| > Opioid addiction (I have seen a lot of it, not had it) is a social problem and is best managed with, opioids I don't entirely disagree with you, but I have also seen enough people stop, who probably wouldn't have if that were the typical treatment, to be pretty cautious about that. There are a number of promising addiction treatments in the wings at the moment, in particular Ozempic and the general GLP-1 agonist class. Transitional opioids like Buprenorphine are fine as a detox strategy, and maybe even fine for the medium term, but committing to them for life I think is a mistake (in most cases). > The problems stem from putting unreasonable obstacles between adicts amd their appropriate treatment. Practical legal and financial obstacles, sadistic legal obstacles, and bizarre moral obstacles There is a lot of truth to this. It is, in fact, what I used to say when I used them. And it is and remains true. It is also true that prolonged opioid use is mostly physiologically harmless (overdoses notwithstanding). However, there are psychological elements that come with long term use that these measures do not capture, and are not fully internalized by the transaction costs (or literal costs) associated with obtaining them. > Nineteenth century society managed it with laudinum Ask China why they fought that opium war, and how they feel about such things lately. They are still mad about it. > The Sacklers are, were, parasites profiting from that social malaise and bad things will finally happen to them. But the cause of the malaise is our irrational attitude to drugs Agree on the Sacklers although personally I'd place more blame on the McKinsey consultants that wrote the original deck that proposed the strategy. I don't know how much the Sackler individuals personally made these decisions, but those people certainly did. Re: irrational attitudes to drugs, I agree, but the situation is substantially more nuanced than it might superficially appear. Laudanum did used to be over the counter, as did cocaine among other things. However, these things were not criminalized for no reason - heroin wasn't criminalized in the 60s/70s anti-hippie craze, or for racist reasons in the 1930s (like marijuana). Heroin was first criminalized for over the counter sale in 1910 - 15 years after Bayer first marketed it. Easily the fastest criminalization of a novel pharmaceutical compound in the history of the world. This is not an accident or a product of some temporary social hysteria. And unfortunately, it was also not criminalized because all of its harms were due to its being illegal. If criminality were the problem we would expect things to get better, not worse, with the introduction of fentanyl which is far cheaper and more readily available. I could be misreading the data, but that does not seem to be working out. |
I am not advocating pure herion (ironically quite a safe drug aside from addiction) or cocaine powder as modern consumer products.
Opium caused upheavals when used as a wedge by Westerners in China, but remember it had been present, and used for millenia in Arabia.
The same, roughly, with cocaine and coca
It is not a choice between continued sadism or free reign herion and cocaine dealing.
We can do better
And I think the "psychological elements that come with long term use" is largely confusing cause and effect.
From my experience people having drug problems recover when the problems recede. Hence advocating treating drug addiction with drugs
One size does not fit all, and some halt and are abstinent. Good on them, I know no-one like that