Drug User Unity

I don't usually just post a link to an article, but the following is worth reading.  The author is Tony Newman, of the Drug Policy Alliance.

Drug Users of the World Unite

How Heroin is Made

This review of a heroin manufacturing process uses images from Afghanistan, though opium poppies grow all over the world and the process of making heroin destined for the black market is the same.  It all starts here with the harvesting of opium from the poppy.  The pods are lightly scored with a blade and the raw opium collected.  The opium is collected into balls and transferred to a makeshift "laboratory" where the morphine will then be extracted and processed into heroin.

Upon arrival at the site the opium is unpacked and placed into tubs.  It is then crushed and divided into portions for each batch.  The crushed opium was then placed into barrels and hot (not boiling) water is added.  At this point the pH is around 8.  The barrel is then stirred and any solids that float to the surface, pieces of plastic or plant matter, are removed.  Hot water with lime (Calcium Oxide, CaO) is added until all the opium has dissolved and the pH reaches 10-12.  The barrels are then filled with water, covered and left to sit overnight.  The following day the insoluble oils and resins will be floating on the surface, the opium solution containing the morphine is then siphoned out into separate containers.  

The dark brown opium solution which contains the morphine is siphoned off from the insoluble oils and residues in the opium.  The solution may then be filtered again through cloth or sacks to further remove insoluble particles.  The filtrate (liquid portion) is then poured back into a barrel.  

At this point the morphine is ready to be precipitated (solid morphine comes out of the liquid)  by the addition of Ammonium Chloride (NH4Cl) while stirring continuously.  After all the ammonium chloride is added, the barrel is covered and left to stand overnight.

The following morning the contents of the barrel are poured into a bucket lined with cloth soaked in warm water.  After being poured through the bucket the morphine base is wrapped in the filtering cloth and squeezed to remove remaining liquid.  The brownish-grey morphine base is then spread out on a cloth to air-dry in the sun.  The dried morphine base is then weighed in preparation for the acetylation reaction to convert the morphine to heroin.  This crude morphine base is about 50% morphine, 20% narcotine and 30% other compounds.

The crude morphine base is placed in an aluminum pot and a slight excess of acetic anhydride is added to the pot.  The pot is stirred until all the morphine has dissolved and then left for 45 minutes.  A fire is built during this time and after the 45 minutes have passed the pot is heated for 30 minutes.  

The reaction mixture is then poured into a bowl with warm water and the solution is filtered again into another barrel.  A solution of sodium bicarbonate (baking soda) is poured into the barrel, carbon dioxide gas is given off as the base reacts with the acid.[1]  When the solution no longer gives off gas and the pH reaches 10 the crude heroin base will be precipitated out of the solution.

The solution is then filtered again through a cloth.  The brownish colored crude heroin is then poured into a bowl to be prepared for the final purification step.  

The brown heroin base is then dissolved in dilute hydrochloric acid until the pH reaches 7-8.  Activated carbon is added to the solution and left to sit for 30 minutes.  The solution is then filtered again through a cloth, and a second time through a filter paper.  After the impurities are removed, the heroin base is precipitated out by addition of a dilute ammonia solution until the pH reaches 12.  The solution is filtered again, leaving a relatively pure, white heroin base.

The final step involves dissolving the heroin base in a hydrochloric acid and acetone solution. The solution is filtered through a filter paper into a metal bowl.  The liquid is evaporated leaving off-white heroin hydrochloride.  This final product is about 75% pure, see Table 4 below.  The yield of heroin from raw opium, is about 6% by weight.  

The process of making heroin from opium is a simple one and can be done anywhere in the world.  The following two tables list the needed equipment and chemicals needed for the process.  Calling these laboratories is generous, and truly an insult to real chemical labs.  For these reasons it should be obvious that there will never be a victory in the war against heroin by attempting to stop the supply at its source.  Opium poppies grow all over the world and the chemical reaction requires only the most primitive equipment.  Electricity and running water is not even needed.  The only chemical that would be difficult in any way to procure is the acetic anhydride.  

UN Intercepts Taliban's Heroin Chemical in Rare Afghan Victory

The intensified effort to block the Taliban's access to acetic anhydride comes as the Afghan war turns deadlier, with a record 236 U.S. and allied troops killed so far this year, according to icasualties.org, a Web site that tracks coalition fatalities. U.S. Army General John Craddock, supreme allied commander for Europe, is pushing to increase military involvement in countering the narcotics trade. 

The chemical allows Afghanistan's drug lords to dramatically increase revenue by producing heroin in their own laboratories instead of shipping out raw opium to be processed elsewhere. According to Craddock, a kilo of opium fetches about $100, compared with $3,500 for heroin.

This article is from 2008, so apparently that "rare" victory was short-lived.  Given the 6% yield of heroin from opium, it would take 16.7 kg of opium to produce 1 kg of heroin.  Using the figures provided by Craddock, to produce a kilogram of heroin requires $1,670 worth of opium to produce a product worth $3,500, more than doubling the value.  Additionally the final product is only 6% the weight, making it easier to smuggle to destination countries.  Compared to the logistics of smuggling thousands of tons of opium out of the country to be processed elsewhere, it is far easier to smuggle the acetic anhydride into the country than opium out.  

 

[1] Sodium bicarbonate is better known as baking soda and acetic acid as vinegar.  Remember in grade school the model volcanoes made by mixing vinegar and baking soda to simulate an explosion?  As the basic soium bicarbonate reacts with the acetic acid carbon dioxide gas is released.  Commercial vinegar used in cooking is only between 4-8% acid, the rest being water.  Acetic Anhydride is like two molecules of acetic acid stuck together, but does not have water added.  Water can degrade the acetic anhydride.  Due to its use in the production of heroin, acetic anhydride is "watched" by the DEA.

Many of the images and information in this post were taken from the following document:

Documentation of a heroin manufacturing process in Afghanistan. U. Zerell, B. Ahrens and P. Gerz. Federal Criminal Police Office, Wiesbaden, Germany [Link]

Conflating the Harms of Heroin with the Harms of Prohibition

I have a problem with this graph, from a 2007 Lancet article by David Nutt. I actually like David Nutt, he was fired from his position in the UK government for criticizing the decision to reclassify cannabis to Class B from C. That's right, a scientist who was working for the UK equivalent of the NIDA actually bucked the orthodoxy of "drugs are bad, mmkay," of course he was sacked for it. You will notice that heroin scores the highest on both dependence and physical harm. This the criteria used to evaluate physical harms in the lancet article:

Assessment of the propensity of a drug to cause physical harm—ie, damage to organs or systems—involves a systematic consideration of the safety margin of the drug in terms of its acute toxicity, as well as its likelihood to produce health problems in the long term. The effect of a drug on physiological functions—eg, respiratory and cardiac—is a major determinant of physical harm. The route of administration is also relevant to the assessment of harm. Drugs that can be taken intravenously—eg, heroin—carry a high risk of causing sudden death from respiratory depression, and therefore score highly on any metric of acute harm. Tobacco and alcohol have a high propensity to cause illness and death as a result of chronic use. Recently published evidence shows that long-term cigarette smoking reduces life expectancy, on average, by 10 years.9 Tobacco and alcohol together account for about 90% of all drug-related deaths in the UK.

     My main problem with the lancet article is they compare legal drugs, alcohol and tobacco, with illegal ones like heroin. Black market heroin is a dangerous drug because of its unknown purity and possibility of being adulterated with any number of substances, assuming you're even getting heroin and some some obscure fentanyl analog. Some basic information would go a long way to making heroin a less dangerous drug. For one combining opiates with CNS depressants dramatically increases the chance of overdose. Easy access to naloxone (narcan) nasal sprays could save countless lives, without having to call 911 and risk arrest in states without "good samaritan" laws. Disseminating information on safe injecting practices would go a long way to improving users health. Instead we get PSAs with a teenage girl destroying her kitchen in an apparently heroin-fueled rage. Furthermore due to the social stigma of using heroin, most users hide their drug use making it more likely no one will be around to save their life should they OD.
     This is comparing apples to oranges. To compare apples to apples one would have to look at a quasi-legal system. One option would be to compare the physical harms of individuals on heroin prescriptions or physician opiate users. Both use pharmaceutically pure opiates and sterile injecting equipment. In the heroin assisted therapy trials in Vancouver there were ODs, but medical staff quickly revived them. Most importantly there were no opiate-related fatalities. Putting aside the potential for an opiate overdose, just how bad for the body is heroin? Dr. Arnold Trebach, writing in "The Heroin Solution," informs us that "putting aside the problem of addiction, the chemical heroin seems almost a neutral or benign substance. Taken in stable, moderate doses, it does not seem to cause organic injury, as does alcoholism over time." Interesting, so if heroin were administered in an environment where the chance of ODs were minimized, and with a readily available narcotic antagonist (antidote), heroin would score below alcohol and tobacco, probably just above cannabis. Heroin is the poster child for prohibition making drug use far more dangerous than it would be in a legal, regulated market.

Rob Arthur writing in his article, "Heroin Is Harmless?" breaks it down the harms further:

Three aspects of an ingestible substance that can be considered harmful are (1) its potential to debilitate, (2) its effects on one’s health, and (3) its potential to kill via an overdose.

(1) Like the stimulants, caffeine and cocaine, heroin is not a debilitating drug. That is, moderate usage does not interfere with one’s functioning, e.g. driving ability. This is in contrast to alcohol, in which one’s performance is directly hampered. Extreme usage can interfere just like with caffeine and cocaine, e.g. too much of a stimulant can make it difficult to focus and even cause hallucinations. However, even heroin addicts can moderate their usage so that they can work unimpaired and avoid withdrawal symptoms. For this reason, heroin addicts can and do have successful professional lives in such diverse fields as surgery and law enforcement.

(2) Long-term heroin addiction is relatively harmless to one’s health. Like caffeine addicts who “need” their coffee in the morning, the side-effects are minimal. Heroin’s long-term side-effects can include constipation and impotency. This is in contrast to alcohol and tobacco which destroy the liver and the lungs respectively.

(3) Like caffeine, it is difficult to fatally overdose on heroin by itself. (It is easy to overdose when using heroin and alcohol in combination.) The popular image of a dead heroin user with the needle still in his or her arm is misleading. A fatal heroin overdose is usually a long process that takes over an hour and it can be countered within minutes by an antidote.

HSBC Launders Drug Money, Two Articles

Outrageous HSBC Settlement Proves the Drug War is a Joke by Matt Taibbi

The banks' laundering transactions were so brazen that the NSA probably could have spotted them from space. Breuer admitted that drug dealers would sometimes come to HSBC's Mexican branches and "deposit hundreds of thousands of dollars in cash, in a single day, into a single account, using boxes designed to fit the precise dimensions of the teller windows."
This bears repeating: in order to more efficiently move as much illegal money as possible into the "legitimate" banking institution HSBC, drug dealers specifically designed boxes to fit through the bank's teller windows. Tony Montana's henchmen marching dufflebags of cash into the fictional "American City Bank" in Miami was actually more subtle than what the cartels were doing when they washed their cash through one of Britain's most storied financial institutions.
[...]
So you might ask, what's the appropriate financial penalty for a bank in HSBC's position? Exactly how much money should one extract from a firm that has been shamelessly profiting from business with criminals for years and years? Remember, we're talking about a company that has admitted to a smorgasbord of serious banking crimes. If you're the prosecutor, you've got this bank by the balls. So how much money should you take? 

How about all of it? How about every last dollar the bank has made since it started its illegal activity? How about you dive into every bank account of every single executive involved in this mess and take every last bonus dollar they've ever earned? Then take their houses, their cars, the paintings they bought at Sotheby's auctions, the clothes in their closets, the loose change in the jars on their kitchen counters, every last freaking thing. Take it all and don't think twice. And then throw them in jail. 

Sound harsh? It does, doesn't it? The only problem is, that's exactly what the government does just about every day to ordinary people involved in ordinary drug cases.
[...]
On the other hand, if you are an important person, and you work for a big international bank, you won't be prosecuted even if you launder nine billion dollars. Even if you actively collude with the people at the very top of the international narcotics trade, your punishment will be far smaller than that of the person at the very bottom of the world drug pyramid. You will be treated with more deference and sympathy than a junkie passing out on a subway car in Manhattan (using two seats of a subway car is a common prosecutable offense in this city). An international drug trafficker is a criminal and usually a murderer; the drug addict walking the street is one of his victims. But thanks to Breuer, we're now in the business, officially, of jailing the victims and enabling the criminals. 

So there is absolutely no reason they couldn't all face criminal penalties. That they are not being prosecuted is cowardice and pure corruption, nothing else. And by approving this settlement, Breuer removed the government's moral authority to prosecute anyone for any other drug offense. Not that most people didn't already know that the drug war is a joke, but this makes it official.

HSBC, too big to jail, is the new poster child for US two-tiered justice system by Glenn Greenwald

The US is the world's largest prison state, imprisoning more of its citizens than any nation on earth, both in absolute numbers and proportionally. It imprisons people for longer periods of time, more mercilessly, and for more trivial transgressions than any nation in the west. This sprawling penal state has been constructed over decades, by both political parties, and it punishes the poor and racial minorities at overwhelmingly disproportionate rates. 

But not everyone is subjected to that system of penal harshness. It all changes radically when the nation's most powerful actors are caught breaking the law. With few exceptions, they are gifted not merely with leniency, but full-scale immunity from criminal punishment. Thus have the most egregious crimes of the last decade been fully shielded from prosecution when committed by those with the greatest political and economic power: the construction of a worldwide torture regime, spying on Americans' communications without the warrants required by criminal law by government agencies and the telecom industry, an aggressive war launched on false pretenses, and massive, systemic financial fraud in the banking and credit industry that triggered the 2008 financial crisis.

A Look at the Morphinan Structure Activity Relationships of Six Popular Opiates

     The terms opiate and opioid are often used interchangeably, different authors define what is considered an opiate or an opioid with little consistency.  The suffix "-iod" means like, hence opioids act like opiates.  In general opiate refers to alkaloids found in the opium poppy that intereact with the body's endorphin receptors.  Opioids are molecules that interact with the same receptors but are either fully synthetic (ie fentanyl), derived from the alkaloids found in opium and thus semi-synthetic (ie buprenorphine), and molecules from other plants that are distinct from morphine but nonetheless do interact with the opioid receptors (eg kratom).  For the purposes of this blog, I define opiates are any molecules with only minor derivations on morphine.   The following is a discussion of five common pharmaceutical narcotics and how they relate to the prototypical opiate, morphine.  I consider codeine, hydromorphone, oxymorphone, hydrocodone and oxycodone all to be opiates.  The most common changes to the morphine molecule involves:

1. Changing substituents at carbons 3 and 6.  In morphine these are alcohol (-OH) groups.   

2.  Reduction of the double bond between carbons 7 and 8. 

3.  Addition of an alcohol (-OH). group at carbon 14.  

4.  Addition or changes to the group coming off the nitrogen, carbon #17.

Figure 1.  Morphine with the carbon atoms numbered.  Morphine is the primary alkaloid in opium.  

Codeine is also found naturally in opium, and in (slightly) more enlightened countries is sold over the counter, though never without added acetaminophen (Tylenol) or acetylsalicylic acid (aspirin).  Codeine is identical to morphine but has a methyl group attached to the oxygen on carbon #3.  A carbon-oxygen-carbon grouping is known as an ether, thus codeine is 3-methyl ether morphine.  This dramatically reduces the activity of codeine to only 10% of morphine.

Hydromorphone has two changes to the morphine molecule which increases its relative potency.  The OH group at position 3 in morphine has the hydrogen removed, the oxygen is now double bonded to carbon 6.  A carbon-oxygen double bond is known as a ketone ("key-tone"), thus the "-one" at the end of hydromorphone.  The double bond between carbons 7 and 8 has been reduced to a single bond, by adding two hydrogen atoms (H not shown).  This should make the molecule "dihydro-morphin-one," due to the addition of two hydrogen molecules (dihydro) and the oxidation of the OH group at carbon 6 to a ketone (morph-INE to morph-ONE).  However the name is derived not from the double bond between carbon's 7 and 8, but for the atom bonded to carbon 14.  In this case hydromorphone retains the same configuration as morphine, a single H at carbon 14. 

Oxymorphone has the same two changes to the morphine molecule as hydromorphone, but also has an OH group attached to carbon 14 in place of the hydrogen in morphine.  This increases the potency and is the reason the name is OXY-morph-ONE.  The oxy prefix refers to the OH on carbon 14, and the one suffix refers to the change at carbon 6.   

Both oxycodone and hydrocodone involve the same changes to the morphine molecule as oxymorphone and hydromorphone, but include the methyl (-CH3) group attached to the 3rd carbon just like codeine.  

The changes to the morphine structure can be summarized as follows:

A.  Addition of a methyl group to the oxygen on carbon 3.  Creates a methyl-3-ether linkage.  Reduces potency.

B.  Alcohol group (-OH) on carbon 6 oxidized to a double bonded ketone (=O).  Increases potency.

C.  Hydrogenation (two H atoms are added) of double bond between carbons 7 and 8.  Increases potency.

D.  Substitution of an alcohol group (-OH) for the hydrogen at carbon 14.  Increases potency.

Opiate                             Changes to Morphine       Brand Names

Morphine                         -                                     MS Contin

Codeine                           A                                    Paramol, Tylenol 3

Hydromorphone               B, C                               Dilaudid, Palladone

Oxymorphone                  B, C, D                          Opana, Numorphan, Numorphone

Hydrocodone                   A, B, C                          Vicodin, Lortab

Oxycodone                      A, B, C, D                     Oxycontin, Percocet, (More here)

Oxycodone is an example of all four changes to the basic morphine structure.  A decreases the potency, while B, C and D increase the potency.  The net result is a molecule slightly more potent than morphine, though far less potent than oxymorphone.  

 Narcotic antagonists are made by using the oxymorphone structure with modified substituents on the nitrogen.  The groups off the nitrogen have major effects on the pharmacological activity.  Both naloxone and naltrexone are used to reverse opioid overdoses and have no intrinsic opioid activity of their own.

Cannabis Legalization, Good or Bad?

If weed has 100% legalized everywhere in the world the drug wars could continue. How many people are busted for weed each year? Something like 800,000? That number could easily be replaced with the ranks of other drug users.

The worst case scenario, as I see it, following cannabis legalization would be a shift in focus to other drugs with no change in enforcement dollars or priorities. In the absence of marijuana, there’s always coca and poppy crops to be eradicated, dealers and users to be hunted down and locked up.
I think this is unlikely, though possible. In part because the debate over weed has included the notion that there are costs to prohibition, costs which are due to prohibition and not drugs (a distinction that prohibitionists do their best to obfuscate). Prohibition has failed at eliminating people’s access to these drugs, a failure which is all the more remarkable given its long history of failure and official denial (that a drug free America is possible, or even desirable). Places like South America, which have born the brunt of the drug war, have had enough.

Legalizing heroin may be too radical a notion for the masses who have known nothing but propaganda for over a generation (and I understand this since I was a DARE grad and firmly anti-drug until being exposed to alternative views), but I think a possible chip in the established dogma would be to start with the plants. Poppies and coca have been used for a very long time, the right to cultivate and use these plants is an easier sell than heroin and cocaine.

Chirality, a Primer (Updated)

    The word chirality comes from the Greek word for "handedness," as in left or right-handed.  Well it turns out molecules can also have different forms that are analogous to the idea of handedness.  For an example look at alanine.  The figure shows two versions, or what chemists call enantiomers, of the amino acid alanine.  Much like each hand has five fingers, one thumb, ect both molecules have the same number of atoms and same general chemical structure, but make no mistake these are two distinct compounds.  

     Chemists have different ways of naming the different enantiomers.  There are three different systems for naming, the S/R system is preferred by chemists and involves numbering the atoms bonded to the center of the plane of symmetry (the chiral carbon).  The +/- system is based on how each enantiomer shifts light, either in a (+) dextrorotary (clockwise), or (-) levorotary (counterclockwise) direction.  Finally there is the D/L system of naming, which has nothing to do with light and is based on the labeling of the biological molecule glyceraldehyde.  Confused yet?  Me too.  All you really need to know is that these are two distinct molecules.  

     Chirality is an important chemical concept, particularly for pharmacology and medicinal chemistry.  Most drugs work by interacting with a specific receptor, oftentimes described like a key (drug molecule) fitting into a lock (receptor).  It is not uncommon for receptors to respond to only one of the two forms, if the receptor was a left-handed glove it would fit well with a left hand but not very well with a right hand.  One of the most famous examples of different pharmacological effects due to chirality is methamphetamine.  

     Methamphetamine has two enantiomers, L-meth and D-meth.  D-methamphetamine is the good stuff, well I personally wouldn't touch the stuff as coffee gets me as stimulated as I care to be, but D-meth is what speed aficionados like.  L-meth is much weaker with little effect on the central nervous system, although it is a good decongestant and is even used in Vicks inhalers!  

    When drugs are synthesized in a laboratory, the chemical reactions often result in a 50:50 mix of the enantiomers, called a racemic mixture.  Because the two drugs have the same basic chemical structure, they are share physical properties (solubility, melting point, ect), which makes them difficult to separate.  In some cases, such as virtually all the methadone sold in the US, what people are actually getting is two different drugs with different pharmacological properties.  

     Methadone such as is dispensed at clinics across the US, is a 50:50 mix of (S)-Methadone and (R)-Methadone.  The only difference is the direction the methyl (CH3) group is facing, in the diagram to the left, in (S)-methadone the methyl is pointing forward as signified by the solid black line.  In (R)-methadone the methyl is facing away from the viewer, into the page as signified by the dashed line.  For another view of the two enantiomers see the three-dimensional methadone models in the image.  The white arrow points to the methyl group, otherwise the molecules are identical.   

   The position of that methyl has a large effect on methadone's opioid properties.  For all practical purposes, only (R)-methadone actually has any opioid effect.  One possible explanation for this has to do with the space between the nitrogen (blue in model) and the oxygen (red).  In (R)-methadone the methyl is facing away from the space between the oxygen and nitrogen, which allows a bond to form.  In (S)-methadone the methyl group is blocking this space.  

It should also be noted that not all molecules have mirror images, hence they are achiral.  Other molecules have more than one chiral center, and the number of different combinations of enantiomers (called stereoisomers) grows exponentially.  For example morphine has five chiral carbons, marked with red dots.  Theoretically at least, morphine has 32 different stereoisomers.  Fortunately plants (and animals) are masters of biochemistry and are able to produce a single specific form of morphine, as all the different stereoisomers could have different pharmacological effects.  This is also a reason why poppies are still used as the source material for all opiates currently used in medicine today.  

Update, 12/3/2012

     If you are taking methadone what does this mean for you.?  If you live in the US, and probably most of the world (there may be places where you can get enantiomerically pure (R)-methadone, I just am not aware of any) you are getting a racemic (50:50) mixture of R/S Methadone.  (R)-methadone is 10-50 times stronger than (S)-methadone, so for all practical purposes only half of your dose is actually an opioid.
    This becomes relevant clinically because the different enantiomers have different pharmacological properties.  Take peak-and-trough testing for example.  Let's say you are on a high dose of methadone but wake up every morning feeling sick.  You request an increase but since you are already on a high dose the clinic says, "Hold up there we can't take your word for it, you're a junkie and everyone knows junkies lie so we are going to confirm your feelings with a blood test."
    Peak and trough testing is a blood test that measures the level of methadone at two points in a 24 hour period.  The first is right before dosing when the methadone is lowest (the trough), then another blood test occurs about 3 hours after dosing when the methadone has reached maximum blood concentration (the peak).  Supposedly based on this test they can tell if you really need additional methadone.
     But here's the thing, the blood test does not distinguish between (S)- or (R)-methadone.  While they are similar in structure and share many pharmacological properties, they are not the same.  An individual may metabolize (R)-methadone faster than (S)-methadone, so that by the time they wake up in the morning the level of (R)-methadone is way down and they are beginning to feel withdrawal.  However their blood is still loaded with (S)-methadone, so the peak and trough test, which does not distinguish between R and S enantiomers, gives results that indicate the level of methadone is adequate.  And so the doctor with their test results can tell the patient it's all in their head, when in reality there is a clinical reason why the person wakes up every morning feeling ill.  The patient should always be trusted when it comes to their own body.
     There may be other differences in the two enantiomers.  Methadone has action on other receptors besides the endorphin receptors.  Would there be any advantages to using pure (R)-methadone?  At this point I am not sure but will revisit this issue as I learn more.

Read more about Peak and Trough testing here.

Dr. Drew Pinsky, Authoritarian Asshole

    Dr. Drew is one of the most well-known faces of the numerous "addiction specialists".  As such he represents everything that is wrong with the drug treatment industry: coercing "treatment" against the patient's will, the use of the criminal justice system to force medical treatment and personal hypocrisy about his own drug use all while profiting handsomely from the "patients" he claims to care about.  No matter the outcome of the "treatment," the "addiction specialists" never fail to help themselves to their "patients" money, either directly or through insurance reimbursement.
     Dr Drew has weighed in on two high profile celebrities that use drugs.  Charlie Sheen and Lindsay Lohan.    Apparently Dr. Drew is concerned that Lohan likes to party until the early hours of the morning, and gosh she's probably having sex too.  Whatever you may think of Lohan, and I don't think much of her either as an actress or for some of the ignorant shit that comes out of her mouth, she is an adult who has the right to consume drugs if she damn well pleases.  Dr. Drew's approach is to frame her by planting illegal drugs in her car and then calling the police.
    You see Dr. Drew really cares about his victims. Losing your freedom, being charged with a crime, suffering the dehumanizing environment of a prison, living with a criminal record, entering "treatment" where "professionals" tell their "clients" how to live their lives, this is all for your own good.  He claims to be a healer catering to semi-famous clients, but is more interested in his own fame and imposing his own arbitrary system of morality on his "patients."  I call that being an authoritarian asshole.

Further Reading:

Dr. Drew Endorses Planting Evidence on Drug Users to Get Them Locked Up [Link]

The board certified addiction specialist tells RadarOnline.com, "If she were my daughter, I would pack her car full with illegal substances, send her on her way, call the police, and make sure she was arrested. I would make sure she was not allowed to get out of jail. I would then go to the judge  and make sure she was ordered to a minimum of a three year sobriety program." [Radar]

You see, Dr. Drew is really concerned about her safety:
"I absolutely wish no harm to her, but I just have a feeling that something awful is going to happen to her, like she is going to lose a limb. I hope Lindsay gets help before something terrible happens."

Something terrible? Like getting framed for a carload of drugs by your own family!? Maybe they don't cover this in medical school, Dr. Drew, but you should really make yourself aware of the fact that many people have been accidentally shot by drug cops, sexually assaulted in jail, and otherwise mercilessly screwed over by the criminal justice system in ways that you and your massive ego don't have the luxury of predicting. 

Planting drugs on anyone is a serious crime that could go wrong in more ways than you can possibly imagine. Anyone who endorses screwing around like this has no business practicing medicine, parenthood or friendship. You can get people killed with this sort of idiocy, and as much as it would reveal about the stupidity of the war on drugs, "Hollywood Starlet Shot in Face by SWAT Team" is a story no drug policy blogger wants to write.

Dr. Drew Pinsky's Authoritarian Approach to Charlie Sheen [Link]

In a recent video with hollywoodlife.com, Dr. Drew Pinsky discusses Charlie Sheen (sprinkled with condescending head nods and ending in smug amusement because the fate of someone's life is such a funny subject): "Whether it's drug induced or drug withdrawal or whether he has bipolar disorder, I don't know but right now he's manic. That's an acute psychiatric emergency. Bipolar patients that are manic are more likely to kill themselves or hurt themselves than when they're depressed. So this is somebody who should be in the hospital."

Note that Dr. Drew Pinsky is calling for the involuntary medical incarceration of someone who has not violated the law. If he wasn't using medical terms to threaten someone's liberty and to dehumanize them by refusing to respond to what they are saying, we would call this "libel." But what is going on here is worse than slander because this kind of insensitive, uncaring, profit-oriented, social-control oriented behavior is destroying people's lives.

It troubles me that Dr. Drew Pinksy's kind are making claims that can strip a person of their freedom and justify dehumanizing them. This sort of authoritarianism is cruel and inhumane. The police are required to read a suspected criminal their Miranda Rights before they lock them up, but not Dr. Drew Pinsky's kind. They can call a person "manic," identify him or her as a risk to either themselves or society, and have them taken away. Having been a victim of this practice, I can tell you that once you're locked-up, your freedom is completely gone. You are at the absolute mercy of outside sources and forces about what goes into your body and whether you ever get out of that institution again or not. Choice is no longer yours. In Dr. Drew Pinsky's addiction-recovery-treatment world a person is guilty until proven innocent.

Let me state this loud and clear--there is a problem. People are suffering with addiction and they do need help. But the problem is not the people, like myself, who find fault with the treatment they are given. The problem is the treatment.

Did Dr. Drew Lie About His Drug Use? [Link]

Dr. Drew Pinsky frequently enjoyed cocaine while working at the LA radio station, KROQ, in the early 1980s. This was asserted by two of his former KROQ co-workers earlier this year in this article, “Dr. Drew’s Drug Shocker!”. This allegation is not shocking because at the time cocaine use was commonplace in the LA entertainment industry.

Dr. Drew has not addressed the KROQ allegation. The fact that the most celebrated addiction doctor in America may have lied about his cocaine use will pass unnoticed. Dishonesty has always been an approved strategy in the war on drugs. 

Dr. Drew's drug shocker! [Link]

In 1982, Drew hadn't even finished medical school when he met KROQ DJ Jim Trenton at a party. "I asked him to do this segment with me called Ask a Surgeon," Trenton tells Life & Style. "Listeners could call in and get answers to their romance and medical questions." The segment was such a hit, it soon evolved into Loveline -- which remains on the air to this day. 

While they spent their days helping listeners with their love, sex and health-related problems, Drew and Jim spent many of their nights partying away. Often, Trenton says, that included cocaine use. "He used to say to me, 'Jim, I love cocaine,'" Trenton notes. "He'd say that a lot -- that he loved coke." In fact, Trenton adds, Drew "did coke with a lot of different people, including myself, on numerous occasions." Joanna Swylde, who worked as an intern at KROQ at the time and partied with Drew and Trenton, confirms Trenton's claims. She tells Life & Style they even used to snort lines of cocaine off album covers in the control room at work. "We would do it during the breaks on the show," Swylde recalls. 

Although Drew used coke, "I don't think he was addicted to it," Trenton tells Life & Style. "He used it recreationally.

Drug Warriors and Their Prey

Drug Warriors and Their Prey From Police Power to Police State
by Richard Lawrence Miller
Book Review (read another review here)

"Everywhere in the world I dread that same self-deception which holds that "it can't happen here." It can happen anywhere. It becomes unlikely only where the mass of the population is aware of the threat, where there is accordingly no relapse into lethargy, where the character of "totalitarianism" is known and recognized from its very inception and in each of its aspects-as a Proteus which is constantly putting on new masks, which glides out of your grasp like an eel, which does the opposite of what it claims, which perverts the meaning of its words, which speaks, not to impart information, but to hypnotize, divert attention, insinuate, intimidate, dupe, which exploits and produces every type of fear, which promises security while destroying it completely."
—Karl Jaspers

Mr Miller's thesis is that the war on drugs is a war on ordinary citizens.  Starting from that premise Miller lays out the similarities between the portrayal of Jews in Nazi Germany and illicit drug users in the United States.  The book is divided into five main chapters, each one titled for a step in the chain of destruction, Identification, Ostracism, Confiscation, Concentration, and Annihilation.  The "chain of destruction" was derived from Raul Hilberg's study of the destruction process.

Identification
Identification is the first step, a group is identified as a threat to the well-being of the society.  In Nazi Germany the Jews were identified as the source of all the problems facing Germany after World War One.  Poverty, crime, inflation, unemployment, social dysfunction, these were all blamed on the insidious influences of the Jew.
.  Today in the United States, illicit drug users are blamed for many of the same problems.  Much like Jews, people who use drugs are just like everyone else.  There are some drug users that can be detected solely by their behavior, much like orthodox Jews who can be detected by their manner of dress and behavior like following Jewish customs, but there are many more drug users and Jews whose behavior and mannerisms are just like everyone else.  To detect the majority of people who use drugs, like the majority of Jews, other detection methods are necessary.  And so the Nazis had to resort to genealogical records and drug warriors resort to drug testing.  People who use drugs and people who have Jewish ancestry are both guilty of status crimes.  Crimes not based on behavior, but on the status of the individual.

Ostracism
    Ostracism is the second step of the destruction process.  Once hate propaganda has identified a particular group as being a problem, ostracism from the Government and society further marginalize the targeted group from society.  In Nazi Germany, Jews were systematically excluded from the workplace and those who owned their own businesses suddenly found themselves facing boycotts.  Legal protections (civil rights) are weakened or removed altogether.  Miller gives many examples of this within the United States showing how the drug warriors have slowly chipped away at the bill of rights until almost nothing is left, and what is left is just rhetoric, easily swept aside by the drug warriors in their persecution.
    Miller also examines how the function of the law shifts from protecting the individual to protecting and promoting the state, which he calls "civic duty."  Thus we have criminal statutes used to "send a message" and the incarceration of "addicts" without a criminal conviction in a process called "civil commitment."

Confiscation
    Confiscation of property is the next step in the destruction process.  In this section Miller notes not only the similarities between the Jews in Nazi Germany, but also Japanese-Americans living in the US during World War Two.  Much of this chapter examines civil forfeiture proceedings, and notes how the transfer of property enriches the drug warriors at cost to their victims, a similar situation to what happened to Jewish property forfeited in Nazi Germany.

Concentration
    "The Germans could not stand the idea of living in a world where one was not protected by law and order.  They would not believe that the prisoners in the camps had not committed outrageous crimes since the way they were punished permitted only this conclusion."
Bruno Bettelheim
    Miller opens the chapter on concentration with this quote, and I think it is apt.  The prison population in the United States has exploded, especially since 1980.  Today the US boasts housing 25% of the world's prison population, with only 5% of the world's population.  Much like the Nazi concentration camps, the general belief is that the victims must have done something to belong there, and like the concentration camps the victims are then used as a source of slave labor.  Companies that would scoff at the idea of hiring drug users are more than happy to hire prisoners once the matter of regular paychecks, safe working conditions, strikes and holidays off are done away with.

Annihilation
    Killing the the ultimate and final stage in the destruction process.  When thinking about the Holocaust, one is immediately reminded of the gas chambers used to exterminate people en mass.  Miller reminds us that the death camps were not the first methods used to achieve annihilation.  Death squads hunted victims, citizens brandished their own vigilante justice, disease was promoted while medical treatment was withheld, unemployment and discrimination encouraged suicide and families were broken up further encouraging dysfunction among the families of victims.  Victims were also sterilized thereby annihilating any future generations.
    The parallels are striking.  Drug prohibition itself maximizes harm.  Suspected drug users and dealers are often involved in extra-judicial killings, especially in "producer" countries.  To this day there are calls for the sterilization of people who use drugs (which I have written about here).  I recently learned that some doctors will not begin treatment for hepatitis or HIV infection unless the patient is at least three months "clean."  I guess people who are "dirty" (use drugs) are unworthy of medical care.  Laws against access to new syringes and against "Good Samaritan" statutes all maximize the probability that people who use drugs will get ill and die.  Pregnant mothers are less likely to seek prenatal care when they face the prospect of losing their child, thereby increasing the mortality of children born to mothers who use illicit drugs.  It should also be pointed out that most illicit drugs are less teratogenic than legal ones like alcohol and tobacco.

    Some will certainly dismiss Miller's analysis as hyperbole.  This reflects a certain amount of denial on the part of Americans, the war on illicit drug users just can't be the same as the Nazi war on Jews.  Others will scream Godwin's Law applies here because, unlike being Jewish, drug use is a choice.  The danger in Miller's approach is that he is preaching to the converted, supporters of the war on drug users are not likely to be impressed with miller's argument.  Those of us who have experienced this war personally are likely to agree with Miller.  Miller's work is also meticulously researched with over 50 pages of this 255 page book devoted to references.

    One final thought to conclude this review is to note how the early steps in the chain of destruction are used to justify further action.  Whether Jewish or an illicit drug user, if an individual is not permitted to live a "normal" life, if they are ostracized from society and have their property confiscated, if they are concentrated in ghettos or prisons, we should not be surprised by a great deal of social dysfunction in the population discriminated against.  The inability to live a "normal" life is then used as further justification for future action.  Whether a drug user or Jew, being forced to live in meager conditions rife with crime and disease is then used as evidence for the debased nature of the individual.  This continues the dehumanization and ensures that the chain of destruction continues.  It is quite obvious that the answer to the "Jewish problem" is the same as the answer to the "drug problem," namely call off the war and leave the people alone.

Needle Tip Under a Microscope

From legalizeheroin.org

The Mystery of the Leaping Fish

This quirky and amusing drug movie came out in 1916.  The following is from YouTube, if you want to download the movie in various formats it can be found at the Internet Archive here. the film is only about a half hour.

Movie summary from wikipedia: 

    The Mystery of the Leaping Fish (1916) is a short film starring Douglas Fairbanks and Bessie Love. In this unusually broad comedy for Fairbanks, the acrobatic leading man plays "Coke Ennyday," a cocaine-shooting detective parody of Sherlock Holmes given to injecting himself with cocaine from a bandolier of syringes worn across his chest and liberally helping himself to the contents of a hatbox-sized round container of white powder labeled "COCAINE" on his desk.
    The film, written by D.W. Griffith, Tod Browning, and Anita Loos, displays a lighthearted attitude toward cocaine and opium. Fairbanks otherwise lampoons Sherlock Holmes with checkered detective hat, coat, and even car, along with the aforementioned propensity for injecting cocaine whenever he feels momentarily down, then laughing with delight. In addition to observing visitors at his door on what appears to be a closed-circuit television referred to in the title cards as his "scientific periscope," a clock-like sign on the wall reminds him to choose between "EATS, DRINKS, SLEEPS, and DOPE".

DEA at their best

From the homepage of DEAsucks.com.

The Birth of Heroin and the Demonization of the Dope Fiend

The Birth of Heroin and the Demonization of the Dope Fiend by Thom Metzger

Today I finished reading Metzger's account of the story of heroin, from wonder drug to demon drug.  Metzger borrows heavily from Thomas Szasz, even quoting him in several chapters.  The majority of the book is accurate, although he does repeat some popular myths about methadone (it was not named Dolophine for Adolf Hitler).  Personally I enjoyed the earlier chapters about the Bayer pharmaceutical company more than the later chapters, although I suspect this is because I am at heart a chemistry geek and already quite familiar with the themes of later chapters.  Metzger shows how the "dope fiend" caricature evolved from notions of racial purity and obsessions about cleanliness and purity.  I thought the last chapter, titled "the new orthodoxy," could have been longer coming in at only 15 pages in a 216 page book.  The book also contains many images of the portrayal of dope in newspapers and notes the similarities to the portrayal of Jews in Nazi Germany.  This is a short book that can easily be read in a day or two, but is worth checking out.

Legalize Drugs Debate

Legalize Drugs Debate



For: Nick Gillespie Editor in Chief of Reason.tv and Reason.com
Paul Butler Professor of Law, Georgetown University Law Center
Against: Asa Hutchinson Former Administrator, Drug Enforcement Administration
Theodore Dalrymple Dietrich Weismann Fellow, Manhattan Institute
Results:
PRE-DEBATE POLL RESULTS 45% FOR | 23% AGAINST | 32% UNDECIDED
POST-DEBATE POLL RESULTS 58% FOR | 30% AGAINST | 12% UNDECIDED

This is encouraging as the undecided broke in favor of legalization 2-to-1.

Loperamide

I'm working on my own guide to the use of loperamide in suppressing the symptoms of opiate withdrawal.  There are a lot of opinions out there, many of which are based on hearsay.  I have several research papers that I will put up so people can look to the science.  In the meantime check out the following, which is among the best summaries available, better than looking to forums.  In the meantime check out the chemical structures below, notice how loperamide looks like a cross between methadone and fentanyl?

The Merits of High Dose Loperamide for Opioid Withdrawal

Loperamide In Opioid Withdrawal

The "evil" of addiction to narcotic drugs

I posted this at DrugWarRant.

SINGLE CONVENTION ON NARCOTIC DRUGS, 1961 [Link]

Recognizing that addiction to narcotic drugs constitutes a serious evil for the individual and is fraught with social and economic danger to mankind... 

Conscious of their duty to prevent and combat this evil...

‘Deliver us from evil’? – The Single Convention on Narcotic Drugs, 50 years on by Rick Lines [Link]

In the context of international treaty law, this wording is notable in that the Single Convention is the only United Nations treaty characterising the activity it seeks to regulate, control or prohibit as being ‘evil’.   

[Conor]  Gearty is correct, however, in his recognition that the use of such language is highly unusual. Indeed, the unique nature of the use of the language of ‘evil’ in the Single Convention is particularly glaring when considered alongside that used in other treaties addressing issues that the international community considers abhorrent.   

For example, neither slavery, apartheid nor torture are described as being ‘evil’ in the relevant international conventions that prohibit them. Nuclear war is not described as being ‘evil’ in the treaty that seeks to limit the proliferation of atomic weapons, despite the recognition in the preamble that ‘devastation that would be visited upon all mankind’ by such a conflict.
The closest one finds to the language contained in the preamble to the Single Convention to describe drugs is that found in international instruments in the context of genocide. For example, in describing the crimes committed during the Second World War, the Universal Declaration of Human Rights uses the term ‘barbarous acts’, while the Genocide Convention uses the term ‘odious scourge’.

    I have been dependent (I'm trying my best not to use terms like "addict" or "addiction" as I think these are loaded with false meanings and used by the treatment industry to justify coercion and control of the lives of people who use drugs) on opiates for a long time, more than ten years.  I don't steal, commit acts of violence or any other criminal activities beyond using certain drugs "non-medically" (itself a meaningless term simply implying using a drug in ways not approved by the medical-industrial complex that is the FDA, AMA, DEA, ect).  People use drugs for all different reasons so I won't speculate on why other people use opiates, but for me it's always been about self-medication.  Without going into details let me say that, for me, opiates are a far better mood elevator than conventional treatments offered by doctors and yes I've tried many different medications.  There is a small but significant percentage of people who only truly feel well on opiates.  In case you think we're all just a bunch of dirty junkies consider that William Steward Halstead, the "father of American surgery" was also a lifelong morphine user, just one of many examples of men and women who accomplished great feats in many different disciplines while also using opiates.  As Ethan Nadelmann has said (quoting from memory so may not be verbatim), "Some people take drugs and say they feel normal for the first time in their lives.  I've only ever heard that reaction from two drugs: prozac and heroin."

    I have tried methadone which made me quite ill, gaining nearly 100 pounds and experiencing serious cognitive decline.  Suboxone is somewhat better, although nowhere near as good as traditional full-agonists like morphine, oxycodone, fentanyl , heroin, ect.  And God no I don't want naltrexone (Vivitrol),  which has such side effects as liver toxicity and inability to experience pleasure (anhedonia)!  Without a doctor to prescribe, indeed even if I could find such a doctor he/she would be be putting their practice and freedom at risk from the DEA, my choice is between the black market or inferior conventional options.  It is true that I could live without opiates, and I have done so for long periods of time (I try not to use terms like "clean" which implies that people who use drugs are "dirty"), but not without experiencing some loss of quality of life.  When people use drugs like antidepressants for depression or caffeine to increase alertness we don't condemn them for inability to "deal with reality."  Why is my particular form of self-medication a "serious evil for the individual" and "fraught with social and economic danger to mankind."

    The truth is that the convention on narcotic drugs, and all other treaties and policies that support global drug prohibition, are responsible for most of the social and economic danger to mankind caused by drugs.  Global drug prohibition is a serious evil that deserves to be compared to slavery and torture, NOT addiction to narcotic drugs.  Calling addiction to narcotic drugs an evil justifies the execution, arbitrary incarceration and torture (including the standard "cold-turkey" treatment in jails) of people who use opiates, as long as combating narcotics is seen as being good.  I myself have experienced violence at the hands of police simply for being a suspected "drug user."  All in all I would say that I've had it much easier (in no small part to being white) than some of my junkie brethren, so many of whom have histories of childhood abuse, neglect and poverty.  

The sooner we can get rid of these archaic and moralistic international treaties the better.  

Updated Mission Statement

Updated the page about this site.

The purpose of opiophilia is:
(I) To advocate for the right of individuals to use opiates, also known as narcotic analgesics, without constraint.  This includes both "medical" and "recreational" use as well as any route of administration as determined by the user (oral, intranasal, intravenous, ect.)
(II) To provide accurate information about opiates.
(III) To offer different perspectives on opiate use.  In an era where the use of opiates is viewed with suspicion at best and outright hostility as worst, Opiophilia hopes to de-stigmatize and de-pathologize opiate use by providing the perspective(s) of a user(s), including the good, bad and downright ugly.
(IV) To document the worst abuses of the "War on (some) Drugs," which is really a war on the people who use the "wrong" drugs.  The truism that the first casualty of war is truth is certainly at work here, as well as the inevitable dehumanization of the "enemy."  As INPUD says, we are people not collateral damage.

I have thought long and hard about these issues over the years.  I always welcome constructive debate, but please do not contact me to tell me how my views are "sick" or "wrong."  Yes, I want to legalize heroin as well as all other pharmaceutical opioid drugs for all adults.  Perhaps you adhere to the "progressive" notion
that people who use opiates are "diseased" and in need of "treatment," delivered against the "patient's" will if necessary.  I support meaningful treatment for people who have issues with their substance use, as long as the treatment is evidence-based and voluntary.  I reject the notion that drug use, in and of itself, is a disease.

If these views offend you, please look away.

Links to Papers on Addiction

I am in the middle of an experiment involving high-dose loperamide and don't feel much like writing at the moment but over the last few days have been compiling a list of random papers I have read relating to addiction.  Over the next week I hope to be able to finish writing my take on addiction, Can't or Won't Stop?

Are there circumstances in which drug use is involuntary?

Further Reading:

Addiction? by Robert M Goodman The Great Issues of Drug Policy 1990 [Link]

Let's explore reasons for the self-delusion, or misimpression, of the addict who says, sincerely though not truthfully, "I habitually do something I don't want to do." This calls for a thought experiment. Imagine a triangle. Make it a purple triangle. Now see that purple triangle whistling "Dixie". Do you see it? Hear it? Is it vivid? 

Now erase the triangle, and imagine yourself hungry, or at least with appetite. (This won't work if you already feel like eating when you do this.) Is the feeling vivid? If you're like me and most people I've asked, the conjured impression of the purple triangle whistling, though an unfamiliar experience, is much more vivid than the imagination of appetite, a familiar percept. 

The lesson is that for most people some percepts, including appetites, are much harder to imagine than others. The phenomenon is manifest every time I try grocery shopping on a full stomach. In evaluating what foods to buy, and how much, I rely on my memory or imagination of how good it would be to eat. But my imagination can't easily penetrate the sensation of fullness in my stomach, though it can easily penetrate a world of lights and sounds to produce the purple triangle whistling "Dixie". 

I'm fat. I like eating. But after a big meal I sometimes wonder, why did I eat (all) that? The problem is that I actually can't remember the appetite or its satisfaction, the good feeling that came with eating. I can't imagine the feeling. Were I not familiar with this defect of imagination, I could easily persuade myself that I habitually do something (eating, or eating more than a certain amount) that I don't want (at that time) to do. (Similarly I might think I could get much more out of life if I just slept less. I can't imagine sleepiness; all I can do is remember that sleepiness does come regularly, and needs to be dealt with by sleeping.)

Alcoholism: A disease of speculation [Link]

Wayburn, Thomas L., "The Case for Drug Legalization and Decontrol in the United States" [Link]

Wayburn, Thomas L., "Fallacies and Unstated Assumptions in Prevention and Treatment," Accepted for publication in The Great Issues of Drug Policy, Arnold S. Trebach and Kevin B. Zeese, Eds., The Drug Policy Foundation, Washington, D.C. (1990) [Link]

Wayburn, Thomas L., "No One Has a Right To Impose an Arbitrary System of Morals on Others," in Drug Policy 1889-1990, A Reformer's Catalogue, Arnold S. Trebach and Kevin B. Zeese, Eds., The Drug Policy Foundation, Washington, D.C. (1989)

The Myth of Drug-Induced Addiction by Bruce K. Alexander
Department of Psychology, Simon Fraser University [Link]

Schaler, J.A. (2004). You, robot. Liberty, October, Volume 18, No. 10, p19-21.[Link]

Themes in Chemical Prohibition by William L. White
Drugs in Perspective, National Institute on Drug Abuse, 1979 [Link]

Drug Addiction as Demonic Possession by Dale Atrens
Reader in Psychobiology University of Sydney
[published in: Overland vol 158, Autumn 2000, pp.19-24] [Link]

The production of stigma by the disease model of addiction: why drug user activists must oppose it by Eliot Albers Presented at the 20th International Conference on the Reduction of Drug Related Harm, Liverpool, April 2010 [Link]

Addiction: Medical Disease or Moral Defect? by Maia Szalavitz [Link]

Several studies find that teaching people that addiction is a brain disease increases rather than reduces stigma. Why should the “scientific” or “medical” model trigger such a seemingly irrational response? Basically, it's because people see those who are “brain diseased” as permanently damaged and scarily out of control. As a result, they want to lock them up (whether or not they get treatment) even if the problem “isn’t their fault.”

The fewer “aspects of mind” you attribute to someone—like being able to freely make choices, feel pain and pleasure, and form intentions and plans—the more you dehumanize at person, research finds. And the more you dehumanize a certain group of people, the more you support measures like incarceration or treatment that is coercive and infantilizing. After all, the treatment is intended to fix those whose behavior is child- or animal-like in being uncontrollable.