4 ms·

Your opioid comparison is wildly apples to oranges. They were marketed and sold to consumers as safe, much more effective, and dramatically less addictive than

Your opioid comparison is wildly apples to oranges. They were marketed and sold to consumers as safe, much more effective, and dramatically less addictive than it actually was. An industrial addiction machine ignored regulatory safeguards, built a 'pay for play' rewards structure to incentivize prescriptions, and a zillion other cartoonishly evil things . There is a world of difference between something like that and government dosed methadone, meth, etc. The problem was not in fact opioids. It was the profit structure behind the distribution network. Remove that and the bulk of the problems go away too. If the drug is socially stigmatized only true addicts will use it. Those are exactly the people you want to have access to it because they can be gradually tapered off on a controlled dosage, they can be targeted for interventions, and it keeps them from stabbing you and stealing your wallet to get more meth. Its incredibly counterproductive to just outlaw a thing that people need on a level that they will do almost anything to get it.

cryzinger 5mo ago
I think another under-discussed factor in the opioid crisis is that opioids are cheap, but (American) healthcare to treat underlying pain is not. You might not be able to afford six weeks of physical therapy, surgery, etc., but you can probably afford $11.23 a month for a generic prescription.
- keepamovin 5mo ago
  My view of a lot of the opioid crisis stuff aside from physical pain is psychological trauma - people self medicating as an alternative to doing the work. That’s why I think the psychoactive legislation that’s introduced recently about psychedelics is so important because those things can rapidly accelerate processing and healing psychological trauma. My view, is if this was done 20 - 30 years ago there wouldn’t be such a large demand for opiates. I take it further and say that probably some in the drug companies understand this already and were lobbying against the introduction of more curative psychedelic treatments so that they could sell subscriptions to painkillers.
  - jazzyjackson 5mo ago
    Sorry what? What does ego death have to do with healing a back injury?
    - ghthor 5mo ago
      Chronic Back pain is correlated with emotional trauma. The physical body is a mere projection of the energetic and spiritual being. This is wahy meditative spiritual practices such as yoga and taiji are good for chronic pain, as the physical pain is a mere projection of a deeper trauma that needs released.
      - bhotka 5mo ago
        how does my spiritual wellness affect the mechanical structure of my lower back?
        munificent 5mo ago
        Setting the woo aside, there is a lot of data on disorders like central sensitization syndrome that show our psychological state has a very strong modulating effect on our perception of pain.
        asgraham 5mo ago
        Ignoring the spiritual part, emotional state does have a well-known feedback loop with physical state. There’s a (largely incorrect) idea in pop psychology that just as happiness leads to smiling, smiling leads to happiness. It’s not nearly that simple, but there are some more straightforward examples: lots of tense emotional states (anger, anxiety) lead to tense muscles (jaw being the classic example). Relaxing your jaw can lead to a (temporary) relaxation of your emotional tenseness. I’ve never heard of a similar result for the lower back, but it’s not hard to imagine. If nothing else, they must be correlated through sedentary lifestyle.
        fc417fc802 5mo ago
hash872 5mo ago
>Those are exactly the people you want to have access to it Yes but that's different from 'every random person can buy some meth at 7-11 or the government store' though. I'm fine with a controlled program for registered, hardcore addicts- the 2% who do 50% of the drugs or what have you. >The problem was not in fact opioids. It was the profit structure behind the distribution network. Remove that and the bulk of the problems go away too I mean, states & countries that have completely state-run liquor stores still have alcoholism and serious alcohol problems though? If 'removing the profit structure' worked magically, more countries would do it. AFAIK rates of alcoholism aren't even different between state-run and private sector models
- applfanboysbgon 5mo ago
  That's a bit of an apples and oranges comparison. The thing about for-profit prescriptions is that they incentivize doctors to prescribe opiates for people who don't need them, people who may not have even been interested in them. A for-profit retailer selling alcohol doesn't have that aspect at play at all; at most the for-profit aspect encourages flashy advertising and displaying alcohol more prominently, but nothing to the level of having a trusted expert in a one-on-one setting personally pushing for you to consume. Instead the pressure to consume alcohol comes at a grassroots level. Social alcohol consumption is deeply rooted in human culture, and it's generally the people around you who will push you to consume. This pressure is independent of any profit motive, so removing the profit motive does nothing to affect it. > AFAIK rates of alcoholism aren't even different between state-run and private sector models Looking at some 2016 WHO statistics, the US seems to have ~3x the rate of alcholism as Iceland, but I recognise these are cherrypicked examples and I'm not interested enough to do a deep dive aggregating countries. Still, it seems plausible that government intervention can reduce alcholism rates. The fact that it's not 0% means nothing; nothing in the world is 0%, outlawing murder doesn't mean murder doesn't happen, but you can strive to reduce it as much as reasonably possible.
  - fc417fc802 5mo ago
    Alcoholics (the really bad ones that we're presumably talking about here) don't consume because of social pressure. It's addiction and all the associated psychological and sociological complexity that implies. I expect any comparison of alcoholism rates will need to account for social (particularly religion) and socioeconomic factors. An awful lot of addicts are engaging in escapism.

cryzinger 5mo ago

I think another under-discussed factor in the opioid crisis is that opioids are cheap, but (American) healthcare to treat underlying pain is not. You might not be able to afford six weeks of physical therapy, surgery, etc., but you can probably afford $11.23 a month for a generic prescription.

keepamovin 5mo ago
My view of a lot of the opioid crisis stuff aside from physical pain is psychological trauma - people self medicating as an alternative to doing the work. That’s why I think the psychoactive legislation that’s introduced recently about psychedelics is so important because those things can rapidly accelerate processing and healing psychological trauma. My view, is if this was done 20 - 30 years ago there wouldn’t be such a large demand for opiates. I take it further and say that probably some in the drug companies understand this already and were lobbying against the introduction of more curative psychedelic treatments so that they could sell subscriptions to painkillers.
- jazzyjackson 5mo ago
  Sorry what? What does ego death have to do with healing a back injury?
  - ghthor 5mo ago
    Chronic Back pain is correlated with emotional trauma. The physical body is a mere projection of the energetic and spiritual being. This is wahy meditative spiritual practices such as yoga and taiji are good for chronic pain, as the physical pain is a mere projection of a deeper trauma that needs released.
    - bhotka 5mo ago
      how does my spiritual wellness affect the mechanical structure of my lower back?
      - munificent 5mo ago
        Setting the woo aside, there is a lot of data on disorders like central sensitization syndrome that show our psychological state has a very strong modulating effect on our perception of pain.
      - asgraham 5mo ago
        Ignoring the spiritual part, emotional state does have a well-known feedback loop with physical state. There’s a (largely incorrect) idea in pop psychology that just as happiness leads to smiling, smiling leads to happiness. It’s not nearly that simple, but there are some more straightforward examples: lots of tense emotional states (anger, anxiety) lead to tense muscles (jaw being the classic example). Relaxing your jaw can lead to a (temporary) relaxation of your emotional tenseness. I’ve never heard of a similar result for the lower back, but it’s not hard to imagine. If nothing else, they must be correlated through sedentary lifestyle.
        fc417fc802 5mo ago

hash872 5mo ago

>Those are exactly the people you want to have access to it Yes but that's different from 'every random person can buy some meth at 7-11 or the government store' though. I'm fine with a controlled program for registered, hardcore addicts- the 2% who do 50% of the drugs or what have you. >The problem was not in fact opioids. It was the profit structure behind the distribution network. Remove that and the bulk of the problems go away too I mean, states & countries that have completely state-run liquor stores still have alcoholism and serious alcohol problems though? If 'removing the profit structure' worked magically, more countries would do it. AFAIK rates of alcoholism aren't even different between state-run and private sector models

applfanboysbgon 5mo ago
That's a bit of an apples and oranges comparison. The thing about for-profit prescriptions is that they incentivize doctors to prescribe opiates for people who don't need them, people who may not have even been interested in them. A for-profit retailer selling alcohol doesn't have that aspect at play at all; at most the for-profit aspect encourages flashy advertising and displaying alcohol more prominently, but nothing to the level of having a trusted expert in a one-on-one setting personally pushing for you to consume. Instead the pressure to consume alcohol comes at a grassroots level. Social alcohol consumption is deeply rooted in human culture, and it's generally the people around you who will push you to consume. This pressure is independent of any profit motive, so removing the profit motive does nothing to affect it. > AFAIK rates of alcoholism aren't even different between state-run and private sector models Looking at some 2016 WHO statistics, the US seems to have ~3x the rate of alcholism as Iceland, but I recognise these are cherrypicked examples and I'm not interested enough to do a deep dive aggregating countries. Still, it seems plausible that government intervention can reduce alcholism rates. The fact that it's not 0% means nothing; nothing in the world is 0%, outlawing murder doesn't mean murder doesn't happen, but you can strive to reduce it as much as reasonably possible.
- fc417fc802 5mo ago
  Alcoholics (the really bad ones that we're presumably talking about here) don't consume because of social pressure. It's addiction and all the associated psychological and sociological complexity that implies. I expect any comparison of alcoholism rates will need to account for social (particularly religion) and socioeconomic factors. An awful lot of addicts are engaging in escapism.