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On April 21 2015 04:08 oneofthem wrote:
addicts would not refrain from using for lack of clean needles, so assuming addiction already exists this doesn't change matters much except prevent hiv spread.
HIV doesn't curtail drug use? Sure seems like someone who has died of HIV is no longer using drugs.
Anyways, my point still stands that you'd get more out of offering free rehab instead of free needles. Free rehab stops the addiction, which has an added perk of curbing the spread of HIV. Handing out free needles is just a band-aid for the problem. It only treats a symptom of the real problem. The real problem is addiction, the HIV epidemic is just a symptom.
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On April 21 2015 03:34 oneofthem wrote:Show nested quote +On April 21 2015 03:21 JonnyBNoHo wrote:On April 21 2015 01:47 oneofthem wrote:On April 21 2015 01:42 JonnyBNoHo wrote:On April 21 2015 00:02 oneofthem wrote:On April 20 2015 23:13 Aveng3r wrote:On April 20 2015 22:58 oneofthem wrote:
progressivity without distributive motive is just a formula for burden sharing. right now we are not even at that. amount of tax avoidance and evasive action is high enough to place tax burden on the most stressed rather than on those with major wealth.
redistributive tax rates havent been seen for half a century and wont evr work given globalization of capital I don't get why so many posts in this thread contend that "the most financially stressed taxpayers pay more in taxes than the rich". on what grounds is this true? the claim was never 'pay more taxes' in absolute amount but in the form of higher rates and also higher burden in terms of impacting life. just based on reported income alone the top 0.1% pays under 25% effective rate, while a working professional would pay around 40%. The top marginal rate is ~40%. How are you getting that a working professional will be paying 40%? Have you ever filed taxes? effective tax rate jonny, including state taxes, payroll and ss. the largest disparity in effective tax burden basically comes down to the composition of income. those who have fairly high income, top 10% even, but have that income in the form of wages will face high tax rate. + Show Spoiler +![[image loading]](http://i.imgur.com/q4BMmVf.png) http://www.economics-finance.org/jefe/econ/Allenpaper2.pdftrash journal i know but the calculations are fairly simple. most state taxes such as property/excise are regressive, and payroll+fica are largely employee burdens. this chart is about 'marginal rate' which means, among other things, counting the loss of transfers in the lower ranges. so no poor people are not taxed at 40% they just face steep marginal effective tax given transfers. these rates should not be very different for present day given the presence of the AMT. but i was talking about working professionals earning 100k-200k in a major city. the amount oou get hit with at this range is pretty brutal. Marginal tax rates aren't your effective tax rates though, that's your effective rate on the next dollar you earn. Actual effective tax rates are much lower. To address your other post, effective tax rates as described by the IRS are going to be different from the CBO because of definitional differences. The CBO tries to get closer to reality, while the IRS goes strictly by tax law. This is important when you get into the top 0.1% and higher, since income will be split between multiple IRS taxpayers (C-corp and individual). the federal effective tax rate on upper middle class professionals is already 25-30%(http://fas.org/sgp/crs/misc/R42043.pdf), adding the state stuff and 40% is a fair estimate. the reason why some CBO estimate for effective tax rate is low is due to the counting rule of various deductibles, many of which are targeted at families.
OK, I understand your 40% comment. Could you explain your top 0.1% pay 25% effective rate comment? Your cbo link seems to flatline after AGI hits $350K (fig 2), and that doesn't seem to include an allocation of corp taxes.
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On April 21 2015 04:19 Millitron wrote:Show nested quote +On April 21 2015 04:08 oneofthem wrote:
addicts would not refrain from using for lack of clean needles, so assuming addiction already exists this doesn't change matters much except prevent hiv spread. HIV doesn't curtail drug use? Sure seems like someone who has died of HIV is no longer using drugs. Anyways, my point still stands that you'd get more out of offering free rehab instead of free needles. Free rehab stops the addiction, which has an added perk of curbing the spread of HIV. Handing out free needles is just a band-aid for the problem. It only treats a symptom of the real problem. The real problem is addiction, the HIV epidemic is just a symptom.
You are forgetting the part where we have to treat the person with HIV until they die. And because they are a drug addict, the government is likely to pick up the bill. Providing them with clean needles is cheaper. And the great part is that we can combat addiction and hand out clean needles.
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On April 21 2015 04:04 Millitron wrote:Show nested quote +On April 21 2015 03:40 {CC}StealthBlue wrote:WASHINGTON -- Indiana Gov. Mike Pence (R) on Monday extended a short-term needle exchange program in order to respond to an exploding HIV crisis in southeastern Indiana.
"While we’ve made progress in identifying and treating those affected by this heartbreaking epidemic, the public health emergency continues and so must our efforts to fight it," Pence said in a statement.
As of April 17, the Indiana State Department of Health had confirmed 128 cases and at least six preliminary cases of HIV in Scott County, the governor's office reported. The week before, the county was looking at 106 cases. Typically, Scott County would see fewer than five new HIV cases a year.
Indiana's HIV crisis is linked to intravenous drug use of a prescription painkiller called Opana. Like many other conservatives, Pence opposes needle exchange programs as part of drug control efforts. The exchanges allow drug users to obtain sterile needles and have been shown to reduce the transmission of diseases like HIV, but critics say the programs facilitate drug abuse. Research has refuted that claim.
The exchanges are technically illegal in Indiana. But last month, Pence made an exception and signed an executive order authorizing a temporary needle exchange program that was set to expire this week. Pence has now extended that order for another 30 days. According to The New York Times, since the temporary exchange was approved, 5,322 clean syringes have been distributed to 86 people.
"The goal of that program is a clean needle for each person for each injection," Amber Kent, a spokeswoman for Indiana's Joint Information Center, told The Huffington Post. The center is working on behalf of the state's Department of Health. Source Can someone tell me how handing out clean needles is not facilitating drug use? Sure seems like it does to me. Maybe instead of handing out needles, they should offer free rehab. Offer real help instead of just stringing people along. In the ideal situation this is what the local governments would do. Provide more rehab facilities and detox beds while also handing out clean needles so that HIV doesn't spread rampantly among impoverished communities, while at the same time offering people who wish to quit the help they need to be successful.
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On April 21 2015 04:19 Millitron wrote:Show nested quote +On April 21 2015 04:08 oneofthem wrote:
addicts would not refrain from using for lack of clean needles, so assuming addiction already exists this doesn't change matters much except prevent hiv spread. HIV doesn't curtail drug use? Sure seems like someone who has died of HIV is no longer using drugs. Anyways, my point still stands that you'd get more out of offering free rehab instead of free needles. Free rehab stops the addiction, which has an added perk of curbing the spread of HIV. Handing out free needles is just a band-aid for the problem. It only treats a symptom of the real problem. The real problem is addiction, the HIV epidemic is just a symptom.
I don't see how those two things are mutually exclusive. Needle exchange stops the addicted from getting HIV, and rehab programs may help them to stop being addicted. Those are both recommendable goals, and both should be pursued.
If you don't give the drug addicts clean needles, they will just use their old ones, or someone elses old ones. That is not a good idea, and needles are so much cheaper than any of the possible results for everyone involved (Not to speak of how much better it is for the drug addicts if they don't also have numerous diseases) that it is actually quite insane to NOT have a needle exchange program.
Having a good free rehab program is also a very good idea. I highly doubt you can convince US conservatives to pay for one with tax payer money, though.
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Cayman Islands24199 Posts
On April 21 2015 04:23 JonnyBNoHo wrote:Show nested quote +On April 21 2015 03:34 oneofthem wrote:On April 21 2015 03:21 JonnyBNoHo wrote:On April 21 2015 01:47 oneofthem wrote:On April 21 2015 01:42 JonnyBNoHo wrote:On April 21 2015 00:02 oneofthem wrote:On April 20 2015 23:13 Aveng3r wrote:On April 20 2015 22:58 oneofthem wrote:
progressivity without distributive motive is just a formula for burden sharing. right now we are not even at that. amount of tax avoidance and evasive action is high enough to place tax burden on the most stressed rather than on those with major wealth.
redistributive tax rates havent been seen for half a century and wont evr work given globalization of capital I don't get why so many posts in this thread contend that "the most financially stressed taxpayers pay more in taxes than the rich". on what grounds is this true? the claim was never 'pay more taxes' in absolute amount but in the form of higher rates and also higher burden in terms of impacting life. just based on reported income alone the top 0.1% pays under 25% effective rate, while a working professional would pay around 40%. The top marginal rate is ~40%. How are you getting that a working professional will be paying 40%? Have you ever filed taxes? effective tax rate jonny, including state taxes, payroll and ss. the largest disparity in effective tax burden basically comes down to the composition of income. those who have fairly high income, top 10% even, but have that income in the form of wages will face high tax rate. + Show Spoiler +http://www.economics-finance.org/jefe/econ/Allenpaper2.pdftrash journal i know but the calculations are fairly simple. most state taxes such as property/excise are regressive, and payroll+fica are largely employee burdens. this chart is about 'marginal rate' which means, among other things, counting the loss of transfers in the lower ranges. so no poor people are not taxed at 40% they just face steep marginal effective tax given transfers. these rates should not be very different for present day given the presence of the AMT. but i was talking about working professionals earning 100k-200k in a major city. the amount oou get hit with at this range is pretty brutal. Marginal tax rates aren't your effective tax rates though, that's your effective rate on the next dollar you earn. Actual effective tax rates are much lower. To address your other post, effective tax rates as described by the IRS are going to be different from the CBO because of definitional differences. The CBO tries to get closer to reality, while the IRS goes strictly by tax law. This is important when you get into the top 0.1% and higher, since income will be split between multiple IRS taxpayers (C-corp and individual). the federal effective tax rate on upper middle class professionals is already 25-30%(http://fas.org/sgp/crs/misc/R42043.pdf), adding the state stuff and 40% is a fair estimate. the reason why some CBO estimate for effective tax rate is low is due to the counting rule of various deductibles, many of which are targeted at families. OK, I understand your 40% comment. Could you explain your top 0.1% pay 25% effective rate comment? Your cbo link seems to flatline after AGI hits $350K (fig 2), and that doesn't seem to include an allocation of corp taxes.
well the top marginal rate for long term cap gains was at 15% for a long time and recently increased to 23.8%. without accounting for double taxation you'd get a figure like low 20% fairly easily, and if the person in question employs various deductions such as mortgage, charity etc it goes lower. the nature of cap gains income also allows flexible assignment of upfront vs deferred tax.
the double taxation thing is real but there are some things to consider:
1. partnerships are not taxed at the entity level and cap gains income in partnerships (real estate, private equity etc) will pass through. so no double taxation here.
2. some corporations face very low effective tax rate.
3. cap gains tax at the wealth level relevant to the discussion about the 'super rich' has to looked at in combination with inheritance. a capital gain never realized does not flow into the tax system. there are lots of ways to increase this kind of 'death' tax shelter.
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On April 21 2015 04:33 Simberto wrote:Show nested quote +On April 21 2015 04:19 Millitron wrote:On April 21 2015 04:08 oneofthem wrote:
addicts would not refrain from using for lack of clean needles, so assuming addiction already exists this doesn't change matters much except prevent hiv spread. HIV doesn't curtail drug use? Sure seems like someone who has died of HIV is no longer using drugs. Anyways, my point still stands that you'd get more out of offering free rehab instead of free needles. Free rehab stops the addiction, which has an added perk of curbing the spread of HIV. Handing out free needles is just a band-aid for the problem. It only treats a symptom of the real problem. The real problem is addiction, the HIV epidemic is just a symptom. I don't see how those two things are mutually exclusive. Needle exchange stops the addicted from getting HIV, and rehab programs may help them to stop being addicted. Those are both recommendable goals, and both should be pursued. If you don't give the drug addicts clean needles, they will just use their old ones, or someone elses old ones. That is not a good idea, and needles are so much cheaper than any of the possible results for everyone involved (Not to speak of how much better it is for the drug addicts if they don't also have numerous diseases) that it is actually quite insane to NOT have a needle exchange program. Having a good free rehab program is also a very good idea. I highly doubt you can convince US conservatives to pay for one with tax payer money, though.
I would of said the same thing about Conservatives and a needle exchange. Because his constituents would see it more like Milli did without the rehab part. The townhall would go something like this. "So are you giving drug addicts free needles to do drugs with?" "Yes I am" "You're as bad as the drug dealers".
What I find funny about it is that they are actually addicted to a legal drug in the first place. Maybe, just maybe it could lead to the widespread realization that prescription drugs kill more people than heroin, crack/cocaine, and all other illegal drugs combined.
These are not isolated events. Each day, 44 people in the United States die from overdose of prescription painkillers.
Source
Not only are more people getting addicted to/overdosing on drugs (amidst the 'War on Drugs'), but the drugs that are killing them the most are legal. While the least deadly substance can still get you a life sentence. A 12 year old could make more sensible drug policy than this country.
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On April 21 2015 04:24 Plansix wrote:Show nested quote +On April 21 2015 04:19 Millitron wrote:On April 21 2015 04:08 oneofthem wrote:
addicts would not refrain from using for lack of clean needles, so assuming addiction already exists this doesn't change matters much except prevent hiv spread. HIV doesn't curtail drug use? Sure seems like someone who has died of HIV is no longer using drugs. Anyways, my point still stands that you'd get more out of offering free rehab instead of free needles. Free rehab stops the addiction, which has an added perk of curbing the spread of HIV. Handing out free needles is just a band-aid for the problem. It only treats a symptom of the real problem. The real problem is addiction, the HIV epidemic is just a symptom. You are forgetting the part where we have to treat the person with HIV until they die. And because they are a drug addict, the government is likely to pick up the bill. Providing them with clean needles is cheaper. And the great part is that we can combat addiction and hand out clean needles.
I guess Millitron would like the HIV drug victims to die in the streets rather then be treated. The argument makes sense then (in a horrible way).
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On April 21 2015 05:00 GreenHorizons wrote:Show nested quote +On April 21 2015 04:33 Simberto wrote:On April 21 2015 04:19 Millitron wrote:On April 21 2015 04:08 oneofthem wrote:
addicts would not refrain from using for lack of clean needles, so assuming addiction already exists this doesn't change matters much except prevent hiv spread. HIV doesn't curtail drug use? Sure seems like someone who has died of HIV is no longer using drugs. Anyways, my point still stands that you'd get more out of offering free rehab instead of free needles. Free rehab stops the addiction, which has an added perk of curbing the spread of HIV. Handing out free needles is just a band-aid for the problem. It only treats a symptom of the real problem. The real problem is addiction, the HIV epidemic is just a symptom. I don't see how those two things are mutually exclusive. Needle exchange stops the addicted from getting HIV, and rehab programs may help them to stop being addicted. Those are both recommendable goals, and both should be pursued. If you don't give the drug addicts clean needles, they will just use their old ones, or someone elses old ones. That is not a good idea, and needles are so much cheaper than any of the possible results for everyone involved (Not to speak of how much better it is for the drug addicts if they don't also have numerous diseases) that it is actually quite insane to NOT have a needle exchange program. Having a good free rehab program is also a very good idea. I highly doubt you can convince US conservatives to pay for one with tax payer money, though. I would of said the same thing about Conservatives and a needle exchange. Because his constituents would see it more like Milli did without the rehab part. The townhall would go something like this. "So are you giving drug addicts free needles to do drugs with?" "Yes I am" "You're as bad as the drug dealers". What I find funny about it is that they are actually addicted to a legal drug in the first place. Maybe, just maybe it could lead to the widespread realization that prescription drugs kill more people than heroin, crack/cocaine, and all other illegal drugs combined. Show nested quote +These are not isolated events. Each day, 44 people in the United States die from overdose of prescription painkillers. SourceNot only are more people getting addicted to/overdosing on drugs (amidst the 'War on Drugs'), but the drugs that are killing them the most are legal. While the least deadly substance can still get you a life sentence. A 12 year old could make more sensible drug policy than this country.
Prescription drug abuse is not legal either. Just because there are legal means to acquire the drugs doesn't mean the people who OD'd on them got them that way. Most of the people who abuse things like Oxycodone do not have a prescription for it.
The possibility of contracting HIV is one factor encouraging people to get help. Handing out clean needles removes the risk of HIV, meaning it removes one incentive to get help.
I don't see how handing out free needles really fights HIV. Sure, this particular outbreak might be stopped, but in the end you still have just as many addicts using just as many needles. It's like the old "Give a man a fish, feed him for a day" adage, except in this case it's "Give a man a needle, prevent HIV for a week or two. Help a man recover from his addiction, prevent HIV for a lifetime."
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Cayman Islands24199 Posts
it's obviously not a final solution. not sure why you are arguing as if it is
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Clean needles are a step towards the right direction. Plus I'm pretty sure like a single case of HIV treatment can probably pay off 10 years worth of free needles for like a bunch of people. It's just a financially responsible thing to do anyways.
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On April 21 2015 06:47 wei2coolman wrote:
Clean needles are a step towards the right direction. Plus I'm pretty sure like a single case of HIV treatment can probably pay off 10 years worth of free needles for like a bunch of people. It's just a financially responsible thing to do anyways.
Money spent handing out free needles is money that would've been better spent on real rehab.
It's opportunity cost. Any money headed towards handing out free needles is money that is not going towards a real solution.
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On April 21 2015 06:50 Millitron wrote:Show nested quote +On April 21 2015 06:47 wei2coolman wrote:
Clean needles are a step towards the right direction. Plus I'm pretty sure like a single case of HIV treatment can probably pay off 10 years worth of free needles for like a bunch of people. It's just a financially responsible thing to do anyways. Money spent handing out free needles is money that would've been better spent on real rehab. It's opportunity cost. Any money headed towards handing out free needles is money that is not going towards a real solution.
That's implying handing out free needles can't be part of spending on rehab.
Let me guess, abstinence is the only policy in regards to birthcontrol?
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On April 21 2015 06:44 Millitron wrote:Show nested quote +On April 21 2015 05:00 GreenHorizons wrote:On April 21 2015 04:33 Simberto wrote:On April 21 2015 04:19 Millitron wrote:On April 21 2015 04:08 oneofthem wrote:
addicts would not refrain from using for lack of clean needles, so assuming addiction already exists this doesn't change matters much except prevent hiv spread. HIV doesn't curtail drug use? Sure seems like someone who has died of HIV is no longer using drugs. Anyways, my point still stands that you'd get more out of offering free rehab instead of free needles. Free rehab stops the addiction, which has an added perk of curbing the spread of HIV. Handing out free needles is just a band-aid for the problem. It only treats a symptom of the real problem. The real problem is addiction, the HIV epidemic is just a symptom. I don't see how those two things are mutually exclusive. Needle exchange stops the addicted from getting HIV, and rehab programs may help them to stop being addicted. Those are both recommendable goals, and both should be pursued. If you don't give the drug addicts clean needles, they will just use their old ones, or someone elses old ones. That is not a good idea, and needles are so much cheaper than any of the possible results for everyone involved (Not to speak of how much better it is for the drug addicts if they don't also have numerous diseases) that it is actually quite insane to NOT have a needle exchange program. Having a good free rehab program is also a very good idea. I highly doubt you can convince US conservatives to pay for one with tax payer money, though. I would of said the same thing about Conservatives and a needle exchange. Because his constituents would see it more like Milli did without the rehab part. The townhall would go something like this. "So are you giving drug addicts free needles to do drugs with?" "Yes I am" "You're as bad as the drug dealers". What I find funny about it is that they are actually addicted to a legal drug in the first place. Maybe, just maybe it could lead to the widespread realization that prescription drugs kill more people than heroin, crack/cocaine, and all other illegal drugs combined. These are not isolated events. Each day, 44 people in the United States die from overdose of prescription painkillers. SourceNot only are more people getting addicted to/overdosing on drugs (amidst the 'War on Drugs'), but the drugs that are killing them the most are legal. While the least deadly substance can still get you a life sentence. A 12 year old could make more sensible drug policy than this country. Prescription drug abuse is not legal either. Just because there are legal means to acquire the drugs doesn't mean the people who OD'd on them got them that way. Most of the people who abuse things like Oxycodone do not have a prescription for it. The possibility of contracting HIV is one factor encouraging people to get help. Handing out clean needles removes the risk of HIV, meaning it removes one incentive to get help. I don't see how handing out free needles really fights HIV. Sure, this particular outbreak might be stopped, but in the end you still have just as many addicts using just as many needles. It's like the old "Give a man a fish, feed him for a day" adage, except in this case it's "Give a man a needle, prevent HIV for a week or two. Help a man recover from his addiction, prevent HIV for a lifetime."
We've had a safe injection site setup in Vancouver for a long while now (even if our Federal Conservative government keeps trying and failing to rope it through the courts), and one of the main reasons it's still going is because the it has a notable rate of getting people who use it to move into rehab programs.
If you want to deal with drug addictions and drug problems, you have to look at the solutions that are actually effective, not the pipe-dream solutions like "just give them rehab".
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On April 21 2015 06:50 Millitron wrote:Show nested quote +On April 21 2015 06:47 wei2coolman wrote:
Clean needles are a step towards the right direction. Plus I'm pretty sure like a single case of HIV treatment can probably pay off 10 years worth of free needles for like a bunch of people. It's just a financially responsible thing to do anyways. Money spent handing out free needles is money that would've been better spent on real rehab. It's opportunity cost. Any money headed towards handing out free needles is money that is not going towards a real solution.
This has been argued repeatedly, but free needles are NOT perpetuating drug addictions. If a drug addict can't get free needles, he will not suddenly say "fuck it, I can't get a needle. Time to quit". He will just reuse an old one. In fact, he may do that anyway even if free clean needles are available.
There are 2 separate goals here:
1. HIV prevention and/or treatment.
2. Drug abuse prevention.
The initiative ONLY serves the former goal and has absolutely NO EFFECT on the latter. In the case of the former goal, it just makes sense. Rather than paying for anti-retrovirals for the rest of his life for even 1 patient, it is cheaper to pay for a needle exchange for ALL drug abusers.
So if you're talking opportunity cost, that is it. Offering free rehab is great, and I am all for it, but it won't get drug abusers who deny they have a problem off the street (or using clean needles). Unless you want to force drug users to enter (free) rehab (and even if you do, that has also been shown not to work).
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On April 21 2015 06:44 Millitron wrote:Show nested quote +On April 21 2015 05:00 GreenHorizons wrote:On April 21 2015 04:33 Simberto wrote:On April 21 2015 04:19 Millitron wrote:On April 21 2015 04:08 oneofthem wrote:
addicts would not refrain from using for lack of clean needles, so assuming addiction already exists this doesn't change matters much except prevent hiv spread. HIV doesn't curtail drug use? Sure seems like someone who has died of HIV is no longer using drugs. Anyways, my point still stands that you'd get more out of offering free rehab instead of free needles. Free rehab stops the addiction, which has an added perk of curbing the spread of HIV. Handing out free needles is just a band-aid for the problem. It only treats a symptom of the real problem. The real problem is addiction, the HIV epidemic is just a symptom. I don't see how those two things are mutually exclusive. Needle exchange stops the addicted from getting HIV, and rehab programs may help them to stop being addicted. Those are both recommendable goals, and both should be pursued. If you don't give the drug addicts clean needles, they will just use their old ones, or someone elses old ones. That is not a good idea, and needles are so much cheaper than any of the possible results for everyone involved (Not to speak of how much better it is for the drug addicts if they don't also have numerous diseases) that it is actually quite insane to NOT have a needle exchange program. Having a good free rehab program is also a very good idea. I highly doubt you can convince US conservatives to pay for one with tax payer money, though. I would of said the same thing about Conservatives and a needle exchange. Because his constituents would see it more like Milli did without the rehab part. The townhall would go something like this. "So are you giving drug addicts free needles to do drugs with?" "Yes I am" "You're as bad as the drug dealers". What I find funny about it is that they are actually addicted to a legal drug in the first place. Maybe, just maybe it could lead to the widespread realization that prescription drugs kill more people than heroin, crack/cocaine, and all other illegal drugs combined. These are not isolated events. Each day, 44 people in the United States die from overdose of prescription painkillers. SourceNot only are more people getting addicted to/overdosing on drugs (amidst the 'War on Drugs'), but the drugs that are killing them the most are legal. While the least deadly substance can still get you a life sentence. A 12 year old could make more sensible drug policy than this country. Prescription drug abuse is not legal either. Just because there are legal means to acquire the drugs doesn't mean the people who OD'd on them got them that way. Most of the people who abuse things like Oxycodone do not have a prescription for it. The possibility of contracting HIV is one factor encouraging people to get help. Handing out clean needles removes the risk of HIV, meaning it removes one incentive to get help. I don't see how handing out free needles really fights HIV. Sure, this particular outbreak might be stopped, but in the end you still have just as many addicts using just as many needles. It's like the old "Give a man a fish, feed him for a day" adage, except in this case it's "Give a man a needle, prevent HIV for a week or two. Help a man recover from his addiction, prevent HIV for a lifetime."
While millions are abusing drugs they never had prescriptions for, there are millions who were prescribed the drugs at some point (their gateway). Not to mention none of these drugs are being manufactured by anyone who is going to prison for their sale. Meaning these drugs are getting on to the streets legally or without consistent significant legal consequences (practically legal).
Needle programs act like a sort of loose quarantine. No one thinks quarantining people cures the problem, but it certainly helps keep it from spreading.
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On April 21 2015 06:56 Acrofales wrote:Show nested quote +On April 21 2015 06:50 Millitron wrote:On April 21 2015 06:47 wei2coolman wrote:
Clean needles are a step towards the right direction. Plus I'm pretty sure like a single case of HIV treatment can probably pay off 10 years worth of free needles for like a bunch of people. It's just a financially responsible thing to do anyways. Money spent handing out free needles is money that would've been better spent on real rehab. It's opportunity cost. Any money headed towards handing out free needles is money that is not going towards a real solution. This has been argued repeatedly, but free needles are NOT perpetuating drug addictions. If a drug addict can't get free needles, he will not suddenly say "fuck it, I can't get a needle. Time to quit". He will just reuse an old one. In fact, he may do that anyway even if free clean needles are available. There are 2 separate goals here: 1. HIV prevention and/or treatment. 2. Drug abuse prevention. The initiative ONLY serves the former goal and has absolutely NO EFFECT on the latter. In the case of the former goal, it just makes sense. Rather than paying for anti-retrovirals for the rest of his life for even 1 patient, it is cheaper to pay for a needle exchange for ALL drug abusers. So if you're talking opportunity cost, that is it. Offering free rehab is great, and I am all for it, but it won't get drug abusers who deny they have a problem off the street (or using clean needles). Unless you want to force drug users to enter (free) rehab (and even if you do, that has also been shown not to work).
You shouldn't pay for anti-retrovirals for someone who's gotten HIV from drug abuse. Just like how you don't give alcoholics a liver transplant. Doctors don't like to waste healthy livers on someone who's just going to drink the new one into oblivion. Paying for anti-retrovirals for heroin users is equally stupid.
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On April 21 2015 07:10 Millitron wrote:Show nested quote +On April 21 2015 06:56 Acrofales wrote:On April 21 2015 06:50 Millitron wrote:On April 21 2015 06:47 wei2coolman wrote:
Clean needles are a step towards the right direction. Plus I'm pretty sure like a single case of HIV treatment can probably pay off 10 years worth of free needles for like a bunch of people. It's just a financially responsible thing to do anyways. Money spent handing out free needles is money that would've been better spent on real rehab. It's opportunity cost. Any money headed towards handing out free needles is money that is not going towards a real solution. This has been argued repeatedly, but free needles are NOT perpetuating drug addictions. If a drug addict can't get free needles, he will not suddenly say "fuck it, I can't get a needle. Time to quit". He will just reuse an old one. In fact, he may do that anyway even if free clean needles are available. There are 2 separate goals here: 1. HIV prevention and/or treatment. 2. Drug abuse prevention. The initiative ONLY serves the former goal and has absolutely NO EFFECT on the latter. In the case of the former goal, it just makes sense. Rather than paying for anti-retrovirals for the rest of his life for even 1 patient, it is cheaper to pay for a needle exchange for ALL drug abusers. So if you're talking opportunity cost, that is it. Offering free rehab is great, and I am all for it, but it won't get drug abusers who deny they have a problem off the street (or using clean needles). Unless you want to force drug users to enter (free) rehab (and even if you do, that has also been shown not to work). You shouldn't pay for anti-retrovirals for someone who's gotten HIV from drug abuse. Just like how you don't give alcoholics a liver transplant. Doctors don't like to waste healthy livers on someone who's just going to drink the new one into oblivion. Paying for anti-retrovirals for heroin users is equally stupid.
Whut? The reason you don't give a new liver to an alcoholic is because it is pointless: it will just get as fucked up as the old one.
However, anti-retrovirals work rather differently from a liver transplant, and will stop HIV's progression to fullblown AIDS regardless of whether the patient is a schoolteacher or a homeless heroin addict.
And no, using a second dirty needle won't make your HIV worse...
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On April 21 2015 07:16 Acrofales wrote:Show nested quote +On April 21 2015 07:10 Millitron wrote:On April 21 2015 06:56 Acrofales wrote:On April 21 2015 06:50 Millitron wrote:On April 21 2015 06:47 wei2coolman wrote:
Clean needles are a step towards the right direction. Plus I'm pretty sure like a single case of HIV treatment can probably pay off 10 years worth of free needles for like a bunch of people. It's just a financially responsible thing to do anyways. Money spent handing out free needles is money that would've been better spent on real rehab. It's opportunity cost. Any money headed towards handing out free needles is money that is not going towards a real solution. This has been argued repeatedly, but free needles are NOT perpetuating drug addictions. If a drug addict can't get free needles, he will not suddenly say "fuck it, I can't get a needle. Time to quit". He will just reuse an old one. In fact, he may do that anyway even if free clean needles are available. There are 2 separate goals here: 1. HIV prevention and/or treatment. 2. Drug abuse prevention. The initiative ONLY serves the former goal and has absolutely NO EFFECT on the latter. In the case of the former goal, it just makes sense. Rather than paying for anti-retrovirals for the rest of his life for even 1 patient, it is cheaper to pay for a needle exchange for ALL drug abusers. So if you're talking opportunity cost, that is it. Offering free rehab is great, and I am all for it, but it won't get drug abusers who deny they have a problem off the street (or using clean needles). Unless you want to force drug users to enter (free) rehab (and even if you do, that has also been shown not to work). You shouldn't pay for anti-retrovirals for someone who's gotten HIV from drug abuse. Just like how you don't give alcoholics a liver transplant. Doctors don't like to waste healthy livers on someone who's just going to drink the new one into oblivion. Paying for anti-retrovirals for heroin users is equally stupid. Whut? The reason you don't give a new liver to an alcoholic is because it is pointless: it will just get as fucked up as the old one (or more likely, the transplant won't even take, because the alcoholic is either going through withdrawal symptoms or flooding the new and fragile liver with poison). However, anti-retrovirals work rather differently from a liver transplant, and will stop HIV's progression to fullblown AIDS regardless of whether the patient is a schoolteacher or a homeless heroin addict. And no, using a second dirty needle won't make your HIV worse...
Not to mention we can't really mass produce livers...
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On April 21 2015 04:04 Millitron wrote:Show nested quote +On April 21 2015 03:40 {CC}StealthBlue wrote:WASHINGTON -- Indiana Gov. Mike Pence (R) on Monday extended a short-term needle exchange program in order to respond to an exploding HIV crisis in southeastern Indiana.
"While we’ve made progress in identifying and treating those affected by this heartbreaking epidemic, the public health emergency continues and so must our efforts to fight it," Pence said in a statement.
As of April 17, the Indiana State Department of Health had confirmed 128 cases and at least six preliminary cases of HIV in Scott County, the governor's office reported. The week before, the county was looking at 106 cases. Typically, Scott County would see fewer than five new HIV cases a year.
Indiana's HIV crisis is linked to intravenous drug use of a prescription painkiller called Opana. Like many other conservatives, Pence opposes needle exchange programs as part of drug control efforts. The exchanges allow drug users to obtain sterile needles and have been shown to reduce the transmission of diseases like HIV, but critics say the programs facilitate drug abuse. Research has refuted that claim.
The exchanges are technically illegal in Indiana. But last month, Pence made an exception and signed an executive order authorizing a temporary needle exchange program that was set to expire this week. Pence has now extended that order for another 30 days. According to The New York Times, since the temporary exchange was approved, 5,322 clean syringes have been distributed to 86 people.
"The goal of that program is a clean needle for each person for each injection," Amber Kent, a spokeswoman for Indiana's Joint Information Center, told The Huffington Post. The center is working on behalf of the state's Department of Health. Source Can someone tell me how handing out clean needles is not facilitating drug use? Sure seems like it does to me. Maybe instead of handing out needles, they should offer free rehab. Offer real help instead of just stringing people along.
A large percentage of HIV-1 infections that happen in America are caused by sharing needles between intravenous drug users. They do not abstain from drug use due to lack of paraphernalia and no more people start using drugs because of its availability. The reliance on needle exchange specifically is financial. Study after study shows that the cost per prevented infected individual for needle exchange is way lower than the cost of HIV treatment.
This is one of those times where a counter intuitive policy is actually really effective. If we made policy based only on merit rather than appearance there would be needle exchange at every pharmacy in the country.
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EPT
