I've always been intrigued by this stance. Do you believe that heroin should be available for purchase, like e.g. cigarettes? Is this a matter of individual liberty, or some other reason?
Not the parent to your comment but I'll chime in here.
Heroin is more dangerous than cigarettes, since the threshold for overdose is so low. So, probably not a great thing to be able to buy at a gas station.
Personally, I think heroin should be available at pharmacies by prescription, cheaply purchasable in small quantities. Addicts should have to visit daily for their doses, and should get some support from doctors and pharmacists if they want to withdraw. Doctors should make it easy for addicts to get prescriptions for heroin, and clean, safe drug delivery options.
It's a matter of harm reduction. It would help reduce overdoses because dosages would be exact. It would help reduce organized crime, because the money would be diverted to legitimate channels and taxed.
These kinds of ideas are already being discussed in Vancouver, where black market fentanyl and carfentanil is causing a rash of fatal overdoses. While we have safe injection sites, addicts are still using black market drugs which are wildly unpredictable.
> It's a matter of harm reduction. It would help reduce overdoses because dosages would be exact. It would help reduce organized crime, because the money would be diverted to legitimate channels and taxed.
I strongly support this as well. Focusing on harm reduction with a stable slope to coming off the addiction. Criminalizing, as the parent poster said, is giving piles of money (power) to people who really, really, really shouldn't be getting it.
I don't "do drugs", and have never done them. The closest I've come is a bit too much to drink. I have no horse in making heroin legal. But I do have the horse race of not wanting to see addicts lined up on the street; not wanting homeless camps turned into drug distribution zones... we have significant problems in Seattle from meth/heroin, and it's time to change what isn't working.
The threshold for overdoses is fairly high in all opioids though lower for heroin than for morphine. The reason people regularly overdose on heroin is that heroin from the illegal market is often of wildly changing purity and sometimes mixed with substances that increase the risk of OD.
Handing out known quality heroin eliminates that risk.
The question is, to what extent is developed tolerance responsible for overdosing, and to what extent is it cheating dealers ? Medical literature at least seems to think that tolerance means overdose is inevitable, though yes, it can take years with careful control.
There is also the longer term side effects of the drug. The way those abused heroin addicts look, if you ignore most bruises (some are a consequence of withdrawal symptoms, wild involuntary movements, presumably not all though), is a medical condition.
The long-term health effects of the drug are probably comparable to the long-term effects of eating a diet of sugar water and cheeseburgers. Both are likely to end your life messily, and young, and neither are worth fighting a war over.
The threshold for overdose isn't really that low, and there is an easy and effective tool to reverse it (Narcan).
The real problem is impurity... people get used to stuff at a certain purity, and then are sold either a much purer batch or something laced with a strong synthetic opiod like Fentanyl.
>Addicts should have to visit daily for their doses, and should get some support from doctors and pharmacists if they want to withdraw.
This is a good sentiment, but I think it would be a disaster in practice. You already have pharmacists moralizing and deciding whether or not to sell birth control (still legal at least in multiple US states last I checked). I don't think it's going to go well to give them power of addicts as well. You need to be sending them to people like social workers, who are made the choice to help with recovery.
I don't think I'd vote for heroin to be legal, but I think we have to ask ourselves some questions: (1) is prohibition even effective? Spending on enforcement has grown steadily but the percentage of the population addicted has remained steady. Not clear that enforcement has any effect. (2) is criminal punishment more effective than mandatory / free treatment? Most of the evidence I've seen suggests otherwise.
I generally go for the person liberty argument, but heroin is a tough sell even to me because of how ridiculously addictive it is. But I see a lot of harm coming due to certain things being illegal, and a lot of harm coming from many of the things we prescribe because the alternatives have an irrational stigma. I've had some very passionate (i.e. rude) messages sent to me on Facebook because I support legalizing marijuana, and apparently this makes me equivalent to a serial child murderer because people might drive under the influence. Nevermind how bad drunk driving statistics are or how easy marijuana is to obtain anyway, or how some of these same people are on opiate pain killers 24/7
The other question is whether they kind of treatment we're using is effective. There isn't much evidence that 12-step programs really make any difference whatsoever.
You jest, but I wouldn't be surprised if leveraging and preserving the stigma has made it too difficult for even more people with non-violent drug arrests to find productive employment where prior usage otherwise wouldn't be an issue.
Decriminalization doesn't mean legalization. It just means that you don't make criminals out of drug users, and instead use the money that you would spend policing drug distribution (which doesn't work) on rehabilitation (which does).
If you don't police drug distribution, wouldn't gangs/drug dealers just take over the city? i.e. it would be safe to deal drugs since its not being policed, so the "bad guys" would all try to corner the local drug market leading to turf wars and such...
We don't police clothing distribution, and lots of people buy clothes, why haven't violent gangs selling clothing just taken over the city? Because they're outcompeted by law-abiding sellers who don't have all the overhead costs of evading the law, who use legal, nonviolent means to wage their turf wars.
As you point out in another comment, every jurisdiction that has decriminalized drug usage while keeping selling drugs illegal has continued to police drug distribution. I'm not OP, but suggesting we stop policing drug distribution implies to me that we're making drug distribution legal. Which is to say, making selling drugs legal. Just like alcohol, tobacco, and caffeine. I'm not saying I agree that's what we should do, but it's a defensible position to take, and seems to me like the obvious reading of OP's comment.
All drugs (weed, cocaine, heroin, amphetamines, etc.) should be as easy to buy as cigarettes are right now. Not for any ideological reason, just that it's going to suck a lot less than the status quo which creates black markets and throws addicts into prison.
You don't get to choose between having drugs and not having drugs. Everywhere in the world has drugs, you just get to choose whether you have an underground criminal black market that the state creates through its policies or not.
The whole decriminalization of consumption argument just moves the goalpost. You create the same problem The Netherlands has had with weeds for the past few decades, which is admittedly better than most of the rest of the world, but production remains and unregulated black market.
I strongly agree on your main point, although personally I feel it is also on issue of personal liberties.
Also, some studies suggest that the current arbitrary blanket ban has hindered possibly useful medical research related to some of the currently prohibited substances.
The whole theory of personal liberties collapses once you consider sufficiently powerful technology.
If there was a drug that gave the user unimaginable euphoria or was guaranteed to kill them with a 50/50 chance should we do everything in our power to stop that? Especially for the young and impressionable? Even as someone who thinks heroin should be legal that gives me pause.
Should knifes for personal use be legal to purchase? How about guns? How about artillery? Tanks? Nuclear weapons?
I don't know, but thinking about these issues in absolutes like "personal liberties" tends to bring you some bad places, just like any other absolute. I think it's more useful to think about the practical implications of our actions given existing data, which shows the current drug war clearly isn't working, but that doesn't mean we shouldn't ever have any sort of ban on substances purely intended for personal use for public health reasons.
We are not talking about all personal liberties. Lets stick to the topic of regulation of Psychoactive substances. You don't face problems of abuse and dependence on, say, guns or Tanks.
> If there was a drug that gave the user unimaginable euphoria or was guaranteed to kill them with a 50/50 chance should we do everything in our power to stop that? Especially for the young and impressionable?
We do have a system in place for controlling access to substances like Alcohol and Tobacco to minors.
> Do you believe that heroin should be available for purchase, like e.g. cigarettes? Is this a matter of individual liberty, or some other reason?
I'm not the OP, but I think so, precisely out of a concern for individual liberty.
There are also prudential concerns, e.g. that criminalisation actually results in worse outcomes for addicts, dealers & society. But even were that not the case, I'd be in favour of legalisation.
It's at most a trade-off (as in e.g. you like to have a drink every now and then, or during some activities, and you do so even though you understand that while doing so, you strengthen your mental models and a kind of addiction).
Few if any substances actually automatically mean throwing one's life in the gutter; the issue of substance abuse is much more complicated (with many external variables that have nothing to do with the substances themselves) – and it may not be relevant to the majority of the population at all.
There are other options - for example illegal selling and manufacturing (like now), legal using (so current addicts are not prosecuted for getting help).
It's interesting that the main reason you can think of is individual liberty. Is that, to you, the best reason cigarettes are available for purchase?
In my personal opinion, if it were possible to enact a law which would have the effect of ending cigarette usage in the US without any other unnecessary effects (cigarette company employees losing their jobs would be a necessary effect, of course; everyone dying because we nuked the world, on the other hand, would be an unnecessary effect), then I would be 100% in favor of enacting it.
Such a law is not physically possible. A law that says "no one shall smoke, buy, sell, or make cigarettes" would not end cigarette usage in the US and would have so many ancillary negative effects as to be worse than the current situation. We saw this with Prohibition, and we're seeing it right now with the War on Drugs.
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It's also worth noting that there is plenty of underexplored middle ground between criminalization and being available at every corner store, such as:
- illegal but not criminal: minor fines for using, huge fines for selling
- suspension of privileges like driver's licenses
- you have to register on a list when you buy and be subject to social services checking up on you (list would obviously be at least as private as medical info, and you get expunged when you get clean)
- available with obstacles such as doctor's prescription, or over-the-counter but still only a subset of pharmacies
There is a middle ground, which is that you dont allow the free import of heroin into the country. Where you have uncut, known-quality heroin available as a tool to treat addicts going through withdrawal (or any other effective substitute), and where you (optionally) pursue only high level smugglers - people who are getting filthy rich peddling a deadly and addictive substance.
If we took even 1% of the total we spend prosecuting addicts and used it internationally, we could probably put a much more severe dent in supply. We already invaded Afghanistan, but in many cases helped the farmers instead of shut them down (this is a complex issue, opium is a much more valuable crop than food - but its a problem money can solve ). We could work with other countries to disincentivize coca production (again - the farmers that grow it can choose coca or bananas, guess which is worth more ?)
There are so many other ways to shut down the drug war, but the first place is to stop prosecuting people for possession.
Heroin is more dangerous than cigarettes, since the threshold for overdose is so low. So, probably not a great thing to be able to buy at a gas station.
Personally, I think heroin should be available at pharmacies by prescription, cheaply purchasable in small quantities. Addicts should have to visit daily for their doses, and should get some support from doctors and pharmacists if they want to withdraw. Doctors should make it easy for addicts to get prescriptions for heroin, and clean, safe drug delivery options.
It's a matter of harm reduction. It would help reduce overdoses because dosages would be exact. It would help reduce organized crime, because the money would be diverted to legitimate channels and taxed.
These kinds of ideas are already being discussed in Vancouver, where black market fentanyl and carfentanil is causing a rash of fatal overdoses. While we have safe injection sites, addicts are still using black market drugs which are wildly unpredictable.