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My experience of losing a friend to heroin (2020) (mattlakeman.org)
319 points by exolymph 3 months ago | hide | past | favorite | 472 comments

This hit like a train.

I was Jack in highschool, addicted to heroin, destroying my family for 4 years. In and out of rehab. At one point my mother chased me through her house with me holding a needle full of heroin over her head, she had caught me using in the bathroom, I didn't want to let the hit go.

My mother died a little over a month ago, brain cancer, from diagnosis to death it happened in 5 months. Reading this brought back a lot of my guilt and reminded me of how futile my family felt trying to help.

Last week a highschool friend died, fentanyl od, he was never into opiates in highschool. I had no idea how serious it was. I had seen him at a wedding a couple months back and he mentioned that he got into fentanyl pressed pills for a period, he said he felt bad for judging me so hard in highschool, he never thought he... I cut him off and said "but your clean now right?" And he gave me this disappointed look, and said yeah. I just moved to a different subject, now I think he might have been asking for help, like how did you kick?

In the throes of addiction, the only thing that made any difference was that I decided one day to buy an ounce of mushrooms. I brewed them all into a tea and put it in my fridge. I drank mushroom tea for basically a week straight. I didn't do anything special, friends visited, we played video games and talked, but eventually I reflected, for the first time I actually saw myself from the outside, I saw what I was doing to my family and friends and it was like a switch flipped in my mind. Physical or mental addiction didn't matter anymore, it just didn't make sense to use. It's all I can really say that helped me, when you are an addict the best cure is gaining perspective because it is so hard to pull your head out of that hole.

Good for you. I'm happy you were able to straighten out your life.

A few months ago I watched a child, maybe 11-13 years old, run out of a hospital barely clothed. A security guard ran after him and must have wrestled something away. Then the child kept jumping for what the guard was holding, like jumping for a toy. The mother ran after him with clothes.

I felt so bad for the family.

> I wish I had a happier note to end this on, but honestly, my biggest takeaway from the whole experience is that maybe some puzzles just can’t be solved. We can try to attribute Jack’s problems to intrinsic biological/psychological issues (social phobia, migraines, etc.) or to environmental causes (super high rate of heroin use and OD in the community), but both sides seem fundamentally lacking in explanatory power. The vast majority of socially anxious people don’t resort to heroin, and despite the problems of these small towns, they are by no means among the worst places to live in America, let alone the world.

Earlier on, the author does speculate about what drove Jack:

> To put it another way, Jack was painfully aware that his future options were, “be a complete loser,” or “be a complete loser who feels really really good for a few hours every day.” He chose the latter.

What's striking about this is how it's possible to live this way without drugs. A brain-numbing job eight hours a day and a life-saving hobby for four. A toxic-family life but wonderful community.

It almost sounds like Tennis could have been this outlet:

> One time when Jack was in middle school, he walked off the tennis court after a well-played match, and his mother asked him how he felt. Jack said something like, “when I’m out there, it’s so nice… it’s like the rest of the world goes away and I don’t have any problems.”

I'm not sure you understand how good heroin feels. Nothing comes close, especially not Tennis or a wonderful community.

I tried heroin once, and I regret it every day, because I am 100% positive that I will never again be as happy as I was that day. If I didn't have what is effectively a dream job I'm sure that I'd be a heroin addict.

That was certainly not my experience, it was an intense physical pleasure but ultimately devoid of mental depth. Having tried most drugs I really think the whole addicted after one dose is bullshit and it's far more about your social economic circumstances.

It's much more tempting to seek out another hit if you have nothing better to do that day.

If I get drunk I become happy and will hug my friends and tell them how much I love and appreciate them. Others become aggressive and start picking fights with random people, or beat up their wives, girlfriends, etc. I don't especially enjoy being drunk though; it's alright once in a while, but there's loads of other activities that are on equal footing as far as I'm concerned.

I tried to smoke weed a few times. I didn't just dislike it but downright hated it every single time. I tried a few other drugs, and responses varied from "I don't really like this" to "meh, so this is it, is it?" Never tried heroin, so I can't speak to that specifically.

Point being: individual responses to drugs vary greatly. I wouldn't say I'm "immune" to becoming an addict, but it'll sure take a lot more than for some other people.

I think it's highly variable.

Some people love opiates. Personally, I hate the feel of opiates. My brain feels like it's encased in concrete. This is not a good feeling to me.

I consider myself fortunate that I don't like the feel of opiates as it means that I didn't become addicted to them from the times I needed them medically.

I will, however, point out that musicians almost universally warn other musicians not to do heroin even once. Musicians aren't exactly straight-laced, and, if they're warning you about something, you probably ought to listen.

This seems to rather callously disregard the parent commenter’s lived experience. Perhaps, just maybe, not everyone is like you; it might be different for different people? Just a thought.

That was certainly not my intention, I was trying to say that the idea that these substances will make anyone a helpless addict if they try them once is misleading and completely ignores the social context around addiction.

I agree with you that social context matters but I want to provide one data point on how psychological setting of that person matter too.

I am an anxious person prone to depression. In one especially bad period of my life I was prescribed Lexaurin (anxiolytic used to handle panic attacks). Taking that was a shocking experience - it made me feel calm, optimistic... and maybe for the first time in my life it made me aware of the ever-present baseline of anxiety that I was living with, like always. Lexaurin made me feel not anxious at all and it felt awesome. I kept asking myself - is that how other people feel all the time? I would give anything to live like that. If I had free access to it all the time, it would be really hard to resist the temptation not to use it. At the same time I can imagine that for many people - like you maybe? - taking Lexaurin would do absolutely nothing, because they live on that anxiety-free baseline their normal lives.

Addiction and the addictive ness of drugs is a multi factorial gradient. It requires the right psychosocial conditions, the right environment, and the right drug, and a person who might become a heroin addiction one day may not be so at a different point in their life.

Roughly 1-2% of people who try heroin once are done forever; many many try once or twice and aren’t. For cigarettes the rate is about 20-30% who become addicted

It seems pretty clear that there's at least some level of genetic component to addiction. It seems likely that this is part of it. Some people, like you I suppose, really genuinely think it's not that big of a deal. Some people, presumably like the grandparent of this thread or the subject of the article, think it's by far the most amazing thing they'll ever experience in their life. Why's that so hard to believe?

It seems pretty likely to me that at least some people really will inevitably go down that road from one dose. Maybe not as many as the hardcore Drug Warriors would like us to think, but at least a few. It's an odd blind spot for the hardcore Libertarians - some people just aren't physically capable of coping with it, and no amount of willpower on their parts will change that.

It’s adding context. I agree with the reply completely, opiates are far from being an outlier in “amazing experiences” for me.

I see no disregarding, it’s simply another lived experience. The whole point of the comment is that it is different for different people.

> That was certainly not my experience

> I really think the whole addicted after one dose is bullshit

When I was ~12 I got nitrous in the dentist's chair.

I remember the thought going through my head: Wow, this is really cool.

However, I didn't have ready access to nitrous! If my parents had a whipped cream maker, would I have started huffing whip-its? Maybe, but at least they aren't addictive. It's not like I would have gone into withdrawl after going through a box.

I think the bigger issue is the physical dependency that opiates have. Once the drug is no longer the "new toy," but the physical dependency is there, it's much harder to stop once the novelty is gone.

This is the scariest thing about heroin IMO. It's basically game over, you've ruined the game of life by using a cheat code and the rest of the game will feel hollow and pointless.

You don't need heroin to reveal this to you. That's in part why burnout is a thing. Just try really hard to do what you think is right, and then be shown that what you put your energy into is basically worthless. Then you start thinking about what ultimate prospects every hypothetical financial reward could result in, and it's pretty bleak out there. Then once you're ready to get back into it after being fired, because you're running out of money, you realize that it takes 4x the effort to do 1x the work for 0.25x the spiritual reward that initially drove you to get into it, and so you turn to heroin or start a farm.

That's pretty specific, you alright?

I'm working on it ;) No heroin here thankfully

Glad to hear it.

I've been pondering for a while if being at certain points on the bathtub curve of learning/integrating new things (the disorientation phase, the sense of no progress) may create exponential sensitivity to emotional stress (like burnout) and make it feel 100x worse. Reading this, now I'm wondering if maybe a similar bathtub curve effect (specifically the "I can't see the light at the end of the tunnel" part) associated with the open-ended constant mental engagement of looking for work precipitates a similar sort of sensitivity to ROI outcomes (with obvious preferences toward lots of positivity).

If this is the case, then as direct as it is to say - these mechanisms are just that, mental mechanisms, and it just happens that when "low point of bathtub curve" bounces off of "really badly timed negative ROI event" bounce off of each other, it's like the result is amplified almost beyond reason. Long-term the signal value ("this will kill your spirit") is absolutely true, but in the immediate (ultra-short) term, compartmentalizing and ignoring it may be both safe and actively helpful. (Standard internet advice disclaimer applies)

TL;DR: Good luck, and may circumstances and equilibrium materially improve and solidify.

Why is it scary? Heroin isn’t unique in this aspect.

I had a friend tell me “when I had the first drink ever my first thought was ‘I want to feel like this the rest of my life’”. He was sucked in right away and struggled for years to break that hold.

Plenty of people feel that way and practically kill themselves with alcohol, opioids, cocaine and even food.

And plenty of people take opioids equivalent to heroin and say “i felt terrible, nauseous and dizzy, I don’t get it”.

I cant find the source but there was a DEA (?) report a long time ago that noted “80%+ of cocaine users use it less than 5 times per year”.

When drug use gets pushed into the shadows the only examples you see are the ones where it spirals out of control.

Say you use heroin or have used it in the past. Now you have to go in for some kind of surgery. Guess what? The opiate pain meds won't work for you! I've seen it first hand. It's awful. Hospitals are only allowed to give so much and if you're a user or were a user, the amount they give you won't touch your pain.

Guy who used heroin shattered his hand in a fall off a roof. Had pins put in. When he came around after surgery they had to call the police he was so out of control because his pain couldn't be managed.

Opioid tolerance will absolutely decline if you stop using. it's actually a significant cause of death. People will quit (or go without due to jail, etc) and then relapse with the same dose they has used before and have a fatal overdose.

Morbid but curious question: when tolerance declines, does a de-rated dose (say, 100% of the body's safe mechanical limit) produce the same mental effect as the previous, now way higher dose would? IOW, does the tolerance affect the mental response as well?

(NB. Have integrated the understanding that pushing The Button™ is a generally bad idea. The above is purely intellectual curiosity.)

Do you really struggle to see why that's scary?

I struggle to see why heroin is uniquely scary.

Because it has such a strong effect for most people compared to food, sex, alcohol, etc.

Obviously I don't know how strong (and I really really hope I never know, unless I'm on my death bed etc) but by all accounts it is overwhelming. Everything is toxic at the right dosage, and heroin is pure toxic pleasure.

That's the point, it's not. At least not any more than other drugs. Plenty of people try heroin or opioids and hate it.

I was spiked with heroin once. It didn't impress me - it made me feel a bit ill.

I've tried coke - good stuff, in good company, for an evening. It didn't impress me much.

I guess I was just lucky. I have an "addictive personality" - I drink way too much, and I'm a heavy smoker. I could easily have fallen into one of those holes, if I'd actually enjoyed those drugs. I found psychedelics much more engaging; but they're generally not addictive - after 3 days of continuous LSD use, no amount of LSD will get you tripping again. It's anti-addictive.

Local Man Not Impressed By Heroin: "It's Basically Novocaine"

Where did I state that?

Because heroin (and similar opiates) are one of the hardest addictions to quit.

It's also easier to accidentally OD on heroin compared to cocaine or alcohol.

I really don't think alcohol causes such a strong reaction in most people. It is pleasant, but not to that extreme.

Also, people dont get addicted to alcohol that fast. It takes a lot more usage to develop physical dependency.

A physical dependency is not a requirement nor is it necessarily that strong of a motivator for continued use. Psychological dependency is often the harder thing to break. Addiction is defined by continued, compulsive use despite negative consequences in one's life.

And sure, most people don't say "I want to drink forever" when they have their first drink. But that's my point, most people don't say that when they get opioids - remember they are very widely used in medicine. Some small fraction of users actually spiral into a deep addiction.

Now, one could argue the percent that develop a problem is larger than with alcohol - that might be true. That said, it's estimated something like 10% of drinkers have "problems" with their drinking. Again, not everyone ends up a homeless drunk - plenty of functioning alcoholics.

10% looks low to me. I know a lot of people that drink, but very few of them are free of drink problems.

This is correct. You have to work on an alcohol addiction. It takes a few months to develop a dependency severe-enough that withdrawal might result in seizures. Short of that, you can just quit, if you can get time off work for a few days in bed.

You also have to work on a heroin addiction, so I have heard. It simply isn't true that "one dose and you're hooked". People become addicts because they want to be addicts, for whatever reason. Part of it is lifestyle; part of it is the desire to be dependant, so you get to not have to be responsible for yourself.

> You also have to work on a heroin addiction, so I have heard. It simply isn't true that "one dose and you're hooked".

When I looked at it, it is something like 30% of people develop dependence after first one-two usages. Then there are people who can use it casually for a long time before developing it.

Could it be that those people were "dependent" even before their first dose? My argument is that some people want to be dependent. So they work on it.

I shouldn't have said "you can just quit" - that's medical advice, and I'm no kind of medic. A decent nurse will tell you if you'll be able to just sleep it off.

Sorry for commenting to self, but it's too late to edit.

I can't be sure because I've never tried heroin, but it might be possible to feel that good without drugs https://en.wikipedia.org/wiki/Dhy%C4%81na_in_Buddhism

Dhyana meditation comes with its own risks. In general, "religion" is quite dangerous stuff, and should not be fed to children.

Expand on this please

Meditating on the six dhyanas (or "janas") is a kind of single-pointed concentration. One of the side-effects is supposedly "bliss" (sukha). It's strong medicine, and if it works, it will alter your mind - that's what it's for.

I have to say I've never tried it; I was warned off it.

If you're doing it for the bliss, your motivation is wrong, and you are at risk of vanity and playing power-games with people. If that happens, you will suffer harm.

If you were asking why I think religion is not for children, well: I think tales about fairies, angels and Santa Claus are not for children. I don't think you should lie to children, nor encourage them to subscribe to superstitious beliefs. By "children", I mean anyone with underdeveloped critical faculties. I read fairy stories to my kids, at bedtime; but I didn't pretend they were true.

Some religious systems present very interesting ways of looking at the world, the mind, and morality. But it's like hard drugs; it affects your mind and your relationships, and not necessarily for the better. I think that tangling with a religious system should only be done with care, and under appropriate supervision. The matter of how to choose a suitable spiritual mentor is an unsolved problem.

I think he’s implying if he had that outlet, maybe heroin would have never been encountered.

He was first prescribed opiates for an injury.

Just to throw in my 2c, I’ve had dilaudid a few times for an injury and other opiates for various reasons, and while they feel great, they really never cross my mind much and I don’t hold them close to many sober experiences. Not even as good as other drugs, of which I could list 3-4 I’d consider as or more enjoyable.

The above comment feels like a really dramatic description of opiates. I don’t think most anyone with a moderately stable life is at risk of addiction trying them.

> feels like a really dramatic description of opiates. I don’t think most anyone with a moderately stable life is at risk of addiction trying them.

A few years back, perhaps close to a decade ago, there was a fairly well known reporter/journalist who said this same thing. Of course, he was cocky enough to test his presumptions & tried either some form of opiate or heroin, can't recall exactly which. He by all means had a happy and successful life/family.

He ended up getting horribly addicted & there was a good writeup/documentation of everything that happened. I'm having issues finding the article right now though.

Also, anesthesiologists, one of the highest paid, disciplined, and well respected jobs you can get, are also one of the highest risk groups for severe drug addiction.

I think your presumptions are quite incorrect and crass.

This took place in real time on reddit, pretty much. If not this exact case - very close to it. You can search for it.

SpontaneousH, was his name.

I think people experience the euphoria of opiates differently. Anecdotally - i've never found opiates compelling. I appreciate their ability to numb severe pain, but they don't do anything for me as a mental release. Whereas a good friend is the opposite, he loves the feeling opiates give him and gets quite a kick out of them. He is very careful around them because he understands that he could easily slip into a full blown addiction with them. BTW - this friend has a stable job, a loving wife and 2 kids.

My wife had chemo and was given oxycodone. She hated it as it just made her nauseous. I had one low dose 5mg pill of hers and suddenly felt as if everything was finally right, the euphoria was there but it was more. ‘I finally feel normal’. It was dramatic and I’ve been battling the temptation ever since.

I wish I’d never tried it.

As I understand it, even mild pain medications like ibuprofen (for women though apparently not for men) and acetominophen can relieve emotional pain as well as physical pain.



I heard a story - can't find the reference now - of a doctor who got addicts to replace their drug addiction with exercise addictions. From what I recall the program was quite successful at making the patients functional, but didn't really do much for the underlying issues - just made the addiction itself less damaging.

Makes sense. I talked about it with a friend of mine, a ex-junky. He said, all people he know from the Methadon-program are dead because they just died on alcohol. He said, they don't take Heroin because Heroin make addicted, they take Heroin because they needed 'the hammer on the head'. They switched from Heroin to a more damaging addiction. Why this should not work with less damaging addictions too?

Pretty common on the west coast to hear about people taking suboxone to quell their heroin addiction but doing meth now to get high because its so cheap and available in this part of the country due to the industrialized processes in mexico that came online over the past 10 years.

There is no organ in the body that isn't harmed by alcohol. This is what doctors have told me. The ethanol molecule is tiny, and can pass through any membrane.

That's the "Trainspotting 2" theory: we're all addicts, just replace one addiction for another. Film director and comedian Kevin Smith once said his friend Jay Mewes manages to stay away from his heroin addiction by drinking gallons of energy drinks.

I really honed in on this part:

> They knew he would never get drugs when I was there. He wouldn’t shatter the illusion he and his family crafted for me. It wouldn’t be worth it, not even for a fix.

seemed to be something that really worked? albeit for the while

I remember my own decade-long struggles with "failing to thrive" and I can assure one can turn your life around, but as author correctly noticed: "The puzzle of getting Jack <...> onto his feet could never be solved because there was a missing piece – Jack wanting to get better".

To me, it rather feels like the opposite, like the "wanting to get better" explanation is a moralistic, post-hoc rationalization. I live a reasonably successful life, but many of the things that made it so are just luck. I was born in a reasonably affluent country, and my parents always provided good care and abundant financial support. I am pretty awkward, but smart enough to get through life. I am naturally interested in programming computers so I don't even need to make an effort to do it, and this happens to match one of the most demanded jobs. I am depressed/anxious but thankfully SSRIs work very well for me. I had no bad influences regarding drugs. To me, it seems those reasons have had a greater influence than "wanting to get better" could ever have. In fact, when you're depressed, there's not even a "wanting to get better" to be had - you're just reflexively pulled to bad feelings.

Not drugs, but I'm playing out this story right now in my own life. No matter how much I try, I can never find a reason I'd rather wake up in the morning than not.

"What does a scanner see? he asked himself. I mean, really see? Into the head? Down into the heart? Does a passive infrared scanner like they used to use or a cube-type holo-scanner like they use these days, the latest thing, see into me - into us - clearly or darkly? I hope it does, he thought, see clearly, because I can't any longer these days see into myself. I see only murk. Murk outside; murk inside. I hope, for everyone's sake, the scanners do better. Because, he thought, if the scanner sees only darkly, the way I myself do, then we are cursed, cursed again and like we have been continually, and we'll wind up dead this way, knowing very little and getting that little fragment wrong too."

'A Scanner Darkly' ends with the most gutting personal note by Philip, which is extremely relevant to the article: https://news.ycombinator.com/item?id=21587769

Relevant to your quote, Philip said: The two basic topics which fascinate me are “What is reality?” and “What constitutes the authentic human being?” Over the twenty-seven years in which I have published novels and stories I have investigated these two interrelated topics over and over again. I consider them important topics. What are we? What is it which surrounds us, that we call the not-me, or the empirical or phenomenal world? — from https://urbigenous.net/library/how_to_build.html

I found this acccount utterly riveting, and I really appreciated the frankness.

One thing I picked up on, though: the OP refers to people dying from OD. I believe it's quite unusual to die from an overdose; my understanding is that nearly all "OD" deaths are not poisonings, but the consequence of inhaling your own vomit. Hendrix, Joplin and Jim Morrison all died from inhaling vomit.

Opiates depress your respiratory reflexes, so you breathe "less well". And they make you dozy, or even pass out. If you puke in your sleep, and then breathe in, bad stuff (like, hydrochloric acid) goes into your lungs, you fail to wake up, so you "drown" i.e. you can't breathe. Death by respiratory failure.

Smack in itself isn't really that harmful. Smackhead doctors have been dosing themselves with clinical heroin for decades, while carrying on their jobs and family lives. Scoring on the street, though, is super-high-risk.

/me never used smack.

I did at one time hang out around losers; a few of them were smackheads, and they robbed the rest of us rotten. Most of these losers were into downers - I once held the tourniquet for a guy that was injecting Tuinal (a discontinued barbiturate combination). Injecting barbs is much more dangerous than injecting smack, if you can get smack that isn't adulterated.

>I believe it's quite unusual to die from an overdose; my understanding is that nearly all "OD" deaths are not poisonings, but the consequence of inhaling your own vomit.

This is probably true but it's true of most anything. People rarely die of stabbings and gunshots but the blood loss, shock, and organ failure they cause.

Heart attacks rarely kill people, but the resulting arrhythmias and ventricular wall ruptures certainly do.

>Then there were the migraines. Even after he died, I never got a straight answer as to the cause or truth of this problem. All I know is that he often complained about getting debilitating migraines that forced him to stay in the quiet dark of his room, sometimes for days straight. Jack’s parents took him to doctors and specialists trying to get to the bottom of it, he tried numerous treatments and medicines, but I don’t think the cause was ever identified.

Migraines are frustrating because there are a thousand different potential causes and no one really understands their physiology. Many people don't respond to medications (outside of opioids, maybe) and even then, a migraine is far more than just pain; it appears to be a general disruption in brain function, possibly related to a phenomenon known as cortical spreading depression, and is often preceded, accompanied, and followed by vague psychological and even gastrointestinal disturbances. What's worse, you may be lucky enough to find a medication to mitigate the pain, but the psychological disturbances generally persist even in the case of a successful abortion. Frequently that means cognitive slowness and emotional disruption that can last for days.

Likely migraines are actually a manifestation of numerous abnormalities which are not always present in all sufferers, and I imagine that makes them particularly difficult to research, especially with first order statistical correlational analysis. Maybe ML will help here with the right data. The only certainty is that a better understanding of and cure for migraines would bring relief to millions of people who suffer unnecessarily.

> Maybe ML will help here with the right data.

Can you please elaborate? What kind of data would you need? What would be the learning task?

Would providing free and clean heroin in safe, monitored sites be a solution? Starve the black market of clients, give people support and safety when they need it, as well as the time required to get their life back together enough to take a leap.

Given what we have observed with alcohol, cannibis, and prescription drugs, I think it's safe I expect that decriminalization, legal suppliers, and free drugs would probably not reduce recreational use & abuse of opiates in America... If anything, I would expect usage to increase.

Don't get me wrong: I am absolutely in favor of decriminalization, as well as other radical changes in our society's relationships with drugs, mental health, and addiction. But it would be catastrophically naive to suggest that legalized/decriminalized opiates are some kind of panacea.

If heroin didn't exist, these people would probably plain old alcoholics. The damage caused by an alcoholic is pretty similar to the wake of a heroin addict... It's not identical, but the overlap in causes & effects of abuse is pretty similar between the two drugs.

Ultimately, the problem is that some people reach young adulthood without having developed a robust set of emotional coping mechanisms for handling the stresses of their lives. These folks are a LOT more likely to fall into the larger patterns of self-destructive behavior that drive them back toward drugs, over and over again.

I think legalization is the only real solution, but you bring up a good point about alcohol. The best approach there is preventative, and do things like strictly ban all advertising of all drugs, before there's a strong lobby to prevent that from being enacted. We should really ban advertising of alcohol and prescription drugs too, but there's unfortunately vested interests that make that a hard task.

I think the ideal system is some sort of government-run one that is not out to profit, and keep on suggesting that maybe you don't need any drugs, but will give you some if you insist and are willing to watch a safety video.

> We should really ban advertising of alcohol and prescription drugs too, but there's unfortunately vested interests that make that a hard task.

Around here ads for alcohol has been banned since I don't know when despite having multiple producers, of which at least one classify as large on a national basis.

The last two decades we've also seen laws against tobacco coming into place and - as someone who had friends who smoked since early teenage years or in at least one case even well before that - it is kind of weird to see someone young smoking in public today so the law has obviously worked.

There is a big problem with your first sentence, possibly semantic. You said: "I think legalization is the only real solution..." Legalization alone is NOT a solution, and it WILL result in increased rates of abuse, addiction, death, and human misery if other changes are not implemented concurrently with legalization.

I understand why people want to focus on legalization of drugs. It's a simple idea, with precedent in th US and many other countries, and it doesn't require expanding goverment spending or power. But it's just too simplistic to be useful. We cannot limit the harms caused by addictive behavior with pure Libertarian self-interest, because addiction IS a self-interested response to larger problems that the addict lacks the capability to handle, emotionally.

If we want to truly reduce the addiction, death, and suffering, we need to develop real, effective social services that help families and individuals on many, many levels. We need to plug the gaps in our children's emotional upbringings, which means permanently repairing the jagged indifference of our society that inflicts so much harm, in the first place.

In short, we need to let go of our fear of collective social welfare programs, and start truly giving a shit about each other.

I believe we agree. Let me rephrase my first sentence:

Legalization is a necessary component of the overall solution that also includes social services intended to reduce both the need for drug use and mitigate any impacts from it.

I just wanted to emphasize that without legalization, we'd be failing before we started to fix the problem as a society.

Decriminalizing use is the only sane solution; using and/or being addicted to a substance is not a crime, period.

I used to believe that — before I lived in a city that effectively decriminalized all drugs.

The result has been a disaster. People on meth run around the streets at night causing chaos. Homeless people on heroin leave needles everywhere. People avoid transit and parks now because there is regularly someone losing his or her mind nearby.

Long sentences aren’t the answer of course. But I do think that sending someone to a Nordic-style prison for a few weeks would be better for these folks than just letting them run free.

By the way, free mental healthcare doesn’t actually work because many of these folks don’t want help and won’t seek it willingly. There needs to be a way to forcefully separate them from the addictive substance for a time, stabilize their drug crisis, and then help them find long term care.

I understand that, although it's difficult to say whether that experiment is indicative of what a nationwide relaxation of drug laws would do. Cities which have decriminalized drugs (removed enforcement) are going to attract a disproportionate number of problematic or homeless addicts from other parts of the country. Cities with a more hospitable climate (in the sense of weather) already have this problem, so I imagine for San Francisco it's a double whammy.

What utter nonsense. Portland has an incredibly inhospitable climate (I mean I live in a lovely house and I find it overbearing). And yet we have more than enough people willing to tough it out in the torrential downpours.

Portland has moderate weather like the rest of the northwest. Have you tried living in New York during the winter?

This doesn't contradict what I said. I don't know much about Portland's homelessness problem, but I'd guess that being the largest city in the state, and having famously left-wing laws, might attract people on the margins to come. There are probably a lot of reasons.

I feel the same way. I was so excited to see a decriminalization measure on the ballot. A year after it took effect, our drug problems are worse than ever. It turns out that for the Portugal model to work correctly, there needs to be carrot and stick, but Portland only opted to implement the carrot, and the quality of life here has gotten much, much worse in a very short amount of time.

There's yet another model, which is to think of compulsory actions not in terms of crime, but in terms of competency to make decisions.

So, you deregulate drugs, but for those who fall into addiction, you evaluate their competency to decide whether or not to take drugs, and if someone(s) decide they're not competent (a panel, psychiatrist, psychologist, whatever), you force them into treatment, take away their drugs, etc and so forth. If a drug dealer provides them with drugs, then they're breaking the law for a different reason.

Part of the problem is this "one size fits all" with drugs, and with criminalizing use rather than treating it as a disease. Call it what it is: someone not being competent to make decisions about drug use, period.

I've never met somebody informed and for decriminalization that isn't aware that the first few years, perhaps even decades, especially when just in a small region and not an entire nation, are going to be a bit of a shitshow.

Things take time to get better, and as others have mentioned, most places that have decriminalized haven't exactly bolstered all other services that need to be around once decriminalization happens.

It's sort of like the amount of people who are pissed about how Chinese tourists act. Their nation has just recently entered a point in which they're able to be tourists. Americans have had decades to learn how to act and are often still shitty tourists. Things take time.

Of course you shouldn't only decriminalized, you must in parallel fund social services and clinics to help drug abusers. Else it's just useless

> it's just useless

Why? Cannabis market thrive is US. More and more people use cannabis every day, making profits for sellers. Some people will switch to hard drugs and die, of course, but car incidents are not stopping car sales.

Cannabis is very very VERY different from heroin and coke in term of dependency creation. Abusers need a totally different level of support from the health system and social services

Yep. My classmates, which started to smoke cannabis in school, died because they switched to opiates.

I see the same in London, where everything is illegal.

I think it's unrelated to whether drugs are a crime or not - homeless and drug users in general will find a way to get it.

It's a sad reflection on the state of society and our cities.

Personally, after a terrible experience in Paris, I decided I will avoid all big cities.

I think we should do something about it and forcefully throw homeless and drug users out of cities, but it's not a very popular (or easily enforceable, for that matter) point of view.

If you don't mind me asking what incident let to you to taking to such a hardline stance? I don't necessarily disagree or agree I just would love to hear that kind of perspective?

As someone else from the UK, at the start of the pandemic lockdown measures several cities tried to give every homeless person a bed. In every case, the majority ended up leaving the accommodation offered due to the rules around drugs, smoking, antisocial behaviour, whatever.

I'm not sure I agree with the above poster about their solutions to the problem, but "solving" homelessness, or addiction, is a lot harder than making some broad brush laws about decriminilisation.

My cousin is a heroin addict, 12 years running at this point. He's in Dundee, the smack capital of the UK and quite possibly western Europe. Methadone is the worst idea possible for him, because he swaps it with the cancer patients for diazepam and then makes himself a happy cocktail. He's from a genuinely loving, supportive family, but still breaks into their house to steal stuff to pawn for smack money.

The only thing that would probably "help" him is full decriminalisation, but that would not help his victims, or his family, or the already overstressed health service in general, because the whole point of these measures is an expectation that addicts will suddenly "see the error of their ways", rather than thinking "wahay, free smack".

And back to the original point, when you have people actively preferring the street to the fully serviced hotel rooms, then you've probably got a severe structural problem. At which point it's easy to understand the above point of view, especially if you have a home and a family in close proximity to the inevitable social disorder (and I've also lived in Portugal. It is far from the free drug liberal paradise that some imagine it as)

> when you have people actively preferring the street to the fully serviced hotel rooms

We don't have all that many people preferring this. Pretty much all of these and all homeless shelters come with massive catches that are reason for why they are not viable solution for many people. It opens at certain hour and you have to completely leave with everything in the morning. Cant have work tools inside, cant lock doors. Noise.

The shelters themselves do have reasons for all those rules. One of them being homeless do make your mental issues and addition issues worst in addition to these people being overrepresented in the first place. But, framing these places as "fully serviced hotel rooms" as if that was what life in them actually looked like is not accurate.

As a guy (as weird as it may sound) I've been followed and jumped on by a drugged up homeless making sexual advances in an isolated street next to Gare du Nord. There was a small altercation and I ran away.

In the same trip I've experienced several instances of homeless or just economic immigrants from Africa grabbing your arm trying to steal / sell you something.

There is also plenty of homeless peeing and pooping pretty much everywhere in Paris, which is disgusting enough.

I found London to be much better compared to Paris, even if things got way worse in the last few years. 5-10 years ago it was a rare occurrence to see homeless people, now you see homeless people sleeping everywhere and shooting drugs on the street like it's nothing.

I've since moved in the middle of nowhere and I'm definitely not going to raise my kids in a city.

> I think we should do something about it and forcefully throw homeless and drug users out of cities, but it's not a very popular (or easily enforceable, for that matter) point of view.

Do you also think that we should forcefully push the Sacklers & all of their paid off politicians out of the nation for what they've done?

> forcefully throw

I live in a market town. Small towns are often a magnet for druggies - they're safer than big cities, and they're often much nicer places.

We don't really want all the druggies from the Big City forcibly ejected, so they end up in small towns. Why should townies have to deal with the problems that Big City folk can't be bothered with?

I don't think you should, keep them out in the same way.

If they can't integrate in society, they can go and live in the woods or start their own town, for what I care.

I'm not opposed to helping people with problems: I think we should use voluntary charities (eg. not forcibly taken taxes) to help them - but healthy citizens' lives should not affected because of the problems of a minority.

If that means keeping someone outside of cities, so be it.

I know that many share your views.

If you have no home, it's hard to get a job. But it's hard to get a home if you have no income. So people end up on the street. They then face a choice of a street in a town, near to shops and services; or sleeping in a ditch in the boonies. I've slept in a ditch in the boonies, and I can't recommend it. And Social Services don't patrol ditches in the boonies.

A homeless person can disappear in a big city; it's easier for services to find them and help them in smaller towns. So if I was in a scrape, I'd head out of the city, to a smaller town.

With respect to forcibly taken taxes: they're taken "forcibly" because it's the law that you have to pay taxes. They don't usually come around with guns, to separate you from your belongings. We have a social contract, where I live, that we get free education and health-care and stuff, in exchange for paying taxes.

I was a fairly high earner, until I retired. I've never objected to paying taxes. I do object, very strongly, to corrupt politicians taking the piss with taxpayers' money; but in fact it's a small proportion of tax revenues that get stolen like that (here).

Frankly, I'm OK with the taxpayer paying up so that we don't have an underclass of people who are ill, psychologically troubled, homeless or intellectually challenged, and who are compelled to live under hedges. It could be me that's down on their luck, some day. If I were in that situation, there's a pretty good chance that I'd be resorting to substance abuse.

You're entitled to your views; but it seems pretty harsh to me, to simply declare that those people need to solve their own problems, and leave the taxpayer alone.

Is it perhaps also your view that the only legitimate use for taxpayers funds is to send armies to foreign countries? I'm not in favour of that. And I'm not in favour of taxpayer subsidies for diesel-oil for motor cars. I cough up, because the deal is that I either put up with the way collective taxpayer resources are spent (after making my point at the ballot box), or I leave the country.

As it happens, there's no other place I'd prefer to live. So here I'm is, very comfortable thank you, and I try to be kind to people who have to live on the street. Nobody would choose that if they had an alternative.

Sounds like any city where it's still illegal to me, the change won't happen overnight and I don't doubt it could get even worse initially.

So, to clarify, these people are not forcing you to do anything, but you want to force them to do something?

I, too, agree that we should leave unvaccinated people alone.

What city?

> By the way, free mental healthcare doesn’t actually work because many of these folks don’t want help and won’t seek it willingly. There needs to be a way to forcefully separate them from the addictive substance for a time, stabilize their drug crisis, and then help them find long term care

This is an inconsistent statement. In once sentence you say that free mental healthcare doesn't work, then in the next you posit that imprisoning them, then providing free mental healthcare is the answer. I think at the end of the day, people need to want to stop using drugs and have the help they need to do so. I don't think prison is the magic bullet for bringing about that change that you imagine it to be.

> People on meth run around the streets at night causing chaos. Homeless people on heroin leave needles everywhere. People avoid transit and parks now because there is regularly someone losing his or her mind nearby.

It's not realistic to expect only legalizing drugs to solve all your social problems. Why are there homeless people? Why are people having mental health crises on the street, and the only options are to ignore them, or put them in prison? I'm not sure what is meant by "causing chaos", but if they are committing non-drug crimes, why are they not being arrested?

Not inconsistent; many will refuse treatment if simply asked, but with forced treatment / detox may come through the woods a bit and make a different decision.

It's the same freedom vs. detention debate and we've swung towards full freedom option in the US since the shutdown of mental health prisons and we've offloaded the care for the most difficult cases to police, ER, health workers, and they live on the streets. It's high time the pendulum swung back a bit with some (hopefully humanely administered) compulsory treatment options which is was the other commenter may have been getting at

I work in the ER in a high drug use area - I estimate around 80% of patients who start outpatient "medication assisted treatment" in the ER (outpatient buprenorphine-naloxone to treat the withdrawal symptoms) are there because the judge in their criminal case tells them it's that or go to prison. Some people definitely can't make good decisions for themselves and need to be "forced" to get treatment - and are later often grateful for having been forced to do so if they stay clean.

It would help for sure. My cousin died not because of overdose but because he shared needles and contracted hepatitis which turned into hepatoma. If safe injection sites had been available he might still be alive.

“My cousin died because he made a choice to try heroin, got hooked on it and made a choice to share needles, contracted hepatitis, which turned into hepatoma.”

Fixed that for you. Truly sorry for your loss, but people make choices, and those choices have consequences.

Can we hold these two things to be true at the same time:

1. No one is forcing people to take these drugs. The choice to start is theirs. They are ultimately responsible for their choice to become addicted.

2. We should view an addict’s behavior through the lens of addiction, not the lens of a rational person making destructive choices. Addicts won’t respond to incentives like a normal person will.

We need to find ways to make it extraordinarily costly to start using drugs. This is how you prevent the crisis we’re in currently.

That means prison time for users. Heroin and fentanyl pour across the border due to demand for it. New users dabble in it because the perceived cost is low. If people understand that possessing or using means automatic and significant jail time if caught, then people are much less likely to even dabble.

Ultimately, people will still try it regardless, get hooked, and eventually get caught and sent to prison. And that’s a good thing. That means there are less users who are on a path to homelessness, overdose, and dependency on family, friends, and government programs. It also means less users out there to persuade others to start using. If we’re not going to run mental health hospitals with involuntary commitments, then prison time is what you’re left with.

Prison terms for using are five times as long as it takes to get users clean. Once they get out, if they’re caught again, the sentence is ten times as long as it takes to get clean. Each consecutive offense ratchets upward.

The result is twofold: users have ample opportunity to get clean and stay clean in prison, but most importantly, we create a society in which we simply do not tolerate drug use. It’s really that simple.

We are going to have as much drug addiction and use as we’re willing to pay for. If you lower the cost of using, you get more usage. Free usage sites with free needles and less risk will, and already has, resulted in more usage. The fact that people won’t recognize this is mind boggling.

> We need to find ways to make it extraordinarily costly to start using drugs. This is how you prevent the crisis we’re in currently

For this to work, people need to think about the longer term consequences of their actions. They don’t.

My personal experience has been that life can be so unbearable, you’ll turn to anything to get some relief from the pain of being alive.

I’m fortunate to be high-functioning bipolar. My uncle isn’t and he can’t tolerant medication. It doesn’t surprise me he constantly struggles with alcohol, along with the rest of his father’s family.

The only reason I’m not an alcoholic is alcohol does not have any positive effect for me. It just makes me sick. Same with opioids.

>Truly sorry for your loss

If that was the case I don't think you would have written what you did.

It is always a sad thing when a person dies. Unfortunately, some deaths are much more predictable than others.

Until we're able to talk candidly about the decisions that led to those outcomes, we will continue to mourn preventable deaths in the future.

The problem with heroine is not that it isn’t “clean”. It’s that it consumes the person addicted to it, becomes the sole driver of every waking behavior, like food, only more important. It happens with prescription pain medication obtained legally as well, and with alcohol to a segment of the population with a particular disposition towards it. For a drug that ensnares every fourth person who uses it once, it’s hard to imagine making it more available solving the problem.

I think it would be better if there was a little more of a barrier, like you had to get a prescription from a doctor or addiction counselor, but it was free. I think we should allow people already addicted to use clean/safe drugs in safe places, but we should be careful about lowering the barrier for those who are not already using.

I imagine it would help with the fentanyl issue. I don't think that anyone would buy fentanyl if they had access to known real heroin that wasn't expensive.

I wish this was true. Fentanyl has demand, both all on its own, and cut into other substances for the extra kick. I'm reluctantly convinced that a free clinic should have it on the menu.

It's not a menu, it's a place where you go to get a clean, safe fix for your opioid addiction.

You get what you get, the best opioid or analogue that the doctors decide to give you, possibly with a slow release mechanism that avoids the rush but allows you function throughout the day, hold a job, not stick the first AIDS-infected needle in your vein etc.

Look, I'm sure you mean well, but it doesn't sound like you understand the behavior of drug users. So let's re-phrase that: I'm going to out-compete the liquor scene with free but watered-down beer.

If you want to help people, you need to meet them where they're at. The moralizing "you get what you get" approach is only going to tide people over for when they can't afford to score the potent stuff.

> out-compete the liquor scene with free but watered-down beer.

Make that: free strong beer versus liquor that has a 2% chance to be mixed with rat poison, is illegal to sell or buy, and costs more to use than the average job pays. A quite compelling offer for any drunk, but, yes, some lost souls will still go for the "real" shit.

I understand the whole "reduce harm, addicts are lab mice caught in a chemical trap" philosophy. But providing ever increasing doses of hard drugs, as most addicts eventually require when left to their own devices, might be an even faster way to the grave.

Let a doctor make the choice minimizes overall harm, not consumer preferences.

But how do we get people to choose the slow release over the rush? Buprenorphine and methadone are the slow release analogs you speak of, we already have those, and they are helpful for some. Still, there is a fraction of the addicted that are not interested in slow release.

Anecdotally, a close friend of mine sold his buprenorphine so that he could afford to purchase heroin.

It’s probably a bad forum for this opinion, but I have a relative struggling with addiction and resulting mental issues ( resulting form substance abuse; he was highly functional and threw it all away), and because of this I made a 180 and think some form of prohibition for hard stuff is the only action that would help us. How to put that cat in the bag is anyone’s guess.

I sympathize, but these drugs are already as prohibited as they're going to get. Possession, manufacture and distribution are punished by years and years of prison time. It doesn't make a difference.

It absolutely makes a difference. I live a five minute walk from a camp of meth users. They smoke it and use needles in broad daylight, right in front of law enforcement. Their camps are a hotbed of drug trafficking, rape, theft, assaults, and prostitution. Some cartels run the camps themselves and demand rent from their victims. If this stuff was enforced these camps would be cleared out and people put in jail, but as it is in my county most people are let off bail and go on to commit further crimes sometimes within the same day (usually the case when picked up for catalytic converter theft or grand theft auto)

The fact that it's criminalized causes those sorts of marginalized camps and cartels to form in the first place. Even if they were cleared out, they would simply move elsewhere.

What I'm saying is that its de facto decriminalized and this is the result. If it were criminalized you wouldn't be able to live like this unhindered and unchecked on any particular piece of public land you can find. If it were decriminalized nominally, nothing would change, because people aren't being criminalized for meth use currently.

I'm not sure what you mean, drug possession is still criminalized? Has been for years, and drug use still happens, it just creates conditions which increase crime and unsafe use.

Unless, do you mean that the laws aren't enforced enough, hence the drug use outside law enforcement? I would argue that increased enforcement still doesn't help the problem, and crime and drug harm increase. Not to mention the public costs of enforcing these laws and imprisoning people on small drug charges with mandatory minimum sentences.

It's criminalized but cops don't enforce these laws, because the DA isn't going to prosecute a homeless person for these laws. Police cite them and release them and then you get stories like this (1) where people might get arrested and released for separate crimes three times in one day. I can find dozens and dozens of stories like this, some more tragic like the final crime of the day being a murder of an innocent victim.

Are these policies helping these people get their lives back on track? I'd say its clearly doing the exact opposite. By offering no consequence to bad behavior, bad behavior continues. If this person was arrested and taken into custody vs released, they'd at least be put into a controlled environment where they would be fed and sheltered and have their medical needs attended to, versus let out onto the street with no direction where they end up right back where they started.

There are costs to the public for sheltering and treating addicted and mentally unwell, certainly, but I'd argue the costs to the public of the status quo are much higher if you were to quantify them. All the petty crime, the emotional toll on innocent people victimized, the price of a life when innocent people are murdered by psychotic people on methamphetamine, the price of ER bills passed on to everyone from someone coming far too late on deaths door with zero insurance, versus the much cheaper price on preventative care that would prevent these situations in the first place, is not a cheap price. But by continuing this status quo this is the price we all bear.

1. https://abc7.com/california-zero-bail-prison-overcrowding-gl...

Even more - it makes for harder kind of drugs being on the market. It is a known phenomenon - harder prohibition leads to harder stuff on the illegal market. That is why fentanyl is in such a wide use.

It does in Singapore. Lowest rates of drug abuse in the world.

But they execute you if you have over 500 grams of marijuana so a bit extreme.

Drug trafficking is a capitol crime in China, but China has an epidemic of methamphetamine and ketamine abuse, to give you one counterexample. My claim is that law enforcement is highly effective in all areas at the scale of a city.

That's a good point. Scale changes law enforcement capabilities.

Difficult to have a measurable rate of drug abuse if you kill all of the people thinking of doing it.

there's the laws, then there's enforcement. enforcement is he harder part, and I don't see any easy wins there. you're right though - much is already "prohibited". it still happens.

> some form of prohibition for hard stuff

I don't know how we could make that work in the US. We already tried alcohol prohibition 100 years ago, and that didn't work. Patent medicines were made illegal, and prescriptions are required, for this reason.

We've already recognized that overprescribed prescription opiates in the early 2000's was a deliberate attempt to bypass these protections and get people hooked.

> How to put that cat in the bag is anyone’s guess.

I think it requires a scientific process instead of a political process. IE, the politicians need to encourage medical professionals to keep trying many different approaches until we figure out what works. This will only happen when politicians stop criminalizing addiction.

FYI: All currently legal treatment options in the US HAVE to target ending addiction. Allowing someone to voluntarily maintain an addiction to anything is currently illegal, and means that only people who voluntarily want to stop their addiction are helped.

Invent better (less harmful, more desirable) drugs?

My condolences to anyone who's lost a friend or relative to addiction - thanks to the human vultures who reap the rewards.

It's possible that by vigorously pursuing and prosecuting the people who can afford to purchase and disseminate hard narcotics - instead of the users and a pusher or two - most of the problem would dry up.

I'm not optimistic about that happening. The little guys are easier to catch, and caps are feathered. Meanwhile, the big guys have contacts and probably political connections.

After talking to a recovering addict regarding heroin, fentanyl and the such. I did some research and found I could get half a kilo of iso (stronger than fentanyl) by the end of the week. It took me 20 minutes

My point is that stuff is so widely available and easily accessible that no sort of enforcement against the higher ups will do a damn thing

Treating the addict with compassion and diligence will be far more effective than attempting to dry up the supply. It of course won't be easy and actually will require a mental shift regarding users

Instead of headlines of law enforcement patting themselves on the back about some meaningless bust

The US has never tried hardcore drug enforcement against drug dealers (i.e, execution, as many other countries do). It would categorically not solve drug addiction as a whole but it would likely have some effect.

Potentially we could decriminalize consumption, open treatment centers, but still go after the traffickers. People who sell fentanyl know that they are killing people.

I think this is a great option. It seems quite a few people opposed to decriminalization don't realize that it typically means decriminalization of personal amounts, but still going after the dealers.

I think it's most effective to prevent them from becoming addicts by addressing the hopelessness that drives so many to that (or crime). And through education of the effects for the others, of course.

Or maybe you could move the other way: treat addiction as a disease and provide free, pharmaceutical grade product or methadone substitutes to all that request it, if they suffer from addiction. It costs essentially nothing.

This will not only kill the bulk of market and force dealers out in the open to find new, high risk recreational customers as opposed to cash cow addicts; but will also give a livable life to the addicts by preventing the financial and personal ruin brought by addiction to a substance that is made artificially scarce and expensive.

Most of the problems with addiction stem from this scarcity, not addiction itself: addicts take up a criminal activities to finance their consumption, lose all property and social capital, the product has high variability in potency and adulterants and is very risky to consume, they have to deal with criminals on a daily basis to get it etc.


At the heart of the opioid epidemic was a company run by medical doctors, with a sales force targeting medical doctors, and a budget to not only buy themselves positive medical literature but also the government agencies that were supposed to watch out for the public, oh and also they had enough wealth to buy themselves immunity from criminal or financial liability.

I am not sure that the solution is a pharmaceutical product…

And I say this as someone who has been pro-science his whole life. It’s just that training people that a pill will solve their problems is a recipe for creating addicts?

Note that they say a free product. It shouldn't be produced by a company, but rather be produced at a loss by the government, so there's not incentives to keep people addicted, but rather to reduce addictions.

I lost a sister to a drug OD close to 15 yrs ago. My belief is she suffered from depression, among other things, and self medicated.

That said, the opioid crisis in the USA has been largerly fueled by prescription drugs. If by little guys you mean doctors, and big guys you mean the manufacturers;well there's been some progress on that. But obviously and certainly not enough.

Let's also not overlook the convenient blind eye of regularors (read: government).

The US has waged a war on drug for several generations with virtually unlimited funding and has made no progress on that goal whatsoever. What makes you think it could ever work, despite the mountains and decades of evidence that it has failed?

They’ve been fighting the suppliers. It’s time to go after the demand side, too. Every user bought their drugs from a dealer. Throw them in jail with the dealer.

It seems like every solution in this thread is something other than “punish people who buy or sell drugs.”

Can we at least try ruthless enforcement before we try free drugs for addicts paid for by taxpayers?

It's almost like you are bragging about your ignorance of the drug war. Ruthless enforcement was the norm for two generations and ruined countless lives. How much more ruthless would you have us be? Asset forfeiture, mandatory minimum sentences and massive violations of privacy rights weren't enough for you?

What’s more expensive, a few grams of an easy to synthesize pharmaceutical or keeping someone in prison? It sounds like your idea would be a massive waste of taxpayer money serving only to gratify a perverse fantasy of sadism and domination.

Take Jack's story and multiply it by at least a million. That's the cost we're currently paying for it. Throwing a small fraction of those people in jail in order to prevent this epidemic is the humane thing to do.

That you'd rather call a real solution to this issue "perverse" and "sadistic" betrays your own cynical view: you really don't care that much about people like Jack. You'd rather grandstand with your smug, politically correct view than actually help people like him.

Why was it so easy for Jack, a high school kid in a small town in the Northeast, to get his hand on hard drugs like this? The answer: we stopped having the stomach for being tough on anyone connected with drugs, by throwing them in prison, and creating incentives to strongly discourage its use.

We don't hesitate to jail people for decades when we find them with illegal explosives or plans to commit acts of terrorism. If those people are successful, at most they kill hundreds of people. The use and distribution of drugs does much more damage and impacts millions in a massively negative way.

It's not popular here on Hacker News due to its libertarian bent, but I'm of the opinion that we should even more brutal to illegal drug production, trafficking, and selling than what we currently are.

I've lost 2 friends to fentanyl poisoning in the last 3 years, and I lost my brother 10 years ago to chronic meth use. I'm so utterly sick of this.


Also see el Chapo. Did either of those high profile busts make one iota of difference? Did the price of cocaine change (hint, it did not) and I all but guarantee the same can be said for meth, heroin and fentanyl. They all cheap to produce and extremely easy to obtain while still being pretty cheap when it hits the streets

Every user made a choice to use at some point. We need to find ways to make that choice more costly. Punish users. Make examples out of people. Give them long prison sentences. Have the Ad Council run anti-drug ads. If users are in prison, they can’t buy street drugs.

If you destroy demand, you’ll crush the cartel’s bottom line. But that would end the nice gig the DEA, cartels, and drug addicted in this country have going on, so I’m not holding my breath.

Your whole comment is so naive about the economics of drug trafficking but I think:

> If users are in prison, they can’t buy street drugs.

is really the ultimate cherry on top. Do you really think prison contraband is extinct?

Just to make sure I understand, you're saying it's just as easy to obtain drugs in prison as it is on the streets?

Yes, or not much more difficult. This is a well studied subject: http://irep.ntu.ac.uk/id/eprint/31877/

It's not popular because it's illogical in the face of all evidence. The highest incarceration rate in the world over several decades and seemingly endless funding for anti-drug efforts failed in every respect (but ruined countless lives in the process).

Sure would be nice if the Sacklers faced any consequences.

I'm not sure that executing drug traffickers would have a strong impact on consumption, but I think it would a more just outcome nevertheless.

I don't know, the current penalties can be pretty stiff already. You can also prosecute under both federal and state laws to stack the terms. They just don't care to do that in most cases.

(Not a libertarian) I get the sentiment, but it's been shown that the war on drugs approach is expensive and ineffective.

That said, I haven't lived your experience, so I can't really know what you're feeling...

>(Not a libertarian) I get the sentiment, but it's been shown that the war on drugs approach is expensive and ineffective.

Is there really a way to show that if the war on drugs never existed, the same number of drug users would exist, thus making the war ineffective? I'm not sure how one would prove this. It seems possible that without the war on drugs, the impact of drugs could be even greater, but again, hard to prove that.

Just an anecdote but in high school my entire reason for not smoking weed was because it was illegal, even though one of my friend groups was really into it.

You may be right but the downsides are large. I think the effects are knowable, but since it's a complex issue there's lots of ways to view the data.


Checking in from Northwestern Poland. Lost my dearest cousin and best friend when he turned 27 (yep that age). I don't have any more tears left. Been crying for a decade.

I lost a friend to meth and GHB at the beginning of this year, and although details are different, the trajectory is similar.

He suffered anxiety and was fearful about his life for years. Meth was what gave him fleeting confidence and euphoria, but also what finished that life. He was terrified to live, and he was terrified of death, so he self-medicated to manage, and ultimately that killed him.

As one of the people that cared about him who is left behind, I've struggled for answers, but I don't think there are any.

> I've struggled for answers, but I don't think there are any.

It took me a long time to learn this: there are problems for which there is no answer.

I got this from Buddhism (I have renounced Buddhism, but I've retained some of the insights). The world is intrinsically fucked-up, and not fixable. You can sometimes fix some things, but in the end the world is an incorrigible mess (samsara).

It's quite a relief once you take that on board. You can go on raging against injustice, war, and political cynicism, and so you should; but there's no need to feel inadequate because you don't know how to fix it.

Thank you. I think I'm getting to that same insight by bashing my brain repeatedly around the same loop. It's good to hear it put more succinctly.

> I've struggled for answers, but I don't think there are any.

I've also experienced drug-related loss and I think one can still find some lessons. Life is terrifying for some and they feel incredibly overwhelmed. We lack Compassion and Respect for those who don't really make it. We glorify individualism and grow up with the expectation that we can also be just like them, but some just can't. The gig-economy is incredibly harsh and brutal, no wonder the weekend with its drug fueled escapades is the only thing keeping them going. For some there is just no way out of loneliness, anxiety, soul-crushing work for minimum wage or without a job. Nobody tells them that everything's okay and giving them hope for the future.

I think selfish international politics just increases economic competition which brutalises our society. We hype up Elon Musk but in the end there's a lot of randomness in life and the super-star entrepreneur could just as well die of a heroin OD in the streets.

Sorry you're trying to make this fit your political worldview. The addicts in my family are privileged lazy, spoiled, selfish people. They literally had every economic and educational advantage, in the top 1% of all people globally. It is a cultural rot and nihilism and indulgence.

Those advantages are not any kind of protection against addiction; if anything, they're a risk factor.

I have no idea what "cultural rot" means. I do know what nihilism is; I don't think it is a philosophy that predisposes people to addiction (could be wrong about that).

"Indulgence" would be when you do what you feel like doing, even if you think you shouldn't? OK, so your relatives indulge themselves. Almost everyone who can indulge themselves goes ahead and indulges themselves. Privilege comes with costs.

Maybe we just learned different lessons ;) People can become addicts under different circumstances and we can't predict individual behaviour. Just because someone exists that violates a principle does not mean the principle is wrong.

When I was nine years old, my cousin died of a heroin overdose at nineteen years old. Most of the grownups around me were very sad, but I didn't really know my cousin very well; he lived on the opposite side of the country, and he was a full decade older than me so the times I did see him we didn't really play together, and so I wasn't really able to feel "sad" about it. People I don't know die every day, I can't feel bad for all of them (cold as that might sound) and my cousin dying wasn't terribly different.

Fast forward eleven years, on my twentieth birthday, and I had a realization: my cousin was the first person I had known that I outlived, and I felt this sudden sinking feeling. Why had I been spared when my cousin had been taken so young? Why did I get to spend more time on earth then he did? It's not like I was some sort of cosmically better human than him, I had been a dumb teenager who was just lucky enough to not have friends who were willing to talk me into doing drugs.

I started asking my parents about my cousin, and it made me somehow feel even worse when I found out that my cousin had a bit of a downward cycle with drugs throughout the tail end of high school, tried joining the army in the hope that it might straighten him out, it didn't, and just fell deeper and deeper until he eventually died. Alcoholism seems to run in the males in my family (with the exception of my dad and me, strangely), so this sadly wasn't even really something completely unexpected.

Addiction is tough, I feel really fortunate to have dodged that bullet. I can't even pretend to know what addicts to hard drugs are going through.

First of all, sorry for your loss.

> Alcoholism seems to run in the males in my family (with the exception of my dad and me, strangely), so this sadly wasn't even really something completely unexpected.

Indeed, familial alcoholism is suspected to be a complex genetic trait (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4056340/). As for why you and your father seem to have been spared by that... if I may ask, did you two have access to mental health care and use it? A common theory in addiction research is the "self-medication hypothesis" (https://www.psychiatrictimes.com/view/dune-and-the-second-co...) - basically, that people accidentally discover during experimenting with drugs that the drugs help with mental or physical health issues.

> As for why you and your father seem to have been spared by that... if I may ask, did you two have access to mental health care and use it?

Well, we've had health insurance for my entire life so I guess we had "access" to it, but as far as I know my dad never used it, and I didn't see a psychiatrist until I was 26 (and I wasn't drinking much before that, certainly not enough to be considered an alcoholic). He certainly didn't have access to it until he finished school, growing up in a relatively poor family.

I think at least in my dad's case, he saw how much his dad's alcoholism screwed things up, and decided that he was going to try and avoid that fate no matter what, sort of using his dad as an example of "what not to do." As I was growing up, I think I saw my dad drink a grand total of four glasses of wine, all of which were done on different New Years events, and never enough to get "drunk" or anything like that. As he's gotten older (and as his kids have all grown up), he's relaxed on that a bit and I will occasionally see him drink slightly more frequently, but I think that habit of sobriety has been somewhat ingrained into him at this point.

I'm a recent teetotaler and my quality of life is massively improved. It took me an unreasonably long time to realize many adult role models in my life (family, and then in my first significant professional workplace) were abusing alcohol. None of them would consider themselves alcoholic. A few of them were dependent at significant cost to their health, which I believe is easily classified as alcoholic.

A few years ago I worked a project with a young foreigner who didn't drink and actively spoke out against it as - in his description - the cause of much dysfunction in his country. Politics aside, I was actually inspired by someone significantly my junior to reconsider my attitudes. What if I took a leaf out of the self-improvement culture and just tried it? It might be too much for a lot of people to simply not drink. Life circumstance counts for a lot, but my life no longer includes socializing in venues where alcohol is served so it actually wasn't too hard to stop.

There's a perspective I feel is sorely missing in this otherwise great piece and the discussion around it: the larger social and even political perspective. We treat it as an individual problem. What could Jack, as an individual, do? In truth, not much. What could the patents do? In truth, not much.

But maybe we can change things on a larger level. Create a society where heroin isn't as appealing by comparison. Where there are spaces for socializing that aren't about social competition, or at least one where there are more distinct and equally good ways to "win". Maybe one where, if you fall, you don't have to carry the guilt that your family will be dragged down with you.

I was lucky enough to grow up with the historical teetotaller community, since my grandfather was a leader of sorts in it. They used to be very adamant on seeing alcohol use (and of course drug use) as a social problem, not an individual one born out of "weakness of will" or genetic factors. They quite deliberately tried to create new social arenas without alcohol, and cultivate a sense of community and common purpose which could make it more than yet another arena for social competition. But they quite literally couldn't keep up with the times. The social venues they made were of types that were extremely popular in their day, but are exotic at best today (e.g. lodges). And along with the rest of society, they gradually embraced AA's medicalized, individualized understanding of alcoholism, turning the message from one of collective self-defense ("we're building this to defend ourselves as a community from the scourge of alcohol") to one of sympathy with the medicalized Other ("We're abstaining out of solidarity with those individuals who will become alcoholics if they touch alcohol").

>What could Jack, as an individual, do? In truth, not much. What could the patents do? In truth, not much.

This is bullshit. People who want to beat their addiction and have the support from their immediate family are the demographic that most readily beats addiction.

When it comes to beating addiction, losing weight and all sorts of other things that require a lot of willpower having some personal motivation to do whatever it is plus a support network who can help you and encourage you is just about the most effective strategy. People care a lot more about doing hard things if they feel their family has a stake in it.

I said not much, not "nothing". It's AFAIK true involving family is one of the most effective things you can do in rehab.

But it can be very costly on a human level, and there's still depressing outcomes.

It's not easy to run such family intervention initiatives. An old friend in my teetotaller org did it for a while, starting up family clubs after the design of a little known Yugoslav/Italian academic, Vladimir Hudolin.

There are things you can do, but they're not very effective and at best they help you and the ones closest to you. I'm saying, I think we should see it as a social problem more than an individual problem, and try to address it at the social level first and foremost. We'll likely always need rehab in some form, for humane reasons, but it's not possible to use it to paper over the deeper problems surrounding drug use. That's like replacing traffic safety with emergency medicine.

> What could Jack, as an individual, do? In truth, not much.

Literally every step of the way he could have done something. This is an unusually clear cut case of someone's actions leading to the outcome that they experienced.

There are attitudes that a community can express which will help or hinder, but there is no escaping that in this specific situation, to get a different outcome Jack had to make different choices.

I'm relatively neutral on drug addictions as a character flaw, it is very easy for me to believe there are people out there who would be making a logical choice to turn to a few moments of reliable pleasure in an otherwise miserable existence. I wouldn't touch hard drugs myself for fear that I would enjoy them. But, nevertheless, the only person who was in control of the outcomes here is Jack.

You're doing what I wanted to warn against, individualizing something that is at heart a social problem. If there are all these better options to choose on every step of the way, why are there so many Jacks who don't choose them?

But what's the alternative? Coerce Jack and his ilk into rehab, effectively institutionalizing them? That doesn't work either, in the long run, and restricting people's freedom is a heavy thing to do.

I stopped drinking because I realized it kept me from accomplishing things I wanted to accomplish. I think (based on my experience, can't speak for others) it's relatively easy to quit once you know why you want to quit.

I don't much regret my drinking days because I had fun and met many people. But then I realized I want to do other things than just get drunk and get a hangover.

I think, based on my experience again, that AA with its confess your sins and label yourself an alcoholic may help some people. But I think it's best to think what you want to do and accomplish, in life. Then do that. No need to keep on repeating you are an alcoholic. You're no more alcoholic than anybody else I would say. It's just that you have decided to drink and keep on drinking. It's your choice.

I appreciate your comment. And I found a similar experience in my life quitting smoking: once the decision was firm, and an understanding of the barriers it was erecting between myself and my goals, my resolve was total and quitting was easy. But you're a tad flippant about AA so let me share my thoughts as I have attended it many times - not for myself, but in support of an old school friend who was drinking himself to death some 10 years after we graduated. When he told me about his struggles in recovery I offered some assistance.

The people at AA are by and large deeply broken, and trying to slowly reassemble their lives without crumbling under the weight of the knowledge - largely gained in sobriety - of the massive damage they have done to themselves and others, and returning to hide in addiction. This harm often includes the repeated abuse of their loved ones throughout their addiction, and their guilt is enormous. If they appear stuck, consider that at least they are stuck in a place where they are not drinking, which in most cases is an enormous improvement.

If you do not prefer the religious component what I would say to you depends on whether you are an addict or not. If you are an addict I would say you are in dire need of a serious dose of humility: admitting you are powerless and that you need the help of a higher being fits that requirement. If you are not an addict, you should really not attack an institution whose sole purpose is to help addicts. Just smile and nod.

> and that you need the help of a higher being

For that to work, you have to suspend your critical faculties. There are no telepathic aliens. Angels don't exist.

…which by the way is also an approach Richard Feynman took: He basically stopped drinking because he liked thinking itself way too much to ever let something impair that.

I‘m fortunate enough to be able to keep my drinking level at a point that helps me socialize and enhance enjoyment (the occasional bottle of wine with friends and peers), but not above.

I‘ve also experimented with drugs in the past because I was just too curious, but in the end, I was lucky to not end up some place I didn‘t want to.

By now I’ve experienced that ability wasn‘t just personal strength, but also my predisposition and experiences.

That does‘t excuse anyone from not trying harder, but it was a sober reminder for me to see that addiction is a way steeper slope for some of us.

> It's just that you have decided to drink and keep on drinking. It's your choice.

That's kind of the dividing line, though, isn't it? If it's your choice and you could choose otherwise, then you're not an alcoholic. Some people don't feel like it's a choice.

I can see one could be in a situation where doing cold turkey might be dangerous so in that situation it might be dangerous to stop. But isn't it still their choice? I know this might get easily into deep thinking of whether we have free will or not, so I'm gonna stop

Hearing alcohol addiction, it seems so "unreal" in the sense that, I can see it as a problem but I always feel it can't be that hard.

I think alcohol, tastes disgusting in general. It's fun to mix with other things to have a stronger effect, but I've always enjoyed everclear to accomplish that, which basically is just pure ethanol.

I never understood alcohol culture, bars, going out, etc.

And I always related that to not being "popular" or feeling calm in a new city or such. I think it's so strange to go to a place, have to wait in line, pay admission/cover, to talk to a bar tender that expects tips, and then pay extravagant costs for something that can be purchased cheaply anywhere else (yes, I understand the transaction/food/beverage/hospitality.)

Never will get it.

You're not alone, I never got bar/drinking culture either. What was always really weird to me was how homogenous it actually is, like how the nightlife in a city is more or less interchangeable, you just swap out the music and the clothes people wear, but otherwise its the same set of interactions every time. How this was settled upon as THE way to socialize is utterly baffling to me.

I understand not wanting to be apart of it, but it seems silly to say you literally can't understand why others do it.

It is very obvious. It lowers inhibitions, causes euphoria, thus increasing the enjoyment of social interactions for many many people.

I think this is really socialization, surroundings and trivial occasions. My family drinks alcohol, but very rarely so. I studied in another city where alcohol consumption is far more common and I was drunk nearly every weekend (didn't have much training). Now I am back to a beer every two weeks and I don't miss drinking more. I don't consider that self-improvement though, that would be a bit much, although it probably is far more healthy to not regularly intoxicate yourself. I also don't think most people were addicts, at least not yet.

Good on you. I think it's important for people to understand their own susceptibilities and react according. Interestingly enough, the boomers are the highest drug using generation by far (1) in the US. I wonder what impact this has on society at large. I would guess not a good one.

(1) https://drugabuse.com/featured/drug-and-alcohol-abuse-across...

> my cousin had been taken so young?

He wasn't taken. He took himself. Exercise: Everytime you remove agency, reintroduce it.

"I am depressed". No, you are depressing yourself. "I am helpless". No, you are making yourself helpless. These are active processes. Let's get more controversial: "I am being bullied". No, you are letting people bully you.

I know this is harsh. I know the societal memes and phrases are the warm place. A sigh, the Soma of "Nothing can be done" or "Somebody needs to do something!!" is not a solution but paralysis.

You can read it in the article: The parents did everything for the addict, he did nothing himself. It didn't work out now, did it? Never does.

(Not absolving the Sacklers of their guilt, that is a separate issue)

Please don't post in the flamewar style to HN. If you want to make a nuanced point about personal responsibility, ok, but turning it into a big binary polarity and then blaring condemnatory, dismissive rhetoric at the pole you disapprove of is no way to do this.

You say you know it is harsh—that's already a reason not to do it here. Maybe "harsh" can do some good when there's already a strong relational connection with the other person. (Emphasis on maybe, because people who take harsh stances generally are paying more attention to their own ideas than to the person they're commenting on—but no doubt it does happen sometimes.) Here, however, you're broadcasting to thousands of people over the internet, with zero relational connection. In such a context, it's merely provocative and destructive, and one could even say selfish.

If you wouldn't mind reviewing https://news.ycombinator.com/newsguidelines.html and taking the intended spirit of the site more to heart, we'd be grateful.

> A good critical comment teaches us something.

I feel as if I did that. Maybe my writing comes across way differently, maybe my comments are not as direct as they could be - but if that is already too upsetting for this crowd, you will never get any actual critical comments. You will never arrive at any traction, at any truth. Too bad, I expected more here. My error.

Case in point:

> Please respond to the strongest plausible interpretation of what someone says

Nobody replying to me did that. Amazing.

> I feel as if I did that.

I'm sorry - I don't mean to pile on! - but I don't think you did that. The comment didn't include interesting specific information; it was a moral hectoring. Those do not come across well on the internet.

> Nobody replying to me did that. Amazing.

Not amazing—quite predictable, given the provocation. In cases like this, the root comment bears the most responsibility. Here are some further explanations of what I mean by this, in case you or anyone want more:



https://news.ycombinator.com/item?id=27162386 (<-- long discussion with a user about a similar thing)


> > Please respond to the strongest plausible interpretation of what someone says

> Nobody replying to me did that. Amazing.

You worded everything in absolutes. If you ask people to take the strongest interpretation of that, you're asking them to just concede that you're right.

I think you actually seem to get it that there's something dangerous about identifying with the problem (e.g. I am depressed) but you're jumping to conclusions about agency from there. No one who replied wanted to make that leap, nor did you offer any compelling reason to do so.

I started writing out a much longer response to this, but it just got very ranty so I'll cut it short. If you insist on such a reevaluation as to why people aren't in their best state, a one word answer "lazy", "attention seeking" (okay thats two words, you get the idea), "weak" isn't going to cut it. You need to continue to ask yourself why that is the case, why are these people so apparently lazy, that they would allow it to work negatively upon them? I obviously don't buy your argument, I think the expectation of complete agency in a society run on hundreds of thousands of people is a bit of a fantasy, but you could have a point. You just don't have anything yet.

Another argument against it, why not turn the mirror on yourself. Why are you not richer, stronger, more popular, happier? Maybe you are somewhat of all those things already, but a wild guess is that your not the strongest, richest, most famous and happiest person in the world. So why not, are you weak, lazy and shallow? Or, perhaps is the truth a bit more complicated?

I have seen the homeless as people to be pitied and helped. Just weak people, down on their luck. So you help them, right?

I let a homeless man sleep in the hallway of my building. He took a shit in front of my door.

Now if I had seen the homeless as what they actually are, maybe weak, maybe helpless, but still people with agency who can be absolute assholes, that wouldn't have happened.

And I hate that this is overlooked. Maybe if the parents in the article wouldn't have fallen into this trap, their son would still be alive.

The assumption everyone downvoting seems to make is that I don't have compassion or as you do, I see them as "weak", "lazy" or "attention seeking" (notice how you are seeing them as that, not me).

I can have compassion and ask them to do their part. That actually solves the problem.

You don't seem to have much interest in answering the crux of my point, which is the continual asking of why until you get to the true reasons why things are the case. Instead, you've just given another high level example.

To be honest I'm not even sure how this new example relates at all. You're simply saying that people can do bad things, which I guess is true, though I don't see how that supports your argument. I don't think anyone was suggesting people have no agency, and can't possibly make any changes in their life, the suggestion is they don't have complete agency, and their life will always be governed by factors beyond their control. Taking your point, yeh, people can be assholes, but why? "Just because" isn't a proper answer, and if it is the same can be used to dispel your argument just as easily.

> notice how you are seeing them as that, not me

Hmmmm, not quite. Your whole argument rests on people refusing to make changes in their life for no apparent reason, and these are typically the words used. You didn't use them yourself, no, but I think it can be quite easily inferred, not least by the fact you called another commenter a coward. Again, following my argument, ask yourself why I thought you would think of them in those terms.

> That actually solves the problem.

Maybe you're right, maybe you're wrong. I suspect you're right in part, but things tend to be more complicated. Either way, thats not my point. My point is asking why they don't do their part, for example.

They don't do their part because they are not expected to. That is my problem with the "disease" label. That is my problem when talking about homelessness. That is my problem when talking about addiction.

And there are people who make a good living keeping it exactly this way, making bank in the wake of the moral outrage of the "helpers".

>I have seen the homeless as people to be pitied and helped. Just weak people, down on their luck.

They are. They also tend to have high rates of mental illness, which often is what leads them to live transient lives. Leaving them in your hallway unsupervised, though well intentioned, isn't the way to help them. It didn't backfire because people are assholes, it backfired because you operated on a faulty understanding of the situation

> I can have compassion and ask them to do their part. That actually solves the problem.

Have you actually done this, and did it solve the problem?

I don't think it's fair of you to use quotation marks when the person you are responding to didn't use that language.

Not is it productive to misinterpret his comment as perpetuating a tired trope and then launch into an emotional rant against something that literally nobody here is supporting.

GP did make a fair point - learned helplessness does nothing but exacerbate your suffering, and taking agency and responsibility for your own mental state is the most effective way to improve things.

Whether the solution comes through lifestyle changes (leaving toxic environment), a simple change in viewpoint or SSRIs, labelling yourself as depressed or burned out and then succumbing to your new fate is never productive. I know this because I've experienced both.

> I don't think it's fair of you to use quotation marks when the person you are responding to didn't use that language.

Which everyone who reads it can clearly see, and understand that I saw that kind of language as a possible response to my question of "why?". I wouldn't say thats any kind of trickery on my part.

> Not is it productive to misinterpret his comment as perpetuating a tired trope and then launch into an emotional rant against something that literally nobody here is supporting.

Theres an irony to saying I "misinterpreted his comment" and then immediately doing the same to mine. It wasn't an "emotional rant", maybe a bit of a rant, but I'm not going to apologise for that. I'm not sure which tired trope I'm perpetuating.

> and the rest...

I think you're missing my point. Perhaps, to use your own words, I could even go further and saying your misinterpretting it and launching into an emotional rant.

My point isn't that people can't change their circumstances, or that self improvement is pointless. Its that so many factors govern these things that its a fantasy to believe anyone is in complete control.

You're not depressed because you just are and theres nothing more to be done, nor are you depressed because you make yourself depressed. Hence why I argued to keep asking why, if you truly believe that your depression is caused by yourself, ask why you would do that to yourself, and keep doing so until you find the true reason.

Just for what it's worth, I wasn't attacking the content of your argument - mainly just defending GP while attacking the tone of yours. What you said wasn't wrong, but it was in response to an argument nobody was making.

I am not entirely in agreement with parent comment, but I need to call false dichotomy on your second argument. There's a whole range of acceptable states between depressed and happiest.

> "I am depressed". No, you are depressing yourself. "I am helpless". No, you are making yourself helpless. These are active processes. Let's get more controversial: "I am being bullied". No, you are letting people bully you.

most people are social animals. it's easy to be an individualist if you have the trait and nigh impossible if you don't.

Fair point. My own character traits certainly color my viewpoints.

What exactly does that restatement change? Also, what is your background?

It removes the victim mindset.

My background is a recovering asshole, partially failing, aka the son in the article.

I see. I had a hard (physically manifested) depression episode recently and had to pull myself by hair and stubborness out of it, so your viewpoint seems valid for the ones who do. But it’s not what society feels. Your anger towards “yourselfness” does a good job, but I guess you’ve been helped, at least instructed on some details. That kid may not have had such privilege, spiralling down on his own (you can’t be strong if you don’t realize that you’re vulnerable, if it doesn’t click as “I allow it to happen”). And one can OD by chance while not being anywhere near the end of that slippery slope.

While advice like this might have been alright if it was in a self-help book where the OP was looking for ways to approach the situation, it is completely uncalled for and inappropriate in this situation.

> "I am depressed". No, you are depressing yourself.

What about Bipolar and Schizophrenia, do you think about them same as depression?

That sounds like a warm place for a anti-social person.

You need to lay off on the Jordan Peterson. It's more complicated than "clean your room".

> "I am depressed". No, you are depressing yourself.

You're assuming a brain that's in good working order. It's difficult to imagine a different one. Consider that not everyone's window into consciousness works like yours does.

This post is victim blaming 101.

Extremely powerful 5 minute interview with an obviously intelligent homeless person addicted to heroin: https://www.youtube.com/watch?v=H6ZFzEW7_Q4


I had a friend die this year from heroin (probably from fentanyl, but his family doesn't talk about what happened, so hard to know for sure).

His friend group were always pill poppers, and a number of them started popping oxy. In two years, three of them have died. They all moved from oxy to heroin. All of them were snorting it, rather than shooting up. My friend told me they got heroin with fentanyl without knowing. He told me this when he came to visit from my old hometown, while he proceeded to crush up and snort an oxy in front of me. He told me he'd been buying heroin recently as well.

I knew at that moment he'd be dead soon too, so when his family gave the news, it didn't come as a shock.

The Sacklers are pure evil. Heroin is a serious problem, but there's a major hurdle that it faces: people know that heroin destroys your life. People trust their doctors, and they don't associate oxy with heroin, but it's a life destroyer just as much as heroin.

Most of the discussion here seems to be about hardcore addicts, and the issues that come from them, but they're just the face of the problem.

> My friend told me they got heroin with fentanyl without knowing.

This is an all too common trend. Most people aren't dying from an accidental overdose, they are being poisoned with fentanyl.

You get addicted to pain killers. Then go to heroin because it's cheaper and more effective. Then you get it laced with fentanyl because dealers are cutting it. Then you die.

To slow it you have to pressure China to stop the labs and you have to crack down on border smugglers, neither will happen anytime soon.

> Most people aren't dying from an accidental overdose

Yes they are. Before fentanyl contaminated heroin came around most heroin overdoses were because of massive differences in product purity. You know the dosage for your usual 10-20% heroin and when you get a batch of 60%+ you are doing over 3 times your usual dose without having a clue and because heroin has a low delta of LD50 to active dose, your usual dose is now letal.

If medical grade heroin was available, with known purity and no contaminants, heroin deaths would drop to almost 0. The drug itself isn't even that distructive in normal dosage, apart from the crippling withdrawl that btw is not letal and dosen't even require hospitalization, unlike benzodiazepine and alcohol withdrawals which can be fatal.

> Before fentanyl contaminated heroin came around

But today, fentanyl poisoning is fueling the massive increase in deaths, it's over half of all overdose deaths.

Benzos are lower than prescription opioids, heroin, and cocaine in terms of overdose death.


The author here is exactly right for the majority of cases. Everyone trying to spin it any other way is delusional. Society is difficult and humans vary greatly – not everyone is able to succeed. Many aspects of society are also competitive – some people will be winners and others will be losers. Losers turn to heroin because 5 years of shooting up and then dying seems like a better option than 60 years of living with the shame of mediocrity and the struggles of daily life.

It's not a function of an inadequate welfare state or de-industrialization or inadequate mental health treatment or any other social malaise. It's just life in a world of abundant resources where 99% of people are living at the top of maslow's hierarchy of needs. The only way to avoid this is to put people into an environment where the struggle for survival eclipses the desire to be happy.

I'm sure there are 20% of addicts who fall into this accidentally or would be able to live a happy post-heroin life, but for many people it basically makes sense and there's nothing to be done.

I know someone just like Jack (some of the similarities were shocking). They have a home to go to, a loving family, a large and supportive friend group, opportunities for work. They are not dead yet, but having been through prison, buprenorphine, and multiple expensive rehabs, I begin to wonder what the solution for them is. If there is anyone here who has beat this addiction perhaps it would be insightful for them to post what worked for them.

I haven't personally dealt with addiction, but I work in this space and the most effective treatment we have is Buprenorphine. Try to find a provider who will work with them and not kick them out of their program if they return to use. There are even telehealth options now, which is what my company does.

The author didn't consider than Jack may have committed suicide by heroin. Considering the rest of his analysis about how grim his life was with no hope of it getting better I think that's a reasonable hypothesis.

As bad as it sounds he may have wanted to end the suffering for him and his family

I’ve just finished reading Empire of Pain: The Secret History of the Sackler Dynasty , and I highly recommend it.

An amazing multi generational history of how the Sacklers inflicted opioids on the US, made a fortune, and got away with no consequence.

It was pretty interesting to read this during pandemic times, and it’s a prime example of how institutions lose legitimacy in the public’s eye. The Sacklers had the FDA in the palm of their hand, as well as the highest reaches of the justice department, as well as large numbers of medical professionals who patients trusted to make decisions that wouldn’t harm them.

What gives me hope? That I can surround myself with people who I can help and who will help me if I need it, not any type of fancy concept or title (Governor Agency, BigCo, professional title etc…).

I wonder what’s being peddled these days as completely safe but survivors will look back on as absolutely foolish.

Probably the wrong place to ask, but is there any information on the social costs for the Sacklers of their criminality? (I'm not excusing it, I'm just interested).

Although they have stuffed Giga$ into their pockets, most people also care deeply about their own social status, so have the Sacklers had severe social repercussions from their peers? Some of their peers or acquaintances of their peers must have been addicted.

The book documents multiple direct instances of Richard Sackler being told that his drugs were affecting people in his community (an anesthesiologist in his kids school told Richard Sackler he would be a modern day Pablo Escobar for example). There is a Sackler family member who had addiction problems and committed suicide. A receptionist an aide to the upper circle of the family/company became addicted.

If there is a positive part to the book it is indeed some very small sense of social justice outside of the legal system (which failed to hold them to account). Nan Goldin is an artist who lead the way in organizing protests and press that would lead to their names being taken off the very museums and universities they had paid to put their name on. They had worked hard, over multiple generations, to have clean name despite their business. Nan and others did a lot of work to make sure that changed.

> Although they have stuffed Giga$ into their pockets

I don't suppose that Giga$ makes you happy. I'm not sure what "social status" is like; is that the same as having friends who own Giga$?

I possess what I'd call "social status" - I'm not a pariah, my neighbours greet me on the street, and my kids and my ex-wives treat me as a friend. I own my home, and I have no debts. That's quite enough "status" for me. I consider myself pretty fortunate.

>Some of their peers or acquaintances of their peers must have been addicted

Rich people can afford the absolute top-tier rehab (and probably can just start doing coke w/o repercussions).

Top-tier rehab is a bit like a nice holiday - class-A cuisine, saunas, massages, therapists who are paid to listen to you wibbling on about your childhood, nice beds, nice gardens. I can imagine people falling back into addiction just so they can have another spell in rehab.

I am also reading it. It's fucking horrifying. Absolutely recommend.

Dopesick is a good show on Hulu on this subject right now.

Singapore already solved this problem: Execute all drug dealers.

Remarkably effective but at a tremendous cost to personal liberty.


Wait, Singapore has the death penalty? I thought it was such an exemplary modern country?

"Exemplary" - it's effectively a very authoritarian one-party state, organized over racial lines, that profits parasitically from their neighbours (refining Indonesian oil, dodging Chinese taxes, etc etc). It works, for sure, which is a sad indictment of humanity in the third millennium, but personally I wouldn't want to follow that "example".

Sometimes it ranks highly in "freedom lists" - for example economic freedom. It is cited for being well run and achieving a successful diverse society. At other times they write how rigid their system is.

> Remarkably effective but at a tremendous cost to personal liberty

Presuming Singapore correctly identifies the dealers, how is this a violation of liberty? You typically don't have the ability to harm others and drugs cause clear harm. It's not like laws against theft cost me personal liberty.

Relevant recent podcast?


my summary: Basically claims the majority of the homeless problem is a some "new" meth type addiction. That traditional meth was a "party drug" that made you want to have fun but some new style meth is a "I want to be alone drug" and the majority people living in tents are the casualties of this new type of meth

Quinones previous book on the issue 'Dreamland' was very good.


Econtalk on that book :


Good read from the same guy (excerpt from his book) here: https://www.theatlantic.com/magazine/archive/2021/11/the-new...

I recall the book “Change your brain, change your life” covers the link between brain trauma and eventual drug abuse as a way to counter an undiagnosed medical issue.

Although I’m not 100% sure it was that book - For curiosity: I’m wondering if Jack had any history of concussion or other head injuries before the addiction.


It was also mentioned that these patients had to be prompted multiple times before they remember accidents like falling off their bikes or tripping etc. as they would promptly forget and get on with their lives.

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