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Practising drugs safely?
September 8, 2008 10:43 PM   Subscribe

Towards a culture of responsible drug use - an essay by the creators of Erowid [via]
posted by daksya (53 comments total) 19 users marked this as a favorite

 
This is an honest question: Do we have evidence than heroin and methamphetamine, when used for a prolonged period of time, can ever happen responsibly? I do not mean methamphetamine derivatives, I mean the pure stuff. And it has been my impression that prolonged exposure to opiate painkillers will inevitably lead to dependency.

I understand their defense of mushrooms, LSD, marijuana, drugs that do not (to my knowledge) develop physical dependencies. I understand the defense of alcohol, a drug that can develop physical dependencies, but requires prolonged and excessive usage that most people will never pursue.

But it is my impression that heroin and meth are basically a one-way ticket to addiction, and are not something you really use recreationally after the first or second experience. And that the people who do become addicted to such drugs are addicted so powerfully it is nigh-impossible to treat. I think the quote I read is that meth sobriety isn't so much sobriety as waiting for a relapse. I mean, shit, if it's illegal in the Netherlands, don't you think that is saying something?

OK, maybe I'm full of D.A.R.E.-induced madness. I will fully admit I am not going to be the most knowledgeable person about all the specific medical effects of every psychoactive out there. But I think that some consideration should be given to the idea that though total prohibition is a bad idea, perhaps its opposite, total legalization is not so great either.
posted by schroedinger at 11:11 PM on September 8, 2008 [2 favorites]


Methamphetamine ( Desoxyn ) an amphetamine used to treat narcolepsy and attention-deficit-disorder in children. In some cases but rare this drug is used to treat depression. This drug is from a family of drugs known as central nervous system stimulants.
posted by telstar at 11:32 PM on September 8, 2008


Do we have evidence than heroin and methamphetamine, when used for a prolonged period of time, can ever happen responsibly

Yes, I've personally known several people who could use either responsibly, over an extended period time.

It is rare, though. And I won't touch either, because I think they are dangerous, and I know myself.

But I also know I'm not everyone.
posted by flaterik at 11:34 PM on September 8, 2008 [3 favorites]


schroedinger, heroin is the prototypical evil drug, and the one historically subject to the most propaganda.

I maintain an annotated index of studies here.

Some of them:


Evidence for controlled heroin use? Low levels of negative health and social outcomes among non-treatment heroin users in Glasgow (Scotland)
Occasional and controlled heroin use: Not a problem?
Characteristics of heroin and cocaine users unknown to treatment agencies. Results from the Swiss Hidden Population Study
A comparison of 'visible' and 'invisible' users of amphetamine, cocaine and heroin: two distinct populations?


There seems to be this general belief that "hard drugs" are different in kind from alcohol and other drugs. Often, they are different in degree. There are a few drugs used in certain ways which make them very risky, but on the whole, it's a matter of degree.
posted by daksya at 11:40 PM on September 8, 2008 [2 favorites]


Another nugget is that drugs aren't magical, and just like pharmaceuticals, don't affect everyone the same. Heroin, for instance, produces dysphoria in some and no significant effect in others, besides those for whom it produces euphoria.
posted by daksya at 11:45 PM on September 8, 2008 [1 favorite]


But it is my impression that heroin and meth are basically a one-way ticket to addiction, and are not something you really use recreationally after the first or second experience.

The thing is, the only people who really show up are the people who do have dependency issues. I seem to recall reading a paper on cocaine use which divided users into four categories:

1. Occasional users. These people use cocaine occasionally. They never develop a tolerance or dependence.

2. Periodic users. These people use cocaine for a while. They sometimes develop tolerance and dependence, but experience few problems in quitting. They drift in and out of use.

3. Stable users. These people use cocaine habitually, but their use doesn't escalate so they remain at a given dose. They don't tend to resort to crime to fund their habit, but may have trouble stopping if their supply disappears. If they do get off the drug they may relapse.

4. Problem users. These people use cocaine habitually. Their use escalates and they are unable to maintain their habit. They often resort to crime to fund their habit and often experience difficulty in quitting the drug and frequently relapse.

Only type 4 users and some type 3 users ever come into contact with the legal or medical systems. Type 1, 2 and some proportion of type 3 are essentially invisible: People without problems don't make it into the statistics, they don't go to rehab and usually don't end up in court. The media rarely sees them.

Nicotine is very addictive and is often reported as being as or more addictive than heroin. You can see similar patterns of users there. There's (1) people who smoke socially; (2) people who go through phases of smoking and quitting; (3) smokers; and (4) people who keep smoking when they have serious smoking-related health problems.

You might also find the rat park experiment interesting. It's far from conclusive, but it suggests that addiction may be closely linked to social deprivation. That is, people with opportunities for rewarding life-choices may find it much easier to get off drugs and stay off them than people who live in miserable conditions. Or, possibly that problematic drug use makes a lot more sense when things suck anyway. The study's fairly controversial, though, so it's worth reading in detail so you can come to your own conclusions.
posted by xchmp at 11:49 PM on September 8, 2008 [9 favorites]


There seems to be this general belief that "hard drugs" are different in kind from alcohol and other drugs. Often, they are different in degree.

OK, personally, I'd include alcohol in any list of 'hard drugs', but I don't think this is strictly true. In the past, the traditional determinant that distinguished the two categories was 'does this drug produce physical dependence'. If it did, it fell into the hard list, if not, it fell into the soft list.

These days, the categories are more fluid. Cocaine -- and particularly crack cocaine, doesn't have the physical dependence thing, but the pharmacological properties of crack, when smoked, tend to rapidly result in such compulsive and self destructive behaviour that it quite reasonably gets categorized as a 'hard drug' despite the absence of any physical dependence.

On to the article: in my younger days, I've written and published similar articles on exactly this subject. Today though, I tend to think they were nonsense. Today, my feeling is that people who aren't predisposed to have a problem with drugs won't will do so, and those who *are* just aren't able -- or have no desire -- to control their use. There's something *really* arrogant about the supposition that all it takes to change culture, psychology and neuroscience is a quick article telling people what they need to do to make it right.

And while there are obviously some people who control their heroin and/or crack use, my experience of this group is that they are extremely small in number. Some proportion of them are still at the early stages of their drug using careers and will go on to develop problems and possibly full blown dependency, but there is a tiny number who continues to use on an occasional basis -- usually no more often than a couple of times a year -- for very protracted periods.

But it's an extremely risky business. You don't *really* know whether you're prone to dependence until it actually happens to you, and when it does, the consequences can be pretty dire. Better to avoid that risk completely, IMO.

One of the organisations that I've worked for in the past, Lifeline, have very simple and easy to follow advice for minimizing the risks associated with drug use. They go like this:

- Don't inject
- Don't do heroin
- Don't take crack cocaine.

Straightforward advice, easy to follow, and not dependent on wooly, highly unlikely stuff like 'monitor your dose and its effects carefully, and then only do heroin every second thursday on months that have an 'r' in them'.

Anyone know how to access the responses to the article by Sullum, Kleinman, etc.?
posted by PeterMcDermott at 12:06 AM on September 9, 2008 [4 favorites]


telstar, drugs provided for medical usage, dispensed under the eye of a doctor who is presumably able to gauge appropriate dosage and properly weigh the risks and benefits of such usage, is hardly a good analogy for the behavior of a consumer on an open drug market (or an indicator of the quality and purity of the drug on such a market).

Also, daksya, the whole "degree" thing is exactly what worries me. If 5%, or even 10%, of the population is capable, for whatever physiological, psychological, or social reason, of handling a drug properly, but for the other 90-95% of the population it can produce devastating effects, is it really a good idea to completely legalize that drug? You talk about "invisible" populations--what proportion does the "invisible" population represent of the total population?

Furthermore, I think it is also worth examining the behavior of someone on one drug or another when it is seriously abused. I am pretty sure that a dude seriously addicted to crack is significantly more dangerous than a three-pack-a-day smoker. So, we as a society have to ask ourselves, are the benefits of legalization worth the risk of maximizing the number of severe abusers? For example, examine the number of alcohol-related crimes and fatalities that happen in the United States. We as a society have decided the benefits of legalization and the number of people who can responsibly use alcohol outweigh the damage caused by those who can't. I am not so sure we could draw those conclusions about meth, heroin, and crack were they to be of widespread usage.

Certainly, addiction can be affected by method of delivery and social surroundings. Are we going to regulate then how the drugs are delivered? Say, you can smoke heroin, but not inject it? How are you going to keep track of that sort of thing? Compare again to alcohol, who basically has one socially acceptable method of delivery. Does this sort of thing really exist with crack, heroin, and meth, where the least addictive method of delivery is the one considered to be most socially acceptable?

My point is, you are introducing a lot of variables that indicate that these particular drugs are not necessarily a one-way ticket to addiction--but not that the benefits of legalization to the responsible users outweigh the risks provided by the irresponsible ones.

(Also, I don't know how I feel about studies that rely on "invisible" drug users self-reporting on their drug use--isn't it obvious that if you haven't sought treatment that you don't think there is a problem with your usage? But does that really mean your usage isn't an issue?)
posted by schroedinger at 12:17 AM on September 9, 2008


Once again we find online an insightful, well-referenced, nuanced article that offers practical solutions to a current political problem. BAN THEM BAN THEM NOW.
posted by leibniz at 12:36 AM on September 9, 2008 [1 favorite]


schroedinger: If 5%, or even 10%, of the population is capable, for whatever physiological, psychological, or social reason, of handling a drug properly, but for the other 90-95% of the population it can produce devastating effects, is it really a good idea to completely legalize that drug?

As I said, some drug-use methods are very risky. Your hypothetical (90% are devastated), is unheard of, among common street drugs, and seems like a strawman. It's the other way around. There may be some yet undiscovered drug that is that insidious, but I don't know of one.

We as a society have decided the benefits of legalization and the number of people who can responsibly use alcohol outweigh the damage caused by those who can't.

Bullshit. When was this "decision" made? I didn't get the invite. Most policy isn't formed that way, only presented rhetorically as such, post facto. Society is a heterogeneous, multitudinous entity, and barring rhetorically, don't make "decisions".

Does this sort of thing really exist with crack, heroin, and meth, where the least addictive method of delivery is the one considered to be most socially acceptable?

Read the linked article, especially the part about factors determining when users modulate their risk. Prohibition doesn't engender the needed attitudes. The preferred delivery methods and forms in the market today are shaped by prohibition, and tend towards the more potent. Look at the trends in the relative consumption of spirits and beers in the US during and after Prohibition.

My point is, you are introducing a lot of variables that indicate that these particular drugs are not necessarily a one-way ticket to addiction--but not that...

I was only responding to your point about certain drugs being one-way tickets

I don't know how I feel about studies that rely on "invisible" drug users self-reporting on their drug use--isn't it obvious that if you haven't sought treatment that you don't think there is a problem with your usage? But does that really mean your usage isn't an issue?

Substitute drugs & usage above with gays in the context of a society of fundamentalists or music / listening in a medieval society of Islamists or sexual indecency in a society of prudish mores. Society has already passed judgement on drugs, represented by prison for most activities related to them. Both, those who have problems and those who don't, have good incentives to not be noticed. Remove the penalties and stigma, and you'll have "visible" users to study. Of course, that won't happen until drugs are legalized, which won't happen till there are studies that are conducted on monitored "visible" users. Catch-22.
posted by daksya at 12:57 AM on September 9, 2008 [3 favorites]


I was only responding to your point about certain drugs being one-way tickets

Right, and after reading your evidence I agree with you. My argument is that even if they aren't automatically addictive that still does not mean they don't pose a significant risk if legalized.

Substitute drugs & usage above with gays in the context of a society of fundamentalists or music / listening in a medieval society of Islamists or sexual indecency in a society of prudish mores.

Now who's using straw men? Homosexuality, listening to music, and sexual indecency aren't addictive. The problem with using potential addicts to judge whether or not their behavior is addictive is that addicts tend to be the last ones to acknowledge their own addiction.
posted by schroedinger at 1:10 AM on September 9, 2008


If 5%, or even 10%, of the population is capable, for whatever physiological, psychological, or social reason, of handling a drug properly, but for the other 90-95% of the population it can produce devastating effects, is it really a good idea to completely legalize that drug?

I think the arguments for legalisation are somewhat (though not completely) independent of the potential harm associated with a drug. In any case prohibition tends to confound studies of drug use, which makes estimating harm difficult (For example, it's hard to tell what proportion of users would choose less harmful patterns of consumption if their drug was much cheaper.) But drugs aren't banned because they're harmful (plenty of drugs are added to the schedules before any evidence of harm is found; here in the UK the list of banned drugs includes a number of substances that have never been produced anywhere). Drugs are banned because drug-use is decadent.

Also, I don't know how I feel about studies that rely on "invisible" drug users self-reporting on their drug use--isn't it obvious that if you haven't sought treatment that you don't think there is a problem with your usage? But does that really mean your usage isn't an issue?

That's a bit of a circular argument isn't it? Invisible drug users are those whose use is, by definition, not recorded by any official body. You can judge for yourself how much you want to trust the methodology of the Robson and Bruce study - here's a pdf of the full article from MAPS.
posted by xchmp at 1:16 AM on September 9, 2008


Dreams based on the ideal of a government accepting reality and choosing to establish an infrastructure capable of integrating support, safety, and legal distribution:

If there could be prescription and anti-prescription based on health, state of mind, and pre-disposition, responsible consumption/application of psychoactives would be more likely.

I think that approach could go far in making an initial sort of people, substances, amounts, duration, et cetera. It wouldn't solve for all cases, though, because there are some people who just want to do what they want to do, damn the consequences. For those folks, laws should remain on the books for those who abuse the system and end up doing harm. If they don't do any harm, then they get treatment, instead.

Age limits, taxes, tolerance tests, safe places to procure/consume/experience...it's just waiting to be called into existence.

Entire industries could spring up, jobs for those who never believed themselves capable of having one are suddenly available, a new source of revenue would flow, so much crime and pain would be ameliorated, bad guys would have to find some other thing to ruin, real research on usage impact could be done...

...I know, some asshole would come along and try to game the system. I also know that there would be a sizable amount of the population against all of this who would act like Pro-Lifers at a Planned Parenthood ribbon-cutting: angry, horrified, and perhaps armed. And, like I said above, there'd be folks who would take that inch for a mile-long ride.

But, gods, I think it would be so much better than what we have now. We've proven every other approach doesn't work. The problems just get worse, the situation more entrenched, the victims more pathetic, the evil-doers more evil.
posted by batmonkey at 1:17 AM on September 9, 2008 [2 favorites]


My argument is that even if they aren't automatically addictive that still does not mean they don't pose a significant risk if legalized.

True. But it does not automatically mean the opposite either. You need to have some qualitative knowledge of drugs & drug use behavior, which most of the population does not. You, for instance, until my links, believed that heroin was a one-way ticket. Were you part of the "decision" to allow alcohol and ban heroin?

Homosexuality, listening to music, and sexual indecency aren't addictive. The problem with using potential addicts to judge whether or not their behavior is addictive is that addicts tend to be the last ones to acknowledge their own addiction.

You have missed the point. Society says X is bad, and those who do X will deny X is bad. The result of the conjunction of those beliefs is that if a user says X is bad, he's seen the light, and if a user says X isn't bad, then that user is in denial. Having already decided that users of X are non compos mentis, the prohibitionist attitude has only one place for users.
posted by daksya at 1:46 AM on September 9, 2008 [3 favorites]


I am wondering how much of this conversation is being curtailed by prohibition, because those people who have real experience (not chipping) have subsequently moved on to other things like marriage and kids and careers.
posted by Samuel Farrow at 2:43 AM on September 9, 2008


Not sure that I understand your point, Samuel Farrow. Most of the people that I know who are actively using drugs like heroin and crack have more important things to spend their money on than a computer and an internet connection. It's precisely those people who *have* moved on (or have never been there to begin with) who dominate the conversation.

FWIW, I'm currently engaged as the policy officer for a national advocacy organisation that services people who are currently in or were recently receiving drug treatment in the UK. The bulk of my work involves consulting with people who have problems with their drug use, and acting as a liasion between them and the various arms of the UK government in an attempt to get as much of this stuff right as we possibly can.
posted by PeterMcDermott at 3:24 AM on September 9, 2008


I don't know the answer here. The argument isn't really "can they be used safely" but "what is the economic impact of legalization". Addiction is costly, treatment is costly... bottom line, can we afford it? I don't know. I don't think we even have the numbers we need to do the math. I do think we need to stop pretending that this is a moral issue one way or the other and focus on the public health and economic impact aspects of this area of liberty.
posted by ewkpates at 4:20 AM on September 9, 2008 [1 favorite]


But it is my impression that heroin and meth are basically a one-way ticket to addiction, and are not something you really use recreationally after the first or second experience.

Unfortunately, yes you're a victim of anti-drug propaganda.
posted by dydecker at 4:51 AM on September 9, 2008


You don't *really* know whether you're prone to dependence until it actually happens to you

It's simply not the case that there are certain people who are prone to addiction and others who are not. This misunderstanding of addiction is rooted in "the myth of personal failure" promulgated by AA, addiction-is-a-disease, and other religious types.

Dependence is caused by the drug itself, not failings in people's character or genetics. Which is very good news for "addicts": all they need to do to stop the addiction is stop taking the drug.
posted by dydecker at 4:57 AM on September 9, 2008


The argument isn't really "can they be used safely" but "what is the economic impact of legalization".

Fun fact time! The cost of the war on drugs in the USA, using the government's own figures, is around the same of Germany's entire military budget (about $45bn). So if the costs of legalisation are less than the costs of running the sixth most expensive military in the world, well, you're probably on to a winner.

Those figures don't, of course, factor in the additional costs imposed by prohibition (for example, the lost tax revenue from the sales of currently-illegal drugs and other things the consumer's money could be spent on if the artificially high cost of drugs was reduced). If you start doing that, then you get up to serious money.
posted by xchmp at 5:26 AM on September 9, 2008



A bit dated, but still one of the best reads concerning drug use


Short version: criminalization of drugs nearly always makes matters worse. Any sound drug policy should take this into consideration before compounding the problem with black markets and criminal records. Most of the detrimental effects of drug use is more a reflection of failed policies than the ill effects of drugs themselves.
posted by quintessencesluglord at 5:37 AM on September 9, 2008 [2 favorites]


It is amusing that everyone includes alcohol in such discussions, and no one, even on Metafilter, has mentioned either caffeine or sugar (whether the white powder or that nasty HFCS crap).

Legalize drugs? What?! You think the people are mature and responsible enough to handle such things? Maybe in some countries, maybe not in the USA. I think the American people really need the government to supervise their lives, for their own good. They've grown entirely dependant on such supervision. Take that away and who knows what might happen! Think of the children!
posted by Goofyy at 6:20 AM on September 9, 2008


xchmp beat me to it. I also wonder, not seeing the figures xchmp refers to, if the "War on Drugs" includes the costs of incarceration and enforcement at all levels. Or the costs of the allied organized crime, including the social costs. The Unites States seems to have this cops and robbers attitude towards things that it never grew out of during it's childhood. We'd rather create a whole avenue for the criminal element (see: Prohibition), and spend money locking them up, than to treat some addicts. We also tend to approach most of our policy with the blunt object method, rather than with a reasoned approach.
posted by Eekacat at 6:34 AM on September 9, 2008


Legalize heroin? Why we haven't even solved the epidemic that is gin!
posted by electroboy at 6:56 AM on September 9, 2008


Dependence is caused by the drug itself, not failings in people's character or genetics. Which is very good news for "addicts": all they need to do to stop the addiction is stop taking the drug.

I'm fairly prolegalization, but your argument is a bit glib. My experiences using opiates under supervised conditions for medium-term pain management suggests that it really is (or can be, if you want to be pedantic) difficult to "stop taking the drug". The advantage to that situation is that your source is going to limit you (leaving aside perfectly valid complaints about the difficulty of getting adequate treatment of serious and chronic pain); in a recreational setting, that's not as likely.
posted by spaceman_spiff at 7:37 AM on September 9, 2008


it really is (or can be, if you want to be pedantic) difficult to "stop taking the drug".

My point is simply that the reason people find it is difficult to stop taking drugs is because the drug itself causes the dependency, both the down as well as the up, not because people have "an addictive personality" or "they are are addict/alcoholic" etc. You simply stop taking the drug, any drug, and given time the cravings for it pass. This is as true for herion & methampetamine as it is cigarettes, alcohol, etc (although the time difference is longer in the case of the former)
posted by dydecker at 7:49 AM on September 9, 2008


So a drug addicted prostitute who self-reports using drugs at first to escape haunting memories of childhood sexual abuse, and who subsequently experienced further physical and sexual abuse as a routine part of her job as a prostitute, upon getting clean off the drugs will no longer have an addiction problem, according to dyedecker, because the drugs are no longer in her system and in time the cravings will disappear. This despite the fact that they psychopathologies which intitally drove her into addiction not only persist, but are intensified by the mental clarity and emotional rawness of life without drugs. But she should have no greater risk for eventual relapse then any other addict, because the cravings eventually go away for her like they do for anyone else. Because there are no contributing personality or environmental factors in addiction, which is not a complicated pathology that interacts with other psychopathologies, but rather is simply a matter of the presence or not of addicting substances in the brain.

Consider me highly susupicious of this conclusion.
posted by The Straightener at 8:50 AM on September 9, 2008 [1 favorite]


>creators of Erowid

What exactly do they know? Their knowledge is not only incredibly biased but also mostly academic.

I really wish the extremists of the world would put their money where their mouths are. Why not test this hypothesis by getting a few hundred like-minded people, finding a territory or frontier they can develop, and setting up a "all drugs, all the time" society. I would expect a complete disaster on the scale of Jonestown, but please prove me wrong. Please done bring kids to this.

Also, libertarians are welcome to do this experiment do with their "nearly no government" hypothesis.
posted by damn dirty ape at 8:53 AM on September 9, 2008 [1 favorite]


Okay white people, I think it is time we let everyone else know our secret. We realized how fun drugs are, but it is really not posh to make life look as if all we do is go home and get smashed. We sort of open about drugs but we realized we don't like the darkies and the poor using drugs. Have you seen their neighborhoods? They should be cleaning up their yard and painting their porches. Anyway we realized that we just couldn't allow them to go on like that, it just looked bad. So then we got clever, and said you had to go to a doctor to get what you needed. But then they caught onto that too, because our doctors were just giving us what they were getting on the street. So we stepped it up a notch. Now we have vague psychological conditions that require all sorts of broad testing. That's expensive, plus our doctor's are just like us and they'll weed you out if you try to sneak past us. When you're diagnosing things without some sort of quantitative test, you can more or less get it to say what you want. We have a myriad of things with chemical names you can't even pronounce. I'd like to see those kids synthesize time-release amphetamine salts! Or look at one of our greatest hits as of late, Ambien. God even knows what is in there, but Barbra Walters is into that. She's one of our stars. She works all the time, has gobs of money and dresses like Barbra Bush (we call that one grandma). When her are her friends need to make that red eye back to JFK they can't be expected to be awake during the flight ... err... I mean she's battling that chronic insomnia. What's that? You spent all night taking care of the kids and you have a second shift? Well good for you, keeping working hard, but we'll so look down on you if you use that bottle of Jack or that joint to correct things.

But you're probably saying, Geoff you're just crazy, don't white people do drugs at clubs and things? Oh yeah of course, there's plenty of instances where we can't really come up with a good excuse. Trust me we had a whole division of P&G trying to figure out how to make something for social anxiety that needed to be taken at social functions. We came damn close too, just couldn't quite beat cocaine. So we just hire off-duty cops to act as bouncers and just try to hide it as much as possible. The little shelf above the toilet was a great idea. But we only do that after a hard week, or when we finish a big project at work. Work, work, work. If we're working we can't be doing anything bad, la, la, la.
posted by geoff. at 9:15 AM on September 9, 2008 [2 favorites]



I really wish the extremists of the world would put their money where their mouths are. Why not test this hypothesis by getting a few hundred like-minded people, finding a territory or frontier they can develop, and setting up a "all drugs, all the time" society.....


Way to straw man dda. If you want to get rid of one gv't program, you must be a drown-it-in-the bathtub libertarian! If you want to reduce or elliminate penalties for drug use, you must be Jim Jones and Charles Manson!
posted by lalochezia at 9:24 AM on September 9, 2008


Addiction is serious stuff. It's not something that can be glibly brushed off as something that only happens in Lifetime movies.

I'm the daughter of a former junkie. Or is he so former? He used for close to 20 years (perhaps more - I don't know, because I liberated myself from both parents when I was 17) and now quells the constant craving with a multitude of other substances - none with the stigma of Heroin (unless you count his Catholicism), but each has health, social, and financial implications that he just can't bear anymore.

Does that mean he's going to give any of those things up? No. He was told a couple of months ago that if he kept drinking, he'd be dying a lot sooner than he had to. He's been drinking for at least forty years. Was alcohol his gateway drug? I don't know. I know he has to use something all the time (or feels he does...the logic of an addict is impermeable and screwy), and, despite this health crisis that had him hospitalised (one of his worst fears) for around three weeks, he's been drinking enough to completely alienate everyone around him (again) and start having the health concerns that put him in care (again).

Gateway drugs...now, that's a funny concept I'm not sure I agree with primarily because it's too simplistic. I think anything can be a gateway to anything for anyone, depending on what that person feels they need to feel differently despite what society feels should be suppressed.

If we were addressing the reasons people self-medicate so indiscriminately and providing honest, evaluation-based recommendations on which substances people can use safely, some of the cases that spin out of control could be brought back from the edge. But not all, because there are some people who are going to abuse substances, regardless.

Caffeine, for example, has been issued recommended levels, warnings, and even anti-prescription ("sleep problems? quit drinking caffeine"; "if you have anxiety issues, don't use caffeine"; "while taking this pill, watch caffeine consumption"), but people given these warnings continue to use it and even over-use it. Not because they can, but because they want to. That's going to happen with anything anyone can get their hands on.

That's one of the reasons I'd like to see a more intelligent approach from our government and society in general. Those who can benefit from responsible use of various substances can do so without stress, shame, danger, and extreme financial impact. Those who find themselves incapable of using responsibly can get the treatment they need for whatever underlying issues causing their tendency towards abuse.

Stigma* and misinformation makes a lot of harmful things look a lot more tempting and reasonable than they should. Eliminating that approach - making it about individual and national health - would take the shine off and allow reason to enter the picture. With increased revenue from the responsible users flowing in constantly, we could afford an incredible investment in health for the entire population while simultaneously reducing the economic and social impact of substance use and abuse.

Dreams aside, addiction isn't something people can just walk away from if they are really and truly addicts. I can drink socially from time to time and then leave it alone for years. My dad can't, even after being told he'd reduce his lifespan to months if he kept it up. That's addiction - irrational, unreasonable, destructive. No law is going to fix that. Only treating it as a health crisis and providing managed care and safer replacements during that process will ever work.

*include in this the stigma of mental and emotional health issues and you've got the perfect recipe for an addicted nation - if we even just focused on removing this particular veil of shame and worry from our populace so they could openly acknowledge their struggle and seek help without the potential of losing their place in the world, we would be much closer to what we should be as a society and species.
posted by batmonkey at 10:04 AM on September 9, 2008 [3 favorites]


I really wish the extremists of the world would put their money where their mouths are. Why not test this hypothesis by getting a few hundred like-minded people, finding a territory or frontier they can develop, and setting up a "all drugs, all the time" society.

It seems like you paid more attention to the byline than the actual article. In case you didn't read the whole thing, I'll summarize it: The current drug policy makes it really hard to be safe about drugs, and it's certainly not stopping people from using them. Particularly, the suppression of accurate information and research about drugs not only directly causes harm to citizens, but also makes it nearly impossible for legislators to have the information necessary to create a reasonable public policy.

This claim doesn't seem very extreme to me. Maybe I am an extremist too!
posted by aubilenon at 10:05 AM on September 9, 2008


Salvia’s Popularity May Thwart Medical Use
posted by homunculus at 10:34 AM on September 9, 2008


Dependence is caused by the drug itself, not failings in people's character or genetics. Which is very good news for "addicts": all they need to do to stop the addiction is stop taking the drug.

I hate to break it to you, but the simple fact is that not everyone gets addicted, not everyone who gets addicted gets addicted in the same way, and not everyone breaks addiction fully when they "stop taking the drug". This would seem to suggest that the disease model cannot fully explain addiction. IMHO, the Rat Park experiment that xchmp linked to above has a lot to say about the ultimate failure of this argument... especially since its findings have been pretty much replicated (with meth in the rural areas, cocaine in the urban, and caffeine and alcohol everywhere) in just about every town in America, at this point.

If addiction strictly followed the disease model, our society would not exist, nor would any human society throughout history. We'd be the lotusalcohol-eaters.

Sorry, but the "if we legalized drugs the world would fall apart!" argument is ridiculous. For one thing, America had legal and widespread use of opiates and the like within living memory, and society did not fall apart. For another: look around you, and read the article again. We are already a nation of drug users. The question should be "what do we do to minimize the harm of widespread drug use", not "what should be do to keep widespread drug use from happening". The latter makes no sense, because it's already happening, and has been since time out of mind.
posted by vorfeed at 10:52 AM on September 9, 2008


A few months ago I was having a conversation with an older friend of mine (he's in his late 30s, I'm in my early 20s) about drugs legal and illegal, amusing tales of his debauched younger days, party culture in general and drug safety. At some point, I said that I have nothing against people who can use drugs safely, but I'm not about to indulge anytime soon because I'm on a number of prescription medications, and there's just no way I'd know how they would interact with what I'm taking. I mean, chocolate and coffee trigger or worsen my headaches if I'm not careful, alcohol can worsen my migraines to the point where I'm puking over the toilet1 - yeah, quite apart from the legal issues, we can forget about pot. (Or LSD or crack or heroin, although the very idea of my acquiring one of those is laughable.)

My friend expressed pleased surprise and said that he was impressed I was being so thoughtful about my psychotropics, because he wouldn't have been at my age and wouldn't expect it of many people. While I was flattered, I was also thinking, Really? Really? Common sense is that rare?

I don't know if this was the realities of how I live with chronic illness (needing to think about things like drug interactions) colliding with the healthy-people-privilege the rest of the world lives in (who gives a crap), or whether most people don't consider these things that much, or whether my friend underestimates how much people consider these things. I'm inclined to say that it's not the third option, at least, and that in Western culture people2 have a very muddled, panicky and somewhat hands-off understanding of what goes in their bodies, where we kind of blindly shovel in things and trust our doctors not to get us killed, or in which we are terrified of doctors and blindly shovel in things in the hopes of not needing them. One example, that leads to OMG TRANS FATS AARGH! Not that trans fats aren't bad (so far as we know right now), but there would be no need for this hysteria if we were all eating moderately in the first place.

Another, very public example: Heath Ledger. That was just so depressing, because it didn't need to happen. I'm not blaming Ledger at all, because from all reports (and given the meds he died from) the poor guy was too tired to be in his right mind. But it seems fairly likely that he tried to self-medicate, had it go horribly wrong, and LOLCELEBRITYTRAGEDY. In my magical fairyland community which has a healthy attitude about needing drugs and how to use them safely, everybody knows you might need to work with the doctor for a while to find one or two (not six) drugs that work for you, and Heath (along with all the other Heathalikes) has been raised to know that mixing drugs without talking to your doctor or at least a reputable pharmacist is not smart. And it's all okay.

Summary: Teach more, fewer people die.


1. Not from being drunk, guys. We're talking a few sips; I get the hangover without even getting tipsy, basically.
2. Medications excepted, I'm not excluding myself.
posted by bettafish at 10:56 AM on September 9, 2008 [1 favorite]


I watched the video and read the article homunculus links to above earlier. What I find interesting in the video is the lawmakers talking about it. It's all about the "scary YouTube videos", and how "these kids might hurt themselves or others." There wasn't any actual, you know, data or facts presented. Like "300 deaths caused by Salvia", or something to that effect. (I made that up). The article also says that there's no information regarding the long term use of it. So instead of trying to find out the data, the lawmakers want to ban it because "people are putting up videos on YouTube, and they're acting WEIRD." Unfortunately that seems to be the basis of much of our policy: emotion based rather than fact based.
posted by Eekacat at 11:02 AM on September 9, 2008 [4 favorites]


vorfeed, the drugs of the early 1900s are not comparable to those used now. They are considerably more potent now than you could get back then. The marijuana of today is not the marijuana of the '60s.

Also, I would like to hear the thoughts of the LEGALIZE IT ALL crowd about why traditionally permissible countries like the Netherlands have kept meth and heroin as restricted drugs. You don't have the same societal influences that started the Drug War in the US. As I stated before--if it's not being done there, isn't that saying something?

I'm concerned with a lot of the arguments here because people seem to be taking the stance that breaking an addiction to crack is like giving up your daily Frappaccino at Starbucks. We live in a society that encourages excess and mass consumption, and you're arguing that if we legalize substances that lend themselves all too easily to excess and mass consumption most people will handle them responsibly and be able to stop when they need to. I don't believe it.
posted by schroedinger at 11:31 AM on September 9, 2008


I really wish the extremists of the world would put their money where their mouths are. Why not test this hypothesis by getting a few hundred like-minded people, finding a territory or frontier they can develop, and setting up a "all drugs, all the time" society. I would expect a complete disaster on the scale of Jonestown, but please prove me wrong. Please done bring kids to this.

I hear there's like thousands of people who've been doing this in the desert in Nevada somewhere for like 15-20 years now. They build an entire city and then clean it all up after themselves and shit. Get this - they even bring their kids!
posted by wretched_rhapsody at 12:46 PM on September 9, 2008 [1 favorite]


schroedinger, there's some feedback in any quality difference between drugs produced decades ago and drugs produced today. If the penalty for a marijuana bust isn't too harsh, any yokel might try to sell what he grows. If there's a big risk, part-timers might bow out; but folks who are getting top dollar for high-quality stuff have more incentive to take the risk.

Not cause and effect. But definitely feedback.
posted by fantabulous timewaster at 1:06 PM on September 9, 2008


the drugs of the early 1900s are not comparable to those used now. They are considerably more potent now than you could get back then. The marijuana of today is not the marijuana of the '60s.

Really? Because LSD sure isn't sold in the strengths -or, indeed, amounts - it was in the 60's and though I can't be bothered to do the research now (if you want figures, you can probably find them from UNODC), I suspect that as the costs of doing business have risen and the supply chain lengthened through the 70's and 80's, the amount of crap that heroin and cocaine have been cut with has risen.

The idea that drugs were OK back when we took them (nudge, nudge, remember the time when Tim got so high he thought he was a tree? wink, wink, those were some days, weren't they? we were some crazy kids!) but are EVIL now (look at the kids today! they can't handle the drugs! the dealers are pushing it on them! the drugs are stronger!) is just another of the many lies of the war on drugs. It's a way for people to feel OK about their former drug use while condemning it in others.

It's a bit like the way it's OK for politicians to have tried drugs, but not to have enjoyed them. Because any curious, intelligent kid would try drugs at one time or another, but only MORAL DEGENERATES enjoy them, right?

As to the claims of the increase in the potency of marijuana, take a look at this story from Ben Goldacre of Badscience.net. For a discussion of how the figures of cannabis potency are manipulated to produce scare stories. The data in that article apply to the UK. Some cannabis is a bit stronger than it used to be (intensively produced herbal cannabis grown indoors has about doubled in strength over the last 30 years, while other forms have remained at around the same potency. A mere doubling in the potency of high quality herb is hardly the drug apocalypse that you imply. I'd say it was absolutely comparable to that of the 1960's. In fact, I seem to have just compared them.

But it doesn't matter if the drugs are stronger. If a drug is stronger, then people will titrate their use to achieve the level of intoxication they want. People don't drink pints of vodka just because it's a lot stronger than beer. And people can (and do) get stupidly drunk on beer alone if they want.
posted by xchmp at 1:07 PM on September 9, 2008 [3 favorites]


vorfeed, the drugs of the early 1900s are not comparable to those used now. They are considerably more potent now than you could get back then. The marijuana of today is not the marijuana of the '60s.

For one thing, it's arguable that the rush toward more potent drugs was actually caused by prohibition, just as the sudden rush toward hard liquor in 1920s America was associated with alcohol prohibition. If most people chose to use milder drugs when drugs were widely legal and available, isn't that saying something?

Also, please provide evidence which backs up your assumption that potency necessarily causes an increase in addiction or other problematic behaviors. As shown in experiments like Rat Park and others, drug addicts tend to titrate their use based on effect. That is to say, they use just enough to "get high", and not more. Thus, if a more potent form of their drug is available, they will end up using less of it to achieve their desired effect. Given that many of the most unpleasant side effects of (for instance) marijuana are connected with the delivery method, not the substances which cause the high, more potent strains would seem to be a positive, not a negative. As for harder drugs: if you've got someone who is stealing in order to buy heroin, do you want him to have to steal more, or less?

Also, I would like to hear the thoughts of the LEGALIZE IT ALL crowd about why traditionally permissible countries like the Netherlands have kept meth and heroin as restricted drugs.

The Netherlands do not exist in a vacuum. The Drug War is international in scope, and the kind of political pressure which would come from legalizing meth and heroin is not pleasant. They get more than enough hassle over marijuana already. Also, the Netherlands does have a harm-reduction approach to meth and heroin, especially when compared to the US. For instance, heroin is mostly smoked there, not injected, even among hard-core addicts, and it is possible for them to get clean and legal heroin by prescription. As for meth, the laws against it are largely not enforced against people caught with personal-use amounts. Many have argued that the development of a risk-reductionist heroin use pattern in the Netherlands was actually caused by the less-harsh laws there.

Considering that the development of Dutch hard-drug policy over the last two decades can be described as "harm-reduction as baby steps toward eventual legalization", I'd say that it is being done there, and that this does say something... but, unfortunately, not what you seem to want it to.

you're arguing that if we legalize substances that lend themselves all too easily to excess and mass consumption most people will handle them responsibly and be able to stop when they need to. I don't believe it.

Again, we are already a nation of drug users. Drugs, even hard drugs, are widely available and widely used. Clearly, most people are able to make reasonable decisions about drugs, handling them responsibly and stopping when they need to. Thus, legalization is not a hypothetical question which belongs to some dystopian future; it is a practical question in today's society, a society in which we already have widespread drug use.

To paraphrase you, you're arguing that we can solve the problems drug use creates as long as we insist on pretending that drugs are magical things which magically make Everything Bad. I don't believe it, particularly since we already live in a drug-saturated society, one in which Everything is not Bad, and much of what is Bad may actually be caused by our own misguided anti-drug efforts. We really need to take a hard look at what our own drug policies are doing to society in this country.

The effects of legalization may turn out to be negative, though I doubt it, but the effects of prohibition are already negative, right here and right now. Breaking an addiction to crack may not be "like giving up your daily Frappaccino at Starbucks", but it isn't any easier if you must also dodge the law and submerge yourself in a dangerous black market economy while doing it! And, frankly, when the single most physically addictive drug known to man is openly sold in every supermarket and gas station in the country, you can take your crack-scare crap and shove it.

If you're so afraid of crack and meth and the like, then you tell me: why do you think it's better to have crack and meth addicts violently spreading impure drugs through our jails and our streets, instead of being under safe observation in hospitals or government recovery programs?
posted by vorfeed at 1:13 PM on September 9, 2008


schroedinger: Also, I would like to hear the thoughts of the LEGALIZE IT ALL crowd about why traditionally permissible countries like the Netherlands have kept meth and heroin as restricted drugs

Mostly, conservative attitudes & international treaty obligations. The same reason that the Netherlands government hasn't formally legalized cannabis (production remains illegal & enforced; it's the coffeeshop sales & purchase that's tolerated). The Dutch aren't some enlightened race, just pragmatic. The Dutch government have sought to ban the sale of magic mushrooms, which were (& are) available in certain shops for a decade now. It's not all regressive. The Dutch legally prescribe heroin to some addicts, the same as some other European countries.
posted by daksya at 1:21 PM on September 9, 2008


"Why do you think it's better to have crack and meth addicts violently spreading impure drugs through our jails and our streets, instead of being under safe observation in hospitals or government recovery programs?"

Oh, come on. I'm sorry, are these the same crack and meth addicts who, a paragraph above, were "able to make reasonable decisions about drugs, handling them responsibly and stopping when they need to"? I mean, I just am having problems wading through all of your hyperbole so I need to double check, you know?

Anyway, I think you are misunderstanding my attitude towards drug legalization--or perhaps purposely exaggerating for effect? I will clarify anyway:

Harm reduction policies like needle exchanges, providing low-cost/no-cost methadone and addiction recovery programs to addicts, extensive, extensive educational programs regarding the effects of various drugs and how those effects differ depending on the drug's administration - YES

More investigation into the nature of addiction and effective addiction treatment programs - YES

Legalization of marijuana and (as I see no reason why not) LSD, ecstasy, so-called "soft drugs", and opening them to sale on the market, provided dispensers have a license and the products undergo strict quality control screening - YES

The prior paragraph, only applied to crack, meth, and heroin - NO.

As I have explained before, I simply do not believe that it is realistically possible for the majority of the population to use those drugs responsibly. Please note the "realistically." In a situation where the United States is like Rat Park only with impeccable drug education, a Heaven where everyone is satisfied with themselves and their identity, is completely knowledgeable about drugs and their effects, and abusive drug use is limited to that small, small percentage who have some sort of genetic/personality addiction issues that make it virtually impossible to use drugs responsibly--you have convinced me that in that United States, hell, maybe we should just legalize everything.

But that is not this United States. I'll repeat my previous assertion: We live in a society that encourages excess and mass consumption. Many, many members of the population suffer from alienation, depression, and the other psychopathologies alluded to by The Straightener. It also has an abysmal educational system that has been notoriously difficult to improve in any way. I am not going to trust for one minute that legalizing will turn our country into this Rat Park, into a place where people are going to magically practice responsible drug usage. I don't think people (especially the under-25 set) practice responsible drug usage with the drugs we do have legal--like alcohol--and most people are not addicts because of how they use alcohol usage but despite it. I'm in college, I see how college kids drink, and I really don't want to see that behavior modeled in crack and heroin, where the potential of them hurting themselves, hurting others, and developing permanent issues is that much greater. Marijuana, ecstasy, they can put themselves through the ringer and come out reasonably OK on the other side. Is this the case for heroin, crack, and meth? I remain strongly doubtful.

(I purposely put tobacco in another category of this discussion. I think it is a misnomer to speak about legalization in pure terms of addictive potential--it is also the behavior of the users when on and off the drug that is important. Tobacco users, while seriously damaging their own health, are basically no risk to anyone except through secondhand smoke.)
posted by schroedinger at 2:09 PM on September 9, 2008


As for the increased potency of marijuana, speaking as a Vancouverite, there are a smorgasbord of varietals out there effecting different physiological results, as there's always been, but ever the more as human breeding skill prevails over the generations. And there are the rare few exceptionally potent enough to be experientially distinct from traditional expectations. However, even with these new fangled means of inebriation, the empirical intoxication remains incomparable to alchohol, much less the more demonized LSD etc. The human body knows what it wants and settles towards homeostasis, drug upgrades may develop the quality of the experiences people can neurochemically finagle, but gated wasted or what have you will always be the same, as it has always been, from the hilarious and intriguing gin craze linked above, to bacchanalia, to the breweries that fomented the rise of non-nomadic civilization, to whoever knows what kinds of crazy plants our ancestors were getting off on.
posted by kaspen at 2:34 PM on September 9, 2008


Lots of interesting discussion here. God I love this place sometimes.

But I only have this comment to make:

"Homosexuality...and sexual indecency aren't addictive."

Then you aren't doing it right.

Seriously, though, the reason why drugs have the power over people's lives that they do is that society puts those that use them automatically into the category of "abuser" without much thought of how they are actually using them. Automatically calling a behavior irresponsible leads to those doing it being more prone to do it irresesponsibly.1


1 - I have no facts or figures to back up this claim -- only the life I've led.
posted by MCMikeNamara at 2:38 PM on September 9, 2008


schroedinger: Whether people can consume responsibly or not is to some extent besides the point. The most irresponsible people - those who are willing to consume adulterated drugs of questionable potency, the possession of which can result in years in jail - are already consuming drugs. And 30 years of the astoundingly expensive War on Drugs hasn't made any appreciable dent in production, supply or consumption.

Drug use has consequences whether it's legal or illegal. The idea that legalising drugs will solve all of the problems of drug use is ridiculous. But nobody's suggesting that it ever could. The conclusion to draw Rat Park experiment isn't that you can legalise drugs and nobody will abuse them and everything will be just peachy. It's that the most effective way of reducing drug abuse is not by punishing their use, but by addressing the social deprivation associated with drug abuse. The real question is whether the consequences of prohibition are worse than the consequences of decriminalisation.

The main argument in favour of the decriminalisation of drugs is not that drugs should be legal because people should be free to use them. It's that the war on drugs is a hugely expensive failure; that it's an utterly irrational way to run a drug policy; and that prohibition actively compounds the harms associated with drug use.
posted by xchmp at 2:58 PM on September 9, 2008



Dependence is caused by the drug itself, not failings in people's character or genetics. Which is very good news for "addicts": all they need to do to stop the addiction is stop taking the drug.

Um, no. People get very confused about "dependence" and addiction because the misguided researchers who wrote the DSM decided that addiction was a stigmatized word and it would be nicer to call the problem "substance dependence." They thereby enshrined in language the idea that dependence on a drug to function is *the* problem-- and therefore that drugs that do not cause physical dependence are not addictive.

Which leaves you with crack = not addictive and everyone on pain medication who has physical dependence and everyone who needs certain blood pressure medications or they will suffer withdrawal and people who need prozac to avoid depression-- all of these are addicts. and people who are stable on methadone to treat opioid addiction are just as addicted as they were before.

Dumb. In fact, physical dependence is neither necessary or sufficient for addiction. And even with the dire scary opioids (heroin, oxycontin, morphine, etc) not everyone who takes them daily for pain develops physical dependence. While the vast majority of chronic pain patients who take them daily *do* develop dependence, only 3% or less who don't have a prior history of drug problems develop addiction.

That's right. You can take pain meds every day and suffer withdrawal like a junkie when you stop--and not be an addict. You can even not realize that the "hospital flu" you had when you left after your injury was in fact, opioid withdrawal.

So, no, dependence isn't simply a reaction of all human bodies to opioids and it doesn't have much to do with the phenomena people worry about when they talk about addiction-- compulsive use despite negative consequences.

Who cares if someone needs a drug to function if it improves their functioning and they can afford it? The problem is making drugs people need too expensive and people who interact with drugs in a way that their drug use makes their lives and the lives of those around them worse. That's the problem society needs to deal with, not "dependence."

And drugs don't cause that. That's addiction. That's caused by a combo of genetics, stress, environment, drugs, culture and individual choices that may be constrained due to the influence of all of the above in varying combinations.

Because of all those complex influences, drug policy is a moving target that should be looking at multifactorial variables and should have moved beyond its current black and white debate.
posted by Maias at 3:11 PM on September 9, 2008 [2 favorites]


Oh, come on. I'm sorry, are these the same crack and meth addicts who, a paragraph above, were "able to make reasonable decisions about drugs, handling them responsibly and stopping when they need to"? I mean, I just am having problems wading through all of your hyperbole so I need to double check, you know?

The fact that "most people" make reasonable decisions about drugs, handling them responsibly and stopping when they need to, necessarily also implies that some people do not do so. I've never said that there's no such thing as addicts; merely that criminalization does not solve the addiction problem, as it makes it much less likely for people to be able to manage their addictions. The criminal vs. medical distinction here is by no means hyperbolic -- it's a reasonable description of the choice at hand. We really do have people spreading drugs through the streets and jails, and we really could have them in hospitals, instead. If one looks at addiction as a universal human health problem with many complex causes, rather than something which will just go away if only we get rid of The Drugs, it becomes rather obvious that a health-based solution is preferable to one based on criminal justice.

You're the one who is making universal, hyperbolic statements about what people can and can't handle.

As I have explained before, I simply do not believe that it is realistically possible for the majority of the population to use those drugs responsibly.

Good for you. However, since you've failed to prove that legalization would lead to the majority of the population even trying these drugs, much less using them irresponsibly, I don't find your argument convincing. For the umpteenth time, hard drugs are already common in America. Despite this, the majority our people choose not to use them, ever, not even once. And many of the people who do use them, use them responsibly. I don't see how legalization is going to seriously change this equation. These are not casual-use drugs in this country, despite their widespread availability, so why do you keep insisting that, if legal, crack and heroin would suddenly become frat party drugs? Come on.

Besides, as xchmp points out, the question of responsible use is not necessarily the issue, here. Drug policy is not a question of "will people use it responsibly"; some will, and some won't. Drug policy is a question of how we, as a society, intend to manage the harm associated with use. And by every metric we have, the War on Drugs has been a failure in this regard -- the drug problem has gotten worse, not better.

I am not going to trust for one minute that legalizing will turn our country into this Rat Park, into a place where people are going to magically practice responsible drug usage.

No one has made this claim. You're getting cause and effect backward, here. The claim I am making is that we cannot begin to make this country into Rat Park without first admitting that Rat Park is a valid goal, and that responsible hard-drug usage actually exists and can be fostered through social and legal change. Simply put, we cannot make this country into Rat Park if we're spending billions on a damaging, lying, self-fulfilling-prophecy of a Drug War, mainly because the Drug War itself is among the chief causes of social unrest and discomfort in our society!

We pretty clearly need to work on harm reduction and social welfare in this country. That does not mean that the legalization of hard drugs should not be the obvious eventual goal of our drug policy. I'm not saying "legalize and the drug problem will just go away with no further effort", I'm saying that our drug policy is a major contributor to our drug problem, and a major barrier to cleaning it up, so it needs to go. The key is legalization in concert with harm-reduction policies and social change.

I don't think people (especially the under-25 set) practice responsible drug usage with the drugs we do have legal--like alcohol--and most people are not addicts because of how they use alcohol usage but despite it.

Wow. Just wow. This is so far removed from reality that I'm not even sure what to say about it. Yes, irresponsible drug use is a problem, but it is nowhere even close to being a "most people" kind of problem, nor has it ever been, nor is it ever likely to be. The vast, vast majority of people in this country use drugs, legal or not, and do not have a serious problem with them.

"Most people are not addicts because of how they use alcohol usage but despite it"?! And you accuse me of hyperbole? This kind of overblown crap went out with the thirties!
posted by vorfeed at 3:48 PM on September 9, 2008


telstar, drugs provided for medical usage, dispensed under the eye of a doctor who is presumably able to gauge appropriate dosage and properly weigh the risks and benefits of such usage, is hardly a good analogy for the behavior of a consumer on an open drug market (or an indicator of the quality and purity of the drug on such a market).

I might even tend to agree with you if half the ADHD drugs out there didn't get diverted to illegal markets.

That link to the desoxyn page gets a little tiresome to keep posting (that must have been the sixth time or so just on mefi) but the reason I do it is because whenever a discussion opens up on drug legalization, some lightweight pops up and says "ooooo....what about meth?". It's kind of a ready answer to someone who knows little and has experienced even less. The idea is to bring you face-to-face with your own ignorance.
posted by telstar at 4:04 PM on September 9, 2008



also, being "under the eye of a doctor" is really pretty much of a joke, at least in America these days where an appointment is five minutes and she's got thousands of patients.

you are lucky to get the right dose of a vaguely appropriate drug-- but doctors have never been very good at distinguishing "addicts" from everyone else because the truth is, they are more similar to everyone else than different.

and because addiction is defined by negative consequences, you can have two people on the same dose of the same drug and one person is an addict and the other isn't.

as with pain, there's no "addiction-o-meter"

regarding the question of the proportion of the population that can use responsibly: one of my favorite ways to look at this is to poll people about what they would do if heroin were legal tomorrow. Vast, vast majority say they wouldn't touch the stuff.

Ask them what their neighbor would do, however-- and they all say the neighbors would go out and become junkies.

we think we're superior to everyone else and therefore drugs need to be illegal to protect *them* from *themselves*-- but in reality, addiction isn't the only drug related harm you have to worry about.

another worry about marketing psychoactive drugs involves the borderline cases of people who will do stupid stuff under the influence that they wouldn't do otherwise-- the people who will do drugs for a period because everyone else does and who will be harmed as a result not of addiction but of particular drug-related dangers. these people-- unlike the addicts, who tend to have some kind of major life problem, drugs or no-- wouldn't be hurt at all if the drug wasn't there.

these two are somewhat separate-- think drunk driving. not all of it involves alcoholics. most kids who die binge drinking aren't alcoholics either. and it's amongst this group that controlling supply has big effects. addicts are affected too when drug prices rise (surprisingly to many)-- but this just means they use less, typically, not that they stop.

so the complexity of drug policy results from the fact that different policies affect these different groups differently and that different drugs have different harms.

the amount of harm done if 40% of the population decided to use marijuana once a week would be tremendously different from the amount of harm done if that proportion decided to use crack cocaine. not only are the "capture" rates different in terms of who would go on to addiction with that high proportion using regularly, but the harms that could result are different. crack can make those inclined to violence much worse, whereas marijuana doesn't have that effect-- and the effect, while worse in addicts, doesn't require addiction.

then you throw in the fact that trauma can increase addiction rates and there are probably different genetics that affect different addictions to some extent and you have a social problem that doesn't lend itself to facile solutions on your hands.
posted by Maias at 6:18 PM on September 9, 2008 [1 favorite]


Maias: Because of all those complex influences, drug policy is a moving target that should be looking at multifactorial variables and should have moved beyond its current black and white debate.

The base policy isn't a moving target. Drugs haven't been put in & out of prohibition over the past 30 years. Penalties may have changed, enforcement priority may have changed, treatment philosophy and practices may have changed..etc but the base of prohibition hasn't. The nuances of any regulatory model is a legitimate target of the multifactorial variables you allude to, but the base stance itself has very few states to choose from, and doesn't have nuances.
posted by daksya at 8:56 PM on September 9, 2008


"in fact, the vast majority of drug users are so responsible and invisible that you have to resort to testing their piss just to figure out who they are."

--Brian Bennett
posted by mrhappy at 11:40 PM on September 9, 2008 [2 favorites]


I would sign my name to this essay, as written. And I'm no druggie.

Thanks for the link.
posted by ikkyu2 at 12:20 PM on September 10, 2008 [1 favorite]


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