> If it had been legal, pure, and known quality that likely wouldn't have happened (he could still have been affected by addiction like our mother with alcohol, but he wouldn't be dead).
Overdoses on opiates happen even with legal opiates [1] and it's related to tolerance mechanisms. You become tolerant to euphoric effects much faster than you become tolerant to respiratory depression and nausea.
This basically makes opiates much more dangerous than any other drug class.
>One thing that rarely gets mentioned is how abundantly SAFE opiates are. If you know what you're getting, know what dosage it is, and know it's not adulterated with other substances, you can use opiates for decades without significant health complications (aside from constipation).
It rarely gets mentioned because it's false.
First off, opiates are usually inefficient for long term pain management. We, at least, have no evidence they are effective for long term (>2 months) pain management and if you actually talk to pain patients the problems with long term opiate use are very obvious. I'm not talking about junkies on the street either, I'm talking about normal people who are obtaining their medication legally through a licensed physician, not the black market.
Patients often rapidly develop tolerance and then dependence. The can also induce hyperalgesia - a paradoxical increase in pain caused by long term opiate use, this is why patients on high doses of opiates usually feel less pain when weened off the drug. Additional side effects are disruption of hormone production, lethargy, listlessness, and sleep apnea.
There's just SO MUCH we don't know about long term use bit it's very clear there is significant harm with questionable benefit in a subset of the population.
>Fundamentally there is one group of people who is angry that other people are using a chemical to feel good because they feel that if other people aren't suffering as much as they have then they were cheated somehow
>Opiates in and of themselves are relatively safe, only slightly worse for you than caffeine, although clearly (arguably?) more addictive.
I've heard this claim so much but I can't possibly comprehend the basis of it.
Virtually nobody is out there overdosing and dying of caffeine (although it does happen). It's very addictive, yes, but if you deprived someone of their coffee for a month, they'll call you an asshole but they'll go about their normal life. With opiates, people are willing to live on the streets because they're more driven to put the drug over their personal well-being. I've known people who talked about having to empty their bowels with a spoon because they can't do it normally. Withdrawal is described as absolute hell and many people accept the possibility of overdose rather than the agony of going without it. People who built up a tolerance, quit using, then return often die because they took a little beyond their current tolerance. One major long term effect is that many people find it hard to find any joy in life as great as heroin.
It's not reefer madness. Thousands are dying and people are oftentimes knowingly sacrificing their lives for opiates. The argument that it's not bad when used responsibly and in small amounts is true of virtually every drug ever. In practice, many people aren't using them responsibly, and the nature of some drugs makes them even more apt to be abused than others.
People are desperate enough to see all the examples of people dying or otherwise destroying their lives for the drug but still deciding it's worth trying. The prohibition isn't the problem. The problem is people are struggling in life and opiates are providing an out. Making them more open and available will not help, and the oft-cited example of Portugal decriminalizing drugs doesn't mean every society should make opiates available. Drug overdoses recently increased in Portugal. [1]
Demonstrably false. The vast majority of opioid users are recovering from surgery, taking Tylenol 3, etc. You're basically just talking out of your butt here.
"This is terribly wrong information, to the point of causing more harm to people who take it seriously."
^ this is generally correct for many of the classes of substances mentioned; however, it is also terribly wrong information concerning Opiate withdrawal.
I'm not sure in terms of case numbers - people can and do die from Opiate withdrawal due to vomiting and diarrhea leading to dehydration and/or heart failure due to elevated sodium levels.
This is clearly very preventable from a harm reduction perspective with the correct information.
> even though people know there will be disastrous repercussions to taking them indefinitely
People have some funny notions about the health consequences of opioid addiction.
In 1942, Burroughs enlisted in the U.S. Army to serve during World War II. After being turned down by the Office of Strategic Services and the Navy, he developed a heroin addiction that affected him for the rest of his life, initially beginning with morphine.[1]
Addicted to opiates by age 23, William S. Burroughs finally died 60 years later. Opioid addiction is not really all that unhealthy, medically or biologically speaking, so long as the addict doesn't fatally overdose or expire from withdrawal. The biggest problem with opioid addiction is social stigma. Ao long as the addict can maintain their addiction, they can lead ordinarily productive lives with a normal life expectancy. Cocaine or methamphetamine or alcohol addiction, on the other hand, will kill you.
What's weird is... cocaine can kill you, no OD necessary. Alcohol will kill you. Smoking national brand cigarettes will definitely kill you. Opiates generally don't kill you. Notorious addict and writer William S. Burroughs lived to 83, and died of a heart attack. His death had nothing to do with using heroin for 60 years or however long.
What hurts opiate addicts is the lifestyle, not the drug. But if they have a job and a stable economy, there is no health effect. What kills opiate addicts is two things.
1) The user quits, then maybe after a year of being clean, to celebrate perhaps, they take their regular dose again, and their tolerance has dropped to nothing, and they accidentally overdose. I believe this is how Sublime's Bradley Nowell died.
2) Evil, sociopathic dealers that spike their heroin with fentanyl, likely aware they will kill someone, because they think it is good advertising, letting everyone know their stuff is strong. I believe this is how we lost Philip Seymour Hoffman, and many many others.
So even beyond the obvious detail, that Naloxone saves lives, I don't understand what life insurance companies have against opiate addicts, and more so than smokers and drinkers? That makes no sense.
> but the rate of overdoses from prescription opiates is, as i understand it, very low, because the dosage is predictable
Over time, addicts do not get the same high from the same dose of opiates. They require higher dosages, until such a point where they have to turn to illicit narcotics (which are also cheaper). Prescription drug abusers are 40x more likely of becoming heroin abusers.
This is all in the article I linked above (click on the subheadings).
Opiates are consumed every day by tens of millions of people in the world and they have absolutely no harmful effects if taken according to prescription.
That opiates when used in proper doses are extremely safe from a physical point of view is an indisputable fact.
> And don't get me started on the bullshit pushed by pharma a few years ago that people in pain can't get addicted to opiates. I loose it almost every time.
Watch out though. Pain comes in broadly two types - long term and short term pain.
Opiates are great for short term pain and the risk of addiction is low.
It's when opiates are misused for long term pain that they become a problem.
People overdose on opiates and die.
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