[qz_]

Not sure why you're being downvoted, you're completely correct. The only significant negative effect heroin use has on you besides addiction is constipation. For a heroin addict, the problem isn't the heroin, it's the absence of heroin.

[throwaway5752]

To anyone who reads the above comments minimizing opioid addiction: heroin will eat you from the inside and kill you eventually. It is the most evil drug that has ever existed. Before it kills you it will ruin your mind irreversibly. Constipation is the least of the problems. Never use it, ever.

[speedplane]

> heroin will eat you from the inside and kill you eventually. It is the most evil drug that has ever existed. Before it kills you it will ruin your mind irreversibly. Constipation is the least of the problems. Never use it, ever.

Heroin and especially heroin addiction is extremely dangerous, many people die. However, it doesn't have the deteriorating affects that you describe. Heroin users that don't die and are able to get over their addiction have few long term health affects. It's not at all like smoking or alcohol.

[throwaway5752]

That's just not true. One habituates to it and they need more to achieve the same feeling that they had before. They need more, and the dynamic changes from trying to stay high to trying to avoid withdrawal. They reach a crisis, and then either die or go clean for a while. It changes the function of your brain, and you remain at a high risk for relapse the rest of your life (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5046044/ and countless others). There is a reason the disease model works and health system vs criminal system has better outcomes.

It eats you from the inside because everything else in life fall away in importance of being high, and if manage to get clean you are essential on a tightrope the rest of your life and the temptation haunts you all the time. It ruins your ability to feel truly happy or fulfilled by anything besides heroin. You are a day or two away from the morgue the rest of your life.

The addiction cycle usually ends in a place where Hep, sepsis, and HIV are comorbidities. But the long term health effect is the addiction and brain structural changes. Just because it's mental health doesn't mean it's any less real than lung cancer or cirrhosis.

[kirstenbirgit]

That's just not true.

Users are currently resorting to crime to acquire their heroin because it's illegal, not because heroin inherently makes you evil.

[speedplane]

> Users are currently resorting to crime to acquire their heroin because it's illegal, not because heroin inherently makes you evil.

That's not quite right. Heroin users definitely resort to crime to fund their addiction. They are not "evil" for being addicted, but they do become desperate. And if you're desperate, you're more likely to do "evil" things.

Most do not immediately resort to crime. Imagine you were addicted to some expensive substance. You'd likely try hard to keep whatever job you had to fund the addiction, then if that fails you'd pressure family to fund it. If family stops paying, then you'd sell whatever property you had. When that's over you may turn to illegal "jobs" such as prostitution or dealing drugs yourself. Only finally, as a last desperate resort, would you try to steal or commit other crimes.

Addiction is not "evil", but it results in desperation. When one is starving for bread, they're more likely push the boundaries of their morality to eat, maybe steal, and in extreme cases maybe worse. Desperation can make people do evil things.

[kirstenbirgit]

That's exactly it, because it is illegal, it's also extremely expensive, and it's hard to afford daily heroin with a regular job without resorting to crime.

If heroin was not illegal, and therefore not extremely expensive, users would not have to resort to crime to afford it.

Now imagine heroin was legalized and/or freely available: noone would bother to commit crimes, and would be able to start living a regular life since they don't have a single reason to exist anymore. One of their basic needs are taken care of.

It's amazing how quickly we've forgotten prohibition. When you make something illegal that there is a demand for, an illegal market pops up.

[speedplane]

> If heroin was not illegal, and therefore not extremely expensive, users would not have to resort to crime to afford it.

If heroin was legal, it's does not necessarily follow that it would be much less expensive. In states that have legalized marijuana, the price is roughly the same (and often more) than black markets.

> it's hard to afford daily heroin with a regular job without resorting to crime.

Regular jobs typically pay more than petty crime. The reason that heroin addicts resort to crime is not because their regular job doesn't pay enough, it's because they can't hold a regular job because they're addicted to heroin.

> Now imagine heroin was legalized and/or freely available: noone would bother to commit crimes, and would be able to start living a regular life

I'm not sure that many heroin addicts (legal or otherwise) can live a regular life.

[kirstenbirgit]

Commenting here since I can't reply downthread:

> If heroin was legal, it's does not necessarily follow that it would be much less expensive. In states that have legalized marijuana, the price is roughly the same (and often more) than black markets.

Heroin is extremely cheap to manufacture, and it's of course also not patented anymore. There's no point to discussing this, really.

> Regular jobs typically pay more than petty crime. The reason that heroin addicts resort to crime is not because their regular job doesn't pay enough, it's because they can't hold a regular job because they're addicted to heroin.

This is partly true. It's a large topic. A heroin habit will take a lot of time, since you're doing a lot of waiting around for dealers. But it depends on the job, though. These days, Americans are very close to losing everything in the time of one or two paychecks. Add a heroin habit of hundreds of dollars a day on top of that, and you need something else.

> I'm not sure that many heroin addicts (legal or otherwise) can live a regular life.

I think far more people are using heroin and keeping a regular life than you realize.

[qz_]

It won’t kill you though.

All the ways heroin can kill you are direct consequences of its prohibition.

[speedplane]

> All the ways heroin can kill you are direct consequences of its prohibition.

Most people die from heroin by overdosing (taking too much). Very often, this is a result of mixing heroin with other drugs and pushing the limits of what a human body can tolerate. If it were legalized and regulated, maybe some accidental overdosing could be prevented, but there would be plenty of deaths.

Heroin is pretty different from other drugs because it's pretty easy to die from it. It's nearly impossible to die from smoking marijuana. Even alcohol is safer if you're not driving a vehicle: you're far more likely to pass out before you get alcohol poisoning.

Heroin is significantly more dangerous. A slightly higher dose or a new formulation can easily kill you.

[kirstenbirgit]

People rarely just die due to random ODs when their heroin is pure, like you're suggesting. It takes more than that, especially when one has a large tolerance like all long-term users do.

There's 2 groups of heroin overdoses.

1) Varying amounts of cut like fentanyl. Due to heroin being illegal, users have no way of knowing whether their drugs are pure, so it's hard to gauge the dose. The exact same dose can kill you if there's a little too much fentanyl.

2) Taking the same amount after e.g. rehab or tolerance break. Due to the way heroin tolerance works, after a while of not using it, your body will reset the tolerance. So you come out of rehab and of course you want to do heroin again, and many unfortunately start right at their old (extremely high) dosage.

Legalization would obviously help no. 1, but I also think it would prevent deaths due to no. 2, since users would not have to go through rehab until they're actually ready for it. When the system forces you to stop, most users will just immediately start again when they have the possibility.

[speedplane]

You're making an assumption and also ignoring a large side affect.

First, you're assuming that legalizing heroin would result in a high quality pure product. Considering that heroin addicts are desparate for heroin, it's pretty likely that they would go to cheaper black market sources with the same quality problems we have today.

Second, legalizing heroin would dramatically normalize it, very likely resulting in many more people becoming addicted to it. Even if the danger of the drug decreased, it would almost certainly be offset by the large increase in new addicts.

In terms of saving lives, I don't see how legalizing heroin can help.

[kirstenbirgit]

Replying here since I can't reply downthread:

> First, you're assuming that legalizing heroin would result in a high quality pure product. Considering that heroin addicts are desparate for heroin, it's pretty likely that they would go to cheaper black market sources with the same quality problems we have today.

I don't feel like this is a genuine argument on your part. If it was available in an affordable, high-quality manner, very few people would continue to use dirty, cut and illegal versions.

I think legalizing it is a good start, but an ideal scenario are heroin treatment clinics like we see in Switzerland or Denmark. They are 100% free and obviously use pure drugs.

> Second, legalizing heroin would dramatically normalize it, very likely resulting in many more people becoming addicted to it. Even if the danger of the drug decreased, it would almost certainly be offset by the large increase in new addicts.

I don't think that everyone would start using heroin after it was legalized. Most people are still extremely afraid of it due to e.g. media characterisations. Even so, as I've already postulated, I don't think there's any inherent danger in using it, so it's really a moot point to be honest.

[goatsi]

3) Users take the same amount of heroin with the same purity as previous cases, but combine it with other CNS depressants and die.

This was probably the main cause of overdose deaths before fentanyl came along. In one study 45% of the deceased also had a blood alcohol level, and 30% were on Benzodiazepines (one Swedish study had benzos present in 55% of fatal overdoses).

https://sci-hub.se/10.1080/09595239996743

>The majority of cases involved heroin in combination with other drugs: alcohol (40%), benzodiazepines (30%)and antidepressants (9%). In only a third of cases was morphine the sole drug detected.

https://sci-hub.se/10.1046/j.1360-0443.1996.911217652.x

>Fatalities involving only heroin appear to form a minority of overdose occasions, the presence of other drugs (primarily central nervous system depressants such as alcohol and benzodiazepines) being commonly detected at autopsy.