I was Jack in highschool, addicted to heroin, destroying my family for 4 years. In and out of rehab. At one point my mother chased me through her house with me holding a needle full of heroin over her head, she had caught me using in the bathroom, I didn't want to let the hit go.
My mother died a little over a month ago, brain cancer, from diagnosis to death it happened in 5 months. Reading this brought back a lot of my guilt and reminded me of how futile my family felt trying to help.
Last week a highschool friend died, fentanyl od, he was never into opiates in highschool. I had no idea how serious it was. I had seen him at a wedding a couple months back and he mentioned that he got into fentanyl pressed pills for a period, he said he felt bad for judging me so hard in highschool, he never thought he... I cut him off and said "but your clean now right?" And he gave me this disappointed look, and said yeah. I just moved to a different subject, now I think he might have been asking for help, like how did you kick?
In the throes of addiction, the only thing that made any difference was that I decided one day to buy an ounce of mushrooms. I brewed them all into a tea and put it in my fridge. I drank mushroom tea for basically a week straight. I didn't do anything special, friends visited, we played video games and talked, but eventually I reflected, for the first time I actually saw myself from the outside, I saw what I was doing to my family and friends and it was like a switch flipped in my mind. Physical or mental addiction didn't matter anymore, it just didn't make sense to use. It's all I can really say that helped me, when you are an addict the best cure is gaining perspective because it is so hard to pull your head out of that hole.
Good for you. I'm happy you were able to straighten out your life.
A few months ago I watched a child, maybe 11-13 years old, run out of a hospital barely clothed. A security guard ran after him and must have wrestled something away. Then the child kept jumping for what the guard was holding, like jumping for a toy. The mother ran after him with clothes.
> I wish I had a happier note to end this on, but honestly, my biggest takeaway from the whole experience is that maybe some puzzles just can’t be solved. We can try to attribute Jack’s problems to intrinsic biological/psychological issues (social phobia, migraines, etc.) or to environmental causes (super high rate of heroin use and OD in the community), but both sides seem fundamentally lacking in explanatory power. The vast majority of socially anxious people don’t resort to heroin, and despite the problems of these small towns, they are by no means among the worst places to live in America, let alone the world.
Earlier on, the author does speculate about what drove Jack:
> To put it another way, Jack was painfully aware that his future options were, “be a complete loser,” or “be a complete loser who feels really really good for a few hours every day.” He chose the latter.
What's striking about this is how it's possible to live this way without drugs. A brain-numbing job eight hours a day and a life-saving hobby for four. A toxic-family life but wonderful community.
It almost sounds like Tennis could have been this outlet:
> One time when Jack was in middle school, he walked off the tennis court after a well-played match, and his mother asked him how he felt. Jack said something like, “when I’m out there, it’s so nice… it’s like the rest of the world goes away and I don’t have any problems.”
I'm not sure you understand how good heroin feels. Nothing comes close, especially not Tennis or a wonderful community.
I tried heroin once, and I regret it every day, because I am 100% positive that I will never again be as happy as I was that day. If I didn't have what is effectively a dream job I'm sure that I'd be a heroin addict.
I heard a story - can't find the reference now - of a doctor who got addicts to replace their drug addiction with exercise addictions. From what I recall the program was quite successful at making the patients functional, but didn't really do much for the underlying issues - just made the addiction itself less damaging.
> They knew he would never get drugs when I was there. He wouldn’t shatter the illusion he and his family crafted for me. It wouldn’t be worth it, not even for a fix.
seemed to be something that really worked? albeit for the while
I remember my own decade-long struggles with "failing to thrive" and I can assure one can turn your life around, but as author correctly noticed: "The puzzle of getting Jack <...> onto his feet could never be solved because there was a missing piece – Jack wanting to get better".
To me, it rather feels like the opposite, like the "wanting to get better" explanation is a moralistic, post-hoc rationalization. I live a reasonably successful life, but many of the things that made it so are just luck. I was born in a reasonably affluent country, and my parents always provided good care and abundant financial support. I am pretty awkward, but smart enough to get through life. I am naturally interested in programming computers so I don't even need to make an effort to do it, and this happens to match one of the most demanded jobs. I am depressed/anxious but thankfully SSRIs work very well for me. I had no bad influences regarding drugs. To me, it seems those reasons have had a greater influence than "wanting to get better" could ever have. In fact, when you're depressed, there's not even a "wanting to get better" to be had - you're just reflexively pulled to bad feelings.
Not drugs, but I'm playing out this story right now in my own life. No matter how much I try, I can never find a reason I'd rather wake up in the morning than not.
"What does a scanner see? he asked himself. I mean, really see? Into the head? Down into the heart? Does a passive infrared scanner like they used to use or a cube-type holo-scanner like they use these days, the latest thing, see into me - into us - clearly or darkly? I hope it does, he thought, see clearly, because I can't any longer these days see into myself. I see only murk. Murk outside; murk inside. I hope, for everyone's sake, the scanners do better. Because, he thought, if the scanner sees only darkly, the way I myself do, then we are cursed, cursed again and like we have been continually, and we'll wind up dead this way, knowing very little and getting that little fragment wrong too."
I found this acccount utterly riveting, and I really appreciated the frankness.
One thing I picked up on, though: the OP refers to people dying from OD. I believe it's quite unusual to die from an overdose; my understanding is that nearly all "OD" deaths are not poisonings, but the consequence of inhaling your own vomit. Hendrix, Joplin and Jim Morrison all died from inhaling vomit.
Opiates depress your respiratory reflexes, so you breathe "less well". And they make you dozy, or even pass out. If you puke in your sleep, and then breathe in, bad stuff (like, hydrochloric acid) goes into your lungs, you fail to wake up, so you "drown" i.e. you can't breathe. Death by respiratory failure.
Smack in itself isn't really that harmful. Smackhead doctors have been dosing themselves with clinical heroin for decades, while carrying on their jobs and family lives. Scoring on the street, though, is super-high-risk.
/me never used smack.
I did at one time hang out around losers; a few of them were smackheads, and they robbed the rest of us rotten. Most of these losers were into downers - I once held the tourniquet for a guy that was injecting Tuinal (a discontinued barbiturate combination). Injecting barbs is much more dangerous than injecting smack, if you can get smack that isn't adulterated.
Would providing free and clean heroin in safe, monitored sites be a solution? Starve the black market of clients, give people support and safety when they need it, as well as the time required to get their life back together enough to take a leap.
Given what we have observed with alcohol, cannibis, and prescription drugs, I think it's safe I expect that decriminalization, legal suppliers, and free drugs would probably not reduce recreational use & abuse of opiates in America... If anything, I would expect usage to increase.
Don't get me wrong: I am absolutely in favor of decriminalization, as well as other radical changes in our society's relationships with drugs, mental health, and addiction. But it would be catastrophically naive to suggest that legalized/decriminalized opiates are some kind of panacea.
If heroin didn't exist, these people would probably plain old alcoholics. The damage caused by an alcoholic is pretty similar to the wake of a heroin addict... It's not identical, but the overlap in causes & effects of abuse is pretty similar between the two drugs.
Ultimately, the problem is that some people reach young adulthood without having developed a robust set of emotional coping mechanisms for handling the stresses of their lives. These folks are a LOT more likely to fall into the larger patterns of self-destructive behavior that drive them back toward drugs, over and over again.
It would help for sure. My cousin died not because of overdose but because he shared needles and contracted hepatitis which turned into hepatoma. If safe injection sites had been available he might still be alive.
It’s probably a bad forum for this opinion, but I have a relative struggling with addiction and resulting mental issues ( resulting form substance abuse; he was highly functional and threw it all away), and because of this I made a 180 and think some form of prohibition for hard stuff is the only action that would help us. How to put that cat in the bag is anyone’s guess.
I sympathize, but these drugs are already as prohibited as they're going to get. Possession, manufacture and distribution are punished by years and years of prison time. It doesn't make a difference.
I don't know how we could make that work in the US. We already tried alcohol prohibition 100 years ago, and that didn't work. Patent medicines were made illegal, and prescriptions are required, for this reason.
We've already recognized that overprescribed prescription opiates in the early 2000's was a deliberate attempt to bypass these protections and get people hooked.
> How to put that cat in the bag is anyone’s guess.
I think it requires a scientific process instead of a political process. IE, the politicians need to encourage medical professionals to keep trying many different approaches until we figure out what works. This will only happen when politicians stop criminalizing addiction.
FYI: All currently legal treatment options in the US HAVE to target ending addiction. Allowing someone to voluntarily maintain an addiction to anything is currently illegal, and means that only people who voluntarily want to stop their addiction are helped.
My condolences to anyone who's lost a friend or relative to addiction - thanks to the human vultures who reap the rewards.
It's possible that by vigorously pursuing and prosecuting the people who can afford to purchase and disseminate hard narcotics - instead of the users and a pusher or two - most of the problem would dry up.
I'm not optimistic about that happening. The little guys are easier to catch, and caps are feathered. Meanwhile, the big guys have contacts and probably political connections.
After talking to a recovering addict regarding heroin, fentanyl and the such. I did some research and found I could get half a kilo of iso (stronger than fentanyl) by the end of the week. It took me 20 minutes
My point is that stuff is so widely available and easily accessible that no sort of enforcement against the higher ups will do a damn thing
Treating the addict with compassion and diligence will be far more effective than attempting to dry up the supply. It of course won't be easy and actually will require a mental shift regarding users
Instead of headlines of law enforcement patting themselves on the back about some meaningless bust
Or maybe you could move the other way: treat addiction as a disease and provide free, pharmaceutical grade product or methadone substitutes to all that request it, if they suffer from addiction. It costs essentially nothing.
This will not only kill the bulk of market and force dealers out in the open to find new, high risk recreational customers as opposed to cash cow addicts; but will also give a livable life to the addicts by preventing the financial and personal ruin brought by addiction to a substance that is made artificially scarce and expensive.
Most of the problems with addiction stem from this scarcity, not addiction itself: addicts take up a criminal activities to finance their consumption, lose all property and social capital, the product has high variability in potency and adulterants and is very risky to consume, they have to deal with criminals on a daily basis to get it etc.
I lost a sister to a drug OD close to 15 yrs ago. My belief is she suffered from depression, among other things, and self medicated.
That said, the opioid crisis in the USA has been largerly fueled by prescription drugs. If by little guys you mean doctors, and big guys you mean the manufacturers;well there's been some progress on that. But obviously and certainly not enough.
Let's also not overlook the convenient blind eye of regularors (read: government).
The US has waged a war on drug for several generations with virtually unlimited funding and has made no progress on that goal whatsoever. What makes you think it could ever work, despite the mountains and decades of evidence that it has failed?
It's not popular here on Hacker News due to its libertarian bent, but I'm of the opinion that we should even more brutal to illegal drug production, trafficking, and selling than what we currently are.
I've lost 2 friends to fentanyl poisoning in the last 3 years, and I lost my brother 10 years ago to chronic meth use. I'm so utterly sick of this.
Checking in from Northwestern Poland. Lost my dearest cousin and best friend when he turned 27 (yep that age). I don't have any more tears left. Been crying for a decade.
I lost a friend to meth and GHB at the beginning of this year, and although details are different, the trajectory is similar.
He suffered anxiety and was fearful about his life for years. Meth was what gave him fleeting confidence and euphoria, but also what finished that life. He was terrified to live, and he was terrified of death, so he self-medicated to manage, and ultimately that killed him.
As one of the people that cared about him who is left behind, I've struggled for answers, but I don't think there are any.
> I've struggled for answers, but I don't think there are any.
It took me a long time to learn this: there are problems for which there is no answer.
I got this from Buddhism (I have renounced Buddhism, but I've retained some of the insights). The world is intrinsically fucked-up, and not fixable. You can sometimes fix some things, but in the end the world is an incorrigible mess (samsara).
It's quite a relief once you take that on board. You can go on raging against injustice, war, and political cynicism, and so you should; but there's no need to feel inadequate because you don't know how to fix it.
> I've struggled for answers, but I don't think there are any.
I've also experienced drug-related loss and I think one can still find some lessons. Life is terrifying for some and they feel incredibly overwhelmed. We lack Compassion and Respect for those who don't really make it. We glorify individualism and grow up with the expectation that we can also be just like them, but some just can't. The gig-economy is incredibly harsh and brutal, no wonder the weekend with its drug fueled escapades is the only thing keeping them going. For some there is just no way out of loneliness, anxiety, soul-crushing work for minimum wage or without a job. Nobody tells them that everything's okay and giving them hope for the future.
I think selfish international politics just increases economic competition which brutalises our society. We hype up Elon Musk but in the end there's a lot of randomness in life and the super-star entrepreneur could just as well die of a heroin OD in the streets.
When I was nine years old, my cousin died of a heroin overdose at nineteen years old. Most of the grownups around me were very sad, but I didn't really know my cousin very well; he lived on the opposite side of the country, and he was a full decade older than me so the times I did see him we didn't really play together, and so I wasn't really able to feel "sad" about it. People I don't know die every day, I can't feel bad for all of them (cold as that might sound) and my cousin dying wasn't terribly different.
Fast forward eleven years, on my twentieth birthday, and I had a realization: my cousin was the first person I had known that I outlived, and I felt this sudden sinking feeling. Why had I been spared when my cousin had been taken so young? Why did I get to spend more time on earth then he did? It's not like I was some sort of cosmically better human than him, I had been a dumb teenager who was just lucky enough to not have friends who were willing to talk me into doing drugs.
I started asking my parents about my cousin, and it made me somehow feel even worse when I found out that my cousin had a bit of a downward cycle with drugs throughout the tail end of high school, tried joining the army in the hope that it might straighten him out, it didn't, and just fell deeper and deeper until he eventually died. Alcoholism seems to run in the males in my family (with the exception of my dad and me, strangely), so this sadly wasn't even really something completely unexpected.
Addiction is tough, I feel really fortunate to have dodged that bullet. I can't even pretend to know what addicts to hard drugs are going through.
> Alcoholism seems to run in the males in my family (with the exception of my dad and me, strangely), so this sadly wasn't even really something completely unexpected.
Indeed, familial alcoholism is suspected to be a complex genetic trait (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4056340/). As for why you and your father seem to have been spared by that... if I may ask, did you two have access to mental health care and use it? A common theory in addiction research is the "self-medication hypothesis" (https://www.psychiatrictimes.com/view/dune-and-the-second-co...) - basically, that people accidentally discover during experimenting with drugs that the drugs help with mental or physical health issues.
I'm a recent teetotaler and my quality of life is massively improved. It took me an unreasonably long time to realize many adult role models in my life (family, and then in my first significant professional workplace) were abusing alcohol. None of them would consider themselves alcoholic. A few of them were dependent at significant cost to their health, which I believe is easily classified as alcoholic.
A few years ago I worked a project with a young foreigner who didn't drink and actively spoke out against it as - in his description - the cause of much dysfunction in his country. Politics aside, I was actually inspired by someone significantly my junior to reconsider my attitudes. What if I took a leaf out of the self-improvement culture and just tried it? It might be too much for a lot of people to simply not drink. Life circumstance counts for a lot, but my life no longer includes socializing in venues where alcohol is served so it actually wasn't too hard to stop.
He wasn't taken. He took himself. Exercise: Everytime you remove agency, reintroduce it.
"I am depressed". No, you are depressing yourself. "I am helpless". No, you are making yourself helpless. These are active processes. Let's get more controversial: "I am being bullied". No, you are letting people bully you.
I know this is harsh. I know the societal memes and phrases are the warm place. A sigh, the Soma of "Nothing can be done" or "Somebody needs to do something!!" is not a solution but paralysis.
You can read it in the article: The parents did everything for the addict, he did nothing himself. It didn't work out now, did it? Never does.
(Not absolving the Sacklers of their guilt, that is a separate issue)
I had a friend die this year from heroin (probably from fentanyl, but his family doesn't talk about what happened, so hard to know for sure).
His friend group were always pill poppers, and a number of them started popping oxy. In two years, three of them have died. They all moved from oxy to heroin. All of them were snorting it, rather than shooting up. My friend told me they got heroin with fentanyl without knowing. He told me this when he came to visit from my old hometown, while he proceeded to crush up and snort an oxy in front of me. He told me he'd been buying heroin recently as well.
I knew at that moment he'd be dead soon too, so when his family gave the news, it didn't come as a shock.
The Sacklers are pure evil. Heroin is a serious problem, but there's a major hurdle that it faces: people know that heroin destroys your life. People trust their doctors, and they don't associate oxy with heroin, but it's a life destroyer just as much as heroin.
Most of the discussion here seems to be about hardcore addicts, and the issues that come from them, but they're just the face of the problem.
> My friend told me they got heroin with fentanyl without knowing.
This is an all too common trend. Most people aren't dying from an accidental overdose, they are being poisoned with fentanyl.
You get addicted to pain killers. Then go to heroin because it's cheaper and more effective. Then you get it laced with fentanyl because dealers are cutting it. Then you die.
To slow it you have to pressure China to stop the labs and you have to crack down on border smugglers, neither will happen anytime soon.
The author here is exactly right for the majority of cases. Everyone trying to spin it any other way is delusional. Society is difficult and humans vary greatly – not everyone is able to succeed. Many aspects of society are also competitive – some people will be winners and others will be losers. Losers turn to heroin because 5 years of shooting up and then dying seems like a better option than 60 years of living with the shame of mediocrity and the struggles of daily life.
It's not a function of an inadequate welfare state or de-industrialization or inadequate mental health treatment or any other social malaise. It's just life in a world of abundant resources where 99% of people are living at the top of maslow's hierarchy of needs. The only way to avoid this is to put people into an environment where the struggle for survival eclipses the desire to be happy.
I'm sure there are 20% of addicts who fall into this accidentally or would be able to live a happy post-heroin life, but for many people it basically makes sense and there's nothing to be done.
I know someone just like Jack (some of the similarities were shocking). They have a home to go to, a loving family, a large and supportive friend group, opportunities for work. They are not dead yet, but having been through prison, buprenorphine, and multiple expensive rehabs, I begin to wonder what the solution for them is. If there is anyone here who has beat this addiction perhaps it would be insightful for them to post what worked for them.
I haven't personally dealt with addiction, but I work in this space and the most effective treatment we have is Buprenorphine. Try to find a provider who will work with them and not kick them out of their program if they return to use. There are even telehealth options now, which is what my company does.
The author didn't consider than Jack may have committed suicide by heroin. Considering the rest of his analysis about how grim his life was with no hope of it getting better I think that's a reasonable hypothesis.
As bad as it sounds he may have wanted to end the suffering for him and his family
I’ve just finished reading Empire of Pain: The Secret History of the Sackler Dynasty , and I highly recommend it.
An amazing multi generational history of how the Sacklers inflicted opioids on the US, made a fortune, and got away with no consequence.
It was pretty interesting to read this during pandemic times, and it’s a prime example of how institutions lose legitimacy in the public’s eye. The Sacklers had the FDA in the palm of their hand, as well as the highest reaches of the justice department, as well as large numbers of medical professionals who patients trusted to make decisions that wouldn’t harm them.
What gives me hope? That I can surround myself with people who I can help and who will help me if I need it, not any type of fancy concept or title (Governor Agency, BigCo, professional title etc…).
I wonder what’s being peddled these days as completely safe but survivors will look back on as absolutely foolish.
Probably the wrong place to ask, but is there any information on the social costs for the Sacklers of their criminality? (I'm not excusing it, I'm just interested).
Although they have stuffed Giga$ into their pockets, most people also care deeply about their own social status, so have the Sacklers had severe social repercussions from their peers? Some of their peers or acquaintances of their peers must have been addicted.
> Remarkably effective but at a tremendous cost to personal liberty
Presuming Singapore correctly identifies the dealers, how is this a violation of liberty? You typically don't have the ability to harm others and drugs cause clear harm. It's not like laws against theft cost me personal liberty.
my summary: Basically claims the majority of the homeless problem is a some "new" meth type addiction. That traditional meth was a "party drug" that made you want to have fun but some new style meth is a "I want to be alone drug" and the majority people living in tents are the casualties of this new type of meth
I recall the book “Change your brain, change your life” covers the link between brain trauma and eventual drug abuse as a way to counter an undiagnosed medical issue.
Although I’m not 100% sure it was that book - For curiosity: I’m wondering if Jack had any history of concussion or other head injuries before the addiction.
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It was also mentioned that these patients had to be prompted multiple times before they remember accidents like falling off their bikes or tripping etc. as they would promptly forget and get on with their lives.
[+] [-] kamranjon|4 years ago|reply
I was Jack in highschool, addicted to heroin, destroying my family for 4 years. In and out of rehab. At one point my mother chased me through her house with me holding a needle full of heroin over her head, she had caught me using in the bathroom, I didn't want to let the hit go.
My mother died a little over a month ago, brain cancer, from diagnosis to death it happened in 5 months. Reading this brought back a lot of my guilt and reminded me of how futile my family felt trying to help.
Last week a highschool friend died, fentanyl od, he was never into opiates in highschool. I had no idea how serious it was. I had seen him at a wedding a couple months back and he mentioned that he got into fentanyl pressed pills for a period, he said he felt bad for judging me so hard in highschool, he never thought he... I cut him off and said "but your clean now right?" And he gave me this disappointed look, and said yeah. I just moved to a different subject, now I think he might have been asking for help, like how did you kick?
In the throes of addiction, the only thing that made any difference was that I decided one day to buy an ounce of mushrooms. I brewed them all into a tea and put it in my fridge. I drank mushroom tea for basically a week straight. I didn't do anything special, friends visited, we played video games and talked, but eventually I reflected, for the first time I actually saw myself from the outside, I saw what I was doing to my family and friends and it was like a switch flipped in my mind. Physical or mental addiction didn't matter anymore, it just didn't make sense to use. It's all I can really say that helped me, when you are an addict the best cure is gaining perspective because it is so hard to pull your head out of that hole.
[+] [-] gwbas1c|4 years ago|reply
A few months ago I watched a child, maybe 11-13 years old, run out of a hospital barely clothed. A security guard ran after him and must have wrestled something away. Then the child kept jumping for what the guard was holding, like jumping for a toy. The mother ran after him with clothes.
I felt so bad for the family.
[+] [-] aazaa|4 years ago|reply
Earlier on, the author does speculate about what drove Jack:
> To put it another way, Jack was painfully aware that his future options were, “be a complete loser,” or “be a complete loser who feels really really good for a few hours every day.” He chose the latter.
What's striking about this is how it's possible to live this way without drugs. A brain-numbing job eight hours a day and a life-saving hobby for four. A toxic-family life but wonderful community.
It almost sounds like Tennis could have been this outlet:
> One time when Jack was in middle school, he walked off the tennis court after a well-played match, and his mother asked him how he felt. Jack said something like, “when I’m out there, it’s so nice… it’s like the rest of the world goes away and I don’t have any problems.”
[+] [-] colinmhayes|4 years ago|reply
I tried heroin once, and I regret it every day, because I am 100% positive that I will never again be as happy as I was that day. If I didn't have what is effectively a dream job I'm sure that I'd be a heroin addict.
[+] [-] SuoDuanDao|4 years ago|reply
[+] [-] jareklupinski|4 years ago|reply
> They knew he would never get drugs when I was there. He wouldn’t shatter the illusion he and his family crafted for me. It wouldn’t be worth it, not even for a fix.
seemed to be something that really worked? albeit for the while
[+] [-] d_silin|4 years ago|reply
[+] [-] sigotirandolas|4 years ago|reply
[+] [-] nisegami|4 years ago|reply
[+] [-] ipnon|4 years ago|reply
[+] [-] denton-scratch|4 years ago|reply
One thing I picked up on, though: the OP refers to people dying from OD. I believe it's quite unusual to die from an overdose; my understanding is that nearly all "OD" deaths are not poisonings, but the consequence of inhaling your own vomit. Hendrix, Joplin and Jim Morrison all died from inhaling vomit.
Opiates depress your respiratory reflexes, so you breathe "less well". And they make you dozy, or even pass out. If you puke in your sleep, and then breathe in, bad stuff (like, hydrochloric acid) goes into your lungs, you fail to wake up, so you "drown" i.e. you can't breathe. Death by respiratory failure.
Smack in itself isn't really that harmful. Smackhead doctors have been dosing themselves with clinical heroin for decades, while carrying on their jobs and family lives. Scoring on the street, though, is super-high-risk.
/me never used smack.
I did at one time hang out around losers; a few of them were smackheads, and they robbed the rest of us rotten. Most of these losers were into downers - I once held the tourniquet for a guy that was injecting Tuinal (a discontinued barbiturate combination). Injecting barbs is much more dangerous than injecting smack, if you can get smack that isn't adulterated.
[+] [-] mmastrac|4 years ago|reply
[+] [-] SkittyDog|4 years ago|reply
Don't get me wrong: I am absolutely in favor of decriminalization, as well as other radical changes in our society's relationships with drugs, mental health, and addiction. But it would be catastrophically naive to suggest that legalized/decriminalized opiates are some kind of panacea.
If heroin didn't exist, these people would probably plain old alcoholics. The damage caused by an alcoholic is pretty similar to the wake of a heroin addict... It's not identical, but the overlap in causes & effects of abuse is pretty similar between the two drugs.
Ultimately, the problem is that some people reach young adulthood without having developed a robust set of emotional coping mechanisms for handling the stresses of their lives. These folks are a LOT more likely to fall into the larger patterns of self-destructive behavior that drive them back toward drugs, over and over again.
[+] [-] codr7|4 years ago|reply
[+] [-] abraxas|4 years ago|reply
[+] [-] headgasket|4 years ago|reply
[+] [-] ipnon|4 years ago|reply
[+] [-] gwbas1c|4 years ago|reply
I don't know how we could make that work in the US. We already tried alcohol prohibition 100 years ago, and that didn't work. Patent medicines were made illegal, and prescriptions are required, for this reason.
We've already recognized that overprescribed prescription opiates in the early 2000's was a deliberate attempt to bypass these protections and get people hooked.
> How to put that cat in the bag is anyone’s guess.
I think it requires a scientific process instead of a political process. IE, the politicians need to encourage medical professionals to keep trying many different approaches until we figure out what works. This will only happen when politicians stop criminalizing addiction.
FYI: All currently legal treatment options in the US HAVE to target ending addiction. Allowing someone to voluntarily maintain an addiction to anything is currently illegal, and means that only people who voluntarily want to stop their addiction are helped.
[+] [-] mythrwy|4 years ago|reply
[+] [-] 8bitsrule|4 years ago|reply
It's possible that by vigorously pursuing and prosecuting the people who can afford to purchase and disseminate hard narcotics - instead of the users and a pusher or two - most of the problem would dry up.
I'm not optimistic about that happening. The little guys are easier to catch, and caps are feathered. Meanwhile, the big guys have contacts and probably political connections.
[+] [-] short12|4 years ago|reply
My point is that stuff is so widely available and easily accessible that no sort of enforcement against the higher ups will do a damn thing
Treating the addict with compassion and diligence will be far more effective than attempting to dry up the supply. It of course won't be easy and actually will require a mental shift regarding users
Instead of headlines of law enforcement patting themselves on the back about some meaningless bust
[+] [-] yholio|4 years ago|reply
This will not only kill the bulk of market and force dealers out in the open to find new, high risk recreational customers as opposed to cash cow addicts; but will also give a livable life to the addicts by preventing the financial and personal ruin brought by addiction to a substance that is made artificially scarce and expensive.
Most of the problems with addiction stem from this scarcity, not addiction itself: addicts take up a criminal activities to finance their consumption, lose all property and social capital, the product has high variability in potency and adulterants and is very risky to consume, they have to deal with criminals on a daily basis to get it etc.
https://time.com/6108812/drug-deaths-safe-supply-opioids/
[+] [-] chiefalchemist|4 years ago|reply
That said, the opioid crisis in the USA has been largerly fueled by prescription drugs. If by little guys you mean doctors, and big guys you mean the manufacturers;well there's been some progress on that. But obviously and certainly not enough.
Let's also not overlook the convenient blind eye of regularors (read: government).
[+] [-] standardUser|4 years ago|reply
[+] [-] beebmam|4 years ago|reply
I've lost 2 friends to fentanyl poisoning in the last 3 years, and I lost my brother 10 years ago to chronic meth use. I'm so utterly sick of this.
[+] [-] abraxas|4 years ago|reply
[+] [-] stichers|4 years ago|reply
He suffered anxiety and was fearful about his life for years. Meth was what gave him fleeting confidence and euphoria, but also what finished that life. He was terrified to live, and he was terrified of death, so he self-medicated to manage, and ultimately that killed him.
As one of the people that cared about him who is left behind, I've struggled for answers, but I don't think there are any.
[+] [-] denton-scratch|4 years ago|reply
It took me a long time to learn this: there are problems for which there is no answer.
I got this from Buddhism (I have renounced Buddhism, but I've retained some of the insights). The world is intrinsically fucked-up, and not fixable. You can sometimes fix some things, but in the end the world is an incorrigible mess (samsara).
It's quite a relief once you take that on board. You can go on raging against injustice, war, and political cynicism, and so you should; but there's no need to feel inadequate because you don't know how to fix it.
[+] [-] LeanderK|4 years ago|reply
I've also experienced drug-related loss and I think one can still find some lessons. Life is terrifying for some and they feel incredibly overwhelmed. We lack Compassion and Respect for those who don't really make it. We glorify individualism and grow up with the expectation that we can also be just like them, but some just can't. The gig-economy is incredibly harsh and brutal, no wonder the weekend with its drug fueled escapades is the only thing keeping them going. For some there is just no way out of loneliness, anxiety, soul-crushing work for minimum wage or without a job. Nobody tells them that everything's okay and giving them hope for the future.
I think selfish international politics just increases economic competition which brutalises our society. We hype up Elon Musk but in the end there's a lot of randomness in life and the super-star entrepreneur could just as well die of a heroin OD in the streets.
[+] [-] tombert|4 years ago|reply
Fast forward eleven years, on my twentieth birthday, and I had a realization: my cousin was the first person I had known that I outlived, and I felt this sudden sinking feeling. Why had I been spared when my cousin had been taken so young? Why did I get to spend more time on earth then he did? It's not like I was some sort of cosmically better human than him, I had been a dumb teenager who was just lucky enough to not have friends who were willing to talk me into doing drugs.
I started asking my parents about my cousin, and it made me somehow feel even worse when I found out that my cousin had a bit of a downward cycle with drugs throughout the tail end of high school, tried joining the army in the hope that it might straighten him out, it didn't, and just fell deeper and deeper until he eventually died. Alcoholism seems to run in the males in my family (with the exception of my dad and me, strangely), so this sadly wasn't even really something completely unexpected.
Addiction is tough, I feel really fortunate to have dodged that bullet. I can't even pretend to know what addicts to hard drugs are going through.
[+] [-] mschuster91|4 years ago|reply
> Alcoholism seems to run in the males in my family (with the exception of my dad and me, strangely), so this sadly wasn't even really something completely unexpected.
Indeed, familial alcoholism is suspected to be a complex genetic trait (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4056340/). As for why you and your father seem to have been spared by that... if I may ask, did you two have access to mental health care and use it? A common theory in addiction research is the "self-medication hypothesis" (https://www.psychiatrictimes.com/view/dune-and-the-second-co...) - basically, that people accidentally discover during experimenting with drugs that the drugs help with mental or physical health issues.
[+] [-] mrslave|4 years ago|reply
A few years ago I worked a project with a young foreigner who didn't drink and actively spoke out against it as - in his description - the cause of much dysfunction in his country. Politics aside, I was actually inspired by someone significantly my junior to reconsider my attitudes. What if I took a leaf out of the self-improvement culture and just tried it? It might be too much for a lot of people to simply not drink. Life circumstance counts for a lot, but my life no longer includes socializing in venues where alcohol is served so it actually wasn't too hard to stop.
[+] [-] hedberg10|4 years ago|reply
He wasn't taken. He took himself. Exercise: Everytime you remove agency, reintroduce it.
"I am depressed". No, you are depressing yourself. "I am helpless". No, you are making yourself helpless. These are active processes. Let's get more controversial: "I am being bullied". No, you are letting people bully you.
I know this is harsh. I know the societal memes and phrases are the warm place. A sigh, the Soma of "Nothing can be done" or "Somebody needs to do something!!" is not a solution but paralysis.
You can read it in the article: The parents did everything for the addict, he did nothing himself. It didn't work out now, did it? Never does.
(Not absolving the Sacklers of their guilt, that is a separate issue)
[+] [-] blackandsqueaky|4 years ago|reply
Terrifying
[+] [-] ryan_lane|4 years ago|reply
His friend group were always pill poppers, and a number of them started popping oxy. In two years, three of them have died. They all moved from oxy to heroin. All of them were snorting it, rather than shooting up. My friend told me they got heroin with fentanyl without knowing. He told me this when he came to visit from my old hometown, while he proceeded to crush up and snort an oxy in front of me. He told me he'd been buying heroin recently as well.
I knew at that moment he'd be dead soon too, so when his family gave the news, it didn't come as a shock.
The Sacklers are pure evil. Heroin is a serious problem, but there's a major hurdle that it faces: people know that heroin destroys your life. People trust their doctors, and they don't associate oxy with heroin, but it's a life destroyer just as much as heroin.
Most of the discussion here seems to be about hardcore addicts, and the issues that come from them, but they're just the face of the problem.
[+] [-] hunterb123|4 years ago|reply
This is an all too common trend. Most people aren't dying from an accidental overdose, they are being poisoned with fentanyl.
You get addicted to pain killers. Then go to heroin because it's cheaper and more effective. Then you get it laced with fentanyl because dealers are cutting it. Then you die.
To slow it you have to pressure China to stop the labs and you have to crack down on border smugglers, neither will happen anytime soon.
[+] [-] theskypirate|4 years ago|reply
It's not a function of an inadequate welfare state or de-industrialization or inadequate mental health treatment or any other social malaise. It's just life in a world of abundant resources where 99% of people are living at the top of maslow's hierarchy of needs. The only way to avoid this is to put people into an environment where the struggle for survival eclipses the desire to be happy.
I'm sure there are 20% of addicts who fall into this accidentally or would be able to live a happy post-heroin life, but for many people it basically makes sense and there's nothing to be done.
[+] [-] oaktrout|4 years ago|reply
[+] [-] dminor|4 years ago|reply
[+] [-] icefo|4 years ago|reply
As bad as it sounds he may have wanted to end the suffering for him and his family
[+] [-] d136o|4 years ago|reply
An amazing multi generational history of how the Sacklers inflicted opioids on the US, made a fortune, and got away with no consequence.
It was pretty interesting to read this during pandemic times, and it’s a prime example of how institutions lose legitimacy in the public’s eye. The Sacklers had the FDA in the palm of their hand, as well as the highest reaches of the justice department, as well as large numbers of medical professionals who patients trusted to make decisions that wouldn’t harm them.
What gives me hope? That I can surround myself with people who I can help and who will help me if I need it, not any type of fancy concept or title (Governor Agency, BigCo, professional title etc…).
I wonder what’s being peddled these days as completely safe but survivors will look back on as absolutely foolish.
[+] [-] robocat|4 years ago|reply
Although they have stuffed Giga$ into their pockets, most people also care deeply about their own social status, so have the Sacklers had severe social repercussions from their peers? Some of their peers or acquaintances of their peers must have been addicted.
[+] [-] iainctduncan|4 years ago|reply
[+] [-] tmsh|4 years ago|reply
[+] [-] DantesKite|4 years ago|reply
Remarkably effective but at a tremendous cost to personal liberty.
https://en.m.wikipedia.org/wiki/List_of_countries_by_prevale...
[+] [-] kkjjkgjjgg|4 years ago|reply
[+] [-] iammisc|4 years ago|reply
Presuming Singapore correctly identifies the dealers, how is this a violation of liberty? You typically don't have the ability to harm others and drugs cause clear harm. It's not like laws against theft cost me personal liberty.
[+] [-] ogma|4 years ago|reply
[deleted]
[+] [-] pronlover723|4 years ago|reply
https://www.econtalk.org/sam-quinones-on-meth-fentanyl-and-t...
my summary: Basically claims the majority of the homeless problem is a some "new" meth type addiction. That traditional meth was a "party drug" that made you want to have fun but some new style meth is a "I want to be alone drug" and the majority people living in tents are the casualties of this new type of meth
[+] [-] razodactyl|4 years ago|reply
Although I’m not 100% sure it was that book - For curiosity: I’m wondering if Jack had any history of concussion or other head injuries before the addiction.
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It was also mentioned that these patients had to be prompted multiple times before they remember accidents like falling off their bikes or tripping etc. as they would promptly forget and get on with their lives.