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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
Ok, it’s late, and I just remembered: some liberal airheads passed a law requiring banks to give loans to poor people, and that greatly contributed to the foreclosure crises: I know. :) But even so, I am not totally opposed to government, or to government regulation.
I am sorry, MFR, I wrote my last comment before seeing your last comment :) Of course, requiring banks to give loans to those who cannot repay them is insanity, but that does not convince me to become a libertarian.
I wouldn’t expect it to :-)
Just to clarify, I don’t want the government to do my nagging for me, but if a majority of citizens decide that the government should do some nagging on some issue, I am ok with that. The majority isn’t always right, and mistakes will be made, but I believe in a democratically elected government doing what the electorate wants them to do, even when the electorate is wrong.
Marci, I actually agree with you that opiates are the most dangerous drugs around. I just disagree wrt the efficacy of banning them and with the impact of Prohibition.
From wikipedia, so take it with a grain of salt:
And also
And also
All of which sounds eerily familiar. As does the argument:
Yup. I confess that you and Fred and Midge have made me think about this.
I don’t know how to keep the opiates out of American life. I can see the point the three of you are making.
I wouldn’t care if I thought I could count on the schools to educate people, but they don’t seem able to get the simplest of messages across to everyone.
Alcoholism is serious. And prohibition failed. No question about that.
I really hate to see opium and heroin addiction. I think it is worse than alcoholism, at least from what I have seen of alcoholism, but I imagine that doctors would argue that there isn’t much difference.
I guess as a society, if we want to protect people, we need to work harder on education.
The usual statistic is that about one in four who try heroin become addicted; that leaves the interesting question of why 3/4 of experimenters don’t become addicted.
A Swedish psychiatrist named Nils Bejerot was at ground zero of the Swedish amphetamine epidemic, and did important research in the UK during their heroin legalization experiment.
In what looks like a good precis of his work, his analysis of addiction goes like this:
Bejerot examined the Swedish and British experiments at managing addiction by physicians prescribing narcotics, but judged them to be failures since the “legal” addicts who got their drugs by prescription from the official drug control project) not only tended to initiate others into drug use (which he had verified by epidemiological contact tracing methodology) but did not decrease their crime rates. Many of these “legal” addicts were arrested by the police for various crimes such as drunk driving, theft, check forgeries etc. This led him to oppose measures based on the thinking of people like Alfred Lindesmith, who thought that the control measures were worse than the addictions, at any rate for opiates.)
Bejerot also observed that the countries with the shortest experience of cannabis (i.e. in the West) were the most tolerant ones, whereas cultures with a long experience (e.g. the Arab world) were much more restrictive. Egypt, having had centuries of experience with cannabis, in 1924 proposed that cannabis be put under inter- national drug control, and this control was achieved in 1925.
The few even temporarily successful efforts at interdicting developing epidemics involved draconian measures such as multi-year intensive compulsory treatment, usually in confinement as well as effective border control to prevent or minimize smuggling.
Efforts at control of endemic/pandemic drug use are interesting: We seem to be gaining ground with respect to tobacco in the US, but cannabis has become endemic. In both trends, mass media have played a role in society’s becoming tolerant or intolerant to the drug use in question.
China’s measures to control opiate addiction (in the original expansion of which from iatrogenic and low level epidemic use to a raging epidemic the British role was truly odious; one could say that the East India Company was the spiritual ancestor of the cocaine cartels.)
Bejerot’s analysis did not include this mechanism of spread of drug use; he was a psychiatrist and not an economist. It has by now become obvious that economic factors are key.
In addition to the object lesson of the cartels, we are seeing tobacco companies seeking to expand their markets to countries where the stigmatization of tobacco use has not taken place to the extent that it has in the USA, (and leveraging their tremendous knowledge of tobacco biology to turn tobacco farms into tobacco pharma) at the same time as cannabis is becoming a large legal business category.
Well, a couple of things
1. Do we need to keep them out? Yes there’s potential for addiction, but they can also be used as a medicine to help people. That’s the who point. When you put barriers into place because some people can’t handle their high, it means people with legitimate medical needs suffer.
2. In a way, alcoholism is much worse. Heroin addicts have trouble functioning. I work with alcoholics. You can be an alcoholic, still suffer the health effects and social damage, and still hold down a job. So it’s less harsh, but far more widespread. When I read what you said, tthat you don’t know how to keep opiates out of American life, I thought the same thing about alcohol.
While recovering from surgery in the hospital earlier this year, I was put on IV dilaudid (basically morphine). For whatever it’s worth, I just hated the stuff. It scrambled my brains. I couldn’t distinguish between memories of dreams and memories of reality. I was talking to my wife about things that had never happened. Assuming that heroine causes similar effects (and I’m told it does), I think it is just bizarre that anyone actually wants to feel that way.
Gee maybe we don’t want hardcore drugs because it will increase domestic abuse, child abuse, DUI’s, and overall crime. The question is when you increase the supply and make the product cheaper how many more instance do you get of drug induced criminality or drug money motivated crimes. Let alone talk about an increase in usage would also destroy more relationships.
We whine and complain about losing the culture war but what libertarians forget, is that culture is a huge mechanize were we regulated behavior on the margins, and which stops people from getting into harmful behaviors. Legalization undermines culture in extreme ways.
It is one thing to argue for legalization where a substance even in some rare instances has befits. It is a another when you start to argue for the legality of behavior and substances that has no befits (or in which any of the rare befits have better cheaper substitutes) and only cost.
The burden of proof should on the one who wants to regulate. Therefor a large body of evidence and experience should have to be provided for to show the extreme negative social cost. However with hard drugs the evidence is overwhelm in the negative on the usage front.
Hear, hear!
You’re applying this to alcohol too, right?
Exactly ALL of the people I know that are, or were, on welfare are, or were, on heroin. Many of them are deeply trapped in the cycle of addiction: use, hit the bottom, go to treatment, do all right for a while, fall of the wagon. Most of them struggle with alcohol addiction as well.
These people didn’t start using heroine because they got hurt and needed pain meds. they did so because they grew up in a culture of substance abuse. They saw their parents smoking pot, drinking to excess, shooting up. They saw their friends doing it. Their friends parents. They didn’t know a different life existed until it was too late. They found themselves in a trap from which there is almost no way out, surrounded by people trying to get out of the the same trap. the dirty awful part of the trap is not the black market. It’s the addiction. The government solution kept them in the trap. Not one of the people I’m talking about here (and I’m not talking about one or two), got clean as the result of a methadone clinic.
Does this mean we shouldn’t legalize the hard stuff? I really don’t know the answer. On paper it seems to be the right thing to do, to let people die in the gutter of their own accord. “It would seem like wisdom, but for the warning in my heart.”
Color me dubious that legalization makes the problem any better.
I, too, think it bizarre that an otherwise healthy person would want to feel that way.
But since pain can addle the brain, too, as well as limit range of motion, I can understand people deciding to trade a pain-addled brain and body for a mildly drug-addled one, on the grounds that the pain relief caused by a drug actually leaves them less addled overall.
Interesting. I can’t say all, but most of the people I know that are or were on welfare are alcoholics to one degree or another.
Seconded. I don’t even drink very often for that same reason.
That being said, Midge, there are a lot of people for whom that is an escape. Shiz in their life got too real. They need a way to feel differently.
Or they grew up in a culture of insobriety, and it’s not addiction to any particular drug that trapped them, but rather the low value placed on sobriety and keeping a clear head.
A lot of people take drugs because they’re seeking insobriety and irresponsibility. But then, a lot of people also take drugs in a search for sobriety and responsibility. I think many ordinary people rely on coffee, for instance, to effectively make them more sober, responsible people every morning. And some people who perceive themselves as suffering from something that leaves them considerably more addled than the average human seek out something stronger than coffee to help. So, for example, depressed people may seek out antidepressants, ADD people may seek out drugs to help make them more attentive, and people who find pain impairing their judgment may seek out pain-relievers that would probably impair a person with no pain.
I think it’s important to have a culture that values keeping your wits about you.
Is it possible that the biggest problem addicts share is not valuing their wits, whether because of their individual preferences or because their subculture never taught them to do so?
I question whether alcoholism is an escape. An alcoholic friend once told me that when he drank his first couple of beers was also the first time he had ever felt normal.
You can definitely use drugs to escape your abnormality. I think that’s what a lot of people who take antidepressants are seeking to do, for example.
Yeah. That’s an escape. An escape from the way he feels sober. That’s actually pretty common among alcoholics.
I don’t prefer terms like “escape” as they seem to be an application of the naturalistic fallacy. It implies weakness and moral inferiority when for many it could just as easily be objectively better.
I wouldn’t characterise taking ibuprofen for pain as an escape, but rather an improvement. YMMV
The major difference is you can causally drink and enjoy it and not get to the point were it effects judgement. Hard core drugs, not so. When something is abuse even when you have a little bit of it, you are talking a whole different order of magnitude. Also having a small amount of these drugs for short periods of time get you physically addicted (caffeine is the same story but their are no harmful effects and only befits except). That is when causally usage is hard or almost none existence you have a problem.
That’s true to a point, but there is a real escapism phenomenon, even if you’d prefer not to term in that way.
I would call taking ibuprofen for pain both an escape and (usually, but not always) an improvement. You use ibuprofen to override (or escape) adaptive mechanisms of the body – pain-reception and inflammatory response. Now, there are benefits as well as costs to overriding these mechanisms, and sometimes one outweighs the other.
I understand it’s a useful word on occasion, It just reads to me like, “Why can’t you suffer or simply enjoy life less like you were meant to, you weakling.”
I think a missed point here is that a successful society should be concerned with the encouragement of industry (in the sense of dilligence, activity, and attentiveness) and the discouragement of idleness. A modern view is “who cares if it harms only the person doing it”. And by that view almost anything goes, but it is hard for me to believe that any drugs (or alcohol for that matter) do not hurt the industry of the individual involved and so are harmful to the society around them.
I wish I could wake up Ronald Reagan. “It’s morning in America.”
There is so much work to be done. Going through life sedated is not good.
Substance abuse, insobriety, it’s sort of the same thing. But what you are saying is what I was trying to say. “Life sucks, so I want a way to ease the pain, since there is no hope of rising above this.”
Honestly, I think an optimal amount of having that attitude towards yourself is helpful. An optimal amount. Either too much or too little can be severely dysfunctional.