Once hailed for decriminalizing drugs, Portugal is now having doubts • Hacker News Board

Re: Once hailed for decriminalizing drugs, Portugal is now having doubts

#441

Post by Retric » Sat, Jul 08, 2023, 1:17 PM UTC

shuckles wrote: post #391

Retric wrote: post #370

Earlier quoted context omitted.

Different populations, you really need to randomly assign people to each group to discover if it’s harmful or a side effect of the selection criteria. I would expect people in SF SROs to OD more for multiple reasons, but I haven’t seen any research on the specifics.

While it's true that shelter placement has some advantages for high needs folks (e.g. older, women, or disabled), those themselves don't correlate with opioid overdose deaths. There was a randomized trial of permanent supportive housing, which is a stronger intervention than simple housing, in Santa Clara (DOI 10.1111/1475-6773.13553) where those who received PSH died at slightly higher rates than those did not and n…

Thanks for finding that, looks like it might indeed increase risks.

> We enrolled 423 participants (199 intervention; 224 control). Eighty-six percent of those randomized to PSH received housing compared with 36 percent in usual care.

> Seventy (37 treatment; 33 control) participants died.

That’s a very high risk population.

> We found a similar high mortality rate in both treatment and control groups. Individuals experiencing homelessness have a greater age-adjusted mortality rate than housed counterparts.25 Among those who died, 89 percent of those in the intervention group had been housed compared with 28 percent in the control group.

I really want to pattern match, but it’s just not enough data. Worse they may have undercounted deaths in the control group. “Abode provided data on death for all participants who died while living in Abode housing. We queried County death certificate data on all participants who did not appear in any source of study data for 6 or more months.”

Re: Once hailed for decriminalizing drugs, Portugal is now having doubts

#442

Post by jwie » Sat, Jul 08, 2023, 1:18 PM UTC

Switzerland seems to be doing great with its drug policies. Why is that strategy so effective and other nations seem incapable of noticing or trying something similar?

Re: Once hailed for decriminalizing drugs, Portugal is now having doubts

#443

Post by lotsofpulp » Sat, Jul 08, 2023, 1:18 PM UTC

throwawaylinux wrote: post #331

cheekibreeki2 wrote: post #304

Earlier quoted context omitted.

California is in a weird place due to the weather, which almost guarantees the self dumping of people living outdoors. I'd be curious to see how this factors into these equations. Much of Europe gets pretty cold in winter.

Weird in what way? There's a dozen with higher average minimum temperatures, several with not signifiantly more rain (or less, Texas).

Wet bulb temperatures and dew point are what determine how comfortable it is outdoors.

https://en.wikipedia.org/wiki/100th_meridian_west

> In the United States, this meridian roughly marks the boundary between the semi-arid climate in the west and the humid continental and humid subtropical climates in the east and is used as shorthand to refer to that arid-humid boundary.

Re: Once hailed for decriminalizing drugs, Portugal is now having doubts

#444

Post by 0xcde4c3db » Sat, Jul 08, 2023, 1:19 PM UTC

jcpst wrote: post #413

hughesjj wrote: post #389

Earlier quoted context omitted.

I think part of it is how isolated the us is. We don't really have walkable neighborhoods in most of the country, which means less spur of the moment decisions to gather at a social place and more isolation since so many people are commuting in single occupancy vehicles and doing drive throughs. Combine that with wealth stratification, Hussle culture, and the complete lack of any real social safety net and if anythin…

Isolation is a big one. The classic study people bring up is the “cocaine rat”. The rat in isolation was drawn to the bottle with cocaine water. When the rat was in a cage with activites and other rats, lost the preference for the cocaine water.

Do you have a citation? A search for "cocaine rat study" mostly turned up references to the Rat Park experiment, which used morphine. A later study comparing heroin and cocaine found that social isolation increased overall usage of heroin (apparently because the isolated rats picked up the habit faster) but not cocaine, and that by the fifth week of the study usage rates were similar between isolated and non-isolated groups for both drugs [1].

[1] https://pubmed.ncbi.nlm.nih.gov/2616610/

Re: Once hailed for decriminalizing drugs, Portugal is now having doubts

#445

Post by andrepd » Sat, Jul 08, 2023, 1:23 PM UTC

comfortabledoug wrote: post #266

virgildotcodes wrote: post #7

Talk about burying the lede, 11 years ago they privatized their drug oversight operation and cut funding by over 80%. Gee, I wonder if that could have an impact? > After years of economic crisis, Portugal decentralized its drug oversight operation in 2012. A funding drop from 76 million euros ($82.7 million) to 16 million euros ($17.4 million) forced Portugal’s main institution to outsource work previously done by th…

What about the other quotes from the article that have nothing to do with funding... > “When you first back off enforcement, there are not many people walking over the line that you’ve removed. And the public think it’s working really well,” said Keith Humphreys, former senior drug policy adviser in the Obama administration and a professor of psychiatry at Stanford University. “Then word gets out that there’s an open…

Those "other quotes" are personal hunches and random people on the street? "I asked random people on the street", really? Come on...

The simple fact is that after drug decriminalisation in 1999 the number of (1) new HIV infections and (2) overdose deaths fell to less than half in a couple years.

After cuts in funding, it started performing worse. Who would have think.

Re: Once hailed for decriminalizing drugs, Portugal is now having doubts

#446

Post by DropInIn » Sat, Jul 08, 2023, 1:24 PM UTC

donatj wrote: post #384

lukeschlather wrote: post #355

Earlier quoted context omitted.

https://msdh.ms.gov/page/44,0,382.html Drug overdoses are a nationwide problem in the USA. Mississippi also had a 49% increase in overdoses in 2020. Shelter is a basic human need and depriving people of it on the grounds that they might overdose doesn't seem like it follows. I know plenty of addicts who take care of their things just fine. They're addicted to coffee and alcohol and cigarettes. It's possible that the…

> They're addicted to coffee and alcohol and cigarettes. It's possible that the problem is not the drug itself but the social stigma attached to the drug. I assure you there is a difference between coffee/cigarettes and methamphetamine beyond just stigma. Coffee and tobacco both improve your mental capabilities without short-term downsides. No one’s been fired for showing up with a coffee or tobacco buzz and being mo…

When meth was literally 15$ a gram back in my youth (shipping hub) there was no one robbing anyone for it, as an hour or two at any job would pay for a GRAM (large amount) of Pure meth (and I mean high quality pure without any opacity nor color).

Back then most people I knew were using it, in the same way they would use an energy drink, and there were nearly no problems aside from the morons who wouldn't stop parting for a week at a time (but those folks would do the same with Any substance).

Really... Where I grew up the literal mayor was doing coke on the regular and also owned many businesses including the baseball team... And so were most of the successful people doing lots of drugs particularly uppers.

What happened was as they pushed enforcement against the drugs the quality decreased and the cost went up, posing a more immediate health risk and inducing crimes respectively.

I know from first hand experience with both the products and the propel that the biggest issue is the mere fact of thier illegality and extreme markups.

A key is to not have the government view the drug as a profit centre, as Canada did with pot, as that only grows the black market and strengthens them rather than destroy them.

Re: Once hailed for decriminalizing drugs, Portugal is now having doubts

#447

Post by pedrosorio » Sat, Jul 08, 2023, 1:32 PM UTC

arcticbull wrote: post #184

pedrosorio wrote: post #168

Earlier quoted context omitted.

> alcohol, a much more dangerous drug than most The overall impact of alcohol on society is not because it is “much more dangerous than most”, but because it is consumed (and abused) by orders of magnitude more people than almost every other drug.

That's partly the case, but part of the higher ranking of other drugs is due to lack of safe access. There's no perfect model, but I would argue alcohol is a drug like any other - with risk of dependence, with health consequences, and with mortality risk. So my question to the parent is: why would we separate alcohol? Would parent be in favor of returning to prohibition? I think it's fair to say that alcohol does far…

> I think it's fair to say that alcohol does far more harm to the user than psychedelics

I agree but also think that’s a very different statement from “alcohol is a much more dangerous drug than most”

Re: Once hailed for decriminalizing drugs, Portugal is now having doubts

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Post by yakubin » Sat, Jul 08, 2023, 1:34 PM UTC

heisenbit wrote: post #219

pineaux wrote: post #57

Earlier quoted context omitted.

This is probably not true.for example: People know smoking kills. The tabacco industry even popularized stories about sad COPD patients that were dying in the hospital and still wouldnt quit smoking. "Its that good!" "It's so nice! Even when you know it kills you, you still dont want to stop! Not to mention! Quiting is hard! Real hard! Dont try to quit. You will only suffer." That is the narrative that they push. The…

Tobacco use - despite its visibility and despite being extremely addictive - went down a lot. Legal and normal are NOT the same thing. The biggest problems arise when normal is illegal as it undermines the law and maintains delusions about what is going on in reality.

In the EU 1 in 4 adults smoke tobacco daily[1]. It sounds pretty normal to me. In practice when I commute daily, I always need to hold my breath several times each way, just to avoid the stench.

[1]: https://ourworldindata.org/grapher/share-of-adults-who-smoke>

Re: Once hailed for decriminalizing drugs, Portugal is now having doubts

#449

Post by jurynulifcation » Sat, Jul 08, 2023, 1:36 PM UTC

mcpackieh wrote: post #248

jurynulifcation wrote: post #102

Earlier quoted context omitted.

Do you think that's down to availability, or down to a lack of support and education?

It's certainly not a problem with education. Nobody in this country can claim they were never told that drugs are bad.

[flagged]

Re: Once hailed for decriminalizing drugs, Portugal is now having doubts

#450

Post by andrepd » Sat, Jul 08, 2023, 1:38 PM UTC

K0balt wrote: post #371

Broken_Hippo wrote: post #318

Earlier quoted context omitted.

Tent cities don't exist solely in places without access to housing "Access to housing" isn't enough. You might have "access" to health care but unable to afford it. You need housing as a right - even without payment - alongside enough adequate housing for everyone. And allow folks to do things in their own home. If they cannot do it at their home with other people, the person in question does not have adequate housin…

Life is misery by default, as a natural consequence of life itself. The never ending tyranny of the need to eat and avoid being eaten is the normal state of affairs. Honestly, if a person isn’t up for it, we need to stop trying to convince them to stay around and be miserable. Elective suicide should be a basic right, and drugs are one way out. We only create misery by “helping” people that don’t want hep. Criminaliz…

> Life is misery by default, as a natural consequence of life itself. The never ending tyranny of the need to eat and avoid being eaten is the normal state of affairs.

Edgy, I would definitely have posted that on myspace when I was 14. Of course, that's not true. We are not hunter-gatherers, or pre-industrial farmers. We have abundance of all of life's necessities and even more.

>We only create misery by “helping” people that don’t want help.

You clearly haven't met any addicts, only observed them from a sneering distance and concluded whatever you wanted to conclude.

Suffice to say: I have. Several people who were on self-destructive paths, of whom you could have said "well fuck him, the fucker doesn't want help and is a burden to those around him, why should I waste money and effort with him?". With the necessary support they are now entirely different persons.

>Provide basic unregulated housing, not unlike squattable buildings. Set up AI monitored surveillance and prohibit attempts to form any kind of exploitative enterprise. Self registration with biometric access. Provide fentanyl dispensers. Come through once a day and dispose of the dead.

I sure am glad you don't make public policy, but you might have a future in dystopian fiction.