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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: 2) by Arik on Thursday July 26 2018, @12:53AM (10 children)

    by Arik (4543) on Thursday July 26 2018, @12:53AM (#712813) Journal
    "So you would be OK with your neighbour not having a fire service, and, when his house burns down, yours also catches fire?"

    In a word, no.

    Fire service pre-exists the state, therefore it is ipso facto far from impossible for it to be provided outside the state.

    Admittedly, it's not a classic market good, and it might well be more efficiently provided by some sort of (local) government. Adding it still leaves a very short list, however.

    "How are you going to enforce the decisions of the courts of last resort?

    In the case of the US Federal Courts, they have the US Marshall Service to do that. Historically, stateless courts relied ultimately upon the power of outlawry. Someone who refuses to submit to the judgement of the court of last resort may be declared an outlaw, which means that they are no longer under the protection of said courts. This is cleaner, if it could be made to work again.

    "You don't care that the economy will tank when millions of people can't afford to educate their kids?"

    Quite the contrary, I'm concerned that we're held artificially poor (in more ways that one) via the provision of free, low-quality education, which ruins the market for anything better.

    "I could go on forever, but these are some examples to show how naive the Libertarian ideal is. "

    And I could probably go on as long, showing how these examples that you think demonstrate Libertarian naïvete, actually only demonstrate your own ignorance and lack of vision.
    --
    If laughter is the best medicine, who are the best doctors?
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  • (Score: 2) by c0lo on Thursday July 26 2018, @01:49AM (4 children)

    by c0lo (156) Subscriber Badge on Thursday July 26 2018, @01:49AM (#712855) Journal

    Fire service pre-exists the state, therefore it is ipso facto far from impossible for it to be provided outside the state.

    Yeah, right.

    Firefighting in the 1800’s: A Corrupt, Bloated, Private For-Profit Industry [huffingtonpost.com]

    Let’s look at this reasonably: Firefighting used to be a private for-profit industry. In the 1800’s, the early days of urbanization, in cities like New York and Baltimore, there were private “clubs” or “gangs” who were in charge of putting out fires. The infamous Boss Tweed started his illustrious political career at a volunteer fire company. The way it functioned was the first club at the scene got money from the insurance company. So, they had an incentive to get there fast. They also had an incentive to sabotage competition. They also often ended up getting in fights over territory and many times buildings would burn down before the issue was resolved. They were glorified looters. It was corrupt, bloated and expensive — but at least it wasn’t the much maligned “government controlled.”

    Horrible histories. Georgians The perils of for-profit fire brigades [youtube.com] (sound track only - sorry) - from the 1800-ish time the fire brigades in London were operated by insurance companies. [wikipedia.org]

    --
    https://www.youtube.com/watch?v=aoFiw2jMy-0 https://soylentnews.org/~MichaelDavidCrawford
    • (Score: 2) by Arik on Thursday July 26 2018, @02:31AM (3 children)

      by Arik (4543) on Thursday July 26 2018, @02:31AM (#712875) Journal
      A system whose roots probably reach back in Britain to the early bronze age if not before and served reasonably well for most of that period had a bit of a breakdown right at the end of the 19th century and BOOM the whole concept never worked.

      Come on man, that's too simple for you to really buy isn't it?
      --
      If laughter is the best medicine, who are the best doctors?
      • (Score: 2) by c0lo on Thursday July 26 2018, @03:05AM (2 children)

        by c0lo (156) Subscriber Badge on Thursday July 26 2018, @03:05AM (#712889) Journal

        A system whose roots probably reach back in Britain to the early bronze age if not before and served reasonably well for most of that period

        [Citation needed].

        The link to Wikipedia says

        Between the 17th century and the beginning of the 19th century, all fire engines and crews in the United Kingdom were either provided by voluntary bodies, parish authorities or insurance companies.

        Missing reference on how those roots looked like in "early bronze age" and how "reasonably well" they worked in Britain... but I'm not the one making the claim.

        ---

        I found some other bits, like this [wikipedia.org]

        The first ever Roman fire brigade of which we have any substantial history was created by Marcus Licinius Crassus. Marcus Licinius Crassus was born into a wealthy Roman family around the year 115 BC, and acquired an enormous fortune through (in the words of Plutarch) "fire and rapine." One of his most lucrative schemes took advantage of the fact that Rome had no fire department. Crassus filled this void by creating his own brigade—500 men strong—which rushed to burning buildings at the first cry of alarm. Upon arriving at the scene, however, the fire fighters did nothing while their employer bargained over the price of their services with the distressed property owner. If Crassus could not negotiate a satisfactory price, his men simply let the structure burn to the ground, after which he offered to purchase it for a fraction of its value.
        ...

        In Europe, firefighting was quite rudimentary until the 17th century. In 1254, a royal decree of King Saint Louis of France created the so-called guet bourgeois ("burgess watch"), allowing the residents of Paris to establish their own night watches, separate from the king's night watches, to prevent and stop crimes and fires. After the Hundred Years' War, the population of Paris expanded again, and the city, much larger than any other city in Europe at the time, was the scene of several great fires in the 16th century. As a consequence, King Charles IX disbanded the residents' night watches and left the king's watches as the only one responsible for checking crimes and fires.

        London suffered great fires in 798, 982, 989, 1212 and above all in 1666 (the Great Fire of London). The Great Fire of 1666 started in a baker's shop on Pudding Lane, consumed about two square miles (5 km²) of the city, leaving tens of thousands homeless. Prior to this fire, London had no organized fire protection system.

        Mmm... the emphasized doesn't look good for your claim. Looks like the very first attempts to organize fire brigades in Britain has been in 17th century and they didn't quite actually worked as private for-profit enterprises just from the start.
        Until they were reassigned to municipalities, the way they mostly stayed until now.

        --
        https://www.youtube.com/watch?v=aoFiw2jMy-0 https://soylentnews.org/~MichaelDavidCrawford
        • (Score: 1) by Arik on Thursday July 26 2018, @04:26AM (1 child)

          by Arik (4543) on Thursday July 26 2018, @04:26AM (#712918) Journal
          Wait, wait, because the earliest date mentioned in the wikipedia article is late you think nothing happened before? And then you cite a Roman fire brigade from many centuries earlier. None of that makes any sense at all.

          "The first ever Roman fire brigade of which we have any substantial history was created by Marcus Licinius Crassus. Marcus Licinius Crassus was born into a wealthy Roman family around the year 115 BC, and acquired an enormous fortune through (in the words of Plutarch) "fire and rapine." One of his most lucrative schemes took advantage of the fact that Rome had no fire department. Crassus filled this void by creating his own brigade—500 men strong—which rushed to burning buildings at the first cry of alarm. Upon arriving at the scene, however, the fire fighters did nothing while their employer bargained over the price of their services with the distressed property owner. If Crassus could not negotiate a satisfactory price, his men simply let the structure burn to the ground, after which he offered to purchase it for a fraction of its value."

          So, a few things that should have been obvious to you here;

          1. This is not by any means the first Roman fire brigade. It's the first one 'of which we have any substantial history.' No doubt precisely because it was so out of line.

          2. There are many antidotes to a situation like that, *as long as they can't get competition prohibited.* I would expect in such a situation the property owners would very quickly hit on the idea of pooling risk and supporting their own fire brigade, if they couldn't attract a more reasonable competitor more easily. The biggest worry here is that they will be able to lobby the state to prevent competition by force, under the guise of lowering costs, making sure everyone is covered, etc.

          As to bronze age Britain having fire brigades, well doh. Of course we don't have any records from the time, but there's plenty of archaeology, and it's fascinating, you should check it out sometime. Bronze age Britain was densely populated, thoroughly cultivated, cultured and wealthy. Furthermore their primary building material was wood, often using thin dried coppice wood and straw. Fire was extraordinarily dangerous in that situation, far more dangerous than it is to us today, not only because buildings were made of tinder but because open flame was a daily necessity, particularly in winter. The settlements often grow in place for centuries without burning down. If you posit they didn't have fire brigades, then you can't explain how that would be possible.

          Firefighting is a local affair though, it doesn't need anything like a modern centralized state to organize it, and in one way it would have been even easier then - since people virtually always worked and lived around the same property, this would have typically been a group of neighbors, who have every incentive to drop everything and run when a fire threatens to spread through their village.

          As transport improved and work and home came to be more separated for many, the need for a specialized force to watch residential areas arose, and that's more the context of your Roman example. But Rome was founded very late, we may be sure that all post-farming civilizations which lacked some method of organizing fire brigades failed. The very fact that they're not something often talked about in ancient literature points towards them working fairly well more often than not - as we already noted, this is something much more likely to be written about when something goes spectacularly wrong (as with Marcus Licinius Crassus) rather than when it's getting the job done.

          --
          If laughter is the best medicine, who are the best doctors?
          • (Score: 2) by c0lo on Thursday July 26 2018, @05:03AM

            by c0lo (156) Subscriber Badge on Thursday July 26 2018, @05:03AM (#712928) Journal

            Wait, wait, because the earliest date mentioned in the wikipedia article is late you think nothing happened before?

            I gave you the chance to provide citations supporting your claims of:

            On July 26, @02:31AM, Arik wrote

            >A system whose roots probably reach back in Britain to the early bronze age if not before and served reasonably well for most of that period

            So... how about some links, especially on the "served reasonable well" concern, before drowning the page with walls of texts?

            (I'll come to "past performance is not an indicator for future performance" aspect after you provided those citation)

            --
            https://www.youtube.com/watch?v=aoFiw2jMy-0 https://soylentnews.org/~MichaelDavidCrawford
  • (Score: 2) by NewNic on Thursday July 26 2018, @04:54PM (4 children)

    by NewNic (6420) on Thursday July 26 2018, @04:54PM (#713219) Journal

    In the case of the US Federal Courts, they have the US Marshall Service to do that.

    So we have to add something like a police force to your list of required government service and agencies. Declaring someone an outlaw is meaningless to someone who already flouts a court order, unless you have some method of enforcement: a police force.

    Fire service pre-exists the state, therefore it is ipso facto far from impossible for it to be provided outside the state.

    Try reading more carefully. That wasn't my point. My point was that you may be impacted by your neighbour's failure to buy fire service protection. C0lo has shown clearly why private fire protection is a bad idea.

    Quite the contrary, I'm concerned that we're held artificially poor (in more ways that one) via the provision of free, low-quality education, which ruins the market for anything better.

    1. Many private schools provide a worse education than public schools provide. Many public schools suffer from two things: a: lack of funding and b: lack of parental support (often because the parents are working multiple jobs and don't have time). Private schools don't have these issues.
    2. You didn't answer the question of how poor people are going to pay for this private education. Your argument amounts to the idea that private schools are too cheap because of "competition" from free public schools, which implies that the result of your changes would be to increase the cost of education, making it unaffordable for even more parents.

    All you are doing is redoubling on your naivete.

    --
    lib·er·tar·i·an·ism ˌlibərˈterēənizəm/ noun: Magical thinking that useful idiots mistake for serious political theory
    • (Score: 2) by Arik on Thursday July 26 2018, @09:26PM (3 children)

      by Arik (4543) on Thursday July 26 2018, @09:26PM (#713372) Journal
      "So we have to add something like a police force to your list of required government service and agencies."

      We're not adding anything, that's a fundamental, necessary elemeent of any state. When you get rid of that you cross the line from minarchy to anarchy.

      The only question is just how small that force can be, and still perform the necessary function.

      "Declaring someone an outlaw is meaningless to someone who already flouts a court order, unless you have some method of enforcement: a police force."

      That's NOT necessarily true. Again, your ignorance of history is showing. This was an effective punishment for centuries if not millennia!

      Once you're declared an outlaw, anyone - whether your old enemy or your best friend or second-in-command; that thinks they can take you is free to try - with no legal consequences if they succeed. This can be very effective in the right setting, and it has the advantage of being an imminently approprate 'punishment' - if you do not consent to the jurisdiction of the court, the court will not take action against you. It will simply withdraw its protection. A good reminder of *why* you should obey it voluntarily, in the first place.

      "Try reading more carefully. That wasn't my point. My point was that you may be impacted by your neighbour's failure to buy fire service protection."

      Well then you were making a shitty, redundant point. Of course it may be. Doh!

      So what? You think there are no potential problems with state-provided fire service?

      "1. Many private schools provide a worse education than public schools provide. Many public schools suffer from two things: a: lack of funding and b: lack of parental support (often because the parents are working multiple jobs and don't have time). Private schools don't have these issues."

      Again, so what? Private schools suffer from a race to the bottom caused by the existence of public schools, as well as by regulations placed on them requiring them to emulate the prussian model just like the public schools do. You're quibbling over a few crumbs sitting on top of a giant trash-heap.

      The prussian model of schooling was never designed for a liberal democracy. It was designed for prussian autocracy. It can't be just a coincidence that we've been hurtling head-first towards that end ever since we adopted it.

      "2. You didn't answer the question of how poor people are going to pay for this private education. "

      Work.

      Look, you want to give the poor things you think they need, and cannot afford. A noble sentiment. But not the most practical, nor is that setting your sights so high.

      Instead, find out why they're poor. Find out why they can't afford what they need. Set your sights on fixing *that*, not procuring handouts that at best tend to be dehumanizing and risk creating dependency.

      "Your argument amounts to the idea that private schools are too cheap because of "competition" from free public schools, which implies that the result of your changes would be to increase the cost of education, making it unaffordable for even more parents."

      Not at all.

      Look, I'll spell it out for you. Everyone pays for the public schools, whether you use them or not, making them 'free' in the bad sense of the word. They're not truly gratis - clearly they have a cost, and we pay for them - nor are they in any way a matter of liberty, quite the contrary, both payment and attendance are compulsory. The only sense in which they are 'free' is that payment and attendance are de-linked, so when you are in a position to attend, you've already paid, and you cannot get a refund, so it's 'free' only in that sense.

      So when you look at a private school as an alternative, you're not comparing the cost of the public school and the cost of the private school. You're oomparing something near the actual cost of the private school with an effective cost of 0 for the public school. This gives the public school a HUGE, and undeserved, advantage. By itself it's very close to a monopoly grant, and when you calculate in all the other advantages given to this system by law, it's virtually impossible for anyone to effectively compete with it. The fact that private schools still exist speaks to just how awful the public schools are, objectively.

      So, no, my system would not necessarily increase the cost of education. It would allow the cost (and other aspects) of education to respond dynamically to the needs of the students, and result in greater value for the dollar. The actual amount spent on education would similarly become a matter for the market to decide, in response to supply and demand. The likely effect would be spending slightly down and results significantly up.

      You're fixated on the fact that the system does not *guarantee* that each and every person gets some shitty minimum level. You're right, it does not. That doesn't mean that anyone would be unable to access education, it means that that's not a function of the high level design, it's an implementation detail. Exactly as it should be. The overall design should maximize opportunity, rather than minimize it.
      --
      If laughter is the best medicine, who are the best doctors?
      • (Score: 2) by NewNic on Thursday July 26 2018, @10:13PM (2 children)

        by NewNic (6420) on Thursday July 26 2018, @10:13PM (#713390) Journal

        You did not list a police force as necessary in your hypothetical state. Now you say it's necessary. What else is also necessary? Your argument style is intellectually bankrupt.

        Of course having a police force then changes other things about your argument, such as the concept of outlaws. If you have a police force, you don't need to have outlaws.

        If you have outlaws, you are going to spend far more on defending yourself from outlaws than a functioning society would spend on keeping an orderly society.

        You still have not provided any way for the poor to be able to afford to educate their kids. You keep trying to dance around the issue, but it still remains. Your society will have a huge underclass of uneducated people that will ultimately provide a drag on society.

        What the children of poor families *need* is education. You seem determined not to provide it, despite acknowledging its value to society as a whole.

        I am not going to challenge your economic arguments because they are simply too stupid and you have chosen to ignore my points on private vs. public schools.

        You are merely deflecting with my point about fire service. I'll take it that you concede my point.

        --
        lib·er·tar·i·an·ism ˌlibərˈterēənizəm/ noun: Magical thinking that useful idiots mistake for serious political theory
        • (Score: 2) by Arik on Thursday July 26 2018, @11:06PM (1 child)

          by Arik (4543) on Thursday July 26 2018, @11:06PM (#713425) Journal
          I don't care what you think about my style, and it's not my fault you lack the basic concepts to keep up with the conversation you barged into.

          Here, read up: https://en.wikipedia.org/wiki/Night-watchman_state

          "Of course having a police force then changes other things about your argument, such as the concept of outlaws. If you have a police force, you don't need to have outlaws."

          Nonsense. There are any number of possible scenarios where you do have some sort of police force, even several of them, yet it's still preferable to simply declare a person outlaw rather than order them to kidnap him. The poverty of your imagination boggles the mind.

          "If you have outlaws, you are going to spend far more on defending yourself from outlaws than a functioning society would spend on keeping an orderly society."

          In the historical examples I referenced, and of which you are clearly completely ignorant, this was an unusual event, most often an exceptional one, and a person declared outlaw almost always left the jurisdiction for the period of the outlawry rather than face a situation where anyone could do anything they wanted to him without legal repercussion.

          "You still have not provided any way for the poor to be able to afford to educate their kids."

          It's not my job to provide your kids with an education! Why do you have so much trouble understanding that?

          "Your society will have a huge underclass of uneducated people that will ultimately provide a drag on society."

          No, no it would not, because what creates that underclass are the same policies I would end. The same policies you persistently advocate, as if it's completely inconceivable to you that anything else were possible! I would let the poor escape from poverty, while you would keep them there so you can feel good about yourself, giving the handouts to those poor desperate folks, aren't you a good boy!

          Your self-righteous posture is as comical as it is misplaced.

          --
          If laughter is the best medicine, who are the best doctors?
          • (Score: 2) by NewNic on Friday July 27 2018, @12:45AM

            by NewNic (6420) on Friday July 27 2018, @12:45AM (#713480) Journal

            Whatever, buddy. Let me suggest you move to Somalia and see how you find life with minimal government.

            --
            lib·er·tar·i·an·ism ˌlibərˈterēənizəm/ noun: Magical thinking that useful idiots mistake for serious political theory