Having grown up in suburbia with a number of friends who have gone the heroin route, from my experience the biggest issue is young kids don't associate their Mom's painkillers in the medicine cabinet with heroin.
Oxycontin is viewed like a fun drug. It's legal, so it must be okay...
Once they're addicted and out of money they eventually turn to heroin(something they would have never touched prior).
My biggest problem with the war on drugs is not the frivolous spending and disgusting financial cost to the taxpayer, or the ruined lives of people in jail for nonviolent crimes. My biggest problem with the war on drugs is that it has created drug education that is propagandized, but even worse, even the nonpartisan content is still severely inadequate and abstinence focused.
It really sucks to hear of my friends from highschool are doing 'MDMA' without waiting long enough to not do brain damage to themselves. Not to mention, they're sourcing these drugs at festivals and are probably instead taking synthetic cathinones. It pains me to think that most of my friends don't reagent test their blotter, and will take 4 tabs of 'acid' without thinking that it actually is probably 2C-E and they could die from it. It bothers me that people have parents that will drug test them, so they're smoking JWH-017 and irreversibly fucking their brains up because they don't know any better.
Those in the know rely on sites like wikipedia, reddit, and erowid to get our drug information. Those that are not in the know rely on their 5th grade DARE education which they've entirely rejected after realizing weed isn't deadly, and word of mouth from other not in the know drug users that are obviously biased towards drugs not being harmful.
So in summary, yes, I 100% agree with you. I've many friends that are on heroin, a few that have escaped it, and a few that I know won't.
I have nothing to say besides that it's super fucked up and I'm glad I learned about erowid before I had the opportunity to do any drugs.
"Abstinence-focused," in drug and sex education, tends to mean "abstinence only." If all the kids are getting is "drugs will all cause you to get addicted and die a horrible death," then once they learn that's not true, they don't have any other knowledge to go on.
I agree that the focus should still be on abstinence in most cases - many drugs can in fact cause you to get addicted and/or die a horrible death in very short order - but "teaching abstinence" is shorthand for not really teaching at all.
I agree that abstinence-only sex education is harmful, but I'm not sure the same could be said of drug usage. There's no reason that the majority of people would need or want drugs, and many go without, so it's a perfectly reasonable assumption that most will not partake.
That being said, any education should still be honest—including explaining the exact harms of different drugs and, hopefully, in the process guiding future users towards safer choices. However, I don't think that should be extended to include the corollary of condom usage—there's no reason to educate people on how to use needles, for example.
A big part of the problem is lumping all drugs together in the first place and painting them with the same broad brush.
While it may be true there's no non-self-destructive reason to use some drugs (meth and heroin come to mind), there are plenty of others that many people are able to use responsibly and gain enjoyment, insight, or other benefits from.
MDMA, for example, while widely abused, has shown great promise as a therapeutic tool for treatment of PTSD and can have powerful strengthening effects on relationships. Is it your place to tell someone who stands to benefit greatly and plans to use this drug responsibly that there's no good reason for them to do it? Shouldn't that be up to them?
> There's no reason that the majority of people would need or want drugs
Alcohol is far far more dangerous than a lot of the illegal drugs, and used by a majority of people.
That we've drawn a line where one of the worse drugs we have are on the "ok" side, while many of the milder, safer ones we know of are on the "horrible, illegal, immoral" side certainly does nothing to good.
Part of the problem of the education here is that if it was honest, then explaining current drug policy would be a big issue. How do you explain why drugs like marihuana or lsd that are near impossible to overdose on are illegal when a drug like alcohol that causes tons of death are not?
How do you explain why codeine sales is legal over the counter in many countries now, but can only be sold adulterated with paracetamol/acetaminophen or ibuprofen in doses that means abuse or accidents of them are now a leading cause of liver failure, to the extent where the illegal prescription opioids they can get hold of on the black market is now vastly safer than some of the non-prescription over-the-counter drugs they can by at their local pharmacy?
Current drug policy makes honest education impossible without admitting that the drug policy itself is not based on harm reduction or public safety. Nobody will accept drug education that explicitly admits that the policy is beyond broken.
E.g. you want to "guide future users towards safer choices"? Then one of the things drug policy should do would be to recommend cannabis over alcohol if you have first made the decision to take a drug. How many places do you think that would fly when many countries still insist on depicting cannabis pretty much as evil?
Opioid addiction is an insidious series of compromises. At 16 years old, I would have laughed off any notion of trying heroin as absurd. "No, I would never do that!" But having recently tried marijuana, and open to exploring drugs I thought of as "safe," the 5mg Vicodin I found in the medicine cabinet didn't seem like such a big deal.
Well I tried it, and boy did I like it. Slowly, over time, I ran the gamut of different strength pharmaceuticals, administered orally, intranasally, and even rectally.
Eventually, you develop a physical addiction. One day, you can't afford the $40 for an 80mg oxycontin that you need to get well, and you're staring down the barrel of a long night of withdrawals. But a small bag of heroin might cost $10 and last you a couple of days. And so it goes.
This is so true. My hometown wasn't far from Camden, NJ, the perfect place to go score heroin once you were out of money and could no longer afford prescription pills.
I had a friend even trick me once into driving into Camden for what I eventually realized was so he could buy heroin.
Meanwhile, Camden continues to be a place riddled with crime fueled by the money coming in from all the rich white surrounding towns buying Camden's drugs. It's a sad state of affairs.
A while back I saw something about heroin addition on the TV. There was an interview with a doctor. She basically said the same thing as you - none of her patients just decide to start heroin one day, they start on prescription opioids. Then their supply runs out...
Then they show videos from pharmaceutical companies from the 90s directed at doctors telling doctors to prescribe their opioids to all their patients (basically). It was basically like "30 million Americans have chronic pain... give them Oxycontin. It's totally safe."
I remember reading something similar about the pharmacy companies telling their doctors that oxycontin didn't cause addiction and therefore it was safer to prescribe than codeine etc:
Trip route should have been from Oxycontin addiction to treatment, not with a detour into illegally obtained needle drugs. The Drug War makes the path to treatment much much more difficult.
As Elvis Presely used to day: these aren't drugs, these are pills see I've got a 'script from my doctor. Psychology is everything, prescriptions aren't drugs, pills are safe, needles are scary.
As a former heroin addict who used to buy from these guys, this article is spot on. They were always polite, fair and non-threatening. They were usually (relatively) on time. They really did have a great customer experience relative to the alternatives (which I also used from time to time). The thing about them keeping business hours is also accurate and was amusing to me at the time, except of course when I ran afoul of the deadline.
As I recall, they even engaged in some network marketing. The group I bought from had a standing offer of a free balloon in exchange for bringing them a new customer.
This is my experience as well. The "runners" (as the delivery persons were called) were always friendly, and usually didn't speak English. They would tell me, "Tengas cuidado," (be careful).
In the US, Methadone also keeps people tethered to a daily drive to a Methadone clinic, followed by a relatively long wait in line. When someone is trying to hang on to a job and get their life back together, this can be a significant drag on the process. Buprenorphine (with or without added naloxone) has no such restriction, and can be dispensed from a normal pharmacy in 30-day supplies. However, the DEA limits the number of patients a buprenorphine-licensed physician can take on, which leads to shortages of available care (or very high prices) in a lot of areas of the US.
The article seems to blame the drug, and the delivery service, and the people selling it. But many of the people in the bottom 20% income bracket in the US are sick, isolated, have no access to health care (at least without winning their $6,250 out-of-pocket maximum on a lottery ticket), are poor enough to have to prioritize rent over food, and have little to no opportunity for social or economic advancement. As the http://en.wikipedia.org/wiki/Rat_Park guy said, "severely distressed animals, like severely distressed people, will relieve their distress pharmacologically if they can."
The DEA needs to lift the 100 patient limit on bupenorpine.
I don't know why this drug is regulated this way.
Bupenorpine is here. We have a problem with opioid addiction. Doctors should be able to prescribe the drug without going to a class, and then limit the number of patients who can take it.
The drug is expensive. Even the generic version is expensive?
I'm not a conspiracy theorist, but something is not right with the way this drug is regulated, and manipulated?
Some of my details are fuzzy, but the original manufacturer
of this drug fought hard to extend the patent.
When that failed, they scared Physicians into thinking your patients will abuse the drug if you don't use our expensive strips.
Antidotal, but I can honestly state it's a hard drug to abuse. It's not a fun drug. It is addictive though. This bit about having a low affinity for addiction might be true for some individuals. The people I know on it have a hard time getting off the drug.
I think people would be surprised to find out just how many people are on this drug; they shouldn't be nickeled and dimed by the cost of the drug, and endless expensive office visits.
(The average patient has usually suffered in life. Why give them a addictive drug and let doctors use the 100 patient limit as a excuse/incentive to raise the cost of mandatory office visits? The office visit is essentially--ok--you showed up and payed me--I will refill your addictive medication.)
> The article seems to blame the drug, and the delivery service, and the people selling it. But many of the people in the bottom 20% income bracket in the US are sick, isolated, have no access to health care...
From the article:
> "the victims — mostly white, well-off and often young"
> "A result has been a rising sea level of prescription painkillers that continues today, of opioids such as Percocet, Vicodin and OxyContin. Sales of these drugs quadrupled between 1999 and 2010. Addiction followed. And this has given new life to heroin, which had been declining in popularity since the early 1980s."
I think your point is valid but not relevant to the article. It's not claiming the things you said.
Also Rat Park is highly controversial and has failed to be reproduced and, obviously, is a rat study, so I wouldn't really rely on it as a robust narrative for what's going on with drug addiction in humans.
I didn't realize that Rat Park was controversial. Can you point me to some scholarly articles or discussions around it, or the latest addiction research?
The wiki page indicates that there was some success in replicating the results. Searching the web is impossible, as it's mostly hype popsci articles in th vein of "you didn't know this about addiction!"
There are almost certainly some issues with the Rat Park experiment, but even exercise alone has been shown to reduce binding availability at the mu opioid receptor in humans, probably as a result of beta-endorphin being released: http://www.ncbi.nlm.nih.gov/pubmed/18296435. It wouldn't be a huge leap to hypothesize that this could decrease exogenous opioid consumption.
Interestingly enough, there's also a genetic mutation that's at least loosely associated with alcoholism, a possible increased response to naturally-produced beta-endorphin, and a need for more opioids to achieve equivalent pain relief:
Point taken with respect to to the original article, but it's definitely not just a well-off white people problem. Here's a different view from Crawford County, Ohio:
"Nestled between major urban hubs, Columbus and Toledo, Crawford County, with 47,000 residents, a median household income of $32,000, and a broken-down industrial base, is a sitting duck. As jobs and hope have left town, stress has mounted dramatically. “There’s never a day that we don’t see patients for depression,” says Crawford County physician and coroner Dr. Mike Johnson."
He's also blaming addicts for being addicts. At the end of the article he lays out a "rugged individualism" argument that addicts should just suck it up and quit being addicts. Well, they can't, and they've proven that they can't multiple times, so what does he propose we do, other than crack down even harder?
Doing the same thing over and over again and expecting a different result is how some define insanity.
Also, if these gangs are non-violent and their custom are non-violent, isn't that preferable to the kind of raw violence that is seen with other Mexican cartels?
No he's not, he's blaming doctors for misunderstanding the medicines they are prescribing and overprescribing them, thus exposing a lot more people to addiction than otherwise would've been.
This may be the case in the US. However in the UK, doctors are scared to prescribe pain killers. As someone who suffers from chronic pain (accident early 2012), it took two years to get even close to adequate pain medication (from a pain specialist in the end).
I work hard and if there was a better option than pain killers, I'd happily pursue it. Being tarred with the same brush as addicts is quite offensive. Also, I have a BMI in the mid 20's so further exercise isn't going to help.
Many people in the UK end up addicted to pain medication after inappropriate prescribing of opiate meds to treat long term pain.
You should be angry about the length of time it took to get you to a pain clinic, not about doctor's decision not to prescribe meds that are both addictive and often ineffective.
Also, "lose weight and do psysiotherapy guided exercise" might not have been right for you but it is good advice for many people with long term pain.
Hell, in the UK doctors often won't even prescribe addicts Methadone. For example, I had to go to a separate service, the CDPS (Community Drug Problem Service, says it all, really) where you are basically treated like criminal scum, no matter what your background is. I gave up on the scheme when my assessor didn't believe I wasn't homeless, had a real job and had never been in prison...
I've had chronic pain in the past that's probably far more minor than yours, and it sucks. But for what it's worth, I've found that the mental effects of exercise are far more dramatic than the physical ones – paradoxically, even running until I'm sore and exhausted seems to relieve more pain over the following two to three days than it causes. Maybe worth considering. Anyway, hope you're trending toward better.
Agree wholeheartedly. Even beyond the acute condition itself, it's been shown that there are genetic factors that likely increase cravings for certain drugs, and may predict development of dependence. For alcoholism, OPRM1 A118G has some substantial evidence behind it. Shaming people for drug addiction isn't any different than shaming a diabetic IMO.
> Myself (and many others) have also been stigmatised from getting the correct medication because of a fear becoming addicts.
No. For most people with long term pain opiate meds are the wrong choice. Those people need rapid access to specialist pain clinics; cbt for pain; short term pain meds to enable them to take part in physiotherapist guided exercise; and possibly weightloss.
Opiate pain meds for long term use are not effective for most people; and are addictive. It is wrong to give someone a med that won't work and that has side effects and that carries a risk of addiction when there are less risky, non-addicting, better solutions to try first.
People with depression have choices. People with OCD have choices. People with diabetes have choices. People with schizophrenia have choices. Having choices doesn't disqualify something from being a medical condition.
You're being downvoted for your stigmatising ignorant comments about people with addiction.
Downvote to disagree is going to happen; it's not forbidden on HN (PG has a post somewhere talking about the acceptability of using downvote to disagree) although there are a large number of people who strongly dislike downvote to disagree.
Chronic pain is very tough and opioids shouldn't just be thrown at it. I've known two people with chronic pain that have gotten addicted to their pain medication... then they didn't even work anymore. So they ended up with addition in addition to their chronic pain. This outcome in a very very real (and very common) concern.
These people didn't want to become addicts and weren't taking Oxy for thrills...
That's definitely part of the problem – especially when it comes to the amount of a particular drug being prescribed. A lot of the addiction/dependence exposure involves diversion, i.e. the people using the prescription opioids are not necessarily the people who they were prescribed to. Often someone will start by buying leftover/extra pills from a friend/acquaintance, become physically dependent, find someone else when their friend runs dry, start running low on cash, and then finally break down and go for the cheaper option (heroin).
I don't think I've ever been prescribed less than 30 of an opioid pain reliever for an injury. Sometimes with refills. Five or ten, with the ability to call the doctor for a same-day script if I were still in pain after those, would be infinitely preferable.
>Well, they can't, and they've proven that they can't multiple times, so what does he propose we do, other than crack down even harder?
Or they don't really want to (getting clean sucks), they have proven again and again that they would rather be on drugs than of drugs, so what are you going to do, other than crack down even harder?
I am not saying that is necessarily the entire truth, but addicts do quit on their own and both narratives predict the behaviour.
The second half of your message, that! If only people realized here that selling the notion of work hard win big isn't working for most middle class and lower class Americans. We can keep on saying its in the name of Capitalism and that this is what this country was founded on that we keep on burying our heads in the sand but at what point does one give up old notions and adjusts to the realities of living at a particular time and stop quoting old cliches that don't work for the majority?
I have a very close friend who this article described perfectly. None of us grew up in a great environment, so when his friends suggested Oxycontin it wasn't abnormal or even strange to do it. But it's been 9 years since and after being homeless, a methadone patient (it's hard to call it treatment when they themselves are so predatory), and endless amounts of family support he is slipping into the harder street drugs that are cheaper and more abundant to find.
Growing up in that world has given me an appreciation for the very slight difference between obsession, which drives us to be great and addiction which drives us into the ground and I wonder why I got one and he got the other.
Let's not forget about the shameful inclusion of acetaminophen (at least partially, explicitly) as a harmful deterrent against opioid abuse. Serial abusers mostly know about this (and have strategies to mitigate it), but kids popping their mom's Percocet with a Bud Light have no idea how harmful that combintaion is. That it's unnecessarily, intentionally harmful is, again, shameful policy.
That's one of my pet peeves too. In the UK, the sales of paracetamol/acetaminophen was a few years ago restricted - pharmacies can only sell 32 pills at the time; other stores can only sell 16 at a time. This was done to cut the number of (accidental or intentional) overdoses, and is credited with having saved hundreds of lives despite obviously being trivial to "work around" by going to multiple stores.
So it is government policy here to consider paracetamol a dangerous, lethal drug. It's far easier to seriously harm yourself with than codeine. But of course, codeine is far more likely to lead to addiction.
That they then considered it a good idea to - when legalising the sale of painkillers that includes codeine - require mixing the highly addictive but relatively safe drug with ones that are far more lethal at low doses (paracetamol or ibuprofen) says everything about how drug policy is set based a core view based on seeing drug addicts as immoral, and drug abuse as an evil in itself where it's apparently ok to harm the addicts or let them die if it reduces addiction.
This was done on purpose? I have seen paracetamol/tramadol combinations to get a synergistic effect (not sure that it works though). But what is the rationale here? "You got an addiction problem, so we're going to fuck your liver while we're at it" ?
Paracetamol/acetaminophen does appear to have synergistic effect with codeine as far as I'm aware, and the combination is often prescribed for severe pain (the prescription-only variation - at least in the UK - has a far higher codeine to paracetamol ratio), but the requirement that they are combined is clearly to deter abuse of the codeine.
The irony is that paracetamol overdoses are far harder to treat and far more likely to lead to death or severe long term damage than opioid overdoses...
In the UK, codeine on it's own is still a controlled substance to the point where if you extracted the codeine from a single pill (possibly two, not sure of the exact limit) of the combination products, possession ould get you arrested, while you can go and buy packets with a total of 64 pills (32 each of ibuprofen and paracetamol combined with codeine) at the time from your local pharmacy no questions asked.
Basically there seems to be a bizarre belief that addicts will act as rational actors when faced with the knowledge of this mix, despite the fact that most other drug policy is based on the assumption that drug users - addicts or not - are incapable of making decisions about harm on their own.
This becomes even more bizarre in places like the UK, where there have been restrictions on the number of paracetamol pills that can be sold per transaction because of the amount of harm caused by accidental or intentional paracetamol overdoses.
There should also be some discussion about why the US uses more prescription narcotics than any other country. Some interesting data and charts here on global consumption and how it's changed over time.
Interesting business model for sure. Very impressed to hear they actually did customer surveys and follow ups. The next step is an app over SSL. Choose the quantity you want and your unique customer identifier and you will be SMS'd a Google Maps link to a pickup ___location.
What a horrible problem this is. I was hooked for a very long time on this stuff and have had many friends die as a result. It is a nasty habit to kick.
It would be interesting to compare this to the Silk Road model: the Tor black-markets are more robust against surveillance (LE pulls countless cell records every year) and more systematic about feedback (every order) but the delivery mechanism is much slower (mail is never faster than overnight and international orders take weeks or months) and it's unclear whether it's more or less secure (individual vendors can be profiled and their packages intercepted reliably; on the other hand, driving around is pretty darn insecure).
I hate when heroin is described as some terrible extremely dangerous drug, when in fact it is quite the opposite - it is very gentle and relatively harmless drug. Of course I am talking about medical grade pure heroin, not that Mexican black tar shit or white heroin mixed with god knows what. Even with street shitty heroin, 90% overdoses can be so easy avoidable: just don't mix with it alcohol or benzos, and have someone in your shooting gallery with shot of Naloxone.
I am not even talking about medical grade morphine/heroine, which is gentle and safe as milk (I mean constipation and some temporary hormone imbalance is the worst you can get, compare it with side affects of otc NSAID, which includes renal failure, myocardial infarction, Gastrointestinal bleeding).
And the solution is so simple - just provide addicts with pure heroin, other countries, like Switzerland do this with great success.
While I agree that the dangers of heroin are severely compounded by its illegality, it is intellectually dishonest to describe it as "gentle and relatively harmless."
Speaking as an ex-user, opioids are a horrendous class of drug. They steal your motivations, your desires, your dreams—your very soul. They turn you into a shell of your former self.
Do not fool yourself into thinking that opioids are gentle and harmless just because they are technically non-toxic.
I don't know. For me, the harmful part is not the heroin per-se, it is the addiction itself. The mentality created by such a powerful addiction is what is most damaging, the heroin itself less so. Although I have ended up in hospital due to poor needle hygiene, causing an infection and abscess that required multiple surgeries to fix.
I don't know, while I never used opiates or any other "hard" drugs (except nicotine and alcohol), I had/have gambling addiction, lost a fortune of money (myself and parents), now have huge debts, caused a huge emotional pain to my parents, now have to live very frugal, because have to cover my debts, etc, etc.
So I think I imagine that full blown heroin addiction does to you, but the way you describe it sound like some virus, which affects your brain and make your a zombie (like some wasps do this to cockroaches). But in reality in just simple chemical with well understood action mechanism. Of course if you high all day, there is no motivation to do anything, but I think, we as humans beings, have to take responsibility for this and not blame some chemical.
When I said "gentle" and "harmless" I meant their psychical properties to human body. A roulette or deck of cards is also harmless to body, but they can ruin lives too.
But the main tragedy is when people lose health, money, commit crimes, prostitute themselves, etc. An as heroin is relative safe and harmless to body, legal heroin supplies to addicts would solve so much problems.
you still aren't getting it though. drugs that cause huge dopamine release like opiates or meth are literally tampering with your motivational/reward system directly, in a way that's much more harmful than other addictions. you can't will yourself out of a fundamental change to your intrinsic will system. you can't say that people have to "take responsibility" and "not blame some chemical". the chemical is literally altering the motivational behavior of the person. this is not something the person can solve themselves. they should not be expected to be able to.
let's say you can place everything you've felt in life on a scale of good to bad feelings from -10 to 10. shooting heroin is like suddenly having an experience rated at 100 on that same scale. the entire scale has permanently shifted. everything else in your life has completely paled in comparison to that experience whether you like it or not. you will have to deal with that changed perspective for the rest of your life.
I like your scale analogy. Is it really that bad as you say that it will change your perspective for the rest of your life? Does that mean that former heroin addicts will never really experience a good/happy life post addiction?
in terms of the changed perspective, you're never going to forget that feeling. it will forever be an "option" that has to be staved off with will. the memory of a feeling like doing heroin is different from, say, the memory of a fact. it forever pulls you towards it in the most primal, low-level way, the human desire to feel good. emotionally trying times, in particular, are the worst because you know you can spend $10 to be yanked into bliss.
a good 30-40% of my friends were addicts and from talking to them i think they'd all agree that it's a long, slow climb back to emotional normalcy. i think it's healed only by time. a lot of time. and i think it's a half-life sort of curve where you get 50% better after the first 5 years, then 25% better after the next 5, then 12% better.. etc. more than anything you're trying to reorient yourself towards a life where the joys are small and fleeting, and waiting for those potent memories of having your bliss-button chemically held down to fade.
You're kidding yourself if that is what you believe. Even pure heroin is still extremely dangerous.
Your solution isn't so simple when you provide pure heroin to an addict who gets behind the wheel and kills a family coming home from dinner. The devil, as always, is in the details - maybe some aspects of that sort of plan will work in a small country like Switzerlend, but in somewhere like the US, there are just too many practical barriers to a plan like that working. Hell, we can't control our drunk driving problem - there is just no way free heroin for addicts is going to work at scale.
You're kidding yourself if that is what you believe.
I think OP is speaking from a medical perspective, and from that perspective I believe OP is correct. You could live a long time without complications taking a medicinal dose of heroin.
To be clear, if you abuse alcohol you get cirrhosis of the liver, if you smoke your more likely to get cancer, emphysema, etc. You don't have those types of complications just from abusing heroin.
So instead of arguing against a straw man, lets try to understand each other.
Is it your belief that heroin use causes medical problems or do you agree with the claim that heroin is relatively benign from a medical perspective. If you disagree, maybe elaborate on the what you believe are the health consequences. (Note: I'm talking about medical heroin, as was the OP. Injecting contaminated substances and sharing needles causes all sorts of health problems. I stipulate that the behavior that typically goes along with heroin abuse is unhealthy).
+1 on the Naloxone. Here in the UK the NHS harm reduction policy is to provide free Naloxone injection pens after some short training; this is advertised in all needle exchange locations. I think this is an excellent idea, and would hope that it will help reduce the number of overdose-related deaths.
That sounds like a much more humane way to manage addiction, but I'm interested in knowing what more effective ideas are out there for stopping the on-ramp into addiction, and what the off-ramp is. Even with better management, it seems to me like addiction still will have great social cost.
> Even with better management, it seems to me like addiction still will have great social cost.
This is a common assumption. But empirically, it turns out that the inherent social cost of heroin use (or even heroin dependence) is relatively low, no greater than the social cost of alcohol use/dependence, and arguably a lot less. The only condition is that heroin has to be easily accessible for an affordable price and with a known potency.
Diacetylmorphine maintenance programs do exactly this, and have had great success in Switzerland and the UK[0]. People on diacetylmorphine maintenance are able to hold steady jobs and lead otherwise "normal" lives, save for a daily trip to their local clinic.
Substitute "bar" or "coffeeshop" for "clinic", and suddenly we're talking about a large chunk of the upper-class workforce, including the tech industry.
As long as you have the funds, say from a well-paying technology job, you should be able to manage your habit. I discussed this in another thread previously (see the comment history for this throwaway account) and pointed out that I have had both a reasonable career and an unreasonable addiction for twenty years. Of course, the career trajectory probably suffered due to my habit, although that could be laid at the feet of a badly judged brief interlude with crack cocaine rather than heroin ;)
Do dealers really drive around with balloons in their mouths, prepared to swallow them if stopped? Do buyers really receive calls from dealers asking them whether they're satisified? Do buyers really announce their intention to quit using or switch dealers, and get free heroin?
I don't have a lot of experience with stuff like this, but it sounds so bogus.
I'm 4 years sober from heroin now, so I can speak from my experience using in Los Angeles from ~2008-2011.
Balloons are typically sold in .1 gram quantities, with lower quality heroin. I do recall buying balloons wet with saliva, but only some of the time. An acquaintance told me that it used to be standard practice for dealers to use young Mexican children to sell dope by this method on foot in Skid Row, but that the city had really cleaned up downtown. With the popularization of cell phones, the delivery system described in this article became the standard.
Higher quality heroin was usually sold by the half gram. Instead of being in a balloon, it would be wrapped in plastic torn from a grocery bag, tied off or melted to close and seal it. I don't recall these ever being spat out. They would often hide it under the hood in their beat up trucks or minivans.
I never got customer satisfaction surveys from dealers. I'm sure that the dealers had customers or friends from whom they got feedback on their product, but I was never one of them.
A dealer's number was quite a hot commodity. You couldn't just call the dealer up and expect to get served—you had to be introduced. And the dealer would often throw in a free bag if you bought x number of them.
The result of this was that one user would have the dealer's contact information, and would make a buying run for other users who didn't. If they bought enough they could keep the free bag, or otherwise pinch off the bags that they acquired for the other users.
Hah, you and I are in the same boat. 4 years sober from heroin, los angeles, 2008-2011. I wonder if we know each other o_O.
It is definitely standard practice for them to keep balloons in their mouths. When I bought from these guys they always spit them out one at a time, and always kept a bottle of water by their side to swallow them if needs be.
I also remember one driver telling me that the organization he worked for actually drug tested him regularly to ensure he wasn't using.
The runners delivering it usually didn't speak much English. I spoke with them in my broken Spanish, which humored them. They were indistinguishable from your average, friendly migrant day laborer.
Phone calls with the operator (el jefe) were brief and to-the-point. Code words were often used, e.g., "I need 2 pairs of pants." There was certainly never any in-depth discussion pertaining to the product.
I'm sure they had users with closer relations that they used for feedback.
Keeping drugs in your mouth to allow swallowing quickly when stopped by the police is SOP for both heroin and crack cocaine dealers in most places I have experience of purchasing on the street.
Once swallowed, a pat-down search finds nothing, you wait until the police leave, then stick your fingers down your throat and throw up the bags. Here they are ususally wrapped with cling-film (saran wrap) and as long as you don't wait too long, stomach acid won't be a problem.
"But instead of pursuing more complicated pain solutions, which might include eating better, exercising more and, thus, feeling better, too many saw doctors as car mechanics endowed with powers to fix everything quickly."
And what's wrong with that? Opiates have a very low side effect profile, compared to other popular medications (like mood stabilizers, antidepressants). Why should someone unfortunate to have a pain issue also need to change diet and exercise if there's another option?
As far as doctors being mechanics -- eh, almost. This unfair system of medicine licensing means that you need to get paid approval before taking medicine of your choosing. And even then, unless you're wealthy enough to demand service, you're entirely left to the doctor's personal whims. Many of which include an anti-addict narrative influencing their decisions.
This story is rather Luddite in its views. Don't use medicine, find your inner strength; be American!
This is why I tend to roll my eyes when people advocate legalizing all drugs, no matter what. All the talk about giving up on the failed war on drugs starts to matter a whole lot less when it's your loved ones who you're not sure you're ever going to see alive again on a day to day basis.
I'm completely willing to grant that keeping certain drugs (like marijuana) illegal isn't effective or necessary from a public safety standpoint compared to legalization/regulation. But for dealers of heroin and other hard drugs like these, I support extremely, extremely harsh penalties and much stronger enforcement. Far harsher and much stronger than what we currently have.
Nowhere did I say I support capital punishment. What I am saying is that we as a society harshly punish other types of criminals who prey on the weak (identity theft, molestation, etc.), so why do we continue to make excuses for this category of criminal?
Will harsher penalties deter dealers? Maybe, maybe not. But if a dealer isn't deterred, I'd still rather see them rot in prison than live freely in society.
> What I am saying is that we as a society harshly punish other types of criminals who prey on the weak (identity theft, molestation, etc.)
I don't think we're especially harsh about identity theft. And I think our approach to paedophilia is wrong and results in more victims. So I'd rather be consistent in the other direction.
> why do we continue to make excuses for this category of criminal?
I think the critical difference here is that it's noncoercive. If someone sells something to someone who wants to buy it and who knows what it is and what the effects are, surely that's a lesser crime than stealing, yet alone a violent crime.
> if a dealer isn't deterred, I'd still rather see them rot in prison than live freely in society.
Why? That's what economists call a deadweight loss - no-one benefits. Even the revenge aspect - while it's something many victims think they want - doesn't actually make people happier (rather like drugs, hmm?).
(Also if you want to "see them rot" you might as well be advocating capital punishment. Prison should be about reform.)
The point is that risk of death does not deter sellers; why do you think a long prison sentence will deter drug sellers?
> so why do we continue to make excuses for this category of criminal?
I am genuinely baffled by this comment. American prisons hold more people - by any measure - than any other society. (America is 5% of the world population but has 25% of the world's prisoners.) Many of those people are serving very long sentences for drug offences. More than half of federal prisoners are there for drug crime, only about 16% of state prisoners are there for drug crime. As of 2001 one in six black American men had been incarcerated! Here's an article talking about the very long (and racistly applied) prison sentencing for minor drug related crime: http://mobile.nytimes.com/2014/07/29/opinion/high-time-the-i...
> In October 2010, Bernard Noble, a 45-year-old trucker and father of seven with two previous nonviolent offenses, was stopped on a New Orleans street with a small amount of marijuana in his pocket. His sentence: more than 13 years.
> At least he will be released. Jeff Mizanskey, a Missouri man, was arrested in December 1993, for participating (unknowingly, he said) in the purchase of a five-pound brick of marijuana. Because he had two prior nonviolent marijuana convictions, he was sentenced to life without parole.
That's life for a cannabis related crime. I don't understand how you think drug dealers in the US get light sentences? "African Americans serve virtually as much time in prison for a drug offense (58.7 months) as whites do for a violent offense (61.7 months). (Sentencing Project)" (from link below)
And so far the only justification you've given for even longer sentences is that it'd make you feel good.
You started this thread by saying that you didn't want to see drugs legalised. So criminal sellers only exist because you have laws against selling the drug. This is obviously going to select for a certain type of person. Removing those people from the chain of supply is one of the reasons to legalise! Why would I visit a scumbag criminal to buy contaminated heroin when I can get a clean product of known strength from a pharmacy?
Society has limited funds to deal with the problems that drugs cause. We can either spend that on very expensive enforcement of law (which tends to be racist in its application) and prison (which clearly hasn't stopped drug use yet despite very long sentences. Or we can spend the money on treatment of addiction; sexual health; child protection; awareness. We save money if we legalised drugs.
I'm not. I'm showing that people selling drugs ignore drug laws. They ignore the laws for drugs with lower addiction risk (like cannabis) even if the consequences are severe - life without parole.
Why does parent think strict laws are going to work to stop people selling drugs with higher addiction risk (like heroin or cocaine)?
I'm also countering parents main point which seems to be that we don't already severely punish people who sell drugs. That's wrong. People who sell drugs, even drugs with lower risk, in America are imprisoned for very long sentences.
Legalization might be the wrong word for it but you can actually get heroin legally in some european countries when you are addicted. In Germany this means you have to show up at the doctor and use the heroin there.
You can't help people that are already addicted by persecuting dealers more, but you can make it more safe for them in lots of ways (harm reduction). Cutting out the dealers might even help getting less people addicted.
See http://en.wikipedia.org/wiki/Drug_policy_of_Portugal for an example of decriminalisation of posession of all drugs, even heroin. Dealers are still prosecuted, but users are not. This seems like a sane solution.
It still fails to address many of the worst problems of criminalisation of drugs, namely the level of other crime associated with production and distribution, and the sale of contaminated products.
The biggest risk from heroin, for example, is contamination and varying strength, not the drug itself. E.g. street heroin is often mixed with all kinds of other drugs or stuff like brick dust. Clean medicinal heroin is a quite safe drug (safe enough to be used for e.g. post-op pain relief as an alternative to morphine in some cases in the UK, for example - if you are ever prescribed "diamorphine", that's heroin).
Decriminalisation of possession is basically a halfway step where politicians don't have to admit to how horribly criminalisation have failed, but can instead "sell" the change as caring about the addicts. But if they really cared about the addicts they wouldn't keep leaving them in a position where they're injecting drugs contaminated by brick dust and where they are still left dealing with criminals for their supply.
Oxycontin is viewed like a fun drug. It's legal, so it must be okay...
Once they're addicted and out of money they eventually turn to heroin(something they would have never touched prior).