Drug war
May 22, 2009 6:35 AM   Subscribe

The Portugal experiment. On July 1, 2001, a nationwide law in Portugal took effect that decriminalized all drugs, including cocaine and heroin. Under the new legal framework, all drugs were “decriminalized,” not “legalized.” Thus, drug possession for personal use and drug usage itself are still legally prohibited, but violations of those prohibitions are deemed to be exclusively administrative violations and are removed completely from the criminal realm.... The data show that, judged by virtually every metric, the Portuguese decriminalization framework has been a resounding success. Within this success lie self-evident lessons that should guide drug policy debates around the world. (pdf of complete paper)

Winds of change are blowing and a primary driver appears to be that very American value - money.
posted by caddis (90 comments total) 21 users marked this as a favorite
 
[D]rugs were “decriminalized,” not “legalized.” Thus, drug possession for personal use and drug usage itself are still legally prohibited, but violations of those prohibitions are deemed to be exclusively administrative violations and are removed completely from the criminal realm...

This is legally similar, it seems, to the Dutch practice of non-enforcement of marijuana possession laws. I don't know if I'd want the same thing to apply to heroin, though. But the experiment is interesting.
posted by goodnewsfortheinsane at 6:48 AM on May 22, 2009


I was sad to hear Obama speak on the radio the other day. He was answering questions that people had submitted via internet, to paraphrase: "A question which surprised me, because it was asked by so many, was whether I would consider legalizing marijuana. The answer is no."

It looks like a democracy, but...
posted by Vindaloo at 6:57 AM on May 22, 2009 [1 favorite]


goodnewsfortheinsane: I don't know if I'd want the same thing to apply to heroin, though. But the experiment is interesting.

Why wouldn't you? If it is at it says, that in every metric it has been a success, what is the reason to keep drugs such as heroin under the criminal realm? I don't mean this to be snarky, I'm legitimately curious.
posted by vernondalhart at 6:57 AM on May 22, 2009 [4 favorites]


The problem with decriminalization instead of legalization is that it makes taxing the narcotics industry impossible, and still pushes even retail drug traffic in the shadows, where quality and dosage are not controlled, regulated or safe.

Better to just legalize it outright, tax the hell out of all parts of the chain (esp production and importation) and give users the security that purchasers of aspirin have now - that what they buy isn't cut with borax or gasoline, or isn't so massively pure that their usual hit will send them into a coma. And if it does, users will have a product liability action against makers and dealer, which they do not now currently have.

If there isn't anything morally wrong with it, then bring it out of the shadows completely and into the light of day so drug users don't have to become criminals, associate with criminals, or enable criminals.
posted by Pastabagel at 6:59 AM on May 22, 2009 [34 favorites]


Drugs are cheaper than ever before and you can buy them anywhere. As Mexico’s cash-starved government struggles to keep up the good fight, the drug barons rake in more than enough to buy political protection and military power while still maintaining profit margins beyond imagining.

Impressive, in terms of commercial wranglings only.

Tax And Regulate Cannabis Sales has some interesting updates for California, and Marijuana Policy Project tracks the nation's workings. California is looking like the bright spot amongst other states, if the MPP front page is anything to go by.
posted by filthy light thief at 7:01 AM on May 22, 2009


...judged by virtually every metric, the Portuguese decriminalization framework has been a resounding success...

So I guess they didn't use the Puritan Index metric, the Reefer Madness Obsession Syndrome metric or the Bodily Fluids Preciousness metric.
posted by DU at 7:02 AM on May 22, 2009 [16 favorites]


It looks like a democracy, but...

...what?

"Fifty-eight percent of Americans say marijuana should be illegal, even after being presented with the idea that the drug could be taxed." source
posted by smackfu at 7:05 AM on May 22, 2009 [1 favorite]


Serious drug reform seems more possible than it has in a long time. I think the real challenge it faces in the short term is crime rates. With the unemployment rate rising as it has been there is almost certainly going to be an uptick in crime. If crime becomes a priority for the government people will demand that the government do something and they will not settle for anything that isn't brutal and stupid.

Because of our current economic woes I'm sort of concerned with instituting drug liberalization policies at a time when crime is almost certain to rise because of the larger economic picture. Of course it takes so long to do anything that my concern is probably misplaced but I think you need to pick your moment and in California at least (probably the best hope for a state effort) the budget problems will persist long after the current economic malaise has cleared up.
posted by I Foody at 7:05 AM on May 22, 2009


Why wouldn't you? If it is at it says, that in every metric it has been a success, what is the reason to keep drugs such as heroin under the criminal realm? I don't mean this to be snarky, I'm legitimately curious.
posted by vernondalhart at 9:57 AM on May 22


I know how you feel. But vicodin is legal and heavily regulated and it would be strange to have a regime in which you couldn't get vicodin recreationally but you could get heroin or coke.

Furthermore, any attempt to restrict something like heroin or coke is just going to lead back to a black market for people to get permits or prescriptions. In a way it is very hard to create a rational regulatory regime for drug legalization, because drug use, esp for drugs like coke and heroin is irrational. The product has a significant chance of killing the user in the very short term, so why do it?

Maybe simply a permit. Sign up, pay $60 and get a dope permit. Flash your dope card at the pharmacy to get coke. This way you keep track of everybody, but it isn't onerous enough to send people to the black market. I don't really have an answer, but I acknowledge its a big problem that's pretty much unanswered.
posted by Pastabagel at 7:05 AM on May 22, 2009


So I guess they didn't use the Puritan Index metric, the Reefer Madness Obsession Syndrome metric or the Bodily Fluids Preciousness metric.

Don't forget the "It Comes From Europe, So It's Deeply Flawed and Probably Socialist" metric.
posted by Thorzdad at 7:06 AM on May 22, 2009 [12 favorites]


I was sad to hear Obama speak on the radio the other day. He was answering questions that people had submitted via internet, to paraphrase: "A question which surprised me, because it was asked by so many, was whether I would consider legalizing marijuana. The answer is no."

It looks like a democracy, but...

First of all, that's not how democracy works. Second, he was answering questions about the economy, and the marijuana issue came up in the context of an economic solution via taxes etc., and a "no" to that doesn't necessarily mean the same thing as a "no" to the entire concept of legalization or decriminalization.
posted by hermitosis at 7:07 AM on May 22, 2009 [2 favorites]


A critique of the Cato Insitute's report, a bit short but hey.



(Is now also the right time to mention that Jose Socrates is hot? Thought not...)
posted by Sova at 7:09 AM on May 22, 2009 [3 favorites]


I read this report a while back. Interesting, but kind of obvious. It just confirms what those of us who support decriminalization have been saying all along.

But we have to be clear about this. President Obama's never endorsed legalization. He's endorsed decriminalization. That's a big difference. And can't we please stop the "libertarian" CATO institute pile-on for just a few posts? I mean, the CATO institute enthusiastically carried the water for the Bush administration on trade policy, even to some extent, after the Iraq war began.

This study is fine for what it is, but don't make this about Obama. Despite what Joe Beese will probably allege again here at some point, Obama actually has stopped raiding medical marijuana dispensaries, in keeping with the DOJ's pledge to leave marijuana policy up to state jurisdiction.

And, lest it be overlooked, the CATO institute has never really been the disinterested, pro-libertarian organization it brands itself as:

The Cato Institute, a libertarian think tank based in Washington DC, was founded in 1977 by Edward Crane and Charles Koch, the billionaire co-owner of Koch Industries, the largest privately held oil company in the U.S.

And CATO has historically and continues to aggressively oppose attempts to regulate Greenhouse Gas emissions and Global Warming.
posted by saulgoodman at 7:13 AM on May 22, 2009 [8 favorites]


...exclusively administrative violations...

What does that mean, technically?
posted by ZenMasterThis at 7:14 AM on May 22, 2009 [1 favorite]


> "A question which surprised me, because it was asked by so many, was whether I would consider legalizing marijuana. The answer is no."

I wonder if Obama thinks he deserved to go to jail, or at least be saddled with a criminal record, for using cocaine and marijuana? We're all equal in the eyes of the law, right?
posted by The Card Cheat at 7:16 AM on May 22, 2009


Pastabagel: But vicodin is legal and heavily regulated and it would be strange to have a regime in which you couldn't get vicodin recreationally but you could get heroin or coke.

But that isn't the discussion at hand. We're talking about decriminalizing drugs, not legalizing them. So it would still be illegal to obtain heroin and coke, but it wouldn't be a criminal offense.
posted by vernondalhart at 7:18 AM on May 22, 2009


I wonder if Obama thinks he deserved to go to jail,

He's for decriminalization. He's said he supports decriminalization on the record numerous times, and by ceding jurisdiction to the states, he's effectively made it possible. Hell, California is seriously talking about legalizing and taxing marijuana right now, and the administration hasn't offered one word to discourage it.
posted by saulgoodman at 7:20 AM on May 22, 2009 [1 favorite]


For marijuana, at least, outright legalization would be a better move than decriminalization, even though that's a good start. It is more ambiguous whether or not heroin and other highly addictive drugs should be legal. The argument that legalization would hurt organized crime and stop adulteration would apply even more to "hard" than to "soft" drugs, but I'm somewhat leery of the idea that anyone could just walk into the local corner store and buy some heroin.

A third approach, one that the Danish have adopted, is to medicalize hard drugs: addicts can go to special clinics to get their daily fix, thus ensuring their relative safety and keeping more drugs off the street. Its not a perfect solution, but is probably the least harmful option.
posted by anarchomonarchist at 7:20 AM on May 22, 2009 [1 favorite]


He was answering questions that people had submitted via internet, to paraphrase: "A question which surprised me, because it was asked by so many, was whether I would consider legalizing marijuana. The answer is no."

It looks like a democracy, but...


Portugal didn't legalize it either and it sounds like they are miles ahead of us, so I'm not sure what you thought he was going to say.

And frankly, legal weed is pretty far down my list of priorities. Health care, clean energy, ending the war(s), education funding, deconstruction of much of the military-industrial complex, etc. Heck, IP reform is higher on my list than drugs, though opinions vary obviously.
posted by DU at 7:24 AM on May 22, 2009 [3 favorites]


Furthermore, any attempt to restrict something like heroin or coke is just going to lead back to a black market for people to get permits or prescriptions. In a way it is very hard to create a rational regulatory regime for drug legalization, because drug use, esp for drugs like coke and heroin is irrational. The product has a significant chance of killing the user in the very short term, so why do it?

posted by Pastabagel at 7:05 AM on May 22 [+] [!]


To be fair, it's not completly irrational - the thing a lot of people forget about drugs (and I haven't used coke, so I can't speak for that - although I would assume that it's the much the same as most of the other popular narcotics) is that their users, at least initially, consider the effects to be terribly, terribly positive - heroin is, for example, a hell of a painkiller, both physical and emotional.

Which brings me to a point of sorts - it's very rare to meet a drug user for whom the use is not a symptom of something else, rather than the core problem. Illicit drugs are just the most effective/available/both medication that they have found. It's hardly a surprise that, just because someone outlaws the medication that works for them(tm), that they choose to ignore that law in order to feel better.

The term "recreational drugs" is a bit of a misnomer, is all I'm saying :)
posted by jaymzjulian at 7:30 AM on May 22, 2009 [3 favorites]


"And frankly, legal weed is pretty far down my list of priorities. Health care, clean energy, ending the war(s), education funding, deconstruction of much of the military-industrial complex, etc. Heck, IP reform is higher on my list than drugs, though opinions vary obviously."

We could save a hell of a lot of money on incarceration and policing, and if we taxed it, we could make a hell of a lot of money. The Drug War is a symptom of misplaced priorities, and as such, it's pretty important, because it affects a great deal of society. If we continue to incarcerate as many people as we do, we create a much bigger problem than drugs cause. Prison is not rehabilitative, at least not its current incarnation here in the US.
posted by krinklyfig at 7:33 AM on May 22, 2009 [5 favorites]


The data show that, judged by virtually every metric, the Portuguese decriminalization framework has been a resounding success.

Depends on what your definition of success is. If you are a manufacturer of light tactical body armor for law enforcement agencies you probably feel that the US "War on Drugs" is a resounding success.
posted by Pollomacho at 7:35 AM on May 22, 2009 [5 favorites]


Yes, what krinklyfig said. People getting their weed is not very important for me. But ending all of the bad effects on our society and the expense of the "War on Drugs" is very important.
posted by grouse at 7:37 AM on May 22, 2009


it's very rare to meet a drug user for whom the use is not a symptom of something else, rather than the core problem

There is a big difference between a drug user and a drug abuser.
posted by ninebelow at 7:39 AM on May 22, 2009 [3 favorites]


The war on drugs is part of the military-industrial complex. Both overseas, where we arm governments and fly raids, and at home, where the increasingly privatized prisons are filled with people there on drug charges.
posted by CheeseDigestsAll at 7:40 AM on May 22, 2009


But vicodin is legal and heavily regulated and it would be strange to have a regime in which you couldn't get vicodin recreationally but you could get heroin or coke.


Vicodin's a weird case because the fun part isn't the physically harmful part - acetaminophen causes liver damage more often than hydrocodone causes permanent harm, AFAIK. So a regime under which you could get codeine or some other similar opiate freely but need a prescription to get the compounded stuff wouldn't be weird even though acetaminophen is otherwise completely legal. The idea being that nobody abuses Tylenol recreationally and the regulation would be solely aimed at getting would-be opiate users to avoid this particular harm. I agree completely with your point as far as non-compounded opiates, though.
posted by Inspector.Gadget at 7:41 AM on May 22, 2009 [1 favorite]


The term "recreational drugs" is a bit of a misnomer, is all I'm saying :)

This is absolutely wrong. Certainly, people do self-medicate with drugs, both legal and illegal, but to suggest that all drug use is self-medication is ridiculous. Is every beer ever drunk a desperate attempt to douse some inner flame of misery? Hardly. By that same token, people smoke joints, do lines at parties, take acid at concerts to have a good time. There is a different between drug use and drug abuse, and the sooner everyone realizes it, the sooner we can start modifying our draconian policies on controlled substances.
posted by solipsophistocracy at 7:42 AM on May 22, 2009 [7 favorites]


We could save a hell of a lot of money on incarceration and policing, and if we taxed it, we could make a hell of a lot of money.

I say this as a supporter of ending this stupid "war" but I think it would be interesting to do a purely capitalist study on the cost vs. return of taxing decriminalized drugs and not stigmatizing large hunks of society vs. the tax revenues generated from weapons/police car/law enforcement flotsam etc. sales and keeping a large hunk of society as a dependent underclass labor force.
posted by Pollomacho at 7:44 AM on May 22, 2009


Okay, let's legalize and drugs. Sounds reasonable enough. I just have a few minor logistical questions:
  • Where do I actually do to buy my pot now? Can my grocery store stock it alongside the 3.2% beer (the maximum allowed by law in grocery stores in Kansas)? Or maybe liquor stores? Or maybe do I go to a pharmacy? Or will the government set up special government-run head shops?
  • Do I need a prescription? If so, who do I see about a prescription for recreational MDMA? Is that classified as a sleep or a marital aid? Or is the stuff purely over-the-counter? If so, what about current legal-but-controlled drugs? I can buy speed at the corner store but need a prescription for Adderal? Or are we also prescription drugs available for recreational use? There's some really great off-label uses for Alzheimer's medication.
  • Who gets to regulate these new drugs? Is it the already-massively-overworked FDA? Or maybe we add it to the ADF's duties? ATFD? Or do we transition the DEA from police to bureaucracy?
  • For that matter, what kind of regulations are there? Exactly how much weed can I purchase in one go? Are "bartenders" required to cut me off after a certain number of lines, or can I rock'n'roll all night?
  • Can I drive while stoned? On speed? How about Provigil? We did make that one OTC, right? Is there a legal limit to my "blood-THC-content"? How do we test that, anyway?
  • Can I grow pot in my backyard? Or do I have to still obtain it from a legally-recognized source? (What would that legally-recognized source be, again? I forgot.) Can I grow poppies?
  • Oh, and speaking of poppies: since heroin's now legal, what happens to our current offensive against poppy growers in Afghanistan? Do we keep burning their fields so that we in the States can get nice clean home-grown opiates? Or do we recognize Afghanistan poppy exports as a path to reconstruction? How about all the fields we've already burned? Just send those farmers a "sorry, you planted a few years too early" note? Or maybe we can use reconstruction money to help those farmers replant.
  • Back to what I can make at home for a sec: I hear meth's really easy to make at home. Sure it's a bit dangerous, but now it's legal, right? Is there a regulated safe distance from my domicile to place my meth lab, or can I have it right in my garage? Are there special building codes for cocaine production facilities?
  • On a different tangent, what do we do about the (roughly) 1,500,000 Americans in prison/jail on drug-related offenses? Do they get grandfathered right into serving the remainder of their sentences? Or do they all get released the day this perpetual Summer of Love begins?
That'll do for a start, I think, but there's more where that came from.

...

Look, I'll be the first to tell you about how fucked up our drug policy is. But Jesus, people, it's a fucking complicated thing we're talking about here that impacts every aspect of our domestic and foreign policy in profound ways. It really pisses me off that the drug legalization folks can't seem to comprehend just what a messy, complicated thing this is. If you really think this shit is simple please put down the bong and back away slowly.

If we get to a point where drugs are legal or decriminalized it'll be through a long, slow, incremental processes, not "The Drug Legalization Act of 2015."
posted by jacobian at 7:44 AM on May 22, 2009 [8 favorites]


Which brings me to a point of sorts - it's very rare to meet a drug user for whom the use is not a symptom of something else, rather than the core problem.

Maybe you haven't realized that you know a lot of normal, upstanding drug users - but you just don't know that they use illegal drugs.
posted by Optimus Chyme at 7:45 AM on May 22, 2009 [9 favorites]


And, lest it be overlooked, the CATO institute has never really been the disinterested, pro-libertarian organization it brands itself as.

I'm confused as to why you think opposing one type of regulation makes it less reasonable to oppose another type (leaving the question of whether each individually is rational for another time). That's what libertarians do. Opposing attempts to regulate greenhouse gases merely pushes the Cato Institute into one variant of libertarianism rather than another.
posted by Inspector.Gadget at 7:46 AM on May 22, 2009 [1 favorite]


Dammit. Need. better. proofreading. Hopefully my point's still clear enough.
posted by jacobian at 7:46 AM on May 22, 2009


"Can I grow pot in my backyard?"

If it's legal without the ability to grow your own, then it's not the best policy, IMO. I'm a bit baffled that people can brew their own beer but not distill alcohol at home in most places in the US.

"Look, I'll be the first to tell you about how fucked up our drug policy is. But Jesus, people, it's a fucking complicated thing we're talking about here that impacts every aspect of our domestic and foreign policy in profound ways. It really pisses me off that the drug legalization folks can't seem to comprehend just what a messy, complicated thing this is. If you really think this shit is simple please put down the bong and back away slowly."

What are you talking about? Who is claiming this is simple, or that nobody who is against the Drug War has any idea how to go about it? Sounds like a bunch of straw men you're fighting.

Policy is not created overnight out of whole cloth. We need to take steps in this direction, at the very least. You might want to look at what happened when prohibition was repealed in the US.
posted by krinklyfig at 7:53 AM on May 22, 2009 [1 favorite]


As Nick Gillespie said in the New York Times last weekend, "when was the last time a tobacco kingpin was killed in a deal gone wrong?"
With legalization - but not with only decriminalization - the production, distribution, and sale of marijuana would be legitimized. Violence would likely be quickly curbed because huge profits would no longer be available and sales would be taken out of the exclusive realm of people willing to make themselves felons with every buy. People with a problem could get help without risking their liberty. And the vast, silent majority of responsible users (who have steady jobs, careers, and families that they don't want to put at risk now) could come out of their basements and garages into the open.

It makes so much sense, but a majority vote of people who get reelected by being tough on crime and saying no to drugs is all but impossible. Frustrating.
posted by AgentRocket at 7:58 AM on May 22, 2009 [2 favorites]


Hopefully my point's still clear enough.

Yes: you don't know the difference between decriminalisation and legalisation and strawmen are your drug of choice.
posted by ninebelow at 8:05 AM on May 22, 2009 [2 favorites]


It looks like a democracy, but...

...what?

"Fifty-eight percent of Americans say marijuana should be illegal, even after being presented with the idea that the drug could be taxed." source
posted by smackfu at 7:05 AM on May 22


I hate to admit it, but I have been smackfu'ed, and pretty good at that.

I was fairly certain that a majority in the US supported decriminalization, but I guess I was way wrong.
posted by Vindaloo at 8:08 AM on May 22, 2009


The self medication hypothesis has been studied extensively and discredited, check out the chapter "The mentally ill substance abuser" In M. Galanter & H. Kleber (Eds.), Textbook of Substance Abuse Treatment (4th ed.) (pp. 537-554). Washington DC: American Psychiatric Press. I don't have the time to retype the findings from my printed copy, but the cites are in there.
posted by The Straightener at 8:08 AM on May 22, 2009 [3 favorites]


It was mentioned above - but I find the Danish solution of distributing hard drugs via a specialized clinic kind of interesting - I'd like to know if it has proven effective at reducing the number of users on the street vs. our U.S. experiments with methadone.

For the record, one of the most profound moments of cognitive dissonance I ever had happened in France, when I was at a retreat with some folks from the Netherlands. One individual and I ended up spending quite a bit of time together, so naturally I asked him what he did for a living. He replied, "I'm on disability." Ah, too bad, I thought. "Do you mind if I ask what happened?" I assumed that there had been some kind of accident.
He slapped his arm - "Smack. I'm addicted to drugs."

I realized that - of course - a good government would provide benefits for someone living with the sickness of drug addiction. But the U.S. part of my mind reeled. I'd never met anyone on disability for drug addiction.
posted by Baby_Balrog at 8:11 AM on May 22, 2009


"As Nick Gillespie said in the New York Times last weekend, 'when was the last time a tobacco kingpin was killed in a deal gone wrong?' "

To be fair, in the states where tobacco tax is unusually high, like NY, there is a burgeoning black market (although in that case it's legal product from elsewhere, without the tax stamps). That has to be considered when enacting policy.
posted by krinklyfig at 8:12 AM on May 22, 2009


"The self medication hypothesis has been studied extensively and discredited, check out the chapter 'The mentally ill substance abuser' In M. Galanter & H. Kleber (Eds.), Textbook of Substance Abuse Treatment (4th ed.) (pp. 537-554). Washington DC: American Psychiatric Press. I don't have the time to retype the findings from my printed copy, but the cites are in there."

Well, again to provide some contrast, that was true in my case. Most of my substance abuse came down to self-medicating for ADD, mostly due to anxiety stemming from it.
posted by krinklyfig at 8:14 AM on May 22, 2009


That's what libertarians do. Opposing attempts to regulate greenhouse gases merely pushes the Cato Institute into one variant of libertarianism rather than another.

I don't believe that, though you're free to disagree. I think the CATO institute's primary reason for being is to promote the trade interests of its founders, and its ostensibly libertarian political mission just provides a convenient cover for those activities. Like the American Enterprise Institute, The Heritage Foundation, and all of Richard Berman's various front organizations, CATO is just another node in the elaborate public relations and political networks of the business and wealthy interests that fund them. There are tons of investigative articles and book accounts about how these Washington "think tank" outfits operate, and their real motivations. Try "Blinded by the Right" just to get a glimpse of their scope and mendacity.
posted by saulgoodman at 8:15 AM on May 22, 2009


The product has a significant chance of killing the user in the very short term, so why do it?

Tell that to Keith Richards.

What kills junkies is not having a regular clean supply, not having the money to buy food, and generally living rough on the margins.
posted by Meatbomb at 8:24 AM on May 22, 2009


"It was mentioned above - but I find the Danish solution of distributing hard drugs via a specialized clinic kind of interesting - I'd like to know if it has proven effective at reducing the number of users on the street vs. our U.S. experiments with methadone."

The last time I checked, the program was specifically for only the most difficult problems, for those people who had not been successful at other treatments and have chronic addiction going back many years. But studies have shown that heroin addiction tends to have a life cycle of around 20 years, even for those who can't seem to kick. If you get maintenance doses, it's enough to stave off withdrawals but not enough to cause euphoria. So, someone can get maintenance doses and live a productive life in the meantime - that can work, and it has for some. It has to be paired with therapy and counseling, as a lot of those people need some life skills and encouragement. Not sure what the success rates are for the Dutch program, however. The original Swiss program was problematic, but they basically decriminalized use and sales in a confined area (a park). I think they're trying a maintenance program, too, but haven't been following it too closely.
posted by krinklyfig at 8:27 AM on May 22, 2009


Most substance abusers do not use drugs that approximate the effects of a medication that would treat their mental health symptoms, in fact, they often use drugs that exacerbate their symptoms. For example, crack cocaine exacerbates psychosis in those with psychotic disorders and alcohol exacerbates depression in those with depressive disorders. I'm not trying to discount any one person's personal experience, I'm just clarifying that across a broad sample of drug abusers with mental health symptoms there simply is no strong correlation to suggest that drug abusers with underlying mental health disorders are seeking a remedy to their symptoms in street drugs.
posted by The Straightener at 8:27 AM on May 22, 2009


"CATO is just another node in the elaborate public relations and political networks of the business and wealthy interests that fund them"

That's true, but that doesn't mean they're incorrect about drug policy.
posted by krinklyfig at 8:28 AM on May 22, 2009


jacobian, you seem to be taking the approach of a massively micromanaged regulatory regime. The problem with decriminalization is that it changes very little except the end users interaction with the law. You still have to fight a drug war, because importation of 600 lbs of coke would still be illegal. Maybe it works for portugal, which wasn't really fighting much of a drug war anyway, but I don't see it working here.

Legalization is different. If it's legal, it becomes like alcohol. No you don't get a prescription because no significant portion of the drug user base is really using them for medicinal purposes. You either get a permit to buy drugs, or you buy them at a liquor store. Drugs would be manufactured by the companies everyone knows and loves, like Philip Morris, or Pfizer, whose subsidiary Park-Davis used to sell cocaine as a pain remedy in the 19th century.

You don't need a blood alcohol measurement, because cops can pull you over for driving impaired for any reason, including simple drowsiness. Can you walk a straight line and say the alphabet backwards? If not, you're ticketed and fine for impaired driving. Likewise, we have drunk and disorderly laws now that would obviously apply to disorderly conduct of those otherwise imparied.

People wouldn't make meth at home, because only dealers make it at home now. The dealers are replaced by the consumer products companies and the pharmaceutical companies. Why bother making it at home if you can just buy it?

Regulating them is easy. They already regulate prescription and OTC pharmaceuticals surprisingly well, these drugs are no-brainers. They've been around for decades, they've been studied in all manner of ways, there's little we don't know about them.

The way to legalize it is to convince people who don't use drugs that it will be good for them. More tax revenue from this industry means their personal income taxes don't go up. It means less crime, more investment opportunity (I'm first in line to buy stock in Rails, Inc., the nations leading Coke manufacturer), etc.

Cocaine alone is a $70 billion industry in the US. The retail drug trade in the US is $100 billion, and that ignores all the middlemen. We are talking about a non-trivial amount of money here, let alone eliminating all the social costs associated with enforcement imprisonment, stigmatization, etc.
posted by Pastabagel at 8:31 AM on May 22, 2009 [7 favorites]


There are tons of investigative articles and book accounts about how these Washington "think tank" outfits operate, and their real motivations.

If we're going to hold publications to that sort of analysis, then there really aren't that many think tanks left standing. And I don't understand where you're going with "ostensibly libertarian": that someone opposes regulation for merely economic reasons doesn't mean that they don't hold a libertarian position on the issue. There's no ideological purity standard for that sort of thing, because consider an analogous situation: a small business that supports universal health care funded by income or sales taxes rather than payroll or corporate taxes still takes that position.
posted by Inspector.Gadget at 8:31 AM on May 22, 2009


And to put the final nail in the coffin of the "drug users self-medicate" argument, the major street drugs like pot, coke, and heroin (not meth) were never designed for mental health problems, they were very clumsy analgesics or painkillers. In the case of meth, not all amphetamines derivatives are created equal, and meth isn't even as good as ecstacy in that regard.

If people have mental illnesses that can be treated with drugs, it should probably be the kinds of drugs that have been found to actually work against those problems.
posted by Pastabagel at 8:39 AM on May 22, 2009


"Most substance abusers do not use drugs that approximate the effects of a medication that would treat their mental health symptoms"

OK, how about this?

I used to drown myself in caffeinated soda, long before I was diagnosed with ADD. The combination of sugar and caffeine was similar in effect to the Adderall I take now (I say "was," because eventually the sugar didn't work so well with me). Alcohol helped to deal with the anxiety of being around people, which also had a similar effect as Adderall as far as anxiety goes, at least with one or two drinks.

"For example, crack cocaine exacerbates psychosis in those with psychotic disorders and alcohol exacerbates depression in those with depressive disorders."

Yes, side effects. And a lot of people who self-medicate have genuine addiction problems beside their self-medication, so self-destructive behavior and poly-drug problems are not uncommon. I drank initially because it helped with my anxiety related to ADD. Eventually it became a serious problem for me, and according to my psychiatrist and my research on the subject, that's not uncommon with people with ADD who have lived with it undiagnosed for a long time. But marijuana also helps with anxiety, although it doesn't really help my focus, but it helps bring out creativity, which is more difficult with Adderall. It's not a problem like alcohol, but I can benefit from it or not, depending on when I use it.

I'm not really of the mind that anyone with a problem with substance abuse is self-medicating, but a lot of people are, although addiction in itself causes problems, so there is usually some attempt to alleviate those problems by using. It's complicated. I had to stop smoking cigarettes before I really came to terms with what's going on with me, which was long after quitting drinking. I still had self-medication of anxiety going on, and it had to be broken before I could see what was really causing my stress.
posted by krinklyfig at 8:45 AM on May 22, 2009 [2 favorites]


"If people have mental illnesses that can be treated with drugs, it should probably be the kinds of drugs that have been found to actually work against those problems."

Yes, well, that's not really what's going through someone's mind when they're self-medicating. They're just using what seems to work for them, even if it's not entirely helpful to them. Self-medicating usually means there is some addictive and/or self-destructive aspect to it, but I do know several people personally who self-medicate with marijuana for ADD, and the side effects to them are minimal compared to stimulants which are prescribed. That doesn't work for everyone with ADD, however.
posted by krinklyfig at 8:47 AM on May 22, 2009 [1 favorite]


I don't think the portugal drug law had any particular remarkable effect by itself - the mainly good thing was that instead of sending drug addicts to jail, we are actually trying to treat them. The good news is also that it obviously didn't increase drug usage exponentially as some predicted but I find it difficult to give it credit for the decrease in certain groups (because if you look at the original statistics, some age groups and specific drug usage has increased - not horribly, but it has increased).

My perception is that, lately, just like it became fashionable to quit smoking and private gyms started mushrooming all over Lisbon, drugs are quite out of fashion. These days I don't know one single drug user (and I mean know as in heard of from family and friends or even considering a more extended social circle which includes acquaintances with teenage kids). Also, the hardcore druggies I knew all died and the very few with rich parents managed to get treated. The cannabis smokers eventually outgrow it. There have been lots of educational campaigns over the years and drug users - especially heroin addicts - are perceived as leading low status lifestyles so that's not something young kids would find cool. The pop stars the kids like these days seem pretty healthy and clean unlike our own drunken, drug stricken idols back then. I knew something had changed when I heard a few yeeeewwww's from teenagers looking at pics of punk bands at a friend's place.

Furthermore, urban changes. The mayor of Lisbon in the late 90's decided to decimate the "drug supermarket" neighborhoods and the dealers scattered into the outskirts. Which means that if I wanted to buy drugs, any drugs, in the 90's I'd know exactly where to go but these days I haven't got a clue. I know it could be a generational thing - or I am too old to know - but 60-something% of the young people in all over Portugal who answered a poll said the same. They just don't know where to get them. So making sure nobody knows where the dealers are anymore is pretty effective too.
posted by lucia__is__dada at 8:56 AM on May 22, 2009 [1 favorite]


Look, I'll be the first to tell you about how fucked up our drug policy is. But Jesus, people, it's a fucking complicated thing we're talking about here that impacts every aspect of our domestic and foreign policy in profound ways. It really pisses me off that the drug legalization folks can't seem to comprehend just what a messy, complicated thing this is. If you really think this shit is simple please put down the bong and back away slowly.

The thing that comes to mind here is a CBC radio documentary I heard recently regarding the struggle for Women's rights in Afghanistan and the enormous frustrations we "enlightened" westerners have encountered when dealing with entrenched and often violently chauvinistic tribal attitudes and beliefs. Then the question was posed by an "enlightened" Afghani, how long did it take women to get full equality in the west?

The answer: they still don't, centuries since the struggle began.

These big changes can take a long, long time.
posted by philip-random at 9:00 AM on May 22, 2009


Second, he was answering questions about the economy, and the marijuana issue came up in the context of an economic solution via taxes etc., and a "no" to that doesn't necessarily mean the same thing as a "no" to the entire concept of legalization or decriminalization.

As mentioned already, the question he was answering was "Would legalizing marijuana help the economy." to which he answered "no" and to which the crowd predictably laughed.

The topic of marijuana decriminalization came up in many different categories in that online survey. Obama chose to answer one of the questions that fell under the topic of the economy. He ignored all the other questions.

And his answer was dead wrong, anyway; of course decriminalizing pot would have a positive economic effect.
posted by Thoughtcrime at 9:08 AM on May 22, 2009


The problem with decriminalization is that it changes very little except the end users interaction with the law. You still have to fight a drug war, because importation of 600 lbs of coke would still be illegal. Maybe it works for portugal, which wasn't really fighting much of a drug war anyway, but I don't see it working here.

Are you kidding? Portugal is only the gateway (with spain) of most of the cannabis and cocaine consumed in Europe. Why do you think the EMCDDA has its headquarters there?

Last year, European law enforcement agencies seized about 100 tons of cocaine. But Spain and Portugal, the Iberian countries that make up the southwestern gateway to Europe, accounted for 70% of the seizures.
posted by lucia__is__dada at 9:08 AM on May 22, 2009 [1 favorite]


Krinklyfig, I'm not going to belabor what was meant as a clarification and not a full on derail. "The majority of the data across a broad spectrum of mental illnesses do not reveal a strong relationship between type of mental illness and type of substance abuse" is a direct quote from the chapter I cited above. You can disagree with it, but you're pitting anecdote against evidence, here.
posted by The Straightener at 9:09 AM on May 22, 2009


"krinklyfig: What does the self-medication issue have to do with legalization, though? You mentioned using caffeine, sugar and alcohols, which are legal.

I was answering the specific issues which Pastabagel and The Straightener brought up regarding self-medication. Self-medication does not necessarily mean illegal drugs.

What would be different or worse about having other legal avenues to self-medicate, ignoring the question of whether self-medication is a good or bad thing in and of itself?"

I never said it would be better or worse, per se. However, people who are self-medicating with an illegal substance who get thrown in jail are not really getting the resources they need to solve their problems. Self-medication is not usually done intentionally. It usually refers to someone who is using substances to alleviate issues without knowing that's what they're doing. To them, they're just doing what it takes to get through the day. But this isn't always true. Some people are aware of their problems and choose to self-medicate, but that's not typically what is meant when people refer to it.
posted by krinklyfig at 9:15 AM on May 22, 2009 [1 favorite]


"Krinklyfig, I'm not going to belabor what was meant as a clarification and not a full on derail. 'The majority of the data across a broad spectrum of mental illnesses do not reveal a strong relationship between type of mental illness and type of substance abuse' is a direct quote from the chapter I cited above. You can disagree with it, but you're pitting anecdote against evidence, here."

That's fine, but when you make unequivocal statements based on one book ("The self medication hypothesis has been studied extensively and discredited"), I think I should mention that you're probably incorrect, according to my personal experiences and the information available to me. I'm basing my information on my own experiences with psychiatrists and my research involving many studies, though I am at work and can't cite them offhand.
posted by krinklyfig at 9:18 AM on May 22, 2009


"I'm a bit baffled that people can brew their own beer but not distill alcohol at home in most places in the US."

This makes a little sense from a public health and safety standpoint as the chances for a significant boom while distilling alcohol are higher than those brewing beer.
posted by Mitheral at 9:19 AM on May 22, 2009 [1 favorite]


I'll see your CBS survey and raise you a Rasmussen: "Sixty percent (60%) of Republicans are opposed to the legalization of marijuana. Democrats are more evenly split on the question, giving legalization the edge by five points."
posted by mullingitover at 9:32 AM on May 22, 2009


Mitheral: "This makes a little sense from a public health and safety standpoint as the chances for a significant boom while distilling alcohol are higher than those brewing beer."

There's also a good chance of poisoning yourself if you don't do things right. Pure ethanol isn't the only thing that is produced by distillation.
posted by mullingitover at 9:33 AM on May 22, 2009




"There's also a good chance of poisoning yourself if you don't do things right. Pure ethanol isn't the only thing that is produced by distillation."

Yeah, but if you don't sterilize when you brew, you could ingest toxins, fungus and mold, too. I think it might be worthwhile to consider inexpensive individual licensing for distillers with resale prohibited, although a lot of outlaw distillers and their customers have been doing things their own way for a very long time and are not really interested in going legit.
posted by krinklyfig at 9:54 AM on May 22, 2009


It really pisses me off that the drug legalization folks can't seem to comprehend just what a messy, complicated thing this is. If you really think this shit is simple please put down the bong and back away slowly.

Dude, I bet you can get wicked baked smoking up some of the straw from that awesome strawman you've built there.

There are thousands and thousands of serious, not-stoned, suit-wearing people working on these issues every day. If you picture every decriminalization/legalization activist as Cheech or Chong, that's you, not reality.
posted by drjimmy11 at 10:02 AM on May 22, 2009 [3 favorites]


Jacobian, "Legal" doesn't mean free drugs in every grade school and opium dens in every library.

We already have a massive infrastructure to deal with one dangerous smokable substance - tobacco. Regulated manufacture, retail channels, secure distribution, public health warnings and education, taxation, all right there. Doing the same with marijuana, adding what amounts to a premium brand at $50 a pack, would be trivial.

Same with the 'hard' stuff. Morphine is legal right now, I've got some at home from my last back problems. Oxycotin. Vicodin. Xanax. Methadone. Safe, controlled, LEGAL. Why would MDMA, coke, heroin be in the supermarket checkout line?

on preivew, what pastabagel said.
posted by anti social order at 10:06 AM on May 22, 2009


"Fifty-eight percent of Americans say marijuana should be illegal, even after being presented with the idea that the drug could be taxed." source
posted by smackfu at 7:05 AM on May 22



A newer poll, asking more than twice as many people:

"A majority of Americans, in a poll released Wednesday, say it "makes sense to tax and regulate" marijuana. The Zogby poll, commissioned by the conservative-leaning O'Leary Report, surveyed 3,937 voters and found 52 percent in favor of legalization. Only 37 percent opposed."

It's really all about how you ask the question. There's been a steady upward trend since the 70's. About as many Americans support legalizing pot as de-legalizing abortion.
posted by oneirodynia at 10:09 AM on May 22, 2009 [1 favorite]


It's really all about how you ask the question. There's been a steady upward trend since the 70's. About as many Americans support legalizing pot as de-legalizing abortion.
posted by oneirodynia at 1:09 PM on May 22


Upwardly trending polls is well and good, but the purpose of a leader is to lead. If this is the correct policy to pursue, the president has to make the case, convince people generally that it is worth doing, and then do it. But this is another example where Obama is subordinating what he thinks is right to a soft and amorphous consensus he can rely upon to justify taking any real action.
posted by Pastabagel at 10:23 AM on May 22, 2009


because drug use, esp for drugs like coke and heroin is irrational. The product has a significant chance of killing the user in the very short term, so why do it?

Been hitting the reefer madness a little hard, eh? I can't speak to coke 'cause I don't know enough about the pharmokinetics but heroin is one of the safest drugs... if you can get a clean supply of known potency. Which you generally can't unless you're a doctor. Because it is criminalized. Even with coke I can say that if it really had a signifcant chance of killing the user in the very short term we'd have corpses piling up in the streets. And we don't.

Can I drive while stoned? On speed?

I dunno, can you? (rimshot). But seriously... why would you think this? Can you drive while drunk legally? Nope, because it makes you unable to drive safely. So you wouldn't be able to drive while stoned.

You can already drive on speed legally so I'm not sure why you think something would change. If you take enough to make you unable to drive safely you could certainly be charged with DUI, but that's true now. This is a solved problem, for values of "solved" that don't work very well right now but we seem to get by.

How about Provigil? We did make that one OTC, right?

Uh, no. No we didn't. And you can drive legally on Provigil right now.
posted by Justinian at 10:25 AM on May 22, 2009 [1 favorite]


* Can I drive while stoned? On speed? How about Provigil? We did make that one OTC, right? (...)

No, no, yes, yes

Huh? Where did we make Provigil OTC? 'Cause right as far as I know it costs about $10 a pill and is available only with a prescription, what with being a schedule iv controlled substance and all.
posted by Justinian at 10:28 AM on May 22, 2009


Oh, too bad. I was hoping you'd correct me and I could order me some legal OTC Provigil. Don't get my hopes up like that.
posted by Justinian at 10:36 AM on May 22, 2009


"I dunno, can you? (rimshot). But seriously... why would you think this? Can you drive while drunk legally? Nope, because it makes you unable to drive safely. So you wouldn't be able to drive while stoned."

Most states already have DUI laws, which is a general law prohibiting driving while under the influence of intoxicants which impair your ability to drive. This includes legal and illegal intoxicants. You can drive legally on codeine, but not if you get pulled over and fail a sobriety test.
posted by krinklyfig at 10:41 AM on May 22, 2009 [1 favorite]


"How about this: Prescriptions will be needed for anything that has a reasonably high physical addiction rate (to be determined by the ATFD (see below)). So yes for heroin and meth, no for weed and acid. Prescription drugs can stay as they are, for now."

I'm not sure how well this would work. Probably prescriptions would be limited to maintenance, and cocaine doesn't really have a maintenance dose, as it doesn't create physical dependencies. It does create intense psychological dependency for those who become addicted. People who want to use either recreationally will not be getting prescriptions (I don't think the medical establishment wants to get involved with prescribing recreational drugs), so there will be a substantial black market for cocaine even if it's available by prescription. Speed does have a physical dependency, but it's not as bad as opiates or alcohol. It's already available by prescription, btw, though it's not used for dependency or addiction issues.
posted by krinklyfig at 10:52 AM on May 22, 2009


heroin is one of the safest drugs

Heroin can't even qualify for the contest that determines the safest drug. If you are talking about all drugs, prescription, OTC, and street, heroin ranks up there with vicodin, oxycontin, coke, and meth. as the leading cause of the roughly 16,000 overdoses per year. The problem with addictive drug use is that no one takes a safe dose after the first time, that's the point. You have to start taking more and more frequently.

And I'm not sure about the idea of making these drugs prescription. What would you be prescribed cocaine for? For the imaginary concocted ailments that people in CA get prescribed pot for? Not everyone buying pot in CA is undergoing chemotherapy. There's no reason to diminish the credibility of the health care industry any further by forcing doctors to prescribe drugs with a wink and having patients fabricating justifications to take drugs that people just want to take so they can get high. Look how much of a joke it is to get a prescription for viagra, a drug whose primary use is recreational.

Just file for a permit, so we can monitor the industry, usages, etc. That way there are no real barriers to drug use that would create an underground market, but we can compile statistics about usage, frequency, habits, that will be helpful in allocating rehab and healthcare resources, planning educational programs and regulating the products.

But the most important reason to legalize instead of decriminalize is a liberty issue. Are we free or not? If we are free, let people buy their drugs in a manner that is safe. If we are not free, then keep it illegal, but then you have an obligation to figure out why so much of your population is turning to illegal drugs, and you must then address that problem.
posted by Pastabagel at 10:55 AM on May 22, 2009


But this is another example where Obama is subordinating what he thinks is right to a soft and amorphous consensus he can rely upon to justify taking any real action.

Quit bullshitting. You're far too smart not to know that the Federal government doesn't have the sole authority to make drug policy. Every state has its own laws on the books banning the sale and possession of drugs. These have to be rolled back one by one, unless you want to endorse an even more egregious extra-constitutional use of Federal power. The DOJ has said its reviewing Federal drug policy and will release findings that include recommendations for changes to existing law. It's also stopped the raids on legal medical marijuana dispensaries in California and their clientele. That's more than any previous administration has done to begin liberalizing drug policy. That's not subordinating anything to an "amorphous consensus" (whatever that means, speaking of things that are amorphous).
posted by saulgoodman at 11:07 AM on May 22, 2009 [1 favorite]


Justinian: "Oh, too bad. I was hoping you'd correct me and I could order me some legal OTC Provigil. Don't get my hopes up like that."

*coughcoughAdrafinilisnotacontrolledsubstanceandismetabolizedtoModafinilinthebodycoughcough*
posted by mullingitover at 11:13 AM on May 22, 2009


"Heroin can't even qualify for the contest that determines the safest drug. If you are talking about all drugs, prescription, OTC, and street, heroin ranks up there with vicodin, oxycontin, coke, and meth. as the leading cause of the roughly 16,000 overdoses per year. The problem with addictive drug use is that no one takes a safe dose after the first time, that's the point. You have to start taking more and more frequently."

Actually, the primary problem for the addict is not knowing the purity. Overdoses usually occur after an unusually potent batch hits the streets. People use what they normally do and end up with more than they expected. Most heroin addicts of any significant duration are not trying to get high anymore but are trying to stave off withdrawals.
posted by krinklyfig at 11:18 AM on May 22, 2009


"Look how much of a joke it is to get a prescription for viagra, a drug whose primary use is recreational."

Erectile dysfunction is a recognized medical condition. It wasn't something we could easily treat until recently. I know it's the butt of many jokes, but Viagra's not really recreational in purpose. It's become popular in certain circles to enhance sex for people without dysfunction, but that's not why it's prescribed. (Although, I'm guessing, but it's probably not too hard to fake the symptoms to get a prescription.)
posted by krinklyfig at 11:23 AM on May 22, 2009


The problem with addictive drug use is that no one takes a safe dose after the first time, that's the point. You have to start taking more and more frequently.

Which is why recreational drugs that have a substantial risk of overdose should be legal but administered clinics, under medical supervision, and in monitored doses of regulated purity. Clinics that are also staffed with addiction treatment counselors who are ready to help addicts that want to quit.
posted by jedicus at 11:32 AM on May 22, 2009


administered in clinics, not that we should administer clinics to the drugs
posted by jedicus at 11:33 AM on May 22, 2009


goodnewsfortheinsane: I don't know if I'd want the same thing to apply to heroin, though. But the experiment is interesting.

vernondalhart: Why wouldn't you? If it is at it says, that in every metric it has been a success, what is the reason to keep drugs such as heroin under the criminal realm? I don't mean this to be snarky, I'm legitimately curious.

Sorry, I meant to say that I literally don't know: I'm not averse to the idea, I'm just not completely convinced of the overall net benefit. Sorry if that was unclear.

Having grown up in the Netherlands, considered by some to be the prototypical example of a decriminalised-weed jurisdiction (although the truth, as I hinted at upthread, is murkier than many think) the sense of taking the crime out of marijuana seems rather obvious to me, much in the same way that state-regulated health care does or the metric system does.

Much of this stems from my belief that marijuana can to an extent be enjoyed responsibly. Of course there are those who hole themselves up and smoke enough weed to forget that they dropped out of school and can't find or hold down a job, etc., but then it's tempting to draw the familiar analogy to alcohol (which I believe is often justified in this context).

But contrast this to heroin, which I believe is pretty much guaranteed to screw up your life (although I know there are some who will disagree even with this). Now, just to be clear I see little credence in that old "gateway drug" canard, and I don't think it has any significant bearing on the matter of decriminalisation: suspending punishment for marijuana possession won't drive people to shoot smack, I feel, nor will decriminalising heroin itself. (If anyone knows any numbers that refute this notion I'd like to hear about them.)

To answer your question, I agree with you wholeheartedly that if and when empirical data leads to the reasonable inference that decriminalising heroin is a Good Thing then we probably should. At least that's what the pragmatist in me believes. Said pragmatist also believes that punishing a heroin addict for their (albeit terrible) vice is morally unacceptable (they are already being punished enough, one might argue), ineffective (I doubt there is a significant deterrent effect) and ultimately wasteful (law enforcement resources could after all be allocated more usefully). I also, like many here, believe the Drug War as it called in American parlance is a quixotic farce. (And as an aside, and again like many here, I consider The Wire to be a convincing illustration of the causes, manifestation and consequences of its failure.)

But -- and here is where a nagging doubt rears its head -- there is also an idealist in me, one who feels using heroin is itself morally wrong, something a person should Not Do and therefore something a good society should Not Accept. As such, since laws exist not just to protect people and property, maintain civic order etc. but also to codify a society's mores, I believe it would not be ethical for a society to allow -- whether implicitly (through decriminalisation) or explicitly (legalisation) -- its citizens to use heroin without even token legal impediment or repercussion.

Now, I'll admit that the former argument is more rational, more practical while the latter is more visceral, if not to say ivorytowery; also, I understand that to some it may conjure up visions of a patronising nanny state descending down the slippery slope into ever increasing legislative condescension (the debates over anti-smoking laws come to mind). But I cannot help but feel this way.

Lastly, I do imagine that if and when our societies develop reliable, universal prevention and support programmes -- say, comprehensive drug education for everyone and comprehensive and free medical and social care for addicts -- the moral/societal argument would probably lose its standing in my mind. But alas, I must report that even in the supposed social Valhalla that is the Netherlands I don't think this condition is satisfied.

I apologise for the length, and I hope my explanation is not too vague. But I hope this answers your question somewhat.
posted by goodnewsfortheinsane at 11:57 AM on May 22, 2009 [3 favorites]


goodnewsfortheinsane: But contrast this to heroin, which I believe is pretty much guaranteed to screw up your life (although I know there are some who will disagree even with this)

With good reason.
posted by daksya at 12:47 PM on May 22, 2009



The self medication hypothesis has been studied extensively and discredited, check out the chapter "The mentally ill substance abuser" In M. Galanter & H. Kleber (Eds.), Textbook of Substance Abuse Treatment (4th ed.) (pp. 537-554). Washington DC: American Psychiatric Press. I don't have the time to retype the findings from my printed copy, but the cites are in there.

Sorry, this is simply not true. There are still holdouts who disagree with the idea of self medication, but that doesn't mean it has been discredited. Kleber is not always a guy who follows the evidence: he opposes needle exchange, for example.

At least 50% of people with addictions have a co-existing mental illness. At least 50% of those with mental illness have a co-existing addiction. It's not a coincidence.

Those who argue against self medication claim that sometimes the addiction predates the mental illness, but that is often not the case and where it is the case, it is often true that the mental illness has an age of onset that is typically later than the age at which people tend to start experimenting with drugs so it is all impossible confounded.

It is also the case that if you look at the number of traumatic events in a person's early life, it is linked in a linear fashion with their odds of becoming an addict. See the Adverse Childhood Experiences study-- a huge study of thousands of people-- for more here

Is it true that there are some happy, productive people who are going along just fine and try a drug and become addicted? Yes-- but that in no way represents the majority of people with addictions, most of whom have at least one comorbidity and/or an elevated rate of childhood trauma.
posted by Maias at 1:55 PM on May 22, 2009


"But -- and here is where a nagging doubt rears its head -- there is also an idealist in me, one who feels using heroin is itself morally wrong, something a person should Not Do and therefore something a good society should Not Accept."

I'm not really sure what this means. Addiction is a medical issue, not a moral issue. Is addiction to other opiates morally wrong, too, or just heroin? How about codeine or morphine? How about dilaudid, which is more or less the prescription equivalent of heroin in pill form, often used for chronic pain issues? How about someone who is using dilaudid for chronic pain becoming physically dependent? Anyone who uses opiods for chronic pain management is going to become dependent (which is not mutually inclusive with addiction). Is your objection that some people might enjoy opiods?

As far as what it means criminally, it might not be the best idea to sell opiods to anyone, but the goal should be reduction of harm and improvement of public health. Morality shouldn't really dictate how we manage such issues, because public opinion about morality sways like the wind. If moral objections clash with these goals, I opt for practical solutions, not just ones which make me feel better but that that aren't effective in dealing with the issues.
posted by krinklyfig at 2:05 PM on May 22, 2009


there is also an idealist in me, one who feels using heroin is itself morally wrong, something a person should Not Do and therefore something a good society should Not Accept.

See, I think this is a corrupting and dangerous view. Verging on the evil, frankly.
posted by Justinian at 2:43 PM on May 22, 2009


Most states already have DUI laws, which is a general law prohibiting driving while under the influence of intoxicants which impair your ability to drive. This includes legal and illegal intoxicants.

Whenever drug policy comes up here, people worry about this drug-driving furphy. Where I am, the same coppers who test you for booze test you for drugs. It's not that tricky a problem.
posted by pompomtom at 4:22 PM on May 22, 2009


Justinian: "there is also an idealist in me, one who feels using heroin is itself morally wrong, something a person should Not Do and therefore something a good society should Not Accept.

See, I think this is a corrupting and dangerous view. Verging on the evil, frankly.
"

I hear ya, man. But... because?

Come on. I used far too many words to voice my ambivalence on this issue, and this is your reply? I'd like to think I do not solely speak for myself when I ask you to please elaborate. Look, I'm sincerely interested in your motivations for disagreeing, but this is just lazy, hit-and-run opining.
posted by goodnewsfortheinsane at 9:59 PM on May 22, 2009


If you want to know more about heroin maintenance programs, where individuals are prescribed heroin, the Abell Foundation published a report (pdf) earlier this year, with a good summary of the findings from the different research projects. They concluded that such a program would be of potential benefit in Baltimore, and certainly worth having an informed debate over.

The North American Opiate Maintenance Initiative (NAOMI) published some of their results last fall. Although NAOMI was originally intended to include several cities in the US, it ended up in Canada only. They found that prescribed heroin was more effective than methadone at keeping people in treatment and reducing their use of illicit drugs.
posted by gingerbeer at 10:09 PM on May 22, 2009


krinklyfig: "As far as what it means criminally, it might not be the best idea to sell opiods to anyone, but the goal should be reduction of harm and improvement of public health. Morality shouldn't really dictate how we manage such issues, because public opinion about morality sways like the wind. If moral objections clash with these goals, I opt for practical solutions, not just ones which make me feel better but that that aren't effective in dealing with the issues."

I generally agree, especially on the "reduction of harm" angle. But I fail to see the relation between ethics and ((how)ever fickle) public opinion: who's to say that the the practical solution is also the most ethical? More practically put, why should we take the crime out of heroin sales yet allow heroin users to sustain their addiction freely?

Just to be abundantly clear, I hope: I'm not saying drug legislation should be based on an arbitrary standard of whatever's deemed to be good for society; it's just that I would be a little uncomfortable with the law completely leaving the heroin user in left field.

So basically, I think we might actually agree on the broader lines. I'll give it a bit more thought tomorrow.
posted by goodnewsfortheinsane at 10:18 PM on May 22, 2009


Okay, you say you have some sort of inner moralist telling you that using heroin (or one assumes various other substances) is inherently wrong and thus shouldn't be tolerated by society. Not because of deleterious effects or costs to society but wrong in and of itself. Malum in se and not malum prohibitum or whatever.

I'm not going to tell you that you don't feel that way; obviously you do. But other people have the same feeling about drinking alcohol. They have the same feeling about dancing. They have the same feeling about women exposing their hair or too much skin. They have the same feeling about gay people. They have the same feeling about sex before marriage, or eating meat, or a woman having an abortion, or smoking a cigarette, or taking anti-depressants, or a million other things that some people think are perfectly normal and other people have an idealist inside telling them is morally wrong and shouldn't not be accepted by society.

So you draw the line in a slightly different place. Maybe you think that what a woman does with her body in terms of a pregnancy is her business, but all of a sudden what she puts into it is society's business? It's all the same. Either we are sovereign individuals or we aren't. Once we agree that society, which in this case usually means the powerful, can tell the individual, which usually means the weak (how many senator's sons do you think do prison time for coke?) what they can or can not do with their own body in the absence of overriding public interest we have forfeited much of the right to complain when the line gets drawn somewhat differently than we would draw it. Hey, I didn't mean alcohol should be illegal, just heroin. Hey, I didn't mean gay dudes shouldn't be allowed to marry because gay marriage is immoral, only that smoking a joint is immoral.

Who are you to say that gay dudes getting married isn't immoral and should never be legalized when you've just said flat out that making policy decisions about what society should and should not accept can legitimately be based on a gut instinct as to what is moral or immoral? What standing do you have to argue against making abortion illegal? Lots of people have an idealist in them telling them that it is very, very immoral... and frankly, they have a better argument than "heroin makes me feel icky inside". What standing do you have to say women shouldn't be made to keep their heads covered to avoid the immoral and corrupting influences that result from such depravity? Because your little voice is better than the other guy's little voice?

There's an argument to be made that the societal harm from weed and speed et al is an overriding public interest and thus they should remain illegal. I think it's a terrible and wrong-headed argument that flies in the face of decades of evidence and the millions upon millions of our own incarcerated citizens, but it is a real argument. I also think it is an argument people often make not because they believe it or even care if it is true but because they, like you, have a feeling that drugs are immoral. But it is a real argument, however wrongheaded.

But basing policy that destroys entire classes of people and maintains a permanent disenfranchised underclass on a tiny Mr. Mackey in your guy going "Drugs are bad, mmmmkay!" is not an actual argument. It's what has destroyed our inner cities, put millions of folks who don't deserve to be there in prison, propped up violent, murderous cartels and gangs, made the United States a land of jailers and the jailed, caused the sick and dying to be unable to receive the care they desperately need and deserve, and caused more harm and suffering than all the heroin in the world could cause in a hundred years.

That's why I think basing policy on the fact that you've got an idealist in you whispering that heroin is inherently immoral and shouldn't be tolerated by society is not a good thing. Not a good thing at all. That voice you hear? It's not an idealist, its Mephistopheles, and you're Dr. Faust.

So, yeah, this was longer than my one-liner.
posted by Justinian at 10:53 PM on May 22, 2009 [8 favorites]


"a tiny Mr. Mackey in your guy" should be "in your gut". Not that Mr. Mackey doesn't appear to, you know, get all up in a guy pretty often but it's not what I meant.
posted by Justinian at 10:57 PM on May 22, 2009


and frankly, they have a better argument than "heroin makes me feel icky inside".

To be fair, they're doing it wrong.
posted by pompomtom at 9:37 PM on May 24, 2009


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