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Anarchists making their own medicine (2018)

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Re: Anarchists making their own medicine (2018)

#51
post #37
post #32

Earlier quoted context omitted.

R&D and quality control provides benefits to patients, and it is critically important to figure out how to reduce the cost of R&D and quality control so we can do a lot more of them. That's what Four Thieves Vinegar and other biohackers are doing. Regulatory compliance doesn't provide benefits to patients; it's a deadweight loss. As you are presumably aware, to a significant extent, the reason that regulatory complia…

Nothing I said above disagrees with the fact that many pharma are indeed doing what you call "monopoly rent extraction". I think all of those drugs are overpriced for non-economic reasons. Regulatory compliance, for example, with the FDA approval process, isn't a deadweight loss; it's a process that reduces the risk a dangerous drug will be given to the public. It's mostly costly due to incompetence and bureaucracy,…

What reduces the risk that a drug will be dangerous is testing, quality control, replication, and transparency. Regulatory compliance is, at best, a means to those ends, not an end in itself. At worst, and far too often, it's a major obstacle to them.

People don't have to be evilly plotting when their incentives are set up to empower only people who do evil things. Don't forget that, in the US, we're talking about the same regulatory regime that rejected magainin, hasn't brought a new class of antibiotics to market in half a century, has outlawed the flavored vape liquids that help people quit smoking, won't allow you to buy a blood sugar meter until after you have diabetes, prohibited covid testing at the beginning of the pandemic, delayed covid vaccination until five or six months after China was doing mass vaccination, and routinely cuts off opiate addicts cold turkey. It's a Kafkaesque farce, as you know very well, and quite possibly the primary cause of death in the US today.

Re: Anarchists making their own medicine (2018)

#52

Earlier quoted context omitted.

I'm not arguing with what you're saying, but GC/MS can be bought for like $100 a sample and it's conceivable a system can be invented where private auditors audit the output of an unregulated pharmaceutical manufacturer in such a way that the QC assurances to the consumer are as good or better as in our current system, with much lower regulatory costs.

In the limit what you are describing is a generic drugmaker. It's certainly possible to audit drug quality by sending it to labs, and people do that for darknet drugs all the time, but there are still problems: 1) There is no way to use ex-post analysis alone to achieve the kind of QA that pharmaceutical companies do; they have visibility into the entire manufacturing process and process control. Put another way, a s…

I think we are seeing the same thing, a system designed to remove corruption/regulatory capture/lobbying as far as possible from the process. I'm seeing a "rogue" auditor that performs the same service, while you are seeing a rogue government. If the outcome is the same, I am fine with either. Your pointed weakness regarding auditing the manufacturing process could be incorporated into either.

Re: Anarchists making their own medicine (2018)

#53
post #42

Earlier quoted context omitted.

> What if everyone had an analysis machine that could analyze the medicines, DIY or not, to find out what was in them I can fairly confidently predict this will not happen like it did for software. Chemical analysis has been around a long time and remains difficult for experts to do accurately without context, let alone for a layman. Gas chromatography, for example, requires large and expensive machinery and some ide…

Clearly making it happen will require a revolution in manufacturing, which may or may not already be underway, but making it happen for software required decades of continuous revolution in semiconductors and telecommunications. Some kinds of analysis machinery, like GC, ICP, and DSC or DTA, are probably inherently fairly large; other kinds, like FT-IR, other kinds of spectrometry, TLC, HPLC, other kinds of liquid ch…

Miniaturized NMR? can you explain how that would work?

Re: Anarchists making their own medicine (2018)

#54
post #44
post #27

Earlier quoted context omitted.

What if the DIY medicines weren't of dubious quality? What if they were higher quality than the ones that cost US$750 a dose? What if everyone had an analysis machine that could analyze the medicines, DIY or not, to find out what was in them, and the DIY stuff turned out to be purer and more precisely dosed? That's what happened with Linux versus, say, Solaris and Microsoft Windows, and it's what's happening now with…

92% of contributors to the Linux kernel are paid by companies: https://www.suse.com/suse-defines/definition/linux-contribut... Most major OSS projects are controlled by a few companies who pay developers to work on them. They're more like industry consortiums than DIY anarchist collectives.

Something can be both an industry consortium and a DIY anarchist collective, like Linux; the Linux Foundation isn't Linux. It turns out that industrial companies don't appreciate being subject to monopoly rents any more than private individuals do! The GPL is undeniably very anarchist, and it serves as a kind of constitution that keeps the companies that participate in GPL projects from controlling them. Consider, for example, Oracle and LibreOffice, MariaDB, and Jenkins, or GitHub (now Microsoft) and Git.

The solution isn't to destroy capitalism or exclude industrial companies from participation. We tried that a century ago. It went badly, because, as it turns out, capitalism is better at limiting the damage done by ambitious psychopaths than the alternative systems are; if Beria had been born in Ohio maybe he would have ended up running a soap company or a division of GE instead of mass-murdering dissidents.

Similarly, the GPL (and, to a lesser extent, non-copyleft open-source licensing) reduces the damage selfish companies can do to software projects and the people and companies that depend on them.

We need to figure out how to do the same thing to drug companies and the FDA, because they are just killing far too many people and causing far too much needless suffering today.

Re: Anarchists making their own medicine (2018)

#55

Earlier quoted context omitted.

In the limit what you are describing is a generic drugmaker. It's certainly possible to audit drug quality by sending it to labs, and people do that for darknet drugs all the time, but there are still problems: 1) There is no way to use ex-post analysis alone to achieve the kind of QA that pharmaceutical companies do; they have visibility into the entire manufacturing process and process control. Put another way, a s…

I think we are seeing the same thing, a system designed to remove corruption/regulatory capture/lobbying as far as possible from the process. I'm seeing a "rogue" auditor that performs the same service, while you are seeing a rogue government. If the outcome is the same, I am fine with either. Your pointed weakness regarding auditing the manufacturing process could be incorporated into either.

> I think we are seeing the same thing, a system designed to remove corruption/regulatory capture/lobbying as far as possible from the process

Not really. It's more like a system to selectively remove intellectual property rights without destroying the financial incentive to develop drugs.

Re: Anarchists making their own medicine (2018)

#56
post #53
post #42

Earlier quoted context omitted.

Clearly making it happen will require a revolution in manufacturing, which may or may not already be underway, but making it happen for software required decades of continuous revolution in semiconductors and telecommunications. Some kinds of analysis machinery, like GC, ICP, and DSC or DTA, are probably inherently fairly large; other kinds, like FT-IR, other kinds of spectrometry, TLC, HPLC, other kinds of liquid ch…

Miniaturized NMR? can you explain how that would work?

Benchtop NMR spectrometers already exist (for decades now), and some are already cryogen-free, permitting room-temperature measurements, eliminating the dewar and cryogens which account for a lot of the mass and volume of traditional NMR spectrometers. We now have room-temperature superconductors, which might work to eliminate the bulky, heavy permanent magnets in current benchtop devices, though the pressures required may turn out to be impractical. Beyond that I can handwave at improved electronics and SQUIDs, but I don't really know.

Do you think there are some fundamental obstacles to miniaturizing NMR, and if so, what?

Re: Anarchists making their own medicine (2018)

#57

Earlier quoted context omitted.

I'm not arguing with what you're saying, but GC/MS can be bought for like $100 a sample and it's conceivable a system can be invented where private auditors audit the output of an unregulated pharmaceutical manufacturer in such a way that the QC assurances to the consumer are as good or better as in our current system, with much lower regulatory costs.

>it's conceivable a system can be invented where private auditors audit the output of an unregulated pharmaceutical manufacturer in such a way that the QC assurances to the consumer are as good or better as in our current system, with much lower regulatory costs. No, it's not. This is ideological libertarian nonsense. There's a reason pharma came to be regulated in the first place. All this will lead to are more inju…

[deleted]

Re: Anarchists making their own medicine (2018)

#58
post #25

> “If you're going to die and you're being denied the medicine that can save you, would you rather break the law and live, or be a good upstanding citizen and a corpse?” It's obviously better to risk using DIY medicine than to die, and it sounds appealing—mutual aid, neighbors helping neighbors, saving lives with free medicine! But framing it this way significantly misrepresents the issue of for-profit medicine. Peop…

> People mostly aren't dying because they can't afford life-saving medicine. No, people are definitely dying because they can't afford medicine. They're not taking things they need, they're cutting pills in half, they're diluting injections. When they finally die from some acute episode, what got them there is never recorded. The amount of bullshit I have gone through to get albuterol inhalers (which cost $5 in civil…

It's also worth mentioning that albuterol and similar inhalers used to be an exception to the prohibitions on CFCs (these inhalers an't used in large enough volume to do significant ozone damage), but due to lobbying from the companies that made them, they no longer are.

Why would a company lobby to outlaw its current product? Well, they had patents on "improved" CFC-free versions, allowing them to exclude new entrants from the market.

Re: Anarchists making their own medicine (2018)

#59
post #53
post #42

Earlier quoted context omitted.

Clearly making it happen will require a revolution in manufacturing, which may or may not already be underway, but making it happen for software required decades of continuous revolution in semiconductors and telecommunications. Some kinds of analysis machinery, like GC, ICP, and DSC or DTA, are probably inherently fairly large; other kinds, like FT-IR, other kinds of spectrometry, TLC, HPLC, other kinds of liquid ch…

Miniaturized NMR? can you explain how that would work?

They use rare earth permanent magnets and don't offer the resolution of superconducting magnet NMR, but they are much smaller and cheaper (tens of thousands of dollars, new) than superconducting units or the even older resistive electromagnet NMR units. The first one I saw was from picoSpin, which has since been acquired by Thermo Fisher Scientific. I think that there are multiple vendors now. Here's a current picoSpin unit:

https://www.thermofisher.com/order/catalog/product/912A0913

Re: Anarchists making their own medicine (2018)

#60
post #51
post #37

Earlier quoted context omitted.

Nothing I said above disagrees with the fact that many pharma are indeed doing what you call "monopoly rent extraction". I think all of those drugs are overpriced for non-economic reasons. Regulatory compliance, for example, with the FDA approval process, isn't a deadweight loss; it's a process that reduces the risk a dangerous drug will be given to the public. It's mostly costly due to incompetence and bureaucracy,…

What reduces the risk that a drug will be dangerous is testing, quality control, replication, and transparency. Regulatory compliance is, at best, a means to those ends, not an end in itself. At worst, and far too often, it's a major obstacle to them. People don't have to be evilly plotting when their incentives are set up to empower only people who do evil things. Don't forget that, in the US, we're talking about th…

So, uh, how are we going to ensure that all that testing, QC, and transparency occurs... without some sort of regulatory agency that enforces it? and that agency woudl use compliance (submit this and that form and follow this and that process)... so it would seem that they act as proxies for the value of the things you listed.
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