December 16, 2013

The drug consumption rooms of Denmark...

"... where adults with serious addictions can bring their illegal drugs and take them, legally, under the watchful eye of a nurse."
Inside, to the left, behind a huge window, is cluster of smokers with improvised pipes, enveloped in haze. To the right is a long, stainless steel table where several people sit, injecting themselves with heroin, cocaine or both. Some finish and leave quietly. A few slump over the table, asleep. One man gets up and paces frantically back and forth, swearing and shouting. In the middle of it all, sits a nurse in street clothes, calmly taking in the scene.

Every day, these nurses witness up to 800 injections.

41 comments:

Chef Mojo said...

Why is it the state's job to make sure they survive their addictions and habits?

Just legalized it and let the chips fall.

madAsHell said...

Pour your own poison.

So, if you're stoned all the time, then who is paying for your habit.

yeah....let them overdose in peace.

David said...

The Scandinavians are so socially advanced. We should take notice.

Mountain Maven said...

The Danes with their monoculture can get away with this nonsense with out nearly the disaster it would be in the US

Carl Pham said...

I dunno, the logic is convoluted here. Presumably the point of these rooms is to reduce the bad effects of drug addiction not the direct result of the drugs themselves, e.g. being set on fire by passing hoodlums while you're strung out.

So, overall, you are reducing the negatives of drug addiction. How is that expected to lead to better outcomes? Less stick, the same carrot -- this is supposed to increase the rate of change? I'm not following that.

Of course, the counter-argument might go, there are still plenty of negatives to drug addiction, even without the ancillary threat of humiliation, violence, or exposure, and you'd think these would be more than sufficient to drive a sane person to seek treatment, so that can't be the issue...

But this just exposes the less obvious, and far more dangerous assumption here, which is that people who are addicted to drugs are sane, or at least have decision making behaviours that are similar enough to those of nonaddicts to be comprehensible to the latter.

As anyone in AA can tell you, they aren't. Christ, addiction is so obviously destructive, if you fall into it you are pretty much ipso facto a weirdo, with bizarre or faulty executive planning facilities upstairs. There is no comparison to the urge to have a drink after a nasty argument, or a fantasy about chucking it all up and becoming a bum. Those are normal. Actually selling your life for just one more fix is something different, alien to most of us.

The ugly bottom line is that the way addicts make decisions does not make sense to non-addicts -- that's why they are addicts and we are not -- and hence all of our instincts about what they'll do when faced with a certain set of incentives are wrong a priori. (This is one reason programs like AA are run by ex-addicts. They get it.)

You simply can't approach treatment of addicts by instinct, or on what feels reasonable, any more than you can repair a widget on the Space Station in zero gee by instinct, the same way you'd do it on Earth. The only way to make real progress is to use your head -- not your feelings. Genuine hard numbers, experiment, cold dispassionate measurement of the results.

I certainly would vote in favor of trying something -- almost anything -- to reduce the carnage of drugs among particularly the young. So go injection rooms!

But I would also couple it with rigorous measurement of the outcomes, with ruthless abandonment or modification if it doesn't work, by the numbers. And in that sense, this article is a piece of trash, filled as it is with warm-hearted fuzzy-brained speculation and narcissistic aren't we noble keepers of our brother self-regard bullshit, and essentially nothing but an offhand link to even hint at the kind of dispassionate measurement that would constitute a first step towards genuine compassionate action.

Jay Vogt said...

. . . Chef Mojo said...Why is it the state's job to make sure they survive their addictions and habits?

Just legalized it and let the chips fall.


Nope, Heroin and other narcotics rob one of their freedom - pretty much immediately. In fact, that's specifically what they're designed to do! No public or private good is served by them, their distributors or users.

The hyper-concentrated pharmabombs of the 20th and 21st century are produced and distributed by evil men intent on doing evil. You've just got to wrap your mind around that. We cannot reward their contempt of and damage to human dignity and life. It's a crime greater than assault and not too far short of homicide.

Paul said...

And who pays for all this? Who pays for them not being able to hold a job? Who pays for whatever crimes they commit for those illegal drugs?

No wonder Denmark is going down the drain.

Broomhandle said...

Sounds like gently managed euthanasia for society's undesirables. Think of it as soft hate.

Smilin' Jack said...

And who pays for all this? Who pays for them not being able to hold a job? Who pays for whatever crimes they commit for those illegal drugs?

Yeah, much cheaper to throw them all in federal prisons, like we do here. That's why our rate of drug-related crime is so much lower than Denmark's.

Broomhandle said...
This comment has been removed by the author.
mccullough said...

This is worth trying here. Basically hospice for addicts.

jelink said...

In the US, these addicts would be schooled by Navigators to help them score more food stamps, more medical care, more dope...anything that would help them descend into whatever temporary nirvana they seek....and

...the Obamanoids would say that's a very good thing.

YoungHegelian said...

That poor nurse!

Many jobs are soul-numbing, but this one must rank right up there as downright soul-destroying.

I wonder what the turnover rate is for the nurse position.

n.n said...

So, there is no productivity; no responsibility; no accountability; it sounds like a social experiment. Is this what happens when the state replaces family and friends? Do these people still vote?

eric said...

I got an idea, let's encourage drug use by giving druggies a place to do their drugs.

Brilliant!

FullMoon said...

"Yeah, much cheaper to throw them all in federal prisons, like we do here. That's why our rate of drug-related crime is so much lower than Denmark's. "

AND once an addict is incarcerated for a few months, he is no longer physically an addict. Time in prison after that is a waste of money. Spending money keeping them clean makes more sense. Most addicts want to kick it.
Non violent acquaintance doing 30 fkn years. Where is the sense in that? Mandatory sentences supposed to scare people out of it. Most people are not even aware of the sentences until they get caught.

FullMoon said...

ric said...

I got an idea, let's encourage drug use by giving druggies a place to do their drugs.

Brilliant!

Yes, drug addiction will become more popular because there is a nice place to go shoot up drugs.

Freeman Hunt said...

Proposed modification:

Each time someone comes in to use the facility, he must fill out form that has two checkboxes and a signature line. One checkbox reads, "I request admittance to use drugs in this facility." The other checkbox reads, "I hereby commit myself to an inpatient drug treatment program." If he checks the second box, he is congratulated and immediately transported to an inpatient drug treatment program.

Every time you come in, you face those two boxes and pick one to check off. Maybe it would be a helpful nudge.

Freeman Hunt said...

Let people's impulsivity work for them.

Revenant said...

This is one reason programs like AA are run by ex-addicts. They get it.

Perhaps, but their success rate isn't actually any higher than programs run by non-addicts.

Revenant said...

Heroin and other narcotics rob one of their freedom - pretty much immediately.

Most people who use heroin are able to stop without outside help. That refutes the claim that the drug robs people of freedom.

In fact, that's specifically what they're designed to do!

Heroin was developed by Bayer to be a non-addictive substitute for morphine. It didn't work out that way, of course. :)

Laura said...

Carl Hart actually has an interesting perspective on the subject, though he might take another look at the design of his reward systems. Cash is addictive too.

Laura said...

Broomhandle beats proofreader. Euthanasia is a key issue.

FleetUSA said...

It would be interesting to know the ages of the 2 men photographed. I think they are a lot younger then they look. Destroyed by drugs.

Illuninati said...

I'm still open in attitude towards drugs. At this time I lean towards reducing most drug charges to misdemeanors with the possible exception of major drug lords. This would still give society a handle on the more detrimental aspects of drug abuse without filling our prisons with non-violent drug offenders.

Larry J said...

Sounds like a potentially dangerous work environment for that nurse. Are there any effects from second-hand drug smoke? With all those needles, the chances of an accidental stick are pretty high with the associated risk of infection.

Michael said...

If a chimp drinks enoug or takes enough drugs the chimp will become addicted to the drink or the drugs. Not because he didnt get enough bananas when he was a baby chimp or because other chimps were mean to him, but because he is addicted to the substance. Take away the substance and in no time at all the chimp is no longer addicted. The state buying into these habits that they deem unbreakable is disgusting. Enabling people to destroy themselves is simply wrong.

lemondog said...

This is worth trying here

Called Starbucks.

John said...

Carl Pham said:

There is no comparison to the urge to have a drink after a nasty argument, or a fantasy about chucking it all up and becoming a bum. Those are normal. Actually selling your life for just one more fix is something different, alien to most of us.

Really?

And the difference is? Other than alcohol being legal and recreational drugs not.

Both are used to alter one's mental state. For all the talk about all the good things with booze, that is all it comes down to in the end. Else why would vodka ("It leaves you breathless.") exist?

How many people would drink wine (or beer, or gin, or scotch etc) if it did not contain alcohol? (Assume identical taste)

I see no distinction between Gin and MJ, Wine and Heroin, Beer and cocaine.

Other than legality.

All can be and frequently are abused. All can be, and often, especially MJ, are used in some moderation.

When Ann posts something on "choice" it usually gets a lot of favorable comments. The definition of choice seems to have become limited to a choice about abortion for women. A woman's right to her own body and so on.

What about my choice? What about my rights to my own body? Who are you, or anyone else, to tell me what I can and cannot do with my body?

If I could make a perfect world, nobody would want drugs. Including alcohol. We don't live in a perfect world so I say let people do whatever drugs they want.

Legalize everything.

That is the true pro-choice position.

John Henry

Tank said...

What percentage of people who use drugs are "adults with serious addictions?"

The overwhelming majority of people who use recreational drugs will never be in this situation, legal or not. So this has nothing to do with the usual recreational drug use.

There are probably a hundred million people in this country who have smoked pot now. A teeny, tiny percentage of them ever had real trouble with drugs (other than legal).

The time/money we waste on this, and the unintended consequences, is itself a crime. ("is" or "are"? Hmmm).

rhhardin said...

Marvin Krislov, idiot president of Oberlin College, wishes alumni a Happy Holidays.

Apparently fund raising is down.

Steffen Pedersen said...
This comment has been removed by the author.
Robert Cook said...

"Christ, addiction is so obviously destructive, if you fall into it you are pretty much ipso facto a weirdo, with bizarre or faulty executive planning facilities upstairs. There is no comparison to the urge to have a drink after a nasty argument, or a fantasy about chucking it all up and becoming a bum. Those are normal."

Uh...one man's "normal" is another man's...not.

I've never had the urge to have a drink after an argument or any upsetting circumstance, and that someone would have such an urge suggests to me that person has a problem. As to "chucking it all and becoming a bum," well, I'd certainly like to chuck it all, but I have no desire to become a bum. Again, that's weird to me.

You're missing the point: I doubt few people set out to become addicts. What happens is that people engage in activities that are pleasurable to them, that are fun and feel good. (This is the motive for the hobbies and leisure time pursuits of everyone.) Some people partake of substances that are fairly physically addicting, and without intending to, they become addicted. Other substances may be less immediately physically addicting, but they satisfy some need in the user, or cover up some pain, and an emotional or psychological addition can develop.

Very, very normal and conventional people become addicts, not just "weirdos."

Jay Vogt said...

….Revenant said…..Most people who use heroin are able to stop without outside help. That refutes the claim that the drug robs people of freedom…..

Specious claim at best. Even if partially true, the fact that humans are not robbed of their freedom completely, permanently and irreversibly does not mean that they are not robbed of their freedom.

…Heroin was developed by Bayer to be a non-addictive substitute for morphine. It didn't work out that way, of course. :)….

Partially, maybe, kinda true. The addictive nature of all things opioid was pretty well known and understood at the time (in the late 19th century). You have to be willing to suspend a great deal of credulity to believe the Bayer corporate story. In any event I reference the pharmabombs of the 20th and 21st century (meperidine, hydromorphone, fentanyl, methadone). Only a fool or a Pharma exec would believe that these were not created with an addicted market in mind. I can guarantee you they talk about how many pills or patches they sell every quarter.

KenK said...

I like this concept though it reeks of nannyism.

ken in sc said...

I once knew two heroin users in Thailand. Their lives appeared to be fairly normal. They worked throughout the week and got high on the weekends. Heroin was so cheap there, they did not have to steal to feed their habit. The main problem they mentioned was that it made them constipated.

They were eventually caught by an Air Force drug test and kicked out.

mrs. e said...

Robert, I believe what Carl is saying there is that those traits are ‘normal’ for the addict. And, for the record, addicts don’t see themselves as very, very normal and conventional. Far from it. No one aspires to be an addict, with their drug of choice perhaps starting out as fun, turns quickly or slowly mask or escape some form of physical or psychic pain and they’ve self-medicated themselves into a corner. Some will look for a way out, others go deeper – to insanity or death. From a public health standpoint, I like what Copenhagen is trying to do.

Peter said...

'FullMoon' said, " Most addicts want to kick it."

I would have to disagree with this. Long-term success rates for drug treatment programs- esp. for heroin- are dismal. And why is that? Well, we medicalize it by saying, "the addict had a relapse." As if there were no element of free-will choice involved.

Just as with smoking, those who truly wish to quit forever proceed to do just that. No one can honestly claim it's easy. But it is possible.

No doubt there is some delusional thinking involved when an addict- after getting himself clean- tells himself, "I can use just this one time without returning to my addicted state." We know, and they know, that's almost surely not true. Nonetheless, there is an element of free-will choise here in choosing to use after one has become clean which is not present in, say, a recurrence of cancer. The disease model i can be useful, but it's not entirely accurate.

Drug addiction is a maladaptive behavior, but not all maladaptive behaviors are diseases. The medical model is useful yet at some point it should be scrapped because the model itself has become maladaptive.

Freeman Hunt said...

I think it could work well here if it provided easy access to treatment. I don't see how addicts hiding out and sharing needles in drug houses or alleyways, never interacting with functional adults or being advised of treatment options, is helpful.

FullMoon said...

Freeman Hunt said...

Proposed modification:

Each time someone comes in to use the facility, he must fill out form that has two checkboxes and a signature line. One checkbox reads, "I request admittance to use drugs in this facility." The other checkbox reads, "I hereby commit myself to an inpatient drug treatment program." If he checks the second box, he is congratulated and immediately transported to an inpatient drug treatment program.

Every time you come in, you face those two boxes and pick one to check off. Maybe it would be a helpful nudge.


That is a great idea. Addicts gonna check the first box a hundred times until hopefully the time is right to check that second box.

Also, quitting drugs, like many other things, may sometimes require practice before it is done correctly.


FullMoon said...
This comment has been removed by the author.