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Comment by TaylorAlexander | Hacker News Reader

"marijuana is currently in the same category as some of the hardest drugs, like heroin and LSD"

Drugs should not be illegal period, but "some of the hardest drugs, like heroin and LSD" is a very funny (dark) sentence to me.

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All while clearly the most dangerous drugs like fentanyl are schedule 2. (╯°□°)╯︵ ┻━┻

this isn't how things are defined, though. these days, heroin is not necessarily the best opiate against opioids. we have more selective drugs that are better at targeting analgesia over euphoria. fentanyl and more euphoric options are generally used for high levels of pain, not routinely. and so diacetylmorphine has very few medical uses besides treating withdrawal, where methadone is a better option.

because it doesn't really have a legit medical use, it's schedule 1. marijuana, lsd, and psilocybin obviously no longer really fit these criteria, but heroin probably does.

with all that said, i'm generally against scheduling and think pharmaceutical and recreational drugs should be available over-the-counter.

> because it doesn't really have a legit medical use

UK seems to think otherwise

https://en.wikipedia.org/wiki/Heroin#Medical_uses

sure, that's one alternative opinion. i am one of the biggest fda-haters you'll find but, in a vacuum, this call isn't really wrong. it can theoretically be used medically - but i'd be hard-pressed to think of why a doctor would use it now over other options. perhaps one can give some examples of cases where it was truly the only option.

I mean Fentanyl should be schedule 2, it has legitimate medical uses. That's why Cocaine and Methamphetamine are also schedule 2. Marijuana should probably be schedule 4 or 5, if not completely de-scheduled and regulated the same way Alcohol is, which is what a lot of recreational legalization states have done.

I used to think this, but now am not as sure. The experience that Portugal and the Pacific Northwest have had has caused me to question this.

I legitimately don’t know.

It might work if you divert all of the funds to recovery programs. But Oregon did not do that and now they are backpedaling.

We also didn't require you to enter recovery programs.

Well, legalizing drugs won't solve other social problems. That takes completely unrelated reforms. But at least people won't end up senselessly put in prison for what they choose to put in their own body.

People usually don't get thrown in jail for getting high, they get thrown in jail for things that they do either in order to get high, or because they got high. Am I wrong?

Blanket legalization without any supporting infrastructure seems dicey. Portugal had fairly promising results early on when they had funding for all of the assistance programs, etc., but this money ran out and the taxes raised as part of the change did not provide enough funding to support them. The PNW implementations are scattershot messes, so no surprise things are going poorly there. (Though I don't think as poorly of harm reduction practices as many do)

I think there are quite a few things we could broadly legalize, like marijuana, lsd, shrooms, dmt, etc., and have little cause for concern. Opioids, amphetamines, cocaine, etc. have enough abuse potential that we do probably need real programs to help people get clean and away from the situation that led them to begin abusing in the first place before we make them broadly legal.

Though, at the same time there are legitimate arguments that we would see significant benefits in some areas by legalizing, if only because we could bundle naloxone with opioids and ensure consistent dosages and purity, which would save a lot of lives.

I agree for the most part. I used to be more pro legalization of everything. It definitely seems like if you do the cost benefit analysis for individual cases it is better to not punish people for ingesting a substance voluntarily.

That said, I've lost two friends to heroin overdoses (one intentional, one not). They were both relatively successful. I find the call for better programs a bit empty - would these programs be voluntary if you are on decriminalized drugs? If so, do they have any chance of success? My friends were both financially fine so they could have opted for rehab and (as far as I know) did not.

Perhaps if legal there'd be better harm reduction practices, though I'm still skeptical this would overcome the increase in ubiquity.

The data also makes things hard. California and Oregon have far few overdoses than West Virginia. But Texas and North Dakota beat the west coast states by a lot.

I've also lost a friend to a heroin overdose, and as best we can tell it was unintentional and the result of a significant difference in purity/dose from what he was expecting. It's the sort of thing legalization and regulation would go a long way to fixing. Naloxone being readily available and using with others capable of dosing you with it to stop an OD would also be a huge deal.

But yes, I imagine any rehabilitation programs would be voluntary, though I think it would be reasonable to force them in situations where people are doing other illegal things while on the drug - DWI, the sort of public abuse you see in some cities (though lots of this is tied to a larger homelessness issue), etc. Bundle it up with programs for the homeless and you probably take care of a lot of the worst situations for people.

I don't think we'll ever get to perfect, but I hope everyone believes we can get to a better spot than we're at today.

If they're legalized it's possible it would be easier to track usage, and stage interventions if someone's demonstrating dangerous patterns.

If it's illegal than maybe fewer people are exposed, but it can be harder to know when it's a problem.

I am skeptical that libertarians who want legalized drugs would be okay with tracking. For progressive-minded people I'm skeptical too, most harm reduction programs I see emphasize anonymity.

The link below is framework for harm reduction policies which seems pretty clear that tracking usage is not part of the practice

"Participation in services is always voluntary, confidential (or anonymous), self-directed, and free from threats, force, and the concept of compliance. Any data collection requires informed consent and participants should not be denied services for not providing information. This means using low-threshold evaluation and data collection systems to measure the effectiveness of harm reduction programs."

https://www.samhsa.gov/sites/default/files/harm-reduction-fr...

Fentanyl has changed everything. The only "old" drug comparable with it is heroin, and it has always been pretty expensive and required "dedication" (intravenous use) from abusers.

Fentanyl is cheap, so a daily dose even for a heavy user is apparently less than $30 now ( https://sfstandard.com/2024/01/22/cheap-street-fentanyl-san-... ). It's also easy to get into, you just smoke it off a foil, no need for scary syringes.

And once you get addicted, you're a walking dead. The success rate for fentanyl addiction treatment is apparently less than 1%. ONE PERCENT. Even for heroin, it's around 5%.

So yeah, drugs are just different. Europe has not yet been hit with fentanyl, but it's starting to appear ( https://www.economist.com/europe/2023/11/16/fentanyl-kills-t... ). We'll see what happens.

you realize that "decriminalization" is the same as 1800s snake oil salesmen at the world's fair right? the exact reason the FDA was created

these substances need to go through the FDA with per ailment clinical trials and side effects listed just like other substances

reach parity with other approved drugs, alongside licensed distribution (like other drugs), treatment programs and education

make options for consumers - like we're already doing at the state level with marijuana - but better options so they don't chose the black market supply

A few things to mention here. First, the government actually paid a university to grow cannabis and they gave it to glaucoma patients for decades without any interesting results (in my opinion probably because the grantees were more interested in getting repeated funding from NIDA than to publish things NIDA didn't want to see). Second, there have been a number of clinical trials on marijuana for quite some time with a wide range of results (it's a tricky drug to study for a number of reasons). For a long time, NIDA made it hard to get funding for this- and also constrained the supply- probably with the goal of preventing studies that would find efficacy. Third, I think the FDA system is really poor at evaluating a wide range of drugs (of which cannabis is an example). They have a really limiting mechanism that doesn't work well in "compassionate use" where we already have a good understanding of the risks from widespread use. Fourth, the FDA wasn't created to do this- it was created mainly to reduce consumer fear of drugs in response to absolutely horrific side effects. The drug that led to this, thalidomide, is approved by the FDA and used in the US as a highly effective medicine.

I think in retrospect, it took the FDA so long to get here for political reasons, not scientific or medical ones.

The product made by that university was whole plant, ground. It might have been paid to grow it, but it wasn't any good at it.

https://www.reddit.com/r/trees/comments/epeb6k/the_universit...

The PNW isn't a monolithic legal environment. Oregon state has dabbled in legalization much more than Washington.

Non-opiois drugs should generally be legal imo. Opioids specifically are tricky.

I’d caution taking too many lessons from what’s happened in Oregon so far.

Measure 110 was advanced by ballot initiative, and there was little planning around how supportive services/infrastructure would be built. As a result, the rollout has gone extremely poorly.

Add to that, despite what people will viciously argue to the contrary, the distribution caused to society by COVID. Across the entire US there was a significant increase in crime, followed by a subsequent reduction. Further, significant numbers of people were let out of the jail system and shelters to reduce crowding.

There are realistically several currents that are leading to people’s anecdotal experiences, which are challenging to disentangle. All I would argue is that it is folly to think that just throwing the doors open without careful planning and consideration is a bad idea (shocking, I know).

Only artificially concentrated drugs should be heavily regulated and tracked. Everything that is a plant should be legal like tobacco. The main danger is the dosage of the drug, and using chemicals and other ways to concentrate the active ingredients, which is what makes them so dangerous.

Hemlock?

If drugs are to be outlawed based on their level of harm to society, tobacco shouldn’t be legal. It kills 7x as many as opioids every day.

That's just because more people are using. Imagine if just as many used heroine. Additionally, tobacco companies add more than just tobacco, which I believe is the most harmful and addictive part of cigarettes. I'm not saying it should all be banned, but the restrictions should align with how transformed and concentrated the product is.

Also, tobacco typically kills after 20-30+ years of use. The people it kills are mostly older people in their 60s. Heroin kills people in the prime of their life.

Imagine if nicotine was banned and people had to get it from dealers who make it in liquid form in huge vats in their basement. There would be a lot more dead from nicotine overdose for sure.

Tobacco frankly probably shouldn't be legal.

That would be like banning sugar. Sugar probably kills more people.

Sugar doesn't deal AOE damage to everyone in the vicinity.

I dunno, ever bring a box of donuts to a party?

Fun quip, but I'll do you the favor of assuming you understand why this isn't the same, explaining it to someone that most likely already understands would feel a bit patronizing

That’s because the article is wrong. Scheduling is not based on the dangerousness of the drug. It’s based on the potential for abuse and the medicinal value.

Yeah what the heck is “hard”. Destructive on the human body? Acid and heroin have about as much in common as beer and psilocybin

degree of effect. marijuana and ecstacy are "soft" because, in common recreational doses, they have less radical effects on one's personality and coherence. heroin, acid, and psilocybin all have more significant effects, microdoses aside.

I would argue that MDMA in common recreational doses has about the same level of radical effects as psilocybin. Different effects, but similar "level" or intensity of effect. And MDMA is much more dangerous for your body.

Opioids including heroin have moderate effects at moderate doses, much like marijuana or alcohol.

Ease of addiction combined with difficulty of quitting.

If that is the criteria, it is clearly wrong to include LSD in that bucket.

Oh, for sure. "Hard drugs" classification makes sense for cocaine, heroin, fentanyl, but not for psychedelics.

I think it's like one of two criteria: 1. Damaging to your body and highly addictive. This is most opioids, arguably tobacco (which is kind of grandfathered into being legal), meth, cocaine etc. 2. Can cause significant, unpredictable shifts in behavior in otherwise stable people, to the point of endangering themselves or others. This is (also) cocaine and meth, arguably alcohol (also grandfathered in), ecstasy, and why LSD is so highly scheduled. There's probably a world in which there're responsible, safe ways to experiment with LSD, but it's not something you necessarily want your given random guy on the street to be taking, lest he walk or drive into traffic or start swinging a 2x4 at people.

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