[brady8]

I'm a physician. Unfortunately, most of our overdoses in North America are from prescribed opiates. They are very addictive, and despite best efforts to control and monitor dosing and schedules, these opiates are often either purposefully overdosed (suicide attempts), diverted, or accidentally ingested. My worst memory in pediatrics was a 7 year old who was brain-dead after ingesting only one (!!!) tablet of her grandfather's high-strength Oxy prescription that she thought was Tylenol.

Opiates are bad news, and physicians unfortunately were duped into prescribing way too much for the last ~15 years.

[mountaineer22]

Have you read this LA Times article?

http://www.latimes.com/projects/oxycontin-part1/

It seems patents, drug marketing and insurance reimbursement are the cause of this epidemic.

[aianus]

> Unfortunately, most of our overdoses in North America are from prescribed opiates.

A more relevant metric would be number of overdoses per number of total doses, no?

If there are 50x more prescription opiate users than heroin users and 10x more prescription overdoses than heroin ones that still implies heroin is more dangerous.

[seibelj]

I don't follow your logic. A 7 year old swallows drain cleaner, so we should ban drain cleaner? A shame that happened, but irrelevant to the discussion.

You think that by banning opiates no one will get opiates? The methadone clinic two blocks from my apartment, and the people who panhandle around it and the subway station, and the needles I walk past when I cut through the tennis court, do not show the government's laws are solving the problem. As a physician you may see the emotional side, but logically I would love to hear your solutions to the problem.

[pacala]

The point of laws is not to make an undesirable behaviors disappear. The point of laws is to discourage undesirable behaviors, and, hopefully, reduce their incidence. There are still thieves and murderers and rapists and pedophiles out there. Yet we don't just throw our hands in despair and claim that we should just remove all laws off the books because some people break the law. True, some people will get opiates even if opiates are banned. However, overall fewer people will get opiates, and overall fewer opiates will be sold.

Logically, I would love to hear your solution to the problem...

[CPLX]

The problem with thieving and murdering is generally considered to be the one presented by the people who's property or lives are unwillingly taken from them.

[seibelj]

Yes, my logic is simple: stop trying to ban victimless crimes like drug use. A grown adult wants to inject himself with heroin? Let him. By banning the drug you create a black market, and all of the crimes that entails. The USA tried to ban alcohol, and the bootleggers won. Take all of the money we put into the war on drugs and redirect it to treatment, and tax the shit out of the drugs to pay for our schools.

Banning stealing, rape, and child pornography is nothing like banning drugs. Completely, totally, 100% unrelated and by trying to loop all of them together you disregard logic and sane, rational arguments.

[HighPlainsDrftr]

The best I can explain it, drugs are like rewiring your brain to need something, like food, water, air, sexual reproduction, etc.

If you go without eating for a day or two, your brain really drives you to find something to eat. Same thing happens with some drugs - within varying degrees.

When I tried to give up smoking cigarettes hundreds of times, my body really felt like it was dying by not having the nicotine around. I eventually got passed it. I haven't had one in 8 years.

The drug laws do nothing more than make addicts bad people. It makes it harder for them to get jobs when they get busted. These guys were just trying to survive - their brains rewired to do that.

They really need to get rid of the drug war. Take that $50 billion a year and spend it on mental health/addiction research - instead of killing a bunch of people on the border. Provide some treatment centers. Let people be anonymous when attending. Get the courts and criminal records out of the equation.

I've known some very smart addicts over the years. The tragedy is they get worse and worse - and they have no way out without getting a very negative stigma attached to them. Some end up unable to get jobs. It all because of our laws.

We would be much better off educating our population honestly on drugs (think of how dishonest the refer madness propaganda was). Keep the drugs available, in clean, reliable doses. Help people addicted get off the drugs. Learn about the cycle. This is much better than the system we have now.

[pacala]

These are some great points. In particular, we need to reduce the stigma on addicts, especially those that [try to] recover. Mind you, reducing the stigma is hard, because the stigma doesn't come from a void, or from laws, it comes from the cumulative experience people have with addicts, which are less than great. In another piece from the same story, http://www.latimes.com/projects/la-me-oxycontin-everett/, read on Brandon Smith, who ended up spending all his savings and belongings on drugs, ultimately resorting to robberies. Personally, the first addict I ever met ended up stealing my winter jacket within 3 month of working in the same building, in the middle of a heavy winter. Robbing and stealing are not great ways to build sympathy or trust.

I happen to share the experience to shrugging off nicotine addiction. It was very easy to get hooked [peer pressure played a role], and surprisingly hard to get rid of. In my case, took a few weeks of fighting my body with reason. From what I hear, opioid addiction is stronger, thus I'm having a really really hard time believing that having over-the-counter opioids that anyone can "try a few times" is going to be anything but a major disaster.

The best strategy for most people is to never use opioids. Simply not worth the risk of ruining one's life for a very short time gratification. Given the reality of rebellious teenagers / young adults, I'd much rather have no easy legal path for opioids. Sorry, no opioids in a supermarket locker that you can get by just showing your driver license. On the flip side, I believe we should still crack down hard on dealers, to keep pressure on the supply side.

Which leaves us with the people caught in the opioid trap. While we already fund addiction research, see https://www.drugabuse.gov/international/research-funding-lan..., we probably could do more. We already have rehab clinics where at least some form of palliative care is to be found, though we should seek to make rehab and rehab clinics a better experience. Whether that includes availability of drugs, I frankly haven't seen any relevant research indicating that's a good idea, and I see some evidence [prescription abuse, see the original article] that it is rather dangerous.