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Someone please explain: Who are the victims in this supposed "crime?"

It would be a huge understatement to claim that the US has a strange obsession with so called prescription narcotics. Sending doctors and patients alike to jail for supposed overuse or over-subscription.

Look, yes, there is a public interest case where someone is known to be selling or allowing others to be selling such medications onto the black market. But in many of these case (most?) that isn't really the case, or at least they have no evidence of that.

So, again, what exactly is it they're trying to accomplish? Why is the victim? Why do they care?

On a related note, I have a family member (in the US) who works in a clinic, the sole purpose of this clinic is to get people with chronic or in some cases even terminal conditions off of narcotic painkillers. These people provably are in pain, but the system in the US is such that they'll kick people off of painkillers who actually need them simply because of some kind of "narcotic painkillers are bad" circular logic which nobody can explain to me.

I'd really like someone to explain to me why the prescription of painkillers isn't a matter best left to patients and doctors in most cases where there is no suggestion of resale or other corruption. It just boggles my mind that the police are getting into people's personal treatment plans and calling their painkillers illegal.



>Who are the victims in this supposed "crime?"

I've been working on this theory harm I tentatively call "moral environmentalism". It is actually very similar to anti-abortion or anti-homosexual stance: some people feel that certain behaviors taint the "moral environment", and this constitutes real harm to them personally. The mechanism of harm is usually, but not always, predicated on the existence of an enforcing deity. The idea is that if you don't work to stop harm (even self-harm of others) that you are somehow culpable.

A deity is not required, however: some claim the these morally 'dirty' actions will result in other wrong actions that do have victims. (it's usually a cover for a deity, though). You see this in the anti-drug (and anti-alcohol, historically) movement, with claims that legalized drugs will cause an orgiastic violent apocalypse.


I think your theory has merit, but is somewhat flawed in the area of deity. Either that, or I'm an outlier. I'm a very religious person, and I think the war on drugs is stupid. I believe God created plants and herbs to benefit people and that drugs like marijuana should be legal and free to grow and use. I don't agree with the control and taxation of such drugs (or alcohol) and think government should get themselves out of the business altogether. A person should have the right to choose for themselves without any nanny-like interference from the state. We don't need government doing that for us.

The same is true if someone wants to be gay. They have the right to choose that lifestyle for themselves. I don't agree with abortion, however. Not because of some societal impact, but because it steals away the agency of another. I think people have every right to choose for themselves, but no right whatsoever to chose for another; including the unborn.


.. if someone wants to be gay. They have the right to choose that lifestyle ..

This really irks me. People do not wake up one day and go "oh gee, let's see, i'll be attracted to a different gender from now on!" It's this attitude that, unchecked, does things like killing Turing.

[abortion] steals away the agency of another

This is retarded too, i'm very sorry, but somebody has to say it. So this clump of cells that was created entirely by the actions of the parents suddenly has rights, but the host, whose body it is (and nobody else's, mind!), doesn't get to choose? Why this sudden flip? On day 1 this person (non-pregnant woman) has full agency according to you, then on day 2 once pregnant, she has magical incubator-only-no-agency restrictions?

I'm sorry, this has nothing to do with you being religious or not (as you rightly point out), but your views don't correspond with a place i would like to live in.


Of course people choose to be gay. Having sex is an action, not a state of being. My nature is to want to have sex with every woman on the face of the planet. If I opt to do so, I become an adulterer, philanderer, womanizer, etc. Or, if I choose not to have sex with every woman I meet, I am not an adulterer, even though my nature is to be one.


Oh, I forgot to comment on your second point regarding abortion. I'm not sure why the concept of losing rights based on personal choices is so foreign to you when similar occurrences happen throughout our country on a daily basis.


I agree. I mean, on day one, I am free to do as I wish in my home; but on day two, just because I invited this guy into MY house (and nobody else's, mind!), I can't kill him if I want? Why this sudden flip?

/sarc


Because supposedly embryo in my example != adult with agency in your example. Also, homes aren't bodies.

I'm not even sure if you're disagreeing, sarc-tag or not :)


The cynic in me finally thinks that it simplifies to this:

Pills can make you feel good. You aren't supposed to just be able to feel good without doing some sort of "work" to "earn" it. So the pills are cheating. We'll give you a concession if your circumstances make you feel extra bad, but only until you reach the normal level of "feel-good" that should be afforded to you by your station in life.

The whole "war on drugs" exploits this involuntary tic in popular opinion.


It's all about "if somebody has something I don't, I'm worse off as a result". It's the same psychology that leads to people telling a lunch lady she can't make such good food because their kids' lunch-lady-prepared food isn't as good[1], so, therefore, their kids are worse off than they would be with everybody having crappy food. People try to justify it as "we should all be equal" or some garbage.

http://www.huffingtonpost.com/2012/10/08/annika-eriksson-swe...


From the link: "Update: The day this article was published, it was announced that Eriksson will be able to continue baking her own bread and providing healthful vegetable options. The incident has been called a 'misunderstanding,' according to Swedish news source dt.se."


In general I agree with your sentiment, but not to the extent that you do. 40 people a day die from prescription painkiller overdoses. They are, in fact, addictive. And they can and will kill you if abused. (http://www.webmd.com/mental-health/addiction/news/20111101/4...)

I'm very much a libertarian kind of guy and part of me wants to say "well so, its their life, let them do what they want". But these deaths have serious societal repercussions: the removal of an otherwise productive body and the orphaning of children.

I don't like shades of gray, but this seems like the government overreacting to a problem. I don't think people should go to jail because of substance abuse, I do think that people in legitimate pain deserve to be relieved from that pain, but I also think the government has a legitimate role in regulating these drugs.


> On a related note, I have a family member (in the US) who works in a clinic, the sole purpose of this clinic is to get people with chronic or in some cases even terminal conditions off of narcotic painkillers. These people provably are in pain, but the system in the US is such that they'll kick people off of painkillers who actually need them simply because of some kind of "narcotic painkillers are bad" circular logic which nobody can explain to me.

People with long term pain need an early referal to a pain management clinic. They need short term pain meds to allow them to do physiotherapist guided exercise.

Long term use of pain meds doesn't work for most people. This is not about some moral panic over heroin; it should be about the unsuitability of ineffective and risky medication.

When someone with long term pain takes opiate meds for that pain they start needing to increase the dose; this puts them at risk of harm from toxic doses.

Short term pain is different; use opiates for that.

Here's a programme with interviews with people at pain clinics. These people had active addictions to opiate pain meds; they were taking huge quantities of pain meds; but importantly they were not getting adaquate pain relief.

http://www.bbc.co.uk/programmes/b04wv052


Whether dose increase happens during long term pain treatment with opioids depends on the opioid.

The common mechanism for dose increase with morphine and similar opioids that act on mu-opiod receptors is their upregulation of NMDA receptors. NMDA upregulation increases pain sensitivity. Wash, rinse, repeat - the patient is on the dose escalation escalator.

The opioid methadone is an NMDA antagonist (along with ketamine, memantine, and dextromethorphan, for example), making it much less likely to induce dose escalation when prescribed for otherwise intractable chronic pain.

Methadone has a bad reputation because of 1) its association with treatment of heroin addiction and 2) its pharmacokinetics. The latter means that its blood concentration increase (and decrease, on cessation of the drug) changes slowly (think a week or so). When it's prescribed, it takes awhile to titrate for effect. If the process is rushed, it's possible to get lethal levels following several days after dose increase. It's basically a PID controller problem with a long phase lag between control input and effect.

In a clinical setting that doesn't involve the difficulties of multiple drug abuse, it's a very useful medication for otherwise intractable chronic pain.

Long way of saying that the opiate dose escalation issue is complicated.


> Someone please explain: Who are the victims in this supposed "crime?"

Children, spouses, parents, family, and friends of people whose free will is compromised by their addiction to prescription drugs? It's a "victimless crime" only from a very narrow perspective of what constitutes social harm.


And the solution to prescription drug addiction is prison time or fines? How does that help the families?


No, it's not. But: 1) it's legitimate to control those who enable addicts by criminalizing illegal distribution of prescription drugs; and 2) the fact our current response may be a bad idea does not mean that the conduct has no victims and it's not legitimate for society to formulate some response.


If our response is causing more harm than the "crime" itself does it make sense to continue down that road just because we can't come up with anything better?


You can argue that treatment, etc, is a better response than criminalization. I agree. But that's a different argument. Arguing that drug use has no victims is an attack on the legitimacy of any response to drug use, and ignores the huge numbers of people hurt by other peoples' drug addictions.


People all over the country are routinely treated with heroin (diamorphine) in a clinical setting. It is a very useful narcotic. If you've had nose surgery, even a simple corrective procedure, you've been treated with cocaine. None of these people leave the hospital craving drugs and looking to score. They do not become addicted.

Addiction does not follow from treatment with narcotics. What you think of as harmful addiction follows from the junkie subculture created by criminalization

The harmful effects of drug addiction are in fact a result of severe criminalization of narcotics. If you suffer from debilitating pain, you will go out of your way to suppress it. If no one will sell you pain killers legally, you will get them illegally.

Indeed, if doctors could legally prescribe opiates for chronic pain sufferers, most of the illegal market would disappear. There would indeed be no crime. People in pain would get their medication for a few dollars and go on having normal lives. Calling these people addicts really is a way of ostracizing them, which only hurts people. True, they might be addicted to their medication. Their pain is now manageable too, really a fair trade off I think. Even more so when a daily dose costs just pennies.




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