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Comment by stephengillie | Hacker News Reader

But isn't the point that you require treatment alongside the drug? And yes, supporting addiction over decades is hugely damaging.

Also, please be more empathetic towards your fellow human. Giving up on someone doesn't help.

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"Predisposed to addiction" is how we say it in the industry, and it really means "has a shitty life."

The diagnostic criteria for addiction are whether the person can't stop doing the thing despite wanting to, and whether doing the thing causes problems. If they're stable-- whether on or off medication of any kind including opiates-- then the addiction is considered successfully managed.

Also, mental illnesses are never cured. They're managed, and the best possible outcome is stability over a lifetime. Typically stressors induce un-managed relapse, so staying on dope and keeping tolerance stable really is the best outcome for people living in adverse circumstances.

So, instead of helping these people with their "predisposition", these countries are helping with their habit. How is this admirable?

Because you can't just wave a magic wand and cure all of someone's problems, and because being a heroin addict with a reliable, legal, relatively safe supply is probably a lot less bad than being a heroin addict without that.

And why are you assuming that these people are not getting any other help? The two aren't mutually exclusive. In fact, not having to deal with all of the risks and stresses of scoring illicit drugs probably makes it significantly easier to make improvements in other areas of your life (which, as well as being a good thing in itself, might in turn make it easier for you to kick the addiction).

Absent convincing evidence to the contrary, it's entirely plausible that this approach is doing a good job of getting people off heroin, as well as improving the lives of those who stay on it. The fact that some people remain addicted doesn't undermine that.

> And why are you assuming that these people are not getting any other help?

To the contrary, I'm wondering how effective is this help, if it fails to wean someone after 20 years. Or, there must be some constant influx of new users.

Is your goal to get people to stop using drugs, no matter what? Because we've seen how well that's worked in the U.S.

If they're solving all the other problems in these addict's lives - if they're able to be functioning members of society - isn't that enough? Why would you upset all that progress by making stopping drugs priority #1?

A lot of people are still under the impression that using Heroin daily has extremely damaging physical effects along the lines of a serious meth habit. A lack of education about the issue is what leads to this kind of outrage, ime.

I'm concerned about a loss of empathy due to drug use. Over years of drug use, neuroplasticity could cause a permanent reduction in the capacity for empathy, and concern for other people & society at large.

It's like CBT but in reverse.

Couldn't that be true for other prescription drugs like Prozac? Or maybe for NSAIDs which I think have had unexpected affects due to sensory changes.

Given that the FDA requires no long term testing of any nature, it seems contrived to pick on one longterm prescription as flawed because you have some kind of problem with not blackmailing people into treatment they don't want and that isn't helpful.

Forced therapy is a form of punishment, and the real intention behind mandating it for something you could just manage is to try to use the addict as an example of applying the stick to people with the "wrong values" for the rest of society.

The result of that is cross generational addiction problems because prisoners have children, children get traumatized by stressing their parents and trauma is addiction predisposition.. "a shitty life."

Why does it matter if they stay addicted? As I already said all the downsides of drug use are fully avoided by using medical grade drugs. It's like eating fast food without getting fat.

Because it's better for them to have legal access to a controlled, safe supply than to be robbing houses for money to score who-knows-what off the street?

Making drugs illegal has never stopped anyone from doing drugs, it just adds additional problems to their life (hey, they have a felony record now, no one will hire them).

Street drugs cause loss of life, health problems and financial distress which leads to an increasing population of chronically homeless people, higher medical costs, loss of tax income, theft or becoming drug dealers themselves to pay for drugs, etc.

Imagine for one second that you could solve all of these problems at once with medical grade drugs and all you have to do is let drug addicts visit a doctor regularly. How is this not admirable?

It’s the worst solution, except for all the rest.

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