Portugal treats addiction as a disease, not a crime
nytimes.com
nytimes.com
Today it is still a poor neighborhood, but you don't see that kind of thing anymore. Taking the bus there is no longer a gamble. You still see a couple of people looking somewhat emaciated, but nothing like the walking cadavers of 30 years ago.
There were some slums outside Lisbon, like Pedreira dos Húngaros, where the police (other than SWAT teams) simply wouldn't go. It was just too dangerous. One would occasionally hear the blasts of fireworks, telling people drugs had arrived, or gunshots, warning drug dealers an intervention squad was near. This slum no longer exists, and many others are simply gone.
It's nice to see this article in HN, for many reasons.
António Guterres is an engineer, and when he graduated he was the best student of his year. From what I know, he considered a PhD in Physics before taking his chances in politics. Back in those days, his university (Instituto Superior Técnico) didn't have a Physics course, so many of its first faculty members came from IST's Electrical Engineering course or Physics courses from other universities. He lectured Theory of Systems and Telecommunication Signals.
Guterres is an intelligent man, and he would've probably become a great physicist, an excellent teacher, or a renowned engineer. Instead he chose politics, and now he's Secretary-general of the UN. His drug policy from his Prime-minister days saved thousands of lives and definitely changed Portugal for the better. I think that was a really nice hack.
Guterres is a worldclass facilitator full of good will. That's his edge - not intelligence - and how he got his position in UN.
In 2001, Guterres was forced to resign from his job as Prime Minister of Portugal. Not the best indicator of great leadership or management skills.
> In December 2001, following a disastrous result for the Socialist Party in the local elections, Guterres resigned, stating, "I am resigning to prevent the country from falling into a political swamp".
Could you clarify why you believe resignation implies a lack of leadership or management skills?
(IMO) his fall, on the eyes of the public opinion at the time, started here: https://en.wikipedia.org/wiki/Hintze_Ribeiro_disaster
Few years later, Guterres found the perfect employer for his skills: UN.
In doing so, you could move to a kind of competency-based system akin to what happens with people who have dementia or cognitive impairments. Basically, you're legally entitled to buy whatever meds you want, until you're deemed incompetent to make that decision. Processes could be set up whereby mental health professionals (psychiatrists, psychologists), ethicists, and the judicial system could make determinations that an individual is not competent to make decisions about the substance use purchasing due to addiction.
This might sound kind of draconian, but decisions about competency could be make pretty thorough, requiring a petition, stringent evaluation criteria involving panels and a judicial decision. It would also be dramatically less restrictive than the current system, that basically assumes everyone is incompetent to make drug-related decisions based on the specific drug.
It would also emphasize that the lack of competency is a health-related problem, and not a criminal problem.
These would be abused. People would be told that they're categorically unable to consent for being LGBT.
Determinations of competency already happen in the US for all sorts of reasons. I'm not saying it's perfect by any means, and that it doesn't get abused, but the abuse of that system pales in comparison to abuses under the current drug enforcement and regulation system.
Personally, I am for complete unrestricted deregulation, but I can see issues around liability for providers, arguments about actual competency to decide, etc., and treating it like other forms of competency decision seems like one mechanism to address that.
Medically speaking it seems like the same situation to me as competency issues due to other forms of neuropsychological incapacitation.
The existence of any social or institutional mechanism that gives one esteemed category of people the right to deny someone else's rationality is always abused. Not even only abused with small probability, it becomes the norm. Therapeutic authoritarianism produces labels like "drug addict" which only results in widespread persecution of people who don't follow society's preference of correct drug usage; soon people who are the wrong weight might also become deemed 'incompetent to make good-hearted decisions based on the specific drug', or their specific religion, or their "oppositional-defiance disorder" etc..
Could you imagine if we said "people who go to work everyday are helpless because their incompetence prevents them from seeing that they are only doing it because their brain has been rewired to make them depend on their salary for satisfaction" or the seemingly innocuous but even more insidious version, "oh, I did hear that new studies showed that some people are just genetically predisposed to employment.. it's not their choice, it's a disease, you know. Haven't you heard about the long-term epigenetics in the reward center? The brain becomes rewritten!"
The thing called addiction is itself little more than the fear that drugs make a person incapable of choice, their free will. Not surprisingly, in pursuing the desire to correct individual behaviors with state-sanctioned superstition, a decades-long nightmare of rights violations and moral duty to dehumanize 'addicts' in the name of therapy ensued. It's like using thermite to put out a candle. Any transformation of the approach to drug use that forfeits the people it's supposedly benefiting from the regularity of the guaranteed rights granted to all of society is doomed to be the opposite of their freedom..
Unless you qualify that statement more, I read it as a blanket indictment of basically any institution with any decision-making power over individuals.
This logic can be equally used to indict:
- courts (because they can throw people in jail and take away their rational decision-making power)
- the military (killing people obvious removes their ability to make decisions)
- taxation (removes the ability to rationally how to allocate a portion of their resources)
- laws (it restricts the freedom of rational individuals to decide right and wrong for themselves)
A heuristic that is so broad that it can be used to paint nearly every social relation in a negative light is not a useful heuristic, because it doesn't let us profitably separate the chaff from the wheat.
The question should not be whether turning addiction into a medical rather than criminal problem would be completely free of abuse. It will not be, because humans and human institutions are imperfect. The question is whether this would be better than the status quo, and it seems like it would be.
What's worse -- no longer having the right to purchase certain drugs, subject to the decisions of a medical bureaucracy, or letting the legal system imprison you for years, like we currently do?
I don't intend to say that coercive systems are abusive because they contain an element of coercion by design. Rather, the people they (aim to) abuse (by design) in practice diverge significantly and often hypocritically from the malefactors whose intolerability was so great they caused the hunt in the first place.
I am not simply arguing coercion is empirically unethical, nor that coercion must be perfect, nor that there are no differences between different instances of coercion.
A difficult example where you need to coerce is when someone has Alzheimer's. If your mother has Alzheimer's, you had better provide care for her because the very material (therefore identified because of reliable differentiability of physical matter) brain disease (the opposite of an immaterial, and only socially-identified disease) that prevents her from accessing her existing body of evidence of the world can still be supplanted for her sake, by you as her child, so the kind of capacity of 'self-honesty' that Alzheimer's steals from the elderly can be compensated in a way where you take responsibility to 'donate' her self-identity back to her.
A simpler example is: if you are crossing the street with your young child, and your child darts out into the street in the path of an oncoming car, your duty is nonetheless to forcefully grab them by the arm if possible, because the child wants to survive instead of die by mistake.
I guess that I am trying to say that exactly because each of your examples (courts, law, taxes, mil) fails to meet the exceptional ideal they establish to allow their exception, they just tend towards abuse of privilege (in the sense that the expectation of the injustice from using the privilege is greater than the expectation of the injustice resulting in not using the privilege of coercion).
The thing they have in common is overestimating the frequency of hard successes that their proponents intend. They often inflict more damage to 'false positive' peripheral individuals than they prevent by coercing the 'true positive' individuals they are meant to stop. Therefore they stray very far from their aim. It is the aim that society is improved - but still respects the individual - that necessitates justifying the coercion that transcends the danger of catastrophically legislating coercion.
- courts are currently so beyond their capacity that the norm in >90% of cases (iirc the number correctly, but i am unsure that the statistic is accurate; merely that the percentage is unbelievably high suffices) is to state a lie over one's guilt and accept a plea bargain because the courts are so crowded due to draconian law that they cannot serve as instruments of justice without causing greater, indiscriminate injustice; the pressure for courts to move forward hastily + the laws whose inappropriate scope and severity harm the ability to achieve justice means their combination results in a failure to meet their social obligation to their optimal capacity of ensuring justice for all. You really have to believe there is a benefit to the guilty for living in a society where punishments for crime must be optimally minimal in misallocation. Justice is not the most ruthless form of litigation that results from encouraging self-inflicted punishment a priori for people who become accused. This is more self-referentially crucial to the ideal of justice itself, irrespective of the drug war at all.
- the military often grows because of the work of people who would prefer less of their taxes go to killing and more towards American prosperity. An example of this is Trump's "America First" doctrine having the opposite cost of his more important doctrine of devoting a plurality of funds to national security. The contradiction between the military and taxes is not because the military kills people that Americans don't want nor that taxes don't improve expenditure towards things America wants, but rather because they achieve unity in spite of expression as contradicting ideals:
+ A) our national security is the most important thing we can spend money on, because survival comes before the ability to even benefit from any other expenditure, and
+ B) we only permit taxation in the first place because taxation gives a non-zero-sum benefit for fulfilment of society as a collective beyond each individual only worrying about their own security
My argument is itself a heuristic argument, I would say:
expectation of iatrogenics (harm of the healing) of avoiding iatrogenics of epistemically-flawed institutions < expectation of iatrogenics of epistemically-validated but non-institutionally-remediated concerns < expectation of severe unknown iatrogenics you become exposed to by succumbing to compulsive institutional remediation of lesser, known iatrogenics
If I understand correctly, all you need to do to heuristically estimate which is most harmful in the big picture is to pick a large number K that you use to compare probabilities [0]. The severe outcome for which the probability P(Outcome | Outcome > Harm severity K) is most harmful for those probabilities where P(outcome | outcome > k) is proportional to k*outcome; so large, widespread minor policies can incur massive damage.
[0] Taleb, Silent Risk (forthcoming), Chapter 1
Isn't that allready pretty much the case?
If a person gets demented, cracy, whatever - then other people around them notice and take action. Hospital, Judge s. There are also other issues than drugs, like driver license, firearms, childcare etc.
Not that it is really easy to determine if a person is sheep-like. Lots of gray area and abuse in that area, so barriers are quite high.
(is a suicidal person for example crazy? I think not necessarily, only in rare exceptions)
But I very much agree, that a normal, mature person should have every right to consume whatever he or she wants. While beeing still fully responsible for all her action s ...
Not every drug you take is limited to impacting just you. A good example is antibiotics. We are having serious issues with drug-resistant bacteria. Allowing people to just take antibiotics of their own free will is absolutely certain to increase the number of drug-resistant bacteria. This will, with absolute certainty, result in an increase people being killed through no fault of their own.
Could this be prevented? Nope. One might say people could be educated and that they'd make the right choices, but the very idea of that is farcical. The planet is not populated with people who make bright choices and exhibit a propensity for long-term thinking.
I very much believe in allowing autonomy over self, and I've strongly supported these ideals. However, that has to have limits in a functioning society. As much as I'd like to say we should be able to take all the drugs, there is a need to draw some lines. We can move those lines, and I think we should, but eliminating them entirely is absolutely certain to harm innocent people at a level I am unwilling to support.
Is there anyone addicted to antibiotics? No? Red herring.
It turns out there's some HIV antiretroviral that, instead of being ingested, is smoked proves one hell of a high.
The problem is that in Africa where these drugs are readily available, they are being smoked. The worry is, that HIV will mutate and become immune to those ARV's.
I might be wrong, and if so, please don't hesitate to provide some factual paper, yet my intuition suggests that in order to obtain solely by selection (under the pressure of a _single_ bioactive substance), a bacterial strain, that is, simultaneously:
- resistant to the aforementioned substance
- stable: resistance is not lost after the generation or so, past the moment when exposure is over
- contagious: strain is resistant to different immune systems (w/o losing its resistance to the substance, of course),
one either needs to perform a directed selection (eg. like that for apple-trees), or to create an environment, where really _huge_ bacterial population could thrive and persist for a long time: like that in hospitals or farms, - where not only frequent turnover of living organisms along with the regular exposure to antibacterial substances do happen, but also some intermediate vessels (medical instruments, ground, water supply, etc.) are available for bacteria to flourish in-between living hosts.
Of course not. There's 7 billion people, and just a tiny percentage uses antibiotics.
There's around 60 billion land mammals raised by humans every year, throughout their life most of them use the strongest antibiotics. It speeds up growth, it prevents silly deaths, increases profit.
Diseases, plagues will come from livestock, as they always did, not from humans.
As a parent, I was pretty pissed off when I learned that over use of antibiotics harms my child, my society.
As a citizen, I'm pretty pissed off that (one aspect) of the opioid epidemic is because doctors changed pain management protocols, without any followup testing, assessment.
“We started it”: Atul Gawande on doctors’ role in the opioid epidemic
https://www.vox.com/2017/9/8/16270370/atul-gawande-opioid-we...
[1]: http://www.cell.com/trends/microbiology/abstract/S0966-842X(...
[2]: https://link.springer.com/article/10.1007/s00284-012-0194-4
[3]: http://www.tandfonline.com/doi/abs/10.1080/01490450902889072
[4]: http://www.annualreviews.org/doi/abs/10.1146/annurev.micro.5...
Still, even in that case, I think you might be better off regulating at the point of sale by pharmacists, kind of akin to pseudoephedrine. I also think situation isn't quite as clear cut as it seems on the surface, in that currently antibiotics are overprescribed anyway, suggesting that our current regulatory regime isn't really working in those cases well either. In any event, my sense of the antibiotics literature is that a, if not the, major contributor to environmental antibiotic resistance is agricultural in nature.
Pharmaceutical marketing has a role in antibiotics mis-usage, and it can be regulated a lot better. I know people that take AB for the flu, or simply don't take the whole prescription. But at least where I live one cannot get AB without a prescription. Why would a doctor prescribe AB for common viral diseases? Bahamas, that's why.
>We can move those lines, and I think we should, but eliminating them entirely is absolutely certain to harm innocent people at a level I am unwilling to support.
I agree. It's a bit like seat belts or bike helmets: they're mandatory for our own good. Before it was mandatory, people use it if they wanted and took unnecessary risk.
But there's always a fuzzy middle ground...
The general reaction for substance usage goes around 'well it's really up to you, unless you're driving/someone depends on you'.
But as for driving a bike not wearing a helmet, people are a lot less lenient, even if the only person harmed is the self. And this is even before considering welfare, hospital expenditure and such.
Do we need protection from ourselves? Does this just boil down to economic and state welfare efficiency? Less diseases is good because Economy? Or is this a way of maneuvering Economy towards a place where economic interest aligns with principles of human dignity? Sometimes I wonder.
With antibiotics, it's a bit like vaccinations. Vaccinations are as effective as they are because they provide herd immunity. Not everybody is vaccinated and the vaccinations aren't always effective, but enough people are vaccinated so that it provides protection for everyone, including those who haven't been vaccinated.
Antibiotics are similar, though the effect probably has a different name. Bacteria reproduces very, very quickly and the growth is exponential. We already have a problem where bacteria has evolved to be resistant to our current crop of antibiotics.
It's also important to note that developing safe antibiotics is extremely difficult. I believe I read that there are only two new antibiotics currently in the human testing phase and that no new antibiotics have made it to market in over a decade.
So, we already have a problem with antibiotics being over-prescribed and bacteria evolving to survive the attack. This is a known problem and an increase in people taking antibiotics is going to speed this up. This isn't something that's in doubt, it is absolutely what will happen if humans are given unrestricted access to antibiotics.
We will take more, we will see bacteria evolve, and that is going to result in stringer infections that kill people who may have, as individuals, never once abused antibiotic medications. It's not quite the same as herd protection, but it is fairly close.
I'm pretty much in favor of legalizing drugs. I absolutely believe we should be able to take drugs. I even believe we should be allowed to take drugs that have a good chance at killing us. I firmly believe the right to life should also include the right to die.
What I don't believe in is that the right to life includes the right to harm others. With all rights, there is a risk of harm to others. That is just a fact of a free society. The problem here is that these acts will harm many. Many, many people would be harmed by this.
I absolutely support the right to own a firearm. In no way do I support the right of an individual to own a weapon of mass destruction. I'm okay with someone owning a fully automatic firearm. I'm not okay with someone owning a nuclear weapon.
Does that make sense? I'm trying to explain it as well as I can.
It's not really protection from ourselves, unless you mean collectively. It's protection from others who would cause us harm through ignorance. From an economical viewpoint, healthier people are more productive - to touch on your last thoughts. Fewer diseases is good. Fewer diseased people is even better. Unfettered access is going to increase the number of sick and suffering, and not necessarily through the fault of the afflicted.
Why should antibiotics be treated any differently than psychoactives? And how could empowering individuals, accepting mistakes will be made, be any worse than our (USA) current system? We currently have people self-medicating with supplies from pet stores and veterinarians.
Actually, thinking about it, to your point, poor compliance is because of barriers to care. Making it easier to receive care will improve outcomes.
The most successful efforts replace enforcement (of controlled substances) with treatment, counseling. Imagine if all drugs could be bought at your local pharmacy, where customers can be advised, counseled.
My pharmacist is just a pill pushing bookkeeper. I'll have to ask her if she'd like to use her degree, training, experience for actually helping people, rather than just checking eligibility and collecting copays.
A few prescription drugs could easily be considered safe for the public to use, some of which might require a pharmacist's advice. This would include things like birth control pills, 400 or 800mg ibuprofen, erectile dysfunction pills, and things I have never really considered.
But I disagree with most prescription drugs being sold without a doctor's orders. Some drugs are outright dangerous to overuse - antibiotics, for example. Some (most) drugs are really helpful to the right patient, but they need some medical oversight. Lithium, a psychiatric drug, needs to be monitored through blood tests to make sure the dose is within the therapeutic range. Some antifungal pills (as well as a range of other medicines) can cause liver damage. Sleeping pills have their own risks, as do prescription cough syrups. And so on. These aren't things folks are taking in their spare time for the fun of it. I think the actual solution is to make sure folks can afford their doctor's visits and medicines as well as having a comprehensive protections to make sure folks can take care of their health, including paid sick days (more for parents, since they are responsible for other's health as well and can't exactly leave the 7-year-old at home).
Now paracetamol (depon) in Greece costs 0.75 EUR. In Greece the market is regulated. In the UK where the market is not regulated and you have pharmacies selling burgers to survive while the same drug costs more than 5 EUR.
How is that possible? :-)
The monopoly you speak of in distribution (pharmacies) happens when you deregulate the market because few big players end up owning what was distributed among thousands.
I agree that more steps need to be taken, but I don't think deregulation has ever worked the way you'd think it did, for the health industry.
Ultimately many decisions stem from your personal belief on the topic:
- Do you think that drugs ought to be social goods and regulated? (social welfare) - Do you think that drugs ought to be public goods and not regulated? (private welfare)
Also note that drug research costs, a lot. Especially if done correctly. It is a fair for some firms to retain the patent for a few years (say 5?).
http://beautyland25.ecrater.co.uk/p/22341811/depon-maximum-p...
I would not buy or use paracetamol from Tesco. I prefer the one made by Bristol-Mayers, which I know and trust.
https://www.mysupermarket.co.uk/tesco-price-comparison/Medic...
Many drugs should be taken only under supervision of a medical professional. So the current system of doctors and pharmacies overall is a good system. We might give pharmacists more powers - they tend to be more knowledgeable about pharmaceuticals anyway, but drugs don't belong on supermarket shelves.
That would also incentivize increasing total substance use to make a profit, just like for-profit prisons create an incentive to increase the incarceration rate to make a profit. Any checks you make against use (like those competency tests) would be undermined by that incentive.
That's a intellectually dishonest and misleading statement: it's comparing Portuguese annual cost per citizen to US cumulative multi-decade cost per household.
I agree it would've been better off with a more apples-to-apples comparison, but let's not miss the forest for the trees here.
It's not to say that I support US drug policy, because I don't, it's that this really is dishonest journalism.
- ..spends less than $10 per citizen per year
- Meanwhile, the U.S. has spent some $10,000 per household...
Do you think to yourself, "yeah, that sounds like about 5x"? The presentation of the data is clearly cherry-picked to make it sound as bad as possible for the US.
Arguments are not soldiers. I was criticizing the yellow journalism, not saying anything one way or the other on the efficacy of US drug policy.
Your comment bothers me more than it should. Why do people who feel strongly about stuff allow, or even encourage, shitty reporting and intellectual dishonesty as long as it suits the narrative they support?
I mean, you're calling out a commenter for being 100% right, putting words in their mouth and then calling those words ridiculous. What's the point?
(The actual numbers are more like 2 and 4 than 10 and 10.)
Anyway for fun here's my estimate: The mean US population between 1971 to 2015 (inclusive) was 262.1 million [1]. There were 44 years in that period (inclusive). Therefore:
1E12/(262.1E6*44) = $86.71/person annually
[1] http://www.multpl.com/united-states-population/table and a spreadsheet
Substance abuse and addiction tends to originate from either a variety of sociological factors, or treatment (self or prescribed). A very large number of addicts are simply self medicating for one reason or another. Or at least they started off that way.
Even if society determines addiction and substance usage to be criminal, it's a victimless crime and a waste of resources.
Apparently the AMA and others disagree:
https://www.centeronaddiction.org/what-addiction/addiction-d...
"Addiction is defined as a disease by most medical associations, including the American Medical Association and the American Society of Addiction Medicine. Like diabetes, cancer and heart disease, addiction is caused by a combination of behavioral, environmental and biological factors. Genetic risks factors account for about half of the likelihood that an individual will develop addiction. Addiction involves changes in the functioning of the brain and body. These changes may be brought on by risky substance use or may pre-exist."
If medicine gets to the point where a single substance or chemical can be easily avoided to entirely prevent diabetes, cancer, or heart disease, the same way that someone can entirely avoid alcoholism by simply not drinking alcohol, that will be quite an achievement.
But this ignores the strong sociological component of addiction and substance abuse. Nobody is choosing to try cancer to self medicate depression, nobody is testing out heart disease to treat their pain or torment, and nobody is giving diabetes a whirl to address a sociological condition.
Like addiction, all of those can be side effects of things people do for exactly those purposes. In fact, heart disease and cancer are, like addiction, specifically frequently consequences of substance use directed at those purposes (and not just illegal substances; tobacco and alcohol are major culprits.)
Bullshit. All kinds of medical conditions and their treatment involve sociological factors. Treating drug abuse as a health issue in no way precludes dealing with its sociological context.
Picking and choose medical conditions that differ markedly from substance abuse and contrasting them is disingenuous. What about other medical conditions that are much more similar such as dietary conditions, overeating disorders, etc? There are a whole range of metabolic diseases caused by or associated with patterns of consumption that are very similar and often even have sociological factors associated with them. These are treated as public health issues. Substance abuse is just another category of related conditions.
Actually, yes, they are. There's no more perfect disease that you could have chosen to disprove your own argument.
Adult-onset diabetes is almost always a variant of substance addiction. It's just that we classify the drug "food" and sell it in the grocery store. But we shouldn't kid ourselves, sugary, highly-processed "foods" are a drug that is intended to be every bit as addictive as alcohol. The sugar high is like being drunk, the subsequent crash is like a hangover and diabetes is like the liver damage that results from alcoholism. The two diseases are remarkably similar.
Well, we do if we want to have a discussion about a particular problem. Using the description from the experts in the subject certainly seems like a good place to start.
You can define food as shards of metal and glass but that means I'm probably not going to take culinary advice from you.
Unless you are an expert, I suggest you follow the guidance of the people who have been studying the subject for almost a hundred years.
It's easy to draw a distinction when physical withdrawal leads to death, but how do you differentiate between physical and psychological pain and suffering when abstaining is not fatal?
Not always, not for the worst drugs out there. Heroin and meth addicts regularly commit violent crimes as a direct result of their addiction. You can say that the actual violence is the crime, but if there is a common root cause for a lot of crimes, doesn't it make sense to criminalize the root cause?
And alcohol, no stranger to huge amount of crime, is still legal. As it should be, but this perfectly shows the hypocrisy around drugs.
Depressed people and diabetics are hurting themselves either through action or inaction, but I've never been threatened by a diabetic or depressive outside a Circle K. I have been threatened by a criddler outside a Circle K. Similarly, few people get all of their stuff stolen out of their house by a diabetic or depressive. They do all the time when their son is addicted to heroin. Depressives don't prostitute their kids to drug dealers for crack, etc.
Drug addiction is one of the few diseases where the patient actively attacks all of the people who are in a position to help him. That generally alienates people who tend to be otherwise generous toward the down-and-out. The laws reflect that, and it takes a superhuman effort of rationality to say, "Yes, addicts do terrible things. Other solutions produce better results than the natural impulse of doing terrible things back to them."
Edit: We see this in the nastier forms of mental illness, too. People are generally compassionate toward those with OCD, eating disorders, and so on. Those with borderline personality disorder or bipolar disorder tend to be relegated to "batshit insane" and viewed with utter contempt. Again, the difference is that someone with anorexia nervosa isn't going to pull a Carrie Underwood[1] on your car, but someone with BPD might.
Well, make the treatment for diabetes unavailable through legal means and very very expensive - and you soon will be.
Mentally ill people can be dangerous to the surrounding people, especially if not treated properly. This is known, and it is also known that the way to deal with it is to address the disease, not hurt them and yell at them "snap out of it, you bastard!"
> The laws reflect that, and it takes a superhuman effort of rationality to say, "Yes, addicts do terrible things. Other solutions produce better results than the natural impulse of doing terrible things back to them."
Calling this "superhuman" only reveals how low the expectations of "human" are. It is truly sad state of affairs that acting rationally and trying to do something that actually might make dent into a solving the problem instead of instinctively biting back is something that is considered "superhuman". If going a tiny step above animal is "super-human", what is left for "human"?
If it turns out true, then it means there's something fundamentally wrong with the legal and voting system where somehow it completely restricts itself from the ability to enact a change in the laws in this area. And if this can't be achieved, there's no hope for any progressive drug use laws.
Regarding your comments about the voting system: of course they are true. How long will the hypocrisy manifest itself before it is changed is the true question.
Here is one such example:
http://politicalticker.blogs.cnn.com/2014/07/24/do-you-want-...
That was just the first result.
Anyhow, we don't always want majority rule. At one time, the majority of people felt it was okay to own people. I suspect you can find areas where the majority of people don't think we should have equal rights for certain classes of people.
You do in a democracy.
>At one time, the majority of people felt it was okay to own people.
Until they decided it wasn't ok, and an abolitionist president was elected.
>I suspect you can find areas where the majority of people don't think we should have equal rights for certain classes of people.
Like civil rights for gays. Also solved by voting.
The problem I have with the 21 year old drinking age is it now allows police to jail college kids at will, essentially limiting their life's prospects. Again the punishment is worse than the crime.
Lately, I had been watching various documentaries and YouTube videos about the opioid crisis in the USA and Canada. Often, the public policy seemed absurd to me, as it was just as if the first responder services were offering free customer support for the drug business. They used Naloxone to save the lives of customers who should normally have overdosed, and with no supervision afterwards, those addicts were soon back in the street where they keep buying and consuming.
A drug that is too lethal has very little commercial viability. By decreasing the lethality of drugs, first responders support the drug business, which is absurd.
I started reading this article expecting it to enforce my position, but I had to acknowledge the fact that apparently, this policy did indeed reduce drug usage in that country. That puzzled me a bit as I was struggling to see how making consumption easier could reduce consumption, but then they mentioned how they provide methadone, and that seemed like a sensible explanation. They don't provide customer support by just giving naloxone for instance, as I saw they do in US and Canada, they also provide an opioid substitute, which should hopefully reduce the likelihood of a relapse.
https://decorrespondent.nl/6562/het-zelden-vertelde-verhaal-...
Amsterdam, 1985, the government supplied methadone using an old city bus they transformed into a drug dispensary, they even supplied clean needles for free.
In the documentary I was mentioning (sorry, can't find a link or remember the title), I saw something like that in Canada (IIRC). It was a room with needles, with a nurse or something to supervise and monitor injections. And of course there were doses of Narcan in case an OD happens.
But no methadone whatsoever was offered. Or if there was, it wasn't mentioned. So basically the government was paying to provide an infrastructure for drug consumption. In other words : customer support. It's as if they were working for drug dealers. To me that's outrageous.
So what?
> customer support. It's as if they were working for drug dealers. To me that's outrageous.
What's outrageous is that you'd rather see those people die. That's the alternative. To get them off the streets, registered and out of the risk of getting hepatitis or HIV is the beginning of giving them a chance to clean up. The government even competed with the drug dealers: they gave out free heroin to those that were already addicted.
And it's not as if any of this isn't a selfish thing by society, the cost of an addict over the longer term is far higher than the cost of helping them, so it is actually better for everybody.
I really don't understand these extremist viewpoints when it comes to healthcare.
You're not supposed to save lives at any cost. Not if that means you'd associate with or reward crime. That's why you don't submit to blackmail, for instance. In the same way when someone is selling drugs illegally, you're supposed to put him in jail, not help him with his business.
The cost is quite manageable.
> Not if that means you'd associate with or reward crime.
They don't.
> That's why you don't submit to blackmail, for instance.
What does that have to do with any of this?
> In the same way when someone is selling drugs illegally, you're supposed to put him in jail, not help him with his business.
I'm sure you will feel right at home in AG Sessions office or with the Philippine leader. Me, I'm much more comfortable starting from root cause analysis rather than to just hunt symptoms, I think hunting symptoms is a waste of time, effort and resources.
It lays out the complex and remarkably individual history of the war on drugs and its consequences to great effect. If you read it and agree, buy a few copies to pass on to random people you encounter.
Edited to add: I saw your response before it was deleted. I appreciate your honesty but I'm really glad you are powerless. I suspect you have some bias issues and that they may be rooted in a lack of understanding.
Drug use should be treated as a health issue, not a criminal issue.
Saying that does not imply that they endorse criminalization.
Medical problems associated with drugs go way beyond just addiction. Kids can die on their first use of a drug, even on a dose that would normally be forced be harmless, due to other factors such as dehydration, alcohol consumption or overheating. Even without becoming addicted, drugs can have other harmful medical effects. The sheer scale of the simpleminded ignorance of this comment is staggering.
It is why kids think "that cannot happen to me". Because its criminal. Because its the plight of the "other". Because its told like a monster in a fable rather than a fact of life and an emergent property of our society and biology.
Drug abuse is a health issue. Most drug use is not abuse.
The war on drugs has failed. We must not be a part of the suncost fallacy, but just embrace another way.
http://www.confessionsoftheprofessions.com/drug-user-decrimi...
The life expectancy of addicts is such that I only know of two people that managed to effectively beat their addiction, both are family members and even though they got out of it they never fully recovered from their encounter with hard drugs. Ugly stuff.
https://imgur.com/gallery/pI8Nm
TL;DR rats trapped in cages will self-administer drugs, often to the point of death. Rats which explore freely have a much lower (order of magnitude) rate of addiction.
At least somebody got the joke.
Normies love to pontificate about the causes of and solutions to addiction, but I never get more than a paragraph in before I find a vacuous statement that highlights how completely the speaker misses the point. It's fucking exhausting.
and what is one of the results of that "moment of clarity? They stop drinking.
That's the whole idea of being addicted. It is a dependency at a physical level outside of any of your abilities to reason. Only very strong people make it out and almost always with assistance from the outside.
Neither can addicts the vast majority of addicts, that's the point.
I would say most addicts don't want to be addicts at some point, yet they are still addicts.
I'm addicted to nicotine since I was 12 and I don't want to be, yet I am. I've quit a few times for a few months, but always get triggered back into starting up again.
“Peer reviewed studies peg the success rate of AA somewhere between five and 10 percent,” writes Dodes. “About one of every 15 people who enter these programs is able to become and stay sober.”
https://www.theatlantic.com/health/archive/2014/03/the-surpr...
Now do you see how it's like a disease? Users literally realize they need to stop or they will die, but they do not.
Non-substance addict in recovery here. You CANNOT (by definition) “decide” to stop having an addiction. I’m not gonna get into a huge discussion but would like to point out the (ongoing) work looking at the various genetic markers that increase vulnerability or statistical predisposition to various substance and non-substance addictions.
http://neurowiki2013.wikidot.com/individual:genetics-of-addi...
You can't just choose to stop having an addiction, either.
That's kind of the whole point of addiction.
> alcoholics and other addicts will often have a so called "moment of clarity".
A moment of clarity is just the point at which one recognizes a problem.
> No such "moment of clarity" exist for other diseases.
This is not at all true.
Plenty of other illnesses trace back to life choices. Unprotected sex gets you STDs. Not exercising and eating right leads to heart failure. Isolating yourself socially leads to depression. Many of these can also be stopped or reversed after a "moment of clarity" that causes you to change how you live your life. Addiction is not particularly special in this regard.
If you believe, that decision itself can stop substance abuse, than think about what is the more probable outcome of such a decision: freedom of addiction or failed attempt to stop. I have no statistics, but looking at other nicotine addicts I would say that decision means almost nothing. Maybe in 1 from 20 cases decision to stop leads to remission. One can argue that in 19 cases there was wrong decision, but it is more likely that there are some other causes, and decision is not cause of remission, though essential accompanying factor.
Addiction is something you cannot comprehend by just abstractly thinking about it. You need explore it either by trying, or (preferrable) by studying addicts or at least reading articles wrote by scientists who are studying addiction.
It just doesn't sound rational. And its not. Many oxy-addicts of today, where former - "The police should get them" conservatives. So what compels a human being to want the state to go after his fellow being, which irony- might be his/her future self.
My guess, at the motivation is a mixture of envy (on a perceived decadent lifestyle) without hard work, a fear for ones offspring and finally grievances caused by known addicts (small time theft and crockery).
As long as these emotions are not respected, taken care off and defused, as long as this is the case, the disease that is drugs can not be handled.
I can think of one: you would still have to incentivize people to go the legal way and pay 15% more. Which could be another intractable problem.
It seems to work just fine for tobacco and alcohol - a black market certainly exists for these drugs, but it's tiny in comparison with legal sales.
On top of this, the increase in safety - getting a pure product that is what it claims to be - would likely be a no-brainer for most users.
https://www.nytimes.com/2017/09/09/us/california-marijuana-g...
Discussion: https://news.ycombinator.com/item?id=15210418
If there is a demand, someone will find a way to make money off of it.
In that span of time, there has been no other nation on the planet with greater technological, military, financial resources to throw at something like prosecuting the so called war on drugs. If the US couldn't kill the cartels & illegal supply with that approach, it can't be done that way. The fact that it would fail was always an obvious logical conclusion ahead of time (we even had prohibition to reference as a blatant demonstration), but we have the benefit of vast actual results of perpetual failure and destruction to throw on top of just reasoning it through.
Fortunately the majority of Americans have come around to understanding the war on drugs has completely failed and for that reason the WoD is over (specifically it's on its last legs).
Can't be done. It's useless to waste a single further breath entertaining that idea.
Would an individual considering whether to buy/use a drug actually evaluate the involvement of a cartel in their decision? I doubt it.
I suspect demand for drugs is largely independent of their legal status. Legalization would not open the floodgates to reservoirs of potential users previously held back by law.
http://www.therooster.com/blog/kids-love-getting-dizzy-and-l...
As in no one would use drugs if the cartels didn't exist?
How about removing the revenue from the drug dealing cartels? How much power would they have then?
Keep in mind "international drug dealing cartels" would not exist if there were no demand for their product.
But we wouldn't jail our precious Wall Street people, would we? 60.000 people dead per year is just...a little statistic...most of them Trump voters or black people anyway!
No problem killing thousands of brown people in the war on drugs though. They shouldn't try to corrupt the American population with patent-free opioids!
I believe addiction is a disease and the sick must be treated with high priority. My younger brother started taking drugs even before high-school, like most boys here where I live. He had no choice. He wanted to play bass with that band and hang out with them. Pot and cocaine, basically. Tobacco and booze came later when he was in college. He made it to the end and got a major in Advertising with a minor in Psychology. Two years after graduation he was struggling to find a decent job and that led him to a whole decade of drug abuse. He has developed some sort of schizophrenia and has a problem in his lungs. Today he lives with my mother, as he cannot live alone, and he makes a living selling SIM chips in a kiosk inside a supermarket. On top of all that, he has depression, so needs to control it taking medications.
My brother is just another drop in the ocean of addicts. I feel sorry for him. I feel sorry for my mother. Our family started treating him as a sick person only 10 years ago, and it was too late for him. So I strongly believe all addicts should be treated at the earliest possible while there is still a chance of recovery.
I have spent the last 40 years of my life watching how drug cartels operate down here in the third world. I hate them, of course. Their entire structure, from the 8 year-old who takes drugs to school and share them with his buddies to the drug lords who dine with politicians every night.
I'm part of the group of people who believe addiction starts at early age, adolescence, when people really enjoy taking drugs, loads of them. Distribution starts really at school, and for free. They normally choose two brothers, one must be older and outside school, the other, in school. They take the older and kindly offer him a gun/ammo or good money. In exchange, his little brother is now part of the cartel and will have to distribute drugs at school. This little man will be arrested countless times, but released in the same day once his mother pops up into the police station. He will be back to his "job" next morning. In case his mother decides to take him out for treatment, the consequence is that the elder brother now has a serious problem with the local drug distributors and will have to choose between working for them, saying goodbye to normal life he used to have, or death. In the long run, both brothers will be neck deep into crime.
The reason "war on drugs" doesn't work anywhere is because it is not a real war. Governments are mostly investigating, arresting, taking to jury etc. There is no extreme, war like violence, between government and drug cartels. No mass killing. Elimination, as I wrote in another thread. So the government thinks it has "destroyed" a cartel, when in fact it has just "dismantled" it until people at lower layers see vacant positions they can be filling in. Yes, government let WoD as it is, is a multi decade, multi trillion dollar worldwide worthless effort. Take that money and help the sick.
On the other hand, WoD in the slums is a completely different ball game. It is extremely effective because it is violent to infinity. Cartels operate in total monopoly within their territories. No sharing. If you look at the news coming from Rio de Janeiro this week, there is a war going on between a handful of groups interested in a specific region. Those "Fallujah battle" like scenes we see on TV is the tip of the iceberg. It is what can be shown to society. Down there in the ground, when a slum is finally taken over, that when the barbaric mode turns on. The unlucky bastards and their relatives who didn't die in shootings will be subject to beheadings, all limbs amputated, burned/buried alive etc. War. Everyone from the losing cartel is killed and a new monopoly starts.
"Ok, so what if you decriminalize production/distribution to weaken the cartels, giving the population the choice to stay away from all that horror and still buy better quality drugs at a fraction of their cost on the streets and use them without the possibility of being arrested?"
Now, you, third-world government and law enforcement broke the monopoly. And now you are going to face the real war on drugs (no quotes). It's going to be everywhere. The immediate reaction will be something like what happened back in 2006 in Sao Paulo[1].
"Since early Friday May 12, 2006 there have been 299 attacks against public establishments such as police stations, justice forums, buses, etc.; which are allegedly organized by the Primeiro Comando da Capital (PCC) criminal organization."
Yep, 299 attacks in 5 days. Just because some cops killed some key assets from the criminal organization. That is insignificant next to the possible impact of ending the monopoly of their main revenue stream: drugs production and distribution.
They would kill/barbarize people all along government's drug "supply chain". At the factory, at the warehouse... retail shop? I can't even imagine the violence. And, finally, consumers. Bad consumers who made the bad decision to support the monopoly break. Those would be killed at the shop's door so the media could do its job and promote it nationwide.
I also believe cartels would have no trouble in massively robbing premium grade drugs from the government and sell them afterwards. For that, they can use the same .50 cal and TNT used elsewhere to rob banks and armored cars[2]. "They" in this case is not a handful of dudes, but 50.
"The robbers numbered about 50 and came armed with high-caliber weapons, grenades, dynamite..."
So, IMHO, drugs decriminalization may weaken some cartel ops in developed countries, improving quality of life in many ways. No doubt. But that's not necessarily the case in third-world nations where organized crime is big, rich and unthinkably violent.
I wish my government could be as violent as the cartels are and kill everyone. Elimination. Yes. That's the monopoly gameplay. It would trigger something like the 2006 event[1], but then the Army and all law enforcement would fight back nationwide, at all levels. The vacant slots in the cartel structure wouldn't see any backfill.
Of course, no government can do that to its own people these days in modern society. Well, maybe there are some examples here and there, but that doesn't matter, my wish is pure utopia, a crazy fantasy. It won't happen. So let's treat the sick the best way we can. Portugal, parabéns!
Thank you for reading this to the end. It was a long day for me and English, as you obviously know, is not my first language.
[1] https://en.wikipedia.org/wiki/2006_S%C3%A3o_Paulo_violence_o... [2] http://www.latimes.com/world/mexico-americas/la-fg-paraguay-...
So yes, he had a choice, and took it.
I consider myself very lucky not to have this particular trait, but even today (and I'm 52...) there is pressure on me to conform, to drink alcohol for instance. I really am not surprised at all that a younger person longing for a particular kind of company could be pushed to indulge.
So yes, he had a choice, but much further back than where the danger was visible, and to make it seem as if he chose willfully for the life of an addict is not very nice.