar class as GHB, benzodiazepines and even opiates. Drinking alcohol IS using drugs, even if society has accepted this drug. Coffee is a stimulant, just like Adderall (i.e. speed) and meth. Weed is another pervasive drug that's used by many mature, temperate and healthy humans. And frankly, I would argue the same of psychedelics and MDMA. I don't know how you could even argue otherwise besides "no true Scottsman."
- Auracle 3y ago
  A lot of people are incapable of realizing other people are different from them. If you could give the entire population each their own “happy button” a significant portion would be hitting it all day long, ignoring everything else in their life. Those on HN are largely not the same type of people.

alephnerd 3y ago

> positive drug culture The same mafias setting up that drug supply chain for your dealer in the Netherlands are the same one who are attempting to assasinate the crown princess, prime minister, and justice minister [0] and have caused over 100 bombings and shootings in Rotterdam by mid-2023 alone in a city where stuff like this was almost unheard of 30 years ago [1] > embraces party drugs and music culture. Party drugs like XTC are smuggled as well, leading to a massive gang war in Israel in the 2000s [2], where most XTC in Europe is synthesized. (Side note - most of the Israeli mafia are ethnic Moroccans just like their Dutch compatriots) [0] - https://www.lemonde.fr/en/international/article/2022/10/15/dutch-crown-princess-and-prime-minister-threatened-by-drug-mafia_6000465_4.html https://www.lemonde.fr/en/international/article/2022/10/15/d... [1] - https://nltimes.nl/2023/07/27/100-explosions-shootings-rotterdam-year-already-political-leaders-express-sadness https://nltimes.nl/2023/07/27/100-explosions-shootings-rotte... [2] - https://www.latimes.com/archives/la-xpm-2009-jan-06-fg-israel-mafia6-story.html https://www.latimes.com/archives/la-xpm-2009-jan-06-fg-israe...

dr_dshiv 3y ago
The drug supply in Amsterdam is heavily regulated by the police. They have closing hours at 11 on weekdays and at 1 on weekends. There are arrangements where some people make money so other people don’t. A few years ago, all the encryption for dealers was broken [1]. Many of them agreed to continue under certain circumstances. It’s a reasonable balance. During Covid, they shut down all the coffee shops selling weed — and that lasted a day. Because they realized the black market would step in. Keeping things flowing in a regulated market is always preferred to a completely illegal (unregulated) market. [1] https://apnews.com/article/encrypted-phones-crime-encrochat-drugs-arrests-3ccc15ef095c201eb9fe55837bfdd886 https://apnews.com/article/encrypted-phones-crime-encrochat-...
- alephnerd 3y ago
  None of that actually disproves my point. If a "regulated" market can still have players explicitly target heads of state, cabinet members, and the future monarch of a country for extrajudicial killings and saw a dramatic increase in violence, then by definition the light touch regulation used is failing. All my examples happened in 2022. You can try to rationalize, but at the end of the day it is a dirty business and even regulation would not clean it up (eg. Oklahoma's attempt at legalizing Marijuana cultivation lead to an influx of Chinese organized crime players [0] because of high taxes on legal marijuana) There is a happy path between harm reduction, decriminalization, and legalization, but imo the Dutch system is clearly not it. [0] - https://www.propublica.org/article/chinese-organized-crime-us-marijuana-market https://www.propublica.org/article/chinese-organized-crime-u...