Drug Policy

You Can Have Free Drugs, but Only If You Don't Behave Yourself

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Vancouver, which already has "a free needle exchange, a methadone maintenance program, a drug injection site where nurses supervise as heroin addicts shoot up, and a clinical trial testing whether chronic opiate addicts can be helped with prescribed heroin," is now experimenting with "maintenance treatment" for stimulant addicts. Under the new program, reports The Globe and Mail, heavy users of cocaine and methamphetamine will receive oral doses of legally prescribed stimulants in the hope that they "might decrease their use of illegal drugs and improve their social and physical health." Both of those outcomes are plausible, assuming the "patients" stop injecting, snorting, or smoking black-market drugs and start swallowing legal, quality-controlled pills instead.

But it isn't really "treatment," is it? Or I guess I should say that it's treatment in the same sense that chewing nicotine gum or wearing a nicotine patch is "treatment" for nicotine addiction, even though many smokers use them as long-term substitutes for cigarettes. These smokers are healthier for making the switch, but the "disease" (addiction) remains.

More troubling is the Vancouver model of free needles, free methadone, free heroin, and free amphetamines, all courtesy of the taxpayers. This strikes me as exactly the wrong way to achieve drug policy reform, guaranteed to alienate people who might be willing to let others use drugs but don't want to pick up the tab for it. The message should be freedom coupled with responsibility, not government-subsidized drug addiction.

The rhetorical and policy contortions produced by prohibition are something to behold. Instead of allowing adults to obtain oral stimulants for whatever purpose they like (which was the situation in the U.S. until the government started requiring a prescription for amphetamines in 1954 and even for a decade or so afterward, when prescriptions were easy to come by), the government drives them into the black market and then allows the select few who are sufficiently fucked up to get oral stimulants at taxpayers' expense. Meanwhile, doctors commonly prescribe stimulants to people who have trouble focusing and paying attention, a condition that used to be self-treated but nowadays is recognized as a disease requiring professional diagnosis. If you take these drugs without that diagnosis, you also have a disease—drug dependence—that one day, if we're lucky, may be treated by giving you the drugs.

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  1. I suppose the lesson to be inferred from this is anything, anything, anything EXCEPT self-determination in matters of drug use.

  2. While I agree with every word, I’d sooner live under Vancouveresque recreational drug socialism that US style fascism.

  3. Hey Jacob, any numbers on heroin users in Vancouver before/after they’ve implemented these policies? Im curious does subsidizing users leads to more users? And if any of these policy objectives (healthier users, less crime by removing incentive to steal, mug, etc) are actually achieved?

  4. I am addicted to fattening ice cream… maybe the gov can send me some free frozen yogurt?

  5. Matt,
    Like the rest of Canada, the winter freeze keeps the population in check.

  6. In theory I agree with Warren. In practice I could never afford to live in Vancouver, and I think there is a connection.

  7. There is nothing unusual about using the word “treatment” to refer to a course of medicine that alleviates symptoms and makes you healthier without curing the underlying disease. That’s why it’s called a treament and not a cure.

    Think of people who use Prilosec to treat their acid reflux disease; they still have acid reflux disease.

  8. joe,
    Don’t be dense. It’s absurd to call a behavior a disease, and then call the exact same behavior treatment when someone else pays for it.

  9. I’m not surprised to see that in Mr. Sullum’s mind the most troubling aspect of this whole scenario is not that people are addicted to drugs or that the help they’re getting may not be addressing the problem successfully, but rather that taxes are being paid. The horror.

  10. until the government started requiring a prescription for amphetamines in 1954

    So where did one buy speed in 1953? Was it just sitting open on the Rexall shelves? If it was so easily available, why was Wm. S. Burroughs taking apart his Benzedrine inhaler?

  11. Giving people with meth abuse problems legal, low-dose, oral stimulants is a lot cheaper than arresting them and throwing them in jail (the only political alternative at the moment). Also, it is very clearly a form of treatment. Don’t buy into the perverse world view of the drug war extremists that see drug use as a moral issue instead of a health issue. The issue isn’t whether or not people are using drugs but whether or not their drug use is causing problems for themselves and others. If you can treat someone’s meth abuse problem by providing them a cheaper and safer drug that reduces or eliminates their problems (overdoses, psychosis, inability to hold down a job, etc), then that’s effective treatment for their problems.

  12. Warren,

    Don’t be illiterate.

    “But it isn’t really “treatment,” is it? Or I guess I should say that it’s treatment in the same sense that chewing nicotine gum or wearing a nicotine patch is “treatment” for nicotine addiction, even though many smokers use them as long-term substitutes for cigarettes. These smokers are healthier for making the switch, but the “disease” (addiction) remains.”

    You go through that and let me know when you find something that has to do with your point about the definition of “disease.”

  13. I envision a system in which people who wish to get drug maintenance – let’s call them “customers” – can go to designated suppliers – let’s call them “shops” – and in return for a reasonable payment – let’s call this the “market price” – can obtain the treatment they so desperately need.

  14. joe,
    it’s right here in the part you didn’t quote.

    Meanwhile, doctors commonly prescribe stimulants to people who have trouble focusing and paying attention, a condition that used to be self-treated but nowadays is recognized as a disease requiring professional diagnosis. If you take these drugs without that diagnosis, you also have a disease-drug dependence-that one day, if we’re lucky, may be treated by giving you the drugs.

  15. Warren,

    That’s a different point, and not the one I was commenting on. One clue about the point I was commenting on is that it is made in the portion I quoted.

    Is it ok with you, pretty please, if I talk about something else?

  16. But since you sucked me in anyway, Warren, drug-taking behavior is not the disease.

    The physical and mental urges to take the drug, and the physical and mental consequences of not taking the drug, are the disease.

    I don’t have “joe scratches his knee disease.” I have eczema on my knee. The behavior is just my reaction to the symptom. In other circumstances, scratching one’s knee has nothing whatsoever to do with a disease. In my case, it does.

    I’ll bet all the ladies are looking for my email now.

  17. joe,
    I see. So even though (as you quote) Jacob explicitly states “it’s treatment in the same sense that chewing nicotine gum or wearing a nicotine patch is “treatment” for nicotine addiction”, thus preemptively acknowledging your point, you feel it’s disingenuous of him to use scare quotes on “treatment” and decided that we should all worry about that and forget about the main thrust of the post.

  18. “If it was so easily available, why was Wm. S. Burroughs taking apart his Benzedrine inhaler?”

    1) his wife was a benzedrine addict.

    2) near as i can tell, they were bought from drugstores in paper strips, or in inhaler fashion.

  19. Oh, c’mon, joe, now who’s being disinguous.

    I would agree that the behavior of taking the drug isn’t a disease.

    I would disagree that the urge to take the drug is a disease. Urges aren’t diseases. They have no vector, do not present any physiologic symptoms, etc.

    Is withdrawal a disease? Not really. More like an injury or, at most, a condition, which goes away if you just ride it out. The idea that going back on the junk is a “cure” for the “disease” of withdrawal is just perverse.

  20. As a former opiate addict, I’d like to toss in my two cents.

    Some drugs, such as opiates, when taken in sufficient amounts, for a sufficient amount of time, will cause an increase in endorphin receptors that causes symptoms of withdrawal when the drug isn’t present. I don’t think that the use of drugs is a disease, just a choice. But, when you’ve used some drugs to the point where withdrawal happens when they aren’t in your system, then you’ve given yourself a disease, much like over use or abuse of some joints will cause arthritis. At least this is my view of how it works. Also, while you may be able to “ride out” the initial withdrawal, the after-effects can last a long time…years some times. In my case, I didn’t feel “normal” for about a year and a half. Of course, I was using more than my fair share of opiates due to the lack of financial constraints endowed by the black market business I was running at the time. Some people are OK much sooner.

    What I DON’T like is the 12 steppers who claim that their desire to use drugs is inherantly a disease, that they don’t have power over it, and that only that silly little book can help them. I’m living proof that if you want to get off your particular addiction, you can. Most of the junkies I know who were forced into 12 step programs used it as meeting ground for drug connections. I’ve seen several customers of mine look sheepishly at each other and talk about how the NA meeting they had just attended went. They both knew why they were at my house.

  21. Warren,

    First, I don’t think he’s being disingenuous. I just disagree with the point he’s trying to make. I don’t see any reason to conclude that something is only treatment “in a sense” because it treats symptoms rather than curing the disease. That seems to be full blown treatment to me. And no, I don’t think you should forget about anything. Mr. Sullum made a number of points, and I addressed one. Please, if you have something to say about others, go on with your bad self.

    RC,

    I’ve always thought the fights about the terms “syndrome,” “disease,” and “condition” were sound and fury, signifying nothing. All three can potentially be treated medically, and none of the three are the same thing as behavior or choices. The doctors call addiction a disease, and absent a really compellling reasons to dissent, I’ll use their term.

    As for my comment, I might have been better off saying that the urges were symptoms of the disease rather than the disease itself. Urges can certainly be symptoms, no? And elevated heart rate, sweating, and other signs of stress certainly are physical.

    “Is withdrawal a disease?” No, it’s a symptom of a disease, like the above urges, but more serious.

    “The idea that going back on the junk is a “cure” for the “disease” of withdrawal is just perverse.” No one’s saying it’s a cure, just a treatment.

  22. Both of those outcomes are plausible, assuming the “patients” stop injecting, snorting, or smoking black-market drugs and start swallowing legal, quality-controlled pills instead.

    They are living in a fantasyland. My old office was next to a methadone clinic here in Boston. The same people who went in for methadone spent the remainder of the day hanging out in a nearby Dunken Donuts swapping various pills and making other illicit deals. I saw the same people for the years I worked there, I don’t really think the clinic saw it in their best interest to help them kick the methadone.

  23. I suppose we’ll be cancelling treatments for Diabetes too? I mean, you can take all the insulin you want but the disease still remains…

  24. Jacob, once again your ideological blinders prevent you from seeing the reality of the situation. I live in Vancouver, and the impetus for setting up the free needle program was the incrdibly high rates of HIV transmission through the sharing of dirty needles. That stands to save our health care system plenty. Yes it is government funded here, but regardless of the system, the cost of AIDS are borne by all of us (unless you want them to die in the streets). Also, providing free drugs makes sense in that people don’t have to steal to support their habit, and with an assured supply, they can focus their energies on fixing other parts of their lives. In the context of prohibition this is the best solution to a bad situation and is widely supported by taxpayers here.

  25. At the New Hampshire Liberty Forum last weekend, Jack Cole of LEAP proposed that the government should give free drugs to anyone who wants them, and should spend the billions of dollars saved from the War on Drugs on new welfare programs instead of letting the taxpayers have the money back. Sigh.

  26. If you compare spending taxpayer’s money for this compared to our multi-billion a month misadventure in Iraq, I’ll take this sort of socialized medicine any day, even though I am a libertarian.

    Mr. Sullum, I am sure, is well aware that Vancouver drug addicts lack the disposable income needed to pay for their own treatment, but does not mention an alternative.

    What it boils down to is the State steals from the taxpayers to pay for the treatments, so the addicts will not steal from the local merchants and populace to support their habit.

    I do think that there is an inverse relation between cold and street crime, so you can’t compare Vancouver to L.A. or Miami.

  27. The line of thought spewed forth by popular libertarian Neal Boortz is that our lives are for the most part the sum total of choices we make. Not enough education= low wages. Give your kids a public school education = dumbass kids tantamount to child abuse. Doing drugs = homlesness, theft, etc. My point is that I believe, Mr. Pope, that alot of folks think it okay if the dopers, the winos, the aids sufferers and the like do simply die in the street. That has to be a better solution than spending any tax dollars toward a compassionate solution.

  28. “The message should be freedom coupled with responsibility, not government-subsidized drug addiction.”

    Oh, dear. I hope that saving these people’s lives isn’t screwing up your message.

  29. guaranteed to alienate people who might be willing to let others use drugs but don’t want to pick up the tab for it

    Right. Like they’re not paying now. Or is it only bad when paid for directly by taxes and not when the taxes pay for absurd levels of law enforcement, incarceration, etc?

  30. How unfortunate so many people lack the insight to see/understand that 1)Canada has ‘free’ healthcare (lets not get into how that is all working) and so drug addiction has finally been moved under the health blanket rather than the criminal justice one. 2) As a health issue the objective is to reduce the harms to the person and/or eliminate the disease 3)as it stands drug users aren’t paying taxes (being homeless and all) but by having a free supply of a less harmful drug are then able to function and thereby look towards working and paying into the system (eg taxes). I’d rather my taxes go to this appraoch than to the CJ system which costs me about 5x more. Thank you PM Harper.

  31. So many morons here.

    So subsidizing illegal behavior to “prevent stealing” is ok in many peoples’ books.

    There also to be a new “Moron’s rule”: similar to Godwin’s rule. The first to invoke a reference to Iraq when applying your logic to the argument (douglas westerman), you lose.

    Not that I disagree, mind you. In fact, there are a gazilion things I’d rather have my tax money spent on than Iraq. But you would never want to give the public that choice, would you? – so long to your futile, expensive, ineffective, domestic policies, statist fanbois.

  32. If our government not only legalized it, but had a bunch of cuties in skimpy nurse outfits load up my bong or roll my joints…

    I may consider switching sides.

  33. The message should be freedom coupled with responsibility, not government-subsidized drug addiction.

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