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This Bold Plan to Fight Opioid Overdoses Could Save Lives--But Some Conservatives Think It's "Immoral"
With Ohio beset by a massive public health around opioid use and overdoses--more than 4,000 Ohioans died of opioid overdoses in 2016--the Cleveland Plain Dealer sent travel editor Susan Glaser to Amsterdam in search of innovative approaches to the problem. While there, she rediscovered Holland's long-standing, radical, and highly effective response to heroin addiction and properly asked whether it might be applied to good effect here.
The difference in drug-related death rates between the two countries is staggering. In the U.S., the drug overdose death rate is 245 per million, nearly twice the rate of its nearest competitor, Sweden, which came in second with 124 per million. But in Holland, the number is a vanishingly small 11 per million. In other words, Americans are more than 20 times more likely to die of drug overdoses than the Dutch.
For Plain Dealer readers, the figures that really hit home are the number of state overdose deaths compared to Holland. Ohio, with just under 12 million people, saw 4,050 drug overdose deaths in 2016; the Netherlands, with 17 million people, saw only 235.
What's the difference? The Dutch government provides free heroin to several score [where a score=20] hardcore heroin addicts and has been doing so for the past 20 years. Public health experts there say that in addition to lowering crime rates and improving the quality of life for users, the program is one reason overdose death rates there are so low. And the model could be applied here, said Amsterdam heroin clinic operator Ellen van den Hoogen.
[...]"It's not a program that is meant to help you stop," acknowledged van den Hoogen. "It keeps you addicted."
That's not a sentiment sits well with American moralizers, such as George W. Bush's drug czar, John Walters, whom Glaser consulted for the story. He suggested that providing addicts with drugs was immoral and not "real treatment," but he also resorted to lies about what the Dutch are doing.
He claimed the Dutch are "keeping people addicted for the purpose of controlling them" and that the Dutch have created "a colony of state-supported, locked-up addicts."
Your humble Ed (who rechopped the quoting, so head off to the full article(s) to see the full story) adds: of course, this is quite a contentious issue, digging deep into moralistic debate, and where clearly there's little agreed-upon objective truth and plenty of opinions. However, we are a community dotted widely round the globe, and so I'm sure there are plenty of stories of what has or has not worked in different locales.
Previous: Tens or Hundreds of Billions of Dollars Needed to Combat Opioid Crisis?
Portugal Cut Drug Addiction Rates in Half by Rejecting Criminalization
(Score: 1, Insightful) by Anonymous Coward on Wednesday July 25 2018, @06:12PM (31 children)
Therefore, in order to figure out both what society needs and whose going to pay for it, there needs to be a market of voluntary exchange to find out the answers.
At most, a government should enforce contracts between individuals, and even that activity should instead be handled by firms that compete in the market place—society is that phenomenon which emerges from countless interactions among individuals; it is an iterative, evolutionary process whose robustness is proportional to variation (supplier competition) and selection (consumer choice).
If you have to fund your ideas at the point of a gun, then your ideas are no good.
(Score: 0) by Anonymous Coward on Wednesday July 25 2018, @06:15PM (3 children)
If you have to make a shitty argument about theoretical violence / murder then you ARE shit. VIMVIMVIMVIMVIM! lol back to try again huh? Just don't spam the same shit repeatedly please, we're tired of you whining about downmods.
(Score: 0) by Anonymous Coward on Wednesday July 25 2018, @06:21PM (1 child)
How can you possibly look back your reply and think "Yup. I'm on the right side of this."
(Score: 0) by Anonymous Coward on Wednesday July 25 2018, @09:49PM
Ditto right back at you. You're an ideological fool and after the typical rational responses have been worn out yet again the only response left is a variation on "you're an idiot!"
(Score: 0) by Anonymous Coward on Wednesday July 25 2018, @06:32PM
Can't we just tell him, ":qa!"
(Score: 1, Funny) by Anonymous Coward on Wednesday July 25 2018, @06:18PM
Don't worry scrow, there are plenty of tards out there living totally kickass lives. My first wife was tarded, she's a pilot now.
(Score: 5, Interesting) by Thexalon on Wednesday July 25 2018, @07:03PM (25 children)
Ah yes, the "Free Market Cures All Ills" hypothesis. I'm now going to demonstrate this can lead to a suboptimal outcome.
Here's a good idea: "Hey, it would really help if we had a road from here to the next town over, so we can get goods and people to and from where we live". And several different organizations are competing to build that road in a marketplace, with the plan of paying the expense of the road via tolls. So far, so good, right? Well, 1 particularly well-funded competitor, Acme Inc, manages to, for $60 million, buy a thin ring of land all around the town in question (easy enough when nobody who is selling knows anything other than "This company is paying well over market value for a small strip of my land), and refuse to allow anyone else to build a road across their land out of the town. The residents are quite concerned about this, and go to Acme and ask them what their terms are: Acme says "OK, here are your options: You can buy this small piece of the ring of land from me for $120 million, or you can sell a strip of land for $20,000 and I'll build the road and charge the tolls." They choose option B because that's short-term cheaper and they really need a road out of town, Acme Inc spends an additional $1 million to build the road to the next town, and proceeds to charge the residents enough in tolls that they make $10.2 million in toll revenue and spend $0.1 million on maintenance each year, and in 6 years they've recouped their entire investment. From now on, they continue to make $10 million or so maintaining their little road.
What's the problem, you ask? Well, I just demonstrated that this town's residents now have to pay, over 10 years, $102 million in tolls for a road that actually cost $2 million to build and maintain. That's ridiculously inefficient. And no, they can't get away with taking a different route, because Acme still controls all the potential alternative routes out of town.
This can be prevented by either of the following actions by the government:
1. Make it illegal to completely surround a town with land you own. Which is to say, prevent the final contract forming that ring of land from happening due to the third-party interest of having a way to leave town.
2. Require a property owner to sell their land at fair market value when there's a compelling public interest in forcing them to do so. This is what the US actually does.
In either of those cases, the government pays about $3 million to build and maintain the road, with the money coming out of taxes, and that's far far cheaper for the residents of this town than the free-market scenario.
The mistake most Free Market believers make is thinking that competitors are going to play fair. But as profit-seeking entities, they won't if there's more profit to be had by playing unfairly.
The only thing that stops a bad guy with a compiler is a good guy with a compiler.
(Score: 0, Disagree) by Anonymous Coward on Wednesday July 25 2018, @07:08PM (11 children)
I'd take irritating voluntary exchange any day over irritating involuntary exchange.
That is to say, your libertarian shithole still eeks out a victory over the governmental alternative.
(Score: 0) by Anonymous Coward on Wednesday July 25 2018, @07:30PM (2 children)
If we eliminate government, we are no longer in the realm of libertarianism. We have crossed over into the twilight zone of anarcho-capitalism.
(Score: 0) by Anonymous Coward on Wednesday July 25 2018, @07:33PM (1 child)
Here [soylentnews.org]. Maybe that will clarify things for you.
(Score: 0) by Anonymous Coward on Wednesday July 25 2018, @08:19PM
Ah. I'll reply over there.
(Score: 3, Interesting) by Thexalon on Wednesday July 25 2018, @08:17PM (7 children)
I just demonstrated how government can be and has been used to solve the problem I presented: Eminent domain laws. It ain't perfect, but it's much cheaper than the scenario I described above.
You definitely have a strange idea of how "voluntary" the situation I described is. If you are a resident of this town, you don't have a lot of options. You can pay the tolls, or you can stay where you are and have all the traders you rely on to stay where you are pay the tolls and pass the cost on to you. Either way, if this town has 10,000 residents, you're paying about $1000 a year to Acme Inc. You could leave town I suppose, but that would mean giving up a substantial percentage of your wealth because everyone is factoring in that they have to pay $1000 / yr to Acme Inc just to get to work.
And while you're doing that, you're looking at the people paying 1/100th of what you're paying, and getting better and more convenient service, and thinking "Those suckers!" I have to admit I have a hard time understanding that mindset. About the only reason I can think of that you don't see a problem in any of this is that you imagine yourself to be part of Acme Inc that is putting this town in a stranglehold, rather than one of the 10,000 people caught in said stranglehold, when the odds are very much the other way.
The only thing that stops a bad guy with a compiler is a good guy with a compiler.
(Score: 0) by Anonymous Coward on Wednesday July 25 2018, @08:37PM
It is blind belief born of the post WWII propaganda. Like religious belief you can't fight it directly. I'm not quite sure how to get such people informed, on this site only the facts have been stated numerous times. I think the only way is to get a majority and vote in the changes. Once the better outcomes are directly evident then these suckers MIGHT change their tune. My money is that they will stop bitching so much but will maintain the "taxes are theft!" mantra even as their lives are saved from financial dissolution over a serious health issue.
(Score: 0) by Anonymous Coward on Wednesday July 25 2018, @09:18PM (5 children)
You forgot the other option, because you are conditioned to view violence as the purview of those who monopolize it. Want me to pay for your shitty road? Got me fucked up. I'll pay the goon squad to fuck your life up. Take sledgehammers to your stuff. Rob your toll booths. Mob any one of you that steps near the town and string them up. It's not pretty, but neither is exploitation. Oppression under the boot of wealthy shysters who use fairy tales like "law" to bully and exploit by the million is even uglier. THAT is the reality of the current system.
(Score: 2) by Thexalon on Wednesday July 25 2018, @09:39PM (2 children)
Also known as "turn the place into a war zone". Because you seem to be assuming that you and your goon squad are going to be more capable of winning that fight than the company who is pulling this off can come up with. Nothing really improves a neighborhood like a good old-fashioned artillery barrage.
The only thing that stops a bad guy with a compiler is a good guy with a compiler.
(Score: 1, Insightful) by Anonymous Coward on Wednesday July 25 2018, @09:52PM (1 child)
He finally showed us the real side of his personality. A violent thug one small step away from justifying his violent tendencies. He wants to live in complete freedom and just IMAGINES that he and his friends will be able to maintain the libertarian utopia against all odds. One person steals some food from them and they'll go get it back and likely end up murdering people over it. Morally. Bankrupt. Asshole. Or MBA for short.
(Score: 0) by Anonymous Coward on Thursday July 26 2018, @03:46AM
Actually, I'm not the VIM guy, just playing devil's advocate. The point was, economic violence can be met in kind, which is why the type of shit he was talking about earlier just wouldn't happen from any serious businessmen. A happy customer will gladly give and give. Fighting, whether literally or figuratively, just isn't sound business. The trick is to make your customer willingly embrace the prison, not extort them like you seem sure would happen.
(Score: 2) by MostCynical on Wednesday July 25 2018, @10:28PM (1 child)
And now we see the viloence inherent in your system
"I guess once you start doubting, there's no end to it." -Batou, Ghost in the Shell: Stand Alone Complex
(Score: 1, Insightful) by Anonymous Coward on Wednesday July 25 2018, @10:56PM
But its mutually agreed to violence! Or something... how does that work again?
I wish every thief had come up to me and had me sign an agreement that if I caught them breaking into my car again I'd kick their ass. Would have saved me some time and kicked their ass right there!
Seriously, that troll reads like a 5th grade bully trying to get out of detention.
(Score: 2) by krishnoid on Wednesday July 25 2018, @08:34PM (10 children)
Or just cut a hole in the fence and walk/drive across to the main road, assuming Acme isn't in the business of private property rights law enforcement as well. Yours is an extreme example, but if it involved a service, the lack of which was more an inconvenience than a necessity, I could see this easily happening, reguarly.
The mistake seems more along the line that competitors don't have enough resources to nearly/completely lock others out of the market. Although at that point, they're more de facto monopolists/oligarchs/owners than competitors, you could say.
(Score: 2) by Thexalon on Wednesday July 25 2018, @08:42PM (9 children)
Which of course we know is bunk, because otherwise Standard Oil, US Steel, and the other major monopolies of the robber baron era wouldn't have existed.
The only thing that stops a bad guy with a compiler is a good guy with a compiler.
(Score: 2) by Arik on Wednesday July 25 2018, @09:23PM (8 children)
But all of those companies relied on help from the legislature to secure a monopoly.
If laughter is the best medicine, who are the best doctors?
(Score: 0) by Anonymous Coward on Wednesday July 25 2018, @10:00PM (4 children)
They wouldn't have needed to rely on legislature if they were in the libertarian anarchy world, they'd just hire their personal army and we'd be living in another version of Medieval Society right now.
(Score: 2) by Arik on Wednesday July 25 2018, @10:23PM (3 children)
Without the intervention of the legislature there would have been no monopoly position, and that monopoly position is what lead to them having so much money the could hire their own armies!
If laughter is the best medicine, who are the best doctors?
(Score: 0) by Anonymous Coward on Wednesday July 25 2018, @10:44PM (2 children)
I don't think you understand the very basic underpinnings of capitalism and market forces. The big corporation purchased favorable legislation, they weren't a monopoly granted to a small 5 man outfit that then grew into Standard Oil.
Government enabled the bad behavior it didn't create it, but that goes against the anti-government mantra constantly pushed around here.
(Score: 0) by Anonymous Coward on Thursday July 26 2018, @12:21AM
Explain Walmart.
(Score: 2) by Arik on Thursday July 26 2018, @12:56AM
If laughter is the best medicine, who are the best doctors?
(Score: 2) by Thexalon on Wednesday July 25 2018, @10:46PM (1 child)
Care to explain? What laws did they pass at the behest of each of the companies I mentioned, and how did it aid them in securing their monopoly?
Because right now, your argument amounts to "Some form of government existed in the US at the time that this thing happened, ergo the government must have been responsible for that thing happening." But by the same token, I can blame the Catholic Church, ragtime music, Howard University, and Evelyn Nesbit.
The only thing that stops a bad guy with a compiler is a good guy with a compiler.
(Score: 2) by Arik on Thursday July 26 2018, @01:18AM
Standard Oil is an interesting case, the academic debate still rages today as to exactly how it got it's position. One popular theory is that they gained it by acting as a sort of justice system for the railroad cartel. The railroads had already relied on the legislature to reduce their competition, and there were only three companies as a result. They had already tried to form a cartel and screw the rest of us, but just as expected these attempts broke down quickly because they all cheated each other as well. In this theory, Standard earned their position by making sure the railroads played fair with each other, while all of the above proceeded to screw us. So under that theory the whole situation stems from the legislative interference in the early days of railroad.
There has been some interesting criticism of that theory, and there were clearly other factors. They had a big advantage of accident in the early days, being established in the area where all the oil was being pumped, and I'm sure they leveraged that just as hard as they could. But that advantage petered out quickly once oil wells started being dug other places.
But no matter how you cut it, they wouldn't have been where they were without the railroads, and the railroad monopolies were built on paybacks for campaign contributions and kickbacks.
If laughter is the best medicine, who are the best doctors?
(Score: 2) by Phoenix666 on Thursday July 26 2018, @03:19PM
Standard Oil became a monopoly because Rockefeller hired thugs to beat up and strong arm all the wildcatters he was competing with. He literally built his company on violence. Later, much later, the Rockefellers hired a private army to set up on a ridge and machine gun men, women, and children who were on strike, living in tents on private land the union had rented for the duration of the strike at Ludlow, CO. Hundreds more would have died except for the intervention of a train engineer who interposed his boxcars between the guns and the camp, on the rail spur that separated them. The Rockefellers should have been rounded up and shot for that, but they barely got a slap on the wrist.
Violence, theft, and thuggery are at the heart of this capitalist system. People sublimate all of that away and pretend it's an aberration; they will do almost anything to rationalize their comfort and convenience rather than confront their own contributory culpability, but it's there, and posterity will curse us for it.
Washington DC delenda est.
(Score: 5, Insightful) by FatPhil on Wednesday July 25 2018, @09:35PM
Eventually, the stock market will be at an all-time high, and everyone will therefore be a winner!
All hail the free market!
Great minds discuss ideas; average minds discuss events; small minds discuss people; the smallest discuss themselves
(Score: 2) by NewNic on Wednesday July 25 2018, @10:24PM
It doesn't even take someone buying up land to block development.
Google "Birmingham gas street basin" to see how private development results in inefficient and expensive infrastructure.
lib·er·tar·i·an·ism ˌlibərˈterēənizəm/ noun: Magical thinking that useful idiots mistake for serious political theory