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My experience of losing a friend to heroin (2020)

mattlakeman.org

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Re: My experience of losing a friend to heroin (2020)

#111

Post by robocat »

d136o wrote: post #54

I’ve just finished reading Empire of Pain: The Secret History of the Sackler Dynasty , and I highly recommend it. An amazing multi generational history of how the Sacklers inflicted opioids on the US, made a fortune, and got away with no consequence. It was pretty interesting to read this during pandemic times, and it’s a prime example of how institutions lose legitimacy in the public’s eye. The Sacklers had the FDA…

Probably the wrong place to ask, but is there any information on the social costs for the Sacklers of their criminality? (I'm not excusing it, I'm just interested).

Although they have stuffed Giga$ into their pockets, most people also care deeply about their own social status, so have the Sacklers had severe social repercussions from their peers? Some of their peers or acquaintances of their peers must have been addicted.

Re: My experience of losing a friend to heroin (2020)

#112

Post by short12 »

dminor wrote: post #34

> There are people and places who specialize in these things. You find them through Google and you use them. > Maybe a Slate Star Codex/Less Wrong reader would start diving into the efficacy rates of different treatment options and crawl through peer-review studies... The best evidence based treatment for opioid addiction is Buprenorphine. Sadly you will not hear that from all treatment/rehab providers.

That drug isn't exactly a secret and is widely prescribed. Also the rules are being loosened to allow more widescale deployment

Re: My experience of losing a friend to heroin (2020)

#113

Post by kyleee »

notJim wrote: post #70
nostromo wrote: post #14

Earlier quoted context omitted.

I used to believe that — before I lived in a city that effectively decriminalized all drugs. The result has been a disaster. People on meth run around the streets at night causing chaos. Homeless people on heroin leave needles everywhere. People avoid transit and parks now because there is regularly someone losing his or her mind nearby. Long sentences aren’t the answer of course. But I do think that sending someone…

> By the way, free mental healthcare doesn’t actually work because many of these folks don’t want help and won’t seek it willingly. There needs to be a way to forcefully separate them from the addictive substance for a time, stabilize their drug crisis, and then help them find long term care This is an inconsistent statement. In once sentence you say that free mental healthcare doesn't work, then in the next you posi…

Not inconsistent; many will refuse treatment if simply asked, but with forced treatment / detox may come through the woods a bit and make a different decision.

It's the same freedom vs. detention debate and we've swung towards full freedom option in the US since the shutdown of mental health prisons and we've offloaded the care for the most difficult cases to police, ER, health workers, and they live on the streets. It's high time the pendulum swung back a bit with some (hopefully humanely administered) compulsory treatment options which is was the other commenter may have been getting at

Re: My experience of losing a friend to heroin (2020)

#114

Post by kyleee »

refurb wrote: post #104
evilos wrote: post #60

Earlier quoted context omitted.

This is the scariest thing about heroin IMO. It's basically game over, you've ruined the game of life by using a cheat code and the rest of the game will feel hollow and pointless.

Why is it scary? Heroin isn’t unique in this aspect. I had a friend tell me “when I had the first drink ever my first thought was ‘I want to feel like this the rest of my life’”. He was sucked in right away and struggled for years to break that hold. Plenty of people feel that way and practically kill themselves with alcohol, opioids, cocaine and even food. And plenty of people take opioids equivalent to heroin and s…

Do you really struggle to see why that's scary?

Re: My experience of losing a friend to heroin (2020)

#115

Post by chimpansteve »

hpoe wrote: post #39
jokethrowaway wrote: post #18

Earlier quoted context omitted.

I see the same in London, where everything is illegal. I think it's unrelated to whether drugs are a crime or not - homeless and drug users in general will find a way to get it. It's a sad reflection on the state of society and our cities. Personally, after a terrible experience in Paris, I decided I will avoid all big cities. I think we should do something about it and forcefully throw homeless and drug users out of…

If you don't mind me asking what incident let to you to taking to such a hardline stance? I don't necessarily disagree or agree I just would love to hear that kind of perspective?

As someone else from the UK, at the start of the pandemic lockdown measures several cities tried to give every homeless person a bed. In every case, the majority ended up leaving the accommodation offered due to the rules around drugs, smoking, antisocial behaviour, whatever.

I'm not sure I agree with the above poster about their solutions to the problem, but "solving" homelessness, or addiction, is a lot harder than making some broad brush laws about decriminilisation.

My cousin is a heroin addict, 12 years running at this point. He's in Dundee, the smack capital of the UK and quite possibly western Europe. Methadone is the worst idea possible for him, because he swaps it with the cancer patients for diazepam and then makes himself a happy cocktail. He's from a genuinely loving, supportive family, but still breaks into their house to steal stuff to pawn for smack money.

The only thing that would probably "help" him is full decriminalisation, but that would not help his victims, or his family, or the already overstressed health service in general, because the whole point of these measures is an expectation that addicts will suddenly "see the error of their ways", rather than thinking "wahay, free smack".

And back to the original point, when you have people actively preferring the street to the fully serviced hotel rooms, then you've probably got a severe structural problem. At which point it's easy to understand the above point of view, especially if you have a home and a family in close proximity to the inevitable social disorder (and I've also lived in Portugal. It is far from the free drug liberal paradise that some imagine it as)

Re: My experience of losing a friend to heroin (2020)

#116

Post by robocat »

ipnon wrote: post #10

"What does a scanner see? he asked himself. I mean, really see? Into the head? Down into the heart? Does a passive infrared scanner like they used to use or a cube-type holo-scanner like they use these days, the latest thing, see into me - into us - clearly or darkly? I hope it does, he thought, see clearly, because I can't any longer these days see into myself. I see only murk. Murk outside; murk inside. I hope, for…

'A Scanner Darkly' ends with the most gutting personal note by Philip, which is extremely relevant to the article: https://news.ycombinator.com/item?id=21587769

Relevant to your quote, Philip said: The two basic topics which fascinate me are “What is reality?” and “What constitutes the authentic human being?” Over the twenty-seven years in which I have published novels and stories I have investigated these two interrelated topics over and over again. I consider them important topics. What are we? What is it which surrounds us, that we call the not-me, or the empirical or phenomenal world? — from https://urbigenous.net/library/how_to_build.html

Re: My experience of losing a friend to heroin (2020)

#117

Post by TimTheTinker »

WalterSear wrote: post #109
TimTheTinker wrote: post #42

Earlier quoted context omitted.

> we seem to have this huge moral hang up in the US about giving addicts drugs For many people, what you're describing all comes down to the law of love. It is not loving to give a person more of the thing that is destroying them. Perhaps free methadone would be a better option? EDIT: care to comment? I'd like to know why people disagree.

It's pride, not love. And a pride that is essentially about avoiding shame; shame being the primary currency of those with an authoritarian bent.

> It's pride, not love. And a pride that is essentially about avoiding shame;

That has nothing to do with my rationale... I'm curious where you got that.

If I give heroin to an addict, the only shame involved to me would be the personal feeling of shame from having caused harm to another human...

So I think this response is a straw man that doesn't address my point.

Re: My experience of losing a friend to heroin (2020)

#118

Post by scythe »

wespiser_2018 wrote: post #24

Good write up. The US is really grappling with diseases of despair, and heroin/fentanyl addition is on of the biggest ones impacting the wellbeing of our society. A massive slice of talent and raw human resource is just dying every year, but the solutions that have worked in other countries are just impossible to implement here due because the the methods that are known to work are politically dead on arrival. I'm a…

The invisible elephant in the US opioid policy discussion is the lacuna between the policy and its implementation.

You have to find a human being to perform the work of enforcing the drug laws. The US has had drug addicts for a hundred years, and the attitude towards opioids hasn't changed very much, but the usage levels go up and down. There's a back-and-forth between "rehabilitation" and " incentivizing" that correlates poorly with the outcome.

What correlates better with opioid use? Recently, the epidemic clearly started with overprescription and then exploded with fentanyl:

https://www.cdc.gov/opioids/basics/epidemic.html

It's important to notice that prescription opioid overdoses don't go down until 2017. This problem started with prescriptions and it won't end until the problem is fixed. Pills should be replaced with patches wherever possible.

The other glaring issue is that the meteoric rise of fentanyl was not noticed until it got out of hand. This is a societal problem: drug messageboard users knew about the fentanyl crisis years before the regulators took any action.

The regulatory system, viz. the DEA, has been starved for talent for decades because nobody wants to work for them. The enforcement-for-profit model of the civil asset forfeiture era of policing has driven talented and motivated people away from law enforcement careers. The people who are left are not qualified or motivated for the task at hand. Enforcement should be more proactive than it was. It should focus on real dangers, not culture wars. Opioids and dopaminergic stimulants are the drugs of self-destruction; everything else is a distraction.

The most ironic thing to hear people chanting in an epidemic of poisonings brought on by illegally and irresponsibly manufactured high-potency addictive drugs is "abolish the police!". These people need the police. But nobody trusts the police.

One quote we were all forced to memorize in school was: "A house divided against itself cannot stand."

Re: My experience of losing a friend to heroin (2020)

#119

Post by iammisc »

jakeinspace wrote: post #17
nostromo wrote: post #14

Earlier quoted context omitted.

I used to believe that — before I lived in a city that effectively decriminalized all drugs. The result has been a disaster. People on meth run around the streets at night causing chaos. Homeless people on heroin leave needles everywhere. People avoid transit and parks now because there is regularly someone losing his or her mind nearby. Long sentences aren’t the answer of course. But I do think that sending someone…

I understand that, although it's difficult to say whether that experiment is indicative of what a nationwide relaxation of drug laws would do. Cities which have decriminalized drugs (removed enforcement) are going to attract a disproportionate number of problematic or homeless addicts from other parts of the country. Cities with a more hospitable climate (in the sense of weather) already have this problem, so I imagi…

What utter nonsense. Portland has an incredibly inhospitable climate (I mean I live in a lovely house and I find it overbearing). And yet we have more than enough people willing to tough it out in the torrential downpours.

Re: My experience of losing a friend to heroin (2020)

#120

Post by TimTheTinker »

standardUser wrote: post #90
TimTheTinker wrote: post #42

Earlier quoted context omitted.

> we seem to have this huge moral hang up in the US about giving addicts drugs For many people, what you're describing all comes down to the law of love. It is not loving to give a person more of the thing that is destroying them. Perhaps free methadone would be a better option? EDIT: care to comment? I'd like to know why people disagree.

More often than not, lives are in greater threat of being "destroyed" by the consequences of drug prohibition than the drugs themselves. Addiction is a serious health problem, but impure drugs that lead to overdose deaths, spreading disease through needle use, avoiding medical care for fear of legal consequences, going to jail and having a criminal record, and becoming involved in black market violence are all vastly…

I'm inclined to agree; substance prohibition in any form (except perhaps for nuclear fuel and the like) has a long history of causing an incredibly wide range of societal problems.

But removing prohibition is a far cry from providing free heroin to addicts... I understand the argument about removing the black market, but after seeing San Francisco in person it's hard to agree that free drugs and paraphernalia makes things better overall.

If my friend became a heroin addict, out of care for him or her I would not provide them with heroin even if I could afford it. Why should I treat other fellow humans worse?

Why is it different when we're speaking at a societal level? Love for neighbors should increase, not invert, when the number of individuals concerned increases.

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