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No. The drug warriors are neither humane nor sensible. Opioids are actually not all that dangerous, but the range between high and dead is not all that great.

No. The drug warriors are neither humane nor sensible. Opioids are actually not all that dangerous, but the range between high and dead is not all that great. When you know what you're getting (chronic pain patients) the problem rate is low. But with the street you get varying purity. And the drug war has caused the manufacturers to move to more concentrated products to make smuggling easier. And fentanyl has a very nasty property: the tendency to clump. This is no problem for the pharmaceutical industry, but when you have a dealer mixing stuff it's easy for a lethal clump to remain in the product. You get that, you better hope somebody nearby has Narcan. You don't see it killing the pain patients like it kill the people on the street--this is a dose problem, not something inherent to the drugs. And why is that a reason, anyway? There is no question as to the most deadly recreational drug: tobacco. Yet it's legal. Protecting the user is clearly not the motivation. (The data isn't so clear on the second because the data is so contaminated, but it looks like it is alcohol.) Also, the majority of crime traces back to drugs. Remove the drug market, you cut the crime rate in half overnight. And there's no question the drug war causes a lot more harm than the drugs. I can see no reasonable justification for the low-addictive stuff not to be legal. The highly addictive stuff you can make an argument for it being legal with a prescription, addiction is a valid reason for a prescription. It has been handled that way in the past in England and worked well. In in ideal world I would favor this approach, but I have a sufficient distrust of the politicians to trust this wouldn't become full of obstacles. Amsterdam's experience with legalization says that it doesn't increase use, but advertising does. Thus, what I would like to see: General promotional stuff is limited to simple item-price listings. Nothing more can be presented unless the customer has already demonstrated interest, either by entering a website (and the insides of the website can't be bookmarked, you must enter the gate each visit), or by entering a portion of a store devoted to that drug. Externally there must be a minimum of information needed to identify what the business is. The selecting your stuff part can never be mixed, you want two different types and you must visit both places even if they have a common checkout. The same rules apply to all recreational drugs, including tobacco and alcohol.

soraminazuki 1y ago
> No. The drug warriors are neither humane nor sensible. I never once advocated for the war on drugs approach, and I made that crystal clear in my comment. Proper policy != war on drugs. It means making sure that drugs get properly certified and its distribution controlled. It means focusing on treatment rather than aggressively punishing those who get addicted. It means addressing the underlying social issues that pushes people towards drugs rather than pouring all money into militarizing the police. > Opioids are actually not all that dangerous Victims of the epidemic would beg to differ. The epidemic highlighted the need for proper control of drugs through certification and prescription. It showed how far the pharmaceutical industry will go if left unregulated. > But with the street you get varying purity. I never advocated for this either. It should be illegal to sell drugs without a license. > There is no question as to the most deadly recreational drug: tobacco. Yet it's legal. Which is why regulation has increased for tobacco all around the world. We could do more to limit the exploitation of people by tobacco companies. > I can see no reasonable justification for the low-addictive stuff not to be legal. Yes, the specifics of regulation should vary depending on the dangers of each drug. I'm against all drugs being unilaterally legalized.
- cluckindan 1y ago
  I mostly agree with your viewpoints, but why would you leave some drugs unregulated and could you provide some examples of such drugs? Opioids are only dangerous due to variance in purity (overdoses) and availability (withdrawal-motivated crime). Of course addiction and dependence can be exploited for profit, but how is opioid dependence different in that respect from alcohol dependence, gambling addiction, sex addiction or even TikTok? We already know what causes compulsive behaviors linked to addictions and also how to undo them. Amphetamines, cocaine, opioids, gambling and sex have a common denominator, namely overexpression of Delta-FosB protein in the orbitofrontal cortex. Those changes can be eradicated overnight with histone deacetylase inhibitors, but this treatment is not generally available.
neurostimulant 1y ago
You can slowly quit alcohol and tobacco addiction with your own willpower alone, but not opioid addiction. Imagine if it were an saas where signing up for a subscription is super easy but quitting on your own is almost impossible, of course regulators would step in.
- cluckindan 1y ago
  It doesn’t need to be entirely willpower. Opioid dependency can be dealt with by doing what they would do in rehab: slowly taper down the daily dose over many weeks. Of course, that only works if you have access to a standardized, regulated supply of opioids. You can’t do it with street drugs of unknown purity. Going cold turkey off potent opioids is a recipe for relapse, or at worst, death. Still, the likelihood of dying from withdrawal is much, much lower than with benzos or alcohol: both of those can cause seizures in withdrawal.
- LorenPechtel 1y ago
  The thing is cold turkey doesn't work. The reactions are bad and can be deadly. But if you have access to accurately known doses that can be stepped down in small amounts you avoid all the bad things. Remember, there's a big problem with inadequate pain control. Drug doesn't work exactly as the doctor expects, they assume drug seeking--and now you have people driven to the street to make life bearable. You're not going to "cure" an "addict" that actually needs the pain control. Cut out all the nonsense, with addiction a valid reason there would be no drug seeking and doctors would be able to work with the patients much better.

soraminazuki 1y ago

> No. The drug warriors are neither humane nor sensible. I never once advocated for the war on drugs approach, and I made that crystal clear in my comment. Proper policy != war on drugs. It means making sure that drugs get properly certified and its distribution controlled. It means focusing on treatment rather than aggressively punishing those who get addicted. It means addressing the underlying social issues that pushes people towards drugs rather than pouring all money into militarizing the police. > Opioids are actually not all that dangerous Victims of the epidemic would beg to differ. The epidemic highlighted the need for proper control of drugs through certification and prescription. It showed how far the pharmaceutical industry will go if left unregulated. > But with the street you get varying purity. I never advocated for this either. It should be illegal to sell drugs without a license. > There is no question as to the most deadly recreational drug: tobacco. Yet it's legal. Which is why regulation has increased for tobacco all around the world. We could do more to limit the exploitation of people by tobacco companies. > I can see no reasonable justification for the low-addictive stuff not to be legal. Yes, the specifics of regulation should vary depending on the dangers of each drug. I'm against all drugs being unilaterally legalized.

cluckindan 1y ago
I mostly agree with your viewpoints, but why would you leave some drugs unregulated and could you provide some examples of such drugs? Opioids are only dangerous due to variance in purity (overdoses) and availability (withdrawal-motivated crime). Of course addiction and dependence can be exploited for profit, but how is opioid dependence different in that respect from alcohol dependence, gambling addiction, sex addiction or even TikTok? We already know what causes compulsive behaviors linked to addictions and also how to undo them. Amphetamines, cocaine, opioids, gambling and sex have a common denominator, namely overexpression of Delta-FosB protein in the orbitofrontal cortex. Those changes can be eradicated overnight with histone deacetylase inhibitors, but this treatment is not generally available.

neurostimulant 1y ago

You can slowly quit alcohol and tobacco addiction with your own willpower alone, but not opioid addiction. Imagine if it were an saas where signing up for a subscription is super easy but quitting on your own is almost impossible, of course regulators would step in.

cluckindan 1y ago
It doesn’t need to be entirely willpower. Opioid dependency can be dealt with by doing what they would do in rehab: slowly taper down the daily dose over many weeks. Of course, that only works if you have access to a standardized, regulated supply of opioids. You can’t do it with street drugs of unknown purity. Going cold turkey off potent opioids is a recipe for relapse, or at worst, death. Still, the likelihood of dying from withdrawal is much, much lower than with benzos or alcohol: both of those can cause seizures in withdrawal.
LorenPechtel 1y ago
The thing is cold turkey doesn't work. The reactions are bad and can be deadly. But if you have access to accurately known doses that can be stepped down in small amounts you avoid all the bad things. Remember, there's a big problem with inadequate pain control. Drug doesn't work exactly as the doctor expects, they assume drug seeking--and now you have people driven to the street to make life bearable. You're not going to "cure" an "addict" that actually needs the pain control. Cut out all the nonsense, with addiction a valid reason there would be no drug seeking and doctors would be able to work with the patients much better.