Posted on 11/01/2017 7:05:20 AM PDT by Kaslin
One painful aspect of the public debates over the opioid-addiction crisis is how much they mirror the arguments that arise from personal addiction crises. If you've ever had a loved one struggle with drugs -- in my case, my late brother, Josh -- the national exercise in guilt-driven blame-shifting and finger-pointing, combined with flights of sanctimony and ideological righteousness, has a familiar echo.
The difference between the public arguing and the personal agonizing is that, at the national level, we can afford our abstractions. When you have skin in the game, none of the easy answers seem all that easy.
For instance, "tough love" sounds great until you contemplate the possible real-world consequences. My father summarized the dilemma well. "Tough love" -- i.e., cutting off all support for my brother so he could hit rock bottom and then start over, had the best chance of success. It also had the best chance of failure, i.e., death.
There's also a lot of truth to "just say no," but once someone has already said "yes," it's tantamount to preaching "keep your horses in the barn" long after they've left.
But if there's one seemingly simple answer that has been fully discredited by the opioid crisis, it's that the solution lies in wholesale drug legalization.
In "Libertarianism: A Primer," David Boaz argues that "if drugs were produced by reputable firms, and sold in liquor stores, fewer people would die from overdoses and tainted drugs, and fewer people would be the victims of prohibition-related robberies, muggings and drive-by-shootings."
Maybe.
But you know what else would happen if we legalized heroin and opioids? More people would use heroin and opioids. And the more people who use such addictive drugs, the more addicts you get.
Think of the opioid crisis as the fruit of partial legalization. In the 1990s, for good reasons and bad, the medical profession, policymakers and the pharmaceutical industry made it much easier to obtain opioids in order to confront an alleged pain epidemic. Doctors prescribed more opioids, and government subsidies made them more affordable. Because they were prescribed by doctors and came in pill form, the stigma reserved for heroin didn't exist.
When you increase supply, lower costs and reduce stigma, you increase use. And guess what? Increased use equals more addicts.
A survey by the Washington Post and the Kaiser Family Foundation found that one-third of the people who were prescribed opioids for more than two months became addicted. A Centers for Disease Control study found that a very small number of people exposed to opioids are likely to become addicted after a single use.
The overdose crisis is largely driven by the fact that once addicted to legal opioids, people seek out illegal ones -- heroin, for example -- to fend off the agony of withdrawal once they can't get, or afford, any more pills. Last year, 64,000 Americans died from overdoses. Some 58,000 Americans died in the Vietnam War.
Experts rightly point out that a large share of opioid addiction stems not from prescribed use but from people selling the drugs secondhand on the black market, or from teenagers stealing them from their parents. That's important, but it doesn't help the argument for legalization. Because the point remains: When these drugs become more widely available, more people avail themselves of them. How would stacking heroin or OxyContin next to the Jim Beam lower the availability? Liquor companies advertise, a lot. Would we let, say, Pfizer run ads for their brand of heroin? At least it might cut down on the Viagra commercials.
I think it's probably true that legalization would reduce crime, insofar as some violent illegal drug dealers would be driven out of the business. I'm less sure that legalization would curtail crimes committed by addicts in order to feed their habits. As a rule, addiction is not conducive to sustained gainful employment, and addicts are just as capable of stealing and prostitution to pay for legal drugs as illegal ones.
The fundamental assumption behind legalization is that people are rational actors and can make their own decisions. As a general proposition, I believe that. But what people forget is that drug addiction makes people irrational. If you think more addicts are worth it in the name of freedom, fine. Just be prepared to accept that the costs of such freedom are felt very close to home.
Many of the illegal users are prescription drug users who lost their prescription.
Libertarians are the most stupid class of people to ever infest the earth.
More poison is NEVER good for a culture.
The libertarian “its no worse than” argument ignores all of the proven and observable effects.
It is unbelievable that some cite self-serving polls concluding “no increase in student use”.
Those situated close to High Schools in WA and CO have observed a huge increase in recent years.
It would be safer, cheaper and more effective to addicts as we treat the morbidly obese.
If an addict commits a crime, deal with the crime. That provides an opportunity to deal with the medical issue.
Addiction is just one of many human problems that solves itself over time.
Serious question:
Small bit of history: Decades ago, back when marijuana was illegal, a college student who wanted to buy some marijuana would not likely have had difficulty. You could approach people who “looked the part” and ask them if they could “help you out”. It just wasn’t difficult.
Modern scenario: I slip off a ladder and hurt my back. I go to my doctor. He prescribes Percocet (or whatever) and this addresses my back pain pretty well. But I get addicted. Where am I going to get my drugs? From my doctor? Not forever.
Maybe I’m just ignorant, but if I were to drive around my town “looking for a Percocet connection” I’d just never get anywhere. I would think that the average addicted person would just be forced to go “cold turkey” because you just can’t get the drugs. The average middle-class person may be susceptible to addiction, but I do not understand how the average middle-class person maintains a habit — except through a complicit medical profession.
What am I missing?
Unfortunately there are some problems just have no solution.
You're not going to get addicted from a single Rx. They'll give you, what, 30 pills? You might like it. You might want it. But you're not going to get addicted from that one prescription.
You'll start seeking additional prescription refills. When your doc starts balking at refills you'll start shopping other docs. Etc. Etc.
Worst case scenario: after you run out of legitimate/legal/quasi legal options, you look for illegal opiates. I suspect that's where much of our heroin use is coming from.
There was a period where doctors were required to treat pain as a symptom, and gave pain pills because of a legal obligation/liability. But now that the medical community has seen the affect of that philosophy, they're backtracking. But in the final analysis, the pain pill addict, by the time they become truly addicted, knows full well what they're doing, and it's up to them to stop. Nobody, and I mean nobody, has your best interests at heart more than you.
It's not the doctors fault, entirely. If you knew what they go through, what with belligerent, demanding, intimidating patients, you could see why many docs simply acquiesce. A sharp doc will require a drug screen on a new patient and, you'd be amazed at the cocktail of drugs they find.
Aren't they? I never really knew how ignorant they are until they flooded onto FR. And nothing brings them out like drug threads.
Actually, the only time I see them post is on drug threads. Maybe they're here just to make conservatives look bad?
Proponents of the drug war have that distinction.
You are missing the underground market. Drug culture will get them for you.
Well, my point is that the underground market is really not well known. Not by the addict in their initial stages. I think the medical community starts this problem and continues this problem. I think medical reform is the real solution. If the patient is so thoroughly addicted that they eventually end up seeking the underground market, then I would say that they’ve been out of control for awhile and their doctors have already screwed them up.
The classic approach in the Drug War is to chase the dealers more than the users. Busting someone for a joint doesn’t get you far. Catching someone with 100 pounds of weed is better.
Well, the opioid addicts are not the best targets. Getting the dealers out of the business is the better strategy. And the primary dealers are the doctors. They initiate the problem. The government needs to study that and find a way to change the medical community. All else is hand-wringing.
In a way, legal prescription opiates have become the gateway drug to street heroin.
Most people addicted to prescription drugs continue to obtain prescriptions to support their habit either by doctor hopping, unethical doctors who knowingly write scripts for non medical purposes or simply by forging prescriptions or buying black market drugs
Opiate abuse is a emerging form of medical insurance fraud
That’s not true. Only about 13% of opioid addicts were ever prescribed these drugs by their doctors. Opioids are effective at certain kinds of pain control, and people using them legitimately do not often become addicts.
The addicts started, many of them very young, through experimenting with drugs, encouraged by dealers, other users, and our entire culture, which glorifies drug use. (Surprisingly enough, Nancy Reagan’s “just say no” campaign was effective, and many people have suggested renewing a similar campaign but one that is more graphic, such as the campaign that successfully reduced smoking in this country.)
And drug users are not “sick” and only in need of more treatment. Studies have shown that the rate of recovery is only about 30% for those who go through programs, and more than 50% of drug addicts who recover do so entirely on their own. Only they can decide to stop using, but they need the encouragement of society to do so, not blathering about how drug use is their right, rap songs about the wonderful world of drug selling and use, TV and Hollywood personalities staying stoned all the time, etc.
Only about 13% of opioid addicts were ever prescribed these drugs by their doctors.
That's very interesting information and may change things for me. The media, in my opinion, has been making an effort to say the opposite. As I understand the official propaganda, almost all opioid addicts are innocent victims. Their doctor gives them drugs for an injury on the soccer field, or because of a workplace accident and the next thing you know, the sweet boy living next door is a raving drug fiend. Just an innocent victim of our society and Big Pharma.
If in fact this is not the standard path, then I think there is no strong argument for a sympathetic pro-Libertarian argument. It's a choice. People make bad choices. And bad choices have consequences. I guess using heroin in a back alley to see what it felt like may have seemed like a good idea at the time ...
Libertarianism shares one thing with communism in that they are both utopian dreams not realizable in a real world.
Communism has the "advantage" that it can be twisted into a tyrannical dictatorship that is at least good for those that end up at the top ... so long as they stay at the top.
So I guess libertarianism is silly in that if it ever did get established for a short bit of time, those that put it in place would be just as likely as everyone else to get screwed over once the government started grabbing back power.
The really silly thing about libertarianism is that anyone with a sufficient amount of intellect and stick-to--it-iveness (and a modicum of luck) could live a libertarian-like lifestyle so long as they didn't try and impose it on anyone else. If you are wealthy and discrete you can get away with a heckuva lot for a heckuva long time.
No, the solution is obvious, make pain meds that kill the pain but don’t get a person high.
I don’t know how to do that and apparently no one else does either but it’s the obvious solution.
Heroin addiction is another matter entirely. That’s a street drug.
You don't have to be wealthy. I wouldn't call my son in law a libertarian; but he is quite poor, but he manages just fine as he buys, fixes and sells cars for a living. He's never paid any income tax as he is off the grid. He owns some 8-10 cars at a time but they are open titles and so he pays no sales tax or registration fees. He'll buy a junker for a few hundred bucks, fix it, sell it, and clear a thousand or so.
He and my daughter are quite happy, so I'm happy for them. He's a poor "John Galt".
If everyone were forced to live under all of the current set of laws, taxes, and regulations then there would be a greater groundswell for less government.
However, so many people are able to sneak around in the gray market that the current system persists.
Where I live it used to be that everyone with a commercial van would plaster it with ads and phone numbers in order to solicit business as they drove around town. Now most of the vans are plain white with no markings. And I'm sure those that drive them will only take cash when they fix someone's plumbing or electricity.
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