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Faced with this evidence, Marks was beginning to believe that many ‘of the harms of drugs are to do with the laws around them, not the drugs themselves’.

I believe this to be quite self-evident. A heroin addict can be quite a succesful and functioning member in society, provided that she can maintain her habit, without the hassle that comes with bad quality drugs and the stress (and invariably crime), which is required to maintain the addiction.

That all falls away when the drug is made available cheaply, regularely and even paid for by health insurance.




How is this different from what happened with OxyContin and the like —- which when made widely available and widely prescribed, resulted in a massive increase in consumption, overdoses, and deaths.


OxyContin was prescribed by doctors that believed it was not addictive to patients that were not yet addicts. The prescription is temporary and ends, so then there is a new illegal drug addict.


Speculating here, the difference is two-fold:

(1) The drugs shouldn't have been prescribed in the first place. This system was creating the cycle of dependence, not attempting to manage it.

(2) Oxy and other opiates were prescribed for specific medical issues rather than recreationally. That leads to drug-seeking behavior once the normal course of treatment wears off, and eventually when cut off from legitimate supply, illicit alternatives.


Don't forget manufacturers of "long release" versions requiring prescription of fewer higher dosage pills instead of more smaller and incidentally cheaper ones.


Yes, it increased consumption by creating new addicts. Because, as with cigarettes, addicts are good customers. But it was inability to keep getting prescriptions that caused overdoses and death. Because you had all these ~middle class addicts switching to heroin, without a clue how to use illicit heroin at least somewhat safely. That, and the increasing use of fentanyl to increase potency of highly cut heroin.


It is different because you have to prove you are an addict to get the free heroin.

The oxycontin crazy created opiate addicts in droves because it was given out virtually unchecked to non addicts.


But you need some strong incentive structure to not start doing heroin in the first place. For most, that's the knowledge that heroin is going to invariably screw you over in the long term. Not to mention the long-term medical side effects of heroin usage...


Is there a young to middle aged person alive in the Western world that doesn't know that long-term drug use is bad for your health?

This doesn't deter. Besides, most folks don't intend to get addicted and only a portion do. Many more can use opiates medicinally or recreationally without addiction.

It seems decriminalisation works. Safety nets help. Offering free, medical-based addiction help would help. Prudent disussions with doctors when using opiate main meds would help - you know, what to watch out for with addiction, help if it happens, and not treating folks like criminals the rest of their lives if it happens.

I'd personally advocate legalisation of most drugs, even if I wouldn't do them, just to keep folks safe.


The painful truth to this problem seems to be that people who actively use drugs and decimate their bodies when provided a steady supply of drugs will simply die sooner?

It seems hard to argue that supporting someone's heroin habit wouldn't incur a higher than normal cost for healthcare?


This is a rotten post and I'll dissect it.

> The painful truth

You're immediately claiming truth. That blocks other viewpoints. Also 'painful' which is a weasel word.

> people who actively use drugs

as opposed to passively use them?

> and decimate their bodies

you presuppose what they do 'decimate' their bodies. Maybe they do but it's a bit short on facts innit. And related, does taking copious amounts of alcohol (which I agree does damage bodies) count, what with alcohol being legal and socially acceptable?

> when provided a steady supply of drugs will simply die sooner?

A presumption, although one I'd have real trouble disputing. But facts are needed here.

> It seems hard to argue

dude, more weasel words!

> that supporting someone's heroin habit wouldn't incur a higher than normal cost for healthcare

The article gives examples of higher healthcare (and police) costs for not supporting them. Quite explicitly.

Also

"when provided a steady supply of drugs will simply die sooner" and "incur a higher than normal cost for healthcare" may be incorrect - they may die sooner thus saving the NHS money because pensions and extended healthcare due to old age are avoided. I understand this argument has been made for smoking; smokers are claimed to cost less than non-smokers. I'll see if I can find a proper study for this.


Thanks for your feedback! This is actually more feedback & more meaningful than what I get from my FAANG manager. I'll use this to better form my arguments going forward, thanks friend.

> you presuppose what they do 'decimate' their bodies. Maybe they do but it's a bit short on facts innit. And related, does taking copious amounts of alcohol (which I agree does damage bodies) count, what with alcohol being legal and socially acceptable?

It's pretty hard to get Hepatitis C, AIDS, pulmonary infections, or collapsed veins from a few mixed drinks or beers...


It speaks well of you that you took it constructively! I appreciate that, upvoted.

> It's pretty hard to get Hepatitis C, AIDS, pulmonary infections, or collapsed veins from a few mixed drinks or beers...

I won't argue with the collapsed veins I guess, I don't know if there's a way to avoid that. I didn't know that pulmonary infections were associated with heroin, thanks for the info.

The other stuff is - I presume, and you may disagree - a product not of the drug but of the contaminants and circumstances. Hep & aids from shared needles (and see my other comment, <https://news.ycombinator.com/item?id=20165469> actually I presume it was shared needles, she was female so it may have been from prostitution). A proper needle exchange facility will fix that, perhaps.

Bad stuff certainly can happen from booze, stories like this <https://www.latimes.com/world/asia/la-fg-poisonous-mix-in-in... keep cropping up over the years from India. It's the contaminants which kill. There may have been similar stories from US prohibition but I can only find this <http://www.1920-30.com/prohibition/prohibition-poison.html> but it's actually from that age so its honesty may be suspect.

Regarding the debating style, it comes with practice - keep it up and all the best!


This is one of the most civil and productive exchanges I’ve ever seen on HN. Props to you both.


Pure heroin is not toxic. It's living on the streets, cutting agents, constant withdrawls, additional substance use and injecting material of unknown purity without supervision that kills you. For most addicts, all of these issues can be fixed with a constant supply of medical grade heroin.

Society saves money with heroin programs, see "Chapter 4: Economic evaluation of supervised injectable heroin treatment" of http://www.emcdda.europa.eu/attachements.cfm/att_154996_EN_H...


Leaving them on the streets or in a state of perpetual craving and poverty is expensive, too. The studies others cited says crime rates plummeted. Imagine how much damage local people and businesses might have suffered, imagine how much police efforts might have been spent, and emergency room visits that might have occurred, if those people were not given treatment.

My guess is that since we already have studies where people are given heroin as a form of rehabilitation, there should also be some studies about the cost of such programs. Wish someone could share some of them.


I completely agree! I think the narrative would then become “rich and greedy big pharma gets rich selling legal narcotics to addicts”


I think the narrative would then become “rich and greedy big pharma gets rich selling legal narcotics to addicts”

Why would ?

Look up Purdue Pharma and their colleagues. Pay attention to the shenagigans they applied to get millions of Americans hooked.

Argueably the only difference between that lot and your average street dealer is that the street dealer doesn't buy himself a bunch of politicians.


Why would that matter? Most likely tapering off the drug dosage is a necessary part of the treatment process.


> But you need some strong incentive structure to not start doing heroin in the first place.

You really don't. You seem like a straight-laced individual, if I told you heroin were legal in the US tomorrow would you go get some? I seriously doubt it. Anyone who wants it can already get it. Anyone not using isn't going to start due to legalization.

You know what legal thing I hear is fun but bad for you? Autoerotic asphyxiation -- but you don't see me hanging from the ceiling fan.

I urge you to research the Portuguese model, where all drugs were decriminalized to massive success [1].

[1] https://www.theguardian.com/news/2017/dec/05/portugals-radic...


I urge you to research the Portuguese model

Also, don't forget to mention that Norway is currently running a test program to give free heroin to its addicts.[0]

[0] https://www.foxnews.com/world/norway-to-test-free-heroin-pro...


That argument doesn't sound well founded. The booming marijuana industry and its popularity among previously non-pot smokers should've been your first clue.


(1) Marijuana is not nearly as bad for you as tobacco or alcohol, whereas I think we all agree hard drugs are worse. This study from a few years back should put things into perspective [1]. I think it's disingenuous to compare a drug that's objectively safe to one that's broadly recognized as objectively harmful.

(2) As of October 2018 (shortly before legalization) 47% of all Canadians have tried pot. [2] Now that it's legal, people are just more willing to fess up to it. Again, it's nothing they couldn't get before if they'd wanted it. Further [3] shows that the percentage of people smoking pot in Canada did not in fact increase after legalization.

[1] https://www.vox.com/2015/2/24/8094759/alcohol-marijuana

[2] https://www.statista.com/statistics/587689/marijuana-consump...

[3] https://www.countable.us/articles/21403-statistics-show-cana...


From Statistics Canada: "For example, the vast majority (98%) of those who have never consumed cannabis indicated that they would not use in the next three months. In contrast, most daily or almost daily (93%) and weekly (84%) users thought they would continue to use in the next few months at the same frequency." [1]

[1] https://www150.statcan.gc.ca/n1/daily-quotidien/190207/dq190...


Anecdotal, but I've found more people are simply willing to admit they smoked pot now that marijuana looks to be legal. People simply lied about it.


> that heroin is going to invariably screw you over in the long term

I understand that about 60% of heroin users can use it recreationally in the way you or I would have a few drinks then stop because we know our limit.

That figure came from a letter in mewscientist mag but I can't find it, so treat with skepticism. I get the impression its reputation for certain and terrible addiction is the from anti-drugs campaigns and they aren't reliable, by design.


Granted, I don't believe that demographic (60% can use recreationally without issue) are the ones already filling the streets...


> Not to mention the long-term medical side effects of heroin usage...

The constipation?




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