I read this yesterday on the BBC, and was struck by, among many other things, the fact that this woman was put into this position in the first place. Most of all, that she was essentially turned into a criminal through the failure of the state. I also hope that people can read that, and understand the trap that so many addicts find themselves in. Instead of medical treatment they're referred to 12 step programs or told to "kick it", unless of course you can pay, of you're lucky.
The system is set up to create failure and re-offense, although I'm not arguing that it was designed that way, the result is the same. All of this comes down to a single root cause which can be addressed: the "war on drugs". It's insane, it's wasteful, it's already going to have generations of negative impacts around the world. The sooner we stop it, the sooner we can start to heal the damage.
Apart from the terrible human suffering that drugs (and their criminalization create), there is another factor that is not, in my opinion, discussed enough.
Drugs are and amazing business and making them illegal, make rich to the worst kind of people. It's giving power to the last people you would want in power.
So, in the consumer countries you have addicts suffering. In the producers countries you have wars and societies totally corrupted, and the worst of the worst get rich.
Amazing strategy.
It looks more like a war on humanity that a war on drugs.
Keep in mind that it came into being right as the Nixon years used anti-drug legislation to effectively take down blacks and hippies.
On top of that you have nations that wanted to hedge around their big and growing pharma industries, and others that was negative to all drugs (except their local cultural ones) for religious and cultural reasons.
In effect religion and economics trumped medical science, and the world has been dealing with the blowback ever since.
It's not a war on humanity it's a war on the working class. The capital class can pay lower wages the more of the labor class are dealing with drug addicted family members. Because it makes the employee afraid.
Companies make a 2x, 3x, 10x, 100x premium off of labor. The only way they can do that is with a perceived shortage of "work". The way they do that is to make enough political instability that a strong single digit percentage of people are visibly falling through the cracks of solvency. Drugs help.
Many business owners are aware on some level that they could double salaries and stay solvent, but they don't think about it, they think in terms of "market rates" for labor, and they want rates to be as low as possible, so they subconsciously collude in cultural movements which make work seem scarce, and life scary and chaotic.
Their brains don't drift to the "what if we all just work hard and get paid a fair share? what if every employee was on a partner track?" scenario because they would lose money. And they're the ones deciding what the partner agreement says so it doesn't change.
There's no technical reason in 2017 for there to be any unemployment, for anyone to be hungry or need health care, lack access to the internet, or anyone to work more than 20 hours a week.
The problem is if that happens, the working class will rest up, get educated, and demand fair compensation for their wages, and the capital class will be stuck with a piddling 20% of the global economy instead of the 80% they currently get.
So they fight tooth and nail to keep a certain level of instability, in the workforce, and in far away places.
The war on drugs is reducing the amount of labor available. If we follow the principles of supply and demand-- if Business Owners wants to pay employees less, then they want _more_ people to be available to work, and they also want those people to have lower cost of living. Having people in prison and having people pay for their family member's drug addiction reduces labor supply and increase cost of living.
I think you have a conspiracy narrative, and you are trying to fit evidence to support it.
The principle of supply and demand doesn't really work, it's too simplistic a view. In the small scale, in a controlled environment sure it works fine, but real markets are messy with lots of factors impacting them, so it tends to break down rapidly. This has always been the failing of those that hew to the freemarket capitalist ideal, this unfailing belief in supply and demand as a market driver.
One (but certainly not the only) missing factor here is a discussion of skilled vs. unskilled labor. The market for skilled labor is relatively small compared to unskilled labor, but even in that market companies struggle sometimes to fill positions, that's one of the claims companies backing H1B programs make (even if it is a bit dubious). On the other hand, there's an almost unlimited supply of unskilled labor available, and that's growing all the time. Further complicating things is the fact that the demand for unskilled labor is directly driven by the size of the market, and they tend to scale together.
People desperate for any work to offset their costs of living are more willing at accept lower pay if it means getting a job and that's exactly the situation we see evolving now. All of this so far has been predicated on the supply side of things being the driver, but there's also the question of demand. If people had options they could fall back on then the unskilled labor market would demand higher wages and refuse to work under the poverty line forcing employers to increase wages. The problem is of course that people are so desperate for anything at all that they're willing to work in jobs that can't keep them financially viable because it at least slows the collapse. Eventually they'll either move into a skilled position that gives them a better chance, get sick, die, or turn to crime or drugs to try to cope. Long term this is of course economically disastrous, the middle class has all but ceased to exist, and the economy is slowly grinding to a halt as more and more of the population finds themselves unable to take part meaningfully in it. However in the short term it means record breaking profits for corporations. It's pretty obvious to anyone who's watched the policies that corporations have pushed for the last 40 years exactly what choice they're going to make.
"The war on drugs is reducing the amount of labor available. If we follow the principles of supply and demand-- if Business Owners wants to pay employees less, then they want _more_ people to be available to work, and they also want those people to have lower cost of living."
If you suddenly have a lower cost of living you have increased your negotiating leverage. This often leads to higher wages.
Similarly, increasing people's desperation commensurately decreases their wages.
The war on drugs only reduces the labor pool by what... 2% max? The premium capital makes on labor is often 100% or more. The lost labor is worth it to them for the chilling effects.
Regarding conspiracies.... There's no conspiracy. Like I said, I think most business owners realize they are making money off their employees. They just don't benefit from paying people a fair wage because they don't have the infrastructure to capture the additional value created by a growing human being.
It makes sense when you think about it: The reason they are a capitalist and not labor is that they don't want to have to do repetitive work, or sometimes don't want to work at all. As your employees develop new skills and abilities, it takes work to restructure the business around them. It's repetitive. "Oh, another one of my tech support people wants to train to do product design. Great." Most capitalists find it easier to just structure the company to support one kind of labor and then try to prevent employees from growing out of it.
Due to information technology, we're getting close to being able to scalably restructure organizations around a group of people with continuously progressing skills, but it's a hard problem. Only a handful of companies (with great management) are able to do it by hand today.
So for now, labor is stuck in a low energy state, even though there is a stronger equilibrium at a higher, "fair" pay. Individual companies don't benefit from going against the norm, so there's a chicken and egg situation, which creates an opening for the afformebtioned disruptive technology.
This is the quote from your original post that I find odd:
> so they subconsciously collude in cultural movements which make work seem scarce, and life scary and chaotic.
I agree that business owners will offer someone lower wages, because the job they're providing is very stable. (i.e. my friend had a choice between being an assistant manager at a chain sandwich shop, or being a manager of a new restaurant in a different city. He's taken the low-risk option.)
I also agree that there are structures that exist that encourage the drug war to go on. The iron triangle between: Politicians passing drug laws and other harsh criminal laws, DAs who want perfect records, police & prison guards who want more overtime and toys, and the unions that represent police and prison guards and lobby for more laws.
It's the business owner -> drug war link that I find tenuous. I know several business owners, of multi-million dollar companies. They aren't consciously thinking like you say they are, they are simply thinking "who do I need to hire to get this job done".
Admittedly, maybe I need to be talking to the CEO of a company that primarily employs retail or blue-collar workers.
You also make the claim that it's subconscious, so I don't even know how to collect evidence in regards to that...
I don't think your theory is falsifiable. Because you're making conjecture about someone's subconscious, and about a small group, it's nearly impossible to prove or disprove.
What kind of evidence would you need to change your mind?
//edit and I have to give credit to the other replies--- the prison workforce is a great counter-example to why the drug war would be useful from an evil capitalist perspective. I feel embarrassed that I missed that :/
You're not the first person to observe this essential fact, but it just seems that it never percolates to policy makers and their gerrymandered voting blocs.
Say no to drugs but the governments' kept it
Running through our community, killing the unity
The war on drugs is a war on you and me
And yet, they say this is the Home of The Free
But if you ask me, it's all about hypocrisy...
I mean... people liked Tupac for a reason, flaws and all.
Huh? Are you talking about the opium wars where China was invaded by the British and forced to stop trying to combat their opium epidemic? I've never heard of an interpretation of events where China made opium illegal in an attempt to forestall invasion by Western powers.
"forced to stop trying to combat their opium epidemic" is a really euphemistic way of saying China banned opium inside their borders, so Britain invades China so Britain can sell opium to China.
It was a national security concern, insofar as smugglers bringing cocaine, heroin, and marijuana into the US via Mexico are a matter of national security for the US.
What's euphemistic about it? I used the same intensity words as your description (literally the same words, like "invaded") and mention a superset of the information (I asserted that the ban was primarily intended to combat their opium epidemic, as opposed to e.g. hurting British interests).
It's circular to bring up the US War on Drugs to support the argument that the opium wars were about national security, in response to a comment challenging whether the opium wars support the argument that the US War on Drugs is about national security. My whole point is that I'm skeptical of the case that either is about national security.
I've always been intrigued by this stance. Do you believe that heroin should be available for purchase, like e.g. cigarettes? Is this a matter of individual liberty, or some other reason?
Not the parent to your comment but I'll chime in here.
Heroin is more dangerous than cigarettes, since the threshold for overdose is so low. So, probably not a great thing to be able to buy at a gas station.
Personally, I think heroin should be available at pharmacies by prescription, cheaply purchasable in small quantities. Addicts should have to visit daily for their doses, and should get some support from doctors and pharmacists if they want to withdraw. Doctors should make it easy for addicts to get prescriptions for heroin, and clean, safe drug delivery options.
It's a matter of harm reduction. It would help reduce overdoses because dosages would be exact. It would help reduce organized crime, because the money would be diverted to legitimate channels and taxed.
These kinds of ideas are already being discussed in Vancouver, where black market fentanyl and carfentanil is causing a rash of fatal overdoses. While we have safe injection sites, addicts are still using black market drugs which are wildly unpredictable.
> It's a matter of harm reduction. It would help reduce overdoses because dosages would be exact. It would help reduce organized crime, because the money would be diverted to legitimate channels and taxed.
I strongly support this as well. Focusing on harm reduction with a stable slope to coming off the addiction. Criminalizing, as the parent poster said, is giving piles of money (power) to people who really, really, really shouldn't be getting it.
I don't "do drugs", and have never done them. The closest I've come is a bit too much to drink. I have no horse in making heroin legal. But I do have the horse race of not wanting to see addicts lined up on the street; not wanting homeless camps turned into drug distribution zones... we have significant problems in Seattle from meth/heroin, and it's time to change what isn't working.
The threshold for overdoses is fairly high in all opioids though lower for heroin than for morphine. The reason people regularly overdose on heroin is that heroin from the illegal market is often of wildly changing purity and sometimes mixed with substances that increase the risk of OD.
Handing out known quality heroin eliminates that risk.
The question is, to what extent is developed tolerance responsible for overdosing, and to what extent is it cheating dealers ? Medical literature at least seems to think that tolerance means overdose is inevitable, though yes, it can take years with careful control.
There is also the longer term side effects of the drug. The way those abused heroin addicts look, if you ignore most bruises (some are a consequence of withdrawal symptoms, wild involuntary movements, presumably not all though), is a medical condition.
The long-term health effects of the drug are probably comparable to the long-term effects of eating a diet of sugar water and cheeseburgers. Both are likely to end your life messily, and young, and neither are worth fighting a war over.
The threshold for overdose isn't really that low, and there is an easy and effective tool to reverse it (Narcan).
The real problem is impurity... people get used to stuff at a certain purity, and then are sold either a much purer batch or something laced with a strong synthetic opiod like Fentanyl.
>Addicts should have to visit daily for their doses, and should get some support from doctors and pharmacists if they want to withdraw.
This is a good sentiment, but I think it would be a disaster in practice. You already have pharmacists moralizing and deciding whether or not to sell birth control (still legal at least in multiple US states last I checked). I don't think it's going to go well to give them power of addicts as well. You need to be sending them to people like social workers, who are made the choice to help with recovery.
I don't think I'd vote for heroin to be legal, but I think we have to ask ourselves some questions: (1) is prohibition even effective? Spending on enforcement has grown steadily but the percentage of the population addicted has remained steady. Not clear that enforcement has any effect. (2) is criminal punishment more effective than mandatory / free treatment? Most of the evidence I've seen suggests otherwise.
I generally go for the person liberty argument, but heroin is a tough sell even to me because of how ridiculously addictive it is. But I see a lot of harm coming due to certain things being illegal, and a lot of harm coming from many of the things we prescribe because the alternatives have an irrational stigma. I've had some very passionate (i.e. rude) messages sent to me on Facebook because I support legalizing marijuana, and apparently this makes me equivalent to a serial child murderer because people might drive under the influence. Nevermind how bad drunk driving statistics are or how easy marijuana is to obtain anyway, or how some of these same people are on opiate pain killers 24/7
The other question is whether they kind of treatment we're using is effective. There isn't much evidence that 12-step programs really make any difference whatsoever.
You jest, but I wouldn't be surprised if leveraging and preserving the stigma has made it too difficult for even more people with non-violent drug arrests to find productive employment where prior usage otherwise wouldn't be an issue.
Decriminalization doesn't mean legalization. It just means that you don't make criminals out of drug users, and instead use the money that you would spend policing drug distribution (which doesn't work) on rehabilitation (which does).
If you don't police drug distribution, wouldn't gangs/drug dealers just take over the city? i.e. it would be safe to deal drugs since its not being policed, so the "bad guys" would all try to corner the local drug market leading to turf wars and such...
We don't police clothing distribution, and lots of people buy clothes, why haven't violent gangs selling clothing just taken over the city? Because they're outcompeted by law-abiding sellers who don't have all the overhead costs of evading the law, who use legal, nonviolent means to wage their turf wars.
As you point out in another comment, every jurisdiction that has decriminalized drug usage while keeping selling drugs illegal has continued to police drug distribution. I'm not OP, but suggesting we stop policing drug distribution implies to me that we're making drug distribution legal. Which is to say, making selling drugs legal. Just like alcohol, tobacco, and caffeine. I'm not saying I agree that's what we should do, but it's a defensible position to take, and seems to me like the obvious reading of OP's comment.
All drugs (weed, cocaine, heroin, amphetamines, etc.) should be as easy to buy as cigarettes are right now. Not for any ideological reason, just that it's going to suck a lot less than the status quo which creates black markets and throws addicts into prison.
You don't get to choose between having drugs and not having drugs. Everywhere in the world has drugs, you just get to choose whether you have an underground criminal black market that the state creates through its policies or not.
The whole decriminalization of consumption argument just moves the goalpost. You create the same problem The Netherlands has had with weeds for the past few decades, which is admittedly better than most of the rest of the world, but production remains and unregulated black market.
I strongly agree on your main point, although personally I feel it is also on issue of personal liberties.
Also, some studies suggest that the current arbitrary blanket ban has hindered possibly useful medical research related to some of the currently prohibited substances.
The whole theory of personal liberties collapses once you consider sufficiently powerful technology.
If there was a drug that gave the user unimaginable euphoria or was guaranteed to kill them with a 50/50 chance should we do everything in our power to stop that? Especially for the young and impressionable? Even as someone who thinks heroin should be legal that gives me pause.
Should knifes for personal use be legal to purchase? How about guns? How about artillery? Tanks? Nuclear weapons?
I don't know, but thinking about these issues in absolutes like "personal liberties" tends to bring you some bad places, just like any other absolute. I think it's more useful to think about the practical implications of our actions given existing data, which shows the current drug war clearly isn't working, but that doesn't mean we shouldn't ever have any sort of ban on substances purely intended for personal use for public health reasons.
We are not talking about all personal liberties. Lets stick to the topic of regulation of Psychoactive substances. You don't face problems of abuse and dependence on, say, guns or Tanks.
> If there was a drug that gave the user unimaginable euphoria or was guaranteed to kill them with a 50/50 chance should we do everything in our power to stop that? Especially for the young and impressionable?
We do have a system in place for controlling access to substances like Alcohol and Tobacco to minors.
> Do you believe that heroin should be available for purchase, like e.g. cigarettes? Is this a matter of individual liberty, or some other reason?
I'm not the OP, but I think so, precisely out of a concern for individual liberty.
There are also prudential concerns, e.g. that criminalisation actually results in worse outcomes for addicts, dealers & society. But even were that not the case, I'd be in favour of legalisation.
It's at most a trade-off (as in e.g. you like to have a drink every now and then, or during some activities, and you do so even though you understand that while doing so, you strengthen your mental models and a kind of addiction).
Few if any substances actually automatically mean throwing one's life in the gutter; the issue of substance abuse is much more complicated (with many external variables that have nothing to do with the substances themselves) – and it may not be relevant to the majority of the population at all.
There are other options - for example illegal selling and manufacturing (like now), legal using (so current addicts are not prosecuted for getting help).
It's interesting that the main reason you can think of is individual liberty. Is that, to you, the best reason cigarettes are available for purchase?
In my personal opinion, if it were possible to enact a law which would have the effect of ending cigarette usage in the US without any other unnecessary effects (cigarette company employees losing their jobs would be a necessary effect, of course; everyone dying because we nuked the world, on the other hand, would be an unnecessary effect), then I would be 100% in favor of enacting it.
Such a law is not physically possible. A law that says "no one shall smoke, buy, sell, or make cigarettes" would not end cigarette usage in the US and would have so many ancillary negative effects as to be worse than the current situation. We saw this with Prohibition, and we're seeing it right now with the War on Drugs.
---
It's also worth noting that there is plenty of underexplored middle ground between criminalization and being available at every corner store, such as:
- illegal but not criminal: minor fines for using, huge fines for selling
- suspension of privileges like driver's licenses
- you have to register on a list when you buy and be subject to social services checking up on you (list would obviously be at least as private as medical info, and you get expunged when you get clean)
- available with obstacles such as doctor's prescription, or over-the-counter but still only a subset of pharmacies
There is a middle ground, which is that you dont allow the free import of heroin into the country. Where you have uncut, known-quality heroin available as a tool to treat addicts going through withdrawal (or any other effective substitute), and where you (optionally) pursue only high level smugglers - people who are getting filthy rich peddling a deadly and addictive substance.
If we took even 1% of the total we spend prosecuting addicts and used it internationally, we could probably put a much more severe dent in supply. We already invaded Afghanistan, but in many cases helped the farmers instead of shut them down (this is a complex issue, opium is a much more valuable crop than food - but its a problem money can solve ). We could work with other countries to disincentivize coca production (again - the farmers that grow it can choose coca or bananas, guess which is worth more ?)
There are so many other ways to shut down the drug war, but the first place is to stop prosecuting people for possession.
The miserable war on drugs is the failure of the society to acknowledge that people have right to their own life and even thought we may not agree with their choices we must nevertheless support them to exercise their right.
Drugs destroy life ? They dont destroy it as much as spending 10 years in jail for having few gms of heroine.
The overall theme of politics these days is to create an "other" group and blame everything on that group. Demonise that group and take more power in hand to then hurt them to cover up the failures of the government doing basic things.
Muslims, illegal immigrants, Asians, China, Blacks, stoners, hippies, Rock musicians, top 1% etc.
Thus government gets to pretend that they are doing something for "us".
>The system is set up to create failure and re-offense, although I'm not arguing that it was designed that way...
It doesn't have to be. The system random walks through all sorts of configurations. All we need to end up like this is no incentive to fix these problems when they occur. In fact, we find a mild incentive to not fix it. In time, all of the poisonous sludge the system produces runs down and collects in these crevices.
What's most odious to us casual onlookers is that there are so many in the system that simply shrug at the human pain as they collect the spoils. "I'm just doing my job" is really no different than "I just did it for the money."
Yeah, but don't methadone maintenance programs work? If the requirements here were lessened, and the woman was prescribed methadone more quickly, wouldn't this article not have to exist?
I feel the problem is less about the "war on drugs" and more about the UK's failure to help her recover from her addiction.
The immediate cause, of not being able to get methadone after the court had ordered it, seems straightforward to fix. Whatever rule prevented the GP from prescribing it can be changed.
I had to wait 7 days to get on my Suboxone treatment. My parents got me codeine and valium from our GP to help me until that point, which amazed me at the time. 7 days is pretty short at least, and it saved my life. Other countries have months long waiting lists.
the NHS has a lot of problems dealing with health issues that aren't A&E-worthy. It's understaffed, the staff they do hire are overworked, and the whole organisation is simultaneously under-budgeted and over-stuffed with bureaucracy.
I can't help but think that since the 80s these systems have been deliberately rigged to fail, to give an excuse to privatize or introduce parallel for-profit options.
That seems a bit surreal. I sometimes read free-marketers who speculate that certain people are intentionally making the US Private healthcare system worse in an attempt to get socialized medicine. That's the first time I've read a suggestion that socialized healthcare was intentionally being made worse to push a private option.
I dunno, maybe healthcare is just hard to get right, whether run publicly or privately. Maybe we still know very little about how to treat and fix the human body, but rapid progress in other areas of technology and the numerous developments we have made in healthcare lead us to think otherwise.
If you read about the NHS it's honestly hard to think otherwise. But also forcing cuts by underfunding programs is something conservatives talk openly about wanting to do: https://en.wikipedia.org/wiki/Starve_the_beast
Well i base my claims on the observation that recent years have seen more and more administrative processes that have been introduced in an effort to emulate free market pressures on public health services.
This based on the idea that free markets are better at operating efficiently.
Thing is that the ultimate goal of any enterprise is wealth extraction.
The most direct such extraction is via racketeering.
But baring that the next best option is to offer a tangible product or service others are willing to pay for.
But note that the goal is not to offer good product or service, it is wealth extraction. Thus one will aim to offer the most minimal product or service one can get away with at the highest price.
So no, i don't think there is any reason why they should fear that the US system is being gamed to introduce public health services. It is being gamed to maximize wealth extraction by everyone involved.
On the other hand, ruining existing public health services to make private equivalent look good would directly lead to increased wealth extraction by those involved with the private health services.
> That's the first time I've read a suggestion that socialized healthcare was intentionally being made worse to push a private option.
It's actually not an uncommon opinion in the UK, at least among the people I know. In fact, Thatcher herself introduced much of the bureaucracy into the NHS in the form of the "internal market".
>That seems a bit surreal. I sometimes read free-marketers who speculate that certain people are intentionally making the US Private healthcare system worse in an attempt to get socialized medicine. That's the first time I've read a suggestion that socialized healthcare was intentionally being made worse to push a private option.
In the US they are literally doing this right now with the post office. In the UK they did it with the rail network.
It's a standard part of the privatization playbook.
I think another part of the problem is that we still don't know how to run large centralised organisations in a way that doesn't lead to continuous bureaucratic expansion.
Labour did not gut the NHS. Their policy on bringing the private sector into the NHS was probably a bad one - PPI was more expensive than direct public investment for hospital rebuilding but kept the costs off the national balance sheet, maintaining a helpful fiction.
But Labour significantly increased spending on the NHS, from 5% to 7% of GDP before the banking crisis (which with GDP falling saw spending rise in GDP terms by about another 1%.)
Since the Tories regained power they've been cutting back on NHS spending (and more dramatically on social care, which increases the demands on the NHS.) That's why we're seeing the horror stories once again of waiting lists and winter crises, which had last been common under the previous Tory administration in the early 1990's.
decreasing spending is not the only way to gut the NHS. Increased bureacratic oversight, unionisation of the labour force, realigning the focus and core competencies, increasing demand for consultants over doctors, you name it. The NHS was in a terrible place when David Cameron came into power, and granted it's gotten worse since, but making out that the conservatives are the only ones who have pushed the NHS to breaking is ridiculous and fallacious.
Labour could have done things better (far too many public sector reorganizations to which all governments seem prone) but things were really pretty awful in the NHS in 1997 with long waiting lists and crises every winter.
One of the things Labour has done pretty well in the past is to bloat out the government with bureaucracy and paper-pushers so they can point to the total number and say "employment increased" or "the NHS is expanding" while throttling the capability of the organisation to perform its function effectively. Part of the reason the NHS is in the situation it's in now is that the ratio of front-line medical workers to administrators and managers has shifted over time (https://www.kingsfund.org.uk/projects/general-election-2010/...). There's also the case of a number of IT projects that have been extremely expensive and/or have failed disastrously, and increases in regulatory burden under Labour.
Headcount is generally not a good metric to measure productivity or effectiveness as it's a number that politicians love to manipulate to for their respective ideologies (social welfare expansion for the left and budget restriction for the right).
The figures you link to show very little to no change in staffing proportions between 1999 and 2009. Professionally qualified clinical staff sum to 52% in both years, increasing exactly in line with total NHS employment.
It's still not enough - Britain spends maybe 2% GDP less on healthcare than other rich European countries. But at the end of Labour's time in power, there were 1/3rd more doctors and nurses employed by the NHS. The funding increase helped enormously.
Edit. But yes, the massive IT projects in the NHS were a hugely wasteful like all massive government IT projects. The approach of the Government Digital Service seems to be a huge improvement.
New Labour put in all the ground work, and the Conservatives ran with it.
Building lots of infrastructure under Public-Private-Partnerships - built up massive bills - brought in under the Conservatives, massively expanded under New Labour.
The internal market, a new Labour innovation, brought in massive inefficiencies, and private profits along the way.
The current government is battering a massively weakened system.
You can't say someone isn't Labour just because you personally disagree with their work. New Labour was still left-of-centre, even if it was closer than previous Labour institutions.
Left and right transcend economic class. The idea that the left is rooted in the working class is a complete fabrication.
Gordon Brown also harmed the NHS by the way. Considerably.
The whole thing of the "new" Democrats and "new" Labour is making a show of staking positions that are essentially a middle finger to their core constituencies.
I want to use this message thread to tell a story and make a point. If it is off-point, delete it, give it negative votes, whatever.
I had abdominal surgery. They had to remove 14cm of my
colon which was badly inflamed due to diverticulitis. When I woke up, I was so doped up that I felt no pain. I even danced a jig in my room.
That evening they hooked me up to a hydromorphone injector for the inevitable pain. Every 12 minutes or so, I could give myself a shot into my IV. Hydromorphone is about 100 times stronger than morphine, so the doses were in micrograms. I was allowed, like, 5 shots per hour, and the machine could get loaded with about 50 shots. I kept a record of the shots in my Iphone Notes. I tried to space them further than 12 minutes, but I only decreased the frequency by a few minutes. I liked those shots. They worked. The nursing staff encouraged me to use this. They could reload the machine, no trouble.
Now the thing about colon surgery is, your colon has to get working. Those opiate shots very effectively prevent this. I wanted to get out of that place. So the next night, I quit cold turkey. I was freezing cold, and the pain I felt was not just from the after effects of the surgery, I am pretty sure. It was fucking horrible.
Now the things is, I was addicted. I did succeed in quitting cold turkey. My colon still didn't work for a day, so I vomited almost a gallon of green bile over the edge of my gurney. It was so much, it lapped up against the walls. Then my colon worked, and I got to go home.
But I was addicted, and I am a recovering addict, from that one time. And every nurse I mention this to says, "Oh no, you weren't an addict." They even quote some bullshit criterion for addiction, which I've forgotten.
I haven't had any problems since, and if I have to take oral oxycodone, or hydrocodone, there have been no problems or instance of abuse.
For how many weeks were you on the medication? For how long were you in withdrawal? Heroin, hydromorphone, oxycodone, etc the withdrawal lasts 5-7 days. Were you in withdrawal for that long? I guess the point I'm trying to make is that most addicts are on much higher doses for much longer periods of time -- and the withdrawal is insane. Furthermore, there's a big difference between physical and psychological addiction. If there weren't, then everyone who takes prescribed pain meds for any length of time would be "an addict" because they'll experience a degree of withdrawal. If you identify as a drug addict, that's fine (though I certainly hope you aren't one!).
IV Hydromorphone is also, by the way, 5x stronger than IV morphine. Granted, that's a lot, but nowhere near 100x!
Personally speaking I was on hydromorphone (orally) for a shattered ankle, and just 72 hours of taking it (at 66% max dose) was enough. Dropping from 2 pills to 1 caused some withdrawal symptoms, and 1 to 0 definitely caused nausea and insomnia.
The surgeon nodded when he heard about this and said yep, that's expected. It's addictive over that short a timespan.
Your last sentence is correct, I made a mistake.
The rest of what you said kind of supplements my post.
One evening of self-medication was enough for to me, a formerly non-opiate addicted person, to experience extremely unpleasant withdrawal symptoms. In a person not particularly susceptible to addiction. Your eagerness to debate me about whether I was addicted mirrors the behavior of those nurses.
I confused you by making two points in one comment. The first was that you had a whiff of withdrawal, but only a whiff. Its disingenuous to compare yourself to the daughter in this article. The second was that physical addiction is very different from psychological addiction. Psychological addiction, for opiate addicts, is reinforced by physical withdrawal, not the other way around.
People like you who throw the word "addict" around willy-nilly like that have no idea what addiction truly means.
You got sick once and now you march around proclaiming "I was an addict", despite the opinions of nearly every medical professional you've discussed it with?
Get over yourself, man. You aren't as important as you clearly think you are...
I think addiction, like depression or war, can segment life into "before" and "after" periods. Before you experience it, you have valid and interesting ideas. After you go through it, however briefly, you become humbled and scared by how you can be controlled by an ugly force, even as you fight it with the most focused energy of your life. After that, the dictatorial "I have been sober for x" makes visceral sense, and you never ever think to suggest "just one to celebrate this special occasion?"
"It could never happen to me", and then it does. You find your siren, and often it's not even a drug.
I just want to add another story, albeit second hand. My wife went through surgery three times. The first times, pain relief (after the initial nerve block) was mainly via a Norspan patch. The patch was great except it took so long to ramp up (maybe they should have applied it 12-24 hours before the nerve block wore off). There was also no real withdrawal even after two weeks of patches.
The third time (for chest surgery) was via a fentanyl pump, but when that was removed she had severe stomach pains, and soon was in the routine of IV morphine once a day as the stomach pains came back like clockwork. She had the option of coming home but was too frightened of the pain and not having a nurse nearby to help immediately.
I could be wrong but it seemed to me the stomach pains were withdrawal from the painkillers. I'm glad they were effective for her pain but I wish there had been a better path that avoided all the nausea and sleepiness.
Opiate addiction is hell. Just pure unadulterated hell. I've been through a lot of hardships in life but I honestly can't begin to explain to you the amount of pain this has caused me. I'm currently in a methadone program after relapsing for the first time since I got clean five years ago. Just.. stay as far away from this stuff as you possibly can. It has the potential to swallow you whole.
It actually didn't start with a prescription.. For me it started as casual use here and there and very quickly turned into self-medication. I've had issues with depression and anxiety for a long time and opiates were a really easy way of dealing with those problems. However I can't tell you how many people I knew who started using after being prescribed opioid painkillers.
I've only ever had opioid painkillers after dental work, and it's enough to convince me that I must _never_ try heroin.
You have my kind thoughts and best wishes.
I never understood how people could be addicted to drugs until the middle of the night screaming in an emergency room bed. A kidney stone was causing so much pain morphine wouldn't touch it. Unbearable.
The nurse came in and put something in my IV and I just stopped. The pain stopped. I stopped talking to my wife in mid-sentence. Everything was fine. My world just stopped and I liked it.
As the nurse left my wife asked what I was given and it was dilaudid, which is equal to heroin on the equianalgesic scale.
It was right then I understood how people become addicted to drugs. Like you, it convinced me to never try heroin or any other opiates outside of emergency medical care.
Thanks, I really appreciate it! All things considered things are actually going really well. My relationship with my SO is better than ever, my career is going well, I'm actually starting a new job next week. I managed to keep my life together through all of this, and I know I'm very lucky for that.
I don't mean to diminish your experience... but "pure unadulterated hell" is having a SO that loves you, a stable place to live, sleep, and eat, as well as a stable career?
If all of that is what "pure, unadulterated hell" looks like to you, I think your life really hasn't been as difficult and full of "hardships" as you would have people believe...
I think the thing that would help you most would be to stop feeling like a victim. That's what helped me! Best of luck to you.
I'm not feeling like a victim, I'm extremely lucky and I know that. I admitted to that.. The unadulterated hell I was referring to is the excruciating pain that comes with opiate withdrawal...
To give you some further perspective here, I was sexually abused as a child. I would rather go through that 100 times before I would go through bad withdrawal again... Fuck off.
This reads like a laundry list of exactly what not to do when you find out your child is addicted to opiates. Everything they do, from being overly controlling to kicking her out and pressing charges against her, is a self-righteous act and harms her greatly. At one point, I thought I was reading a scene cut from Trainspotting for being too mundane. The naivety about the legal and health systems is also appalling. These are people who claim the ability to function in the world, yet they don't know the most basic things about the world they claim the ability to function in. I think towards the end, the mother actually starts to get a glimpse of the reality of what is going on with her daughter and is more compassionate by letting her live in their house again. I hope their daughter recovers and other parents heed this story as to what not to do to their sick children.
From person experience with a family member who had a severe case of alcoholism (and eventually died from it)... there's very little you can do to help somebody if they don't want to quit. After a while these behaviors start to negatively affect everyone else in the household, too.
(Also, keep in mind we're actually talking about an adult here... since they're old enough to join the military.)
The cardinal error in "helping" addicts is to try and fix the addict's problems for them. As you said, that's impossible. Even being available to provide support rarely makes any sense, because addicts try to divest themselves of their problems instead of solving them — so they might ask you for help on something they could do themselves, or on something they think you could fix but actually can't (e.g. "Can you keep an eye on how much I drink tonight?" This just pits my will against yours.)
Detoxing, preventing withdrawal symptoms, transportation — addicts often can't provide these things for themselves, so if asked, they're good ways to help out. But addicts have to choose themselves to stay on a path that leads away from that addiction. That will be the case even if that path ends up being as simple as a pill you can take.
"These are people who claim the ability to function in the world, yet they don't know the most basic things about the world they claim the ability to function in."
I have no idea where you see them 'claim to be able to function in the world'. They didn't make that claim, they are just people doing the best they can in the world. Yes, they clearly don't know how to deal with a drug addicted daughter, but we all have things that we don't know how to deal with. You might know how to deal with addiction, so you find it incredulous that these parents don't. I am sure, however, there is some situation that you don't know how to deal with, and there are certainly some people who would find it incredulous that you don't know how to deal with that part.
They're the ones who took her to court and were surprised when the authorities left her sick after she was convicted. What did they expect? Roses and an all expense paid trip to rehab? All they had to do was to be decent parents to her. There's no trick to dealing with addiction. Just don't be a shitty person to the people who are suffering. Don't kick out your own children when they need you most. The mother starts to realize this towards the end, but her actions towards her daughter are absolutely shitty and should not be excused.
> They didn't make that claim, they are just people doing the best they can in the world.
It's not enough.
The people here were trying to "do their best." In direct and immediately visible effect of their "best intentioned" actions, their daughter was harmed much worse than she would be had they known what to do.
There's a famous novella from the late 19th century where a village girl catches a cold. She's then packed into a bread furnace for some time, to make her "sweat the illness out," by her very own parents. The girl dies, of course, burned to death, the end.
The parents in TFA did exactly the same thing. They ended up not killing their daughter by sheer luck, but they still harmed her greatly. Do you really think they should be absolved of their fault because they "meant well?" Or is their fault any lesser just because they "didn't know?"
No. Sorry, but no. They could have known. They could have educated themselves. They could have used contraceptives in the first place. They could have prevented the tragedy, yet they didn't. It. Is. Their. Fault. Period.
However, the mother refuses to acknowledge even that much, to the very end. I have my opinion about such behavior, and it's not favorable one.
GPs should know about clonodine. It's a blood pressure medicine that counteracts the massive norepinephrine dump you experience when you kick (and which is the number one thing that makes it so unbearable). It helps a lot.
Besides methadone there's also buprenorphine and Suboxone, which are opiate replacements. Not the kind of thing you take to get high, something to use to taper off so the withdrawals aren't so intense.
Heroin abuse is a big problem that's only going to get bigger in the US. A lot of folks got addicted back when Purdue was pushing Oxycontin, and now that it's harder for them to obtain they've switched to the cheaper and more potent stuff.
Doctors need to know how to treat withdrawal, period. There are lots of options besides methadone (which has it's own nightmare withdrawal if stopped abruptly, and which lasts three times longer than heroin withdrawal).
"Heroin abuse is a big problem that's only going to get bigger in the US. With legal weed, a lot of former marijuana producers are getting wise and starting to farm the opium poppy. Plus a lot of folks got addicted back when Purdue was pushing Oxycontin, and now that it's harder for them to obtain they've switched to the cheaper and more potent stuff."
I'd really like to see some numbers on this.
From what I understand, there are far, far more marijuana users than there are heroin users -- like many orders of magnitude more. So, yeah, illegal marijuana growers could certainly switch to growing opium, but they're not going to magically get anywhere near the number of customers.
Well, there were more deaths by overdoses involving an opiod then deaths from car accidents in 2015, the last year a quick search can find more data on. And to be clear, deaths from car accidents are growing, likely because of things like cell phone use.
Here's a business insider article, and the data sources I used.
From these links, main number seems to be "Nearly 10 million Americans, or 4.1 percent of the adult population, used prescription opioid painkillers for nonmedical reasons in 2012-2013". Numbers I've seen for marijuana were about 11.5% in a year, though that was for 2001.
So certainly higher usage for marijuana, but definitely not "many orders of magnitude"
Basic economics. Your most profitable product line disappears to the tune of a few billion usd. Your next move is to push up the volume of your next profitable product line and increase the margins.
Doctors need to stop blindly following big pharma suggestions on prescriptions more like it.
Supposedly a pharmacorp released a painkiller a few years ago thats supposed to last longer pr dose than then existing ones.
but when patients complained that they didn't work, the corporate advice to doctors was to up the pr pill dosage rather than advice the patients to take the pills more often (as that would make a lie of their marketing claims).
In contrast [with Ibogaine], all other known SERT inhibitors are competitive with substrate (28). These competitive inhibitors include several compounds that also inhibit the closely related dopamine and norepinephrine transporters
Does someone with enough knowledge to actually understand this paper want to chime in and maybe explain? It seems well-written, but reliant upon knowing, what, say, SERT and DAT are.
I am not an expert, but since no one has answered I'll give what I know and hope somebody corrects me if I'm terribly wrong.
Substrate: the thing that's supposed to bind to something normally.
SERT: transporter that pulls serotonin out of synapses back into the neuron that put them there in the first place.
DAT: similar, but for dopamine and to some degree norepinephrine.
Competitive inhibition: inhibition depends on whether the intended substrate for a site is present—the drug and substrate interfere with each other competitively.
Non-competitive inhibition: the drug inhibits the function of a site even if the intended substrate is already bound to it.
As to how any of this explains or refutes claims ibogaine short-circuits withdrawal, I dunno. Feels a bit like trying to explain JavaScript in terms of quantum mechanics. Both these papers are evaluating the drug's interaction with neurons, not the drug's effect or non-effect on addiction.
ITYM Clonidine[1]. There's also Lofexidine[2] which is available on prescription in the UK, but seems largely unknown elsewhere. From personal experience (quitting long-term morphine treatment due to intolerable side effects), it was extremely helpful in moderating some of the physical withdrawal symptoms.
"GPs should know about clonodine. It's a blood pressure medicine that counteracts the massive norepinephrine dump you experience when you kick (and which is the number one thing that makes it so unbearable). It helps a lot."
Is that a labelled use? Because most physicians are restricted or prevented from prescribing drugs for "off label" use.
This is really sad. I got the impression while reading through that whole sorry story that the poor girl's parents really just don't see how they are a huge source of negativity and pain in their daughter's life. They kick her out of the house, sabotage her job, put conditions on their provision of love and support. These are terrible parents. I feel awful just reading about that whole situation.
Not to sound harsh, but have you dealt with someone who has a serious drug problem before?
When things get very bad, you try anything in the hope it gets though to them. (It often doesn't, but you try anyway.)
Keep in mind that major drug addictions cause problems for everyone involved. Nobody resorts to these things as their first option.
(And frankly, if one's job involves driving, and they're doing it while under the influence... they really should lose their job/license. That's how innocent people get killed on the road.)
> Our daughter at that point didn't feel it was a problem. She kept saying, "It's just fun, OK? It's just fun." And that would be interspersed with periods of depression and it not being fun, but her not being prepared to admit that. And as time went on we gave her an ultimatum. Looking back I don't know whether it was the right decision or not, but we said, "If you continue to use drugs, you can no longer live at home." And we kicked her out, because she continued.
Then her drug use got worse, and her friendship groups deteriorated more and more.
> I hated her. I hated her so much.
Am I really being harsh?
This is a mother writing about how she felt hatred towards her daughter. She hated her daughter for doing drugs and for socializing with the wrong people. As a result of her hatred she kicked her own daughter out of the home, which instigated a downward spiral that made things far worse than they might have been otherwise.
Here in the USA, you have to kick them out. If you don't, your house can be taken via civil asset forfeiture laws. Landlords also have to kick out renters. Kick them out ASAP or risk the loss of your property. You can't even let them loiter outside.
While I, uh, don't necessarily support the advice given by your parent comments ... this was literally the top result of a Google search for [a parent's house being seized because their child was arrested for drug possession]: http://www.cnn.com/2014/09/03/us/philadelphia-drug-bust-hous...
Choice quotation: "In 1988, Paul and Ruth Derbacher, a couple in their eighties, lost their Connecticut home after police raided their house and arrested their twenty-two year old grandson for selling drugs. Police found $50,000 worth of marijuana and cocaine in the house. The grandson was convicted of drug charges and sentenced to prison. The Derbachers were also charged with drug possession and were placed on probation. Prosecutors claimed the drugs were kept in plain view and that the Derbachers must have been aware of their grandson’s illicit activities. Although the Derbachers fought the seizure of their home, they ultimately reached a settlement agreement. The house was sold, and the couple split the proceeds of the sale with the government."
It may be "rare", but one doesn't normally take risks with a house. For most people, the financial loss alone would be devastating. There is also the matter of a house being a home, a familiar place to feel somewhat secure and to associate with memories.
Economics-wise, drug manufacturing can be the next-big-thing for the US economy. Sprinkle in some regulation and oversight for quality, and BAM we're good to go.
They teach you in school, drugs are bad. Don't do drugs. Just say no. At least where and when I went to school, they went out of their way, above and beyond to ensure this simple message was hammered into every single child.
The image of a drug addict in pop culture -- it's never a pleasant one. They lie, cheat, steal. They're a burden and a trial to their families.
People are warned about what happens when you get addicted to drugs. I simply fail to understand why so many people do drugs in the first place, and I have little sympathy for addicts.
The world is a dangerous place. If you drive your car off the side of a bridge, or you mix the wrong household chemicals, or you stay in a running vehicle in an enclosed garage, or you grab on to a downed powerline, you'll probably die. It's simple cause and effect, and for the most part people understand it and aren't stupid enough to do these things unless they're suicidal.
If you do drugs, you'll probably ruin your life. It's simple cause and effect. For the most part people understand it, but it seems that enormous hordes of people do them anyway. I don't get it, what's the difference?
> I simply fail to understand why so many people do drugs in the first place, and I have little sympathy for addicts.
Do you know one? If not, don't judge. Try to have sympathy. Try to be a decent empathetic human being and understand that people have different life circumstances than you, and the fact that they are addicts does not make them undeserving of sympathy.
> If you do drugs, you'll probably ruin your life. It's simple cause and effect.
Nope. Because you have the cause and effect backwards. More often than not, people doing these sorts of drugs already are in a tough spot in life. They do drugs BECAUSE their life is already in shambles or because they're already suffering from a mental illness. This is not to say that the drugs won't continue to cause people to spiral downwards (because they often will), but it is to say that the kind of person who chooses to inject a substance of unknown purity directly into their bloodstream is most likely NOT the kind of person who has their life together to begin with.
And I know plenty of people who do drugs and their lives are just fine. Because they're normal, well adjusted people who choose to do them because it's fun and _not_ to escape their problems, which is unfortunately the case for a lot of people who become addicts.
Do consider that, in many places in the U.S., anti-drug programs deliver the same ruinous message about all drugs, regardless of their actual dangerousness or potential to harm. When the children exposed to this rhetoric discover that drugs are not uniformly lethal - oftentimes through experimentation - this has the effect of undermining fundamentally the messaging they've heard (while also serving to discredit the person who warned them in the first place - often a police officer or other authority figure).
Have you considered the possibility that what they taught you in school isn't true?
Many people choose to do opiates on the advice of their doctor, to relieve pain from surgery and the like. Most do not ruin their lives.
Many people choose to become addicted to caffeine. Most do not ruin their lives.
Many people choose to use "soft" recreational drugs like alcohol, tobacco, and marijuana. Most do not ruin their lives.
Many people choose to use "hard" recreational drugs like cocaine, ecstasy, etc. I believe most, but definitely many, including many I personally know, do not ruin their lives.
It's not simple cause and effect. Many causes have to conspire to ruin someone's life. Drugs can contribute, but people can and do use them safely. Conversely, many people being abusing drugs because they're already at a low place in life, as other comments have pointed out.
Addressing those other problems and minimizing the harm contributed by drugs are how we solve the drug abuse problem. More of those school programs to convince people of something untrue won't.
We have an epidemic because people were told by pharmaceuticals and doctors that they were taking medicine, and that it was safe and unlikely to be habit forming. This wasn't true.
As to recreational drug use, I'll leave it to others to comment.
I was in severe depression, for more than 1 year, had a good job, a good relationship and threw it all.
Simply could not understand what was wrong with me.
I did never had any contact with drugs before. After a while , and some not necessarily-recreational-experiences, I could understand better a whole new spectrum of ideas.
This breaks the HN guidelines. If you have a substantive point, please make it thoughtfully; if you don't, please don't comment. Personal attacks will get your account banned.
I'm speaking from experience. Mexico's become a huge producer of tar. It also matters where you live - if you're on the east coast the H is completely different from what you see in the midwest or southwest.
The first time I read your post, I thought you meant that producers of legal marihuana were now getting into poppy seeds, hoping for further decriminalization.
Regarding the downvotes, I had to read your top level post three times to understand what you are getting at:
a) Mexican pot growers need a new line of business, now that it's legal to produce for the medical and recreational markets in many places in the US.
b) Therefore they are supplying heroin addicts in the US.
The first time I read what you wrote I got the impression you were saying cannabis is a gateway drug. I didn't understand you were talking about the effects of legalization on Mexican traffickers.
Have you had severe withdrawals? I've withdrawn cold turkey off of a $500/day heroin habit. It is the worst pain I have ever experienced. If I had a gun on me at the time, I am 100% sure that I would have killed my self. You have no idea what you're talking about
Except that there is a psychological component involved. The craving for another fix, I am told, can be incredibly intense, and the harshness of a reality you tried to escape from in the first place, does not really help.
From what I have read (all this is strictly second- to fourth-hand knowledge!), it is very hard to watch somebody you love (or just care about) go through this.
The system is set up to create failure and re-offense, although I'm not arguing that it was designed that way, the result is the same. All of this comes down to a single root cause which can be addressed: the "war on drugs". It's insane, it's wasteful, it's already going to have generations of negative impacts around the world. The sooner we stop it, the sooner we can start to heal the damage.