Washington faltered as fentanyl gripped America
washingtonpost.com
washingtonpost.com
Back in college, I was a fiend for all type of stuff that was presumably made at these facilities. I would purchase styff from american and canadian resellers who had labs in china that would synth specific drugs for them. Always wondered what the lab conditions were like, what likelihood I was supporting nefarious business practices, how likely it was that I got harmful byproducts etc.
https://en.wikipedia.org/wiki/Opium_Wars
https://en.wikipedia.org/wiki/Fentanyl
https://www.brookings.edu/research/china-and-synthetic-drugs...
There’s another video here where a guy explains how the cartels went from super labs to many smaller apartment style labs. Chinese chemists come and train each small lab for 90 days until they can do it on their own.[1]
Or maybe the same gangs who could no longer profitably sell pirated media found a new way to profit on a country which has historically been completely incompetent when dealing with drugs.
So fentanyl is the drug most people overdose on, or is it killing more people than heart diseases, traffic accidents, etc do?
The numbers for other types of fatalities are available so you could do a quick comparison:
42,000 motor vehicle fatalities in the US for 2021 (all ages), so way above that
Heart disease is more unclear, I mostly found age-adjusted risks/etc. It looks like at best I could find, around ~400,000 americans in that age group have heart attacks (eg. MI) each year, though the death rate is obviously going to be lower than that.
So, it's definitely possible. IIRC "death by misadventure" and the like are super high on the list of causes of death for young people (18-25), so very possible fentanyl is way up there if not at the top.
https://www.snopes.com/fact-check/fentanyl-overdose-death/
Interesting that Google searches for this info return RT results
Yeah, I'm not surprised - motor vehicle accidents were always super high on the list for that demographic so if fentanyl is even remotely close to the number reported above it would easily surpass everything else.
It looks like the authors are comparing numbers from different methodologies and then claiming a quantitative rank order can be deduced and it can't unless you can demonstrate the methodologies yield equivalencies especially when you're looking at small population percentages...
I had a good friend lose a multi-year battle with opioids about 7 years ago who ended up sleeping on my couch for months when his family had abandoned him. It's a life changing and terrible thing and I've never been through anything more difficult than helping someone struggling with opioids but I don't think these claims in the article are well supported.
I wish nothing but the best for others going through these troubles. I wish compassion worked as better medicine
"Top Ten Leading Causes of Death in the U.S. for Ages 1-44"
https://www.cdc.gov/injury/wisqars/animated-leading-causes.h...
"Unintentional Injury" holds overdoses, which are called "unintentional poisoning" in the breakdown in the bottom chart.
For 2020:
80,208 Unintentional Injury deaths
(consisting of)
49,643 Unintentional Poisoning deaths <-- overdoses, 2/3 fentanyl
21,780 Unintentional MV Traffic deaths
2,232 Unintentional Drowning deaths
1,176 Unintentional Fall deaths
5,377 All Other Unintentional deaths
22,431 Suicide deaths
18,838 Homicide deaths
17,310 Heart Disease deaths
16,708 Heart Disease deaths
8,902 COVID-19 deaths
6,620 Liver Disease deaths
4,445 Diabetes deaths
2,927 Stroke deaths
2,100 Influenza & Pneumonia deaths[1] https://wisqars.cdc.gov/data/lcd/drill-down?lcd=eyJjYXVzZXMi...
My mother is a physician, she just last night told me about a case she saw over the weekend in which a young 20-something nearly OD’d on fentanyl from taking ecstasy. She survived, but with life-altering brain trauma rendering her unable to remember who she is. She needs tubes for her food supply, and a ventilator to breathe.
Here you can see a few images of what is a lethal dose of fentanyl: https://www.dea.gov/galleries/drug-images/fentanyl
Scary stuff, and maybe there’s an argument there to be made in favor of legalizing current black-market drugs. Definitely a PSA to test your drugs.
CDC on cross-contamination: https://www.cdc.gov/drugoverdose/deaths/other-drugs.html
The drugs are often completely different from what they’re sold as, with all sorts of toxic things added.
People do a dose that is sensible based on their assumption of what the drug is, but the drug is something else, so their dose is completely incorrect and they overdose and die.
No drug user at this point should expect their drugs are what they’re advertised as.
Isn't the USA the only country other than NZ that allows advertising of drugs on TV? Also sales reps from drugs companies isn't a thing we have here either (largely because the NHS is The Buyer of all drugs in the UK).
Oh you show signs of strokes and autoimmune condition? Here’s some chill pills.
Of course, the drugs with ads are usually the most expensive name brand drugs that will earn the pharma companies a lot of money.
- Most physicians agreed that because their patient saw a DTC ad, he or she asked thoughtful questions during the visit. About the same percentage of physicians thought the ad made their patients more aware of possible treatments.
- Many physicians thought that DTC ads made their patients more involved in their health care.
- Physicians thought the ads did not convey information about risks and benefits equally well. Seventy-eight percent of physicians believe their patients understand the possible benefits of the drug very well or somewhat, compared to 40 percent who believe their patients understand the possible risks, and 65 percent believe DTC ads confuse patients about the relative risks and benefits of prescription drugs. In addition, about 75 percent of physicians surveyed believed that DTC ads cause patients to think that the drug works better than it does, and many physicians felt some pressure to prescribe something when patients mentioned DTC ads.
- Eight percent of physicians said they felt very pressured to prescribe the specific brand-name drug when asked.
- DTC ads help patients have better discussions with their physicians and provide greater awareness of treatments. The study demonstrated that when a patient asked about a specific drug, 88 percent of the time they had the condition that the drug treated. And 80 percent of physicians believed their patients understood what condition the advertised drug treats.
- Doctors believe that patients understand that they need to consult a health care professional about appropriate treatment. Eighty-two percent responded either "very well" or "somewhat" when asked whether they believe that their patients understand that only a doctor can decide whether a drug is right for them.
https://www.fda.gov/drugs/information-consumers-and-patients...
In fact:
https://www.ofcom.org.uk/tv-radio-and-on-demand/broadcast-co...
probably tells you why those 'little blue pill' adverts are only on after 9pm.
Lots of content that should be 90min or 2 hours at most is now 4 hours or more.
I simply stop watching or fast forward through that nonsense. If I wanted to see people get high and drunk over and over, there are more entertaining venues.
I suppose Isolation during Covid might play a role, but I have not seen any stats relating drugs and the pandemic so far.
A culture hyping 70-hours weeks and over-employment as solutions to cost-of-living issues is not healthy, and drugs are just one of the symptom.
Fentalyn isn't really the problem. The need for drugs to escape/cope is.
I mean, if a doctor has a question about a drug, who better to ask than the rep from the company who makes it?
I worked in the industry and reps are generally account managers for the company.
ideally a third party in the form of a board of scientists who don't have a direct conflict of interest. Look at the billion dollar settlements of J&J in the last decade alone for misleading marketing and health risks from products including hip replacements, psychoactive drugs and implants.
But if your patient is having a specific side effect and you want to know what information is available, your only choice is the company because they collect the information.
To ban sales reps is like running a garage to repair cars and never talking to the manufacturer.
I dated a girl who went into pharmaceutical sales. They're basically bribed. They get kickbacks in some form or fashion.
They get invited to speak a medical conferences by drug company reps, those conferences just happen to be at luxury retreats.
Certain hotels and resort chains are banned for those types of events (Ritz Carlton, etc). All payments are “fair market value” based on the doctor’s typical compensation rate (say $500/hour for oncologist). All payments are reported to the government under the Sunshine Act.
To be honest, it’s not that lucrative for the doctors at all. They could be making more money elsewhere.
Medical students and residents will attend these, because they can't afford to eat those meals.
Now, the device industry... that does not operate under the PhRMA rules.
The one drug I've ever given a talk for (sugammadex, trade name Bridion) is an excellent drug that has a unique mechanism of action for which there is absolutely no equally-efficacious substitute. It is expensive, at around $90 a vial cost to the hospital, but it can and has prevented overnight ICU stays that would have cost the hospital far more. I was a big fan of the drug even before it was released in the US, so I didn't need a bribe to do the talk. But if they're going to pay someone, I saw no reason it shouldn't be me. I didn't say anything I didn't already believe.
I hadn't watched TV in years before I went to Southeast Asia. I always laughed that it seemed all the commercials were for coffee and beauty products, rarely anything else.
Then I happened to catch live TV for the first time in a while after I returned, and realized it seemed 80% of the commercials were for random drugs. It made me wish we had more coffee and beauty product commercials!
*Eyeballing success by the number of murders with illegal firearms and drug deaths.
At some point organizations exist for the benefit of the organization only. What would success look like for people at DEA/ATF/etc?
The only true business value is trying to put oneself out of business.
What can the DEA do to prosecute more internally and externally? We would have to revert back to the ways of less human-rights friendly warfare. We would have to build physical and surveillance barriers. On borders. We would have to more heavily control shipments of goods and overall freedom of navigation of waters. We would have to turn our nation into a prison-island.
As for the ATF, well, only so much one can do for stolen arms… and even then we may have a critical mass problem. Unless we abolish the right to self-defense and start violating civil rights to clear the possession of weapons.
All politically untenable, and so what would rolling up these departments do other than consolidating power? They would have the exact same set of issues.
Much like invading Afghanistan, it’s a winnable issue in theory. After all, Alexander the Great did. However, modern political reality defeats you before the boardgame is out of the box.
Same as every other specialty law enforcement agency (campus police, transit system police, etc), prioritizing stuff that the "real police" would get raked over the coals for wasting resources on. You couldn't have the FBI kicking down the doors of medium time drug dealers and suburban dads who violated some arcane statute the way the DEA and ATF do in the same way that a city police department can't justify pissing away man-hours chasing every bum that Karen calls in for pissing on the train tracks. Easier to just spend the money on a bespoke enforcement agency than to have the hard conversations about political will and how much the long tail of stuff these organizations do actually matters.
Are they using it to escape the grinding anxiety and desperation of their shitty lives?
Are they using it instead of alcohol, again as escapism from reality? Is this use any different from how people used alcohol in past decades?
I guess the point I'm poorly trying to make is that people aren't suddenly different to those in the 1970s, 1920s, or the 1800s. They have a similar environment with similar anxieties, pains, responsibilities, etc etc.
I'm very, very biased on this subject. I suffer from constant pain, this comment being written while I sit down to recover from walking my dog. I've been given Morphine and Vicodin, Suboxone and Lyrica. Currently I'm lucky enough to be on Zubsolv, which is a better formulation of Suboxone that doesn't disrupt my sleep as much nor give me horrible muscle spasms. I've tried edibles, as I live in Michigan which has legalized Marijuana. Unfortunately I tolerate them way too fast and they just send me to sleep.
People I know across the USA have wildly different results to seeing a doctor for pain relief. Some can't even see a doctor who will even discuss pain with them. Others, like me, have been accused of drug seeking. Or ripped off by hospitals promising to help with nerve abrading, injections, implants, etc. Those hospitals eager to help are also very proficient at billing to extract the most money from insurance and patient.
If I were 16 again, armed with what I know now, I'd go into medical research. Specifically tolerance, because in my opinion that's the keystone of the building that is drug dependence. People get tolerant of their drug of choice, take more to get the same effect, chasing that dragon around and around not noticing that the circle has become a downward spiral. Plus so many overdoses are from people taking an old high dose that used to work, when they've been off the drug for a while and are no longer as tolerant.
There has to be a way of factory resetting people's tolerance for drugs without harming the person. I wish that could be found and added to opiates especially.
My apologies for the rambling rant. Just realize that these statistics you read about are all people. All lives that may have tried to feel better about themselves and ended up drowning in their dependence. Please don't write us all off as junkies who deserve punishment for stumbling in life.
As far as the common narrative I've seen in the media goes, it's not that they are actively seeking out fentanyl to use (generally). It's that they are seeking out opioids in general, and a lot of unscrupulous distributors and dealers are cutting their product with fentanyl to make it more potent, or something to that effect. Whether or not this is actually the case, I'm not sure.
Of course, American authorities immediately turned that into a "Fentanyl candy!" panic.
Not in agreement on this. 2020 looks profoundly different than 1920, for example from the lens of western societies. People are more atomized, have less friends, are having less kids, are getting married less often, divorced more often, job prospects for blue collars workers have diminished, etc etc. Not to mention the simple fact that Fentanyl did not exist in 1920. While man might not have changed much inherently, their environment has changed profoundly and seemingly not for the better.
People still look to escape the drudgery of their world, that doesn't change. You're right that we have far fewer social supports. Although I do wonder if a study would confirm that people with smaller in person social networks use or overuse drugs less than more isolated people.
Depends on which man, or woman. I would say the environment has changed for the better for quite a few.
Define significant part. There are people in 2020 living in absolutely abhorrent slums. Most major US cities have areas meeting this definition.
> People on average worked 60 hours weeks,
Unsure if this is true. Even if it is, probably more accurate to say of those people who worked, they worked an average of 60 hours per week. But in 2020 a higher percentage of the population is working. Women in the workforce has grown exponentially. This too is a major shift / difference.
> Overall, the conditions of living were so harsh that people were numbing themselves with alcohol on a massive scale, ultimately leading to Prohibition Act.
Suicide rate in the US has been steadily climbing decade over decade. What does that say about our living conditions?
The 1920 slums meant living at 5-10 people per room, with no running water, in constant stench from the nearby factories. I doubt you can find many places like that in US today.
> Unsure if this is true.
That's what the data I've found says - average time worked in non-agriculture was close 3000 hours per year (so, 60 hours per week for 52 weeks per years - no sick days, no vacation). Plus constant risk of death or maiming, plus obviously inhaling all the deadly pollution etc. (Communist countries at least started recognizing that conditions of working in a coal mine or steel mill will literally kill you over time, and gave those workers full retirement after "just" 15-20 years of work there). Conditions were bad enough that people were risking their lives trying to start trade unions. Many were killed for it, too. How many trade union members were killed in 2022 in the US?
Women didn't worked at jobs, but slaved away at homes. Living without modern amenities plus large families meant a mountain of work. For example, my grandmother didn't have a washing machine and washed the bed linen by hand, which meant 10+ hours of physical labor. She insisted on doing that every 3 weeks or so.
> Suicide rate in the US has been steadily climbing decade over decade. What does that say about our living conditions?
Hard to say? For example, during wartime (cannot imagine harsher living conditions than war), number of suicides can go down significantly - they did in the UK during WWII for example. The relation between living conditions and suicides are complex at best.
Going back to the subject at hand (fentanyl use), I think one can safely state that more people are dying from drug overdoses and suicide than they were in other decades in US history. Is it people who have changed, or their environment? And do you disagree that there is a correlation? Certainly there has to be. Availability of fentanyl correlates with fentanyl deaths, whereas unavailability of fentanyl would correlate with lack of fentanyl deaths. And so all the ways that the environment of 2020 is now better than in 1920, seems not to translate to less drug overdoses and suicides. And I can think of no better indicator of quality of life, than the indicator of how many people are choosing death over living.
Yes, less fentanyl in the supply chain would be the right answer.
It’s an empty statement, neither side agrees on the fix for poor mental health and so the ball keeps on spinning.
https://www.businessinsider.com/abbott-cut-mental-health-ser...
Not all solutions can be fixed with infinite dollars.
So no, it isn’t “worse than that.”
Meanwhile we have folks creating problems then taxing the populace then shifting tax dollars to unaccountable private sector friends and donors. True problems.
https://www.mayoclinic.org/healthy-lifestyle/consumer-health...
"In a study testing kratom as a treatment for symptoms of opioid withdrawal, people who took kratom for more than six months reported withdrawal symptoms similar to those that occur after opioid use. Too, people who use kratom may begin craving it and require treatments given for opioid addiction, such as naloxone (Narcan) and buprenorphine (Buprenex)."
Maybe don't allow people to drive under the influence of any drug that's not a stimulant, or improve tests that measure the dose a person is on so we know if they're on normal dose adderal or high on huge doses of meth.
I know law isn't easy to test and iterate but we need something like that in order to improve things, maybe invent temporary laws, specific to certain test cities, which require direct voting to enforce, have a maximum test period and require another vote to lengthen.
Homeless people aren't camping! That's where they live. If you want to make homelessness a crime you could prosecute landlords who evict people with nowhere to go. Why isn't that the crime?
Just think for a minute please about the propaganda you've internalized and are now spreading with these positions. These are complex issues and the view of the police, and police-based solutions, are not the only or best approaches.
Should I commit suicide?
And the extremely high rents means in the US you don’t even need to be jobless to not be able to afford rent. The lowest 10-20% of paying jobs may not pay enough money for a person to live in the area the job exists.
Homelessness in the US is a massive problem. But the homeless are not the cause of homelessness. They’re the victims. The U.S. has multiple failed policies which allows homelessness to exist in the richest country in the world.
And there are solutions across the ideological spectrum. You can go left and have the government give them housing. This is cheap (way cheaper than shelters) and extremely effective. On the extreme right you can stop NIMBYs from allowing housing to be built, which will in itself drop costs and rent.
The answer probably lies somewhere in the middle. But the US has chosen to simply ignore the solutions altogether.
When the U.S. does pick a solution, it chooses to incarcerate them. Which is the worst possible solution because now you’ve led them to joining a gang and predictably becoming real criminals themselves who now learn know how to rob and steal and commit violence to satisfy their need for money.
And it’s also ridiculously more expensive than all the other solutions above.
(
Why must people be subjected to witnessing others misery and self-destruction? If you care so little about their public camping would you also let someone camp in your yard?
You seem to have no sympathy for shop owners that get robbed constantly, if someone robbed you on your way to the car from the grocery store would you also be ok with it?
Of course it makes sense for economically precarious people to move to the city. We should expect and applaud them for making this decision. It’s where all the jobs are.
I think the U.S. overall has low single digits. And even those exist in an extremely dubious legal space, requiring the cops to turn a blind eye to their existence.
[0] - https://missionlocal.org/2022/12/san-francisco-fentanyl-tend...
The authority figure in their lives lied to them about marijjana, and now they think they they’re lying again about fentanyl.
Fentanyl is a poison. It’s killing people. It is not like marijuana.
What has drug prohibition done to help the problem of addiction and violence in the United States?
It is naive to think the war on drugs was ever about protecting people. If the protection of people is a goal, you don't treat the people who need the most help as criminals. Imagine if you discover your brother has a drinking problem and it's destroying his health and finances - is your first instinct to call the police and have him arrested? Most people I think would not even think about that - they would urge him to get help, somehow, through rehab, counseling, any number of things, but no one would say he needs to go to prison.
The only actual criminals involved with drugs are organized crime cartels, gangs, etc that use violence in controlling their market. If you make their product legal and obtainable, they no longer have any incentive to sell it and you eliminate a big chunk of their profits.
Legalizing drugs is about treating addiction as a medical issue instead of a criminal one and eliminating the illicit drug trade which contributes to violence and profits for organized crime.
Drug abuse is a massive problem in those parts of the US where it is de-facto decriminalized on the west coast.
I think the evidence is fairly clear on what would constitute a solution, rather the debate is on whether we’d be willing to pay the costs of that solution.
https://www.outlookindia.com/international/thai-temple-left-...
The impact of legislation like Citizens United and the outsized influence of large institutions on American politics is really unfortunate.
Fentanyl is a Schedule II controlled substance. So while yes, it’s “legal” - it’s an extremely controlled narcotic.
Said differently, it’s illegal if you’re in position of it and it wasn’t prescribed by a medical doctor.
Unlike marijuana that doesn’t need a prescription where it’s allowed.
Thanks for clarification.
E.g. car accidents kill more people per year than marijuana.
Does that mean driving a car should become illegal, and marijuana legalized?
https://www.cdc.gov/injury/wisqars/LeadingCauses.html
https://www.huffpost.com/entry/marijuana-deaths-2014_n_56816...
Fent addiction has huge negative utility for everyone - except its manufacturers and their investors.
MJ is probably more or less neutral.
In terms of broad social effects, refined sugar is probably the deadliest of all drugs, but its direct effects - especially in sodas - are much smaller than its indirect contribution to obesity and diabetes. And unlike a dramatic overdose death, it's very slow-acting. So it's barely considered a problem.
Honestly, yes. Or at least driving a car should require a much more strict licensing process. My daughter got a license during the pandemic and all that was required of her was driving around a parking lot once and then parking parallel. Skills which can be acquired in a couple of hours just prior to the test. Yes there is usually a written test as well, so there is some reason to believe people know what the basic road signs mean, but to let people loose on public roads traveling at 70 mph after a 5 minute driving test is just asking for widespread vehicle collisions.
If you get in as much trouble doing/buying/selling/etc MJ as Fentanyl, you might as well do the latter.
If MJ is legal, many would stick to that.
Same for MJ-to-alcohol: and the alc producers know it, they lobbied fiercly against legal MJ and when it became legal (like in Canada) they were the first to invest heavily in it.
If that argument is true, wouldn't fent/meth users just use alcohol since that is legal?
Alcohol is much better for you than meth and both are cns depressents.
The current populist wave has shown that the opposite is true. The threats posed by citizens united were overblown as small dollar donors are generally significantly more radical than large institution.
If lots of people do it, (1) is better, even though it normalizes the danger, because we get seat belts and pharmaceutical controls and the ability to innovate and discuss changes in public.
If the people involved can be cast as lower moral status / other, then it becomes a problem of "Dealing with THEM", and we get (2). This is correct if the primary activity is a real, moral crime (theft, extortion rackets), which changing consciousness and numbing pain aren't. This is almost NEVER correct in the case of voluntary economic transactions (for which the societal benefits of regulation have proven to be enormous), unless those interactions are inherently theftlike/extortionate/exploitative-involuntary, because it creates a spiral of violence.
So the questions are: Should pain numbing / consciousness altering be the province of organized crime? Should we devote substantial societal resources to a failed project of stopping people from altering consciousness and numbing pain, or change to make that fact less damaging? Should one part of society get to impose the violence-filled option on everyone else?
Fentanyl is notable because it's more concentrated and cheaper, so there's more available and it's easier to dangerously overdose. But the "why" behind the market for it hasn't changed in hundreds of years.
Source: My mother used fentanyl for many many years.
I can think of at least a few angles that might be interesting since I'm too uninformed to know any better:
Is it possible to create mRNA vaccine that block opioid receptors?
What happened to the scanning tech mentioned in the post? That thread seems to just stop with "failure to innovate". We have ML that feels like it could do that now. There's that open robotics repository of scanned objects -- it sounds silly, but why not scan every single car (maybe with some help from automakers) so there's a reference and train with that?
As far as the physical problem of scanning, can we scan cars/trucks/containers/etc with sonar rather than visually and let a computer figure it out?
Plus forcing people to take medicine against their Will is fraught with civil rights issues.
find a solution
Because the whole point of fentanyl is the massive therapeutic window and difficulty of overdosing.
You should be able to buy cocaine, heroin, fentanyl at the local grocery store. No question asked. Maybe even subsidize it for poor people who can't afford market prices.
The local pharmacy should provide training on how to inject/consume them safely and give for free the associated consumables.
Anyone that continues voting Tory after all the damage done to the UK is unlikely to be change their vote just due to drug laws being changed.
That said, only 30% or so support the status quo criminalisation of marijuana. That's past due for some change.
It's easy to cater to them. In the packet that legalizes all drugs you also remove all gun control laws.
So you make all drugs and all guns legal in all circumstances and at all times, just like it should be in a free country. The state should not control what you put in your mouth or veins or what you carry in your pocket.
And don't say "carry" because that's been proven time and again to be utter nonsense in practice.
Plenty of people go to the mall or school without catching a bullet from a "rando"
The last time someone tried to shoot up a mall they got clapped by some rando who was carrying. The last time someone tried to shoot up a school the police prevented anyone from interfering while they went at it for 40min. Your selection of examples seem specifically chosen to highlight the failure of the policy you are at least pretending to advocate for.
Existing gun laws do basically nothing to stop the kind of pre-meditated violence of which you speak. At best they act as a marginal deterrent and that marginal effect carries over into the actual results.
Frankly, I don't think that crimes of pure possession (for guns, drugs or any other vice) should be crimes except with some specific time and place qualifiers (bomb at home -> ok, bomb in airport -> not ok).
The research here also does not support broad legalization:
+ https://pubmed.ncbi.nlm.nih.gov/24456133/
+ https://med.stanford.edu/news/all-news/2019/06/medical-marij...
Of special note is that opiod deaths increased as legal prescribed opiods were given more freely.
My proposal would sell pharma-grade drugs of known quality/dose in grocery stores at affordable prices. The illegal market would die overnight.
So why not treat other drugs the exact same way? There is no way to be logically consistent about this UNLESS you think that alcohol should also be illegal.
Rather than some off white powder that contains an unknown amount fentanyl.
What does work is making the cost of drugs prohibitive by placing great transaction costs on the drug trade. (See: taxes and tobacco.)
Wouldn't this be a better title?
Washington faltered as Fentanyl & OxyCotion gripped America
Many of the current overdose deaths are not the result of people knowingly taking an acutely risky dose; they are instead the result of black market drugs having unpredictable composition and purity. It is likely that drug legalization would reduce that kind of overdose.
Note I wrote legalization rather than decriminalization. The distinction is that with legalization, production and distribution are legal, while decriminalization just removes serious penalties for end users.
In doing so we’ve saved many lives.
Chicago had a population of 2.7 million in the 1920 census and 3.3 million in the 1930 census. NYC had a population of 5.6 million in the 1920 census and 6.9 million in the 1930 census.
Even if we use the lower 1920 numbers, that works out to ~2 Prohibition gang related murders per 100k population in Chicago per year. For NYC it's ~1.4.
Cirrhosis deaths during Prohibition ranged from 7.1 to 7.5 per 100k for the US as a whole. The study I linked attributes only 10-20% of the reduction to Prohibition, but other studies attribute more than that. The pre-Prohibition peak of 14.8 per 100k in 1907. It's likely that the temperance movement generally (which is what led to Prohibition) as well as state-level Prohibition acts prior to constitutional prohibition, contributed to this decline.
In any case, if we assume only 10% of the reduction was due to Prohibition, and we use the lowest of the Prohibition era cirrhosis numbers (7.1 per 10k), that works out to ~.7 per 100k fewer deaths per year due to alcoholism nationwide, as opposed to the gang murders focuses in cities (or about 13k total for the 1920 us population, or about 14k for the 1933 US population). If we assume 20% those numbers double, obviously, and if we attribute any more of the drop from the 1907 peak to state level prohibition movements, we have an upper bound of ~156k, though that's unlikely since cultural forces like the temperance movement probably played a significant role there as well.
There are plenty of arguments that can be made in favor of or against prohibition, but the most common arguments that I see ("It didn't actually reduce drinking!" and "Gang related killings outweigh the lives saved!") don't really hold water.
If you die, you weren't fit to survive. So - you know - no real loss to anyone who matters.
There are many reasons for the popularization of more concentrated drugs, but the two big ones are that more potent drugs generally make for cheaper doses, and that it's more profitable to create addicts than to create satisfied customers.
The latter is also an increasing problem outside the drug space, e.g. gambling and pay-to-win video games.
https://www.smithsonianmag.com/history/inside-story-americas...
Congrats, prohibition has made the situation worse.
1. https://www.hhs.gov/opioids/about-the-epidemic/opioid-crisis...
> You should be able to buy cocaine, heroin, fentanyl at the local grocery store. No question asked. Maybe even subsidize it for poor people who can't afford market prices.
I think that a basic familiarity of the Chinese experience with British opium would suggest that full legalization for the more dangerous drugs is not a panacea.
After the wars, the Qing China quickly became top opium exporter.
Even during prohibition it was way easier and profitable to make bootleg whiskey than beer.
Why? It’s easier to conceal, packs the most punch, and is the most profitable by weight.
Instead of making heroin legal, make opium legal. Or even weaker opioids like codeine. Then people who wanted an opioid high would have access to legal, clean, less potent opioids that could be taken in a less harmful way than IVing black tar heroin.
One of the most unhinged things I've read on this site, and that's saying something.
https://news.ycombinator.com/newsguidelines.html#comments
I'll quote the guidelines here:
"Please don't use Hacker News for political or ideological battle. That tramples curiosity."
Most comments here are political. Did I miss a blog post that says to be politicans?
"Presidents from both parties failed to take effective action"
Past explanations on this point: https://hn.algolia.com/?dateRange=all&page=0&prefix=false&so...