There is no such thing as "a safe supply of drugs". Whether the street drugs are produced in a quality-controlled way or not, it is well-known that use of the substances has negative outcomes in health and occupational functioning.
Direct sale of street narcotics would only be another harm reduction practice, similar to "safe use sites". But no harm reduction practice makes the harm "safe".
The political double-speak around this is very similar to "clean coal"; it implies a strong position ("coal is clean") while offering an escape hatch if challenged ("coal pollution mitigation, otherwise known as clean coal, reduces greenhouse emissions when coal is used as a fuel"). Similarly as there is no "clean coal" in reality, there is no "safe supply of drugs".
When we take deceiving loaded words like "safe" out of the equation, it becomes harder to argue against substance control, even if seen as prohibition. While it is evident that street drug crisis in the US has been mishandled, if restricting the access of these substances (or "prohibition") was done correctly, it would benefit society. Particularly, the prohibition would benefit society more if it was not mainly enforced through criminalization of street drugs, but instead through teaching, rehabilitation, and prevention.
In contrast, "safe" drug harm is an oxymoron. And it's very ineffective to even discuss anything on a double-speak premise. We should instead focus on fixing the root problem of drug use, rather than be distracted by harm reduction, especially when it's been politicized so much.
When I buy a beer from the store that is a "safe" regulated supply of a substance purchased by a government regulated supplier that will ultimately cause liver damage and cancer.
An un-safe supply of alcohol would be the sort of stuff that was common during prohibition, the sort of home brewed moonshine that poisoned people and made them blind.
We already do harm reduction and safe supply of many drugs in our society because we recognize the alternatives of adhoc illegal supply is dramatically worse.
Using opioids like heroin (boy if one could even get heroin at this point) is obviously not "safe."
These sort of concerns around safety are at this point however irrelevant because the reality is that people are chemically addicted to these harmful substances and the issue is how to best get them un-addicted or manage that addiction.
Anyone attempting to get off a chemical drug addiction can be absolutely be expected to relapse at some point (many points most likely!) along the journey to ultimately kicking the addiction for good.
The point of harm reduction is so that when someone relapses they do not die from street drugs that are so incredibly toxic there is no known safe dose and that they have yet another opportunity to try to wean themselves off their harmful addiction.
The context of this discussion around street drugs is about the unregulated street drugs that are so cut with various unknown chemicals that it is impossible to have a dose that yields any sort of expected results. This is what is resulting in an incredible spike in overdose deaths.
There is a clear difference between harm reduction and rehabilitation, although both are beneficial to society. However, we should not use double-speak terms like "safe use", as all efforts to facilitate continuous narcotics use are not safe, and it is counter-productive to imply otherwise. To see my point of view more clearly, consider whether it would be beneficial for any user or potential user to truly believe it is genuinely safe to use narcotics as a part of a harm reduction program.
We should be educating people about the dangers of narcotics addiction, and helping those who are already addicted through rehabilitation programs. They should have access to the narcotics for reduction therapy/tapering. But they also need a lot more — counselling, withdrawals management, relapse management, replacement therapy, group support, and other effective measures.
I suppose the core of what I am trying to say is this: harm reduction is not addressing the core issue effectively enough, and calling any part of harm "safe" communicates a wrong message and is damaging. Harm reduction efforts are important, but are not enough alone; continued narcotics use not be sold by politicians as "safe". There is a subtle but distinct difference between "safe" and "safer", the latter of which is appropriate in harm reduction efforts, but not the former.
Coffee in regular amounts, nicotine not by burning, a beer or two now and then... shouldn't be controversial. Less obvious but still true: opiates at maintanance levels under supervision, regular amphetamine in moderate dosages, MDMA or ketamine on occasion. Loads of drugs in loads of usage scenarios really are "safe".
But just because supervised heroin won't kill you doesn't mean it's somehow good, actually. That's a separate judgement.
There's surely no upside. It's overwhelmingly likely to make you less healthy and less happy. But so will too much bacon and sitting.
Chairs are still safe though, by any sane definition.
Alcohol consumption is proven unsafe to health[1], but it's not controversial. Adults have the right to choose risky behaviors, just like they do in fire fighting, coal mining, underwater welding, or mountain climbing. In some cases, we admire those who choose them for their bravery.
Let's not confuse "unsafe" with "controversial" or "unquestionably bad." But let's remember that "safe" has a clear definition, which does not describe current "safe use" narcotics harm reduction programs. Harm reduction by definition means that harm is involved. Someone safe from street narcotics is someone who is not using them, at least in the way that they are generally used recreationally.
The core issue is a series of failed policies originally implemented to address the problem of white women hanging around black and Chinese men. I don’t think the world would end if we sold Vyvanse and Nucynta ER over the counter at CVS. Let the people predisposed to be addicts just be addicts instead of wrecking their lives and the lives of those around them with failed program after failed program.
The most important part is to not get people into substance abuse in the first place.
Many people start with light drugs (weed or subscription drugs) and then go to heavier stuff. If it is easy to get light drugs and easy to get heavy stuff then more people will be doing drugs. If it is legal to carry around drugs for personal use and if it is considered accepted, then more people will be using drugs.
These findings are consistent with the idea of marijuana as a "gateway drug." However, the majority of people who use marijuana do not go on to use other, "harder" substances. Also, cross-sensitization is not unique to marijuana. Alcohol and nicotine also prime the brain for a heightened response to other drugs51 and are, like marijuana, also typically used before a person progresses to other, more harmful substances.
It is important to note that other factors besides biological mechanisms, such as a person’s social environment, are also critical in a person’s risk for drug use. An alternative to the gateway-drug hypothesis is that people who are more vulnerable to drug-taking are simply more likely to start with readily available substances such as marijuana, tobacco, or alcohol, and their subsequent social interactions with others who use drugs increases their chances of trying other drugs. Further research is needed to explore this question.
I think drawing a line between light and heavy drugs (high risk of overdose/harm/very addictive)
If you have to buy your weed from a dealer who also sells other stuff the chances that you might decide to try something more harmful one days are much higher than if you can get your weed in a legal store.
>Whether the street drugs are produced in a quality-controlled way or not, it is well-known that use of the substances has negative outcomes in health and occupational functioning.
No, the problem is that this is an urban myth. There have been drug clinics that let trained staff inject people with clinical heroin and other drugs with no adverse health effects and often the controlled dosage ended up so low that the drug users maintained self awareness and the high wasn't present or extremely weak.
The clinic was shut down after twenty years of success because people were jealous of drug addicts without health consequences.
A single digit number of people died from overdoses on street dugs within a week of closing the clinic. I wouldn't call that harm reduction.
The truth is that most of the drugs that people want to take voluntarily are perfectly safe and it is the illegal distribution system that adds unsafe cutting agents with severe health consequences.
While I agree that adulteration of street drugs contributes significantly to them being unsafe, it is proven beyond doubt that illicit narcotics cause addiction with negative health and social outcomes:
Even sustained use of quality-controlled narcotics is detrimental and harmful to health and social cohesion. And you do not need to read these studies that prove it, you can simply ask drug users to speak on the topic.
In contrast, actual measures taken to legalize (if not make widely available) and focus on safety actually work to reduce issues and use.
With many drugs, actually quitting via tapering is a valid approach. How the heck do you propose to do that otherwise than having safe use?
By making it legal and say requiring ID to get, you can actually track and find who has a problem and deliver help to them.
That also requires the pharmacy and doctors to not be drug pushers, a tough sell in USA.
That easy. Worked pretty well in one or two countries.
I do not disagree with medication-assisted treatment (MAT) rehabilitation which involves tapering/dose reduction. I do disagree with the implementation of "safe use" Western countries have now, which is ineffective for rehabilitation.
Drug rehab programs regularly go much further to be effective, and include group counselling, individual counselling, substance replacement, medication to reduce withdrawal symptoms, relapse management, and similar.
On the other hand, harm reduction is a completely different effort that does not constitute safe use in my opinion, because it facilitates continuous use, which is very harmful, even if the harm is reduced. Even in rehabilitation centres, the use of controlled substances is not considered safe by all medics. It is rather more agreeable to call it safer use.
By the way, which are the countries that you mention where legalizing narcotics and selling them in pharmacies yielded positive results, and what were the results?
If you are talking about legalizing cannabis in some US states and Canada, it is far too early to see the long-term results, although preliminarily, it seems like the use of cannabis has increased. This might be acceptable as a trade-off, as legalizing cannabis will lead to less social stigma for the users, fewer engagements with law enforcement, and safe access. For the producers and distributors, it will mean safer working conditions and labor protections. All for a 10-15% growth in known cannabis use. And cannabis is a relatively safe narcotic.
If you are talking about Portugal's decriminalization of drug possession about 20 years ago, the distribution there is still not facilitated by pharmacies, and those in possession of hard narcotics are required to seek treatment, education, or other interventions as prescribed by drug commissions case-by-case. Portugal has not decriminalized narcotics fully, it was more of a shift from punitive measures to rehabilitation measures for the users. The laws surrounding distribution remain generally in line with Western countries.
You speak as if you've never read about the US opioid epidemic and how we got here. Do realize, this makes you sound like a religious prohibitionist extremist..
Your proposal is bunk. Someone who became addicted to prescription opiates does not deserve to play roulette with their life by being forced to buy street drugs after their own physician arbitrarily decides not to provide any more.
A prescribed drug, mind you, where one of the known side effects (of opiate consumption) is addiction, but the physicians prescribing aren't responsible for curing the addicts they create. Because <regulations, guidelines, prescribing practices, etc> mandate they cut patients off. This is "Just say No" all over again, but now it's the doctors saying "No."
What utter BS..
And to think that possession of fentanyl testing equipment is illegal in dozens of US States. It's as if the laws are designed to funnel humans to be slaughtered by adulterated product. Under the revenge-ethics banner of "they deserve it".
The US system:
- humans that are too poor to pay an expensive private doctor get to buy street drugs.
- Rich folks get private doctors that will prescribe what they physically depend on.
Ex:
Prince didn't accidentally die from taking Fentanyl-poisoned street drugs. He was adequately supplied with whatever he needed, for years. Years! While also functioning!
Prince was a functioning human, while also being addicted. There, I said it.
What harm to society was he? Why must we eliminate all addicts as you suggest?
I am not only aware of the opioid epidemic, but my family is strongly involved in rehabilitation clinic work in Europe.
My proposal is to reduce use through education, rehabilitation (including tapering/MAT), and not facilitating continued use. I also propose not using language such as "safe use". Please see the approach Portugal took in 2001 where narcotics possession was legalized but interventions such as rehabilitation were enforced — this is my proposal. The approach can be supplemented by harm reduction, but harm reduction alone is ineffective and selling it as a "safe" alternative to rehabilitation programs is malicious, as can be very evidently seen in the US.
I am saying exactly this. Fixing the root problem through rehabilitation can be supplemented by harm reduction efforts. But harm reduction does not by itself eliminate harm, and should not be called "safe". It could be called "safer". A rehabilitated person is safe from drug use. One using hard narcotics through legalized means is not.
It seems like some people are very strong supporters of "safe use" though, it is difficult to argue that there is another more sustainable approach to the narcotics problem.
Direct sale of street narcotics would only be another harm reduction practice, similar to "safe use sites". But no harm reduction practice makes the harm "safe".
The political double-speak around this is very similar to "clean coal"; it implies a strong position ("coal is clean") while offering an escape hatch if challenged ("coal pollution mitigation, otherwise known as clean coal, reduces greenhouse emissions when coal is used as a fuel"). Similarly as there is no "clean coal" in reality, there is no "safe supply of drugs".
When we take deceiving loaded words like "safe" out of the equation, it becomes harder to argue against substance control, even if seen as prohibition. While it is evident that street drug crisis in the US has been mishandled, if restricting the access of these substances (or "prohibition") was done correctly, it would benefit society. Particularly, the prohibition would benefit society more if it was not mainly enforced through criminalization of street drugs, but instead through teaching, rehabilitation, and prevention.
In contrast, "safe" drug harm is an oxymoron. And it's very ineffective to even discuss anything on a double-speak premise. We should instead focus on fixing the root problem of drug use, rather than be distracted by harm reduction, especially when it's been politicized so much.