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Why are some countries decriminalising drugs?
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One of maaaany variables.
Culture plays into it heavily too. Both in terms of how you handle problems and how people conduct themselves.
Like. Simplistic example. Say you're a homeless IV user. Do you throw your needle on the ground? Or into a juice box you picked up?
It's an action you choose because the cultural expectations lead you to it, and in turn it causes less issues for the people around you.
Etc.
What the state does is highly important and worthy of looking into, and of equal importance is investigating the way people using substances relate to themselves and those around themselves.