Teen-age fentanyl deaths in a Texas county
newyorker.com
newyorker.com
Before the pandemic, roughly 10% of students at her school came and went through her office seeking mental health treatment. After the pandemic and school reconvened, that number shot up to about 70% of students and has now leveled out around 50% and held steady for the last year. Of course, being a public school district, they couldn't afford to bring on additional caseworkers, so she's having to ration her schedule to see as many students as she can. And the stories she's getting from her kids are often pretty terrible (lots of alcoholism and domestic-violence related issues).
I read stories like this and it's completely unsurprising to see. Between the trauma of the pandemic, endless school shootings and a future that looks increasingly uncertain ecologically and economically, I get it. Who among us honestly wishes they were a kid in this world in this time? I thank my lucky stars every day that I'm not.
Maybe there was somewhere to go, but therapy and counselors were not part of the culture.
(I do not intend to imply that people don't need help for exam stress)
Is there any time in history that would have been better though?
Whether it's true or not, in this time there is a pervasive feeling of hopelessness and impending doom. These things aren't unique to our time, other people have rightfully felt them. But also we do feel them now, even if you think we shouldn't, even if the data, when looked at in a certain way, indicates we shouldn't. My limbic system just doesn't care.
Examples include: more equality; more opportunity; less democracy; reducing gun accidents; less stress; and less teenage parenthood.
Many of these problems have been around for a long time. For example, the US has long been unequal and long been a democracy. Teenage parenthood has actually been falling. The fentanyl epidemic is relatively recent. You cannot explain a change by a constant.
I would support more intellectual humility and attention to the evidence in thinking about this terrible problem.
Edit: oh it’s illegal unless you’re in a very specific position that will likely not save anyone unless it’s very lucky thanks U.K. government. Dickheads.
Unaccountable policing strikes again, this time by running organized crime importing fentanyl.
My theory is that this is why there is so much more fentanyl. If you think of a street level hard drug dealer, other than law enforcement, his biggest problem is the churn of his customer base due to overdoses/prison/going clean. The logical consequence of preventing overdoses is that his customer base will have less churn, expand more over time, and be more profitable. The effect of that is that organized crime becomes a bigger business, with all that entails.
Nowadays someone ODing means your stuff is cut with fent, which isn't good marketing.
street dealers aren't that sophisticated in my experience. If there's competition they just kill each other. They don't have to worry about demand because addiction handles it for them. All the actual street dealers i've encountered ( quite a few in my 20s ) were basically the equivalent of a vending machine.
edit: well i will admit one clever setup i saw in old East Dallas. A drug house started taking copper as payment for drugs because, at the time, copper scrap was very valuable. So like the dealer would take a bunch of copper pipe in trade for drugs. It made for a rash of ridiculous copper thefts, like breaking into and stealing all the wire out of the walls in apartment construction sites.
- The best customers are newly minted addicts. They still have jobs, personally property, and friends and family who trust them. They can spend massive amounts of money quickly.
- Over time, these customers lose access to money as they spiral into addiction. They lose their jobs, run out of things to sell, and run out of friends and family to steal from.
- Eventually, they end up breaking into cars, stealing from businesses, mugging people, and committing burglary.
- This increase in crime attracts the attention of the general public and law enforcement.
- Drug dealers, in order to refresh their customer base and start the cycle over, distribute a 'hot' batch of product that kills off many of their customers.
Not sure how sound this theory is, but I thought it was interesting.
Many of the Hays County kids who overdosed thought they were taking Xanax or Percocet; instead, the pills turned out to be counterfeits laced with fentanyl. Fentanyl is easier and cheaper to manufacture than natural opioids. It’s also much stronger, and can be unevenly distributed in counterfeit pills, making dosing more difficult
Unfortunately, we're starting to face a new monster named Carfentanil, and that monster is Narcan resistant.
That said, the move to make it OTC will definitely reduce the deaths. At risk people, can now keep it readily available. In the cases where there is someone able to call a medic for their friend, and wait for a possibly too late Narcan application, that person will simply be able to administer it immediately.
As Wiki mentions, carfentanil is powerful enough to be classed as a chemical weapon. It's time this message was widely broadcast.
(If addicts know they're taking carfentanil and risks associated with it then it's indicative of how powerful a hold the drug has over them.)
Might as well ban the sale of Purple Shoes as well, who knows how many lives that could save...
However I still don’t understand the point of lacing drugs with fentanyl. As a drug dealer you make more money with living clients, right?
An analog to the tech industry would be the universal frustration with end user data collection vs its continuing proliferation.
Most of us don't like the lack of privacy online and how much data companies capture, and many if not most of us work at companies that aren't capturing end user data. But many if not most of us, do make tools that are sold to companies who do capture an insane amount of user data. Ultimately, we still are often paid, at least indirectly, through privacy-violating user data collection because it's an extremely common web monetization model.
I'd be willing to bet that there more than a few Facebook engineers on this forum who unironically complain about the lack of privacy on the web. But what pays their salaries?
https://www.wsj.com/articles/fentanyl-crisis-fed-by-flow-of-...
The chemicals are still making it to Mexico from China, that is still easy to track:
https://www.cnn.com/videos/world/2023/03/08/fentanyl-pipelin...
https://www.texasstandard.org/stories/fentanly-drug-path-chi...
Etc...
TLDR; China is still the source for the vast majority of fentanyl in the states (a lot of it is seized in Mexico in containers that come from china, though they get around this by just shipping a lot of it), and no one (including China) is really claiming otherwise since it is just too obvious ATM.
I didn't see this in the article. I read that Barnett didn't realize the trend until after a few events - but I didn't see anything indicating a lack of empathy. It's possible to both be emphatic and think an unfortunate event is a one-off caused by external factors, for which a policy change is not necessary.
No one is intentionally mixing fentanyl and MDMA or cocaine but with poor lab work it's easy to get a bit of the wrong whitish powder and the people selling it down stream have no more idea than their buyers what's really in it.
Affluent recreational drug connoisseurs can use basic chemistry and test kits to be highly confident what they're taking but even they get bit sometimes if reckless and using a new source.
Anecdotal: I have had many exposures to the illicit drug markets in my areas throughout the years. The symptom of many underlying unresolved issues I am sure, but that is not relevant. What I wish to say is that I have seen many pressed counterfeit tablets in my lifetime and have had the luxury and wherewithal to test a majority of them before usage. I have personally never identified fentanyl in a product that was not marketed as an opioid. With illicitly manufactured oxycontin and its ilk you will come across it a majority of the time. But with other things such as MDMA, ketamine and such it's incredibly rare to see. That is not to say it doesn't happen however, there have been instances of things containing fentanyl which had no business doing so. Despite this I echo GP's claim that it's largely due to inadvertant cross contamination than it is some intentional reason. The supply chains for these drugs are very long and windy once they are finalized for consumer use inside the US as well, with many middlemen making a few dollars to facilitate a transaction. Each of those hand-offs is one more opportunity for the new seller to say "I bought X, but could sell much more if I said it was Y", and that ends up killing people occasionally too.
Hypothesis: There is a number of factors at play here that add to the death toll. There is the occasional unintended cross contamination during production. It's also worth noting that individuals who import bulk drugs from overseas for their own sales often order multiple different substances and craft them for sale, further increasing the chance for that contamination during production. There is the fact that fentanyl and a majority of it's analogues are active at shockingly low doses relative to more classical opioids, which makes improper distribution of active ingredients into the final pill mixture highly likely when you consider they are usually not created with the best quality control procedures or equipment. There is the fact that younger users (I would argue they are more experimenters than users per se) of opioid drugs have less physical tolerance to these chemicals. We should also consider that youths also have less practical experience, and not knowing the "lay of the land" with these substances can kill you very easily. And then of course the obvious increase in the average American's listlissness, hopelessness, economic uncertainty, fear of the future and so on. The ground under our feet is shifting and drugs are a temporary respite from that, if harmful long term.
Add to this the fact that we have a very drugs-illiberal society on the whole, whose governments oftentimes think the best way to address this problem is simply banning substances or once in a while executing operations to damage the supply chain, while completely avoiding the idea that perhaps most usage of these substances is symptomatic of a problem and not the problem itself? And you end up with an firehose of drug analogues that can escape easy regulation and restriction juuuuust long enough to gain a foothold in the market and shift the consumer culture of a particular drug. It's not a problem you can legislate your way out of, and it never will be.
All of this is to say I expect US overdoses per capita, the "never-before-seenness" (and by extension lack of medical knowledge surrounding it) of the drug analogues on the market, and the overall appetite for drugs of dependency, all to continue increasing for the forseeable future. I wish it wasn't this way. But like most of the US' modern cultural issues we enjoy arguing about what could offer relief far more than we do finding a bipartisan way to address them.
To anyone reading: Please don't take this at face value. The article itself has a story of someone who OD'ed on fentanyl that was present in their "xanax".
From reading the results from the harm reduction tent at a nearby music festival it's in all the drugs, not just opiates
And yeah, don't take what I say at face value. I'm a nobody on the internet with one story out of billions. Test everything. Every single time.
I graduated high school in the mid 00's. When I last ran the numbers in 2018, my graduating class of ~250 had lost roughly 4% of its people over the years due to OD.
I deeply want this set of problems to get better, but I cannot convince myself that it will during my lifetime.
Puzzling over how we reach bipartisan without ever getting to the agreement part.
> However I still don’t understand the point of lacing drugs with fentanyl. As a drug dealer you make more money with living clients, right?
I don't get that either. Maybe the dealers actually want their clients dead. Or maybe they're incompetent.
I always assumed the dealers knew they had terrible cocaine and would lace it with fentanyl to give it more of an effect. The problem is that such a small amount is lethal so it doesn’t get mixed well enough or they just put too much in.
No idea if that’s why.
The "tranq" additive that's becoming endemic in streets drugs doesn't respond to narcan either. It's only going to get worse. Wait till carfentanil gets into the supply.
We'd have to sell it cheaply enough that the black market wouldn't under cut it. And I can't see this every passing in america. Maybe if every congressman in america had a kid who almost overdosed?
Too bad more people don't know how or don't have access to darknet markets. They are a panacea for drug safety problems.
The average street drug user won't have capacity to learn how to order from darknet markets and may not have an address to receive it either.
Wealthy, tech literate demographics get their drug of choice safely while the poor or the youth getting drugs from "friends" or dealers keep filling body bags.
https://www.dea.gov/sites/default/files/2020-03/DEA_GOV_DIR-...
I don't really know how I would go about it, but I think the only solution is to make people not want to turn to the drugs in the first place.
Make poor people less poor? Make people feel better about their lives and prospects?
I guess I would spend a heap of money working out what makes people turn to the drugs and try and help them solve those problems some other way.
There are rules for safe drug use. There are test kits (today, back then they were expensive) and most countries gladly have drug checking places as well.
The issue aren't the drugs but the culture and knowledge around it.
There is no "culture" here. It's just some kid getting a pill from a friend at school. They're not going to check it for safety.
I think those are two unrelated issues. There's many places in the world where people have substantially less than in the US but have much higher life satisfaction and extremely lower rates of drug addiction.
> Effective May 1, 2019, China officially controlled all forms of fentanyl as a class of drugs. This fulfilled the commitment that President Xi made during the G-20 Summit. The implementation of the new measure includes investigations of known fentanyl manufacturing areas, stricter control of internet sites advertising fentanyl, stricter enforcement of shipping regulations, and the creation of special teams to investigate leads on fentanyl trafficking. These new restrictions have the potential to severely limit fentanyl production and trafficking from China. This could alter China’s position as a supplier to both the United States and Mexico
For what it's worth, China as a whole (both the people and the government) remember the Opium Wars quite well and are thus strongly anti-drug: stats are thin on the ground, but by all accounts drug offenses are the top reason for the death penalty. Of course, it only take a few factories to churn out vast quantities of the stuff, and the profits are sufficient to lubricate any officials who might otherwise object.
So the flows look much different now. The precursors are shipped to Mexico, where fentanyl is produced in small labs, often trained by Chinese associates, and then shipped to the USA.
Same thing, more steps, more plausible deniability. What's the diff?
That won’t solve our problem because Mexico will buy chemical precursors from Brazil, India, or any of the large chemical companies in Mexico. The labs are already there (invested capital) and the chemicals (marginal costs) aren’t specialized.
So the “solution” has changed if you want prohibition. I mean, we’ve tried prohibition for 70+ years now. It doesn’t work. But we can keep trying!
I'm not sure that our dabbling with legalization is a panacea either. Maybe we should aggressively try both at the same time. Extremely harsh punishment for dealers, decriminalization for users, well funded treatment for anybody who wants it.
> Directing blame at Mexico is also a way to avoid looking at how Texas fails children.
But also includes anecdotes like:
> When Noah awoke from his coma, he was tearful and apologetic. He thought only a few hours had passed; it had been four days. Janel and her husband called treatment centers, but none would take Noah without his consent, and he insisted that he didn’t have a problem. Even so, Janel was hopeful; that summer was one of the best they’d had as a family. Noah was dating a sweet girl, and when he wasn’t with her he seemed happy enough to hang around the house doing TikTok cooking challenges. Then, the first week of school, sixteen days after Janel gave birth to another son, Noah overdosed at his girlfriend’s house.
It seems to me that if a child overdoses, but refuses to accept their parents demand to seek treatment, they should be denied privileges - forbidden from spending time with unapproved friends, denied a cell phone, denied allowance, etc. This case (and a few others) seem to be clear cut cases where a parent could have forced compliance, but choose not to - I can't imagine any kid choosing no friends and no cell phone to avoid going to one hour per week of narcotics anonymous.
Let's not forget that attending substance abuse classes is the recommend medical treatment for substance abuse, a medical problem. Doctors wouldn't recommend it if it didn't work sometimes. Imagine if the story was about a broken leg instead of substance abuse and the child similarly said they didn't feel like anything was wrong with their leg, and so it similarly went untreated.
That's quite different from consuming synthetic opioids in elementary / middle school. The former is fairly common at colleges and universities in the west. I'm glad that you were able to dodge that bullet though.
> I don't know that such cautionary tales would necessarily have helped this child, but they might have
They certainly didn't for me. Adolescents aren't necessarily known for their ability to accurately weigh long term consequences when making decisions.
> is the recommend medical treatment for substance abuse, a medical problem
AA and NA would like to disagree. Spirituality is the central component of these programs.
> Imagine if the story was about a broken leg instead of substance abuse and the child similarly said they didn't feel like anything was wrong with their leg, and so it similarly went untreated
A broken leg would be painful enough to spur anyone to seek treatment. Consequences from substance abuse and experimenting with drugs often don't manifest as quickly or as obviously.
The bottom line is that putting further shame on a person who is abusing substances, often leads to the further abuse of substances. This was the case with myself, and most people I encountered throughout my trips to AA / NA meetings, rehabs and a halfway house. I didn't start getting better until I began loving myself enough to stop wanting to slowly kill myself. Punishing or shaming a child who is suffering or simply comitting a mistake, is most certainly not the key to ending their suffering or helping them to realize their misstep.
We know there are better and more effective ways (Sinclair method, or even just reading The easy way to stop drinking), but they don't have the cultural heft that AA has.
A large part of the problem was not having my own social group from being grounded for a full year when I wasn’t getting all my homework done.
Would you blame yourself if your 3-year old overdosed on Tylenol he grabbed from your medicine cabinet? Would you blame yourself if your 17-year old daughter chose to commit suicide by grabbing a bottle of Tylenol from your medicine cabinet?
a lot of immigrants have a tough time with this general concept - they have no idea what it's like growing up in the US, none whatsoever. it produces wildly bi-modal outcomes. the ones that end up on the bottom of the curve are left scratching their heads, because they're ego-driven/stubborn or stupid, or both. and plenty of the outwardly successful kids have issues later on.
also the reason i'm not going to have kids. i don't think i could handle it, and this isn't the sort of thing you get another shot at.
Furthermore, rehab would not have fixed my conditions that led to addiction. I turned 18, my father moved out, I immediately found better things to do with my time now that I was free to plan my own day. And I never struggled with addiction again.
I don’t think rehab would have helped, because it couldn’t solve my actual problem.
https://trone.house.gov/2023/01/08/chinas-role-in-illicit-fe...
If your ordered a dangerous substance, and it arrives clearly labeled, they've done their job.
If you are putting it where you shouldn't, it's on you.
They say those who don't learn history are doomed to repeat it. Well here we are and it seems the CCP's learned from the past. Have we?
Sure it could be cartels, it could also be snowbirds bringing meds from Mexico to people in the north. You and I don’t have conclusive evidence of either.
No idea. I'm certain it won't be limited to that county for long. I assume the cartels are selling it to somebody who is then selling it at the schools or at a local hangout that the students go to.
>You and I don’t have conclusive evidence of either.
Trone said “99 percent of the fentanyl is coming from precursor drugs from China, and then it’s manufactured by two cartels, the Jalisco and Sinaloa Cartels, and they’re the ones that are bringing it across the border,” adding that it’s important to stop it from the source.
This is from the government report I linked up above. That's what I was going on. That seems fairly conclusive evidence if you trust the report.
As an aside, further down the linked article this is stated:
Fentanyl is coming from Mexico, but it is most commonly brought through ports of entry, by U.S. citizens.
They don't cite any evidence, so I'm not sure where they came up with that, but it directly contradicts the government report I linked.
Only took me 2 years to get a prescription for a common but off label use for one medication.
What does it mean?
The prescription opioid "epidemic" re: Purdue et al was exclusively or virtually exclusively non-fentanyl opioids.
I gist I get is that cheaper-to-produce counterfeit pills laced with Fentanyl are causing accidental overdosing because people think they're taking something else.
And the bogus pills are wildly inconsistent in the dose they deliver.
Before I'd only heard the complete bullshit from Fox News that Fentanyl laced Halloween candy will kill your children if they even touch it.
I bought a THC vape cartridge in a non-legal state several years ago, right around the time when there was a spike in hospitalizations and deaths around fake THC carts. My guy promised me that it came from Colorado, but I googled the brand name from the packaging and quickly discovered that it was counterfeit packaging that anyone could buy on Alibaba. Maybe my guy knew that it was fake, maybe he didn't. But that's the crux the black market, unless it comes from the earth, you can't really know what it is you're getting.
Same difference. Why do the suppliers think it's smart to poison their product?
When your product is consumed by people who are at one point or another in the process of killing themselves, it’s all churn all the time.
Dealing opiates is a high volume, high frequency business. If cutting x or y with fentanyl both saves significant money and even helps you extract some more transactions from the customer before they OD for the last time, it’s a business advantage.
The market for junkies seeking out “high quality opiates” is vanishingly small. People get hooked on fentanyl, literally want it, and then it’s game over.
Basically death is where the high growth is.
If so, that's a very clear explanation I actually haven't seen stated so simply before.
At some layer of the long winding black market route, people will be cutting drugs with any sort of lacing to increase profits, they might be dealing with multiple different kinds of drugs in high volume and use fentanyl to cut their heroin/opiates to get more potency out of less product. When using some tool that wasn't cleaned properly and still has residues of fentanyl (which has a ridiculous high ratio of potency vs dosage) it ends up getting mixed into other drugs.
I was a private yacht chef for 6 years. One yacht guest was the biggest condescending jerk so I made him what he said was the best food he has ever had in his life and thought I was putting in the extra effort to impress him. Diplomacy is telling someone to go to hell and make them look forward to the trip. When I liked guests they ate much more plain simple food. If I serve the most perfect Foie Gras, Beef Wellington, and Creme Brulee to a person am I breaking the law? Heart disease the biggest killer in the United States. I haven't worked on a yacht in over a decade and I'm still very close with one family I worked for, for whom I cooked very healthy food. I have joked during that time the reason I cooked healthy plain food for them was that I liked the job security knowing they will be around for a while. One of the many reasons I became a software engineer instead of working in restaurants was guilt feeling like a drug dealer while I ate healthy food which I cooked for myself and friends. Don't get high on your own supply.
With heroin, you can eyeball an appropriate dose even if it’s 100% pure.
You cant do that with fentanyl.
Since fentanyl is so strong, it's pretty easy to screw up the cutting and people end up dying occasionally.
It can take time to get the full picture, even for people directly involved.
- ease of availability
- teens being too trusting of other teens
- teens having too much time on their hands and not enough vision of the long term
Parents have a lot to do with this, naturally, but of course some of these teens have only one parent, and others have two working parents, and there's only so many hours in the day.
I spoke to a few folks I attended rehab / lived in a halfway house with, and those who had been using fentanyl said that nothing compared - subs, heroin, morphine, you name it. The first time I went to rehab, the majority of people there were there for pain pills and heroin. The second time around, almost all the opiate users were using or had at least tried fentanyl.
The problem with subs and methadone, is that it gets into your bones and both substances are addictive in themselves. Trading one addiction for another, even if less harmful, never works out well. Drugs being illegal isn't the problem here - I used to think that if the US followed in the steps of Portugal, the country would be much better off - we're talking school age kids here though. They're not thinking about legal consequences nor are they going to seek out help. They're going to try something out of boredom, some sort of mental state or because their friends are doing it, and with fentanyl many are going to end up dead.
It's easy to understand why kids are becoming increasingly despondent and increasingly turning to drugs for an escape. They don't have a chance to grow up before the weighty issues of the world are thrust upon their shoulders. Between social media, the news cycle, and the education system in our country - they're being done no favors. When they can't handle the load anymore, they often have no one to turn to as their parents are busy working to sustain a family. It's going to require a reckoning (for all of humanity) of what is truly valuable in life - chasing a dollar or being present.
Reading the headlines, seeing the billboards, hearing the stories on the radio while driving is all pretty surreal. I'm not sure what the solution to the problem is, other than making sure one's children know that they are loved and being the best parent one can. I know for me, fear is what caused me to use and that fear manifested itself in many forms - mostly a dissatisfaction with reality. I pretty much had to reshape my entire perspective regarding my existence and reason for being, before I found a way to move past my substance abuse issues. I'm not sure how you help a child realize there's more to life than what can be perceived with our five senses, and that every life is worth infinitely more than a pill or a fun time, but I suppose I get to figure this out with my own son.
I hope that we can all show one another a little more love in this world, and that we can also stop being sold on so much fear.
Many of them sought help for it. I did not - I quit cold turkey after my third mild overdose. I had access to a nearly unlimited amount (>400 pills) left over from an earlier surgery.
For me opiates were a very effective relief against terrible emotional pain. I think just being there for your son a lot, including him in your activities as much as you can, treating him like an adult that you accept, will go a long way to immunizing him against addiction.
It’s important that your son feel it’s safe to bring his shameful actions to you for hands-off advice and support.
Oxycodone should never be a default medication. Suffering through the pain of recovery from an injury or surgery is better than what I understand the suffering from oxy is.
However, it was an ideal drug for emotional pain in later years and I was extremely functional on it. Much more functional than I was sober.
Obviously pain medication needs to exist but they don't have to be that powerful. It is normal feel pain through recovery and puts good markers on your own improvement process. How are people supposed to listen to their body signals if we numb everything?
What the actual fuck? Was this some kind of surgery with long term pain that needed to managed (over a year?) and you slowly built up excess pills, or was this really the quantity that some doctors were prescribing (hence the lawsuits)?
Drugs being illegal is a huge part of the problem here. Because it's manufactured with essentially no QC, fentanyl dosage varies hugely from pill to pill, it's being sold as other drugs or adulterated into other drugs, etc etc.
If adults could get their drugs legally, it would almost entirely eliminate demand for illegal fentanyl and thus prevent it from making it into the hands of kids. Sure, some pills would still be diverted/stolen etc by kids, but at least it would eliminate the class of problems where pill #1 gets you high and pill #2 in the same batch kills you
There's already a wide variety of substances kids can legally get their hands on to get high with. Some are available for purchase at your local gas station, and are much cheaper than a Percocet. The drugs are being sold TO kids in this county, it's not a case of kids getting it from their parents. There are dealers in the schools selling the fentanyl and advertising it as other opiates. These dealers aren't getting it from their parents either, they're getting it from suppliers who are bringing it in from Mexico.
> Because it's manufactured with essentially no QC, fentanyl dosage varies hugely from pill to pill, it's being sold as other drugs or adulterated into other drugs
The fentanyl isn't being manufactured in the US and thus is not subject to any US drug regulation or quality control. It wouldn't eliminate the class of problems you're suggesting either as it's being purposefully pumped into the US. Drug users are always looking for the next best high - they don't stop because something is legal. It's eventually going to stop working for them anyway because, tolerance.
I never claimed they weren't. My point was that if it was just about kids wanting to get high, they could easily find one elsewhere, for cheaper and most likely it would be easier to obtain.
> Dealers in schools selling hard drugs exist because the cartels have the economies of scale to produce and smuggle opiates in huge quantities, which their adult customers consume in huge quantities and pay (in aggregate) huge amounts for
I don't disagree with this point.
> If that adult demand goes away because they can get their hard drugs legally and safely elsewhere (the Swiss model), it is no longer profitable to peddle fentanyl in junior high bathrooms in exchange for a teen's lunch money
I'm pretty sure people living in Portugal / Switzerland aren't legally buying synthetic opioids like fentanyl, and even if they are - the investment into social programs like substance abuse treatment, education and mental health, dwarfs whatever the US invests in these areas. Decriminalizing / legalizing all drugs or the manufacture and distribution of said drugs, is not going to solve the opioid epidemic in the US.
Drug addiction and death are profitable and there is much incentive for policy makers to preserve the status quo. The lack of social programs and infrastructure is arguably a larger hurdle we'd need to overcome before legalization would bear any fruits. Not every country is a Switzerland or Portugal and you can't just lift and shift and guarantee success. Even the countries that have implemented these types of policies have experienced increases in opioid use: https://www.thelancet.com/journals/lanepe/article/PIIS2666-7...
Now, I am glad I don't have a kid. This world is ruthless - and I speak with the sword of layoffs hanging on my neck because that's how the system is designed.
Kids are given less hope for their careers and futures. They have to deal with constant training fearing that one of their classmates could pick up a gun and kill their friends or teachers. Parents (and especially the more toxic kind) encroach more on schools, handcuffing them from providing aid, taking away books, telling them exactly how to behave even when such behavior causes no problems. Schools get less funding for teachers and support staff so when kids have issues or need help they struggle to do so. Then there's the increasing squeeze that lower and middle class parents see where even if they are supportive and love their kids, their daily lives get a little bit worse every day.
It shouldn't be a surprise that they're anxious messes. But fixing it requires recognizing that America is broken.
"Don't take drugs" is a good start but reminding kids that they're playing in hardcore mode only goes so far -- even the good ones get unlucky or make bad decisions...
[1] https://thehill.com/newsletters/health-care/3924952-fda-appr...
Teach them basic pharmacology, dosage calculations, and give access to free test kits to know how strong the stuff they're about take is.
This doesn't solve any societal problems at a grander scale, it doesn't improve the mental health of teenagers, and it won't eliminate overdose deaths entirely...
But it will save the lives of some children who haven't had a chance to really live their life in the first place. It will give them time to look for help they didn't know they needed.
how are you going to get children to measure micrograms
From there you’re measuring concentration, which opens a host of options from community labs to minimal test kits.
children measuring the concentration of something that can kill if you breathe around it wrong
i think you're on to something
Yes, illegal drug abuse is still an issue here, but it's nowhere close to major contributor of death and crime.
For a large variety of reasons, the Singapore model doesn’t work here. It doesn’t even work across all of SEA. The Philippines have banned drugs for a long time, but they still have 2-3 million people who regularly use illegal drugs. 4% of Thais have used illegal drugs in the past year, and both countries have very strict laws about drug trafficking.
The “SEA Solution” isn’t even a universal solution across SEA!
I mean FFS we found out we were completely wrong about the prohibition on marijuana here in the USA. and Alcohol. What’s next? MDMA?
They all had severe drug problem in the 20th century. They all have drugs get you an express ticket to firing squad, and all of them don't have major drug problem today.
As for Philippine, they are close to failed state since 80s. Drugs lords are rampant, Duterte despite being frowned upon many philippines like him since he's only man are willing to do something about it.
The place to bomb would be Mexican border states and I’m not sure anyone wants about Iraq 2.0 in our back yard. An ex Mexican police/reporter I saw on podcast claimed the US military was the only one who could stop it.
Fentanyl lab: https://youtu.be/jZFjV9BRyNw
The labs are smaller now and operate very lean so if one gets busted they have 5 others.
> If it was a 50/50 if vodka killed you we would murder and imprison until it wasn't.
I urge you to look at what actually happened in the US prohibition era.
My bias, I have type 2 ADHD.
This sort of issue is a community problem but the West is so geared to the individual I don't see this being solved.
I mean, it (fentanyl) exists here, but is relatively rare for now.
We have large numbers of opiate users, most of whom are not the "homeless drug addicts" you would expect (though we have fucking loads of those).
We also have a massive number of people hooked on benzos and similar drugs, which here are almost all "legit contents, but dodgily branded generics from Asia".
Again, the vast majority of these addicts you wouldn't notice/know about.
From the data I've seen, in the US and Canada, both opiates and benzos are supplanted by fentanyl - fake benzos that are actually fentanyl, fent sold as oxys, sold as heroin, etc
The quality of heroin here tends to be pretty low, so whenever a stronger batch arrives there's often a number of deaths or near fatal overdoses.
Once fentanyl starts showing up in any significant amounts, there's probably going to be a fucking massive spike in overdoses.
The opiate problem here is only getting worse too, the governments been sitting on its hands and various plans to try deal with it besides just arresting people have languished in committees/planning for as long as I can remember.
Pretty much daily when out walking in a residential area I come across discarded syringes, the frequency of which increases the closer you get to the city center.
I regularly see users nodding off or shooting up in public, and that's just the visible ones. Seen a fair few OD's too, called ambo for a couple.
Narcan and similar aren't really accessible here - our health service has made a lot of noise about an access program, but the iron grip of the regulator won't simply make it OTC for private persons to purchase without paperwork.
Supervised injection rooms and such have also stalled out entirely due to nobody wanting one near them. Which is a bit daft.
If you walk around central Dublin, Temple Bar, etc, you will see dozens of people openly using "hard" drugs on the street. That is where the addicts are. So building a facility there makes sense, right? The local businessmen disagree, due to magical thinking that if its built somewhere else, the addicts will move. They won't.
I'm almost glad that the worst we have to contend with (for now) is the crack epidemic finally hitting our shores.
lol politicized everything. clueless people making statements, nothing good will ever happen. what can you do but laugh at this point to cope?
https://nytimes.com/2023/02/20/nyregion/sudden-deaths-overdo...
It's the most serious issue facing the country, and we have 0 idea what to do. It's 30 9/11s a year worth of death and misery. https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2021/...
In other words the US numbers are roughly 50x as bad.
I mean... If you vote to let violent criminals out of jail in the hopes violent crime will go down, something is missing up there. This has been my universal experience with democrat voters. It is what drove me away from the party. They'll trust 'experts' ridiculous advice over their own common sense. Most of them are extremely partisan, and will quickly label any independent candidate as a Republican, which is enough reason to not vote for them.
Either way, democrats have been in charge of cities for years in this country and it simply hasn't turned out well.
I often align with democrats on fiscal policy, but the voting bases inability to use common sense reasoning and their overuse of the cliche of everything being 'complicated' has driven me away
Border security is very much a partisan issue, with the far-right being very much opposed to freedom of movement.
Even with the CBS "slant" for migrant support, they do say this:
"According to the DEA, most of the fentanyl is smuggled over land across the U.S.-Mexico border. Smaller amounts are smuggled by air from China."
(TikTok is also available in France btw)
With a steady supply of heroin, there is no demand for synthetics like fentanyl, and dealers dont need to sell fake heroin - they can sell the real thing.
So the question is why?
I argue it’s because heroin is so plentiful there is no need and if you try and sell fentanyl people will stop buying from you.
Essentially unsafe drugs aren't popular. Available but not mainstream.
Here in Switzerland they get clean heroin from the state, not surprised fentanyl is still a niche phenomenon.
Darknet works like Amazon, but unlike Amazon reviews are usually real. Bad actors get blamed.
If they do, and there is a known risk, why did nobody in the distribution chain use a $15 test kit to verify the quality? Someone must have bought a few hundred pills at once to redistribute them, $15 and 5 minutes wouldn't matter.
Or general save drug use. You have a pill you haven't tried yet. No way to check properly. So you only take a bit and see if it turns out as expected.
This fentanyl thing is new and wasn't a thing when I popped pills. However there have always been dangerous pills. We've checked them, online, at labs, in person and small doses. If they were shit we throw them.
I believe the main difference is culture. We were aware of the dangers, we had mobile labs at parties and flyers about the current bad pills.
(Other than that Xanax and prescription drugs are nowhere as popular in Europe than they appear in the US)
Also worth noting in my state possessing kits design for testing for illegal drugs is a felony. [note: not legal advice]. No one reputable is going to risk a felony to sell drug testing kits for shitty margins.
https://www.azleg.gov/viewDocument/?docName=http://www.azleg...
https://dancesafe.org/drug-checking/
That said, how many users actually test every single drug they purchase? Especially if they are addicted and using multiple times per day?
This is part of the solution which is sorely lacking in many US states but it’s not some catch-all solution to drugs. It’s basically a better version of Methadone which has been available widely in the US since the 1980s.
I recently watched Sid and Nancy about Sid Vicious and him and his girlfriend are getting Methadone at a pharmacy in 1980s NYC before he later relapsed and offed himself.
https://www.imdb.com/title/tt0091954/
It’s important no doubt but moving beyond the prohibition drug war approach (which is failing in places going hard as it is weak like Canada) to dealing with this requires a serious reckoning and public investment that we aren’t ready to accept yet but will be imposed on us whether we like it or not.
There are lots of contradictions here. Voters don't understand how they can be asked to liberalize hard drug use (and even decriminalize dealing) on the one hand, and are asked for billions of dollars for drug addiction treatment on the other. In Seattle, we have a particularly bad mess, where the biggest thing now is trying to fentanyl smoking off of public buses and light rail. They are even talking about studying the dangers of second hand fentanyl smoke to bus drivers.
Hopefully we can learn something from our neighbors up north, but frankly it doesn't seem to be that much better in Vancouver.
The burnt peanut butter smell is pretty rancid. Voters, even in Seattle, only have a finite amount of empathy to spare on this problem, and it has mostly been expended.
> It is expelling fentanyl users from society and expecting that will stop new users appearing. That's why they don't want to spend money on treatment or services. They think enabling the existence and recovery of existing users will encourage more.
We (King County at least) spend around $100k/junkie per year on services. And that still isn't considered enough. So should we double our property taxes or something to spend even more money on this problem?
> They think enabling the existence and recovery of existing users will encourage more.
If Seattle is the only place these people can get help across the whole country, that would definitely occur. You can't fight a national problem with local resources and not expect distortions (people are mobile).
The war on drugs has failed miserably (for it's ostensible purpose (to "protect" us from dangerous drugs).
We need to legalize and regulate them all, and make their abuse a medical issue rather than a criminal issue.
For those that have no desire or ability to quit, we can put them in camps and hand out dope to keep them sedated and "safe" from questionable supplies. If they want to get clean, they can have the support to do that but otherwise are effectively interned on work farms.
This is the cheapest, safest, and most humane way of dealing with this problem.
That will never exist but you will destroy the humanity of yourself and others in an attempt to delude yourself.
If they could get high without causing problems I couldn't care.
We are going to spend money on them one way or the other; my way would be far more effective than how it happens today (both in cost and in actual remediation).
How would this destroy my (and others) humanity? It's currently challenged by watching people live in tents, shit on the sidewalk, and pass out in public on dope. How is my suggestion worse?
> around $100k/junkie per year
Absolute nonsense. We spend nothing of the sort. We are not even pretending to approach it. Sounds like you're getting your hot takes from Christopher Rufo misinterpreting the Puget Sound Business Journal speculation a couple years ago.
The lies spread by Rufo and his ilk certainly contribute to the unwillingness to do anything, by making people confidently delusional about what currently exists.
It's also a timing issue. I think a lot of people that are currently in the "just get rid of them" camp would have been in the "let's help them rehabilitate" camp when the problem was in small or controlled scale.
But we are way passed that. It's a downright epidemic and needs to be dealt with in more drastic and immediate terms for some of us. I'm not going to wait 5 years while my children are innocent and in school and wandering around for the problem to get better. I want my neighborhood safe and clean and innocent for them now. This is why suburbs popped up on some level. People just want to be left alone and in relative calm and clean surroundings.
It's easy to communicate this: We spend billions to incarcerate people for drug crimes, and then send them out with a criminal record that pushes them right back toward drug use. OR we spend fewer billions on drug addiction treatment and housing. It's not confusing or contradictory at all.
People who end up in prison don't get help, and people who get help don't end up in prison.
"Voters" wouldn't be confused if certain interests didn't keep them confused. It's profitable to keep housing scarce and prisons full. Until we start prioritizing sick people over profiteers we won't fix this problem.
Not sure prohibition is the correct approach but let's not strawman the other side of the argument.
True, but how much time does the average non-addict spend in drug rehabs? Both prisons and rehab facilities isolate addicts from the general population.
but mostly a better chance of not going back to the sending state's prison.
California’s prison population has been stable since 2017.
13 of 35 state-owned facilities operate beyond capacity.
Source: https://www.ppic.org/publication/californias-prison-populati...
It isn't even less money, we passed that mark a long time ago. The average junkie in Seattle costs King County around $100k/year (w/o making any progress on their addiction), while we can put them in prison for around half that. This isn't about saving money anymore, its about throwing money into a bottomless pit and seeing nothing improving at all.
> At the same time, according to the Puget Sound Business Journal, the Seattle metro area spends more than $1 billion fighting homelessness every year. That’s nearly $100,000 for every homeless man, woman, and child in King County, yet the crisis seems only to have deepened, with more addiction, more crime, and more tent encampments in residential neighborhoods. By any measure, the city’s efforts are not working.
For incarceration costs:
https://www.doc.wa.gov/docs/publications/reports/200-AR001.p...
About $110/day (so $40,150/year)
Often these funds go towards housing people so they are no longer homeless, so you might have X people who are currently homeless, but Y people relying on that $1B to remain housed.
Because of that, it's inaccurate to divide $1B by X and then claim that's how much going towards individuals who are still homeless anyway, when it is more accurate to divide that figure by X+Y.
It isn't like that money is being flushed down a hole, results are being had on an individual basis, but for reasons that are nationwide in scope, the overall problem (# of homeless people on the streets of Seattle) isn't getting any better.
National problems require national solutions, but half the senate is perfectly happy to offload the cost of social ills onto coastal metros.
Think about how monumentally worse the problem might be if they didn't spend that money. There are very likely tens of thousands more people who would be homeless if not for government support/programs. Just imagine how many people would be on the streets in a week if EI and disability income streams were cut.
In fact, the author encourages services to drug addicts near the end:
> With a secure emergency shelter system like that in San Diego, the county and city governments can reroute existing resources and “flood the zone” with on-site treatment options for the homeless. For addiction services, we should prioritize recovery programs and terminate policies like safe-injection sites that draw addicts from other cities.
I think you're assuming for some reason that these folks are just having fun.
A solid majority of these people were abused as children, which at least from those I've met certainly wasn't their own choice.
We, as a society, as responsible for this situation, because we allowed a company to turn hundreds of thousands of people into drug addicts, and let all of the company executives walk away without any repercussions.
We have two options, both of which are bottomless pits:
1. Do nothing, and pay the costs associated with drug addicts being left untreated (shelters, prisons, run down portions of cities, lowered property values) 2. Treat people
One of those options may cost a lot, but it also improves everyone's lives. I don't understand why this choice is so hard for some folks.
It won't happen though, because of regulatory capture, and general lobbying / corruption.
We need to address the source and the problem at the same time. Regulatory capture doesn't really apply here, but lobbying (which is synonymous with corruption at this point) definitely does. Fixing the citizen's united issue would be a proper start at addressing the lobbying problem.
If you were a doctor would your response to a patient in unbearable pain be, “Sorry, can’t help you”?
Tying success to "progress on their addiction" is also puritan brainworms, sorry.
A lot of US stuff seems to rely on punitive monitoring and "you relapsed, back to square one" nonsense, like a game of snakes and ladders. But with a body count.
Some people will never recover. Some will. Some will take fucking ages.
Being an addict and being a mostly functional, productive member of society are not mutually exclusive.
The actual ways to start fixing this problem are unfortunately, rather unpalatable to voters despite being cheaper in the long run.
Here's the thing. Heroin is dirt cheap to make at a controlled quality - its used in hospitals as diamorphine for end of life care, and some other uses.
State supply of heroin to heroin addicts is a policy that has been tested in the UK, Switzerland, Netherlands, and elsewhere at various points and it fucking works.
Decriminalization of possession with referral to addiction services is a policy that has worked phenomenally in Portugal.
Housing-first policies have worked out fantastically in Finland.
Putting supervised/safe injection rooms and needle exchanges in areas where addicts actually are (as opposed to where they are not) also works to reduce issues like people nodding off on the street, smoking up on buses, needles being discarded everywhere, etc.
Another point to note: the vast majority of addicts don't want to be addicts.
Those who do get off the drugs often relapse.
A vanishingly small minority don't want to get off the stuff.
Safe consumption spaces with state supply, clean needles/pipes/works, etc can effectively act as onboarding for users to engage with further services and progress along their journey to reintegration into society.
Get people into those spaces. Get them into supported housing.
Become their drug supplier, so they are no longer engaging in criminality or at risk of contaminated supply.
Don't make "being sober" a requirement for progression.
Aim to get them into "own door" independent housing with engagement with social services.
Help them find paid jobs and start supporting themselves, reintegrating into society.
Offer rehab/treatment, suboxone, etc.
Basically, TL;DR - offer them dignity and agency, and you will see far greater success.
End rant.
Or something like that. At least the first half. Most of us here are engineers, scientists, and tech leaders who can see how disruption can make a better system. But a lot of people see the opioid crisis not as health crisis but as a moral dilemma.
The actual “baddies” would lose their funding if you cure the junkies. The problem is the system as it is is profitable for other more socially acceptable “baddies” who stand to lose out. e.g sacklers
At it's core this is a social issue that is swept under the rug for decades since the real solutions requires harsh reform that will likely destroy careers for pursuing it.
Drugs are a strong form of control, not just for the peddlers but to appease the masses from their painful reality, something that certain branches might like with AI and stuff reducing the usefulness of labor.
The solution is to promote this alternative narrative, something which is happening now thanks in part to successful activism and better education, but also an increasing wariness on the part of the public on the true motives behind public drug policy. I don’t think it’s a pure coincidence that this is all happening at the tail end of the opioid pandemic!
The root of the sickness often extends far beyond the individual into society. That's what many people don't want to look at or acknowledge. They insist on casting blame on the victim, and keep creating more victims.
https://standardebooks.org/ebooks/samuel-butler/erewhon/text...
It's ironic that Christianity says they should do exactly that.
I don't have a strong position on drug laws, as I don't live in a city that's devastated by drug use. I just wanted to weigh in on the meaning of that parable.
The point is to contrast retribution and discrimination with rehabilitation and empathy. Christianity very much endorses the latter option at least as long as the other is part of the in-group.
But maybe the in-group and out-group separation is very much the point of these laws since the war on drugs (started by Nixon) is a direct continuation of slavery after peonage was ended by FDR during WWII.
Do you have any justification for this? It seems an utterly bizarre take on the face of it.
> “You want to know what this was really all about?” he asked with the bluntness of a man who, after public disgrace and a stretch in federal prison, had little left to protect. “The Nixon campaign in 1968, and the Nixon White House after that, had two enemies: the antiwar left and black people. You understand what I’m saying? We knew we couldn’t make it illegal to be either against the war or black, but by getting the public to associate the hippies with marijuana and blacks with heroin, and then criminalizing both heavily, we could disrupt those communities. We could arrest their leaders, raid their homes, break up their meetings, and vilify them night after night on the evening news. Did we know we were lying about the drugs? Of course we did.”
Family members of Ehrlichman reject the veracity of the quote but I see no reason to since it is not about himself, it is about Nixon and his policies. There are some more voices questioning whether he was lying but even those voices admit Nixon was racist. I think it matters not whether introducing those laws had racism as a primary purpose, or whether they "coincidentally" aligned with a hidden agenda. Prohibition might not have had the purpose of creating a mafia network but failure to foresee that and failure to promptly react when the negative side effects of a law become apparent still matter. Prohibition in the US lasted 13 years, the US war on drugs is ongoing since the 70 even after other countries like Portugal demonstrated it is cheaper and more efficient to focus on rehabilitation.
If you mean the second part, see FDR's Circular 3591 from 1941-12-12. September 1942 is when the last slave in the US was freed. Nixon was elected a few decades later.
Feel free to explain which part is an utterly bizarre take.
I don't know which is; it just appears that way. It would be that the war on drugs was a continuation of slavery, which I don't think you've mentioned
It's a continuation in the sense that it is a manifestation of the same social illness.
Ugh, no, don't argue in favor of my beliefs this badly. We know what slavery is, and creative redefinitions only make you sound dishonest. Slavery, real slavery, still exists in the US, and we don't have to make up weird definitions to say that.
Slavery still exists in the US, legally. The thirteenth amendment says:
"Neither slavery nor involuntary servitude, except as a punishment for crime whereof the party shall have been duly convicted, shall exist within the United States, or any place subject to their jurisdiction." (Emphasis mine).
This is a massive loophole, and one which has been taken full advantage of. By criminalizing things which shouldn't be criminalized, and then enforcing those laws unequally, you can effectively enslave a large portion of whatever group you want to.
In some cases such as Angola prison, the prisoners/slaves are literally forced to pick cotton for no pay. In other cases, the prisoners/slaves are paid some small amount: this is better for optics, but these same prisons easily recover the money by vending basic necessities at gouged prices: if you pay a seamstress $1/hour and then charge her $10 for a tampon at commissary, that's not pay. Prisoners can't shop elsewhere and can't work elsewhere.
And to be clear: the work isn't voluntary. Refusal to work is punished with solitary confinement and sensory deprivation--and that's if they bother to comply with the law instead of just beating prisoners who don't work or paying another prisoner to shank them. With little oversight, there's little stopping prisons from doing this.
In addition to lack of oversight allowing abuses of power, it also allows unsafe work conditions. Prisoners/slaves are unable to report unsafe conditions to anyone, and when unsafe conditions occur, there's no incentive to fix them.
Prison slavery is used by a variety of industries. JCPenney and KMart use prison slavery to manufacture clothes, IBM uses prison slavery to assemble circuitry, Wendy's and McDonald's use prison slavery to process foods.
As an eastern European, for whom high school had almost nothing to say about American history (other than WWII) and afterwards I originally learned the usually parroted variant only to later correct the knowledge I had, I am baffled again and again every time when learning new things about the putrid fractal that is slavery in the US. I was never even that curious in the first place.
I did hear about the prison industrial complex but I had no idea about the "Angola" and how close this gets to slavery called by a different name. Reading about it now. I believed that while for profit prisons were inhuman, prisoners were not used for forced labor. I always kinda assumed that meant that prisons received so much money from the state they even made a profit.
That major western brands make use of it feels nauseating. I believed this was stuff we were criticizing China for.
I hope we (as humanity) will get over punishment for the sake of punishment. It is a power tool to steer people away from harmful behavior and I don't think we can stop using it altogether anytime soon but it should be used to the extent it actually changes people's behavior - longer sentences not necessary better in this regard than shorter ones in combination with some re-integration program. And if we can prevent antisocial behavior without punishment why not at least try?
And it’s an island country with only a single airport, a couple ports and 2 bridges into the country and the death penalty for smuggling. They throw a ton of resources at trying to stop it from coming in in the first place.
If they cant stop it, i dont know how a country like the US with thousands of miles of undefended borders can.
The U.S. is failing to stop multiple TONNES of drugs. (actually >100 tonnes if you look at DEA extrapolated figures). Border policy is clearly non-existent.
But I believe he claims rightly, since the statistics match for Singapore's population and drug abusers. Please note that Singapore also considers cannabis as drug abuse.
Report: https://www.cnb.gov.sg/docs/default-source/drug-situation-re...
Not to say opioid abuse is less, but its way more than youd think considering the governments stance.
This is silly nonsense. There is no crime that can be made to zero. There is definitely crime that can be severely mitigated. You are throwing the towel on border security. Please don't make up stupid figures like trillions of dollars. Our border security budget is a fraction of the "Ukrainian War" budget. Exceed that first and you are free to complain.
Understand the scope of the problem first and you'll be free to think about how to meaningfully address the border situation.
No need for additional drug scanners at our ports or a border wall to reduce cartel trafficking. Who cares if tens-of-thousands of bright teenagers die of drugs being sent across the southern border ? We need Ukraine to crush Russia. RAWR.
"You know we're shipping military hardware to them and not pallets of dollar bills right?"
Ah.. but you are quite mistaken there. We are not just shipping military hardware. There is $30 billion in financial aid alone - and even far more being planned this year. Wow - thats more generous than many U.S. states receive for disasters.
Sure, the US could check 50% of it. But are you willing to pay 10-20% more in the cost of everything due to the subsequent inflation?
"The United States has appropriated approximately $115 billion in emergency funding to support Ukraine since February 24, 2022."
The Trump border wall cost is $12 billion. I think ~1/9th is a tiny fraction right ? I don't mean milli-fractions or micro-fractions, just tiny.
And btw, that $115 billion towards Ukraine is expected to grow quite a bit further in 2023/24. Who knows - it might become a milli-fraction or micro-fraction eventually.
Ukraine received about $7b in 2022.
$12b does not look like a tiny fraction of $7b.
A fairly conservative source is here:
Bilateral aid to Ukraine between January 24, 2022, and January 15, 2023 https://www.cfr.org/article/how-much-aid-has-us-sent-ukraine... .
This by itself $76.8 billion in committed aid and does not include all U.S. spending related to the war. And newer appropriations made just after Jan 2023
The non-conservative estimate: https://www.crfb.org/blogs/congress-approved-113-billion-aid... which adds upto $113 billion in 2022.
https://usafacts.org/articles/how-much-money-has-the-us-give...
Please do that for border security in the U.S. Like Ukraine, there is utterly NO need to transfer all the money in ONE big bang - can do the same in chunks. As long as the "border aid" is allocated in chunks - we can have better drug scanners at ports, more personnel and patrols, more funds to care for actual migrants (as opposed to drug camels), investigative teams to track down drug-routes and personnel involved, etc
The M113s we sent to Ukraine, we have been trying to dump them on ANYONE who will take them because shipping them across the world is literally cheaper than cutting them up and making them not a weapon anymore. The stryker program is done, and the vehicles will be replaced. We don't want to keep any of these vehicles, because unlike Russia, we think using 20 year old machines to fight a modern war would be extremely embarrassing and pathetic.
We haven't spent a hundred billion dollars helping Ukraine. We spent trillions of dollars over the past many decades buying stuff to kill the soviets and blow up the desert and we have nothing better to do with them. We literally have thousands of Abrams and Bradleys sitting all over the world, being worked on every week to keep them in tip top shape, that we would rather replace before we think we have to fight China.
Russia's best is being torched by our TABLE SCRAPS.
Quit parroting the narrative of people trying to deceive you.
It would be better if the state's were allowed to do more on their own borders but it's a federal thing and therefore impossible. Texas has the money and will to do a lot of border enforcement on its own but it's prohibited by law.
Your prime issue is corruption, not drug use
my cynical take, entrenched people have something to gain by the grey area decriminalization offers.
* Hasn't reduced drug use
* Makes them more likely to continue their drug use
* Often leads to the use of harder drugs
* Is expensive
* Provides funding to cartels
* Causes violence
Decriminalising, or legalising drug use removes one of the main motivators of gang formation/violence while allowing the state to focus on helping addicts recover and contribute to society. The money spent on enforcement can now be spent on treatment, reducing the need for further funding rather than increasing it.
Personally, I believe the legal supply should be delivered by the state. With a focus on providing monitored, unadulterated doses of the safest alternative and a program aimed at weaning the user off in a sustainable manner.
that achieved 0 results in 40+ years of drug warfare with millions dead and the rise of international cartels who are as powerful as nation states.
This is not the way, complete legalization is the only way to break the power of cartels.
You don't have to legalize the drug, simply giving it to existing junkies for free by prescription for a while would allow you to break the cartels. Also, actually do break the cartels like Ecuador is doing, with life sentences or death.
The problem with the methods we've used is that we've used them piecemeal and inconsistently.
Once the pushers are gone you force the junkies into rehab. Then when there's no epidemic you could actually legalize to prevent a black market from returning.
Portugal tried. In 2001, they decriminalized the possession of all drugs for personal use and started treating drug possession as a medical issue instead of a criminal issue. Ever since, Portugals rate of drug addiction and drug death is below the EU average. The policy is considered a success. It reduced harm for the addicted and at the same time, reduced the social costs of drug addiction. The rate of HIV, Hepatitis infection and other side effects of drug addiction dropped significantly.
See https://transformdrugs.org/blog/drug-decriminalisation-in-po...
Now, they didn’t just legalize drugs, but put the money they saved on the enforcement side into rehab, clean needle and other flanking programs, essentially “giving” it to the addicts. This may seem unpalatable to many, but the outcome is a win for everyone.
They use the criminal justice system and the underlying crime of public use and unsafe intoxication to force you into rehab, which is the very definition of criminalized.
It should be obvious when reading a story about Portugal that they couldn't get the junkie to stay in rehab voluntarily, so obviously they don't mean "no potential of a criminal charge at all".
Whereas in Vancouver they specifically changed the rules so you can buy and do drugs in front of the police, pass out and almost die - get revived and smoke more drugs, and have no charges, no special detainment, nothing.
What I haven't found is a single short and simple article that explains for ... people like you, that what Vancouver/Seattle/Portland/SF and Portugal mean by decriminalization is not the same.
You have been told something exists, that's 95% of the way there. Now go to a search engine and type 'vancouver drug decriminalization' and 'Portugal drug treatment' and read about the issue.
You're trying so very hard to use me to justify your ignorance and to be insulting in the process.
> what would the criminal record be
Public intoxication, possession, etc.
> everything I saw previously was correct and they indeed decriminalized all drugs
They haven't decriminalized public usage. You can have your small amount of drugs if you do it in private and are discrete.
> This goes against the claims that you previously made that they did not have a decriminalization
It's a system of not giving you a criminal record by using the mere threat of the criminal justice system for force you to voluntarily enter rehab. So you have to do what they say but then they don't label you a criminal and they sort of pretend you went into treatment on your own.
In the words of the guy who invented and runs their system:
"There are a lot of myths around the Portuguese model that, for instance, we just liberalize you do whatever you want, nobody cares ... It's important to say that using drugs in Portugal is still prohibited under the law ... If somebody in Portugal starts injecting heroin in public [...] he would be arrested and conducted to the police station. The substances would be apprehended. If they have more than the amount that is calculated on the basis of personal use he undergoes criminal procedures as before. If he has less than that amount he would be intimated to present himself to the commission. It's not a court, it's not a formal institution, but he will be confronted to discuss his drug use with professionals. It's mandatory, with a little bit of muscle you have them in front of you. We can try to understand what is happening with this person. For each hundren people that is conducted through those commissions, ten of them are problematic users." -- João Goulão - National drug coordinator for Portugal - https://twitter.com/ShellenbergerMD/status/16412220666858455...
This next part is where you have to read between the lines a bit. They don't come right out and say that they can't arrest junkies for junking in public - you have to understand that they wouldn't pass a bylaw to make it happen if they didn't need to which means that in the rest of the cities they would not arrest and move them proactively.
Here's a typical article about Vancouver BC's decriminalization - https://archive.is/f2Q0k
"Police forces across British Columbia are finalizing training on new drug laws that will limit or entirely cease their interactions with people who use drugs as the province becomes the first in Canada to decriminalize simple possession."
"While many police departments have in recent years moved away from arresting and recommending charges for possession alone, officers will now also stop confiscating illegal drugs"
"at least one city is preparing to introduce a new bylaw that would re-engage police if people use in certain public spaces."
From which we learn that 1) they won't be able to arrest at all for drug possession, 2) they won't even be able to confiscate dangerous drugs, 3) they won't even arrest people for public use (unless cities pass a bylaw overriding the province.)
In Portugal they will arrest, and will confiscate, and will use legal powers (if you push them to it) to detain you. In Vancouver they can not arrest, can not confiscate, and will not engage the criminal justice system at all.
Portugal is saving lives by using the courts, Vancouver is getting worse with every loosening. Seattle and SF are roughly the same as Vancouver.
Only now as of January 31, 2023 are police in Vancouver supposed to stop confiscating drugs. we're only 3 months into this new era.
Vancouver/BC didn't have decent recovery programs, and not enough capacity even in the bad programs, and critically - no legal capacity to force someone into them even if they did. People can be detained for up to 72hrs and "dried out" but that merely lets some of the detox pass, it's not at all related to kicking the drug and recovering from addiction. Even when they want to be clean the city usually houses them in a drug hotel where peer pressure drags them back in.
Arrest and seizure are valid tactics, Portugal proves it, despite Vancouver failing to apply them properly as part of a holistic program.
There's a published list [1] of illegal substances and what quantities constitute as "personal use" (like 25g of weed or 5g of hash - translated in "individual doses"). More than that you can be trialed for drug dealing, which is a fair trade-off.
Yes it's still illegal to possess any of these substances, but what happens is that if you're below the "criminal" threshold, you get a doctor/shrink appointment and usually pay a small fine (around 25 euros). Nothing gets written to your criminal record. Repeated offenders might have more several penalties like community service.
Recently there's been a surge in homelessness and harder drug consumption, analog to the rest of Europe, due to a huge housing crisis, very stagnant salaries and overall poor quality of life here (in Portugal).
[1]: https://dre.pt/dre/legislacao-consolidada/decreto-lei/1993-5...
Here, decriminalized is uncontrolled. You can buy your fentanyl in front of a cop and do it in public. Cops can't arrest you for it. There is a maximum amount but it's huge! Pot is still limited though, and you can be arrested for having more than an ounce but you can't be arrested for carrying enough fentanyl to kill an entire building of people.
This has been done so that there's no way to force people into rehab, so they're a continual source of income for the taxpayer funded "charities" that provide for them.
Cutting the supply off without any alternatives absolutely caused harm. However, that only serves as evidence that safe and legal means of procurement are better than illegal ones.
If there had been a network of state dispensaries to provide safe regulated doses and support, over-prescription could have been stopped without leaving the victims to fend for themselves.
I'm not disagreeing about access to treatment, but just to be clear I don't see much intersectionality there with stopping the black market. For so many of them it becomes "sweet I can buy my black market shit, plus get whatever the addiction center place offers me on top of that."
That's the best outcome. In Canada the legal drugs they gave the junkies ended up being sold by mail to other parts of the country.
Not only are street drugs inherently unsafe, the dealers view their customers as so expendable they're willing to kill them for advertising.
To fix this we've got to switch to government supply, but only when we simultaneously wipe out the illegal supply and suppliers, so that we don't simply compound the problem. Our interventions are like antibiotics. They lose their power over time when misused. They're best employed heavily in a cocktail and used fully.
And the government has decided that drug users are on palliative care, that they're never expected to improve, so they can be given drugs that are likely to end or destroy their life without any concern for recovery. That sounds 'caring' but in areas without this assumption they actually do rescue many people from this death, making the 'caring' cities into uncaring hellholes for the addicted - where they go to die on the streets of a preventable death.
There is no fear of 'famine' because the people who are being given drugs are being given drugs for the rest of their life. There's no fear of running out because even if the government stopped the supply the street drugs are only a few dollars.
What these excess drugs do is 1) increase the amount of drugs the person is taking and/or 2) get sold outside of the drug cities, both of which increase the scope of the problem.
Also, druggies don't need money because they can just take whatever they want from stores and at most will be forced to give the item back. They're given food and shelter and drugs and can steal any luxury under $1000. (Not that they'd be punished above that, but the stores aren't required to sit and accept it - they can apply reasonable force to recover their goods.)
The way 7 year olds are kept out of rushing rivers, or consuming black market dope, is they have a parent, guardian, foster caretaker, someone looking after them. It's illegal to neglect a child. Sending a 7 year old to buy you cigarettes arguably isn't neglect, letting them smoke cigarettes or research chemicals probably is.
Because without a steady, safe supply, people are still going to continue overdosing.
[edit] I like your username btw... I actually said that to someone tonight... a man, a plan, a canal; Panama. The couple stared at me until I said "palindrome" and then I'm pretty sure they thought I was crazy.
Easier access to drugs sounds humane but it's exactly the opposite.
Legalization + safe supply might not reduce the occurrence of people using (or at least not right away), but it will provide better overall outcomes for society. If we address the systemic issues which cause so much suffering (which is why we're seeing so much addiction), and also provide treatment options, people will be more inclined to seek out those options.
I assume you're familiar with the Rat Park findings? (https://en.wikipedia.org/wiki/Rat_Park)
We are increasingly spending more on drug treatment. The current approach has failed and <x> are dead. It's time to change our approach, and a radical change is needed for this massive problem.
That depends on the voters.
In the 90s Switzerland experienced a significant change in its drug policy.
One of the pillars (arguably the most important) is harm reduction. At that time hardcore addicts could get heroin prescribed and paid for by health insurance. Getting into the program was not simple, but for those that were hopelessly addicted and not able to kick the habit it was fundamentally successful.
The policy is still in place and was confirmed with significant majorities by the voters in multiple referendums.
And understandably so. It's a textbook example of privatizing the profits, and socializing the costs.
It's not enough to tax drugs. Certain products are so harmful, and their harmful use so profitable, that allowing any kind of private profit from it at all is a disaster. (Yes, the most prominent of those are tobacco, alcohol and gambling).
Worse, addiction treatment is really expensive and not very effective - even the best addiction treatment programs have high relapse rates. Even the relatively cheap programs that only seek to limit the damage addicts do to themselves and others, can only be defended on humanitarian grounds, not economic ones.
Yes, we need to help addicts. Yes, including in purely harm-reduction ways. But we're deluding ourselves if we think this is a solution at all, let alone one we can afford if we let private economic interests profit from addiction without obstacles.
They are just the victim of right wing propaganda
And British Colombia is have record numbers of fatal overdoses, so while a tool, its not a solution to the crisis.
I should also note that being in favour of harm reduction doesn’t mean tolerating Portland style appeasement of crime and public …craziness. The baby is often thrown out with the bath water with this stuff and it doesn’t have to be that way. But that overreaction goes both ways in terms of dealing with the drug problem.
Additionally, the actual treatment provided varies considerably between doctors. Do they give the patient enough to avoid severe withdrawal? Do they allow the patient to stay on buprenorphine long term if needed? How do they handle relapses? What sort of counseling or therapy do they provide (if any)? Do they take insurance?
https://www.statnews.com/2022/03/07/doctors-companies-push-t...
I wont argue there are some barrier, but it’s not hard to get anywhere in the US.
Then because you're not just putting a bandaid on it you have the funds available to actually get people off the street (and not just into shitty drug hotels) which is one of the biggest obstacles to getting sober.
The sad fact is that most people who would benefit from it simply do not have access to it.
Low cost, or even just free if you register as an addict.
Same for naloxone/narcan/whatever "overdose stopper" autoinjectors. Which, I'm reliably told, are the opposite of a good time.
Suboxone is not a drug you can really abuse in any fun way, and a lot of folks won't engage "formally" with addiction services due to stigma, paranoia, worries about their medical records being tainted forever, etc.
The addicts you see on the streets are just the tip of the iceberg. Much like alcoholism, the vast majority of users are "hidden".
There are multiples more users who are still functioning within society, holding down jobs, etc.
I agree that there's a huge problem with opiates and am in favor of legalizing everything, but it's good to realize that buprenorphine is not a magic candy that fixes everything - you're just replacing an addiction to a deadly feel-good opiate with an addiction to a slightly less feel-good opiate with a larger therapeutic index.
[1]: https://www.euronews.com/2023/03/16/why-are-so-many-young-fi...
In another comment I went into a bit more detail around ways of dealing with the issue, using Finland's homeless housing policy as part of it.
Its a complex issue that certainly isn't going to be resolved through the criminal system.
Despite its miraculous efficacy for addiction treatment it certainly has some recreational potential and the long lasting opioids used for maintenance are a bitch to quit. Many people stay on the stuff for life because while you can taper down it's really, really hard to drop the last bit. While milder than with the fast-acting opioids, the physical withdrawals go on for weeks. With heroin or fentanyl they're over by day 3 or 4 and it's all mental after that.
In my ideal gay luxury space communist world most drugs would be available for anyone after a doctor's consultation where you learn basic harm reduction and such. Currently people abuse OTC medications or buy fentanyl laced stuff of the street to get high even though they're absolute trash for that. Safer options exist.
Not sure about where you are, but in the countries in EU/UK I've lived, OTC can mean either "behind the counter" (where you must speak with the pharmacist), or "in front of the counter" (you just pick it up and buy it).
Depending on country, different drugs are sold differently.
In Germany and Ireland, to buy normal antihistamines or pretty much any good OTC painkiller, I have to request it and usually get asked some questions, depending on the drug, whereas in the UK I can buy the same medications in Tesco.
I'm also of the view that a lot more drugs should simply be available via the model of informed consent or just "available by asking for them".
Waiting weeks and paying 60 euros for a GP to toss a coin on if they are going to agree with you about a medicine is a nightmare.
Though that may be due to the broken health system here making me wait 4 weeks for a GP appointment so I could get a fucking salbutamol inhaler after my asthma came back, among other things.
Interesting aside, the "mental" addiction can be harder to kick than the physical. Some former opiate and gabapentin users I know have mentioned this - psychological cravings for even years after stopping. Anyone who has ever tried quit nicotine will also know this.
Oh yes for sure, didn't mean to make it seem like it wasn't. I was(/am) a poly drug addict from Finland. Buprenorphine and amphetamine were my jam for a couple years. One year of using intravenously daily. It's been years since my last time but I still think about shooting up every now and then. It's a deviously strong urge. But the mental battle doesn't only start after the physical stuff is over: at the beginning they both compound on each other and it's absolutely devastating when you've been awake for two weeks because of the restless legs...
I was a recreational user and managed to keep things under control (except spending all my money) for many years. But in those circles most people are a bad influence on you. Eventually it all just spiraled out of control. It was so easy to keep slipping deeper a little at a time while taking steps in the other direction felt enormously hard.
It's been about 6 years since I last shot up. Everything's going really good now. Granted I'm not sober by AA standards; I still smoke weed, and drink a couple of beers every now and then, and do psychedelics maybe once or twice a year. Whenever I start feeling blue.
https://www.fda.gov/news-events/press-announcements/fda-appr...
Buprenorphine just makes opiate dependence more manageable. It doesn't make you not dependent on opiates and it doesn't make you stop wanting to change how you feel. And given it also doesn't much change how you feel, if you want to change how you feel, you'll stop taking it.
Addiction is a predictable outcome of inequality and lack of social safety net in the US. If you don't give people any way to solve their problems they'll settle for feeling better about their problems. We only help people if it's profitable to do so. The war on drugs just gives people more problems. The changes we'd have to make to fix the opiate epidemic are a lot more fundamental than giving people more manageable opiates.
that's actually one of the things buprenorphine and methadone help with, but as you point out it's easier for that part to work if you have a good life already
"More manageable" is a very creative way of saying less deadly, I congratulate you on your turn of phrase.
In all seriousness though, buprenorphene has a number of benefits aside from being difficult to overdose on. It lasts much longer and lacks the euphoric effects of other opioids. People on buprenorphene tend to get their life back together, and if you're truly concerned about getting someone off opioids that's a much better starting point.
Opiate addiction doesn't give a damn about the size of your bank account, your social class, or how loving your family is.
The president's own son has struggled with addiction. Heck go back in history and you'll find the roots of the Opium war in China are tied to the emperor's own son dieing from an opium overdose.
Opiates destroy people at the neural level.
Yes there needs to be medical interventions for addicts. There also needs to be enforcement actions to reduce the supply of the drugs in the first place. Don't just target street dealers either, this crisis started with Perdue and other big pharma players. They shouldn't be able to wash their hands of responsibility simply by writing a big check.
So do coffee, tobacco, antidepressants and antipsychotics.
https://www.sciencedirect.com/science/article/pii/S131901642...
https://www.pharmacistsmb.ca/files/2001/May-June/Opioid_Indu...
Neurotoxic does not mean “your neurons are damaged”, at least not how those articles define it.
Neurotoxic to a scientist means “can have negative impact to neuron function, whether temporary or permanent”.
The layman thinks neurotoxic means “kills your brain cells”.
From Wikipedia:
> Neurotoxicity is a form of toxicity in which a biological, chemical, or physical agent produces an adverse effect on the structure or function of the central and/or peripheral nervous system. It occurs when exposure to a substance – specifically, a neurotoxin or neurotoxicant– alters the normal activity of the nervous system in such a way as to cause permanent or reversible damage to nervous tissue.
Brain cells getting killed is a normal process, you could call it pruning. Cells grow back, you know!
One year later, with the spare oxy in my closet, do you know how often I take it? Zero times.
These drugs helped me handle, with minimal fuss, massive physical trauma. And for 9/10 people opiates are not addictive. You will ban them and rid doctors of them over my dead body.
> Purdue has known about the problem for decades. Even before OxyContin went on the market, clinical trials showed many patients weren’t getting 12 hours of relief. Since the drug’s debut in 1996, the company has been confronted with additional evidence, including complaints from doctors, reports from its own sales reps and independent research.[0]
> OxyContin taken at 12-hour intervals could be “the perfect recipe for addiction,” said Theodore J. Cicero,[0]
> Patients in whom the drug doesn’t last 12 hours can suffer both a return of their underlying pain and “the beginning stages of acute withdrawal,” Cicero said. “That becomes a very powerful motivator for people to take more drugs.”[0]
Richard Sackler:
> When another family member sent him a press cutting in 2001 about 59 deaths in a single state linked to their drug, he responded: ‘This is not too bad. It could have been far worse.’ Then he asked a friend why addicts deserved sympathy, since ‘they are criminals’.[1]
Preventing companies from pushing doctors to prescribe medication in a manner that encourages addiction isn't anything like saying they should be banned.
[0] https://www.latimes.com/projects/oxycontin-part1/
[1] https://www.spectator.co.uk/article/the-scandal-of-oxycontin...
The opioid epidemic happens because 1/10 is a crazy ratio. It means every doctor is creating multiple addicts a week.
I'm fine with them denying this degree of painkiller to most people so long as ones like me can receive it. From my actual lived experience that it is not addictive, and that all of fentanyl, hydromorphone, and oxycodone were tremendously helpful, I'm not going to go along with this banning stuff.
That said, I agree with you that patients who need these drugs should get them. I had to get emergency surgery a few years ago and they also gave me morphine, oxycodone and fentanyl at the hospital. I find it hard to imagine how awful the experience would have been without medication.
Almost no one is suggesting this medication should be banned. A significant driver of the problem was that Purdue pushed heavily for 12 hour dosing periods despite knowing that the medication wore off in only 8 hours for a non-negligible number of patients. Their motivation for this was explicitly financial.
Patients were faced with following the dosing periods Purdue were strong-arming which meant enduring 4 hours of pain, finally salved by an addictive opiate or taking the medication more frequently than prescribed, running out early, and exposing many of them to black market alternatives.
>Opiate addiction doesn't give a damn about the size of your bank account, your social class, or how loving your family is.
He didn't say that addiction only affects poorer or more marginalized people, he said it's more likely to affect them. Which is true. Yes this means the president's son can get addicted too. Anyone can. Which is why it's a big deal for people with less access to resources such as expensive rehab and medical care
I don't know why this keeps getting repeated. The southern neighbor of the US, Mexico, suffers from greater inequality and substantially less social safety net and does not have any comparable opiate situation as the US.
[1]: https://www.statnews.com/2022/11/16/fentanyl-isnt-just-causi...
(I work for Boulder)
What are drugs for? For most people, it's not as much chasing the high as pushing away the pain. Look at your own drinking for example (not necessarily you, dminor, but many readers). Mind-altering chemicals are overwhelmingly used in the US to numb oneself and push away the pain of daily living. Folks start with a little to take the edge off, dull the fear & give themselves a bit of mental space, not have to think about the bills, and then...
https://injepijournal.biomedcentral.com/articles/10.1186/s40...
> We estimate that there were 110 unintentional firearm deaths to children 0–14 annually in the U.S. during this 8 year time period, 80 % higher than reported by the Vital Statistics. The victims were predominantly male (81 %). Approximately two thirds of the shootings were other-inflicted, and
I somehow feel that maybe the pharmaceutical marketing machine, which has successfully turned drugs into name brands that are recognized by kids, might have something to do with the problem. But what do I know?
https://www.pastemagazine.com/drink/alcohol-history/prohibit...
"Suffice to say, the public didn’t take too kindly to that kind of “it’s their own damn fault they’re dead” reasoning, and it fanned the flames of the growing movement to repeal Prohibition. "
You should probably restrict it to people over the age of 18 like cigarettes
if the market is a government monopoly, you'll likely have fewer problems than if t's run by violent criminals.
Rational people don't want to take street-drugs which they know might kill them because of bad quality. They are seeing a lot of people dying around them so they know.
This is conceptually not that different from methanol-laced alcohol being available during prohibition. Of course nobody wants to take methanol if they can take ethanol instead. Ethanol is very bad as well. But harm reduction should be the thing that guides our policy.
This should be patently evident from the fact that other countries don’t face similar issues.
The U.S. is simply not willing to do what it knows it must do. And worse, the public, using US exceptionalism, simply ignore the fact that the rest of the world doesn’t face the same problems, and so excuses the politicians who tell them that nothing can be done.
https://substanceabusepolicy.biomedcentral.com/articles/10.1...
China learned this lesson during the opium wars, too. They couldn't stop the flow of opium because it would have been terribly unpopular with the people. The script has been flipped with Fentanyl (and to a lesser extent, TikTok).
It remains to be seen whether we actually care about the drugs, though. Simply ignoring their presence may be a legitimate strategy.
Interesting that two very different national legal policies have such similar outcomes among Asians.
Phillipines has experimented with allowing anyone to murder anyone else they suspect of using drugs. That hasn’t significantly decreased the rate of illegal drug use in the country. This is despite making payments to people to summarily execute drug addicts. Thousands have been executed across the Phillipines. I can’t find any evidence that drug use in the Philippines has decreased in the past 5 years.
Care to wager on the fraction of US users of illegal drugs?
https://www.fmprc.gov.cn/mfa_eng/wjbxw/202302/t20230209_1102...
> In 2021, findings by NCDAS show about 19.4 percent of Americans have used illegal substances at least once. Out of the 280 million aged 12 and older, 31.9 million are drug users, with 11.7 percent on illegal substances and 19.4 percent either having consumed illicit drugs or misused prescription drugs in 2020. If alcohol and tobacco users are included, the number of people in the United States who are abusing substances totals 165 million.
> During the past 12 months, 48.2 million Americans over the age of 18 consumed cannabis at least once.
> During the past 12 months, 10.1 million Americans have consumed opium at least once.
Opium is at 3.3% by your number, which is comparable to the numbers I showed on Thailand.
We can both cherry pick data but USA has tried prohibition of various substances for over 100 years. Prohibition by itself caused more problems than it solved.
But I can understand people wanting strong government action, especially in Mindanao which has two different insurgencies (Islamic and Communist) to contend with besides drug gangs. One of my relatives had a work trip (she worked for the national government) to rural Mindanao and they sent her by military helicopter with a squad of soldiers for protection.
On the other hand, countries like the Netherlands and Portugal figured out a way for drug users to not die. That's probably the first thing you should fix: how to help people to not die when using drugs. Educate your population about it, most Dutch people I know are very aware of drugs; their effects, risks, etc.
The cat's out of the box, there's only one level of repression that could have a chance to work on stopping the flow of drugs: maximum repression by the government, maximum shame by the population, is that really what you want? I don't believe that's a solution if you are already in a free society...
> Despite encouraging results, conclusions indicate that these policies are marked by contradictions and ambiguities that have permeated its history since the very beginning, and modest ambitions, particularly regarding the implementation of harm reduction measures. Moreover, the polemical Supreme Court judgment that reestablished, in 2008, drug use as a crime when the quantities at play exceeded those required for an average individual’s use for 10 days, might have impacted the landscape of drug use penalization. The last decade saw an increase of punitiveness targeted at drug users, including criminal sentences of jail terms.
But it's hard to take the article entirely seriously when it acts as if the goal is, in their words, "emancipate drug use from the stigma that associates it either with crime or pathology," and it opposes acting as if drugs are a problem:
> Finally, casting drugs as malevolent agents that allow classifying users as bad or sick (or both) became a fabrication that eases the stigmatization of users and human rights violations.
Yes, there are accidental overdoses where someone takes too much of a prescribed drug without realizing it or accidentally combines it with someone that amplifies the effect and results in death. That’s a different matter.
Many opiate addicts who die of overdose are essentially (oftentimes even openly) accepting they’ll die due to the drug someday. We treat PTSD-affected soldiers as humans who need assistance in pulling through their difficulties before making an irreversible mistake. But we treat drug addiction as a problem regarding the addiction itself, and not that people with troubled circumstances fall into drug addiction out of despair or other difficulties in life.
But I think attitudes regarding this won’t change because the US will instantly shoot ahead of the world in suicide death statistics—in a shame-based society that’s all about saving face like the US, that’s simply not going to happen.
There's life, liberty, and the pursuit of happiness, but what if there's no happiness to go after? There're no jobs to be had, the Earth is dying, Wall Street is taking all the money. Doing heroin is way easier than fixing capitalism.
Anyway, yes absolutely don't be a doomer. I'm not, despite how I presented above. Life's not even worth living with that attitude. But if you're unable to even sympathize with someone else's plight, what are you even doing? How can you help them out of their pit if you can't see it?
What in the world would that accomplish? Does this framing help us reduce these “suicides” ? Or is your proposal a way of helping us think there’s nothing we can do and ignoring it?
On the contrary it seems to me like an extremely unhelpful way of framing the problem.
Treating opiate addiction as someone on the path to suicide would be very different than framing them as a criminal or hopelessly diseased (the “progressive” model of addiction that took over the criminal model). But clearly there’s a lot of opposition to that idea, even here.
Some people hide their addiction well. Some don’t and are surrounded by friends and family who are aware of their struggle but don’t know how to help. It’s in many cases less surprising than people want to think.
Wasn't it a big thing to get people to stop fat shaming?
Covid did a great job of brushing a lot of problems under the rug which are now inevitably popping back up.
I'm not sure how this could ever be measured objectively, but I think a lot of the extra social malaise that exists today originated from the absolutely horrendous and devastating Covid policies especially for the young. And these deaths occurring among the young are far more tragic than any conceivable Covid deaths among the elderly.
I personally think that we're going to be paying the consequences for short-sighted policies for a long time and that ultimately the attempts to fix Covid will have harmed far more people than were helped.
Our politicians would rather feed the drug-incarceration-industrial complex than serve our society at the expense of their rent seeking patrons.
We don't have zero idea what to do: the solution is just something that people who are part of this machine refuse to grok.
Plato wrote in his famous work on democracy that the body of citizens in a polis should not exceed 10000, else the direct democracy disintegrates, and both electing officials consciously, and keeping them accountable becomes hard.
The representative democracy in the US works with 350M people, 240M eligible to vote, is hopelessly part these confines. It's not a wonder that it works not really ideally; it's a wonder that it works at all for nearly 250 years.
The US needs to upgrade the mechanisms of its democracy to better suit its scale. Switching to Condorcet voting or other preferential voting schemes on municipal and state levels in a few states is one such upgrade. Maybe people will start electing more officials who actually care, and who might shake the inadequate equilibria, in drug-related policies, and elsewhere.
Also people need to stop having kids if they are only going to raise them while cute babies and then say "oh well I tried" when they are teens.
I'll try to look at what I've listened to tomorrow and see if I can find it.
We have plenty of ideas. The most obvious one is to begin controlling the areas of the border through which these drugs are entering the country.
Unfortunately that would require an admission by the current US administration that there is a catastrophic crisis at the southern border - one encompassing human, financial, drug, cartel, Chinese, terrorist, human trafficking, and a myriad of other elements. This harsh admission of reality is a current impossibility for the Biden administration and US Democrats.
And just to be clear, the southern border isn't the only point of entry, but it is the largest and most elaborate. There is an entire industry set up exclusively for opioids. Ignoring the human trafficking, slavery, coyotes, and other elements: just the fentanyl trade alone involves at least two cartels, and an international supply chain that includes India, China, and MexicoS[1][2]. The US would be the fourth sovereign participant in that it facilitates a degree of free trade that would make anyone else incredibly jealous.
---
[1] https://www.dea.gov/sites/default/files/2020-03/DEA_GOV_DIR-... Note this is from 2020, and as predicted, the bulk of fentanyl did in fact shift to entering through Mexico, even if the precursors arrive from China and India to Mexico.
[2] https://www.wilsoncenter.org/article/briefing-senate-foreign...
Additionnally, if cartels can't smuggle drugs through the border, they'll build fentanyl shops inside the USA.
https://cis.org/Arthur/Yuma-Reveals-How-Migrant-Surge-Has-Fu...
"..they'll build fentanyl shops inside the USA..."
US law-enforcement would love this to happen. Damn easy to get a court order and bust up. Damn easy to setup informants to reveal such locations. Its like comparing peanut impacts versus asteriod impacts. You solve the critical asteroid problem first. The peanuts don't really make any significant difference.
The 115th United States Congress: Senate majority - Republican, House majority - Republican, Presidency - Republican.
Blame the party not in power.
Further, there's only so much an admin can focus on and they had a variety of other issues. My point stands which is that one party is very focused on this issue and worked towards concrete measures against it, while the other worked against them.
"... Mexico — which has just one gun store and issues fewer than 50 gun permits a year "
https://www.usatoday.com/story/news/nation/2021/08/25/americ...
The war on drugs is great for US gun-manufacturers.
US has a drug-problem. Mexico has a cartel-problem. I think Mexico's problem might be worse, because everybody suffers from criminals ruling the country.
I disagree. Gun deaths are. Children don't choose to use guns typically. Bullets are forced into them by others.
https://www.kff.org/global-health-policy/issue-brief/child-a...
I'm not convinced these things are mutually exclusive. When you break down the statistics, 61 kids between the ages of 0-11 were killed so far in 2023 by gun violence (just typing that makes my stomach hurt...). In comparison, 355 teenagers (ages 12-17) were killed. (1) That's 6x the amount of death in an age bracket half the size.
The huge spike in death rate is largely linked to gang violence. Gangs often start recruiting around the age kids hit puberty. Take a look at the Gun Violence Archive's incident reports on mass shootings, and you find a huge percentage are tagged as "gang violence" and resulted in dead or injured teenagers. (2)
When you hear about "school shootings" happening in America, very few are Columbine style events. Most are gang related, and impact the most vulnerable and poverty-stricken student populations who have the least resources to deal with the resulting trauma. There is a reason poor, inner-city schools are usually the ones with metal detectors at their doors.
Gangs are still fueled by drug sales. Drugs and gun violence go hand in hand. I don't think we can solve one without solving the other.
We desperately need resources and reforms poured into both issues. But I think if we treat them as unrelated problems, we're doomed to fail.
1) https://www.gunviolencearchive.org 2) https://www.gunviolencearchive.org/mass-shooting
A huge amount of violent crime of all types in the US is a figment of drug distributors and dealers, and to some extent users robbing, shooting and beating each other to settle scores.
Hell, just making possession completely legal (none of this "civil infraction" bullshit) so that people can go to the cops when they're robbed instead of getting revenge on who they think done it would be a huge step forward.
[1]: https://web.archive.org/web/20230330052658/https://www.newyo...
If only there was a thing to learn from other countries. That already starts with the basics such as in which amounts pills are available over the counter. From a European's perspective the entire idea that you get pills in a bottle is so wild.
[1]: https://www.opensocietyfoundations.org/publications/mountain...
It's a cultural/religious problem if you ask me.
It’s a cultural problem.
Religion and civic groups are basically gone, with no replacement. We're in these weird atomized suburban bubbles. Seems bad.
People are self-medicating due to not getting the pain medication they need because they lack healthcare. Or they have untreated mental issues. or, if they do have healthcare, they might very well get prescribed super addictive drugs over a long period of time.
I'm convinced the "crackdown" on pills is what led to where we are today. Many doctors won't prescribe pain medication because they're afraid to lose their license or have a DEA raid. People find what they want in heroin and now fentanyl. Why we keep fighting the drug war this way is beyond me.
>if they do have healthcare, they might very well get prescribed super addictive drugs over a long period of time.
I think this is also why we are here today.
In short, substance use disorder is treated as a primary condition here, there’s a massive high-profit industry built around it and specifically treating it using faith-based 12 step methodology so a lot of mentally ill people who use drugs never receive proper treatment
It really is taking advantage of people who are vulnerable. Sickening that that's what is on offer in a "developed" nation.
That's not even getting to the fact that the leading cause of death in children and teenagers is guns[1]
I can't really understand it.
[1]: https://eu.statesman.com/story/news/politics/politifact/2022...
[1]: https://eu.statesman.com/story/news/politics/politifact/2022..."<
No surprise, because the URL contradicts what you say. If omitting certain age ranges is your idea of the truth, please say so up front.
Yes OK, excluding those under a year old. So guns are the leading cause of death in America for those between 1 and 18 years old.
Is that OK now? Defensible now? Did that undermine my entire point? Or are you nit picking to detract from the toxic state of the country?
The programs are faith based and widely supported by medical professionals. Plenty of folks have problems with anything being faith based, but unfortunately there aren’t better alternatives for alcoholics and addicts.
I remember telling my mother in the 90s that my 'substance abuse' was a symptom, not the problem itself. I was self medicating. No one wanted to hear it.
In the time since, it often feels like we've gotten worse at recognizing this. Meanwhile, proper treatment for mental health issues continues to be difficult to find (many if not the majority of so-called professionals are anything but), as well as increasingly expensive and inconvenient. To say nothing of how much of psychiatry has devolved into pinning you to a DSM category and throwing drugs at you in as short of a session as possible-- "come back in 2 months and we'll just as quickly throw some different drugs at you if those aren't working"... rinse and repeat ad infinitum. Anyone struggling to get through each day is not going to be well served by this.
We need at least 10x more therapists willing to spend time with patients and address their many intertwined issues, using logical, rational, evidence based methods. Right now, I don't see how we even start to get there from here.
12 step can be a lifeline for people at the end of their rope who have no other options, but it also inevitably fails anyone who doesn't buy into the narrative about a higher power. [I would argue it fails even those who do, as it teaches powerlessness.] Some may benefit from such an extreme approach, but it is deeply, deeply flawed. The main strength it does have is connecting you with other people and being very accessible. But we can & should do better.
oh indeed. I found myself in the rooms of AA/NA at the age of 19, still very foolish in my youth, confused, pretty desperate. Even in that state I had such a hard time buying into just the first few steps. it all seemed so utterly nonsensical to me and I realized believing in god was a prerequisite I could never meet. for those unfamiliar with the 12 steps of alcoholic anonymous this is how they begin...
1. We admitted we were powerless over alcohol—that our lives had become unmanageable.
2. Came to believe that a Power greater than ourselves could restore us to sanity.
3. Made a decision to turn our will and our lives over to the care of God as we understood Him.
It doesn’t have to mean “God”, and it certainly doesn’t have to be the Judeo-Christian definition of God. It just has to mean “something other than yourself”. It can be the meetings themselves, the cute dog you saw in the dog park the other day who let you rub his belly, the Flying Spaghetti Monster, or whatever.
The idea behind it is that, if your best thinking brought you to rock bottom, and you’ve tried everything you could think of to stop drinking without success, then maybe it’s time to let something else take the wheel.
Again, let me stress that I don’t have an opinion on this one way or the other, I am simply correcting the record here. It wasn’t for me, and I certainly don’t think AA/NA has a monopoly on sobriety. But I had 5 good years of being clean and sober before going back out, and when I finally did start drinking again, it was in a MUCH healthier way. It also helped a lot of good friends, and I’m grateful for that.
This is true. It's also true that AA broke off from the Oxford Group ("kicked out", according to Lois W, the wife of founder Bill W) for being too agnostic. Apparently it was pretty dramatic- see "AA Started In Riots" by Roger C. for more. [1]
> The word god is constantly thrown around in meetings and throughout the literature and, make no mistake, that is a Christian god they are talking about.
The meetings I went to were quite secular. I'm vehemently agnostic, and I never once felt like the people there were proselytizing to me. If they had, I would have left real quickly and not gone back.
Most of the meetings I went to were in SF, LA, NYC, Shanghai, etc.), making it easier to find secular meetings that were run by people like me. Someone living in small-town America might have a different experience from mine. Hopefully with the advent of Zoom meetings, this is now less of an issue, but I can’t say since I left AA before Zoom became a thing.
Each meeting is meant to be independent from the others, and each has its own bent. You'll find meetings for Christians but also meetings for atheists, just like you'll find mens' meetings, womens' meetings, young peoples' meetings, etc.
> 12-step meetings are typically held in churches.
I've been to meetings in church basements and Sunday school rooms, but I've also been to meetings at American Legion halls, recreation fields, City Halls, even the basement of a donut shop.
Consider the cost of running a meeting. Literally their only revenue source is donations from attendees. Giving a donation might be hard for someone who has just hit rock bottom, and it can be expensive to rent a room for use as an Alano Club. Churches might be more likely to cut AA groups a break on the rent.
I don't want to be accused of promotion by either HN or AA, so I won't link to them, but secular AA meetings are plentiful and pretty easy to Google. Secularism is part of AA’s "12 Traditions", as well. [2]
All that said, if AA still feels too religious for someone, there are other groups out there which don’t make use of the “higher power” concept in any capacity. Again, I maintain that AA doesn’t have a monopoly on sobriety.
That’s great you were able to access secular meetings in SF/LA/NYC, but the reality for most Americans is that those meetings you attended might as well not exist, they are elusive, infrequent, and make up a tiny percentage of the total meetings online or otherwise
Having said all that. and while we are nitpicking- it’s probably worth mentioning that “secular” meetings still have 12 steps and still involve handing your will and life over to a higher power of some more palatable flavor (such as “the program”)- so definitionally we are still talking about faith-based treatment. This will never work out well for atheists and that’s the point me and others are making.
Personally I think the non-faith-based centers only exist as a result of severe religious trauma. I’ve met plenty of 12-step alcoholics who make jokes about how bad things like SMART recovery are. It’s a trope on recovery meme sites.
* physical health resources are tied to work-provided health insurance, and are often not great
* lack of the above two lead to easy fixes, like prescribing opioids aggressively
* aggressive anti-drug laws that put more people away than attempting to treat them
* no real safety net if any of the above screw up, driving many to poverty, jail, addiction, etc. $30 of pills might be the only joy or relief from their shitty situation, so pop em if you got em.
West Virginia: 41.5 per 100,000 people
New Hampshire: 34.3 per 100,000 people
Kentucky: 29.9 per 100,000 people
Ohio: 29.9 per 100,000 people
Rhode Island: 28.2 per 100,000 people
Pennsylvania: 26.3 per 100,000 people
Massachusetts: 25.7 per 100,000 people
New Mexico: 25.3 per 100,000 people
Utah: 23.4 per 100,000 people
No, San Francisco is at number 11 on the top 10 in 2020. The rest are below that.Why didn't he mention any of the top 10? Why does foxnews discuss crime in San Francisco and NY so much?
https://www.foxnews.com/search-results/search?q=Baltimore
Same with every other city on that list:
https://www.foxnews.com/search-results/search?q=Philadelphia
etc
Opiod overdoses have devastated rural areas. https://www.usda.gov/topics/opioids
What was your point if not propoganda? Just to let us know drug abuse is bad? Is this new information? Your comment doesn't offer interesting information, a solution, not even a personal experience. That's why I think it's right wing propaganda.
Just like foxnews you repeat something over and over in order to imprint it on the ding dongs who base their knowledge off hearsay instead of facts.
"Oh look a post about something bad that happens everywhere but I can increase the association level with cities run by democrats in order to justify my political support. Because if the opposition is suffering worse than me then I'm not wrong in who I support...even if it's not true"
But I will concede your point. The whole West is circling the toilet bowl but as you point out some areas a little faster than others.
Compared to what?
My point was that you were spewing republican propoganda either willingly or unintellionally
> It is notable that by many measures, policing did not decline with the advent of the four-pillars policy. As Figure 2 shows, policing continued to be very active well after the drug policy changes occurred, though the bulk of arrests since the early 1990s have been related to cannabis use by young persons (Reuter and Schnoz 2009). Relatively few of these arrests, however, led to incarceration and many resulted in administrative fines not registered on a person’s criminal record (Ibid.; Killias 2009).
These pills are MUCH cheaper/widely available than the non-"counterfeit" opioids. And much more likely to spontaneously kill you vs how people more traditionally overdosed. Addicts aren't the only ones ODing.
The "war on drugs" is probably a good thing as far as this goes because making opioids more widely available is not really what we should want in society. I think greater availability of other "party" drugs like ketamine in Europe could maybe help some, but I'm not sure how much.
A culture of widely available test strips + narcan + fentanyl education should be the minimum we should be doing. We definitely shouldn't be trying delusional attempts at limiting narcan availability. Ex:
https://idahocapitalsun.com/2023/03/28/idaho-lawmakers-vote-...
Gabor Mate worked with those dealing with addiction for many years. In his book, Hungry Ghosts, he explains that addiction is an escape from deep psychological pain usually caused by childhood trauma.
The solution, then, is psychological help – something we do very poorly with for addiction right now. This is in part because psychologists often don’t understand the nature of addiction either.
And we can avoid making the problem worse by not trying to punish away pain and instead implementing harm reduction strategies.
If you google things like "When does someone have a drinking problem?", the vast majority of sites will use a really weird and vague definition like "If you answer yes to more than 3 of these 7 statements, you might have a problem". I think this is because we want to draw a (pretty arbitrary) line between what we consider normal drug use and addiction, when in reality it makes more sense to say that everyone who drinks or smokes semi-regularly has a light addiction. Most people manage to more-or-less stagnate on this light addiction, although from my limited experience, I feel like people generally drink ever slightly more as they age, so it is just a very slow increase in addiction, others don't.
The reason why I think this is really important is because a) it reduces stigma; Most of us are more or less in the same boat and b) addicts don't have a fundamental different psychology or life experience. Yes, if you have trauma or a generally bad life experience, you are more likely to binge on drugs, but the reasons for this are quite obvious given the definition above: The narrowing of pleasure comes both from addiction as well as external circumstances.
I agree with you on the solutions though, we need more empathic care and therapy, harm reduction plans, and reduce poverty and the causes of extreme psychological trauma where possible.
Similarly trauma is also on a sliding scale.
Agreed that low-level addiction, even in cases that it may similarly be a form of escapism, is not necessarily caused by trauma. But I think that's actually why addicts are stigmatized. I just need a little more willpower today- a good night's sleep and some exercise is often enough- to avoid addictive behaviors. But for those suffering from severe addiction it's not helpful to think with that mindset. Understanding the root cause has opened me up to truly empathizing to those with addiction- something often lacking in our society.
It really changed my outlook on severe addiction.
Nothing is getting done because the deaths are concentrated among populations that a) don't pay a lot of taxes b) don't have a lot of wealth c) can't easily be manipulated as a homogeneous blob of political pawns.
Basically there's little upside to solving the problem for government, big business, moralizing ideologues and the rest of the usual suspects who weigh in on these sorts of things.
So I guess we're back to the tried-and-true approach of charities putting as many band-aids on the broken leg as they can, politicians spouting empty rhetoric with crocodile tears around election season, and cops policing the affluent neighborhoods while largely leaving the rest to rot.
How do we fix all of this, that might have a chance of actually happening? Capital controls. Make TVs, mixers and smart toasters expensive again, but made in America. We need a full economic ladder, not just the top rungs. College degrees should not be required to enter the middle class, in their current state many degrees don't even provide that anymore.
There are certainly other causes of addiction, but at the end of the day a lot of rehab programs fail because even if the addict gets clean, they're immediately sent back to the living situation that got them addicted in the first place. This is especially true for the homeless, "congrats you're free of heroin, now go back to your tent under the bridge where you live in constant fear of rape from other drugged-out homeless people and no employer will touch you! You're free!"
As for "poverty and lack of opportunity" not being a new thing, no shit. But we've seen a hollowing out of the middle class over the past few decades. So a lot of newly impoverished people who grew up middle class, or are else seeing their quality of life decline through no fault of their own. That is relatively new on the scale that we're seeing it.
And I say this as someone who's immediate family has had some past issues with fentanyl addiction, so it's anecdotal, but I'm hardly just speaking from my armchair here.
Opioid addiction has been a spectacularly difficult nut to crack as long as there have been opioids, and highly related issues like alcoholism likewise.
There's a lot of inputs to addiction. You rightly point out the input of economic dignity, which probably is top of the list from a policy standpoint. And on a public policy basis there's also culture, media, simple availability of the drug, availability of interventions, and many other inputs.
But the largest input to addiction is family structure and dynamics, and it's not even kind of close.
It isn't the end of the world if someone becomes addicted to opiates. There are pathways to recovery and one can live a relatively normal life while addicted. What makes it exceptionally harmful is the amount of fentanyl in street drugs, the legal ramifications of use, and the lack of realistic treatment.
I get it, a lot of people don't like Texas but it doesn't make them wrong.
Opioid addiction is a lifelong curse.
EDIT I read about Fentanyl nowhere other than US media, and it is made in china, and as I say nobody made so much as a peep when perdue were taking in billions