No surprise. The modern drug supply is a mess: in most cases users don’t know what they’re buying and it’s often cut with fentanyl, which is incredibly potent. It doesn’t take much to throw a user into an overdose and kill them. (Black tar heroin is often an exception, if it’s available where you are and you use, use that.)
The dirty supply, plus increasing use due to economic despair and social alienation, are behind increasing drug deaths. You can’t solve that with half-assed decriminalization.
Instead you have to offer a clean supply, which means thru government and government approved and inspected suppliers. That has its own downsides, but it’s the only way to make sure people know exactly what drugs they are taking and in what amount.
When articles are written about legalization, they’re almost never actually about legalization: they’re about de-criminalization: there is no clean supply.
The other problem is that stronger drugs replace weaker when they are criminalized. This is a well known, well studied sociological fact. Pot in the 60s and 70s was FAR less potent than it became over decades of illegality. Fentanyl, though invented legally, is so much more potent than heroin by weight that it’s far easier to smuggle: but also far easier to overdose. (And heroin is more potent than morphine, which is more potent than codeine and so on.)
Treat drug use as a medical issue. Sell it thru pharmacies, over the counter. Keep the information on drug use 100% confidential, so that people are willing to be honest about it, and make it illegal to fire someone for drug use that isn’t effecting their job performance.
If you want to keep some drugs illegal, make them the harder ones: meth and fentanyl, for example. If you offer morphine, codeine and opium, you may find that many people don’t move up the scale. And manufacture properly: I’ve never tried Meth, but I’m told by old timers that before it was made illegal and hard to buy the precursors, it was a lot less harsh: one might go back to that type of meth, or back to older forms of “uppers.”
People will have their drugs one way or the other. If you want to reduce deaths, especially in the current environment, you need to keep the supply clean or you need to go full totalitarian, Maoist style.
Since that isn’t happening, give legalization a shot. Start with simple uppers, codeine and morphine. No weird pills, just clean and simple.
If it doesn’t reduce deaths, well, you can criminalize again. But the current methods aren’t working, and we’ve been trying the “war on some drugs” for almost fifty years now: longer for opiates (which were legal throughout the 19th century.)
Oh, and if you actually want to reduce the number of addicts fix the economy so that ordinary people have good jobs they can live well on. If you insist on running the economy to make people miserable, many of the will reach for drugs.
You get what you support. If you like my writing, please SUBSCRIBE OR DONATE
GrimJim
Sad to say that this is another area where profit is far more important than lives.
Too much money is being made… Legally and illegally, and both by the same players… For any reasonable, sensible policy to ever be enacted.
The craptastic drug system in the US is right where everyone, except those who actually want to use drugs, wants it to be. Just like health and legal pharmaceuticals, the end users are nothing more than profit centers squeezed by intermediaries for national profit until they die.
Soredemos
Fentanyl is getting stronger because the demand is for stronger fentanyl.
Yes there’s a systemic element, but I have yet to meet a single fentanyl user who wasn’t ultimately attempting to medicate away some deep trauma (‘trauma’ had been debased into a nigh-meaningless sociological buzzword in the last ten years, but it can still be genuinely useful if carefully deployed). Offering jobs won’t make many of these people stop using. Meth users, maybe. Heroin, when you can find anyone who still does that novelty, sure. But fentanyl is a whole different category.
Meth makes people annoying and weird. Fentanyl makes people annoying, weird, induces literal psychosis, and, ultimately, kills reliably. And the users are well aware of all this. They’re the ones regularly narcaning each other back, until finally someone does it alone, or does a dose with tranq and the narcan doesn’t work. And they just keep using.
Purple Library Guy
A friend of mine told me about a study involving rats and addiction. In the past, there had been studies showing that rats, given the option to press a lever to gain (addictive drug), would often keep on pressing it instead of doing anything else even as they starved.
The new study had two groups of rats. One was in the usual crappy little rat cages, and the other was in this awesome environment full of interesting things to do and explore. They found that sure, the rats in the crappy little cages behaved like total strung out addicts pressing the heck out of those levers, but the rats in the interesting environment didn’t do a lot of the drugs. Apparently having fun things to do and a good life is just as compelling as drugs. Of course I’m sure that couldn’t have any implications for humans.
Ian Welsh
Soredemos — And that’s why I suggest making the less powerful opiates legal, but not Fentanyl. The thing about heroin is that you can’t really get it, it’s almost always cut with fentanyl. Black tar heroin is an exception, but geographically limited (comes out of Mexico.)
Grimjim–agreed.
paintedjaguar
And for the rest of us… well, I recently had a couple of severe toothaches, each of which lasted for more than two weeks before I could get treatment. But it’s been years since I’ve had a dentist who was willing to prescribe anything better than aspirin for pain. I’ve also had a double handful of kidney stones over the years and good luck to the average Joe trying to get relief from that torture short of going to an emergency room, where if you are lucky they commonly put one on a gurney to wait it out with a drip feed of Demerol, then send an outrageous bill. Yes, I live in the United States of Pain and Suffering. Of course I do.
Ian Welsh
PLG,
when I was 25 I spent 3 months in the hospital. Lots of serious pain. Came out addicted. As I recovered from the illness (I was 90lbs leaving the hospital) I reduced the morphine until I eventually titrated off (took about 2 1/2 months.)
I found morphine an honest drug, so to speak. It was clear I could have the morphine, or I could have all the other things I enjoyed. On morphine I couldn’t enjoy reading, playing games or exercising. It was morphine or everything else and once I was healthy enough to do other things, the morphine use fell off very naturally.
For me personally, the dangerous drugs are ones that seem like you can live a normal life, that ease things, but do their damage in the long run.
I never smoked, but I have a friend who smoked for 30 years. He quit, but by the time he did he had a persistent smoker’s cough, and it’s never gone away.
Oh, and I’d rather someone was addicted to codeine or morphine, than alcohol. That stuff is nasty, and it makes a lot of people violent (same issue with Meth, I understand, though I’ve never had an IRL friend who was a meth user.)
Ian Welsh
PaintedJaguar — never had kidney stones, but some of the most genuine sounding pain I’ve ever witnessed was from a man with kidney stones.
Of all the pain killers I was every on, Demerol was the nicest feeling. Discussed it with some other patients at the time and we all agreed. Has a warm glow to it.
Last time I was in hospital they had me on serious painkillers, then when I left gave me a prescription which was equal to a day and a half of what they had me on in the hospital. Either they were over-dosing me in the hospital (they sure as hell were not) or they under-prescribed when I left. Cost me a few weeks in much more pain than necessary.
One of the problems is that when you’re really sick, it’s hard to advocate forcefully for yourself.
different clue
@ Purple Library Guy,
You may be referring to the series of experiments known as ” rat park”. The way wikipedia describes it, the results were strongly suggestive of what you say though not always ironclad. Anyway, here is the link.
https://en.wikipedia.org/wiki/Rat_Park
@GrimJim,
The rancid legacy of putrid Puritanism continues to fill every corner of the American collective mind like a cloud of persisten poison gas. The only way I can think of to slowly ventilate that gas away from out of the American Mind is for brave political movement-loads of people to run for office on legalization of addictive drugs. But calling it “legalization” implies to all the legacy Puritans among us that you favor free-range pleasure use on the totally private unregulated market. It sounds like you are suggesting handing out fentanyl to all the nice Spring Break students featured on those ‘Girls Gone Wild’ videos.
What to do? Maybe rename it and reconceptualize it as “medicalization”. Do everything Ian Welsh suggested with the supply lines including surrounding it with total medical-style control. Everyone who wants their currently-illegal drug of addiction would have to go to their local Department of Addiction Maintainance clinic to get their dose under professional or at least technicianal observation and would have to use the whole dose there on the premises.
I believe fentanyl first reached the street markets unannounced and undercover as a hidden undisclosed presence within the heroin/morphine/whatever-elsed that illegal market buyers thought they were buying. The first wave of fentanyl doses were of people who didn’t know they were receiving fentanyl. I suppose by now the user base is so used to the idea of fentanyl in whatever they are buying, and so addicted to it, that they will now buy fentanyl by name, or at least buy their other drugs of desire expecting the inevitable fellow-traveling fentanyl.
I see no point in keeping fentanyl illegal. That would simply keep its price up where it is now and guarantee its continued sale by the various cartels and other mass handlers. Would a war on fentanyl in particular turn out any different than the war on drugs has turned out so far? I think it would turn out the same, and so I would suggest medicalizing fentanyl along with the rest of the hopefully-medicalized addictive opiates, cocaine, meth, etc.
Soredemos
If I could be permitted a partially relevant rant, Oregon’s entire approach has been an utter, abject failure. And has discredited any kind of similar approach for at least a generation. We did the first step of the Portugal model, decriminalization, but then didn’t follow up with any of the promises for the other steps. Drug addiction is, actually, bad, and while attempting to just jail the problem into submission has clearly failed, just letting it go rampant and unaddressed hasn’t worked either.
I live just outside of Portland. It actually is a giant shithole; that isn’t just some retrograde Republican smear*. We have to deal with the runoff from Multnomah county’s fractal failure every day.
I am a firm believer, and I know for a fact that this makes me something of an outlier in social work, in a push and pull approach. When all you have is a hammer, every problem looks like a nail, yes. But also the hammer is part of the toolbox for a reason, and is sometimes exactly the proper tool for the job.
Especially with fentanyl we’re talking about life and death. Many of these people aren’t going to stop on their own. Well, to be more accurate, none of them will, and it would be physically dangerous for them to even try. But what I mean is that many will not willingly engage with the support services on offer. They just won’t. And the ones that might eventually, they have to manage to avoid dying before they reach whatever epiphany they need to accept help. And they keep fucking dying before they ever reach that point. I have another memorial to visit because of exactly that in a couple days.
I know multiple people for whom throwing them in jail for months was exactly what they needed. It wasn’t nice. It wasn’t fun. And it was the moment their lives started to be fixed. It forced then to dry out and get sober in a way they never would have on their own. They left jail finally in a place mentally to actually be able to make a coherent decision, and also the experience of going to jail (and for one of them very narrowly avoiding a real prison sentence because of a competent public defender) that acted as a huge wake up call.
I also know someone else who, in the depths of a bad trip, broke into a house only to be held by the homeowner at gunpoint until the cops arrived. Another huge wake up call.
Not only has Portland decided on the ‘enlightened’ approach of decriminalizing everything while providing virtually no support for treatment, it has also decided to not punish petty (and even not so petty) crime that is predominantly done by desperate users. It is absolutely not hyperbole to talk about areas of Portland being no-go zones unless you really have to. And if you do have to, you park your car a few neighborhoods away. I know not just random people, but social workers whose jobs is helping people whose cars have been jacked. The cutting off of catalytic converters is also utterly ubiquitous, and utterly unpunished.
We need police, we need jails, we need state detox and treatment centers, and we to bring back the asylums for good measure. We also need much lower barriers for forcibly committing people to treatment and asylums as needed. I know literal crazy people doomed to live on the street because the burden of proof is unachievably high.
*American conservatives aren’t qualified to run anything, but also neither are American liberals. Or to put it another way, a Reublican gimmick is to claim government is inept and bad, while a Democratic gimmick is to prove them right. Another example I’ll throw out is that almost a quarter of Californian adults are functionally illiterate in English, while the number is almost 70% for elementary students in the state. These sound like they have to be bullshit numbers pulled from sketchy sources for a Breitbart article or something , but they actually aren’t. They’re real. Can you imagine a more damning statistic that utterly discredits modern American ‘progressivism’? This isn’t fucking progress. This is literally medieval regression, perversely done in the name of some deeply misguided, wooly brained notion that this is kinder or more accepting.
Wooly thinking pushed by exactly the type of DEI boosted moron that constitutes many of the youngest generation currently entering my field. These people are as thin skinned as they are clueless and stupid, and I suspect (hope, actually) many of them will burn out and leave social work after a few years. This is not a line of work why you get to cry and claim you were ‘triggered’. A guy in an animal costume calling you the C word and habitually talking about how he’s going to murder you is a daily occurrence with this crowd. If you can’t stomach that, why are you even doing this work? Deal with it or get out.
Rant over.
Purple Library Guy
California education has been kneecapped for decades by that one proposition they passed that chopped property taxes. So it’s not much of a surprise that it doesn’t work well. Not sure that has much to do with progressivism, though.
The thing about Democrats is that in some ways they’re more committed to small and yet simultaneously over-bureaucratized government than the Republicans are. They’re “liberal” in certain social terms, but economically they are by most standards pretty hard right wing, neoliberals who believe in “free markets”. So they sort of want to be nice, but not in any way that does anything useful enough to feel like intervention in the market. So any social programs have to be small and unobtrusive and carefully targeted and means-tested nearly out of existence, which means you have to have this bureaucracy to make sure nobody much actually gets whatever service, and the bureaucracy in question costs more than what it would cost to just give everybody the service. Of course Republicans would rather do no service at all and pretend private charity would do the job, which is monstrous.
(Note: I’m not necessarily against bureaucracy, I’m a bureaucrat myself, of sorts. But at the library, our bureaucracy is dedicated to trying to give people stuff, not trying to make sure they don’t get it. Bureaucracies that gauge themselves by how useful they manage to be can be good; bureaucracies who measure their success by how much they’ve managed to limit their usefulness are not so good)
Poul
The Swiss have experimented with free heroine with good results.
https://www.northcarolinahealthnews.org/2019/01/21/switzerland-couldnt-stop-drug-users-so-it-started-supporting-them/
It doesn’t reduce addiction but makes it easier to live with the dependency and reduces crime.
mago
Don’t know squat about fentanyl except for the anecdotal.
Opium and its offspring, more. Puts you in a deep dream state, temporarily soothes mental, emotional and physical pain. Constipates. Creates dependency both physical and mental, although it’s a body drug. The liver grows tolerant and craves it. One can maintain the habit and function. Witness one prominent example, William Burroughs.
I came of age in a time and place where the Vietnam war dominated. Many of my small town contemporaries served there, shipped opium and heroin back home, not to mention weed that was off the potency charts, contrary to our host’s assertion. Vietnamese weed in the early 70’s was hallucinogenic.
I count at least five of my friends who came back from that war and died of overdose. I watched a few of them fix. I broke needles to try and stop them.
About alcohol, yes it’s a sloppy drug. Although I know highly functional beer drinkers who measure their expensive habit. The pill dependent, not so much.
The cycle goes thusly: tolerance, dependence, withdrawal. It’s a bitch every step along the way.
I’m a long time advocate of drug legalization as Ian has posited. Not happening for reasons already laid out in comments.
Another aspect blocking sane drug policy— in the US at least—is bureaucratic constipation. (There’s that constipation word again.)
There ain’t no easy way out . . .
j
The supply has become dirty indeed.
For example, ever since China started curbing down on pseudoephedrine, all of amphetamine class drugs on the US market have moved into full synthetic manufacture origin. The resulting drugs, e.g. the infamous zombie meth, put the good ol’ lithium poisoning shake’n’bake to shame in health effects, getting straight up to crocodile territory of awful. Shoot up on it for a while, and in a few months you will not even know your own name anymore. The person in the body will be gone, in permanent brain damage, and only the craving will remain. But since this stuff is now produced on the industrial scale by the tons right across the border in Mexico, you just cannot argue with the price of it. This has wiped the market clear of anything else, personal use home cooking included.
I fully expect the same to happen to all and any other drugs that get the natural ingredients limited. Mexico has lost the war on drugs, with the government of Mexico mostly only being the government of Mexico City by now, so there is no stopping of this. Honestly, looking at where the US is going with basically illegalizing homelessness and such, I cannot imagine them taking an honest and constructive approach to any of this. Sadly I find it much more believable that they will end up managing the problem with holes in the ground sooner or later, with everyone cheering on.
j
The Rat Park experiment has actually been conducted on humans, in a way. The Vietnam War. People there were shooting up like there was no tomorrow. Because there really was no tomorrow. Stuck in a pointless war with an invisible enemy you could very well be dead by the next day. The rational thing to do was to get something going today. But once the soldiers returned home, drug use pretty much returned to pre-war levels, although the user base was not completely the same. For some, the war was a catalyst to call it quits, for some, to stay on it. But most often what happened was that those who had an actual homesm families and futures waiting once again had better things to do with their lives.
There’s an informative study here: https://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.64.12_Suppl.38
GrimJim
There is no Left left in this country. Politically speaking.
Liberals are not Leftists. Liberals are at best Capitalist Apologetics who are fine with letting people go to hell in their own way, as long as they do not have to pay for it, and as long as it is not in their own back yard.
Most Democrats are not even properly Liberals anymore; as Purple says, they are Neoliberal hacks who use and abuse “Liberal Social Ideals” to differentiate themselves from what used to be Moderate Republicans, who were Socially Conservative but not Christofascists as the Trumpist “Republicans” are.
There is no Left in the US. Sure, there are still remnant orgs and “parties” that claim the name, but they are at best armchair theoretical Leftists. There are maybe a handful of true Anarchists in the various Black Mask Brigades, but most of those guys are in it for the ultra violence, with no proper political affiliation or dogma.
The Left in the US died off or was outright murdered in the 70s, and the Leftish Liberals in the Democrats were co-opted or exiled by the Clintons and the Third Way Democrats. Bernie is the safe, u threatening Old Socialist waved in front of the attenuated Progressive branch to give the Dems a whiff of legitimacy.
That’s why everything is so hopeless right now. Everyone knows the game is rigged, that the battle in November is between Oligarchic Corporatist Capitalist Kleptocracy and Christofascist Reactionary Trumpist Autocratic Kakistocracy and no matter who wins or takes the victory, most of us still lose…
Though of course, with a Trump Regime, some lose much harder than others…
Soredemos
@mago
Fentanyl isn’t soothing anything mentally or emotionally. Fentanyl is causing you to hallucinate invisible people who won’t stop harrasing you and now you’re punching yourself because they tell you to, before escalating to carving up you own arm.
Tallifer
Look to Singapore: https://www.washingtonpost.com/opinions/singapore-is-winning-the-war-on-drugs-heres-how/2018/03/11/b8c25278-22e9-11e8-946c-9420060cb7bd_story.html
Jan Wiklund
Decriminalizing would also reduce death in another way – it will reduce the scope of businesses specializing in violence.
The reason why they exist is that trade needs something to enforce contracts. Legal trade can use the regular court system, illegal trade can’t. They must rely on shady gunmen. And when they are well into business they want to use their particular skill in other trades to, for example blackmailing.
No wonder that crime grew quickly during prohibition. But on the other hand, when it has established itself it is hard to root out.
mago
@Soredemos
That comment was about opium, not fentanyl, of which I am ignorant, although I’ve learned more through this post and the comments.
After extensive dental work I was
prescribed OxyContin and codeine. After one use of each I decided to live with the pain rather than deal with the side effects, mostly the jagged mental and emotional states the day after. Anyway, pills aren’t my thing, nor is opium.
Interesting comment about the corrupt state of heroin these days. It was high potency Mexican Mud and China White where I lived back in the day. Seems like toxicity has increased across the board in contemporary life.
different clue
@j,
I am no expert so I can only wonder: is this the drug you mean by crocodile?
https://www.drugs.com/illicit/krokodil.html
( There used to be images of krokodil damage on users’ bodies, but maybe they were too graphic to stay up, because I don’t find bunches of them anymore.)
Ian Welsh
Yeah, a lot of stuff is easier if you’re a city state. But also Singapore provides real support to addicts in addition to draconian penalties for selling drugs.
Willy
What would the end game be like? What would a late-stage drug capitalism be like? What influence would the prevailing local socio-economic norms have? Obviously, in the USA things could be different from the Netherlands.
If liberalization policies were allowed in greed-conquistador-is-good USA, we’d start out with friendly neighborhood head shops, then wind up with globalized multinational domination. If the biz was lucrative (and USAIN big pharma is mostly highly lucrative), we’d wind up with a handful of gigantic entities so full of concentrated power in the hands of a few sociopathic MBAs, that waves of encouraged (and subliminally seduced) addiction could sweep the land.
In the idiocracy of the future I forsee a Cheech and Chong Doobie Corporation re-imagineered to be as culturally legit as a Jack Daniels and Jim Beam are today.
Adam Eran
The Oregon experiment with decriminalization was the epitome of half-assed. They got the cops to hand out tickets redeem-able for rehab. Yes, these are the same cop tasked with enforcing drug criminality before the law changed. Sabotaging such programs is a commonplace, with “See! We told you it wouldn’t work!” as the natural, expected outcome. Wait until we get Medicare for All (California has this in the works now)…just wait!
Occasional Commentator
Almost all of the “heroin” sold in Vancouver is fentanyl + cut. This wasn’t always the case, 10 years ago heroin actually was heroin. Possession of drugs has been all but decriminalized in BC and there are plentiful safe injection sites and harm reduction supply places in bigger towns and cities. Addicts can get opioids and stimulants prescribed by a doctor (safe supply).
But people are still ODing every day and the monthly death count remains very high. On top of that the number of addicts and homeless people in Vancouver are at record numbers, and a right-wing major and city council was voted in as a result.
Ian’s point that a moribund economic system which consigns a lot of people to the margins of society will keep producing addicts and people who give up on ever having a stable and reasonably comfortable life is spot on. Decriminalizing and prescribing drugs to addicts without first ensuring that people have affordable housing, healthcare and jobs is not going to work out well. You’ll get lots of street -level users who take the free drugs but otherwise still live in the same misery and despair. Which in turn triggers people fed up with drug addicts shooting up everywhere and shitting and pissing on the sidewalks etc. which inevitably results in law and order politicians getting elected.
It never ceases to amaze me how adept media and politicians are at ignoring the most basic facts of reality. I’m no Bill Clinton fan but his “it’s the economy, stupid” is correct. Fix the economy so that people can earn at least enough money to provide a modestly prosperous life and you solve a lot of chronic social problems. But ignore the economic component and the problems you’re trying to solve will keep getting worse and well-meaning harm reduction polices will get a bad rep because everyone can see they aren’t working as promised.
different clue
@Occasional Commentator
The shooting up on the street part might be solved by allowing addicts to get their drug only one dose at a time and only under supervision in a Medicalized Addiction Maintainance Center. Those who don’t want to come into an Addiction Maintainance Center for their one-supervised-dose-at-a-time access to their drug of addiction will continue to take their chances on the street with the illegal street markets, which will work the same as now. And there will still be a War On Drugs for the Illegal Street side of drug use which will work as well as it has worked so far.
The “failure to work as promised” part will be solved by not making any unkeepable pie in the sky promises. No promises made? No promises not working out as promised. The only promise will be ” safe drug use for those who want to use their drug safely.”
Maybe you could bribe addicts into the Addiction Maintainance Centers by offering them housing, a universal basic income, etc. as long as they confined their use to within the 4 walls of the Addiction Maintainance Center. And for people who would still prefer the homeless illegal street drug street life, perhaps arrest, conviction, and incarceration until forcibly de-addicted from their drug of choice?
A major purpose of the kind of legalization being suggested would be to reduce the amount of money and power flowing to the secretly government-sponsored International Drug and Money Laundering Cartels. Come to think about it, they too would be a major source of opposition to anything which would reduce their drug money and money laundering power. And so would their secretly sponsoring governments.