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Comment by mnm1 | Hacker News Reader

Why not end this stupid drug war, let J&J and other companies like it sell prescriptions to addicts until they are actually ready to stop, provide support to those addicts like counseling, jobs, housing, clean needles, etc. and actually do something to better their lives than sue these companies while addicts are dying left and right because their doctors are legally forced to cut them off from their pure supply of opioids making them turn to impure supplies on the streets and overdose? No, why do the only thing that's ever been shown to work to help people? We couldn't have that. We're the United States of America and if we don't kill suck and helpless addicts and force the rest of the world to kill them as well, then who will? If we don't treat every problem like a war we might have some compassion and we can't have that. Landmark ruling my ass.

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>> let J&J and other companies like it sell prescriptions to addicts

Sounds like you're pretty angry, but you realize they didn't "sell to addicts" - they created them with a concentrated, coordinated strategy involving all aspects of the medical system. Letting them carry on business as usual while leaving it to public health and society at large to clean up the mess strikes me as a bizarre suggestion...

Some drugs are simply too physically addictive to just release into the 'wild' and let the chips fall where they may. I'll tell you where the chips fall - with huge portions of the country hopelessly addicted to drugs that are extremely difficult to quit.

This isn't weed, which isn't physically addictive, or even alcohol, where addictiveness varies from one person to the next. Opioids are addictive across the board. The best comparison is cigarettes. And look at how many people ended up nicotine addicts when we let those chips fall (40% of American adults in the 60's and 70's).

And unlike cigarettes, opioids can make you feel really, stupendously good.

I agree strongly with legalization of many drugs. But I can't find a way to agree with legalization of the most physically addictive drugs. Those are better handled through strict regulation, ample support and, even though it's a losing battle, some measure to limit supply.

Interesting data point that I saw. A century ago, heroin was freely available. In the 1960s it was illegal, but not heavily enforced. In 2010 it was illegal, and tremendous law enforcement effort was brought against it.

The percentage of the population addicted to heroin was roughly the same at all three points. The consequences for addicts was not. This demonstrates that banning a serious opioid produces no measurable effect other than having us spend a lot of money to create problems for addicts.

The problem with what the drug companies did here is not that they were producing dangerous substances (though they were), it is that they were getting doctors to prescribe them to be used in a way that was virtually guaranteed to create addiction on a large scale. Which is an argument for correct prescription policies, and not for banning the substances themselves.

I am sympathetic to your argument, but most people are not going to be willing to take you at your word unfortunately. do you have any sources you could link?

I heard it from a spokesman for Law Enforcement Against Prohibition (LEAP).

I can't find it but https://www.youtube.com/watch?v=W8yYJ_oV6xk is from the same organization and is well worth watching.

Restricting the supply when you have a population of addicts just leads to what the GP talked about - turning to less pure, more dangerous alternatives on the street.

I have no love of doctors handing out oxycodone like candy, but we're in serious danger of swinging the pendulum back the other way.

I believe we should legalize these drugs, but require their usage to occur under medical supervision, given the risk of respiratory depression. This simultaneously solves the "dirty needle" problem and helps the "city streets full of drug addicts" problem.

The only drug I support making illegal for recreational consumption is fentanyl (and others like it) - but frankly even that is probably unnecessary because the rise of fentanyl has happened _because_ of the war on drugs [1].

[1] I have no citation here. I'll note that as someone who has never tried fentanyl (besides being given it by a doctor as part of a cocktail to put me under as many people have experienced), it's said to not have much recreational value, so take that for what little it's worth. Rather, it is commonly added to other drugs like heroin and pressed alprazolam primarily because high potency drugs are easier to smuggle than low potency drugs. For example, a gram of LSD is trivial to smuggle and is equivalent to $10,000 hits of LSD, with an end retail value of $100,000 in many markets although naturally not priced that way when sold in bulk], whereas smuggling the equivalent value of weed would mean transporting on the order of 10,000 grams or more.

> require their usage to occur under medical supervision

This only really works for recreational use, not medical use. Being observed multiple times per day could well be just as restricting as the pain, so there is still an opportunity for diversion/misuse.

Restricting the supply isn't intended to help the addicts, it's to prevent new ones.

Addiction is much more than physical dependence. Providing methadone or medical grade heroin has been the only route that has helped keep this problem in check. Switzerland has had great success with it. Portugal has had great success with it. America has had great success with it (when we've tried it). The idea that the chemical causes the addiction is ridiculous. How do you explain the roughly ninety percent of people who take the same drugs and don't become addicted then? You don't need to sell heroin at the 7-11. You can give it out under controlled medical supervision. I mean seriously you think throwing someone in jail is going to make them quit? Addicts use because they are in pain, mental, emotional, or physical. Putting them in more pain is going to help them quit? How does that work? Because there is no evidence now over a hundred years into this insane drug war that it has ever worked. Instead providing addicts with counseling, jobs, homes, and treating them like human beings has been shown to work time and time again the few times it has ever been tried. Imagine that. Treating people like human beings helps them to fix their lives. You can't do that with a drug war. It's impossible.

> Providing methadone or medical grade heroin has been the only route that has helped keep this problem in check.

There are better heroin substitutes than methadone (which is probably more addictive than heroin).

Suboxone in particular needs to be used more in the US.

What about if the drugs were available in controlled hospital/clinic environments for existing addicts, but illegal for anyone to buy or sell? Addicts stop stealing and feeding money into gangs, and those gangs will no longer push those drugs as there is no money in them.

In my country at least, I've seen ( from people I've known at various points in my life ) that addicts have no trouble obtaining the real article on the black market. The thing that really alarmed me though was how easily people who were clearly addicts seemed to be able to get legitimate prescriptions for opioids from doctors and dentists. I'm also not sure I agree with allowing opioid addicts a clean supply of prescriptions, but this is clearly a very nuanced problem and I haven't seen any of the data on what works and what doesn't.

What's the problem with addicts getting opioids from their doctor? If the doctor thinks they should be prescribed opioids for addiction shouldn't the doctor's prescription be honored in the same way a prescription for chemotherapy would? The chemo prescription is much more dangerous. Or should the doctor face 25 years in prison for doing what he thinks is best (our current system) while the addict goes out and robs someone to get drugs that would cost $5 with a prescription? Which way do you think is better for society and the patient?

I think the moral objection to supporting addictions is quite valid here. We try to provide societal remedies for other similar self-destructive behavior so actively supporting this seems against the societal values we've settled on. I personally think it is callous to so disregard even an addict's well being and it seems like there are decent alternatives we can invest in like counseling and programs to build out social support structures for addicts that are by no means out of reach for the US.

What is the moral objection to helping people?

Sorry, to clarify, I'm talking about a moral objection to feeding their addiction.

Oh I can answer that! Because J&J would isolate this responsibility into a subsidiary and spin it off, it may be difficult to do and maaaaybe some of the companies spinning these subsidiaries off would get dragged through the mud - but spinning liabilities off into separate companies is a time honored tradition[1].

1. @see just about any superfund site related bankruptcy... like: https://en.wikipedia.org/wiki/Eagle-Picher

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