Comment by dalke | Hacker News Reader

Comment by dalke | Hacker News Reader

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While vivid, is that true? Given all of the people who have taken LSD, I would expect more reported accidents of the sort you describe.

According to http://www.drugabuse.gov/publications/drugfacts/nationwide-t... , about 0.4% of the US uses a hallucinogen each month. According to http://www.niaaa.nih.gov/alcohol-health/overview-alcohol-con... about 60% have had alcohol in the same month.

Thats a ratio of about 150. Let's round it up to 200.

Nearly 88,000 people die from alcohol related deaths per year (see http://www.niaaa.nih.gov/alcohol-health/overview-alcohol-con... ).

Thus, if the risk factors for death related to hallucinogens is higher than that of alcohol, I would expect to see about 440 such deaths per year.

10,322 died due to alcohol-impaired-driving. Using the same ratio, I would expect to see about 50 such deaths related to hallucinogens.

I have failed to find deaths of the sort you described, which make me doubt that there's a simple causal relationship between the number of fatalities and the prohibition of a substance.

While I expect the death rate of psychedelics/hallucinogens to be much, much lower than that of alcohol, it should be noted that the analysis you presented here doesn't really provide solid evidence that it is so.

Given that an average LSD dose is 50-150mcg and because of the "Cascade effect" nature of the drug, LSD is often not measurable in the blood even when someone is heavily under the influence. And even in the cases where it would be detectable if they tested for it, LSD is not included in coroners' postmortem tox-screens unless it is specifically suspected. Movies and TV get this wrong frequently.

Basically, I'm saying that since it isn't routinely tested for (and is often undetectable anyway) the published statistics have no reason to be accurate.

But really, how much more common (even after adjusting for frequency of overall usage) are "Hey, watch this. Hold my beer" deaths than any deaths from LSD? My estimate is "a lot."

I agree. The OP drew a conclusion, and rather than just demanding proof I wanted to point out why I didn't think it was obviously true. There would very well be other things not in my analysis that could lead the OP to that conclusion.

For example, methods besides chemical traces might determine the cause of death. Friends of the deceased might provide information about the circumstances of death, additional drugs or paraphernalia might be in the pockets of the victim, or in the immediate surroundings.

In addition, if it were true then there should be a lot more people who are injured in similar circumstances. The medical personnel at the hospital may learn some of the background context when asking for details about what happened to cause the injury.

I would be very wary of "drug-related death" statistics.

I've read that when people are admitted to the hospital, if drugs are mentioned, they are required by law to report the admission as "drug-related". The person admitted doesn't have to be actually taking any drugs him/herself, much less be in the hospital because of any action on such drugs on their body or mind, nor even do the people around them have to be on any drugs. They only have to be mentioned and then the admission is considered "drug-related".

Furthermore, when people die and they're on illegal drugs, it's rare for there to be just one drug involved. Usually it's a cocktail mix of chemicals (often with alcohol being one of them, and one of the drugs that's most dangerous to mix with others).

Finally, lots of drugs are metabolized very quickly or don't show up in the standard tests that are done during an autopsy (if an autopsy is actually performed).

You are making a general statement, right, and not something related to my estimate?

The bias you mention should only serve to increase the number of reported cases. As I cannot find statistics anywhere near the scores of people who must die each year for the OP's comments to make sense, nor historical justifications for the prohibition of psychedelics that were based on scores of people dieing per year, your comment doesn't seem relevant. That is, I could ignore it completely and still draw the same conclusion.

LSD certainly kills people, but it's down around the danger level (to the user) of Cannabis or Ecstasy. Much safer than scary drugs like alcohol or cocaine let alone even worse ones (to the user) like Meth or Heroin.

http://www.economist.com/blogs/dailychart/2010/11/drugs_caus...

(That list has alcohol at the top but that's mainly due to drunk people's tendency to harm others via driving or violence)

Alcohol is far worse than Heroin or the other opiates. Nearly all the problems with opiates relate to having unknown quantities due to the lack of regulated producers. The opiate side effect profile is rather tame, mainly constipation. (Apart from respiratory depression, and the unfortunate people that get nauseous.)

The most heinous thing about opiate overdoses is that there exists a drug (Naloxone/Narcan) that if administered in a comfortable window of time will completely negate the effects of the overdose and there are still states in the US that don't condone or approve of its use among drug addicts.

Here's a link to a Vice documentary talking about it: http://www.vice.com/video/back-from-the-brink-heroins-antido...

I bet Naloxone/Narcan isn't available over the counter so it isn't as available as it should be. First I'm hearing of this.

It's available in Australia at the needle exchange. You do a 1 day course as a training session, and you're allowed to purchase it. $5 for three doses, which is pretty great.

There is one more issue with many opiates, which is actually inherent to the drugs and not to the regulatory/market context - the relatively quick gain and loss of tolerance, and the uncertainty this introduces as to the actual physiological effects even of a known dosage.

This is why there are many opiate overdoses where the victim is starting to use after being sober for some time - they go back to the doses that were normal for them not so long ago, but their body chemistry has changed enough that those dosages are now dangerous.

See for example http://www.bmj.com/content/326/7396/959

Well that's still rather related to legal issues. If opiates didn't have legal issues, then the social stigma would drop and people wouldn't need to go on these binge rehabs. Also note that other very popular legal drugs require care when going on or off. Eg benzodiazepines can cause death if suddenly discontinued. SSRIs also require care when stopping. Yet these two groups are the most prescribed medications, ever.

Sure - and some opiates (including ones with dangers of addiction and overdose morphine) are themselves prescribed, carefully. But they're not safe on the same level that, say, marijuana or LSD are.

Right I'm just objecting to classifying opiates as the evil hardcore drug, the personification of bad. Alcohol is far worse. In fact, opiates are one if the current post human steps we can take to a Culture-like humanity. Being able to turn off physical and emotional pain, on-demand? Until neuroscience gets us there, opiates are a good start.

"LSD certainly kills people"

Citation please.

Come on - this isn't Wikipedia, and not everything easily Google-able needs to have a citation.

Anyhow, here's one result to get you started: http://www.ncbi.nlm.nih.gov/pubmed/4043895

I can't read that paper (because of the paywall) to figure out how how they determined the cause of death, beyond simply measuring LSD in the body. http://www.erowid.org/chemicals/lsd/lsd_death.shtml says "LSD was listed as a cause of death by a coroner where more plausible causes of death were the injuries received in fights with police officers."

Assuming it were true, it's odd that a PubMed search finds no more recent papers. No matter what, it's decidedly rare. Renee Honaker was believed to have died of LSD overdose. Quoting http://www.wvgazette.com/News/201303090102 :

> Downey said his initial research into LSD-related fatalities hasn't returned very many reported cases. ... Dr. Elizabeth Sharman, head of the West Virginia Poison Center, hadn't researched the case but said it's the first fatality she's heard of in the state.

Later, "It turns out that the drug Todd and Reneee Honaker took was not LSD after all; according to WSAZ, a TV station in Charleston, it was an NBOMe compound." - http://www.forbes.com/sites/jacobsullum/2013/10/21/lsd-did-n...

NBOMe is also a psychedelic, so falls under the general thesis of the OP. However, it's a rather recent psychedelic so cannot be the reason for the prohibition.

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