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posted by FatPhil on Wednesday July 25 2018, @05:46PM   Printer-friendly
from the choose-life dept.

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


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  • (Score: 0) by Anonymous Coward on Wednesday July 25 2018, @06:47PM (17 children)

    by Anonymous Coward on Wednesday July 25 2018, @06:47PM (#712570)

    There is a difference between iteration and recursion.

    It doesn't have to be turtles all the way down.

  • (Score: 1, Insightful) by Anonymous Coward on Wednesday July 25 2018, @07:11PM (16 children)

    by Anonymous Coward on Wednesday July 25 2018, @07:11PM (#712584)

    Both iterative and recursive algorithms can be non-terminating. That is why I call contract enforcement in anarcho-capitalism an endless regress.

    Other endless regresses such as turtles all the way down can be iterated, but the iteration never terminates.

    We can have contract enforcement without an endless regress. The termination condition is called a violently imposed monopoly.

    • (Score: 0) by Anonymous Coward on Wednesday July 25 2018, @07:28PM (15 children)

      by Anonymous Coward on Wednesday July 25 2018, @07:28PM (#712600)

      If anything, violent imposition is what encourages people to retaliate with their own violent imposition, thereby resulting in an endless regress of violence.

      Better instead to advocate for a well-defined system of dispute resolution, entailing contract negotiation and enforcement according to the resulting contracts.
      That's why the arc of Civilization has involved an improving appreciation for the individual over the ruling class or even the collective, because society will always be more stable when individuals at least feel that their existence is voluntary rather than involuntary.

      So, thanks for your honesty.

      You have decided to throw your voice behind violent imposition, while I have chosen to spend [part of] my short life seriously considering alternatives.

      • (Score: 0) by Anonymous Coward on Wednesday July 25 2018, @07:36PM (10 children)

        by Anonymous Coward on Wednesday July 25 2018, @07:36PM (#712610)

        How do you prevent contract enforcement from becoming an endless regress?

        Furthermore, since you brought it up, how do you deal with the inevitable original sin of the first violent act?

        Have I misjudged that you're looking for men to become angels when you're actually trying to wind back the clock and restore man to his state before original sin?

        • (Score: 1, Insightful) by Anonymous Coward on Wednesday July 25 2018, @07:49PM (9 children)

          by Anonymous Coward on Wednesday July 25 2018, @07:49PM (#712616)

          Like the Newton–Raphson method [wikipedia.org] for finding successively better approximations to the roots (or zeroes) of a real-valued function, you don't have to start with perfection. Even a bad guess for a start to law-by-contracts (as opposed to law-by-imposition) can be good enough—capitalism is an iterative, evolutionary process.

          In contrast, a violently imposed monopoly requires the men in charge to be angels; this is the reason that a modern, constitutional, parliamentary republic always involves a Separation of Powers, because it is competition amongst powers that keeps them in check. Alas, multiple, competing branches of government are a poor approximation of competition within a culture that reveres voluntary interaction; that's why in a mere 200+ years, the United States have consolidated power under the increasingly kingly Federal executive.

          Consider that there has never been One World Government; at the level of the nation state, there has always been total anarchy, whereby something as crude as mutual annihilation as managed to keep relative peace among the powers, and where mutual trade has done the most to spread prosperity and good will.

          • (Score: 1, Insightful) by Anonymous Coward on Wednesday July 25 2018, @08:04PM (7 children)

            by Anonymous Coward on Wednesday July 25 2018, @08:04PM (#712626)

            I understand better the distinction you were making between iterative and recursive. (Let us table the idea of a one world government for later, because this is a logical consequence of my position, but we are not quite there yet.)

            So we will use international diplomacy as our model for contract enforcement without a central authority.

            Between nations, we see a pattern of imperialism throughout history. The condition of anarchy leads to overreach by those who have power, which leads to war. Consider the Iran nuclear deal. According to an independent authority, who could be a contract enforcement service for our purposes, Iran has upheld their end of the bargain. Yet we see that the actor who believes they have more power unilaterally tearing up the agreement and issuing violent threats.

            So let's elevate that independent authority to contract enforcement, and let's even suppose that they are the contract enforcement service mutually agreed upon. (And, indeed, in the Iran nuclear deal example, that seems very much to be the case.) How does that prevent disregard of the verdict given by the contract enforcer and initiation of violence?

            Wouldn't the contract enforcer need to have more power than the strongest party involved in order to prevent the initiation of violence?

            • (Score: 0) by Anonymous Coward on Wednesday July 25 2018, @08:44PM (6 children)

              by Anonymous Coward on Wednesday July 25 2018, @08:44PM (#712668)

              Caveat Emptor. I guess Iran shouldn't have agreed to such a piss-poor enforcer of the contract. That's not a fault with the concept, but rather a fault in this iteration's implementation. One World Government doesn't solve this issue; in fact, it would probably exacerbate the problem by providing a centralized point of failure for special interests to hijack.

              What you've identified is that at the level of the nation state, the framework for dispute resolution, contraction negotiation, and contract enforcement is really poorly defined; part of the natural iteration that WILL occur is that Iran and its ilk won't be quick to enter into such an agreement without more robust guarantees. Indeed, Iran should have insisted on the deal being approved by the Senate, which would have made it a treaty.

              The point of promoting capitalism and this way of thinking is to hasten this iterative development by explicitly identifying the need for a system that is not only better defined, but that is also designed around competitive implementation rather than decree. "Honor" is something that nations talk about; hard collateral is what capitalists bank on. Where are the objective incentives? Most "private" disputes in the U.S. are already handled by arbitration, because governmental courts just don't work well, and most people (and their corporations) are more than happy to follow rules laid out in advance (like a game); nations, in contrast, are not so sophisticated, because their violent imposition affords their wastefulness, slothfulness, and stupidity, and it also means they are used to taking what they want when they can.

              One of the hardest aspects of enforcing something like the Iran deal is creating the right incentives for all parties. Maybe something like Bitcoin is necessary, so that the United States can be forced to transfer into an internationally controlled escrow some large sum of money that can be released to an aggrieved party when M of N parties to the treaty agree to do so. Sure, the U.S. could wage war over such a decision, but when rules to the game are set in advance, it's much easier for politicians to say "Well, sometimes you win and sometimes you lose; everything went according to the rules." Game rules allow for people to save face even when they lose. And, hell, if war did break out, well, the aggrieved party would be flush with American bitcoin for funding its defense and retaliation.

              • (Score: 4, Insightful) by Azuma Hazuki on Wednesday July 25 2018, @08:53PM (5 children)

                by Azuma Hazuki (5086) on Wednesday July 25 2018, @08:53PM (#712676) Journal

                You still haven't answered how you prevent an infinite regress of contract enforcement.

                Face it, at some point, "violently-imposed monopoly" is where the buck stops. End of story. There's just no way around it. Men, as you point out, are not angels. I go a step further: some people are about as close to demons as one can get in reality, and understand nothing *but* violence. Sometimes violence *is* the answer. What you want to do it make sure 1) it's very rare, 2) it's applied surgically and intelligently, and 3) it's an absolute last resort.

                --
                I am "that girl" your mother warned you about...
                • (Score: 0) by Anonymous Coward on Wednesday July 25 2018, @08:59PM (4 children)

                  by Anonymous Coward on Wednesday July 25 2018, @08:59PM (#712684)

                  The problem is imposition.

                  If a contract specifies violence as agreed enforcement for some condition, then that violence is necessarily voluntary.

                  • (Score: 1, Insightful) by Anonymous Coward on Wednesday July 25 2018, @09:43PM (3 children)

                    by Anonymous Coward on Wednesday July 25 2018, @09:43PM (#712722)

                    So basically treaties and laws like we already have? You just love to evade the problem where the enforcers will become the violent monopolies and we'll at BEST get dystopian corporate rule where if you want to survive in the world you "voluntarily" agree to their terms. Probably some small groups of co-op humans will be around, but again the "violently imposed monopolies" or "economically imposed monopolies" will still come to power.

                    We're still tired of this debate yet you keep trying to push it. At least thanks for not being your usual jerk self and spamming the comment section.

                    • (Score: -1, Redundant) by Anonymous Coward on Wednesday July 25 2018, @10:05PM (2 children)

                      by Anonymous Coward on Wednesday July 25 2018, @10:05PM (#712737)

                      I just don't even understand what your point is; your Government doesn't solve your problem.

                      Well, when you're don't censor someone with downmods, you don't get "spammed". Get it yet?

                      • (Score: 0) by Anonymous Coward on Wednesday July 25 2018, @10:39PM

                        by Anonymous Coward on Wednesday July 25 2018, @10:39PM (#712758)

                        Ugh you're too lame.

                        No one agrees with you except a few of the more extreme libertarians around here! You ignore all the valid arguments and just repeat your mantra and spew the same shit over and over. You spam cause people downmod your bullshit? Grow up, do YOU get it yet?

                        Of course not, keep reinventing the wheel buddy but it sure was hell won't be done here. I'll take the less-than-perfect system of government we've developed so far over your outlandish mad maxx style of society.

                      • (Score: 1, Insightful) by Anonymous Coward on Wednesday July 25 2018, @10:58PM

                        by Anonymous Coward on Wednesday July 25 2018, @10:58PM (#712769)

                        You keep stating that without demonstrating how a series of contracts prevents the formation of warlords, which are the precursors of government. All you can seem to offer us are magic free market beans.

                        In fact, the path of capitalism, observable in the real world with transnational corporations, is towards oligarchy. That is, it results in concentration of power in the hands of the very few. Pure capitalism is inherently anti-democratic. Sufficiently advanced capitalism, therefore, is indistinguishable from one world government.

          • (Score: 2) by c0lo on Thursday July 26 2018, @05:47AM

            by c0lo (156) Subscriber Badge on Thursday July 26 2018, @05:47AM (#712937) Journal

            Welcome to the hell of Newton-Raphson [wikipedia.org], where the starting point and the shape of your curve can lead to chaotic and/or divergent behaviour.
            And this only when considering one dimension.

            --
            https://www.youtube.com/watch?v=aoFiw2jMy-0 https://soylentnews.org/~MichaelDavidCrawford
      • (Score: 2) by sjames on Wednesday July 25 2018, @09:46PM (3 children)

        by sjames (2882) on Wednesday July 25 2018, @09:46PM (#712726) Journal

        The problem is, when someone wrongs another (for example by reneging on a contract), if that person is intractible the options are:

        1. Give up and accept a crippling loss
        2. An endless regression of arbitrators saying "make it right or I'll say make it right again!"
        3. Either a government or you impose a settlement by force.

        One reason we evolved a court system and forbade individual efforts is that the latter often ended up with one or more people dead, often not the party that cheated in the first place.

        On a further note, we are experimenting with non-government arbitration now. Already we can see an issue where the party that pays the arbitrator regularly seems to have an unfair advantage over their opponent. Already there are calls to either disallow arbitration clauses or to make the regular courts available to appeal the decisions of arbitrators.

        It's good to consider alternatives, but only if you look for and consider the available data from existing experiments.

        • (Score: 0) by Anonymous Coward on Wednesday July 25 2018, @10:35PM (2 children)

          by Anonymous Coward on Wednesday July 25 2018, @10:35PM (#712753)

          As emphasized earlier [soylentnews.org]: Nobody said that violence is never the answer.

          The problem is imposition.

          If a contract specifies violence as agreed enforcement for some condition, then that violence is necessarily voluntary; it is not imposition.

          • (Score: 0) by Anonymous Coward on Wednesday July 25 2018, @11:29PM

            by Anonymous Coward on Wednesday July 25 2018, @11:29PM (#712781)

            You don't seem to want to acknowledge the inevitability of violence that is not stipulated by a contract.

          • (Score: 2) by sjames on Thursday July 26 2018, @12:19AM

            by sjames (2882) on Thursday July 26 2018, @12:19AM (#712800) Journal

            All that means is that every contract will specify force. That's different from now in what way?