Comment by onelittlepoint | Hacker News Reader

Comment by onelittlepoint | Hacker News Reader

I'm an upper-middle-class, white, software developer with a CS degree from a top university. I do not drink a drop; I do not "get high."

But I used to be a heroin addict.

Before then, I used Oxycontin - crushed up and snorted - which was a great kick and very, very easy to fall in love with when you first try it.

The Oxycontin pill formula switch had ominous effect. In short, my pusher had no clients anymore and switched straight to heroin. Turned from kids snorting pills for highs into a shooting gallery almost overnight. The last "classic" Oxycontin I remember hearing about went for $160 a pill.

Like Scudo, I started with brown heroin. Snorting it also. And under the same delusion that somehow snorting it made me "not a heroin addict."

Nothing like the cognitive dissonance of a dozen middle-class white kids making their first casual acquaintances with heroin.

But drug has a noxious, subtle allure. One night, with only a few $20s in my pocket and the ATM just out of walking distance, I chased down a bit more rush. Someone showed me how to shoot it.

"You put the needle in your arm." Casually as ever. Like explaining how to pull a good espresso. "You're new to this so your veins are easy to find. Not like mine. When you pull back the plunger - like this," drawing blood, "you know you've found it." Had it done for me, because I was scared and couldn't hit.

I threw up a lot and felt better than uninitiated will ever comprehend.

Months passed. Then something started happening, something I hadn't dealt with before: People started dying. Kids who had futures started dying.

I won't bore you with the howls of addiction and disaster that followed, nor with my own personal triumph of escape. But I will leave with one point:

This article is spot-on; the elephant in the room for many a community of parents who can't stomach much longer watching more of their kids die.

Heroin is not just in the underbelly of the world anymore. We need to stop treating it like a pariah and start actually trying to fix it.

It's always seemed to me the fix is technically quite easy even if politicians find it hard to vote for - provide safe heroin or similar to addicts for free / low cost at addiction treatment centres while at the same time keep supplying drugs on the open market illegal. That way the dealers lose most of their income and get other jobs, the addicts are at least safe and the general public don't get their stuff nicked. I don't know why it's so hard to get that implemented. It has been done in the past in the UK and it works.

I'm generally in favour of drug legalization and I think we should carefully experiment with even legalizing heroine/opiates.

However, I don't think this is a "fix" any more than legal alcohol is a fix for alcoholism. Legal or not, there will be user and there will be addicts. Legality might be an improvement but it doesn't solve the problem.

I don't know if there is a solution. An effective treatment for addiction is the only thing I can think of. We don't even have effective treatments for eating disorders.

There is a difference: alcohol can kill you in various ways, both acute and long term. Heroin can too, but by knowing what you're getting and your own tolerance you can avoid overdoses and then the side effects are pretty mild (constipation).

A quote I like to fall back on is the one from Portugal, which no longer has (edited) criminalized substances.

"If you realize addiction is simply a symptom of a deeper underlying mental illness. Treat the illness, you solve the addiction."

But yes there will be addicts.

Recreational drug possession is decriminalized in Portugal, but still illegal. You will still be fined if caught, and if you possess over a certain amount, charged with a crime. That being said, addiction has declined since the decriminalization.

If caught consuming (under a certain amount), the drug will be apreend and you can be required to present yourself before a comitte formed by a lawyer, a doctor and a social worker. It's possible to be fined but that it's not the primary objective.

While I think it's a huge improvement to see addiction something other than a 'crime', I think assuming it's a symptom of a deeper underlying mental illness is still not ideal. It's too simple.

Consider addiction to smoking. There are plenty of people who picked up smoking for no other reason than 'fitting in' or 'curiosity'. Which I'd hardly call a mental illness. Many of these people kept smoking, and sadly probably many of them died from smoking.

Similarly, I suspect there are many alcoholics who slowly became so because they entered a culture of alcohol.

Addiction is a powerful thing in itself, and while the solution to many might be uncovering the underlying mental illness, for many it might 'just' be a matter of unlearning a powerful, destructive habit.

Of course in both cases professional help is necessary, but treating an 'underlying mental illness' in cases where there are none can also have bad consequences.

Among the many addicts and ex-addicts I've known, there have been more than a few that were actively treating a 'deeper underlying mental illness' that I suspected didn't really exist in the first place. And while that's probably better than being an addict, it's still not good.

in fact, this is one reason I have issues with the approach Alcoholics Anonymous. They seem to treat all alcoholics as sufferers of a lifelong disease, and I cannot help but wonder if being constantly reminded of a thing you don't want to do anymore is a good solution for all people. For some, sure. Some people might have the 'alcoholism gene'. But I don't think that's always the case.

There is a difference between chemical and psychological addiction you completely overlook. I was generalizing the later, as it can be dealt with, with consoling.

The former can be very nasty and serious. It didn't mean to belittle it, or people who've fallen prey to it.

There's a difference, but it's not black and white, and I find it hard to imagine that most chemical addictions we know are bad enough in themselves to cause the extreme behavior that addicts exhibit.

Regardless, I was primarily thinking about the psychological side of addiction in the above post, and I think my point still stands. There are many examples of (almost) purely psychological addictions that people suffer from, and also in those cases I think it can be an interplay of habit formation, personality characteristics, and environment, that 'maintain' it, and not always 'deeper issues' (although I suppose one could consider environment a deeper issue...).

The critical point in my suggestion above is that heroin at any rate is not legalised in general. It is only made legal for it to be supplied to support addicts at registered non profit treatment centres. This is actually pretty much the law at the moment in the UK - heroin can be prescribed legally by doctors, but there are still issues in getting it done. The alternate policy of tolerating illegal heroin use such as practiced in Amsterdam at times has many problems - you get the criminal dealers, the parks full of junkies who steal stuff to buy the drugs and so on.

What's interesting is that the USA has very high rates of drug abuse, illegal and prescription drug abuse, despite having very strict laws and harsh punishments for drugs (it varies by state, but generally).

The lesson is that the harsh punishments don't solve the problem.

Drug addictions should not be blamed on the addict, there is still a huge problem here. I think they can be treated if they are accepted, the addiction approached like a mental disease, with counseling and honesty.

But legal alcohol did work to make it far less dangerous and remove the organized crime effect

This is spot on, prescribing heroin wouldn't necessarily help addicts to recover but it would go a long way to making the disease itself more bearable for individuals and society.

If misery causes drug abuse, like it seems to do, then obviously making misery more rare is the solution. Legality is one easy step towards that goal, other steps include societal acceptance (i.e. drug users not immediately being regarded as worse people) and increased wealth.

> However, I don't think this is a "fix" any more than legal alcohol is a fix for alcoholism.

Is it too much of a stretch to suggest that legal alcohol IS a fix for alcoholism, at least if you're speaking of the sort of alcoholism that might exist is a world where alcoholics are all destitute and social pariahs? I think we live in a world where many functional alcoholics exist, for better or for worse. But I would rather have more functional alcoholism and legality, than live in a society that views alcoholics as criminals and condemns them to destitution.

In the same way, while i dont necessarily want more heroin addicts, i think i want to live in society where functional heroin addicts can lead the semblance of a normal life as we coolectively sort out how to help them recover.

> Is it too much of a stretch to suggest that legal alcohol IS a fix for alcoholism, at least if you're speaking of the sort of alcoholism that might exist is a world where alcoholics are all destitute and social pariahs?

Prohibition doesn't make all addicts destitute social pariahs. There are plenty of rich & popular addicts of illegal drugs now, just as there were plenty of rich & popular people who were also alcoholics when alcohol was the subject of Prohibition.

It does make more addicts destitute social pariahs, though, and the stigmatization complicates treating addiction.

> It's always seemed to me the fix is technically quite easy

You're absolutely, 100% right in that sentence alone.

The solution to heroin addiction is technically quite easy, and it's called Iboga.

Switzerland and the Netherlands have done just that, with promising results: http://www.economist.com/news/united-states/21595963-how-mak...

Don't forget Canada.

Australia too

Also Portugal

> It's always seemed to me the fix is technically quite easy even if politicians find it hard to vote for - provide safe heroin or similar to addicts for free / low cost at addiction treatment centres while at the same time keep supplying drugs on the open market illegal. That way the dealers lose most of their income and get other jobs, the addicts are at least safe and the general public don't get their stuff nicked.

It seems to me the whole problem stems from a misunderstanding of what needs to be prevented.

What you don't want is people addicted to drugs. Allowing heroin to be sold at Walmart for $1 would be no problem whatsoever if nobody was using it. Where the stupidity comes in is that the laws and law enforcement are targeted at sale and distribution rather than consumption, the theory apparently being that if people can't buy drugs then they can't use them.

Which, of course, doesn't work, and instead leads to the rise of organized crime and violence.

What we need is for sale and possession to be legal, which kills the drug cartels instantly, but then do everything we can to discourage usage. Make the penalty for drug use a fine and instant mandatory rehab, and make drug possession legal but probable cause for a drug test.

The idea is to make distribution legal and therefore unprofitable, and make usage as safe as possible but so inconvenient that nobody wants to do it. And then use the revenue generated from taxing it to pay to help the people who are already addicted.

I've thought similar things but came to a slightly different conclusion.

Let people buy and use heroin legally, but make the process like the DMV or a welfare office. That is to say, it takes hours, it's boring and uncomfortable, you can't play on your phone, and is so lacking in romance or mystique that it could be a synonym for mundane inanity. Plus they can only get a limited amount at a time and there is a cooldown period.

thanks for sharing your story. based on your experience, what do you think can be done to address the situation?

Social stigma is a huge problem. The people who won't get help because "A bum sitting under a bridge with a needle in his arm, robbing houses to feed his addiction," c.f. the article, is what people think of when they think of heroin. There are people who won't seek help out of fear they will be thrown away by society. Nobody wants to stop being who they are and start being "an addict."

Part of what can help this is education. To most people, heroin is a mythical creature. It's either glamorized or demonized, but neither of these things have any grounds in reality. There's obviously nothing glamorous about being so broken that you need to turn to powerful opiates to solve it. And there's obviously nothing so demonic about it, either: it's some sort of cognitive or emotional failure on the user's part, but it's not evil.

While I share some of the concerns of others about it, I think "safe heroin or similar to addicts for free / low cost at addiction treatment centres" is still worth consideration. I think "not heroin" is the reasonable choice, though picking something (eg opiate replacements) completely devoid of pleasure fails to solve the real problem.

People tend to neglect that money is a big part of the reason that drugs turn up in a community. We're a society built on money and illicit drugs are a profit area that huge corporations, by law, cannot capitalize upon. But that doesn't mean that people won't, and those people have profit motives to do things that encourage use of their product.

It's clear that killing these people or putting them in prisons doesn't help. This is why the "war on drugs" is a failure: it just opens up the market for new players.

In truth, heroin is no more strange or evil than alcohol. In fact, they're fairly similar: they both feel good, hobble your senses, and dull "pain." But drugs carry with them certain cultures, and the culture of alcohol is a reasonable one. An obscure and "dangerous" substance like heroin carries with it an obscure and dangerous drug market. That is what's truly dangerous; moreso than even the drug.

So some combination of (1) educating the public in a sane way rather than fearmongering and (2) using the newly-earned social support to open doors for tactics that destroy the black market are my idea of a solution.

I could be wrong, though. I'm just one data point.

I've had leftover opioid painkillers from surgeries and I can see how easily this could turn into a gateway. I often feel simply lucky that oxy et al wasn't prevalent when I was 16-24yrs old, as I'm sure I would have encountered it. And as a new father I am also worried what kids will be up to in 10-15 years if we can't learn from experiences like yours. So again, thank you - I really appreciate your story.

The point on stigma is a hard one.

On one hand, I see your point. There's a lot of merit in allowing various mental and emotional illnesses to be treated as illnesses rather than moral failings.

On the other, this seems orthogonal to the AA/NA approach. "I am an addict. I am no different from other addicts." Own the problem. Make it your primary mission. Many members give "recovering addict" a very central place in their identity.

Do you think it's better to encourage addicts embrace the label or allow them to wear it lightly?

Also, regarding the "drug culture." I don't know much about the heroin culture but the prescription painkiller culture seems to be very different. Recreational users seem to treat it like a party drug. A lot of addicts seem to treat it like medicine. There's an obvious compulsiveness to it, but it's not incompatible with a normal life the way heroine seems to be. I don't know if it's mostly stigma and culture or properties of the actual substance, but using heroin and going to work and then picking up the kids seems like a total contradiction.

I know as a smoker that smoking and exorcise (and healthy eating) feel incompatible. If you do this self destructive thing 10-20 time a day, going into a gym or playing soccer seems ridiculous. This is something that changed over the last generation. In the 50s, you could see professional athletes take smoke breaks between training sessions. But now, with the current cultural treatment of cigarettes, relapsing on smoking usually means relapsing on exercise too.

Again, I think there's a contradiction between AA/NA approach and another approach. One is to encourage the oxy culture in heroin. Shooting heroin doesn't mean your whole life is derelict. The NA/AA approach is the other way, oxy addicts need to see that they're addicts just like the bum with a needle in his arm. Thoughts?

I think that in the same way that depression can have many causes, and that different solutions might apply to each of them, addiction is not one 'thing' either. I tried to explain my view elsewhere: https://news.ycombinator.com/item?id=8658316

> Social stigma is a huge problem. The people who won't get help because "A bum sitting under a bridge with a needle in his arm, robbing houses to feed his addiction," c.f. the article, is what people think of when they think of heroin. There are people who won't seek help out of fear they will be thrown away by society.

True, and as a side point it's sad that people are willing to discard the person under the bridge any more than the person in their middle-class neighborhood. The person under the bridge is far more vulnerable and more likely to need help.

Ibogaine (http://en.wikipedia.org/wiki/Ibogaine) reportedly works for some people to get rid of their additions.

Thanks for telling your story. I have an odd question. How do you feel about the way current members of the military and veterans are treated w/r/t painkillers like Oxycontin?

This site provides much help and information about dealing with heroin: http://www.heroinhelper.com/

Thank you for sharing.

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