5 ms·

Anecdotes are not a valid citation. Heroin is the most harmful drug, statistically, according to numerous studies.

by bcook 11y ago

ryanlol 11y ago
Not heroin, but a completely unknown substance presented as heroin that probably consists of around 30% heroin.
- bcook 11y ago
  Heroin addiction is one of the most harmful documented drug-addictions. The need for heroin, physically and psychologically, is the driving force behind the social and personal damage attributed to heroin. People do not get addicted to non-narcotic adulterants and become prostitutes. A cutting agent like caffeine or sugar is probably the safest ingredient...
  - blumkvist 11y ago
    Caffeine? Sugar? Lol! How about mice poison? Reading wikipedia and actually knowing stuff about drugs are very different things. Please stop posting, you don't have a clue.
    - bcook 11y ago
      You focused on the least important part of what I wrote then resort to ad hominem attacks. There is no sensible conversation to be had here.
      - blumkvist 11y ago
        I don't want to have a conversation with you. You don't know the first thing about the subject. Why would I want to talk to you about it?
        corin_ 11y ago
        I don't disagree with you that he's wrong, but arguing without proper arguments then insulting him doesn't really help the conversation. @bcook: Heroin, if it was 100% pure (e.g. as manufactured by a pharmacuticals company), and used with completely safe equipment (e.g. sterylised needles), and used at not-too-high dose levels, it would actually be pretty safe. It essentially has the same effect as morphine or oxycodone, both of which are prescribed legally (my dad has been on morphine for a few years, extended release so he doesn't get high.. but it also doesn't kill him). The biggest danger is indeed purity - if you think that "x" amount is the right dose for your tolerance (and tolerance not only varies based on how much a user has had before, but also on that person's body in the first place) but one batch you buy is y% pure and the next batch is 2y% pure, you can accidentally dose yourself twice as much as you are expecting and overdose. Of course overdose is possible with drugs where you completely know the strength - such as oxycontin pills - but with semi-sensible use it's a lot harder, since you actually know how much of the drug you're taking. Yes it can be addictive, but if you never over do it and can afford to keep buying clean drugs like oxycontin you're most likely going to be fine. The biggest risk with prescription painkillers like this is not that they'll kill you, but that you'll become addicted to them and, when you either can't get another prescription or can't afford your illegal purchases, you move onto heroin because it's much cheaper per dose. Cheaper per dose, but also less pure and therefore more likely to be dangerous. I personally wouldn't try heroin because I don't want to become dependant on something (other than tobacco..), but if it was completely pure then addition would be the only thing that scared me away from it, not fear of death from using it.
        bcook 11y ago
        Cite an article that says the purity of heroin is the most dangerous part of heroin use. Just one reputable article. Put up or shutup. I posted 3 well-established papers above if you want some reading.
        ryanlol 11y ago
        https://scholar.google.com/scholar?hl=en&q=heroin+overdose+purity&btnG=&as_sdt=1%2C5&as_sdtp= https://scholar.google.com/scholar?hl=en&q=heroin+overdose+p... Considering purity fluctuations will actually KILL you rather than just make you want more, yeah I'd say that's by far the most dangerous part of street heroin.
    - ryanlol 11y ago
      The cuts are VERY rarely anything harmful by themselves, that'd be a pretty shitty business move.
      - DanBC 11y ago
        Some supporting references: The adulterants and bulking agents cover a wide range of substances. At the cleaner end you have caffeine (reduces vapour point of heroin), Chloroquine (looks a bit like heroin), and paracetamol. https://www.unodc.org/unodc/en/frontpage/2009/June/afghanistan-identifies-cutting-agents-for-heroin.html https://www.unodc.org/unodc/en/frontpage/2009/June/afghanist... At the dirtier / dangerous end you have lead (possibly a contaminant from "cooking" vessels, causes serious harm when injected) http://www.cph.org.uk/wp-content/uploads/2012/08/cut-a-guide-to-the-adulterants-bulking-agents-and-other-contaminants-found-in-illicit-drugs.pdf http://www.cph.org.uk/wp-content/uploads/2012/08/cut-a-guide... The illegal nature of the drugs means there are risks of bacterial / fungal contamination - anthrax, botulism, etc from the drug, but also from household products used to increase the potency. For example, if a heroin user goes to a clinic they'll be provided with clean vitamin C. If they're at home they may use lemon juice. > In Glasgow 23 heroin users were diagnosed with Candida endophthalmitis (intraocular fungal infection), bio-typing analysis indicated that the lemon juice used to prepare heroin injections was the source of contamination (Shankland & Richardson, 1988). In Spain, contaminated lemon juice was also suspected as the cause of an outbreak of Candida albicans amongst injecting heroin users (Miro et al., 1987). Probably most relevant: > As discussed previously, the evidence detailed above suggests that adulterants are added to heroin typically either to (1) dilute the product with benign substances making it less pure and increasing profits, or (2) to enhance the heroin (i.e. to make it more efficient when smoked) (Huizer, 1987). The evidence does not concur with the mythology of the addition of gravel, brick dust, household cleaning products or poisons by unscrupulous drug dealers.
  - throwaway7767 11y ago
    > People do not get addicted to non-narcotic adulterants and become prostitutes. A cutting agent like caffeine or sugar is probably the safest ingredient... The biggest physical danger of heroin use is the risk of overdose. The main reason people overdose is because of the adulterants - they don't know how potent the stuff is. x mg of batch A might be a good high, whereash x mg of batch B will kill you from an overdose. Even if the adulterants are themselves safe, the presence of them is a risk to the users, because they make it impossible to determine dosage.
- malka 11y ago
  30% how generous. In EU the average purity for heroin is ~2%.
  - corin_ 11y ago
    Wikipedia states "The average purity of street heroin in the UK varies between 30% and 50% and heroin that has been seized at the border has purity levels between 40% and 60%" (https://en.wikipedia.org/wiki/Heroin#Adverse_effects https://en.wikipedia.org/wiki/Heroin#Adverse_effects). It doesn't actually have a citation that confirms that, but another quick google gives http://drugscope.org.uk/how-pure-are-street-drugs/ http://drugscope.org.uk/how-pure-are-street-drugs/ saying "The 2010/11 police recorded average purity for heroin was 30 per cent." So I'm inclined to believe the 30% number unless you have a source for thinking it's much lower.
    - malka 11y ago
      I stand corrected, my information was wrong. Thanks for the sources.
  - ryanlol 11y ago
    2% is definitely not accurate, consuming that would be a very unpleasant experience.
DanBC 11y ago
Do you have links to those studies? A lot of the harm from heroin come from adulterants which are injected, causing abscess; or from the illegality of providing clean needles and injection advice and safe spaces to inject which causes infection etc; or from the illegality of providing maintenance doses from doctors which cause people to burgle or sex work to get money to buy the drug. Heroin is undoubtedly an unwise choice, but keeping it illegal has been a public health disaster.
- bcook 11y ago
  http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)61462-6/abstract http://www.thelancet.com/journals/lancet/article/PIIS0140-67... http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61530-5/abstract http://www.thelancet.com/journals/lancet/article/PIIS0140-67... http://bmjopen.bmj.com/content/2/4/e000774.full.html#T1 http://bmjopen.bmj.com/content/2/4/e000774.full.html#T1 There are more, but freely accessing journals online is troublesome. I have NEVER seen any study say heroin is anything but one of the most crippling and dangerous addictions. I am still waiting for anyone to cite one...
  - DanBC 11y ago
    Your first one is available here: http://www.sg.unimaas.nl/_old/oudelezingen/dddsd.pdf http://www.sg.unimaas.nl/_old/oudelezingen/dddsd.pdf Have a read. Do you think it still supports your position? It says, clearly, that alcohol is more harmful than heroin. Are you calling for alcohol to be made illegal? Or: Bob is a heroin addict. Should Bob continue to buy heroin from the street? That heroin will be adulterated; of unknown strength; sold by criminals; and may require Bob to engage in acquisitive crime or prostitution to get the money needed. It will be injected with whatever needle Bob has, which may not be sterile and may be shared with other people, some of whom have blood borne diseases. Or should Bob be prescribed heroin by his doctor. That heroin will not be adulterated; will be of known strength; will be supplied with clean needles and advice on safe injection; and will not require Bob to engage in acquisitive crime or prostitution to get it. Again: Heroin is undoubtedly an unwise choice, but keeping it illegal causes very great harm.
cthalupa 11y ago
Diacetylmorphine is probably the best opiate analgesic modern medicine has. British ambulances still carry it as a first-line drug for acute myocardial infarctions. It's an anxiolytic, a wonderful painkiller, and dilates corony arteries. It's not as widely used as it probably should be because of the feat of addiction. Recreational heroin drug use is dangerous because of the illegality - you don't know what you're getting. The varying levels of purity have twofold danger - increasing the risk of overdose due to getting a more pure drug and using the larger dosage you became accustomed to from the less pure stuff, as well as the risk of the substance used to cut the heroin being harmful in itself. Historically, heroin was used by people that WERE holding down jobs[0]. >According to Dr James Mills, a historian who has traced drug use through the 20th century, they tended to be doctors or middle-class patients who could afford to sustain a habit. Additionally, if we were to legalize heroin's use, we could sell naloxone packaged alongside the heroin. Naloxone, if you're not familiar, is an opiate antidote that is extremely effective. This would greatly reduce the chance of an overdose having fatal effect. As I've noted with meth elsewhere in this thread, I'm not suggesting anyone go and pick up a drug habit, but the vast majority of the dangers related to heroin (and most drugs - though obviously stuff like jimson weed is just plain bad for you...) are related to the illegal nature of it, and even those inherent to the drug itself can be mitigated much more easily in a legal setting [0]http://news.bbc.co.uk/2/hi/uk_news/magazine/4647018.stm http://news.bbc.co.uk/2/hi/uk_news/magazine/4647018.stm

Anecdotes are not a valid citation. Heroin is the most harmful drug, statistically, according to numerous studies.

by bcook 11y ago

Anecdotes are not a valid citation. Heroin is the most harmful drug, statistically, according to numerous studies.

ryanlol 11y ago

Not heroin, but a completely unknown substance presented as heroin that probably consists of around 30% heroin.

bcook 11y ago
Heroin addiction is one of the most harmful documented drug-addictions. The need for heroin, physically and psychologically, is the driving force behind the social and personal damage attributed to heroin. People do not get addicted to non-narcotic adulterants and become prostitutes. A cutting agent like caffeine or sugar is probably the safest ingredient...
- blumkvist 11y ago
  Caffeine? Sugar? Lol! How about mice poison? Reading wikipedia and actually knowing stuff about drugs are very different things. Please stop posting, you don't have a clue.
  - bcook 11y ago
    You focused on the least important part of what I wrote then resort to ad hominem attacks. There is no sensible conversation to be had here.
    - blumkvist 11y ago
      I don't want to have a conversation with you. You don't know the first thing about the subject. Why would I want to talk to you about it?
      - corin_ 11y ago
        I don't disagree with you that he's wrong, but arguing without proper arguments then insulting him doesn't really help the conversation. @bcook: Heroin, if it was 100% pure (e.g. as manufactured by a pharmacuticals company), and used with completely safe equipment (e.g. sterylised needles), and used at not-too-high dose levels, it would actually be pretty safe. It essentially has the same effect as morphine or oxycodone, both of which are prescribed legally (my dad has been on morphine for a few years, extended release so he doesn't get high.. but it also doesn't kill him). The biggest danger is indeed purity - if you think that "x" amount is the right dose for your tolerance (and tolerance not only varies based on how much a user has had before, but also on that person's body in the first place) but one batch you buy is y% pure and the next batch is 2y% pure, you can accidentally dose yourself twice as much as you are expecting and overdose. Of course overdose is possible with drugs where you completely know the strength - such as oxycontin pills - but with semi-sensible use it's a lot harder, since you actually know how much of the drug you're taking. Yes it can be addictive, but if you never over do it and can afford to keep buying clean drugs like oxycontin you're most likely going to be fine. The biggest risk with prescription painkillers like this is not that they'll kill you, but that you'll become addicted to them and, when you either can't get another prescription or can't afford your illegal purchases, you move onto heroin because it's much cheaper per dose. Cheaper per dose, but also less pure and therefore more likely to be dangerous. I personally wouldn't try heroin because I don't want to become dependant on something (other than tobacco..), but if it was completely pure then addition would be the only thing that scared me away from it, not fear of death from using it.
        bcook 11y ago
        Cite an article that says the purity of heroin is the most dangerous part of heroin use. Just one reputable article. Put up or shutup. I posted 3 well-established papers above if you want some reading.
        ryanlol 11y ago
        https://scholar.google.com/scholar?hl=en&q=heroin+overdose+purity&btnG=&as_sdt=1%2C5&as_sdtp= https://scholar.google.com/scholar?hl=en&q=heroin+overdose+p... Considering purity fluctuations will actually KILL you rather than just make you want more, yeah I'd say that's by far the most dangerous part of street heroin.
  - ryanlol 11y ago
    The cuts are VERY rarely anything harmful by themselves, that'd be a pretty shitty business move.
    - DanBC 11y ago
      Some supporting references: The adulterants and bulking agents cover a wide range of substances. At the cleaner end you have caffeine (reduces vapour point of heroin), Chloroquine (looks a bit like heroin), and paracetamol. https://www.unodc.org/unodc/en/frontpage/2009/June/afghanistan-identifies-cutting-agents-for-heroin.html https://www.unodc.org/unodc/en/frontpage/2009/June/afghanist... At the dirtier / dangerous end you have lead (possibly a contaminant from "cooking" vessels, causes serious harm when injected) http://www.cph.org.uk/wp-content/uploads/2012/08/cut-a-guide-to-the-adulterants-bulking-agents-and-other-contaminants-found-in-illicit-drugs.pdf http://www.cph.org.uk/wp-content/uploads/2012/08/cut-a-guide... The illegal nature of the drugs means there are risks of bacterial / fungal contamination - anthrax, botulism, etc from the drug, but also from household products used to increase the potency. For example, if a heroin user goes to a clinic they'll be provided with clean vitamin C. If they're at home they may use lemon juice. > In Glasgow 23 heroin users were diagnosed with Candida endophthalmitis (intraocular fungal infection), bio-typing analysis indicated that the lemon juice used to prepare heroin injections was the source of contamination (Shankland & Richardson, 1988). In Spain, contaminated lemon juice was also suspected as the cause of an outbreak of Candida albicans amongst injecting heroin users (Miro et al., 1987). Probably most relevant: > As discussed previously, the evidence detailed above suggests that adulterants are added to heroin typically either to (1) dilute the product with benign substances making it less pure and increasing profits, or (2) to enhance the heroin (i.e. to make it more efficient when smoked) (Huizer, 1987). The evidence does not concur with the mythology of the addition of gravel, brick dust, household cleaning products or poisons by unscrupulous drug dealers.
- throwaway7767 11y ago
  > People do not get addicted to non-narcotic adulterants and become prostitutes. A cutting agent like caffeine or sugar is probably the safest ingredient... The biggest physical danger of heroin use is the risk of overdose. The main reason people overdose is because of the adulterants - they don't know how potent the stuff is. x mg of batch A might be a good high, whereash x mg of batch B will kill you from an overdose. Even if the adulterants are themselves safe, the presence of them is a risk to the users, because they make it impossible to determine dosage.
malka 11y ago
30% how generous. In EU the average purity for heroin is ~2%.
- corin_ 11y ago
  Wikipedia states "The average purity of street heroin in the UK varies between 30% and 50% and heroin that has been seized at the border has purity levels between 40% and 60%" (https://en.wikipedia.org/wiki/Heroin#Adverse_effects https://en.wikipedia.org/wiki/Heroin#Adverse_effects). It doesn't actually have a citation that confirms that, but another quick google gives http://drugscope.org.uk/how-pure-are-street-drugs/ http://drugscope.org.uk/how-pure-are-street-drugs/ saying "The 2010/11 police recorded average purity for heroin was 30 per cent." So I'm inclined to believe the 30% number unless you have a source for thinking it's much lower.
  - malka 11y ago
    I stand corrected, my information was wrong. Thanks for the sources.
- ryanlol 11y ago
  2% is definitely not accurate, consuming that would be a very unpleasant experience.

DanBC 11y ago

Do you have links to those studies? A lot of the harm from heroin come from adulterants which are injected, causing abscess; or from the illegality of providing clean needles and injection advice and safe spaces to inject which causes infection etc; or from the illegality of providing maintenance doses from doctors which cause people to burgle or sex work to get money to buy the drug. Heroin is undoubtedly an unwise choice, but keeping it illegal has been a public health disaster.

bcook 11y ago
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)61462-6/abstract http://www.thelancet.com/journals/lancet/article/PIIS0140-67... http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)61530-5/abstract http://www.thelancet.com/journals/lancet/article/PIIS0140-67... http://bmjopen.bmj.com/content/2/4/e000774.full.html#T1 http://bmjopen.bmj.com/content/2/4/e000774.full.html#T1 There are more, but freely accessing journals online is troublesome. I have NEVER seen any study say heroin is anything but one of the most crippling and dangerous addictions. I am still waiting for anyone to cite one...
- DanBC 11y ago
  Your first one is available here: http://www.sg.unimaas.nl/_old/oudelezingen/dddsd.pdf http://www.sg.unimaas.nl/_old/oudelezingen/dddsd.pdf Have a read. Do you think it still supports your position? It says, clearly, that alcohol is more harmful than heroin. Are you calling for alcohol to be made illegal? Or: Bob is a heroin addict. Should Bob continue to buy heroin from the street? That heroin will be adulterated; of unknown strength; sold by criminals; and may require Bob to engage in acquisitive crime or prostitution to get the money needed. It will be injected with whatever needle Bob has, which may not be sterile and may be shared with other people, some of whom have blood borne diseases. Or should Bob be prescribed heroin by his doctor. That heroin will not be adulterated; will be of known strength; will be supplied with clean needles and advice on safe injection; and will not require Bob to engage in acquisitive crime or prostitution to get it. Again: Heroin is undoubtedly an unwise choice, but keeping it illegal causes very great harm.

cthalupa 11y ago

Diacetylmorphine is probably the best opiate analgesic modern medicine has. British ambulances still carry it as a first-line drug for acute myocardial infarctions. It's an anxiolytic, a wonderful painkiller, and dilates corony arteries. It's not as widely used as it probably should be because of the feat of addiction. Recreational heroin drug use is dangerous because of the illegality - you don't know what you're getting. The varying levels of purity have twofold danger - increasing the risk of overdose due to getting a more pure drug and using the larger dosage you became accustomed to from the less pure stuff, as well as the risk of the substance used to cut the heroin being harmful in itself. Historically, heroin was used by people that WERE holding down jobs[0]. >According to Dr James Mills, a historian who has traced drug use through the 20th century, they tended to be doctors or middle-class patients who could afford to sustain a habit. Additionally, if we were to legalize heroin's use, we could sell naloxone packaged alongside the heroin. Naloxone, if you're not familiar, is an opiate antidote that is extremely effective. This would greatly reduce the chance of an overdose having fatal effect. As I've noted with meth elsewhere in this thread, I'm not suggesting anyone go and pick up a drug habit, but the vast majority of the dangers related to heroin (and most drugs - though obviously stuff like jimson weed is just plain bad for you...) are related to the illegal nature of it, and even those inherent to the drug itself can be mitigated much more easily in a legal setting [0]http://news.bbc.co.uk/2/hi/uk_news/magazine/4647018.stm http://news.bbc.co.uk/2/hi/uk_news/magazine/4647018.stm