My experience of losing a friend to heroin (2020) • Hacker News Board

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

#161

Post by ghufran_syed » Tue, Oct 26, 2021, 4:37 AM UTC

kyleee wrote: post #113

notJim wrote: post #70

Earlier quoted context omitted.

> 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.…

I work in the ER in a high drug use area - I estimate around 80% of patients who start outpatient "medication assisted treatment" in the ER (outpatient buprenorphine-naloxone to treat the withdrawal symptoms) are there because the judge in their criminal case tells them it's that or go to prison. Some people definitely can't make good decisions for themselves and need to be "forced" to get treatment - and are later often grateful for having been forced to do so if they stay clean.

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

#162

Post by spoonjim » Tue, Oct 26, 2021, 4:40 AM UTC

Clubber wrote: post #146

spoonjim wrote: post #145

Earlier quoted context omitted.

Still many more annual overdoses of prescription pills than illegal drugs.

>Still many more annual overdoses of prescription pills than illegal drugs. Not since around 2016, which is around when the panic with pills started and we started cracking down. It did put a small dent in pills but fentanyl is off the charts. We probably would have been better off, at least in terms of deaths, if we had just ignored the "opioid epidemic." https://www.drugabuse.gov/drug-topics/trends-statistics/over.…

Thanks for the correction.

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

#163

Post by asdff » Tue, Oct 26, 2021, 4:41 AM UTC

somethoughts wrote: post #80

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…

It'd be interesting if there were any country wide experiments that are similar to the approach that has been taken with tobacco. Basically legalize it for those over 18, slap it silly with warning labels and then tax the heck out it to make it prohibitively expensive. And raise the tax every year. And then fund ad campaigns and social media campaigns which make it generally look dumb and unfashionable as well as tre…

People on meth can have psychotic episodes and hallucinations. It's a common sight today to find shoeless people high on meth yelling incoherent things in traffic. That's the answer to your experiment. In my city in CA, meth is dirt cheap and enforcement on the side of the police is zero. I've seen a shirtless man smoke crystal meth right outside of the train station with metro security not reacting at all. BMWs appear by night to sell meth and pimp out people from homeless encampments, aid workers appear by day to feed people boxed lunches. That sort of environment doesn't lead to people picking themselves up by the bootstraps and stepping into a job and a $2000 1br apartment (going rate in LA). This situation of nothing checking drug use leads to them falling further and further into psychosis until they die in poor health in a bad situation with a necrotic limb or two, as I've seen play out before my own eyes in this city.

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

#164

Post by ryan_lane » Tue, Oct 26, 2021, 4:44 AM UTC

TimTheTinker wrote: post #120

standardUser wrote: post #90

Earlier quoted context omitted.

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…

They don't give out free heroin in SF. There are needle exchange programs, and a small number of safe usage sites. Also, you're assuming most of the addicts are heroin addicts. Quite a few of them are meth addicts, who are harder to reach, partially because the type of meth they're getting causes severe psychosis.

Giving meth addicts forms of meth that are produced more cleanly would reduce the level of psychosis and would further reduce the price of meth to a point where it may not be profitable to produce (it's already cheap to the point where it's nearly unprofitable - it requires massive volume).

Giving addicts access to clean drugs provides you an opportunity to help them, a place to keep them away from others while they're using, a way to ensure they don't die while using, reduces funding to organized crime, and removes their need to commit crimes to fund their habits.

You may see it as treating them poorly, but ultimately, you're doing them and the rest of society a benefit.

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

#165

Post by tmsh » Tue, Oct 26, 2021, 4:46 AM UTC

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…

Dopesick is a good show on Hulu on this subject right now.

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

#166

Post by kenneth » Tue, Oct 26, 2021, 4:47 AM UTC

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…

As a Swiss person who spent a few years in the 90s going to primary school on Langstrasse, watching junkies shoot up, and having to be careful in city parks to not step on the mountains of used needles… that is about the WORST idea I have ever heard.

The Swiss experiment in the 80s and 90s was a complete disaster, and it wasn't until the 2010s that that part of Zurich was finally cleaned up. It attracted the worst junkies from all around Europe, it created a crime wave in a country that was crime-free. It didn't work, either, it just led to more addiction, death, and despair.

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

#167

Post by jwilber » Tue, Oct 26, 2021, 4:48 AM UTC

Ansil849 wrote: post #160

hackyhacky wrote: post #159

Earlier quoted context omitted.

If someone is hit by a car while jaywalking, the jaywalker is typically viewed as a victim, not a reckless hooligan who got what they deserved.

Jaywalking is illegal in several jurisdictions. So no, the jaywalker is not just viewed as a victim. But yes, socially, of course like I said it is extremely sad to see, but also like I said...If someone made a choice to recklessly endanger themselves, then at some point personal responsibility needs to be taken into account.

Jaywalking isn’t super black and white, though.

Someone jaywalking at night directly in front of a car is not the same as someone jaywalking in an empty town and getting hit by a speeding drunk driver.

It also involves another party causing the death.

The two seem extremely unrelated.

Edit: that said I do agree in most cases drug addiction is self-inflicted and a personal responsibility issue. Unfortunately it has societal externalities.

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

#168

Post by jorgesborges » Tue, Oct 26, 2021, 4:48 AM UTC

Ansil849 wrote: post #156

My view on drug use has been described as uncompassionate, and I legitimately want to change my perspective, but I haven't been able to. I view drug use as a choice. Yes, there are tons of social, economic, even genetic predisposing factors...but the decision to try drugs or alcohol or smoking or gambling or any other strongly addictive behavior is in the end the user's own choice. It's like it is someone's choice to…

I work with youth that are addicted to heroin, meth, alcohol. There isn’t one who hasn’t witnessed or been subject to trauma, violence or substance abuse in their childhood. Compassion comes from understanding that the majority of addicts were born into a family they did not choose. These are children who weren’t loved or fed or clothed adequately, who had dangerous people move in and out of their lives without safety or stability, who witnessed people using intravenous drugs, fighting, and having sex. Unfortunately more often than not they’re more than just witnesses.

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

#169

Post by danjac » Tue, Oct 26, 2021, 4:51 AM UTC

Ansil849 wrote: post #156

My view on drug use has been described as uncompassionate, and I legitimately want to change my perspective, but I haven't been able to. I view drug use as a choice. Yes, there are tons of social, economic, even genetic predisposing factors...but the decision to try drugs or alcohol or smoking or gambling or any other strongly addictive behavior is in the end the user's own choice. It's like it is someone's choice to…

The most harmful forms of drug use (other than alcohol) are not due to someone trying out a drug at a party just for fun, but being addicted to drugs legally prescribed by their doctor for pain due to injury or illness:

https://www.addictioncenter.com/news/2019/08/15-most-dangero...

But I guess it's just one's personal choice, yeah?

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

#170

Post by asdff » Tue, Oct 26, 2021, 4:51 AM UTC

krater23 wrote: post #141

SuoDuanDao wrote: post #49

Earlier quoted context omitted.

I heard a story - can't find the reference now - of a doctor who got addicts to replace their drug addiction with exercise addictions. From what I recall the program was quite successful at making the patients functional, but didn't really do much for the underlying issues - just made the addiction itself less damaging.

Makes sense. I talked about it with a friend of mine, a ex-junky. He said, all people he know from the Methadon-program are dead because they just died on alcohol. He said, they don't take Heroin because Heroin make addicted, they take Heroin because they needed 'the hammer on the head'. They switched from Heroin to a more damaging addiction. Why this should not work with less damaging addictions too?

Pretty common on the west coast to hear about people taking suboxone to quell their heroin addiction but doing meth now to get high because its so cheap and available in this part of the country due to the industrialized processes in mexico that came online over the past 10 years.