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Seattle Is Opening First in U.S. “Safe Injection Facility” for Heroin Addicts

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Re: Seattle Is Opening First in U.S. “Safe Injection Facility” for Heroin Addicts

#11

Post by jayajay »

xyzzy4 wrote: post #3

They should also sell heroin in pharmacies so people can inject an accurate dosage. This would greatly reduce overdoses and drug trafficking.

I am not convinced that that it will reduce overdose or trafficking. It depends on the drug's economics and pharmacodynamics, ease of production, addictiveness, LD50, etc. What's better? More people using high-grade heroin in a controlled, safe environment, or less people using low quality heroin in an uncontrolled, dangerous environment?

If the LD50 is very easy to arrive at in everyday usage, then I don't see this helping out very much. You could sell heroin in doses People would just end up riding their doses up to dangerous levels, in which case they would now have a dependency on heroin. Would it bet better for everyone to have a safe, controlled dependency on heroin, or for 5% of people to have an unsafe, uncontrolled dependency on heroin?

Re: Seattle Is Opening First in U.S. “Safe Injection Facility” for Heroin Addicts

#12

Post by yread »

xyzzy4 wrote: post #3

They should also sell heroin in pharmacies so people can inject an accurate dosage. This would greatly reduce overdoses and drug trafficking.

It works in some countries

> Heroin assisted treatment is fully a part of the national health system in Switzerland, Germany, the Netherlands, Denmark and the United Kingdom.

https://en.wikipedia.org/wiki/Heroin-assisted_treatment

Re: Seattle Is Opening First in U.S. “Safe Injection Facility” for Heroin Addicts

#13

Post by snowpanda »

martinald wrote: post #7
xyzzy4 wrote: post #3

They should also sell heroin in pharmacies so people can inject an accurate dosage. This would greatly reduce overdoses and drug trafficking.

I literally cannot understand why this is being downvoted. Prescribed heroin would save thousands of lives and billions of dollars in ER OD cases and the acquisitive crime that this disorder causes. Shame on you HN.

>Shame on you HN.

Yeah shame on people for having a different opinion then yours.

Re: Seattle Is Opening First in U.S. “Safe Injection Facility” for Heroin Addicts

#14

Post by paulmd »

jayajay wrote: post #11
xyzzy4 wrote: post #3

They should also sell heroin in pharmacies so people can inject an accurate dosage. This would greatly reduce overdoses and drug trafficking.

I am not convinced that that it will reduce overdose or trafficking. It depends on the drug's economics and pharmacodynamics, ease of production, addictiveness, LD50, etc. What's better? More people using high-grade heroin in a controlled, safe environment, or less people using low quality heroin in an uncontrolled, dangerous environment? If the LD50 is very easy to arrive at in everyday usage, then I don't see this…

> Would it bet better for everyone to have a safe, controlled dependency on heroin, or for 5% of people to have an unsafe, uncontrolled dependency on heroin?

For an answer, you can just look at alcohol, which is typically assessed as having roughly similar social harm to heroin (although it varies by source). Were things better during prohibition, or today?

Re: Seattle Is Opening First in U.S. “Safe Injection Facility” for Heroin Addicts

#15

Post by jayajay »

brianwawok wrote: post #6
lend000 wrote: post #5

Earlier quoted context omitted.

It's too bad this is being down-voted, because you're absolutely right. There will always be people who turn to substances, but the war on recreational drugs creates a black market that results in sketchy, dangerous product. Decriminalization and legalization of drugs will make everyone better off (except drug Cartels).

I know that is the popular meme. But is it really true? What country on earth can you buy any drug you want without a prescription in a pharmacy, and how does the culture look like? Frankly some stuff is really bad and should be kept away from people.

Yes, people don't realize that this "solution" doesn't work for any drug just because it makes sense for marijuana. For the people who disagree: In the limiting case thought experiment, imagine a drug which provides a complete DMT + MDMA experience with a single molecule, but has a 50% chance of killing you. Should this drug be easily available in a store? Run a simulation, let me know what the half life of your population ends up being...

Heroin isn't too different, really. It's very addictive, has a low LD50, and when it's easy to get, people effectively get a free ticket to a brothel on an accelerating rocket-fuel train with rarely stops. If a drug can have that much power over the body, people might think we could create microdoses, and sell those, and then it'd be safe. But then, the market for heroin/tar/etc. would still be there, and would continue underground.

It's not as simple as "selling it at CVS w/o prescription will lower overdoses and dissolve the underground H market"

Re: Seattle Is Opening First in U.S. “Safe Injection Facility” for Heroin Addicts

#16

Post by Dagwoodie »

martinald wrote: post #7
xyzzy4 wrote: post #3

They should also sell heroin in pharmacies so people can inject an accurate dosage. This would greatly reduce overdoses and drug trafficking.

I literally cannot understand why this is being downvoted. Prescribed heroin would save thousands of lives and billions of dollars in ER OD cases and the acquisitive crime that this disorder causes. Shame on you HN.

There is a fallacy at work here where people automatically assume that outright banning a substance through legal action is always wise or even always effective. And if the people die as a result, our attitude is essentially stuck on 'screw em, they shouldn't have been breaking the law anyway'.

Meanwhile, with proper health care and psychiatric care, the same people who could have stayed within the system, could have greatly boosted research into all kinds of conditions that compel people to take hard drugs in the first place and we could have had this issue solved long ago.

Instead, the medical industry is hamstrung in helping them almost as much as the addicts themselves. But politicians from the left to the right get to look good on camera, and journalists can bravely declare more drugs will be off the streets as they show children walking to school, ensuring nobody will ever suspect they're setting those same children up for severe problems that will go untreated.

Re: Seattle Is Opening First in U.S. “Safe Injection Facility” for Heroin Addicts

#17

Post by jayajay »

paulmd wrote: post #14
jayajay wrote: post #11

Earlier quoted context omitted.

I am not convinced that that it will reduce overdose or trafficking. It depends on the drug's economics and pharmacodynamics, ease of production, addictiveness, LD50, etc. What's better? More people using high-grade heroin in a controlled, safe environment, or less people using low quality heroin in an uncontrolled, dangerous environment? If the LD50 is very easy to arrive at in everyday usage, then I don't see this…

> Would it bet better for everyone to have a safe, controlled dependency on heroin, or for 5% of people to have an unsafe, uncontrolled dependency on heroin? For an answer, you can just look at alcohol, which is typically assessed as having roughly similar social harm to heroin (although it varies by source). Were things better during prohibition, or today?

I can't accept that heroin and alcohol are equal in that sense. I would be very skeptical about any sources claiming this equality. Ease of production, pharmacodynamics, etc.

Edit: Ideally, humans wouldn't be consuming poison? But, what is poison? It's a lot more complicated than "alcohol is bad" or "heroin is bad". Maybe you are right, letting down the flood gates will surely kill people who don't have control, and we'll be OK asymptotically. Making alcohol legal certainly killed people who wouldn't have died, and saved people who would have died. At some point, this is just a variation of the trolley problem. If heroin was made CVS-able without prescription, I would not guarantee that I wouldn't try it, and that scares me because I know how dangerous it is.

Re: Seattle Is Opening First in U.S. “Safe Injection Facility” for Heroin Addicts

#18

Post by hackermailman »

yread wrote: post #12
xyzzy4 wrote: post #3

They should also sell heroin in pharmacies so people can inject an accurate dosage. This would greatly reduce overdoses and drug trafficking.

It works in some countries > Heroin assisted treatment is fully a part of the national health system in Switzerland, Germany, the Netherlands, Denmark and the United Kingdom. https://en.wikipedia.org/wiki/Heroin-assisted_treatment

There's about 200 chronic addicts doing a heroin treatment study in Vancouver too http://www.theglobeandmail.com/news/british-columbia/vancouv...

They found using pharma grade heroin worked better than methadone in weening addicts off heroin but it is difficult to get from Europe, so they did another study to see if hydromorphone worked just as well and it did, effectively cutting costs for any prescribed opiate treatment program. They also found by prescribing it, the addicts no longer were getting arrested everyday or participating in the black market, and made long term goals like savings since they no longer needed to live day to day committing crimes to support the addiction.

As for injection sites I hope Seattle doesn't make the mistake of not making sure treatment is also available or else they'll end up like Vancouver with a growing number of injection sites because of the months long waiting list to get into treatment. These facilities are majority used by street addicts too so you still have a large amount of fentanyl overdoses since it's casual users dropping dead in their houses who don't frequent the clinics.

Another issue with these facilities is there's constantly a crowd of gangsters out front ready to sell you drugs on your way in or collect debts from addicts in the lineup so some addicts don't go to the injection sites.

Patrick K Kroupa of LoD/Cult of Dead Cow managed to clean himself up with ibogaine doses and a lot of self discipline http://ibogaine.mindvox.com/articles/heroin-ibogaine-patrick...

Re: Seattle Is Opening First in U.S. “Safe Injection Facility” for Heroin Addicts

#19

Post by zkms »

jayajay wrote: post #11
xyzzy4 wrote: post #3

They should also sell heroin in pharmacies so people can inject an accurate dosage. This would greatly reduce overdoses and drug trafficking.

I am not convinced that that it will reduce overdose or trafficking. It depends on the drug's economics and pharmacodynamics, ease of production, addictiveness, LD50, etc. What's better? More people using high-grade heroin in a controlled, safe environment, or less people using low quality heroin in an uncontrolled, dangerous environment? If the LD50 is very easy to arrive at in everyday usage, then I don't see this…

Opioid use is not inherently dangerous (indeed, long-term pharmaceutical-grade opioid use is remarkably safe does not cause organ damage, unlike alcohol). There are several actual circumstances where opioid use gets dangerous to life and they are:

1) Dosage/concentration uncertainty

2) Contamination of a lower strength opioid (say, morphine or heroin) with a much higher strength one (fentanyl or fentanyl analogues)

3) Poly-drug use -- such as combining opioids with benzos to exploit synergistic effects

When it comes to pharmaceutical-grade opioids, the doses are known and measured and there's no risk of contamination with unknown amounts of fentanyl analogues. Indeed, the mechanisms of drug prohibition actually incentivize the use of extremely high potency/volume opioids such as fentanyl.

The third issue, poly-drug use, also is a consequence of prohibition -- the prices of opioids in the black market are artificially inflated (if you don't have the requisite permission slip for the drugs, you need to invest in all sorts of countermeasures to avoid being put in a cage and your product seized), so users need to economize, and this sadly happens by combining benzos with opioids, which can lead to fatal respiratory depression. This is also a symptom of prohibition and is not inherent to opioid use.

There are definitely real harms involved with / caused by opioid use today -- but most of those are caused by (or greatly worsened by) opioid prohibition.

Re: Seattle Is Opening First in U.S. “Safe Injection Facility” for Heroin Addicts

#20

Post by JumpCrisscross »

pauljaworski wrote: post #4

The Midwest/East Coast really need this, since that is where all the powder, fentanyl-laced heroin goes. People are dropping like flies in those regions of the country, while I would imagine the West Coast, where black tar heroin is sold, hasn't seen as much of an increase in overdoses/deaths.

What's the difference between powder and black-tar heroin?
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