[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.

[DarylZero]

It's important to understand -- the ODs are caused by adulterated supply.

Perhaps PhDs are on average better socially-connected so that they have better supply chains. But it isn't directly because of personal characteristics.

[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.

[obstacle1]

I think that's more of an assumption based on social norms than something we can strongly conclude is true. Here is a study that suggests alcohol is one of just four 'high risk' drugs in terms of harm per user, and of those 4 alcohol is the highest-risk. Also alcohol is the highest risk drug at population scale, which we know:

> for individual exposure the four substances alcohol, nicotine, cocaine and heroin fall into the “high risk” category with MOE [margin of exposure] < 10, the rest of the compounds except THC fall into the “risk” category with MOE < 100. On a population scale, only alcohol would fall into the “high risk” category, and cigarette smoking would fall into the “risk” category

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4311234/

[netizen-936824]

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