Comment by keepamovin
6 hours ago
The ephedrine (or pseudoephedrine) synthesis is a one step using phosphorus/iodine reduction directly to methamphetamine. It’s simple and clean in that only an acid base extraction is required, and only one set of NP solvents.
All these others syntheses with multiple steps up the chances of weird toxic solvents or contaminants creeping in. I think it’s a contaminant issue that’s exacerbated by the drug use.
The government should just regulate it, control purity and production and let people access small amounts for recreation/performance. It’s not an evil drug per se - long history before it was criminalized. Plus that would neuter the cartels and protect people’s health more than pushing it underground.
>The government should just regulate it, control purity and production and let people access small amounts for recreation/performance
Famously, the US spent about 15-20 years attempting this with opioids. They were widely available to people via a pseudo-medical process, or via secondhand dealing. Opioids were/are manufactured by regulated, publicly traded companies with inspectors who controlled purity and production. The result? A shattering drug addiction crisis that at its height killed more people annually than the entire Vietnam War.
(For people saying 'no, that was illegal heroin or fentanyl that did all that damage'- the Wiki page for the opioid crisis is quite clear that at least 50% of all deaths were due to perfectly legal, regulated opioids).
When you make drugs legal & easy to get, lots & lots of people do them- who develop life-shattering addictions and OD en masse. They also build tolerance and then move on to even harder stuff. AFAIK out of the 300ish countries on the globe, there is not 1 that has decriminalized hard drugs in the modern era. And no don't say Portugal, contrary to widespread myth they forced people under threat of jail to attend drug rehab, and anyways they've recently curtailed even that.
I realize this is not going to get a lot of upvotes on HN, but yes making it difficult to do hard drugs is a reasonable public policy goal. (Which again, is why literally every country on the planet does it). There's room to argue about the exact tactics, but the broad goal is perfectly legitimate
I think a astronomically better example would be programs in the Netherlands, Denmark or Switzerland, where people heavily addicted to heroine can get into programs that will provide them with pharmaceutical heroine. Still prescribed by doctors (although specialized ones), but not just for pulling a wisdom tooth with huge margins for the Sacklers...
The last time I looked up the Swiss program it was only servicing a small number of people. Around 1500 in a country if 9 million. It also wasn’t prescribed like a typical medication but part of a program where they received other treatment as well. There was some exception where some people could get 2 days of it at a time to take home, but it wasn’t a free for all prescription where they could just talk to a doctor and get their monthly desired supply from a pharmacy.
Many countries, including the US, use methadone for maintenance. As I understand it it’s not as enjoyable as some people’s opioids of choice but it’s still an extremely powerful opioid depending on the dose (easily fatal).
So it’s not only the countries you mentioned that provide pharmaceutical opioids as maintenance treatment. The US does too, though the form is different.
A problem LAR programs have had since the start is that although methadone is less attractive as a drug than heroin, it's still attractive, and basically the only way to figure out how much a heroin addict needs is to ask them. Leading to users asking for extra, selling the excess (to users who were not in the LAR program) and buying other drugs with the profits. For some years, more people died from methadone overdose in Norway than heroin.
Sure, you could demand injection on site to reduce this problem. But that just makes the program less appealing. You could also just hand out the users' drug of choice directly (heroin) rather than the less harmful substitute, but at some point that starts counting as physician-assisted suicide, really.
"the Wiki page for the opioid crisis is quite clear that at least 50% of all deaths were due to perfectly legal, regulated opioids"
Are you talking about this page?
https://en.wikipedia.org/wiki/Opioid_epidemic
Could you then be more clear where exactly your claim came from? I did not find it, but rather this:
"According to medical professionals, supervised injection sites are effective in reducing overdose deaths and the transmission of infectious diseases."
Are you referring to the massive opiate abuse crisis that followed World War One?
I believe the gp meant the last few decades and the crisis that culminated with the Purdue trial.
What if they were legal but hard to get? Say, we stop/arresting for possession or use in private, stop giving dealers and producers harsh sentences, but still give them moderate to weak sentences, stop proactively searching for dealers and producers, allow companies to produce with strict KYC, and don't allow retail sale in stores?
Your opioid comparison is wildly apples to oranges. They were marketed and sold to consumers as safe, much more effective, and dramatically less addictive than it actually was. An industrial addiction machine ignored regulatory safeguards, built a 'pay for play' rewards structure to incentivize prescriptions, and a zillion other cartoonishly evil things .
There is a world of difference between something like that and government dosed methadone, meth, etc.
The problem was not in fact opioids. It was the profit structure behind the distribution network. Remove that and the bulk of the problems go away too.
If the drug is socially stigmatized only true addicts will use it. Those are exactly the people you want to have access to it because they can be gradually tapered off on a controlled dosage, they can be targeted for interventions, and it keeps them from stabbing you and stealing your wallet to get more meth.
Its incredibly counterproductive to just outlaw a thing that people need on a level that they will do almost anything to get it.
I think another under-discussed factor in the opioid crisis is that opioids are cheap, but (American) healthcare to treat underlying pain is not. You might not be able to afford six weeks of physical therapy, surgery, etc., but you can probably afford $11.23 a month for a generic prescription.
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>Those are exactly the people you want to have access to it
Yes but that's different from 'every random person can buy some meth at 7-11 or the government store' though. I'm fine with a controlled program for registered, hardcore addicts- the 2% who do 50% of the drugs or what have you.
>The problem was not in fact opioids. It was the profit structure behind the distribution network. Remove that and the bulk of the problems go away too
I mean, states & countries that have completely state-run liquor stores still have alcoholism and serious alcohol problems though? If 'removing the profit structure' worked magically, more countries would do it. AFAIK rates of alcoholism aren't even different between state-run and private sector models
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There are 193 countries, plus the Holy See.
How many died because they were cut of from the supply that they had been told by doctors did not cause addiction?
> A shattering drug addiction crisis that at its height killed more people annually than the entire Vietnam War.
Except that you're wrong. The war-on-drugs kept drugs under control. It did not _eliminate_ them, but they also were not available on every street corner.
Once we stopped the war-on-drugs, the abuse rates skyrocketed. Not just opiods, but also meth. You can see it on the graphs in this article, the general wind-down of drug abuse policies started around 2008-2010.
I personally consider the war on drugs to be a colossal failure and there tends to be widespread agreement that the War on Drugs was somewhat effective at enabling enforcement, but ineffective or counterproductive at eliminating drugs or reducing long-term harm.
What America continues to ignore, intentionally or not, is the root cause of drug addiction which tends to be a more complicated and nuanced
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I think we're agreeing with each other?
> The government should just regulate it, control purity and production and let people access small amounts for recreation/performance.
The phrase “small amount” is doing a lot of heavy lifting in this statement.
The government does regulate and control amphetamine and methamphetamine (Desoxyn) as prescription drugs. The former is not all that hard to access. For a while it was as easy as signing up for a service through a TikTok ad and filling out a form, after which you were guaranteed a prescription. Those mills got shut down but it’s not hard to find a doctor willing to write a prescription in your area with some Internet searching (Side note: Lot of people get surprised when they get a prescription from some random doctor and discover that all of their other doctors know about it. Controlled substance prescriptions go to shared databases and it will be on that record for a while)
> It’s not an evil drug per se - long history before it was criminalized
Dose makes the poison, the recreational users aren’t going to be satisfied with your government regulated small amounts.
These discussions always end up with two parties talking past each other because one side wants to focus only on the ideal drug user who uses small amounts and has perfect education and self control, while ignoring that the meth users wouldn’t be stopped from seeking their larger quantities than a theoretical government regulated small amount program would allow.
I should also mention that methamphetamine appears to be quite neurotoxic at recreational doses. Maybe even smaller doses too.
We should also mention that the “long history” you speak of isn’t actually that long and was associated with small epidemics of overuse and addiction, too. It’s not like addiction is a modern phenomenon.
Having to go through the medical system is why there's such a thriving black market. How do you propose changing things that this isn't the case?
No, policy wise I appreciate you getting into the nuance, but I feel like you take the argument to polar extremes (with an attitude of confident, final certainty), when the expected outcome is across the middle. This smells more like ideology than practicality.
> These discussions always end up …
Before your comment i wouldn’t say anyone is lacking curiosity here. Tho your comment about fixing into a stereotype, seems the example of itself. I think it’s better to listen and discuss than assume the futures settle into a mischaracterization that you’ve already decided. That doesn’t seem very useful - except for ideology…
On the toxicity side, do you have any studies to cite? I wasn’t aware of toxicity, but it’s plausible.
Big picture tho, I’m not an expert in drug policy. It just sounds like a logical way to reduce harm overall. Reduce harm overall - worth repeating; on average, create a better society.
The conceivable parties who would lose out are: government funded agencies charged with fighting drug crime because their caseload and budgets would probably decrease; and on the other side the cartels and dealers. Although what seems to happen with the latter is once something is legalized, the supply chains morph into legitimate businesses somehow.
I still think it would work. I’m not convinced by what you said. Thank you tho
> On the toxicity side, do you have any studies to cite? I wasn’t aware of toxicity, but it’s plausible.
A typical therapeutic dose of amphetamines is around 20mg, topping at around 60mg for serious narcolepsy. Recreational doses can go up to around 1000mg for long-term users with 360mg as the median: https://pubmed.ncbi.nlm.nih.gov/40385390/
That's the area of crazy toxic side effects just from vasoconstriction. Never mind direct effects on the brain.
Oregon decriminalized drugs in 2020 and the experiment is widely viewed as a failure by both sides of the political spectrum. The Democratic legislature rolled it back four years later.
It doesn’t necessarily follow that it’s impossible to have a legalized or decriminalized regime that works, but it is non-trivial to get right.
Its meaningless to decriminalize using it, since it does not give big benefit of replacing narco terrorists producers with pure, controlled stuff from legal pharma companies.
The world is obviously better of without drugs, but given that is not going to happen, the question to decide is: is the world better of with drugs from legal pharmacutical companies, or (somewhat) restricted access to drugs through an illegal system?
Decrimininalizing drug use is the worst of both worlds: you get more drug access, but it still happens through the illegal system and benefits narco terrorists.
If you don't want to put drug users in jail (you cannot reasonably fine homeless people), you can offer drug courts and diversionary programs.
You need the federal government to do what it did with Marijuana (which is still federally illegal), to be able to try the other choice.
> I think it’s a contaminant issue that’s exacerbated by the drug use.
I think the various pieces of evidence presented in the article basically all point against this. Is there a reason you think the evidence in the article is flawed?
I don’t take the article as authoritative. It’s argument against contamination is not strong. It doesn’t present any real evidence for it. You can elaborate if you like
> All these others syntheses with multiple steps up the chances of weird toxic solvents or contaminants creeping in. I think it’s a contaminant issue that’s exacerbated by the drug use.
The article addresses this:
> Second, the evidence we have is against the idea of contaminants in P2P meth. Almost all meth was produced using P2P since 2012, before most reports of schizophrenia. And P2P meth synthesis has changed several times in the interim, resulting in higher purity than ever before.
Not saying they're right, but the author at least believes this hypothesis is contradicted by the data.
Government does sorta regulate it. Desoxyn is (rarely) prescribed for ADHD when other meds aren't effective enough.
The difference between most amphetamines and Desoxyn is that extra methyl group. That methyl group helps it cross the blood-brain barrier a little faster but the chemical that reaches the brain is the same in both cases.
It's a pretty bad drug, I can see only disadvantages over plain amphetamine.
If amphetamine isn't strong enough, you already have a serious problem.
I'm not saying that criminalization is the right way, just that I don't see a responsible recreational/performance use for methamphetamine. It's too strong and too toxic. The regulation should permit only use for addiction management imho.
Also, the long history is not exactly in its favor, given how the Nazis extensively used it and Hitler was probably a serious meth-junkie.
> The government should just regulate it, control purity and production and let people access small amounts for recreation/performance.
The thing is, drugs are addictive. ESPECIALLY meth. How would you prevent people from just getting as much as they want and then becoming drug zombies? Fentanyl is similar. Cartels perfected its production, so now it's pure and widely available.
It's even worse than meth in some regards. Once you start using fentanyl, you're going to become a hardened addict. And there will be almost no hope of recovery, the success rate of drug rehab treatments is in single-digit percentages.
I guess the idea is that people will just keep using "safer" drugs like cocaine instead? I'm not sure it's working, we legalized cannabis and it made zero difference.
Check out the book “The Fort Bragg Cartel” if you’re wondering why drugs are illegal even if legalization makes more sense from a harm reduction standpoint. The highest levels of the military are involved in drug trafficking. Use of drugs by clandestine colonial states goes all the way back to the opium wars. US is nothing new. The deep state funds off the books operations with drug money and possibly human trafficking as well.
Extraordinary claims require extraordinary evidence. "Go read this book" ain't it.
“I don’t feel like reading a book” isn’t a counter argument. That’s just a tidbit about how your day is going
'extraordinary claims' is laughable.
https://en.wikipedia.org/wiki/CIA_involvement_in_Contra_coca...
Except that you fail to mention that amphetamine abuse is strongly associated with Parkinson's and other neurological diseases, which are serious public health burdens, and likely contribute to the phenomena of high personal tax regions like the EU.
Yeah i didn’t know that. I guess tho with regulated supply we have more chance to handle abuse and addiction.
The craziness of so many legal things being pretty bad for health is also something worth addressing (alcohol, cigarettes).