Heroin Addicts Often Seem Normal
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The article discusses how heroin addicts can appear normal, sparking a discussion on the complexities of addiction, its relation to mental health, and the need for empathy and understanding.
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People always think all opioid addicts are slumped over passed out all the time. And that is usually only when their addiction is really far gone. Early on heroin addicts take moderate doses and keep on functioning. They watch a movie or play video games. You hear people talk about how “clean” the high is, because unlike alcohol they wake up the next day feeling great with no hangover. And they aren’t physically dependent at first, so they think, hey, this is nothing like all of the scary PSAs said it was.
That said, there can be signs. You may find them normalized from exposure. Or, perhaps: hidden, your cousin maintained appearances. With time and circumstance, everyone slips. Sometimes it's seen.
My (much older) brother managed his addiction, and appearances, well at work for decades. Now clean, thank goodness.
Wikipedia:
> There is no confirmed evidence, either historical or archaeological, of coffee as a [missing word?] being consumed before the 15th century.
(Also, an unknown point in the 15th century could be less than 600 years ago.)
sugar, wheat, barley, egg, soybean oil, starch, whey, salt, tallow
These go back before the beginning of history. Quite a long time before.
There are also quite a few additives and preservatives in a Twinkie.† If you're making a point about ultraprocessed food, you're definitely correct. If you're trying to make a point about basic foodstuffs, you aren't.
† https://www.youtube.com/watch?v=KcS3kQg5blw
Soon after I thought I'd try to kick the caffeine habit. Went from 4 cups, to 1 over a month, then just green tea, then just water. I only lasted about 6 weeks on water only.
My god. I couldn't believe how unmotivated, soulless, and empty I felt. Judging by the reddit sub for kicking caffeine, this can last for over a year. It's terrifying
Your example also doesn't really hold up because people typically don't process cocaine in the way they do with sugar and other carbohydrates. In your hypothetical scenario, we might see people consuming large amounts of pure sugar (or artificial sweeteners), but they wouldn't go to lengths of baking bread using it.
Not as cheap as sugar, but probably as cheap as coffee. Coca and coffee grow in the same climates, and in recent years the cartels have bred varieties of coca that grow outside of the traditional climate as well. Imagine what modern agribusiness would be capable of.
Sugar? For snobs anyway. Corn starch for the masses.
His roommate’s klepto friend sure seemed abnormal.
Also, my understanding from folk who do use is that heroin doesn’t exist in meaningful quantity in today’s market. It’s all fent. Even the stuff that claims to be h is cut with fent, and maybe xylazine if you are especially unlucky.
I truly believe that there would be fewer addicts and fewer overdoses if you could buy regulated heroin.
This has a dual effect - addicts get clean drugs and take them under medical supervision, reducing deaths, helping funnel some towards programs that will eventually get them clean etc. With this sort of support it turns out that people no longer steal to get their fix either, and can usually even hold down employment pretty well.
But also the young folk get to see these tired, worn out, older people queuing outside the clinic in the morning to get their fix and realise hey, maybe that isn't so cool and edgy after all...
Seems like a good plan to me, the problem is (as ever) puritans and their politicians, it's an easy thing to screech about. All it would take to kill it dead in a lot of countries would be someone standing up to shout "The opposition party want to spend YOUR tax money giving DRUGS to filthy JUNKIES!"
IME most people dont want to be addicted, theyre just in a rut or life took them a certain way and just need support to get through the other side.
People who dont use drugs are way to hysterical about drug use though to ever see real improvement.
Making it legal we could have things sold over the counter in pharmacies with proper age checks, we could even require further checks like before you can purchase heroin you need to go through a process where it is explained how it works, what a reasonable dose is, what side effects are, how addictive it is etc.
Same with other stuff. Most drugs are quite safe and harmless if done by people who know what they're doing. Of course self destructive people and morons would still harm themselves but honestly I'm not too worried about that. They will always find ways to harm themselves.
At least drug users wouldn't be funding cartels and warlords etc.
Prohibition does not stop the sale, use and abuse of substances. This is indisputable. The question then is whether or not legalization actually reduces the harm caused by these substances. I believe it does. Both by weakening the black market, ensuring people actually get what they think they're buying rather than whatever the dealer happens to give them, controlling who can purchase things, providing opportunities to educate people before they are able to purchase etc.
All these things are already widely and easily available. Legalization doesn't really change anything in that regard. And most illegal drugs aren't as bad as people are led to believe either. Most of them can be used responsibly with hardly any negative effects, certainly no more than alcohol. The worst part about them is that we don't know what we're getting. We don't know the concentration and we don't even know whether it is what we think it is at all.
There's also the tax revenue we would collect from the legal sale of drugs which could be used to provide education and help those who are struggling.
There is a reason why heroine used to be sold as cough syrup and over time became illegal. I know we want to say the war on drugs was all a war on minorities (and with pot it was), but have you looked into the history of people turning into junkies?
It’s a balance sheet and you can’t just look at the debits and not the credits.
Also we didn’t just try that with gambling (48 states have had some legal form of it forever) we just tried it with online sports books, which turn out to be a particularly virulent form of gambling. And we haven’t really begun to sensibly regulate that, a lot of harm may be reduced in the near future as we do.
Now they do; make it legal and in two generations it won't be viewed that way because, after all, it's legal!
In the last case gambling is pretty much everywhere in all developed societies.
These are pure gamblimg, the skill part is thinly weiled excuse having little to do with the reality. Even if it was skilled, it would still be gambling, but for the most part it is not skilled.
> or gambling as in trading?
Yeah many small investors treat it as a pure gambling. But investing has more regulations and somewhat saner culture. The companies are not intentionally trying to identify and hook addicts deeper and deeper.
Which "sports" literally do.
"Games of skill" in this context essentially always refers to poker, which is demonstrably not "pure gambling".
>Yeah many small investors treat it as a pure gambling. But investing has more regulations and somewhat saner culture. The companies are not intentionally trying to identify and hook addicts deeper and deeper.
>Which "sports" literally do.
This was perhaps largely true in the pre-robinhood era, now it's hard to draw any meaningful distinction between sports gambling and daytrading.
Get your first dose for free! Refer a friend and get more free shots! Every tenth shot for free!
Also Coca-Cola should be allowed to use a real coke extract. I doubt they will as they cannot even use a real sugar in USA anymore.
They do. It's bought from a Peruvian state-owned company and the cocaine is extracted for medical use.
Some countries don’t even allow advertising legal and OTC pharmaceuticals.
Its also a society openly xenophobic for immigration to any ethnicity not being part of original mix of population (not race, not language but properly ethnicity, ie tamils from south india big NO, malay tamils YES). White westerners not welcomed, only toleracted for specific set of high flying positions, and only for specific time while they keep economy running.
Its a very interesting place to observe some sort of south east asian version of Switzerland (sans most freedoms), but there are hardly any lessons for the west. Sort of like what ideal China could be, but probably never will. If you want to see proper western-possible high point, that Switzerland IMHO is top spot. They have some drug addicts, but have rather sensible approach to them.
I found this draconian policy jarring at first (never a drug user, but casual cocaine / pot use was everywhere in both London and NY, and the usual cocktail of whatever was fashionable too).
You get used to these policies pretty quickly, and in exchange there are no (visible) drug users and no (visible) homelessness; I don't think in the West we are willing to sacrifice the freedom to do these things, or impose the death penalty for importing drugs (we have abolished it for nearly every other crime apart from murder in most jurisdictions).
I say that not making a value judgement (I cherish and in some cases miss western freedoms, and believe we do all too little to defend them at home), rather observing from nearly 40 years in western society and <12 months in the East.
It's worth remembering that much of Asia went through terrible drug addiction epidemics in the 20th century [0], and they decided to take drastic action, which probably took 25 years to fully bear fruit.
I also don't believe this policy, in isolation, is the whole answer. Asia (and particularly Singapore) focuses on society, community and other values which attenuate the factors which lead to, and are exacerbated by, drug use (violence, theft, vagrancy, unemployment, under-employment).
You give up a lot of freedom, but you get order in return. For some of us, that is acceptable. For others, this is not (and that is ultimately a matter for voters in each polity).
[0] https://www.unodc.org/unodc/en/data-and-analysis/bulletin/bu...
How many people do you approximately know of that have had the thought “I’d try heroin”?
> I truly believe that there would be fewer addicts and fewer overdoses if you could buy regulated heroin.
How many people do you approximately know of that have had the thought “I’d try heroin but only because I cannot buy regulated heroin”?
The whole context was "regulated heroin would be safer", but we've had a whole crisis of overprescribed (but still regulated) opiates that very much disagrees with the notion that regulated heroin is safer.
Reading my comment as "all opioid addiction is only due to regulated drugs (and that one commercial)" is misguided, at best.
>Also... isn't the whole opioid addiction crisis basically because people were in fact buying regulated ~heroin?
Of course not, this is a ridiculous comment. People have been addicted to opiates for hundreds, maybe thousands of years. Blaming oxycontin is passé
https://pmc.ncbi.nlm.nih.gov/articles/PMC9261968/
The first wave of the opioid crisis began in the 1990s when the long-acting opioid OxyContin and other high potency opioids were employed for an extremely wide array of patients.
As if I meant that every single opioid addiction in history is because of "regulated heroin"?
You think that's a reasonable read?
People aren't mind readers. If you mean some, don't say whole and you'll probably avoid confusing people.
And overprescribed pain meds are seen as a large cause of it / aggravating factor.
So yeah, "that whole thing". It's not an unusual expression, that I know of.
1- https://en.wikipedia.org/wiki/Opioid_epidemic
Perhaps it's because they weren't experiencing enough pain at the time. I think most people fall into drugs circumstantially, I'm not sure it often presents as a conscious lifestyle decision.
> I truly believe that there would be fewer addicts and fewer overdoses if you could buy regulated heroin.
I believe that there would be less drug use overall if our economic system wasn't as rapacious as it currently is.
https://theonion.com/drugs-now-legal-if-user-is-employed-181...
Then I met a wonderful woman who wouldn’t give up on me. We went to the doctor over and over again until I was diagnosed with dystonia, a disease which alcohol relieves the painful symptoms of. Once I knew that I wasn’t simply cured, but I had the hope and the knowledge to see though my pain.
Many other drugs are the same way. It’s easier to get these classes of drug illegally rather than legally. People who do these drugs know there’s something wrong with them, but they remain defiant and strong in the face of a society projecting its own decadence onto them.
If you do drugs or alcohol and you know it hurts you and want to stop, there is always hope for you as long as you can accept help. I know from experience.
And to all you who need drugs, but reject a diagnosis. As Big L said “If that’s what you need to maintain, go ahead and do your thang.”
Most people do drugs or alcohol for kicks or to put the pain away, as in general, but there are a lot of people who are self medicating symptoms they are well aware and they know this "medicine" works for them.
Breaking out of that habit is extremly hard.
At the beginning of covid I found myself in a really dark place and opted to seek help with psychotherapy.
I had a long story of health and legal issues and I often told my peers that second opinion is key, no one is omnipotent and with hard legal or medical case it's worth seeking out opinion of at least two professionals (and if their opinions are contradicting - keep seeking).
I met eleven certified experts.
At the beginning of my journey one of them, guy with stellar reviews, upon hearing that I haven't been properly diagnosed, but I suspect I might be on the spectrum looked at me and said "no... I'm looking at you look perfectly healthy". One after five sessions when I said I'm not getting any feedback, like anything, I was the only one talking during the sessions, told me it take years to get to the core.
Long story short - just before someone advertise as an expert doesn't mean they know anything, or they care. Even in highly regulated circuit.
That’s the grift — healing sold as a subscription. The incentive for therapists to behave this way can’t be regulated away because the regulation itself acts as a cover for this behavior: credentials, ethics boards, continuing-ed checkboxes — all window dressing to sanctify creating a dependency in the patient. The system launders manipulation through professionalism and calls it care.
You can have bad experiences with therapy.
It will put patients off entirely from further therapy.
It sucks if this is you. It really does - because on the flip side, if therapy has worked for you, then you know how your life has improved.
You have your whole life to ingrain thoughts, behaviors, and emotional responses into your being. If you anre unlucky, you might be surrounded by other people who reinforce maladaptive ways of thinking and being, such that they seem 100% normal. Expecting those deeply carved neural pathways to change quickly through any intervention is ridiculous.
Think about how cult deprogramming is a specialized skill with a high failure rate. Except this cult only has a single member, your inner monologue. It can take a lot of time for a therapist to figure out what the cult is even about, and it all comes from you talking (and talking and talking…)
BTW, I think a lot of the HN cynicism on this subject comes from how psychotherapy is practiced in California specifically. California has a separate licensing system from the rest of the country and doesn't allow eg. teletherapy from therapists in other states. As a result I found that therapists in CA were more expensive, more difficult to access, and significantly lower quality than I've experienced elsewhere. I've heard that regulatory reforms might be on the way though, hopefully that happens.
From what I understand, it's generally a lot easier to heal from an acute traumatic event of some sort, no matter how serious it is (e.g. physical or sexual assault), that than it is to heal from sustained and repeated trauma caused by "well-meaning" people.
In the latter case you probably don't even realize that it happened at first because it's an accumulation of a million paper cuts throughout your life. Then if you try to talk to the people involved (e.g. your parents) they'll probably dismiss you and say that you're being dramatic because each instance is utterly insignificant on its own.
You have to peel back so many layers of it until you finally understand what happened, how it affected you, and how to heal from it. And that's just on a cognitive level, on an emotional level which is the one that actually matters it's going to take even longer to internalize everything.
The best thing we could do as a society to solve like half of all of our problems (with everything from unemployment due to personality disorders, to drug use, to violent crime) is to start taking mental well-being seriously, to prevent as much harm as possible and to offer help (for free) at the earliest possible opportunity.
There should be mass public education campaigns about how seemingly subtle and inconsequential things can break people's minds if they're sustained and perpetuated over a long period of time and especially in childhood. And I don't mean those trendy "mental health matters" and "we accept your depression and anxiety <3" campaigns that have been going around for a while because 99.9% of that is completely inauthentic. Even out of the people who claim to care, the vast majority only care long as it's a mild case of it that doesn't actually visibly affect you too much - then the judgement starts.
I mean, I drove a Mustang in EU, shipped from US before Ford started selling them here. Local Ford didn't even had "mustang" in their system. I kept trolling them when they were offering free service for Ford drivers. My first 6 car mechanics were either a total scam or they were genuine but had absolutely no clue what they were doing.
What was I thinking? Maybe that the trade is regulated, and people with a title are more professional? Hell no.
It's more like working with a physical trainer. You won't accomplish your fitness goals by just showing up. Rather, you need be engaged, learn how to actually use the tools they give you, strive to improve yourself and put in the effort to do so.
I met a gal who kept silent for five visits.
Five paid visits and I got no feedback at all. Silent treatment is what you call it.
And when I finally confronted her about that she told me that I'm making a scene, because normally people are seeing a change only after couple of years.
I know a few people, who import and run vintage american cars in EU. They do all servicing themselves, buy spare parts from american ebay. They totaly think modern car industry is a scam. They would never allow some "professional" mechanic into their beloved car.
This is like saying dating is pointless because you dated a half dozen people and didn't end up marrying any of them. (That attitude is also increasingly common these days I've found, maybe because we've all been spoiled by the conveniences provided by the internet and modern consumer capitalism.)
It's no different with mental health. We are perpetual works in progress. Any changes take not only effort to accomplish, but effort to maintain. That's just how humans work.
You can feel and see the effects of exercise very soon after starting. It's cumulative and predictable. Therapy is nothing like that.
When therapy works, it works really really well, and relatively quickly too. From casual observation of friends and other people around me (ie, as a regular person; I'm not a health care professional.) I've seen people manage to make sustained healthy changes in just a handful of sessions. I've also seen people not improve, or take far longer.
If you've been going to therapy for more than a few months and haven't been improving, it's time to change something up. Therapy should be "something like that".
I think most if not all need for drug use would pretty much disappear overnight if we lived in a society where just being human didn't result in excommunication.
Was there something "wrong" with me? No, but I definitely prefer this version of myself! And it takes sustained, ongoing effort — there are still nights when I'm tempted to just order takeout, but I push myself to cook something and end up glad I did so.
The same goes for physical fitness, career, hobbies, personal relationships, mental health… you can just sort of blindly stumble through life without any intentionality, but to me it seems like a good way to squander your precious years on this planet.
This therapist might've been, but often problems that require psychotherapy can't be done quickly, no matter how qualified they are and how expediently they're trying to help you. What they said wasn't wrong, but that description certainly makes it sound like they weren't trying to help at all which would've moved that healing timeline from "years" to "never".
Are you saying that psychological issues could be healed quickly if they just tried harder and didn't have the profit motive, or that they don't need to be healed at all?
But anytime I looked for instructions or objectives on how to improve my life they would basically say “I can’t tell you exactly what to do, you need to come to that conclusion for yourself.” The problem was I genuinely didn’t know what to do. They always tried to see things from my side, but never really believed that spending my night in a drunken stupor watching TV until I passed out was actually contributing to my happiness more than being in agony every night slowly building my contempt for humanity. Even though it’s against their training, they can’t help but judge you lifestyle and unusually that manifests as silence on important issues instead of disagreement.
That is the problem, yes.
I think a lot of the confusion from people just beginning their psychotherapeutic journey is that they think the point of therapy is to make them happier. No. The point of therapy is to make them happier, and sadder, and angrier, and more driven, and aware of their fear, and connected to their shame and guilt, and able to love. In short, it's to give you perspective on emotions, so that you can feel them on a minute-to-minute basis and decide what you want to do, and realize that "because you want to do it" is just as valid as any other reason, if not more.
> spending my night in a drunken stupor watching TV until I passed out was actually contributing to my happiness more than being in agony every night slowly building my contempt for humanity
A therapist would be naturally conflicted about this, because spending your night in a drunker stupor watching TV will make you happier, but being in agony every night slowly building your contempt for humanity is the work that needs to be done. The point of therapy is to help your understand a.) that you are in agony every night and b.) why are you building your contempt for humanity? It's to help you feel the emotions, and to feel them as emotions, and then to eventually integrate them into your life in a way that is constructive.
The majority of people are tourists in the world of pain. They enter, make observations, then exit, assured that they had a harrowing experience. But for those of us who are residents in the city of pain, we know it stinks and it will grind us down until we become evil people. We are stuck there due to some kind of undeserved poverty which is not within our power to control. No amount of compromise or contemplation can escape you from a physical prison. It’s a cage that exists inside you rather than around you and it does nothing to shake the bars other than annoy the tourists who gawk as they pass by.
I know that’s pretty dark, but people simply will never acknowledge that life long happiness is somewhat dependent on luck. It would likely cause society to fail if the lucky people realized evil people were actually equally self aware but just fundamentally less lucky and under the influence of random inexplicable pain, that’s just a result of human biology. People just reject this idea even though it’s obviously true. Therapists simply don’t understand this simple fact because it’s not their job, they are there to guide the tourists.
It comes down to this. I can meet and talk with you and pronounce judgement on your life, but me telling you what to do isn't the same as you figuring it out for yourself. You have to do that hard work. you have to sit there until you're past bored and reflect on the things you've done. and it sucks, and it's boring, and why can't you just give me the answer. But human psychology is what it is. me telling you just isn't going to be internalized the same way. One external entity has has better questions that others. some of the deepest and best insights have come from random strangers I don't know and have little connection to, in random and serendipitous moments. Watching TV, your not going up find that, imo. you've got to go out there to find yourself, as hokey as that sounds.
Sometimes, you need to be pointed in the right direction (or even told they exist). All the self-searching won't do any good if you're continually looking in the wrong places.
So FWIW, that part is true. I started therapy in 2012. I got to the core in 2020, after going through 4 different therapists. Along the way I founded about 15 startups, missed out on roughly $2M in lost wages, almost divorced my wife and walked out on my kid, thought seriously about killing myself, and needed a global pandemic to finally get my life in order. But I did eventually get my life back. And I didn't even get involved with any drugs or chemical dependencies; video games were my worst addiction.
The reason it takes so long is because a therapist will never tell you the problem, they need you to experience it for yourself. That is part of the point. As one of the better therapists I saw (the last one, actually, the one that got me through the breakthrough) said: "One of the ways to make feelings go away is to, well, feel them." Until your brain has the capacity to distinguish your feelings from existence, separate them out, and then push through some often very unpleasant, potentially life-ending feelings and actually feel them, you'll usually tend to end up deflecting or coping with them.
Much of the process of therapy involves stripping away these coping mechanisms and seeing what the feelings are beneath them. And that takes years, and has to be done in parallel with your life, because living your life is the point of therapy. That's why my first therapist encouraged me to try getting involved in my first relationship, even though I suspected I would end up hurt by it. (I ended up marrying and having three kids with her - the youngest is currently sleeping with his foot draped over me. And yes, I gave up nearly all my dreams and everything I thought was my identity for her.) That's why my therapist encouraged me to quit my highly-paid but soul-sucking FANG job to follow my startup dreams. Until you're actually in those situations, where you are risking your ego and living with vulnerability, you're not in a position to process the feelings that arise from them.
Possibly the best advice I got - from a random stranger on Reddit, not a therapist - was to think of your therapist as a guide, not a fixer or even an expert. You do the work of figuring out yourself, and it takes years, perhaps a lifetime. The therapist is there to make sure you don't hurt yourself and to keep the focus on your real issues, because when it comes to unpleasant feelings, the natural inclination is to avoid them. It almost doesn't matter if they're any good, as long as they adhere to a basic code of ethics and professional conduct, because all of the heavy lifting and all the major discoveries are made by you yourself.
Add to the above the subtle notion of the onus on improvement lying with oneself as the patient, and it becomes all the easier for a therapist to fail because they don't know what they're doing, and then claim their patient failed because they didn't "try hard enough" or do the right things.
I've seen cases of therapy working, and know there's a lot of good exploration in related psychological fields, but it's definitely an area in which to tread carefully as someone seeking help.
If you go a therapy and all you get is talking to a wall while you're therapist is skimming through a phone, that's not a progress, that's a scam.
But if you've been to 11 therapists and none worked, the problem is probably not all 11 of the therapists.
You have to be at least engaged in the session and actively introspecting too. If you're not curious about where your issues stem from and willing to try some (oftentimes difficult) approaches to dealing with them, the therapist isn't going to be either. They'll happily take your money and give you their time, but there isn't anything to work with to get better.
With that said, those first few months were not just my therapist being "a guide" through the life I was living. There were parts of my history that I didn't realize I needed to cry about and forgive myself over, before I could even try to go through life without that chip on my shoulder.
> almost doesn't matter if they're any good
It's very difficult to rate therapists, because there's both an empirical (their training and experience) and subjective (do you feel comfortable with them?) component. A therapist can be incredibly smart and talented and will be the absolute wrong fit for a patient who doesn't feel comfortable with them. And someone else can be not-a-therapist-at-all (i.e. clergy), who the patient feels very comfortable talking to, but those conversations will go nowhere if the patient is never challenged and/or never willing to face the challenges. All anybody can do, really, is just keep trying.
> as long as you can accept help
What help? Society simple does not care about 49% of people, like at all! There are no shelters for abuse and violence victims, no support groups...
If you speak up or seek help, there is good chance society or abuser retaliates aganst you! You may endup in prison, homeless, or out of job. Or lose your kids!
> but reject a diagnosis
often that means months on strong medication, that makes things much worse. And if that does not work, oopsie, lets "try" another diagnosis. No compensation for the hell, from doctor who caused it, of course!
This is the argument that actual quacks leverage to handwave away all of modern science and medicine in favor of whatever vibes-based nonsense they're selling, fyi. Creationists love using this one as well.
Rehabilitation efforts would be more successful if not de-incentivized to expel participants for relapsing, i.e., compared to the rest of the world, US rehab programs are soft. Why?
This idea raises many questions about the reproducibility of certain cultures outside of specific locales, Silicon Valley being an obvious example.
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