Comment by Tiktaalik | Hacker News Reader

Comment by Tiktaalik | Hacker News Reader

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When I buy a beer from the store that is a "safe" regulated supply of a substance purchased by a government regulated supplier that will ultimately cause liver damage and cancer.

An un-safe supply of alcohol would be the sort of stuff that was common during prohibition, the sort of home brewed moonshine that poisoned people and made them blind.

We already do harm reduction and safe supply of many drugs in our society because we recognize the alternatives of adhoc illegal supply is dramatically worse.

Using opioids like heroin (boy if one could even get heroin at this point) is obviously not "safe."

These sort of concerns around safety are at this point however irrelevant because the reality is that people are chemically addicted to these harmful substances and the issue is how to best get them un-addicted or manage that addiction.

Anyone attempting to get off a chemical drug addiction can be absolutely be expected to relapse at some point (many points most likely!) along the journey to ultimately kicking the addiction for good.

The point of harm reduction is so that when someone relapses they do not die from street drugs that are so incredibly toxic there is no known safe dose and that they have yet another opportunity to try to wean themselves off their harmful addiction.

The context of this discussion around street drugs is about the unregulated street drugs that are so cut with various unknown chemicals that it is impossible to have a dose that yields any sort of expected results. This is what is resulting in an incredible spike in overdose deaths.

There is a clear difference between harm reduction and rehabilitation, although both are beneficial to society. However, we should not use double-speak terms like "safe use", as all efforts to facilitate continuous narcotics use are not safe, and it is counter-productive to imply otherwise. To see my point of view more clearly, consider whether it would be beneficial for any user or potential user to truly believe it is genuinely safe to use narcotics as a part of a harm reduction program.

We should be educating people about the dangers of narcotics addiction, and helping those who are already addicted through rehabilitation programs. They should have access to the narcotics for reduction therapy/tapering. But they also need a lot more — counselling, withdrawals management, relapse management, replacement therapy, group support, and other effective measures.

I suppose the core of what I am trying to say is this: harm reduction is not addressing the core issue effectively enough, and calling any part of harm "safe" communicates a wrong message and is damaging. Harm reduction efforts are important, but are not enough alone; continued narcotics use not be sold by politicians as "safe". There is a subtle but distinct difference between "safe" and "safer", the latter of which is appropriate in harm reduction efforts, but not the former.

The core issue is a series of failed policies originally implemented to address the problem of white women hanging around black and Chinese men. I don’t think the world would end if we sold Vyvanse and Nucynta ER over the counter at CVS. Let the people predisposed to be addicts just be addicts instead of wrecking their lives and the lives of those around them with failed program after failed program.

Coffee in regular amounts, nicotine not by burning, a beer or two now and then... shouldn't be controversial. Less obvious but still true: opiates at maintanance levels under supervision, regular amphetamine in moderate dosages, MDMA or ketamine on occasion. Loads of drugs in loads of usage scenarios really are "safe".

But just because supervised heroin won't kill you doesn't mean it's somehow good, actually. That's a separate judgement.

There's surely no upside. It's overwhelmingly likely to make you less healthy and less happy. But so will too much bacon and sitting.

Chairs are still safe though, by any sane definition.

Alcohol consumption is proven unsafe to health[1], but it's not controversial. Adults have the right to choose risky behaviors, just like they do in fire fighting, coal mining, underwater welding, or mountain climbing. In some cases, we admire those who choose them for their bravery.

Let's not confuse "unsafe" with "controversial" or "unquestionably bad." But let's remember that "safe" has a clear definition, which does not describe current "safe use" narcotics harm reduction programs. Harm reduction by definition means that harm is involved. Someone safe from street narcotics is someone who is not using them, at least in the way that they are generally used recreationally.

[1] https://www.who.int/europe/news/item/04-01-2023-no-level-of-...

> Alcohol consumption is proven unsafe to health, but it's not controversial. Adults have the right to choose risky behaviors

As long as they do have a choice yes. But that's not always the case with highly addictive substances.

Yes. An important point.

The most important part is to not get people into substance abuse in the first place.

Many people start with light drugs (weed or subscription drugs) and then go to heavier stuff. If it is easy to get light drugs and easy to get heavy stuff then more people will be doing drugs. If it is legal to carry around drugs for personal use and if it is considered accepted, then more people will be using drugs.

https://nida.nih.gov/publications/research-reports/marijuana...

These findings are consistent with the idea of marijuana as a "gateway drug." However, the majority of people who use marijuana do not go on to use other, "harder" substances. Also, cross-sensitization is not unique to marijuana. Alcohol and nicotine also prime the brain for a heightened response to other drugs51 and are, like marijuana, also typically used before a person progresses to other, more harmful substances.

It is important to note that other factors besides biological mechanisms, such as a person’s social environment, are also critical in a person’s risk for drug use. An alternative to the gateway-drug hypothesis is that people who are more vulnerable to drug-taking are simply more likely to start with readily available substances such as marijuana, tobacco, or alcohol, and their subsequent social interactions with others who use drugs increases their chances of trying other drugs. Further research is needed to explore this question.

I think drawing a line between light and heavy drugs (high risk of overdose/harm/very addictive)

If you have to buy your weed from a dealer who also sells other stuff the chances that you might decide to try something more harmful one days are much higher than if you can get your weed in a legal store.

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