Trapped by the ‘Walmart of Heroin’ • Hacker News Board

Re: Trapped by the ‘Walmart of Heroin’

#11

Post by Itaxpica » Fri, Oct 12, 2018, 8:21 PM UTC

breakingcups wrote: post #9

rwmj wrote: post #2

A problem that could easily be solved by simply prescribing them all heroin. This was successful when it was done in the UK ( https://health.spectator.co.uk/the-case-for-prescription-her... ) although of course the government eventually shut it down.

Not just the UK. Switzerland, Belgium, Germany, Denmark and The Netherlands too. The Netherlands had a very bad heroin epidemic in the 90's which has virtually disappeared thanks to this approach. The two main takeaways in my opinion are: Treat heroin addiction as a health issue instead of a criminal issue and don't just give out heroin, always couple it with social services, treatment, etc. Note that this approach m…

Of course, the one thing that all of those countries have in common is universal healthcare. "Treat addiction as a disease and prescribe heroin for it" doesn't really work so well when the overwhelming majority of addicts most likely don't have insurance or the means to pay for medical treatment out-of-pocket.

Re: Trapped by the ‘Walmart of Heroin’

#12

Post by leetcrew » Fri, Oct 12, 2018, 8:23 PM UTC

yayana wrote: post #7

benbreen wrote: post #4

Earlier quoted context omitted.

Well, maybe not "easily," but I agree. Worth noting that heroin prescriptions have been happening in Switzerland for going on 20 years now, with excellent results.[1] The article was fantastic reporting by the way. Hard to read, but difficult to put down once you start. [1] https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

It's becoming a logistical problem in Switzerland to have so little replacement as they've aged. There aren't enough to warrant many centers anymore, but each closing means some would have travel further, possibly dropping out. The US doesn't have to worry about these kinds of problems.. or about who will buy it's newly acquired crop domestically with veterans such as the one in the article coming home with trauma an…

> It's becoming a logistical problem in Switzerland to have so little replacement as they've aged.

this sounds like a pretty good problem to have.

Re: Trapped by the ‘Walmart of Heroin’

#13

Post by alphabettsy » Fri, Oct 12, 2018, 8:24 PM UTC

Seems like it would be cheaper and safer to continue giving them the opioid derivitive medications they were already using until they are willing to go through treatment.

Re: Trapped by the ‘Walmart of Heroin’

#14

Post by alecco » Fri, Oct 12, 2018, 8:27 PM UTC

rwmj wrote: post #2

A problem that could easily be solved by simply prescribing them all heroin. This was successful when it was done in the UK ( https://health.spectator.co.uk/the-case-for-prescription-her... ) although of course the government eventually shut it down.

It's good results for society but bad for the addict and their families. They are the ones pushing back. And they have a point.

Re: Trapped by the ‘Walmart of Heroin’

#15

Post by TomK32 » Fri, Oct 12, 2018, 8:36 PM UTC

The weirdest X of Y I've ever heard of...

Re: Trapped by the ‘Walmart of Heroin’

#16

Post by TomK32 » Fri, Oct 12, 2018, 8:38 PM UTC

bluetwo wrote: post #10

Philly Proud

if this was reddit we'd recite the lyrics of a certain song...

Re: Trapped by the ‘Walmart of Heroin’

#17

Post by intuitionist » Fri, Oct 12, 2018, 9:06 PM UTC

Itaxpica wrote: post #11

breakingcups wrote: post #9

Earlier quoted context omitted.

Not just the UK. Switzerland, Belgium, Germany, Denmark and The Netherlands too. The Netherlands had a very bad heroin epidemic in the 90's which has virtually disappeared thanks to this approach. The two main takeaways in my opinion are: Treat heroin addiction as a health issue instead of a criminal issue and don't just give out heroin, always couple it with social services, treatment, etc. Note that this approach m…

Of course, the one thing that all of those countries have in common is universal healthcare. "Treat addiction as a disease and prescribe heroin for it" doesn't really work so well when the overwhelming majority of addicts most likely don't have insurance or the means to pay for medical treatment out-of-pocket.

This is surely true, but the US can and does cover certain medical expenses as part of Medicare/Medicaid. The political obstacles are much harder to overcome than the logistical ones.

Re: Trapped by the ‘Walmart of Heroin’

#18

Post by golemiprague » Fri, Oct 12, 2018, 9:13 PM UTC

Itaxpica wrote: post #11

breakingcups wrote: post #9

Earlier quoted context omitted.

Not just the UK. Switzerland, Belgium, Germany, Denmark and The Netherlands too. The Netherlands had a very bad heroin epidemic in the 90's which has virtually disappeared thanks to this approach. The two main takeaways in my opinion are: Treat heroin addiction as a health issue instead of a criminal issue and don't just give out heroin, always couple it with social services, treatment, etc. Note that this approach m…

Of course, the one thing that all of those countries have in common is universal healthcare. "Treat addiction as a disease and prescribe heroin for it" doesn't really work so well when the overwhelming majority of addicts most likely don't have insurance or the means to pay for medical treatment out-of-pocket.

Heroin is very cheap if not for the added cost of being illegal, you could sell it for not much more than a bag of flour if it is legal.

Re: Trapped by the ‘Walmart of Heroin’

#19

Post by jpatokal » Fri, Oct 12, 2018, 9:26 PM UTC

alecco wrote: post #14

rwmj wrote: post #2

A problem that could easily be solved by simply prescribing them all heroin. This was successful when it was done in the UK ( https://health.spectator.co.uk/the-case-for-prescription-her... ) although of course the government eventually shut it down.

It's good results for society but bad for the addict and their families. They are the ones pushing back. And they have a point.

Worse than overdosing in the streets?

This seems like a classic case of the perfect (being off drugs completely) being an enemy of the good (off the streets but on prescribed heroin).

Re: Trapped by the ‘Walmart of Heroin’

#20

Post by yayana » Fri, Oct 12, 2018, 10:04 PM UTC

alecco wrote: post #14

rwmj wrote: post #2

A problem that could easily be solved by simply prescribing them all heroin. This was successful when it was done in the UK ( https://health.spectator.co.uk/the-case-for-prescription-her... ) although of course the government eventually shut it down.

It's good results for society but bad for the addict and their families. They are the ones pushing back. And they have a point.

IMO the family is actually much better off, especially children. A big part of the problem is over valuing the addicted parent and the shadow life they should have been.

Not fixing the problem let's them keep a lot of blame for reality being far from expectations on the new environment, and probably that is pretty healthy. But it doesn't mean this solution is actually wrong.