How the fentanyl crisis' fourth wave has hit every corner of the US | Hacker News Reader

How the fentanyl crisis' fourth wave has hit every corner of the US

bbc.com

31 pointsvinni299 comments

Fentanyl is one of the few drugs I can buy all the anti-drug propaganda on given the insane death rate compared to other drugs (I remember meth being advertised on tv as deadly)[1].

But it's the direct result of making alternatives harder to get and harder to produce.

[1]https://nida.nih.gov/research-topics/trends-statistics/overd...

It is a direct result of the drug war...

Legalize all drugs, disempower doctors from being gatekeepers and allow anyone to get anything they want at any time, aside from age restrictions and things like antibiotics (which can contribute to making bacteria more robust and dangerous).

Testable, trackable access to all drugs, without any stigma of illegality. This removes all incentive for adulterated substances, gives access to drug users to therapy / rehab / services without risk of law enforcement, provides for new classes of business around safe use locations (bars for alcohol, new kinds if bars for you name it), taxable revenue streams (which would still be cheaper than black markets for consumers), reduced medical costs (if you know what you need, why spend $500 seeing a doctor? An AI is cheaper and more effective here anyway) -- oh, and it actually wins the drug war against cartels and gangsters. The list goes on, but sounds kind of dumb to me not to do this?

Fentanyl would be a non-issue, along with a host of other issues. We would switch to new issues that live in the light, and we could actively work on them suddenly.

Freedom solves most of our invented issues. Controlling the will of people introduces all sorts of insidious complications. I wonder why that is?

You have to fund rehabilitation for addiction if you're going to open those flood gates. I'm all about legalization, but we need to follow Portugal's lead on this as they saw a major drop in overall drug use.

You could easily fund rehabilitation with a fraction of the taxable proceeds from legal drug sales.

I kind of agree, I agree 100% with transparency, it's something I think the UK does wonders with having drug testing sites where they don't confiscate the drug instead the user themselves can decide if they want to take whatever toxic waste is mixed in with MDMA for instance.

I don't think legalizing it to the point where anyone can get it anywhere is the way to go, you have to rehabilitate not only users but the drug itself.

Ecstasy as an example will contribute to death as long as people see ecstasy as a party drug (since most cause of death is because of heat stroke or drinking too much water), if you can rehabilitate the public perception that ecstasy is more of a relax drug akin to weed, then I think we're on to something.

Issue is also that the cartel has grown so vast and powerful I doubt even if USA went full legalization that this will change much, the cartel will find grey area to smuggle in "illegal" legal drugs like how the Italian mafia are notorious for fake olive oil.

I agree with the idea of rehabilitating public perception, but I believe that happens naturally with legalization.

The issue is that every day there is friction to acquire unadulterated drugs, is another day some young human dies for causes unrelated to the negative impacts of the substance they are taking themselves.

It is easy to plan for the risk of something when you know what it is. How can they plan for risk of fentanyl laced MDMA? They are going to take the drug one way or another, so we can all start by making sure what they take is what they think it is. That will immediately begin saving lives and have drastic societal impacts.

By doing that, the reshaping of perceptions and use of these drugs happens naturally. People taking them can be open about what they are on, and can have support when they use. Conversations will happen naturally -- "did you know MDMA has significant benefits when taken quietly and contemplatively? Maybe try that sometime." These conversations rarely happen now because you have to establish trust and knowledge with people to make sure they won't be a danger to your safety and freedom.

With current mechanics, often times, people hide their use so well they look like advocates against use. How many police officers, for instance, are users of something? We don't have a clue. The users are absolute masters of hiding. But I promise you, they exist, and the numbers are higher than anyone would expect.

A lot of street drugs are being laced with fentanyl, so like you think you are just snorting cocaine but someone in the chain snuck a bunch of fent so they could skimp on more expensive cocaine and still have a potent product.

Non US person here, so feel free to call me out on BS. IMHO people who do fentanyl already have pretty serious mental and/or existential issues going on, like who tf would play russian roulette like that? Sounds more like a societal problem than a mere drug distribution regulation problem to me.

From what I understand - people who got addicted to legal opiates now can't access them and fentanyl is somewhat accessible and gives same effect with lower dose. So it's not necessarily your stereotypical junkies that are using it, it's normal people who were given opiates to deal with pain and now got addicted.

So all those oxy prescriptions weren't a good idea then?

I don’t think you’ll find anyone to argue that they were.

Unfortunately, my understanding is that some companies found a _lot_ of people to argue exactly that - if anything, to create plenty of value for the shareholder.

And who are the shareholders at the end of the day? The same people taking the pills.

Edit: I’m talking about the elderly and their 401ks / pensions and retirement all invested in these types of companies.

You'll find some right in this thread

https://news.ycombinator.com/item?id=37544012

Lots of people think non-trivial pain warrants opiods. The problem becomes who decides what counts as non-trivial pain. There was a shift in early 2000's towards "believe the patient", which caused an explosion in prescriptions pretty quickly. After all "if 5% of people after xyz surgery demand them, maybe the other 95% are silently suffering", etc.

(just describing what is, not what ought to be)

Not at all. In fact, we're having a huge public reckoning right now.

it's very very rare that somebody would intentionally seek out fentanyl without a pre-existing opiate addiction, probably from over prescribed pain meds that turned into black market pain meds then heroin

Presumably you start with other drugs and especially weaker opiates. E.g. painkillers in pill form might be relatively harmless (compared to Fentanyl of course) but are more expensive and harder to get especially after the crackdown on prescriptions.

Fentanyl OTH seems to have a great cost/“value” ratio so when you’re already addicted and can’t afford anything else you don’t really have much of a choice. At that point your description of Fentanyl users is probably accurate but there is a long road to get there for most.

Also let’s be fair, it’s not like some European countries don’t have serious problems with drug related deaths (even if on a much smaller scale overall). Scandinavian countries all especially bad in that regard (Sweden has the highest number of deaths per capita though Finland and Norway are not that far behind). They are just much better at sweeping these problems under the rug because it’s not as visible (no homeless people).

While it's true that we indeed do have a severe drug problem in Finland, it really hasn't been pushed under the rug. We have a working social services system and the addicts have a place they can get their legal drugs from.

Also the overdoses per 100k residents are around 5.8, while in the us it seems to be 27.8

> Sweden has the highest number of deaths per capita

In Europe? It looks like the US has almost 3X as many. The US' map of deaths looks dominated by economics, while the European one looks like it follows the latitude with seasonal depression.

> In Europe? It looks like the US has almost 3X as many.

Yeah, of course, US is on a completely different scale.

> while the European one looks like it follows the latitude with seasonal depression.

And/or drug policies. Sweden is significantly more prohibitionist than most countries in Europe. Generally discussion about drug use are also generally much less tolerated and the social stigma attached to it is bigger.

As the article mentions, some people are unwittingly taking it because their other drug of choice is laced with it, and they become addicted this way.

Fentanyl is frequently laced into other drugs (without the buyer knowing) because it is cheaper to produce than e.g. heroin. Or it is used as the main ingredient in fake versions of “real” painkillers like Oxy.

But it’s so deadly at low levels that it’s very easy to end up with a lethal amount in a single dose through inconsistent manufacturing processes, unbeknownst to seller or buyer.

Everything related to the surge in opioid addiction is obviously a societal problem. But not the one you’re imagining.

It's now in pressed pills that look identical to prescription pills. Someone goes to take a 5mg hydrocodone and they end up overdosing on fentanyl. All of the safer drugs that existed in the past are now either cut with fentanyl or are just fentanyl, even things like cocaine, ketamine, ecstasy, etc.

Sometimes (from what I've read, I'm also non-US) many people who end up on fentanyl were not even going through any mental or existential issues, at least not overtly, but rather were prescribed opiates such as oxycodone after being legitimately diagnosed with more-or-less severe and prolonged pain. When I say they were "legitimately" diagnosed, I mean that the patient didn't fake their ailment nor went to the doctor with the intent of getting opiates—at least not initially. Whether opiates were a reasonable approach to deal with the patient's pain is a whole'nother issue.

Over time, as the prescribed opiate painkiller loses effectiveness (as well as its pleasurable side-effects), patients may request a longer or a stronger prescription. Their doctor may or may not oblige. The patient may switch doctors to another who is more accommodating. Then the new prescription loses potency, and the cycle repeats. At some point the patient is not even taking the opiate primarily for their pain, whether they are aware of it or not, but rather for how it makes them feel. Eventually the patient cannot get a stronger prescription, or even prolong the one they had already, for whatever reason—be it financial, insurance, or doctor's refusal. That's when getting a tiny dose of fentanyl will "help". And now they're on fentanyl.

Obviously this does not happen in a vacuum. There are many societal, cultural and healthcare issues that make this scenario much more likely in the USA than in other developed countries: a combination of the healthcare system, workplace expectations, and the culture of pulling oneself up from ones own bootstraps.

Fent is mostly a street drug. While i guess those cases exist, the problem we are seeing now is mainly a flood of cheap fent on the street from people who have probably never been prescribed opioids before (or indeed, haven’t seen a doctor very much at all in their life). The older middle class people who were/are abusing opioids aren’t the same people on the street who never had much anyways.

Think of it like guns. In the east, children don't touch guns that easy as Americans. So you not going to hear about accidental gunshot in the east no matter how stupid or how genius you are as Asian. In America, that is a normal annual statistical happenings. Fentanyl is like that. There are many incidents paper money laced with fentanyl where you touch it, you get fentanyl overdose. You almost can argue it seems foreign agents are slowly decimating American people to soften the take over with immigrants.

> There are many incidents paper money laced with fentanyl where you touch it, you get fentanyl overdose.

This is a myth perpetuated by cops having panic attacks.

You can dip your hand in liquid fentanyl and be fine. https://pubmed.ncbi.nlm.nih.gov/35722948/

"This has never happened," said Dr. Ryan Marino, a toxicologist and emergency room physician who studies addiction at Case Western Reserve University. "There has never been an overdose through skin contact or accidentally inhaling fentanyl." https://www.npr.org/2023/05/16/1175726650/fentanyl-police-ov...

Just to get an impression for the scale, the paper that is linked in the article shows that there were ~40000 deaths due to overdose in 2010 and a bit more than 100000 deaths in 2021. So this is not just fentanyl becoming a larger part of the portion of deaths, but a very significant increase in total deaths as well.

Minor nitpick: when you provide figures in the multiple thousands, it really improves readability if you use the thousand separator (40000 -> 40,000, and even more so 100000 -> 100,000). Thanks.

To be fair in many parts of the world 40000 and 100000 is written like this 40.000 and 100.000. So it may confuse non Americans.

I've seen a trend of using spaces (40 000) for this reason.

Let's use Python unambiguous notation with underscores 100_000 or 40_000.

Yes, I don't really use thousands separators because I use both number systems regularly and the ambiguity annoys me. It's not a practical issue in this case I think as almost everyone would assume US numbers here. But they feel weird to me somehow. I have used spaces at times as a thousands separator, but that might be even more confusing.

Spaces is actually an international standard, as part of SI, for scientific writing. If a numerical value has more than 4 digits on either side of the decimal marker, make groups of three using a thin fixed space.

For the decimal marker "." and "," are both acceptable. Use whichever is appropriate for your country or for where you readers are or whatever.

Unicode U+2009 (thin space) or U+202F (narrow no-break space) are good for this, but unfortunately neither of them are among the Unicode that works on HN. HN converts them on input to a normal space.

E.g., 12 345 (space), 12 345 (U+2009), and 12 345 (U+202F) are all the same on HN.

That wasn't always the case. I'm not sure when they started filtering these out on input, but 6 years ago I posted a comment where I pasted in some text demonstrating various Unicode spaces [1], and that works so the change was sometime in the last 6 years.

Note: it only works for me in Chrome. In Firefox and Safari the browser changes them all to normal space. I don't know if that is just something peculiar to my Firefox and Safari installations or if Chrome just does Unicode better than they do.

[1] https://news.ycombinator.com/item?id=16194485

Can't get confused with the traditional notation either! Your options are to demarcate by -illion (40e3, 100e3) or by order of magnitude (4e4, 1e5).

Commas and periods perpetuate cultural ambiguity and waste characters.

My wife has pre-cancerous moles and every few years some need to be removed. This year it was done - and they told her to take Advil for 6 inch long incisions on her back.

In the past? Pain pills like Oxicotin - which they are now afraid to prescribe. So she’s dealt w 2 weeks of agony as she heals.

American medicine is cruel.

Doctors aren't always right. You know you can push back?

The unfortunate reality is that if you push back, you may get "drug seeking behavior" added to your records, making it even less likely to receive sufficient pain relief in the future, even for unrelated situations.

>American medicine is cruel.

I'm pretty sure if I asked any Norwegian doctor for opioids after a mole removal I'd be laughed out of the office.

It sounds like Op’s wife is having more than a mole being frozen off. He references a 6” incision.

I think Op meant six 1" incisions(hence the plural), but I could be mistaken.

Right on. My wife had some tremendous neck pain for days when we lived I Germany. Something that here in Mexico would have been treated by ibuprofen , until it receded.

The German doctor basically redered her to a masseur (sp?) Prescribing massages until the pain subsided. After some days, it did.

The culture of "quick fix" for everything that we have adopted in some western countries is biting us back.

That's why you have so many unhealthy people (like overweight or even diabetic people who dont want to do any kind of effort so prefer to be filled with pills)

She might ask her doctor about ramping up the Advil(ibuprofen) - dosage is not limited to one 400 mg pill per 4-hour period.

An adult can usually tolerate up to 3200 mg of Advil per day. Large dosages can be prescribed (easier to take as a single pill). Again, she should ask her doctor.

I had a cracked bone once - 800 mg Advil for 8 weeks erased the pain while the bone healed. Bone healed OK (advil didn't affect healing negatively).

There are other NSAIDS. Aleve(Naproxen sodium) is one of my favorites. Read up on the differences and side effects, b/c YMMV.

This is how foreign agents able to slowly destroy America. It is the people that make a country and not the land. Unalive the native and flood it with "specific" immigrants. Given how incompetent America congress is for the past 3 decades, we are seeing the beginning of fall of Rome unfolding in our lifetime. What a time to live in. Is like given a chance to see destruction of Spanish Armada or sack of Rome....defining moment in history of any fall of great superpower.

What specific immigrants do you mean? Most of the immigrants I'm aware of work in kitchens and construction sites or the skilled ones in software or medicine. Most of the people I see calling for ever more power and wealth for the plutocrats who would sell the nation for scrap are natives who want a piece of that action.

I’m old enough to have heard this theory with a few different variations, now, and I can’t help but hear the racial dog whistle undertones, even if the person making the argument doesn’t intend that. I don’t think there is any logical progression of this theory that doesn’t end with horrible cruelty towards “them”. It’s not like we haven’t seen this play out multiple times in the US.

Just out of curiosity, how old are you? These things don't exactly happen overnight.

Please have more vacation weeks so that people are less stressed. Remake the financial system so that people cannot take on more debt a cause for stress. Make a progressive tax system for people and large cooperations so that people spend time in local communities and buy local.

One thing you can do is have some narcan (naloxone) on hand. It's available without a prescription at national brand pharmacies. Many insurance plans have a $0 copay for it, almost all would be under $20. Useful even if you don't know anyone in your life that would use fentanyl. There's any number of situations where it could happen.

Naloxone is a medication used to reverse or reduce the effects of opioids, like fentanyl.

Naloxone is the generic name for Narcan(TM)

Some states offer it for free at pharmacies, no insurance needed.

I had to get a colonoscopy and be awake for the whole thing. They gave me fentanyl (my first and only time ever experiencing this drug) for the procedure. I have very fond memories of the entire experience, which is extremely disconcerting considering what was going on at the time. This drug probably shouldn’t exist imho.

It feels like somewhere along the way we declared discomfort and pain to be an invalid human state that should not exist and therefore must be dutifully banished at whatever cost.

Maybe it’s okay if a colonoscopy sucks.

I can’t tell if this is satire but suffering for the sake of suffering seems senseless

You shouldn’t look forward to someone you slicing you up, though I do agree with you, to an extent. Like, I don’t want to needlessly suffer, but I also don’t want to think it is “fun” either.

> Maybe it’s okay if a colonoscopy sucks.

Eh... no thanks.

Could it be the colonoscopy rather than the drug

Uh no. I think I would be rather fascinated to see a red light moving around my belly if I were sober, but not to the point that I actually was fascinated. Seeing my intestines all twisted up on the monitor should have freaked me out, but I thought it was very pretty looking and asked for a picture to take home and put on my wall. My emotions don’t match up to the facts and my reactions were borderline cringe-worthy. The fact that I can remember it in detail is part of what makes it even more disconcerting.

So, no, if I were sober, I don’t think I would have fond memories of the experience.

The drug was made for invasive medical procedures - the only time I've ever had it was when they were pulling my wisdom teeth out of my face, which did end up being rather pleasant. Within a medical context it seems very useful.

You had to be awake? Must've been something really unusual, normally they knock you out with propofol or similar.

My impression is that normally it's only used for extreme pain management scenarios like immediately following surgery and breakthrough cancer pain.

Shit, I once got a colonoscopy in the UK's NHS without sedatives nor opioids.

It freaking hurt a lot which apparently shouldn't have. That gave doctors the clue that I had IBS and a very sensitive colon apparently (I didn't have anything wrong from what they saw).

All future colonoscopies I've had, I demand to get knocked out. Better for everyone haha

Getting knocked out is standard for colonoscopies in the states. I can’t imagine doing that awake. The worst part is the laxative the day before, I didn’t get anti-nausea meds, I will totally go for those next time.

On a micro level, I live in the US and I don't know anyone who takes fentanyl. "Every corner" is likely journalistic hyperbole.

Brown heroin doesn’t exist anymore. It’s all fent, they’re even cutting coke with fent which makes absolutely no sense to me.

It started with oxys until the gov cracked down then everyone went to brown heroin until fent arrived.

Report of Fentanyl in coke circa 2018.

https://www.dea.gov/sites/default/files/2018-07/BUL-039-18.p...

https://www.npr.org/2021/07/05/1013203805/party-drugs-are-be...

> makes absolutely no sense

It makes a lot of sense if you assume they're trying to kill everyone

I assume drug dealers like recurring revenue as much as a SaaS company does and it's hard to get recurring revenue from a dead person.

Last year here in Argentina we had a cocaine lot cut with carfentanil. IIRC the big drug dealers detected that something was wrong and decided to throw it away. But they had an internal miscommunication (or steal) and the drug was sell anyway. The result was 24 death and like 100 hospitalizations (and probably more unreported cases). Even the Security Minister of our biggest province said on TV something like:

paraphrasing> If you bought cocaine yesterday, please discard it. It may be the bad one.

One of the reports during the problem: https://www.theguardian.com/world/2022/feb/03/argentina-tain...

One report one year later: https://batimes.com.ar/news/argentina/one-year-without-answe...

Maybe not on purpose. Fentanyl is being used to cut other recreational drugs like cocaine and MDMA.

I bet you know people who take illegal drugs. And those drugs could easily have fentanyl in them, unknowing.

Is this happening in other countries?

It’s been a problem in Canada. Not sure if the same magnitude.

Fentanyl needs to be made legal and sold at grocery stores. In 2-for-1 packs, fentanly+narcan, at affordable prices. Even better, subsidized prices for poor people which can't afford it.

That would solve the fentanyl problem, which is solely due to it being illegal and impure.

More generally, all drugs need to be decriminalized and sold at affordable prices and pharma-grade quality.

I think it is the opposite. People are looking for fentanyl free drugs.

I don't disagree. At your local grocery store you should have a drug aisle with cocaine, heroin, fentanyl, MDMA, mushrooms, all pharma-grade quality. So you would know exactly what you are getting.

Maybe we could also have Futurama style euthanasia booths just outside the entrance?

Not a booth per se but you sign a few papers and you can be suicided within 30 days in Canada.

Medical assistance in dying (MAID)

The only difference to 'Medical assistance in addiction', is the former is much cheaper as the person won't need any help, ever.

Not exactly. But generally making less harmful drugs legal would help - generally the more prohibition the stronger the drugs become.

Making all drugs legal to use makes sense to me. Criminalizing users only makes things worse. But make it illegal to sell, transport, possess in large quantities etc.

How are drug users going to know what they are buying if they are illegal to sell? Dealers are putting fentanyl in cocaine nowadays.

It wouldn’t surprise me if a large number of fentanyl overdoses were by people who had no idea they were taking fentanyl at all.

Decriminalizing drug use is intended to solve a different problem - that being throwing people in jail for being addicts is bad in a number of ways and consequences.

Making all drugs legal and available (with quality assurance) will (at least help) solve the problem you are talking about, but will at the same time create whole new problems that more and easier access to drugs will mean more people try and use them and then an increase in lives destroyed through addiction (and related consequences). My opinion is that would be worse.

Decriminalizing use basically decriminalizes selling as far as I can tell here in the northwest. Police and prosecutors can no longer threaten users with legal action to give up their dealers, and since buying is now low risk, dealing also becomes lower risk. I’ve seen people on the street looking for drugs and find them on my morning walks (they are pretty vocal when asking, and dealers aren’t shy about replying).

It would be easy to put out fake buyers to find the sellers. Sounds like lazy policing.

It is hard to find police that can convincingly do unhoused drug addict well enough.

There are test kits available that can show you what you have, including tests for fentanyl. It requires a bunch of different reagent tests if you bought a Mystery Powder that you want to ID. But if you were after MDMA, for example, and bought what’s claimed to be MDMA, you can test it with a specific reagent to confirm whether it is that or not, then test it with a fentanyl test strip to show if it’s free of that contaminant.

Dance Safe sets up tents at big festivals to do this kind of testing as a harm reduction service. They (and others) are trying to normalize the step of testing what you have before using it, and I think that’s a wise choice especially with fentanyl in the mix. I’d expect that with decriminalized use of “white powder” drugs, you’d see these kits become more readily available from smoke shops, maybe even pharmacies, instead of being something you have to search for online.

The problem I see with criminalizing drugs (including sell, posses and transport) is that drug addicts and abuse is mainly a health issue.

There's an underlying reason why those people start consuming that shit. Same as with sugar/obesity/diabetes here in Mexico.

Once you make it ilegal, suddenly you created a criminal issue. You've created another problem for yourself and split your resources to fight both problems now.

I would rather prefer government/society focus only in the underlying health issue. And disappear the criminal issue by making it 100% legal.

Imagine if suddenly refined sugar became illegal in Mexico, suddenly the government would have to fight not only the obesity epidemic, but also the sugar trafficking criminals.

Better to allow doctors to prescribe heroin maintenance. In fact this was tried in the UK back in the 1980s (and earlier) and is generally regarded as a success: https://en.wikipedia.org/wiki/Heroin-assisted_treatment

I used to share a similar position until I realized: drugs are bad, actually, and there should be substantial friction in making them available to people.

Disincentivizing drug consumption is a good thing. The war on drugs obviously leads to some absurdities - e.g. drug cartels, unnecessary incarceration - and I much prefer the Portuguese model.

But making fentanyl in particular available in the grocery store would be bad; some substantial number of people would die who wouldn't have died otherwise. Some substantial number of people who would never have tried fentanyl would give it a try.

Some sensible balance needs to be struck between a free society and preventing people from e.g. leaving live landmines in their parking lots. Doing things which inevitably kill people/mess up their lives without active violence is still bad, and should be heavily discouraged.

Even the Portuguese model has had mixed success at best

My understanding is that the Portuguese model was going along pretty well until fentanyl came along.

I shared this understanding. I'd be curious to hear where GP's understanding differs.

What led to your realization that "drugs are bad", and does that include all external consciousness altering substances? (caffeine, alcohol, nicotine, THC, and so on).

Can't speak for somebody else's post, but addiction ruins lives, not only yours but also possibly the people around you, and leads people to other criminal behavior.

It's perfectly legal to obtain and use alcohol for example, but alcoholism is an insidious evil disease.

Sure, yet you'll probably find no-one who is destroying lives (their own or others) for caffeine. THC is certainly a more mixed bag, but at the very least you will never die from it. So "drugs are bad" is just too much of a blanket term, and we should probably come up with better terminology that correctly reflects addiction potential and intrinsic and extrinsic damage. In addition, the illegal market shifts those dangers quite significantyl. Someone can take morphine for the rest of their lives with out much of any bodily harm, but in an illegal market it can be deadly quickly and procurement leads to much pain and harm. Last but not least, humanity will never not want to use drugs, no matter what we do, so we need to come up with harm reduction that is effective (which includes regulation, education and probably also includes doing away with prohibition).

yeah, definitely. "Drugs are bad, actually" is decidedly an over simplification. For the record my drugs of choice are SSRIs, caffeine, and mushrooms.

Full agree with everything you're saying here. The less oversimplified realization I had: In the pros/cons of "Should drugs be fully legalized?" I was counting only the negative aspects of making drugs illegal, not the negative aspects of legalization. I expect others make this error too, so "drugs are bad, actually" is intended as a pithy corrective, less a broad ethical directive.

The specific causes of this realization: the accruing evidence of the downsides of THC, and the easy access of teenagers to extremely potent weed. The ditch weed I bought from Curtis behind The Globe coffee shop in high school simply had less potential for harm.

> we should probably come up with better terminology that correctly reflects addiction potential and intrinsic and extrinsic damage

Full agree. Really there are complex policy trade offs here. I don't pretend to know optimal solutions, and agree that arriving at optimal solutions is unlikely via an extremely polarized discourse.

It’s not binary.

Drugs that kill or otherwise destroy your life are very bad. Other drugs that don’t do that are probably much less bad, and we should allow things somewhere that fall under a line between not bad and very bad. Where that line exists is a matter of current debate.

> all drugs need to be decriminalized and sold at affordable prices and pharma-grade quality.

Sure, fuck the 20%-30% of the population who can't control their addiction and ruin the country in the process.

Makes it a lot easier to increase the government dependency pool by 20-30%.

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