> Opioids can't be banned until we can replace them with something equally generally effective.
Opioids should not be banned
Opioid addiction (I have seen a lot of it, not had it) is a social problem and is best managed with, opioids
The problems stem from putting unreasonable obstacles between adicts amd their appropriate treatment. Practical legal and financial obstacles, sadistic legal obstacles, and bizarre moral obstacles
Great Britain for many y4ars managed Opioid addiction with opioids, principally methadone and heroin
Nineteenth century society managed it with laudinum
We westerners in the twenty first century are failing to manage it with cruelty
The Sacklers are, were, parasites profiting from that social malaise and bad things will finally happen to them. But the cause of the malaise is our irrational attitude to drugs
> Opioid addiction (I have seen a lot of it, not had it) is a social problem and is best managed with, opioids
I don't entirely disagree with you, but I have also seen enough people stop, who probably wouldn't have if that were the typical treatment, to be pretty cautious about that. There are a number of promising addiction treatments in the wings at the moment, in particular Ozempic and the general GLP-1 agonist class.
Transitional opioids like Buprenorphine are fine as a detox strategy, and maybe even fine for the medium term, but committing to them for life I think is a mistake (in most cases).
> The problems stem from putting unreasonable obstacles between adicts amd their appropriate treatment. Practical legal and financial obstacles, sadistic legal obstacles, and bizarre moral obstacles
There is a lot of truth to this. It is, in fact, what I used to say when I used them. And it is and remains true. It is also true that prolonged opioid use is mostly physiologically harmless (overdoses notwithstanding). However, there are psychological elements that come with long term use that these measures do not capture, and are not fully internalized by the transaction costs (or literal costs) associated with obtaining them.
> Nineteenth century society managed it with laudinum
Ask China why they fought that opium war, and how they feel about such things lately. They are still mad about it.
> The Sacklers are, were, parasites profiting from that social malaise and bad things will finally happen to them. But the cause of the malaise is our irrational attitude to drugs
Agree on the Sacklers although personally I'd place more blame on the McKinsey consultants that wrote the original deck that proposed the strategy. I don't know how much the Sackler individuals personally made these decisions, but those people certainly did.
Re: irrational attitudes to drugs, I agree, but the situation is substantially more nuanced than it might superficially appear. Laudanum did used to be over the counter, as did cocaine among other things. However, these things were not criminalized for no reason - heroin wasn't criminalized in the 60s/70s anti-hippie craze, or for racist reasons in the 1930s (like marijuana).
Heroin was first criminalized for over the counter sale in 1910 - 15 years after Bayer first marketed it. Easily the fastest criminalization of a novel pharmaceutical compound in the history of the world. This is not an accident or a product of some temporary social hysteria. And unfortunately, it was also not criminalized because all of its harms were due to its being illegal.
If criminality were the problem we would expect things to get better, not worse, with the introduction of fentanyl which is far cheaper and more readily available. I could be misreading the data, but that does not seem to be working out.
I'll quibble on two points. "used as a wedge issue by foreigners", while perhaps true in some moral sense, it does not really make much sense, on closer scrutiny. To reduce things down to being some foreign imposition is to suggest that it could have been any product. But it couldn't - only opium has the special properties necessary to become this kind of product. Nobody fought a war over tobacco, or even cocaine.
It is also true that Arabia, and even the ancient Greeks ('land of the lotus eaters') were aware of and could obtain Opium. However, I'd inquire as to how it is that the primary opium growing regions of Arabia are doing lately, or say, ever.
It is true that Opium has been available to varying degrees, at various times, in various places without a total social breakdown. However, widespread, sustained, cheap availability of pure Opium without total social breakdown is, as far as I know, unheard of. The over the counter stuff in Europe and the early US were mixed with other things, as in Laudanum. Almost all of high society at the time was addicted anyway, and this was the mild form.
The Chinese discovered that they could smoke it, and changing ROA from oral to smoking is a radical step change in addictiveness. I'm not entirely sure why this didn't catch on elsewhere at the time, but the fact of the matter is it didn't, and the difference between these things is a difference in kind, not degree.
> It is not a choice between continued sadism or free reign herion and cocaine dealing
I hope you're right! But I don't observe anything in the world that would support it, unfortunately. I quit because I was arrested, for instance. I want to be careful about causal meaning here, I didn't stay off because I was arrested, but it was the excipient that proximately caused and also facilitated it. It was a structural break that allowed other things to change around it.
That's not to say that the judicial system is a good way to deal with things - it's not. But the credible threat of the judicial system cannot really be done away with here without courting disaster. When dealing with highly physically addictive substances, shaping short term behavior by force is often a necessary ingredient in having any hope of shaping medium or long term behavior via therapy, life circumstance changes, or anything else.
Causality is hard to tease out here, but more importantly, all they're doing is decriminalizing it and offering methadone/buprenorphine maintenance treatments. And the effect on number of addicts has not been good:
> Coca in Bolivia (I am on thin ice, I know too little, but they elected a coca grower as president)
Coca is really not anything. If you've ever chewed coca leaves, they're mildly stimulating. They're nothing like cocaine.
> I think there is plenty of evidence that a considered thoughtful approach to drugs is better
Considered, thoughtful approaches are always better! The question is, what are you considering and being thoughtful about. And the fact of the matter is that the most drug-liberal cities in the US have the worst drug problems, and so do the most drug liberal countries (like Portugal).
The countries that have the fewest problems with addiction are the harshest: Singapore, China, Japan. These things are not an accident. I'm not necessarily advocating adopting policies that harsh, just pointing out that they do actually work, whereas the liberal policies fail disastrously everywhere they're implemented. I'm in favor of criminalization, but only as a tool to force people into deferral/treatment programs. I don't want to see anyone actually put in jail for using drugs, unless they fail to complete their deferral program.
> Ask China why they fought that opium war, and how they feel about such things lately. They are still mad about it.
Was this meant to be ironic? Most of the illicit fent precursors comes from China now, I would guess it’s only a matter of time until Chinese producers look inward rather than just at export, which is why I’m surprised the Chinese government isn’t taking a harder line stance on illicit fent production and export.
Opioids should not be banned
Opioid addiction (I have seen a lot of it, not had it) is a social problem and is best managed with, opioids
The problems stem from putting unreasonable obstacles between adicts amd their appropriate treatment. Practical legal and financial obstacles, sadistic legal obstacles, and bizarre moral obstacles
Great Britain for many y4ars managed Opioid addiction with opioids, principally methadone and heroin
Nineteenth century society managed it with laudinum
We westerners in the twenty first century are failing to manage it with cruelty
The Sacklers are, were, parasites profiting from that social malaise and bad things will finally happen to them. But the cause of the malaise is our irrational attitude to drugs