The sad truth is, the U.S. is a country that emphasizes punishment over rehabilitation, and we've brought this upon ourselves by isolating people and banning access to substances that they've become dependent on. The solution here is not complex: give addicts safe access to the substances they're addicted to and resources for improving their situation. It's disheartening, to say the least, that one of the main strategies for dealing with this is apparently "reducing medical prescriptions of opioids". People are in pain -- they need to be helped.
I highly recommend the book Chasing the Scream, for anyone who's looking for a primer on the War on Drugs. It traces the hysteria around drug use back to the 1930s, when race panic was used to push forward prohibition in the face of mounting evidence against that strategy.
I've had discussions with coworkers and friends about this issue and similar issues where there is a lot of moral ambiguity but a lot less academic ambiguity - we basically know what works and doesn't work but what does work is not morally acceptable to about half the country. It is super frustrating to a lot of us because there doesn't seem to be a way to reach them, they can change their minds but only when they are personally affected by the issue but it doesn't seem to then spread much to their peers.
To paraphrase one conversation that reminded me a lot of the larger national conversation "I play by the rules, why shouldn't everyone else?". It didn't matter that punishment didn't help or in a lot of cases, was costing them more and having worse outcomes, the larger (and to me, more trivial) moral and emotional argument won out.
This sounds exactly right to me. In discussions with a religious friend of mine some years ago, I noticed that she had a tendency to conflate law and morality, when they really have nothing to do with each other. Further, she seemed to think that because it was illegal or bad to do something, it was reasonable to expect that people wouldn't do that thing as a result. I found (and find) this ridiculous - in large enough groups, you can use incentive/disincentive structures to push the population's behavior in a certain direction, but never with 100% effectiveness. Naturally, she disagreed.
The legal = moral line of thought is one of my most hated things to come across. It correlating with the highly religious makes sense, but it's by no means limited to them. It's incredibly wide spread in American culture to have at least a small degree of that, people always feel naughty when they break the law. I too find it ridiculous.
Keep in mind that there’s actually a path to breaking people out of this point of view, but it’s a really deep, dark rabbit hole, with lasting ramifications.
When you take this principle into account, however, a huge segment of the world makes much more sense, although the realities that become evident are kind of horrible.
The fastest path to lead people out of this mindset, is to prove to them their own error by bringing them in on some misbehavior (such that they perceive it as a serious violation of their own personal code), for which they both benefit from, experience no consequences, and find deep tempatation to repeat.
To broach the subject of crossing some personal line with a person like this raises an eyebrow. Crossing that line in front of them reveals a mixture of feelings. Inviting them to participate is met with uncertainty. Pulling the trigger with them gives way to a period of paranoia, until the coast is clear. Then, twice then, three times. Now, they’re convinced that morality isn’t set in stone, and laws are the commands of mere mortals, to be broken at will.
But, now what you have on your hands is a convert. Once conservative, and yet still as much, but eager to experiment and challenge their own views. This is where stereotypical morally abivalent, yet superficially conservative people come from. Seduced out of their naive, obedient world view, but entertaining dubious integrity. So now it’s no longer divine authority in an imperfect world conceived by some paranormal perfection, but instead, simply might makes right. And so, you get tasteless materialism, and a ruthlessness to obtain status.
After a certain age, this sort of thing really can’t happen with some people. When you’re a teenager, transgressing certain boundaries can be harmless and naive, but after a certain age, cheap thrills don’t work. That’s why we find a broad split of sheltered, uptight squares, mixed in with smaller segments of snobby, cavalier libertines or cheesey, greedy sociopaths.
It’s a distribution of age brackets for teenage misbehavior. The cornier the yuppie, the later in college they started breaking the rules, or maybe they never broke any rules, and that’s why they’re stuck with this holier-than-thou attitude.
> It's disheartening, to say the least, that one of the main strategies for dealing with this is apparently "reducing medical prescriptions of opioids". People are in pain -- they need to be helped.
While I pretty much agree with everything you say, I take a bit of issue with this.
Overprescription of opioids is a major factor for creating addicts in the first place, and in that regard, the US is a rather obvious outlier. [0]
Afaik the legalization of Cannabis has already helped with this overprescription trend of opioids [1] and that's a very good thing. If done right, the US could turn this around from being the worst offender to being a world leader in pain treatment research and sensible application.
Yes, that would require a rather big paradigm shift on the political level, one many would consider unthinkable. Just as unthinkable as the legalization of cannabis had been for very long periods in the US.
Yeah, that's a fair point. I agree that prescribing opioids is overkill in most cases, and is surely creating more addicts, but what I really take issue with is how we've been completely overlooking the environmental factors in addiction. This paradigm of reducing access to drugs to reduce addiction rates has prevailed for a long time, with pretty dire consequences. There's certainly more to this than the chemical component.
The traditional rural tough on crime voters are now dealing with the dissonance when its their communities and families that are being ripped apart. It seems like the thing that would most help (funding free/attainable healthcare and mental health/addiction treatment) is the very last thing that any would consider.
On "Chasing the Scream", I would just include the disclaimer that Seth Mnookin(a professor of science writing at M.I.T) in his NYT review stated:
> Unfortunately, his misunderstanding of some of the basic principles of scientific research — that anecdotes are not data; that a conclusion is not a fact — transforms what had been an affecting jeremiad into a partisan polemic.
I highly recommend the book Chasing the Scream, for anyone who's looking for a primer on the War on Drugs. It traces the hysteria around drug use back to the 1930s, when race panic was used to push forward prohibition in the face of mounting evidence against that strategy.