13 ms·

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

153 points by kolbe 10y ago

theparanoid 10y ago
A strong confounder is those getting a 10 day prescription are a sicker group.
- abtinf 10y ago
  This seems so obvious a factor that I have a hard time believing mere negligence explains the failure to mention it in the article. I've seen a few hit pieces like this now and it seems to me some powerful lobby must be waging a PR war against opioids.
- ScottBurson 10y ago
  Maybe sometimes. Seven or eight years ago, I had a badly ingrown toenail; my doctor removed the left half of it under local anesthesia, and then wrote me a prescription for 30 Vicodin tablets. (I think 3 or 4 would have been plenty; the pain was gone in 2 or 3 days.) Maybe things have changed enough that he wouldn't do that now.
  - CydeWeys 10y ago
    I've had similar experiences with overly speculative opioid prescriptions, and I have to wonder, do the doctors think they're doing you a favor by being generous??
oaf357 10y ago
The problem with the backlash against opiod use in the US is that people who actually have to have the drugs are finding it increasingly harder to get. As a disabled veteran with nerve damage I am rationing pain medication daily. I cannot afford to have a manageable pain day due to the fact I might have a week of excruciating pain. As you may or may not know, little can be done for functional nerve damage. Some experimental procedures are available but in general, only the symptoms can be treated. For me this means a lot of different muscle relaxers and an opiod for when things are beyond control. But, the opioids have become increasingly more difficult to get prescribed because of recent DEA rule changes and legislation affecting these medications. This basically means, for me at least, I will take my own life at some point as the pain will be too unbearable and I won't be able to acquire the medications necessary to control it.
- markdown 10y ago
  Is Kratom legal in your state? Many people use kratom to manage pain, while others use it to get off opioids.
  - curuinor 10y ago
    Kratom is indeed not an opoid but still is a painkiller. However, unfortunately, it still can be addictive.
    - darpa_escapee 10y ago
      Kratom is 100% an opioid and is addictive in exactly the same way opiates and opioids are.
      - sudojudo 10y ago
        Could the next person please source their comment. Kratom seems a bit controversial.
        darpa_escapee 10y ago
        There is no controversy unless one is fooled by Kratom peddlers' "non-addictive" rhetoric. I don't have the time to beyond Wikipedia, but there are sources cited in the article. A simple Google search would solve the problem here as well. The main active substances in Kratom are Mitragynine and 7-HO-Mitragynine. According to Wikipedia[0]: > Mitragynine is an indole-based opioid and the most abundant active alkaloid in the plant Mitragyna speciosa, commonly known as kratom[1] and biak-biak.[2] Dry kratom leaf contains roughly 1.2–2.1% mitragynine.[3] > Mitragynine itself acts primarily via μ-opioid receptors, though its oxidation product mitragynine pseudoindoxyl, acts as an even more potent and selective μ-opioid agonist but with less affinity for δ or κ receptors.[9][10] Another alkaloid with a major contribution to the μ-opioid activity of the kratom plant is the related compound 7-hydroxymitragynine, which, while present in the plant in much smaller quantities than mitragynine, is a much more potent μ-opioid partial agonist. Mu-opioid receptor agonism is how opioid drugs of abuse work. Kratom contains opioids that bind to mu-opioid receptors in the brain and opioids that bind to mu-opioid receptors in the brain cause opioid addiction. [0] https://en.wikipedia.org/wiki/Mitragynine https://en.wikipedia.org/wiki/Mitragynine
fragsworth 10y ago
If you're given a 10 day supply of opioids, you probably have a much worse problem than someone who is given a 3 day supply of opioids. The 1 in 5 that are still taking opioids a year later probably had a long-term problem that caused significant, chronic pain. Looking at the study, they didn't adjust for this at all. Also, keep in mind: 1 in 5 are continued on prescriptions, which are given by doctors who assessed the situation and thought it was OK to continue it. It's NOT saying that 20% of people who try opiates for 10 days become hopelessly addicted, which the clickbaity headline implies.
- smsm42 10y ago
  Wanted to leave the same comment and found a few here saying the same. It is surprising how such an obvious objection has not been addressed - unless they expected most of the readers to miss it, which is then very sad. The deaths figure - 91 per day or about 33K per year - seems to be the deaths of all opioids (including heroin abuse, etc.) and not the prescription opioids, which are half that: https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates https://www.drugabuse.gov/related-topics/trends-statistics/o... Moreover, prescription deaths are relatively stable for last 6 years (though lower before that) while heroin deaths are raising quickly.
  - sergior 10y ago
    The study obviously has an agenda.
- empath75 10y ago
  I was given at least a 10 day supply of opioids after laproscopic surgery even after I told them I wasn't in a lot of pain and didn't even really want them. I stopped taking them after 4 days and still almost have a full bottle left. They asked me if I had an opioid problem when I told them I didn't want them. Didn't ask me prior to that.
stevecalifornia 10y ago
"The United States makes up only 4.6 percent of the world's population, but consumes 80 percent of its opioids -- and 99 percent of the world's hydrocodone, the opiate that is in Vicodin." [1] I spend a lot of time listening to podcasts where addiction medicine doctors talk about the state of their industry. Their views and their guests views, are almost in complete alignment and those views are the exact opposite of the comments in this thread. I find that alarming. If you listen to addiction medicine doctors, they will tell you: 1) There is a massive epidemic of opioid addiction. Opioids are wildly addictive and are negligently / over prescribed. 2) There is little evidence that opioids provide benefit for long term chronic pain and evidence that long-term use of opioids actually causes many problems. Getting off the opioids tends to reduce the chronic pain. 3) Patient surveys rule supreme and patients want pain-killers even if the doctor does not believe they are the solution. Anecdotally, if you watch the A&E show "Intervention", the number of opioid and heroin cases has shot through the roof since the series started two decades ago. There has been a titanic shift in addiction. It's painful to watch some of these addicts lie to their doctor to get opioids, turn around and sell them, then use the money to get heroin because the opioids aren't strong enough anymore. This comment thread really saddens me. [1] http://abcnews.go.com/US/prescription-painkillers-record-number-americans-pain-medication/story?id=13421828 http://abcnews.go.com/US/prescription-painkillers-record-num...
- throwawayheroin 10y ago
  I'm 23 years old living in a major city in the midwest, grew up a in a middle-small town (120k population) a few hours away. Everyone I grew up with is either selling heroin or taking it, or both. The fact that I'm a software developer (making a living legally) and not taking and/or selling heroin is an anomaly.
  - PKop 10y ago
    I'm seeing similar increases in heroin use in my small midwest hometown. Multiple overdose deaths monthly, as well as arrests. I honestly don't get what most of the other commenters are going on about. The stats are pretty widely reported on the massive increase in opioid abuse. They must live on the coasts or otherwise have avoided what has been plaguing many states in recent years http://www.economist.com/blogs/graphicdetail/2017/03/daily-chart-3 http://www.economist.com/blogs/graphicdetail/2017/03/daily-c... Here's a long but very informative article outlining a few important issues plaguing the US, drug abuse playing a significant part: https://www.commentarymagazine.com/articles/our-miserable-21st-century/ https://www.commentarymagazine.com/articles/our-miserable-21...
tashapenguin 10y ago
I broke my wrist on march 1st, and I've had opioids absolutely dished out for me. Seemingly more easily prescribed in the US than South Africa. I was upped on my second refill to 15mg oxycodone three hourly. Seriously hoping getting off them isn't going to be a struggle :(
- taude 10y ago
  Wow, that seems like a strong dose! I had total hip replacement, I took 5mg Oxy 4x/day for 6 days. I went through a day of agitation and grumpiness when I stopped.
- _acme 10y ago
  If you're taking 45mg of oxycodone an hour, you are definitely going to have discontinuation symptoms when you stop.
lutusp 10y ago
About the linked study, it's important to emphasize that it's retrospective -- it tracks the behavior of people who applied for and received opioid prescriptions. This means the stated results may not apply to a person not inclined to use opioids. A hypothetical prospective study, obviously impractical on multiple grounds -- one that chooses study subjects from the population at random -- might produce a completely different result. Or the outcome might be the same -- for ethical reasons that deserve to exist, we may never know.
troydavis 10y ago
Here's the actual study, rather than a summary of it: https://www.cdc.gov/mmwr/volumes/66/wr/mm6610a1.htm https://www.cdc.gov/mmwr/volumes/66/wr/mm6610a1.htm Here's what it says about adjusting for pain intensity: > Third, information on pain intensity or duration were not available, and the etiology of pain, which might influence the duration of opioid use, was not considered in the analysis.
taude 10y ago
I had a total hip replacement very recently. Having been given a 2 week supply of Oxy, I took very minimal doses and was off of it after six days. I had no idea how addicting this is for people. Personally, I didn't like how it made me feel, so I can only wonder about different people getting different types of "buzz" from it? I think I was irritable for a day after I stopped.
intrasight 10y ago
I see a bright future for cannabinoids - assuming that politicians figure out that it's an obvious escape hatch for this opioid epidemic.
- TallGuyShort 10y ago
  Assuming that politicians care more about the opioid epidemic and the actual well-being of their constituents than they do about their public image with their supporters. You really need everyone to catch on to the relative harm of opiates and cannabis.
- cmrdporcupine 10y ago
  I don't get it. Cannabis has always worsened my pain, not relieved it. I have chronic often severe back pain and cannabis has always emphasized it. I spent 4 hours thinking constantly about the pain until the drug wears off. I may be a minority, but it hardly inspires confidence in cannabis as a silver bullet. Opiates however... they really work. They really make the pain go away. Which is why I stay the hell away from them. :-(
  - cowpewter 10y ago
    I also have chronic pain (fibromyalgia) and have had a similar experience with cannabis. It makes me feel spacey and like I'm dreaming rather than awake. It didn't really reduce my pain at all, only my ability to concentrate on things that aren't pain as a distraction from the pain. Overall it left me in a worse place than before I had taken it. I've never taken opiates for pain, only occasionally for cough (tussin + codeine during a bout of pnuemonia and again when I had bronchitis, and low dose vicodin once for about a week one winter when my asthma was extremely bad and I couldn't sleep because of the coughing).
- deleted 10y ago
  [deleted]
rgejman 10y ago
We will solve the opioid crisis in this country and the solution will almost certainly come through new scientific advances. For instance, a recent study in Nature Medicine[1] showed that you could decouple the positive analgesic (pain relief) effects of opioids from the negative effects of increased tolerance to opioids and increased sensitivity to pain. This is critical because tolerance to the effect of opioids and increased sensitivity of pain to opioids is part of what drives increased use and eventually abuse of opioids. The practical upshot of this study (if validated) is that you could potentially take a smaller amount of opioids and not have to increase your dose over time to get the same level of benefit. This could severely limit the mortality associated with opioids. I am hopeful that we will get through the opioid crisis in this country if we invest money in fixing the underlying physiological problems associated with these drugs. [1]http://www.nature.com/nm/journal/v23/n2/full/nm.4262.html http://www.nature.com/nm/journal/v23/n2/full/nm.4262.html
mrcactu5 10y ago
every few years I get an operation, this year it was 4 wisdom teeth extractions. they gave me 21 oxycodones, I took 18, threw 3 down the trash. (this was on top of maximum strength ibuprophen) for acute pain, discipline.
tmp-20150107 10y ago
Sounds about right. As a heroin addict, I have seen people who are completely clean relapse after maybe three days of taking it daily again, and I have even noticed signs of withdrawal in people who have only taken the drug a couple of times, but on consecutive days. In general, it is the repeated consumption without giving your body time to return to its baseline state (which can take up to three days, depending on the drug and its half-life) that causes the physical addiction - all the scare stories about 'one hit and you're addicted' are just that; stories. For anyone needing opiates as pain medication, I would suggest taking them only in response to acute pain, not as a regular dose, although this may not be possible for chronic sufferers. It's a difficult situation, the best painkillers are horribly addictive and socially stigmatized.
CydeWeys 10y ago
I've been prescribed opioids twice in my life, once for wisdom teeth extraction and again for a broken ankle. In the first case I filled the prescription but ended up flushing the pills down the toilet without taking a single one, as the pain did not override my fear of developing dependency. I never even filled the prescription for the broken ankle, and also didn't need it. These should be treated as treatments of last, not first resort. In both cases, marijuana would have been a more appropriate for pain relief anyway (though I did not use any).
staticelf 10y ago
I got opiods after a surgery, still have 1 left that I am saving for a rainy day :) I wasn't even close to become addicted. But it is a nice painkiller.
- RubenSandwich 10y ago
  You could also take part in National Prescription Drug Take-Back Day: https://www.deadiversion.usdoj.gov/drug_disposal/takeback/ https://www.deadiversion.usdoj.gov/drug_disposal/takeback/. Just a thought. :)
logicallee 10y ago
Doing something illegal (like pot) doesn't automatically make you a criminal. I'm serious. For example, any time two people have sex if they drank first (are drunk) then no matter how much they consent and really, really want to have sex it's "technically rape" (I am serious). That doesn't make them criminals. And rape is serious. You have to look at the ACTUAL enforcement practices where you're located. What do people (police) ACTUALLY do? Also, remember: the reason it is not completely legal might have nothing to do with your consumption of it. For example, would like advertisements for it? Totally legit companies doing things that are "legal" today like shilling on Reddit, trying to get people to use their (legal) drugs? So I would encourage you not to have such a black and white view of what is "criminal." It's a scale. Just as you're not raping a girl if you two have great drunk sex some night and both wanted it, you're not a criminal if you light up a joint.
- sergior 10y ago
  I wish it was that simple. My girlfriend said if it is not prescribed by a doctor I shouldn't be taking it and started calling me an addict. I personally don't recognize these laws, but I know unlucky people that were caught and did time for it. Yes, for having a joint and they have criminal record now.
  - logicallee 10y ago
    Well, I can only try to convince you, not your girlfriend. I can see it bothering her. For her information if you want to share this thread, in my research marijuana is less addictive than soda: if you drink 3 liters of soda every day then suddenly stop and don't get caffeine from somewhere else like coffee, then due to the caffeine withdrawal you would have a headache for a day. (That's it.) it would be uncomfortable. Have her read the comments disagreeing with this article: https://teens.drugabuse.gov/blog/post/marijuana-withdrawal-real https://teens.drugabuse.gov/blog/post/marijuana-withdrawal-r... You will not be "addicted.". (Waaay less than caffeine or tobacco.) You can read people's own reports there, including peoplr in a similar situation as you who lead happy lives. That said, the smoke itself could be uncomfortable, and you don't want to get high, so I am not saying this is a solution or anything. Also the enforcement practices in your area are a different matter, and if people you actually know served jail time, then perhaps the enforcement is not lax enough. In that case I can see what you mean. (Btw pot now figures in TV shows, like Silicon Valley, too. It's "normal".)

153 points by kolbe 10y ago

theparanoid 10y ago

A strong confounder is those getting a 10 day prescription are a sicker group.

abtinf 10y ago
This seems so obvious a factor that I have a hard time believing mere negligence explains the failure to mention it in the article. I've seen a few hit pieces like this now and it seems to me some powerful lobby must be waging a PR war against opioids.
ScottBurson 10y ago
Maybe sometimes. Seven or eight years ago, I had a badly ingrown toenail; my doctor removed the left half of it under local anesthesia, and then wrote me a prescription for 30 Vicodin tablets. (I think 3 or 4 would have been plenty; the pain was gone in 2 or 3 days.) Maybe things have changed enough that he wouldn't do that now.
- CydeWeys 10y ago
  I've had similar experiences with overly speculative opioid prescriptions, and I have to wonder, do the doctors think they're doing you a favor by being generous??

oaf357 10y ago

The problem with the backlash against opiod use in the US is that people who actually have to have the drugs are finding it increasingly harder to get. As a disabled veteran with nerve damage I am rationing pain medication daily. I cannot afford to have a manageable pain day due to the fact I might have a week of excruciating pain. As you may or may not know, little can be done for functional nerve damage. Some experimental procedures are available but in general, only the symptoms can be treated. For me this means a lot of different muscle relaxers and an opiod for when things are beyond control. But, the opioids have become increasingly more difficult to get prescribed because of recent DEA rule changes and legislation affecting these medications. This basically means, for me at least, I will take my own life at some point as the pain will be too unbearable and I won't be able to acquire the medications necessary to control it.

markdown 10y ago
Is Kratom legal in your state? Many people use kratom to manage pain, while others use it to get off opioids.
- curuinor 10y ago
  Kratom is indeed not an opoid but still is a painkiller. However, unfortunately, it still can be addictive.
  - darpa_escapee 10y ago
    Kratom is 100% an opioid and is addictive in exactly the same way opiates and opioids are.
    - sudojudo 10y ago
      Could the next person please source their comment. Kratom seems a bit controversial.
      - darpa_escapee 10y ago
        There is no controversy unless one is fooled by Kratom peddlers' "non-addictive" rhetoric. I don't have the time to beyond Wikipedia, but there are sources cited in the article. A simple Google search would solve the problem here as well. The main active substances in Kratom are Mitragynine and 7-HO-Mitragynine. According to Wikipedia[0]: > Mitragynine is an indole-based opioid and the most abundant active alkaloid in the plant Mitragyna speciosa, commonly known as kratom[1] and biak-biak.[2] Dry kratom leaf contains roughly 1.2–2.1% mitragynine.[3] > Mitragynine itself acts primarily via μ-opioid receptors, though its oxidation product mitragynine pseudoindoxyl, acts as an even more potent and selective μ-opioid agonist but with less affinity for δ or κ receptors.[9][10] Another alkaloid with a major contribution to the μ-opioid activity of the kratom plant is the related compound 7-hydroxymitragynine, which, while present in the plant in much smaller quantities than mitragynine, is a much more potent μ-opioid partial agonist. Mu-opioid receptor agonism is how opioid drugs of abuse work. Kratom contains opioids that bind to mu-opioid receptors in the brain and opioids that bind to mu-opioid receptors in the brain cause opioid addiction. [0] https://en.wikipedia.org/wiki/Mitragynine https://en.wikipedia.org/wiki/Mitragynine

fragsworth 10y ago

If you're given a 10 day supply of opioids, you probably have a much worse problem than someone who is given a 3 day supply of opioids. The 1 in 5 that are still taking opioids a year later probably had a long-term problem that caused significant, chronic pain. Looking at the study, they didn't adjust for this at all. Also, keep in mind: 1 in 5 are continued on prescriptions, which are given by doctors who assessed the situation and thought it was OK to continue it. It's NOT saying that 20% of people who try opiates for 10 days become hopelessly addicted, which the clickbaity headline implies.

smsm42 10y ago
Wanted to leave the same comment and found a few here saying the same. It is surprising how such an obvious objection has not been addressed - unless they expected most of the readers to miss it, which is then very sad. The deaths figure - 91 per day or about 33K per year - seems to be the deaths of all opioids (including heroin abuse, etc.) and not the prescription opioids, which are half that: https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates https://www.drugabuse.gov/related-topics/trends-statistics/o... Moreover, prescription deaths are relatively stable for last 6 years (though lower before that) while heroin deaths are raising quickly.
- sergior 10y ago
  The study obviously has an agenda.
empath75 10y ago
I was given at least a 10 day supply of opioids after laproscopic surgery even after I told them I wasn't in a lot of pain and didn't even really want them. I stopped taking them after 4 days and still almost have a full bottle left. They asked me if I had an opioid problem when I told them I didn't want them. Didn't ask me prior to that.

stevecalifornia 10y ago

"The United States makes up only 4.6 percent of the world's population, but consumes 80 percent of its opioids -- and 99 percent of the world's hydrocodone, the opiate that is in Vicodin." [1] I spend a lot of time listening to podcasts where addiction medicine doctors talk about the state of their industry. Their views and their guests views, are almost in complete alignment and those views are the exact opposite of the comments in this thread. I find that alarming. If you listen to addiction medicine doctors, they will tell you: 1) There is a massive epidemic of opioid addiction. Opioids are wildly addictive and are negligently / over prescribed. 2) There is little evidence that opioids provide benefit for long term chronic pain and evidence that long-term use of opioids actually causes many problems. Getting off the opioids tends to reduce the chronic pain. 3) Patient surveys rule supreme and patients want pain-killers even if the doctor does not believe they are the solution. Anecdotally, if you watch the A&E show "Intervention", the number of opioid and heroin cases has shot through the roof since the series started two decades ago. There has been a titanic shift in addiction. It's painful to watch some of these addicts lie to their doctor to get opioids, turn around and sell them, then use the money to get heroin because the opioids aren't strong enough anymore. This comment thread really saddens me. [1] http://abcnews.go.com/US/prescription-painkillers-record-number-americans-pain-medication/story?id=13421828 http://abcnews.go.com/US/prescription-painkillers-record-num...

throwawayheroin 10y ago
I'm 23 years old living in a major city in the midwest, grew up a in a middle-small town (120k population) a few hours away. Everyone I grew up with is either selling heroin or taking it, or both. The fact that I'm a software developer (making a living legally) and not taking and/or selling heroin is an anomaly.
- PKop 10y ago
  I'm seeing similar increases in heroin use in my small midwest hometown. Multiple overdose deaths monthly, as well as arrests. I honestly don't get what most of the other commenters are going on about. The stats are pretty widely reported on the massive increase in opioid abuse. They must live on the coasts or otherwise have avoided what has been plaguing many states in recent years http://www.economist.com/blogs/graphicdetail/2017/03/daily-chart-3 http://www.economist.com/blogs/graphicdetail/2017/03/daily-c... Here's a long but very informative article outlining a few important issues plaguing the US, drug abuse playing a significant part: https://www.commentarymagazine.com/articles/our-miserable-21st-century/ https://www.commentarymagazine.com/articles/our-miserable-21...

tashapenguin 10y ago

I broke my wrist on march 1st, and I've had opioids absolutely dished out for me. Seemingly more easily prescribed in the US than South Africa. I was upped on my second refill to 15mg oxycodone three hourly. Seriously hoping getting off them isn't going to be a struggle :(

taude 10y ago
Wow, that seems like a strong dose! I had total hip replacement, I took 5mg Oxy 4x/day for 6 days. I went through a day of agitation and grumpiness when I stopped.
_acme 10y ago
If you're taking 45mg of oxycodone an hour, you are definitely going to have discontinuation symptoms when you stop.

lutusp 10y ago

About the linked study, it's important to emphasize that it's retrospective -- it tracks the behavior of people who applied for and received opioid prescriptions. This means the stated results may not apply to a person not inclined to use opioids. A hypothetical prospective study, obviously impractical on multiple grounds -- one that chooses study subjects from the population at random -- might produce a completely different result. Or the outcome might be the same -- for ethical reasons that deserve to exist, we may never know.

troydavis 10y ago

Here's the actual study, rather than a summary of it: https://www.cdc.gov/mmwr/volumes/66/wr/mm6610a1.htm https://www.cdc.gov/mmwr/volumes/66/wr/mm6610a1.htm Here's what it says about adjusting for pain intensity: > Third, information on pain intensity or duration were not available, and the etiology of pain, which might influence the duration of opioid use, was not considered in the analysis.

taude 10y ago

I had a total hip replacement very recently. Having been given a 2 week supply of Oxy, I took very minimal doses and was off of it after six days. I had no idea how addicting this is for people. Personally, I didn't like how it made me feel, so I can only wonder about different people getting different types of "buzz" from it? I think I was irritable for a day after I stopped.

intrasight 10y ago

I see a bright future for cannabinoids - assuming that politicians figure out that it's an obvious escape hatch for this opioid epidemic.

TallGuyShort 10y ago
Assuming that politicians care more about the opioid epidemic and the actual well-being of their constituents than they do about their public image with their supporters. You really need everyone to catch on to the relative harm of opiates and cannabis.
cmrdporcupine 10y ago
I don't get it. Cannabis has always worsened my pain, not relieved it. I have chronic often severe back pain and cannabis has always emphasized it. I spent 4 hours thinking constantly about the pain until the drug wears off. I may be a minority, but it hardly inspires confidence in cannabis as a silver bullet. Opiates however... they really work. They really make the pain go away. Which is why I stay the hell away from them. :-(
- cowpewter 10y ago
  I also have chronic pain (fibromyalgia) and have had a similar experience with cannabis. It makes me feel spacey and like I'm dreaming rather than awake. It didn't really reduce my pain at all, only my ability to concentrate on things that aren't pain as a distraction from the pain. Overall it left me in a worse place than before I had taken it. I've never taken opiates for pain, only occasionally for cough (tussin + codeine during a bout of pnuemonia and again when I had bronchitis, and low dose vicodin once for about a week one winter when my asthma was extremely bad and I couldn't sleep because of the coughing).
deleted 10y ago
[deleted]

rgejman 10y ago

We will solve the opioid crisis in this country and the solution will almost certainly come through new scientific advances. For instance, a recent study in Nature Medicine[1] showed that you could decouple the positive analgesic (pain relief) effects of opioids from the negative effects of increased tolerance to opioids and increased sensitivity to pain. This is critical because tolerance to the effect of opioids and increased sensitivity of pain to opioids is part of what drives increased use and eventually abuse of opioids. The practical upshot of this study (if validated) is that you could potentially take a smaller amount of opioids and not have to increase your dose over time to get the same level of benefit. This could severely limit the mortality associated with opioids. I am hopeful that we will get through the opioid crisis in this country if we invest money in fixing the underlying physiological problems associated with these drugs. [1]http://www.nature.com/nm/journal/v23/n2/full/nm.4262.html http://www.nature.com/nm/journal/v23/n2/full/nm.4262.html

mrcactu5 10y ago

every few years I get an operation, this year it was 4 wisdom teeth extractions. they gave me 21 oxycodones, I took 18, threw 3 down the trash. (this was on top of maximum strength ibuprophen) for acute pain, discipline.

tmp-20150107 10y ago

Sounds about right. As a heroin addict, I have seen people who are completely clean relapse after maybe three days of taking it daily again, and I have even noticed signs of withdrawal in people who have only taken the drug a couple of times, but on consecutive days. In general, it is the repeated consumption without giving your body time to return to its baseline state (which can take up to three days, depending on the drug and its half-life) that causes the physical addiction - all the scare stories about 'one hit and you're addicted' are just that; stories. For anyone needing opiates as pain medication, I would suggest taking them only in response to acute pain, not as a regular dose, although this may not be possible for chronic sufferers. It's a difficult situation, the best painkillers are horribly addictive and socially stigmatized.

CydeWeys 10y ago

I've been prescribed opioids twice in my life, once for wisdom teeth extraction and again for a broken ankle. In the first case I filled the prescription but ended up flushing the pills down the toilet without taking a single one, as the pain did not override my fear of developing dependency. I never even filled the prescription for the broken ankle, and also didn't need it. These should be treated as treatments of last, not first resort. In both cases, marijuana would have been a more appropriate for pain relief anyway (though I did not use any).

staticelf 10y ago

I got opiods after a surgery, still have 1 left that I am saving for a rainy day :) I wasn't even close to become addicted. But it is a nice painkiller.

RubenSandwich 10y ago
You could also take part in National Prescription Drug Take-Back Day: https://www.deadiversion.usdoj.gov/drug_disposal/takeback/ https://www.deadiversion.usdoj.gov/drug_disposal/takeback/. Just a thought. :)

logicallee 10y ago

Doing something illegal (like pot) doesn't automatically make you a criminal. I'm serious. For example, any time two people have sex if they drank first (are drunk) then no matter how much they consent and really, really want to have sex it's "technically rape" (I am serious). That doesn't make them criminals. And rape is serious. You have to look at the ACTUAL enforcement practices where you're located. What do people (police) ACTUALLY do? Also, remember: the reason it is not completely legal might have nothing to do with your consumption of it. For example, would like advertisements for it? Totally legit companies doing things that are "legal" today like shilling on Reddit, trying to get people to use their (legal) drugs? So I would encourage you not to have such a black and white view of what is "criminal." It's a scale. Just as you're not raping a girl if you two have great drunk sex some night and both wanted it, you're not a criminal if you light up a joint.

sergior 10y ago
I wish it was that simple. My girlfriend said if it is not prescribed by a doctor I shouldn't be taking it and started calling me an addict. I personally don't recognize these laws, but I know unlucky people that were caught and did time for it. Yes, for having a joint and they have criminal record now.
- logicallee 10y ago
  Well, I can only try to convince you, not your girlfriend. I can see it bothering her. For her information if you want to share this thread, in my research marijuana is less addictive than soda: if you drink 3 liters of soda every day then suddenly stop and don't get caffeine from somewhere else like coffee, then due to the caffeine withdrawal you would have a headache for a day. (That's it.) it would be uncomfortable. Have her read the comments disagreeing with this article: https://teens.drugabuse.gov/blog/post/marijuana-withdrawal-real https://teens.drugabuse.gov/blog/post/marijuana-withdrawal-r... You will not be "addicted.". (Waaay less than caffeine or tobacco.) You can read people's own reports there, including peoplr in a similar situation as you who lead happy lives. That said, the smoke itself could be uncomfortable, and you don't want to get high, so I am not saying this is a solution or anything. Also the enforcement practices in your area are a different matter, and if people you actually know served jail time, then perhaps the enforcement is not lax enough. In that case I can see what you mean. (Btw pot now figures in TV shows, like Silicon Valley, too. It's "normal".)