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Pointers from Portugal on Addiction and the Drug War

nytimes.com

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Re: Pointers from Portugal on Addiction and the Drug War

#71

Post by sloshnmosh »

Drugs will never be decriminalized fully here in the US. There is too much untraceable money involved.

It is said that after the housing bubble burst around 2008 that there was very little “liquid” cash floating around and that dark money from drug trafficking was one of things that helped the US from going completely under.

Add to that all the covert operations to overthrow governments and bribe crooked foreign leaders that require vast sums of money that doesn’t leave a paper trail.

The “war” on drugs is too keep drugs illegal and to sustain the flow of dirty monies.

Re: Pointers from Portugal on Addiction and the Drug War

#72

Post by rsynnott »

varispeed wrote: post #52
base wrote: post #45

Earlier quoted context omitted.

Portugal have needle exchange programs and places with health practitioners for people to shoot drugs, this last point was very controversial when it was implemented. Nowadays there are even mobile sites for this: https://idpc.net/alerts/2019/07/inside-portugal-s-first-mobi...

That is helpful, but even with a clean needle they will administer something possibly contaminated anyway. Good program would also give out medical grade clean heroin like they do in Switzerland. Clean heroin is relatively safe contrary to popular opinion. This removes the dealers from that segment of the market or at least severely reduces the sales volume.

> That is helpful, but even with a clean needle they will administer something possibly contaminated anyway

In general, the main drug-related vector for disease is needle sharing. Most pathogens wouldn't survive long in the actual heroin, and it's not clear how they'd get there in the first place.

Re: Pointers from Portugal on Addiction and the Drug War

#73

Post by rsynnott »

Krasnol wrote: post #26
Synaesthesia wrote: post #16

There was a RAND study many years ago which showed that, from a pure cost benefit point of view, the best way to deal with drugs is through education and treatment, not policing and punishment. Eg Americans today smoke a lot less tobacco and drink less coffee too. Education works!

> Eg Americans today smoke a lot less tobacco and drink less coffee too. Education works! Are there any scientific facts which would back this? To me it feels like there have been several other causes to that which were much more relevant. Not allowing people to smoke inside, vaping and smoking getting "out of fashion" were much more successful. It's just not cool anymore and those who still want to smoke are being c…

Smoking was already generally in decline in most countries, including the US, who introduced public bans. It was a big part of what made the bans politically feasible in the first place.

Re: Pointers from Portugal on Addiction and the Drug War

#74

Post by DanBC »

Krasnol wrote: post #26
Synaesthesia wrote: post #16

There was a RAND study many years ago which showed that, from a pure cost benefit point of view, the best way to deal with drugs is through education and treatment, not policing and punishment. Eg Americans today smoke a lot less tobacco and drink less coffee too. Education works!

> Eg Americans today smoke a lot less tobacco and drink less coffee too. Education works! Are there any scientific facts which would back this? To me it feels like there have been several other causes to that which were much more relevant. Not allowing people to smoke inside, vaping and smoking getting "out of fashion" were much more successful. It's just not cool anymore and those who still want to smoke are being c…

The biggest driver of behaviour change is increasing the price. Cigarettes are considerably more expensive (even when adjusting for inflation) than they used to be.

https://247wallst.com/special-report/2019/06/19/price-of-a-p...

Other things (bans on ads, bans on smoking in venues, health information) do help, but they're a smaller part of the picture.

Re: Pointers from Portugal on Addiction and the Drug War

#75

Post by f-securus »

galfarragem wrote: post #57
DoingIsLearning wrote: post #33

A lot of anglo speaking countries like to quote Portugal as an example, I would just like to add some reality to the picture perfect descriptions I read: - The main public opinion driver for both the needle exchange programs and the decriminalization was a _massive_ Heroin epidemic which lead to an HIV, Hepatitis B/C, AND Tubercolosis epidemic, the last one of those is particularly airborne contagious. I often see th…

It's not the first time the NYT insists in this idea. Ok, it's good advertisement to our tourism but this is just fake news. I grew up in one of the "drug towns" of the late 80's/early 90's in Portugal. It was bad, really bad. There wasn't any extended family without a drug problem. That generation, bornt after the 1974 revolution, now in the mid 40's, was almost erased from there. Some died and those remaining, afte…

Personally, growing up in Appalachia in the 90s it was more likely my extended family was abusing drugs than not. Cracking down on pill mills and making Oxy less abusable has pushed more and more to heroin/meth/synthetics. The drug problem is still rampant in the area. People need help and the barrier to receiving help in this country is too high.

I had a friend begging for help with treatment and the only in patient place at the time for substance abuse in the area had an 8 week waiting list... and you had to pay your way so unless you had a family/friend with extra resources you were on your own.

We wonder why the drug problem still exists in this country where we punish those struggling instead of help them.

Re: Pointers from Portugal on Addiction and the Drug War

#76

Post by richrichardsson »

jamexcb wrote: post #69
adamcharnock wrote: post #47

Earlier quoted context omitted.

I've been living in rural Portugal for a little while now, and these are some excellent comments. Especially the first point. I'd also add that there is still a Heroin problem, albeit diminished. It is not unusual to see someone walking though the local village, out-of-their head drunk at 9am on a Wednesday. It isn't alcohol though, it's Heroin. But it is also an economically poor area. The weather is amazing and the…

"I've been living in rural Portugal for a little while now" Not long enough! I'm from Castelo Branco and coffee is not $0.15... not even a "carioca de limão". Needle exchange program started 1993 along with other programs like "metadoda" to help addiction. With a needle they also provided condoms and an open door if you wanted help. During the 80's you could find needles everywhere, people stealing from their own par…

> And if you find someone "drunk" at 9am you bet he is drunk

People "gouching out on smack" do not look like they are drunk, so I think you're correct.

Re: Pointers from Portugal on Addiction and the Drug War

#78

Post by varispeed »

at_a_remove wrote: post #70
varispeed wrote: post #60

Earlier quoted context omitted.

Yes this is helpful in that way, but call me cynical - without removing the market from the hands of criminals, what it does is ensures that the consumer will be a paying client a little bit longer. But if a dealer messes up and mixes the Fentanyl unevenly, the clean needle won't help much.

Dealers are typically not cutting their products with HIV or hepatitis virii.

They cut drugs with various substances to increase volume and / or perceived strength, and that can cause health issues just as dangerous or even death by accidental overdose. In fact the number of overdose deaths have increased in Portugal since that policy has been implemented. Another flaw of this policy is that when users don't have to spend money on paraphernalia, they will have more money to spend on drugs. So I would say this is not about safety of the consumers, but to protect Portugal's healthcare system. It is easier and cheaper to deal with a dead overdosed consumer than a consumer who caught HIV.

Re: Pointers from Portugal on Addiction and the Drug War

#79

Post by [deleted] »

hypnotist wrote: post #54
adamcharnock wrote: post #47

Earlier quoted context omitted.

I've been living in rural Portugal for a little while now, and these are some excellent comments. Especially the first point. I'd also add that there is still a Heroin problem, albeit diminished. It is not unusual to see someone walking though the local village, out-of-their head drunk at 9am on a Wednesday. It isn't alcohol though, it's Heroin. But it is also an economically poor area. The weather is amazing and the…

starting ISP - that is very cool! What about Portuguese language ? do you need to able to speak to be accepted there ?

[deleted]

Re: Pointers from Portugal on Addiction and the Drug War

#80

Post by tonyarkles »

f-securus wrote: post #75
galfarragem wrote: post #57

Earlier quoted context omitted.

It's not the first time the NYT insists in this idea. Ok, it's good advertisement to our tourism but this is just fake news. I grew up in one of the "drug towns" of the late 80's/early 90's in Portugal. It was bad, really bad. There wasn't any extended family without a drug problem. That generation, bornt after the 1974 revolution, now in the mid 40's, was almost erased from there. Some died and those remaining, afte…

Personally, growing up in Appalachia in the 90s it was more likely my extended family was abusing drugs than not. Cracking down on pill mills and making Oxy less abusable has pushed more and more to heroin/meth/synthetics. The drug problem is still rampant in the area. People need help and the barrier to receiving help in this country is too high. I had a friend begging for help with treatment and the only in patient…

Your description of the in-patient problem sadly reflects the state of affairs up in Canada too, where most, but not all, healthcare is free (eyes and teeth are strange exceptions).

I’ve got an older friend who did a lot of drugs back in the day, but got his life mostly figured out until a few years ago when he had to get shoulder surgery. Prescribed Oxy for recovery, even after telling the surgeon about his past addiction struggles. As expected, they become less effective over time, he likes getting high, so he starts taking larger doses. Gets to the end of his prescription and can’t get a refill.

Did he make bad choices here? Definitely. But then the health care system screws up:

“I want to detox and get clean again.”

“Sorry, you’ve never overdosed, so you can’t detox in the hospital. Maybe you can get on a waiting list for a private (out of pocket) facility. Oh, and no refills, you’re an addict”

“Maybe I can be a short-term patient at a mental health facility?”

“Sorry, you’ve never tried committing suicide because of your drug use. Maybe you can get on a wait list at a private facility? Oh, and no refills, you’re an addict!”

So... what does an opioid addict who is in withdrawal and can’t get support from the health care system do? Goes and scores some heroin...

Today he’s mostly clean again. I think he pops a pill here and there but isn’t high all day. But... this could have all been avoided. The health care system had many opportunities to help out here, but didn’t.

Edit: one last note: the private facilities are quite expensive and have massive waiting lists. Even if he had had the cash to go, he would have still been in limbo for weeks-to-months with no access to clean drugs nor support to get clean.

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