
Top medical experts say we should decriminalize all drugs (2016) - anythingnonidin
https://www.washingtonpost.com/news/wonk/wp/2016/03/24/top-medical-experts-say-we-should-decriminalize-all-drugs-and-maybe-go-even-further/
======
fsloth
Finally. I hope this will signal a turning point on this insane approach to
national health in all countries. Drugs are a _health_ problem, not a criminal
problem.

Lone experts have been fired in western countries when they have expressed
this common sense sentiments alone [0]. I hope this groups fares better.

Nixon started the war on drugs anyway as a mean to attack left and black
activists [1]. Any previous legislation for control has been instigated on
behalf of race and class warfare.The fact that some drugs have been the staple
narcotic in some groups has been used as a control mechanism upon those groups
by criminalizing the substance.

Substance distribution should be controlled by law. But that is status quo
anyway - governments control the distribution of any number of dangerous
substances at any point.

[0] [https://www.theguardian.com/politics/2009/oct/30/drugs-
advis...](https://www.theguardian.com/politics/2009/oct/30/drugs-adviser-
david-nutt-sacked)

[1] [https://qz.com/645990/nixon-advisor-we-created-the-war-on-
dr...](https://qz.com/645990/nixon-advisor-we-created-the-war-on-drugs-to-
criminalize-black-people-and-the-anti-war-left/)

~~~
justonepost
Depends on your goal. If it's to reduce mortality, yes, decriminalize is good.
But it will increase usage.

~~~
ekianjo
>But it will increase usage.

Not necessarily. When people really want something they will eventually find a
way to get it anyway, it's not because you criminalize it that its usage
drops. Just like IP infringement has not significantly dropped since they can
put people in jail for it.

~~~
everdev
Well, barriers to entry matter. If you're craving a drug and it's sold in a
convenient store around the corner, you might purchase it more frequently than
if you had to buy it from potentially dangerous people in a seedy part of
town. That said, as with any bad habit I'm sure usage would still decrease
over time for most individuals as they mature or if healthier alternatives are
readily available.

~~~
joesb
Barrier to exit matters as well.

When you buy it from dangerous people, you have to be in contact with
dangerous people. It gives dangerous people leverage against you and people
who care about you.

~~~
alexasmyths
There is no 'danger' from 'not buying stuff from your dealer' anymore.

~~~
enord
I see you've never dealt with a dealer before.

~~~
alexasmyths
I've known many a dealer in my lifetime, and a distant family member who spent
some time incarcerated for 'high level' activity, who gives me long tales of
how the business works as well.

Dealers don't assault, endanger or attack random customers who just stop
buying.

That's totally absurd, and that someone would suggest it - indicates that they
are getting their information from Netflix/Hollywood films or something, not
reality.

The vast majority of dealers are actually fairly normal people anyhow.

~~~
enord
Well exuse me, I didn't know i was talking to a renneissance man. Addicts
wheel and deal with each other, rack up debts to eachother, steal from one
another. Some of them buy wholesale from larger distributors, usually with
credit, to be repaid with interest or else. They rob, assault, rape and kill
eachother over this stuff. I wish i was making this up.

Doctors in emergency rooms usually have instructions to confiscate any illegal
drugs they discover on OD-patients, but are faced with the very real dilemma
of leaving the patient at their creditors mercy. This can cause real harm (as
in "First do no harm") to the patient and their prospects of recovery or harm
reduction.

~~~
alexasmyths
If you don't pay your dealer, that will cause pain, and possibly violence.

But nobody is 'going after' someone who just decided to stop smoking
something.

~~~
enord
Maybe if that someone was just smoking pot and otherwise paid taxes. This
particular group of drug users are not the central point of concern of the UN
Special Assembly, even though its part of the wider problem. They are not
dying in the streets and they are not socially marginalized. Allthough
(anecdotally) i've known several fumb pot-smoking ducks who thought they could
finance their proclivity through distribution and wound up several thousand
dollars in debt to people who take names and chew bubble-gum.

------
jeffdavis
"scientific consensus"

I am very troubled by this phrase -- it's almost an oxymoron. Science is not
democratic, and scientists aren't anointed arbiters of facts.

Anyone can be a scientist simply by following the scientific method and
collecting data in good faith; and a lone outsider with new data can challenge
100 years of "consensus". Obviously they are subject to challenges themselves,
or if it's unlikely enough they might reasonably be ignored (e.g. a known
charlatan saying they observed cold fusion).

Did this terminology start with the "scientific consensus" on anthropogenic
climate change (which I do not dispute, by the way)? I think I understand why
it was used in that debate, but I don't think it was a good precedent. Now
it's being used to directly apply to policy ("growing scientific consensus on
the failures of the global war on drugs").

Before long, it will be used directly in political debates to try to force
some scientific organizations to choose a side. And then all credibility is
lost.

Researching policies that require deep analysis of scientific (or other) data
should be left to think tanks or something similar.

~~~
pjc50
> think tanks

I'm not sure what you think a think tank is, but they're basically either (a)
PR organisations, especially the ones with opaque funding or (b) some guy with
a letterhead and skill at getting articles published. They certainly _aren 't_
impartial in any way.

I'd much prefer my policy research to be done by civil service bodies which
might at least nominally be impartial.

I don't think it's feasible to impose a boundary between science and politics.
If scientists think that something is both true and important, then why should
they not speak up about it? Especially if they believe that doing so will save
lives.

~~~
dalbasal
Because of the effect of politics on intellectual honesty.

Once a debate triggers our "political" brain, it seems to scramble the kind of
intellectual honesty science requires. An even more insiduous cousin of the
maxim:

 _" It is difficult to get a man to understand something, when his salary
depends upon his not understanding it."_

I think the use of the phrase: "scientific consensus" indicates to jeff (it
does to me) that we are having that kind of a conversation, and its likely to
be quickly misused to the point where it makes reaching a political/societal
"consensus" even more difficult.

I don't think it's possible to seperate science and politics either, but I
think "Science" needs to be wary of speaking for science, instead of speaking
as well informed and interested individuals.

It's fine to speak for science on purely scientific matters. When it comes to
policy, especially social policy like this, it's preferable if they don't push
the boundary towards rhetorical cheating.

For the record, I agree with this article and most others on the "scientific
consensus" side.

~~~
jeffdavis
""Science" needs to be wary of speaking for science, instead of speaking as
well informed and interested individuals."

Well said.

"It's fine to speak for science on purely scientific matters."

The thing about science is that one high-quality study is often all you need
to have a lot of confidence. They don't need 100 experiments confirming the
Higgs boson, they just needed one really good experiment.

And bad studies can be summarily ignored for the purposes of fact finding. 100
bad studies are no better than one or zero. The only thing they tell you is an
area that may be interesting to conduct a good study later.

If there are a hundred high-quality studies saying one thing, and one high-
quality study saying something else, then something very interesting is going
on and everyone should pay close attention and get ready to learn something
new. But this is very rare and is certainly not a situation where you want to
inject politics.

So the only time when it makes sense for science and politics to intersect is
when you have one good study concluding something relevant to the policy
decision, and no high-quality studies to the contrary. And in that case you
only need to cite one study and be done with it -- you don't need to "speak
for science".

There is room to argue over the quality of experiments and studies, of course.
And that's where the sparks should fly -- not over signatures on a report. If
the results of one study are contended, it could go through some kind of
extreme peer review that can re-analyze the results or question the data
collection methods. The great thing about this is that laypersons will back
out and wait, and the scientists and statisticians can argue in peace among
their peers. When the smoke clears, then you can take those facts to the bank.

This doesn't for scientific fields where study quality is a major problem
(social sciences are hard and don't usually have nearly enough funding to
produce quality studies -- or have funding from overly-interested parties).
But in that case, you _definitely_ should not lend undue weight to the claims
by speaking for science.

------
blubb-fish
Here in Germany politicians are still stating that Cannabis is a gateway drug,
causes psychosis and makes stupid. They will even actively lie and twist
statistics.

My theory for why many politicians - especially from the right-wing - are so
opposed is b/c they didn't like their weed smoking and long-haired fellow
students. It's a Pavlov thing.

Like many people dislike golf (justly so in my humble opinion) b/c they
dislike the stereotypical golf enthusiasts.

~~~
lima
I'm strongly in favor of legalization, but I still believe Cannabis is
dangerous (just like alcohol, tobacco and countless other legal drugs are).

It's a well known fact that it can trigger psychosis in susceptible persons
and I have even witnessed it happen to a close friend.

It also had hugely detrimental effects on some of my weed-smoking friends, to
the point that I no longer want to spend time with them since it affected
their personality. I also know people who smoke it daily without any (visible)
negative effects whatsoever..

~~~
blubb-fish
it definitely should be used in moderation.

regarding psychosis - if you compare weed consumption with number of
schizophrenic diagnoses then the idea that weed causes schizophrenia can be
easily falsified.

but - of course - any psycho active substance can and will impair the mind of
somebody consuming it irresponsibly.

a lot of people micro dose weed - less than 0.05g per consumption unit -
that's not going to cause any issues.

~~~
lima
> if you compare weed consumption with number of schizophrenic diagnoses then
> the idea that weed causes schizophrenia can be easily falsified

That's not how it works. There are many potential triggers for psychosis in
general (and schizophrenia in particular), and there are reputable studies
which show that cannabis consumption is one of them.

> but - of course - any psycho active substance can and will impair the mind
> of somebody consuming it irresponsibly.

I think it's safe to say that even responsible use can have negative effects
for some people.

Likewise, the claim that micro dosing is not going to cause issues at all is
unfounded and dangerous. We simply don't know enough about it to make such
claims (enabling scientific research is a big argument for legalization!).

~~~
sooheon
So what? It is perfectly legal for me to choose to sit in a cubicle and rot
away the best years of my life, a fate little better than as clinical
psychosis. Let people do the things they want with their own lives.

~~~
blubb-fish
of course you are downvoted by the cubicle victims here. but bottom line you
are right. even alcoholism and liver zirrosis is considered socially more
acceptable than admitting you are vaping a bud once a week.

------
shihching
Perverse, plentiful incentives to addict and sell -- or invest in the
manufacturer who does so -- act quicker than panels of doctors, and dodge
responsibility too easily.

Living long lives as a beacons of philanthropic humanism on top of your legal
drug empire (or profits gained through accompanying ownership) counteracts
much stigma accrued from the deaths of your customers.

> On Tuesday [July 17, 2017], OxyContin manufacturer Raymond Sackler died at
> the age of 97. The same day, 91 other Americans died due to lethal overdoses
> of the pill that made Sackler a billionaire. Sackler died in comfort, in a
> hospital bed, with the best possible medical care, “following a brief
> illness."

[http://www.huffingtonpost.com/entry/raymond-sackler-
oxyconti...](http://www.huffingtonpost.com/entry/raymond-sackler-oxycontin-
dead_us_596f881ee4b0bb3867496f43)

~~~
abakker
A bit ad hominem, right? Do we complain about Alfred Nobel having invented
dynamite, which has been used to kill people?Pain medicine especially seems
like a place where we can't rush to judgement. Even if he acted badly, the
drug has done good for some people. Billionaires acting philanthropically is
probably better than them not acting that way.

~~~
shihching
The Huffington Post article is written by an anti-corporate former heroin
addict who, yes, clearly holds animus against those who profited off of
opiates.

> By convincing doctors that OxyContin was “safer,” offering financial support
> and special perks to family physicians who were willing to push the drug,
> and investing millions in a marketing campaign that claimed OxyContin was
> not only harmless but beneficial, Purdue Pharma cornered the pain pill
> market. By 2003, Purdue was selling $1.6 billion of the pill annually.

The crux of his condemnation is the incentivization of doctors to prescribe --
which one could call bribery. Also, the misrepresentation of known addictive
and deleterious long term health effects, which I believe could likely be
demonstrated through internal company documents.

Wealth allows the purchase of goodwill at a discount price -- the ultimate
destination of Mr. Sackler hinges on both the wilfulness and premeditation of
his capitalist technique and the breadth and compassion of his philanthropy.

Collecting and displaying Oriental artwork appears to be at the center of his
humanism -- the other side of which is biomedical research. I have not
scrutinized the publications emerging from the Sackler School of Medicine in
Tel Aviv, but for the sake of his soul and millions of prescription opiate
addicts, I hope the papers reveal cures proportionate to his profits.

------
Synaesthesia
As Chomsky said, the way to deal with drug abuse is through education and
treatment. That’s how we successfully reduced smoking, drinking coffee and
other unhealthy habits in the USA. Not by throwing people in jail.

~~~
brndnmtthws
Drinking coffee is unhealthy? You sure about that?

> Studies have shown that coffee may have health benefits, including
> protecting against Parkinson's disease, type 2 diabetes and liver disease,
> including liver cancer. Coffee also appears to improve cognitive function
> and decrease the risk of depression.

[http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-
he...](http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-
eating/expert-answers/coffee-and-health/faq-20058339)

~~~
spaceseaman
The high caffeine intake is still quite bad for your heart. And it's bad for
your teeth. Just googling shows that the scientific results have been quite
mixed. By that I mean that scientists have found some positive correlations,
and some negative ones.

From my layman's perspective, I would think a doctor would say there isn't a
consensus on whether coffee is holistically healthy. In other words, it's good
for some things, bad for others.

~~~
moozilla
What scientific results are you googling exactly? Everything I can find shows
a strong consensus that coffee has positive effects across the board. This
seems like a good summary:

[https://www.nytimes.com/2015/05/12/upshot/more-consensus-
on-...](https://www.nytimes.com/2015/05/12/upshot/more-consensus-on-coffees-
benefits-than-you-might-think.html)

Highlight from that article:

>There have been two meta-analyses published within the last year or so. The
first reviewed 20 studies, including almost a million people, and the second
included 17 studies containing more than a million people. Both found that
drinking coffee was associated with a significantly reduced chance of death. I
can’t think of any other product that has this much positive epidemiologic
evidence going for it.

I don't understand how you can claim coffee is bad for your heart in good
faith if you have read _any_ of the research... for example, this meta-
analysis of 36 studies:
[https://www.ncbi.nlm.nih.gov/pubmed/24201300](https://www.ncbi.nlm.nih.gov/pubmed/24201300)

> A nonlinear association between coffee consumption and CVD risk was observed
> in this meta-analysis. Moderate coffee consumption was inversely
> significantly associated with CVD risk, with the lowest CVD risk at 3 to 5
> cups per day, and heavy coffee consumption was not associated with elevated
> CVD risk.

I think any doctor worth their salt would tell you that there is a strong
scientific consensus that drinking coffee is not only completely safe, but it
has preventative effects towards cancer, cardiovascular disease, Parkinson's,
and Type-2 diabetes.

Here's a bonus review of 112 meta-analyses:
[http://www.annualreviews.org/doi/abs/10.1146/annurev-
nutr-07...](http://www.annualreviews.org/doi/abs/10.1146/annurev-
nutr-071816-064941)

> Of the 59 unique outcomes examined in the selected 112 meta-analyses of
> observational studies, coffee was associated with a probable decreased risk
> of breast, colorectal, colon, endometrial, and prostate cancers;
> cardiovascular disease and mortality; Parkinson's disease; and type-2
> diabetes.

~~~
ssijak
Well, at least anecdotally regular caffeine (several cups per day) intake
messes up your energy level, sleep patterns, etc. And if you mess with your
adrenal glands, there could be subtle and long-lasting effects on your energy
and mood.

~~~
KozmoNau7
That's a high intake, though.

A cup of day has solely positive effects, as far as I can tell from reading
the research.

All things in moderation and moderation in all things.

------
otakucode
Drugs were not made illegal because they're bad for your health and they don't
remain illegal because they're bad for your health. Poisons are generally not
illegal. Drugs are illegal because they make people feel good or make them
happy which offends the Protestant Work Ethic. The Protestant Work Ethic says
that the only legitimate route to happiness is through physically difficult
labor which causes you to suffer. The greater the suffering, the greater the
virtue and the greater the happiness you 'deserve' as consequence. The PWE is
not openly advocated or consciously held much any longer, but it was a large
part of US history and its effects stick with us.

Aside from just the people who have bought into the scaremongering about
drugs, there is a significant contingent of people who see it as 'unfair' that
anyone could use a drug and get even temporary happiness. Nothing offends
Americans (I simply don't know how prevalent this is in other countries) more
than the idea that someone else might be having an easier time than
themselves. It's why many would prefer companies to go without substantive
punishment for harming many people over having one person receive a large
punitive judgement in court cases. The McDonald's coffee lawsuit is usually
the canonical example. If McDonald's had only paid the lady actual damages,
they would have simply continued their practices and harmed more people. But
that is preferable to the situation where that one lady got a 'payday'.
Apparently nothing is worse than the feeling that someone else has had it
easier than one has had it ones self.

~~~
coleifer
Dope costs money. When you've got a habit and no job, how are you going to
pay? People steal to support their habits. Little children have their
childhood stolen because their parents were addicts. People crash cars and
kill people. That's why drugs are illegal.

~~~
rublev
Video games costs money. When you've got a habit and no job, how are you going
to pay? People steal to support their habits. Little children have their
childhood stolen because their parents were always gaming. People crash cars
and kill people because their attention is on their little screen. That's why
video games should be illegal.

You can do this with literally anything.

~~~
coleifer
That's patently absurd. You're not likely to see a gamer out there ripping and
robbing to support a habit. Do people get addicted to games? Food? Sex?
Whatever? Yeah sure. But by far drugs lead to more crime.

~~~
posixplz
Drugs do not lead to crime. Desperation and opportunity, the need to survive,
with a lack of morality, all directly lead to crime. Drugs do not make people
commit crimes. Emotions, those mental states, do however. What we need, as a
country, society, and human race is to recognize the importance of treatment
of the mind above all else. Reduce suffering. Sure, there will always be a
degree of sadness in life, we should as an intelligent species, strive to end
mental and physical suffering.

~~~
coleifer
I don't see a lot of clinically depressed people sticking guns in people's
faces. Nor do I think lack of morality has anything to do with addiction.

Rather than treat the mind, I believe in treating the spirit.

~~~
BatFastard
Totally! Lets try to remove the hopelessness from peoples lives that makes
them turn to drugs. We can put the whole drug fighting budget into mental
health.

------
ars
And not just recreational drugs. All drugs.

We trust people to manage their own life, this includes medicine. Maybe
insurance won't pay for it without a Dr, but if someone wants to self pay,
that's their choice.

~~~
shakna
There's a whole class of drugs guaranteed to kill your child during pregnancy,
and another where the interactions may seriously harm the child. Another where
two relatively harmless drugs, when interacting, can produce the previous
results.

It isn't acceptable to just put the risk on the average, uneducated person,
who is easily swayed by the way media portrays something. We have experts for
a reason, which is to guide us in what choices are safest, or "best" in the
current circumstances they face.

Here's a little example, which is fairly common:

Alice has borderline personality disorder. Most people don't notice, she just
seems to be rather outgoing, and prone to depression and anger. Alice isn't
sure she has it.

Bill, Alice's husband, convinces her to go to therapy, where the psychologist
practices Cognitive Behavioral Therapy (as CBT is the only government-approved
therapy), which has no affect.

Alice's psychiatrist puts her on quetiapine.

The amount is strongly controlled, because an overdose is very likely to be
lethal, and one of it's known side-effects is suicidal ideation.

She gains 10kg in a month, and her mood is barely affected, but people feel
more comfortable around her. The weight gain depresses her.

The psychiatrist moves her to lithium.

Alice finds she can live a normal life, and no one notices her being
outrageous anymore.

Alice and Bill decide to have a child.

Here's the hard part of "best": lithium is class D for pregnancy.

It's probably the best medication for Alice though, who has demonstrated she
is fully capable of being a normal and productive member of society.

The same problems will continue if Alice chooses to breastfeed, which is best
for the baby, so long as they are careful around medications.

\---

Neither Alice nor Bill are remotely qualified to determine what will, or will
not, harm a child.

> We trust people to manage their own life

No, we don't.

We create laws, and regulations, to guide people into making safe choices.

Seatbelts are every bit as useful as a prescription.

~~~
DanBC
Which country are you talking about? This treatment plan for a person with
borderlinePD is likely to cause harm.

> where the psychologist practices Cognitive Behavioral Therapy (as CBT is the
> only government-approved therapy), which has no affect

CBT is a short form therapy, normally about 8 weeks.

Do not use brief psychological interventions of less than 3 months.
[https://www.nice.org.uk/donotdo/do-not-use-brief-
psychologic...](https://www.nice.org.uk/donotdo/do-not-use-brief-
psychological-interventions-of-less-than-3-months-duration-specifically-for-
borderline-personality-disorder-or-for-the-individual-symptoms-of-the-
disorder-outside-a-service-that-has)

> Alice's psychiatrist puts her on quetiapine.

Antipsychotic drugs should not be used for the medium- and long-term treatment
of borderline personality disorder.
[https://www.nice.org.uk/donotdo/antipsychotic-drugs-
should-n...](https://www.nice.org.uk/donotdo/antipsychotic-drugs-should-not-
be-used-for-the-medium-and-longterm-treatment-of-borderline-personality-
disorder)

> The psychiatrist moves her to lithium.

Drug treatment should not be used specifically for borderline personality
disorder or for the individual symptoms or behaviour associated with the
disorder (for example, repeated self-harm, marked emotional instability, risk-
taking behaviour and transient psychotic symptoms).
[https://www.nice.org.uk/donotdo/drug-treatment-should-not-
be...](https://www.nice.org.uk/donotdo/drug-treatment-should-not-be-used-
specifically-for-borderline-personality-disorder-or-for-the-individual-
symptoms-or-behaviour-associated-with-the-disorder-for-example-repeated-
selfharm-marked)

What Alice probably needs is a long form talking therapy. Have a look at
_Meeting the Challenge, Making a Difference_ for more information:
[http://www.crisiscareconcordat.org.uk/inspiration/meeting-
th...](http://www.crisiscareconcordat.org.uk/inspiration/meeting-the-
challenge-making-a-difference/)

~~~
vidarh
I don't know whether you or the person you're replying to is more correct, but
it doesn't change their point: That these decisions are not something the
average person should be making for themselves. If anything, your disagreement
kind of makes the point even clearer.

Maybe there might be an argument for people to be able to choose to obtain
drugs like the ones mentioned by GP, but not without some kind of control-
mechanism to at a bare minimum ensure they have been presented with the risks
and have given some level of demonstration that they understand them.

E.g. I quite like the mechanism now in place for online pharmacies in the UK,
where you can buy prescription drugs like Viagra, or OTC but restricted
products like Daktacort (combination anti-fungal and steroids), but need to
convince a doctor (for the former) or pharmacist (for the latter) in writing
that you've at least bothered to read what they've written about the drugs
(since nothing stops you from just faking the symptoms, but you at least need
to describe relevant symptoms free-form semi-coherently, or they'll do
additional checks before selling to you).

It has weaknesses, and certainly won't stop people from abusing abusable
drugs, but it at least makes it possible to pick up on the most idiotic
attempts at misusing drugs they don't even understand.

Alternatively, I've used PushDoctor a couple of times - a UK service that
connects you with an actual GP via video chat; the last time it took me 10
minutes from I scheduled an appointment until I'd uploaded pictures of a rash,
had a conversation with the GP and had the prescription passed to a local
pharmacy electronically; even _if_ one were to consider taking away their
"gatekeeper" role in terms of letting them deny treatments they don't think
are necessary, I don't think it'd be unreasonable to still at least require a
consultation like that for the most dangerous drugs to give an opportunity to
at least inform.

~~~
arielb1
But these are "customer protection" laws, which are intended to make sure
people are informed and to make it reasonable to shop in the street, not to
protect against people who intentionally try to break them.

They are easily opted out of - they won't prevent you from e.g. buying
whatever you want from China, and that's by design. There's no point in
protecting a customer that doesn't want your protection.

As opposed to drug laws, which are designed to make drugs hard and dangerous
to buy, even if you really want them.

~~~
vidarh
And that's how I think it makes sense to treat narcotics too.

------
runesoerensen
It's worth noting that this article is from March 2016 (e.g. before the UN
failed to course correct at UNGASS 2016), and that this and many other efforts
have failed already.

There are some related discussions in this thread from last year after UNGASS:
[https://news.ycombinator.com/item?id=12601956#12602296](https://news.ycombinator.com/item?id=12601956#12602296)

------
anythingnonidin
Some reasons for decriminalization of use and possession, summarized:

(i.e., removing criminal penalties or making it no jail time possible, but not
government supplied)

\- War on drugs has failed. Criminalization has consequences on community - in
many cases, most of the negative effects come from the criminalization, not
the drug.

\- Consensual crimes that don’t harm others shouldn’t be crimes.

\- Drug prohibition doesn’t seem to decrease use — Portugal. (Also perhaps
Czech, Italy, Spain?)

\- Drug war enforcement costs a ton, we could save tax money.

\- 1.2 million people arrested for drug possession in 2015.
[http://www.drugwarfacts.org/chapter/crime_arrests#arrests](http://www.drugwarfacts.org/chapter/crime_arrests#arrests)

\- Prisons are crowded. Would reduce this a little.

\- Easier for addicts to seek treatment.

I think the strongest reasons are that drug use should be treated as a health
issue and not a criminal issue, and that consensual crimes that don't harm
others shouldn't be crimes.

What is the single strongest reason for or against decriminalizing all drugs,
in your opinion?

~~~
rectang
The main reason we won't get decriminalization is moral panic. :( But if we
did...

There are still better and worse ways to make drugs available. Same as with
alcohol, addicts doing high volume are where the money is -- and it's better
to design regimes that prevent commercial actors from abusing vulnerable
populations. Mark Kleiman has a lot of great stuff to say on the subject.

~~~
microcolonel
> _and it 's better to design regimes that prevent commercial actors from
> abusing vulnerable populations._

Unless we're looking to apply the law inconsistently based on some arbitrary
prejudice of "vulnerability", this would seem to be basically what we're
already doing. Any decriminalization approach which criminalizes access for
addicts almost defeats the purpose according to your own rubric.

~~~
vidarh
Consider that some countries have state monopoly stores for wine and stronger
alcoholic drinks, and most no longer allow advertising for alcohol.

Similarly, consider the option of regulations like those in place for
pharmacies in some countries, that e.g. requires the pharmacist to ensure you
are aware of certain risks, but doesn't prevent you from buying.

Consider the way some countries now requires tobacco to be out of view and
with health warnings all over or no branding.

In other words: There are mechanisms you can put in place that legalizes drugs
fully, but still heavily restricts commercial entities ability to try to take
advantage of peoples weaknesses.

Personally I believe even drugs like heroin should be legal, on the basis of
harm reduction, but at the same time, I don't see a problem with e.g.
restricting where it can be sold and ensuring that it's sold in plain
packaging, no advertising is allowed, and to e.g. have a pharmacist inform you
of the risks before selling it. I don't think that threshold will be high
enough to make people go to a dealer, but it may still reduce abuse.

In the UK there are restrictions on how many pills of paracetamol
(acetaminophen) and ibuprofen you can buy at a time, for example. In
pharmacies you can buy up to 32 of each at a time, while elsewhere only up to
16 of each at a time. Those restrictions were put in place because of overdose
deaths, and they appear to have saved hundreds of lives so far, while being
lenient enough not to drive anyone to a black market.

So while I think we should be allowed to buy pretty much whatever drugs we
want, we can combine that with making it sufficiently unattractive that you're
not buying them on a whim.

~~~
microcolonel
I live in a place where the government had a monopoly on alcohol retail until
recently (Ontario, Canada). I don't think it had any impact on sales. The
biggest factor was price, the government fixed the prices fairly high (but
those prices were the same for the retail exceptions, such as brewers' own
premises).

> _Personally I believe even drugs like heroin should be legal, on the basis
> of harm reduction, but at the same time, I don 't see a problem with e.g.
> restricting where it can be sold_

Well, if you nationalize heroin retail, then you will need to have a heroin
shop in every hamlet, town, and neighbourhood. It hardly seems practical.
You'll just end up with a somewhat smaller black market, instead of
eliminating it.

~~~
vidarh
The point of having the monopoly is be able to strictly enforce restrictions
on things like marketing through an organization that is judged by compliance
rather than by selling as much as possible.

> Well, if you nationalize heroin retail, then you will need to have a heroin
> shop in every hamlet, town, and neighbourhood. It hardly seems practical.
> You'll just end up with a somewhat smaller black market, instead of
> eliminating it.

Yet somehow places like Norway, with a population density nearly identical to
Ontario manages to keep the black market for wine and spirits quite small,
despite very high taxes on them compared to e.g. neighboring Denmark.

Which means there already _is_ a suitable retail network. Or you can license
pharmacies.

And the big difference is that people would be assured of getting clean,
uncut, predictable doses. The cost of heroin is also so high and unstable that
while there is reason to be concerned about making it too cheap, a large
portion of the harm from heroin today is the high cost. The daily consumption
of heroin for a typical user in clean, medical grade heroin costs less than
$20 (we know, because it is produced for medical use, and prescribed e.g. in
UK hospitals).

------
lord_jim
Full steam ahead with decriminalization of possession/use, and with regulated
markets for psychedelic and most stimulants

However after seeing how business behaves when it can sell opiates, I'm in
favor of even more regulation than we currently have on some drug markets

(Also, if it were up to me, I'd ban ads for drugs, including alcohol and
prescriptions)

~~~
Synaesthesia
Stimulants can be pretty dangerous TBH. I don’t think class a drugs should
just go on sale, but I don’t think people should be locked up for them. Baby
steps.

~~~
vidarh
The problem is that for a lot of these drugs the greatest harm comes from the
lack quality control and regulation of sale.

Not just because it results in drugs getting cut with all kinds of shit, and
people being sold the wrong thing (e.g. selling heavily cut fentanyl instead
of heroin), but also because of a the race to find alternatives that slip
through cracks.

A great deal of modern drugs only exists to circumvent the law, either because
they're not covered for a while, or because they can more easily be produced.
E.g. a number of "synthetic cannabinoids" have been manufactured, and so far
indications are that at least some of them have health effects that are far
worse than anything possible to tie to actual cannabis.

Without decriminalising and regulating manufacture and sale, there will still
be an incentive for dealers to sell drugs like that which nobody particularly
want, and that increases harm, instead of selling clean versions of the safest
drugs.

E.g. for opiates, many of them are "close enough" in terms of effect that
there is a lot of potential harm reduction benefit just in getting the more
dangerous variants off the market by legalizing and regulating the safest
ones. Unlike blanket bans that has a hope of working.

~~~
Synaesthesia
Yes but even the pure, quality drugs like adderall, which is really
amphetamine can be dangerous.

For opiates, especially people injecting, it is very inportant to get clean
drugs, and actually opiates are not particularly harmful to the body if used
correctly. They also don’t really present a threat to society if given the
drug. Holland has provided addicts with heroin with great success, as a form
of treatment.

~~~
vidarh
They can be, but so can a lot of drugs sold at the grocery store. E.g.
paracetamol/acetaminophen is one of the largest causes of liver damage in the
UK. One of the big shifts there has been to restrict size of packaging and
require pharmacists to exercise care (some will explicitly verbally warn you
about the risk).

Ultimately I think that we'd in many respects do a lot better if it was
possible for someone who wants to use things like Adderall for recreational
use to go to their doctor and ask for advice and appropriate monitoring and
know they won't be refused, than having people randomly taking it without
getting proper advice.

But I also think another large potential benefit would be for doctors to be
able to steer those who insist on using drugs to safer analogs were possible.

------
marze
Bottom line is deaths from overdose.

Drugs criminalized, USA:

150 deaths/million people/year

Drugs legalized, Portugal:

3 deaths/million people/year

~~~
yznovyak
Death penalty for drug trafficking, Singapore:

0 deaths/million people/year

~~~
maze-le
Drug use might be more prevalent than the official statistics suggest.

[0]:
[https://www.reuters.com/article/idUSSIN135004](https://www.reuters.com/article/idUSSIN135004)

------
II2II
While I support the decriminalizing of drugs, I also have to question how
effective it would be if all drugs were decriminalized and became highly
regulated.

Example 1: prescription drugs are highly regulated, yet their legal
availability has not stopped criminal activities surrounding the illegal
trade. Legalizing may solve some social issues relating to the war on drugs,
but not all.

Example 2: alcohol is legal, easily available, and has a (proportionally) low
amount of illegal trade. On the other hand, a lot of people do illegal stuff
when impared by it. Perhaps some drugs should not be legal, particularly since
there is worse stuff ou there.

On the other hand, you have example 3: tobacco. Reasonable precautions taken,
its main issue is self harm due to the impact on health. While there are
obvious reasons to regulate its use (e.g. people frequently smoke in
environments where it can harm others), do we really want to regulate self-
harm?

Perhaps we should be regulating based upon the drug, keeping some illegal,
rather than pursuing blanket legalization and regulation.

Edit: an occurance of legal should have been illegal.

~~~
tertius
> do we really want to regulate self-harm?

In the worst cases we do: Euthanasia.

Drinking under 21: We do.

Marijuana use under 25: We should.

~~~
pitaj
I don't. I think drinking age should be 18, and kids should be allowed to
drink with their parents. I think marijuana should be the same way. I think
assisted suicide should be allowed (euthanasia is different).

I think every drug, even prescription medicines, should be totally legal to
possess, distribute, sell, and buy.

~~~
tertius
Why should we limit it by age?

Also, you say that "I think x,y,z." But you do not say why. Do you have some
expertise that informs your decision on safety or is your opinion purely
philosophical (based on personal freedom or even Darwin Awards)?

------
chewz
Sure. How do you keep millions of unemployed people happy? Give them drugs and
UBI.

------
good_sir_ant
Decriminalization of drugs would have to come with a massive restructuring of
our social programs. You could get into a lot of trouble by financially
supporting people who become addicted beyond their control.

~~~
amigoingtodie
As opposed to now? Many of today's opiate addicts' supply is subsidized by the
US taxpayer.

------
SilentCrossing
The article is about "decriminalization of all nonviolent drug use and
possession". This sounds noble, but as we found out in the Netherlands you
will have to make a distinction between soft drugs and hard drugs. Hard drugs
is always associated with crime and most of the time violent crime and gangs.

So I would say. Been there done that. We are cracking down on this type of
policy, since 'education' does not work and it seems that prisons do not make
the criminal as some other comments claim... Well they can always wish for it,
but reality does not care either way.

~~~
katastic
We're living in a strange culture of over optimism that thinks if we just
magically change certain systems "literally everyone will be better."

No. Heroin users aren't going to magically become productive members of
society just because we legalize heroin.

~~~
KozmoNau7
Maybe not, but the heroin addicts will no longer have to resort to robberies
and other crime in order to fund their addictions, and it will become easier
to offer them help and treatment.

~~~
chrisan
> the heroin addicts will no longer have to resort to robberies and other
> crime in order to fund their addictions

How does decriminalization of the possession and use lead to increased money
for addicts that they will no longer have to resort to illegal acts to fund
addictions?

Less jail/court fees = more money in pocket to buy drugs?

~~~
KozmoNau7
To be clear, I'm a proponent of full legalization, not just decriminalization.

------
knodi123
Why would medical experts be considered authoritative? It's a legal and
political problem. For the record, I agree with the doctors, but I think
decades of research into marijuana have already demonstrated that medical
facts have jack shit to do with legislative agendas.

My guess is, the only way we'll move past this ridiculous situation is if a
majority of individual states decide to legalize hard drugs the same way a
minority of them have already legalized weed, and eventually the federal
government will cave in once they realize it's not going to cost anybody an
election. That is, it will take lots of baby steps over a couple of decades. I
hope I'm underestimating progress, though!

------
watertom
Legalize.

Why should we funnel money to illegal drug cartels to fuel their crime and
violence by decriminalizing drugs?

------
burger_moon
What about other drugs like steroids and growth hormones? Those are schedule 2
drugs which can be prescribed but have no addictive properties. Testosterone
is something your [male] body produces but even if you have a low free T count
doctors often still won't prescribe it, and since you cannot buy it legally
most men live out their lives feeling the negative affects of this.

Of course the focus is always on weed, opiates, and other common
hallucinogenic drugs, but what about all the other drugs that aren't.

What is the reason for those to be illegal? I legitimately don't know the
reasons because even the reasons for 'harmful' drugs causes lots of debate
such as the comment thread here shows.

~~~
redblacktree
Steroids are drugs of abuse by athletes seeking better performance in their
sports. That is the reason why it's scheduled, despite low addictive
potential.

------
sjwright
Even if you had a staunchly anti-drug stance, it's also fair to say that law
enforcement resources are not unlimited. Dealing with drugs like cannabis and
cocaine are a waste of taxpayer dollars relative to serious issues of opioids
and methamphetamine.

------
anythingnonidin
Full report:
[http://www.thelancet.com/journals/lancet/article/PIIS0140-67...](http://www.thelancet.com/journals/lancet/article/PIIS0140-6736\(16\)00619-X/abstract)

------
AKifer
The drug war not working does NOT mean that all the drugs should be
decriminalized. If you fail to fight drug cartels, it's a political and
organizational issue. We should never fall into the trap of mixing everything.

------
leksak
> decriminalization of all nonviolent drug use and possession

What is meant by nonviolent drug use?

~~~
DanBC
You can't be a criminal gang that murders people to smuggle the drugs into the
country.

You can't be a criminal gang that forces modern slaves to grow cannabis in
squat houses.

You can't be a criminal gang that uses violence to control a street corner.

------
danschumann
The way to "win" the drug war, is the way you win in capitalism.
COMPETITION!!! No one would go to illegal drug gangs if they could go to
7-11(or similar).

~~~
ringaroundthetx
Out of curiosity, what goods and services will people in that line of business
switch to?

Will they exploit inefficiencies in other drugs markets that the state hasn't
caught on to yet? And just accept the diminishing returns before switching to
the next drugs?

Will they try other lines of business, like computer hacking syndicates?

Or they all magically disappear, or be cut off from appearing because there is
simply no unskilled labor + high margin + low overhead business line
remaining?

~~~
danschumann
What happened to the gangsters of Al Capone's day, when prohibition took away
their competitive edge? Did they sell "insurance"? You seem quite passive
aggressive, without offering any thoughts yourself.

My guess is, most will be unemployed. They aren't criminal geniuses. They've
found a cheap way to make money and get high at the same time, most of them.

------
grondilu
Imagine a old dam. It's in poor condition, with cracks here and there, letting
some water through. Its maintenance is extremely expensive and seemingly
useless, since for ever crack that is fixed, a new one appears.

Now some guy shows up and says "this dam costs us too much and we are failing
to fix it. Let's just blow it up!"

~~~
OscarCunningham
So the problem with blowing up the dam is that there's a large amount of water
behind it that will flood out dangerously if they blow up the dam. I guess?

So what's the analogy here? You think there's a large amount of potential drug
users who will suddenly start abusing as soon as drugs are legalised?

~~~
grondilu
> You think there's a large amount of potential drug users who will suddenly
> start abusing as soon as drugs are legalised?

The opiod crisis already is quite severe. And yet most opioids are illegal. I
doubt making them legal will decrease usage. Also, if they were legal, big
pharma companies would see them as business opportunities. Things could get
ugly fast.

~~~
TallGuyShort
I'm not following any of the logic here. Big pharma companies are already
making a killing on a significant portion of the opioid addiction epidemic.
They're legally (but perhaps irresponsibly) prescribed by a doctor, and either
become abused by the intended patient or subsequently depart from those legal
channels.

The opioid crisis isn't the only crisis. America hovers around being the 1st
or 2nd worst incarceration rate in the world, and it's predominantly non-
violent drug offenses. Friend of mine just lost a job offer they had
provisionally because of a tiny marijuana possession charge from years ago,
and that's happened to them over and over again.

If your best argument in favor of continuing to ruin people lives over
something so petty is "big pharma will make money off of opioids", I call
bullshit.

edit: I would also argue that in your analogy, there is almost no water built
up behind that dam, and getting rid of the dam would hardly be noticeable
downstream. We can't even keep drugs out of prisons very well. I live in a
town that hasn't had a single case of violent crime in 13 years, and yet I
know _exactly_ where I could go and buy some heroin right this very minute if
I wanted to. I know where in the Bay Area I could buy some meth if I wanted
to. And these are locations that have been repeatedly raided by the cops, but
the selling of drugs at those locations doesn't stop, because someone else who
recently finished their sentence will just take over while the person who got
busted servers theirs. I was in a concert venue last night with cops, and
weed, everywhere. Freaking out about the weed, but no one caring about people
having 6 or 7 beers and then getting in their cars to drive home drunk at 1am.
The dam makes zero sense to me.

------
bigtex
This was a very good interview with a neuropsychiatrist, Dr. Phyllis Bonafice,
who has a different opinion,
[https://youtu.be/W_i2mC5fAmI](https://youtu.be/W_i2mC5fAmI). I do think
focusing on treatment more than punishment may be a better idea in most cases.

------
vectorEQ
a lot of drugs used to be legitimate drugs,but are now illegal to be able to
sell other shitty substances which are more expensive and often less
effective. example: mdma treatment for ptsd. most ptsd treatments are ill
effective these days, but before wo2 mdma treatment was very effective. it's
now only able to be given in certain places, usually from people who can't
licence themselves properly, adding risk to this treatment where before it was
solid. [http://www.mdmaptsd.org/news.html](http://www.mdmaptsd.org/news.html)
most banned substances are just 'buisness deals' between pharma industry and
government. For the US people, this is not just due to war on drugs. war on
drugs is an effect , not a cause.

------
transverse
Instead of drugs, I think we could ban fried chicken and watermelon exceeding
a diameter of three inches. It would be more effective for the goals the
government has in mind. Fried chicken is well, fried, and a large watermelon
can be used to hit someone and cause head injury.

------
blauditore
Honest question: How would decriminalization of drugs work in practice? Would
it be legal to e.g. import and sell cristal meth in stores? What about cheap
self-made alcohol that might contain dangerous stuff like methanol; where do
you draw the line?

~~~
MaxfordAndSons
Decriminalization ≠ legalization; the idea here is decriminalizing usage and
personal possession, which in no way entails legalizing production,
cultivation or commercialization. The point is to enable addicts to seek
treatment without fear of legal trouble.

~~~
subroutine
I would argue, somewhat pedantically, that decriminalization = legalization.
Drug use can either be legal or illegal. Drug possession can be either legal
or illegal. Same for drug, manufacture, and drug distribution.

In that order: use, possession, manufacture, distribution

I think you will get a reduction in the number of people who would agree with
having no restrictions. For instance, drug use is probably ok, but not while
driving a vehicle, or playing a competitive sport. Drug possession is probably
fine, but not more than X amount. Drug manufacture might be fine, if you are
just growing/making for yourself. Drug distribution is probably not ok unless
you have a license and follow state/federal guidelines.

I think where the law breaks down is under: 'possession'

If it's legal to possess say, 200 pills of oxy at any time, no Rx, no
questions asked, I don't see how that isn't going to result in increased
distribution.

------
stretchwithme
I think the best approach is to allow each neighborhood to decide what
recreational drugs, if any, can be consumed in public. And only enforce such
restrictions with fines, not jail time.

Regulating at the neighborhood level makes it easier to live in or travel to
the kind of neighborhood you want to be in. People that want to use drugs in
public where they live can pick their neighborhood accordingly.

The more permissive neighborhoods can tax drug use to pay for any negative
consequences of drug use. Maybe they need more enforcement of traffic laws,
for example.

If we allow everything everywhere, eventually there will be pressure to
control everything again. Better to allow people who want drug-free
neighborhoods to have them, while ensuring that those who want to use drugs
are still able to.

------
mac01021
I can't read the article because I have no Washington Post subscription.

But isn't this more of a question for an economist than one for a medical
doctor?

------
Yaggo
I like how 'drug' can refer to both medicin and non-medical substances in
English. In Finnish, they are two separate words.

------
Madmallard
Seems really dangerous to have things like PCP and Heroin available

------
pcurve
I think this can cause interest shift in relevant job sectors.

~~~
anythingnonidin
How so?

------
AKifer
I'm thinking internally if all this buzz on drug decriminalization isn't just
the visible part of darwinian process that will naturally eliminate the
stupids and the mentally weak from humanity gene pool.

~~~
fifnir
Yeah their idiotic comments in online forums should hopefully make them
undesirable to the opposite sex...

------
csmark
So 22 medical experts state the War on Drugs "directly and indirectly
contribute to lethal violence, disease, discrimination, forced displacement,
injustice and the undermining of people’s right to health."

In Mexico 23,000 people were killed in drug related violence in 2016. Drug
overdoses in the USA jumped to 59,000 in 2016. Arrest numbers in the USA in
2015 totaled 10.8 million. Drug related: 1.49 million; (Broken down: 1.25
million for drug possession; 340,000 for sale or manufacture.) 1.09 million
drunk driving; 11,092 for murder or manslaughter.

Ratios of note: 438:1 Possession:Sale or manufacture; 1.25:1.5 Drunk
driving:Drug related.

Government v Science: In 2009 a British psychiatrist and
neuropsychopharmacologist was sacked from his position chief drug advisor
position in government after publishing a list of most to least harmful drugs.

"Alcohol and tobacco are more harmful than many illegal drugs, including LSD,
ecstasy and cannabis..."

He also stated horse riding was safer than ecstasy with 100 riding fatalities
per year(on average).

The political blowback was massive. On the floor in House of Commons MPs
vehemently rebuffed the document and its author. It was a parade of "my
ignorance trumps your expert scientific opinion."

The congress and courts in the USA are no better. There's no official list but
there is a pattern that has no scientific basis. The crack epidemic of the
late 80's saw congress pass mandatory sentencing laws for crack. Crack is the
crystalized version of cocaine. It was popular in the inner city minority
population. Movie stars from the 80's would have a "cocaine nail." The nail on
the pinky finger (it could be any finger) would be noticeably longer. Carrie
Fisher in the Empire Strikes Back has one that really stands out.

[https://www.theguardian.com/politics/2009/oct/29/nutt-
drugs-...](https://www.theguardian.com/politics/2009/oct/29/nutt-drugs-policy-
reform-call)

[https://www.theguardian.com/politics/2009/oct/30/drugs-
advis...](https://www.theguardian.com/politics/2009/oct/30/drugs-adviser-
david-nutt-sacked)

It was difficult to locate reputable sources of recent data on costs in the
United States. Tobacco and alcohol combined total slightly over $600
Billion/year while illegal drugs are estimated at just under $200 billion.

[https://www.verywell.com/what-are-the-costs-of-drug-abuse-
to...](https://www.verywell.com/what-are-the-costs-of-drug-abuse-to-
society-63037) Joshua J. (2017) The Consequences of the Use of Illicit Drugs
and Their Associated Private and Social Costs. In: The Economics of Addictive
Behaviours Volume III. Palgrave Macmillan, Cham

[http://ktla.com/2017/05/09/23000-killed-during-mexicos-
drug-...](http://ktla.com/2017/05/09/23000-killed-during-mexicos-drug-wars-
in-2016-making-it-second-deadliest-conflict-in-the-world-after-syria/)

[http://www.occnewspaper.com/americans-are-still-getting-
arre...](http://www.occnewspaper.com/americans-are-still-getting-arrested-for-
marijuana-possession-at-staggering-rates/)

So you discussed your drug habit with your physician? Physician–patient
privilege isn't a sure thing anymore. The police are requesting and getting
warrants to access a person's medical files. I didn't know this was happening
until I started writing this post.

[https://www.aclu.org/other/faq-government-access-medical-
rec...](https://www.aclu.org/other/faq-government-access-medical-records)

Anythingnonidin has a good list of reasons.

A few others:

\- Alcohol is legal yet it's the only drug where stopping cold turkey can be
fatal. Most people have heard of DTs or the shakes. So drinking too much too
fast and not drinking afters of hitting the bottle every day can both be
fatal.

\- It's impossible to overdose on cannabis. People do have bad reactions or
trips and go to the hospital but it's nothing life threatening.

\- For profit prisons (almost always) cannot take prisoners who've committed a
violent crime. Wonder why the dealer to possession ratio was 1:438? This is
probably a factor.

\- We have 5% of the world's population but 25% of the world's prisoners

\- Tuberculosis, HIV, Hepatitis C - The sentence wasn't for live but these
transmissible diseases are.

\- "If we legalize drugs think of the damage to the economy. ATF, prison
guards, police, cities that are only financially solvent because of the income
from the courts and prisons would face financial ruin. \- Innocent until
proven guilty unless there's a empty cell? How is this not a conflict of
interest for the parole board?

\- So we hear nothing about how many drunks get behind the wheel of a 3000lb
vehicle. Only after 3-5 DWI's will they possibly face prison time. Someone
smoking weed is "a threat to national security?" They pose a threat to the
safety of the community. That car swerving down the road only get a slap on
the wrist.

\- I don't think it should be all drugs and I don't think the article made
that argument. The point was to stop treating a health condition as a crime
and end what Nixon started.

------
palad1n
Paywall?

~~~
grzm
There's a workaround via Facebook: here's an example of its use:

[https://news.ycombinator.com/item?id=15270969](https://news.ycombinator.com/item?id=15270969)

~~~
anythingnonidin
A clickable one for this one would then be:

[http://facebook.com/l.php?u=https://www.washingtonpost.com/n...](http://facebook.com/l.php?u=https://www.washingtonpost.com/news/wonk/wp/2016/03/24/top-
medical-experts-say-we-should-decriminalize-all-drugs-and-maybe-go-even-
further/)

------
caxistic
Needs to go even further, and deregulate access to prescription drugs as well,
to open up provider competition and increase consumer choice.

~~~
anythingnonidin
What does this mean? Make all Rx drugs OTC?

~~~
andrewfromx
I think we leave the Rx system as is, in that we still let pharmacists do
their job and protect their mainstream normal patients and give good standard
of care, but any party drugs where there is already a clandestine market
become OTC. i.e. if you want some weird medicine for some weird thing that no
one else wants, you'll have to go through the steps to get a Rx for it. But it
won't be hard to get. Because once adderall is OTC there will be 1000's of
freed up doctors who don't have to write Rx for that.

~~~
fujiters
I just wish we could do away with having to get the prescription in the first
place and have the pharmacist be the gatekeeper. You keep a medical history on
file so they can quickly figure out if the medication you want is likely to
cause complications. Then I don't have to leave work and meet with my doctor
every few weeks/months to get another prescription which I then have to take
to the drug store and wait to get filled.

~~~
vidarh
In the UK we now have at least three alternatives (other than "grey market"
import; most prescription drugs outside of narcotics can be legally imported
to the UK for personal use):

For OTC drugs with restrictions, online pharmacies can sell subject to asking
you sufficient questions (and potentially doing a followup call if you answers
raises questions). This covers drugs like steroid creams and the like which
may have risks, but are usually ok.

For prescription drugs, online pharmacies can likewise sell to you if they
have you fill in a questionnaire and a qualified GP agrees to write a
prescription for you. This is increasingly done for low risk but prescription
only drugs like Viagra.

The mechanisms above are simple enough that even though buying from e.g.
companies shipping from Indian manufacturers is trivial in the UK, I'll prefer
UK online pharmacies when possible as the extra hassle is minimal and they're
better regulated.

Alternatively there's a service called Push Doctor (I've got no connection to
them other than being a satisfied user) that lets you have an actual
conversation with a doctor over a video chat (+ text chat and ability to
upload images) after which they can issue you a prescription that gets sent
electronically to the nearest pharmacy. I've tried it twice - once I got seen
within an hour, the other time in less than 10 minutes, and the prescriptions
were ready within half an hour in both cases, so I could just wait for a text
message and go pick it up when it was ready.

It's a fantastic service - the only downside is it's private only, and while
the consultations aren't expensive (28 pounds or 20/month), for more expensive
prescriptions it's not great as you'd be paying full price for the drugs (but
you do have the option of e.g. use them for diagnosis and go see your GP to
get an NHS prescription if they think you need anything expensive, so you at
least avoid having to visit your GP for minor things); I'd love to see this
service get a deal with the NHS...

With the above setup there's very little reason to take risks as the barriers
are low enough for most people to have very little reason to circumvent them.

I do agree with you though that for most drugs delegating it to a pharmacist
would probably provide a good enough barrier - at least in the UK, and I
suspect most other places too, they're well educated. When it isn't we should
ask why. E.g. are doctors looking for signs of any issues? If those issues are
simple enough and there's low enough abuse potential, then either let
pharmacists do it or standardize a questionnaire.

------
dispo001
Drugs cause psychopathic behavior in those who didn't take them.

It is all because of a self-enslavement formula where it is magically expected
to have every angle of everyones life managed by others.

I say we force them to smoke the weed and calm them the fuck down. It's just
better for them.

~~~
dispo001
I suppose I should clarify that without joking so much.

Drug addiction can be very harmful but society retaliating against the victim
is endlessly worse.

Its like death by a thousand cuts, everyone seems to want to take a stab at
the person as if that is going to cure them but it only makes them use more.
They have to hang out with criminals to buy their fix and become one
themselves to finance it.

A drug addict can be successful and have a happy life but only if no one finds
out. When people do it triggers a kind of social death spiral.

You get the proverbial guy drinking a liter of coffee then smoking a cigar
with a glass of whiskey at 11 am ranting about drugs as if the drug user is
the embodiment of evil on earth.

