Monday, April 20, 2015

A complex matter

Serving All Your Heroin Needs - NYTimes.com

This was an interesting article about the new sales mechanism for heroin in the United States, and its relationship with the apparent over-prescription of opioid painkillers in that nation.

The opening paragraph sets the scene:
FATAL heroin overdoses in America have almost tripled in three years.
More than 8,250 people a year now die from heroin. At the same time,
roughly double that number are dying from prescription opioid
painkillers, which are molecularly similar. Heroin has become the
fallback dope when an addict can’t afford, or find, pills. Total
overdose deaths, most often from pills and heroin, now surpass traffic
fatalities. 
As I have commented before, this startling fact about the number of people who die in America via prescription opioids surely should make people somewhat skeptical of one of the key arguments for drug decriminalisation at least with regard to heroin - that it is not so much the drug that kills, but the poor and variable quality of the black market version that people are forced to buy.

If people can't even safely self administer a high quality legal opioid, what do reformers suggest as an the answer to that problem if you allowed them to be legalised?   A massive expansion of the type of supervised drug taking that is inherent in the methodone program?   (In Australia, at least, the addict attends the pharmacy and has to drink their dose in front of staff.)     Yet drug legalisation proponents are often libertarians who hate the nanny statism that would be part of that.  And besides, not everyone can fit a daily visit to a clinic discretely into their work or domestic life... 

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