Xylazine, a dangerous new drug fuelling Canada’s opioid crisis
macleans.ca
macleans.ca
> “The tranq dope literally eats your flesh,” she said. “It’s self-destruction at its finest.”
> She unrolled a bandage from elbow to palm. Beneath patches of blackened tissue, exposed white tendons and pus, the sheared flesh was hot and red. To stave off xylazine’s excruciating withdrawal, she said, she injects tranq dope several times a day. Fearful that injecting in a fresh site could create a new wound, she reluctantly shoots into her festering forearm.
> The only person who would let her use a cellphone was a guy whose arm and leg had been amputated because of his tranq wounds. He was still injecting into his leg stump.
If a drug that literally turns you into a melting, oozing zombie with flesh dripping off your bones doesn't make you find a different drug - not even quit, I mean, find a different drug to get fucked up on - I think that person is suicidal. This is some morbid shit right here.
Someone doing this stuff isn't thinking of the endgame any more than an alcoholic is thinking about cirrhosis. They just want to get high. They're not at the opiod buffet picking their fave. They're doing the best stuff their dealer has that they can afford.
It’s not to say being an alcoholic is easier per se, but whatever specific substance a person is abusing is going to be what their body demands to feel relief. If you’re addicted to pain meds, alcohol intoxication isn’t going to be the sensation your body will fiendishly crave.
Highs aren't fungible in the way you're describing. Don't mistake "I begrudgingly took a worse opiod because I couldn't get the one I want" for "I'm fine with anything"
It doesn’t matter because you can’t just push-button swap chemical dependencies.
Try, and you’re likely to end up dead or addicted to both the one you tried to switch from and the one you tried to switch to.
Stick to crypto Monero, I think your talents will be better suited there.
And by the way, the equivalent death of an alcoholic (happens to millions of people every day) would be an agonizing death with gastrointestinal bleeding, maybe cirrhosis, maybe a long period of disability before (which effectivel can mean death if you're homeless)...
As others have already said, you pretend to understand problems which you obviously have not experienced or witnessed at close yourself.
Your "I'd rather be" sounds like "They should rather eat pie" to any person with any kind of empathy or emotional connection to addicted humans.
That being said, yeah, I'll too rather not be addicted, as addiction to hard drugs (including alcohol) means pure agony. Why does anyone "choose" agony then?
Overcoming any serious addiction is a personal, social and medical problem requiring lots resources, luck and extreme willpower.
I'd say, a form of willpower that people comparing addiction to sheer indulgence cannot even grasp.
Beating addiction is not simply a decision, although an individual decision is of course required. Seeing that as the root of the problem is a flawed view from outside that contradicts everything we know about how human brains (and lifes) work.
Or not even that, just to avoid withdrawal symptoms.
The most common cause of overdose deaths is quitting cold turkey as people end up taking more of the drug to compensate the withdrawal.
I think the danger is from relapses long after withdrawal when both tolerance and knowledge of the supply has been lost. In some ways, withdrawal is the easy the bit - brutal but something to fight that gets easier as time passes. The nagging empty hole in your soul with sobriety is harder to fill and drags you back.
To underscore this, the reason we have a heroin epidemic is because our solution to the preceding prescription opioid epidemic was to take away the pills.
Yes [1].
Law-abiding Americans became addicted to prescription opioids (wave 1). We clamped down on their distribution, particularly prescription, and left those addicted with no legal choices. They turned to heroin (wave 2). So we clamped down on its distribution, particularly import, and so got concentrated (easier to ship) and synthetic (no unique precursors) fentanyl (wave 3).
Criminalization of drugs, but not of all substances is a must. Alcohol and marajuana are certainly okay. But again criminalization is the only way to ensure people get the attention they need. We just need to change the way we jail people.
In Thailand you get two options go to jail or go to a temple and get clean.
Reminds me of Krokodil [1].
That said, I just finished listening to an episode of Radiolab [2] describing how unsubstantiated claims about fentanyl causing overdoses through contact may have triggered episodes of mass psychogenic illness [3]. So I'm inclined to take these gory images with a grain of salt, e.g. these may be a wounds that were neglected due to drug use versus unavoidably caused by it.
[1] https://en.wikipedia.org/wiki/Desomorphine#Toxicity_of_kroko...
[2] https://radiolab.org/podcast/good-samaritan
[3] https://en.wikipedia.org/wiki/Desomorphine#Toxicity_of_kroko...
https://en.wikipedia.org/wiki/MPTP https://en.wikipedia.org/wiki/Tryptophan
The mechanism in play for Xlyazine is that it's a relatively powerful vasoconstrictor. So the repeated use leads to decreased perfusion/flow/oxygen in the injection site. Which means wounds in the area don't heal.
So, yes, there's neglect involved, but the cycle is mentioned in the article. They get one abscess, have heard of this side effect, and become scared to inject anywhere other than the wound site for fear of a second abscess. Then that area gets infected, tissue necrosis, etc, and they finally start ruining another area.
Important to remember that the alternative to shooting up is, often, to be cold, and miserable, alone, on the street, with no sleep.
One possibility potentiates the other.
Horrifically, you could even think of drug use as an attempt to adapt to loss of housing.
The backdrop for urban drug use, here in Vancouver, is a profound housing crisis and shortage, and a complete, thoroughgoing failure on the part of multiple levels of government to do anything about it.
https://en.m.wikipedia.org/wiki/Reward_system#Wanting_and_li...
I think you have not even the most basic understanding of addiction, or (perhaps most relevant to this case) specifically withdrawal. If you are addicted, you can’t simply choose a substitute, and particularly you can’t avoid withdrawal from one drug just by choosing another, except for some very special cases.
And I doubt it would be easier to get either since they're unlikely to hand out an unlimited quantity to anyone who pays for it even if it were legal.
2. I think some drugs would become cheaper, and other drugs would become more expensive. Drugs with limited supply would become cheaper as more production/supply chains open up. Think cocaine, heroin, and some pharmaceuticals without large overseas labs. There are inefficiencies in the illegal drug trade that legal trade could smooth over as well: better payment methods, more open price negotiations, legal settlement for disputes, reduced employee churn from violence/arrest, reduced bribes/corruption related charges.
3. Regardless of the price of drugs, the overall price would be smaller, as illegal drug use has huge externalized costs. Everything from corrupt governments to increased health care utilization to wasted law enforcement resources to destroyed human capital.
4. The existence of an available quality tested market would force the black market to compete more on quality.
Tranq is cheaper because it is available for animals, and not 'seizing and destroying something while putting the people who possess it in prison' is a great market force for lowering prices.
Ergo, don't criminalize heroin and tranq stops appearing in it.
We already see this with alcohol. Most liquor is tarted-up industrial ethanol, delivered by train tankers to the bottling plants, with some marketing and branding wrapped around it. Industrial ethanol is very inexpensive to produce, around $1/liter; the price of consumption alcohol is downstream of excise taxes and branding.
Cost is not a relevant factor. We can produce all of these chemicals for so little that it is a rounding error. This is a matter of policy.
Consider the principles from another perspective. The leading causes of death in the US are diabetes, heart disease and obesity related conditions. Should we prohibit fast-food franchises, TV dinners and sedentary lifestyles?
As you said, "Do you want to live in an obese society?"
Logically, opposing prohibition isn't the same as endorsing obesity or drug abuse. There is an important distinction here.
There is a direct social cost in terms of health care, law enforcement, crimes committed to obtain drugs, fallout from broken families resulting in further dysfunction and more.
Then there is also the unseen cost of lost productivity. If users, deceased users, imprisoned users, distributors, deceased distributors, imprisoned distributors, and law enforcement personnel were not engaged in these activities, their efforts could be focused on more productive areas of the economy. We all pay for this policy socially and economically.
Alcohol is everywhere. Alcohol consumption correlates heavily, like crazy heavily, with assaults, rape, murder, domestic violence, accidents, and serious or fatal car crashes.
Weed is now legal or legal-ish in many places, essentially all of the big population centers in N. America. Edibles and vapes mean you don't even have to smell it.
And let's not forget all of those articles about SV wunderkunds "micro-dosing".
The addicts that the OP was discussing have serious withdrawal issues and are, compared to things like booze or marijuana, trivial in terms of overall population.
There is absolutely no valid reason we can't treat people with suboxone, which will allow them to maintain their addiction without getting high. However it needs a prescription and doctors usually won't just prescribe it to addicts, especially for extended time periods.
This could all be 'fixed' if people didn't have a subconscious need to make people 'pay' for doing things they feel are wrong.
A good example of this is when I got a complete workup done by a liver specialist, having been a very hard drinker earlier in life. Upon telling a close family member that everything came up fine and there were no lasting effects they commented 'that shouldn't be right' as if I had cheated society somehow by not having health consequences for being an alcoholic.
That's not my interpretation of it, which is that "that shouldn't be right" refers to an unexpected outcome given the assumptions, rather than some sort of sense of justice being violated.
You're absolutely 100% right about this. This should be the first part of any treatment, to make it easier to separate the druggie from the drug camp and then come off, if possible, at a reasonable time as decided on by them and their team. This is one of the cores of the Portuguese system, to use some drugs to wean people off the dangerous ones.
> This could all be 'fixed' if people didn't have a subconscious need to make people 'pay' for doing things they feel are wrong.
I know some people like this, but I see more people saying this in that we shouldn't forgive the violent and non-drug related crimes people committed while resisting being removed from the streets. They don't want them not treated, but they want them jailed instead of released once they're clean. It's hard to argue - I've personally helped two old female shopkeepers chase thieves out of their store. Threatening and obviously disrespectful and non-needs related thieves too, not someone simply trying to take a bottle of water and food.
I found out Omega 3's are used to get people off opioid and alcohol addiction.
Why is this?
The DHA part of Omega 3's is one of the main raw "ingredients"/chemicals in the brain and it helps with learning (brain plasticity), but it takes time, in kids it takes a few months before improvements are seen and in adults it can be longer because their bodies are larger. Ironically if you have an out of control teen, dosing them up on omega3's should help rein them in, whilst putting them in good standing for a longer healthy lifespan because of what they do to oesteoclasts.
Omega 3's also down regulate oesteoclasts, these are cells that destroy the bone and release it into the blood stream. Why does that happen? Because the calcium amplifies the effect of the catcholamines (andrenaline/noraandrenaline/dopamine). You can find catcholamines in a coup of tea which probably explains the extreme nature of the British! Its ironic that in old age, we end up literally but mildly out of our faces on the chemicals that are illegal!
If you are an adult, take several grams of omega3's for about a week or two and then feel your aches and pains. Err towards the two weeks if you are older and/or have really partied in your younger years. It will make you feel old, but this is a classic example of no pain no gain because whilst your bones are dissolving into your bloodstream helping to mask the pain and stimulate you in ways reminiscent of cocaine, speed or plain old off the shelf sudafed, they are a step closer to repairing themselves. The other step is increasing oesteoblast activity, the bone building cells, which is a different conversation, but if you feel wired at night when you want to get some sleep vitamin K2-MK4 is an excellent sedative in 5/10/15 milligram amounts!
Omega 3's also increase the size of the neutrophils, these make up a large part of our immune system cells and are the first line of defence. They go after pathogens, like most bacteria, some viruses, alien pathogens like plastics from bottles, nylon from toothbrushes, polysterene from fast food outlets, polution from vehicles like brake dust and emissions and other crap in our body.
So omega3's help our body stay healthier for longer.
Its not the only chemical that helps, beta alanine is another chemical which can make people quit addictive substances but you'll feel nauseous on it. However considering inflammation is reduced on a calorie restricted diet because the immune system doesnt have to attack as much food, it breaks down into a variety of chemicals which stimulate glucagon that increase blood sugar so you feel satiated for longer, so its a cheap alternative to semaglutide the Hollywood weight loss injection chemical and some of the Sulfonamide chemicals which were invented by a Nazi scientist (prontosil) that helped Winston Churchill and Franklin Roosevelt Jr, which are sulfur based antibiotics. It also gets desposited rapidly into the olfactory bulb so your sense of smell comes back rapidly and it also helps people with hearing loss to work out the words and sounds more quickly reducing the number of times they have to ask a speaker to repeat themselves. But by being able to smell better which is another of those creeping aging losses, you get to smell how bad things are.
When thinking of where pathogens are likely to enter the body, it seems logical from an evolutionary perspective to have a chemical beta alanine making up the sensing and detecting of pathogens which can also become a sulfur based antibiotic! In fact is this what gave Gerhard Domagk the idea to investigate and develop them? We shall never know, but I do know one thing and this comes out when looking at historical medicine, the medicine that worked from the 1800's and early 1900's still hold their own in todays world especially with antibiotic resistance. Keep the pathgens at bay your live a longer less stressful life.
So how much are pathogens and poor diet contributing to addiction, considering the above? People consume chemicals to seek solace. So addiction like this needs to be treated as a health condition, and the medical experts need to up their game and be less schadenfreude about it.
Is the refusal of experts to recognise the above, a stealth form of exploitation to keep their high paychecks and "respected" position in society?
There are chemicals and pathogens (bacteria and virus) to make people do nearly any behaviour. Once this is recognised, most problems with society become a health care issue.
The social net / missing social network is.
Our society struggles to take care of its own people because we live in a mentally restraint.
Even in Germany were you have a right for a basic living like a flat and heat and foot and electricity we have homeless.
And no we don't spend the money a flat and everything would cost us into alternative 'equivilent' like enough street worker / social help for them.
People with good choices and support primarily choose non self harming activities.
Everyone else should get proper professional care.
That’s not true. People in the west have so many more choices than people in my dad’s village in Bangladesh. But it’s people in the west who are destroying themselves with drug and other vices.
Additionally, just from a cursory google, it looks like addiction is also on an alarming rise in Bangladesh, especially in the youth. I don’t see evidence addiction is isolated to “the West”.
Addiction is rising in Bangladesh—but as it’s getting richer and more westernized. But even then, to put it into context, the drug overdose rate in the US is 20 times higher adjusted for population.
The drug is the problem, and so are the suppliers -- they are killing people. Addicts and people who need psychiatric care are harming themselves. If the criminal suppliers were supplying contraband woolen socks instead, there might only be a trade dispute and a loss of retail tax income.
That said, users of harmful drugs fall into two sacrifice zones: SZ1) the purveyors of the harmful drugs don't care much if you die, and SZ2) the rest of society doesn't care if you die, but doesn't want you dying in a business district.
Government is willing to be in some "dealing" businesses, such as tobacco and alcohol, because by far most users of these substances can keep working and paying taxes. The economic advantage of government involvement is clear.
There is only so much that the levels of government will invest to reduce (palliate) the suffering of users of harmful drugs. Local government is directly motivated to not have its community (revenue base) supplanted by drug zones. Citizens don't want that either. So the minimal mitigation is what you would expect.
When we say something is a social problem, we often mean that we wish humans were kinder to humans.
>The economic advantage of government involvement is clear.
Does this also include the prison-industrial complex?
It’s more of a head space where you don’t care whether or not you are alive tomorrow, and I definitely shouldn’t be doing this, but that’s a problem for tomorrow.
If there’s even a brief moment of contemplation it is no match for the physical withdrawal that takes over from your rational mind, like a totally different person carjacking your your body at gunpoint with a sensible plan to save the day. The negotiation lasts less than one second.
Frustration, bewilderment, terror, despair, oblivion, repeat.
Recovery is not easy. It’s obviously a lot more complicated than “don’t do that, dummy!”, considering that message combined with gangrene loses the argument with the carjacker nine times out of ten.
Edit: sober for 9 years (one day at a time).
They're not suicidal. Addiction is a pathological state. I've been an addict, with some long periods of sobriety and/or healthy moderation, since my late teens and I'm in my 40s now. Opioids is what got me started but it doesn't matter the substance. They change. At the moment I'm trying really hard to get clean from a serious cocaine and ketamine addiction.
I'm also a successful business owner and CEO, I'm Very High Net Worth, I have a loving partner and a loving family. I had no significant traumas growing up. I have access to the highest level of care possible. Between my psychiatrist and my addiction specialist and all the various coaches and providers I spend hours a week working on this problem.
And yet I cannot stop taking drugs. I cannot stop by will alone. Having been through the ups and downs so many times I know I have to attack this problem from like 20 different angles 20 different times before I'll stop. I've been through this so many times now.
I went to rehab a year ago and then I maintained sobriety for a few weeks until the unexpected death of someone very close to me triggered me to relapse. Life stressors tend to be triggers. That's why I say I've been an addict for 20 something years. Even though I was clean many of those years, it's just an illness in remission. The struggle never ends it just waxes and wanes.
Now I'm trying to make arrangements in my affairs so I can go away to rehab again.
My point was, I'm not suicidal. I'm terrified of death. I'm not even depressed. I love the life that I've built. Yet I continue to use, compulsively, drugs that are causing me physical health problems and that have a high risk of ultimately killing me.
Addiction is a pathological state. Full genetic sequencing recently told me I have a D2 receptor subtype that is associated with a higher risk for addiction. Confirmed what I already knew.
It's a compulsion. It feels like a tic. There's a button in my brain that needs to be pressed, an itch that needs to be scratched, and only taking certain substances will do it.
I'm all for the decriminalization of drugs. No one should be incarcerated for this. It's reprehensible that our society does that. But full legalization of all substances? That's a position born of ignorance. These substances are not evil but they are biologically dangerous. Any chemicals that directly activate the reward pathways in the brain are inherently dangerous. Addicts are created they are not born. You shouldn't be able to buy heroin from the heroin store anymore than you should be able to buy sarin gas from the sarin gas store.
I've read all the articles about tranq. My heart aches for these addicts. My heart aches for all the friends I've lost to addiction. Welcome to Coming of Age in the Opioid Epidemic.
https://www.aad.org/dw/dw-insights-and-inquiries/archive/202...
The use site has a (24/7 guarded) attached pharmacy with government-produced clean heroin, meth, etc. Users can trade in their drug, the pharmacist runs it through a mass spec analyzer and dispenses back to them an amount of pharmaceutical-grade drug of interest, the amount dispensed being equal to the fraction that is present in whatever cut/mixed drug sample they handed in.
In addition to the obvious safety benefits of only consuming guaranteed-pure drugs, the drug user gets an on-the-spot and very salient piece of information about the quality of the drug they purchased. This creates a lot of precise and accurate drug quality information and feeds it back into the drug abuse cycle. A user buys from a dealer, and right before their first hit they get a purity score to evaluate their dealer with - and maybe some information about what other drugs their dealer just tried to poison them with.
(To avoid some obvious risks: the tested drug sample should be immediately ejected from the analyzer into a denaturing bath and regularly incinerated, so that handed-in drugs are not a theft or recycling target. You probably need to mandate they can trade in only the dose they are about take, and they have to take it on the spot, so that government supplies do not leak back into the streets. There are certainly other failure modes too, a close eye should be kept on this and further processes brought in as needed.)
If you're distributing drugs just distribute the drugs. Why cut in the dealers and cartels?
It's really the only way forward. Everything else within the naïve prohibition framework has been tried again and again and has continuously failed.
Arguably the cycle of police aggressively confiscating drugs from users induces more petty theft as the police confiscations become a new sink to drain drug user wealth. Those chemically addicted to drugs need to replace the confiscated drugs, which creates a new need to find something to sell to get enough money to once again buy drugs on the illegal market.
A safe supply of regulated drugs breaks this cycle.
Direct sale of street narcotics would only be another harm reduction practice, similar to "safe use sites". But no harm reduction practice makes the harm "safe".
The political double-speak around this is very similar to "clean coal"; it implies a strong position ("coal is clean") while offering an escape hatch if challenged ("coal pollution mitigation, otherwise known as clean coal, reduces greenhouse emissions when coal is used as a fuel"). Similarly as there is no "clean coal" in reality, there is no "safe supply of drugs".
When we take deceiving loaded words like "safe" out of the equation, it becomes harder to argue against substance control, even if seen as prohibition. While it is evident that street drug crisis in the US has been mishandled, if restricting the access of these substances (or "prohibition") was done correctly, it would benefit society. Particularly, the prohibition would benefit society more if it was not mainly enforced through criminalization of street drugs, but instead through teaching, rehabilitation, and prevention.
In contrast, "safe" drug harm is an oxymoron. And it's very ineffective to even discuss anything on a double-speak premise. We should instead focus on fixing the root problem of drug use, rather than be distracted by harm reduction, especially when it's been politicized so much.
With many drugs, actually quitting via tapering is a valid approach. How the heck do you propose to do that otherwise than having safe use?
By making it legal and say requiring ID to get, you can actually track and find who has a problem and deliver help to them. That also requires the pharmacy and doctors to not be drug pushers, a tough sell in USA.
That easy. Worked pretty well in one or two countries.
Drug rehab programs regularly go much further to be effective, and include group counselling, individual counselling, substance replacement, medication to reduce withdrawal symptoms, relapse management, and similar.
On the other hand, harm reduction is a completely different effort that does not constitute safe use in my opinion, because it facilitates continuous use, which is very harmful, even if the harm is reduced. Even in rehabilitation centres, the use of controlled substances is not considered safe by all medics. It is rather more agreeable to call it safer use.
By the way, which are the countries that you mention where legalizing narcotics and selling them in pharmacies yielded positive results, and what were the results?
If you are talking about legalizing cannabis in some US states and Canada, it is far too early to see the long-term results, although preliminarily, it seems like the use of cannabis has increased. This might be acceptable as a trade-off, as legalizing cannabis will lead to less social stigma for the users, fewer engagements with law enforcement, and safe access. For the producers and distributors, it will mean safer working conditions and labor protections. All for a 10-15% growth in known cannabis use. And cannabis is a relatively safe narcotic.
If you are talking about Portugal's decriminalization of drug possession about 20 years ago, the distribution there is still not facilitated by pharmacies, and those in possession of hard narcotics are required to seek treatment, education, or other interventions as prescribed by drug commissions case-by-case. Portugal has not decriminalized narcotics fully, it was more of a shift from punitive measures to rehabilitation measures for the users. The laws surrounding distribution remain generally in line with Western countries.
An un-safe supply of alcohol would be the sort of stuff that was common during prohibition, the sort of home brewed moonshine that poisoned people and made them blind.
We already do harm reduction and safe supply of many drugs in our society because we recognize the alternatives of adhoc illegal supply is dramatically worse.
Using opioids like heroin (boy if one could even get heroin at this point) is obviously not "safe."
These sort of concerns around safety are at this point however irrelevant because the reality is that people are chemically addicted to these harmful substances and the issue is how to best get them un-addicted or manage that addiction.
Anyone attempting to get off a chemical drug addiction can be absolutely be expected to relapse at some point (many points most likely!) along the journey to ultimately kicking the addiction for good.
The point of harm reduction is so that when someone relapses they do not die from street drugs that are so incredibly toxic there is no known safe dose and that they have yet another opportunity to try to wean themselves off their harmful addiction.
The context of this discussion around street drugs is about the unregulated street drugs that are so cut with various unknown chemicals that it is impossible to have a dose that yields any sort of expected results. This is what is resulting in an incredible spike in overdose deaths.
We should be educating people about the dangers of narcotics addiction, and helping those who are already addicted through rehabilitation programs. They should have access to the narcotics for reduction therapy/tapering. But they also need a lot more — counselling, withdrawals management, relapse management, replacement therapy, group support, and other effective measures.
I suppose the core of what I am trying to say is this: harm reduction is not addressing the core issue effectively enough, and calling any part of harm "safe" communicates a wrong message and is damaging. Harm reduction efforts are important, but are not enough alone; continued narcotics use not be sold by politicians as "safe". There is a subtle but distinct difference between "safe" and "safer", the latter of which is appropriate in harm reduction efforts, but not the former.
But just because supervised heroin won't kill you doesn't mean it's somehow good, actually. That's a separate judgement.
There's surely no upside. It's overwhelmingly likely to make you less healthy and less happy. But so will too much bacon and sitting.
Chairs are still safe though, by any sane definition.
Let's not confuse "unsafe" with "controversial" or "unquestionably bad." But let's remember that "safe" has a clear definition, which does not describe current "safe use" narcotics harm reduction programs. Harm reduction by definition means that harm is involved. Someone safe from street narcotics is someone who is not using them, at least in the way that they are generally used recreationally.
[1] https://www.who.int/europe/news/item/04-01-2023-no-level-of-...
As long as they do have a choice yes. But that's not always the case with highly addictive substances.
Many people start with light drugs (weed or subscription drugs) and then go to heavier stuff. If it is easy to get light drugs and easy to get heavy stuff then more people will be doing drugs. If it is legal to carry around drugs for personal use and if it is considered accepted, then more people will be using drugs.
These findings are consistent with the idea of marijuana as a "gateway drug." However, the majority of people who use marijuana do not go on to use other, "harder" substances. Also, cross-sensitization is not unique to marijuana. Alcohol and nicotine also prime the brain for a heightened response to other drugs51 and are, like marijuana, also typically used before a person progresses to other, more harmful substances.
It is important to note that other factors besides biological mechanisms, such as a person’s social environment, are also critical in a person’s risk for drug use. An alternative to the gateway-drug hypothesis is that people who are more vulnerable to drug-taking are simply more likely to start with readily available substances such as marijuana, tobacco, or alcohol, and their subsequent social interactions with others who use drugs increases their chances of trying other drugs. Further research is needed to explore this question.
If you have to buy your weed from a dealer who also sells other stuff the chances that you might decide to try something more harmful one days are much higher than if you can get your weed in a legal store.
No, the problem is that this is an urban myth. There have been drug clinics that let trained staff inject people with clinical heroin and other drugs with no adverse health effects and often the controlled dosage ended up so low that the drug users maintained self awareness and the high wasn't present or extremely weak.
The clinic was shut down after twenty years of success because people were jealous of drug addicts without health consequences.
A single digit number of people died from overdoses on street dugs within a week of closing the clinic. I wouldn't call that harm reduction.
The truth is that most of the drugs that people want to take voluntarily are perfectly safe and it is the illegal distribution system that adds unsafe cutting agents with severe health consequences.
1. https://pubmed.ncbi.nlm.nih.gov/22225671/
2. https://nida.nih.gov/publications/drugs-brains-behavior-scie...
3. https://pubmed.ncbi.nlm.nih.gov/26816013/
4. https://pubmed.ncbi.nlm.nih.gov/20148788/
5. https://pubmed.ncbi.nlm.nih.gov/17485608/
Even sustained use of quality-controlled narcotics is detrimental and harmful to health and social cohesion. And you do not need to read these studies that prove it, you can simply ask drug users to speak on the topic.
A more sustainable solution to the drug epidemic is Portugal-style legalization and rehabilitation of users: https://en.wikipedia.org/wiki/Drug_policy_of_Portugal.
It is very sad to see that we in the West are stuck with so much confusion when a working model for this problem exists.
That's really an over-exaggeration at least if we're focusing on longterm effects.
Your proposal is bunk. Someone who became addicted to prescription opiates does not deserve to play roulette with their life by being forced to buy street drugs after their own physician arbitrarily decides not to provide any more.
A prescribed drug, mind you, where one of the known side effects (of opiate consumption) is addiction, but the physicians prescribing aren't responsible for curing the addicts they create. Because <regulations, guidelines, prescribing practices, etc> mandate they cut patients off. This is "Just say No" all over again, but now it's the doctors saying "No."
What utter BS..
And to think that possession of fentanyl testing equipment is illegal in dozens of US States. It's as if the laws are designed to funnel humans to be slaughtered by adulterated product. Under the revenge-ethics banner of "they deserve it".
The US system: - humans that are too poor to pay an expensive private doctor get to buy street drugs.
- Rich folks get private doctors that will prescribe what they physically depend on.
Ex: Prince didn't accidentally die from taking Fentanyl-poisoned street drugs. He was adequately supplied with whatever he needed, for years. Years! While also functioning!
Prince was a functioning human, while also being addicted. There, I said it.
What harm to society was he? Why must we eliminate all addicts as you suggest?
My proposal is to reduce use through education, rehabilitation (including tapering/MAT), and not facilitating continued use. I also propose not using language such as "safe use". Please see the approach Portugal took in 2001 where narcotics possession was legalized but interventions such as rehabilitation were enforced — this is my proposal. The approach can be supplemented by harm reduction, but harm reduction alone is ineffective and selling it as a "safe" alternative to rehabilitation programs is malicious, as can be very evidently seen in the US.
It seems like some people are very strong supporters of "safe use" though, it is difficult to argue that there is another more sustainable approach to the narcotics problem.
But in the spirit of discussion, I will instead say: why compete when you could regulate?
This proposal would essentially introduce a tax on cutting drugs that is exactly proportionate to the amount of cutting done. Further processes could emulate other forms of regulation: if the drug dose contains enough of some adulterant that it would have been acutely lethal (for example, way too much fentanyl accidentally mixed in), you could withhold the dose or otherwise induce the user to give up the dealer to the police - not as hard of a sell as you might think, given that the pharmacist literally just saved the user from dying in the next 30 minutes - and now you have something sort of like safety and QA regulations that impose jail time penalties for improper manufacturing.
I pay a dealer for a ticket. I take it to the dispensary. They clip the ticket and give me new drugs. Now replace “ticket” with “tainted drugs.”
The street-purchase requirement is totally performative. The dispensary is selling drugs with extra steps, with the bonus of sending their revenue to the dealers.
This is prohibition with extra steps. Granted, you deal with the problem of tainted drugs. But that isn’t the chief issue, and creating a giant hole in the budget aimed exclusively at that harm seems political suicide.
If we’re talking about political feasibility, I think replacing harmful street drugs with their pure versions at the point of consumption is politically much closer to “safe injection sites” than it is to “government agents with the job title of Drug Dealer”.
I mean you couldn't even get these legal/clean drugs directly before buying something from a street dealer under this scheme? Why? IMHO that's just beyond absurd we might just as well provide direct cash subsidies to drug cartels instead if that's your goal.
An example is the supply arms race with research chemicals/designer drugs (RC). Every month, a new RC hits the streets with greater potency and skirting any previously-established regulations. The drug dealers will always be winning the potency race because they're on the bleeding edge, using the latest formulas and cutting it with experimental/unsafe/word-of-mouth additives.
The only way to win is making them free. And even then, the potency race continues. It's a ginormous value edge that the dealers have, and sadly, it preys on the most vulnerable sufferers.
Semantics, misused a term there.
> The major drugs like heroin and methamphetamine are already pretty optimal in this regard.
In a world where this was true, cutting drugs with fentanyl wouldn’t be a thing. It’s not just a cost optimization, it’s also because it gets you the best high on the block.
> The only people who care about RCs are people trying to skirt the law, and drug nerds.
“Spice”, as one example, has destroyed many communities. Legal highs and designer drugs are everywhere as of the past decade. “Bath salts” (cathinones), synthetic cannabinoids, etc.
Not exactly designer, but the isomerization process to extract delta-8 from hemp is a novel technique that’s being done underground by labs everywhere and distributed widely across America. We have no idea what’s in this stuff, even testing labs usually report XX% of unknown substances, reaction residues and cannabinoids in samples.
Research chemicals are everywhere. This arms race has touched millions.
These are real problems that affect real people.
This is suggested semi-facetiously, but at the same time, feels like there's something to it.
Decriminalize, tax, regulate, and focus enforcement efforts on black market dealers.
The waste of human effort and life that has gone into the last 60 years of drug policy is insane to consider. We have got to try _something_ other than what we're doing now with prohibition.
I'd add that I think more explanation around the black market angle could probably help the argument further since atm the state of legalization advocacy in the US tends to be "But think about the tax revenue!" which is fine for less problematic drugs like weed but which is going to stall fast when you get to things like heroine. Emphasizing legalization and government regulation/distribution as a way to take money out of the hands of gangs and street dealers would be compelling to a lot of people imo if framed in the right way.
If it worked well. There are probably many problems with this idea.
Just how cheap do you think mass spec is?
I worked in a well funded private lab and we didn't have "a dozen" of them.
When a lot of that equipment gets aged out from industrial uses it will be given to universities in still-working order. Biotechs going bust can also be a boon to the second-hand market where state of the art equipment can be had for a song. I know one lab which acquired a piece of equipment that had been used in a background shot of a Jurassic Park movie.
Keep in mind there is significant expense in their upkeep as well.
That's why I guessed they were probably gas chromatographers with wavelength or FID detectors. Those are pretty cheap (gas source, injector and column).
According to https://harmreductionjournal.biomedcentral.com/articles/10.1... mass spec machines are between $5000 and $1m, and commercial labs offer services for between $5 and $100 per sample. Presumably the capital investment of buying a mass spec machine and hiring a technician drop the cost per sample drop lower than $5, as it seems businesses are able to stay profitable charging that amount.
According to Wikipedia, the budget for the safe injection site in the article is $1.2m initial investment and $500k/year operating cost to handle 175k injections per year. Even at $5 a sample that’s $875k a year. So mass spec is actually completely plausible, in both capital investment and operating cost, for the budget of a single injection site at the volume that injection site handles. https://en.m.wikipedia.org/wiki/Insite
That the conservative estimates and some upper bounds for gold standard mass spec are within the actual budgets of individual injection sites is, I feel, justification enough for my glib “cheap enough!” quip above. Of course, we may not need the gold standard. For the limited scope of identifying pharmaceutical chemicals in small doses, there may be cheaper processes that function just as effectively.
However, while searching for a source to back up my above statement, all I could find is https://www.nytimes.com/2022/07/26/health/fentanyl-vancouver... from Aug '22. So apparently they are supplying now.
We are doing this for many years now and seems that new opiods rarely really hit the market at all.
Not to mention that users will begin to bring in all kinds of crap to see if they can get heroin from it — notably, their own excrement. Drug sellers likewise may decide it is unnecessary to recrystallize their products to remove solvents, since your suggestion makes no distinction between the sample contaminated with acetic anhydride and the one that was cut with mannitol. So there is still plenty of moral hazard.
Drug dealers leaving solvents in because this suggestion makes no distinction between different cutting compounds? I propose that we do draw a distinction, then.
Drug users trying to hand us a baggie of their shit and call it heroin? I propose that, uh, we say no?
To be frank, none of your objections seem like very difficult obstacles to overcome.
I’m an Iraq war vet. I’ve lost friends to drugs, suicide, incredibly reckless behavior to the point it might as well be suicide. Once you’re in a cohort of people that are close to death, the mental strain of losing your friends has a way of squaring the circle for you. It takes an extraordinary amount of self control, and daily effort to change your circumstances. Being at arms distance all day from IV drug use is not going to do it. Previously I’ve been all for harm reduction centers, and safe places to test and use drugs, because I don’t believe that heavy handed prohibition solves anything. I’ve never seen a motivated human stopped from doing anything self destructive by threatening them with more self destruction. I hadn’t considered the mental tax on the employees that work in these centers. I think it’s still a net positive, but wow.
https://www.dea.gov/sites/default/files/2022-12/The%20Growin...
Article quotes "We know that xylazine is a veterinary tranquilizer, but we’re not sure how the drug dealers are getting it from clinics."
DEA says "A kilogram of xylazine powder can be purchased online from Chinese suppliers with common prices ranging from $6-$20 U.S. dollars per kilogram. At this low price, its use as an adulterant may increase the profit for illicit drug traffickers, as its psychoactive effects allows them to reduce the amount of fentanyl or heroin used in a mixture. It may also attract customers looking for a longer high since xylazine is described as having many of the same effects for users as opioids, but with a longer-lasting effect than fentanyl alone."
It's an alpha-2 adrenergic receptor agonist.
There are indications that alpha-2 antagonists can reverse or mitigate xylazine's effects.
Yohimbine, a very popular dietary supplement, is an alpha-2 antagonist. It reverses the sedative and cardiac effects of xylazine in animals [1], and should be quite well-tolerated in humans. It's also available in pure form via Amazon.com and millions of other places.
So it's not as though xylazine has no antidote in principle...
[1] - Spoerke, D. G., Hall, A. H., Grimes, M. J., Honea, B. N., & Rumack, B. H. (1986). Human overdose with the veterinary tranquilizer xylazine. The American Journal of Emergency Medicine, 4(3), 222–224. doi:10.1016/0735-6757(86)90070-7
Granted, atipamezole seems somewhat "cleaner" than yohimbine, which is a natural product with quite a few off-target effects.
I don’t think there are any easy answers here.
Xylazine has a very rapid onset and a short half-life. So, as it can take >40 minutes for orally-administered drugs to be absorbed, there are really only two options that _might_ be legal and effective.
1) Administer an FDA-approved alpha-2 antagonist intravenously. There are no good options here. AFAIK, the only FDA-approved alpha-2 antagonist that's available as an intravenous injection is Thorazine -- and it does a hell of a lot besides counteract alpha-2 adrenoceptor activation. It's also an alpha-1 antagonist, dopamine antagonist, serotonin antagonist, and more. This likely makes it a little bit unpredictable in drug overdose scenarios.
2) Sidestep FDA approval with a fast-acting yohimbine nasal spray, administered as a "dietary supplement."
The FDA process is a terrible roadblock in situations like this. Intravenous atipamezole, which would be much better than either of the two options above, is available for veterinary use, but would be totally illegal for use in humans. (Like xylazine itself!)
Why don't we take a look at each category of drugs (benzos, opiates, stimulants, psychedelics, ...) and make the least harmful one or two of those legal? Regulate it, control it, make it safe. Create clinics where people can get educated about safe use, and where people can get clean, medical-grade drugs that they'll buy off of random dude in the suburbs otherwise.
People are going to use drugs. Alternatively, they'll get addicted to other things, like gambling, which can be just as destructive.
Stop making drug addiction a moral failure. It's not. It's a part of life, and a very human thing. I wonder how many wall street traders still regularly do coke nowadays.
Of course, suffering then leads to people seeking out quick fixes. But you know what? If you're suffering from chronic pains, and medical experts can't help you (as has been the case for many people), taking some of these drugs (like THC) is highly preferable to not having anything.
FTFY
I grew up in the 80s in the San Fernando valley. I was in the center of DARE, in the middle of the Crips and the Bloods and their narco-fueled civil war. The biggest drug bust in history (to that point) occured 7 blocks from my house. I rolled my eyes ever since...
And then...
I lost college friends to drug overdoses. I saw some of the best and brightest of my university program permanently addle their brains, I saw friends in their 40s, with amazing baby children, commit suicide after years of fighting opiates (the completely legal ones). I saw the CEO in waiting of a fortune 500 company destroy his life with heroin. Now the very first of my children's schoolmates and friends are dying to Fentanyl.
Drugs are more and more powerful. The bar to them is less and less. Some people (including myself) have issues with addictive behavior. True enough. But thoose don't melt the skin off your body.
Stop normalizing drug use.
> ... Now, I’m a daily intravenous meth user.
I really didn't expect the harm reduction worker to be actively addicted.
These stories usually feature someone who went clean. That it's someone who still using and contributing to society makes it unexpected. (I hadn’t considered the possibility of a functional meth addict.)
And although more rare, functional desoxyn users too, which is a methamphetamine pill typically used for narcolepsy and severe obesity.
But you skipped the part of the quote where he's been abusing drugs since age 11 - it'd certainly be more alarming if he was sober but after working at the clinic for a bit, started taking up IV meth. But yes, still surprising, however there are benefits to serving the people that you can relate most to.
Eh, it's more like an obese doctor treating obese patients. The goal isn't become thin, but to reduce harm. Yes, the doctor should tell the patient they should lose weight. But in cases where that's unrealistic, there are second-best options before abandonment.
Adderall users are doing all kind of productive things in society.
Why can't Meth users?
Adderall is regular (non-methylated) amphetamine, specifically a mixture of levo-amphetamine and dextro-amphetamine. There are minor differences in effect profile between methamphetamine and amphetamine, the biggest of these minor differences being in neuroprotectivity (it’s been a while since I’ve done the research but iirc amphetamine is mildly neuroprotective while meth is neutral or mildly negative, due to meth interrupting some metabolizing process). The major difference is that milligram-for-milligram, meth is 2-5x more potent than regular amphetamine.
The perception that they are very different is valid, though, because amphetamine is usually consumed therapeutically (lower doses, guaranteed purity, controlled dosing schedule, safer administration route) while meth is usually consumed recreationally (higher doses, unknown and often dubious purity, erratic dosing schedule, riskier administration routes). Injecting a quarter of a gram of street meth over a three day binge is much more harmful than taking 40mg Adderall extended release formulation by mouth every morning.
On some level, it is similar as they are both stimulants and nearly the same chemical. But my own research suggests the methyl group has a significant effect on how the body metabolizes the drug.
The methyl group makes it fat-soluble which allows it to cross the blood brain barrier. Apparently this causes it to have an effect on dopamine and serotonin receptors which it would otherwise not - hence the euphoric effect. It also cleaves into amphetamine in the blood stream which gives it a significantly higher half-life.
How you administer a drug is important, which is self explanatory. Most newer ADHD stimulants are made in such that they must be metabolized through the stomach.
Additionally, the dosage is important. Meth is not only more potent, but when abused is likely to be taken in 10x (or more) amount than a therapeutic dose.
So.. safe to say they are chemically similar but different in practice. This info is from my quick googling. I’m on a therapeutic dose of Adderall, and given its effect on my blood pressure I would be concerned taking meth due to all of the above. And this is why I have a doctor to help me with all of this.
Then there's just the nature of addiction. Some people seem predisposed to it. The Vietnam war is a good example. High percentage of heroin use there by US soldiers, but a much smaller percentage of the in-country users returned home with a habit. Another example is the high occurrence of addiction following bariatric surgery, with people who didn't have the issue prior.
After seeing the absolute mess that SF has become, what I've come to realize is that these "supporters" of drug addicts are doing NOTHING to help them break their addiction. They are letting them accelerate their addiction, and they are doing nothing to help them get rid of their addiction.
If you look at all of these "progressive" programs, they look like insidious plots to hurt those they claim to want to help.
"Safe injection" sites actually keep addicts addicted for longer and don't help them conquer their addiction.
Education activists that want to drop education requirements because they are too hard to achieve for Black and Brown students don't help them learn, in fact they leave them uneducated by the time they graduate high school.
Mental health/homeless activists don't help homeless people solve the problems that lead to homelessness (usually mental health or drug addiction), instead they give band aid solutions that keep them homeless in perpetuity. The number of homeless people passed out on SF sidewalks and using the streets as their bathrooms have skyrocketed even though homeless funding is $600 million a year.
"Restorative justice" programs cause crime to skyrocket because criminals take advantage of these laws and commit crimes with no fear. Alameda County DA Pamela Price cares more about freeing criminals than helping her constituents get any modicum of justice or to keep their streets safe. She is doing the opposite of what she should be doing.
Everything that was promised by these far-left progressive policies have failed in the real world, and the fact they continue pushing them in the face of their failures is indication that they don't care about science or data, all their care about is dogma.
SF is a perfect example, because there has been decades of left wing politics in charge and there's no Republican boogeyman to blame. And it's been nothing but failure and failure, and things are getting worse and worse.
Education is the thing that really makes me the most angry, because the fact that 50% of Black and Brown students are "graduating" from high school barely able to read [1] is 100% the fault of the progressives. They claim to care about equity, yet all they are producing is generations of students unable to compete in the real world. Lowell is/was a top 100 high school in the US, and the progressives gutted the admissions because too many Asians got in, so they changed it to a lottery system. All that did was admit kids who were unprepared and flunked classes. The number of flunks classes tripled in a single year after merit-based admissions was cut [2].
All of these things are related. The progressive policies since the 60s have produced fantastic policies that are important for freedom. Gays and trans deserve the right to live in safety and be treated like everyone else. Drug addicts should not be criminalized, they are addicts that need help. Mental health problems should not be stigmatized. Racism against any group should never be tolerated. Lower-income neighborhoods need to be lifted up, and yes at the expense of richer neighborhoods.
But the policies we are seeing these days go too far and are damaging the people that they purport to help.
[1] https://darrellowens.substack.com/p/half-of-black-students-c... [2] https://www.yahoo.com/video/top-sf-high-school-sees-19230360...
Xylazine test strips link: https://www.btnx.com/Product?id=2019
Really good to see more reporting about this, but also alarming at the delay from when the problem started and when mainstream press is starting to talk about it.
Advocacy groups have achieved a bit of traction of getting some media to correctly call this a "toxic drug" crisis, but here we see an example of a major national media outlet while thankfully still ploddingly coming around to reporting on the issue, still framing things in the deprecated terms of an "opioid crisis" framework that is years out of date.
And I've never heard of a seller being targeted for smoking related lawsuits.
One example of a grocery store being held liable for unknowingly selling a pre-prepared item that caused illness is the case of In Re: King Soopers Listeria Outbreak Litigation. In this case, a number of people became ill with listeriosis, a serious and potentially life-threatening bacterial infection, after consuming pre-packaged deli meats sold at various King Soopers grocery store locations in Colorado.
The outbreak was traced back to contaminated meat produced by a third-party supplier, and a number of people filed lawsuits against King Soopers alleging that the store was liable for selling the contaminated meat. The lawsuits alleged that King Soopers had a duty to ensure that the food it sold was safe for consumption and that it had breached that duty by selling the contaminated meat.
The case ultimately settled for an undisclosed sum, with King Soopers agreeing to compensate those who became ill as a result of consuming the contaminated meat.
This case illustrates how grocery stores can be held liable for selling pre-prepared food items that cause illness, even if the store was unaware of the contamination at the time of sale. It also highlights the importance of ensuring that food safety measures are in place throughout the supply chain, from the producers of the food to the stores that sell it to the public.
I'm not shocked the article is from BC and even less that it was Downtown Eastside.. I think all Canadians know about the Downtown Eastside. Even here on the opposite coast I know its reputation.
YouTube suggested a video just a few days ago to me of a Vancouver fire hall located in the Downtown Eastside. Most fire halls in Vancouver average 600 calls per month but Fire hall 2 they get 1,600 calls per month!
Instead, we get kvetching and hand-wringing about "what can be done", and tittering discussions on online message boards, while society decays even further.
plus now you can just blame china for everything. it's super convenient and lucrative!
Doesn't Thailand/Japan etc have even harsher anti-drug laws?
On the supply side, even the death penalty can be priced in when the demand is strong. The narcotics business is one of death, not just due to the criminality and the death penalty in some regions, but also due to no labor protections, prevalent drug use among the producers and distributors, and clashes with law enforcement and rival criminal orgs. This has deterred neither the suppliers nor consumers. When even the probability of death isn't a good deterrent, a probability of imprisonment won't work either.
Speaking of death not being a deterrent to lucrative business, the narcotics industry is not an outlier. Industries involving underwater operations like welding, oil rig work, coal mining, logging, high-rise maintenance, stunt performance, mercenary work, experimental aircraft piloting, and similar all exploit death for large profits. It's just capitalism. So a solution to the drugs crisis needs to work within a capitalist world.
The correct answer is to decriminalize everything and improve public health programs like Portugal did 20+ years ago. They saw extremely good outcomes. [1]
[1] https://www.theguardian.com/news/2017/dec/05/portugals-radic...
Edit: Joke aside - i am fine with marijuana, and some forms of cocaine being kinda ok-ish, but a death sentence for every person that distributes fentanyl and carfentanil won't extract too much tears from me.
Some vices should be entertained - but there should be hard limits somewhere.
Oregon decriminalized personal possession of basically all of these drugs in 2021. As of today, a large swathe of downtown Portland is basically one highly dangerous open air drug market. It’s going to end up like the Tenderloin and Civic Center in SF. The cannabis tax money flooding into addiction treatment businesses seems to be not making a dent. Between lower quality of life and some of the highest tax burdens in the US, Oregon is decreasing in population every year now.
> “The national policy is to treat each individual differently,” Goulão told me. “The secret is for us to be present.”
If you want to learn more the article I linked is very good. It goes into great detail and I think covers how long it took to work.
But the reality is it's not just enough to decriminalize, you also have to provide appropriate care. Oregon didn't do what Portugal did - they only did part of it.
Vancouver has taken away the police's ability to confiscate a drug that has just killed someone, or to arrest the dealer. This is directly opposite of what Portugal does, dishonestly borrowing the words without their original meaning or critically the other 90% of the Portuguese response like actual rehab in a drug-free society.
Our cities, SF, Vancouver, Portland, Seattle, LA, Victoria, etc know they're distorting the meaning by claiming it's what Portugal does. They've been told that they're wrong in this by journalists with experience in Portugal and by the very architect of the Portuguese system and they refuse to choose other language or admit that they are in actuality enacting the exact opposite to Portugal.
Oregon isn't even in the top half of states by overall tax burden.
Note that I said the decline is multi-factorial though. A significant part of it isn’t even outward migration, but excess deaths due to COVID combined with a low birth rate and a lack of inward migration. (Here again though, who do you think has the most opportunity to move to a new state and what kind of tax policy deters them?)
I feel a kind of duality when I look at the US from outside. People seems to be trying at all costs to avoid taxes but if someone get seriously hurt or have a serious disease one of the immediate response is to start a gofundme and ask to pass the word for charity and a lot of people are happy to donate. On one hand it is kind of touching to see that people are willing to donate for someone they sometimes barely know, on the other hand shouldn't everybody seek a society where everybody is happy to donate but nobody has to ask for charity from his community because gov takes care of that through that tax money.
I don't know if I am alone, maybe people will make fun of me for that but I am kind of proud of paying a lot of taxes. I know governments don't always take the best decisions, some money is sometimes plainly stolen or badly used and I may not agree with all decisions but I feel it is part of being a citizen and it makes me also more responsible and eager to vote and try to make a difference when I can.
There's a lot to like about those places, but their approach is antithetical to at least the way the US and Canada likes to represent themselves. Decriminalization seems far more in line with western ideology. Freedom and personal responsibility combined with liberty. What's not to like? Especially since it works.
Shall we solve the stuck gum under park benches with caning too? Smacking people with sticks does solve problems, but I'm not sure that's the kind of society I want to advocate for. Despite very much enjoying my time in Singapore. The benevolent authoritarianism model of Singapore is unique and interesting - and attempts to replicate it elsewhere have failed. Including a famous attempt in China where Deng Xiaoping and Lee Kwan Yew gave it a real college try in the early 90s. Worth reading about. [1]
[1] https://www.thinkchina.sg/construction-singapore-model-mainl...
Japan's prohibitionist approach has left it with a meth problem we can't measure because of said prohibitionism [1].
[1] https://www.opendemocracy.net/en/japan-place-with-strangest-...
The problem is enforcement, as long as there are open drug markets, then the issue isnt the laws its the joke of a police that pretends to do anything, or rather idiots trying to sympathies with drug users and dealers keeping the police from doing their work.
Maybe it's time to start sympathizing with the drug users if you want to get rid of shady dealers and narcos. We've tried it your way. It sucks.
You know where else doesn't have those things? Portugal.
If so that still counts as a failure, nobody should be allowed to ever take these drugs in their lifetime.
So the police gets them, and gets the dealer then they either get treated or prisoned depending if its their first time or they are actually addicted.
But a lot of what you're describing is literally the Portuguese model, which you can find out if you read the article. They can require you go to rehab depending on if it's your first time or if you're addicted. It's just not a criminal matter, it's a public health matter. Which means you have less stigma, you avoid prison, a record - and you are more likely to ask for help.
We know for a fact prison is a place you can get drugs, and going there leaves you more likely to be addicted, not less, because you look to those same drugs as an escape from your prison situation.
The police is going to be the first one to interact with addicts because they should be working on dismantling the entire drug network and working on catching dealers, through catching addicts/buyers.
Dealers aren't users or addicts. Different people. The police would not be the first to respond to them in 99% of cases.
And you can dismantle the network by making it uncompetitive. Let the state sell drugs, who cares? Then the narcos die off and the network dismantles itself.
The thing is we've provided all sorts of ways for you to achieve your goal of not seeing zombies on the street without the cruelty. And yet you continue to try and find ways to invent problems. It seems like the cruelty of your suggestion may be the point?
That's the entire problem, that's why most police forces can't enforce shit against drug dealers and addicts.
There is a balance, and currently its at the wrong side.
Isn’t that what we’ve been doing for the last 50 years? How did that work out?
We shouldn't criminalize addiction but we certainly shouldn't let it proliferate. Forced drug rehab is an essential part of the equation. Without forced rehab, you get open air drug markets like SF which is making things worse, not better.
Today a drug addicted woman gave birth to a baby on the street in SF. It's all over Twitter. It's worse than a 3rd world country in this so-called utopia of progressive freedom. It's sick and disgusting.
So my understanding is correct then. I'm familiar with what I'm advocating.
I also didn't say legalize, I said decriminalize. These are two different concepts. Legalize weed and psychedelics, sure. Decriminalize hard drugs. And improve public health programs, like I said, including mandatory rehab (which I left out - not for any particular reason - but support for addicts).
> It's a complete failure and downright evil what is going on right now in SF.
I agree completely.
I don't think we disagree on much, tbh.
What made you think he suggested you could? He clearly stated that there was decriminalization, not legalization.
It doesn't seem to be working. What if we try the opposite instead?
Dubai actually enforces these laws and the result? No addicts on the streets and no public drug dealers.
Oh wait, you meant just the scary drugs?
48,000 deaths per year in canada from tobacco.
One is legal to sell on every street corner. The other is a crisis.
My uncle has smoked 2-3 packs a day from when he was 15 years old. He is 70 now. Somewhere between one and two million cigarettes in his lifetime. Many health issues, of course, but could you eat million burgers or drink a million cans of coke in a lifetime and end up with less health issues? (No, you couldn’t: that’s something like 8,000 calories a day every day for 80 years, you die of obesity by age 35. I’m not even completely sure you could drink that many cups of water, 3 packs a day is 90 cups of water or 5.5 gallons, perilously close to the ~6 gallon maximum rate of healthy kidneys working 24/7.)
My point is not that smoking is better for you than heroin or soft drinks or burgers or coffee or water. It’s that the dose makes the poison, and we tend to legislate based as much on “lethal dose” as on “total attributable deaths”.
*: Adding diabetes and heart disease together from https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=131003...
But if your argument is that opioids should also be sold by the government in a program that ensures we have a safe supply, then I agree with you.
I think criminalization of drugs is essential, what isn't is the method of jailing individuals under the influence. Jail doesn't make them clean and it puts them with the sort of people who enable their habits.
We need a more diverse system that helps people get passed the subtance abuse.
Criminalization also implies that the government has any right to tell citizens what they can and cannot do with their mind. Ridiculous.
Not being in control of yourself is no different than be on drugs, but one adds a layer of support providing we can implement a system to aid and clean a person.
The problem with criminalizing comes with the negative connotation of being unemployable. The benefit is that it obligates that the drug abuser to be processed through our system.
Fundamentally it is the no flexibility in our legal system.
I don't disagree with you. It is just that we need a better model.
The black and white, night and day. Non-flexible meanings in criminalization and rehabilitation are problematic.