[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.