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America’s opioid epidemic is worsening

economist.com

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Re: America’s opioid epidemic is worsening

#141

Post by alva »

DanBC wrote: post #94
rwmj wrote: post #21

In the UK it appears that there's a Spice epidemic. It's often called "synthetic cannabis" or "(formerly) legal highs", but it in reality it's all kinds of research chemicals sprayed onto leaves to be smoked. It has some pretty hideous side effects, and seems very addictive ( https://video.vice.com/en_uk/video/the-hard-lives-of-britain... ) Oh, and the government just handed the whole market over to illegal drug deal…

The spice epidemic is mostly prison related though. Prisons should stop testing for cannabis; and should consider prescribing cannabis of known strengths (and higher CBD rather than THC content). (Also, they need to start providing a lot more mental health support and meaningful activity).

In some ways I find the drug policy hilarious.

If you cannot stop drugs being used in what arguably should be the most secure, closed system, how on earth do governments expect to stop in outside?

I would love to know how prisons are so incompetent when they literally control all the system's I/O.

Re: America’s opioid epidemic is worsening

#142

Post by DanBC »

microtherion wrote: post #127
tptacek wrote: post #92

Earlier quoted context omitted.

I'm not sure I was arguing that opiate addicts are violent when they're high . I'm not making a moral argument about legalization or even (as is being repeatedly suggested on this thread) subsidization of opiates. I'm saying that if the cause of the epidemic is prescription opioids, and the ultimate problem is "too many people are non-functional opioid addicts", then deregulation won't fix the problem .

> too many people are non-functional opioid addicts Experience here in Switzerland would suggest that if the state takes dirty needles, expensive supply, and highly variable purity out of the equation, opioid addicts can lead a life that is, while far from ideal, considerably more functional than before. My impression is that drugs like Heroin, taken in correct dosage, do not inherently cause massive health damage. I…

> It's not clear how deregulation would work with drugs like meth, which DOES seem to inherently cause health damage.

Pure clean meth causes harm. Dirty street meth obtained using the methods addicts use would be more harmful to the addict and to society.

Re: America’s opioid epidemic is worsening

#144

Post by nicholasserra »

padobson wrote: post #12

I live in Trumbull County in Ohio, the dark red county in North East Ohio. We recently had 23 (non-fatal) overdoses in a two-day period[0]. That's roughly .01% of the county's total population - so yeah, it's getting bad here. There were recently two shootings within a mile of my house. Several people dead. Both shootings were drug related. I can't help but look around and believe that the needs these folks are tryin…

I'm in Youngstown. Watching the news in our area is horrifying anymore.

Re: America’s opioid epidemic is worsening

#145

Post by goatsi »

interfixus wrote: post #133
dsmithatx wrote: post #67

Earlier quoted context omitted.

Checkout Denmark. They had a huge problem with robberies and started giving legal pure Heroin shots to users. They also helped them find jobs. No more deaths and no more black market for Heroin. Hence burglaries also went away. It looks like our current President is looking at cracking down on pot again though so, I don't imagine we'll have a sensible drug policy anytime soon. Only one motivated by profits.

Which Denmark is this? Doesn't resemble the one I live in. Neither the robberies problem nor the legal pure heroin, and most certainly not the disappearance of burglaries - not statistically, not anecdotally, and not according to the several people of my acquaintance who have had it happen to them.

http://sciencenordic.com/heroin-clinics-improve-addicts-live...

>Reduced the number of days spent on crimes to a third

Not all crime is committed by heroin addicts so the programs won't stop burglaries completely but they have been shown to dramatically reduce the amount of crimes committed by participants.

http://www.citizensopposingprohibition.org/resources/swiss-h...

>Crime Issues: 60% drop in felony crimes by patients (80% drop after one year in the program). 82% drop in patients selling heroin.

Re: America’s opioid epidemic is worsening

#146

Post by pnathan »

senorjazz wrote: post #70
pnathan wrote: post #10

So what is the answer here? Like another poster said, there's a demand problem. How do we as a society address this? I've seen a lot of mumbles about dealing with supply problems, dealing with overdose problems, but it'd be good to head the problems off at the pass before they descend into major trouble. I should also note, this is a burgeoning problem in the Puget Sound/Seattle region. It's not just rural people dyi…

The problem is you have a large addicted population. Helping them get off opiates is expensive and time consuming (although orders of magnitude less than the war on drugs). Also, depending on the level of addiction that may just be no hope for some. As another commenter said, in Holland they have had legal heroin dispensaries for 30 years, with medical staff and clean rooms for injecting. The addicts can be monitored…

I'm kind of interested in the funnel prior to the addiction. How to make heroin etc uninteresting...

Re: America’s opioid epidemic is worsening

#147

Post by Kluny »

DanBC wrote: post #100
Kluny wrote: post #58

Earlier quoted context omitted.

American doctors follow national guidelines, because if they don't they expose themselves to malpractice suits. The guidelines currently say that if someone is in pain, give them as much painkiller as they want. Their ability to use their extensive training and judgement to make a better call is somewhat limited.

> The guidelines currently say that if someone is in pain, give them as much painkiller as they want Can you point me to those guidelines please? I'm struggling to find them. I can understand the advice if it's relating to short term immediate pain - for example post-operative pain. Addiction is unlikely to result from pain medication use in that example. Here's the English advice: http://www.fpm.ac.uk/faculty-of-pai…

I went looking for you. The guidelines appear to have been updated since last I checked, and are no longer as irresponsible as I thought they were. Here's what I found:

(easy version) https://www.cdc.gov/drugoverdose/pdf/guideline_infographic-a...

(hard version) https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm

Re: America’s opioid epidemic is worsening

#148

Post by pnathan »

tbrownaw wrote: post #106
DougN7 wrote: post #19

Earlier quoted context omitted.

Preventing that first time is probably the secret. It's got to be so much harder to resist once you know what you're missing. And it's not like you're rational about it and considering long term consequences when you're confronted with a second opportunity. Unfortunately, we live in a society where it's all good, live free, don't judge, do what feels good, etc. That leads to things that feel extremely good... I'm gra…

I remember reading somewhere about how a decent chunk of drug users just plain grow out of it as they grow into life roles that it doesn't quite work for. Nothing to do with theoretical long term consequences, just "this is more trouble than it's worth".

I'd concur.... anecdotes from reading Reddit suggest that's true for a number of pot or hallucinogen users. They move on to more fulfilling roles in life.

Re: America’s opioid epidemic is worsening

#149

Post by pmoriarty »

I once read of a 20-year-long study that found that when heroin-addicted UK doctors were given unlimited access to pure heroin they performed slightly better than their non-heroin-addicted colleagues, and they had no negative long-term health consequences. If anyone else has heard of this study, or especially if they have some documentation on it, I would appreciate a link.

Re: America’s opioid epidemic is worsening

#150

Post by kevinmchugh »

tptacek wrote: post #137
jessaustin wrote: post #128

Earlier quoted context omitted.

If we believe that some addicts can be helped to deal more productively with their addiction (personally I think that's true), and we observe that prohibition tactics don't help addicts get that help (see TFA and basically every other serious examination of this), then ending prohibition will certainly help some addicts. One might argue that more people would start using without prohibition, but that would be pretty…

I understand that it's difficult to avoid litigation of decriminalization (or, apparently, subsidization) in discussions about illegal drugs. I'm generally receptive to decriminalization. But I'm not making a point about decriminalization. In the same way that it's counterproductive to spend a lot of time talking about prohibition in mass incarceration discussions (significant reduction in incarceration --- which is…

Are prescription opiate users as likely to overdose as heroin users? My understanding is that they are not. If you're buying oxycontin at CVS, you're getting oxycontin in the dosage prescribed. At least once a year in Chicago we see a news story about dozens of people hospitalized after using what they bought as heroin but which was not.

Making heroin available to those who want or need to use it may reduce deaths or even hospitalizations without changing the number of opiate users.

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