The World Health Organization Model List of Essential Medicines is an extensive list of the drugs required to maintain a healthy population. Many of those are addictive Schedule II substances, and heavily regulated. Drugs like propofol (which killed Michael Jackson), diazepam (Valium), methadone, morphine, and fentanyl fall on that list (Source: WHO model list of essential medicines: 21st list).Their use cases are very specific, and VERY temporary. Why? Because recreational use has the SIDE-EFFECT of ADDICTION and/or DEATH.

I believe so many of us are ignorant of the problems that can be created by playing fast-and-loose with prescription medication. Doctors are in no position to create a solution. They trust the pharmaceutical companies blindly, who incentivize them to push new drugs with free weekends of golf. These companies throw billions of dollars at the FDA to fast-track their drugs for approval. They must, for their quarterly earnings reports, lest their investors flee and bankrupt them. The altruistic vision shared by doctors and researchers to create a healthier, happier population has to fit within the paradigm of finance. And this is where the incentives of the investors, regulators, doctors and patients part ways. It is exactly how the opioid epidemic was created. Hundreds of thousands of people, with families and friends who miss them desperately, died because of misaligned incentives, and ultimately, ignorance. That death toll is still rising as you read this.

It is exceedingly easy to cast blame, and point the finger at any (or all) of the above: Wall Street, for its psychopathic pursuit of higher margins; regulators, for being reactionary and punitive; doctors, for prescribing the drugs; or patients, for abusing them. No matter which one(s) you decide to blame, blaming them does little in the way of solving the problem.

As easy as it is to cast blame, it is equally difficult to propose a solution. The only workable solution is going to be one that forces the incentive structure of the financial sector to be aligned with positive healthcare outcomes, rather than quarterly profits. Applying free-market principles to healthcare is literally putting our lives in the hands of psychopathic financial policies. Wall Street's only motivation is realizing profits. They do not care about the consequences to society. Or whether you live or die. People (like their profits) are numbers, and they already have dollar values assigned to them. Consequences to society are supposed to be mitigated by regulations, which they lobby against. The role of government is to protect its citizens. But if a drug starts killing people en masse? The responsible company immediately regresses to a state of victimhood--finger-wagging, blame-casting, and buck-passing. They will spend millions defending themselves in court, while people continue to die. Why? Because liability for someone's death is synonymous with bankruptcy. This is a myopic and self-defeating perspective, and our society is treating the problem as if we are all the victims, and looking for someone to blame. So the cycle of abuse goes.

And yet, the long, ignorant arm of the law has decided someone must be held accountable. They blame the doctors, for prescribing the opioids that led to the epidemic. They are audited, scrutinized, and stripped of their medical licenses. Faced with the prospect of career implosion, they must pass the buck. "I can't be held accountable for someone misusing what I prescribed," or, "PDQ Pharma told me Oxycontin was perfectly safe," as it goes. Regulators and citizens also go after the pharmaceutical companies. Culpability is synonymous with liability. And IF (and this is a BIG if) the pharmaceutical companies are held liable for thousands upon thousands of deaths, then what happens? Decades of litigation and appeals in a class-action lawsuit, where the ACTUAL victims get essentially nil. The companies continue business as usual, until the next population-wide faux pas. And the cycle of abuse continues.

Now, patients who have legitimate needs for narcotic medication cannot get them. Doctors who used to give them away like Pez, now refuse; then, they pass the buck when their patient, in the throes of withdrawal, comes to them for help. "Rehab isn't my forte. Try XYZ clinic, which is the only one, and has a months-long waitlist. And costs a fortune." There are only so many doctors, and so many rehab clinics. Nobody can give or get the care they need. Patients are forced to undergo drug testing, as if their pain makes them criminals. Many of those patients are forced to become criminals, and find similar medicine on the black market. Why? Because heroin is 3-4x stronger and 10x cheaper than pharmaceutical opioids, such as morphine or oxycodone. Why are these patients suddenly labelled criminals? Because our society seems to think the best way to treat addiction is with the CRIMINAL JUSTICE SYSTEM. Who are the victims in these supposed crimes? Are you beginning to see a pattern? Finger-wagging, blame-casting,and buck-passing are acts of desperation. They are done out of fear, out of self-preservation. It is a self-perpetuating, reactionary cycle that, while eliminating some bad actors, will only result in more of the same. More deaths, more scapegoating, more buck-passing.

Let me ask you a question. How do you feel about that? Are you looking to assign culpability to any of the above entities? If so, you might be one of those people who prefers a state of victimhood. You might be one of those who would rather blame and punish than feel compassion and help. And if you are, I urge you to reconsider. Because. You. Are. Part. Of. The. Problem. And we have enough problems. What this world needs right now is solutions. It needs compassion. It needs forgiveness for its own ignorance, so that it can raise its awareness. It needs to end the cycle of abuse, before it kills even more people than it already has.

The United States government's official policy on drug use is abstinence by prohibition. Prohibition was such a terrible idea with alcohol that it was reversed--but, not before it gave birth to organized crime, and resulted in more crime and more deaths overall. That bootlegging infrastructure for organized crime is one that is still used today, for the drugs that remain under prohibition. And abstinence? Find me a school that teaches abstinence-only sex education, and I'll show you a school with higher rates of teenage pregnancy. Why? Because some of those students are going to have sex, and none of them understand how contraception works.

The War on Drugs is a Reagan-era policy, and not much has changed since then. We have been fighting it for about 40 years. So, is it working? Are we winning?

Rather than set the stage for arguments and ignorance to proliferate, let's take a look at the numbers for a country that doesn't need to declare war on a problem to solve it.

Portugal took a radical approach to helping treat the disease of addiction, way back in 2001. The possession of personal quantities of any drug has been decriminalized there for nearly 20 years. No criminal record, no jail time. Perhaps a fine, and a pamphlet with resources such as rehab clinics and work programs. The result? In 2017, there were 3 drug overdose deaths for every million citizens in Portugal (source: https://www.washingtonpost.com/news/wonk/wp/2015/06/05/why-hardly-anyone-dies-from-a-drug-overdose-in-portugal/). By comparison, the CDC stated there were 217 overdose deaths per million citizens in the US in the same year. People are roughly 70 times more likely to die from an overdose in the United States than in Portugal. In fact, that number was so high in 2017 that it actually reduced the life expectancy of all Americans _(source: __https://www.vox.com/science-and-health/2018/11/29/18117906/opioid-epidemic-drug-overdose-deaths-2017-life-expectancy). I doubt those numbers have improved significantly for Americans since then, because the policies driving those numbers have yet to change.

These statistics fail to take into account deaths as a result of chronic use. I know that at least one of those deaths was a friend of mine. I had known him since I was three or four years old--longer than anyone else I can call a friend. Sure, we drifted apart in later years. Addiction has the tendency to shift an addict's behavior toward supporting that habit, no matter who it hurts. He stole some 300 dollars from me to finance his habit, under the guise of helping me finance my own. I couldn't care less about the 300 dollars, but I would have loved to see him have access to the resources he needed to get better. I am sure that his mother, father, sisters, and daughter who miss him everyday would have, too.

So is the War on Drugs working? That would be a big, fat NOPE. If you had the disease of addiction, which country would you prefer to be in? The good ol' U-S-of-A, who says addiction is a crime? Or, would you rather be in Portugal, who decided to take a compassionate approach? If you are an addict in the USA, what are your options for treatment? Be rich enough to afford an expensive rehab clinic, or go to jail. And if you go to jail, you can bet that they will set you up with a halfway house and a menial

job to pay for the drug testing required by probation or parole. What if your addiction is so "offensive" that it results in a felony, like the typical addict/dealer? Good luck getting a job that pays a living wage. Ever. Does this sound like the type of policy that is best suited to treat addiction? Maybe, if you wear a badge or sell drugs. But I digress.

Bear in mind that if you are fortunate enough not to have the disease of addiction in the USA, it is still costing you. Your tax dollars are paying for the incarceration of people with medical problems. If you take a look at rates of recidivism in this country, your tax dollars are helping that revolving door stay open. You are paying for the police officers, prison guards, and court costs. And your insurance premiums are paying for all the uninsured overdoses treated at hospitals--which are for-profit businesses, by the way. Whether or not you agree with me, you are still paying for inefficiencies created by this abhorrent, inhumane set of policies. So this is your problem, too. You are financing a war that cannot be won. Not by you, nor any other tax-paying, insurance-purchasing citizen. And certainly not by the addicts, who can't get the help they need.

Well, there are SOME winners in this War on Drugs. Law enforcement AND drug dealers, to name a couple. Both want these policies to remain in place on account of job security. Perhaps the owners of mortuaries, cemeteries--those in the business of death--might be "winning," so to speak. They are getting more business, anyway. Let us not forget investors in private prisons, who actually PROFIT from higher incarceration rates. I bet they are doing quite well, considering the USA incarcerates more people per capita than any other country--at a rate of more than 5,000 prisoners per million citizens. Nowhere else in the world compares. So, I guess the USA is still number one at something.

The costs of overdose deaths can be measured in dollars and cents, to be sure. What about the families of those who have died of overdoses? They miss their loved ones everyday. I bet they would give anything to go back in time and move to Portugal, a country that treats its citizens--yes, even the drug users--with compassion, because it saves lives. I bet many would also like to find a way to cope with their loss and grief. Considering addiction is a problem that disproportionately affects the poor, the loved ones who survived overdose victims probably are too. They can't afford to see the therapists, doctors, and other healthcare workers they need. The War on Drugs is actually having the effect of making it MORE cost-prohibitive, by raising the costs of healthcare.

Sorry, Reagan, we have learned something since you said, "why don't you be a generation that doesn't need anything," before declaring a war on drugs. War is something to be declared against a sovereign nation, not a collection of chemicals used (irresponsibly) by a countercultural youth. Maybe that's why Reagan's War on Drugs has cost more lives than every other war fought by Americans since the Revolution. In 2017 ALONE, the War on Drugs led to the deaths of almost as many American citizens as the Vietnam War and the Korean War--COMBINED. Many veterans who weren't killed in action continue to be among those who die of overdoses. And why? Lack of access to quality healthcare (as they were self-medicating their PTSD), and policies that labelled them criminals for it.

It would be easy to say that I am pointing the finger of blame. To that end, I vehemently disagree. I am identifying the root cause of a VERY costly problem. The solution, however, is where we need to shift our focus. Culpability is something that doesn't end with blame. It ends when we take responsibility for being a part of the solution. We all need to be a part of the solution.

Let's help them take a page out of the books of countries like Portugal, who has two decades' worth of data to support the effectiveness of their policies. Or, perhaps we could take a few pages from Switzerland's book, which has been administering heroin to its addicts since 1994. That is the same year that heroin played a role in the death of rockstar Kurt Cobain. I am suggesting that doctors should be empowered to treat the opioid epidemic, and addiction in general. They are the ones who want to save lives, and actually have the skill set to do so. Given the state of the opioid epidemic in the United States, I believe some facts are in order.

Of the patients enrolled in Switzerland's heroin program, there has been a 60% drop in felony crimes among them. That increases to an 80% drop in felonious activity after one year in the program. There has also been an 82% drop in the number of patients selling heroin. Why sell it or buy it when everyone can get the purest dope from the clinic? For free, by the way. Of the more than 10,000,000 doses that have been administered, there have been exactly ZERO deaths. None. Ever. And who says doctors are the irresponsible ones? Rates of HIV and Hepatitis have been reduced, and the rate of new users actually fell BELOW expectations. Fewer new users than they expected. Why could that be? Medicalizing heroin has had the effect of making it less attractive to younger generations. It's not a recreational party drug in Switzerland anymore; it's a medical problem--an addiction, for which there is treatment. By putting the users and dealers of heroin in the same place, non-users are less likely to be exposed to it at all. That is how effective compassion can be.

But what about the cost? The Swiss program costs $48.00 per day, per patient, which is covered by the national healthcare program. Patients pay $700.00 per year for insurance, as does every other Swiss person. Swiss citizens are saving $38.00 per day per patient, mostly in court and police costs, because the patients are committing less crime.

The crimes committed by heroin addicts are perpetrated in order to not be dope sick. Heroin withdrawal is like the worst depression, flu and diarrhea you have ever had times a thousand. A calm, cool breeze feels like daggers slicing your skin. You are freezing cold, yet sweating buckets. You can't even use a blanket because your skin is so sensitive, you wish you could unzip it and hang it up in your closet. Recovering addicts say is the closest thing to Hell on Earth. Don't believe me? Just ask any current or former heroin addict. For crimes committed by anyone, including addicts, we have the criminal justice system. Restricting access to treatment for addicts only increases the likelihood that you could be the victim of an armed robbery, assault, or murder at the hands of an addict. Many will do anything to not be sick.

Why did Switzerland take such a radical approach to treating the problem of heroin addiction? In the 1990's, there was an epidemic of heroin use. The number of IV drug users was rising, as were rates of AIDS, Hepatitis, overdose deaths, poor physical health, and criminality. They had an open air drug market that was contributing to a public health crisis. Sound familiar? Instead of locking up the addicts in jail, they decided to listen to these people. Lo and behold, they found a solution (source: https://www.citizensopposingprohibition.org/resources/swiss-heroin-assisted-treatment-1994-2009-summary).

All of this actual data runs counter the sanctimonious, idealistic stances taken by groups such as the Drug Free America Foundation, who fear that expanding treatment and the implementing harm reduction strategies will normalize drug use. They believe the best way to treat addiction is to stigmatize drug use through propaganda and fear mongering, and to punish those who do. The evidence clearly shows that it does the opposite. Treating addiction like the disease that it is makes it a medical problem, and leaves it in the hands of medical professionals. All you need to do is look at the laws in the USA to find out who policy makers believe. Fear is not an effective tool to treat the disease of addiction. I think we will have better luck with compassion.

26 years after Switzerland started giving heroin to its addicts (and many more years after Reagan declared the War on Drugs), and the USA still refuses to admit it made a huge mistake. This is highly problematic, because mistakes are how we learn. Policymakers are still under the delusion that their policies are perfect, and they don't make mistakes. No mistakes means no learning, means no change, means more deaths, means more of the same. This decades-old mistake has cost more American lives than every war every American has ever fought. This might be due to the fact that our policies on drug use correspond to the punitive, Puritanical mindset shared by our first settlers. Their main motivations were racism and greed, which ultimately resulted in genocide.

Nobody is perfect. The sooner we admit that, the sooner we can see the mistakes we make, and the costs associated with them. Then comes the learning, and finally, the healing. There are a lot of dope sick people who deserve to heal, just like people with any other disease.

It is time to forget who to blame and start learning how to solve the public health crisis of addiction. This is not a problem of criminality. If people want to get high, they will find a way. When getting high progresses into the disease of addiction, slapping cuffs and a criminal record on it only perpetuates the problem. It lines the pockets of a select few, at the expense of the rest of us. This gross negligence needs corrected, and as soon as possible. Addicts need compassion, not incarceration. Germany, Denmark, Holland, Belgium, England, Spain and Canada have already implemented similar programs. I will bet anybody any amount of money that their programs see positive outcomes. Nevermind that I have zero dollars to my name. That is how certain I am that they will yield better results than prohibition and criminalization.

The incentive structure is what needs to change. Not Wall Street, who will always follow the profits. Not the pharmaceutical companies, whose intent is to create effective medicine. Not the doctors, who want to save lives. And certainly not the patients, who place their trust in all of the above. In order to achieve this, the policies that shape the structure of these incentives need to change. In order to change these policies, we need to be mindful of where we cast our votes. We need to hold policymakers accountable by raising their awareness, and our own. We need to write our congresspeople and senators, when we have an objection to their actions.

If you still need something to point your finger at, something to blame, point it at the policies. They don't need your compassion. The addicts do. The price of maintaining the drug policy status quo in the United States is far too high to let it continue. And if that price isn't being extracted from your heart, rest assured it is being taken from your wallet.

This is my original content and expresses my opinions. Follow me on Cent: https://beta.cent.co/@idontuseapick