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Comment by jlgreco | Hacker News Reader

I don't find this too hard to believe. Even today we see a push to either reformulate narcotic painkiller medications to make abuse difficult/impossible, or bundle them with acetaminophen/paracetamol. The problem is that when drugs like Oxycontin are reformulated to make abuse difficult ("Oxycontin OP") addicts are driven to attempt abuse of other narcotic painkillers which get them the desired affects... but with a potentially deadly dose of acetaminophen.

So instead of attempting to help these people while providing them with a safer alternative (methadone clinics exist, but for the most part they really are not targeted towards the middle-class/middle-aged prescription painkiller addict crowd), we are pushing to eliminate drugs that are safe to abuse. This move seems based in the plainly idiotic attitude of "well if an addict can't do something safely, he'll just give it up".

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The thesis of the War on Drugs is pretty much that there are abstract, amorphous dangers to recreational drug use, and the proper role of government is to provide immediate, concrete dangers so that people will stop.

It does have a certain twisted logic to it, if you ignore every piece of empirical evidence generated over the last hundred years.

Mixing Tylenol with oxy is twisted in a different way, because it replaces an abstract danger (if you take some amount in some period of time, you might become dangerously dependent) with a somewhat less abstract danger (if you take some smaller amount in some shorter period of time, you might die).

In Australia we've had ads which specifically focus on the unsafe, illegal manufacturing conditions of a banned drug as a reason to avoid the drug. For example: http://3.bp.blogspot.com/-J1b1lX7HRxU/TlBbd9d4WHI/AAAAAAAAAN...

When I first saw this ad series I was stunned by the hollow, almost cynical reasoning on display, only to then be even more stunned by the lack of reaction in others. Your one-sentence summary of the War On Some Drugs, however, provides an insightful context to the campaign.

When I first saw this ad series I was stunned by the hollow, almost cynical reasoning on display, only to then be even more stunned by the lack of reaction in others.

There's a substantial cohort of the population[1] that thinks If something is illegal it must be wrong. They wouldn't make it illegal unless it was. Getting through to these people, in my experience, is almost impossible.

[1] Probably not on HN. But we're not representative of the country at large.

MP "You can't compare harms from a legal activity with an illegal one."

Professor Nutt "Why not?"

MP "Because one's illegal."

Professor Nutt "Why is it illegal?"

MP "Because it's harmful."

Professor Nutt "Don't we need to compare harms to determine if it should be illegal?"

MP "You can't compare harms from a legal activity with an illegal one."

http://www.amazon.com/Drugs-Without-Hot-David-Nutt/dp/190686...

The thesis of the War on Drugs is that we can expand police power, persecute minorities with impunity, give hand-outs to well-connected industries (pharma, alcohol, tobacco, prison operators, etc.), and generally terrify the population into submission. There has never been any other goal, all the way back to cocaine first being made illegal a century ago.

And fund the CIA dark side ops. (Iran Contra)

You're making a huge assumption here, which is that the central point of the war on drugs is actually to stop people using drugs.

http://en.wikipedia.org/wiki/Prison%E2%80%93industrial_compl...

Or that the role of the US Government, as presently practiced is to do anything other than funnel tax money to crony capitalists. Take it form the middle class and give it to the plutocrats.

I guess the logic is not much different from the one used to burn people at the stake for their sins. If you smoke weed, it's bad for you, so we will put you in jail, which is 100 times worse, but at least your soul is cleansed by the government now.

Forcing oxycodone with acetaminophen has caused thousands of deaths. I recall reading a study that did the statistical analysis and got more precise numbers but can't find it with a five minute search.

In 2009, a federal advisor board recommended that Vicodin and Percocet be banned. Instead, they have to be reformulated to have about half as much acetaminophen. http://www.nytimes.com/2011/01/14/health/policy/14fda.html?_...

Suboxone prescribing physicians are more targeted towards the middle-class/middle-aged crowds.

This reminds me of the result of the abstinence argument. Namely, even if you believe all premarital sex is immoral, it's still important to realize that safe immoral sex is better for the man and woman than unsafe immoral sex. When the government forces what society believes to be "right," as opposed to what is effective (in regards to health, purse or morality), it can have harsh consequences.

[Edit: grammar]

I think you mean immoral. An amoral action is neither moral ("good") nor immoral ("bad").

Oxycontin OP is just Oxycontin in a "tamper-proof" pill. It only increases the effort needed to take a recreational dose; it doesn't increase the danger.

What you're talking about is a real problem, but you'd better pick a better example.

Speaking of addicts/drugs/adulterants, what was the conclusion about levamisole in cocaine?

Also, many of the FDA's objections to safer forms of Nicotine consumption are that less deaths might lead to more use.

Both things like Oxycontin OP and drug clinics seem like good ideas to me. I don't know why you seem to be saying it's one or the other and we're making the wrong choice. I don't think that's a valid representation of the decision space.

Because poisoning people as a way to get them to stop using drugs is abhorrent?

Withdrawing an abusable drug is not the same as deliberately poisoning people. I know they are in the narrative you wove for yourself, but I just wrote a post about how I don't buy that narrative.

The acetaminophen dosage that you get when you abuse many narcotic pain killers is poisoning.

We're not talking about a bittering agent, or something that makes you throw it back up. We're talking: if you abuse it, it will kill you.

Narcotic pain killers containing acetaminophen have a lower risk of addiction than the equivalent opiate. That is the whole reason why they're so readily available. A dentist prescribing Vicodin is unlikely to create another addict. As a person who has had two root canals, one for a severely infected tooth, I am glad that this is the situation.

Oxycontin, as a time-release opiate, is another drug intended to maximize the painkilling:abuse potential ratio. You are implying that things like Oxycontin OP are an attempt to poison drug users. I reject this weird-ass conspiracy theory, and submit that perhaps things like Oxycontin OP are designed to do exactly what they say--lower risk of abuse. Nobody wakes up one day and says "I am going to become an addict today", it happens in cumulative moments of weakness.

Edit: now people are saying that the point of Vicodin is to kill people who overdose on it. Nonsense. It's an effective painkiller with reduced addiction risk; reason enough for its existence if you care at all about consumer freedom. But whether or not Vicodin should exist is not even what this subthread is about. I give up.

>submit that perhaps things like Oxycontin OP are designed to do exactly what they say--lower risk of abuse.

They do so by attempting to deter abuse via threat of poison. People die from acetaminophen poisoning from this tactic.

>Nobody wakes up one day and says "I am going to become an addict today", it happens in cumulative moments of weakness.

You don't know what you're talking about. The Vicodin comment was bad enough. It's widely known to be abused and it often leads to abuse of other painkillers.

edit: I'm worried I've misunderstood. I got the impression from the context that Oxycontin OP had acetaminophen in it. If it doesn't, why are we even talking about it?

Despite the assertions of low abuse potential, the reality is that people do become addicted to narcotic pain killers. Vicodin abuse is massively widespread, you are entirely ignorant in this subject if you think otherwise.

When the original, "higher abuse potential" (read: safer) Oxycontin formulation was replaced by Oxycontin OP, addicts were driven to abusing high-acetaminophen narcotics anyway (attempting cold water extraction if they knew enough), or to more dangerous sources of a fix: black market original formulation Oxycontin or, often, street heroin.

No addict wakes up one day and says "Oh, my painkillers have acetaminophen? Guess it's a good day to quit".

Why? Because they are addicts.

Creating slow-releasing narcotic painkillers to reduce accidental addiction is fine. Removing all safe narcotic painkillers from the market damages addicts and is unethical. Oxycontin OP was not invented in a vacuum, it replaced the traditional Oxycontin in a misguided attempt to stop deliberate abuse (the differences are not merely limited to slower release).

Creating narcotic painkillers that are purposely deadly when abused is never fine.

I honestly don't know how an MD would permit himself to be involved in the Vicodin/Percocet crime. There had to be hundreds of doctors involved in development and approval. It kills people, completely unnecessarily, in the name of the drug war.

(if I ever get a painkiller from my dentist, I ask specifically for vicoprofen, anyway)

Opiate abuse is damaging enough. Increasing the danger does nothing to slow abuse among the addicted and is incredibly unethical. It's like building a car that disables it's own airbags when you start speeding.

Worse actually. Speeding is not a physically addicting activity, merely psychologically addicting.

Adrenaline addiction is physical, not just psychological. There are some studies which shine light on the underlying cause:

http://www.reuters.com/article/2010/02/01/us-dopamine-idUSTR...

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