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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 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.

    --
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  • (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)

      --
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