All these others syntheses with multiple steps up the chances of weird toxic solvents or contaminants creeping in. I think it’s a contaminant issue that’s exacerbated by the drug use.
The government should just regulate it, control purity and production and let people access small amounts for recreation/performance. It’s not an evil drug per se - long history before it was criminalized. Plus that would neuter the cartels and protect people’s health more than pushing it underground.
Famously, the US spent about 15-20 years attempting this with opioids. They were widely available to people via a pseudo-medical process, or via secondhand dealing. Opioids were/are manufactured by regulated, publicly traded companies with inspectors who controlled purity and production. The result? A shattering drug addiction crisis that at its height killed more people annually than the entire Vietnam War.
(For people saying 'no, that was illegal heroin or fentanyl that did all that damage'- the Wiki page for the opioid crisis is quite clear that at least 50% of all deaths were due to perfectly legal, regulated opioids).
When you make drugs legal & easy to get, lots & lots of people do them- who develop life-shattering addictions and OD en masse. They also build tolerance and then move on to even harder stuff. AFAIK out of the 300ish countries on the globe, there is not 1 that has decriminalized hard drugs in the modern era. And no don't say Portugal, contrary to widespread myth they forced people under threat of jail to attend drug rehab, and anyways they've recently curtailed even that.
I realize this is not going to get a lot of upvotes on HN, but yes making it difficult to do hard drugs is a reasonable public policy goal. (Which again, is why literally every country on the planet does it). There's room to argue about the exact tactics, but the broad goal is perfectly legitimate
They’ll be outside funeral homes, outside schools, offering free graduation crack. Ads on every bus, hot women handing it out in the street.
Many countries, including the US, use methadone for maintenance. As I understand it it’s not as enjoyable as some people’s opioids of choice but it’s still an extremely powerful opioid depending on the dose (easily fatal).
So it’s not only the countries you mentioned that provide pharmaceutical opioids as maintenance treatment. The US does too, though the form is different.
Sure, you could demand injection on site to reduce this problem. But that just makes the program less appealing. You could also just hand out the users' drug of choice directly (heroin) rather than the less harmful substitute, but at some point that starts counting as physician-assisted suicide, really.
Are you talking about this page?
https://en.wikipedia.org/wiki/Opioid_epidemic
Could you then be more clear where exactly your claim came from? I did not find it, but rather this:
"According to medical professionals, supervised injection sites are effective in reducing overdose deaths and the transmission of infectious diseases."
"From 1999 to 2020, nearly 841,000 people died from drug overdoses,[7] with prescription and illicit opioids responsible for 500,000 of those deaths"
Here's a chart showing overdose deaths from all drugs in the US- yes there's definitely a large spike from 'synthetic opioids' at the end there that's probably all illegal fentanyl. But notice the blue line for 'prescription drugs' was very very steady for the entire length of the chart. That's an enormous number of deaths from completely legal, regulated drugs!
https://upload.wikimedia.org/wikipedia/commons/f/fa/US_timel...
Theory: this is a socioeconomic problem rather than a public health problem. Our systems care too little for people. The easiest solution then is for people to self-medicate.
It's easier to deny people a harmful salve that they feel they need than to provide them the social supports that they deserve.
1. US tobacco policy is far more liberal than the War on Drugs, yet which of the two is a successful case study in curbing harmful addiction?
2. The recent opioid epidemic is far more complex than "the government tried legalizing opioids and it failed". Whatever policies did exist weren't legalization of opioids, and didn't exist in a vacuum. You can't model that policy without factoring in the wide availability of contaminated street drugs and absence of safer OTC cannabis alternatives. More importantly, the drugs weren't merely available, but actively pushed in a way that should have been legally discouraged.
3. The above analysis completely ignores the most important point raised in the top-level comment: prohibition simply redirects capital from businesses that are regulated to those that are not. Say what you will about Big Pharma, but they usually don't go around hanging mutilated bodies from bridges.
4. Even if drug prohibition were the optimal policy for reducing addiction rates, at some point protecting people from their own choices ceases to be a valid excuse for harming the rest of us. We've punished countless marijuana users who mostly aren't addicts, inflicted terror and destabilization upon our neighbors to the south, and created what at least half of America believes to be an illegal immigration crisis.
5. The claim that drug prohibition even helps the people it's ostensibly supposed to help is extremely dubious. We're subjecting addicts to more dangerous substances than the ones they're actually seeking out, and locking up the ones who survive. Maybe there's a narrow slice of people who really want narcotics but lack the motivation to navigate black markets, but otherwise who is this all for? We're hurting everyone in our confusion just to enrich a cabal of warlords.
There is a pretty decent argument that this was still a result of pseudo-prohibition, which goes like this:
Opioids were easy to get a prescription for, but still required a prescription (and were covered by insurance), and were still highly restricted in who could manufacture them. That made the margins high, and consequently created a perverse incentive for the manufacturers to want patients taking the high margin insurance-funded opioids rather than a cheap commodity out-of-pocket NSAID or acetaminophen.
Because they still required a prescription, getting people taking them meant they had to capture the prescribing physicians, who now get their own perverse incentives. Not only marketing/kickbacks/incentives from the pharma companies, if something over the counter would work and that's what you recommend, the patients buy a bottle at Walmart for $5 whenever they need it and you never see them again, but prescribe something stronger and you get to bill their insurance again and again every time they need another appointment to re-up.
But "ask your doctor" was supposed to be the thing you do to get sound advice. Give the medical establishment a profit incentive to over-recommend the addictive thing and what do you expect?
Meanwhile if they were all available at the convenience store for the same price, nobody would have the incentive to push the addictive one, and then when you ask your doctor (or for that matter anyone else) what they recommend, they would generally tell you not to take opioids unless you really need them.
In any case, drug dealers really don’t need to do any pushing, the drugs sell themselves. Have you ever taken an opioid? The idea that unfettered access would result in less addiction and death is a pretty remarkable POV
Like how about you have to do a short course which actually explains to you how a drug works, how to use it correctly, what are potential downsides, what are markers of overuse/wrong use.
And the other main issue with opioids and co: some people really have constant / chronic pain.
Do you know how exhaustive it is to constantly have pain? How annoying it is that you can't just go to bed and sleep?
But also we can't play devils advocate to say "you are not allowed to do drugs to num whatever issue you have" and also "but i don't want to take time and effort of helping you".
Oh i don't want you to kill yourself! But i don't want to spend time tomorrow afternoon either with you.
Our society is very hypcritical in this sense. Honestly i think people just don't want to see homeless people or fentapoeple. Its not about helping, its just about not being disturbed by them.
That depends on the drug. Both it's addictiveness and its destructiveness. It's likely true for meth. I doubt it's true for weed. It's demonstrably not true for many of the OTC drugs that have been easy to get for hundreds of years without the collapse of society
This is complete nonsense.
Opioids have never been made legal for recreational purpose. They were sold as painkillers by pharma corporations lying about their addictive effects and promoted through marketing campaign targeting doctors to prescribe them.
I has nothing to do with the topic of recreational drugs.
I believe 1970 was also the year when amphetamine (Benzedrine) inhalers stopped being OTC.
There is a world of difference between something like that and government dosed methadone, meth, etc.
The problem was not in fact opioids. It was the profit structure behind the distribution network. Remove that and the bulk of the problems go away too.
If the drug is socially stigmatized only true addicts will use it. Those are exactly the people you want to have access to it because they can be gradually tapered off on a controlled dosage, they can be targeted for interventions, and it keeps them from stabbing you and stealing your wallet to get more meth.
Its incredibly counterproductive to just outlaw a thing that people need on a level that they will do almost anything to get it.
Yes but that's different from 'every random person can buy some meth at 7-11 or the government store' though. I'm fine with a controlled program for registered, hardcore addicts- the 2% who do 50% of the drugs or what have you.
>The problem was not in fact opioids. It was the profit structure behind the distribution network. Remove that and the bulk of the problems go away too
I mean, states & countries that have completely state-run liquor stores still have alcoholism and serious alcohol problems though? If 'removing the profit structure' worked magically, more countries would do it. AFAIK rates of alcoholism aren't even different between state-run and private sector models
The result is that the illegal market dwarfs the legal market. The legal suppliers simply can't compete with efficient and untaxed illegal or grey market sellers.
Note that the consumers who choose the illegal market are not in general socially excluded, habitual criminals or broken down addicts. Weed is widespread in almost all parts of society and probably less prevalent along dirt poor, mentally unwell or homeless drug users, who favour fent or meth.
People with jobs and houses choose illegal weed because it's both cheaper and easier to get hold of.
If the drugs are pure, and health problems that occur with abusing them (overdoses and addiction) are treated as health issues rather than criminal issues, then it's all a solvable problem.
Heroin being illegal didn't stop my brother from dying on it.
Except that you're wrong. The war-on-drugs kept drugs under control. It did not _eliminate_ them, but they also were not available on every street corner.
Once we stopped the war-on-drugs, the abuse rates skyrocketed. Not just opiods, but also meth. You can see it on the graphs in this article, the general wind-down of drug abuse policies started around 2008-2010.
What America continues to ignore, intentionally or not, is the root cause of drug addiction which tends to be a more complicated and nuanced
At best it kept some amount of some drugs less visible in some suburbs and communities, while making it profitable for suppliers to cross those lines.
The main effect of the war on drugs was a level of incarceration outdoing almost any society in human history. The fact that the numbers jailed for victimless and quality of life 'crimes' kept going up is testament to the fact that there was hardly any effective deterrence.
Something which has always grounded my beliefs is the comparison to alcohol.
Imagine we walked into bars and were presented with unmarked bottle of clear liquid, and had to order "1 alcohol, please!", where the alcohol % and quality of the drink was totally random. It'd be fucking chaos.
I think I've settled on the "drugs should be legal" but heeavvviillyyy regulated and marked. I wouldn't mind going to a bar and ordering a very weak MDMA drink, or going to a shisha cafe with weakened opium, weed, crack, etc.
Also, it seems the way drugs are punished criminally is totally wrong. Why not lock people up for false advertising rather than 'strength'? I.e if you're heavily cutting drugs, you should be strung up for manslaughter. It would put pressure on the manufacturers to label and regulate themselves.
Here is some of what the US has been doing ever since the "war on drugs" started:
- Ban the sale of such substances, forcing users to resort to the black market.
- Lock up anyone who uses or possesses such substances, training users that there is no help for them.
- Lock up anyone who helps or intends to help anyone else use or possess such substances, training users that there is no helping others.
- Censor information on how to reduce the risks of substance use, forcing users to put themselves in more danger. (Contrary to apparent popular belief, this does not dissuade users, only harm them.)
- Censor information on how to produce or obtain such substances, preventing the discovery of reliable sources.
- Engage in relentless fearmongering about how terrible and bad such substances are, encouraging users to entirely disregard all warnings about substance use.
In my opinion, here is what one should actually do:
- Regulate the production and sale of such substances. Don't force users to resort to the black market.
- Encourage harm reduction and responsibility towards substance use. Don't train users that there is no help for them.
- Warn only of the real risks and concerns about substance use. Don't train users to disregard very real dangers by flooding them with fake ones.
- Offer reliable sources for such substances. Don't force users to resort to dubious leads.
Recent research into psilocybin therapy, for instance, is very exciting. I've been using psychedelics at home for years, and I dream of a world where known quantities and potencies of such things can be reliably sourced over-the-counter for such use. I don't know if I'll live to see the day.
Also note that none of this prevents helping users who genuinely need it -- users with less self-control, for instance, or harmful dependency. But forcing them all into terrible shame, withdrawal and eventually an utterly preventable death, is the same kind of bullshit that looked at building more homes and then invented anti-homeless architecture instead.
The phrase “small amount” is doing a lot of heavy lifting in this statement.
The government does regulate and control amphetamine and methamphetamine (Desoxyn) as prescription drugs. The former is not all that hard to access. For a while it was as easy as signing up for a service through a TikTok ad and filling out a form, after which you were guaranteed a prescription. Those mills got shut down but it’s not hard to find a doctor willing to write a prescription in your area with some Internet searching (Side note: Lot of people get surprised when they get a prescription from some random doctor and discover that all of their other doctors know about it. Controlled substance prescriptions go to shared databases and it will be on that record for a while)
> It’s not an evil drug per se - long history before it was criminalized
Dose makes the poison, the recreational users aren’t going to be satisfied with your government regulated small amounts.
These discussions always end up with two parties talking past each other because one side wants to focus only on the ideal drug user who uses small amounts and has perfect education and self control, while ignoring that the meth users wouldn’t be stopped from seeking their larger quantities than a theoretical government regulated small amount program would allow.
I should also mention that methamphetamine appears to be quite neurotoxic at recreational doses. Maybe even smaller doses too.
We should also mention that the “long history” you speak of isn’t actually that long and was associated with small epidemics of overuse and addiction, too. It’s not like addiction is a modern phenomenon.
For instance, I could purchase psilocybin/mescaline/ibogaine treatment at a dispensary (obviously imagining a therapeutic commoditized future). I could also purchase mescaline/psilocybin/salvia recreationally. Some recreational access may be "psych tested", or at least "need to pass the monitored orientation session" using special assays to ensure people could handle a "solo flight".
For the chem in question, it really is a more basic case I think of purity/quality/amount/regulation. I could walk into a dispensary and do a 50mg (is that correct?) line instead of a hit of espresso. Would I do this? I'd like to try, at least. The fact that I could, and know it was high quality and safe would be very cool.
I'm probably a bit weird/sci-fi/psychedelic utopian but I love the idea of a menagerie of dispensaries dealing out all kinds of cool, useful and exploratory chemicals safely. There could even be a chain of PiHKaL/TIHKAL outlets. Perhaps affectionately named "Shulgin's Drug Store". lol :)
> These discussions always end up …
Before your comment i wouldn’t say anyone is lacking curiosity here. Tho your comment about fixing into a stereotype, seems the example of itself. I think it’s better to listen and discuss than assume the futures settle into a mischaracterization that you’ve already decided. That doesn’t seem very useful - except for ideology…
On the toxicity side, do you have any studies to cite? I wasn’t aware of toxicity, but it’s plausible.
Big picture tho, I’m not an expert in drug policy. It just sounds like a logical way to reduce harm overall. Reduce harm overall - worth repeating; on average, create a better society.
The conceivable parties who would lose out are: government funded agencies charged with fighting drug crime because their caseload and budgets would probably decrease; and on the other side the cartels and dealers. Although what seems to happen with the latter is once something is legalized, the supply chains morph into legitimate businesses somehow.
I still think it would work. I’m not convinced by what you said. Thank you tho
A typical therapeutic dose of amphetamines is around 20mg, topping at around 60mg for serious narcolepsy. Recreational doses can go up to around 1000mg for long-term users with 360mg as the median: https://pubmed.ncbi.nlm.nih.gov/40385390/
That's the area of crazy toxic side effects just from vasoconstriction. Never mind direct effects on the brain.
The article addresses this:
> Second, the evidence we have is against the idea of contaminants in P2P meth. Almost all meth was produced using P2P since 2012, before most reports of schizophrenia. And P2P meth synthesis has changed several times in the interim, resulting in higher purity than ever before.
Not saying they're right, but the author at least believes this hypothesis is contradicted by the data.
It doesn’t necessarily follow that it’s impossible to have a legalized or decriminalized regime that works, but it is non-trivial to get right.
The world is obviously better of without drugs, but given that is not going to happen, the question to decide is: is the world better of with drugs from legal pharmacutical companies, or (somewhat) restricted access to drugs through an illegal system?
Decrimininalizing drug use is the worst of both worlds: you get more drug access, but it still happens through the illegal system and benefits narco terrorists.
If you don't want to put drug users in jail (you cannot reasonably fine homeless people), you can offer drug courts and diversionary programs.
You need the federal government to do what it did with Marijuana (which is still federally illegal), to be able to try the other choice.
You slip such a confident assertion in there seemingly without justification. Do you think (for example) that the world would be better off without alcohol? I certainly don't. Everything has downsides; that doesn't on its own justify eliminating it. It's analogous to the adage that the most secure computer is the one encased in a block of cement so as to render it entirely unusable.
I think the various pieces of evidence presented in the article basically all point against this. Is there a reason you think the evidence in the article is flawed?
After a fact dump about different types of meth, it's literally a collection of anecdotal evidence from meth users going "for the first 5 years of smoking weekly, I had a great time partying in a relaxed way with my best buds, now that I've lost my job, partner, family and home and smoke daily my mental health is fucked up".
And people working in drug care and enforcement saying "when a few rich hedonists would spend $60 for the next level high, it didn't cause schizophrenia. Now that we have thousands of former crack and opiate addicts living in tents injecting $10 bags three times a day it seems to be contaminated with something that causes detachment from reality."
The literal two most common and evergreen things in drug culture are users claiming that the old stuff was much better and would deliver a clean high without addiction for barely any money, and cops claiming that the old users were better, gentlemen fiends who did not sell their bodies or rob and exploit their own families, never bit or stabbed you when being arrested, and did not soil themselves or set fire to their own clothes while in custody.
I have multiple close family members who have struggled badly with drug and alcohol abuse. Good treatment is the way, not the government handing out drugs.
The difference between most amphetamines and Desoxyn is that extra methyl group. That methyl group helps it cross the blood-brain barrier a little faster but the chemical that reaches the brain is the same in both cases.
The thing is, drugs are addictive. ESPECIALLY meth. How would you prevent people from just getting as much as they want and then becoming drug zombies? Fentanyl is similar. Cartels perfected its production, so now it's pure and widely available.
It's even worse than meth in some regards. Once you start using fentanyl, you're going to become a hardened addict. And there will be almost no hope of recovery, the success rate of drug rehab treatments is in single-digit percentages.
I guess the idea is that people will just keep using "safer" drugs like cocaine instead? I'm not sure it's working, we legalized cannabis and it made zero difference.
A prime example is alcohol, where prohibition led to bad outcomes. This led to the regulated legalization model.
E.g. in some Nordic countries hard liquor is still only available in government stores and licensed restaurants, with exactly this logic. Not long ago bars could serve only one "unit" of alcohol at a time. Longer ago there were limits to how much alcohol one could buy in a week.
> I guess the idea is that people will just keep using "safer" drugs like cocaine instead? I'm not sure it's working, we legalized cannabis and it made zero difference.
Cannabis and cocaine are very different kinds of substances with very different uses and audiences. Expecting legalized cannabis to substantially reduce cocaine use is like expecting banning of coffee would substantially increase alcohol consumption. There can be some minor effects due to multiple illegal substances tending to have the same outlets, but this is likely a subtle at best.
Also how much more "safe" cocaine is from methamphetamine is not that clear. Probably the largest effect is from very different demographics of methamphetamine vs cocaine users.
The problem is that addicts are not going to be satisfied. Canada tried "safe supply" programs, where addicts are provided with medical opiates. Some addicts ended up selling pills because they were too weak and buying stronger street drugs.
It also apparently failed to improve long-term outcomes, although it's a bit early to tell that for certain.
> Expecting legalized cannabis to substantially reduce cocaine use is like expecting banning of coffee would substantially increase alcohol consumption.
Well, it did not reduce opiate consumption either.
I have, and the argument that everyone addicted had some other issue going on is pretty pointless imho. Yes, they had some other issue, and now before fixing that issue they also have to deal with being a drug addict.
Some are. Your life could be better than it's ever been but if you've got a physiological dependence on a drug and don't have enough of it in your system you're going to have a very very bad time until you get more. Some drugs will even kill you if you fail to get more and you need to be carefully weaned off them before you can stop taking it.
If amphetamine isn't strong enough, you already have a serious problem.
I'm not saying that criminalization is the right way, just that I don't see a responsible recreational/performance use for methamphetamine. It's too strong and too toxic. The regulation should permit only use for addiction management imho.
Also, the long history is not exactly in its favor, given how the Nazis extensively used it and Hitler was probably a serious meth-junkie.
The main "advantage" is probably the smoking RoA of methamphetamine. The RoA difference is likely a larger factor in methamphetamine vs plain amphetamine effects than the pharmacology of the molecule.
The craziness of so many legal things being pretty bad for health is also something worth addressing (alcohol, cigarettes).
https://en.wikipedia.org/wiki/CIA_involvement_in_Contra_coca...
