Great article. I would like to further suggest we end the use of the word "war" in contexts that do not involve mandatory conscription and the deaths of large numbers of combatants until one side totally surrenders. (This implies there is a "side" to be able to surrender.) Politicians have so destroyed the word "war" that it's impossible to have a reasonable discussion about any use of violence by the state. Perhaps that was the goal. Don't know.
Drug use is a health-related issue, whether it is a doctor prescribing medications, a patient taking meds off-label, a person self-medicating, an addict, or some kind experimentation. All of these situations are much more personal health concerns than public safety concerns. Yes, addiction is a terrible tragedy and sometimes danger for the rest of us -- but it's a personal disaster a long time before it affects any of us. I'd argue that in the aggregate most addicts suffer a lot more personally than any damage they inflict on society.
We have a caricatured view of the drug addict -- the unwashed, illiterate, toothless junkie hiding out in a crack house. Yes, addiction ends up that way for some, but by and large addicts are middle-class, educated, and live in houses with their friends or families. Hollywood and moralists have done us a great disservice by putting these horrible outlier pictures in people's heads when they think of drug use. Take for instance the word "addict", which like the word "war" is such a broad term that it doesn't have much meaning on it's own without further clarification. One side wants you to believe that all drug use consists of PhDs smoking pot while talking astronomy. The other side wants you to believe that all drug use ends in addiction and death. People need to stop with the histrionics.
I support legalization, although I am extremely cautious personally when it comes to drug use. I might support criminalization of dealing hard drugs. I'd have to think about it a bit. But declaring "war" on our own population is a pretty idiotic way to spend our social resources if you ask me. Just like the "war on poverty," the "war on illiteracy," the "war on obesity," and the "culture war," enough with the wars already.
> Drug use is a health-related issue, whether it is a doctor prescribing medications, a patient taking meds off-label, a person self-medicating, an addict, or some kind experimentation
> We have a caricatured view of the drug addict -- the unwashed, illiterate, toothless junkie hiding out in a crack house. Yes, addiction ends up that way for some, but by and large addicts are middle-class, educated, and live in houses with their friends or families
Excellent points. If there were just two things I wish everyone in the world (or at least in the US) would understand, it's this:
1. The drugs that you are prescribed and the drugs people consume recreationally are not fundamentally different. In fact, in many cases, they're essentially interchangeable from a chemical perspective (Adderall/Desoxyn/Methamphetamine/"Speed" are a great example; Marijuana/Marinol is a partial example too). The prescription vs. "everything else" divide is almost arbitrary. If someone told you that they were prescribed diacetylmorphine for chronic pain, what would you say? What would you say if they took heroin for pain?
2. The stereotypes of 'drug addicts' and 'drug users' are grossly inaccurate. Yes, some people who use heroin/meth/coke/etc. fall into the respective stereotypes. But many don't - you just don't know it, because they're the ones who manage to maintain normal lives. Look up diactylmorphine (heroin) maintenance programs in Switzerland and the UK, and you'll see that many people who used to fit the stereotypes of the homeless sex-working heroin addict are able to maintain steady 'normal' jobs if they are given regular access to heroin of a consistent quality/potency and with no adulterants (this requirement is key!)
In the UK, there was a 'Nice People Use Drugs' campaign, which was aimed at exactly that - demonstrating to people that the stereotypical drug users are just more visible; the invisible majority of people who use or have used drugs have no lasting/debiltating/noticeable problems (if any at all). Everybody knows people who use drugs of some sort; they just don't always know that those people use drugs. (And sometimes, they're not the ones you'd expect!)
> Adderall/Desoxyn/Methamphetamine/"Speed" are a great example
Small clarification: Adderall isn't methamphetamine, it's amphetamine. When discussing street drugs, for some value of safe, it is a considerably safer substance.
(Real, lab-made methamphetamine, even abused, is naturally much less bad for you than the typical battery acid sold on the street, too.)
I should have been clearer - I was just trying to be concise to prove a point. And I'm making the assumption that we're comparing drugs of high quality in either category (because obviously drugs that are mixed with adulterants are going to have other problems). You seem to understand what's going on, but for anybody else who's curious:
Adderall isn't methamphetamine. However, the methyl group doesn't change the way that the drug affects the brain; it just makes the drug cross the blood-brain barrier more easily. The increased bioavailability means that less of the drug (by weight) is needed to achieve the same result, but the drug isn't activating any different receptors or having a substantially different neurological effect in any other way or for any other reason. Subjectively, there may appear to be a difference for that reason (more efficient access to the brain), but the same pathways are being accessed - just to a greater degree.
An analogous and more familiar (but not identical) example would be Vyvanse and Adderall. The actual metabolic process is different from the example above, but in essence, about 50% of Vyvanse is lost when converting from a form which has no effect on the brain to a form which does. Once it's converted, it's chemically equivalent to Adderall. That's part of why Adderall XR is prescribed in doses about half the weight of Vyvanse.
[Nitpick: Yes, this isn't a perfect analogy; pharmacology is complicated! Vyvanse contains a single enantiomer of a single amphetamine; Adderall contains two enantiomers each of two amphetamines, but if you know that, you probably already know everything else I'm clarifying here anyway. The reason Vyvanse has reportedly lower side-effects is because it lacks the less effective l-enantiomer, not because the amphetamine is otherwise radically different.]
Maybe I should have been a bit clearer, but my point was that Adderall (legally prescribed amphetamine), Desoxyn (legally prescribed methamphetamine), [street] methamphetamine, and [street] amphetamines ('speed') are pharmacokinetically different because of the way that they are taken, the mode of ingestion, and the set & setting, not because of the active ingredient itself. In general, people don't seem to understand that difference, and for that matter, neither do our laws.
[Disclaimer: Everything I've said above is 'false' in the sense that it is an oversimplification, but this is HN, not a discussion board on pharmacology, so I'm sacrificing some precision in favor of accessibility/simplicity and (attempted) conciseness.]
While unrelated to the science, I am a previous user of Adderall XR and then Vyvanse and I want to share some advice on the subject for any hackers out there using these drugs or thinking about them:
It's crazy, it makes you operate on a different level, and I feel bad for anyone in a competitive college or learning situation that isn't using it: it's just unfair. But is cheating at being smart unethical? Oh, nootropics.
However, for hackers, for developers, for designers: it's not what you need. I've written code and spent months in photoshop on and off of those drugs, and that stuff will not put you in the mindset you need to be a great hacker. Highly productive for hours on end? Sure! But it tends to tunnel your vision and cause you to waste time on details.
My work is always better, hands down, off that stuff. That's because the intensity they brought were fantastic for my grueling science degree, but terrible for creating great apps. Nothing beats 8 hours of sleep, healthy diet and exercise for developing good software. Nothing.
If you're going to use it, in my experience, Vyvanse was 100X better than Addy. Addy felt like it crammed energy and focus down your throat and you were a passenger on the productivity express. Vyvanse, I felt, allowed me to be calm when I wanted to be calm, and focused and energetic when I wanted that. I could sleep and eat on it fine. Also, keep your dose small, increasing it is a slippery slope, you will build tolerance, and quitting might take effort. Best not to start.
Hacking and code need a non sedating opiate/opioid. Hydrocodone to start, maybe hydromorphone, then into oxycodone and oxymorphone. Stay away fro the morphines, diacetylmorphine, as they are too sedating. The others give you focus and drive.
Just wanted to offer a second opinion. I too went from Adderall to Vyvanse; I still take the latter. It doesn't give me tunnel vision, and it helps me focus where sleep/diet/exercise did not. So don't rule it out or go for it based on our anecdotal experience. If your psychiatrist thinks it's a good idea, try it and see how it interacts with your individual brain chemistry!
Thanks for your explanation. I know I like knowing /how/ drugs / medical treatments actually work, and I think many of the people on here also appreciate this.
Doctors, in the US at least, are a bit less than helpful when you ask about this kind of stuff, and I've had more than one actually act offended when asked about how/why what they're prescribing works. I know that in IT, if a client asks us how something works, I'm more than happy to explain, or at least point them in the right direction and link them to some documentation and/or how-to articles. With doctors, I typically get more of a "it just does" / "it's complicated and you wouldn't understand" / [very technical explanation, not even trying to make it make sense to laypersons].
It's a rare doctor that really knows -- in many cases, nobody really knows.
For example: How do SSRIs work? Statistically, they do "work," for certain values of work. We know that they result in more serotonin in the synapse. But we also know that that's not the reason they work, because that happens immediately but it usually takes a few weeks for the drug to actually work. Evidently they work by inducing some kind of structural change, but nobody knows what.. Nor do we need to know what to know that they're good drugs to prescribe in certain circumstances.
Meanwhile, many people want "reassurance" to be part of the product that they receive when they go to the doctor. If your doctor said, "these pill seem to sort of go with your symptoms in the massive table I have painstakingly memorized, nobody really knows what they do, try eating them", she would be providing a strictly worse product in many people's eyes than if she said "You have condition X. It happened because of Y. Take these pills and you'll be all right."
The curious will get labeled as doctor shoppers, then you will get nothing but an entry in their database. It's crazy, they treat the stats not the patient.
Vyvanse needs to go through the gut to be converted to its active form, which means that injecting it or crushing it and snorting it does nothing. This is intended to prevent abuse, but it does nothing extra for the user.
I'd add as a third point, that among people who've used a relatively broad range of legal and illegal substances, alcohol and tobacco are widely considered two of the most disgusting, damaging, abuse-prone substances known to man
> The drugs that you are prescribed and the drugs people consume recreationally are not fundamentally different.
That is not true.
> In fact, in many cases, they're essentially interchangeable from a chemical perspective
This is true.
In a sane society, both would be true. But they are not. The "war on drugs" is not an innocent mistake. It is calculated and it is doing precisely what it was designed to do.
Its purpose it to line the pockets of the politicians who support it.
By prosecuting drug dealers and users, you bring the cost of using illegals drugs up. Significantly. In other words, you make illegal drugs less competitive vs legal drugs. This allows the pharmaceutical companies to maintain or increase prices for legal drugs. The additional funds the pharmaceutical companies get, they do not get to keep. They funnel that into the regulatory apparatus and more importantly, into the campaigns of the very politicians who support the system.
Maybe. I think that you're at least partially right, but I also think it has a lot to do with the Christian values that affect our laws way more than they should (see also: abortion laws in USA.)
>Its purpose it to line the pockets of the politicians who support it.
I would say that it's more for the large pharmaceutical companies. Politicians are cheap these days, and the profits from the "war on drugs" are orders of magnitude larger than the money given to politicians to support it. The ATT/T-Mo merger "only" had $9 million in lobbying support -- an order of magnitude less than they stand/stood to lose if the deal fell through REF: http://www.electronista.com/articles/11/12/09/attmay.have.tr... .
I think both of you are on the right track but may be mistaken regarding who stands to profit the most from continued prohibition.
Both local law enforcement and the for-profit companies behind our jails profit enormously from the US having the highest percentage of population incarcerated of any first world country. The majority of individuals currently doing time are in for drug-related crimes.
You are right. There are indeed various entities whose advocacy of their own self-interests and belief systems tends to promote the traditional failed American drug policy. Drug makers, religious zealots, etc... even individuals, small businesses, and schools (such as, say, those located where aggressive or even thuggish levels of law enforcement make that particular place safer on a local, short-term basis).
For-profit prisons, however, are the most direct beneficiaries of the (completely fucking insane) "war on drugs". For-profit prisons are one of the best examples of how an otherwise fairly functional democratic society can end up with a system of profoundly deranged incentives that visits grievous harm upon a staggering number of people.
These institutions conduct a program of systematic, industrialized dehumanization of millions of people -- including millions of people who have never harmed another person. In my view, this makes them evil, profoundly evil.
Although this sounds extreme to some people (especially those who have never paused to think it through), I put America's industrial prisons in the same league with the Nazi extermination camps. America doesn't actually starve people to death or gas them in ovens, but that's a matter of degrees. America does separate children from parents and force nonviolent human beings to live out their lives as caged animals. Millions and millions and millions of them.
There is not much about America so disgusting and disgraceful.
What you suggest not to call a "war" has killed thousands of people in countries like Mexico and Colombia[1]. Is this what you mean when you say "deaths of large numbers of combatants"?
I come from a country that suffers this "war on drugs", I've had members of my family kidnapped, I've seen people being assassinated in front of me by hit-men. Some others haven't been that lucky.
What he is saying is in support of your point. Those gangs are actually at war. They're fighting over money and control, directly enlisting soldiers and killing each other. Calling a prohibition "The War on Drugs" is a new speak tactic that not only takes the public eye off of real problems, but also waters down the impact the word WAR has.
This produces 2 less that awesome situations:
It is because of the prohibition called "The War on Drugs" that a real war fueled by drug money is out of control.
Because of the over use of the word, it's now harder to distinguish between what is a war and what is not a war.
TLDR: You can't have a war on a concept. It logically and literally makes no sense.
The US has been waging what can pretty validly be called a war on drug lords in Latin America for a few decades. After the fall of the USSR, that's basically what our military bases in Latin America do. Generally I agree with macuenca; claiming that it's a war on an abstract principle trivializes the very real combat between US-backed authorities and local drug lords.
This is exactly what I'm talking about. Humans fighting humans. That is a war. The War on Drugs also includes locking up 16 year olds for smoking pot in their own houses. Calling the general concept of drug control and prohibition a war generates this very confusion.
"claiming that it's a war on an abstract principle trivializes the very real combat"
Claiming those 16 year olds are part of the war is what trivializes it. Theres bloodshed in Latin America? Oh well that's just part of the war on drugs. Got caught with an ounce on you at a party? Oh thats just part of the war on drugs.
> I come from a country that suffers this "war on drugs"
I don't think anyone's disputing the toll the “war on drugs” is exacting – often outside the US, as is typically the case with these things. The problem is the idiotic approach to a problem, declaring it a “war”.
It may be held a truism, but it bears repeating that the violence in Mexico and South America is caused by drugs being illegal. Prohibition benefits three parties: criminals (especially organized, like the cartels), makers of non-prohibited drugs, and those making profit on jailing people, selling weapons and so on.
(I'm sure that many of the criminals would find other illicit activities to engage in, but I doubt they'd escalate to the level the cartel warfare has.)
Well-armed criminal groups and government forces can have a war. I don't think anyone disputes that. But you can't go to war against a concept (i.e. drug use).
I would like to further suggest we end the use of the word "war" in contexts that do not involve mandatory conscription and the deaths of large numbers of combatants until one side totally surrenders.
It's really interesting to me in what way his statement is actually true, as you say, just not in the way that it is sold (he is right on that part - declaring "war" on anything from Iraq to Christmas is in itself an issue that can create dangerous narratives). As you've said, the way it is conducted in the US, it certainly does involve large numbers of deaths - if the drug-related deaths (due to criminalization) within the US don't convince you, the Mexican border or even further south paint a clear picture. Furthermore, the only option that is offered is indeed total surrender - the stated goal of The War On Drugs being to end illegal drug trade, preferably to end illegal drug use, completely.
The problem, via Wikipedia, is: >>ONDCP's view is that "drug addiction is a disease that can be successfully prevented and treated... making drugs more available will make it harder to keep our communities healthy and safe."(2011)<<
Illegal drugs equal addiction equal disease. Increasing availability increases addiction, reducing safety (think of the children!), meaning the only option is criminalizing any sort of availability. If that is the narrative you are selling, you have indeed polarized the debate enough to warrant a war. The problem is that it really just isn't true. The US has created this war - it is a fight they picked.
Today, the economics of prohibition have tipped off the scale and laid power in the hands of people that really shouldn't have any. The reality of criminalization has simply created a large number of criminals (rocketing the percentage of US citizens in prison from 0.2 to 0.8), it has not served to scare people from using drugs, it has actually been an example of the same-old "hide it, to make it more interesting".
But again, the real issue is that the War On Drugs completely misunderstands the actual reality: Drug addicts are people primarily having a problem, not causing problems. Drug Users can range from people enjoying a glass of wine to the Hollywood "crack house zombies". That is a sliding scale of regular folks to folks with some military grade issues. Rubber-stamping the majority of them as criminals is simple, costly and foolish. What they don't get is that you shouldn't punish people for having a problem. You should help them. That is what Portugal got right.
The problem is understood backwards and then it is "solved" backwards again. That such a thing can happen in a country that already got a pretty definitive statement on the counter-productivity of prohibition is incredibly ironic.
Drugs use and addiction are mental health issues. People who use drugs often have other problems. Maybe not serious problems, but, who doesn't have some problems that can't get better with some "talking it out"?
How many of us have had a beer or smoked a bowl of marijuana to "chill out" after the stress of work? It's normal to self-medicate in this modern world. We have to work at jobs, and then we take a chemical that used to be a religous sacrament, and use it to get a little numb and giddy.
People who can't handle life in a modern society... some of them become the drug addicts, who self-medicate to create a curtain between themselves and the world.
Correct - there are problems in this world that cannot be solved with force and guns, quite the opposite. The US is learning that in various ways these days.
I would like to further suggest we end the use of the word "war" in contexts that do not involve mandatory conscription and the deaths of large numbers of combatants until one side totally surrenders.
I'd like to upvote condemnation of misuse of the word war too, however note real war frequently does not involve mandatory conscription, deaths of large numbers of combatants, or one side totally surrendering.
If you are engaged in a mass bombing of civilians and military targets or committing ground forces to combative action for a period of longer than a week or two, that is a war, not a "police action" or other euphemism meant to get around (American) Constitutional requirements.
Yes. I posted to this thread https://news.ycombinator.com/item?id=2158522 outlining some of the unfortunate history of war and militarism changing the face of what was originally a more libertarian (small L) form of government in the U.S. If I were to expand that comment I would add the role Wilsonian Internationalism played in making War a good thing, if not a moral obligation. War becomes a euphemism for any given social engineering project (war on poverty, war on cancer, war on obesity, war on drugs).
> Drug use is a health-related issue, whether it is a doctor prescribing medications, a patient taking meds off-label, a person self-medicating, an addict, or some kind experimentation. All of these situations are much more personal health concerns than public safety concerns.
Not so fast. "We" have decided that obesity is a public health issue that warrants all manner of intrusions.
> I would like to further suggest we end the use of the word "war" in contexts that do not involve mandatory conscription and the deaths of large numbers of combatants until one side totally surrenders.
This is totally orthogonal to your main point, but by this definition the recent conflicts in Iraq and Afghanistan would not qualify as wars.
The 'War on Drugs' in the USA is simply a way for the government to heavily arm the police in order to enforce the Police State that it is itself becoming.
The government know that the war can never be won, but that isn't actually the point of the war.
Drug use is a health-related issue, whether it is a doctor prescribing medications, a patient taking meds off-label, a person self-medicating, an addict, or some kind experimentation. All of these situations are much more personal health concerns than public safety concerns. Yes, addiction is a terrible tragedy and sometimes danger for the rest of us -- but it's a personal disaster a long time before it affects any of us. I'd argue that in the aggregate most addicts suffer a lot more personally than any damage they inflict on society.
We have a caricatured view of the drug addict -- the unwashed, illiterate, toothless junkie hiding out in a crack house. Yes, addiction ends up that way for some, but by and large addicts are middle-class, educated, and live in houses with their friends or families. Hollywood and moralists have done us a great disservice by putting these horrible outlier pictures in people's heads when they think of drug use. Take for instance the word "addict", which like the word "war" is such a broad term that it doesn't have much meaning on it's own without further clarification. One side wants you to believe that all drug use consists of PhDs smoking pot while talking astronomy. The other side wants you to believe that all drug use ends in addiction and death. People need to stop with the histrionics.
I support legalization, although I am extremely cautious personally when it comes to drug use. I might support criminalization of dealing hard drugs. I'd have to think about it a bit. But declaring "war" on our own population is a pretty idiotic way to spend our social resources if you ask me. Just like the "war on poverty," the "war on illiteracy," the "war on obesity," and the "culture war," enough with the wars already.