Comment by idiotsecant
5 hours ago
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.
My view of a lot of the opioid crisis stuff aside from physical pain is psychological trauma - people self medicating as an alternative to doing the work.
That’s why I think the psychoactive legislation that’s introduced recently about psychedelics is so important because those things can rapidly accelerate processing and healing psychological trauma.
My view, is if this was done 20 - 30 years ago there wouldn’t be such a large demand for opiates. I take it further and say that probably some in the drug companies understand this already and were lobbying against the introduction of more curative psychedelic treatments so that they could sell subscriptions to painkillers.
Cocaine and Heroin (and LSD...) were widely available 20-30-40-50 years ago. Maybe this is a "It's the economy, stupid" thing?
Sorry what? What does ego death have to do with healing a back injury?
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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
> I mean, states & countries that have completely state-run liquor stores still have alcoholism and serious alcohol problems though
They have less of it. Reducing access and increasing price reduces consumption, as any economist would expect.
The main problem with government monopolies of this sort is that they usually lack democratic legitimacy (i.e. would be voted away in a single issue vote) are under constant PR attack from people who profit from the regulated product. Leading to concessions such as the Norwegian monopoly being run as a for-profit corporation.
> If 'removing the profit structure' worked magically, more countries would do it.
No they wouldn't, for the obvious reason: those who profit from it have a voice, and are better organized than the ones who suffer from it (many who are addicts and want easy access anyway).
That's a bit of an apples and oranges comparison. The thing about for-profit prescriptions is that they incentivize doctors to prescribe opiates for people who don't need them, people who may not have even been interested in them. A for-profit retailer selling alcohol doesn't have that aspect at play at all; at most the for-profit aspect encourages flashy advertising and displaying alcohol more prominently, but nothing to the level of having a trusted expert in a one-on-one setting personally pushing for you to consume.
Instead the pressure to consume alcohol comes at a grassroots level. Social alcohol consumption is deeply rooted in human culture, and it's generally the people around you who will push you to consume. This pressure is independent of any profit motive, so removing the profit motive does nothing to affect it.
> AFAIK rates of alcoholism aren't even different between state-run and private sector models
Looking at some 2016 WHO statistics, the US seems to have ~3x the rate of alcholism as Iceland, but I recognise these are cherrypicked examples and I'm not interested enough to do a deep dive aggregating countries. Still, it seems plausible that government intervention can reduce alcholism rates. The fact that it's not 0% means nothing; nothing in the world is 0%, outlawing murder doesn't mean murder doesn't happen, but you can strive to reduce it as much as reasonably possible.
State run liquor stores in the US don’t prevent companies advertising alcohol on TV. The US is really bad at allowing drugs without then also allowing drug promotion.
A better comparison is probably countries where prescription drugs can’t be advertised to the general public. But, then you’re dealing with a lot of differences in other government policies.
All Scandinavian countries except Denmark have some form of state-run monopoly on the sale of harder alcohol, and of these countries, Denmark is the country where people drink the most, in particular among the youth.
It is disingenuous to claim that something doesn't work if it doesn't eliminate it completely. It is pretty well recognized that tight regulation of alcohol sales and marketing together with taxation helps reduce overall consumption. Alcohol consumption was also not eliminated during the prohibition in the US.
It's also important to recognize that making a drug legal is not the same as regulating it properly, and just making it legal can very well bring more harms than keeping it prohibited if no regulation of its sale and marketing is introduced.
Lets not forget that in the US not only opioids get legalized, but they were given to people as a substitute for aspirins. And then retired without mercy. Did you get addicted? Well, you are on your own now, go get some fentanyl under a bridge.
I live in Spain. Alcohol is not tighty regulated here, and is cheap if we compare with nordic countries. But we, overall, have a culture of knowing how to drink, low proof drinks and in low quantities. The worst drinkers here are tourists from northern countries that binge on high grade alcohol because it is cheap. I had never seen someone chugging a liter of beer like it is water, or do that thing with a can of beer where you force the whole can, or that other thing with the funnel and a tube, like you were in a hurry to get drunk. You just drink a beer whenever you want, at slow pace. Spain, overall, consumes a lot of alcohol, but the consumption is so spread among the population that you rarely see adults drunk.
Our neighbor in the south, Morocco, allows for marihuana consumption and selling, and they have way less problems with it than any european country. But they have alcohol tightly forbidden, and it is a big problem there.
I went to Finland, and there were ships going from Finland to Estonia, carrying people just to buy cheaper alcohol there. They went back to Helsinki with shopping bags full of vodka. Makes you wonder how does it look Tallin in drinking statistics. I bet something similar is going on between Sweden and Denmark or Germany, whatever trip is shorter and cheaper.
The point is that a culture of taking drugs needs time to develop.
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