Comment by zkms | Hacker News Reader

Comment by zkms | Hacker News Reader

Ah, if the trend toward nastier and more potent fentanyl analogues was an expected and predicted consequence of opioid prohibition. That would have been nice to know!

Before opioid prohibition deaths from opioid use were quite rare. You ever heard a pothead drone on about "it's nearly impossible to overdose from smoking marijuana"? The same thing applies to smoking opium. It's nearly impossible to overdose on that. But prohibition has pushed us from opium smoking and oral laudanum to injectable heroin to fentanyl and now we're at carfentanil.

The current USian "opioid crisis" is another manifestation of opioid prohibition pushing people from safer, cheaper, less disruptive and deadly drugs to more deadlier ones. Two decades ago some USian opioid users could go to pill mills and get prescriptions for pharmaceutical grade opioids but the DEA kicked down doctor's doors a bunch and that ended up pushing people to the illicit market. Maybe next time you see those scary increasing graphs of opioid deaths vs time, give that a thought? Sum up all those deaths (compared to the baseline, prior to the increased LEA focus on "pill mills) and ask yourself: are all those needless deaths worth it?

For a unit volume (so, for a unit risk of ending up in a concrete box as a consequence of shipping/making raw product) of uncut/active material, you want to be able to sell the most diluted/cut doses to end-users. Of course people will want their chemist to synthesise carfentanil (over regular fentanyl), because you can supply the the same number of end-user doses with 10,000 times less active material. The harder the enforcement, the more potent this selection pressure gets: https://en.wikipedia.org/wiki/Iron_law_of_prohibition

I agree with your dim view of prohibition. It clearly makes things much worse. In fact, I lean toward the extreme opinion that prohibition isn't merely counterproductive, prohibition is the entire problem. Furthermore, the notion of "drugs" and all that they represent is socially constructed; only a sliver of what is believed about drugs comes from the chemicals themselves; most of it is a tradition of myths that form a sort of secular religion, along parallel lines to belief in things like black magic and curses. Drugs are thought of as possessing evil and demonic properties; they are tainted with black magic, and consuming them brings the black magic into a person's body and causes them to commit evil acts, infects their minds and causes madness and irrationality, causes everything the person is connected to to self-destruct, and ultimately kills them. Unless, that is, they are able to break the hold of the magic, renounce drugs, and perform rituals of cleansing (getting "clean"), etc., to symbolically remove the magic and show that you have been reborn as a person who recognizes the terrible power of the black magic and now wants nothing to do with it. Except that the magic can never be completely washed off; you are now an "addict".

Anyway...

This is entirely consistent with how weirdly cultish the "rehab/treatment" industry is in US: https://news.ycombinator.com/item?id=13848273

I see the rehab industry as selling snake oil. I'm sure that it has been a good business to be in with the trend to send fewer addicts to jail and redirect them to rehab instead. Going to rehab is a good idea if you need to rehabilitate your image, e.g. to get a job. I have no experience of American rehab. The whole idea seems weird to me.

I think one of the practical effects of it is that serves to teach drug users about the "addiction disease" and how to act their part in the drama. I suspect that it helps bring about the symptoms of the "disease", because without being educated about the symptoms, how would you know what you're supposed to do?

One more thing. I think rehab causes people to die, because a heroin user is made to stop, then they are in rehab for a while, and then they get out and accidentally inject too much and overdose. When you are denied something you want for a period of time, the tendency is to make you want it more. It makes the drug into an obsession and the whole thing just reinforces the importance and perceived desirability of the drug.

I think that even users of a drug have beliefs about the drug and its effects that are myths promoted by the anti-drug side. Drugs are supposed to feel like more pleasure than 100 orgasms, right? I actually think that no drug directly causes pleasure. It's like alcohol. Alcohol by itself does not plaster a smile on your face. The enjoyment of drinking comes from combining it with an enjoyable activity. Likewise for drugs. Their effect on mood is neutral and the enjoyment comes from combining it with an enjoyable activity.

It almost seems like the message of NA was maliciously designed to induce hopelessness and defeatism, the exact opposite of what would help a person who needs optimism and confidence to make a change that might seem scary.

> Before opioid prohibition deaths from opioid use were quite rare.

Maybe in the U.S., less so in China where ~25% of adult males were opium addicts in the early 1900s. The war on drugs isn't a success by any means, but at least the problems that exist aren't on that scale.

A better example of prohibition backfiring is with marijuana, where before prohibition ~0% of Americans were marijuana users, whereas today ~85% of American adults have used marijuana.

My argument isn't that opioid use in the time of opium dens was harmless, nor that opioids can be used willy-nilly without any harms. I am well familiar with some of the dangers of opioid use and do not wish to discount them at all. My argument is that opioid prohibition in the 21st century in the US is a legal regime that amplifies those dangers -- it kills lots of people quite effectively (and keeps killing more every year).

The number of people who use opioids regularly is a second-order concern (if only because fent-laced heroin certainly gets that number down) to me, frankly -- reducing morbidity and mortality due to drug use is a lot more important. With a decent medical infrastructure, addicts should be able to get opioid maintenance therapy with the right drugs and dosage and be able to lead actual interesting lives beyond trying to score the next hit.

I'd so much rather live in a country where people who want to get high on opioids can buy cheap, pure, precisely metered opioids that won't kill them rather than smashing car windows to be able to pay for overpriced fentanyl-laced drugs sold by criminals that might overdose them in the street (which will cause even more expense and load on the already-awful USian medical system).

"There are 100,000 total marijuana smokers in the US, and most are Negroes, Hispanics, Filipinos and entertainers. Their Satanic music, jazz and swing, result from marijuana usage. This marijuana causes white women to seek sexual relations with Negroes, entertainers and any others." ~ Harry J. Anslinger

By comparing the anecdotal regular users in the 1930s to the current population that has had at least one use you are purposefully making a faulty comparison. Why did you not compare past and current users?

> The harder the enforcement, the more potent this selection pressure gets:

And the higher the potency, the easier it becomes to smuggle. Contrast marijuana, where they have to haul the stuff over by the bale, vs even one brick of super potent opioid which could supply half the country for a couple days.

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