Top medical experts say we should decriminalize all drugs (2016) - <AUTHOR> https://www.washingtonpost.com/news/wonk/wp/2016/03/24/top-medical-experts-say-we-should-decriminalize-all-drugs-and-maybe-go-even-further/ <comment><USER3> Finally. I hope this will signal a turning point on this insane approach to national health in all countries. Drugs are a _health_ problem, not a criminal problem.

Lone experts have been fired in western countries when they have expressed this common sense sentiments alone [0]. I hope this groups fares better.

Nixon started the war on drugs anyway as a mean to attack left and black activists [1]. Any previous legislation for control has been instigated on behalf of race and class warfare.The fact that some drugs have been the staple narcotic in some groups has been used as a control mechanism upon those groups by criminalizing the substance.

Substance distribution should be controlled by law. But that is status quo anyway - governments control the distribution of any number of dangerous substances at any point.

[0] [https://www.theguardian.com/politics/2009/oct/30/drugs- advis...](https://www.theguardian.com/politics/2009/oct/30/drugs-adviser- david-nutt-sacked)

[1] [https://qz.com/645990/nixon-advisor-we-created-the-war-on- dr...](https://qz.com/645990/nixon-advisor-we-created-the-war-on-drugs-to- criminalize-black-people-and-the-anti-war-left/)

<comment><USER4> Depends on your goal. If it's to reduce mortality, yes, decriminalize is good. But it will increase usage.

<comment><USER5> >But it will increase usage.

Not necessarily. When people really want something they will eventually find a way to get it anyway, it's not because you criminalize it that its usage drops. Just like IP infringement has not significantly dropped since they can put people in jail for it.

<comment><USER6> Well, barriers to entry matter. If you're craving a drug and it's sold in a convenient store around the corner, you might purchase it more frequently than if you had to buy it from potentially dangerous people in a seedy part of town. That said, as with any bad habit I'm sure usage would still decrease over time for most individuals as they mature or if healthier alternatives are readily available.

<comment><USER7> Barrier to exit matters as well.

When you buy it from dangerous people, you have to be in contact with dangerous people. It gives dangerous people leverage against you and people who care about you.

<comment><USER8> There is no 'danger' from 'not buying stuff from your dealer' anymore.

<comment><USER9> I see you've never dealt with a dealer before.

<comment><USER8> I've known many a dealer in my lifetime, and a distant family member who spent some time incarcerated for 'high level' activity, who gives me long tales of how the business works as well.

Dealers don't assault, endanger or attack random customers who just stop buying.

That's totally absurd, and that someone would suggest it - indicates that they are getting their information from Netflix/Hollywood films or something, not reality.

The vast majority of dealers are actually fairly normal people anyhow.

<comment><USER9> Well exuse me, I didn't know i was talking to a renneissance man. Addicts wheel and deal with each other, rack up debts to eachother, steal from one another. Some of them buy wholesale from larger distributors, usually with credit, to be repaid with interest or else. They rob, assault, rape and kill eachother over this stuff. I wish i was making this up.

Doctors in emergency rooms usually have instructions to confiscate any illegal drugs they discover on OD-patients, but are faced with the very real dilemma of leaving the patient at their creditors mercy. This can cause real harm (as in "First do no harm") to the patient and their prospects of recovery or harm reduction.

<comment><USER8> If you don't pay your dealer, that will cause pain, and possibly violence.

But nobody is 'going after' someone who just decided to stop smoking something.

<comment><USER9> Maybe if that someone was just smoking pot and otherwise paid taxes. This particular group of drug users are not the central point of concern of the UN Special Assembly, even though its part of the wider problem. They are not dying in the streets and they are not socially marginalized. Allthough (anecdotally) i've known several fumb pot-smoking ducks who thought they could finance their proclivity through distribution and wound up several thousand dollars in debt to people who take names and chew bubble-gum.

</comment></comment></comment></comment></comment></comment></comment></comment></comment></comment></comment><comment><USER10> "scientific consensus"

I am very troubled by this phrase -- it's almost an oxymoron. Science is not democratic, and scientists aren't anointed arbiters of facts.

Anyone can be a scientist simply by following the scientific method and collecting data in good faith; and a lone outsider with new data can challenge 100 years of "consensus". Obviously they are subject to challenges themselves, or if it's unlikely enough they might reasonably be ignored (e.g. a known charlatan saying they observed cold fusion).

Did this terminology start with the "scientific consensus" on anthropogenic climate change (which I do not dispute, by the way)? I think I understand why it was used in that debate, but I don't think it was a good precedent. Now it's being used to directly apply to policy ("growing scientific consensus on the failures of the global war on drugs").

Before long, it will be used directly in political debates to try to force some scientific organizations to choose a side. And then all credibility is lost.

Researching policies that require deep analysis of scientific (or other) data should be left to think tanks or something similar.

<comment><USER11> > think tanks

I'm not sure what you think a think tank is, but they're basically either (a) PR organisations, especially the ones with opaque funding or (b) some guy with a letterhead and skill at getting articles published. They certainly _aren 't_ impartial in any way.

I'd much prefer my policy research to be done by civil service bodies which might at least nominally be impartial.

I don't think it's feasible to impose a boundary between science and politics. If scientists think that something is both true and important, then why should they not speak up about it? Especially if they believe that doing so will save lives.

<comment><USER12> Because of the effect of politics on intellectual honesty.

Once a debate triggers our "political" brain, it seems to scramble the kind of intellectual honesty science requires. An even more insiduous cousin of the maxim:

 _" It is difficult to get a man to understand something, when his salary depends upon his not understanding it."_

I think the use of the phrase: "scientific consensus" indicates to jeff (it does to me) that we are having that kind of a conversation, and its likely to be quickly misused to the point where it makes reaching a political/societal "consensus" even more difficult.

I don't think it's possible to seperate science and politics either, but I think "Science" needs to be wary of speaking for science, instead of speaking as well informed and interested individuals.

It's fine to speak for science on purely scientific matters. When it comes to policy, especially social policy like this, it's preferable if they don't push the boundary towards rhetorical cheating.

For the record, I agree with this article and most others on the "scientific consensus" side.

<comment><USER10> ""Science" needs to be wary of speaking for science, instead of speaking as well informed and interested individuals."

Well said.

"It's fine to speak for science on purely scientific matters."

The thing about science is that one high-quality study is often all you need to have a lot of confidence. They don't need 100 experiments confirming the Higgs boson, they just needed one really good experiment.

And bad studies can be summarily ignored for the purposes of fact finding. 100 bad studies are no better than one or zero. The only thing they tell you is an area that may be interesting to conduct a good study later.

If there are a hundred high-quality studies saying one thing, and one high- quality study saying something else, then something very interesting is going on and everyone should pay close attention and get ready to learn something new. But this is very rare and is certainly not a situation where you want to inject politics.

So the only time when it makes sense for science and politics to intersect is when you have one good study concluding something relevant to the policy decision, and no high-quality studies to the contrary. And in that case you only need to cite one study and be done with it -- you don't need to "speak for science".

There is room to argue over the quality of experiments and studies, of course. And that's where the sparks should fly -- not over signatures on a report. If the results of one study are contended, it could go through some kind of extreme peer review that can re-analyze the results or question the data collection methods. The great thing about this is that laypersons will back out and wait, and the scientists and statisticians can argue in peace among their peers. When the smoke clears, then you can take those facts to the bank.

This doesn't for scientific fields where study quality is a major problem (social sciences are hard and don't usually have nearly enough funding to produce quality studies -- or have funding from overly-interested parties). But in that case, you _definitely_ should not lend undue weight to the claims by speaking for science.

</comment></comment></comment></comment><comment> blubb-fish Here in Germany politicians are still stating that Cannabis is a gateway drug, causes psychosis and makes stupid. They will even actively lie and twist statistics.

My theory for why many politicians - especially from the right-wing - are so opposed is b/c they didn't like their weed smoking and long-haired fellow students. It's a Pavlov thing.

Like many people dislike golf (justly so in my humble opinion) b/c they dislike the stereotypical golf enthusiasts.

<comment><USER13> I'm strongly in favor of legalization, but I still believe Cannabis is dangerous (just like alcohol, tobacco and countless other legal drugs are).

It's a well known fact that it can trigger psychosis in susceptible persons and I have even witnessed it happen to a close friend.

It also had hugely detrimental effects on some of my weed-smoking friends, to the point that I no longer want to spend time with them since it affected their personality. I also know people who smoke it daily without any (visible) negative effects whatsoever..

<comment> blubb-fish it definitely should be used in moderation.

regarding psychosis - if you compare weed consumption with number of schizophrenic diagnoses then the idea that weed causes schizophrenia can be easily falsified.

but - of course - any psycho active substance can and will impair the mind of somebody consuming it irresponsibly.

a lot of people micro dose weed - less than 0.05g per consumption unit - that's not going to cause any issues.

<comment><USER13> > if you compare weed consumption with number of schizophrenic diagnoses then > the idea that weed causes schizophrenia can be easily falsified

That's not how it works. There are many potential triggers for psychosis in general (and schizophrenia in particular), and there are reputable studies which show that cannabis consumption is one of them.

> but - of course - any psycho active substance can and will impair the mind > of somebody consuming it irresponsibly.

I think it's safe to say that even responsible use can have negative effects for some people.

Likewise, the claim that micro dosing is not going to cause issues at all is unfounded and dangerous. We simply don't know enough about it to make such claims (enabling scientific research is a big argument for legalization!).

<comment><USER14> So what? It is perfectly legal for me to choose to sit in a cubicle and rot away the best years of my life, a fate little better than as clinical psychosis. Let people do the things they want with their own lives.

<comment> blubb-fish of course you are downvoted by the cubicle victims here. but bottom line you are right. even alcoholism and liver zirrosis is considered socially more acceptable than admitting you are vaping a bud once a week.

</comment></comment></comment></comment></comment></comment><comment><USER15> Perverse, plentiful incentives to addict and sell -- or invest in the manufacturer who does so -- act quicker than panels of doctors, and dodge responsibility too easily.

Living long lives as a beacons of philanthropic humanism on top of your legal drug empire (or profits gained through accompanying ownership) counteracts much stigma accrued from the deaths of your customers.

> On Tuesday [July 17, 2017], OxyContin manufacturer Raymond Sackler died at > the age of 97. The same day, 91 other Americans died due to lethal overdoses > of the pill that made Sackler a billionaire. Sackler died in comfort, in a > hospital bed, with the best possible medical care, "following a brief > illness."

[http://www.huffingtonpost.com/entry/raymond-sackler- oxyconti...](http://www.huffingtonpost.com/entry/raymond-sackler-oxycontin- dead_us_596f881ee4b0bb3867496f43)

<comment><USER16> A bit ad hominem, right? Do we complain about Alfred Nobel having invented dynamite, which has been used to kill people?Pain medicine especially seems like a place where we can't rush to judgement. Even if he acted badly, the drug has done good for some people. Billionaires acting philanthropically is probably better than them not acting that way.

<comment><USER15> The Huffington Post article is written by an anti-corporate former heroin addict who, yes, clearly holds animus against those who profited off of opiates.

> By convincing doctors that OxyContin was "safer," offering financial support > and special perks to family physicians who were willing to push the drug, > and investing millions in a marketing campaign that claimed OxyContin was > not only harmless but beneficial, Purdue Pharma cornered the pain pill > market. By 2003, Purdue was selling $1.6 billion of the pill annually.

The crux of his condemnation is the incentivization of doctors to prescribe -- which one could call bribery. Also, the misrepresentation of known addictive and deleterious long term health effects, which I believe could likely be demonstrated through internal company documents.

Wealth allows the purchase of goodwill at a discount price -- the ultimate destination of Mr. Sackler hinges on both the wilfulness and premeditation of his capitalist technique and the breadth and compassion of his philanthropy.

Collecting and displaying Oriental artwork appears to be at the center of his humanism -- the other side of which is biomedical research. I have not scrutinized the publications emerging from the Sackler School of Medicine in Tel Aviv, but for the sake of his soul and millions of prescription opiate addicts, I hope the papers reveal cures proportionate to his profits.

</comment></comment></comment><comment><USER17> As Chomsky said, the way to deal with drug abuse is through education and treatment. That's how we successfully reduced smoking, drinking coffee and other unhealthy habits in the USA. Not by throwing people in jail.

<comment><USER18> Drinking coffee is unhealthy? You sure about that?

> Studies have shown that coffee may have health benefits, including > protecting against Parkinson's disease, type 2 diabetes and liver disease, > including liver cancer. Coffee also appears to improve cognitive function > and decrease the risk of depression.

[http://www.mayoclinic.org/healthy-lifestyle/nutrition-and- he...](http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy- eating/expert-answers/coffee-and-health/faq-20058339)

<comment><USER19> The high caffeine intake is still quite bad for your heart. And it's bad for your teeth. Just googling shows that the scientific results have been quite mixed. By that I mean that scientists have found some positive correlations, and some negative ones.

From my layman's perspective, I would think a doctor would say there isn't a consensus on whether coffee is holistically healthy. In other words, it's good for some things, bad for others.

<comment><USER20> What scientific results are you googling exactly? Everything I can find shows a strong consensus that coffee has positive effects across the board. This seems like a good summary:

[https://www.nytimes.com/2015/05/12/upshot/more-consensus- on-...](https://www.nytimes.com/2015/05/12/upshot/more-consensus-on-coffees- benefits-than-you-might-think.html)

Highlight from that article:

>There have been two meta-analyses published within the last year or so. The first reviewed 20 studies, including almost a million people, and the second included 17 studies containing more than a million people. Both found that drinking coffee was associated with a significantly reduced chance of death. I can't think of any other product that has this much positive epidemiologic evidence going for it.

I don't understand how you can claim coffee is bad for your heart in good faith if you have read _any_ of the research... for example, this meta- analysis of 36 studies: [https://www.ncbi.nlm.nih.gov/pubmed/24201300](https://www.ncbi.nlm.nih.gov/pubmed/24201300)

> A nonlinear association between coffee consumption and CVD risk was observed > in this meta-analysis. Moderate coffee consumption was inversely > significantly associated with CVD risk, with the lowest CVD risk at 3 to 5 > cups per day, and heavy coffee consumption was not associated with elevated > CVD risk.

I think any doctor worth their salt would tell you that there is a strong scientific consensus that drinking coffee is not only completely safe, but it has preventative effects towards cancer, cardiovascular disease, Parkinson's, and Type-2 diabetes.

Here's a bonus review of 112 meta-analyses: [http://www.annualreviews.org/doi/abs/10.1146/annurev- nutr-07...](http://www.annualreviews.org/doi/abs/10.1146/annurev- nutr-071816-064941)

> Of the 59 unique outcomes examined in the selected 112 meta-analyses of > observational studies, coffee was associated with a probable decreased risk > of breast, colorectal, colon, endometrial, and prostate cancers; > cardiovascular disease and mortality; Parkinson's disease; and type-2 > diabetes.

<comment><USER21> Well, at least anecdotally regular caffeine (several cups per day) intake messes up your energy level, sleep patterns, etc. And if you mess with your adrenal glands, there could be subtle and long-lasting effects on your energy and mood.

<comment><USER22> That's a high intake, though.

A cup of day has solely positive effects, as far as I can tell from reading the research.

All things in moderation and moderation in all things.

</comment></comment></comment></comment></comment></comment><comment><USER23> Drugs were not made illegal because they're bad for your health and they don't remain illegal because they're bad for your health. Poisons are generally not illegal. Drugs are illegal because they make people feel good or make them happy which offends the Protestant Work Ethic. The Protestant Work Ethic says that the only legitimate route to happiness is through physically difficult labor which causes you to suffer. The greater the suffering, the greater the virtue and the greater the happiness you 'deserve' as consequence. The PWE is not openly advocated or consciously held much any longer, but it was a large part of US history and its effects stick with us.

Aside from just the people who have bought into the scaremongering about drugs, there is a significant contingent of people who see it as 'unfair' that anyone could use a drug and get even temporary happiness. Nothing offends Americans (I simply don't know how prevalent this is in other countries) more than the idea that someone else might be having an easier time than themselves. It's why many would prefer companies to go without substantive punishment for harming many people over having one person receive a large punitive judgement in court cases. The McDonald's coffee lawsuit is usually the canonical example. If McDonald's had only paid the lady actual damages, they would have simply continued their practices and harmed more people. But that is preferable to the situation where that one lady got a 'payday'. Apparently nothing is worse than the feeling that someone else has had it easier than one has had it ones self.

<comment><USER24> Dope costs money. When you've got a habit and no job, how are you going to pay? People steal to support their habits. Little children have their childhood stolen because their parents were addicts. People crash cars and kill people. That's why drugs are illegal.

<comment><USER25> Video games costs money. When you've got a habit and no job, how are you going to pay? People steal to support their habits. Little children have their childhood stolen because their parents were always gaming. People crash cars and kill people because their attention is on their little screen. That's why video games should be illegal.

You can do this with literally anything.

<comment><USER24> That's patently absurd. You're not likely to see a gamer out there ripping and robbing to support a habit. Do people get addicted to games? Food? Sex? Whatever? Yeah sure. But by far drugs lead to more crime.

<comment><USER26> Drugs do not lead to crime. Desperation and opportunity, the need to survive, with a lack of morality, all directly lead to crime. Drugs do not make people commit crimes. Emotions, those mental states, do however. What we need, as a country, society, and human race is to recognize the importance of treatment of the mind above all else. Reduce suffering. Sure, there will always be a degree of sadness in life, we should as an intelligent species, strive to end mental and physical suffering.

<comment><USER24> I don't see a lot of clinically depressed people sticking guns in people's faces. Nor do I think lack of morality has anything to do with addiction.

Rather than treat the mind, I believe in treating the spirit.

<comment><USER27> Totally! Lets try to remove the hopelessness from peoples lives that makes them turn to drugs. We can put the whole drug fighting budget into mental health.

</comment></comment></comment></comment></comment></comment></comment><comment><USER28> And not just recreational drugs. All drugs.

We trust people to manage their own life, this includes medicine. Maybe insurance won't pay for it without a Dr, but if someone wants to self pay, that's their choice.

<comment><USER29> There's a whole class of drugs guaranteed to kill your child during pregnancy, and another where the interactions may seriously harm the child. Another where two relatively harmless drugs, when interacting, can produce the previous results.

It isn't acceptable to just put the risk on the average, uneducated person, who is easily swayed by the way media portrays something. We have experts for a reason, which is to guide us in what choices are safest, or "best" in the current circumstances they face.

Here's a little example, which is fairly common:

Alice has borderline personality disorder. Most people don't notice, she just seems to be rather outgoing, and prone to depression and anger. Alice isn't sure she has it.

Bill, Alice's husband, convinces her to go to therapy, where the psychologist practices Cognitive Behavioral Therapy (as CBT is the only government-approved therapy), which has no affect.

Alice's psychiatrist puts her on quetiapine.

The amount is strongly controlled, because an overdose is very likely to be lethal, and one of it's known side-effects is suicidal ideation.

She gains 10kg in a month, and her mood is barely affected, but people feel more comfortable around her. The weight gain depresses her.

The psychiatrist moves her to lithium.

Alice finds she can live a normal life, and no one notices her being outrageous anymore.

Alice and Bill decide to have a child.

Here's the hard part of "best": lithium is class D for pregnancy.

It's probably the best medication for Alice though, who has demonstrated she is fully capable of being a normal and productive member of society.

The same problems will continue if Alice chooses to breastfeed, which is best for the baby, so long as they are careful around medications.

\---

Neither Alice nor Bill are remotely qualified to determine what will, or will not, harm a child.

> We trust people to manage their own life

No, we don't.

We create laws, and regulations, to guide people into making safe choices.

Seatbelts are every bit as useful as a prescription.

<comment><USER30> Which country are you talking about? This treatment plan for a person with borderlinePD is likely to cause harm.

> where the psychologist practices Cognitive Behavioral Therapy (as CBT is the > only government-approved therapy), which has no affect

CBT is a short form therapy, normally about 8 weeks.

Do not use brief psychological interventions of less than 3 months. [https://www.nice.org.uk/donotdo/do-not-use-brief- psychologic...](https://www.nice.org.uk/donotdo/do-not-use-brief- psychological-interventions-of-less-than-3-months-duration-specifically-for- borderline-personality-disorder-or-for-the-individual-symptoms-of-the- disorder-outside-a-service-that-has)

> Alice's psychiatrist puts her on quetiapine.

Antipsychotic drugs should not be used for the medium- and long-term treatment of borderline personality disorder. [https://www.nice.org.uk/donotdo/antipsychotic-drugs- should-n...](https://www.nice.org.uk/donotdo/antipsychotic-drugs-should-not- be-used-for-the-medium-and-longterm-treatment-of-borderline-personality- disorder)

> The psychiatrist moves her to lithium.

Drug treatment should not be used specifically for borderline personality disorder or for the individual symptoms or behaviour associated with the disorder (for example, repeated self-harm, marked emotional instability, risk- taking behaviour and transient psychotic symptoms). [https://www.nice.org.uk/donotdo/drug-treatment-should-not- be...](https://www.nice.org.uk/donotdo/drug-treatment-should-not-be-used- specifically-for-borderline-personality-disorder-or-for-the-individual- symptoms-or-behaviour-associated-with-the-disorder-for-example-repeated- selfharm-marked)

What Alice probably needs is a long form talking therapy. Have a look at _Meeting the Challenge, Making a Difference_ for more information: [http://www.crisiscareconcordat.org.uk/inspiration/meeting- th...](http://www.crisiscareconcordat.org.uk/inspiration/meeting-the- challenge-making-a-difference/)

<comment><USER31> I don't know whether you or the person you're replying to is more correct, but it doesn't change their point: That these decisions are not something the average person should be making for themselves. If anything, your disagreement kind of makes the point even clearer.

Maybe there might be an argument for people to be able to choose to obtain drugs like the ones mentioned by GP, but not without some kind of control- mechanism to at a bare minimum ensure they have been presented with the risks and have given some level of demonstration that they understand them.

E.g. I quite like the mechanism now in place for online pharmacies in the UK, where you can buy prescription drugs like Viagra, or OTC but restricted products like Daktacort (combination anti-fungal and steroids), but need to convince a doctor (for the former) or pharmacist (for the latter) in writing that you've at least bothered to read what they've written about the drugs (since nothing stops you from just faking the symptoms, but you at least need to describe relevant symptoms free-form semi-coherently, or they'll do additional checks before selling to you).

It has weaknesses, and certainly won't stop people from abusing abusable drugs, but it at least makes it possible to pick up on the most idiotic attempts at misusing drugs they don't even understand.

Alternatively, I've used PushDoctor a couple of times - a UK service that connects you with an actual GP via video chat; the last time it took me 10 minutes from I scheduled an appointment until I'd uploaded pictures of a rash, had a conversation with the GP and had the prescription passed to a local pharmacy electronically; even _if_ one were to consider taking away their "gatekeeper" role in terms of letting them deny treatments they don't think are necessary, I don't think it'd be unreasonable to still at least require a consultation like that for the most dangerous drugs to give an opportunity to at least inform.

<comment><USER32> But these are "customer protection" laws, which are intended to make sure people are informed and to make it reasonable to shop in the street, not to protect against people who intentionally try to break them.

They are easily opted out of - they won't prevent you from e.g. buying whatever you want from China, and that's by design. There's no point in protecting a customer that doesn't want your protection.

As opposed to drug laws, which are designed to make drugs hard and dangerous to buy, even if you really want them.

<comment><USER31> And that's how I think it makes sense to treat narcotics too.

</comment></comment></comment></comment></comment></comment><comment><USER33> It's worth noting that this article is from March 2016 (e.g. before the UN failed to course correct at UNGASS 2016), and that this and many other efforts have failed already.

There are some related discussions in this thread from last year after UNGASS: [https://news.ycombinator.com/item?id=12601956#12602296](https://news.ycombinator.com/item?id=12601956#12602296)

</comment><comment><AUTHOR> Some reasons for decriminalization of use and possession, summarized:

(i.e., removing criminal penalties or making it no jail time possible, but not government supplied)

\- War on drugs has failed. Criminalization has consequences on community - <USER2> many cases, most of the negative effects come from the criminalization, not the drug.

\- Consensual crimes that don't harm others shouldn't be crimes.

\- Drug prohibition doesn't seem to decrease use — Portugal. (Also perhaps Czech, Italy, Spain?)

\- Drug war enforcement costs a ton, we could save tax money.

\- 1.2 million people arrested for drug possession in 2015. [http://www.drugwarfacts.org/chapter/crime_arrests#arrests](http://www.drugwarfacts.org/chapter/crime_arrests#arrests)

\- Prisons are crowded. Would reduce this a little.

\- Easier for addicts to seek treatment.

I think the strongest reasons are that drug use should be treated as a health issue and not a criminal issue, and that consensual crimes that don't harm others shouldn't be crimes.

What is the single strongest reason for or against decriminalizing all drugs, in your opinion?

<comment><USER34> The main reason we won't get decriminalization is moral panic. :( But if we did...

There are still better and worse ways to make drugs available. Same as with alcohol, addicts doing high volume are where the money is -- and it's better to design regimes that prevent commercial actors from abusing vulnerable populations. Mark Kleiman has a lot of great stuff to say on the subject.

<comment><USER35> > _and it 's better to design regimes that prevent commercial actors from > abusing vulnerable populations._

Unless we're looking to apply the law inconsistently based on some arbitrary prejudice of "vulnerability", this would seem to be basically what we're already doing. Any decriminalization approach which criminalizes access for addicts almost defeats the purpose according to your own rubric.

<comment><USER31> Consider that some countries have state monopoly stores for wine and stronger alcoholic drinks, and most no longer allow advertising for alcohol.

Similarly, consider the option of regulations like those in place for pharmacies in some countries, that e.g. requires the pharmacist to ensure you are aware of certain risks, but doesn't prevent you from buying.

Consider the way some countries now requires tobacco to be out of view and with health warnings all over or no branding.

In other words: There are mechanisms you can put in place that legalizes drugs fully, but still heavily restricts commercial entities ability to try to take advantage of peoples weaknesses.

Personally I believe even drugs like heroin should be legal, on the basis of harm reduction, but at the same time, I don't see a problem with e.g. restricting where it can be sold and ensuring that it's sold in plain packaging, no advertising is allowed, and to e.g. have a pharmacist inform you of the risks before selling it. I don't think that threshold will be high enough to make people go to a dealer, but it may still reduce abuse.

In the UK there are restrictions on how many pills of paracetamol (acetaminophen) and ibuprofen you can buy at a time, for example. In pharmacies you can buy up to 32 of each at a time, while elsewhere only up to 16 of each at a time. Those restrictions were put in place because of overdose deaths, and they appear to have saved hundreds of lives so far, while being lenient enough not to drive anyone to a black market.

So while I think we should be allowed to buy pretty much whatever drugs we want, we can combine that with making it sufficiently unattractive that you're not buying them on a whim.

<comment><USER35> I live in a place where the government had a monopoly on alcohol retail until recently (Ontario, Canada). I don't think it had any impact on sales. The biggest factor was price, the government fixed the prices fairly high (but those prices were the same for the retail exceptions, such as brewers' own premises).

> _Personally I believe even drugs like heroin should be legal, on the basis > of harm reduction, but at the same time, I don 't see a problem with e.g. > restricting where it can be sold_

Well, if you nationalize heroin retail, then you will need to have a heroin shop in every hamlet, town, and neighbourhood. It hardly seems practical. You'll just end up with a somewhat smaller black market, instead of eliminating it.

<comment><USER31> The point of having the monopoly is be able to strictly enforce restrictions on things like marketing through an organization that is judged by compliance rather than by selling as much as possible.

> Well, if you nationalize heroin retail, then you will need to have a heroin > shop in every hamlet, town, and neighbourhood. It hardly seems practical. > You'll just end up with a somewhat smaller black market, instead of > eliminating it.

Yet somehow places like Norway, with a population density nearly identical to Ontario manages to keep the black market for wine and spirits quite small, despite very high taxes on them compared to e.g. neighboring Denmark.

Which means there already _is_ a suitable retail network. Or you can license pharmacies.

And the big difference is that people would be assured of getting clean, uncut, predictable doses. The cost of heroin is also so high and unstable that while there is reason to be concerned about making it too cheap, a large portion of the harm from heroin today is the high cost. The daily consumption of heroin for a typical user in clean, medical grade heroin costs less than $20 (we know, because it is produced for medical use, and prescribed e.g. in UK hospitals).

</comment></comment></comment></comment></comment></comment><comment><USER36> Full steam ahead with decriminalization of possession/use, and with regulated markets for psychedelic and most stimulants

However after seeing how business behaves when it can sell opiates, I'm in favor of even more regulation than we currently have on some drug markets

(Also, if it were up to me, I'd ban ads for drugs, including alcohol and prescriptions)

<comment><USER17> Stimulants can be pretty dangerous TBH. I don't think class a drugs should just go on sale, but I don't think people should be locked up for them. Baby steps.

<comment><USER31> The problem is that for a lot of these drugs the greatest harm comes from the lack quality control and regulation of sale.

Not just because it results in drugs getting cut with all kinds of shit, and people being sold the wrong thing (e.g. selling heavily cut fentanyl instead of heroin), but also because of a the race to find alternatives that slip through cracks.

A great deal of modern drugs only exists to circumvent the law, either because they're not covered for a while, or because they can more easily be produced. E.g. a number of "synthetic cannabinoids" have been manufactured, and so far indications are that at least some of them have health effects that are far worse than anything possible to tie to actual cannabis.

Without decriminalising and regulating manufacture and sale, there will still be an incentive for dealers to sell drugs like that which nobody particularly want, and that increases harm, instead of selling clean versions of the safest drugs.

E.g. for opiates, many of them are "close enough" in terms of effect that there is a lot of potential harm reduction benefit just in getting the more dangerous variants off the market by legalizing and regulating the safest ones. Unlike blanket bans that has a hope of working.

<comment><USER17> Yes but even the pure, quality drugs like adderall, which is really amphetamine can be dangerous.

For opiates, especially people injecting, it is very inportant to get clean drugs, and actually opiates are not particularly harmful to the body if used correctly. They also don't really present a threat to society if given the drug. Holland has provided addicts with heroin with great success, as a form of treatment.

<comment><USER31> They can be, but so can a lot of drugs sold at the grocery store. E.g. paracetamol/acetaminophen is one of the largest causes of liver damage in the UK. One of the big shifts there has been to restrict size of packaging and require pharmacists to exercise care (some will explicitly verbally warn you about the risk).

Ultimately I think that we'd in many respects do a lot better if it was possible for someone who wants to use things like Adderall for recreational use to go to their doctor and ask for advice and appropriate monitoring and know they won't be refused, than having people randomly taking it without getting proper advice.

But I also think another large potential benefit would be for doctors to be able to steer those who insist on using drugs to safer analogs were possible.

</comment></comment></comment></comment></comment><comment><USER37> Bottom line is deaths from overdose.

Drugs criminalized, USA:

150 deaths/million people/year

Drugs legalized, Portugal:

3 deaths/million people/year

<comment><USER38> Death penalty for drug trafficking, Singapore:

0 deaths/million people/year

<comment> maze-le Drug use might be more prevalent than the official statistics suggest.

[0]: [https://www.reuters.com/article/idUSSIN135004](https://www.reuters.com/article/idUSSIN135004)

</comment></comment></comment><comment><USER39> While I support the decriminalizing of drugs, I also have to question how effective it would be if all drugs were decriminalized and became highly regulated.

Example 1: prescription drugs are highly regulated, yet their legal availability has not stopped criminal activities surrounding the illegal trade. Legalizing may solve some social issues relating to the war on drugs, but not all.

Example 2: alcohol is legal, easily available, and has a (proportionally) low amount of illegal trade. On the other hand, a lot of people do illegal stuff when impared by it. Perhaps some drugs should not be legal, particularly since there is worse stuff ou there.

On the other hand, you have example 3: tobacco. Reasonable precautions taken, its main issue is self harm due to the impact on health. While there are obvious reasons to regulate its use (e.g. people frequently smoke in environments where it can harm others), do we really want to regulate self- harm?

Perhaps we should be regulating based upon the drug, keeping some illegal, rather than pursuing blanket legalization and regulation.

Edit: an occurance of legal should have been illegal.

<comment><USER40> > do we really want to regulate self-harm?

In the worst cases we do: Euthanasia.

Drinking under 21: We do.

Marijuana use under 25: We should.

<comment><USER41> I don't. I think drinking age should be 18, and kids should be allowed to drink with their parents. I think marijuana should be the same way. I think assisted suicide should be allowed (euthanasia is different).

I think every drug, even prescription medicines, should be totally legal to possess, distribute, sell, and buy.

<comment><USER40> Why should we limit it by age?

Also, you say that "I think x,y,z." But you do not say why. Do you have some expertise that informs your decision on safety or is your opinion purely philosophical (based on personal freedom or even Darwin Awards)?

</comment></comment></comment></comment><comment><USER42> Sure. How do you keep millions of unemployed people happy? Give them drugs and UBI.

</comment><comment><USER43> Decriminalization of drugs would have to come with a massive restructuring of our social programs. You could get into a lot of trouble by financially supporting people who become addicted beyond their control.

<comment><USER44> As opposed to now? Many of today's opiate addicts' supply is subsidized by the US taxpayer.

</comment></comment><comment><USER45> The article is about "decriminalization of all nonviolent drug use and possession". This sounds noble, but as we found out in the Netherlands you will have to make a distinction between soft drugs and hard drugs. Hard drugs is always associated with crime and most of the time violent crime and gangs.

So I would say. Been there done that. We are cracking down on this type of policy, since 'education' does not work and it seems that prisons do not make the criminal as some other comments claim... Well they can always wish for it, but reality does not care either way.

<comment><USER46> We're living in a strange culture of over optimism that thinks if we just magically change certain systems "literally everyone will be better."

No. Heroin users aren't going to magically become productive members of society just because we legalize heroin.

<comment><USER22> Maybe not, but the heroin addicts will no longer have to resort to robberies and other crime in order to fund their addictions, and it will become easier to offer them help and treatment.

<comment><USER47> > the heroin addicts will no longer have to resort to robberies and other > crime in order to fund their addictions

How does decriminalization of the possession and use lead to increased money for addicts that they will no longer have to resort to illegal acts to fund addictions?

Less jail/court fees = more money in pocket to buy drugs?

<comment><USER22> To be clear, I'm a proponent of full legalization, not just decriminalization.

</comment></comment></comment></comment></comment><comment><USER48> Why would medical experts be considered authoritative? It's a legal and political problem. For the record, I agree with the doctors, but I think decades of research into marijuana have already demonstrated that medical facts have jack shit to do with legislative agendas.

My guess is, the only way we'll move past this ridiculous situation is if a majority of individual states decide to legalize hard drugs the same way a minority of them have already legalized weed, and eventually the federal government will cave in once they realize it's not going to cost anybody an election. That is, it will take lots of baby steps over a couple of decades. I hope I'm underestimating progress, though!

</comment><comment><USER49> Legalize.

Why should we funnel money to illegal drug cartels to fuel their crime and violence by decriminalizing drugs?

</comment><comment><USER50> What about other drugs like steroids and growth hormones? Those are schedule 2 drugs which can be prescribed but have no addictive properties. Testosterone is something your [male] body produces but even if you have a low free T count doctors often still won't prescribe it, and since you cannot buy it legally most men live out their lives feeling the negative affects of this.

Of course the focus is always on weed, opiates, and other common hallucinogenic drugs, but what about all the other drugs that aren't.

What is the reason for those to be illegal? I legitimately don't know the reasons because even the reasons for 'harmful' drugs causes lots of debate such as the comment thread here shows.

<comment><USER51> Steroids are drugs of abuse by athletes seeking better performance in their sports. That is the reason why it's scheduled, despite low addictive potential.

</comment></comment><comment><USER52> Even if you had a staunchly anti-drug stance, it's also fair to say that law enforcement resources are not unlimited. Dealing with drugs like cannabis and cocaine are a waste of taxpayer dollars relative to serious issues of opioids and methamphetamine.

</comment><comment><AUTHOR> Full report: [http://www.thelancet.com/journals/lancet/article/PIIS0140-67...](http://www.thelancet.com/journals/lancet/article/PIIS0140-6736\(16\)00619-X/abstract)

</comment><comment><USER53> The drug war not working does NOT mean that all the drugs should be decriminalized. If you fail to fight drug cartels, it's a political and organizational issue. We should never fall into the trap of mixing everything.

</comment><comment><USER54> > decriminalization of all nonviolent drug use and possession

What is meant by nonviolent drug use?

<comment><USER30> You can't be a criminal gang that murders people to smuggle the drugs into the country.

You can't be a criminal gang that forces modern slaves to grow cannabis in squat houses.

You can't be a criminal gang that uses violence to control a street corner.

</comment></comment><comment><USER55> The way to "win" the drug war, is the way you win in capitalism. COMPETITION!!! No one would go to illegal drug gangs if they could go to 7-11(or similar).

<comment><USER56> Out of curiosity, what goods and services will people in that line of business switch to?

Will they exploit inefficiencies in other drugs markets that the state hasn't caught on to yet? And just accept the diminishing returns before switching to the next drugs?

Will they try other lines of business, like computer hacking syndicates?

Or they all magically disappear, or be cut off from appearing because there is simply no unskilled labor + high margin + low overhead business line remaining?

<comment><USER55> What happened to the gangsters of Al Capone's day, when prohibition took away their competitive edge? Did they sell "insurance"? You seem quite passive aggressive, without offering any thoughts yourself.

My guess is, most will be unemployed. They aren't criminal geniuses. They've found a cheap way to make money and get high at the same time, most of them.

</comment></comment></comment><comment><USER57> Imagine a old dam. It's in poor condition, with cracks here and there, letting some water through. Its maintenance is extremely expensive and seemingly useless, since for ever crack that is fixed, a new one appears.

Now some guy shows up and says "this dam costs us too much and we are failing to fix it. Let's just blow it up!"

<comment><USER58> So the problem with blowing up the dam is that there's a large amount of water behind it that will flood out dangerously if they blow up the dam. I guess?

So what's the analogy here? You think there's a large amount of potential drug users who will suddenly start abusing as soon as drugs are legalised?

<comment><USER57> > You think there's a large amount of potential drug users who will suddenly > start abusing as soon as drugs are legalised?

The opiod crisis already is quite severe. And yet most opioids are illegal. I doubt making them legal will decrease usage. Also, if they were legal, big pharma companies would see them as business opportunities. Things could get ugly fast.

<comment><USER59> I'm not following any of the logic here. Big pharma companies are already making a killing on a significant portion of the opioid addiction epidemic. They're legally (but perhaps irresponsibly) prescribed by a doctor, and either become abused by the intended patient or subsequently depart from those legal channels.

The opioid crisis isn't the only crisis. America hovers around being the 1st or 2nd worst incarceration rate in the world, and it's predominantly non- violent drug offenses. Friend of mine just lost a job offer they had provisionally because of a tiny marijuana possession charge from years ago, and that's happened to them over and over again.

If your best argument in favor of continuing to ruin people lives over something so petty is "big pharma will make money off of opioids", I call bullshit.

edit: I would also argue that in your analogy, there is almost no water built up behind that dam, and getting rid of the dam would hardly be noticeable downstream. We can't even keep drugs out of prisons very well. I live in a town that hasn't had a single case of violent crime in 13 years, and yet I know _exactly_ where I could go and buy some heroin right this very minute if I wanted to. I know where in the Bay Area I could buy some meth if I wanted to. And these are locations that have been repeatedly raided by the cops, but the selling of drugs at those locations doesn't stop, because someone else who recently finished their sentence will just take over while the person who got busted servers theirs. I was in a concert venue last night with cops, and weed, everywhere. Freaking out about the weed, but no one caring about people having 6 or 7 beers and then getting in their cars to drive home drunk at 1am. The dam makes zero sense to me.

</comment></comment></comment></comment><comment><USER60> This was a very good interview with a neuropsychiatrist, Dr. Phyllis Bonafice, who has a different opinion, [https://youtu.be/W_i2mC5fAmI](https://youtu.be/W_i2mC5fAmI). I do think focusing on treatment more than punishment may be a better idea in most cases.

</comment><comment><USER61> a lot of drugs used to be legitimate drugs,but are now illegal to be able to sell other shitty substances which are more expensive and often less effective. example: mdma treatment for ptsd. most ptsd treatments are ill effective these days, but before wo2 mdma treatment was very effective. it's now only able to be given in certain places, usually from people who can't licence themselves properly, adding risk to this treatment where before it was solid. [http://www.mdmaptsd.org/news.html](http://www.mdmaptsd.org/news.html) most banned substances are just 'buisness deals' between pharma industry and government. For the US people, this is not just due to war on drugs. war on drugs is an effect , not a cause.

</comment><comment><USER62> Instead of drugs, I think we could ban fried chicken and watermelon exceeding a diameter of three inches. It would be more effective for the goals the government has in mind. Fried chicken is well, fried, and a large watermelon can be used to hit someone and cause head injury.

</comment><comment><USER63> Honest question: How would decriminalization of drugs work in practice? Would it be legal to e.g. import and sell cristal meth in stores? What about cheap self-made alcohol that might contain dangerous stuff like methanol; where do you draw the line?

<comment><USER64> Decriminalization ≠ legalization; the idea here is decriminalizing usage and personal possession, which in no way entails legalizing production, cultivation or commercialization. The point is to enable addicts to seek treatment without fear of legal trouble.

<comment><USER65> I would argue, somewhat pedantically, that decriminalization = legalization. Drug use can either be legal or illegal. Drug possession can be either legal or illegal. Same for drug, manufacture, and drug distribution.

In that order: use, possession, manufacture, distribution

I think you will get a reduction in the number of people who would agree with having no restrictions. For instance, drug use is probably ok, but not while driving a vehicle, or playing a competitive sport. Drug possession is probably fine, but not more than X amount. Drug manufacture might be fine, if you are just growing/making for yourself. Drug distribution is probably not ok unless you have a license and follow state/federal guidelines.

I think where the law breaks down is under: 'possession'

If it's legal to possess say, 200 pills of oxy at any time, no Rx, no questions asked, I don't see how that isn't going to result in increased distribution.

</comment></comment></comment><comment><USER66> I think the best approach is to allow each neighborhood to decide what recreational drugs, if any, can be consumed in public. And only enforce such restrictions with fines, not jail time.

Regulating at the neighborhood level makes it easier to live in or travel to the kind of neighborhood you want to be in. People that want to use drugs in public where they live can pick their neighborhood accordingly.

The more permissive neighborhoods can tax drug use to pay for any negative consequences of drug use. Maybe they need more enforcement of traffic laws, for example.

If we allow everything everywhere, eventually there will be pressure to control everything again. Better to allow people who want drug-free neighborhoods to have them, while ensuring that those who want to use drugs are still able to.

</comment><comment><USER67> I can't read the article because I have no Washington Post subscription.

But isn't this more of a question for an economist than one for a medical doctor?

</comment><comment><USER68> I like how 'drug' can refer to both medicin and non-medical substances in English. In Finnish, they are two separate words.

</comment><comment><USER69> Seems really dangerous to have things like PCP and Heroin available

</comment><comment><USER70> I think this can cause interest shift in relevant job sectors.

<comment><AUTHOR> How so?

</comment></comment><comment><USER53> I'm thinking internally if all this buzz on drug decriminalization isn't just the visible part of darwinian process that will naturally eliminate the stupids and the mentally weak from humanity gene pool.

<comment><USER71> Yeah their idiotic comments in online forums should hopefully make them undesirable to the opposite sex...

</comment></comment><comment><USER72> So 22 medical experts state the War on Drugs "directly and indirectly contribute to lethal violence, disease, discrimination, forced displacement, injustice and the undermining of people's right to health."

In Mexico 23,000 people were killed in drug related violence in 2016. Drug overdoses in the USA jumped to 59,000 in 2016. Arrest numbers in the USA in 2015 totaled 10.8 million. Drug related: 1.49 million; (Broken down: 1.25 million for drug possession; 340,000 for sale or manufacture.) 1.09 million drunk driving; 11,092 for murder or manslaughter.

Ratios of note: 438:1 Possession:Sale or manufacture; 1.25:1.5 Drunk driving:Drug related.

Government v Science: In 2009 a British psychiatrist and neuropsychopharmacologist was sacked from his position chief drug advisor position in government after publishing a list of most to least harmful drugs.

"Alcohol and tobacco are more harmful than many illegal drugs, including LSD, ecstasy and cannabis..."

He also stated horse riding was safer than ecstasy with 100 riding fatalities per year(on average).

The political blowback was massive. On the floor in House of Commons MPs vehemently rebuffed the document and its author. It was a parade of "my ignorance trumps your expert scientific opinion."

The congress and courts in the USA are no better. There's no official list but there is a pattern that has no scientific basis. The crack epidemic of the late 80's saw congress pass mandatory sentencing laws for crack. Crack is the crystalized version of cocaine. It was popular in the inner city minority population. Movie stars from the 80's would have a "cocaine nail." The nail on the pinky finger (it could be any finger) would be noticeably longer. Carrie Fisher in the Empire Strikes Back has one that really stands out.

[https://www.theguardian.com/politics/2009/oct/29/nutt- drugs-...](https://www.theguardian.com/politics/2009/oct/29/nutt-drugs-policy- reform-call)

[https://www.theguardian.com/politics/2009/oct/30/drugs- advis...](https://www.theguardian.com/politics/2009/oct/30/drugs-adviser- david-nutt-sacked)

It was difficult to locate reputable sources of recent data on costs in the United States. Tobacco and alcohol combined total slightly over $600 Billion/year while illegal drugs are estimated at just under $200 billion.

[https://www.verywell.com/what-are-the-costs-of-drug-abuse- to...](https://www.verywell.com/what-are-the-costs-of-drug-abuse-to- society-63037) Joshua J. (2017) The Consequences of the Use of Illicit Drugs and Their Associated Private and Social Costs. In: The Economics of Addictive Behaviours Volume III. Palgrave Macmillan, Cham

[http://ktla.com/2017/05/09/23000-killed-during-mexicos- drug-...](http://ktla.com/2017/05/09/23000-killed-during-mexicos-drug-wars- in-2016-making-it-second-deadliest-conflict-in-the-world-after-syria/)

[http://www.occnewspaper.com/americans-are-still-getting- arre...](http://www.occnewspaper.com/americans-are-still-getting-arrested-for- marijuana-possession-at-staggering-rates/)

So you discussed your drug habit with your physician? Physician–patient privilege isn't a sure thing anymore. The police are requesting and getting warrants to access a person's medical files. I didn't know this was happening until I started writing this post.

[https://www.aclu.org/other/faq-government-access-medical- rec...](https://www.aclu.org/other/faq-government-access-medical-records)

Anythingnonidin has a good list of reasons.

A few others:

\- Alcohol is legal yet it's the only drug where stopping cold turkey can be fatal. Most people have heard of DTs or the shakes. So drinking too much too fast and not drinking afters of hitting the bottle every day can both be fatal.

\- It's impossible to overdose on cannabis. People do have bad reactions or trips and go to the hospital but it's nothing life threatening.

\- For profit prisons (almost always) cannot take prisoners who've committed a violent crime. Wonder why the dealer to possession ratio was 1:438? This is probably a factor.

\- We have 5% of the world's population but 25% of the world's prisoners

\- Tuberculosis, HIV, Hepatitis C - The sentence wasn't for live but these transmissible diseases are.

\- "If we legalize drugs think of the damage to the economy. ATF, prison guards, police, cities that are only financially solvent because of the income from the courts and prisons would face financial ruin. \- Innocent until proven guilty unless there's a empty cell? How is this not a conflict of interest for the parole board?

\- So we hear nothing about how many drunks get behind the wheel of a 3000lb vehicle. Only after 3-5 DWI's will they possibly face prison time. Someone smoking weed is "a threat to national security?" They pose a threat to the safety of the community. That car swerving down the road only get a slap on the wrist.

\- I don't think it should be all drugs and I don't think the article made that argument. The point was to stop treating a health condition as a crime and end what Nixon started.

</comment><comment><USER73> Paywall?

<comment><USER74> There's a workaround via Facebook: here's an example of its use:

[https://news.ycombinator.com/item?id=15270969](https://news.ycombinator.com/item?id=15270969)

<comment><AUTHOR> A clickable one for this one would then be:

[http://facebook.com/l.php?u=https://www.washingtonpost.com/n...](http://facebook.com/l.php?u=https://www.washingtonpost.com/news/wonk/wp/2016/03/24/top- medical-experts-say-we-should-decriminalize-all-drugs-and-maybe-go-even- further/)

</comment></comment></comment><comment><USER75> Needs to go even further, and deregulate access to prescription drugs as well, to open up provider competition and increase consumer choice.

<comment><AUTHOR> What does this mean? Make all Rx drugs OTC?

<comment><USER76> I think we leave the Rx system as is, in that we still let pharmacists do their job and protect their mainstream normal patients and give good standard of care, but any party drugs where there is already a clandestine market become OTC. i.e. if you want some weird medicine for some weird thing that no one else wants, you'll have to go through the steps to get a Rx for it. But it won't be hard to get. Because once adderall is OTC there will be 1000's of freed up doctors who don't have to write Rx for that.

<comment><USER77> I just wish we could do away with having to get the prescription in the first place and have the pharmacist be the gatekeeper. You keep a medical history on file so they can quickly figure out if the medication you want is likely to cause complications. Then I don't have to leave work and meet with my doctor every few weeks/months to get another prescription which I then have to take to the drug store and wait to get filled.

<comment><USER31> In the UK we now have at least three alternatives (other than "grey market" import; most prescription drugs outside of narcotics can be legally imported to the UK for personal use):

For OTC drugs with restrictions, online pharmacies can sell subject to asking you sufficient questions (and potentially doing a followup call if you answers raises questions). This covers drugs like steroid creams and the like which may have risks, but are usually ok.

For prescription drugs, online pharmacies can likewise sell to you if they have you fill in a questionnaire and a qualified GP agrees to write a prescription for you. This is increasingly done for low risk but prescription only drugs like Viagra.

The mechanisms above are simple enough that even though buying from e.g. companies shipping from Indian manufacturers is trivial in the UK, I'll prefer UK online pharmacies when possible as the extra hassle is minimal and they're better regulated.

Alternatively there's a service called Push Doctor (I've got no connection to them other than being a satisfied user) that lets you have an actual conversation with a doctor over a video chat (+ text chat and ability to upload images) after which they can issue you a prescription that gets sent electronically to the nearest pharmacy. I've tried it twice - once I got seen within an hour, the other time in less than 10 minutes, and the prescriptions were ready within half an hour in both cases, so I could just wait for a text message and go pick it up when it was ready.

It's a fantastic service - the only downside is it's private only, and while the consultations aren't expensive (28 pounds or 20/month), for more expensive prescriptions it's not great as you'd be paying full price for the drugs (but you do have the option of e.g. use them for diagnosis and go see your GP to get an NHS prescription if they think you need anything expensive, so you at least avoid having to visit your GP for minor things); I'd love to see this service get a deal with the NHS...

With the above setup there's very little reason to take risks as the barriers are low enough for most people to have very little reason to circumvent them.

I do agree with you though that for most drugs delegating it to a pharmacist would probably provide a good enough barrier - at least in the UK, and I suspect most other places too, they're well educated. When it isn't we should ask why. E.g. are doctors looking for signs of any issues? If those issues are simple enough and there's low enough abuse potential, then either let pharmacists do it or standardize a questionnaire.

</comment></comment></comment></comment></comment><comment><USER78> Drugs cause psychopathic behavior in those who didn't take them.

It is all because of a self-enslavement formula where it is magically expected to have every angle of everyones life managed by others.

I say we force them to smoke the weed and calm them the fuck down. It's just better for them.

<comment><USER78> I suppose I should clarify that without joking so much.

Drug addiction can be very harmful but society retaliating against the victim is endlessly worse.

Its like death by a thousand cuts, everyone seems to want to take a stab at the person as if that is going to cure them but it only makes them use more. They have to hang out with criminals to buy their fix and become one themselves to finance it.

A drug addict can be successful and have a happy life but only if no one finds out. When people do it triggers a kind of social death spiral.

You get the proverbial guy drinking a liter of coffee then smoking a cigar with a glass of whiskey at 11 am ranting about drugs as if the drug user is the embodiment of evil on earth.</comment></comment>


Defender of the Favicon - <AUTHOR> http://www.p01.org/defender_of_the_favicon/ <comment><USER2> Too bad Safari doesn't display favicons any more.

<comment><USER3> Consider choosing a browser that supports the features you use.

<comment><USER4> Please. Safari is the IE6 of 2016.

</comment></comment></comment><comment><USER5> What a fun idea.

Meanwhile I can only get a favicon to show on my homepage...

<comment><USER6> Make sure you're using absolute paths:

`href="[http://example.com/favicon.png"`](http://example.com/favicon.png"`)

Or at least that your relative paths are correct:

`href="/favicon.png"`</comment></comment>


Dear PG - <AUTHOR>

	Frequently while reading one of your essays, I will read the footnote immediately after finishing the paragraph to understand the context of the footnote. But near the footnote there is no link back to the corresponding paragraph. So the footnote is often followed by a horrifying scrolling period leading back to the paragraph which is disorienting and detracts from the essay.
I don't know if this is just me, but I'm sure if I've experienced it others likely have also.
If you could kindly add the extra links in future essays, that would be aces. I'm sure an intern or anyone really would be more than willing to add them retroactively also. I think it would improve the reading experience (and one of the few advantages reading on a computer has over conventional novels).
Now I'm going to casually slide back into the darkness of Hacker News.
Kind Regards,
Your friendly neighbourhood Sohum <comment><USER2> Since the foot note links use anchor tags, have you considered just hitting the back button?

<comment><AUTHOR> That was so obvious. I feel rather ridiculous. A bit like the time I realised what insert did in a word document. Thanks.

</comment></comment><comment> mark-r You could simply open the footnote in a new tab, then the only effort to returning would be to close the tab. Or better just leave it open for the next footnote you come to.</comment>


Rhapsody Ends DRM - Itunes in trouble? - <AUTHOR> http://www.nytimes.com/2008/07/01/arts/01arts-RHAPSODYENDS_BRF.html

<comment><USER2> Rhapsody isn't producing cutting-edge consumer devices in combination with a seamless user-experience from start-to-finish.

AAPL also takes-two with the iPhone, and iTunes will be the de-facto store for software. Naturally, most people will prefer to consolidate their digital media purchasing -- a small portion may purchase from Rhapsody.

Last, Steve did push to remove DRM in his open-letter some ~1.5 years ago. <http://www.apple.com/hotnews/thoughtsonmusic/>

</comment><comment><USER3> [http://weblog.raganwald.com/2008/05/why-apple-is-more- expens...](http://weblog.raganwald.com/2008/05/why-apple-is-more-expensive- than-amazon.html)

iTunes has DRM while the "competition" doesn't because the music industry cartel is trying to use its monopoly over music rights to manipulate the distribution market.

</comment><comment><USER4> I find it rather interesting that companies are removing DRM from their music, yet Canada's government is trying to copy the DMCA because of US lobbying.

I seriously forget the point in voting as government officials already have their opinion bought by big companies.

</comment><comment><USER5> "The music download service Rhapsody [has made] its catalog of five million songs available without electronic restrictions on playback or duplication"

"free previews of complete songs"

"Rhapsody will restrict full-song previews to 25 a month"

Two of these sentences are not like the other.

<comment><USER6> Not necessarily - paid-for downloads aren't restricted, but by limiting the number of free full-song previews, they keep themselves from being an online radio station.</comment></comment>


Salary, from an employee's perspective - <AUTHOR> http://ddrewdesign.com/blog/salary-from-an-employees-perspecti-1

<comment><USER2> _" Software development tends to make it pretty easy with things like Github to track development, so I figure when the time comes to start hiring people, I'll have a decent way for myself to track people."_

This last bit sounds like the start of a trip down a bad road that's been traveled before. Unless this guy is planning on reading carefully over _all_ of his employee's code to see how much "passion" it contains, what he's proposing is essentially payment based on how many times you commit, or by lines of code, or some other equally meaningless metric. All he's going to end up doing is creating cynical employees who save their last push to GitHub for Sunday so they can get their 10% passion bonus for working during personal time.

Personally, if given the choice between a salaried position and equivalent hourly pay, I'd rather just be paid hourly. People treat the move to salary as a reward for employees moving up in a business, but it also removes the direct reward you get for working an extra 20 hours to bail your boss out or ship a product on a given week. There's this nebulous idea of annual bonuses for hard work or high performance but honestly putting those extra hours on my time sheet and being paid for them is enough for me.

<comment><USER3> I agree with you, and I don't. With the way many companies seem to treat salary, I'd certainly rather work hourly, but that's really not the way salary is supposed to work (or does where I work).

When your hourly, if you start feeling sick in the middle of the afternoon go home, you have to put it on your timecard and it shows on your paycheck. Similarly, if shit hits the fan and you pull an extra 20 hours cleaning it up, you have to put it on your timecard and it shows on your paycheck. Seems fair right? And it is. But both you and your employer are spending a fair amount of effort on simply making sure your _time_ (not work) is accounted for correctly.

Salary done right is when both you and your employer agree to skip the bean- counting. They have around, say, 40 hours worth of work they'd like to hire you to do, and they'd like to pay you 'x' much to do it. Now when it'd a lovely spring day and you decide to take an afternoon walk with your significant other, eh you still get paid the same. All caught up and don't feel like being at the office anymore? Eh take off. Whose counting? At the same time when there's a fire in the server room and you all pull all nighters bringing things back up, no one needs to waste time figuring exactly how much time you spent.

The problem with the way so many companies are doing salary currently is that the company is very happy not to count the extra hours you spend at work, but insist on an exact account of the time you didn't. Hell, they usually even go so far as to give you an allotment of time your allowed to not spend at the office. That double standard is the problem with most salaries, not the concept of salary itself.

</comment></comment><comment><USER4> Halfway through the article, this started to sound like rationalization for paying your employees less. Am I wrong? Should I have read through to the end?

<comment><AUTHOR> I hope it didn't come off that way. You shouldn't be getting paid less, but instead, at bare minimum and equitable amount, and additional if you're the kind of employee who is constantly pushing.</comment></comment>


Ask HN: Do you consider yourself to be a good programmer? - <AUTHOR> if not, why? how do you validate your achievements? <comment><USER2> I'm pretty confident that I am an average programmer. The operating systems class I took in college went almost entirely over my head. I'm pretty sure I got a C- or a D as my final grade and that was only because I ended up in a group that had a few people better than I was. I got C's in a lot of the higher level classes that I took.

The root cause of this, I think, is that I just don't like programming that much. I'm a smart person and I think I could be an above average programmer if I applied myself but I just don't care enough to do so. There are other things that I enjoy more that I want to spend my time and effort on.

I thought that this would be a problem when I graduated but it turns out that the world needs average programmers. My current project at work is a Windows Forms app written in C# to pull data out of a database and plug it into a Word template to generate a Word document. It's not glamorous and it's not trendy but it needs to be done by someone. Pay me a decent salary, give me good insurance, and I'll gladly clock 40 hours a week writing CRUD apps because it beats manual labor, retail, or going back to school.

</comment><comment><USER3> Compared to coworkers in my last two companies I'd say I'm definitely well above average, but not the best. This might sound like boasting, but it boils down to being good at delivering on time, caring about the craft and being motivated to improve things.

I think if you care about what you do, then you're probably already in the upper 50%, because most people don't, and it shows. Now if you pair giving a fuck with some programming talent and interest in improving your skills and productivity you can easily get into the top 10%.

To get into the top 1% you need to be very focused on programming. I have too many other hobbies to be that focused only on this aspect of my life. But I'm ok with that.

If you start comparing yourself to internet people, there are just too many that you can compete with them on everything. There are too many experts in too many niches that you could read all the HN articles and compare favorably in comparison.

<comment><USER4> Never mind caring, in my experience a lot of people in this industry struggle to even write working code. You might not see them much in startups but do some work for enterprises and you soon discover there are a lot of them. They usually make up for their lack of technical skills with an abundance of political activity.

<comment><USER3> I know exactly what you mean.

</comment></comment></comment><comment><USER5> I care deeply about my craft. My code is as simple to understand as I can possibly make it. I spend almost zero time debugging. (OK, last week I had a WTF??? bug. The black screen turned out to be the lens cap still on.)

I feel no need to validate my achievements.

(This is a little bit trollish, forgive me.) You could use a matrix of pots, pans and knife work as a proxy for a chefs competency I suppose. Or, you know, you could taste the food he creates.

</comment><comment><USER6> > For identifying strengths and weaknesses: "Programmer Competency Matrix":

> \- [http://sijinjoseph.com/programmer-competency- > matrix/](http://sijinjoseph.com/programmer-competency-matrix/)

> \- [https://competency-checklist.appspot.com/](https://competency- > checklist.appspot.com/)

> \- [https://github.com/hltbra/programmer-competency- > checklist](https://github.com/hltbra/programmer-competency-checklist)

<comment><USER7> Don't read too much into that. TDD for example is not leveling up it's an opinionated approach to development.

<comment><USER6> Automated testing is not a choice in many industries.

If you're not familiar with TDD, you haven't yet achieved that level of mastery.

There's a productivity boost to being able to change quickly without breaking things.

Is all unit/functional/integration testing and continuous integrating TDD? Is it still TDD if you write the tests after you write the function (and before you commit/merge)?

I think this competency matrix is a helpful resource. And I think that learning TDD is an important thing for a good programmer.

<comment><USER8> There is absolutely no need to follow TDD to be good at testing.

<comment><USER6> This is all unfounded conjecture: it seems easier to remember which parameter combinations may exist and need to be tested _when writing the function_ ; so "let's all write tests later" becomes a black box exercise which is indeed a helpful perspective for review, but isn't the most effective use of resources.

<comment><USER9> IMHO being convinced that there's only one true and correct methodology (TDD, Scrum, etc.) or paradigm (functional, objective, reactive programming, etc.) is a sign of being a bad programmer.

<comment><USER6> A good programmer finds common attributes and behaviors and organizes them into namespaced structs/arrays/objects with functions/methods and tests. Abstractly, which terms should we use to describe hierarchical clusters of things with information and behaviors if not those from a known software development or project management methodology?

And a good programmer asks why people might have spent so much time formalizing project development methodologies. "What sorts of product (team) failures are we dealing with here?" is an expensive question to answer as a team.

By applying tenets of Named agile software development methodologies, teams and managers can feel like they're discussing past and current experiences/successes/failures with _comparable_ implementations of approaches that were or are appropriate for different contexts.

To argue the other side, just cherry picking from different methodologies is creating a new methodology, which requires time to justify basically what we already have terms for on the wall over here.

"We just pop tasks off the queue however" is really convenient for devs but can be kept cohesive by defining sensible queues: [kanban] board columns can indicate task/issue/card states and primacy, [sprint] milestone planning meetings can yield complexity 'points' estimates for _completable_ tasks and their subtasks. With team velocity (points/time), a manager can try to appropriately schedule _optimal paths_ of tasks (that meet the SMART criteria (specific, measurable, achievable, relevant, and _Time-bound_ )); instead of fretting with the team over adjusting dates on a Gantt chart (task dependency graph) deadline, the team can

What about your testing approach makes it ' _NOT_ TDD'?

How long should the pre-release static analysis and dynamic analyses take in my fancy DevOps CI TDD with optional CD? Can we release or deploy right now? Why or why not?

'We can't release today because we spent too much time arguing about quotes like "A foolish consistency is the hobgoblin of little minds, adored by little statesmen and philosophers and divines." ("Self Reliance" 1841\. Emerson) and we didn't spec out the roof trusses ahead of time because we're continually developing a new meeting format, so we didn't get to that, or testing the new thing, yet.'

A good programmer can answer the three questions in a regular meeting at any time, really:

> 1\. What have you completed since the last meeting?

> 2\. What do you plan to complete by the next meeting?

> 3\. What is getting in your way?

And:

Can we justify refactoring right now for greater efficiency or additional functionality?

</comment></comment></comment></comment></comment></comment></comment><comment><USER10> I'm a shitty programmer. I've written code for gameboy, playstation, servers in C, assembly, mobile apps, tons of backends, a CPU simulator, assembler & disassembler. I'm in a leadership role now, but still hacking go, javascript/typescript, python, & prolog for the love of it. But am I a good programmer?

Not even close.

Ever heard of Jeff Dean, Linus? Carmack? Norvig? Then when I look at the multitudes of opensource projects in Github, I can only stay humble. I'm average at best if that.

</comment><comment><USER11> No but I don't have to be good because 90% of all software is stupid CRUD.

<comment><USER4> I don't do a lot of CRUD but it always struck me a lot of this work should be configuration rather than coding.

</comment></comment><comment><USER12> What is a "good programmer"? What would you like to accomplish by soliciting the feedback? Without agreeing to a common definition and measurement, it's not a well-founded question.

I don't think of myself as a "good programmer" because "good" is too blunt a qualitative measure to be productive. It's a disagreeable and poorly specified measurement. I haven't seriously thought about whether or not I'm a good programmer, just as I haven't thought about whether or not I'm a good person. In fact I consciously disengage from assessment like that.

I validate my achievements on a case by case basis, and I validate them according to how close I came to maximal efficiency and minimal time in accomplishing a task. It would be deceptively attractive to use those two heuristics as a rhetorical scaffolding for the meaning of "good", except that I don't compare achievements; they're mostly orthogonal.

The question of whether or not I'm "good" has no meaning for me, because I only evaluate performance within the confines of discrete tasks and sets of related tasks. Further I personally don't have enough insight into the difficulty of all possible tasks, so I refuse to generalize my performance on any particular subset of them to how well I'd do on a majority of them. And to the extent that there are only so many tasks and skills are transferrable: any given task may have differing dimensions of deadline, efficiency or implementation requirements. To get a useful measurement, you'd have to draw arbitrary lines in the sand across each of these dimensions _and_ convince everyone else in discussion that these lines are the sensible ones.

This probably isn't a satisfying answer. But it's not intended to be. The idea of a "good programmer" is conceptually attractive but practically meaningless.

<comment><USER2> The question has nothing to do with whether anyone is actually a good programmer or not - the OP asked "do you _consider yourself to be_ a good programmer?".

It's a question about how you view yourself, not about objectively comparing your programming skills to someone else's, therefore it doesn't require a common definition or measurement.

<comment><USER12> Yes, exactly. And such a question would still have utility - despite being a subjective assessment - if the measures of the assessment were common. But that's not the case here. Not only are respondents subjectively assessing themselves, they're subjectively assessing themselves according to arbitrarily different measurement criteria which they need not disclose.

Therefore, the only thing anyone can conclude from responses is, "For some definition of 'good programmer' which is specific to each individual respondent, approximately _x_ % of respondents believe they satisfy the definition." It's one thing to solicit opinions; it's another thing entirely to open the floor for opinions which may not even be the same. The OP may have received personal assessments and anecdotes about steak, apples and cauliflower when their intention was to solicit personal assessments about almonds.

</comment></comment></comment><comment><USER13> I would consider myself a very average programmer. I have some good experience and a good knowledge set, but I'm not super passionate about programming to drive myself to be a "great" programmer.

edit: I think the biggest thing holding me to being average at best is practical experience in larger systems. In school, I was always good at the theory parts of computer science, but did so-so in projects. In my professional experience, I think that still holds true: I can manage language intricacies, and write pretty clean code for smaller problems, but I can get into trouble with architecture-level stuff like defining models. I also have a tendency to over-engineer solutions to complex problems.

</comment><comment><USER14> Comparing yourself to people on the internet is pointless so I'll skip that. I've been working for about 5 years and out of the technical people I've worked with I'd say I'm a better programmer than exactly one.

At times it's because of laziness (didn't read up on X), at other times due to temperament (I refuse to hold on to easily googl-able information), but frequently it's because of limited working memory or lesser ability for abstract thought.

I'm aware of impostor syndrome but I'm not sure this is a case of it.

This isn't stopping me from contributing on every team I'm a part of, getting consistently good feedback, getting interviews however. I feel in general, as you can get most things done given enough or even close to too much time, then you are generally valuable.

</comment><comment><USER15> No, at least not compared to some of the people that I work with. I really like the creative parts of programming, but I actually have a really hard time getting into a headspace where I can pick up a problem and just go. I can produce a high-quality product quickly enough that my employer is happy with my performance, but I don't feel like I have the kind of raw talent that makes someone really good. I miss doing things where I spend most of my day working with humans. I don't feel like I'm making the most of my time by doing dev work.

</comment><comment><USER16> I consider myself capable enough to solve most problems in an average way.

</comment><comment><USER17> I consider myself able to be a good programmer but I have no experience.

I'm a mature student studying a computer science degree at distinction level however my overall lack of experience is obvious to me. I know how to program the way I've been taught but I don't have the experience to say whether what I'm doing is any good.

I also have no idea where to find out whether what I'm doing is right or wrong.

</comment><comment><USER18> I consider myself a lazy programmer who is also very hardworking.

As in instead of solving the problem at hand I'd rather spend a week working on my own framework so that I could save 5 minutes should I have to deal with the same thing again in future although the chance of it happening is 1 in 100.

</comment><comment><USER19> No, because I don't finish my projects and I haven't written anything I consider good.

</comment><comment><USER20> Nah, but I get by.</comment>


Show HN: I wrote a utility for reading Xbox 360 HDDs - <AUTHOR> https://github.com/landr0id/Up

<comment><USER2> It's great.I'm not in the Xbox scene anymore but there is a huge lack in Xbox360 software that is not Windows only.

A lot of the use of tools like this comes from users who have "jailbroken" their console and can freely move games on and off the hdd. As most things are signed to the console or profile.

Out of curiosity what prompted you to make this? Was it just about learning QT or did you feel there was a need for multiplatform FATX explorer?

<comment><AUTHOR> A little bit of both. I'm not sure if you saw my previous comment, but I was also the developer of Party Buffalo [1], which is Windows-only and C#. I wanted to learn a little bit more C++ and Qt. The project was a great C# learning experience for me when I was 13 and wrote Party Buffalo because I had to develop my own I/O classes, and it involved a lot of different concepts. Plus, there has never been a multiplatform FATX explorer.

[1] <http://clkxu5.com/about-party-buffalo/>

</comment></comment><comment><USER3> +1 looks legit.

<comment><AUTHOR> Hey thanks! When I was about 13 I started working on a similar app in C# [1] which was REALLY popular, but the code base was sloppy and I didn't really know what I was doing. I made this utility because there is currently no cross-platform solution, and since it's written in C++/Qt, it will work on most platforms.

<http://clkxu5.com/about-party-buffalo/>

<comment><USER3> Man that link looks so suspicious! lol. At 13 though?! wow! thats pretty impressive.

<comment><AUTHOR> Yep! Thank you. It's also a neglected blog which got a lot of spam, so it doesn't shock me that someone would say that.</comment></comment></comment></comment>


Incredible Working Factory Made With Lego Robots - <AUTHOR> http://singularityhub.com/2011/04/20/wow-model-factory-made-with-lego-robots-moves-48-items-per-minute-video/

<comment><USER2> I was expecting this to be building things rather than sorting them, but the designer deserves props regardless.

Also, seeing the robot from the 2nd angle (the camera in the middle of the room) really put this contraption in perspective and blew me away. Those robotic arms are really something else. The amount of amazing things people create out of lego never ceases to amaze me.

<comment><USER3> Yea, the first angle in the video doesn't do it justice. On his blog, he states the entire thing is around 12 feet long. Incredibly impressive stuff, especially the programming needed to get the arm pickup to be so accurate. If you want to see more pictures, descriptions, check out his blog post here: [http://tinkernology.blogspot.com/2011/04/quad-flexpicker- nea...](http://tinkernology.blogspot.com/2011/04/quad-flexpicker-nearing- completion.html)

</comment></comment><comment><USER4> I won't start worrying until it can build other Lego factories.

<comment><USER5> With a bit of Java, he can create a LegoFactoryFactory!

</comment></comment><comment><USER6> It seems to be more of a block sorter than a factory; admittedly, that's only slightly less impressive.

</comment><comment><USER7> would be incredible if it could assemble other lego kits from pieces in a bin/conveyor belt.

<comment><USER8> That actually has been done: <http://www.youtube.com/watch?v=4YZeX8ti7Io>

<comment><USER7> amazing.</comment></comment></comment>