I am a heroin user. I do not have a drug problem
m.nautil.us
m.nautil.us
I just lost my brother-in-law to heroin overdose. He overdosed because he went into rehab, came out, and then used far more than his body could tolerate. This is unfortunately common. Not because he mixed it with alcohol or antihistamines or whatever.
Overall, his entire life has been extremely tragic. He was a good guy at heart. He was a hard worker and did good work in general.
However, he did did A LOT of crazy things. He was the poster child for "your emotional development stops at the point you got addicted to heroin". He basically acted like a troubled 13 yr old in a 40 yr old's body. This craziness has caused a LOT of problems over the years, especially for his daughters.
I get that the popular notions of drug use are wrong, but when is that not true of anything? Drug use does itself cause a lot of problems. While some people may be able to use them without any issues, many cannot.
The way a lot of this is phrased, it makes it sound like drugs are fine and there is a conspiracy to demonize them. While the popular notion of them isn't perfectly balanced, it is not the case that they are just fine for people to use.
We'll see how things turn out in the end (maybe I'm wrong), but I'm pretty skeptical of a positive outcome.
I know my own problems, way back when, really got going at around the 5 year mark, and turned from weekend fun to every day need. If I hadn't have met my partner who helped pull me out I'm not sure where I would be right now. Knowing what I know from personal experience, this book seems reckless to me.
Imagine being in the nursing home with the heroin addict who thinks he has everything under control.
Everything is about risk. Bad shit happens in life and people have to deal with it. Bad shit can happen unexpectedly. And it’s difficult to know how it will feel when it happens. Look at how many people will “hit the bottle” because someone dies. Or a relationship ends. Imagine if that becomes something 100x more risky.
We see all the disastrous effects from legal drugs and now he wants to add more to the mix.
The difficulty in obtaining drugs reduces their use. That is the bottom line. Everyone wants to argue against it but it’s the clear reality.
This guy just lives in a bubble.
While I am now pro-decriminalization, I don't believe marijuana is as harmless as its proponents contend, mostly because I detect the same signature addiction rationalizations and defense mechanisms in the discussions and messages.
But I guess I am pro-decriminalization primarily due to me wanting to alleviate the economic basis of smuggling destroying the cultural vitality of Mexico, Central America, and Latin America, converting them into zombie narco states.
I still believe decriminalization will vastly increase use/abuse of drugs (the most heavily used ones are the legal ones) and treat our own people and problems.
But truly addressing that would be addressing the depression, loneliness, and lack of fulfillment the modern capitalist media consumer state creates.
Prescription drugs are more controlled because easier to OD.
It does seem like acute danger is a big factor in scheduling. There’s always the argument that drugs were scheduled out of fear and bad science. But maybe as more knowledge was gleaned over the years, it just became sensible for other reasons to leave the laws as they are.
Honestly, society is better that you don’t have a large contingent of people abstaining. And the idea that people make their own choices - I think this is greatly affected by parental attitudes. So you could easily see a big jump in a few generations from changing attitudes.
When you think about the argument for decriminalization, the issue of public safety from addiction and overdose is not very much considered. Publix safety from crime, yes. But there is inevitably an increase in risk.
What’s good at least is that we have a baseline of usage and addiction from very strict drug controls. So we can always monitor if things get out of control via more legalization.
> The way a lot of this is phrased, it makes it sound like drugs are fine and there is a conspiracy to demonize them.
Those who cry foul at the imagined conspiracies may already be deep in the throes of an addiction.
(Alcohol) prohibition ended, not because people changed their minds about alcohol being problematic, but because it failed, basically, and I think such an arrangement is politically unpalatable in today's world.
I think that Dr Hart makes a lot of good points, but he also makes some dubious ones. For example, his point about the "normal range" of height. Its a fine thing to point out, but it is such an incomplete picture that its borderline preposterous.
Lets say you are 6'5". If I take a chainsaw and cut off 7 inches of your feet/shins, does that mean you are just fine? You would still be within the normal height range, after all! In fact, theoretically you might be better off, because before you were outside of the normal range!
This is intentionally absurd, so no need to point it out, but that is my point; the way some points in this article are made, it really makes me worry how many people who are on the border of being sure they have a problem are going to keep going down their destructive paths.
To be honest, I bet my brother in law would have said the same thing about himself -- he is "fulfilling all of his obligations", after all! He did work, aside from periods when he was homeless/unable to hold down steady work/keep himself from spending literally all of his income on drugs. But, the last few years, he has been working and had an apartment, all while using.
It really isn't though. Hart's entire thesis is that drugs like heroin are no different than alcohol. The economic damage and emotional brainwashing from 50 years of the racialized war on drugs has ingrained to people's minds that they are somehow different, but they objectively are not. And if we live in a society where it is socially acceptable to be a recreational alcohol user, there is simply no reason other than racism or classism to think that recreational heroin use is not an equally valid way to destress.
>To be honest, I bet my brother in law would have said the same thing about himself -- he is "fulfilling all of his obligations", after all! He did work, aside from periods when he was homeless/unable to hold down steady work/keep himself from spending literally all of his income on drugs. But, the last few years, he has been working and had an apartment, all while using.
And again, this is literally no different from an alcoholic. The entire point is that the substance is not the issue. Addiction is the issue. And addiction stems from factors that are entirely unrelated to the substance itself. Focusing on the substance is like focusing on cheeseburgers as the cause of obesity in our society; it is a profoundly more complex issue than that, and banning cheeseburgers or putting people in jail for eating cheeseburgers will not solve it.
This article is way out on facts. This guy should better read some science based books like the of Gabor Mate, 'in the realm of hungry ghosts'. Inside this books it is well explained in detail, if drugs create addictions, why humans take drugs, what happens to the brain on drugs, what happens in long term usage and what somehow all users share in common, from their emotional journey. Its about getting love, feeling seen, feeling rewarded, ..from friends, next one's and society itself or more often, in the search for rest from trauma and depression....
Damn nautilus this article was reputation hurting.
Heroin and opioids may be slow and gradual, but then it’s an insta kill.
Maybe food for thought though about how society views direct vs indirect causes of death.
If heroin was legalized, it could be standardized at a non-variable purity, and other methods of intake would be more popular. Lots of people were going blind from alcohol consumption during prohibition also.
If I could pick something, it would probably be legalization + social support for people dealing with addiction, along with actual consequences for people who do bad things while on drugs, as opposed to what the police do now, which is basically throw up their hands and say "we cant put every heroin addict in prison".
I think the biggest issue I have with Heroin personally is how it seems to totally consume so many peoples lives and how completely unable they are to recover. There is a reason people say heroin addicts never really recover, they just take breaks.
Then you can also argue that you might not have lost your friends only because of Heroin the substance, but also how people with heroin addiction is "treated" and frowned upon in society.
I think what the article is trying to say is that harm reduction is a much more human and possibly effective approach to fighting real addition. Compared to other ways, which some of them include "there is no such thing as responsible drug use, it's all addiction" and treating people as such.
That coupled with the fact of how heroin is treated in society makes it worse. On top of that, add that not everyone that uses it is healthy and responsible, makes it even worse providing some bad validation. And then, not everyone is capable of making the distinction between fun or addiction early on when an addiction is starting.
I too think it's dangerous.
The article is an interview with a Heroin user. It's as dangerous as an interview with a sex-worker. The interviewer even seems to bring up some interesting counter-points to the interviewee.
In the end, the interview is just providing a voice for the person getting interviewed. Are you saying that interviewing people who might do harm to world is dangerous?
I think that's the logic, anyway. It's ironic that most people here are in the camp of "decriminalize drugs! Oh wait, no, not these drugs, just some drugs."
While Portugal is probably the most famous example of decriminalizing working in humans favor, it's not the only example, it has been employed in other states too. Netherlands has de-facto decriminalized all drugs (in practice, not in law), Czech Republic has decriminalized all (most?) drugs as well.
Illegal heroin is very dangerous.
> That coupled with the fact of how heroin is treated in society makes it worse.
The story, as it was told to me, was that he chased a few Vicodin with a single beer, which resulted in him registering a 0.03, but he fell asleep in an intersection with his foot on the brake pedal. Despite this, he passed the field sobriety test, but the officer judged him to be intoxicated, and he was arrested. Apparently he was supposed to get a blood test; he was taken in early on Saturday and held until Monday, but they didn't do the test until he was "on his way out". It turned up nothing and he got out with a lawyer bill.
[0] I'm convinced that things are so bad/ineffective right now, that I'm pretty close to support of all-out decriminalization (of possession), simply because it reduces the impact of addiction on the addicted.
'All substances of abuse self-administered by humans that can result in addiction are believed to exert their reinforcing effects by increasing DA in the nucleus accumbens (NAc)'
Anecdata and broad brush strokes of course - In my experience anyway, the actually responsible and heathy adults I know haven’t felt the need to use heroin. The people who somehow are able to delude themselves into thinking they are responsible and healthy while obviously in crippling mental and/or physical pain, have - and it’s been devastating to them.
I’ve had prescription opioids before (hydrocodone, codeine, morphine) during medical emergencies. The feeling of peace and calm is amazing - which is exactly why it attracts people in pain and suffering, destructively so in many cases. It is difficult to know if that feeling is going to be magnetic or repulsive to you until you try it. It happens to be repulsive in my case (I know it’s a trap), thankfully.
It’s a complicated story of course, and bad outcomes tend to get the press. Better treatment (including in many cases mental health treatment) is definitely needed.
It is not the only substance like this - alcohol, tobacco, amphetamines, and others have track records of similar problems.
Pretending that anyone and everyone could self evaluate and go for it without a decent percent of them having major problems for them and those around them is unfortunately just not a good idea.
You do. It's not up to someone to decide, you're responsible for your own body and your own decisions to improve/harm it.
I don't think they are saying advising governments to setup some sort of screening process for this. It's more for the people who are interested in the drugs themselves. When I first started getting interested in drugs, many pushed the idea that I should be psychologically healthy first (mostly because my first interest was psychedelics and I have good and well-meaning friends). I think that's what the article is trying to signal here.
The libertarian 'you can do what you want and it's your own responsibility' is great until the people who obviously made the wrong decision stop quietly owning the results of their decisions and start murdering random people for money to fund their habit.
An argument can be made that the answer is free heroin and mental health treatment of course, and maybe it is the right answer. It seems hard for societies to accept however, outside of some very niche locations (Netherlands) though.
Some might not even have a drug habit if not for illegal drugs laced with addictive substances they didn’t even know were there.
If you're saying 'I meant it should be legal to buy over the counter for cheap and/or given away for free', then that might decrease the number of people being robbed for it - but doesn't seem to decrease the number of overdose deaths, area crime rate, or urban decay by as huge an amount (or maybe it just concentrates it?), at least based on the experiment in Vancouver, BC, Canada's lower east side. The Netherlands is also problematic, and not a solved problem. [https://www.areavibes.com/vancouver-bc/downtown+eastside/cri..., and overdose deaths have continued to skyrocket in Vancouver [http://www.vch.ca/Documents/CMHO-report.pdf] despite harm reduction, decriminalization, and other means.
Areas like San Francisco with de-facto decriminalization also have major problems with people, for lack of a better word, rotting of neglect on the street - something that I've also seen first hand in Vancouver. I also have friends who have seen this first hand in Seattle. Resident complaints around muggings, being assaulted unpredictably by unstable mentally ill people (on drugs or not is hard to say, but there is a high correlation with this and these areas in my personal experience) are hard to ignore.
This isn't a solved problem, and I'm not advocating for 'lock them up' policies - but pretending this will all be cool if everyone can walk down to the corner store and buy heroin if they think they're up for it isn't helping anyone either.
Also, correct me if I’m wrong, but that doesn’t seem to address my core point?
Legality can reduce some negative effects, but it isn’t a cure-all. There are also a lot of people that should just not use opiates or bad things will happen, and we can’t predict who those people will be reliably until it is too late.
So please don’t use opiates unless you really really need to, and be aware of the dangers.
Commit any infraction, drive or work heavy machinery while under the influence, your license is suspended until you complete rehab. Do it too many times and it’s suspended permanently. Use while unlicensed, it’s jail time.
This way there is a progression. We don’t have to waste police resources on those who can handle it. The minority who can’t are directed into rehab to deal with their issues first, and only the minority of that group who fail to shake up get jail time.
Meanwhile crime is down because drugs are affordable. New addicts are down because kids aren’t getting laced drugs. Deaths and overdoses are down for same reason.
And it all costs society less, less police, less crime, less hospitalization and less death means less taxes.
And legal drugs have known potencies, and aren’t mixed with other more addictive drugs.
Don’t compare decriminalization to legalization, they are entire different things. Decriminalization still suffers from higher addiction and death rates because selling the drugs is still illegal.
Economic tide : the 80ies was a different time with lots of youth unemployment in NL/NWE.
> You do. It's not up to someone to decide, you're responsible for your own body and your own decisions to improve/harm it.
That's obviously not that black and white. If it was, then breathalyzer interlocks wouldn't be a thing, for instance.
I was thinking in the context of "Should I be able to use drugs", which we normally leave up to the individual to decide, except for _those_ drugs that we don't leave up to the individual to peruse on their own.
Yeah, but that's just an example. If you were about to make a suicide attempt, you could be involuntarily committed, and the only person's life being protected would be your own.
The point that I was trying to get at was that black and white individualist statements like:
>>> You do. It's not up to someone to decide, you're responsible for your own body and your own decisions to improve/harm it.
...paper over some important complexities of real life. There are many, many cases where people have responsibility for others (and I'm not just talking about legal responsibility, even though my examples all intersected with the law in some way).
So if you create an accomodating and encouraging area for taking heroin you will find it surges in population when heroin is freely available and detox discouraged. Everybody points to the European model but they must have done something different than just harm reduction, like proactive policing breaking up open air drug markets and shutting down slums teeming with addicts forcing them into detox.
And because it’s illegal most addicts have to pay high prices for heroin of unknown potency, and frequent laced with Fentanyl. That directly leads to overdoses and hundreds of deaths, along with street crime to fund expensive habits.
Every bus stop since March last year in the drug slums also has instructions where to get prescribed opiates. Area only got worse
> The Vancouver motion however for the moment has no force in law.
A municipality doesn't have the authority to decriminalize drugs. They're just requesting the Federal government to act. It's not official, though it could eventually be.
Also, Europe is a collection of sovereign countries, each of whom has their own drug policies.
The impact of failure to somehow prevent yourself from being addicted can be catastrophic ... even if you are successful in getting them out of the cycle of addition. And that impact can extend WAY beyond the individual.
I'm open to the possibility that some drugs really can't be used responsibly by enough people that they absolutely should not be legal.
This not a very helpful observation, as we all know that this is far from what happens and is not going to become the norm.
Furthermore, quite a lot of people became addicted to opiates through acting seemingly responsibly (at least initially taking the drugs under the supervision of a doctor whom they could reasonably assume was looking out for their best interests) and in the persuit of better health.
I should add that Hart himself punted on this issue when the interviewer touched on it. In the interview, he does this a lot - for example, when the interviewer raised the question of physical addiction, Hart merely discussed the physiological basis, without touching the obvious issues it raises for the concept of responsible use. It may be telling that, in his description of himself as a responsible user, he avoided saying anything about this particular issue.
> Then you can also argue that you might not have lost your friends only because of Heroin the substance, but also how people with heroin addiction is "treated" and frowned upon in society.
This is also rather beside the point, as, while the way addiction is treated is also a problem, it is not an issue except where there is already a problem with addiction.
That aside, there is such a thing as responsible addictive-drug use (including, but not necessarily limited to, people with chronic pain that only responds to such drugs) and the way we respond to addiction today is in many ways ineffective and in some ways very harmful. One cannot make a very good argument for reform, however, on the basis that some people can use some of these drugs responsibly.
Exposing oneself to developing a heroin addiction seems a somewhat irresponsible and unhealthy thing to do.
A few years ago I had a lot of stress and started drinking to help me sleep. After only a few months I felt kind of agitated without a nightcap. I immediately stopped and now I just don't drink when I'm stressed.
So maybe in one sense I was right about being responsible, but on the other hand it could have very easily become a habit and now I understand how people slowly slide into addiction. It's arrogant to assume anyone knows how they'll respond to a drug as habit forming as heroin.
The funny thing I've been reading the article and the tone of it reminded me of heroin addicts who was not hit by their addiction heavily yet. I mean, Carl Hart thinks he is a responsible user, that he have an ability to decide for himself. It doesn't seem so for me. It is hard to tell, having as a data only one interview with him. But... you know, I'm an addict also, a nicotine one. I know how it is. First ten years of my addiction I though that there is nothing wrong with that, it costs some money and gives an urge to smoke sometimes, but it brings some benefits too. A few years ago I stopped smoking, after a month of abstinence I saw no benefits in smoking at all. My abstinence lasted for a couple of years, now I'm smoking again. Seeing no benefits at all.
I know what I'm speaking about, I know the signs, I see the signs, and I see Carl Hart as a fellow addict, though with a different substance.
I drink alcohol sometimes, and I know that I'm not an addict. Even despite the fact that sometimes I want to drink. A wish to drink is a warning sign of course, but I see no other signs. Like a despair coming with the thought that now it is not the good time to drink for some reasons. I have no ideas about benefits of being drunk: it is a funny state of mind, but mostly annoying, I'm really stupid when drunk, I see my stupidity and can do nothing to it. An addiction is a special state of mind, I believe one (i.e. me) could feel it as distinct from other states. Though it takes some learning, one needs to become an addict and to stop using an addictive substance of his choice. If Carl Hart wanted to prove that he is not an addict, he should stop using heroin for a couple of years, and then try to state his freedom from an addiction with a straight face. While he is using heroin for just five years and didn't tried to stop, I'd never believe his words that he is not an addict. When it would be 10-15 years or 5 years of abstinence, I'll probably believe his word on it.
Having known someone who was a responsible, highly educated adult with a fantastic career who died of a heroin overdose, this whole article sounded eerily familiar.
> If Carl Hart wanted to prove that he is not an addict, he should stop using heroin for a couple of years, and then try to state his freedom from an addiction with a straight face.
So by that logic... we should only believe that you're not an alcohol addict after you stop using alcohol for a couple of years?
I don't know if ordu has thought of that, but they don't appear to have from their comment.
I find the idea that the only way to know if you're not an addict is to give up for a period of years to be very problematic. Most definitions of addict suggest they are unable to control their compulsion, but I couldn't see any indication of that from the article. If the author of the article can sustain occasional use while maintaining a high profile job (science professor), their use doesn't appear to be out of control.
Yeah, something like this. I'm not entirely sure that alcoholic addiction would be just like a nicotine one, but I believe it would be similar enough for me to detect it. If I'm right I might hope that my experience with nicotine could be generalized to alcohol.
Maybe unrelated to a discussion of "is a period of abstinence is revealing", but I rarely drink alcohol, and a year or two without a drop of alcohol is a normal to me.
> Most definitions of addict suggest they are unable to control their compulsion, but I couldn't see any indication of that from the article.
I see no indication that he is able to control it. He is like "I want to take heroin, so I'm taking it". It is a very popular stance for addicts. When I tried to control my nicotine addiction it mostly ended with "I do not want to control". Even now I do not want to control, though I now see the difference between "I do not want to control" and "I want to smoke". I do not want to smoke and do not want to control my addiction.
When plane uncontrollable falling to a ground due to a failure, a pilot could state that it is his intention, and therefore the fall is a controlled one. People often do something like this, but for an addict it is a symptom by itself.
Carl is a white collar professor. The worst thing that can happen if his drug indulgence becomes a problem is he knocks over the water cooler or loses his job.
I work a blue collar job servicing heavy diesel engines. Casual hard drug users are aggravatingly cavalier to work alongside. They forget important things constantly. They show up late and lose things often. You'll spend all day repeating things they'll never retain and at the end of the month they will lose a finger or toe or suffer a massive back injury and get fired. The back injury usually turns the casual heroin into constant endless heroin.
Drug tests exist in my field for a really valid reason and it has nothing to do with having a problem but becoming one.
The issues is "drug decriminalization" people treating addictions like it's not a real problem for many people.
Many of these folks want it to get to a point where you can quite easily buy heroin and suffer no legal consequences.
I'm not saying our drug laws are just or can't be reformed but the fact that heroin is illegal prevents a LOT of people from using it. How many people will then use, aided by these pronouncements that "Heroin isn't actually that addictive!" and ruin their lives?
We already have an opioid epidemic in this country that has destroyed communities.
There's a middle ground between our terrible war on drugs and the naive "make it all legal and experiment with heroin!"
Do you know a lot of people who have expressed to you that they would use heroin recreationally if only it were legal? My gut is that the number isn’t large.
My impression of the evidence from places that have tried decriminalization (eg Portugal) is that the number of people who use and then are able to get their lives back on the rails is higher than the extra people who use because it’s decriminalized.
What if people tell them it's not addictive? And now it's not illegal?
What illegal does is make it far more likely to die from using heroin.
Lack of access (or not knowing how to access it) comes to mind, among many other reasons.
Also, my understanding of most drug legalization is that the intent is to legalize usage/possession, not distribution. This is done with the intent to make it easier/safer to gain treatment and decrease addiction.
I don’t know if you read it, but it also talks about how many deaths are from bad education (not understanding drug interactions, i.e. between two depressants), and bad drugs (i.e. lacing heroin with fentanyl) with no easy way for users to test their drugs.
It further goes on to discuss that addiction treatment in the US is terrible precisely because it focuses on the drugs as a pathology and does not consider the holistic person or helping the person solve their underlying problems.
Progressive drug policy isn’t “legalize it all”, it is “prevent needless deaths and treat addiction properly”. It has been for some time. Here are garden variety articles I found about these policies being implemented in the wild:
https://www.washingtonpost.com/world/2019/01/04/allow-festiv...
https://www.fda.gov/news-events/press-announcements/statemen...
The middle ground you seek is already defined clearly. Are you sure your perspective here is as informed as it could be?
I wholeheartedly agree. a couple google searches showed buying alcohol for a minor was a $1000 fine, but heroin possession for personal use is $20000 and a year in jail.
I think there's room to scale back the penalties and still be a deterrent. I think there's room to scale up addiction recovery.
Hell, keep the horrible penalties, but waive them if the accused, with counseling and whatever other support makes sense, can stay clean for a year.
So much of the system is about papering over problems rather than fixing the root cause.
Most people that fall into heavy addiction are probably driven there more by chaotic circumstances than intellectual considerations.
Social contagion can have significant effects on social issues like this.
You are right. I ended up with easily maintained hypertension and the urge to smoke that probably will never go away.(While on it, I also had significantly worse anxiety, decreased sleep quality, and bubbly urine. I definitely don't recommend trying it)
But the social dynamics between it and heroin are the same. If we normalize its use and downplay its risks, more people will use it. And the physical and social harms from heroin use are far worse than nicotine.
(I was turned onto this after listening to an interview with Dr. Peter Attia [haven't yet made up my mind on whether he is a huckster])
To quit, I switched to vaping for a few weeks, then tapered the nicotine concentration to zero over the course of a month or two. Cigarettes have MAOIs which make it more addictive which is why I switched.
I was irritable for weeks and still get the urge to smoke sometimes(it's been over 5 years since I quit). I don't recommend starting.
I've listened to him off and on, and think he's ok. He tests on himself pretty relentlessly, and still sees patients (though it's a boutique practice). He also appears open to new ideas as new research presents itself. And while crazy people can come from anywhere, he also has all the proper credentials.
There's this guy who hates him lol: https://www.libertariannews.org/2016/03/07/dr-peter-attia-re...
Finally, if you haven't already, you should find the podcast episode where he talks about Theranos. Pretty wild that he was asked to join and turned Holmes down.
Did you get addicted to the gum or the patch?
That's something important to consider when reading about experiences on the internet. There are people who are relatively resistant to addiction. When they talk about their experiences, they make it sound like it's no big deal, and it's not to them. But that's not how it is for everyone.
Nowadays I have a pretty big nicotine consumption and probably extremely marginal nootropic effects.
How many people are going to storm a national capitol because of what they see online?
It all sounds farcical and easy to dismiss until you actually put some thought into it.
You can't just lie to people and tell them that everything is deadly or they're gonna question everything else you've said. That's basically what DARE was.
I know a chainsaw is dangerous. But listening to every Youtuber lecture me about how I have lock out tag out to change a lightbulb my own home and every Redditor jump at the opportunity to engage in a monologue about how I should wear safety classes when I use a screwdriver sure lends a lot of legitimacy to the people who say their dad never wore PPE and retired with all his limbs so it must be fine.
Edit for more context:
Depending on the drug, substances consumed outside of working hours would still show up in a drug test. Firing someone for something they do outside of work shouldn't be acceptable.
If you can prove they consumed drugs that would impair their ability to perform their job during working hours, that'd be a valid cause for dismissal. Drug tests don't measure that precisely enough though.
Not to mention, drug tests are not infallible. They can come back positive for morphine if you eat a poppy seed bagel in the morning [1].
[1] https://www.snopes.com/fact-check/poppy-seeds-alter-drug-tes...
Airline pilots, I believe, have a no-drink-within-X-hours rule. I'm not sure whether X is 12, 24, or more. So even one drink the night before a morning flight would be prohibited, even though logically a single drink with dinner the night before should be a non-issue.
Did you know eating a poppyseed bagel will cause a positive for heroin for upto 60 hours afterwards while doing a small amount of heroin will not show up on that same test.
Here's a non-drug related one. In many places road construction companies will disallow workers from wearing headphones. This is because of the heavy machinery and you need to hear the beeps of a machine backing up. Drivers of those do not have good sight around the machinery and large trailers. Headphones on can mean not hearing a warning sound and being struck and possibly killed.
Are wearing headphones a problem? Do you want to fire someone until an accident happens?
Part of the proactive nature to this is insurance companies. If there aren't strict safety policies that are enforced than insurance companies won't cover companies. When accidents occur they have to pay out and want to avoid that.
Drug use has been proven to cause certain issues depending on the drug that can have safety impacts at work sights. This can costs lives and money.
This is why it becomes a big deal in certain fields.
I had to mummify a guy's hand because it was sliced open by glass, once. They were airlifted to the hospital because the bleeding couldn't be controlled.
Another guy was doing something unsafe with his forklift, probably because he was in a hurry, right before Christmas, it rolled over on him and he died.
That's why we couldn't keep people who were careless for any reason around. People could, and did, die for a moment of carelessness.
You're asking for more of this kind of story.
Make workers do a 30 second ability test before going on shift. Design the test to measure reaction speed, short term memory, etc.
[follow up thought] - Test must be immune to practice/muscle memory. Don't want a drunk passing the test through familiarity, then performing shit on the job.
I think the better solution is to abstract out the judgement into a formula that the pilot must follow, so not courting "gethereitis"
At least pilots mostly actually do their paperwork and checklists, even if they sometimes fall prey to things like neglecting to land their helicopter when they end up in IFR conditions while, say, transporting Kobe to a game.
A) when getting hired B) if you show up to work intoxicated C) after any serious accident
So other than at hiring, which the person can anticipate the timing of, the drug tests are effectively only done after failing such a test to begin with. The average factory doesn't care about hiring people with a record, either, so long as it's not too serious or likely to impact work.
Your test is one of those things that sounds like a good idea until you realize that the people who are needed for some big customer's order are too tired, but still able to work and you don't have anyone to replace them. Rolling the dice on that kind of stuff enough times until a failure happens is what gets factory floors in trouble.
That poor guy just wanted to get home to see his family for Christmas and busted ass to get one more dumpster of trash dumped even if it meant messing with the dumpster while the forklift was on too much of an incline. I don't truly know what he was thinking, but we can make an educated guess that he'd probably done that kind of thing before and doing things the right way took more time and effort than his poor, tired body had left in him at that point.
You don't appear to be aware of all the bad incentives that aren't going anywhere and are advocating something that will cause more people in more factories to roll more dice that will have more injuries. and hoping that the same tired, overworked, short-handed people will make a fuss over these rules instead of rolling the dice as they have so many times before if you just try to warn them or give them tests which they could skip to save 5 minutes they could've been working and then go home that much earlier.
Most of the ways to fix these problems require more staff and/or resources, shorter and more stable shifts, etc. all of which costs more money. Then those labor costs make them less competitive with factories in places like China where they may be trying to compete with literal slave labor in a race to the bottom. The factories already do look at incidents, as well as close calls, but there's only so much you can do when your grand ideas are paired with awful execution thereof.
The best ideas come when you understand their job and help them do things in a better, safer and, ideally, easier way.
A pre-shift only needs to fail once and you have a co-workers recklessness injuring another worker.
I wonder what unions think of drug tests? As a union member I might prefer that my coworkers were tested to be honest if I worked closely with them around heavy machinery.
Many software developers working for companies have agreements that they can't compete with their current employer on what they do while employed there. It's something employees give up while employed somewhere.
In the name of safety, many jobs with safety issues have to give up certain things (i.e. drugs) while employed there.
This same logic would also apply to lack of sleep, and is often glorified as part of the culture (doctors).
First, I'm attempting to describe how the system works rather than give my opinion on how it should be.
Second, the headphones situation is meant to illustrate how safety plays in. This isn't a "what if" example. People on job sites wearing headphones have died because they missed the warning tones. I am aware of one case, personally.
Safety is a big deal. It plays into the insurance companies who drive much of the policies and practices. They are driving the things they do to keep their costs down. Insurance companies often try to be pretty methodical in what they do to keep costs down. It's not just random ideas but looking at cause/effect relationships.
Third, many drugs have effects outside of the time they are used. It's not just the impact of the drug while one is on it but how it affects them in the time they are not on it, as well. From a safety perspective that cannot be discounted.
From the standpoint of the companies and the people involved, if you want to do drugs than work elsewhere. Safety is a higher priority.
I proposed my catch-all solution for this in another comment: https://news.ycombinator.com/item?id=26183297
My ideal is we just ensure competence - guy who smoked weed last night may be more competent than a clean guy getting divorced. Test the competence
It would be great if there was a way to test for competence. Some drugs cause long term issues with decision making and being able to see what's likely to happen. This reminds me of a job I had years ago framing houses. I remember some of the work men firing nails from a nail gun into a nearby woods. An area where neighborhood kids happen to play.
That's poor decision making and a liability. How do you test for complex things like that?
Film the worksite or send surprise inspectors to catch workers too lazy/reckless about their nail gunning. Maybe show them videos of nail gun injuries!
Improper nailgunning I think is more related to ingrained attitude than ephemeral competence degraders (drugs)
> Hart reports that more than 70 percent of drug users—whether they use alcohol, cocaine, prescription medications, or heroin—do not meet the health criteria for drug addiction
> “My heroin use is as rational as my alcohol use,” Carl Hart writes
> Let’s just talk about alcohol first. When you’re at a wedding reception, alcohol serves as a social lubricant. People are more gregarious. They talk, they interact. The same is true with cocaine at parties, heroin among friends, or opium among friends, NDMA among lovers.
> It’s just like with alcohol. Most people drink alcohol on a regular basis, but they don’t become physically dependent
> I don’t know a term. I simply mean people who take drugs, like alcohol users, somebody who may have a glass of wine or two every night for dinner, whereas somebody else may only drink on the weekend. It’s a wide range. And the same can be true with cocaine or heroin
> Why do you use heroin? > That’s like saying, “Why do you use alcohol?”
Although realistically, alcohol is probably one of the worst from a work safety perspective.
No. The worst that can happen to him is that he is pulled over by a cop in the parking lot. Gets charged with possession of heroin. Goes to jail for a couple nights, then looses his job/pension/car/house/wife/kids (in whatever order) and winds up on the street. Regardless of the biological realities of heroin, the realworld criminal consequences of regular heroin possession can be worse.
And I have yet to meet any longterm drug user who hasn't on occasion sold some to a friend. Get caught "dealing" and you will face an entirely different legal regime.
Many street-level drug dealers will still separate the drug and money handovers between different people. This isn't to avoid legal issues. It is to avoid the money being seized when the cops move on the guy they see handing over bags of drugs.
It's been 45 years since it was first established that heroin CAN be used safely when accompanied by a social ritual. Part of the problem IS the mindset and stigma around addiction, and that "insanely addictive drugs" have full power over people, and there is no ability to moderate their use, which is false. People are either 100% sober or a social pariah. The response in these comments mostly confirms this sort of black or white thinking. Maybe somebody should ask if its the lack of social ritual / social controls causing the problem, not the drug. Maybe society is failing otherwise responsible drug use by making all users outcasts. Or is a spectrum and complex interaction of multiple issues, and not just drugs. "This is too dangerous of a conversation to have" puts us in danger of not having productive conversations.
https://web.archive.org/web/20201111183716/https://www.harva...
I think the mistake siliconvalleyites have is that they imagine everyone as intelligent and rational as they think they themselves are which leads them to encourage open discussion.
But it’s clear throughout history that all people are stupid sheep on occasion and their thinking needs to be curated in a way.
Therapeutic use for diagnosed conditions - interesting.
Safety for recreational use - interesting.
As a recreational activity - seems like we have enough fun already without adding more risk.
Just my 2cents.
Years ago I was an office manager at a battery supply warehouse (car batteries not AA’s). We had an employee that had started working for us for about 6 months when it became vary apparent that he had a drug problem. Because his brother also worked there we knew that he had suffered a major car accident, was in crippling debt from the medical bills, and developed a pain pill habit as a result. He was only 19 at the time.
The issues that involved the work place were things like being consistently late, taking 2-3 hour lunch breaks and coming back high. So high, that he could not perform basic job tasks like counting a pallet of battery cores. My biggest concern was that he was licensed to use our fork lifts and so I had our warehouse manager do his best to keep him off the forklifts.
At this point I recommended to my boss that we fire him for the repeated offenses, as well as recommend that he seek drug consoling. I felt bad for him. He had a problem. He needed help. But he did not need to be working at that job for his and others safety. My boss and my boss’ boss, on the other hand, decided it was best to send to him to a “random” drug test, so that when the fired him they could do so with indisputable cause. This did not work, he disappeared for many hours, despite the drug testing facility being just down the street, and the results came back clean. I know that people have many ways of faking drug tests. I suggested again that he be fired for the offenses and not the drug test. Again my bosses disagreed and sent him to two more “random” tests each week after that.
The employee in question got wise to this. He knew what they were trying to do. So he went to a therapist and got a declaration of temporary disability. My company then had to pay him his full wages for 6 months with out him needed to come to work.
And I sat back and laughed at my bosses, as the unemployment claim would have be nominal by comparison.
edit: not sure why this would be down-voted. It is just a real story, relevant to the thread. I was only suggested that waiting for test results when possible danger lurks was not the right course of action. i forgot to add the employee did come back after his psychological disability ran out. And of course they sent him to take a drug test again. He failed that one and was fired.
The experiences of your friends is anecdotal. This article discusses the mechanisms of the drug, both the physical and personal cause of addiction, the common factors that lead to death, and the rate of users that end up addicted.
This seems to me to be a excessively myopic way of thinking about it. To the point of amounting to rationalization.
Third, as someone else says below, stories about your friends are also anecdotes. (I'm sorry, genuinely, that they died.) You don't know "the reality" of heroin because there are a litany of such realities - and here's a scientist telling you about his. The thousands (more?) who use heroin like my aunt uses a snifter of brandy at Christmas don't appear on anyone's radar because they're not dying and they're not rocking the boat. I could go on and on about the lives lost or ruined by alcohol in my family tree alone, let alone just "people I know", but I'm not terrified and calling to ban alcohol.
Finally, that so many people on a web forum whose userbase is wealthier, whiter, and way more privileged than the population at large rushing breathlessly into a post to call a black man (from the ghetto of Miami FL, no less) who uses small amounts of opiates "dangerous" is, excuse me, pretty effing rich. I thought tech-libertarians were supposed to be less reactionary.
On the WHO lists, alcohol ranks below heroin and the like, but not far below, and certainly not as low as cannabis.
Harmfulness seems largely irrelevant for legislation.
Responsible drug users are invisible to society and to judgemental people like you. You have no data to discredit it.
With the exception made of MDMA & speed (That I'll consume both on occasions) I was consuming weed, hash and mushrooms on a weekly basis.
And everybody on a certain group of friends was doing the same. We had a surplus of mushrooms, as we had somebody in our group (A neurobiologist) growing them.
13 years ago I came back to Argentina, and then stopped consuming cold turkey.
And in the end, it's only alcohol and nicotine that have me firmly in their grasp. Perhaps it's just the ease of access.
I believe I could quit nicotine, but not alcohol. I don't even drink a lot. But I do, regularly. I've used way more addictive stuff, and I could go out and buy it tomorrow, but I don't. Kind of funny how it works.
I mean, there's the billions of people who manage to consume alcohol without it interfering with the rest of their lives and the lives of others. Don't pretend that one substance that alters perception and behavior somehow isn't a "drug" in the same way that many others are just because of its legal status.
But if you mean drugs that are illegal, yes, there are also plenty of responsible users of those too. My wife and I have taken MDMA together a few times and it has been transformative for our relationship. As well as sharing our love for each other it also helped us talk about difficult subjects, something which I found hard for a long time, and as a result I am now better at talking about hard things when sober too. I think most people would say that going on a date night is a "responsible" act of relationship maintenance and I don't see what we did as any different, except much, much more enjoyable than a cocktail and meal. Every time we were careful with dosing, made sure we had no other responsibilities, and so on. It's as responsible as quality time with each other at a cafe.
I recognise that the production of illegal drugs is damaging and awful, but that's the fault of our legal framework. In the same way that producing soft drinks or beer isn't necessarily damaging nor should be producing drugs that are currently illegal.
Even more so, _nobody_ wants to hear about responsible drug users, because that'll contradict the general discourse.
I wish people didn’t dismiss Carl Hart immediately out of hand. Prohibition has never been a successful strategy. People are going to buy drugs no matter what. The biggest problem we have with drugs in the US is that people are uninformed about safe drug use and they are unable to easily verify the purity of the drugs they buy.
I’ve lost dozens of friends and family to alcoholism and drunk driving.
I can’t really get behind the cherry picking; society is being damaged in other real ways to a much greater extent than heroin, yet we find the ennui to overlook them; freedom of choice, speech, too expensive to bother, political authority...
Portugal has the model we should adopt and let this be as solved a problem it can be.
Stigma around drug use is dangerous. This is extremely evident from the state of treatment of heroin addiction in society today.
I don't really see how challenging this stigma is more dangerous than pandering to the status quo here.
Well, I picked up smoking from a girlfriend in college and we used to smoke all the time. Like ten cigs a day for a year and a half. Real bad, right?
Well, one day, I decided "Meh. I'll just stop" and I did. Not because of any reason. I just chose not to.
Now cigarettes are way addictive but I just chose to stop. More addictive than Benzos and shit and I just stopped cold turkey without any other reason.
Many of my friends struggled with quitting but eventually did. But I did it way easy. It's unlikely that I'm some super outlier, but clearly I'm some near the right edge of the bell curve in ease of exiting cigarette dependence.
That makes me think there are other outliers. This guy must be a heroin outlier. And considering the dependence inducing strength of that drug, he must be a far outlier.
edit: this is agreement with the original comment, not sure why I'm being down voted. Just highlighting how outliers can exist, but it doesn't reflect on the danger of the underlying activity in general
I think different substances are differently addictive to people.
For me: I eat cookies because my Mom baked a lot, and I lost her early. This is a way to feel close to her. Knowing that makes it easier to not eat all the cookies. That doesn't mean all addictions are rooted in early childhood or psychological symptoms, or that your life gets fixed if you just talk about your parents a lot ;) But especially with addictions that only create mild physical addiction symptoms, it's worth looking at.
People are very very different in their drug tolerances and really shouldn't give advice to other people, because they are not the same.
I can understand why this infuriates people who've seen or known people who've died from an addiction but it's important for people to understand that alcohol, drugs, gambling, facebook, the internet, shopping, and everything that can turn into an addiction are not the problem. The problem is deep emotional pain from traumatic experiences.
The hard part is quitting something when you want to but cannot make yourself i.e. addictions are what is hard to quit.
The majority of people are able to smoke, drink, eat, and fornicate without developing an addiction. The people that become addicted are the outliers.
That's interesting, though.
Experts were expecting an unprecedented heroin epidemic from veterans returning from the Vietnam war as drug use among soldiers was rampant. Turned out these soldiers came back and were no longer addicted. Scientists are guessing the causal factor for the loss of addiction was a "change in environment." It is literally the same thing that happened to the European person who replied to your post. Your brain hard wires dependencies to certain drugs but when you change your environment it may trigger something in your brain to actually unconsciously eliminate these dependencies. This makes evolutionary sense.
No doubt about it, people think that the above description means that the addiction is some sort of conscious decision. It is not the case. Addition is real, but the tricks to get out of addiction may be simpler then most people think.
So the question to ask is, when you quit tobacco, were you in the process of moving? Were there big changes going on in your life that would change the environment around you?
I know grandpa quit cold turkey after my dad (newly invested as a medical doctor) came home and said "You will die of lung cancer almost surely if you keep this up". And an uncle quit after his 8-year-old daughter (my cousin) said "Papa please. I don't want you to die" plaintively or something like that.
I guess some things just change the game for people.
My wife for example has struggled to quit smoking for at least 10 years. As in very hardcore struggle.
When I was young my father managed to quit from a 3 pack a day habit to nothing cold turkey. But it was obviously pretty tough on him during the process and took a couple of years to really break out of.
My brother has a pretty bad pot addiction, a relatively harmless drug with almost no known chemical mechanism for addiction. Yet he can't shake it and it's haunted him his entire life.
I'm a bit like you w/r to tobacco. I occasionally smoke cigars and have played around with cigarettes from time to time. Once I lose interest I just stop and it's over. No urge or desire or anything else.
On the other hand, I have a bad day at work and all I want to do is shove shit food in my mouth.
You addiction might seem trivial in comparison, but you could be experiencing something quite similar to someone who is addicted to a "hard" substance.
So I guess I had a pretty good hold on what the population of smokers was, and so I know most struggled to quit.
As for the other drugs, yeah, I'm open to thinking otherwise. I have lots of friends who recreationally use cocaine, MDMA, LSD, mushrooms, and whatever else. Personally I've tried all of those and really just use shrooms now occasionally¹. No particular addictions there among my group of friends, so I'm open to your school of thought there.
¹ Cocaine is boring. MDMA is great. LSD is cool. Shrooms has massive therapeutic effects for me. I can skip my Adderall for two weeks after a trip. I feel so motivated to work and find it trivial to focus.
Lots and lots of living people have smoked at some point. However, many (most?) of those people quit smoking at some point.
So, the remaining people are the people that are most addicted, which gives us the impression that tobacco is highly addictive for everyone.
Edit: the CDC says that 62% of people who have ever smoked have quit.
https://www.cdc.gov/tobacco/data_statistics/fact_sheets/cess...
It could be selection bias. Maybe I hang out with other people with addiction potential because of who I am. But it's definitely not survival bias (which is sort of what the rest of your comment talks about). The thing that makes it unlikely and the article's premise unlikely is that the weight of evidence is on this stuff being addictive.
But, you know, I'm a huge fan of the therapeutic effects of many scheduled drugs, so I'm open to the idea that addiction works differently from currently understood.
Back during one of the big buyouts of ca. 1980, an executive of KKR explained why it was buying some cigarette company: You make it for a dime, you sell it for a dollar, and people are addicted to it.
I outright abused alcohol early in 2020 because shit got a bit cray-cray. Then just stopped because alcohol got boring. Done that a lot with alcohol.
Had an experience with Xanax several years ago though and I'm not touching that stuff again ever unless I'm terminal (then, yes, please). Still managed to identify the onset of addiction and stop it before it really got going, but I'm not touching that chemical again.
It's bizzarre the genetic/environmental differences in addiction.
Cannabis? Smoked for months every day, decided it wasn't for me and that was it. Same for many other chemicals, including cocaine. I just... stopped.
I feel like I could stop nicotine intake within a few weeks. Could be wrong about it. But not alcohol, that's the number 1 enemy. Every time I think about it, there's an insane urge to drink some, it's insane.
I mean, I literally have access to something with effects between alcohol and cannabis, yet I go with alcohol. Ridiculous.
I just couldn't stand it the feel of tabacco. Same goes for weed, i hung around very heavy smokers all during college but just hated the feeling from THC so i never really got into it.
My girlfriend smoked for almost a decade and did the same thing as you, including drinking. She's been 2 years clean.
And no, I don't really even 'want' a cigarette. I know what addiction is, in that I feel this strong pull towards sweet stuff. I must have any kind of dessert, and if I see a novel food, I must eat it. I just must. It's like a fugue state. Try as I might I fall. Also with online validation for comments I write or stories I tell. The dopamine hit from an upvote has a debilitating hold on me.
But with no drugs have I felt this desire. Not even shrooms which I enjoy or MDMA which has been my all time favourite. I have some shrooms and some LSD in my fridge so I can partake any time. I just don't.
I'm amenable to the Rat Park hypothesis too. Maybe it's all Rat Park stuff.
In highschool almost everyone I know got into smoking pot, at least for awhile, and within a year or two 90+% of them just lost interest in it, maybe 5% kept using and maybe a quarter of them literally made pot the center of their lives and are still daily users with big impact on their lives and careers (or, honestly, lack thereof for all but one). The same thing happened with alcohol.
As an adult, I've seen the same pattern repeat for people who just didn't try things, for whatever reason, or perhaps people who changed.
What's actually happening, IMHO, is that you have a ton of overlapping processes that are filtering for with people who are vulnerable to becoming addicted to a given drug. Obviously those people will have trouble quitting.
That there exists people like this person who can chip (controlled use of opiates) always intrigues me -- as this drug was the ultimate pathway to euphoria and thus I became the mouse hitting the button for more more more. If you're on the chipping path I hope you can find peace just for today.
I am pro-legalization of all drugs with some FDA oversight on quality.
When the pain subsided, I stopped taking them, and within a day I found myself curled up in a ball and wanting to rip my own skin off. It's really true when addicts describe it as "being uncomfortable in your own skin".
The moment I realized I was experiencing withdrawal, I flushed the meds down the toilet and just suffered through it for a couple days.
Never ever touch heroin. Stay away from prescription opioids unless it's really really needed, and make sure it's short term only.
This is the kind of FUD that TFA is specifically addressing. Namely, that this is not always a true statement.
Of course, for many people, it is, which is why people make such sweeping (and incorrect) statements. Your warning is valid, your claimed facts are not.
"Treat every gun as if it were loaded" is the traditional advice, and is a wonderful attitude to have about firearms. But if it's not loaded, it's not loaded, those are the facts.
Perhaps the same with opiods: treat them as if they are highly addictive, in a rapid manner. But if (for you) they aren't, they aren't.
Here's one showing only 5% of people filling opioid scripts go on to long term use.[1]
Another older study citing 2% of US adults regularly using opioids, while a further 29% use them infrequently. Other more recent studies I seen hold this pretty constant. [2]
Here [3] only 13% of elective surgery patients fill opioid scripts beyond 90 days, and "mental health disorders, and tobacco dependence or abuse were associated with prolonged opioid use". It's well known that people with one substance abuse issue tend to be at higher risk for developing others.
You could go on and on finding studies that show that relatively few people with high risk medical/mental health history go on to develop opioid addiction after using these substances. There doesn't seem to be any support for the idea that the average person can take these drugs once and become "hooked".
All that said, they are dangerous and have strong addictive potential so caution is warranted.
[1] https://link.springer.com/article/10.1007/s11606-016-3810-3?...
[2]https://www.sciencedirect.com/science/article/abs/pii/S03043...
[3] https://www.sciencedirect.com/science/article/abs/pii/S03635...
And for what?
It is an incredibly slippery slope for people to walk out on. It would be incredibly hard for someone to say whether or not they will spiral out of control if they try it and the consequences of becoming heavily addicted are life destroying. It seems like playing Russian roulette and I'm not sure it's a good thing to raise the idea that one can potentially manage it. Also, the person being interviewed could be one of the people that can't control it and will spiral out of control or him saying he manages it well and it's possible to do so could be a facade and he could be trying to do whatever possible to keep his habit alive, but we just don't know. Many people manage it fine for years without anyone knowing until they start their sharp decline towards bottom.
Wherw do you think he got these assertions? There have already been studies about how often heroin users are addicts or what the addiction rate of prescription opioids are.
He's very clearly advising against getting addicted, something most opiate users accomplish.
https://jamanetwork.com/journals/jamapsychiatry/fullarticle/...
Is that true generally, or just for a subset of people who have some predisposition to addiction?
While it could just be Purdue Pharma propaganda, I vaguely recall hearing that the "instant addiction" was a myth. However, people like you have experiences like yours, so there must be some truth to the "instant addiction" idea.
Edit for downvoters: I think it totally makes sense for everyone treat opioids like a loaded gun, like another poster said, if some people are vulnerable to an instant addiction effect. I just want to clarify what the actual situation is (for me and all the other people who were told it was a myth).
A prerequisite for addiction is that one must believe the drug makes them feel “normal” or functional in some way. “I can’t live with this pain - I need it.”
If instead you as a user go into the drug experience with the mindset that you are entering a temporary state, one that is reserved for special occasions, you’re far less likely to become addicted.
If it were true that it was instantly physically addictive, then literally every human being that has ever had any kind of surgery or been to the ER for trauma would be a rabid opioid zombie. But they aren’t.
My cousin is a social worker, dealing with addicts. I've done heroin myself. I know heroin addicts, though not as many as he does.
We both agree: almost all addicts have a backdrop of broken families, poverty, unemployment, some kind of trauma or just a general lack of opportunities in life. Heroin makes all that go away... for a while. How could they NOT become addicted?
The myth is about shifting blame from social inequality onto a drug. The addiction is but a symptom of a societal disease.
LOL no. Some people here, most of them highly educated, are spewing myths like it's "instantly addictive", lies laid out to try to curb the epidemic from the 80s.
It takes relatively long daily use for one to become dependent, and basically you only do that if you don't have a job or anything you value waiting for you after the high, really. Sure, there are exceptions, but that's the norm. The fact that drug abuse heavily correlates with economic recessions and unemployment increases should give everyone a hint. [0]
In 2020, we know roughly 80% of the users never become dependent. [1] In the same ballpark as alcohol, unsurprisingly.
And it's normal. Because it's bliss, but then it's pretty shitty. For a few hours of high you have a few hours of nausea and general discomfort.
> You have to be seld destructive to even try.
No, you just have to be curious and know how to evaluate risks and benefits. It's not a "starter happy drug", but it's not the devil. In 2020, the people doing heroin know a good deal more what they're doing than the ones from the 80s.
Harm prevention and reduction has moved on a lot too. There are high precision scales for very cheap. There are testing kits, too. In the 80s pharmacies in most countries were told not to sell syringes to addicts, again to curb the epidemic, causing them to share needles with all the associated problems (HIV expansion, needles leaving more bruises, sepsis...). Now most countries with a sane drug policies provide free needles to addicts, when not straight up supplying heroin to them [2]. Unsurprisingly such countries have lower problematic drug use than the US, where the problem is policed rather than treated.
[0] https://www.sciencedirect.com/science/article/pii/S095539591... [1] https://drugpolicy.org/drug-facts/can-using-heroin-once-make... [2] https://en.wikipedia.org/wiki/Heroin-assisted_treatment
Where did come up with this? This is not accurate.
Some people are definitely more prone or vulnerable to becoming addicted to it. Im lucky, I guess.
I've been through plenty of addictions, but quitting Oxy after surgery is the closest thing to hell I've experienced so far.
After a couple of days he was experiencing identical symptoms as the GP.
I'm not trying to chime in on how strictly we're interpreting "instantly," but for me I will definitely do my best to avoid opiods. Taking the prescribed amount for 2-3 days, and literally not taking the rest of the pills (both GP and my brother), and having serious physical withdrawals--that's fast enough that I would rather avoid it.
Edit: Just to clarify, she was not prescribed any opioids/drugs to be taken post surgery, it was purely the anesthetics.
Of these drugs, the only ones that might cause withdrawal symptoms would be the benzo or the opioid. The benzo, if it's even given at all, is going to be tiny. Even if we were to hypothesize that a single unusually large dose of an opioid could induce dependency, a surgery where the patient isn't even given opioids to take home wouldn't warrant such a dose in the OR.
In short, your second-hand account makes no sense.
I am fuzzy on the details, because the person was just an acquaintance. There was a huge investigation on her history, looking for substance abuse. They found nothing.
I've smoked opium a handful of times. It smells wonderfully.
And yet, if I take any drug regularly, I'm using something with THC in it (hash or pot, in general). I currently do not, however, and tend to have a few drinks and get high on the weekends. Not a big deal if I don't, though.
I've had medical grade heroin in the hospital (morphine didn't take care of the pain). No withdrawal, though I was wonderfully high. Haven't gone to a morphine habit.
The prudent thing to do is not to say, "opioids are instantly addictive", but to give folks safe ways to detox from them and give folks information on signs of addiction - because not everyone has such experiences.
Would I do opium again? Sure. It was fun. Would I do medical grade heroin or morphine again, under controlled circumstances with a nursing staff dosing me? Yeah. It was fun. Did I have some weird urge to go out and do it frequently? Nope. But to be fair, lots of folks drink on more than one occasion as well. They get high more than once. They might even have more than one drink or hit in one day. Simply wanting to do something again doesn't mean anything. I've done acid more times than I can count, and I wouldn't call it a habit. The only drug that I'd probably do more often if it were not dangerous to do too often is MDMA because it feels spectacular (better than opioids, to me anyway), but I'd not even call it a strong urge.
This isn't addiction, nor is it anything uncontrollable in general.
Unless you are implying that folks get uncontrollable urges, and in that case, please back that up with facts. Though I've met my share of addicts, most things just aren't instantly addictive. Even heroin isn't that way - especially if you actually improve an addicts like (hence, troops addicted to heroin in wars came home to be non-addicts).
With as much respect as I can offer I think you should consider the following notion, which in my personal experience is an actual fact:
"Until and unless you have been an addict you truly cannot understand the experience. And subsequently you are not able to point out what is and is not addiction."
I believe the most-essential factor is this: loss-of-control over the behavior in question.
IOW, when the behavior takes places in spite of the individual wishing to stop, or committing to stopping -- then it is almost certainly "an addiction". It is the behavior that is most important, not 'substances' particularly.
The trouble is that it is very, very difficult for someone to recognize AND admit that they are unable to control some aspect of their behavior.
Most of us will create elaborate explanations to avoid admitting (to ourselves mostly) that sometimes we window up in a situations where we are completely powerless to control our behavior.
No, the 'vast majority' do not. I've supervised medical grade opioid administration to more than a few people, both acutely and chronically, and *folks without a pre-existing substance use problem* do not often develop one, especially if it's over the short term. The idea that "I give you an opioid and then BAM I want more!" is highly divergent from my clinical experience.
Use != Misuse, but use for pleasure is a direct precursor of misuse.
The grand-parent comment to which I am replying describes near-instant addiction in the context of an opioid prescribed for pain control.
FWIW, good on you for recognizing that you're one of the third group and getting off of it entirely before the addiction gets even worse.
And I say this as someone who's plenty happy with drugs legalization, who likes the occasional MDMA, and who drinks plenty of alcohol. I guess I'm lucky I never run the risk of opiates addiction, because despite all that I have no desire to every touch the stuff again.
Do you have a source for this assertion? I'm just a physician with a particular specialty in medically managed (as opposed to procedurally managed) pain, and I've never seen a "I took it once and was instantly addicted." I don't mean to undercut your subjective experience, but I've seen a few folks on pain killers, and if what you described was more common than "very rare", I would have by now.
They may be instantly addictive for you, but they are not for everyone.
After I had a pleurodesis, the nurse sat me down in the chair next to the hospital bed and gave me a little controller I could use to release morphine into my saline solution if the pain became unbearable (and it did). It was the strangest sensation—I could 'feel' the pain, in a sense, but it was like I was on a different plane, and it didn't quite bother me.
But to say it was instantly addictive—nope. Not at all. Have had no desire to try anything like that again outside of a hospital setting. Maybe some people are just not prone to it.
Heroin terrifies me.
Most relevantly, coffee contains a relatively large amount of Harmala alkaloids, which are a family of beta-carboline monoamine oxidase inhibitors commonly found in Ayahuasca brews (and named after one of its ingredients, Penganum harmala).
Honestly, I need to ween myself back a bit.
Try caffeine pills, they have a cleaner effect with no stomach/intestine troubles. Somewhat easier to quit, too.
It's probably some variable physiological response - hopefully one day we'll have a good way of profiling a priori which people may have difficulty with using opioids in a controlled fashion so people don't have to suffer to find out they're among the unlucky ones. (Or maybe we'll come up with either a new class of drugs to replace opioids entirely, or a cocktail to block the adverse effects...)
Some of us don’t like the “sinking into oblivion” feeling of that class of drugs. I don’t want to feel like my IQ has been sliced in half. Really hate it actually.
The dragon to chase is of the functional businessman’s variety- cocaine. I’d rather take something that enhances my life experience, turns conversation in liquid gold oozing from mouth. Opiates and barbiturates temporarily hide your problems under a blanket of haze, confusion, and constipation. No thanks.
But I love cocaine, psychedelics, and weed though, and I have been somewhat addicted to all three at different times in my life. I specifically wouldn't ever get drunk if I didn't have weed to go with it, as that's the only way to make alcohol any fun for me.
I was a dumb teenager (I'm still not very smart) but I'm grateful I had the intuition to realize how dangerous it was. The only way I can describe it was that I felt the pleasure overwhelming my ability to reason, and that felt very disabling.
This does lead to the weird situation where an entire population has easy access to opium should they want to raid nearby fields; the fields are lightly fenced with warning signs stating that it's bad for your health. Perhaps surprisingly to many Tasmania doesn't really have any issues from this. This may lend some credence to the above article - it takes more than just access to lead to issues for people.
https://en.wikipedia.org/wiki/Tasmanian_opium_poppy_farming_...
The process is very crude but works well for experimentation. I think if you were a serious opiate user it would probably be too inefficient and inconvenient to warrant over simply buying opium.
https://depts.washington.edu/hortlib/resources/wp-resource_s...
Michael Pollan also wrote an essay about it (I think taking a slightly stronger position).
I think substances can be addictive on their own, which gets occluded by many on the "pro-drugs" side.
The only bit I will agree with is that addiction is not caused by the drug itself, and is typically the result of childhood trauma. With that drug use is not a solution for dealing with that trauma, dealing with that trauma directly through therapy and mediation is a much better solution.
Traumatic experiences plays a big role on addiction, but purely chemical addiction should still be factored in. Heroine is extremely addictive not just because of traumatic experiences, but because it induces very high dopamine releases.
His assertion the 70% of all drug users including alcohol and prescription users aren't addicted if anything seems extremely low to me. I'd say the vast majority of my friends drink alcohol and are more than likely on prescription drugs but I don't think any of them are addicts
Which means that the other less common drugs must be a lot more addictive to bring the number down to 70%
I get the point the article is trying to make, but its headline and opening paragraphs frame it more as a "decriminalise all drugs" article
Actually, I'm not sure. 30% of alcohol drinkers being addicted might be roughly right (though surprising to me as well).
In the US, 50% of Americans hardly drink at all (under 0.15 drinks/week). But 10% of Americans drink a staggering 75 drinks a week, or over ten drinks a day every day (where a drink is a can of beer, glass of wine, or equivalent). [1]
Of course you can't determine from that alone whether those people are clinically addicted, but it sound reasonable to me that most are. Further, probably some proportion of people in the other groups are also addicted, but not drinking nearly as much.
So that's 10%, and only 50% of Americans are drinking at all, so that's 20% of drinkers are drinking 10+ drinks a day, and some unknown proportion have alcohol problems while drinking less.
1. https://www.washingtonpost.com/news/wonk/wp/2014/09/25/think...
Maybe we're getting a very different view of the US from the UK, but despite all of America's flaws and how weak the beer is, it seems so unexpected to me that 1/10 of people are opening a new drink every 90 minutes and somehow managing to hold down a job to be able to afford such a habit.
It just seems odd that in the UK, binge drinking is considered to be an issue, and yet a significant percentage of the US population is drinking the equivalent of a night out on a daily basis.
I've since cut back a lot but in my worst post-college days I could drink the equivalent of 8-10 drinks in a night and feel perfectly fine the next morning as long as I got a decent amount of sleep.
I think the conclusion to draw here is not that having 4-5 drinks a day is no big deal, but that different people react to alcohol and other drugs differently. For some people, like me, it turns out to be no big deal. For others I'm pretty sure it would be a very big deal. A one-size-fits-all drug policy is never going to work.
the-east-end.co.uk/the-gin-craze
The bulk of my customers drink 5-7 nights per week. We call them "regulars." They come every night when their shift ends, and most of them stay until close (although they are primarily service industry, so this is 5-7 hours per day). If they have a day off, they often show up earlier.
For these people, I think that one drink every half hour is an understatement. They're having a beer/cocktail every half hour or so, and mixing in shots, jello shots, etc. If they have limited time, they will up their rate of consumption. They're after a specific result.
I have no idea what percentage of the population they represent.
We have a lot of other customers who we see maybe once a week, every other week. Some folks come in to eat our food special and just have a couple beers and go. Stuff like that.
I think that you are probably in the latter group (or the non-drinking group) and so you don't see the former group. I very much agree that the heavy drinkers are not living normal lives; they ARE in fact permanently hungover (or should be--they learn to deal with it in various ways). It's a continuing problem with my own staff, actually.
Anyway, they're out there, they're holding jobs and making children, and they undeniably have a problem with alcohol. But again, I have no idea what percentage of the population they make up. Maybe I'm seeing the worst of the problems--but I don't actually believe that.
It's really, really prevalent in some industries. I've hired concrete finishers before (multiple times), and I've never NOT had a bunch of empty cans crushed up and hidden somewhere random on the worksite afterwords, even if it's only for a couple hours. When I worked with some writers years ago, they kept bottles of cheap scotch and 2 buck chuck in their desks, and had to replenish them regularly.
The go to drug selection in tech skews our perception a bit (weed being incredibly pervasive, but lsd,shrooms,stimulatns far from absent).
The bars are open until at least 2, you know.
I'm thinking of the office worker who might have a glass of orange juice, 2-3 cups of tea/coffee, then 2 pints after work most days.
Cheap hard liquor is even more cost-effective. You can get a big bottle of awful vodka for around $0.25 a "drink".
That is to say, you don't have to be able to hold down a particularly good job to afford this.
I assume that as you drink more your tolerance would increase? As an occasional light drinker, I'm pretty sure I'd be physically incapable of getting through that much alcohol in a day with enough time left to also attend a job.
[laughs in Belgian Trappiste at the English ales]
Is beer in the US still as bad as it was 10 years ago? I understood it now has a huge craft-/micro brewery scene with some very drinkable APA/IPA's? Or is this just a tiny fraction of the market still?
Edit: And as a lover of belgian beers I can only agree. I wonder why people even drink so many IPAs when there's so many different and delicious varieties of beers around.
That said, a quick googling shows that 2/3 of the American beer market is still dominated by non-craft domestics (AKA your cheap, watery lagers like Bud/Miller). Even amongst the craft segment it's definitely the case as another commenter pointed out that IPAs are overrepresented for whatever reason.
I think where we're still really lagging behind is quality of beers at your average bar. If you know where to go you can find great selection but the average bar probably still has just a handful of decent non-domestic-lager offerings, likely in cans/bottles. In comparison to when I lived in the UK and it seemed like any corner pub would have a couple great draft ales .. it's not the same.
A fair amount of the 10+ drinks isn't to "feel good" or "get drunk" once you're hooked. It's to stop the shaking and be able to minimally function.
Funny, I've never heard someone take a jab at the strength of American beer. I'm curious what is the ABV of a normal beer you're used to in the UK? The 'commercial grade' American domestics tend to be about 5% maybe 4.5%. In the last decade though, 'craft'/ micro breweries have exploded so it's very easy to find stronger at any bar. In almost any convenience/ grocery store, there are plenty of 7%-9% IPAs and the like. I'll admit I like strong beer :) A lot of bars around my area will have some exotic options of 10% or more. I had one recently that was 13%! That's as much as a glass of wine. That being said, the large majority of folks are drinking beer that's 4-5%.
As far as alcohol addicts go, I learned from a friend who had to take some court ordered 'rehab' classes, that (at least in the USA) something like 90% of all alcohol is consumed by only 10% of the drinking population. That means the dirty little secret they don't want you to know is basically the entire alcohol industry is propped up by addicts.
Edit: I just clicked the WaPo story you guys were talking about, and that lines up with what I heard previously. Most people drink very moderately, but the top 10% are the cash cows for the industry.
Now, in the case of my particular family members, I wouldn't exactly say they don't have a problem. Most of them live on the edge of poverty, which would be much less of a problem if they didn't drink and smoke at least a pack of cigarettes a day.
But most of these folks who drink massive amounts of the sort of beers-I-wouldn't-touch-with-a-ten-foot-pole are mostly functional in society. By that, I mean, they don't have a monopoly on family and money problems. Shockingly few people have their shit together in the way that we talk about when we talk about the dangers of addiction.
Like I said, I don't know. It's not very clear/cut-and-dried to me.
Source: https://www.cdc.gov/alcohol/features/excessive-alcohol-death...
Most of the UK beer I've heard of is at a similar level or lower to US macro brews.
On my worst weeks when I think "i need to cut back" I might average ~3 drinks a day, maybe 5 on a holiday bender.
Once the habit is ingrained and you become reliant on it to control your moods, 'cutting back' is a whole different proposition. My triglycerides are terrible, but other than that I seem to be ok, so why not just keep going? It's the easiest path, inexpensive, and most importantly, a LOT less hassle than dealing with the minefield of incompetence you encounter when seeking mental health treatment.
I haven't given up completely on 'doing better'. But on the other hand, maybe that's not for everybody. We only have so much time here, how do we want to spend it? Stumbling over ourselves in an impossible quest for imaginary perfection, until we die anyway? Or enjoying ourselves the best we can given the dire circumstances?
"I haven't given up completely on 'doing better'. But on the other hand, maybe that's not for everybody. We only have so much time here, how do we want to spend it? Stumbling over ourselves in an impossible quest for imaginary perfection, until we die anyway? Or enjoying ourselves the best we can given the dire circumstances?"
I hope you do arrive at "doing better". It is likely you will enjoy yourself a lot more.
Really, not a single drink or sip.
That way your liver has time to heal itself again, lest it will develop a cirrhosis, which will signifanctly decrease your quality and expectancy of life. If you have a cirrhosis of the liver, it's too late, you're going to die in at most 5 years, and it won't be pleasant until then, either.
That's got nothing to do with "doing better", "perfection" or whatever, just hard facts.
Some mimosa with brunch is one thing, but if you're into pretty much anything else (beer, wine, liquor), you should probably stop immediately and take a good hard look in the mirror.
I did not, and I was completely stunned, but he said he knew he had to start now because then he could be strong like his dad. And he treated it purely like a chore, drinking every single morning for the next year and change, when we parted ways.
This guy was brilliant - his 4th grade science project was a to measure the lift of different airfoil shapes using as a testbed a hand-built, full-on wind tunnel made from a discarded cylinder vacuum cleaner. I think he dropped out of school in highschool.
> Which means that the other less common drugs must be a lot more addictive to bring the number down to 70%
I don't think your sample of friends is enough to support this kind of conclusion. n is small, there is likely selection bias at play, and you can't have perfect knowledge of what your friends do when you're not around. it's not uncommon for addicts to be able to keep it together for a few hours of socializing. I had a friend in college who would only have a single glass of wine when he was visiting family. for a while, they thought he was very responsible or just not that interested in drinking. the reality was if he had more than one, he wouldn't be able to stop. back at school, he got plastered every day and eventually failed out and had to go to rehab. addicts can be very good at hiding things until they hit the tipping point where their life falls apart completely.
There's a confounding variable: the difficulty of obtaining drugs vs alcohol. This causes a selection bias and means that a higher proportion of heroin users are addicts than otherwise would be. You can't necessarily deduce that heroin is more addictive from that (although there are other ways I'm sure).
Just like everyone may need a bank loan (which is totally socially acceptable), sometime you may need a happiness/energy/relief/whatever loan.
The thing is, just like a money loan, you should be ready to pay your debt after. The day you think you can run away without paying, it's where the trouble begin.
This is true even with alcohol: Go to a party, drink a few glasses. One or two more. Have fun. The day after you pay it with a little (or even big) hangover. Just drink a lot of water and you will be ok.
Obviously this is more difficult with some drugs. They are dangerous because they are more subtle, somehow you think you're still in charge, until it's too late and your debt is out of control.
Now, I'm aware that this is quite complex, but still I wonder how many people there are out there who can self-control themself and diligently keep their debt in order.
I guess, compared to "meth-heads" and other rock bottom abusers, they just don't make the news. Plus they may want to avoid a lot of social rejection.
A craving feeling arises to have fun. The craving exists there because it feels nice. This also implies that you feel less nice than you'd like to feel. This craving doesn't happen that often, but often enough that you're curious about taking drugs.
You try cocaine. Suddenly you feel energized and amazing, this is how you always want to feel! The effect wanes after 20 minutes, you take it again and you feel amazing. You're starting to do this every weekend. Cocaine gets associated with the craving feeling for fun.
After a few months, whenever you feel like your normal self, a craving feeling arises. This feeling is now a mix of wanting to have fun and wanting cocaine.
The thing is, where I think the debt metaphor breaks down is that this increase in craving acts a bit different than actual debt.
Many addicts feel strong cravings for years afterwards, and it only very slowly decreases. Once hooked again to the substance, it's easily back to previous all-time high levels. Psychologists claim that in conditioning processes, it's impossible to delete conditioning (called extinction). So you can never truly repay our debt.
Moreover, once your craving is extinct (for as much as possible) it's really only dormant in reality. Make one wrong move and you're quickly back to rock bottom. With debt, if I pay back my debt of $50K, then splurge for another $1K, I am not back in debt with $50K. This is however how addiction works.
Finally, the debt metaphor doesn't capture the uncontrollableness of cravings that are arising. You have no free will in what spontaneous thought or feeling arises. This is quite easily seen when you're sitting still and try to do nothing: your mind will still chatter away, you'll still feel things based on that chatter. In quite a few cases it's impossible what your mind will show you next. The same is true for the cravings that an addict gets with a drug. Sure, the craving will arise when one starts to talk about it, but it may also arise when somebody twitches their leg, because the muscle tension is super vaguely associated to a memory when one was partying with the drug, but the person is not even aware of that association or that it's part of a memory.
Disclaimer: I'm not a drug addict, but based on my personal life experiences, I think it's fair to say that I have enough experience how it must feel like (I experience a mild pull to alcohol, a strong pull to caffeine and an overwhelming pull to videos and video games).
I'm not a drug addict either, but I can relate with some of it about my cigarette smoking habit (it's actually an addiction, I know).
As for the metaphor, "every weekend" looks already like an enormous amount of debt to me.
Unfortunately, I don't know enough (anymore) on the science of craving, most of what I wrote is actually what I've noticed because of meditation and self-reflection, so it's a very subjective account. Though, what I stated about conditioning, that is scientifically proven, you can read the wiki of operant and classical conditioning.
> The description of your craving process is both fascinating and horrifying. Well, mostly horrifying.
In certain forms of mindfulness meditation you're asked to observe your sensations in your body. In practice this can translate to observing whatever craving you're experiencing :P
Let me think a bit what areas of research might be interesting to account a bit for my subjective experience...
- Wanting and Liking from Berridge's lab [1].
- Research on how to make slot machine's addictive [2]
But those ideas are a bit more circumstantial I believe.
[1] https://en.wikipedia.org/wiki/Motivational_salience
[2] https://www.researchgate.net/publication/247926701_Addictive...
>Now, I'm aware that this is quite complex, but still I wonder how many people there are out there who can self-control themself and diligently keep their debt in order.
The analogy breaks down a bit here for me.
Before I had a cat, I couldn't understand how people could pay so much for veterinary bills. After I got a cat, I could see myself spending more on her than I would spend on myself. Like, what's the point of having money if not to make my cat happy? My relationship to money itself changed. Self-control isn't a factor.
I'm stretching this analogy, but I wonder how many drug users with their happiness debts in balance have really just reframed their happiness finances around their addiction.
The first Wednesday of every month at 10am he shot himself heroin.
It's one of his extremely methodical routines. It can be seen as an habit, but you can't truly call him an addict.
If you reframe your happiness around your drug use you're already addicted. The question about my original post was more like: Are there people who have a drug habit without the addiction? If yes, how many of them are there?
I think this is likely wrong. I guess it partly depends on the definition of a "drug user" (like, does it include alcohol drinkers) but I would be very surprised if most heroin users are responsible professionals - how can you do anything when you're high on heroin? I'd go so far as to say that saying people that are addicted are "typically responsible professionals" is a little disrespectful and downplays the reality of those that are actually afflicted with addiction, as it feels like it's just pushing the "burden" onto the drug user, which reinforces negative stereotypes and makes it harder to get people on the side of treating addiction as a health issue and not a moral failing.
It is a straw-man to assume that drug users are high during work. There are plenty of hours in the day. Erowid puts the duration of a heroin high at 2-4 hours.
8 hours for getting your $80 for the day to get high
4 hours to get high
4 hours for...I don't know, working on a novel or something
The statistics for alcohol consumption in the Nordic countries in the 19th century are staggering, adult males were basically drinking hard liquor all day every day as they went about their work. Alcohol definitely has its effects on the body and is a huge safety risk, but apparently men were still able regardless to run their farms, build the buildings they needed, chop wood, etc.
Design work though? There was many a time I awoke the next morning and had a dread-chill panic thinking I'd need to get some project done, only to find I'd not only done it the night before, but I'd actually not hate it. Which, as a designer at the time, was high praise. Sure, there might be some rough edges or stupid typos, but the overall work would be Great, by my standards at least, so after a quick review, would be ready to go. I used to refer to it as 'free work'.
I guess letting go is more of a useful trait in design.
I'd not recommend it for doing work in critically-important fields, obviously!
- ed last line
For most of my life I also cooked sober. But when I started cooking tipsy, I began preparing meals I could have never believed I made myself. My current lasagna recipe is an absolute bomb and it's been perfected over a dozen drunken cooking sessions. Even Italians asked me for the recipe.
Main problem there is replicability. My partner often gets annoyed at me when she asks if I can cook some nice thing I'd recently made, only for me to umm and aaah because I didn't write down the exact ingredients... .
For several years I made a living playing poker, and I played a lot better with morphine in my system. It made me more patient and focused. I even tracked my results in different databases (with pokertracker) to compare my results while high. I made almost 10% more while high, and this is over hundreds of hours played.
Every single person in group homes and foster system had same sort of tale.
Helps them keep calm when navigating a road which has sections only marginally wider than the truck, with a 500m drop on one side.
I'm not promoting DUI (lost too many friends that way, mostly from OTHER people DUI'ing and hitting them), just saying that there are professions where the people engaged think that dulling the fear/panic response is worth the reduced reaction times.
The rock scene of the 80s comes to mind. Lots of them did it af the time while they were touring.
I get up around seven
Get out of bed around nine
...
I used to do a little but a little wouldn't do it
So the little got more and more
I just keep tryin' to get a little better
Said a little better than before
...
Now I get up around whenever
I used to get up on time> A typical drug user is someone who uses drugs.
It's impossible to neatly encapsulate every single type of drug user into a "typical" category. Everyone is different.
Some people use drugs. Others don't. Some people can use drugs recreationaly, others can't (including myself).
As for knowing any functional, well I've seen many have functional phases would be the best I could attest to that from experience and out of about 30 heroin addicts I've endured in the past 2 decades, I'd say only 2 would be close to being classed as functional.
Really gets down to if somebody who is using drugs can just stop and take a break every now and then, then in that clean period - still hold the same mentalities towards their usage and if they can come to the same conclusion - bravo as that is what I would call somebody with their head working well for them.
What really is the issue for many drug users is the point in which the drugs use them - that's the turning point of addiction I'd say.
Yet all that said, you can't help but accept that the brain is driven by chemical stimulus and there lays the hard barrier of having the will power to quite.
I've personally never done heroin, no desire too as like a fine wine, I might like it and it is easier to miss what you never had and one step I've become very mindful never to take having learned from others, many who's lifestyle choices I had thrust upon me and I will say, not best neibours to have from my numerous experiences.
personally I lean more in the direction that heroin and friends are significantly more addictive than most other drugs. but I have to say, if there were a sizable group of recreational users, they would probably know better than to ever say anything about it in public.
Without a doubt, how else do they get introduced/exposed to such temptations otherwise.
Pattern that usually follows is, cocaine, then onto doing crack as suddenly in their mind it's cheaper better high or other mental juggling to avoid having a break and carry on chasing that next level of high, building tolerance all the time. Then the comedowns, well whilst the highs may not seem as good and cost more to reach that level the downsides are less easier to adjust tolerance wise. So you find that chasing a line of heroin solves all that nasty crack come down and once in a while, you won't get hooked, after all you are able to do all that crack and your mentally strong and other decisions made whilst completely out of it on crack cocaine. So you make that leap, the odd bit becomes more and year on and your addicted. Coz prices and that, not long before your after that next level, so injecting for many becomes a hurdle that gets lower and more appealing and justified in crossing. You will just do it the once, case of only way to solve your needs as not enough to chase and sort the cramps. I've seen all this play out many times, heck even audio surveillance from chasing to shooting up to introducing new recruits into junkie club, via crack and then heroin. After all, opportunity to sort somebody out and charge them extra for sorting it, kickback from dealer and chance to share a hit - addiction makes people greedy and that greed plays out in doing what's best for them, if others freely bit that apple, they will certainly not stop them that hard. After all, how they themselves started doing drugs. Seen it play out just too many times and from start to coffin too many times and shocking how much goes on, ignored as society as a whole class the addicts as the victims and the dealers as the baddies in a clear cut way when I can attest that the lines are very blurred indeed.
One of the more chilling posts on there[1] is the account of a user who randomly tried Heroin one day, got addicted within 2 weeks, overdosed and was clinically dead within a month, got revived and admitted, came clean, then posted an update to his story 7 years later.
I would personally suggest trying meditation first before trying opioids to alter consciousness and feel euphoric.
[1] https://www.reddit.com/r/MuseumOfReddit/comments/68srty/spon...
>I overdosed on a combination of (mostly) fentanyl, plus I had a lot of diphenhydramine, pregabalin, temezepam, and maybe some lingering oxymorphone in my system. I stopped breathing with several fentanyl patches in my mouth (they were previously used and I thought they had much less left in them) partially blocking my airway and would have been dead dead if I was found 10 minutes later according to EMS. It took multiple shots of Narcan to revive me.
https://www.reddit.com/r/IAmA/comments/dw6u0/iama_patient_in...
The problem is that what it takes "negatively affect the rest of your life" depends a lot on what role you have in society.
Short of pornography producer, fantasy fiction author, songwriter and other professions where copious drug use fit one's "brand image" or potentially enhance one's work, a tenured college professor gets about about as much leeway from the rest of society as a white collar professional can get. He can be "eccentric" and nobody blinks twice. But for other professions the standards of behavior are different (and generally get more permissive as you go down the economic ladder).
Defining the difference between acceptable use and addiction, and by proxy who's problems are bad enough to be considered problems and therefore in need of solving in a way that is relative to one's place in society is very dangerous. If you're blind in one eye you're still blind in one eye even if it doesn't negatively affect you. Addiction (and a multitude of other conditions) are the same.
Doesn’t this bolster the argument that the principal damage from this type of drug use is social, not chemical?
Most people would rather not be debilitated than have society be accommodating.
That's what distinguishes dependency from addiction.
I think he's glossing over the fact that some drugs can be addictive, which is a thing on its own, aside from promoting happiness.
What an incredibly dangerous idea to promote. Do not mess with opioids. You think you are in control, until you are not.
Otherwise the people who inevitably will/do use, only hear and have only heard, 'don't do it to start' or get ostracized instead of getting the help they need or the education they need to know when they are overdoing it or not in control any more.
We also need more clinics and support for safely quitting or managing drugs and tools for it similar to what we have for tobacco.
Shamefully, here in Canada, some of these clinics in Vancouver are getting shut down, rather than more of them popping up, during the worst opioid crisis this country has ever seen.
These closures are a direct result of a 'don't ever do/touch drugs' policy and the stigma and ostracization that come with it.
Speaking from experience...education is better than 'don't'. I have had friends who have died from using drugs, and I have many, many friends who are regular users but not abusers - pull an insane variety of different full-time jobs. (And well!)
The huge difference between these two groups of people for me is education (for instance, preexisting mental health conditions that would be made worse by a particular substance and the knowledge to avoid it), and having a support system, etc..
It is fascinating and inspiring that someone has chosen to put themselves in the very vulnerable position of coming out about their personal use, and I believe the intention is to help remove the stigma around drug use, so education can be bettered. :)
Edit: Maybe better to say 'Drugs can be extremely harmful and addictive. If you choose to use them, please be sure you are educated, safe, and have someone nearby.'
In fact, that doesn't seem dissimilar to the surgeon general warnings on cigarette packs, anyway.
What kind of warning labels will we see on cocaine, heroin, etc - in countries where its sale will inevitably be legalized? These are the kinds of statements we should be making rather than 'just stay away from opioids.'
for existing users. We should not tempt people who would have otherwise never used them with false fantasies that they will be able to dabble and remain in control without getting addicted
Right, but this is harm-denial.
You should also examine the proportion of heroin "users" who become abusers. You should then do the same comparison for alcohol use.
I'm willing to entertain the notion that the risks of heroin are overblown. I'm even willing to believe it. What seems entirely unsupported by evidence is the notion that alcohol and heroin are in remotely the same league.
That's an orthogonal concern. That being said, I don't understand your reasoning.
Firstly, this is opioid abuse. Granted, the responsibility for this abuse falls on the prescriber rather than the user, but it is nevertheless a pathological pattern of use.
Secondly, you've substituted "heroin" for "pharmaceutical-grade opiates" in your argument. The irony is that this supports my position more than yours because it demonstrates that the slope is particularly slippery, even with medical-grade opioids. This point bears repeating: the addictive and toxicological potential of opioid medicine is greater than alcohol. The trend is even less in your favor when we return to the topic at hand: heroin.
I share your concern about opioid-based medication, but this argues against your point.
Doctors are rationally ok with such prescriptions because the effects are not as bad as alcohol.
Simply put: opiate abusers and users don't need liver transplants or get such severe brain damage; alcohol is more damaging in a myriad of ways for both uses and abusers. There is plenty of data supporting this, and it is valid to use data regarding medical grade opiates.
The risks of heroin are almost entirely side-effects of the war on drugs rather than the drug itself.
It's not nearly as addictive. It's not nearly as deadly. It's much easier to control dosage. It has modes of consumption that are non-pathological.
This is typical of the distorted anglo-saxon view of alcohol as a tool for getting flat-out drunk. This is not how most of the world relates to alcohol, nor is it a healthy relationship with it.
Honestly, this says more about you than about booze.
Strangely I know more ex-heroin addicts than ex-alcoholics, and there are way more alcoholics out there, but that's just anecdotal data I guess :)
> It's not nearly as deadly.
Maybe if you leave out all of the DUI and accidents where alcohol played a role, you'd be right, but overall alcohol causes way more damage than heroin. While David Nutt ranked heroin as more addictive than alcohol, overall he found alcohol more harmful.[0] Precisely because even though it doesn't harm one as much as heroin, it's way more likely that you harm others with alcohol.
> It's much easier to control dosage.
Actually no. Lots of things affect gastrointestinal absorption of alcohol. Just compare a few shots on empty stomach vs after a meal. Also don't get me started with the absurdly long and not always obvious list of drug interactions that alcohol has.
Heroin, assuming known purity, will work roughly the same, either snorted, smoked or injected. If you make a point about its purity, that's a consequence of its legal status. Most, if not all of the interactions are self-evident (other CNS depressants).
> It has modes of consumption that are non-pathological.
I guess you have preconceptions about what heroin use implies. How is unwinding after work a pathological use of heroin vs whiskey?
> Honestly, this says more about you than about booze.
Ah, ad hominem to finish, a classic.
Indeed it is! You conveniently ignore all alcohol consumers except the ones with dependency problems.
>Actually no.
Actually, yes! You're arguing that there is variance in absorbtion, and you are right. That is different, however, from e.g. the LD50 or the ability of people to measure dosage accurately.
>I guess you have preconceptions about what heroin use implies.
You're conveniently ignoring that non-pathological use of heroin is extremely small. It's a rounding error when compared to alcohol usage. You are cherry-picking.
> Strangely I know more ex-heroin addicts than ex-alcoholics, and there are way more alcoholics out there, but that's just anecdotal data I guess :)
Good thing this has been formally studied
>Maybe if you leave out all of the DUI and accidents where alcohol played a role, you'd be right [...]
Yes, and people with pools in their back-yards experience more drowning. Color me surprised.
You're also leaving out all the incidental damage from heroin use in your analysis. Shall we factor in drug-related murders? How about secondary complications like pneumonia?
Again, cherry-picking.
>Ah, ad hominem to finish, a classic.
An observation, actually. I've rarely seen this level of bad-faith argumentation.
Actually a significant part of alcohol users have dependency problems, roughly 10% as someone already mentioned.
> Actually, yes! You're arguing that there is variance in absorbtion, and you are right. That is different, however, from e.g. the LD50 or the ability of people to measure dosage accurately.
So... no? Unless you ignore all that I said, that is. Active to LD50 ratio for alcohol it's 0.1, for heroin it's 0.17, in the same ballpark. When you factor in the variability of oral administration, alcohol is way more dangerous. Most overdoses in heroin are due to fentanyl or changes in purity; in case of alcohol it's due to wanting to get drunk fast, and doing it too fast (plus interactions).
> You're also leaving out all the incidental damage from heroin use in your analysis.
There is a lot of it, it's just that alcohol is bigger. People on heroin don't usually go driving or picking up fights, they're usually just lying on the couch.
> Shall we factor in drug-related murders?
I wouldn't factor anything external to the use/abuse of the substance, like its legal status. It'd be interesting to compare them with roughly 25% of vehicle deaths that can be attributed to alcohol.
> How about secondary complications like pneumonia?
Which was already accounted for in Nutt's analysis.
> An observation, actually. I've rarely seen this level of bad-faith argumentation.
I could say the same, it feels like you have a horse in this race, pun intended.
I am often wondering about how addiction "feels". I don't consider myself being addicted to anything, and always wonder how an addiction actually manifests itself. Is it a pain? Is it comparable to being extremely hungry or thirsty?
Slightly related: a few years ago, I overheard a conversation between a fairly large woman and a child. The child said that it was hungry. The woman said: "Oh yes, that hurts". That struck me as odd, because even after eating nothing for 1-2 days, I never actually felt pain when I was hungry. It was surprising to me that some people seem to do, and it would have certainly explained why the woman was so heavy: I, too, would of course eat much more if being hungry was painful.
I got stinking headaches for a week, but not an overwhelming urge to drink caffeine
When smokers quit, they almost always describe the urge to smoke rather than the physical side effects, often described more like hunger.
This is exactly my experience after not drinking coffee for 1-2 days. Headaches that make the thought of drinking coffee slightly disgusting.
And when you decide to quit, it takes quite a while before you stop feeling that strange thirst.
Sounds like pop psychology. There are tons of extremely addictive substances.
Try one and you will get addicted after a while, even if your whole childhood was hugs and roses and ponies.
Maybe, but why would it be due to childhood trauma alone?
I can imagine someone with a happy childhood and a big 20-something or 30-something trauma (loss, divorce, various other issues) falling for drugs/alcohol addiction for the first time just the same.
Veterans who had many Adverse Childhood Experiences (A high ACE score), such as coming from a broken home, or faced neglect and isolation growing up, were much more likely to become addicted to the opioids they were given to treat pain.
Do you have any evidence as basis for your theory?
Veterans at that stage are also usually young, so if they came from a broken home, or had isolation growing up, they'd still return to something like that.
What about veterans that have build a succesful family and working life in between (aside from having had childhood trauma)?
Some people might feel a drive to do something completely non-rational, some might go into depression, some might even feel hungry.
then, the press secretary in your brain (the thing between your subconscious & conscious mind) goes into hyper-rationalization (denial) mode and you start to defend the amount and type of chemicals you use, even when they are literally killing you and those around you
If you're asking about what physical or psychological withdrawal from a drug feels like, it depends on the person, the chemical, and other variables. The worst opiates (Suboxone / Methadone) have 6 month+ withdrawal symptoms, and the faster ones are ~7 days. Hellish times. However, while abstinence frees you from withdrawal symptoms, unless the underlying mental issues are addressed it's likely you'll go back to the very same substance that got you here.
I would say that's basically how addiction manifests itself: even if you know that you're dealing with substance abuse, come on, one more time won't matter, will it?
And then there's also the comfort aspect: you're getting back from a hard day's work, you're feeling tired and cranky, you do deserve something nice, don't you?
N.B.: I'm not saying that not being able to drop the book or stop playing that game IS addiction, just that substance addiction might feel the same way.
N.B. 2:And I'm not talking here about the medical aspects of withdrawal, because that's not the thing an addict would usually experience (withdrawal would only happen because you're trying to stop or cannot get access to the substance you need).
Sure, but one can be dependent on e.g. SSRIs or SNRIs. But they aren't addictive!
Dependence + addiction is a special problem with opiates, I think you can die from withdrawals?
SSRI/SNRIs can be problematic. The difference is that SSRIs tend not to have the other features of dependence:
Seeking the meds when you run low; preoccupation with the meds; continuing to take the meds even though you know they're doing harm.
For opiates and benzos it might manifest as stress and depression. For uppers, drowsiness and inability to focus.
It's compounded by the fact that the reason you started is usually that you suffered from those things to start with.
To me, it always felt like there was something like a little pebble be stuck in my brain and there was only one way to get it out. Not physically, but in terms of how it affected me mentally.
It highly depends on the "thing" (it must not really be a thing). I would say "its the desire to plug a hole".
Do you drink tea? Why dont you drink tea without sugar? There are lots of answers to this question. It can be "it tastes better". Thats what your mind is telling you. It probably would be more healthier to drink tea without sugar but you still add sugar to it.
Thats addiction. And there are tons of other examples and its hard to determine it for every case. Addictions are deeply implemented in our brains. Eating, the urge to be close to people, getting complemented for things you do, all this is kind of an addictional behaivour.
Drugs can basically fill this already existing but empty receptors more efficient. Then your brain tells you to do it again. It will find reasons.
That was harder to explain than i thought. I hope it makes sense.
I generally tried to explain what addiction is and what it feels like. It really depends on the matter.
Hunger never hurt me, but I used to give into it quickly because it distracted me a lot and I enjoyed cooking and eating. The first time I dieted intensively it took about 5 days but I mostly stopped feeling it. It was more of a notice "probably a good time to eat" than a strong urge anymore. It was easy to reframe in my mind as a positive - this is the feeling of fat evaporating! Getting to that point can be tough though.
Btw, in relation to the article, there was a Reddit user who ar some point wanted to "just try" this heroin thing and his message history depicts very amazingly hiw he spiraled to addiction.
This beverage has no redeeming qualities, and I want to kick off this habit.
However, it triggers some addiction mechanism in my brain, and I must drink it every day. No moderation for me -- it really is an addiction. I don't go to McDonald's: I drink it at home. Diet Coke, so no excess sugar, but I'm pretty sure Diet Coke is unhealthy as well, and I'm not sure those sweeteners are good for you anyway.
You might enjoy some of the accounts in The Realm of Hungry Ghosts: https://www.google.com/books/edition/In_the_Realm_of_Hungry_...
Not for me. I used to be a smoker and alcoholic.
For smoking, I just felt uneasy without it, like idk when you're anxiously waiting for something important.
That's the physical dependence and was only the first two weeks and relatively easy to overcome. I got dizzy and other withdrawal symptoms but you can fight through that for a couple of weeks. The other part is the ritual to it. E.g. like most people probably brush their teeth once a day, smoking after eating is just something you do, give in once and you're back to physical dependence.
Alcohol was different for me. Self medication. Once i solved the issues i was medicating (insomnia and stress) i... just stopped drinking and never missed it. The biggest adjustment here was getting used to not being drunk and figuring out what to do with all the time i had now.
It was a small community whose members looked more like the Hacker News crowds than the meth heads you'd see in the news.
[edit]: My bad, now it's back!
> Despite the current false narrative, the addiction rate among people prescribed opioids for pain in the United States, for example, ranges from less than 1 percent to 8 percent.
What's the threshold where it's a problem? 1% of prescription drug users getting addicted sounds like a terrible situation to me. Let alone 8%. Especially if they're already in a situation where finding a way to escape is tempting.
There would be few to no deaths, suffering, or crime associated with heroin if it were cheap and accessible, and if addicts were under the care of a doctor or social worker. It would be a mild burden to public health services tasked with helping people quit, but far cheaper than tobacco smoking or alcoholism.
I think legalizing it to the point where an addict had access to predictable dosage would save countless lives.
If anyone were left to their own devices and still in pain, I suspect a lot more than 8% would continue to take the painkillers.
> Hiya kids. Here is an important message from your Uncle Bill. Don't buy drugs. Become a pop star, and they give you them for free.
... except in this case the message is don't do drugs kids, but "grown ups" should (as defined as a state of maturity where you know how the drugs behave, know your limits and can balance your experimentation with fulfilling your societal obligations)
I see this as a bit like speeding. The government sets fairly arbitrary speed limits for different types of road. They do it based on what they think the majority of people can cope with, versus the likelihood of risks, vs the need to get from A to B in a reasonable amount of time. The government hasn't been amazingly scientific about the speed limits, and don't take into account time of day, traffic, weather conditions etc. A healthy, fully-alert person can probably go at 150% of the speed limit on an ambient clear day on an empty road - and do so perfectly safely. But that isn't the message they give people, because it would be impossible to assess person-by-person, minute-by-minute.
And yet, some would consider the above information to be recklessly given, because some people will on read "go at 150% of the speed limit... perfectly safely" and take that as my advice.
So the question is, should it be legal to travel at any speed, provided you feel like you're doing a good job of it? In both cases, misjudgement can be disastrous for yourself and the people around you (and innocent bystanders too)
And when you are talking about something that can alter your perceptions, you would surely need a non-drug-taking associate with you at all times who could give you an honest blow-by-blow assessment of where you are dropping the ball as a "normal" human being, and where your drug-fuelled failings are happening?
When the potential downsides so vastly outweigh the benefits, I can understand why laws take the side they do. That said, I absolutely do think that there are massive downsides to making drugs illegal when taken responsibly. Countries should be realistic about what they can and can't do. If they can't eradicate drug use - and most countries can't - they need to put effort into safeguarding above incarceration.
But I think that's the consensus anyway on most social issues. And it seems to be a lesson that governments globally are very slow to learn.
People are never going to stop using these drugs, so we should take steps to make their use safer. Thanks to widespread education, most people know the basics about how to drink safely (e.g. don't drink and then take NSAIDs). Because alcohol is sold legally, nobody has to worry about going blind or dying from moonshine. We should be applying the same principles to drugs like opioids. You should be able to buy them in precise dosages and know that they're not contaminated with something way too strong like fentanyl. People should be educated about unsafe drug combinations, which is the other major cause of overdoses.
It doesn't matter if that's why he's doing it - that's still the effect.
The one drug that has interestingly been demonized is meth. It’s used as a prescription drug and was commonly used recreationally in the 70’s. Now it’s viewed as a one way road to destitution and death.
Drugs are illegal so the media covers the train wrecks. The users who aren’t train wrecks don’t make the news.
Can you imagine if alcohol was illegal and the only stories you heard about users were the people who drank themselves to death? You’d assume nobody could use alcohol in moderation, which isn’t true.
He's basically for personal freedom and responsibility, drugs included.
His position is really hard to argue with, given the disaster that alcohol prohibition and this 'war on drugs' has been.
The word heroin has triggered a lot of comments here - just because you've known someone who has ruined their life and feel strongly about it, does not make you qualified to draw conclusions on the effects of drug use at large.
Why did you decide this?
Bear in mind, I am willing to take vacation from work and go cold turkey as needed. I do this a couple times a year for caffeine, just to be sure, and the headaches are brutal.
- Yes it would be nice if drugs were decriminalized ... but they aren't ... and the supply chain for heroin causes a lot of suffering in the world.
- Shrugging and leading with "only 30% of people have addictions" is astoundingly innumerate. If there were a 30% chance of a potentially fatal outcome in almost any other context it would be a big deal.
There are plenty of comparisons that might be made, but driving seems an apt comparison. Driving is extremely dangerous, magnifies even small mistakes, and kills or maims very large numbers of people on a regular basis. And yet even with similar evidence of harm and habit formation people do not treat driving with the same fear but instead face driving with irrational positivity and optimism.
Scientists using rigorous observations and mathematical analysis do not see drug use and driving as having risk profiles that are completely different.
Driving was my go-to analogy too (I've got a longer post where I go into it) Surely there's the concept of legal drugs though too? You're allowed to have wine, but not drive at 120 miles per hour past school gates.
My feeling is that there's a difference between "safe" and "worth the risk". And as far as lawmakers are concerned, for most drugs there's not case where it's worth the risks.
Please, don't take this horrible advice. Drugs are harmful and can do fatal damage to you and those around you. I mean, is this guy advocating drug use? It sounds like he wants to justify his dependency.
I’m glad this made it front page news given that the northwest coast of US now gets hard drugs, so maybe one of them will think twice about being a full-on grade A dumbass.
Also remember: with legality especially in a rich entrepreneurial country comes business which lobbies, funds studies, etc. Pot strived for many years for legitimacy, and once they got it, it exploded all over the US.
If you don't have or want kids, you're missing what made you and was given to you.
Addiction, as the article says is more complicated than any drug and is factor of a person’s life situation in general. Look at the work of Gabor Mate for a better understanding of addiction.
The world is full of chemicals that affect us, some more than others. People self-medicate all the time (alcohol, coffee, chocolate, sugar); I see no problem with (after learning and carefully experimenting) broadening one's set of "self-medication" tools.
I would expect one of the first things to come up in a the conversation would be something along the lines of "yeah, I took a break for a month last year. It was easy, I had no cravings or other problems."
Drugs have had a profound effect on my life. Like many, I started with alcohol - the most boring and most dangerous drug there is. I later used cannabis, which I decided had an overall negative effect on my life, and MDMA. The latter I only used a few times but it changed me. I don't need to take it any more but it has improved my life no end. Now I only use caffeine (in tea and coffee). I haven't used other drugs for almost two years at this point (my last drink was around May 2019 and it ruined my sleep, as it always does, for the last time).
There are people immune to some poison, people that don't feel pain at all, a woman which has two vaginas, there were people that never stopped growing, people that don't sleep, etc.
Thats before we get into psycology and personal experiences that shaped them.
I willing to believe that ther are some people who can abuse drugs, and not become adicts. However odds are I am not one of them, and its not worth finding out by experiment.
I think drug use also encourages people to seek out more thrills in their personal lives. It takes away their ability to enjoy a simple life and makes them greedier for endorphins. I wouldn't be surprised if the current narcissistic, monopolistic corporate economic environment is a result of heavy drug use among executives. They can never get enough money or power because they can never get the life satisfaction that their brains need to match the highs provided by drugs; even given the fact that their regular life experiences are far better than the average person; it still doesn't compare to the drugs. The best possible life experiences they can get don't meet their new baseline for happiness. Drug use also seems to encourage cheating and other unethical behaviours since these behaviours deliver a natural high (alas, it still falls short of their drug baseline).
I know if I had a ready supply of clean heroin I would probably not just take it once in a while. Ive never done heroin, and that is because I know how much I like hydrocodone and its much weaker chemical cousins. I also know 2 people severely harmed by heroin use.(Brothers in fact) Maybe if they had a regimented way of copping it and safe supply of needles one of them wouldnt have Hep C now.
The real problem with treating opiates or other drugs as a public health problem is that the US does not have that sort of infrastructure set up to deal with the problem. Why do you think the police are called in now for drug problems(non criminal)? There is literally nobody else to deal with it. I dont agree with locking up addicts, but is checking them into a hospital with no insurance a viable option?
Now, how do you square that with almost everyone here universally claiming that these words are dangerous?
> The statements that make people mad are the ones they worry might be believed. I suspect the statements that make people maddest are those they worry might be true.
Giving people the autonomy to live their life, means there are many dangerous things you can say about things that are legal, and should be legal.
I believe people should be responsible enough to drive a car, drink alcohol, and with or without prescription take a drug without risking a prison sentence.
Now my advice is: It's not okay to drive while extremely tired, it's not healthy to drink yourself uncounscious (even if you're not an alcoholic), and you should probably continue to not treat heroin lightly.
I'm okay with all those things being legal. I'm not okay with people equating legal with safe. Of course words can be dangerous. That's why we call them out, but that's not a reason to send people to federal 'technically your life is not over' prison.
The thing is, wouldn't you agree that if something isn't criminal, then it should be fine to talk about the act of doing that thing? Because that's all this interview seems to be.
I think it's completely okay to talk about drugs, creating taboos around dangerous things has rarely been helpful in the past.
However, I think people's reaction to this piece shows what's missing: more warnings around it than seem entirely necessary to the average person. You just don't want today's lucky 10,000 [0] to come away with the impression that heroin is a pretty casual thing, and while the fact of talking about it is great, the words themselves can be dangerous if they promote unsafe behavior without adequate warnings.
All that being said, I have to admit that people might be over-reacting a smidge to the interview, but I can't really fault them. I haven't personally lost anyone to heroin addiction, but I imagine I might read the article less generously if I had.
Cheers!
Say I am a prominent professor at a university and I write an article about how I use cigarettes responsibly and how I'm not addicted and that tons of people use cigarettes without getting addicted. I also note that it's a great way for me (and implicitly others) to find happiness. I then publish my article to influence millions.
So then what's wrong when critics say my article is dangerous and caution readers to take it with a grain of salt?
I suppose my root objection is that such warnings are incredibly boring, because everyone in the world knows that both heroin and cigarettes are dangerous. We're not living in the era of cigarette advertising; surgeon general's warnings are required by law.
But that's a different sort of objection than the one I started with.
If one (adult) can’t handle drugs then help should be readily available as is for alcoholics.
No need to get political and emotional about it, there’s a pragmatic way.
The claim that a drug changes your brain forever is trivially true - it is literally true of strawberries. Once you've had the taste, you'll likely remember the experience of tasting it (and if you're not too young, you might remember the place and people that were there during your first bite).
For all the hysteria about the harms of drugs, we seldom hear a level-headed point of view about the possibility of them being a(nother) wonderful aspect of life.
Unfortunately though these kind of positio are made possible by our stand against drugs. Currently nearly all western countries are simply banning all drugs. This war on drugs, however has proven to be ineffective at best. The truth is that the more we fight drugs the more problems we cause.
We should aknowledge that drug use is not the problem, it's a symptom. So instead of prohibiting the drugs, we should be helping those that seek drugs, to cure the underlying problem. If we did that, we could even sell drugs in pharmacies. The point is curing and helping out people, not putting them in jail.
Switzerland has done this for nearly 30 years with great results, we should learn from them.
This starts off reading like one of those spam emails of the past where some claim was made backed up by 'and my brother/sister/father/friend' 'is a professor at Harvard' (or similar) to get you to take it as authoritative and serious. [1]
The issue with drug use is the outliers. Just like the issue with driving fast is the driver who is not you it's not about what you or most capable drivers can do under the best circumstances and driving a well equipped and responsive modern car it's about 'the other guy/gal'.
[1] What is the name for the logical fallacy here?
I feel like he just wrote off 450000 deaths from 1990-2019 with people don't know how to mix alcohol and opioids correctly.
Most of them started out with prescription pills, often legally prescribed, and switched to H when the pills ran out and the source ran dry.
If they started shooting up, it was to use it more efficiently.
The biggest danger with heroin is unpredictable dosage and lacing with fent.
I would never advise anyone to use heroin, it's a terribly dangerous pursuit, and the payoff is burning out your pleasure receptors.
I think it would save countless lives to somehow legalize it to the point of an addict being able to get predictable dosage and not off the street.
This definitely convinced me that it doesn’t make sense to pull drug users out of productive society and either fire them or put them to jail. It’s just very unproductive that makes things only worse.
It would be much cheaper to treat their addiction while they are working.
That's how crazy ecstasy was for me. I am 100% sure if I would try heroine once I would fall for it, especially because as a tech guy I have the means to sustain it to a deadly degree.
I don't think it's about health criteria. It's about whether you want to add yet another item to things you depend on just to feel normal.
Also, the need is a symptom of a real issue that needs to be addressed instead of just numbed and berried i.e., unhappy at a job or a situation etc that needs to be addressed.
Changing your environment is also a good idea - if nothing else move change room to sleep in and move furniture to new places, and you’ve got a new “place”.
I use it to quit my daily beer habit. Kindest regards to you internet friend who struggles with addiction.
Short version - your body longs to be at equilibrium/homeostasis and drugs (alcohol, stimulants, opiates, etc) upset that equilibrium, so your body attempts to return you to your previous state.
There is no free lunch, and a high will be accompanied by a low. The lows come in numerous and surprising forms.
The book is significantly better than my description.
I was struck by the point where he talked about how heroin had made him a better person. The description he gives sounds like meditation and mindfulness would be a better prescription/solution than heroin.
One would hope that would be well over 99%, given how many use asperin/acetaminophen/etc, caffeine, alcohol, nicotine, and so forth.
Check out the work of Gabor Mate. It's silly how simple it is. It's silly how misunderstood it is.
Partly because I may have a weird pleasure in feeling like crap the day after and likely because I view life as contempt for misery. No matter how terrible I feel - I'll crank out the work.
A lot of these questions are real softballs.
The same argument could be made for heroin. The point is that 'not wearing a mask' does not endanger someone's life in any way unless someone is infected with covid. yet the author suggests that not wearing a mask is "potentially impacting the rights of other people" Then surely the same argument could be made for people using heroin, you're not endangering anyones life by using heroin unless you're causing drug-related crimes. Which is the exact argument the government used to declare war on drugs. This is quite a contradiction by equavalency.
The rest of the article is reasonable. I dont think he has said anything that fell outside the mainstream medical and psychological view.
Are you saying heroin causes people to commit crime?
> This is quite a contradiction by equavalency.
I thought he meant it similarly. We created the war on drugs from this logic, yet do not have a war on people not wearing masks.
You're right in that mask wearing is a tricky situation, and I think so is hard drug usage. He brushed that off maybe a little too quickly.
I think smoking and covid masks are a better equivalence. Second hand smoking can cause you to maybe affect others, so areas where you are allowed to smoke were restricted. I see masks in a similar fashion.
There was no ambiguity, from the article "Your birthright to use drugs is part of the pursuit of happiness, you write." The author consideres it a birthright to use drugs irrespective of the consequences drugs have for a percentage of the population. To wear or not to wear masks however is "... potentially impacting the rights of other people." which is why I think its a slight contradiction.
>Are you saying heroin causes people to commit crime?
I dont understand what you're asking, drug-related crimes are drug related, using heroin in the states is a crime so the continued habit also constitutes committing crimes? My point was that anyone could be a heroin user who commits crimes or a heroin user and write an article, there's no way of predicting the future, mainstream society has deemed the 'risk' too great and instituted a method of preventing heroin use by making the use of the substance illegal. The article goes against that narrative with a libertarian point of view. I think I prefer the libertarian on this one.
The way I read the author is that they argue that it's our birthright to do whatever we want, as long as it doesn't interfere with the same right of others to do whatever they want.
So with that logic, it would need to be that one's use of drugs impacted another's persons rights for it to be regulated, similar to how cigarettes smoking isn't allowed everywhere, because it impacts others around, so too is not wearing a mask when around others during a global pandemic. But it doesn't justify why lots of drugs are banned, when they only affect the user and not others.
Yes, the author claims that heroin and drug-related crimes have little to do with heroin and more with the addiction or background of a person which means that the crime of using heroin violates your birthright to do what you want as long as it does not impact the rights of others, because, the author argues, he uses heroin himself and does not infringe on other people's rights.
>so too is not wearing a mask when around others during a global pandemic.
If I have been tested negative yesterday and I do not wear a mask, Do you still think I am impacting the rights of others? The wearing ( or not) of a mask does not infringe upon anyone's rights. The invisible virus is.
Another question for you, If I have contracted covid, show symptoms and go around in as many public places wearing a mask. Do you believe I was not impacting the rights of others because I wore a mask?
The legal system is not to punish vices, the legal system is to round up behaviour that we've outlawed in a manner that proves it beyond reasonable doubt. I cannot think of any example where indirect behaviour correlated with a possible infringement of rights has been a crime. Exept in authoritarian states ofcourse. Dont take this as an endorsement of not wearing masks. I dont have a strong opinion on the subject.
> Hart presents himself as a model drug user. “I am now entering my fifth year as a regular heroin user,” he writes. “I do not have a drug-use problem. Never have. Each day, I meet my parental, personal, and professional responsibilities. I pay my taxes, serve as a volunteer in my community on a regular basis, and contribute to the global community as an informed and engaged citizen. I am better for my drug use.”
Anyone who has plumbed the depths of addiction either with a family member or personally has spoken this exact paragraph, potentially word for word. It's a rationalization for addiction, and honestly the most common and basic one.
Good luck to him as he descends through addiction. He's extremely educated and very assured of his self-perception so for him to hit Step 1: Realize you have a Problem, is going to be a lot harder than the average person.
People die when they over-dose (which more often than not happens because they don't know exactly what they're getting, or the purity of it) or mix with other substances that they shouldn't.
A person quits for a while, decides to start using again and shoots up their usual dose for which they no longer have sufficient tolerance.
If that person knew that this is a common way people end up killing themselves, they probably wouldn't make this mistake.
Legal substances also have lots of information readily available around them - if I go to my pharmacy and ask for ibuprofen, they will tell me the dosages in advance. If I go to my doctor and they put me on oxycodone, they will give me a dose that they think is safe, (and in theory, a plan to reduce my dependence on them) without judgement. If you develop an opiod addiction, your support options are much more limited.
So heroin is actually pretty safe if used correctly.
Not many legal drugs has such short list of side effects.
Also, Joplin took heroin AND massive quantities of alcohol on the day of her death. It will be close to saying that when someone dies in a car crash while DUI, driving is the real and unique problem here.
But the drug-war irrationality is better exposed by taking a look at weed and MDMA. Two quite safe substances (certainly more safe than alcohol), with clear medical applications, and forbidden just because some ignorant decided to put them in Schedule I. MDMA at the time of its prohibition was being used in psychotherapy with success in tens of thousands of patients [1]. Today, no medical use is recognized, and being in Schedule I (making it un-researchable), none will be. I wouldn't be too surprised that some country discover that it could be used as a treatment for depression or PTSD.
Users often mix heroin with benzos and/or alcohol which increases the level of risk enormously. The vast majority of overdoses are caused by mixing CNS depressants in with heroin, not by heroin use alone.
If you can't get a steady supply then withdrawals are vicious and can cause a host of other problems (crime in order to get money for more heroin being a commonly cited one).
One of the ways that heroin itself can cause overdose deaths is relapses - users may take a dose that they were previously tolerant to. I believe this is still far less of a danger than combining with other substances.
Many classic drugs (as opposed to research chemicals which introduce small molecular changes to circumvent banns on another substance) are pretty safe or at least have a well known safety profile.
Here's a reddit famous account from someone claiming to be an opiate addict that some find enlightening/haunting: https://www.reddit.com/r/IAmA/comments/wnj2d/iama_heroin_add...
"Repeated heroin use changes the physical structure and physiology of the brain, creating long-term imbalances in neuronal and hormonal systems that are not easily reversed. Studies have shown some deterioration of the brain’s white matter due to heroin use, which may affect decision-making abilities, the ability to regulate behavior, and responses to stressful situations."
I expected something more damning. Unfortunately, I feel that we don't have enough studies (incl. long-term ones) when it comes to recreational drugs.
Personally, I've always felt I had a personality that is prone to addiction, so I've stayed away from even alcohol on a regular basis. (Though at one point I was having my favorite alcoholic drink every night... I stopped when I realized what I was doing.)
Even breaking away from caffeine (again) is tough for me. Soda was also tough, and I ended up on soda water instead and still drink way too many of those.
I've also spent too much money on mobile gacha games, but because I know my personality, I managed to keep it from spiraling out of control. (Some people would even say the amount I spent wasn't a big deal, but it was far more than a single game is worth, so it's a sign that I was going wrong.)
Someone else asked how addiction feels, and I almost answered there, but didn't because I'm sure they meant hard addiction that you need help to correct, and I haven't been there. But as far as I've been, it's an almost-uncontrollable desire and subsequent rationalization and then capitulation. Each time. Fighting the feeling is depressing, even if everything else is going great. I only ever escape when I make myself feel worse about doing the thing than I feel from not doing it.
Maybe he is the one out of 100k who can manage a Heroin habit. Well good for him, he can keep it to himself.
Addiction is a force that counteracts your will power. You may not have drug problem but you are an addict if you feel compulsion to use the drug.
Today you may have enough willpower to counteract that force to consume more alcohol or drugs. But the next day may be worse, you may find some family or work problem and your will power may decrease enough that you will run into drug problem and have really hard time getting rid of it if at all.
It is called slippery slope for a reason.
Don't dismiss power of addiction just because you "don't have a problem now". Our willpower levels change so what isn't a problem now may become another day.
You may loose your job and have hard time finding new one and try to use something that has been giving you comfort to lighten your day. And because your "bigger" worries you may not be paying attention to it or you may need that extra comfort so much you will just say "yeah, it will not hurt if I do this for a while". This is frequently how these things start. It doesn't happen that you are completely normal one day and die hard alcoholic or drug user the next.
Now, I wouldn't call what you described even remotely close to a problem. I also consume alcohol socially and even privately. I pay attention to whether I "crave" alcohol and when this happened I cut it instantly.
I have a test for this. Even if you don't drink alcohol, are you constantly thinking about it?
If you are not using but constantly thinking about it it means there exists a force (addiction) that you are currently able to overcome.
But what if it's actually the heroin speaking?
You want to talk about some shit that gets demonized for no reason? Testosterone replacement therapy is legal, but if you decide that you want to use an extra 100mg, suddenly it’s a criminal offense and you are a bad person. For what? Wanting to have bigger biceps or train harder in the gym? What is the alternative? Drink alcohol which has a measurable death rate per year, or smoke some legal cigarettes and second hand smoke poison countless people?
Controlled use of anabolic steroids is demonstrably safe and effective.
I saw an interview years ago on TV and someone was saying it felt like that appendage was not part of their body, it belonged to someone else. It was so mentally uncomfortable they'd rather remove it.
When you use the term "recreationally", my assumption is that you are asking about how to use these drugs in contrast to using them in an "addicted" state. Since I am very interested in fitness and physical culture, my .02 is that recreational use is anything where you are not endangering your short term health, endangering anyone else's health or well being, you can afford and understand everything you are using and what side effects and ancillaries you would need to take, and you are taking an amount of drugs that are "way less" than what would be necessary to compete at the Mr.Olympia.
This is dangerous!
1. Some people do not seem have an addictive response to opioids. It's roughly in the same safety category as alcohol and weed.
2. Some people become nearly-instantly profoundly physically addicted to the point that it will inexorably destroy their lives.
The only way to figure which category you're in is to try it and find out. There's a personal liberty principle argument that if you are in the first category, you should have access to opioids just like you have access to other pursuits of happiness. But the inability to determine whether you're that category induces a significant risk at the aggregate level. People die and everyone, even those who can take opioids safely end up indirectly dealing with the negative consequences in terms of rising healthcare costs, dealing with homeless drug users on the street, etc.
I can think of three philosophical approaches to this:
* Communal: Say that since some fraction of people will be grievously harmed by opioids, the greatest good for all is to prohibit them universally. We ask the safe users to sacrifice the harmless positive experience to protect the unsafe users from harm. This is nominally what we do now by outlawing them.
* Libertarian: Acknowledge that even trying is a roll of the dice and that if you choose to roll them, you have to take the consequences. This is effectively what we do now since the law enforcement is so ineffective.
* Technological: Research a way to determine whether you can take opioids safely without having to try them. Imagine a test your doctor could give you that says "Yes, you'll be physically addicted." That increased certainty would remove much of the stigma of use, and make it easier for those that are at risk to stay away because they know they really are likely to get addicted.
I don't usually lean towards tech solutions to societal problems, but this seems like a case where having more insight into an individual's physiology would help everyone make better choices.
(Personally, after receiving fentanyl during a medical procedure, I am absolutely certain I should never be given easy access to opioids.)
[1] https://www.uit.co.uk/drugs-without-the-hot-air
https://www.amazon.com/Drugs-without-hot-air-illegal/dp/0857...
God this is so stupid. Please, stop amplifying this nonsense.
I have never been addicted to heroine, so I cannot speak from personal experience. But I have seen its impact first-hand, thankfully, a number of times I can only count with one of my hands.
The way I explain addiction to my kids is the way it was explained to me by an addict (alcohol, Vicodin and others):
(1) There's no difference between "Psychologically Addictive" and "Physically Addictive" -- he said this in the context that he was an abuser of alcohol, every day, but was not chemically addicted to it and required no medicine to quit, but it was easily as difficult as quitting Vicodin.
(2) Addicts don't love their drugs more than their family/kids/morals -- your body uses addiction to make you eat, drink, etc -- go without those things for long enough and you will start to sacrifice things that are otherwise more important. Imagine your desire to do this particular drug is substantially stronger than your desire to eat or drink.
Having the benefit of a few decades away from childhood and been witness to some really incredible individuals' lives being flushed down the toilet, I don't believe either of those two statements to be sensationalized in any way. It's internalizing these things and understanding that the people I know who became addicts were very strong people. One was a person I counted among the "Great Men"[0] in my life (and still do).
Politically speaking, I tend to fall pretty narrowly on the whole "victimless crime shouldn't be criminal[1]", so my puritanical beliefs that you should "just stay as far away from that stuff as you possibly can" doesn't translate into support for the War on Drugs(tm). Personally speaking, I've watched people maintain a heroine addiction for years, Vicodin for decades. In the early days, they managed OK. They all quit because the drug became it--the single need that remained. That's what it does. People nearing this stage delude themselves into thinking it's not affecting their lives/loved ones, but I'd be curious -- with the benefit of hindsight bias -- at what point a former addict[2] would admit their drug problem was out of control.
[0] My measure is not just a man who can be counted on to do the right thing when nobody is looking, but who will do the right thing when the outcome will/might serve him poorly.
[1] A person should not be able to be convicted of a crime if the criminal and the only victim are the same person.
[2] Recovering addict is the phrase most frequently used. One acquaintance of mine (who didn't do 12-steps/rehab) corrected me and said he's "not an alcoholic anymore" or a "former alcoholic" because he quit a decade ago and has no desire/temptation to drink (whole household is extremely anti-alcohol; he couldn't hide it if he tried) and feels that claiming to have a problem he doesn't have feels too much like being a "pity whore". He wasn't chemically addicted, either. Can't please everyone, I guess.
Our blind catering to individual freedoms is really unbecoming and I question why this author wanted to bring attention to himself and his own private struggles.
I thought the UBC professor who faked being indigenous and doxxed Asian Canadian students for being white supremacist and threatened another professor topped it.
Just what in the hell is going on with North American academia and educators? How did it fall from grace like this?
Insulin users don't just need to have insulin for the sake of it. They have a medical issue that forces them to take it.
>I think at the core of the issue is that our society generally regards psychological ailments as a personal flaw, rather than a health issue
I think that our society tends to do the inverse: tends to see all kinds of personal flaws as issues beyond the control of the person.
How many insulin users lose their jobs, lose their homes, turn to acquisitive crime or prostitution to fund their insulin habit?
We can talk about how many people who use heroin this happens to, and how much it's caused by current drug prohibition laws, but it's more than zero.
Decriminalisation makes a lot of sense but we need to be realistic about the harm caused to about 10% of people who become addicts.
It’s really difficult to disentangle this from the illegality of the drug.
This article is very clearly about recreational drug use
This was a good story to flag.
When a person reports something about their own life and internal state, you need to have overwhelming evidence before you can dismiss what they are saying. On what grounds do you dismiss the author's claims about their life? He clearly has his life well-enough-together to get an essay published in a reputable science magazine.
I don't think I would use getting published as evidence that somebody "has their life together". Again, I don't care if he does have his life together. It may entirely fake, it can be temporary, and it can be one account.
Look, I'm wholly for the idea of not shaming people who use drugs. I am also wholly against treating drugs which have established track records of destroying lives as recreational or not a problem when used regularly, especially to avoid personal problems. So I'm strongly against publishing essays which tell a soft story to play down the millions of other stories, which this absolutely does.
Why doesn't he talk about how this impairs his motor or thinking? Is he somehow magic, isn't the entire point to alter his conciousness? No, it's all positive about drugs. Ridiculous. Why doesn't he point to the side effects? Using alcohol as an example of how "harmless" drugs are is obscene. Alcohol destroys millions of lives every year as well.
If he wants to sell tolerance of people's choices in the name of the freedom to ruin your own life, then so be it. Don't soft peddle me bullshit.
Could we have a story about all the men and women who had their entire lives destroyed by drugs as a counter example?
Hearing an opposing point of view is a breath of fresh air for people who are fed up with the one sidedness and hysteria.
Stories distort reality. They oversimplify and hide details.
Think about a parallel: pizza. People in the US are notoriously (unhealthily) overweight. Should we be hysterical about someone who says "I can eat pizza without going overboard"?
Like in Russian group Splin lyrics: "Я наяву вижу то, что многим даже не снилось, Hе являлось под кайфом".
Rough translation: "I see the things in reality, others don't even when dreaming, when getting high"
I eventually completely quit because it seemed like a black hole in my day and in my life, where the sober me just lost valuable time and focus. It also dampened my motivation. Part of it may have been physiological, I would be less focused the next day. But part of it was also that compared to being on weed, life was just not as enjoyable when I was sober. I did not like that contrast.
Certainly not only drugs are fake or toxic.