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I've seen people drink themselves over the course of a year into a state of health similar to what you allude to with "a year of meth, oh my". I've also known meth users who were highly functional and used it for years with no significant health issues. All in all, I'd say they're about equal.



I don't doubt your personal experience. Statistically, your friends are outliers.


Where do you get statistics on occasional/light illegal drug users who have no contact with law enforcement or mental health researchers? People with jobs and families have a lot more to lose by admitting to the wrong person that they sniffed $50 of coke at a party last weekend than by admitting they chugged $50 of booze and almost choked on their own vomit (for example).


Great points, and much more succinct than mine below.

I think your point is exactly what I mean about romanticizing alcohol. People practically brag about how hungover they are, or how much they drank. Shared misery.


Heroin is an opiate, and opiates do almost zero damage to the body. I know meth and heroin have culturally maintained their status as horrific amoungst young people despite the drug war's campaign of misinformation, and opiate addiction is a horrific thing, but clearly these drugs are not what you think they are.


Whilst this is largely true, there are plenty of opportunities for harm from contaminated or adulterated drugs, blood-bourne disease from needle sharing, and all manner of peripheral damage from poor injection technique or inappropriate routes of administration. And, of course, the ever-present risk of overdose due to wildly varying purity.

Of course, almost all of those things apply to other drugs when injected as well, but there is some evidence to suggest long-term use, even medically, can lead to Opioid Induced Hyperalgesia[1], which is definitely not harmless.

I'm not disagreeing with you entirely, but I wouldn't paint quite such a rosy picture.

[1] https://en.wikipedia.org/wiki/Opioid-induced_hyperalgesia


Regarding your first paragraph, almost every hazard you mention is a consequence of prohibition, not an innate hazard of opiates themselves.

Illegal drugs get adulterated due to black market actors looking to pad their margins. Needles get shared because they're not legal to buy OTC. Poor injection technique and inappropriate routes of administration occur (in part) due to the desire to hide drug use. Those two items would probably be lessened if addicts had the same access to education that diabetics do.

And wildly varying purity is not something you find in drugs bought from a pharmacy, but is found from sellers operating in the shadows.

Cigarettes and alcohol do not suffer from these things, because they're legal and regulated.


> Regarding your first paragraph, almost every hazard you mention is a consequence of prohibition, not an innate hazard of opiates themselves. > Illegal drugs get adulterated due to black market actors looking to pad their margins.

There was a group that offered free purity checks for MDMA (ecstasy) around 1999-2000 and they performed the service at raves. They announced that they would appear at a party I went to in the Midwest, but didn't operate because the police announced that the group would be arrested on site if they ran any tests. A warehouse of people took unknown substances without a basic safety net because the cops weren't willing to concede that this would have been a public service that might actually do some good.

I stopped taking ecstasy about a year later because the increasing impurities made us feel awful the following day, but not before taking many doses that had who knows what in them. As such, while I am somewhat moderate in my stance on decrimianization, I also believe that the authorities are largely responsible for the mess that drug use can create.


> Needles get shared because they're not legal to buy OTC

-_-

Seriously, fuck this bullshit. Syringes with needles and isopropyl alcohol not being sold without prescription. I'd laugh if it wasn't so sad.

I complain about anti-depressants and some other drugs not being available OTC, but this... just why...


This is me being naive I guess, but isn't anti-depressant withdrawal super dangerous mentally? Not sure I'd want that to be OTC if that's the actual case.


Yes it is, but imo it's also a reason for it being OTC - you get diagnosed by a doctor, you go get what you're prescribed (without that piece of (e)paper).

If you can't get a prescription, or if you move, you're gonna have some bad time...

Then again, I think people should be able to get what they want, but that's clearly stupid if applied to the average...


> opiates do almost zero damage to the body

People overdose on opiates and die.


They also do that with acetaminophen awfully lot.


Do you have a source for these statistics? I know hundreds of people who have taken meth/speed during the weekend for years and are working, functioning people.


Street meth or pharmaceutical meth?


Yes, maybe in one focus they are outliers, but the assumptions and parameters of the statistic should be qualified before dismissing the true harm alcohol causes. It's like the 'how would you like to die' game, slow or fast.

A DUI can be fatal on your first drunk at any age. I know personally of a college roommates brother, who was a straight A student, and got drunk for the third time in his life, and wound up killing somebody with his car. He went away for manslaughter. I'd say the side-effect there was pretty 'oh boy' for him and the victim. Think of how many people you may have seen go into a car after a few drinks, and how many of them actually got pulled over or fined for DUI. A lot of people drive under the influence and fly below the radar of the statistics. I have acquaintances and business associates who have been doing it for years.

Heroin and meth are stigmatized, and not a industrially-produced, government-controlled product like alcohol. They are almost always impure with other deleterious ingredients. Pure heroin used to be released on purpose in my old neighborhood in the 70s and 80s under somebody's 'brand' to hype sales of their 'product' for a few weeks even at the expense of a few overdoses.

Alcohol is under government regulation per % of alcohol per type of beverage, health inspections, and additives. People have a casual drink at lunch, but you don't see somebody whip out a needle at a casual business lunch, so meth and heroin tend to be relegated to dark alleys, loners at home, parties, etc...

The typical photo of a toothless, emaciated person comes from the side-effects of societal stigmatization, remaining in the shadow of crime, and less acceptance for that type of substance. There are plenty accounts of functional heroin addicts, and I knew/know a few personally. Their colleagues would never know. They eat right, go to work, and just use weekly and sometimes daily.

There are 17 times as many alcoholics as meth addicts per a 2012 study [1]. And alcohol kills slowly. Even the healthiest person who has 3 or more drinks a day is putting mileage on their body, the liver in particular, not to mention the mental effects. Choose your poison - one's government and socially embraced, the other(s) are associated with criminals and 'addicts'.

For a quick, non-academic feel of what I am trying to convey, watch and compare 'Requiem for A Dream' with any of the 'Hangover' movies. Can you find a meth/heroin movie like the 'Hangover' movies? A comedy that a broad range of people view and laugh at. Why not? The movie has what, 2 sequels already?

[1] https://www.drugabuse.gov/publications/research-reports/meth...


During the 80's and the early 90's, the city of Zurich (Switzerland) had an area where the use of hard drugs was legal. Eventually, in '91, the area was closed because the consequences were disastrous. See for instance: http://www.tagesanzeiger.ch/extern/storytelling/needletrauma...

I'm not saying that the use of alcohol is harmless, and surely there will be people who can have an almost normal life while using hard drugs, but the stigma that hard drugs have is not coming out of nowhere.


>Can you find a meth/heroin movie like the 'Hangover' movies?

Well, there is Trainspotting, but that's a much darker form of comedy...


You are not wrong in your assessment of some of the unfairness of the stigmatization, but alcohol does have some advantages that led to this position.

A) It's "more than just a drug", it's a food. It's actually a food that can taste quite good to be honest. Many other things (especially synthetics) in contrast taste very nasty (usually very bitter).

B) Alcohol has a pretty good dose-response curve. In contrast, dose-response issues are a problem with most synthetics and even injection oriented drugs like heroin -- it is usually "all at once" being difficult to dose any other way. As a result, it is more difficult to build up to a desired level of effect without going overboard.

The stimulant of choice in most of the world is not meth, it is either coffee or tea. These have similar advantages that alcohol does (moreso actually since neither are as damaging or addictive). Consequently, coffee or tea is actually far more socially integrated, and less regulated than alcohol!

I have heard of people using synthetic stimulants in a kind of similar way one would have a few beers at a party (eg as a pep up, to get through a cram or all nighter etc.), but usually when I hear about that it's something like Adderall (aka government regulated, mg clearly stated, etc. amphetamine). Using such off-label is the same sort of illegal in a way, but it seems to have far less social stigma.

Meth has medical uses at lower dose, but stimulant abuse (which due to stuff like Adderall is probably the main case for meth) is all about the "euphoric" dose. That dose is less like someone is having a few beers at a party and more like going for an entire fifth of hard liquor in short order. At that level, damage occurs for any drug pretty fast.

But certainly, there's some additional social / class issues that exaggerate the impact of many recreational chemicals in people's minds. Cannabis after all has a pretty good dose/response curve, and is not terribly offensive in taste, yet for a long time it had a huge stigma as well.


Taste is very subjective, and sometimes acquired. Most children do spit-takes upon a first sip of whiskey or beer, so alcohol being tasty is debatable.

The drug effects of alcohol certainly seem to be a large part of it given how few non-alcoholic beers sell, although kombucha has very low alcohol and is popular amongst healthy eaters.

I don't ever view beer as "more than just a drug, it's a food", since those are empty calories, and the damage done by drinking just 3 or 4 drinks at a time is not worth it for me.

The body tries to rid itself of alcohol as fast as it can. Surprisingly, the blood alcohol level of somebody who has 1 2oz. shot of whiskey each hour for 4 hours (8 ounces) is around 0.10%, and if you drink it all at once it is 0.15%, so even drinking over a longer time isn't 'the right way to drink' as some profess.

Ask yourself when was the last time you went out for a social occasion and drank 4 or more sodas in an hour, or 12 to 20 on a weekend night out? Or substitute orange juice, milk or even water into that thought experiment.

The body cannot keep up with the alcohol dosing. Over time, the liver becomes more and more damaged and cannot as efficiently handle it, but unlike a car filter, you can't get your filters changed that often. The damage is accumulative. It cascades from a failing liver, stomach and other tissues over time like cancer.

When studies or people claim the benefits of 1 to 2 drinks of wine per day, I always wonder why there isn't such a push for other healthier options of lower alcoholic fermented foods. Or simply eating grapes, or drinking an occassional grape juice.

Maybe it's my age or sober bias, but I find that I have wandered away from watering holes, and watching people get drunk, or laughing at things that just aren't funny to me unless you're intoxicated. As a side-effect, I have more money and sober time to enjoy the things in life I like like skating, swimming, climbing and reading.


Right, I understand the personal opinion. I'm just explaining why I feel alcohol has less stigma (aside from obvious historical class / race bias) and probably always will.

By "more than just a drug, it's a food", I mean in usage. It's made with food. People cook with alcoholic beverages all the time. A large part of some alcohol culture is pairing alcoholic beverages with food. When cooking with alcohol, a large percentage of the intoxicant is boiled away, so there is something to the flavor contribution as well. It makes sense given that it's a fermented food. (I do feel it is somewhat acquired, but a lot of foods are to be honest.)

Some people do binge on 4 or more sodas at a time. Some American stores sell 100-128 oz to-go soda containers after all. :) Even the "smaller" 7-11 Double Big Gulp, at 64 ounces, is over 5 standard serving (12 ounce) soda cans. Account less for ice, but still I bet it's over 4. Soda binging may not quite be as bad for your health as ethanol binging, but it's not exactly healthy either. On the other hand, there's nothing really wrong with a standard size soda every now and then. It is "empty calories" (like ethanol) but there's room for treats in life.

Many alcohol watering holes aren't exactly dens of moderation (4 drinks in a night really isn't). I am personally wonder if the "benefits of 1 to 2 drinks" is more the benefits of a moderate lifestyle in all aspects of life.


My city has a reputation as having a heroin problem. I see a lot more alcoholics out on the street than heroin addicts.




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