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Comment by nostromo | Hacker News Reader

American law is so disjointed.

On one hand, we're decriminalizing drugs. Pot is widely legal now. Other states are allowing mushrooms and LSD. Cocaine and heroin are not legal, but have all but been decriminalized on the West Coast.

Meanwhile it's harder than ever to get pain killers from your doctor, even when you have a demonstrated need for them. Same with ephedrine -- a very useful drug -- it's very difficult to get even when in need. And if you mention enjoying tobacco products, you're treated as a leper.

I wish we had a self-consistent view of the issue.

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It's not inconsistent to treat different things differently and different drugs are radically different in their individual health and societal effects.

I live in Seattle where marijuana is legal. Alcohol and marijuana are widely consumed and I rarely see any large-scale problems from it. Obviously, there are many people who can't handle either of those, but their failure to handle it well seems to not impinge on others as much. And, compared to them, there are a huge number of people able to consume alcohol and marijuana in a safe, healthy, non-problematic way.

I also live next to a couple of homeless encampments. Many of the people living there are clearly addicted to opioids and/or meth. In just this month and within a mile of my house:

* I saw a woman, topless, brandishing an umbrella, wandering between the sidewalk and into the street screaming at no one.

* A man was shot in the stomach in front of a food bank.

* Another man was shot in the neck at an encampment.

* A drive-by shot up an RV and car. (The people inside fortunately weren't hit.)

There's more I'm sure but these are just the ones I know about in the last few weeks.

It's entirely consistent to say that we should treat drugs that lead to the latter behavior differently from drugs that don't. Opioids and meth are incredibly destructive. I'm not saying what specific policies I advocate for them, just that it is reasonable to have different policies for those drugs compared to others.

I believe the parent is referring to policies about how addiction is defined; a good article on the matter is

https://slatestarcodex.com/2019/09/16/against-against-pseudo...

Essentially by rules a patient asking for higher dosage of an addictive drug is automatically seen as a sign of addiction, even if sometime it might just be that the current dosage is too low.

You don't see anyone who is using opioids in the privacy of their own home who aren't out on the streets, so your sampling is massively biased.

And the way we should look at drug addition with opiates isn't by looking at the homeless users, but consider the fact that we're all potentially one bad car accident away from getting hooked on pain killers, and asking what kind of support we would need to avoid winding up homeless due to that.

Punishment via the criminal justice system is what is likely to wind up with you losing your job and winding up out there in that camp with them. So how should you be treated if it happens to you?

And the glib answer of "put a bullet in my head" or whatever isn't an acceptable response. Treat the problem seriously and propose how society helps you help yourself to get clean without at trip through a homeless camp. And the people who refuse to deal with the reality that it could happen to them or engage with the problem are likely those most at risk of lacking the self-awareness to recognize when it starts happening to them.

> You don't see anyone who is using opioids in the privacy of their own home who aren't out on the streets

I also don't see anyone who is using alcohol and marijuana in the privacy of their own home.

My sampling is biased in that it doesn't accurately reflect the percentage all people using those various drugs. But it is (I believe) relatively unbiased in that it shows that of the people whose drug use concurrent with homelessness a much higher fraction of them are using opioids or meth compared to booze and pot.

I think there is a reasonable inference there that using opioids or method is much more likely to result in homelessness than using booze or pot.

Again, I'm not making any claims about what our policies should be for opioids and method. All I claim is that it's entirely reasonable to have different policies for them versus booze, pot—hell, caffeine—because while, sure, they are all technically drugs, they are radically different in how they affect individuals and society at large.

I'll also point out that I didn't suggest criminalizing hard drug use. Also, of the four epidodes I described, only one is about drug use itself. The other three were violent crimes whose victims were homeless people.

Alcohol, marijuana and caffeine aren't anywhere near as likely to lead to someone losing their job.

You've observed that the most highly criminalized drugs are used by the people who have probably been the most affected by trying to use the criminal justice system as our drug treatment program.

You need to disentangle the effects of the drug from the effects of how we treat the users of the drug. You can't look at the end product at attribute it entirely to the inherent properties of the substance. You're not observing it in a sociological vacuum.

The fallout from the over-criminalization of opioids, meth, etc is a big reason that you're observing these behaviors. Stigmatizing drug use perpetuates the punitive approach to this problem. If the law treated addiction and the abuse of hard drugs with compassion rather than the draconian approach that we have in place currently you'd be seeing a lot less of this stuff.

This post could have easily been written about alcohol in the prohibition era. We've since learned that criminalizing alcohol makes its impact on society worse rather than better. We can't strip drug users of their autonomy and their ability to lead any sort of normal life and then act surprised when they turn to crime or turn back to drugs when they have nothing left.

> This post could have easily been written about alcohol in the prohibition era. We've since learned that criminalizing alcohol makes its impact on society worse rather than better.

It's worth remembering that Prohibition was, in fact, quite successful: https://www.vox.com/the-highlight/2019/6/5/18518005/prohibit...

To quote that article:

> Across the Hudson River, in Manhattan, the number of patients treated in Bellevue Hospital’s alcohol wards dropped from fifteen thousand a year before Prohibition to under six thousand in 1924. Nationally, cirrhosis deaths fell by more than a third between 1916 and 1929. In Detroit, arrests for drunkenness declined 90 percent during Prohibition’s first year. Domestic violence complaints fell by half.

Of course, one can still find Prohibition objectionable, or think that the costs outweighed the benefits. But there is strong evidence that Prohibition succeeded in reducing some of the negative impacts of alcohol use.

Interesting, thanks! I think I mostly took issue with the idea that throwing drug users in jail is the best course of action, and the condescending/judgemental tone of the original comment. I think we can dissuade substance use and abuse through other means (better drug education and rehabilitation, taxation, non-felony level criminalization) that will be a good middle ground between no drug laws and the draconian life-ruining ones that we have in place right now.

> The fallout from the over-criminalization of opioids, meth, etc is a big reason that you're observing these behaviors.

Didn't the massive opiod epidemic occur before they were criminalized?

Opioid possession without a prescription is a class C felony

I just finished reading The Urge: Our history of Addiction. If you're interested in some background on how we got here, the author does a great job of laying out the historical, legal, and social constructs that have resulted in the inconsistent mess.

https://www.harvard.com/book/the_urge/

>all but been decriminalized on the West Coast.

There's talk that WA is going to introduce a bill in the next session to completely decriminalize.

There is probably some truth to this but it is worth noting the opiod epidemic is largely why it's hard to get pain killers now. A few of the pharma companies have settled that they sort of knew people were taking them from pharmacies and selling them on the black market.

“Cocaine and heroin are not legal, but have all but been decriminalized on the West Coast.”

Citation needed. Never heard this before now. Or is this just some California thing?

In several cities they are now citations. You may get a fine for possession but you will not be arrested. In Portland for example the ticket is around $150, which is about the same as the fee for an expired vehicle registration. This change in policies has basically stopped enforcement. As you can imagine it is not a profitable practice to ticket the unhoused.

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