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The rise of drug overdoses in New Hampshire has created a backlog of autopsies

nytimes.com

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Re: The rise of drug overdoses in New Hampshire has created a backlog of autopsies

#11

Post by twblalock »

This opioid epidemic has made me question my position on legalization of drugs. I had believed that, in general, legalization of drugs would be a good policy -- it worked fine for marijuana where it has been tried, and I doubted that very many people who don't take hard drugs would start doing so if they were legalized. Now, I'm not so sure.

It seems to be the case that some opioid addicts transition from using prescribed medication to illegally obtained medication, which is sometimes illegally produced and adulterated with other drugs. So, it seems that legalizing the recreational use of opiates would enable people to use the "authentic" version of the drug, which is safer.

On the other hand, there are tons of overdoses from prescribed opiates, which are legally obtained; and the overdoses are increasing. Contra my earlier belief, it seems that as access to opiates became easy and legal (via prescriptions), the number of addicts increased dramatically.

This seems to be a situation in which tens of thousands of people will die every year via ingestion of legal drugs unless some kind of intervention is made to remove their access to those drugs. It's hard to see how legalization or decriminalization would make a big difference.

Re: The rise of drug overdoses in New Hampshire has created a backlog of autopsies

#12

Post by neuronexmachina »

vixen99 wrote: post #10

So what effect would drug decriminalization have on this situation?

A large portion of the deaths are from prescription drugs:

https://www.cdc.gov/drugoverdose/index.html

> Opioids (including prescription opioids, heroin, and fentanyl) killed more than 33,000 people in 2015, more than any year on record. Nearly half of all opioid overdose deaths involve a prescription opioid.

Re: The rise of drug overdoses in New Hampshire has created a backlog of autopsies

#13

Post by michaelchisari »

twblalock wrote: post #11

This opioid epidemic has made me question my position on legalization of drugs. I had believed that, in general, legalization of drugs would be a good policy -- it worked fine for marijuana where it has been tried, and I doubted that very many people who don't take hard drugs would start doing so if they were legalized. Now, I'm not so sure. It seems to be the case that some opioid addicts transition from using presc…

I think there are a lot of different ways to "legalize", and the particulars of how you do it amplifies the results when it comes to hard drugs, especially highly addictive opiates.

Putting aside the more libertarian approach to legalization where hard drugs are left to the market and profits are made off of their sale, there are other options.

For instance, where drug use is legal, manufacture is illegal, and addicts are able to get free doses while under the supervision of medical staff. The free availability undercuts any potential black market, supervision severely reduces the potential for overdose, and the medical staff is able to have a regular conversation with the patient about options for getting clean.

Moreover, by turning drug use into a medical and welfare issue, it's my belief that it will prevent addiction by removing the "romance" of hard drug use for first time users.

Marijuana is a totally different story, it's benign enough that market legalization works just fine. But for opiates and amphetamines and the like, you need a very different approach.

That said, the opiate epidemic has shown that we have a problem of overprescription that stems from the pharmaceutical industry, and that's something we'd have to address if we were ever to move towards this approach.

Re: The rise of drug overdoses in New Hampshire has created a backlog of autopsies

#14

Post by njarboe »

twblalock wrote: post #11

This opioid epidemic has made me question my position on legalization of drugs. I had believed that, in general, legalization of drugs would be a good policy -- it worked fine for marijuana where it has been tried, and I doubted that very many people who don't take hard drugs would start doing so if they were legalized. Now, I'm not so sure. It seems to be the case that some opioid addicts transition from using presc…

If you read up on Oxycontin, it was formulated and prescribed in a particular way that created many addicts[1]. In particular it was claimed to work for 12 hours when in some people worked for much less. Being on an opiate for pain and then having it wear off and being forced to wait in pain for sometime before taking it again, is a recipe for creating addiction. Many people also were less wary of taking the opiates when prescribed by their doctors.

I'm not sure if the opiate overdoes epidemic is a clear strike against legalization, but it is surely a cautionary tale about supporting a system of all drugs being open sale of unlimited quantities and unlimited advertising. I support some form of drug legalization but, unlike food that is controlled for content but not much else, legal drugs will need more regulation.

[1] http://www.latimes.com/projects/oxycontin-part1/

Re: The rise of drug overdoses in New Hampshire has created a backlog of autopsies

#15

Post by owens99 »

twblalock wrote: post #11

This opioid epidemic has made me question my position on legalization of drugs. I had believed that, in general, legalization of drugs would be a good policy -- it worked fine for marijuana where it has been tried, and I doubted that very many people who don't take hard drugs would start doing so if they were legalized. Now, I'm not so sure. It seems to be the case that some opioid addicts transition from using presc…

IMO this is a drastic over-simplification of the issue. Legalization is one of many variables here.

Re: The rise of drug overdoses in New Hampshire has created a backlog of autopsies

#16

Post by marindez »

thr0waway187 wrote: post #8
pmoriarty wrote: post #2

"With the nation snared in what the government says is the worst drug epidemic in its history..." When have I heard that before? Maybe during the crack epidemic. Or the meth epidemic. Now it's the opioids' turn. "But this time it's different," I'm sure.

Yes, this time is different -- since white people are dying, we suddenly feel sympathy. When blacks OD from crack, they were thrown into jail and treated like morally failed individuals. When whites die from heroin, we feel sympathy and want to treat them.

I’ve heard this argument many times now and I still fail to see how we’re feeling sympathy for these people. Every time this conversation is brought up I see 0 solutions and people that very low-key suggest these people have to die because coal must disappear, because outsourcing to China is good because we’re living in a global economy, because they vote Trump and they don’t share our liberal view of society and they might not like black people or feminists, etc.

Re: The rise of drug overdoses in New Hampshire has created a backlog of autopsies

#18

Post by fabian2k »

The numbers just seemed incredibly high to me. I looked for similar data for the EU, and I found one report for 2015 (http://www.emcdda.europa.eu/system/files/publications/4541/T...).

The number of overdose deaths in the EU is ~7500 there, and there is no similar large increase since 2006 (the data in that report doesn't go as far back as the NY Times article data for the US). The report cautions that there is underreporting in some countries, but even then the number seems to be much lower than in the US.

Re: The rise of drug overdoses in New Hampshire has created a backlog of autopsies

#19

Post by arjie »

twblalock wrote: post #11

This opioid epidemic has made me question my position on legalization of drugs. I had believed that, in general, legalization of drugs would be a good policy -- it worked fine for marijuana where it has been tried, and I doubted that very many people who don't take hard drugs would start doing so if they were legalized. Now, I'm not so sure. It seems to be the case that some opioid addicts transition from using presc…

Why shouldn't we let them die? One in six base jumpers will die young while jumping. We don't make that illégal.

I mean, everyone knows you can overdose. So that makes it a conscious choice, and we should preserve people's ability to make an informed choice to put themselves in danger.

Re: The rise of drug overdoses in New Hampshire has created a backlog of autopsies

#20

Post by marchenko »

marindez wrote: post #16
thr0waway187 wrote: post #8

Earlier quoted context omitted.

Yes, this time is different -- since white people are dying, we suddenly feel sympathy. When blacks OD from crack, they were thrown into jail and treated like morally failed individuals. When whites die from heroin, we feel sympathy and want to treat them.

I’ve heard this argument many times now and I still fail to see how we’re feeling sympathy for these people. Every time this conversation is brought up I see 0 solutions and people that very low-key suggest these people have to die because coal must disappear, because outsourcing to China is good because we’re living in a global economy, because they vote Trump and they don’t share our liberal view of society and the…

I think the overall tone today is much more sympathetic than that surrounding the crack panic of the 90s, especially when the legal and political environments are compared (3 strike laws v complaints about Narcan expense seem to constitute the political extremes). However, I agree that the disturbing undercurrent of contempt for certain demographics is certainly quite prominent in the public discussion.
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