Earlier quoted context omitted.
Sure would help if they went through rehab to kick the addiction, and not get AIDS then.
Which is why programs like this are important. Keep them alive and healthy long enough to seek help...
Seek help from _where_?
Seattle Is Opening First in U.S. “Safe Injection Facility” for Heroin Addicts
171–180 of 193 posts
Re: Seattle Is Opening First in U.S. “Safe Injection Facility” for Heroin Addicts
#172Earlier quoted context omitted.
I'm pro-legalization, but there is a good argument to be made that legalization increases access and as a result you'd see a much higher rate of casual use (orders of magnitude higher). Any slight increase in healthcare costs or negative outcomes on a per-person basis multiplied across a large population is a factor worth considering.
This is purely anecdotal, but I'm not so sure legalization would have a large effect on the rate of drug use. I consider myself fairly well insulated from drug use. In my entire social group I know of only one person that has ever tried methamphetamine (which is rampant here in Australia), and none that have tried heroin. Despite that, if you set me to the task of aquiring heroin I'd be pretty confident in my ability…
I don't know, I think there are a number of factors about illegal heroin that make it less attractive than legal heroin might be:
1. Buying it illegally funds criminal organizations
2. Quality is terrible, it's certainly adulterated
3. Association with low class and poor people
You can ingest or smoke opium products, too, if the needle is the off-putting part of heroin.
But yeah, another anecdotal perspective: I've had prescription opioid painkillers but don't have any particular interest in continuing to use them after the pain goes away. So if opioids were legal tomorrow, I don't think it would change my behavior at all either.
Re: Seattle Is Opening First in U.S. “Safe Injection Facility” for Heroin Addicts
#173I live in Seattle and regularly see needles on the street, and occasionally see paramedics tending to OD'ing addicts. This is a great development but should've happened years ago.
Definitely, as a Seattlite I'm all for it, less needles in parks, under I-5, and on the streets are good. Having users all in one place where they can be monitored, attended to and offered services much more effectively and at a lower cost to the taxpayer is also a huge win!
Replying to a sibling (dead) comment:
> Go take a stroll up to Vancouver to the safe-injection site they are modeling this after and you'll discover destitute conditions in a large radius.
The site is located in the Downtown Eastside - aka "the poorest postal code in Canada" which had been like that long before the site opened.
Re: Seattle Is Opening First in U.S. “Safe Injection Facility” for Heroin Addicts
#174Earlier quoted context omitted.
You have a great comment, and I agree with much of it. However, Rat Park doesn't replicate and probably shouldn't be touted as a good example of addiction behavior.
Interesting. I sure as shit don't know enough about Rat Park. Do you have some links to the failure to replicate?
Re: Seattle Is Opening First in U.S. “Safe Injection Facility” for Heroin Addicts
#175Earlier quoted context omitted.
I literally cannot understand why this is being downvoted. Prescribed heroin would save thousands of lives and billions of dollars in ER OD cases and the acquisitive crime that this disorder causes. Shame on you HN.
>Prescribed heroin would save thousands of lives and billions of dollars in ER OD cases and the acquisitive crime that this disorder causes. If you get a prescription for heroin that would probably lead to addiction right? Now as an addict you want more, so you go back to the doctor but they won't prescribe anymore ostensibly to prevent overdose. So now you have an addict looking for a way to score more outside of a…
Not really, most heroin users reach a sort of stable dose, which can be very high.
The idea is you stabilize people's lives. Prescribe them heroin for say 3 months to start with. Their lives are no longer endless crime, prostitution, police cells etc. They can get housing and other things sorted without having to also find $1000s a month for a drug habit.
From that the community is already seeing a benefit (less crime and the market for black market heroin mostly vanishes), and then from that you can start helping people reduce their dose and get proper drug treatment while living a far more normal life.
There will probably be some black market dealing, but it will be much smaller scale and won't have anywhere near the scale.
Re: Seattle Is Opening First in U.S. “Safe Injection Facility” for Heroin Addicts
#176Earlier quoted context omitted.
"Opioid use is not inherently dangerous" Yes, it is. It's extremely addictive, and is very well known to destroy lives.
They most certainly can - but the majority of the harms actually result from our treatment of the issue, not the issue itself. I think we simply have to accept that people are going to want to use these substances, and make it as safe as possible for them to do so. If the first step of a plan says something like "1) First, change fundamental human nature", the plan really needs a rethink.
"but the majority of the harms actually result from our treatment of the issue, not the issue itself."
Total nonsense.
Please tell me what 'harms' come from heroin treatments?
The primary 'treatment' for heroin addiction is to simply 'not do heroin'.
Stop doing it.
Ultimately, that's the only way out.
" I think we simply have to accept that people are going to want to use these substances, and make it as safe as possible for them to do so."
No - again false. Law of Supply and Demand: if we make it hard enough to get, and raise the barrier of supply, and also try to push back demand by teaching kids not to use it - then it becomes rare.
Enabling users lowers the 'difficulty of access', like lowering the cost curve - and creates more usage.
Anyhow who is caught in public, high on heroin, can be asked to go to a dry out clinic where they won't have access to it. They have to go through withdrawal.
Re: Seattle Is Opening First in U.S. “Safe Injection Facility” for Heroin Addicts
#177Earlier quoted context omitted.
"See Vancouver's Insite program for proof it works. It's been a huge economic and social success" No - this is not true. OD's are at an all time high in the region [1] It's a highly politicized issues and the entities behind it are strongly incented to make it seem as though it's working. The only evidence of Insite 'working' is provided by them - and the data points they provide are selective, unscientific and defin…
That data has to be normalized for the surge in fentanyl use. Sydney has had safe injecting for 15 years, initially the rate of overdose went down ~75% to around 1 per month but now in the past few years it has spiked back up again to record levels. There are also other factors to safe injecting rooms - such as opening pathways to recovery, removing litter from the streets, preventing hepatitis and other diseases and…
"That data has to be normalized for the surge in fentanyl use"
I agree.
"I don't think anybody claims that safe injecting alone can prevent all opioid deaths,"
'Safe injecting' is not saving any lives and is not doing any 'harm reduction' is my point.
The only evidence provided that 'it's working' is the sites data where they say 'we prevented x number of ODs' - but this is not quite valid - just because they think they prevented an OD, does not mean they did. Someone who takes too much on the street can still get an ambulance and emergency services. Someone on the street who does 'way too much' is gong to die one way or another.
There's no evidence that the sites actually 'get more people into programs' than otherwise.
I believe that more directly interventionist programs might work: if you are caught, high on heroin in public - then you don't go to jail, but you go to a facility of sorts. This facility is basically a 'dry out hotel'. The only thing about this facility is you have zero access to heroin - you have to go through withdrawal and be clean for 30 day.
Withdrawal is the unavoidable 'first step' to getting off heroin. There is absolutely no other way, and it must be done.
Then programs to help people stay off of it.
Re: Seattle Is Opening First in U.S. “Safe Injection Facility” for Heroin Addicts
#178Earlier quoted context omitted.
Interesting. I sure as shit don't know enough about Rat Park. Do you have some links to the failure to replicate?
https://www.ncbi.nlm.nih.gov/pubmed/9148292?dopt=Abstract https://www.ncbi.nlm.nih.gov/pubmed/11072395?dopt=Abstract https://en.wikipedia.org/wiki/Rat_Park#Reaction_to_the_exper...
Interesting. However, those are attempting to replicate the results, and not the experiment; from my level of education and based on the abstracts, that sounds more like "significant results" rather than "disproving results".
The first abstract actually describes a theory that cannot be correct given the Rat Park experiment as described on Wikipedia, due to group PC (no new rats were supplied to that group). Or, rather, a theory that does not explain group PC.
Re: Seattle Is Opening First in U.S. “Safe Injection Facility” for Heroin Addicts
#179Earlier quoted context omitted.
Good points, but what about addiction and neurotransmitter equilibrium? If something is addictive enough, and highly available, do you think that it would become an unnecessary brain dependency?
I feel like someone functions better with their regular, stable dose of pharmaceutical-grade opioids in them -- I don't have any medical or moral issue with that at all. It's honestly...a lot like the hair dryer anecdote in http://slatestarcodex.com/2014/11/21/the-categories-were-mad... . As for the LD50 issue -- yes, opioid-naive (non-tolerant) users will have a low LD50 but they also won't need much a dose to get t…
These are all good points, in agreement with the general consensus here. I think most people here can agree that uncertain (i.e. impure, unpredictable) doses of pretty much anything is far worse than having predictable doses. You also mention the LD50 is a function of tolerance, which, of course makes sense. My main concern is the backlash of suddenly stopping opioid consumption after one has reached a significantly higher (compared to the naive values) personal LD50 and dosage.
Re: Seattle Is Opening First in U.S. “Safe Injection Facility” for Heroin Addicts
#180Earlier quoted context omitted.
They most certainly can - but the majority of the harms actually result from our treatment of the issue, not the issue itself. I think we simply have to accept that people are going to want to use these substances, and make it as safe as possible for them to do so. If the first step of a plan says something like "1) First, change fundamental human nature", the plan really needs a rethink.
"but the majority of the harms actually result from our treatment of the issue, not the issue itself." Total nonsense. Please tell me what 'harms' come from heroin treatments? The primary 'treatment' for heroin addiction is to simply 'not do heroin'. Stop doing it. Ultimately, that's the only way out. " I think we simply have to accept that people are going to want to use these substances, and make it as safe as poss…
> "the treatment for heroin addiction is to simply not do heroin... ...they have to go through withdrawal."
This is true for people who do not consume heroin a priori. For the others, suddenly stopping heroin use can be life threatening. Most people need assistance to wane off of things like that. Also, I think you are right that enabling will increase usage, but you must also consider the black markets which are enabled in response to disabling the regulated markets.
It seems like a majority viewpoint on this thread is that it's better for more people to be using real opioids safely than to have a smaller, effectively invisible/black-market population using "opioids" very, very dangerously.