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

[beefheart]

I have a niece that was addicted to opiods through her scumbag old boyfriend, then it went into heroin. Boyfriend was driving and had a diabetic seizure (he isn't supposed to drive) and he had heroin in his system. He has been in prison for about 5 years now. Niece went into a residential 28 day program and is clean. She has a new guy who is fantastic, and a beautiful 3 year old. Anyone can become addicted, it is frightening.

I've been given Oxycodone by doctors a few times, but I didn't use any more than one, I didn't care for the side effects. I take ibouprofen when my carpal tunnel acts up (usually when I try to use a hammer or power tool), but I'm also on blood pressure meds so I try not to do too much. I am planning on getting a medical MJ card, more for protection than anything else. Marijuana is a great pain killer, and you can't OD, and you don't get addicted, and, it can be fun.

Also, I take a small amount of dextro-amphetimine every work day for ADHD. It helps me focus and actually get work done, but I've never taken more than what is prescribed, usually less. I don't care for some of the side effects...dry mouth, sometimes clenched mouth. I receive no "high" from it, my brain doesn't work that way with it. It really helps, but on the weekends, I don't take it, nice to not always be focused...LOL

 

[Threegoofs]

Thank you for the accurate statement.

And I know I am making MOSTLY a semantic point, and I appreciate your understanding that.

But I think a valid question is: do they really have the same pharmacological action?

Given the addiction/abuse problem that has been so apparent and well documented, are the opioids more addictive than straight old-fashioned opiates? I may be wrong, but I cannot help but think they are more dangerous than old-fashioned morphine or heroin. I say that as a veteran of Vietnam, where opiate abuse/addiction was rampant. I saw it. More opium and morphine and heroin were used, usually by smoking and very little injecting, than cigarette smoking.

IMO, the finely tuned synthetic chemicals are more addictive for humans than the older straight opiates. I do not recall anybody in Vietnam dying from opiate use, though the use itself was widespread, but I know many, probably dozens, of youngsters who have died from the scourge of Oxy.

Yes, they have similar pharmacological actions- they affect the opioid receptors in the body.

The newer synthetic drugs can actually designed to hit specific receptor subtypes, making dependence theoretically less likely, but this hasn't seemed to actually be a real thing in clinical practice.

Are they more addictive? Not necessarily. In fact, they can be used to treat addiction, in the case of the synthetic opioids Suboxone or methadone.

 

[Simon W. Moon]

Unless you believe that 80% of the pain in the world is suffered in the United States (a country with just 5% of the world's population), then we do indeed have a very big opiate addiction / dependence issue.

We disproportionately consume all manner health care when compared to the rest of the world.

Does this mean that the US has more health problems than the rest of the world?

Or is it a reflection on our relative access to health care?

 

[ALiberalModerate]

We disproportionately consume all manner health care when compared to the rest of the world.

Does this mean that the US has more health problems than the rest of the world?

Or is it a reflection on our relative access to health care?

I agree we disproportionately consume other health care services, particularly testing. However, we disproportionately consume opiates by an order of magnitude, and that is not the case with the vast majority of other healthcare services.

 

[Simon W. Moon]

Good point - so how about this:

View attachment 67215459

OD data ≠ addiction data

addiction data = addiction data

 

[ALiberalModerate]

OD data ≠ addiction data

addiction data = addiction data

Addiction data is very hard to come by because most people hide their addiction.

 

[VanceMack]

Vance

About 100 years ago, as Johns Hopkins Medical School was in its early days, there was the case of Dr. William Halstead, a teacher there.

Hypodermic syringes were fairly new in those days, and Dr. Halstead became a morphine addict. With his medical training he understood what he was doing. He discovered then what the Swiss and everybody else discovered later--a morphine addict could be maintained on a certain dosage given at the proper interval. When so maintained, morphine (opiate) addicts can carry on perfectly normal lives and contribute to society. Just as, one might, a caffeine or nicotine addict does.

So opiate use in and of itself, properly administered, is not fatal.

The problem with heroin addicts has always been the black market brought by our dumb drug policy. Under that policy the purity and strength is completely unknown and unregulated. A large part of today's (50 years back too) heroin deaths are from contaminated drugs with no known strength.

There are a fair number of casual heroin users. People that use occasionally and do not become addicts. Regardless of purity...regardless of content...and regardless of US drug laws, addicts become addicts through repetitive use and abuse. Blaming heroin addiction on US drug laws is goofy. Similarly, pain meds when used properly tend to not become a problem. However when misused, cracked, crushed and snorted, smoked, and injected, they become a big ****ing problem.

 

[JasperL]

OD data ≠ addiction data

addiction data = addiction data

Not sure why you're participating in the thread if you don't want to have an actual debate. If you looked at the graph, there are three lines - sales, deaths, AND treatment admissions, and the latter will be directly correlated with addiction prevalence (people who seek drug treatment are normally addicted to it) and obviously so will the data on overdose deaths. Those people dying aren't people on a three day post surgery schedule of using opiates.

If you want to add to the discussion by showing something interesting about addiction data going in a different direction or being uncorrelated with overall opiate use in this country (# of pills sold per year) or overdose deaths, that would be good, but I am sure you'll find that those all track each other quite closely - not quite correlations of +1 but much closer to +1 than 0, as this other graph shows: Source: PCSS-MAT ? Defining Opioid Use Disorders under tab - Opioid Addiction in the U.S.

 

[JasperL]

There are a fair number of casual heroin users. People that use occasionally and do not become addicts. Regardless of purity...regardless of content...and regardless of US drug laws, addicts become addicts through repetitive use and abuse. Blaming heroin addiction on US drug laws is goofy. Similarly, pain meds when used properly tend to not become a problem. However when misused, cracked, crushed and snorted, smoked, and injected, they become a big ****ing problem.

But I think that sort of glosses over the objections people have. Just for example, there are casual cocaine users - I knew several in college who bought a gram or so before big parties and used it to stay up all night and party - I did that ONE time - it was so good it scared the crap out of me and I've never touched it again. But we also know that lots of users of cocaine end up addicted to it, and the problems that causes - see Richard Pryor, Belushi.

The point is if you're a doctor and you know this drug has a high abuse potential, should it be handed out like candy for e.g. what is often pretty mild post-op pain? How about if doctors started handing out cocaine for people who need an extra boost before a big presentation at work, or to treat chronic fatigue? I doubt if anyone would approve of that with the excuse, well, of course, those who became addicts didn't take that highly addictive drug with an enormous potential for abuse, and that we KNOW is killing over 20,000 every year, exactly as directed, which is only occasionally before big presentations!

Or to put it another way, at least as I see it, we're handing out loaded guns that we know 20k per year use to kill themselves (another 13k killed themselves with heroin, which is directly related to pain killer use). Seems like the fact that if you use a loaded gun as directed, few if any will die is not actually a good reason to keep handing out loaded guns to patients, unless there is a VERY compelling need for it, and there are no good alternatives.

 

[VanceMack]

But I think that sort of glosses over the objections people have. Just for example, there are casual cocaine users - I knew several in college who bought a gram or so before big parties and used it to stay up all night and party - I did that ONE time - it was so good it scared the crap out of me and I've never touched it again. But we also know that lots of users of cocaine end up addicted to it, and the problems that causes - see Richard Pryor, Belushi.

The point is if you're a doctor and you know this drug has a high abuse potential, should it be handed out like candy for e.g. what is often pretty mild post-op pain? How about if doctors started handing out cocaine for people who need an extra boost before a big presentation at work, or to treat chronic fatigue? I doubt if anyone would approve of that with the excuse, well, of course, those who became addicts didn't take that highly addictive drug with an enormous potential for abuse, and that we KNOW is killing over 20,000 every year, exactly as directed, which is only occasionally before big presentations!

Or to put it another way, at least as I see it, we're handing out loaded guns that we know 20k per year use to kill themselves (another 13k killed themselves with heroin, which is directly related to pain killer use). Seems like the fact that if you use a loaded gun as directed, few if any will die is not actually a good reason to keep handing out loaded guns to patients, unless there is a VERY compelling need for it, and there are no good alternatives.

I think we can all agree...we over-prescribe pretty much ALL medications. Part of that is the medical system (docs and pharma) and the other component is a society that demands a pill solution for all problems.

There is a standard joke in the military. Got back spasms? Take 800 mgs of Motrin. Got a broken arm? Take 800 mgs of Motrin. Got cancer? Oh...thats different. Lets up the dose to 1200 mgs of Motrin. Motrin is the military cure-all. THEN...you retire and go to the VA. Sore toe? Here...take this bag of narcotics. Ive got pretty severe arthritis in both hands. They are constantly trying to push pain pills at me. I only go to the VA for a once a year physical just to keep my status current with them and every time its the same thing. Do you need any pain meds? Ive even had them send them t my house without telling me they were sending them. WHen thy screwed up my knee replacement they knew I didnt take ANY pain pills while in the hospital. Yet they sent me home with a refillable prescription for Dilaudid. Thats some serious stuff. When I didnt have the prescription filled they did it for me automatically.

Florida used to be the prescription pill pipeline. "At one point, more than 90% of all the prescription opioids dispensed by doctors in the US were sold in Florida." People got hooked...then the gov cracked down...but people were still hooked. SO...shortage of pain pills? No problem...increase the input of heroin. Problem solved.

 

[Simon W. Moon]

Not sure why you're participating in the thread if you don't want to have an actual debate. If you looked at the graph, there are three lines - sales, deaths, AND treatment admissions, and the latter will be directly correlated with addiction prevalence (people who seek drug treatment are normally addicted to it) and obviously so will the data on overdose deaths. Those people dying aren't people on a three day post surgery schedule of using opiates.

If you want to add to the discussion by showing something interesting about addiction data going in a different direction or being uncorrelated with overall opiate use in this country (# of pills sold per year) or overdose deaths, that would be good, but I am sure you'll find that those all track each other quite closely - not quite correlations of +1 but much closer to +1 than 0, as this other graph shows: Source: PCSS-MAT ? Defining Opioid Use Disorders under tab - Opioid Addiction in the U.S.

Combining the stats presented...

300,000,000 R[SUB]x[/SUB] yields:

• 5/100,000 seeking treatment
• 5/100,000 dying
• 99.995% of the population not seeking treatment for opioid addiction

 

[JasperL]

Combining the stats presented...

300,000,000 R[SUB]x[/SUB] yields:

• 5/100,000 seeking treatment
• 5/100,000 dying
• 99.995% of the population not seeking treatment for opioid addiction

LOL, you can almost do basic math - 5/10,000 = 99.95% not getting treatment. Just a silver star for you.

I'll never understand why people who don't care about an issue feel some obligation to come on threads and point that out....

 

[Thoreau72]

Yes, they have similar pharmacological actions- they affect the opioid receptors in the body.

The newer synthetic drugs can actually designed to hit specific receptor subtypes, making dependence theoretically less likely, but this hasn't seemed to actually be a real thing in clinical practice.

Are they more addictive? Not necessarily. In fact, they can be used to treat addiction, in the case of the synthetic opioids Suboxone or methadone.

Yes, and the Titanic was designed so as not to be sinkable.

The best laid plans of mice and men......

I have a friend who became addicted to suboxone. I helped him through the process and it was brutal to watch. That was about 2 years ago and he is free today.

 

[Thoreau72]

There are a fair number of casual heroin users. People that use occasionally and do not become addicts. Regardless of purity...regardless of content...and regardless of US drug laws, addicts become addicts through repetitive use and abuse. Blaming heroin addiction on US drug laws is goofy. Similarly, pain meds when used properly tend to not become a problem. However when misused, cracked, crushed and snorted, smoked, and injected, they become a big ****ing problem.

Regardless of purity??? Do you really mean that? If so, that is one of the most nonsensical statements I have ever read. Regardless of content???? Put a little strychnine in with it and see how quickly they die.

The drug prohibition creates a very long list of social pathologies that are well documented. Way more than heroin addiction AS WE SEE IT is the direct result of our asinine and pernicious policy of prohibition.

 

[natsb]

<snip>

The point is if you're a doctor and you know this drug has a high abuse potential, should it be handed out like candy for e.g. what is often pretty mild post-op pain? <snip>

I was wondering about that. I recently had a molar pulled and was warned about the terrible pain I was about to experience. After the removal, was feeling well, so I completed a bunch of errands. By the time I got to the pharmacy, my mouth had stopped hurting. So I turned around put the 4 day opioid prescription in the box with all the other prescriptions I don't fill.

Why would a Doctor give 4 days worth of pills for something that only hurt for 30 minutes?

 

[VanceMack]

Regardless of purity??? Do you really mean that? If so, that is one of the most nonsensical statements I have ever read. Regardless of content???? Put a little strychnine in with it and see how quickly they die.

The drug prohibition creates a very long list of social pathologies that are well documented. Way more than heroin addiction AS WE SEE IT is the direct result of our asinine and pernicious policy of prohibition.

Habitually abuse PERFECT heroin...and what do you get?

 

[LetsGoBrandon]

Notice the following statement:

When they're taken in the short-term and used as directed...

Short term to the CDC is a three day prescription.

We have 5% of the world's population, yet we use 80% of the world's opiate prescriptions, some 300 million opiate prescriptions a year. We don't have 80% of the pain in the world. We just have a very disproportionate amount of patients now addicted to opiates. Not everyone will become addicted to opiates if they are prescribed them for chronic pain, but a very high percentage of patients will. That is why no other country does it and thus they don't have the opiate addiction epidemic that we do.

The problem is that people go to see their GP wanting a panacea. They want a pill, not to be told to make any life style changes and they certainly don't want a prescription for physical therapy. They don't want to be told that their knees are in pain because they have spent a lifetime of being overweight and the solution ultimately is to lose weight. They don't want to be told that their back hurts because their muscles are atrophied due to years of a sedentary lifestyle and thus the solution is ultimately exercise and physical therapy. They just want a pill so they can go about life they way they did before without making any real changes. This is combined with overworked GP's that must see more patients every day than ever before, and a pharmaceutical industry that makes 24 billion a year off of narcotics, and thus has a financial interest in creating addicts.

One, America is by far not the only nation with a serious opioid addiction problem. Two, not all the opioid addictions are pain patients, a large segment are recreational users. Having said that, we have already agreed that pain medications are over-prescribed. Where we do not agree is whether or not opioid meds have a legitimate place in the treatment of chronic pain. They do, however they should be monitored by doctors. And not everyone who suffers from chronic pain is an overweight couch potato. Some are born with conditions that lead to a life of chronic pain. Others are just unlucky. Some come down with conditions such as parkinsons disease, multiple sclerosis, sickle cell anemia,ALS, etc. Annette Funicello for instance was never overweight a day in her life. The same with Michael J. Fox.

 

[Fearandloathing]

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.

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

 

[Removable Mind]

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

Good on you. I just had my 30th anniversary for my sobriety, but I did my share of drugs.

I only take drugs if it's really necessary, when my doctor insist that I take something, which is rare, because he knows my past problems with alcohol and drugs. He's been my doc for 25 years so he's really hip on my reluctance to take narcotics.

But I believe what you're saying about painkillers has merit.

 

[vesper]

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.

 

[chromium]

a bit over 10 years ago I experienced a herniated L4/L5 disc in my low back.
The associated symptoms & pain were a complete b****.
At times I experienced MAXIMUM pain levels.
I had excellent health insurance but that was NOT The problem.
I nearly begged the medical folks to operate & I also repeatedly asked for prescription drugs that would help with the excessive pain levels.
The PROBLEM was no one wanted to operate to eliminate the REAL issue, that being the herniated disc.
The other PROBLEM was no one wanted to offer me prescriptions that were strong enough to combat the excessive pain levels I experienced.

IMO the medical community FAILED ME; F*** THEM ................... these people are f***ing useless ............

You need to learn how to get what you want, because it's your body and ultimately the only way they can know what you need is observation or your own testimony. Far too few doctors worship their training rather than believe in their patients' right to self determination. Their proper role is to help patients make an informed decision

So tell them either give you something that will work or you'll get what you need on the street and they won't see you again. Or tell them the pain and limitations have made you disabled, unable to work, and suicidal. Also impress upon them "I've taken 3 kinds of NSAIDS and all they do is tear up my stomach, all the muscle relaxers do is put me to sleep, and all the cortisone shots and RFA crap does is shift the pain" If you've tried everything and had all the tests, that gives them less ammunition to refuse

 

[Fearandloathing]

Good on you. I just had my 30th anniversary for my sobriety, but I did my share of drugs.

I only take drugs if it's really necessary, when my doctor insist that I take something, which is rare, because he knows my past problems with alcohol and drugs. He's been my doc for 25 years so he's really hip on my reluctance to take narcotics.

But I believe what you're saying about painkillers has merit.

30 years is a long time between drinks my friend. Congratulations. I too did hard drugs. It was part of the job at times, especially in television in the 70's and 80's, coke mike as well have been dispensed in beverage machines. And when you've pulled a breaking story that goes all night and the rest of the day, you need something to keep your eyes open that won't be obvious on camera.

First guy I told when I started my sobriety was my doc. We used to share the odd pint together at a local pub. He knows I have an addictive personality and so we take the slow lane on a lot of stuff.

 

[Fearandloathing]

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.

It is said that addicts/alcoholics, I am both, take 15 people down with them. I have worked volunteer in the addictions arena form 27 years and I think we take down 20 to 30 people who loved us.

That's why making amends is so important in sobriety.

 

[Removable Mind]

30 years is a long time between drinks my friend. Congratulations. I too did hard drugs. It was part of the job at times, especially in television in the 70's and 80's, coke mike as well have been dispensed in beverage machines. And when you've pulled a breaking story that goes all night and the rest of the day, you need something to keep your eyes open that won't be obvious on camera.

First guy I told when I started my sobriety was my doc. We used to share the odd pint together at a local pub. He knows I have an addictive personality and so we take the slow lane on a lot of stuff.

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".

 

[Thoreau72]

Habitually abuse PERFECT heroin...and what do you get?

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.