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What is the Problem with Heroin?
In his post “Bringing Conservatives and Libertarians Together” about marijuana legalization, Fred Cole wrote:
I think it’s the situation with marijuana that it’s already so widely accepted and widely available, that most people who want to smoke already do. Whatever society costs it imposes are already there.
So marijuana prohibition means we get all of the downsides of legalization and all of the downsides of prohibition, but none of the upsides that come with legalization. It’s the worst of both worlds.
It’s a pretty similar situation with LSD, cocaine and heroin. However in the case of those three drugs, there are also issues of supply and cost.
On the other hand, here is a caption from a recent article “Eastside Facing Heroin Epidemic” in a local newspaper:
The Eastside branch of Therapeutic Health Services opened its methadone clinic in Bellevue two years ago, serving 90 clients at that time. THS now dispenses methadone to 415 clients from its Bellevue clinic daily, and is contracted with King County for 440.
There seems to be some confusion here. Fred suggests that there may be upsides to legalization of heroin, while the other source considers increasing usage of heroin a problem. One source argues for increased access to heroin, while the other expresses concern about heroin use.
So, what is the problem with heroin? Is it a health issue (addiction)? Is it an access issue (supply and cost)? Will legalizing heroin help resolve or mitigate the problem?
Published in General
Actually I think it addresses the deeper philosophical issue of when the State should criminalise consumer (and other) decisions made by adults. I think some of these decisions should remain criminalised – specifically those which involve force or violence against other individuals (and perhaps animals). But when they don’t, what is the rationale to criminalise them, and what (as I keep being asked in other circumstances) are its limiting factors?
To use an extreme example, heroin is very bad for people while trans fats (??) are just sort of bad for people. How can we consistently uphold a society’s right to ban heroin while finding local Governments which ban trans fats ridiculous and unjustified? Does it hinge on just how bad something is (in which case who decides? Is it just a matter of popular opinion?) or is the difference between the two qualitative rather than just one of degree? How about heroin and cigarettes? Or heroin and alcohol?
It’s not that it hasn’t “sunk in,” it’s that others simply disagree.
Well, the real problem is conservatives demand perfection, and nothing less, from the application of libertarianism, when all we’re offering is “morally sound” with a side order of “more optimal.” Perfection is a strawman.
If you think you can completely legalize heroin and meth while allowing circa 100 million uneducated non-English speaking immigrants (as Fred Cole wants) while keeping a massive welfare state and the minimum wage without it being a huge disaster, you don’t simply disagree, you are simply wrong.
The order is vital.
I think the right libertarian response is to legalize possession of heroin but continue to criminalize the distribution and sale.
The libertarian can believe that everyone has the right to harm their own body, but libertarian can deny that selling heroin is causing actual harm in society. If libertarians truly operate on the harm principle, it seems obvious to me that dealing heroin is objectively harming people.
This has been my position during my anarcho-libertarian days and has remained so ever since.
I think it’s obvious to say that it was much tougher on my Aunt and Uncle. For them, it’s about as bad as you can imagine with two sons who are addicted to drugs.
I don’t know all the details of how they got started or what drugs they used, and I don’t want to know, but I’ve observed the outcome for my cousins, their children, and my Aunt and Uncle. And candidly, I don’t think legalization would have made anything better (well, upon reflection, it probably would have saved my one cousin from being shot, but in the grand scheme of things, that was pretty low on the list of negative outcomes).
Interestingly enough, there are studies that show while while in Vietnam, 40% of soldiers tried heroin and 20% were addicted, only 5% of the addicts continued their habit upon returning to the United States. Source. When back in the US, heroin’s criminalized status required criminal connections that most soldiers simply didn’t have, and they were able to quit the supposedly unquitable drug.
Given that, to say that criminalization hasn’t stopped heroin is misleading, as it has certainly reduced its use. It’s a drug almost exclusively for rich yuppies and the urban poor instead of being as widespread as pot.
Unless one suspects that such things will make the welfare state unsustainable more quickly, or that there may be a more or less a natural ceiling based on the level of welfare Americans will tolerate, but I never discount the possibility of being wrong.
I don’t operate on the harm principle. It’s a blunt approximation that gets you the right answer most of the time, but it’s trivial to show counterexamples. Harm principle libertarians then add caveats for the counterexamples, and suddenly the harm principle is not nearly the elegant solution it’s constantly made out to be.
I can. Under its other name, “diacetylmorphine”, heroin has great value in palliative care. Methamphetamine is likewise occasionally prescribed by doctors. Now the reasons doctors prescribe methamphetamine may not impress you, so you would probably find it easier to make the case that meth has less societal value than heroin.
But to say heroin has not any societal value is to say that giving cancer patients, the elderly, and the terminally ill optimal palliative care doesn’t matter (heroin is used because it is better than other options – morphine, for example, would be an incomplete substitute). But I think good palliative care matters. Why should decent people suffer from suboptimal palliative care just because some miscreants can’t control themselves?
Now, maybe you think suboptimal palliative care is the price decent people should be willing to pay to prevent recreational use, but then heroin does have societal value, you just think the value is outweighed by the costs.
Last night I read the story about Vermont that Rico linked in his original post, and it has been bothering me ever since.
My daughter lives in Burlington, and my other daughter went to school there, so it is a place I know well.
I can understand the shock and dismay people in and around Vermont feel with regard to the heroin epidemic.
And I suddenly realized how it is spreading up there, and would spread similarly anywhere it was introduced. Person A tries it, likes it, and becomes addicted to it. Paying for the fixes, which are needed more frequently and in higher amounts, becomes all consuming in Person A’s life. The easiest way to raise the money is to get five other people addicted who depend on Person A to supply them. So Person A hands out free samples. Heroin addiction really does spread like an infectious disease.
If Person A can’t find five people or if the five people Person A depended on don’t continue to buy or find another cheaper dealer to buy from, Person A is in big trouble. That’s when the flat screens and cars start disappearing from people’s homes in the neighborhood.
The more I thought about this last night, the more I began to see the issue differently from the way I looked at it before: Heroin is a very dangerous substance.
Alcohol and heroin are different, and they act on the brain and nervous system differently. Alcohol has never been strong enough to get people past the pain of surgery or painful diseases.
I think when painkillers were first discovered and manufactured, I think the medical community realized that they were dealing with substances that were different from alcohol. These substances were not restricted originally, and their effects in the community were experienced in real life, not theory. The medical community perhaps didn’t articulate the hazards and effects they saw, but they were real and alarming.
Legalizing heroin and opium would destroy this country. If nothing else, we couldn’t afford the prison sentences for people stealing to support their habits, and we could never find enough foster care for the abandoned families. Legalizing heroin would be like putting radioactive uranium out on the streets.
As a drug counselor in Boston once said, “The first dose is always free.”
Oh, that use of “anymore”. Did you know it’s a dialect thing?
Anyhow, maybe I should chime in here as someone who, though never having tried heroin or meth, has been prescribed opiates, amphetamine salts*, and other “dangerously addictive” drugs without addiction problems.
Part of this is because, knowing that alcoholism runs in my family (and therefore addiction might be a problem), I’m wary about my own motivation for taking any drug and watch myself carefully. I had to be persuaded by a medical authority into trying these drugs in the first place, and my gut instinct is still to begrudge being weak enough to find these drugs helpful.
Part of this is because, honestly, I’ve had worse withdrawal symptoms from “non-addictive” drugs like prednisone and Benadryl.
When you’re taking any drug that suppresses inflammation, sensitivity to pain, or your cholinergic response, it’s not surprising that your body adapts to compensate, and you’ll have a flare-up when you stop. So I know what it’s like to find yourself unexpectedly curled into ball, weeping, because every bone in your body feels like it’s on fire (prednisone withdrawal), or covered in sweat, puking, etc, uncontrollably into the toilet, itching uncontrollably, restless, feverish and crazy-miserable (quitting Benadryl cold turkey).
But these things pass.
If recreational drug addicts are addicts because they don’t have the courage to bear even ordinary misery, or because they believe they’re already intolerably miserable, I could see how the pains of withdrawal could loom in their minds like some insurmountable obstacle. But then maybe what they need more than anything else is a bit more courage or a motivating goal that makes the short-term misery worth it.**
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* Yes, I was one of those kids prescribed ADD medicine. And it did help. But I never liked how it felt and ultimately quit. How that feeling could be described as a pleasant “high” is beyond me.
** If it’s not already obvious, I wouldn’t count people who, after the flare-up of withdrawal, still find themselves stuck with, say, severe physical pain, as addicts. They are the people that palliative care is for.
Actually, Mike… I tend to agree with your brand of libertarianism far more than you seem to think. I’d generally refer to myself as a Richard Epstein conservative, as there are very few points of departure from his take on things. I am not suggesting that Libertarians demand perfection, but that their optimal system relies on something working, which I don’t believe will work. They place too much importance on the negative consequences of criminalization. Being as criminal law is my field (I’m not appealing to authority, here, merely stating a reason for my personal belief), I tend to see a lot more of the need for criminalization. On virtually every other issue, though, I frequently side with you (and Midge and Sal, etc…). The idea of criminalizing merely moral action, for instance, is something that I strongly resist. I think that a lot of Libertarians mistakenly put drugs in that category – so our disagreement is a categorical one, not necessarily a legal or philosophical one.
That’s a bit too much like the ol’ “overturning roe v. wade will result in coat hanger abortions – so your position is that you want more coat hanger abortions?”
I can think of societal value that is brought to the table by hydrogen bombs and plutonium rods as well… but we’re not talking about making those things widely available. If palliative care is what you’re really interested in, then the medical system is well enough equipped to provide that sort of care. And yes, as with everything else that is regulated to some extent, the question is whether the harm outweighs the good. Nobody is arguing that “good” is nonexistent.
Exactly.
Taken literally, your use of the word “any” argues exactly that.
Since we agree, though, that there are both costs and benefits, the question is what to do about them. Drugs are not the political hill I want to die on, so even if I had certain proof that complete legalization was the real optimum, I’m not sure how hard I’d push for it.
I do suspect, though, that we’d be considerably better off without the DEA. An agency that holds doctors under suspicion of “dealing” simply because they’re unusually good at palliative care is not an agency worth having, I think. Yes, without oversight, some doctors will unethically prescribe to addicts, but I think a system where doctors feel free to prescribe whatever they believe, in their best judgment, might work, no matter what some bureaucrat thinks, would be overall the more ethical system.
And I’m not suggesting that you’re not very libertarian. I understand that. I’m a little unsure what you think won’t work. I’m guessing you believe the negative consequences of legalization are going to greatly outway the increase in liberty, which is a morally sound position, if it’s true.
You see, I’m not a utilitarian, even though libertarianism usually results in extremely utilitarian ends, and I will point these out in an argument. The real reason I support drug legalization has nothing to do with the negative consequences of criminalization.
Instead, I’m a common sense moralist. It’s wrong to go over to your neighbor’s house and stop them from doing something unless you’re highly certain they are going to hurt/kill themselves or someone else. This moral truth doesn’t go away when “society” decides collectively to go over your neighbor’s house and stop them from doing something that has an increased likelihood of bad consequences when averaged over the population. This, again, can be overcome if the consequences greatly outway the benefits, but unless you can show this very good reason, morality errors on the side of letting people make their own choices.
hah – I can certainly agree with that! On both parts. Don’t get me started on methadone. oye!
oh, ok. Yes, that is a very interesting position, and it does make your argument a lot more clearer when you put it that way. That morality question is a fascinating one, but I think it is a perfect example of the “points of departure” thing that I’m always talking about with arguments. We will argue over legalization/criminalization forever before ever really discovering that our point of departure is really a defining-morality question. I love that! Especially because, holding your constants, you’re perfectly right; holding my constants, I’m perfectly right. We could start a whole new thread about those constants and then come back to revisit this issue.
I have also seen the negative consequences of our overzealous control of drugs.
And there have been many. Doctors under-treat pain because of addiction issues. My concern is that the power of controlling the prescription market has gone to doctors’ heads, and they are withholding drugs unnecessarily. I think antibiotics and high blood pressure medicine should be available over the counter. It bugs me that people have to go to the doctor every six months for some of these medicines. Everything is poison, basically. The prescription issue has pushed up the cost of health care for patients in a big way.
And I have taken these painkillers after surgery. I know them well, and I didn’t develop an addiction problem. So not everyone is going to succumb.
But many will, especially insecure and depressed teenagers.
These painkiller drugs are different from everything else. The opiates should probably be the last things on the libertarian’s list for deregulating. :)
Interesting story: I hate regulations, but there are no absolutes, and some regulations are good. Aspirin poisoning used to be one of the top reasons kids were seen in emergency rooms. Then the aspirin companies introduced the first child-safe caps, and the rate of aspirin poisoning went down something like 90 percent in the first year. There were many factors contributing to the aspirin poisonings, but the fix was simple and correct.
I have sympathy for insecure, depressed teenagers, having been one myself. I worry, though, that there’s some wishful thinking going on in blaming the drugs themselves too much for the self-destructive impulses. (I avoided all of the typical teenage pitfalls of sex, drug addiction, and rock’n’roll, yet nonetheless managed to engage in some incredibly self-destructive behavior.)
Naw, I think I’d be worried more about drugs likely to cause violent psychosis. Like maybe (Ryan, Ryan)… meth?
Perhaps the violent rampages attributed to drugs are really more about violent people using drugs an excuse to indulge their already-violent nature, but if a drug caused violent rampages, that’s the kind of drug I’d be more worried about. Sedating drugs are at least sedating.
And supposing people really are better off almost never having access to heroin, it doesn’t follow that all opiates are that risky.
I actually agree with this.
Boy, do I agree with this. I’ve been following the school shootings for years, and it is stunning how many of these teenagers and young adults were on dopamine-altering drugs. That’s a post I want to write some day. This is a huge problem. Like heroin, it is true that these drugs are safe for many people. It is hard to sort out cause and effect with Ritalin and resperidone (sp?) and the other psychoactive drugs.
When it comes to the opiates, I guess I’m willing to accede to the judgment of the old-timer doctors who were the ones who wanted them taken off the market.
Again, the article on Vermont was disturbing. I can see why people are watching Vermont so closely. It isn’t a controlled experiment, but it feels like one because Vermont doesn’t otherwise have a huge drug addiction problem. So the sociologists are looking at the effect of dropping heroin into a community with few barriers. They are watching crime go up fast too. Big new problem for them.
Midge, you’ve brought up an interesting point. As long as people are sedated, they aren’t a concern to anyone. The problem with it is that while they are sedated, they lack the energy to solve the problem of how to get their next fix. So when they “wake up” from the sedation, they are in a panic already because they need to go back to the sedated state and they lack the means to do so. Ergo the uptick in crime.
I read that article when it came out and it was pretty shocking to me.
VT and MT are often compared because they have similar rural/mountain cultures (we get a lot of VT transplants here in MT). We had a large problem in MT in the early to mid 2000’s with meth. While meth is still a problem, a concerted public/private ad/propaganda campaign known as the Montana Meth Project surprisingly seemed to make a pretty good dent in the problem by producing very shocking advertisements portraying teenage meth users violently stealing from friends and family and/or (for girls) selling their bodies for meth money.
I agree that the way we have approached the drug issue as a “War on Drugs” has largely been a failure and a corrupting influence on police departments due to the asset forfeiture laws associated with drug law. Instead of focusing on supply, we should be focusing on demand through propaganda efforts. I don’t agree with legalization of drugs, but I would be fine with ending the Federally funded “War on Drugs”.
In my vision, what I see is the states taking the leading role in the regulation of most drugs with the Feds only assisting with interstate criminal enterprises (i.e. smuggling drugs from Nevada into Utah). I doubt that any state will legalize heroin, opium, etc. for recreational use. If a state did, it would quickly be overwhelmed by health and welfare cases, and lost economic productivity. Recreational opiates are always destructive to society. And when their recreational use has been briefly tolerated it isn’t long before governments intervene to criminalize their use because their terrible effects on lives of citizens are readily apparent. Sorry, libertarians, most people are not dispassionate enough allow people to choose their own death through the heroin needle.
Okay, a couple of points in no particular order:
1. To anybody on Ricochet, if you’re going to take someone’s words out of one conversation and use them in another, it’s just common courtesy to (a) credit the person and (b) drop them a line. I’m the author of the above quoted words. I want to know so I can answer things before the conversation is 50+ comments in.
2. For the record, this right here:
That is an epic league cop-out.
3. As to the questions asked in the OP:
What is the problem with heroin?
Is it a health issue (addiction)?
Is it an access issue (supply and cost)?
Will legalizing heroin help resolve or mitigate the problem?
The problem with heroin is that some people who consume it get hooked on it. That’s true of lots of things. Including above mentioned pain killers. Including alcohol. Including nicotine.
A misconception needs to be corrected: you will not be instantly and forever addicted to heroin if you use it once.
From the 2013 National Survey on Drug Use and Health:
Figures in thousands:
Lifetime users: 4,812
Past year: 681
Past month: 289
A percentage of those who used it in the last month are addicts, but considering the number who used heroin in the last year is more than twice that number, I’m going to go out on a limbs and suggest that not everyone who uses heroin is an addict. Some people can handle their high.
Additionally, I don’t know where the OP is posting about with his local epidemic, but every place seems to have a local epidemic (mine is next door in Guilderland).
However, talk about an epidemic doesn’t match actual usage:
But there are other public health issues other than addiction. There’s diseases spread through dirty needles. There’s overdoses causes by incorrect usage. There’s people who are injured because the product they consume isn’t especially clean.
These problems, and yes, addiction too, are made worse by prohibition. Because of prohibition, it’s harder to get clean needles. Because of prohibition, if you were to buy heroin on the street, the is no guarantee of production quality.
And yeah, addiction is made worse by prohibition. If I’m a heroin addict, not only do I have to deal with that monkey on my back, but there’s a stigma of illegality attached if I go to get help. And when I do, in addition to the other problems I face, there’s additional costs in terms of financial drain (and other costs) if the law becomes involved.
Heroin prohibition has been an utter failure. It continues to be an utter failure. If you want to fight the scourge of addiction, if you want to compassionately help those people who can’t handle their high, if you want to improve the function of our criminal justice system, ending prohibition is the way to do it.
Don’t forget about food. I’m no longer willing to subsidize the devastating healthcare costs incurred by obesity either.
My kids were in Vermont at that time. :) They talked about it a lot.
The similarities between Vermont and Montana are great.
I can’t argue with that. I’m sure it’s true. I understand the point you are making.
Nevertheless, I’m not sure those stats are telling the whole story with opiates.
I’m leaning toward thinking it is the sedative nature of them that makes them difficult to treat and therefore more dangerous than other recreational drugs. Anything that kills initiative–television shows?–would be difficult to treat.
In my head, I’m seeing it as similar to the “attractive nuisance problem.” A homeowner was sued because the kid next door climbed his tree and fell out. The judge ruled that the homeowner should have realized that the tree was especially attractive to kids. There is such a thing as drugs that are especially attractive and/or obtainable–and in way different from all the other trees on the street or the other addictive substances out there.
I guess what I’m saying is the opiates fall into a gray area in my head.
Obviously we’re not handling these drugs well, and our prevention strategies are failing. How to combat them I don’t know. But I wouldn’t unleash them in communities until we figure what we are dealing with.
I think I’m in agreement with Fred Cole on this one. I do not think heroin and it’s lead on drug, Oxycontin, should be completely legal, it should be regulated by prescriptions and not marketed for recreational use. But some inevitable seepage into the recreational market would be better than what we have now.
The fact is addiction risk is like playing Russian Roulette, most people can take it or leave it, but an unfortunate few will have their lives taken over. The same can be said of alcohol, gambling or sports. This discussion has not really focused on the costs of prohibition – the shredding of the Fourth Amendment, the coarsening of law enforcement, the pain of people that need opiate relief but are denied them by the pecksniffs in the medical system.
Read anything recent by Radley Balko, e.g., his artical about an infant getting her face burnt off because some Barney Fife threw a flash bang grenade in her playpen on a drug raid on the wrong house. I think tolerating some inevitable human tragedies caused by people choosing to go to hell their own way is the lesser evil.
I think I just realized what happened with meth in Missoula and heroin in Burlington: When a person needs drugs in a city, that person goes to an existing drug-dealing community, a place that is already dealing drugs. But when a person needs drugs in a rural area, he or she has to create his or her own drug-dealing community. That’s why the spread in rural areas is so noticeable and fast.