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With a 10-day supply of opioids, 1 in 5 become long-term users

Habitually USE pharmaceutical quality heroin at maintenance levels and what do you get? A normally functioning person who works and pays his taxes.

You offer no definition Vance. What do you mean by "perfect"? It's difficult to carry on a rational discussion with no definitions of terms. I'm talking about use, you're talking about abuse, and never define the term. Give me something to work with here.

What if that person ever gets pneumonia and thus must stop using that drug while he recovers due depressed lung function?
 
Habitually USE pharmaceutical quality heroin at maintenance levels and what do you get? A normally functioning person who works and pays his taxes.

You offer no definition Vance. What do you mean by "perfect"? It's difficult to carry on a rational discussion with no definitions of terms. I'm talking about use, you're talking about abuse, and never define the term. Give me something to work with here.
Its like you have this vision that addicts are all emotionally healthy reasonably well maintained individuals that except for the grade and quality of product may become addicted but would be fully functioning participating members of society...

Have you ever WORKED with addicts?
 
https://arstechnica.com/science/201...ply-of-opioids-1-in-5-become-long-term-users/

This is why we have such an opioid addiction epidemic in this country. They are dangerous, its much better to man up and deal with the pain than it is to risk getting hooked.

What a load crap.

First.. dependence IS NOT addiction.

A person that needs pain control for chronic pain.. such as a person with a amputation... does not mean they are an addict because they have a physical dependence.

Anymore than a person who has a dependence on heart medication is an addict because they need to take heart medication.
 
Last year in Vancouver 904 people died of fentanyl overdose. Three times as many as the year before. So far this year the rate is down, but not by much.

They may be "just addicts" but they had people who cared for them and loved them. But the real hit is what's happening to our first responders. They are the worst hit with PTSD and other issues.

We are responding by throwing money at it and asking "what else? Any suggestions?" And while we struggle to find answers - better control of the materials needed to make it, more focused policing, hard time for real dealers, and more assisted user sights which have proven to be the best means of reducing ODs.

But even I am frightened. I've spent 27 years volunteer in the addictions area and never have I seen anything like this.

To comment directly on your post many of us have seen addiction happen with ONE use.

And I will go on record agreeing with you that facing the pain is a lot easier, and you heal faster. These days I deal with migraines 24/7, and while we got on top of most of it, when they hit there is nothing I can take safely, especially now I am on blood thinners for Afib. What I do know is when a migraine hits and I take the meds I used to be able to take the situation would last an hour, maybe two.

Now, I take nothing and find that the headache lasts about an hour, maybe two.

When I broke a bunch of ribs mountain falling years ago, because I am a recovered addict pain killers were not available to me. When I went to see the specialist a few days later he was amazed at how much I had mended. You heal faster when you don't use painkillers

In regards to the science behind pain control and healing:

Inadequately managed pain can lead to adverse physical and psychological patient outcomes for individual patients and their families. Continuous, unrelieved pain activates the pituitary-adrenal axis, which can suppress the immune system and result in postsurgical infection and poor wound healing. Sympathetic activation can have negative effects on the cardiovascular, gastrointestinal, and renal systems, predisposing patients to adverse events such as cardiac ischemia and ileus. Of particular importance to nursing care, unrelieved pain reduces patient mobility, resulting in complications such as deep vein thrombosis, pulmonary embolus, and pneumonia. Postsurgical complications related to inadequate pain management negatively affect the patient’s welfare and the hospital performance because of extended lengths of stay and readmissions, both of which increase the cost of care.

https://www.ncbi.nlm.nih.gov/books/NBK2658/

http://www.woundsaustralia.com.au/journal/1803_02.pdf

I would strongly dissuade anyone telling people that they will heal better if they are in pain. The research does not support that. In fact.. most research shows that inadequate pain relief has deleterious effects on healing rates.
 
What a load crap.

First.. dependence IS NOT addiction.

A person that needs pain control for chronic pain.. such as a person with a amputation... does not mean they are an addict because they have a physical dependence.

Anymore than a person who has a dependence on heart medication is an addict because they need to take heart medication.

In so far as opiates are concerned, the difference between dependence and addiction is a semantics distinction. Either way, when they come off them they go through the same withdrawals.

To repeat what has been pointed out a half a dozen times before on this thread:

1. The difference between addiction and dependence in terms of opiates is semantics. Whether you call yourself dependent on opiates or addicted to them, the withdrawal symptoms are the same.

2. There is little evidence that opiates are effective for long term chronic pain due to tolerance and hyperalgesia. This is why the CDC only recommends them to be used for short term pain relief after surgery or major trauma and only to be used for long term relief for end term cancer patients.

3. As has been pointed out many times in this thread: We have 5% of the world's population, yet 80% of the opiate prescriptions, 300 million opiate prescriptions written every year, and its 24 billion dollar a year industry. That means we write exponentially more opiate prescriptions in this country per capita than anywhere else. Unless you can somehow show that we have an order of magnitude more pain in this country than anywhere else, its obvious we are creating a lot of addicts.

Finally, as I pointed out in this post, I know what extreme pain is like: https://www.debatepolitics.com/break...post1067004223 (With a 10-day supply of opioids, 1 in 5 become long-term users)
 
In regards to the science behind pain control and healing:



https://www.ncbi.nlm.nih.gov/books/NBK2658/

http://www.woundsaustralia.com.au/journal/1803_02.pdf

I would strongly dissuade anyone telling people that they will heal better if they are in pain. The research does not support that. In fact.. most research shows that inadequate pain relief has deleterious effects on healing rates.



Thanks for the consideration, however neither indicates who financed the research. Nor does it indicate when this was written but I do notice the organization who is mentioned at the top went out of business last year.

I am old enough and experienced enough to know that conclusions like these are often a result of "studies" financed by pharmaceutical companies. And it may SAY it is a "nurses handbook", it must not be the handbook being used here as everyone from nurses to specialists have complimented me on the choice I made.

This caught my attention: "Despite the availability of analgesics—particularly opioids—and national guidelines to manage pain, cade.4 Thus, acute pain associated with surgical and diagnostic procedures is a common occurrence in U.S. hospitals and remains inadequately manged for many patients." I have nothing at my finger tips, my my information is that opioids are being over-prescribed, in one study, "like candy."

I don't know if the mean inadequately managed as in their lives are screwed because of the addiction, or the patients aren't getting enough. The later suggestion is laughable since the US has the highest addiction rate of prescribed opioids in the world.

Having seen the ravages of opioids added to the fact millions of Americans and Canadians are fully addicted as the rest of over-prescribing my belief is to ban them all together. Throw the makers in prison for life. Heroin in the right does is more effective and less addictive and, cannabis arguably the best pain reliever, far less addictive than even coffee and nothing can touch pain-associated nausea, only pot.

Like Americans and their government, we have become wary and suspicious of pharmaceutical companies and have been developing alternative measures. Canadians live an average three and a half years longer than Americans, so I think I will stick with what's working. I've seen too many addicts die, too many kids and families lives get ruined because of this crap. When you have 17 to 20 year olds dying to the tune of 904 people in one year...the wise look for something else. We have already locked down controls of the drug and Health Canada is writing a new protocols, but they are still dying.

It is now the "drug of death".
 
Last year in Vancouver 904 people died of fentanyl overdose. Three times as many as the year before. So far this year the rate is down, but not by much.

They may be "just addicts" but they had people who cared for them and loved them. But the real hit is what's happening to our first responders. They are the worst hit with PTSD and other issues.

We are responding by throwing money at it and asking "what else? Any suggestions?" And while we struggle to find answers - better control of the materials needed to make it, more focused policing, hard time for real dealers, and more assisted user sights which have proven to be the best means of reducing ODs.

But even I am frightened. I've spent 27 years volunteer in the addictions area and never have I seen anything like this.

To comment directly on your post many of us have seen addiction happen with ONE use.

And I will go on record agreeing with you that facing the pain is a lot easier, and you heal faster. These days I deal with migraines 24/7, and while we got on top of most of it, when they hit there is nothing I can take safely, especially now I am on blood thinners for Afib. What I do know is when a migraine hits and I take the meds I used to be able to take the situation would last an hour, maybe two.

Now, I take nothing and find that the headache lasts about an hour, maybe two.

When I broke a bunch of ribs mountain falling years ago, because I am a recovered addict pain killers were not available to me. When I went to see the specialist a few days later he was amazed at how much I had mended. You heal faster when you don't use painkillers

Unless you have a condition with chronic pain that just does not heal.
 
I have lived through a family member addicted to opioids. It is an ugly ugly situation for the entire family. Mine was my youngest brother who started dabbling in drugs in early years. It was his drug addiction to opioids that caused his liver to fail at the age of 55. But not until he absolutely created a living Hell for the entire family.

I had a cousin that was addicted to pain killers of all kinds. Whatever she could get her hands on, she took. She doctor shopped when she could not easily get a prescription or attempted to bum pain medications from family and friends. Her liver failed at the age of 49.
 
I think I'm addicted to anything that makes me feel good, but at my age I'm not experimenting with much of anything more addictive than a Baskins and Robbins, "World Class Chocolate Malt or Milkshake". ;)



Oh yeah, you are never 'cured'. I had a real long battle with cigarettes, and I don't buy ice cream in any size bigger than one snack. There are few things that don't affect me that way, strangely one of them is cannabis.
 
Habitually USE pharmaceutical quality heroin at maintenance levels and what do you get? A normally functioning person who works and pays his taxes.

You offer no definition Vance. What do you mean by "perfect"? It's difficult to carry on a rational discussion with no definitions of terms. I'm talking about use, you're talking about abuse, and never define the term. Give me something to work with here.


Heroin is easier to kick than methadone. More than one of the men I have walked with had to go back on heroin and then quit.
 
In regards to the science behind pain control and healing:



https://www.ncbi.nlm.nih.gov/books/NBK2658/

http://www.woundsaustralia.com.au/journal/1803_02.pdf

I would strongly dissuade anyone telling people that they will heal better if they are in pain. The research does not support that. In fact.. most research shows that inadequate pain relief has deleterious effects on healing rates.

I agree. When it comes to injuries or painful conditions that will heal, you are absolutely not better off just dealing with the pain, at least initially. I had a chest trauma injury that led to a fractured sternum and a bruised heart. Complete healing takes a minimum of 12 weeks. I absolutely had to do something about the pain on that first day as the pain was equal to a heart attack. Morphine got me over the hump and then after going home, I threw out most of the pain medication as was well taken care of the first day.
 
I never said it was a blanket and even then there are alternatives to opiates

Agreed. And fortunately many of those alternatives are now being treated like narcotics, just as opioids are.
 
What if that person ever gets pneumonia and thus must stop using that drug while he recovers due depressed lung function?

What if that person gets killed in a motorcycle accident before he gets pneumonia?

I'm not trying to be flippant, but I don't see the relevance of your hypothetical.
 
Heroin is easier to kick than methadone. More than one of the men I have walked with had to go back on heroin and then quit.

Yes, I have heard that before. Individual reactions to various drugs are a big consideration.
 
Its like you have this vision that addicts are all emotionally healthy reasonably well maintained individuals that except for the grade and quality of product may become addicted but would be fully functioning participating members of society...

Have you ever WORKED with addicts?

I have lived with addicts too. Coffee addicts, alcohol addicts, suboxone addicts, tobacco addicts.

Chronic use of various drugs is part of the human condition. How do you define addiction?
 
What if that person gets killed in a motorcycle accident before he gets pneumonia?

I'm not trying to be flippant, but I don't see the relevance of your hypothetical.

The point is that even if you assume that someone can be maintained on opiates their entire life, any kind of severe respiratory infection or issue will most likely require them to stop taking them until the issue is resolved, which will bring on narcotic withdrawal symptoms.

On top of that, long term opiate use is hell on your endocrine system.
 
I agree. When it comes to injuries or painful conditions that will heal, you are absolutely not better off just dealing with the pain, at least initially. I had a chest trauma injury that led to a fractured sternum and a bruised heart. Complete healing takes a minimum of 12 weeks. I absolutely had to do something about the pain on that first day as the pain was equal to a heart attack. Morphine got me over the hump and then after going home, I threw out most of the pain medication as was well taken care of the first day.

You are describing the safe use of narcotic pain meds, for 2 to 3 days after surgery or severe trauma. There is little risk of dependence for short usage like that. The problem is taking them for chronic pain. The CDC recommends now that doctors only write 3 day prescriptions. That way you have to come back and get another 3 day prescription if you are still in severe pain and doctors can much more closely monitor usage.
 
The point is that even if you assume that someone can be maintained on opiates their entire life, any kind of severe respiratory infection or issue will most likely require them to stop taking them until the issue is resolved, which will bring on narcotic withdrawal symptoms.

On top of that, long term opiate use is hell on your endocrine system.

Yes, there is no question that opiates in large dose can and will suppress breathing. As to whether any given maintenance dose will be sufficient to suppress breathing, maybe so, maybe not. As you say "most likely".

And for the sake of argument I will agree that long term opiate use is hell on the endocrine system. Chronic use of many drugs can cause problems.

My only point is that our policy of prohibition causes far more harm to all of society, users and non-users alike, than any individual harm that might be caused by poor lifestyle choices. Government laws cannot make people exercise good judgment, but they can and do have often enormous unintended consequences.
 
I have lived with addicts too. Coffee addicts, alcohol addicts, suboxone addicts, tobacco addicts.

Chronic use of various drugs is part of the human condition. How do you define addiction?
There are dictionary definitions of addicts, and there are clinical definitions of addicts and then there are people that will inject **** into their system that will cause this...
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Because they are desperate for the 'effect'. They arent healthy physically or emotionally. We put people through detox programs where they come out clean and within weeks they are back at it and it doesnt matter if we are talking alcoholics or heroin users or synthetic opioid users. Hell...Russian soldiers used to put shoe polish on bread,put it in a toaster and inhale it. Oh...did we talk about huffers? Glue sniffers? The world is not full of emotionally healthy productive individuals that if simply allowed a healthy clinical medical dose of heroin would serve wonderful full and complete lives.

You remind of the college professors of the 70s and 80s that used to promote drug legalization because they themselves were casual users and felt that if it were all legal people would be able to make responsible choices and our drug problem would go away. And they may have been right...for the casual user.
 
Yes, there is no question that opiates in large dose can and will suppress breathing. As to whether any given maintenance dose will be sufficient to suppress breathing, maybe so, maybe not. As you say "most likely".

And for the sake of argument I will agree that long term opiate use is hell on the endocrine system. Chronic use of many drugs can cause problems.

My only point is that our policy of prohibition causes far more harm to all of society, users and non-users alike, than any individual harm that might be caused by poor lifestyle choices. Government laws cannot make people exercise good judgment, but they can and do have often enormous unintended consequences.

I agree with you about the drug war and so on. However, the problem with the opiate epidemic is that we have doctors prescribing them for weeks, months or years. Thus they are creating addicts out of people that would not normally be a drug addict and there are huge societal costs to that.
 
There are dictionary definitions of addicts, and there are clinical definitions of addicts and then there are people that will inject **** into their system that will cause this...
View attachment 67215580

Because they are desperate for the 'effect'. They arent healthy physically or emotionally. We put people through detox programs where they come out clean and within weeks they are back at it and it doesnt matter if we are talking alcoholics or heroin users or synthetic opioid users. Hell...Russian soldiers used to put shoe polish on bread,put it in a toaster and inhale it. Oh...did we talk about huffers? Glue sniffers? The world is not full of emotionally healthy productive individuals that if simply allowed a healthy clinical medical dose of heroin would serve wonderful full and complete lives.

You remind of the college professors of the 70s and 80s that used to promote drug legalization because they themselves were casual users and felt that if it were all legal people would be able to make responsible choices and our drug problem would go away. And they may have been right...for the casual user.

You remind me of politicians who like to scare people by posting ugly pictures of depraved and pitiful humans, and pretend it's education. It's not education, it is just fear-mongering, and I'm fairly immune to fear-mongering based upon ignorance.

The simple, unvarnished and unpleasant truth is that our current drug policy has not stopped addiction, but it has allowed the CIA to be in the dope business since its inception, and it has led to the highest per capita rate of imprisonment in the entire world for more than 30 years.

Fear-mongering is not debate or rational dialogue, it is an appeal to emotion, nothing more. Keep those eyes wide shut Vance, and be afraid, very afraid. :peace
 
I agree with you about the drug war and so on. However, the problem with the opiate epidemic is that we have doctors prescribing them for weeks, months or years. Thus they are creating addicts out of people that would not normally be a drug addict and there are huge societal costs to that.

I very much agree. That so many doctors have stock in the companies that produce the OPIOIDS provides valuable insight for the curious as to one very large factor in why they prescribe the pills.
 
You remind me of politicians who like to scare people by posting ugly pictures of depraved and pitiful humans, and pretend it's education. It's not education, it is just fear-mongering, and I'm fairly immune to fear-mongering based upon ignorance.

The simple, unvarnished and unpleasant truth is that our current drug policy has not stopped addiction, but it has allowed the CIA to be in the dope business since its inception, and it has led to the highest per capita rate of imprisonment in the entire world for more than 30 years.

Fear-mongering is not debate or rational dialogue, it is an appeal to emotion, nothing more. Keep those eyes wide shut Vance, and be afraid, very afraid. :peace
Im simply stating truth and the real world. You are trying to turn the drug addiction epidemic into a crusade for legalized drugs.

You should never be 'afraid' of the truth...even when the truth is brutal and ugly. But your 'eyes wide shut' comment...dood...thats not THE stupidest thing you have said, but it is right up there. You intentionally avoid reality in the name of cause...and no one is more blind that a crusading political zealot.

We probably agree more than you can know about our drug policy. But that doesnt change the real world. That doesnt change the world of addiction.
 
Hell...Russian soldiers used to put shoe polish on bread,put it in a toaster and inhale it. Oh...did we talk about huffers? Glue sniffers? The world is not full of emotionally healthy productive individuals that if simply allowed a healthy clinical medical dose of heroin would serve wonderful full and complete lives.

You remind of the college professors of the 70s and 80s that used to promote drug legalization because they themselves were casual users and felt that if it were all legal people would be able to make responsible choices and our drug problem would go away. And they may have been right...for the casual user.

This line of reasoning sounds eerily similar to the logic of someone who might be labelled an anti-gun nut.

You remind of folks who promote gun legalization because they themselves were responsible gun-owners. They felt that if gun ownership were legal, people would be able to make responsible choices and our gun problem would go away. And they may have been right...for the responsible gun-owner.

Different subjects of course—but similar rationale.

Maybe you have more in common with "anti-gun nuts" than you had previously expected.

The societal parallels between gun use and drug use are not insignificant.
Both potentially dangerous to the user and those around the user.
Both potentially beneficial, useful and fun for the user and those around the user.
Both the subject of strong emotional reactions.​

It would not be illogical for someone who was in favor of allowing adults access to one to be in favor of allowing adults access to the other.


Should we prevent people who have certain mental issues from having potentially harmful drugs?
Is it reasonable to allow people who are not mentally or emotionally impaired to have drugs?

What about guns?
Should we prevent people who have certain mental issues from having guns?
Is it reasonable to allow people who are not mentally or emotionally impaired to have guns?


Back on the subject of the opioid "epidemic"...
People's health is highly idiosyncratic—there are precisely 2.23½ kajillion variables which could vary from one person to the next.
We already have a system of qualified experts in place to assist us with making health decisions.
I'm all for educating doctors and patients with the facts, strategies to prevent problems, and ways to correct problems which occur.

The opioid "epidemic" directly affects only a minute percentage of the population, so we should be careful about enacting any unnecessary legislation that interferes with Dr.s' ability to make judgements on behalf of their patients.
 
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