Opioids

City Councilman's Proposal to Deal With Opioid Overdoses: Let Them Die

A Middletown, Ohio, lawmaker wants paramedics to stop treating to overdose patients after two strikes.

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Premier of Alberta/flickr

While more Americans are coming around to the idea that drug addiction should be treated as a public-health issue rather than a crime, the recent rise in opioid overdoses threatens this shift in public opinion, especially in the areas most ravaged by this new epidemic.

In Cincinnati—my hometown—174 overdoses took place in less than one week last year. Many counties in Ohio no longer have enough room to store all of the bodies of overdose victims, forcing the state to lend out mobile morgues that are normally reserved for large-scale disasters. The lieutenant governor of the state has even opened up about her family's struggle with opioid addiction.

The desperation to end this epidemic has not brought out the best in everyone. Recently, Middletown, Ohio, city councilman Dan Picard proposed that paramedics not respond to addicts upon a third overdose.

Critics decried the proposal as unbelievably cruel. Picard countered that many didn't understand just how bad the situation had gotten in his city, where "out-of-the-box thinking" was now required.

By Picard's estimation, each overdose response costs the city $1,104. At this rate, he says, emergency services eventually won't be able to respond to other calls and "the city's going to run out of money." The city, meanwhile, is not even sure Picard's proposal is legal. However if lawyers determine that it is, it will come up for a city council vote.

Should the proposal pass, supporters may be surprised at how little it does to stop the onslaught of overdose calls. Middletown Fire Chief Paul Lotti, a critic of the proposal, noted that 85 percent of the department's overdose runs involve first-time callers, who would not be subject to the three-strikes rule.

Effective or not, the policy still raises ethical concerns. Paramedics should not become, at the direction of ill-informed politicians, arbiters of who deserves to live and who deserves to die based on one's lifestyle choices. Even the sorts of serial overdosers who grab headlines—such as a Dayton, Ohio, man who has been revived by paramedics twenty times—do not deserve to just be left for dead in the streets.

Addicts need access to treatment, not ultimatums.

But seldom is treatment readily available. An arcane federal law has inhibited the growth of drug-treatment centers in places where they are needed the most. Centers that accept Medicaid patients are prohibited from having more than sixteen beds.

With a population of less than 50,000, Middletown has already seen 577 overdoses in 2017 alone. Permitting drug-treatment centers to expand at the local level would be a step in the right direction, giving addicts more opportunities to get the help they need and relieving pressure on emergency services and overcrowded jails.

More treatment centers are only one part of the equation, of course. Currently, these centers are limited in what they can provide for addicts by America's outdated drug laws. When Switzerland experienced a heroin epidemic in the early 1990s, it started treating addicts with substitution therapy, using opiates like methadone to taper off addiction to other opiates and even giving prescription heroin to some heavy users. It worked.

Methadone treatment is becoming more common in the U.S., despite being hampered by Medicaid rules regarding its use, but the nation is still a long way off from taking on major reforms like the Swiss did. In fact, the Drug Enforcement Administration (DEA) is still sticking to its old ways of prohibiting any drug they set their eyes on, including Kratom, another substitute drug addicts can use in place of more dangerous opioids.

Despite the rhetoric of the DEA and other government regulators, drug prohibition has made many drugs like heroin far more dangerous than they would be otherwise. Large spikes in overdose deaths often involve influxes of heroin laced with synthetic opioids like fentanyl or carfentanil, which are far more potent than heroin itself. Because these drugs are bought on the black market, users have no way of knowing what they're really buying, and thus no way to adjust their dosing accordingly when synthetics are in play.

This doesn't seem to matter to the DEA. U.S. drug-prohibition laws aren't set up to solve drug addiction so much as satisfy the need to punish what is viewed as bad behavior (and make Uncle Sam a few bucks in the process).

Picard himself says that the proposed three-strikes rule for drug overdoses in Middletown is "not a proposal to solve the drug problem." He says he wants to "put a fear" in people thinking about overdosing in his town.

But drug addiction makes people do irrational things. Addicts are not going to ask themselves if they're within Middletown's city limits before shooting up.

As long as politicians and government officials continue to view the opioid epidemic as a war to be fought against drug users, rather than a battle to save them, many more lives will be lost.

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  1. Here’s hoping he comes into contact with Fentanyl

    1. I’m making over $7k a month working part time. I kept hearing other people tell me how much money they can make online so I decided to look into it. Well, it was all true and has totally changed my life.

      This is what I do… http://www.onlinecareer10.com

      1. You’re selling opioids online, aren’t you?

  2. He says he wants to “put a fear” in people thinking about overdosing in his town

    I was so looking forward to overdosing this weekend. I guess I am not doing in this guy’s town!

    1. If he was really serious about this thing he’d make it illegal altogether.

    2. Thus creating a need for an app to find safe places to OD, G-d I love capitalism!

  3. He is just wanting to establish a principle of non-interference, a “Prime Directive”, if you will.

    1. Make it so.

        1. May the force be with you.

          1. Nerd.

            1. Fake nerd – even worse.

              1. Fnerd.

                1. Bunch of dren!

  4. The desperation to end this epidemic has not brought out the best in everyone. Recently, Middletown, Ohio, city councilman Dan Picard proposed that paramedics not respond to addicts upon a third overdose.

    Not sure why this is a bad thing.

    rather than a battle to save them

    Not sure if serious.

    1. EMTs and paramedics have a code of ethics they have to follow that conflicts with the councilman’s proposal.

      1. Not to mention the MASSIVE civil liability this will cause. It would be a lot easier for a few people to get together after the council meeting and beat the stuffing out of this guy.

      2. Do the EMTs always know the identity of the person they are called to treat? Even if they know it once they get there, what are they going to do, punch the guy’s name into a portable computer to see if he has two prior ODs? They’ve already spent some money just getting to the call. It doesn’t sound too practical. Then there’s the question of, if someone with two prior ODs is disliked by someone else, could they not “arrange” for him to have a third OD, which would then go untreated? Other than those little matters, great idea. That is, maybe not totally unethical if it were workable, but it isn’t.

    2. Bad precedence to set.

      Or next up will be instructing paramedics not to intervene in an obese person’s heart attack. Why should we subsidize their unhealthy lifestyle? They’re just gonna go back to McDonalds anyway.

      1. Why are paramedics billing the city in the first place?

        1. Bill the patient instead? Do you think a person who can’t get off heroin is going to pay a $1,000 ambulance bill? Get real.

          1. So since the addict can’t pay then I should? Get real.

            1. You already are.

        2. Because the city pays?

        3. I work in EMS. We’re a private business. 90% of the time we pick up a patient in the city we cover (as opposed to the suburbs), we’re billing Medicaid. They don’t cover shit. We lose money running 911s in the city.

          Recently K2 became a thing again. We’re picking up the same people 2 or 3 times a day. It’s insane. And we’re losing money on every call.

          EMS is a fucked up a system, at least in my state.

      2. Very much this.

    3. THINK OF IT AS EVOLUTION IN ACTION.

      1. ^This

        “Even the sorts of serial overdosers who grab headlines?such as a Dayton, Ohio, man who has been revived by paramedics twenty times?do not deserve to just be left for dead in the streets.”

        I would humbly disagree. As a free individual, if I haven’t learned my lesson about drugs after 20 overdoses, and continue with my drug abuse, I would consider myself to have made a choice with full knowledge of the consequences of my actions and therefore am willing to accept those consequences, even when they result in my death. In fact, after 20 times I would imagine I am actually trying to die, but those dam paramedics keep fucking with my choice.

        Removing my drug addicted arse from the gene pool is just evolution at work and quite frankly, I would consider that a good thing.

        1. Reason is increasingly less libertarian and more a group of nanny-staters who just want legalized drugs.

          1. Is libertarianism synonymous with social Darwinism?

            1. You’re free to make stupid choices. You’re not free to compel me to subsidize that stupidity.

              1. So is that a yes?

          2. That was my thought exactly as I read this distinctly un-libertarian article.

            It seems that the libertarian position is now to simply legalize all drugs, but not do any of the other things that would take the burden of such an action off the state.

            You can’t have one without the other and still be a libertarian. The entire libertarian argument for legalization of drugs is (or used to be) that it’s a matter of personal responsibility for adults to decide to use drugs — and accept the consequences — and neither the state nor anyone else should regulate their behavior.

            But when you’re calling for state resources to consistently revive overdoses and provide widespread ‘treatment’ programs to help get these people off the drugs you just argued they have every right to take… well, it just seems quite a bit problematic from a libertarian standpoint.

            If you want to legalize drugs, great, then people who choose to use drugs are on their own.

        2. You’ve little understanding of the human brain. Perhaps educate yourself on neurology and its implications for the concept of free will before your next post on this topic.

        3. Removing my Allowing you to remove you drug addicted arse from the gene pool is just evolution at work and quite frankly, I would consider that a good thing.

          FIFY.

          Calling the people who insist on passively standing by while you OD, for the nth time, ‘nanny-staters’ is the just dumb.

        4. Talk to me after you have a wisdom tooth removed and 4 months later find yourself looking for that last Vicodin you know your brother had somewhere.

    4. Agreed. Yeah, me neither.

      Picard himself says that the proposed three-strikes rule for drug overdoses in Middletown is “not a proposal to solve the drug problem.”

      That’s cool, because it’s not government’s job to “solve the drug problem.” Next.

  5. Addicts need access to treatment, not ultimatums.

    As those of us who’ve had an addict in the family knows, treatment doesn’t do shit if the addict doesn’t want to change. I wish people would still offer that up as some sort of solution when they barely understand its effectiveness.

    1. “would stop offering that up”
      d’oh

    2. Yeah, treatment doesn’t do a damned bit of good until the addict decides that they need the help. Otherwise, it is just wasting time and money for something that will not solve any issues.

    3. While what you say is 100% true that there is absolutely nothing anyone can do for an addict who doesn’t want to change, it sounds to me like what the author is advocating is access to treatment, not mandatory treatment – i.e. he’s advocating removing the existing legal barriers to operating treatment facilities.

      1. Is there such a barrier? You can google ‘rehab” in my area and find a program easily.

        In fact, rehab is so lucrative the scammers have gotten involved:
        http://www.philly.com/philly/h…..70623.html

        1. Is there such a barrier?

          FTA:

          An arcane federal law has inhibited the growth of drug-treatment centers in places where they are needed the most. Centers that accept Medicaid patients are prohibited from having more than sixteen beds.

          Methadone treatment is becoming more common in the U.S., despite being hampered by Medicaid rules regarding its use

          Since a lot of addicts tend to be poor, it’s probably a safe bet that many of them are on Medicaid, which as the article points out has some stupid rules. Just because Robert Downey Jr. can afford a glorified spa weekend at some treatment center/ resort whenever he falls of the wagon doesn’t mean the average addict can.

        2. Seemingly so, according to the next paragraph in the article:

          “But seldom is treatment readily available. An arcane federal law has inhibited the growth of drug-treatment centers in places where they are needed the most. Centers that accept Medicaid patients are prohibited from having more than sixteen beds.”

          Maybe he’s overstating it, but this is argument he is making – not that treatment is a magic bullet, but that it doesn’t make sense for government to be standing in its way.

          1. I agree that govt shouldn’t be standing in the way, although if they are the payer, maybe they have some good reasons for some of the restrictions based on past experience. Medicaid fraud has been around for day one, and rehab is in that nebulous area of “when is the patient considered cured?”

            1. I agree that the payer should have every right to question whether they should be obligated to continue paying, whoever that payer may be.

              It seems to me like we’ve fallen into a situation all over where EDs and EMTs are compensated by cities for responding to the indigent, which the responders are going to do anyway, in the name of spreading those costs across the community.

              This is why, for example, in my county all the most aggressive lobbying to save the local county-subsidized hospital was from all the other hospitals in the area who didn’t want the indigent in their EDs.

              It seems unclear to me whether Picard is proposing that the city simply doesn’t reimburse after the third time, or whether he wants to forbid EMTs from even responding with or without compensation.

              In the end, though, this treats problems arising from a particular kind of drug overdose as unique, when they aren’t. This logic should be applied just as much to a backpacker who has to call for the helicopter one too many times.

    4. Yeah, I’m not so sure that these people are aware that some people make the choice to stay addicted. There is no room in the narrative for people who just really love doing drugs, it would seem, but I’ve known a few people like that. Thankfully, they aren’t in my family so I’m able to stop being around them but I imagine it’s tough if they’re closely related.

      1. Oh, and for the record I did a whole lot of ‘mind expanding’ drugs in my youth. Always stayed away from anything more than cigarettes as far as addictive drugs though (and that one is pretty bad). Personally I’d still suggest everyone try LSD at least once, assuming they don’t have a high risk of mental instability. ^_-

        1. Oh, and for the record I did a whole lot of ‘mind expanding’ drugs in my youth. Always stayed away from anything more than cigarettes as far as addictive drugs though (and that one is pretty bad).

          Your record sounds similar to mine (and man were cigarettes hard to give up!) I had a couple of friends expand their horizons into heroin, and watching it from the outside was off-putting enough to keep me well away from it. Although I still rank it above meth or coke. I’ll share the room with junkies, but if you’re on meth or coke, you need to stay well away from me. Like drunks with 10x more energy and stamina (and verbosity).

          LSD should be encouraged though. Even mentally unstable people I’ve known who’ve taken it got positive things out of it (along with a vow never, ever to touch the stuff again).

          1. Hell, I still vape but that’s because I’ve never wanted to quit smoking. Which is more or less the point, I suppose. ^_^

            1. I still don’t want to quit. I only did it so my daughter wouldn’t grow up around it. MJ, OTOH, . . .

          2. A little weed and tequila is enough for me.

            1. It is a splendid combination, isn’t it? Although I’m pushing well into middle age, so it’s wine for me. I had a rather painful falling out with tequila some years back, and we don’t speak anymore.

      2. The narrative for people that like doing drugs is to legalize drugs so they have access to drugs of known stregth and quality. Most people OD not because they can’t control their addiction but because they misjudge the dose either because the drugs are of unknown strength, because they had to go off drugs because of a lack of availability and then their tolerance decreases, or they are mixing drugs due to a lack of availability.

      3. Statements like this are a good illustration of how the free and easy use of the term ‘addiction’ has ruined any understanding of what addiction is.

        1. People use alcohol but not everybody who drinks is an alcoholic. I suspect there are some recreational drug users who aren’t addicts but like to get high. The federal government needs to give up on the drug war. All it does is cost money and kill people.

    5. That is true. But most addicts seem to get to that point eventually. And access to treatment helps at that point.

      The approach of Portugal or Switzerland where heroin is decriminalized or available to addicts by prescription seems to be fairly effective both at harm reduction and getting more junkies into treatment.

    6. The addict wouldn’t have to change if the drug was legal and safe.

      1. Most of my experience with people who “have to change” is with drunks, and the issue tends to be “you are an insufferable person and your inability to control yourself literally breaks things and damages other people. You need to stop, or you need to leave.”

        I have a harder time imagining a junkie really getting to be as big of a problem as drunks can be, though. My experience with junkies has been more like “you can’t just sit there and watch cartoons while you drool on yourself all the time, and you’re starting to smell. Can you please take a shower?”

        But I can see that if you were married to one, for example, you might apply some pressure for a lifestyle change.

        In no way does it ever need to be an issue for the government to be involved in.

        1. Junkies do a lot of theft and scamming. They don’t break things and ruin parties as much as drunks, but they do cause problems. But since they are largely money related, it’s another prohibition created or enhanced problem. Opioids are pretty cheap outside of the black market.

          1. Fair enough – I agree there are situations where for the good of themselves, friends, family, whatnot – they “have” to change. I had OD’ing mind.

            Here’s a question: how come when all these drugs were perfectly legal until the 20th century, there weren’t addicts lying around all over the place? I think the answer has something to do with shitty economic prospects combined with no pressure to f’ing grow up.

            1. how come when all these drugs were perfectly legal until the 20th century, there weren’t addicts lying around all over the place?

              There were legal places you could go. I.e., opium dens, where white women were seduced into whoredom by the mysterious wiles of the Yellow Menace.

              It’s the irony of prohibition. We’re having a similar issue in my neighborhood with a “massage parlor.” A neighborhood web discussion has much outrage over the fact that they were “allowed” to have this “adult business” so close to the elementary school and library.

              A libertarian guy pointed out that the reason the city couldn’t forbid the business from being next to the school is that the business is not allowed to be honest about what it is. There’s a lesson in there, but it was lost on the community.

              1. Why could it not be close to a library or elementary school? Is there a fear that eight-year-olds with a liking for Jane Austen might be tempted to enjoy the pleasures of the night?

          2. But since they are largely money related, it’s another prohibition created or enhanced problem.

            ^ This.

            I agree that in the current situation, you can’t trust a junkie for shit, and half the time when they look at you all they see is a few dollars they might be able to get for the next fix. But I do think that legalization would take it down to a level comparable with drunks, who are no less sociopathic about it, but who are considerably less desperate.

        2. Yes, I hate drunk stupid people. Alcohol is the worst.

        3. Yes, I hate drunk stupid people. Alcohol is the worst.

        4. Yes, I hate drunk stupid people. Alcohol is the worst.

    7. It’s shorthand. The full argument is:

      Mmmm, drugs are bad mkay, don’t do drugs.

      People will always do drugs.

      Mmmm, drugs are bad mkay, so let’s lock up the small time dealers and users, and launch a drug war that eviscerates civil liberties m’kay.

      How about you take half the proposed spending on the drug war and put it towards treatment for people to seek help with addiction and save the other half?

    8. Yep. On average, addicts do six stints of rehab before they quit. They do this because they know someone will give them another chance. Listen to the enablers of addicts talk about how the various, multiple rehab facilities “failed” their precious alkie/junkie, while they file an insurance claim for the next place.

      Let ’em die. Seriously. There’s no shortage of humans, so the obsession with saving the most worthless examples of humanity–at the expense of the ones who make smarter choices and drive our economy and the advancement of civilization–boggles my mind, quite frankly.

      1. I propose that anyone who proposes to let other humans die should be shunned. Big time. Until they learn the value of all humans.

        1. hypothetical…mother having baby, with complications…drug user ODing on other side of town…where do you send the last ambulance available? No right answer, and no wrong answer and no changing the question, like buy another ambulance.

  6. RE: City Councilman’s Proposal to Deal With Opioid Overdoses: Let Them Die
    A Middletown, Ohio, lawmaker wants paramedics to stop treating to overdose patients after two strikes.

    1. How would a paramedic know if a victim convulsing on the ground already has two strikes on him?
    2. Since when do politicians can make a life and death decision over someone, especially since that person has a serious drug problem?
    3. I don’t see how this idea would stand up in court.
    4. Another example of the ruling elites making decisions that are not up to them to decide.

    1. I wonder, too, is just overdosing on whatever, or does it have to be the same thing three times?

      If two are for heroin, but the third is alcohol poisoning, would they still refuse?

    2. 1. Yeah, what are they supposed to do? Ask for ID and check against the 3-strikes list before giving any treatment?

      1. Amusingly, I recall my time in the E.R. involved talking to two people more than any other: John Doe and Jane Roe. I’m guessing this particular went over the City Councils head.

        1. Yeah – what do you do about John Doe’s 400th overdose call?

        2. Ask any medical student who does an ER rotation at a county hospital. You see a lot of junkie regulars. It’s a giant revolving door. All paid for by the rest of us, of course.

    3. Since when do politicians can make a life and death decision over someone

      Since the days of Hammurabi, unfortunately.

    4. Real Christian of them!

    5. How long of a time period are we talking about? If you have a problem when you are young but then 30 years later forget that you took your pills and double dose, do they leave you to die?

      Of course the whole thing would require a registry which would require funding and a bureaucracy to manage. Just another statist power grab.

    6. 1. How would a paramedic know if a victim convulsing on the ground already has two strikes on him?

      The paramedics don’t just go walking around looking for people to treat. Especially when they’re busy, 911 and unit commanders prioritize calls/responses. Since when, as libertarians have we been about compulsory expenditure of resources, especially by the public, to save people? Especially people who have a habit or predisposition to nearly killing themselves? If we were talking throat slitting or broken glass swimming rather than heroine, this wouldn’t be a problem. The whole lying/incentivization thing works both ways, if you keep forcing EMTs to go save the same dude from the same OD, you’re either going to have to pay them progressively more or they’re going to start slow-walking it in favor of little old ladies who’ve fallen and can’t get up.

    7. 2. Since when do politicians can make a life and death decision over someone, especially since that person has a serious drug problem?

      WTHF? I thought we moved past this libertarian-ethics wise. Allowing the fat man to die is not the same thing as killing him. A politician saving a buck because an addict, accidentally or intentionally, OD’ed for the nth time is not the same thing as just putting them down.

      3. I don’t see how this idea would stand up in court.

      Once again, FFS, court and the law has got nothing to do with it. They’re responding to potentially dozens of calls a day. If they don’t overtly prioritize it and hang it around an elected representative’s neck, they’re going to covertly prioritize it and/or garner funding.

      4. Another example of the ruling elites making decisions that are not up to them to decide.

      He’s not making a decision. He’s unmaking decisions that were made in the past. The addict/user makes a decision, whomever is watching over them makes a decision, the dispatcher makes a decision, the paramedic makes a (few) decision(s)… before the decision none of them were allowed to make at any time is ‘are we doing this for a good reason’ or ‘does this make sense’? They are still entirely free to answer yes, just as they did before. The only difference is, the city won’t be forced to start saying ‘No’ to everyone in the middle of the year when the budget, X2, is spent.


  7. By Picard’s estimation, each overdose response costs the city $1,104. At this rate, he says, emergency services eventually won’t be able to respond to other calls and “the city’s going to run out of money.”

    Unsurprisingly, the government wants this to be the norm across the board with single-payer health care. Rationing for all, because costs. This is before you get into what personal decisions the government will be able to legislate on, because costs and your decisions are negatively impacting the cost curve and availability for everyone.

    On the plus side, people will die a lot younger so that should at least bring down costs, right? RIGHT?! Nope. Just more death along with higher prices, not that your individual will really care about the cost. They’ll probably care about the waiting time and physician availability, assuming that they live to be seen in the first place, but by then it will be too late. A whole generation of few to no doctors is in the works. Incentives matter, after all.

    Many of us see this shit coming from miles and miles away, yet when it gets here there’s that certain portion of the country that always seems very surprised by the inevitable consequences of their preferred policy positions.

    1. Opioid addicts might actually cost less if you look at life expectancy and total lifetime costs. If you die young then you can’t incur the costs of a multiple bypass surgeries and dozens of other problems typical for older people.

      1. I doubt it, since in a state-run medical institution the elderly aren’t getting them either since their net utility to society isn’t worth the cost. Seriously. That’s the kind of calculus you get into when you have limited resources, but everyone wants access to it.

        1. Oh, and as a follow up to the utility point it should be noted that if you’re elderly but also well connected and/or wealthy than you’ll be happy to know that you can still get the level of care you want because your utility is still considered higher (and even if it isn’t, you can get care in another country).

          Thus you begin to see that it doesn’t really matter which system you try and install, the capitalist system is still better since it allows everyone the same opportunity even if they don’t have the same means.

          This is basically ignored, because people all think that their life is the most important life thus they will be the one to benefit from a nationalized system. They can’t all be right, you know? Irrationality on display.

          1. They can’t all be right, you know?

            And there’s the fundamental disconnect in socialist thinking. To paraphrase Ayn Rand, no one advocates socialism thinking they’re going to be on the side that works more and gets less.

      2. Just like the stats for smokers costing less over a lifetime than long lived healthy people.

  8. I’m not 100% sure how this runs afoul of Libertarian philosophy.

    We should legalize drugs because people are adults. Why should be required to foot the bill for their problems? Liberty means people are free to make asinine decisions, but if all of US have to financially support that decision, then the freedom needs to be curbed.

    If we’re EXPECTED to foot the bill, then it makes zero sense to legalize drugs at all.

    1. Depends upon the flavor of Libertarian.

      1. Depends upon the flavor of Libertarian.

        No it doesn’t. The first libertarian to put someone else in charge of someone else’s decisions, bad or otherwise, is no longer a libertarian.

        Fuck You. Cut Spending.

    2. It is darkly amusing to see a Reason writer adopt War on Drugs terminology like “epidemic”.

      Exactly what is the State’s responsibility for saving someone who seems determined to commit suicide by OD for an ideology which believes suicide is not the State’s business?

      1. It is darkly amusing to see a Reason writer adopt War on Drugs terminology like “epidemic”.

        ^This

        1. What? In a libertarian philosophy there is no such thing as an epidemic?

      2. Well, he’s just an intern. Probably been hearing it his whole adult life. It is annoying ,though.

        I think the real question is what is the state’s responsibility for saving anyone at all? I think that what makes this policy idea particularly irksome is that it singles out just one kind of bad choice that leads to injury because of people’s moral judgement about drug use. Why should the state save someone who gets lost in the mountains or crashed their motorcycle? Those are dangerous and optional activities too.

        1. well if you are a statist, everyone is state property so they want to preserve their property.

        2. Why should the state save someone who gets lost in the mountains or crashed their motorcycle? Those are dangerous and optional activities too.

          And if they do it REPEATEDLY, they shouldn’t be bailed out (or, bare minimum, they should have to pay for the costs involved with saving them). A one-time thing should be protected as a basic part of a human civilization. Multiple times? That’s just Darwinism at work.

      3. Yeawp.

        Dickens wanted his readers to believe that Scrooge’s statement, “If they would rather die, they had better do it, and decrease the surplus population” was the height of monstrous cruelty. It’s the fundamental assumption of all statist do-gooder fail: that some higher power or hive mind or “society” owns humans and their choices, and therefore, government cannot let people make stupid or risky or potentially irreversible choices.

        It’s not cruel to “let” people choose to die, either by action or inaction or stupid mistake. Just like the First Amendment is there to protect the ugly speech, personal liberty is there to protect the rights of people to choose to do even fatally stupid shit.

    3. If someone is prone to reckless driving, should we all be forced to subsidize their problems, or should the EMTs stop responding after your third accident?

      1. If someone is prone to reckless driving, should we all be forced to subsidize their problems, or should the EMTs stop responding after your third accident?

        Well, they can’t avoid it given that, odds are, you’ve injured somebody else innocent. But jail time or massive fines for your actions are more than justifiable.

    4. If a large part of the OD problem is that society has decided to make drug use illegal and therefore the drugs of an uncertain quality, then society can foot the bill for the consequences, just as they do by paying for more cops and more jail and the ensuing corruption and police brutality and loss of civil rights and so on. You’re taking people’s liberty and complaining that it costs too much to deprive them of their liberty? Boo-fucking-hoo.

      1. If a large part of the OD problem is that society most people has decided to make drug use illegal and therefore the drugs of an uncertain quality, then society everybody can foot the bill for the consequences

        See how dumb that looks now?

      2. If a large part of the OD problem is that society has decided to make drug use illegal and therefore the drugs of an uncertain quality, then society can foot the bill for the consequences, just as they do by paying for more cops and more jail and the ensuing corruption and police brutality and loss of civil rights and so on.

        In the end, they are aware that there are risks and are taking them. If you’re unaware that there seem to be an awful lot of people dying from opiates as of late, well, then you’re too ignorant to be taking them and should be barred from doing so.

        If it’s legal, it’ll be even MORE “imperative” that we “save” them from a “totally legal” product that was made “incompetently”.

        1. Or a legal product, made competently, but used incompetently.

    5. Because the overdose epidemic is driven by government prohibition?

    6. You’ve pointed out a flaw in libertarian philosophy. Just how free are we to make decisions? Growing evidence from neurology suggests: not free at all. So how responsible can we be?

      1. Silly argument. Even if free will does not exist the desire for liberty dictates that we still proceed as if it does.

  9. Large spikes in overdose deaths often involve influxes of heroin laced with synthetic opioids like fentanyl or carfentanil, which are far more potent than heroin itself. Because these drugs are bought on the black market, users have no way of knowing what they’re really buying, and thus no way to adjust their dosing accordingly when synthetics are in play.

    This can’t be emphasized enough, and is often lacking in coverage of these overdose “epidemics.”

    Opioid addicts who can get a steady supply of something predictable almost never overdose. I remember a sudden spike in heroin overdoses in the LA area in the early 90s during a three-day stay by the Dead. The cause was directly attributable to some joker who was selling 98% pure heroin, which is at least twice as pure as was typical from a street dealer at the time.

    I would bet good money that minimal investigation would turn up similar “surprises” in these strings of sudden overdoses – i.e. yesterday you were getting 35% heroin and 65% coffee grounds and airplane glue, today you got 15% heroin, 55% fentanyl, and 30% yard clippings, and you overdosed.

    1. Yep. Yard clippings make a dangerous high.

    2. I guess not that timely but I read that when Janice Joplin died, there were a bunch of heroin ODs that same day, she and half of LA got some bad dope.

      1. Wasn’t booze a big factor with Janis??

        1. It was, but an unexpectedly potent batch of heroin was the direct cause. The extreme and probably imminently fatal alcohol-related issues were an also-ran in cause-of-death such that she might have withstood the heroin OD if she had been healthier. But as Number 7 points out, a number of other customers of the same dealer had the same problem at the same time, with the same result.

      2. Did you deliberately misspell her name for some reason? It’s funny how two names which sound the same conjure up such different mental images. “Janice” sounds like a clean-cut girl-next-door type, “Janis” sure as hell doesn’t.

    3. I agree. And I think that there is two different issues being discussed here.

      One, is what you said. Many overdoses are simply due to black market product having uncertain quality. An open market would likely clear this up entirely. This is an obvious step. It won’t happen because drug usage has become a moral imperative, but it is an obvious choice otherwise.

      Two, when people do overdoes, or otherwise have serious consequence of their own action, how much responsibility does the state have to save them from their own action? I’m presuming when they say each overdose costs 1,105$ that it implies that the overdosers are not paying them back (If they are paying for it, then I don’t understand the guy’s complaint at all). At that point, how responsible are tax payers to save their ass?

      1. I’m presuming the $1,105 must be city-employed “first responder” costs – i.e. all the city units that “have to” go when there’s a call. Police, hook-and-ladder, whatever. Stuff that’s written city policy that there wouldn’t be any way to go after the OD patient for (because, in principal, the City is sending these units out of its own accord without consent from the party being “served”).

        My suggestion is that an open market would clear this up enough that it wouldn’t be any more of a debate than any other “why should I have to pay EMTs to help that guy who fell off that thing he decided to climb on” issue.

        IOW, this is just a subset of public vs. private means of handling sudden emergencies, and not something particular to the “opioid crisis.”

        1. Yes, but it is something with enough publicity that it is dredging up assumptions about how funding is handled that are not usually discussed.

          1. This is true, and it might be worth looking at first responder costs across the board, because that’s exactly one of those areas where people would be less inclined to question the need for three dozen union-scaled EMTs to show up to every 911 call.

        2. I’m skeptical about the cost estimate here. Is $1,105 the actual additional costs incurred that wouldn’t have been realized had the person not OD’d? Or are they factoring in firefighter, police and EMT wages, which would have been paid either way?

          1. It’s hard to say specifically for Middleton. As far as I know, a lot of EMT places just bill per pick up.

    4. I believe that investigations have turned up exactly what you say. Almost all of the big overdose clusters are because of fentanyl or even stronger synthetic opioids being sold as heroin. Some of those things are so potent that you can easily get 10x the desired dose just from a tiny crumb that didn’t get mixed well enough with whatever they are cutting with.
      Make clean heroin or morphine available and all of those ODs go away.

      1. ODs may go away but deaths wont. Prolonged heroin use (several years) will probably kill you, same with methadone.

        1. I don’t think that’s true. Plenty of people spend years or decades as junkies, and that’s with street shit.

          1. I’m pretty sure Mr. Burns is correct on this one. That shit takes a toll on your health. I can’t say with certainty if it’s the drug, or what it’s cut with, but these people age more than the usual each year. I’ve seen people who their record says 30, but they appear to be 50-60 years old. Obviously that isn’t a study or anything, but it’s been my first hand experience.

            1. I’ve seen people who their record says 30, but they appear to be 50-60 years old.

              Were those people on opioids, or some kind of speed? And were they drinkers?

              The most road-worn, 30-going-on-60 people I’ve met were into meth. But my experience may be idiosyncratic.

              1. Honestly, I’m referring more to the meth side since the last Hospital I worked for was in East Texas.

                Heroin I couldn’t say, I was never one of the people looking at specific medical records and therefore I have no idea if that was the specific drug. Meth, believe it or not, you don’t really need to look at the MR to know. That probably sounds like bullshit, but after you’ve seen your 20th meth-head and had a few conversations with them you’ll have a pretty good idea on sight.

                1. That probably sounds like bullshit, but after you’ve seen your 20th meth-head and had a few conversations with them you’ll have a pretty good idea on sight.

                  Oh believe me, I’ve had enough meth in my own family that I’m 100% on board with the idea of being able to identify them on sight. That’s why I ask – I’ve more than once been surprised to find out that someone was a secret junkie. But meth? Yeah – you can practically smell it.

                  1. LOL LOL LOL

            2. I think it’s the lifestyle and adulterated drugs that cause that a lot more than the drugs themselves. As far as I’ve been able to figure out, opioid drugs really don’t do that much direct physical damage.

              1. Opioid drugs are generally considered immediately non-deleterious to one’s health. The harm comes from lifestyle (generally, favoring the high over nutrition and being unable to afford both, but also the sympathetic relationship to behaviors like cigarette smoking and alcohol abuse, which do cause direct long-term damage (cell death). Also, yes, cutting agents are often directly harmful as well.

                Suffice it to say that prohibition is clear contributor to each of the indirect harms associated with opioid abuse.

        2. Prolonged heroin use (several years) will probably kill you, same with methadone.

          Better tell this guy.

          In all seriousness, there’s little in the way of direct medical side effects from even decades of opioid use, especially as compared with alcohol or tobacco.

          Decades of life as an impoverished fugitive criminal, on the other hand . . .

          1. There are also a good number of physicians who have had secret morphine habits and successful careers. Maybe there is something about heroin that is worse for you than the ones with common medical uses, but I’ve never seen anything that suggests it’s true if you really get the pure drug.

            1. I’ve never heard a doctor assert that there’s any essential difference between heroin and morphine. In fact, there was a medium-significant movement 25 years ago or so to reschedule heroin to the same level as morphine, since the risks are essentially identical and heroin is a much smaller molecule that’s less painful to inject than morphine.

              My own grandfather was a doctor with a secret codeine habit. He was also a raging alcoholic (fifth of vodka a day for decades).

              Guess which one destroyed his life and eventually killed him?

              1. Boil morphine in salycylic acid and you get Heroin?, just as acetylizing salycilic acid made Aspirin so much handier than those syrups. They are the same thing–opiates that cause dopamine production to atrophy. One of the pre-code movies “Heroes for Sale,” tells of a WWI soldier wounded and doped against pain by the Germans, who returns to prohibitionist America an addict. It is the only effort made to register the facts of the 1920s, when the Government banned both competitors in the market for depressants. No effort has been spared to produce comics, dross and chaff by the same name so as to distract audiences from seeing the movie.

        3. Burroughs was a junkie for 50 odd years.

    5. And, notably, if the city weren’t paying for the paramedics to respond to every call do we think these people would still be alive, or would they be dead? Well, it would depend how much of their income went directly into their addiction presumably.

      The only reason this is being discussed is because it was decided that the government should foot the bill for this type of call. What is the problem in the government no longer being the guarantor of those payments?

      I dare say charities, but if not than oh well. Not giving is not taking.

    6. I vaguely remember that 3 night stint. I was living across the street at the time.

  10. Even the sorts of serial overdosers who grab headlines?such as a Dayton, Ohio, man who has been revived by paramedics twenty times?do not deserve to just be left for dead in the streets.

    Deserve’s got nothing to do with it.

    1. Deserve’s got nothing to do with it, but what about “paramedic fetish”?

  11. Recently, Middletown, Ohio, city councilman Dan Picard proposed that paramedics not respond to addicts upon a third overdose.

    Christ, what an asshole. I hope he’s not one of Jean-Luc’s ancestors.

  12. Tip for Councilman Picard on the proper way to present this:

    The paramedics can save people from ODs as much as they want. Hell, they can save someone five times a day if they want to. But after the third time, they’re doing it for free because the city ain’t shelling out any more cash.

  13. Should the proposal pass, supporters may be surprised at how little it does to stop the onslaught of overdose calls. Middletown Fire Chief Paul Lotti, a critic of the proposal, noted that 85 percent of the department’s overdose runs involve first-time callers, who would not be subject to the three-strikes rule.

    Then make it one strike instead of three: paramedics will not respond to drug overdoses whether it’s the first, second or third time caller. If you overdose on drugs, you’re on your own and the taxpayers will not foot the bill.

    1. What if you overdose on something legal, like alcohol?

    2. What if it is an accidental overdose on perscription pain killers by an older person that forgot they already took their pills?

  14. Can’t they city just forward the bill to the patients? Seems like you could give a couple cronies a bill sending/collecting gig.

    1. Are you seriously thinking there’s money there to collect?

  15. Middletown is frighteningly Warty-adjacent. Death is not the worst fate possible in Middletown.

  16. Picard’s proposal is impractical since it is impossible to know for sure why somebody is unresponsive before treating them. But I disagree with the author’s contention that some of these individuals don’t “deserve to be left for dead in the streets.” The one individual who has been revived 20 times is consuming obscene amounts of health care resources and dollars. I would guess that each rescue and emergency treatment costs several thousands of dollars so his total bill for such insanity is probably well over $100,000 if not more. And I’m pretty sure he isn’t going to pay it. Going forward, our rescue of this individual will probably cost hundreds of thousands of dollars if not millions more in health care costs due to drug related illnesses including infections and other complications. If he is left disabled by one of these events, the cost will be millions to care for him. Again, this will all be at societal expense. And there is no effective treatment for his addiction. So technically, the author is wrong. Other people are arguably more deserving of the health care resources this individual is selfishly consuming. And other people slaving away to support this individual’s insane lifestyle are more deserving of the money he’s wasting. I’m not arguing that it would be a great idea to just let people die. I am a bleeding heart libertarian. But the author’s moral calculus is a little off.

    1. So if you’re knocked off your bike three times and keep stupidly getting run over, that’s ok? By whose judgment? The person making the decision to ride their bike is at least not being ruled by a true addiction.

  17. I have quit high dose fetanyl twice and low dose three times as my condition waxes and wanes. It is like having the flu for a month with muscle spasms/tremors occasionally, it makes you sleepy and stupid. No one takes it to get high, they takes to escape being fully alive because life is difficult or unpleasant . The causes vary and are obviously very hard to , perhaps impossible, to fix.. Sometimes ignorant or careless people take it against the instructions received from their doctor , or they get it illegally and overdose. It’s their choice and if resuscitated they will likely do it again. If you want to help people who dont care about themselves go ahead but count me out. I strongly resent the forced altruism of group think that cares so much for people who dont care for themselves while simultaneously denying people in great pain relief and denying terminally ill folks the right to try medicines because it might possibly hurt them. Opiates aren’t contagious so the epidemic crap is a lie, and so is the compassion . The only people this fake epidemic hysteria benefits is drug enforcement people who are terrified of losing jobs, funding and graft because of marijuana legalization . It has all happened before when prohibition was repealed.

    1. I was given fentanyl to put me under for minor sinus surgery once, and i’m told i was walking around and talking afterward but remember nothing until a day and a half later. I can’t conceive of taking it regularly.

      1. I get the impression they affect different people in wildly different ways. The only opioids I’ve ever had are Vicodin and codeine, and I dislike them both rather strongly. I couldn’t imagine taking them of my own accord, let along getting addicted to them.

        So what mr burns says about “No one takes it to get high, they takes to escape being fully alive because life is difficult or unpleasant” rings true to me, as I found them not fun, but just numbing. But I’ve also known people to be semi-religious about heroin in a way that seems to go well beyond just “numb.” It does something rather profound for them, somehow.

        1. I got a bottle of Vicodin after a root canal once – I only needed one pill but the rest was quite pleasant. H, the several times I tried it, very much not pleasant.

          1. In double-blind clinical trials, the ones the scheduling system now prohibits, most normal people were unimpressed with the effect of acetylmorphine. Insane people, on the other hand, find the stuff enchanting. The results are summarized in “Drugs and the Mind” by De Ropp
            As for the competition Nanny State blocks, we had a harmless schizophrenic acidhead writer in Austin. To this day Philip K. Dick’s sci-fi is being reworked into successful movies. So where’s the harm?

        2. I’va always quite enjoyed the various opioid/opiate drugs I’ve tried (including heroin, but never injected). So I make a special point of avoiding doing them for fun very often.

      2. I was given fentanyl to put me under for minor sinus surgery once, and i’m told i was walking around and talking afterward but remember nothing until a day and a half later. I can’t conceive of taking it regularly.

        That was the benzodiazapene, cuck.

        1. Cuck
          Cuck
          Cuck
          Cuck
          Cuck
          Cuck

    2. My dad had the fentanyl patch for neuropathy. After a week he was like hell to the no with this.

      1. Opioids are a flat out lousy choice for nerve pain. You sure it was fentanyl? There are other pain patches (e.g. Lidoderm) that do not contain opioids.

  18. “While more Americans are coming around to the idea that drug addiction should be treated as a public-health issue rather than a crime”

    On the one hand, since an overdose is not the unwarranted infliction of harm on another, we should celebrate that it is not being treated as a criminal act.

    On the other hand, what business do we have celebrating government riding in to save you from yourself as being any more libertarian than the government riding in to punish you?

    Kinder gentler statism is still statism.

  19. By Picard’s estimation, each overdose response costs the city $1,104

    Really? That seems relatively cheap in the modern scheme of things.

    1. Oh – at government rates that sounds like maybe 2 guys and a truck for about an hour.

  20. Is this going to be as bad as the crack epidemic of the late 80s/90s?

    1. It involves many middle-class white people, so it will be worse.

      1. You misspelled ‘awesome’.

    2. There was no crack epidemic. That was a marketing alternative. Needle-banning fanaticism (coupled with intenventionism) was causing a major HIV epidemic where the same superstition had already caused a hepatitis epidemic. It made coke (which isn’t addictive) easy to smoke. Heroin always has been easy to smoke, but it is addictive. The bottom line is that the Kleptocratic Political State makes the stuff so expensive that injection is a temptation. Making coke smokeable (but no good for sniffing, according to my police lab source) is good business for they who confiscate for resale. You brand someone a felon so they can’t get a job, then your agents turn them into vendors for the Thin Blue Line Beneficent Association Asset-Forfeiture Fund. This is the Honest Graft Tammany Hall politics is all about. This (and the taxman) is what pays for anti-libertarian teevee propaganda.

      1. Come isn’t addictive? You haven’t done coke.
        Coke is also easy to smoke.

        1. Fucking autocorrect. That first word should be coke.

          1. Freudian slip – Say one thing, and mean your mother.

        2. He’s obviously talking about crack.

          And, no, you can’t snort crack.

          While I would agree that coke is addictive, I have certainly seen folks whose addictive response to coke might as well be zero when compared to the addictive response to heroin of every person who doesn’t actively dislike it upon trying it.

  21. Back in 2006 there was a lawsuit in WV. Seems that a police chief pulled a similar stunt with a man having a heart attack: “You’re gay, you got AIDS, no CPR for you.” Should have been arrested but for the magic badge.

  22. >>>not respond to addicts upon a third overdose

    can’t tax them if they’re dead, dummy…

  23. “Refusing to work and getting government support is bad”–Libertarian
    “Repeatedly overdosing on drugs and getting government support is good”–Libertarian

    Because drugs are good, mkay?

    1. “Repeatedly overdosing on drugs and getting government support is good”–Libertarian No one

      FTFY

    2. No. If the government provides a service they have to provide it to everyone equally. If the city doesn’t want to pay, get rid of the service completely. I’d bet anything that when word gets around that overdoses have to call a private ambulance and pay for it there will be fewer overdoses.

      1. Yes.

        I can think you’re an idiot for riding your bicycle right? So you get knocked off three times. Do I pay for your third accident?

    3. Some drugs are good compared to Christian Prohibition and National Socialism. In the real world we deal in trade-offs, maximizing and minimizing, calculus. Cigarettes and whiskey have more to fear from relegalized hemp and acid than from the cartel-building Anti-Saloon League, Methodist White Terror and Landover Baptist Church.

  24. While this is pretty heartless, I’m not sure why a supposed libertarian is complaining about this.

    It’s not the role of the government to save your life when you do something stupid. That’s harsh, but how is this any different than the government providing food for the starving? Health care for the sick? (Of course, Reason is for this when it’s health care for illegal immigrants and of course, abortion on demand)

    1. I think that the libertarian angle is mostly “here’s some more awful shit that wouldn’t even be an issue if not for the war on drugs and its “unintended” consequences”.

      But yes, the pure libertarian answer is probably that if you want to be saved when you do something stupid and injure yourself, then you should probably buy some kind of insurance or be ready to pay.

  25. Here’s another idea. Make Narcan readily available OTC and junkies can save each other from overdoses.

    1. You can in some states.

  26. Detained immigrants are mostly refugees from the economic conditions the USA exported to their countries at gunpoint. William Jennings Bryan and Herbert Hoover travelled South America preaching the virtues of shoot-first prohibitionism and failed. Everybody but churchly fanatics still likes coke, beer and mushrooms. Cold War handouts, election fraud and destabilization changed all that. Now but their machine politicians like Chicago-style extortion, bribery and graft. Every country south of Brownsville is a colonial client-state of the fanaticism that made Prohibition for 14 years. To grasp how this affects employment, inflation, interest rates, banking and investment, visit the Chicago Tribune online and look up the Herbert Hoover years 1929-32. The economy Terminator the federal government created here it also exports along with cigarettes and whiskey. Folks are fleeing what Republican and Democrat machine politicians installed as an asset-forfeiture machine to rob money overseas and impound it here. Those undocumented immigrants are following their own country’s money.

    1. That is one heck of a comment.

      1. Bravo.

  27. How about 3rd OD and the city starts billing you for the costs of saving yer tired ass?

    1. Why wait till the 3rd? I’m sure they charge for the first one now but they can’t throw the destitute into a workhouse anymore.

    2. These folks in rural Ohio (where I live) generally don’t have two dimes to rub together. “Like getting blood from a stone” is the old phrase.

      1. Okay – so if they don’t pay for the first one, you don’t show up for the second one. That should make everyone happy. The costs go down and the druggies get a free warning.

      2. These folks in rural Ohio (where I live) generally don’t have two dimes to rub together. “Like getting blood from a stone” is the old phrase.

        Wait. They have money for drugs – but not for emergency medical services?

        1. Oh yeah. Various government benefits that aren’t attachable in civil court and under-the-counter-cash income from odd jobs and illegal income. You bet that’s how it works out here.

          1. Eta: It’s cute that you are surprised by that.

  28. Like the “final solution” proposed in Christopher Buckley’s novel, Boomsday, the councilman’s proposal has a certain utilitarian logic.

  29. Do you know who else thought society would be better off if the weak-willed, vice-ridden addicts were culled from the gene pool?

    1. Margaret Sanger?

      Nikolai Tesla?

    2. Everyone with an IQ above room temperature?

    3. The Brits in China in the middle of the 1800s?

    4. Mr. McGoo?

    5. That wasn’t self-culling like a drug overdose. Pretty significant distinction, no?

  30. He who pays the piper calls the tune. Isn’t this a libertarian approach to the problem? What right does the government have to appropriate my money and use it to reward people who make bad choices with medical service?

    I’m sure all the people who care so much can band together and create their own voluntary EMT service that responds to such calls.

    Voluntarism. It’s what libertarians are supposed to have for dinner.

    1. Nobility always tastes better when you use someone else’s money.

    2. The problem is that, in the current ‘war on drugs’ environment, the user cannot make an informed decision.

  31. Treatment really doesn’t work not in any significant way. So you try to bring them back from the dead until you can’t or you can let them go.

    1. It seems that a lot of people die in the months following drug treatment, but the experts say that the
      treatment works fine, its just the patients keep dying.

  32. Paramedics should not become, at the direction of ill-informed politicians, arbiters of who deserves to live and who deserves to die based on one’s lifestyle choices.

    This is a bit like the gay/sex change bullshit.

    If your choice of lifestyle causes you to die – it’s your CHOICE. Yeah, okay. Everyone should get one free call. The guy who O.D.s on drugs, the 500-pound woman who has a heart attack, the 3-pack-a-day smoker, the couch potato who never exercises. But unless you pay the full freight for the call, you don’t get a second call.

  33. This would not be a ‘public health’ problem were it not for Drug War Criminals and their ilk.

    I don’t want to pay for your medical care after a skiing accident, nor after a heroin accident.

    Forcing you to buy black market heroin, however, is functionally equivalent to paying the ski patrol to throw hand grenades at you as you race for the bottom of the hill.

  34. Interestingly, Massachusetts wants to have it both ways: war against and battle to save.

    1. We certainly have our heads firmly up our arses in MA…look who we send to DC…

  35. Legalize the damn drugs.

  36. I agree with the councilman. All drugs should be legal and anyone that incurs negative consequences from the use of those drugs should have to deal with the consequences without taxpayer assistance. I, quite frankly, don’t understand how an alleged Libertarian organization would feel otherwise.
    Maximum freedom comes with maximum responsibility. My mother eventually died from opioid abuse. She was never able to be rehabilitated. She caused a lot of pain along the way.

    1. The problem is that the drugs are NOT legal, so the user makes no informed decision.

  37. Oh Ben, this is so sad. “HMMM…. my addicted body is telling me to take drugs; I have no ideas or guarantees the drugs I’m taking are safe, the dosage they say they are; my body is screaming in pain; oh but I might not be rescued again????”

    So …….. inhumane.

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