> And remember - we did have a long experiment with legally prescribed opioids, and their widespread availability contributed to the current addiction crisis.
Well yeah, when you have criminally-encouraged over prescription of highly addictive, fairly dangerous drugs, you’re going to create an addiction crisis, but the actual deaths happening now are due to the unavailability of those same prescription drugs. Before the prescription crackdown and fentanyl prevalence, some people who got addicted turned to heroin, and some of those people ODed, but now nearly every addicted individual only has access to fentanyl-laced street opiates.
Methadone clinics are a decent example of how regulation helps this issue.
Sure, they can help, but wouldn't you say that's treating the symptoms rather than the disease?
>> the actual deaths happening now are due to the unavailability of those same prescription drugs
But you just said the initial reason was "criminally-encouraged over prescription". How do you not trace the deaths now all the way back to that? The thing about opioids is that you develop tolerance. I guess if those people were still getting higher and higher prescribed doses, they would never need to dip into illegal markets where their drugs might be contaminated with fentanyl. But it's hard for me to cut off the search for a root cause of deaths at this latest unavailability. The root cause is the over-prescription in the first place.
Stigmatization serves a role. I'm a smoker - but I know anti-smokers will agree with me, that stigmatizing my behavior prevents more people from starting to do something terrible to their health.
And if that's true, then legalization would be a root cause of the next wave of deaths. It's the addiction that kills; the erstwhile lack of good drugs is just the way it happens to kill some people.
What’s the disease? Is it the body’s down-regulation of opioid receptors? If so, then you’re right. But if it also includes the impact of an active opioid addiction on one’s lifestyle, methadone clinics help treat that, which in turn makes it much easier to address the former.
I think for practical purposes, it’s most helpful to ascribe it to a recent and controllable factor.
Otherwise, you could say that the “no medical benefit” scheduling of cannabis also contributed. Restricting medical pain management options to (with a few exceptions) just opioids when there was an unexplored (medically) class of less addictive, less destructive, physiologically safe medicine, definitely didn’t curb the opioid issue.
I agree that stigmatization is a good thing, but if all tobacco products got taken off shelves overnight, people wouldn’t stop smoking, they’d just have to buy on an unregulated (unsafe) market. Not saying that current regulation is perfect, but at least it can be controlled, which allows the market to move in (hopefully) the right way.
> The thing about opioids is that you develop tolerance.
This isn’t really unique to opioids, and I picture the legalization/regulation being discussed in this thread as more along the lines of existing cannabis programs, though obviously stricter in whatever necessary dimensions.
> It's the addiction that kills
Not necessarily, now at least. Lifestyle, maybe, but plenty of people now are overdosing on fentanyl from just experimenting, not even necessarily with opioids. And yes it is dumb to experiment with unknown street narcotics, but I’d be surprised if you took your first sip of alcohol when you were 21, and it’s the same principle of doing something that feels forbidden (and will make you feel good). And, if it were during prohibition, that sip could have had methanol in it. Now it can’t because of legalization and regulation.
Well yeah, when you have criminally-encouraged over prescription of highly addictive, fairly dangerous drugs, you’re going to create an addiction crisis, but the actual deaths happening now are due to the unavailability of those same prescription drugs. Before the prescription crackdown and fentanyl prevalence, some people who got addicted turned to heroin, and some of those people ODed, but now nearly every addicted individual only has access to fentanyl-laced street opiates.
Methadone clinics are a decent example of how regulation helps this issue.