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

Re: Trapped by the ‘Walmart of Heroin’

#31

Post by secabeen » Sat, Oct 13, 2018, 2:01 AM 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…

It also eliminates the Fentanyl contamination.

Re: Trapped by the ‘Walmart of Heroin’

#32

Post by tomcam » Sat, Oct 13, 2018, 2:24 AM UTC

leetcrew wrote: post #12

yayana wrote: post #7

Earlier quoted context omitted.

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.

> this sounds like a pretty good problem to have.

Think that one through. Who pays for the disabled, unemployed, and elderly?

Re: Trapped by the ‘Walmart of Heroin’

#33

Post by TylerE » Sat, Oct 13, 2018, 2:52 AM UTC

stephengillie wrote: post #30

xkcd-sucks wrote: post #27

Earlier quoted context omitted.

"Predisposed to addiction" is how we say it in the industry, and it really means "has a shitty life." The diagnostic criteria for addiction are whether the person can't stop doing the thing despite wanting to, and whether doing the thing causes problems. If they're stable-- whether on or off medication of any kind including opiates-- then the addiction is considered successfully managed. Also, mental illnesses are ne…

So, instead of helping these people with their "predisposition", these countries are helping with their habit. How is this admirable?

Because it's better for them to have legal access to a controlled, safe supply than to be robbing houses for money to score who-knows-what off the street?

Making drugs illegal has never stopped anyone from doing drugs, it just adds additional problems to their life (hey, they have a felony record now, no one will hire them).

Re: Trapped by the ‘Walmart of Heroin’

#34

Post by [deleted] » Sat, Oct 13, 2018, 3:03 AM UTC

stephengillie wrote: post #22

yayana wrote: post #7

Earlier quoted context omitted.

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…

20 years is enough to quit anything. Something here doesn't add up. Have there been a lot of new heroin users entering this system over the past 20 years? Or have these governments been supporting the drug addiction of a small handful of people who refuse to kick the habit, despite 20 years of therapy? Also, who fills the prescriptions? Or do the doctors just prescribe whatever the patient can get from a dealer? How…

[deleted]

Re: Trapped by the ‘Walmart of Heroin’

#35

Post by leetcrew » Sat, Oct 13, 2018, 3:15 AM UTC

tomcam wrote: post #32

leetcrew wrote: post #12

Earlier quoted context omitted.

> 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.

> this sounds like a pretty good problem to have. Think that one through. Who pays for the disabled, unemployed, and elderly?

unless I misread the post, the logistical problem is that there aren't enough new heroin addicts to justify keeping so many centers open. not sure what that has to do with paying for the unemployed and elderly.

Re: Trapped by the ‘Walmart of Heroin’

#36

Post by toasterlovin » Sat, Oct 13, 2018, 3:19 AM UTC

stephengillie wrote: post #30

xkcd-sucks wrote: post #27

Earlier quoted context omitted.

"Predisposed to addiction" is how we say it in the industry, and it really means "has a shitty life." The diagnostic criteria for addiction are whether the person can't stop doing the thing despite wanting to, and whether doing the thing causes problems. If they're stable-- whether on or off medication of any kind including opiates-- then the addiction is considered successfully managed. Also, mental illnesses are ne…

So, instead of helping these people with their "predisposition", these countries are helping with their habit. How is this admirable?

It’s the worst solution, except for all the rest.

Re: Trapped by the ‘Walmart of Heroin’

#37

Post by stochastic_monk » Sat, Oct 13, 2018, 3:35 AM UTC

secabeen wrote: post #31

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…

It also eliminates the Fentanyl contamination.

And smuggling of fentanyl from China.

Re: Trapped by the ‘Walmart of Heroin’

#38

Post by retsibsi » Sat, Oct 13, 2018, 4:20 AM UTC

stephengillie wrote: post #30

xkcd-sucks wrote: post #27

Earlier quoted context omitted.

"Predisposed to addiction" is how we say it in the industry, and it really means "has a shitty life." The diagnostic criteria for addiction are whether the person can't stop doing the thing despite wanting to, and whether doing the thing causes problems. If they're stable-- whether on or off medication of any kind including opiates-- then the addiction is considered successfully managed. Also, mental illnesses are ne…

So, instead of helping these people with their "predisposition", these countries are helping with their habit. How is this admirable?

Because you can't just wave a magic wand and cure all of someone's problems, and because being a heroin addict with a reliable, legal, relatively safe supply is probably a lot less bad than being a heroin addict without that.

And why are you assuming that these people are not getting any other help? The two aren't mutually exclusive. In fact, not having to deal with all of the risks and stresses of scoring illicit drugs probably makes it significantly easier to make improvements in other areas of your life (which, as well as being a good thing in itself, might in turn make it easier for you to kick the addiction).

Absent convincing evidence to the contrary, it's entirely plausible that this approach is doing a good job of getting people off heroin, as well as improving the lives of those who stay on it. The fact that some people remain addicted doesn't undermine that.

Re: Trapped by the ‘Walmart of Heroin’

#39

Post by stephengillie » Sat, Oct 13, 2018, 4:43 AM UTC

retsibsi wrote: post #38

stephengillie wrote: post #30

Earlier quoted context omitted.

So, instead of helping these people with their "predisposition", these countries are helping with their habit. How is this admirable?

Because you can't just wave a magic wand and cure all of someone's problems, and because being a heroin addict with a reliable, legal, relatively safe supply is probably a lot less bad than being a heroin addict without that. And why are you assuming that these people are not getting any other help? The two aren't mutually exclusive. In fact, not having to deal with all of the risks and stresses of scoring illicit dr…

> And why are you assuming that these people are not getting any other help?

To the contrary, I'm wondering how effective is this help, if it fails to wean someone after 20 years. Or, there must be some constant influx of new users.

Re: Trapped by the ‘Walmart of Heroin’

#40

Post by Latteland » Sat, Oct 13, 2018, 5:17 AM UTC

yayana wrote: post #20

alecco wrote: post #14

Earlier quoted context omitted.

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.

Being able to not be a criminal, to not be arrested, to not die on the street, this is dramatically better than the alternative. No one can be prevented from buying street drugs in western countries, where there is demand someone will meet it. But this is far better for society too.