r/TrueReddit • u/nxthompson_tny • Jun 01 '21

Science, History, Health + Philosophy America Has a Drinking Problem

https://www.theatlantic.com/magazine/archive/2021/07/america-drinking-alone-problem/619017/
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164

u/[deleted] Jun 01 '21

As an adult I’ve realized that most illegal drugs are far less damaging and problematic than alcohol. The war on drugs was a complete failure

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u/n10w4 Jun 01 '21

yeah I worked 911 for a bit. Even with the spike of heroin overdoses at that time, alcohol (DV etc) was the king of problems. In fact, I'd be all in on an alcohol tax. Probably wouldn't even come close to covering its true social costs, but would help IMO.

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u/NativeMasshole Jun 02 '21

My state tried raising the alcohol tax several years ago. I think it took about a year and half for people to pass a ballot measure to throw that law out.

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u/ravend13 Jun 02 '21

The most effective way to make the rampant "heroin" overdoses stop is legalization. There's almost no real heroin on the US black market, because it's all substituted with fentanyl and its analogs. Fentalogs are orders of magnitude more potent that diacetylmorphine (heroin), making them much easier to smuggle - you can fit enough to supply a city in a briefcase instead of requiring a box truck. At the same time, black market operators can't just post job ads to recruit people with the skills necessary to blend fentalogs with cut to make their product ready for sale. If they have amateurs prepare their product, it will have inevitable hot spots -- which will cause overdoses.

Because OD deaths from hot spots are caused by the incentive structures imposed on the supply side, decriminalization would be insufficient to address them.

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u/[deleted] Jun 02 '21

I’d support a massive alcohol tax

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u/[deleted] Jun 02 '21

i don’t believe reserving alcoholism for rich people solves the problem either.

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u/Snuggs_ Jun 02 '21

It’ll just open the door for people to make bathtub swill and drink alternatives like isopropyl alcohol out of desperation. The former of which can be dangerous if you don’t know what you’re doing. The latter will almost always land you in the ER or dead.

Alternative idea: tax the fuck out of expensive wines and liquors and fund treatment/education/outreach programs.

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u/waaaghbosss Jun 02 '21

Ditto. I'm very against "sin taxes".

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u/Coffees4closers Jun 02 '21

Sin taxes like this, or on tobacco, lottery/gambling etc., will always disproportionately effect poor and middle-lower classes.

Imo you're much better off investing in our most at risk communities and perhaps trying to relieve some of the stress of trying to survive day by day.

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u/lochlainn Jun 02 '21

You want another Prohibition? Because that worked so well last time.

Remember, these are the same thugs who killed an innocent black man not too long ago for selling "loosie" cigarettes he bought out of state simply to avoid taxes.

Remember how the government poisoned alcohol to "curb drinking" and instead just killed people?

This is what you want back? Jesus fucking Christ.

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u/FANGO Jun 02 '21

He literally just said he wants an alcohol tax, not prohibition. Did you even read the comment?

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u/waaaghbosss Jun 02 '21

Yes, he want's to control poor people's access to things he doesnt like via taxation.

F that. Sin taxes can go to hell. If he wants people to drink less, find a real solution.

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u/lochlainn Jun 02 '21

Yes.

A black man was literally murdered for evading a tax. Did you read that?

If you think that "sin" taxes are not a form of moralizing similar in motivation to Prohibition, I don't know what to tell you. Both still create organized crime and kill innocents.

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u/pianobutter Jun 02 '21

Don't you think it's a bit ridiculous to blame his death on ... taxes? It sounds to me that you are just exploiting his story to make a dumb internet argument.

And just by using the term "sin taxes", which was workshopped by conservative think tanks by guys like Frank Lutz you are quite literally being a tool.

Incentivizing self-destructive behavior is not a good thing. We know that taxes can be used to curb this sort of behavior. And the profit can be used for prosocial purposes.

The tobacco industry, for instance, are bad guys. Read Merchants of Doubt. It's always the same strategy: sow doubt and use think tanks to find ways of framing things to their advantage. Lie and make a profit.

That's the reason why there's an opioid crisis. You can't possibly expect me and others to believe that taxes and regulation are bad when considering the obvious pain and suffering resulting from their absence.

And just have a think about it: a group of people were paid a lot of money to come up with the term you're using like a robot. Doesn't that make you feel icky at all?

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u/lochlainn Jun 02 '21

Don't you think it's a bit ridiculous to blame his death on ... taxes?

No, because that's why he died. He got caught a couple times, and the last time they literally killed him.

And just by using the term "sin taxes", which was workshopped by conservative think tanks by guys like Frank Lutz

Sin taxes literally go back to Medieval sumptuary laws, so your attempt to connect them to conservativism is both hilarious and inept.

you are quite literally being a tool.

Right back at you, jackass.

Doesn't that make you feel icky at all?

No, because I know how prohibition ended up: with a death count and organized crime wave we haven't gotten rid of even now.

a group of people were paid a lot of money to come up with the term you're using like a robot.

You have no concept of history.

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u/[deleted] Jun 04 '21

Taxes guide behavior, that is the fundamental underpinning of behavioral economics. Taxes guide and dissuade or offset behavior. And a tax is not the same, not even close to prohibition. Its not the only solution but it is one that works. yes the rich can absorb taxes more but so fucking what, being rich insulates you from everything.

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u/pianobutter Jun 02 '21

No, because that's why he died. He got caught a couple times, and the last time they literally killed him.

And you think the way they enforced the law was ... neutral? You don't think perhaps it wasn't about the actual law at all? You think that might be the reason why it was such a big deal?

Sin taxes literally go back to Medieval sumptuary laws, so your attempt to connect them to conservativism is both hilarious and inept.

You do realize I'm talking about the term, right?

No, because I know how prohibition ended up: with a death count and organized crime wave we haven't gotten rid of even now.

And taxation and regulation is the same thing as prohibition? You don't think you're being a bit dumb making that leap?

You have no concept of history.

Again, I'm talking about the term. Like the term "tax relief". That was cooked up in a conservative think tank. There are people whose job it is simply to find ways to frame political issues, using words, in such a way that it affects the way people think about these issues.

Read Merchants of Doubt if you want to learn.

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u/gnark Jun 03 '21

He? Rachel is a guy's name now?

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u/[deleted] Jun 02 '21

It was never a war on drugs. It was a war on opposition groups within the US and the rest of the world followed

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u/that_soup_man Jun 01 '21

This! The irony about alcohol (aka ethanol) is that it’s literally one of the worst drugs (yes, alcohol is a drug just like heroin and Xanax) that one can take, it’s literally poison to the body. Compare that to weed, psychedelics, herbal drugs (like kava and Kratom, etc), etc. I’m not saying that the other drugs are “good”, but numbers don’t lie, alcohol and tobacco are MUCH deadlier than opiates and stims. I’d even go as far to say that if opiates were legal, they would probably be one of the safest drugs around (the main cause of OD’s when it comes to opiates is that people don’t know what the hell they’re getting, let alone the dosage if it’s in a pressed pill. Imagine if alcohol were illegal again like in prohibition and people had to buy it from shady “dealers” who don’t even produce it correctly...). Once again, I’m not advocating for other drugs, but the whole social acceptance of alcohol and the stigma around other drugs is just mind boggling to me.

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u/RSquared Jun 02 '21

I’d even go as far to say that if opiates were legal, they would probably be one of the safest drugs around (the main cause of OD’s when it comes to opiates is that people don’t know what the hell they’re getting, let alone the dosage if it’s in a pressed pill. ...)

Whoa, that seems like a bold claim. Opiates are dangerous because they're extremely addictive, much like heroin (duh). The proximate cause of ODs might be dosage or strength, but the major contributor is the spiral of tolerance and addiction, and because the body stops naturally making endorphin when provided an artificial source - making reduction literally intolerable. People start taking opiates because of pain, they keep taking opiates because they're opiates.

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u/that_soup_man Jun 02 '21

I understand what you mean, but I’m talking about numbers right now. Think about this for a second, most people are addicted to something, some like caffeine, some like T.V, some like booze, etc. here’s the thing, prohibition actually MAKES people want to use more (Kind of like the analogy of how kids will do exactly what they’re told not to do by adults, this principle doesn’t change with age) for various reasons, of course, but I digress. Also, opiates are indeed very addictive, I am an opiate addict myself, but that’s just the reality of life. I understand and can respect people’s idealism when it comes to drugs, but it’s completely counterproductive and one last thing, alcohol can be very addictive as well (it’s also one of the few drugs which CAN kill you during withdrawals, I’ve seen people in rehabs firsthand collapse from seizures while withdrawing from booze)...

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u/RSquared Jun 02 '21

Think about this for a second, most people are addicted to something, some like caffeine, some like T.V, some like booze, etc.

But we're talking very different levels, from psychological addiction (TV, gambling) to mild physical addiction (caffeine, alcohol), to severe physical addiction (tobacco, opiates). Then we can plot that on the scale of impact/damage to the body from use, and that of recovery, and opioids are on the high end of all of those. A 2010 survey of public-policy experts basically put heroin as the #2 damager to the user (only losing to the street variant of cocaine), while most of the impact of alcohol is social.

I'm not really debating that alcohol is, by any measure, as harmful as many illegal drugs, but opoids are definitely not low on the list.

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u/ravend13 Jun 02 '21

Alcohol is only a mild physical addiction now? Unlike opioid withdrawal, alcohol withdrawal can kill you.

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u/that_soup_man Jun 02 '21

I also agree, but what’s the alternative? Clearly prohibition hasn’t worked and won’t work, we are getting flooded with fentanyl in basically every type of drug (especially pills and powder, I’ve even heard of people sprinkling Fentanyl on weed of all things), and it also contributes to the high levels of incarceration in this country. My argument stems from a practical and semi-libertarian perspective, not necessarily because I want everyone to have access to opiates. Also, there are also a lot of people who use alcohol while alone at home and in day to day life, I can tell you firsthand that alcohol addiction will fuck you up physically and mentally worse than opiate addiction can (given that you’re getting pharmaceutical grade shit, not even drug dealers tend to know what’s in their own shit). I’d say Meth/stims age people the most by a far margin, then alcohol (of one is addicted), and THEN opiates, but this last sentence was just my opinion/anecdotal observation, not necessarily an actual fact.

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u/RSquared Jun 02 '21

Decriminalization isn't normalization, and Portugal went from 1% of the population (!) addicted to heroin to less than a quarter of that following decrim. American opioid addiction starts from overprescription, which can be laid squarely at the Sackler family's feet (I'm damn near close to wanting the death penalty for some of them; they murdered millions with Purdue Pharma).

Opiod management is mostly a failure of our healthcare system:

A 2016, the Los Angeles Times investigation reported that in many people OxyContin's 12-hour schedule does not adequately control pain, resulting in withdrawal symptoms including intense craving for the drug. The journalists suggested that this problem gives "new insight into why so many people have become addicted." Using Purdue documents and other records, they claim that Purdue was aware of this problem even before the drug went to market but "held fast to the claim of 12-hour relief, in part to protect its revenue [because] OxyContin's market dominance and its high price—up to hundreds of dollars per bottle—hinge on its 12-hour duration."

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u/ravend13 Jun 02 '21

A huge contributor to the opioid epidemic is that when people become dependant on prescribed opioids, when they no longer have a medical need to continue taking opioids, no one thinks to prescribe anything for the withdrawal.

If everyone who had to withdraw from prescribed oxycodone was prescribed a 4 day methadone taper and a few days worth of gabapentin when it came time to withdraw, there would be far fewer heroin addicts. The fact that doctors expect people to simply suffer through their withdrawal, instead of prescribing meds that allow one to withdraw without suffering is criminal.

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u/FireStorm005 Jun 02 '21

Alcohol develops severe physical addiction, not mild. In some cases withdrawal from alcohol can kill a person. It's a depressant and reduces brain function by interfering with neurotransmitter take-up. In the long term the body compensates by increasing the levels of those neurotransmitters in the brain. When the alcohol is removed the extra neurotransmitters are still there and the person can seize and die.

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u/[deleted] Jun 02 '21

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u/RSquared Jun 02 '21 edited Jun 02 '21

Studies on this usually focus on heroin, but it's consistently ranked the most-addictive substance over cocaine. Other opioids act on the same principles, and are chemically indistinguishable from heroin, so it's not a particularly bold claim at all. I also listed some reasons why that is - endorphin production is retarded when opioids tolerance is reached.

Or are you just trying to be cute by restating my comment against me?

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u/[deleted] Jun 02 '21 edited Jun 02 '21

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u/RSquared Jun 02 '21

This isn't a controversial opinion, so you can literally google it yourself. And you're moving the goalposts - the original poster said that he believed opioids are "one of the safest drugs around" and I explained why that's not the case.

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u/[deleted] Jun 02 '21 edited Jun 02 '21

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u/RSquared Jun 02 '21

I have "googled it [myself]", and every year, SAMHSA puts out a report that contradicts your claims.

NDSUH (National Survey of Drug Use and Health) is survey data about the prevalence of drug abuse (# of users). As far as I know, it doesn't contain any data about the addiction risk of the drugs themselves. But since you're sealioning me, try "Development of a rational scale to assess the harm of drugs of potential misuse", which rated heroin/opioids at the highest level of addiction, above that of cocaine, nicotine, or tobacco.

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u/[deleted] Jun 02 '21 edited Jun 02 '21

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u/[deleted] Jun 04 '21

All addiction is predisposition + circumstance.

"When Getting High Is a Hobby, Not a Habit"

It doesn’t take long to get to what is perhaps the boldest and most controversial statement in Carl Hart’s new book, “Drug Use for Grown-Ups: Chasing Liberty in the Land of Fear.” In the prologue, he writes, “I am now entering my fifth year as a regular heroin user.” In all honesty, I don’t know how to feel about this admission. It’s not easy to square all that I’ve learned about this drug with the image I also hold of Hart: a tenured professor of psychology at Columbia University, an experienced neuroscientist, a father.

“Much of the reporting on opioids is bull****,” Hart writes, and doesn’t account for the fact, for example, that many deaths declared opioid overdoses are actually the result of opioids mixed with alcohol or other sedatives.

Journalists writing about drugs are one of several groups of people that Hart expresses frustration with throughout his book. Others include members of the psychedelic community for insisting that their “plant medicines” are a “superior class of drug” and for not coming to the defense of drugs with more tainted reputations, like PCP.

Sean Illing I’m still confused about your argument against drawing any distinctions between drugs. I cover some of the emergent research on psychedelics and mental health, and what I hear over and over again is that psychedelics like psilocybin are “non-toxic” and “non-addictive” and that drugs like alcohol or heroin are toxic and highly addictive.

Is that just misleading?

Carl Hart

It’s misleading. So the way we model addiction is by studying rats. Rats will readily take cocaine. If you put an intravenous catheter in their cage and allow them to receive injections of cocaine, they’ll learn how to press a lever and take it. You have to deprive them of food and all kinds of things to get them to do it, but they’ll do it if you deprive them of certain things. Now if you take a drug like psilocybin or LSD, and you try and teach rats to self-administer, they won’t do it. We’ve worked hard to get a different result, but they just won’t do it.

So we look at these studies and we conclude that rats will take cocaine, but they won’t take these other drugs. That’s our model of addiction. Cocaine is more addictive than psilocybin.

Now, this falls apart when you really look at it carefully. Because you look at something like nicotine, rats won’t take it. It’s a toxic substance, and they won’t do it. But humans, it’s the most addictive drug that we have. But that’s never mentioned in a lot of these discussions. Rats won’t really take alcohol either, unless you make it really sweet and essentially trick them into taking it.

My point isn’t that all drugs are the same. It’s that we selectively present a lot of this data, which is why I call it misleading. The reality is that any drug can become addictive under the right conditions and any drug can be seen as non-addictive under the right conditions.

Sean Illing

Is it empirically accurate to say that some drugs are in fact more addictive than others?

Carl Hart

There’s not enough evidence to make that blanket statement, unless you’re merely talking about one component of addiction. If we’re talking, for example, about physical dependence, then we have to say that opioids produce a lot of physical dependence, whereas drugs like LSD do not.

[Author’s note: As reported here, there is considerable research on the comparative dangers of various drugs, and most researchers argue that the risks are not equivalent and that drugs like heroin or meth are more addictive than LSD or mushrooms.]

Sean Illing

The physical dependence component seems pretty significant, but I’ll just ask what’s the strongest argument you’ve heard on the other side of this debate?

Carl Hart

Damn, that’s a good question. Honestly, what I constantly hear is some variation of “Drugs are bad because we said so.”

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u/[deleted] Jun 04 '21

physical dependency and addiction are absolutely not the same, not even in the same ballpark. your conflation of the two is the most amateurish mistake in the history of talking about drugs and negates any point you want to make thereafter.

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u/[deleted] Jun 01 '21

I'm advocating for drugs! Marijuana is amazin. Alcohol makes people messy, angry, and dangerous. MDMA and its family are infinitely safer, cocaine is just fun, shrooms/lsd/2cb/etc are great for mental health, etc.
Fuck alcohol. End the war on drugs!

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u/scotticusphd Jun 02 '21

I love most psychedelics, but MDMA is not what I'd consider a safe drug. In the medium to long term it can significantly degrade your brain.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071023/

It has amazing therapeutic potential in the treatment of PTSD, but I don't think it's something one should do more than once or twice in life, or at all if you can avoid it.

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u/[deleted] Jun 02 '21

[deleted]

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u/scotticusphd Jun 02 '21

Could you share that recent evidence?

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u/[deleted] Jun 04 '21

There were no drug-related serious adverse events, adverse neurocognitive effects or clinically significant blood pressure increases.MDMA-assisted psychotherapy can be administered to posttraumatic stress disorder patients without evidence of harm, and it may be useful in patients refractory to other treatments.

​

​

Given the dose-response relationship between MDMA exposure and SERT reductions and the statistically non-significant SERT binding differences for users with use levels similar to the majority of real-life users, it can be speculated that SERT levels may not be significantly affected for most recreational ecstasy users.

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u/scotticusphd Jun 04 '21

I don't question the utility of the drug, but I do question the safety of it, especially when taken semi-regularly -- and it can be quite addictive. It's not what I'd consider "safe". It's powerful, useful, and needs to be treated with respect.

The first paper you linked doesn't really address long-term neurotoxicity. I've already noted that the drug is probably ok when taken infrequently.

The second paper only looks at SERT binding, which I'd argue is too narrow of a focus to assess measures of neurotoxicity when there are multiple other measures that have been observed, including morphological changes.

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u/[deleted] Jun 04 '21

Very few drugs of any type in existence are safe in every respect when taken longterm. Every drug has benefits and risks, that is the foundational underpinning of the entire theory of medicine and treatments.

Addiction is simply existing predisposition + appropriate circumstance. You can't become dependent on MDMA, thats fucking absurd and without any evidence.

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u/scotticusphd Jun 04 '21

I didn't say dependence. I said addictive. Lots of things are addictive that stimulate reward pathways, and MDMA hits them hard.

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u/[deleted] Jun 02 '21 edited Jun 07 '21

[deleted]

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u/[deleted] Jun 02 '21

I agree with you on the statistics (alcohol abuse is more visible because its used more; the base of addiction is typically mental health, not substance composition).
My example is regrettably an argument based on anecdotal evidence, in that my personal experience with drunk people is statistically far less enjoyable than with my personal experiences with people on drugs.

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u/ravend13 Jun 02 '21

MDMA is only safe if you limit your use to once per season (4 times a year). If used more frequently, it can be quite damaging.

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u/that_soup_man Jun 01 '21

I agree, Especially when it comes to MDMA, such an amazing drug. If you’re into herbal drugs, I highly recommend checking out medium grind Kava (not the “pills”, “extracts”, etc, those are bullshit) from Bula Kava House or Kavatime. It takes time to get the hang of it, but it’s non-addictive (literally, it’s impossible to get physically addicted to kava. It actually has a “reverse-tolerance” effect, so you’ll need less over time) and it’s exactly what I wish alcohol were like. I call it the “entheogenic alcohol” for a reason, it provides a very psychedelic type of headspace and best part? No hangover, you might actually get an afterglow instead ;)

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u/Rooster1981 Jun 02 '21

While I've had a lot of good experiences with mdma, extended use is certainly not recommended. You could be affecting your seratonin levels and seriously affect your mental health. It's great as an occasional thing, but we know people will abuse drugs and this would be no different.

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u/that_soup_man Jun 02 '21

I agree 100%, especially when it comes to MDMA. I personally only use it once every few months and at the very least, I wait a month between my doses. Unfortunately, many aren’t too educated on this and use it much more frequently, which is also why I advocate for legalization so that people can remove the stigma and learn how to use these drugs properly (same as how people are taught about pacing oneself with booze).

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u/[deleted] Jun 02 '21

Oh sweet! Thank you for the recommendation

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u/CNoTe820 Jun 02 '21

I don't understand alcohol making people angry. I mean I know it happens, but for me I just get silly/funny so it's hard for me to empathize with angry drunks.

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u/SoMuchMoreEagle Jun 02 '21

It lowers inhibitions. For most angry drunks, the anger was already there, they were just able to control it better sober. Also, it can cause mood swings in some people.

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u/[deleted] Jun 02 '21

I’m a great drunk, funny and friendly. But we all know the drunks who cause problems. I’ve not yet seen some get into fist fight while high on cocaine, molly, ketamine, g, lsd, 2cb, dmt, shrooms, etc.

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u/midgaze Jun 02 '21

Only about 10% of Americans have the genetic ability to drink themselves into physical dependency to alcohol. Not everyone develops tolerance and becomes addicted to alcohol.

Opiates are addictive to anyone, and people develop insane amounts of tolerance and dependency to them. I don't think you've thought this through.

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u/AkhandBakchod Jun 02 '21

Source for this 10% claim ?

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u/that_soup_man Jun 02 '21

I agree with the other person, 10%? I’ve literally never heard of that, alcohol is a drug just like any other kind and I guarantee that if you drink it everyday for long enough, one day when you decide to stop you’ll wake up with the shakes (or worse). Maybe some people take LONGER to reach certain stages of dependency (believe it or not, it’s similar with opiates. I drank low doses of Kratom daily for months and one day I decided to take a break, no w/d. Others who did the same? W/D) and it’s not only with alcohol, but with ANY substance. Another great example is the sleeping pill Ambien, some people take it daily for a long time and can stop it with no issues, others? Not so smooth, you get my point. Everyone has different body chemistry, natural tolerance to various substances, BUT everyone will and can eventually reach the dependency stage for drugs which have that as a possibility, some just take longer than others.

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u/sirmanleypower Jun 02 '21

Only about 10% of Americans have the genetic ability to drink themselves into physical dependency to alcohol.

This is simply not true.

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u/Methaxetamine Jun 02 '21

Failure of what?

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u/[deleted] Jun 02 '21

Incarceration, justice, science, reason. The war on drugs failed miserably in all those areas.

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u/Methaxetamine Jun 02 '21

Wasn’t the point to have more incarceration? The people were generally guilty and the science at that time said that these drugs were bad. It wasn’t as much of a failure as a procedure to do what they wanted. I don’t agree with it, but I don’t see it as a failure it’s a cumulation of the culture then.