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> The drugs may have changed slightly over the years, but the sad reality is that the real change was their accumulated tolerance and long term damage from drug abuse had blunted their response so much that they could barely feel the drugs any more.

This varies with the drug. MDMA is notorious for losing its "magic" after six or so trips. There's a special empathic, soul-opening quality to it - the kind of thing that makes it such a good candidate for treating PTSD. But after a few times, it becomes more like a regular psychedelic amphetamine.. fun, but not life-changing.

On the other hand, pure psychedelics don't really lose their magic. Tolerance develops, but goes away after a week. Psychedelics aren't associated with brain damage, while MDMA mildly is.

Then there's opioids, of course, which are ruinously addictive and fickle with tolerance.

When you're on the outside of the community, it's easy to lump "drugs" together and make generalizations. But every class of drug is different.

The champion of pointless addiction is tobacco

Nicotine is a very effective nootropic, better than almost all the well known ones, and it's also a remarkably good schizophrenia treatment. It gets a bad rap because of the delivery mechanism, but there's a reason people like smoking.

This well-known video explains what you describe in graphical form, in case anyone has not seen it: https://www.youtube.com/watch?v=HUngLgGRJpo

The sad thing is many overdoses are due to people who quit, lose their tolerance, but take the same amount of their drug as when they were still actively using.

> A sobering reminder that the negative effects of recreational drugs last long after the hangover. I’m seeing an alarming trend of young people reading “harm reduction” material online and assuming they know the full picture of the risks of drug use.

I don't think that's ever been in question. Harm reduction isn't some utopian ideal that safe drug use == nobody ever suffers long-term negative effects.

Conquering those demons takes a lot of time, introspection, and often outside help. Harm reduction is about making sure you live long enough to hopefully get there.

> I don't think that's ever been in question. Harm reduction isn't some utopian ideal that safe drug use == nobody ever suffers long-term negative effects.

To you, maybe, but it only takes a cursory glance at drug-related subreddits to see numerous people suggesting that you just need to follow harm reduction websites, stick to some arbitrary rules (e.g. only do MDMA every N weeks and take X, Y, and Z supplements), and you can avoid the negative consequences. You may know that’s untrue, but it’s common to see among drug users.

It’s also common to blame drug users who experience problems on failure to follow harm reduction guides, as if the guides are a perfect guide for avoiding the harms.

> Harm reduction is about making sure you live long enough to hopefully get there.

Modern harm reduction websites are about education in general, not just helping addicts survive. You will find things like dosing guidelines for first time users, expectations for what to expect, how to prepare, and so on.

These things are targeted at beginner drug users or the drug curious.

What negative consequences are there to doing MDMA or LSD a couple times a year?

Especially when comparing with the negative consequences of doing alcohol.

The argument that any drug use is bad is pretty blown out of proportion.

LSD can mess you up big time even with a single intake in your life.

If you have a family history of psychosis, it can trigger schizophrenia or bipolar.

If you're not predisposed to psychosis, can it really do anything besides give you a bad trip? Bad trips are traumatizing and may take a while to work through, psychologically, but it's not permanent damage.

Personally, I had a very bad trip that led me to stop doing drugs and, ultimately, to a lot of very positive changes in my life.

The problem with advice like this is, how do you know you're not predisposed to psychosis if you haven't tried it yet? It needs to be more actionable.

Is this backed by research? Or even some serious anecdotes?

Bad trip ?

> Especially when comparing with the negative consequences of doing alcohol.

This sentiment is confusing to me. I get that alcohol is bad. But how is that relevant to whether or not MDMA or LSD are bad?

I see it come up in these conversations pretty regularly, so there's probably a point there I'm missing. But I can't help but read it as "this thing I like to do isn't bad because other people do a different bad thing".

Smart, well adjusted drug people will frequently point out that most common drugs they use (LSD, MDMA, MDAA, psilocybin, etc) have an orders of magnitude better risk profile than smoking or drinking. The latter is essentially socially ubiquitous.

That community has an ongoing bitterness about this double standard.

Usually though, people making this point are not advocating for heroin or meth (although there's a reasonable argument there that the drug is not what does most of the damage in those situations - krokodil is just heroin manufactured with an extremely dirty process. It's perceived as being much worse, but what's "much worse" are the impurities from using gasoline as a solvent.

MDMA and LSD in particular have the advantage of no fast, cheap ways to synthesize at the expense of safety or purity.

I think the reality with LSD in particular is the normal way of making it is fast & cheap anyways. I'm sure you _could_ cut some corners. But why? We're talking about a drug used in microgram doses. Synthesis several kilograms and you have basically created an annual supply for an entire continent.

I think the point is people disproportionately tsk tsk about the harms of drug use compared to the harms of alcohol.

Personally I think most substances in moderate quantities taken only occasionally are no big deal. Yes there is probably some minute health impact visible in long term longitudinal studies but it's probably dwarfed by other lifestyle factors. I would rather be someone who exercises regularly, eats a healthy diet and uses MDMA or cocaine a few times a year than a sedentary obese teetolar who's never touched drugs.

The worst part is that keeping them all illegal drives people towards whatever is available, and some of those choices are far worse than others.

A more flexible approach would see drugs regulated purely based on actual harm coupled with availability of a less harmful analogue (will fentanyl users pick heroin if it's more easily available than fentanyl? If so regulate one much more strictly than the other)

Incidentally that approach might well see tighter regulations on alcohol than several currently illegal drugs.

> Incidentally that approach might well see tighter regulations on alcohol than several currently illegal drugs.

Well, from the scientific view things are pretty clear.

https://commons.wikimedia.org/wiki/Category:Psychoactive_dru...

Only politics don't want to move. Because why ask science when you can ask the alcohol and tobacco lobby?

The majority of the population accepts the risk associated with alcohol. So touting risks of other drugs as if they where somehow greater than that already by most accepted risk feels dishonest.

Now you can say, well I don’t drink alcohol either, but that’s not the reality of most people.

There is another approach though. You can imbibe in any of these things and also acknowledge that they are probably a negative thing.

I'll have a drink occasionally, and (more rarely these days anyway) I'll occasionally have too many drinks. But I won't look at either of those as "well, I didnt do heroin, so that was a good choice".

I tend to look at it just as if I had eaten mcdonalds or taco bell or a tub of ice cream. It's something that I wouldn't do if I really wanted the best for myself (for some definition of best. Obviously everyone will have their own. Maybe your best is exploring your psyche, and damn whatever consequences may or may not come).

You don't need to justify it. Just recognize that you're probably trading off something else in your life for it, and in some cases that tradeoff may be sizable.

In any case, I think the comparative view isn't a great one. It implies that you have to have some kinda vice, and at least you kinda picked a lesser one. My own ideal would be to do very little of any of it, maybe even none. But if I miss that ideal, I don't have to rationalize it away.

Harm reduction itself isn't a bad thing, the problem is if it displaces other forms of help for drug users, or ends up encouraging more drug use.

e.x. skip to 2:00 in this video https://twitter.com/sav_says_/status/1603512522509668352

I think your comment is an example of an important discussion we need to have around what are the consequences to our drug policies, whether they are tough-lovish or harm-reductionist. I can see value in both, in different circumstances.

However, the video you link to is from a notorious far right propaganda outlet. I don't think people will get an honest perspective from TPUSA, who clearly have an axe to grind (and bills to pay, which they accomplish by manufacturing outrage).

Ricci Wynne posts most of his videos like this independently (https://twitter.com/RawRicci415). In most of them he lets the video speak for itself. I don't have any reason to believe he's lying and I think he'd strongly dispute being characterized as "far right".

Do you react similarly to left wing propaganda, or is your “partisan sources do not provide honest perspectives” limited to right wing sources?

Yes, I do. I despise the far left.

True, but you are saying that with more awareness than many young people have when they are first looking into it. The brain tends to assume "risk reduction" means "risk approaches zero" and thus negligeable risk.

Also "harm reduction" is patronising to users.

People use drugs for there benefits

Addiction is a symptom, generally, of alienation. To the addict the drug is helping. As the addicts loved ones that can be hard to belive, and demonstrably untrue. But still.

A much better paradigm is "benefit maximisation"

Ask ourselves what social policies will help maximize the benefits of drug use.

Leads to the same place with the harm, but without patronising users, and allows us as a society to explore the upsides of these drugs

> an alarming trend of young people reading “harm reduction” material online and assuming they know the full picture of the risks of drug use

Is anyone attempting to harm-reductively try meth?

Probably not, but this is an artifact of the audience of "harm reduction" material. If there were things aimed at students and professionals who take prescription stimulants informing them that there's an alternative prescription stimulant that is comparably very highly reviewed by patients[0] for boring reasons like "it helps me live my life and has fewer annoying side effects" then that probably wouldn't be "harm reduction" material.

[0]: https://astralcodexten.substack.com/p/know-your-amphetamines

Methamphetamine has a bad rep, but taken orally in small quantities it is not much more dangerous than adderall, and has pretty much the same side effects. It can be legally prescribed for ADHD (brand name Desoxyn).

Meth is significantly different than regular amphetamine. Consider that simple changes in isomers can elicit radically different effects. A great example is levmetamfetamine (or l-meth), which is sold over the counter as a decongestant (as opposed to d-meth, the “fun” kind).

Now, if the difference between a “left-handed” and “right-handed” meth molecule can be so great, it shouldn’t come as a surprise that adding a methyl group to regular amphetamine will change its effects considerably.

This can be seen in the different receptor binding profiles (which receptors, where in the brain, and how strong or long the modulation is).

Meth’s increased addictive and neurotoxic effects are owed to this difference in receptor binding.

I'm not sure about meth specifically, but there were billboards in SF telling people safer ways to use drugs:

https://www.ktvu.com/news/san-francisco-supervisor-drug-over...

Yes.

The “harm reduction” websites are full of information about things like: Dose ranges for beginners, what effects to expect at different dose levels, routes of administration, and so on.

This information is targeted at beginners or drug curious people.

"accumulated tolerance and long term damage from drug abuse had blunted their response"

The succinct term for this phenomenon is "chasing the dragon".

First heard that term in the movie "Killing Zoe." Takes me back.

"harm reduction" doesn't mean "good addiction" or even "risk reduction" . It means dying more slowly with less collateral damage. It means what the name says.

Unfortunately it doesn’t mean just one thing. People use a slogan like “harm reduction” to describe a wide array of beliefs and practices ranging from the very practical (don’t make sobriety a condition of care) to the very dogmatic (it’s not ok to discourage drug use of any kind, anyone who suggests otherwise is part of the problem). Most people will be somewhere in between those extremes. Once a slogan has been in use for some time, you can’t take the words at face value anymore. The mean whatever people use them for, not what they would mean in plain English.

As an aside this is true about language more generally. There is no true meaning of any given string of words. Language is a communication tool (and a lossy one at that). History of use gives words and phrases additional contextual meaning beyond any dictionary definition. Feedback is often necessary to avoid misunderstanding.

> this is true about language more generally. There is no true meaning of any given string of words. Language is a communication tool (and a lossy one at that). History of use gives words and phrases additional contextual meaning beyond any dictionary definition. Feedback is often necessary to avoid misunderstanding.

Very insightful. It would be great if we all were a bit more aware of this.

And all die we must