The War on Drugs


I see that Donald Trump tried to declare that opioid abuse is an Emergency. To be fair, it’s a problem; they are dangerous when abused. Probably the greatest danger is that people who are addicted to them become desperate and turn to doses that have no quality control: you may get heroin that has been cut with fentanyl, shoot your usual dose, and then you’re suddenly dead. That’s a problem.

(I got these numbers from CDC’s report on 2015 deaths, 2016 deaths for opioids will be higher)

Apparently nobody died of marijuana in 2015. Or, if they did, it was recorded as something else. If we look at this as a simple public health issue (AKA: Emergency) then, frankly, why are we worried about Methamphetamine at all? I was genuinely surprised that there are virtually no deaths caused directly by amphetamines, though it appears that some users mix amphetamines with opioids (Hitler’s “wake me up” was Oxycodone and Pervitin, an early version of Benzedrine) The benzodiazapenes, like Nancy “just say no” Reagan was hooked on, hardly register.

[CDC]

If we were at all concerned with health outcomes, we would immediately ban tobacco. And regulate alcohol. Or maybe we’d try to arrange our civilization that that people can put whatever they want into their bodies, as long as they understand the choices and the consequences. There’s a problem with that basic libertarian position, namely that our past selves cannot adequately understand what our addicted future selves will think of their decision.

Last year, firearm deaths were about 12,000 and an additional 20,000 suicides using firearms. Would Hemingway have counted double, I wonder?

If opiates are an “Emergency” what are Alcohol, Tobacco, and Firearms? Drinking alcohol seems to be about as likely to kill you as firearms, the difference being that you (arguably – we are not going to debate free will here) choose to drink alcohol, but only 2/3 of the people who die by firearms did it of their own volition.

Alpha-PHP (not a programming language)

I’m not entirely sure where I am going here, but I think that alcohol and tobacco, being highly regulated and taxed, are predictable drugs: you don’t suddenly die like Carrie Fisher or Prince, you follow a predictable trajectory. People have plenty of time to ignore or facilitate you. Of course, Prince and Fisher and so on – they had facilitators, too, who saw it coming and variously tried or didn’t try to intervene. I’ve made my own minor attempts at interventions, usually against smoking. It has only worked once (but the patient relapsed a decade later). Michael Jackson could afford a private doctor to shoot him up; normally that would have been a good approach except the doctor screwed up.

Someone once said to me, “It’s not the heroin that kills you, it’s the poverty brought on by heroin that kills you.” To that extent, it’s true. There are people who have lived long (so far!) successful careers on heroin – they had access to good stuff that wasn’t cut, and they were controlled and careful about it. If we’re going to point to fentanyl as an emergency, we need to recognize that fentanyl is being used as a substitute for the oxycodone that used to be handed around like candy. The oxycodone was high quality stuff, made by careful robots in labs, and when it became harder to get, addicts started buying unregulated synthetic pure product from the black market. [stderr]

It’s hard to see opioids or fentanyl as an “emergency” when US drug policy is so completely irrational and unbalanced. It makes as much sense as using terrorism to fight a war on terror: doomed to fail, so hurry up and get the failing over with.

Imagine if the fentanyl makers (or the meth cookers!) had lobbyists. Come to think of it, I’m actually surprised they don’t – they ought to do like the alcohol makers did and get it regulated, then lock up the manufacture, tax it, and operate openly. Because “who will speak for the poisoners?” hand-wringing in the name of capitalism: [bbc]

The tobacco industry is hampering efforts to introduce life-saving interventions in low and middle-income countries, according to a report by the World Health Organization.

It makes me wonder, if tobacco were more closely regulated, are they prepared to go underground, cartel-style? No, not really, they’re just going to places that are less regulated and enjoying their profits here.

“There has been progress, but there’s more to do,” said Dr Vinayak Prasad, head of WHO’s tobacco control unit in Geneva.

“Most of tobacco usage is now happening in the Middle East, in Asian economies and (tobacco use ) in Africa is also adding up”

He said that tobacco companies are now increasingly setting their sights on “easier, less regulated markets”, and putting pressure on their governments.

Imagine this: today, representatives of the New Mexico Meth Cookers cartel gave anonymous testimony to congress, explaining “We are going to sell this stuff, anyway. You may have made it illegal to sell in the US, but why not let us bring jobs to New Mexico by cooking our meth and selling it in Africa. It’s good for the tax-base, it creates jobs, and if we operate openly, our product will be better and – who knows – it may save a life or two.” Goldman Sachs has expressed interest in underwriting the meth labs, “This is a significant vertical market and there are many synergies to exploit here,” said senior stock analyst J. Redacted.

Some of the world’s biggest tobacco manufacturing companies have told the BBC that whilst they do not oppose reasonable tobacco regulation, they do need to be part of the debate on policy.

Jonathan Duce from Japan Tobacco International, responsible for brands such as Benson and Hedges and Camel cigarettes, said: “We believe that public officials and policing organizations should have access to all facts when it comes to policy-making, including from businesses.

Oh. They’re already ahead of me.------ divider ------

My drug of choice is caffeine, which appears to kill about as many people as marijuana (which, sadly, doesn’t have any effect on me).

Oddly, the people who are being the most rational, in my mind, about drugs are the mormons and the 7th day adventists. When religions are being more rational than public policy, public policy is probably a mess.

Comments

  1. Dunc says

    It makes me wonder, if tobacco were more closely regulated, are they prepared to go underground, cartel-style?

    Interesting question… Over here in the UK, where tobacco is very heavily taxed (a 20-pack of regular cigarettes is around GBP10.00), there is a thriving black market (estimated at 16% of cigarette and 48% of handrolling tobacco). Some of that is supplied via smuggling of “legitmate” products from lower-tax jurisdictions (mostly other EU states, and some of it is “counterfeit” products produced illegally in the UK – the bulk tobacco used in the manufacture of those mostly comes from China. What any of that says about what might happen if the tobacco majors found themselves without any legal markets, I wouldn’t care to say. However, it doesn’t seem unreasonable to argue that, given the volumes we’re talking about, the industry must know that they’re selling a lot of product that’s finding its way across borders. How culpable they are and and what they could do about it are harder questions…

    Another thing you need to bear in mind when wondering about why tobacco is so tolerated is that the big tobacco companies remain very attractive investments and form the backbone of many investment portfolios, since they offer excellent yields. It’s surprisingly difficult to find a well-diversified pension fund that doesn’t include at least some weighting to tobacco – and often a fairly hefty one at that. We’re talking about somewhere in the region of 750 billion dollars of market cap on the NYSE alone.

  2. sonofrojblake says

    There’s a problem with that basic libertarian position, namely that our past selves cannot adequately understand what our addicted future selves will think of their decision

    Our past selves cannot adequately understand what our unqualified/unemployable future selves will think of their decision to coast through school and fail exams. Our past selves cannot adequately understand what our impoverished future selves will think of their decision to have children too young. Young people will make mistakes. Right now we’re just locking up mainly the black ones for those mistakes. Isn’t it more morally sound to educate them all, give them accurate information instead of scaremongering, then have a safety net to help those who nevertheless fall? That safety net to treat the addiction as a health and social issue, rather than a crime?

  3. Siobhan says

    I’m not saying I’ve tried marijuana since that is as of now still a crime in Canada, but if I did I’m just saying it would probably be more effective than any anti-anxiety medication I’ve ever tried and only comparably intoxicating.

    I’m not saying I’ve tried medical-grade marijuana either, just that I’ve heard from reputable sources that that shit is so smooth you could spread it on toast.

    I am saying I’ve tried prescription anti-anxiety medication and the inability to wake up in the morning is kind of a dealbreaker.

    @sonofojblake

    Isn’t it more morally sound to educate them all, give them accurate information instead of scaremongering, then have a safety net to help those who nevertheless fall? That safety net to treat the addiction as a health and social issue, rather than a crime?

    I agree. It’s just that self-styled Libertarians are typically against things like “education for all” and “safety nets.” If I had my way, drug laws would barely exist, and they would be the business of the health sector, not law enforcement.

  4. Siobhan says

    Also, from the OP:

    It’s hard to see opioids or fentanyl as an “emergency” when US drug policy is so completely irrational and unbalanced. It makes as much sense as using terrorism to fight a war on terror: doomed to fail, so hurry up and get the failing over with.

    That’s easy, Marcus: The policy makers can’t criminalize the only thing keeping themselves awake! That would be awkward, or something.

  5. colinday says

    Caffeine not only doesn’t kill people, it saves lives. Really, do you want nurses pulling twelve-hour shifts on decaf?

  6. says

    Shiv@#3:
    (I changed ‘now’ to ‘not’ because I know that’s what you meant)

    If I had my way, drug laws would barely exist, and they would be the business of the health sector, not law enforcement.

    I agree about the barely exist; I think I’d want to see education more leveraged. Teach people “If you ingest this, this is how it will affect you. And the effect will last this long.” Heroin is more likely to be a life-long engagement than a one-night stand, etc. I think I’m being an optimist when I imagine that people are able to make their own decisions about this stuff, but I don’t agree with the decisions that the state makes for us. It’s a tricky problem but I do think we’re going about it all wrong.

  7. says

    colinday@#5:
    Caffeine not only doesn’t kill people, it saves lives. Really, do you want nurses pulling twelve-hour shifts on decaf?

    I agree. I wouldn’t mind if they had access to real amphetamines, as long as they were not using them so consistently that they started getting paranoid (‘psychosis’ is a symptom of long-term amphetamine use) The US military hands out “go pills” in Afghanistan, etc – what do you think they are? They’re amphetamines that have been formulated to be No Fun. There’s some weird thing going on, there, some left-over puritanism: it’s OK to give people psychoactives as long as they’re not fun.

  8. Siobhan says

    @Marcus

    it’s OK to give people psychoactives as long as they’re not fun.

    Literally: My anti-depressant is a meth derivative that biochemically does the same thing, except it burns slower.

  9. says

    sonofrojblake@#2:
    Our past selves cannot adequately understand what our unqualified/unemployable future selves will think of their decision to coast through school and fail exams. Our past selves cannot adequately understand what our impoverished future selves will think of their decision to have children too young. Young people will make mistakes.

    Yes, although I think there’s a certain value to explaining to people (who don’t understand) the possible consequences of their actions. Personally, I think smoking is kind of stupid. But I’m not sure whether I should be able to tell people “don’t do it.” On the other hand, I want to be able to offset the tobacco companies saying “it’s cooooooool” – I don’t want to balance lies with lies and propaganda with propaganda. But what kind of cost/benefit analysis can we fairly ask our past selves to make? I’m also not really fond of saying to someone’s present self “your past self made a bad decision and now you must suffer for the rest of your life.”

    Right now we’re just locking up mainly the black ones for those mistakes. Isn’t it more morally sound to educate them all, give them accurate information instead of scaremongering, then have a safety net to help those who nevertheless fall? That safety net to treat the addiction as a health and social issue, rather than a crime?

    Absolutely.

    I probably wasn’t overt enough about my beliefs but I think that the real problem is lying to people, which means they cannot make a good decision. And that cuts all directions – if you lie and say “methamphetamine bakes your brain” well, that’s kind of unreasonable when “tequila bakes your brain” is probably as true or more true.

    Differential prosecution based on race or anything else is, of course, a horrible wrong. I know the US started the War On Drugs as a way of getting black people in the crosshairs. That was a horrible crime for which careers ought to have been broken and people ought to have been sent to prison.

  10. says

    Shiv@#8:
    Literally: My anti-depressant is a meth derivative that biochemically does the same thing, except it burns slower.

    Yup! And illegal ecstacy is also an amphetamine. Ritalin is a patentable version of the old German WWII Pervitin.

    In a medical context you have the advantage of being fairly sure that your anti-depressant has good quality control and is not cut with fentanyl or whatever’s powerful and cheap this week. There’s a lot of goodness in that.

    Here’s another one that makes me scratch my head: I have a friend who’s on benzodiazapenes. They have a pretty long-term prescription and it’s mostly recreational (i.e.: red wine and Valium after dinner every other sunday) I don’t have a problem with that. I don’t have a problem with anti depressants. I certainly don’t have a problem with people drinking red wine or smoking or eating pot.

    I have a problem with marketing tobacco as ‘cool’ but I think my problem with that is with marketing in general. If people could be adequately informed as to the side effects, then, sure. I’m OK with people skydiving or hang gliding for entertainment, too.

  11. says

    Dunc@#1:
    Some of that is supplied via smuggling of “legitmate” products from lower-tax jurisdictions

    Yeah. That’s the invisible hand of the market, shuffling those packs of cigarettes around.

    And I do suspect the tobacco companies sell large amounts in lower tax areas, knowing that for the size of the population they’d have to all be smoking 20 packs a day to use all those cigarettes. They must know that the cigarettes are going wandering.

  12. says

    I’m always rather boggled to see people who manage to kill themselves with hydrocodone. Every day, I take hydrocodone, tramadol and a cyclobenzaprine. I do not take the recommended dosage, I exceed it, because as effective pain meds, they fucking suck. I can’t imagine anyone being addicted to fucking hydrocodone, it’s a barely jumped up ibuprofen. I certainly can’t get any sort of decent high off the stuff. I can barely get it to deal with the pain. All that said, you would have to do some serious dosing to kill yourself with it. Hard to imagine someone downing 30 to 60 of the things for any reason.

  13. lanir says

    I don’t think our politics in the US has been involved in any evidence-based big problem solving in my lifetime. Or at least nothing I can think of off the top of my head. Someone always finds a way to profit off of it first and then they pay to have everyone look the other way. The politicians get campaign contributions and the public gets ad buys stuffed with lies and misinformation.

    Lies are where I lock horns with the one libertarian I know. He never has an answer for why people should be responsible for a choice they make when they have no access to the correct information to base the choice on. It makes me think he lacks any real sense of what being responsible means in the first place. I sometimes wonder if the libertarian party has some better answer he just isn’t familiar with, but I don’t wonder for long. There isn’t any good answer to that which doesn’t amount to a pile of lies and nonsense equivalencies.

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