Supreme Court blocks controversial Purdue Pharma opioid settlement

I don’t think that’s really the case. What happened here was that peddling oxy, created the excess demand that is now met by illicit sources that cause more deaths now that oxy is regulated. But what you’re missing in your understanding is that without oxy, demand wouldn’t exist in the first place. And that’s the harm everyone is talking about.

You’re talking about the aftermath of the problem. Parent is talking about the root cause.

Are you sure they'll give "better answers" when they're the ones prescribing like that?

As a reminder, Oxy was heavily marketed, (to doctors!) as a "not bad" opioid. As in, not as addictive, not as problematic, and something that can be prescribed more easily and with less worries.

If a doctor comes up and tell you "don't worry about this one, it isn't addictive like the others", and you are in a ton of pain at the time, you are going to thank modern medicine for its new miracle pain drug and accept the prescription.

> but this is taught in every highschool.

And as another reminder, most schools, until recently, just taught that "drugs are bad" and kind of left it at that. They exaggerated some of the down sides, and didn't mention any of the positive experiences.

IMHO South Park actually did the world's best anti pot ad -

"Well, Stan, the truth is marijuana probably isn't gonna make you kill people, and it most likely isn't gonna fund terrorism, but… well, son, pot makes you feel fine with being bored. And it's when you're bored that you should be learning some new skill or discovering some new science or being creative. If you smoke pot you may grow up to find out that you aren't good at anything."

-

And IMHO messages like that are more useful than what kids are being told.

There is also the social contract side of things - Since around 1950s, if people worked hard they things in return from society: A stable job, a house, the opportunity to raise a family. That social contract is shot to shit, and so it should be no surprise that more and more people are choosing to drop out of society via drugs/games/apathy.

I don't entirely disagree with you, but I have also seen enough people stop, who probably wouldn't have if that were the typical treatment, to be pretty cautious about that. There are a number of promising addiction treatments in the wings at the moment, in particular Ozempic and the general GLP-1 agonist class.

Transitional opioids like Buprenorphine are fine as a detox strategy, and maybe even fine for the medium term, but committing to them for life I think is a mistake (in most cases).

> The problems stem from putting unreasonable obstacles between adicts amd their appropriate treatment. Practical legal and financial obstacles, sadistic legal obstacles, and bizarre moral obstacles

There is a lot of truth to this. It is, in fact, what I used to say when I used them. And it is and remains true. It is also true that prolonged opioid use is mostly physiologically harmless (overdoses notwithstanding). However, there are psychological elements that come with long term use that these measures do not capture, and are not fully internalized by the transaction costs (or literal costs) associated with obtaining them.

> Nineteenth century society managed it with laudinum

Ask China why they fought that opium war, and how they feel about such things lately. They are still mad about it.

> The Sacklers are, were, parasites profiting from that social malaise and bad things will finally happen to them. But the cause of the malaise is our irrational attitude to drugs

Agree on the Sacklers although personally I'd place more blame on the McKinsey consultants that wrote the original deck that proposed the strategy. I don't know how much the Sackler individuals personally made these decisions, but those people certainly did.

Re: irrational attitudes to drugs, I agree, but the situation is substantially more nuanced than it might superficially appear. Laudanum did used to be over the counter, as did cocaine among other things. However, these things were not criminalized for no reason - heroin wasn't criminalized in the 60s/70s anti-hippie craze, or for racist reasons in the 1930s (like marijuana).

Heroin was first criminalized for over the counter sale in 1910 - 15 years after Bayer first marketed it. Easily the fastest criminalization of a novel pharmaceutical compound in the history of the world. This is not an accident or a product of some temporary social hysteria. And unfortunately, it was also not criminalized because all of its harms were due to its being illegal.

If criminality were the problem we would expect things to get better, not worse, with the introduction of fentanyl which is far cheaper and more readily available. I could be misreading the data, but that does not seem to be working out.