[HN Gopher] I am a heroin user. I do not have a drug problem
       ___________________________________________________________________
        
       I am a heroin user. I do not have a drug problem
        
       Author : CapitalistCartr
       Score  : 238 points
       Date   : 2021-02-18 12:23 UTC (10 hours ago)
        
 (HTM) web link (m.nautil.us)
 (TXT) w3m dump (m.nautil.us)
        
       | mmlkrx wrote:
       | There is a subreddit called /r/MuseumOfReddit that is "dedicated
       | to cataloguing the posts and comments that will go down in reddit
       | history."
       | 
       | One of the more chilling posts on there[1] is the account of a
       | user who randomly tried Heroin one day, got addicted within 2
       | weeks, overdosed and was clinically dead within a month, got
       | revived and admitted, came clean, then posted an update to his
       | story 7 years later.
       | 
       | I would personally suggest trying meditation first before trying
       | opioids to alter consciousness and feel euphoric.
       | 
       | [1]
       | https://www.reddit.com/r/MuseumOfReddit/comments/68srty/spon...
        
         | amvalo wrote:
         | Fake story -- that's way too fast.
        
           | mmlkrx wrote:
           | You're correct, he actually overdosed roughly a year after
           | his first use of heroin, not a month like I remembered:
           | 
           | >I overdosed on a combination of (mostly) fentanyl, plus I
           | had a lot of diphenhydramine, pregabalin, temezepam, and
           | maybe some lingering oxymorphone in my system. I stopped
           | breathing with several fentanyl patches in my mouth (they
           | were previously used and I thought they had much less left in
           | them) partially blocking my airway and would have been dead
           | dead if I was found 10 minutes later according to EMS. It
           | took multiple shots of Narcan to revive me.
           | 
           | https://www.reddit.com/r/IAmA/comments/dw6u0/iama_patient_in.
           | ..
        
         | biolurker1 wrote:
         | I'm reading Freud book "civilization and it's discontent" and
         | he says that some people can experience what others experience
         | with substances, only by yoga and meditation. I'm really
         | curious cause I have only done "simple yoga" and simple
         | meditation like just breathing exercises.
        
       | mavsman wrote:
       | He says only 1% to 8% of opioid prescriptions result in addiction
       | (and that this is often misreported as being higher). If knew it
       | was even this high I would never accept a bottle.
        
         | confidantlake wrote:
         | Absolutely. 8% is incredibly high.
        
       | wrongdonf wrote:
       | I've lost a close friend to heroin. But the vast majority or
       | Vietnam soldiers who were doing heroin overseas stopped using
       | without issue after coming home -- an inconvenient truth for the
       | chemical-centric model of addiction. In reality, it's deep
       | emotional pain or psychological distress that makes the
       | difference between a person who gets addicted to drugs and a
       | person who doesn't, basically. Like everything else that is
       | touched by dogma and epidemiology, this fact has been lost.
        
       | jariel wrote:
       | So does your health insurer know, and how much are your premiums?
        
       | Etheryte wrote:
       | Even this comment section alone demonstrates that this is a very
       | loaded topic and that's one of the main reasons purely logical
       | argumentation won't help drive the discussion far. If someone has
       | a person close to them that's had (or has) issues with drug
       | abuse, it won't be easy to have a neutral discussion on the
       | matter. What I find contrasting though, is that this doesn't seem
       | to be the case with alcohol abuse. This probably stems from a
       | number of reasons, normalization of alcohol being one of the
       | largest, but I would also argue that lack of education is
       | probably one of the highest contributing factors. Without delving
       | into the subject of whether regular heroin use is or isn't
       | healthy, as I simply don't know enough about the matter, I think
       | it's good to educate people on the topic. Educated people make
       | better choices, regardless of what they choose to do in the end.
        
       | mmmBacon wrote:
       | I had a group of college friends who started taking heroin in the
       | 90's who thought like this. It upset me and I told them so. At
       | the time they said I was "being uptight." We fell out over their
       | heroin use. About a year later, one of these former friends died
       | from an overdose. He was a generous person with a great future
       | ahead of him. He's been dead 25 years now. When I think about it
       | now, it still saddens me. He missed so much.
        
       | gojomo wrote:
       | The article, and "Carl", attribute this sentiment to Professor
       | Carl Hart.
       | 
       | But what if it's actually the heroin speaking?
        
       | Noctem wrote:
       | It's bizarre to me that he would describe heroin as a "social
       | lubricant." I've had the misfortune of attempting to socialize
       | with people who were under the influence of heavy opioids and
       | "social lubricant" is not how I would describe their vacant
       | stares or frequent nodding off.
        
       | m0llusk wrote:
       | This is interesting personal testimony. For anyone curious about
       | a more scientific view of this issue I would recommend the book
       | High Price by Dr. Carl Hart. While it is common for people to
       | believe strongly that drugs are bad and addictive, actual
       | scientific observation of drug users finds in many cases there is
       | little evidence of harm and instead of forming an enduring habit
       | they follow a progression which is more like a hobby.
       | 
       | There are plenty of comparisons that might be made, but driving
       | seems an apt comparison. Driving is extremely dangerous,
       | magnifies even small mistakes, and kills or maims very large
       | numbers of people on a regular basis. And yet even with similar
       | evidence of harm and habit formation people do not treat driving
       | with the same fear but instead face driving with irrational
       | positivity and optimism.
       | 
       | Scientists using rigorous observations and mathematical analysis
       | do not see drug use and driving as having risk profiles that are
       | completely different.
        
         | undecisive wrote:
         | I'm assuming that's the same Dr. Carl Hart from this interview?
         | 
         | Driving was my go-to analogy too (I've got a longer post where
         | I go into it) Surely there's the concept of legal drugs though
         | too? You're allowed to have wine, but not drive at 120 miles
         | per hour past school gates.
         | 
         | My feeling is that there's a difference between "safe" and
         | "worth the risk". And as far as lawmakers are concerned, for
         | most drugs there's not case where it's worth the risks.
        
           | m0llusk wrote:
           | Yes, that is the same guy. I misread his name with my early
           | morning scanning. Time for some caffeine maybe?
        
       | renewiltord wrote:
       | The fascinating thing about this stuff is that you _can_ have
       | outlier people. For instance, tobacco is supposed to be highly
       | addictive.
       | 
       | Well, I picked up smoking from a girlfriend in college and we
       | used to smoke all the time. Like ten cigs a day for a year and a
       | half. Real bad, right?
       | 
       | Well, one day, I decided "Meh. I'll just stop" and I did. Not
       | because of any reason. I just chose not to.
       | 
       | Now cigarettes are way addictive but I just chose to stop. More
       | addictive than Benzos and shit and I just stopped cold turkey
       | without any other reason.
       | 
       | Many of my friends struggled with quitting but eventually did.
       | But I did it way easy. It's unlikely that I'm some super outlier,
       | but clearly I'm some near the right edge of the bell curve in
       | ease of exiting cigarette dependence.
       | 
       | That makes me think there are other outliers. This guy must be a
       | heroin outlier. And considering the dependence inducing strength
       | of that drug, he must be a far outlier.
        
         | chasd00 wrote:
         | i remember struggling to start smoking tobacco in 8th grade to
         | impress a girl (heh i saw her get sent home for wearing a
         | Metallica Kill'Em All concert shirt, I was instantly in love).
         | 
         | I just couldn't stand it the feel of tabacco. Same goes for
         | weed, i hung around very heavy smokers all during college but
         | just hated the feeling from THC so i never really got into it.
        
         | lamontcg wrote:
         | I used to smoke a cigarette or three a year. Get drunk on NYE,
         | smoke a couple cigs. Wake up the next day with a hangover and
         | have zero impulse to ever touch a cigarette again for another
         | year.
         | 
         | I outright abused alcohol early in 2020 because shit got a bit
         | cray-cray. Then just stopped because alcohol got boring. Done
         | that a lot with alcohol.
         | 
         | Had an experience with Xanax several years ago though and I'm
         | not touching that stuff again ever unless I'm terminal (then,
         | yes, please). Still managed to identify the onset of addiction
         | and stop it before it really got going, but I'm not touching
         | that chemical again.
        
         | staunch wrote:
         | This is a bit silly. You never developed an addiction to
         | cigarettes so you were able to easily quit smoking them. Well,
         | yeah, of course.
         | 
         | The hard part is quitting something when you want to but cannot
         | make yourself i.e. addictions are what is hard to quit.
         | 
         | The majority of people are able to smoke, drink, eat, and
         | fornicate without developing an addiction. The people that
         | become addicted are the outliers.
        
           | mattowen_uk wrote:
           | The parent comment is being downvoted for some reason, even
           | though the viewpoint is exactly the same as the original
           | article.
        
           | renewiltord wrote:
           | Are the majority of people able to smoke without developing
           | an addiction? That's not been my experience growing up. I
           | only know three people total who quit cold turkey and I'm
           | one.
           | 
           | That's interesting, though.
        
         | neonological wrote:
         | In the science of addiction what people have found is that if
         | you change your environment you can literally get rid of any
         | addiction. The studies from this are from Vietnam.
         | 
         | Experts were expecting an unprecedented heroin epidemic from
         | veterans returning from the Vietnam war as drug use among
         | soldiers was rampant. Turned out these soldiers came back and
         | were no longer addicted. Scientists are guessing the causal
         | factor for the loss of addiction was a "change in environment."
         | It is literally the same thing that happened to the European
         | person who replied to your post. Your brain hard wires
         | dependencies to certain drugs but when you change your
         | environment it may trigger something in your brain to actually
         | unconsciously eliminate these dependencies. This makes
         | evolutionary sense.
         | 
         | No doubt about it, people think that the above description
         | means that the addiction is some sort of conscious decision. It
         | is not the case. Addition is real, but the tricks to get out of
         | addiction may be simpler then most people think.
         | 
         | So the question to ask is, when you quit tobacco, were you in
         | the process of moving? Were there big changes going on in your
         | life that would change the environment around you?
        
           | renewiltord wrote:
           | Nothing notable in my case. I'd broken up with the girl
           | halfway through the period of using but I was still using
           | after.
           | 
           | I know grandpa quit cold turkey after my dad (newly invested
           | as a medical doctor) came home and said "You will die of lung
           | cancer almost surely if you keep this up". And an uncle quit
           | after his 8-year-old daughter (my cousin) said "Papa please.
           | I don't want you to die" plaintively or something like that.
           | 
           | I guess some things just change the game for people.
        
         | bane wrote:
         | Addiction is an incredibly fascinating endless hole to get
         | into, including these outlier folks.
         | 
         | My wife for example has struggled to quit smoking for at least
         | 10 years. As in very hardcore struggle.
         | 
         | When I was young my father managed to quit from a 3 pack a day
         | habit to nothing cold turkey. But it was obviously pretty tough
         | on him during the process and took a couple of years to really
         | break out of.
         | 
         | My brother has a pretty bad pot addiction, a relatively
         | harmless drug with almost no known chemical mechanism for
         | addiction. Yet he can't shake it and it's haunted him his
         | entire life.
         | 
         | I'm a bit like you w/r to tobacco. I occasionally smoke cigars
         | and have played around with cigarettes from time to time. Once
         | I lose interest I just stop and it's over. No urge or desire or
         | anything else.
         | 
         | On the other hand, I have a bad day at work and all I want to
         | do is shove shit food in my mouth.
        
           | spaetzleesser wrote:
           | I have repeatedly tried to stop eating pastries and candy but
           | can't do it. I can't imagine how much willpower it takes to
           | get off truly addictive drugs.
        
             | mywittyname wrote:
             | Sweets can be very addictive.
             | 
             | You addiction might seem trivial in comparison, but you
             | could be experiencing something quite similar to someone
             | who is addicted to a "hard" substance.
        
         | ecmascript wrote:
         | Same here, stopping to smoke was really easy but my candy
         | addiction is real hard. It's like day and night for me. I
         | struggle and have been struggling in not eating candy for years
         | (or at least a lot less) but I have failed each time.
         | 
         | I think different substances are differently addictive to
         | people.
        
           | renewiltord wrote:
           | Likewise, I found it impossible to quit sugar. Fruits
           | especially still ruin me. I'll eat any amount of fruit you
           | place before me.
        
             | groby_b wrote:
             | With any kind of addiction, it's worth exploring what the
             | triggers are. There might well be some underlying emotional
             | thing that makes you eat fruit.
             | 
             | For me: I eat cookies because my Mom baked a lot, and I
             | lost her early. This is a way to feel close to her. Knowing
             | that makes it easier to not eat all the cookies. That
             | doesn't mean all addictions are rooted in early childhood
             | or psychological symptoms, or that your life gets fixed if
             | you just talk about your parents a lot ;) But especially
             | with addictions that only create mild physical addiction
             | symptoms, it's worth looking at.
        
           | king_panic wrote:
           | Sugar is one of the hardest addictions to kick. I've kicked
           | cocaine and alcohol too.. sugar was by far the hardest
           | physically. It's also hard to stay sober because it's so
           | accessible in foods and accepted by society.
        
             | ecmascript wrote:
             | Yeah it's like if people would put nicotine in every
             | product, it would most likely make smoking harder to quit
             | as well.
        
         | nickthemagicman wrote:
         | My dad quit smoking cold turkey one day and never thought about
         | it again, my mom smoked until she died of lung cancer, she
         | would take the oxygyn mask off to take a puff.
         | 
         | It's bizzarre the genetic/environmental differences in
         | addiction.
        
         | bserge wrote:
         | Indeed, it's very dependent on the individual. Nicotine has me
         | by the balls, very firmly. Alcohol even more so, it's something
         | that I'm trying to quit for over a decade to no success.
         | 
         | Cannabis? Smoked for months every day, decided it wasn't for me
         | and that was it. Same for many other chemicals, including
         | cocaine. I just... stopped.
         | 
         | I feel like I could stop nicotine intake within a few weeks.
         | Could be wrong about it. But not alcohol, that's the number 1
         | enemy. Every time I think about it, there's an insane urge to
         | drink some, it's insane.
         | 
         | I mean, I literally have access to something with effects
         | between alcohol and cannabis, yet I go with alcohol.
         | Ridiculous.
        
           | confidantlake wrote:
           | That is interesting because alcohol was extremely easy for me
           | to quit. I decided at the start of last year to not drink for
           | a year and that was that. Haven't hadn't a drink since last
           | January. But 2 weeks without my morning decaf coffee, oh boy
           | was that hard.
        
         | AntiImperialist wrote:
         | Nicotine helps calm down anxiety. People with anxiety disorders
         | get addicted to it because when they do it, the anxiety
         | subsides. The anxiety starts setting in once the effect wears
         | out. One doesn't get addicted to it right away because it takes
         | time for the body to model what is this thing that is helping
         | it and how it is getting access to it it. Once the body finds
         | out, it seeks cigarettes; usually the body "overfits" and
         | thinks it needs a particular brand of cigarette... and reliance
         | on a particular brand is a problem, one can switch to another
         | one by alternating with the brand you want to switch to... you
         | can use the same strategy to switch to vaping or other nicotine
         | delivery mechanisms.
         | 
         | For people with no existing anxiety disorders, like you, there
         | is no significant effect so the body doesn't bother seeking it.
         | 
         | Same is true for any other drug addictions. They work by
         | suppressing trauma or sadness or depression... and when the
         | effect wears out, people need it again because the extreme
         | emotions that were being suppressed come back with a bang.
        
         | [deleted]
        
         | foobiekr wrote:
         | I honestly don't think it's actually an outlier issue.
         | 
         | In highschool almost everyone I know got into smoking pot, at
         | least for awhile, and within a year or two 90+% of them just
         | lost interest in it, maybe 5% kept using and maybe a quarter of
         | them literally made pot the center of their lives and are still
         | daily users with big impact on their lives and careers (or,
         | honestly, lack thereof for all but one). The same thing
         | happened with alcohol.
         | 
         | As an adult, I've seen the same pattern repeat for people who
         | just didn't try things, for whatever reason, or perhaps people
         | who changed.
         | 
         | What's actually happening, IMHO, is that you have a ton of
         | overlapping processes that are filtering for with people who
         | are vulnerable to becoming addicted to a given drug. Obviously
         | those people will have trouble quitting.
        
         | [deleted]
        
         | umvi wrote:
         | There most certainly are outliers, and you are likely one of
         | them for nicotine at least. What you want to avoid though is
         | using your outlier status to influence people into thinking
         | "hey, maybe I'm an outlier too, maybe I can use highly
         | addictive substances and still stay in control too" because
         | statistically that's going to end in a public health disaster.
        
           | hellohello1 wrote:
           | Pretty much. My mom's soon-to-be-former partner had been an
           | alcoholic previous to their relationship and was clean when
           | they met. She got him some whisky for Christmas and figured
           | it would be fine if he drank a little, because its never been
           | a problem for her. Big mistake.
           | 
           | People are very very different in their drug tolerances and
           | really shouldn't give advice to other people, because they
           | are not the same.
        
         | goat_whisperer wrote:
         | Yeah, I mean some people smoke all of their lives and live to
         | be 90 and die of natural causes. Doesn't mean that smoking
         | isn't incredibly dangerous and bad for you.
         | 
         | edit: this is agreement with the original comment, not sure why
         | I'm being down voted. Just highlighting how outliers can exist,
         | but it doesn't reflect on the danger of the underlying activity
         | in general
        
         | datavirtue wrote:
         | I practically tried to get addicted to cigarettes about 20+
         | years ago. Smoked quite a bit but could never quite cozy up to
         | an addiction. The taste and smell was really bothering me so I
         | just quit. Most of the people I know who smoked, never quit,
         | and did various hard drug cocktails are all dead from heroine
         | overdoses. I experimented with nearly every drug (no heroine,
         | by they time that was available it was not something I would
         | consider trying) but never formed an opiate or cocaine habit.
        
         | king_panic wrote:
         | The argument the author is making is that addiction is an
         | outlier. Many many many people drink, snort cocaine, smoke
         | cigarettes and in the author's case, use heroin, and never
         | develop addiction.
         | 
         | I can understand why this infuriates people who've seen or
         | known people who've died from an addiction but it's important
         | for people to understand that alcohol, drugs, gambling,
         | facebook, the internet, shopping, and everything that can turn
         | into an addiction are not the problem. The problem is deep
         | emotional pain from traumatic experiences.
        
           | ta8645 wrote:
           | You had me until your last sentence. There are people who are
           | born with huge lung capacity, they are able to swim faster
           | and longer than anyone else. We would never believe that it's
           | emotional pain that is keeping everyone else from swimming as
           | well. And people are born colorblind, they don't lose that
           | ability because of emotional pain. Physics and our individual
           | body chemistry at birth plays a deep role in our unique life
           | experiences. There's every reason to suspect the same
           | mechanism affects addiction proclivity.
        
             | renlo wrote:
             | I think OP is saying that trauma leads to addiction, not
             | necessarily the act itself; ie, shopping addicts are
             | addicted to shopping because of past trauma not necessarily
             | because of the act of shopping itself. As a prior nicotine
             | addict I don't necessarily agree with this, as I have felt
             | firsthand what the addictiveness nicotine feels like and I
             | don't believe it's psychological (and, it seems like heroin
             | may be similar)
        
               | datavirtue wrote:
               | If you have lower dopamine levels watching TV can be
               | enough to get addicted. Any opiate is going to grab you.
               | Some people cannot stop watching TV as it bumps up the
               | pleasure enough for them to feel normal or not
               | depressive. Some people get from seeing comments/likes on
               | their FB posts.
        
             | king_panic wrote:
             | Look up Gabor Mate
        
             | pcthrowaway wrote:
             | Take a look at https://en.wikipedia.org/wiki/Rat_Park .
             | It's not conclusively relevant to humans, but it does at
             | the very least cast doubt on the models historically used
             | to understand addiction.
        
             | Cederfjard wrote:
             | I think it makes sense that people who, due to trauma or
             | other lived experiences ( _in addition_ to those who are
             | genetically predisposed), have a brain chemistry that
             | leaves them not feeling as well as they could, would be
             | more vulnerable to getting addicted to substances that make
             | them feel better (or "normal", even).
        
         | jimz wrote:
         | I don't know why you'd assume you're the outlier. Never mind
         | the differences between physical and psychological dependence
         | and problem use (which can happen without dependence, and one
         | can be dependent but not using problematically), you personally
         | experienced underwhelming withdrawal effects on multiple drugs
         | that don't all affect the same parts of your brain, and some
         | more physically addictive than others (benzos on top of that
         | list). As for your friends, you know about their struggles
         | because they had struggles in the first place. Just as the news
         | doesn't report things when nothing bad happens, it's unlikely
         | that, with the potential of stigmatization and jailtime, most
         | people would volunteer something that caused them no issues but
         | can only cause issues if they let it be known. If I were in
         | your shoes I'd not assume that you and this guy happens to be
         | the outliers, but rather, selection bias, the well-documented
         | history of our drug laws being based on racial panics (Chinese
         | for opiates, cocaine for African-Americans, marijuana for
         | Mexicans, the crack sentencing disparity, et cetera) that
         | happens to fund a lot of the economy via the prison-industrial
         | complex, it's not much of a leap to think that a great deal of
         | the harm linked to drug use is linked really to the various
         | behavior undertaken to hide from detection and not necessarily
         | from the drugs themselves, most of which - diamorphine included
         | - are classified as having some medical use somewhere, although
         | for whatever reason MDMA and marijuana are classified as having
         | none. I think it's not hard to buy into the idea that
         | problematic use is not the outlier because that's been taught
         | to us for decades. But if your personal experience doesn't
         | indicate that, why jump directly to thinking that you're the
         | odd man out?
        
           | renewiltord wrote:
           | A fair question. I haven't thought about it deeply. But
           | smoking is a very social habit. No one hides the smoking. And
           | it's really hard to hide because smokers have a sharp odour
           | that's really hard to mask. So among the people I know, I
           | know the smokers (or knew, since vaping wasn't common when I
           | was young and had the habit).
           | 
           | So I guess I had a pretty good hold on what the population of
           | smokers was, and so I know most struggled to quit.
           | 
           | As for the other drugs, yeah, I'm open to thinking otherwise.
           | I have lots of friends who recreationally use cocaine, MDMA,
           | LSD, mushrooms, and whatever else. Personally I've tried all
           | of those and really just use shrooms now occasionally1. No
           | particular addictions there among my group of friends, so I'm
           | open to your school of thought there.
           | 
           | 1 Cocaine is boring. MDMA is great. LSD is cool. Shrooms has
           | massive therapeutic effects for me. I can skip my Adderall
           | for two weeks after a trip. I feel so motivated to work and
           | find it trivial to focus.
        
             | nostromo wrote:
             | I think it's selection bias.
             | 
             | Lots and lots of living people have smoked at some point.
             | However, many (most?) of those people quit smoking at some
             | point.
             | 
             | So, the remaining people are the people that are most
             | addicted, which gives us the impression that tobacco is
             | highly addictive for everyone.
             | 
             | Edit: the CDC says that 62% of people who have ever smoked
             | have quit.
             | 
             | https://www.cdc.gov/tobacco/data_statistics/fact_sheets/ces
             | s...
        
               | renewiltord wrote:
               | The part that breaks that is that in the population I'm
               | talking about, I have known the people continuously from
               | age 15 to age 34. Twenty years continuously, over 20
               | people. No one ever tried to hide the habit (hiding your
               | smoking is a thing no one did 20 years ago). So I can
               | observe this population fixedly and not suffer from
               | survival bias.
               | 
               | It _could_ be selection bias. Maybe I hang out with other
               | people with addiction potential because of who I am. But
               | it 's definitely not survival bias (which is sort of what
               | the rest of your comment talks about). The thing that
               | makes it unlikely and the article's premise unlikely is
               | that the weight of evidence is on this stuff being
               | addictive.
               | 
               | But, you know, I'm a huge fan of the therapeutic effects
               | of many scheduled drugs, so I'm open to the idea that
               | addiction works differently from currently understood.
        
               | pseudalopex wrote:
               | That doesn't mean quitting was easy for them.
        
           | cafard wrote:
           | Considering only tobacco, I'd assume he is an outlier. I'd
           | assume so because of the many quite intelligent people who
           | started smoking before the Surgeon General's warning, tried
           | to quit after it, maybe eventually quit after a dozen years
           | of work, maybe never did.
           | 
           | Back during one of the big buyouts of ca. 1980, an executive
           | of KKR explained why it was buying some cigarette company:
           | You make it for a dime, you sell it for a dollar, and people
           | are addicted to it.
        
         | Kaze404 wrote:
         | > Well, one day, I decided "Meh. I'll just stop" and I did. Not
         | because of any reason. I just chose not to.
         | 
         | My girlfriend smoked for almost a decade and did the same thing
         | as you, including drinking. She's been 2 years clean.
        
         | blamestross wrote:
         | Nicotine is well established as a nootropic and use of it
         | correlates with reduced incidence of dementia (even when
         | corrected for mortality biases). I am at a really high risk for
         | dementia and I keep trying to vape in hopes of that (possible)
         | benefit but I keep forgetting to do it. Note that the logic for
         | your health choices get weird when accounting for high odds of
         | being a zombie after the age of 65. Plenty of room to dump
         | externalities onto "zombie-you"
        
         | zappo2938 wrote:
         | This video about our primate cousins, the alcoholic vervet
         | monkeys in St. Kitts, might give some insight into addiction.
         | [0]
         | 
         | [0] https://www.youtube.com/watch?v=pSm7BcQHWXk
        
           | renewiltord wrote:
           | Very cool. Thanks.
        
         | tshaddox wrote:
         | I did the same thing. In fact, everyone I know who successfully
         | quit smoking for a long time quit the same way. I'm not really
         | sure that proves that cigarettes were any less addictive for
         | you, unless you're saying you never had any significant craving
         | or desire to resume.
        
           | renewiltord wrote:
           | Interesting. None of my friends smoke any more, with the last
           | having quit two years ago after a long struggle and then
           | reading Alan Carr's book and working with patches and gum.
           | Cold turkey quitting hasn't been the norm. Most have tapered
           | off.
           | 
           | And no, I don't really even 'want' a cigarette. I know what
           | addiction is, in that I feel this strong pull towards sweet
           | stuff. I _must_ have any kind of dessert, and if I see a
           | novel food, I _must_ eat it. I just must. It 's like a fugue
           | state. Try as I might I fall. Also with online validation for
           | comments I write or stories I tell. The dopamine hit from an
           | upvote has a debilitating hold on me.
           | 
           | But with no drugs have I felt this desire. Not even shrooms
           | which I enjoy or MDMA which has been my all time favourite. I
           | have some shrooms and some LSD in my fridge so I can partake
           | any time. I just don't.
           | 
           | I'm amenable to the Rat Park hypothesis too. Maybe it's all
           | Rat Park stuff.
        
       | yters wrote:
       | There is a possibility that drugs being illegal has resulted in
       | many less addicted and dead drug users. Supposedly, prohibition
       | back in the day was quite successful keeping people from becoming
       | alcoholics.
        
       | throwaway0a5e wrote:
       | This guy's whole viewpoint seems to be pinned on "it's not
       | addiction if it's not negatively affecting the rest of your life"
       | (yes, I know this is a major criteria for a lot of medical
       | diagnosis, addiction included).
       | 
       | The problem is that what it takes "negatively affect the rest of
       | your life" depends a lot on what role you have in society.
       | 
       | Short of pornography producer, fantasy fiction author, songwriter
       | and other professions where copious drug use fit one's "brand
       | image" or potentially enhance one's work, a tenured college
       | professor gets about about as much leeway from the rest of
       | society as a white collar professional can get. He can be
       | "eccentric" and nobody blinks twice. But for other professions
       | the standards of behavior are different (and generally get more
       | permissive as you go down the economic ladder).
       | 
       | Defining the difference between acceptable use and addiction, and
       | by proxy who's problems are bad enough to be considered problems
       | and therefore in need of solving in a way that is relative to
       | one's place in society is very dangerous. If you're blind in one
       | eye you're still blind in one eye even if it doesn't negatively
       | affect you. Addiction (and a multitude of other conditions) are
       | the same.
        
         | JumpCrisscross wrote:
         | > _a tenured college professor gets about about as much leeway
         | from the rest of society as a white collar professional can
         | get_
         | 
         | Doesn't this bolster the argument that the principal damage
         | from this type of drug use is social, not chemical?
        
           | throwaway0a5e wrote:
           | >Doesn't this bolster the argument that the principal damage
           | from this type of drug use is social, not chemical?
           | 
           | Most people would rather not be debilitated than have society
           | be accommodating.
        
           | altcognito wrote:
           | A better way to say that is that if the tenured professor
           | accidentally takes 5mg more, or has an off day, he doesn't
           | kill somebody while driving a truck, or someone who programs
           | a circuit wrong and causes a dump of chemical into a water
           | supply.
        
         | wuxb wrote:
         | The time axis is incomplete. It's just 5 years "without
         | problem".
        
         | vmchale wrote:
         | > This guy's whole viewpoint seems to be pinned on "it's not
         | addiction if it's not negatively affecting the rest of your
         | life" (yes, I know this is a major criteria for a lot of
         | medical diagnosis, addiction included).
         | 
         | That's what distinguishes dependency from addiction.
         | 
         | I think he's glossing over the fact that some drugs can be
         | addictive, which is a thing on its own, aside from promoting
         | happiness.
        
         | pessimizer wrote:
         | This is not about refusing people treatment who want it, this
         | is about not forcing treatment on people who don't.
        
       | mcguire wrote:
       | " _Hart reports that more than 70 percent of drug users--whether
       | they use alcohol, cocaine, prescription medications, or heroin--
       | do not meet the health criteria for drug addiction._ "
       | 
       | One would hope that would be well over 99%, given how many use
       | asperin/acetaminophen/etc, caffeine, alcohol, nicotine, and so
       | forth.
        
       | marcosscriven wrote:
       | He states he's been a regular user for five years AMD is not
       | addicted. I'll believe him when he writes an article saying he
       | just happened to not have it for at least several months just
       | because he decided to.
        
       | lqet wrote:
       | > One of the major reasons people can't overcome it is because
       | we're not very good at treating addiction in this country.
       | 
       | I am often wondering about how addiction "feels". I don't
       | consider myself being addicted to anything, and always wonder how
       | an addiction actually manifests itself. Is it a pain? Is it
       | comparable to being extremely hungry or thirsty?
       | 
       | Slightly related: a few years ago, I overheard a conversation
       | between a fairly large woman and a child. The child said that it
       | was hungry. The woman said: "Oh yes, that hurts". That struck me
       | as odd, because even after eating nothing for 1-2 days, I never
       | actually felt pain when I was hungry. It was surprising to me
       | that some people seem to do, and it would have certainly
       | explained why the woman was so heavy: I, too, would of course eat
       | much more if being hungry was painful.
        
         | Geee wrote:
         | I'd say that cigarette addiction doesn't really feel like
         | anything. Mostly it's just like a feeling that you forgot
         | something. Or a feeling that you didn't complete your to-do
         | list. Then you get satisfaction when you're able to complete
         | it.
        
           | darkerside wrote:
           | Former smoker. You also get increasingly annoyed at anyone
           | and everyone until you get to check off that box. Nothing
           | feels complete, none of life's little victories or big
           | disasters, until you've had a smoke to commemorate it.
           | 
           | To me, it always felt like there was something like a little
           | pebble be stuck in my brain and there was only one way to get
           | it out. Not physically, but in terms of how it affected me
           | mentally.
        
         | entropie wrote:
         | > I am often wondering about how addiction "feels"
         | 
         | It highly depends on the "thing" (it must not really be a
         | thing). I would say "its the desire to plug a hole".
         | 
         | Do you drink tea? Why dont you drink tea without sugar? There
         | are lots of answers to this question. It can be "it tastes
         | better". Thats what your mind is telling you. It probably would
         | be more healthier to drink tea without sugar but you still add
         | sugar to it.
         | 
         | Thats addiction. And there are tons of other examples and its
         | hard to determine it for every case. Addictions are deeply
         | implemented in our brains. Eating, the urge to be close to
         | people, getting complemented for things you do, all this is
         | kind of an addictional behaivour.
         | 
         | Drugs can basically fill this already existing but empty
         | receptors more efficient. Then your brain tells you to do it
         | again. It will find reasons.
         | 
         | That was harder to explain than i thought. I hope it makes
         | sense.
        
           | lqet wrote:
           | But certainly it is much harder for an alcoholic to stop
           | drinking, than for me to stop putting sugar in coffee or tea?
           | I actually did that 15 years ago because I was too lazy to
           | buy sugar. It tasted strange for 4-5 cups, then I was
           | accustomed.
        
             | entropie wrote:
             | Alcohol is very addictive. Its one of the few drugs that
             | can actually kill you on cold turkey. Your body will sign
             | that it wants it and it feels very bad.
             | 
             | I generally tried to explain what addiction is and what it
             | feels like. It really depends on the matter.
        
         | hnick wrote:
         | A guy I knew in college told me not smoking for him was like
         | not eating. Not physically in the stomach, but those same urges
         | and feelings that you'd better do something about it soon
         | because it's important. It becomes the main thing you're
         | thinking about until it's resolved and anything or anyone that
         | gets in the way annoys you.
         | 
         | Hunger never hurt me, but I used to give into it quickly
         | because it distracted me a lot and I enjoyed cooking and
         | eating. The first time I dieted intensively it took about 5
         | days but I mostly stopped feeling it. It was more of a notice
         | "probably a good time to eat" than a strong urge anymore. It
         | was easy to reframe in my mind as a positive - this is the
         | feeling of fat evaporating! Getting to that point can be tough
         | though.
        
         | [deleted]
        
         | kenniskrag wrote:
         | do you drink coffee or soft drinks? Try not to drink them for 2
         | weeks.
        
           | ChrisRR wrote:
           | Speaking as someone who cut out caffeine cold turkey, it's a
           | different thing
           | 
           | I got stinking headaches for a week, but not an overwhelming
           | urge to drink caffeine
           | 
           | When smokers quit, they almost always describe the urge to
           | smoke rather than the physical side effects, often described
           | more like hunger.
        
           | monadic3 wrote:
           | There's got to be more to this because even though I consume
           | prolific amounts of caffeine I do not experience any pain on
           | cessation. Yet, many of my coworkers do feel this pain.
        
           | arsome wrote:
           | I've done this several times, I have a headache for 24-48
           | hours then pretty much back to normal. Tolerance takes longer
           | to reset obviously and I'm sure I get more energetic in
           | subtle ways I'm unaware of in there... but I don't think it's
           | remotely comparable to a serious addiction, from what I've
           | read tobacco is probably the most widely accepted thing able
           | to cause that level of addiction.
        
             | darkerside wrote:
             | The worst is over after a couple of days off cigarettes
             | too, but there's a thick trail for a couple of weeks and a
             | long thin tail for a couple of years.
        
             | varjag wrote:
             | You don't get cramps from nicotine withdrawal, it's more a
             | nagging discomfort and unease.
        
         | ishmaeel wrote:
         | I was a smoker for several decades. I would describe being away
         | from a cigarette as "an acute feeling of thirst, but in your
         | chest."
         | 
         | And when you decide to quit, it takes quite a while before you
         | stop feeling that strange thirst.
        
           | nemo44x wrote:
           | Good way of putting it. It's in the chest for sure. I've
           | always thought of it as something missing in your chest - a
           | type of emptiness. "Thirst" is a good metaphor.
        
           | tmp-20210218 wrote:
           | for heroin it's ... hard to describe? one thing about heroin
           | though is it is motivating as hell, at least in terms of
           | motivation to _obtain heroin_ and you're going to do stuff
           | that ranges from ill advised to ... very ill advised? anyway,
           | thing i discovered is that if you stop taking the stuff, it
           | takes a long time to find a replacement motivation. e.g.
           | found myself waking up, discovering i didn't have an
           | immediate need for heroin, and then, well that's it. nothing
           | important to do here. it was ... annoying? fucking terrible?
           | still is, so there's that.
        
         | aminozuur wrote:
         | Addiction is rooted in truama. It's almost impossible to become
         | an addicted if you didn't have to endure (childhood) trauma. So
         | addiction is often an attempt of escaping, or soothing that
         | pain.
        
           | coldtea wrote:
           | > _Addiction is rooted in truama. It 's almost impossible to
           | become an addicted if you didn't have to endure (childhood)
           | trauma._
           | 
           | Sounds like pop psychology. There are tons of extremely
           | addictive substances.
           | 
           | Try one and you will get addicted after a while, even if your
           | whole childhood was hugs and roses and ponies.
        
             | arsome wrote:
             | I'm not sure, I agree it sounds like pop psych crap and
             | you'll develop physical dependence of course, but I suspect
             | there's a big difference between people who can pick up
             | smoking weed on a weekly or monthly basis recreationally
             | and people who find a need to be high every waking minute
             | of their day. People who take to drinking a bottle of vodka
             | for breakfast and those who keep it to the odd occasion. I
             | don't see why we wouldn't see similar for other, even more
             | physically addictive drugs.
        
               | coldtea wrote:
               | > _but I suspect there 's a big difference between people
               | who can pick up smoking weed on a weekly or monthly basis
               | recreationally and people who find a need to be high
               | every waking minute of their day._
               | 
               | Maybe, but why would it be due to childhood trauma alone?
               | 
               | I can imagine someone with a happy childhood and a big
               | 20-something or 30-something trauma (loss, divorce,
               | various other issues) falling for drugs/alcohol addiction
               | for the first time just the same.
        
             | aminozuur wrote:
             | Veterans who are given an opioid for pain, rarely got
             | addicted if they had a warm and loving childhood, and lived
             | a life with community and friends.
             | 
             | Veterans who had many Adverse Childhood Experiences (A high
             | ACE score), such as coming from a broken home, or faced
             | neglect and isolation growing up, were much more likely to
             | become addicted to the opioids they were given to treat
             | pain.
        
               | ChrisRR wrote:
               | Got a source for that?
        
               | coldtea wrote:
               | > _Veterans who had many Adverse Childhood Experiences (A
               | high ACE score), such as coming from a broken home, or
               | faced neglect and isolation growing up, were much more
               | likely to become addicted to the opioids they were given
               | to treat pain._
               | 
               | Veterans at that stage are also usually young, so if they
               | came from a broken home, or had isolation growing up,
               | they'd still return to something like that.
               | 
               | What about veterans that have build a succesful family
               | and working life in between (aside from having had
               | childhood trauma)?
        
               | darkerside wrote:
               | I'd say it's much more likely related to their existing
               | support network (which is correlated to childhood
               | situation). See the Rat Park study.
               | 
               | Do you have any evidence as basis for your theory?
        
         | gundisclosed wrote:
         | When source of addiction is not fulfilled for a long time it
         | can have different effects on different individuals. It is not
         | a generalised "feeling".
         | 
         | Some people might feel a drive to do something completely non-
         | rational, some might go into depression, some might even feel
         | hungry.
        
           | [deleted]
        
         | rmac wrote:
         | there could be some underlying pain or trauma or anxiety, and
         | when you find a chemical that obfuscates it, your brain goes
         | "oh I like this new feeling", and you start using that chemical
         | as a way to mute the negative, often without realizing it OR
         | realizing those underlying issues even exist.
         | 
         | then, the press secretary in your brain (the thing between your
         | subconscious & conscious mind) goes into hyper-rationalization
         | (denial) mode and you start to defend the amount and type of
         | chemicals you use, even when they are literally killing you and
         | those around you
         | 
         | If you're asking about what physical or psychological
         | withdrawal from a drug feels like, it depends on the person,
         | the chemical, and other variables. The worst opiates (Suboxone
         | / Methadone) have 6 month+ withdrawal symptoms, and the faster
         | ones are ~7 days. Hellish times. However, while abstinence
         | frees you from withdrawal symptoms, unless the underlying
         | mental issues are addressed it's likely you'll go back to the
         | very same substance that got you here.
        
         | aktiur wrote:
         | Ever read a good book, or played a video game, and known that
         | you have to stop now but thought "I'll just read another
         | chapter / play one more turn"?
         | 
         | I would say that's basically how addiction manifests itself:
         | even if you know that you're dealing with substance abuse, come
         | on, one more time won't matter, will it?
         | 
         | And then there's also the comfort aspect: you're getting back
         | from a hard day's work, you're feeling tired and cranky, you do
         | deserve something nice, don't you?
         | 
         | N.B.: I'm not saying that not being able to drop the book or
         | stop playing that game IS addiction, just that substance
         | addiction might feel the same way.
         | 
         | N.B. 2:And I'm not talking here about the medical aspects of
         | withdrawal, because that's not the thing an addict would
         | usually experience (withdrawal would only happen because you're
         | trying to stop or cannot get access to the substance you need).
        
         | Xenoamorphous wrote:
         | Like trying not to scratch an itch.
        
         | curtisblaine wrote:
         | Addiction to smoking is like a mixture of itch and thirst, to a
         | certain extent. You can get other psychological symptoms, like
         | irritability and anxiety, or physical ones, like headache, but
         | mainly it's this continuous need of absorbing the substance,
         | that never goes away. A bit like when you're itching and you
         | can't scratch, or you're thirsty and you can't drink.
        
         | throwaway0asdfg wrote:
         | > Is it comparable to being extremely hungry or thirsty
         | 
         | Not for me. I used to be a smoker and alcoholic.
         | 
         | For smoking, I just felt uneasy without it, like idk when
         | you're anxiously waiting for something important.
         | 
         | That's the physical dependence and was only the first two weeks
         | and relatively easy to overcome. I got dizzy and other
         | withdrawal symptoms but you can fight through that for a couple
         | of weeks. The other part is the ritual to it. E.g. like most
         | people probably brush their teeth once a day, smoking after
         | eating is just something you do, give in once and you're back
         | to physical dependence.
         | 
         | Alcohol was different for me. Self medication. Once i solved
         | the issues i was medicating (insomnia and stress) i... just
         | stopped drinking and never missed it. The biggest adjustment
         | here was getting used to not being drunk and figuring out what
         | to do with all the time i had now.
        
         | konfusinomicon wrote:
         | It depends on the addiction. Opiate addiction comes along with
         | flu like symptoms, insomnia, restless legs/arms AKA crazy legs,
         | and an ever present anxiety that you really really want some
         | that will make you do some weird shit just to get it. Other
         | addictions are more subtle, some worse, but all of them I've
         | experienced have the same feeling of stress/anxiety that can
         | only be cured by the vice they are caused by. Many are all in
         | your head, or, can be overcome by willpower, but definitely not
         | opiates
        
           | vmchale wrote:
           | > Opiate addiction comes along with flu like symptoms,
           | insomnia, restless legs/arms AKA crazy legs, and an ever
           | present anxiety that you really really want some that will
           | make you do some weird shit just to get it. ... Many are all
           | in your head, or, can be overcome by willpower, but
           | definitely not opiates
           | 
           | Sure, but one can be dependent on e.g. SSRIs or SNRIs. But
           | they aren't addictive!
           | 
           | Dependence + addiction is a special problem with opiates, I
           | think you can die from withdrawals?
        
             | swirepe wrote:
             | The two big dangerous things to withdraw from are alcohol
             | and benzodiazepines. Opiates withdrawal won't kill you (but
             | you'll want it to)
        
             | DanBC wrote:
             | You can't die from opioid withdrawal. It's unpleasant and
             | many people need help. But it's not like alcohol dependence
             | which can kill people if they stop suddenly.
             | 
             | SSRI/SNRIs can be problematic. The difference is that SSRIs
             | tend not to have the other features of dependence:
             | 
             | Seeking the meds when you run low; preoccupation with the
             | meds; continuing to take the meds even though you know
             | they're doing harm.
        
         | swirepe wrote:
         | Addiction controls what you _want_ , regardless of whether you
         | like the thing you are addicted to. That's what makes it hard
         | to beat by just white-knuckling it; whatever strength or will
         | you have gets redirected against you.
         | 
         | You might enjoy some of the accounts in The Realm of Hungry
         | Ghosts:
         | https://www.google.com/books/edition/In_the_Realm_of_Hungry_...
        
         | xtracto wrote:
         | It happens to me with CocaCola. I have stopped drinking it, but
         | when I waz i the process, the cravings it gave me were crazy. I
         | NEEDED to have a coke.
         | 
         | Btw, in relation to the article, there was a Reddit user who ar
         | some point wanted to "just try" this heroin thing and his
         | message history depicts very amazingly hiw he spiraled to
         | addiction.
        
           | the_af wrote:
           | I'm currently a Coca Cola addict. It's not unbearable, but I
           | really have strong cravings regularly. It's not thirst -- I
           | don't want water, I specifically want Coca Cola.
           | 
           | This beverage has no redeeming qualities, and I want to kick
           | off this habit.
        
         | recny wrote:
         | It depends on the drug.
         | 
         | For opiates and benzos it might manifest as stress and
         | depression. For uppers, drowsiness and inability to focus.
         | 
         | It's compounded by the fact that the reason you started is
         | usually that you suffered from those things to start with.
        
       | viraptor wrote:
       | I found this quote pretty strange:
       | 
       | > Despite the current false narrative, the addiction rate among
       | people prescribed opioids for pain in the United States, for
       | example, ranges from less than 1 percent to 8 percent.
       | 
       | What's the threshold where it's a problem? 1% of prescription
       | drug users getting addicted sounds like a terrible situation to
       | me. Let alone 8%. Especially if they're already in a situation
       | where finding a way to escape is tempting.
        
         | ChrisRR wrote:
         | That's exactly why prescriptions exist, so that doctors can
         | limit the time taking the opioids and reduce the risk of
         | addiction
         | 
         | If anyone were left to their own devices and still in pain, I
         | suspect a lot more than 8% would continue to take the
         | painkillers.
        
         | pessimizer wrote:
         | If heroin were cheap and accessible to addicts, there would be
         | no need to escape until the user were ready. It's so bizarre
         | how laws against heroin get to be the Gallant against the
         | Goofus of anti-pot laws when virtually all societal problems
         | springing from heroin spring from the drug war.
         | 
         | There would be few to no deaths, suffering, or crime associated
         | with heroin if it were cheap and accessible, and if addicts
         | were under the care of a doctor or social worker. It would be a
         | mild burden to public health services tasked with helping
         | people quit, but far cheaper than tobacco smoking or
         | alcoholism.
        
           | xzel wrote:
           | Heroin is already relatively cheap and accessible to addicts.
           | The bigger issue right now is the latter part, helping people
           | get off the drug and contamination, ex. fentanyl. I agree
           | with everything else though.
        
       | criley2 wrote:
       | :|
       | 
       | > Hart presents himself as a model drug user. "I am now entering
       | my fifth year as a regular heroin user," he writes. "I do not
       | have a drug-use problem. Never have. Each day, I meet my
       | parental, personal, and professional responsibilities. I pay my
       | taxes, serve as a volunteer in my community on a regular basis,
       | and contribute to the global community as an informed and engaged
       | citizen. I am better for my drug use."
       | 
       | Anyone who has plumbed the depths of addiction either with a
       | family member or personally has spoken this exact paragraph,
       | potentially word for word. It's a rationalization for addiction,
       | and honestly the most common and basic one.
       | 
       | Good luck to him as he descends through addiction. He's extremely
       | educated and very assured of his self-perception so for him to
       | hit Step 1: Realize you have a Problem, is going to be a lot
       | harder than the average person.
        
         | FDSGSG wrote:
         | If he can afford it, a problem may not exist. Heroin use has
         | few if any negative physical effects in the long term.
        
           | JohnJamesRambo wrote:
           | Death is pretty long term. Pardon me if I'm pessimistic on
           | this topic, I just watched a Janis Joplin documentary.
        
             | otherme123 wrote:
             | Thing is, good heroin/morphine is almost free of side
             | effects. Paracetamol, for example, is a lot more dangerous
             | than heroin.
             | 
             | Also, Joplin took heroin AND massive quantities of alcohol
             | on the day of her death. It will be close to saying that
             | when someone dies in a car crash while DUI, driving is the
             | real and unique problem here.
             | 
             | But the drug-war irrationality is better exposed by taking
             | a look at weed and MDMA. Two quite safe substances
             | (certainly more safe than alcohol), with clear medical
             | applications, and forbidden just because some ignorant
             | decided to put them in Schedule I. MDMA at the time of its
             | prohibition was being used in psychotherapy with success in
             | tens of thousands of patients [1]. Today, no medical use is
             | recognized, and being in Schedule I (making it un-
             | researchable), none will be. I wouldn't be too surprised
             | that some country discover that it could be used as a
             | treatment for depression or PTSD.
             | 
             | [1] https://www.amazon.com/dp/0791418189
        
               | JohnJamesRambo wrote:
               | Okay sounds like you've got it all figured out. Good
               | luck!
        
             | nvilcins wrote:
             | Death comes from _mis_use, which usually stems from
             | _mis_information ("drugs are bad, let's not talk about
             | them").
             | 
             | People die when they over-dose (which more often than not
             | happens because they don't know exactly what they're
             | getting, or the purity of it) or mix with other substances
             | that they shouldn't.
        
               | FDSGSG wrote:
               | Another common cause of overdoses which stems from a lack
               | of education:
               | 
               | A person quits for a while, decides to start using again
               | and shoots up their usual dose for which they no longer
               | have sufficient tolerance.
               | 
               | If that person knew that this is a common way people end
               | up killing themselves, they probably wouldn't make this
               | mistake.
        
             | maccard wrote:
             | That's not a side effect of heroin, that's a side effect of
             | overdosing. Death is also a side effect of overdosing on
             | acetaminophen, and alcohol. Imagine if when I went to my
             | local wine shop they made a mistake and sold me something
             | that was 80% abv rather than 12-14% and I drank the bottle.
             | Or my pharmacy gave me 5g acetaminophen tablets instead of
             | 500mg, and I took 2 of them every four hours for a few
             | days. Or my finely ground table salt was cut with some form
             | of rodent poison. I'd be pretty dead in those cases most
             | likely. Most illegal substances you have absolutely no idea
             | what you're buying or how much you're buying unless you
             | test it yourself. Yes, word gets around but that's no use
             | to you if you accidentally take 10x a dose, or something
             | that is just not what you were told it was.
             | 
             | Legal substances also have lots of information readily
             | available around them - if I go to my pharmacy and ask for
             | ibuprofen, they will tell me the dosages in advance. If I
             | go to my doctor and they put me on oxycodone, they will
             | give me a dose that they think is safe, (and in theory, a
             | plan to reduce my dependence on them) without judgement. If
             | you develop an opiod addiction, your support options are
             | much more limited.
        
             | hlasdjlfhalwjk wrote:
             | Switzerland started a program in 1995 where they give
             | medical grade heroin to people suffering from addiction.
             | From the people taking part in this program, none have died
             | from heroin overdoses or due to toxic contamination in the
             | drug.
             | 
             | So heroin is actually pretty safe if used correctly.
        
               | otherme123 wrote:
               | Indeed. If one reads the adverse effects of heroin (e.g.
               | in Wikipedia) and ignores the ones caused by dirty
               | injection, lacing and overdose, you are left with no long
               | term effects other than a blurry "brain impairment to
               | make decissions". On the short term, respiratory
               | depression. That's it.
               | 
               | Not many legal drugs has such short list of side effects.
        
           | Geee wrote:
           | So, what's the problem then? Why is using heroin bad?
        
             | FDSGSG wrote:
             | Heroin habits tend to be incredibly expensive. Most people
             | simply can't afford it, that's when the problems arise.
        
             | maybeOneDay wrote:
             | Black market incentivises dealers doing things like mixing
             | fentanyl into heroin in order to make it vastly more
             | profitable (fentanyl is cheap and incredibly potent), with
             | the side effect of increasing its deadliness massively.
             | 
             | Users often mix heroin with benzos and/or alcohol which
             | increases the level of risk enormously. The vast majority
             | of overdoses are caused by mixing CNS depressants in with
             | heroin, not by heroin use alone.
             | 
             | If you can't get a steady supply then withdrawals are
             | vicious and can cause a host of other problems (crime in
             | order to get money for more heroin being a commonly cited
             | one).
             | 
             | One of the ways that heroin itself can cause overdose
             | deaths is relapses - users may take a dose that they were
             | previously tolerant to. I believe this is still far less of
             | a danger than combining with other substances.
        
               | Geee wrote:
               | Are there benefits in using heroin?
        
               | maybeOneDay wrote:
               | What would you characterize as a benefit? Medical,
               | certainly. Recreationally, certainly (it feels good).
               | Socially, I imagine so for some people and some doses.
               | 
               | Here's a reddit famous account from someone claiming to
               | be an opiate addict that some find enlightening/haunting:
               | https://www.reddit.com/r/IAmA/comments/wnj2d/iama_heroin_
               | add...
        
               | pessimizer wrote:
               | These are all symptoms of the drug war, not heroin
               | addiction.
        
               | hlasdjlfhalwjk wrote:
               | That's kinda the point. Most drugs are not bad/evil in
               | themselves. They can be used irresponsibly.
               | 
               | Many classic drugs (as opposed to research chemicals
               | which introduce small molecular changes to circumvent
               | banns on another substance) are pretty safe or at least
               | have a well known safety profile.
        
           | hiq wrote:
           | One source I've found about the long-term effects:
           | https://www.drugabuse.gov/publications/research-
           | reports/hero...
           | 
           | "Repeated heroin use changes the physical structure and
           | physiology of the brain, creating long-term imbalances in
           | neuronal and hormonal systems that are not easily reversed.
           | Studies have shown some deterioration of the brain's white
           | matter due to heroin use, which may affect decision-making
           | abilities, the ability to regulate behavior, and responses to
           | stressful situations."
           | 
           | I expected something more damning. Unfortunately, I feel that
           | we don't have enough studies (incl. long-term ones) when it
           | comes to recreational drugs.
        
             | Solid_Applaud wrote:
             | Worse: heroin destroys hippocampus function over time. If
             | the hippocampus is damaged by disease or injury, it can
             | influence a person's memories as well as their ability to
             | form new memories. Hippocampus damage can particularly
             | affect spatial memory, or the ability to remember
             | directions, locations, and orientations.
             | 
             | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6758897/
        
         | wccrawford wrote:
         | Yeah, and he's putting out his experience as an example for
         | others to point to and say, "If that guy could do it, so can
         | I!"
         | 
         | Personally, I've always felt I had a personality that is prone
         | to addiction, so I've stayed away from even alcohol on a
         | regular basis. (Though at one point I was having my favorite
         | alcoholic drink every night... I stopped when I realized what I
         | was doing.)
         | 
         | Even breaking away from caffeine (again) is tough for me. Soda
         | was also tough, and I ended up on soda water instead and still
         | drink way too many of those.
         | 
         | I've also spent too much money on mobile gacha games, but
         | because I know my personality, I managed to keep it from
         | spiraling out of control. (Some people would even say the
         | amount I spent wasn't a big deal, but it was _far_ more than a
         | single game is worth, so it 's a sign that I was going wrong.)
         | 
         | Someone else asked how addiction feels, and I almost answered
         | there, but didn't because I'm sure they meant _hard_ addiction
         | that you need help to correct, and I haven 't been there. But
         | as far as I've been, it's an almost-uncontrollable desire and
         | subsequent rationalization and then capitulation. Each time.
         | Fighting the feeling is depressing, even if everything else is
         | going great. I only ever escape when I make myself feel worse
         | about doing the thing than I feel from not doing it.
        
       | major505 wrote:
       | To be honest, is what I expect someone with a drug problem to
       | say.
        
       | CapitalistCartr wrote:
       | Three years ago, I decided, for New Years, to try getting
       | addicted to caffeine and alcohol. The caffeine was a rapid
       | success, the effects of which which I still enjoy. After half a
       | dozen bottles of bourbon, I gave up on the alcohol for a lack of
       | interest/effect. Peoples bodies and neurochemistry are simply
       | different.
        
         | ohnemint wrote:
         | > I decided, for New Years, to try getting addicted to caffeine
         | and alcohol
         | 
         | Why did you decide this?
        
           | CapitalistCartr wrote:
           | I wanted to better understand the experience. I've known
           | several addicts in my family. My wife and I adopted a deeply
           | addicted family member's son, who was born with severe
           | problems from her drug use.
           | 
           | Bear in mind, I am willing to take vacation from work and go
           | cold turkey as needed. I do this a couple times a year for
           | caffeine, just to be sure, and the headaches are brutal.
        
             | superkuh wrote:
             | It's easy to become dependent on caffine. But caffeine
             | itself is not intrinsically addictive. It does not directly
             | interact with the systems in the brain associated with
             | predicting reward.
        
       | coding123 wrote:
       | > Some people don't know not to mix specific sedatives with
       | opioids. For example, they don't know not to mix large amounts of
       | alcohol or large amounts of antihistamines. Specific combinations
       | can lead to respiratory depression, which can lead to death.
       | Another point of ignorance involves people who buy street drugs
       | and don't necessarily know if the drugs contain contaminants.
       | That's the kind of ignorance I'm talking about.
       | 
       | I feel like he just wrote off 450000 deaths from 1990-2019 with
       | people don't know how to mix alcohol and opioids correctly.
       | 
       | https://www.cdc.gov/drugoverdose/data/analysis.html
        
       | [deleted]
        
       | mdip wrote:
       | All I can say about this is "Good Luck with That".
       | 
       | I have never been addicted to heroine, so I cannot speak from
       | personal experience. But I have seen its impact first-hand,
       | thankfully, a number of times I can only count with one of my
       | hands.
       | 
       | The way I explain addiction to my kids is the way it was
       | explained to me by an addict (alcohol, Vicodin and others):
       | 
       | (1) There's no difference between "Psychologically Addictive" and
       | "Physically Addictive" -- he said this in the context that he was
       | an abuser of alcohol, every day, but was not chemically addicted
       | to it and required no medicine to quit, but it was easily as
       | difficult as quitting Vicodin.
       | 
       | (2) Addicts don't love their drugs more than their
       | family/kids/morals -- your body _uses_ addiction to make you eat,
       | drink, etc -- go without those things for long enough and you
       | will start to sacrifice things that are otherwise more important.
       | Imagine your desire to do this particular drug is substantially
       | stronger than your desire to eat or drink.
       | 
       | Having the benefit of a few decades away from childhood and been
       | witness to some really incredible individuals' lives being
       | flushed down the toilet, I don't believe either of those two
       | statements to be sensationalized in any way. It's internalizing
       | these things and understanding that the people _I know_ who
       | became addicts were _very strong people_. One was a person I
       | counted among the  "Great Men"[0] in my life (and still do).
       | 
       | Politically speaking, I tend to fall pretty narrowly on the whole
       | "victimless crime shouldn't be criminal[1]", so my puritanical
       | beliefs that you should "just stay as far away from that stuff as
       | you possibly can" doesn't translate into support for the War on
       | Drugs(tm). Personally speaking, I've watched people maintain a
       | heroine addiction for _years_ , Vicodin for _decades_. In the
       | early days, they managed OK. They all quit because the drug
       | became _it_ --the single need that remained. That's what _it
       | does_. People nearing this stage delude themselves into thinking
       | it 's not affecting their lives/loved ones, but I'd be curious --
       | with the benefit of hindsight bias -- at what point a former
       | addict[2] would admit their drug problem was out of control.
       | 
       | [0] My measure is not just a man who can be counted on to do the
       | right thing when nobody is looking, but who will do the right
       | thing when the outcome will/might serve him poorly.
       | 
       | [1] A person should not be able to be convicted of a crime if the
       | criminal and the only victim are the same person.
       | 
       | [2] Recovering addict is the phrase most frequently used. One
       | acquaintance of mine (who didn't do 12-steps/rehab) corrected me
       | and said he's "not an alcoholic anymore" or a "former alcoholic"
       | because he quit a decade ago and has no desire/temptation to
       | drink (whole household is _extremely_ anti-alcohol; he couldn 't
       | hide it if he tried) and feels that claiming to have a problem he
       | doesn't have feels too much like being a "pity whore". He wasn't
       | chemically addicted, either. Can't please everyone, I guess.
        
       | heyflyguy wrote:
       | I worked in an ad agency in the nineties that had a cocaine and
       | amphetamine tidal wave going through it. I never realized the
       | number of seemingly high functioning and reputable people that
       | are utterly addicted. I don't love the article because I think it
       | shows a statistical anomaly, but in that light, yes this is
       | interesting.
        
       | omginternets wrote:
       | Let's check in on this guy in a few years.
        
       | pif wrote:
       | I'd like to understand where he buys his legal heroin. Because,
       | if he is choosing to pour his money into the worst criminal
       | businnes existing, either he is a piece of scum or he does have a
       | drug problem!
        
         | leetcrew wrote:
         | kind of a weak jab. it's not that complicated to make heroin.
         | morphine extraction is trivial; the conversion to heroin is
         | just one more step. any chem major could probably do it if they
         | had a way to source enough poppies without attracting
         | attention. even if he does source his heroin through the usual
         | channels, is that so much worse than the business practices we
         | support when we buy clothes, iphones, meat, etc.?
        
       | tonymet wrote:
       | Let's see how he ends up in 10 years. Better yet, let's ask his
       | wife and kids if they agree.
       | 
       | Maybe he is the one out of 100k who can manage a Heroin habit.
       | Well good for him, he can keep it to himself.
        
       | rmac wrote:
       | Man, I read this as someone who tried to use opioids and I just
       | couldn't chip. It spiraled into full blown physical dependence. I
       | guess i'm the type with an underlying psychiatric illness which
       | drove my usage and denial.
       | 
       | That there exists people like this person who can chip
       | (controlled use of opiates) always intrigues me -- as this drug
       | was the ultimate pathway to euphoria and thus I became the mouse
       | hitting the button for more more more. If you're on the chipping
       | path I hope you can find peace just for today.
       | 
       | I am pro-legalization of all drugs with some FDA oversight on
       | quality.
        
         | cwmma wrote:
         | My wife can have a cigarette once and a while when she drinks
         | and it's no big deal, last time I did that (6 months after I
         | had quit) it took me 6 or 7 years to quit again.
        
         | rincebrain wrote:
         | I've been given opioid prescriptions a few times in my life,
         | and I've never found myself wanting to take them for their own
         | sake or suffering from withdrawal afterward.
         | 
         | It's probably some variable physiological response - hopefully
         | one day we'll have a good way of profiling a priori which
         | people may have difficulty with using opioids in a controlled
         | fashion so people don't have to suffer to find out they're
         | among the unlucky ones. (Or maybe we'll come up with either a
         | new class of drugs to replace opioids entirely, or a cocktail
         | to block the adverse effects...)
        
           | throwawayboise wrote:
           | Same. Never felt the slightest euphoria taking the prescribed
           | dose. Maybe got a bit sleepy, but it's been so long I don't
           | quite remember.
        
           | seibelj wrote:
           | I got prescribed Percocet back when they casually gave them
           | away to teenagers who had their wisdom teeth removed, and did
           | not like it. Not only was I constipated but it made me feel
           | really lazy and itchy. Not a fan.
        
         | fingerlocks wrote:
         | Because it's not the ultimate pathway to euphoria for everyone.
         | 
         | Some of us don't like the "sinking into oblivion" feeling of
         | that class of drugs. I don't want to feel like my IQ has been
         | sliced in half. Really hate it actually.
         | 
         | The dragon to chase is of the functional businessman's variety-
         | cocaine. I'd rather take something that enhances my life
         | experience, turns conversation in liquid gold oozing from
         | mouth. Opiates and barbiturates temporarily hide your problems
         | under a blanket of haze, confusion, and constipation. No
         | thanks.
        
           | 3131s wrote:
           | Yeah, I've done heroin, morphine, oxycodone, opium, and a few
           | others in the past and never felt any pull to do them.
           | 
           | But I love cocaine, psychedelics, and weed though, and I have
           | been somewhat addicted to all three at different times in my
           | life. I specifically wouldn't ever get drunk if I didn't have
           | weed to go with it, as that's the only way to make alcohol
           | any fun for me.
        
           | tmp-20210218 wrote:
           | yeah, cocaine doesn't have the awesomest rep either - a crack
           | addiction is just another way of temporarily getting away
           | from something problematic.
        
         | mabbo wrote:
         | I can barely control my use of caffeine. Without it, I turn
         | into a raging psychopath. And I'm consuming more and more of it
         | all the time.
         | 
         | Heroin _terrifies_ me.
        
           | bserge wrote:
           | I would say caffeine is easy to quit, but I'm an alcoholic so
           | I understand perfectly. It seems like you don't need it, yet
           | you use it regularly.
           | 
           | Try caffeine pills, they have a cleaner effect with no
           | stomach/intestine troubles. Somewhat easier to quit, too.
        
           | eurasiantiger wrote:
           | Caffeine, or coffee? They are very different substances: one
           | is a pure alkaloid with well-defined effects, the other is a
           | concoction of hundreds, possibly thousands of active
           | ingredients.
           | 
           | Most relevantly, coffee contains a relatively large amount of
           | Harmala alkaloids, which are a family of beta-carboline
           | monoamine oxidase inhibitors commonly found in Ayahuasca
           | brews (and named after one of its ingredients, Penganum
           | harmala).
        
         | vmchale wrote:
         | > I guess i'm the type with an underlying psychiatric illness
         | which drove my usage and denial.
         | 
         | I think substances can be addictive on their own, which gets
         | occluded by many on the "pro-drugs" side.
        
         | steve_adams_86 wrote:
         | As a teen I made opium from poppies around the neighbourhood.
         | After smoking it once I threw the rest out. The intensity of
         | how perfect it felt was alarming. I remember within minutes
         | thinking I'll become addicted to it if I don't get rid of it.
         | Despite that being a scary prospect, I kept feeling great the
         | entire time. It really beats any bad feeling out of you.
         | Incredibly creepy.
         | 
         | I was a dumb teenager (I'm still not very smart) but I'm
         | grateful I had the intuition to realize how dangerous it was.
         | The only way I can describe it was that I felt the pleasure
         | overwhelming my ability to reason, and that felt very
         | disabling.
        
           | tptacek wrote:
           | You grew up in a neighborhood full of opium poppies?
        
             | tanseydavid wrote:
             | He lives next to next to the Land of Oz.
        
             | likpok wrote:
             | It may be legal to grow opium poppies in the US for garden
             | or seed purposes, just not for the processing into opium.
             | 
             | https://depts.washington.edu/hortlib/resources/wp-
             | resource_s...
             | 
             | Michael Pollan also wrote an essay about it (I think taking
             | a slightly stronger position).
        
               | tptacek wrote:
               | I don't doubt it, but are they so common that I might
               | walk by them in my own neighborhood? (I'm asking, I have
               | no idea).
        
               | steve_adams_86 wrote:
               | Yes, I still see them while walking around here in
               | Victoria, BC. I have some seeds from a friend as well.
               | They circulate and people grow them out of curiosity as
               | well I guess. You've maybe seen them without realizing
               | it.
        
             | AnotherGoodName wrote:
             | Perhaps Tasmania? Tasmania has legalized opium production
             | and you'll see fields of opium poppies everywhere since
             | it's the source of the majority of medical opiates. The
             | reasons for Tasmania being the center of the western worlds
             | poppy production are obvious. It's easy to ensure the
             | exports to the rest of the world are done via controlled
             | channels.
             | 
             | This does lead to the weird situation where an entire
             | population has easy access to opium should they want to
             | raid nearby fields; the fields are lightly fenced with
             | warning signs stating that it's bad for your health.
             | Perhaps surprisingly to many Tasmania doesn't really have
             | any issues from this. This may lend some credence to the
             | above article - it takes more than just access to lead to
             | issues for people.
             | 
             | https://en.wikipedia.org/wiki/Tasmanian_opium_poppy_farming
             | _...
        
             | steve_adams_86 wrote:
             | Not full of them, but I've always been especially fond of
             | plants, and poppies in particular because my mom grew some
             | spectacular varieties. Through boredom and interest I
             | discovered a home nearby was growing a variety of poppy
             | which could be processed into opium. I took some seed heads
             | at the correct growth stage on an evening walk, then
             | processed them later.
             | 
             | The process is very crude but works well for
             | experimentation. I think if you were a serious opiate user
             | it would probably be too inefficient and inconvenient to
             | warrant over simply buying opium.
        
           | dmitryminkovsky wrote:
           | When I was 17 I had a bad cough and my mom gave me what
           | turned out to be too much codeine cough syrup. An hour later
           | I realized my cough was gone but I had spent all that time
           | staring at my Windows ME desktop, in some sort of euphoric
           | daze, repeatedly selecting and deselecting all the icons. For
           | an hour! It was really, really creepy and deeply unsettling.
           | And this was codeine, a "mild" opiate! Have aggressively
           | stayed away from opioids ever since then.
        
             | steve_adams_86 wrote:
             | Ah, yeah - this is very much like my experience as well. I
             | sat on my bed and just cycled through the same thoughts for
             | a shockingly long time. Nevertheless it felt great. Very
             | creepy.
        
             | wittyreference wrote:
             | Ever taken codeine again? You may have a genetic variant of
             | CYP2d6 that makes codeine, in particular, hit you hard.
             | It's not an effect common across opioids.
        
               | dmitryminkovsky wrote:
               | Nope never, or any other opioid either, fortunately. But
               | thanks that's really interesting. Neither of my parents
               | seem particularly affected. But who knows.
        
         | koheripbal wrote:
         | Opioids are insanely and ~~instantly~~ quickly addictive. I
         | accidentally became addicted after knee surgery.
         | 
         | When the pain subsided, I stopped taking them, and within a day
         | I found myself curled up in a ball and wanting to rip my own
         | skin off. It's really true when addicts describe it as "being
         | uncomfortable in your own skin".
         | 
         | The moment I realized I was experiencing withdrawal, I flushed
         | the meds down the toilet and just suffered through it for a
         | couple days.
         | 
         | Never ever touch heroin. Stay away from prescription opioids
         | unless it's really really needed, and make sure it's short term
         | only.
        
           | f1refly wrote:
           | I can't confirm your experience at all. I've had a serious
           | car accident after which they kept me on opium in the
           | hospital for three days. After they replaced it with weaker
           | pain treatment compounds I didn't have any desire to go back,
           | despite how I was feeling when taking opium. I wouldn't say
           | they're instantly addictive.
        
             | [deleted]
        
             | ChrisRR wrote:
             | 3 days is a very typical prescription length to stop
             | addiction kicking in
        
             | mod wrote:
             | I can confirm his experience via my brother's nearly
             | identical experience. He asked for a non-addictive
             | painkiller, as he knows he has an addictive personality. He
             | was prescribed an opiod anyway, I don't recall which, for a
             | serious abscessed tooth.
             | 
             | After a couple of days he was experiencing identical
             | symptoms as the GP.
             | 
             | I'm not trying to chime in on how strictly we're
             | interpreting "instantly," but for me I will definitely do
             | my best to avoid opiods. Taking the prescribed amount for
             | 2-3 days, and literally not taking the rest of the pills
             | (both GP and my brother), and having serious physical
             | withdrawals--that's fast enough that I would rather avoid
             | it.
        
           | csunbird wrote:
           | Someone I know had a basic nose surgery (bone deviation) and
           | then she experienced withdrawal symptoms after the surgery
           | because of the anesthetics, which required intervention by
           | professionals and she was unable to work for a month.
           | 
           | Edit: Just to clarify, she was not prescribed any
           | opioids/drugs to be taken post surgery, it was purely the
           | anesthetics.
        
             | wl wrote:
             | An anesthetic would typically consist of something like a
             | small dose of a short-acting benzo before surgery for
             | anxiety, propofol (very short acting) for induction, an
             | opioid for pain management, an anesthetic gas like
             | sevoflurane to maintain anesthesia, pressors to bring up
             | blood pressure if necessary, and a few other drugs that
             | probably don't merit mention.
             | 
             | Of these drugs, the only ones that might cause withdrawal
             | symptoms would be the benzo or the opioid. The benzo, if
             | it's even given at all, is going to be tiny. Even if we
             | were to hypothesize that a single unusually large dose of
             | an opioid could induce dependency, a surgery where the
             | patient isn't even given opioids to take home wouldn't
             | warrant such a dose in the OR.
             | 
             | In short, your second-hand account makes no sense.
        
               | csunbird wrote:
               | To be honest, a lot of people, including the doctors
               | themselves, doubted her as well.
               | 
               | I am fuzzy on the details, because the person was just an
               | acquaintance. There was a huge investigation on her
               | history, looking for substance abuse. They found nothing.
        
           | Broken_Hippo wrote:
           | They aren't instantly addictive, though: As in, I've had
           | opioids prescribed, took as needed, and still have some in
           | the cabinet that are probably expired.
           | 
           | I've smoked opium a handful of times. It smells wonderfully.
           | 
           | And yet, if I take any drug regularly, I'm using something
           | with THC in it (hash or pot, in general). I currently do not,
           | however, and tend to have a few drinks and get high on the
           | weekends. Not a big deal if I don't, though.
           | 
           | I've had medical grade heroin in the hospital (morphine
           | didn't take care of the pain). No withdrawal, though I was
           | wonderfully high. Haven't gone to a morphine habit.
           | 
           | The prudent thing to do is not to say, "opioids are instantly
           | addictive", but to give folks safe ways to detox from them
           | and give folks information on signs of addiction - because
           | not everyone has such experiences.
        
             | TheAdamAndChe wrote:
             | You're an outlier. The vast majority of people who smoke
             | opium or experience euphoria from taking medical grade
             | heroin will obtain the urge to do it more.
        
               | Broken_Hippo wrote:
               | See, this is saying something else entirely. Also, do you
               | have a source for this?
               | 
               | Would I do opium again? Sure. It was fun. Would I do
               | medical grade heroin or morphine again, under controlled
               | circumstances with a nursing staff dosing me? Yeah. It
               | was fun. Did I have some weird urge to go out and do it
               | frequently? Nope. But to be fair, lots of folks drink on
               | more than one occasion as well. They get high more than
               | once. They might even have more than one drink or hit in
               | one day. Simply wanting to do something again doesn't
               | mean anything. I've done acid more times than I can
               | count, and I wouldn't call it a habit. The only drug that
               | I'd probably do more often if it were not dangerous to do
               | too often is MDMA because it feels spectacular (better
               | than opioids, to me anyway), but I'd not even call it a
               | strong urge.
               | 
               | This isn't addiction, nor is it anything uncontrollable
               | in general.
               | 
               | Unless you are implying that folks get uncontrollable
               | urges, and in that case, please back that up with facts.
               | Though I've met my share of addicts, most things just
               | aren't instantly addictive. Even heroin isn't that way -
               | especially if you actually improve an addicts like
               | (hence, troops addicted to heroin in wars came home to be
               | non-addicts).
        
               | tanseydavid wrote:
               | >> This isn't addiction, nor is it anything
               | uncontrollable in general.
               | 
               | With as much respect as I can offer I think you should
               | consider the following notion, which in my personal
               | experience is an actual fact:
               | 
               | "Until and unless you have been an addict you truly
               | cannot understand the experience. And subsequently you
               | are not able to point out what is and is not addiction."
        
               | memorysafety wrote:
               | Asking for opinion: can one transfer experiences with
               | non-drug addictions (videogames, promiscuity, social
               | nets, etc) to the substance-abuse kind? How similar are
               | these?
        
               | wittyreference wrote:
               | As a physician:
               | 
               | No, the 'vast majority' do not. I've supervised medical
               | grade opioid administration to more than a few people,
               | both acutely and chronically, and *folks without a pre-
               | existing substance use problem* do not often develop one,
               | especially if it's over the short term. The idea that "I
               | give you an opioid and then BAM I want more!" is highly
               | divergent from my clinical experience.
        
               | TheAdamAndChe wrote:
               | As a physician, you should know that using opioids to
               | experience euphoria and pleasure is drastically different
               | from using appropriate doses to combat the effects of
               | pain. It's the euphoria and pleasure that triggers
               | operant conditioning and the accumulation of DFosB that
               | occurs in the vast majority of addictions[1]. Only after
               | receptor downregulation does withdrawal avoidance become
               | a factor, but once that occurs, it doubles the strength
               | of the operant conditioning.
               | 
               | Use != Misuse, but use for pleasure is a direct precursor
               | of misuse.
               | 
               | [1] https://en.wikipedia.org/wiki/FOSB?wprov=sfla1
        
           | sneak wrote:
           | > _Opioids are insanely and instantly addictive._
           | 
           | This is the kind of FUD that TFA is specifically addressing.
           | Namely, that this is not always a true statement.
           | 
           | Of course, for many people, it is, which is why people make
           | such sweeping (and incorrect) statements. Your warning is
           | valid, your claimed facts are not.
        
             | bostonsre wrote:
             | The assertions that the are made in the article seem like
             | something that should be backed up with studies and not
             | anecdotal evidence from one person (even if he is well
             | respected).
             | 
             | It is an incredibly slippery slope for people to walk out
             | on. It would be incredibly hard for someone to say whether
             | or not they will spiral out of control if they try it and
             | the consequences of becoming heavily addicted are life
             | destroying. It seems like playing Russian roulette and I'm
             | not sure it's a good thing to raise the idea that one can
             | potentially manage it. Also, the person being interviewed
             | could be one of the people that can't control it and will
             | spiral out of control or him saying he manages it well and
             | it's possible to do so could be a facade and he could be
             | trying to do whatever possible to keep his habit alive, but
             | we just don't know. Many people manage it fine for years
             | without anyone knowing until they start their sharp decline
             | towards bottom.
        
               | boomboomsubban wrote:
               | >The assertions that the are made in the article seem
               | like something that should be backed up with studies and
               | not anecdotal evidence from one person (even if he is
               | well respected).
               | 
               | Wherw do you think he got these assertions? There have
               | already been studies about how often heroin users are
               | addicts or what the addiction rate of prescription
               | opioids are.
        
               | bostonsre wrote:
               | From the interview, it sounds a lot like he got them from
               | his personal experience. He mentions percentages, but I
               | see no references to any sources. It matters what those
               | sources are (e.g. if they are from Purdue pharma or the
               | sacklers, it's probably BS).
        
             | treeman79 wrote:
             | A gun is always loaded. Even if it has no bullets.
        
               | mod wrote:
               | I think you're trying to argue GP's point, but you've
               | only confirmed it, because you're misrepresenting both
               | the facts and the traditional advice.
               | 
               | "Treat every gun as if it were loaded" is the traditional
               | advice, and is a wonderful attitude to have about
               | firearms. But if it's not loaded, it's not loaded, those
               | are the facts.
               | 
               | Perhaps the same with opiods: treat them as if they are
               | highly addictive, in a rapid manner. But if (for you)
               | they aren't, they aren't.
        
             | burnthrow wrote:
             | Two things I don't like FUD around: My Linux and my heroin.
        
             | read_if_gay_ wrote:
             | So even if it's not true for everyone that's a practically
             | useless observation because how are you going to find out
             | it's not true for you without risking becoming instantly
             | addicted?
        
               | ch4s3 wrote:
               | I don't have the reference at hand, but the rates of
               | problematic use in the population seem to mirror alcohol.
               | A small single digit percent of people will absolutely
               | have a horrible problem, 8-10% will engage in disordered
               | use, ~10% will over use in some way, and 80% will never
               | develop a problem at all.
        
               | read_if_gay_ wrote:
               | Excuse the snark, but any chance it was funded by the
               | Sacklers?
        
               | ch4s3 wrote:
               | No. There's a large body of research.
               | 
               | Here's one showing only 5% of people filling opioid
               | scripts go on to long term use.[1]
               | 
               | Another older study citing 2% of US adults regularly
               | using opioids, while a further 29% use them infrequently.
               | Other more recent studies I seen hold this pretty
               | constant. [2]
               | 
               | Here [3] only 13% of elective surgery patients fill
               | opioid scripts beyond 90 days, and "mental health
               | disorders, and tobacco dependence or abuse were
               | associated with prolonged opioid use". It's well known
               | that people with one substance abuse issue tend to be at
               | higher risk for developing others.
               | 
               | You could go on and on finding studies that show that
               | relatively few people with high risk medical/mental
               | health history go on to develop opioid addiction after
               | using these substances. There doesn't seem to be any
               | support for the idea that the average person can take
               | these drugs once and become "hooked".
               | 
               | All that said, they are dangerous and have strong
               | addictive potential so caution is warranted.
               | 
               | [1] https://link.springer.com/article/10.1007/s11606-016-
               | 3810-3?...
               | 
               | [2]https://www.sciencedirect.com/science/article/abs/pii/
               | S03043...
               | 
               | [3] https://www.sciencedirect.com/science/article/abs/pii
               | /S03635...
        
               | jshevek wrote:
               | That you cannot imagine an approach doesn't mean an
               | approach doesn't exist. It may be possible to form a
               | generalized understanding of an individuals
               | predisposition based on testing with other substances,
               | just as one example.
        
               | read_if_gay_ wrote:
               | You're still taking a substantial risk when forming that
               | generalized understanding, and then another substantial
               | risk when you start making conclusions from that general
               | understanding.
               | 
               | And for what?
        
               | jshevek wrote:
               | My point is only that you strongly implied a fallacious
               | argument, which damages your ability to reason on a
               | topic.
        
               | read_if_gay_ wrote:
               | Ok, so basically, since we haven't _proven_ the opposite,
               | we can't be sure, regardless of how the situation
               | appears. I think that's a weak argument in a general
               | sense, but point taken.
        
               | jshevek wrote:
               | No, I'm not arguing that proof is necessary for
               | certainty. I'm pointing out that the implied reasoning is
               | akin to argument from ignorance. We don't have to take a
               | position on a topic if we are ignorant, but we often do
               | so when doing so can be used to justify existing biases.
        
           | ardy42 wrote:
           | > Opioids are insanely and instantly addictive. I
           | accidentally became addicted after knee surgery.
           | 
           | Is that true generally, or just for a subset of people who
           | have some predisposition to addiction?
           | 
           | While it could just be Purdue Pharma propaganda, I vaguely
           | recall hearing that the "instant addiction" was a myth.
           | However, people like you have experiences like yours, so
           | there must be some truth to the "instant addiction" idea.
           | 
           | Edit for downvoters: I think it totally makes sense for
           | everyone treat opioids like a loaded gun, like another poster
           | said, if some people are vulnerable to an instant addiction
           | effect. I just want to clarify what the actual situation is
           | (for me and all the other people who were told it was a
           | myth).
        
             | eplanit wrote:
             | I've been prescribed oxycontin several times over the
             | years, and never completed a single bottle. Couldn't wait
             | to stop as the pain subsided due to the brain fog. I think
             | at most I completed one third of one.
             | 
             | Some people are definitely more prone or vulnerable to
             | becoming addicted to it. Im lucky, I guess.
        
             | fingerlocks wrote:
             | Yeah it's a total myth. Not sure why you're being
             | downvoted. My wife and I kept a bottle of oxy in our
             | bathroom for a few years, taking it only occasionally. No
             | one got addicted because neither of us wanted to keep
             | taking it.
             | 
             | A prerequisite for addiction is that one must believe the
             | drug makes them feel "normal" or functional in some way. "I
             | can't live with this pain - I need it."
             | 
             | If instead you as a user go into the drug experience with
             | the mindset that you are entering a temporary state, one
             | that is reserved for special occasions, you're far less
             | likely to become addicted.
        
               | watwut wrote:
               | It is not myth. Some people get instantly addicted to
               | heroin, others can continue using casually for years. We
               | dont really know what exactly is different, but it cant
               | be psychological only. The withdrawal symptoms are
               | physical, not just how you feel emotionally.
        
               | fingerlocks wrote:
               | Yes, it's a myth that they are "instantly" addicting. I
               | don't deny the drug is powerful, but you have to want it.
               | 
               | If it were true that it was instantly physically
               | addictive, then literally every human being that has ever
               | had any kind of surgery or been to the ER for trauma
               | would be a rabid opioid zombie. But they aren't.
        
               | watwut wrote:
               | They dont give heroin im ER.
        
               | fingerlocks wrote:
               | Heroin metabolizes into morphine
        
               | watwut wrote:
               | That does not make it the same thing.
        
               | Uberphallus wrote:
               | It's a myth.
               | 
               | My cousin is a social worker, dealing with addicts. I've
               | done heroin myself. I know heroin addicts, though not as
               | many as he does.
               | 
               | We both agree: almost all addicts have a backdrop of
               | broken families, poverty, unemployment, some kind of
               | trauma or just a general lack of opportunities in life.
               | Heroin makes all that go away... for a while. How could
               | they NOT become addicted?
               | 
               | The myth is about shifting blame from social inequality
               | onto a drug. The addiction is but a symptom of a societal
               | disease.
        
               | watwut wrote:
               | That is not mutually exclusive. Every single person
               | living in 2020 knows dangers of heroin addiction. It is
               | not starter drug happy person will try these days. You
               | have to be seld destructive to even try.
        
               | tanseydavid wrote:
               | >> A prerequisite for addiction is that one must believe
               | the drug makes them feel "normal" or functional in some
               | way.
               | 
               | Where did come up with this? This is not accurate.
        
           | ufmace wrote:
           | From what I've read, this varies hugely among the population.
           | Some people seem to not be affected by them at all. Some
           | people are able to use them short-term for pain relief and
           | stop with no drama when the pain subsides. And some people
           | get dangerously addicted even with a legitimately prescribed
           | short-term dose for actual crippling pain. It seems it's
           | often hard to determine which one a person is ahead of time.
           | 
           | FWIW, good on you for recognizing that you're one of the
           | third group and getting off of it entirely before the
           | addiction gets even worse.
        
           | kenneth wrote:
           | I've only ever tried opioids after being a surgery. I was
           | prescribed off oxy to take every 4h. Was supposed to take it
           | for two weeks. Every dose knocked me out and made me feel so
           | uselessly drowsy... I quickly dropped it to one a day and by
           | day 3 I just stopped taking it altogether. Couldn't stand
           | it... the pain was better than the feeling of being high. I
           | ended up using barely 5% of the prescribed amount. Random
           | acquaintances came out of the woodwork to ask to buy my
           | pills. I just tossed them all... that shit was nasty and I
           | didn't want it nor did I want to enable anyone.
           | 
           | And I say this as someone who's plenty happy with drugs
           | legalization, who likes the occasional MDMA, and who drinks
           | plenty of alcohol. I guess I'm lucky I never run the risk of
           | opiates addiction, because despite all that I have no desire
           | to every touch the stuff again.
        
           | wittyreference wrote:
           | "Opioids are insanely and ~~instantly~~ quickly addictive."
           | 
           | Do you have a source for this assertion? I'm just a physician
           | with a particular specialty in medically managed (as opposed
           | to procedurally managed) pain, and I've never seen a "I took
           | it once and was instantly addicted." I don't mean to undercut
           | your subjective experience, but I've seen a few folks on pain
           | killers, and if what you described was more common than "very
           | rare", I would have by now.
        
           | codr7 wrote:
           | It's all about the profit, synthetic opioids are designed to
           | be as addictive as possible.
           | 
           | I've been through plenty of addictions, but quitting Oxy
           | after surgery is the closest thing to hell I've experienced
           | so far.
        
           | theli0nheart wrote:
           | > _Opioids are insanely and ~~instantly~~ quickly addictive.
           | I accidentally became addicted after knee surgery._
           | 
           | They may be _instantly_ addictive for _you_ , but they are
           | not for everyone.
           | 
           | After I had a pleurodesis, the nurse sat me down in the chair
           | next to the hospital bed and gave me a little controller I
           | could use to release morphine into my saline solution if the
           | pain became unbearable (and it did). It was the strangest
           | sensation--I could 'feel' the pain, in a sense, but it was
           | like I was on a different plane, and it didn't quite bother
           | me.
           | 
           | But to say it was instantly addictive--nope. Not at all. Have
           | had no desire to try anything like that again outside of a
           | hospital setting. Maybe some people are just not prone to it.
        
       | ClumsyPilot wrote:
       | When I read these sort of accounts, it helps to keep in mind the
       | diversity of human condition, physique and psycology.
       | 
       | There are people immune to some poison, people that don't feel
       | pain at all, a woman which has two vaginas, there were people
       | that never stopped growing, people that don't sleep, etc.
       | 
       | Thats before we get into psycology and personal experiences that
       | shaped them.
       | 
       | I willing to believe that ther are some people who can abuse
       | drugs, and not become adicts. However odds are I am not one of
       | them, and its not worth finding out by experiment.
        
       | aminozuur wrote:
       | I remember the early days of the Silk Road market. The members
       | posted thoughtful reviews of their orders, sometimes containing
       | lab-tests results of the drugs they'd ordered.
       | 
       | It was a small community whose members looked more like the
       | Hacker News crowds than the meth heads you'd see in the news.
        
         | jtxx wrote:
         | yeah that was amazing. it felt like a lot of people on there
         | were also fans of Erowid, which I now realize probably had a
         | lot of the same people submitting experiences
        
         | achairapart wrote:
         | Meanwhile the Hacker News community has just flagged this
         | "scandalous" article. How ironic.
         | 
         | [edit]: My bad, now it's back!
        
         | temp0826 wrote:
         | Considering how early in the bitcoin days that SilkRoad came
         | along, it makes sense that it was a more technically-minded
         | crowd to begin with.
        
       | thezoginator wrote:
       | My dad used to say the exact same thing, until he lost his job
       | his family, and his life. He used to pretend that he was
       | "functioning", and that his drug use wasn't a problem. This is a
       | classic example of someone who we will read about losing their
       | job and life in 10 years or less.
       | 
       | The only bit I will agree with is that addiction is not caused by
       | the drug itself, and is typically the result of childhood trauma.
       | With that drug use is not a solution for dealing with that
       | trauma, dealing with that trauma directly through therapy and
       | mediation is a much better solution.
        
         | gnagatomo wrote:
         | >The only bit I will agree with is that addiction is not caused
         | by the drug itself, and is typically the result of childhood
         | trauma.
         | 
         | Traumatic experiences plays a big role on addiction, but purely
         | chemical addiction should still be factored in. Heroine is
         | extremely addictive not just because of traumatic experiences,
         | but because it induces very high dopamine releases.
        
       | originalvichy wrote:
       | I've listened to Hart a few times on JRE podcast. His heart might
       | be in a good place - trying to destigmatize/humanize drug users,
       | but the flip side is he is making actually addictive substances
       | seem like no big deal. Irresponsible.
        
         | capableweb wrote:
         | On the flip-flip side, he's one person spreading harm reduction
         | about drugs that are currently frowned upon. If you look in
         | society right now, you have people (and businesses!) marketing
         | much more harmful drugs to people of all ages with fancy ads
         | and more. Not a lot of people are reacting to that though.
        
         | [deleted]
        
       | BannedQuick wrote:
       | I am a civilization user. I do not have a racism problem.
        
       | refurb wrote:
       | Drug addiction is a continuum not a binary state of being (addict
       | or not an addict). Addiction can run from someone who uses every
       | night after work because that's how they relax (and they feel
       | like something is missing if they don't) to a person who
       | compulsively uses to the exclusion of sleep and eating. And it
       | can vary over an addicts life time.
       | 
       | The one drug that has interestingly been demonized is meth. It's
       | used as a prescription drug and was commonly used recreationally
       | in the 70's. Now it's viewed as a one way road to destitution and
       | death.
       | 
       | Drugs are illegal so the media covers the train wrecks. The users
       | who aren't train wrecks don't make the news.
       | 
       | Can you imagine if alcohol was illegal and the only stories you
       | heard about users were the people who drank themselves to death?
       | You'd assume nobody could use alcohol in moderation, which isn't
       | true.
        
       | [deleted]
        
       | f0ff wrote:
       | When you rationalize your drug habit so hard you write a book
        
       | oezi wrote:
       | Obligatory link to "Drugs without the hot air" [1] which begs to
       | differ. Heroin is terribly addictive and destructive.
       | 
       | [1] https://www.uit.co.uk/drugs-without-the-hot-air
       | 
       | https://www.amazon.com/Drugs-without-hot-air-illegal/dp/0857...
        
       | ChrisRR wrote:
       | This sounds like dangerous clickbait. It's entirely expected that
       | someone whose job it is to study the effect of drugs would have a
       | much better understanding of how to not become addicted
       | 
       | His assertion the 70% of all drug users including alcohol and
       | prescription users aren't addicted if anything seems extremely
       | low to me. I'd say the vast majority of my friends drink alcohol
       | and are more than likely on prescription drugs but I don't think
       | any of them are addicts
       | 
       | Which means that the other less common drugs must be a lot more
       | addictive to bring the number down to 70%
       | 
       | I get the point the article is trying to make, but its headline
       | and opening paragraphs frame it more as a "decriminalise all
       | drugs" article
        
         | n4r9 wrote:
         | > Which means that the other less common drugs must be a lot
         | more addictive to bring the number down to 70%
         | 
         | There's a confounding variable: the difficulty of obtaining
         | drugs vs alcohol. This causes a selection bias and means that a
         | higher proportion of heroin users are addicts than otherwise
         | would be. You can't necessarily deduce that heroin is more
         | addictive from that (although there are other ways I'm sure).
        
         | leetcrew wrote:
         | > His assertion the 70% of all drug users including alcohol and
         | prescription users aren't addicted if anything seems extremely
         | low to me. I'd say the vast majority of my friends drink
         | alcohol and are more than likely on prescription drugs but I
         | don't think any of them are addicts
         | 
         | > Which means that the other less common drugs must be a lot
         | more addictive to bring the number down to 70%
         | 
         | I don't think your sample of friends is enough to support this
         | kind of conclusion. n is small, there is likely selection bias
         | at play, and you can't have perfect knowledge of what your
         | friends do when you're not around. it's not uncommon for
         | addicts to be able to keep it together for a few hours of
         | socializing. I had a friend in college who would only have a
         | single glass of wine when he was visiting family. for a while,
         | they thought he was very responsible or just not that
         | interested in drinking. the reality was if he had more than
         | one, he wouldn't be able to stop. back at school, he got
         | plastered every day and eventually failed out and had to go to
         | rehab. addicts can be _very_ good at hiding things until they
         | hit the tipping point where their life falls apart completely.
        
         | dariusj18 wrote:
         | This is like the textbook overconfidence that addicts have.
         | They all think they have a complete understanding of their body
         | and the chemicals they use.
        
           | nobleach wrote:
           | A few years ago, right here on HackerNews, I made some
           | comment about heroin being extremely dangerous and addictive.
           | I had a gentleman with a Throwaway account come at me with a
           | "cool story bro, but I use heroin often, and I hold down a
           | high-paying job" response. Basically, he told me that I'm an
           | idiot and I should stop spreading FUD. I looked at his other
           | threads like a year later, and the poor dude, sure enough is
           | hopelessly hooked. I'm never one to say, "I told you so",
           | especially not to someone who's now in such dire
           | circumstances... but, WHY do people think that THEY are going
           | to be the one to beat the odds? If you use a horribly
           | addictive substance, don't be surprised when you
           | become...addicted! The risk/reward is just too big.
        
             | tmp-20210218 wrote:
             | probably me, although i can't remember the password to that
             | account, so you'll have to take my word for it. but yeah,
             | from a perspective of a couple years on, heroin addiction
             | is fucking terrible. i mean, heroin's nice and all, but i
             | was an idiot ;)
        
               | nobleach wrote:
               | Dude, I'm just glad to hear you're alive! Hope you're
               | doing well.
        
           | biolurker1 wrote:
           | Exactly and this spills over to gambling too. All addictions
           | are the same and people try to convince everyone that they
           | have been thinking about it wrong.
        
         | np- wrote:
         | While I do agree with your underlying point that it's likely
         | less common drugs are dangerous, I just want to say that a lot
         | of alcohol addiction and abuse is often completely hidden in
         | plain sight, due to social and cultural acceptance and the way
         | it's portrayed in media.
        
         | SamBam wrote:
         | > His assertion the 70% of all drug users including alcohol and
         | prescription users aren't addicted if anything seems extremely
         | low to me. I'd say the vast majority of my friends drink
         | alcohol and are more than likely on prescription drugs but I
         | don't think any of them are addicts
         | 
         | Actually, I'm not sure. 30% of alcohol drinkers being addicted
         | might be roughly right (though surprising to me as well).
         | 
         | In the US, 50% of Americans hardly drink at all (under 0.15
         | drinks/week). But 10% of Americans drink a staggering _75
         | drinks a week_ , or over ten drinks a day every day (where a
         | drink is a can of beer, glass of wine, or equivalent). [1]
         | 
         | Of course you can't determine from that alone whether those
         | people are clinically addicted, but it sound reasonable to me
         | that most are. Further, probably some proportion of people in
         | the other groups are also addicted, but not drinking nearly as
         | much.
         | 
         | So that's 10%, and only 50% of Americans are drinking at all,
         | so that's 20% of drinkers are drinking 10+ drinks a day, and
         | some unknown proportion have alcohol problems while drinking
         | less.
         | 
         | 1.
         | https://www.washingtonpost.com/news/wonk/wp/2014/09/25/think...
        
           | jboog wrote:
           | Jesus, I thought I drank too much but it's still hard to
           | believe 10% of Americans drink the equivalent of 10 drinks
           | EVERY DAY.
           | 
           | On my worst weeks when I think "i need to cut back" I might
           | average ~3 drinks a day, maybe 5 on a holiday bender.
        
             | slfnflctd wrote:
             | From direct personal experience totaling well over a
             | decade, 10 drinks is not hard to get to, especially for a
             | larger person. 2-3 to get things going, and 1 an hour after
             | that, for up to 7 hours. On weekends, I split it up; 3-4 in
             | the morning & before lunch, then eat/sleep, then 6-7
             | through the afternoon & evening. Beer usually seems to be
             | easier on the system than anything else, but that may vary
             | by physiology.
             | 
             | Once the habit is ingrained and you become reliant on it to
             | control your moods, 'cutting back' is a whole different
             | proposition. My triglycerides are terrible, but other than
             | that I seem to be ok, so why not just keep going? It's the
             | easiest path, inexpensive, and most importantly, a LOT less
             | hassle than dealing with the minefield of incompetence you
             | encounter when seeking mental health treatment.
             | 
             | I haven't given up completely on 'doing better'. But on the
             | other hand, maybe that's not for everybody. We only have so
             | much time here, how do we want to spend it? Stumbling over
             | ourselves in an impossible quest for imaginary perfection,
             | until we die anyway? Or enjoying ourselves the best we can
             | given the dire circumstances?
        
               | nouveaux wrote:
               | Thanks for sharing.
               | 
               | "I haven't given up completely on 'doing better'. But on
               | the other hand, maybe that's not for everybody. We only
               | have so much time here, how do we want to spend it?
               | Stumbling over ourselves in an impossible quest for
               | imaginary perfection, until we die anyway? Or enjoying
               | ourselves the best we can given the dire circumstances?"
               | 
               | I hope you do arrive at "doing better". It is likely you
               | will enjoy yourself a lot more.
        
               | svnpenn wrote:
               | I think if you're drinking before noon you have a
               | problem.
               | 
               | Some mimosa with brunch is one thing, but if you're into
               | pretty much anything else (beer, wine, liquor), you
               | should probably stop immediately and take a good hard
               | look in the mirror.
        
               | red0point wrote:
               | Consider doing _absolute_ abstinency for at least 6 weeks
               | every few years.
               | 
               | Really, not a single drink or sip.
               | 
               | That way your liver has time to heal itself again, lest
               | it will develop a cirrhosis, which will signifanctly
               | decrease your quality and expectancy of life. If you have
               | a cirrhosis of the liver, it's too late, you're going to
               | die in at most 5 years, and it won't be pleasant until
               | then, either.
               | 
               | That's got nothing to do with "doing better",
               | "perfection" or whatever, just hard facts.
        
           | ChrisRR wrote:
           | I'll admit that is an insane amount that I wasn't expecting,
           | but something about those numbers just feels off. Like 10
           | drinks a day? Many people don't even drink that much water
           | 
           | Maybe we're getting a very different view of the US from the
           | UK, but despite all of America's flaws and how weak the beer
           | is, it seems so unexpected to me that 1/10 of people are
           | opening a new drink every 90 minutes and somehow managing to
           | hold down a job to be able to afford such a habit.
        
             | [deleted]
        
             | frakkingcylons wrote:
             | To your second point, high functioning alcoholics are real.
             | The bad effects take longer to manifest, but long term
             | alcohol abuse makes up half of the 95,000 annual alcohol
             | related deaths in the US.
             | 
             | Source: https://www.cdc.gov/alcohol/features/excessive-
             | alcohol-death...
        
             | wyldfire wrote:
             | I don't have any evidence one way or the other but the tale
             | of the functioning alcohol addict is one that shows up
             | frequently in popular culture: dramatic films and novels.
             | The narrative is only advanced by a conflict that results
             | in some kind of climax resulting in redemption or doom. But
             | in real life people probably just plod on.
        
             | kemayo wrote:
             | On the subject of affording it, you don't have to spend
             | _that_ much to drink 10 drink-equivalents a day. Buying
             | low-end beer like PBR  / Bud Light / Rolling Rock can be
             | around $0.40-$0.60 per can, at which point your 10 drinks
             | of the day is costing you around what a Starbucks latte
             | does.
             | 
             | Cheap hard liquor is even more cost-effective. You can get
             | a big bottle of awful vodka for around $0.25 a "drink".
             | 
             | That is to say, you don't have to be able to hold down a
             | particularly good job to afford this.
             | 
             | I _assume_ that as you drink more your tolerance would
             | increase? As an occasional light drinker, I 'm pretty sure
             | I'd be physically incapable of getting through that much
             | alcohol in a day with enough time left to also attend a
             | job.
        
             | RandallBrown wrote:
             | Is the beer weaker in the US than the UK?
             | 
             | Most of the UK beer I've heard of is at a similar level or
             | lower to US macro brews.
        
             | 40four wrote:
             | _"... how weak the beer is "_
             | 
             | Funny, I've never heard someone take a jab at the strength
             | of American beer. I'm curious what is the ABV of a normal
             | beer you're used to in the UK? The 'commercial grade'
             | American domestics tend to be about 5% maybe 4.5%. In the
             | last decade though, 'craft'/ micro breweries have exploded
             | so it's very easy to find stronger at any bar. In almost
             | any convenience/ grocery store, there are plenty of 7%-9%
             | IPAs and the like. I'll admit I like strong beer :) A lot
             | of bars around my area will have some exotic options of 10%
             | or more. I had one recently that was 13%! That's as much as
             | a glass of wine. That being said, the large majority of
             | folks are drinking beer that's 4-5%.
             | 
             | As far as alcohol addicts go, I learned from a friend who
             | had to take some court ordered 'rehab' classes, that (at
             | least in the USA) something like 90% of all alcohol is
             | consumed by only 10% of the drinking population. That means
             | the dirty little secret they don't want you to know is
             | basically the entire alcohol industry is propped up by
             | addicts.
             | 
             | Edit: I just clicked the WaPo story you guys were talking
             | about, and that lines up with what I heard previously. Most
             | people drink very moderately, but the top 10% are the cash
             | cows for the industry.
        
               | arpinum wrote:
               | Its more a comment on how popular your light beers are,
               | and they seem to be in the low 4% range. We also say your
               | cars can't go around turns, don't take it too literally.
        
             | Nbox9 wrote:
             | It's definitely possible while holding down a job,
             | especially if you consider its 75 drinks a week, which
             | allows for heavier drinking on the weekend then during the
             | middle of the week.
        
             | DyslexicAtheist wrote:
             | > Maybe we're getting a very different view of the US from
             | the UK, but despite all of America's flaws and how weak the
             | beer is
             | 
             |  _[laughs in Belgian Trappiste at the English ales]_
             | 
             | Is beer in the US still as bad as it was 10 years ago? I
             | understood it now has a huge craft-/micro brewery scene
             | with some very drinkable APA/IPA's? Or is this just a tiny
             | fraction of the market still?
        
               | ChrisRR wrote:
               | The perception from the UK is despite what seems like a
               | growing trend in microbreweries, Americans still don't
               | venture out much further than IPAs
               | 
               | Edit: And as a lover of belgian beers I can only agree. I
               | wonder why people even drink so many IPAs when there's so
               | many different and delicious varieties of beers around.
        
               | anonAndOn wrote:
               | Because the easiest way to sell a crappy beer in the US
               | is to dump a bunch of hops in it and call it an IPA? I
               | jest there are 47 varieties of Pale Ale and 3 of
               | something else at the supermarket these days, but it's
               | not far from the truth.
        
               | pdovy wrote:
               | Good quality domestic craft beer and imports are
               | typically very easy to find in most populated areas in
               | the US in my experience. Granted I'm in a big city
               | (Chicago) but the "big box" liquor store here has a whole
               | aisle of Belgian imports, for example.
               | 
               | That said, a quick googling shows that 2/3 of the
               | American beer market is still dominated by non-craft
               | domestics (AKA your cheap, watery lagers like
               | Bud/Miller). Even amongst the craft segment it's
               | definitely the case as another commenter pointed out that
               | IPAs are overrepresented for whatever reason.
               | 
               | I think where we're still really lagging behind is
               | quality of beers at your average bar. If you know where
               | to go you can find great selection but the average bar
               | probably still has just a handful of decent non-domestic-
               | lager offerings, likely in cans/bottles. In comparison to
               | when I lived in the UK and it seemed like any corner pub
               | would have a couple great draft ales .. it's not the
               | same.
        
             | ta11a wrote:
             | I can't verify the 10%, but I can say 10 drinks a day is
             | well below what I was doing in the height of my madness.
             | That's one pint of vodka. And when I landed in a rehab
             | center, 10+ drinks a day was more common than not when
             | listening to the stories.
             | 
             | A fair amount of the 10+ drinks isn't to "feel good" or
             | "get drunk" once you're hooked. It's to stop the shaking
             | and be able to minimally function.
        
             | moron4hire wrote:
             | I don't know. A lot of my "working-class" childhood
             | acquaintances and extended family goes through at least 2
             | six-packs of Miller Light in a night.
             | 
             | Now, in the case of my particular family members, I
             | wouldn't exactly say they don't have a problem. Most of
             | them live on the edge of poverty, which would be much less
             | of a problem if they didn't drink and smoke at least a pack
             | of cigarettes a day.
             | 
             | But most of these folks who drink massive amounts of the
             | sort of beers-I-wouldn't-touch-with-a-ten-foot-pole are
             | mostly functional in society. By that, I mean, they don't
             | have a monopoly on family and money problems. Shockingly
             | few people have their shit together in the way that we talk
             | about when we talk about the dangers of addiction.
             | 
             | Like I said, I don't know. It's not very clear/cut-and-
             | dried to me.
        
             | flatiron wrote:
             | if someone drinks from 5pm-10pm one can of beer every 30
             | minutes thats 10 drinks. they could easily wake up at 7am,
             | hold down a job and rinse and repeat. a 30 rack of miller
             | light (my beer of choice) is $22 which is 73 cents a beer
             | so thats ~$7.50 a day on beer. obviously there are cheaper
             | routes (buying $10 handles of vodka for instance). so at
             | least in america, price really isn't a factor here. and
             | holding down a job most likely isn't a factor since they
             | are stone cold sober from when they wake until 5pm. i
             | assume a lot of people silently live like this sadly
        
               | bluedino wrote:
               | >> if someone drinks from 5pm-10pm one can of beer every
               | 30 minutes thats 10 drinks.
               | 
               | The bars are open until at least 2, you know.
        
               | ChrisRR wrote:
               | Even if you ignore the price and how fast drinking once
               | every half hour for 5 hours straight seems, that's 13.86
               | units of alcohol every day. So 10% of the population are
               | in a state of being permanently hungover?
               | 
               | It just seems odd that in the UK, binge drinking is
               | considered to be an issue, and yet a significant
               | percentage of the US population is drinking the
               | equivalent of a night out on a daily basis.
        
               | jessebro wrote:
               | You aren't hungover if you never stop drinking - which is
               | the point.
               | 
               | It's really, really prevalent in some industries. I've
               | hired concrete finishers before (multiple times), and
               | I've never NOT had a bunch of empty cans crushed up and
               | hidden somewhere random on the worksite afterwords, even
               | if it's only for a couple hours. When I worked with some
               | writers years ago, they kept bottles of cheap scotch and
               | 2 buck chuck in their desks, and had to replenish them
               | regularly.
               | 
               | The go to drug selection in tech skews our perception a
               | bit (weed being incredibly pervasive, but
               | lsd,shrooms,stimulatns far from absent).
        
               | emteycz wrote:
               | Don't forget about the amphetamines and cocaine... I
               | actually think more than half of people in tech take
               | something regularly
        
               | mod wrote:
               | I own a bar so I figured I'd chime in with some personal
               | observations of my customers:
               | 
               | The bulk of my customers drink 5-7 nights per week. We
               | call them "regulars." They come every night when their
               | shift ends, and most of them stay until close (although
               | they are primarily service industry, so this is 5-7 hours
               | per day). If they have a day off, they often show up
               | earlier.
               | 
               | For these people, I think that one drink every half hour
               | is an understatement. They're having a beer/cocktail
               | every half hour or so, and mixing in shots, jello shots,
               | etc. If they have limited time, they will up their rate
               | of consumption. They're after a specific result.
               | 
               | I have no idea what percentage of the population they
               | represent.
               | 
               | We have a lot of other customers who we see maybe once a
               | week, every other week. Some folks come in to eat our
               | food special and just have a couple beers and go. Stuff
               | like that.
               | 
               | I think that you are probably in the latter group (or the
               | non-drinking group) and so you don't see the former
               | group. I very much agree that the heavy drinkers are not
               | living normal lives; they ARE in fact permanently
               | hungover (or should be--they learn to deal with it in
               | various ways). It's a continuing problem with my own
               | staff, actually.
               | 
               | Anyway, they're out there, they're holding jobs and
               | making children, and they undeniably have a problem with
               | alcohol. But again, I have no idea what percentage of the
               | population they make up. Maybe I'm seeing the worst of
               | the problems--but I don't actually believe that.
        
               | jboog wrote:
               | When you're a high-functioning alcohol like we're talking
               | you get to the point you can down a 12 pack of beer in a
               | night and feel relatively fine the next morning. Maybe a
               | slight headache or mild hangover but nothing like the
               | bender hangovers non-alcoholics have where they are
               | bedridden most of the day.
               | 
               | I've since cut back a lot but in my worst post-college
               | days I could drink the equivalent of 8-10 drinks in a
               | night and feel perfectly fine the next morning as long as
               | I got a decent amount of sleep.
        
               | [deleted]
        
               | lisper wrote:
               | I was a teetotaler until my late 20s when I decided to
               | try to develop a taste for wine for social reasons. Fast-
               | forward 30 years and today my wife and I have a cocktail
               | and a glass of wine most nights. That sounds like two
               | drinks, but one day I started measuring how much alcohol
               | I was actually putting in to the cocktails and they
               | turned out to be triples. So technically we're having 4
               | drinks a day. We get a slight buzz, but never feel
               | impaired, never drink before dinner time, and never have
               | hangovers. When we travel we will often go a few days
               | without drinking at all and it's no problem. A few years
               | ago I bought a blood-alcohol meter and have never
               | registered above the legal limit, even immediately when I
               | feel buzzed. The highest I've ever registered is 0.04.
               | And over the years I've used three difference BAC meters
               | with consistent results.
               | 
               | I think the conclusion to draw here is not that having
               | 4-5 drinks a day is no big deal, but that different
               | people react to alcohol and other drugs differently. For
               | some people, like me, it turns out to be no big deal. For
               | others I'm pretty sure it would be a very big deal. A
               | one-size-fits-all drug policy is never going to work.
        
               | biolurker1 wrote:
               | It's very well established that over two drink increase
               | multiple cancer rates, just keep that in mind.
        
               | n4r9 wrote:
               | It's been estimated that during the "Gin Craze" of the
               | early 18th Century, the average Londoner was drinking a
               | pint of (strong) gin every three days.
               | 
               | the-east-end.co.uk/the-gin-craze
        
               | [deleted]
        
             | n4r9 wrote:
             | I'm also in the UK but I wouldn't be at all surprised if a
             | lot of people's liquid intake is more from alcoholic drinks
             | than non-alcoholic ones.
             | 
             | I'm thinking of the office worker who might have a glass of
             | orange juice, 2-3 cups of tea/coffee, then 2 pints after
             | work most days.
        
       | frakkingcylons wrote:
       | So many comments in this thread are misconstruing Hart's
       | arguments. He's not being open about his drug use in order to
       | encourage everyone else to start using opiates and amphetamines
       | willy-nilly. We can't just keep applying the same Reagan-era drug
       | prohibition policies and expect anything to change.
       | 
       | People are never going to stop using these drugs, so we should
       | take steps to make their use safer. Thanks to widespread
       | education, most people know the basics about how to drink safely
       | (e.g. don't drink and then take NSAIDs). Because alcohol is sold
       | legally, nobody has to worry about going blind or dying from
       | moonshine. We should be applying the same principles to drugs
       | like opioids. You should be able to buy them in precise dosages
       | and know that they're not contaminated with something way too
       | strong like fentanyl. People should be educated about unsafe drug
       | combinations, which is the other major cause of overdoses.
        
         | mdoms wrote:
         | > He's not being open about his drug use in order to encourage
         | everyone else to start using opiates and amphetamines willy-
         | nilly.
         | 
         | It doesn't matter if that's why he's doing it - that's still
         | the effect.
        
       | hapless wrote:
       | "I am a heroin user. I suffer from delusions."
        
       | CyberRabbi wrote:
       | Can we ban "nautilus" from HN? This blog post is both clickbait
       | and the post itself is deceptive and harmful to the general
       | public. This is not the first time either.
        
       | dionian wrote:
       | I'm very worried about heroin addiction, but I am also worried
       | about a pro-censorship culture. Reading the comments here, I see
       | a lot of people worried about this 'dangerous' information. I
       | think this kind of opinion is potentially dangerous, but I am
       | very glad we are able to have it aired in public and discuss it
       | rationally.
        
       | Stronico wrote:
       | The book Never Enough by Judith Grisel is a good addition this
       | field, and probably this book.
       | 
       | Short version - your body longs to be at equilibrium/homeostasis
       | and drugs (alcohol, stimulants, opiates, etc) upset that
       | equilibrium, so your body attempts to return you to your previous
       | state.
       | 
       | There is no free lunch, and a high will be accompanied by a low.
       | The lows come in numerous and surprising forms.
       | 
       | The book is significantly better than my description.
        
       | mothsonasloth wrote:
       | This is postmodernism 101, "there is no objective truth, we are
       | shackled by subjectivity"
       | 
       | This is dangerous!
        
       | Out_of_Characte wrote:
       | "If you're not wearing a mask, when we have this highly
       | communicable disease, then you're potentially impacting the
       | rights of other people."
       | 
       | The same argument could be made for heroin. The point is that
       | 'not wearing a mask' does not endanger someone's life in any way
       | unless someone is infected with covid. yet the author suggests
       | that not wearing a mask is "potentially impacting the rights of
       | other people" Then surely the same argument could be made for
       | people using heroin, you're not endangering anyones life by using
       | heroin unless you're causing drug-related crimes. Which is the
       | exact argument the government used to declare war on drugs. This
       | is quite a contradiction by equavalency.
       | 
       | The rest of the article is reasonable. I dont think he has said
       | anything that fell outside the mainstream medical and
       | psychological view.
        
         | didibus wrote:
         | > you're not endangering anyones life by using heroin unless
         | you're causing drug-related crimes
         | 
         | Are you saying heroin causes people to commit crime?
         | 
         | > This is quite a contradiction by equavalency.
         | 
         | I thought he meant it similarly. We created the war on drugs
         | from this logic, yet do not have a war on people not wearing
         | masks.
         | 
         | You're right in that mask wearing is a tricky situation, and I
         | think so is hard drug usage. He brushed that off maybe a little
         | too quickly.
         | 
         | I think smoking and covid masks are a better equivalence.
         | Second hand smoking can cause you to maybe affect others, so
         | areas where you are allowed to smoke were restricted. I see
         | masks in a similar fashion.
        
       | coldtea wrote:
       | Well, needing to use a drug is already a drug problem (addiction
       | or not).
        
         | emsy wrote:
         | Do insulin users have a drug problem? I think at the core of
         | the issue is that our society generally regards psychological
         | ailments as a personal flaw, rather than a health issue. (I'm
         | talking generally, not about the professor from the article)
        
           | gdsdfe wrote:
           | insulin doesn't make you suck dick in an alley to get a fix
        
             | [deleted]
        
           | ChrisRR wrote:
           | That's a false equivalence and you know it. Insulin is not a
           | recreational drug
           | 
           | This article is very clearly about recreational drug use
        
             | emsy wrote:
             | I was not talking about recreational drug use. Please read
             | my full comment before replying.
        
           | Solid_Applaud wrote:
           | Yes, they do for the most part. Most insulin users are T2DM,
           | and a large portion of these are able to get off of it over
           | time.
           | 
           | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5357144/
        
           | pessimizer wrote:
           | Even worse, I think it's treated as a modern version of
           | demonic possession, where the cure killing the patient isn't
           | considered enough of a reason not to deliver the cure.
        
           | coldtea wrote:
           | > _Do insulin users have a drug problem?_
           | 
           | Insulin users don't just need to have insulin for the sake of
           | it. They have a medical issue that forces them to take it.
           | 
           | > _I think at the core of the issue is that our society
           | generally regards psychological ailments as a personal flaw,
           | rather than a health issue_
           | 
           | I think that our society tends to do the inverse: tends to
           | see all kinds of personal flaws as issues beyond the control
           | of the person.
        
           | DanBC wrote:
           | > Do insulin users have a drug problem?
           | 
           | How many insulin users lose their jobs, lose their homes,
           | turn to acquisitive crime or prostitution to fund their
           | insulin habit?
           | 
           | We can talk about how many people who use heroin this happens
           | to, and how much it's caused by current drug prohibition
           | laws, but it's more than zero.
           | 
           | Decriminalisation makes a lot of sense but we need to be
           | realistic about the harm caused to about 10% of people who
           | become addicts.
        
             | JumpCrisscross wrote:
             | > _How many insulin users lose their jobs, lose their
             | homes, turn to acquisitive crime or prostitution to fund
             | their insulin habit?_
             | 
             | It's _really_ difficult to disentangle this from the
             | illegality of the drug.
        
             | werber wrote:
             | Unfortunately, insulin users in the United States are
             | sometimes forced to turn to more nefarious means of getting
             | money to support their body from dying. I've known 2 people
             | who died that were unisured and broke who died from not
             | being able to support their dependency on it. Universal
             | Healthcare should cover those dependent on Insulin and
             | Heroin
        
         | adrr wrote:
         | Drugs have a pleasure effect on the brain. Food does too. So do
         | experiences or playing sports. Winning a sports game feels
         | exactly the same as doing cocaine. Issue with drugs is the
         | risk. Risk of damage to your body or your mind. But the other
         | activities have associated risk. For example, I ski and
         | including back country. I risk avalanches and injury. I've
         | broken a rib and have countless other injuries. I have friends
         | with permanent injuries and have seen deaths on the ski slope.
         | No one says skiing is a national problem.
        
       | slk500 wrote:
       | Guy is regular heroin user a he is trying to prove that drugs are
       | ok. Who's paying for this bullshit research?
        
       | balozi wrote:
       | Your mind is playing tricks on you, my dear. The biggest problem
       | in addiction is the rationalization.
        
       | king_panic wrote:
       | Addiction engenders unresolved trauma. Can be drugs, shopping,
       | sex, internet, or anything that gives you a temporary sense of
       | relief from a deep underlying pain that usually forms in
       | childhood.
       | 
       | Check out the work of Gabor Mate. It's silly how simple it is.
       | It's silly how misunderstood it is.
        
       | drewmassey wrote:
       | Oh man I've seen Hart making the rounds. The obvious privilege of
       | being a tenured Ivy League professor aside, a few things jump out
       | 
       | - Yes it would be nice if drugs were decriminalized ... but they
       | aren't ... and the supply chain for heroin causes a lot of
       | suffering in the world.
       | 
       | - Shrugging and leading with "only 30% of people have addictions"
       | is astoundingly innumerate. If there were a 30% chance of a
       | potentially fatal outcome in almost any other context it would be
       | a big deal.
        
         | mrwh wrote:
         | Yes, this. If 1% of airline passengers died we would ground all
         | planes immediately. 30% is awful.
        
       | say_it_as_it_is wrote:
       | Your brain is physically changed the first time you use heroin.
       | There's no going back to normal. There was the person who you
       | were before heroin and the person who you are after using heroin.
       | If you manage to quit heroin, ten years after kicking your heroin
       | habit, you're still thinking about heroin. Twenty years later,
       | you're still thinking about heroin. You never stop thinking about
       | heroin until you die. Every painful event in your life triggers
       | the impulse to reach for the heroin, just as you did the first
       | time. You get to collect sobriety tokens and tell strangers how
       | you've been living life on the straight and narrow. The only
       | redemption you may find is by helping other people cope with
       | addiction. Heroin addiction isn't overcome. You learn how to live
       | with it.
        
         | yboris wrote:
         | Your brain is physically changed the first time you try a
         | strawberry. There is no going back to normal. There was the
         | person who you were before you tried a strawberry and the
         | person who you are after you tried a strawberry. If you manage
         | to never eat another strawberry, ten years later you're still
         | thinking about what a tasty berry it was. You will fondly
         | remember that taste until you die ...
        
           | say_it_as_it_is wrote:
           | I need to know where you get your strawberries, for a friend.
        
             | yboris wrote:
             | I just think it's a nice parallel. Drugs are experiences.
             | Visiting Paris, or visiting a visually-inventive part of
             | your mind while on LSD - from a certain perspective, these
             | are the same thing.
             | 
             | The claim that a drug changes your brain forever is
             | trivially true - it is literally true of strawberries. Once
             | you've had the taste, you'll likely remember the experience
             | of tasting it (and if you're not too young, you might
             | remember the place and people that were there during your
             | first bite).
             | 
             | For all the hysteria about the harms of drugs, we seldom
             | hear a level-headed point of view about the possibility of
             | them being a(nother) wonderful aspect of life.
        
       | bigwheeler wrote:
       | Weird that he claims to be a heroin user. Anyone that would write
       | this and publish it to the world comes off more like a crackhead
       | to me.
        
       | Zenst wrote:
       | Whilst I'm sure there are many functional `users` of heroin,
       | there are many more who think they are functional and yet they
       | are not and just don't see it themselves. I've lived near many
       | heroin `users` and I will say that the biggest issue is that if
       | they can lie about their habits to themselves, then others are a
       | given. Equally, whilst they may not see their usage of as a
       | problem, they neglect to see the impact upon others - be that
       | antisocial noise, keeping odd hours so again, noise or shady
       | dealer meetings in the streets that scare the parents across the
       | road to not allow their kids to play out in the park near there.
       | That's just the good part of the spectrum. Then you have those
       | who buy on-line and feel like their not supporting criminal
       | activities, well until heroin comes with a fair trade logo, or
       | you know the farmer, producer and workers personally - it's easy
       | to say you don't have a problem and yet create problems for
       | others when you look at the bigger picture.
       | 
       | As for knowing any functional, well I've seen many have
       | functional phases would be the best I could attest to that from
       | experience and out of about 30 heroin addicts I've endured in the
       | past 2 decades, I'd say only 2 would be close to being classed as
       | functional.
       | 
       | Really gets down to if somebody who is using drugs can just stop
       | and take a break every now and then, then in that clean period -
       | still hold the same mentalities towards their usage and if they
       | can come to the same conclusion - bravo as that is what I would
       | call somebody with their head working well for them.
       | 
       | What really is the issue for many drug users is the point in
       | which the drugs use them - that's the turning point of addiction
       | I'd say.
       | 
       | Yet all that said, you can't help but accept that the brain is
       | driven by chemical stimulus and there lays the hard barrier of
       | having the will power to quite.
       | 
       | I've personally never done heroin, no desire too as like a fine
       | wine, I might like it and it is easier to miss what you never had
       | and one step I've become very mindful never to take having
       | learned from others, many who's lifestyle choices I had thrust
       | upon me and I will say, not best neibours to have from my
       | numerous experiences.
        
         | peteretep wrote:
         | Hot take: anyone writing articles about how they're sensibly
         | using heroin is an addict in denial
        
           | leetcrew wrote:
           | not really a hot take, this is more or less the mainstream
           | opinion. it's also unfalsifiable. you can take anyone who
           | chimes in to say they use heroin responsibly as more evidence
           | for your claim.
           | 
           | personally I lean more in the direction that heroin and
           | friends are significantly more addictive than most other
           | drugs. but I have to say, if there were a sizable group of
           | recreational users, they would probably know better than to
           | ever say anything about it in public.
        
             | Zenst wrote:
             | > personally I lean more in the direction that heroin and
             | friends are significantly more addictive than most other
             | drugs. but I have to say, if there were a sizeable group of
             | recreational users, they would probably know better than to
             | ever say anything about it in public.
             | 
             | Without a doubt, how else do they get introduced/exposed to
             | such temptations otherwise.
             | 
             | Pattern that usually follows is, cocaine, then onto doing
             | crack as suddenly in their mind it's cheaper better high or
             | other mental juggling to avoid having a break and carry on
             | chasing that next level of high, building tolerance all the
             | time. Then the comedowns, well whilst the highs may not
             | seem as good and cost more to reach that level the
             | downsides are less easier to adjust tolerance wise. So you
             | find that chasing a line of heroin solves all that nasty
             | crack come down and once in a while, you won't get hooked,
             | after all you are able to do all that crack and your
             | mentally strong and other decisions made whilst completely
             | out of it on crack cocaine. So you make that leap, the odd
             | bit becomes more and year on and your addicted. Coz prices
             | and that, not long before your after that next level, so
             | injecting for many becomes a hurdle that gets lower and
             | more appealing and justified in crossing. You will just do
             | it the once, case of only way to solve your needs as not
             | enough to chase and sort the cramps. I've seen all this
             | play out many times, heck even audio surveillance from
             | chasing to shooting up to introducing new recruits into
             | junkie club, via crack and then heroin. After all,
             | opportunity to sort somebody out and charge them extra for
             | sorting it, kickback from dealer and chance to share a hit
             | - addiction makes people greedy and that greed plays out in
             | doing what's best for them, if others freely bit that
             | apple, they will certainly not stop them that hard. After
             | all, how they themselves started doing drugs. Seen it play
             | out just too many times and from start to coffin too many
             | times and shocking how much goes on, ignored as society as
             | a whole class the addicts as the victims and the dealers as
             | the baddies in a clear cut way when I can attest that the
             | lines are very blurred indeed.
        
       | umvi wrote:
       | > "My heroin use is as rational as my alcohol use"
       | 
       | What an incredibly dangerous idea to promote. Do not mess with
       | opioids. You think you are in control, until you are not.
        
         | lostgame wrote:
         | Ugh. Come on. Be part of the solution, not the problem. We
         | should be promoting _safe use and harm reduction education_ ,
         | not these bullshit blanket statements such as 'do not mess with
         | opioids'/'say no to drugs', and stop using them quick.
         | 
         | Otherwise the people who inevitably will/do use, only hear and
         | have only heard, 'don't do it to start' or get ostracized
         | instead of getting the help they need or the education they
         | need to know when they are overdoing it or not in control any
         | more.
         | 
         | We also need more clinics and support for safely quitting or
         | managing drugs and tools for it similar to what we have for
         | tobacco.
         | 
         | Shamefully, here in Canada, some of these clinics in Vancouver
         | are getting _shut down_ , rather than more of them popping up,
         | during the worst opioid crisis this country has ever seen.
         | 
         | These closures are a direct result of a 'don't ever do/touch
         | drugs' policy and the stigma and ostracization that come with
         | it.
         | 
         | Speaking from experience...education is better than 'don't'. I
         | have had friends who have died from using drugs, and I have
         | many, many friends who are regular users but not abusers - pull
         | an insane variety of different full-time jobs. (And well!)
         | 
         | The huge difference between these two groups of people for me
         | is education (for instance, preexisting mental health
         | conditions that would be made worse by a particular substance
         | and the knowledge to avoid it), and having a support system,
         | etc..
         | 
         | It is fascinating and inspiring that someone has chosen to put
         | themselves in the very vulnerable position of coming out about
         | their personal use, and I believe the intention is to help
         | remove the stigma around drug use, so education can be
         | bettered. :)
         | 
         | Edit: Maybe better to say 'Drugs can be extremely harmful and
         | addictive. If you choose to use them, please be sure you are
         | educated, safe, and have someone nearby.'
         | 
         | In fact, that doesn't seem dissimilar to the surgeon general
         | warnings on cigarette packs, anyway.
         | 
         | What kind of warning labels will we see on cocaine, heroin, etc
         | - in countries where its sale will inevitably be legalized?
         | These are the kinds of statements we should be making rather
         | than 'just stay away from opioids.'
        
           | omginternets wrote:
           | >We should be promoting safe use and harm reduction education
           | 
           | Right, but this is harm- _denial_.
        
           | umvi wrote:
           | > We should be promoting safe use and harm reduction
           | education
           | 
           |  _for existing users_. We should not tempt people who would
           | have otherwise never used them with false fantasies that they
           | will be able to dabble and remain in control without getting
           | addicted
        
           | [deleted]
        
         | balozi wrote:
         | Alcohol is not any better.
        
           | whatshisface wrote:
           | Metaphysically maybe but physically, not really.
        
             | ajkdhcb2 wrote:
             | Alcohol literally destroys your brain and gives you
             | dementia. It is objectively more physically damaging than
             | opiate usage.
        
               | omginternets wrote:
               | This is dose-dependent. You're comparing alcohol _abuse_
               | to heroine _use_. That 's not a fair comparison.
               | 
               | You should also examine the proportion of heroin "users"
               | who become abusers. You should then do the same
               | comparison for alcohol use.
               | 
               | I'm willing to entertain the notion that the risks of
               | heroin are overblown. I'm even willing to believe it.
               | What seems entirely _unsupported_ by evidence is the
               | notion that alcohol and heroin are in remotely the same
               | league.
        
               | ajkdhcb2 wrote:
               | Look at the data on those who have chronic pain: they are
               | prescribed opiates at high dosages daily (equivalent to
               | extreme abuse), and doctors think this is acceptable.
               | Heroin is essentially just an opiate. They do not show
               | effects as bad as life-long alcohol users, nor obviously
               | abusers. A lot of socially acceptable alcohol use would
               | be called abuse if society was fair about it.
        
               | omginternets wrote:
               | >they are prescribed opiates at high dosages daily
               | (equivalent to extreme abuse), and doctors think this is
               | acceptable
               | 
               | That's an orthogonal concern. That being said, I don't
               | understand your reasoning.
               | 
               | Firstly, this _is_ opioid abuse. Granted, the
               | responsibility for this abuse falls on the prescriber
               | rather than the user, but it is nevertheless a
               | pathological pattern of use.
               | 
               | Secondly, you've substituted "heroin" for
               | "pharmaceutical-grade opiates" in your argument. The
               | irony is that this supports my position more than yours
               | because it demonstrates that the slope is particularly
               | slippery, even with _medical-grade_ opioids. This point
               | bears repeating: the addictive and toxicological
               | potential of opioid _medicine_ is greater than alcohol.
               | The trend is even less in your favor when we return to
               | the topic at hand: _heroin_.
               | 
               | I share your concern about opioid-based medication, but
               | this argues against your point.
        
               | ajkdhcb2 wrote:
               | You didnt say anything at all in this comment about
               | physical consequences, so I am lost in the discussion.
               | 
               | Doctors are rationally ok with such prescriptions because
               | the effects are not as bad as alcohol.
               | 
               | Simply put: opiate abusers and users don't need liver
               | transplants or get such severe brain damage; alcohol is
               | more damaging in a myriad of ways for both uses and
               | abusers. There is plenty of data supporting this, and it
               | is valid to use data regarding medical grade opiates.
               | 
               | The risks of heroin are almost entirely side-effects of
               | the war on drugs rather than the drug itself.
        
           | omginternets wrote:
           | Good grief, yes it is.
           | 
           | It's not nearly as addictive. It's not nearly as deadly. It's
           | much easier to control dosage. It has modes of consumption
           | that are non-pathological.
           | 
           | This is typical of the distorted anglo-saxon view of alcohol
           | as a tool for getting flat-out drunk. This is not how most of
           | the world relates to alcohol, nor is it a healthy
           | relationship with it.
           | 
           | Honestly, this says more about you than about booze.
        
             | Uberphallus wrote:
             | > It's not nearly as addictive.
             | 
             | Strangely I know more ex-heroin addicts than ex-alcoholics,
             | and there are way more alcoholics out there, but that's
             | just anecdotal data I guess :)
             | 
             | > It's not nearly as deadly.
             | 
             | Maybe if you leave out all of the DUI and accidents where
             | alcohol played a role, you'd be right, but overall alcohol
             | causes way more damage than heroin. While David Nutt ranked
             | heroin as more addictive than alcohol, overall he found
             | alcohol more harmful.[0] Precisely because even though it
             | doesn't harm one as much as heroin, it's way more likely
             | that you harm others with alcohol.
             | 
             | > It's much easier to control dosage.
             | 
             | Actually no. Lots of things affect gastrointestinal
             | absorption of alcohol. Just compare a few shots on empty
             | stomach vs after a meal. Also don't get me started with the
             | absurdly long and not always obvious list of drug
             | interactions that alcohol has.
             | 
             | Heroin, assuming known purity, will work roughly the same,
             | either snorted, smoked or injected. If you make a point
             | about its purity, that's a consequence of its legal status.
             | Most, if not all of the interactions are self-evident
             | (other CNS depressants).
             | 
             | > It has modes of consumption that are non-pathological.
             | 
             | I guess you have preconceptions about what heroin use
             | implies. How is unwinding after work a pathological use of
             | heroin vs whiskey?
             | 
             | > Honestly, this says more about you than about booze.
             | 
             | Ah, ad hominem to finish, a classic.
             | 
             | [0] https://www.bbc.com/news/uk-11660210
        
               | omginternets wrote:
               | >Strangely I know more ex-heroin addicts than ex-
               | alcoholics, and there are way more alcoholics out there,
               | but that's just anecdotal data I guess :)
               | 
               | Indeed it is! You conveniently ignore all alcohol
               | consumers _except_ the ones with dependency problems.
               | 
               | >Actually no.
               | 
               | Actually, yes! You're arguing that there is variance in
               | absorbtion, and you are right. That is different,
               | however, from e.g. the LD50 or the ability of people to
               | measure dosage accurately.
               | 
               | >I guess you have preconceptions about what heroin use
               | implies.
               | 
               | You're conveniently ignoring that non-pathological use of
               | heroin is extremely small. It's a rounding error when
               | compared to alcohol usage. You are cherry-picking.
               | 
               | > Strangely I know more ex-heroin addicts than ex-
               | alcoholics, and there are way more alcoholics out there,
               | but that's just anecdotal data I guess :)
               | 
               | Good thing this has been formally studied
               | 
               | >Maybe if you leave out all of the DUI and accidents
               | where alcohol played a role, you'd be right [...]
               | 
               | Yes, and people with pools in their back-yards experience
               | more drowning. Color me surprised.
               | 
               | You're also leaving out all the incidental damage from
               | heroin use in your analysis. Shall we factor in drug-
               | related murders? How about secondary complications like
               | pneumonia?
               | 
               | Again, cherry-picking.
               | 
               | >Ah, ad hominem to finish, a classic.
               | 
               | An observation, actually. I've rarely seen this level of
               | bad-faith argumentation.
        
               | Uberphallus wrote:
               | > Indeed it is! You conveniently ignore all alcohol
               | consumers except the ones with dependency problems.
               | 
               | Actually a significant part of alcohol users have
               | dependency problems, roughly 10% as someone already
               | mentioned.
               | 
               | > Actually, yes! You're arguing that there is variance in
               | absorbtion, and you are right. That is different,
               | however, from e.g. the LD50 or the ability of people to
               | measure dosage accurately.
               | 
               | So... no? Unless you ignore all that I said, that is.
               | Active to LD50 ratio for alcohol it's 0.1, for heroin
               | it's 0.17, in the same ballpark. When you factor in the
               | variability of oral administration, alcohol is way more
               | dangerous. Most overdoses in heroin are due to fentanyl
               | or changes in purity; in case of alcohol it's due to
               | wanting to get drunk fast, and doing it too fast (plus
               | interactions).
               | 
               | > You're also leaving out all the incidental damage from
               | heroin use in your analysis.
               | 
               | There is a lot of it, it's just that alcohol is bigger.
               | People on heroin don't usually go driving or picking up
               | fights, they're usually just lying on the couch.
               | 
               | > Shall we factor in drug-related murders?
               | 
               | I wouldn't factor anything external to the use/abuse of
               | the substance, like its legal status. It'd be interesting
               | to compare them with roughly 25% of vehicle deaths that
               | can be attributed to alcohol.
               | 
               | > How about secondary complications like pneumonia?
               | 
               | Which was already accounted for in Nutt's analysis.
               | 
               | > An observation, actually. I've rarely seen this level
               | of bad-faith argumentation.
               | 
               | I could say the same, it feels like you have a horse in
               | this race, pun intended.
        
           | vmchale wrote:
           | It's less addictive.
        
       | JoelMcCracken wrote:
       | I read this a few hours ago and didn't decide to comment then.
       | But I just have to.
       | 
       | I just lost my brother-in-law to heroin overdose. He overdosed
       | because he went into rehab, came out, and then used far more than
       | his body could tolerate. This is unfortunately common. Not
       | because he mixed it with alcohol or antihistamines or whatever.
       | 
       | Overall, his entire life has been extremely tragic. He was a good
       | guy at heart. He was a hard worker and did good work in general.
       | 
       | However, he did did A LOT of crazy things. He was the poster
       | child for "your emotional development stops at the point you got
       | addicted to heroin". He basically acted like a troubled 13 yr old
       | in a 40 yr old's body. This craziness has caused a LOT of
       | problems over the years, especially for his daughters.
       | 
       | I get that the popular notions of drug use are wrong, but when is
       | that _not_ true of anything? Drug use does itself cause a lot of
       | problems. While some people may be able to use them without any
       | issues, many cannot.
       | 
       | The way a lot of this is phrased, it makes it sound like drugs
       | are fine and there is a conspiracy to demonize them. While the
       | popular notion of them isn't perfectly balanced, it is not the
       | case that they are just fine for people to use.
        
         | ewokone wrote:
         | Same here.
         | 
         | This article is way out on facts. This guy should better read
         | some science based books like the of Gabor Mate, 'in the realm
         | of hungry ghosts'. Inside this books it is well explained in
         | detail, if drugs create addictions, why humans take drugs, what
         | happens to the brain on drugs, what happens in long term usage
         | and what somehow all users share in common, from their
         | emotional journey. Its about getting love, feeling seen,
         | feeling rewarded, ..from friends, next one's and society itself
         | or more often, in the search for rest from trauma and
         | depression....
         | 
         | Damn nautilus this article was reputation hurting.
        
         | moreranchplease wrote:
         | The fact that they're illegal and you don't know the dose is
         | why this happens though.
        
           | sandworm101 wrote:
           | No. It is very simple, even common, to know exactly what the
           | dose is and still OD. Look at any prescription opioid. The
           | labels on those bottles are very accurate. People still OD
           | and die.
        
             | frakkingcylons wrote:
             | The circumstances of the overdose are important though.
             | Many of them occur because the victim consumed it with
             | another respiratory depressant like alcohol.
        
               | sandworm101 wrote:
               | Exactly. The level at which one might "OD" fluctuates. So
               | even if you know the dose, you can be wrong about your
               | ability to handle it.
        
             | s1artibartfast wrote:
             | What do you mean by common and what would you wager the
             | ratio is between dosing errors and unintentional OD with
             | known doses? 1:10? 1:10,000?
        
           | unishark wrote:
           | One explanation I've read is that heavy addicts build up such
           | a tolerance that they need dangerously high doses in the
           | first place. If they quit for awhile like in this story,
           | their tolerance drops and what they could previously handle
           | now kills them.
        
         | aphextron wrote:
         | More lives have been destroyed by alcohol than have ever even
         | tried heroin. What you are describing sounds no different than
         | an alcoholic. The whole point of this article, and Dr. Hart's
         | research in general, is that it's not ok to demonize some drugs
         | over others just because they are culturally accepted.
         | Addiction is addiction, and there's zero evidence to support
         | the fact that heroin is any more addictive or dangerous than
         | alcohol.
        
           | zigh wrote:
           | You will not be able to say this if heroin is as accessible
           | as alcohol. It's easy to test objectively which one is more
           | addictive.
        
         | happy-go-lucky wrote:
         | My hypothesis is that there is always a thin line between
         | drug/substance abuse and doing them in moderation.
         | 
         | > The way a lot of this is phrased, it makes it sound like
         | drugs are fine and there is a conspiracy to demonize them.
         | 
         | Those who cry foul at the imagined conspiracies may already be
         | deep in the throes of an addiction.
        
           | chordalkeyboard wrote:
           | I agree that "conspiracy" is loaded and inappropriate in this
           | context. But the GP is referencing a social phenomenon that
           | exists: https://archive.org/details/ceremonialchemist00szas
        
         | pcthrowaway wrote:
         | I'm sorry to hear about your brother-in-law. I've met many
         | people who have had similar issues with alcohol. And yet,
         | myself and many people are also able to use it in balance, in a
         | way that contributes positively to our well-being.
        
         | fossuser wrote:
         | Yeah, the piece reads like a rationalization by a drug user
         | still in the early stages of a problem.
         | 
         | We'll see how things turn out in the end (maybe I'm wrong), but
         | I'm pretty skeptical of a positive outcome.
        
           | bsder wrote:
           | Yeah, I tend to place a lot more stock in the vast legions of
           | musicians who can't agree on anything but are almost
           | unanimous in "Look, just don't do heroin. _Any_ drug but
           | that. "
        
           | sibeliuss wrote:
           | The fact that he started only 5 years ago is a conspicuous
           | detail -- I keep googling trying to find _why_ he started in
           | the first place, but haven 't found that question asked.
           | There seems to be some shadow material expressing itself in
           | the form of a book.
           | 
           | I know my own problems, way back when, really got going at
           | around the 5 year mark, and turned from weekend fun to every
           | day need. If I hadn't have met my partner who helped pull me
           | out I'm not sure where I would be right now. Knowing what I
           | know from personal experience, this book seems reckless to
           | me.
        
           | cambaceres wrote:
           | Don't take this wrong, but I'm pretty skeptical of a positive
           | outcome of your life too. We all die in the end.
        
             | Cerium wrote:
             | Snarky comments generally get down-voted. I would like to
             | take a look at your point though. Is death the outcome of
             | life? I don't buy a computer to wait for it to break, even
             | though that is the inevitable outcome. The meaning of life
             | is not to have an opportunity to die.
        
               | iamacyborg wrote:
               | I guess that would depend on whether you believe there's
               | a meaning to life in the first place.
        
               | emteycz wrote:
               | Why do you need meaning? Have fun!
        
           | pvitz wrote:
           | Agree! When he said that he meets his parental, personal
           | [...] responsibilities, I thought I would like to hear if his
           | partner and his children think the same. Maybe everything is
           | really fine, but more often, the drug user doesn't realize
           | how his (ab-)use affects his closest environment.
        
       | undecisive wrote:
       | Reminds me of a quote from Love Actually:
       | 
       | > Hiya kids. Here is an important message from your Uncle Bill.
       | Don't buy drugs. Become a pop star, and they give you them for
       | free.
       | 
       | ... except in this case the message is don't do drugs kids, but
       | "grown ups" should (as defined as a state of maturity where you
       | know how the drugs behave, know your limits and can balance your
       | experimentation with fulfilling your societal obligations)
       | 
       | I see this as a bit like speeding. The government sets fairly
       | arbitrary speed limits for different types of road. They do it
       | based on what they think the majority of people can cope with,
       | versus the likelihood of risks, vs the need to get from A to B in
       | a reasonable amount of time. The government hasn't been amazingly
       | scientific about the speed limits, and don't take into account
       | time of day, traffic, weather conditions etc. A healthy, fully-
       | alert person can probably go at 150% of the speed limit on an
       | ambient clear day on an empty road - and do so perfectly safely.
       | But that isn't the message they give people, because it would be
       | impossible to assess person-by-person, minute-by-minute.
       | 
       | And yet, some would consider the above information to be
       | recklessly given, because some people will on read "go at 150% of
       | the speed limit... perfectly safely" and take that as my advice.
       | 
       | So the question is, should it be legal to travel at any speed,
       | provided you feel like you're doing a good job of it? In both
       | cases, misjudgement can be disastrous for yourself and the people
       | around you (and innocent bystanders too)
       | 
       | And when you are talking about something that can alter your
       | perceptions, you would surely need a non-drug-taking associate
       | with you at all times who could give you an honest blow-by-blow
       | assessment of where you are dropping the ball as a "normal" human
       | being, and where your drug-fuelled failings are happening?
       | 
       | When the potential downsides so vastly outweigh the benefits, I
       | can understand why laws take the side they do. That said, I
       | absolutely do think that there are massive downsides to making
       | drugs illegal when taken responsibly. Countries should be
       | realistic about what they can and can't do. If they can't
       | eradicate drug use - and most countries can't - they need to put
       | effort into safeguarding above incarceration.
       | 
       | But I think that's the consensus anyway on most social issues.
       | And it seems to be a lesson that governments globally are very
       | slow to learn.
        
       | Pulcinella wrote:
       | This is not a particularly hard hitting interview. I wish the
       | interviewer pushed back more against Dr. Hart. E.g. do some
       | digging on who funds his research. Push back against minimizing
       | the opioid crisis.
       | 
       | A lot of these questions are real softballs.
        
       | tibbydudeza wrote:
       | A functioning heroin addict does not exist , he might just be an
       | outlier.
        
       | ddelt wrote:
       | I wish I'd see more discussion and analysis like this over the
       | recreational use of anabolic steroids (read: not for professional
       | sports or contests, but rather for physical appearance).
       | 
       | You want to talk about some shit that gets demonized for no
       | reason? Testosterone replacement therapy is legal, but if you
       | decide that you want to use an extra 100mg, suddenly it's a
       | criminal offense and you are a bad person. For what? Wanting to
       | have bigger biceps or train harder in the gym? What is the
       | alternative? Drink alcohol which has a measurable death rate per
       | year, or smoke some legal cigarettes and second hand smoke poison
       | countless people?
        
         | insickness wrote:
         | There's a good book on this called Better Than Well that
         | discusses the use of medicine for life improvement rather than
         | treating disease. One of the most interesting chapters was on
         | amputees by choice, people who want to cut off a limb to become
         | handicapped. Doctors were left with the painful decision of
         | helping these people achieve this or having them do it on their
         | own in a much more dangerous way. While most would agree the
         | behavior of amputees by choice is in some way pathological, it
         | presents an interesting question about whether people have the
         | right to do to their own bodies what they want and the role of
         | medicine in helping them achieve those aims.
        
           | fire7000 wrote:
           | You can go to a doctor and get them to prescribe the same
           | hormones to change you from a girl to a boy. Tell them it's
           | for gender re-assignment and they will send you home with a
           | lifetime supply
        
           | diegoperini wrote:
           | Is there a testimony of someone who went through such
           | surgery? What's the mindset of a person who really needs
           | his/her limbs removed because of such urges?
        
             | burnthrow wrote:
             | I would never do it, but there's some convincing evidence
             | (the experience of eunuchs) that castration evens out the
             | male/female longevity difference.
        
             | hnick wrote:
             | One possible cause is
             | https://en.wikipedia.org/wiki/Body_integrity_dysphoria but
             | there are related conditions with other names.
             | 
             | I saw an interview years ago on TV and someone was saying
             | it felt like that appendage was not part of their body, it
             | belonged to someone else. It was so mentally uncomfortable
             | they'd rather remove it.
        
         | fire7000 wrote:
         | No alcohol won't give you the growth you want. The alternative
         | is a horse steroid Boldenone undecylenate
        
         | fire7000 wrote:
         | Your biceps will shrink after your cycle and put you into a
         | depression in combination with having low testosterone. It's
         | not a good place.
        
         | rkachowski wrote:
         | slightly OT, but in what situations can anabolic steroids be
         | used recreationally?
        
         | huffmsa wrote:
         | This'll get downvoted, but it strikes me how hypocritical it is
         | that you can say you don't feel comfortable in your body
         | they'll put you on test blockers and estrogen replacement to
         | help you look like how you identify, but saying you think you
         | need to look like Adonis is illegal.
         | 
         | Controlled use of anabolic steroids is demonstrably safe and
         | effective.
        
           | thgaway17 wrote:
           | Who is the "they" you're referring to? Both groups in your
           | example need therapy, not hormones.
        
             | huffmsa wrote:
             | Doctors
        
       | pfortuny wrote:
       | But... he gives no counter-research references to the research he
       | critizices... so I'll pass on this one.
        
         | Hnrobert42 wrote:
         | Yeah. I am disappointed in Nautilus presenting such a
         | controversial position with no scrutiny and very few probing or
         | challenging questions.
        
       | Babiker wrote:
       | > Hart reports that more than 70 percent of drug users--whether
       | they use alcohol, cocaine, prescription medications, or heroin--
       | do not meet the health criteria for drug addiction.
       | 
       | I don't think it's about health criteria. It's about whether you
       | want to add yet another item to things you depend on just to feel
       | normal.
       | 
       | Also, the need is a symptom of a real issue that needs to be
       | addressed instead of just numbed and berried i.e., unhappy at a
       | job or a situation etc that needs to be addressed.
        
       | yladiz wrote:
       | > Hart strives to "present a more realistic image of the typical
       | drug user: a responsible professional who happens to use drugs in
       | his pursuit of happiness."
       | 
       | I think this is likely wrong. I guess it partly depends on the
       | definition of a "drug user" (like, does it include alcohol
       | drinkers) but I would be very surprised if most heroin users are
       | responsible professionals - how can you do anything when you're
       | high on heroin? I'd go so far as to say that saying people that
       | are addicted are "typically responsible professionals" is a
       | little disrespectful and downplays the reality of those that are
       | actually afflicted with addiction, as it feels like it's just
       | pushing the "burden" onto the drug user, which reinforces
       | negative stereotypes and makes it harder to get people on the
       | side of treating addiction as a health issue and not a moral
       | failing.
        
         | mellavora wrote:
         | Friend of mine is from Pakistan. He says that the guys who
         | drive heavy trucks through the mountains always take heroin
         | first.
         | 
         | Helps them keep calm when navigating a road which has sections
         | only marginally wider than the truck, with a 500m drop on one
         | side.
         | 
         | I'm not promoting DUI (lost too many friends that way, mostly
         | from OTHER people DUI'ing and hitting them), just saying that
         | there are professions where the people engaged think that
         | dulling the fear/panic response is worth the reduced reaction
         | times.
        
           | biolurker1 wrote:
           | That must be the definition of urban myth
        
           | selimthegrim wrote:
           | Are you sure he's not talking about charas?
        
         | jimmaswell wrote:
         | > but I would be very surprised if most heroin users are
         | responsible professionals - how can you do anything when you're
         | high on heroin?
         | 
         | The rock scene of the 80s comes to mind. Lots of them did it af
         | the time while they were touring.
        
           | waterhouse wrote:
           | The Guns N' Roses song "Mr. Brownstone" is essentially about
           | this (brownstone being slang for heroin). It seems it worked
           | for some time, but eventually...                 I get up
           | around seven       Get out of bed around nine       ...
           | I used to do a little but a little wouldn't do it       So
           | the little got more and more       I just keep tryin' to get
           | a little better       Said a little better than before
           | ...       Now I get up around whenever       I used to get up
           | on time
        
         | rkachowski wrote:
         | From my reading, alcohol drinkers are absolutely included in
         | his definition of a "drug user" and the exact same objection
         | would apply - how can you do anything when you're drunk on
         | alcohol?
        
           | detritus wrote:
           | I've actually often used booze to power beyond sense and get
           | extra work done at the end of a day, however there is a HUGE
           | proviso - it has to be design work, or stuff that I know
           | inside out and could do blind-folded anyway. Anything to do
           | with programming or logic and I became a useless head-
           | scratching moron, going around in ever tighter circles of
           | stupidity.
           | 
           | Design work though? There was many a time I awoke the next
           | morning and had a dread-chill panic thinking I'd need to get
           | some project done, only to find I'd not only done it the
           | night before, but I'd actually not hate it. Which, as a
           | designer at the time, was high praise. Sure, there might be
           | some rough edges or stupid typos, but the overall work would
           | be Great, by my standards at least, so after a quick review,
           | would be ready to go. I used to refer to it as 'free work'.
           | 
           | I guess letting go is more of a useful trait in design.
           | 
           | I'd not recommend it for doing work in critically-important
           | fields, obviously!
           | 
           | - ed last line
        
             | Uberphallus wrote:
             | Same. I tried coding tipsy, especially after colleague
             | farewell meals, and I never did anything good. At most I
             | gave funny code reviews to people.
             | 
             | For most of my life I also cooked sober. But when I started
             | cooking tipsy, I began preparing meals I could have never
             | believed I made myself. My current lasagna recipe is an
             | absolute bomb and it's been perfected over a dozen drunken
             | cooking sessions. Even Italians asked me for the recipe.
        
               | detritus wrote:
               | Oh! Don't get me started on tipsy cooking.
               | 
               | Main problem there is replicability. My partner often
               | gets annoyed at me when she asks if I can cook some nice
               | thing I'd recently made, only for me to umm and aaah
               | because I didn't write down the exact ingredients... .
        
           | Mediterraneo10 wrote:
           | > how can you do anything when you're drunk on alcohol?
           | 
           | The statistics for alcohol consumption in the Nordic
           | countries in the 19th century are staggering, adult males
           | were basically drinking hard liquor all day every day as they
           | went about their work. Alcohol definitely has its effects on
           | the body and is a huge safety risk, but apparently men were
           | still able regardless to run their farms, build the buildings
           | they needed, chop wood, etc.
        
             | wingerlang wrote:
             | On the other hand the government had to step in and make
             | alcohol restrictions because of the abuse.
             | https://en.wikipedia.org/wiki/Systembolaget#History
        
           | [deleted]
        
         | nicoburns wrote:
         | I've never taken heroin, but I've heard that it is quite
         | possible to work while high on it. Partly because the high
         | isn't quite like other drugs that give you a high. Which is
         | apparently one of the reasons why it's so easy to become
         | addicted: at first you can feel pretty normal and competent
         | while on it.
        
         | throwaway_du wrote:
         | I used drugs recreationally until I had children. During this
         | time I knew many colleagues that used drugs every week. Some
         | used amphetamines and mdma at parties. Some used morphine
         | substitutes day time during the weekends, and on a few
         | occasions some were high during work hours (the last few hours
         | on friday). They were very productive. Just because you use a
         | hard drug does not mean that you have to take a large dose. I
         | would argue that most people will be more productive with a low
         | dose of amphetamines. On the other hand, I think no one codes
         | better with alcohol. It all depends on the drug.
         | 
         | For several years I made a living playing poker, and I played a
         | lot better with morphine in my system. It made me more patient
         | and focused. I even tracked my results in different databases
         | (with pokertracker) to compare my results while high. I made
         | almost 10% more while high, and this is over hundreds of hours
         | played.
        
           | treeman79 wrote:
           | Bio parents of my adopted child used them recreationally.
           | They used them all through kids childhood. Really screwed em
           | up.
           | 
           | Every single person in group homes and foster system had same
           | sort of tale.
        
             | pksebben wrote:
             | Does that mean the substances are to blame? IMHO, people
             | who would create a responsibility for themselves (child)
             | and then ignore that responsibility have problems above and
             | beyond how they recreate. Their indulgence is a symptom,
             | not a cause.
        
         | dijksterhuis wrote:
         | Here's a better definition (imo):
         | 
         | > A typical drug user is someone who uses drugs.
         | 
         | It's impossible to neatly encapsulate every single type of drug
         | user into a "typical" category. Everyone is different.
         | 
         | Some people use drugs. Others don't. Some people can use drugs
         | recreationaly, others can't (including myself).
        
         | avisser wrote:
         | > how can you do anything when you're high on heroin?
         | 
         | It is a straw-man to assume that drug users are high during
         | work. There are plenty of hours in the day. Erowid puts the
         | duration of a heroin high at 2-4 hours.
         | 
         | https://erowid.org/chemicals/heroin/heroin_basics.shtml
        
           | swirepe wrote:
           | 8 hours for sleeping
           | 
           | 8 hours for getting your $80 for the day to get high
           | 
           | 4 hours to get high
           | 
           | 4 hours for...I don't know, working on a novel or something
        
       | S_A_P wrote:
       | Im not sure how I feel about this. I do think that Dr Hart is
       | probably right in an academic sense. What I worry about is that
       | reality is messy. I think in the spectrum of people in the world
       | there are likely people who can take heroin and only take it once
       | in a while. He may even not be glossing over the harm drugs do in
       | his life(I dont know him so I wont make that judgement).
       | 
       | I know if I had a ready supply of clean heroin I would probably
       | not just take it once in a while. Ive never done heroin, and that
       | is because I know how much I like hydrocodone and its much weaker
       | chemical cousins. I also know 2 people severely harmed by heroin
       | use.(Brothers in fact) Maybe if they had a regimented way of
       | copping it and safe supply of needles one of them wouldnt have
       | Hep C now.
       | 
       | The real problem with treating opiates or other drugs as a public
       | health problem is that the US does _not_ have that sort of
       | infrastructure set up to deal with the problem. Why do you think
       | the police are called in now for drug problems(non criminal)?
       | There is literally nobody else to deal with it. I dont agree with
       | locking up addicts, but is checking them into a hospital with no
       | insurance a viable option?
        
       | spaetzleesser wrote:
       | I used to know an engineer who used cocaine, heroin and drank a
       | lot. He definitely wasn't performing at his best and the long
       | term outlook wasn't good. But he was able to hold his job and
       | didn't miss work more often than other people with other health
       | issues like cancer or back problems.
       | 
       | This definitely convinced me that it doesn't make sense to pull
       | drug users out of productive society and either fire them or put
       | them to jail. It's just very unproductive that makes things only
       | worse.
       | 
       | It would be much cheaper to treat their addiction while they are
       | working.
        
       | goat_whisperer wrote:
       | I'm all for re-thinking drug policy, but normalizing heroin use?
       | Hell no. It's gonna catch up to this guy one day -- he says he's
       | good now but just wait until he feels like he needs to stop.
        
       | juskrey wrote:
       | It did not take a while to understand all drug experiences are
       | deeply fake comparing to living full life. And if they enrich
       | you, you life is probably fake.
       | 
       | Like in Russian group Splin lyrics: "Ia naiavu vizhu to, chto
       | mnogim dazhe ne snilos', He iavlialos' pod kaifom".
       | 
       | Rough translation: "I see the things in reality, others don't
       | even when dreaming, when getting high"
        
         | ZoomZoomZoom wrote:
         | Isn't it ironic that you provide a quote from Vasilyev, who's
         | not exactly known for being straight edge? Moreover, this is a
         | line from a song about love from first sight, which itself is a
         | specific kind of an altered state of mind.
        
           | juskrey wrote:
           | I am not making any idols here. The quote just comes to my
           | mind now and then, when reality, so to say, happens.
        
         | insickness wrote:
         | I used to smoke weed every day. At the end of the day after
         | work, I would vape until I was fairly intoxicated. Almost
         | everything was better on weed--sex, food, television, etc. I
         | would be out with friends and look forward to getting home and
         | smoking weed. In essence, it made being bored fun. But I
         | started to question who I really was when I smoked weed. I was
         | in a different state mentally, a state that in many ways was
         | disconnected to my sober state. Almost as if I were a different
         | person.
         | 
         | I eventually completely quit because it seemed like a black
         | hole in my day and in my life, where the sober me just lost
         | valuable time and focus. It also dampened my motivation. Part
         | of it may have been physiological, I would be less focused the
         | next day. But part of it was also that compared to being on
         | weed, life was just not as enjoyable when I was sober. I did
         | not like that contrast.
        
         | rkachowski wrote:
         | The same could be said about any experience from reading
         | fiction, watching movies or enjoying art.
        
           | juskrey wrote:
           | I must say I've stopped watching movies too, and reading most
           | fiction (except at least 100 years old), after diving deeper
           | into life.
           | 
           | Certainly not only drugs are fake or toxic.
        
             | [deleted]
        
       | globular-toast wrote:
       | I recommend David Nutt for more logical analysis of drugs and
       | their dangers. Essentially the way drugs are classified makes no
       | sense and is mostly a result of corruption and political,
       | religious and even racist ideologies.
       | 
       | Drugs have had a profound effect on my life. Like many, I started
       | with alcohol - the most boring and most dangerous drug there is.
       | I later used cannabis, which I decided had an overall negative
       | effect on my life, and MDMA. The latter I only used a few times
       | but it changed me. I don't need to take it any more but it has
       | improved my life no end. Now I only use caffeine (in tea and
       | coffee). I haven't used other drugs for almost two years at this
       | point (my last drink was around May 2019 and it ruined my sleep,
       | as it always does, for the last time).
        
       | jack_riminton wrote:
       | I saw this guy on Rogan and his claim that opioids weren't
       | addictive just isn't born out by the facts
        
       | oreally wrote:
       | I get that you need outlets, but drugs are the worst you can
       | choose amongst the many other outlets you have today. At least go
       | play video games - at least you'll still be able to recover. With
       | drugs you're risking so much of your health. Make the smart
       | choice kids.
        
       | renewiltord wrote:
       | Yo, no one uses NDMA for that shit. You mean MDMA.
        
       | konfusinomicon wrote:
       | It's only a problem when you don't have any right?
        
       | joemazerino wrote:
       | This is legitimately dangerous reporting. Heroin is ranked in the
       | top 3 of addictive chemicals and all this article reports about
       | is this anecdotal nonsense. I've too many friends to Heroin to
       | know the reality of the drug.
        
         | lucideer wrote:
         | > _dangerous_
         | 
         | Stigma around drug use is dangerous. This is extremely evident
         | from the state of treatment of heroin addiction in society
         | today.
         | 
         | I don't really see how challenging this stigma is more
         | dangerous than pandering to the status quo here.
        
         | capableweb wrote:
         | I think you're missing the point of the article a bit. Everyone
         | knows Heroin is dangerous and it's iterated on in the article
         | as well. Only responsible and healthy individuals should self-
         | use drugs, generally speaking.
         | 
         | Then you can also argue that you might not have lost your
         | friends only because of Heroin the substance, but also how
         | people with heroin addiction is "treated" and frowned upon in
         | society.
         | 
         | I think what the article is trying to say is that harm
         | reduction is a much more human and possibly effective approach
         | to fighting real addition. Compared to other ways, which some
         | of them include "there is no such thing as responsible drug
         | use, it's all addiction" and treating people as such.
        
           | hackermailman wrote:
           | Anybody who thinks this harm reduction strategy works should
           | go visit cities that have employed it for years like
           | Vancouver, Canada where there are legal shooting galleries
           | everywhere, no arrests for personal amounts, and prescribed
           | heroin that thousands of drug addicts have been on for 10
           | years now and the problem gets worse everyday. There used to
           | just be a contained area of people passed out all over the
           | street now it extends to the rest of the city. There is even
           | a drug takers union that demanded treatment options be
           | removed from drug taking clinics as 'it shamed drug users'.
           | 
           | So if you create an accomodating and encouraging area for
           | taking heroin you will find it surges in population when
           | heroin is freely available and detox discouraged. Everybody
           | points to the European model but they must have done
           | something different than just harm reduction, like proactive
           | policing breaking up open air drug markets and shutting down
           | slums teeming with addicts forcing them into detox.
        
             | Dma54rhs wrote:
             | I live in Europe where drugs are legalized. Definetly it
             | doesn't mean anti social behavior is "legalized" what often
             | at least seems the case with Nort American progressive
             | cities. People are treated as adults and are expected to
             | act like ones.
        
             | valuearb wrote:
             | Heroin is still illegal in Vancouver. Only a handful of
             | addicts get free heroin.
             | 
             | And because it's illegal most addicts have to pay high
             | prices for heroin of unknown potency, and frequent laced
             | with Fentanyl. That directly leads to overdoses and
             | hundreds of deaths, along with street crime to fund
             | expensive habits.
        
               | hackermailman wrote:
               | It's been decrim unofficially for personal use for 5
               | years now, now officially decriminalized
               | https://www.rcinet.ca/en/2020/11/28/vancouver-votes-to-
               | decri...
               | 
               | Every bus stop since March last year in the drug slums
               | also has instructions where to get prescribed opiates.
               | Area only got worse
        
               | valuearb wrote:
               | Decriminalization isn't legalization. Not only is it
               | still a federal crime to buy and use, but it's also
               | illegal to sell. And illegal heroin is still cut with a
               | variety of substances leading to more overdoses and
               | deaths.
        
               | slavik81 wrote:
               | From your link:
               | 
               | > The Vancouver motion however for the moment has no
               | force in law.
               | 
               | A municipality doesn't have the authority to
               | decriminalize drugs. They're just requesting the Federal
               | government to act. It's not official, though it could
               | eventually be.
        
           | kgwgk wrote:
           | > Only responsible and healthy individuals should self-use
           | drugs, generally speaking.
           | 
           | Exposing oneself to developing a heroin addiction seems a
           | somewhat irresponsible and unhealthy thing to do.
        
           | rovr138 wrote:
           | I think the tone of the article is dangerous.
           | 
           | That coupled with the fact of how heroin is treated in
           | society makes it worse. On top of that, add that not everyone
           | that uses it is healthy and responsible, makes it even worse
           | providing some bad validation. And then, not everyone is
           | capable of making the distinction between fun or addiction
           | early on when an addiction is starting.
           | 
           | I too think it's dangerous.
        
             | mdip wrote:
             | > That coupled with the fact of how heroin is treated in
             | society makes it worse.
             | 
             | So this is sort of a problem with treating the thing
             | "Heroin" as bad, versus treating the Heroin Addict as bad.
             | Society makes it worse, mainly, by tossing addicts in jail
             | and I'm generally against drug laws as they stand[0]. But
             | making "everything legal" doesn't reduce the impact of the
             | law on drug users as much as you'd expect. At least,
             | anecdotally, every addict that I've known personally has
             | had run-ins with law enforcement _because of their drug
             | use_ but having _nothing_ to do with the drugs, themselves.
             | In one case, a friend ended up with an  "impeding traffic"
             | charge when he fell asleep in the left-turn lane at an
             | intersection.
             | 
             | The story, as it was told to me, was that he chased a few
             | Vicodin with a single beer, which resulted in him
             | registering a 0.03, but he fell asleep in an intersection
             | with his foot on the brake pedal. Despite this, he _passed_
             | the field sobriety test, but the officer judged him to be
             | intoxicated, and he was arrested. Apparently he was
             | supposed to get a blood test; he was taken in early on
             | Saturday and held until Monday, but they didn 't do the
             | test until he was "on his way out". It turned up nothing
             | and he got out with a lawyer bill.
             | 
             | [0] I'm convinced that things are _so bad_ /ineffective
             | right now, that I'm pretty close to support of all-out
             | decriminalization (of possession), simply because it
             | reduces the impact of addiction on the addicted.
        
             | valuearb wrote:
             | Heroin isn't dangerous.
             | 
             | Illegal heroin is very dangerous.
        
             | capableweb wrote:
             | The tone is dangerous? What does that even mean?
             | 
             | The article is an interview with a Heroin user. It's as
             | dangerous as an interview with a sex-worker. The
             | interviewer even seems to bring up some interesting
             | counter-points to the interviewee.
             | 
             | In the end, the interview is just providing a voice for the
             | person getting interviewed. Are you saying that
             | interviewing people who might do harm to world is
             | dangerous?
        
               | sillysaurusx wrote:
               | Well, after all, interviewing a sex worker is dangerous
               | too. People might have a bunch of sex and catch some
               | nasty diseases.
               | 
               | I think that's the logic, anyway. It's ironic that most
               | people here are in the camp of "decriminalize drugs! Oh
               | wait, no, not these drugs, just some drugs."
        
               | 3131s wrote:
               | I would hope people here recognize that legalization
               | together with smart regulation is far preferable to
               | decriminalization.
        
               | coryrc wrote:
               | As Portugal shows, decriminalizing drugs _reduces_ their
               | use. The position you are mocking is actually consistent.
        
               | sillysaurusx wrote:
               | Fair point. But, if something isn't criminal, then it
               | should be fine to read about people doing that thing --
               | which is all that this article is. Railing against it
               | like it's somehow an affront to post it seems neither
               | productive nor fair.
        
               | throwaway0a5e wrote:
               | Portugal has a much more comprehensive set of programs to
               | get people off hard drugs than any of the US
               | jurisdictions that have decriminalized (or stopped
               | enforcing through executive action) hard drugs.
        
               | jboog wrote:
               | I'm not sure we can take the results of a single
               | experiment in an incredibly homogenous tiny country in
               | Europe to mean an outcome is replicable across the world.
        
               | capableweb wrote:
               | Indeed. The "experiment" in Portugal is not proving it
               | works everywhere, but shows it can work, which indicates
               | we should study it further and possibly deploy it in more
               | countries across the world, to see if it works elsewhere
               | and if we could possibly make it even more effective.
               | 
               | While Portugal is probably the most famous example of
               | decriminalizing working in humans favor, it's not the
               | only example, it has been employed in other states too.
               | Netherlands has de-facto decriminalized all drugs (in
               | practice, not in law), Czech Republic has decriminalized
               | all (most?) drugs as well.
        
               | akiselev wrote:
               | We can, however, easily take the opposite conclusion:
               | drug criminalization has been an unmitigated disaster in
               | almost every country it's been tried short of a few
               | incredibly homogenous countries like Japan and countries
               | for which no real data is available like North Korea.
        
               | rwmj wrote:
               | It's a disaster in Japan and North Korea too, albeit in
               | different ways. In North Korea the state manufactures
               | some very nasty narcotics and distributes them as a way
               | to gain foreign currency with the "nice" side effect of
               | destabilising those places they export to. Japan has a
               | plainly crazy attitute to cannabis, with people losing
               | their careers and being socially ostracised over the most
               | passing association with the drug.
        
           | ordu wrote:
           | _> Only responsible and healthy individuals should self-use
           | drugs, generally speaking._
           | 
           | The funny thing I've been reading the article and the tone of
           | it reminded me of heroin addicts who was not hit by their
           | addiction heavily yet. I mean, Carl Hart thinks he is a
           | responsible user, that he have an ability to decide for
           | himself. It doesn't seem so for me. It is hard to tell,
           | having as a data only one interview with him. But... you
           | know, I'm an addict also, a nicotine one. I know how it is.
           | First ten years of my addiction I though that there is
           | nothing wrong with that, it costs some money and gives an
           | urge to smoke sometimes, but it brings some benefits too. A
           | few years ago I stopped smoking, after a month of abstinence
           | I saw no benefits in smoking at all. My abstinence lasted for
           | a couple of years, now I'm smoking again. Seeing no benefits
           | at all.
           | 
           | I know what I'm speaking about, I know the signs, I see the
           | signs, and I see Carl Hart as a fellow addict, though with a
           | different substance.
           | 
           | I drink alcohol sometimes, and I know that I'm not an addict.
           | Even despite the fact that sometimes I want to drink. A wish
           | to drink is a warning sign of course, but I see no other
           | signs. Like a despair coming with the thought that now it is
           | not the good time to drink for some reasons. I have no ideas
           | about benefits of being drunk: it is a funny state of mind,
           | but mostly annoying, I'm really stupid when drunk, I see my
           | stupidity and can do nothing to it. An addiction is a special
           | state of mind, I believe one (i.e. me) could feel it as
           | distinct from other states. Though it takes some learning,
           | one needs to become an addict and to stop using an addictive
           | substance of his choice. If Carl Hart wanted to prove that he
           | is not an addict, he should stop using heroin for a couple of
           | years, and then try to state his freedom from an addiction
           | with a straight face. While he is using heroin for just five
           | years and didn't tried to stop, I'd never believe his words
           | that he is not an addict. When it would be 10-15 years or 5
           | years of abstinence, I'll probably believe his word on it.
        
             | chimprich wrote:
             | > I drink alcohol sometimes, and I know that I'm not an
             | addict.
             | 
             | > If Carl Hart wanted to prove that he is not an addict, he
             | should stop using heroin for a couple of years, and then
             | try to state his freedom from an addiction with a straight
             | face.
             | 
             | So by that logic... we should only believe that you're not
             | an alcohol addict after you stop using alcohol for a couple
             | of years?
        
               | wizzwizz4 wrote:
               | Indeed. Why do you think this is a gotcha? Do you think
               | the comment's author hasn't thought of that?
        
               | chimprich wrote:
               | Why do I think it's a gotcha? Because there seems to be a
               | double standard: ordu is allowed to innately know that
               | they are not an alcohol addict, but the author of the
               | article is not extended the same courtesy.
               | 
               | I don't know if ordu has thought of that, but they don't
               | appear to have from their comment.
               | 
               | I find the idea that the only way to know if you're not
               | an addict is to give up for a period of years to be very
               | problematic. Most definitions of addict suggest they are
               | unable to control their compulsion, but I couldn't see
               | any indication of that from the article. If the author of
               | the article can sustain occasional use while maintaining
               | a high profile job (science professor), their use doesn't
               | appear to be out of control.
        
               | ordu wrote:
               | _> ordu is allowed to innately know that they are not an
               | alcohol addict, but the author of the article is not
               | extended the same courtesy._
               | 
               | Yeah, something like this. I'm not entirely sure that
               | alcoholic addiction would be just like a nicotine one,
               | but I believe it would be similar enough for me to detect
               | it. If I'm right I might hope that my experience with
               | nicotine could be generalized to alcohol.
               | 
               | Maybe unrelated to a discussion of "is a period of
               | abstinence is revealing", but I rarely drink alcohol, and
               | a year or two without a drop of alcohol is a normal to
               | me.
               | 
               |  _> Most definitions of addict suggest they are unable to
               | control their compulsion, but I couldn 't see any
               | indication of that from the article._
               | 
               | I see no indication that he is able to control it. He is
               | like "I want to take heroin, so I'm taking it". It is a
               | very popular stance for addicts. When I tried to control
               | my nicotine addiction it mostly ended with "I do not want
               | to control". Even now I do not want to control, though I
               | now see the difference between "I do not want to control"
               | and "I want to smoke". I do not want to smoke and do not
               | want to control my addiction.
               | 
               | When plane uncontrollable falling to a ground due to a
               | failure, a pilot could state that it is his intention,
               | and therefore the fall is a controlled one. People often
               | do something like this, but for an addict it is a symptom
               | by itself.
        
             | cirgue wrote:
             | > The funny thing I've been reading the article and the
             | tone of it reminded me of heroin addicts who was not hit by
             | their addiction heavily yet.
             | 
             | Having known someone who was a responsible, highly educated
             | adult with a fantastic career who died of a heroin
             | overdose, this whole article sounded eerily familiar.
        
               | shmageggy wrote:
               | Do you know whether this person's overdose was due to an
               | escalating addiction or due to mixing with other
               | substances or impurities? That's the distinction the
               | article is trying to make
        
               | cirgue wrote:
               | It was due to an escalating addiction, not impurities.
        
           | duxup wrote:
           | What is the success rate of folks who use heroin with some
           | effort to not be addicted ... and what is the cost of getting
           | them out of the cycle of addition? and what is even the
           | success rate of getting them out of that cycle?
           | 
           | The impact of failure to somehow prevent yourself from being
           | addicted can be catastrophic ... even if you are successful
           | in getting them out of the cycle of addition. And that impact
           | can extend WAY beyond the individual.
           | 
           | I'm open to the possibility that some drugs really can't be
           | used responsibly by enough people that they absolutely should
           | not be legal.
        
           | mannykannot wrote:
           | > Only responsible and healthy individuals should self-use
           | drugs, generally speaking.
           | 
           | This not a very helpful observation, as we all know that this
           | is far from what happens and is not going to become the norm.
           | 
           | Furthermore, quite a lot of people became addicted to opiates
           | through acting seemingly responsibly (at least initially
           | taking the drugs under the supervision of a doctor whom they
           | could reasonably assume was looking out for their best
           | interests) and in the persuit of better health.
           | 
           | I should add that Hart himself punted on this issue when the
           | interviewer touched on it. In the interview, he does this a
           | lot - for example, when the interviewer raised the question
           | of physical addiction, Hart merely discussed the
           | physiological basis, without touching the obvious issues it
           | raises for the concept of responsible use. It may be telling
           | that, in his description of himself as a responsible user, he
           | avoided saying anything about this particular issue.
           | 
           | > Then you can also argue that you might not have lost your
           | friends only because of Heroin the substance, but also how
           | people with heroin addiction is "treated" and frowned upon in
           | society.
           | 
           | This is also rather beside the point, as, while the way
           | addiction is treated is also a problem, it is not an issue
           | except where there is already a problem with addiction.
           | 
           | That aside, there is such a thing as responsible addictive-
           | drug use (including, but not necessarily limited to, people
           | with chronic pain that only responds to such drugs) and the
           | way we respond to addiction today is in many ways ineffective
           | and in some ways very harmful. One cannot make a very good
           | argument for reform, however, on the basis that some people
           | can use some of these drugs responsibly.
        
           | lazide wrote:
           | Who decides that someone is a responsible and healthy adult?
           | Do we have any data on how many responsible and healthy
           | adults try heroin?
           | 
           | Anecdata and broad brush strokes of course - In my experience
           | anyway, the actually responsible and heathy adults I know
           | haven't felt the need to use heroin. The people who somehow
           | are able to delude themselves into thinking they are
           | responsible and healthy while obviously in crippling mental
           | and/or physical pain, have - and it's been devastating to
           | them.
           | 
           | I've had prescription opioids before (hydrocodone, codeine,
           | morphine) during medical emergencies. The feeling of peace
           | and calm is amazing - which is exactly why it attracts people
           | in pain and suffering, destructively so in many cases. It is
           | difficult to know if that feeling is going to be magnetic or
           | repulsive to you until you try it. It happens to be repulsive
           | in my case (I know it's a trap), thankfully.
           | 
           | It's a complicated story of course, and bad outcomes tend to
           | get the press. Better treatment (including in many cases
           | mental health treatment) is definitely needed.
           | 
           | It is not the only substance like this - alcohol, tobacco,
           | amphetamines, and others have track records of similar
           | problems.
           | 
           | Pretending that anyone and everyone could self evaluate and
           | go for it without a decent percent of them having major
           | problems for them and those around them is unfortunately just
           | not a good idea.
        
             | capableweb wrote:
             | > Who decides that someone is a responsible and healthy
             | adult?
             | 
             | You do. It's not up to someone to decide, you're
             | responsible for your own body and your own decisions to
             | improve/harm it.
             | 
             | I don't think they are saying advising governments to setup
             | some sort of screening process for this. It's more for the
             | people who are interested in the drugs themselves. When I
             | first started getting interested in drugs, many pushed the
             | idea that I should be psychologically healthy first (mostly
             | because my first interest was psychedelics and I have good
             | and well-meaning friends). I think that's what the article
             | is trying to signal here.
        
               | jessebro wrote:
               | The problem with that attitude is when the body count
               | gets high enough, there is incredible pressure to 'do
               | something' - because enough people are terrible at
               | judging this (or don't have the right friend group, or
               | whatever) that we end up with huge crime problems,
               | destroyed lives, and other social ills.
               | 
               | The libertarian 'you can do what you want and it's your
               | own responsibility' is great until the people who
               | obviously made the wrong decision stop quietly owning the
               | results of their decisions and start murdering random
               | people for money to fund their habit.
               | 
               | An argument can be made that the answer is free heroin
               | and mental health treatment of course, and maybe it is
               | the right answer. It seems hard for societies to accept
               | however, outside of some very niche locations
               | (Netherlands) though.
        
               | valuearb wrote:
               | You don't have to murder anyone to fund a legal drug
               | habit. Legal drug habits are easier to treat.
               | 
               | Some might not even have a drug habit if not for illegal
               | drugs laced with addictive substances they didn't even
               | know were there.
        
               | lazide wrote:
               | Oxycodone is legal [albeit controlled]. There are plenty
               | of pill doctors that will prescribe oxycodone to anyone
               | that doesn't look like too big of a mess. A cousin of
               | mine stole oxycodone from my grandmother when she
               | couldn't afford the ever increasing costs of her
               | spiraling out of control oxycodone habit. People have
               | murdered and gone bankrupt acquiring oxycodone, and
               | continue to do so.
               | [https://www.pharmacytimes.com/news/pharmacist-killed-
               | after-r...]
               | 
               | If you're saying 'I meant it should be legal to buy over
               | the counter for cheap and/or given away for free', then
               | that might decrease the number of people being robbed for
               | it - but doesn't seem to decrease the number of overdose
               | deaths, area crime rate, or urban decay by as huge an
               | amount (or maybe it just concentrates it?), at least
               | based on the experiment in Vancouver, BC, Canada's lower
               | east side. The Netherlands is also problematic, and not a
               | solved problem. [https://www.areavibes.com/vancouver-
               | bc/downtown+eastside/cri..., and overdose deaths have
               | continued to skyrocket in Vancouver
               | [http://www.vch.ca/Documents/CMHO-report.pdf] despite
               | harm reduction, decriminalization, and other means.
               | 
               | Areas like San Francisco with de-facto decriminalization
               | also have major problems with people, for lack of a
               | better word, rotting of neglect on the street - something
               | that I've also seen first hand in Vancouver. I also have
               | friends who have seen this first hand in Seattle.
               | Resident complaints around muggings, being assaulted
               | unpredictably by unstable mentally ill people (on drugs
               | or not is hard to say, but there is a high correlation
               | with this and these areas in my personal experience) are
               | hard to ignore.
               | 
               | This isn't a solved problem, and I'm not advocating for
               | 'lock them up' policies - but pretending this will all be
               | cool if everyone can walk down to the corner store and
               | buy heroin if they think they're up for it isn't helping
               | anyone either.
        
               | pharrington wrote:
               | Oxycodone was the #1 recent example of patients and even
               | doctors being lied to about the addictivene potential of
               | the drug. For well over a decade, pharmaceutical
               | marketers (from Purdue Pharma especially) straight up
               | falsely claimed that habitual use of Oxycontin would not
               | lead to opioid dependency.
        
               | lazide wrote:
               | Which is a very near mirror to Heroin, which was created
               | as a less addictive/problematic alternative to Opium.
               | 
               | Also, correct me if I'm wrong, but that doesn't seem to
               | address my core point?
               | 
               | Legality can reduce some negative effects, but it isn't a
               | cure-all. There are also a lot of people that should just
               | not use opiates or bad things will happen, and we can't
               | predict who those people will be reliably until it is too
               | late.
               | 
               | So please don't use opiates unless you really really need
               | to, and be aware of the dangers.
        
               | valuearb wrote:
               | It's easy to predict who will have problems with opiates,
               | very few go from 0 to 100 without skipping steps. Just
               | license the users.
               | 
               | Commit any infraction, drive or work heavy machinery
               | while under the influence, your license is suspended
               | until you complete rehab. Do it too many times and it's
               | suspended permanently. Use while unlicensed, it's jail
               | time.
               | 
               | This way there is a progression. We don't have to waste
               | police resources on those who can handle it. The minority
               | who can't are directed into rehab to deal with their
               | issues first, and only the minority of that group who
               | fail to shake up get jail time.
               | 
               | Meanwhile crime is down because drugs are affordable. New
               | addicts are down because kids aren't getting laced drugs.
               | Deaths and overdoses are down for same reason.
               | 
               | And it all costs society less, less police, less crime,
               | less hospitalization and less death means less taxes.
        
               | valuearb wrote:
               | People rob and murder people for all sorts of reasons.
               | But drug addicts have to commit fewer crimes if their
               | drugs are cheap and easy to get.
               | 
               | And legal drugs have known potencies, and aren't mixed
               | with other more addictive drugs.
               | 
               | Don't compare decriminalization to legalization, they are
               | entire different things. Decriminalization still suffers
               | from higher addiction and death rates because selling the
               | drugs is still illegal.
        
               | the-dude wrote:
               | And it seems to have worked ( source : Dutch and old
               | enough to remember what it seemed like in the 80ies ).
        
               | lazide wrote:
               | Interestingly enough - all crime (including in the US
               | with it's war on drugs) has dropped dramatically since
               | the 80's. Lots of theories about leaded gasoline phase-
               | outs, etc. but it's a complex multi-variate problem.
               | Merely having the issues about use widely known (and the
               | initial round of people super susceptible to it) can also
               | cause many people to shy away, with significant decreases
               | in abuse.
        
               | the-dude wrote:
               | Dutch coffeeshops keep large amounts of people away from
               | 'regular' drugs dealers who carry coke/heroin besides
               | weed.
               | 
               | Economic tide : the 80ies was a different time with lots
               | of youth unemployment in NL/NWE.
        
               | ardy42 wrote:
               | >> Who decides that someone is a responsible and healthy
               | adult?
               | 
               | > You do. It's not up to someone to decide, you're
               | responsible for your own body and your own decisions to
               | improve/harm it.
               | 
               | That's obviously not that black and white. If it was,
               | then breathalyzer interlocks wouldn't be a thing, for
               | instance.
        
               | foogazi wrote:
               | breathalyzer interlocks are not there for heroin or for
               | your body
        
               | capableweb wrote:
               | IID/BAIIDs that gets installed in vehicles are often
               | installed to protect other peoples life, not your own.
               | 
               | I was thinking in the context of "Should I be able to use
               | drugs", which we normally leave up to the individual to
               | decide, except for _those_ drugs that we don't leave up
               | to the individual to peruse on their own.
        
               | ardy42 wrote:
               | > IID/BAIIDs that gets installed in vehicles are often
               | installed to protect other peoples life, not your own.
               | 
               | Yeah, but that's just an example. If you were about to
               | make a suicide attempt, you could be involuntarily
               | committed, and the only person's life being protected
               | would be your own.
               | 
               | The point that I was trying to get at was that black and
               | white individualist statements like:
               | 
               | >>> You do. It's not up to someone to decide, you're
               | responsible for your own body and your own decisions to
               | improve/harm it.
               | 
               | ...paper over some important complexities of real life.
               | There are many, many cases where people have
               | responsibility for others (and I'm not just talking about
               | legal responsibility, even though my examples all
               | intersected with the law in some way).
        
           | dfsegoat wrote:
           | They all work by increasing dopamine. But 'Addictive
           | potential' does vary by drug, and by the person [1].
           | 
           | 'All substances of abuse self-administered by humans that can
           | result in addiction are believed to exert their reinforcing
           | effects by increasing DA in the nucleus accumbens (NAc)'
           | 
           | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3050051/
        
         | nimbius wrote:
         | Fully agree.
         | 
         | Carl is a white collar professor. The worst thing that can
         | happen if his drug indulgence becomes a problem is he knocks
         | over the water cooler or loses his job.
         | 
         | I work a blue collar job servicing heavy diesel engines. Casual
         | hard drug users are aggravatingly cavalier to work alongside.
         | They forget important things constantly. They show up late and
         | lose things often. You'll spend all day repeating things
         | they'll never retain and at the end of the month they will lose
         | a finger or toe or suffer a massive back injury and get fired.
         | The back injury usually turns the casual heroin into constant
         | endless heroin.
         | 
         | Drug tests exist in my field for a really valid reason and it
         | has nothing to do with having a problem but becoming one.
        
           | Grustaf wrote:
           | Well, how many people will see this headline and rush off to
           | a back alley to buy a shot of heroin from some junkie?
        
             | throwaway0a5e wrote:
             | There's a balance to be struck.
             | 
             | You can't just lie to people and tell them that everything
             | is deadly or they're gonna question everything else you've
             | said. That's basically what DARE was.
             | 
             | I know a chainsaw is dangerous. But listening to every
             | Youtuber lecture me about how I have lock out tag out to
             | change a lightbulb my own home and every Redditor jump at
             | the opportunity to engage in a monologue about how I should
             | wear safety classes when I use a screwdriver sure lends a
             | lot of legitimacy to the people who say their dad never
             | wore PPE and retired with all his limbs so it must be fine.
        
             | TheAdamAndChe wrote:
             | Several years ago, I read about the significant nootropic
             | effects of nicotine and spent time on forums that
             | downplayed the potential negative impacts. I ended up
             | trying it and became addicted for years.
             | 
             | Social contagion can have significant effects on social
             | issues like this.
        
               | fouc wrote:
               | I tried the gum and the patch for nootropic purposes. I
               | even had to cut up the patch into smaller pieces to get
               | the proper dosage. It was hard to get the dosage down
               | enough, and I just mostly ended up feeling really
               | twitchy. It didn't seem worth it and I didn't notice any
               | real boost in the mental realm that a good nap wouldn't
               | give me.
               | 
               | Did you get addicted to the gum or the patch?
        
               | TheAdamAndChe wrote:
               | I vaped. I've also taken adderall and enjoyed it, so our
               | neurochemistries are probably different.
               | 
               | That's something important to consider when reading about
               | experiences on the internet. There are people who are
               | relatively resistant to addiction. When they talk about
               | their experiences, they make it sound like it's no big
               | deal, and it's not to them. But that's not how it is for
               | everyone.
        
               | filleokus wrote:
               | Heh, same happened to me. I managed to get hooked on
               | Nicotine gums after reading about the nootropic effects.
               | After a while I moved on to snus (Swedish smokeless
               | tobacco) due to expense/hassle of getting the gums.
               | 
               | Nowadays I have a pretty big nicotine consumption and
               | probably extremely marginal nootropic effects.
        
               | xibalba wrote:
               | I've experimented with nicotine (in the form of gum)
               | myself, but haven't really observed much in the way of
               | benefits. Did you see benefits? What form(s) were you
               | using? How did you end up quitting?
               | 
               | (I was turned onto this after listening to an interview
               | with Dr. Peter Attia [haven't yet made up my mind on
               | whether he is a huckster])
        
               | TheAdamAndChe wrote:
               | I personally didn't experience benefits, just side
               | effects. I started with vaping, then moved to smoking.
               | 
               | To quit, I switched to vaping for a few weeks, then
               | tapered the nicotine concentration to zero over the
               | course of a month or two. Cigarettes have MAOIs which
               | make it more addictive which is why I switched.
               | 
               | I was irritable for weeks and still get the urge to smoke
               | sometimes(it's been over 5 years since I quit). I don't
               | recommend starting.
        
               | matwood wrote:
               | > Dr. Peter Attia [haven't yet made up my mind on whether
               | he is a huckster])
               | 
               | I've listened to him off and on, and think he's ok. He
               | tests on himself pretty relentlessly, and still sees
               | patients (though it's a boutique practice). He also
               | appears open to new ideas as new research presents
               | itself. And while crazy people can come from anywhere, he
               | also has all the proper credentials.
               | 
               | There's this guy who hates him lol:
               | https://www.libertariannews.org/2016/03/07/dr-peter-
               | attia-re...
               | 
               | Finally, if you haven't already, you should find the
               | podcast episode where he talks about Theranos. Pretty
               | wild that he was asked to join and turned Holmes down.
        
               | stefan_ wrote:
               | By that logic, we need to ban cooking shows - the habit
               | reinforcing qualities of food are well known and obesity
               | is a leading cause of health issues. It looks like you
               | got off easy since your "drug" of choice nicotine has
               | entirely negligible negative effects on an organism of
               | the size of a human - it's a neurotoxin that in the
               | quantities we use it for recreationally can't even harm
               | insects (much like caffeine!).
        
               | TheAdamAndChe wrote:
               | > It looks like you got off easy since your "drug" of
               | choice nicotine has entirely negligible negative effects
               | on an organism of the size of a human
               | 
               | You are right. I ended up with easily maintained
               | hypertension and the urge to smoke that probably will
               | never go away.(While on it, I also had significantly
               | worse anxiety, decreased sleep quality, and bubbly urine.
               | I definitely don't recommend trying it)
               | 
               | But the social dynamics between it and heroin are the
               | same. If we normalize its use and downplay its risks,
               | more people will use it. And the physical and social
               | harms from heroin use are far worse than nicotine.
        
             | tmp-20210218 wrote:
             | I mean, genuinely, i'm thinking about it right now, however
             | i had a serious heroin habit until recently.
        
             | jboog wrote:
             | That's not the problem though.
             | 
             | The issues is "drug decriminalization" people treating
             | addictions like it's not a real problem for many people.
             | 
             | Many of these folks want it to get to a point where you can
             | quite easily buy heroin and suffer no legal consequences.
             | 
             | I'm not saying our drug laws are just or can't be reformed
             | but the fact that heroin is illegal prevents a LOT of
             | people from using it. How many people will then use, aided
             | by these pronouncements that "Heroin isn't actually that
             | addictive!" and ruin their lives?
             | 
             | We already have an opioid epidemic in this country that has
             | destroyed communities.
             | 
             | There's a middle ground between our terrible war on drugs
             | and the naive "make it all legal and experiment with
             | heroin!"
        
               | woeirua wrote:
               | The decriminalization folks recognize for the most part
               | that addiction is real. The difference is that they want
               | to use taxes on legal drug sales to fund rehab clinics
               | and treatment programs. The people who want to maintain
               | the status quo want to throw users in jail and forget
               | about them. We already know for certain that throwing
               | people in jail does not solve addiction. So why wouldn't
               | we at least try the alternative?
        
               | conradev wrote:
               | The central point of the article is actually not "let's
               | decriminalize drugs". It is "drug addiction is not brain
               | disease", which seems like a reasonable argument to me.
               | 
               | I don't know if you read it, but it also talks about how
               | many deaths are from bad education (not understanding
               | drug interactions, i.e. between two depressants), and bad
               | drugs (i.e. lacing heroin with fentanyl) with no easy way
               | for users to test their drugs.
               | 
               | It further goes on to discuss that addiction treatment in
               | the US is terrible precisely because it focuses on the
               | drugs as a pathology and does not consider the holistic
               | person or helping the person solve their underlying
               | problems.
               | 
               | Progressive drug policy isn't "legalize it all", it is
               | "prevent needless deaths and treat addiction properly".
               | It has been for some time. Here are garden variety
               | articles I found about these policies being implemented
               | in the wild:
               | 
               | https://www.washingtonpost.com/world/2019/01/04/allow-
               | festiv...
               | 
               | https://www.fda.gov/news-events/press-
               | announcements/statemen...
        
               | 4eor0 wrote:
               | Most advocates for decriminalization I've encountered
               | have a platform of using taxes for counseling and
               | addiction services.
               | 
               | The middle ground you seek is already defined clearly.
               | Are you sure your perspective here is as informed as it
               | could be?
        
               | jfoutz wrote:
               | > There's a middle ground between our terrible war on
               | drugs and the naive "make it all legal and experiment
               | with heroin!"
               | 
               | I wholeheartedly agree. a couple google searches showed
               | buying alcohol for a minor was a $1000 fine, but heroin
               | possession for personal use is $20000 and a year in jail.
               | 
               | I think there's room to scale back the penalties and
               | still be a deterrent. I think there's room to scale up
               | addiction recovery.
               | 
               | Hell, keep the horrible penalties, but waive them if the
               | accused, with counseling and whatever other support makes
               | sense, can stay clean for a year.
               | 
               | So much of the system is about papering over problems
               | rather than fixing the root cause.
        
               | rflrob wrote:
               | > I'm not saying our drug laws are just or can't be
               | reformed but the fact that heroin is illegal prevents a
               | LOT of people from using it. How many people will then
               | use, aided by these pronouncements that "Heroin isn't
               | actually that addictive!" and ruin their lives?
               | 
               | Do you know a lot of people who have expressed to you
               | that they would use heroin recreationally if only it were
               | legal? My gut is that the number isn't large.
               | 
               | My impression of the evidence from places that have tried
               | decriminalization (eg Portugal) is that the number of
               | people who use and then are able to get their lives back
               | on the rails is higher than the extra people who use
               | because it's decriminalized.
        
               | jboog wrote:
               | You genuinely believe that there is no large group of
               | people curious about trying a drug that supposedly offers
               | the most euphoric feeling imaginable "better than sex" as
               | many have claimed?
               | 
               | What if people tell them it's not addictive? And now it's
               | not illegal?
        
               | valuearb wrote:
               | Why would illegal stop them from trying heroin if someone
               | thought it better than sex?
               | 
               | What illegal does is make it far more likely to die from
               | using heroin.
        
               | Natsu wrote:
               | > Why would illegal stop them from trying heroin if
               | someone thought it better than sex?
               | 
               | Lack of access (or not knowing how to access it) comes to
               | mind, among many other reasons.
        
               | valuearb wrote:
               | Illegal drugs increase addiction rates because drugs are
               | often cut with different drugs. How many heroin addicts
               | were created by lacing lesser drugs with more addictive
               | ones?
        
               | Shared404 wrote:
               | Tobacco is legal, and also illegal to tell people it's
               | not addictive, at least in any sort of marketing sense.
               | 
               | Also, my understanding of most drug legalization is that
               | the intent is to legalize usage/possession, _not_
               | distribution. This is done with the intent to make it
               | easier /safer to gain treatment and decrease addiction.
        
               | bjourne wrote:
               | Decriminalized isn't the same thing as legalized.
               | Legalized means that you will have multinational
               | companies promoting heroin nonstop through massive
               | advertising campaigns. That would completely change
               | peoples' usage patterns. Like how many people would smoke
               | if tobacco was legal? Answer: many.
        
               | webkike wrote:
               | That is not necessarily true. Alcohol and tobacco are
               | legal and there are massive restrictions on how they are
               | aloud to be advertised. The point being made here is that
               | not many people would by more of it if they felt that
               | purchasing it was not going to put them in legal trouble.
               | For example, how many people do you know that do
               | whippets?
        
             | reaperducer wrote:
             | _Well, how many people will see this headline and rush off
             | to a back alley to buy a shot of heroin from some junkie?_
             | 
             | How many people are going to storm a national capitol
             | because of what they see online?
             | 
             | It all sounds farcical and easy to dismiss until you
             | actually put some thought into it.
        
             | lostgame wrote:
             | Dunno about you, but I have never bought drugs from a
             | junkie, but, of course, through dealers, who - in my
             | experience, more often than not - do not actually use many
             | of the substances they sell.
        
               | Grustaf wrote:
               | I haven't actually bought or even used any illegal drugs
               | at all, my point was just that I don't think a lot of
               | people will be inspired by an article like this to try
               | heroin, unless they were already considering it.
               | 
               | Most people that fall into heavy addiction are probably
               | driven there more by chaotic circumstances than
               | intellectual considerations.
        
               | throwawayboise wrote:
               | When I was in high school I toyed with the idea of trying
               | heroin due to how it was described in health class. Never
               | did, though.
        
             | mrtweetyhack wrote:
             | How many people are flat-earthers, anti-vaccine? Somebody
             | will take this article, make it viral by picking out one
             | sentence. Bam! Heroine and meth become legal.
        
             | wellthisisgreat wrote:
             | people who are familiar with less dangerous drugs may
             | easily become more inclined to try heroin after reading
             | this
        
           | Bodell wrote:
           | I want to agree with what your saying but with a caveat.
           | 
           | Years ago I was an office manager at a battery supply
           | warehouse (car batteries not AA's). We had an employee that
           | had started working for us for about 6 months when it became
           | vary apparent that he had a drug problem. Because his brother
           | also worked there we knew that he had suffered a major car
           | accident, was in crippling debt from the medical bills, and
           | developed a pain pill habit as a result. He was only 19 at
           | the time.
           | 
           | The issues that involved the work place were things like
           | being consistently late, taking 2-3 hour lunch breaks and
           | coming back high. So high, that he could not perform basic
           | job tasks like counting a pallet of battery cores. My biggest
           | concern was that he was licensed to use our fork lifts and so
           | I had our warehouse manager do his best to keep him off the
           | forklifts.
           | 
           | At this point I recommended to my boss that we fire him for
           | the repeated offenses, as well as recommend that he seek drug
           | consoling. I felt bad for him. He had a problem. He needed
           | help. But he did not need to be working at that job for his
           | and others safety. My boss and my boss' boss, on the other
           | hand, decided it was best to send to him to a "random" drug
           | test, so that when the fired him they could do so with
           | indisputable cause. This did not work, he disappeared for
           | many hours, despite the drug testing facility being just down
           | the street, and the results came back clean. I know that
           | people have many ways of faking drug tests. I suggested again
           | that he be fired for the offenses and not the drug test.
           | Again my bosses disagreed and sent him to two more "random"
           | tests each week after that.
           | 
           | The employee in question got wise to this. He knew what they
           | were trying to do. So he went to a therapist and got a
           | declaration of temporary disability. My company then had to
           | pay him his full wages for 6 months with out him needed to
           | come to work.
           | 
           | And I sat back and laughed at my bosses, as the unemployment
           | claim would have be nominal by comparison.
           | 
           | edit: not sure why this would be down-voted. It is just a
           | real story, relevant to the thread. I was only suggested that
           | waiting for test results when possible danger lurks was not
           | the right course of action. i forgot to add the employee did
           | come back after his psychological disability ran out. And of
           | course they sent him to take a drug test again. He failed
           | that one and was fired.
        
           | sandworm101 wrote:
           | >> Carl is a white collar professor. The worst thing that can
           | happen if his drug indulgence becomes a problem is he knocks
           | over the water cooler or loses his job.
           | 
           | No. The worst that can happen to him is that he is pulled
           | over by a cop in the parking lot. Gets charged with
           | possession of heroin. Goes to jail for a couple nights, then
           | looses his job/pension/car/house/wife/kids (in whatever
           | order) and winds up on the street. Regardless of the
           | biological realities of heroin, the realworld criminal
           | consequences of regular heroin possession can be worse.
           | 
           | And I have yet to meet any longterm drug user who hasn't on
           | occasion sold some to a friend. Get caught "dealing" and you
           | will face an entirely different legal regime.
        
             | renewiltord wrote:
             | Everyone wealthy enough doesn't sell. They just share.
        
               | sandworm101 wrote:
               | Most "dealers" are actually charged with 'intent to
               | distribute', a crime that doesn't require evidence of
               | money changing hands. Giving drugs to your friends, even
               | for free, will result in basically the same drug charges
               | as if you were selling. The law is setup this was
               | specifically to avoid the need to money evidence. The
               | cops only need to see you hand over the drugs. They don't
               | need to _also_ see you receive any money. (Actually, you
               | don 't even need to hand over the drugs. Possess a large
               | amount, or a smaller amount divided into little bags, and
               | that will be enough for intent to distribute.)
               | 
               | Many street-level drug dealers will still separate the
               | drug and money handovers between different people. This
               | isn't to avoid legal issues. It is to avoid the money
               | being seized when the cops move on the guy they see
               | handing over bags of drugs.
        
               | renewiltord wrote:
               | Consider me better informed now. Thanks.
        
             | soperj wrote:
             | I don't know if you've ever worked a blue collar job with a
             | drug user, but what they were saying is that the Carl isn't
             | going to lose a limb, kill himself, or worse, kill me on
             | the job as a professor because he's on drugs. That can be a
             | very different story working on a drilling rig for
             | instance.
        
             | batmansmk wrote:
             | One dude left his 3 and 5 yo kids in his locked car for a
             | full hot afternoon with no water while using in the heroin
             | den in my appartment complex in San Francisco. He was not a
             | bad guy, just a totally confused person. When we told him
             | what could have happened, he realized his mistake. We never
             | saw him again.
        
           | khalilravanna wrote:
           | His whole point is you can use drugs _and_ keep up all your
           | normal daily responsibilities. He states this several times
           | as the definition of "functioning". If you show up to work on
           | drugs you're not functioning and that's not what he's
           | advocating for.
        
           | [deleted]
        
             | [deleted]
        
           | basch wrote:
           | But, the response here seems to be "this is too dangerous an
           | idea to talk about, or consider" which seems really shitty.
           | 
           | It's been 45 years since it was first established that heroin
           | CAN be used safely when accompanied by a social ritual. Part
           | of the problem IS the mindset and stigma around addiction,
           | and that "insanely addictive drugs" have full power over
           | people, and there is no ability to moderate their use, which
           | is false. People are either 100% sober or a social pariah.
           | The response in these comments mostly confirms this sort of
           | black or white thinking. Maybe somebody should ask if its the
           | lack of social ritual / social controls causing the problem,
           | not the drug. Maybe society is failing otherwise responsible
           | drug use by making all users outcasts. Or is a spectrum and
           | complex interaction of multiple issues, and not just drugs.
           | "This is too dangerous of a conversation to have" puts us in
           | danger of not having productive conversations.
           | 
           | https://web.archive.org/web/20201111183716/https://www.harva.
           | ..
        
             | steve76 wrote:
             | Someone hooks your wife, or kid, or parents to junk and
             | ruins their life. They're a protected class. All those
             | police and soldiers protect them.
             | 
             | If addicts get to do that, why can't I do the same to them?
             | Instead of heroin, I'm going to go after a genetic cancer
             | cure, or see what applications of Bell's Theorem I can
             | create on human cellular mitosis and quantum biology.
        
           | fbelzile wrote:
           | Not defending drug use at work, but if you're to be fired it
           | should be for the performance related issues you mentioned
           | caused by the drug, not because of the drug itself.
           | 
           | Edit for more context:
           | 
           | Depending on the drug, substances consumed outside of working
           | hours would still show up in a drug test. Firing someone for
           | something they do outside of work shouldn't be acceptable.
           | 
           | If you can prove they consumed drugs that would impair their
           | ability to perform their job during working hours, that'd be
           | a valid cause for dismissal. Drug tests don't measure that
           | precisely enough though.
           | 
           | Not to mention, drug tests are not infallible. They can come
           | back positive for morphine if you eat a poppy seed bagel in
           | the morning [1].
           | 
           | [1] https://www.snopes.com/fact-check/poppy-seeds-alter-drug-
           | tes...
        
             | mfer wrote:
             | In many places there are safety issues to deal with. You
             | have to be proactive to avoid an incident.
             | 
             | Here's a non-drug related one. In many places road
             | construction companies will disallow workers from wearing
             | headphones. This is because of the heavy machinery and you
             | need to hear the beeps of a machine backing up. Drivers of
             | those do not have good sight around the machinery and large
             | trailers. Headphones on can mean not hearing a warning
             | sound and being struck and possibly killed.
             | 
             | Are wearing headphones a problem? Do you want to fire
             | someone until an accident happens?
             | 
             | Part of the proactive nature to this is insurance
             | companies. If there aren't strict safety policies that are
             | enforced than insurance companies won't cover companies.
             | When accidents occur they have to pay out and want to avoid
             | that.
             | 
             | Drug use has been proven to cause certain issues depending
             | on the drug that can have safety impacts at work sights.
             | This can costs lives and money.
             | 
             | This is why it becomes a big deal in certain fields.
        
               | jackric wrote:
               | Stupid analogy, the worker can be told to remove the
               | headphones during paid hours, non-compliance makes you
               | fired. We are talking about whether what you do outside
               | of work, that is isolated from work, should get you
               | fired.
        
               | mfer wrote:
               | A few things.
               | 
               | First, I'm attempting to describe how the system works
               | rather than give my opinion on how it should be.
               | 
               | Second, the headphones situation is meant to illustrate
               | how safety plays in. This isn't a "what if" example.
               | People on job sites wearing headphones have died because
               | they missed the warning tones. I am aware of one case,
               | personally.
               | 
               | Safety is a big deal. It plays into the insurance
               | companies who drive much of the policies and practices.
               | They are driving the things they do to keep their costs
               | down. Insurance companies often try to be pretty
               | methodical in what they do to keep costs down. It's not
               | just random ideas but looking at cause/effect
               | relationships.
               | 
               | Third, many drugs have effects outside of the time they
               | are used. It's not just the impact of the drug while one
               | is on it but how it affects them in the time they are not
               | on it, as well. From a safety perspective that cannot be
               | discounted.
               | 
               | From the standpoint of the companies and the people
               | involved, if you want to do drugs than work elsewhere.
               | Safety is a higher priority.
        
               | jackric wrote:
               | I agree Safety is the top priority. Don't risk people
               | with drugs traces in their blood; it may degrade their
               | competence. Also don't risk a guy that didn't sleep last
               | night working - his competence will be degraded.
               | 
               | I proposed my catch-all solution for this in another
               | comment: https://news.ycombinator.com/item?id=26183297
               | 
               | My ideal is we just ensure competence - guy who smoked
               | weed last night may be more competent than a clean guy
               | getting divorced. Test the competence
        
               | mfer wrote:
               | A lot of this is driven by insurance agencies and data
               | from investigations of events. I don't have insight into
               | that. Insurance companies, these days, tend to be very
               | data driven.
               | 
               | It would be great if there was a way to test for
               | competence. Some drugs cause long term issues with
               | decision making and being able to see what's likely to
               | happen. This reminds me of a job I had years ago framing
               | houses. I remember some of the work men firing nails from
               | a nail gun into a nearby woods. An area where
               | neighborhood kids happen to play.
               | 
               | That's poor decision making and a liability. How do you
               | test for complex things like that?
        
               | fbelzile wrote:
               | In this case, the grounds for dismissal are for wearing
               | headphones during working hours. Drug test results can be
               | positive for things done outside of working hours.
        
               | [deleted]
        
               | mfer wrote:
               | Drugs, in many cases, outside of working hours can have
               | effects during working hours.
               | 
               | Many software developers working for companies have
               | agreements that they can't compete with their current
               | employer on what they do while employed there. It's
               | something employees give up while employed somewhere.
               | 
               | In the name of safety, many jobs with safety issues have
               | to give up certain things (i.e. drugs) while employed
               | there.
        
               | vinger wrote:
               | It is not because it affects their job performance it is
               | because the test they use can't measure if things were
               | done a minute ago or 3 weeks ago.
        
               | Natsu wrote:
               | Drugs still affect people during working hours even if
               | used off-duty.
               | 
               | I had to mummify a guy's hand because it was sliced open
               | by glass, once. They were airlifted to the hospital
               | because the bleeding couldn't be controlled.
               | 
               | Another guy was doing something unsafe with his forklift,
               | probably because he was in a hurry, right before
               | Christmas, it rolled over on him and he died.
               | 
               | That's why we couldn't keep people who were careless for
               | any reason around. People could, and did, die for a
               | moment of carelessness.
               | 
               | You're asking for more of this kind of story.
        
               | jackric wrote:
               | I have a solution to prevent this, which doesn't
               | prejudice Mike for having a bit of weed 2 weeks ago
               | camping. Also it will filter out those unfit to work from
               | _legal_ medication, or tiredness.
               | 
               | Make workers do a 30 second ability test before going on
               | shift. Design the test to measure reaction speed, short
               | term memory, etc.
               | 
               | [follow up thought] - Test must be immune to
               | practice/muscle memory. Don't want a drunk passing the
               | test through familiarity, then performing shit on the
               | job.
        
               | laurent92 wrote:
               | Serious question: Can we design a test for
               | "getthereitis"? Most often, people would pass the test,
               | but then misjudge and, in the case of Christmas, hurry up
               | to "get there" (hence the name) and underestimate a risk.
               | Ability is 10/10 but judgement is 2/10, and it is hard to
               | verify that their mindset is calm.
        
             | snovv_crash wrote:
             | Proactive vs reactive? If you can tell someone will cause
             | an accident, you don't wait until it happens.
        
               | [deleted]
        
               | minitoar wrote:
               | How can you tell they will definitely cause an accident?
        
               | vorpalhex wrote:
               | The same reason you're not supposed to drive or operate
               | heavy machinery on a wide variety of medications,
               | including legal and over the counter ones.
        
               | minitoar wrote:
               | Sure, but op is talking about someone who uses controlled
               | substances outside of work. If they're not under the
               | influence of a substance at work, then it's not the same
               | situation you are talking about.
        
               | edgyquant wrote:
               | The effects of almost any narcotic last for 72 hours at
               | least. Not as intense, for sure, but there are still
               | symptoms.
        
               | Kaze404 wrote:
               | Should people who drink get fired because they might
               | drink on a Sunday and come back hungover?
        
               | mattnewton wrote:
               | If they are putting other people's lives at risk, maybe!
        
               | throwawayboise wrote:
               | Depends on what they are responsible for.
               | 
               | Airline pilots, I believe, have a no-drink-within-X-hours
               | rule. I'm not sure whether X is 12, 24, or more. So even
               | one drink the night before a morning flight would be
               | prohibited, even though logically a single drink with
               | dinner the night before should be a non-issue.
        
               | minitoar wrote:
               | "8 hours from bottle to throttle"
        
               | vinger wrote:
               | The effects can last a lifetime but saying any narcotic
               | will last for at least 72 hours doesn't take into
               | consideration dose, weight, history isn't even closely
               | true.
               | 
               | Did you know eating a poppyseed bagel will cause a
               | positive for heroin for upto 60 hours afterwards while
               | doing a small amount of heroin will not show up on that
               | same test.
        
               | Bootvis wrote:
               | What kind of person is willingly going to significantly
               | increase the loss of life or limb?
        
               | minitoar wrote:
               | Not sure what you're talking about here. If someone is
               | falling down drunk, k, get them out of the machine shop.
        
               | mattnewton wrote:
               | Because they showed up on depressants that are known to
               | inhibit your ability to operate heavy machinery?
        
               | minitoar wrote:
               | How can you tell they are on depressants? Did you drug
               | test them?
        
               | mattnewton wrote:
               | I can see where you are going with this, and I am aware
               | of the problems with drug tests and largely agree they
               | are over-applied. But I don't know of an alternative to
               | these imprecise tests in many cases.
        
             | biolurker1 wrote:
             | This is really going overboard personal freedom. It reminds
             | me of arguments like Clinton's "what is, is". No, having
             | heroin addicts at work is not OK even if they perform well
             | because it's very clear that they will not perform well
             | very soon and you don't need to wait for that as an
             | employer.
        
             | ryanmarsh wrote:
             | I'd like to know the word that describes the sort of
             | cognitive dissonance in your comment.
        
               | vntok wrote:
               | Denial?
        
             | mdoms wrote:
             | Do you have the same attitude to other safety procedures?
             | If an electrician routinely, consciously failed to check
             | the mains had been turned off before working do you think
             | he shouldn't be reprimanded until he electrocutes himself
             | or someone else?
        
               | [deleted]
        
               | minitoar wrote:
               | I know how to tell if mains is off -- use a multimeter.
               | Please provide a citation for the safety procedure for
               | determining if my electrician has used drugs that might
               | impact his judgement.
        
               | mdoms wrote:
               | You're moving the goalposts.
        
               | minitoar wrote:
               | Not sure what you mean. I believe mine and op's point is
               | that you have no objective criteria for determining if
               | someone is impaired. The criteria for determining someone
               | didn't follow safety procedures is well defined.
        
           | GordonS wrote:
           | The author is not suggesting you take heroin at work, any
           | more than it would be acceptable to drink alcohol at work.
        
             | ryanmarsh wrote:
             | Are we equating alcohol with heroin?
        
               | Toutouxc wrote:
               | Shouldn't we? Alcohol ruins more lives and causes more
               | injuries and damage than heroin.
        
               | biolurker1 wrote:
               | Just because it's used by a vast number of people.
               | Getting rational, for every 100 alcohol and 100 heroin
               | users who do you think is in better health shape?
        
               | GordonS wrote:
               | But how much of that is not because of the actual drug
               | itself, but rather because the drug is illegal?
        
               | GordonS wrote:
               | My point is the _opposite_ , that from a social
               | perspective, "just" alcohol is a serious no-no during
               | work, especially if working with machinery etc.
               | 
               | Although realistically, alcohol is probably one of the
               | worst from a work safety perspective.
        
               | mdoms wrote:
               | The article does this numerous times.
        
               | GordonS wrote:
               | I read TFA, and didn't see any such mention. I've gone
               | back to it with the search tool, and still don't see any
               | such thing. Would you mind pointing to where these
               | numerous points are please?
        
               | mdoms wrote:
               | Really, dude?
               | 
               | > Hart reports that more than 70 percent of drug users--
               | whether they use alcohol, cocaine, prescription
               | medications, or heroin--do not meet the health criteria
               | for drug addiction
               | 
               | > "My heroin use is as rational as my alcohol use," Carl
               | Hart writes
               | 
               | > Let's just talk about alcohol first. When you're at a
               | wedding reception, alcohol serves as a social lubricant.
               | People are more gregarious. They talk, they interact. The
               | same is true with cocaine at parties, heroin among
               | friends, or opium among friends, NDMA among lovers.
               | 
               | > It's just like with alcohol. Most people drink alcohol
               | on a regular basis, but they don't become physically
               | dependent
               | 
               | > I don't know a term. I simply mean people who take
               | drugs, like alcohol users, somebody who may have a glass
               | of wine or two every night for dinner, whereas somebody
               | else may only drink on the weekend. It's a wide range.
               | And the same can be true with cocaine or heroin
               | 
               | > Why do you use heroin? > That's like saying, "Why do
               | you use alcohol?"
        
             | throwawayboise wrote:
             | Drinking alcohol at work is acceptable in many office jobs.
             | Getting drunk is mostly not.
        
         | SubiculumCode wrote:
         | Hard agree. I've lost some loved ones to meth, and it tears up
         | whole communities. When I was young I was lax about drugs, but
         | after seeing the same story over and over...drug addiction is
         | real and it hurts.
        
         | ajkdhcb2 wrote:
         | You just threw out your own anecdotal nonsense.
         | 
         | Responsible drug users are invisible to society and to
         | judgemental people like you. You have no data to discredit it.
        
           | ericol wrote:
           | > Responsible drug users are invisible to society
           | 
           | Even more so, _nobody_ wants to hear about responsible drug
           | users, because that'll contradict the general discourse.
        
           | vntok wrote:
           | _Responsible drug users_ sounds like an oxymoron. Is there
           | any data that shows those people even exist?
        
             | wzkhstfx wrote:
             | > Responsible drug users sounds like an oxymoron. Is there
             | any data that shows those people even exist?
             | 
             | I mean, there's the billions of people who manage to
             | consume alcohol without it interfering with the rest of
             | their lives and the lives of others. Don't pretend that one
             | substance that alters perception and behavior somehow isn't
             | a "drug" in the same way that many others are just because
             | of its legal status.
             | 
             | But if you mean drugs that are illegal, yes, there are also
             | plenty of responsible users of those too. My wife and I
             | have taken MDMA together a few times and it has been
             | transformative for our relationship. As well as sharing our
             | love for each other it also helped us talk about difficult
             | subjects, something which I found hard for a long time, and
             | as a result I am now better at talking about hard things
             | when sober too. I think most people would say that going on
             | a date night is a "responsible" act of relationship
             | maintenance and I don't see what we did as any different,
             | except much, much more enjoyable than a cocktail and meal.
             | Every time we were careful with dosing, made sure we had no
             | other responsibilities, and so on. It's as responsible as
             | quality time with each other at a cafe.
             | 
             | I recognise that the production of illegal drugs is
             | damaging and awful, but that's the fault of our legal
             | framework. In the same way that producing soft drinks or
             | beer isn't necessarily damaging nor should be producing
             | drugs that are currently illegal.
        
             | sdeep27 wrote:
             | How about the 150 million people every day that drink a cup
             | of coffee and head to work?
        
             | boomboomsubban wrote:
             | The article mentions ~70% of users of any drug are not
             | addicts, and surely you know somebody who is both
             | responsible and drinks alcohol.
        
             | ericol wrote:
             | Obviously this is highly anecdotal, but for the 5 years
             | that I lived in Spain, I was a regular drug user.
             | 
             | With the exception made of MDMA & speed (That I'll consume
             | both on occasions) I was consuming weed, hash and mushrooms
             | on a weekly basis.
             | 
             | And everybody on a certain group of friends was doing the
             | same. We had a surplus of mushrooms, as we had somebody in
             | our group (A neurobiologist) growing them.
             | 
             | 13 years ago I came back to Argentina, and then stopped
             | consuming cold turkey.
        
             | bserge wrote:
             | I am one. I have used a lot of stuff, anything I could get
             | my hands on (not "just 'cause", I'm trying to find
             | something to fix specific problems).
             | 
             | And in the end, it's only alcohol and nicotine that have me
             | firmly in their grasp. Perhaps it's just the ease of
             | access.
             | 
             | I believe I could quit nicotine, but not alcohol. I don't
             | even drink a lot. But I do, regularly. I've used way more
             | addictive stuff, and I could go out and buy it tomorrow,
             | but I don't. Kind of funny how it works.
        
         | varispeed wrote:
         | The dangers of the drug mostly come from its legal status and
         | that it is being adulterated with various substances in the
         | unregulated market. People also don't get a leaflet that they
         | can consult on the strength or dosage so often they overdose.
         | Medical grade heroin is not as dangerous as people supporting
         | prohibition would like it to be. You can take clean heroin for
         | decades and be perfectly fine. This would rather not apply to
         | alcohol or other legal drugs.
        
           | johnyzee wrote:
           | I would say the main danger is the crippling physical
           | addiction (as well as psychological, but that is harder to
           | quantify) it causes in a substantial amount of users.
        
           | tanseydavid wrote:
           | >> You can take clean heroin for decades and be perfectly
           | fine.
           | 
           | This seems to me to be a excessively myopic way of thinking
           | about it. To the point of amounting to rationalization.
        
         | andrei_says_ wrote:
         | May I recommend the rat park experiment and possibly the work
         | of Gabor Mate as a way of establishing context for addiction.
        
         | frakkingcylons wrote:
         | It's not anecdotal, and he's not just talking about heroin.
         | He's been involved in pharmacology studies for over 20 years.
         | 
         | I wish people didn't dismiss Carl Hart immediately out of hand.
         | Prohibition has never been a successful strategy. People are
         | going to buy drugs no matter what. The biggest problem we have
         | with drugs in the US is that people are uninformed about safe
         | drug use and they are unable to easily verify the purity of the
         | drugs they buy.
        
         | 4eor0 wrote:
         | Yes, let's have your anecdotal experience be the basis for
         | curbing speech.
         | 
         | I've lost dozens of friends and family to alcoholism and drunk
         | driving.
         | 
         | I can't really get behind the cherry picking; society is being
         | damaged in other real ways to a much greater extent than
         | heroin, yet we find the ennui to overlook them; freedom of
         | choice, speech, too expensive to bother, political authority...
         | 
         | Portugal has the model we should adopt and let this be as
         | solved a problem it can be.
        
         | boomboomsubban wrote:
         | >all this article reports about is this anecdotal nonsense.
         | I've too many friends to Heroin to know the reality of the drug
         | 
         | The experiences of your friends is anecdotal. This article
         | discusses the mechanisms of the drug, both the physical and
         | personal cause of addiction, the common factors that lead to
         | death, and the rate of users that end up addicted.
        
         | maybelsyrup wrote:
         | Sorry, I call BS. First, ranked by whom? Besides internet
         | listicles, I mean. Second, those rankings, valid or not, are
         | _always_ a mix of legal and illegal drugs, with legal ones like
         | alcohol, nicotine, and benzodiazepines sitting above heroin,
         | morphine, and opium. Not to mention caffeine, which we begin
         | feeding to children at extremely young ages alongside the
         | amphetamines we pump them full of if they have trouble paying
         | attention when locked in a classroom all day.
         | 
         | Third, as someone else says below, stories about your friends
         | are also anecdotes. (I'm sorry, genuinely, that they died.) You
         | don't know "the reality" of heroin because there are a litany
         | of such realities - and here's a scientist telling you about
         | his. The thousands (more?) who use heroin like my aunt uses a
         | snifter of brandy at Christmas don't appear on anyone's radar
         | because they're not dying and they're not rocking the boat. I
         | could go on and on about the lives lost or ruined by alcohol in
         | my family tree alone, let alone just "people I know", but I'm
         | not terrified and calling to ban alcohol.
         | 
         | Finally, that so many people on a web forum whose userbase is
         | wealthier, whiter, and way more privileged than the population
         | at large rushing breathlessly into a post to call a black man
         | (from the ghetto of Miami FL, no less) who uses small amounts
         | of opiates "dangerous" is, excuse me, pretty effing rich. I
         | thought tech-libertarians were supposed to be less reactionary.
        
           | fnordsensei wrote:
           | I know that the EU and WHO at least rank drugs by
           | harmfulness.
           | 
           | On the WHO lists, alcohol ranks below heroin and the like,
           | but not far below, and certainly not as low as cannabis.
           | 
           | Harmfulness seems largely irrelevant for legislation.
        
       | codingdave wrote:
       | I've heard that statistic before, that 70% of drug users aren't
       | addicted. But I've also heard that the 30% who do get addicted is
       | less about good practices, and more of a genetic trait - if you
       | have the brain chemistry to get addicted, you do. Most people
       | don't, but 30% is non-trivial. If you are given a choice of "70%
       | chance to feel good for a few hours with a 30% chance to ruin
       | your life.", it doesn't feel like good odds to me. There surely
       | are safer and more reliable ways to enjoy your life.
        
       | vagrantJin wrote:
       | I've done my fair bit in the underbelly of night-life and not a
       | single drug has caught me out.
       | 
       | Partly because I may have a weird pleasure in feeling like crap
       | the day after and likely because I view life as contempt for
       | misery. No matter how terrible I feel - I'll crank out the work.
        
       | f430 wrote:
       | This article is just sheer irresponsible. Heroin especially now
       | is risky because so many dealers are cutting it with Fentanyl and
       | the users won't even know the difference until its too late.
       | 
       | Our blind catering to individual freedoms is really unbecoming
       | and I question why this author wanted to bring attention to
       | himself and his own private struggles.
       | 
       | I thought the UBC professor who faked being indigenous and doxxed
       | Asian Canadian students for being white supremacist and
       | threatened another professor topped it.
       | 
       | Just what in the hell is going on with North American academia
       | and educators? How did it fall from grace like this?
        
       | sillysaurusx wrote:
       | How many of you want to decriminalize drug use? Be honest --
       | raise your hand.
       | 
       | Now, how do you square that with almost everyone here universally
       | claiming that these _words are dangerous_?
       | 
       | > _The statements that make people mad are the ones they worry
       | might be believed. I suspect the statements that make people
       | maddest are those they worry might be true._
        
         | loves_mangoes wrote:
         | Hey there! Hand raised, and happy to disagree =)
         | 
         | Giving people the autonomy to live their life, means there are
         | many dangerous things you can say about things that are legal,
         | and should be legal.
         | 
         | I believe people should be responsible enough to drive a car,
         | drink alcohol, and with or without prescription take a drug
         | without risking a prison sentence.
         | 
         | Now my advice is: It's not okay to drive while extremely tired,
         | it's not healthy to drink yourself uncounscious (even if you're
         | not an alcoholic), and you should probably continue to not
         | treat heroin lightly.
         | 
         | I'm okay with all those things being legal. I'm not okay with
         | people equating legal with safe. Of course words can be
         | dangerous. That's why we call them out, but that's not a reason
         | to send people to federal 'technically your life is not over'
         | prison.
        
           | sillysaurusx wrote:
           | Happy to hear your disagreement! (Also, please have a
           | wonderful day this fine Thursday.)
           | 
           | The thing is, wouldn't you agree that if something isn't
           | criminal, then it should be fine to talk about the act of
           | doing that thing? Because that's all this interview seems to
           | be.
        
             | umvi wrote:
             | Ok, cigarettes are legal.
             | 
             | Say I am a prominent professor at a university and I write
             | an article about how I use cigarettes responsibly and how
             | I'm not addicted and that tons of people use cigarettes
             | without getting addicted. I also note that it's a great way
             | for me (and implicitly others) to find happiness. I then
             | publish my article to influence millions.
             | 
             | So then what's wrong when critics say my article is
             | dangerous and caution readers to take it with a grain of
             | salt?
        
               | sillysaurusx wrote:
               | Mm, perhaps I should change my mind on this one.
               | 
               | I suppose my root objection is that such warnings are
               | incredibly boring, because everyone in the world knows
               | that both heroin and cigarettes are dangerous. We're not
               | living in the era of cigarette advertising; surgeon
               | general's warnings are required by law.
               | 
               | But that's a different sort of objection than the one I
               | started with.
        
             | loves_mangoes wrote:
             | Thank you, a wonderful day to you too!
             | 
             | I think it's completely okay to talk about drugs, creating
             | taboos around dangerous things has rarely been helpful in
             | the past.
             | 
             | However, I think people's reaction to this piece shows
             | what's missing: more warnings around it than seem entirely
             | necessary to the average person. You just don't want
             | today's lucky 10,000 [0] to come away with the impression
             | that heroin is a pretty casual thing, and while the fact of
             | talking about it is great, the words themselves can be
             | dangerous if they promote unsafe behavior without adequate
             | warnings.
             | 
             | All that being said, I have to admit that people might be
             | over-reacting a smidge to the interview, but I can't really
             | fault them. I haven't personally lost anyone to heroin
             | addiction, but I imagine I might read the article less
             | generously if I had.
             | 
             | Cheers!
             | 
             | [0]: https://xkcd.com/1053/
        
       | achairapart wrote:
       | I can see addiction like unpaid debt.
       | 
       | Just like everyone may need a bank loan (which is totally
       | socially acceptable), sometime you may need a
       | happiness/energy/relief/whatever loan.
       | 
       | The thing is, just like a money loan, you should be ready to pay
       | your debt after. The day you think you can run away without
       | paying, it's where the trouble begin.
       | 
       | This is true even with alcohol: Go to a party, drink a few
       | glasses. One or two more. Have fun. The day after you pay it with
       | a little (or even big) hangover. Just drink a lot of water and
       | you will be ok.
       | 
       | Obviously this is more difficult with some drugs. They are
       | dangerous because they are more subtle, somehow you think you're
       | still in charge, until it's too late and your debt is out of
       | control.
       | 
       | Now, I'm aware that this is quite complex, but still I wonder how
       | many people there are out there who can self-control themself and
       | diligently keep their debt in order.
       | 
       | I guess, compared to "meth-heads" and other rock bottom abusers,
       | they just don't make the news. Plus they may want to avoid a lot
       | of social rejection.
        
         | mettamage wrote:
         | I disagree with this view. I think the metaphor captures some
         | elements of the experience, but it doesn't capture enough.
         | 
         | A craving feeling arises to have fun. The craving exists there
         | because it feels nice. This also implies that you feel less
         | nice than you'd like to feel. This craving doesn't happen that
         | often, but often enough that you're curious about taking drugs.
         | 
         | You try cocaine. Suddenly you feel energized and amazing, this
         | is how you always want to feel! The effect wanes after 20
         | minutes, you take it again and you feel amazing. You're
         | starting to do this every weekend. Cocaine gets associated with
         | the craving feeling for fun.
         | 
         | After a few months, whenever you feel like your normal self, a
         | craving feeling arises. This feeling is now a mix of wanting to
         | have fun and wanting cocaine.
         | 
         | The thing is, where I think the debt metaphor breaks down is
         | that this increase in craving acts a bit different than actual
         | debt.
         | 
         | Many addicts feel strong cravings for years afterwards, and it
         | only very slowly decreases. Once hooked again to the substance,
         | it's easily back to previous all-time high levels.
         | Psychologists claim that in conditioning processes, it's
         | impossible to delete conditioning (called extinction). So you
         | can never truly repay our debt.
         | 
         | Moreover, once your craving is extinct (for as much as
         | possible) it's really only dormant in reality. Make one wrong
         | move and you're quickly back to rock bottom. With debt, if I
         | pay back my debt of $50K, then splurge for another $1K, I am
         | not back in debt with $50K. This is however how addiction
         | works.
         | 
         | Finally, the debt metaphor doesn't capture the
         | uncontrollableness of cravings that are arising. You have no
         | free will in what spontaneous thought or feeling arises. This
         | is quite easily seen when you're sitting still and try to do
         | nothing: your mind will still chatter away, you'll still feel
         | things based on that chatter. In quite a few cases it's
         | impossible what your mind will show you next. The same is true
         | for the cravings that an addict gets with a drug. Sure, the
         | craving will arise when one starts to talk about it, but it may
         | also arise when somebody twitches their leg, because the muscle
         | tension is super vaguely associated to a memory when one was
         | partying with the drug, but the person is not even aware of
         | that association or that it's part of a memory.
         | 
         | Disclaimer: I'm not a drug addict, but based on my personal
         | life experiences, I think it's fair to say that I have enough
         | experience how it must feel like (I experience a mild pull to
         | alcohol, a strong pull to caffeine and an overwhelming pull to
         | videos and video games).
        
           | achairapart wrote:
           | The description of your craving process is both fascinating
           | and horrifying. Well, mostly horrifying. Is there a
           | scientific name for this very process?
           | 
           | I'm not a drug addict either, but I can relate with some of
           | it about my cigarette smoking habit (it's actually an
           | addiction, I know).
           | 
           | As for the metaphor, "every weekend" looks already like an
           | enormous amount of debt to me.
        
             | mettamage wrote:
             | Yea, I'm talking from the perspective of an addict or in-
             | between addict during that sentence. From their
             | perspective, every weekend is fine. Moreover, I know one
             | (exactly 1) acquaintance that has done cocaine for more
             | than 30 years every weekend and only in the weekends. So
             | arguably he wasn't addicted, not in the psychopathological
             | sense where he wasn't functioning in society (he was, I
             | think he did construction work).
             | 
             | Unfortunately, I don't know enough (anymore) on the science
             | of craving, most of what I wrote is actually what I've
             | noticed because of meditation and self-reflection, so it's
             | a very subjective account. Though, what I stated about
             | conditioning, that is scientifically proven, you can read
             | the wiki of operant and classical conditioning.
             | 
             | > The description of your craving process is both
             | fascinating and horrifying. Well, mostly horrifying.
             | 
             | In certain forms of mindfulness meditation you're asked to
             | observe your sensations in your body. In practice this can
             | translate to observing whatever craving you're experiencing
             | :P
             | 
             | Let me think a bit what areas of research might be
             | interesting to account a bit for my subjective
             | experience...
             | 
             | - Wanting and Liking from Berridge's lab [1].
             | 
             | - Research on how to make slot machine's addictive [2]
             | 
             | But those ideas are a bit more circumstantial I believe.
             | 
             | [1] https://en.wikipedia.org/wiki/Motivational_salience
             | 
             | [2] https://www.researchgate.net/publication/247926701_Addi
             | ctive...
        
         | swirepe wrote:
         | I liked the way you framed drug use as temporary happiness
         | loans. That's very insightful.
         | 
         | >Now, I'm aware that this is quite complex, but still I wonder
         | how many people there are out there who can self-control
         | themself and diligently keep their debt in order.
         | 
         | The analogy breaks down a bit here for me.
         | 
         | Before I had a cat, I couldn't understand how people could pay
         | so much for veterinary bills. After I got a cat, I could see
         | myself spending more on her than I would spend on myself. Like,
         | what's the point of having money if not to make my cat happy?
         | My relationship to _money itself_ changed. Self-control isn 't
         | a factor.
         | 
         | I'm stretching this analogy, but I wonder how many drug users
         | with their happiness debts in balance have really just reframed
         | their happiness finances around their addiction.
        
           | achairapart wrote:
           | There is a scene in the movie The Consequences of Love by
           | Paolo Sorrentino where you find out one of the secrets of the
           | mysterious leading character:
           | 
           | The first Wednesday of every month at 10am he shot himself
           | heroin.
           | 
           | It's one of his extremely methodical routines. It can be seen
           | as an habit, but you can't truly call him an addict.
           | 
           | If you reframe your happiness around your drug use you're
           | already addicted. The question about my original post was
           | more like: Are there people who have a drug habit without the
           | addiction? If yes, how many of them are there?
        
       | gist wrote:
       | > Carl Hart is a neuroscientist and Ziff Professor of Psychology
       | at Columbia University--he was the first tenured African-American
       | professor of sciences at Columbia.
       | 
       | This starts off reading like one of those spam emails of the past
       | where some claim was made backed up by 'and my
       | brother/sister/father/friend' 'is a professor at Harvard' (or
       | similar) to get you to take it as authoritative and serious. [1]
       | 
       | The issue with drug use is the outliers. Just like the issue with
       | driving fast is the driver who is not you it's not about what you
       | or most capable drivers can do under the best circumstances and
       | driving a well equipped and responsive modern car it's about 'the
       | other guy/gal'.
       | 
       | [1] What is the name for the logical fallacy here?
        
       | kneel wrote:
       | This man will eventually die of overdose, calling it now. It's
       | one thing to be a user, it's another to be a delusional user that
       | thinks they're immune to addiction.
        
       | werber wrote:
       | I've done heroin a handful of times and enjoyed it. The last time
       | I did it was laced with fentanyl and I nearly died. I don't agree
       | with everything in this article but I've lost so many friends to
       | laced heroin, and they were addicted and I really believe they
       | would have somewhat normal lives after their addiction. The
       | demonization and misinformation surrounding the drug is
       | staggering, I wish we treated it more like alcoholism, for a lot
       | of people it's not instant addiction, but for some one sip or
       | snort and they're on an isolating and destructive path that could
       | kill them. People don't have a way of knowing the equivalent of
       | one shot of alcohol in heroin because it's illegal. There is no
       | way for most people to consistently and rationally use it and
       | most people have no interest in doing so. But for the minority
       | who are going to throw caution to the wind (which at one point in
       | my life included me) I strongly believe we should remove as much
       | risk as possible
        
       | cryptica wrote:
       | My experience with drug users in the workplace is that the drugs
       | make them seem more empathetic in a superficial way but in fact
       | reduce their real empathy in the sense that they're less likely
       | to help others in need; when they do help others, it's often to
       | get attention to boost their personal image so that they can get
       | more money and/or power.
       | 
       | I think drug use also encourages people to seek out more thrills
       | in their personal lives. It takes away their ability to enjoy a
       | simple life and makes them greedier for endorphins. I wouldn't be
       | surprised if the current narcissistic, monopolistic corporate
       | economic environment is a result of heavy drug use among
       | executives. They can never get enough money or power because they
       | can never get the life satisfaction that their brains need to
       | match the highs provided by drugs; even given the fact that their
       | regular life experiences are far better than the average person;
       | it still doesn't compare to the drugs. The best possible life
       | experiences they can get don't meet their new baseline for
       | happiness. Drug use also seems to encourage cheating and other
       | unethical behaviours since these behaviours deliver a natural
       | high (alas, it still falls short of their drug baseline).
        
       | lmilcin wrote:
       | I am Coca Cola and coffee user. I am not addicted. That is, until
       | I try to leave it for a while and then even if I succeed it still
       | takes a lot of willpower.
       | 
       | Addiction is a force that counteracts your will power. You may
       | not have drug problem but you _are_ an addict if you feel
       | compulsion to use the drug.
       | 
       | Today you may have enough willpower to counteract that force to
       | consume more alcohol or drugs. But the next day may be worse, you
       | may find some family or work problem and your will power may
       | decrease enough that you will run into drug problem and have
       | really hard time getting rid of it if at all.
       | 
       | It is called slippery slope for a reason.
        
         | Etheryte wrote:
         | I'm not entirely sure if I follow the narrative here, perhaps
         | you can clarify what you mean. Occasionally I have a beer,
         | either socially or to try out a new beer -- does this make me
         | an addict? I would argue no, this alone is not a good
         | definition. I don't have a better definition myself, and surely
         | this is a subject many people have put a lot of effort into
         | figuring out, but I don't think this approach has merit.
        
           | lmilcin wrote:
           | It is up to you. People have different levels of willpower
           | regarding different things.
           | 
           | Don't dismiss power of addiction just because you "don't have
           | a problem now". Our willpower levels change so what isn't a
           | problem now may become another day.
           | 
           | You may loose your job and have hard time finding new one and
           | try to use something that has been giving you comfort to
           | lighten your day. And because your "bigger" worries you may
           | not be paying attention to it or you may need that extra
           | comfort so much you will just say "yeah, it will not hurt if
           | I do this for a while". This is frequently how these things
           | start. It doesn't happen that you are completely normal one
           | day and die hard alcoholic or drug user the next.
           | 
           | Now, I wouldn't call what you described even remotely close
           | to a problem. I also consume alcohol socially and even
           | privately. I pay attention to whether I "crave" alcohol and
           | when this happened I cut it instantly.
           | 
           | I have a test for this. Even if you don't drink alcohol, are
           | you constantly thinking about it?
           | 
           | If you are not using but constantly thinking about it it
           | means there exists a force (addiction) that you are currently
           | able to overcome.
        
           | nicoburns wrote:
           | I think their key point was that you don't ever really know
           | if you're an addict until you try to stop for a prolonged
           | period.
        
       | Spinnaker_ wrote:
       | I've been hearing about Carl Hart for a while. I can't find an
       | answer to if he's ever tried stopping heroine use?
       | 
       | I would expect one of the first things to come up in a the
       | conversation would be something along the lines of "yeah, I took
       | a break for a month last year. It was easy, I had no cravings or
       | other problems."
        
       | pid_0 wrote:
       | I don't have a problem I can stop whenever I want!
       | 
       | God this is so stupid. Please, stop amplifying this nonsense.
        
       | supr_strudl wrote:
       | >When you're at a wedding reception, alcohol serves as a social
       | lubricant. People are more gregarious. They talk, they interact.
       | The same is true with cocaine at parties, heroin among friends,
       | or opium among friends, NDMA among lovers. It enhances empathy,
       | openness, and forgiveness, all of these pro-social attributes.
       | 
       | Please, don't take this horrible advice. Drugs are harmful and
       | can do fatal damage to you and those around you. I mean, is this
       | guy advocating drug use? It sounds like he wants to justify his
       | dependency.
        
         | quattrofan wrote:
         | Do you drink alcohol? If so you're a drug user... We've just
         | decided for myriad, commercial, political and historical
         | reasons to legitimise some and make others illegal. Note I
         | never used the word "scientific" in that sentence.
        
           | supr_strudl wrote:
           | I don't drink alcohol. The best advocates of drug use are
           | drug users. They're quite passionate about it. Where I come
           | from, they make fun of you if you don't drink and sing a song
           | about how you're "too weak to drink." Every occasion calls
           | for a drink: childbirth, Friday, getting married, getting
           | divorced. It is so common that you're the weird one for not
           | drinking.
        
             | swirepe wrote:
             | For what it's worth, I don't think it's weird that you
             | don't drink alcohol.
        
             | selimthegrim wrote:
             | Bavaria? (Oh I see your profile. I've been to NG some years
             | ago - my uncle's family is from Maribor I think)
        
         | diegoperini wrote:
         | It doesn't look like an advice but a simple, neutral
         | observation of the pluses. Of course there are also minuses but
         | this quote doesn't seem it rejects those.
        
         | yboris wrote:
         | Coffee, chocolate, and sugar are drugs. If a drug is a
         | substance that affects how your mind functions, then water is a
         | drug too. There is no definition of "drug" that cleanly
         | separates the (currently) illegal substances from those that
         | are legal.
         | 
         | The world is full of chemicals that affect us, some more than
         | others. People self-medicate all the time (alcohol, coffee,
         | chocolate, sugar); I see no problem with (after learning and
         | carefully experimenting) broadening one's set of "self-
         | medication" tools.
        
         | darkerside wrote:
         | I'm glad this has been flagged. This is the WOMM of putting
         | dangerous shit in your body.
        
         | 5600k wrote:
         | While slinging a cat has always been a disturbing analogy to
         | me, in this case I think it's appropriate; you can't sling a
         | cat without it hitting a popular rockstar that did heroin or
         | similar at small or varying doses, was convinced they had it
         | under control, and their careers slowly and then quickly
         | tanked. I also have friends and acquaintances whose lives were
         | ruined by it or they died early because of it.
         | 
         | I'm glad this made it front page news given that the northwest
         | coast of US now gets hard drugs, so maybe one of them will
         | think twice about being a full-on grade A dumbass.
         | 
         | Also remember: with legality especially in a rich
         | entrepreneurial country comes business which lobbies, funds
         | studies, etc. Pot strived for many years for legitimacy, and
         | once they got it, it exploded all over the US.
        
           | Icathian wrote:
           | Since you called it out specifically I figure you might be
           | interested to know the idiom is actually "swing a cat.
           | Definitely a disturbing mental image, I agree.
        
           | swirepe wrote:
           | 'Slinging cat' is slang for selling methcathinone.
           | Interestingly, this doesn't change the meaning of your first
           | sentence.
           | 
           | https://en.wikipedia.org/wiki/Methcathinone
        
         | kardianos wrote:
         | I agree. I consider the ability caring for children to be
         | integral to life. I consider things that interfere with that
         | (getting drunk, high, unresponsive for periods of time) bad.
         | 
         | If you don't have or want kids, you're missing what made you
         | and was given to you.
        
         | rand_r wrote:
         | We need a more nuanced discussion of "drugs". The word drug is
         | about as useful as "chemical". The biggest evidence that we've
         | been lied to and manipulated by the media and the government is
         | that "drug use" is even a term.
         | 
         | Addiction, as the article says is more complicated than any
         | drug and is factor of a person's life situation in general.
         | Look at the work of Gabor Mate for a better understanding of
         | addiction.
        
         | sneak wrote:
         | The section you quoted didn't give any advice.
        
         | achairapart wrote:
         | How is that you can totally talk about social
         | media/sugar/porn/whatever addiction but when there are drugs
         | there is always someone screaming "OH MY GOD LOOK THIS GUY IS
         | TALKING BAD THINGS CALL THE COPS!"?
        
       | ballballball wrote:
       | Rationalization is a helluva drug.
        
       | moreranchplease wrote:
       | I agree with him. Only a small percentage of people who do
       | cocaine become addicted. It's almost always those who are trying
       | to escape shitty circumstances. While heroin is dangerous the
       | uncertainty of what you're getting and its strength is the cause
       | of most deaths.
        
       | Bakary wrote:
       | Grossly simplified, there are two very broad categories of users.
       | Those who use in an assertive way because they are confident and
       | naturally inclined to try new experiences tend to do quite well.
       | Those who use to escape don't do well.
        
       | jeofken wrote:
       | A life hack for anyone here trying to quit is using lent which
       | has just begun, to both set a time limit and to externalise
       | quitting. "I'm giving X up for lent" isn't so daunting, and
       | something you can tell people.
       | 
       | Changing your environment is also a good idea - if nothing else
       | move change room to sleep in and move furniture to new places,
       | and you've got a new "place".
       | 
       | I use it to quit my daily beer habit. Kindest regards to you
       | internet friend who struggles with addiction.
        
       | mrwh wrote:
       | My only direct experience of opioids is a one week prescription
       | for percocet after surgery. It got me through, and probably was
       | safer short-term than taking massive amounts of Tylenol. But I
       | was glad to stop taking it. It felt insidious: it didn't make the
       | unpleasantness go away so much as remove my ability to care about
       | the unpleasantness. Everything felt fine, kind of light and
       | bouncy. I can easily imagine being trapped in that.
        
       | altcognito wrote:
       | Because one person _thinks_ he has it under control at this time,
       | I don 't see how advocating for wider acceptance of drug classes
       | that have killed and destroyed the lives of millions every year
       | is even a story that deserves a platform.
       | 
       | This was a good story to flag.
        
         | yboris wrote:
         | It is interesting to me how ready we sometimes are to dismiss
         | others' self-reports. This is akin to doctors in early 1900's
         | (and even now) simply ignoring women's self reports of pain.
         | 
         | When a person reports something about their own life and
         | internal state, you need to have overwhelming evidence before
         | you can dismiss what they are saying. On what grounds do you
         | dismiss the author's claims about their life? He clearly has
         | his life well-enough-together to get an essay published in a
         | reputable science magazine.
        
           | altcognito wrote:
           | I'm not dismissing his account, so you should read my comment
           | closer.
           | 
           | I don't think I would use getting published as evidence that
           | somebody "has their life together". Again, I don't care if he
           | does have his life together. It may entirely fake, it can be
           | temporary, and it can be one account.
           | 
           | Look, I'm wholly for the idea of not shaming people who use
           | drugs. I am also wholly against treating drugs which have
           | established track records of destroying lives as recreational
           | or not a problem when used regularly, especially to avoid
           | personal problems. So I'm strongly against publishing essays
           | which tell a soft story to play down the millions of other
           | stories, which this absolutely does.
           | 
           | Why doesn't he talk about how this impairs his motor or
           | thinking? Is he somehow magic, isn't the entire point to
           | alter his conciousness? No, it's all positive about drugs.
           | Ridiculous. Why doesn't he point to the side effects? Using
           | alcohol as an example of how "harmless" drugs are is obscene.
           | Alcohol destroys millions of lives every year as well.
           | 
           | If he wants to sell tolerance of people's choices in the name
           | of the freedom to ruin your own life, then so be it. Don't
           | soft peddle me bullshit.
           | 
           | Could we have a story about all the men and women who had
           | their entire lives destroyed by drugs as a counter example?
        
             | yboris wrote:
             | We _do_ hear (literally) hundreds of stories about how
             | drugs destroy lives. Growing up in the US, there would be
             | nearly a yearly assembly where we were told about
             | (exaggerated) dangers of drugs. One story was  "a mother
             | put her child in the oven" and other horrors.
             | 
             | Hearing an opposing point of view is a breath of fresh air
             | for people who are fed up with the one sidedness and
             | hysteria.
             | 
             | Stories distort reality. They oversimplify and hide
             | details.
             | 
             | Think about a parallel: pizza. People in the US are
             | notoriously (unhealthily) overweight. Should we be
             | hysterical about someone who says "I can eat pizza without
             | going overboard"?
        
               | altcognito wrote:
               | Comparing heroin to unhealthy eating is an interesting
               | take.
        
       | munificent wrote:
       | If I try to synthesize the ancedotes in this thread, it seems:
       | 
       | 1. Some people do not seem have an addictive response to opioids.
       | It's roughly in the same safety category as alcohol and weed.
       | 
       | 2. Some people become nearly-instantly profoundly physically
       | addicted to the point that it will inexorably destroy their
       | lives.
       | 
       | The only way to figure which category you're in is to try it and
       | find out. There's a personal liberty principle argument that if
       | you are in the first category, you should have access to opioids
       | just like you have access to other pursuits of happiness. But the
       | inability to determine _whether_ you 're that category induces a
       | significant risk at the aggregate level. People die and everyone,
       | even those who can take opioids safely end up indirectly dealing
       | with the negative consequences in terms of rising healthcare
       | costs, dealing with homeless drug users on the street, etc.
       | 
       | I can think of three philosophical approaches to this:
       | 
       | * Communal: Say that since some fraction of people will be
       | grievously harmed by opioids, the greatest good for all is to
       | prohibit them universally. We ask the safe users to sacrifice the
       | harmless positive experience to protect the unsafe users from
       | harm. This is nominally what we do now by outlawing them.
       | 
       | * Libertarian: Acknowledge that even trying is a roll of the dice
       | and that if you choose to roll them, you have to take the
       | consequences. This is effectively what we do now since the law
       | enforcement is so ineffective.
       | 
       | * Technological: Research a way to determine whether you can take
       | opioids safely without having to try them. Imagine a test your
       | doctor could give you that says "Yes, you'll be physically
       | addicted." That increased certainty would remove much of the
       | stigma of use, and make it easier for those that are at risk to
       | stay away because they know they really are likely to get
       | addicted.
       | 
       | I don't usually lean towards tech solutions to societal problems,
       | but this seems like a case where having more insight into an
       | individual's physiology would help everyone make better choices.
       | 
       | (Personally, after receiving fentanyl during a medical procedure,
       | I am absolutely certain I should never be given easy access to
       | opioids.)
        
       | alexashka wrote:
       | There's an excellent recent Joe Rogan podcast episode on Spotify
       | with Carl Hart - the fella in this article, for those who want to
       | get a more comprehensive understanding of his position.
       | 
       | He's basically for personal freedom _and responsibility_ , drugs
       | included.
       | 
       | His position is really hard to argue with, given the disaster
       | that alcohol prohibition and this 'war on drugs' has been.
       | 
       | The word heroin has triggered a lot of comments here - just
       | because you've known someone who has ruined their life and feel
       | strongly about it, does not make you qualified to draw
       | conclusions on the effects of drug use at large.
        
         | crescentfresh wrote:
         | More recently he appeared on the Toure Show podcast:
         | https://play.acast.com/s/toureshow/dr.carlhart-idodrugs
        
       | etempleton wrote:
       | All the luck to him. I have seen enough of heroin use second hand
       | to know that this is how it starts and is rationalized for many.
       | Some people spiral immediately, others after a few years, others
       | after a decade. Eventually, if you keep using, it will catch up
       | to you and you risk losing everything.
        
       | wuxb wrote:
       | Just ask the man two questions: Would you like to give heroin to
       | your children, relatives, and colleagues. Would you like to pay
       | for them if they don't have the money to get enough doses in
       | their life? Many "leaders" I know tell people "this company is
       | great". But they ended up sending their kids to other (better)
       | places.
        
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