[PraetorianGourd]

Though not entirely aligned with the article, it does remind me of the toxic culture we have with drugs (at least in the United States) that I think makes it hard to have a non-toxic relationship with drugs.

I like drugs. But I set a ton of rules for myself. I never buy more than a small amount of a drug at a time, I take scheduled breaks from any drug, I know the signs of addiction for drugs that I take and I take unscheduled breaks if I notice any of those. I also don't hide it from friends or family, so they can help catch signs that I may miss (though it hasn't been an issue yet).

My point is that there is so much shame around doing drugs; that one bump of coke can make you a fiend or that everything is laced with fentanyl, that we lose sight of the true way in which drugs take hold of a person. Addiction happens "slowly, then all at once" and recognizing that and knowing the early warning signs helps.

I am not suggesting everyone do all the drugs they want all the time; additive personalities are a thing, unknown quality of street drugs is a thing, and acting dangerous to yourself or others while high is a thing. But I think the shame associated with drugs, forcing people to use drugs in the shadows, exposes us all to the biggest risk, which is addiction.

[jeffreyrogers]

Since you're on HN you're probably more intelligent and somewhat more disciplined than the general population. I doubt that what works for you would scale to the population at large.

> Addiction happens "slowly, then all at once" and recognizing that and knowing the early warning signs helps.

There are different types of addicts and it is hard to know in advance if you are one of the more at risk types or what will trigger you to become one. I don't particularly care if people do drugs, but it seems like common sense that exposing more people to drugs will increase the number of addicts.

[DarylZero]

> Since you're on HN, you're probably more intelligent and somewhat more disciplined than the general population.

The drug-using population is more intelligent than the non-drug-using population -- except if the drug is cigarettes. Something I learned recently here.

https://bigthink.com/neuropsych/intelligent-people-drugs/

[jeffreyrogers]

But harm falls disproportionately on the less-intelligent, that was my point in bringing it up in the first place. If you are intelligent and disciplined you are better positioned to use drugs in a way that doesn't lead to harm.

Edit: From https://www.irp.wisc.edu/publications/fastfocus/pdfs/FF32-20...

> Recent research using 1992 to 2011 National Health Interview Survey data combined with data from the National Vital Statistics System indicates that the recent drug overdose epidemic—driven largely by prescription opioids and heroin—has implications for life expectancy differences by education level. Specifically, while drug overdose deaths have grown for all education groups, those with less than a high school education lost the most years of life. Overdose deaths now represent a substantial share of the widening inequality in life expectancy by education level.

[netizen-936824]

Sounds to me like education would help. A large part of harm reduction philosophy focuses on that

[netizen-936824]

>When Ronald Graham, a concerned friend and fellow mathematician, bet him $500 that he couldn’t stay off his drug of choice for a month, Erdős accepted and easily won the challenge. When the 30 days was up, Erdős said to Graham, “You’ve showed me I’m not an addict. But I didn’t get any work done. I’d get up in the morning and stare at a blank piece of paper. I’d have no ideas, just like an ordinary person. You’ve set mathematics back a month.”

This quote is hilarious, and I find it interesting that there's a difference in intelligence between drug users and non users. My gut feeling is that there would be no significant difference.

I will note that most drug use does not impact intelligence negatively. Of course it can if abused to a great enough degree as that will significantly alter neural function but this also depends on the specific mechanisms of the substance.

Dr. Carl Hart is a great example of this. He's been a recreational heroin user for 5 years and is a tenured professor of neuroscience at Columbia.

https://en.m.wikipedia.org/wiki/Carl_Hart

[DarylZero]

Wow, he published a book admitting to using heroin. I would think even with tenure, you would get fired for that.

[jeffreyrogers]

And yet most people who OD on heroin or otherwise ruin their lives due to it are not PhDs.

[netizen-936824]

You're right, but simply because most of the population does not have PhDs.

If people had a fully tested and clean source of heroin (free from fentanyl) there would be less overdose deaths.

[jeffreyrogers]

2% of people in the US have PhDs. I would be surprised if 2% of people who die of ODs have PhDs. Harm falls disproportionately on those unlike the OP.

[throwaway2331]

> Since you're on HN you're probably more intelligent and somewhat more disciplined than the general population. I doubt that what works for you would scale to the population at large

IME, it's never been a discipline issue.

It's always been a "Crack is for the rich; but we're not rich; we're working class" issue.

Simply having money leads to better/healthier sources of pleasure, a more stable emotional state, and another, competing "addiction": a paycheck.

Taking away someone's source of income is the quickest way to turn them into a drug addict (especially if they have no safety net). Add in a dash of hopelessness for the future, and we're all set to someone never getting off their feet, as they spiral into self-destruction.

I would also wager that there's a confounding "drug users in lower socioeconomic strata cannot maintain their expensive habits for long, before either: running out of money, self-destructing and blowing up what little of their lives is left, or simply OD'ing." Someone in a higher socioeconomic strata is likely to be hooked on the dopamine drip of a steady cashflow, and the "need" to keep their present level of material comfort (lest their behavioural conditioning starts throwing "fear" at them!), and thus less liable to be broke; thus, less likely to be undisciplined; thus, less likely to score poorly on IQ tests; and thus, able to keep an active drug habit.

[PraetorianGourd]

To be fair crack was thought of as the poor man’s coke. You can take high quality coke, cook it with sodium bicarbonate and make more money using less supply

[netizen-936824]

You are correct that more exposure would likely lead to more addiction, but consider alcohol. As a society we have developed cultural norms for avoiding addiction such as drinking only in the evenings, weekends, or special occasions. This is only one of many cultural mechanisms we have for regulating drug use, we just need the exposure to develop the mechanisms.

[jeffreyrogers]

Aren't roughly 10% of people alcoholics? And I imagine that percentage is similar across the world, despite widely varying cultures.

Edit: I recall reading somewhere that 25% of people who use heroin develop addictions. Let's say that we are as successful at developing a culture of heroin use as we have been at developing a culture of alcohol use so that we can reduce addiction to 10%. It seems likely to me that any such culture would more than triple the number of people using heroin, so the overall effect is probably to increase the number of addicts.

[DarylZero]

Absolutely not. Alcoholism varies widely between cultures.

[mise_en_place]

Yet many will happily drive extremely drunk or high (or both, as I’m currently seeing where I live as Californians invade). Sometimes societal regulation mechanisms like social pressure are not strong enough. Perhaps we as a society should understand what drives a man to drink until he can barely move, examining shared social traumas that many of us experience.

[plantain]

Culture can and does change, and not on evolutionary timescales but within decades - in Australia drink driving was absolutely rampant in the 60's-80's, but now it's really quite taboo.

"Drink drive, bloody idiot" is a slogan every Australian knows.

[netizen-936824]

We should work to understand what drives use, and we are. Plenty of researchers are working on understanding the physiological underpinnings of the desire to use any given substance.

I personally suspect that over 50% of drug users are attempting to self medicate in some way. Whether or not they are consciously aware that self medication is what they are doing, that's another question entirely.

[mise_en_place]

Your point about self-medication got me thinking. Perhaps we are also at a crossroads in receiving medical care as well. There is an abundance of information available related to medical care that did not exist even 10 years ago. Doctors and mental health professionals can no longer gatekeep critical information, like was tried with ivermectin.

[giantg2]

Yet we see 50k-80k alcohol related deaths each year in the US.

[netizen-936824]

You are correct, but my comment was about mechanisms to avoid addiction. We do need to do something about reducing harm but prohibition is not the answer.

[obstacle1]

Wasn't your argument that increased exposure leads to less harm via developing social regulation mechanisms, though? Using alcohol as an example?

Yet alcohol is by far the most destructive substance in terms of both $ and human life costs. Which seems to weaken the argument significantly...

So maybe prohibition is not the answer. But whatever we've done with alcohol clearly isn't, either.

[hattmall]

Alcohol is the most destructive in aggregate because of its widespread usage though. The destruction per user is far worse on other drugs.

[netizen-936824]

Alcohol is very destructive yes, I was just discussing the social mechanisms that reduce the harm

[KronisLV]

> But I think the shame associated with drugs, forcing people to use drugs in the shadows, exposes us all to the biggest risk, which is addiction.

You know, i'm not entirely sure about that.

On one hand, that is a good argument and speaking about all of the "vices" that humans enjoy in a more frank manner and how to engage in them in a more safe manner could be a good thing. Also, the legalization of certain substances could lead to more regulation, quality control and tax income.

I could draw parallels with how men in society are oftentimes expected not to show emotions, or how mental health isn't really addressed in social discourse all that much, leaving many feeling miserable. Or perhaps how sex workers often operate without proper testing in place or worker protections, versus the countries where that sort of thing is legalized.

On the other hand, i'm not sure that normalizing potentially harmful behaviors is acceptable. For example, personally, i don't even drink alcohol - i've tried it a few times, but didn't feel like it's for me. Being detached from drinking just makes me aware of how much of a deeply ingrained drinking culture there is in our society - people drink for celebrations, for relaxation, talk about the supposed health benefits of wine, there are commercials on TV and online for alcohol and the end result is that many people end up drinking.

This leads to traffic accidents (DUI). This leads to preventable disease and lower life spans. This leads to more violence due to drinking. This also leads to the kind of addiction that makes members of society lose their income and housing. Perhaps this plays into your point about addictive personalities or just poor decision making.

I feel like it's the same story with cigarettes. And that it would be the same story for other types of substances.

Either way, it's a pretty slippery slope and it's hard to reason about these things.

[tsol]

Hmm maybe I'm younger than you, but I thought this was going in a different direction, to me there was often too much of an open acceptance. Growing up for me, drugs have felt like the opposite. It's what the cool kids did, and doing it was cool. Not doing it well, mind you, with lots of rules and carefulness. Just doing it to party and fit in. I know that isn't new, but where I was growing up even the smart kids who were clean most of the year would go to music festivals and experiment with ecstacy and other powerful drugs. It's in music, on tv, and multiple presidents have done them. The problem I've felt, has been that very few seem to know how to do drugs the right way

Most people seem to use them like a button that you hit when you wanna party and let loose. To me, they're very different-- they're buttons with very specific effects. A very very small dose of an opiate can make you more sociable and even less stressed. It's not optimal, but before I learned healthier coping mechanisms I used this a lot. But damn it though I stay away, I have to admit in extreme moderation they still can enhance performance unbelievably well. Only problem is they're insanely addictive, so I stay away.

My point is that I think there are smarter ways to use drugs, more like a doctor than like a rapper. I know some people will always want to use drugs like they're in a music video, you can't do much about that. But I think much of the population would actually like to use drugs in a more informed and pragmatic way. Is it not right to use drugs to have fun? No, at least I don't think there is a right way to use drugs. But I do think treating them like "fun" buttons is a terrible idea. I'm not against ecstacy, but it's neurotoxic. I'm not against weed but it can trigger mental disorders in some who are susceptible. I'm not against cocaine but honestly a lot of it does have fentanyl added in nowadays and unless you have the patience to test it in advance first you should stay away. Most people don't consider any of this, but they should. Drugs change your brain permanently(that's why the second time is never like the first), they're not to be taken lightly.

Unfortunately, there's very little discussion on harm reduction and smart drug use. It's either the devil, or it's not a big deal. The truth, as always, is somewhere in between

[netizen-936824]

I completely agree, the US does have a toxic relationship with drugs. Generally fueled by the ideology that sobriety is somehow superior to any form of intoxication. This misguided belief has done immense damage to communities through the application of criminalization of substances.

[katzgrau]

> Generally fueled by the ideology that sobriety is somehow superior to any form of intoxication.

Huh? Perhaps fueled by the idea that intoxication leads to more harmful events for society, its members, and the individual.

Perhaps we put on airs about being responsible and avoiding intoxication - but when it really comes down to it, society prefers the intoxicated over straight edge types.