America’s opioid epidemic is worsening

> Maybe the answer isn't to make heroin available OTC at Walgreens

Actually, in UK you can get actual opioids (as co-codamol) behind the counter, without a prescription. Funny how they don't seem to have a disastrous and deadly opioid epidemic like the US has.

I'd so much rather live where people can get cheap pharmaceutical grade heroin at the pharmacy than where people who need opioids end up smashing windows to steal my laptop to buy some dangerous and overpriced fentanyl contaminated "heroin" that ends up making them overdose in the street (transnational criminal organisations tend to lack purity standards commensurate with those of prescription drug manufacturers, weirdly enough).

Crackdowns on "pill mills" and "doctors who overprescribe" is what denies people a safe and legal source of pharmaceutical-grade opioids and forces them onto the black market of illegal, extremely overpriced, dose-uncertain, and fentanyl-contaminated opioids -- all of which make drug use a lot more problematic and dangerous (for both the user and the community) and pushes people from "drug dependence" (needing a regular, constant dose of a medication to function) to "drug addiction" (problematic, damage-causing drug use).

Dose uncertainty especially contributes to the harm of drug use -- if the doses aren't uncertain (and are precisely metered like those of other, pharmaceutical-grade medications), it's a lot easier for the user to find the right dose that extinguishes the withdrawal symptoms and the pain while not ending up anywhere near an overdose. Also the ability to access pure opioids with precise doses means it's a lot easier to take the drugs as a periodic, regular dose and not have one's life disrupted by extreme highs and extreme lows and drug-craving. This allows users to maintain a normal, productive, non-criminal life with other things in their life (family, hobbies, career) than just the pursuit of opioids.

In US, the "epidemic" of OD deaths only began when crackdowns intensified on legal, pharmaceutical, sources and prescribers of opioids. The DEA cracking skulls over opioids and investigating doctors is literally the only reason illicit fentanyl (and its even nastier analogues) are common illicit products now. I am so very doubtful that skull-cracking and door-kicking will miraculously work after decades of it not working. Prohibition has given us carfentanil in illicit heroin. If you don't know what that is, it's a fentanyl analogue so potent that it's been successfully used as a chemical weapon. This is not an anomaly -- it's just the "iron law of prohibition (https://en.wikipedia.org/wiki/Iron_law_of_prohibition) at work.

> It's not like anything else is working.

Prohibition isn't working, and has caused tremendous devastation to society, and the opioid epidemic is just another instance of this. Prohibition has to get wound down, from the top (end the Single Convention on Narcotic Drugs and the statutes that give it effect) to the bottom (make it so local police can't arrest or search people for any drugs offences (possession, manufacture, use, transport, sale, purchase) regardless of the drug or quantity).

I'm not sure if this is inherent in your #1, but there should be an increased focus on alternative methods for dealing with pain. For instance, since starting meditation training, I haven't needed so much as a single Ibuprofen. It's not that my incidence of pain has decreased, but my way of thinking about/reacting to that pain has changed dramatically and I can now make just about any pain quickly fade into the background. It's also helped me to clarify the difference between pain and injury to know when I can push through the pain and when I need to pull back and rest.

I learned an important lesson, however. Doctors will frequently use the amount of pain someone is experiencing as a diagnostic aid when determining a patient's diagnosis. I had a ruptured eardrum that I saw a doctor for and that doctor misdiagnosed it because I wasn't showing any signs of pain and that injury is supposed to be excruciating. The doctor explained to me that if it was ruptured, I'd be near tears and screaming for pain medication.

Speaking from Singapore here. We don't have any drug problem at all. Drug dealers get death penalty. It's illegal to consume, too. You are put in jail.

I pity your poor citizens who can only resort to legalization. Addicts are not healthy for the society or for the economy. It's just a matter of very bad (crime) or bad (jobless and getting high at home, disturbing neighbors).

Government use tax I paid to supply water, electricity and infrastructure. I don't agree that it's wasted on addicts.

You'd think thats the point where it gets fixed, but thats when the cycle begins again.

Speaking from Australia, I find the Singapore solution barbaric and totalitarian, no better than the new Philippines president.