
Alcohol and tobacco kill far more people than opioids - anythingnonidin
https://www.vox.com/policy-and-politics/2017/10/27/16557550/alcohol-tobacco-opioids-epidemic-emergency
======
crankylinuxuser
I've never been a fan of these kinds of articles. They beg the question "Why
arent we doing X?". There's a similar article about "Why aren't we stopping
gamblers from addictive behavior?" on HN's front page. They seem to share a
trend:

They look for legalistic controls over an individuals actions. And both
attempt to say that their actions are addictive, therefore we cannot trust
their actions, so we have to decide for them. I'm not comfortable with that
logic. Nor am I for shoving more drugs underground. Cause that's that high
taxation and controls do.

I tend to go on the side of freedom, even if it's "free to be dumb". And
people will do destructive things. I don't particularly like this notion of
nanny state.

~~~
abhi3
> I tend to go on the side of freedom, even if it's "free to be dumb"

The issue is not as simple as you characterize it. Should 'freedom to be dumb'
include freedom to drive drunk/while texting?

>And both attempt to say that their actions are addictive, therefore we cannot
trust their actions, so we have to decide for them.

You seem to think that these controls exist for the protection of the addicts.
They don't. They exist to protect the society and economy from a downward
spiral caused by widespread drug addiction - which is what will happen if you
remove all controls.

~~~
crankylinuxuser
> The issue is not as simple as you characterize it. Should 'freedom to be
> dumb' include freedom to drive drunk/while texting?

But, it is. No law stops drunk driving. It is "illegal", but that's only a
threat after the fact. And bringing cell phones is only a recent phenomenon..
How about people who read books while driving, or eating, or a thousand
different things?

You only need 1 law for this: distracted driving. Distracted can be from doing
things unrelated to driving, or being high, or drunk, sleepy, or whatever.

And I also have issue with "drunk driving". The .08 standard is not based in
science. It's from MADD lobbying. And to be honest, if someone drives well at
.08, so be it. People have different sensitivities - you should reasonably
know if you're not safe.

> You seem to think that these controls exist for the protection of the
> addicts. They don't. They exist to protect the society and economy from a
> downward spiral caused by widespread drug addiction - which is what will
> happen if you remove all controls.

So throwing people in metal cages is a good solution here? Cause that's the
cost that the US has accepted when violating these controls. And these laws
don't exactly have a good result either.

~~~
abhi3
>So throwing people in metal cages is a good solution here? Cause that's the
cost that the US has accepted when violating these controls. And these laws
don't exactly have a good result either.

Compared to the Opium Wars where China had to go to war with Britain to
prevent civilizational collapse from drug use, yes jailing peddlers of poison
seems acceptable.

~~~
crankylinuxuser
Given my ignorance on the subject, it was called the Opium wars, but it was
more about direct trade routes and rights of sovereignty in China vs British.

It's a lot more complicated than your comment portrays. All I can assume, is
that you saw Opium wars, and try to use it as some emotional plea.

Sorry, not buying it.

I would rather have the Portuguese system than the current lock everyone up
one. Cause we know it doesn't work. And thats experimental data, not
theoretical.

------
jmh530
The subtitle is "Should they be considered an “epidemic”" and it says in the
article "We don’t often call alcohol or tobacco “epidemics,” even as we
regularly use that same language for opioids that are linked to a fraction of
the deaths from alcohol or tobacco.".

They are basically proposing to re-define epidemic. Traditionally, an epidemic
is the rapid spread of something, usually a disease but not necessarily.
Alcohol and tobacco have already rapidly spread. There's nowhere else for them
to spread.

~~~
24gttghh
Feels like people are forgetting that _Endemic_ is the perfect word for this
sort of thing...They don't need to redefine epidemic; they need to use a more
accurate word.

------
Bromskloss
This doesn't seem to be the right metric. Surely, alcohol and tobacco are more
common than opioids. To judge how defensible a certain consumption or action
is, surely you need to see to the danger _per instance_. If not, I'm sure
there are many other, perfectly normal, things that would en up on top of the
list.

~~~
ChrisGranger
Indeed, falling down the stairs probably kills more people annually than
opioid overdose does, but you're never going to hear anyone complain about how
dangerous they are.

~~~
tialaramex
Actually slip, trip and fall accidents are a huge safety focus. Regulations
can ensure stairs are designed to make falling less likely to cause serious
injuries. Or, of course, as with most things Americans can insist their
"freedom" to suffer so that somebody else can make a buck comes first.

Another big cause of household accidents is excessively hot water. Sure the
kitchen sink might need the possibility of water hot enough to clean grease
off a steel pan, but you don't need that for bathing your baby. So some
countries legally require bathroom outlets are thermostatically controlled to
a fixed limit, if there's not enough cold pressure to hit the limit, the water
shuts off safely rather than char you. Simple mechanical valves can do this,
and they're not that expensive - once a country is buying them for everybody.

------
peterwwillis
Why do we spend billions of dollars on airport security when nobody in this
country dies from terrorism, yet 66,000 people die every year from guns and
cars? Because we're fine with people dying en masse if it doesn't bother our
morals or make us afraid.

Also, thanks for flagging this article. Intellectual discussion about critical
health and safety issues is clearly off topic.

------
jjkk0101
It boggles me that we still are faced with aggregated statistics to deny there
is opioid crisis going on. If nothing else, alcohol and tobacco are also prone
to addiction and should be curbed as well.

------
drinchev
Living in Berlin and coming from Eastern Europe I would say that people smoke
and drink a lot more than US.

It’s quite normal to have a glass of wine with your business lunch in Italy
and Portugal. As well as a cigarette allowed restaurants in Czech Republic,
and smokers bars here in Berlin.

Almost everyone drinks and smokes at least on the weekend. I was really
shocked when I visited SF 2 months ago to discover that having a beer and a
cigarette is impossible at any bar I tried ( smoking was forbidden 20 feet
from entrance ).

Not sure how does it help reduce the death percentage compared to here (
Europe ) where most people consume moderately.

------
crimsonalucard
What about the percentage of users vs deaths? The numbers speak of something,
but it would be unwise to use the numbers as a metric to say that opioids are
safer than tobacco and alcohol.

~~~
GordonS
I think it's tricky to quantify; a lot of opioid use is illegal, and that
aspect undoubtedly alters things.

------
leroy_masochist
The author seems to be striving to miss the point.

There's a big difference between dying of cirrhosis, heart disease, diabetes,
lung cancer, emphysema, etc in middle age and a 19-year-old kid OD'ing a
couple of weeks or months after falling down the addiction spiral.

It's not just the number of deaths, it's the impact to society. Line cooks
don't steal kitchen equipment to buy booze and smokes. Opiate addiction upends
lives in a way that alcohol and tobacco simply do not.

~~~
24gttghh
The CDC would point out that yes, Alcohol has a huge impact on society; in
this context, via drunk driving:

[https://www.cdc.gov/motorvehiclesafety/impaired_driving/impa...](https://www.cdc.gov/motorvehiclesafety/impaired_driving/impaired-
drv_factsheet.html)

>Every day, 28 people in the United States die in motor vehicle crashes that
involve an alcohol-impaired driver. This is one death every 51 minutes. The
annual cost of alcohol-related crashes totals more than $44 billion.

------
stmfreak
This article tackles death from hundreds and thousands of individual choices
as if it were death by accident which a few regulations could cut in half.
Everyone knows smoking kills you quicker, but still 11% of U.S. adults choose
to smoke. You want to increase the burden on their already burdened existence?
Have a heart. Let people slowly kill themselves in peace.

------
tryingagainbro
Overeating also kills. Lack of exercise kills and so on.

Opiods are different, IMO, because they are generally issued by doctors, and
they can kill you pretty quickly. Alcohol and tobacco, while dangerous, do
give quite a bit of time to change and be saved.

Obviously the govt should do anti-smoking campaigns, but opiods are different.

~~~
Alex3917
> Alcohol and tobacco, while dangerous, do give quite a bit of time to change
> and be saved.

The typical tobacco death is someone in their 70s, whereas the typical alcohol
death is someone in their 30s. (The majority of alcohol-related deaths are
from suicide, car crashes, and slip-and-fall type injuries.) I doubt the types
of deaths we're seeing from heroin are that much different than with alcohol.

~~~
jrs95
True, but alcohol deaths are a much lower percentage of the drinking
population than opioid deaths are to opioid users. That makes it more
difficult to reduce imo. Alcohol kills indirectly in such a way that aside
from efforts to curb drunk driving or drinking altogether there's not much
that can be done. Personally I think mandatory breathalyzer ignition locks are
probably the best you could do to quickly cut down on alcohol related deaths.

~~~
GordonS
> alcohol deaths are a much lower percentage of the drinking population than
> opioid deaths are to opioid users

Unlike alcohol and tobacco, a lot of opioid use is illegal, and a lot is
prescribed by doctors - this makes for a very different playing field.

If opioids were legally and openly sold, it would likely have a big impact
(I'm not saying they _should_ be, BTW).

Regulation would mean quality control, so you'd be much more likely to get
what you thought you were buying.

Another example, if choice was available, almost no recreational opioid user
would choose fentantyl or some of the random opioid RCs that pop up, instead
opting for safer versions.

------
CodeWriter23
I’ve never heard of a court ordering drug addicts to consume alcohol or
tobacco as part of their sentence. In certain states however, courts routinely
order addicts into opioid drug replacement therapy programs during sentencing.

~~~
djur
We haven't criminalized alcohol or tobacco addiction in the same way we have
other drugs, so that's not really a reasonable comparison. Tobacco cessation
programs do use tobacco substitutes like gum, patches, etc. though, and
there's been some experimentation with providing small doses of alcohol to
people recovering from serious alcohol addiction.

~~~
CodeWriter23
Actually, most of the opioid epidemic is perfectly legal, as they are
pharmaceutically-manufactured substitutes for the Opiates found in street
drugs like heroin. Which brings up my secondary point, doctors don't prescribe
tobacco nor alcohol. Nor do doctors receive incentives from pharmaceutical
companies for prescribing tobacco and alcohol, but they do receive incentives
for prescribing opioids. [https://arstechnica.com/tech-policy/2017/10/doj-
billionaire-...](https://arstechnica.com/tech-policy/2017/10/doj-billionaire-
pharma-owner-fueled-the-opioid-epidemic-with-bribery-scheme/)

That said, are you asserting that society's answer for someone out of control
on Opiates is for the state to mandate Opioid use? The addicts I work with all
tell me on no uncertain terms that kicking opioids is much harder than kicking
opiates.

------
s0rce
The solution to all three is probably to offer more support for addicts and
other mental health issues.

------
Omnius
We should make them illigal like illegal drugs that fixed everything.

------
jmh530
We tried banning alcohol once already...

~~~
ghostbrainalpha
And besides the whole rise of organized crime thing, it was a fabulous
success!

Did you know that the customer warranty didn't exist before prohibition?
People were generally so drunk that it wasn't considered a viable option to
warranty your products because people would break them in their drunkenness.

