Afghanistan, too?

But he has to do something. After all, rich people are dying from heroin and anything that affects rich people is important.

It makes sense to me to limit the supply-side, especially since 90% of the world's supply comes from one country that we spend billions to occupy. However, folks routinely tell me that is sophomoric and you cannot impact drug use from supply-side (see 'war-on-drugs'). Unlike marijuana which you can grow anywhere, 90% of poppy and heroin come from one country, so I do not understand the argument that supply-side will not work. I have a 43yo younger sister who is a 17-year heroin addict who constantly struggles with recovery. She started with Vicodin and graduated to heroin after 20+ Vicodin a day became too expensive. I have been through tons of counseling both group and individual to understand how this impacts me, my sister, and my extended family and dependence is not foreign to me. I agree the war-on-drugs has been an utter failure, but the Afghanistan poppy fields seem to be an exception to me. However, poppy is the foundation of their entire economy and what happens when you destroy the foundation?

I don't have the answers and struggle with this stuff every day.

getting so much richer off it.

Funny how Afghanistan produced only about 10% of the heroin and then our troops went it and it's up to over 90% now. Funny how war works. Will those benefiting from supply (not the users, but those getting richer off the stuff) give it up? Not until US soldiers stop working for these monsters by enlisting. As long as there are US soldiers, there'll be an active hard drug trade in our country.

The soldiers could protect farmers who want to cultivate something else. But they'd have to be ordered to do that on a grand scale. I'm not holding my breath.

And I'm sorry to hear about your struggles with addiction in your family. I know it can be a rough road.

As to controlling the supply--I would note that, while Afghanistan currently produces much of the supply of heroin, there's no reason that it has to. Mexico and Latin America have been gaining market share for a while now. Also, when the Taliban severely limited the poppy fields, other countries (like Burma) stepped up to fill the void.

Latin American poppies supply most of the US market. That Afghan smack is going to junkies from Lahore to London.

185 heroin deaths in MA, 45 in RI, 22 in PA - all in the past 4 months

http://www.nydailynews.com/life-style/health/185-dead-heroin-overdose-mass-cops-article-1.1701795

http://www.providencejournal.com/breaking-news/content/20140117-overdose-deaths-in-r.i.-spike-to-22-in-13-days.ece

more $$$ for law enforcement.

Suboxone seems to be the best possible treatment for heroin addiction. It works and allows people with addiction to focus on the recovery phase of treatment without the physical trauma that often leads to relapse.

There is no good reason that in a nation with this many addicts, we only allow about 10% of them to be treated humanely. It just leads to unnecessary crime and suffering.

What is also needed is more doctors to get 'certified' to use it in their practice, and then be willing to actually do so. Many of them don't want to, for fairly obvious reasons.

Another issue is that many sub docs won't take insurance (and/or many insurances won't cover it) and have very high initial office visit fees (around $300-$500) ... so essentially this is how they weed out the more 'undesirable' patients. Given that many addicts don't decide to give it up and seek treatment til they've lost their jobs, insurance, and spent their last dime on dope, coming up w/the hundreds of dollars to start their sub course upfront can be cost-prohibitive. Junkies have a hard enough time scrounging $20 for their bag from the street, how the hell are they gonna put together $500?

Basically the high cost to get started is almost certainly keeping a ton of people from going the sub route ... but I suspect the docs like it that way. This way 'attracts' a higher 'class' of addict ... or at least those with families who still care enough to help them out w/a loan. It's kinda like how posh clubs in big cities have massive cover fees ... to keep the riff-raff away. What doctor really wants a lobby full of people looking like that one Dave Chappelle character ... the crackhead one ... I forget his name. But you get the idea.

Even if zie has spent zir life eating nothing but milk shakes and Cheetos. (I'm not saying that people with type II have done this, just that we don't make medical judgements this way.* We mitigate the physiological problem first then deal with the behavioral aspect.) Denying a functional treatment based on moralism/greed doesn't fix the problem.

The current limits are still too restrictive, the licensing requirements are still too high a barrier to entry, and the limited insurance/cash situation is hurting everyone.

If it's not clear, I am in agreement with you -- the situation has improved over the last few years versus what it once was, but it's only been a kludgy patch, not a true fix. It has not at all addressed the problem of rural opiate addiction (most clinics that handle suboxone are still in metro areas) and it doesn't address the cash situation at all.

And there is no good way to fix the current situation without addressing the harm-reduction aspect of effective treatment. It would be nice if all addicts had tidy backgrounds, tons of cash and the ability to access the services they need, but a) we would have a lot fewer addicts if that was the case and b) that's not reality. Cracking down without access to a good diversionary system just means more people dying.

*yes, I know, social judgements do exist. They're a barrier to effective treatment, too.

And to be sure, it's a nasty, nasty addiction. But as for whether it's the worst of the worst, I actually think that's fairly debatable. Particularly so if the person is snorting or smoking rather than shooting ... there's many H addicts who don't shoot (although eventually when it gets bad enough, they often start).

There's many reasons I think it's more complicated than just saying 'its the worst', but the primary one is that, believe it or not, opioids are remarkably 'non-toxic' i.e. they're almost entirely harmless to the body. Put another way, their use is not associated with any known organ or tissue damage. Reason being that our bodies are 'built' for them. Their mode of action is just mimicking the bodies own 'feel good' chemicals.

Obviously this assessment is predicated on someone NOT OD'ing, but as long as one doesn't do so, they're not especially 'bad for you'. And also obviously, the issues around a consumer not knowing what actually comes in the baggie, and the excessive use of needles (clean ones being hard to come by in many areas) directly into one's veins complicates that equation as well, but those things aside, being an opioid addict isn't going to kill you in and of itself.

That's in contrast to many other addictions, including tobacco and alcohol, drugs which are known to literally destroy one's body and even one's mind in the case of alcohol. In fact, alcohol actually produces it's high ... by giving you a mild case of poisoning.

Another 'mitigating' factor, if you will, is the fact that withdrawal from opioids is almost never fatal. It's brutal, to be sure, and not something I'd wish on my worst enemy, but it won't kill you. Again, that's in contrast to barbiturates, alcohol, and even the benzos like valium and xanax. And from what I've heard told by a number of people, the w/d's from serious addictions to any of these chemicals is even more brutal than w/d's from opioids. W/opioids it mostly feels like you're afflicted with the absolute worst flu of your life, but at least that's a somewhat 'familiar' experience. W/D's from alcohol and other depressants, is, from what I understand, incomparable to anything else a body normally goes through. And their W/D lasts longer, too.

Meth is also clearly in the running for 'the worst' as well. Esp. the crap that comes from the streets. You wanna talk nasty? The friggin' CHEMICALS people are putting into their body when they use that stuff. Everyone's seen the before/after pics. That shit is some hardcore poison. And staying up for days on end, and not eating (and usually what meth addicts eat is junk food) absolutely wreaks havoc on ones body and mind. It is also extremely well-known for causing domestic violence, hallucinations, and all manner of erratic behavior. The W/D's aren't as acutely nasty as opioids, but quitting that stuff is no picnic, and there's also been studies that show the damage one can do their brain may well be PERMANENT if they do that crap long enough.

At least w/an opioid addiction, it may take a bit, but one CAN recover, and get entirely back to 'normal' (other than always being, in a sense, an 'addict').

Lastly, opioid addiction is the only addiction for which less harmful 'substitutes' (like methadone and buprenorphine) are available, wherein a person doesn't HAVE to go through withdrawals in order to get a semblance of a life back. Pretty much all the other drug addictions, your options are to continue the downward spiral into hell, or quit doing the drug and go through detox, period.

Don't get me wrong ... heroin (and every other opioid) is dangerous and highly addictive, and an addiction to opioids is bad, bad news for the addict. It wrecks lives and families, and it costs society in many ways. But I'm not personally convinced that an opioid addiction ... be that to heroin, oxys, codeine, morphine, or whatever ... is necessarily the worst of the worst (although vicodin is real bad news, cause of the tylenol in it ... you'd actually probably be better off using heroin). In many ways, as far as the 'addiction' goes, for all the reasons I laid out above, it may actually be reasonably considered one of the more benign addictions. At least you're not destroying organs, poisoning yourself, and permanently damaging your brain, you have more options for 'quitting' than w/any other drugs, and the w/d's won't kill you.

Not that I wanna sign up for any of it, but I'd take an opioid addiction over a hard-core alcohol addiction, a crack addiction, a benzo addiction, or especially a meth addiction, any day of the week.

Nope he can't do that---Rather than price supports for Corporate mega farms.

This is how the "world's policeman" does business to bribe his client's who run the shit holes we protect.

Does changing the drug being discussed all of a sudden induce honesty?

Maybe what Holder says is true, but who knows? I'd certainly need to see it from other sources.