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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?
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It’s a damned shame what has happened to Missoula, my dad’s (and at one time, my) hometown. Missoula was once a working-class lumber-mill town and it’s now a leftist hippie-burg overrun with bums and drug addicts.
This. And it is applicable to the open-borders issue as well, though that is something I will never support.
I am in favor of decriminalizing heroin for possession; no one should be sent to jail for using heroin or being addicted to it. Decriminalization would solve some of the problems Fred Cole listed.
Actually making heroin legal is a whole other story. I support pot being legal; in doing so, I accept that large numbers of young people who otherwise never would have tried it will try it. I accept that because pot is not all that dangerous-it’s not worse than alcohol. Even if there are some people who can “handle their high” with heroin, there is no doubt that heroin is far more addictive than pot.
Basically, I can accept living in a country where most people have tried pot; I can even accept living in a country where most people smoke pot. I don’t know what a country where most people have tried heroin would look like, and I don’t want to find out. That is why I am opposed to heroin being legal.
This is silly. Nobody is proposing to “go over to your neighbor’s house and stop them from doing something.” The proposition is to make certain items difficult to obtain.
Okay, what is your model for legal heroin distribution and addiction mitigation?
I wasn’t talking about the proposition. I was talking about general philosophy.
No, the line is actually extremely bright. If you have a legitimate prescription for Oxy, that’s legal. Otherwise it’s not. Heroin is illegal.
Where’s the blur?
The blur is where many of those illegally using heroin started off as perfectly legal oxy users, and they were using oxy for totally legitimate reasons. When the drug companies first started marketing oxy, they sold it as something that was not addictive; it turns out that for many, it is addictive, so much so that when their prescriptions run out, they feel compelled to seek heroin.
I don’t know what the answer is, and there may not be one, but this is for sure: before being given a script for oxy, people should be informed about what they are about to take, or what their children are about to take. People have a right to know if a drug they are taking is potentially addictive.
So, your general philosophy is “common sense”?
The problem with that is, everything thinks their philosophy is common sense. It’s like saying you are a “pragmatic centrist”, everything thinks they are pragmatic (as Goldberg would say, “Who claims to be for what doesn’t work?”) and over 90% of the people consider themselves in the “center” relative to the extremists.
I have nothing against your moral philosophy, but there isn’t much to discuss about it. We have obviously reached different conclusions on what constitutes “common sense”, so now what?
Meh. I think your argument that legalizing heroin and putting in the drug store next to aspirin is all upside and no down side is an epic league cop out.
Forgive me for evaluating laws in the context of the existing set of laws and institutions. I think to do otherwise is foolish.
You and I agree on the end game, but we disagree on the best route to get there. If you consider that a cop-out, I can live with that.
Yes, people should be informed. Before taking any drug, you should inform yourself on the basics as to what it does.
That opiates cause dependency is, I thought, a matter of general knowledge, but doctors, in my experience, are fairly up-front about their wishes that their patients use these sorts of drugs responsibly.
As a basically law-abiding person who’s witnessed over and over again situations where these sorts of medicines are appropriate care, what I’ve observed is over-regulation of these drugs throwing sand in the gears of appropriate medical care.
Common sense is ironically not that common. For example, it’s common sense to believe our intuition, until there is evidence to the contrary. Many people believe their intuition in the face of evidence, but this is a violation of common sense, even if they believe they are sticking with their common sense. But by common sense in this case I mean an uncontroversial proposition concerning person-person interaction. When people start thinking about “society” and “government,” that common sense goes out the window and gets replaced by… something else.
FWIW, my cousins grew up in a relatively rural area in Western KY. My parents moved away when I was quite young and I grew up in suburbs of the 70s. Back then, drugs were a concern where I grew up and they were almost non-existent in the small town my cousins lived in.
Somehow in the late 90s, this flipped 180 degrees. Drugs were less of a problem in the middle-class suburbs and they became a huge problem in the rural areas. I’ve pondered why this is, and the only plausible reason I can come up with is the lack of cultural immunity. Drugs were always considered a ‘big city” problem that small people didn’t have to deal with, so parents in rural areas didn’t inoculate their children with defenses (and didn’t know how to). But I think your argument has a lot of validity too.
Like I said, I don’t have the answer :) I totally agree that over regulation is a bad thing, and am not arguing for that at all, but I suspect that you are far better educated about drugs and their effects than I am, and than most people are.
Recently, my 82 year old mother was given a script for a very strong pain killer for pain that she rated as 4 on a scale of 1-10. I can’t remember what the name of it was, but I had to show Id at the pharmacy, and when it came time for a refill, the doctor wasn’t allowed to call it in. I was in the room with the doctor who prescribed it; he said nothing about potential addiction concerns, or anything like that. Now, granted, my octogenarian mother will never go looking for heroin, but still.
I feel guilty now, because I should inform myself about the medications my parents are taking, but then again, my parents trust the doctor far more than they would trust my medical advice. And if the doctor doesn’t mention any potential problems, they will figure that it’s all good: that is how most people are. I don’t want to tie doctors’ hands, but it isn’t realistic to expect people to inform themselves. Couldn’t we just mandate that a pamphlet be given out along with prescriptions for opiates? I don’t want interfere with medical care, but too many people really don’t understand anything about the drugs they are taking.
I think the point is that the price would fall because it would be produced legally and competitively – so the associated crime would fall as well – as would abandoned families. Here’s a very interesting take from Britain – I don’t know if they’re doing it any more.
I’m not sanguine about drug use – I have friends who destroyed their lives with drugs. But the illegality of drugs didn’t stop them from using, and it made many of the consequences of deciding to use worse (from how they got their money to afford drugs, to the damage they did themselves with adulterated items, to how their families were affected when they encountered the law).
People say that junkies only decide to stop using when they hit rock bottom – I don’t know if that’s true, but I do believe that it’s a decision: to use, or not to use. You could argue that the illegality of a substance brings people to the decision to not use quicker – that’s logical, after all – but from what I’ve seen (and I’m not doubting or calling into question any of the other comments here, merely adding to them) ease of access to any particular thing is the smallest factor driving addiction, while the collateral damage of addiction is immensely increased by illegality.
jmho.
I see the illegality of it as one barrier. You’re right, and I realize it is insufficient to prevent heroin use completely. But it’s one way for society to put a big skull and crossbones on the label. That in and of itself will do a little bit of good.
Probably the same model we use for alcohol distribution and addiction mitigation. But only because you demand a model. I’d rather it be a free market thing.
You need it to be illegal to know not to take it? Is prohibition what keeps you from doing heroin?
My point was that the illegality makes the collateral damage worse, and I doubt it really limits anybody from using if they want to. (As yourself – would you be more likely to use heroin, knowing what you do about it, if it was a legal drug?)
I think public money could go more meaningfully into harm minimisation, education and rehab – as it currently does with liquor ( and really successfully wrt the first two with cigarettes).
Imho empowering the decision to stop works better (because it addresses the root issue – use and addiction) while making the decision for someone else (which is what making something illegal and unavailable tries to do) doesn’t work – because the decision to stop is more significant than not being able to buy occycontin so trying heroin instead.
In other words, you haven’t thought through the practical aspects of legalization. According to others on this thread, legalization would bring the price down, thus making heroin more affordable. That means that more people can and will purchase and use it. That means more people dependent on it and more resources pumped into treating them. This just might be a problem on multiple levels… but mail-order heroin would certainly be convenient.
FWIW, I doubt it. Your core assumption is that addicts have a set amount of drugs they will consume and if prices drop, they will just steal less. I don’t think it works that way. I think addicts use as much as they can, and if prices drop, they will steal as much as they possibly can (which is what they are doing now) and simply consume more.
My cousins robbed their parents blind and stole from everyone they could, including their ex-wives.
Another comment. There appears to be an underlying assumption that if we legalize heroin, we can get more people in treatment centers. My aunt and uncle mortgaged their house to put my cousins in the best treatment centers around. It did very little good. I recognize that you should not generalize from anecdotes, but the core point is, the success rate of treatment centers is relatively low, so even if every addict went to the best treatment centers, a significant increase in the number of users would swamp the ability of treatment centers to “cure” people and the number of addicts and the amount of crime and broken families would increase.
And of course, many addicts will tell you they are never cured, they are always one day away from falling back into the habit.
Again, I still favor legalizing possession of small amounts (after we get rid of the welfare state) because I think you have the right to kill yourself through stupidity and if we aren’t going to have a major ground war in the near future, we need a way to thin the population, but I absolutely do think that legalization is this universally positive panacea that the libertines believe it to be.
Not me, no. But it does make it harder to get for people thinking about trying it.
That is interesting, but it doesn’t move the conversation forward. What I hear you saying that is you think you are right about what represents “common sense” and everyone else is wrong.
That’s great. I happen to think the exact same thing and yet we still disagree on what represents ‘common sense”. You think I’m wrong and I think you’re wrong. So, now what?
Everyone in this thread is discussing a very serious problem from the perspective of (their own) common sense, yet we have a number of different views, so common sense can’t be used to evaluate the differences. The problem is, our common sense often starts from different positions on first principles. As far as I’m concerned, this remains the core differences between the left and the right. We can never agree on what is “common sense” if we have diametrically opposed views about why people behave the way they do.
I would also submit that what is “common sense” on a person-person interaction does not equal common sense for a law governing everyone. I think many things should be legal that should be shunned by everyone. Many things that are “common sense” on a personal level become disastrous at a government run level. To use but one obvious example, charity as a personal level is a good thing. Forced charity at a government level is disastrous for a whole host of reasons. Certain things, such as reciprocal altruism, only work at a personal level, not at a government level.
It isn’t?
Is it realistic to expect people to inform themselves about other potentially life-altering decisions like buying a house or deciding who to marry? If it is, why isn’t it realistic to expect people to inform themselves about the drugs they put in their own bodies?
Drugs are powerful, life-altering tools, potentially dangerous when misused. Misusing a drug can really screw up your body and your life (even if it’s not a “fun” drug). And you don’t have to second-guess your doctor’s decision to prescribe in order to inform yourself of the basics. In fact…
I believe the FDA already requires a drug packet insert for prescription medicine, which includes a section on drug abuse and dependence, where applicable. The pharmacy I use most often (whether out of compliance or just because it thinks it’s a good idea) provides its own in-house leaflet with prescriptions, too. The type on the package insert may be too small for old eyes to read, but my pharmacy’s in-house leaflet has bigger type, and does large-print versions of stuff on request.
I realize I sound like a broken record, but I think the opiates are more dangerous than other drugs. I don’t think possession of a small amount should land someone in prison, but I think there should be a serious penalty for selling these particular drugs.
I can see the libertarian point of view, that the governments’ controlling the distribution is one thing that is jacking up the price, which is causing some of the other problems. That said, if heroin were to become legal, the demand would increase, and the price would go up anyway. And if there were any government within two feet of the purchase of heroin, there would be sin taxes to be paid. The price is not going to come down just because it is suddenly legal. And the heroin sold legally is not necessarily going to be more pure and less harmful than the stuff sold now illegally.
I would have retired the war on drugs a long time ago. It was a great PR tool for a few years, but its usefulness expired a long time ago, and it has caused a lot of harm.
I would do things differently, but the one thing I would keep the same is that the opiates would be illegal to have or sell without a prescription.
I understand that’s an issue with using the term “common sense,” but everything that’s convincing to anyone is only convincing because at some level it appeals to a fundamental aspect of common sense. Where I see the biggest problem is getting from the individual to the government. I’ve not seen a way to form a government that does not greatly violate common sense morality. Government’s are imposed, no matter how well marketed it’s founding is. You are left with a bare consequentialist arguments. “It’s way better than not having a government.” “Ours is better than any other government.” That’s fine, as long as it’s true. And if it turns out to not be true, common sense will win… someday.
Calling government welfare “forced charity” does a huge disservice to the word charity. It’s theft, with fear of imprisonment, and an appeal to consensus. That consensus depends somewhat on a good chunk of that money appearing to go to sympathetic individuals. To say welfare is government applied common sense is simply ridiculous, no matter how many delusional people there are.
@ Midget Faded Rattlesnake: one of the reasons why there have been so many foreclosures in recent years is because a lot of people didn’t do a very good job of informing themselves before they bought a house; one of the reasons we have such a high divorce rate is because many young people have never been within close proximity of a good marriage, and they don’t receive good advice from their parents about marriage. Much of this comes down to how well educated people should deal with those who are not as well educated, and how the old should deal with the young; making sure beyond any doubt that people are informed, even if it means nagging them a little, does not constitute taking away anyone’s freedom.
The vast majority of those who are at risk of heroin addiction are teenagers or those in their early twenties; us older people, particularly those of us who are doctors, owe them, at the very least, good information and good advice.
I have not said that mere nagging takes away others’ freedom. On the contrary, I expect the norm to be for parents to nag their kids, for doctors to nag their patients, for the wise and experienced to nag the foolish and inexperienced, etc. Nagging, one way or another, is a basic part of human interaction. Whether it’s wise or foolish, nagging will happen – and I, too, prefer wise nagging to foolish nagging.
But does a healthy culture of nagging require that the government do your nagging for you?
(And unfortunately nagging cannot make sure beyond any doubt that everyone is informed. Nothing can.)
Maybe. I am not a libertarian; in the case of the recent foreclosures, it seems as though some banks were taking advantage of uneducated people, giving them loans that they would obviously be unable to keep up with, collecting money from them for a while, and then taking the house back. When it comes to that sort of thing, I believe there is a place for regulation. Dealing with drugs like oxy is far more difficult, and I would err on the side of letting doctors do what they want, but would not object to a little government nagging. Like I said, I am not a libertarian :)
Well, regulation was, by many accounts, much of what got us into that mess:
Is it conceivable that, if regulation got us into this mess, even more regulation might cure it? Possibly. But I wouldn’t bet on it.