If you have not yet been personally touched by the rapidly expanding human tragedy of opiate addiction, I suggest reading this.
It seems a moral and policy shame that the companies who helped create this crisis–marketing oxycontin and other pain killers as having no addiction risk–are not paying more to stop it.
Should we tax them to pay for treatment? What else should we be doing?
I’ve known many opiate addicts in my life, all of them began using the drugs recreationally, usually as teenagers. I’ve also known many who have been prescribed opiates for pain, none have become addicts. I know to expect excuses from addicts. When I started hearing the addicts blaming the drugs/doctors/drug companies for their situation, that was a familiar sound.
This is a deeper problem with society, not drugs or drug-suppliers.
The media definitely needs to stop glamorizing it, that’s for sure. :rolleyes:
If I never see an interview with an attractive white person from a middle- or upper-class family who says, “I was addicted, but now I’m clean and my life is so wonderful now” (and we find out after they later die from an OD that they got high in the bathroom just before the interview), it will be too soon. It would not surprise me if some people are deliberately seeking out heroin and other opiates, because they think addiction is cool. Also, whenever I hear about somebody dying that way, I’m torn between “Their friends and families will miss them” and “Their former friends and estranged families were probably spared a lot of further misery because they finally offed themselves.”
(dons flameproof suit)
Years ago, I was watching a show on suburban heroin addiction, on Dateline or some similar program. They went to a parents’ support group, where a group of women were talking about their kids. The voice-over said, “Fathers can attend, but they’ve never seen one.”
That spoke volumes to me.
I assume you are talking mainly about Purdue. I’d say that, IMHO, yeah, they should be held accountable for misrepresenting the risks of addiction. From here:
Would pursing what was done in places like denmark work? Over there, you just go to a heroin depot and shoot up there, then go home. The drugs are free and you are in a safe spot in case you OD.
The big issue seems to be synthetic opiates which are far cheaper and deadlier than heroin. So I don’t know how you can legislate your way out of this.
The US doesn’t have the legislative or economic power to intimidate China into not producing fentanyl, and even if they did it is easy enough to mass produce that the supply would still be there.
I once was roommates with a guy that was a legitimate heroin addict, he had syringes laying all around his bedroom, he also abused Xanax and some other substances. He also went to a Methadone clinic but that seemed to be just trading out one addiction for another and he still did all of the other drugs too. I think the best way might be some kind of publicly and privately funded addiction clinics or housing where the people could get out of their environments of drug use to help ensure a recovery, but I know there would still be a lot of relapses. Admittedly I don’t know that much about the subject. It seems odd too that the pharmaceutical companies keep coming out with new, much more powerful opiates, not sure how punishing the companies that make the stuff would work though or whether it is the right thing to do, maybe something could be worked out but there would be a huge push-back from those corporations.
If you are dependent on drugs, your quality of life goes up. If you are addicted to drugs, it goes down.
That’s the big difference.
People who take opiates and other drugs of abuse due to legitimate need rarely become addicted; they try to keep the dose as low as possible and have no desire to obtain it through illicit means or to stay on them if the pain, physical and/or mental, goes away.
I’ve talked to doctors I know in the UK about this and they are completely amazed doctors were not prosecuted (or at the very least struck off wholesale) for this. Regardless of the what the drug reps say if you’ve been to medical school you absolutely expect that if you send someone home with a repeat prescription for a drug that connects to the opioid receptors in the brain they WILL get addicted. That is as basic a medical fact as if you send someone home with potassium prescription their blood pressure will go up.
But in answer to the OP, the solution seems mind blowingly obvious to me. Treating opioid addiction as a criminal justice problem has crippled Latin American (and other drug producing) societies, and massively damaged US and European societies.
Treat it as a medical problem and allow doctors to prescribe heroin to heroin addicts. At a stroke it would solve the problem.
Legalise and de-restrict the drugs. Opium, heroin, oxycontin, viagra, everything.
No legalization, ever.
Mandatory rehab. No prison time.
Create clean, supervised shoot up places.
For that to be an effective proposal you’d have to show that rehab is actually an effective treatment, in anything but a minority of patients. If it doesn’t that solution will not do anything (or very much) to prevent the incredible harm prohibition does on both sides of the supply chain.
Addicts will do anything to procure a supply of the substance they are addicted to, if you have prohibition that will mean committing crimes to procure their opioids at an insanely marked up price from a massive criminal network. No amount of hand wringing or rehab programs will change that. Allowing doctors to prescribe addicts opioids WILL change that.
They SHOULD be able to offer rehab (including harm reducing drug treatments) as well, but rehab alone without ending prohibition is not a solution.
We do not need an even more drugged out society than we already have. Do you know how easy it is for addicts to doctor shop as it is with legal opiates? We shouldn’t be encouraging addiction. Legalization encourages it. There is a difference between decriminalization and legalization. I would support the former; not the latter. Being caught with an illicit drug should go on the person’s “permanent record” but not result in any fine or jail time. But they’d still have to say to a potential employer that they were arrested for having an illicit drug; the employer would therefore know what they’re potentially dealing with.
I’ve seen people on Heroin. They’re basically zombies. They are literally useless when high. No employer should have to hire a heroin addict. We need to stop being such a sentimental society.
Exactly right.
How are you going to let them shoot up in these places if shooting up is illegal ?
I will say I wish druggies no harm, but I also don’t care if they die from their habits. Habits they should be free to choose over the mind-numbing boredom they find in modern society.
Let’s just encourage every form of decadence there is 
I don’t think enough attention is paid to the effect that widespread addiction has on communities and economies. I think it’s a huge contributing factor to the much touted societal problems in the Rust Belt and other declining industrial areas. Neighborhoods and communities suffer when all the disposable income goes to pill mills and Mexican heroin dealers instead of being spent in the communities. Businesses suffer from the lack of reliable employees and large inventory losses due to shoplifting and employee theft. Social services for children and families are stretched beyond belief, children suffer from the lack of a stable home environment. These problem exact a further cost on the communities. When addicts comprised a double digit percentage of your population, everyone hurts.
And I’m not sure what the solution is. Traditional inpatient rehab is enormously expensive and has a very low success rate but it’s the best we have.
The only further suggestion I have is for some sort of targeted effort at a community based rehab, the idea being that if you get enough members of the community into rehab at the same time you create a large peer support group and destigmatize recovery.
We could come up with a model for some sort of community based recovery center. I see a place that offers fitness and yoga classes, arts and crafts, volunteer projects around the community and job counseling and assistance as well as round the clock 12 step meetings. And maybe some sober evening activities. Because relapse after rehab is a huge problem and boredom can be a huge factor.
But OTOH, I can see how this could backfire - if the recovery centers aren’t properly managed and if screening isn’t enforced, they could actually become magnets for dealers and users. And since I’m not a public policy expert I’m going to leave it at saying the idea is worth studying.
And enough with trying to draw some sort of differentiation between people that take drugs for pain and people that take them to get high. Plenty of people that take opiates for pain become addicted. Because we all walk around with some amount of pain that is psychological or emotional. And that pain is going to be softened even if you take the drug for a bad back. And that softening can be…well, addictive.
There is an excellent book on the Opioid Crisis called Dreamland - The True Tale of America’s Opioid Epidemic by Sam Quinones. A lot of what I wrote about, including the idea of community based recovery - came from this book. And he writes a lot about the irresponsible prescribing encouraged by drug companies pushing the myth that people taking opiates for pain had a low risk of addiction. And they were irresponsible in other ways. Purdue continued to insist that a dose of OxyContin would last 12 hours despite a widespread insistence among doctors and patients that it wore off much sooner, starting a dangerous cycle of craving and relief. But they told doctors that a higher dose, not a more frequent dose, was the answer to breakthrough pain. Which made the problem worse and made the drug more addictive.
So I’m think the drug companies should be penalized. But ultimately, that’s not going to roll back the clock and fix this.
TL/DR - it’s a big problem and no one has any idea how to solve it.
How do you define “the problem”? The only problem this would seem to solve is keeping people out of jail because using would no longer be a crime. It wouldn’t make for fewer addicts. Maybe a few less people would OD, but only if the addicts were only allowed to take their prescription in the presence of a doctor.
It happens, obviously (and that is part of the huge network of criminality that prohibition causes, any idea how many doctors are in prison right now for supplying opioids who would otherwise be treating patients right now?) but it is not that easy, as witnessed by the fact it is so lucrative for drug cartels to smuggle billions upon billions of dollars worth of illegally produced heroin (and other even worse opioids) into the US.
That’s a knee jerk reaction but does it? There is a basic logical fallacy that because heroin is bad, and heroin addiction is terrible, the only logical option is to make it illegal. In fact that makes it worse.
While decriminalization is clearly a good thing, and reduces the harm some. It doesn’t change the basic economics. Addicts are going to do whatever it takes to get their supply. If you don’t supply a legal alternative they will get it on the criminal market that is hugely harmful to both the addicts and society (on both ends of the supply chain).
Of course. Heroin addiction is truly awful, no one is denying that. But how has prohibition improved it? It hasn’t reduced heroin addiction at all. It has just made lots of money for drug barons, police forces, and prison companies. But it has done NOTHING to combat heroin addiction.
The problem is that a large percentage of the US population is required (literally required, by a physical addiction) to make enough cash on daily basis to purchase massively over priced, unregulated, dangerously tampered-with, opioids. That means they are funding a massive criminal network that is responsible for thousands upon thousands of violent deaths, and the break down of civil society in huge swathes of opium producing/processing/smuggling territory (not to mention being a huge income source for Al Qiadia and the Taliban). It also means, as most addicts don’t earn enough to support their habit by legal means, that they are responsible a huge percentage of the crime in the US. That includes of course most low level heroin dealing, the 1960s stereotype of a pusher might be a myth, but there is a huge economic incentive for low level drug dealers to get people hooked on heroin if they want a regular income from them.
Most of the harm of heroin addiction comes from the fact it is illegal, not that drug itself.