People feeling left aside by society always find a way out, it's more of a systemic issue than an alcohol or drug one.
I guess having a for profit health industry trying to prescribe as much opioid as possible doesn't help.
As long as we keep putting the blame on individuals* and not on the system they live in we're doomed to fail. Putting tax on alcohol, war on drugs and banning beer sales on Sunday aren't going to fix any of the underlying problems.
* which is very easy and relieving, after all I don't have to do anything if that's just how people are.
Perhaps. It’s not a simple issue though. Thoroughly affluent kids get hooked. Affluent parents get hooked. Runaways get hooked, homeless get hooked. Working poor get hooked.
It’s more than “society sucks.” If it really sucked people would be escaping our borders going to Mexico and Canada in droves but it’s the opposite.
If a Mexican citizen is worse off on average than an American, why are Mexicans never the less less impacted by this kind of epidemic?
What do people in depressed areas of Japan do, do they fall for this, why or why not?
Being affluent or rich doesn't makes your life meaningful by itself.
Some very poor workers enjoy their craft and are 100% fulfilled by it, some very rich celebrities lost themselves in their money and fame. I tend to think that having a community has more importance than money in that regard.
People survived in the past by working 12+ hours a day 7 days a week, but they had strong family bond (someone sick wouldn't get paid, no welfare, no pension, &c ..).
If anything (too much) money enables you to go down the rabbit hole and amplify your vices.
That some poor guys are trying to get to your country doesn't mean much, this can be said about most countries in the world these days in some way or the other. Its not easy, and often even feasible for people to move their life, probably forever, half around the world. I claim from my experience that most americans have no clue how life is different compared to say some western europe country. You can't grasp it from internet, nor few days tourist visit.
And another claim - if they knew, and moving would be painless easy cheap weekend effort, you would see much of US population move out someplace better, mainly those with lower incomes.
Its really THAT different. Less pressure for monetary success and pressures in general, much less crime, system generally helps you much more when you hit the bottom, healthcare is a topic on its own and so on. US used to be great place although never easy. Then it got OK. Now, if I would be moving, I would consider every single continent, including Antarctica as new home rather than US. And I am stating this as a person who in every country I lived so far belonged in say top 5% earners in population, and I would be a very much OK in US too.
(1) The prevalence of drug overdose deaths and opioid prescriptions has risen unevenly across the county, with rural areas more heavily affected. Specific geographic areas, such as Appalachia, parts of the West and the Midwest, and New England, have seen higher prevalence than other areas.
(2) Poverty, unemployment rates, and the employment-to-population ratio are highly correlated with the prevalence of prescription opioids and with substance use measures. On average, counties with worse economic prospects are more likely to have higher rates of opioid prescriptions, opioid-related hospitalizations, and drug overdose deaths.
(3) Some high-poverty regions of the country were relatively isolated from the opioid epidemic, as shown by our substance use measures, as of 2016.
Still as 3 can attest and as you said, it isn’t simple.
* It’s not a simple issue though. Thoroughly affluent kids get hooked. Affluent parents get hooked.*
Didn't some affluent, highly educated guys go to Syria to join terrorists? Anyone can feel left out, ignored - even the wealthy and educated people. Maybe the breakdown of family structures, not having good friendships/relationships, loneliness contribute to these problems? People long to be a part of something- when that doesn't happen, they numb themselves with drugs, join criminal gangs etc.
This is not something that can be fixed by passing some laws or demonizing the affected people, it requires a more empathetic approach than use of force or law.
I think it’s something very much societal. In Japan or China, Vietnam, etc., drug use is almost always seen in a negative light. It’s not about sowing wild oats, having forbidden fun, an outlet for hardship, etc. They’re always denigrated in all media, in society, in school, in music, films, at work, etc. It’s never any kind of cool in any way. It’s shunned ostracized outlawed and unaccepted. Does that map well to our society? I’m afraid not much. We’ll have to find another way out.
Well, politicians and American media tend to sell Mexico as a 3rd-world hellhole (which it isn’t) and Canada as a socialist utopia with death panels and high taxes (which it isn’t). So people find another escape while feeling helpless.
This assumes helplessness is a main cause, if it were, why aren’t helpless people in other places equally affected, say Japan, India, Zimbabwe, Costa Rica, etc?
I agree that alcohol taxes aren't enough on their own, but their effect is likely very large and positive. This meta-analysis found that doubling the alcohol tax would reduce alcohol related mortality by 35% which is an incredibly high metric in the public health world.
In other words, by effectively prohibiting (legal access to) alcohol to the poor you can save them from their freedoms.
This is a disturbing way to think about people. The state should not be in the business of saving people from themselves, least of all with a deeply regressive tax.
>>The state should not be in the business of saving people from themselves
What should the state be in the business of exactly? It's in the business of defending people from other people. You could frame it as "saving people from themselves" or you could justifiably frame it as "saving people from companies seeking to poison them".
Also, the state has account for these people in the form of emergency care and treatment when they kill themselves (and often times others on their way out). These people are unfairly burdening the tax base when they decide to kill themselves in a spectacular flaming car crash, so why doesn't it make sense for the state to protect the interests of the group as a whole?
Yes. Literally that. You can't advertise cigarettes on TV. You can't even have a business bank account if you run a medical marijuana dispensary. But somehow you can advertise alcohol on network television during prime time.
Alcohol related deaths are the 3rd highest preventable form of death in the US. It's great that you can responsibly enjoy an IPA with your friends. Pretending it's only fun and good times on the larger scale is naive at best.
> Alcohol related deaths are the 3rd highest preventable form of death in the US.
It is not your right to choose what others do with their life. When it's abortion, some people are all "her body, her choice!", and when it's alcohol or cigarettes, it's "her body, our choice!".
Why do you think the sanctity of somebody's own life is yours to weigh against the risks of alcoholism or a tobacco habit, or a taste for soda?
And if they want to do that, they can. Nobody is removing your ability to drink. You're taxing it more heavily because this specific choice results in societal problems that everyone else has to clean up. You'll notice I'm not calling for a ban on alcohol sales. You still have the right to buy it. But it's being priced in a way that reflects the extra burden you put on the rest of us with your choices. This hypothetical tax is meant to represent my desire not to have to deal with the consequences of your choices.
> And if they want to do that, they can. Nobody is removing your ability to drink. You're taxing it more heavily because this specific choice results in societal problems that everyone else has to clean up.
Apply the same argument to healthcare. The main difference is that you think that you have the right to tell people what's good for them.
> This hypothetical tax is meant to represent my desire not to have to deal with the consequences of your choices.
If a man and his son crack a couple beers by the fire in Wyoming, why should their private activities be any of your business? Why impose your will more on the poor than on the middle class or the rich? Your desires are not relevant to the right of ordinary Americans to buy and sell alcohol to and from the willing, just as they are irrelevant to the right of a single mother to raise her own son, or for teenagers to get pregnant; it's just none of your business what people do once you've said your piece, no matter what you think of the risk that they might tend to be more likely to behave in a way you dislike.
> The state should not be in the business of saving people from themselves
Then who should ?
You can blame everything on individuals: "they're lazy", "they're dumb", "they didn't work as hard as I did", "they could save themselves", that's very easy to do, and reassuring in a way. But that's also a very bleak view on our social organization.
Or you can admit that we're all infinitely small parts of a gigantic machinery, that we're all mutually responsible for the system we live in, and that some of the issues raised here are direct consequences of "the state" and its policies.
Just like some people are born in good conditions, probably a majority of hn readers are, a lot of people are not. You don't have to care, you don't have to help them, but at least don't criticize people trying to better society.
Even if you don't care about people and just think in numbers, getting these people out of misery/addiction is a net positive for society on purely a monetary perspective.
> You can blame everything on individuals: "they're lazy", "they're dumb", "they didn't work as hard as I did", "they could save themselves", that's very easy to do, and reassuring in a way. But that's also a very bleak view on our social organization.
I think the lazy people are those who think they should attempt to fix social ills by levying regressive taxes, rather than doing the actual work of convincing and helping people to do better.
> Or you can admit that we're all infinitely small parts of a gigantic machinery, that we're all mutually responsible for the system we live in, and that some of the issues raised here are direct consequences of "the state" and its policies.
But you are not responsible for, nor entitled to, deciding what people do to themselves in private. When a lone free man hurts himself, no injustice is carried out in the act.
> Just like some people are born in good conditions, probably a majority of hn readers are, a lot of people are not. You don't have to care, you don't have to help them, but at least don't criticize people trying to better society.
You can try to better society all you want, but do it without worsening the part of society where people drink responsibly but live on a budget. Minimum pricing punishes all people who buy alcohol for the perceived benefit of those who are presumed to be prone to abusing it, that is why it is unjust. If you just want to better society, work with your local chapter of alcoholics anonymous. If you're just going to sign off on the minimum pricing laws and feel morally righteous about it (because you have no skin in the game), then surely you are the one who is failing morally; the compulsion to "do something, anything!" about each perceived societal ill does not make you a good person.
> Even if you don't care about people and just think in numbers, getting these people out of misery/addiction is a net positive for society on purely a monetary perspective.
I think the whole thing is an exercise in not caring about people and just thinking in numbers. It is not your right to go around imposing your vision of the moral duties one owes to oneself.
The moral wrong of imposing a regressive tax on your personal pet peeves is long lasting, and indicates a lack of commitment to principle. Society does not benefit, on the whole, from standing in favour of an endless stream of petty tyrannies.
Your compulsion to control other people's alcohol consumption by fiat is purely selfish, no matter what you tell yourself, and no matter what word games you choose to impugn the character of those who don't agree.
People with substance misuse disorders have huge impacts on other people - often spouses and children - so the state has a role to play in protecting those people from violence.
Minimum unit pricing is a good way to do this, especially if the money raised is hypothecated for alcohol treatment programmes.
> People with substance misuse disorders have huge impacts on other people - often spouses and children - so the state has a role to play in protecting those people from violence.
What about forcible vaccination? Forcible quarantine? This issue hits close to home, but I still don't see how it is better to prohibit lawful access to alcohol to the poor than it is to support CPS in their overlapping duties.
> Minimum unit pricing is a good way to do this, especially if the money raised is hypothecated for alcohol treatment programmes.
Why do middle class alcoholics get to risk abusing their families more readily than poor alcoholics?
Added:
We have (33.5%, per capita [similar difference in median]) lower household disposable incomes in Canada, and very high minimum unit prices. In 2015, the rate of death due to conditions entirely caused by alcohol was around 8.6 per 100,000; about 150% the rate of death in motor vehicle accidents. It's hard to compare the stats between the two countries since the U.S. tends to track "alcohol-related deaths", whereas Canada tends to track "hospitalization due to conditions entirely caused by alcohol" and "death due to conditions entirely caused by alcohol". The National Hospital Discharge Survey indicated in 2010 that approximately 390,000 hospital discharge episodes for persons ages 15 and older had an alcohol-related principal diagnosis, so assuming the worst, one person per discharge, an annual rate of ~126 per 100,000 2010 census persons; in 2015 there were ~77,000 hospitalizations entirely caused by alcohol (a stricter subset, I think), assuming again one person per hospitalization, an annual rate of ~214 per 100,000 estimated Canadians.
I do not think it is settled that particularly high unit prices will reduce rates of death and hospitalization; and as far as I'm aware, we don't have the comparable numbers between the U.S. and Canada (let alone the U.S. and the world at large relative to minimum unit prices), let alone finer grained jurisdictional comparisons, to draw any conclusions like that.
And all of this notwithstanding, I think it is unamerican (as a dual citizen of Canada and the U.S.) to tell free adult people what personal risks they are not entitled to, especially in the form of a regressive price fixing scheme, and I think this is not a proper or appropriate solution to alcohol-related domestic violence.
How do beer sales and alcohol taxes have anything to do with the other things you mentioned? Sunday sales laws have been in effect for 3-4 generations it’s just a way for politicians to get the conservative Christian vote.
Alcohol taxes are a valuable source of revenue for cities. The area I’m moving to is trying to incorporate. The alcohol taxes and restaurant permits will directly fund police, fire, and sanitation. It will allow us to improve services without relying on the county.
I think you're missing the point. OP is just saying that contrary to some politicians they aren't realy relevant to this issue, as you say as well, not necessarily that they are bad things as such.
There are so many issues with the US health industry that it's hard to pin point which one is the worst. It's almost an example of what shouldn't be done.
For profit isn't an issue per say, but when you add greedy executives in the mix you're in for a disaster. Look at insulin or other basic necessities, companies clearly put profit over people. I don't think that would fly in any other first world country.
Again, other first world countries don't let the health industry get away with highly fractionized buyers which are powerless against service providers.
There are probably many factors, but there seems to be too little negotiating power on the demand side, even with the bigger insurances. And I assume the bigger buyers are getting better prices, right? Are those buyers bigger by the number of insured members or just according to expense volume?
Again, mostly the government should tell the industry to knock it off, mainly by empowering the demand side rather than the supply side.
I guess having a for profit health industry trying to prescribe as much opioid as possible doesn't help.
As long as we keep putting the blame on individuals* and not on the system they live in we're doomed to fail. Putting tax on alcohol, war on drugs and banning beer sales on Sunday aren't going to fix any of the underlying problems.
* which is very easy and relieving, after all I don't have to do anything if that's just how people are.