Don't understate the "do not do crime". I've known addicts and the biggest damage they cause (apart from dying when they OD on unknown-quality junk) is that they become thieves and liars. No one trusts them and it tears relationships apart. Both are fixed by having more legal availability. If they were simply able to get opiate as easily as pot, then addicts for the most part would be just like potheads. Perhaps being useless, perhaps seen as a drain or whatever, but not dangerous, not bad people like some junkies turn into.
With proper availability, opiates are very well tolerated. Being addicted, by itself, is not a big deal. Apart from the negative pieces you see like this one, opiates are still a huge success for many people. Not just physical pain, but emotional pain, depression, and stress. Keep an eye out for pinned pupils and notice how many professionals have them.
There's this stigma that addiction is inherently bad. Yet it only applies to "fun" drugs like opiates. No one, in general, goes on about the terribleness it is to be addicted to antipsychotics or insulin or antidepressants. At best, you hear how annoying it is, having to always make sure you've got your gear - but I've not seen people go on about the intrinsic badness of addictions lifesaving medications cause.
What should be available is more public health awareness, and a cultural shift. People should be free to get addicted, but easily obtain services to help with it, without being labelled or criminalized. You don't need to rob people of liberty and cause suffering by requiring a paid gatekeeper to watch over everyone.
"Being addicted, by itself, is not a big deal."
- As someone with an en extensive amount of first-hand knowledge, I disagree very very much. It is in fact so big of a deal that it becomes your one and only deal.
The worst part is, if you use opiates for a long period of time consistently - you WILL become reliant upon them. Your body will be chained to them, physically dependent, and I don't care who you are, where you come from, or how much money you have. 100% of the time, no exceptions willpower be damned.
And as far as using opiates as a means to heal emotional pain and depression? That's is possibly the worst idea ever. You're flat out asking for a long, long slow death in which you probably kill yourself in the end anyway but in the meantime you disappoint anyone who has ever cared about you even slightly.
Well I guess we have two different sets of people and experience then. I've seen people do rather successfully in business, all while using opiates on the side. (I've seen a few people die too, but that was pretty much caused by illegal supply and lack of regulation/QC.) The actual addiction part, without supply constraints, becomes very, very simple logistics.
Those logistics are not as simple as it may seem. 2 bags of dope/pills/caps/doses a day becomes 3, 4, 6, 8 twice a day + 9 on Sundays. Happens to everyone given a long enough usage period. There's that proverbial slippery slope there, and once you're over the hump it's checkmate. Wait until something happens to these successful folks - and it will. there's a weak link somewhere in the chain and when it breaks they will act like every other junky.
And what is "acting like every other junkie" mean? Göring was a morphine user for what, 2 decades? Didn't stop him from becoming extremely powerful (misguided, but he accomplished a lot).
I mean the guys who are successful you mentioned, i assume they have nice jobs, families, maybe children -- the good stuff. Once shit hits the fan and they get a taste of dopesickness they will ignore all of that, the drug becomes priority #1 hell with everything else. Then they will do whatever and screw over whoever to fix the link of the chain that broke (ie, where to get them or how to pay for them, how to hide it, or whatever the problem may be) just like every other junkie. You will eventually look in their eyes and see nothing, like every other junkie. It's a short ride from having it all to having nowhere to sleep.
It's a cycle and story told time and time again. If your friends want to stay successful and keep the good stuff in their lives they should get off the shit is all i'm saying. That's nowhere near easy to do, but it's gotta be done or they will crash & burn. Opiates don't really cure the pain anyway, just mask it.
Goring had the advantage of being in a prominent position close to the leader before he got hooked and fell off. I'm sure any other lower nazi officer would've been cast off if they weren't buddies with the fuhrer. He also was in the advantageous (but bad) position of being able to tell his doctor "you're going to give me this dope when i ask for it or i'm going to toss you in the fucking oven"
Those things (except legality, because that's not stopping anyone) can be part of the problem, sure but it's a lot more than that. It's such a fragile house of cards you're describing with that situation and I don't know if you just don't believe me or you're taking it WAY too lightly.
Those people who are successful are headed for disaster, even if they have the money to mitigate supply issues/price. If you care about these people, tell them rich people go to Passages in Malibu. It costs $80,000 and i can prove that. but maybe they can afford it?
Alcohol is cheap, legal and abundantly available, and plenty of addicts destroy the lives of themselves and others around them. One part of it is true though: legalisation does reduce crime dramatically. You don't hear of alcoholics breaking into houses to feed their habit.
Heroin isn't that cheap, and the availability is sporadic, if you take quality control into account. Factored into this is the legality aspect, meaning a patient might not be able to buy when the need arises. It should be as easy to get as alcohol or Tylenol.
Look at the prices of morphine on goodrx: I don't think unlicensed manufacturers and retailers approach the low cost legit ones do.
I've enjoyed the discussion we've had here and in the other thread as well- and I mean no disrespect, but I take it that you're not used to the streets (if i've missed the mark, i apologize). It sounds like that world is unfamiliar to you - which isn't a bad thing, but in that underworld people don't think the same way. It also sounds like you're someone who has never experienced withdrawal symptoms of a severe opiate addiction (which is definitely not a bad thing). Legality isn't stopping anyone. There is not a dopefiend on the planet who, given the opportunity, wouldn't do just about anything for a fix in dire straits. It is that bad, regardless of your place in life or social status. I don't know if you are taking into account how incredibly easy it is to go from "i'm getting these from a doctor, and have a prescription" to shooting dope in places you wouldn't come within miles of otherwise.
Price - It depends on location and other factors, but i can tell you from personal experience that as a user, as far as pure numbers go, heroin ends up being much cheaper than prescription pills (which are the most popular form of opiates). it was pretty close in price on either coast and the midwest, in big cities and smaller towns. (except Florida, surprise! pills are dirt cheap there and it's deadly. there are pharmacies on top of pharmacies on top of shady doctors offices in Florida, it's like goddamn Mexico. not an exaggeration). I've been out of the game for a while, but I hear through the grapevine there are recent shifts in the market as Govt. officials crack down on Docs who they perceive as writing too many scripts. This immediately takes a major source of Rx meds out of the game, which is the ideal opportunity for heroin dealers to move in - and as soon as that happens, on day 0, it's too late to fix in the current system we have in place in the US.
Availability for 'street drugs' right now isn't really an issue in my experience. Opiate addicts are a subset within a subset of drug addicts and they tend to flock together. An addict of many years on the streets can spot another addict (or a corner boy) easily, and they all know where to go to get it.
There is also quality control on the streets, it's messed up but it's true and works: If a dealer sells a new batch to a group of 5 users and 3 of them overdose word will get around that it's killer shit and then that's what all the other users WANT because they figure it's potent. I've seen dealers with Narcan nose injections on them at all times, specifically with the intention of saving a dope fiend's life when they OD just so he goes out and tells the other users it's good shit. Then he can either cut it to stretch it out and make more money, or continue giving out the goods to build loyal clientele.
The converse of that works as well, if you sell a faulty product then you become the LAST option on the addict's go-to list. The fact that someone who sells a faulty product intentionally is even still on the list at all is a testament to how fucked up opiate addiction is.
And I'm all for legalizing, controlling, and even taxing weed (for recreation and ESPECIALLY medicinally) -- but if heroin ever becomes as easy to get as alcohol.... man, unless someone discovers how to drastically change how opiate receptors in your brain work, that would be the modern day equivalent to the zombie apocalypse. We'd be doomed, everyone.
Couldn't the opposite be said as well? Isn't being completely bound by ANY substance at all, be it air or narcotics or whatever, inherently a negative? Reliance on oxygen makes the whole space thing difficult, chained to opiates makes you a monster, etc.
Heroin has been illegal for a hundred years. We still have junkies.
You can say the same about alcohol. Does alcohol ruin lives? Yes. But we limit many of the social impacts by treating it as a regulated substance vs a controlled substance.
Even with heroin being illegal, I've seen people get it without a problem. They have to resort to no crime to get it other than getting it itself being a crime. But this hurts no one.
What hurts people isn't getting it, it's what they do as addicts. Throw their lives away, resorting to crime to live day to day, get housing and food… They partly ruin the lives of those close to them too.
Legalization would do nothing to help this, it would just hurt a little. They'd get it a bit easier, but since they didn't resort to violent crime to get it in the first place it would be meaningless. The crime and disaster they cause after getting it and becoming addicted would remain.
But like you said in the other branch, we have seen different people and have had different experiences.
I've seen friends destroy their relationships and careers over addiction.
I've also seen a burned out house where a dealer set fire to it with the occupant inside to incentivise future debtors to pay up faster.
I've seen the grey market involved in buying such things suck far harder on somebody's lifeblood than buying alcohol would an alcoholic.
So ... my gut feeling is that, overall, legalisation would probably be an improvement. But I think that, if so, it would be an improvement overall, and that doing the math carefully beforehand is a really good idea.
Or: I think you and MichaelGG both have valid points, and that any opinion on this subject that doesn't include both is probably going to fall short of the mark.
(to be clear, I'm replying to this specific comment largely because of your last line, since I'm seeking synthesis, not antithesis, by this line of thought)
> With proper availability, opiates are very well tolerated.
This just is not true. With proper availability people develop tolerance, and require higher doses. That does becomes high enough to become dangerous, and so they need to change to a different, stronger opiate. They develop a tolerance to that too.
Eventually they're cycling through 2 or three different opiates (sometimes at the same time) at very high dose. And their pain is not being managed.
> addicted to antipsychotics or insulin or antidepressants
No tolerance, no seeking, no preoccupation, no continuing to take them when you know they're doing you harm -- those things are not addictive.
What you keep saying in these threads is that opiates aren't effective. Why then do people continue to use them? Certainly if you're in pain, you're not taking a gram of morphine-equivalent per day just because. If there are effective alternatives, why are they not used? Then with pain under control, you can slowly (over a year, say) taper down.
I'm not saying it. National organisations are saying it - Public Health England (part of government); the Faculty of Pain Medicine (part of the Royal College of Anaesthetists); NICE (The National Institute for Health and Care Excellence, a non-departmental public body) all say it. So, unusually, do the CDC: http://www.cdc.gov/vitalsigns/opioid-prescribing/index.html
People take opiates because doctors inappropriately prescribe them (in some countries); because the word "opiate" is well known; because people reject other treatments; and because people stick to the med they know. That's why co-proxamol (and very dangerous, ineffective medication, is still being prescribed today even though there are many other better meds).
They continue taking them, at massive doses, because they're addicted. And that's the problem - if they were addicted but getting pain relief we could understand the continued use of opioids as first line treatment, but most people don't get good pain control with opiates for long term pain. They end up having to mix different meds, these combinations are often dangerous. https://www.theguardian.com/science/2014/dec/09/us-patients-...
This would be basically why after breaking my hip and having it reassembled around a Dynamic Hip Screw, every week I dropped my dose of codeine so that the pain was back to being as bad as I'd been dealing with a week ago. I do wish people being prescribed opiates for situations where that's possible (i.e. the pain will lessen over time anyway) basically got a guide on doing that, not everybody's an ornery bastard like I am.
The only time opiates for control of pain that wasn't going to lessen over time seems like a good idea is in the case of palliative care for the dying; my father got several months of mostly-pain-free end of life out of it, and whether it was increased pain from the cancer or decreased effectiveness due to addiction that eventually meant the maximum dose allowable didn't help, he was dead within a week after that so even given all the obvious caveats I think he picked the right set of trade-offs.
This is what I've seen firsthand from the treatment facility I've volunteered at. Long term use becomes a problem for many patients and eventually they have pain even with dangerously high doses of opiodes.
You're talking about acute, short term, pain. I have repeatedly said that I am not talking about short term pain. I am talking about chronic, long term, pain.
With proper availability, opiates are very well tolerated. Being addicted, by itself, is not a big deal. Apart from the negative pieces you see like this one, opiates are still a huge success for many people. Not just physical pain, but emotional pain, depression, and stress. Keep an eye out for pinned pupils and notice how many professionals have them.
There's this stigma that addiction is inherently bad. Yet it only applies to "fun" drugs like opiates. No one, in general, goes on about the terribleness it is to be addicted to antipsychotics or insulin or antidepressants. At best, you hear how annoying it is, having to always make sure you've got your gear - but I've not seen people go on about the intrinsic badness of addictions lifesaving medications cause.
What should be available is more public health awareness, and a cultural shift. People should be free to get addicted, but easily obtain services to help with it, without being labelled or criminalized. You don't need to rob people of liberty and cause suffering by requiring a paid gatekeeper to watch over everyone.