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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: 2) by crafoo on Wednesday July 25 2018, @07:11PM (11 children)
The USA is not Denmark. There is no reason to believe emulating them will produce successful results in the USA unless you are also going to transplant their culture and demographics at the same time. I doubt the majority of Dutch people taking heroin are even doing it for the same reasons as people in the USA.
Still, I'm pro drug legalization. All drugs. Actually, I believe they already should be legal except for gross government over-reach.
(Score: 1, Touché) by Anonymous Coward on Wednesday July 25 2018, @07:18PM (4 children)
Dutch people are not Danish people. Dutch people live in Holland and Danish people live in Denmark.
(Score: 1, Touché) by Anonymous Coward on Wednesday July 25 2018, @07:37PM (3 children)
Dutch people do not necessarily live in Holland. Holland is in the Netherlands, but the Netherlands is/are not in Holland.
(Score: 0) by Anonymous Coward on Wednesday July 25 2018, @08:16PM
We all know Netherlands is where Peter Pan and Tinkerbell live ...
(Score: 2) by MichaelDavidCrawford on Wednesday July 25 2018, @08:24PM
Find a Computer Industry Job in...
... The Netherlands
Yes I Have No Bananas. [gofundme.com]
(Score: 2) by hendrikboom on Thursday July 26 2018, @01:26AM
To be precise, Holland consists of two provinces of the Netherlands.
(Score: 2) by MichaelDavidCrawford on Wednesday July 25 2018, @08:03PM
I spent the Summer of 1993 at CERN in Geneva.
While it's true that every Swiss citizen possesses a fully-automatic rifle, they're the property of the Swiss Army.
I never saw any evidence of a gun culture of any sort, let alone such as we have here in These United States.
Yes I Have No Bananas. [gofundme.com]
(Score: 5, Touché) by Thexalon on Wednesday July 25 2018, @08:31PM (1 child)
I was wondering when this argument was going to be trotted out.
You're saying this in nice polite language, but what you really mean is "I don't wanna pay for heroin for blacks and Hispanics". Never mind that based on the OD statistics heroin users are disproportionately white and rural, which makes heroin users more like the Dutch or Danes than the US population as a whole. So not only are you being racist, you're wrong on your facts.
As for why people are addicted to heroin, in the US the most common reason is over-prescription of opioid painkillers. Which may be related to the fact that another major chemical source of pain relief, cannabis, is illegal. Which is less of an issue in the Netherlands, since cannabis is sometimes legal there, and thus odds are more of their addicts became addicted due to recreational drug use rather than medical drug use.
The only thing that stops a bad guy with a compiler is a good guy with a compiler.
(Score: 0) by Anonymous Coward on Thursday July 26 2018, @05:43AM
Not to be a dick here, just looking at this as rationally as possible..
He didn't say that at all, veiled or bluntly. But you did, bluntly. You effectively put words in his mouth, and then built the rest of your rebuttal around the words he didn't say but you say he said. That's not very good debating. I think there's a term for it.
My personal opinion is that the OD statistics you quote aren't wrong, and we should approach the problem from that starting point. Since it agrees with me I feel no need to verify by checking facts on it. I'm as human as anyone that way. But lets keep the outright logical fallacies out of the debating, eh? We've had several thousand years of written history to figure those out. It's time to shit-can them and actually get something accomplished when we discuss issues.
(Score: 0) by Anonymous Coward on Wednesday July 25 2018, @08:53PM (2 children)
Ah crafoo the closet racist. Tell me, what is your rationale for believing that what worked for one group of humans won't work for another? Last time I checked heroin use was a pretty standard thing with the same effects across all societies.
You think Dutch people do heroin for what then? Not the escape of a drug high? Hmmmm, I smell a bullshit artist who thinks he's Michelangelo.
(Score: 2) by Azuma Hazuki on Wednesday July 25 2018, @08:58PM (1 child)
He wants to say "nigger" but he's too much of a chickenshit to say it, and/or he thinks he's fooling the rest of us that he's not actually a racist because he doesn't outright say the word.
I am "that girl" your mother warned you about...
(Score: 0) by Anonymous Coward on Wednesday July 25 2018, @10:17PM
Yeah, but now he'll pull the persecution card saying "all you SJWs are the same just call people racist if they don't agree with you!"
Sadly he didn't use explicit enough language to be called out as a racist. These days the bigots are so OFFENDED by being called "racist" because they truly don't think that is the cause. They'll point to behaviors, cultural differences, all sorts of things that get divided along racial lines yet they aren't racist.
Crafoo seems stuck on stage one of grief, but as a country the US seems like a blend between steps 1-4 (denial, guilt, anger, depression). I'd say the most average US person is stuck on #2, guilt. They know shits fucked up, they realize minorities have a real problem with discrimination and these people feel back about it. A good portion have moved on to anger, some angry about the situation and a large minority angry that there even is a problem. The last group are the Trumpettes, proclaiming there is no more racism and that nazis don't exist in the US, it is more like a combination of steps 1 and 3 because they couldn't own up to #2.
I'm hoping that Trump gets the boot and we can continue with steps 5,6,7. Upward turn, reconstruction, and finally widespread acceptance and hope for a better future. It is gonna be a tough time though with people such as crafoo digging in their heels and ignoring reality in favor of hate propaganda.
(Score: 2, Flamebait) by realDonaldTrump on Wednesday July 25 2018, @07:11PM (4 children)
They have the ultimate penalty. And, by the way, they have much less of a drug problem than we do.
When I was in China -- and other places, by the way -- I said, "Mr. President, do you have a drug problem?" "No, no, no. We do not." I said, "Huh, big country, 1.4 billion people, right? Not much of a drug problem." I said, "What do you attribute that to?" "Well, uh, the death penalty."
I talked to the President of Singapore. He said "We have a zero tolerance policy. That means if we catch a drug dealer, death penalty." And they don't have a lot of problems. With opioid or anything else.
They have a big drug problem in the Philippines. Not for long. President Duterte says they have 3 million addicts. But he's getting it under control. He's doing many many executions, I think he's done 12,000. Probably more by now. No Due Process, very efficient. Very quick. And he'll kill them all if he has to. He says he'll kill them all. And I believe him. He doesn't play games. He's doing an unbelievable job.
Think of it. You kill 5,000 people with drugs, because you’re smuggling them in and you’re making a lot of money and people are dieing, and they don’t even put you in jail. They don’t do anything. But you might get 30 days, 60 days, 90 days. You might get a year. Not a lot. And then you wonder why we have a problem. That’s why we have a problem, folks. And I don’t think we should play games. We can't just keep setting up blue ribbon committees to talk, talk, talk. We have to get tough. Probably you'll have some people who say "oh, that's not nice." But we have to do something. Eventually.
(Score: 1) by gtomorrow on Wednesday July 25 2018, @07:28PM (3 children)
Excuse me, Mr President, but just to be clear: are you advocating emulation/adoption of the aforementioned asian nations' policies? Do you believe the United States of America should have a no-due-process death penalty for drug dealers?
(Score: 2) by realDonaldTrump on Wednesday July 25 2018, @08:19PM (2 children)
China & Singapore, they have Due Process, it's very quick. Not like here. They have death penalty, they have zero tolerance -- and they have very few problems. Very few.
Philippines, they elected a very tough guy. And he's doing great. 3 million people, it's a lot. How do you do the Due Process on that? It's too much. So he said, we won't do that. Just shoot them. And he's getting great results. Very tough, it's working.
USA, hopefully we can get much tougher. Death penalty works, maybe we can try that here. I'd love to try that here. See how that one works out for us. And if there's a way to handle these people immediately, with no Judges or Court Cases, even better. By the way, we need that for our immigration too, we need to send them back with NO Judges, no Court Cases. As I've said. Our Judges are very busy. We're doing Quotas for Judges. Must go faster!
(Score: 0) by Anonymous Coward on Wednesday July 25 2018, @08:50PM
The punishment should fit the crime. Theft? Cut off a finger. Drug dealer? Feed them what they were selling. Aggravated Murder? Public hanging. Cheating on your wife? You get a choice, have your willy chopped off or you get to park it in goatse.
(Score: 0) by Anonymous Coward on Thursday July 26 2018, @12:00AM
Washington Post would have a hissy fit about "human rights". You should reverse-pardon Bezos first.
(Score: 3, Insightful) by krishnoid on Wednesday July 25 2018, @07:20PM (1 child)
"America doesn't need heroin for that. We have a non-opioid solution called "Fox News" over here."
(Score: 2) by DannyB on Wednesday July 25 2018, @08:53PM
We also have Social Media.
The lower I set my standards the more accomplishments I have.
(Score: 2, Insightful) by Coward, Anonymous on Wednesday July 25 2018, @07:59PM (2 children)
Maybe the Chinese are paying us back with drug shipments because they think of Americans as proxy-Anglos who forced decades of opium addiction on them.
(Score: 0) by Anonymous Coward on Wednesday July 25 2018, @08:59PM (1 child)
"All you people look alike."
Works no matter which race says it!
(Score: 0) by Anonymous Coward on Thursday July 26 2018, @03:51AM
Call it racism if you want to, but the enormous crimes that nations committed against each other explain a lot of ill will. Chinese kids learn in school that China was great before it was oppressed by the West. Not all of that is fabricated. It's easy for the richest country in the world to say, let bygones be bygones, and respect our intellectual property.
(Score: 2) by MichaelDavidCrawford on Wednesday July 25 2018, @07:59PM (7 children)
I ran into him in downtown Portland one evening. He told me that he had to go do something, but would return in an hour.
I waited four. That was three years ago; he never returned.
He once asked to use my MacBook Pro to download his iPhone photos from iCloud. I still have all those photos. In all of them, Anthony is quite a lot more muscular. In most of them he is with friends and family - in happier times.
I asked the staff of the Portland Rescue Mission if they'd seen him. "No, he doesn't come round here any more."
"I really miss Anthony. He's a great guy."
"Yeah, when he's not strung out."
"He shoots up?"
"Yes."
Later that same day I found a mugshot from one of his heroin possession arrests.
I searched the inmate rosters of the Multnomah County Jail in Portland as well as the Oregon and Washington State Prisons.
I miss you Anthony.
Requiescat In Pace.
Yes I Have No Bananas. [gofundme.com]
(Score: 3, Insightful) by Thexalon on Wednesday July 25 2018, @08:35PM (6 children)
I've had to bury 2 friends so far: Adam was a musician who started on opioids for pain relief after an operation and couldn't quit and couldn't get clean, so he eventually gave up and shot himself. Caitlin got hooked again via medical prescription after recovering from her ex-husband beating the crap out of her, tried to clean up, met a guy in rehab, and they ended up ODing together.
Given those stories, if a doctor were offering me Oxy, I'd at least consider refusing it.
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, @08:57PM (4 children)
The 1st could have been helped with government health services running a sane rehab program and the 2nd would have been helped by better safety regulation to prevent accidental ODs. Two stories showing how a lack of societal support led to sad consequences.
This comment is more a reply for others, not some critique of your story.
(Score: 3, Touché) by DannyB on Wednesday July 25 2018, @09:04PM (3 children)
Bu, bu, but . . . societal support would be
terrorismcommunismsocialism!The lower I set my standards the more accomplishments I have.
(Score: 2) by FatPhil on Wednesday July 25 2018, @09:49PM (2 children)
needlegun!Great minds discuss ideas; average minds discuss events; small minds discuss people; the smallest discuss themselves
(Score: 0) by Anonymous Coward on Wednesday July 25 2018, @10:20PM (1 child)
If that is what it takes to make you understand the need to support civil society, then sure I'll let the irony ride out. Selfish narrow minded behavior is not a *good thing* bub.
(Score: 2) by DannyB on Thursday July 26 2018, @01:30PM
Some people (especially corporations) are too dumb to see any kind of long term view. Everything must be short term focused. My immediate needs. Right now!. What I want. Screw you! I'll shoot myself in the foot if it helps
this quarter's profitsmy short term interest. I don't want to pay for public education but I am too dumb to realize what would happen if we end up with a world full of uneducated dolts like Trump.The lower I set my standards the more accomplishments I have.
(Score: 2) by DannyB on Wednesday July 25 2018, @09:00PM
As a counterexample, I use hydrocodone, occasionally, for the past ten years (come next January). I use it when I need it. I ignore it when I don't need it. It is a tool. Nothing more. It improves my quality of life. I don't build up a tolerance to it, so when I do need it -- it works! I have a great life and don't want to screw it up with narcotic pain killers. I'm more afraid of the drugs than of the pain. But if it feels like a wire saw cutting through my bone, then I'll take the drugs.
The lower I set my standards the more accomplishments I have.
(Score: 0) by Anonymous Coward on Wednesday July 25 2018, @08:23PM (4 children)
also think it's immoral?
If I think it's immoral, does that make me conservative?
(Score: 1, Insightful) by Anonymous Coward on Wednesday July 25 2018, @09:00PM
No, drug abuse is immoral even if the damage done is only to yourself. However, forcing morality upon others can have serious negative consequences so it is safer to try and fix problems without prohibition.
Note the *abuse* aspect, there are no problems with doing drugs if they don't become a problem for you or anyone else.
(Score: 3, Insightful) by DannyB on Wednesday July 25 2018, @09:03PM (1 child)
A better question: Is it more cost effective to society to provide the addict with drugs, or is it better to pay for losses to crime, increased insurance costs, violence due to crime, law enforcement costs, incarceration costs, property devaluation costs next to drug houses, etc.
The lower I set my standards the more accomplishments I have.
(Score: 2) by deimtee on Thursday July 26 2018, @07:16AM
Given that the actual cost of enough heroin to kill a horse* is about ten cents**, providing free legal drugs to addicts is a clear winner, by about a million to one.
(* for the hard of thinking, I am not advocating killing either horses or addicts.)
(** production cost not including legal and/or law enforcement costs )
If you cough while drinking cheap red wine it really cleans out your sinuses.
(Score: 2) by FatPhil on Wednesday July 25 2018, @10:01PM
I also think that personal morals should not be confused with societal ethics, and that laws and policies should be based on the latter rather than the former, even if the latter is a consensus based on the former.
Great minds discuss ideas; average minds discuss events; small minds discuss people; the smallest discuss themselves
(Score: 0) by Anonymous Coward on Wednesday July 25 2018, @08:28PM (1 child)
Right now we don't have a great solution for getting and keeping people off drugs.
There are factors like genetics, current environment, and childhood to early adulthood trauma that we as outsiders have little if any control over.
If we had medications that could help keep people off, that would probably be the thing that gives us the edge in controlling the addiction problem.
(Score: 0) by Anonymous Coward on Wednesday July 25 2018, @09:17PM
Rehab programs are good but not 100%. Medication to keep people off? Would have to be voluntary and unless they provide the same high then you won't get much of a difference from current methods because you rely on people wanting to be off the drugs more than getting high.
Physical and mental support programs are the way to go, it is that simple and should be free to everyone as it helps make the whole society a better place.
(Score: 2) by JustNiz on Wednesday July 25 2018, @10:15PM (3 children)
Can we agree that in some circumstances "lives saved" is not automatically the same as "better"?
(Score: 0) by Anonymous Coward on Wednesday July 25 2018, @10:49PM (2 children)
In this case? No.
The only times I could agree with such a statement is if it came at the expense of everyone's freedom. Mass surveillance? Probably saved more lives than it has cost so far but the number of lives saved doesn't even come close to rationalizing the surveillance. In fact it is arguable that it will almost never be a better choice to implement mass surveillance.
But paying less money in taxes by dismantling the DEA and various local taskforces and implementing a safe drug program with rehab and mental health facilities? Yeah, I'll call that better. Money saved, lives saved, freedom increased.
Did you have a more specific point?
(Score: 0) by Anonymous Coward on Thursday July 26 2018, @04:11AM (1 child)
Well, there is a moral hazard if society makes life too easy for people on the dole. And forcibly transferring money to people you disapprove of could seem worse than paying more money to hassle those same people. If you're a parent, you don't always pick the quick and easy way to solve a problem either. Otherwise my kid would be eating only ice cream and watching endless TV.
(Score: 0) by Anonymous Coward on Thursday July 26 2018, @05:23AM
Wow, ignoring the good point and falling back on "but monies to baaaad peeeeopleeeee, but its miiiinneeee"
So I put forth a plan that is likely to actually SAVE you money and you go the stupid moralizing route with a bad analogy. The tired simplistic wisdom from you law&order types is too much. You don't care about reality, you care only to fit your personal narrative in there somewhere.
"I don't like taxes, I don't like drug users, therefore anything that helps drug users using tax money is doubleplus ungood!!!"
People like you are truly why we can't have nice things.
(Score: 2) by ElizabethGreene on Wednesday July 25 2018, @10:50PM (1 child)
I need some data to make an informed opinion.
What proportion of overdoses are because a person's supply are impure, poisoned, or cut with Fentanyl? Given that data, is it possible to estimate what proportion of those people could be saved by a low cost supply of known purity and quality? The number isn't 100%, but 0% doesn't seem right either.
Prescription opiate addicts are a non-trivial component of the installed base of addicts. Could a legalization/decriminalization efforts include a non-discriminatory path to treatment for those individuals?
At what price point is it no longer profitable for cartels and street dealers to distribute their products?
What level of difficulty in getting into a legal opiate program maximizes the number of people entering the program legally and minimizes the number of people entering it for recreational purposes?
(Score: 0) by Anonymous Coward on Wednesday July 25 2018, @11:25PM
Pretty much all the info you need is around so go gather it if it helps you decide one way or another.
I can give you the simple answer, DEA budget is roughly $3 billion right now and that doesn't factor in courts, other law enforcement activities, and incarceration.
Simple answer is legalize and provide support programs. Criminality decreases as it becomes less cost effective to run and more prone to prosecution. Users will more easily share info on their black market dealers if those users will suffer zero consequences from the law. Users will be less likely to totally ruin their lives if they have easy access to treatment and support programs.
Whether the government pays for heroin doses would simply be a matter of how much crime is committed in the pursuit of a dose? If the market is cheap enough probably no crime will occur and all funds can be focused on treament / support instead.
(Score: 2) by Phoenix666 on Thursday July 26 2018, @03:27PM
The War on Drugs is a failure. The rectitude that spawned it has destroyed orders of magnitude more than it ever helped.
I don't use drugs. I'm not pro-drugs. I'm not anti-drug either. It might be refreshing to get heroin or morphine easily, of high quality, when i break a leg or have some other pain that nothing else could numb. Mostly, i want the government to fuck off and mind its own business.
Washington DC delenda est.